bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Spasticity With Sonoelastography Following Stroke: A Feasibility Study
Authors: Kesikburun Serdar , Yaşar Evren , Adıgüzel Emre , Güzelküçük Ümüt , Alaca Rıdvan , Tan Arif Kenan 
Published: May 2015

AbstractObjectiveTo investigate the feasibility of sonoelastography to show muscle stiffness in poststroke spasticity, as well as the relationship between sonoelastography findings and muscle architecture features and clinical spasticity scores in the spastic gastrocnemius.DesignCross‐sectional study.SettingUniversity rehabilitation center.ParticipantsA total of 26 stroke patients with gastrocnemius muscle spasticity (≥1 using the Modified Ashworth Scale score).InterventionsNone.Main outcomesSonoelastography parameters (elasticity index and elasticity ratio) and muscle architecture features (muscle fascicle length, fascicle pennation angle, muscle thickness and compressibility) were measured from the medial and lateral gastrocnemius muscle on both the affected and unaffected sides.ResultsBoth the elasticity index and elasticity ratio on the affected side were significantly increased in both the medial and lateral gastrocnemius compared with those on the unaffected side (P < .05). Of the muscle architecture parameters, the compressibility in the medial and lateral gastrocnemius and the fascicle pennation angle in the lateral gastrocnemius were significantly decreased on the affected side (P < .05). There was no significant difference in other parameters between the affected and unaffected side (P > .05). Sonoelastographic findings showed a weak negative correlation with compressibility and a weak positive correlation with the Modified Ashworth Scale score in the spastic medial gastrocnemius.ConclusionsIt was found to be feasible to assess stiffness in spastic gastrocnemius muscles of stroke patients with sonoelastography. Further studies are needed to confirm the potential role of sonoelastography to help guide treatment of spasticity and its sequelae.
Identifying localized changes in large systems: Change-point detection for biomolecular simulations
Authors: Fan Zhou , Dror Ron O. , Mildorf Thomas J. , Piana Stefano , Shaw David E. 
Published: May 2015

SignificanceWith data proliferating across many disciplines, data analysts often wish to identify abrupt changes in complex systems with many measured quantities—a problem complicated by the fact that a given change might affect only a few of these quantities. We developed a method that accurately identifies changes in such systems by searching concurrently for change times and the subset of measured quantities that change at each of these times. This work was motivated by the challenge of detecting biologically interesting structural changes in proteins, but our method may prove useful in diverse application domains.
Differential protein expression and peak selection in mass spectrometry data by binary discriminant analysis
Authors: Gibb Sebastian , Strimmer Korbinian 
Published: May 2015

Abstract
Motivation: Proteomic mass spectrometry analysis is becoming routine in clinical diagnostics, for example to monitor cancer biomarkers using blood samples. However, differential proteomics and identification of peaks relevant for class separation remains challenging.
Results: Here, we introduce a simple yet effective approach for identifying differentially expressed proteins using binary discriminant analysis. This approach works by data-adaptive thresholding of protein expression values and subsequent ranking of the dichotomized features using a relative entropy measure. Our framework may be viewed as a generalization of the ‘peak probability contrast’ approach of Tibshirani et al. (2004) and can be applied both in the two-group and the multi-group setting. Our approach is computationally inexpensive and shows in the analysis of a large-scale drug discovery test dataset equivalent prediction accuracy as a random forest. Furthermore, we were able to identify in the analysis of mass spectrometry data from a pancreas cancer study biological relevant and statistically predictive marker peaks unrecognized in the original study.
Availability and implementation: The methodology for binary discriminant analysis is implemented in the R package binda, which is freely available under the GNU General Public License (version 3 or later) from CRAN at URL http://cran.r-project.org/web/packages/binda/. R scripts reproducing all described analyzes are available from the web page http://strimmerlab.org/software/binda/.
Contact: k.strimmer@imperial.ac.uk
Geodetic secular velocity errors due to interannual surface loading deformation
Authors: Santamaría-Gómez Alvaro , Mémin Anthony 
Published: May 2015

Abstract
Geodetic vertical velocities derived from data as short as 3 yr are often assumed to be representative of linear deformation over past decades to millennia. We use two decades of surface loading deformation predictions due to variations of atmospheric, oceanic and continental water mass to assess the effect on secular velocities estimated from short time-series. The interannual deformation is time-correlated at most locations over the globe, with the level of correlation depending mostly on the chosen continental water model. Using the most conservative loading model and 5-yr-long time-series, we found median vertical velocity errors of 0.5 mm yr−1 over the continents (0.3 mm yr−1 globally), exceeding 1 mm yr−1 in regions around the southern Tropic. Horizontal velocity errors were seven times smaller. Unless an accurate loading model is available, a decade of continuous data is required in these regions to mitigate the impact of the interannual loading deformation on secular velocities.
γ-ray emission states in the redback millisecond pulsar binary system PSR J1227−4853
Authors: Bednarek W. 
Published: May 2015

Abstract
Long expected transition states between the rotation powered and accretion powered non-thermal emission in the millisecond pulsar binary systems have been recently observed in the case of three objects PSR J1023+0038, PSR J1824−2452, and PSR J1227−4859. Surprisingly, the transition is related to the significant change in the γ-ray flux being a factor of a few higher with the presence of an accretion disc. The origin of this enhanced emission seems to be related to the penetration of the inner pulsar magnetosphere by the accretion disc. We propose that the radiation processes, characteristic for the rotation powered pulsar, can co-exist with the presence of an accretion disc in the inner pulsar magnetosphere. In our scenario additional γ-ray emission is produced by secondary leptons, originated close to the acceleration gap, which Compton up-scatter thermal radiation from the accretion disc to GeV energies. The accretion disc penetrates deep into the pulsar magnetosphere allowing the matter to fall on to the neutron star surface producing pulsed X-ray emission. We show that the sum of the rotation powered pulsar γ-ray emission, produced by the primary electrons in the curvature process, and the γ-ray emission, produced by secondary leptons, can explain the observed high-energy radiation from the redback binary pulsar PSR J1227−4853 in the state with evidences of the accretion disc.
Pulse Photoplethysmographic Analysis Estimates the Sympathetic Activity Directed to Heart and Vessels
Authors: Colombo Riccardo , Marchi Andrea , Borghi Beatrice , Fossali Tommaso , Rech Roberto , Castelli Antonio , Corona Alberto , Guzzetti Stefano , Raimondi Ferdinando 
Published: May 2015

AbstractAbstract
In controlled experimental conditions, novel pulse plethysmograhic indices estimated changes of the sympathetic outflow directed to vessels and the sympathovagal balance modulating heart rate.

Background:
Novel pulse photoplethysmographic–derived indices have been proposed as tools to measure autonomic nervous system (ANS) modulation in anesthetized and awake patients, but nowadays their experimental validation is lacking. The authors aimed to investigate the ability of pulse photoplethysmographic amplitude (PPGA), ANS state (ANSS), and ANSS index (ANSSi) to measure changes of ANS modulation in response to sympathetic stimulation.

Methods:
Ten awake healthy volunteers underwent two passive head-up tilts at 45° and 90°. The heart rate variability (HRV) and systolic arterial pressure variability were analyzed in the frequency domain as a measure of ANS modulation directed to the heart and the vessels. HRV, baroreflex sensitivity, and pulse photoplethysmographic indices were measured at baseline and after tilt maneuvers. The agreement between HRV-derived indices and pulse photoplethysmographic indices was assessed using Bland–Altman plots.

Results:
PPGA, ANSS, and ANSSi changed significantly during the study protocol. Head-up tilt decreased PPGA and ANSS and increased ANNSi. There was a good agreement between ANSSi and baroreflex sensitivity explored in the high-frequency band (bias, 0.23; 95% CI, −22.7 to 23.2 normalized units) and between ANSSi and the sympathovagal modulation directed to the heart (bias, 0.96; 95% CI, −8.7 to 10.8 normalized units).

Conclusions:
In controlled experimental conditions, novel pulse plethysmographic indices seem to estimate the changes of the sympathetic outflow directed to the vessels and the sympathovagal balance modulating heart rate. These indices might be useful in the future to monitor the fluctuation of sympathetic activity in anesthetized patients.
Assessment of Cerebral Autoregulation Patterns with Near-infrared Spectroscopy during Pharmacological-induced Pressure Changes
Authors: Moerman Annelies T. , Vanbiervliet Valerie M. , Van Wesemael Astrid , Bouchez Stefaan M. , Wouters Patrick F. , De Hert Stefan G. 
Published: May 2015

AbstractAbstract
Paradoxical reactions might be part of a normal physiological autoregulatory response, thereby challenging the conventional paradigm. Intact cerebral autoregulation comprises additional patterns of normal cerebrovascular responses that might be obscured if the existence of different mechanisms is ignored, and analysis is based on the mean response of a group.

Background:
Previous work has demonstrated paradoxical increases in cerebral oxygen saturation (ScO2) as blood pressure decreases and paradoxical decreases in ScO2 as blood pressure increases. It has been suggested that these paradoxical responses indicate a functional cerebral autoregulation mechanism. Accordingly, the authors hypothesized that if this suggestion is correct, paradoxical responses will occur exclusively in patients with intact cerebral autoregulation.

Methods:
Thirty-four patients undergoing elective cardiac surgery were included. Cerebral autoregulation was assessed with the near-infrared spectroscopy–derived cerebral oximetry index (COx), computed by calculating the Spearman correlation coefficient between mean arterial pressure and ScO2. COx less than 0.30 was previously defined as functional autoregulation. During cardiopulmonary bypass, 20% change in blood pressure was accomplished with the use of nitroprusside for decreasing pressure and phenylephrine for increasing pressure. Effects on COx were assessed. Data were analyzed using two-way ANOVA, Kruskal–Wallis test, and Wilcoxon and Mann–Whitney U test.

Results:
Sixty-five percent of patients had a baseline COx less than 0.30, indicating functional baseline autoregulation. In 50% of these patients (n = 10), COx became highly negative after vasoactive drug administration (from −0.04 [−0.25 to 0.16] to −0.63 [−0.83 to −0.26] after administration of phenylephrine, and from −0.05 [−0.19 to 0.17] to −0.55 [−0.94 to −0.35] after administration of nitroprusside). A negative COx implies a decrease in ScO2 with increase in pressure and, conversely, an increase in ScO2 with decrease in pressure.

Conclusions:
In this study, paradoxical changes in ScO2 after pharmacological-induced pressure changes occurred exclusively in patients with intact cerebral autoregulation, corroborating the hypothesis that these paradoxical responses might be attributable to a functional cerebral autoregulation.
Pediatric Tibial Osteomyelitis
Authors: Stone Brad , Street Matthew , Leigh Warren , Crawford Haemish 
Published: May 2015

Background:
Osteomyelitis shows a strong predilection for the tibia in the pediatric population and is a significant source of complications. The purpose of this article is to retrospectively review a large series of pediatric patients with tibial osteomyelitis. We compare our experience with that in the literature to determine any factors that may aid diagnosis and/or improve treatment outcomes.

Methods:
A 10-year retrospective review was performed of clinical records of all cases of pediatric tibial osteomyelitis managed at the 2 children’s orthopaedic departments in the Auckland region. The Osteomyelitis Database was used to identify all cases between 1997 and 2007, at Starship Children’s Hospital, and 1998 and 2008 at Middlemore’s Kids First Hospital.

Results:
One hundred ninety-one patients fulfilled the inclusion criteria, and had a review of clinical notes and relevant investigations. The average duration of symptoms before presentation to hospital was 5.7 days. Less than 40% of patients had a recent episode of trauma. Almost 60% of patients could not bear weight on admission. Over 40% of patients had a temperature above 38°C. Erythrocyte sedimentation rate was elevated in 78% and the C-reactive protein was elevated in 90% of patients. In total, 42% of blood cultures and almost 75% of tissue cultures were positive, with Staphylococcus aureus being the most commonly cultured organism. X-rays, bone scans, and magnetic resonance imaging were all used to aid the diagnosis. About 43% of patients had surgery. Treatment length was an average of 2 weeks 6 days of intravenous antibiotics followed by 3 weeks 2 days of oral treatment. Six postsurgical complications and 46 readmissions were noted: 25 for relapse, with the remainder due to social and antibiotic-associated complications.

Conclusions:
Although generally diagnosed on presentation, pediatric tibial osteomyelitis can require more sophisticated investigations and prolonged management. Treatment with intravenous and oral antibiotics and surgical debridement where indicated can lead to a good clinical outcome, although complications are often noted.

Level of Evidence:
Level IV—Prognostic study.
Temporary Percutaneous Pedicle Screw Stabilization Without Fusion of Adolescent Thoracolumbar Spine Fractures
Authors: Cui Shari , Busel Gennadiy A. , Puryear Aki S. 
Published: May 2015

Background:
Pediatric spine trauma often results from high-energy mechanisms. Despite differences in healing potential, comorbidities, and length of remaining life, treatment is frequently based on adult criteria; ligamentous injuries are fused and bony injuries are treated accordingly. In this study, we present short-term results of a select group of adolescent patients treated using percutaneous pedicle screw instrumentation without fusion.

Methods:
An IRB-approved retrospective review was performed at a level 1 pediatric trauma center for thoracolumbar spine fractures treated by percutaneous pedicle screw instrumentation. Patients were excluded if arthrodesis was performed or if instrumentation was not removed. Demographics, injury mechanism, associated injuries, fracture classification, surgical data, radiographic measures, and complications were collected. Radiographs were analyzed for sagittal and coronal wedge angles and vertebral body height ratio and statistical comparisons performed on preoperative and postoperative values.

Results:
Between 2005 and 2013, 46 patients were treated surgically. Fourteen patients (5 male, 9 female) met inclusion criteria. Injury mechanisms included 8 motor vehicle collisions, 4 falls, and 2 all-terrain vehicle/motorcycle collisions. There were 8 Magerl type A injuries, 4 type B injuries, and 2 type C injuries. There was 1 incomplete spinal cord injury. Implants were removed between 5 and 12 months in 12 patients and after 12 months in 2 patients. Statistical analysis revealed significant postoperative improvement in all radiographic measures (P<0.05). There were no neurological complications, 1 superficial wound dehiscence, and 2 instrumentation failures (treated with standard removal). At last follow-up, 11 patients returned to unrestricted activities including sports. Average follow-up was 9 months after implant removal and 19.3 months after index procedure.

Conclusions:
Adolescent thoracolumbar fractures present unique challenges and treatment opportunities different from the adult patient. We present a nonconsecutive series of 14 patients temporarily stabilized with percutaneous pedicle screw fixation for injuries including 3-column fracture dislocations and purely ligamentous injuries. Temporary fusionless instrumentation can provide successful management of select thoracolumbar spine injuries in pediatric trauma patients.

Level of Evidence:
Level IV—Retrospective case series.
Correction of Tibial Torsion in Children With Cerebral Palsy by Isolated Distal Tibia Rotation Osteotomy: A Short-term, In Vivo Anatomic Study
Authors: Andrisevic Emily , Westberry David E. , Pugh Linda I. , Bagley Anita M. , Tanner Stephanie , Davids Jon R. 
Published: May 2015

Background:
Excessive internal or external tibial torsion is frequently present in children with cerebral palsy. Several surgical techniques have been described to correct excessive tibial torsion, including isolated distal tibial rotation osteotomy (TRO). The anatomic changes surrounding this technique are poorly understood. The goal of the study was to examine the anatomic relationship between the tibia and fibula following isolated distal TRO in children with cerebral palsy.

Methods:
Twenty patients with 29 limbs were prospectively entered for study. CT scans of the proximal and distal tibiofibular (TF) articulations were obtained preoperatively, at 6 weeks, and 1 year postoperatively. Measurements of tibia and fibula torsion were performed at each interval. Qualitative assessments of proximal and distal TF joint congruency were also performed.

Results:
The subjects with internal tibia torsion (ITT, 19 limbs) showed significant torsional changes for the tibia between preoperative, postoperative, and 1 year time points (mean torsion 13.21, 31.05, 34.84 degrees, respectively). Measurement of fibular torsion in the ITT treatment group also showed significant differences between time points (mean −36.77, −26.77, −18.54 degrees, respectively). Proximal and distal TF joints remained congruent at all time points in the study.
Subjects with external tibia torsion (ETT, 10 limbs) showed significant differences between preoperative and postoperative tibial torsion, but not between postoperative and 1 year (mean torsion 54, 19.3, 23.3 degrees, respectively). Measurement of fibular torsion in the ETT treatment group did not change significantly between preoperative and postoperative, but did change significantly between postoperative and 1 year (mean torsion −9.8,−16.9, −30.7 degrees, respectively). Nine of 10 proximal TF joints were found to be subluxated at 6 weeks postoperatively. At 1 year, all 9 of these joints had reduced.

Conclusions:
Correction of ITT by isolated distal tibial external rotation osteotomy resulted in acute external fibular torsion. The fibular torsion alignment remodeled over time to accommodate the corrected tibial torsional alignment and reduce the strain associated with the plastic deformity of the fibula. Correction of ETT by isolated distal internal TRO resulted in acute subluxation of the proximal TF articulation in almost all cases. Subsequent torsional remodeling of the fibula resulted in correction of the TF subluxation in all cases. Acute correction of TT by isolated distal TRO occurs by distinct mechanisms, based upon the direction of rotational correction.

Level of Evidence:
Level II—Diagnostic.
Displaced Tibial Shaft Fractures With Intact Fibula in Children: Nonoperative Management Versus Operative Treatment With Elastic Stable Intramedullary Nailing
Authors: Canavese Federico , Botnari Alexei , Andreacchio Antonio , Marengo Lorenza , Samba Antoine , Dimeglio Alain , Pereira Bruno , Mansour Mounira , Rousset Marie 
Published: May 2015

Background:
The main objective of this study was to retrospectively evaluate the clinical and radiographic outcomes of displaced tibial shaft fractures with intact fibula in children after nonoperative management and operative treatment by elastic stable intramedullary nailing.

Methods:
A study was performed on 80 consecutive children, 56 males, 24 females from 2 Institutions, with displaced and closed tibial shaft fracture with intact fibula. All patients underwent regular clinical and radiographic follow-up visits for at least 2 years after injury.

Results:
In total, 26 patients (group A-Institution I) were treated surgically by elastic stable intramedullary nailing and 54 patients (18 patients from group B-Institution I and 36 patients from group C-Institution II) were treated nonoperatively with closed reduction and casting. groups A, B, and C did not significantly differ on sex (P=0.37), side (P=0.54), and fracture site (P=0.14).
Valgus deformity was significantly controlled in group A patients only (P=0.001); during follow-up in group B patients (P=0.017), and showed no significant change between pretreatment images and last follow-up in group C patients (P=0.71). Procurvatum deformity was significantly controlled in group A patients only (P=0.001); it showed no significant improvement after conservative treatment in group B (P=0.73) and C patients (P=0.8). Recurvatum was significantly improved in group A (P<0.001) and C patients (P<0.001) but remained unchanged in group B patients (P=0.15). Varus deformity improved significantly in all patient groups.
Immobilization time was significantly shorter in group A compared with group B and C patients (P<0.001).
However, numerical differences, although statistically significant, were not clinically relevant for all variables but immobilization time.

Conclusions:
This study showed good functional and radiologic outcomes in the pediatric population who had sustained closed, traumatic, displaced fracture of tibial diaphysis without associated fibula fracture.
On the basis of the findings reported here, it is not contraindicated to operate skeletally immature patients with displaced fracture of tibial diaphysis without associated fibula fracture. However, results were essentially the same and either method is a satisfactory choice for pediatric tibia shaft fractures with an intact fibula. In particular, we found that conservative treatment was as efficacious as surgical treatment apart from the length of time for immobilization.

Level of Evidence:
Level III.