bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods
Authors: Schulz Amy J. , Israel Barbara A. , Mentz Graciela B. , Bernal Cristina , Caver Deanna , DeMajo Ricardo , Diaz Gregoria , Gamboa Cindy , Gaines Causandra , Hoston Bernadine , Opperman Alisha , Reyes Angela G. , Rowe Zachary , Sand Sharon L. , Woods Sachiko
Published: March 2015

Objectives. The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health ( WYHH) intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit, Michigan. The study was designed and implemented using a community-based participatory research approach that actively engaged community residents, health service providers and academic researchers. It was implemented between 2009 and 2012. Method. WYHH was a 32-week community health promoter–facilitated walking group intervention. Groups met three times per week at community-based or faith-based organizations, and walked for 45 to 90 minutes (increasing over time). The study used a cluster randomized control design to evaluate effectiveness of WYHH, with participants randomized into intervention or lagged intervention (control) groups. Psychosocial, clinical, and anthropometric data were collected at baseline, 8, and 32 weeks, and pedometer step data tracked using uploadable peisoelectric pedometers. Results. Participants in the intervention group increased steps significantly more during the initial 8-week intervention period, compared with the control group (β = 2004.5, p = .000). Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference and body mass index at 8 weeks, and maintained at 32 weeks. Conclusion. The WYHH community health promoter–facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community. Such interventions can contribute to reductions in racial, ethnic, and socioeconomic inequities in cardiovascular mortality.
On the running-in behavior of lubricated line contacts
Authors: Lohner T , Mayer J , Michaelis K , Höhn B-R , Stahl K
Published: March 2015

The first operating period of machine elements is subject to a running-in phase. Thereby, stresses applied on the contacting surfaces are influenced by the running-in conditions including the lubricant used and can strongly affect the frictional behavior and load-carrying capacity of lubricated contacts after running-in. This study investigates the influences of operating conditions and lubricant additives on the running-in behavior of lubricated line contacts of discs and gears. Results show a strong influence of the lubricant additive on the coefficient of friction during running-in as well as on the surface roughness and surface condition after running-in. The specific boundary friction power, supplemented by considering load carrying capacity limits, has been introduced as a criterion for defining the running-in conditions of gears.
How well do parental and peer relationships in adolescence predict health in adulthood?
Authors: Landstedt Evelina , Hammarström Anne , Winefield Helen
Published: March 2015

Aim: Although health effects of social relationships are well-researched, long-term health consequences of adolescent family as well as peer relationships are poorly understood. The aim of the study was to explore the prospective importance of parental and peer social relationships in adolescence on internalising and functional somatic symptoms in adulthood. Methods: Data were drawn from four waves of the Northern Swedish Cohort Study, response rate 94.3%, N=1001. Outcome variables were internalising and functional somatic symptoms at the ages of 21, 30 and 42. Relationship variables at age 16 were poor parental contact and three indicators of poor peer relationships. Associations were assessed in multivariate ordinal logistic regressions with adjustment for confounders and baseline health. Results: Results show that the main relationships-related predictors of adult internalising symptoms were self-rated poor peer relationships in terms of spending time alone during after-school hours and poor parental relationship. Functional somatic symptoms on the other hand were most strongly associated with poor parental contact and not being happy with classmates at age 16. Conclusions: The quality of parental and peer relationships in adolescence predicts adult mental and functional somatic health as much as 26 years later, even when accounting for confounders and adolescent symptomatology. This study extends past research by exploring how both adolescent parental and peer relationships (self-reported as well as teacher reported) predict adult self-reported health.
Transferability of the youth foyer model for women exiting the criminal justice system
Authors: Grace Marty , Malone Jennifer , Murphy Angela
Published: March 2015

This article reports on research with an Australian Homelessness Prevention Project, Restart, which set out to test the transferability of a Youth Foyer model for women exiting prison. The aim of the program was to prevent homelessness for this group of women by stabilising both housing and employment. The program design included a comprehensive package of services including support, housing, and assistance with finding employment. The research methods included analysis of program data, and interviews with program staff and clients.

Findings

The research found that while the Restart model was described as an adult foyer model, it had some characteristics of a Youth Foyer model and some characteristics of a Housing First model. The imperative to be employed within 12 months in order to be able to afford the housing prevented the program from supporting women to pursue longer-term goals such as education and training which typify youth foyers. Although the program had only limited success with assisting the women to find employment, it demonstrated that intensive assistance that includes support and housing can assist women to stabilise their lives and avoid re-offending post release.

Application

This research indicates that it would be worthwhile to pursue a model that provides social housing that is permanent and will be affordable in the long term, facilitates employment by establishing corporate partnerships, perhaps with social enterprises, and assists women to establish longer-term goals and undertake education and training in order to provide them with better labour market access in the future.
Detection and quantification of diameter reduction due to corrosion in reinforcing steel bars
Authors: Amjad Umar , Yadav Susheel Kumar , Kundu Tribikram
Published: March 2015

Guided wave–based techniques are becoming popular for damage detection in pipes, rods, and plates. For monitoring reinforced concrete beams, the longitudinal guided wave is excited and recorded after its transmission through the reinforcing steel bar for estimating its corrosion level. Recorded signal amplitude is affected by the corrosion level. Thus, the corrosion level is estimated from the transmitted wave amplitude. Instead of investigating the amplitude of the transmitted guided waves, the differential time-of-flight of the propagating wave modes is recorded in this article. The differential time-of-flight is obtained from the time–frequency representations of the recorded transient signals and from the high temporal resolution using the cross-correlation technique. It is observed that the corrosion level can be quantified from the change in time-of-flight of the L(0,1) mode. The guided wave modes are experimentally generated, recorded, and compared with the theoretical dispersion curves to identify different modes and select the most efficient mode for quantifying the corrosion level. Unlike the recorded signal strength, the time-of-flight is not influenced by the bonding condition between the sensors and the specimen; therefore, the time-of-flight-based corrosion-monitoring technique is less influenced by the sensor bonding condition. This investigation is necessary because most investigators have studied the effect of corrosion on the recorded signal strength instead of its time-of-flight.
Temporal variables and personal factors in glare sensation
Authors: Kent MG , Altomonte S , Tregenza PR , Wilson R
Published: March 2015

Previous laboratory experiments have provided evidence of an effect of time of day on glare sensation. During the tests, temporal variables and personal factors were also measured to analyse their influence on levels of visual discomfort as the day progresses. The results revealed statistically significant and practically relevant tendencies towards greater tolerance to source luminance from artificial lighting at all times of day for earlier chronotypes and for participants not having ingested caffeine. No conclusive evidence was found for the effect of fatigue, sky condition and prior light exposure on glare sensation throughout the day. These findings suggest that temporal variables and personal factors should be measured in conjunction with visual discomfort levels to explore the causes of the wide individual differences commonly associated with the subjective evaluation of glare sensation.
Consumer Demand for Telecasts of Tennis Matches in Germany
Authors: Konjer Mara , Meier Henk Erik , Wedeking Katrin
Published: March 2015

The research presented here aims to fill the existing gap in empirical research on demand for individual sports. A unique data set on audiences for live broadcast tennis matches from Germany, as Europe’s biggest and most competitive TV market, is analyzed. The results indicate that canonical approaches of empirical sport economics can be fruitfully applied to individual sports. Consumers prefer prestigious competitions, relevant matches, highly ranked, and German players. The findings suggest that the German tennis industry needs to provide national tennis stars in order to revitalize the interest of major networks and audiences.
The “Five Things” That Don Lemon Forgot to Tell White People
Authors: Richmond Sanford
Published: March 2015

This article will analyze the comments that noted CNN anchor and social critic, Don Lemon, provided in which he outlined “five things” African Americans need to do to improve their social circumstances. Lemon’s “five things” soliloquy was triggered by the aftermath of the George Zimmerman verdict, which found Zimmerman not guilty of killing unarmed teenager, Trayvon Martin. I will discuss how Lemon’s sermon ignored the history of violence that has followed Zimmerman, before the killing of Trayvon Martin, and then shortly thereafter. I will also explain how Lemon’s comments represented a larger and more historical narrative that highlights the fear of many in the Black community about the dubious and troublesome legacy of the “White gaze.”
A Structural Theoretical Framework Based on Motor Play to Categorize and Analyze Active Video Games
Authors: González Carina Soledad González , Adelantado Vicente Navarro
Published: March 2015

Active video games (AVG) take the form of motor play (MP) and resemble active practices. In this article, both types of games (AVG and MP) were analyzed, in an effort to find categorical structural criteria shared by both. The main objective of this research is to analyze and propose valid and viable categorical shared criteria to guide the enhancement of AVG analysis. To this end, a comparative analysis that encompasses a description of shared elements, analysis of the ludic structures, description of the motor requirements, and analysis of across-the-board categorization criteria was conducted. After the analyzing related research literature and developing a study with experts in MP and video game designers and developers, an academic framework for AVG based on knowledge of MP was proposed. The authors hope that this framework will aid designers, developers, and researchers in the categorization and analysis of AVG.
Development of a multi-objective scheduling system for offshore projects based on hybrid non-dominated sorting genetic algorithm
Authors: Li Jinghua , Yang Boxin , Zhang Dan , Zhou Qinghua , Li Lingyao
Published: March 2015

In order to enhance the efficiency of offshore companies, a multi-objective scheduling system based on hybrid non-dominated sorting genetic algorithm was proposed. An optimized model for multi-objective and multi-execution mode was constructed under the condition of taking time, cost, and resource into account, and then the mathematical model for the same was established. Moreover, the key techniques of the proposed system were elaborated, and the flowchart was designed. Aiming at the weaknesses of non-dominated sorting genetic algorithm which is short for non-dominated sorting genetic algorithm-II in the facet of local search and computational efficiency, Pareto-dominated simulated annealing algorithm was applied in search global solution. Finally, by simulation examples and industrial application, the robustness and outperformance of the improved algorithm were verified.
Static characteristic analysis and experimental research of aerostatic thrust bearing with annular elastic uniform pressure plate
Authors: Dong Hao , Zhao Xiao-Long , Zhang Jun-an
Published: March 2015

In this article, an aerostatic thrust bearing with annular elastic uniform pressure plate structure was designed. In order to obtain a relationship between bearing capacity and stiffness of aerostatic thrust bearing designed in this article, first, the stress field mechanics model of the gas thrust bearing was established in the static. Second, deformation control equations of the elastic uniform pressure plate and gas lubrication Reynolds equation were established according to the flow continuity principle. Here, finite element mesh of gas flow field was woven using the technology of grid overlapping and grid stitching. Then, gas–solid coupling control equations were solved using the numerical method. Gas film pressure distribution and gas static bearing capacity of thrust bearing were analyzed. Function relationship between bearing capacity and the stiffness and the thickness of gas film was obtained. Finally, the results of theory analysis and experiment were compared. The results of the comparison can be listed as, under the effect of gas pressure, orifice area and the equilibrium pressure groove depth are changed due to elastic deformation of the elastic uniform pressure plate. The static stiffness of aerostatic thrust bearing with elastic equilibrium pressure groove increased by 30% than the static stiffness of aerostatic thrust bearing with rigid equilibrium pressure groove. The maximum carrying capacity occurred in the gas film thickness of 3.5 µm. The maximum static stiffness appeared in the gas film thickness of 5.5 µm. It can be seen from the comparison results of experiments and theoretical analysis that data results of gas film thickness and the bearing capacity are the same. The feasibility of the theoretical analysis method is validated.
The analysis and measurement of motion errors of the linear slide in fast tool servo diamond turning machine
Authors: Zhang Xu , Zhou Xiaoqin , Liu Qiang , Xu Pengzi
Published: March 2015

This article proposes a novel method for identifying the motion errors (mainly straightness error and angular error) of a linear slide, which is based on the laser interferometry technique integrated with the shifting method. First, the straightness error of a linear slide incorporated with angular error (pitch error in the vertical direction and yaw error in the horizontal direction) is schematically explained. Then, a laser interferometry–based system is constructed to measure the motion errors of a linear slide, and an algorithm of error separation technique for extracting the straightness error, angular error, and tilt angle error caused by the motion of the reflector is developed. In the proposed method, the reflector is mounted on the slide moving along the guideway. The light-phase variation of two interfering laser beams can identify the lateral translation error of the slide. The differential outputs sampled with shifting initial point at the same datum line are applied to evaluate the angular error of the slide. Furthermore, the yaw error of the slide is measured by a laser interferometer in laboratory environment and compared with the evaluated values. Experimental results demonstrate that the proposed method possesses the advantages of reducing the effects caused by the assembly error and the tilt angle errors caused by movement of the reflector, adapting to long- or short-range measurement, and operating the measurement experiment conveniently and easily.
New method for predicting the incipient cavitation index by means of single-phase computational fluid dynamics model
Authors: Ferrarese Giacomo , Messa Gianandrea V , Rossi Marco MA , Malavasi Stefano
Published: March 2015

Due to its serious consequences, cavitation in pipeline systems is one of the main concerns of engineers. In this context, the incipient cavitation index defined in many international standards such as those from International Society of Automation and International Electrotechnical Commission is a very important parameter as it accounts for the onset of cavitation. However, the standards define only the experimental determination of the incipient cavitation index, which is furthermore difficult to perform due to the considerable technical and economical burden of the experimental tests, above all in case of large-size systems. In this work, we propose a new method for predicting the incipient cavitation index by means of computational fluid dynamics, avoiding the need of making any experiment. The method is based on the generalized pressure criterion and requires only one Reynolds-averaged Navier–Stokes simulation of single-phase incompressible flow to provide estimates of the incipient cavitation index. The method is applied to predict the incipient cavitation index of multi-hole orifices with different geometrical characteristics, in terms of equivalent diameter ratio (0.40–0.70), relative thickness (0.73, 1.00), and number (13–52) and disposition of the holes. The experimental data revealed the reliability of the method. Its applicability was also confirmed for more complex geometries, and an application example regarding a control valve is briefly illustrated at the end of this article.
Dynamic stiffness matrix of partial-interaction composite beams
Authors: Bao Guangjian , Xu Rongqiao
Published: March 2015

Composite beams have a wide application in building and bridge engineering because of their advantages of mechanical properties, constructability and economic performance. Unlike static characteristics, the methods of studying the dynamic characteristics of partial-interaction composite beams were limited, especially dynamic stiffness matrix method. In this article, the dynamic stiffness matrix of partial-interaction composite beams was derived based on the assumption of the Euler–Bernoulli beam theory, and then it was used to predict the frequencies of the free vibration of the single-span composite beams with various boundary conditions or different axial forces. The corresponding vibration modes and buckling loads were also obtained. From the comparison with the existing results, the numerical results obtained by the proposed method agreed reasonably with those in the literatures. The dynamic stiffness matrix method is an accurate method which can determine natural vibration frequencies and vibration mode shapes in any precision theoretically. As a result, when the higher precision or natural frequencies of higher order are required, the dynamic stiffness matrix method is superior when compared to other approximate and numerical methods. The dynamic stiffness matrix method can also be combined with the finite-element method to calculate the free vibration frequencies and natural mode shapes of composite beams in complex conditions.
Ultrasound diagnosis of bilateral cataracts in a fetus with possible cerebro-ocular congential muscular dystrophy during the routine second trimester anomaly scan
Authors: Drought Alexandra , Wimalasundera Ruwan , Holder Susan
Published: March 2015

The finding of bilateral congenital cataracts in the fetus is rare. We report bilateral congenital cataracts detected during the routine second trimester anomaly scan, which subsequently were found to be associated with other congenital anomalies and the parents opted for a termination of pregnancy. At post-mortem, Muscle–Eye Brain disease or Walker–Warburg Syndrome was considered likely, which are autosomal recessive congenital muscular dystrophy disorders associated with cerebral, cerebellar, muscle and eye anomalies. On ultrasound, bilateral cataracts appear as echogenic, solid areas within the fetal orbits. The examination of the fetal face and orbits plays an important role in confirming fetal well-being antenatally. We propose that it should become a routine part of the structural survey of fetal anatomy during the obstetric anomaly scan. This is especially important in pregnancies previously affected by fetal cataracts or pregnancies at risk of rare genetic syndromes.
A Review Study on the Effect of Iranian Herbal Medicines on Opioid Withdrawal Syndrome
Authors: Ebrahimie Marzieh , Bahmani Mahmoud , Shirzad Hedayatollah , Rafieian-Kopaei Mahmoud , Saki Kourosh
Published: March 2015

Addiction is a chronic and recurring disease that recurrence phenomenon is the most important challenge in treatment of this disease. Recent experiences have shown that synthetic drugs have undesirable side effects. Recent studies on medicinal plants have shown that they might be effective in treatment of different stages of addiction with lower side effects and costs. The aim of this study was to review the effects of medicinal plants in the treatment of morphine addiction in experimental animals. In this review article, by using keywords of morphine, withdrawal, and plants or herbal medicine in databases of indexing cites, desired articles were obtained since 1994. Inclusion criteria for selecting articles were the articles related to application of medicinal plants in decreasing symptoms resulting from morphine withdrawal were selected. Results of this study on experimental studies have shown that medicinal plants such as Trachyspermum copticum L and Melissa officinalis decrease the symptoms of withdrawal syndrome in a dose-dependent. Also, medicinal plants like Avena sativa, Hypericum perforatu, Passiflora incarnate, Valeriana officinalis, Satureja hortensis L, and Mentha piperita can have effects on behavior, emotions, and other problems of addicts, decreasing withdrawal symptoms. Results of this study showed that medicinal plants can be effective in controlling deprivation, decreasing dependency creation, and possibly detoxification of opioid addicts.
New Media, Creativity, and the Olympics
Authors: Girginova Katerina
Published: March 2015

The Olympic Games are not only the world’s biggest media event but now also the world’s largest hypermedia (online, mobile, and social media) event, too. This presents a ripe context for the proliferation of new communication technologies and creative practices, a phenomenon that has yet to receive systematic scholarly treatment. By tracing the contours of one ray from the Olympic hypermedia spectrum, the #NBCFail movement during the Sochi 2014 Winter Olympics, this article argues that the evolution and proliferation of the media and the voices telling the Olympic story has resulted in an extension and renegotiation of the Olympic narrative through various acts of global communicative creativity. Studying these acts not only allows us to better understand the Olympic movement as an emergent hypermedia event but also to (re)theorize creativity in an era of ubiquitous digital communication.
What’s the Best Exposure? Examining Media Representations of Female Athletes and the Impact on Collegiate Athletes’ Self-Objectification
Authors: Reichart Smith Lauren
Published: March 2015

Many studies offer clear evidence that exposure to glamorized and sexualized media images results in distorted body image perceptions in girls and young women. Researchers have examined the link between sports media exposure and the negative effect on body perceptions of young girls and women, though a gap exists in the examination of the relationship between media images and positive impact. Grounded in the theories of self-objectification and social comparison, this study tested the relationships between self-objectification and body esteem and sports media exposure. Using a between-participants experimental design, this study examined how three different images of elite female athletes—performance, glamorized, and overly sexualized—impacted collegiate-level female athlete’s tendency to self-objectify and their levels of body esteem. Results suggest that less self-objectification occurs and greater body satisfaction is achieved when images of performance athletes are viewed, suggesting a need for more of these images in mainstream media.
Outcome Following Isolated Osteochondral Allograft Transplantation of the Femoral Trochlea
Authors: Cameron James I. , Pulido Pamela , DeYoung Allison , Gortz Simon , Bugbee William
Published: March 2015

Objectives:

Osteochondral allograft (OCA) transplantation is a recognized treatment modality for cartilage damage in the knee. Few reports on outcomes of OCA in the patellofemoral joint and no reports on lesions isolated to the femoral trochlea are available. The goal of this study was to evaluate graft survivorship and clinical outcomes in patients who had an OCA of the femoral trochlea.

Methods:

Twenty-nine knees in twenty-eight patients (mean age, 30. 2 years; range 12-47 years) were treated with fresh OCA transplant limited to the femoral trochlea. There were eight females and twenty males. Minimum follow-up was 2 years. The primary outcome was graft survivorship. Pain and function were assessed by the Modified Merle d’Aubigné-Postel (18-point) scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society function (KS-F), International Knee Documentation Committee (IKDC) and UCLA activity scores. The OCA patient satisfaction score (five point scale from extremely satisfied to extremely unsatisfied) was reported.

Results:

Mean follow-up was 7.0 years (range 2.1-19.9 years) with 65.5% of patients with more than five years of follow-up. Graft survivorship was 91.7% at a mean of 7.0 years. One patient was converted to a total knee arthroplasty at 7.6 years after allograft surgery. Mean Modified Merle d’Aubigné-Postel (18-point) scale improved from 13.0 to 16.1, mean KS-F score from 65.6 to 85.2 and mean IKDC from 38.5 to 71.9. Mean UCLA score postoperatively was 7.9 and mean KOOS QOL (quality of life) scores improved from 34.0 preoperatively to 75.1 postoperatively. Eighty-nine percent of patients were extremely satisfied or satisfied with the outcome of surgery.

Conclusion:

Fresh OCA transplantation appears to have good results in this cohort of patients with advanced articular cartilage damage to the femoral trochlea. The procedure resulted in improved pain and function and could delay the need for patellofemoral or total knee arthroplasty for many years.
Correlates With Injury In Youth And Adolescent Pitchers
Authors: Chalmers Peter Nissen , Sgroi Terrance , Riff Andrew Joseph , Lesniak Matthew , Sayegh Eli , Verma Nikhil N. , Cole Brian J. , Romeo Anthony A.
Published: March 2015

Objectives:

Shoulder and elbow injuries are common among youth and adolescent baseball players. While previous cross-sectional studies have identified breaking pitches as a risk factor for injury, breaking pitches have not been associated with higher shoulder and elbow torques in motion analysis. We hypothesized that pitch velocity and kinematic factors would be more important predictors of injury than breaking pitches.

Methods:

Demographic and kinematic data were collected on normal youth and adolescent pitchers in pre-season training using dual orthogonal high-speed video analysis. Pitching history was also collected. Players were asked whether they had ever experienced a pitching-related shoulder or elbow injury. Multivariate logistic regression analysis was performed on those variables that correlated with injury to identify the most important predictors.

Results:

Four hundred and twenty pitchers were included, of whom 31% had a history of a pitching related injury. After multivariate logistic regression analysis only subject height (p=0.009, R2=0.023), pitching for more than one team (p=0.019, R2=0.018), and pitch velocity (p=0.006, R2=0.194), served as independent correlates of injury status. A model constructed with these three variables could correctly predict 77% of injuries. Within our cohort, the presence of either an 8.6 inch increase in height or a 17 mile per hour increase in velocity was associated with a doubling of likelihood of history of injury. Playing for more than one team increased the likelihood of a history of injury 61%.

Conclusion:

Pitch velocity, pitcher height, and pitching for more than one team correlate with a history of shoulder and elbow injury. Current recommendations regarding breaking pitches may not prevent injury. Pitchers should be cautioned from pitching for more than one team. Taller pitchers and high velocity pitchers may be at risk for injury. To fully prevent injury, age-based velocity limits could be considered.
15 Year Survival Of Endoscopic Anterior Cruciate Ligament Reconstruction In Patients Aged 18 Years And Under
Authors: Pinczewski Leo A. , Morgan Matthew , Salmon Lucy J. , Waller Alison , Thompson Simon , Roe Justin P.
Published: March 2015

Objectives:

The incidence and risk factors for further anterior cruciate ligament (ACL) injury after ACL reconstruction have been examined in adults but not in juveniles. The aim of this study was to determine the long term survival of the ACL graft and the contralateral ACL (CACL) after primary reconstruction in those 18 years and under, and to identify the factors that increase the odds of subsequent ACL injury over the long term.

Methods:

All patients having undergone primary ACL reconstruction at the age of 18 or less between January 1993 and December 1998 by a single surgeon in a single unit were considered. ACL reconstruction was performed using a single-incision endoscopic technique with either autologous bone-patellar tendon-bone graft (BPTB) or hamstring tendon graft (HT). Femoral tunnel drilling was performed via the anteromedial portal. Patients were contacted to complete a subjective interview by telephone or online questionnaire at a minimum of 15 years after the index surgery.

Results:

A total of 288 juveniles met the inclusion criteria of which 237 (82%) were reviewed at a mean of 16.6 years after ACL reconstruction. The mean age at the time of surgery was 16 years (13-18). Subsequent ACL injury occurred in 29% of juveniles. 16% of suffered an ACL graft rupture, 19% suffered a CACL rupture and 5% ruptured both the graft and CACL. Expected survival of the ACL graft after reconstruction was 93%, 89%, 87% and 85% at 2, 5, 10 and 15 years, respectively. Expected survival of the CACL was 97%, 90%, 84% and 82%, respectively. Survival of the ACL graft was less favourable in those with a positive family history (73% versus 91%, p = .001). Survival of the CACL was less favourable in males than in females (77% versus 87%, p = .05). Graft source, age at surgery and graft diameter did not significantly increase the odds of graft or CACL rupture. The mean International Knee Documentation Committee (IKDC) subjective score at 15 years was 88. Return to preinjury sport level was reported in 69% of patients and 65% were still participating in strenuous or very strenuous activities at a mean 16 years post-reconstruction.

Conclusion:

After ACL reconstruction in those aged 18 years or less, further ACL injury occurred to 1 in 3 over 15 years. The expected 15 year survival of the ACL graft was 85% and expected 15 year survival of the CACL was 82%. Family history of ACL rupture significantly increased the odds of ACL graft rupture. CACL injury was more common in males than females. High subjective scores and continued participation in sports were maintained over the long term after ACL reconstruction in the juvenile population.
All-Arthroscopic Suprapectoral versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii
Authors: Gombera M. Mustafa , Kahlenberg Cynthia A. , Nair Rueben , Saltzman Matthew D. , Terry Michael A.
Published: March 2015

Objectives:

Pathology of the long head of the biceps tendon is a recognized source of shoulder pain in adults that can be treated with tenotomy or tenodesis when non-operative measures are not effective. It is not clear whether arthroscopic or open biceps tenodesis has a clinical advantage. To date, we are not aware of any studies that directly compare clinical outcomes between an arthroscopic and an open technique for tenodesis of the long head of the biceps brachii. The purpose of this study was to determine whether a difference in outcomes and complications exists between matched cohorts after biceps tenodesis utilizing an open subpectoral versus an all-arthroscopic suprapectoral technique.

Methods:

A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a popeye deformity, muscle cramping, post-operative ASES scores, satisfaction scores, and complications were evaluated.

Results:

Forty-six patients (23 all-arthroscopic, 23 open) patients with an average age of 57.2 years (range, 45-70) were evaluated at a mean 28.7 months (range, 18-42) follow-up. No patients in either group developed a popeye deformity or complained of arm cramping. There was no significant difference in mean ASES scores between the open and all-arthroscopic groups (92.7 vs. 88.9, P = 0.42, Table 1). Similarly, there was no significant difference between patient satisfaction scores (8.9 vs. 9.1, P = 0.73). Eighteen patients (78.3%) in the arthroscopic cohort and sixteen patients (69.6%) in the open cohort fully returned to athletic activity (P = 0.50). There were no complications in the all-arthroscopic group. There were two complications in the open group (superficial incisional erythema, and brachial plexopathy) that resolved by final follow-up.

Conclusion:

Biceps tenodesis is a reliable treatment option for pathology of the long head of the biceps that may avoid arm cramping and a cosmetic “popeye” deformity that can occur following tenotomy. Open subpectoral and all-arthroscopic suprapectoral are two commonly used techniques to reattach the biceps tendon distal to the bicipital groove. In this study, patients undergoing an all-arthroscopic tenodesis experienced similar pain relief, shoulder function, and return to athletic activity as patients undergoing an open tenodesis. An open subpectoral technique may increase the risk of complications secondary to a larger incision and increased surgical dissection. Larger studies with longer follow-up would help delineate the long-term effects and potential differences between an all-arthroscopic suprapectoral and open subpectoral biceps tenodesis.
Characterizing Patterns In Patellar Maltracking On Dynamic Kinematic CT Imaging
Authors: Tanaka Miho Jean , Williams Ariel , Elias John J. , Demehri Shadpour , Cosgarea Andrew J.
Published: March 2015

Objectives:

Patellar maltracking has been traditionally difficult to assess due to its dynamic component. Unlike the assessment of malalignment, which relies on static radiographic measurements, maltracking is a dynamic phenomenon described subjectively with the J sign. The advent of dynamic, kinematic computed tomographic imaging (DKCT) has allowed for the dynamic assessment of the patellofemoral joint. We used DKCT to visualize and quantify patterns of patellar maltracking and correlated these findings with the presence or absence of symptoms of patellar instability.

Methods:

76 knees in 38 subjects were analyzed using DKCT. Measurements of bisect offset at 10° intervals of knee flexion were performed for each knee during active flexion/extension cycles. Patterns in bisect offset were assessed and graded in terms of 1, 2 or 3 quadrants of lateral patellar motion, based on 75-100, 100-125, and >125% bisect offset. The presence or absence of symptomatic patellar instability were recorded for each knee, and ratios of patients with symptoms were calculated for J sign tracking patterns of grades 1, 2 and 3. Differences in ratios between Grades 1, 2 and 3 were calculated using chi squared analysis.

Results:

76 knees were available for analysis, of which 51 had symptomatic patellar instability. 9 knees demonstrated normal patterns of tracking. 58 knees demonstrated increased lateral translation in extension. 7 knees showed persistent lateralization of the patella throughout range of motion, and 2 knees showed increased translation in flexion. In the 58 knees that showed maximal lateral translation in extension (J sign), the J sign was graded as 1(N=24), 2 (N=20) and 3 (N=14). The sensitivities of J sign grades in predicting patellar instability were 45.8% (J1), 80% (J2), and 92.9% (J3) (p<0.01), with statistically significant differences between Grades 1 and 2/3 (0=0.018).

Conclusion:

On DKCT imaging, we noted additional patterns of patellar maltracking besides the standard J sign. Of those with maltracking in extension (J sign), Grade 2 and 3 J signs with > 2 quadrants of patellar lateralization in extension were predictive of symptomatic patellar instability. Further understanding of patellar maltracking patterns can provide the clinician with information regarding the pathoanatomy and pathophysiology of patellar instability, and allow us to better plan for surgical stabilization.
Medial Meniscus Root Repair
Authors: Tjoumakaris Fotios P. , Lombardi Nick J. , Tucker Bradford S. , Levi Dave , Austin Amy , Pepe Matthew D.
Published: March 2015

Objectives:

Meniscus root tears are associated with loss of hoop stress, increased peak pressure, and reduction in contact area of the affected compartment of the knee. Reversal of this outcome is predicated on the successful restoration of the meniscus through biologic healing to the tibial attachment. The purpose of this investigation was to evaluate the biologic healing of meniscus root tears through high resolution MRI and correlate this appearance to clinical outcome

Methods:

Nine patients were identified as having undergone a medial meniscus root repair using an identical pull-out surgical technique by a single surgeon. Outcomes were determined using Lysholm and WOMAC scores and quality of meniscus healing was assessed using a 3 Tesla MRI. MRI studies were reviewed by two fellowship trained musculoskeletal radiologists according to pre-defined criteria.

Results:

There were 4 females and 5 males in the study group. The average follow-up time was 30 months (range 21-41). MRI demonstrated a new tear medial to the prior repair in 4/9 patients. 4 patients demonstrated recurrence of tear or lack of biologic healing of the root attachment. In patients with recurrent tears of the root, meniscal extrusion averaged 1.5mm. In patients with evidence of healing, extrusion averaged 1.0mm. The average WOMAC and Lysholm scores were 11.2 and 81.6 respectively. There was no correlation between healing and clinical outcome scores in this series.

Conclusion:

4 of 9 patients demonstrated recurrent tearing of the meniscus root. There was an increase in peripheral meniscus tears away from the repair in 4/9 patients, indicating excessive stress induced by the repair. Successful repair and healing was associated with decreased meniscus extrusion; however, this did not correlate with functional outcome scores, indicating that biologic healing is not a pre-requisite for good clinical outcome. A similar finding has been shown in studies evaluating rotator cuff repair.
The Use of Osteochondral Allograft Transplantation for Primary Treatment of Cartilage Injuries in the Knee
Authors: Briggs Dustin , Sadr Kamran N. , Pulido Pamela , Bugbee William
Published: March 2015

Objectives:

To assess the clinical outcome of OCA transplantation used as primary treatment for chondral and osteochondral lesions in the knee. In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as a salvage procedure when previous treatments have failed. No publications have assessed the outcome of OCA transplantation used as primary treatment for cartilage lesions in the knee.

Methods:

Our OCA outcomes database was used to identify 61 patients who underwent OCA transplantation as primary treatment for a chondral or osteochondral defect and had a minimum follow-up of two years. None of the patients had previous surgery on the involved knee prior to the OCA. Included in the analysis were 32 males and 29 females with a mean age of 32.9 years (range 15.7-67.8 years). The most common diagnoses were osteochondritis dissecans (44.3%) and avascular necrosis (31.1%), followed by osteoarthritis (8.2%), degenerative chondral lesion (6.6%), traumatic chondral injury (6.6%), and fracture (3.2%). The mean graft area was 9.6 cm2. The majority of grafts were located on the medial (47.5%) and lateral (24.6%) femoral condyles. Thirty-five patients (57.4%) had one graft, 22 (36.2%) had two grafts, and 4 (6.6%) had three grafts. Each patient was evaluated pre- and postoperatively with the International Knee Documentation Committee (IKDC), a modified Merle d’Aubigné-Postel (18-point) scale, and Knee Society function (KS-F) score. Patients came in for a clinical evaluation or were contacted via telephone for follow-up. The number and type of reoperations following the OCA transplantation was captured. Failure was defined as revision OCA or conversion to arthroplasty. Patient satisfaction was assessed.

Results:

The mean follow-up duration was 7.6 years (range, 1.9 to 22.6 years). Eighteen knees (29.5%) had further surgery following the OCA transplantation. Seven knees (11.5%) had procedures unrelated to the allograft and 11 knees (18%) were considered OCA failures with eight conversions to arthroplasty, two revision OCA, and one patellectomy. The mean time to failure was 5.9 years (range, 0.5-13.7 years). OCA survivorship was 89.5% at 5 years and 74.7% at 10 years. Forty-three (70.5%) knees had their OCA still in situ at latest follow-up. Thirty-eight (84.5%) were rated good/excellent on the 18-point scale. The mean IKDC scores improved from 36.9 preoperatively to 80.4 postoperatively. The KS-F scores improved from 66.5 to 89.7. Eighty-six percent of patients reported being “extremely satisfied” or “satisfied.”

Conclusion:

OCA transplantation is an acceptable primary treatment method for some chondral and osteochondral defects of the knee. Failure of previous surgical treatment is not a prerequisite for OCA surgery. Outcomes in this group are comparable to other cartilage repair treatment options.
The Epidemiology of Revision Anterior Cruciate Ligament Reconstruction in Adults from Ontario, Canada
Authors: Leroux Timothy , Wasserstein David , Dwyer Tim , Ogilvie-Harris Darrell , Marks Paul H. , Bach Bernard R. , Townley John , Mahomed Nizar , Chahal Jaskarndip
Published: March 2015

Objectives:

The morbidity associated with revision anterior cruciate ligament reconstruction (ACLR) is largely unknown. The objective of this study was to determine the rate of and risk factors for re-revision, re-operation, and re-admission following revision ACLR in the general population.

Methods:

All patients who underwent first revision ACLR in Ontario, Canada from January 2004 to December 2010 were identified and followed to December 2012. Exclusions included age (<16 years), previous osteotomy, or multi-ligament knee reconstruction. The main outcome was re-revision ACLR. Secondary outcomes included re-operation [irrigation and debridement (I&D), meniscectomy, manipulation under anesthesia (MUA), contralateral ACLR, and total knee arthroplasty (TKA)], and re-admission within 90 days of surgery. Survival to re-revision was determined using the Kaplan-Meier (KM) approach. A Cox proportional hazards model or logistic regression were used to determine the influence of patient factors (age, sex, neighborhood income quintile, and comorbidity), surgical factors (graft choice, concurrent meniscal procedure, and fixation method), and provider factors (surgeon volume, surgeon years in practice, and hospital status) on outcomes. A post-hoc analysis was performed to determine the influence of the aforementioned factors on overall post-operative infection risk, including both operative and non-operative cases.

Results:

Overall, 827 patients were included (median age: 30 years; 58.8% males). Single stage revisions comprised 92.9% of cases, and a meniscal procedure (repair or debridement) was performed in 45.3% of cases. The re-revision rate at a mean follow-up of 4.8±2.2 years was 4.4%, and the five-year survival rate was 95.4% (Figure 1). The rates of I&D, meniscectomy, contralateral ACLR, and re-admission were 0.8%, 3.1%, 3.4%, and 4.1%, respectively. MUA and TKA were rare. Young age significantly increased contralateral ACLR risk (risk decreased by 5.1% with each year of age above 16 years, p=0.02), but not re-revision ACLR risk. Low surgeon annual volume of revision ACLR [<4 revisions/year: odds ratio (OR) 1.2, p=0.02)] and male sex (OR 13.3, p=0.01) significantly increased overall infection risk, while male sex also influenced I&D risk. No other factors significantly influenced re-revision, re-operation, or re-admission risk.

Conclusion:

Re-revision, re-operation, and re-admission rates following revision ACLR are low. The risk of I&D, overall infection, and contralateral ACLR were influenced by male sex, low surgeon volume, and young age, respectively. This is the first study of this magnitude to determine rates of and risk factors for morbidity following revision ACLR, providing clinicians with reference data from the general population.