bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fabrication of bioactive porous bredigite (Ca7MgSi4O16) scaffold via space holder method
Authors: Ghomi Hamed , Emadi Rahmatollah 
Published: January 2018

AbstractBredigite has been recently evaluated as a biodegradable ceramic with high mechanical strength, biocompatibility, bioactivity and excellent cell behavior. The objective of this research was to fabricate a nanostructured bredigite scaffold for bone repair and restoration via the space holder technique. The crystallite size, phase composition, particle size, pore morphology and pore size distribution of the scaffold were characterized using X-ray diffraction, as well as transmission and scanning electron microscopy. The results showed the fabrication of a highly interconnected porous scaffold, with a total porosity of about 86%, a pore size of about 400–600 μm, and the compressive strength of about 1.1 MPa. The prepared scaffold with nanosized structure and high porosity level leading to a high specific surface area could be used as an ideal scaffold for bone regeneration in bone tissue engineering applications.
Systematic Review: ClearCode 34 – A Validated Prognostic Signature in Clear Cell Renal Cell Carcinoma (ccRCC)
Authors: Ghatalia Pooja , Rathmell W. Kimryn 
Published: January 2018

Background: ccA/ccB classification was developed to classify clear cell renal carcinoma (ccRCC) patients into high and low risk based on gene expression patterns. ClearCode34 is a genetic signature that was developed from the ccA/ccB classification to predict recurrence in localized ccRCC patients. Objective: This review will evaluate the molecular signature ClearCode34, discuss its role in predicting recurrence and consider the rational application of the tool as a strategy to guide future applications of adjunctive therapy in ccRCC. Methods: A review of all the relevant papers in PubMed with the terms “ccA/ccB” or “ClearCode34” in ccRCC were reviewed. Results: Gene expression data was used to model dominant molecular subtypes of ccRCC tumors using consensus clustering methods. The most stable model implied two dominant subgroups – subsequently named ccA and ccB. A 34-gene panel was developed for clinical application, with 10 genes highly expressed corresponding to ccB subtype and 24 from ccA subtype. ClearCode34 independently correlated with cancer-specific survival, overall survival and recurrence in localized ccRCC patients in multiple validations. Conclusions: ClearCode34 is a robust and well validated molecular signature that can identify aggressive ccRCC in primary tumors. Along with basic clinical and pathologic variables like stage, necrosis and grade, robust molecular based prognostic markers are needed that could help better predict groups of patients who will most benefit from risk-adapted treatment approaches.
Effects of modified constraint-induced movement therapy with trunk restraint in early stroke patients: A single-blinded, randomized, controlled, pilot trial
Authors: Bang Dae-Hyouk , Shin Won-Seob , Choi Ho-Suk 
Published: January 2018

BACKGROUND: Reducing compensatory strategies during repetitive upper-limb training may be helpful in relearning motor skills. OBJECTIVE: To explore the effects of modified constraint-induced movement therapy (mCIMT), additionally modified by adding trunk restraint (TR), on upper-limb function and activities of daily living (ADLs) in early post-stroke patients. METHODS: Twenty-four participants with early stroke were randomly assigned to mCIMT combined with TR (mCIMT + TR) or mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk for 4 weeks). Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer Assessment-Upper extremity (FMA-UE), the Modified Barthel index (MBI), the Maximal elbow extension angle during reaching (MEEAR), and Motor Activity Logs (MAL-AOU and MAL-QOM). RESULTS: The mCIMT + TR group exhibited greater improvement in the ARAT, FMA-UE, MBI, MEEAR, and MAL-AOU, and MAL-QOM than the mCIMT group. Statistical analyses showed significant differences in ARAT ( P = 0.003), FMA-UE ( P = 0.042), MBI ( P = 0.001), MEEAR ( P = 0.002), and MAL-AOU ( P = 0.005) between the groups. CONCLUSION: Modified CIMT combined with TR may be more effective than mCIMT alone in improving upper-limb function and ADLs in patients with early stroke.
French validation of the Stroke Specific Quality of Life Scale (SS-QoL)
Authors: Legris Nicolas , Devilliers Hervé , Daumas Anaïs , Carnet Didier , Charpy Jean-Pierre , Bastable Philip , Giroud Maurice , Béjot Yannick 
Published: January 2018

OBJECTIVE: To adapt the SS-QoL into French and test its psychometric properties. METHODS: Seventy-seven patients from a population-based registry were enrolled 3 months after their stroke. SS-QoL, NIHSS score, Barthel index, HAD, FSS, SF-36 scales, and MMSE were administered at enrolment. SS-QoL was re-administered at 15 days and 2 months. Internal consistency was assessed by Cronbach’s α coefficients, factorial validity by an exploratory factor analysis and external validity by Mann-Whitney test and Spearman’s correlations ( ρ), comparing SS-QoL scores with those obtained from established scales. Reliability was assessed by intra-class correlation coefficients (ICC) and responsiveness by standardized effect sizes (ES). RESULTS: Test-retest and inter-observer reliabilities were excellent (ICC> 0.88). Internal consistency was acceptable ( α= 0.65–0.91), except for the Personality domain ( α= 0.58). Factor analysis individualized eight homogenous axes. SS-QoL scores were different between groups opposed by their modified Rankin score at enrolment or their overall quality of life compared with pre-stroke status ( p < 0.001). Ten of the twelve domains correlated moderately ( ρ> 0.35) to strongly ( ρ> 0.5) with established measures. Nine domains were mildly to moderately responsive to change (ES> 0.3). CONCLUSION: The French version of the SS-QoL is a valid, reliable and moderately responsive instrument.
Validation of Manual Muscle Testing (MMT) in children and adolescents with cerebral palsy
Authors: Manikowska Faustyna , Chen Brian Po-Jung , Jóźwiak Marek , Lebiedowska Maria K. 
Published: January 2018

BACKGROUND: Weakness is a major impairment in many movement disorders, including cerebral palsy (CP), which presents as a decrease in muscle strength. Manual muscle testing (MMT) is very popular in clinical practice, however it has many limitations. OBJECTIVE: (1) Whether maximum voluntary contraction (MVC) measures differ across clinical MMT groups; (2) Whether an association exists between clinical MMT score groups and instrumental MVC measures. METHODS: Twenty-one participants with spastic CP were recruited (11 females and 10 males; age = 13.46±3.62 years). To achieve the aims of the study, we investigated the relationship between qualitative (MMT) and instrumental (MVC) measures of knee flexor muscles’ strength in patients with CP. RESULTS: MVC values increased somewhat proportionally with increasing MMT score group ( p = 0.032, MS = 207.54, F = 3.75). The differences in MVC values was only statistically significant between score groups 3 and 5. A weak correlation (R = 0.4, MVC = –2.54 + 4.50 MMT, p < 0.01) was found between measured MVCs and the MMT score groups. CONCLUSIONS: In pediatric research studies, instrumental MVC should be preferred over MMT scoring. Also, MMT score groups higher than 3 should be modified in clinical testing of children and adolescents with cerebral palsy.
Reproducibility of gait kinematics and kinetics in chronic stroke patients
Authors: Fotiadou Styliani , Aggeloussis Nikolaos , Gourgoulis Vassilios , Malliou Paraskevi , Papanas Nikolaos , Giannakou Erasmia , Iliopoulos Ioannis , Vadikolias Konstantinos , Terzoudi Aikaterini , Piperidou Haritomeni 
Published: January 2018

BACKGROUND: The search for reliable techniques to assess gait in stroke patients is crucial for the design and follow-up of rehabilitation programs. OBJECTIVE: To assess the reproducibility of kinematic and kinetic gait parameters in chronic stroke patients using a three-dimensional gait analysis system. METHODS: Ten chronic stroke patients were assessed while walking along a 20 m walkway at their natural speed, using a gait analysis system of six infrared cameras and two force plates. Each patient performed 10 gait trials on 2 separate days. Inter-measurement agreement was assessed with the Coefficient of Multiple Correlation, while Root Mean Square Differences were used to quantify the variability of the trials. RESULTS: The majority of kinetics and kinematics showed excellent reproducibility in all patients. Joints’ power seemed to be more reliable compared with joints’ angle and moment. Most parameters presented greater variability in non-paretic than the paretic leg, while they were less variable in the sagittal compared with the non-sagittal planes. Less than 10 trials were sufficient to obtain excellent reproducibility for most kinematic and kinetic parameters. CONCLUSIONS: The reproducibility of movement assessment through three-dimensional gait analysis appears excellent in chronic stroke patients.
Bilateral anodal transcranial direct current stimulation effect on balance and fearing of fall in patient with Parkinson’s disease
Authors: Hadoush Hikmat , Al-Jarrah Muhammed , Khalil Hanan , Al-Sharman Alham , Al-Ghazawi Sadik 
Published: January 2018

BACKGROUND: A number of studies have examined the therapeutic effects of transcranial direct current stimulation (tDCS) stimulation in patients with Parkinson’s disease (PD) using unilateral anodal stimulation applied either on the left or right brain hemisphere. However, PD involves the dysfunctions of both brain hemispheres. OBJECTIVES: This study investigates the therapeutic effects of bilateral anodal tDCS stimulation on balance and fear of fall outcomes in patient with PD. METHODS: Eighteen patients with idiopathic PD completed the study. Ten sessions of bilateral anodal tDCS stimulation were applied over the FC1 and FC2 targeting both pre-frontal and motor areas for each patient, 5 sessions per week for 2 weeks. Berg Balance Scale (BBS), Falls Efficacy Scale-International (FES-I), and 10 meters walk test (10mwt) were applied before and after the stimulation therapy. RESULTS: Paired t-test showed a significant increase in the BBS scores and decrease in the FES-I scores after the bilateral tDCS compared with those scores before tDCS therapy ( P < 0.05), as well improvement in the 10mwt scores. CONCLUSION: Our data showed that bilateral anodal tDCS serves as an effective, safe and feasible approach for rehabilitation of patients with PD with the issues related to balance and fear of fall.
Male and female opinions about orthotic devices of the lower limb: A multicentre, observational study in patients with central neurological movement disorders
Authors: Swinnen Eva , Lefeber Nina , Werbrouck Amber , Gesthuizen Yelena , Ceulemans Lisa , Christiaens Sofie , De Wael Lise , Buyl Ronald , Ilsbroukx Stephan , Van Nieuwenhoven Johan , Michielsen Marc , Lafosse Christophe , Kerckhofs Eric 
Published: January 2018

BACKGROUND AND OBJECTIVE: Because user-satisfaction and acceptance may partly determine the grade of compliance to an orthotic device (OD), the aim of this multicentre observational study was to inquire the reasons for acceptance and the user-satisfaction of an OD of the lower limb in male and female central neurological movement disorders (CNMD) patients. METHODS: Persons with CNMD having at least one prescribed OD of the lower limb were included. Two questionnaires were used: the MIRAD-ACCORT-II (reasons for acceptance) and a modified version of the D-QUEST 2.0 (user-satisfaction). Descriptive analyses were performed and to analyse the differences between the males’ and females’ answers Chi2- and Mann-Whitney U tests were used. RESULTS: Twenty-six stroke and 23 multiple sclerosis patients participated (53% males). “Comfort”, “safety”, “effectiveness” and “ease of use” were reported as most important aspects. 86% of the patients were (very) satisfied about their OD. Only for the aspect safety, compared to males, significant more females reported that if the OD is not safe enough they will not use it. CONCLUSION: For both, males and females, aspects related to comfort and functionality were reported as much more important than the esthetical aspects, and in general they are quite satisfied with the OD and the process of providing the OD. Orthopaedic technicians and health care providers can take these aspects into account when developing, constructing and providing OD’s.
A comparative study of rehabilitation therapy in traumatic upper limb peripheral nerve injuries
Authors: Milicin Cristian , Sîrbu Elena 
Published: January 2018

INTRODUCTION: Lower motor neurons are the only neurons of the central nervous system (CNS) with the ability to regenerate without any intervention after an axotomy. AIM: This present study was conducted to analyze clinical and electrophysiological parameters in four groups of upper limb peripheral neuropathies, before and after treatment, comparing the results obtained after three cures of complex rehabilitation therapy. MATERIALS AND METHODS: We selected a number of 107 patients (66 women and 41 men) aged between 29 and 77 years (mean age = 49.6). Clinical (muscular strength, sensitivity) and electrophysiological parameters (accommodation coefficient α, nerve conduction velocity) were analyzed. All patients received 3 comprehensive treatment cures, each cure of 14 days and a rest period of 3 months between the cures. RESULTS: From the total of 107 patients included in the study, 52 were diagnosed with brachial plexus palsy, 27 with radial nerve palsy, 18 with median nerve palsy and 10 with ulnar nerve palsy. We did not observe a statistically significant difference between the mean age of males (47.2) and females (51.2) ( p = 0.07), but peripheral neuropathies were more common in young males. At the end of the rehabilitation treatment all patients achieved better outcomes in muscle strength, sensitivity, adjustment coefficient α and nerve conduction velocity ( p < 0.001). CONCLUSION The intervention of a physical therapy program in patients with peripheral neuropathies provided significantly better outcomes in clinical and electrophysiological parameters. Our rehabilitation protocol can be considered an alternative in order to stimulate and accelerate the nerve regeneration process.
What is the opinion of patients with multiple sclerosis and their healthcare professionals about lower limb orthoses? A qualitative study using focus group discussions
Authors: Swinnen Eva , Deliens Tom , Dewulf Elke , Van Overstraeten Shauni , Lefeber Nina , Van Nieuwenhoven Johan , Ilsbroukx Stephan , Kerckhofs Eric 
Published: January 2018

OBJECTIVE: The aim of this study was to collect patients’ and healthcare professionals’ opinions about lower limb orthoses (LL-orthoses): 1) the positive and negative aspects; 2) the differences in wearing them according to location; and 3) their recommendations for future modifications. METHODS: Four focus group discussions were performed, with in total twenty patients with MS with a prescribed LL-orthosis and seven healthcare professionals. Audiotaped discussions were transcribed and qualitatively processed (NVivo11). RESULTS: Healthcare professionals and patients state that a LL-orthosis improves gait and reduces the risk of falling. Some negative aspects were indicated like stigmatization, difficulties to put on and off the LL-orthosis and the aesthetic aspects. Several patients mentioned that they did not get enough or no correct information about the adaptability and use of the orthoses. Opinions regarding differences in wearing according to location (e.g. in and outside the rehabilitation center) were diverse. Recommendations for future changes were e.g. more refined and firmer orthoses. CONCLUSIONS: The opinions collected are interesting for taking into account in the process of construction and delivering of LL-orthoses. Future research should focus on the opinions concerning different types of LL-orthosis in relation with the severity of the limitations of the patients.
Mildly disabled persons with multiple sclerosis use similar net joint power strategies as healthy controls when walking speed increases
Authors: Brincks John , Christensen Lars Ejsing , Rehnquist Mette Voigt , Petersen Jesper , Sørensen Henrik , Dalgas Ulrik 
Published: January 2018

BACKGROUND: To improve walking in persons with multiple sclerosis (MS), it is essential to understand the underlying mechanisms of walking. This study examined strategies in net joint power generated or absorbed by hip flexors, hip extensors, hip abductors, knee extensors, and plantar flexors in mildly disabled persons with MS and healthy controls at different walking speeds. METHODS: Thirteen persons with MS and thirteen healthy controls participated and peak net joint power was calculated using 3D motion analysis. RESULTS: In general, no differences were found between speed-matched healthy controls and persons with MS, but the fastest walking speed was significantly higher in healthy controls (2.42 m/s vs. 1.70 m/s). The net joint power increased in hip flexors, hip extensors, hip abductors, knee extensors and plantar flexors in both groups, when walking speed increased. Significant correlations between changes in walking speed and changes in net joint power of plantar flexors, hip extensors and hip flexors existed in healthy controls and persons with MS, and in net knee extensor absorption power of persons with MS only. CONCLUSION: In contrast to previous studies, these findings suggest that mildly disabled persons with MS used similar kinetic strategies as healthy controls to increase walking speed.
Using association rules to measure Subjective Organization after Acquired Brain Injury
Authors: Parente Frederick , Finley John-Christopher 
Published: January 2018

BACKGROUND: Subjective Organization (SO) refers to the human tendency to impose organization on our environment. Persons with Acquired Brain Injury (ABI) often lose the ability to organize however, there are no performance based measures of organization that can be used to document this disability. OBJECTIVE: The authors propose a method of association rule analysis (AR) that can be used as a clinical tool for assessing a patient’s ability to organize. METHOD: Twenty three patients with ABI recalled a list of twelve unrelated nouns over twelve study and test trials. Several measures of AR computed on these data were correlated with various measures of short-term, long-term, and delayed recall of the words. RESULTS: All of the AR measures correlated significantly with the short-term and long-term memory measures. The confidence measure was the best predictor of memory and the number of association rules generated was the best predictor of learning. CONCLUSIONS: The confidence measure can be used as a clinical tool to assess SO with individual ABI survivors.
Swallowing impairments in Amyotrophic Lateral Sclerosis and Myotonic Dystrophy type 1: Looking for the portrait of dysphagic patient in neuromuscular diseases
Authors: Andrenelli Elisa , Galli Federica Lucia , Gesuita Rosaria , Skrami Edlira , Logullo Francesco Ottavio , Provinciali Leandro , Capecci Marianna , Ceravolo Maria Gabriella , Coccia Michela 
Published: January 2018

BACKGROUND: Dysphagia is a critical symptom of Neuromuscular Diseases and is often associated with considerable morbidity and mortality. OBJECTIVE: This study is designed to investigate the prevalence of dysphagia and to identify different clinical profiles of swallowing disorders in Myotonic Dystrophy type 1 (DM1) and Amyotrophic Lateral Sclerosis (ALS), the most common Neuromuscular Diseases in the adult age. METHODS: Consecutive DM1 and ALS patients from 2013 to 2015 referred to a Centre for Neuromuscular Disease were enrolled. A comprehensive assessment of swallowing function with a Clinical Swallowing Examination and Fluid and Food Trials was performed. RESULTS: 157 patients were included: 86 ALS, 71 DM1. The dysphagic patients affected by ALS and DM1 (79% and 86% of the respective samples) showed two different profiles. ALS patients with dysphagia were older and underweight. They experienced a global dysfunction of the oral and pharyngeal phases with more difficulty in swallowing thin liquids. Conversely, DM1 patients with dysphagia were younger and tended to obesity. Most of them showed impairment of oral phase and had more frequently difficulty in swallowing solid bolus. CONCLUSION: The recognition of specific clinical profiles supports and guides the detection of swallowing disorders in patients with neuromuscular diseases.
Sexual orientation disclosure in health care: a systematic review
Authors: Brooks Hannah , Llewellyn Carrie D , Nadarzynski Tom , Pelloso Fernando Castilho , De Souza Guilherme Felipe , Pollard Alex , Jones Christina J 
Published: January 2018

BackgroundSignificant health disparities between sexual minority individuals (that is, lesbian, gay, bisexual, or transgender [LGBT]) and heterosexual individuals have been demonstrated.AimTo understand the barriers and facilitators to sexual orientation (SO) disclosure experienced by LGBT adults in healthcare settings.Design and settingMixed methods systematic review, including qualitative, quantitative, and mixed methods papers following PRISMA guidelines.MethodStudy quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a qualitative synthesis was performed. Studies were included if their participants were aged ≥18 years who either identified as LGBT, had a same-sex sexual relationship, or were attracted to a member of the same sex.ResultsThe review included 31 studies representing 2442 participants. Four overarching themes were identified as barriers or facilitators to SO disclosure: the moment of disclosure, the expected outcome of disclosure, the healthcare professional, and the environment or setting of disclosure. The most prominent themes were the perceived relevance of SO to care, the communication skills and language used by healthcare professionals, and the fear of poor treatment or reaction to disclosure.ConclusionThe facilitators and barriers to SO disclosure by LGBT individuals are widespread but most were modifiable and could therefore be targeted to improve healthcare professionals’ awareness of their patients’ SO. Healthcare professionals should be aware of the broad range of factors that influence SO disclosure and the potential disadvantageous effects of non-disclosure on care. The environment in which patients are seen should be welcoming of different SOs as well as ensuring that healthcare professionals’ communication skills, both verbal and non-verbal, are accepting and inclusive.