bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric tethered cord syndrome: response of scoliosis to untethering procedures
Authors: McGirt Matthew J. , Mehta Vivek , Garces-Ambrossi Giannina , Gottfried Oren , Solakoglu Can , Gokaslan Ziya L. , Samdani Amer , Jallo George I. 
Published: September 2009

Object
Tethered cord syndrome (TCS) is frequently associated with scoliosis in the pediatric population. Following spinal cord untethering, many patients continue to experience progression of spinal deformity. However, the incidence rate, time course, and risk factors for scoliosis progression following tethered cord release remain unclear. The aim of this study was to determine factors associated with scoliosis progression and whether tethered cord release alone would halt curve progression in pediatric TCS.

Methods
The authors retrospectively reviewed 27 consecutive pediatric cases of spinal cord untethering associated with scoliosis. The incidence rate and factors associated with scoliosis progression (> 10° increased Cobb angle) after untethering were evaluated using the Kaplan-Meier method.

Results
The mean age of the patients was 8.9 years. All patients underwent cord untethering for lower-extremity weakness, back and leg pain, or bowel and bladder changes. Mean ± SD of the Cobb angle at presentation was 41 ± 16°. The cause of the spinal cord tethering included previous myelomeningocele repair in 14 patients (52%), fatty filum in 5 (18.5%), lipomeningocele in 3 (11%), diastematomyelia in 2 (7.4%), arthrogryposis in 1 (3.7%), imperforate anus with an S-2 hemivertebra in 1 (3.7%), and lipomyelomeningocele with occult dysraphism in 1 (3.7%). Mean follow-up was 6 ± 2 years. Twelve patients (44%) experienced scoliosis progression occurring a median of 2.4 years postoperatively and 8 (30%) required subsequent fusion for progression. At the time of untethering, scoliosis < 40° was associated with a 32% incidence of progression, whereas scoliosis > 40° was associated with a 75% incidence of progression (p < 0.01). Patients with Risser Grades 0–2 were also more likely to experience scoliosis progression compared with Risser Grades 3–5 (p < 0.05). Whereas nearly all patients with Risser Grades 0–2 with curves > 40° showed scoliosis progression (83%), 54% of patients with Risser Grades 0–2 with curves < 40° progressed, and no patients with Risser Grades 3–5 with curves < 40° progressed following spinal cord untethering.

Conclusions
In this experience with pediatric TCS-associated scoliosis, patients with Risser Grades 3–5 and Cobb angles < 40° did not experience curve progression after tethered cord release. Patients with Risser Grades 0–2 and Cobb angles > 40° were at greatest risk of curve progression after cord untethering. Pediatric patients with TCSassociated scoliosis should be monitored closely for curve progression using standing radiographs after spinal cord untethering, particularly those with curves > 40° or who have Risser Grades 0–2.
Combined endoscopic-microsurgical approach for transsphenoidal (sphenopalatine) encephalocele with an intralesional pituitary gland
Authors: Faggin Roberto , Pentimalli Luigi , Grazzini Maurizia , Saetti Roberto , Drigo Paola , d'Avella Domenico 
Published: September 2009

The treatment of the transsphenoidal sphenopalatine encephalocele in infants has not been thoroughly described in the literature. Pterional and subfrontal transbasal approaches have been reported as the advised treatment for transethmoidal encephalocele, but their feasibility for transsphenoidal encephalocele remains controversial, particularly in neonates. The potential harm to vital structures within the herniated tissue and intraoperative bleeding have been considered the major cause of poor postoperative results.
The authors present the case of a full-term newborn with a cleft palate and a large transsphenoidal sphenopalatine encephalocele, which filled the nasopharyngeal space and provided MR imaging evidence of an intralesional pituitary gland.
The lesion is unusual, and the extracranial intraoral endoscopic approach with an optimal outcome and sparing of the pituitary tissue has never been described in detail in an infant of this age.
Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation Type I
Authors: Elliott Robert , Kalhorn Stephen , Pacione Donato , Weiner Howard , Wisoff Jeffrey , Harter David 
Published: September 2009

Patients with symptomatic Chiari malformation Type I (CM-I) typically exhibit a chronic, slowly progressive disease course with evolution of symptoms. However, some authors have reported acute neurological deterioration in the setting of CM-I and acquired Chiari malformations. Although brainstem dysfunction has been documented in patients with CM-II and hydrocephalus or shunt malfunction, to the authors' knowledge only 1 report describing ventriculoperitoneal (VP) shunt malfunction causing neurological deterioration in a patient with CM-I exists.
The authors report on their experience with the treatment of previously asymptomatic CM-I in 2 children who experienced quite different manifestations of acute neurological deterioration secondary to VP shunt malfunction. Presumably, VP shunt malfunction created a positive rostral pressure gradient across a stenotic foramen magnum, resulting in tetraparesis from foramen magnum syndrome in 1 patient and acute ataxia and cranial nerve deficits from syringobulbia in the other. Although urgent shunt revisions yielded partial recovery of neurological function in both patients, marked improvement occurred only after posterior fossa decompression.
Topographic influences on recent changes of very small glaciers in the Monashee Mountains, British Columbia, Canada
Authors: DeBeer Christopher M. , Sharp Martin J. 
Published: September 2009

AbstractAn analysis of the local topographic setting of very small (<0.4 km2) glaciers within a small region of the Monashee Mountains, British Columbia, was conducted to investigate its influence on recent changes in the extent of these glaciers. Net changes in glacier extent were determined from a detailed manual comparison of remotely sensed imagery acquired in 1951, 2001 and 2004. Most of the 86 glaciers included in the study showed no observable net change in area over the study period, while six glaciers retreated, four disappeared entirely and only one advanced. Indices derived to characterize elements of the local topographic setting that might affect the local mass balance suggest that most of the glaciers are situated in locations that favor ice preservation by enhancing mass input and/or reducing ablation rates. Glaciers situated in less favorable settings generally either decreased in area or disappeared. The results suggest that most of the glaciers studied have retreated as far as they are likely to under the climatic conditions of the late 20th century.
Temporal dynamics of a jökulhlaup system
Authors: Ng Felix , Liu Shiyin 
Published: September 2009

AbstractRecurring jökulhlaups from ice-dammed lakes often form irregular time sequences that are seemingly unpredictable. Using the flood dates of Merzbacher Lake, Kyrgyzstan, as an example, we study these sequences through a model of lake filling and drainage where flood events initiate at a threshold water depth. Even with a constant threshold, model simulation can explain key aspects of the Merzbacher flood sequence. General analysis of model dynamics reveals a pacing mechanism that links one flood to the next, and which may be represented mathematically as an iterative map. This theory clarifies how environmental factors govern the long-term pattern of flood timings and their frequency distribution in the year. A reconstruction of the past level of Merzbacher Lake also suggests that its flood-initiation threshold decreases with the rate of lake-level rise. These results may help us understand how to forecast future outbursts from jökulhlaup lakes.
Properties of a marine ice layer under the Amery Ice Shelf, East Antarctica
Authors: Craven Mike , Allison Ian , Fricker Helen Amanda , Warner Roland 
Published: September 2009

AbstractThe Amery Ice Shelf, East Antarctica, undergoes high basal melt rates near the southern limit of its grounding line where 80% of the ice melts within 240 km of becoming afloat. A considerable portion of this later refreezes downstream as marine ice. This produces a marine ice layer up to 200 m thick in the northwest sector of the ice shelf concentrated in a pair of longitudinal bands that extend some 200 km all the way to the calving front. We drilled through the eastern marine ice band at two locations 70 km apart on the same flowline. We determine an average accretion rate of marine ice of 1.1 ± 0.2 m a−1, at a reference density of 920 kg m−3 between borehole sites, and infer a similar average rate of 1.3 ± 0.2 m a−1 upstream. The deeper marine ice was permeable enough that a hydraulic connection was made whilst the drill was still 70–100 m above the ice-shelf base. Below this marine close-off depth, borehole video imagery showed permeable ice with water-filled cavities and individual ice platelets fused together, while the upper marine ice was impermeable with small brine-cell inclusions. We infer that the uppermost portion of the permeable ice becomes impermeable with the passage of time and as more marine ice is accreted on the base of the shelf. We estimate an average closure rate of 0.3 m a−1 between the borehole sites; upstream the average closure rate is faster at 0.9 m a−1. We estimate an average porosity of the total marine ice layer of 14–20%, such that the deeper ice must have even higher values. High permeability implies that sea water can move relatively freely through the material, and we propose that where such marine ice exists this renders deep parts of the ice shelf particularly vulnerable to changes in ocean properties.
Retreating alpine glaciers: increased melt rates due to accumulation of dust (Vadret da Morteratsch, Switzerland)
Authors: Oerlemans J. , Giesen R.H. , Van Den Broeke M.R. 
Published: September 2009

AbstractThe automatic weather station (AWS) on the snout of the Vadret da Morteratsch, Switzerland, has delivered a unique 12 year meteorological dataset from the ablation zone of a temperate glacier. This dataset can be used to study multi-annual trends in the character of the surface energy budget. Since 2003 there has been a substantial darkening of the glacier tongue due to the accumulation of mineral and biogenic dust. The typical surface albedo in summer has dropped from 0.32 to 0.15. We have analysed the implications of the lowered albedo for the energy balance and the annual ablation. For the 4 year period 2003–06, the decreased albedo caused an additional removal of about 3.5 m of ice. Calculations with an energy-balance model show that the same increase in ablation is obtained by keeping the ice albedo fixed to 0.32 and increasing the air temperature by 1.7 K. Our analysis confirms that for retreating glaciers the deposition of dust from exposed side moraines on the glacier surface constitutes an important feedback mechanism. The mineral dust stimulates the growth of algae, lowers the surface albedo, enhances the melt rates, and thereby facilitates the further retreat of the glacier snout.
Indices for estimating fractional snow cover in the western Tibetan Plateau
Authors: Shreve Cheney M. , Okin Gregory S. , Painter Thomas H. 
Published: September 2009

AbstractSnow cover in the Tibetan Plateau is highly variable in space and time and plays a key role in ecological processes of this cold-desert ecosystem. Resolution of passive microwave data is too low for regional-scale estimates of snow cover on the Tibetan Plateau, requiring an alternate data source. Optically derived snow indices allow for more accurate quantification of snow cover using higher-resolution datasets subject to the constraint of cloud cover. This paper introduces a new optical snow index and assesses four optically derived MODIS snow indices using Landsat-based validation scenes: MODIS Snow-Covered Area and Grain Size (MODSCAG), Relative Multiple Endmember Spectral Mixture Analysis (RMESMA), Relative Spectral Mixture Analysis (RSMA) and the normalized-difference snow index (NDSI). Pearson correlation coefficients were positively correlated with the validation datasets for all four optical snow indices, suggesting each provides a good measure of total snow extent. At the 95% confidence level, linear least-squares regression showed that MODSCAG and RMESMA had accuracy comparable to validation scenes. Fusion of optical snow indices with passive microwave products, which provide snow depth and snow water equivalent, has the potential to contribute to hydrologic and energy-balance modeling in the Tibetan Plateau.
Communication, Comanagement, and Collaborative Care for Children and Youth with Special Healthcare Needs
Authors: Stille Christopher J. 
Published: September 2009

CME Educational Objectives

1.
Demonstrate the role of primary care-specialist communication in high-quality care delivery.

2.
Apply the role of communication in the larger concept of primary care provider-specialist comanagement.

3.
Identify a suitable comanagement approach to patient care in individual practices.
On the Threshold to the Adult Medical Home: Care Coordination in Transition
Authors: White Patience H. , Hackett Patti 
Published: September 2009

CME Educational Objectives

1.
Outline the role of care coordination for transitioning youth to adult medical homes.

2.
Distinguish the different tasks required of each member of the care team to achieve a smooth transition to an adult care model.

3.
Identify tools useful for assisting in the transition process.
Effect of Epithelial Retention and Removal on Riboflavin Absorption in Porcine Corneas
Authors: Samaras Konstantinos , O'Brart David P. , Doutch James , Hayes Sally , Marshall John , Meek Keith M. 
Published: September 2009

Purpose:
To compare stromal riboflavin absorption after 20% alcohol application and partial or complete epithelial removal by analyzing light transmission properties of porcine corneas after riboflavin/ultraviolet A (UVA) corneal collagen cross-linking.

Methods:
Riboflavin 0.13% eye drops were applied to 18 porcine eyes (6 in which 20% alcohol solution had been applied for 40 seconds, 6 eyes with a grid pattern of full-thickness epithelial trauma, and 6 with the central epithelium fully removed) at 5-minute intervals for 35 minutes. In all eyes, the corneal surface was exposed to UVA light for 30 minutes during riboflavin administration. The light transmission spectra of the corneas were analyzed with a spectrophotometer and compared to those of 9 untreated controls (4 corneas with epithelium and 5 without) and to the spectra of riboflavin 0.13% solution.

Results:
The spectra of riboflavin-treated corneas in the alcohol group were similar to controls. Those with grid-pattern epithelial trauma showed a dip in light transmission between 400 and 490 nm, but this was significantly less than that in eyes for which epithelial removal was complete, where the spectrum was similar to that of riboflavin 0.13% solution.

Conclusions:

Complete removal of the corneal epithelium appears to be necessary to allow sufficient riboflavin absorption into the stroma to alter the normal light transmission properties of the porcine cornea. Although partial grid-pattern epithelial removal allows some riboflavin penetration, uptake is limited and non-homogeneous, which may affect the efficacy of the cross-linking process. [
J Refract Surg.
2009;25:771–775.]
Transplantation of Endothelium and Descemet Membrane for Aphakic Corneal Edema in 1980
Authors: Hoffer Kenneth J. , Hofbauer John D. 
Published: September 2009

Purpose:
To describe a corneal endothelial layer and Descemet membrane transplantation into the anterior chamber for the treatment of bullous keratopathy in 1980.

Methods:
A retrospective report of an interventional case study is presented. A patient with aphakic bullous keratopathy in one eye was interested in undergoing a previously untested corneal transplantation procedure. Snellen visual acuity testing and slit-lamp examination were performed. The main outcome measures were visual acuity and degree of corneal clarity.

Results:
Visual acuity and corneal clarity improved in the months following the endothelial/Descemet membrane transplant but gradually returned to preoperative levels 1 year later. A subsequent successful penetrating keratoplasty resulted in excellent visual acuity (∼20/25).

Conclusions:
An attempt to perform endothelial and Descemet membrane transplantation for aphakic corneal edema in 1980 resulted in early improvement in corneal clarity and visual acuity but required full penetrating keratoplasty at 2 years postoperatively.
Early Laser Photocoagulation Treatment as an Option in Central Serous Chorioretinopathy
Authors: Sturm Veit 
Published: September 2009

Background and Objective:
To investigate the effect of early photocoagulation in central serous chorioretinopathy.

Patients and Methods:
In a prospective study, 15 consecutive patients with central serous chorioretinopathy and single leakage points were treated with photocoagulation between 2 days and 8 weeks after onset of symptoms. The main outcome measures were best-corrected visual acuity and metamorphopsias (Amsler grid) at months 1 and 4 compared with baseline.

Results:
Mean visual acuity improved by 1.53 lines 1 month after treatment. The mean squares involved in the Amsler grid were reduced by 2.07 squares. No relapse occurred during the follow-up period.

Conclusion:
Considering the characteristics of individuals affected by central serous chorioretinopathy, a fast recovery would be advantageous. This study identified early laser photocoagulation in central serous chorioretinopathy as an effective treatment regarding resorption of subretinal fluid, recovery of visual acuity, and improvement of metamorphopsia.

[Ophthalmic Surg Lasers Imaging 2009;40:453–460.]
Intravitreal Triamcinolone Acetonide Preceding Photodynamic Therapy for Exudative Age-Related Macular Degeneration
Authors: Roth Daniel B. , Kulkarni Kaushal M. , Walsman Scott , Modi Amy 
Published: September 2009

Background and Objective:
To evaluate the efficacy of intravitreal triamcinolone acetonide 1 week before photodynamic therapy (PDT) with verteporfin in the treatment of exudative age-related macular degeneration (AMD).

Patients and Methods:
Retrospective chart review of 70 eyes of 66 consecutive patients who were treated with intravitreal triamcinolone acetonide followed by standard PDT 1 week later. Group 1 consisted of 42 eyes that received one or more previous treatments with PDT alone and responded poorly. Group 2 consisted of 28 eyes that had never received PDT.

Results:
No statistically significant change in mean visual acuity was seen during the follow-up period for either group. At 12 months, 90% of group 1 eyes and 80% of group 2 eyes lost less than 2 lines of Snellen visual acuity. A mean of 1.24 additional PDT sessions were required in group 1 eyes and 1.04 additional sessions in group 2 eyes during the follow-up period.

Conclusion:
In eyes with exudative AMD, intravitreal triamcinolone acetonide preceding PDT with verteporfin results in stabilization of visual acuity and a decreased need for re-treatments with PDT. This regimen may be superior to PDT monotherapy.

[Ophthalmic Surg Lasers Imaging 2009;40:467–471.]
Sedation Management in Australian and New Zealand Intensive Care Units: Doctors’ and Nurses’ Practices and Opinions
Authors: O’Connor Mark , Bucknall Tracey , Manias Elizabeth 
Published: September 2009

Objective To explore the use of sedatives and analgesics, tools for scoring level of sedation, sedation and pain protocols, and daily interruptions in sedation in Australian and New Zealand intensive care units and to examine doctors’ and nurses’ opinions about the sedation management of critically ill patients.Methods A cross-sectional Internet-based survey design was used. In total, 2146 members of professional critical care organizations in Australia and New Zealand were e-mailed the survey during a 4-month period in 2006 through 2007.Results Of 348 members (16% response rate) who accessed the survey, 246 (71%) completed all sections. Morphine, fentanyl, midazolam, and propofol were the most commonly used medicines. Newer medicines, such as dexmedetomidine and remifentanil, and inhalant medications, such as nitrous oxide and isoflurane, were rarely used by most respondents. Respondents used protocols to manage sedatives (54%) and analgesics (51%), and sedation assessment tools were regularly used by 72%. A total of 62% reported daily interruption of sedation; 23% used daily interruption for more than 75% of patients. A disparity was evident between respondents’ opinions on how deeply patients were usually sedated in practice and how deeply patients should ideally be sedated.Conclusions Newer medications are used much less than are traditional sedatives and analgesics. Sedation protocols are increasingly used in Australasia, despite equivocal evidence supporting their use. Similarly, daily interruption of sedation is common in management of patients receiving mechanical ventilation. Research is needed to explore contextual and personal factors that may affect sedation management.
Online control of the injection molding process based on process variables
Authors: Michaeli Walter , Schreiber Andreas 
Published: September 2009

AbstractThe conventional control of the injection molding process is based on machine variables, which cannot sufficiently characterize the course of the process. Hence, a system that controls the injection molding process based on process variables has been developed at the Institute of Plastics Processing at RWTH Aachen University during the last years. It controls the quality determining process variable cavity pressure directly and realizes a desired course of cavity pressure in the injection and holding pressure phases. The cavity pressure course in the holding pressure phase is controlled online on the basis of pvT behavior of the processed plastic material. Thus, an optimal course of the process in the pvT diagram can be guaranteed and the quality constancy of the molded parts can be clearly increased. Using the pvT‐based process control, the effect of varying mold and melt temperatures on the molded part weight can be decreased by about 90% compared with the conventional process control. © 2009 Wiley Periodicals, Inc. Adv Polym Techn 28:65–76, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20153
Stressors, resources, and well‐being among Latino and White warehouse workers in the United States
Authors: Hoppe Annekatrin , Heaney Catherine A. , Fujishiro Kaori 
Published: September 2009

AbstractBackgroundSocial forces and cultural factors may contribute to Latino and White workers experiencing similar jobs differently. This study examines the psychosocial stressors and resources experienced by Latino and White workers in manual material handling jobs in the US and the effects of these stressors and resources on worker well‐being.MethodsFifty‐nine Latino warehouse workers were matched with White workers by job title, job tenure, and warehouse facility. Matched sample t tests and linear regression analyses models were conducted.ResultsResults reveal similar psychosocial stressors and resources for both groups. However, Latino workers reported better well‐being. For Latino workers, social resources at work such as management fairness and supervisor support have a stronger relationship with well‐being. For White workers wage fairness is the most significant predictor for well‐being.ConclusionsThese differential results challenge us to consider how cultural factors, expectations and the prior work history of Latino workers may influence their experience of work and the effect of work on health. Am. J. Ind. Med. 53:252–263, 2010. © 2009 Wiley‐Liss, Inc.