bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research report
Authors: Ingholt Liselotte , Sørensen Betina Bang , Axel Erik , Frank Vibeke Asmussen 
Published: February 2013

Drug Use within Vocational Education: Health Promotion, Social Relations and Institutional Organization Aim The article explores the significance of drug use and peer relations for students’ participation in vocational education. Design From 22 qualitative interviews two girls’ case stories are analyzed, one still being in, the other having left vocational education. The article is rooted in theory of social practice and critical psychology. Key concepts include institutional and personal trajectories of participation. Results Learning in vocational education is part of how young people develop and coordinate their trajectory of everyday social life. Additionally drug use may become important in the process of forming peer relations. For some students, the focus is drifting from vocational to social interactions with drugs. School institutional organization including the significance of other students, teachers, and student counselors play an important role with regard to students’ participation in and dropout of vocational school. Conclusions Organizing social life in vocational schools influences students’ learning as well as dropout and tobacco, alcohol, and drug use.
Women, work and wine
Authors: Buvik Kristin , Sagvaag Hildegunn 
Published: February 2013

Aims There are many grey zones between work and leisure time, where colleagues drink together. Managers are more often involved in grey-zone situations than other employees, and the managerial arena is dominated by men. What is the significance of female managers’ visibility in their understanding of their own consumption of alcohol? What leads female managersto moderate their work-related alcohol consumption? Data and Methods To capture the female managers’ perspectives, we conducted 13 in-depth interviews. The female managers represented various kinds of work within care or nursing, media or publishing, public administration and commodity trading. Results The female managers’ reflections and experiences of consuming alcohol in grey zones explain how their heightened visibility as women leads them to moderate their alcohol consumption. Three themes were especially salient: (1) need to be in control, (2) concern about stigmatisation, and (3) life stages marked with caring tasks. Conclusions The results show the importance of external factors in work-related drinking. Women's visibility is significant in relation to cultural dimensions, moderating work-related drinking even when women are managers. The women place demands upon themselves based on their own conceptions of others’ expectations of female managers.
Research report
Authors: Tryggvesson Kalle 
Published: February 2013

Aims The purpose of this article is to demonstrate how Swedish authorities and politicians have related to syringe exchange in Sweden during the last 25 years. As the syringe exchange in Sweden still is very limited, this study focuses on the arguments for and against syringe exchange, and how the question has been formulated in the political proposals during the period studied. Methods and Data Since 1988 the National Board of Health and Welfare conducted three major studies on the effects and relevance of syringe exchange. These studies, and the policy documents that followed, are qualitatively analyzed in this paper. Results The processes have all looked the same; NBHW has proposed syringe exchange programs, which are a mix of drug policy and infection control aspects. During the political process the proposals have changed so that the infections control aspects has been downgraded on behalf of drug-policy interests. The arguments for this change have to their nature been abstract. Conclusions Even though Sweden established its first experiments with syringe exchange already in the mid-1980s, it is not before the year 2006 that the country's all counties by law are allowed to provide clean syringes to their drug users. However, the law is modeled on a fear of harmful effects of drug use, and a will to rather encourage drug treatment than other measures. Thereby the importance of the infections control aspect is heavily undermined.
A Proposed Model to Study Immunologic Changes during Chronic Rhinosinusitis Exacerbations: Data from a Pilot Study
Authors: Rank Matthew A. , Hagan John B. , Samant Shefali A. , Kita Hirohito 
Published: February 2013

Background One way to gain insight into the pathophysiology of chronic rhinosinusitis (CRS) is to study the immunologic changes that occur with exacerbation. This study describes the immunologic changes during CRS exacerbation Methods We performed a prospective study to investigate the immunologic changes seen during exacerbation of CRS with nasal polyposis. We recruited adult subjects who met clinical criteria for CRS with sinus CT scan within the past 5 years with Lund-Mackay score of >5 and nasal polyps. Subjects underwent a baseline visit with collection of nasal secretion and nasal wash. With acute worsening of symptoms, subjects underwent 6 near-consecutive-day collections and one follow-up collection 2 weeks later. IL-6, IL-33, eosinophil major basic protein (MBP), eosinophil-derived neurotoxin (EDN), myeloperoxidase (MPO), and uric acid were measured on the nasal samples from each visit. Results A total of 10 subjects were recruited and 9 had acute worsening of CRS during the study period. Eight of the nine subjects were women and ages ranged from 26 to 56 years. At baseline, most inflammatory parameters were low and eight of the nine subjects were on intranasal corticosteroids. Compared with baseline measurements, IL-6, MBP, MPO, EDN, and uric acid were significantly elevated during CRS exacerbation. Levels of IL-6 and MBP (r = 0.47) levels as well as IL-6 and MPO (r = 0.75) were both significantly correlated (p < 0.01). Conclusion Prospective study of CRS exacerbations is feasible and provides insights into the immunologic mechanisms of CRS.
Achilles Tendon Rupture
Authors: Cruz Mario F. , Jordan Susan S. , Bolgla Lori A. 
Published: February 2013

The patient was a 30-year-old man who was referred to a physical therapist for a chief complaint of a painful, swollen left lower leg that had caused difficulty with walking in the previous 3 weeks. Prior to physical therapist referral, the patient's primary care provider ordered radiographs of the left ankle, which were interpreted as normal. Due to history and physical examination findings that were concerning for an Achilles tendon rupture, the physical therapist immediately referred the patient to an orthopaedic surgeon. Magnetic resonance imaging confirmed the presence of a complete rupture of the Achilles tendon. J Orthop Sports Phys Ther 2013;43(2):105. doi:10.2519/jospt.2013.0403
Hip Pain in a Young Athlete
Authors: Kovacs Christopher J. , Paterno Mark V. , Chandran Sheila 
Published: February 2013

The patient was an 11-year-old boy who was referred to a physical therapist for a chief complaint of left anterior/lateral hip pain. Prior to referral to the physical therapist, radiographs were completed and interpreted as normal. Initially, his hip pain did not limit his participation in athletic activities; however, following a prescription of an exercise program, the patient reported worsening left hip pain that caused an inability to participate in lacrosse, as well as 2 episodes of severe night pain. The patient was immediately referred to his physician, where magnetic resonance imaging revealed signs most concerning for an infectious process/osteomyelitis in the region of the proximal femur and greater trochanter. J Orthop Sports Phys Ther 2013;43(2):106. doi:10.2519/jospt.2013.0404
Improved survival in the largest national cohort of adults with cerebellar versus supratentorial low-grade astrocytomas
Authors: Bagley Jacob H. , Babu Ranjith , Friedman Allan H. , Adamson Cory 
Published: February 2013

Object
Low-grade gliomas (LGGs) are indolent tumors that have the potential to dedifferentiate into malignant high-grade tumors. Recent studies have demonstrated that cerebellar low-grade tumors have a better prognosis than supratentorial tumors, although no study has focused on the risk factors for poor prognosis in cerebellar LGGs in adults. The authors of the current study aimed to address both of these concerns by using a large cohort derived from a national cancer registry and a smaller cohort derived from their institution's experience.

Methods
Adults with diagnosed Grade I and Grade II gliomas of the cerebellum were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox proportional hazard models were used to predict rates of survival, and the log-rank test was applied to evaluate differences in Kaplan-Meier survival curves. An institutional cohort was created by isolating all patients whose surgical pathology revealed an LGG of the cerebellum. Excluded from analysis were patients in whom a glioma was first diagnosed under the age of 18 years and those whose tumors could not be definitively determined to arise from the cerebellum.

Results
Data from the local cohort (11 patients) demonstrated that the most common presenting symptom was headache, which occurred in more than 70% of the cohort. Approximately half of the patients in this cohort had symptomatic improvement after treatment. Results from the SEER cohort (166 patients) revealed that adults with Grade I gliomas were slightly younger than those with Grade II tumors (p < 0.01), but no other demographic differences were observed. Patients with Grade I tumors were twice as likely to undergo gross-total resection (54% vs 21%), and those with Grade II gliomas were much more likely to receive postoperative radiation (3% vs 48%). Five-year survival was greater in the patients with Grade I gliomas than in those with Grade II lesions (91% vs 70%). Multivariate analysis revealed that an age ≥ 40 years (HR 7.30, 95% CI 3.55–15.0, p < 0.0001) and Grade II tumors (HR 2.76, 95% CI 1.12–6.84, p = 0.028) were risk factors for death, whereas female sex was protective (HR 0.28, 95% CI 0.14–0.59, p < 0.001). Log-rank tests revealed that a cerebellar location was protective (p < 0.0001), but this relationship was only true for Grade II tumors (p < 0.0001). Survival in patients with Grade I gliomas was not different based on the various lesion locations (p = 0.21).

Conclusions
Taken together, adults with cerebellar WHO Grade I and II astrocytomas have a much more favorable survival curve than those with similar supratentorial tumors. Research demonstrates that the primary driver of this phenomenon is the improved survival in patients with cerebellar Grade II gliomas.
Postoperative ischemic changes following resection of newly diagnosed and recurrent gliomas and their clinical relevance
Authors: Gempt Jens , Förschler Annette , Buchmann Niels , Pape Haiko , Ryang Yu-Mi , Krieg Sandro M. , Zimmer Claus , Meyer Bernhard , Ringel Florian 
Published: February 2013

Object
The aim of surgical treatment of glioma is the complete resection of tumor tissue with preservation of neurological function. Inclusion of diffusion-weighted imaging (DWI) in the postoperative MRI protocol could improve the delineation of ischemia-associated postoperative neurological deficits. The present study aims to assess the incidence of infarctions following resection of newly diagnosed gliomas in comparison with recurrent gliomas and the influence on neurological function.

Methods
Patients who underwent glioma resection for newly diagnosed or recurrent gliomas had early postoperative MRI, including DWI and apparent diffusion coefficient (ADC) maps. Postoperative areas of restricted diffusion were classified as arterial territorial infarctions, terminal branch infarctions, or venous infarctions. Tumor entity, location, and neurological function were recorded.

Results
New postoperative ischemic lesions were identified in 26 (31%) of 84 patients with newly diagnosed gliomas and 20 (80%) of 25 patients with recurrent gliomas (p < 0.01). New permanent and transient neurological deficits were more frequent in patients with recurrent gliomas than in patients with newly diagnosed tumors. Patients with neurological deficits had a significantly higher rate of ischemic lesions.

Conclusions
Postoperative infarctions occur frequently in patients with newly diagnosed and recurrent gliomas and do have an impact on postoperative neurological function. In this patient cohort there was a higher risk for ischemic lesions and for deterioration of neurological function after resection of recurrent tumors. Radiogenic and postoperative tissue changes could contribute to the higher risk of an ischemic infarction in patients with recurrent tumors.
In-hospital mortality after traumatic brain injury surgery: a nationwide population-based comparison of mortality predictors used in artificial neural network and logistic regression models
Authors: Shi Hon-Yi , Hwang Shiuh-Lin , Lee King-Teh , Lin Chih-Lung 
Published: February 2013

Object
Most reports compare artificial neural network (ANN) models and logistic regression models in only a single data set, and the essential issue of internal validity (reproducibility) of the models has not been adequately addressed. This study proposes to validate the use of the ANN model for predicting in-hospital mortality after traumatic brain injury (TBI) surgery and to compare the predictive accuracy of ANN with that of the logistic regression model.

Methods
The authors of this study retrospectively analyzed 16,956 patients with TBI nationwide who were surgically treated in Taiwan between 1998 and 2009. For every 1000 pairs of ANN and logistic regression models, the area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow statistics, and accuracy rate were calculated and compared using paired t-tests. A global sensitivity analysis was also performed to assess the relative importance of input parameters in the ANN model and to rank the variables in order of importance.

Results
The ANN model outperformed the logistic regression model in terms of accuracy in 95.15% of cases, in terms of Hosmer-Lemeshow statistics in 43.68% of cases, and in terms of the AUC in 89.14% of cases. The global sensitivity analysis of in-hospital mortality also showed that the most influential (sensitive) parameters in the ANN model were surgeon volume followed by hospital volume, Charlson comorbidity index score, length of stay, sex, and age.

Conclusions
This work supports the continued use of ANNs for predictive modeling of neurosurgery outcomes. However, further studies are needed to confirm the clinical efficacy of the proposed model.
Neurological sequelae from brachiocephalic vein stenosis
Authors: Herzig David W. , Stemer Andrew B. , Bell Randy S. , Liu Ai-Hsi , Armonda Rocco A. , Bank William O. 
Published: February 2013

Stenosis of central veins (brachiocephalic vein [BCV] and superior vena cava) occurs in 30% of hemodialysis patients, rarely producing intracranial pathology. The authors present the first cases of BCV stenosis causing perimesencephalic subarachnoid hemorrhage and myoclonic epilepsy.
In the first case, a 73-year-old man on hemodialysis presented with headache and blurry vision, and was admitted with presumed idiopathic intracranial hypertension after negative CT studies and confirmatory lumbar puncture. The patient mildly improved until hospital Day 3, when he experienced a seizure; emergency CT scans showed perimesencephalic subarachnoid hemorrhage. Cerebral angiography failed to find any vascular abnormality, but demonstrated venous congestion. A fistulogram found left BCV occlusion with jugular reflux. The occlusion could not be reopened percutaneously and required open fistula ligation. Postoperatively, symptoms resolved and the patient remained intact at 7-month follow-up.
In the second case, a 67-year-old woman on hemodialysis presented with right arm weakness and myoclonic jerks. Admission MRI revealed subcortical edema and a possible dural arteriovenous fistula. Cerebral angiography showed venous engorgement, but no vascular malformation. A fistulogram found left BCV stenosis with jugular reflux, which was immediately reversed with angioplasty and stent placement. Postprocedure the patient was seizure free, and her strength improved. Seven months later the patient presented in myoclonic status epilepticus, and a fistulogram revealed stent occlusion. Angioplasty successfully reopened the stent and she returned to baseline; she was seizure free at 4-month follow-up.
Central venous stenosis is common with hemodialysis, but rarely presents with neurological findings. Prompt recognition and endovascular intervention can restore normal venous drainage and resolve symptoms.
Radiographic predictors of delayed instability following decompression without fusion for degenerative Grade I lumbar spondylolisthesis
Authors: Blumenthal Claire , Curran Jill , Benzel Edward C. , Potter Rachel , Magge Subu N. , Harrington J. Frederick , Coumans Jean-Valery , Ghogawala Zoher 
Published: February 2013

Object
It is not known whether adding fusion to lumbar decompression is necessary for all patients undergoing surgery for degenerative lumbar spondylolisthesis with symptomatic stenosis. Determining specific radiographic traits that might predict delayed instability following decompression surgery might guide clinical decision making regarding the utility of up-front fusion in patients with degenerative Grade I spondylolisthesis.

Methods
Patients with Grade I degenerative lumbar spondylolisthesis (3–14 mm) with symptomatic stenosis were prospectively enrolled from a single site between May 2002 and September 2009 and treated with decompressive laminectomy without fusion. Patients with mechanical back pain or with gross motion (> 3 mm) on flexion-extension lumbar radiographs were excluded. The baseline radiographic variables measured included amount of slippage, disc height, facet angle, motion at spondylolisthesis (flexion-extension), and sagittal rotation angle. Data were analyzed using multivariate forward selection stepwise logistic regression, chi-square tests, Student t-test, and ANOVA.

Results
Forty patients were enrolled and treated with laminectomy without fusion, and all patients had complete radiographic data sets that were available for analysis. Reoperation was performed in 15 (37.5%) of 40 patients, with a mean follow-up duration of 3.6 years. Reoperation was performed for pain caused by instability at the index level in all 15 cases. Using multivariate stepwise logistic regression with a threshold p value of 0.35, motion at spondylolisthesis, disc height, and facet angle were predictors of reoperation following surgery. Facet angle > 50° was associated with a 39% rate of reoperation, disc height > 6.5 mm was associated with a 45% rate of reoperation, and motion at spondylolisthesis > 1.25 mm was associated with a 54% rate of reoperation. Patients with all 3 risk factors for instability had a 75% rate of reoperation, whereas patients with no risk factors for instability had a 0% rate of reoperation (p = 0.14).

Conclusions
Patients with motion at spondylolisthesis > 1.25 mm, disc height > 6.5 mm, and facet angle > 50° are more likely to experience instability following decompression surgery for Grade I lumbar spondylolisthesis. Identification of key risk factors for instability might improve patient selection for decompression without fusion surgery. Clinical trial registration no.: NCT00109213
Neck motion following multilevel anterior cervical fusion: comparison of short-term and midterm results
Authors: Wu Xiao-Dong , Yuan Wen , Chen Hua-Jiang , Chen Yu , Wang Jian-Xi , Cao Peng , Zhang Ying , Wang Xin-Wei , Yang Li-Li , Chen Yuan-Yuan , Tsai Nicholas 
Published: February 2013

Object
Multilevel anterior cervical decompression and fusion is indicated for patients with multilevel compression or stenosis of the spinal cord. Some have reported that this procedure would lead to a loss of cervical range of motion (CROM). However, few studies have demonstrated the exact impact of the procedure on CROM. Here, the authors describe short- and midterm postoperative CROM following multilevel anterior cervical decompression and fusion.

Methods
Thirty-five patients underwent a 3- or 4-level anterior cervical decompression and fusion. In all patients, active CROM was measured preoperatively and at both the short-term (3–4 months) and midterm (12–15 months) follow-ups by using a CROM device. The preoperative and postoperative data were analyzed using ANOVA (α = 0.05).

Results
Patients had significantly less ROM in all planes of motion postoperatively. The greater limitation in CROM was observed at the short-term follow-up. However, at the midterm follow-up, an obvious increase in CROM was observed in each cardinal plane compared with that in the short-term (sagittal plane 17.4%, coronal plane 14.1%, and horizontal plane 19.5%). A gradual increase in the CROM in each cardinal plane was observed during the recovery period in 5 patients. In the 6 conventional motions, the major recovery of CROM was observed in flexion (27.5%), while relatively less recovery was seen in extension (10.5%).

Conclusions
Patients had an obvious reduction in active CROM following multilevel anterior cervical decompression and fusion. The greater limitation in CROM was observed at the short-term follow-up. In the midterm follow-up, however, an obvious recovery in CROM was observed in each cardinal plane, reducing the restriction of neck motion further.
Dynamik dichter, gleichförmiger Gebirgsfichtenwälder
Authors: Bebi Peter , Krumm Frank , Brändli Urs-Beat , Zingg Andreas 
Published: February 2013

Dynamics of dense, uniform spruce-dominated mountain forests
Dense, uniform stands have increased in spruce-dominated mountain forests during the last century and often cause silvicultural problems. During recent years, different research activities at Swiss Federal Institute for Forest, Snow and Landscape Research (WSL) have addressed the development of such mountain forests with or without active management. For this, plots of the Swiss National Forest Inventory (NFI) between 1983/1985 and 2004/2006 have been analysed, dendroecological methods have been used to investigate competition and selfthinning processes and a reassessment of WSL long-term investigation plots has been conducted. NFI plots of stands which have already been dense during the first inventory period generally showed increasing basal area, stagnating stem numbers, strongly increasing amounts of deadwood and slightly increasing regeneration levels, both in managed and in unmanaged stands. Dendroecological field studies confirm that trees in the generally about 80 to 150 years old stands were strongly affected by competition-induced self-thinning and subsequent small-scale mortality processes few decades after stand initiation already. WSL long-term investigation plots generally confirm this dominance of relatively small-scale processes, but also show potential for silvicultural interventions, especially in early stages of self-thinning. According to the guidelines for silvicultural intervention in forests with protective functions (NAIS), an active management of later self-thinning stages with already short crowns and higher mortality should focus on stands where risks have to be considered as too high, based on hazard and damage potential and the size of the dense, uniform stands.