bluuebunny/crossref_metadata_2025_split huggingface dataset:
Photodynamische Therapie in Deutschland – Quo vadis?
Authors: Pauleikhoff L. , Rothaus K. , Groß-Bölting F. , Böhringer D. , Lübke J. , Agostini H. , Lange C. ,   Retina.Net CCS Register Studiengruppe
Published: March 2023

Zusammenfassung
Hintergrund
Die photodynamische Therapie (PDT) wurde ursprünglich zur Behandlung der neovaskulären altersabhängigen Makuladegeneration (nAMD) sowie der sekundären chorioidalen Neovaskularisation im Rahmen einer Myopie (mCNV) zugelassen. Zudem wird sie im Rahmen einer Off-label-Therapie bei Patienten mit Aderhauthämangiom, polypoidaler chorioidaler Vaskulopathie (PCV) sowie Chorioretinopathia centralis serosa (CCS) eingesetzt.

Ziel der Arbeit
Das Ziel dieser Arbeit war es, die Entwicklung der PDT-Behandlungszahlen in Deutschland zwischen 2006 und 2021 nachzuzeichnen und die Zusammensetzung der Indikationen für die Behandlung zu untersuchen.

Methoden
In dieser retrospektiven Studie wurden die Qualitätssicherungsberichte der deutschen Krankenhäuser in dem Zeitraum von 2006 bis 2019 ausgewertet und die Anzahl der durchgeführten PDT erfasst. Zudem wurde das Indikationsspektrum für eine PDT exemplarisch an der Klinik für Augenheilkunde des Universitätsklinikums Freiburg und dem Augenzentrum am St. Franziskus Hospital in Münster zwischen 2006 bis 2021 ermittelt. Anhand der geschätzten Prävalenz der CCS und der Chronifizierungsrate wurde schlussendlich die Anzahl der theoretisch behandlungsbedürftigen CCS-Patienten in Deutschland modelliert.

Ergebnisse
Die Anzahl der in Deutschland durchgeführten PDT ist von 1072 Behandlungen im Jahr 2006 auf 202 Behandlungen im Jahr 2019 zurückgegangen. Während die PDT im Jahr 2006 in 86 % der Fälle bei Patienten mit nAMD und in 7 % der Fälle bei mCNV eingesetzt wurde, wurde sie in den Jahren 2016 bis 2021 vornehmlich bei Patienten mit CCS (70 %) und Aderhauthämangiomen (21 %) durchgeführt. Bei einer geschätzten Prävalenz der CCS von 1:10.000 und unter der Annahme, dass 16 % der Fälle eine behandlungsbedürftige chronische CCS (cCCS) entwickeln, müssten in Deutschland ca. 1330 PDT allein für die neu an einer cCCS erkrankten Patienten pro Jahr durchgeführt werden.

Diskussion
Die in Deutschland rückläufige Anzahl an durchgeführten PDT ist v. a. durch eine Umstellung auf die intravitreale Therapie für die nAMD und mCNV zu erklären. Da die PDT aktuell die Therapie der Wahl für die cCCS darstellt, ist von einer Unterversorgung der PDT in Deutschland auszugehen. Es sind zur Gewährleistung einer adäquaten Versorgung der Patienten die robuste Verfügbarkeit von Verteporfin, eine vereinfachte Bewilligungsstruktur seitens der Krankenkassen sowie eine enge Kooperation zwischen niedergelassenen Augenärzten und größeren Zentren notwendig.
Cardiac anomalies in children with congenital duodenal obstruction: a systematic review with meta-analysis
Authors: Pijpers Adinda G. H. , Eeftinck Schattenkerk Laurens D. , de Vries Ralph , Broers Chantal J. M. , Straver Bart , van Heurn Ernest L. W. , Musters Gijsbert D. , Gorter Ramon R. , Derikx Joep P. M. 
Published: March 2023

AbstractBackgroundCardiac anomalies occur frequently in patients with congenital duodenal obstruction (DO). However, the exact occurrence and the type of associated anomalies remain unknown. Therefore, the aim of this systematic review is to aggregate the available literatures on cardiac anomalies in patients with DO.MethodsIn July 2022, a search was performed in PubMed and Embase.com. Studies describing cardiac anomalies in patients with congenital DO were considered eligible. Primary outcome was the pooled percentage of cardiac anomalies in patients with DO. Secondary outcomes were the pooled percentages of the types of cardiac anomalies, type of DO, and trisomy 21. A meta-analysis was performed to pool the reported data.ResultsIn total, 99 publications met our eligibility data, representing 6725 patients. The pooled percentage of cardiac anomalies was 29% (95% CI 0.26–0.32). The most common cardiac anomalies were persistent foramen ovale 35% (95% CI 0.20–0.54), ventricular septal defect 33% (95% CI 0.24–0.43), and atrial septal defect 33% (95% CI 0.26–0.41). The most prevalent type of obstruction was type 3 (complete atresias), with a pooled percentage of 54% (95% CI 0.48–0.60). The pooled percentage of Trisomy 21 in patients with DO was 28% (95% CI 0.26–0.31).ConclusionThis review shows cardiac anomalies are found in one-third of the patients with DO regardless of the presence of trisomy 21. Therefore, we recommend that patients with DO should receive preoperative cardiac screening.Level of evidenceII.
Wunden durch Vaskulitiden – aktuelle Klassifikation, Diagnostik und Therapie
Authors: Dissemond Joachim 
Published: March 2023

ZusammenfassungWunden an der Haut können sehr unterschiedliche Ursachen haben. Insbesondere bei klinisch atypischen oder nicht-heilenden Wunden ist die sehr heterogene Gruppe der Vaskulitiden von besonders wichtiger differenzialdiagnostischer Bedeutung. Die Klassifikation der Vaskulitiden erfolgt heute entsprechend den betroffenen Gefäßen nach der Chapel-Hill-Konsensus-Konferenz. Von einer Vaskulitis kann potenziell jeder Teil des Gefäßsystems betroffen sein. Dadurch wird deutlich, dass oft die Gefahr von systemischen Erkrankungen mit hoher interdisziplinärer Relevanz besteht.Klinisch entwickeln sich die in der Regel sehr schmerzhaften Wunden bei kutaner Vaskulitis aus Nekrosen und sind typischerweise in der floriden Phase von einem erythematös-lividen Randsaum umgeben. In der meist umfangreichen Diagnostik hat zusätzlich zu der klinischen Inspektion die histopathologische Untersuchung von Biopsien einen besonders großen Stellenwert.Therapeutisch sollte immer eine adäquate Wundtherapie mit dem Fokus auf Schmerzvermeidung und Infektionsprophylaxe durchgeführt werden. Bei begleitenden Ödemen unterstützt die Kompressionstherapie zudem die Wundheilung. Darüber hinaus ist es oft notwendig, systemische Therapien mit immunsuppressiven oder immunmodulierenden Medikamenten einzuleiten. Wann immer möglich, sollten die ursächlich relevanten Faktoren und Komorbiditäten frühzeitig diagnostiziert und vermieden bzw. behandelt werden. Andernfalls besteht die Gefahr von schweren oder sogar tödlichen Krankheitsverläufen.
Subjektives Gefühl digitaler Ausgegrenztheit
Authors: Seifert Alexander 
Published: March 2023

Zusammenfassung
Hintergrund
Nicht nur jüngere, sondern zunehmend auch ältere Menschen leben heute in einer Welt, in der digitale Technologien ihren Alltag maßgeblich begleiten. Dennoch nutzen gerade ältere Personen seltener die neuesten Technologien. Fühlen sich ältere Menschen dadurch im Vergleich zu jüngeren Personen besonders ausgeschlossen? Um diese Fragen zu beantworten, wurde anhand einer Bevölkerungsbefragung bei Personen ab 18 Jahren das Empfinden digitaler Exklusion gemessen.

Material und Methoden
Das Datenmaterial stammt aus einer Schweizer Befragung (n = 1604) von Personen im Alter von 18 bis 98 Jahren. Die Datenerhebung erfolgte als standardisierte Onlinebefragung und wurde mit einer optionalen telefonischen Befragung kombiniert.

Ergebnisse
Ein Teil der Personen unter und über 65 Jahren fühlt sich jeweils sozial ausgrenzt, da er nicht immer die aktuellen Alltagstechnologien beherrscht. Innerhalb der Gruppe der 18- bis 64-Jährigen haben 3,6 % ein sehr starkes Exklusionsempfinden, und bei der älteren Gruppe (65 bis 98 Jahre) beträgt dieser Wert 5,5 %, womit ältere Personen eher zur Gruppe der Personen mit sehr starken Gefühlen digitaler Exklusion gehören. Gleichzeitig zeigt die multivariate Zusammenhangsanalyse, dass der Einfluss des Alters durch andere Variablen (Einkommen, Technikeinstellung) nivelliert wird.

Schlussfolgerung
Auch wenn die digitale Transformation voranschreitet, gibt es bei der Techniknutzung weiterhin Ungleichheiten, die sich in Exklusionsgefühlen äußern können. Neben der Frage, welche älteren Personen Technik nutzen oder nicht, sollte in Zukunft die Frage des subjektiven Empfindens der Ausgrenzung stärker berücksichtigt werden.
Unravelling morphoea aetiopathogenesis by next-generation sequencing of paired skin biopsies
Authors: Saracino Amanda M. , Kelberman Daniel , Otto Georg W. , Gagunashvili Andrey , Abraham David J. , Denton Christopher P. 
Published: March 2023

Abstract
Background
Morphoea can have a significant disease burden. Aetiopathogenesis remains poorly understood, with very limited existing genetic studies. Linear morphoea (LM) may follow Blascho’s lines of epidermal development, providing potential pathogenic clues.

Objective
The first objective of this study was to identify the presence of primary somatic epidermal mosaicism in LM. The second objective was tTo explore differential gene expression in morphoea epidermis and dermis to identify potential pathogenic molecular pathways and tissue layer cross-talk.

Methodology
Skin biopsies from paired affected and contralateral unaffected skin were taken from 16 patients with LM. Epidermis and dermis were isolated using a 2-step chemical-physical separation protocol. Whole Genome Sequencing (WGS; n = 4 epidermal) and RNA-seq (n = 5-epidermal, n = 5-dermal) with gene expression analysis via GSEA-MSigDBv6.3 and PANTHER-v14.1 pathway analyses, were performed. RTqPCR and immunohistochemistry were used to replicate key results.

Results
Sixteen participants (93.8% female, mean age 27.7 yrs disease-onset) were included. Epidermal WGS identified no single affected gene or SNV. However, many potential disease-relevant pathogenic variants were present, including ADAMTSL1 and ADAMTS16. A highly proliferative, inflammatory and profibrotic epidermis was seen, with significantly-overexpressed TNFα-via-NFkB, TGFβ, IL6/JAKSTAT and IFN-signaling, apoptosis, p53 and KRAS-responses. Upregulated IFI27 and downregulated LAMA4 potentially represent initiating epidermal ‘damage’ signals and enhanced epidermal-dermal communication. Morphoea dermis exhibited significant profibrotic, B-cell and IFN-signatures, and upregulated morphogenic patterning pathways such as Wnt.

Conclusion
This study supports the absence of somatic epidermal mosaicism in LM, and identifies potential disease-driving epidermal mechanisms, epidermal-dermal interactions and disease-specific dermal differential-gene-expression in morphoea. We propose a potential molecular narrative for morphoea aetiopathogenesis which could help guide future targeted studies and therapies.
A pilot study using unique targeted testing of the urogenital microbiome has potential as a predictive test during IVF for implantation outcome
Authors: Evans Gloria E. , Mahajan Vishakha , Wakeman Sarah , Slatter Tania , Ponnampalam Anna P. , Anderson Trevor P. , Sarwar Makhdoom , Evans John J. 
Published: March 2023

Abstract
Purpose
This pilot study aimed to develop a methodology characterising the urogenital microbiome as a predictive test in the IVF workup.

Methods
Using unique custom qPCRs, we tested for the presence of specific microbial species from vaginal samples and First Catch Urines from the male. The test panel included a range of potential urogenital pathogens, STIs, ‘favourable bacteria’ (Lactobacillus spp.) and ‘unfavourable bacteria’ (anaerobes) reported to influence implantation rates. We tested couples attending Fertility Associates, Christchurch, New Zealand for their first round of IVF.

Results
We found that some microbial species affected implantation. The qPCR result was interpreted qualitatively using the Z proportionality test. Samples from women at the time of Embryo Transfer who did not achieve implantation had significantly higher percent of samples that were positive for Prevotella bivia and Staphylococcus aureus compared to women who did achieve implantation.

Discussion
The results provide evidence that most other microbial species chosen for testing had little functional effect on implantation rates. The addition of further microbial targets (yet to be determined) could be combined in this predictive test for vaginal preparedness on the day of embryo transfer. This methodology has a substantial advantage of being affordable and easily performed in any routine molecular laboratory. This methodology is most suitable as a foundation on which to develop a timely test of microbiome profiling. Using the indicators detected to have a significant influence, these results can be extrapolated.

Conclusion
Using a rapid antigen test, a woman can self-sample prior to embryo transfer and obtain an indication of microbial species present which could influence implantation outcome.
A comparison of special intrauterine balloons and intrauterine contraceptive devices in the treatment of intrauterine adhesions
Authors: Zhuang Lin-Lin , Wang Kai , Shen Hai-Lan , Lin Jia-Hui , Lu Ye , Luo Zhen-Yu , Wang Wen-Rong 
Published: March 2023

Abstract
Purpose
This study aimed to compare the efficacy of a special kind of intrauterine balloon (IUB) and that of an intrauterine contraception device (IUD) for patients with intrauterine adhesions (IUAs) after transcervical resection of adhesion (TCRA).

Methods
In this retrospective cohort study, after TCRA, 31 patients received a special IUB, and 38 patients received an IUD. The Fisher exact test, logistic regression method, Kaplan–Meier method and Cox proportional hazards regression model were used for statistical analysis. A two-sided value of P < 0.05 was considered statistically significant.

Results
The readhesion rate significantly differed between the IUB group and IUD group, at 15.39% and 54.06%, respectively (P = 0.002). For recurrent moderate IUA, patients in the IUB group had lower scores than patients in the IUD group (P = 0.035). There was a significant difference in the intrauterine pregnancy rate of IUA patients in the IUB group and IUD group after treatment, with rates of 55.56% and 14.29%, respectively (P = 0.015).

Conclusion
Patients in the special IUB group had better outcomes than those in the IUD group, which has a certain guiding significance for clinical work.
Third molar eruption in orthopantomograms as a feature for forensic age assessment—a comparison study of different classification systems
Authors: Timme Maximilian , Viktorov Jan , Steffens Laurin , Streeter Adam , Karch André , Schmeling Andreas 
Published: March 2023

AbstractEvaluation of third molar eruption represents an established method for age assessment of living individuals. Different classification systems are available for the radiological assessment of third molar eruption. The aim of this study was to identify the most accurate and reliable classification system for the mandibular third molar eruption on orthopantomograms (OPG). We compared the method of Olze et al. (2012) with the method of Willmot et al. (2018) and a newly derived classification system using OPGs from 211 individuals aged 15–25 years. The assessments were performed by three experienced examiners. One examiner evaluated all radiographs twice. The correlation between age and stage was investigated and the inter- and intra-rater reliability was estimated for all three methods. Correlation between stage and age was similar between classification systems, although higher in the data from males (Spearman’s rho ranging from 0.568 to 0.583) than from females (0.440 to 0.446). Inter- and intra-rater reliability measures were similar across methods and invariant on sex, with overlapping confidence intervals, although the highest point estimates for both intra- and inter-rater reliability were for the method by Olze et al. with Krippendorf’s alpha values of 0.904 (95% confidence interval 0.854, 0.954) and 0.797 (95% confidence interval 0.744, 0.850). It was concluded that the method of Olze et al. from 2012 is a reliable method for practical application and future studies.
Natalizumab continuation versus switching to ocrelizumab after PML risk stratification in RRMS patients: a natural experiment
Authors: Muñoz-Vendrell Albert , Arroyo-Pereiro Pablo , León Isabel , Bau Laura , Matas Elisabet , Martínez-Yélamos Antonio , Martínez-Yélamos Sergio , Romero-Pinel Lucía 
Published: March 2023

Abstract
Background
Natalizumab (NTZ) and ocrelizumab (OCR) can be used for the treatment of relapsing–remitting multiple sclerosis (RRMS). In patients treated with NTZ, screening for JC virus (JCV) is mandatory, and a positive serology usually requires a change in treatment after 2 years. In this study, JCV serology was used as a natural experiment to pseudo-randomize patients into NTZ continuation or OCR.

Methods
An observational analysis of patients who had received NTZ for at least 2 years and were either changed to OCR or maintained on NTZ, depending on JCV serology status, was performed. A stratification moment (STRm) was established when patients were pseudo-randomized to either arm (NTZ continuation if JCV negativity, or change to OCR if JCV positivity). Primary endpoints include time to first relapse and presence of relapses after STRm and OCR initiation. Secondary endpoints include clinical and radiological outcomes after 1 year.

Results
Of the 67 patients included, 40 continued on NTZ (60%) and 27 were changed to OCR (40%). Baseline characteristics were similar. Time to first relapse was not significantly different. Ten patients in the JCV + OCR arm presented a relapse after STRm (37%), four during the washout period, and 13 patients in the JCV-NTZ arm (32.5%, p = 0.701). No differences in secondary endpoints were detected in the first year after STRm.

Conclusions
The JCV status can be used as a natural experiment to compare treatment arms with a low selection bias. In our study, switching to OCR versus NTZ continuation led to similar disease activity outcomes.
Benefit of intravitreal injections in patients with sub-threshold baseline visual acuity: a retrospective single-centre study
Authors: Grimm Nina-Antonia , Fahimi Sarah , Kück Fabian , Take Patricia , Lauermann Peer , Nguyen-Hoehl Anna , Hoerauf Hans , Feltgen Nicolas , Bemme Sebastian 
Published: March 2023

Abstract
Purpose
To investigate the lower visual acuity threshold for recommending intravitreal injection therapy (IVI). The lower limit of 1.3 logMAR best-corrected visual acuity (BCVA) was adopted in 2006 and has been maintained since then.

Methods
In this retrospective study, data from patients with a logMAR BCVA ≤ 1.3 and 24 months follow-up were analysed. We included patients with neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DME), or retinal vein occlusion (RVO).

Results
The data from 164 patients (nAMD: 107; DME: 15; RVO: 42) were analysed. We observed a significant improvement at all time intervals (0 to 6, 6 to 12, 12 to 18, and 18 to 24 months after initiating IVI) compared to baseline. Across all indications, median BCVA improved from 1.4 to 1.0 within the first 6 months and remained stable within 24 months. Patients received a median of 5 and 10 injections within 6 and 24 months, respectively. Median foveal retinal thickness was 594.5 μm at baseline and dropped to 244.5 μm, 235.5 µm, 183 µm, and 180 µm during the four consecutive time intervals.

Conclusion
Patients with nAMD, DME, and RVO with poor baseline BCVA may also benefit from intravitreal therapy with VEGF-inhibitors. In the present study, we observed functional and morphological improvement over 2 years irrespective of the underlying macular disease. Those patients should not be excluded from therapy.
The angular gyrus serves as an interface between the non-lexical reading network and the semantic system: evidence from dynamic causal modeling
Authors: Junker Frederick Benjamin , Schlaffke Lara , Lange Joachim , Schmidt-Wilcke Tobias 
Published: March 2023

AbstractUnderstanding encoded language, such as written words, requires multiple cognitive processes that act in a parallel and interactive fashion. These processes and their interactions, however, are not fully understood. Various conceptual and methodical approaches including computational modeling and neuroimaging have been applied to better understand the neural underpinnings of these complex processes in the human brain. In this study, we tested different predictions of cortical interactions that derived from computational models for reading using dynamic causal modeling. Morse code was used as a model for non-lexical decoding followed by a lexical-decision during a functional magnetic resonance examination. Our results suggest that individual letters are first converted into phonemes within the left supramarginal gyrus, followed by a phoneme assembly to reconstruct word phonology, involving the left inferior frontal cortex. To allow the identification and comprehension of known words, the inferior frontal cortex then interacts with the semantic system via the left angular gyrus. As such, the left angular gyrus is likely to host phonological and semantic representations and serves as a bidirectional interface between the networks involved in language perception and word comprehension.
SARS-CoV-2 transmission in teenagers and young adults in Fútbol Club Barcelona’s Multidisciplinary Sports Training Academy
Authors: Hernández-García María , Bassat Quique , Fumado Victoria , Rodas Gil , Pi Ramon , Miranda-Garcia Maite , Girona-Alarcón Mònica , Català Martí , Alonso Sergio , Alvarez-Lacalle Enrique , López Daniel , Melé-Casas Maria , Pons-Tomas Gemma , F. de Sevilla Mariona , Bonet-Carne Elisenda , Fortuny Claudia , García-Miquel Aleix , Jou Cristina , Adroher Cristina , Claverol Joana , Cubells Marta , Codina Anna , Cuadras Daniel , Gratacós Eduard , Brotons Pedro , Muñoz-Almagro Carmen , Prats Clara , García-García Juan José , Jordan Iolanda 
Published: March 2023

AbstractMost studies, aimed at determining the incidence and transmission of SARS-CoV-2 in children and teenagers, have been developed in school settings. Our study conducted surveillance and inferred attack rates focusing on the practice of sports. Prospective and observational study of those attending the sports facilities of Fútbol Club Barcelona (FCB), in Barcelona, Spain, throughout the 2020–2021 season. Participants were young players (from five different sports) and adult workers, who belonged to stable teams (shared routines and were involved in same quarantine rules). Biweekly health questionnaires and SARS-CoV-2 screening were conducted. From the 234 participants included, 70 (30%) both lived and trained in the FCB facilities (Recruitment Pathway 1;RP1) and 164 (70%) lived at their own household and just came to the facilities to train (RP2). During the study, 38 positive cases were identified; none had severe symptoms or needed hospitalization. The overall weekly incidence in the cohorts did not differ compared to the one expected in the community, except for 2 weeks when an outbreak occurred. The attack rate (AR) was three times higher for the participants from RP1, in comparison to those from RP2 (p < 0.01). A Basketball team showed a significant higher AR. Conclusion: Physical activities in stable teams are not related to an increased risk of transmission of SARS-CoV-2, since there were the same observed cases than expected in the community. The risk is higher in indoor sports (Basketball vs. Football), and in closed cohort living settings (RP1 vs. RP2). The fulfilment of preventive measures is essential.

What is Known:• Despite the low numerical impact caused in paediatric hospitalizations during COVID-19 pandemic, the social impact has been maximum.• The transmission potential in children and teenagers is limited, and it had been widely demonstrated in school settings.

What is New:• Group physical activities in children and teenagers are not also related to an increased risk of transmission of SARS-CoV-2, when preventive measures, such as washing hands, and screening protocols are applied.• Routine and semi-professional sports activities seem safe environments to promote during this pandemic.