bluuebunny/crossref_metadata_2025 huggingface dataset:
Perturbations of Vascular Homeostasis and Aortic Valve Abnormalities in Fibulin-4 Deficient Mice
Authors: Hanada Katsuhiro , Vermeij Marcel , Garinis George A. , de Waard Monique C. , Kunen Maurice G.S. , Myers Loretha , Maas Alex , Duncker Dirk J. , Meijers Carel , Dietz Harry C. , Kanaar Roland , Essers Jeroen
Published: February 2007

The Fibulins are a 6-member protein family hypothesized to function as intermolecular bridges that stabilize the organization of extracellular matrix structures. Here, we show that reduced expression of Fibulin-4 leads to aneurysm formation, dissection of the aortic wall and cardiac abnormalities. Fibulin-4 knockdown mice with a hypomorphic expression allele arose from targeted disruption of the adjacent Mus81 endonuclease gene. Mice homozygous for the Fibulin-4 reduced expression allele (Fibulin-4
R/R
) show dilatation of the ascending aorta and a tortuous and stiffened aorta, resulting from disorganized elastic fiber networks. They display thickened aortic valvular leaflets that are associated with aortic valve stenosis and insufficiency. Strikingly, already a modest reduction in expression of Fibulin-4 in the heterozygous Fibulin-4
+/R
mice occasionally resulted in small aneurysm formation. To get insight into the underlying molecular pathways involved in aneurysm formation and response to aortic failure, we determined the aorta transcriptome of Fibulin-4
+/R
and Fibulin-4
R/R
animals and identified distinct and overlapping biological processes that were significantly overrepresented including cytoskeleton organization, cell adhesion, apoptosis and several novel gene targets. Transcriptome and protein expression analysis implicated perturbation of TGF-β signaling in the pathogenesis of aneurysm in fibulin-4 deficient mice. Our results show that the dosage of a single gene can determine the severity of aneurysm formation and imply that disturbed TGF-β signaling underlies multiple aneurysm phenotypes.
Conditioning Effect of Blood Flow on Resistance Artery Smooth Muscle Myosin Phosphatase
Authors: Zhang Haiying , Fisher Steven A.
Published: February 2007

Myosin phosphatase is the primary effector of smooth muscle relaxation and a target of signaling pathways that regulate vascular tone. The mesenteric small resistance artery and large vessel smooth muscle express distinct isoforms of the myosin phosphatase targeting subunit (MYPT1), and the isoforms in the small resistance artery switch in a disease model of altered blood flow. We thus hypothesized that small resistance artery smooth muscle phenotype is responsive to altered blood flow. To test this hypothesis alternating pairs of rat second order mesenteric arteries were ligated so that the upstream first order mesenteric artery (MA1) is under chronic low flow and the adjacent first order mesenteric artery under chronic high flow. The initial response was similar in high flow and low flow MA1, and included rapid reduction in MYPT1 and switch to the 3′ alternative exon skipped/leucine zipper positive MYPT1 isoform. Between 14 to 28 days, MYPT1 abundance was restored along with reversion to the MYPT1 leucine zipper
−
isoform under chronic high flow. In contrast, under continued low flow, there was further switching to the MYPT1 leucine zipper
+
isoform. As would be predicted based on the switch to the MYPT1 leucine zipper
+
isoform, the sensitivity for relaxation to the NO donor SIN-1 and to cGMP was increased in the
Day28
low flow first order mesenteric artery. We conclude that pulsatile blood flow conditions the phasic program of gene expression in the small resistance artery smooth muscle. The loss of this conditioning effect significantly increases the sensitivity to vasodilator signals in the setting of chronically reduced blood flow.
Important Role for Bone Marrow–Derived Cholesteryl Ester Transfer Protein in Lipoprotein Cholesterol Redistribution and Atherosclerotic Lesion Development in LDL Receptor Knockout Mice
Authors: Van Eck Miranda , Ye Dan , Hildebrand Reeni B. , Kar Kruijt J. , de Haan Willeke , Hoekstra Menno , Rensen Patrick C.N. , Ehnholm Christian , Jauhiainen Matti , Van Berkel Theo J.C.
Published: February 2007

Abundant amounts of cholesteryl ester transfer protein (CETP) are found in macrophage-derived foam cells in the arterial wall, but its function in atherogenesis is unknown. To investigate the role of macrophage CETP in atherosclerosis, LDL receptor knockout mice were transplanted with bone marrow from CETP transgenic mice, which express the human CETP transgene under control of its natural promoter and major regulatory elements. CETP production by bone marrow-derived cells induced a 1.8-fold (
P
<0.01) increase in atherosclerotic lesion development. The increase in lesion size coincided with an increase in VLDL/LDL cholesterol and a decrease in HDL cholesterol. The cholesterol redistribution in serum was a direct effect of the substantial serum CETP activity and mass (38±3 nmol/mL/h and 4.8±0.5 μg/mL, respectively) induced by CETP production by bone marrow-derived cells. Conversely, specific disruption of CETP production by bone marrow-derived cells in CETP transgenic mice resulted in a ≈2-fold (
P
<0.0001) reduction in serum CETP activity and mass, demonstrating the quantitative relevance of bone marrow-derived CETP. Finally, we show that in liver Kupffer cells, hepatic macrophages, contribute ≈50% to the total hepatic CETP expression. In conclusion, bone marrow-derived CETP induces a proatherogenic lipoprotein profile and promotes the development of atherosclerotic lesions in LDL receptor knockout mice. Most importantly, we show for the first time that bone marrow-derived CETP is an important contributor to total serum CETP activity and mass.
Univentricular Heart
Authors: Khairy Paul , Poirier Nancy , Mercier Lise-Andrée
Published: February 2007

As early as 1699, Chemineau described a heart composed of 2 auricles but only 1 ventricle.

1

The univentricular heart has since fascinated the medical community. Unique in its complexity and scope, the univentricular heart has sparked intense debates about embryology and nomenclature, challenged our understanding of cardiovascular physiology and hemodynamics, and inspired some of the most creative surgical and interventional approaches in human history. The present report provides an overview of the nomenclature and classification of the univentricular heart, epidemiology and pathological subtypes, genetic factors, physiology, clinical features, diagnostic assessment, therapy, and postoperative sequelae. Although the present report touches on issues applicable to neonates and children with univentricular hearts, the focus is on information of interest and relevance to the adult cardiologist.
Principles of Genetic Murine Models for Cardiac Disease
Authors: Yutzey Katherine E. , Robbins Jeffrey
Published: February 2007

It was only ≈15 years ago that methodologies evolved to the point where we began to manipulate the genetic apparatus of the mouse such that proteins of the investigator’s choice could be expressed in a 4-chambered, mammalian heart. Our abilities to express both normal and mutated proteins in the heart or to create genetic nulls in which the protein is not expressed at all continue to evolve. With the tools now available, one can target protein expression to the different cell types present in the heart, often at a particular time, and, in some cases, turn off the protein as development progresses or the animal ages. These abilities have enabled us to model many of the genetic mutations identified as causative for pediatric and/or adult cardiovascular disease and heart failure. Identifying the primary genetic cause is, more often than not, insufficient for designing effective therapeutics or interventions. Therefore, it is critical to be able to develop animal models that accurately recapitulate the pathogenic processes that ensue as a result of mutant gene expression or loss of protein expression. In this review, we discuss the nature, strengths, and weaknesses of the current set of tools for developing genetically manipulated mouse models, as well as the relevance of these models for understanding cardiovascular disease and illuminating potential therapeutic avenues.
Does FDI Mode of Entry Matter for Economic Developments of a Host Country? The Case of Korea
Authors: Lee Seong-Bong , Yun Mikyung
Published: February 2007

There is an ongoing debate on whether benefits of foreign direct investment (FDI) differ depending on the modes of FDI entry. This paper examines this debate using firm-level data on FDI in Korea. The paper adopts a new, more accurate classification scheme than the current official classification system and finds that there is little difference in firm-level performance according to FDI mode of entry. The paper thus argues against any provision of preferential incentives based on modes of entry.
Economic Liberalization with Rising Segmentation in China's Urban Labor Market
Authors: Démurger Sylvie , Fournier Martin , Shi Li , Zhong Wei
Published: February 2007

The massive downsizing of the state-owned sector and the concomitant impressive growth of the private sector at the end of the 1990s have altered the nature of the Chinese labor market. The introduction of market mechanisms has contributed to increasing labor turnover and competitiveness in market wages. Using two urban household surveys for 1995 and 2002, this paper analyzes the evolution of labor market segmentation in urban China by applying an extended version of Oaxaca-Blinder decomposition methods. During the seven-year period, the sharp increase in real earnings for all workers shows substantial differences across ownership, economic sectors, and regions. We find strong evidence of a multitiered labor market along these three major lines and highlight increasing segmentation within each of the three dimensions, with the gap between the privileged segments of the labor market and the most competitive segments widening over time.
Pattern of Care for Schizophrenia Patients in Granada (Spain): A Case Register Study
Authors: Moreno B. , Cervilla J. , Luna J. D. , Torres F.
Published: February 2007

Aims: This study sets out to explore the use flow of mental health services by a cohort of patients with schizophrenia located in Granada (Spain).

Methods: All cases (N = 844) included in the analysis were users of the community mental healthcare public service provided in the area. The Markov chain model was used to calculate the probability of transition from one type of contact with mental health services resources to another type of contact in the next month, over a three-year follow-up.

Results: For a given one-month period, for each level of service contact, most patients continued to use the same level of care.

Conclusions: Our results can be interpreted as a reflection of adequate continuity of mental health care provided by the Andalusian community service.
Case Management for Individuals with a Severe Mental Illness: A 6-Year Follow-Up Study
Authors: Björkman Tommy , Hansson Lars
Published: February 2007

Background: As a part of a set of reforms launched in 1995, 10 pilot case management services were established in Sweden, which have been subject to an evaluation with regard to outcome and changes in use of services. The present study was designed to provide information about client outcomes over a 6-year follow-up period.

Aims: The aim of the study was to investigate changes during the follow-up period with regard to symptoms, needs for care, psychosocial functioning, quality of life and social network.

Methods: The study used a time series design with 6-year follow-up of client outcomes.

Results: Of the original 176 clients, 92 clients participated in the 6-year follow-up. Improvements were found in a number of clinical aspects, quality of life and social network, and a decrease in use of psychiatric services during the follow-up period.

Conclusions: The findings support results from earlier studies showing a decrease in use of psychiatric services and sustained improvements in social functioning. The study also supports the findings that client outcomes change over time and that certain outcomes do not appear in a short-term perspective.
The Heart of the Problem
Authors: Connell Raewyn
Published: February 2007

The familiar sociology of intellectuals has been constructed in the global metropole, and it is debatable how relevant its concepts are to the periphery. A life-history study was conducted with diverse intellectual workers in South Africa. A range of intellectual identities is apparent. The specific history of the Apartheid era, the struggle against Apartheid, and the advent of neo-liberalism have all shaped intellectual workers' cultural formation and created major differences in trajectories. Periphery/metropole relations profoundly structure cultural practices and consciousness, but these relations are not static. Distinctive patterns of intellectual work appear. The legacy of democratic struggle gives prominence to ‘crossover’ forms of intellectual work, fuels resistance to neo-liberal globalization, and gives a distinctive form to the problem of reproducing the intellectual workforce and project. The research thus emphasizes the cultural productiveness of the global ‘periphery’ and the need for forms of social theory based here.
The Clinical Encounter and the Problem of Context
Authors: May Carl
Published: February 2007

The encounter between professional and patient is one of the basic units of analysis in the field of ‘medical’ sociology. From the very beginnings of the sociological investigation of medical practice it has been conceived as a dyadic encounter, defined by asymmetries of power, the negotiation of rational and authoritative scientific knowledge, and private, proximal, relations. This article argues for a more dynamic theoretical vision of the clinical encounter: one that shifts attention away from a Parsonian ‘paradigm’ of professional–patient interaction towards a perspective that incorporates the systemic changes that late modernity brings to medicine.The clinical encounter is no longer the dyadic system envisaged by Parsons, and his theoretical perspective–which has played an important part in framing sociological accounts of the practice of medicine – now needs to be reframed in relation to the organizing impulses of contemporary corporate professional practice.
Trust as a Process
Authors: Khodyakov Dmitry
Published: February 2007

What is trust? Should trust be used as a variable or as a process? Is trust in people similar in nature to trust in institutions? These are three main questions I address in this article. I argue that trust is a complex and multi-dimensional phenomenon, which consists of a mix of trust in strong ties, weak ties, and institutions. I explain the need for a new approach to trust, using the Soviet Union as an example. I argue that rigid distinctions in social capital theory between high-trust and low-trust societies fail to account for the complexity of trust. In this article, I view trust as a process. I also suggest a new definition of trust based on the notion of agency, which underscores the idea of temporality and incorporates the roles of the past, present, and future.
Stereotyping in a Traditional Society and its Implications for School Psychologist Referral Patterns: The Case of the Negev Bedouin
Authors: Thein Ram
Published: February 2007

The present report describes the psycho-educational services referral pattern in the school system serving both a permanent Bedouin town A and its vicinity in Israel’s Negev desert. The subjects of the study were students in the school system in A between the years 1997 to 2002 (with additional data from 2004). The total number of referrals to school psychologists, referrals according to the tribe membership of the referred and individual tribe base-rates in the school population are discussed along with the traditional, collectivist and hierarchical society concepts. It is observed that despite the X tribe’s lower percentages in the school population (8 percent of the total 2,694 students) the tribe’s members are over-represented among the referrals to psychological interventions (13.3 percent of 346). In addition, they are the most referred group in absolute terms. The existence and the use of stereotypes among the asli and the fellaheen Bedouin are reported. The implication for the rates of psychological intervention and psychological evaluations for the consistency of special education classes as well as for the perpetuation of social differences among the tribes are discussed. The data are supplemented by a Bedouin informer’s report about the marital options for males and females of various tribes and by a close relatives marriages report acquired from the pre-/post-natal care government station.
Teachers’ Use of Classroom Management Procedures in the United States and Greece: A Cross-Cultural Comparison
Authors: Akin-Little K. Angeleque , Little Steven G. , Laniti Mariana
Published: February 2007

A survey was conducted of teachers’ classroom management practices in the United States and Greece. The United States sample consisted of 149 teachers in Arizona, Illinois, Louisiana, Mississippi and Alabama. The Greek sample consisted of 97 teachers in Athens and the surrounding area. The survey asked questions regarding teachers’ use of important classroom management principles (e.g. rules, classroom management practices). Responses of the teachers in the two samples were remarkably similar which indicates that, overall, teachers are reporting the use of empirically validated classroom management procedures (e.g. rules, positive reinforcement) in relatively high frequencies. Results and implications are discussed in terms of the importance of cross-cultural research of this type.
Aggressive and Antisocial Behaviours Among Secondary School Students in Botswana: The Influence of Family and School Based Factors
Authors: Malete Leapetswe
Published: February 2007

This study examined the relationship between family factors and secondary school students’ aggressive and antisocial behaviours. Participants were 1,478 junior and senior secondary school students from four major urban centres in Botswana, aged 12-20. Results showed significant prevalence of self-reported aggressive tendencies and antisocial behaviours among secondary school students in Botswana. Boys rated themselves higher on aggression, use of alcohol and drugs and carrying and using dangerous weapons compared to girls. High scores on antisocial and aggressive behaviours were significantly related to poor parent-child relations and low parental monitoring. The results are consistent with findings from previous studies. The findings have important implications to violence prevention programs for children and adolescents. Suggestions for future research and the development of intervention programs are made.
Discrepancies in the Viewpoints of Different German Health Care Providers on Palliative Care
Authors: Schneider Nils , Buser Kurt , Amelung Volker E.
Published: February 2007

In many countries with highly developed health care systems, significant improvements in end-of-life care are strongly recommended. Up to the present, the assessment of perceived deficits predominantly reflects the point of view of experts in the palliative and hospice movement, with very little being known about the perspective of other professionals. The aim of this study was to assess the points of view of a wide range of different health care providers who treated or interacted with palliative care patients. The authors subsequently performed 597 semistructured telephone interviews with a wide range of German health care professionals. Overall, the assessment of the current situation was better than expected, although statistically significant differences existed among the groups surveyed. However, there is an unquestionable need for improvement, although opinions regarding the extent of these deficits depend significantly on the individual respondents’ roles and professional orientation.
Teaching Patient Communication Skills to Medical Students
Authors: Smith Sherilyn , Hanson Janice L. , Tewksbury Linda R. , Christy Cynthia , Talib Nasreen J. , Harris Mitchell A. , Beck Gary L. , Wolf Fredric M.
Published: February 2007

Tools to examine the effects of teaching interventions across a variety of studies are needed. The authors perform a meta-analysis of 24 randomized controlled trials evaluating the effects of teaching on medical students’ patient communication skills. Study quality is rated using a modified Jadad score, and standardized mean difference effect size ( d) measures are calculated. Fifteen of 24 studies have sufficient data for analysis. Students’ ability to establish rapport improves after teaching. The effects are large when the teaching intervention was small group discussion ( n = 5) or giving structured feedback on a student-patient interview ( n = 6). A similar effect of teaching is seen on student data gathering skills ( n = 5). Teaching medical students patient communication skills using small group discussion or providing feedback on a student-patient interview results in improvement in student performance.
The Relationship Between Experience With Standardized Patient Examinations and Subsequent Standardized Patient Examination Performance
Authors: Talente Gregg , Haist Steven A. , Wilson John F.
Published: February 2007

Standardized patient (SP) exams are becoming an important part of testing clinical skills. The dynamics of this test format warrant exploration. This study is designed to measure the relationship between experience with SPs and performance on a SP examination. A general linear model is used to determine if a relationship exists and the pattern of that relationship as experience increases. There is a linear association between increased experience and better performance in technical domains. In interpersonal skill domains, there is a curvilinear association between experience and performance with improved performance with moderate levels of experience but not in the most experienced group. Different levels of experience with SPs are associated with differences in performance. The varied pattern of associations suggests a possible practice effect or test-taking behavior. Additional studies are needed to assess this potential effect on SP exam validity.
Empirical Bayes Estimation of the Prevalence of Uninsured Individuals by County in the State of Tennessee and Analyses of Predictive Factors
Authors: Lei Pui-Wa , Warcholak Nicholas D. , Suen Hoi K. , Williams Bryan L. , Magsumbol Melina S.
Published: February 2007

Lawmakers at the state level require good estimates of those without health insurance in the areas they serve to inform policy decisions. These estimates are often built on inadequate data from smaller geographic areas, such as counties. The Small Area Estimates Branch of the U.S. Census Bureau developed a method to generate stable estimates at the county level using data from the Annual Social and Economic Supplement to the Current Population Survey and several other sources. Using data collected in the state of Tennessee, this article presents a less complicated and arguably less expensive alternative to that method, while providing comparable results. Limitations of both methods and suggestions for future research are discussed.
The Impacts of Subsidized Health Insurance on Employees’ Use of Preventive Health Services
Authors: Kahn Linda S. , Tumiel-Berhalter Laurene , Cadzow Renee , Watkins Robert , Leonard Kathleen M. , Taylor John S.
Published: February 2007

This study presents an uncontrolled preliminary evaluation of a pilot health insurance subsidy program and addresses whether provision of subsidized insurance that required employee contribution had an impact upon preventive health utilization among small businesses and their employees. Self-report questionnaires were mailed to the employees; these included questions on use of preventive health services before and after enrollment in the subsidy program. The analysis was stratified by self-reported prior enrollment in an insurance program to compare employees with and without prior health insurance. The findings suggest significant increases in health service utilization among the previously uninsured. Regular checkups more than doubled ( p < .0001), as did the number of individuals receiving regular blood work ( p < .0001). Nearly twice the number of individuals filled regular prescriptions after enrollment in the subsidy program as compared with before ( p < .0001). This study suggests that employees of small businesses are willing to contribute to the cost of a health insurance premium, and once insured are more likely to use preventive services. A model of shared cost responsibility is an effective way to provide affordable insurance to small-business employees, thus increasing preventive services in these populations.
Sampling Bias in an International Internet Survey of Diversion Programs in the Criminal Justice System
Authors: Hartford Kathleen , Carey Robert , Mendonca James
Published: February 2007

Despite advances in the storage and retrieval of information within health care systems, health researchers conducting surveys for evaluations still face technical barriers that may lead to sampling bias. The authors describe their experience in administering a Web-based, international survey to English-speaking countries. Identifying the sample was a multistage effort involving (a) searching for published e-mail addresses, (b) conducting Web searches for publicly funded agencies, and (c) performing literature searches, personal contacts, and extensive Internet searches for individuals. After pretesting, the survey was converted into an electronic format accessible by multiple Web browsers. Sampling bias arose from (a) system incompatibility, which did not allow potential respondents to open the survey, (b) varying institutional gate-keeping policies that “recognized” the unsolicited survey as spam, (c) culturally unique program terminology, which confused some respondents, and (d) incomplete sampling frames. Solutions are offered to the first three problems, and the authors note that sampling bias remains a crucial problem.
Adaptation to Chronic Vision Impairment
Authors: McKinzie Charla A. , Reinhardt Joann P. , Benn Dolores
Published: February 2007

The purpose of this research was to determine whether race had a significant, unique impact on adaptation to a common late-life impairment, age-related vision loss, after accounting for sociodemographic, health, functional disability, and personal and social resource variables. Older visually impaired African American ( n = 61) and Caucasian ( n = 488) applicants for vision rehabilitation service were interviewed in their homes. The results demonstrated that race accounted for unique variability in the domain-specific indicator of adaptation to age-related vision loss. The results support the importance of further work examining race differences in adaptation to specific chronic impairments in later life.
Socioeconomic Differentials in Mortality Among the Oldest Old in China
Authors: Zhu Haiyan , Xie Yu
Published: February 2007

Although an inverse relationship between socioeconomic status (SES) and mortality has been well documented for many populations throughout the world, it remains unclear whether this relationship holds true for the oldest old. Most notably, some scholars have suggested that the relationship may disappear at the oldest ages. Using data from the 1998, 2000, and 2002 waves of the Chinese Longitudinal Healthy Longevity Survey, this study examined the relationship between SES and mortality among the oldest old (80 years and older) population in China. The results show the continuing prevalence of SES differentials in mortality—higher SES is significantly associated with lower mortality risks—among the oldest old in China. The authors further show that the relationship holds regardless of how the oldest old are operationalized (as 80 years and older, 90 years and older, or 100 years and older).
Formal and Informal Volunteer Activity and Spousal Caregiving Among Older Adults
Authors: Choi Namkee G. , Burr Jeffrey A. , Mutchler Jan E. , Caro Francis G.
Published: February 2007

On the basis of data from the 1998 and 2000 waves of the Health and Retirement Study, this study tested two alternative hypotheses, role overload and role extension, about the relationship between volunteering and spousal caregiving among older married persons. Spousal caregiving was not significantly associated with the likelihood of formal or informal volunteering for men; however, female caregivers were found to be less likely than noncaregivers to have engaged in formal or informal volunteering to a certain extent, thus lending partial support to the role overload hypothesis. Functional health status and other human and cultural capital resources were significant predictors of both formal and informal volunteering for both men and women. Future studies need to examine in more depth the effect of spousal caregiving on volunteering, taking caregiving burden and stress into consideration, to more fully understand these two types of productive activity in later life.
Opening the Library Catalogue up to the Web: a view from South Africa
Authors: de Jager Karin
Published: February 2007

While libraries still spend much time and money on building and maintaining catalogues according to accepted international standards, there is considerable evidence that users are inclined to bypass libraries and their catalogues in their search for information and to rely solely on information provided by web search engines. This paper discusses the different and sometimes conflicting needs of on the one hand instant information seekers and on the other the needs of scholars that may be better served by information not obtainable by web searching alone. It proposes that one way of promoting and facilitating catalogue use is to include records for remote electronic resources into online catalogues, so that information about both print and electronic resources could be retrieved by a single search. The paper concludes by reporting on a survey done at a training workshop on the cataloguing of electronic resources, which was held by the Library and Information Association of South Africa ‘s Interest Group for Bibliographic Standards, in July 2006.
Effects of a Novel Sterilization Process on Soft Tissue Mechanical Properties for Anterior Cruciate Ligament Allografts
Authors: Schimizzi Aimee , Wedemeyer Michelle , Odell Tim , Thomas Walter , Mahar Andrew T. , Pedowitz Robert
Published: February 2007

Background

Allograft anterior cruciate ligament reconstruction provides benefits such as earlier return to activities and less pain, but concerns remain regarding potential infection and biomechanical stability.

Hypothesis

There is no difference in biomechanical properties of soft tissue allografts treated with the Biocleanse tissue sterilization process compared with irradiated and fresh-frozen allografts.

Study Design

Controlled laboratory study.

Methods

Thirty-six tibialis anterior allografts were equally divided between Biocleanse, irradiated, and fresh-frozen groups. Grafts were measured for cross-sectional area and looped over a smooth rod with the free sutured ends of the graft fixed in custom clamps. Specimens were tensioned to 10 N for 2 minutes and then loaded between 50 and 300 N for 1000 cycles followed by a failure test. Data for creep (mm); stiffness (N/mm) at cycles 1, 10, 100, and 1000; failure load (N); and failure stress (MPa) were compared with a one-way analysis of variance (P < .05).

Results

There were no statistically significant differences in creep between groups. Sterilized groups (irradiated = 144.7 ± 17.7 N/mm and Biocleanse = 146.5 ± 28.2N/mm) were significantly stiffer during the first cycle than the fresh-frozen group (117.8 ± 15.7 N/mm, P < .005) without statistically significant differences for subsequent cycles. There were no differences between groups for either failure load (fresh-frozen = 1665 ± 291.3 N, irradiated = 1671.9 ± 290.2 N, Biocleanse = 1651.6 ± 377.4 N) or failure stress.

Conclusion

Data for “time-zero” physiologic stiffness and failure loads indicate that the Biocleanse process does not adversely affect the biomechanical properties of the allograft material.

Clinical Relevance

This novel sterilization technique may provide surgeons with potential allograft material with similar biomechanical properties to native tissue.
Reconstruction of Chronic Achilles Tendon Rupture with the use of Interposed Tissue between the Stumps
Authors: Yasuda Toshito , Kinoshita Mitsuo , Okuda Ryuzo
Published: February 2007

Background

The gap between the tendon stumps in chronic Achilles tendon rupture has reportedly been filled with interposed scar tissue. In the authors’ clinical experience, this interposed tissue is often thick and resists tension, so they considered it was possible to use the interposed tissue for reconstruction of Achilles tendon rupture.

Hypothesis

Scar tissue interposed between the tendon stumps has the capacity to form tendon-like repair tissue in patients with chronic Achilles tendon rupture.

Study Design

Case series; Level of evidence, 4.

Methods

Six patients with chronic rupture of the Achilles tendon underwent tendon reconstruction with the use of interposed tissue between the stumps. The average time from the primary injury to surgery was 22 weeks (range, 9 to 30 weeks). Preoperative magnetic resonance imaging (MRI), histology of the interposed tissue, and clinical results were evaluated. The average postoperative follow-up period was 31 months (range, 24 to 43 months).

Results

Preoperative T2-weighted MRI in all cases revealed that chronically ruptured Achilles tendons were thickened and fusiform-shaped with diffuse intratendinous high-signal alterations throughout. Longitudinal high-signal bands were seen throughout the tendon, except at the musculotendinous junction and insertion on the calcaneus. Histologically, scar tissue interposed between the tendon stumps consisted of dense collagen fibers, and degenerative changes were not seen. After surgery, no patient had difficulty in walking or stair climbing, and all were able to perform a single-limb toe raise. The mean preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were 88.2 and 98.3 points, respectively; the difference was statistically significant (P = .0277).

Conclusion

Interposed tissue between the tendon stumps is suitable for repair of chronic Achilles tendon rupture if preoperative MRI shows a thickened fusiform-shaped Achilles tendon with diffuse intratendinous high-signal alterations throughout.
Matrix Metalloproteinase Inhibitors Prevent a Decrease in the Mechanical Properties of Stress-Deprived Tendons
Authors: Arnoczky Steven P. , Lavagnino Michael , Egerbacher Monika , Caballero Oscar , Gardner Keri
Published: February 2007

Background

An increase in matrix metalloproteinases (MMPs) and the resulting degradation of the extracellular matrix have been implicated in the pathogenesis of tendinopathy. Studies have documented the beneficial effects of MMP inhibitors used to treat pathologic conditions in which MMP activity has had a negative effect on connective tissues.

Hypothesis

Matrix metalloproteinase inhibitors will prevent the decrease in material properties associated with tendon stress deprivation by inhibiting MMP activity.

Study Design

Controlled laboratory study.

Methods

Rat tail tendons were subjected to 7 days of in vitro stress deprivation with and without the addition of 1 of 2 broad-spectrum MMP inhibitors (doxycycline and ilomastat). The material properties (ultimate tensile stress, strain, and tensile modulus) of the tendons were compared with each other and with fresh control tendons. In addition, tendons from each group were evaluated for MMP-13 messenger RNA expression, MMP-13 protein synthesis, MMP-13 activity, and pericellular matrix morphology.

Results

Both MMP inhibitors resulted in a statistically significant reduction in MMP activity in 7 day stress-deprived tendons when compared with nontreated, stress-deprived tendons. Similarly, tendons treated with either ilomastat or doxycycline had significantly improved material properties. MMP-13 messenger RNA expression and protein synthesis were not significantly affected by either MMP inhibitor. Both MMP inhibitors were able to maintain the integrity of the pericellular matrix when compared with nontreated, stress-deprived tendons.

Conclusion

Matrix metalloproteinase inhibitors prevented the activation of MMP-13 and significantly inhibited pericellular matrix degeneration and the loss of material properties associated with stress deprivation.

Clinical Relevance

Matrix metalloproteinase inhibitors may play a supportive role in the treatment of tendinopathy by limiting the MMP-mediated degradation of the extracellular matrix.
Glenohumeral Internal Rotation Deficits in Professional Pitchers Enrolled in an Internal Rotation Stretching Program
Authors: Lintner David , Mayol Magdiel , Uzodinma Obinna , Jones Rex , Labossiere David
Published: February 2007

Background

Repetitive throwing motion creates increased external rotation and decreased internal rotation in the glenohumeral joint. There is controversy regarding the contribution of osseous and soft tissue adaptations to these changes in rotation.

Objective

To evaluate internal rotation deficits in the professional baseball thrower's shoulder and determine the impact of an internal rotation stretch program on that deficit.

Study Design

Cross-sectional study; Level of evidence, 3.

Methods

Eighty-five male professional pitchers were evaluated in this study. Players were divided into 2 groups based on length of participation in an appropriate internal rotation stretch program. Data were collected on internal and external rotations and total range of motion in both dominant and nondominant arms using a goniometer. Internal rotation deficit (the lack of internal rotation relative to the opposite side) was calculated. Generalized comparative statistical tests were used.

Results

Pitchers with 3 or more years in a stretch program (group 1) had greater internal rotation (74.3° vs 54.3°) and greater total range of motion (217.0° vs 194.2°) in dominant shoulders than did pitchers with less than 3 years (group 2). Total range of motion was greater in the dominant than in the nondominant arm for group 1. Internal rotation deficit in dominant arms was significantly greater for group 2 than for group 1. The analysis of dominant arm rotation relative to years in an internal rotation stretching program for pitchers in both groups showed a progressive increase in both internal rotation and total arc of motion with the number years in such a program plateauing after year 3.

Conclusion

The throwing motion shifts the total arc of motion toward external rotation and diminishes internal rotation. The increased external rotation may be attributable to increased humeral retroversion. The internal rotation deficit, however, is caused by soft tissue adaptations that can be addressed by consistent participation in a stretching program focused on internal rotation.
The Epidemiology of Knee Injuries in English Professional Rugby Union
Authors: Dallalana Richard J. , Brooks John H. M. , Kemp Simon P. T. , Williams Andrew M.
Published: February 2007

Background

Detailed injury epidemiology is an invaluable tool for reducing risks associated with sporting injuries. Very little accurate injury surveillance data exist regarding knee injuries in professional rugby.

Hypotheses

(1) Knee injuries have a greater impact on the game than injuries to other body locations. (2) Anterior cruciate ligament and medial collateral ligament injuries cause the greatest days absent from training and match play.

Study Design

Descriptive epidemiology study.

Methods

Medical personnel prospectively reported time-loss injuries sustained by 546 professional rugby union players from 12 clubs in England over 2 seasons, and the knee injuries were evaluated.

Results

Injuries to the knee accounted for the highest number of days absent due to injury (7776 days, 21%) and were characteristically severe, with a disproportionately high number of days missed per injury (37 days). Anterior cruciate ligament injuries accounted for the greatest proportion of days missed of all knee injuries (29%), followed by medial collateral ligament injuries (25%). Most severe injuries occurred during contact, mostly during a tackle, and most commonly in the final 20 minutes of a match. Injuries tended to be more common in backs. Injuries sustained during training accounted for 16% of all knee injuries. Each club studied had a mean of 10 knee injuries per season resulting in a total of 353 days absent.

Conclusions

The incidence of knee injuries sustained during matches was higher than that reported in all other football codes, surpassed only by rugby union at the international level. Knee injuries accounted for the highest player absence due to injury; 5% of an average playing squad were absent at any one time due to knee injuries.
Increasing the Distance between the Posterior Cruciate Ligament and the Popliteal Neurovascular Bundle by a Limited Posterior Capsular Release during Arthroscopic Transtibial Posterior Cruciate Ligament Reconstruction
Authors: Ahn Jin Hwan , Wang Joon Ho , Lee Sang Hak , Yoo Jae Chul , Jeon Woo Joo
Published: February 2007

Background

During arthroscopic transtibial posterior cruciate ligament reconstruction, popliteal vessel injury is the most serious complication, and it rarely occurs.

Purpose

To evaluate the distance change between the posterior cruciate ligament and the neurovascular bundle by limited release of the posterior capsule during arthroscopic posterior cruciate ligament reconstruction.

Study Design

Controlled laboratory study.

Methods

The authors performed an arthroscopic posterior cruciate ligament reconstruction procedure on 10 fresh-frozen cadaveric knees. The experimental procedure included 4 steps. Before the procedure and just after each step, angiographic lateral radiographs were checked to find the relationship and the distances between the popliteal artery and the posterior cruciate ligament. Changes in the distances at each step were compared and analyzed by ANOVA with Bonferroni correction.

Results

The mean distance between the popliteal artery and the tibial insertion of the posterior cruciate ligament increased significantly (from 4.4 ± 3.2 mm to 14.7 ± 4.1 mm) after limited posterior capsular release (P < .01). The distance from the popliteal artery to the midsubstance of the posterior cruciate ligament at the level of the posterior trans-septal portal significantly increased (from 11.3 ± 3.9 mm to 17.6 ± 4.0 mm) just after distension of the knee joint with a pump (P < .01).

Conclusion

This study showed a significant increase in the distance from the popliteal artery to the posterior cruciate ligament through arthroscopic limited posterior capsular release during arthroscopic transtibial posterior cruciate ligament reconstruction.

Clinical Relevance

The results of this study support the claim that risk of iatrogenic popliteal vessel injury could be reduced by limited posterior capsular release during arthroscopic transtibial posterior cruciate ligament reconstruction.
Kant, Kissinger, and Other Lutherans: On Ethics and International Relations
Authors: Andersen Svend
Published: February 2007

Many people alive today grew up during the so-called Cold War and even more experienced the fall of the Berlin Wall. The Cold War can be taken as the name of the order of international relations during four decades of the twentieth century. In the following, I want first to comment on the concept of world order and the related one of institution (law). Then I shall deal with the relation between these concepts and various schools in international politics. Next, I will pay attention to the ethical dimensions of those schools. And finally, I want to reflect on the place of theology in the ethics of international relations. My thesis is (1) that theological ethics has an important role to play in understanding contemporary international politics (IP); (2) that if theological ethics takes a Lutheran starting point, it will endorse elements both in the liberal and the realist tradition of international relations theory. As I regard Kant and Kissinger as representatives of the two schools, I hope that explains my somewhat provocative title.
Sensitive moisture response to Holocene millennial-scale climate variations in the Mid-Atlantic region, USA
Authors: Li Yong-Xiang , Yu Zicheng , Kodama Kenneth P.
Published: February 2007

Millennial-scale climate variability has been increasingly recognized as one of the most prominent features of the Holocene. However, regional responses, especially in terms of moisture conditions, are poorly documented and understood. Here we present lithologic and magnetic evidence from White Lake in northern New Jersey, USA, to show that low lake levels occurred at about 1.3, 3.0, 4.4 and 6.1 ka (1 ka = 1000 cal. yr BP). The low lake levels are indicated by heterogeneous coarse calcareous sediment layers showing strong magnetic intensities. These detrital layers were likely formed during low stands when shallow-water marls were exposed, oxidized, transported and redeposited. This model is supported by laboratory experiments showing that oxidation of marls can enhance magnetic intensities. The dry periods inferred from the low lake levels of White Lake appear to occur concurrently with the cold periods recorded in the North Atlantic sediments. The correlation between millennial-scale dry/wet cycles inferred from lake-level fluctuations of White Lake and cold/warm cycles in North Atlantic sediments suggests sensitive moisture responses to Holocene millennial-scale climate variability. The dry-cold (or wet-warm) association is supported by instrumental records of the last century showing that the Mid-Atlantic region was dominated by wet conditions, while most parts of the conterminous USA experienced droughts, when the North Atlantic Ocean was warm. The consistent moisture responses of the Mid-Atlantic region to temperature changes of the North Atlantic Ocean may have persisted for the past 6000 years.
Holocene floodplain sediment storage and hillslope erosion within the Rhine catchment
Authors: Hoffmann T. , Erkens G. , Cohen K. M. , Houben P. , Seidel J. , Dikau R.
Published: February 2007

The response of fluvial systems to land use and climate change varies depending on catchment size. While forcing-response mechanisms of small catchments are reasonably well understood, the response of larger drainage basins is less clear. In particular, the impact of land use and climate change on the Rhine system is poorly understood because of the catchment size (185 000 km2) and the long history of human cultivation, which started approximately 7500 years ago. A sediment budget is calculated to specify the amount of alluvial sediment that was deposited during the Holocene and to estimate long-term soil erosion rates. The results suggest that 59±14 X 109 t of Holocene alluvial sediment is stored in the non-alpine part of the Rhine catchment (South and Central Germany, Eastern France, The Netherlands). About 50% of Holocene alluvial sediment is deposited along the trunk valley and the delta (Upper Rhine, Lower Rhine, coastal plain), while the rest is stored along the tributary valleys. The floodplain sediment storage corresponds to a mean erosion rate of 0.55±0.16 t/ha per yr (38.5±10.7 mm/kyr) across the Rhine catchment outside the Alps. This Holocene-averaged estimate amounts for sediments that were delivered to the channel network and is at the lower limit of erosion rates from other studies of different methodology.