bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Therapist Treatment of Patients in the Neurological Intensive Care Unit: Description of Practice
Authors: Sottile Peter D. , Nordon-Craft Amy , Malone Daniel , Luby Darcie M. , Schenkman Margaret , Moss Marc 
Published: February 2015

Background
Although studies have established the safety and feasibility of physical therapy in the critical care setting, minimal information about physical therapist practice in the neurological intensive care unit (NICU) is available.

Objective
This study describes physical therapists' treatment of people admitted to a NICU.

Design
People admitted to the NICU with a diagnosis of subarachnoid hemorrhage, subdural hematoma, intracranial hemorrhage, or trauma were retrospectively studied.

Methods
Data on patient demographics, use of mechanical ventilation, and intracranial pressure (ICP) monitoring were collected. For each physical therapy session, the length of the session, the location (NICU or post-NICU setting), and the presence of mechanical ventilation or ICP monitoring were recorded. Data on safety parameters, including vital sign response, falls, and dislodgement of lines, were collected.

Results
Over 1 year, 180 people were admitted to the NICU; 86 were evaluated by a physical therapist, for a total of 293 physical therapy sessions in the NICU (n=132) or post-NICU setting (n=161). Only one session (0.3%) was stopped, secondary to an increase in ICP. The first physical therapy session occurred on NICU day 3.0 (25%–75% interquartile range=2.0–6.0). Patients received a median of 3.4 sessions per week (25%–75% interquartile range=1.8–5.9). Patients with mechanical ventilation received less frequent physical therapy sessions than those without mechanical ventilation. Patients with ICP monitoring received less frequent sessions than those without ICP monitoring. However, after multivariate analysis, only the admission Glasgow Coma Score was independently associated with physical therapy frequency in the NICU. Patients were more likely to stand, transfer, and walk in the post-NICU setting than in the NICU.

Limitations
The results are limited by the retrospective, single-center nature of the study. There is inherent bias of evaluating only those patients who had physical therapy, and therapists were unable to completely adjust for the severity of illness of a given patient.

Conclusions
Physical therapy was performed safely in the NICU. Patients who required invasive support received less frequent physical therapy.
Longitudinal Relationship Among Physical Fitness, Walking-Related Physical Activity, and Fatigue in Children With Cerebral Palsy
Authors: Balemans Astrid C.J. , van Wely Leontien , Becher Jules G. , Dallmeijer Annet J. 
Published: February 2015

BackgroundA vicious circle of decreased physical fitness, early fatigue, and low physical activity levels (PAL) is thought to affect children with cerebral palsy (CP). However, the relationship of changes in physical fitness to changes in PAL and fatigue is unclear.ObjectiveThe objective of this study was to investigate the associations among changes in physical fitness, walking-related PAL, and fatigue in children with CP.DesignThis study was a secondary analysis of a randomized controlled trial with measurements at baseline, 6 months (after the intervention period), and 12 months.MethodsTwenty-four children with bilateral spastic CP and 22 with unilateral spastic CP, aged 7 to 13 years, all walking, participated in this study. Physical fitness was measured by aerobic capacity, anaerobic threshold, anaerobic capacity, and isometric and functional muscle strength. Walking-related PAL was measured using an ankle-worn activity monitor for 1 week. Fatigue was determined with the Pediatric Quality of Life (PedsQL) Multidimensional Fatigue Scale. Longitudinal associations were analyzed by random coefficient regression analysis.ResultsIn children with bilateral CP, all fitness parameters showed a positive, significant association with walking-related PAL, whereas no associations between physical fitness and walking-related PAL were seen in children with unilateral CP. No clinically relevant association between physical fitness and fatigue was found.LimitationsAlthough random coefficient regression analysis can be used to investigate longitudinal associations between parameters, a causal relationship cannot be determined. The actual direction of the association between physical fitness and walking-related PAL, therefore, remains inconclusive.ConclusionsChildren with bilateral spastic CP might benefit from improved physical fitness to increase their PAL or vice versa, although this is not the case in children with unilateral CP. There appears to be no relationship between physical fitness and self-reported fatigue in children with CP. Interventions aimed at improving PAL may be differently targeted in children with either bilateral or unilateral CP.
Computed tomography morphometric analysis for C-1 posterior arch crossing screw placement in the pediatric cervical spine
Authors: Xiang Guang-Heng , Wang Chong , Lou Chao , Fang Ming-Qiao , Tian Nai-Feng , Xu Hua-Zi 
Published: February 2015

OBJECT
The goal of this study was to evaluate the feasibility of the C-1 posterior arch crossing screw fixation technique in the pediatric age group.

METHODS
One hundred twenty-three pediatric patients were divided into 6 age groups. Computed tomography morphometric analysis of the C-1 posterior arch was performed. Measurements included height, width, and length. Statistical analysis was performed using the Student t-test and linear regression analysis.

RESULTS
The mean measurement of the posterior arch was height (6.35 ± 1.80 mm), width (Width 1: 4.48 ± 1.25 mm; Width 2: 4.42 ± 0.68 mm; Width 3: 4.42 ± 0.50 mm), and length (14.48 ± 1.67 mm). Seven (6.93%) of the 101 children in Groups 1–4 and 13 (59.1%) of the 22 children in Groups 5 and 6 could safely accommodate placement of C-1 posterior arch crossing screws.

CONCLUSIONS
This investigation found that a C-1 posterior arch crossing screw was feasible in this group of Chinese pediatric patients, particularly in those 13 years and older. Preoperative thin-cut CT is essential for identifying children in whom this technique is applicable and for planning screw placement.
A pilot study to assess the construct and face validity of the Northwestern Objective Microanastomosis Assessment Tool
Authors: Aoun Salah G. , El Ahmadieh Tarek Y. , El Tecle Najib E. , Daou Marc R. , Adel Joseph G. , Park Christine S. , Batjer H. Hunt , Bendok Bernard R. 
Published: February 2015

OBJECT
Microsurgical skills remain an integral component of neurosurgical education. There is a need for an objective scale to assess microsurgical skills. The objective of this study was to assess the face and construct validity of a benchtraining microanastomosis module and an objective assessment scale, i.e., the Northwestern Objective Microanastomosis Assessment Tool (NOMAT).

METHODS
Medical students, neurosurgical residents, and postdoctoral research fellows at Northwestern University were enrolled in the study. Trainees were divided into 3 groups based on microsurgical experience: 1) experienced, 2) exposed, and 3) novices. Each trainee completed two end-to-end microanastomoses using a 1-mm and a 3-mm synthetic vessel. Two cameras were installed to capture procedural footage. One neurosurgeon blindly graded the performance of trainees using both objective and subjective methods to assess construct validity. Two neurosurgeons reviewed the contents of the simulation module to assess face validity.

RESULTS
Twenty-one trainees participated in the study, including 6 experienced, 6 exposed, and 9 novices. The mean NOMAT score for experienced trainees on the 1-mm module was 47.3/70 compared with 26.0/70 and 25.8/70 for exposed and novice trainees, respectively (p = 0.02). Using subjective grading, experienced trainees performed significantly better on the 1-mm module (64.2/100) compared with exposed or novice trainees (23.3/100 and 25.0/100, respectively; p = 0.02). No statistical difference between groups was noted for the 3-mm module with both NOMAT and subjective grading. Experienced trainees took less time to perform both tasks compared with the others.

CONCLUSIONS
Face and construct validities of the microanastomosis module were established. The scale and the microanastomosis module could help assess the microsurgical skills of neurosurgical trainees and serve as a basis for the creation of a microsurgical curriculum.
Cochlear line: a novel landmark for hearing preservation using the anterior petrosal approach
Authors: Kim Seong Min , Lee Ho Yun , Kim Han Kyu , Zabramski Joseph M. 
Published: February 2015

OBJECT
The goal of this study was to develop a practical landmark for the safe and easy identification of the cochlea when performing anterior petrosectomy based on cadaver dissection results.

METHODS
The cochlear line was defined as the line drawn from the crossing point between the greater superficial petrosal nerve (GSPN) and the petrous internal carotid artery to the line drawn over the apex of the superior circumference of the dura of the internal auditory canal at a right angle. The validity of the cochlear line marking the anteromedial perimeter of the cochlea at the angle of the GSPN and the internal acoustic canal as a practical landmark were evaluated using 5 cadaver heads.

RESULTS
The mean distance (± SD) measured from the cochlear line to the margin of the cochlear cavity was 2.25 ± 0.51 mm (range 1.50–3.00 mm).

CONCLUSIONS
Anterior petrosectomy can be performed more efficiently by using the cochlear line as a key landmark to preserve the cochlea.
Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study
Authors: Lee Cheng-Chia , Chen Ching-Jen , Ball Benjamin , Schlesinger David , Xu Zhiyuan , Yen Chun-Po , Sheehan Jason 
Published: February 2015

OBJECT
Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patients who have previously undergone partial AVM embolization with Onyx.

METHODS
Among a consecutive series of 199 patients who underwent SRS between January 2007 and December 2012 at the University of Virginia, 25 patients had Onyx embolization prior to SRS (the embolization group). To analyze the obliteration rates and complications, 50 patients who underwent SRS without prior embolization (the no-embolization group) were matched by propensity score method. The matched variables included age, sex, nidus volume before SRS, margin dose, Spetzler-Martin grade, Virginia Radiosurgery AVM Scale score, and median imaging follow-up period.

RESULTS
After Onyx embolization, 18 AVMs were reduced in size. Total obliteration was achieved in 6 cases (24%) at a median of 27.5 months after SRS. In the no-embolization group, total obliteration was achieved in 20 patients (40%) at a median of 22.4 months after SRS. Kaplan-Meier analysis demonstrated obliteration rates of 17.7% and 34.1% in the embolization group at 2 and 4 years, respectively. In the no-embolization group, the corresponding obliteration rates were 27.0% and 55.9%. The between-groups difference in obliteration rates after SRS did not achieve statistical significance. The difference in complications, including adverse radiation effects, hemorrhage episodes, seizure control, and patient mortality also did not reach statistical significance.

CONCLUSIONS
Onyx embolization can effectively reduce the size of many AVMs. This case-control study did not show any statistically significant difference in the rates of embolization or complications after SRS in patients who had previously undergone Onyx embolization and those who had not.
Aneurysm diameter as a risk factor for pretreatment rebleeding: a meta-analysis
Authors: Boogaarts Hieronymus D. , van Lieshout Jasper H. , van Amerongen Martinus J. , de Vries Joost , Verbeek André L. M. , Grotenhuis J. André , Westert Gert P. , Bartels Ronald H. M. A. 
Published: February 2015

OBJECT
Aneurysmal rerupture prior to treatment is a major cause of death and morbidity in aneurysmal subarachnoid hemorrhage. Recognizing risk factors for aneurysmal rebleeding is particularly relevant and might help to identify the aneurysms that benefit from acute treatment. It is uncertain if the size of the aneurysm is related to rebleeding. This meta-analysis was performed to evaluate whether an association could be determined between aneurysm diameter and the rebleeding rate before treatment. Potentially confounding factors such age, aneurysm location, and the presence of hypertension were also evaluated.

METHODS
The authors systematically searched the PubMed, Embase, and Cochrane databases up to April 3, 2013, for studies of patients with aneurysmal subarachnoid hemorrhage that reported the association between aneurysm diameter and pretreatment aneurysmal rebleeding. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria were used to evaluate study quality.

RESULTS
Seven studies, representing 2121 patients, were included in the quantitative analysis. The quality of the studies was low in 2 and very low in 5. Almost all of the studies used 10 mm as the cutoff point for size among other classes, and only one used 7 mm. An analysis was performed with this best unifiable cutoff point. Overall rebleeding occurred in 360 (17.0%) of 2121 patients (incidence range, from study to study, 8.7%–28.4%). The rate of rebleeding in small and large aneurysms was 14.0% and 23.6%, respectively. The meta-analysis of the 7 studies revealed that larger size aneurysms were at a higher risk for rebleeding (OR 2.56 [95% CI 1.62–4.06]; p = 0.00; I2 = 60%). The sensitivity analysis did not alter the results. Five of the 7 studies reported data regarding age; 4 studies provided age-adjusted results and identified a persistent relationship between lesion size and the risk of rebleeding. The presence of hypertension was reported in two studies and was more prevalent in patients with rebleeding in one of these. Location (anterior vs posterior circulation) was reported in 5 studies, while in 4 there was no difference in the rebleeding rate. One study identified a lower risk of rebleeding associated with posterior location aneurysms.

CONCLUSIONS
This meta-analysis showed that aneurysm size is an important risk factor for aneurysmal rebleeding and should be used in the clinical risk assessment of individual patients. The authors' results confirmed the current guidelines and underscored the importance of acute treatment for large ruptured aneurysms.
Duration of the horizontal decubitus position for prevention of cerebrospinal fluid leakage following transection of a tight filum terminale
Authors: Ogiwara Hideki , Joko Masahiro , Takado Michiko , Uematsu Kodai , Kameda Masahiro , Sasaki Natsu , Kitagawa Masashi , Morota Nobuhito 
Published: February 2015

OBJECT
The untethering of a tethered spinal cord in patients with a tight filum terminale is a relatively simple procedure that can prevent or improve neurological symptoms. Postoperatively, patients are usually kept in the horizontal decubitus position to prevent a CSF leak. However, the optimal period for keeping patients flat has not been determined yet. The authors compared 2 cohorts with different periods of horizontal decubitus; one with 72 hours and the other with 8 days.

METHODS
The authors retrospectively analyzed surgical results in 2 cohorts of pediatric patients who had tethered spinal cord with a tight filum terminale. One cohort was maintained flat for 8 days and the other cohort for 72 hours postoperatively. The patients' charts were reviewed for demographic data, clinical presentation, surgical therapy, and clinical course.

RESULTS
Three hundred fifty-four patients underwent sectioning of a tight filum terminale. Of those, 238 were kept lying flat for 8 days postoperatively, and 116 were maintained flat for 72 hours. Magnetic resonance imaging was performed 1 to 2 weeks after the surgery. None of the patients in either cohort developed a CSF leak. Pseudomeningocele, which was confirmed by MRI, developed in 1 patient who had been kept flat for 8 days. The occurrence rates of a CSF leak and pseudomeningocele were not significantly different in either cohort.

CONCLUSIONS
Keeping patients flat for longer than 72 hours did not change the rate of postoperative CSF leakage or pseudomeningocele. Seventy-two hours or less would be an appropriate period for maintaining patients flat after transection of a tight filum terminale.
Libidinal Symptomatology in Deleuze'sMasochism – Coldness and Cruelty
Authors: Gaudlitz Erika 
Published: February 2015

In taking up Deleuze's differential diagnosis by observing Masoch's literary practice and extracting his libidinal principles of imperatives, contracts, fetishism and rituals, I demonstrate Deleuzian libidinal symptomatology as a specific semiotics in the service of schizoanalysis. I shall argue that in Masoch the schizoanalytic curettage of the unconscious is executed as schizoid waiting where the fleeting outer symptoms of pain–pleasure reveal the masochist's desired inner splitting of the senses.Several critical-clinical inroads to the schizoanalytic project can be envisaged. Initially, Masoch's visionary concept of sexualised world history is supported by his strategic move to the law of the oral mother, yet then extended by Deleuze's concept of (inter)maternal symbolic which speculates on the fantasised rebirth of a sexless or hermaphroditic man. Finally, the parodic enactment of eros and thanatos functions as technique of dialectical disguise within the masochist's scheme of practising libidinal liberation.Masochism considered as a state of bodily experimentation which turns the oedipal law upside down, emerges as a distinct literary genre in Deleuzian aesthetics.
Les relations entre parents et personnels d’accueil de jeunes enfants. La transmission des normes au prisme des rapports entre classes sociales
Authors: Geay Bertrand 
Published: February 2015

The relationship between parents and child carers of young children
Communicating norms throught social class interrelations

Following a year-long investigation on fifty families from wide-ranging social backgrounds, the author examines the relationships between parents and different types of child carers. The analysis brings to light a differential gap between parenting methods, and also identifies the norms that are passed on by different institutions surrounding family life. It also highlights the importance of social class in the way how child carers become involved with families. For example, specific connections are observed among registered pre-school assistants and the intermediary categories between working and middle classes. Privileged, yet less symmetrical, relationships between collective day nurseries and the educated upper class, and domestic employees and the wealthy upper class are outlined. The most precarious percentage of working class is excluded from any other relations with the family and loved ones.
Le droit à l'envers
Authors: Maviel Jean , Fino Patrick 
Published: February 2015

Practice of the Law involves the growth of a more and more complex knowledge. This knowledge intends to stand for the deed to which it is faced.
Now we try to show that representing a deed not only legitimates it but also cancels it. Failing to recognize this cancellation leads to put the deed in a system where Law adresses to nothing but Law and where the not represented remains of the deed are subject to expert's knowledge and to the scope of Sociology of Law.
What we attempt to do is to propose an alternative way of holding the deed in the practice of Law - to present it as something actual rather than to represent it - and this, as well from the side of sentence as from the side of offence.
We are then led to consider first, the myth of absolute power with the lose of the deed's oneness, second the care to comeback to the lost oneness in two stages : by rite in traditional society and by knowledge in historic society. This comeback to oneness is finally achieved into the theoretical model of perfect crime.
L'agriculture et l'industrie dans le droit de la CEE
Authors: Snyder Francis G. 
Published: February 2015

What is the difference between agriculture and industry ? If any differences exist, to what extent are they recognised, perpetuated or even created by law ? What consequences follow from the ways in which law symbolises, sanctions and maintains a distinction between these economic sectors ? This article explores these questions with regard to European Community law.
The argument of the article is three-fold. First, EC law draws a sharp distinction between agriculture and industry. Second, this legal distinction is now out of date. Third, EC law regarding the Common Agricultural Policy (CAP) is deeply contradictory. Fourth, to the extent that equity and equality are important Community social goals, the agricultural sector, as a sector, should not be recognised in EC law as having a special legal status.
La réception de l'œuvre de Max Weber dans la sociologie du droit aux Etats-Unis
Authors: Rocher Guy 
Published: February 2015

L'accueil de la sociologie de Max Weber par les sociologues américains a été plutôt lent. Quatre périodes peuvent être distinguées : tout d'abord, la diffusion de la pensée de Weber par Talcott Parsons dans les années 1930 ; puis, après la Seconde Guerre mondiale, deux décennies durant lesquelles les travaux de Weber ont été traduits. Ensuite, une période de discussion de la pensée de Weber ; enfin, les quinze dernières années, marquées par un grand intérêt pour l'œuvre de Max Weber et de nombreuses publications la commentant.
Quant à sa sociologie du droit, elle fut la partie de ses travaux la plus longue à être reconnue. Karl Llewellyn fut le premier juriste américain à reconnaître l'influence de Weber dans les années 1930. Mais c'est seulement depuis les années 1970 que les juristes et les sociologues américains se sont intéressés à la sociologie juridique de Weber. Son influence actuelle peut se sentir spécialement dans trois courants de pensée : les théories évolutionnistes du droit, le Critical Legal Studies Movement et la sociologie du droit phénoménologique.
Définitions légales et interprétation de la loi
Authors: van Hoecke Mark 
Published: February 2015

Four topics concerning legal definitions in statutes are studied : the utility and the nature of statutory definitions, the way in which these definitions are formulated, the importance of legal definitions for legal drafting, and the consequences of such statutory definitions for the interpretation of the statutes. It appears that the legislator defines concepts in the statutes in different way s. To such an extent that one cannot
clearly distinguish between an explicitly formulated classical definition, on the one side, and the other stipulations in the statutes in which the defined word is used , on the other side. This follows from the fact that the latter stipulations determine, precise and shade the legal meaning of the defined word to an important extent. It is argued that the "legal" meaning of a word is not in the first place determined by a statutory definition, but rather by the function the word fulfills in the statute and in the social regulation the legislator is aiming at, or, more generally speaking, the normative context of the word.