bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subclinical ischemic events in patients undergoing carotid artery stent placement: comparison of proximal and distal protection techniques
Authors: Aytac Emrah , Gürkaş Erdem , Akpinar Cetin Kursad , Saleem Muhammad A , Qureshi Adnan I 
Published: October 2016

ObjectiveTo determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI).MethodsWe analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptomatic internal carotid artery (ICA) stenosis (with last ischemic events within 3 months). The study was performed prospectively; patients were not randomized, and were treated either with a proximal balloon occlusion system (Mo.Ma; Invatec, Roncadelle, Italy) or filter-type distal protection device (Spider device; ev3, Plymouth, Minnesota, USA).ResultsOf the 45 patients (mean age±SD: 66.9±9.8 years; 73.3% were men) who underwent CAS, 19 had proximal protection and 26 distal protection. New ischemic lesions were detected in 26/45 patients on DW-MRI scans obtained within 24 hours after CAS. The proportion of patients with new lesions on DW-MRI at 24 hours was not different between the two groups (47.4% vs 65.4% for proximal and distal protection, respectively). The mean number of new ischemic lesions on post-CAS DW-MRI was non-significantly higher in patients who underwent CAS with distal protection (2.80±3.54 for proximal protection vs 4.96±5.11 for distal protection; p=0.12). The proportion of patients with new lesions >1 cm did not differ between the two groups (5.3% for proximal protection vs 11.5% for distal protection; p=0.62). There was no difference in the rates of ischemic stroke between patients who underwent CAS treatment using proximal and distal protection (5.3% vs 7.7%; p=1.000).ConclusionsWe found a relatively high rate of new ischemic lesions in patients undergoing CAS with cerebral protection. There was no difference in the proportion of patients with new lesions between patients treated using distal protection and those treated using proximal protection.
From Softimage to Postimage
Authors: Hoelzl Ingrid , Marie Rémi 
Published: October 2016

Abstract
With the digital revolution, the photographic paradigm of the image has become supplemented with an algorithmic paradigm. The result is a new kind of image capable to gather, compute, merge and display heterogeneous data in real time; no longer a solid representation of a solid world but a softimage—a program-mable database view. In today’s neurosciences and machine vision, the very concept of “image” as a stable visual entity becomes questionable. As a result, the authors propose that the need exists to radically expand the definition of image and abandon its humanist and subjective frame: The posthuman image—which the authors propose to call the postimage—is a collaborative image created through the process of distributed vision involving humans, animals and machines.
Gomphonema shanghaiensis sp. nov., a new diatom species (Bacillariophyta) from a river in Shanghai, China
Authors: ZHANG WEI , XU XIAO-YING , KOCIOLEK J. PATRICK , WANG LI-QING 
Published: October 2016

This paper describes the new species Gomphonema shanghaiensis sp. nov. from Shujiawan River, Shanghai City, in the lower reaches of Yangtze River, China. The description is based on data derived from light and scanning electron microscopy. Valves of Gomphonema shanghaiensis are narrowly lanceolate to rhombic-lanceolate, slightly asymmetrical to the apical axis, with a gibbous central region. The footpole is broadly rounded and the headpole is slightly rostrate to narrowly rounded. The axial area is narrow and linear. Central area is small, and irregularly rectangular in shape. 1–5 rounded external stigmal openings are evident, and internally 1–2 of these are positioned on the central nodule. Striae are slightly radiate at the center, radiate towards the poles. The new species was compared with G. hasta, G. archaevibrio, G. spiculoides, G. stagnorum, G. guaraniarum, G. tumens and G. disgracile, all of which resemble Gomphonema shanghaiensis but differ from the new species in specific details of size, striae density, valve shape and stigmal openings number. This species occurs in relatively clean water in Shanghai.
Storm-Track Shifts under Climate Change: Toward a Mechanistic Understanding Using Baroclinic Mean Available Potential Energy
Authors: Mbengue Cheikh , Schneider Tapio 
Published: October 2016

Abstract
Zonal-mean storm-track shifts in response to perturbations in climate occur even in idealized simulations of dry atmospheres with axisymmetric forcing. Nonetheless, a generally accepted theory of the mechanisms controlling the storm-track shifts is still lacking. Here, mean available potential energy (MAPE), a general measure of baroclinicity that is proportional to the square of the Eady growth rate, is used to understand storm-track shifts. It is demonstrated that, in dry atmospheres, the eddy kinetic energy (EKE) in a storm track is linearly related to the mean available potential energy, relative to a local reference state, and that maxima of the two are generally collocated in latitude. Changes in MAPE with climate are then decomposed into components. It is shown that in simulations of dry atmospheres, changes in the latitude of maximum MAPE are dominated by changes in near-surface meridional temperature gradients. By contrast, changes in the magnitude of MAPE are primarily determined by changes in static stability and in the depth of the troposphere. A theory of storm-track shifts may build upon these findings and primarily needs to explain changes in near-surface meridional temperature gradients. The terminus of the Hadley circulation often shifts in tandem with storm tracks and is hypothesized to play an important role in triggering the storm-track shifts seen in this idealized dry context, especially in simulations where increases only in the convective static stability in the deep tropics suffice to shift storm tracks poleward.
Sensitivity and Bias in the Resolution of Stream-Bounce Stimuli
Authors: Zeljko Mick , Grove Philip M. 
Published: October 2016

The audiovisual stream-bounce effect refers to the resolution of ambiguous motion sequences as streaming or bouncing depending on the presence or absence of a sound. We used a novel experimental design and signal detection theory (SDT) to determine its sensory or decisional origins. To account for issues raised by Witt et al. on the interpretation of SDT results, we devised a pure signal detection (as opposed to signal discrimination) paradigm and measured participants’ sensitivity and criterion when detecting a weak tone concurrent with objectively streaming or bouncing visual displays. We observed no change in sensitivity but a significant change in criterion with participants’ criterion more liberal with bouncing targets than for streaming targets with. In a second experiment, we tasked participants with detecting a weak tone in noise while viewing an ambiguous motion sequence. They also indicated whether the targets appeared to stream or bounce. Participants’ reported equivalent, mostly bouncing responses for hit and false alarm trials, and equivalent, mostly streaming responses for correct rejection and miss trials. Further, differences in participants’ sensitivity and criterion measures for detecting tones in subjectively streaming compared to subjectively bouncing targets were inconsistent with sensory factors. These results support a decisional account of the sound-induced switch from mostly streaming to mostly bouncing responses in audiovisual stream-bounce displays.
Intramedullary Nailing and External Ring Fixation for Tibiotalocalcaneal Arthrodesis in Charcot Arthropathy
Authors: Richman James , Cota Adam , Weinfeld Steven 
Published: October 2016

Background: Surgical strategies to address deformities of the ankle and hindfoot in patients with Charcot arthropathy include the use of retrograde intramedullary nails and ring fixators. The literature has not shown superiority of one technique over the other. This study presents a single surgeon’s case series of Charcot arthropathy patients treated with either a ring fixator or retrograde intramedullary nail to achieve tibiotalocalcaneal arthrodesis. Methods: We performed a retrospective analysis of 27 consecutive patients with Charcot arthropathy who underwent a tibiotalocalcaneal arthrodesis using either a retrograde intramedullary (IM) nail (n = 16 patients) or a ring fixator (RF) (n = 11 patients) by a single surgeon. We report the rates of limb salvage complications requiring secondary surgery and fusion in both groups. The patient demographics and presence of medical comorbidities known to increase the risk of surgical complications were similar between groups. The mean duration of follow-up for the retrograde nail group was 3.6 years and 2.2 years for the ring fixator group. Results: The mean time to discharge from the hospital after the index surgical procedure was 2.7 days for the IM group and 4.6 days for the RF group. For the patients treated with a ring fixator, the mean time to removal of the frame after the initial application was 13.3 ± 1.8 weeks. The limb salvage rate for the RF group was 9 of 11 patients whereas it was 15 of 16 in the IM group. Complications including deep infection, hardware failure, and symptomatic nonunion requiring revision surgery were common in the IM group, with 11 of 16 patients requiring further surgery. Seven patients in the IM group required removal of the implant at a mean of 117.2 weeks after the index procedure because of the development of deep infection or nail cutout. In the RF group, only 1 patient required revision surgery. Fusion rates were similar between both groups, with 10 of 16 patients fusing in the IM group and 7 of 11 in the RF group. Conclusion: Use of a retrograde intramedullary rod or ring fixator resulted in high rates of successful limb salvage when used for tibiotalocalcaneal arthrodesis in patients with Charcot arthropathy. However, in this study, the need for revision surgery was more frequent in the retrograde nail group compared to the ring fixator group. Level of Evidence: Level III, retrospective comparative series.
The impact of multiple sclerosis severity on health state utility values: Evidence from Australia
Authors: Ahmad Hasnat , Taylor Bruce V , van der Mei Ingrid , Colman Sam , O’Leary Beth A , Breslin Monique , Palmer Andrew J 
Published: October 2016

Background: The measurement of health state utility values (HSUVs) for a representative sample of Australian people with multiple sclerosis (MS) has not previously been performed. Objectives: Our main aim was to quantify the HSUVs for different levels of disease severities in Australian people with MS. Method: HSUVs were calculated by employing a ‘judgement-based’ method that essentially creates EQ-5D-3L profiles based on WHOQOL-100 responses and then applying utility weights to each level in each dimension. A stepwise linear regression was used to evaluate the relationship between HSUVs and disease severity, classified as mild (Expanded Disability Status Scale (EDSS) levels: 0–3.5), moderate (EDSS levels: 4–6) and severe (EDSS levels: 6.5–9.5). Results: Mean HSUV for all people with MS was 0.53 (95% confidence interval (CI): 0.52–0.54). Utility decreased with increasing disease severity: 0.61 (95% CI: 0.60–0.62), 0.51 (95% CI: 0.50–0.52) and 0.40 (95% CI: 0.38–0.43) for mild, moderate and severe disease, respectively. Adjusted differences in mean HSUV between the three severity groups were statistically significant. Conclusion: For the first time in Australia, we have quantified the impact of increasing severity of MS on health utility of people with MS. The HSUVs we have generated will be useful in further health economic analyses of interventions that slow progression of MS.
Reimbursement changes and drug switching: are severe patients more affected?
Authors: Cheng Shou-Hsia , Chen Chi-Chen , Kuo Hung-Chih , Wang Chi-Chuan 
Published: October 2016

Objectives To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. Methods A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan. Observation of five 6-month phases before and after a drug reimbursement adjustment implemented in October 2009. Drug switching was defined as a brand change within the same anatomical therapeutic chemical group between two consecutive physician visits. Generalized estimating equations were employed to control for the random subject effect. Results The drug-switching rates in the five phases were 10.85% and 13.71% before implementation and 31.53%, 28.29% and 15.61% after implementation. Results from the regression model revealed a higher likelihood of receiving switched drugs in phases 3, 4 and 5, with odds ratios of 3.16, 2.72 and 1.44 (with 95% confidence interval 3.04–3.29, 2.61–2.84 and 1.38–1.51), respectively, compared with phase 1. Patients with complicated or severe conditions were more likely to have their drugs switched after the reimbursement adjustment. Conclusions The drug reimbursement adjustment under the health insurance program resulted in an increase in drug-switching decisions, and patients were not exempt from medication switching regardless of the complications or the severity level of their illness.
Comparison of distal radius fracture intra-articular step reduction with volar locking plates and K wires: a retrospective review of quality and maintenance of fracture reduction
Authors: Johnson N. A. , Dias J. J. , Wildin C. J. , Cutler L. , Bhowal B. , Ullah A. S. 
Published: October 2016

This study investigated the accuracy and maintenance of reduction of intra-articular steps achieved with closed reduction and percutaneous K wires and open reduction and a volar locking plate for the treatment of intra-articular distal radius fractures. We performed a retrospective review of 359 patients with an intra-articular fracture of their distal radius. Multivariate linear regression was undertaken to investigate the influence of multiple variables such as age, gender, initial displacement and treatment method on reduction despite differences between groups. A total of 36% of patients treated with K wires and 29% with volar locking plate had a step greater than or equal to 1 mm present on the first post-operative radiograph. A total of 23% treated with K wires and 28% with volar locking plate had a residual step of 1 mm or more on the last available radiograph. There was no difference identified between the two techniques for quality of initial reduction or persisting step on the last available radiographs. Step behaviour and further reduction of step post-operatively was similar for both treatment methods. Initial displacement and increased age influenced initial reduction. Initial fracture displacement shown radiologically was the only variable identified that influenced the persistence of a step on post-operative radiographs. Level of evidence: IV
Factors associated with subluxation in mallet fracture
Authors: Moradi A. , Braun Y. , Oflazoglu K. , Meijs T. , Ring D. , Chen N. 
Published: October 2016

Radiographs and medical record of all adult patients with a mallet fracture in three hospitals between 2004 and 2014 were reviewed. International Classification of Diseases, Ninth Revision (ICD-9) codes and text search in radiographic reports were used to identify all acute patients with potential mallet fractures in our institutional database. Manually checking, 392 true mallet fractures were identified among them, 78 had subluxation at the time of diagnosis and 19 had subluxation at a later time point during treatment. Fragment size, fragment displacement, and interval between injury and treatment were associated with initial and late subluxation. Subluxation was not observed when the fracture size was less than 39% of the total articular surface. For each 1% increase in total articular surface involvement in fractures with more than 39% involvement, the risk of subluxation increased by 4% and for each 1% of displacement, the risk of subluxation increased by 4%. Level of Evidence: IV
Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion
Authors: Stone Sarah , Lee Bobby , Garrison J. Craig , Blueitt Damond , Creed Kalyssa 
Published: October 2016

Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non–sport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population.
Evaluation of Letournel and Judet Classification of Acetabular Fracture with Plain Radiographs and Three-Dimensional Computerized Tomographic Scan
Authors: Visutipol Boonyarak , Chobtangsin Pornchai , Ketmalasiri Bunyat , Pattarabanjird Narongchai , Varodompun Namchai 
Published: October 2016

Letournal and Judet classification of acetabular fracture is widely used. The classification is based on the identification of fracture lines on plain radiographs. Three-dimensional CT scan was claimed to give a better view of the fracture line. Our study showed that intraobserver reproducibility and interobserver reliability were almost the same when classification was done by using plain radiographs and 3D-CT scan. And 3D-CT scan did not increase either the interobserver reliability or the intraobserver reproducibility in classifying the fracture.
Natural History of Lumbar Disc Hernia with Radicular Leg Pain: Spontaneous MRI Changes of the Herniated Mass and Correlation with Clinical Outcome
Authors: Takada Eiichi , Takahashi Masaya , Shimada Kimio 
Published: October 2016

A prospective sequential MRI study was done to investigate the morphologic changes of the lumbar disc hernia (LDH). We also studied the relationship between the MRI changes and the type of LDH and the clinical outcome. MRI was performed every 3 months from the onset for a maximum of 24 months in 42 patients with radicular leg pain and symptoms definitely diagnosed as caused by LDH. The size of the herniated mass was determined by the ratio of the anteroposterior diameter of the spinal canal to the maximum diameter of the LDH mass on T2-weighted axial images. The clinical outcome was evaluated as excellent, good, or poor depending on leg pain and physical findings. The JOA (Japanese Orthopaedic Association) score for LDH was also used to assess the outcome. Thirty-seven (88%) of the 42 patients showed >50% reduction of the hernia on MRI 3–12 months after onset, and the morphologic changes of the herniated mass were well correlated with the clinical outcome.
Profile of Congenital Transverse Deficiencies among Cases of Congenital Orthopaedic Anomalies
Authors: Jain Sanjay , Lakhtakia P. K. 
Published: October 2016

The authors showed the data of congenital amputation in 36 cases among the physically handicapped individuals (who attended a district level hospital for the purpose of obtaining a handicap certificate) during the period from 1 January 1999 to 31 December 2000. Out of 3,550 individuals, we found 612 with congenital orthopaedic anomalies, which accounted for 17.2%. Of these 612 individuals, we noted 36 cases with congenital amputation (amputation through digits and toes were not included). Both unilateral and bilateral congenital amputations were much more common in the upper extremity as compared to lower extremity. Not a single case of simultaneous upper and lower extremity involvement was seen. The most common transverse deficiency in the upper limb was through the forearm, and in the lower limb it was through the foot. Congenital amputation was common in males with a gender ratio of 3.5:1. Left limb involvement was twice as much as right limb involvement, and it was common in both sexes. Bilateral limb involvement was seen only in males.
Skeletal Angiomatosis in Association with Gastro-Intestinal Angiodysplasia and Paraproteinemia: A Case Report
Authors: Clayer Mark 
Published: October 2016

Skeletal-extraskeletal angiomatosis is defined as a benign vascular proliferation involving the medullary cavity of bone and at least one other type of tissue. It has also been known as cystic angiomatosis in which multiple cystic lesions are scattered diffusely throughout the skeleton often with similar angiomatous changes in other tissues, usually the spleen. A case of skeletal angiomatosis in association with gastro-intestinal angiodysplasia and paraproteinemia is reported.
Traumatic Cervical Cord Injury at C3–4 without Radiographic Abnormalities: Correlation of Magnetic Resonance Findings with Clinical Features and Outcome
Authors: Takahashi M , Harada Y , Inoue H , Shimada K 
Published: October 2016

Purpose. Clinical features and outcomes of 43 patients at the Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama, were studied prospectively. These patients were not found to have radiographic abnormalities but magnetic resonance images showed acute cervical spinal cord trauma at the C3–4 disc level. Methods. Magnetic resonance images were analysed at presentation (immediately after the injury) and subsequent follow-up visits (at subacute and chronic stages, respectively) in an attempt to correlate imaging findings to clinical features and outcomes, respectively. Results. The injury mechanism was usually a yper-extension of the cervical spine. The level of neurological involvement was assessed in 9 patients with complete tetraplegia: the motor level was C5 in 6 patients and C4 in 3, whereas the sensory level was C5 in 7 patients, C4 in one, and C3 in one. Respiratory dysfunction in patients with severe paralysis, or numb and clumsy hands in patients with incomplete paralysis were the characteristic clinical features of cervical spinal cord injury at these lesions. Three patterns of signal change on magnetic resonance images were observed in patients with spinal cord injury at C3–4. A low-intensity area on T2-weighted images in the acute stage indicated a poor prognosis, while a high-intensity area at 2 to 3 weeks after injury indicated some degree of permanent paralysis. Conclusion. The serial signal changes of magnetic resonance images and the clinical severity or outcome seemed to be well correlated.