bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurologic Deficit Associated With Lateralizing Calcaneal Osteotomy for Cavovarus Foot Correction
Authors: VanValkenburg Scott , Hsu Raymond Y. , Palmer Daniel S. , Blankenhorn Brad , Den Hartog Bryan D. , DiGiovanni Christopher W. 
Published: June 2016

Background: Lateralizing calcaneal osteotomy (LCO) is a frequently used technique to correct hindfoot varus deformity. Tibial nerve palsy following this osteotomy has been described in case reports but the incidence has not been quantified. Methods: Eighty feet in 72 patients with cavovarus foot deformity were treated over a 6-year span by 2 surgeons at their respective institutions. Variations of the LCO were employed for correction per surgeon choice. A retrospective chart review analyzed osteotomy type, osteotomy location, amount of translation, and addition of a tarsal tunnel release in relation to the presence of any postoperative tibial nerve palsy. Tibial nerve branches affected and the time to resolution of any deficits was also noted. Results: The incidence of neurologic deficit following LCO was 34%. With an average follow-up of 19 months, a majority (59%) resolved fully at an average of 3 months. There was a correlation between the development of neurologic deficit and the location of the osteotomy in the middle third as compared to the posterior third of the calcaneal tuber. We found no relationship between the osteotomy type, amount of correction, or addition of a tarsal tunnel release and the incidence of neurologic injury. Conclusions: Tibial nerve palsy was not uncommon following LCO. Despite the fact that deficits were found to be transient, physicians should be more aware of this potential problem and counsel patients accordingly. To decrease the risk of this complication, we advocate extra caution when performing the osteotomy in the middle one-third of the calcaneal tuberosity. Although intuitively the addition of a tarsal tunnel release may protect against injury, no protective effect was demonstrated in this retrospective study. Level of Evidence: Level III, retrospective cohort study.
Osteochondral Autograft Transfer Combined With Cancellous Allografts for Large Cystic Osteochondral Defect of the Talus
Authors: Zhu Yuan , Xu Xiangyang 
Published: June 2016

Background: Large cystic osteochondral defects of the talus can be challenging to treat. This retrospective control study looked at the use of osteochondral autograft transfer combined with cancellous allograft in patients with advanced cartilage and subchondral bone damage of the talus. Methods: Thirteen patients were treated with large cystic osteochondral defect of the talus between February 2010 and July 2013. All of these cystic osteochondral defects were larger than 15 mm in diameter. The subchondral defects were filled with cancellous allograft and the center of the lesions were sealed with an osteochondral cylinder autograft that was harvested from the ipsilateral medial femoral condyle. The visual analog scale (VAS) score for pain during daily activities, American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS-AH) scores and subjective satisfaction survey rating were obtained. Plain radiographs and magnetic resonance imaging of the ankle were obtained before and after surgery. In 5 cases, arthroscopy was performed 12 months postoperatively, and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society. Twelve patients were available for follow-up at a mean of 25.4 months (range, 18 to 48 months). Results: Average postoperative AOFAS-AH score 12 months after surgery was 88±7 compared with 64±10 preoperatively. The mean VAS score decreased from 6±1 preoperatively to 1±1 at the latest follow-up. Seven patients rated their result as excellent, 5 as good and none as fair. The radiolucent area of the cysts disappeared on the plain radiographs in all cases. The mean International Cartilage Repair Society arthroscopic score from follow-up arthroscopy was 9±1 points. Conclusions: The use of osteochondral autograft transfer combined with cancellous allograft was an effective option for the treatment of large cystic talar osteochondral lesions. Level of Evidence: Level IV, retrospective case series.
Posterior to Anteriorly Directed Screws for Management of Talar Neck Fractures
Authors: Beltran Michael J. , Mitchell Phillip M. , Collinge Cory A. 
Published: June 2016

Background: Screws placed from posterior to anterior have been shown to be biomechanically and anatomically superior in the fixation of talar neck and neck-body fractures, yet most surgeons continue to place screws from an anterior start point. The safety and efficacy of percutaneously applied posterior screws has not been clinically defined, and functional outcomes after their use is lacking. Methods: After institutional review board approval, we performed a retrospective review of 24 consecutive talar neck fractures treated by a single surgeon that utilized posterior-to-anterior screw fixation. Clinical, radiographic, and functional outcomes were assessed at a minimum follow-up of 12 months. Functional outcomes including the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, Olerud-Molander Scores, and the Short Form 36 (SF-36) measurement were collected and reviewed. Average patient follow-up was 44 months. Results: According to the classification system of Canale and Kelly, there were 4 type I fractures, 15 type II fractures, 4 type III fractures, and 1 type IV fracture. Four patients had open fractures. One superficial wound infection occurred, 1 patient reported FHL stiffness, and 6 complained of numbness or paresthesias in the distribution of the sural nerve (5 transient, 1 permanent). One reoperation was required to exchange a screw impinging on the talonavicular joint. Radiographically, 44% developed a positive Hawkins sign, and the specificity of this finding was 100% for talar dome viability. Avascular necrosis developed in 43% of patients, with 33% revascularizing and none going on to collapse. Subtalar arthrosis developed in 62% of patients. Conclusion: Screws placed from posterior to anterior are a useful technique in the treatment of talar neck fractures. Functional outcomes following their use appear favorable compared with recent reports with minimal risk to local structures. Level of Evidence: Level IV, retrospective case series.
The Relationship Between Health-Promoting Behaviors and Metabolic Syndrome in Community-Dwelling Older Adults
Authors: Wu Tzu-Ting , Chen I-Ju , Cho Shu-Ling , Chiou Ai-Fu 
Published: June 2016

Background: Poor health-promoting behaviors increase the risk of chronic disease and disability in older adults. Nevertheless, the predictors of health-promoting behaviors and their relationship with metabolic syndrome have been poorly characterized in older Taiwanese adults. Objective: To explore the determinants of health-promoting behaviors in community-dwelling older adults in Taiwan and the relationship of health-promoting behaviors with metabolic syndrome. Methods: A cross-sectional design was used. A convenience sample of 200 community residents aged 60 years and over was recruited from two large communities in New Taipei City, Taiwan. Data collection included physical examination and a structured questionnaire including measures of health status, health-promoting behaviors, self-efficacy, social support, and metabolic syndrome. Results: Metabolic syndrome was found in 60% of older Taiwanese adults. These participants had higher scores in interpersonal relationships but lower scores in physical activity. Half of the health-promoting behaviors were explained by behavior-specific cognitions and affect, and 44% of behavior-specific cognitions and affect was explained by the health status of the older adult. Conclusions: Physical activity should be promoted in older Taiwanese adults. Positive behavior-specific cognitions and affect and better health status might impact the health-promoting behaviors of these adults.
Identification of galectin-3 as a possible antibody target for secondary progressive multiple sclerosis
Authors: Nishihara Hideaki , Shimizu Fumitaka , Kitagawa Takao , Yamanaka Nanami , Akada Junko , Kuramitsu Yasuhiro , Sano Yasuteru , Takeshita Yukio , Maeda Toshihiko , Abe Masaaki , Koga Michiaki , Nakamura Kazuyuki , Kanda Takashi 
Published: June 2016

Background: Recent studies have revealed that the disruption of the blood–brain barrier (BBB) might contribute to the induction of neurodegeneration in the progressive stage of multiple sclerosis (MS). Objective: We investigated a potential target for the serum auto-antibodies responsible for the BBB impairment in patients with secondary progressive MS (SPMS). Methods: We identified undetermined target antigens in human brain microvascular endothelial cells (BMECs) that reacted with auto-antibodies in sera from SPMS patients using a proteomic approach. In addition, we examined how the identified auto-antibodies compromise the BBB integrity. Results: We found that 10 of 11 SPMS sera had auto-antibodies against galectin-3, although the patients with other neurological diseases did not have these antibodies. Downregulation of galectin-3 led to elevated intercellular adhesion molecule-1 (ICAM-1) and phospho-nuclear factor-kappa (NFκ) B p65 expression in the BMECs. Exposure to SPMS patients’ sera also increased the protein levels of ICAM-1 and phospho-NFκB p65 in BMECs, but these effects induced by anti-galectin-3 immunoreactivity were canceled by the downregulation of galectin-3. Conclusion: Galectin-3 is a possible immunological target molecule of the pathogenic auto-antibodies and contributes to the persistent BBB breakdown in patients with SPMS. These antibodies may also serve as a novel biomarker for SPMS.
Slowly eroding lesions in multiple sclerosis
Authors: Sethi Varun , Nair Govind , Absinta Martina , Sati Pascal , Venkataraman Arun , Ohayon Joan , Wu Tianxia , Yang Kelly , Shea Colin , Dewey Blake E , Cortese Irene CM , Reich Daniel S 
Published: June 2016

Background: At autopsy, 20%–40% of chronic multiple sclerosis (MS) lesions are labeled “slowly expanding” and feature myelin phagocytosis at the lesion edge. As pathological lesion classification relies on a single, terminal time point, the rate of lesion expansion cannot be directly measured. Objective: To study long-term volume changes in individual MS lesions. Methods: Volumes of individual lesions on proton density magnetic resonance imaging (MRI) acquired between 1992 and 2015 were measured in 22 individuals (one lesion per person). After correction for acquisition protocol, a mixed model evaluated lesion volume changes. Results: The mean (standard deviation) lesion volume at baseline was 142 (82) mL, falling to 74 (51) mL after 16 (3) years. All lesions shrank over time. Change in lesion volume did not correlate with change in supratentorial brain volume ( p = 0.33). In simulations, the results could be explained by a process of slow radial expansion superimposed on substantially more rapid resorption of damaged tissue. Conclusion: We noted sustained radiological contraction of MS lesions, a surprising result given that fresh myelin breakdown products within chronic active lesions are observed relatively frequently at autopsy. Therefore, the primary pathological process in chronic lesions, even those described as “slowly expanding,” is likely to be tissue loss.
Challenges confronting African Americans and Hispanics living with chronic illness in their families
Authors: Saulsberry Loren , Blendon Robert J , Benson John M 
Published: June 2016

Objective To examine the life experiences of African American and Hispanic adults whose personal chronic illness and/or that of a family member is the biggest health problem for their families. Data source Telephone (landline and cell phone) interviews of random, nationally representative samples of 1081 African-American and 1478 Hispanic adults, age 18 and older. We evaluated the responses of 757 African-American and 697 Hispanic participants who reported a chronic illness as the biggest health problem in their families. Methods Weighted analysis of cross-sectional survey responses from African-American and Hispanic adults. Results African Americans and Hispanics with chronic illness in their families reported experiencing challenges with the health care delivery system, with financial/economic insecurity, and with their communities that may influence how they live with chronic disease. Discussion Policymakers and clinicians should be aware that some African-American and Hispanic patients face obstacles within and beyond the health care system that are relevant to how they live with chronic conditions affecting their families. Additional tools and supports may need to be identified and supplied to effectively manage chronic illness in these communities. The payment system for physicians should account for the supplementary supports and services these patients might require.
Characteristics of hand injuries caused by powered wood splitters
Authors: Jokihaara J. , Ranta T. K. P. , Leppänen O. V. , Hellevuo C. 
Published: June 2016

Accidents with powered wood splitters cause a distinct group of hand injuries in which the injury spectrum ranges from a minor lesion to mutilating defects. We studied these injuries in order to assess the consequences and estimate the associated costs. A 2-year cohort of patients was retrospectively identified from medical records. The details of the injuries and the treatment were collected, and estimates of the resources used were based on hospital billing and the average costs of sick leave and disability. A total of 67 patients were identified and seven of those were children. Most patients sustained a major hand injury and an emergency microsurgical operation was indicated in 40% of patients. The total cost associated with the injuries was estimated at €3.33 million (£2.56 million, US$3.62 million). The treatment of this relatively small number of injuries demands substantial medical resources, and most of the costs are due to sick leave and disability. Level of evidence IV
Relationship between timed 25-foot walk and diffusion tensor imaging in multiple sclerosis
Authors: Klineova Sylvia , Farber Rebecca , Saiote Catarina , Farrell Colleen , Delman Bradley N , Tanenbaum Lawrence N , Friedman Joshua , Inglese Matilde , Lublin Fred D , Krieger Stephen 
Published: June 2016

Objective/Background The majority of multiple sclerosis patients experience impaired walking ability, which impacts quality of life. Timed 25-foot walk is commonly used to gauge gait impairment but results can be broadly variable. Objective biological markers that correlate closely with patients’ disability are needed. Diffusion tensor imaging, quantifying fiber tract integrity, might provide such information. In this project we analyzed relationships between timed 25-foot walk, conventional and diffusion tensor imaging magnetic resonance imaging markers. Design/Methods A cohort of gait impaired multiple sclerosis patients underwent brain and cervical spinal cord magnetic resonance imaging. Diffusion tensor imaging mean diffusivity and fractional anisotropy were measured on the brain corticospinal tracts and spinal restricted field of vision at C2/3. We analyzed relationships between baseline timed 25-foot walk, conventional and diffusion tensor imaging magnetic resonance imaging markers. Results Multivariate linear regression analysis showed a statistically significant association between several magnetic resonance imaging and diffusion tensor imaging metrics and timed 25-foot walk: brain mean diffusivity corticospinal tracts (p = 0.004), brain corticospinal tracts axial and radial diffusivity (P = 0.004 and 0.02), grey matter volume (p = 0.05), white matter volume (p = 0.03) and normalized brain volume (P = 0.01). The linear regression model containing mean diffusivity corticospinal tracts and controlled for gait assistance was the best fit model (p = 0.004). Conclusions Our results suggest an association between diffusion tensor imaging metrics and gait impairment, evidenced by brain mean diffusivity corticospinal tracts and timed 25-foot walk.
Generalized enrichment analysis improves the detection of adverse drug events from the biomedical literature
Authors: Winnenburg Rainer , Shah Nigam H. 
Published: June 2016

Abstract
Background
Identification of associations between marketed drugs and adverse events from the biomedical literature assists drug safety monitoring efforts. Assessing the significance of such literature-derived associations and determining the granularity at which they should be captured remains a challenge. Here, we assess how defining a selection of adverse event terms from MeSH, based on information content, can improve the detection of adverse events for drugs and drug classes.

Results
We analyze a set of 105,354 candidate drug adverse event pairs extracted from article indexes in MEDLINE. First, we harmonize extracted adverse event terms by aggregating them into higher-level MeSH terms based on the terms’ information content. Then, we determine statistical enrichment of adverse events associated with drug and drug classes using a conditional hypergeometric test that adjusts for dependencies among associated terms. We compare our results with methods based on disproportionality analysis (proportional reporting ratio, PRR) and quantify the improvement in signal detection with our generalized enrichment analysis (GEA) approach using a gold standard of drug-adverse event associations spanning 174 drugs and four events. For single drugs, the best GEA method (Precision: .92/Recall: .71/F1-measure: .80) outperforms the best PRR based method (.69/.69/.69) on all four adverse event outcomes in our gold standard. For drug classes, our GEA performs similarly (.85/.69/.74) when increasing the level of abstraction for adverse event terms. Finally, on examining the 1609 individual drugs in our MEDLINE set, which map to chemical substances in ATC, we find signals for 1379 drugs (10,122 unique adverse event associations) on applying GEA with p < 0.005.

Conclusions
We present an approach based on generalized enrichment analysis that can be used to detect associations between drugs, drug classes and adverse events at a given level of granularity, at the same time correcting for known dependencies among events. Our study demonstrates the use of GEA, and the importance of choosing appropriate abstraction levels to complement current drug safety methods. We provide an R package for exploration of alternative abstraction levels of adverse event terms based on information content.
Coupled fixed point theorems in $C^{*}$-algebra-valued b-metric spaces with application
Authors: Bai Chuanzhi 
Published: June 2016

AbstractBased on the concept of a$C^{*}$C∗-algebra-valuedb-metric space, this paper establishes some coupled fixed point theorems for mapping satisfying different contractive conditions on such space. As applications, we obtain the existence and uniqueness of a solution for an integral equation.
Equivalence results between Nash equilibrium theorem and some fixed point theorems
Authors: Yu Jian , Wang Neng-Fa , Yang Zhe 
Published: June 2016

AbstractWe show that the Kakutani and Brouwer fixed point theorems can be obtained by directly using the Nash equilibrium theorem. The corresponding set-valued problems, such as the Kakutani fixed point theorem, Walras equilibrium theorem (set-valued excess demand function), and generalized variational inequality, can be derived from the Nash equilibrium theorem, with the aid of an inverse of the Berge maximum theorem. For the single-valued situation, we derive the Brouwer fixed point theorem, Walras equilibrium theorem (single-valued excess demand function), KKM lemma, and variational inequality from the Nash equilibrium theorem directly, without any recourse.
An exploratory genre analysis of three graduate degree research proposals in applied linguistics
Authors: Yin Bin 
Published: June 2016

AbstractThis exploratory study investigated the rhetorical structure of three research proposals written by students who successfully sought entry into MA/PhD programs in applied linguistics at a Singapore university. Despite the abundance of research on published academic texts (such as the research article), not much is known about research proposals written for degree admission purposes, which are identified as an occluded genre. Following the Swales tradition of genre analysis, the proposals were analyzed in terms of their rhetorical “move” structure, complemented by interviews with the proposal writers and one expert informant to elicit contextual factors such as intended readership, authorial positioning, and institutional expectations for this genre. The results show that the rhetorical structuring and the realization of moves were shaped by the communicative purpose of research proposals and disciplinary expectations. Differences between subfields of applied linguistics can be seen in the presence/absence of moves such as those related to proposed methodology. While exploratory in nature, this study sheds light on an important, occluded genre, with pedagogical implications.
Engineering approaches for regeneration of T lymphopoiesis
Authors: Roh Kyung-Ho , Roy Krishnendu 
Published: June 2016

Abstract
T cells play a central role in immune-homeostasis; specifically in the induction of antigen-specific adaptive immunity against pathogens and mutated self with immunological memory. The thymus is the unique organ where T cells are generated. In this review, first the complex structures and functions of various thymic microcompartments are briefly discussed to identify critical engineering targets for regeneration of thymic functions in vitro and in vivo. Then the biomimetic regenerative engineering approaches are reviewed in three categories: 1) reconstruction of 3-D thymic architecture, 2) cellular engineering, and 3) biomaterials-based artificial presentation of critical biomolecules. For each engineering approach, remaining challenges and clinical opportunities are also identified and discussed.