bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapie und Sekundärprävention der venösen Thromboembolie – Orale Antikoagulation im Wandel
Authors: Helms Thomas-Maria , Gulba Dietrich , Ahrens Ingo , Schäfer Andreas , Hankowitz Johannes , Kuhlencordt Peter , Lipp Hans-Peter , Nikol Sigrid , Riess Hanno , Stargardt Tom , Bramlage Peter 
Published: April 2017

ZusammenfassungMit der kürzlich erfolgten Zulassung des vierten direkten, neuen nicht-Vitamin-K-abhängigen oralen Antikoagulans (NOAK) Edoxaban hat sich die Palette der verfügbaren NOAKs zur Therapie der venösen Thromboembolie (VTE) erweitert. Kurz danach sind zwei aktualisierte Leitlinien zur Prophylaxe und Therapie der VTE veröffentlicht worden, in denen NOAKs als gleichwertige Antikoagulanzien zu niedermolekularem Heparin (NMH), Fondaparinux (FDX) und VKA gelistet sind. Alle NOAKs sind für die Erhaltungstherapie nach VTE verfügbar. Darüber hinaus sind zwei NOAKs in erhöhter Dosis auch für die Initialtherapie (Rivaroxaban und Apixaban) zugelassen.Zwischen den einzelnen NOAKs gibt es pharmakokinetische und pharmakodynamische Unterschiede. Wie bei NMH/FDX muss bei allen NOAKs die Dosis bei relevanter Niereninsuffizienz verringert werden. Ein Bridging im Falle operativer Eingriffe ist dagegen – anders als bei VKA – generell nicht notwendig. Eine Dosispause, deren Dauer von der Nierenfunktion und dem individuellen Blutungsrisiko abhängt, ist, wie bei NMH bzw. FPX, in der Regel ausreichend. Die üblichen Gerinnungsparameter aPTT und INR sind für ein Monitoring ungeeignet. Ein Labormonitoring ist bei Xabanen mittels adjustierten Anti-Xa-Testen, bei Dabigatran mittels der verdünnten Thrombinzeit nur in Ausnahmesituationen, z. B. bei individuell stark erhöhtem Blutungsrisiko oder Fehleinnahmeverdacht, hilfreich.
Myositis ossificans traumatica im kraniozervikalen Übergang – Fallbericht und Literaturübersicht
Authors: Reinke Andreas , Kraus Michael , Wild Alexander 
Published: April 2017

Zusammenfassung
Hintergrund Die Myositis ossificans (MO) ist eine seltene, aber wichtige Differenzialdiagnose für eine heterotrophe Ossifikation in der Muskulatur. Sie wird häufig als maligner Tumor fehlgedeutet. Nach einem vorgeschalteten Trauma ist die Diagnose Myositis ossificans traumatica (MOT). Es handelt sich hierbei aber um eine benigne Veränderung, die meist in den großen Muskeln auftritt. Jedoch gibt es auch maligne Ätiologien.
Fallbeschreibung Wir berichten über eine seltene Lokalisation der MO in der Muskulatur des kraniozervikalen Übergangs. Diese 37-jährige Frau berichtet über einen Reitunfall vor Jahren. Auf dem Boden von persistenten Schmerzen und Bewegungseinschränkungen der Halswirbelsäule erfolgte die Totalresektion.
Klinische Konsequenz Die MOT ist ein benigner Tumor, der grundsätzlich konservativ behandelt werden kann. Jedoch empfiehlt sich eine operative Resektion bei persistierenden Schmerzen, neurologischen Defiziten und insbesondere zur Diagnosesicherung.
Loki then and now: the trickster against civilization
Authors: Bassil-Morozow Helena 
Published: April 2017

ABSTRACTLoki, one of the most mischievous of the Norse gods, is a classic Trickster figure. This mythological character is difficult to define but is an archetype that Jung himself explored. The Trickster can be understood not only as a part of the Jungian individuation process, but also, from an anthropological perspective, as a metaphor for change, embodying the dynamics between the personal and the systemic. Mythological narratives featuring Loki portray him as a figure that frequently challenges the civilising forces of society, a challenge that can lead to either destruction or renewal for the society in question. More recently, however, the character of Loki has been revived as part of a Hollywood film franchise featuring a number of the comic book giant Marvel’s characters. This highly profitable enterprise, includes contemporary versions of other members of the Norse pantheon including Thor, Odin and Frigg, but Loki, as played by Tom Hiddleston, has proved a particularly popular character with the fans. This paper examines the history of Loki in the Icelandic Edda as well as the Hollywood commodification of the character in order to explore the psychological importance of the Trickster for the contemporary individual.
The Categorical Imperative and Universalizability
Authors: Timmons Mark 
Published: April 2017

Abstract
This chapter critically discusses Kant’s universalization tests associated with the universal law formula of the categorical imperative. The first part of the chapter explains the main steps in Kant’s tests in order to foreground the various interpretive questions that scholars have raised about them—questions that pertain to this formula serving as an adequate decision procedure. The chapter then proceeds to isolate those key desiderata that represent the core assumptions of the tests in order to then determine whether the tests can satisfy the desiderata in question. It is argued that the universalization procedure reflected in Kant’s tests cannot serve as an adequate decision procedure. This, of course, raises the question of the true significance of the universal law formula, which is taken up in chapter 4.
The Philosophical and Practical Significance of Kant’s Universality Formulations of the Categorical Imperative
Authors: Timmons Mark 
Published: April 2017

Abstract
If the universal law formula of the categorical imperative (FUL) cannot serve as an adequate decision procedure (as explained in chapter 3, then one may inquire about its true philosophical and practical significance within Kant’s ethical theory. Regarding its philosophical significance, the chapter argues that in the realm of practical reasoning it serves to reveal a set of interconnected metaethical constraints that moral reasons, qua moral, must have that distinguishes them from non-moral reasons. This leads to the “formal constraints” interpretation of the philosophical significance of the formula. Regarding its practical significance, it is argued that rather than serving as a decision procedure of the sort explained in chapter 3, the tests associated with FUL can serve to help foreground a conflict in one’s practical deliberations between morality and self-interest. Finally, this understanding avoids the charges of empty formalism, disguised egoism, and limited scope sometimes raised against this formula.
Kant’s Grounding Project in the Doctrine of Virtue
Authors: Timmons Mark 
Published: April 2017

Abstract
In the Doctrine of Virtue, Part II of the Metaphysics of Morals, Kant’s project is to set forth and defend a system of fundamental duties by deriving them from the categorical imperative. With respect to all but one of these duties, Kant employs the humanity formula in his derivations—which requires that one treat humanity in oneself and others always as an end and never merely as a means. One standard worry about the derivations is that the humanity formula is not doing real work because the concepts featured in it are too indeterminate to provide a basis for genuine derivations. This chapter examines Kant’s complex notion of dignity (implicated in the humanity formula) as a basis for responding to this worry. Doing so allows one to formulate a battery of “specification principles” that yield genuine derivations. The conclusion is that Kant’s derivations are by and large successful.
The Moral Significance of Gratitude in Kant’s Ethics
Authors: Timmons Mark 
Published: April 2017

Abstract
In the Doctrine of Virtue, Kant includes gratitude as one of the three primary ethical duties of love toward others. This chapter considers the following questions about Kant’s treatment of this ethical duty. (1) What grounds the duty of gratitude? (2) In addition to considerations governing the content of the duty of gratitude, what role (if any) does affect play in Kant’s conception of gratitude? Kant claims that the duty of gratitude has a special status—it is a “holy” as opposed to an ordinary duty. (4) How is this status to be understood? (5) What role does gratitude play in Kant’s account of a virtuous agent? Nowhere in his writings does Kant provide a justification for the claim that gratitude is a duty. (6) Is such a justification needed, and, if so, can Kant’s theory provide one?
The Good, the Bad, and the Badass
Authors: Timmons Mark 
Published: April 2017

Abstract
Claudia Card has argued that Kant’s conception of moral evil is lacking in breadth because it cannot account for cases of moral indeterminacy or for cases of moral fragmentation. Others have argued that Kant’s conception lacks depth because it fails to distinguish various degrees of evil. In response to the objection concerning breadth, it is argued that Kant’s character rigorism, which fuels the objection—the claim that one is either morally good or morally evil—should be restricted in a way that allows for the types of morally flawed character Card describes. In response to the objection regarding depth, appeal is made to Kant’s conception of the particular vices that does allow for degrees of evil. Finally, the chapter considers the case of the “badass,” or someone who is aptly described as doing evil for evil’s sake, and explains how Kant’s view can be elaborated to accommodate this sort of character.
Clinical Effectiveness and Safety of Intraoperative Methadone in Patients Undergoing Posterior Spinal Fusion Surgery
Authors: Murphy Glenn S. , Szokol Joseph W. , Avram Michael J. , Greenberg Steven B. , Shear Torin D. , Deshur Mark A. , Vender Jeffery S. , Benson Jessica , Newmark Rebecca L. 
Published: April 2017

Abstract

Background
Patients undergoing spinal fusion surgery often experience severe pain during the first three postoperative days. The aim of this parallel-group randomized trial was to assess the effect of the long-duration opioid methadone on postoperative analgesic requirements, pain scores, and patient satisfaction after complex spine surgery.

Methods
One hundred twenty patients were randomized to receive either methadone 0.2 mg/kg at the start of surgery or hydromorphone 2 mg at surgical closure. Anesthetic care was standardized, and clinicians were blinded to group assignment. The primary outcome was intravenous hydromorphone consumption on postoperative day 1. Pain scores and satisfaction with pain management were measured at postanesthesia care unit admission, 1 and 2 h postadmission, and on the mornings and afternoons of postoperative days 1 to 3.

Results
One hundred fifteen patients were included in the analysis. Median hydromorphone use was reduced in the methadone group not only on postoperative day 1 (4.56 vs. 9.90 mg) but also on postoperative days 2 (0.60 vs. 3.15 mg) and 3 (0 vs. 0.4 mg; all P< 0.001). Pain scores at rest, with movement, and with coughing were less in the methadone group at 21 of 27 assessments (all P = 0.001 to < 0.0001). Overall satisfaction with pain management was higher in the methadone group than in the hydromorphone group until the morning of postoperative day 3 (all P = 0.001 to < 0.0001).

Conclusions
Intraoperative methadone administration reduced postoperative opioid requirements, decreased pain scores, and improved patient satisfaction with pain management.
Fracture Liaison Services
Authors: Briot Karine 
Published: April 2017

Purpose of review
The purpose of this review is to report the evidence of beneficial effects of Fracture Liaison Service (FLS) including data regarding their impact on subsequent fracture, mortality risk and cost-effectiveness. This review also discusses the limitations of these data and the challenges faced during the implementation of FLS.

Recent findings
Recent studies showed the beneficial impact of implementation of FLS on the prevention of subsequent fracture risk, reduced mortality and cost-effectiveness. However, heterogeneity of FLS models and small number of studies limited the conclusion about the impact of FLS on secondary fracture prevention.

Summary
Patients with osteoporosis-related fractures are at higher risk of subsequent refractures. These subsequent fractures are associated with increased morbidity and premature mortality. However, there is a gap between evidence-based recommendations for postfracture care and actual clinical practice. FLS care is recommended for the management of the prevention of secondary fracture. FLS implementation reduces the risk of subsequent fracture, but the level of evidence is low as the interpretation of data is limited by the number of studies and their heterogeneity. FLS care significantly reduces the postfracture mortality, especially in patients with hip fractures. FLS implementation is cost-effective compared with usual care. Additional studies (with large sample and long-term follow-up) are needed to assess the impact of FLS care on subsequent fracture risk.
Intrathecal Morphine in Spine Surgery
Authors: Pendi Arif , Acosta Frank L. , Tuchman Alexander , Movahedi Rana , Sivasundaram Lakshmanan , Arif Ibraheem , Gucev Gligor 
Published: April 2017

Study Design.
Meta-analysis of randomized controlled trials (RCTs).

Objective.
The aim of this study was to evaluate the effectiveness of intrathecal morphine (ITM) in reducing postoperative pain and opioid analgesic consumption following spine surgery.

Summary of Background Data.
The use of ITM following adult spine surgery is of particular interest because of the ease of access to the thecal sac and the potential to provide adequate analgesia at low doses. However, previous studies of ITM have been limited by small sample sizes and conflicting results.

Methods.
A comprehensive search of PubMed, Web of Science, Clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials for prospective RCTs was performed by two independent reviewers. Postoperative opioid consumption, pain scores, and complications were documented from the identified studies. Standard mean differences (SMDs) were applied to continuous outcomes and odds ratios were determined for dichotomous outcomes.

Results.
Eight RCTs involving 393 subjects met inclusion criteria and were included in this meta-analysis. Patients receiving ITM (ITM group) as an adjunct to postoperative opioid analgesic were compared to patients receiving postoperative opioids only (control group). Postoperative morphine equivalent consumption was significantly lower during the first 24 hours postoperative in the ITM group (P < 0.001). Pain scores were similarly lower in the first 24 hours following spine surgery in those who received ITM (P < 0.001). In patients administered ITM, a greater percentage experienced pruritus (P < 0.001). Respiratory depression was solely encountered in the ITM group (P = 0.25). There were no significant differences between the ITM and control groups in terms of sedation (P = 0.18), nausea (P = 0.67), vomiting (P = 0.62), or length of stay (P = 0.13).

Conclusion.
In patients undergoing spine surgery, use of ITM significantly reduced opioid analgesic consumption and Visual Analogue Schores pain scores compared to controls within the first 24 hours postoperatively. High-quality, follow-up RCTs with large sample sizes are recommended to determine the potential of supplementary ITM in spine surgery and complete the side effects profile.

Level of Evidence: 1
Lower Cranial Nerves Paralysis Following Prone-Position Mechanical Ventilation
Authors: Trejo-Gabriel-Galan Jose M. , Perea-Rodriguez Maria Eugenia , Aicua-Rapun Irene , Martinez-Barrio Esther 
Published: April 2017

Objective:
To communicate a complication of prone-position ventilation.

Data Sources:
Case history.

Study Selection:
Case report.

Data Extraction and Data Synthesis:
Clinical information from medical record.

Conclusions:
This is a very infrequent cause of dysphagia following prone-position ventilation.
Population-Based Epidemiology of Sepsis in a Subdistrict of Beijing
Authors: Zhou Jianfang , Tian Hongcheng , Du Xueping , Xi Xiuming , An Youzhong , Duan Meili , Weng Li , Du Bin 
Published: April 2017

Objective:
Information about the epidemiology of sepsis in community residents in China remains scarce and incomplete. The purpose of this study was to describe the occurrence rate and outcome of sepsis in Yuetan Subdistrict of Beijing and to estimate the occurrence rate of sepsis in China.

Design:
Retrospective cohort study.

Setting:
All public hospitals serving residents in Yuetan Subdistrict, Beijing.

Patients:
All patients (n = 1,716) meeting criteria for sepsis based on American College of Chest Physicians/Society of Critical Care Medicine consensus definition.

Interventions:
None.

Measurement and Main Results:
We screened all adult residents in Yuetan Subdistrict who were hospitalized from July 1, 2012, to June 30, 2014, and reviewed medical records. Patients with sepsis were included in the analysis. We enrolled 1,716 patients with sepsis out of 21,191 hospitalized adults screened, among whom severe sepsis developed in 256 patients, and septic shock developed in 233 patients. The crude annual occurrence rates of sepsis, severe sepsis, and septic shock in Yuetan Subdistrict were 667, 103, and 91 cases per 100,000 population, corresponding to standardized occurrence rates of 461, 68, and 52 cases per 100,000 population per year, respectively. Both occurrence rate and mortality increased significantly with age, although males had higher age-adjusted occurrence rate and mortality. The occurrence rate of sepsis also exhibited seasonal variation, peaking in winter season. The overall hospital mortality rate of sepsis was 20.6%, yielding a standardized mortality rate of 79 cases per 100,000 population per year.

Conclusions:
Sepsis is a common and frequently fatal syndrome in Yuetan Subdistrict, Beijing. The occurrence rate and mortality of sepsis are significantly higher in males and elderly people.
Ultrasound as a Screening Tool for Central Venous Catheter Positioning and Exclusion of Pneumothorax*
Authors: Amir Rabia , Knio Ziyad O. , Mahmood Feroze , Oren-Grinberg Achikam , Leibowitz Akiva , Bose Ruma , Shaefi Shahzad , Mitchell John D. , Ahmed Muneeb , Bardia Amit , Talmor Daniel , Matyal Robina 
Published: April 2017

Objectives:
Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax.

Setting:
All operating rooms and surgical and trauma ICUs at the institution.

Design:
Single-center, prospective noninferiority study.

Patients:
Patients receiving ultrasound-guided subclavian or internal jugular central venous catheters.

Interventions:
During ultrasound-guided central venous catheter placement, correct positioning of central venous catheter was accomplished by real-time visualization of the guide wire and positive right atrial swirl sign using the subcostal four-chamber view. After insertion, pneumothorax was ruled out by the presence of lung sliding and seashore sign on M-mode.

Measurements and Main Results:
Data analysis was done for 137 patients. Chest radiograph ruled out pneumothorax in 137 of 137 patients (100%). Lung ultrasound was performed in 123 of 137 patients and successfully screened for pneumothorax in 123 of 123 (100%). Chest radiograph approximated accurate catheter tip position in 136 of 137 patients (99.3%). Adequate subcostal four-chamber views could not be obtained in 13 patients. Accurate positioning of central venous catheter with ultrasound was then confirmed in 121 of 124 patients (97.6%) as described previously.

Conclusions:
Transthoracic echocardiography and lung ultrasound are noninferior to chest x-ray for screening of pneumothorax and accurate central venous catheter positioning. Thus, the point of care use of ultrasound can reduce central venous catheter insertion to use time, exposure to radiation, and improve patient safety.
Neoadjuvant treatment: a novel standard?
Authors: Pasquali Sandro , Palassini Elena , Stacchiotti Silvia , Casali Paolo G. , Gronchi Alessandro 
Published: April 2017

Purpose of review
The aim of this study was to summarize developments in the adjuvant/neoadjuvant chemotherapy of high-risk adult-type soft tissue sarcomas (STS).

Recent findings
The role of adjuvant/neaodjuvant chemotherapy in these patients is controversial, with a meta-analysis suggesting a 10% survival benefit. Recently, a randomized controlled trial in high-risk STS of extremities and trunk wall showed a 20% improvement in progression-free and overall survival after three preoperative cycles of epirubicin along with ifosfamide compared with a histology-tailored chemotherapy. This study has major strengths, including the selected high-risk population and the full-dose chemotherapy regimen. However, this was an interim analysis with a short follow-up in a trial originally planned to test the superiority of a histology-driven chemotherapy. As to high-risk patient selection, the new AJCC TNM staging system adds primary tumour site as a stratifying factor, while available prognostic nomograms account for additional criteria.

Summary
A recent trial strengthens perioperative chemotherapy as an option for high-risk STS patients within a shared decision-making process. If the final analysis of this trial confirms the currently observed progression-free and overall survival benefits, perioperative chemotherapy may become a standard. Also, new staging tools may refine our ability to select patients with a risk high enough as to deserve chemotherapy.
Diffusion Tensor Tractography for Detection of Concomitant Traumatic Brain Injury in Patients With Traumatic Spinal Cord Injury
Authors: Jang Sung Ho , Ahn Sang Ho , Cho Yun Woo , Lim Ji Woon , Cho Ik Tae 
Published: April 2017

Objectives:
We investigated concomitant traumatic brain injury in patients with traumatic spinal cord injury (TSCI) who had head trauma history, using diffusion tensor tractography (DTT).

Design:
Retrospective survey.

Participants:
We recruited 14 consecutive patients with TSCI and coexisting head trauma history at the time of TSCI and 30 control subjects.

Methods:
The corticospinal tract (CST), corticoreticulospinal tract (CRT), cingulum, and fornix were reconstructed using DTT, and DTT parameters (fractional anisotropy and fiber volume) and configuration were estimated.

Results:
The values of fractional anisotropy and fiber volume in the CST, CRT, cingulum, and fornix of the patient group were significantly lower than those of the control group (P < .05). On configurational analysis of DTT for each tract, the neural tracts for motor function (the CST and CRT) had more injury than the neural tracts for cognitive function (the cingulum and fornix). No association between the severity of TSCI and traumatic brain injury was observed in terms of DTT parameters.

Conclusions:
Using DTT, we found injury of the neural tracts in patients with head trauma history at the time of TSCI. Our results suggest that brain evaluation using DTT can be recommended for the patients with head trauma history at the time of TSCI irrespective of the results of conventional brain MRI.