bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limb Salvage of Ankle Fracture Dislocation With LIMA External Fixator
Authors: Ross Adrianne JinLing , Little Jessica , Seligson David 
Published: October 2012

Open ankle fractures with dislocation are potentially limb-threatening injuries with complications ranging from infection to amputation. External fixation has been used in trauma institutions for limb salvage, particularly in the setting of extensive soft tissue compromise. The authors present a case of an elderly woman with an open ankle fracture dislocation who underwent a staged surgical approach. A LIMA external fixator was used in conjunction with antibiotic beads and subsequent definitive open reduction with internal fixation. At 5-year follow-up, the patient demonstrated pain-free range of motion with a return to activity comparable to the preinjury state. The authors highlight the benefit of procedure staging in the presence of a severe fracture dislocation of the tibiotalar joint. Levels of Evidence: Therapeutic, Level IV: Case Study
Case Report
Authors: Brown Michael J. C. , Yeoman Thomas F. M. , Roberts Sam , Pillai Anand 
Published: October 2012

Brachymetatarsia is an abnormal shortening of a metatarsal. It causes disruption of the normal metatarsal parabola, resulting in metatarsalgia, calluses and dislocation of the digits. Patients often express discontent with the appearance of their feet. Lengthening by distraction osteogenesis and 1-stage intercalary bone grafting procedures are the mainstays of operative treatment. We present a modified 1-stage technique, combining the use of a Chevron osteotomy of the fourth metatarsal with shortening osteotomies of the second and third metatarsals. Bone removed from the third metatarsal was used to lengthen the fourth. The Chevron segments provided mediolateral, dorsoplantar, and rotational stability. The technique was used on both feet of 1 patient. The mean increase in AOFAS score was 34.5 (right foot, 46; left foot, 23.) There were no complications. A 1-stage technique does not require an external fixator or postoperative manipulation and has a quicker healing time. Taking the bone graft from neighboring metatarsals decreases the discrepancy between metatarsal lengths. A smaller increase in the length of the fourth ray is then required, and the chance of neurovascular injury as a result of soft-tissue stretching is minimized. This technique allows restoration of the metatarsal parabola and provides good correction, immediate stability, and good integration. Levels of Evidence: Therapeutic Level IV, Case Study
Magnetic Resonance Imaging Versus Musculoskeletal Ultrasound for Identification and Localization of Plantar Plate Tears
Authors: Klein Erin E. , Weil Lowell , Weil Lowell Scott , Knight Jessica 
Published: October 2012

Purpose: Plantar plate injuries have been identified as a cause of forefoot pain and deformity. Magnetic resonance imaging (MRI) and musculoskeletal ultrasound (US) have been suggested as appropriate imaging modalities for this pathology. A comparison of these two modalities utilizing intra-operatively pathology as the reference standard has not been published. Methodology: 51 feet of 42 consecutive patients presenting to clinic with forefoot pain and a suspected unilateral plantar plate tear at the 2nd metatarsophalangeal (MTP) joint were identified. A two plane (longitudinal and transverse) US was performed on the painful second MTP joint. Longitudinal ultrasound images were graded as ‘torn’ or ‘intact’. Transverse ultrasound images were used to localize pathology. All ultrasound exams were performed by the same reconstructive foot & ankle fellow. A pre-operative MRI was performed on these patients and read by a Fellowship Trained Musculoskeletal Radiologist. The physicians reading US and the MRI were blinded to each other’s findings. Results: All 51 feet were examined intra-operatively. 46 plantar plate tears were identified. The sensitivity, specificity, positive predictive value and negative value of MRI were 73.9%, 100%, 100%, 29.4% respectively while the same values for US were 91.5%, 25%, 91.5%, 25% respectively. MRI identified 4 collateral ligaments tears not identified on ultrasound. Discussion & Conclusions: Both MRI and US are appropriate modalities for imaging of the plantar plate. While US is a highly sensitive exam, MRI is a more specific exam. Overall these results do not suggest that MR should be replaced by US in all cases. Level of Evidence: Diagnostic, Level I
Pneumococcal Meningitis, Cerebral Venous Thrombosis, and Cervical Arterial Dissection
Authors: Panicio Mauricio Isaac , Foresto Renato Demarchi , Mateus Lucas , Monzillo Paulo Helio , Alves Monique Bueno , Silva Gisele Sampaio 
Published: October 2012

Background: Pneumococcal meningitis in adults is widely associated with intracranial complications, which occur in up to 74.7% of the patients. Method: Case report. Results: We report the case of a 40-year-old white female with pneumococcal meningitis after a sinus surgery, who developed a concomitant cerebral venous thrombosis and multiple cervical artery dissections. Following treatment with antibiotics and intravenous heparin, she had complete neurological recovery. Conclusions: Vascular complications should always be remembered and adequately treated in patients with bacterial meningitis. Cervical arterial dissections should be investigated as potential embolic sources of intracranial ischemic lesions.
Revisiting the Multicultural Experience–Creativity Link
Authors: Cheng Chi-Ying , Leung Angela K.-y. 
Published: October 2012

A growing literature provides evidence for the multicultural experience–creativity link such that exposure to the juxtaposition of two cultures facilitates individual creativity. The underlying mechanisms for this relationship, however, are still far from being well explored. Drawing upon the novel perspective of motivated cognition, we hypothesize that two factors interact to affect creative outcomes: (a) perceived cultural distance between the two juxtaposed cultures, and (b) comparison mind-sets. Specifically, we argue that individuals’ creative performance will be increased only when a difference mind-set is employed to process the cultural stimuli that are sufficiently different from each other. In two studies, individuals exposed to dual cultural primes with higher levels of perceived cultural distance consistently performed more adeptly in creative insight tasks when they personally predisposed to or experimentally manipulated to adopt a difference (vs. similarity) mind-set. Theoretical and practical implications are discussed.
Gene Fusion Markup Language: a prototype for exchanging gene fusion data
Authors: Kalyana-Sundaram Shanker , Shanmugam Achiraman , Chinnaiyan Arul M 
Published: October 2012

Abstract

Background
An avalanche of next generation sequencing (NGS) studies has generated an unprecedented amount of genomic structural variation data. These studies have also identified many novel gene fusion candidates with more detailed resolution than previously achieved. However, in the excitement and necessity of publishing the observations from this recently developed cutting-edge technology, no community standardization approach has arisen to organize and represent the data with the essential attributes in an interchangeable manner. As transcriptome studies have been widely used for gene fusion discoveries, the current non-standard mode of data representation could potentially impede data accessibility, critical analyses, and further discoveries in the near future.

Results
Here we propose a prototype, Gene Fusion Markup Language (GFML) as an initiative to provide a standard format for organizing and representing the significant features of gene fusion data. GFML will offer the advantage of representing the data in a machine-readable format to enable data exchange, automated analysis interpretation, and independent verification. As this database-independent exchange initiative evolves it will further facilitate the formation of related databases, repositories, and analysis tools. The GFML prototype is made available athttp://code.google.com/p/gfml-prototype/.

Conclusion
The Gene Fusion Markup Language (GFML) presented here could facilitate the development of a standard format for organizing, integrating and representing the significant features of gene fusion data in an inter-operable and query-able fashion that will enable biologically intuitive access to gene fusion findings and expedite functional characterization. A similar model is envisaged for other NGS data analyses.
The human "magnesome": detecting magnesium binding sites on human proteins
Authors: Piovesan Damiano , Profiti Giuseppe , Martelli Pier Luigi , Casadio Rita 
Published: October 2012

Abstract

Background
Magnesium research is increasing in molecular medicine due to the relevance of this ion in several important biological processes and associated molecular pathogeneses. It is still difficult to predict from the protein covalent structure whether a human chain is or not involved in magnesium binding. This is mainly due to little information on the structural characteristics of magnesium binding sites in proteins and protein complexes. Magnesium binding features, differently from those of other divalent cations such as calcium and zinc, are elusive. Here we address a question that is relevant in protein annotation: how many human proteins can bind Mg2+? Our analysis is performed taking advantage of the recently implemented Bologna Annotation Resource (BAR-PLUS), a non hierarchical clustering method that relies on the pair wise sequence comparison of about 14 millions proteins from over 300.000 species and their grouping into clusters where annotation can safely be inherited after statistical validation.

Results
After cluster assignment of the latest version of the human proteome, the total number of human proteins for which we can assign putative Mg binding sites is 3,751. Among these proteins, 2,688 inherit annotation directly from human templates and 1,063 inherit annotation from templates of other organisms. Protein structures are highly conserved inside a given cluster. Transfer of structural properties is possible after alignment of a given sequence with the protein structures that characterise a given cluster as obtained with a Hidden Markov Model (HMM) based procedure. Interestingly a set of 370 human sequences inherit Mg2+ binding sites from templates sharing less than 30% sequence identity with the template.

Conclusion
We describe and deliver the "human magnesome", a set of proteins of the human proteome that inherit putative binding of magnesium ions. With our BAR-hMG, 251 clusters including 1,341 magnesium binding protein structures corresponding to 387 sequences are sufficient to annotate some 13,689 residues in 3,751 human sequences as "magnesium binding". Protein structures act therefore as three dimensional seeds for structural and functional annotation of human sequences. The data base collects specifically all the human proteins that can be annotated according to our procedure as "magnesium binding", the corresponding structures and BAR+ clusters from where they derive the annotation (http://bar.biocomp.unibo.it/mg).
Modelling osteomyelitis
Authors: Liò Pietro , Paoletti Nicola , Moni Mohammad Ali , Atwell Kathryn , Merelli Emanuela , Viceconti Marco 
Published: October 2012

AbstractBackgroundThis work focuses on the computational modelling of osteomyelitis, a bone pathology caused by bacteria infection (mostlyStaphylococcus aureus). The infection alters the RANK/RANKL/OPG signalling dynamics that regulates osteoblasts and osteoclasts behaviour in bone remodelling, i.e. the resorption and mineralization activity. The infection rapidly leads to severe bone loss, necrosis of the affected portion, and it may even spread to other parts of the body. On the other hand, osteoporosis is not a bacterial infection but similarly is a defective bone pathology arising due to imbalances in the RANK/RANKL/OPG molecular pathway, and due to the progressive weakening of bone structure.ResultsSince both osteoporosis and osteomyelitis cause loss of bone mass, we focused on comparing the dynamics of these diseases by means of computational models. Firstly, we performed meta-analysis on a gene expression data of normal, osteoporotic and osteomyelitis bone conditions. We mainly focused on RANKL/OPG signalling, the TNF and TNF receptor superfamilies and the NF-kB pathway. Using information from the gene expression data we estimated parameters for a novel model of osteoporosis and of osteomyelitis. Our models could be seen as a hybrid ODE and probabilistic verification modelling framework which aims at investigating the dynamics of the effects of the infection in bone remodelling. Finally we discuss different diagnostic estimators defined by formal verification techniques, in order to assess different bone pathologies (osteopenia, osteoporosis and osteomyelitis) in an effective way.ConclusionsWe present a modeling framework able to reproduce aspects of the different bone remodeling defective dynamics of osteomyelitis and osteoporosis. We report that the verification-based estimators are meaningful in the light of a feed forward between computational medicine and clinical bioinformatics.
Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA
Authors: Yang Xian , Han Rui , Guo Yike , Bradley Jeremy , Cox Benita , Dickinson Robert , Kitney Richard 
Published: October 2012

Abstract

Background
Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways.

Method
Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed.

Results
A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation.

Conclusions
ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting hospitals to effectively manage time and resources in clinical pathway.
Dotted collar placed around carotid artery induces asymmetric neointimal lesion formation in rabbits without intravascular manipulations
Authors: Kivelä Antti , Hartikainen Juha , Ylä-Herttuala Seppo 
Published: October 2012

Abstract

Background
Neointimal formation in atherosclerosis has been subject for intense research. However, good animal models mimicking asymmetrical lesion formation in human subjects have been difficult to establish. The aim of this study was to develop a model which would lead to the formation of eccentric lesions under macroscopically intact non-denuded endothelium.

Methods
We have developed a new collar model where we placed two cushions or dots inside the collar. Arterial lesions were characterized using histology and ultrasound methods.

Results
When this dotted collar was placed around carotid and femoral arteries it produced asymmetrical pressure on adventitia and a mild flow disturbance, and hence a change in shear stress. Our hypothesis was that this simple procedure would reproducibly produce asymmetrical lesions without any intraluminal manipulations. Intima/media ratio increased towards the distal end of the collar with the direction of blood flow under macroscopically intact endothelium. Macrophages preferentially accumulated in areas of the thickest neointima thus resembling early steps in human atherosclerotic plaque formation. Proliferating cells in these lesions and underlying media were scarce at eight weeks time point.

Conclusion
The improved dotted collar model produces asymmetrical human-like atherosclerotic lesions in rabbits. This model should be useful in studies regarding the pathogenesis and formation of eccentric atherosclerotic lesions.
Acute pulmonary embolism in the era of multi-detector CT: a reality in sub-Saharan Africa
Authors: Tambe Joshua , Moifo Boniface , Fongang Emmanuel , Guegang Emilienne , Juimo Alain Georges 
Published: October 2012

Abstract

Background
The advantages of multi-detector computed tomography (MDCT) have made it the imaging modality of choice for some patients with suspected cardiothoracic disease, of which pulmonary embolism (PE) is an exponent. The aim of this study was to assess the incidence of PE in patients with clinical suspicion of acute PE using MDCT in a sub-Saharan setting, and to describe the demographic characteristics of these patients.

Methods
Consecutive records of patients who underwent MDCT pulmonary angiography for suspected acute PE over a two-year period at the Radiology Department of a university-affiliated hospital were systematically reviewed. All MDCT pulmonary angiograms were performed with a 16-detector computed tomography (CT) scanner using real-time bolus tracking technique. Authorization for the study was obtained from the institutional authorities.

Results
Forty-one MDCT pulmonary angiograms were reviewed of which 37 were retained. Of the 4 excluded studies, 3 were repeat angiograms and 1 study was not technically adequate. Twelve of 37 patients (32.4%) had CT angiograms that were positive for PE, of which 7 were males. The mean age of these patients was 47.6±10.5 years (age range from 33 to 65 years). Twenty five patients out of 37 (67.6%) had CT angiograms that were negative for PE. Eleven PE-positive patients (91.7%) had at least 1 identifiable thromboembolic risk factor whilst 5 PE-negative patients (20%) also had at least a thromboembolic risk factor. The relative risk of the occurrence of PE in patients with at least a thromboembolic risk factor was estimated at 14.4.

Conclusion
Acute PE is a reality in sub-Saharan Africa, with an increased likelihood of MDCT evidence in patients with clinical suspicion of PE who have at least a thromboembolic risk factor. The increasing availability of MDCT will help provide more information on the occurrence of PE in these settings.
The association of sleep difficulties with health-related quality of life among patients with fibromyalgia
Authors: Wagner Jan-Samuel , DiBonaventura Marco D , Chandran Arthi B , Cappelleri Joseph C 
Published: October 2012

AbstractBackgroundDifficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM.MethodsThe current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables.ResultsOf the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population.ConclusionsAmong the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.
Precocious puberty in Turner Syndrome: report of a case and review of the literature
Authors: Improda Nicola , Rezzuto Martina , Alfano Sara , Parenti Giancarlo , Vajro Pietro , Pignata Claudio , Salerno Mariacarolina 
Published: October 2012

Abstract

Introduction
Turner Syndrome (TS) is caused by monosomy or structural abnormalities of the X chromosome, with a prevalence of about 1/2000 females live birth. Most important clinical features of TS are short stature and gonadal failure. Approximately one third of girls with TS may undergo spontaneous puberty. Here we report on the case of a girl with a rare 45X0/47XXX mosaic TS exhibiting a precocious puberty.

Case report
The patient was diagnosed with TS at the age of 4 years, upon a diagnostic work-up for dysmorphic features. Chromosome analysis revealed a mosaic karyotype (45X0/47XXX). She presented with normal height and normal growth velocity so that Growth Hormone (GH) therapy was not started. She was referred to our Department at the age of 7 years and 10 months, because of vaginal bleeding. A physical examination revealed a Tanner stage III for breast and Tanner stage III for pubic hair development. Height and weight were within the normal range for age. Psychological evaluation showed moderate global developmental delay, together with emotional and social immaturity and reading difficulties. The growth rate was accelerated. Her bone age was 10 years. Pelvic ultrasound demonstrated increased size for age of both the uterus and the ovaries, with bilateral ovarian follicles. GnRH stimulation test revealed pubertal response of gonadotropins (peak LH 22.5 mIU/ml). MRI of the brain was normal. These clinical, radiologic and laboratory findings were consistent with a diagnosis of idiopathic central precocious puberty; therefore, GnRH analog therapy was started, in order to slow pubertal progression and to preserve adult stature. Furthermore, GH treatment was added to further improve adult height.

Conclusion
Our case highlights the possibility of precocious puberty as an atypical clinical feature of TS. Thus, precocious puberty may occur in TS girls when a dosage compensation by the cell line with more than two X chromosomes allows normal ovarian function. GnRH analog therapy in addition to GH treatment should be recommended in TS girls with precocious puberty in order to slow pubertal progression and to preserve adult stature.