Miracle-dz/UniFAR-FTUs huggingface dataset:
Probleme des Teams in der deutschen ambulanten Versorgung

Das Team, bestehend aus Personen meist unterschiedlicher Professionen, die in (gleichberechtigter) Zusammenarbeit an einer gemeinsamen Aufgabe arbeiten, wird auch für den ambulanten Bereich in Deutschland zunehmend als Zukunftsorientierung gesehen. Die Idee der Überlegenheit des Teams ist einleuchtend, aber es ist auffällig, dass sich diese Überlegenheit noch nicht durchgesetzt hat. Es wird zunächst eine konzeptionelle Analyse zu den Stärken und den Schwächen des Teams in der ambulanten hausärztlichen Versorgung vorgenommen. Fragestellung ist hierbei, inwiefern diese Teamkonzepte die Kernkompetenzen der Allgemeinmedizin verbessern oder schwächen würden. Anschließend wird eine historisch-politische Analyse zu den Gründen des Scheiterns derartiger Teamkonzepte sowohl in den 70er- und 80er-Jahren (Gruppenpraxis) als auch den beginnenden 90er-Jahren (Ärztenetze) vorgenommen. Teamkonzepte sind bisher immer gescheitert – an der Finanzierung , den strukturellen Problemen des deutschen Gesundheitssystems und den mentalen Schwierigkeiten, die Ärzte mit ihrem Selbstbild im Verhältnis zu anderen Gesundheitsberufen haben. Zudem gibt es zahlreiche konzeptionelle Gründe, die bezweifeln lassen, dass ein Team die spezifische Arbeit der Allgemeinmedizin mit dem generalistischen Ansatz verbessern würde. Sieht man die Zukunft der Allgemeinmedizin im Team, so wären immer zuerst die strukturell-finanziellen Grundbedingungen dafür zu schaffen. Dabei erscheint eine solche Voraussetzung nur in einem verstaatlichten/vergesellschafteten System vorstellbar.
Konflikte um Leitlinien – am Beispiel der S3-Leitlinie „Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke“

Die Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaften versuchte, auch bei den Leitlinien verschiedener Fachgesellschaften zum Thema Schlaganfall eine Vereinheitlichung herzustellen. Bedingt durch interne personelle Probleme formulierte die DEGAM ihre Kritik an der neurologischen S3-Leitlinie „Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke“ erst spät. Die DGN entschied sich darauf dagegen, die DEGAM weiter an ihrem Leitlinien-Prozess zu beteiligen. Damit verliert die DGN-Leitlinie ihre Gültigkeit für den hausärztlichen Versorgungsbereich.
RELATIONSHIP BETWEEN LOWER EXTREMITY STIFFNESS AND ECCENTRIC LEG STRENGTH IN HORIZONTAL JUMPERS

Eccentric strength in the lower extremity has been identified as a key performance component in the horizontal jumps (Graham-Smith & Lees, 2005). Whilst isokinetic dynamometry provides a safe and reliable method of testing maximal eccentric strength, it is often criticised as being non functional due to testing at constant angular velocity and being an open kinetic chain movement (Baltzopoulos & Brodie, 1989; Augustsson & Thomee, 2000). Therefore, eccentric leg strength measured during isokinetic testing may have limited transfer to functional performance. Lower extremity stiffness, such as vertical stiffness and knee joint stiffness (Farley et al., 1998) and knee joint moment, can be calculated during functional movements utilising force platforms, motion analysis and inverse dynamics. The purpose of this study was to examine the relationship between isokinetic eccentric leg strength and measures of lower extremity stiffness and knee joint moment during a single leg hop for distance test.
Cognitive Behavioral Analysis System of Psychotherapy versus Antidepressiva: eine systematische Übersichtsarbeit

Die Depression ist in Deutschland noch vor anderen Volkskrankheiten wie Diabetes mellitus oder koronarer Herzerkrankung als die gesellschaftlich belastendste Krankheitsgruppe einzuordnen und neigt in besonderem Maße zur Chronifizierung. Eine Depression wird dann als chronisch bezeichnet, wenn sie über einen Zeitraum von mindestens zwei Jahren besteht. Im Vergleich zu episodisch depressiv Erkrankten weisen chronisch depressive Patienten ein niedrigeres Ersterkrankungsalter auf, unternehmen häufiger Suizidversuche und reagieren schlechter auf Antidepressiva. Lediglich bei 12% der chronisch depressiven Patienten werden neben Antidepressiva auch psychotherapeutische Interventionen eingesetzt. Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) ist eine speziell zur Behandlung der chronischen Depression entwickelte Psychotherapieform. Ziel dieser Arbeit war es, die Psychotherapie mit CBASP und die Pharmakotherapie mit Antidepressiva bezüglich ihrer Effektivität bei chronisch depressiven Patienten einander gegenüberzustellen. Systematische Literatursuche (PubMed, Em-base und Cochrane Library) Es konnten insgesamt nur zwei randomisierte kontrollierte Studien (RCTs) gefunden werden. Zudem konnte eine Re-Analyse identifiziert werden, in der eine Neuauswertung der Daten einer der oben genannten RCTs hinsichtlich des Vorliegens von Traumatisierungen in der Kindheit durchgeführt wurde. In diesen Studien stellt das CBASP zur Behandlung von Patienten mit einer chronischen Depression bezogen auf die Response- und Remissionsraten eine der Pharmakotherapie durchaus ebenbürtige (im Falle von komorbiden Frühtraumatisierungs-erlebnissen sogar überlegene) Option dar. Aufgrund der spärlichen Datenlage ist eine metaanalytische Auswertung der Fragestellung schwierig und besitzt nur eine stark eingeschränkte statistische Aussagekraft. Bei Frühtraumatisierungen kann das CBASP erfolgreich mit Pharmakotherapie kombiniert werden.
Public-Key Cryptography from Different Assumptions (Extended Abstract)

This paper attempts to broaden the foundations of public- key cryptography. We construct new public-key encryption schemes based on new hardness-on-average assumptions for natural combinatorial NP-hard optimization problems. We consider the following assumptions: 1. It is infeasible to solve a random set of sparse linear equations mod 2, of which a small fraction is noisy. 2. It is infeasible to distinguish between a random unbal- anced bipartite graph, and such a graph in which we \plant" at random in the large side a set S with only jSj=3 neighbors.
Radiographic Outcomes of Robot-Assisted Versus Conventional Total Knee Arthroplasty

Background: Total knee arthroplasty (TKA) has long been considered the definitive treatment for knee osteoarthritis. Although tremendous improvements have been made in surgical techniques for conventional TKA, a substantial dissatisfaction rate among patients has persisted because of moderate-to-severe pain and stiffness following TKA. Robot-assisted TKA was developed as an alternative to conventional TKA with the goal of improving operative precision and producing better clinical outcomes with minimal postoperative complications. The aim of this study was to compare the radiographic outcomes, duration of surgery, and complication rate between robot-assisted TKA and conventional TKA. Methods: We conducted relevant literature searches of Medline, Scopus, ClinicalTrials.gov, and the Cochrane Library databases with use of specific keywords. The outcomes for continuous variables were pooled into mean differences, whereas the outcomes for dichotomous variables were pooled into odds ratios with 95% confidence intervals with use of random-effects models. Results: A total of 12 randomized clinical trials were included. Our pooled analysis revealed that robot-assisted TKA was associated with fewer outliers in the hip-knee-ankle (HKA) angle (p < 0.0001), femoral component (coronal) angle (p = 0.0006), femoral component (sagittal) angle (p = 0.009), tibial component (coronal) angle (p = 0.05), and tibial component (sagittal) angle (p = 0.01) when compared with conventional TKA. The postoperative HKA angle was also significantly more neutral in the robot-assisted TKA group (mean difference, −0.77°; p < 0.0001). However, the complication rate did not differ significantly between the 2 groups. Conclusions: Robot-assisted TKA may produce more accurate placement of the prosthetic component and better joint alignment accuracy than conventional TKA as shown by fewer outliers in several joint angles. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Can Anterior Osteophyte Fractures Be Distinguished From Fracture Mimics in the Subaxial Cervical Spine? A Retrospective Analysis Evaluating Reported Fractures With Clinical Management Correlation

Objective This study aimed to retrospectively distinguish true- from false-positive fractures of anterior subaxial cervical osteophytes, which were reported on noncontrast computed tomography reports, and to correlate the imaging findings with patient symptoms and analyze the downstream impact on management of both true and false positive fractures. Methods A total of 127 patients had computed tomography reports of anterior osteophyte fractures. Radiology reports and imaging studies were evaluated to distinguish true fractures from fracture mimics. We analyzed imaging features including rigid spine (RS), prevertebral soft tissue swelling (PVSTS), and instability. We categorized symptoms and examination findings into 3 groups (0, asymptomatic; 1, neck pain; 2, neurological symptoms). Management was categorized into 3 groups (0, no treatment; 1, external bracing; 2, surgery). Associations between imaging features, fracture classification, clinical symptoms, magnetic resonance imaging utilization, and management were calculated using χ2 with Cramer V test to determine effect size. Results Eighty patients had false-positive fractures, and 47 were true positive. There were significant associations between magnetic resonance imaging utilization and fracture classification (P ≤ 0.001), PVSTS (P ≤ 0.005), patient symptoms (P ≤ 0.001), and patient management (P ≤ 0.001). There were significant associations between patient management and fracture classification (P ≤ 0.001), patient symptoms (P ≤ 0.001), PVSTS (P ≤ 0.001), imaging findings of instability (P ≤ 0.001), and RS (P ≤ 0.021). There were significant associations between fracture classification and patient symptoms (P ≤ 0.045), and RS (P ≤ 0.006). Conclusions Subaxial isolated anterior osteophyte fractures fell into 3 major categories. By our methodology, if a suspected fracture was determined to be a fracture mimic in an asymptomatic patient, it was unlikely to be clinically significant. Isolated anterior osteophyte fractures without neurological symptoms or more concerning imaging findings can be treated conservatively. Finally, fractures that demonstrate indirect signs of instability or are associated with RS are more associated with surgical management.
Feasibility of Bone Mineral Density and Bone Microarchitecture Assessment Using Deep Learning With a Convolutional Neural Network

Objectives We evaluated the feasibility of using deep learning with a convolutional neural network for predicting bone mineral density (BMD) and bone microarchitecture from conventional computed tomography (CT) images acquired by multivendor scanners. Methods We enrolled 402 patients who underwent noncontrast CT examinations, including L1–L4 vertebrae, and dual-energy x-ray absorptiometry (DXA) examination. Among these, 280 patients (3360 sagittal vertebral images), 70 patients (280 sagittal vertebral images), and 52 patients (208 sagittal vertebral images) were assigned to the training data set for deep learning model development, the validation, and the test data set, respectively. Bone mineral density and the trabecular bone score (TBS), an index of bone microarchitecture, were assessed by DXA. BMDDL and TBSDL were predicted by deep learning with a convolutional neural network (ResNet50). Pearson correlation tests assessed the correlation between BMDDL and BMD, and TBSDL and TBS. The diagnostic performance of BMDDL for osteopenia/osteoporosis and that of TBSDL for bone microarchitecture impairment were evaluated using receiver operating characteristic curve analysis. Results BMDDL and BMD correlated strongly (r = 0.81, P < 0.01), whereas TBSDL and TBS correlated moderately (r = 0.54, P < 0.01). The sensitivity and specificity of BMDDL for identifying osteopenia or osteoporosis were 93% and 90%, and 100% and 94%, respectively. The sensitivity and specificity of TBSDL for identifying patients with bone microarchitecture impairment were 73% for all values. Conclusions The BMDDL and TBSDL derived from conventional CT images could identify patients who should undergo DXA, which could be a gatekeeper tool for detecting latent osteoporosis/osteopenia or bone microarchitecture impairment.
Inverse Probability Weighting Difference-in-Differences (IPWDID)

Abstract:In this American Causal Inference Conference (ACIC) 2022 challenge submission, the canonical difference-in-differences (DID) estimator has been used with inverse probability weighting (IPW) and strong simplifying assumptions to produce a benchmark model of the sample average treatment effect on the treated (SATT). Despite the restrictive assumptions and simple model, satisfactory performance in both point estimate and confidence intervals was observed, ranking in the top half of the competition.
A limit theorem for a class of supercritical branching processes

In the Bellman-Harris (B-H) age-dependent branching process, the birth of a child can occur only at the time of its parent's death. A general class of branching process in which births can occur throughout the lifetime of a parent has been introduced by Crump and Mode. This class shares with the B-H process the property that the generation sizes {ξn } form a Galton-Watson process, and so may be classified into subcritical, critical or supercritical according to the value of m = E{ξ 1}. Crump and Mode showed that, as regards extinction probability, asymptotic behaviour, and for the supercritical case, convergence in mean square of Z(t)/E[Z(t)], as t → ∞, where Z(t) is the population size at time t given one ancestor at t = 0, properties of the B-H process can be extended to this general class. In this paper conditions are found for the convergence in distribution of Z(t)/E{Z(t)} in the supercritical case to a non-degenerate limit distribution. In contrast to the B-H process, these conditions are not the same as those for ξn /mn to have a non-degenerate limit. An integral equation is established for the generating function of Z(t), which is more complicated than the corresponding one for the B-H process and involves the conditional probability generating functional of N(x), x 0, ≧ the number of children born to an individual in the age interval [0, x].
A Fully Automated Visual Grading System for White Matter Hyperintensities of T2-Fluid Attenuated Inversion Recovery Magnetic Resonance Imaging.

BACKGROUND The Fazekas scale is one of the most commonly used visual grading systems for white matter hyperintensity (WMH) for brain disorders like dementia from T2-fluid attenuated inversion recovery magnetic resonance (MR) images (T2-FLAIRs). However, the visual grading of the Fazekas scale suffers from low-intra and inter-rater reliability and high labor-intensive work. Therefore, we developed a fully automated visual grading system using quantifiable measurements. METHODS Our approach involves four stages: (1) the deep learning-based segmentation of ventricles and WMH lesions, (2) the categorization into periventricular white matter hyperintensity (PWMH) and deep white matter hyperintensity (DWMH), (3) the WMH diameter measurement, and (4) automated scoring, following the quantifiable method modified for Fazekas grading. We compared the performances of our method and that of the modified Fazekas scale graded by three neuroradiologists for 404 subjects with T2-FLAIR utilized from a clinical site in Korea. RESULTS The Krippendorff's alpha across our method and raters (A) versus those only between the radiologists (R) were comparable, showing substantial (0.694 vs. 0.732; 0.658 vs. 0.671) and moderate (0.579 vs. 0.586) level of agreements for the modified Fazekas, the DWMH, and the PWMH scales, respectively. Also, the average of areas under the receiver operating characteristic curve between the radiologists (0.80 ± 0.09) and the radiologists against our approach (0.80 ± 0.03) was comparable. CONCLUSIONS Our fully automated visual grading system for WMH demonstrated comparable performance to the radiologists, which we believe has the potential to assist the radiologist in clinical findings with unbiased and consistent scoring.
Overnight Abstinence, Ventrostriatal-Insular Connectivity, and Tridimensional Personality Traits in Cigarette Smokers.

BACKGROUND Personality traits contribute to the risks of smoking. The striatum has been implicated in nicotine addiction and nicotine deprivation is associated with alterations in resting state functional connectivity (rsFC) of the ventral (VS) and dorsal (DS) striatum. However, it remains unclear how striatal rsFC may change following overnight abstinence or how these shorter-term changes in inter-regional connectivity relate to personality traits. METHODS In the current study, 28 smokers completed assessments with Fagerström Test of Nicotine Dependence, Tridimensional Personality Questionnaire (TPQ), as well as resting state functional magnetic resonance imaging (fMRI) scans during satiety and after overnight abstinence. We processed imaging data with published routines and evaluated the results with a corrected threshold. RESULTS Smokers showed increases in the VS-insula rsFC but no significant changes in the DS rsFC after overnight abstinence as compared to satiety. The difference in the VS-insula rsFC (abstinence minus satiety) was negatively correlated with harm avoidance. CONCLUSIONS These findings highlighted striatal connectivity correlates of very short-term abstinence from smoking and how the VS-insula rsFC may vary with individual personality traits, interlinking neural markers and personality risk factors of cigarette smoking at the earliest stage of abstinence.
Tax revenue-economic growth relationship and the role of trade openness in developing countries

Abstract This study investigates the impact of tax revenue on economic growth in the context of increasing trade openness in developing countries by using the data of 29 developing countries with accelerating economic growth during the period 2000–2020. This study further applies the Fixed Effect Model (FEM) and the Generalized Least Squares (GLS) estimation methods for panel data to test the proposed hypotheses. The research results show that tax revenue positively affects economic growth in general. Furthermore, we find that trade openness increases the positive relationship between tax revenue and economic growth but excessive trade openness reduces such a relationship. Our findings provide important implications for developing countries in the context of increasing tax revenue and trade openness.
SWAMP: A new experiment for simulating permafrost warming and active layer deepening on the Tibetan Plateau

Our knowledge on the responses of permafrost ecosystems to climate warming is critical for assessing the direction and magnitude of permafrost carbon‐climate feedback. However, most of the previous experiments have only been able to warm the air and surface soil, with limited effects on the permafrost temperature. Consequently, it remains challenging to realistically simulate permafrost thawing in terms of increased active layer (a layer freezing and thawing seasonally above permafrost) thickness under climate warming scenarios. Here, we presented the experimental design and warming performance of a novel experiment, Simulate Warming at Mountain Permafrost (SWAMP), the first one to successfully simulate permafrost warming and the subsequent active layer deepening in a swamp meadow situated on the Tibetan Plateau. Infrared heating was employed as above‐ground warming to elevate the temperature of the air and surface soil, and heating rods were inserted vertically in the soil to provide below‐ground warming for transmitting heat to the deep active layer and even to permafrost deposits. In 3 m diameter warmed circular plots, the air and the entire soil profile (from surface soil to 120 cm) was effectively heated, with an increase of approximately 2°C in the upper 60 cm, which progressively weakened with soil depth. Warming increased soil moisture across the growing season by inducing an earlier thawing of the soil. Values varied from 1.8 ± 1.8 to 12.3 ± 2.3% according to the soil depth. Moreover, during the growing season, the warmed plots had greater thaw depths and a deeper active layer thickness of 12.6 ± 0.8 cm. In addition, soil thawing duration was prolonged by the warming, ranging from 22.8 ± 3.3 to 49.3 ± 4.5 days depending on the soil depth. The establishment of SWAMP provides a more realistic simulation of warming‐induced permafrost thaw, which can then be used to explore the effect of climate warming on permafrost ecosystems and the potential permafrost carbon‐climate feedback. Notably, our experiment is more advantageous for investigating how deep soil processes respond to climate warming and active layer deepening, compare with experiments which use passive warming techniques such as open top chambers (OTCs).
The Mesoscale and Microscale Structure and organization of Clouds and precipitation in Midlatitude Cyclones. Part V: The Substructure of Narrow Cold-Frontal Rainbands

Abstract The organization and structure of a narrow cold-frontal rainband (NCFR) on the small mesoscale and the microscale have been investigated through quantitative radar reflectivity, Doppler radar observations, airborne observations and surface measurements. The NCFR was composed of small mesoscale regions of heavy precipitation called “precipitation cores” (PCs) oriented at an angle to the synoptic-scale cold front; in horizontal cross section the PCs were roughly elliptical in shape. Areas of lighter precipitation called “gap regions” (GRs) separated the PCs. The PCs were so oriented that their loading edges were regions of strong low-level convergence. The weather associated with the passage of a PC resembled that of a squall-line gust front, with concurrent windshifts and pressure checks occurring ∼5 min before heavy precipitation and a fall in temperature. The changes in surface weather that accompanied the passage of a GR were more variable but tended to be less marked than for PCs. Thus, the se.
A second look at the asymptotic PTAS for square packing

In the Square Packing problem the goal is to use as few unit squares as possible to pack a given set of squares. This problem is known to be NP-hard and is a special case of the 2-dimensional Bin Packing problem. For the Square Packing problem there exists an asymptotic PTAS that runs in worst-case, triple exponential in terms of 1 . In this paper we want to improve the running time by improving the analysis of the known asymptotic PTAS. We do this by lowering the upper bound on the wasted area for unit squares containing large or small squares. Let S denote the largest possible size for small squares and L denotes the smallest possible size for large squares. We show that the wasted area is within O ( − S log L L ) . Furthermore we show that this new upper bound implies that the running time is in fact in worst-case double exponential in terms of 1 .
College Students' Mental Health Help-Seeking Behaviors

Abstract:The present study explored where and how college students sought assistance and information for themselves and their family or friends who may have needed behavioral health and substance abuse disorder assistance. Two hundred and fifty-nine college students responded to the questionnaire at one of the 50 largest public higher education institutions in the Southeastern United States. Findings confirm that help-seeking is a multifaceted process involving social and professional support. Participants indicated that they would seek assistance earlier than they had and also make personal changes in their lives to address well-being. These findings can guide higher education administrators, faculty members, counseling staff on campuses, funders, and policymakers in designing and developing accessible and user-friendly programs and services for increasing student success on campuses.