bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Exam and Evaluation of the Unstable Shoulder
Authors: Valencia Mora María , Ibán Miguel Ángel Ruiz , Heredia Jorge Diaz , Gutiérrez-Gómez Juan Carlos , Diaz Raquel Ruiz , Aramberri Mikel , Cobiella Carlos 
Published: September 2017

Background:The clinical evaluation of the patient with shoulder instability can be challenging. The pathological spectrum ranges from the straightforward “recurrent anterior dislocation” patient to the overhead athlete with a painful shoulder but not clear instability episodes. Advances in shoulder arthroscopy and imaging have helped in understanding the anatomy and physiopathology of the symptoms. The aim of this general article is to summarize the main examination manoeuvres that could be included in an overall approach to a patient with a suspicion of instability.Material and Methods:In order to achieve the above-mentioned objective, a thorough review of the literature has been performed. Data regarding sensibility and specificity of each test have been included as well as a detailed description of the indications to perform them. Also, the most frequent and recent variations of these diagnostic tests are included.Results:Laxity and instability should be considered separately. For anterior instability, a combination of apprehension, relocation and release tests provide great specificity. On the other hand, multidirectional or posterior instability can be difficult to diagnose especially when the main complain is pain.Conclusion:A detailed interview and clinical examination of the patient are mandatory in order to identify a shoulder instability problem. Range of motion of both shoulders, clicking of catching sensations as well as pain, should be considered together with dislocation and subluxation episodes. Specific instability and hyperlaxity tests should be also performed to obtain an accurate diagnosis.
Rehabilitation for Shoulder Instability – Current Approaches
Authors: Jaggi Anju , Alexander Susan 
Published: September 2017

Background:The shoulder relies predominantly on dynamic muscular control to provide stability. Successful treatment is highly dependent upon the correct clinical diagnosis, identification of anatomical structural defects and abnormal movement patterns so that rehabilitation programs can be designed accordingly and individualised to the patient.Method:A systematic outline is provided to guide the clinician on how to identify muscular insufficiencies both local to the shoulder joint and global muscles that can influence shoulder instability. Management is based on expert experience and current literature.Results:The Stanmore classification helps to correctly diagnose the type of instability and prioritise management. Symptom modification tests can help to guide management, however assessing individual muscle groups local to glenohumeral control is also recommended.Conclusion:Physical and psychosocial factors can influence motor control in the presence of pain and injury. A multi-disciplinary approach is required to avoid recurrence of symptoms with rehabilitation focusing on kinetic chain, scapular and gleno-humeral control.
Rationale of Cruciate Retaining Design in Rheumatoid Arthritis: A Review of Clinical Analysis and its Role in Rheumatoid Arthritis
Authors: Ashraf Munis , Sharma Om Prakash , Priyavadhana Sruthi , Sambandam Senthil Nathan , Mounasamy Varatharaj 
Published: September 2017

Background:
Over the years, proponents of total knee designs (cruciate retaining and posterior stabilised) have conducted several long-term
studies to claim the potential of these designs in several subsets of patients. Total knee arthroplasty (TKA)
in patients with rheumatoid arthritis has also been one such domain where numerous studies were conducted in the past.
A general perception among majority of arthroplasty surgeons is that, posterior stabilised (PS) is the implanted design
of choice among patients with Rheumatoid arthritis (RA). However, with the available literature there is a significant
disparity related to the selection of implants in patients with rheumatoid RA. In this review of literature, an attempt is made
to identify the clinical performance and role of one such implant design, the cruciate retaining (CR) prosthesis in rheumatoid arthritis.

Method:
The review was conducted after a series of advanced search in the following medical databases; Pub med, Biomed central, Cochrane
and Google scholar for articles related to long term follow up studies of cruciate retaining total knee arthroplasty in rheumatoid
arthritis using the keywords cruciate retaining prosthesis, total knee arthroplasty, rheumatoid arthritis.

Results:
The
available data demonstrate that the CR design is attributed with an excellent long term survivorship and functional outcome even in
follow up studies up to twenty-five years.

Conclusion:
The advantages of using a CR design are long term survivorship, controlled
femoral roll back and preservation of bone stock. Thus, the data gathered in this review lead to a consideration that the CR design is an implant
design on par with PS design in patients with RA.
The Meaning of Flowers: A Cultural and Perceptual Exploration of Ornamental Flowers
Authors: Huss Efrat , Yosef Kfir Bar , Zaccai Michele 
Published: September 2017

Background:Since ancient times people have been attracted by flowers and have invested precious energy to cultivate them even though there is no known reward for this costly behavior- in all cultures. How can this attraction be understood? To what extend is this relationship between people and flowers made up of evolutionary, cognitive, perceptual, emotional or socio-cultural components? Does it shift within different cultures? How can we better understand the attraction of people to flowers on both a cultural and universal level? Many questions in this field remain open.Objective:To understand culturally constructed versus universal-perceptual components of the attraction of people to flowers. To explore how different types of cultivated flowers (with different perceptual elements) are conceptualized within a specific culture.Methods:Using mixed methods, we investigated the comparative preference of 150 participants for four visually different flowers. We explored the reasons for the preferred choice of flower. Based on the above first phase, we investigated participants' perceptions of the concept of a generic 'flower' and compared this to a mandala. Based on this second phase, we moved into cultural, perceptual and psychological theories using a concept-map, to access cultural understandings of specific flowers.Results:All four different flowers were equally chosen as first choice and therefore we introduced the generic or universal concept of 'floweriness' that was characterized by enhancing calmness and happiness.On this level, the concept of the flower ranked higher for inducing happiness as compared to a mandala shape that induced more interest. The other three flowers were ranked and differentiated in terms of the cultural connotations that their different visual components aroused, within the context of Israeli culture.Conclusion:The results illustrate the interactive synergetic interplay between universal perceptual and specific cultural elements in relation to specific flowers. Together with this differentiation, the results also point to a central concept of “floweriness” that transcends the specific cultural connotations of specific flowers.
Membangun Model Pelayanan Publik Desa : Mendekatkan Pelayanan Masyarakat di Tingkat Lokal
Authors: Marsono Marsono 
Published: September 2017

Construction of village’s public service model is imperative since village has more authorities as has been mandated by Law Number 6 of 2014 concerning the village. The authorities allow village government to prepare RPJMDes, APBDes, and village planning independently. Therefore, village has wider opportunities to improve its services in accordance with its nature and characteristics. In rural public service perspective, it is necessary to develop a public service model. This study concludes several things: (1) Classification, types and numbers of village services are different; (2) The village’s services are mostly in the form of recommendations at first level which then should be completed at higher levels at sub district and disctrictagencies; (3) To improve the quality of village’s services, they are classified into three groups, namely: (a) recommendation letter; (b) citizenship services; and (c) rural community empowerment. Furthermore, the recommended model is a dispersed model because village service is a part of public service system at subdistrict and disctrict levels. However, only a small part of the public services are fully completed at village government, such as administrative service.Keywords: Capacity building, public services, the village governmentPembangunan model pelayanan publik desa mendesak sejalan dengan meningkatnya kewenangan Pemerintahan Desa sebagaimana diamanatkan Undang-Undang Nomor 6 Tahun 2014 tentang Desa. Pemerintahan desa berwenang menyusun RPJMDes, APBDes, serta menyusun rencana pembangunan tahunan secara mandiri. Dengan demikian, terbuka peluang untuk memperbaiki pelayanan publik sesuai dengan sifat dan karakteristik desa. Oleh karena itu, dalam perspektif pelayanan publik desa, perlu disusun model pelayanan publik desa sesuai dengan kewenangannya. Studi tentang pengembangan model pelayanan publik desa ini telah menghasilkan kesimpulan : (1) Klasifikasi, jenis dan jumlahnya masih berbeda-beda; (2) Secara umum pelayanan publik desa masih berupa pengantar atau rekomendasi dan penyelesaian pelayanannya berada di Kantor Kecamatan atau bahkan di Dinas Teknis Pemerintah Kabupaten/Kota; (3) Untuk meningkatkan kualitas pelayanan publik desa, maka perlu dikelompokkan menjadi tiga, yaitu: (a) surat pengantar; (b) layanan kependudukan; dan (c) pemberdayaan masyarakat. Adapun model pelayanan publik desa yang direkomendasikan adalah model terpencar, mengingat pelayanan publik desa merupakan bagian yang tak terpisahkan dari sistem pelayanan publik Kecamatan dan Pemerintah Kabupaten/Kota. Hanya sebagian kecil saja pelayanan publik desa yang betul-betul dapat diselesaikan di desa, yaitu surat pengantar.Kata Kunci: Penguatan kapasitas, pelayanan publik, pemerintahan desa
Accelerometer-Determined Physical Activity and Clinical Low Back Pain Measures in Adolescents With Chronic or Subacute Recurrent Low Back Pain
Authors: Leininger Brent , Schulz Craig , Gao Zan , Bronfort Gert , Evans Roni , Pope Zachary , Zeng Nan , Haas Mitchell 
Published: September 2017

Study Design Cross-sectional. Background Although low back pain (LBP) occurs commonly in adolescence, little is known about the relationship between objectively measured physical activity and chronic LBP. Objectives To assess the relationship between an objective physical activity measure (accelerometer) and standard clinical measures (pain intensity, disability, and quality of life) in a sample of adolescents with recurrent or chronic LBP. Methods The study included a subsample of 143 adolescents, 12 to 18 years of age, from a randomized clinical trial. Pearson correlations (r) and bivariate linear regression were used to assess the relationship between baseline measures of sedentary, light, and moderate-to-vigorous physical activity using accelerometers and clinical measures of LBP (pain intensity, disability, and quality of life). Results Participants spent an average of 610.5 minutes in sedentary activity, 97.6 minutes in light physical activity, and 35.6 minutes in moderate-to-vigorous physical activity per day. Physical activity was very weakly associated with clinical measures of LBP (r<0.13). None of the assessed correlations were statistically significant, and bivariate regression models showed that physical activity measures explained very little of the variability for clinical measures of LBP (R2<0.02). Conclusion We found no important relationship between objectively measured physical activity and self-reported LBP intensity, disability, or quality of life in adolescents with recurrent or chronic LBP. The parent randomized clinical trial was registered at ClinicalTrials.gov (NCT01096628). J Orthop Sports Phys Ther 2017;47(10):769–774. Epub 12 Sep 2017. doi:10.2519/jospt.2017.7345
The Management of Complex Pain in Children Referred to a Pain Clinic at a Tertiary Children's Hospital in Australia
Authors: Collins John , Haynes Natasha , Klingberg Hannah , Nicholas Heather , Pounder Meg , Sandells Renee 
Published: September 2017

Synopsis One of the key aspects of good health care for children and young people is the prevention and management of pain. The experience of persistent pain in children and adolescents not only has a major impact on physical, emotional, social, and developmental well-being, but also impacts the broader world, which includes family, school, and social networks. The multidisciplinary pediatric pain clinic adopts a holistic approach to care through a biopsychosocial model. One outcome of an initial pediatric pain clinic review is the creation of a pain management plan that addresses the pharmacological, physical, psychological, and other domains of care. Pediatric pain clinics are improving access by embracing technology through tele-health and internet-based treatment options. Outcome measurement will guide the development of models of care in the future. J Orthop Sports Phys Ther 2017;47(10):806–813. Epub 12 Sep 2017. doi:10.2519/jospt.2017.7355
Leukocyte-reduced platelet-rich plasma stimulates the in vitro proliferation of adipose-tissue derived mesenchymal stem cells depending on PDGF signaling
Authors: Lang Siegmund , Herrmann Marietta , Pfeifer Christian , Brockhoff Gero , Zellner Johannes , Nerlich Michael , Angele Peter , Prantl Lukas , Gehmert Sebastian , Loibl Markus 
Published: September 2017

BACKGROUND: Platelet-rich Plasma (PRP) is suggested as xenoprotein-free cell-culture medium replacement for animal-derived supplements. OBJECTIVE: The aim of this study was to investigate PRP-triggered signaling in adipose derived mesenchymal stem cells (ASCs). METHODS: PRP was obtained from 4 male patients. We incubated ASCs in α-MEM with different Platelet derived growth factor (PDGF) subtypes or 10% or 20% pooled PRP or 20% fetal calf serum (FCS) prior to determination of the S-phase fraction (SPF). To investigate the influence of PDGF signaling on ASCs, PDGF receptor β inhibitor was added, and protein expression of ASCs was measured. RESULTS: ASCs exposed to 20% PRP, PDGF-AB and – BB demonstrated significant higher SPF in comparison to PDGF-AA and 20% FCS after 48 hours (all P < 0.05). PDGF receptor β inhibition diminished the PRP-induced SPF increase of ASCs significantly after 48 hours ( P < 0.01). ASCs with PDGF receptor β inhibition showed significant higher PDGF receptor β and significant lower c-MYC expression compared to untreated cells in presence of 20% PRP after 48 hours (both P < 0.05). CONCLUSIONS: The proliferation promoting effect of PRP on ASCs is mediated by PDGF signaling and is associated with c-MYC overexpression.
Can Musical or Painting Interventions Improve Chronic Pain, Mood, Quality of Life, and Cognition in Patients with Mild Alzheimer’s Disease? Evidence from a Randomized Controlled Trial
Authors: Pongan Elodie , Tillmann Barbara , Leveque Yohana , Trombert Béatrice , Getenet Jean Claude , Auguste Nicolas , Dauphinot Virginie , El Haouari Hanane , Navez Malou , Dorey Jean-Michel , Krolak-Salmon Pierre ,   The LACMé Group, Laurent Bernard , Rouch Isabelle , Auguste Nicolas , Bachelet Romain , Brunon Laurence , Dayot Jenny , Dorey Jean-Michel , El Haouari Hanane , Fatisson Marion , Ferrer Marion , Gaillat Charlotte , Gentil Claire , Getenet Jean Claude , Goldet Karine , Krolak-Salmon Pierre , Laurent Bernard , Leroyer Marie , Leveque Yohana , Michon Agnès , Mortreux Angélique , Navez Malou , Neagu Anca , Perrot Catherine , Pongan Elodie , Rouch Isabelle , Solimeo Mathilde , Tillmann Barbara , Touzet du Vigier Anaïs , Vulliez Elodie 
Published: September 2017

Background: Among non-pharmacological therapies, musical intervention is often used for patients with Alzheimer’s disease (AD) and patients presenting chronic pain. However, their efficacy is still under debate. Objective: Our aim was to determine the efficacy of choral singing versus painting sessions on chronic pain, mood, quality of life, and cognition in AD patients. Methods: In this multicenter randomized controlled trial, 59 mild AD patients were randomized to a 12-week singing (SG; n = 31) or painting group (PG; n = 28). Chronic pain, anxiety, depression, and quality of life were assessed before, after, and 1 month after the sessions. Cognitive abilities were assessed before and after interventions. The evolution of these different measures was assessed with mixed linear models. The primary data analysis was by intention-to-treat, and completed by a ‘per protocol’ approach. Results: Both singing and painting interventions led to significant pain reduction (Time effect: F = 4.71; p = 0.01), reduced anxiety (Time effect: F = 10.74; p < 0.0001), improved Quality of Life (Time effect: F = 6.79; p = 0.002), improved digit span (F = 12.93; p = 0.001), and inhibitory processes (Time effect: F = 4.93; p = 0.03). Depression was reduced over time in PG only (Time x Group effect: F = 4.53; p = 0.01). Verbal Memory performance remained stable over time in SG, but decreased in PG (Time x group effect: F = 9.29; p = 0.004). Conclusion: Findings suggest that singing and painting interventions may reduce pain and improve mood, quality of life, and cognition in patients with mild AD, with differential effects of painting for depression and singing for memory performance.
Statins and Cognition in Parkinson’s Disease
Authors: Deck Benjamin L. , Rick Jacqueline , Xie Sharon X. , Chen-Plotkin Alice , Duda John E. , Morley James F. , Chahine Lana M. , Dahodwala Nabila , Trojanowski John Q. , Weintraub Daniel 
Published: September 2017

Background: The relationship between statins and cognition in Parkinson’s disease (PD) is poorly understood. Objectives: Analyses were performed to determine associations between statin use and cross-sectional and longitudinal cognitive performance in PD. Methods: Neuropsychological tests, medication logs, and ratings of functional abilities were collected from 313 PD participants longitudinally. Results: At baseline, statin users (SU; N = 129) were older, more likely male, and had shorter PD duration than non-statin users (NSU; N = 184). In Cross-sectional analysis, SU performed better on global cognition, Trails B, semantic fluency, and phonemic fluency tasks. Rate of long-term global cognitive (Dementia Rating Scale-2 and MoCA) decline was significantly less in SU.
Evaluation of RNA Blood Biomarkers in Individuals at Risk of Parkinson’s Disease
Authors: Santiago Jose A. , Potashkin Judith A. 
Published: September 2017

Background: Substantial progress has been made in the discovery of blood biomarkers for Parkinson’s disease (PD), a progressive neurodegenerative disease that affects more than 4 million worldwide. Olfactory dysfunction and dopamine deficits usually precede motor symptoms years before the onset of PD. A readily accessible biomarker useful for identifying patients at risk of PD is expected to accelerate clinical trials. Objective: To evaluate previously identified PD blood RNA biomarkers in a cohort of asymptomatic individuals at risk of PD. Methods: Here we tested 16 previously identified PD RNA biomarkers using quantitative PCR assays in a total of 269 blood samples at baseline from hyposmic and normosmic participants enrolled in the Parkinson’s Associated Risk Syndrome study. Results: Expression levels of four biomarkers, SOD2, PKM2, ZNF134, and ZNF160 were negatively correlated with the total Unified Parkinson’s Disease Rating Scale, thus suggesting these biomarkers may be useful to stratify patients prior to the onset of motor symptoms. Levels of SOD2 were upregulated in hyposmic males compared to females, whereas levels of PKM2 were upregulated in hyposmic males compared to normosmic males and hyposmic females. Further, levels of SOD2 were upregulated in males with abnormal dopamine transporter (DAT) scans compared to females with abnormal DAT scans. Conclusions: These results suggest that some of these biomarkers may be useful for stratification of individuals at risk for PD and that there may be sex differences in the expression of some biomarkers. Future studies in larger longitudinal studies will be key to assessing the validity of these findings.
Pancreatic Polypeptide in Parkinson’s Disease: A Potential Marker of Parasympathetic Denervation
Authors: Knudsen Karoline , Hartmann Bolette , Fedorova Tatyana D. , Østergaard Karen , Krogh Klaus , Møller Niels , Holst Jens J. , Borghammer Per 
Published: September 2017

Background and objectives: Parkinson’s disease (PD) patients experience several non-motor symptoms from the gastrointestinal tract that may partly be caused by parasympathetic deficiency. The pancreas is densely innervated by the vagus nerve, which mediates early meal-induced secretion of pancreatic polypeptide (PP). Early secretion after sham feeding has been validated as a marker of vagal integrity. Thus, the aim was to evaluate the ratio of increased PP plasma levels after sham feeding in PD and correlate findings with gastrointestinal transit time (GITT). Methods: Twenty-five PD patients and 17 controls were included. PP, insulin, and blood glucose levels were measured before, during, and after sham feeding with white bread and chocolate spread. GITT was measured using radiopaque markers. Furthermore, faeces samples were analyzed for pancreatic elastase enzyme as a marker of exocrine pancreatic function. Results: PD patients showed significantly lower PP ratio levels after sham feeding, which was most pronounced at 10 minutes. No significant association was seen between attenuated PP response and GITT in PD patients. No between-group differences were seen in glucose or insulin levels over time, but PD patients showed generally lower insulin levels compared to controls. No difference was found in faeces pancreatic elastase. Conclusions: Early-to-moderate stage PD patients demonstrated significantly decreased PP response after sham feeding suggestive of vagal denervation.
Barriers, facilitators, and survival strategies for GPs seeking treatment for distress: a qualitative study
Authors: Spiers Johanna , Buszewicz Marta , Chew-Graham Carolyn A , Gerada Clare , Kessler David , Leggett Nick , Manning Chris , Taylor Anna Kathryn , Thornton Gail , Riley Ruth 
Published: September 2017

BackgroundGPs are under increasing pressure due to a lack of resources, a diminishing workforce, and rising patient demand. As a result, they may feel stressed, burnt out, anxious, or depressed.AimTo establish what might help or hinder GPs experiencing mental distress as they consider seeking help for their symptoms, and to explore potential survival strategies.Design and settingThe authors recruited 47 GP participants via e-mails to doctors attending a specialist service, adverts to local medical committees (LMCs) nationally and in GP publications, social media, and snowballing. Participants self-identified as either currently living with mental distress, returning to work following treatment, off sick or retired early as a result of mental distress, or without experience of mental distress. Interviews were conducted face to face or over the telephone.MethodTranscripts were uploaded to NVivo 11 and analysed using thematic analysis.ResultsBarriers and facilitators were related to work, stigma, and symptoms. Specifically, GPs discussed feeling a need to attend work, the stigma surrounding mental ill health, and issues around time, confidentiality, and privacy. Participants also reported difficulties accessing good-quality treatment. GPs also talked about cutting down or varying work content, or asserting boundaries to protect themselves.ConclusionSystemic changes, such as further information about specialist services designed to help GPs, are needed to support individual GPs and protect the profession from further damage.