bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACL Strain and Tensile Forces for Weight Bearing and Non—Weight-Bearing Exercises After ACL Reconstruction: A Guide to Exercise Selection
Authors: Escamilla Rafael F. , Macleod Toran D. , Wilk Kevin E. , Paulos Lonnie , Andrews James R. 
Published: March 2012

Synopsis There is a growing body of evidence documenting loads applied to the anterior cruciate ligament (ACL) for weight-bearing and non—weight-bearing exercises. ACL loading has been quantified by inverse dynamics techniques that measure anterior shear force at the tibiofemoral joint (net force primarily restrained by the ACL), ACL strain (defined as change in ACL length with respect to original length and expressed as a percentage) measured directly in vivo, and ACL tensile force estimated through mathematical modeling and computer optimization techniques. A review of the biomechanical literature indicates the following: ACL loading is generally greater with non—weight-bearing compared to weight-bearing exercises; with both types of exercises, the ACL is loaded to a greater extent between 10° to 50° of knee flexion (generally peaking between 10° and 30°) compared to 50° to 100° of knee flexion; and loads on the ACL change according to exercise technique (such as trunk position). Squatting with excessive forward movement of the knees beyond the toes and with the heels off the ground tends to increase ACL loading. Squatting and lunging with a forward trunk tilt tend to decrease ACL loading, likely due to increased hamstrings activity. During seated knee extension, ACL force decreases when the resistance pad is positioned more proximal on the anterior aspect of the lower leg, away from the ankle. The evidence reviewed as part of this manuscript provides objective data by which to rank exercises based on loading applied to the ACL. The biggest challenge in exercise selection post-ACL reconstruction is the limited knowledge of the optimal amount of stress that should be applied to the ACL graft as it goes through its initial incorporation and eventual maturation process. Clinicians may utilize this review as a guide to exercise selection and rehabilitation progression for patients post-ACL reconstruction. J Orthop Sports Phys Ther 2012;42(3):208–220. doi:10.2519/jospt.2012.3768
Anatomic Anterior Cruciate Ligament Reconstruction Utilizing the Double-Bundle Technique
Authors: Hensler Daniel , van Eck Carola F. , Fu Freddie H. , Irrgang James J. 
Published: March 2012

Synopsis The goal of every orthopaedic surgeon should be to restore anatomy as close as possible to normal. Intense research on reconstruction of the anterior cruciate ligament (ACL) and an advancing knowledge of the anatomy and function of the 2 primary bundles of the ACL have led to techniques of ACL reconstruction that more closely restore normal anatomy. Restoring the ACL footprint is one of the most important goals of the surgery, and the choice between anatomic single-bundle and double-bundle ACL reconstruction is determined by the anatomical features of each patient. After reconstruction, the graft undergoes a complex, lengthy process of remodeling; therefore, inappropriate (early), aggressive rehabilitation can lead to graft failure and compromise the patient's outcome. The purpose of this article is to provide an overview of the anatomy and function of the ACL, the methods for anatomic single-bundle and double-bundle ACL reconstruction, and our recommendations for postoperative rehabilitation. J Orthop Sports Phys Ther 2012;42(3):184–195. doi:10.2519/jospt.2012.3783
Surgical treatment for primary spinal aneurysmal bone cysts: experience from Children's Hospital Boston
Authors: Zenonos Georgios , Jamil Osama , Governale Lance S. , Jernigan Sarah , Hedequist Daniel , Proctor Mark R. 
Published: March 2012

Object
Spinal aneurysmal bone cysts (ABCs) constitute a rare and clinically challenging disease, primarily affecting the pediatric population. Information regarding the management of spinal ABCs remains sparse. In this study the authors review their experience with spinal ABCs at Children's Hospital Boston.

Methods
The medical records of all patients treated surgically for primary spinal ABCs between January 1998 and July 2010 were retrospectively reviewed.

Results
Fourteen cases were identified (6 males and 8 females, ages 5–19 years old). The ABCs were located throughout the spine, with an equal number in the thoracic and lumbar spine, and rarely in the cervical spine. The majority of patients presented with back pain, but neurological deficits and spinal deformity were common. A variety of radiographic techniques were used to establish the diagnosis, including needle biopsy. Preoperative selective arterial embolization was performed in 7 cases (50%), and the majority of cases required spinal instrumentation along with resection. Mean follow-up was 55.9 months (range 15–154 months) after initial intervention. Two ABCs recurred (14%), at 9 months and 8 years after incomplete initial resection, and the patients underwent reoperation. Complete resection was ultimately achieved in all cases. All patients were asymptomatic and neurologically intact at their last follow-up evaluation, and showed no evidence of deformity or recurrence on imaging.

Conclusions
Computed tomography and MR imaging are adequate for an initial evaluation of spinal ABCs, although solid variants can present a diagnostic challenge. Given the high rates of recurrence with residual disease, complete obliteration of the lesion should be the goal of treatment. Preoperative embolization is often performed, although in the authors' opinion the degree of bleeding tends not to support its routine use. Long-term follow-up is warranted as recurrences can occur years after initial intervention. However, gross-total excision in conjunction with spinal stabilization, as needed, usually provides cure of the ABC and excellent long-term spinal alignment.
Long-term outcome of extratemporal resection in posttraumatic epilepsy
Authors: Hakimian Shahin , Kershenovich Amir , Miller John W. , Ojemann Jeffrey G. , Hebb Adam O. , D'Ambrosio Raimondo , Ojemann George A. 
Published: March 2012

Object
Posttraumatic epilepsy (PTE) is a common cause of medically intractable epilepsy. While much of PTE is extratemporal, little is known about factors associated with good outcomes in extratemporal resections in medically intractable PTE. The authors investigated and characterized the long-term outcome and patient factors associated with outcome in this population.

Methods
A single-institution retrospective query of all epilepsy surgeries at Regional Epilepsy Center at the University of Washington was performed for a 17-year time span with search terms indicative of trauma or brain injury. The query was limited to adult patients who underwent an extratemporal resection (with or without temporal lobectomy), in whom no other cause of epilepsy could be identified, and for whom minimum 1-year follow-up data were available. Surgical outcomes (in terms of seizure reduction) and clinical data were analyzed and compared.

Results
Twenty-one patients met inclusion and exclusion criteria. In long-term follow-up 6 patients (28%) were seizure-free and an additional 6 (28%) had a good outcome of 2 or fewer seizures per year. Another 5 patients (24%) experienced a reduction in seizures, while only 4 (19%) did not attain significant benefit. The presence of focal encephalomalacia on imaging was associated with good or excellent outcomes in 83%. In 8 patients with the combination of encephalomalacia and invasive intracranial EEG, 5 (62.5%) were found to be seizure free. Normal MRI examinations preoperatively were associated with worse outcomes, particularly when combined with multifocal or poorly localized EEG findings. Two patients suffered complications but none were life threatening or disabling.

Conclusions
Many patients with extratemporal PTE can achieve good to excellent seizure control with epilepsy surgery. The risks of complications are acceptably low. Patients with focal encephalomalacia on MRI generally do well. Excellent outcomes can be achieved when extratemporal resection is guided by intracranial EEG electrodes defining the extent of resection.
Vagus nerve stimulation after lead revision
Authors: Dlouhy Brian J. , Viljoen Steven V. , Kung David K. , Vogel Timothy W. , Granner Mark A. , Howard Matthew A. , Kawasaki Hiroto 
Published: March 2012

Object
Vagus nerve stimulation (VNS) has demonstrated benefit in patients with medically intractable partial epilepsy. As in other therapies with mechanical devices, hardware failure occurs, most notably within the VNS lead, requiring replacement. However, the spiral-designed lead electrodes wrapped around the vagus nerve are often encased in dense scar tissue hampering dissection and removal. The objective in this study was to characterize VNS lead failure and lead revision surgery and to examine VNS efficacy after placement of a new electrode on the previously used segment of vagus nerve.

Methods
The authors reviewed all VNS lead revisions performed between October 2001 and August 2011 at the University of Iowa Hospitals and Clinics. Twenty-four patients underwent 25 lead revisions. In all cases, the helical electrodes were removed, and a new lead was placed on the previously used segment of vagus nerve. All inpatient and outpatient records of the 25 lead revisions were retrospectively reviewed.

Results
Four cases were second lead revisions, and 21 cases were first lead revisions. The average time to any revision was 5 years (range 1.8–11.1 years), with essentially no difference between a first and second lead revision. The most common reason for a revision was intrinsic lead failure resulting in high impedance (64%), and the most common symptom was increased seizure frequency (72%). The average duration of surgery for the initial implantation in the 15 patients whose VNS system was initially implanted at the authors' institution was much shorter (94 minutes) than the average duration of lead revision surgery (173 minutes). However, there was a significant trend toward shorter surgical times as more revision surgeries were performed. Sixteen of the 25 cases of lead revision were followed up for more than 3 months. In 15 of these 16 cases, the revision was as effective as the previous VNS lead. In most of these cases, both the severity and frequency of seizures were decreased to levels similar to those following the previous implantation procedure. Only 1 complication occurred, and there were no postoperative infections.

Conclusions
Lead revision surgery involving the placement of a new electrode at the previously used segment of vagus nerve is effective at decreasing the seizure burden to an extent similar to that obtained following the initial VNS implantation. Even with multiple lead revisions, patients can obtain VNS efficacy similar to that following the initial lead implantation. There is a learning curve with revision surgery, and overall the duration of surgery is longer than for the initial implantation. Note, however, that complications and infection are rare.
Natürliche und künstliche Verjüngung der Douglasie in Bayern aus genetischer Sicht
Authors: Konnert Monika , Fussi Barbara 
Published: March 2012

Genetic aspects related to natural and artificial regeneration of Douglas-fir in Bavaria
One of the most important factors when planting Douglas-fir is choosing the most suitable provenance for the site. Under climate change, genetic diversity as the basis for adaptation is of increasing importance. Both aspects, provenance and genetic diversity, have to be considered if natural regeneration of adult stands or planting of new stands are discussed. Numerous provenance trials have proven that the most suitable provenances for Bavaria originate from the coastal region west of the Cascade Mountains in Washington (Pseudotsuga menziesii var. menziesii). The interior variety (Pseudotsuga menziesii var. glauca and P. menziesii var. caesia) is unsuitable both because of growth rate and susceptibility to needle cast. However, not only coastal Douglas-fir was planted in Bavaria. Isozyme analysis showed that around 20% of the Bavarian stands represented interior Douglas-fir or a mixture of coastal and interior variety. Through natural regeneration the genetic structure of the adult trees is passed on to the following generation. If gene flow through pollen or seed from neighbouring stands occurs, significant changes in the genetic composition of natural regeneration in comparison with the adult generation will be observed. The same is true for the seed collected from adult stands. This must be taken into consideration when stands are selected as registered seed collection stands. Stands with low genetic diversity and mixture of green and gray variety of Douglas-fir have to be excluded from seed collection. To maintain an appropriate level of genetic diversity in the seed, cones should be collected from at least 20 trees per stand. This should be considered the absolute minimum. Concerning the level of genetic diversity in seed collections from Germany, West Washington (USA) and France (seed orchards), no clear differences were observed.
Wachstum und Wertleistung der Douglasie in Abhängigkeit von der Standraumgestaltung
Authors: Klädtke Joachim , Kohnle Ulrich , Kublin Edgar , Ehring Andreas , Pretzsch Hans , Uhl Enno , Spellmann Hermann , Weller Andreas 
Published: March 2012

Growth and value production of Douglas-fir under varying stand densities
The investigation is focused on the effects of initial tree number and thinning on growth and value performance of Douglas-fir stands. Data base is a coordinated Douglas-fir spacing experiment in South Germany, started 40 years ago and comprising variants of tree numbers with 500, 1,000, 2,000 and 4,000 Douglas-firs per hectare. The treatment was performed according to a standardized experiment program. The results show that at low initial tree numbers, the diameter on breast height (DBH) of (pre)dominant trees at the beginning of the observations (with 12 m top height) is bigger than at higher initial plant numbers. Accordingly, the quotient of height (H) to DBH (as an indicator for tree's static stability) is lower. The further development of DBH and H/DBH quotient is decisively determined by stand treatment, which superimposes the effect of the initial tree number. The total volume growth shows a clear differentiation, too, the variants with initially high tree numbers appearing on top. In the monetary analysis, this ranking is reversed: despite a supposed inferior wood quality, the variants with lower initial tree numbers clearly outperform the ones with higher numbers in terms of value. From these results, the following silvicultural recommendations for Douglas-fir can be derived: the initial tree numbers should be in the range from 1,000 to 2,000 plants per hectare. On technically not accessible sites, even lower tree numbers may come into question. The strong influence of stand treatment on DBH and H/DBH development highlights the problem of postponed thinnings, for this causes growth and stability losses even under favorable starting conditions in terms of competition.
Multi-class HingeBoost
Authors: Wang Z. 
Published: March 2012

SummaryBackground: Multi-class molecular cancer classification has great potential clinical implications. Such applications require statistical methods to accurately classify cancer types with a small subset of genes from thousands of genes in the data.Objectives: This paper presents a new functional gradient descent boosting algorithm that directly extends the HingeBoost algorithm from the binary case to the multi-class case without reducing the original problem to multiple binary problems.Methods: Minimizing a multi-class hinge loss with boosting technique, the proposed Hinge-Boost has good theoretical properties by implementing the Bayes decision rule and providing a unifying framework with either equal or unequal misclassification costs. Furthermore, we propose Twin HingeBoost which has better feature selection behavior than Hinge-Boost by reducing the number of ineffective covariates. Simulated data, benchmark data and two cancer gene expression data sets are utilized to evaluate the performance of the proposed approach.Results: Simulations and the benchmark data showed that the multi-class HingeBoost generated accurate predictions when compared with the alternative methods, especially with high-dimensional covariates. The multi-class Hinge-Boost also produced more accurate prediction or comparable prediction in two cancer classification problems using gene expression data.Conclusions: This work has shown that the HingeBoost provides a powerful tool for multi-classification problems. In many applications, the classification accuracy and feature selection behavior can be further improved when using Twin HingeBoost.
Patient-specific and Surgical Characteristics in the Development of Pressure Ulcers
Authors: Tschannen Dana , Bates Ondrea , Talsma AkkeNeel , Guo Ying 
Published: March 2012

BackgroundImplementation of the ruling on the Inpatient Prospective Payment System by the Centers for Medicare and Medicaid has challenged nurses to focus on the prevention of pressure ulcers. Despite years of research, pressure ulcers are still one of the most common complications experienced by patients in health care facilities.ObjectiveTo examine the relationship between patients’ characteristics (age, sex, body mass index, history of diabetes, and Braden Scale score at admission) and care characteristics (total operating room time, multiple surgeries, and vasopressor use) and the development of pressure ulcers.MethodsIn a cohort study, data from the electronic medical records of 3225 surgical patients admitted to a Midwest hospital, from November 2008 to August 2009 were analyzed statistically to determine predictors of pressure ulcers.ResultsA total of 12% of patients (n = 383) had at least 1 pressure ulcer develop during their hospitalization. According to logistic regression analysis, scores on the Braden Scale at admission (P &lt; .001), low body mass index (P &lt; .001), number of vasopressors (P = .03), multiple surgeries during the admission (P &lt; .001), total surgery time (P &lt; .001), and risk for mortality (P &lt; .001) were significant predictors of pressure ulcers.ConclusionScores on the Braden Scale at admission can be used to identify patients at increased risk for pressure ulcers. For other high-risk factors, such as low body mass index and long operative procedures, appropriate clinical interventions to manage these conditions can help prevent pressure ulcers.
Effect of a Computerized Insulin Dose Calculator on the Process of Glycemic Control
Authors: Dumont Cheryl , Bourguignon Cheryl 
Published: March 2012

BackgroundGlycemic control is important to patients’ outcomes. However, the process of maintaining glycemic control is risk laden and labor intensive for nurses.ObjectivesTo examine the effects of using a computerized insulin dose calculator to facilitate management of glycemic control for critically ill cardiac patients.MethodsA prospective randomized controlled trial was conducted with a sample of 300 intensive care patients, 141 randomized to the calculator group and 159 in the control (paper protocol) group. A convenience sample of 44 intensive care nurses responded to a nurse satisfaction survey.ResultsA significantly higher percentage of glucose measurements were in the target range in the calculator group than in the control group (70.4% [SD, 15.2%] vs 61.6% [SD, 17.9%], Z = −4.423, P &lt; .001), and glucose variance was significantly less in the calculator group (35.5 [SD, 18.3] mg/dL vs 42.3 [SD, 21.2] mg/dL, Z = −3.845, P &lt; .001). Fewer hypoglycemic events occurred in the calculator group (7 vs 18), although this difference was not statistically significant. Nurse satisfaction was higher for the calculator group than for the control group (8.4 [SD, 1.4] vs 4.8 [SD, 2.4], Z = −5.055, P &lt; .001). Nurses’ deviation from the protocol was also less in the calculator group than in the control group.ConclusionsManagement of glycemic control and nurse satisfaction were improved with use of the dose calculator. Improving nurses’ processes of care may improve nurses’ use of time and patient care overall. Studies with larger sample sizes over time are needed to determine these relationships.
MicroRNA-Deficient NK Cells Exhibit Decreased Survival but Enhanced Function
Authors: Sullivan Ryan P. , Leong Jeffrey W. , Schneider Stephanie E. , Keppel Catherine R. , Germino Elizabeth , French Anthony R. , Fehniger Todd A. 
Published: March 2012

Abstract
NK cells are innate immune lymphocytes important for early host defense against infectious pathogens and malignant transformation. MicroRNAs (miRNAs) are small RNA molecules that regulate a wide variety of cellular processes, typically by specific complementary targeting of the 3′UTR of mRNAs. The Dicer1 gene encodes a conserved enzyme essential for miRNA processing, and Dicer1 deficiency leads to a global defect in miRNA biogenesis. In this study, we report a mouse model of lymphocyte-restricted Dicer1 disruption to evaluate the role of Dicer1-dependent miRNAs in the development and function of NK cells. As expected, Dicer1-deficient NK cells had decreased total miRNA content. Furthermore, miRNA-deficient NK cells exhibited reduced survival and impaired maturation defined by cell surface phenotypic markers. However, Dicer1-deficient NK cells exhibited enhanced degranulation and IFN-γ production in vitro in response to cytokines, tumor target cells, and activating NK cell receptor ligation. Moreover, a similar phenotype of increased IFN-γ was evident during acute MCMV infection in vivo. miRs-15a/15b/16 were identified as abundant miRNAs in NK cells that directly target the murine IFN-γ 3′UTR, thereby providing a potential mechanism for enhanced IFN-γ production. These data suggest that the function of miRNAs in NK cell biology is complex, with an important role in NK cell development, survival, or homeostasis, while tempering peripheral NK cell activation. Further study of individual miRNAs in an NK cell specific fashion will provide insight into these complex miRNA regulatory effects in NK cell biology.
IL-17A Differentially Regulates Corneal Vascular Endothelial Growth Factor (VEGF)-A and Soluble VEGF Receptor 1 Expression and Promotes Corneal Angiogenesis after Herpes Simplex Virus Infection
Authors: Suryawanshi Amol , Veiga-Parga Tamara , Reddy Pradeep B. J. , Rajasagi Naveen K. , Rouse Barry T. 
Published: March 2012

Abstract
Ocular infection with HSV causes corneal neovascularization (CV), an essential step in the pathogenesis of the blinding immunoinflammatory lesion stromal keratitis. The infection results in IL-17A production, which contributes to CV in ways that together serve to shift the balance between corneal concentrations of vascular endothelial growth factor A (VEGF-A) and the soluble vascular endothelial growth factor receptor 1 molecule, which binds to VEGF-A and blocks its function (a so-called VEGF trap). Accordingly, animals lacking responses to IL-17A signaling, either because of IL-17 receptor A knockout or wild-type animals that received neutralizing mAb to IL-17A, had diminished CV, compared with controls. The procedures reduced VEGF-A protein levels but had no effect on the levels of soluble vascular endothelial growth factor receptor 1. Hence the VEGF trap was strengthened. IL-17A also caused increased CXCL1/KC synthesis, which attracts neutrophils to the inflammatory site. Neutrophils further influenced the extent of CV by acting as an additional source of VEGF-A, as did metalloproteinase enzymes that degrade the soluble receptor, inhibiting its VEGF-blocking activity. Our results indicate that suppressing the expression of IL-17A, or increasing the activity of the VEGF trap, represents a useful approach to inhibiting CV and the control of an ocular lesion that is an important cause of human blindness.