Disease modifies the dependency of percentiles of the phase angle distribution on age, sex, height and weight in hospitalized patients.

Background & Aims: Phase angle (PhA) is viewed as a holistic indicator of quantity and quality of cellularity and hydration status and has emerged as a significant predictor of patient outcome in clinical medicine. We sought to analyze the impact of hospitalization as a surrogate for disease on the distribution of PhA and its dependency on influence variables age, sex, height and weight without any assumption as to the form of PhA-distribution.

Methods: First PhA measurements obtained from 2418 women (median age 75 IQR[63; 82]) and 2541 men (median age 70 IQR[60; 79]) hospitalized in a Community General Hospital were analyzed.

Real-World Outcomes After Switch From Aflibercept to Faricimab in Eyes With Diabetic Macular Edema.

Purpose: To assess the anatomic and functional outcomes in eyes with diabetic macular edema (DME) switched from intravitreal aflibercept to faricimab in a real-world setting.

Methods: Retrospective, interventional consecutive case series. Patients with DME were switched from aflibercept to faricimab and categorized based on central subfield thickness (CST) 4 weeks after last aflibercept injection into responding DME (rDME, CST reduction >20% or CST ≤ 250 µm) and nonresponding DME (nrDME, CST unchanged or increased).

Impact of light dose and fluence rate on the efficacy and tolerability of topical 5-ALA photodynamic therapy for actinic keratoses: A randomized, controlled, observer-blinded intrapatient comparison study.

Background: Conventional photodynamic therapy (cPDT) is an effective treatment option for field cancerization and multiple actinic keratoses (AK). The main side effect of cPDT is pain during illumination which in severe cases might necessitate early termination of treatment. Modification of treatment parameters such as light dose and fluence rate is a promising approach to mitigate PDT-associated pain.

Cross-Sectoral Comparisons of Process Quality Indicators of Health Care Across Residential Regions Using Restricted Mean Survival Time.

Background: Practice guidelines recommend patient management based on scientific evidence. Quality indicators gauge adherence to such recommendations and assess health care quality. They are usually defined as adverse event rates, which may not fully capture guideline adherence over time.

Normative prospective data on automatically quantified retinal morphology correlated to retinal function in healthy ageing eyes by two microperimetry devices.

Purpose: The relationship between retinal morphology, as assessed by optical coherence tomography (OCT), and retinal function in microperimetry (MP) has not been well studied, despite its increasing importance as an essential functional endpoint for clinical trials and emerging therapies in retinal diseases. Normative databases of healthy ageing eyes are largely missing from literature.

Methods: Healthy subjects above 50 years were examined using two MP devices, MP-3 (NIDEK) and MAIA (iCare).

Conventional versus task-based package organization for out-of-hospital emergency kits: an emergency medical services simulation study.

Background: Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting.

Human cold pain: a randomized crossover trial.

The mechanism causing cold pain in humans is unresolved. Animal data suggest a nonredundant contribution to cold pain for transient receptor potential channels TRPM8 and TRPA1 for detection and voltage-gated sodium channels NaV1.7 and NaV1.

Emotions in misinformation studies: distinguishing affective state from emotional response and misinformation recognition from acceptance.

Prior studies indicate that emotions, particularly high-arousal emotions, may elicit rapid intuitive thinking, thereby decreasing the ability to recognize misinformation. Yet, few studies have distinguished prior affective states from emotional reactions to false news, which could influence belief in falsehoods in different ways. Extending a study by Martel et al.

Study protocol for the PICASSO trial: A randomized placebo-controlled trial to investigate the efficacy and safety of intraarticular steroid injections and an occupational therapy intervention in painful inflammatory carpometacarpal-1 osteoarthritis.

Objective: Our primary objectives are to assess whether intraarticular corticosteroid injections are superior to saline injections with regards to thumb base pain after 4 weeks, and to compare the efficacy of steroid injections, saline injections, and an occupational therapy intervention on thumb base pain after 12 weeks in people with painful inflammatory osteoarthritis (OA) of the first carpometacarpal (CMC-1) joint.

Design: In this three-armed, double-blind, randomized multicenter trial, 354 participants with painful inflammatory CMC-1 OA from six Norwegian hospitals are recruited. Participants are randomized 1:1:1 to intraarticular steroid or saline injections in the CMC-1 joint or a multimodal occupational therapy intervention.

Effect of patient-contextual skin images in human- and artificial intelligence-based diagnosis of melanoma: Results from the 2020 SIIM-ISIC melanoma classification challenge.

Background: While the high accuracy of reported AI tools for melanoma detection is promising, the lack of holistic consideration of the patient is often criticized. Along with medical history, a dermatologist would also consider intra-patient nevi patterns, such that nevi that are different from others on a given patient are treated with suspicion.

Objective: To evaluate whether patient-contextual lesion-images improves diagnostic accuracy for melanoma in a dermoscopic image-based AI competition and a human reader study.

Extracorporeal Photopheresis for the prevention of rejection after lung transplantation - a prospective randomized controlled trial.

Rationale: Lung transplant recipients have the worst long-term outcomes of all solid organs due to acute rejection and chronic lung allograft dysfunction (CLAD).

Objective: To investigate the efficacy of ECP as a prophylactic treatment to prevent acute cellular rejection (ACR), CMV infections and reduce the risk of CLAD.

Methods: Single-center prospective randomized controlled trial conducted at Medical University of Vienna between 2018 and 2020.

Enhancing Arden-Syntax-Based Clinical Reasoning with Ontologies.

We present a new methodological approach based on integrating Arden-Syntax-based clinical decision support (CDS) with an upstream ontology service. Incoming linguistic patient data, such as single reports about detected germs or viruses, shall be identified by the applied ontology at a low level. Then, higher-level concepts are activated by ontology-based bottom-up reasoning.

FHIR-Based Arden Syntax Compiler for Clinical Decision Support.

The Arden Syntax is a language designed for the encoding of medical knowledge into clinical decision support systems. Its evolution is overseen by Health Level 7. A significant enhancement in its new version 3.

Topographic and quantitative correlation of structure and function using deep learning in subclinical biomarkers of intermediate age-related macular degeneration.

To examine the morphological impact of deep learning (DL)-quantified biomarkers on point-wise sensitivity (PWS) using microperimetry (MP) and optical coherence tomography (OCT) in intermediate AMD (iAMD). Patients with iAMD were examined by OCT (Spectralis). DL-based algorithms quantified ellipsoid zone (EZ)-thickness, hyperreflective foci (HRF) and drusen volume.

Multi-modal representation learning in retinal imaging using self-supervised learning for enhanced clinical predictions.

Self-supervised learning has become the cornerstone of building generalizable and transferable artificial intelligence systems in medical imaging. In particular, contrastive representation learning techniques trained on large multi-modal datasets have demonstrated impressive capabilities of producing highly transferable representations for different downstream tasks. In ophthalmology, large multi-modal datasets are abundantly available and conveniently accessible as modern retinal imaging scanners acquire both 2D fundus images and 3D optical coherence tomography (OCT) scans to assess the eye.

In-Stent Restenosis in Peripheral Arterial Disease: Ultra-High-Resolution Photon-Counting Versus Third-Generation Dual-Source Energy-Integrating Detector CT Phantom Study in Seven Different Stent Types.

Purpose: The visualization of peripheral in-stent restenosis using energy-integrating detector CT is challenging due to deficient spatial resolution and artifact formation. This study compares the first clinically available photon-counting detector CT to third-generation dual-source energy-integrating detector CT.

Materials And Methods: Nylon cylinders with central bores (4 mm, 2 mm), mimicking 75% and 95% stenoses, were placed inside seven different 8-mm diameter stents and filled with diluted contrast medium.

VLFATRollout: Fully transformer-based classifier for retinal OCT volumes.

Background And Objective: Despite the promising capabilities of 3D transformer architectures in video analysis, their application to high-resolution 3D medical volumes encounters several challenges. One major limitation is the high number of 3D patches, which reduces the efficiency of the global self-attention mechanisms of transformers. Additionally, background information can distract vision transformers from focusing on crucial areas of the input image, thereby introducing noise into the final representation.

Definition of clinically relevant intraoperative hypotension: A data-driven approach.

Background: Associations between intraoperative hypotension (IOH) and various postoperative outcomes were shown in retrospective trials using a variety of different definitions of IOH. This complicates the comparability of these trials and makes clinical application difficult. Information about the best performing definitions of IOH regarding 30-day mortality, hospital length of stay (hLOS), and postanesthesia care unit length of stay (PACU-LOS) is missing.

Efficiency of multivariate tests in trials in progressive supranuclear palsy.

Measuring disease progression in clinical trials for testing novel treatments for multifaceted diseases as progressive supranuclear palsy (PSP), remains challenging. In this study we assess a range of statistical approaches to compare outcomes as measured by the items of the progressive supranuclear palsy rating scale (PSPRS). We consider several statistical approaches, including sum scores, a modified PSPRS rating scale that had been recommended by FDA in a pre-IND meeting, multivariate tests, and analysis approaches based on multiple comparisons of the individual items.

Serum uromodulin associates with kidney function and outcome in a cohort of hospitalised COVID-19 patients.

This study investigates the prevalence and evaluates the prognostic implications of acute kidney injury (AKI) in COVID-19 patients, with a novel emphasis on the evaluation of serum uromodulin (sUmod) as a potential kidney-specific biomarker. A cohort of hospitalised COVID-19 patients (n = 378) was examined for AKI using standard criteria. In addition to traditional urinary biomarkers, sUmod levels were analysed.