bluuebunny/crossref_metadata_2025 huggingface dataset:
Amputação de membros por carcinoma escamocelular da pele: fatores envolvidos nesta evolução desfavorável
Authors: Wainstein Alberto Julius Alves , Oliveira Thiago Augusto de , Guelfi Daniel Claus Fruk , Gontijo Barbara Roberta , Castro Eduardo Vitor de , Carvalho Rafael Almeida de , Paz Nathalia Mansur , Lacerda Lycia Tobias
Published: August 2012

OBJETIVO: Analisar retrospectivamente uma série de casos que culminaram em amputação por carcinoma escamocelular avançado. MÉTODOS: Foram estudados oito pacientes com diagnóstico histológico de carcinoma escamocelular de pele que tiveram membros amputados por invasão tumoral, em nossa Instituição entre 2005 e 2008. Foram avaliados: fatores histológicos, institucionais e psicossociais que contribuíram para este desfecho desfavorável. RESULTADOS: A média de idade ao diagnóstico foi 63 anos; 37,5% dos pacientes (três pacientes) tinham exposição abusiva e contínua aos raios solares, e seis (75%) pacientes tinham outros fatores de risco para CEC de pele. Sete pacientes foram diagnosticados quando o tumor já era maior que 2cm, e foi necessário um período grande de tempo (6,7 anos em média) entre o aparecimento da lesão inicial e o diagnóstico histopatológico correto do tumor localmente avançado. CONCLUSÃO: O desfecho desfavorável (amputação) nos pacientes portadores de carcinoma espinocelular pode estar associado à agressividade da neoplasia e às comorbidades relacionadas, podendo ainda sofrer influência de fatores como acesso à saúde pública, qualidade da assistência médica e relação do paciente com a doença.
Modelo experimental de isquemia: reperfusão intestinal por clampeamento de aorta abdominal em ratos Wistar
Authors: Rocha Bruno da Costa , Mendes Rogério Rafael da Silva , Lima Gabriel Varjão , Albuquerque Gabriel de Souza , Araújo Lucas Lacerda , Jesus Mateus Neves da Silva de , Santos Washington Luís Conrado dos , Carreiro Mário Castro
Published: August 2012

OBJETIVO: desenvolver um modelo experimental de isquemia global normotérmica transitória capaz de demonstrar os tempos de isquemia e reperfusão necessários para desenvolvimento de lesão de isquemia/reperfusão em intestinos delgados de ratos Wistar através clampeamento de aorta abdominal suprarrenal. MÉTODOS: Vinte ratos Wistar adultos machos, pesando entre 250 e 350g, foram distribuídos aleatoriamente em cinco grupos, com quatro ratos cada, e submetidos a tempos crescentes de isquemia (0 - 30 - 45 - 60 - 90 minutos). Dentro de cada grupo, à exceção do grupo controle, dois ratos foram submetidos à 60 minutos de reperfusão e dois à 90 minutos. Após os procedimentos, procedeu-se análise histológica através de medição de áreas de necrose. RESULTADOS: O grau de necrose intestinal variou de 15 a 54% (p=0,0004). Houve tendência de aumento progressivo no grau de lesão relacionado ao aumento no tempo de isquemia, contudo, os maiores graus de lesão foram observados nos menores tempos de reperfusão. A análise do coeficiente de variação de necrose entre os dez grupos de isquemia/reperfusão demonstrou diferença estatisticamente significante em 15 postos, sendo 13 relacionados ao grupo controle. CONCLUSÃO: O modelo foi capaz de demonstrar os tempos necessários para que ocorra lesão de isquemia/reperfusão intestinal através de clampeamento aórtico e poderá servir como base para facilitar o desenvolvimento de estudos voltados para a compreensão deste tipo de lesão.
Avaliação da regeneração hepática com modulação pelo pré-condicionamento isquêmico após isquemia e reperfusão e hepatectomia parcial
Authors: Salomão Laura Sampaio , Young Silvia Barbosa , Galhardo Maria Aparecida , Pereira Leandro Alves , Pires Andréa Rodrigues Cordovil , Boaventura Gilson Teles , Ferreira Ana Maria Reis , Martinho José Manoel
Published: August 2012

OBJETIVO: Avaliar a regeneração hepática com modulação pelo pré-condicionamento isquêmico após isquemia, reperfusão e hepatectomia parcial. MÉTODOS: Foram usadas 24 ratas Wistar, de 12 semanas de idade, distribuídas randomicamente em quatro grupos: Grupo Controle (SHAM), Grupo Hepatectomia (HEP), Grupo Isquemia e Reperfusão (GIR) e Grupo Pré-condicionamento Isquêmico (PRE). Foi feita a análise das enzimas hepáticas ALT e AST, avaliação da regeneração através dos pesos inicial e final do fígado e da proliferação dos hepatócitos pela análise imunoistoquímica com o Proliferating Cell Nuclear Antigen (PCNA). RESULTADOS: Em todos os grupos ocorreu regeneração do fígado, não havendo significância estatística entre eles. Houve diferenças significativas em relação a ALT e AST entre os grupos HEP-SHAM, GIR-PRE, GIR-SHAM E PRE-SHAM (p< 0,05). Também houve diferença significativa em relação à marcação de PCNA do grupo SHAM quando comparado aos demais grupos (p< 0,05). CONCLUSÃO: O pré-condicionamento isquêmico diminuiu a lesão hepática, mas não influenciou na regeneração até 48 horas.
Repercussões pulmonares após isquemia hepática parcial e reperfusão: modelo experimental
Authors: Canedo Leonardo Fernandes , Lima Gabriel Varjão , Machado Marcel Cerqueira César
Published: August 2012

OBJETIVO: Descrever um modelo experimental de lesão de isquemia/reperfusão hepática com manifestações sistêmicas, representadas pelo envolvimento pulmonar, que possa ser utilizado por aqueles que pretendem compreender esse fenômeno. MÉTODOS: Ratos Wistar machos (200-250g) foram usados. Quatorze foram alocados em dois grupos, sendo G1 com oito submetidos somente à laparotomia e G2, seis à isquemia e reperfusão hepática. As funções hepática (aminotransferases séricas, respiração mitocondrial, histologia) e pulmonar (teste do azul de Evans) foram analisadas. RESULTADOS: houve diferença estatística significativa entre G1 e G2 ao se comparar valores de AST (24,3 ± 108 e 5406 ± 2263), ALT (88,5 ± 28,5 e 5169 ± 2690), razão de controle respiratório (3,41 ± 0,17 e 1,91 ± 0,55) e relação ADP/O (1,93 ± 0,03 e 1,45 ± 0,27), lesões histológicas (necrose, células inflamatórias, hemorragia, microesteatose) e teste do azul de Evans (194,31 ± 53 e 491,8 ± 141). CONCLUSÃO: O modelo mostrou-se útil para o estudo de lesão de isquemia/reperfusão hepática.
Toda lesão do diafragma por ferimento penetrante deve ser suturada?
Authors: Saad Júnior Roberto , Gonçalves Roberto
Published: August 2012

Os ferimentos da região tóracoabdominal podem cursar com ferimentos diafragmáticos em até 48% dos casos. Lesões associadas ao trauma diafragmático, estão presentes na maioria das vezes, o que facilita o diagnóstico da lesão diafragmática e em consequência impõe o tratamento operatório. Porém em 8 a 10% dos casos, as lesões diafragmáticas são isoladas e por apresentarem pouco ou nenhum sintoma, estas lesões podem passar despercebidas. Nestas situações, o diafragma poderia ser tratado de modo conservador, sem a sutura do mesmo? Após a realização de trabalhos experimentais com animais e de analisar a literatura, concluímos que ainda não podemos afirmar com certeza de que é possível não suturar um ferimento diafragmático.
Atendimento pré-hospitalar à múltiplas vítimas com trauma simulado
Authors: Simões Romeo Lages , Duarte Neto Caio , Maciel Gustavo Sasso Benso , Furtado Tatiana Piotz , Paulo Danilo Nagib Salomão
Published: August 2012

OBJETIVO: Analisar a qualidade do atendimento pré-hospitalar realizado pelas agências em Vitória-ES. MÉTODOS: Estudo retrospectivo realizado nos arquivos da Liga Acadêmica de Cirurgia e Atendimento ao Trauma do Espírito Santo (Lacates) dos dados de 40 vítimas de um acidente simulado entre um ônibus e dois automóveis. Os pacientes foram assistidos por quatro equipes: Corpo de Bombeiro Militar do Espírito Santo, Samu 192, Guarda Municipal e Defesa Civil. A atuação dessas equipes foi avaliada pela Lacates, através da análise do check-list com orientações pré-estabelecidas para cada vítima. RESULTADO: O Corpo de Bombeiros Militar do Espírito Santo (CBMES), que desencarcerou as vítimas, delimitou as zonas de perigo e realizou a triagem pelo método START atuou corretamente em 92,5% dos casos. O Samu 192 que atendeu as vítimas pelo método mnemônico (ABCDE) no posto médico avançado agiu corretamente em 92,5% dos casos, no quesito Via Aérea; 97,5%, no Respiração; 92,5%, no Circulação; 90%, no Avaliação Neurológica; e 50%, no Exposição e Controle do Ambiente. A análise conjunta do ABCDE mostrou que o atendimento foi correto em 42,5% dos casos. O transporte dos pacientes foi realizado corretamente em 95% dos casos. A Guarda Municipal garantiu a perviedade das avenidas para transporte dos pacientes, e a Defesa Civil coordenou eficazmente o trabalho das equipes envolvidas no posto de comando. CONCLUSÃO: A triagem e o transporte foram executados satisfatoriamente, entretanto, maior atenção deve ser dada à exposição e proteção contra hipotermia das vítimas, já que esse item comprometeu o tratamento.
Campyloneurum C. Presl (Polypodiaceae) no estado de São Paulo, Brasil
Authors: Vasques Diego T. , Prado Jefferson
Published: August 2012

Campyloneurum pertence à família Polypodiaceae, a qual é de difícil circunscrição através de poucos caracteres morfológicos. Presl segregou o gênero Campyloneurum de Polypodium L. em 1836 e reconheceu 11 espécies. O objetivo deste estudo é apresentar o levantamento florístico das espécies de Campyloneurum no Estado de São Paulo. Foram realizadas coletas e uma extensa revisão das coleções dos principais herbários do estado. Baseado em caracteres morfológicos, nove espécies foram reconhecidas, sendo apresentadas chave de identificação, descrições, comentários, mapas de distribuição geográfica e ilustrações para todas as espécies estudadas.
Transition metal complexes with Girard reagents and their hydrazones
Authors: Vojinovic-Jesic Ljiljana , Novakovic Sladjana , Leovac Vukadin , Cesljevic Valerija
Published: August 2012

This is the first review dealing with the coordination chemistry of metal
complexes with Girard's reagents and their hydrazones. The short
introduction points out to chemical properties and significance of these
organic compounds. The next section briefly describes synthetic methods for
preparing complexes with Girard's reagents, as well as modes of coordination
of these ligands. The last two extensive sections review the preparation,
stereochemistry and structural characteristics of metal complexes with
Girard's hydrazones, including some newer non-hydrazonic derivatives of
Girard's reagents, also.
Public Perceptions of Population Changes in Hungary
Authors: Kulcsár László , Brown David
Published: August 2012

Public Perceptions of Population Changes in Hungary

This study examines the public perceptions of population dynamics in Hungary. Based on a representative national sample survey from 2005, we discuss how the general public perceives demographic trends and attitudes people have towards the possible reasons behind these trends and solutions they believe are appropriate to contend with the trends. Rural populations were expected to have poorer knowledge of current population trends and changes and more conservative attitudes toward controversial demographic issues, but this expectation was not supported by the data. Since relatively little research has been conducted on population literacy, this study contributes to a better understanding of how public perceptions on population are formed and how this knowledge and attitudes may affect public policy addressing demographic trends.
Differences in Fertility Behaviour among the Farm, Rural and Urban Populations in Slovenia
Authors: Istenič Majda
Published: August 2012

Differences in Fertility Behaviour among the Farm, Rural and Urban Populations in Slovenia

Below replacement fertility in almost all European countries and lowest low fertility in a large part of the continent are significant demographic issues that concern contemporary policy makers and social scientists. Statistical data for Slovenia show that, with the exception of the farm population, all social groups have fertility levels that are below reproduction. This paper attempts to find out which factors are the most accountable for these differences and intends to contribute to broader scientific and public debates about the reasons for very low fertility in the ‘industrialized world’. The results of the analysis based on the survey "Generations and Gender Relationships on Slovenian Farms" (2007) indicate that differences in fertility behaviour among the farm and other parts of the Slovenian population are more related to the structural than cultural characteristics of the people.
Women's Contribution to Rural Development in Croatia: Roles, Participation and Obstacles
Authors: Šikić-Mićanović Lynette
Published: August 2012

Women's Contribution to Rural Development in Croatia: Roles, Participation and Obstacles

Unequal access to formal employment, decision-making power and social prestige can lead to vulnerabilities and social exclusion especially in rural areas. Feminist researchers and advocates for women assert that the preservation of agriculture, family farming and diverse rural culture in particular depend on the empowerment and participation of women (Hoff 1992, p. 79). In this paper, I attempt to evaluate rural/farm women's position and the extent of their vulnerability and social exclusion in an area of Slavonia in the eastern part of Croatia. Specifically, I use interview and fieldwork data to identify and elaborate their roles, participation in decision-making, and the obstacles/constraints that rural women face in these rural communities to evaluate the extent of their contribution to rural development. Further, it is my intention to explore if rural women represent an untapped resource in rural spaces that would contribute to rural development and raise the quality of life in these areas.
Sequential integration of measurements of navigational position parameters
Authors: Banachowicz Andrzej , Wolski Adam
Published: August 2012

Sequential integration of measurements of navigational position parameters

The sequential method of integrating navigational parameters obtained from non-simultaneous navigational measurements is presented. The proposed algorithm of position coordinates estimation is general and includes two modes of data processing - from simultaneous and non-simultaneous measurements. It can be used in hybrid receivers of radionavigation systems integrating non-homogeneous position lines or in integrated navigation systems, particularly in receivers combining the measurements of various satellite navigation systems.
Conversion between Cartesian and geodetic coordinates on a rotational ellipsoid by solving a system of nonlinear equations
Authors: Ligas Marcin , Banasik Piotr
Published: August 2012

Conversion between Cartesian and geodetic coordinates on a rotational ellipsoid by solving a system of nonlinear equations

A new method to transform from Cartesian to geodetic coordinates is presented. It is based on the solution of a system of nonlinear equations with respect to the coordinates of the point projected onto the ellipsoid along the normal. Newton's method and a modification of Newton's method were applied to give third-order convergence. The method developed was compared to some well known iterative techniques. All methods were tested on three ellipsoidal height ranges: namely, (-10 - 10 km) (terrestrial), (20 - 1000 km), and (1000 - 36000 km) (satellite). One iteration of the presented method, implemented with the third-order convergence modified Newton's method, is necessary to obtain a satisfactory level of accuracy for the geodetic latitude (σφ < 0.0004") and height (σh< 10-6km, i.e. less than a millimetre) for all the heights tested. The method is slightly slower than the method of Fukushima (2006) and Fukushima's (1999) fast implementation of Bowring's (1976) method.
Any Lesson from the History of Sustainable Development?
Authors: Lapka Miloslav , Cudlínová Eva
Published: August 2012

Any Lesson from the History of Sustainable Development?

Have we still got time for sustainability and reasonable application of ideas of sustainable development? It has been just over twenty years since the Brundtland Commission Report but, taken as an axiological term; sustainable development resonates with older historical horizons. At the heart of a long running history we are beginning to articulate more or less sustaining relationships between man and nature. We have described the (human) needs in the environmental, economic and social dimension of sustainable development to show some amazing shift in perception of sustainable development from local to global level. We are convinced that historical lesson of sustainable development shows there is no more time for sustainability, but time for SOStainability. Our proposed S-O-S in SOStainability means Save Our Sustainability! SOStainability represents the need to end the compromise between economic development and natural life supporting systems.
Analysis of Ecology of a Little Known White Oak Quercus Polycarpa Schur, Using Geobiocoenological Typology
Authors: Matula Radim
Published: August 2012

Analysis of Ecology of a Little Known White Oak Quercus Polycarpa Schur, Using Geobiocoenological Typology

Quercus polycarpa Schur is a little known oak species of the Sessile Oak aggregate (Quercus petraea s. lat.). Different habitats were studied using geobiocoenological typology system in order to investigate its ecology. In total, 65 experimental plots were set in forest stands with Q. polycarpa in the main storey in 12 protected areas situated in south-east of the Czech Republic. Ecological conditions, basic tree parameters and representation of Q. polycarpa within other oak species were evaluated on each plot. The mean values of height, height of life crown setting, stem and crown diameter were related to sub-categories of geobiocoenological system and compared by one-way ANOVA and Scheffé post-hoc test. It has been found out that Q. polycarpa grow in a high number in the 2nd altitudinal zone. It often occurs in a variety of habitats with different hydric and trophic conditions. As expected, the lowest values of measured parameters were found in the dry hydric range, this species reaches the highest values in the normal hydric and mesic ranges.
Transformation of the Slovak Cultural Landscape Since the 18th Cent. and its Recent Trends
Authors: Olah Branislav , Boltižiar Martin , Gallay Igor
Published: August 2012

Transformation of the Slovak Cultural Landscape Since the 18th Cent. and its Recent Trends

The paper is focused on a long-term development of the selected Slovak cultural landscape types (plains, basins, uplands, highlands, and mountains) in approx. 200 years, which shaped the main land use features as well as on the recent transformation trends. The land use development analyses showed that from a long term view perspective several distinct periods can be distinguished. Each of these periods was characteristic for certain land use changes depending both on the landscape character or the socioeconomic situation. The recent trends as land use intensification (intense agriculture, sub-urbanisation, industrial construction) or land use extensification (agricultural land overgrowing) are considered to be common for the entire Slovak territory. Special transformation trends reflect more local conditions, human needs and preferences (construction of water reservoirs, wind calamities or tourism resorts) and though they are spatially isolated and small they influence the majority of Slovak inhabitants.
Topographic Exposure and its Practical Applications
Authors: Mikita Tomáš , Klimánek Martin
Published: August 2012

Topographic Exposure and its Practical Applications

Topographic exposure is a topographic characteristic representing a degree of protection by a surrounding topography of a certain site. Detailed knowledge of topographic exposure has broad use in a number of applications ranging from studying forest wind damage through research on snow storage dynamics to optimisation in positioning wind power stations. This paper describes a method for creation of topographic exposure on the basis of a digital elevation model (DEM) using GIS. In combination with other climatic data on wind direction and speed, this factor is used to define the degree of terrain ventilation. Low terrain ventilation has, among other things, a significant influence on the creation of valley inversions and related vegetation zoning inversions. By combining the degree of terrain ventilation with DEM and forest vegetation zones in the area of the Training Forest Enterprise Křtiny, a clear relationship between the influence of topographic exposure, or terrain ventilation, and the creation of the vegetation zoning inversion was determined.
Integrative Research and Transdisciplinary Knowledge Production: A Review of Barriers and Bridges
Authors: Axelsson Robert
Published: August 2012

Integrative Research and Transdisciplinary Knowledge Production: A Review of Barriers and Bridges

Contemporary policies about use of natural resources clearly pronounce sustainable development towards the goal sustainability as a focal objective. A key challenge for research is to support improvements and management by evaluation of sustainability policy implementation, i.e. outcomes on the ground and the social process in actual landscapes. However, while a landscape consists of integrated social and ecological subsystems and should thus be treated as a holistic unit or system, most research and postgraduate training is disciplinary. This means that very few researchers are equipped to solve problems or contribute to solutions in the non-academic world. There is thus a need for universities to learn integrative (interdisciplinary and transdisciplinary) research and knowledge production that meets complex challenges related to sustainable development and sustainability issues as for example management and governance of natural resources. In this paper I review the background, concepts and the barriers and bridges to integrative research and knowledge production. As a base for evaluation and development of integrative research projects I propose a normative model for integrative knowledge production processes. This was done through a literature review and a study of an integrative research project. I discuss how transdisciplinary research about landscapes and to solve complex sustainability issues can be designed, viz. (1) there is a need for a common understanding of different types of integrative research, (2) an outspoken aim to develop socially robust knowledge, (3) a model for transdisciplinary collaborative learning processes, and (4) a funding scheme that include academic and non-academic participants and matches the long process of partnership building during the full knowledge production process, from problem identification/definition to an improvement or a management solution.
Biosphere Reserves - Suggested Model of the Institution of Commons (Case study of the Šumava Biosphere Reserve)
Authors: Těšitel Jan , Kušová Drahomíra
Published: August 2012

Biosphere Reserves - Suggested Model of the Institution of Commons (Case study of the Šumava Biosphere Reserve)

An attempt to address the interdependence between human economies and natural ecosystems has been articulated in ecological economics, among others, in terms of ecosystem services. Introducing ecosystem services yields positive result in the sense that the theoretical concept of cultural landscape has been complemented by the more or less effective political scheme, suitable as a basis for practical decision making. Nevertheless, practical management of ecosystem services on landscape scale is a rather complex task. The concept ofinstitution of commonscould be suggested to be used when dealing with the problem of implementation of ecosystem services concept in practice. The overall aim of the contribution is to discuss whether or not, or to which extent,UNESCO Biosphere Reserve, the modern strategy in biodiversity conservation backed up by internationally agreed upon conventions, can be used as a model for institution of commons in landscape-scale nature protection. The discussion is based on empirical evidence gained within a long-term research conducted in the Šumava Biosphere Reserve, Czech Republic.
Responses of Vegetation Stages with Woody Dominants to Stress and Disturbance During Succession on Abandoned Tailings in Cultural Landscape
Authors: Kovář Pavel , Štefánek Michal , Mrázek Jakub
Published: August 2012

Responses of Vegetation Stages with Woody Dominants to Stress and Disturbance During Succession on Abandoned Tailings in Cultural Landscape

Studies of ecological succession on tailing containments (abandoned sedimentation basins with waste deposited by a factory producing sulphuric acid from pyrite ore) near the village of Chvaletice (Eastern Bohemia, Czech Republic) were carried out since 1973 with increased intensity and complexity between 1986 and 2002 (Kovář 2004). Vegetation cover in its relationships to various factors has been periodically monitored up to now. The abandoned ore-washery deposit is characterized by relative strong toxicity of the sediment material (high heavy metal content) and fluctuations of the microsite conditions up to extreme values (pH, salinity, surface temperatures). Species richness and the courses of some ecological processes are influenced both by availability of plant diaspores (regional species pool) determined with the presence of adequate dispersal mechanisms (anemochory, zoochory) and by the seasonal moderation of environmental variables excluding stress non-tolerant species at extreme epizodes and enabling survival of resistant species during the competition. Long lasting existence of patches without any vegetation together with herbaceous types of stands and woody successional stages create mosaics on the surface plateau. The oldest tree stands (in average 20 - 30 years old) are predominantly formed byPopulus tremulaandBetula pendula, with minor admixture ofSalixsp. div. (mainlyS. caprea),Pinus sylvestris,Quercus roburorCerassus avium, rarelySarothamnus scoparius.The abundance ratio of two main dominants, aspen and birch, was changed for the benefit of the first one after the summer fire in extremely hot days. The effect of clonality on aspen regeneration and regrowth immediately after the fire disturbance was profitably manifested and it apparently facilitates the present state with aspen prevailing in the most forested tailing places at present, seventeen years after the fire. This fact supports the importance of clonal plant species role during primary succession.
Safety and Feasibility of an Exercise Prescription Approach to Rehabilitation Across the Continuum of Care for Survivors of Critical Illness
Authors: Berney Sue , Haines Kimberley , Skinner Elizabeth H. , Denehy Linda
Published: August 2012

Background

Survivors of critical illness can experience long-standing functional limitations that negatively affect their health-related quality of life. To date, no model of rehabilitation has demonstrated sustained improvements in physical function for survivors of critical illness beyond hospital discharge.

Objective

The aims of this study were: (1) to describe a model of rehabilitation for survivors of critical illness, (2) to compare the model to local standard care, and (3) to report the safety and feasibility of the program.

Design

This was a cohort study.

Methods

As part of a larger randomized controlled trial, 74 participants were randomly assigned, 5 days following admission to the intensive care unit (ICU), to a protocolized rehabilitation program that commenced in the ICU and continued on the acute care ward and for a further 8 weeks following hospital discharge as an outpatient program. Exercise training was prescribed based on quantitative outcome measures to achieve a physiological training response.

Results

During acute hospitalization, 60% of exercise sessions were able to be delivered. The most frequently occurring barriers to exercise were patient safety and patient refusal due to fatigue. Point prevalence data showed patients were mobilized more often and for longer periods compared with standard care. Outpatient classes were poorly attended, with only 41% of the patients completing more than 70% of outpatient classes. No adverse events occurred.

Limitations

Limitations included patient heterogeneity and delayed commencement of exercise in the ICU due to issues of consent and recruitment.

Conclusions

Exercise training that commences in the ICU and continues through to an outpatient program is safe and feasible for survivors of critical illness. Models of care that maximize patient participation across the continuum of care warrant further investigation.
Effectiveness of an Early Mobilization Protocol in a Trauma and Burns Intensive Care Unit: A Retrospective Cohort Study
Authors: Clark Diane E. , Lowman John D. , Griffin Russell L. , Matthews Helen M. , Reiff Donald A.
Published: August 2012

Background

Bed rest and immobility in patients on mechanical ventilation or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase costs, and can be associated with decreased ICU and hospital lengths of stay (LOS).

Objective

The purpose of this study was to assess the effects of an early mobilization protocol on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU).

Design

This was a retrospective cohort study of an interdisciplinary quality-improvement program.

Methods

Pre– and post–early mobility program patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared.

Results

No adverse events were reported related to the early mobility program. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and deep vein thrombosis) post–early mobility program. Ventilator days and TBICU and hospital lengths of stay were not significantly decreased.

Limitations

Using a historical control group, there was no way to account for other changes in patient care that may have occurred between the 2 periods that could have affected patient outcomes. The dose of physical activity both before and after the early mobility program were not specifically assessed.

Conclusions

Early mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administrators, have embraced the new culture of early mobilization in the ICU.
Which Prognostic Factors for Low Back Pain Are Generic Predictors of Outcome Across a Range of Recovery Domains?
Authors: Cook Chad E. , Learman Kenneth E. , O'Halloran Bryan J. , Showalter Christopher R. , Kabbaz Vincent J. , Goode Adam P. , Wright Alexis A.
Published: August 2012

Background

Recovery from low back pain (LBP) is multidimensional and requires the use of multiple-response (outcome) measures to fully reflect these many dimensions. Predictive prognostic variables that are present or stable in all or most predictive models that use different outcome measures could be considered “universal” prognostic variables.

Objective

The aim of this study was to explore the potential of universal prognostic variables in predictive models for 4 different outcome measures in patients with mechanical LBP.

Design

Predictive modeling was performed using data extracted from a randomized controlled trial. Four prognostic models were created using backward stepwise deletion logistic, Poisson, and linear regression.

Methods

Data were collected from 16 outpatient physical therapy facilities in 10 states. All 149 patients with LBP were treated with manual therapy and spine strengthening exercises until discharge. Four different measures of response were used: Oswestry Disability Index and Numeric Pain Rating Scale change scores, total visits, and report of rate of recovery.

Results

The set of statistically significant predictors was dependent on the definition of response. All regression models were significant. Within both forms of the 4 models, meeting the clinical prediction rule for manipulation at baseline was present in all 4 models, whereas no irritability at baseline and diagnosis of sprains and strains were present in 2 of 4 of the predictive models.

Limitations

The primary limitation is that this study evaluated only 4 of the multiple outcome measures that are pertinent for patients with LBP.

Conclusions

Meeting the clinical prediction rule was prognostic for all outcome measures and should be considered a universal prognostic predictor. Other predictive variables were dependent on the outcomes measure used in the predictive model.
Tipping Point Discourse in Dangerous Times
Authors: Russill Chris , Lavin Chad
Published: August 2012

Abstract:

The concept of the tipping point has reshaped how crisis is perceived and understood in public discourse. We study this trend in selected instances, including the 2005 Iraqi elections, the 2005 flooding in Louisiana, and the climate-change crisis, before situating Malcolm Gladwell's theory of the tipping point in historical context. We discuss how Gladwell interprets key dimensions of the epidemiological approach in an overly selective manner in order to advance a particular political perspective on public policy. This perspective restricts an understanding of the way social inequalities shape the environmental conditions, contexts, and politics of social problems.
Cinéma américain, communication politique et information
Authors: Gusse Isabelle
Published: August 2012

Résumé :

L'auteure appréhende le cinéma en tant que support de communication politique dans l'axe informateur/information. Il se dégage de l'analyse qualitative de trois films historiques américains (Good night, and good luck, Bobby et Across the universe) produits entre 2006 et 2007 et de leurs notes de production deux figures de l'informateur : réalisateurs et personnages expriment et relaient certains idéaux démocratiques liés au respect des droits fondamentaux du citoyen.
Prediction of Potential Cracking Failure Modes in Three-Dimensional Airfield Rigid Pavements with Existing Cracks and Flaws
Authors: Evangelista Francisco , Roesler Jeffery R. , Duarte C. Armando
Published: August 2012

This paper predicts the potential for crack propagation in concrete pavements under aircraft loading given a starter fatigue crack at the bottom of the concrete slab or a surface-initiated shrinkage crack on top of the slab. The generalized finite element method was used to evaluate the stress intensity factors for quarter elliptical cracks placed at the critical top and bottom tensile stress locations. The pavement was loaded with a single triple-dualtandem (TDT) gear and two TDTs accounting for the entire belly gears. When the pavement was loaded with the two TDT gear configuration, the analyses showed significantly higher KI (shear mode) values for surface-initiated cracks than for bottom-initiated cracks for the same crack size. Therefore, concrete slabs with preexisting surface cracks are more likely to exhibit top-down crack growth despite being designed for bottom-up fatigue cracking under certain loading conditions. The theoretical framework allows for improved assessment of the fracture susceptibility of concrete slabs under aircraft loading, specifically the potential for top-down over bottom-up cracking.
Lifestyle Segmentation Variables as Predictors of Home-Based Trips for Atlanta, Georgia, Airport
Authors: Kressner Josephine D. , Garrow Laurie A.
Published: August 2012

This research investigated the influence of demographic and socio-economic factors on air travel demand by using a unique data set purchased from a credit-reporting agency. Linear regression models based on lifestyle segmentation variables were used to predict air passenger trips for Hartsfield–Jackson International Airport in Atlanta, Georgia. The study focused on predicting trips that originated from or terminated at residences in Atlanta's 13-county metropolitan area. The lifestyle regression models were compared with regression models based on income, because the latter were similar to the regression models currently used by the Atlanta Regional Commission to predict home-based airport passenger trips. The results provide directional evidence for using lifestyle clusters over income groups in predicting airport passenger trips. The evidence suggests that alternative data sources with adequate information for lifestyle segmentation can improve airport passenger models. The discussion points out the need for air passenger surveys to collect information about the number of annual air trips a surveyed individual takes.
Parsimonious Modeling and Uncertainty Quantification for Transportation Systems Planning Applied to California High-Speed Rail
Authors: Noreiga Quentin , McDonald Mark
Published: August 2012

This paper presents a parsimonious travel demand model (PTDM) derived from a proprietary parent travel demand model developed by Cambridge Systematics (CS) for the California high-speed rail system. The purpose of the PTDM is to reduce computational expense for model simulations, optimization and sensitivity analyses, and other repetitive analyses. The PTDM is used to quantify the significance of parameter uncertainties with the use of mean value first-order second moment methods for uncertainty quantification and sensitivity analysis. The PTDM changes the model resolution of the parent travel demand model from a traffic analysis zone to a county-level analysis. The three-step model contains trip frequency, destination choice, and main mode choice models and is calibrated to match the results of the CS model. The main mode choice model predicts primary mode choice results for car, commercial air, conventional rail, and high-speed rail. The PTDM uses data and models similar to parent models to show how uncertainty in travel demand model predictions can be quantified. This paper does not attempt to assess the reliability of parent model forecasts, and the results should not be used to evaluate uncertainty in the California High-Speed Rail Authority's rider ship and revenue forecasts. However, the uncertainty quantification methodology presented here, when applied to the CS model, can be used to quantify the impact of parameter uncertainty on the forecast results.
Fiber-Reinforced Asphalt Concrete as Sustainable Paving Material for Airfields
Authors: Stempihar Jeffrey J. , Souliman Mena I. , Kaloush Kamil E.
Published: August 2012

Sustainability at airports has received attention recently as owners have worked to incorporate sustainable practices into projects and daily operations. Several guides have been published by airport agencies to document sustainable practices. One potential practice involves alternative paving materials for airfield pavements. Specifically, fiber-reinforced asphalt concrete has shown promising results and has recently been used to resurface Runway 1–19 at the Jackson Hole Airport in Jackson, Wyoming. This paper explores the feasibility of using fiber-reinforced asphalt concrete as a sustainable paving strategy for airfields. The study includes an extensive literature review, performance testing of an asphalt mixture, cost analysis, a sustainable credit summary, and a carbon dioxide emission comparison. Laboratory testing showed that the Jackson Hole Airport mixture performed better than a control mixture produced in the laboratory with similar materials. Further analysis concluded that a fiber-reinforced, porous asphalt friction course could qualify for several sustainable site credits. In addition, the minimal upfront cost of fibers makes this product attractive because the cost can be recouped by an approximate 1-year extension in service life. Pavement design simulations indicated a reduction in equivalent carbon dioxide emissions through the extension of service life. Recommendations for the use of fiber-reinforced asphalt concrete on airfields are provided based on the findings of this study and future research is identified.
Risk Assessment of Bird–Aircraft Strikes at Commercial Airports
Authors: Wang Jinfeng , Herricks Edwin E.
Published: August 2012

Bird strikes are a continuing problem in aviation. Despite the number and severity of reported bird strikes, quantification of the effect of contributory factors has been limited because of the absence of data, especially data on bird activity around airfields. The purpose of this study is to provide initial insight into this important problem by combining a number of databases and information resources available at the Seattle–Tacoma International Airport in Washington, including airplane operations, bird strike reports, and the avian radar data on bird movements. Logistic regression and multinomial regression models were used to analyze, respectively, bird strike occurrence and severity. The results indicate that bird track density and airplane movement frequency significantly correlate with bird strike occurrence. High altitude and cloudy weather increase the probability of serious damage. Airplanes weighing less than 27,000 kg and those with turbofan engines and struck positions including tail and light move the propensity toward minor damage compared with no damage. Factors such as single-engine airplanes, medium and large birds, and strikes occurring at engines and wings increase the chance of both serious and minor damage. The findings of this study could provide support for potential changes in airport bird hazard management, airplane operations, and engineering designs of engines and airframes. The study highlights the importance of managing accurate bird strike reports and applying new statistical approaches as more data become available.
Analysis of Taxiway Aircraft Traffic at George Bush Intercontinental Airport, Houston, Texas
Authors: Yin Kai , Tian Chunyu , Wang Bruce X. , Quadrifoglio Luca
Published: August 2012

Serving one of the largest metropolitan areas in the United States, the George Bush Intercontinental Airport (IAH) in Houston, Texas, is one of the 10 airports with the longest average taxi-out and taxi-in times. This paper assesses the congestion at IAH by analyzing taxi times and flight data during different hours of the day. The capacity of IAH is investigated by examining the number of departing flights on the ground. IAH is operating close to capacity most of the time. Because increasing airport capacity can mitigate congestion, this report develops a surface operation model based on analyzed results to achieve this aim. A mixed-integer programming formulation is proposed to optimize total taxi times by finding optimal taxi routes and the related schedules. The model is applied to a sample from real data.
Cerebrospinal fluid volume measurements in hydrocephalic rats
Authors: Basati Sukhraaj , Desai Bhargav , Alaraj Ali , Charbel Fady , Linninger Andreas
Published: August 2012

Object

Experimental data about the evolution of intracranial volume and pressure in cases of hydrocephalus are limited due to the lack of available monitoring techniques. In this study, the authors validate intracranial CSF volume measurements within the lateral ventricle, while simultaneously using impedance sensors and pressure transducers in hydrocephalic animals.

Methods

A volume sensor was fabricated and connected to a catheter that was used as a shunt to withdraw CSF. In vitro bench-top calibration experiments were created to provide data for the animal experiments and to validate the sensors. To validate the measurement technique in a physiological system, hydrocephalus was induced in weanling rats by kaolin injection into the cisterna magna. At 28 days after induction, the sensor was implanted into the lateral ventricles. After sealing the skull using dental cement, an acute CSF drainage/infusion protocol consisting of 4 sequential phases was performed with a pump. Implant location was confirmed via radiography using intraventricular iohexol contrast administration.

Results

Controlled CSF shunting in vivo with hydrocephalic rats resulted in precise and accurate sensor measurements (r = 0.98). Shunting resulted in a 17.3% maximum measurement error between measured volume and actual volume as assessed by a Bland-Altman plot. A secondary outcome confirmed that both ventricular volume and intracranial pressure decreased during CSF shunting and increased during infusion. Ventricular enlargement consistent with successful hydrocephalus induction was confirmed using imaging, as well as postmortem. These results indicate that volume monitoring is feasible for clinical cases of hydrocephalus.

Conclusions

This work marks a departure from traditional shunting systems currently used to treat hydrocephalus. The overall clinical application is to provide alternative monitoring and treatment options for patients. Future work includes development and testing of a chronic (long-term) volume monitoring system.
The therapeutic potential of ex vivo expanded CD133+ cells derived from human peripheral blood for peripheral nerve injuries
Authors: Ohtsubo Shin , Ishikawa Masakazu , Kamei Naosuke , Kijima Yasumu , Suzuki Osami , Sunagawa Toru , Higashi Yukihito , Masuda Haruchika , Asahara Takayuki , Ochi Mitsuo
Published: August 2012

Object

CD133+ cells have the potential to enhance histological and functional recovery from peripheral nerve injury. However, the number of CD133+ cells safely obtained from human peripheral blood is extremely limited. To address this issue, the authors expanded CD133+ cells derived from human peripheral blood using the serum-free expansion culture method and transplanted these ex vivo expanded cells into a model of sciatic nerve defect in rats. The purpose of this study was to determine the potential of ex vivo expanded CD133+ cells to induce or enhance the repair of injured peripheral nerves.

Methods

Phosphate-buffered saline (PBS group [Group 1]), 105 fresh CD133+ cells (fresh group [Group 2]), 105 ex vivo expanded CD133+ cells (expansion group [Group 3]), or 104 fresh CD133+ cells (low-dose group [Group 4]) embedded in atelocollagen gel were transplanted into a silicone tube that was then used to bridge a 15-mm defect in the sciatic nerve of athymic rats (10 animals per group). At 8 weeks postsurgery, histological and functional evaluations of the regenerated tissues were performed.

Results

After 1 week of expansion culture, the number of cells increased 9.6 ± 3.3–fold. Based on the fluorescence-activated cell sorting analysis, it was demonstrated that the initial freshly isolated CD133+ cell population contained 93.22% ± 0.30% CD133+ cells and further confirmed that the expanded cells had a purity of 59.02% ± 1.58% CD133+ cells. However, the histologically and functionally regenerated nerves bridging the defects were recognized in all rats in Groups 2 and 3 and in 6 of 10 rats in Group 4. The nerves did not regenerate to bridge the defect in any of the rats in Group 1.

Conclusions

The authors' results show that ex vivo expanded CD133+ cells derived from human peripheral blood have a therapeutic potential similar to fresh CD133+ cells for peripheral nerve injuries. The ex vivo procedure that can be used to expand CD133+ cells without reducing their function represents a novel method for developing cell therapy for nerve defects in a clinical setting.