bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Two Adjustable-Autonomy Models on the Scalability of Single-Human/Multiple-Robot Teams for Exploration Missions
Authors: Valero-Gomez Alberto , de la Puente Paloma , Hernando Miguel 
Published: October 2011

Objective: The aim of this study was to evaluate two models for adjusting autonomy in mobile robots to find out the best way for the operator to interact with the system with as many robots as possible. The first model is the most used in mobile robots; the second proposes a flexible autonomy management. Background: There are different ways of adjusting the autonomy level in man-machine systems: adjustable autonomy, in which the operator has the initiative over the autonomy level; adaptive autonomy, in which the autonomy level is adjusted depending on the task and context; and mixed initiatives. One of the drawbacks of using adjustable autonomy is that it is claimed not to be flexible enough, resulting in a high operator workload. We propose and evaluate a flexible adjustable autonomy model for robot-team supervision. Method: Two experiments were designed to test the scalability and performance of the man-machine system with two alternative configurations for the autonomy management. The independent variable is the number of robots, and the measured variable is the man-machine system performance. The experiments are between subjects. We have used ANOVA and Bonferroni post hoc analysis for analyzing the results. Results: On the basis of these analyses, we conclude that a flexible adjustable autonomy model results in better performance than the classic, rigid one, in which the operator directly chooses the autonomy level. Conclusion: Flexible autonomy adjustment permits one operator to control a team of robots with better results in terms of performance and robot use, as he or she can directly act at the error level, leaving the responsibility of readjusting and resuming the task to the system and hence reducing the operator’s workload. Application: The results can be applied to exploration robotics, mainly, in which one operator controls a team of robots. In general, these principles can be extended to other single-man/multiple-machine systems.
Using the Landmark–Route–Survey Framework to Evaluate Spatial Knowledge Obtained From Synthetic Vision Systems
Authors: Lapeyre Brigitte , Hourlier Sylvain , Servantie Xavier , N’Kaoua Bernard , Sauzéon Hélène 
Published: October 2011

Objective: Using the landmark–route–survey frame-work, this research investigated the effect of synthetic vision systems (SVS) in either low or high visibility conditions on performance in wayfinding and spatial-knowledge-based tasks that probed spatial awareness. Background: SVS are cockpit displays that depict computer-generated views of the terrain surrounding an aircraft and have been developed to support flight efficiency through improved spatial awareness. No studies have directly measured SVS impact on the three levels of spatial knowledge (landmark, route, and survey). Method: A total of 55 nonpilots learned a route in four different experimental conditions (high or low visibility, either with or without SVS). Subsequently, they underwent four recall tasks: wayfinding, scene recognition, scene classification, and sketch map. Six dependent measures were used to probe the three levels of spatial knowledge (selection errors, sorting errors, number of landmarks depicted, bidimensional regression) and their use in the wayfinding task (direction errors, designated landmark errors, and wayfinding verbalized hesitations). Results: SVS produced higher performance in all four tasks. The low visibility condition lowered the wayfinding and scene-recognition performance. Conclusion: The overall results indicated that visibility mostly affected the first level of spatial knowledge (landmark) inducing a decreased wayfinding performance, whereas the use of SVS influenced the three levels of spatial knowledge (route and survey) inducing an increased wayfinding performance. Application: Potential applications of this work include spatial knowledge-based measures to evaluate SVS prototypes as well as to assess the relationship between spatial knowledge and spatial awareness.
Mobile and Landline Telephone Performance Outcomes among Telephone‐Using Cochlear Implant Recipients
Authors: Tan Barrie Yau Boon , Gluth Michael Brian , Statham Elle Louise , Eikelboom Robert Henry , Atlas Marcus David 
Published: October 2011

ObjectiveTo objectively study mobile and standard landline telephone speech perception performance using cochlear implant recipients.Study DesignNonrandomized trial.SettingTertiary referral center.Subjects and MethodsTwenty‐five subjects enrolled in this study from a pool of 50 cochlear implant recipients who had participated in an earlier questionnaire study from which demographic data were gathered. Preoperative speech perception scores were collated from preoperative audiological data. Postoperative speech perception scores were calculated with subjects listening to the Australian Version of the Bamford‐Kowal‐Bench Sentence Test read aloud in a soundproof booth via live voice, played back on a speaker, on a standard landline and mobile phone. Telephone speech perception scores were analyzed and banded into 3 performance categories: very good (90%‐100%), good (80%‐89%), and fair (<80%).ResultsThe mean speech perception scores were 88.6% (SD, 14.3%) for postoperative recorded speech and 92.3% (SD, 10.7%) for live voice listening, which were significantly better than the mean score of 37.2% (SD, 29.1%) listening to recorded voice preoperatively. The mean speech perception score was 84.3% (SD, 20.7%) using a mobile telephone and 57% (SD, 29.4%) using the standard landline. Further analysis showed better performance with mobile phones over standard landlines. Seventy‐six percent of subjects attained at least good telephone speech performance (score >80%). Older patients had poorer telephone speech perception than younger patients did.ConclusionsMany cochlear implant recipients achieve good objective telephone speech perception performance, indicating that they should be effective telephone users, especially when using mobile telephones and among younger implant recipients.
Barriers and facilitators to the receipt of palliative care for people with dementia: The views of medical and nursing staff
Authors: Ryan Tony , Gardiner Clare , Bellamy Gary , Gott Merryn , Ingleton Christine 
Published: October 2011

Background: The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms of care, but evidence indicates that many fail to access such provision at the end of life. The role of the health care team is pivotal if people with dementia are to benefit from the transition to palliative care. Aim: This paper reports on qualitative research conducted in the UK that sought to explore the experiences of health care practitioners working in palliative care and sought to establish the issues relating to end-of-life care for people with dementia. Design: Eight focus groups and four individual interviews were held. Data were analysed using a thematic approach. Setting/participants: The study included palliative care practitioners (n = 58) including medical, nursing and allied health professionals. Participants were recruited from acute hospitals, general practice, hospices and specialist palliative care units in the UK. Results: Four themes were identified: Making the transition; Competence challenged; ‘The long view’ and Working together. Whilst there exists good practice in this area, the barriers to timely and appropriate transitions to palliative care for people with dementia and their families continue to exist. The paper concludes with recommendations for policy and practice development.
Donor-specific anti-HLA Abs and graft failure in matched unrelated donor hematopoietic stem cell transplantation
Authors: Ciurea Stefan O. , Thall Peter F. , Wang Xuemei , Wang Sa A. , Hu Ying , Cano Pedro , Aung Fleur , Rondon Gabriela , Molldrem Jeffrey J. , Korbling Martin , Shpall Elizabeth J. , de Lima Marcos , Champlin Richard E. , Fernandez-Vina Marcelo 
Published: October 2011

AbstractAnti-HLA donor-specific Abs (DSAs) have been reported to be associated with graft failure in mismatched hematopoietic stem cell transplantation; however, their role in the development of graft failure in matched unrelated donor (MUD) transplantation remains unclear. We hypothesize that DSAs against a mismatched HLA-DPB1 locus is associated with graft failure in this setting. The presence of anti-HLA Abs before transplantation was determined prospectively in 592 MUD transplantation recipients using mixed-screen beads in a solid-phase fluorescent assay. DSA identification was performed using single-Ag beads containing the corresponding donor's HLA-mismatched Ags. Anti-HLA Abs were detected in 116 patients (19.6%), including 20 patients (3.4%) with anti-DPB1 Abs. Overall, graft failure occurred in 19 of 592 patients (3.2%), including 16 of 584 (2.7%) patients without anti-HLA Abs compared with 3 of 8 (37.5%) patients with DSA (P = .0014). In multivariate analysis, DSAs were the only factor highly associated with graft failure (P = .0001; odds ratio = 21.3). Anti-HLA allosensitization was higher overall in women than in men (30.8% vs 12.1%; P < .0001) and higher in women with 1 (P = .008) and 2 or more pregnancies (P = .0003) than in men. We conclude that the presence of anti-DPB1 DSAs is associated with graft failure in MUD hematopoietic stem cell transplantation.
Randomized, Double-Blind, Placebo-Controlled Phase II Study of Single-Agent Oral Talactoferrin in Patients With Locally Advanced or Metastatic Non–Small-Cell Lung Cancer That Progressed After Chemotherapy
Authors: Parikh Purvish M. , Vaid Ashok , Advani Suresh H. , Digumarti Raghunadharao , Madhavan Jayaprakash , Nag Shona , Bapna Ajay , Sekhon Jagdev S. , Patil Shekhar , Ismail Preeti M. , Wang Yenyun , Varadhachary Atul , Zhu Junming , Malik Rajesh 
Published: October 2011

Purpose To investigate the activity and safety of oral talactoferrin (TLF) in patients with stages IIIB to IV non–small-cell lung cancer (NSCLC) for whom one or two prior lines of systemic anticancer therapy had failed. Patients and Methods Patients (n = 100) were randomly assigned to receive either oral TLF (1.5 g in 15 mL phosphate-based buffer) or placebo (15 mL phosphate-based buffer) twice per day in addition to supportive care. Oral TLF or placebo was administered for a maximum of three 14-week cycles with dosing for 12 consecutive weeks followed by 2 weeks off. The primary objective was overall survival (OS) in the intent-to-treat (ITT) patient population. Secondary objectives included progression-free survival (PFS), disease control rate (DCR), and safety. Results TLF was associated with improvement in OS in the ITT patient population, meeting the protocol-specified level of significance of a one-tailed P = .05. Compared with the placebo group, median OS increased by 65% in the TLF group (3.7 to 6.1 months; hazard ratio, 0.68; 90% CI, 0.47 to 0.98; P = .04 with one-tailed log-rank test). Supportive trends were also observed for PFS and DCR. TLF was well tolerated and, generally, there were fewer adverse events (AEs) and grade ≥ 3 AEs reported in the TLF arm. AEs were consistent with those expected in late-stage NSCLC. Conclusion TLF demonstrated an apparent improvement in OS in patients with stages IIIB to IV NSCLC for whom one or two prior lines of systemic anticancer therapy had failed and was well tolerated. These results should be confirmed in a global phase III trial.
Prognostic Value of the Stage 4S Metastatic Pattern and Tumor Biology in Patients With Metastatic Neuroblastoma Diagnosed Between Birth and 18 Months of Age
Authors: Taggart Denah R. , London Wendy B. , Schmidt Mary Lou , DuBois Steven G. , Monclair Tom F. , Nakagawara Akira , De Bernardi Bruno , Ambros Peter F. , Pearson Andrew D.J. , Cohn Susan L. , Matthay Katherine K. 
Published: October 2011

Purpose Patients with neuroblastoma younger than 12 months of age with a 4S pattern of disease (metastases limited to liver, skin, bone marrow) have better outcomes than infants with stage 4 disease. The new International Neuroblastoma Risk Group (INRG) staging system extends age to 18 months for the 4S pattern. Our aim was to determine which prognostic features could be used for optimal risk classification among patients younger than 18 months with metastatic disease. Methods Event-free survival (EFS) and overall survival were analyzed by log-rank tests, Cox models, and survival tree regression for 656 infants with stage 4S neuroblastoma younger than 12 months of age and 1,019 patients with stage 4 disease younger than 18 months of age in the INRG database. Results Unfavorable biologic features were more frequent in infants with stage 4 disease than in infants with 4S tumors and higher overall in those age 12 to 18 months (although not different for stage 4 v 4S pattern). EFS was significantly better for infants younger than 12 months with 4S pattern than with stage 4 disease (P < .01) but similar for toddlers age 12 to 18 months with stage 4 versus 4S pattern. Among 717 patients with stage 4S pattern, patients age 12 to 18 months had worse EFS than those age younger than 12 months (P < .01). MYCN, 11q, mitosis-karyorrhexis index (MKI), ploidy, and lactate dehydrogenase were independently statistically significant predictors of EFS and more highly predictive than age or metastatic pattern. MYCN, 11q, MKI, histology, and 1p were combined in a survival tree for improved risk stratification. Conclusion Tumor biology is more critical than age or metastatic pattern for prognosis of patients age younger than 18 months with metastatic neuroblastoma and should be considered for risk stratification.
Neurosurgical Management and Prognosis of Patients With Glioblastoma That Progresses During Bevacizumab Treatment
Authors: Clark Aaron J. , Lamborn Kathleen R. , Butowski Nicholas A. , Chang Susan M. , Prados Michael D. , Clarke Jennifer L. , McDermott Michael W. , Parsa Andrew T. , Berger Mitchel S. , Aghi Manish K. 
Published: October 2011

Abstract

BACKGROUND:
The management and prognosis of glioblastoma patients after Stupp protocol treatment and progression during bevacizumab (BV) treatment remain undefined.

OBJECTIVE:
We compared the morbidity and survival of patients whose glioblastomas progressed during BV treatment requiring craniotomy with those of patients not treated with BV.

METHODS:
We retrospectively reviewed patients who underwent craniotomy for recurrent glioblastoma from 2005 to 2009. Patients operated on for progression during BV (preoperative BV) were compared with patients receiving no BV or receiving BV after surgery (postoperative BV). Patients receiving BV preoperatively were compared with those patients whose gliobastoma progressed on BV treatment but were not operated on (no surgery).

RESULTS:
There were 23 preoperative BV patients, 135 no BV patients, 16 postoperative BV patients, and 25 no surgery patients. Patients receiving BV preoperatively had a worse postoperative overall survival rate (hazard ratio, 3.1; P &lt; .001) and worse postoperative progression-free survival rate (hazard ratio, 3.4, P &lt; .001) than patients not receiving BV. Patients receiving BV preoperatively had a higher perioperative morbidity rate (44%) than patients not receiving preoperative BV (21%) (P = 0.02). Survival after diagnosis was comparable between groups (86–93 weeks, P = .9), consistent with glioblastomas developing BV evasion being not intrinsically more aggressive, but possibly BV evasion conferring a uniquely poor prognosis. No surgery patients had a shorter overall survival after progression during BV treatment compared with preoperative BV patients (hazard ratio, 3.6, P &lt; .001).

CONCLUSION:
Patients whose glioblastomas progress while receiving BV leading to craniotomy exhibit shorter postoperative survival and more perioperative morbidity than patients not treated with BV. Although there may be benefits to surgical debulking, the decision to pursue repeat surgery in patients in whom BV treatment failed must be balanced against the increased risk of perioperative complications.
Ventriculoperitoneal Shunt Surgery Outcome in Adult Transition Patients With Pediatric-Onset Hydrocephalus
Authors: Reddy G. Kesava , Bollam Papireddy , Caldito Gloria , Guthikonda Bharat , Nanda Anil 
Published: October 2011

Abstract

BACKGROUND:
Ventriculoperitoneal shunting remains the most widely used neurosurgical procedure for the management of hydrocephalus, albeit with many complications.

OBJECTIVE:
To review and assess the long-term clinical outcome of ventriculoperitoneal shunt surgery in adult transition patients with pediatric-onset hydrocephalus.

METHODS:
Patients 17 years or older who underwent ventriculoperitoneal shunt placement for hydrocephalus during their pediatric years (younger than 17 years) were included. Medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively.

RESULTS:
A total of 105 adult patients with pediatric-onset hydrocephalus were included. The median age of the patients was 25.9 years. The median age at the time of the initial ventriculoperitoneal shunt placement was 1.0 year. The median follow-up time for all patients was 17.7 years. The incidence of shunt failure at 6 months was 15.2%, and the overall incidence of shunt failure was 82.9%. Single shunt revision occurred in 26.7% of the patients, and 56.2% had multiple shunt revisions. The cause of hydrocephalus was significantly associated with shunt survival for patients who had shunt failure before the age of 17 years. Being pediatric at first shunt revision, infection, proximal shunt complication, and other causes were independently associated with multiple shunt failures.

CONCLUSION:
The findings of this retrospective study show that the long-term ventriculoperitoneal shunt survival remains low in adult transition patients with pediatric-onset hydrocephalus.
Correlation Between Persistent Neurological Impairment and Clinical Outcome After Microdiscectomy for Treatment of Lumbar Disc Herniation
Authors: Righesso Orlando , Falavigna Asdrubal , Avanzi Osmar 
Published: October 2011

Abstract

BACKGROUND:
Outcome of lumbar disc herniation is often based on clinical scores and less frequently on the neurological examination. However, even when clinical outcome measures are favorable, patients may still experience motor or sensory impairment.

OBJECTIVE:
To evaluate the percentage of patients with persistent neurological deficits after lumbar disc surgery and whether these correlate with clinical outcome.

METHODS:
A total of 150 patients with sciatica and lumbar disc herniation with neurological impairment underwent microdiscectomy and were prospectively followed for 24 months. Patients were assessed pre- and postoperatively with neurological examination, the Oswestry Disability Index (ODI), and the visual analog scale (VAS) for pain.

RESULTS:
Twenty-four months after surgery, 25% of patients who presented with motor deficits, 40% of patients with sensory deficits, and 48% of patients with reflex abnormalities remained unchanged. The VAS and the ODI showed significant improvement in both patients with and without persistent neurological impairment immediately after surgical repair of the herniated disc with progressive improvement over the follow-up period. However, when calculating the area under the receiver operating characteristics curve, no statistically significant correlation could be established between the presence and persistence of neurological impairment and the 2 clinical scores.

CONCLUSION:
There seems to be no correlation between clinical results and neurological impairment when assessed by the VAS and ODI.
Surgical Treatment of Low-Grade Isthmic Spondylolisthesis With Transsacral Fibular Strut Grafts
Authors: Passias Peter G. , Kozanek Michal , Wood Kirkham B. 
Published: October 2011

Abstract

Background:
The ideal surgical treatment for adult low-grade isthmic spondylolisthesis (ALIS) remains unknown. Isolated anterior and posterior procedures are popular but have resulted in equivocal outcomes, whereas combined anterior and posterior procedures are associated with higher complication rates despite improved outcome.

Objective:
To evaluate the clinical and radiographic outcomes following the treatment of ALIS using a 1-stage posterior approach with posterior decompression and posterolateral arthrodesis combined with an interbody fibular allograft strut.

Methods:
Fifteen patients underwent fusion by a single surgeon using our modified technique. Seven patients were female and 8 were male, with a mean age of 48 years. All patients were classified as Meyerding grade II slips and underwent a posterior approach only, a decompressive laminectomy, and a circumferential fusion with the use of a transsacral fibular allograft and a posterolateral instrumented fusion. Postoperative clinical and radiographic evaluations were performed at 3, 6, and 12 months, and then on an annual basis.

Results:
The average follow-up interval was 61 months. Three complications were seen: a single dural tear, an L5 radiculopathy secondary to a malpositioned pedicle screw, and one patient with urinary retention. The spines of all patients were determined to be fused by the 6-month postoperative visit. All patients returned to their normal activities of daily living. Significant improvements in the visual analog score were seen at all follow-up intervals.

Conclusion:
Transsacral interbody fibular allograft can be used successfully to supplement a posterolateral instrumented fusion in selected patients with low-grade ALIS.
Management of Residual and Recurrent Aneurysms After Initial Endovascular Treatment
Authors: Dorfer Christian , Gruber Andreas , Standhardt Harald , Bavinzski Gerhard , Knosp Engelbert 
Published: October 2011

Abstract

Background:
Coil instability possibly translating into higher delayed rebleeding rates remains a concern in the endovascular management of cerebral aneurysms.

Objective:
To report on 127 patients with endovascular aneurysmal remnants who underwent re-treatment over an 18 year period.

Methods:
Patients presenting with aneurysm residuals &gt;20% of the original lesion, unstable neck remnants, aneurysmal regrowth, or new aneurysmal daughter sacs were treated by an individualized approach, using both endovascular and surgical techniques.

Results:
Seventy-five aneurysmal remnants (59.1%) were treated by further re-embolization. Standard coil embolization was used in 65 cases, stent-protected coiling in 9 cases, and balloon remodeled coiling in 1 case, respectively. Fifty-two (40.9%) aneurysmal remnants were treated surgically. Standard microsurgical clipping was used in 44 patients, parent artery occlusion or trapping under bypass protection in 5 cases, deliberate clipping of the basilar artery trunk in 2 cases, and aneurysm wrapping in one case, respectively. Mechanisms of aneurysm recurrence were coil compaction in 93 cases and regrowth in 34 cases. A single reembolization was sufficient to occlude 78.7% of recurrences from coil compaction, but only 14.3% of recurrences from aneurysm regrowth.

Conclusion:
The individualized approach resulted in complete occlusion of 114 aneurysms (89.7%), with neck remnants and residual aneurysms detectable in 11 (8.7%) and 2 (1.6%) cases, respectively. Treatment morbidity was 11.9%, without significant differences between surgical (15.6%) and endovascular (9.3%) patients (P = .09). Recurrences from coil compaction were safely treated by re-embolization, whereas recurrences from aneurysmal regrowth may best be managed surgically when technically feasible.