bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the Effects of Using an Oral Appliance to Reduce Movement Dysfunction in an Individual With Parkinson Disease: A Single-Subject Design Study
Authors: Lane Hillary , Rose Lindsey E. , Woodbrey Megan , Arghavani David , Lawrence Michael , Cavanaugh James T. 
Published: December 2016

Background and Purpose:
Clinical reports suggest that wearing an oral appliance can improve the gait and balance of an individual with Parkinson disease (PD). Our primary purpose was to systematically explore this effect using a single-subject study design and quantitative motion analysis. Secondarily, we sought to examine the quality-of-life outcomes following 1-month of routine oral appliance wear.

Methods:
The participant was a 73-year-old ambulatory man with mid-stage PD. Using an A-B-A design, for which a custom-made oral appliance served as the intervention, kinematic and kinetic data were captured during performance of Four Square Step Test, serpentine walk, and tandem walk tasks. Grip strength was quantified with a dynamometer. Quality-of-life outcomes were collected after 1 month of appliance wear using the Parkinson Disease Questionnaire-39 (PDQ-39). Perceived changes in balance, mobility, and quality of life were captured from the participant using an 11-point Global Rate of Change (GRC) scale.

Results:
Changes in mobility, postural control, and grip strength during appliance wear were suggestive of reduced movement dysfunction. The PDQ-39 revealed a significant improvement in quality of life, primarily related to increased emotional well-being, decreased stigma, and increased communication. GRC scores indicated a clinically significant improvement in ease of movement in the community (+3), ease of movement during the performance of activities of daily living (+4), and in standing balance while performing activities of daily living (+4).

Discussion and Conclusions:
Study findings provided quantitative evidence supporting the effectiveness of oral appliance wear for reducing movement dysfunction in a patient with mid-stage PD.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A155).
Reliability and Concurrent Validity of the Narrow Path Walking Test in Persons With Multiple Sclerosis
Authors: Rosenblum Uri , Melzer Itshak 
Published: December 2016

Background and Purpose:
About 90% of people with multiple sclerosis (PwMS) have gait instability and 50% fall. Reliable and clinically feasible methods of gait instability assessment are needed. The study investigated the reliability and validity of the Narrow Path Walking Test (NPWT) under single-task (ST) and dual-task (DT) conditions for PwMS.

Methods:
Thirty PwMS performed the NPWT on 2 different occasions, a week apart. Number of Steps, Trial Time, Trial Velocity, Step Length, Number of Step Errors, Number of Cognitive Task Errors, and Number of Balance Losses were measured. Intraclass correlation coefficients (ICC2,1) were calculated from the average values of NPWT parameters. Absolute reliability was quantified from standard error of measurement (SEM) and smallest real difference (SRD). Concurrent validity of NPWT with Functional Reach Test, Four Square Step Test (FSST), 12-item Multiple Sclerosis Walking Scale (MSWS-12), and 2 Minute Walking Test (2MWT) was determined using partial correlations.

Results:
Intraclass correlation coefficients (ICCs) for most NPWT parameters during ST and DT ranged from 0.46–0.94 and 0.55–0.95, respectively. The highest relative reliability was found for Number of Step Errors (ICC = 0.94 and 0.93, for ST and DT, respectively) and Trial Velocity (ICC = 0.83 and 0.86, for ST and DT, respectively). Absolute reliability was high for Number of Step Errors in ST (SEM % = 19.53%) and DT (SEM % = 18.14%) and low for Trial Velocity in ST (SEM % = 6.88%) and DT (SEM % = 7.29%). Significant correlations for Number of Step Errors and Trial Velocity were found with FSST, MSWS-12, and 2MWT.

Discussion and Conclusions:
In persons with PwMS performing the NPWT, Number of Step Errors and Trial Velocity were highly reliable parameters. Based on correlations with other measures of gait instability, Number of Step Errors was the most valid parameter of dynamic balance under the conditions of our test.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A159).
A Cross-sectional Analysis of the Characteristics of Individuals With Parkinson Disease Who Avoid Activities and Participation Due to Fear of Falling
Authors: Landers Merrill R. , Lopker Morgan , Newman Molly , Gourlie Russell , Sorensen Spencer , Vong Rithea 
Published: December 2016

Background and Purpose:Avoidance behavior can have deleterious consequences on health and quality of life for persons with Parkinson disease (PD); for this reason, it is important to identify potentially mitigable characteristics. We compared the characteristics of individuals with PD who exhibit fear of falling (FOF) avoidance behavior with those who do not.Methods:Fifty-nine participants with PD were classified as avoiders (n = 27) or nonavoiders (n = 32) by using the Fear of Falling Avoidance Behavior Questionnaire and compared across 5 domains: demographic characteristics; PD-specific symptoms (subtype, Movement Disorder Society–Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Hoehn and Yahr Scale, Parkinson's Disease Questionnaire–39 [PDQ-39]); balance and falls (fall history, Berg Balance Scale [BBS], Activities-Specific Balance Confidence [ABC] Scale, Impact of Events Scale, Consequences of Falling Questionnaire [CoFQ]); physical performance (30 Second Sit-to-Stand Test, Timed Up and Go Test, physical activity monitoring); and psychological factors (Zung Anxiety Scale, Beck Depression Inventory [BDI]).Results:There were no differences between avoiders and nonavoiders for demographic characteristics and fall history (Ps > 0.272). Avoiders had worse MDS-UPDRS (Ps < 0.014) and PDQ-39 scores (Ps < 0.028). Avoiders had poorer balance performance (BBS,P= 0.003), lower balance confidence (ABC,P< 0.001), and more fall catastrophization (CoFQ,P< 0.001). Avoiders reported more depression (P= 0.015) and anxiety (P= 0.028).Discussion and Conclusions:PD FOF avoiders had more involved symptoms and scored lower on balance and physical performance measures. In addition, they reported greater psychological stress. Several potentially mitigable characteristics of those with FOF avoidance behavior were identified.Video Abstract availablefor more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A153).
Effects of 2 Years of Exercise on Gait Impairment in People With Parkinson Disease: The PRET-PD Randomized Trial
Authors: Rafferty Miriam R. , Prodoehl Janey , Robichaud Julie A. , David Fabian J. , Poon Cynthia , Goelz Lisa C. , Vaillancourt David E. , Kohrt Wendy M. , Comella Cynthia L. , Corcos Daniel M. 
Published: December 2016

Background and Purpose:
This study presents a secondary analysis from the Progressive Resistance Exercise Training in Parkinson Disease (PRET-PD) trial investigating the effects of progressive resistance exercise (PRE) and a Parkinson disease (PD)-specific multimodal exercise program, modified Fitness Counts (mFC), on spatial, temporal, and stability-related gait impairments in people with PD.

Methods:
Forty-eight people with PD were randomized to participate in PRE or mFC 2 times a week for 24 months; 38 completed the study. Gait velocity, stride length, cadence, and double-support time were measured under 4 walking conditions (off-/on-medication, comfortable/fast speed). Ankle strength was also measured off- and on-medication. Twenty-four healthy controls provided comparison data at one time point.

Results:
At 24 months, there were no significant differences between exercise groups. Both groups improved fast gait velocity off-medication, cadence in all conditions, and plantarflexion strength off-/on-medication. Both groups with PD had more gait measures that approximated the healthy controls at 24 months than at baseline. Plantarflexion strength was significantly associated with gait velocity and stride length in people with PD at baseline and 24 months, but changes in strength were not associated with changes in gait.

Discussion and Conclusions:
Twenty-four months of PRE and mFC were associated with improved off-medication fast gait velocity and improved cadence in all conditions, which is important because temporal gait measures can be resistant to medications. Spatial and stability-related measures were resistant to long-term improvements, but did not decline over 24 months. Strength gains did not appear to transfer to gait.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A161).
A Survey Assessment of Perceived Importance and Methods of Maintenance of Critical Procedural Skills in Pediatric Emergency Medicine
Authors: Mittiga Matthew R. , FitzGerald Michael R. , Kerrey Benjamin T. 
Published: December 2016

Objective
The aim of this study was to delineate pediatric emergency medicine provider opinions regarding the importance of, and to ascertain existing processes by which practitioners maintain, the following critical procedural skills: oral endotracheal intubation, intraosseous line placement, pharmacologic and electrical cardioversion, tube thoracostomy, and defibrillation.

Methods
A customized survey was administered to all members of the Listserv for the American Academy of Pediatrics Section on Emergency Medicine. Perceived importance of maintaining critical pediatric procedural skills was measured using a 5-point Likert-type scale. Secondary outcomes included presence and type of mandatory training, availability of on-site backup, and perceived barriers to maintenance of skills.

Results
Two hundred sixty-two members (25%) responded representing 106 different institutions, 70% of freestanding children’s hospitals that received graduate medical education payments in 2014, and 68% of pediatric emergency medicine fellowship programs. More than 90% of respondents felt it was either very or extremely important to maintain competency for 5 of the 6 critical procedures, but no more than 49% of respondents felt that clinical care alone provided opportunity to maintain skills. The proportion of respondents indicating no mandatory training for each critical procedural skill was as follows: oral endotracheal intubation (23%), intraosseous line placement (30%), pharmacologic cardioversion (32%), electrical cardioversion (32%), tube thoracostomy (40%), and defibrillation (32%).

Conclusions
Critical procedural skills are perceived by emergency providers who care for children as extremely important to maintain. Direct care of pediatric patients likely does not provide sufficient opportunity to maintain these skills. There are widespread deficiencies relating to mandatory maintenance of critical procedural skill training.
Reliability of the Faces, Legs, Activity, Cry, and Consolability Scale in Assessing Acute Pain in the Pediatric Emergency Department
Authors: Kochman Adam , Howell John , Sheridan Michael , Kou Maybelle , Shelton Ryan Esther Emory , Lee Susan , Zettersten Wendy , Yoder Lauren 
Published: December 2016

Objectives
The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale is one of the most widely utilized observational pain assessment scales in clinical practice. Although designed and validated to assess postoperative pain, the tool is currently applied to assess acute pain in multiple settings, including the emergency department. Scarce literature exists evaluating the reliability of the FLACC scale in the nonsurgical population and none in the emergency department. We sought to investigate the reliability of the FLACC scale in assessing acute pain in the pediatric emergency department and to examine the sensitivity of FLACC scores after the administration of analgesia.

Methods
In phase 1 of this prospective study, a series of 2 independent evaluators, blinded to each other's evaluations, scored 66 patients using the FLACC tool. Degree of concordance among the 6 dyads was used to measure interrater reliability. In phase 2, FLACC scores were obtained just before the administration of analgesia in 35 patients and measured at 30 and at 60 minutes after administration.

Results
Among the 6 dyads of evaluators, Kendall W demonstrated a strong concordance (27 of 30 measures; range, 0.63–1.00) for individual components of the scale and for the composite scores (range, 0.85–0.96). Significant mean reductions from preanalgesia FLACC scores [5.54; 95% confidence interval (CI), 4.79–6.30] were seen at 30 minutes (2.00; 95% CI, 1.61–2.39) and 60 minutes (1.14; 95% CI, 0.79–1.50) postanalgesia (P < 0.0001 for all comparisons).

Conclusions
The FLACC scale demonstrated high interrater reliability for both individual FLACC items and total scores in a convenience sample of patients aged 6 months to 5 years in a pediatric emergency department. It seems to be an appropriate observational tool to assess acute pain in this population.
Hugoniot equation of state of rock materials under shock compression
Authors: Zhang Q. B. , Braithwaite C. H. , Zhao J. 
Published: December 2016

Two sets of shock compression tests (i.e. conventional and reverse impact) were conducted to determine the shock response of two rock materials using a plate impact facility. Embedded manganin stress gauges were used for the measurements of longitudinal stress and shock velocity. Photon Doppler velocimetry was used to capture the free surface velocity of the target. Experimental data were obtained on a fine-grained marble and a coarse-grained gabbro over a shock pressure range of approximately 1.5–12 GPa. Gabbro exhibited a linear Hugoniot equation of state (EOS) in the pressure–particle velocity (P–up) plane, while for marble a nonlinear response was observed. The EOS relations between shock velocity (US) and particle velocity (up) are linearly fitted asUS = 2.62 + 3.319upandUS = 5.4 85 + 1.038upfor marble and gabbro, respectively.This article is part of the themed issue ‘Experimental testing and modelling of brittle materials at high strain rates’.
Measurement of fracture properties of concrete at high strain rates
Authors: Rey-De-Pedraza V. , Cendón D. A. , Sánchez-Gálvez V. , Gálvez F. 
Published: December 2016

An analysis of the spalling technique of concrete bars using the modified Hopkinson bar was carried out. A new experimental configuration is proposed adding some variations to previous works. An increased length for concrete specimens was chosen and finite-element analysis was used for designing a conic projectile to obtain a suitable triangular impulse wave. The aim of this initial work is to establish an experimental framework which allows a simple and direct analysis of concrete subjected to high strain rates. The efforts and configuration of these primary tests, as well as the selected geometry and dimensions for the different elements, have been focused to achieve a simple way of identifying the fracture position and so the tensile strength of tested specimens. This dynamic tensile strength can be easily compared with previous values published in literature giving an idea of the accuracy of the method and technique proposed and the possibility to extend it in a near future to obtain other mechanical properties such as the fracture energy. The tests were instrumented with strain gauges, accelerometers and high-speed camera in order to validate the results by different ways. Results of the dynamic tensile strength of the tested concrete are presented.
This article is part of the themed issue ‘Experimental testing and modelling of brittle materials at high strain rates’.
High-performance concrete engineered for protective barriers
Authors: Dancygier Avraham N. 
Published: December 2016

This paper reviews the effects of high-performance concrete mix ingredients on its resistance to impact of non-deforming projectiles, and on the resistance of layered barriers, engineered based on these findings. First, the reported effects of the aggregate types and sizes and the application of steel fibres, which were observed experimentally, are presented, considering resistance parameters that include the impact energy at the ballistic limit, the extent of the damaged areas at the impacted (front) and rear faces and the overall damage. These findings indicate that a protective barrier may be engineered to have layers that utilize these effects to produce a better performance under impact. Results from reported experiments of double-layered specimens, which examined the effects of the aggregate size and application of fibres, confirm this idea to a certain extent. They lead to conclusions regarding the importance of fibres in mitigating the damage, the use of large aggregates in a thicker front layer and their associated effect on increasing the damage at the front, impacted face. A ‘resistance index’ is proposed to quantify the resistance in a comprehensive way and the experimental results have been re-evaluated in view of this parameter.
This article is part of the themed issue ‘Experimental testing and modelling of brittle materials at high strain rates’.
A pulse-shaping technique to investigate the behaviour of brittle materials subjected to plate-impact tests
Authors: Forquin Pascal , Zinszner Jean-Luc 
Published: December 2016

Owing to their significant hardness and compressive strengths, ceramic materials are widely employed for use with protective systems subjected to high-velocity impact loadings. Therefore, their mechanical behaviour along with damage mechanisms need to be significantly investigated as a function of loading rates. However, the classical plate-impact testing procedures produce shock loadings in the brittle sample material which cause unrealistic levels of loading rates. Additionally, high-pulsed power techniques and/or functionally graded materials used as flyer plates to smooth the loading pulse remain costly, and are generally difficult to implement. In this study, a shockless plate-impact technique based on the use of either a wavy-machined flyer plate or buffer plate that can be produced by chip-forming is proposed. A series of numerical simulations using an explicit transient dynamic finite-element code have been performed to design and validate the experimental testing configuration. The calculations, conducted in two-dimensional (2D) plane-strain or in 2D axisymmetric modes, prove that the ‘wavy’ contact surface will produce a pulse-shaping effect, whereas the buffer plate will produce a homogenizing effect of the stress field along the transverse direction of the sample. In addition, ‘wavy-shape’ geometries of different sizes provide an easy way to change the level of loading rate and rise time in an experimentally tested ceramic specimen. Finally, when a shockless compression loading method is applied to the sample, a Lagrangian analysis of data is made possible by considering an assemblage of ceramic plates of different thicknesses in the target, so the axial stress–strain response of the brittle sample material can be provided.
This article is part of the themed issue ‘Experimental testing and modelling of brittle materials at high strain rates’.
Brittle materials at high-loading rates: an open area of research
Authors: Forquin Pascal 
Published: December 2016

Brittle materials are extensively used in many civil and military applications involving high-strain-rate loadings such as: blasting or percussive drilling of rocks, ballistic impact against ceramic armour or transparent windshields, plastic explosives used to damage or destroy concrete structures, soft or hard impacts against concrete structures and so on. With all of these applications, brittle materials are subjected to intense loadings characterized by medium to extremely high strain rates (few tens to several tens of thousands per second) leading to extreme and/or specific damage modes such as multiple fragmentation, dynamic cracking, pore collapse, shearing, mode II fracturing and/or microplasticity mechanisms in the material. Additionally, brittle materials exhibit complex features such as a strong strain-rate sensitivity and confining pressure sensitivity that justify expending greater research efforts to understand these complex features. Currently, the most popular dynamic testing techniques used for this are based on the use of split Hopkinson pressure bar methodologies and/or plate-impact testing methods. However, these methods do have some critical limitations and drawbacks when used to investigate the behaviour of brittle materials at high loading rates. The present theme issue ofPhilosophical Transactions Aprovides an overview of the latest experimental methods and numerical tools that are currently being developed to investigate the behaviour of brittle materials at high loading rates.This article is part of the themed issue ‘Experimental testing and modelling of brittle materials at high strain rates’.
Charge influences substrate recognition and self-assembly of hydrophobic FG sequences
Authors: Chen Wesley G. , Witten Jacob , Grindy Scott C. , Holten-Andersen Niels , Ribbeck Katharina 
Published: December 2016

AbstractThe nuclear pore complex controls the passage of molecules via hydrophobic phenylalanine-glycine (FG) domains on nucleoporins. Such FG-domains consist of repeating units of FxFG, FG, or GLFG sequences, which can be interspersed with highly charged amino acid sequences. Despite the high density of charge exhibited in certain FG-domains, if and how charge influences FG-domain self-assembly and selective binding of nuclear transport receptors is largely unexplored. Studying how individual charged amino acids contribute to nuclear pore selectivity is challenging with modernin vivoandin vitrotechniques due to the complexity of nucleoporin sequences. Here, we present a rationally designed approach to deconstruct essential components of nucleoporins down to 14 amino acid sequences. With these nucleoporin-based peptides, we systematically dissect how charge type and placement of charge influences self-assembly and selective binding of FG-containing gels. Specifically, we find that charge type determines which hydrophobic substrates FG sequences recognize while spatial localization of charge tunes hydrophobic self-assembly and receptor selectivity of FG sequences.
Correcting Chimeric Crosstalk in Single Cell RNA-seq Experiments
Authors: Dixit Atray 
Published: December 2016

AbstractAs part of the process of preparing sequencing libraries that include unique molecular identifiers (UMIs) such as many single cell RNA-seq (scRNA-seq) libraries, a diverse template must be amplified. During amplification, spurious chimeric molecules can be formed between molecules originating in different cells. While several computational and experimental strategies have been suggested to mitigate the impact of chimeric molecules, suitable approaches for scRNA-seq experiments do not exist. We demonstrate that chimeras become increasingly problematic as samples are sequenced deeply and propose both supervised and unsupervised computational solutions. These solutions are validated in the context of a deeply sequenced species mixing experiment, and, orthogonally, using replicate PCR amplifications of the same scRNA-seq library. Our code is publicly available athttps://github.com/asncd/schimera.