bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reversal of Acute Ischemic Stroke After THA Using Tissue Plasminogen Activator
Authors: Ezzet Kace A. 
Published: May 2013

Acute ischemic stroke is a potentially catastrophic medical emergency. Recently, successful reversal of the neurologic deficits associated with major ischemic strokes has been accomplished in selected patients through the use of intravenous tissue plasminogen activator (tPA), an agent that can accomplish thrombolysis of arterial clots if given within the first few hours after the onset of stroke. Because tPA works by thrombolysis of fresh clots, a potential exists for catastrophic hemorrhage if given to acute postoperative patients. Therefore, the use of tPA has never been studied in postoperative patients, and the safety of the drug in postoperative patients is unknown.
The author describes a patient who had an acute ischemic stroke 2 days after total hip arthroplasty who was successfully treated with tPA without major complications. The patient was 51 years old and developed progressive facial droop, right arm paralysis, and dysarthria 2 days after elective hip arthroplasty. Imaging confirmed occlusion of the left middle cerebral artery. Neurologic recovery was believed to be unlikely without tPA. After tPA administration, the patient had full neurologic recovery within minutes but did develop a large (nondraining) hematoma and severe ecchymosis at the surgical site; a drop in hematocrit required 3 units of packed red blood cell transfusion. The wound did not develop skin necrosis, infection, or compartment syndrome, and the hematoma resolved within several weeks without the need for surgical intervention.
The author describes the patient’s specific circumstances, the decision-making process behind the use of tPA, and the need for contingency plans in the event that severe uncontrolled hemorrhage occurs. This information may be useful if other surgeons are faced with the dilemma of a major stroke in acute postoperative patients.
Arthroscopic Internal Fixation of Osteochondritis Dissecans of the Femoral Head
Authors: Matsuda Dean K. , Safran Marc R. 
Published: May 2013

Osteochondritis dessicans of the femoral head is an uncommon problem. Limited literature reports the incidence of osteochondritis dessicans and its treatment. The surgical technique used and outcomes for a 40-year-old man with symptomatic femoral head osteochonditis dissecans who was treated 11 years previously with retrograde drilling and hip arthroscopy are discussed.
Despite temporary symptomatic improvement without subchondral collapse after his index procedure, increasing pain a decade later was thought to be caused by a large apical osteochondritic fragment and chondrolabral dysfunction from femoroacetabular impingement. Acetabuloplasty of acetabular overcoverage permitted arthroscopic internal fixation of the bone fragment by improving screw trajectory. Labral refixation and femoroplasty were subsequently performed. At 18-month follow-up, his nonarthritic hip score improved from 53 to 76 and his osteochondritic lesion had healed radiographically.
Although clinical improvement with radiographic union has been reported following open screw fixation of femoral head osteochondritis dissecans, to the authors’ knowledge this is the first published case with a similar outcome using arthroscopic techniques. Clinical improvement and union of even long-standing osteochondritis dissecans of the femoral head may occur with arthroscopic fragment fixation. Hip arthroscopy may play significant therapeutic and diagnostic roles in the treatment of this condition while offering a less invasive alternative to open osteosynthesis.
Creative Brisbane, Expérience touristique, villes créatives et esthétique de la transformation urbaine
Authors: Da Lage Émilie 
Published: May 2013

À travers l’étude de l’expérience touristique de la ville de Brisbane en Australie, est posée la question de la créativité et des référents associés : comment est-elle médiée et diffractée par la presse, les guides touristiques, les institutions culturelles, voire certaines formes de l’espace public urbain ? En articulant approches sémiotique et pragmatique de l’expérience touristique, sont mises en lumière les modalités par lesquelles ces politiques se rendent visibles et sensibles dans l’espace public urbain et participent à produire une esthétique de la créativité, entendue au sens de relation sensible. Ainsi, le touriste est invité à faire l’expérience d’une ville « transformée » et anhistorique. Si l’aménagement urbain tend à évacuer la conflictualité de l’espace public, celle-ci peut refaire surface dans des formes « touristiques » traditionnelles, comme la visite guidée.
Analise van die Tswanaraaisel
Authors: Swanepoel S. A. 
Published: May 2013

’n Strukturele, stilistiese en funksionele bcskrywing van die Twanaraaisel bring mee dat daar aan die volgende aspekte aandag gegee moet word: •	Wat is ’n raaisel en lioe word dit in Tswana genoem. •	Tot watter studiegebied en literere genre hoort die raaisel en watter subvorme kan vir Tswana onderskei word. •	Hoe sien die struktuur van Tswanaraaisels daar uit. •	Deur wie, waar, wanneer en hoe word Tswanaraaisels voorgedra. •	Watter stilistiese kenmcrke kan in Tswanaraaisels onderskei word. •	Watter funksies vervul raaisels in ’n Tswanagcmeenskap.
La défense de l’identité provençale dans I’oeuvre de Frédéric Mistral (<i>seconde partie</i>)
Authors: Pach R. 
Published: May 2013

The Provençale poet Frédéric Mistral (1830-1914) is remembered for his attempt at revitalizing the Proven?al language. He was one of the main founders of the literary academy named Félibrige, and was awarded the Nobel Prize for Literature in 1904. Although his poetical works have been extensively studied, the political inspiration which pervades a great part of his writings has not so far received the attention it deserves. This article, the first part of which appeared in the previous issue of Literator (vol. 8, no. 3), shows how profoundly Mistral was influenced by the ideal of independence and liberty which was a distinctive feature of the European XIXth century, and how his patriotic enthusiasm is reflected in his poetry.
Lacan avec saint Paul
Authors: Causse Jean-Daniel 
Published: May 2013

La compréhension paulinienne de la loi a fait l’objet d’une réception dans la théorie psychanalytique de Jacques Lacan, en particulier le chapitre 7 de l’Épître aux Romains. Sur ce thème, plusieurs travaux récents en psychanalyse défendent la thèse selon laquelle Paul n’a pas su distinguer la loi symbolique du surmoi et, prenant l’un pour l’autre, a organisé tout un monde de la culpabilité, de la haine et de la persécution. Lacan adopte un point de vue assez différent. Sans ignorer la part du surmoi, il attribue une dimension plus structurelle à la loi paulinienne. Dans la compréhension de la loi chez Paul, il voit une dialectique, centrale en psychanalyse, où le désir se porte vers ce qu’il ne doit pas obtenir. De ce fait, l’originalité de Paul est d’avoir indiqué que le péché se découvre paradoxalement sur l’axe d’un Bien et dans le mouvement de la fidélité à la loi. C’est ce que cette contribution met en lumière pour reconsidérer, à partir de là, le sens de l’amour et de la grâce.
Entre intégration et patrimonialisation (trans-) frontalières : les dynamiques territoriales de l’ancienne frontière interallemande
Authors: Quéva Christophe 
Published: May 2013

L’ancienne frontière interallemande a longtemps représenté une ligne de fracture majeure au sein des espaces allemand et européen. Avec la réunification de l’Allemagne, elle est passée d’une logique séparative à celle d’une nouvelle interface attractive entre les anciens et les nouveaux Länder. Les enjeux d’intégration ont alors conduit à un gommage certain de la frontière, aussi bien spatialement que politiquement. Néanmoins, l’héritage de la partition reste présent dans les représentations et les pratiques des populations. Il se réaffirme même de façon plus concrète dans le cadre d’un projet de patrimonialisation de tronçons de l’ancienne frontière, dont les enjeux sont à la fois mémoriels et écologiques. En quoi l’ancienne frontière interallemande incarne-t-elle des dynamiques complexes de perméabilité et de « frontiérisation » ? En s’appuyant sur l’exemple précurseur du projet de ceinture verte thuringienne, cet article analyse les enjeux spatiaux et identitaires de la patrimonialisation de cette ancienne frontière, de l’échelle locale à l’échelle européenne.
Biased‐Coin Randomization
Authors: Smith Mike D. 
Published: May 2013

AbstractThe biased coin randomisation is introduced as a procedure to minimize study bias whilst maintaining treatment balance throughout the trial. The range of biased coin randomizations are described for 2 and more than 2 treatment groups, and also for equal and unequal randomization. Biased coin randomizations are described which use both fixed and adaptive levels of coin ‘bias’. The well‐known urn model is described as a special representation of the biased coin randomization, and the link is discussed. Finally, the use of the biased coin randomization procedure for balance within covariate strata, and the application to response adaptive randomizations are described.
Censored Data
Authors: Andersen Per Kragh 
Published: May 2013

AbstractThe concepts of independent right censoring and noninformative right censoring in survival analysis are defined. Dependent censoring is a kind of selection bias and adds to biased inference for the survival time distribution. Informative censoring typically leads to inefficient inference. Examples are presented and relations between right censoring and competing risks are discussed. Other kinds of censoring, including interval censoring are touched upon.
Clinical Data Management
Authors: McBride Ruth 
Published: May 2013

AbstractClinical data management is data management systems and process focused on providing clean, current and reliable data to support clinical research, especially for clinical trials. Computerized systems have been used since the early 1960's. Current clinical data management systems vary. Many, but not all clinical trials use electronic data capture to collect data from clinical research sites. Efforts are underway to standardize the way clinical data are organized.
DNA
Bank
Authors: Sivakumaran Theru A , Iyengar Sudha K 
Published: May 2013

Abstract

Most diseases are multifactorial and are caused by a combination of genetic and environmental factors. Similarly, the way a person responds to a drug is also a complex trait that is influenced by many different genes. Paradigms to identify causative genetic variants responsible for disease or response to drugs are well described in the literature, and the following essential elements are required for successful completion of such studies: (
1
) rapid detection of genetic variation; (
2
) large number of samples of high quality with well‐characterized clinical data from participants, which includes longitudinal follow‐up for effect of treatment; (
3
) advanced informatics for storage and retrieval of samples and data; and (
4
) establishment of correlation between clinical and genetic data through modern statistical techniques. Although the basic conventions for sample collection in gene mapping were already established, it was only after completion of Human Genome Project and the initiation of the International HapMap Project that the need for large databases of well‐phenotyped study participants collected under unified protocols with DNA available was expressed. These endeavors resulted in the establishment of national and international DNA banks aimed initially at mapping specific disease entities, but later encompassing more global undertakings. Establishment of these DNA biobanks has not been without ethical, legal, and personal controversies, although their value to the biomedical research community is indisputable. The overall outcome of these initiatives is that the promise of personalized medicine is nearby, particularly for identification of the genetic variations responsible for drug response. We anticipate that clinical trials could perform genetic prescreening to exclude people who are unresponsive to treatment, which reduces side effects and increases the effectiveness of the drug for particular subgroups. This model is already being implemented for the P450 class of drugs, with the hope of more to come.
Missing Data
Authors: Molenberghs Geert , Lesaffre Emmanuel 
Published: May 2013

AbstractMissing data frequently occur in clinical trials. An important source for missing data are patients who leave the study prematurely, so‐called dropouts. We will concentrate here on the impact of dropouts on the clinical trial analysis.When patients are evaluated under treatment only once, then the presence of dropouts makes it hard to comply with the intention‐to‐treat (ITT) principle. However, when repeated measurements are taken, then one can make use of the observed portion of the data to retrieve information on dropouts. Generally, commonly used methods to analyze incomplete longitudinal clinical trial data include complete case (CC) analysis and a last observation carried forward (LOCF) analysis. However, these methods rest on strong and unverifiable assumptions about the dropout mechanism. Over the last decades, several longitudinal data analysis methods have been suggested, providing a valid estimate for, e.g., the treatment effect under less restrictive assumptions.The assumptions regarding the dropout mechanism have been classified by Rubin and co‐workers as missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR). We will argue that repeated measures analysis provide valid estimates of the treatment effect under MAR. Finally, as it is impossible to verify that the dropout mechanism is MAR, we argue that, to evaluate the robustness of the conclusion, a sensitivity analysis thereby varying the assumption on the dropout mechanism should become a standard procedure when analyzing the results of a clinical trial.
Multiple Risk Factor Intervention Trial (MRFIT)
Authors: Eberly Lynn E. , Stamler Jeremiah , Kuller Lewis H. , Neaton James D. 
Published: May 2013

AbstractThe Multiple Risk Factor Intervention Trial (MRFIT) was a randomized controlled trial on primary prevention of coronary heart disease (CHD) death in men with elevated blood pressure (BP), serum cholesterol, and/or smoking habit. In all, 361,662 men were screened in 18 U.S. cities; 12,866 men were randomized to multifactor Special Intervention (SI) or Usual Care (UC). With a 7 year average follow‐up, the CHD death rate was 7.1% lower for SI than UC [relative difference in proportion dead; 90% CI (−15%, 25%)]. UC men made more extensive risk factor reductions than anticipated in trial design, and the number of UC deaths was substantially smaller than expected. This result led to an underpowered comparison. Post‐hoc assessments showed significantly lower rates of combined morbidity/mortality outcomes for SI than UC. Other findings from MRFIT substantially changed the treatment of hypertension, and long‐term epidemiologic follow‐up of all 361,662 screenees yielded important findings of great impact on major public health and medical care issues.
N
of 1 Randomized Trial
Authors: Avins Andrew L. , Neuhaus John 
Published: May 2013

Abstract
“N‐of‐1 clinical trials” are randomized, multiple‐period crossover trials carried out in individual patients. Most clinical trials are conducted for the purpose of producing information generalizable to a larger population, but N‐of‐1 trials are usually conducted to inform a single patient and a clinical‐care provider about the effects of a specific therapy for that patient. Generalizing beyond that patient is usually not the intent of an N‐of‐1 study, though multiple N‐of‐1 trials may be combined to produce results with greater external validity. Like all crossover studies, there is a limited range of conditions and treatments that are amenable to investigation with an N‐of‐1 design, and practical barriers often exist to wider implementation of these studies in the typical clinical setting. Nevertheless, N‐of‐1 trials provide a potential means for providing more evidence‐based individualized therapeutic decision‐making in clinical practice.
Open‐Labeled Trial
Authors: Day Simon 
Published: May 2013

Abstract
This article discusses open‐labeled studies; that is, studies that are not blinded. It is usually assumed that lack of blinding is “total,” not just single‐blinded (either patient‐ or investigator‐blinded). Different levels and aspects of blinding can often be achieved so that trials may be only partially open label. In some cases, open‐label trials might be practically more acceptable, and in some studies, they may even be preferred to blinded studies.
Pharmacoepidemiology, Overview
Authors: Suissa S. 
Published: May 2013

AbstractPharmacoepidemiology is the study of patterns of medication use in the populations and their effects on diseases. Particular interest is focused on unexpected risks, especially events such as rare side effects. These can typically not be adequately assessed in the context of randomized clinical trials. This entry describes the use of Pharmacoepidemiology through the case‐crossover design, dealing with confounding in observational studies, the specification of appropriate risk functions over time, the probabilistic assessment of causality, and study methods based on the use of prescription data.
Population Pharmacokinetic and Pharmacodynamic Methods
Authors: Bulitta Jürgen B , Holford Nicholas H G 
Published: May 2013

Abstract
Pharmacokinetic and pharmacodynamic models are widely used to provide the quantitative basis for understanding the clinical pharmacology of pharmaceuticals. These models are used to describe both the average behavior in the population and differences between individuals. Pharmacokinetic models describe the time course of absorption, distribution, and elimination of a drug and any metabolites. Pharmacodynamic models describe the relationship between drug concentration and biological response. The pharmacokinetic‐pharmacodynamic model often has to account for a delay between the time course of concentrations and the time course of pharmacodynamic effect. Statistical models can describe the predictable and the unpredictable variability between and within subject variability in response. Predictable variability is most commonly understood for drug elimination processes and typically uses subject factors such as weight, renal function, and other medications to account for between subject differences. Unpredictable variability is usually larger than predictable variability. A wide variety of software has been developed for implementing these pharmacological and statistical models; of these, NONMEM (GloboMax LLC, Hanover, MD) is the most widely used. Newer algorithms are actively being developed. Model building and parameter estimation are often computationally intensive. Population models are used by drug developers to create a rationale framework for development, by regulatory health authorities to evaluate clinical trials and enhance product labels and by clinical researchers to understand human biology and disease progression.
Sample Size Considerations for Morbidity/Mortality Trials
Authors: Shih Joanna H. 
Published: May 2013

Abstract
Sample size and power determination plays a crucial role in the design of morbidity/mortality clinical trials. To ensure that a trial is adequately sized so that the true treatment effect can be detected with a desired power, it is important to evaluate the assumptions used in the sample‐size calculation procedure. Various close‐form sample‐size formulas have been proposed for the analysis of morbidity/mortality trials with survival endpoints. However, most of them are formed based on restrictive assumptions and do not take into consideration factors that may affect the estimate of the treatment effect. These factors include drop‐in, drop‐out, staggered entry, loss to follow‐up, lags in treatment effects, and informative noncompliance. This article reviews the sample‐size calculation methods for testing the treatment effect in two‐arm survival trials. For each method considered, its basic features, underlying assumptions, and limitations are discussed. Presented first are the test statistics and associated methods that yield close‐form sample‐size formulas. Then attention will be focused on methods with aforementioned complexities in sample‐size calculation.
Odontometric determination of sex at Mound 72, Cahokia
Authors: Thompson Andrew R. 
Published: May 2013

ABSTRACTThe mortuary context of Mound 72 at the Cahokia site is one of the most unusual ever described in prehistoric North America. Previous skeletal analyses suggested that four large mass graves within the mound contained only female skeletons. However, these findings were complicated by extremely poor bone preservation that limited the number of skeletal observations that could be made. Furthermore, most skeletons were aged in the 15–25 year range, a time when sexually dimorphic bony traits may still be developing. In this study, dental remains were used to examine sex in the four presumably all‐female mass graves in Mound 72. Additional sources of information, including the original field/laboratory notes and new sexing data based on modern standards, were gathered to fully evaluate the dental estimates. Initially, discriminant function analysis was performed on odontometrics using the original Mound 72 sex assignment. Inconsistent results indicated that some of the skeletons may have been misclassified in the original analyses. To overcome this issue, discriminant function equations were generated using a large pooled skeletal sample from two sites in close temporal and geographic proximity to Cahokia. Application of the equations to Mound 72 revealed that each of the four mass burial groups contained individuals classified as male. These assignments were checked against the skeletal remains and the original field/laboratory notes. Discussion centers on how the results affect previous archaeological interpretations as well as the methodological considerations associated with this study. Am J Phys Anthropol 151:408–419, 2013.© 2013 Wiley Periodicals, Inc.
Recent progress in interfacial toughening and damage self‐healing of polymer composites based on electrospun and solution‐blown nanofibers: An overview
Authors: Wu Xiang‐Fa , Yarin Alexander L. 
Published: May 2013

ABSTRACTIn this article, we provide an overview of recent progress in toughening and damage self‐healing of polymer–matrix composites (PMCs) reinforced with electrospun or solution‐blown nanofibers at interfaces with an emphasis on the innovative processing techniques and toughening and damage self‐healing characterization. Because of their in‐plane fiber architecture and layered structure, high‐performance laminated PMCs typically carry low interfacial strengths and interlaminar fracture toughnesses in contrast to their very high in‐plane mechanical properties. Delamination is commonly observed in these composite structures. Continuous polymer and polymer‐derived carbon nanofibers produced by electrospinning, solution blowing, and other recently developed techniques can be incorporated into the ultrathin resin‐rich interlayers (with thicknesses of a few to dozens of micrometers) of these high‐performance PMCs to form nanofiber‐reinforced interlayers with enhanced interlaminar fracture toughnesses. When incorporated with core–shell healing‐agent‐loaded nanofibers, these nanofiber‐richened interlayers can yield unique interfacial damage self‐healing. Recent experimental investigations in these topics are reviewed and compared, and recently developed techniques for the scalable, continuous fabrication of advanced nanofibers for interfacial toughening and damage self‐healing of PMCs are discussed. Developments in the near future in this field are foreseen. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 130: 2225–2237, 2013