bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Tapping on the Holding Strength of Cancellous Bone Screws
Authors: Surowiak J. F. , Schatzker J. , Hearn T. C. 
Published: March 2018

SummaryThe purpose of the study was to determine whether tapping affects the holding strength of cancellous bone screws in soft material. Paired extraction tests were conducted using 6.5 mm cancellous bone screws in porous polyurethane foam. One member of each pair had a pre-tapped pilot hole, the other was inserted in a self-tapping manner. The maximum value of tensile force during extraction with a servohydraulic materials testing machine was recorded as the screw holding strength.Comparison of the holding strengths between the pre-tapped and self-tapping groups revealed a lower mean holding strength for the pre-tapped group (p <0.05). This result contrasts with previous studies which showed that pre-tapping increases the holding strength of bone screws in relatively stronger materials. The effect of tapping on the holding strength of bone screws is therefore dependant on the material properties of the host medium.This study examined the effect of tapping the pilot hole on the extraction strength of 6.5 mm cancellous bone screws in soft, synthetic cancellous material. In contrast with previous studies in stronger materials, it was found that tapping significantly reduces the holding strength of bone screws. The effects of tapping depend on the material properties of the host medium.
Clinical Review of the Mechanism and Applications of Hyperbaric Oxygen Therapy in Small Animal Surgery
Authors: Kerwin Sharon , Lewis D. D. , Strain G. S. , Hedlund Cheryl , Elkins A. D. , Hosgood Giselle 
Published: March 2018

SummaryHyperbaric oxygen therapy has shown benefits both experimentally and clinically in human disease associated with vascular compromise and reduced host defenses. Potential benefits include the stimulation of leucocyte and macrophage function, increased oxygen availability for cellular function, stimulation of wound healing, and direct antibacterial effects. Similar applications may exist in veterinary medicine. This study documents 14 consecutive animals treated with hyperbaric oxygen, as an adjunct to standard therapy, for degloving injuries and/or skin grafts (n = 6), severe trauma (n = 3), compromised wound healing (n = 3), osteomyelitis (n = 1), and for anaerobic infection (n = 1). Subjectively, recovery was improved in these animals. If available, hyperbaric oxygen therapy deserves consideration as an adjunct to standard therapy for certain disorders.The potential benefits of hyperbaric oxygen therapy are discussed in the light of a study of 14 cases.
Integrierte psychiatrische Versorgung aus Sicht der Gesetzlichen Krankenversicherung
Authors: Roick C. 
Published: March 2018

ZusammenfassungDie Integrierte Versorgung (IV) bietet viele Möglichkeiten zur Verbesserung der Versorgung psychisch kranker Patienten. Dies gilt besonders für Patienten mit schweren Erkrankungen, bei denen durch eine bessere Verzahnung der stationären und ambulanten Versorgung Rückfälle und Klinikaufnahmen vermieden werden könnten. Dabei können in der IV auch Therapieelemente eingesetzt werden, die in der Routineversorgung nicht generell zur Verfügung stehen. Zudem können die Bereiche psychiatrischer Versorgung stärker zusammengefasst werden, sodass die administrativen Barrieren zur Auswahl eines optimalen Versorgungsangebots für die Patienten niedriger sind. Dadurch kann die Versorgung flexibler und bedarfsgerechter erfolgen. Darüber hinaus können für die IV leitlinienorientierte, evidenzbasierte Behandlungspfade entwickelt werden, für deren Umsetzung ausgewählte Leistungsanbieter unter Vertrag genommen werden. Je pauschalierter die Vergütung in IV-Projekten gestaltet wird, umso wichtiger ist eine kontinuierliche Qualitätssicherung. Um aus den mit unterschiedlichen IV-Konzepten gesammelten Erfahrungen Erkenntnisse für die Weiterentwicklung der psychiatrischen Versorgung zu gewinnen, sollten Krankenkassen IV-Projekte mit Methoden evidenzbasierter Medizin evaluieren und die Ergebnisse veröffentlichen.
Hamburger Modell
Authors: Lambert M. , Bock T. 
Published: March 2018

ZusammenfassungKaum ein Versorgungssystem leistet sich soviel Neben- und Gegeneinander wie das deutsche. Die Ressourcen sind zersplittert und ungerecht verteilt. Ein Primat an Psychotherapie ist zu fordern, doch in der gegenwärtigen Struktur bleiben die Patienten mit ernsten Diagnosen allzu oft außen vor. Die Trennung von ambulanter und stationärer Versorgung zu überwinden, und die finanziellen Belohnungsmechanismen zu verändern, wäre ein echter Fortschritt. Doch wieder tun sich Widersprüche auf zwischen erfolgreichen Modellen und einer entgegen gesetzten Gesundheitspolitik. Integrierte Versorgung zeigt neue Wege auf; doch um die wirklich bedürftigen Patienten zu erreichen, müssen die Ressourcen der Kliniken einfließen. Das Hamburger Modell setzt neue Maßstäbe für die Krankenhausversorgung. Doch dafür sind nicht nur andere Abrechnungsmechanismen und neue Behandlungswege nötig; es geht dabei auch um eine andere Haltung, eine Integration in den Köpfen, um anthropologisches Verständnis, Integration von Psychotherapie und Dialogbereitschaft. Die Integration von Peer-Beratung kann diesen Weg unterstützen.
Gemeindepsychiatrie gestaltet Zukunft
Authors: Faulbaum-Decke W. 
Published: March 2018

ZusammenfassungDie Integrierte Gesundheitsversorgung (IGV) ist ein zeitgemäßes Konzept, das die Behandlungssituation von Menschen mit psychischen und seelischen Erkrankungen weiter verbessert. Aufsuchende Hilfen in einer ambulanten Struktur stärken sie darin, selbstbestimmt zu leben. Evidenzbasiert gilt eine ambulante Netzwerkstruktur als die Behandlungsform mit den besten Erfolgsaussichten. Sie ist den höchsten nationalen und internationalen Qualitätsstandards und Leitlinien verpflichtet. Mit der Umsetzung der IGV sind mindestens drei große Chancen verbunden: 1. Das Konzept ordnet nicht allein die gemeindepsychiatrische Arbeit neu, die Versorgungslandschaft insgesamt ist von allen Akteuren gemeinsam neu zu gestalten. 2. Leistungsangebote der gesetzlichen Krankenversicherung sind schneller und mit weniger administrativem Aufwand umzusetzen. 3. Die entsprechenden Hilfen orientieren sich an der Lebenswelt der Patienten, damit erhöht sich ihre Chance auf soziale und berufliche Teilhabe. Die weiteren Schritte erfordern vor allem eines: dass die Beteiligten sektorenübergreifend mehr ins Gespräch kommen und miteinander im Gespräch bleiben.
Integrierte Versorgung aus Sicht der Versorgungsforschung und Gesundheitsökonomie
Authors: Jacke C. O. , Salize H. J. 
Published: March 2018

ZusammenfassungModelle der Integrierten Versorgung (IV) sind angetreten, um bestehende Mängel im deutschen Versorgungssystem zu überwinden. Der vorliegende Beitrag skizziert die legislativen Hintergründe dieser Entwicklung, fasst Gütekriterien zur Bewertung komplexer Interventionen zusammen und wendet diese auf Studien an, die eine empirische Evidenz zu psychiatrisch-psychotherapeutischen IVModellen in Deutschland anbieten. Es gingen zwei populationsbasierte Studien in die Bewertung ein, die aus Sicht der Versorgungsforschung und Gesundheitsökonomie analysiert wurde. Die Studien besitzen eine hohe Güte und beachten die aufgestellten Kriterien im hohen Umfang. Eine dritte Studie befasst sich mit einem Teilaspekt. Aus Sicht der Versorgungsforschung und Gesundheitsökonomie besteht derzeit ein Theorie-, Methoden-, Ergebnis- und Verwertungsdefizit, um höhere Effektivität und Effizienz mit IV-Modellen zu erreichen. Ausgewählte Aspekte zur Weiterentwicklung von Projekten und ihren Bewertungen warden diskutiert.
Pelvic fractures in the dog and cat: a classification system and review of 556 cases
Authors: Montavon P. M. , Messmer M. 
Published: March 2018

SummaryA system for the classification of pelvic fractures in small animals is described. The system is based on a review of 556 cases and adapted from the AO/ASIF classification system for fractures of long bones in humans and small animals. A coding method was created to encompass the multiple sites in pelvic fractures, and associate fracture location and morphology with complexity of therapy and prognosis. The classification is based on criteria derived from standard radiographs and well-defined in a glossary of terms. Illustrations of fracture configurations given by the codes facilitate the designation of codes to cases. This article introduces the classification system and reports the findings when applied to 556 cases of pelvic fractures.
Quality Assessments of HMO Diagnosis Databases Used to Monitor Childhood Vaccine Safety
Authors: Drew L. , DeStefano F. , Maher J. , Bohlke K. , Immanuel V. , Black S. , Lewis E. , Ray P. , Vadheim C. , Lugg M. , Chen R. , Mullooly J. 
Published: March 2018

Summary

Objective:
To assess the quality of automated diagnoses extracted from medical care databases by the Vaccine Safety Datalink (VSD) study.

Methods:
Two methods are used to assess quality of VSD diagnosis data. The first method compares common automated and abstracted diagnostic categories (“outcomes”) in 1-2% simple random samples of study populations. The second method estimates positive predictive values of automated diagnosis codes used to identify potential cases of rare conditions (e.g., acute ataxia) for inclusion in nested case-control medical record abstraction studies.

Results:
There was good agreement (64-68%) between automated and abstracted outcomes in the 1-2% simple random samples at 3 of the 4 VSD sites and poor agreement (44%) at 1 site. Overall at 3 sites, 56% of children with automated cerebella ataxia codes (ICD-9 = 334) and 22% with “lack of coordination” codes (ICD-9 = 781.3) met objective clinical criteria for acute ataxia.

Conclusions:
The misclassification error rates for automated screening outcomes substantially reduce the power of screening analyses and limit usefulness of screening analyses to moderate to strong vaccine-outcome associations. Medical record verification of outcomes is needed for definitive assessments.
A Ruler for Interpreting Diagnostic Test Results
Authors: Lehmacher W. , Hellmich M. 
Published: March 2018

Summary

Objectives:
Bayes’ rule formalizes how the pre-test probability of having a condition of interest is changed by a diagnostic test result to yield the post-test probability of having the condition. To simplify this calculation a geometric solution in form of a ruler is presented.

Methods:
Using odds and the likelihood ratio of a test result in favor of having the condition of interest, Bayes’ rule can succinctly be expressed as ”the post-test odds equals the pre-test odds times the likelihood ratio”. Taking logarithms of both sides yields an additive equation.

Results:
The additive log odds equation can easily be solved geometrically. We propose a ruler made of two scales to be adjusted laterally. A different, widely used solution in form of a nomogram was published by Fagan [2].

Conclusions:
Whilst use of the nomogram seems more obvious, the ruler may be easier to operate in clinical practice since no straight edge is needed for precise reading. Moreover, the ruler yields more intuitive results because it shows the change in probability due to a given test result on the same scale.
Normalization for Affymetrix GeneChips
Authors: Neuhäuser M. , Boes T. 
Published: March 2018

Summary

Objectives:
The high density oligonucleotide micro-arrays from Affymetrix (Affymetrix GeneChips) are very popular in biomedical research. They enable to study the expression of thousands of genes simultaneously. In experiments with multiple arrays, normalization techniques are used to reduce the so-called obscuring variation, i.e. the technical variation that is of non-biological origin. Several different normalization methods have been proposed during the last years.

Methods:
We review published results about the comparison of normalization methods proposed for Affymetrix GeneChips.

Results:
The quantile normalization seems to perform favorably regarding precision (low variance), accuracy (low bias), and practicability (low computing time). However, according to very recent results [1], this normalization method can have an impact on the biological variability and, therefore, appears to be less than optimal from this point of view.

Conclusion:
Although the quantile normalization may be recommendable, more investigations based on more data sets are needed so that the different normalization methods can be evaluated on widely differing data.
A Novel Artificial Intelligence Method for Weekly Dietary Menu Planning
Authors: Vassányi I. , Kozmann G. , Gaál B. 
Published: March 2018

Summary

Objectives:
Menu planning is an important part of per-sonalized lifestyle counseling. The paper describes the results of an automated menu generator (MenuGene) of the web-based lifestyle counseling system Cordelia that provides personalized advice to prevent cardiovascular diseases.

Methods:
The menu generator uses genetic algorithms to prepare weekly menus for web users. The objectives are derived from personal medical data collected via forms in Cordelia, combined with general nutritional guidelines. The weekly menu is modeled as a multilevel structure.

Results:
Results show that the genetic algorithm-based method succeeds in planning dietary menus that satisfy strict numerical constraints on every nutritional level (meal, daily basis, weekly basis). The rule-based assessment proved capable of manipulating the mean occurrence of the nutritional components thus providing a method for adjusting the variety and harmony of the menu plans.

Conclusions:
By splitting the problem into well determined sub-problems, weekly menu plans that satisfy nutritional constraints and have well assorted components can be generated with the same method that is for daily and meal plan generation.
A Four-dimensional Approach to Medical Image Retrieval
Authors: Amghar Y. , Flory A. , Chbeir R. 
Published: March 2018

Abstract:Image retrieval is faced with different problems. Few proposed solutions consider the heterogeneity of user competence (e.g. physicians, researchers, students, etc.) and the necessity of a high expressive power for medical image description. This paper presents a solution designed for medical imaging retrieval. It consists of providing a four-dimensional approach able to integrate different views of the medical image, to deal with complex medical queries. Via use of the Spatial Knowledge Model, we propose hybrid (textual and visual) and customizable interfaces, appropriate for non-computer scientist users. Our prototype, accessible through the Web, has been tested by a group of medical students and physicians and gives very satisfactory results.
Probabilistic Record Linkage: Relationships between File Sizes, Identifiers, and Match Weights
Authors: Olson L. M. , Dean J. M. , Cook L. J. 
Published: March 2018

Abstract:This study investigates relationships between file sizes, amounts of information contained in commonly used record linkage variables, and the amount of information needed for a successful probabilistic linkage project. We present an equation predicting the amount of information needed for a successful linkage project. Match weights for variables commonly used in record linkage are measured using artificially created databases. Linkage algorithms were successful when the sum of minimum weights for variables used in a linkage exceeded the predicted cutoff. Linkage results were acceptable when this sum was near the predicted cutoff. This technique enables researchers to determine if enough information exists to perform a successful probabilistic linkage.
Status and Perspective of Hospital Information Systems in Japan
Authors: Ogushi Y. , Okada Y. , Kimura M. , Kumamoto I , Sekita Y. , Haruki Y. 
Published: March 2018

AbstractQuestionnaire surveys were sent to hospital managers, designed to shape the policy for future hospital information systems in Japan. The answers show that many hospitals use dedicated management systems, especially for patient registration and accounting, and personnel, food control, pharmacy and financial departments. In many hospitals, order-entry systems for laboratory tests and prescriptions are well developed. Half of the hospitals have patient databases used for inquiries of basic patient information, history of outpatient care and hospital care. The most obvious benefit is the reduction of office work, due to effective hospital information system. Many hospital managers want to use the following sub systems in the future for automatic payment, waiting time display, patient records search, automatic prescription verification, drug side-effect monitoring, and graphical display of patient record data.
Design Elements for a Computerized Patient Record
Authors: Adelhard K. , Hölzel D. , Überla K. 
Published: March 2018

AbstractComputerized medical record systems have to present user-and problem-oriented views of a patient record to health-care professionals. Presentation and manipulation of data must be easily adaptable to current and future demands of medical specialties and specific settings. During the definition, development and evaluation of a prototype of a computerized patient record system, design elements were elaborated to support physicians and other health-care professionals. Our approach shows a high degree of flexibility and adaptability to specific needs, problem orientation and connectivity to other systems, via a hospital information network. The explicit description of the contents of a patient record allows to augment the number of items that can be recorded without modifying the data structure. New views on patient data can be added to the system without interfering with the routine use of the system. Application in several medical specialties proved the feasibility of our prototype.
An Electronic Study Form to Support Collaborating Agents in the Management of Clinical Knowledge
Authors: Fierz W. , Grütter R. 
Published: March 2018

AbstractWhen dealing with biological organisms, one has to take into account some peculiarities which significantly affect the representation of knowledge about them. These are complemented by the limitations in the representation of propositional knowledge, i. e. the majority of clinical knowledge, by artificial agents. Thus, the opportunities to automate the management of clinical knowledge are widely restricted to closed contexts and to procedural knowledge. Therefore, in dynamic and complex real-world settings such as health care provision to HIV-infected patients human and artificial agents must collaborate in order to optimize the time/quality antinomy of services provided. If applied to the implementation level, the overall requirement ensues that the language used to model clinical contexts should be both human- and machine-interpretable. The eXtensible Markup Language (XML), which is used to develop an electronic study form, is evaluated against this requirement, and its contribution to collaboration of human and artificial agents in the management of clinical knowledge is analyzed.
ICT in Health Care: Sociotechnical Approaches
Authors: Berg M. , Aarts J. , van der Lei J. 
Published: March 2018

SummaryThe importance of the social sciences for medical informatics is increasingly recognized. As ICT requires interaction with people and thereby inevitably affects them, understanding ICT requires a focus on the interrelation between technology and its social environment. Socio-technical approaches increase our understanding of how ICT applications are developed, introduced and become a part of social practices. Sociotechnical approaches share several starting points: 1) they see health care work as a social, ‘real life’ phenomenon, which may seem ‘messy’ at first, but which is guided by a practical rationality that can only be overlooked at a high price (i.e. failed systems). 2) They see technological innovation as a social process, in which organizations are deeply affected. 3) Through in-depth, formative evaluation, they can help improve system design and implementation.
Images of Health Technology in National and Local Strategies
Authors: Klecun-Dabrowska E. , Cornford T. 
Published: March 2018

Summary
Objectives: This paper examines the potential of various models relating technology to society and institutional structures to inform health policy. Among the models discussed are various versions of technological determinism, social constructivism, actor network theory and critical theory.
Methods: The paper considers recent developments in policy and strategy that aim to shape the way the UK’s National Health Service (NHS) integrates Information and Communication Technologies (ICTs) into health care and considers what these alternative models highlight or emphasise, and how they might influence the activities of setting local implementation strategies.
Results and Conclusions: Contemporary ICTs are often presented as having a particular relevance and power in reforming or transforming the delivery of health care. Understanding how such technologies might be conceived of, implemented and become an integral part of some future health care system is an important and challenging task that requires innovative theoretical treatments.
Working IT Out in Medical Practice: IT Systems Design and Development as Co-Realisation
Authors: Hartswood M. J. , Rouchy P. , Rouncefield M. , Slack R. , Voss A. , Procter R. N. 
Published: March 2018

Summary
Objectives: The paper explores possibilities for situating IT design and development work within the context of use so as to support the co-realisation of technology and ‘design in use’. The aim is to build a new understanding between IT professionals and users which is grounded upon what happens as the latter grapple with the problems of applying IT, appropriating its functionalities and affordances into their work practices and relations.
Methods: Following a discussion of participatory design and ethnomethodology, a novel method called co-realisation, which aims to provide a synthesis of the preceding methods, is suggested as an alternative. Through a discussion of findings from a case study of IT systems design and development in healthcare we show how the co-realisation approach might provide work-affording systems and how user-designer relations might be reformulated. We suggest that work-affording systems can be developed through the deployment of an engaged facilitator who works with the users to unpack the work site-specific potentialities of technology.
Results: The case study shows how risk of non-adoption might be minimised through the development of partnerships, and how the presence of the facilitator in the workplace capitalises on the mundane work undertaken therein and how the facilitator might work with the users to develop artefacts that support this work as opposed to reconfiguring it.
Conclusions: The case study illustrates co-realisation in action and how it might be seen to reconfigure relations between users and designers in a way that appears productive. Co-realisation can help address the widely observed problem of IT systems failures in healthcare.
Requirements for Speech Recognition to Support Medical Documentation
Authors: Mönnich G. , Wetter T. 
Published: March 2018

Abstract:Recent advances in the development of automated speech recognition (ASR) have made routine applications for medical documentation possible. To achieve this, ASR has to be optimally integrated into the specific documentation scenario. The classification presented in this paper allows the definition of specification requirements. For two different documentation scenarios the appropriate product selection has been done according to this classification. Two evaluation studies are presented, addressing the usefulness of applying automated speech recognition.