Young Software Engineer of the Year 2021

BCS-in-Scotland, a grouping of the BCS Branches and Specialist Groups in Scotland, continued its long-standing involvement with the annual ScotSoft event organised by ScotlandIS. Mike Hurst, Treasurer and Webmaster of the BCS Edinburgh Branch, reports.

Collaborative research in Australasian plastic surgery

Many specialist groups have developed clinical trial initiatives in response to the growing need for more collaborative research, and these are proliferating in multiple countries across the globe. The Royal Australasian College of Surgeons (RACS), under the direction of Professor John Windsor, established the clinical trials network of Australia and New Zealand (CTANZ). CTANZ supports the Australasian clinical trials in plastic, reconstructive and aesthetic surgery (ACTPRAS) research group which has already facilitated two multicentre, international, collaborative studies.

50 years of design and operation of large wastewater treatment plant conferences. A history of innovation and development

Large wastewater treatment plants (>50,000 population equivalents) treat more than 80% of the wastewater treated on a global scale, today it might be even >90%. They therefore provide the most relevant contribution to water protection from urban and industrial wastewater. This was already the case in 1971 when academics realised that progress in the scientific community alone will not succeed in a rapid transfer of research results to practitioners in design and operation of these plants. At the same time, it was recognised that urgent problems in practice are not recognised early enough by the globally networking scientific community. The most effective means of solving these problems was the creation of a new forum where experts from both sides meet. Scientists normally create their special conferences and workshops to enhance global co-operation in their specific field of research and development. This is reflected in the existence of many IWA Specialist Groups (SG) with global representation. The IWA Large Wastewater Treatment Plants (LWWTP) events and the formation of the LWWTP Specialist Group have been the first to take care of a complex technology for water protection, where specialists from most of other SGs can meet and discuss together with the practitioners designing and operating treatment plants. In fact, many new Specialist Groups had their origin in the workshop series starting in 1971 in Vienna taking care of many specific problems reported from practice. The managers and chief operators of large plants, usually only served by meetings of national professional associations, got a new opportunity for global exchange of knowledge and experience together with the global network of scientists and researchers.

Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey

BackgroundIn 2020, around 1.4 million new prostate cancer (PCa) cases were recorded worldwide. Early detection of PCa by prostate-specific antigen (PSA) screening remains debated, leading to different specialist-specific recommendations in PCa guidelines. This study aimed to assess attitudes toward and use of PSA testing among urologists in Germany and general practitioners (GPs) in Lower Saxony (Germany).MethodsA nationwide questionnaire was sent to urologists via the mailing lists of the Professional Association of German Urologists and the German Urological Society. A version of the questionnaire for GPs was sent to email addresses via the Association of Statutory Health Insurance Physicians Lower Saxony. The online questionnaires covered use of PSA testing, information communication, handling of test results, and handling of/knowledge about national and international guidelines and recommendations on early detection of PCa. Statistical analysis was performed at a descriptive level.ResultsIn total, 432 of 6,568 urologists (6.6%) and 96 of 1,579 GPs (6.1%) participated in this survey. Urologists and GPs differed in their attitudes and approaches toward PSA testing. Most urologists (86.8%, n=375) judged the test as “very meaningful” or “meaningful”, compared with 52.1% (n=50) of GPs. Almost two-thirds of the urologists (64.4%, n=278) viewed the PCa mortality reduction by PSA testing as proven, compared with one-fifth of GPs (20.8%, n=20). Almost 80% of male urologists (79.9%, n=291) indicated that they would undergo a PSA test in the future (again), compared with 55.1% of male GPs (n=38). In addition, 56.3% (n=243) of urologists stated that “considerably more than half” or “almost all” men aged 45 years or older received a PSA test, compared with 19.8% (n=19) of GPs.ConclusionsUrologists are more convinced about the PSA test than GPs. PSA testing is therefore used more often in urological settings, although the preselected patient population must be considered. In accordance with specialist-specific recommendations, GPs show a more reserved approach toward PSA testing. Instead of focusing on different attitudes and recommendations on PSA testing, the exchange between specialist groups should be improved to achieve a consistent approach to PSA testing.

Increasing Number of Individuals Receiving Hepatitis B nucleos(t)ide Analogs Therapy in Germany, 2008–2019

Background: Germany is a low prevalence country for hepatitis B virus (HBV) infection with higher prevalence in vulnerable groups. The number of treated chronic hepatitis B (CHB) patients is unknown. We aimed to determine the number of CHB patients treated with nucleos(t)ide analogs (NUCs), the treatment costs within the statutory health insurance (SHI) in Germany and per patient per month.Methods: Data on pharmacy bills of NUCs to patients with SHI between 2008 and 2019 were purchased from Insight Health™ and described. Negative binomial regression was used for trend analysis.Results: Number of patients increased between 2008 and 2019 (4.9% per year) with little changes in treatment options. Overall prescription costs were increasing (6.7% per year on average) until the introduction of tenofovir and entecavir generics in 2017 after which costs decreased by 31% in 2019. Average therapy costs peaked at 498 Euro per patient per month in 2016 and decreased to 214 Euro in 2019. Prescriptions changed from 30 to 90 pills per pack over time. HBV therapy was prescribed to 97% by three medical specialist groups, mainly specialists in internal medicine (63%), followed by hospital-based outpatient clinics (20%) and general practitioners (15%). Contrary to guideline recommendation, adefovir was still prescribed after 2011 for 1–5% of patients albeit with decreasing tendency. Prescriptions per 100,000 inhabitants were highest in Berlin and Hamburg.Conclusion: Our data shows, that the number of treated CHB patients increased steadily, while NUC therapy costs decreased. We recommend continued testing and treatment for those eligible to prevent advanced liver disease and possibly decrease further transmission of HBV.

Treating epistaxis – who cares for a bleeding nose? A secondary data analysis of primary and secondary care

Background The primary objective was to describe outpatient treatment of epistaxis among different physicians based on a large patient population over a period of 10 years. The secondary objective was to evaluate the value of the practice fee as an instrument of allocation in patients with epistaxis. Methods Anonymized statutory health insurance data (AOK Lower Saxony) of patients with a diagnosis of epistaxis treated between 2007 and 2016 were examined. Demographic data, accompanying diagnoses, medication and involved medical groups (general practitioners (GP), pediatricians, ear, nose and throat (ENT) specialists or other) were analyzed. Furthermore, we assessed whether the use of specialist groups changed after abolition of the practice fee in 2013. Results Epistaxis was responsible for 302,782 cases (160,963 patients). The distribution of cases was slightly in favor of ENT specialists vs. GP (119,170 vs. 110,352). The cases seen by GP and ENT specialists were comparable with regard to age and sex distribution. Hypertension, atrial fibrillation/flutter and an antithrombotic therapy were slightly more common among cases consulting a GP. The GP recorded more co-diagnoses than the ENT. The use of outpatient care and the proportions of the involved physicians scarcely fluctuated during the study period. Overall, 23,118 patients (14.4%) were diagnosed by both, GP and ENT during a relatively short time period. The practice fee remuneration had no impact on the consultation of the physician groups. Conclusion The outpatient treatment of epistaxis constitutes a considerable medical and economic burden in Germany. Strengthening the primary medical sector (GP-centered care) is necessary to reach the goal of initially directing patients to primary care, providing specialists more time for severe cases and reducing the impact on public health balance sheets.

Misleading terminology in pathology: lack of definitions hampers communication

Accurate terminology is the basis for clear communication among specialists and relies upon precise definitions, indispensable for the WHO Classification of Tumours. We identified a number of potentially misleading terms in use in the recently published WHO Classification of Tumours, 5th edition. From a list of common sources that might be consulted by specialists in the pathology field, we searched for definitions of the terms. Where at least two sources provided definitions for a term, we assessed their level of agreement using an ad hoc developed scale. We identified 26 potentially misleading terms from the 5th edition Digestive System and Breast Tumour Books, and 16 sources. The number of definitions provided by the sources ranged from no definition (for four terms) to ten (for two terms). No source had definitions for all terms. We found only 111 (27%) of a possible 416 definitions. Where two or more definitions were present for a term, the level of agreement between them was judged to be high. There was a paucity of definitions for potentially misleading terms in the sources consulted, but there was a good agreement when two or more definitions were present. In a globalized world where healthcare workers and learners in many fields may access these sources to learn about terminology with which they are unfamiliar, the lack of definitions is a hindrance to a precise understanding of classification in the speciality of pathology and to clear communication between specialist groups.

Eastern Africa and the Early Indian Ocean: Understanding Mobility in a Globalising World

This paper situates Eastern Africa in the early maritime trade of the Indian Ocean, reviewing evidence for connections from Egypt and Red Sea, the Gulf, and Southeast Asia from prehistory to the Islamic Period. The region played a pivotal role in developing global networks, but we argue that it has become the “forgotten south” in an era of emerging empires. One reason for this is a lack of understanding of maritime mobility around the rim of the Indian Ocean, often undertaken by small scale or specialist groups, including sea nomads. These groups are characterised as marginalised and victimised during globalisation, yet dualising into categories—such as “exploiter” and “exploiting”—oversimplifies what was almost certainly in reality a complex array of roles and activities, both in the context of East Africa and elsewhere around the Indian Ocean. Through modern scientific-based excavation and analysis, we can now begin to more fully understand these interactions.

Understanding Professional Expertise in Unfamiliar Face Matching

Deciding whether or not two images are of the same unfamiliar face is an important task in many professions. These decisions are a critical part of modern identity verification processes with direct—and often profound—consequences for individual rights and the security of society. As a result, the public expect the people entrusted with these decisions to perform accurately. But do they? Here we review 29 published tests comparing face matching accuracy in professional and novice groups. Twelve of these tests show no significant differences between professional and novice groups, suggesting that merely performing the task in daily work is not sufficient to improve accuracy. However, specialist groups of facial examiners and police super-recognizers consistently outperform novices. Staff selection, mentorship, deliberate practice, motivation, feedback and training may all contribute to enhancing the performance of individuals working in these groups, and future research is necessary to delineate their relative contributions.

What’s driving dermatology? Contribution title analysis of the largest German Dermatology Congress 2019

Background Every two years, German-speaking dermatologic specialist groups gather in Berlin to share the latest developments at Germanýs largest dermatologic conference, the Annual Meeting of the Germany Society of Dermatology (DDG). Because this conference has a lasting effect on dermatologic practice and research, understanding what is moving the specialist groups means understanding what is driving dermatology in Germany. Methods We used word network analysis to compile and visualize the information embedded in the contribution titles to the DDG Annual Meeting in 2019. We extracted words, contributing cities and inter-connections. The data was standardized, visualized using network graphs and analyzed using common network analysis parameters. Results A total of 5509 words were extracted from 1150 contribution titles. The most frequently used words were “therapy”, “patients”, and “psoriasis”. The highest number of contributions came from Hamburg, Berlin and Munich. High diversity in research topics was found, as well as a well-connected research network. Conclusions Focus of the well-connected German-speaking dermatology community meeting 2019 was patient and therapy centered and lies especially on the diseases psoriasis and melanoma. Network graph analysis can provide helpful insights and help planning future congresses. It can facilitate the choice which contributors to include as imbalances become apparent. Moreover, it can help distributing the topics more evenly across the whole dermatologic spectrum.