Danube University Krems

About: Danube University Krems is a education organization based out in Krems, Niederösterreich, Austria. It is known for research contribution in the topics: Stroke & Population. The organization has 498 authors who have published 1572 publications receiving 68797 citations.

Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews

Abstract: Objectives This study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects. Design This is a review of systematic reviews. Data sources This study used MEDLINE, Embase, Cochrane Library, PsycINFO and Epistemonikos from 2011 up to February 2017 for systematic reviews of randomised controlled trials in adult patients with acute-phase MDD. Methods We dually reviewed abstracts and full-text articles, rated the risk of bias of eligible systematic reviews and graded the strength of evidence. Results Nineteen systematic reviews provided data on 28 comparisons of interest. For general efficacy, only second-generation antidepressants were supported with high strength evidence, presenting small beneficial treatment effects (standardised mean difference: −0.35; 95% CI −0.31 to −0.38), and a statistically significantly higher rate of discontinuation because of adverse events than patients on placebo (relative risk (RR) 1.88; 95% CI 1.0 to 3.28). Only cognitive behavioural therapy is supported by reliable evidence (moderate strength of evidence) to produce responses to treatment similar to those of second-generation antidepressants (45.5% vs 44.2%; RR 1.10; 95% CI 0.93 to 1.30). All remaining comparisons of non-pharmacological treatments with second-generation antidepressants either led to inconclusive results or had substantial methodological shortcomings (low or insufficient strength of evidence). Conclusions In contrast to pharmacological treatments, the majority of non-pharmacological interventions for treating patients with MDD are not evidence based. For patients with strong preferences against pharmacological treatments, clinicians should focus on therapies that have been compared directly with antidepressants. Trial registration number International Prospective Register of Systematic Reviews (PROSPERO) registration number: 42016035580.

Unintended Side Effects of the Digital Transition: European Scientists' Messages from a Proposition-Based Expert Round Table

Abstract: We present the main messages of a European Expert Round Table (ERT) on the unintended side effects (unseens) of the digital transition. Seventeen experts provided 42 propositions from ten different perspectives as input for the ERT. A full-day ERT deliberated communalities and relationships among these unseens and provided suggestions on (i) what the major unseens are; (ii) how rebound effects of digital transitioning may become the subject of overarching research; and (iii) what unseens should become subjects of transdisciplinary theory and practice processes for developing socially robust orientations. With respect to the latter, the experts suggested that the “ownership, economic value, use and access of data” and, related to this, algorithmic decision-making call for transdisciplinary processes that may provide guidelines for key stakeholder groups on how the responsible use of digital data can be developed. A cluster-based content analysis of the propositions, the discussion and inputs of the ERT, and a theoretical analysis of major changes to levels of human systems and the human–environment relationship resulted in the following greater picture: The digital transition calls for redefining economy, labor, democracy, and humanity. Artificial Intelligence (AI)-based machines may take over major domains of human labor, reorganize supply chains, induce platform economics, and reshape the participation of economic actors in the value chain. (Digital) Knowledge and data supplement capital, labor, and natural resources as major economic variables. Digital data and technologies lead to a post-fuel industry (post-) capitalism. Traditional democratic processes can be (intentionally or unintentionally) altered by digital technologies. The unseens in this field call for special attention, research and management. Related to the conditions of ontogenetic and phylogenetic development (humanity), the ubiquitous, global, increasingly AI-shaped interlinkage of almost every human personal, social, and economic activity and the exposure to indirect, digital, artificial, fragmented, electronically mediated data affect behavioral, cognitive, psycho-neuro-endocrinological processes on the level of the individual and thus social relations (of groups and families) and culture, and thereby, the essential quality and character of the human being (i.e., humanity). The findings suggest a need for a new field of research, i.e., focusing on sustainable digital societies and environments, in which the identification, analysis, and management of vulnerabilities and unseens emerging in the sociotechnical digital transition play an important role.

Helicopter Transport of Stroke Patients and Its Influence on Thrombolysis Rates Data From the Austrian Stroke Unit Registry

Abstract: Background and Purpose—Acute stroke management requires minimization of prehospital time. This study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis. Methods—Prospective data collection and prespecified evaluation of data from 32 stroke units between 2003 and 2009 were used. We distinguished between patients transported either directly to a stroke unit or transferred indirectly via a peripheral hospital. Thus, there were 6 transport groups: helicopter emergency service (HEMS) direct and indirect, ambulance accompanied by an emergency physician direct and indirect, and ambulance without physician direct and indirect. Demographic and clinical factors, time delays, and rates of thrombolysis of patients transported by helicopter were compared with factors of patients transported otherwise. Results—Of 21 712 ischemic stroke patients, 905 patients (4.1%) were transported by helicopter. Of thes...

Grain-size dependent demagnetizing factors in permanent magnets

Abstract: The coercive field of permanent magnets decreases with increasing grain size. The grain size dependence of coercivity is explained by a size dependent demagnetizing factor. In Dy free Nd2Fe14B magnets, the size dependent demagnetizing factor ranges from 0.2 for a grain size of 55 nm to 1.22 for a grain size of 8300 nm. The comparison of experimental data with micromagnetic simulations suggests that the grain size dependence of the coercive field in hard magnets is due to the non-uniform magnetostatic field in polyhedral grains.