Parsing User Queries using Context Free Grammars

In legal information retrieval, query cooking can significantly improve recall and precision. Context free grammars can be used to effectively parse user queries, even if the number of items torecognize is high and recognition patterns are complicated

When Offline Stores Reduce Online Returns

Among the dark sides of contemporary multi-channel retailing are the vast amounts of product returns, especially in the online channel. High product returns not only put pressure on the retailers' profitability, but also come at high societal and environmental costs. A central question then is whether multi-channel retailers can use their offline stores to help reduce product returns in the online channel without harming online sales. In an empirical study, we address this issue using data from a large Dutch shoe retailer. We develop a novel spatial model to estimate the influence of proximate retail stores on customers' online shopping behavior, while controlling for spatial and customer heterogeneity. Results demonstrate that an increased offline channel presence indeed reduces online returns, depending on the product's risk profile, without significantly lowering online sales. Offline stores can thus be an effective and appealing way for retailers to mitigate the negative impact of online shopping related to product returns

When Offline Stores Reduce Online Returns

Among the dark sides of contemporary multi-channel retailing are the vast amounts of product returns, especially in the online channel. High product returns not only put pressure on the retailers' profitability, but also come at high societal and environmental costs. A central question then is whether multi-channel retailers can use their offline stores to help reduce product returns in the online channel without harming online sales. In an empirical study, we address this issue using data from a large Dutch shoe retailer. We develop a novel spatial model to estimate the influence of proximate retail stores on customers' online shopping behavior, while controlling for spatial and customer heterogeneity. Results demonstrate that an increased offline channel presence indeed reduces online returns, depending on the product's risk profile, without significantly lowering online sales. Offline stores can thus be an effective and appealing way for retailers to mitigate the negative impact of online shopping related to product returns.</p

Parsing User Queries using Context Free Grammars

In legal information retrieval, query cooking can significantly improve recall and precision. Context free grammars can be used to effectively parse user queries, even if the number of items to recognize is high and recognition patterns are complicated

Teaching Microsurgical Breast Reconstruction&mdash;A Retrospective Cohort Study

Microsurgical breast reconstruction demands the highest level of expertise in both reconstructive and aesthetic plastic surgery. Implementation of such a complex surgical procedure is generally associated with a learning curve defined by higher complication rates at the beginning. The aim of this study was to present an approach for teaching deep inferior epigastric artery perforator (DIEP) and transverse upper gracilis (TUG) flap breast reconstruction, which can diminish complications and provide satisfying outcomes from the beginning. DIEP and TUG flap procedures for breast reconstruction were either performed by a senior surgeon (&gt;200 DIEP/TUG, &rdquo;no-training&nbsp;group&rdquo;), or taught to one of five trainees (&gt;80 breast surgeries; &gt;50 free flaps) in a step-wise approach. The latter were either performed by the senior surgeon, and a trainee was assisting the surgery (&ldquo;passive training&rdquo;); by the trainee, and a senior surgeon was supervising (&ldquo;active training&rdquo;); or by the trainee without a senior surgeon (&ldquo;after training&rdquo;). Surgeries of each group were analyzed regarding OR-time, complications, and refinement procedures. A total of 95 DIEP and 93 TUG flaps were included into this study. Before the first DIEP/TUG flap without supervision, each trainee underwent a mean of 6.8 DIEP and 7.3 TUG training surgeries (p &gt; 0.05). Outcome measures did not reveal any statistically significant differences (passive training/active training/after training/no-training: OR-time (min): DIEP: 331/351/338/304 (p &gt; 0.05); TUG: 229/214/239/217 (p &gt; 0.05); complications (n): DIEP: 6/13/16/11 (p &gt; 0.05); TUG: 6/19/23/11 (p &gt; 0.05); refinement procedures (n): DIEP:71/63/49/44 (p &gt; 0.05); TUG: 65/41/36/56 (p &gt; 0.05)), indicating safe and secure implementation of this step-wise training approach for microsurgical breast reconstruction in both aesthetic and reconstructive measures. Of note, despite being a perforator flap, DIEP flap required no more training than TUG flap, highlighting the importance of flap inset at the recipient site

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Purpose The COVID-19 pandemic has transformed medical care worldwide. General surgery has been affected in elective procedures, yet the implications for emergency surgery are unclear. The current study analyzes the effect of the COVID-19 lockdown in spring 2020 on appendicitis treatment in Germany. Methods Hospitals that provided emergency surgical care during the COVID-19 lockdown were invited to participate. All patients diagnosed with appendicitis during the lockdown period (10 weeks) and, as a comparison group, patients from the same period in 2019 were analyzed. Clinical and laboratory parameters, intraoperative and pathological findings, and postoperative outcomes were analyzed. Results A total of 1915 appendectomies from 41 surgical departments in Germany were included. Compared to 2019 the number of appendectomies decreased by 13.5% (1.027 to 888, p=0.003) during the first 2020 COVID-19 lockdown. The delay between the onset of symptoms and medical consultation was substantially longer in the COVID-19 risk group and for the elderly. The rate of complicated appendicitis increased (58.2 to 64.4%), while the absolute number of complicated appendicitis decreased from 597 to 569, (p=0.012). The rate of negative appendectomies decreased significantly (6.7 to 4.6%; p=0.012). Overall postoperative morbidity and mortality, however, did not change. Conclusion The COVID-19 lockdown had significant effects on abdominal emergency surgery in Germany. These seem to result from a stricter selection and a longer waiting time between the onset of symptoms and medical consultation for risk patients. However, the standard of emergency surgical care in Germany was maintained

Dual guidance structure for evaluation of patients with unclear diagnosis in centers for rare diseases (ZSE-DUO): study protocol for a controlled multi-center cohort study

Background In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process. Study design This multi-center, prospective controlled study has a two-phase cohort design. Methods Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to the first visit to the CRD’s outpatient clinic (T0), at the first visit (T1) and 12 months thereafter (T2). Outcomes Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30% in standard care to 40% in the innovative dual expert cohort. Secondary outcomes are (a) time to diagnosis/diagnoses explaining the symptomatology; (b) proportion of patients successfully referred from CRD to standard care; (c) costs of diagnosis including incremental cost effectiveness ratios; (d) predictive value of screening instruments administered at T0 to identify patients with mental disorders; (e) patients’ quality of life and evaluation of care; and f) physicians’ satisfaction with the innovative care approach. Conclusions This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease