bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-Step Test for Unilateral Limb Ability Following Total Knee Arthroplasty
Authors: Marmon Adam Rubin , McClelland Jodie A. , Stevens-Lapsley Jennifer , Snyder-Mackler Lynn 
Published: November 2012

Study Design Secondary analysis of a cohort enrolled in a prospective, randomized, longitudinal clinical trial. Objectives The single-step test (SST) was evaluated to assess its intertester reliability, validity as a test of activity limitation, and responsiveness to change for patients after unilateral total knee arthroplasty (TKA). The SST was also examined to determine whether it could differentiate between the surgical and nonsurgical lower limbs of patients after unilateral TKA and between the surgical limbs of patients after TKA and the limbs of healthy controls. Background Tests of functional ability for patients recovering from TKA cannot differentiate the contribution of each limb to performance outcome. A test of unilateral limb ability would provide a metric for assessing the surgical lower extremity, without the confounder of the status of the contralateral lower extremity. Methods Intertester reliability was assessed between clinicians and between a clinician and a switch mat. Patients who underwent unilateral TKA were tested at initial outpatient physical therapy evaluation, at 3 months after TKA, and at 1 year after TKA. Results The assessment of function with the SST was determined to be reliable between testers when using a stopwatch. SST times were significantly correlated with other measures of lower extremity functional performance, providing evidence of its validity in patients after TKA. The SST was responsive to treatment in patients after TKA, with improvements in time for test completion. Performance on the SST also differed between limbs of patients after TKA and when comparing the limbs of healthy controls to those of patients after TKA. Conclusion The SST is a reliable measure between testers and a valid and responsive test of activity limitations when assessing unilateral lower extremity impairments in patients after TKA. J Orthop Sports Phys Ther 2013;43(2):66–73. Epub 16 November 2012. doi:10.2519/jospt.2013.4372
Clinimetric Analysis of Pressure Biofeedback and Transversus Abdominis Function in Individuals With Stabilization Classification Low Back Pain
Authors: Grooms Dustin R. , Grindstaff Terry L. , Croy Theodore , Hart Joseph M. , Saliba Susan A. 
Published: November 2012

Study Design Descriptive laboratory study. Objective To determine if a proposed clinical test (pressure biofeedback) could detect changes in transversus abdominis (TrA) muscle thickness during an abdominal drawing-in maneuver. Background Pressure biofeedback may be used to assess abdominal muscle function and TrA activation during an abdominal drawing-in maneuver but has not been validated. Methods Forty-nine individuals (18 men, 31 women) with low back pain who met stabilization classification criteria underwent ultrasound imaging to quantify changes in TrA muscle thickness while a pressure transducer was used to measure pelvic and spine position during an abdominal drawing-in maneuver. A paired t test was used to compare differences in TrA activation ratios between groups (able or unable to maintain pressure of 40 ± 5 mmHg). The groups were further dichotomized based on TrA activation ratio (high, greater than 1.5; low, less than 1.5). Sensitivity, specificity, and likelihood ratios were calculated. Results There was not a significant difference (P = .57) in TrA activation ratios (able to maintain pressure, 1.59 ± 0.28; unable to maintain pressure, 1.54 ± 0.24) between groups. The pressure biofeedback test had low sensitivity of 0.22 (95% confidence interval [CI]: 0.10, 0.42) but moderate specificity of 0.77 (95% CI: 0.58, 0.89), a positive likelihood ratio of 0.94 (95% CI: 0.33, 2.68), and a negative likelihood ratio of 1.02 (95% CI: 0.75, 1.38). Conclusion Successful completion on pressure biofeedback does not indicate high TrA activation. Unsuccessful completion on pressure biofeedback may be more indicative of low TrA activation, but the correlation and likelihood coefficients indicate that the pressure test is likely of minimal value to detect TrA activation. This study was registered with ClinicalTrials.gov (NCT01015846). J Orthop Sports Phys Ther 2013;43(3):184–193. Epub 16 November 2012. doi:10.2519/jospt.2013.4397
The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties
Authors: Bartels Bart , de Groot Janke F. , Terwee Caroline B. 
Published: November 2012

Background
The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use.

Purpose
The purpose of this study was to systematically review all published clinimetric studies on the 6MWT in chronic pediatric conditions.

Data Sources
The databases MEDLINE, EMBASE, CINAHL, PEDro, and SPORTDiscus were searched up to February 2012.

Study Selection
Studies designed to evaluate measurement properties of the 6MWT in a chronic pediatric condition were included in the systematic review.

Data Extraction
The methodological quality of the included studies and the measurement properties of the 6MWT were examined.

Data Synthesis
A best evidence synthesis was performed on 15 studies, including 9 different chronic pediatric conditions. Limited evidence to strong evidence was found for reliability in various chronic conditions. Strong evidence was found for positive criterion validity of the 6MWT with peak oxygen uptake in some populations, but negative criterion validity was found in other populations. Construct validity remained unclear in most patient groups because of methodological flaws. Little evidence was available for responsiveness and measurement error. Studies showed large variability in test procedures despite existing guidelines for the performance of the 6MWT.

Limitations
Unavailability of a specific checklist to evaluate the methodological quality of clinimetric studies on performance measures was a limitation of the study.

Conclusions
Evidence for measurement properties of the 6MWT varies largely among chronic pediatric conditions. Further research is needed in all patient groups to explore the ability of the 6MWT to measure significant and clinically important changes. Until then, changes measured with the 6MWT should be interpreted with caution. Future studies or consensus regarding modified test procedures in the pediatric population is recommended.
Comparing indocyanine green videoangiography to the gold standard of intraoperative digital subtraction angiography used in aneurysm surgery
Authors: Washington Chad W. , Zipfel Gregory J. , Chicoine Michael R. , Derdeyn Colin P. , Rich Keith M. , Moran Christopher J. , Cross DeWitte T. , Dacey Ralph G. 
Published: November 2012

Object
The purpose of aneurysm surgery is complete aneurysm obliteration while sparing associated arteries. Indocyanine green (ICG) videoangiography is a new technique that allows for real-time evaluation of blood flow in the aneurysm and vessels. The authors performed a retrospective study to compare the accuracy of ICG videoangiography with intraoperative angiography (IA), and determine if ICG videoangiography can be used without follow-up IA.

Methods
From June 2007 through September 2009, 155 patients underwent craniotomies for clipping of aneurysms. Operative summaries, angiograms, and operative and ICG videoangiography videos were reviewed. The number, size, and location of aneurysms, the ICG videoangiography and IA findings, and the need for clip adjustment after ICG videoangiography and IA were recorded. Discordance between ICG videoangiography and IA was defined as ICG videoangiography demonstrating aneurysm obliteration and normal vessel flow, but post-IA showing either an aneurysmal remnant and/or vessel occlusion requiring clip adjustment.

Results
Thirty-two percent of patients (49 of 155) underwent both ICG videoangiography and IA. The post-ICG videoangiography clip adjustment rate was 4.1% (2 of 49). The overall rate of ICG videoangiography–IA agreement was 75.5% (37 of 49) and the ICG videoangiography–IA discordance rate requiring post-IA clip adjustment was 14.3% (7 of 49). Adjustments were due to 3 aneurysmal remnants and 4 vessel occlusions. These adjustments were attributed to obscuration of the residual aneurysm or the affected vessel from the field of view and the presence of dye in the affected vessel via collateral flow. Although not statistically significant, there was a trend for ICG videoangiography–IA discordance requiring clip adjustment to occur in cases involving the anterior communicating artery complex, with an odds ratio of 3.3 for ICG videoangiography–IA discordance in these cases.

Conclusions
These results suggest that care should be taken when considering ICG videoangiography as the sole means for intraoperative evaluation of aneurysm clip application. The authors further conclude that IA should remain the gold standard for evaluation during aneurysm surgery. However, a combination of ICG videoangiography and IA may ultimately prove to be the most effective strategy for maximizing the safety and efficacy of aneurysm surgery.
Pneumonia in patients with severe head injury: incidence, risk factors, and outcomes
Authors: Wang Kuo-Wei , Chen Han-Jung , Lu Kang , Liliang Po-Chou , Huang Chun-Kai , Tang Pi-Lien , Tsai Yu-Duan , Wang Hao-Kuang , Liang Cheng-Loong 
Published: November 2012

Object
The reported incidence of hospital-acquired bacterial pneumonia in critically ill trauma patients varies from as low as 4% to as high as 87%, with fatality rates varying from 6% to 59%. Clinical studies have identified the risk factors for pneumonia. The authors undertook this retrospective study to evaluate the incidence, risk factors, and outcomes of hospital-acquired bacterial pneumonia in a group of patients with severe head injuries.

Methods
This was a retrospective review of consecutive adult patients admitted to the neurosurgical ICU in the authors' hospital because of severe head injury (Glasgow Coma Scale scores ≤ 8) between January 2008 and December 2010.

Results
During the study period, 290 patients were admitted to the neurosurgical ICU. Multivariate Cox regression analysis showed that age (HR 1.01, 95% CI 1.001–1.02), nasogastric tube insertion (HR 4.56, 95% CI 1.11–18.64), and hemiplegia or hemiparesis (HR 3.79, 95% CI 2.01–7.17) were significantly associated with the development of pneumonia.

Conclusions
The authors identified 3 risk factors (age, nasogastric tube insertion, and hemiplegia or hemiparesis) associated with the development of pneumonia in patients with severe head injury. This finding constituted the basis for developing a simple screening tool that can be used to assess the risk of occurrence of pneumonia in such patients.
The inferior medullary velum: anatomical study and neurosurgical relevance
Authors: Tubbs R. Shane , Bosmia Anand N. , Loukas Marios , Hattab Eyas M. , Cohen-Gadol Aaron A. 
Published: November 2012

Object
Although it is often visualized surgically, details regarding the inferior medullary velum are lacking in the literature. The present study is intended to better elucidate this neuroanatomical structure using microsurgical and immunohistochemical analyses.

Methods
To study the inferior medullary velum, the authors performed microdissection in 15 adult cadavers. Following gross study, specimens were examined histologically.

Results
The inferior medullary velum extended from the flocculus to the middle cerebellar peduncle and stretched between the inferior cerebellar peduncle and the nodule and pyramid. The average thickness of the velum was found to be 0.5 mm (range 0.35–0.8 mm) and the average length was found to be 6 mm (range 5.5–7.2 mm). Arterial branches were identified in all specimens that arose from medullary branches of the posterior inferior cerebellar artery and supplied the inferior medullary velum. Histologically and from internal to external, a choroid plexus epithelium as a single cell layer was adjacent to a cuboidal layer of ependymal cells with no visible cilia. The next layer contained scattered glia in single cells or small clusters. The most external layer was composed of flat spindle cells resembling fibroblasts. No neurons of any type were identified. Only rare axons traversed the thin hypocellular zone that disappeared toward the midline.

Conclusions
Based on this cadaveric study, the authors conclude that division of the inferior medullary velum should be relatively harmless as no neuronal cells were identified in this structure, which appears to be a vestigial bridge of tissue between the left and right sides of the cerebellum.
Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia
Authors: Sweeney Kieron J. , Caird John , Sattar Muhammad Taufiq , Allcutt David , Crimmins Darach 
Published: November 2012

Object
McLone and Knepper's unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

Methods
All newborns who required closure of a myelomeningocele at the authors' institution between 2008 and 2011 and who were between 4 weeks premature and 2 months, corrected gestational age, at the time of MRI were included in this study. Volumes and measurements were obtained from axial and sagittal T2-weighted MR images of the brain and spine.

Results:
A total of 56 newborn infants met the inclusion criteria. There was a direct linear relationship between both posterior fossa volume and cerebellar volume and the spinal level of the myelomeningocele lesion (p = 0.0012 and p = 0.0041, respectively). There was a negative linear relationship between the cerebellar descent, the spinal level of the lesion, and posterior fossa volume and cerebellar volume. These relationships strengthen in patients with no syringomyelia and are not significant in those groups with syringomyelia. The results of a 1-way ANOVA for the 3 groups did not reach significance.

Conclusions
Using a linear equation derived from the Hagen-Poiseuille law that describes pressure in the fourth ventricle as being directly related to the length of the central canal from the obex to the myelomeningocele lesion, the authors were able to explain the directly observed linear relation between posterior fossa volume, intracranial cerebellar volume, and cerebellar descent to the level of the spinal lesion. As this model assumes a uniform radius of the central canal they were able to validate this model when they observed a strengthening in relationships in the no syringomyelia group and statistically insignificant correlations in the groups with syringomyelia. They therefore propose that the spinal level of the lesion is one of the major determinants of posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.
Arthroscopic treatment of fragmented coronoid process with severe elbow incongruity
Authors: de Bakker E. , Van Vynckt D. , Coppieters E. , van Bree H. , Van Ryssen B. , Samoy Y. C. A. 
Published: November 2012

SummaryThe purpose of this study was to investigate the long-term treatment results of fragmented coronoid process (FCP) in joints with a radio-ulnar step greater than 3 mm. Treatment of these patients only consisted of fragment removal, without correction of the incongruity.The eight Bernese Mountain Dogs (11 joints) included in this study showed obvious clinical signs of elbow disease and were diagnosed with severe elbow incongruity and concomitant FCP in the time period from 1999–2003. At that time, elbow radiography, computed tomography, and arthroscopy were performed. The mean follow-up period was 5.6 years. The follow-up consisted of a telephone questionnaire combined with a clinical and radiographic re-evaluation at our clinic.The questionnaire revealed that all dogs were either free of lameness or only lame following heavy exercise. One dog sporadically required medication after heavy exercise. The owner satisfaction rate was 100%. The clinical re-evaluation did not reveal any signs of pain or lameness in all cases. Range-of- motion was decreased in nine of the 11 elbows. Radiographs revealed an increase in severity of osteoarthritis in every case.In this case series, arthroscopic fragment removal without treatment of incongruity was demonstrated to be a valuable treatment option and may provide a satisfactory long-term outcome.
Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture
Authors: Plesman R. , Campbell J. , Gilbert P. 
Published: November 2012

SummaryObjectives: To evaluate and compare detection of meniscal tears associated with cranial cruciate ligament insufficiency by either arthroscopy or arthrotomy.Methods: A retrospective, cohort study was completed with stifles (n = 531) of dogs with cranial cruciate ligament rupture. Either a medial parapatellar arthrotomy or an arthroscopy procedure was performed and groups were compared for significant differences in meniscal tears detected using logistic regression analysis.Results: Arthroscopy was performed on 58.8% and arthrotomy on 41.2% of the stifles. In total, 44.4% of the examined stifles had meniscal tears. Meniscal tears were found in 38.8% of the stifles examined by arthrotomy, and 48.4% of those examined by arthroscopy. Overall, the rate of detection of a meniscal tear was significantly different (p = 0.019) between the groups, and meniscal tears were observed more frequently by arthroscopy than by arthrotomy (odds ratio 1.54; 95% confidence interval 1.07 – 2.22).Clinical significance: These results suggest that arthroscopy may be more sensitive than arthrotomy for detection of meniscal pathology in clinical patients. However, these results must be interpreted with caution since this was a retrospective study. Randomized prospective clinical studies are required to further test this hypothesis.
Myositis ossificans circumscripta of the triceps muscle in a Rottweiler dog
Authors: Palumbo Piccionello A. , Dini F. , Vullo C. , Rossi G. , Scrollavezza P. , Tambella A. M. 
Published: November 2012

SummaryA 20-month-old male Rottweiler dog was presented with the complaint of chronic right forelimb lameness that was unresponsive to conservative treatment. Physical examination allowed for the topographical identification of the source of the problem as a firm enlargement of the soft tissues that was partially movable from humeral bone and compatible with an alteration of the triceps brachii muscle. Radiographic images showed signs that were highly suggestive of myositis ossificans. Computed tomography allowed for a more accurate characterization of the lesion, to exclude involvement of the elbow joint and humeral bone, and to localize anatomically the lesion in the caput accessorium and longum of the triceps brachii muscle. Surgical excision of the ossified portion of the triceps muscle was performed. Histological examination of the excised tissue substantiated the diagnosis of myositis ossificans. A one year clinical and radiographic follow-up examination showed a complete recovery, with no evidence of complications or recurrence. Despite myositis ossificans in dogs having previously been identified in the hindlimbs, this case of myositis ossificans circumscripta of the triceps muscle suggests that it may also occur in the muscles of the forelimb.
Learning in Games : Neural Computations underlying Strategic Learning
Authors: Hsu Ming , Zhu Lusha 
Published: November 2012

Résumé Les dernières décennies ont connu une croissance inédite de notre compréhension des fondements cérébraux de la prise de décision économique. En particulier, la recherche a découvert non seulement la localisation de régions du cerveau où certains processus ont lieu, mais également la nature de variables latentes (économiquement significatives) ainsi que la manière dont elles sont liées au comportement. Cette transition d’une compréhension du lieu de la décision économique vers la manière dont se prend cette décision au niveau cérébral est intégrante à l’identification d’une relation entre processus nerveux et modèles de comportements économiques. Toutefois, le progrès accompli a été inégal. Les études neuro-économiques sur la prise de décision individuelle, telles que celles impliquant les préférences temporelles ou l’attitude face au risque, ont l’avantage de s’inscrire dans des décennies d’études neuroscientifiques sur les comportements animaliers. La plupart de ces résultats sont basés sur des approches quantitatives et informatiques, qui se prêtent aisément à l’expérimentation économique. En revanche, notre compréhension des systèmes nerveux sous-jacents au comportement social est bien moins spécifique. Une grande partie du défi actuel résulte des lacunes empiriques des prédictions de comportement issues de la théorie des jeux standard, qui sont largement basées sur l’équilibre. Utilisant notre propre étude comme exemple, nous montrons comment il est possible de chercher directement les variables latentes induites par les modèles actuels d’apprentissage stratégique, et de tenter de les localiser dans le cerveau. Plus précisément, nous montrons que les systèmes nerveux sous-jacents à l’apprentissage stratégique s’ajoutent à ceux impliqués dans l’apprentissage par essais-erreurs, mais incluent également des calculs additionnels qui captent l’apprentissage basé sur la croyance. Finalement, nous discutons la manière dont notre approche peut être élargie pour traiter les problèmes fondamentaux de l’économie. Classification JEL : C92, D83.