bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ergebnisse einer Befragung orthopädischer
Rehabilitationseinrichtungen zur Umsetzung der Medizinisch-beruflich
orientierten Rehabilitation: Bedarfsidentifizierung und Analyse der
Arbeitsanforderungen
Authors: Bühne David , Alles Torsten , Mathis Elling Jan , Hetzel Christian 
Published: October 2024

Zusammenfassung
Ziel der Studie Untersuchungen im Kontext der Medizinisch-beruflich
orientierten Rehabilitation (MBOR) deuten darauf hin, dass die Umsetzung der
MBOR durch eine ausgeprägte Heterogenität gekennzeichnet ist und zudem keine
flächendeckende Erfüllung der durch die Rentenversicherungsträger definierten
Rahmenvorgaben erfolgt. Vor diesem Hintergrund zielte die vorliegende
Untersuchung darauf ab, die Umsetzung des MBOR-Anforderungsprofils in der
Orthopädie in Bezug auf die Identifikation besonderer beruflicher Problemlagen
(BBPL) sowie die Anamnese der Arbeitsanforderungen zu erheben.
Methodik 2023 erfolgte eine als Vollerhebung angelegte schriftliche
Befragung von Rehabilitationseinrichtungen mit Zulassung für die orthopädische
MBOR. Zum Einsatz kam ein in Anlehnung an das MBOR-Anforderungsprofil
entwickeltes Instrument. 86 der 317 angeschriebenen Einrichtungen beantworteten
den Fragebogen und erfüllten zugleich die Einschlusskriterien (Durchführung von
MBOR-Heilverfahren).
Ergebnisse Während die Einrichtungen überwiegend berichteten, dass nahezu
alle Personen mit BBPL eine MBOR erhalten, lag der einrichtungsinterne
MBOR-Anteil überwiegend bei weniger als zehn Prozent. In Bezug auf die
Anforderungsanamnese wurde in den Untersuchungsergebnissen vor allem der Wunsch
deutlich, die Objektivität und Validität der Informationen durch einen stärkeren
Einbezug der Arbeitgeber bzw. Werks-/Betriebsärzte im Vorfeld der Reha zu
steigern.
Schlussfolgerung Den Angaben der Befragten folgend, wird die Umsetzung der
MBOR in Bezug auf die Verfahren zur Identifikation von Personen mit BBPL sowie
die Anamnese der Arbeitsanforderungen vielfach dem Anforderungsprofil
entsprechend realisiert. Zentrale Herausforderungen liegen in der Deckung des
MBOR-Bedarfs sowie der stärkeren Einbindung von Arbeitgebern.
Versorgung von Patient*innen der Außerklinischen Intensivpflege in
ärztlich geleiteten Einrichtungen – eine Querschnitterhebung der Deutschen
Interdisziplinären Gesellschaft für Außerklinische Beatmung
Authors: Hornemann Donatha , Schucher Bernd , Bayarassou Hakim , Jaschke Christoph , Fabritius Georg , Platz Thomas , Schmidt-Wilcke Tobias , Pohl Marcus , Groß Martin 
Published: October 2024

Zusammenfassung
Hintergrund Patient*innen der Außerklinischen Intensivpflege (AKI) sind
meist mit einer Trachealkanüle versorgt und häufig invasiv beatmet. Seltener
sind sie nichtinvasiv beatmet. Ab 01. Januar 2025 muss bei ihnen halbjährlich
das Beatmungsentwöhnungs- und Dekanülierungspotential erhoben werden. Liegt
Potential vor, soll die Einweisung in eine spezialisierte Einrichtung
erfolgen.
Ziel: Ärztlich geleitete Einrichtungen, die das Dekanülierungs- und
Beatmungsentwöhnungspotential erheben und dessen Umsetzung gewährleisten können,
sollten charakterisiert werden.
Methode Unter Schirmherrschaft der Deutschen Interdisziplinären
Gesellschaft für Außerklinische Beatmung (DIGAB) e.V. und mit Unterstützung der
Arbeitsgemeinschaft Neurologisch-neurochirurgische Frührehabilitation fand eine
Online-Querschnitterhebung statt.
Ergebnisse Zertifizierungen nach DGAI, DGP, DGNR oder DGMP besaßen n=11
(61,1%) von 18 teilnehmenden Einrichtungen. Am häufigsten war der leitende Arzt
Facharzt für Neurologie, gefolgt von Innere Medizin und Pneumologie,
Anästhesiologie und Pädiatrie. Viele Berufsgruppen und Qualifikationen sowie
diagnostischen und therapeutischen Methoden wurden vorgehalten. Insgesamt sahen
n=10 (55,6%) regional keine ausreichenden Möglichkeiten zur stationären Aufnahme
von Patient*innen der AKI zur Beatmungsentwöhnung oder Dekanülierung. Ca. ein
Drittel der Einrichtungen bot Televisiten an.
Diskussion Patient*innen der AKI benötigen aufgrund medizinischer
Komplexität und eingeschränkter Teilhabe eine interdisziplinäre, intersektoral
organisierte Versorgung. Zwar wurden Interdisziplinarität und eine Vielzahl
diagnostischer und therapeutischer Methoden von den teilnehmenden Einrichtungen
vorgehalten, jedoch waren ihre Strukturmerkmale uneinheitlich.
Schlussfolgerung Für Zentren, die ein Dekanülierungs- und
Beatmungsentwöhnungspotential erheben sowie bei Feststellung umsetzen, sollten
Qualitätskriterien etabliert werden. Es besteht Forschungsbedarf bezüglich 1.
der Präzisierung dieser Kriterien, 2. der Kapazitäten der Einrichtungen, die die
Beatmungs- und Trachealkanülenentwöhnung durchführen, 3. der ambulanten
Beatmungs- und Trachealkanülenentwöhnung und 4. der telemedizinischen Strukturen
für Patient*innen der AKI.
Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis
Authors: Mohamed Tahagod , Alexander Robin , Davidson Brielle , Klamer Brett , Gehred Alison , Starr Michelle C. , Slagle Cara , Krawczeski Catherine , Harer Matthew W. 
Published: October 2024

Objective Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive AKI biomarker. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized. The objective of this study was to evaluate the current literature to determine normal uNGAL values for preterm neonates without AKI.
Study Design Systematic review and meta-analysis of all articles published before November 2021 evaluating uNGAL values in preterm neonates without AKI.
Results Of 1,607 studies evaluated for eligibility, 11 were included in the final meta-analysis (210 males, 202 females). uNGAL values were higher in the preterm neonates <29 weeks and ranged between 20.7 and 782.65 ng/mL. Meta mean estimates of gestational age (GA), birthweight, and neutrophil gelatinase-associated lipocalin were 29.4 weeks (95% confidence interval [CI]: 28.8–30.0), 1,241 g (95% CI: 1,111–1,372), and 148.9 ng/mL (95% CI: 48–231), respectively.
Conclusion In limited studies, a wide range of uNGAL values in preterm neonates without AKI are reported. Future studies should identify normal uNGAL values in preterm neonates using larger cohorts by GA and birthweight.
Key Points
Transtuberositäre, ventral öffnende hohe Tibiaosteotomie zur Korrektur eines negativen Slope
Authors: Harrer Jörg , Ferner Felix , Lutter Christoph , Petersen Wolf , Perl Mario , Simon Michael 
Published: October 2024

ZusammenfassungEin knöchernes Genu recurvatum tritt klinisch durch eine Überstreckbarkeit des Kniegelenks in Erscheinung. Neben den Problemen durch die Hyperextension kann es hierdurch langfristig außerdem zu einer Insuffizienz des hinteren Kreuzbandes (HKB) kommen. Kausale Therapie dieser Tibiakopfextensionsdeformität stellt eine Slope-erhöhende Tibiakopfosteotomie dar. Hierbei gibt es bisher nur wenige Publikationen zu klinischen Ergebnissen, insbesondere zur reinen Slope-Korrektur ohne Veränderung der Frontalachse. Im Folgenden wird die Technik der transtuberositären ventral öffnenden Tibiakopf-Flexions-Osteotomie (Transtuberositary Anterior Opening Wedge High Tibial Osteotomy, TT-AOW HTO) zur Erhöhung des tibialen Slope gezeigt (mit Ablösen und „Bioplating“ der Tuberositas tibiae). Nach vorgeschalteter Arthroskopie erfolgt nach der Osteotomie von ventral die Interposition eines autologen Beckenkammspans und die Osteosynthese mit 2 winkelstabilen Platten von medial und anteromedial.
Chronotype, sleep hygiene, and sleep characteristics among athletes
of different disciplines
Authors: Borghi Stefano , Bizzozero Sara , Vitale Jacopo A. , Tallini Elisa , Corazza Francesco , La Torre Antonio , Banfi Giuseppe , Codella Roberto 
Published: October 2024

AbstractThe objective of the study was to assess chronotype, sleep hygiene, and sleep
characteristics of Italian athletes in order to identify differences among sport
disciplines (team- vs individual-sports), level of competition (Elite vs
Non-Elite) and sexes. Moreover, correlations between chronotype, sleep hygiene
and sleep quality were evaluated. Two hundred eighty Italian athletes
(Females:113; Males:167) participated in the study. They completed the
Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Index (SHI) and the
MorningnessEveningness Questionnaire (MEQ). Among the athletes, 66.4% were
intermediate-type, 21.8% were morning-type and 11.8% were evening-type. 55.4% of
the sample was classified as good sleeper (PSQI<5), while 16.1% had poor
sleep hygiene (SHI≥35). Females had higher total sleep time (p=0.022) than
males. Individual-sports showed more morning-oriented score (p=0.001) and lower
PSQI (p=0.006) and SHI (p<0.001) scores, with earlier timing of sleep
(bedtime:p<0.001; wake-up time:p<0.001) compared to teamsports. Elite
athletes exhibited greater sleep efficiency (p=0.009), and lower sleep latency
(p=0.018) and wake after sleep onset (p=0.043) than Non-Elite athletes.
Additionally, significant correlations were found between PSQI and SHI (r=0.43,
p<0.001), and between MEQ and SHI (r=−0.35, p<0.001). This study yields
crucial insights into the sleep behaviors of Italian athletes, revealing that
nearly half of the sample were bad sleepers.
Age- and sex-related variations of normal spleen T1rho and the more stable liver T1rho to spleen T1rho ratio
Authors: Wáng Yì Xiáng J. , Yu Wei-Ling , Deng Min 
Published: October 2024

AbstractWe aim to evaluate the potential age- and sex-related variations of normative values of spleen T1rho.Two T1rho sequences were used, with one based on fast spin echo sequence (FSE) and the other based on gradient echo sequence (GRE). Spleen and liver FSE T1rho values were measured in 52 healthy volunteers (36 females, 16 males), and spleen and liver GRE T1rho values were measured in 14 healthy volunteers (6 females, 8 males).For FSE data, an age-related decreasing trend of spleen T1rho was noted for both females and males. This trend was consistent with female liver T1rho values, while such a trend was not noted for male liver T1rho. Females had a higher T1rho than males, both for the spleen (92.8 vs 77.3 ms, p<0.0001) and for the liver (44.2 vs. 38.9 ms, p<0.0001, FSE data). The spleen T1rho value was approximately double the liver T1rho value. The spleen T1rho and liver T1rho were positively correlated, both for FSE data (r=0.611) and GRE data (r=0.541). When the spleen T1rho was used to normalize the liver T1rho, the ratio of T1rholiver/T1rhospleen largely removed the sex and age effect. The spleen T1rho in menstrual phase women was 10.7% lower (p=0.012) than that of non-menstrual phase women, while the liver T1rho in menstrual phase women was 3.8% lower than that of non-menstrual phase women.Since women in the menstrual phase tend to have lower body iron, the fact that both liver T1rho and spleen T1rho are shorter among women in the menstrual phase than women in the non-menstrual phase indicates that liver and spleen T1rho physiological variations may not be dominantly affected by the iron content of the tissue. If a pathology has only affected the liver while the spleen is normal, there is a possibility the ratio T1rholiver/T1rhospleen may offer better characterization of liver pathologies.
Postoperative Protocols for Lower Extremity Free Flap Reconstructions: Literature Review and a National Survey of the United Kingdom's Major Trauma Centers
Authors: Glynou Sevasti Panagiota , Georgiannakis Ariadni , Ackling Edward , Bystrzonowski Nicola , Pafitanis Georgios , Diver Andrew 
Published: October 2024

Abstract
Background Evidence for postoperative care of lower extremity free flap reconstruction (LEFF) varies and is yet to be standardized, despite established guidelines by the British Orthopedic Association Standard for Trauma (BOAST-4). This study assesses postoperative protocols for LEFF clinical monitoring, warming, dangling, and compression in the United Kingdom's (UK) major trauma centers (MTCs).
Methods An online questionnaire was distributed to consultant leads of all UK adult MTCs. Data requested the existence of a standardized protocol, intensity, and takeback of LEFF procedures and specific practices in clinical monitoring, warming, dangling, and compression. Analysis was performed in Excel.
Results The survey was returned by 23 (79.3%) units and most (86.9%) had standardized LEFF monitoring protocols. Centers typically performed four to eight surgeries monthly and on average had 2.7 salvageable LEFFs in 2022. Clinical monitoring was common (>92%) and included color, capillary refill, and temperature assessment. Compression initiation varied between 45.5% (starting after day 7) and 40.9% (from days 3 to 5). Continuous compression was favored (78.3%), using pillows (88.9%). Dangling protocols begin between days 3 and 7, for 5 minutes (52.2%) with frequencies of three to four times daily (25–37.5%). The preferred tool for LEFF warming was the Bair hugger (82.6%) and the mean termination day for warming was 3.61.
Conclusion The survey highlights the need for evidence-based and consensus in UK MTC protocols for LEFFs. We encourage ongoing research and collaborative efforts in creating an accepted protocol among MTCs that could be incorporated into the BOAST-4 guidelines for postoperative care standardization and improved patient outcomes.
Silyl Ethers as Latent Pronucleophiles in Enantioselective Lewis Base Catalyzed Synthesis of Allylic Ethers from Allylic Fluorides
Authors: Lange Markus , Barakat Abdulrahman , Vilotijevic Ivan 
Published: October 2024

AbstractAllylic ethers are a common occurrence in natural products, and are often used as intermediates in target-oriented synthesis. Their synthesis often relies on the use of transition-metal catalysts. Here, we report an organocatalytic method for the allylation of O-centered nucleophiles, the Lewis base catalyzed allylation of silyl ethers with allylic fluorides. The method relies on the concept of latent pronucleophiles in Lewis base catalysis to overcome common limitations in substrate scope, even permitting the allylation of sterically congested O-pronucleophiles. When chiral Lewis base catalysts are used, the allyl ethers are produced in an enantioenriched form through kinetic resolution of fluorides, where the stereoselectivity is determined by the chiral catalyst.
Efficient Synthesis of Benzospirocyclohexadienones via PIFA-Promoted Intramolecular Dearomative Spiroannulation
Authors: Wang Mingan , An Xinkun , Zhang Tingting , Ma Haoyun , He Xie 
Published: October 2024

AbstractA rapid and convenient method for the synthesis of differently substituted spiro[cyclohexane-1,1′-isochromane]-2,5-dien-4-one derivatives via phenyliodine(III) bis(trifluoroacetate) (PIFA)-promoted intramolecular oxidative dearomatization at the para position is disclosed, with the aim of building a library of new spirocyclohexadienone scaffolds. Subsequently, this strategy is modified to access novel cyclohexanedienone-containing polycyclic compounds.
Nonpharmacological Prevention and Management of Delirium: Past, Present, and Future
Authors: Ryan Sophia L. 
Published: October 2024

AbstractDelirium has been recognized, documented, and examined for centuries. In 500 BC Hippocrates described hyper- and hypoactive forms of delirium. As medicine, surgery, and critical care have accelerated over the last century, so too has our understanding of delirium and its profound risks to patients, families, and health care teams. It has also been increasingly understood that it is the accumulation of risk factors that ultimately precipitates delirium and nonpharmacological interventions to reduce these risks remain the cornerstone of delirium prevention and management. However, over the last three decades, these nonpharmacological strategies have moved from a single-component approach to a multicomponent approach, targeting multiple risk factors. Additionally, our understanding of what constitutes a risk factor for delirium has evolved, and in particular, it has been recognized that delirium can sometimes be a byproduct of our interventions and health care systems. In the surgical setting, for example, optimization of risk factors prior to surgery, when possible, is now seen as a key way to prevent postoperative delirium. Similarly, critical care medicine now operates with the appreciation of the profound risk to patients of prolonged mechanical ventilation, sedation, and immobilization and seeks to minimize each to reduce the risk of delirium, among other negative effects. The future of delirium prevention and management lies in both better implementation of best practices that have been defined over the last three decades as well as taking more of a whole patient view. This includes harnessing the electronic medical record, artificial intelligence, and so on to risk assess and individualize care for each patient; restructuring care to reduce deliriogenic practices and care environments; redefining what usual care looks like (e.g., utilizing music and involving loved ones, etc.); policy changes to change systematic priorities. In this paper, we will explore the past, present, and future of nonpharmacological prevention and management of delirium across care settings.
A Prospective Study of CSF Flow Dynamics Across Foramen Magnum in Adult Chiari Malformation/Syringomyelia Complex and its Clinical Correlation with Outcomes after Surgery
Authors: Prakash Manas , Shrivastava Adesh , Chouksey Pradeep , Raj Sumit , Mishra Rakesh , Agrawal Amit , Nair Suresh 
Published: October 2024

Abstract
Introduction Chiari I malformation refers to cerebellar tonsillar descent below the foramen magnum and is frequently associated with syringomyelia. Prior cerebrospinal fluid (CSF) flow studies correlated the clinical severity of these lesions with general flow velocity or bulk flow at the foramen magnum; however, these techniques have not assessed the effect on surgical outcomes. The study aims to present clinical and radiological factors and CSF flow parameters (pre- and postoperative) that affect the surgical outcome.
Materials and Methods The institutional ethics committee approved the study. We collected the prospective clinical data, including pre- and postoperative symptoms. Functional grades were determined along with the change in clinical improvement based on clinical examination notes, the change in functional grade was calculated, and the radiologic data were analyzed according to the degree of clinical improvement. The surgical procedure included suboccipital bony decompression with duroplasty. Patients were followed up at 1 month, 3 months, and 1 year.
Results There were a total of 25 patients. The mean age of the patients was 45.52 ± 13.37 years, with 40% being males and 60% being females. After the surgery, there was a significant increase in the anterior and posterior CSF flows at the foramen magnum. Most had a resolution in the headache and sensory symptoms, while the lower cranial nerve and motor symptoms had a minor resolution at follow-up. Age, sex, and headache do not correlate with the outcome or syrinx improvement. Motor power in the lower limb (preintervention) and syrinx shape (preintervention) were significantly associated with the variable “anterior flow at the foramen magnum” (preintervention; p < 0.05). Average flow, cervicomedullary angle (postintervention), sensory symptom progression, and CSF flow change anterior to the foramen magnum were significantly associated with the variable “anterior flow at the foramen magnum” (postintervention; p < 0.05).
Conclusion Even after surgery, persistent foramen magnum CSF outflow obstruction has a robust negative correlation with the outcome. The Chiari outcome predictability index has shown a significant correlation with patient outcomes and can be used to inform patients about the expected outcome. The results of the present study will be helpful in stratifying patients according to their desired outcomes.
Bürokratie gefährdet Versorgung
Authors: Pintarelli-Rauschenbach Manuela 
Published: October 2024

ZusammenfassungDie jüngste VPT-Umfrage (► Seite 6) zeigt deutlich: Die Verwaltungsarbeit und der Fachkräftemangel
gefährden die Versorgung unserer Patientinnen und Patienten. Praxen müssen aufwendig fehlerhaft
ausgestellte Rezepte korrigieren: Rund 40 Prozent der Befragten gaben an, dass 10 bis 20 Prozent der
Verordnungen einer Nachbearbeitung bedürfen. Das erschwert den Arbeitsalltag massiv! Diese Zeit
könnten wir viel sinnvoller für die Patientenversorgung nutzen.
Long-Term Orthopaedic and Radiological Outcomes of Symphysis Approximation without Osteotomy in Primary Bladder Exstrophy Repair
Authors: Promm Martin , Hofbauer Raphael , Brandl Roland , Gossler Christopher , Brandstetter Susanne , Kertai Michael , Hofmann Aybike , Schnabel Marco J. , Rösch Wolfgang H. 
Published: October 2024

Abstract
Introduction Previous assumptions suggested that the technique of approximation without osteotomy in primary exstrophy repair (PER) could only be applied in newborns and anticipated poorer outcomes. Recent studies indicated that this technique can be successfully executed not only in immediate PER but also yields favorable long-term results. Therefore, we evaluated and compared the orthopaedic and radiological long-term outcomes after pubic symphysis approximation without osteotomy in immediate and delayed PER.
Methods From March 2018 to December 2020, individuals with PER and approximation of the symphysis without osteotomy were recruited. Patients <12 years and with a history of orthopaedic surgery of the bony pelvis were excluded. Orthopaedic examinations and magnetic resonance imaging (MRI) of the bony pelvis including the hip joints were performed and pubic diastasis, the acetabulum angle (ACA), and the center-edge angle (CEA) were evaluated.
Results Twenty-nine patients were included, 11 of them had an immediate and 18 had a delayed PER. Between the two groups, no significant differences could be observed concerning hip pain (p = 0.419), mobility impairment (p = 0.543), sports impairment (p = 0.543), hip impingement (p = 1.000), leg length discrepancy (p = 0.505), and width of the pubic diastasis as measured by MRI (p = 0.401). There were also no significant differences with regard to CEA right (median 30 degrees, p = 0.976), CEA left (median 31.5 degrees, p = 0.420), ACA right (median 19 degrees, p = 0.382), and ACA left (median 17 degrees, p = 0.880).
Conclusion There were no significant differences in clinical orthopaedic or radiological long-term outcomes between bladder exstrophy patients after immediate and delayed bladder closure with symphysis approximation without osteotomy. Establishing core outcome sets is essential to get robust and comparable results, further advancing and substantiating our initial insights.