bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risikoanalyse gastroenterologischer Endoskopien durch Routinedaten am Beispiel der Endoskopischen Retrograden Cholangio-Pankreaticographie (ERCP)
Authors: Frieling Thomas , Cools Andre , Leuwer Rudolf 
Published: November 2021

Zusammenfassung
Hintergrund Die vorliegende Arbeit untersucht die Auswertung von Routinedaten im Rahmen der Qualitätssicherung anhand der ERCP von einem Maximalversorger über 5 Jahre.
Methode In einer retrospektiven Beobachtungsstudie wurden Routinedaten gemäß § 21 KHEntgG verwendet. Diese Daten können pseudonymisiert bezüglich definierter Indikatoren für alle Krankenhäuser gesamt oder nach Rückverschlüsselung und Identifizierung der Fälle für jedes Krankenhaus zurückverfolgt werden. Hierbei können die Indikatoren aus Kombinationen von Diagnose- bzw. OPS-Ziffern gewählt werden. In der Studie wurde die Häufigkeit der Kombinationen von ERCP mit Pankreatitis (Zähler) im Verhältnis der ERCP gesamt ohne diesen Parameter (Nenner) des Helios-Klinikums Krefeld für die Jahre 2016 bis 2020 untersucht. Die Datenrekrutierung erfolgte durch 3M Deutschland. Die Depseudonymisierung der Daten wurde durch Helios durchgeführt. Die Daten wurden absolut, in Prozent bzw. Mittelwert + Standardabweichung und Spanne dargestellt.
Ergebnisse Insgesamt wurden am Helios-Klinikum Krefeld von 2016 bis 2020 bei 1.521 Patienten ERCPs mit 4.981 Prozeduren inkl. 688 Papillotomien durchgeführt. Es wurden insgesamt 47 Männer und 52 Frauen mit ERCP-assoziierter Pankreatitis und 718 Männer und 504 Frauen mit ERCP ohne assoziierter Pankreatitis erfasst. In 30–70% wurde die Untersuchung nach einer Notfallaufnahme durchgeführt. Bei den 99 Patienten mit der Kombination von ERCP und Pankreatitis entwickelten 41% der Patienten die Pankreatitis nach (n=41) und 59% der Patienten die Pankreatitis bereits vor der ERCP (n=58). In beiden Gruppen war die Rate an Notfallaufnahmen bzw. Papillotomien vergleichbar (25–83%). Alle post-ERCP-Pankreatitiden traten innerhalb von 12 Stunden postinterventionell auf. Der Krankheitsverlauf der ERCP-induzierten Pankreatitis (n=41) war bei den meisten Patienten leicht. In 30 Fällen trat eine ödematöse und in 9 Fällen eine exsudative Pankreatitis auf. In 2 Fällen entwickelte sich eine nekrotisierende Pankreatitis, an deren Folgen ein Patient im Verlauf verstarb.
Schlussfolgerung Unsere Ergebnisse zeigen, dass die Analyse pseudonymisierter Routinedaten relativ einfach die Abschätzung der Komplikationsraten von elektiven ERCPs, auch mit Intervention an der naiven Papille, ermöglicht. Dies trifft wahrscheinlich auch für andere endoskopische Leistungen zu. Zur Aufrechterhaltung der Qualität ist in einem ambulanten Setting die Überwachung in einer interdisziplinären Tagesklinik mit Anbindung an ein Krankenhaus und endoskopischem Hintergrunddienst notwendig.
Diabetes und Fettleber
Authors: Stefan Norbert , Roden Michael 
Published: November 2021

ZUSAMMENFASSUNGDie nichtalkoholische Fettlebererkrankung (nonalcoholic fatty liver disease, NAFLD) betrifft weltweit mehr als 25 % der erwachsenen Bevölkerung. Mit etwa 70 % ist die Häufigkeit der NAFLD besonders hoch bei Menschen mit Adipositas und/oder Typ-2-Diabetes. Deshalb gilt es vor allem bei Menschen mit Typ-2-Diabetes nach dem Vorliegen einer NAFLD und vor allem nach dem Schweregrad der NAFLD zu fahnden und die Therapie entsprechend zu planen. Zur Diagnose der NAFLD werden zurzeit die Ultraschalluntersuchung, die Protonen-Magnetresonanzspektroskopie (MRS) und die MR-Bildgebung (MR-Imaging, MRI) herangezogen. Gibt es keine Hinweise für diese Erkrankungen, dann liegt sehr häufig eine NAFLD vor. An erster Stelle der Therapie der NAFLD und der Prävention ihrer Progression steht die Lebensstilmodifikation im Sinne einer kalorienreduzierten ausgewogenen Ernährung und einer Erhöhung der körperlichen Aktivität. Bariatrische Chirurgie ausgeprägter Adipositas bzw. moderater Adipositas und Typ-2-Diabetes bewirkt parallel zur Gewichtsabnahme eine ausgeprägte Verminderung des Leberfettgehalts. Bislang ist noch keine pharmakologische Therapie der NAFLD zugelassen. Falls ein Typ-2-Diabetes vorliegt, kann man aber gezielt Medikamente zur Therapie des Diabetes einsetzen, um auch die NAFLD zu behandeln.
Effect of an artificial intelligence-based quality improvement system on efficacy of a computer-aided detection system in colonoscopy: a four-group parallel study
Authors: Yao Liwen , Zhang Lihui , Liu Jun , Zhou Wei , He Chunping , Zhang Jun , Wu Lianlian , Wang Hongguang , Xu Youming , Gong Dexin , Xu Ming , Li Xun , Bai Yutong , Gong Rongrong , Sharma Prateek , Yu Honggang 
Published: November 2021

Background Tandem colonoscopy studies have found that about one in five adenomas are missed at colonoscopy. It remains debatable whether the combination of a computer-aided polyp detection (CADe) system with a computer-aided quality improvement (CAQ) system for real-time monitoring of withdrawal speed results in additional benefits in adenoma detection or if the synergetic effect may be harmed due to excessive visual burden resulting from information overload. This study aimed to evaluate the interaction effect on improving the adenoma detection rate (ADR).
Methods This single-center, randomized, four-group, parallel, controlled study was performed at Renmin Hospital of Wuhan University. Between 1 July and 15 October 2020, 1076 patients were randomly allocated into four treatment groups: control 271, CADe 268, CAQ 269, and CADe plus CAQ (COMBO) 268. The primary outcome was ADR.
Results The ADR in the control, CADe, CAQ, and COMBO groups was 14.76 % (95 % confidence interval [CI] 10.54 to 18.98), 21.27 % (95 %CI 16.37 to 26.17), 24.54 % (95 %CI 19.39 to 29.68), and 30.60 % (95 %CI 25.08 to 36.11), respectively. The ADR was higher in the COMBO group compared with the CADe group (21.27 % vs. 30.6 %, P = 0.024, odds ratio [OR] 1.284, 95 %CI 1.033 to 1.596) but not compared with the CAQ group (24.54 % vs. 30.6 %, P = 0.213, OR 1.309, 95 %CI 0.857 to 2.000, respectively).
Conclusions CAQ significantly improved the efficacy of CADe in a four-group, parallel, controlled study. No significant difference in the ADR or polyp detection rate was found between CAQ and COMBO.
The Effect of Size of Decompressive Craniectomy on Outcome in Deep Spontaneous Intracerebral Hemorrhage
Authors: Kode Sashanka , Hegde Ajay , Menon Girish R. 
Published: November 2021

AbstractIntroduction Spontaneous intracerebral hemorrhage (SICH) is one of the most devastating forms of stroke with a mortality of 30 to 40%. We aimed to evaluate the effect of craniotomy size and volume of decompression on surgical outcome, complications, mortality, and morbidity in patients with supratentorial capsuloganglionic bleeds who underwent a decompressive craniectomy (DC) at our institute.Materials and Methods It is a retrospective study done between January 2015 and December 2019. All patients with capsuloganglionic bleeds who had DC and hematoma evacuation were included in the study.Results A total of 55 patients underwent DC for SICH at our hospital during the study period. Mean anteroposterior (AP) diameter of the bone flap was 12.42 cm. The volume of decompression did not influence mortality and morbidity in our study but a larger AP diameter was associated with a higher incidence of hydrocephalus. A smaller craniectomy with an AP diameter of < 12 cm caused a lesser reduction in midline shift (MLS). Persistent postoperative MLS had a significant impact on mortality and its reduction was dependent on the size of craniectomy (p =–0.037)Conclusion DC with a recommended AP diameter of 12 to 13 cm achieves optimal results in terms of reduction in MLS. Larger DC volume carries a higher risk of hydrocephalus and requires close follow-up.
Evaluation and Impact of ASPIRE: An Interactive Tobacco Prevention Curriculum among University Students in India
Authors: Vishwakarma Gayatri , Singh Sohini , Marani Salma K , Arya Ashish , Calabro Karen , Gupta Garima , Mehta Anurag , Alexander V. 
Published: November 2021

AbstractOnline education approach provides innovative opportunities for engaging youths. Web-based, multimedia smoking prevention programs have been tested in high-income countries; however, efficacy of such programs is not well-investigated in low- and middle-income countries. The aim of this study was to evaluate the impact of A Smoking Prevention Interactive Experience (ASPIRE), an interactive tobacco prevention curriculum, among university students in India.A single-subject cohort study where each subject serves as their own control was conducted among university student participants engaged in ASPIRE, 60 minutes per week for five consecutive weeks during July to August of 2019. Assessments were conducted at baseline and immediately after exposure to ASPIRE. To evaluate the program, a structured instrument was specifically designed to measure the outcomes.A total of 103 university students participated voluntarily. Average age of the participants was 18.3±0.9 ranging from 17 to 20 years. Eighteen percent of students were curious to know about the various smoking products. More males were more susceptible to cigarette smoking as compared to females. The majority of participants felt that ASPIRE was culturally appropriate for young adults in India, but a modified version targeted toward Indian youth would be more acceptable. Pre- to postintervention knowledge of tobacco-related hazards increased from 70 to 97% (p < 0.001).ASPIRE, a multimedia interactive program, demonstrated its considerable potential to discourage smoking initiation among Indian youth.
Primary Segmental Small Bowel Volvulus in an Adolescent Female
Authors: Heidtmann Friederike , Eckoldt Felicitas , Mentzel Hans-Joachim , Alhussami Ilmi 
Published: November 2021

AbstractSmall bowel volvulus is a rare but important cause of abdominal pain and small bowel obstruction in children and adults. In the neonate, small bowel volvulus is a well-known complication of malrotation. Segmental small bowel volvulus is a lesser-known condition, which occurs in children and adults alike and can rapidly progress to bowel ischemia. Primary segmental small bowel volvulus occurs in the absence of rotational anomalies or other intraabdominal lesions and is rare in Europe and North America. Clinical presentation can be misleading, causing a delay in diagnosis and treatment, in which case the resection of necrotic bowel may become necessary.We report on a 14-year-old girl who presented with severe colicky abdominal pain but showed no other signs of peritoneal irritation or bowel obstruction. An emergency magnetic resonance imaging was highly suspicious for small bowel volvulus. Emergency laparotomy revealed a 115 cm segment of strangulated distal ileum with no underlying pathology. We performed a detorsion of the affected bowel segment. Despite the initial markedly ischemic appearance of the affected bowel segment, the patient achieved full recovery without resection of bowel becoming necessary.
Cephalometric Analysis, Severity Malocclusion, and Orthodontic Treatment Need Using IOTN in Deaf Children
Authors: Prameswari Noengki , Herniyati Herniyati , Sucahyo Bambang , Brahmanta Arya , Syahdinda Meralda Rossy 
Published: November 2021

Abstract
Objectives Studies associated with deaf children's malocclusion and their treatment need are still very rare. Therefore, cephalometric analysis with the ability to access the skeletal, dental, and soft tissues can be used to score the severity of malocclusion and index of orthodontic treatment need (IOTN) in deaf children. This study examined the use of cephalometric analysis, severity malocclusion, and orthodontic treatment need in deaf students at special need school type B (SLB-B) Tunarungu Karya Mulia in Surabaya using IOTN along with investigating IOTN correlation with the result of dental cephalometric analysis and dental health component (DHC) and aesthetic component (AC) in IOTN index.
Material and Methods Sample data consisted of 33 students between the ages of 8 to 12 years old and never had any orthodontic treatment. This investigation applied the indices from IOTN, in which DHC had 10 malocclusions, and AC with the aesthetic anterior dentition comprising 10 color photographs and different dental attractiveness levels. In addition, scores were chosen from the worst feature, with the data analyzed at a significant correlation test of 0.05%.
Result There was no skeletal abnormality in deaf children. It displayed the highest number of malocclusion severity scores, while the DHC assessment showed the moderate and severe categories. Based on AC evaluation, the highest numbers of malocclusion severity were found in good and moderate category in terms of teeth arrangement and aesthetic.
Conclusion There was a correlation between the dental cephalometric analysis in deaf children and treatment need using IOTN with AC and DHC.
The Impact of the American Academy of Ophthalmology's Leadership Development Program: Experience from the First 20 Years
Authors: Tsai Linda M. , Schroth Holly A. , Schmidt Gail E. , Sternberg Paul 
Published: November 2021

Abstract
Objective This study aimed to analyze the effectiveness of the American Academy of Ophthalmology (AAO)'s Leadership Development Program (LDP), report the program's impact on participants in attaining ophthalmic leadership positions, and identify opportunities to improve future LDP programming.
Design An open cohort study was performed on AAO LDP graduates by using an online questionnaire and retrospective monitoring.
Participants and Methods AAO LDP graduates from 1999 to 2019 participated in the study. A Likert-scale survey was distributed via email. Online responses were submitted anonymously to a team at the Berkeley Haas School of Business for analysis. A separate review of gender demographics and ophthalmic leadership positions held by graduates was performed.
Main Outcomes Measures Regression analysis was performed to determine whether survey results supported a meaningful relationship between the measured impact and the AAO LDP program's perceived effectiveness. Ascension into leadership positions of AAO-related organizations at the national, regional, state, and subspecialty level by AAO LDP graduates was collated.
Results Of 381 potential respondents, 203 survey responses were returned (53.3%). 158 reported that they are currently holding a leadership position (77.8%). Statistical analyses indicated that the overall value of the program was seen as highly effective (M = 4.6), and that the development programs combined contributed significantly to AAO LDP being judged as effective overall, F (11,191) = 24.79; p < 0.001 with an R
2 of 0.59. Longitudinal tracking of the 383 graduates revealed that 268 (70.0%) have served as AAO committee/task force members, councilors, or representatives to outside organizations. A total of 242 (63.2%) graduates have served as president or chair of a state, subspecialty, or specialized interest ophthalmology society. 25 (6.5%) have served at the highest level of AAO leadership and two have been elected AAO President. A higher percentage of participants identifying as female was found in the LDP program compared with both U.S. overall and trainee ophthalmic populations.
Conclusion The AAO LDP has fulfilled its initial goals of effectively developing a large cohort of ophthalmologists interested in and prepared to take on leadership roles across the profession. Development of more specific outcome measures to evaluate the program, as well as direct optimal programming, are needed to further the success of its aims.
Global Health Curricula in Ophthalmology Residency Programs in the United States
Authors: Ponsetto Momoko K. , Siegel Nicole H. , Desai Manishi A. , LaMattina Kara C. 
Published: November 2021

Abstract
Objective The aim of the study is to investigate the design, content, and administration of global health curricula within ophthalmology residency programs in the United States (U.S.) and share the curriculum utilized in the Department of Ophthalmology at Boston University School of Medicine (BUSM).
Design A survey designed through the Association of University Professors in Ophthalmology platform was emailed to residency program directors at 106 accredited ophthalmology residency programs.
Setting BUSM Department of Ophthalmology, Boston, MA. Tertiary clinical care.
Participants Twenty-eight ophthalmology residency program directors responded, which represent 26% of the total number of residency programs in the United States. Twenty-seven programs fully completed the survey, and one program partially completed the survey.
Results Of the respondents, three programs do not include global health curricula. The most common curricular elements included are: lectures (n = 15, 60%); wet laboratories (n = 10, 40%); and journal clubs (n = 9, 36%). In terms of annual frequency, global health activities occur: twice a year (n = 12, 46%); less than once a year (n = 10, 39%); or every few months (n = 4, 15%). Fewer than half of programs (n = 10, 42%) incorporate local outreach at least once a year into their program. Twelve programs (48%) do not incorporate ethics-related topics, while the 13 remaining programs (52%) incorporate them at least once annually. The most common curricular topic is surgical techniques, with manual small incision cataract surgery (MSICS) being the most frequently emphasized (n = 17, 68%).
Conclusion A robust global health curricula combined with a hands-on international component can contribute to a well-rounded training experience. Many ophthalmology residency programs value the importance of incorporating global health into their residents' training. The most common elements of global health curricula in U.S. ophthalmology residency programs included are teaching of surgical techniques for resource-limited settings and international electives. Further investigation into the impact of different components of a global health curriculum on both resident experience and international partnerships is warranted.
Sepsis-Induced Myocardial Dysfunction in Pediatric Septic Shock: Prevalence, Predictors, and Outcome—A Prospective Observational Study
Authors: Swami Viresh S. , V. Lalitha A. , Ghosh Santu , Reddy Mounika 
Published: November 2021

AbstractThere is a paucity of literature on the prevalence, predictors, prognostic markers, and outcomes of sepsis-induced myocardial dysfunction (SMD) in pediatric septic shock. The objectives of our study were to estimate the prevalence of SMD in pediatric septic shock by point-of-care functional echocardiography (POCFE) and to study the association of SMD with severity of illness, organ dysfunctions, and outcomes. This prospective, observational study was conducted over a period of 1 year (from July 2018 to July 2019) in a 12-bed, tertiary pediatric intensive care unit (PICU) of an academic and referral hospital in South India. Children presenting with septic shock were enrolled in the study. POCFE was done within 6 hours of PICU admission and patients were categorized as having SMD based on POCFE findings. The prevalence of SMD (left ventricle ± right ventricle) was 32% (32/100). More than half of the children (54.5%) died in SMD group, whereas only 7.5% died in non-SMD group (p < 0.001). SMD was associated with higher organ dysfunctions, worse patient outcomes, and was found to be an independent predictor of mortality. The median lactate levels were higher in SMD group (3.15 [2.7, 5] vs. 2 [1.3, 2.7], p < 0.001) as compared with non-SMD group. We observed significantly lower median lactate clearance at 6 hours in SMD than non-SMD (30.0% [−14.44, 44.22] vs. 59.8% [45.83, 71.43], p < 0.001). Lactate levels at 6 hours with a threshold of 2.4 mmol/L was a good predictor of SMD with sensitivity and specificity of 73 and 80%, respectively. SMD is not an uncommon entity in children with septic shock. SMD was associated with worse patient outcomes, organ dysfunction, and mortality. Serum lactate trends may predict SMD and can be used as prognosticate markers as well.
Understanding the Basics of Commonly Used Wires in Interventional Radiology
Authors: Pandhi Mithil B. , Tyagi Ravi , Surabhi Divya , Shah Ketan Y. 
Published: November 2021

AbstractA wide variety of wires are available for use in interventional radiology, with wires demonstrating differences in construction, diameter, length, coating, shape, and taper. It is crucial to understand the difference in characteristics between these wires to select the most effective and safe wire for the intended purpose when undertaking a procedure. This article reviews the qualities and functions of different types of wires to aid in this decision-making process.
A Semi-Automated Term Harmonization Pipeline Applied to Pulmonary Arterial Hypertension Clinical Trials
Authors: Urbanowicz Ryan J. , Holmes John H. , Appleby Dina , Narasimhan Vanamala , Durborow Stephen , Al-Naamani Nadine , Fernando Melissa , Kawut Steven M. 
Published: November 2021

Abstract
Objective Data harmonization is essential to integrate individual participant data from multiple sites, time periods, and trials for meta-analysis. The process of mapping terms and phrases to an ontology is complicated by typographic errors, abbreviations, truncation, and plurality. We sought to harmonize medical history (MH) and adverse events (AE) term records across 21 randomized clinical trials in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.
Methods We developed and applied a semi-automated harmonization pipeline for use with domain-expert annotators to resolve ambiguous term mappings using exact and fuzzy matching. We summarized MH and AE term mapping success, including map quality measures, and imputation of a generalizing term hierarchy as defined by the applied Medical Dictionary for Regulatory Activities (MedDRA) ontology standard.
Results Over 99.6% of both MH (N = 37,105) and AE (N = 58,170) records were successfully mapped to MedDRA low-level terms. Automated exact matching accounted for 74.9% of MH and 85.5% of AE mappings. Term recommendations from fuzzy matching in the pipeline facilitated annotator mapping of the remaining 24.9% of MH and 13.8% of AE records. Imputation of the generalized MedDRA term hierarchy was unambiguous in 85.2% of high-level terms, 99.4% of high-level group terms, and 99.5% of system organ class in MH, and 75% of high-level terms, 98.3% of high-level group terms, and 98.4% of system organ class in AE.
Conclusion This pipeline dramatically reduced the burden of manual annotation for MH and AE term harmonization and could be adapted to other data integration efforts.