bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrale MALT-Lymphome
– von pathogenetischen Erkenntnissen zu konsequenter Deeskalation der Therapie
Authors: Fischbach Wolfgang 
Published: November 2021

ZusammenfassungDas gastrale MALT (mucosa-associated-lymphoid-tissue) -Lymphom ist das häufigste gastrointestinale Lymphom. Über Jahrzehnte hinweg galten zunächst die Operation und später Bestrahlung und Chemotherapie als etablierte Therapiestandards. Vor etwa 30 Jahren wurde die pathogenetische Bedeutung der Helicobacter-pylori-Infektion für die Entstehung des gastralen MALT-Lymphoms deutlich. In den folgenden Jahren wurden die pathogenetischen Erkenntnisse konsequent in die klinische Medizin umgesetzt. Dies hat zu einer radikalen Änderung der Therapie dieser Lymphome geführt. Heute ist international die Helicobacter-pylori-Eradikation als Therapie der ersten Wahl anerkannt. Sie führt in den meisten Fällen zu einer Lymphomregression. Die Langzeitprognose der Patienten nach alleiniger Eradikationsbehandlung ist exzellent, selbst dann, wenn endoskopische und/oder histologische Residuen bestehen bleiben und eine „Watch-and-wait“-Strategie gewählt wird.Die pathogenetischen Erkenntnisse und ihre klinische Anwendung haben zu einer konsequenten Therapiedeeskalation bei den gastralen MALT-Lymphomen geführt. Die vorliegende Übersicht zeigt die einzelnen Schritte dieser Entwicklung und gibt eine Empfehlung zum aktuellen Management von Patienten mit gastralen MALT-Lymphomen.
Current epidemiological trends and in-hospital mortality of acute pancreatitis in Germany: a systematic analysis of standardized hospital discharge data between 2008 and 2017
Authors: Loosen Sven H. , Essing Tobias , Jördens Markus , Koch Alexander , Tacke Frank , Knoefel Wolfram T. , Bode Johannes , Roderburg Christoph , Luedde Tom 
Published: November 2021

Abstract
Background Acute pancreatitis (AP) represents a common gastrointestinal disorder. Complicated disease courses in particular still represent a major clinical challenge and are associated with high mortality. Evaluation of existing data sets and their careful interpretation can support a rational discussion to optimize outcomes of this common gastrointestinal disease.
Methods We used standardized hospital discharge data provided by the Federal Statistical Office of Germany to evaluate hospital mortality and current developments of AP in Germany between 2008 and 2017.
Results In this analysis, 516,618 hospitalized AP cases were included. Main disease etiologies featured biliary (29.9%) and alcoholic (22.7%) AP. The annual frequency of AP increased from 48,858 (2008) to 52,611 (2017), mainly due to a rising incidence of biliary AP. Average hospital mortality was 2.85% and significantly improved over time. While uncomplicated AP had low hospital mortality (1.38%), the presence of organ complications was associated with a mortality of 12.34%. The necessity of mechanical ventilation dramatically increased hospital mortality to 44.06%. Hospital mortality was significantly higher in female patients (3.31%) than males (2.55%) and showed a stepwise increase with patient age. We further identified type 2 diabetes mellitus and obesity as factors associated with increased hospital mortality. Hospital mortality was lowest among patients treated at departments specializing in gastroenterology. Finally, high case volume centers (defined as >98 annual AP cases) had the lowest hospital mortality for patients with complicated courses of AP.
Conclusion With over 50,000 annual hospitalization cases, AP is one of the most important inpatient treatment indications in gastroenterology in Germany. Overall, AP mortality has improved in recent years, presumably due to improved interdisciplinary treatment concepts. In this study, we identified important clinical and epidemiological risk factors for an unfavorable course, which could help to improve risk prediction and triaging, and thus the management of AP.
A Chiral, Dendralenic C–H Acid
Authors: List Benjamin , Höfler Denis 
Published: November 2021

AbstractWe report the synthesis of a chiral dendralenic C–H acid, which contains three unsubstituted binaphthyl moieties. This motif and an achiral variant can be made from their corresponding bis(sulfone) precursors in one step. Despite the presence of the enantiopure binaphthyl backbone, the newly designed chiral C–H acid showed only poor enantioselectivity in a Mukaiyama aldol reaction. First attempts toward the synthesis of 3,3′-hexasubstituted binaphthyl-based dendralenic acids are also reported.
A Retrospective Clinicoradiologic Study of 126 Cerebellopontine Angle Tumors to Predict the Outcome of House–Brackmann Status to Prognosticate Them: A Single-Center Tertiary Care Perspective
Authors: Dhar Sambuddha , Sahu Anurag , Pal Barnava , Singh Kulwant 
Published: November 2021

Abstract
Introduction House–Brackmann (HB) grading had been described to quantify the facial nerve involvement in cerebellopontine angle (CPA) tumors, a very common tumor in neurosurgical practice. Very few studies have specifically looked into the factors predicting the facial nerve morbidity and its severity. Here, we try finding these while going through the clinicoradiologic factors and its natural course to help us prognosticate the patients.
Objective To analyze the size of tumor and duration of symptoms to predict the severity of HB status of facial nerve presentation and outcome, and to study the course of the disease to help prognosticate the patients with respect to facial nerve status.
Materials and Methods This was a retrospective analysis of 126 operated CPA tumors, where we studied the natural course of HB status with respect to size and duration of symptoms of patients at our institute between December 2016 to February 2020.
Results Average duration of symptoms were 33.8 days with increasing risk of HB outcome after 36 days of symptoms. All patients improved to their preoperative facial nerve status at 3 months and only 18 maintained the worsened HB status. Average size of tumor was 3.53 cm, and size higher than 3.8 cm was associated with poorer HB outcome.
Conclusion Although there can be a significant deterioration of HB status in immediate postoperative period, it improves to preoperative status in due time. Tumor larger than 3.8 cm and symptom duration more than 36 days are two important factors predicting poorer HB outcome.
Analysis of Factors Influencing the Long-term Outcome in Primary Spinal Cord Tumors: Review of Literature
Authors: Srinivasan Uddanapalli , Raghunathan Natarajan 
Published: November 2021

Abstract
Introduction Primary spinal cord tumors are amenable to total surgical excision but the outcomes are still diverse.
Objective The purpose of this study is to identify the significant factors which influence the long-term outcome of spinal cord tumors.
Materials and Methods A total of 84 consecutive spinal cord tumor patients who underwent microsurgical excision during April 2003 to 2014 were retrospectively studied. Patients operated after April 2014 were not considered. Ten factors were taken and correlated with the outcome. Multiple regression analysis was used. Patients were periodically evaluated at 1, 6 months, 1, 2, and 5 years. In 72 cases, postoperative MRI scans were performed. The follow-up period ranged between 5 to 15 years.
Results In our study, we had 64 extramedullary tumors and 21 intramedullary tumors with varied pathology. Axial location of the tumour (20.294/0.000), extent of the resection of the tumour (13.827/0.001), preoperative Nurick grade (11.349/0.023), and location of the tumour in the spine with respect to vertebral segments (8.151/0.017) were significant predictive factors. We had good outcomes in 65 cases and poor outcomes in 19 cases.
Conclusion Our results show location of the tumor with respect to axial plane and vertebral segments were the main contributing factors. They influence the extent of excision of the spinal cord tumor. Preoperative neurological status is the fourth factor which independently determines the long-term outcome. It is one of the few papers where patients have been followed-up for a long period ranging from 5 to 15 years.
Application of the International Society on Thrombosis and Haemostasis Scoring System in Evaluation of Disseminated Intravascular Coagulation in Patients with Acute Leukemias
Authors: Aggarwal Aditi , Mahajan Deepti , Sharma Poonam 
Published: November 2021

AbstractBackground Coagulation abnormalities are common in acute leukemia (AL) and disseminated intravascular coagulation (DIC) frequently complicates the onset of AL.Aim To determine the prevalence of overt DIC in AL using the International Society on Thrombosis and Haemostasis (ISTH) scoring system.Materials and Methods This prospective observational study was performed on 57 newly diagnosed or relapsed cases of AL. Detailed clinical history and coagulation profile of the patients were evaluated. Diagnosis of overt and nonovert DIC was established using the ISTH scoring system and results tabulated.Observations A total of 57 patients with AL participated in the study, including 31 (54.39%) patients with acute lymphoblastic leukemia (ALL) and 26 (45.61%) with acute myeloid leukemia (AML). In total, 18 of 57 patients (31.58%) with AL fulfilled the criteria of overt DIC according to the ISTH scoring system, including 10 (32.25%) patients with ALL and 8 (30.76%) patients with AML. The highest prevalence of DIC was seen in the M3 subtype among AML and the L1 subtype among ALL, respectively. The mean ISTH score in patients of overt DIC in ALL and AML patients was 5.1 and 5, respectively. Abnormalities in platelet count and D-dimer levels were the most useful parameters in diagnosing overt DIC and the difference between overt DIC and nonovert DIC groups was highly significant.Conclusions Overt DIC was observed in approximately one-third of patients with AL. Prevalence of overt DIC was found to be comparable in patients with ALL and AML. Mean platelet count and D-dimer levels were the most useful parameters in detecting overt DIC.
Highlighting Differences in Cancer Epidemiology in India: A Descriptive Report from a Private Sector Hospital-Based Cancer Registry in Delhi for the Years 2013 to 2017
Authors: Shrivastav Gunjan , Adhana Arun , Kumari Kamlesh , Khan Naseem , Kumar Ankit , Rathore Shailender , Anand Anil Kumar , Arora Ramandeep Singh 
Published: November 2021

Abstract
Introduction Cancer continues to grow in number. Knowing the epidemiology helps in prevention and treatment. Existing hospital-based cancer registries (HBCRs) provide little data of private sector including patients for medical tourism.
Objectives The aim of this study was to describe the distribution of cancer at a tertiary center in the private sector in North India for all cancer patients.
Materials and Methods Cases were ascertained from the Oncology Outpatient Department of Max Super Specialty Hospital, Saket, between January 1, 2013, and December 31, 2017, and from pathology database since July 2015. They were abstracted into National Cancer Registry Program (NCRP) core pro forma. We conducted a descriptive analysis of distribution by age, gender, nationality, site, stage, and treatment.
Results Among the 15,850 confirmed cases, 8,034 (51%) were males. Nearly 1.8% of patients were pediatric (<15 years) and 30.1% geriatric (>65 years). A high proportion of patients (13%) came from outside India and 27% from outside Delhi-National Capital Region. The most common cancers in males were prostate (10.9%), lung (10%), and mouth (7.6%). Stomach was the most common site of cancer in international male patients. Four of the top ten cancers in males were of the gastrointestinal tract (esophagus, stomach, colon, and rectum). The most common cancers in females were breast (37.4%), ovary (7.1%), and corpus uteri (5.6%). Tobacco-related cancers accounted for 36.9% of cancers in males and 11.3% in females. The composite stage in males was IV in 54%, followed by stage III (21%), stage II (15%), and stage I (10%). In females, stage IV was 33%, stage III was 23%, stage II was 28%, and stage I was 16%. As registry included outpatient record visits and pathology records, not all registered patients received treatment at Max Super Specialty Hospital. Overall, 49.8% of male patients and 49.7% of female patients received treatment at Max Super Specialty Hospital. Data quality metrics matched other national HBCRs.
Conclusion We highlight the differences from other NCRP HBCRs, with prostate cancer being the top cancer in males and gastrointestinal cancers forming major proportion among all. Socioeconomic status of our patients, referral bias, and international medical tourism could be responsible.
Polymethylmethacrylate Incorporating Nanodiamonds for Denture Repair: In Vitro Study on the Mechanical Properties
Authors: Gad Mohammed M. , Ali Mohamed Saber , Al-Thobity Ahmad M. , Al-Dulaijan Yousif A. , Zayat Mai El , Emam Abdel-Naser M. , Akhtar Sultan , Khan Soban Q. , Al-Harbi Fahad A. , Fouda Shaimaa M. 
Published: November 2021

Abstract
Objective This study aimed to evaluate the effect of nanodiamond (ND) addition to repair resin with repair gap modifications on the flexural and impact strength of repaired polymethylmethacrylate denture base.
Materials and Methods Heat-polymerized acrylic resin specimens (N = 100/test) were prepared and sectioned to half creating two repair gaps: 2.5- and 0 mm with 45 degrees beveling. They were further divided into subgroups (n = 20) according to ND concentration (control, 0.25%ND, and 0.50%ND), thermocycling (500 cycles) was done to half the specimens in each subgroup. Flexural strength was tested using 3-point bending test and impact strength was tested by Charpy's impact test. Analysis of variance and post-hoc Tukey's tests were performed for data analysis (α = 0.05). Scanning electron microscope was employed for fracture surface analysis and ND distribution.
Results Before and after thermocycling, the addition of ND significantly increased the flexural strength and elastic modulus in comparison to control group (p ˂ 0.001), while 0 mm repair gap showed insignificant difference between ND-reinforced groups (p ˃ 0.05). Regarding impact strength, ND addition increased the impact strength with 0 mm gap in comparison to control and 2.5 mm with ND (p˂0.001), while later groups showed no significant in between (p ˃ 0.05). Comparing thermocycling effect per respective concentration and repair gap, thermocycling adversely affected all tested properties except elastic modulus with 0 mm–0.25 and 0 mm–0.5% and impact strength with 2.5 mm, 2.5 mm–0.25%, 2.5 mm– 0.5% (p ˃ 0.05).
Conclusion ND addition combined with decreased repair gap improved the flexural strength, elastic modulus, and impact strength of repaired denture resin, while thermocycling has a negative effect on denture repair strength.
Physicochemical Properties of Zinc and Lactose in Solid Mixtures: Influence of Trituration Process
Authors: Fontes Clarissa , Oliveira Adriana P. , Batista João V.C. , Martins Cleo , Rossi André , Yapuchura Enrique R. , Furtado Priscila , Meireles Paloma , Capella Marcia Alves Marques , Picciani Paulo H.S. , Holandino Carla 
Published: November 2021

Abstract
Background Recent experimental results supporting the dynamization process show modification in the characteristics of solid mixtures.
Objective The present work aims to evaluate the physicochemical properties of metallic zinc and lactose, evidencing the interactions between all chemical components presented in dynamized solid mixtures by analytical techniques.
Methods Mixtures of zinc and lactose (1:9 w/w) were successively triturated at the same proportion according to the Brazilian Homeopathic Pharmacopoeia, receiving the designation of 10−1 – 10−6 (1dH – 6dH). All samples were submitted to the following characterization techniques: Atomic Absorption Spectrometry (AAS), Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD), Differential Scanning Calorimetry (DSC), Thermogravimetry (TG), and Raman Spectroscopy (RS).
Results AAS results detected 97.0% of zinc in the raw material, and the triturated zinc lactose system (ZnMet) presented mean values similar to those expected for the physical mixtures: i.e., 9.94%, 1.23%, and 0.11% in the three first proportions (10−1, 10−2, 10−3), respectively. SEM images showed particle size reduction due to the trituration process. The XRD assays of ZnMet 10−3 and 10−6 indicated peak changes at 12.3° and 43.26°, probably associated with modifications of inter-atomic crystalline spacing. The thermal analysis results of dynamized samples suggest modifications in the chemical interaction between zinc and lactose induced by the physical forces applied. RS experiments showed variation in vibration frequencies due to the dynamization procedure, in which marked ZnMet 10−6 spectral modifications were detected at 357, 477, 1086 and 1142 cm−1, and in the wavelength range 860–920 cm−1.
Conclusion These results highlight the importance of applying suitable characterization methods to improve our understanding of the properties of homeopathic solid mixtures, whereas the uses of sensitive tools evidence the influence of trituration on the crystalline properties and in the enthalpy variation of dynamized samples.
Development of a Perioperative Medication-Related Clinical Decision Support Tool to Prevent Medication Errors: An Analysis of User Feedback
Authors: Nanji Karen C. , Garabedian Pamela M. , Shaikh Sofia D. , Langlieb Marin E. , Boxwala Aziz , Gordon William J. , Bates David W. 
Published: November 2021

Abstract
Objectives Medication use in the perioperative setting presents many patient safety challenges that may be improved with electronic clinical decision support (CDS). The objective of this paper is to describe the development and analysis of user feedback for a robust, real-time medication-related CDS application designed to provide patient-specific dosing information and alerts to warn of medication errors in the operating room (OR).
Methods We designed a novel perioperative medication-related CDS application in four phases: (1) identification of need, (2) alert algorithm development, (3) system design, and (4) user interface design. We conducted group and individual design feedback sessions with front-line clinician leaders and subject matter experts to gather feedback about user requirements for alert content and system usability. Participants were clinicians who provide anesthesia (attending anesthesiologists, nurse anesthetists, and house staff), OR pharmacists, and nurses.
Results We performed two group and eight individual design feedback sessions, with a total of 35 participants. We identified 20 feedback themes, corresponding to 19 system changes. Key requirements for user acceptance were: Use hard stops only when necessary; provide as much information as feasible about the rationale behind alerts and patient/clinical context; and allow users to edit fields such as units, time, and baseline values (e.g., baseline blood pressure).
Conclusion We incorporated user-centered design principles to build a perioperative medication-related CDS application that uses real-time patient data to provide patient-specific dosing information and alerts. Emphasis on early user involvement to elicit user requirements, workflow considerations, and preferences during application development can result in time and money efficiencies and a safer and more usable system.
Validation of a Newly Developed Competency Assessment Tool for the Posterior Sagittal Anorectoplasty
Authors: Joosten Maja , Bökkerink Guus M.J. , Sutcliffe Jonathan , Levitt Marc A. , Diefenbach Karen , Reck Carlos A. , Krois Wilfried , Blaauw Ivo de , Botden Sanne M.B.I. 
Published: November 2021

Abstract
Introduction The correction of an anorectal malformation (ARM) is complex and relatively infrequent. Simulation training and subsequent assessment may result in better clinical outcomes. Assessment can be done using a competency assessment tool (CAT). This study aims to develop and validate a CAT for the posterior sagittal anorectoplasty (PSARP) on a simulation model.
Materials and Methods The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while tissue and instrument handling were scored separately. Participants of pediatric colorectal hands-on courses in 2019 and 2020 were asked to participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP.
Results A total of 82 participants were enrolled. A fair interobserver agreement was found for general skills (intraclass correlation coefficient [ICC] = 0.524, p < 0.001), a good agreement for specific skills (ICC = 0.646, p < 0.001), and overall performance (ICC = 0.669, p < 0.001). The experienced group scored higher on all steps (p < 0.001), except for “anoplasty (p = 0.540),” compared with an inexperienced group.
Conclusion The CAT-PSARP is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM on a simulation model.
Retinal Nerve Fibre Layer Analysis in Non-Glaucomatous Pseudoexfoliation Syndrome Patients
Authors: Khateeb Erum Waris , Lone Imtiyaz Ahmad , Qazi Ifrah Ahmad 
Published: November 2021

Abstract
Background Pseudoexfoliation syndrome (PXS) is a disorder characterized by the progressive accumulation of fibrillary extracellular deposits in several ocular tissues. It is an independent risk factor for glaucomatous optic nerve damage. Retinal nerve fiber layer (RNFL) thickness analysis using optical coherence tomography is a documented investigative tool to detect glaucoma at an early stage.
Objective The aim was to evaluate and compare RNFL thickness in PXS patients without glaucoma with their age- and sex-matched healthy controls and detect the possibility of early glaucomatous damage in patients with RNFL thinning.
Study Design This was a cross sectional case–control study.
Materials and Methods A total of 100 patients were included, of which 50 were cases (Group A) and 50 were controls (Group B). RNFL thickness of cases and controls were compared using Zeiss Cirrus HD-OCT 500 (ZEISS Medical Technology, United States).
Results There were no significant differences between the two groups with respect to mean RFNL thickness in nasal (p = 0.129) and temporal quadrants (p = 0.832). The mean inferior RNFL thickness values were 112.9 ± 21.72 μm in Group A and 120.6 ± 10.35 μm in Group B (p = 0.002). The mean thickness of the retinal nerve fiber layer in superior quadrant in Group A was 101.6 ± 23.16 μm, whereas it was 113.5 ± 13.47 μm in group B (p < 0.001). The average RFNL thickness in Group A was 85.1 ± 13.99 μm and it was 88.9 ± 7.01 μm in Group B (p = 0.017).
Conclusion There was statistically significant difference in RNFL thickness between cases and controls in inferior and superior quadrants and in global average thickness.