bluuebunny/crossref_metadata_2025_split huggingface dataset:
Envisioning engineering education and practice in the coming intelligence convergence era — a complex adaptive systems approach
Authors: Noor Ahmed 
Published: August 2013

AbstractSome of the recent attempts for improving and transforming engineering education are reviewed. The attempts aim at providing the entry level engineers with the skills needed to address the challenges of future large-scale complex systems and projects. Some of the frontier sectors and future challenges for engineers are outlined. The major characteristics of the coming intelligence convergence era (the post-information age) are identified. These include the prevalence of smart devices and environments, the widespread applications of anticipatory computing and predictive / prescriptive analytics, as well as a symbiotic relationship between humans and machines. Devices and machines will be able to learn from, and with, humans in a natural collaborative way. The recent game changers in learnscapes (learning paradigms, technologies, platforms, spaces, and environments) that can significantly impact engineering education in the coming era are identified. Among these are open educational resources, knowledge-rich classrooms, immersive interactive 3D learning, augmented reality, reverse instruction / flipped classroom, gamification, robots in the classroom, and adaptive personalized learning. Significant transformative changes in, and mass customization of, learning are envisioned to emerge from the synergistic combination of the game changers and other technologies. The realization of the aforementioned vision requires the development of a new multidisciplinary framework of emergent engineering for relating innovation, complexity and cybernetics, within the future learning environments. The framework can be used to treat engineering education as a complex adaptive system, with dynamically interacting and communicating components (instructors, individual, small, and large groups of learners). The emergent behavior resulting from the interactions can produce progressively better, and continuously improving, learning environment. As a first step towards the realization of the vision, intelligent adaptive cyber-physical ecosystems need to be developed to facilitate collaboration between the various stakeholders of engineering education, and to accelerate the development of a skilled engineering workforce. The major components of the ecosystems include integrated knowledge discovery and exploitation facilities, blended learning and research spaces, novel ultra-intelligent software agents, multimodal and autonomous interfaces, and networked cognitive and tele-presence robots.
Tumor control after surgery for spinal myxopapillary ependymomas: distinct outcomes in adults versus children
Authors: Feldman William B. , Clark Aaron J. , Safaee Michael , Ames Christopher P. , Parsa Andrew T. 
Published: August 2013

Object
Myxopapillary ependymomas (MPEs) are rare WHO Grade I tumors found in the conus medullaris, cauda equina, and filum terminale. Treatment generally consists of resection with or without adjuvant radiotherapy. Evidence-based guidelines for surgical management are lacking due to the rarity of this tumor.

Methods
An English-language PubMed search was performed using the key words “myxopapillary” and “ependymoma.” Reports describing fewer than 3 patients or those lacking data on the extent of resection or radiotherapy were excluded. A total of 28 articles describing 475 patients met the authors' inclusion criteria. Patients were grouped by extent of resection and whether or not they underwent adjuvant radiotherapy. Differences in recurrence rates were assessed by chi-square test.

Results
The overall recurrence rate was 15.5% in patients treated by gross-total resection (GTR) and 32.6% in patients treated by subtotal resection (STR), irrespective of whether they underwent adjuvant therapy (p < 0.001). Regardless of the extent of resection, adjuvant radiotherapy was not associated with a decrease in recurrence rates. The overall recurrence rate was 15.6% in patients who underwent GTR and radiotherapy compared with 15.9% in patients who underwent GTR alone (p = 0.58), and it was 29.3% in patients who underwent STR and radiotherapy compared with 35.1% in those who underwent STR alone (p = 0.53). The difference between recurrence rates for patients who underwent GTR alone versus STR and radiotherapy was statistically significant (p = 0.02). Subgroup analysis demonstrated significantly higher recurrence rates in pediatric patients compared with adults (40.5% vs 23.4%, respectively; p = 0.02). Even in the setting of GTR alone, recurrence rates were higher in pediatric patients (65% vs 7.6%; p < 0.001).

Conclusions
Gross-total resection alone is associated with decreased recurrence rates compared with STR with or without radiotherapy. The authors' results suggest that treatment goals should include attempted GTR whenever possible. The observation that children benefitted from radiation therapy to a greater extent than did adults suggests that biological differences between tumors in these patient populations warrants more rigorous scientific studies.
Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery
Authors: Baschnagel Andrew M. , Meyer Kurt D. , Chen Peter Y. , Krauss Daniel J. , Olson Rick E. , Pieper Daniel R. , Maitz Ann H. , Ye Hong , Grills Inga Siiner 
Published: August 2013

Object
The aim of this study was to examine tumor volume as a prognostic factor for patients with brain metastases treated with Gamma Knife surgery (GKS).

Methods
Two hundred fifty patients with 1–14 brain metastases who had initially undergone GKS alone at a single institution were retrospectively reviewed. Patients who received upfront whole brain radiation therapy were excluded. Survival times were estimated using the Kaplan-Meier method. Univariate and multivariate analyses using Cox proportional hazard regression models were used to determine if various prognostic factors could predict overall survival, distant brain failure, and local control.

Results
Median overall survival was 7.1 months and the 1-year local control rate was 91.5%. Median time to distant brain failure was 8.0 months. On univariate analysis an increasing total tumor volume was significantly associated with worse survival (p = 0.031) whereas the number of brain metastases, analyzed as a continuous variable, was not (p = 0.082). After adjusting for age, Karnofsky Performance Scale score, and extracranial disease on multivariate analysis, total tumor volume was found to be a better predictor of overall survival (p = 0.046) than number of brain metastases analyzed as a continuous variable (p = 0.098). A total tumor volume cutoff value of ≥ 2 cm3 (p = 0.008) was a stronger predictor of overall survival than the number of brain metastases (p = 0.098). Larger tumor volume and extracranial disease, but not the number of brain metastases, were predictive of distant brain failure on multivariate analysis. Local tumor control at 1 year was 97% for lesions < 2 cm3 compared with 75% for lesions ≥ 2 cm3 (p < 0.001).

Conclusions
After adjusting for other factors, a total brain metastasis volume was a strong and independent predictor for overall survival, distant brain failure, and local control, even when considering the number of metastases.
Electrostatic discharges and their effect on the validity of registered values in intracranial pressure monitors
Authors: Andresen Morten , Juhler Marianne , Thomsen Ole Cornelius 
Published: August 2013

Object
Intracranial pressure (ICP) monitoring is used extensively in clinical practice, and as such, the accuracy of registered ICP values is paramount. Clinical observations of nonphysiological changes in ICP have called into question the accuracy of registered ICP values. Subsequently, the authors have tried to determine if the ICP monitors from major manufacturers were affected by electrostatic discharges (ESDs), if the changes were permanent or transient in nature, and if the changes were modified by the addition of different electrical appliances normally used in the neurointensive care unit environment.

Methods
The authors established a test setup in the neurointensive care unit using a large container filled with isotonic saline, creating a phantom patient. Intracranial pressure monitors were sequentially lowered into the container and subjected to a predefined test battery of ESDs.

Results
Five pressure monitors from 4 manufacturers were evaluated. Three monitors containing electrical circuitry at the tip of the transducer were all affected by ESDs. Clinically significant permanent changes in the reported ICP values for 1 pressure monitor were observed, as well as temporary deflections for 2 other monitors. The monitors had different levels of sensitivity to discharges at low voltages.

Conclusions
These results explain some of the sudden shifts in ICP noted in the clinical setting. However, a clear deflection pattern related to the addition of electrical appliances was not found. The authors recommend instituting policies for reducing the risk of subjecting patients to ESDs in the neurointensive care unit setting.
Surgical treatment of refractory status epilepticus in children
Authors: Bhatia Sanjiv , Ahmad Faiz , Miller Ian , Ragheb John , Morrison Glenn , Jayakar Prasanna , Duchowny Michael 
Published: August 2013

Object
Refractory status epilepticus (RSE) is a life-threatening neurological emergency associated with high morbidity and mortality. Affected patients often require prolonged intensive care and can suffer multiple complications. Surgical intervention to control RSE is rarely used but can obviate the risks of prolonged seizures and intensive care treatment. Authors of the present study analyzed their experience with the surgical management of patients suffering from RSE.

Methods
The Epilepsy Surgery Database at Miami Children's Hospital was reviewed for patients who had undergone surgery for RSE. Clinical presentation, electrophysiological profile, radiological data, surgical details, and postoperative course were evaluated.

Results
Between 1990 and 2012, 15 patients underwent surgery for uncontrolled seizures despite high-dose medical suppressive therapy. The mean preoperative duration of status epilepticus was 8 weeks. Ictal SPECT and FDG-PET imaging in conjunction with intraoperative electrophysiological studies helped to outline the extent of resection. Surgical intervention controlled seizures in all patients and facilitated the transition out of intensive care. Adverse events related to a prolonged intensive care unit stay included sepsis and respiratory complications. Four patients had worsened neurological function, developing hemiparesis and dysphasia. There was no operative mortality.

Conclusions
Surgical intervention can successfully control refractory partial status epilepticus, prevent associated morbidity, and decrease intensive care unit stay. Ictal SPECT and PET are valuable in guiding resection.
18FDG-PET to assess recurrence and long term survival in patients with malignant melanoma
Authors: Wieder H. A. , Tekin G. , Rosenbaum-Krumme S. , Klode J. , Altenbernd J. , Bockisch A. , Nagarajah J. 
Published: August 2013

SummaryAim: To assess the diagnostic and prognostic value of FDG-PET/CT in the follow-up of malignant melanoma in comparison to the serum protein S100B. Patients and methods: A total of ninety patients with either low-risk or high-risk malignant melanoma, respectively, were included in this study. The followup of the patients was pursuant with the guidelines of the German Dermatological Association. The diagnostic accuracy and diagnostic power were determined for PET/CT and for the serum protein S100B. Results: In 28 of the 90 patients PET/CT was positive in the follow up, 47 patients had an elevated Serum S100B level. Sensitivity, specificity, PPV and NPV of PET/CT for the total groups of patients were 87%, 93%, 87% and 93%. The corresponding values for the serum protein S100B were 65%, 52%, 43% and 74%, respectively. PET/CT positive patients showed a significantly (p < 0.001) higher risk of melanoma associated death compared to patients with PET/CT negative findings. No statistical significance could be found in the 5 year survival rate between the S100B positive and S100B negative patients. Conclusion: PET/CT is suitable to confirm or exclude recurrences and can be used to assess the prognosis in melanoma patients. The diagnostic accuracy and the prognostic power is much higher compared to the serum protein S100B.
Issues in working with families in the Midwest USA during the perinatal period
Authors: Maldonado-Dúran Jesus-Martin , Karacostas Velissarios , Millhuff Charles 
Published: August 2013

Résumé En partant de l’expérience clinique d’un travail effectué dans de multiples lieux du Centre-Ouest des Etats-Unis, les auteurs exposent un certain nombre de stratégies de parentalité d’un point de vue transculturel. Des stratégies de parentalité qui ne sont clairement significatives que dans un certain contexte culturel sont parfois présentées comme « scientifiques », plus modernes et avancées en comparaison avec des pratiques en usage dans des sociétés traditionnelles et des pays du Tiers-Monde. Sont examinées des stratégies de parents pour promouvoir l’autonomie, l’individuation et l’indépendance chez leurs enfants parfois depuis la toute petite enfance. L’importance d’être fort, d’assumer ses responsabilités et les conséquences de ses actions sont des thèmes culturels très importants. Les auteurs explorent comment les parents font avec les pleurs des jeunes enfants, quelle est leur approche de la nourriture et du sommeil, ainsi que la question de la discipline. Les thématiques culturelles résonnent à travers tous ces domaines, où les stratégies utilisées par les parents sont la conséquence logique du besoin d’être un individu dès le début de la vie. Sont explorées quelques raisons possibles qui expliquent pourquoi dans une société capitaliste hautement industrialisée, marquée par une importante mobilité sociale et par une progressive nucléarisation des familles, ces stratégies de parentalité tendent à favoriser des traits émotionnels et de caractère qui sont adaptés à la survie dans une telle société.
Le pacte avec le diable : étiologie et métaphore de violence
Authors: Valenzuela-Pérez Alicia , Rojas-Viger Celia , Sterlin Carlo 
Published: August 2013

Résumé Cette étude illustre le parcours d’un immigrant latino-américain dans les systèmes de soins montréalais (Québec, Canada) et les difficultés à penser et à vivre la maladie dans un contexte d’opposition, de rupture et d’exclusion. Elle rend compte des possibilités thérapeutiques d’une clinique transculturelle qui favorise l’ouverture des espaces de soins et facilite l’émergence des images et des représentations culturelles de la maladie et du processus de guérison. Elle témoigne aussi des défis thérapeutiques posés par les « maladies du surnaturel » (pacte avec le diable) et veut ouvrir le débat sur la possibilité d’historiciser et de politiser ces problématiques dans l’intervention ethnopsychiatrique.
L'école, les cultures et la laïcité
Authors: Giraud François 
Published: August 2013

Résumé Afin d’éclairer les controverses actuelles concernant la place des enfants de migrants à l’école, l’auteur examine quelques points essentiels du débat transculturel dans la société et l’école en France. Du fait des liens étroits existant entre celle-ci et la République, il montre que les problèmes sont liés à la difficulté à penser le religieux dans la culture contemporaine, mais aussi à articuler droits culturels et droits individuels, comme le montre l’affaire dite du « foulard islamique ». Plus globalement, il plaide pour une meilleure intégration de la connaissance des civilisations extra-européennes à l’école et pour une véritable laïcisation qui fasse le partage entre culture et société politique.
Cash transfers for HIV prevention: considering their potential
Authors: Heise Lori , Lutz Brian , Ranganathan Meghna , Watts Charlotte 
Published: August 2013

IntroductionCash payments to vulnerable households and/or individuals have increasingly garnered attention as a means to reduce poverty, improve health and achieve other development‐related outcomes. Recent evidence from Malawi and Tanzania suggests that cash transfers can impact HIV‐related behaviours and outcomes and, therefore, could serve as an important addition to HIV prevention efforts.DiscussionThis article reviews the current evidence on cash transfers for HIV prevention and suggests unresolved questions for further research. Gaps include (1) understanding more about the mechanisms and pathways through which cash transfers affect HIV‐related outcomes; (2) addressing key operational questions, including the potential feasibility and the costs and benefits of different models of transfers and conditionality; and (3) evaluating and enhancing the wider impacts of cash transfers on health and development.ConclusionsOngoing and future studies should build on current findings to unpack unresolved questions and to collect additional evidence on the multiple impacts of transfers in different settings. Furthermore, in order to address questions on sustainability, cash transfer programmes need to be integrated with other sectors and programmes that address structural factors such as education and programming to promote gender equality and address HIV.
Long-Term Recurrence-Free Survival After Metachronous Surgery of the Stomach and Liver for Gastric Adenocarcinoma and Multiple, Synchronous Liver Metastases: A Case Report and Review of Literature
Authors: Kiyasu Yoshito 
Published: August 2013

Abstract
This report describes a 58-year-old woman with gastric adenocarcinoma and liver metastases, who survives for more than 18 years after diagnosis. At diagnosis and first surgery, a moderately differentiated gastric adenocarcinoma with subserosal invasion was detected, along with 2 regional lymph node metastases and 2 liver metastases. She underwent gastrectomy and regional lymph node dissection but did not undergo liver operation then. After gastrectomy, she received adjuvant chemotherapy for 1 month but discontinued it due to severe diarrhea. Another metastasis in another area of the liver was detected, for which she underwent excision of the right lobe of the liver (subsegments 5, 6, and 7) about 30 months later. No signs of recurrence have been detected for 18 years (as of March 2012). This patient represents a rare case of long-term survival of gastric adenocarcinoma without recurrence after surgical treatment, despite multiple, synchronous, liver and regional lymph node metastases.
Comparison of Three Different Minimally Invasive Procedures of Distal Gastrectomy for Nonoverweight Patients with T1N0-1 Gastric Cancer
Authors: Haga Norihiro , Ishiguro Toru , Kuwabara Kouki , Kumamoto Kensuke , Kumagai Youichi , Baba Hiroyuki , Ishibashi Keiichiro , Ishida Hideyuki 
Published: August 2013

Abstract
Laparoscopic-assisted distal gastrectomy has recently come to be a standard procedure for the treatment of early gastric cancer1–5 in select patients. The minimal invasiveness associated with laparoscopic procedures for the resection of gastrointestinal cancer has been repeatedly explained in part by the short incision that is required.6–11 We used two different approaches to perform distal gastrectomies for the resection of gastric cancer as minimally invasive alternatives to a standard laparoscopic approach prior to our surgical team's complete mastery of the skills required for laparoscopic oncological surgery for gastric cancer.9,12 If the minimal invasiveness associated with laparoscopic-assisted gastrectomy can be explained by the small incision, a gastrectomy via a small incision without the use of a pneumoperitoneum may provide a similar outcome in patients. However, to our knowledge, such a comparison has not been previously made. We compared the minimal invasiveness of three different approaches (minilaparotomy, minilaparotomy approach with laparoscopic assistance, and standard laparoscopic-assisted approach) to performing a distal gastrectomy for T1N0-1 gastric cancer in nonoverweight patients (body mass index, ≤25 kg/m2) performed within a limited study period.
Rational Manipulation of the Standard Laparoscopic Instruments for Single-Incision Laparoscopic Right Colectomy
Authors: Watanabe Makoto , Murakami Masahiko , Kato Takashi , Onaka Toru , Aoki Takeshi 
Published: August 2013

Abstract
This report clarifies the rational manipulation of standard laparoscopic instruments for single-incision laparoscopic right colectomy (SILRC) using the SILS Port. We classified the manipulations required into 4 techniques. Vertical manipulation was required for medial-to-lateral retroperitoneal dissection. Frontal manipulation was needed for extension and establishment of a retroperitoneal plane. External crossing manipulation was used for dissection or ligation of the ileocolic or right colic vessels. Internal crossing manipulation was required for mobilization from the cecum to ascending colon. We performed SILRC for a series of 30 consecutive patients. One additional port was needed in 5 of the patients (16.7%) because of severe adhesion between the ileum and abdominal wall. No intraoperative complications were encountered. Four rational manipulations of the standard laparoscopic instruments are required for SILRC using the SILS Port. However, more experience and comparative trials are needed to determine the exact role of SILRC.
Oncologic Outcome With Use of Sodium Hyaluronate–Carboxymethylcellulose Barrier in Gastric Cancer
Authors: Mohri Yasuhiko , Tanaka Koji , Uchida Keiichi , Ohi Masaki , Inoue Mikihiro , Araki Toshimitsu , Inoue Yasuhiro , Kusunoki Masato 
Published: August 2013

Abstract
Hyaluronan is a component of an anti-adhesive barrier and has been implicated in tumor growth and metastasis. We aimed to determine whether this anti-adhesive barrier was associated with rates of postoperative complications and duration of survival in patients with gastric cancer. We identified 415 consecutive patients with gastric cancer who underwent gastrectomy. Information about patients' demographics, medical history, surgical procedures, postoperative complications, disease stage, histology, and survival was collected from medical records. One hundred and ninety-six patients received intraoperative placement of an anti-adhesive barrier composed of hyaluronan–carboxymethylcellulose (HA-CMC) (HA-CMC group), and 219 did not (control group). The incidence of postoperative complications was significantly increased in the control group (22.8%) compared with the HA-CMC group (13.3%). However, there was no significant difference in overall survival between the HA-CMC and control groups. Our study suggests that the anti-adhesive barrier does not affect oncologic outcome, nor does it increase postoperative complications in patients undergoing surgery for gastric cancer.