bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance imaging characteristics and the prediction of outcome of vestibular schwannomas following Gamma Knife radiosurgery
Authors: Wu Chih-Chun , Guo Wan-Yuo , Chung Wen-Yuh , Wu Hisu-Mei , Lin Chung-Jung , Lee Cheng-Chia , Liu Kang-Du , Yang Huai-che 
Published: February 2017

OBJECTIVEGamma Knife surgery (GKS) is a promising treatment modality for patients with vestibular schwannomas (VSs), but a small percentage of patients have persistent postradiosurgical tumor growth. The aim of this study was to determine the clinical and quantitative MRI features of VS as predictors of long-term tumor control after GKS.METHODSThe authors performed a retrospective study of all patients with VS treated with GKS using the Leksell Gamma Knife Unit between 2005 and 2013 at their institution. A total of 187 patients who had a minimum of 24 months of clinical and radiological assessment after radiosurgery were included in this study. Those who underwent a craniotomy with tumor removal before and after GKS were excluded. Study patients comprised 85 (45.5%) males and 102 (54.5%) females, with a median age of 52.2 years (range 20.4–82.3 years). Tumor volumes, enhancing patterns, and apparent diffusion coefficient (ADC) values were measured by region of interest (ROI) analysis of the whole tumor by serial MRI before and after GKS.RESULTSThe median follow-up period was 60.8 months (range 24–128.9 months), and the median treated tumor volume was 3.54 cm3 (0.1–16.2 cm3). At last follow-up, imaging studies indicated that 150 tumors (80.2%) showed decreased tumor volume, 20 (10.7%) had stabilized, and 17 (9.1%) continued to grow following radiosurgery. The postradiosurgical outcome was not significantly correlated with pretreatment volumes or postradiosurgical enhancing patterns. Tumors that showed regression within the initial 12 months following radiosurgery were more likely to have a larger volume reduction ratio at last follow-up than those that did not (volume reduction ratio 55% vs 23.6%, respectively; p < 0.001). Compared with solid VSs, cystic VSs were more likely to regress or stabilize in the initial postradiosurgical 6–12-month period and during extended follow-up. Cystic VSs exhibited a greater volume reduction ratio at last follow-up (cystic vs solid: 67.6% ± 24.1% vs 31.8% ± 51.9%; p < 0.001). The mean preradiosurgical maximum ADC (ADCmax) values of all VSs were significantly higher for those with tumor regression or stabilization at last follow-up compared with those with progression (2.391 vs 1.826 × 10−3 mm2/sec; p = 0.010).CONCLUSIONSLoss of central enhancement after radiosurgery was a common phenomenon, but it did not correlate with tumor volume outcome. Preradiosurgical MRI features including cystic components and ADCmax values can be helpful as predictors of treatment outcome.
Interactive Effects of Dementia Severity and Comorbidities on Medicare Expenditures
Authors: Zhu Carolyn W. , Cosentino Stephanie , Ornstein Katherine A. , Gu Yian , Andrews Howard , Stern Yaakov 
Published: February 2017

Background: Few studies have examined how dementia and comorbidities may interact to affect healthcare expenditures. Objective: To examine whether effects of dementia severity on Medicare expenditures differed for individuals with different levels of comorbidities. Methods: Data are drawn from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Comprehensive clinical assessments of dementia severity were systematically carried out at ∼18 month intervals. Dementia severity was measured by Clinical Dementia Rating (CDR). Comorbidities were measured by a modified Elixhauser comorbidities index. Generalized linear models examined effects of dementia severity, comorbidities, and their interactions on Medicare expenditures (1999–2010). Results: At baseline, 1,280 subjects were dementia free (CDR = 0, 66.4%), 490 had very mild dementia (CDR = 0.5, 25.4%), 108 had mild dementia (CDR = 1, 5.6%), and 49 had moderate/severe dementia (CDR = 2/3, 2.5%). Average annual Medicare expenditures for individuals with moderate/severe dementia were more than twice as high as those who were dementia free (CDR = 0: $9,108, CDR = 0.5/1: $11,664, CDR≥2: $19,604, p < 0.01). Expenditures were approximately 10 times higher among those with≥3 comorbidities than among those with no comorbidities ($2,612 for those with no comorbidities, to $6,109 for those with 1, $10,656 for those with 2, and $30,244 for those with≥3 comorbidities, p < 0.001). Dementia severity was associated with higher expenditures, but comorbidities were the most important predictor of expenditures. We did not find strong interaction effects between number of comorbidities and dementia severity. Conclusions: Increasing dementia severity and higher comorbidities are associated with higher Medicare expenditures. Care of individuals with dementia should focus on management of comorbidities.
Classification of Depression, Cognitive Disorders, and Co-Morbid Depression and Cognitive Disorders with Perfusion SPECT Neuroimaging
Authors: Amen Daniel G. , Krishnamani Pavitra , Meysami Somayeh , Newberg Andrew , Raji Cyrus A. 
Published: February 2017

Background: Depression and cognitive disorders (CDs) are two common co-morbid afflictions that commonly present with overlapping symptoms. Objective: To evaluate if perfusion neuroimaging with brain SPECT can distinguish persons with depression from those with CDs or both conditions. Methods: Inclusion criteria were DSM-IV defined depression or CDs (Alzheimer’s disease, vascular dementia, dementia not otherwise specified, and amnestic disorders not otherwise specified) including persons with both (total n = 4,541; 847 CDs, 3,269 depression, 425 with both). Perfusion differences between the groups were calculated using two-sampled t-tests corrected for multiple comparisons. Diagnostic separation was determined with discriminant analysis. Feature selection revealed predictive regions in delineating depression from CDs and comorbid cases. Results: Persons with CDs had lower cerebral perfusion compared to depression. In co-morbid persons, cerebral hypoperfusion was additive, with regions showing lower regional cerebral blood flow compared to either diagnosis alone. Both baseline and concentration SPECT regions yielded correct classification of 86% and leave one out cross-validation of 83%. AUC analysis for SPECT regions showed 86% accuracy, 80% sensitivity and 75% specificity. Discriminant analysis separated depression and CDs from comorbid cases with correct classification of 90.8% and cross validated accuracy of 88.6%. Area under the curve was 83% with sensitivity of 80% and specificity of 70%. Feature selection identified the most predictive regions in left hippocampus, right insula, cerebellar, and frontal lobe regions. Conclusion: Quantitative perfusion SPECT neuroimaging distinguishes depression from dementia and those with both co-morbidities. Perfusion brain SPECT can be utilized clinically to delineate between these two disorders.
Dual-afferent sensory input training for voluntary movement after stroke: A pilot randomized controlled study
Authors: Bae Seahyun , Kim Kyung-Yoon 
Published: February 2017

BACKGROUND: Stimulation through afferent sensory input is necessary to improve voluntary functional movement in stroke patients. OBJECTIVES: Dual-afferent sensory input, which combines electromyography-triggered functional electric stimulation (ETFES) and action observation, was investigated to determine its effects on voluntary movements in stroke patients. METHODS: This study was conducted on 18 patients with left hemiplegia diagnosed between 6 and 24 months prior. The 9 subjects in the dual-afferent sensory input (DASI) group underwent ETFES with action observation training for 4 weeks (20 min/d, 5 d/wk), while the 9 control group subjects underwent functional electric stimulation (FES) for the same duration. The outcome measures were the movement-related cortical potential (MRCP), H-reflex, electromyography (EMG), and balance. RESULTS: The control and DASI groups showed significant increases in MRCP, muscle activity, and balance, while H-reflex was significantly decreased. MRCP and balance showed significant differences between DASI and control groups. CONCLUSIONS: DASI stimulates voluntary movement in patients, causes rapid activation of the cerebral cortex, and reduces excessive excitation of spinal motor neurons. Therefore, DASI, which stimulates voluntary movement, has a greater effect on brain activation in stroke patients.
A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke
Authors: Fakhari Zahra , Ansari Noureddin Nakhostin , Naghdi Soofia , Mansouri Korosh , Radinmehr Hojjat 
Published: February 2017

BACKGROUND: Spasticity is a common complication after stroke. Dry needling (DN) is suggested as a novel method for treatment of muscle spasticity. OBJECTIVE: To explore the effects of DN on wrist flexors spasticity poststroke. METHODS: A single group, pretest-posttest clinical trial was used. Twenty nine patients with stroke (16 male; mean age 54.3 years) were tested at baseline (T0), immediately after DN (T1), and one hour after DN (T2). DN was applied for flexor carpi radialis (FCR) and flexor carpi ulnaris on the affected arm for single session, one minute per muscle. The Modified Modified Ashworth Scale (MMAS), passive resistance force, wrist active and passive range of motion, Box and Block Test, and FCR H-reflex were outcome measures. RESULTS: Significant reductions in MMAS scores were seen both immediately after DN and at 1-hour follow-up (median 2 at T0 to 1 at T1 and T2). There were significant improvements in other measures between the baseline values at T0 and those recorded immediately after the DN at T1 or one hour later at T2. CONCLUSIONS: This study suggests that DN reduced wrist flexors spasticity and alpha motor neuron excitability in patients with stroke, and improvements persisted for one hour after DN.
Effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke: A pilot randomized controlled trial
Authors: Dell’Uomo Daniela , Morone Giovanni , Centrella Antonio , Paolucci Stefano , Caltagirone Carlo , Grasso Maria Grazia , Traballesi Marco , Iosa Marco 
Published: February 2017

BACKGROUND: Despite upper limb rehabilitation is widely investigated in patients with stroke, the effects of scapulohumeral rehabilitation on trunk stabillization are mainly unknown. OBJECTIVE: To test the effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke. METHODS: A pilot randomized controlled trial with two groups of 14 patients each one performing 20 minutes per day, 5 days a week, for 6 weeks in add on to standard therapy. Experimental group performed a specific scapulohumeral rehabilitation protocol aiming to improve trunk competencies whereas control group performed conventional arm rehabilitation. Clinical scale tests and accelerometric evaluations were performed pre- and post-treatment. RESULTS: Experimental groups showed better scores at discharge at Trunk impairment Scale ( p < 0.001), Barthel Index ( p = 0.024), Trunk Control Test ( p = 0.002), Sitting Balance Scale ( p = 0.002), but neither at Fugl-Meyer Scale ( p = 0.194) nor Modified Ashworth Scale ( p = 0.114). Accelerometric analysis showed higher stability of trunk for experimental group especially during static and dynamic items. CONCLUSIONS: The recovery of scapulohumeral functions also acts on trunk stabilization post-stroke.
Effects of gait training using the Hybrid Assistive Limb® in recovery-phase stroke patients: A 2-month follow-up, randomized, controlled study
Authors: Watanabe Hiroki , Goto Ryohei , Tanaka Naoki , Matsumura Akira , Yanagi Hisako 
Published: February 2017

BACKGROUND: Gait training using the Hybrid Assistive Limb® (HAL®) may have beneficial effects on post-stroke gait function and independent walking. However, the long-term and medium-term efficacies of gait training using HAL® in stroke patients remain unclear. OBJECTIVE: To compare the medium-term efficacy of gait training using a single-leg version of the Hybrid Assistive Limb® (HAL®) on the paretic side with conventional gait training (CGT) in recovery-phase stroke patients. METHODS: Twenty-four post-stroke participants (HAL® group: n = 12, CGT group: n = 12) completed the trial. Over 4 weeks, all participants received twelve 20-min sessions of either HAL® (using the single-leg version of HAL® on the paretic side) or conventional (performed by skilled and experienced physical therapists) gait training. Outcome measures were evaluated prior to training, after 12 sessions, and at 8 and 12 weeks after intervention initiation. Functional Ambulation Category (FAC) was the primary outcome measure. RESULTS: The HAL® group showed significant improvement in FAC after 12 sessions, and at 8 and 12 weeks compared to the conventional group ( P = 0.02). CONCLUSIONS: The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention.
Impaired scaling of preparatory postural responses to repeated balance perturbations in Parkinsonian patients with comorbid white matter disease
Authors: Cioncoloni David , Martelli Lodovica , Rosignoli Deborah , Mazzocchio Riccardo 
Published: February 2017

BACKGROUND: Postural instability may result from altered sequencing of automatic motor programs for anticipatory postural corrections and/or impaired motor learning in Parkinson Disease (PD) patients. Comorbid white matter disease is a major determinant of axial motor impairment, leading to poorer stability than nigrostriatal dopaminergic denervation per se. OBJECTIVE: To assess differences in anticipatory control of postural stability function between subjects affected by PD with comorbid leukoaraiosis (LPD), idiopathic Parkinson disease (IPD) and elderly healthy subjects (EHS) as control group. METHODS: Eight patients with IPD, eight patients with LPD and eight age/weight matched elderly healthy subjects (EHS) were tested in standing position by measuring the Center of Pressure (CoP) along the anteroposterior axis (CoP-Y) while subjects were expecting three repeated backward surface translation. RESULTS: LPD patients positioned the CoP-Y significantly backward while waiting for the second and third platform translations, with respect to their COP-Y position in preparation for the first translation. The IPD and EHS showed no significant differences in the COP-Y position among the repeated perturbation trials. CONCLUSIONS: LPD patients show inability to rescale an effective preparatory postural pattern to known, repeated postural perturbations suggesting impaired sensory-motor strategies in anticipating perturbations. Anticipatory postural patterns remain effective in IPD patients.
Pilot study of the Sub-Symptom Threshold Exercise Program (SSTEP) for persistent concussion symptoms in youth
Authors: Chrisman Sara P.D. , Whitlock Kathryn B. , Somers Elissa , Burton Monique S. , Herring Stanley A. , Rowhani-Rahbar Ali , Rivara Frederick P. 
Published: February 2017

BACKGROUND: Prior studies suggest potential benefit using monitored aerobic exercise to treat youth with persistent concussion symptoms, but these studies have been small. OBJECTIVES: To explore the safety and potential benefits of a rehabilitative exercise intervention, the Sub-symptom Threshold Exercise Program (SSTEP), for treating youth with persistent concussion symptoms >1 month. METHODS: We conducted a retrospective cohort study of 83 youth who participated in SSTEP, completing trajectory analysis of concussion symptoms using the symptom subscale of the Sport Concussion Assessment Tool, version 2 (SCAT-2). RESULTS: The average age of patients was 14.9+/–2.3 years and 54% were female. Most concussions (76%) were due to sports, the majority from football and girls’ soccer, and 55% had a previous concussion. Comorbidity was not uncommon: 14% had history of ADHD and 16% history of depression and/or anxiety. Most patients improved following the intervention, and none reported worsening. Symptoms decreased exponentially following initiation of SSTEP, and trajectory did not differ by duration of symptoms at presentation (<6 weeks, 6–12 weeks, >12 weeks). CONCLUSIONS: Monitored exercise programs appear to be safe and potentially beneficial for youth with persistent concussive symptoms. Large-scale controlled studies are needed to examine efficacy, ideal timing and duration.
Comparison of online awareness and error behaviour during occupational performance by two individuals with traumatic brain injury and matched controls
Authors: Doig Emmah , Fleming Jenny , Lin Bonnie 
Published: February 2017

BACKGROUND: Online awareness and error behaviour has largely been studied using computer-based tests or prescribed functional tasks in participants with traumatic brain injury (TBI). OBJECTIVES: This study aimed to compare online awareness and error behaviour of two participants with TBI with two matched controls during tasks of meaning and importance to the participants with TBI, using an occupation-based online awareness assessment. METHODS: Participants were two males with TBI (aged 22 and 23) and two controls (aged 23 and 27). The participants with TBI identified personally meaningful occupations and performed each task on two consecutive occasions. Performances were video-recorded and assessed by two occupational therapists to measure the frequency of errors, the percent of errors that were self-corrected, and the types of error behaviours observed. RESULTS: The participants with TBI demonstrated more frequent errors and poorer self-correction of errors compared to controls. Control participants made greater improvements in error frequency and self-correction with practice, and demonstrated a narrower range of error behaviours. CONCLUSIONS: This study builds upon previous research, by utilising an individualised, occupation-based approach to assess error behaviour and online awareness.
Communication vulnerable in patients with Amyotrophic Lateral Sclerosis: A systematic review
Authors: Neto Lavoisier Leite , Constantini Ana Carolina , Chun Regina Yu Shon 
Published: February 2017

BACKGROUND: Individuals with Amyotrophic Lateral Sclerosis (ALS) exhibit speech disorders since the early stages that decrease the communication rate and interfere in social participation. OBJECTIVE: To conduct a literature review on communication vulnerable and Augmentative and Alternative Communication (AAC) in Amyotrophic Lateral Sclerosis. METHOD: Descriptors of the Health Sciences Descriptors (DeCS) were used: Amyotrophic Lateral Sclerosis, Health Vulnerability, Communication Barriers, Nonverbal Communication, and Communication Aids for Disabled. Articles in Portuguese and English from 2010 to 2015, fully available in the Virtual Health Library, PubMed, and Scopus were used. Duplicate articles and those not related to communication/language were excluded. RESULTS: Of the 94 articles found, 37 met the criteria. All of them were published in the USA and Europe, none was Brazilian; 27% of 2012 to 2014; 40.5% descriptive studies and 24.3% case studies; 45.9% addressed ALS and 24.3%, other serious motor alterations, including ALS. A large proportion (89.2%) addressed AAC, 70.3% Brain-Computer Interface (BCI). CONCLUSION: The results show that the researches recurrently addressed communication vulnerable, although not necessarily in these terms. The device which was most employed was the BCI, mainly in advanced stages of the disease.
Vanishing bone tumor (Gorham-Stout syndrome): A case report
Authors: Jindal Mohit , Garg Keerty 
Published: February 2017

Gorham-Stout syndrome/Vanishing bone tumor also known by a dozen other eponyms is an extremely rare disorder of the musculoskeletal system reported first in 1938 by Jackson and later detailed description was given by Gorham and Stout. Since then about 200 cases of this disorder have been reported. Gorham-Stout syndrome is a poorly understood disorder of abnormal lymphovascular proliferation resulting in a localized bone loss, usually painless unless complicated by a pathological fracture and usually involving the proximal humerus (most common),shoulder girdle, pelvis, skull and mandible. In our case, a 50 year old female presentedwith a 2 year history of pain and restriction in movements involving the left shoulder for which a skiagram revealed marked bone loss. Further investigations including MRI and Tc 99 bone scan were also affirmative. Biopsy revealed lymphovascular ectasia. The patient, diagnosed as a case of Stout syndrome, was managed with removal of the involved portion of proximal humerus and shoulder hemiarthroplasty. Post operatively the patient was put on bisphosphonates and recovered remarkably well. A high index of suspicion is required while managing a case of osteolytic lesions of bone. However due to limited available literature regarding this entity the prognosis and treatment protocols are yet to be established.
Grass plastomes reveal unexpected paraphyly with endemic species of Micrairoideae from India and new haplotype markers in Arundinoideae
Authors: Duvall Melvin R. , Yadav Shrirang R. , Burke Sean V. , Wysocki William P. 
Published: February 2017

PREMISE OF THE STUDY:We investigated the little‐studied Arundinoideae/Micrairoideae clade of grasses with an innovative plastome phylogenomic approach. This method gives robust results for taxa of uncertain phylogenetic placement. Arundinoideae comprise ∼45 species, although historically was much larger. Arundinoideae is notable for the widely invasive Phragmites australis. Micrairoideae comprise nine genera and ∼200 species. Some are threatened with extinction, including Hubbardia, some Isachne spp., and Limnopoa. Two micrairoid genera, Eriachne and Pheidochloa, exhibit C4 photosynthesis in this otherwise C3 subfamily and represent an independent origin of the C4 pathway among grasses.METHODS:Five new plastomes were sequenced with next‐generation sequencing‐by‐synthesis methods. Plastomes were assembled by de novo methods and phylogenetically analyzed with eight other recently published arundinoid or micrairoid plastomes and 11 outgroup species. Stable carbon isotope ratios were determined for micrairoid and arundinoid species to investigate ambiguities in the proxy evidence for C4 photosynthesis.KEY RESULTS:Phylogenomic analyses showed strong support for ingroup nodes in the Arundinoideae/Micrairoideae subtree, including a paraphyletic clade of Hubbardieae with Isachneae. Anatomical, biochemical, and positively selected sites data are ambiguous with regard to the photosynthetic pathways in Micrairoideae. Species of Hubbardia, Isachne, and Limnopoa were definitively shown by δ13C measurements to be C3 and Eriachne to be C4.CONCLUSIONS:Our plastome phylogenomic analyses for Micrairoideae are the first phylogenetic results to indicate paraphyly between Isachneae and Hubbardieae. The definitive δ13C data for four genera of Micrairoideae indicates the breadth of variation possible in the proxy evidence for photosynthetic pathways of both C3 and C4 taxa.