bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of an Early Mobilization Protocol in a Trauma and Burns Intensive Care Unit: A Retrospective Cohort Study
Authors: Clark Diane E. , Lowman John D. , Griffin Russell L. , Matthews Helen M. , Reiff Donald A. 
Published: August 2012

BackgroundBed rest and immobility in patients on mechanical ventilation or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase costs, and can be associated with decreased ICU and hospital lengths of stay (LOS).ObjectiveThe purpose of this study was to assess the effects of an early mobilization protocol on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU).DesignThis was a retrospective cohort study of an interdisciplinary quality-improvement program.MethodsPre– and post–early mobility program patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared.ResultsNo adverse events were reported related to the early mobility program. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and deep vein thrombosis) post–early mobility program. Ventilator days and TBICU and hospital lengths of stay were not significantly decreased.LimitationsUsing a historical control group, there was no way to account for other changes in patient care that may have occurred between the 2 periods that could have affected patient outcomes. The dose of physical activity both before and after the early mobility program were not specifically assessed.ConclusionsEarly mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administrators, have embraced the new culture of early mobilization in the ICU.
Which Prognostic Factors for Low Back Pain Are Generic Predictors of Outcome Across a Range of Recovery Domains?
Authors: Cook Chad E. , Learman Kenneth E. , O'Halloran Bryan J. , Showalter Christopher R. , Kabbaz Vincent J. , Goode Adam P. , Wright Alexis A. 
Published: August 2012

BackgroundRecovery from low back pain (LBP) is multidimensional and requires the use of multiple-response (outcome) measures to fully reflect these many dimensions. Predictive prognostic variables that are present or stable in all or most predictive models that use different outcome measures could be considered “universal” prognostic variables.ObjectiveThe aim of this study was to explore the potential of universal prognostic variables in predictive models for 4 different outcome measures in patients with mechanical LBP.DesignPredictive modeling was performed using data extracted from a randomized controlled trial. Four prognostic models were created using backward stepwise deletion logistic, Poisson, and linear regression.MethodsData were collected from 16 outpatient physical therapy facilities in 10 states. All 149 patients with LBP were treated with manual therapy and spine strengthening exercises until discharge. Four different measures of response were used: Oswestry Disability Index and Numeric Pain Rating Scale change scores, total visits, and report of rate of recovery.ResultsThe set of statistically significant predictors was dependent on the definition of response. All regression models were significant. Within both forms of the 4 models, meeting the clinical prediction rule for manipulation at baseline was present in all 4 models, whereas no irritability at baseline and diagnosis of sprains and strains were present in 2 of 4 of the predictive models.LimitationsThe primary limitation is that this study evaluated only 4 of the multiple outcome measures that are pertinent for patients with LBP.ConclusionsMeeting the clinical prediction rule was prognostic for all outcome measures and should be considered a universal prognostic predictor. Other predictive variables were dependent on the outcomes measure used in the predictive model.
Tipping Point Discourse in Dangerous Times
Authors: Russill Chris , Lavin Chad 
Published: August 2012

Abstract: The concept of the tipping point has reshaped how crisis is perceived and understood in public discourse. We study this trend in selected instances, including the 2005 Iraqi elections, the 2005 flooding in Louisiana, and the climate-change crisis, before situating Malcolm Gladwell's theory of the tipping point in historical context. We discuss how Gladwell interprets key dimensions of the epidemiological approach in an overly selective manner in order to advance a particular political perspective on public policy. This perspective restricts an understanding of the way social inequalities shape the environmental conditions, contexts, and politics of social problems.
Cinéma américain, communication politique et information
Authors: Gusse Isabelle 
Published: August 2012

Résumé : L'auteure appréhende le cinéma en tant que support de communication politique dans l'axe informateur/information. Il se dégage de l'analyse qualitative de trois films historiques américains (Good night, and good luck, Bobby et Across the universe) produits entre 2006 et 2007 et de leurs notes de production deux figures de l'informateur : réalisateurs et personnages expriment et relaient certains idéaux démocratiques liés au respect des droits fondamentaux du citoyen.
Cerebrospinal fluid volume measurements in hydrocephalic rats
Authors: Basati Sukhraaj , Desai Bhargav , Alaraj Ali , Charbel Fady , Linninger Andreas 
Published: August 2012

Object
Experimental data about the evolution of intracranial volume and pressure in cases of hydrocephalus are limited due to the lack of available monitoring techniques. In this study, the authors validate intracranial CSF volume measurements within the lateral ventricle, while simultaneously using impedance sensors and pressure transducers in hydrocephalic animals.

Methods
A volume sensor was fabricated and connected to a catheter that was used as a shunt to withdraw CSF. In vitro bench-top calibration experiments were created to provide data for the animal experiments and to validate the sensors. To validate the measurement technique in a physiological system, hydrocephalus was induced in weanling rats by kaolin injection into the cisterna magna. At 28 days after induction, the sensor was implanted into the lateral ventricles. After sealing the skull using dental cement, an acute CSF drainage/infusion protocol consisting of 4 sequential phases was performed with a pump. Implant location was confirmed via radiography using intraventricular iohexol contrast administration.

Results
Controlled CSF shunting in vivo with hydrocephalic rats resulted in precise and accurate sensor measurements (r = 0.98). Shunting resulted in a 17.3% maximum measurement error between measured volume and actual volume as assessed by a Bland-Altman plot. A secondary outcome confirmed that both ventricular volume and intracranial pressure decreased during CSF shunting and increased during infusion. Ventricular enlargement consistent with successful hydrocephalus induction was confirmed using imaging, as well as postmortem. These results indicate that volume monitoring is feasible for clinical cases of hydrocephalus.

Conclusions
This work marks a departure from traditional shunting systems currently used to treat hydrocephalus. The overall clinical application is to provide alternative monitoring and treatment options for patients. Future work includes development and testing of a chronic (long-term) volume monitoring system.
The therapeutic potential of ex vivo expanded CD133+ cells derived from human peripheral blood for peripheral nerve injuries
Authors: Ohtsubo Shin , Ishikawa Masakazu , Kamei Naosuke , Kijima Yasumu , Suzuki Osami , Sunagawa Toru , Higashi Yukihito , Masuda Haruchika , Asahara Takayuki , Ochi Mitsuo 
Published: August 2012

Object
CD133+ cells have the potential to enhance histological and functional recovery from peripheral nerve injury. However, the number of CD133+ cells safely obtained from human peripheral blood is extremely limited. To address this issue, the authors expanded CD133+ cells derived from human peripheral blood using the serum-free expansion culture method and transplanted these ex vivo expanded cells into a model of sciatic nerve defect in rats. The purpose of this study was to determine the potential of ex vivo expanded CD133+ cells to induce or enhance the repair of injured peripheral nerves.

Methods
Phosphate-buffered saline (PBS group [Group 1]), 105 fresh CD133+ cells (fresh group [Group 2]), 105 ex vivo expanded CD133+ cells (expansion group [Group 3]), or 104 fresh CD133+ cells (low-dose group [Group 4]) embedded in atelocollagen gel were transplanted into a silicone tube that was then used to bridge a 15-mm defect in the sciatic nerve of athymic rats (10 animals per group). At 8 weeks postsurgery, histological and functional evaluations of the regenerated tissues were performed.

Results
After 1 week of expansion culture, the number of cells increased 9.6 ± 3.3–fold. Based on the fluorescence-activated cell sorting analysis, it was demonstrated that the initial freshly isolated CD133+ cell population contained 93.22% ± 0.30% CD133+ cells and further confirmed that the expanded cells had a purity of 59.02% ± 1.58% CD133+ cells. However, the histologically and functionally regenerated nerves bridging the defects were recognized in all rats in Groups 2 and 3 and in 6 of 10 rats in Group 4. The nerves did not regenerate to bridge the defect in any of the rats in Group 1.

Conclusions
The authors' results show that ex vivo expanded CD133+ cells derived from human peripheral blood have a therapeutic potential similar to fresh CD133+ cells for peripheral nerve injuries. The ex vivo procedure that can be used to expand CD133+ cells without reducing their function represents a novel method for developing cell therapy for nerve defects in a clinical setting.
Electromagnetic-guided neuronavigation for safe placement of intraventricular catheters in pediatric neurosurgery
Authors: Hermann Elvis J. , Capelle Hans-Holger , Tschan Christoph A. , Krauss Joachim K. 
Published: August 2012

Object
Ventricular catheter shunt malfunction is the most common reason for shunt revision. Optimal ventricular catheter placement can be exceedingly difficult in patients with small ventricles or abnormal ventricular anatomy. Particularly in children and in premature infants with small head size, satisfactory positioning of the ventricular catheter can be a challenge. Navigation with electromagnetic tracking technology is an attractive and innovative therapeutic option. In this study, the authors demonstrate the advantages of using this technology for shunt placement in children.

Methods
Twenty-six children ranging in age from 4 days to 14 years (mean 3.8 years) with hydrocephalus and difficult ventricular anatomy or slit ventricles underwent electromagnetic-guided neuronavigated intraventricular catheter placement in a total of 29 procedures.

Results
The single-coil technology allows one to use flexible instruments, in this case the ventricular catheter stylet, to be tracked at the tip. Head movement during the operative procedure is possible without loss of navigation precision. The intraoperative catheter placement documented by screenshots correlated exactly with the position on the postoperative CT scan. There was no need for repeated ventricular punctures. There were no operative complications. Postoperatively, all children had accurate shunt placement. The overall shunt failure rate in our group was 15%, including 3 shunt infections (after 1 month, 5 months, and 10 months) requiring operative revision and 1 distal shunt failure. There were no proximal shunt malfunctions during follow-up (mean 23.5 months).

Conclusions
The electromagnetic-guided neuronavigation system enables safe and optimal catheter placement, especially in children and premature infants, alleviating the need for repeated cannulation attempts for ventricular puncture. In contrast to stereotactic techniques and conventional neuronavigation, there is no need for sharp head fixation using a Mayfield clamp. This technique may present the possibility of reducing proximal shunt failure rates and costs for hydrocephalus treatment in this age cohort.
Anatomical feasibility of performing intercostal and ilioinguinal nerve to pelvic nerve transfer: a possible technique to restore lower urinary tract innervation
Authors: Brown Justin M. , Barbe Mary F. , Albo Michael E. , Lai H. Henry , Ruggieri Michael R. 
Published: August 2012

Object
Nerve transfers are effective for restoring control to paralyzed somatic muscle groups and, recently, even to denervated detrusor muscle in a canine model. A pilot project was performed in cadavers to examine the feasibility of transferring somatic nerves to vesical branches of the pelvic nerve as a method for potentially restoring innervation to control the detrusor muscle in humans.

Methods
Eleven cadavers were dissected bilaterally to expose intercostal, ilioinguinal, and iliohypogastric nerves, along with vesical branches of the pelvic nerve. Ease of access and ability to transfer the former 3 nerves to the pelvic vesical nerves were assessed, as were nerve cross-sectional areas.

Results
The pelvic vesical nerves were accessed at the base of the bladder, inferior to the ureter and accompanied by inferior vesical vessels. The T-11 and T-12 intercostal nerves were too short for transfer to the pelvic vesical nerves without grafting. Ilioinguinal and iliohypogastric nerves (L-1 origin) were identified retroperitoneally and, with full dissection, were easily transferred to the pelvic vesical nerves intraabdominally. The mean cross-sectional area of the dominant pelvic vesical branch was 2.60 ± 0.169 mm2; ilioinguinal and iliohypogastric branches at the suggested transection site were 2.38 ± 0.32 mm2 (the means are expressed ± SEM).

Conclusions
Use of the ilioinguinal or iliohypogastric nerves for heterotopic transfer to pelvic vesical nerves is surgically feasible, based on anatomical location and cross-sectional areas.
Le mythe des premiers réfugiés climatiques : mouvements de populations et changements environnementaux aux îles Torrès (Vanouatou, Mélanésie)
Authors: Siméoni Patricia , Ballu Valérie 
Published: August 2012

Depuis la fin des années 1990, la montée du niveau de l’océan aux îles Torrès, dans le nord de l’archipel du Vanouatou, a provoqué l’inquiétude des communautés locales et internationales. En 2004, le village de Lataw sur l’île de Tégoua fut déplacé de plusieurs centaines de mètres avec le soutien du gouvernement du Vanouatou et de l’aide canadienne. Sur la scène internationale, ces villageois devinrent les « premiers réfugiés climatiques » de l’Histoire, et furent présentés comme les victimes du réchauffement. Notre étude porte sur deux villages de deux îles différentes du groupe qui ont vu au cours des douze dernières années leur morphologie côtière évoluer, un phénomène interprété comme lié au réchauffement climatique et à son corollaire : la montée des océans. Cet article présente une analyse des données géophysiques et eustatiques expliquant la variation relative du niveau marin. S’il contribue à la montée des eaux, le réchauffement climatique n’a pas le rôle dominant qui lui a été attribué dans les inondations observées aux Torrès. En effet, les mouvements tectoniques soudains (séismes) ou plus lents nommés intersismiques (entre les séismes), ainsi que des variations temporaires du niveau marin dans le bassin Pacifique liées par exemple à l’oscillation australe (El Niño et La Niña) sont les principaux responsables de la rapide montée des eaux observée sur la période 1997-2009. Les Torrès sont constituées d’un groupe d’îles faiblement peuplées dont les vicissitudes démographiques ont fortement contribué à la distribution contemporaine des habitants. Aujourd’hui essentiellement côtiers, les Torrésiens ne l’ont pas toujours été. Ils sont plus sensibles aux changements environnementaux littoraux que du temps où ils résidaient à l’intérieur des terres. Par ailleurs, leurs croyances en certains pouvoirs surnaturels qui pouvaient commander les éléments naturels subsistent mais de façon approximative au cœur de leurs nouvelles valeurs chrétiennes. Ces dernières n’étant pas axées sur la compréhension de l’environnement, elles n’aidèrent pas particulièrement les insulaires à moderniser leur perception des dangers environnementaux.
Aménagement durable des territoires soumis à de fortes contraintes : enjeux et perspectives à travers l'examen des outils juridiques. L'exemple de la basse vallée du Var (06)
Authors: Reghezza Magali , Sanseverino-Godfrin Valérie 
Published: August 2012

Le développement durable demande de reconsidérer l’aménagement d’espaces exposés à des risques naturels ou présentant de forts enjeux environnementaux. La basse vallée du Var (Alpes-Maritimes) constitue un exemple très représentatif de ces territoires considérés comme stratégiques pour le développement local, mais soumis à des dispositifs juridiques de protection très contraignants. Elle fait aujourd’hui l’objet d’un projet d’aménagement dans le cadre d’une opération d’intérêt national (OIN). Pour les porteurs de projet, cette opération est explicitement fondée sur la durabilité, « l’excellence écologique » devenant un moteur de métropolisation. Cet article propose d’étudier la difficile conciliation des objectifs de durabilité à partir des outils juridiques mis en œuvre sur ce territoire et de leurs usages par les différents acteurs. On s’attardera en particulier sur les conséquences de l’inadéquation entre les dispositifs juridiques existants et le nouveau référentiel du développement durable.
Symptoms of Anxiety in Patients with Autism Spectrum Disorder
Authors: Budoff Hillarie 
Published: August 2012

CME Educational Objectives

1.
Understand that symptoms of anxiety are common in patients with autism spectrum disorder (ASD).

2.
Incorporate into practice the knowledge that research suggests that selective serotonin reuptake inhibitor (SSRI) treatment for patients with ASD plus anxiety symptoms is effective in reducing anxiety.

3.
Know when cognitive-behavior therapy, in conjunction with direct instruction of social skills using applied behavior analysis intervention components, may be effective for treating anxiety in individuals with high-functioning ASD.

The patient is a 15-year-old boy who began exhibiting behavioral difficulties shortly after birth. At age 2 months, he cried all day, every day, and this lasted until he was 8 months old. He would have to be rocked violently to be soothed. He had to be touched constantly, and for months could not sleep without his mother’s touch; if she withdrew her hand he would start screaming. He complains of ongoing sleep issues.
Differentiation of Social Phobia from High-Functioning Autism Spectrum Disorder
Authors: Taylor Bonnie P. 
Published: August 2012

CME Educational Objectives

1.
To identify symptom similarities between social phobia and high-functioning autism spectrum disorder (ASD).

2.
To learn how to differentiate social phobia from high-functioning ASD.

3.
To understand how social phobia may manifest comorbidly with high-functioning ASD.

The patient is a 10-year-old boy who was brought to the clinic by his mother, who believes he is suffering from social phobia. The mother’s concern for her son stems from his poor eye contact, his preference to play alone, and his lack of peer friendships. According to the mother, her son spends most of his free time by himself on the computer, usually searching the Internet for superhero-related information. She interprets this behavior as his way of decompressing once he is away from the anxiety of being surrounded by people all day at school.
Determination of ADHD vs. Autism Spectrum Disorder
Authors: Antar Laura N. 
Published: August 2012

CME Educational Objectives

1.
Recognize that symptoms of inattention, impulsivity, and hyperactivity (attention-deficit/hyperactivity disorder [ADHD]) are common in patients with autism spectrum disorder (ASD), and ADHD symptoms should be considered an associated symptom domain of ASD.

2.
Understand that although the ADHD-associated symptom domain of ASD is often a target for treatment with medication, treatment has a slightly lower response rate and slightly more side effects than in patients with ADHD alone.

3.
Realize that pharmacologic treatment of the ADHD symptoms in patients with ASD may help them benefit from other interventions targeted at social deficits.

The patient is a 5-year, 6-month-old boy who has received comprehensive interventions for his sparse speech since he was 3 years old. He met most physical milestones on time, spoke words at 12 months, and phrases followed by sentences at 3 years. His IQ testing shows average intelligence. He has no fear of danger and will eat non-food items and lick objects. At times of transition, the patient can become combative with his mother and teachers, a daily occurrence that makes his mother consider home-schooling him for kindergarten, as he does not play with classmates nor is he learning. He cannot write the letters of his name, although he can spell it. The boy has trouble using spoons and is generally clumsy. He does not know the names of any children in his class, and although he insists on being watched by adults while he plays, he has no friends his age and does not play cooperatively or wait his turn.
Differential Diagnosis of Infantile Hemangiomas
Authors: Perman Marissa J. , Castelo-Soccio Leslie , Jen Melinda 
Published: August 2012

CME Educational Objectives

1.
Compare and contrast infantile hemangiomas with other vascular anomalies that may be confused clinically.

2.
Describe the vascular anomalies classification system according to the International Society for the Study of Vascular Anomalies (ISSVA), highlighting the differences between vascular tumors, such as infantile hemangiomas, and vascular malformations.

3.
Briefly review associated signs or syndromes found in the context of certain vascular anomalies.
Mondes possibles, lendemains qui chantent ? Projections utopiques dans la littérature de jeunesse contemporaine
Authors: Bazin Laurent 
Published: August 2012

Le roman contemporain pour adolescents met fréquemment en scène des alternatives au monde où nous vivons : positive, dans le cas de l’utopie proprement dit, ou négative, dans le cas de la contre-utopie. On analyse la façon dont sont présentées de telles alternatives en étudiant leurs caractéristiques (par comparaison avec ce qui est proposé en littérature générale) et en explorant les enjeux qui y sont liés (politiques, psychologiques, anthropologiques).