bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status quo: Immuntherapie in der Uroonkologie
Authors: Jentzmik Florian 
Published: August 2017

ZusammenfassungDas Jahr 2016 markiert das Jahr der Immunonkologie bei urologischen Tumoren. Es wurde als erster Vertreter der Immuncheckpoint-Inhibitoren bei uroonkologischen Tumoren der PD-1-Antikörper Nivolumab beim fortgeschrittenen Nierenzellkarzinom in der zweiten Therapielinie (nach „Vortherapie“) zugelassen. Grundlage für die Zulassung von Nivolumab waren Daten der Phase-III-Studie CheckMate-025, in der Nivolumab im Vergleich zu Everolimus bei Patienten mit fortgeschrittenem klarzelligen Nierenzellkarzinom (RCC) nach Vortherapie mit einem Angiogeneseinhibitor untersucht wurde. Für den PD-1-Antikörper wurden eine höhere Remissionsrate (25 % vs. 5 %) und eine Verlängerung des Gesamtüberlebens um 5,4 Monate im Vergleich zu Everolimus analysiert.In den USA wurde zudem der Anti-PD-1-Antikörper Atezolizumab beim metastasierten Urothelkarzinom nach platinbasierter Chemotherapie zugelassen. Ausschlaggebend dafür waren Phase-II-Daten der IMvigor-210-Studie, die eine Gesamtansprechrate von 15 % belegt. Das mediane Gesamtüberleben (mOS) betrug 7,9 Monate in der Gesamtpopulation.Die Substanzgruppe der Immuncheckpoint-Inhibitoren zeichnet sich durch geringe Nebenwirkungen aus. Derzeit werden in zahlreichen Phase-III-Studien Immuncheckpoint-Inhibitoren geprüft, um bisherige Erstlinien-Standardtherapien bei metastasierten urologischen Tumoren abzulösen.
Herausforderungen für den Urologen in der Betreuung von Patienten mit Lynch-Syndrom am Beispiel eines Patienten mit Muir Torre-Syndrom als Unterform des Lynch-Syndroms
Authors: Löhmann C. , Kächele V. , Martinschek A. , Sparwasser C. 
Published: August 2017

ZusammenfassungDas Muir-Torre Syndrom (MTS) stellt eine Variante des Lynch-Syndroms (LS) dar, die neben den typischen mit LS-assoziierten Malignomen zusätzlich mit Talgdrüsentumoren oder Keratoakanthomen einhergeht. Das MTS ist meist mit einer Mutation von MSH2 verknüpft. Vergleicht man die Mutationen der Gene MLH1, MSH6, PMS2 und MSH2 die im Zusammenhang mit dem Lynch-Syndrom beschrieben sind, zeigt sich vor allem bei MSH2 eine Häufung von urologischen Tumoren. Die Rolle des behandelnden Urologen beinhaltet die frühzeitige Detektion eines möglichen hereditären Hintergrunds bei jüngeren Patienten mit Tumoren der ableitenden Harnwege oder auffälliger Familienanamnese. Darüber hinaus ist der behandelnde Urologe involviert in die Überwachung von Mutationsträgern mit sehr hohem Risiko einer malignen Erkrankung der ableitenden Harnwege, hier vor allem Männern mit bekannter MSH2-Mutation.Wir berichten über einen Patienten, der an einer Vielzahl von typischerweise mit Lynch-Syndrom assoziierten Tumoren sowie Tumoren mit unklarem Zusammenhang zum LS erkrankte und im Verlauf der Erkrankung an multifokalen Metastasen eines Urothelkarzinoms verstarb. Die Kasuistik zeigt exemplarisch die wichtige Bedeutung einer engen interdisziplinären Zusammenarbeit in der Betreuung von Patienten mit komplexen Erkrankungen.
Was ist ein Muss in der präoperativen Diagnostik vor elektiver Endoprothetik?
Authors: Haas Holger , Weber Christian 
Published: August 2017

Zusammenfassung
Hintergrund Im Vorfeld einer elektiven Endoprothesenimplantation sind diagnostische Maßnahmen erforderlich. Diese haben das Ziel, die patientenbezogene und eingriffsbezogene Risikokonstellation zu erfassen und durch die Einleitung geeigneter prä- und perioperativer Maßnahmen mögliche Komplikationen zu vermeiden bzw. deren Auftretenswahrscheinlichkeit zu reduzieren. Daneben dient die klinische und bildgebende Untersuchung des Patienten der Indikationsstellung zum Eingriff, die jedoch nicht Thema des vorliegenden Beitrags ist.
Ziel der Arbeit Die aktuelle Literatur zur präoperativen Diagnostik vor elektiven endoprothetischen Eingriffen wurde analysiert.
Methode Eine selektive Literaturrecherche wurde durchgeführt.
Ergebnisse Wir identifizierten studienbasierte Empfehlungen hinsichtlich (1) präoperativer Anämie, (2) Optimierung der Stoffwechsellage, (3) Gewichtskontrolle, (4) Schlafapnoesyndrom, (5) MRSA-Problematik und Hautdekontamination, (6) Harnwegsinfektion, (7) dentales Screening, (8) kardiologischer Diagnostik, (9) technisch-planerischen Vorbereitungen, insbesondere der Revisionsendoprothetik.
Schlussfolgerung Auch wenn nicht zu allen präoperativen diagnostischen Maßnahmen belastbare evidenzbasierte Empfehlungen vorliegen, bestehen bereits klare Anforderungen an die präoperative Diagnostik elektiver Patienten vor endoprothetischen Eingriffen. Die zunehmende Fokussierung auf erweiterte Maßnahmen im Rahmen des perioperativen Managements wird den Umfang notwendiger Untersuchungen im Vorfeld dieser Operationen erhöhen.
A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations
Authors: Lee Joy L , Matthias Marianne S , Menachemi Nir , Frankel Richard M , Weiner Michael 
Published: August 2017

AbstractBackgroundPatient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area.ObjectiveTo understand how existing guidelines align with current practice, evidence, and technology.MethodsWe performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices.ResultsAcross 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed.ConclusionOur analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.
Bacteremia and Skin Infections in Four Patients Caused by
Helicobacter-Like Organisms
Authors: Pérez-Santiago Josué , Ramirez-Gaona Miguel , Holm-Kennedy Robert , Smith Davey M , Fierer Joshua 
Published: August 2017

Abstract

Background
Enterohepatic Helicobacter-like organisms (HLO) have been recognized as causes of human infection since 1984, primarily as a cause of bacteremia and cellulitis in immunocompromised individuals, but the spectrum of illness due to HLO has expanded based on numerous reports from Japan.

Methods
We report 4 epidemiologically unrelated immunocompetent patients with HLO bacteremia diagnosed within a 2-year period. Three patients had cellulitis and 1 patient had unexplained fever. 16S ribosomal deoxyribonucleic acid (rDNA) sequence analysis of 2 isolates suggested that they were Helicobacter cinaedi, and whole-genome sequencing showed that they differed only slightly from reference strains.

Conclusions
We believe that this syndrome is more common than reported, but it is easily overlooked because the skin lesions resemble streptococcal cellulitis and respond very rapidly to β-lactam antibiotics, and the organism is difficult to isolate from the blood. All HLO in our series were isolated from blood using the ESP system and were not detected in 2 other widely used commercial blood culture systems.
Drug Use Is Associated With Purulent Skin and Soft Tissue Infections in a Large Urban Jail: 2011–2015
Authors: Szeto Betsy , Kaba Fatos , Herzig Carolyn T A , Befus Montina , Lowy Franklin D , Miko Benjamin A , Rosner Zachary , Larson Elaine L 
Published: August 2017

Abstract

Background
Skin and soft tissue infections (SSTIs) are a common problem in jails in the United States. This study aimed to identify factors associated with purulent SSTIs in the New York City jail system.

Methods
We conducted a case-control study of purulent SSTIs at the New York City jail. Cases were matched to controls by visit date to the jail’s urgent care clinic. Bivariate and multivariable analyses were conducted using conditional logistic regression.

Results
From April 2011 to April 2015, 1010 cases of SSTIs were identified and matched to 1010 controls. In multivariable analyses, report upon entry to jail of current injection drug use (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.77–4.31), current snorting of drugs (OR, 1.50; 95% CI, 1.12–2.00), current heroin use (OR, 1.53; 95% CI, 1.08–2.17), current cocaine use (OR, 1.76; 95% CI, 1.18–2.65), and antibiotic use within the previous 6 months (OR, 4.05; 95% CI, 2.98–5.49) were significantly associated with SSTI diagnosis.

Conclusions
Skin and soft tissue infections were strongly associated with a history of drug use at jail entry. Targeting intravenous drug use may be a preventive strategy for SSTIs in this population. Strategies such as harm reduction programs may be investigated.
Validating Performance of a Hospital Discharge Planning Decision Tool in Community Hospitals
Authors: Holland Diane E. , Brandt Cheryl , Targonski Paul V. , Bowles Kathryn H. 
Published: August 2017

Purpose of Study:
The Early Screen for Discharge Planning (ESDP) is a decision support tool developed in an urban academic medical center. High ESDP scores identify patients with nonroutine discharge plans who would benefit from early discharge planning intervention. We aimed to determine the predictive performance of the ESDP in a different practice setting.

Primary Practice Setting:
Rural regional community hospital.

Methodology and Sample:
We designed a comparative, descriptive survey study and enrolled a convenience sample of 222 patients (identified at admission) who provided informed consent. Sample characteristics and ESDP scores were collected during enrollment. The Problems After Discharge Questionnaire, EuroQoL-5Dimensions quality-of-life measure, length of stay, and use of post-acute care services were recorded after discharge. We compared outcomes between patients with low and high ESDP scores.

Results:
More than half of the sample (51.8%) had a high ESDP score. Patients with high ESDP scores reported more problems after discharge (p = .02), reported lower quality of life (p < .001), had longer length of stays (p = .04), and used post-acute care services (p = .006) more than patients with low ESDP scores. The difference in the average percentage of unmet needs was not statistically significant (p = .12), but patients with high ESDP scores reported more unmet needs than patients with low ESDP scores.

Implications for Case Management Practice:
The value of systematically proactive approaches to discharge planning is increasingly recognized, but establishing the performance capacity of support tools is critical for optimizing benefit. These study findings support use of the ESDP in regional community hospitals, making it a useful, open-source decision support tool for various health care delivery systems.
Planar Bone Scan Versus Computerized Tomography in Staging Locally Advanced Breast Cancer in Asymptomatic Patients: Does Bone Scan Change Patient Management Over Computerized Tomography?
Authors: Bansal Gaurav Jyoti , Vinayan Changaradil Deepthi 
Published: August 2017

Aim
The Royal College of Radiologists guidelines from 2013 recommend that contrast-enhanced computerized tomography of chest, abdomen and pelvis (CT TAP) for breast cancer patients with suspected metastasis could obviate the need for bone scan in asymptomatic patients. The purpose of this study was to perform a head-to-head comparison of bone scan and CT scan in locally advanced breast cancer patients. The aim of this study was to evaluate the utility of planar bone scan in changing the stage or management of locally advanced breast cancer patients.

Methods
Between June 2006 and January 2016, 156 breast cancer patients had staging investigations (either CT and bone scans, bone scans only, or CT only). All images and reports on picture archiving and communication system were evaluated retrospectively.

Results
One hundred five of 156 patients had both CT TAP and bone scan within 10 days of each other. Of the total of 105 patients, 33 (31.4%) had concordant normal results on CT TAP and bone scan. There were 18/105 (17.1%) patients with extraosseous metastasis on CT with negative or inconclusive bone scan. Bone scans diagnosed peripheral osseous metastasis in 5/105 (4.7%), which were either skull or extremity metastasis outside CT TAP field of view. All of these 5 patients had other metastatic lesions within axial skeleton or soft tissues on CT and led to no change in patient management.

Conclusions
Our findings suggest routine use of bone scan in asymptomatic patients with locally advanced breast cancer did not change patient management.
Automated Segmentation of Head Computed Tomography Images Using FSL
Authors: Cauley Keith A. , Och Joe , Yorks Patrick J. , Fielden Samuel W. 
Published: August 2017

Objective
The aim of this study was to investigate the use of one magnetic resonance image-processing tool, FSL, in its ability to perform automated segmentation of computed tomographic images of the brain.

Methods
Head computed tomography (CT) images were brain extracted and segmented using the FSL tools BET and FAST, respectively. The products of segmentation were analyzed by histogram. The impact of image intensity inhomogeneity correction was investigated using simulated bias fields, 14 routine head CT scans, and selected illustrative clinical cases.

Results
FSL FAST performs direct segmentation of head CT images, permitting quantitation of gray and white matter densities and volumes, achieving a more complete segmentation than masking methods. “Bias field correction” reduced the covariance of image signal intensities of the total brain and gray matter images (P < 0.01). Correction is larger when the effects of beam hardening and radiation scatter are larger, resulting in improved segmentation.

Conclusions
FSL FAST enables direct segmentation of head CT images.
Dopaminergic drug effects on probability weighting during risky decision-making
Authors: Ojala Karita E. , Janssen Lieneke K. , Hashemi Mahur M. , Timmer Monique H. M. , Geurts Dirk E. M. , ter Huurne Niels P. , Cools Roshan , Sescousse Guillaume 
Published: August 2017

AbstractDopamine has been associated with risky decision-making, as well as with pathological gambling, a behavioural addiction characterized by excessive risk-taking behaviour. However, the specific mechanisms through which dopamine might act to foster risk-taking and pathological gambling remain elusive. Here we test the hypothesis that this might be achieved, in part, via modulation of subjective probability weighing during decision-making. Healthy controls (n = 21) and pathological gamblers (n = 16) played a decision-making task involving choices between sure monetary options and risky gambles both in the gain and loss domains. Each participant played the task twice, either under placebo or the dopamine D2/D3 receptor antagonist sulpiride, in a double-blind, counter-balanced, design. A prospect theory modelling approach was used to estimate subjective probability weighting and sensitivity to monetary outcomes. Consistent with prospect theory, we found that participants presented a distortion in the subjective weighting of probabilities, i.e. they overweighted low probabilities and underweighted moderate to high probabilities, both in the gain and loss domains. Compared with placebo, sulpiride attenuated this distortion in the gain domain. Across drugs, the groups did not differ in their probability weighting, although in the placebo condition, gamblers consistently underweighted losing probabilities. Overall, our results reveal that dopamine D2/D3 receptor antagonism modulates the subjective weighting of probabilities in the gain domain, in the direction of more objective, economically rational decision-making.Significance statementDopamine has been implicated in risky decision-making and gambling addiction, but the exact mechanisms underlying this influence remain partly elusive. Here we tested the hypothesis that dopamine modulates subjective probability weighting, by examining the effect of a dopaminergic drug on risk-taking behaviour, both in healthy individuals and pathological gamblers. We found that selectively blocking dopamine D2/D3 receptors diminished the typically observed distortion of winning probabilities, characterized by an overweighting of low probabilities and underweighting of high probabilities. This made participants more linear in their subjective estimation of probabilities, and thus more rational in their decision-making behaviour. Healthy participants and pathological gamblers did not differ in their risk-taking behaviour, except in the placebo condition in which gamblers consistently underweighted losing probabilities.
Extended TPB model to understand consumer “selling” behaviour
Authors: Kumar Anita 
Published: August 2017

PurposeMany academic studies on reverse supply chain management have emphasised on the development of conceptual and operational models for managing returns and extracting value, but have largely ignored the consumer selling behaviour, the starting point of a reverse supply chain. The purpose of this paper is to consider a twofold perspective to understand and analyse the reverse supply chain design of mobile phone in Delhi NCR: first, motivation and intentions of consumer selling their mobile phones and second, the returns management process through the organised and informal channels.Design/methodology/approachIt first utilises a survey methodology and the theory of planned behaviour (TPB) model to understand and analyse the consumers’ intentions to recycle and then employs an in-depth interview methodology to derive qualitative insights needed to plot the reverse supply chain design.FindingsIn an extended TPB model, attitude, mediated by a “sense of duty” and perceived control, has a strong influence on the recycling behaviour than subjective norms and benefits. The qualitative insights draw attention to the design, configuration and management of informal and organised recycling channels that differ significantly, but remain relevant and coexist, especially in the context of emerging economies.Research limitations/implicationsIt proposes an extended TPB model to understand consumer selling behaviour that can help the companies to plan and handle their demand-supply mechanisms in the reverse supply chain.Social implicationsThis study calls for a proactive intervention by the Indian Government and other key stakeholders to regulate and streamline electrical and electronics waste management in India.Originality/valueThis research is positioned at the interface of logistics and marketing to understand and create a sustainable reverse supply chain design for high-value products.
Returns to search when consumers use and do not use recommendation agents
Authors: Maheswarappa Satish Sasalu , Sivakumaran Bharadhwaj , Kumar Arun G. 
Published: August 2017

Purpose
The purpose of this paper is to investigate returns to search (getting a better product and/or a lower price as a result of search) when consumers use/do not use recommendation agents (RAs). Specifically, it studies the effect of RAs/no RAs on decision quality, decision confidence and decision satisfaction taking into account subjective knowledge (SK) and involvement.

Design/methodology/approach
This paper employed two between-subjects factorial experimental designs with subjects searching for digital cameras in a simulated online digital camera store. The experiment was conducted with graduate students in Chennai, Bengaluru and Mysore in India.

Findings
Results of two online experiments showed that when consumers used RAs, low search led to better decision quality, whereas when consumers did not use RAs, medium search led to optimum decision quality. When consumers use RAs, SK had a U-shaped influence on the decision quality indicating that decision quality was the lowest for those with medium SK. When consumers did not use RAs, the effect of SK on decision quality was an inverted U-shape, indicating optimum decision quality for medium SK consumers. When consumers did not use RAs, subjects with high involvement made better choices, whereas when consumers used RAs, low involvement subjects made better choices. However, subjects who searched more had higher decision confidence and decision satisfaction even if their choices were not better.

Originality/value
The effect of RA vs no RA in conjunction with relevant consumer characteristics influencing decision quality of the consumer is demonstrated in this study. The findings have important managerial, consumer and theoretical contributions to make.
Service quality of sports centers and customer loyalty
Authors: Lee Sheng Yen 
Published: August 2017

PurposeThe purpose of this paper is to establish the effects of service quality of sports centers on customer loyalty and intention to adhere to exercise.Design/methodology/approachIn total, 500 questionnaires were distributed to five sports centers located in the city of Seoul, of which 472 were returned and used in the data analysis. The collected data were subjected to frequency analysis, exploratory factor analysis, a reliability test, and structural equation model analysis using SPSS 21.0 and AMOS 18.0.FindingsThe results show that, first, service quality, comprising the two factors of the facilities of sports centers and instructors, positively influences customer loyalty. Second, the service quality of sports centers positively influences the intention to adhere to exercise, and, third, so does customer loyalty.Practical implicationsManagement needs to make more efforts to strengthen service quality, comprising facilities and instructors, in order to increase customer loyalty, represented by the sense of closeness with and attachment of customers using sports centers, as well as to increase the need for exercise.Originality/valuePrevious studies on the service quality of sports centers have been limited to customer satisfaction, customer trust, reuse intention, recommendations to others, consumption behavior, and relationship commitment. Since the research on the direct relationship between service quality of sports centers and exercise adherence is still limited, this study provides data and implications relevant to the management of sports centers by investigating the relationship among service quality of sports centers, customer loyalty, and intention to adhere to exercise.