bluuebunny/crossref_metadata_2025 huggingface dataset:
Antitumor immunity of DNA vaccine based on CTLA-4 fused with HER2 against colon carcinoma
Authors: Huang Shumin , Yu Xinxin
Published: April 2018

Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) negatively regulates the T cell activation and competes with CD28 in binding with B7.1/B7.2 molecules. Fusion of the extracellular region of CTLA-4 and a specific antigen is an effective method for improving the immune efficacy of DNA vaccines. This study aimed to investigate the effects of DNA vaccine of human epidermal growth factor receptor-2 (HER2) fused with CTLA-4 on the development of colon carcinoma in mice and to identify the potential immune mechanisms underlying its effects. We constructed recombinant plasmids corresponding to the control group, individual antigen group, and fusion antigen group. Then, mice were intramuscularly injected with the corresponding plasmids and exposed to electrical pulses. Immunogenicity was evaluated at 2 weeks after the last immunization. Furthermore, to investigate the antitumor immune effects of the recombinant plasmid, we established a mouse model of HER2 expression in transplanted tumors. Experimental results showed that the recombinant plasmids expressing fusion antigen induced a stronger cellular immune response. Inoculation of the HER2-CTLA-4 plasmid exerted the strongest inhibitory effect on HER2 expression-mediated tumor growth in mice. These results highlight the potential of the CTLA-4 fusion DNA vaccine as a therapeutic vaccine against colon cancer based on HER2 and CTLA-4.
Rethinking the role of music in the neurodevelopment of autism spectrum disorder
Authors: Janzen Thenille Braun , Thaut Michael H.
Published: April 2018

Music has played a prominent role in the clinical and research literature on autism spectrum disorder (ASD) in regard to diagnosis, therapy, and behavioral observations of exceptional artistic abilities in this population. Music as therapy for ASD has traditionally focused on social interaction, communication skills, and social-emotional behaviors. However, recently, there has been an increased research focus on the role of motor and attention functions as part of the hallmark features of ASD, which may have significant implications for the role of music as an intervention for individuals with autism. The purpose of this article is to provide a critical appraisal of new research developments for therapists and researchers to potentially reassess the role of music as intervention to support healthy neurodevelopment in individuals with ASD and expand the current clinical scope of practice in music therapy for autism. Our argument is based upon compelling research evidence indicating that motor and attention deficits are deeply implicated in the healthy neurodevelopment of socio-communication skills and may be key indicators of structural and functional brain dysfunction in ASD. In light of this evidence, we suggest that music-based developmental training for attention and motor control may receive a critical new functional role in the treatment of autism due to the significant effect of auditory-motor entrainment on motor and attention functions and brain connectivity.
The Unfair Selection: A Study on Skin-Color Bias in Arranged Indian Marriages
Authors: Nagar Itisha
Published: April 2018

Underlying the growing popularity of skin-lightening or fairness cosmetics in India is one of the most baseless biases experienced and practiced. Yet, the overriding importance of skin-color especially in context of marriage has been largely unaddressed. This exploratory study examined the influence of skin-color on preference for potential marriage partner. A 2 × 2 (gender × skin-color) between-group experimental design was used. Mothers ( N = 108) of individuals of marriageable age group were presented with an option of five marital profiles containing education and work information only. The participants were shown profiles of either males or females depending on whether they had a son or a daughter. Once a profile was chosen, the participant was either shown a photograph of highly attractive fair girl/boy or a highly attractive dark girl/boy. The light-skinned and dark-skinned photograph was of the same person, except their skin tones were manipulated with the use of computer software. Participants were asked to rate how strongly would they recommend the girl/boy as potential bride/groom for their children. As expected, fair-skinned highly attractive people received higher ratings than dark-skinned highly attractive people. However, contrary to our expectations, ratings received for dark-skinned woman were not significantly lower than the ratings received for dark-skinned man. This study shows that the color of skin has the potential to even overpower traits such as general competency and physical attractiveness in both men and women.
Trials of the Past: A Theoretical Approach to State Centralisation in Afghanistan
Authors: Parkes Aidan
Published: April 2018

German sociologist Max Weber observes that the centralisation of administrative function is imperative to a stable nation state. Yet, despite this sovereign necessity, attempts at incorporating heterogeneous sociopolitical entities into a cohesive society eluded nineteenth- and early twentieth-century Afghanistan. Ahmad Shah Durrani is known as the father of Afghanistan. He bears this title because he unified a collection of tribes and established a pseudo-confederation of territories in 1747. However, the following two centuries were less constructive and subsequent state centralisation was fraught and ultimately fruitless for Afghanistan. Contemporaneous centralisation remains embryonic and strained by tribal clout. It is within this context that nineteenth- and twentieth-century Afghan amirs, khans, and kings attempted to modernise, centralise, and unify a consortium of conservative tribal microsocieties. Many of the same complications of the nineteenth and twentieth century continue to obfuscate modern Afghanistan.
The type of approach (medial versus lateral) influences TKA component rotation in total knee arthroplasty - a clinical study using 3D-CT
Authors: Schiapparelli Filippo-Franco , Amsler Felix , Hirschmann Michael
Published: April 2018

The purpose of this study was to investigate if the type of approach (medial parapatellar approach (MPA) versus lateral parapatellar subvastus approach with tibial tubercle osteotomy (LPA)) influences the rotation of femoral and/or tibial component and leg axis in total knee arthroplasty (TKA).

This study included 200 consecutive patients in whom TKA was performed using either a parapatellar medial (n=162, MPA) or parapatellar lateral subvastus approach with tibial tubercle osteotomy (n=38, LPA). All patients underwent clinical follow-up, standardised radiographs and computed radiography (CT). TKA components’ position and the whole leg axis were assessed on 3D reconstructed CT scans (sagittal, coronal and rotational). Mean values of TKA component position and the whole leg alignment of both groups were compared using a T-test. The tibial component was graded as internally rotated (< 3° of external rotation (ER)), neutral rotation (equal or between 3° and 6° of ER) and and externally rotated (>6° ER). The femoral component was graded as internally rotated (< 3° of internal rotation (IR)), neutral rotation (equal or between -3° IR and 3° of ER) and externally rotated (>3° ER).

There was no significant difference in terms of whole leg axis after TKA between both groups (MPA: 0.2° valgus ± 3.4; LPA: 0.0° valgus ± 3.5). Means of tibial component position were 2.7° ER ± 6.1 (MPA) and 7.6° ER ± 5.4 (LPA). Patients of group LPA presented a significantly less internally rotated (LPA: 18.4%; MPA: 48.8%) and more externally rotated (LPA: 52.6%; MPA: 22.8%) tibial component (p<0.001). No significant differences were seen for the femoral component position, tibial valgus/varus and tibial slope.

The type of approach significantly influences the tibial TKA component rotation. It appears that a MPA tends to internally rotate the tibial TKA component and a LPA tends to externally rotate the tibial TKA.
The stem fixation technique do influence the tibial alignment in TKA revisions. A comparative study between cemented and cementless / hybrid cemented tibial stems using 3D-CT
Authors: Schiapparelli Filippo-Franco , Amsler Felix , Hirschmann Michael
Published: April 2018

Purpose of the study was to investigate if the fixation technique for intramedullary stems in total knee arthroplasty revisions (rTKA), influence the alignment of the components, leg axis and the rates of complications, reoperations and revisions.

Sixteen patients with cemented tibial stems (Group C) and twenty-six patients with either cementless or hybrid cemented tibial stems (Group PF) were collected. All patients underwent regular clinical follow-up (41.5 months) and postoperative 3D-CT scans. Mean values of the three-dimensional rTKA component position and of the leg axis were compared between groups with the T-test. The tibial components were graded on the transversal plane into internal, neutral and external rotated, and, on the coronal plane, in neutral and varus/valgus aligned. The graded measurements and the incidences of postoperative complications, reoperations and revisions were analysed with a Chi2-Test.

The mean measurements of the component position did not significantly differ between groups (p < 0.05). Group C showed a tendency to internal rotation (Group C: 62.5%; Group PF: 34.6%) and a significant higher coronal alignment accuracy (p = 0.004). Group PF instead a tendency to external rotation (Group C: 25.0%; Group PF: 46.2%) (p = 0.094). Both groups presented a neutral leg alignment (Group C: 0.00° ± 3.37; Group PF: 1.04° ± 2.6) (p = 0.268). Group PF showed a tendency to more complications (Group C: 35.7%; Group PF: 60.9%; p = 0.138). No significant differences were seen between rates of reoperations (Group C: 35.7%; Group PF: 30.4%; p = 0.565) and revisions (Group C: 28.6%; Group PF: 8.7%; p = 0.894).

The stem fixation technique influence the tibial component alignment. A more accurate coronal alignment was achieved in Group PF.
Experiences with an intra-articular pain catheter in approx. 3.000 TKR over a period of 6.5 years
Authors: Mai Burkhard
Published: April 2018

The optimal pain treatment after a TKR has been under discussion for a long time. With the use of pain catheters you can save analgesics and opiates. A femoral and sciatic nerve catheter became already established. Disadvantages are a the time-consuming application of the catheter with neuro-tracer or ultrasound as well as facing possible palsy, especially of the extension muscle of the knee, which disturbs the autonomous mobility of the patients. Would it be possible to treat the postoperative pain sufficiently and preserve the active mobility of the patients by using an intraarticular pain catheter, that will not influence the muscle power, which can also be used time-sparing during TKR surgeries in combination with an external, continuous local anesthesia from a portable valve-controlled reservoir?

We report on case series of our clinic from July 2010 till October 2017, which included more than 3.000 TKRs. We made use of 4 different catheter and pump systems (for example the Painbuster). The LA used was Ropivacaine.

With a postoperative rate of fluid flow of 10-15 ml/h in a concentration of 3,75 mg/ml (0,375%) Ropivacaine Hydrochloride over a period of 2-3 days, we achieved a good pain reduction comparable to a femoral catheter and perfusor application of 2,0 mg/ml (0,2%) Ropivacaine.

Most patients feel strong pain following a TKR due to the special vulnerability of the knee joints with large inner surface of the joint and thin soft-tissue coverage. The established pain catheters positioned beside the femoral nerve need a relative long turnover time (the time from the end of the previous surgical procedure to the beginning of the next) and have an important disadvantage of palsy of the quadriceps muscle with the risk of falling due to the immobilization of the patient. The intra-articular painbuster systems lead to excellent pain reduction and fast mobilization of the patient with full control of muscle power. The application of the catheter during the operation is not time consuming and you will not face longer turnover and surgery times.
A Tomahawk Shaped Femur is a Risk Factor for Anterior Cruciate Ligament Injury
Authors: Pfeiffer Thomas , Burnham Jeremy , Herbst Elmar , Shafizadeh Sven , Musahl Volker
Published: April 2018

Bony morphologic characteristics have been demonstrated to increase the risk of anterior cruciate ligament (ACL) injury. The purpose of the study was to examine distal femoral morphology relative to ACL injury, reconstruction failure, and contralateral ACL injury. It was hypothesized that an increased posterior femoral condylar depth, quantified as the tomahawk ratio, would correlate with increased risk of primary ACL ruptures, ACL reconstruction failures, and contralateral ACL injuries.

Consecutive patients undergoing arthroscopic knee surgery at an academic medical center from 2012-2016 with minimum 24-month follow-up were retrospectively reviewed. Subjects were stratified into four groups: a control group consisting of patients with no ACL injuries and three groups of patients with a primary ACL injury, failed ACL reconstruction, or previous ACL injury with subsequent contralateral ACL injury. Using lateral radiographs, the ratio of posterior condylar depth over total condylar distance was defined as the tomahawk ratio. Analysis-of-variance (ANOVA) and post-hoc testing were used to test for differences in the mean tomahawk ratio between study groups (p<0.05). Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal tomahawk ratio cut-off for detecting increased risk for ACL injury

175 patients met inclusion criteria. The mean tomahawk ratios in the control group, primary ACL injury group, failed ACL reconstruction group, and contralateral ACL injury group were 61.1% (± 2.1), 64.2% (± 3.8), 64.4% (± 3.6), and 66.9% (± 4.0), respectively. Patients with a primary ACL injury, failed ACL reconstruction, or contralateral ACL injury had a significantly higher tomahawk ratio compared to the control group (p<0.008). ROC analysis demonstrated a tomahawk ratio of 63% or greater to be associated with an increased risk for ACL injury with a sensitivity of 83% and a specificity of 71%.

The data from this study show that an increased posterior femoral condylar depth, or tomahawk ratio, is associated with increased risk of ACL injury, including primary ACL injury, failed ACL reconstruction, and contralateral ACL injury. Readily identifiable risk factors, such as an increased tomahawk ratio, could assist clinicians in identifying at-risk individuals who may experience greater benefit from targeted ACL injury prevention counseling and intervention. The presence of the tomahawk-shaped femur could also be used to guide treatment decisions and identify ACL reconstruction patients who may benefit from additional surgical procedures such as extra articular tenodesis.
Prevention of knee injuries and ACL ruptures Systematic review and recommendations of the the German Knee Society (DKG): The Stop-X program
Authors: Petersen Wolf , Stoffels Thomas , Achtnich Andrea
Published: April 2018

Introduction Knee injuries and especially anterior cruciate ligament (ACL) tears are frequent in athletes. Therefore, primary and secondary prevention of sports-related lower limb injuries is an ongoing topic of interest. The aim of present study was to establish guidelines for the prevention of knee and ACL injuries on the basis of evidence-based concepts represented in current literature.

A comprehensive literature review regarding prevention programs for knee and ACL injuries was conducted.

Several modifiable and non-modifiable risk factors for knee injuries in athletes have been reported in literature. Referring to the ACL, specific injury mechanisms have been identified and are well understood. In particular, it has been demonstrated that dynamic valgus is one of the most important modifiable risk factors. Simple tests like the drop jump test have shown their efficacy in screening and detecting athletes at risk. There is only little evidence for the preventive effect on knee and ACL injuries by single exercises. However, in order to prevent or correct endangering movement patterns including dynamic valgus, several complex prevention programs have been developed in the past. These prevention programs are included in standard warm-up exercises and are focusing on muscle strength, balance, and proprioception, as well as running and flexibility. It is reported that these training programs can reduce the incidence of knee injuries by up to 27% and ACL injuries by up to 51%.

Screening, identification, and correction of endangering movement patterns like the dynamic valgus are the first crucial steps in order to prevent knee and ACL injuries in athletes. Furthermore, jumping, running and flexibility exercises as well as balance and strength training are proven to reduce the incidence of these injuries and should, therefore, be integrated into the regular warm up program. Appropriate complete prevention programs are freely accessible via the Internet and should be adapted to the specific sport disciplines
Knee injuries in Rock climbing and Bouldering - An Update
Authors: Lutter Christoph , Popp Dominik , Schöffl Volker
Published: April 2018

Rock climbing and bouldering is undergoing a worldwide “boom” and has recently been selected for the next Olympic summer games. Besides ground falls, an injury mechanism in this sport is the so-called heel hook position, which is used more frequently today due to changing training and competition modes, especially in indoor bouldering. With the rising number of knee injuries in climbing and bouldering, we now aimed to analyze this specific injury mechanisms and its underlying pathologies.

Among 50 climbing athletes with unspecific knee pain, we identified 9 patients with injuries of the lower extremities after performing a heel hook. The outcome was evaluated at a minimum of 6 months after the injury and classified in a sport-specific score. After clinical examination and exclusion of the minor injuries we performed ultrasound and/or magnetic resonance imaging. Patients were treated conservatively with initial partial immobilization and early functional therapy with physiotherapy. Only one patient with a partial meniscus tear needed a surgical procedure.

All patients reported sudden dorsal-sided pain in the knee while performing the hook. Seven also reported hearing a snapping sound, similar to those reported in achilles tendon tears. Walking was difficult in all cases and all were limping. Five patients were diagnosed a strain of the lateral collateral ligament and two patients a lateral meniscus tear. The other patients had either a partial tear of the PCL, or a strain of the distal hamstring tendons. In 8 of 9 cases, we received “good” to “excellent” outcomes with a conservative approach. The popping sound at the time of injury may correspond to a change of the pivot of the tractus ileotibialis that then “jumps” over the condyle. While the hook is performed, there is frequently an active knee flexion involved, which thus changes the pivot of the tractus.

In climbing and bouldering, injuries of the knee will further increase due to modern training and competition modes requiring the use of heel hooks. MRI shows the proper diagnosis and the proper therapeutic approach is conservative treatment. The outcome after heel hook injuries is good to excellent in most of the cases. Warm-up routine, an avoidance of muscular imbalances, and flexibility training can help to avoid injuries during heel hook.
The Popliteus Bypass Graft is biomechanically superior to the isometric Larson Technique for posterolateral instabilities of the knee
Authors: Drenck Tobias C. , Domnick Christoph , Preiss Achim , Frosch Karl-Heinz , von Glahn Mathias
Published: April 2018

Injuries of the posterior cruciate ligament (PCL) are most often accompanied by injuries of the posterolateral corner (PLC) and the ligamentum collaterale fibulare (LCL). This leads to a combined dorsal- and external rotational instability. In Germany most of these types of injuries are treated by an arthroscopic reconstruction of the PCL and combined posterolateral augmentation in the way, of an isometric “Larson-Procedure”. Techniques, which reconstruct the LCL and PLC in a more anatomic way provide better clinical results according to current literature. Comparative studies of these two types of reconstructions do not exist, biomechanical studies are inhomogeneous and the isometric Larson-technique has not been adequately tested so far. In this study the isometric (extra anatomic) Larson-technique was tested against a more anatomic reconstruction of the LCL and PLC with a popliteus bypass graft.

20 human knee specimen were divided into Group A and B. The PCL, as well as the PLC and LCL were dissected and kinematic measurements were determined using a robotic and optical tracking system. The knee kinematics were determined for 134 N posterior loads, 10 Nm varus loads and 5 Nm external rotational loads in 0°, 20°, 30°, 60° and 90° of knee flexion. All specimens underwent a double bundle PCL reconstruction. In Group A the reconstruction of the PLC was accomplished by a popliteus bypass graft and an additional anatomic LCL graft. In Group B the reconstruction was performed using a Larson-technique with a single femoral tunnel and a sling through the head of the fibular. The protocol was repeated and the differences in the two groups where analyzed (2W-Anova and t-Test, p=0,05)

Both groups gained a significant increase of instability after dissecting the ligamentous structures (deficient) in all algorithms tested. Postoperatively both groups achieved a significant improvement in all these parameters. Group A with the popliteus bypass technique revealed significant 37±8% less external rotational instability compared to group B (p<0,03). In contrast to group A, group B presents a remaining increase of external rotation compared to the intact knee. The popliteus bypass in group A reduced the external rotational instability to less than 1,3 degree difference compared to the intact state on average. No significant results were found between the two groups in terms of varus instability and posterior loads.

In this study we showed for the first time, that the most frequently used posterolateral reconstruction technique (isometric Larson) has limited biomechanical properties compared to a more anatomic reconstruction (popliteus bypass) in terms of reducing external rotation. Whether this is the cause of the remaining posterolateral instability in patients treated with the Larson technique and whether it can be prevented by using a popliteus bypass graft is subject of future clinical studies.
Effects of gracilis tendon harvest on in vivo knee joint kinematics
Authors: Flies Anne , Agres Alison , Kraus Natascha
Published: April 2018

The gracilis tendon is a commonly used autologous tendon graft in orthopedic surgery (e.g. anterior cruciate ligament (ACL), medial patellofemoral ligament (MPFL) or chronic acromioclavicular joint (ACJ) reconstruction) but also for example in anal incontinence surgery for formation of a neosphincter. In previous studies the effects of gracilis tendon harvest were analyzed after ACL rupture, its reconstruction and rehabilitation. However, all of these three incidents influence the outcome. Thus, the purpose of the present study was to evaluate the effect of isolated gracilis tendon harvest from uninjured knees on knee kinematics during daily activities.

Patients between 18 to 60 years with harvest of their gracilis tendon for reconstruction of the ACJ were included. Exclusion criteria were previous surgeries or injuries of their knees. Knee kinematics were evaluated during gait analysis using an infrared optical motion capture system with 10 cameras (T20 S cameras, Vicon, Oxford, United Kingdom) and reflective skin markers. A set of 59 markers was attached on anatomical landmarks of the patients’ lower extremities, pelvis, spine and shoulders with double-sided tape. The position of these markers was tracked at 120 Hz during the trials. Daily activities such as walking and running were performed. Additionally, kick-backs were performed to analyze maximal active knee flexion an important function of gracilis muscle. To quantify the tibiofemoral motion and reduce soft tissue artifacts, the OSSCA (OCST, SARA, and SCoRE combined approach) technique was used. (Boeth 2013) The D’Agostino&Pearson Test was used to test for a Gaussian distribution. For parametric data the dependent t-test, otherwise the Wilcoxon test was used.

Sixteen patients were evaluated. However, four had to be excluded after MRIs showed an accidental harvest of the semitendinosus tendon. The mean age was 43 years [standard deviation (SD) 13 years] and time to follow up was 44 months (SD 25). The affected limb showed an increased abduction of 1,38° (SD 4,05; p=0,31) during walking and 0,65° (SD 5,23; p=0,70) during running, as well as an increased rotational translation of 2,26 mm (SD 3,62; p=0,08) during walking and 1,38 mm (SD 3,27; p=0,21) during running. The mean anterior-posterior translation was larger for the healthy limb with 1,15 mm (SD=5,30; p=0,08) during walking and with 2,43 mm (SD=5,99; p=0,23) during running. A larger mean knee flexion angle was measured for the healthy limb during walking, running and kick-backs (mean difference during walking: 3,05°; SD=7,15; p=0,28; running: 2,39°; SD=7,34; p=0,33; kick-backs: 5,31°; SD=8,59; p=0,10). However, none of these results reached statistical significance.

These results show that gracilis tendon harvest in healthy knees does not lead to altered knee kinematics. However, the small size of our cohort should be taken into consideration. These data support the use of the gracilis tendon as autologous graft for reconstructive surgery.
X-Ray based navigation system for torsional correction - first clinical data
Authors: Grünwald Leonard , Buschbaum Jan , Lobenhoffer Philipp , Windolf Markus , Schröter Steffen
Published: April 2018

It is well known that treatment of femoral shaft fractures can lead into torsional malalignment. In up to 15% of these cases a torsional correction is necessary. Further there are congenital torsional abnormities causing disbalances in the knee joint. In both cases a torsional correction osteotomy can be helpful. However the results of these kind of osteotomies can defer from the planned correction-angle. There are various intraoperative tests to check the corrected angle with the planned one. But still there are a lot of unsatisfying results. It is well known that there exist navigation systems for this kind of surgery. But usually they are expensive, time consuming and need a lot of hardware. The so called X-in-One system is a truly x-ray-based navigation system. Besides the c-arm two probes and one tablet pc are needed. The objective of this study was to proof the feasibility in a clinical setting. Additionally it was meant to be a validity check.

After testing two cadaver legs in the laboratory we received the ethical approval to perform a first clinical trial. From November 2016 to June 2017 we included 5 patients who underwent torsional correction of their femur. Planning of rotational-angle was done by CT and measured with the Waidelich-method. After surgery CT and measurement was performed again to verify the success of surgery. During surgery the angle was measured with two wire technique and an angle template. To stabilize the osteotomized bone during surgery we used an external fixator. Therefore we could attach both navigation probes at each Schanz’screw (distal and proximal to the osteotomy). The surgeon was blinded to the results of the system. So the calculation was performed by the system after surgery. Therefore we took two x-ray images done during surgery, one before osteotomy and the other after the correction was stabilized. With these values we were able to calculate the validity of the new system to the CT-measurement and against the intraoperative measurement of the surgeon.

In all 5 patients no adverse events, such as infection or non-union occurred. In one case the Schanz’screw with the attached probe was rotated during sugery accidentally. However the system detected this rotation correctly. There was no significant time delay by attaching and removing the probes. All intraoperative x-rays could be used as values for calculations of the X-in-One System. The results of our new system are impressive precise. No deviation more than 1° towards the CT measurement was recognized.

After finishing the development of this system it will be an easy to use tool for torsional corrections of each bone. It is very helpful to perform precise torsional osteotomies without apparent disadvantages during surgery performance and patients’ safety. An additional benefit is that post-op CT is unnecessary. But still a lot of work has to be done to implement this system into the c-arm and get the certificate for intraoperative usage.
Improved early recovery after TKA through an app-based, feedback-controlled active muscle training - A prospective randomized trial
Authors: Weber-Spickschen Sanjay , Hardt Sebastian , Horstmann Hauke , Krettek Christian
Published: April 2018

The aim of this prospective randomized controlled trial was to evaluate if an app-based, feedback-controlled active muscle training can be used to improve the early outcome after total knee arthroplasty.

Sixty patients (mean age 67.3 years, range 45 to 84) awaiting primary total knee arthroplasty (TKA) were randomized into a control- and training group. Both Groups followed an identical postoperative protocol. Additionally, the training group performed an appbased, feedback-controlled active muscle training multiple times daily postoperatively. Outcome measures were active and passive range of motion, pain at rest and in motion, knee extension strength, the Timed “Up and Go”, 10 Meter Walk Test, 30 Second Chair Stand Test, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS) and inpatient data.

Mean time to follow-up was 6.88 days in the control group and 6.59 days in the training group for a total of 47 patients (78.3 percent follow-up). The training group used the GenuSport Knietrainer a total of 18.4 times (range 6 to 42 times) on average. Active range of motion was 11.4 degrees higher in the training group (p=0.038), while passive range of motion was almost the same (p=0.906). Mean pain was significantly lower in the training group both at rest (p=0.01) and in motion (p=0.002). The training group reported significantly better outcomes in the KOOS Activities of Daily Living Score (p=0.037). No significant differences were observed in KOOS pain, symptoms, sports and quality of life (p=219, p=0.625, p=0.204, p=0.452, respectively). The KSS Knee Score and KSS Function Score were significantly better in the training group (p<0.001, p=0.011, respectively).

An app-based and feedback-controlled active muscle training can significantly improve the early outcome after total knee arthroplasty, particularly reduce pain and improve the range of motion. More training had better effects on the outcome than less training. Treatment costs could possibly be reduced. These findings are highly relevant regarding rising expectations from patients and the need to reduce costs in the health care system. Further studies with a longer follow up are necessary.
Arthroscopic revision surgery in the arthrofibrotic knee: who benefits?
Authors: Weber Christian , Müller-Stromberg Jochen , Weber Nicola
Published: April 2018

Arthrofibrotic stiffness of the knee joint has been recognized as a highly debilitating complication after complex knee reconstruction. The clinical impact of arthroscopic revision surgery was evaluated for patients with knee arthrofibrosis following total knee arthroplasty (TKA) and after joint preserving procedures. Hypothesis: Arthroscopic revision surgery is associated with functional benefits in both groups.

We retrospectively reviewed a consecutive series of adult patients (#CHR: greaterlike#18 years) at a single institution who underwent arthroscopic revision for knee stiffness. Minimum follow-up: 24 months. The analysis included demographic, surgical and histological data. The following outcome parameters were evaluated: pain (Visual Analog Scale, VAS); objective score systems (Oxford Knee Score) and patient activity (Tegner Activity Scale (TAS), Univ. of California Activity Scale (UCLA)). Furthermore, range of motion (ROM) was compared pre-, intra- and postoperatively. Finally, we compared body mass index (BMI) and quality of life (EQ-5D) changes.

We identified a total of 57 patients who underwent arthroscopic adhesiolysis for knee arthrofibrosis: 45 after TKA (Group 1) and 12 patients with ligament reconstruction (Group 2). The patient cohort included thirty (43.5%) males and thirty-six (56.5%) females. Mean age was 69 (SD 10.6) years in the TKA group and 41 (SD 12.7) years in group 2 (p=0.01). Mean length of stay (LOS) was 4.6 days in Group 1 and 2.8 days in Group 2. Pain levels (VAS) were reduced significantly in both groups (p=0.004); from 7.5 to 4.8 in Group 1 and from 7.8 to 2.9 (Group 2). In terms of sports activity, 26 patients (37.7%) reported an improved sports activity (UCLA score). The TAS improved from 2.58 to 4.08 in Group 2. The Oxford Knee Score improved from 23.5 to 27.2 in Group 1 and from 16.5 to 36.3 in Group 2. No reduction in BMI was observed. However, quality of life (EQ-5D) improved from 47.6 to 51.9 Group 1; and from 52.9 to 71.7 in Group 2.

Arthroscopic revision of the stiff knee may offer clinical benefits in terms of significant pain reduction, an improved level of activity and quality of life in stiffness following both TKA and joint preserving surgical reconstruction.
Differences between primary and secondary osteosynthesis for fractures of the lower limb with acute compartment syndrome
Authors: Ull Christopher , Seybold Dominik , Königshausen Matthias , Schildhauer Thomas , Geßmann Jan
Published: April 2018

To analyze the differences between primary and secondary osteosynthesis for fractures of the lower limb with acute compartment syndrome (ACS).

From our trauma database, we indentified a total number of 107 patients with 126 fractures of AO/OTA type 41 to 44 and 120 ACS from January 01, 2001 to December 31, 2015 who were treated with primary or secondary osteosynthesis after compartment incision.

71 patients with 77 fractures of AO/OTA classification type 41 to 44 suffering ACS received primary osteosynthesis after compartment incision (POCI) and were compared to 36 patients with 49 fractures of AO/OTA type 41 to 44 and ACS, who were treated by secondary osteosynthesis after compartment incision (SOCI). Patients with POCI showed a significantly shorter length of stay in the hospital with significantly less necessary surgeries for definitive treatment of the fractures and the soft tissue closure than SOCI patients (p < 0,001). The overall rate of infections in both groups were 13% without any difference between POCI and SOCI.

The POCI of AO/OTA fractures type 41 to 44 with ACS is a safe and effective procedure for unilateral und single fractures of the lower limb without an increasing infection rate.
Pre-soaking of hamstring grafts reduces risk of infection after ACL-reconstruction. A prospective study including 1000 patients
Authors: Offerhaus Christoph , Höher Jürgen , Balke Maurice
Published: April 2018

Post-operative infection of the knee is one of the major concerns following ACL-reconstruction. The purpose of this study was to investigate whether the pre-soaking of hamstring grafts in vancomycin reduces the incidence of post-operative infection.

This prospective study included more than 1000 patients undergoing primary ACL-reconstruction over a period of 4 years. Group 1 received intra-operative iv-antibiotics without pre-soaking of the graft. Group 2 received iv-antibiotics and additionally the graft was bathed in a vancomycin solution of 5 mg/mL.

In group 1, a total of 2,3% of the patients suffered a post-operative joint infection. In contrast, there were no post-operative infections in the second group (0%). Statistical analysis revealed a significantly reduced post-operative infection rate when bathing the autograft in vancomycin.

Pre-soaking of hamstrings grafts with vancomycin combined with classical iv antibiotic prophylaxis reduced the rate of post-operative infection when compared to iv-antibiotics alone. This technique should be utilized to reduce the overall incidence of knee infections following ACL reconstruction.
The Prior Odds of Testing a True Effect in Cognitive and Social Psychology
Authors: Wilson Brent M. , Wixted John T.
Published: April 2018

Efforts to increase replication rates in psychology generally consist of recommended improvements to methodology, such as increasing sample sizes to increase power or using a lower alpha level. However, little attention has been paid to how the prior odds ( R) that a tested effect is true can affect the probability that a significant result will be replicable. The lower R is, the less likely a published result will be replicable even if power is high. It follows that if R is lower in one set of studies than in another, then all else being equal, published results will be less replicable in the set with lower R. We illustrate this point by presenting an analysis of data from the social-psychology and cognitive-psychology studies that were included in the Open Science Collaboration’s (2015) replication project. We found that R was lower for the social-psychology studies than for the cognitive-psychology studies, which might explain why the rate of successful replications differed between these two sets of studies. This difference in replication rates may reflect the degree to which scientists in the two fields value risky but potentially groundbreaking (i.e., low- R) research. Critically, high- R research is not inherently better or worse than low- R research for advancing knowledge. However, if they wish to achieve replication rates comparable to those of high- R fields (a judgment call), researchers in low- R fields would need to use an especially low alpha level, conduct experiments that have especially high power, or both.
Brentuximab vedotin plus bendamustine: a highly active first salvage regimen for relapsed or refractory Hodgkin lymphoma
Authors: LaCasce Ann S. , Bociek R. Gregory , Sawas Ahmed , Caimi Paolo , Agura Edward , Matous Jeffrey , Ansell Stephen M. , Crosswell Howland E. , Islas-Ohlmayer Miguel , Behler Caroline , Cheung Eric , Forero-Torres Andres , Vose Julie , O’Connor Owen A. , Josephson Neil , Wang Yinghui , Advani Ranjana
Published: April 2018

Key Points

The outpatient BV and bendamustine regimen is highly active as first salvage therapy in relapsed/refractory HL, with manageable toxicity. The CR rate of 73.6% exceeded those reported for standard chemotherapy regimens, and post-ASCT outcomes generally appeared excellent.
Enhancing recurrent neural network-based language models by word tokenization
Authors: Noaman Hatem M. , Sarhan Shahenda S. , Rashwan Mohsen. A. A.
Published: April 2018

Different approaches have been used to estimate language models from a given corpus. Recently, researchers have used different neural network architectures to estimate the language models from a given corpus using unsupervised learning neural networks capabilities. Generally, neural networks have demonstrated success compared to conventional n-gram language models. With languages that have a rich morphological system and a huge number of vocabulary words, the major trade-off with neural network language models is the size of the network. This paper presents a recurrent neural network language model based on the tokenization of words into three parts: the prefix, the stem, and the suffix. The proposed model is tested with the English AMI speech recognition dataset and outperforms the baseline n-gram model, the basic recurrent neural network language models (RNNLM) and the GPU-based recurrent neural network language models (CUED-RNNLM) in perplexity and word error rate. The automatic spelling correction accuracy was enhanced by approximately 3.5% for Arabic language misspelling mistakes dataset.
Evaluation of the 2D reflection seismic method toward the exploration of thrust-controlled mineral deposits in southwestern Fujian Province, China
Authors: Liu Guofeng , Meng Xiaohong , Ni Jianhui , Chen Zhaoxi , Zhang Da
Published: April 2018

The southwestern region of the Fujian Province is one of the major ore districts in China. The current model states that mineral deposition is highly controlled by thrust structure, which means that there may be concealed deposits located deep within overlapping thrust areas. Reflection seismology, which has great depth penetration and higher resolution than other geophysical methods, has great potential to delineate complex structures and give some clues to mineralization. In 2015, an experimental 2D reflection seismic survey called “Fujian 2D” was conducted in this region. Data were acquired along a 13.8 km length, with a source interval of 60 m, and 691 identical receivers with an equal spacing of 20 m were used to record data for each source. Due to topographical restrictions caused by the source environment, the mass or position of some shots was changed. Despite the restrictions, the average fold number reached 64 for a 10 km distance along the middle of the survey line. During the data processing procedure, conventional technologies involving static correction, noise elimination, deconvolution, and iterative velocity analyses were applied. After the prestack time migration failed to obtain a high-quality imaging result, rugged prestack depth migration (PSDM) was introduced that resulted in a better quality image of the subsurface structure and which included near-surface parts of the thrusts. In addition, P- and S-wave velocities and density data were determined from two borehole cores. Forward modeling and imaging found that the Permian marble hosting the mineral deposits has lower velocity than the surrounding rocks, where contacts give rise to strong reflections. The final rugged PSDM also clearly delineated the thrust bodies and magma intrusion zones. Combining this forward modeling with the known geology of the investigated site, the Fujian 2D reflection seismic experiment demonstrates great potential for unveiling the main elements controlling mineral deposition, such as tectonic structure, stratigraphic contacts, and lithology. Our experimental results demonstrate that reflection seismology has a wide range of applications for future mineral exploration at greater depths.
Gay Priori
Authors: Adler Libby
Published: April 2018

Libby Adler offers a comprehensive critique of the mainstream LGBT legal agenda in the United States, showing how LGBT equal rights discourse drives legal advocates toward a narrow array of reform objectives that do little to help the lives of the most marginalized members of the LGBT community.
Terrorist Assemblages
Authors: Puar Jasbir K.
Published: April 2018

Tenth Anniversary Expanded Edition

Ten years on, Jasbir K. Puar’s pathbreaking Terrorist Assemblages remains one of the most influential queer theory texts and continues to reverberate across multiple political landscapes, activist projects, and scholarly pursuits. Puar argues that configurations of sexuality, race, gender, nation, class, and ethnicity are realigning in relation to contemporary forces of securitization, counterterrorism, and nationalism. She examines how liberal politics incorporate certain queer subjects into the fold of the nation-state, shifting queers from their construction as figures of death to subjects tied to ideas of life and productivity. This tenuous inclusion of some queer subjects depends, however, on the production of populations of Orientalized terrorist bodies. Heteronormative ideologies that the U.S. nation-state has long relied on are now accompanied by what Puar calls homonationalism—a fusing of homosexuality to U.S. pro-war, pro-imperialist agendas.

As a concept and tool of biopolitical management, homonationalism is here to stay. Puar’s incisive analyses of feminist and queer responses to the Abu Ghraib photographs, the decriminalization of sodomy in the wake of the Patriot Act, and the profiling of Sikh Americans and South Asian diasporic queers are not instances of a particular historical moment; rather, they are reflective of the dynamics saturating power, sexuality, race, and politics today.

This Tenth Anniversary Expanded Edition features a new foreword by Tavia Nyong’o and a postscript by Puar entitled “Homonationalism in Trump Times.” Nyong’o and Puar recontextualize the book in light of the current political moment while reposing its original questions to illuminate how Puar’s interventions are even more vital and necessary than ever.
Me and My House
Authors: Zaborowska Magdalena J.
Published: April 2018

The last sixteen years of James Baldwin's life (1971–87) unfolded in a village in the South of France, in a sprawling house nicknamed “Chez Baldwin.” In Me and My House Magdalena J. Zaborowska employs Baldwin’s home space as a lens through which to expand his biography and explore the politics and poetics of blackness, queerness, and domesticity in his complex and underappreciated later works. Zaborowska shows how the themes of dwelling and black queer male sexuality in The Welcome Table, Just above My Head, and If Beale Street Could Talk directly stem from Chez Baldwin's influence on the writer. The house was partially torn down in 2014. Accessible, heavily illustrated, and drawing on interviews with Baldwin's friends and lovers, unpublished letters, and manuscripts, Me and My House offers new insights into Baldwin's life, writing, and relationships, making it essential reading for all students, scholars, and fans of Baldwin.
Carbon Quantum Dots as Fluorescent Component in Peroxyoxalate Chemiluminescence for Hydrogen Peroxide Determination
Authors: Nakano Koji , Honda Takayuki , Yamasaki Kanako , Tanaka Yoshiki , Taniguchi Keiichi , Ishimatsu Ryoichi , Imato Toshihiko
Published: April 2018

Nitrogen-doped carbon quantum dots synthesized by one-pot, microwave-assisted pyrolysis of citric acid in the presence of a small number of N-doping precursors, 1,2-ethylenediamine, were found to be involved in the chemically initiated electron exchange luminescence enabling peroxyoxalate chemiluminescence assay of hydrogen peroxide in the concentration range of 10–1000 µM.
Préface: Populaire, paralittéraire et transferts culturels
Authors: Polycandrioti Ourania
Published: April 2018

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A politician and his books: the Venizelos library in Chania
Authors: Llewellyn-Smith Michael
Published: April 2018

Eleftherios Venizelos loved books. He collected them, read them, andannotated them. With few exceptions, the most important being his translation of Thucydides into modern Greek, he did not write them. Books were an important part of his life, and he continued until the end to buy them. His collection of books is of historical and psychological interest. After his death in 1936, the books were transferred from his apartment in Paris and his wife’s house in Athens to the Venizelos family house in Halepa, near Chania in Crete. After many vicissitudes, especially during the German occupation of Crete, they came to rest in Chania Municipal Library, where they remain today. This paper explores Venizelos’ reading habits and preferences through this collection, showing that he used books both for professional information, for pleasure, and to improve his knowledge of foreign languages, in particular English. He was familiar with the great authors from Homer to Shakespeare; with philosophy from Aristotle to Bergson; with poetry, fiction, but especially with political thought, history and literature. It is good that the collection remains in the hands in the Municipal Library in the city where Venizelos lived and worked.
Review of: Fabrice Brandli, Christophe Cave, Thomas Wynn et al. (éd.) OEUVRES COMPLÈTES DE VOLTAIRE, vol. 58. OEuvres de 1764, Oxford, Voltaire Foundation, 2016.
Authors: Sfoini Alexandra
Published: April 2018

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