bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing a Guideline to Improve Management of Syncope in the Emergency Department
Authors: Guse Sabrina E. , Neuman Mark I. , O’Brien Megan , Alexander Mark E. , Berry Mark , Monuteaux Michael C. , Fine Andrew M. 
Published: October 2014

BACKGROUND AND OBJECTIVES:
Thirty-five percent of children experience syncope at least once. Although the etiology of pediatric syncope is usually benign, many children undergo low-yield diagnostic testing. We conducted a quality improvement intervention to reduce the rates of low-yield diagnostic testing for children presenting to an emergency department (ED) with syncope or presyncope.

METHODS:
Children 8 to 22 years old presenting to a tertiary care pediatric ED with syncope or presyncope were included. We excluded children who were ill-appearing, had previously diagnosed cardiac or neurologic disease, ingestion, or trauma. We measured diagnostic testing rates among children presenting from July 2010 through October 2012, during which time we implemented a quality improvement intervention. Patient follow-up was performed 2 months after the ED visit to ascertain subsequent diagnostic testing and medical care.

RESULTS:
A total of 349 patients were included. We observed a reduction in the rates of low-yield diagnostic testing after our quality improvement intervention: complete blood count testing decreased from 36% (95% confidence interval 29% to 43%) to 16% (12% to 22%) and electrolyte testing from 29% (23% to 36%) to 12% (8% to 17%). Performance of recommended testing increased, such as electrocardiograms and pregnancy testing in postpubertal girls. Despite a reduction in diagnostic testing among children with syncope, patients were not more likely to undergo subsequent diagnostic testing or seek further medical care following their ED visit.

CONCLUSIONS:
Implementation of a quality improvement intervention for the ED evaluation of pediatric syncope was associated with reduced low-yield diagnostic testing, and was not associated with subsequent testing or medical care.
Targeted Therapy for Metastatic Renal Carcinoma: an Update
Authors: Donalisio da Silva Rodrigo , Gustafson Diedra , Nogueira Leticia , Werahera Priya N. , Molina Wilson R. , Kim Fernando J. 
Published: October 2014

Conventional chemotherapy is associated with poor outcomes in metastatic renal cell carcinoma (RCC). Advances in the understanding of tumor molecular biology and the implementation of new drugs that target these molecular pathways have increased the arsenal against advanced RCC and improved outcomes in these patients. Herein, we briefly describe the latest data on targeted therapies used in the treatment of advanced renal cell carcinoma. Search strategy was performed according to PRISMA guidelines. Abstracts of relevant studies published in PubMed between 2000 and 2014 were analyzed by two authors. Abstracts were selected if they were published in English, data reported was of phase II or III clinical trials, and outcomes followed FDA approval. If consensus between the two authors was achieved, they were included in the review. Key words used were “target therapy” and “metastatic renal cell carcinoma”. The results of the studies analyzed in this review support the benefits of targeted therapy in metastatic RCC. These include improved progression-free survival, overall survival, and quality of life as well as reduced toxicities compared to immunotherapy. The improvement in outcomes in metastatic RCC makes these drugs a preferred option as a primary treatment for these patients.
Révolutions technologiques et représentations du monde. Au risque de l'expérimentation
Authors: Bretagnolle Anne , Robic Marie-Claire 
Published: October 2014

Révolutions technologiques et représentations du monde.
Au risque de l'expérimentation — A. Bretagnolle et M.-C. Robic.

Depuis la fin du XIXe siècle, les géographes étudient les effets de l'accroissement des vitesses et des possibilités nouvelles de transfert, de l'information. Leurs recherches concluent à des réorganisations du monde, créatrices de déformations et de structures spatiales discontinues, et non à la réduction uniforme que supposent certaines représentations de l'impact des NTIC (Nouvelles technologies de l'information et de la communication). Dans cet article qui en étudie les modes successifs, et les auteurs expliquent l'accroissement des inégalités dans les systèmes de peuplement par des processus de sélection liés à l 'accessibilité des lieux. Dans un second temps, leurs recherches méthodologiques rendent compte d'un espace relatif, référé à des distances anthropologiques évaluées en temps ou en coût, et des constructions théoriques destinées à comprendre l'évolution des systèmes de villes. Le renforcement de la complexité de l'organisation des plus grandes métropoles et leur mise en réseau, à l'échelle mondiale, y sont soulignés. Plusieurs éléments restent en discussion, notamment celui sur la nouveauté ou non de ces processus de mondialisation, ou sur l'évolution de la structuration hiérarchique des réseaux de ville ; maintien, voire renforcement des inégalités ou affaiblissement des contrastes, voire émergence d'un certain polycentrisme ?
L'intraduisible : ombilic de l'œuvre de parole
Authors: Gori Roland 
Published: October 2014

Au cours d’un entretien avec Rajaa Stitou, Roland Gori évoque les figures anthropologiques des discours sociaux et normatifs contemporains, le robot et l’animal, pour rendre compte de la réduction de l’humain à un « être de signaux » et de « connexion ». Alors même que la catachrèse se révèle comme la figure de style qui féconde les découvertes humaines, la folie normative contemporaine fabrique l’illusion que nos langages de machine pourraient en finir une fois pour toutes avec l’intraduisible de la langue. Ce qui revient à penser que l’on pourrait une fois pour toutes se débarrasser de la culpabilité qui fonde le lien social et l’altérité.
L'accent, une langue qui résiste
Authors: Masson Céline 
Published: October 2014

Dans cet article, nous nous intéresserons à l’accent en proposant l’idée qu’il est une langue du dessous. Une langue de transport d’autres langues dissimulées sous la langue parlée et qui introduisent toute la géographie intérieure de l’exil. L’accent désigne bien souvent l’étranger de la langue du pays et cet accent dérange car il perturbe la musique bien connue de la langue vernaculaire. Le locuteur introduit une impureté dans la langue dite maternelle mais cette impureté est une résistance à trahir sa langue maternelle, qu’il met en concurrence avec une langue d’adoption. Traces mémorielles de langue(s) sous la langue qui font irruption « sur » la langue comme un symptôme. Il est intéressant d’entendre les tours de langue que le sujet « déplacé » peut infliger à la langue du pays d’accueil, une manière de négocier avec sa langue maternelle en faisant un « écart » avec la langue du pays d’accueil.
Lorsque l'œuvre fait lien
Authors: Ducombs Anne-Sophie 
Published: October 2014

La vie du compositeur Robert Schumann permet de s’interroger sur la fonction de la création. Plusieurs éléments et symptômes laissent supposer une psychose maniaco-dépressive : humeur dépressive, désintérêt pour le monde extérieur, autodépréciations, idées de mort, hallucinations, ainsi qu’un rapport au corps particulier. R. Schumann invente non pas une solution, mais des solutions pour suppléer à la forclusion du Nom-du Père. En effet, nous pouvons faire l’hypothèse que sa paralysie de la main est une suppléance, un traitement du réel par le réel. Il s’appuie aussi sur des identifications imaginaires, ses maîtres et sa compagne Clara. Il semble que ces suppléances lui permettent de faire de la création musicale un sinthome. Cependant, à un moment donné, ces solutions subjectives ne tiennent plus. L’émergence d’un réel à travers la rencontre d’Un-père et sa nomination à un poste de directeur musical semblent amener des éléments d’explication quant au déclenchement de la psychose.
Le corps, son image et le désir du scientifique dans la fiction cinématographique
Authors: Trichet Yohan , Marion Élisabeth 
Published: October 2014

La logique du discours de la science nécessite l’exclusion du sujet de l’inconscient et l’ignorance de la position impossible du savant. Au cours des siècles, le statut de l’Autre, comme instance érigeant des limites à la jouissance, a évolué. La figure de Dieu, qui remplissait autrefois cette fonction, a chuté, dévoilant ainsi l’inexistence de l’Autre. La fiction, quand elle s’intéresse à la science, est un espace narratif privilégié pour interroger cette logique et ses conséquences : les affres du savant et le surgissement d’un objet monstrueux. Les auteurs de cet article proposent d’examiner comment la fiction cinématographique traite ces questions posées par les avancées de la science aux XIX e et XXI e siècles en prenant appui sur le Frankenstein de Kenneth Branagh (1994) et La piel que habito de Pedro Almodovar (2011).
Gouverner par les labels
Authors: Bergeron Henri , Castel Patrick , Dubuisson-Quellier Sophie 
Published: October 2014

De nombreuses politiques publiques qui visent à réguler, directement ou indirectement, les conduites individuelles ou collectives s’appuient sur le déploiement d’un type d’instrument que nous qualifions de « label ». En prenant pour cas d’étude la comparaison de la politique de la consommation durable et celle de la lutte contre l’obésité, et en nous inspirant de l’analyse des dispositifs de sécurité menée par Foucault (2004), nous proposons de mettre en évidence certaines des caractéristiques essentielles de ce mode de gouvernement. Nous montrons en particulier que celui-ci joue sur la volonté que manifestent les acteurs pour se positionner et se distinguer les uns par rapport aux autres dans un champ concurrentiel donné, afin de les orienter, de manière souple, vers des options que les acteurs de l’action publique considèrent comme collectivement bénéfiques. La logique de ce mode de gouvernement n’est pas la stabilisation d’un standard qui permette l’uniformisation des entités et pratiques d’un champ, mais la création continue de labels toujours plus exigeants dont seule une partie des membres pourra prétendre s’orner.
Un changement politisé dans la politique de défense
Authors: Béraud-Sudreau Lucie 
Published: October 2014

En 2000, l’instruction des demandes d’autorisation d’exportations d’armement est retirée de la direction du ministère de la Défense responsable du soutien à ces exportations, afin de renforcer les procédures de contrôle. Puis, cette réforme est annulée en 2008, afin cette fois-ci de renforcer le soutien à l’export. Comment expliquer ce revirement, qui coïncide avec des phases d’alternance politique, ce alors que la littérature considère la politique de défense comme insensible aux changements de majorité ? Grâce à l’approche programmatique, cet article montre que le contenu du changement s’explique par la politisation de la répartition des fonctions de contrôle et de soutien des ventes d’armes par des acteurs politico-administratifs. Toutefois, l’alternance seule n’explique pas le timing du changement, il faut pour cela porter attention aux rapports de force entre acteurs.
La censure militaire et la surveillance politique des étrangers en Australie occidentale pendant la Grande Guerre (1914-1919)
Authors: Dorvidal Jérôme 
Published: October 2014

Au début de la Grande Guerre, la seule institution susceptible d’endosser la responsabilité d’assurer la sécurité nationale était l’Intelligence militaire. Certes, dans les villes de Sydney ou de Melbourne, la censure militaire a été perçue par de nombreux citoyens comme une atteinte à la démocratie. Mais en Australie occidentale, l’État le plus provincial à cette époque, la surveillance politique des Allemands et Autrichiens était vraiment poussée : chaque cas signalé était l’objet d’un examen approfondi par la police étatique ou les services du renseignement militaire. En résumé, cet article propose d’étudier la diversité des cas considérés comme suspects par l’Intelligence militaire et les réactions des habitants d’Australie occidentale dans un tel climat de suspicion
Classification of Images Acquired with Colposcopy Using Artificial Neural Networks
Authors: Simões Priscyla W. , Izumi Narjara B. , Casagrande Ramon S. , Venson Ramon , Veronezi Carlos D. , Moretti Gustavo P. , da Rocha Edroaldo L. , Cechinel Cristian , Ceretta Luciane B. , Comunello Eros , Martins Paulo J. , Casagrande Rogério A. , Snoeyer Maria L. , Manenti Sandra A. 
Published: October 2014

Objective To explore the advantages of using artificial neural networks (ANNs) to recognize patterns in colposcopy to classify images in colposcopy. PURPOSE: Transversal, descriptive, and analytical study of a quantitative approach with an emphasis on diagnosis. The training test e validation set was composed of images collected from patients who underwent colposcopy. These images were provided by a gynecology clinic located in the city of Criciúma (Brazil). The image database ( n = 170) was divided; 48 images were used for the training process, 58 images were used for the tests, and 64 images were used for the validation. A hybrid neural network based on Kohonen self-organizing maps and multilayer perceptron (MLP) networks was used. Results After 126 cycles, the validation was performed. The best results reached an accuracy of 72.15%, a sensibility of 69.78%, and a specificity of 68%. Conclusion Although the preliminary results still exhibit an average efficiency, the present approach is an innovative and promising technique that should be deeply explored in the context of the present study.
Religion and Indigenous Hermeneutics
Authors: Adebanwi Wale , Grillo Laura S. , Wariboko Nimi , Olupona Jacob K. , Adebanwi Wale 
Published: October 2014

Abstract
Jacob Olupona's City of 201 Gods critically engages the question of interpretation and understanding in the analysis of specific African lifeworlds (re)defined by religious culture. Olupona's interpretation invites further interpretation of how emergent symbolic forms in a context of plural religious practices provoke both consensus and dissensus with respect to secularist practices.
Ironic Reversals:
Authors: Grillo Laura S. 
Published: October 2014

Abstract
Olupona's “indigenous hermeneutic” offers a privileged guided journey into the dense ritual space of a vital city. I underscore a subtle leitmotif—gender and female agency—running throughout this interpretive account to show women's power to be both a sustaining force and source of ironic reversals in the fate of Ilé-Ifẹ̀
A High Resolution Chronology for Steward’s Promontory Culture Collections, Promontory Point, Utah
Authors: Ives John W. , Froese Duane G. , Janetski Joel C. , Brock Fiona , Ramsey Christopher Bronk 
Published: October 2014

AbstractDespite the rich array of perishables Julian Steward (1937) recovered during his 1930s excavations, the Promontory Cave assemblages were dated in relative terms with just a handful of radiocarbon assays until recently. Yet Promontory Caves 1 and 2 are the type sites from which the Promontory Culture was defined, and these assemblages have a critical bearing on our conception of three significant issues in western North American prehistory: the terminal Fremont transition, Numic expansion, and the potential presence of migrating ancestral Apachean populations. To better fix the age of the Promontory Phase, we have undertaken an additional 45 AMS determinations for Promontory perishables. Because of a research focus concerning Promontory footwear, most age estimates come from moccasins, but we have also dated gaming pieces, a bow, an arrow, netting, basketry, matting, and cordage. With the exception of a winnowing basket fragment and some ceramic residue dates, all Promontory Phase assays are tightly focused in an interval running from 662 to 826 radiocarbon years before present (a calibrated 2s range spanning A.D. 1166–1391). Bayesian analyses of the Cave 1 and 2 Promontory Phase perishables suggest that this late period occupation comprised one or two human generations, centering on the interval running from ca. A.D. 1250–1290.
Seasons of Change: Using Seasonal Morphological Changes in Brodiaea Corms to Determine Season of Harvest from Archaeobotanical Remains
Authors: Gill Kristina M. 
Published: October 2014

AbstractI present archaeobotanical evidence for intensive and long-term harvesting of edible geophytes in the Brodiaea complex, most likely blue dicks (Dichelostemma capitatum), during multiple seasons on California’s Santa Cruz Island. Ethnographic data indicate that Brodiaea corms were an important food source throughout prehistoric California, usually harvested in the late spring–early summer, after flowering. However, at least two ethnographic sources may suggest multiple seasons of harvest, an idea supported by careful examination of seasonal morphological changes in modern and ancient Brodiaea corms. Archaeobotanical identification of features associated with these morphological changes allows inferences about the specific seasons in which Brodiaea corms were harvested, a conclusion that has the potential to provide higher resolution seasonality data for geophyte remains recovered in western North America and other areas around the world.
Citizen Science in Archaeology
Authors: Smith Monica L. 
Published: October 2014

Abstract
Citizen science, as a process of volunteer participation through crowdsourcing, facilitates the creation of mass data sets needed to address subtle and large-scale patterns in complex phenomena. Citizen science efforts in other field disciplines such as biology, geography, and astronomy indicate how new web-based interfaces can enhance and expand upon archaeologists’ existing platforms of volunteer engagement such as field schools, community archaeology, site stewardship, and professional–avocational partnerships. Archaeological research can benefit from the citizen science paradigm in four ways: fieldwork that makes use of widely available technologies such as mobile applications for photography and data upload; searches of large satellite image collections for site identification and monitoring; crowdfunding; and crowdsourced computer entry of heritage data.
Radiocarbon and Protein Analyses Indicate an Early Holocene Age for the Osseous Rod from Grenfell, Saskatchewan, Canada
Authors: Ives John W. , Froese Duane , Collins Matthew , Brock Fiona 
Published: October 2014

AbstractThe Grenfell bone rod resembles other instances of Clovis-era organic or osseous technology and has on a number of occasions been considered with other Clovis bone, antler, and ivory rods or beveled artifacts. It had been suspected of being constructed from proboscidean long bone. As an early discovery (made in 1883), the Grenfell artifact had somewhat obscure provenience details and a lengthy curatorial history. We describe accelerator mass spectrometry and zooarchaeology by mass spectrometry methods that allow rapid, minimally destructive determinations of both the age and the raw material composition of osseous artifacts. Our analysis reveals that the Grenfell artifact is actually a terminal Paleoindian-era manifestation made of bison bone. Similar methods could be more widely applied in North America in order to build more refined data sets for osseous technologies. These results also reveal the ease with which archaeologists can secure additional information from existing collections, highlighting our ethical obligations to do so.
Reference Ranges for 2‐Dimensional Sonographic Lung Measurements in Healthy Fetuses
Authors: Britto Ingrid Schwach Werneck , Júnior Edward Araujo , Sangi-Haghpeykar Haleh , Bussamra Luiz Cláudio Silva , Deter Russell L. , Belfort Michael A. , Lee Wesley , Ruano Rodrigo 
Published: October 2014

ObjectivesThe purpose of this study was to establish reference ranges for 2‐dimensional sonographic measurements of fetal lungs from longitudinal data.MethodsA total of 214 fetal lung measurements were longitudinally evaluated in 62 healthy fetuses between 20 and 36 weeks’ menstrual age. Both right and left lung areas were measured in the heart 4‐chamber view using lung area tracing and axis diameter methods. Multilevel modeling was used to evaluate the expected values and variability with respect to menstrual age and to generate reference ranges for the lung area, lung‐to‐head ratio, quantitative lung index, and observed‐to‐expected lung‐to‐head ratio for both lungs.ResultsThe expected values varied with menstrual age for all parameters. Variance was menstrual age dependent for all parameters except the longest diameter area measurements and their lung‐to‐head ratios.ConclusionsModels are presented for expected 2‐dimensional sonographic lung size parameters and their variance as a function of menstrual age. These data have been used to generate age‐specific reference ranges for both measurements and indices.
The Tram Track Sign
Authors: Jang Ji Hye , Jin Wook , Chun Young Soo , Rhyu Kee Hyung , Park So Young , Lee Ka Eun , Park Ji Seon , Ryu Kyung Nam 
Published: October 2014

ObjectivesPolyethylene liner dissociation from an acetabular component is a complication of total‐hip arthroplasty (THA) caused by slippage of the liner, which causes pain and requires a revision. The aim of this study was to evaluate sonographic features of liner dissociation and detect useful sonographic findings compared to conventional radiography and computed tomography (CT).MethodsAmong a total of 226 patients who underwent revision THA at our institution between September 2008 and June 2012, 10 patients (6 male and 4 female; mean age, 56.2 years) who showed severe narrowing of the superior joint space on the THA side and underwent sonography were retrospectively reviewed by evaluating radiographic, CT, and sonographic findings. In evaluation of the images, we put more emphasis on the “radiographic crescent sign,” “CT crescent sign,” and “sonographic tram track sign.”ResultsAt surgery, 7 patients showed liner dissociation, and 3 showed severe liner wear. On radiography, 8 of 10 patients (80%) had a correct diagnosis of the presence or absence of liner dissociation; on sonography, all 10 patients (100%) had a correct diagnosis. The sensitivity, specificity, and accuracy for diagnosis of liner dissociation by pelvic radiography and sonography were 100% (7 of 7), 33% (1 of 3), and 80% (8 of 10) and 100% (7 of 7), 100% (3 of 3), and 100% (10 of 10), respectively.ConclusionsLiner dissociation can be easily and well visualized by sonography, especially compared to pelvic radiography and CT. The sonographic tram track sign should be a very useful feature in the early diagnosis of liner dissociation.