GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Diagnostic test accuracy in longitudinal study settings: theoretical approaches with use cases from clinical practice
    Elsevier BV ; 2024
    In:  Journal of Clinical Epidemiology Vol. 169 ( 2024-05), p. 111314-
    Details
    In: Journal of Clinical Epidemiology, Elsevier BV, Vol. 169 ( 2024-05), p. 111314-
    Type of Medium: Online Resource
    ISSN: 0895-4356
    URL: Article
    DOI: 10.1016/j.jclinepi.2024.111314
    RVK:
    XA 52630
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 1500490-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Utility of deep learning networks for the generation of artificial cardiac magnetic resonance images in congenital heart disease
    Springer Science and Business Media LLC ; 2020
    In:  BMC Medical Imaging Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Medical Imaging, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Deep learning algorithms are increasingly used for automatic medical imaging analysis and cardiac chamber segmentation. Especially in congenital heart disease, obtaining a sufficient number of training images and data anonymity issues remain of concern. Methods Progressive generative adversarial networks (PG-GAN) were trained on cardiac magnetic resonance imaging (MRI) frames from a nationwide prospective study to generate synthetic MRI frames. These synthetic frames were subsequently used to train segmentation networks (U-Net) and the quality of the synthetic training images, as well as the performance of the segmentation network was compared to U-Net-based solutions trained entirely on patient data. Results Cardiac MRI data from 303 patients with Tetralogy of Fallot were used for PG-GAN training. Using this model, we generated 100,000 synthetic images with a resolution of 256 × 256 pixels in 4-chamber and 2-chamber views. All synthetic samples were classified as anatomically plausible by human observers. The segmentation performance of the U-Net trained on data from 42 separate patients was statistically significantly better compared to the PG-GAN based training in an external dataset of 50 patients, however, the actual difference in segmentation quality was negligible ( 〈  1% in absolute terms for all models). Conclusion We demonstrate the utility of PG-GANs for generating large amounts of realistically looking cardiac MRI images even in rare cardiac conditions. The generated images are not subject to data anonymity and privacy concerns and can be shared freely between institutions. Training supervised deep learning segmentation networks on this synthetic data yielded similar results compared to direct training on original patient data.
    Type of Medium: Online Resource
    ISSN: 1471-2342
    URL: Article
    DOI: 10.1186/s12880-020-00511-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2061975-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Clinical evaluation of an interoperable clinical decision-support system for the detection of systemic inflammatory response syndrome in critically ill children
    Springer Science and Business Media LLC ; 2021
    In:  BMC Medical Informatics and Decision Making Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Medical Informatics and Decision Making, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Systemic inflammatory response syndrome (SIRS) is defined as a non-specific inflammatory process in the absence of infection. SIRS increases susceptibility for organ dysfunction, and frequently affects the clinical outcome of affected patients. We evaluated a knowledge-based, interoperable clinical decision-support system (CDSS) for SIRS detection on a pediatric intensive care unit (PICU). Methods The CDSS developed retrieves routine data, previously transformed into an interoperable format, by using model-based queries and guideline- and knowledge-based rules. We evaluated the CDSS in a prospective diagnostic study from 08/2018–03/2019. 168 patients from a pediatric intensive care unit of a tertiary university hospital, aged 0 to 18 years, were assessed for SIRS by the CDSS and by physicians during clinical routine. Sensitivity and specificity (when compared to the reference standard) with 95% Wald confidence intervals (CI) were estimated on the level of patients and patient-days. Results Sensitivity and specificity was 91.7% (95% CI 85.5–95.4%) and 54.1% (95% CI 45.4–62.5%) on patient level, and 97.5% (95% CI 95.1–98.7%) and 91.5% (95% CI 89.3–93.3%) on the level of patient-days. Physicians’ SIRS recognition during clinical routine was considerably less accurate (sensitivity of 62.0% (95% CI 56.8–66.9%)/specificity of 83.3% (95% CI 80.4–85.9%)) when measurd on the level of patient-days. Evaluation revealed valuable insights for the general design of the CDSS as well as specific rule modifications. Despite a lower than expected specificity, diagnostic accuracy was higher than the one in daily routine ratings, thus, demonstrating high potentials of using our CDSS to help to detect SIRS in clinical routine. Conclusions We successfully evaluated an interoperable CDSS for SIRS detection in PICU. Our study demonstrated the general feasibility and potentials of the implemented algorithms but also some limitations. In the next step, the CDSS will be optimized to overcome these limitations and will be evaluated in a multi-center study. Trial registration : NCT03661450 (ClinicalTrials.gov); registered September 7, 2018.
    Type of Medium: Online Resource
    ISSN: 1472-6947
    URL: Article
    DOI: 10.1186/s12911-021-01428-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2046490-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 12 ( 2022-12-18), p. 1993-
    Details
    In: Children, MDPI AG, Vol. 9, No. 12 ( 2022-12-18), p. 1993-
    Abstract: In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-abdominal pressure (IAP), macro- and microcirculation (near-infrared spectroscopy (NIRS)), clinical and laboratory status and outcomes of 27 patients (16 female) after pLT (median age at pLT 35 months). Of the patients, 85% developed an elevated IAP, most of them mild. However, 17% achieved IAH° 3, 13% achieved IAH° 4 and 63% developed ACS. A multiple linear regression analysis identified aortal hepatic artery anastomosis and cold ischemia time (CIT) as risk factors for increased IAP and longer CIT and staged abdominal wall closure for ACS. ACS patients had significantly longer mechanical ventilation (p = 0.004) and LOS-PICU (p = 0.003). No significant correlation between NIRS or biliary complications and IAH or ACS could be shown. IAH and ACS after pLT were frequent. NIRS or grade of IAH alone should not be used for monitoring. A longer CIT is an important risk factor for higher IAP and ACS. Therefore, approaches such as the ex vivo machine perfusion of donor organs, reducing CIT effects on them, have great potential. Our study provides important basics for studying such approaches.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9121993
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Prediction of prognosis in patients with tetralogy of Fallot based on deep learning imaging analysis
    BMJ ; 2020
    In:  Heart Vol. 106, No. 13 ( 2020-07), p. 1007-1014
    Details
    In: Heart, BMJ, Vol. 106, No. 13 ( 2020-07), p. 1007-1014
    Abstract: To assess the utility of machine learning algorithms for automatically estimating prognosis in patients with repaired tetralogy of Fallot (ToF) using cardiac magnetic resonance (CMR). Methods We included 372 patients with ToF who had undergone CMR imaging as part of a nationwide prospective study. Cine loops were retrieved and subjected to automatic deep learning (DL)-based image analysis, trained on independent, local CMR data, to derive measures of cardiac dimensions and function. This information was combined with established clinical parameters and ECG markers of prognosis. Results Over a median follow-up period of 10 years, 23 patients experienced an endpoint of death/aborted cardiac arrest or documented ventricular tachycardia (defined as 〉 3 documented consecutive ventricular beats). On univariate Cox analysis, various DL parameters, including right atrial median area (HR 1.11/cm², p=0.003) and right ventricular long-axis strain (HR 0.80/%, p=0.009) emerged as significant predictors of outcome. DL parameters were related to adverse outcome independently of left and right ventricular ejection fraction and peak oxygen uptake (p 〈 0.05 for all). A composite score of enlarged right atrial area and depressed right ventricular longitudinal function identified a ToF subgroup at significantly increased risk of adverse outcome (HR 2.1/unit, p=0.007). Conclusions We present data on the utility of machine learning algorithms trained on external imaging datasets to automatically estimate prognosis in patients with ToF. Due to the automated analysis process these two-dimensional-based algorithms may serve as surrogates for labour-intensive manually attained imaging parameters in patients with ToF.
    Type of Medium: Online Resource
    ISSN: 1355-6037 , 1468-201X
    URL: Article
    DOI: 10.1136/heartjnl-2019-315962
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2378689-9
    detail.hit.zdb_id: 1475501-4
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Idiopathic Aneurysm of the Aortic Arch in an Infant
    Georg Thieme Verlag KG ; 2022
    In:  The Thoracic and Cardiovascular Surgeon Reports Vol. 11, No. 01 ( 2022-01), p. e54-e57
    Details
    In: The Thoracic and Cardiovascular Surgeon Reports, Georg Thieme Verlag KG, Vol. 11, No. 01 ( 2022-01), p. e54-e57
    Abstract: Congenital aortic aneurysms are rare disorders, usually associated with genetic aortic syndromes. Here, we describe the case of an idiopathic aortic arch aneurysm which had been diagnosed prenatally by fetal echocardiography. The diagnosis was confirmed after birth in the neonatal period and successful surgical resection of the aneurysm was performed at the age of 3 months. The idiopathic etiology of the aneurysm, its localization, and the early surgical resection render this case very unusual.
    Type of Medium: Online Resource
    ISSN: 2194-7635 , 2194-7643
    URL: Article
    DOI: 10.1055/s-0042-1750426
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2706759-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Three-step preoperative sequential planning for pulmonary valve replacement in repaired tetralogy of Fallot using computed tomography
    Oxford University Press (OUP) ; 2021
    In:  European Journal of Cardio-Thoracic Surgery Vol. 59, No. 2 ( 2021-01-29), p. 333-340
    Details
    In: European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 59, No. 2 ( 2021-01-29), p. 333-340
    Abstract: OBJECTIVES Our goal was to compare results between a standard computed tomography (CT)-based strategy, the ‘three-step preoperative sequential planning’ (3-step PSP), for pulmonary valve replacement in repaired tetralogy of Fallot versus a conventional planning approach. METHODS We carried out a retrospective study with unmatched and matched groups. The 3-step PSP comprised the planning of mediastinal re-entry, cannulation for cardiopulmonary bypass (CPB) and the main procedure, using standard 3-dimensional videos. Operative times (skin incision to CPB, CPB time, end of CPB to skin closure and cross-clamp time) as well as postoperative length of stay and in-hospital mortality were compared. RESULTS Eighty-two patients (49% classical tetralogy of Fallot) underwent an operation (85% with pulmonary homograft) with 1.22% in-hospital mortality. The 3-step PSP (n = 14) and the conventional planning (n = 68) groups were compared. There were no statistically significant differences in the preoperative characteristics. Differences were observed in the total operative time (P = 0.009), skin incision to CPB (P = 0.034) and cross-clamp times (74 ± 33 vs 108 ± 47 min; P = 0.006), favouring the 3-step PSP group. Eight matched pairs were compared showing differences in the total operative time (263 ± 44 vs 360 ± 66 min; P = 0.008), CPB time (123 ± 34 vs 190 ± 43 min; P = 0.008) and postoperative length of stay (P = 0.031), favouring the 3-step PSP group. CONCLUSIONS In patients with repaired tetralogy of Fallot undergoing pulmonary valve replacement, preoperative planning using a standard CT-based strategy, the 3-step PSP, is associated with shorter operative times and shorter postoperative length of stay.
    Type of Medium: Online Resource
    ISSN: 1010-7940 , 1873-734X
    URL: Article
    DOI: 10.1093/ejcts/ezaa346
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1500330-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    4D-flow cardiac magnetic resonance imaging after aortic root replacement with long-valved decellularized aortic homografts: comparison to valve-sparing aortic root replacement and healthy controls
    Oxford University Press (OUP) ; 2022
    In:  European Journal of Cardio-Thoracic Surgery Vol. 61, No. 6 ( 2022-05-27), p. 1307-1315
    Details
    In: European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 61, No. 6 ( 2022-05-27), p. 1307-1315
    Abstract: OBJECTIVES Long-valved decellularized aortic homografts (DAH) may be used in young patients to treat aortic valve disease associated with aortic root dilatation, thereby eliminating the need for prosthetic material and anticoagulation. METHODS Thirty-three male subjects in 3 equally sized cohorts were compared: patients following DAH implantation with a median age of 29 years [interquartile range (IQR) 27.5–37.5], patients post-valve-sparing aortic root replacement (VSARR), median 44 years (IQR 31.5–49) and healthy controls, median 33 years (IQR 28–40, P = 0.228). Time-resolved three-dimensional phase-contrast cardiac magnetic resonance imaging was performed to assess maximum blood flow velocity, pulse wave velocity, mechanical energy loss (EL), wall shear stress and flow patterns (vorticity, eccentricity, helicity) in 5 different planes of the aorta. RESULTS The mean time between surgery and cardiovascular magnetic resonance was 2.56 ± 2.0 years in DAH vs 2.67 ± 2.1 in VSARR, P = 0.500. No significant differences in maximum velocity and pulse wave velocity were found between healthy controls and DAH across all planes. Velocity in the proximal aorta was significantly higher in VSARR (182.91 ± 53.91 cm/s, P = 0.032) compared with healthy controls. EL was significantly higher in VSARR in the proximal aorta with 1.85 mW (IQR 1.39–2.95) compared with healthy controls, 1.06 mW (0.91–1.22, P = 0.016), as well as in the entire thoracic aorta. In contrast, there was no significant EL in DAH in the proximal, 1.27 m/W (0.92–1.53, P = 0.296), as well as in the thoracic aorta, 7.7 m/W (5.25–9.90, P = 0.114), compared with healthy controls. There were no significant differences in wall shear stress parameters for all 5 regions of the thoracic aorta between the 3 groups. DAH patients, however, showed more vorticity, helicity and eccentricity in the ascending aorta compared with healthy controls (P  & lt; 0.019). CONCLUSIONS Decellularized long aortic homografts exhibit near to normal haemodynamic parameters 2.5 years postoperatively compared with healthy controls and VSARR.
    Type of Medium: Online Resource
    ISSN: 1010-7940 , 1873-734X
    URL: Article
    DOI: 10.1093/ejcts/ezac016
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1500330-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Impact of Sex and Obesity on Echocardiographic Parameters in Children and Adolescents
    Springer Science and Business Media LLC ; 2022
    In:  Pediatric Cardiology Vol. 43, No. 7 ( 2022-10), p. 1502-1516
    Details
    In: Pediatric Cardiology, Springer Science and Business Media LLC, Vol. 43, No. 7 ( 2022-10), p. 1502-1516
    Abstract: Subclinical alterations in left ventricular structure and function are detectable in adolescents with hypertension or obesity. However, data on early echocardiographic abnormalities in seemingly healthy children are lacking. Sex differences in cardiac structure and function have been previously reported, but sex-specific reference values are not available. Specifically, the potential interaction of sex and overweight has not been addressed at all. Anthropometric data, blood pressure and exercise tests were obtained in 356 healthy children. Echocardiographic parameters comprised peak early ( E ) and late ( A ) mitral inflow Doppler velocities, E / A  ratio, tissue Doppler peak velocities of early ( e ′) and late diastolic ( a ′) excursion of mitral/septal annulus and isovolumetric relaxation time (IVRT). Left ventricular mass index (LVMI) and LVMI z -score were calculated. Interaction terms between BMI and sex and stratification by sex were used for analysis. We provide values for echocardiographic parameters for children of two age groups separated by BMI. Overweight/obese children had a significant higher LVMI, lower E / A  ratio, higher E / e ′ ratios and a longer IVRT. For a given BMI in the upper ranges we demonstrated a higher LVMI in girls than in boys, the IVRT extended significantly more in girls than in boys with increasing BMI. There are sex differences in structural and functional echocardiographic parameters in children and adolescents. Our data not only confirms the importance of overweight and obesity, but demonstrates important interactions between sex and overweight. The greater susceptibility of overweight girls toward echocardiographic changes associated with potential long-term functional impairment needs further exploration and follow-up. Trial registration number DRKS00012371; Date 18.08.2017.
    Type of Medium: Online Resource
    ISSN: 0172-0643 , 1432-1971
    URL: Article
    DOI: 10.1007/s00246-022-02876-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463000-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Cardiomyopathies (Myocarditis, Dilated Cardiomyopathy, Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Siderosis)
    Georg Thieme Verlag KG ; 2020
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 192, No. 01 ( 2020-01), p. 27-37
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 192, No. 01 ( 2020-01), p. 27-37
    Abstract: Hintergrund Strukturierte Befundung bietet viele Vorteile in der Standardisierung der Befunderstellung und -kommunikation und bildet dennoch bisher die Ausnahme im radiologischen Alltag. Den Einsatz der strukturierten Befundung zu fördern ist daher erklärtes Ziel nationaler und internationaler radiologischer Gesellschaften. Bisher existierten für den deutschsprachigen Raum keine konsentierten Befundvorlagen auf dem Gebiet der kardialen Schnittbilddiagnostik. Methode Auf Einladung der AG Herz- und Gefäßdiagnostik der Deutschen Röntgengesellschaft fanden an der Uniklinik Köln im Jahr 2018 zwei interdisziplinäre Konsensus-Treffen zwischen Experten der kardiovaskulären Bildgebung und strukturierten Befundung aus den Fachrichtungen Radiologie, Kardiologie, Kinderkardiologie und Thorax-, Herz- und Gefäßchirurgie statt. Ziel der Treffen war es, im interdisziplinären Diskurs Befundvorlagen zur bildgebenden CT- und MR-Diagnostik verschiedener Krankheitsbilder und Untersuchungen des Herzens gemeinsam zu erarbeiten. Ergebnisse Im Rahmen der beiden Treffen wurden Vorlagen zu folgenden Krankheitsbildern und Untersuchungen entwickelt und im Konsens verabschiedet: Myokarditis, dilatative Kardiomyopathie, hypertrophe (obstruktive) Kardiomyopathie, arrhythmogene rechtsventrikuläre Kardiomyopathie (ARVC), Siderose, Ischämie- und Vitalitätsdiagnostik, Fallot’sche Tetralogie, Aortenisthmusstenose, Koronar-CT und TAVI-CT. Die 5 erstgenannten Vorlagen sind Gegenstand der vorliegenden Publikation und werden aktuell von der AG für Informationstechnologie (AGIT) der DRG in ein HTML-5/IHE-MRRT-konformes Format überführt. Anschließend werden die Vorlagen auf der Seite www.befundung.drg.de zur freien Nutzung bereitgestellt werden. Schlussfolgerung Im Rahmen der vorliegenden Publikation werden erstmals interdisziplinär konsentierte deutschsprachige Befundvorlagen für die Schnittbilddiagnostik des Herzens vorgeschlagen. Der Einsatz der erarbeiteten Vorlagen soll helfen, für eine gleichbleibend hohe Befundungsqualität zu sorgen und die Effizienz der Befunderstellung und -kommunikation zu steigern. Kernaussagen:  Zitierweise
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-0998-4116
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    detail.hit.zdb_id: 2031079-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...