bluuebunny/crossref_metadata_2025 huggingface dataset:
Synergistic cobalt oxide/reduced graphene oxide/biochar nano-composite catalyst: harnessing the power of the catalyst for sustainable remediation of organic dyes and chromium(vi)
Authors: Priyadarsini Amrita , Mohanty Chirasmayee , Nanda Spandan , Mishra Abinash , Das Nigamananda , Swain Nandita , Dash Manasi , Jena Pradip Kumar
Published: April 2024

The first-ever report on the use of a Co3O4/reduced graphene oxide/biochar composite as an inexpensive, easily separable, and highly reactive visible light active photocatalyst.
Luminescence properties of a green-emitting mechanoluminescent phosphor CaSrGa4O8:xTb3+ without pre-excitation
Authors: Shi Rui , Liu Wei , Li Lin , Li Huan , Zhang Zhijun , Rao Guanghui , Zhao Jingtai
Published: April 2024

The strong green mechanoluminescence and long persistent luminescence properties of CaSrGa4O8:Tb3+ without pre-excitation were observed for the first time.
Aqueous solution and solid-state behaviour of l-homophenylalanine: experiment, modelling, and DFT calculations
Authors: Tenberg Vico , Sadeghi Masoud , Schultheis Axel , Joshi Meenakshi , Stein Matthias , Lorenz Heike
Published: April 2024

In the present study, the solid-state and aqueous solubility behaviour of l-homophenylalanine (l-Hpa) is explored.
Axially-chiral boramidine for detailed (chir)optical studies
Authors: Saleh Nidal , Sucre-Rosales Estefanía , Zinna Francesco , Besnard Céline , Vauthey Eric , Lacour Jérôme
Published: April 2024

An axially-chiral boramidine displays UV-absorption, deep-blue fluorescence (Φ up to 94%), and |10−3| gabs and glum. Deactivation pathways of the emissive state to triplet excited states, involving increased spin–orbit coupling, are identified.
Emerging single-atom catalysts in the detection and purification of contaminated gases
Authors: Liu Lingyue , Yung Ka-Fu , Yang Hongbin , Liu Bin
Published: April 2024

This review examines methods for characterizing single-atom catalysts (SACs) structures, SACs' mechanisms in gas sensors, techniques for purifying noxious gases using catalysis, and highlights challenges and solutions.
An iridium(iii)-based photosensitizer disrupting the mitochondrial respiratory chain induces ferritinophagy-mediated immunogenic cell death
Authors: Feng Tao , Tang Zixin , Karges Johannes , Shu Jun , Xiong Kai , Jin Chengzhi , Chen Yu , Gasser Gilles , Ji Liangnian , Chao Hui
Published: April 2024

A mitochondria-localizing iridium(iii) photosensitizer produces singlet oxygen and superoxide anion radicals upon two-photon irradiation, disrupting the mitochondrial respiratory chain and inducing ferritinophagy and immunogenic cell death.
Long-range proton and hydroxide ion transfer dynamics at the water/CeO2 interface in the nanosecond regime: reactive molecular dynamics simulations and kinetic analysis
Authors: Kobayashi Taro , Ikeda Tatsushi , Nakayama Akira
Published: April 2024

The structural properties, dynamical behaviors, and ion transport phenomena at the water/CeO2 interface are investigated by reactive MD simulations employing NNPs, and a counting analysis based on the semi-Markov process is formulated and performed.
A high-fidelity DNAzyme-assisted CRISPR/Cas13a system with single-nucleotide resolved specificity
Authors: Wu Yunping , Jin Ruigang , Chang Yangyang , Liu Meng
Published: April 2024

DNAzyme Operation was uniquely exploited to Enhance the Specificity of the CRISPR/Cas13a system (DOES-CRISPR). The versatility of DOES-CRISPR was demonstrated for the detection of microRNAs, CYP2C19*17 gene, SARS-Cov-2 variants, and Omicron subtypes.
GQD-PAN-based high-performance supercapacitor: an approach towards wealth from waste
Authors: Kumar Dheeraj , Vashishth Ekta , Rani Sweety , Kumar Advitiya , Nandan Bhanu , Bahga Supreet Singh , Srivastava Rajiv K.
Published: April 2024

Conversion of styrofoam waste into high-performance energy storage material: graphene quantum dots coated cPAN matrix yields 78 times capacitance improvement.
Decoding the manganese-ion storage properties of Na1.25V3O8 nano-rods
Authors: Soundharrajan Vaiyapuri , Nithiananth Subramanian , Alfaza Ghalib , Piao JunJi , Pham Duong Tung , Ang Edison Huixiang , Kasnatscheew Johannes , Winter Martin , Kim Jung Ho , Kim Jaekook
Published: April 2024

The Na1.25V3O8 (NVO) cathode is investigated as an Mn2+ storage host and the electrochemical Mn2+ storage capability is verified using the Zn–Mn alloy‖NVO hybrid full cell configuration.
LEGO® brick-inspired ultra-stable and rapid transport 2D membrane for fast water purification
Authors: Zhu Bo , Li Nan , Guo Changsheng , Liu Pengbi , Li Tianyu , Wang Lijing , Xu Zhiwei
Published: April 2024

Inspired by the modular homogenization and interlocking structure concepts of LEGO® bricks, we developed high-performance graphene oxide composite nanofiltration membranes using the subject–object recognition effect.
Mechanistic insights into the solvent assisted thermal regeneration of spent graphite and its upcycling into dual graphite batteries
Authors: Ghosh Shuvajit , Bhar Madhushri , Bhattacharjee Udita , Yalamanchili Kali Prasad , Krishnamurthy Satheesh , Martha Surendra K.
Published: April 2024

The spent lithium-ion battery is upcycled into a dual-graphite battery via a solvent assisted thermal treatment.
Microcosmic modulation of the Co–N bonding structure improves the multi-functional electrocatalytic performance
Authors: Deng Wenhui , Wu Tianjing , Wu Yufeng , Chen Fang , Bai Yansong , Zou Xiaoqing , Jing Mingjun , Deng Wentao , Hou Hongshuai , Wang Xianyou
Published: April 2024

The coordination environment of Co–Nx models is modulated in systematic theoretical studies. Thereinto, the well-defined Co-phenazine bonding structure (Co–N2) can efficiently reduce the reaction energy barrier for ORR and OER.
Ring-size dependent ratiometric photoluminescence of cyclophane mechanophores
Authors: Thazhathethil Shakkeeb , Thuluvanchery Fazil Salim , Shimizu Shohei , Scarlat Iulia , Clough Jess M. , Weder Christoph , Sagara Yoshimitsu
Published: April 2024

Ring size determines the mechanochromic luminescence properties of cyclophane mechanophores whose mechanism relies on the dissociation of the CT complexes between a 9,10-bis(phenylethynyl)anthracene and a pyromellitic diimide.
Homochirality to design high-Tclead-free ferroelastic semiconductors
Authors: Deng Bo-Wen , Rao Zhi-Peng , Shen Ming-Jing , Liang Ke-Wei , Zhu Yang , Wang Zhi-Jie , Ding Kun , Su Chang-Yuan , Lun Meng-Meng , Zhang Zhi-Xu , Zhang Yi , Fu Da-Wei
Published: April 2024

High-Tclead-free ferroelastic semiconductor (R/S-CTA)2SbCl5was obtained through an H/OH-substitution-induced homochirality strategy, and undergoes phase transition at 410 K accompanied by switching between the SHG-active and SHG-inactive states.
Perovskite quantum dots embedded paper photodetectors with high flexibility and self-powered operation
Authors: Guan Xinwei , Huang Chien-Yu , Hu Long , Periyanagounder Dharmaraj , Lei Zhihao , Kim Jiyun , Rahaman Md. Zahidur , Huang Jing-Kai , Kumar Prashant , Lin Chun-Ho
Published: April 2024

Hybrid MAPbBr3 quantum dot cellulose papers are fabricated via a one-step, oleic acid/oleylamine-free vacuum filtration method, and the corresponding photodetectors demonstrate self-powered capability, high flexibility, and exceptional stability.
Edge‐guided representation learning for underwater object detection
Authors: Dai Linhui , Liu Hong , Song Pinhao , Tang Hao , Ding Runwei , Li Shengquan
Published: April 2024

Underwater object detection (UOD) is crucial for marine economic development, environmental protection, and the planet's sustainable development. The main challenges of this task arise from low‐contrast, small objects, and mimicry of aquatic organisms. The key to addressing these challenges is to focus the model on obtaining more discriminative information. The authors observe that the edges of underwater objects are highly unique and can be distinguished from low‐contrast or mimicry environments based on their edges. Motivated by this observation, an Edge‐guided Representation Learning Network, termed ERL‐Net is proposed, that aims to achieve discriminative representation learning and aggregation under the guidance of edge cues. Firstly, an edge‐guided attention module is introduced to model the explicit boundary information, which generates more discriminative features. Secondly, a hierarchical feature aggregation module is proposed to aggregate the multi‐scale discriminative features by regrouping them into three levels, effectively aggregating global and local information for locating and recognising underwater objects. Finally, a wide and asymmetric receptive field block is proposed to enable features to have a wider receptive field, allowing the model to focus on smaller object information. Comprehensive experiments on three challenging underwater datasets show that our method achieves superior performance on the UOD task.
Continuous‐dilated temporal and inter‐frame motion excitation feature learning for gait recognition
Authors: Hua Chunsheng , Zhang Hao , Li Jia , Pan Yingjie
Published: April 2024

The authors present global‐interval and local‐continuous feature extraction networks for gait recognition. Unlike conventional gait recognition methods focussing on the full gait cycle, the authors introduce a novel global‐ continuous‐dilated temporal feature extraction (TFE) to extract continuous and interval motion features from the silhouette frames globally. Simultaneously, an inter‐frame motion excitation (IME) module is proposed to enhance the unique motion expression of an individual, which remains unchanged regardless of clothing variations. The spatio‐temporal features extracted from the TFE and IME modules are then weighted and concatenated by an adaptive aggregator network for recognition. Through the experiments over CASIA‐B and mini‐OUMVLP datasets, the proposed method has shown the comparable performance (as 98%, 95%, and 84.9% in the normal walking, carrying a bag or packbag, and wearing coats or jackets categories in CASIA‐B, and 89% in mini‐OUMVLP) to the other state‐of‐the‐art approaches. Extensive experiments conducted on the CASIA‐B and mini‐OUMVLP datasets have demonstrated the comparable performance of our proposed method compared to other state‐of‐the‐art approaches.
Primary component segmental design to suppress the normal force ripple for the permanent magnet linear synchronous motor
Authors: Tan Qiang , Tian Bing , Wang Xinbang , Huang Xuzhen , Li Liyi
Published: April 2024

There is not only thrust but also normal force between the primary and secondary components for the single‐side flat plate permanent magnet linear synchronous motor (PMLSM). The normal force will fluctuate periodically, which will cause friction perturbation and finally affect the positioning accuracy of linear feed system. For the single‐side flat plate PMLSM, the variation law of normal force ripple under the coupling effect of multiple effects is studied, and the method of primary component segmental design to suppress it is proposed. Firstly, the influence of the cogging effect, the end effect and the armature reaction on the normal force ripple is analysed. Meanwhile the mathematical model of normal force ripple is established. Secondly, the PMLSM with segmental primary component is introduced and its suppression mechanism to the normal force ripple is expounded. On this basis, a scheme combining the non‐integer pole slot matching with the primary component segmental design is proposed to further suppress the normal force ripple. Finally, an 18‐slot 96/5‐pole prototype is taken as an example to carry out the finite element simulation and experimental test, of which the results verify the research theory in this paper.
Grid voltage sensorless control of a single‐phase shunt hybrid active power filter
Authors: Karbasforooshan Mohammad‐Sadegh , Monfared Mohammad
Published: April 2024

Here, a grid voltage sensorless control of an LCL‐filtered LC‐tuned single‐phase shunt hybrid active power filter (HAPF) is proposed, which offers high‐quality harmonic current compensation with low hardware requirements. An estimation algorithm replaces the grid voltage sensor and associated circuitry to reduce the size and cost. This paper presents a straightforward and accurate modelling of the suggested structure and its filtering characteristics, followed by a comprehensive yet simple parameter design procedure. An inherent damping technique that uses digital delay rather than virtual or physical damping resistors eliminates the need for additional sensors or extra power losses. As part of the design, a high‐quality reference current is generated for the filter, which is then effectively tracked using a proportional controller with sufficient bandwidth and stability margin. An experimental prototype is implemented to verify the theoretical results, and several steady‐state and transient waveforms are reported to demonstrate the superior performance of the HAPF.
Analysis, design, and reliability evaluation of a modified multi‐port quasi‐resonant converter with high gain
Authors: Harini Sampath , Nallaperumal Chellammal , Hosseinpour Alireza
Published: April 2024

High‐gain converters play a vital role in all industrial applications such as automobiles, motor drives, renewable energy systems, and railway transportation sectors. The conventional converters have low gain owing to high‐voltage stress on active MOSFET, diode and low efficiency related with high operating pulse ratio. To overcome the limitations associated with the conventional converters, this study proposes a non‐isolated configuration of multiport quasi‐resonant converter (MP‐QRC) with high gain. The proposed MP‐QRC has the merits of high‐voltage gain, reduced number of components, minimum conduction losses, realization of soft switching in the devices and improved reliability. Moreover, the proposed converter is scalable and can serve as a good candidate in microgrid environment where the integration of more than one input is essential. In this paper, first a comprehensive analysis of various operation modes and design constraints are presented. Further, the study is supported with a reliability evaluation of proposed converter based on component failure. Also, the futuristic behaviour of MP‐QRC under continuous conduction mode as a function of operational and environmental variables is investigated to ascertain the reliability. The steady‐state operation of the converter is demonstrated for off‐board electric vehilce (EV) charging using MATLAB/SIMULINK and experiments performed on a 300‐W test rig.
Influence of different terminations on the surface properties of rare earth sesquioxides: first-principle calculations
Authors: Zheng Zhi , Wang Jian , He Zhijun
Published: April 2024

Rare earth sesquioxide (R2O3) have attracted significant attention because of their stable surface and operable optical properties. In this paper, we comprehensively analyze the surface and optical properties of five rare earth sesquioxides (R2O3, where R = Sc, Y, La, Sm, Dy) using the first-principles method. The obtained results are consistent with other theoretical and experimental values. It is observed that the R terminated surfaces of R2O3 exhibits the lowest work function while the mixed atom terminations have the lowest surface energy, indicating their potential as electron emission materials. Additionally, calculations of optical properties reveal that R2O3 exhibits high reflectivity and optical absorption in the far ultraviolet region. Notably, Y2O3 demonstrates a remarkable 95% reflectivity in the far ultraviolet region, highlighting the immense potential of R2O3 in designing and applying optical devices. The theoretical calculation data in this paper provide a theoretical basis for related experiments.
Ausbildung von MFA in der Ophthalmologie. Ergebnisse einer Stichprobe
von großen augenmedizinischen Zentren
Authors: Hahn Ursula , Kellner Ulrich
Published: April 2024

Der Fachkräftemangel in der vertragsärztlichen Versorgung betrifft zunehmend auch
Medizinische Fachangestellte (MFA) in ärztlichen Praxen und MVZ. Ausbildung kann
die damit verbundenen Probleme perspektivisch abfedern, aktuell bilden jedoch
nur 42% der Praxen aus. Mit einer Erhebung in einer Stichprobe großer
augenmedizinischer Zentren sollte eine anderweitig aufgestellte These, dass
größere Praxen und MVZ überproportional ausbilden, überprüft werden. Außerdem
wurde eine Wechselwirkung zwischen Trägerschaft (ärztlicher Eigenbesitz (äE);
Fremdbesitz (F)) und dem Ausbildungsengagement evaluiert. In einer
fragebogengestützten Vollerhebung (2022) von in einem Verbund organisierten
großen augenmedizinischen Zentren unterschiedlicher Trägerschaft wurden die
Ausbildungsquote nach Hauptbetriebsstätten (HBS), die Zahl der
MFA-Auszubildenden (MFA-A) je HBS, Besetzungsprobleme und geplante Änderung im
Ausbildungsengagement erhoben. Die Verteilungsmaße der quantitativen Daten
wurden gesamt und getrennt nach Trägerschaft ausgewertet und auf Signifikanz
geprüft. Die Ergebnisse wurden den Daten einer repräsentativen Erhebung
(2020/2021) über alle Praxen und MVZ gegenübergestellt. Um den auf die
Stichprobe entfallende Anteil an allen augenheilkundlichen MFA-A zu ermitteln,
wurde in einer Hochrechnung deren Gesamtzahl ermittelt. Die Ausbildungsquote der
insgesamt 100 HBS der 14 befragten Zentren (äE: 11,F: 3) der Stichprobe lag mit
82% (äE: 93%, F: 79%) über der repräsentativen Erhebung (41%). In der Stichprobe
waren im Durchschnitt 5,9 MFA-A je HBS tätig (äE: 5,6, F: 7,1), in der
Vergleichserhebung 1,5. 50% der Zentren der Stichprobe berichteten von
Besetzungsproblemen, 25% wollten ihr Ausbildungsengagement ausweiten; die
Vergleichswerte der repräsentativen Befragung lagen für beide Parameter bei 11%.
Stratifiziert nach Trägerschaft wiesen weder Ausbildungsquote noch MFA-A je HBS
signifikante Unterschiede auf. Laut Hochrechnung waren 2021 knapp 1.966 MFA-A in
der Augenheilkunde tätig, davon entfielen 19,5% auf die Zentren der
Studienpopulation. Von allen MFA-A der Stichprobe entfielen 71% auf die nach
Anzahl HBS deutlich größeren Zentren in Fremdbesitz. Die Erhebung bestätigt für
die Stichproben den positiven Zusammenhang von Größe von Praxen und MVZ und
Ausbildungsengagement. Es bestehen keine signifikanten Unterschiede nach
Trägerschaft.
Qualitätsgesicherte Behandlung in zertifizierten
Versorgungsnetzwerken von Patientinnen mit Mammakarzinom in der Region
Oberfranken: Eine Analyse auf Basis von Bayerischen
Krebsregisterdaten
Authors: Friebel Sophie , Thater Andrea , Völkel Vinzenz , Klinkhammer-Schalke Monika , Müller-Nordhorn Jacqueline , Emmert Martin
Published: April 2024

Zielsetzung Brustkrebs nimmt den größten Anteil von Krebsneuerkrankungen
und -sterbefällen bei Frauen in Deutschland ein. Für die Gewährleistung einer
qualitätsgesicherten Versorgung wird die Behandlung in zertifizierten
Brustkrebszentren empfohlen. Die Zielsetzung der Studie besteht in der Analyse
der onkologischen Versorgungssituation von Mammakarzinom-Patientinnen und
-Patienten aus dem Regierungsbezirk Oberfranken.

Methodik Es erfolgte eine Betrachtung des Behandlungsortes sowie des
Zertifizierungsstatus der Leistungserbringer hinsichtlich der Erstdiagnose,
Operation, Chemotherapie und Bestrahlung bei der Versorgung. Hierauf basierend
erfolgte ein Vergleich von Patientinnencharakteristika, die in zertifizierten
und nicht-zertifizierten Zentren und ihren Netzwerken behandelt wurden. Die
Auswertung erfolgte basierend auf einem Datensatz des Bayerischen Krebsregisters
(4/2017-3/2022).

Ergebnisse Die Analyse umfasste 5.545 Primärtumoren von insgesamt 5.355
Patientinnen (Alter: 64,5±14,2 Jahre; 99,2% weiblich). Die Rate der
Inanspruchnahme zertifizierter Leistungserbringer betrug 78,8% für die
Erstdiagnose, 82,6% für die Operation, 79,5% für die Chemotherapie sowie 99,6%
für die Bestrahlung. Der gewichtete Mittelwert über alle Therapiesequenzen
hinweg ergab einen Anteil von 84,3% Inanspruchnahme von Leistungserbringern
zertifizierter Versorgungsnetzwerke. Patientinnen in zertifizierten
Versorgungsnetzwerken waren in drei Therapiesequenzen signifikant jünger
(p+<+0.001). Zudem zeigte sich insbesondere für die Diagnose und Operation
ein überdurchschnittlicher Anteil von Patientinnen mit fortgeschrittenen
Tumorstadien, die in nicht-zertifizierten Versorgungsnetzwerken behandelt wurden
(p+<+0.001).

Schlussfolgerungen Es zeigten sich in Hinblick auf die
Behandlungssequenzen Differenzen beim Anteil der Patientinnen, die in
Oberfranken eine qualitätsgesicherte Behandlung in einem zertifizierten
Versorgungsnetzwerk erhalten haben. Im deutschlandweiten Vergleich zeigt das
Ergebnis für die Region Oberfranken eine durchschnittliche Inanspruchnahme
zertifizierter Versorgungsnetzwerke. Es sollte sichergestellt werden, dass
Patientinnen und Patienten eine umfassende Aufklärung über die Versorgung in
zertifizierten Einheiten erhalten.
Das Gleichgewichtsorgan als Element der Sicherheit
Authors: Corts Magga
Published: April 2024

In dieser DHZ-Ausgabe beschäftigt sich die Rubrik „Funktionelle Anatomie“ mit dem Vesitbularorgan.
Prüfungsthema: Angst
Authors: Schmid Eva C.
Published: April 2024

Liebe Heilpraktikeranwärter – mit diesen Karteikarten wollen wir Sie bei der Vorbereitung auf die mündliche Heilpraktikerüberprüfung unterstützen. Viel Erfolg beim Lernen wünscht Ihnen HP Eva C. Schmid!
Phobien
Authors: Stern Cornelia , Saldow Reinhold , Thumm Anusati , Welsch Katja
Published: April 2024

4 Expert*innen stellen Ihnen Behandlungsstrategien aus der Spagyrik, kreativen Heilhypnose, Aromatherapie und Klassischen Homöopathie vor.
Frage an das Unbewusste
Authors: Saldow Reinhold
Published: April 2024

Im Gegensatz zu gesunden Schutzreaktionen tritt neurotische Angst als seelische Hemmung in eigentlich unproblematischen Situationen auf und wirkt über diesen Weg lebensbestimmend und -verstimmend. Kreative Heilhypnose kann bislang unerkannte Ursachen aufdecken und in einem geschützten Rahmen durch Techniken wie die Arbeit mit Bildern (zum Beispiel Kinotechnik) oder der Lebensgeschichte in aktive Gestaltung überführen. Im vorgestellten Fall konnte eine Gewitterphobie durch Aufdecken und Verarbeiten der Ursachen in Trance innerhalb von 3 Sitzungen komplett überwunden werden.
Potenzen gegen die Furcht
Authors: Welsch Katja
Published: April 2024

Unter der Vielzahl homöopathischer Angstmittel haben sich einige Arzneien besonders bewährt, hier vorgestellt: Arsenicum album, Aconitum napellus, Stramonium, Kalium bromatum, Calcium carbonicum und Phosphorus. Im ersten Fallbeispiel führt Arsenicum album bei generalisierter Angst zu einer langsamen Entspannung, im zweiten Fall verbessert Stramonium die nächtliche Angst bei einem achtjährigen Jungen. In einer weiteren Kasuistik kann die „Universalwaffe“ Calcium carbonicum Krankheits- und Höhenangst deutlich lindern, im 4. Fall ermöglichte das Breitbandmittel Phosphorus einer Patientin mit Schwäche und Ängstlichkeit den Wiedereinstieg in den Präsenzberuf.
A Retrospective Review on Dysregulated Autophagy in Polycystic Ovary
Syndrome: From Pathogenesis to Therapeutic Strategies
Authors: Zhao Yan , Zhao Xiaoxuan , Jiang Tianyue , Xi Hongyan , Jiang Yuepeng , Feng Xiaoling
Published: April 2024

The main purpose of this article is to explore the relationship between autophagy
and the pathological mechanism of PCOS, and to find potential therapeutic
methods that can alleviate the pathological mechanism of PCOS by targeting
autophagy. Relevant literatures were searched in the following databases,
including: PubMed, MEDLINE, Web of Science, Scopus. The search terms were
“autophagy”, “PCOS”, “polycystic ovary syndrome”, “ovulation”,
“hyperandrogenemia”, “insulin resistance”, “inflammatory state”, “circadian
rhythm” and “treatment”, which were combined according to the retrieval methods
of different databases. Through analysis, we uncovered that abnormal levels of
autophagy were closely related to abnormal ovulation, insulin resistance,
hyperandrogenemia, and low-grade inflammation in patients with PCOS. Lifestyle
intervention, melatonin, vitamin D, and probiotics, etc. were able to improve
the pathological mechanism of PCOS via targeting autophagy. In conclusion,
autophagy disorder is a key pathological mechanism in PCOS and is also a
potential target for drug development and design.
Clinical and Growth Correlates of Retinopathy of Prematurity in Preterm Infants with Surgical Necrotizing Enterocolitis and Intestinal Perforation
Authors: Garg Parvesh M. , Riddick Robin A. , Ansari Md A.Y. , Meilstrup Asha C. , Zepponi David , Smith Andrea , Mungan Nils , Shenberger Jeffrey , Hillegass William B. , Garg Padma P.
Published: April 2024

Objective This study aimed to identify the clinical and growth parameters associated with retinopathy of prematurity (ROP) in infants with necrotizing enterocolitis (NEC) and spontaneous ileal perforation (SIP).

Study Design We conducted a retrospective cohort study that compared clinical data before and after NEC/SIP onset in neonates, categorizing by any ROP and severe ROP (type 1/2) status.

Results The analysis included 109 infants with surgical NEC/SIP. Sixty infants (60/109, 55%) were diagnosed with any ROP, 32/109 (29.3%) infants (22% type 1 and 7.3% type 2) with severe ROP. On univariate analysis, those with severe ROP (32/109, 39.5%) were of lower median gestational age (GA, 23.8 weeks [23.4, 24.6] vs. 27.3 [26.3, 29.0], p < 0.001), lower median birth weight (625 g [512, 710] vs. 935 [700, 1,180], p < 0.001) and experienced higher exposure to clinical chorioamnionitis (22.6 vs. 2.13%, p < 0.006), and later median onset of ROP diagnosis (63.0 days [47.0, 77.2] vs. 29.0 [19.0, 41.0], p < 0.001), received Penrose drain placement more commonly (19 [59.4%] vs. 16 [34.0%], p = 0.04), retained less residual small bowel (70.0 cm [63.1, 90.8] vs. 90.8 [72.0, 101], p = 0.007) following surgery, were exposed to higher FiO2 7 days after birth (p = 0.001), received ventilation longer and exposed to higher FiO2 at 2 weeks (p < 0.05) following NEC and developed acute kidney injury (AKI) more often (25 [86.2%] vs. 20 [46.5%], p = 0.002) than those without ROP. Those with severe ROP had lower length, weight for length, and head circumference z scores. In an adjusted Firth's logistic regression, GA (adjusted odds ratio [aOR] = 0.51, 95% confidence interval [CI]: [0.35, 0.76]) and diagnosis at later age (aOR = 1.08, 95% CI: [1.03, 1.13]) was shown to be significantly associated with any ROP.

Conclusion Infants who develop severe ROP following surgical NEC/SIP are likely to be younger, smaller, have been exposed to more O2, develop AKI, and grow poorly compared with those did not develop severe ROP.

Key Points
Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches
Authors: Brown Nolan J. , Pennington Zach , Patel Saarang , Kuo Cathleen , Chakravarti Sachiv , Bui Nicholas E. , Gendreau Julian , Van Gompel Jamie J.
Published: April 2024

Introduction Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates.

Methods Three databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria.

Results Seven studies comprising 288 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion. In the three comparing the endoscopic endonasal (n = 21) versus transcranial (n = 32) approaches, there was no significant difference between the two with respect to gross total resection (p = 0.34) or rates of Simpson Grade 1 resection (p = 0.69). EEA demonstrated higher rates of overall complications (p < 0.01) including postoperative infection (p = 0.03). In the four studies comparing bilateral (n = 117) versus unilateral approaches (n = 118), overall complication rates (p < 0.01) and disease recurrence (p = 0.01) were higher with bilateral approaches. All surgery-related mortalities also occurred in the bilateral cohort (n = 7, 7.14%). Gross total resection (p = 0.63) and Simpson grade (p = 0.48) were comparable between approaches. Olfaction preservation was superior for unilateral approaches (p < 0.01).

Conclusions Though the literature is limited, current evidence suggests that the endoscopic endonasal approach may be favorable over conventional craniotomy for select olfactory groove meningioma patients. Where craniotomy is used, unilateral approaches appear to reduce complications and the risk of olfaction loss.
User-Centered Design and Implementation of an Interoperable FHIR Application for Pediatric Pneumonia Prognostication in a Randomized Trial
Authors: Turer Robert W. , Gradwohl Stephen C. , Stassun Justine , Johnson Jakobi , Slagle Jason M. , Reale Carrie , Beebe Russ , Nian Hui , Zhu Yuwei , Albert Daniel , Coffman Timothy , Alaw Hala , Wilson Tom , Just Shari , Peguillan Perry , Freeman Heather , Arnold Donald H. , Martin Judith M. , Suresh Srinivasan , Coglio Scott , Hixon Ryan , Ampofo Krow , Pavia Andrew T. , Weinger Matthew B. , Williams Derek J. , Weitkamp Asli O.
Published: April 2024

Objectives To support a pragmatic, electronic health record (EHR)-based randomized controlled trial, we applied user-centered design (UCD) principles, evidence-based risk communication strategies, and interoperable software architecture to design, test, and deploy a prognostic tool for children in emergency departments (EDs) with pneumonia.

Methods Risk for severe in-hospital outcomes was estimated using a validated ordinal logistic regression model to classify pneumonia severity. To render the results usable for ED clinicians, we created an integrated SMART on Fast Healthcare Interoperability Resources (FHIR) web application built for interoperable use in two pediatric EDs using different EHR vendors: Epic and Cerner. We followed a UCD framework, including problem analysis and user research, conceptual design and early prototyping, user interface development, formative evaluation, and postdeployment summative evaluation.

Results Problem analysis and user research from 39 clinicians and nurses revealed user preferences for risk aversion, accessibility, and timing of risk communication. Early prototyping and iterative design incorporated evidence-based design principles, including numeracy, risk framing, and best-practice visualization techniques. After rigorous unit and end-to-end testing, the application was successfully deployed in both EDs, which facilitated enrollment, randomization, model visualization, data capture, and reporting for trial purposes.

Conclusion The successful implementation of a custom application for pneumonia prognosis and clinical trial support in two health systems on different EHRs demonstrates the importance of UCD, adherence to modern clinical data standards, and rigorous testing. Key lessons included the need for understanding users' real-world needs, regular knowledge management, application maintenance, and the recognition that FHIR applications require careful configuration for interoperability.
Network Analysis of the North American Skull Base Society Membership
Authors: Luebs John K. , Snyderman Carl H.
Published: April 2024

Background The membership of the North American Skull Base Society (NASBS) has grown considerably in recent years with diversity in subspecialty training, gender, and geography. The academic relationships and contributions of its membership have not been studied.

Objectives This study aimed to (1) measure academic contributions of NASBS membership; (2) identify influential nodes of academic collaboration; (3) identify opportunities for future collaboration and mentorship.

Methods Peer-reviewed publications of members of NASBS (2019 NASBS website) were identified using Scopus author name search. Network structures were constructed and analyzed using the graph-tool python library to produce a weighted coauthorship network and compute centrality measures. Visual network maps were then produced using Gephi network visualization software.

Results The coauthor network contained 952 members with found publications and 4,996 connections. A total of 846 (88.9%) members were contained in a single connected giant component; 102 members were unconnected, and 64 members had a single connection. Girvan–Newman clustering identified 267 communities, where 13 contained at least 1% of the total membership each. The three largest communities contained 23.3, 8.4, and 6.9% of members. There were 111 published members identified as women; 5.4% of women were unconnected versus 11.4% of men. Average publication count for women was 32.3 (standard deviation [SD] 38.5) versus 70.5 (SD 106) for men. Average citation count for women was 543 (SD 1,012) versus 1,389 (SD 2,893) for men.

Conclusion Network mapping of membership of the NASBS helps to visualize the academic activities and relationships of the NASBS and reveals areas of concentration and influence within the specialty.
Endoscopic Endonasal Anterior Skull Base Meningoencephalocele and Cerebrospinal Fluid Leak Repair: Our Intraoperative and Postoperative Protocol and Long-term Outcomes
Authors: Ruiz Gianna M. , Uram Zach , Strelko Oleksandr , Hossain Adnan , Ng Isaac , Patel Chirag R. , Germanwala Anand V.
Published: April 2024

Objective We evaluated the long-term outcomes from a single neurosurgeon and otolaryngologist team using a specific operative protocol for repair and postoperative evaluation.

Design The charts of patients undergoing endoscopic endonasal repair of meningoencephaloceles (MECs) and cerebrospinal fluid (CSF) leaks were retrospectively reviewed from 2015 to 2023. Intraoperative steps of the repair and reconstruction were analyzed. Patients' postoperative assessments and complications were analyzed.

Setting Loyola University Medical Center's electronic medical record database.

Participants Forty-three patients (32 female) aged between 11 and 81 years.

Main Outcome Measures Long-term outcomes of patients who underwent endoscopic endonasal repair of MECs and CSF leaks by a single team and protocol. We hypothesized that there would be minimal complications and no recurrences, requiring secondary operation.

Results The most common site for MECs was the cribriform plate. Lumbar drain opening pressures ranged from 10 to 35 cm H2O with 18 out of 34 patients having the lumbar drain removed immediately postoperatively. The median hospital stay was 3 days. The average length of follow-up was 3.8 years. No recurrences or secondary operations were noted in all patients. One patient had a sinonasal infection that was successfully treated. Eight patients were noted to have venous stenosis and underwent further evaluation.

Conclusion This study represents one of the largest long-term analyses of outcomes by a single team. Our specific protocol for the endoscopic endonasal repair of anterior skull base MECs and CSF leaks is safe and effective. These patients should be evaluated and treated for elevated intracranial pressure following the repair.
Outcomes following duodenectomy in patients with familial adenomatous polyposis
Authors: Aelvoet Arthur S. , Martin Isabel , Cockburn James , Cabalit Cherryl , Cuthill Victoria , Spalding Duncan , Busch Olivier , Bastiaansen Barbara A.J. , Clark Susan K. , Dekker Evelien , Latchford Andrew
Published: April 2024

Background and study aims Some patients with familial adenomatous
polyposis (FAP) and extensive duodenal polyposis or cancer require total duodenectomy. Regular
postoperative endoscopic surveillance of the remaining jejunum and stomach is recommended, but
little is known about the outcomes after this surgery.

Patients and methods Patients with FAP who underwent either
pancreatoduodenectomy (PD) or pancreas-preserving total duodenectomy (PPTD) were identified at
two expert centers. Data about postoperative endoscopic surveillance outcomes were collected,
as well as survival outcomes.

Results Overall, 119 patients (50% female) underwent duodenectomy
(86 PD and 33 PPTD); 100 for benign duodenal polyposis and 19 for duodenal or ampullary
cancer. Details of postoperative endoscopic surveillance were available for 88 patients (74%).
During a median follow-up of 106 months, 36 patients (41%) were diagnosed with jejunal
adenomas after duodenectomy, with a significantly higher proportion in patients who underwent
PPTD compared with patients who underwent PD (log-rank, P <
0.01). Two patients developed jejunal cancer (2%). Twenty-six patients (30%) were diagnosed
with a total of 66 gastric adenomas, of which 61% were located in the fundus/body and 39% in
the antrum. Five patients (6%) developed gastric cancer after a median of 15 years (range 6–23
years), all but one within carpeting fundic gland polyposis. Patients who underwent surgery
for cancer had worse survival than patients with benign disease and all but one patient with
postoperative gastric/jejunal cancer died.

Conclusions After duodenectomy in FAP, a considerable risk of
developing adenomas and cancer in the stomach and jejunum exists with poor cancer prognosis,
highlighting the need for close postoperative endoscopic surveillance.
Minimally-Invasive Approach in the Setting of a Malignant Primary Cardiac Tumor
Authors: Polat Emre , Stock Sina , Owais Tamer , Girdauskas Evaldas
Published: April 2024

A 71-year-old man with dilated cardiomyopathy without clinical complaints revealed a suspicious finding in checkup. After a multimodality cardiac imaging, the suspicion of a malignant primary cardiac tumor in the left ventricle was substantiated and the patient underwent minimally-invasive cardiac surgery for tumor resection. Postoperative chemotherapy with multiple cycles of liposomal doxorubicin was established and supported by proton beam radiotherapy. Two-year follow-up revealed no disease recurrence.
Three Patients of the Early Onset Epileptic Spasms without Hypsarrhythmia
Authors: Ohshiro Ikko , Okanishi Tohru , Ohta Ryo , Ohta Kento , Arai Yuto , Kanai Sotaro , Fujimoto Ayataka , Maegaki Yoshihiro
Published: April 2024

Epileptic spasms without hypsarrhythmia occur when patients do not display hypsarrhythmia on electroencephalogram (EEG) at the onset and throughout the clinical course. We report three patients of epileptic spasms in patients with early onset, all of whom experienced other types of seizures.

We detail three patients (two boys and one girl) of epileptic spasms without hypsarrhythmia, occurring between 1 and 3 months of age, with no abnormalities detected on neurometabolic analysis and brain magnetic resonance imaging. Long-term video-EEG monitoring revealed epileptic spasms with focal onset seizures in two patients, and epileptic spasms followed by generalized tonic-clonic seizures in one patient. Hypsarrhythmia was never observed in repeated EEG examinations. Two patients achieved seizure freedom and improved development through treatment with topiramate alone or in combination with valproate, without requiring hormonal therapies or vigabatrin. The remaining patient achieved seizure freedom following administration of antiseizure medications, including topiramate, after a trial of adrenocorticotropic hormone therapy.

We report the cases of three patients with early onset epileptic spasms without hypsarrhythmia. All patients achieved seizure freedom after topiramate treatment. Topiramate may be considered as a relatively effective antiseizure medication for early onset epileptic spasms without hypsarrhythmia.
Editorial: Liebe Leserin, lieber Leser,
Authors: Siems Katrin , Spencker Martin
Published: April 2024

die Digitalisierung des Gesundheitswesens hat inzwischen deutlich an Fahrt aufgenommen und mit dem Boom um Artificial Intelligence (AI) nochmals an Schwung gewonnen. Doch was kommt nach dem Hype um ChatGPT und Co.? Wie gelingt eine sinnvolle Integration von AI in die Versorgung? Was ist schon heute möglich und was ist Zukunftsmusik? Antworten auf diese Fragen finden wir, davon sind wir überzeugt, nur miteinander: im Dialog, in der Kollaboration, in gemeinsamen Visionen.
Präziser, stärker personalisiert und zielgerichteter: Medizin-Wissen trifft AI
Authors: Mehdorn Andreas
Published: April 2024

Thieme gehört zu den führenden Anbietern medizinischer Fachinformationen. Welche Chancen und Perspektiven in der Verbindung qualitätsgesicherten Fachinhalte und standardisierter Patientendaten mit künstlicher Intelligenz liegen, darüber haben wir mit Katrin Siems, Senior Executive Vice President Marketing and Sales der Thieme Gruppe, und AI-Experte Alexander Thamm gesprochen.
Durchgängig verfügbare Patientendaten: Digital gestützte Patientenaufnahme
Authors: Gärisch André
Published: April 2024

Mit der Erfassung der Patienteninformationen, der Einwilligung in die Behandlung und dem Unterzeichnen weiterer klinikspezifischer Dokumente startet in der Regel der Prozess der klinischen Patientenversorgung. Werden sämtliche relevanten Daten und Dokumente in standardisierter Form digital gespeichert, ist die Basis für einen digital gestützten, effizienten Workflow gelegt. Grundlage hierfür sind moderne Technologien, wie sie Thieme Compliance und x-tention jetzt auf der Basis bereits bewährter Lösungen entwickelt haben.
Bessere Prozesse durch nutzergerechte Informationen: Passgenauer Patient Content
Authors: Hölbling Catrin
Published: April 2024

Emily Frühwald ist IT-Projektleiterin am Klinikum Stuttgart. Dort begleitet sie derzeit den Aufbau eines Patientenportals. In Zukunft sollen darüber Termine vergeben und Patienteninformationen angeboten werden. Für das Projekt „Patient Content“ steht sie im engen Austausch mit Thieme.
Thieme beteiligt sich am Healthtech Scale-up XUND: Mit AI die Patientenkommunikation revolutionieren
Authors: Schindler Carola
Published: April 2024

Thieme beteiligt sich am Wiener Healthtech Scale-up XUND. Gemeinsam wollen die Unternehmen Mediziner*innen bei der Diagnosestellung und der Therapiewahl mit relevanten Informationen unterstützen und die Kommunikation mit den Patient*innen in diesem Prozess verbessern. Basis hierfür sollen die AI-basierte Technologie von XUND und die hochwertigen Fachinformationen von Thieme sein. Ziel ist es, beides in einem Medical Large Language Model (MedLLM) zusammenzuführen und damit die dynamische Bereitstellung personalisierter medizinischer Inhalte zu ermöglichen.
Klinikverbund Südwest: Wieder ein Verlustjahr
Authors: Schmidt Hartmut
Published: April 2024

Nachdem die kommunalen Gesellschafter 2022 das EAT-Minus von 53 Millionen Euro ausgeglichen haben, soll der Verlust 2023 auf 66 Millionen Euro steigen. Ob es gelingt, bis 2030 eine schwarze Null zu schreiben, bleibt abzuwarten.
Connecting Digital Health: DMEA live in Berlin
Authors: Gerlach Luisa
Published: April 2024

Von der Gesundheitsdatennutzung über den Einsatz von KI in der Medizin bis zur elektronischen Patientenakte für alle – die Zukunft der digitalen Gesundheitsversorgung steht vom 9. bis 11. April 2024 auf der DMEA im Fokus.
KIS-Markt: Gute Aussichten dank SAP
Authors: Lang Michael
Published: April 2024

Die Turbulenzen um die SAP-Branchenlösung IS-H und das Krankenhausinformationssystem (KIS) i.s.h.med werden auch nach dem Ende der KHZG-Projekte dafür sorgen, dass den KIS-Herstellern die Aufträge nicht ausgehen. Des einen Freud ist des anderen Leid, denn die Kunden benötigen dringend eine Lösung.
Bilanz KHZG-Projekte: Erst das große Versprechen, jetzt der große Druck
Authors: Hollmig Luisa-Maria , Hofmann Lisa-Marie
Published: April 2024

Das Krankenhauszukunftsgesetz (KHZG) ist eine Milliardenförderung für moderne Versorgungsstrukturen. Weg vom Papier – hin zur digitalen Behandlungsdokumentation. Die Erwartungen waren groß, doch die Umsetzungszeit läuft nun ab. Ein Spiel aus Licht und Schatten im deutschen Klinikmarkt.
Elektronische Patientenakte: Erfahrung sammeln im Produktivbetrieb
Authors: Lang Michael
Published: April 2024

Die Charité ist als eine der ersten Universitätskliniken in Deutschland bereit für die elektronische Patientenakte (ePA). Chief Digital Officer Dr. Peter Gocke und Projektleiterin Dr. Julia Kallenberg erläutern die klinikweite Einführung.
Forschungsprojekt DAIOR: KI auf Reisen
Authors: Kucera Martin
Published: April 2024

Ein deutsch-französisches Forschungsprojekt entwickelt derzeit KI-Modelle, die anhand lokaler Analysen von chirurgischen Daten trainiert werden. Daraus entstehende Assistenzsysteme können künftig nicht nur Operationen unterstützen, sondern auch roboterassistierte Telechirurgie in Echtzeit ermöglichen.
Telemedizin: Wenn der Arzt aus der Ferne „mithört“
Authors: Lang Michael
Published: April 2024

Auf der Fachmesse CES 2024 wurde ein Telemedizingerät vorgestellt, mit dem Patientinnen und Patienten zu Hause – allein oder während einer Telekonsultation – vier verschiedene Messungen durchführen können. Der Hersteller plant, den behandelnden Ärzten die Daten über die Telematikinfrastruktur (TI) zur Verfügung zu stellen.
Versorgung: Der Hürdenlauf zur Teleradiologie
Authors: Ghadamgahi Ehssan
Published: April 2024

Dank teleradiologischer Einrichtungen ist eine Befundung von CT-, MRT- oder Röntgenuntersuchungen rund um die Uhr möglich. Was es bei der Suche für einen geeigneten Anbieter zu beachten gilt.
Digitale Innovationen: Gesundheitswesen auf der Überholspur
Authors: Heeser Alexandra
Published: April 2024

Egal ob KI zur Hautkrebserkennung oder Digitaler Zwilling – KI und Robotik halten auch im Gesundheitswesen Einzug, sollen Ärzte und Pflegekräfte entlasten und können das Gesundheitswesen nachhaltig verändern.
Umfrage: Cybersicherheit an Deutschlands Kliniken
Authors: Engberg Anna
Published: April 2024

Die Zahl der Cyberangriffe an deutschen Krankenhäusern steigt: Wie steht es aktuell um die IT-Sicherheit? kma hat sich bei den CIOs, IT- und Sicherheitsbeauftragten umgehört – auch denjenigen, die zuletzt Vorfälle hatten. Die Umfrage verrät, was in puncto Cybersecurity jetzt zu tun ist.
Erster Hybrid-DRG-Katalog: Nagen am Brot-und-Buttergeschäft
Authors: Pabst Inga
Published: April 2024

Mit der Hybrid-DRG-Einführung hat Prof. Karl Lauterbach dem deutschen Gesundheitssystem einen Ambulantisierungsbooster verordnet. Eine Vielzahl von Baustellen ist damit eröffnet. Den Kliniken reißen sie die Mischkalkulation auseinander; für die Abrechnung der Fälle fehlen sämtliche Voraussetzungen.
Energiemanagement: Diese Kliniken machen die Energiewende vor
Authors: Hofmann Lisa-Marie
Published: April 2024

Zwischen hohen Preisen, einem hohen Verbrauch und wenig Sicherheit baut sich für die Kliniken bei der Energieversorgung ein schwieriges Handlungsfeld auf. kma hat vier Häuser befragt, wie sie mit dem wachsenden Druck im Energiemanagement umgehen und welche Maßnahmen ihnen Stabilität geben.
Ausfallmanagement: Springerpools: Win-Win für beide Seiten
Authors: Heeser Alexandra
Published: April 2024

Täglich neue Ausfälle sowie Ärger mit kostenintensiven Leasingfirmen treiben immer mehr Kliniken an, selbst mit Springerpools ihr Ausfallmanagement in die Hand zu nehmen. kma hat sich an Unikliniken umgehört.