bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gunshot Injuries in the Elderly: Patterns and Outcomes. A National Trauma Databank Analysis
Authors: Lustenberger Thomas , Inaba Kenji , Schnüriger Beat , Barmparas Galinos , Eberle Barbara M. , Lam Lydia , Talving Peep , Demetriades Demetrios 
Published: January 2011

AbstractBackgroundTrauma in the elderly (≥55 years) accounts for a significant proportion of admissions to trauma centers. Our understanding of the epidemiology and outcomes associated with penetrating injury in this age segment of the population, however, is severely limited. The aim of the present study therefore was to investigate the incidence and type of injuries sustained by elderly patients from firearms and the impact of age on outcomes.MethodsThis was a 5‐year National Trauma Databank (NTDB) study. Injury demographics, mortality rates, and lengths of stay in the Intensive Care Unit (ICU) and the hospital were analyzed. Elderly patients ≥55 years old were assigned to one of three categorical strata: 55–64 years old, 65–74 years old, and ≥75 years old.ResultsDuring the study period, 98,242 patients were admitted for firearm‐related injuries, and 3,190 (3.2%) of them were ≥55 years old. Within the elderly age segment of the population, 1,676 patients (52.5%) were 55–64 years of age, 727 (22.8%) were 65–74 years of age, and 787 (24.7%) were ≥75 years old. The incidence of severe trauma [Injury Severity Score (ISS) ≥ 16] in the elderly age strata was 43.3, 46.8, and 57.6%, respectively (p < 0.001). Patients ≥75 years old were significantly more likely than patients 55–74 years old to suffer self‐inflicted injuries. The most commonly encountered injury in elderly patients was gunshot wounds to the head, which increased in a stepwise fashion with advancing age (25.8, 31.6, and 39.4% respectively; p < 0.001). The crude mortality rate in all patients sustaining gunshot wounds increased progressively with age. Within the elderly age segment, mortality ranged from 28.5% in the age stratum 55–64 years, to 55.4% in the stratum ≥75 years (adjusted p < 0.001). Intensive care unit and hospital length of stay increased with advancing age but peaked and remained stable among the elderly age groups. An admission Glasgow Coma Score (GCS) ≤ 8, an ISS ≥ 16, hypotension on admission, age, self‐inflicted injury, and injury sustained by assault were factors independently associated with death in patients ≥55 years.ConclusionsInjury from firearms is not uncommon in the elderly patient population and is primarily a result of self‐inflicted gunshot wounds to the head. These patients sustain a high burden of injury and a high rate of mortality, which increases with advancing age.
Cases and Literature Review of Breast Sparganosis
Authors: Koo MinYoung , Kim Jung‐Han , Kim Jee Soo , Lee Jeong Eon , Nam Seok Jin , Yang Jung‐Hyun 
Published: January 2011

AbstractBackgroundSparganosis is a seldom encountered disease of the breast. Based on the results of previous studies and our own experience, we investigated the clinical characteristics of breast sparganosis.MethodFour patients who were treated for breast sparganosis at Samsung Medical Center were included in the study, and additional data were retrieved from the Index Medicus and the Science Citation Index (SCI). The Korean Medical (KM) database and the Korean Association of Medical Journal Editors (KAMJE) database were searched to include information from Korean journals that is not included in international citation indexes.ResultsAmong 35 patients, 8 (32%) had a record of oral ingestion of an intermediary host. All patients presented with a breast mass, with migration in 6 cases (25%) and pain or an itching sensation in 6 cases (25%). Elongated tubular structures were found in the subcutaneous layer in 22 cases (88%) during radiologic exam. All patients underwent complete surgical excision. Twenty‐seven of 29 (93.1%) patients’ spargana was separated and confirmed grossly. Histologically, granulomatous inflammation was the most common feature. A single worm was extracted in 16 cases (76.2%) and 5 cases (23.8%) had multiple worms.ConclusionSparganosis tends to present as a suspicious mass in the subcutaneous layer of the breast. Complete surgical excision is the treatment of choice, with careful postoperative surveillance.
Reverse Airflow in Certain Chest Drains May be Misinterpreted as Prolonged Air Leakage
Authors: Stouby Anna , Neckelmann Kirsten , Licht Peter B. 
Published: January 2011

AbstractBackgroundProlonged air leakage is common after lung resection. We observed that during deep inspiration some patients were able to empty the water‐seal of commercial chest drainage systems and retract air back into the chest tube, which subsequently escaped during the following expiration, mimicking “true” air leakage. This led us to perform in vitro and in vivo pressure measurements in chest tube systems and investigate possible relationships with “false” air.MethodsCommercially available one‐ and three‐chamber drainage systems were used as models for large and small water‐seals, respectively. Digital pressure measurements were performed in vitro and in ten selected patients with clinical suspicion of reverse airflow.ResultsRepeated measurements in the laboratory demonstrated that in three‐chamber chest drainage systems with small water‐seals a negative pressure below −30.4 cmH2O led to emptying of the water‐seal with retrograde flow of air. Retrograde airflow was not possible in one‐chamber chest drainage systems. In vivo measurements demonstrated that six of ten highly selected patients were able to create negative pressures below −30.4 cmH2O during deep inspiration.ConclusionDuring deep inspiration some patients are able to create negative pressure large enough to empty small water‐seals in commercial chest drainage systems and retract air back into the chest tube. This excess air escapes during the following expiration and may mislead interpretation of continued air leakage even when there is none, subsequently resulting in prolonged and unnecessary chest tube drainage. Any surgeon who treats patients with chest tubes should be aware of this phenomenon.
Levels of Community Engagement in Youth Violence Prevention: The Role of Power in Sustaining Successful University‐Community Partnerships
Authors: Nation Maury , Bess Kimberly , Voight Adam , Perkins Douglas D. , Juarez Paul 
Published: January 2011

AbstractPrevious research indicates that communities can be engaged at various levels in research to reduce youth violence. In this paper, we argue that the method of power sharing among partners is a central factor distinguishing different levels of engagement. Using cases from the Nashville Urban Partnership Academic Center of Excellence, we identify community initiation and community collaboration as distinct approaches to community engaged violence prevention research. The power relationships among partners are analyzed to highlight differences in the types of engagement and to discuss implications for establishing and sustaining community partnerships. Also, the implications of levels of engagement for promoting the use of evidence‐based practices are discussed.
Essential Elements for Community Engagement in Evidence‐Based Youth Violence Prevention
Authors: Miao Tai-An , Umemoto Karen , Gonda Deanna , Hishinuma Earl S. 
Published: January 2011

AbstractIn the field of youth violence prevention, there has been increasing emphasis on “evidence based” programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence‐based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence‐based youth violence prevention based on their work in a university‐community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self‐reflection. The authors propose placing greater emphasis on “evaluative thinking” and organizational capacity for evaluation as we pursue evidence‐based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.
“You Have to Sit and Explain it All, and Explain Yourself.” Mothers’ Experiences of Support Services for Their Offspring with a Rare Genetic Intellectual Disability Syndrome
Authors: Griffith Gemma Maria , Hastings Richard P. , Nash Susie , Petalas Michael , Oliver Chris , Howlin Patricia , Moss Joanna , Petty Jane , Tunnicliffe Penelope 
Published: January 2011

AbstractThe experiences of mothers of adult offspring with Angelman, Cornelia de Lange, or Cri du Chat syndrome have not been previously explored in research. The current study focuses on experiences with social and medical services and the impact the rareness of an adult offspring's syndrome has on the experiences of mothers. Eight mothers of adults with Angelman, Cornelia de Lange, or Cri du Chat syndrome were interviewed. Thematic Content Analysis was used to interpret the interviews. Four themes emerged from the analysis: (i) The rarity of their offspring's syndrome, (ii) Uneven medical and social care service provision, (iii) The inertia of social care services, and (iv) Mothers as advocates. Mothers felt that the rareness of their offspring's syndrome did not affect experiences with social care services, but did affect access to medical services and some aspects of day‐to‐day living. Accessing appropriate social care services was reported to be a lengthy and complex process. These data may help inform care service providers about how best to support adults with rare genetic syndromes and their families.
Peer Observed Interaction and Structured Evaluation (POISE): A Canadian Experience with Peer Supervision for Genetic Counselors
Authors: Goldsmith Claire , Honeywell Christina , Mettler Gabrielle 
Published: January 2011

AbstractPeer observation, while often used in other professions, has not been formally applied in genetic counseling. The objective of this study was to pilot a method of peer evaluation whereby genetic counselors observed, and were observed by, each other during patient interaction. All of the available genetic counselors participated in both rounds of the pilot study (six in round one, seven in round two). The genetic counselors that observed the session used an observation room. Most participants reported learning a new skill. Sensitivity to, and comfort with, the feedback process improved. We conclude that Peer‐Observed Interaction and Structured Evaluation (POISE) provides an opportunity to refresh counseling approaches and develop feedback skills without causing undue team discord. This new approach to peer supervision in genetic counselling offers a live observation approach for genetic counsellor supervision.
CT colonography: avoiding traps and pitfalls
Authors: Lefere Philippe , Gryspeerdt Stefaan 
Published: January 2011

Abstract
Computed tomographic colonography (CTC) is a reliable technique for detecting tumoral lesions in the colon. However, good performance of polyp detection is only achieved if experienced CTC radiologists combine meticulous interpretation with state-of-the-art CTC technique. To reach this experience level, CTC training is mandatory. With a considerably long and steep learning curve, it has been demonstrated that in inexperienced hands both technical failure and observer errors stand for the majority of missed lesions. The purpose of this pictorial review is to give an overview of traps and pitfalls in CTC imaging resulting in false negative and positive findings, and how to avoid them by application of state-of-the-art CTC technique and interpretation.
Science Is an Attitude: A Response to Kamhi
Authors: Apel Kenn 
Published: January 2011

Purpose
I provide alternative views to Kamhi’s (2011) assertion that clinical practice cannot be scientific. I also discuss how the field of communication sciences and disorders might encourage scientific thinking about clinical practices in researchers and clinicians.

Method
Kamhi’s three main points for why clinical practice cannot be scientific are discussed, and alternate perspectives are offered.

Results
Clinicians and clinical practice can be scientific and can contribute to changes in scientific orthodoxy.

Conclusion
Science is an attitude that needs to be instilled in future researchers and clinicians during their educational programs. Model clinical scientists should be used as role models when educating these individuals.
Rational Thinking in School-Based Practice
Authors: Clark Mary Kristen , Flynn Perry 
Published: January 2011

Purpose
We reflect on Alan Kamhi’s (2011) prologue on balancing certainty and uncertainty as it pertains to school-based practice.

Method
In schools, rational thinking depends on effective team processes, much like professional learning communities. We consider the conditions that are required for rational thinking and how rational team dialogue confronts uncertainties. We provide suggestions for how this dialogue can be used throughout the individualized education program (IEP) process to lead to more positive experiences for all team members as well as improved student outcomes.

Conclusion
Rational thinking in school-based practice may be manifest by closer adherence to the tenants of the Individuals With Disabilities Education Improvement Act of 2004 (IDEIA), ultimately resulting in increased rational thought and improved student outcomes.
Questions About Certainty and Uncertainty in Clinical Practice
Authors: Nelson Nickola Wolf 
Published: January 2011

PurposeThis article offers a critical response to Kamhi’s (2011) essay regarding the need to balance certainty and uncertainty in evidence-based practice (EBP).MethodPoints of concordance and discordance (counterpoints) between Kamhi’s essay and the author’s frames of reference were considered.ResultsIn agreement with Kamhi, a major role is outlined for clinicians to use questions strategically (i.e., acting on uncertainty) to prioritize intervention targets and select approaches that best fit the context and stakeholders' values for purposes of planning, accomplishing, and evaluating change. The first counterpoint emphasizes a need for larger roles for theoretical frameworks involving systems theory and collaborative, contextualized approaches to assessment and intervention. The second notes opportunities for self-correction by using outcome data from relevant contexts outside of treatment sessions.ConclusionClinicians should capitalize on Kamhi’s ideas by working with other key stakeholders to make points of certainty and uncertainty explicit. By generating insightful questions that can guide the process of EBP and gathering evidence from broader outcomes, clinicians can gain external validation for the approach taken or for the need to consider alternatives.
Balancing Certainty and Uncertainty in Clinical Practice
Authors: Kamhi Alan G. 
Published: January 2011

Purpose
In this epilogue, I respond to each of the five commentaries, discussing in some depth a central issue raised in each commentary. In the final section, I discuss how my thinking about certainty and uncertainty in clinical practice has evolved since I wrote the initial article.

Method
Topics addressed include the similarities/differences between science and clinical practice, how to teach rational and critical thinking, access to new ideas, evidence-based practice (EBP) and theory, the importance of knowledge for clinical practice, clinical expertise, and the feeling of certainty.

Conclusion
I was wrong about certainty and uncertainty. They are not the products of rational thought processes. Like many others, I have fallen prey to the myth of the autonomous rational mind. Burton (2008) and Marcus (2008) have convinced me that the certainty of our beliefs is influenced by feelings, emotions, desires, goals, and simple self-interest and is vulnerable to the idiosyncrasies of memory. This explains why highly rational thinkers will often reach different conclusions about the same set of observations (data). The only way to ensure scientific or clinical progress is to embrace a system that has a built-in mechanism for independent evaluation.
Assessing Speech Intelligibility in Children With Hearing Loss: Toward Revitalizing a Valuable Clinical Tool
Authors: Ertmer David J. 
Published: January 2011

Background
Newborn hearing screening, early intervention programs, and advancements in cochlear implant and hearing aid technology have greatly increased opportunities for children with hearing loss to become intelligible talkers. Optimizing speech intelligibility requires that progress be monitored closely. Although direct assessment of intelligibility has been a cumbersome undertaking, advancements in digital recording technology and expanded strategies for recruiting listener-judges can make this tool much more practical in contemporary school and clinical settings.

Purpose
The main purposes of this tutorial are to present a rationale for assessing children’s connected speech intelligibility, review important uses for intelligibility scores, and describe time-efficient ways to estimate how well children’s connected speech can be understood. This information is offered to encourage routine assessment of connected speech intelligibility in preschool and school-age children with hearing loss.
Close Relationships in Adolescents With and Without a History of Specific Language Impairment
Authors: Wadman Ruth , Durkin Kevin , Conti-Ramsden Gina 
Published: January 2011

Purpose
Engagement in close friendships and romantic relationships becomes particularly salient in adolescence. This study examined the influence of language, behavioral, and social variables on the level of emotional engagement experienced by adolescents with and without a history of specific language impairment (SLI).

Method
Ninety adolescents with SLI and 91 adolescents with typical language abilities (TD) completed two assessment sessions between the ages of 16 and 17.

Results
The group with SLI had significantly lower emotional engagement scores than the TD group. Some 24% of adolescents with a history of SLI were judged to have poor emotional engagement in close relationships, compared to only 2% of the TD adolescents. A regression analysis found that language ability, prosocial behavior, and shyness were concurrently predictive of level of emotional engagement in close relationships.

Conclusion
Some adolescents with SLI may be less emotionally engaged in their close relationships than their TD peers.
The Unfolded Protein Response: How Protein Folding Became a Restrictive Aspect for Innate Immunity and B Lymphocytes1
Authors: Costa C. Z. F. , da Rosa S. E. A. , de Camargo M. M. 
Published: January 2011

AbstractChaperone production is an essential step for proper folding of certain proteins. Accumulation of misfolded/unfolded proteins within the endoplasmic reticulum (ER) lumen triggers a signalling pathway named unfolded protein response (UPR). Upon activation, the UPR pathway augments transcription of ER chaperones increasing protein folding, decreases protein translation to ameliorate the ER overload, increases protein degradation, and activates the apoptotic programme if all previous measures fail. In this review, we will cover the chaperones involved in folding of proteins related to the immune response, followed by an overview of the UPR pathway. Lastly, we will discuss data from this last decade that demonstrate how the improper activation of the UPR pathway has been uncovered as a mechanism responsible for failure to mount a proper immune response, both innate and adaptive.
Leptospirosis: Aspects of Innate Immunity, Immunopathogenesis and Immune Evasion From the Complement System
Authors: Fraga T. R. , Barbosa A. S. , Isaac L. 
Published: January 2011

AbstractLeptospirosis is a neglected infectious disease caused by spirochetes from the genus Leptospira. It constitutes a major public health problem in developing countries, with outcomes ranging from subclinical infections to fatal pulmonary haemorrhage and Weil′s syndrome. To successfully establish an infection, leptospires bind to extracellular matrix compounds and host cells. The interaction of leptospires with pathogen recognition receptors is a fundamental issue in leptospiral immunity as well as in immunophatology. Pathogenic but not saprophytic leptospires are able to evade the host complement system, circulate in the blood and spread into tissues. The target organs in human leptospirosis include the kidneys and the lungs. The association of an autoimmune process with these pathologies has been explored and diverse mechanisms that permit leptospires to survive in the kidneys of reservoir animals have been proposed. However, despite the intense research aimed at the development of a leptospirosis vaccine supported by the genome sequencing of Leptospira strains, there have been relatively few studies focused on leptospiral immunity. The knowledge of evasion strategies employed by pathogenic leptospires to subvert the immune system is of extreme importance as they may represent targets for the development of new treatments and prophylactic approaches in leptospirosis.
Jasmonic acid perception by COI1 involves inositol polyphosphates in Arabidopsis thaliana
Authors: Mosblech Alina , Thurow Corinna , Gatz Christiane , Feussner Ivo , Heilmann Ingo 
Published: January 2011

SummaryPlant responses to wounding are part of their defense responses against insects, and are tightly regulated. The isoleucin conjugate of jasmonic acid (JA‐Ile) is a major regulatory molecule. We have previously shown that inositol polyphosphate signals are required for defense responses in Arabidopsis; however, the way in which inositol polyphosphates contribute to plant responses to wounding has so far remained unclear. Arabidopsis F‐box proteins involved in the perception of JA‐Ile (COI1) and auxin (TIR1) are structurally similar. Because TIR1 has recently been shown to contain inositol hexakisphosphate (InsP6) as a co‐factor of unknown function, here we explored the possibility that InsP6 or another inositol polyphosphate is required for COI1 function. In support of this hypothesis, COI1 variants with changes in putative inositol polyphosphate coordinating residues exhibited a reduced interaction with the COI1 target, JAZ9, in yeast two‐hybrid tests. The equivalent COI1 variants displayed a reduced capability to rescue jasmonate‐mediated root growth inhibition or silique development in Arabidopsis coi1 mutants. Yeast two‐hybrid tests using wild‐type COI1 in an ipk1Δ yeast strain exhibiting increased levels of inositol pentakisphosphate (InsP5) and reduced levels of InsP6 indicate an enhanced COI1/JAZ9 interaction. Consistent with these findings, Arabidopsis ipk1‐1 mutants, also with increased InsP5 and reduced InsP6 levels, showed increased defensive capabilities via COI1‐mediated processes, including wound‐induced gene expression, defense against caterpillars or root growth inhibition by jasmonate. The combined data from experiments using mutated COI1 variants, as well as yeast and Arabidopsis backgrounds altered in inositol polyphosphate metabolism, indicate that an inositol polyphosphate, and probably InsP5, contributes to COI1 function.