bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Organization of Cooperative Effort by Multiple Hospitals, Exemplified by Testing of Therapeutic Agents in Rheumatoid Arthritis
Authors: Herrera Lee 
Published: March 2018

The advantage of a multi-center clinical investigation lies in the possibility of obtaining conclusive results on the basis of relatively few numbers of patients from each of the participating institutions. It has the disadvantage of a lack of uniformity of methods among centers, which must be overcome by careful advance planning, including the institution of a central coordinating unit, the biometrical unit. Its functions include (1) participation in the planning of all phases of the investigation, (2) editing and processing of the data, and (3) analysis of the data and evaluation of results.Three devices for promoting uniformity of methods are: (1) the protocal, (2) specially designed record forms, and (3) visits to participating centers by a team of observers, including the statistician. The protocol is the document which contains all important specification for the conduct of the investigation, including statement of purpose of the study, definition of the study population, and explicit instructions on methods of patient assessment.In a clinical trial, the biometrical unit prepares the random allocation of treatments to patients. Stratification may be used to make comparisons between strata, and/or increase the sensitivity of the experiment. Stratification by exclusion may increase sensitivity at the cost of restricting the generality of results.A well-planned multi-center study, in which the members really cooperate, may achieve objectives exceeding the scope of single-center studies and provide a setting for the fruitful exchange of knowledge and ideas.
Die Planung therapeutischer Untersuchungen bei den chronisch rheumatischen Erkrankungen
Authors: Schuler B. 
Published: March 2018

Bei der Planung eines therapeutischen Versuches bei den chronisch rheumatischen Erkrankungen bestimmt die voraussichtliche Wirkung des Medikamentes oder des Heilverfahrens, das geprüft werden soll, sowohl die Auswahl der Kranken als auch die für seine Prüfung geeigneten Methoden und die “Wahl der Beurteilungsmerkmale.Zur Prüfung dürfen nur sorgfältig abgegrenzte Krankheitsbilder in geeigneten Krankheitsstadien herangezogen werden. Sie sollen nicht nur in der Ausprägung der Symptome, sondern auch in der Prognose des Krankheitsverlaufs vergleichbar sein.Krankheitsstadien mit starkem Wechsel der Krankheitserscheinungen müssen in Kollektiven geprüft werden, deren Zusammensetzung nicht durch willkürliche Auswahl bestimmt sein darf. Auch bei chronisch sich längere Zeit hinziehenden Krankheitsbildern kann man zur Ausschaltung von Remissionen oder Spontanbesserungen auf den Gruppenvergleich nicht verzichten. Er muß aber durch eine kritische kasuistische Bearbeitung jedes Krankheitsbildes ergänzt werden.Die Kriterien einer therapeutischen Wirkung müssen so gewählt werden, daß sie die Symptome, die durch das Heilmittel verändert werden, möglichst gut zahlenmäßig erfassen. Sie müssen so häufig notiert werden, daß der Verlauf der Prüfung in allen Phasen kontrolliert werden kann.Nur wenn die Beurteilungsmerkmafe das rheumatische Krankheitsgeschehen und seinen Verlauf unter der Einwirkung des zu prüfenden Heilverfahrens richtig und vollständig erfassen, ist das Ergebnis der Prüfung stichhaltig.
Evaluation of a metal acrylic repair product as a clamp for an external fixator
Authors: Gibson N. R. , Read R. A. , Day R. , Robertson I. D. , Staudte K. L. 
Published: March 2018

SummaryMechanical testing was performed to evaluate an acrylic steel repair paste when used in the construction of external fixators. Individual pin-bar-acrylic constructs were compared with those made from Kirschner-Ehmer (KE) clamps or polymethylmethacrylate. The constructs were subjected to cantilever bending forces, pin-pullout tests and cantilever bending after undergoing cyclical fatigue. Forty mm segments of acrylic were significantly stronger than medium ESF clamps. Twenty-five mm segments of acrylic were of equivalent strength to clamps. Ten mm segments failed under physiological loads expected from dogs greater than 20 kg and were less likely to provide adequate pin coverage to protect against pin pull-put. The placement of a wire loop to secure the pin-bar intersects made application of the acrylic easier but did not alter stiffness. There was not any significant variation between different operators in the strength of their constructs nor tolerance of their constructs to pin pullout. Cyclical loading forces were applied to acrylic-pinbar units without significant loss of strength, and acrylic and polymethylmethacrylate units did not show any difference in stiffness after being subjected to cyclical fatigue. The acrylic steel repair paste is a handkneadable, fast setting, inexpensive and readily available acrylic for use in the construction of external fixators. It allows more flexibility in frame design than a clamp and on the basis of mechanical testing offers a very stiff and secure substitute for KE clamps or polymethylmethacrylate.
The radiographic evaluation of repaired canine ilial fractures (69 cases)
Authors: Fitch R. B. , Wallace L. J. , Wells C. S. , Swiderski J. K. , Breshears L. A. 
Published: March 2018

SummaryA retrospective radiographic evaluation of 69 canine ilial fractures was performed. The patient information, concurrent injuries, fracture description, implant characteristics, fixation, radiographic outcome, and complications were assessed. Ilial fracture repairs were divided into four groups: lateral plate only, lateral plate with ventral interfragmentary screws, lateral plate with ventral plate, and ventral plate only fixation. The number of screws, degree of purchase, use of oversized screws, presence of sacral penetration, alignment, apposition, and pelvic collapse were evaluated. Radiographic follow-up (> 4 weeks) was available in 42 of these cases. Radiographic complications were recognized in 24% of the cases. All implant complications were identified within the lateral component of the fixation, but not necessarily confined to the patients repaired with only a lateral plate. Repairs that utilized ventral fixation had significantly greater screw purchase while providing additional lag screw compression across the fracture site. Of the three groups utilizing ventral stabilization (25 repairs), only one case had implant loosening. Ventral screw fixation appears to provide additional rigidity to ilial fracture repair that may be beneficial in some cases. This report describes additional surgical repair options available for repair of canine ilial fractures.
The Life Table according to Chiang as a Method for the Description and Assessment of the Efficacy of Oral Contraceptives
Authors: Wolfrum Christine 
Published: March 2018

At the present time, the Pearl Index is usually calculated for the assessment of the efficacy of an oral contraceptive. The Pearl Index represents an index number for the entire treatment period. The model on which the calculation is based is an urn model with the treatment months of all subjects instead of the balls.The Pearl Index cannot be interpreted as a probability, since the treatment months are the reference units. Some of these are interdependent (treatment months of one subject), while others are independent of each other (treatment months of various subjects). For an interpretation as probability, the subjects themselves must be the reference units.In order to render the presentation of only one index number for the entire treatment period meaningful, it must be assumed that the probability of pregnancy is the same for all treatment months. In reality this is not the case.The »number of pregnancies per treatment month< can be regarded as a non-stationary stochastic process; the assumption of an urn model is, therefore, inappropriate.The Pearl Index is unsuitable for the description of a stochastic process; instead, a life table analysis according to Chiang is recommended. In the life table, various probabilities are estimated per treatment month. The net probabilities can be chosen as the index number per treatment month. The prerecjuisites for the derivation of those probabilities are described.
Mechanical Allodynia Predicts Better Outcome of Surgical Decompression for Painful Diabetic Peripheral Neuropathy
Authors: Liao Chenlong , Nickerson D. , Visocchi Massimiliano , Yang Min , Liu Pengfei , Zhong Wenxiang , Zhou Han , Zhang Wenchuan 
Published: March 2018

Background To determine the role of mechanical allodynia (MA) in predicting good surgical outcome for painful diabetic peripheral neuropathy (DPN).
Materials and Methods Data of 192 patients with painful DPN were collected in this study, with 148 surgical patients and 44 patients in the control group. Both groups were further divided into subgroups based on the presence of MA on admission. Clinical evaluations including the visual analog scale (VAS), the Hospital Anxiety and Depression Scale (HADS), nerve conduction velocity (NCV), and high-resolution ultrasonography (cross-sectional area, CSA) were performed preoperatively and postoperatively.
Results The levels of VAS and HADS and the results of NCV and CSA were improved in the surgical group (p < 0.05). In the surgical subgroups, pain reduction, psychiatric amelioration, improvement in NCVs, and the restoration of the CSA were observed in patients with signs of MA (p < 0.05), whereas only pain reduction, psychiatric amelioration, and restoration of the CSA were noted in patients without signs of MA (p > 0.05). Furthermore, better pain reduction was achieved in patients with MA when compared with those without MA (p < 0.05).
Conclusions MA is proved to be a reliable predictor of good surgical outcome for painful DPN.
Emergency Repair of a Perforated Mycotic Aneurysm with a Self-made Pericardial Tube-graft
Authors: Diab Nawras , Pingpoh Clarence , Siepe Matthias , Beyersdorf Friedhelm , Kharabish Ahmed , Czerny Martin 
Published: March 2018

AbstractA 63-year-old female with a history of kidney transplantation was admitted for emergency repair of a perforated mycotic aneurysm of the right subclavian artery (RSA) in combination with a paravertebral and posterior mediastinal abscess. After resection of the aneurysm and after radical local debridement, orthotopic repair was performed with a self-made pericardial tube graft from the brachiocephalic bifurcation to the thoracic outlet. The paravertebral and posterior mediastinal abscess was drained. The postoperative course was uneventful. Using a self-made readily available pericardial neo-tube enlarges the armamentarium of handling complex infective surgical scenarios and presents a smart alternative to alloplastic vascular reconstruction.
Transposition of Great Arteries with Left Main Coronary Artery Atresia—Case Report
Authors: Elmahrouk Ahmed , Hamouda Tamer , Ismail Mohamed , Jamjoom Ahmed 
Published: March 2018

Background The coronary artery anatomy in patients with transposition of the great artery (TGA) is a contributing factor for outcome in arterial switch procedure.
Case Presentation A full-term, 7-day-old baby boy diagnosed as dextro-TGA (dTGA) with intact ventricular septum. Intraoperatively, the left coronary sinus had a blind indentation from which a firm cord-like left main coronary artery originates. Procedure completed as usual for a routine arterial switch operation.
Conclusion About 5% of patients with D-TGA have a single coronary artery. Assessment of blood flow to all branches intraoperatively is mandatory to choose between either transfer of single ostium or bypass grafting to the other coronary system.
Integrated Advanced Medical Information Systems (IAIMS): Payoffs and Problems
Authors: Clayton P. D. 
Published: March 2018

AbstractIAIMS (Integrated Advanced Information Management Systems) is an initiative to improve the access to information needed to provide patient care, health-oriented education, biomedical research, and management of large medical center environments. This paper will review the goals, history, and accomplishments of the IAIMS initiative. Shortcomings and frustrations, lessons learned, and the future of such initiatives will also be discussed.
The Harvard-MIT-NEMC Research Training Program in Medical Informatics
Authors: Greenes Robert A. , Octo Barnett G. , Pauker Stephen G. , Szolovits Peter , Weinstein Milton C. 
Published: March 2018

AbstractThe Harvard-MIT-NEMC Research Training Program in Medical Informatics brings together five separate research groups to provide a diversified training experience in Boston with sponsorship by the National Library of Medicine. This program offers predoctoral and postdoctoral programs, supplemented by many opportunities for collegial exchange and interaction among the groups.
Graduate Programs in Medical Informatics at the Paris Universities
Authors: Venot Alain , Auvert Bertran , Grémy François , Degoulet Patrice 
Published: March 2018

Abstract:Most medical schools in France have chairs in Biostatistics and Medical Informatics to coordinate the teaching of these two disciplines both within the regular curriculum of the medical studies and as a specialized teaching. This paper describes the current medical informatics specialized program offered at the Paris Universities. Since 1968 the program has comprised a Master of Science and a Ph.D. degree. At the Master Level, despite several reforms and in-depth program revisions the curriculum is still organized as a set of modules of 100 hours teachins with a large freedom for the medical faculties to define the contents of the courses and for the students to organize their studies and combine medical informatics, biomathematics and biostatistics training. Since 1990, an intensive one-year full-time course is offered, called Advanced Study Diploma in Medical Informatics, which is strongly research oriented. This program seems a good strategy to form medical informatics special1 ists who have initially received a broader education in informatics and statistics.
Medical Informatics Training at Columbia University and the Columbia-Presbyterian Medical Center
Authors: Allen B. A. , Clayton P. D. , Cimino J. J. 
Published: March 2018

Abstract:The Department of Medical Informatics at Columbia University College of Physicians and Surgeons consists of a faculty of 17 full-and part-time faculty. The Department faculty collaborate with the Department of Computer Science and several clinical departments of the medical center. We offer courses in medical informatics, formal degrees (M.A., M.Phil. and Ph.D.) and a postdoctoral training program. In addition to academic offerings, the close affiliation with the Columbia-Presbyterian Medical Center and the primary responsibilities for clinical information systems offers trainees unique opportunities to work with and develop real-world applications. Faculty research programs include work on the Integrated Advanced Information Management System (IAIMS), Unified Medical Language System (UMLS), High-Perfor-mance Computing and Communications (HPCC), Electronic Medical Records, automated decision support and technology transfer through the Center for Advanced Technology.
Clinical workstations: An architectural perspective
Authors: Clayton P.D. , Sengupta S. 
Published: March 2018

AbstractThe role of a clinical workstation is examined as an integral part of a larger, clinical information delivery and acquisition system. Different care scenarios and environmental factors influence the behavior of a workstation. The common functional components of a workstation are information resources, application logic and presentation. A workstation is successful when each of its components operates within an information architecture and contributes to meet user needs. New technologies to integrate and display information are making the workstation functions independent of the actual hardware and software platform.
An Information Mediator Network for Tasks in Dynamic Environments
Authors: Zhang W. , Shen W. , Patil R. 
Published: March 2018

AbstractCoordination of activities among information workers and services, tracking and managing activities, and intelligent distribution of information are essential to the efficient operation of any large enterprise. This is particularly important in the healthcare domain, where many different organizations must cooperate to provide patient care reliably in a dynamically changing environment. In this review paper we present a distributed system that supports cooperative problem solving, activity management, and intelligent delivery of information in dynamic and unreliable environments. The system consists of a network of task/context managers (TCMs). Each TCM manages a group of related agents. It maintains up-to-date information on availability, operational status, and activities of participating agents, and it acts as a mediator between service requesters and service providers. In addition, the TCM acts as a representative for its agents with other TCMs, allowing different groups of agents to collaborate with one another. This paper describes the system architecture, its implementation and capabilities including matchmaking, plan monitoring, and failure recovery. Our system has been used in prehospital emergency patient information management applications.
Integrating Informatics into the Undergraduate Curriculum: A Report on a Pilot Project
Authors: Murphy J. , Ingram D. 
Published: March 2018

AbstractPrevious case reports in this series on Education and Training have looked at specialist courses for postgraduate students seeking an in-depth know ledge of informatics and a career in the field. By contrast, this review describes a project designed to pilot a series of learning opportunities for undergraduate medical students. Although some UK medical colleges have opted to introduce informatics into the curriculum as a discipline in its own right, the Informatics Department at St Bartholomew’s Hospital Medical College chose a different approach. When a new curriculum was introduced at St Bartholomew’s and at The London Hospital Medical College, the Head of the Informatics Department saw this as an ideal opportunity to explore ways of integrating informatics into the curriculum. The initiatives described in this paper were made possible as a result of an award from the UK government Department of Employment. Money from an Enterprise in Higher Education grant funded a range of programmes, one of which was designed to introduce students to selected aspects of informatics and to demonstrate what is feasible in the undergraduate curriculum. The work carried out over a period of three and a half years was intended to provide the basis for the next phase of curriculum development. However, in the wake of the restructuring which has taken place in London medical colleges, the Informatics Department at what was St Bartholomew’s has relocated to University College London Medical School, and is now called The Centre for Health Informatics and Multi professional Education (CHIME). University College is designing a new medical curriculum and CHIME is drawing on the experience gained through the Enterprise Project to find the best way to integrate informatics into this curriculum.
Robotische Chirurgie – operiert der Roboter?
Authors: Schuler Patrick 
Published: March 2018

ZusammenfassungDer Roboter-assistierten Chirurgie (RAC) im Kopf-Hals-Bereich wird ein großes Potenzial zugeschrieben. Vor allem in der operativen Onkologie wird der Einsatz von Roboter-Systemen als besonders interessant erachtet. Bislang sind 2 Gerätetypen (DaVinci® und FLEX®) für die klinische Anwendung im Kopf-Hals-Bereich zugelassen, und multiple weitere Systeme befinden sich in der präklinischen Erprobungsphase. Auch wenn prinzipiell bestimmte Patientengruppen von der RAC profitieren könnten, finden sich keine systematischen randomisierten Studien. Ein möglicher Vorteil der RAC gegenüber den bisherigen Standardverfahren kann daher bisher nicht nachgewiesen werden. Der begrenzte klinische Nutzen und die finanzielle Zusatzbelastung scheinen aktuell der Hauptgrund zu sein, warum der flächendeckende Einsatz der RAC bislang ausgeblieben ist. Diese Übersichtsarbeit beschreibt die verschiedenen Anwendungsmöglichkeiten der RAC im Kopf-Hals-Bereich. Außerdem werden die finanziellen und technischen Herausforderungen, sowie anstehende Weiterentwicklungen der RAC beleuchtet. Besonderes Augenmerk wird auf spezielle Risiken der Roboter-Chirurgie und aktuell laufende klinische Studien gelegt. Mittelfristig wird davon ausgegangen, dass die RAC Einzug in die klinische Routine erhalten wird und sich das medizinische Personal zunehmend mit den technischen, wissenschaftlichen und auch ethischen Besonderheiten auseinandersetzen muss.
Regeneration – eine neue therapeutische Dimension in der Hals-Nasen-Ohrenheilkunde
Authors: Rotter Nicole , Zenobi-Wong Marcy 
Published: March 2018

ZusammenfassungDie Regeneration als therapeutisches Prinzip und damit die Regenerative Medizin ist ein vielversprechender Ansatz künftig die therapeutischen Optionen der Hals-Nasen-Ohrenheilkunde um eine weitere Dimension zu erweitern. Während heute rekonstruktive chirurgische Verfahren, Medikamente und Prothesen wie bspw. das Cochlea Implantat die Funktionen defekter Gewebe im Kopf-Hals-Bereich ersetzen, sollen durch die Regenerative Medizin die defekten Gewebe und deren Funktion selbst wiederhergestellt werden. In dieser Übersichtsarbeit werden neue Entwicklungen wie das 3D-Bioprinting und dezellularisierte, natürliche Biomaterialien für regenerative Ansätze vorgestellt und durch eine Zusammenstellung aktueller präklinischer und klinischer Studien im Bereich der Regenerativen Medizin in der Hals-Nasen-Ohrenheilkunde ergänzt.
Estradiol: A Steroid with Multiple Facets
Authors: Kumar Anita , Banerjee Antara , Singh Dipty , Thakur Gargi , Kasarpalkar Nandini , Gavali Shubhangi , Gadkar Sushama , Madan Taruna , Mahale Smita , Balasinor N. , Sachdeva Geetanjali 
Published: March 2018

AbstractSeventy-five glorious years have passed since estradiol was discovered by Edward Doisy. From discovery in the ovaries to delineation of diverse physiological effects, research on estrogens has covered a lot of ground. Estrogen receptors that mediate estrogenic effects, have been detected not only in reproductive organs, but also in other body organs. Estrogen receptors function either as conventional transcription factors or as rapid signal transducers. These different modes of action are opted by estrogens to elicit an array of reproductive and non-reproductive functions. It is well established that estrogens promote cell proliferation in various tissues and hence are also linked to carcinogenesis. Anti-estrogens are being used as adjunct therapies for cancers since several years. On the other hand, estrogen-based strategies are used to alleviate adverse effects of menopause. Apart from estrogens synthesized in various organs, exposure to environmental estrogens can also impact physiology. Thus, too much or too less of estrogens can tip the balance and lead to unfavorable consequences. Multiple estrogen receptors with their tissue- or cell type-specific expression eliciting dose-dependent effects make it perplexing to ‘unify’ estrogenic actions in diverse tissues/organs. This warrants more research on estrogen-mediated effects and their regulation in somatic and reproductive tissues. This review presents physiological and pathological aspects of estrogens thus highlighting the good, bad, and ugly facets of estrogens.