bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effekte einer tiergestützten Intervention in der stationären psychiatrischen Suchtbehandlung – eine Pilotstudie
Authors: Uhlmann Carmen , Nauss Carmen , Worbs Anette , Pfund Ute , Schmid Petra 
Published: February 2019

Zusammenfassung
Anliegen Tiergestützte Interventionen sind in der stationären psychiatrischen Behandlung zunehmend beliebt. In der vorliegenden Pilotstudie wurde untersucht, wie komorbid und chronisch erkrankte Patienten einer psychiatrischen Suchtstation die therapeutische Unterstützung durch den Einsatz eines Therapiehundes bewerten.
Methode Evaluation der Interventionsvariable „Therapiehund“ in einer prospektiven Studie mit Ein-Gruppen-Prä-Post-Design im naturalistischen Setting. Im Prä-Zeitraum ohne Therapiehund wurden 50 Patienten, im Post-Zeitraum 52 Patienten, mittels Fragebogen zu den Themenfeldern soziale Interaktion / Stationserleben, emotionale Kompetenzen und suchtpathologisches Verhalten befragt.
Ergebnisse In den Themenbereichen soziale Interaktion / Stationserleben und Emotionalität unterscheiden sich die Patienten zu den beiden Messzeitpunkten hochsignifikant zu Gunsten der tiergestützten Intervention. Auch die Häufigkeit des Zigarettenrauchens und der Umgang mit Suchtdruck nahmen in dieser Gruppe signifikant ab. Die Effektstärken lagen im mittlerem bis hohem Bereich.
Schlussfolgerung Patienten beurteilen den Einsatz eines Therapiehundes auf einer Suchstation als sehr positiv. Das Stationsklima wird angenehmer erlebt und die Patienten sehen eher die Möglichkeit der Veränderung des Erlebens und Verhaltens in Bezug auf soziale und emotionale Kompetenzen. Auch zeigten sich positive Veränderungen in suchtpathologischem Verhalten, wie Zigarettenkonsum und Umgang mit Suchtdruck.
Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment
Authors: Kutney-Lee Ann , Sloane Douglas , Bowles Kathryn , Burns Lawton , Aiken Linda 
Published: February 2019

Background Despite evidence suggesting higher quality and safer care in hospitals with comprehensive electronic health record (EHR) systems, factors related to advanced system usability remain largely unknown, particularly among nurses. Little empirical research has examined sociotechnical factors, such as the work environment, that may shape the relationship between advanced EHR adoption and quality of care.
Objective The objective of this study was to examine the independent and joint effects of comprehensive EHR adoption and the hospital work environment on nurse reports of EHR usability and nurse-reported quality of care and safety.
Methods This study was a secondary analysis of nurse and hospital survey data. Unadjusted and adjusted logistic regression models were used to assess the relationship between EHR adoption level, work environment, and a set of EHR usability and quality/safety outcomes. The sample included 12,377 nurses working in 353 hospitals.
Results In fully adjusted models, comprehensive EHR adoption was associated with lower odds of nurses reporting poor usability outcomes, such as dissatisfaction with the system (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.61–0.92). The work environment was associated with all usability outcomes with nurses in better environments being less likely to report negatively. Comprehensive EHRs (OR: 0.83; 95% CI: 0.71–0.96) and better work environments (OR: 0.47; 95% CI: 0.42–0.52) were associated with lower odds of nurses reporting fair/poor quality of care, while poor patient safety grade was associated with the work environment (OR: 0.50; 95% CI: 0.46–0.54), but not EHR adoption level.
Conclusion Our findings suggest that adoption of a comprehensive EHR is associated with more positive usability ratings and higher quality of care. We also found that—independent of EHR adoption level—the hospital work environment plays a significant role in how nurses evaluate EHR usability and whether EHRs have their intended effects on improving quality and safety of care.
Salvage Therapy for Local Progression following Definitive Therapy for Skull Base Chordomas: Is There a Role of Stereotactic Radiosurgery?
Authors: Evans Linton T. , DeMonte Franco , Grosshans David R. , Ghia Amol J. , Habib Ahmed , Raza Shaan M. 
Published: February 2019

Objective The objective of this study was to identify factors associated with improved tumor control at individual sites of recurrence and to define the role of stereotactic radiosurgery (SRS) in the management of local or distant progression following prior radiotherapy.
Study Design Clinical data of patients with recurrent skull base chordoma following prior radiotherapy were retrospectively reviewed.
Setting and Participants This is a single-center retrospective study including 16 patients from the University of Texas MD Anderson Cancer Center Houston, Texas, United States.
Main Outcome Measures Each site of recurrence was considered independently, and the primary outcome was freedom from treatment site progression (FFTSP).
Results There were 40 episodes of either local or distant progression treated in 16 patients with skull base chordoma. Tumor recurrence was classified as either local, distant, or both local and distant involving the skull base, spinal column, or leptomeninges. Patients were treated with repeat surgical resection (n = 16), SRS (n = 21), or chemotherapy (n = 25). In multivariate analysis, SRS was the only treatment modality associated with improved FFTSP (p = 0.006). For tumors treated with SRS, there was no evidence of tumor progression or adverse radiation events. Other factors associated with worse FFTSP included the number of progressive episodes (>3), tumor histology, and leptomeningeal disease.
Conclusions For local recurrence following prior radiotherapy, SRS was associated with improved FFTSP. SRS may represent an effective palliative treatment offering durable tumor control at the treated site without significant treatment-related morbidity.
The ancient and medieval garden
Authors: Campbell Gordon 
Published: February 2019

Abstract
‘The ancient and medieval garden’ considers the earliest documented gardens from around the world. It begins with the gardens of the Near East and eastern Mediterranean, such as the gardens of the Assyrian kings, Sennacherib and Ashurbanipal, at Nineveh; the villa gardens of Greece and Rome; the ancient gardens of South Asia, including Sigiriya, a Buddhist site in central Sri Lanka; medieval European gardens; the gardens of the Byzantium Empire, which provided the link between the Roman garden and the Islamic garden; and the Mayan, Aztec, and Inca gardens of Central and South America. It explains how gardens and their plants were early players in the process of globalization.
Postscript: the future history of the garden
Authors: Campbell Gordon 
Published: February 2019

Abstract
Planting and garden design have never stood still, in part because fashions change, but also because of external factors. The most conspicuous fashion in recent decades has been the rise of organic gardening, a movement originating in the 1920s, which aspires to sustainability achieved by a synergy with natural systems of soil enrichment and pest and disease control. Another driver of change is the reduction in biodiversity. The Postscript considers the likely impact of climate change on garden design and suggests gardens will continue to evolve, as they have since remote antiquity. Garden design will adapt to changing conditions, but gardens will continue to provide havens of beauty and respite for the weary.
Long-term outcomes of patients undergoing tricuspid valve surgery†
Authors: Saran Nishant , Dearani Joseph A , Said Sameh M , Greason Kevin L , Pochettino Alberto , Stulak John M , Maltais Simon , Cicek Sertac , Crestanello Juan , Daly Richard C , King Katherine S , Schaff Hartzell V 
Published: February 2019

Abstract

OBJECTIVES
Limited literature is available on the best management strategy for tricuspid valve (TV) disease in adults. We sought to review our long-term outcomes of TV surgery with regard to survival and reoperation.

METHODS
A retrospective analysis of all patients ≥18 years of age [n = 2541, aged 67 ± 13years, 1433 (56%) females] who underwent first-time TV surgery between January 1993 and December 2013 was done. There were 1735 patients who received TV repair and 806 patients underwent replacement. A gradient boosting machine model was used to derive a propensity score for predicting replacement using 27 preoperative characteristics. Four hundred and eighteen propensity-matched pairs of TV repair and replacement were identified. Cox proportional hazard regression was used on the matched subset to determine the effect of replacement.

RESULTS
Functional TV regurgitation was present in 54% (n = 1369). A bioprosthesis was used in 84% (n = 680) of replacements, while 54% (n = 934) of TV repairs were ring annuloplasties. Operative mortality was 8% (n = 212). Overall survival was 54%, 29% and 13% at 5, 10 and 15 years, respectively. After propensity score matching, replacement was significantly associated with increased mortality [hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.18–2.00; P = 0.001]. The cumulative incidence of TV reoperation was similar between the 2 groups when accounting for the competing risk of death [Fine–Gray HR 1.56, 95% CI 0.9–2.8; P = 0.144].

CONCLUSIONS
TV surgery is associated with poor outcomes due to multiple patient comorbidities. TV repair results in better survival compared to replacement in patients with similar comorbidities with no increased risk of getting a reoperation.
Quality of Life and Lung Function in Survivors of Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome
Authors: Grasselli Giacomo , Scaravilli Vittorio , Tubiolo Daniela , Russo Riccarda , Crimella Francesco , Bichi Francesca , Corinna Morlacchi Letizia , Scotti Eleonora , Patrini Lorenzo , Gattinoni Luciano , Pesenti Antonio , Chiumello Davide 
Published: February 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Survivors of acute respiratory distress syndrome (ARDS) have long-term impairment of pulmonary function and health-related quality of life, but little is known of outcomes of ARDS survivors treated with extracorporeal membrane oxygenation. The aim of this study was to compare long-term outcomes of ARDS patients treated with or without extracorporeal membrane oxygenation.

Methods
A prospective, observational study of adults with ARDS (January 2013 to December 2015) was conducted at a single center. One year after discharge, survivors underwent pulmonary function tests, computed tomography of the chest, and health-related quality-of-life questionnaires.

Results
Eighty-four patients (34 extracorporeal membrane oxygenation, 50 non–extracorporeal membrane oxygenation) were studied; both groups had similar characteristics at baseline, but comorbidity was more common in non–extracorporeal membrane oxygenation (23 of 50 vs. 4 of 34, 46% vs. 12%, P < 0.001), and severity of hypoxemia was greater in extracorporeal membrane oxygenation (median Pao
2/Fio2
72 [interquartile range, 50 to 103] vs. 114 [87 to 133] mm Hg, P < 0.001) and respiratory compliance worse. At 1 yr, survival was similar (22/33 vs. 28/47, 66% vs. 59%; P = 0.52), and pulmonary function and computed tomography were almost normal in both groups. Non–extracorporeal membrane oxygenation patients had lower health-related quality-of-life scores and higher rates of posttraumatic stress disorder.

Conclusions
Despite more severe respiratory failure at admission, 1-yr survival of extracorporeal membrane oxygenation patients was not different from that of non–extracorporeal membrane oxygenation patients; each group had almost full recovery of lung function, but non–extracorporeal membrane oxygenation patients had greater impairment of health-related quality of life.
Preload Dependence Is Associated with Reduced Sublingual Microcirculation during Major Abdominal Surgery
Authors: Bouattour Karim , Teboul Jean-Louis , Varin Laurent , Vicaut Eric , Duranteau Jacques 
Published: February 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Dynamic indices, such as pulse pressure variation, detect preload dependence and are used to predict fluid responsiveness. The behavior of sublingual microcirculation during preload dependence is unknown during major abdominal surgery. The purpose of this study was to test the hypothesis that during abdominal surgery, microvascular perfusion is impaired during preload dependence and recovers after fluid administration.

Methods
This prospective observational study included patients having major abdominal surgery. Pulse pressure variation was used to identify preload dependence. A fluid challenge was performed when pulse pressure variation was greater than 13%. Macrocirculation variables (mean arterial pressure, heart rate, stroke volume index, and pulse pressure variation) and sublingual microcirculation variables (perfused vessel density, microvascular flow index, proportion of perfused vessels, and flow heterogeneity index) were recorded every 10 min.

Results
In 17 patients, who contributed 32 preload dependence episodes, the occurrence of preload dependence during major abdominal surgery was associated with a decrease in mean arterial pressure (72 ± 9 vs. 83 ± 15 mmHg [mean ± SD]; P = 0.016) and stroke volume index (36 ± 8 vs. 43 ± 8 ml/m2; P < 0.001) with a concomitant decrease in microvascular flow index (median [interquartile range], 2.33 [1.81, 2.75] vs. 2.84 [2.56, 2.88]; P = 0.009) and perfused vessel density (14.9 [12.0, 16.4] vs. 16.1 mm/mm2 [14.7, 21.4], P = 0.009), while heterogeneity index was increased from 0.2 (0.2, 0.4) to 0.5 (0.4, 0.7; P = 0.001). After fluid challenge, all microvascular parameters and the stroke volume index improved, while mean arterial pressure and heart rate remained unchanged.

Conclusions
Preload dependence was associated with reduced sublingual microcirculation during major abdominal surgery. Fluid administration successfully restored microvascular perfusion.
Association of Pain History and Current Pain With Sagittal Spinal Alignment and Muscle Stiffness and Muscle Mass of the Back Muscles in Middle-aged and Elderly Women
Authors: Masaki Mitsuhiro , Ikezoe Tome , Yanase Ko , Ji Xiang , Umehara Jun , Aoyama Junichi , Minami Seigo , Fukumoto Yoshihiro , Watanabe Yuya , Kimura Misaka , Ichihashi Noriaki 
Published: February 2019

Study Design:
A cross-sectional study.

Objective:
To investigate the association of low back pain history (LBPH) and LBP with sagittal spinal alignment, stiffness assessed using ultrasonic shear wave elastography, and mass of the back muscle in community-dwelling middle-aged and elderly women.

Summary of Background Data:
The association of LBPH and LBP with sagittal spinal alignment, stiffness, and mass of the back muscles remains unclear in middle-aged and elderly women.

Participants and Methods:
The study comprised 19 asymptomatic middle-aged and elderly women [control (CTR) group], 16 middle-aged and elderly women with LBPH (LBPH group), and 23 middle-aged and elderly women with LBP (LBP group). Sagittal spinal alignment in the standing and prone positions (kyphosis angle in the thoracic spine, lordosis angle in the lumbar spine, and anterior inclination angle in the sacrum) was measured using a Spinal Mouse. The stiffness of the back muscles (lumbar erector spinae and multifidus) in the prone position was measured using ultrasonic shear wave elastography. The mass of the back muscles (thoracic and lumbar erector spinae, lumbar multifidus, and quadratus lumborum) was also measured.

Results:
Multiple logistic regression analysis with a forward selection method showed that the stiffness of the lumbar multifidus muscle was a significant and independent factor of LBPH. The stiffness of the lumbar multifidus muscle was significantly higher in the LBPH group than in the CTR group. Multiple logistic regression analysis also indicated that lumbar lordosis angle in the standing position was a significant and independent factor of LBP. The lumbar lordosis angle was significantly smaller in the LBP group than in the CTR group.

Conclusions:
Our results suggest that LBPH is associated with increased stiffness of the lumbar multifidus muscle in the prone position, and that LBP is associated with the decreased lumbar lordosis in the standing position in community-dwelling middle-aged and elderly women.
Mini-open Lateral En Bloc Corpectomy
Authors: Turner Jay D. , Zaidi Hasan A. , Godzik Jakub , Albuquerque Felipe C. , Uribe Juan S. 
Published: February 2019

Background:
Open approaches to the thoracolumbar spine for en bloc vertebral body tumor resection are associated with significant surgical morbidity. Less invasive surgical techniques may reduce complications.

Objective:
To present our experience with a staged posterior midline and mini-open anterolateral extracoelomic approach to en bloc corpectomy for vertebral body tumor resection in cadaver specimens and patients.

Materials and Methods:
The feasibility and safety of the staged posterior midline and mini-open anterolateral extracoelomic approach were evaluated in 3 cadaveric specimens. The procedure was performed at 3 levels (L1–L3) in each cadaver specimen (9 levels) and then in 1 clinical case. The cadaveric neurovascular structures were evaluated for tissue injury, whereas the operative experience, patient complications, and early surgical and clinical outcomes were reviewed.

Results:
The approach allowed for en bloc corpectomy without any injury to the cadaveric neurovascular structures. The procedure was reproducible in the clinical setting, which showed favorable clinical and radiographic patient outcomes.

Conclusions:
Early clinical experience suggests the staged posterior midline and mini-open anterolateral extracoelomic approach is feasible and safe for en bloc tumor resection compared with open techniques with related morbidity. Long-term studies are needed to understand the strengths and limitations of this technique.
Accuracy in Percutaneous Transpedicular Screws Placement Using Biplane Radioscopy
Authors: Rasmussen Jorge Ariel , Landriel Federico , Hem Santiago , Kornfeld Sebastián , Yampolsky Claudio 
Published: February 2019

Study Design:
Systematic review and descriptive data meta-analysis.

Objective:
The objective of this study was to appropriately establish the accuracy in the percutaneous transpedicular screws (PTS) placement using biplane radioscopy (Rx-2D).

Summary of Background Data:
The Rx-2D is a widely-used technique for PTS as it is practical, ubiquitous, and cost-effective. However, the reported “acceptable” accuracy attained by this method is widely variable ranging between 76% and 100%.

Methods:
A systematic review was conducted to screen publications about PTS placement using Rx-2D guidance. PubMed/MEDLINE database was consulted using the search term “percutaneous pedicle screw” from 1977 to 2017. Previous meta-analysis and reference lists of the selected articles were reviewed. Accuracy values were assessed fulfilling the proposed criteria. Observational data meta-analysis was performed. Cochran’s Q test was used to determine heterogeneity among data extracted from the series, which was quantified by I
2 test. P-values≤0.05 were considered statistically significant. The results were depicted by Forest plots. Funnel plots were outlined to visualize a possible bias of publication among the selected articles.

Results:
In total, 27 articles were included in the analysis. Results of the accuracy were as follow, 91.5% (n=7993; 95% CI, 89.3%-93.6%) of the screws were placed purely intrapedicular, and 96.1% (n=8579; 95% CI, 94.0%-98.2%) when deviation from the pedicle was up to 2 mm.

Conclusions:
This meta-analysis is the largest review of PTS placed with Rx-2D guidance reported up to date. We concluded that the procedure is a safe and reproducible technique. The key values obtained in this work set reliable references for both clinical and training outcome assessing.
Phase II Trial of Eribulin in Patients With Metastatic Hormone Refractory Prostate Cancer
Authors: Stein Mark N. , Chen Yu-Hui , Carducci Michael A. , Hudes Gary R. , Lerma Pauline M. , Tan Winston W. , Dalune Robert , Rowland Kendrith M. , Kuzel Timothy M. , DiPaola Robert S. 
Published: February 2019

Background:
Eribulin mesylate, a synthetic analog of halichondrin B, is a novel tubulin-binding agent that inhibits cancer cell proliferation at low-nanomolar levels.

Methods:
In a multicenter ECOG trial, patients with progressive metastatic CRPC, ECOG 0-2 were treated with eribulin 1.4 mg/m2 as an IV bolus over 5 minutes on days 1 and 8 of a 21-day cycle. This noncomparative study stratified points to either a chemonaive (CN), prior-taxane (Tax) only, or 2 prior cytotoxic (TCx) chemotherapy arm. The trial was powered to detect a 50% PSA reduction using Consensus Criteria in at least 40% versus 20% (90% power, one-sided α=0.10) for the CN stratum and 25% versus. 10% (power 87%, one-sided α=0.10) for the Tax and TCx strata.

Results:
In total, 119 pts received treatment of which 116 were eligible for the primary response determination in this study. Median age 70 years (range, 45 to 88); median number of treatment cycles 4 (range, 1 to 20+); ECOG 0-1 90%. Confirmed PSA response rates (50% decline from baseline) were 29% (90% [18.2%, 41.2%]; P=0.20), 10% (90% [5.2%, 27.1%]; P=1.00), and 4% ([0.2%, 18.3%]; P=0.59) in the chemonaive stratum, the prior-taxane stratum, and the 2-prior-chemotherapy stratum, respectively. Median progression-free survival was 3.5 months (95% CI, 2.0, 5.9), 2.3 months (95% CI, 2.0, 2.9) and 3.7 months (95% CI, 2.1, 4.2) for the chemonaive stratum, the prior-taxane stratum and the 2-prior-chemotherapy stratum, respectively. Nonhematological toxicities of any grade (mainly grade 1 and 2) were fatigue (74%), neuropathy (40%), alopecia (39%), nausea (35%), and anorexia (34%). Common hematological toxicities were decreased leukocytes (75%), decreased neutrophils (72%), and decreased hemoglobin (66%). The most common grade ≥ 3 toxicities were decreased neutrophils (55%), decreased leukocytes (42%), sensory neuropathy (13%), and fatigue (11%). Overall, there was a 4% rate of febrile neutropenia.

Conclusions:
In summary, per the prespecified study endpoints, eribulin did not have adequate activity in chemotherapy naïve or chemotherapy pretreated patients with metastatic CRPC to support further study in this setting.