bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nach der Strukturreform der ambulanten Psychotherapie zeigen sich vor
allem in jüngeren Altersgruppen Effekte
Authors: Müller Doreen , Erhart Michael , Tillmanns Hanna , Dräther Hendrik , Klipker Kathrin 
Published: November 2021

Zusammenfassung
Ziel der Studie Die Strukturreform der ambulanten Psychotherapie im Jahr 2017
hatte zum Ziel, den Zugang zu einer Richtlinien-Psychotherapie zu erleichtern
und zu flexibilisieren. Die vorliegende Arbeit untersucht, ob nach der Reform
mehr Personen Zugang zur ambulanten Psychotherapie finden, und welche
Behandlungspfade sie dabei in Anspruch nehmen.
Methodik Die bundesweiten
Routinedaten der AOK-Gemeinschaft dienen als Datengrundlage. Aus 2 Kohorten
(2016 und 2019) werden nach Alter und Geschlecht unterteilt Versicherte mit
einer neu auftretenden Psychotherapie indizierenden Diagnose identifiziert.
Anschließend wird geprüft, inwieweit diese Versicherten eine
Behandlung im Rahmen der Richtlinien-Psychotherapie erhalten und welche
Behandlungselemente dabei in Anspruch genommen werden.
Ergebnisse Nach der Reform
erhalten prozentual mehr Versicherte mit einer inzidenten psychischen
Störung eine Behandlung nach der Psychotherapie-Richtlinie. Innerhalb
der weiblichen Versichertenpopulation ist die Inanspruchnahme höher. Am
stärksten ausgeprägt ist der Anstieg bei Jugendlichen und jungen
Erwachsenen. Die neu eingeführten Leistungen der psychotherapeutischen
Sprechstunde und Akutbehandlung werden in großem Umfang
angenommen.
Schlussfolgerungen Die Ergebnisse weisen darauf hin, dass die Reform
das Ziel, den Zugang zur ambulanten Psychotherapie zu erleichtern, zumindest in
einigen Bevölkerungsgruppen nähergebracht hat. Zudem scheint die
neue Leistung der psychotherapeutischen Sprechstunde nun einen zuvor nicht
explizit in den Gebührenordnungspositionen berücksichtigten
psychotherapeutischen Beratungsbedarf abzudecken.
Prescription rates of common medications in patients with decompensated cirrhosis in Germany
Authors: Labenz Christian , Kostev Karel , Galle Peter Robert , Wörns Marcus-Alexander , Schattenberg Jörn M. 
Published: November 2021

Abstract
Background Adequate pharmacological treatment is of pivotal importance to improve prognosis in patients with decompensated liver cirrhosis. We studied the adherence to recommended pharmacological treatments as secondary prevention in cirrhotic patients following a first decompensation in German primary care.
Methods Using the Disease Analyzer Database, the current study sample included patients with liver cirrhosis who had an initial diagnosis of a first decompensation event between 2015 and 2018 (index date) and a follow-up time of at least 6 months after the index date. Pharmacological treatments following the 6 months after the index date were studied.
Results The study included 1538 patients with a first decompensation event. The frequency of first-time complications of cirrhosis was 60% new onset of ascites, 25% overt hepatic encephalopathy (HE), 3% spontaneous bacterial peritonitis (SBP), and 12% acute variceal bleeding. The adherence to guideline-recommended treatment following the initial decompensation was highest for ascites, with 91.3% of patients receiving diuretics. Non-selective beta-blockers following an event of variceal bleeding were prescribed in 69.1% and lactulose and/or rifaximin in 59.1% after a bout of HE. The frequency of prescriptions of antibiotics after SBP was 60.4%. Potenzially harmful prescribed medications included non-steroidal anti-inflammatory drugs in 15.5%, benzodiazepines in 12.8%, opioids in 9.5%, and proton pump inhibitors in 73.7%.
Conclusion Our findings underline the need for intensified efforts to distribute practice guidelines for liver cirrhosis and increase awareness of over-prescribing of potentially harmful medication.
Operationsindikationen bei Tumoren der Bauchspeicheldrüse
Authors: Brunner Maximilian , Belyaev Orlin , Bösch Florian , Keck Tobias , Witzigmann Helmut , Grützmann Robert , Uhl Waldemar , Werner Jens 
Published: November 2021

ZusammenfassungAufgrund einer steigenden Inzidenz nehmen Pankreasneoplasien, welche hauptsächlich Adenokarzinome, neuroendokrine und zystische Neoplasien umfassen, im klinischen Alltag eine zunehmende Relevanz ein.Auf Grundlage einer systematischen Literaturrecherche wurden von Pankreasexperten im Auftrag der DGAV zur Verbesserung der Indikationsqualität evidenzbasierte Empfehlungen zur Indikationsstellung bei Pankreasneoplasien erarbeitet.Eine eindeutige Operationsindikation besteht bei primär oder sekundär resektablen Pankreaskarzinomen ohne Metastasierung, bei funktionell aktiven sowie über 2 cm großen funktionell inaktiven neuroendokrinen Neoplasien und bei symptomatischen oder malignitätsverdächtigen zystischen Pankreasneoplasien einschließlich intraduktaler papillär-muzinöser Neoplasien (IPMN) vom Hauptgang und vom Mischtyp, muzinös-zystischer Neoplasien (MCN) > 4 cm und solid pseudopapillärer Neoplasien (SPN). Eine Operation kann bei Pankreaskarzinomen mit isolierter arterieller Gefäßinfiltration oder über längere Zeit stabiler Oligometastasierung im Rahmen von neuroendokrinen Neoplasien zur Metastasen- oder Debulkingchirurgie sowie bei Seitengang-IPMN mit Risikokriterien und MCN < 4 cm indiziert sein. Keine primäre Operationsindikation ergibt sich bei lokal fortgeschrittenen und metastasierten Pankreaskarzinomen oder serös-zystischen Neoplasien (SCN).Insgesamt sollte die Operationsindikationsstellung individualisiert unter Berücksichtigung von Alter, Komorbiditäten und Patientenwunsch erfolgen.
Access to Chiral 1-Aminoindene Derivatives by Asymmetric Brønsted Acid Catalysis
Authors: Wu Xiang 
Published: November 2021

AbstractAsymmetric organocatalysis is emerging as an elegant tool for accelerating chemical reactions and creating specific types of molecules. Chiral Brønsted acid catalysis is an important area of organocatalysis. We recently described an intramolecular iminium-ion cyclization reaction of 2-alkenylbenzaldimines catalyzed by a chiral Brønsted acid (a BINOL-derived N-triflylphosphoramide) for the synthesis of chiral 1-aminoindenes and tetracyclic 1-aminoindanes in good yields and high enantioselectivities. One of the resulting 1-aminoindenes is a useful intermediate for the synthesis of (S)-rasagiline, an effective drug for the symptomatic treatment of Parkinson’s disease. Moreover, some tetracyclic 1-aminoindanes are present in the skeletons of homoisoflavanoid natural products such as brazilin.
Effectiveness and adverse events of endoscopic clipping versus band ligation for colonic diverticular hemorrhage: a large-scale multicenter cohort study
Authors: Kobayashi Katsumasa , Nagata Naoyoshi , Furumoto Yohei , Yamauchi Atsushi , Yamada Atsuo , Omori Jun , Ikeya Takashi , Aoyama Taiki , Tominaga Naoyuki , Sato Yoshinori , Kishino Takaaki , Ishii Naoki , Sawada Tsunaki , Murata Masaki , Takao Akinari , Mizukami Kazuhiro , Kinjo Ken , Fujimori Shunji , Uotani Takahiro , Fujita Minoru , Sato Hiroki , Suzuki Sho , Narasaka Toshiaki , Hayasaka Junnosuke , Kaise Mitsuru ,   CODE BLUE-J study collaborators
Published: November 2021

Abstract
Background Prior studies have shown the effectiveness of both endoscopic band ligation (EBL) and clipping for colonic diverticular hemorrhage (CDH) but have been small and conducted at single centers. Therefore, we investigated which was the more effective and safe treatment in a multicenter long-term cohort study.
Methods We reviewed data for 1679 patients with CDH who were treated with EBL (n = 638) or clipping (n = 1041) between January 2010 and December 2019 at 49 hospitals across Japan (CODE BLUE-J study). Logistic regression analysis was used to compare outcomes between the two treatments.
Results In multivariate analysis, EBL was independently associated with reduced risk of early rebleeding (adjusted odds ratio [OR] 0.46; P < 0.001) and late rebleeding (adjusted OR 0.62; P < 0.001) compared with clipping. These significantly lower rebleeding rates with EBL were evident regardless of active bleeding or early colonoscopy. No significant differences were found between the treatments in the rates of initial hemostasis or mortality. Compared with clipping, EBL independently reduced the risk of needing interventional radiology (adjusted OR 0.37; P = 0.006) and prolonged length of hospital stay (adjusted OR 0.35; P < 0.001), but not need for surgery. Diverticulitis developed in one patient (0.16 %) following EBL and two patients (0.19 %) following clipping. Perforation occurred in two patients (0.31 %) following EBL and none following clipping.
Conclusions Analysis of our large endoscopy dataset suggests that EBL is an effective and safe endoscopic therapy for CDH, offering the advantages of lower early and late rebleeding rates, reduced need for interventional radiology, and shorter length of hospital stay.
Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
Authors: Lodha Piyush , Srinivas P Rao , Danda Vijay Sheker Reddy , Rao Gollapudi Prakash 
Published: November 2021

AbstractAbscess formation within a Rathke's cleft cyst (RCC) is extremely rare, particularly at a young age. We report the case of a young girl with abscess formation in RCC. A 21-year-old female presented with headache, vomiting, visual deterioration and features suggestive of hypopituitarism. She had bitemporal hemianopia with impairment of visual acuity. MRI revealed a cystic lesion in the sella with suprasellar extension and peripheral rim enhancement. On the basis of history and imaging, this was indistinguishable from more commonly encountered pituitary pathology. She underwent transsphenoidal decompression, which revealed yellowish purulent material that when cultured grew Staphylococcus epidermidis. Histological examination revealed numerous neutrophils and cyst wall lining with features characteristic of RCC. Postoperatively, she received antibiotics and replacement therapy for hypopituitarism. Three months later, she experienced deterioration in visual fields. Considering persistent disease, she underwent redo surgery which revealed similar findings. Postsurgery, pituitary MRI revealed an empty sella syndrome. Thereafter, follow-up for 1 year was stable with permanent diabetes insipidus and multiple pituitary hormone deficiency on supplementation. Although uncommon, we recommend considering RCC abscess as a differential diagnosis of a pituitary mass lesion, as predicting its presence can be difficult preoperatively. Persistent or recurrent disease is common in these cases, so timely diagnosis and adequate surgical drainage leads to lower morbidity and mortality.
A Co-morbid Condition of Warts and Vitiligo Treated with Individualized Homeopathy: An Evidence-Based Case Report
Authors: Prusty Akhyaya Kumar , Bhandari Preeti 
Published: November 2021

AbstractBackground Whilst warts and vitiligo are both common skin diseases, their co-morbidity is rare. Here we present a clinical case of warts with vitiligo to illustrate the utility of individualized homeopathic treatment.Method The homeopathic medicine Sepia officinalis was prescribed, based on individualization. During follow-up, changes were documented by photographs. The non-invasive methods ORIDL (Outcome Related to Impact on Daily Living), VASI (Vitiligo Area and Scoring Index), and VETF (Vitiligo European Task Force) were used to assess treatment progress. Possible causal attribution of outcome with treatment was evaluated using the Modified Naranjo Criteria for Homeopathy (MONARCH).Result There was a marked improvement of vitiligo, along with the disappearance of warts, as evidenced photographically. VASI and VETF scores were significantly reduced. Main complaints, as well as overall well-being, improved on the ORIDL scale (+3). The MONARCH score (+9) suggested that the clinical improvement was attributable to the homeopathic intervention.Conclusion The study suggests a significant role for individualized homeopathic treatment in the co-morbidity of warts and vitiligo.
Hemi-Clamshell Approach for Fetal Lung Interstitial Tumor Resection in a Neonate: A Case Report
Authors: Kuroda Yasuhiro , Fukuzawa Hiroaki , Kawahara Insu , Morita Keiichi 
Published: November 2021

AbstractFetal lung interstitial tumor (FLIT) is a rare primary lung mass in neonates. Classical incisions, such as posterolateral thoracotomy or median sternotomy, do not provide optimal exposure of the operative field for the resection of pediatric thoracic giant tumors. Herein, we report a rare case of a FLIT in a full-term male neonate, with complete resection achieved using a hemi-clamshell approach, which provided the required visualization of the operative field. The neonate was transferred to our hospital because of mild respiratory distress, which developed 18-hour after normal vaginal delivery. A mass in his right chest, without a midline shift, was observed on chest radiographs. Computed tomography showed a well-circumscribed solid anterior cervicothoracic mass, with a uniform density and no apparent cysts, diagnosed as a primary thoracic giant tumor. Once the patient was clinically stabilized, we proceeded with right upper lobectomy, using a hemi-clamshell approach, full sternotomy, and anterolateral thoracotomy, on postnatal day 22.Histopathologic examination revealed an 8.5 × 6.5 × 4.0 cm solid mass within the right upper lobe, which was diagnosed as a FLIT. His postoperative recovery was uneventful. The patient was followed up for 1 year, with no complaints or symptoms and no postoperative shoulder dysfunction. Gross total resection of primary thoracic giant tumors can be accomplished in neonates with optimal exposure of the chest cavity using a hemi-clamshell approach.
Early Experience with Dabrafenib–Trametinib Combination in Patients with BRAF-Mutated Malignant Melanoma—A Single-Center Experience
Authors: Ganguly Sandip , Ghosh Joydeep , Mishra Deepak , Biswas Gautam , Dabkara Deepak , Roy Somanth , Biswas Bivas 
Published: November 2021

Abstract
Background Combination of dabrafenib–trametinib is one of the standard treatments in patients with BRAF-mutated advanced malignant melanoma (MM). Real-world data on the usage of this combination is scarce, especially from India. Here, we are reporting our early experience with the usage of this combination therapy.
Materials and Methods This is a single institutional data assessment of patients with BRAF-mutated MM registered and treated with BRAF–MEK inhibitors in our hospital. Clinico-pathological features and treatment details were reviewed for all patients.
Results A total of seven patients with BRAF-mutated MM treated with this combination therapy with a median age of 66.5 years (range: 49–72 years) and a male:female ratio of 3:4. Six (85.7%) patients had metastatic disease at presentation. In total, 80% of our patient population had two or less than two sites of metastasis at presentation. The initial response rate of the study population was 71%. The drug was well tolerated with fever being the most common side effect which was seen in two (28.5%) of the patients.
Conclusion Combination of dabrafenib–trametinib is effective in patients with BRAF-mutated MM with good tolerability. Further studies are required to look for improvement in outcome in this group of patients.
Musculoskeletal Interventions: A Review on Genicular Artery Embolization
Authors: Sajan Abin , Bagla Sandeep , Isaacson Ari 
Published: November 2021

AbstractSymptomatic knee pain is one of the most common joint diseases that affects millions of people worldwide. The treatment for knee pain secondary to osteoarthritis (OA) begins with conservative therapy and progresses to surgical intervention when conservative therapy fails. Genicular artery embolization (GAE) offers an alternative option for patients who are poor surgical candidates. Multiple studies have been conducted worldwide demonstrating the safety and efficacy of GAE in patients with mild to moderate OA. The purpose of this article is to describe the current literature on GAE and highlight the latest findings from a randomized controlled trial comparing GAE versus sham embolization.
Endovascular Arteriovenous Fistula Creation: A Review
Authors: Tyagi Ravi , Ahmed S. Samaduddin , Navuluri Rakesh , Ahmed Osman 
Published: November 2021

AbstractEndovascular arteriovenous fistula (endoAVF) creation offers a minimally invasive method for the formation of arteriovenous shunts utilized for hemodialysis. Currently, there exist two similar yet unique devices: WavelinQ and Ellipsys. This review analyzes the anatomy, pre- and postoperative considerations, fistula creation methods, and outcomes associated with endoAVF. Currently, data are limited with regard to clinical efficacy of endoAVFs when compared to surgical AVFs. However, early data suggest endoAVFs are a useful technique in the creation of AVFs.
Image-Guided Robotics for Standardized and Automated Biopsy and Ablation
Authors: Christou Anna S. , Amalou Amel , Lee HooWon , Rivera Jocelyne , Li Rui , Kassin Michael T. , Varble Nicole , Tsz Ho Tse Zion , Xu Sheng , Wood Bradford J. 
Published: November 2021

AbstractImage-guided robotics for biopsy and ablation aims to minimize procedure times, reduce needle manipulations, radiation, and complications, and enable treatment of larger and more complex tumors, while facilitating standardization for more uniform and improved outcomes. Robotic navigation of needles enables standardized and uniform procedures which enhance reproducibility via real-time precision feedback, while avoiding radiation exposure to the operator. Robots can be integrated with computed tomography (CT), cone beam CT, magnetic resonance imaging, and ultrasound and through various techniques, including stereotaxy, table-mounted, floor-mounted, and patient-mounted robots. The history, challenges, solutions, and questions facing the field of interventional radiology (IR) and interventional oncology are reviewed, to enable responsible clinical adoption and value definition via ergonomics, workflows, business models, and outcome data. IR-integrated robotics is ready for broader adoption. The robots are coming!
Genetic Evidence for Congenital Vascular Disorders in Patients with VACTERL Association
Authors: Ritter Jessica , Lisec Kristina , Heinrich Martina , von Schweinitz Dietrich , Kappler Roland , Hubertus Jochen 
Published: November 2021

Abstract
Introduction The VACTERL association is a rare malformation complex, showing at least three anomalies of the following organ systems: vertebra, anorectum, heart and vessels, trachea and esophagus, genitourinary tract, and limbs. In addition to a multifactorial event, congenital vascular disorders are also discussed as triggers for the VACTERL association. The aim of this study was to determine whether there is a genetic background for vascular disorders triggering VACTERL association.
Materials and Methods We performed a functional analysis on whole exome sequencing data of 21 patients with VACTERL or VACTERL-like phenotype using the online analysis tool “Database for Annotation, Visualization and Integrated Discovery (DAVID) v6.8.” The study was approved by the institutional ethics committee (approval no. 026–13). Written informed consent was obtained from all patients or their parents.
Results We identified a total of 86 genetic variants (in 75 genes) classified as damaging (including probably damaging missense, nonsense, and frameshift variants), which are associated to cardiovascular development. Each investigated patient showed at least one damaging variant in genes associated to cardiovascular development. These variants were further reduced by significance in cardiovascular development to 39 genetic variants (in 33 genes). Of note, a pair of siblings, both presenting with cardiac and renal defects, had the same damaging variant in two different genes.
Conclusion Our results indicate a genetic background for congenital vascular disorders in patients with VACTERL association. In line with the literature, our data suggest that genetic mutation led to vascular diseases, which in turn may cause malformations similar to the VACTERL association.
Clinician and Health Care Leaders' Experiences with—and Perceptions of—COVID-19 Documentation Reduction Policies and Practices
Authors: Moy Amanda J. , Schwartz Jessica M. , Withall Jennifer , Lucas Eugene , Cato Kenrick D. , Rosenbloom S. Trent , Johnson Kevin , Murphy Judy , Detmer Don E. , Rossetti Sarah Collins 
Published: November 2021

Abstract
Background Substantial strategies to reduce clinical documentation were implemented by health care systems throughout the coronavirus disease-2019 (COVID-19) pandemic at national and local levels. This natural experiment provides an opportunity to study the impact of documentation reduction strategies on documentation burden among clinicians and other health professionals in the United States.
Objectives The aim of this study was to assess clinicians' and other health care leaders' experiences with and perceptions of COVID-19 documentation reduction strategies and identify which implemented strategies should be prioritized and remain permanent post-pandemic.
Methods We conducted a national survey of clinicians and health care leaders to understand COVID-19 documentation reduction strategies implemented during the pandemic using snowball sampling through professional networks, listservs, and social media. We developed and validated a 19-item survey leveraging existing post-COVID-19 policy and practice recommendations proposed by Sinsky and Linzer. Participants rated reduction strategies for impact on documentation burden on a scale of 0 to 100. Free-text responses were thematically analyzed.
Results Of the 351 surveys initiated, 193 (55%) were complete. Most participants were informaticians and/or clinicians and worked for a health system or in academia. A majority experienced telehealth expansion (81.9%) during the pandemic, which participants also rated as highly impactful (60.1–61.5) and preferred that it remain (90.5%). Implemented at lower proportions, documenting only pertinent positives to reduce note bloat (66.1 ± 28.3), changing compliance rules and performance metrics to eliminate those without evidence of net benefit (65.7 ± 26.3), and electronic health record (EHR) optimization sprints (64.3 ± 26.9) received the highest impact scores compared with other strategies presented; support for these strategies widely ranged (49.7–63.7%).
Conclusion The results of this survey suggest there are many perceived sources of and solutions for documentation burden. Within strategies, we found considerable support for telehealth, documenting pertinent positives, and changing compliance rules. We also found substantial variation in the experience of documentation burden among participants.