bluuebunny/crossref_metadata_2025_split huggingface dataset:
Häufigkeit und Barrieren bei Patientenverfügung und Vorsorgevollmacht: Erkenntnisse aus einer prospektiven Observationsstudie im palliativmedizinischen Dienst
Authors: Breen Benedict Mathias , Flohr Claudia , Wendt Heike , Chalk Katharina , Haase Ulrike , Hartog Christiane , Tafelski Sascha 
Published: May 2024

ZusammenfassungHintergrund und FragestellungVorsorgevollmacht und Patientenverfügung sind Instrumente zur Stärkung der Patientenautonomie. Palliativmedizinische Dienste bieten entsprechende Beratung für Patient:innen und Angehörige an. Gegenstand der vorliegenden Studie ist es, den Beratungsbedarf von lebensbedrohlich erkrankten Patient:innen zu erfassen.Studiendesign und UntersuchungsmethodeDiese prospektive Beobachtungsstudie erfasste stationäre Patient:innen mit einer palliativmedizinischen Mitbehandlung. Es wurden patientenbezogene Faktoren ermittelt, die mit dem Vorliegen von Vorsorgevollmacht oder Patientenverfügung assoziiert waren. Zusätzlich erfolgten Fokusgruppeninterviews mit Mitgliedern des Konsildiensts zur Ermittlung von Barrieren zur Erstellung von Vorsorgeverfügungen.ErgebnisseInsgesamt wurden 294 Patient:innen eines palliativmedizinischen Diensts mit einem medianen Alter von 67 Jahren eingeschlossen, davon 69 (23 %) intensivmedizinisch behandelte Patient:innen. Insgesamt 98 (33 %) Patient:innen hatten eine Patientenverfügung, 133 (45 %) eine Vorsorgevollmacht. Es verstarben 52 Patient:innen (17,7 %) im Krankenhaus. Lediglich das Alter sowie der Familienstand waren mit dem Vorhandensein von Verfügungen assoziiert. Fokusgruppeninterviews erarbeiteten folgende Barrieren: Informationsdefizite, Sorgen vor einem Therapieabbruch, Autonomieverlust sowie den Wunsch, Belastung der Familie bzw. Patientenvertreter zu vermeiden.DiskussionEs zeigt sich, dass auch in dieser schwer erkrankten Population die Mehrheit keine Vorausverfügung trifft. Um Hürden abzubauen, ist eine verbesserte Aufklärung und Beratung über Vorausverfügungen notwendig, insbesondere in spezifischen Situationen der eigenen Urteilsunfähigkeit.
Muskelverletzungen: Stellenwert der hochauflösenden dynamischen Sonographie in der Diagnostik, Therapie und im Monitoring
Authors: Dünkel Jörg , Scheider Thomas-Oliver , Tamborrini Giorgio 
Published: May 2024

Zusammenfassung
Hintergrund
Im Fußballsport sind Muskelverletzungen ein häufiges Verletzungsmuster. Die Bildgebung ist ein zentrales Element zur Diagnosestellung. Hierfür werden hauptsächlich die MRT und der Ultraschall eingesetzt. Beide Verfahren haben Vor- und Nachteile, welche abgewogen werden sollten.

Neue Ultraschalltechniken
Die Rolle der MRT als Goldstandard wird zunehmend durch neue Techniken des hochauflösenden Ultraschalls abgelöst und nicht immer ist eine MRT-Bildgebung sinnvoll. Auch während der Reha-Phase empfehlen sich regelmäßige Ultraschallbildgebungen, um Komplikationen frühzeitig zu erkennen. Hierbei kann der Heilungsverlauf monitorisiert werden, und es besteht die Möglichkeiten für ultraschallnavigierte Interventionen, wie Hämatompunktionen und gezielte Infiltrationsbehandlungen.

Vorteile und Nachteile
Ein Nachteil der Ultraschalldiagnostik ist jedoch die Nutzerabhängigkeit. Bei erfahrenen Anwendern wird diese durch die zahlreichen Vorteile des modernen Ultraschalls ausgeglichen, womit er der MRT in vielen Bereichen – speziell auch mit der Möglichkeit eines dynamischen Ultraschalls – überlegen ist. Dennoch bleibt die MRT bei bestimmten Fragestellungen eine sinnvolle und notwendige Untersuchungsmethode.
The hydrates of chlorogenic acid in its aqueous solution and in stored food products
Authors: Dawidowicz Andrzej L. , Typek Rafał , Hołowiński Piotr , Olszowy-Tomczyk Małgorzata 
Published: May 2024

AbstractChlorogenic acids (CQAs), a large family of naturally occurring esters of quinic acid with one, two or even three cinnamic acids moieties and/or moieties of cinnamic acids derivatives, supplied to human organisms mainly with coffee, tea, fruit and vegetables, have been among the most frequently studied polyphenols. Of these, caffeic acid esters predominate, and 5-O-caffeoylquinic acid (5-CQA) is their main and most widespread representative. Recently performed studies have shown that after removing water from the aqueous solution of 5-CQA, its dry residue contains two hydrates of this compound, each consisting of two 5-CQA molecules and two molecules of H2O (2 × 5-CQA*2xH2O). The results presented in the paper not only define the characteristic features of 5-CQA but, more importantly, offer solid evidence that 5-CQA hydrates begin to form already in the aqueous solution of 5-CQA immediately after the dissolution of this compound and that the analogous process can occur in food products containing 5-CQA during their storage. Moreover, the performed experiments indicate the validity of the hypothesis that 5-CQA hydrates are formed by active collisions of 5-CQA molecules with monomeric/dimeric water molecules existing in trace amount in strongly associated aqueous systems. The presence of 5-CQA hydrates in liquid food products may have a significant impact on the assessment of some of their physicochemical properties as well as their biochemical activity.
Dual engineered bacteria improve inflammatory bowel disease in mice
Authors: Wu Yong-Qi , Zou Zhen-Ping , Zhou Ying , Ye Bang-Ce 
Published: May 2024

Abstract
Currently, there are many different therapies available for inflammatory bowel disease (IBD), including engineered live bacterial therapeutics. However, most of these studies focus on producing a single therapeutic drug using individual bacteria, which may cause inefficacy. The use of dual drugs can enhance therapeutic effects. However, expressing multiple therapeutic drugs in one bacterial chassis increases the burden on the bacterium and hinders good secretion and expression. Therefore, a dual-bacterial, dual-drug expression system allows for the introduction of two probiotic chassis and enhances both therapeutic and probiotic effects. In this study, we constructed a dual bacterial system to simultaneously neutralize pro-inflammatory factors and enhance the anti-inflammatory pathway. These bacteria for therapy consist of Escherichia coli Nissle 1917 that expressed and secreted anti-TNF-α nanobody and IL-10, respectively. The oral administration of genetically engineered bacteria led to a decrease in inflammatory cell infiltration in colon and a reduction in the levels of pro-inflammatory cytokines. Additionally, the administration of engineered bacteria did not markedly aggravate gut fibrosis and had a moderating effect on intestinal microbes. This system proposes a dual-engineered bacterial drug combination treatment therapy for inflammatory bowel disease, which provides a new approach to intervene and treat IBD.

Key points
• The paper discusses the effects of using dual engineered bacteria on IBD
• Prospects of engineered bacteria in the clinical treatment of IBD

Graphical Abstract
Retrospective analysis of radiological investigation of surgically excised head and neck lipomas
Authors: Schranz Amy L. , Riordan Fiona , Dolan Roisin , Lawlor Catriona , Morrison Colin , O’Toole Gary , Killeen Ronan , McNeill Graeme , O’Donohoe Rory , Moran Tom , O’Duffy Fergal 
Published: May 2024

Abstract
Purpose
Differentiating benign lipomas from malignant causes is challenging and preoperative investigative guidelines are not well-defined. The purpose of this study was to retrospectively identify cases of head and neck lipomas that were surgically resected over a 5-year period and to identify the radiological modality chosen and features discussed in the final report. Multidisciplinary outcomes and pathology reports were examined with a view to identifying high risk features of a lipoma to aid in future risk stratification.

Methods
Retrospective chart review of pathology characteristics, radiological features (modality, size, calcifications, septations, globular/nodular foci), multidisciplinary discussion and history of presenting complaint was performed.

Results
Two liposarcomas and 138 lipomas were identified. Twenty-two percent of all lipomas received radiological investigation. Twenty-two percent of imaging referrals were possibly inappropriate. Furthermore, radiological features suggestive of malignancy were not present in the final radiology report, X2 = 28.8, p < 0.0001.

Conclusion
As expected, the incidence of liposarcoma is low. There is limited awareness of radiology referral guidelines superimposed with a tendency to over-investigate lipomas. Furthermore, radiological features suggestive of malignancy were inconsistently reported on and not documented in multidisciplinary discussions. Therefore, we propose a multidisciplinary checklist for referring physicians and radiologists to aid in diagnostic work-up.
Keep Calm: Does parental preoperative anxiety affect post-tonsillectomy pain scores in children?
Authors: Alves Clara Serdoura , Dias Joana , Azevedo Sara , Sousa Francisco , Santos Mariline , Lino Joao , Meireles Luis 
Published: May 2024

Abstract
Purpose
To understand if high parental anxiety leads to increased post-tonsillectomy pain in children.

Methods
Prospective study including parents of children aged 3–10 years old submitted to tonsillectomy with or without adenoidectomy. To evaluate anxiety, parents were asked to fill the State-Trait Anxiety Inventory form-Y, with postoperative pain being evaluated with the Wong-Baker FACES pain scale at postoperative days 1, 3 and 7. Parents were also asked to register the number of days during which children took analgesic and the number of analgesic intakes needed.

Results
41 parents were enrolled, of which 95.1% (n = 39) were female with a mean age of 35.64 years (SD 5.751), with 41 children also being enrolled, of which 85.4% of children (n = 35) underwent tonsillectomy and adenoidectomy. 43.9% (n = 18) of parents presented State anxiety scores above the cut-off level and 53.7% (n = 22) above the Trait anxiety scores above the cut-off. Children of parents with high State anxiety presented statistically higher pain scores in both the third (p = 0.035) and the seventh postoperative days (p = 0.006), with significantly longer use of analgesic medication (p = 0.043) being found, as well as a statistically higher number of analgesic intakes (p = 0.045) (Table 4).

Conclusion
The present study establishes an association between preoperative parental anxiety, postoperative pain scores and the need for longer analgesic use in children undergoing tonsillectomy. This reinforces the importance of reducing parental anxiety and opens the door for further strategies to better post-tonsillectomy outcomes.
The interplay between excess weight and hyper-glycemia on NCDs in Italy: results from a cross-sectional study
Authors: Atella Vincenzo , Belotti Federico , Giaccherini Matilde , Medea Gerardo , Piano Mortari Andrea , Sbraccia Paolo , Nicolucci Antonio 
Published: May 2024

Abstract
Purpose
To evaluate the prevalence of chronic comorbidities according to BMI classes and assess the interplay between excess body weight and blood glucose abnormalities in increasing the risk of major chronic diseases.

Methods
The study is based on data from the Health Search/IQVIA Health LPD Longitudinal Patient Database, an Italian general practice registry, with data obtained from electronic clinical records of 800 general practitioners throughout Italy. Data relative to the year 2018 were analyzed. The study population was classified according to BMI (normal weight, overweight, and obesity classes 1, 2 and 3) and glucose metabolism status (normoglycemia—NGT; impaired fasting glucose—IFG; diabetes mellitus—DM). Comorbidities were identified through ICD-9 CM codes.

Results
Data relative to 991,917 adults were analyzed. The prevalence of overweight was 39.4%, while the prevalence of obesity was 11.1% (class 1: 7.9%, class 2: 2.3%, class 3: 0.9%). In the whole population, the prevalence of DM and IFG was 8.9% and 4.2%, respectively. Both overweight and obesity were associated with an increasing prevalence of glucose metabolism alterations and a large array of different chronic conditions, including cardio-cerebrovascular diseases, heart failure, chronic kidney disease, osteoarticular diseases, depression, sleep apnea, and neoplasms of the gastrointestinal tract. Within each BMI class, the presence of IFG, and to a greater extent DM, identified subgroups of individuals with a marked increase in the risk of concomitant chronic conditions.

Conclusion
Addressing the double burden of excess weight and hyperglycemia represents an important challenge and a healthcare priority.
Klinische Prüfungen von Arzneimitteln
Authors: Köglberger Paul , Perschinka Fabian , Joannidis Michael , Stingl Nina , Pirklbauer Christina 
Published: May 2024

ZusammenfassungEntscheidungsfähige Erwachsene können in klinische Prüfungen von Arzneimitteln nur selbst einwilligen. Bei Erwachsenen ohne vorliegende Entscheidungsfähigkeit kann der Erwachsenenvertreter stellvertretend im Interesse des Patienten entscheiden. Bei Minderjährigen ist unabhängig vom Vorliegen der Entscheidungsfähigkeit bei klinischen Prüfungen von Arzneimitteln die Einwilligung des Obsorgeberechtigten (zusätzlich) einzuholen. Bei der Erforschung von Krankheitsbildern in der Intensiv- und Notfallmedizin ist es nicht unüblich, dass Patienten auf Grund ihres Krankheitszustandes nicht entscheidungsfähig sind, daher muss bereits bei der Studienplanung das Vorgehen zum Einschluss nicht entscheidungsfähiger Patienten im Protokoll genau festgelegt werden sowie eine geeignete Patienteninformation und Einwilligungserklärung (Informed Consent Form, ICF) für den jeweiligen in Frage kommenden Adressaten der Aufklärung vorbereitet werden. Dieser Artikel soll praxisorientiert die wichtigsten Aspekte der ärztlichen Aufklärung und Einwilligung bei klinischen Prüfungen von Arzneimitteln vermitteln. Neben den einheitlich geltenden Normen in der Europäischen Union berücksichtigt dieser Artikel weiters ausschließlich die nationale Rechtslage Österreichs.
The gills and skin microbiota of five pelagic fish species from the Atlantic Ocean
Authors: Varela José Luis , Nikouli Eleni , Medina Antonio , Papaspyrou Sokratis , Kormas Konstantinos 
Published: May 2024

Abstract
The gills and skin microbiota and microbiome of wild fish remain far more under-investigated compared to that of farmed fish species, despite that these animal-microbe interactions hold the same ecophysiological roles in both cases. In this study, the gills and skin bacterial microbiota profiles and their presumptive bacterial metabolisms were investigated in five open-sea fishes: bullet tuna (Auxis sp.), common dolphinfish (Coryphaena hippurus), Atlantic little tunny (Euthynnus alletteratus), Atlantic bonito (Sarda sarda) and Atlantic white marlin (Kajikia albida). Gills and skin tissues were collected from two to three individuals per species, from specimens caught by recreational trolling during summer of 2019, and their bacterial 16S rRNA gene diversity was analysed by high-throughput sequencing. The gills bacterial communities among the five species were clearly different but not the skin bacterial microbiota. The dominant operational taxonomic units belonged to the Moraxellaceae, Pseudomonadaceae, Rhodobacteraceae, Staphylococcaceae and Vibrionaceae families. Despite the differences in taxonomic composition, the presumptive bacterial metabolisms between the gills and skin of the five fishes investigated here were ≥ 94% similar and were dominated by basic metabolism, most likely reflecting the continuous exposure of these tissues in the surrounding seawater.
An “integration” of professional identity formation among rural physicians experiencing an interplay between their professional and personal identities
Authors: Miyachi Junichiro , Iwakuma Miho , Nishigori Hiroshi 
Published: May 2024

AbstractThe present understanding of professional identity formation is problematic since it underrepresents minority physicians and potentially excludes their professional identity formation experiences. Rural physicians are expected to have similar underrepresented aspects as minority physicians because of their specific sociocultural contexts and consequent private–professional intersection, which lead to ethical complexities. Therefore, to bridge this research gap, we interviewed 12 early- to mid-career Japanese physicians working in rural areas and explored their experiences. Through a narrative analysis guided by Figured Worlds theory, we analysed the data by focusing on the vocabulary, expressions, and metaphors participants used to describe their experiences. A central theme emerged concerning how the rural physicians configurated their personal versus professional participation in their local communities. Further, their identity narratives varied regarding how they constructed their identities, rural communities, and relationships as well as their identity formation ideals and strategies to achieve them. Informed by ‘Big Questions’ concerning worldview framework, we delineated four identity narratives as prototypes to describe how they participated in their communities. These identity narratives provide a preliminary understanding of how diverse identity formation is for rural physicians. In addition, our findings exposed the current professional identity formation framework as potentially biased towards single forms of participation in monolithic communities, overlooking complicated forms of participation in multiple communities. We argue that applying frameworks and concepts to capture these multiple forms of participation as well as revisiting the ‘discourse of integration’ are necessary steps to overcome the limitation of the current understanding of professional identity formation.
Generating probabilistic forecasts from arbitrary point forecasts using a conditional invertible neural network
Authors: Phipps Kaleb , Heidrich Benedikt , Turowski Marian , Wittig Moritz , Mikut Ralf , Hagenmeyer Veit 
Published: May 2024

AbstractIn various applications, probabilistic forecasts are required to quantify the inherent uncertainty associated with the forecast. However, many existing forecasting methods still only generate point forecasts. Although methods exist to generate probabilistic forecasts from these point forecasts, these are often limited to prediction intervals or must be trained together with a specific point forecast. Therefore, the present article proposes a novel approach for generating probabilistic forecasts from arbitrary point forecasts. In order to implement this approach, we apply a conditional Invertible Neural Network (cINN) to learn the underlying distribution of the data and then combine the uncertainty from this distribution with an arbitrary point forecast to generate probabilistic forecasts. We evaluate our approach by generating probabilistic forecasts from multiple point forecasts and comparing these forecasts to six probabilistic benchmarks on four data sets. We show that our approach generally outperforms all benchmarks with regard to CRPS and Winkler scores and generates probabilistic forecasts with the narrowest prediction intervals whilst remaining reasonably calibrated. Furthermore, our approach enables simple point forecasting methods to rank highly in the Global Energy Forecasting Competition 2014.
A rehearsal framework for computational efficiency in online continual learning
Authors: Davalas Charalampos , Michail Dimitrios , Diou Christos , Varlamis Iraklis , Tserpes Konstantinos 
Published: May 2024

AbstractIn the realm of online continual learning, models are expected to adapt to an ever-changing environment. One of the most persistent hurdles in this adaptation is the mitigation of a phenomenon called "Catastrophic Forgetting" (CF). This critical condition occurs when models trained on non-identically distributed data lose performance in previously learned tasks. Rehearsal methods, leveraging the ability to replay older samples, aim to address this challenge by incorporating a buffer of past training samples. However, the absence of known task boundaries complicates the adaptation of current CF mitigation methods. This paper proposes a method attuned to data stream characteristics and online model performance in a resource-constrained environment. The number of training iterations and learning rate emerges as crucial hyperparameters, impacting the efficacy and efficiency of online continual learning. Up to this point, we propose a combination of Experience Replay methodologies, a Drift Detector, and various training convergence policies, specially tailored for scenarios with unknown task boundaries. Experimental results demonstrate the effectiveness of our approach, maintaining or enhancing performance compared to baseline methods, while significantly improving computational efficiency.
Heavy metals and potential health risk assessment of Lactuca sativa and Daucus carrota from soil treated with organic manures and chemical fertilizer
Authors: Aina O. E. , Mugivhisa L. L. , Olowoyo J. O. , Obi C. L. 
Published: May 2024

AbstractThe large-scale production of food crops with heavy application of chemical fertilizers in the effort to meet the astronomical increase in food demands may be counterproductive to the goal of food security. This study investigated the effect of different soil treatments on the levels of heavy metals (Cr, Cu, Fe, Ni, Pb, and Zn) in two types of vegetables Lactuca sativa (lettuce) and Daucus carrota (carrot). The potential carcinogenic and non-carcinogenic health risks from their consumption were also evaluated. Planting experiment was set up in a randomized block design, with different soil treatments of soil + cow dung (CD), soil + sewage sludge (SS), soil + chemical fertilizer (nitrogen-phosphorus-potassium (NPK)), and untreated soil (UNTRD). The vegetables were harvested at maturity, washed with distilled water, and subjected to an acid digestion process before the levels of heavy metals were measured by inductively coupled plasma spectrometry (ICP-MS). The mean concentrations of the metals in the vegetables across all treatments were below the maximum permissible limits. The pattern of heavy metal accumulation by the vegetables suggested that the lettuce from SS treatment accumulated higher concentrations of heavy metals like Cr (0.20 mg/kg), Cu (3.91 mg/kg), Ni (0.33 mg/kg), and Zn (20.44 mg/kg) than carrot, with highest concentrations of Fe (90.89 mg/kg) and Pb (0.16 mg/kg) recorded in lettuce from NPK treatment. The bioaccumulation factor (BAF) showed that lettuce, a leafy vegetable, has bioaccumulated more heavy metals than carrot, a root vegetable. The BAF was generally below the threshold value of 1 in both vegetables, except in lettuce from NPK and CD treatments and carrot from NPK treatments, with BAF values of 1.6, 1.69, and 1.39, respectively. The cancer risk assessment factors were well below the unacceptable maximum range of 10−4 suggesting that consuming these vegetables might not expose an individual to potential risk of cancer development. The hazard quotient estimations were below the threshold values of 1 for all heavy metals; however, the hazard index (HI) values of 1.27 and 1.58 for lettuce from NPK and SS treatments indicate a potential non-carcinogenic health risk to consumers from intake of all the heavy metals.