bluuebunny/crossref_metadata_2025 huggingface dataset:
“There is no such thing as pure fiction”: Impossible worlds and the principle of minimal departure reconsidered
Authors: Mikkonen Kai
Published: September 2011

As has been argued in various theories of fiction, there can be no such thing as a totally fictional world. This paper seeks to examine the principle of minimal departure, defined by David Lewis and Marie-Laure Ryan, as an explanation for the impossibility of total fiction that would undermine all assumptions based on our actual world. The principle says that readers reconstrue the fictional world as being the closest possible to the reality we know, unless otherwise indicated.

By drawing examples from the ontologically fluid worlds in Jasper Fforde's Thursday Next series, I suggest new areas in narrative analysis where the principle could be applied and point out some limitations in earlier definitions of this notion. On the one hand, we can examine those narrative and literary devices that directly play upon the principle of mimimal departure and allow fiction to enlarge the scope of the world that must be explained. On the other hand, I argue that questions of modality in fiction may be relatively immune to this principle. I thus introduce the rule of suspension of modal claims, indicating the need to refrain from making assumptions, in any strong sense, about what may be possible, necessary, or contingent in a fictional world. The principle of suspension of modal claims emphasizes the way fiction may encourage epistemological and ontological doubt rather than mimetic or antimimetic expectations (i.e. principles of minimal and maximal departure), compelling our judgement of the possibility and reality of fiction to hesitate, to linger over a range of possibilities.
Simile and dissimilarity
Authors: Moon Rosamund
Published: September 2011

Simile is generally explained as an explicit comparison between two things, which presupposes they have features or qualities in common – but equally, there must be essential differences too. This paper pursues these differences, and explores ideas of dissimilarity in simile, here considered as a separate device from metaphor. It then looks at implications for text analysis, in particular the role of simile in articulating the experience of the unknown and the new in narrations of travel. Drawing on texts by three 19th-century explorers (Livingstone, Stanley, Kingsley) and contrasting them with fiction (Conrad), I argue that the dissimilarities within similes reveal much, particularly with respect to ideological meanings on the one hand, and the expression of certainty and uncertainty on the other.
Author's characters and the character of the author: The typical in fiction
Authors: Wood Tahir
Published: September 2011

This article situates the semantics of fictional characters within a broader framework of authorial communication. It argues that theories of character in the novel will be deficient to the extent that characters are not conceptualised as motivated creations of an author. The influential approach of Georg Lukács effectively excluded the point of view of the author in favour of a direct relationship between the fictional work and processes of history, as an instance of the particular related to the universal. But here it is argued that the notion of the typical should rather be seen as a relation between the social milieu of the authorial experience on the one hand and the figure-ground construction of character on the other. This constitutes part of a project to examine the question of realism on a renewed basis, particularly in terms of the authorial presence within the fictional world, and the case is argued with specific reference to a novel by John Fowles.
Effect of the glass fiber length on the mechanical properties of long glass fiber reinforced polyphenylene sulfide
Authors: Yasuda Hiroshi , Chiba Yusuke , Ishikawa Masaru
Published: September 2011

The effects of the length of glass fibers on the toughness of long glass fiber reinforced polyphenylene sulfide (PPS) composites (PPS-LFT), made by the pulltrusion process, were studied with regards to both the molding V notched specimen and the cutting V notched specimen. Toughness was excellent on the molding V notched specimen. By observing the fracture morphology of the molded V notched specimen, it was found that a crack was formed, due to a slip or debonding at the fiber surface. The crack was propagated along the fiber, due to the pulling out of fibers from the matrix polymer. Both the maximum load and the fracture energy increased with increasing length of the glass fiber, because the resistance created by pulling out the fibers increased with increasing fiber length. In the case of PPS-LFT, it is understood that toughness improved because the slip between the fiber and the resin occurs before the excessive elastic strain energy is stored.
Thermodynamic study of poly(ethylene glycol) in water/acetone solutions by viscometry
Authors: Mehrdad Abbas , Taghi Taghizadeh Mohammad , Moladoust Roghieh
Published: September 2011

In this work, the intrinsic viscosities of poly(ethylene glycol) (PEG) with a molar mass of 20,000 g·mol-1 were measured in water/acetone solutions from (283.1 to 313.1) K. The expansion factors of the polymer chains were calculated from the intrinsic viscosity data. The thermodynamic para­meters (entropy of dilution parameter, the heat of dilution para­meter, θ temperature, polymer-solvent interaction parameter and second osmotic virial coefficient) were derived by the temperature dependence of the polymer chain expansion factor. The thermodynamic parameters indicate that mixtures of water/acetone are changed to the poorer solvents for PEG, by increasing temperature and volume fractions of acetone. Also, the temperature dependency of segment-segment and segment-solvent interactions for PEG in mixed water/acetone, is decreased by increasing volume fractions of acetone.
Synchronisierbarkeit autonomer Agenten durch vernetzte Regelungen
Authors: Lunze Jan
Published: September 2011

Bei der Synchronisation von autonomen Systemen hat die Regelung die Aufgabe, die Teilsysteme asymptotisch auf eine gemeinsame Trajektorie zu führen. Es wird eine Synchronitätsbedingung bewiesen, mit der die Wahl einer solchen Regelung in zwei Schritte zerlegt werden kann. Im ersten Schritt wird durch eine Analyse der Teilsysteme der Stabilitätsbereich festgelegt, für den im zweiten Schritt eine Regelung ausgelegt wird. Anschließend wird eine notwendige und hinreichende Synchronisierbarkeitsbedingung für die Teilsysteme angegeben, die zeigt, dass nur Agenten, die durch eine proportionale Ausgangsrückführung stabilisierbar sind, durch eine vernetzte Regelung synchronisiert werden können. Die Ergebnisse werden am Beispiel der Abstandsregelung einer Fahrzeugkolonne illustriert.
Zwei Beispiele für die Berücksichtigung von Symmetrien beim Reglerentwurf
Authors: Collon Carsten , Rudolph Joachim
Published: September 2011

Es werden zwei Anwendungsbeispiele für den sogenannten invarianten Reglerentwurf diskutiert. Die Verwendung eines geometrisch motivierten Folgefehlers für das kinematische Fahrzeug erlaubt den Entwurf einer bezüglich der speziellen Euklidischen Gruppe SE(2) invarianten Folgeregelung. Im Anschluss wird die Konstruktion des Folgefehlers auf den dreidimensionalen Fall übertragen. Als weiteres Beispiel dient der Entwurf einer stabilisierenden Rückführung für einen Räuber-Beute-Bioreaktor, die dem System bezüglich eines Arbeitspunktwechsels ein invariantes Verhalten aufprägt.
Entwurf dualer Störbeobachter für lineare konzentriert- und verteilt-parametrische Systeme
Authors: Deutscher Joachim
Published: September 2011

Dieser Beitrag stellt den Entwurf von dualen Störbeobachtern für konzentriert- und verteilt-parametrische Systeme vor. Als Ergebnis des Entwurfs erhält man für beide Systemklassen einen endlich-dimensionalen Ausgangsregler. Damit kann das für duale Beobachter gültige Separationsprinzip auch zur Stabilisierung verteilt-parametrischer Systeme herangezogen werden, wofür ein auf der Vollständigen Modalen Synthese basierendes Eigenwertvorgabeverfahren vorgeschlagen wird. Die asymptotische Kompensation von Sinusstörungen für einen Wärmeleiter mittels eines endlich-dimensionalen Störbeobachters veranschaulicht die Ergebnisse der Arbeit.
Medienzugriffsverfahren für einen Echtzeit-Wireless-Feldbus
Authors: May Gunther
Published: September 2011

In diesem Beitrag wird ein Medienzugriffsverfahren für einen echtzeitfähigen Wireless-Feldbus vorgestellt, mit dem Zykluszeiten in der Größenordnung von 1 ms auch bei einer großen Anzahl von Netzknoten erzielt werden können. Das Verfahren wird mit bestehenden Konzepten verglichen und anhand von Simulationen auf seine Leistungsfähigkeit hin untersucht. Zusätzlich werden weitere Aspekte untersucht, die bei der Implementierung eines echtzeitfähigen Wireless-Feldbus zu beachten sind.
X-by-Wire Plattform — Konzept und Auslegung
Authors: Reichel Reinhard , Armbruster Michael
Published: September 2011

Dargestellt wird eine X-by-Wire Plattform zur gesamtheitlichen Umsetzung des Global Chassis-Control. Die Plattform basiert auf FlexRay-Technologie. Sie vermag eine Vielzahl aktiver Fahrerassistenzfunktionen unterschiedlicher Sicherheitsintegrität auszuführen — ohne mechanische Rückfallebene. Die X-by-Wire Plattform wurde im Rahmen des Forschungsprojektes SPARC entwickelt, als Prototyp in drei Fahrzeuge integriert und auf einer Teststrecke getestet. Einen Weg zu zeigen, wie eine komplexe Plattform unter Berücksichtigung der Sicherheitsintegrität ausgelegt werden kann, ist Kern dieses Beitrags.
Synchronisierung identischer linearer Systeme — ein Zugang über LMIs
Authors: Listmann Kim D. , Adamy Jürgen , Scardovi Luca
Published: September 2011

Dieser Beitrag stellt ein neues Verfahren zur Synchronisierung identischer linearer Systeme vor, die über statische Kommunikationsnetzwerke verbunden sind. Dazu wird das Entwurfsproblem auf ein simultanes Stabilisierungsproblem zurückgeführt. Aus diesem werden dann neue notwendige und hinreichende Bedingungen für den Entwurf abgeleitet. Diese sind konstruktiv, so dass auf Basis linearer Matrixungleichungen, geeignete Rückführungen für Multi-Agenten-Systeme mit stabilisierbarer Dynamik und zusammenhängendem Kommunikationsnetzwerk entworfen werden können. Es wird gezeigt, dass dies sogar dann möglich ist, wenn die Agenten nur einen Teil ihrer Zustandsinformation austauschen dürfen.
Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis
Authors: Hekkala Anne , Ilonen Jorma , Knip Mikael , Veijola Riitta , _ _
Published: September 2011

Objective

Our purpose was to assess whether family history of diabetes or the HLA-DR-DQ genotype of the index case was associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of childhood type 1 diabetes.

Patients and methods

The study cohort comprised 1518 children aged <15 years and diagnosed with type 1 diabetes in Finland in 2002–2005. Family history of type 1 and type 2 diabetes among first-degree relatives (FDRs) and grandparents was assessed at diagnosis. HLA-DR-DQ genotypes were analysed using time-resolved fluorometry.

Results

In total, 12.6 and 1.7% of children had at least one FDR affected with type 1 or type 2 diabetes, respectively, and 6.6 and 34.8% had at least one grandparent with type 1 or type 2 diabetes. DKA (pH <7.30) occurred less frequently in children having a type 1 diabetes affected FDR (7.4 vs 20.5%, P<0.001). Type 2 diabetes among the parents or grandparents had no such effect. Lower risk HLA genotypes were observed to predispose to DKA (P<0.024). In a logistic regression analysis, the risk of DKA was independently associated with the absence of a family member affected by type 1 diabetes, the presence of a low-risk HLA genotype and older age at diagnosis (odds ratio 3.23, 1.45 and 1.07 respectively).

Conclusion

The presence of type 1 diabetes in an FDR is associated with an decreased risk of DKA at diagnosis. The rate of DKA seems to be higher in children with lower HLA-conferred risk for type 1 diabetes.
ENDOCRINE DISORDERS IN PREGNANCY: Pheochromocytoma and pregnancy: a deceptive connection
Authors: Lenders Jacques W M
Published: September 2011

A pheochromocytoma in a pregnant patient is one of the most threatening medical conditions for mother, fetus, and physician. Although extraordinarily rare with a frequency of 0.002% of all pregnancies, this tumor is notorious for its devastating consequences. As in non-pregnant patients, the signs and symptoms are quite variable but not specific, with hypertension being one of the most prominent signs. Confusion with the much more prevalent forms of pregnancy-related hypertension is the main cause of overlooking the diagnosis. If undiagnosed, maternal and fetal mortality is around 50%. Conversely, early detection and proper treatment during pregnancy decrease the maternal and fetal mortality to <5 and 15% respectively. For the biochemical diagnosis, plasma or urinary metanephrines are the tests of first choice since they have a nearly maximal negative predictive value. For reliable localization, only magnetic resonance imaging is suitable, with a sensitivity of more than 90%. When the tumor is diagnosed in the first 24 weeks of gestation, it should be removed by laparoscopic adrenalectomy after 10–14 days of medical preparation with the same drugs as in non-pregnant patients. If the tumor is diagnosed in the third trimester, the patient should be managed until the fetus is viable using the same drug regimen as for regular surgical preparation. Cesarean section with tumor removal in the same session or at a later stage is then preferred since vaginal delivery is possibly associated with higher mortality. Despite all technical diagnostic and therapeutic progress over the last decades, the key factor for further reduction of maternal and fetal mortality is early awareness and recognition of the potential presence of a pheochromocytoma in a pregnant patient with hypertension.
ENDOCRINE TUMOURS: Approach to the patient with advanced differentiated thyroid cancer
Authors: Schlumberger M , Sherman S I
Published: September 2011

Patients with advanced thyroid cancer may benefit froml-thyroxine treatment at doses that suppress serum TSH level, local treatment interventions, and radioiodine therapy. In those patients who are refractory to radioiodine therapy and in whom progressive disease has been documented, the efficacy of cytotoxic chemotherapy is poor. Encouraging results have been obtained with the use of kinase inhibitors that should be offered as first-line treatment, preferably in the context of a prospective trial.
Policy harmonized approach for the EU agricultural sector modelling
Authors: SALPUTRA G. , CHANTREUIL F. , HANRAHAN K.
Published: September 2011

Policy harmonized (PH) approach allows for the quantitative assessment of the impact of various elements of EU CAP direct support schemes, where the production effects of direct payments are accounted through reaction prices formed by producer price and policy price add-ons. Using the AGMEMOD model the impacts of two possible EU agricultural policy scenarios upon beef production have been analysed  full decoupling with a switch from historical to regional Single Payment scheme or alternatively with re-distribution of country direct payment envelopes via introduction of EU-wide flat area payment. The PH approach, by systematizing and harmonizing the management and use of policy data, ensures that projected differential policy impacts arising from changes in common EU policies reflect the likely actual differential impact as opposed to differences in how common policies are implemented within analytical models. In the second section of the paper the AGMEMOD models structure is explained. The policy harmonized evaluation method is presented in the third section. Results from an application of the PH approach are presented and discussed in the papers penultimate section, while section 5 concludes.;
Impact of temperature and germination time on the success of a C4 weed in a C3 crop: Amaranthus retroflexus and spring barley
Authors: HYVÖNEN T.
Published: September 2011

Elevation in temperatures due to climate change could promote the invasion by C4 weed species of arable fields in the boreal region, which are dominated by C3 crops. The success of Amaranthus retroflexus L. (a C4 weed) in spring barley (a C3 crop) was studied at current and elevated temperatures (3°C difference) in a greenhouse experiment in southern Finland. The competition treatments included no competition and four levels of competition with barley, differing in terms of germination time. The success of A. retroflexus was measured as growth (height and biomass) and seed production (number and biomass). Elevation in temperature enhanced seed production of A. retroflexus, but the impact on growth was minor (only difference in plant height in one treatment). The growth and seed production of A. retroflexus in competition with barley was minimal although the growth of barley decreased with the rise in temperature. The results indicate that climate change could improve growth of a C4 weed such as A. retroflexus, but it is unlikely to succeed in spring barley.;
The phytotoxic effects and biodegradability of stored rapeseed oil and rapeseed oil methyl ester
Authors: VAUHKONEN V. , LAUHANEN VENTELÄ , S. SUOJARANTA
Published: September 2011

The aims of this study were to determine the phytotoxicity of stored rapeseed (Brassica rapa) oil (RSO) and rapeseed oil methyl ester (RME) after "spill like" contamination on the growth of barley (Hordeum vulgare) and the biodegradability of these substances in OECD 301F test conditions and in ground water. Rapeseed oil and rapeseed oil methyl ester were both stored for a period of time and their fuel characteristics (e.g. acid number) had changed from those set by the fuel standards and are considered to have an effect on its biodegradation. The phytotoxicity was tested using two different types of barley cultivars: Saana and Vilde. The phytotoxic effect on the barley varieties was determined, after the growth season, by measuring the total biomass growth and the mass of 1000 kernels taken from the tests plots. Also visual inspection was used to determine what the effects on the barley growth were. These measurements suggest that both RSO and RME have a negative impact on barley sprouts and therefore the total growth of the barley. RSO and RME both decreased the total amount of harvested phytomass. The weight of 1000 kernels increased with low concentrations of these contaminants and high contamination levels reduced the mass of the kernels. The results of these experiments suggest that the stored rapeseed oil and rapeseed oil methyl ester are both phytotoxic materials and therefore will cause substantial loss of vegetation in the case of a fuel spill. The RSO and RME biodegraded effectively in the measurement period of 28 days under OECD test conditions: the degree of biodegradation being over 60%. The biodegradation in the ground water was much slower: the degree of biodegradation being about 10% after 28 days.;
Preliminary studies on using LAB strains isolated from spontaneous sauerkraut fermentation in combination with mineral salt, herbs and spices in sauerkraut and sauerkraut juice fermentations
Authors: WIANDER B. , KORHONEN H.J.T.
Published: September 2011

The use of mineral salt, herbs and spices in combination with isolated lactic acid bacteria strains in sauerkraut fermentation was studied. Mineral salt differs from ordinary salt because NaCl is partially replaced by KCl. The mineral salt contains 28% KCl and 57% NaCl. The final NaCl content in the sliced white cabbage mixture was 0.5%. In approximately 20 hours the pH dropped to the desired level. All the pressed sauerkraut juices had a good microbiological quality. The sensory quality of all pressed juices was found to be either good or acceptable.;
Comparison of different DNA extraction methods from hair root follicles to genotype Finnish Landrace boars with the Illumina PorcineSNP60 BeadChip
Authors: SIRONEN A. , UIMARI P. , VILKKI J.
Published: September 2011

Recent developments in sequencing methods have enabled whole genome sequencing of several species and the available sequence information has allowed the development of high throughput genotyping chips. However, these genotyping methods require high quality DNA. The possibility to genotype samples based on DNA from non-invasive sources would permit retrospective genotyping of previously collected samples and also facilitate the analysis of large populations e.g. for genomic selection. In this study we have developed and evaluated different DNA preparation methods from porcine hair root follicles for high throughput genotyping with the PorcineSNP60 Genotyping BeadChip (Illumina). We describe a method for DNA extraction from porcine hair root samples, which produces results from high throughput genotyping with the same high degree of accuracy as previously reported for DNA extracted from sperm, blood or tissue samples. This method was used for the genotyping of 273 hair follicle samples. When the DNA concentration was > 30 ng/ìl all samples had the same high call rate ( > 99%) as sperm samples confirming the robustness of this DNA extraction method for high throughput genotyping. Our data also establishes the suitability of the PorcineSNP60 BeadChip for genotyping the Finnish Landrace population.;
Sauerkraut and sauerkraut juice fermented spontaneously using mineral salt, garlic and algae
Authors: WIANDER B. , PALVA A.
Published: September 2011

The use of mineral salt in natural fermentation of white cabbage into sauerkraut and sauerkraut juice, in order to evaluate whether the amount of NaCl could be lowered, was studied. Mineral salt differs from ordinary salt because NaCl is partially replaced by KCl. In the fermentations mineral salt was used in various amounts (0.81.5%) and in combination with garlic and algae. The final NaCl concentrations in these fermentation trials were 0.50.9%. Fermentations were also carried out with cabbage sliced to different degrees. The sauerkraut juice fermented by using 0.8% mineral salt (0.5% NaCl) was found to have the best sensory quality. The yield of sauerkraut juice increased as the coarseness of the cabbage mix decreased.;
A family of two-point methods with memory for solving nonlinear equations
Authors: Petkovic Miodrag , Dzunic Jovana , Petkovic Ljiljana
Published: September 2011

An efficient family of two-point derivative free methods with memory for
solving nonlinear equations is presented. It is proved that the convergence
order of the proposed family is increased from 4 to at least 2 + ?6 ? 4.45,
5, 1/2 (5 + ?33) ? 5.37 and 6, depending on the accelerating technique. The
increase of convergence order is attained using a suitable accelerating
technique by varying a free parameter in each iteration. The improvement of
convergence rate is achieved without any additional function evaluations
meaning that the proposed methods with memory are very efficient. Moreover,
the presented methods are more efficient than all existing methods known in
literature in the class of two-point methods and three-point methods of
optimal order eight. Numerical examples and the comparison with the existing
two-point methods are included to confirm theoretical results and high
computational efficiency. 2010 Mathematics Subject Classification. 65H05
A facile catalyst and solvent-free synthesis of spiro thia heterocycles on grinding
Authors: Dandia Anshu , Singh Ruby , Laxkar Ashok
Published: September 2011

An efficient and mild method for the synthesis of spiro [1,3-
oxathiolan/oxathianes] in the solid state reaction at room temperature has
been described. This method is a good option to obtain the title compounds
in quantitative yields in a simple and inexpensive way. Applying this
methodology, different thia heterocycles were synthesized.
Complexes of some 3d-metals with a Schiff base derived from 5-acetamido-1,3,4-thiadiazole-2-sulphonamide and their biological activity
Authors: Malik Suman , Ghosh Suparna , Mitu Liviu
Published: September 2011

Using a bidentate ligand, a Schiff base of 5-acetamido-1,3,4-
thiadiazole-2-sulphonamide, complexes of transition metals having the
general formula ML2, where M = Mn(II), Fe(II), Ni(II) and Cu(II), were
synthesized. The complexes were characterized by elemental analysis, molar
conductivity, magnetic moment, electronic, ESR and IR spectroscopy, and
particle size analysis. The conductivity data of the complexes suggests
their non-electrolytic nature. The stability constants and free energy
change for the complexes were calculated. Spectral studies and magnetic
susceptibility measurements revealed an octahedral geometry for all the
complexes. The ligand and its complexes were screened for their fungicidal
activity against Aspergillus niger and A. flavus.
An ultrasound-promoted green approach for the synthesis of 3-(indol-3-yl)-3-hydroxyindolin-2-ones catalyzed by Fe(III)
Authors: Khorshidi Alireza , Tabatabaeian Khalil
Published: September 2011

Ferric chloride hexahydrate was used as a recyclable homogeneous catalyst in
aqueous media for the synthesis of 3-(indol-3-yl)-3-hydroxyindolin-2-ones
under sonication. It was found that the employed conditions afford the
products smoothly in good to excellent yields.
The Effect of Therapeutic Exercise and Mobilization on Patients With Shoulder Dysfunction: A Systematic Review With Meta-analysis
Authors: Brudvig Tracy J. , Kulkarni Hetal , Shah Shalvi
Published: September 2011

Study Design

Systematic review with meta-analysis.

Objective

To pool and summarize the published research evidence examining if the combination of therapeutic exercise and joint mobilization is more beneficial than therapeutic exercise alone in patients with shoulder dysfunction.

Background

Therapeutic exercise is an effective intervention for patients with shoulder dysfunction, which is often supplemented by joint mobilization techniques. Numerous studies have examined the effects of the combination of therapeutic exercise and joint mobilization on patients with shoulder dysfunction.

Method

Six databases were searched for randomized controlled trials. All the randomized controlled trials published in English that have studied the effectiveness of therapeutic exercise and joint mobilization on adults with either clinically or radiographically confirmed shoulder dysfunction resulting in pain, restriction of range of motion (ROM), and/or limitation in function, were included in this review. Effect size was calculated in the form of standardized mean difference and 95% confidence interval (CI) for each variable, then combined to represent weighted standardized mean differences (WSMDs) and 95% CIs.

Results

Seven studies that met the inclusion criteria were identified, with a total of 290 participants. The WSMDs and CIs, which combined the results of all the studies for a particular variable, revealed equivocal results for all variables. The resulting WSMD (95% CI) for each of the variables was 0.2 (−0.68, 1.08) for pain, 0.15 (−0.67, 0.97) for abduction ROM, −0.04 (−0.65, 0.57) for flexion ROM, 0.01(−0.79, 0.81) for internal and external rotation ROM, and 0.09 (−0.46, 0.64) for function and disability. Even after elimination of sources of heterogeneity, the new WSMDs and CIs continued to overlap zero, giving equivocal results.

Conclusion

The current evidence is inconclusive with respect to the beneficial effects of the combination of therapeutic exercise and joint mobilization versus therapeutic exercise alone for reducing pain, increasing ROM and function, and limiting disability in patients with shoulder dysfunction.

Level of Evidence

Therapy, level 1a−. J Orthop Sports Phys Ther 2011;41(10):734–748, Epub 4 September 2011. doi:10.2519/jospt.2011.3440
Evoked Spinal Reflexes and Force Development in Elite Athletes With Middle-Portion Achilles Tendinopathy
Authors: Wang Hsing-Kuo , Lin Kwan-Hwa , Wu Yu-Kuang , Chi Shyh-Ching , Shih Tifany Ting-Fang , Huang Yung-Cheng
Published: September 2011

Study Design

Controlled laboratory study.

Objectives

To compare the neuromuscular function of the triceps surae muscle bilaterally in elite athletes with unilateral chronic Achilles tendinopathy.

Background

Previous studies suggest that tendinopathies or chronic pain may lead to a spinal/supraspinal level modulation of the excitability or voluntary activation of ipsilateral motor units. However, this has not been studied in Achilles tendinopathy.

Methods

Fourteen college athletes (mean ± SD age, 24.2 ± 1.7 years) who had unilateral chronic middle-portion tendinopathy in their Achilles tendons were recruited. Bilateral measurements of soleus reflex tests, including H-reflex and V wave, and rate of force development (RFD), as well as corresponding electromyography of the tibialis anterior and triceps surae muscles, were performed. Statistical within-subject and between-leg comparisons were made.

Results

In the leg with tendinopathy, the V wave of the soleus muscle was significantly increased (P<.001). The side with tendinopathy also had a reduced normalized RFD (0–30, 0–50, and 0–100 ms) in plantar flexion, and concomitant higher electromyography ratios between the tibialis anterior and soleus (0–30 and 0–50 milliseconds) during the early stage of explosive contractions (P<.05). No significant differences were found for H-reflex, maximal plantar flexion and dorsiflexion torque, and absolute RFD.

Conclusions

Higher volitional supraspinal reflexes and lower maximal-strength independent force development occur in the triceps surae of elite athletes with unilateral middle-portion Achilles tendinopathy. These changes potentially indicate an acquired compensatory mechanism for maximal force production and deficits in explosive strength. The RFD is also suggested as a sensitive parameter to depict neuromuscular changes during treatment of chronic tendinopathies. J Orthop Sports Phys Ther 2011;41(10):785–794, Epub 4 September 2011. doi:10.2519/jospt.2011.3564
Muscle Functional MRI as an Imaging Tool to Evaluate Muscle Activity
Authors: Cagnie Barbara , Elliott James , O'Leary Shaun , D'Hooge Roseline , Dickx Nele , Danneels Lieven
Published: September 2011

Synopsis

Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique that offers a noninvasive method to quantify changes in muscle physiology following the performance of exercise. The mfMRI technique is based on signal intensity changes due to increases in the relaxation time of tissue water. In contemporary practice, mfMRI has proven to be an excellent tool for assessing the extent of muscle activation following the performance of a task and for the evaluation of neuromuscular adaptations as a result of therapeutic interventions. This article focuses on the underlying mechanisms and methods of mfMRI, discusses the validity and advantages of the method, and provides an overview of studies in which mfMRI is used to evaluate the effect of exercise and exercise training on muscle activity in both experimental and clinical studies. J Orthop Sports Phys Ther 2011;41(11):896–903, Epub 4 September 2011. doi:10.2519/jospt.2011.3586
Treatment of Patients With Degenerative Cervical Radiculopathy Using a Multimodal Conservative Approach in a Geriatric Population: A Case Series
Authors: Forbush Steven W. , Cox Terry , Wilson Eric
Published: September 2011

Study Design

Retrospective clinical case series.

Objective

To describe the management of 10 patients with advanced cervical spondyloarthrosis with radiculopathy, using manual therapy, intermittent mechanical cervical traction, and home exercises.

Background

Predictors and short-term outcomes of cervical radiculopathy have been published. These predictors have not been developed for, or applied to, geriatric patients with spondylitic radiculopathy.

Case Description

A series of 10 patients (aged 67 to 82 years) were referred to a physical therapist for medically prediagnosed cervical spondyloarthrosis and radiculopathy, as determined by magnetic resonance imaging. Neck Disability Index (NDI), numeric pain rating scale (NPRS), upper limb tension testing, Spurling's test, and the cervical distraction test were all completed on each patient at initial examination and at discharge. NDI and NPRS data were also collected at 6 months posttreatment. Intervention included manual therapy (including high-velocity low-amplitude thrust manipulation) of the upper thoracic and cervical spine, intermittent mechanical cervical traction, and a home program (including deep cervical flexor strengthening) for 6 to 12 sessions over a period of 3 to 6 weeks.

Outcomes

All 10 patients had substantial improvement in NPRS and NDI scores. The mean NPRS score was less than 1/10, and the mean NDI score was 6/50 at discharge, compared to the original mean NPRS and NDI scores of 5.7 and 27.4, respectively. All patients reported maintaining those gains for 6 months.

Discussion

A multimodal approach for patients diagnosed with cervical spondyloarthrosis with radicular symptoms was useful in this geriatric population to reduce pain, minimize radicular symptoms, and improve functional outcomes.

Level of Evidence

Therapy, level 4. J Orthop Sports Phys Ther 2011;41(10):723–733, Epub 4 September 2011. doi:10.2519/jospt.2011.3592
Change in Knee Cartilage Volume in Individuals Completing a Therapeutic Exercise Program for Knee Osteoarthritis
Authors: Woollard Jason D. , Gil Alexandra B. , Sparto Patrick , Kwoh C. Kent , Piva Sara R. , Farrokhi Shawn , Powers Christopher M. , Fitzgerald G. Kelley
Published: September 2011

Study Design

Prospective cohort study.

Objectives

To characterize knee cartilage change in individuals with knee osteoarthritis (KOA) who have completed a therapeutic exercise program.

Background

While therapeutic exercise is frequently used successfully to improve pain and function in individuals with KOA, no studies have reported the volume of cartilage change or individual factors that may impact volume of cartilage change in those completing an exercise program for KOA.

Methods

Thirteen individuals with KOA underwent magnetic resonance imaging to quantify cartilage volume change in the weight-bearing regions of the medial and lateral femoral condyles and the entire surface of the tibial plateaus from baseline to 1-year follow-up. Body structure and function measures were taken for body mass index, knee axis alignment, knee motion, and knee strength. Activity limitations and activity levels were also measured prior to the therapeutic exercise program, using the Western Ontario and McMaster Universities Osteoarthritis Index and the Physical Activity Scale for the Elderly. At 6 months from baseline, follow-up clinical measurements of knee strength and motion were performed. At 1 year from baseline, imaging of the knee cartilage and knee alignment were performed, and participants completed the Western Ontario and McMaster Universities Osteoarthritis Index and Physical Activity Scale for the Elderly.

Results

The central region of the medial femoral condyle (cMF) had a median volume of cartilage loss of 3.8%. The other 3 knee tibiofemoral articular surfaces had minimal median cartilage volume change. Individuals were dichotomized into progressors (n = 6) and nonprogressors (n = 7), based on the standard error of measurement of cartilage volume change for the cMF. Progressors were younger, had a larger body mass index, had a higher Kellgren-Lawrence grade in the medial compartment of the knee, and had a greater increase in knee varus alignment from baseline to 1-year follow-up. The progressors also had frontal plane hip and knee kinetics during baseline gait analysis that potentially increased medial knee joint loading.

Conclusion

The loss of cMF cartilage volume was highly variable and the median loss of cartilage was within the range previously reported. Seven of the 13 individuals did not have cMF cartilage volume loss greater than the standard error of measurement. Change in cartilage volume of the cMF may be influenced to a greater extent by personal factors than by completion of a therapeutic exercise program. Additional research is needed to decipher the interactions among therapeutic exercise and personal characteristics that impact knee cartilage loss. J Orthop Sports Phys Ther 2011;41(10):708–722, Epub September 2011. doi:10.2519/jospt.2011.3633
Diffusion-Weighted Magnetic Resonance Imaging of the Musculoskeletal System: An Emerging Technology With Potential to Impact Clinical Decision Making
Authors: Beattie Paul F.
Published: September 2011

Synopsis

Diffusion-weighted imaging (DWI) is an application of magnetic resonance imaging that allows the measurement of water movement within and between tissues. Originally developed as a way of detecting early signs of stroke or brain disease, DWI is now being used to study physiologic events within the musculoskeletal system. The accurate measurement of water diffusion can provide important information regarding tissue responses associated with trauma and disease, as well as offer insight toward the mechanism by which physical therapy interventions affect tissues. The purpose of this paper is to discuss the rationale for DWI and its potential clinical and research applications for patients with musculoskeletal disorders. Specific examples of the use of DWI for patients with painful spinal disorders are used as illustrations. J Orthop Sports Phys Ther 2011;41(11):887–895, Epub 4 September 2011. doi:10.2519/jospt.2011.3744
Screening the Lumbopelvic Muscles for a Relationship to Injury of the Quadriceps, Hamstrings, and Adductor Muscles Among Elite Australian Football League Players
Authors: Hides Julie A. , Brown Cassandra T. , Penfold Lachlan , Stanton Warren R.
Published: September 2011

Study Design

Longitudinal observational study.

Objectives

To examine the relationship between severity of preseason hip, groin, and thigh (HGT) muscle injuries, and lumbopelvic muscle size, asymmetry, and function at the start and end of the preseason.

Background

In Australian Rules Football, HGT muscle injuries have the highest prevalence and incidence. Deficits within the lumbopelvic region, such as impaired muscle function and muscle asymmetry, could contribute to injuries in the preseason, and injury could, in turn, affect muscle size and function.

Methods

MRI examinations were performed on 47 male elite Australian Rules Football players at the start and at the end of the football preseason. The cross-sectional area (CSA) of multifidus, psoas major, and quadratus lumborum muscles was measured, as well as change in trunk CSA due to the function of voluntarily contracting the transversus abdominis muscle. Injuries occurring during each preseason training session were routinely recorded by the club's performance staff.

Results

Analysis of variance indicated that players with more severe preseason HGT injuries (more training sessions missed) had significantly smaller multifidus muscle CSA compared to players with no HGT injury (P = .006). No relationship was found for size or asymmetry of the quadratus lumborum or psoas major muscles, or ability to contract the transversus abdominis muscle through drawing in of the abdominal wall (P>.05). Small multifidus muscle size at L5 predicted 5 of 6 players who incurred a more severe HGT injury.

Conclusions

An association between multifidus muscle size (relative to age, height, and weight) and preseason injury suggests a way to identify players at risk of severe HGT injuries. This result needs to be replicated in a larger sample before resources are committed to intervention efforts. J Orthop Sports Phys Ther 2011;41(10):767–775, Epub 4 September 2011. doi:10.2519/jospt.2011.3755
Reliability and Diagnostic Accuracy of the Lachman Test Performed in a Prone Position
Authors: Mulligan Edward P. , Harwell Jordan L. , Robertson William J.
Published: September 2011

Study Design

Prospective, blinded, diagnostic accuracy study.

Objective

To investigate the reliability and diagnostic accuracy of the Lachman test, performed in a prone position, to detect the presence of an anterior cruciate ligament (ACL) tear. Direct arthroscopic visualization and a consensus of clinical findings, including joint arthrometry and magnetic resonance imaging, were used as the reference standards.

Background

An alternative position for evaluating the integrity of the ACL has been proposed as a means for examiners with smaller hands to adequately stabilize the thigh of a larger individual; however, the diagnostic accuracy of this method has not been established.

Methods

Fifty-two consecutive patients with a complaint of knee pain were independently evaluated in a prone position for the status of their ACL by 2 physical therapists, before any other diagnostic assessment. The 31 men and 21 women ranged in age from 16 to 57 (mean ± SD, 34.3 ± 4.2) years and in acuity of knee injury from 21 to 365 (mean ± SD, 195 ±130) days.

Results

Twenty-three of 52 (44%) of the patients had a torn ACL. The agreement between examiners was 90%, with a kappa coefficient of 0.81. The sensitivity of the prone Lachman test was 70% and the specificity was 97%, resulting in a positive likelihood ratio of 20.17 and a negative likelihood ratio of 0.32. The positive predictive value was 94% and the negative predictive value was 80%. The diagnostic odds ratio was 64.0, with a number needed to diagnose of 1.5.

Conclusion

The prone Lachman test is a reliable evaluation technique that can be used to confirm the presence of an ACL tear; however, the test should not be used as the sole criterion to rule out the presence of the injury.

Level of Evidence

Diagnosis, level 2b. J Orthop Sports Phys Ther 2011;41(10):749–757, Epub 4 September 2011. doi:10.2519/jospt.2011.3761
Meniscus Repair and Transplantation: A Comprehensive Update
Authors: Noyes Frank R. , Heckmann Timothy P. , Barber-Westin Sue D.
Published: September 2011

Synopsis

Preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following repair of meniscus tears for both simple longitudinal tears located in the periphery and complex multiplanar tears that extend into the central third avascular region. This operation is usually indicated in active patients who have tibiofemoral joint line pain and are less than 50 years of age. However, not all meniscus tears are repairable, especially if considerable damage has occurred. In select patients, meniscus transplantation may restore partial load-bearing meniscus function, decrease symptoms, and provide chondroprotective effects. The initial postoperative goal after both meniscus repair and transplantation is to prevent excessive weight bearing, as high compressive and shear forces can disrupt healing meniscus repair sites and transplants. Immediate knee motion and muscle strengthening are initiated the day after surgery. Variations are built into the rehabilitation protocol according to the type, location, and size of the meniscus repair, if concomitant procedures are performed, and if articular cartilage damage is present. Meniscus repairs located in the periphery heal rapidly, whereas complex multiplanar repairs tend to heal more slowly and require greater caution. The authors have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies. J Orthop Sports Phys Ther 2012;42(3):274–290, Epub 4 September 2011. doi:10.2519/jospt.2012.3588
Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals
Authors: Moksnes Håvard , Engebretsen Lars , Risberg May Arna
Published: September 2011

Synopsis

Anterior cruciate ligament (ACL) injuries in skeletally immature individuals remain a challenge for the child, the parents, orthopaedic surgeons, and physical therapists. The main challenges are the potential risk of recurrent instability, secondary injuries following nonoperative treatment, and the risks involved with surgical treatment due to the vulnerability of the epiphyseal growth plates. We first present the physiological background for considerations that must be made when advising on treatment alternatives for skeletally immature individuals after ACL injury. The implications of continuous musculoskeletal development for treatment decisions are emphasized. No randomized controlled trials have been performed to investigate outcomes of different treatment algorithms. There is no consensus in the literature on clinical treatment decision criteria for whether a skeletally immature child should undergo transphyseal ACL reconstruction, physeal sparing ACL reconstruction, or nonoperative treatment. Additionally, well-described rehabilitation programs designed for either nonoperative treatment or postoperative rehabilitation have not been published. Based on the currently available evidence, we propose a treatment algorithm for the management of ACL injuries in skeletally immature individuals. Finally, we suggest directions for future prospective studies, which should include development of valid and reliable outcome measures and specific rehabilitation programs. J Orthop Sports Phys Ther 2012;42(3):172-183, Epub 4 September 2011. doi:10.2519/jospt.2012.3608
Cosmopolitanism and Biogeography of the Genus Manganonema (Nematoda: Monhysterida) in the Deep Sea
Authors: Zeppilli Daniela , Vanreusel Ann , Danovaro Roberto
Published: September 2011

Spatial patterns of species diversity provide information about the mechanisms that regulate biodiversity and are important for setting conservation priorities. Present knowledge of the biogeography of meiofauna in the deep sea is scarce. This investigation focuses on the distribution of the deep-sea nematode genus Manganonema, which is typically extremely rare in deep-sea sediment samples. Forty-four specimens of eight different species of this genus were recorded from different Atlantic and Mediterranean regions. Four out of the eight species encountered are new to science. We report here that this genus is widespread both in the Atlantic and in the Mediterranean Sea. These new findings together with literature information indicate that Manganonema is a cosmopolitan genus, inhabiting a variety of deep-sea habitats and oceans. Manganonema shows the highest diversity at water depths >4,000 m. Our data, therefore, indicate that this is preferentially an abyssal genus that is able, at the same time, to colonize specific habitats at depths shallower than 1,000 m. The analysis of the distribution of the genus Manganonema indicates the presence of large differences in dispersal strategies among different species, ranging from locally endemic to cosmopolitan. Lacking meroplanktonic larvae and having limited dispersal ability due to their small size, it has been hypothesized that nematodes have limited dispersal potential. However, the investigated deep-sea nematodes were present across different oceans covering macro-scale distances. Among the possible explanations (hydrological conditions, geographical and geological pathways, long-term processes, specific historical events), their apparent preference of colonizing highly hydrodynamic systems, could suggest that these infaunal organisms are transported by means of deep-sea benthic storms and turbidity currents over long distances.