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Long-Term Outcomes of the PRESERFLO MicroShunt Implant in a Heterogeneous Glaucoma Cohort
No full textThe Preserflo MicroShunt represents a novel glaucoma treatment device, necessitating long-term follow-up data to accurately assess its efficacy. The aim of this study is to report real-world data of a heterogenous glaucoma cohort who received Preserflo implantation at a specialized glaucoma clinic. A total of 160 eyes of 160 patients who underwent Preserflo MicroShunt implantation were retrospectively enrolled in this study. Patient characteristics, as well as success and failure rates, were assessed. The numbers of adverse events and revision procedures were recorded, along with any reduction in supplementary medication. The progression of intraocular pressure (IOP) was assessed over the course of 12 months, and fluctuations were analyzed. The overall success rate was 61.9% (complete success: 51.3%, qualified success: 10.6%). Revision surgery was performed in 25% of cases. Excessive hypotony occurred postoperatively in 54.4% of patients and regressed after 7 days in 88.8% of all cases. Median IOP decreased from 22 (interquartile range (IQR): 17–27) mmHg preoperatively to 14 (IQR 12–16) mmHg at 12 months postoperatively (p < 0.01). The median number of antiglaucomatous agents decreased from three to zero at latest follow-up. The Preserflo MicroShunt achieved a noticeable reduction in IOP over the course of 12 months in glaucoma patients, irrespective of disease severity or disease subtype. The frequency of postoperative adverse events and number for revision surgeries over the course of the follow-up period were low
Mapping the Bibliometrics Landscape of AI in Medicine: Methodological Study
No full textBackground: Artificial intelligence (AI), conceived in the 1950s, has permeated numerous industries, intensifying in tandem with advancements in computing power. Despite the widespread adoption of AI, its integration into medicine trails other sectors. However, medical AI research has experienced substantial growth, attracting considerable attention from researchers and practitioners. Objective: In the absence of an existing framework, this study aims to outline the current landscape of medical AI research and provide insights into its future developments by examining all AI-related studies within PubMed over the past 2 decades. We also propose potential data acquisition and analysis methods, developed using Python (version 3.11) and to be executed in Spyder IDE (version 5.4.3), for future analogous research. Methods: Our dual-pronged approach involved (1) retrieving publication metadata related to AI from PubMed (spanning 2000-2022) via Python, including titles, abstracts, authors, journals, country, and publishing years, followed by keyword frequency analysis and (2) classifying relevant topics using latent Dirichlet allocation, an unsupervised machine learning approach, and defining the research scope of AI in medicine. In the absence of a universal medical AI taxonomy, we used an AI dictionary based on the European Commission Joint Research Centre AI Watch report, which emphasizes 8 domains: reasoning, planning, learning, perception, communication, integration and interaction, service, and AI ethics and philosophy. Results: From 2000 to 2022, a comprehensive analysis of 307,701 AI-related publications from PubMed highlighted a 36-fold increase. The United States emerged as a clear frontrunner, producing 68,502 of these articles. Despite its substantial contribution in terms of volume, China lagged in terms of citation impact. Diving into specific AI domains, as the Joint Research Centre AI Watch report categorized, the learning domain emerged dominant. Our classification analysis meticulously traced the nuanced research trajectories across each domain, revealing the multifaceted and evolving nature of AI’s application in the realm of medicine.
Conclusions: The research topics have evolved as the volume of AI studies increases annually. Machine learning remains central to medical AI research, with deep learning expected to maintain its fundamental role. Empowered by predictive algorithms, pattern recognition, and imaging analysis capabilities, the future of AI research in medicine is anticipated to concentrate on medical diagnosis, robotic intervention, and disease management. Our topic modeling outcomes provide a clear insight into the focus of AI research in medicine over the past decades and lay the groundwork for predicting future directions. The domains that have attracted considerable research attention, primarily the learning domain, will continue to shape the trajectory of AI in medicine. Given the observed growing interest, the domain of AI ethics and philosophy also stands out as a prospective area of increased focus
State Bankruptcies in the Financial Market Crisis
No full textDie globale Finanzmarktkrise begann 2007 in den USA, betraf dann aber viel stärker die Eurozone, in der Staatsinsolvenzen drohten und Griechenland seine Schulden tatsächlich nicht mehr vollständig bediente. Es fehlen jedoch geordnete Verfahren für Staatsinsolvenzen oder auch für einen Austritt aus der Eurozone, in der die Probleme zu hoher Staatsschulden größer und schwerer lösbar sind.The global financial market crisis began in the USA in 2007, but then affected the euro zone much more severely, where national bankruptcies threatened and Greece actually no longer fully serviced its debts. However, there are no orderly procedures for state bankruptcies or for exiting the euro zone, where the problems of excessive national debt are greater and more difficult to solve
Surgical Management of Periprosthetic Joint Infections in Hip and Knee Megaprostheses
No full textPeriprosthetic joint infection is a feared complication after the megaprosthetic reconstruction of oncologic and non-oncologic bone defects of including the knee or hip joint. Due to the relative rarity of these procedures, however, optimal management is debatable. Considering the expanding use of megaprostheses in revision arthroplasty and the high revision burden in orthopedic oncology, the risk of PJI is likely to increase over the coming years. In this non-systematic review article, we present and discuss current management options and the associated results focusing on studies from the last 15 years and studies from dedicated centers or study groups. The indication, surgical details and results in controlling infection are presented for debridement, antibiotics, irrigation and retention (DAIR) procedure with an exchange of the modular components, single-stage implant exchange, two-stage exchanges and ablative procedures
Survival of Patients with Acute Coronary Syndrome and Hematologic Malignancies—A Real-World Analysis
No full textBackground: The impact of the encounter between coronary heart disease (CHD) and cancer, and in particular hematologic malignancies (HM), remains poorly understood. Objective: The aim of this analysis was to clarify how HM affects the prognosis of acute coronary syndrome (ACS). We analyzed German health insurance data from 11 regional Ortskrankenkassen (AOK) of patients hospitalized for ACS between January 2010 and December 2018, matched by age, sex and all comorbidities for short- and long-term survival and major adverse cardiac events (MACE). Results: Of 439,716 patients with ACS, 2104 (0.5%) also had an HM. Myelodysplastic/myeloproliferative disorders (27.7%), lymphocytic leukemias (24.8%), and multiple myeloma (22.4%) predominated. These patients were about 6 years older (78 vs. 72 years *). They had an ST-segment elevation myocardial infarction (STEMI, 18.2 vs. 34.9% *) less often and more often had a non-STEMI (NSTEMI, 81.8 vs. 65.1% *). With the exception of dyslipidemia, these patients had more concomitant and previous cardiovascular disease and a worse NYHA stage. They were less likely to undergo coronary angiography (65.3 vs. 71.6% *) and percutaneous coronary intervention (PCI, 44.3 vs. 52.0% *), although the number of bleeding events was not relevantly increased (p = 0.22). After adjustment for the patients’ risk profile, the HM was associated with reduced long-term survival. However, this was not true for short-term survival. Here, there was no difference in the STEMI patients, * p < 0.001. Conclusion: Survival in ACS and HM is significantly lower, possibly due to the avoidance of PCI because of a perceived increased risk of bleeding
Mitochondrial DNA mutations in Medulloblastoma
No full textTo date, several studies on genomic events underlying medulloblastoma (MB) biology have expanded our understanding of this tumour entity and led to its division into four groups—WNT, SHH, group 3 (G3) and group 4 (G4). However, there is little information about the relevance of pathogenic mitochondrial DNA (mtDNA) mutations and their consequences across these. In this report, we describe the case of a female patient with MB and a mitochondriopathy, followed by a study of mtDNA variants in MB groups. After being diagnosed with G4 MB, the index patient was treated in line with the HIT 2000 protocol with no indications of relapse after five years. Long-term side effects of treatment were complemented by additional neurological symptoms and elevated lactate levels ten years later, resulting in suspected mitochondrial disease. This was confirmed by identifying a mutation in the MT-TS1 gene which appeared homoplasmic in patient tissue and heteroplasmic in the patient’s mother. Motivated by this case, we explored mtDNA mutations across 444 patients from ICGC and HIT cohorts. While there was no statistically significant enrichment of mutations in one MB group, both cohorts encompassed a small group of patients harbouring potentially deleterious mtDNA variants. The case presented here highlights the possible similarities between sequelae caused by MB treatment and neurological symptoms of mitochondrial dysfunction, which may apply to patients across all MB groups. In the context of the current advances in characterising and interpreting mtDNA aberrations, recognising affected patients could enhance our future knowledge regarding the mutations’ impact on carcinogenesis and cancer treatment
Modeling Length Changes in De Novo Open Reading Frames during Neutral Evolution
No full textFor protein coding genes to emerge 'de novo' from a non-genic DNA, the DNA sequence must gain an open reading frame (ORF) and the ability to be transcribed. The newborn 'de novo' gene can further evolve to accumulate changes in its sequence. Consequently, it can also elongate or shrink with time. Existing literature shows that older 'de novo' genes have longer ORF, but it is not clear if they elongated with time or remained of the same length since their inception. To address this question we developed a mathematical model of ORF elongation as a Markov-jump process, and show that ORFs tend to keep their length in short evolutionary timescales. We also show that if change occurs it is likely to be a truncation. Our genomics and transcriptomics data analyses of seven 'Drosophila melanogaster' populations are also in agreement with the model’s prediction. We conclude that selection could facilitate ORF length extension that may explain why longer ORFs were observed in old 'de novo' genes in studies analysing longer evolutionary time scales. Alternatively, shorter ORFs may be purged because they may be less likely to yield functional proteins
Moore – die unbekannten Klimaretter:Interview mit Prof. Dr. Klaus Holger Knorr
No full textDer Klimawandel ist eines der drängendsten Probleme unserer Zeit. Dass Moore dabei eine wichtige Rolle spielen, wissen allerdings nur die wenigsten. Moore binden große Mengen des klimaschädlichen Kohlendioxids. Werden sie trockengelegt, um sie beispielsweise für die Landwirtschaft zu nutzen – was häufig der Fall ist – geben sie die Treibhausgase in die Atmosphäre und beschleunigen somit den Klimawandel. Klaus Holger Knorr ist Professor für Hydrologie am Institut für Landschaftsökologie und erklärt im Podcast, wie es im Moment um die Moore steht, was jeder einzelne für sie tun kann und wie gefährlich die Tatsache ist, dass viele Permafrost-Moore auftauen
Schreibförderung durch formatives Feedback unter besonderer Berücksichtigung von migrationsbedingter Mehrsprachigkeit:Ergebnisse aus einer Studie mit Lehrkräften und Lernenden neunter Klassen
No full textDas übergeordnete Ziel der Dissertation ist es, Schreibförderung im Kontext migrationsbedingter Mehrsprachigkeit zu verbessern. Die Arbeit ist eingebettet in das Mercator-geförderte quasi-experimentelle Interventionsprojekt WeLiKe Feedback, das aus zwei verbundenen Einzelstudien bestand. In Studie 1 wurden Lehrkräfte im Einsatz prozessorientierter Schreib- und Feedbackmethoden fortgebildet, die in Studie 2 im Deutschunterricht eingesetzt werden sollten. Da Studie 2 pandemiebedingt nicht wie geplant umgesetzt werden konnte, werden in der Dissertation Untersuchungen zum Status Quo in Form von vier empirischen Teilstudien fokussiert: 1) Analyse von Bildungsdokumenten für den Schreibunterricht 2) Analyse von Feedbackpraktiken der teilnehmenden Lehrkräfte (N = 8), 3) Analyse der Textqualität von Lernenden in Jahrgang 9 (N = 208) sowie 4) Zusammenhänge zwischen Feedbackpraktiken der Lehrkräfte und Textqualität der Lernenden. Es werden Implikationen für Forschung und Praxis diskutiert.The overarching aim of this dissertation is to enhance fostering writing in the context of migration-related multilingualism. It is embedded in the Mercator-funded quasi-experimental intervention project WeLiKe Feedback, which consisted of two connected individual studies. In study 1, teachers were trained in a professional learning intervention (PLI) on process-oriented writing and feedback methods, which were to be implemented in their German classes in study 2. However, due to the pandemic, the implementation of the PLI content in study 2 could not take place as planned. Therefore, within this dissertation, investigations of the status quo are carried within four empirical studies: 1) Analysis of policy documents for teaching German, 2) analysis of teachers’ feedback routines (N = 8), 3) analysis of Year 9 students’ text quality (N = 208), as well as 4) relations between teachers’ feedback routines and students’ text quality. Implications for research and practice are discussed
Self-motion illusions from distorted optic flow in multifocal glasses
No full textProgressive addition lenses (PALs) are ophthalmic lenses to correct presbyopia by providing improvements of near and far vision in different areas of the lens, but distorting the periphery of the wearer’s field of view. Distortion-related difficulties reported by PAL wearers include unnatural self-motion perception. Visual self-motion perception is guided by optic flow, the pattern of retinal motion produced by self-motion. We tested the influence of PAL distortions on optic flow-based heading estimation using a model of heading perception and a virtual reality-based psychophysical experiment. The model predicted changes of heading estimation along a vertical axis, depending on visual field size and gaze direction. Consistent with this prediction, participants experienced upwards deviations of self-motion when gaze through the periphery of the lens was simulated, but not for gaze through the center. We conclude that PALs may lead to illusions of self-motion which could be remedied by a careful gaze strategy