Search

Objective: To evaluate the impact of three different AEEP techniques on the training performance of novices using a realistic hydrogel prostate phantom model., Material and Methods: The experimental setup utilized realistic prostate phantom model provided by the Max Planck Institute for Intelligent Systems, Germany. For the enucleation, we utilized a new solid-state pulsed thulium laser (Thulio®, Dornier MedTech, Weßling, Germany). We explored three different AEEP techniques-bilobar, trilobar, and en-bloc-repeated ten times each, totaling 30 procedures., Results: Median enucleation time was 9.5 min (range: 6-16), median laser time was 4.29 min (3.21-6.34), median total energy used was 25.8 kJ (19.4-38.1), and median number of laser pulses was 12.8 thousand (9.7-17). There were no significant differences in operation time, laser time, pulses, or joules among the en-bloc, two-lobe, and three-lobe techniques (p = 0.113, 0.143, 0.148, 0.141 respectively). Ultrasound evaluations showed the one-lobe technique to be superior in accuracy, smoothness, and circularity (p = 0.0002, 0.012, 0.00005 respectively) (Figs. 9, 10, 11), despite having the highest perforation rate, which was not statistically significant compared to other techniques (p = 1.4). The one-lobe technique's higher accuracy may increase the risk of perforation. In contrast, the three-lobe technique had the lowest perforation rate and removal efficiency due to its lower accuracy., Conclusion: The en-bloc, bilobar, and trilobar enucleation techniques exhibited comparable operation times. The one-lobe method emerged as superior in terms of accuracy, smoothness, and circularity. However, it also presented the highest rate of perforation., Competing Interests: Declarations. Ethical approval: This article does not contain any studies with human participants performed by the author. Competing interests: Senol Tonyali has received a grant (1-year scholarship) from European Urology Scholarship Programme (EUSP)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Workload and stress in excess can lead to work disability. The aim of our study was to determine whether commercially available "activity trackers" can be used to make statements about the work - or stress load of different occupational groups., Material and Methods: The study was conducted at the University Hospital Freiburg, Germany. Four occupational groups with a total of 32 subjects were studied: senior physicians (SP, 4), assistant physicians (AP, 11), nursing staff (NS, 12) and administrative staff (AS, 5). The activity trackers were worn on five working days and one day off. Step frequency, distance and heart rate (HR) were measured, and workload was assessed using a visual analog scale., Results: The highest workload was reported by SP, the lowest by AS. Male employees feel higher workload than female employees ( p  = 0.009). NS covered the greatest daily distance, AP the least ( p  = 0.001). There was a significant difference in average HF between AP and NS ( p  = 0.008). AS showed higher daily distance and maximum HF on days off compared to work days, and NS showed the opposite behavior. With increasing patient volume for ambulatory care, the average HF increased ( p  = 0.037) in NSs., Conclusion: "Activity trackers" reliably provide body data during work. In our small sample, interesting differences and results on workload emerged. More data would require more subjects and more study variables., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2024.)

Background: The selection of data elements is a decisive task within the development of a health registry. Having the right metadata is crucial for answering the particular research questions. Furthermore, the set of data elements determines the registries' readiness of interoperability and data reusability to a major extent. Six health registries shared and published their metadata within a German funding initiative. As one step in the direction of a common set of data elements, a selection of those metadata was evaluated with regard to their appropriateness for a broader usage., Methods: Each registry was asked to contribute a 10%-selection of their data elements to an evaluation sample. The survey was set up with the online survey tool "LimeSurvey Cloud". The registries and an accompanying project participated in the survey with one vote for each project. The data elements were offered in content groups along with the question of whether the data element is appropriate for health registries on a broader scale. The question could be answered using a Likert scale with five options. Furthermore, "no answer" was allowed. The level of agreement was assessed using weighted Cohen's kappa and Kendall's coefficient of concordance., Results: The evaluation sample consisted of 269 data elements. With a grade of "perhaps recommendable" or higher in the mean, 169 data elements were selected. These data elements belong preferably to groups' demography, education/occupation, medication, and nutrition. Half of the registries lost significance compared with their percentage of data elements in the evaluation sample, one remained stable. The level of concordance was adequate., Conclusions: The survey revealed a set of 169 data elements recommended for health registries. When developing a registry, this set could be valuable help in selecting the metadata appropriate to answer the registry's research questions. However, due to the high specificity of research questions, data elements beyond this set will be needed to cover the whole range of interests of a register. A broader discussion and subsequent surveys are needed to establish a common set of data elements on an international scale., (© 2024. The Author(s).)

Standardized structured radiological reporting (SSRB) has been promoted in recent years. The aims of SSRB include that reports be complete, clear, understandable, and stringent. Repetitions or superfluous content should be avoided. In addition, there are advantages in the presentation of chronological sequences, tracking and correlations with structured findings from other disciplines and also the use of artificial intelligence (AI)-based methods. The development of the presented template for SSRB of native computed tomography for urinary stones followed the "process for the creation of quality-assured and consensus-based report templates as well as subsequent continuous quality control and updating" proposed by the German Radiological Society (DRG). This includes several stages of drafts, consensus meetings and further developments. The final version was published on the DRG website ( www.befundung.drg.de ). The template will be checked annually by the steering group and adjusted as necessary. The template contains 6 organ domains (e.g., right kidney) for which entries can be made for a total of 21 different items, mostly with selection windows. If "no evidence of stones" is selected for an organ in the first query, the query automatically jumps to the next organ, so that the processing can be processed very quickly despite the potentially high total number of individual queries for all organs. The German, European, and North American Radiological Societies perceive the establishment of a standardized structured diagnosis of tomographic imaging methods not only in oncological radiology as one of the current central tasks. With the present template for the description of computed tomographic findings for urinary stone diagnostics, we are presenting the first version of a urological template. Further templates for urological diseases are to follow., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

A range of dopamine-dominating neuropsychiatric disorders present with cognitive deficits. In accordance, the dopamine transporter overexpressing rat model (DAT-tg rat) displays cognitive deficits by means of behavioral inflexibility and learning disabilities. It remains to be investigated when cognitive deficits emerge, due to the inherent DA irregularities, during the life course of the DAT-tg rat and what may relieve symptoms. The Morris water maze (MWM) was used to assess cognitive abilities in three cohorts of DAT-tg rats. In the first cohort, the development of cognitive deficits was assessed by repeatedly testing animals in the MWM at postnatal day (PND) 35, 60, and 90. In the second and third cohort, pharmacological interventions and transcranial direct current stimulation (tDCS) were tested in adult animals to understand what drives, and thus relieves, the deficits. Minor differences were observed between DAT-tg rats and control rats at PND 35 and 60, whereas cognitive deficits fully emerged at PND 90. A high dosage of methylphenidate diminished both behavioral inflexibility and improved learning abilities in adult rats. Interestingly, rats subjected early in life to the MWM also displayed improved behavioral flexibility as compared to rats naïve to the paradigm. Cognitive deficits gradually develop over time and fully emerge in adulthood. Pharmacological modulation of the ubiquitous DAT overexpression overall improves deficits in adult rats, whereas early training decreases later development of behavioral inflexibility. Thus, former training may constitute a preventive avenue that alters some aspects of cognitive deficits resulting from inherent DA abnormalities., (© 2022. The Author(s).)

Background: Urinary stone disease is a widespread disease with tremendous impact on those affected and on societies around the globe. Nevertheless, clinical and health care research in this area seem to lag far behind cardiovascular diseases or cancer. This may be due to the lack of an immediate deadly threat from the disease and therefore less public and professional interest. However, the patients suffer from recurring, sometimes intense pain and often must be treated in hospital. Long-term morbidity includes doubled rates of chronic kidney disease and arterial hypertension after at least one stone-related event. Observational studies, more specifically, registries and other electronic data sets have been proposed as a means of filling critical gaps in evidence. We propose a nationwide digital and fully automated registry as part of the German Ministry for Education and Research (BMBF) call for the "establishment of model registries"., Methods: RECUR builds on the technical infrastructure of Germany's Medical Informatics Initiative. Local data integration centres (DIC) of participating medical universities will collect pseudonymized and harmonized data from respective hospital information systems. In addition to their clinical data, participants will provide patient reported outcomes using a mobile patient app. Scientific data exploration includes queries and analysis of federated data from DICs of eleven participating sites. All primary patient data will remain at the participating sites at all times. With comprehensive data from this longitudinal registry, we will be able to describe the disease burden, to determine and validate risk factors, and to evaluate treatments. Implementation and operation of the RECUR registry will be funded by the BMBF for five years. Subsequently, the registry is to be continued by the German Society of Urology without significant costs for study personnel., Discussion: The proposed registry will substantially improve the structural and procedural framework for patients with recurrent urolithiasis. This includes advanced diagnostic algorithms and treatment pathways. The registry will help us identify those patients who will most benefit from specific interventions to prevent recurrences. The RECUR study protocol and the registry's technical architecture including full digitalization and automation of almost all registry-associated proceedings can be transferred to future registries., Trial Registration: This study is registered at the German Clinical Trial Register (Deutsches Register Klinischer Studien), DRKS-ID DRKS00026923 , date of registration January, 11 th 2022., (© 2022. The Author(s).)