bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcome and Gait Analysis of Ankle Arthrodesis
Authors: Fuentes-Sanz Adela , Moya-Angeler Joaquin , López-Oliva Felipe , Forriol Francisco 
Published: November 2012

Background: The purpose of our study was to describe and analyze the functional outcomes of mid-term followup patients with ankle arthrodesis. Methods: Twenty patients who had an isolated ankle arthrodesis were followed for a mean of 3 years after surgery. We performed physical and functional examination, radiographic examination and CT scan. Each completed standardized, self-reported outcome questionnaires SF-36, AOFAS and Mazur scores. All subjects were evaluated with a kinetic and kinematic gait analysis and a plantar pressure study. Results: Only one patient used a cane and seven patients required an insole to walk. We observed no relation between the scores obtained. Most of the patients showed good functional results and poor life quality scores. The joints that were significantly more degenerated were the Chopart and the subtalar joints, which were affected in 16 patients in the fused limb. The kinematic parameters showed compensatory motion in the neighboring joints and the kinetic parameters studied were similar in the arthrodesis limb and the control limb. There was no significant difference between the arthrodesis limb and the contralateral limb for plantar pressures. Conclusion: Although ankle arthrodesis will help to relieve pain and to improve overall function, it is considered to be a salvage procedure that causes persistent alterations in gait, with the possible development of symptomatic osteoarthritis in the other joints of the foot. Patients and treating physicians should also expect overall pain and functional limitations to increase over time. Level of Evidence: IV, Case Series
Monitoring of Systemic Inflammatory Response in Diabetic Patients with Deep Foot Infection Treated with Negative Pressure Wound Therapy
Authors: Dzieciuchowicz Łukasz , Kruszyna Łukasz , Krasiński Zbigniew , Espinosa Gaudencio 
Published: November 2012

Background: The purpose of this study was to establish the safety of negative pressure wound therapy (NPWT) in the treatment of acutely debrided, deep diabetic foot infections (DDFI) and to determine the value of inflammatory markers in monitoring of treatment of these infections with negative pressure wound therapy. Methods: A group of ten patients with DDFI treated by radical surgical debridement and simultaneous NPWT was prospectively studied. During the debridement, a deep tissue sample was obtained and sent for microbiological testing. The patients were followed clinically for 10 days and NPWT dressings were changed every 2 to 3 days or sooner when indicated. The peripheral blood samples were obtained before the radical debridement and 3 and 10 days afterwards and concentrations of white blood cell, neutrophils, lymphocytes and C-reactive protein (CRP) were measured. The changes in concentration of inflammatory markers were analyzed with a Friedman test. Results: In all but one patient the presence of DDFI was confirmed by the culture results. At baseline, the elevated WBC and neutrophil concentrations were observed only in half of the patients while the CRP concentration was elevated in nine patients. During followup, all patients showed a favorable clinical evolution and statistically significant decrease of WBC, neutrophils and CRP ( p < 0.001). There were not statistically significant changes in lymphocyte count. Conclusion: NPWT can be safely applied in acutely debrided DDFI. CRP seems to be the most adequate parameter for both diagnosis and monitoring of treatment of DDFI. Level of Evidence: IV, Case Series
Patterns in neurosurgical adverse events: cerebrospinal fluid shunt surgery
Authors: Wong Judith M. , Ziewacz John E. , Ho Allen L. , Panchmatia Jaykar R. , Bader Angela M. , Garton Hugh J. , Laws Edward R. , Gawande Atul A. 
Published: November 2012

Object
As part of a project to devise evidence-based safety interventions for specialty surgery, the authors sought to review current evidence in CSF shunt surgery concerning the frequency of adverse events in practice, their patterns, and the state of knowledge regarding methods for their reduction. This review may also inform future and ongoing efforts for the advancement of neurosurgical quality.

Methods
The authors performed a PubMed search using search terms “cerebral shunt,” “cerebrospinal fluid shunt,” “CSF shunt,” “ventriculoperitoneal shunt,” “cerebral shunt AND complications,” “cerebrospinal fluid shunt AND complications,” “CSF shunt AND complications,” and “ventriculoperitoneal shunt AND complications.” Only papers that specifically discussed the relevant complication rates were included. Papers were chosen to be included to maximize the range of rates of occurrence for the adverse events reported.

Results
In this review of the neurosurgery literature, the reported rate of mechanical malfunction ranged from 8% to 64%. The use of programmable valves has increased but remains of unproven benefit even in randomized trials. Infection was the second most common complication, with the rate ranging from 3% to 12% of shunt operations. A meta-analysis that included 17 randomized controlled trials of perioperative antibiotic prophylaxis demonstrated a decrease in shunt infection by half (OR 0.51, 95% CI 0.36–0.73). Similarly, use of detailed protocols including perioperative antibiotics, skin preparation, and limitation of OR personnel and operative time, among other steps, were shown in uncontrolled studies to decrease shunt infection by more than half.
Other adverse events included intraabdominal complications, with a reported incidence of 1% to 24%, intracerebral hemorrhage, reported to occur in 4% of cases, and perioperative epilepsy, with a reported association with shunt procedures ranging from 20% to 32%. Potential management strategies are reported but are largely without formal evaluation.

Conclusions
Surgery for CSF shunt placement or revision is associated with a high complication risk due primarily to mechanical issues and infection. Concerted efforts aimed at large-scale monitoring of neurosurgical complications and consistent quality improvement within these highlighted realms may significantly improve patient outcomes.
On the value of routine prothrombin time screening in elective neurosurgical procedures
Authors: Dützmann Stephan , Geßler Florian , Marquardt Gerhard , Seifert Volker , Senft Christian 
Published: November 2012

Object
The authors performed a study to evaluate whether preoperative assessment of prothrombin time (PT) is mandatory in patients undergoing routinely planned neurosurgical procedures.

Methods
The charts of all patients admitted to general wards of the authors' department for routinely planned surgery (excluding trauma and ICU patients) between 2006 and 2010 were retrospectively reviewed. The authors assessed preoperative PT and the clinical courses of all patients, with special consideration for patients receiving coagulation factor substitution. All cases involving hemorrhagic complications were analyzed in detail with regard to pre- and postoperative PT abnormalities. Prothrombin time was expressed as the international normalized ratio, and values greater than 1.28 were regarded as elevated.

Results
Clinical courses and PT values of 4310 patients were reviewed. Of these, 33 patients (0.7%) suffered hemorrhagic complications requiring repeat surgery. Thirty-one patients (94%) had a normal PT before the initial operation, while 2 patients had slightly elevated PT values of 1.33 and 1.65, which were anticipated based on the patient's history. In the latter 2 cases, surgery was performed without prior correction of PT. Preoperatively, PT was elevated in 78 patients (1.8%). In 73 (93.6%) of the 78 patients, the PT elevation was expected and explained by each patient's medical history. In only 5 (0.1%) of 4310 patients did we find an unexpected PT elevation (mean 1.53, range 1.37–1.74). All 5 patients underwent surgery without complications, while 2 had received coagulation factor substitution preoperatively, as requested by the surgeon, because of an estimated risk of bleeding complications. None of the 5 patients received coagulation factor substitution postoperatively, and later detailed laboratory studies ruled out single coagulation factor deficiencies. There was no statistically significant association between preoperatively elevated PT levels and the occurrence of hemorrhagic complications (p = 0.12). Before the second procedure but not before the initial operation, 4 (12%) of the 33 patients had elevated PT.

Conclusions
The findings suggest that the value of preoperative PT testing is limited in patients in whom a normal history can be ascertained. Close postoperative PT control is necessary in every neurosurgical patient, and better tests need to be developed to identify patients who are prone to hemorrhagic complications.
“Team time-out” and surgical safety—experiences in 12,390 neurosurgical patients
Authors: Oszvald Ági , Vatter Hartmut , Byhahn Christian , Seifert Volker , Güresir Erdem 
Published: November 2012

Object
Quality and safety are basic concerns in any medical practice. Especially in daily surgical practice, with increasing turnover and shortened procedure times, attention to these topics needs to be assured. Starting in 2007, the authors used a perioperative checklist in all elective procedures and extended the checklist in January 2011 according to the so-called team time-out principles, with additional assessment of patient identity and the planned surgical procedure performed immediately before skin incision, including the emergency cases.

Methods
The advanced perioperative checklist includes parts for patient identification, preoperative assessments, team time-out, postoperative treatment, and imaging controls. All parts are signed by the responsible physician except for the team time-out, which is performed and signed by the theater nurse on behalf of the surgeon immediately before skin incision.

Results
Between January 2007 and December 2010, 1 wrong-sided bur hole in an emergency case and 1 wrong-sided lumbar approach in an elective case (of 8795 surgical procedures) occurred in the authors' department. Using the advanced perioperative checklist including the team time-out principles, no error occurred in 3595 surgical procedures (January 2011–June 2012). In the authors' department all team members appreciate the chance to focus on the patient, the surgical procedure, and expected difficulties. The number of incomplete checklists and of patients not being transferred into the operating room was lowered significantly (p = 0.002) after implementing the advanced perioperative checklist.

Conclusions
In the authors' daily experience, the advanced perioperative checklist developed according to the team time-out principles improves preoperative workup and the focus of the entire team. The focus is drawn to the procedure, expected difficulties of the surgery, and special needs in the treatment of the particular patient. Especially in emergency situations, the team time-out synchronizes the involved team members and helps to improve patient safety.
Creating a culture of safety within operative neurosurgery: the design and implementation of a perioperative safety video
Authors: Lau Catherine Y. , Greysen S. Ryan , Mistry Rita I. , Han Seunggu J. , Mummaneni Praveen V. , Berger Mitchel S. 
Published: November 2012

Object
Surgical and medical errors result from failures in communication and handoffs as well as lack of standardization in clinical protocols and safety practices. Checklists, simulation training, and teamwork training have been shown to decrease adverse patient events and increase the safety culture of surgical teams. The goal of this project was to simplify and standardize perioperative patient safety practices and team communication processes within operative neurosurgery through the creation of an educational safety video targeted at a neurosurgical provider audience.

Methods
A multidisciplinary group consisting of neurosurgeons, anesthesiologists, nurses, neuromonitoring specialists, quality champions, and a professional video production company met over several months in an iterative process to 1) determine the overall objectives of the video, 2) decide on the content and format of the video, 3) modify the proposed content and format based on stakeholder feedback, and 4) record the video and complete final revisions during postproduction.

Results
The video was launched within the authors' institution in July 2012 in conjunction with ongoing research projects to study the effects of the video on 1) multidisciplinary providers' knowledge of perioperative safety practices, 2) provider safety attitudes and safety culture in the operating room, and 3) provider behavior in performing predetermined elements of the preoperative timeout and postoperative debrief.

Conclusions
The neurosurgical perioperative safety video can serve as a national model for how quality champions can drive changes in safety culture and provider behavior among multidisciplinary perioperative patient care teams. Ongoing research is being performed to assess the impact of the video on provider knowledge, behavior, and safety attitudes and culture.
Isolation of microsatellite primers for Melampyrum sylvaticum (Orobanchaceae), an endangered plant in the United Kingdom
Authors: Crichton Rhiannon J. , Squirrell Jane , Woodin Sarah J. , Dalrymple Sarah E. , Hollingsworth Peter M. 
Published: November 2012

• Premise of the study: Microsatellite markers were developed for the hemiparasitic plant Melampyrum sylvaticum to investigate the breeding system, genetic diversity, and structure of populations in the United Kingdom, Sweden, and Norway.• Methods and Results: Microsatellites were isolated from genomic DNA using an enrichment protocol. Twenty‐nine loci were characterized in two individuals from each of 15 geographically disparate populations (“global”). Seven polymorphic loci were further characterized in one population (“local”). The number of alleles per locus ranged from two to 12 in the global sample and one to seven in the local sample. The expected heterozygosity ranged from 0–0.75, the observed heterozygosity from 0–0.1, and the inbreeding coefficient from 0.84–1 in the local sample.• Conclusions: The results show the utility of these novel polymorphic microsatellite markers for further conservation genetic analyses. The strong deficit of heterozygosity across all loci in the local sample suggests the species may be inbreeding.
Development of microsatellite markers from Mussaenda pubescens (Rubiaceae)
Authors: Duan Ting‐Ting , Gong Wei , Zhang Dian‐Xiang 
Published: November 2012

• Premise of the study: Microsatellite markers were developed and characterized in Mussaenda pubescens for further study of its levels of genetic diversity and changes in population genetic structure in reproductive character displacement and in shifts of sexual systems.• Methods and Results: Nineteen microsatellite loci were amplified successfully in M. pubescens, 17 of which were polymorphic. A maximum of eight alleles were detected per locus in 68 individuals at population level. The observed and expected heterozygosities varied from 0 to 1.000 and 0 to 0.882, respectively.• Conclusions: These newly developed microsatellite markers will be useful in further investigations of genetic diversity and gene flow among populations of M. pubescens and its congeneric species.
Psoriasis and Psoriatic Arthritis in Peruvian Aborigines: A Report from the GRAPPA 2011 Annual Meeting
Authors: TOLOZA SERGIO M.A. , VEGA-HINOJOSA OSCAR , CHANDRAN VINOD , VALLE ONATE RAFAEL , ESPINOZA LUIS R. 
Published: November 2012

Objective.To determine the presence of psoriasis and psoriatic arthritis (PsA) in aboriginal people living in the Andean Mountains of Peru.Methods.Consecutive patients with psoriasis and PsA attending an arthritis clinic in Juliaca, Puno, Peru, located 3824 m above sea level were examined. The CASPAR (ClASsification of Psoriatic ARthritis) criteria were used for classification of PsA. Diagnosis of psoriasis was confirmed by a dermatologist.Results.Seventeen patients [11 (65%) men and 6 (35%) women] fulfilled classification criteria for PsA; one patient was of European ancestry and is not included in this report. Of the 16 aboriginal patients in this report, 5 were natives of Quechua ancestry and one was native Aymara. At the time of their first clinic visit, no native patient with PsA had a family history of psoriasis or PsA, and all patients exhibited an established disease of long duration and severity. Methotrexate was the drug of choice for all patients; 2 patients are currently receiving biological therapy.Conclusion.Contrary to what has been reported in the literature, both psoriasis and PsA are present in aboriginal people from the Andean Mountains of Peru. More studies are needed to further define the phenotype of these disorders, as well as the pathogenetic role of genetic and environmental factors.
Évolutions des politiques locales de jeunesse
Authors: Loncle Patricia 
Published: November 2012

Résumé Le présent article a pour objectif de proposer une synthèse des évolutions qui affectent les politiques locales de jeunesse depuis une décennie. Pour ce faire, il s’intéresse aux changements qui concernent, d’une part, les problèmes publics définis par les politiques locales et, d’autre part, les niveaux d’intervention desdites politiques. Les politiques de jeunesse sont envisagées comme faisant partie d’un processus de complexification, de transversalisation de l’action publique, sur fond de désengagement de l’État. En procédant de la sorte, nous tentons de revenir sur l’hypothèse générale qui structure ce numéro : est-ce que les évolutions en matière de politiques locales de jeunesse vont dans le sens d’un développement des politiques territoriales ?
Les étudiants animateurs : un petit boulot vocationnel
Authors: Pinto Vanessa 
Published: November 2012

Résumé L’exercice par certains étudiants d’un « petit boulot » dans l’animation résulte d’un ajustement entre, d’une part, les propriétés à la fois objectives et subjectives de cette population et, d’autre part, les caractéristiques et les exigences d’un secteur historiquement marqué par une pratique bénévole et des valeurs spécifiques. Cet article, qui repose sur une enquête ethnographique, tente de montrer en quoi ces étudiants ont vocation à occuper occasionnellement cet emploi et à y être considérés comme idéalement ajustés, alors même qu’ils n’envisagent pas d’y faire carrière.
Jeunes de rue et trafic de stups
Authors: Sauvadet Thomas 
Published: November 2012

Résumé Cet article repose sur une enquête socio-ethnographique effectuée dans une cité du sud de Paris. Il s’intéresse aux enfants, mais surtout aux adolescents et aux jeunes adultes qui utilisent les rues de leur cité davantage comme un lieu de vie que comme un lieu de passage, et qui forment des « bandes » plus ou moins structurées par des activités délinquantes, et en particulier par le trafic de stupéfiants, l’activité la plus rentable. Il éclaire ensuite la structuration de cette activité par l’accumulation, entre les années 1980 et aujourd’hui, de compétences techniques, relationnelles et économiques.
Les rencontres « jeunes et sociétés en Europe et autour de la Méditerranée »
Authors: Lebon Francis , de Linarès Chantal 
Published: November 2012

Résumé Cette chronique éclaire la genèse des Rencontres « Jeunes et sociétés » nées en 2003, en explicite les objectifs, met en perspective ce projet avec ceux de groupes plus anciens. Les auteurs analysent la mise en œuvre depuis 2003 du projet construit sur la compréhension de la place des jeunes dans les évolutions sociétales, la pluridisciplinarité et la dimension internationale dans les travaux. Ils relèvent également les problématiques émergentes au cours des rencontres en 2003, 2005 et 2007, les points de vue différents de certains participants et concluent sur l’importance de la construction d’un réseau de chercheurs en Europe et autour de la Méditerranée. Le rendez-vous des IV es Rencontres en 2009 à Forli en Italie constituera une étape importante dans cette construction.
Hip-Hop et politique de la ville
Authors: Faure Sylvia , Garcia Marie-Carmen 
Published: November 2012

Résumé Cet article analyse les catégories de pensée et d’action mobilisées depuis les années 1980 jusqu’au début des années 2000 par les politiques publiques locales en vue de reconnaître la danse hip-hop en tant que pratique artistique. Dès le début des années 1980, alors que les grands ensembles HLM étaient parfois apparus comme des espaces de non-droit, en déficit de citoyenneté, voire communautaristes, la danse hip-hop, associée aux « cultures urbaines », a été perçue comme un vecteur de l’intégration pour les jeunes de familles populaires et les danseurs et chorégraphes, aidés par les institutions de jeunesse et les élus locaux, ont été sollicités pour se faire les modèles du « pacte républicain ».
L'indépendance des autorités de régulation économique à l'égard des opérateurs régulés
Authors: Dezobry Guillaume 
Published: November 2012

Résumé Les autorités de régulation économique sont‑elles indépendantes vis‑à‑vis des opérateurs régulés ? Cette question, qui est au cœur du processus de libéralisation des industries de réseau, peut être appréhendée en envisageant la capacité des autorités de régulation sectorielle à résister aux facteurs de dépendance vis‑à‑vis des opérateurs régulés. Plus précisément, afin de s’émanciper de l’influence de l’opérateur historique, l’autorité de régulation doit parvenir, d’une part, à limiter le risque de capture et, d’autre part, à combler l’asymétrie d’information. Pour cela, elle doit disposer de moyens humains et financiers importants et pouvoir inscrire son action dans la durée.
L'indépendance des autorités de régulation financière à l'égard des opérateurs régulés
Authors: Lasserre Capdeville Jérôme 
Published: November 2012

Résumé Il est classique d’affirmer que la question de l’indépendance occupe une place importante dans le droit régissant les autorités de régulation financière, c’est‑à‑dire l’Autorité des marchés financiers (AMF) et l’Autorité de contrôle prudentiel (ACP). Cette indépendance qui est requise à l’égard du pouvoir politique, l’est tout autant, et c’est ce qui nous importe ici, vis‑à‑vis des opérateurs régulés. Mais qu’en est‑il, aujourd’hui, en 2012 ? Comment se manifeste cette indépendance à l’égard de ces derniers ? Des améliorations ne sont‑elles pas envisageables dans certains cas ? Cette contribution tente de répondre à l’ensemble de ces interrogations.
L'indépedance des autorités de régulation en Allemagne
Authors: Walther Julien 
Published: November 2012

Résumé Les autorités de régulation allemandes, largement calquées sur le modèle de l’office fédéral des cartels, ne sont pas indépendantes mais seulement autonomes. Une indépendance de droit serait, selon les canons constitutionnels allemands, inacceptable : toute administration doit en principe être ancrée par une « chaîne de légitimation » au pouvoir élu. Cette notion même d’autonomie est d’une grande complexité et s’entend comme découlant tant de l’organisation administrative que de l’agencement fédéral allemand. Cependant, malgré cela, des espaces d’indépendance semblent exister dans cette autonomie. Pour certaines de ces autorités, la structure particulière des chambres décisionnelles, le mode de financement, l’absence factuelle de sujétion aux éventuelles instructions ministérielles peuvent – prudemment – être lus comme les marqueurs d’une autonomie fonctionnelle réelle, proche d’une véritable indépendance.