bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update for the Performance of CT Coronary Angiography – Evidence-Based Application and Technical Guidance According to Current Consensus Guidelines and Practical Advice from the Clinical Routine
Authors: Soschynski Martin , Hagar Muhammad Taha , Taron Jana , Krauss Tobias , Ruile Philipp , Hein Manuel , Nührenberg Thomas , Russe Maximilian Frederik , Bamberg Fabian , Schlett Christopher L 
Published: March 2022

Background Coronary CT angiography (cCTA) is a class 1 recommendation in the current guidelines by the European Society of Cardiology (ESC) for excluding significant coronary artery stenosis. To achieve optimal image quality at a low radiation dose, the imaging physician may choose different acquisition modes. Therefore, the consensus guidelines by the Society of Cardiovascular Computed Tomography (SCCT) provide helpful guidance for this procedure.
Method The article provides practical recommendations for the application and acquisition of cCTA based on the current literature and our own experience.
Results and Conclusion According to current ESC guidelines, cCTA is recommended in symptomatic patients with a low or intermediate clinical likelihood for coronary artery disease. We recommend premedication with beta blockers and nitrates prior to CT acquisition under certain conditions even with the latest CT scanner generations. The most current CT scanners offer three possible scan modes for cCTA acquisition. Heart rate is the main factor for selecting the scan mode. Other factors may be coronary calcifications and body mass index (BMI).
Key Points:
Citation Format
Traumatisierung im Arztberuf: Auslöser, Rollen und
Prozessfaktoren
Authors: Renner Anna , Kaiser Julia , Kersting Anette 
Published: March 2022

Zusammenfassung
Hintergrund ÄrztInnen zeigen eine erhöhte
Prävalenz von posttraumatischen Belastungsstörungen (PTBS).
Potentiell traumatische Ereignisse im Arztberuf sind unter anderem die
Konfrontation mit Leid, Tod, Gewalterlebnissen und medizinischen Fehlern. Ziel
der vorliegenden Analyse ist die Erfassung traumatischer Ereignisse (TE) bei
hilfesuchenden ÄrztInnen sowie die qualitative Analyse der Rollen und
beteiligten Prozessfaktoren.
Methode Mittels eines Online-Fragebogens wurden ÄrztInnen, die ein
TE erlebt hatten, hinsichtlich posttraumatischem Stress (PCL-5),
Depressivität (PHQ-9), Alkoholmissbrauch (CAGE-Test) sowie
Suizidalität (BSIS) befragt. Berichte von TEs wurden qualitativ mithilfe
der strukturierten Inhaltsanalyse ausgewertet.
Ergebnis N=41 ÄrztInnen beschrieben mindestens ein TE. Es
wurden K=54 Beschreibungen von TE qualitativ ausgewertet. Die
Betroffenen waren in einigen Fällen selbst Opfer von z. B.
Unfällen oder Gewalt, in anderen Fällen waren sie als ZeugInnen
oder Behandelnde involviert. Folgende Themen konnten identifiziert werden:
Begleitung von und Konfrontation mit Leid und Sterben, negative
Behandlungsverläufe (insbesondere Komplikationen und medizinische
Fehler) und mangelnde Unterstützung (insbesondere mangelndes
Fehlermanagement). Bei 90,3% der ÄrztInnen lagen Hinweise auf
eine vollständige oder unterschwellige PTBS vor, bei 24,4% auf
schädlichen Alkoholkonsum. Psychotrope Medikamente wurden von
31,7% der Befragten eingenommen.
Diskussion Die Ergebnisse zeigen eine hohe Belastung durch TE im
Arztberuf. Dabei sind ÄrztInnen von Traumatisierung in der Rolle als
Opfer, ZeugIn oder Behandelnde betroffen. Von besonderer Relevanz sind die
Konfrontation mit Leid und Sterben, negative Behandlungsverläufe und
subjektiv mangelnde Unterstützung. Die AssistenzärztInnenzeit
stellt möglicherweise eine vulnerable Phase dar.
Schlussfolgerung Leicht zugängliche Therapieformen (z. B.
Internettherapie) und strukturelle Veränderungen (z. B.
adäquate Unterstützung für AssistenzärztInnen,
Programme zu funktionalem Fehlermanagement) könnten die psychische
Gesundheit von ÄrztInnen fördern.
Randomized Noninferiority Trial of Expectant Management versus Early Treatment of Patent Ductus Arteriosus in Preterm Infants
Authors: Potsiurko Solomiia , Dobryanskyy Dmytro , Sekretar Lesya , Salabay Zoryana 
Published: February 2022

Objective The study aimed to investigate, whether expectant management is noninferior to early patent ductus arteriosus (PDA) treatment with regard to the composite of mortality and/or incidence of bronchopulmonary dysplasia (BPD) in very preterm infants.
Study design A total of 208 very preterm infants of the gestational age <32 weeks, birth weight <1,500 g, chronological age <72 hours, and PDA >1.5 mm were randomized between the treatment or expectant management groups. Both, the intention-to-treat and per-protocol analyses were performed.
Results A total of 104 (50%) patients received rectal ibuprofen (n = 52) or intravenous acetaminophen (n = 52) within first 72 hours of life. In 104 (50%) infants, expectant management was used. Eight of them (8%) received rescue treatment at the median age of 7 (range: 6–13) days. PDA closure rates by the 10th day of life were 81% (n = 84) in the treatment arm, and 58% (n = 60) in the expectant management arm (p < 0.01). The median age at the time of ductus closure was 5 (range: 5–6) days in the treatment arm and 8 (range: 6–11) days in the expectant management arm (p < 0.01). At the time of discharge, ductus was closed in 83% of treated infants and in 78% of patients who were managed expectantly (p > 0.05). No significant difference between the groups was found for the primary clinical outcomes, BPD/death, or the secondary outcomes at a postmenstrual age of 36 weeks or discharge.
Conclusion Expectant management is noninferior to early PDA treatment for reducing the incidence of death/BPD. Compared with the expectant management, early pharmacological treatment provides more frequent and faster PDA closure in preterm infants with gestational age <32 weeks, but it neither reduces morbidity nor improves survival rates.
Key Points
Individualised Homeopathic Treatment of Nausea and Vomiting in the First Trimester and of COVID-19 in the Third Trimester of Pregnancy—A Case Report
Authors: Glas Katarina Lucija 
Published: February 2022

Abstract
Introduction/Background Nausea and vomiting in pregnancy are common physiological disturbances, causing physical, social and psychological symptoms in the affected women. Though it is difficult to draw absolute conclusions on whether or not pregnant women are at high risk of acquiring severe consequences from corona-virus disease 2019 (COVID-19), clinical experience has shown them to be potentially vulnerable to other coronaviruses. Lack of specific conventional therapy for these conditions called for a complementary and individualised homeopathy approach in the presented case.
Methods The homeopathic medical management of early symptoms of nausea and vomiting in pregnancy (NVP) and the beginning of COVID-19 symptoms shortly before a scheduled Caesarean section is described. No ongoing specific treatments were discontinued. The connection between intervention with individualised homeopathy and clinical improvement was assessed by two independent reviewers using the MOdified NARanjo Criteria for Homeopathy (MONARCH) inventory.
Results There was improvement of NVP symptoms in early pregnancy and in later-onset COVID-19 symptoms following an individually prescribed unipotent homeopathic medicine, Sepia officinalis, after tele-consultation during lockdown. The agreed MONARCH score was +8 points, suggesting that homeopathy contributed to clinical improvement.
Conclusion Individualised homeopathy may be a helpful complementary medical approach for managing symptoms associated with NVP and COVID-19 during pregnancy.
Transcranial Magnetic Stimulation for the Neurological Patient: Scientific Principles and Applications
Authors: Eldaief Mark C. , Dickerson Bradford C. , Camprodon Joan A. 
Published: February 2022

AbstractNon-invasive brain stimulation has been increasingly recognized for its potential as an investigational, diagnostic and therapeutic tool across the clinical neurosciences. Transcranial magnetic stimulation (TMS) is a non-invasive method of focal neuromodulation. Diagnostically, TMS can be used to probe cortical excitability and plasticity, as well as for functional mapping. Therapeutically, depending on the pattern employed, TMS can either facilitate or inhibit stimulated cortex potentially modulating maladaptive physiology through its effects on neuroplasticity. Despite this potential, applications of TMS in neurology have only been approved for diagnostic clinical neurophysiology, pre-surgical mapping of motor and language cortex, and the treatment of migraines. In this article, we discuss the principles of TMS and its clinical applications in neurology, including experimental applications in stroke rehabilitation, seizures, autism spectrum disorder, neurodegenerative disorders, movement disorders, tinnitus, chronic pain and functional neurological disorder. To promote increased cross-talk across neurology and psychiatry, we also succinctly review the TMS literature for the treatment of major depression and obsessive compulsive disorder. Overall, we argue that larger clinical trials that are better informed by circuit-level biomarkers and pathophysiological models will lead to an expansion of the application of TMS for patients cared for by neurologists.
The Evolution of Neurosurgery Throughout the Ages: From Trepanations in Prehistory to The Robotic Era
Authors: Souza Felipe dos Santos , Silva Rhuann Pontes dos Santos , Junior Luiz Severo Bem , Azevedo Filho Hildo Rocha Cirne de 
Published: February 2022

Abstract
Introduction Throughout the historical course, the emergence of neurosurgery invariably involved the narrative about different eras, marked by relevant discoveries in the field of medical science. From prehistoric mystical and therapeutic reports to the Robotic Era in the 21st century, there were changes that contributed to current neurosurgery. Thus, this study will analyze articles and studies that describe the history of neurosurgery and demonstrate the main advances in the field of science.
Materials and methods This is a narrative review of scientific literature, carried out by searching the following databases: Scientific Electronic Library Online (SCIELO), Online System for Searching and Analyzing Medical Literature (MEDLINE), Latin American Literature and Caribbean in Health Sciences (LILACS), and Public Medical Literature Analysis and Retrieval System Online (PubMed).The following descriptors were used: History of neurosurgery and Neuroanatomy, together with the Boolean operator “AND”. In addition, the descriptors History
of
Neurosurgery and Robotics were used between the Boolean operator “AND”. In this sense, in order to establish a linearity of the narrative presented, the evolution of neurosurgery in five eras was didactically separated.
Conclusion Neurosurgery, throughout history, has undergone several transformations. There was a series of events that made neurosurgery one of the most evolutionary and progressive sciences. This is because technology combined with scientific knowledge was, in fact, what made it possible to get where we are. In this sense, the studied ages allow the comprehension of a history that needs to be understood and valued by all students of the neurological and neurosurgical sciences.
Surgical Dilemmas Associated with Malignant Large Bowel Obstructions
Authors: Schwartzberg David M. , Valente Michael A. 
Published: February 2022

AbstractDespite an increase in screening colonoscopy, with the objective to decrease the incidence of colorectal cancer, a third of patients will present with an obstructing cancer. Malignant large bowel obstructions (MLBO) pose a challenging workup and treatment paradigm where an oncologic primary tumor resection must be balanced with relieving the obstruction, functional outcomes, palliation, and consideration for adjuvant therapy. A thorough work up with cross-sectional imaging and medical optimization should be attempted; however, patients may present in extremis and require emergent intervention. The onset of MLBO can be insidious, but result in electrolyte derangements, perforation, small bowel obstruction, hemorrhage, and ischemia. Self-expandable metallic stents have been used as palliation or as a bridge to surgery and have allowed for minimally invasive surgical options as well as a decrease in stoma rates. Patients with signs of colon ischemia or perforation require emergent surgery, which is associated with an increase in stoma formation, morbidity, mortality, and a decrease in overall survival.
Routine Mediastinal Drainage Fluid Culture for Early Diagnosis of Poststernotomy Mediastinitis
Authors: Jung Yochun , Lee Kyo Seon , Oh Sang Gi , Jeong Yangseung 
Published: February 2022

Abstract
Background Early diagnosis of poststernotomy mediastinitis (PSM) is challenging. Since 2016, we have routinely performed mediastinal drainage fluid culture (MDFC) in patients undergoing sternotomy. This study aimed to determine the utility of MDFC for early diagnosis of PSM.
Methods Between November 2016 and April 2020, we conducted MDFC in 1,012 patients on the third postoperative day and prospectively observed for PSM occurrence for 3 months. If bacteria were identified, additional MDFC or blood culture was performed to reduce the possibility of false positives. Based on MDFC results, the decision for early treatment for PSM was at the attending physician's discretion.
Results Bacteria were identified in MDFC of 29 patients, eight of whom subsequently developed PSM. Among 983 patients with negative MDFC, only 15 developed PSM. In multivariate analysis, previous sternotomy history and positive MDFC were predictors of PSM. Positive MDFC was regarded as true positive if (1) PSM occurred subsequently, and/or (2) the same bacteria were identified in additional MDFC/blood culture. Non-occurrence of PSM in the absence of antibiotic treatment was regarded as false-positive MDFC. The sensitivity, specificity, and positive and negative predictive values of routine MDFC for diagnosis of mediastinal infection were 46.4, 99.0, 56.5, and 98.5%, respectively. When categorizing cases with positive MDFC based on the identified bacteria, the positive predictive value was highest (76.9%) when Staphylococci were identified.
Conclusion Routine MDFC after sternotomy can facilitate early diagnosis of PSM. Early treatment for PSM may be indicated in patients in whom Staphylococci are identified in the MDFC.
Noninvasive Systemic Modalities for Prevention of Head and Neck Radiation-Associated Soft Tissue Injury: A Narrative Review
Authors: Kim Leslie N. , Rubenstein Robyn N. , Chu Jacqueline J. , Allen Robert J. , Mehrara Babak J. , Nelson Jonas A. 
Published: February 2022

Abstract
Background Radiation-associated soft tissue injury is a potentially devastating complication for head and neck cancer patients. The damage can range from minor sequelae such as xerostomia, which requires frequent daily maintenance, to destructive degenerative processes such as osteoradionecrosis, which can contribute to flap failure and delay or reverse oral rehabilitation. Despite the need for effective radioprotectants, the literature remains sparse, primarily focused on interventions beyond the surgeon's control, such as maintenance of good oral hygiene or modulation of radiation dose.
Methods This narrative review aggregates and explores noninvasive, systemic treatment modalities for prevention or amelioration of radiation-associated soft tissue injury.
Results We highlighted nine modalities with the most clinical potential, which include amifostine, melatonin, palifermin, hyperbaric oxygen therapy, photobiomodulation, pentoxifylline–tocopherol–clodronate, pravastatin, transforming growth factor-β modulators, and deferoxamine, and reviewed the benefits and limitations of each modality. Unfortunately, none of these modalities are supported by strong evidence for prophylaxis against radiation-associated soft tissue injury.
Conclusion While we cannot endorse any of these nine modalities for immediate clinical use, they may prove fruitful areas for further investigation.
Clinical Outcomes after Mitral Valve Surgery in Failed MitraClip Procedures
Authors: Pingpoh Clarence , Kreibich Maximillian , Berger Tim , Thoma Martin , Beyersdorf Friedhelm , Comberg Thomas , Fagu Albi , Siepe Matthias , Czerny Martin 
Published: February 2022

Abstract
Background We retrospectively evaluated in-hospital and overall outcome of patients who received mitral valve replacement (MVR) after failed MitraClip procedure.
Methods A total of 26 out of 740 patients received MVR after treatment with MitraClip between June 2010 and December 2020. We analyzed in-hospital mortality and overall mortality during the median follow-up period of 72 days after MVR.
Results The median age in the entire cohort was 77.5 years. In-hospital mortality was 15.4% (n = 4) and the overall mortality during the follow-up period was 27% (n = 7). The median time between the MitraClip procedure and surgery was 34.5 days. The main reasons for surgery were mitral stenosis (23.1%), persistent prolapse of the mitral valve leaflets (42.3%), and persistent tethering of the mitral valve leaflets (34.6%). At the time of surgery all of the patients presented with New York Heart Association 3 and above. The underlying mitral valve pathology was mainly secondary 61.5% (n = 16). Median left ventricular end-diastolic diameter was 60 mm. Preoperative ejection fraction was 40% and above in 73% of the cohort. In addition to the mitral valve procedure, 57.7% of patients received either concomitant tricuspid annuloplasty, aortic valve surgery, ascending aortic replacement, or coronary artery bypass grafting.
Conclusion The need for MVR for failed MitraClip repair is low and the results are acceptable. However, remaining options for reconstruction are usually limited and MVR is often needed. Anticipating success or failure according to the underlying pathology more than according to concomitant risk factors should form the basis in decision making for the treatment modality of first choice.
Safety and Efficacy of Stereoelectroencephalography in Pediatric Epilepsy Surgery
Authors: Kassiri Janani , Elliott Cameron , Liu Natarie , Narvacan Karl , Wheatly Matt , Sinclair D.Barry 
Published: March 2022

AbstractStereoelectroencephalography (SEEG) is the preoperative assessment of choice when the epileptogenic zone (EZ) is unclear in patients requiring surgery for severe, drug-refractory epilepsy. There are relatively little data on the safety and efficacy of SEEG in the pediatric epilepsy population. We, therefore, investigated the insertional complications, rate of successful identification of the EZ, and long-term seizure outcomes following surgery after SEEG in children. This was a retrospective study of drug-resistant pediatric epilepsy patients treated with surgery between 2005 and 2020 and who underwent presurgical SEEG. Rationale for and coverage of SEEG, identification of the EZ, and ultimate seizure outcome following SEEG-tailored resections were collected and analyzed. Thirty patients (15 male, mean age: 12.4 ± 5 years) who underwent SEEG were studied. SEEG-related complications occurred in one case (3%). A total of 190 multicontact electrodes (mean: 7.0 ± 2.5 per patient) were implanted across 30 insertions capturing 440 electrographic seizures (mean: 17.5 ± 27.6 per patient). The most common rationale for SEEG was normal magnetic resonance imaging with surface EEG that failed to identify the EZ (17/30; 57%). SEEG identified a putative EZ in all cases, resulting in SEEG-tailored resections in 25/30 (83%). Freedom from disabling seizures was achieved following resections in 20/25 cases (80%) with 5.9 ± 4.0 years of postoperative follow-up. SEEG is a safe and effective way to identify the EZ in the presurgical evaluation of children with refractory epilepsy and permits effective and long-lasting SEEG-tailored resections.
Comparison of Bioinformatics Approaches for Fetal Microdeletions and Monogenic Variations Estimation in Non-invasive Prenatal Testing
Authors: Paul Lizzy Teleboshe , Ergoren Mahmut Cerkez 
Published: February 2022

AbstractPrenatal testing provides crucial information about the health status of fetuses as well as recommending better treatment. For the past decades, prenatal testing using chorionic villus sampling and amniocentesis were the two majorly used forms of invasive prenatal diagnostic approaches. However, to facilitate prenatal testing without causing any danger to the fetus, the noninvasive prenatal diagnostic method, which uses circulating cell-free deoxyribonucleic acid (DNA), has become a suitable method of prenatal diagnosis. This review discusses the recent bioinformatics approaches used for analyzing fetal DNA concentration.
Vietnam tourism: a view from within.
Authors: Bui Huong T. , Phi Giang T. 
Published: February 2022

Abstract

This chapter defines the scope of the book with reference to the political, social and economic situation of Vietnam. By reviewing existing work on Vietnam tourism published in English, the authors highlight the issues of minorities and fragmentation with regards to current writing on the topic. This justifies the importance and significance of compiling a compendium of current work on policies and practices of tourism development from various levels of administration across different types and forms of tourism and encompassing diverse segments of the tourism industry.
Ecotourism in forests and protected areas.
Authors: Pham Long H. , Bui Huong T. , Do Huong H. , Jones Thomas E. 
Published: February 2022

Abstract

This chapter offers an overview of ecotourism in forest-protected areas in Vietnam from theoretical concepts and historical evolution of forest conservation to the current structure of governance and management of forest resources and the economic and socio-cultural perspectives of forest resources ecotourism and ecotourists. Differentiated from conventional approaches using cases or empirical research focus on particular sites, the current study systematically analyses national policies and practices of ecotourism in national parks and protected areas (PAs). The review synthesizes existing studies published on various channels in and outside the country and numerous government reports and research conducted by NGOs on ecotourism, PAs and forest conservation. The analysis pertinent in this chapter, however, excludes marine-based ecotourism, which is covered in a separate chapter.
Community-based tourism: challenges and opportunities for sustainable development.
Authors: Phi Giang T. , Pham Long H. 
Published: February 2022

Abstract

The chapter first provides background information on the evolution of community-based tourism (CBT) in Vietnam before exploring critical areas of the CBT literature. Next, the qualitative approaches utilized for the study, on which the findings and discussions are drawn upon, are presented. The findings are further discussed within the context of three CBT case studies in Vietnam. Finally, recommendations are suggested for the future sustainable development of CBT in Vietnam.
Dark tourism in the former Demilitarized Zone (DMZ).
Authors: Ngo Phuong M. , Bui Huong T. , Dimache Alexandru 
Published: February 2022

Abstract

This chapter discusses the current practices of dark tourism conducted in the former demilitarized zone (DMZ), evoking the confrontation of two ideologies between Vietnamese and American troops in the Vietnam War. The two authors, Ngo, Bui and Dimache, examine the structure of the dark tourism industry, issues of governance, promotion and production of dark tourism and the involvement of tourists and tour guides in the historic sites in the DMZ of Quang Tri province. The analysis of construction and narration at former battlefields offers an in-depth understanding of dark tourism at former war sites in post-war Vietnam.