bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuronal Calcium Sensor-1 Promotes Immature Heart Function and Hypertrophy by Enhancing Ca
2+
Signals
Authors: Nakamura Tomoe Y. , Jeromin Andreas , Mikoshiba Katsuhiko , Wakabayashi Shigeo
Published: July 2011

Rationale:

Neuronal calcium sensor-1 (NCS-1) regulates various neuronal functions. Although it is expressed in the heart, very little is known about its cardiac functions.

Objective:

This study aimed to identify the physiological and pathological roles of NCS-1 in the heart.

Methods and Results:

We characterized the cardiac functions of knockout mice (
Ncs1
−/−
) and identified NCS-1 as a novel regulator of cardiac Ca
2+
signaling, specifically in immature and hypertrophic hearts. NCS-1 was highly expressed in young hearts, and its deletion decreased survival and contractile function in young mice. Intracellular Ca
2+
levels and sarcoplasmic reticulum Ca
2+
content were significantly lower in
Ncs1
−/−
myocytes than in wild-type cells. This was due to reduced Ca
2+
/calmodulin-dependent protein kinase II (CaMKII) activity in
Ncs1
−/−
myocytes, which led to reduced sarcoplasmic reticulum Ca
2+
uptake and release. NCS-1 physically and functionally interacted with inositol 1,4,5-trisphosphate receptors (IP
3
Rs) in the heart. In addition, IP
3
R stimulation resulted in phosphorylation of CaMKII-δ, which was enhanced by NCS-1 overexpression. These results suggest that a functional link exists between NCS-1, IP
3
R function, and CaMKII activation that may affect global Ca
2+
signals in the immature heart. Furthermore, NCS-1 was upregulated in hypertrophic hearts, and hormone-induced hypertrophy was largely prevented in
Ncs1
−/−
hearts. Inhibitors of IP
3
Rs, CaMKII, and calcineurin all prevented NCS-1–induced hypertrophy, which suggests the involvement of these pathways.

Conclusions:

NCS-1 is an important regulator of immature heart function and hypertrophy, and it functions in part by promoting IP
3
R function, followed by CaMKII-dependent signal activation.
Intravenous Thrombolysis of Basilar Artery Occlusion
Authors: Sairanen Tiina , Strbian Daniel , Soinne Lauri , Silvennoinen Heli , Salonen Oili , Artto Ville , Koskela Ilkka , Häppölä Olli , Kaste Markku , Lindsberg Perttu J. ,   for the Helsinki Stroke Thrombolysis Registry (HSTR) Group
Published: July 2011

Background and Purpose—

Basilar artery occlusion has a high mortality rate (85% to 95%) if untreated. We describe a large single-center cohort treated mostly with intravenous alteplase and heparin.

Methods—

The cohort included 116 patients with angiography-verified basilar artery occlusion. We studied baseline characteristics, frequencies of recanalization and symptomatic intracranial hemorrhage, and 3-month outcome (modified Rankin Scale [mRS]).

Results—

Thirty patients (25.9%) had mRS 0 to 2, 42 patients (36.2%) had moderate outcome (mRS, 0–3), 26 patients (22.4%) required daily help (mRS, 4–5), and 48 patients (41.4%) died. Eighteen patients (15.7%) developed symptomatic intracranial hemorrhage. In patients with post-treatment angiogram available (n=91), 59 patients (64.8%) had a complete or partial recanalization. Radiological location of basilar artery occlusion was known in 55 of 91 instances, and recanalization was associated directly with clot location at the top-of-basilar (odds ratio, 4.8 [1.1–22];
P
=0.048). Independent outcome (mRS 0-2) was associated with lower age and National Institutes of Health Stroke Scale (NIHSS) score at baseline. Age, nil or minimal recanalization, and symptomatic intracranial hemorrhage were independently associated with fatal outcome. Sixteen of 71 patients (22.5%) who presented with coma eventually reached moderate outcome, and additional 8 patients (11.3%) progressed to mRS 4.

Conclusions—

Whereas recanalization after intravenous thrombolysis strongly predicts survival and moderate outcome, therapeutic techniques should concentrate on clot location. Although most adverse baseline variables, age, symptom severity, but also coma are beyond control, it should not preclude thrombolysis, which may permit independent survival.
Association Between
VEGF
Polymorphisms and Homocysteine Levels in Patients With Ischemic Stroke and Silent Brain Infarction
Authors: Kim Ok Joon , Hong Seung Ho , Oh Seung Hun , Kim Tae Gon , Min Kyung Tae , Oh Doyeun , Kim Nam Keun
Published: July 2011

Background and Purpose—

Vascular endothelial growth factor (VEGF) plays a role in atherosclerosis-related diseases such as cerebrovascular or cardiovascular diseases. However, the effect of
VEGF
-2578C>A, -1154G>A, -634G>C, and 936C>T polymorphisms on the susceptibility to stroke and silent brain infarction has not been reported.

Methods—

Using polymerase chain reaction-amplified DNA,
VEGF
polymorphisms were analyzed in 615 patients with ischemic stroke, 376 patients with silent brain infarction, and 494 control subjects.

Results—

The AA and CC+CA (
C
allele bearing) genotype frequencies of the -2578C>A polymorphism and the CT+TT (
T
allele-bearing) genotype frequency of the 936C>T polymorphism were significantly different between the stroke and control groups (false discovery rate-adjusted probability values of 0.016, 0.044, and 0.044, respectively). When stratified by the size of the occluded vessel, the
VEGF
polymorphisms were associated with patients with multiple small-artery occlusions. Several haplotypes of the
VEGF
polymorphisms were significantly different between the control and stroke groups. With respect to silent brain infarction, the difference in the frequency of the -634G>C polymorphism between the GC+CC (
C
allele-bearing) genotype and the controls was marginally significant (false discovery rate-adjusted probability value of 0.056). On the other hand, the -634G>C and 936C>T polymorphisms were associated with plasma homocysteine levels of patients with multiple or single small-artery occlusions, respectively.

Conclusions—

This study suggests that
VEGF
polymorphisms and haplotypes are possible genetic determinants for the risk of ischemic stroke, particularly in patients with multiple small-artery occlusions. However,
VEGF
polymorphisms had only a weak association with plasma homocysteine levels in the Korean population.
Programmed Death-1 Pathway Limits Central Nervous System Inflammation and Neurologic Deficits in Murine Experimental Stroke
Authors: Ren Xuefang , Akiyoshi Kozaburo , Vandenbark Arthur A. , Hurn Patricia D. , Offner Halina
Published: July 2011

Background and Purpose—

Evaluation of infarct volumes and infiltrating immune cell populations in mice after middle cerebral artery occlusion strongly implicates a mixture of both pathogenic and regulatory immune cell subsets that affect stroke outcome. Our goal was to evaluate the contribution of the well-described coinhibitory pathway, programmed death (PD)-1, to the development of middle cerebral artery occlusion.

Methods—

Infarct volumes, functional outcomes, and effects on infiltrating immune cell populations were compared in wild-type C57BL/6 versus PD-1-deficient mice after 60 minutes middle cerebral artery occlusion and 96 hours reperfusion.

Results—

The results clearly demonstrate a previously unrecognized activity of the PD-1 pathway to limit infarct volume, recruitment of inflammatory cells from the periphery, activation of macrophages and central nervous system microglia, and functional neurological deficits. These regulatory functions were associated with increased percentages of circulating PD-ligand-1 and PD-ligand-2 expressing CD19
+
B-cells in blood, the spleen, and central nervous system with the capacity to inhibit activation of inflammatory T-cells and central nervous system macrophages and microglial cells through upregulated PD-1.

Conclusions—

Our novel observations are the first to implicate PD-1 signaling as a major protective pathway for limiting central nervous system inflammation in middle cerebral artery occlusion. This inhibitory circuit would likely be pivotal in reducing stroke-associated Toll-like receptor-2- and Toll like receptor-4-mediated release of neurotoxic factors by activated central nervous system microglia.
Notch Activation Enhances the Microglia-Mediated Inflammatory Response Associated With Focal Cerebral Ischemia
Authors: Wei Zelan , Chigurupati Srinivasulu , Arumugam Thiruma V. , Jo Dong-Gyu , Li He , Chan Sic L.
Published: July 2011

Background and Purpose—

Activation of Notch worsens ischemic brain damage as antisense knockdown or pharmacological inhibition of the Notch pathway reduces the infarct size and improves the functional outcome in a mouse model of stroke. We sought to determine whether Notch activation contributes to postischemic inflammation by directly modulating the microglial innate response.

Methods—

The microglial response and the attendant inflammatory reaction were evaluated in Notch1 antisense transgenic (Tg) and in nontransgenic (non-Tg) mice subjected to middle cerebral artery occlusion with or without treatment with a γ-secretase inhibitor (GSI). To investigate the impact of Notch on microglial effector functions, primary mouse microglia and murine BV-2 microglial cell line were exposed to oxygen glucose deprivation or lipopolysaccharide in the presence or absence of GSI. Immunofluorescence labeling, Western blotting, and reverse-transcription polymerase chain reaction were performed to measure microglial activation and production of inflammatory cytokines. The nuclear translocation of nuclear factor-κB in microglia was assessed by immunohistochemistry. The neurotoxic potential of microglia was determined in cocultures.

Results—

Notch1 antisense mice exhibit significantly lower numbers of activated microglia and reduced proinflammatory cytokine expression in the ipsilateral ischemic cortices compared to non-Tg mice. Microglial activation also was attenuated in Notch1 antisense cultures and in non-Tg cultures treated with GSI. GSI significantly reduced nuclear factor-κB activation and expression of proinflammatory mediators and markedly attenuated the neurotoxic activity of microglia in cocultures.

Conclusions—

These findings establish a role for Notch signaling in modulating the microglia innate response and suggest that inhibition of Notch might represent a complementary therapeutic approach to prevent reactive gliosis in stroke and neuroinflammation-related degenerative disorders.
Synergistic Memory Impairment Through the Interaction of Chronic Cerebral Hypoperfusion and Amlyloid Toxicity in a Rat Model
Authors: Choi Bo-Ryoung , Lee Sang Rim , Han Jung-Soo , Woo Sang-Keun , Kim Kyeong Min , Choi Dong-Hee , Kwon Kyoung Ja , Han Seol-Heui , Shin Chan Young , Lee Jongmin , Chung Chin-Sang , Lee Seong-Ryong , Kim Hahn Young
Published: July 2011

Background and Purpose—

Vascular pathology and Alzheimer disease (AD) pathology have been shown to coexist in the brains of dementia patients. We investigated how cognitive impairment could be exacerbated in a rat model of combined injury through the interaction of chronic cerebral hypoperfusion and amyloid beta (Aβ) toxicity.

Methods—

In Wistar rats, chronic cerebral hypoperfusion was modeled by permanent occlusion of bilateral common carotid arteries (BCCAo). Further, AD pathology was modeled by bilateral intracerebroventricular Aβ (Aβ toxicity) using a nonphysiological Aβ peptide (Aβ 25 to 35). The experimental animals were divided into 4 groups, including sham, single injury (Aβ toxicity or BCCAo), and combined injury (BCCAo-Aβ toxicity) groups (n=7 per group) . Cerebral blood flow and metabolism were measured using small animal positron emission tomography. A Morris water maze task, novel object location and recognition tests, and histological investigation, including neuronal cell death, apoptosis, neuroinflammation, and AD-related pathology, were performed.

Results—

Spatial memory impairment was synergistically exacerbated in the BCCAo–Aβ toxicity group as compared to the BCCAo or Aβ toxicity groups (
P
<0.05). Compared to the sham group, neuroinflammation with microglial or astroglial activation was increased both in multiple white matter lesions and the hippocampus in other experimental groups. AD-related pathology was enhanced in the BCCAo–Aβ toxicity group compared to the Aβ toxicity group.

Conclusion—

Our experimental results support a clinical hypothesis of the deleterious interaction between chronic cerebral hypoperfusion and Aβ toxicity. Chronic cerebral hypoperfusion-induced perturbation in the equilibrium of AD-related pathology may exacerbate cognitive impairment in a rat model of combined injury.
An Investigation of the Initial Development of the Double-ITCZ Warm SST Biases in the CCSM
Authors: Liu Hailong , Zhang Minghua , Lin Wuyin
Published: July 2011

This paper investigates the initial development of the double ITCZ in the Community Climate System Model version 3 (CCSM3) in the central Pacific. Starting from a resting initial condition of the ocean in January, the model developed a warm bias of sea surface temperature (SST) in the central Pacific from 5°S to 10°S in the first three months. This initial bias is caused by excessive surface shortwave radiation that is also present in the stand-alone atmospheric model. The initial bias is further amplified by biases in both surface latent heat flux and horizontal heat transport in the upper ocean. These biases are caused by the responses of surface winds to SST bias and the thermocline structure to surface wind curls. This study also showed that the warming biases in surface solar radiation and latent heat fluxes are seasonally offset by cooling biases from reduced solar radiation after the austral summer due to cloud responses and in the austral fall due to enhanced evaporation when the maximum SST is closest to the equator. The warming biases from the dynamic heat transport by ocean currents however stay throughout all seasons once they are developed, which are eventually balanced by enhanced energy exchange and penetration of solar radiation below the mixed layer. It was also shown that the equatorial cold tongue develops after the warm biases in the south-central Pacific, and the overestimation of surface shortwave radiation recurs in the austral summer in each year. The results provide a case study on the physical processes leading to the development of the double ITCZ. Applicability of the results in other models is discussed.
Improved Seasonal Precipitation Forecasts for the Asian Monsoon Using 16 Atmosphere–Ocean Coupled Models. Part I: Climatology
Authors: Kumar Vinay , Krishnamurti T. N.
Published: July 2011

The goal of this study is to utilize several recent developments on rainfall data collection, downscaling of available climate models, training and forecasts from such models within the framework of a multimodel superensemble, and first a detailed examination of the seasonal climatology. The unique aspect of this study is that it became possible to use the forecast results from as many as 16 state-of-the-art coupled climate models. A downscaling component, with respect to observed rainfall estimates, uses a very dense Asian rain gauge network. This feature enables the forecasts of each model to be bias corrected to a common 25-km resolution. The downscaling statistics for each model, at each grid location, are developed during a training phase of the model forecasts. This is done wherever the observed rainfall estimates are available. In the “forecast phase,” the forecasts from all of the member models use the downscaling coefficients of the “training phase.” The downscaling and the extraction of the superensemble weights are done during the training phase. This makes use of the cross-validation principle. This means that the season to be forecasted is left out of the entire forecast dataset. Thus all of the statistics for downscaling and the superensemble construction are done separately for the forecasts of each season for all the years. The forecast phase is the season that is being forecast, where the aforementioned statistics are deployed for constructing the final downscaled superensemble.

These forecasts are next used for the construction of a multimodel superensemble. The geographical distributions of the downscaling coefficients provide a first look at the systematic errors of the member model forecasts. This combination of multimodels, the vast rain gauge dataset, the downscaling, and the superensemble provides a major improvement for the rainfall climatology and anomalies for the forecast phase. One of the main results of this paper is on the improvement of rainfall climatology of the member models. The downscaled multimodel superensemble shows a correlation of nearly 1.0 with respect to the observed climatology. This high skill is important for addressing the rainfall anomaly forecasts, which are defined in terms of departures from the observed (rather than a model based) climatology. This first part of the paper provides a description of the member models, the length of the training and forecast phases, the sensitivity of results as the numbers of forecast models are increased, and the skills of the downscaled climatology forecasts.
Global Warming, El Niño, and High-Impact Storms at Extreme Altitude: Historical Trends and Consequences for Mountaineers
Authors: Moore G. W. K. , Semple J. L. , Hoyland G.
Published: July 2011

The twentieth century was bracketed by two high-profile events on Mount Everest: the 1924 Mallory and Irvine disappearance and the 1996 Into Thin Air storm. During both events, fatalities occurred high on the mountain during deteriorating weather conditions. Although there have been dramatic improvements in knowledge of the mountain and in the technology used on it, it is shown that an unappreciated change that has also occurred, as a result of warming in the region, is an increase in barometric pressure. A rare and unique set of meteorological data collected at various elevations on the mountain during the 1924 British Everest expedition as well as modern datasets are used to compare and contrast conditions during the two storms and the two climbing seasons. It is shown that both storms were associated with weather systems known locally as western disturbances that resulted in summit barometric pressure drops sufficient to have exacerbated altitude-induced hypoxia. It is further shown that the Mallory and Irvine attempt occurred later in the season than typically is the case now and that this was most likely the result of a concurrent El Niño event. Despite the trend of increasing barometric pressure, the pressure drop associated with storms in the region should remain a concern for those who venture to extreme altitudes. The authors therefore argue that success and failure on Everest and other Himalayan peaks requires knowledge of the variability and trends in both the weather and climate.
An Equatorial Ocean Bottleneck in Global Climate Models
Authors: Karnauskas Kristopher B. , Johnson Gregory C. , Murtugudde Raghu
Published: July 2011

The Equatorial Undercurrent (EUC) is a major component of the tropical Pacific Ocean circulation. EUC velocity in most global climate models is sluggish relative to observations. Insufficient ocean resolution slows the EUC in the eastern Pacific where nonlinear terms should dominate the zonal momentum balance. A slow EUC in the east creates a bottleneck for the EUC to the west. However, this bottleneck does not impair other major components of the tropical circulation, including upwelling and poleward transport. In most models, upwelling velocity and poleward transport divergence fall within directly estimated uncertainties. Both of these transports play a critical role in a theory for how the tropical Pacific may change under increased radiative forcing, that is, the ocean dynamical thermostat mechanism. These findings suggest that, in the mean, global climate models may not underrepresent the role of equatorial ocean circulation, nor perhaps bias the balance between competing mechanisms for how the tropical Pacific might change in the future. Implications for model improvement under higher resolution are also discussed.
Impact of Shelf–Basin Freshwater Transport on Deep Convection in the Western Labrador Sea
Authors: McGeehan Timothy , Maslowski Wieslaw
Published: July 2011

Freshwater exiting the Arctic Ocean through the Canadian Arctic Archipelago (CAA) has been shown to affect meridional overturning circulation and thereby the global climate system. However, because of constraints of spatial resolution in most global ocean models, neither the flow of low salinity water through the CAA to the Labrador Sea nor the eddy activity that may transport freshwater from the shelf to areas of open ocean convection can be directly simulated. To address these issues, this study uses a high-resolution ice–ocean model of the pan-Arctic region with a realistic CAA and forced with realistic atmospheric data. This model resolves conditions in the Arctic Ocean upstream of the Labrador Sea and is coupled to a thermodynamic–dynamic sea ice model that responds to the atmospheric forcing. The major shelf–basin exchange of liquid freshwater occurs south of Hamilton Bank, whereas the largest ice flux occurs in the northwest of the basin. Freshwater flux anomalies entering the Labrador Sea through Davis Strait do not immediately affect deep convection. Instead, eddies acting on shorter time scales can move freshwater to locations of active convection and halt the process. Convection is modulated by the position of the ice edge, highlighting the critical need for a coupled ice–ocean model. Finally, the size of eddies and the short duration of events demonstrate the need for high resolution, both spatial and temporal.
Governing Immigrant City
Authors: Siemiatycki Myer
Published: July 2011

This article explores the paradoxes of Toronto’s experience of immigrant and minority political incorporation. The city once synonymous with ethnic homogeneity is now among the world’s most multicultural urban centers. The city, which proclaims “Diversity Our Strength” as its official motto, has a poor record of electing immigrants and minorities to public office. And the city, whose municipal council is overwhelmingly composed of White, European-origin politicians, has an exemplary record of promoting inclusion, equity, antiracism, and human rights in its policies and programs. The article analyzes these ambiguities of governing immigrant city Toronto.
Evaluation of Eye Metrics as a Detector of Fatigue
Authors: McKinley R. Andy , McIntire Lindsey K. , Schmidt Regina , Repperger Daniel W. , Caldwell John A.
Published: July 2011

Objectives: This study evaluated oculometrics as a detector of fatigue in Air Force–relevant tasks after sleep deprivation. Using the metrics of total eye closure duration (PERCLOS) and approximate entropy (ApEn), the relation between these eye metrics and fatigue-induced performance decrements was investigated.

Background: One damaging effect to the successful outcome of operational military missions is that attributed to sleep deprivation-induced fatigue. Consequently, there is interest in the development of reliable monitoring devices that can assess when an operator is overly fatigued.

Method: Ten civilian participants volunteered to serve in this study. Each was trained on three performance tasks: target identification, unmanned aerial vehicle landing, and the psychomotor vigilance task (PVT). Experimental testing began after 14 hr awake and continued every 2 hr until 28 hr of sleep deprivation was reached.

Results: Performance on the PVT and target identification tasks declined significantly as the level of sleep deprivation increased. These performance declines were paralleled more closely by changes in the ApEn compared to the PERCLOS measure.

Conclusion: The results provide evidence that the ApEn eye metric can be used to detect fatigue in relevant military aviation tasks.

Application: Military and commercial operators could benefit from an alertness monitoring device.
A Longitudinal Study of Kindergarten Children At Risk for Reading Disabilities
Authors: McNamara John K. , Scissons Mary , Gutknecth Naomi
Published: July 2011

Over the past decade, educators and researchers concerned about children with reading disabilities have called for widespread adoption of early identification tools and early effective programming. This call may be the result of, in part, what Stanovich calls “Matthew effects in reading.” That is, when stakeholders delay identification and support for young children struggling to read, the variance of individual differences in reading will inevitably increase, creating a widening of the gap between strong and struggling readers. In this longitudinal study, reading achievement data from 382 children were collected as they progressed from kindergarten through Grade 3. In kindergarten, children were screened with a battery of phonological awareness measures. Percentile rank scores were collected, and children were identified as having poor, average, or strong phonological awareness. As children moved through Grades 1, 2, and 3, reading-based data were collected in the spring of each year. Results indicated that, in general, as children progressed from kindergarten to Grade 3, those in lower ranks of reading achievement were likely to remain in the lower ranks, and furthermore, at each progressing data collection point struggling readers fell further behind their grade-level reading peers. In other words, as each year passed the variance between strong and struggling readers increased significantly. The authors hypothesized that this finding is consistent with the “Matthew effect”—the rich were getting richer while the poor were getting poorer.
Manipulator and object tracking for in-hand 3D object modeling
Authors: Krainin Michael , Henry Peter , Ren Xiaofeng , Fox Dieter
Published: July 2011

Recognizing and manipulating objects is an important task for mobile robots performing useful services in everyday environments. While existing techniques for object recognition related to manipulation provide very good results even for noisy and incomplete data, they are typically trained using data generated in an offline process. As a result, they do not enable a robot to acquire new object models as it operates in an environment. In this paper we develop an approach to building 3D models of unknown objects based on a depth camera observing the robot’s hand while moving an object. The approach integrates both shape and appearance information into an articulated Iterative Closest Point approach to track the robot’s manipulator and the object. Objects are modeled by sets of surfels, which are small patches providing occlusion and appearance information. Experiments show that our approach provides very good 3D models even when the object is highly symmetric and lacks visual features and the manipulator motion is noisy. Autonomous object modeling represents a step toward improved semantic understanding, which will eventually enable robots to reason about their environments in terms of objects and their relations rather than through raw sensor data.
In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff
Authors: Bey Michael J. , Peltz Cathryn D. , Ciarelli Kristin , Kline Stephanie K. , Divine George W. , van Holsbeeck Marnix , Muh Stephanie , Kolowich Patricia A. , Lock Terrence R. , Moutzouros Vasilios
Published: July 2011

Background: Surgical repair of a torn rotator cuff is based on the belief that repairing the tear is necessary to restore normal glenohumeral joint (GHJ) mechanics and achieve a satisfactory clinical outcome.

Hypothesis: Dynamic joint function is not completely restored by rotator cuff repair, thus compromising shoulder function and potentially leading to long-term disability.

Study Design: Controlled laboratory study and Case series; Level of evidence, 4.

Methods: Twenty-one rotator cuff patients and 35 control participants enrolled in the study. Biplane radiographic images were acquired bilaterally from each patient during coronal-plane abduction. Rotator cuff patients were tested at 3, 12, and 24 months after repair of a supraspinatus tendon tear. Control participants were tested once. Glenohumeral joint kinematics and joint contact patterns were accurately determined from the biplane radiographic images. Isometric shoulder strength and patient-reported outcomes were measured at each time point. Ultrasound imaging assessed rotator cuff integrity at 24 months after surgery.

Results: Twenty of 21 rotator cuff repairs appeared intact at 24 months after surgery. The humerus of the patients’ repaired shoulder was positioned more superiorly on the glenoid than both the patients’ contralateral shoulder and the dominant shoulder of control participants. Patient-reported outcomes improved significantly over time. Shoulder strength also increased over time, although strength deficits persisted at 24 months for most patients. Changes over time in GHJ mechanics were not detected for either the rotator cuff patients’ repaired or contralateral shoulders. Clinical outcome was associated with shoulder strength but not GHJ mechanics.

Conclusion: Surgical repair of an isolated supraspinatus tear may be sufficient to keep the torn rotator cuff intact and achieve satisfactory patient-reported outcomes, but GHJ mechanics and shoulder strength are not fully restored with current repair techniques.

Clinical Relevance: The study suggests that current surgical repair techniques may be effective for reducing pain but have not yet been optimized for restoring long-term shoulder function.
Results of Arthroscopic Repair of Type II Superior Labral Anterior Posterior Lesions in Overhead Athletes
Authors: Neuman Brian J. , Boisvert C. Brittany , Reiter Brian , Lawson Kevin , Ciccotti Michael G. , Cohen Steven B.
Published: July 2011

Background: The majority of the literature on surgical outcomes of superior labral anterior posterior (SLAP) repairs has focused on short-term follow-up of 1 to 2 years, not allowing adequate time for full rehabilitation and return to maximum level of competition for all types of athletes. Also, previous studies have concentrated on using questionnaires that primarily evaluate patients’ activities of daily living, which do not focus on sport-specific performance.

Purpose: To determine the midterm results of type II SLAP repairs in overhead athletes, focusing primarily on athletic performance as well as activities of daily living.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective review of 30 overhead athletes, who underwent an arthroscopic superior labral repair for a symptomatic type II SLAP tear between 2002 and 2007, was performed. Our study population included 22 male and 8 female patients with a mean age at the time of surgery of 24 years. Twenty-one patients participated in baseball or softball, and the remainder of patients were involved in javelin throwing or tennis. The average follow-up was 3.5 years. The outcome of treatment was evaluated using the American Shoulder and Elbow Society (ASES) scoring system, assessing activities of daily living, and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) score, assessing sport-specific performance. In addition, the length of time to return to sport and the degree of successful performance were evaluated.

Results: Repairs resulted in ASES scores comparable with those from prior published studies (average ASES score, 87.9). The KJOC score averaged 73.6. The athletes’ perception was that they returned to approximately 84.1% of their preinjury level of function with a mean time to return to play of 11.7 months. There was a significant drop in the ASES to KJOC score for the baseball/softball players (87.9 ± 14.94 and 72 ± 19.24, respectively; P = .006). Patients reported an overall satisfaction rate of 93.3% with the procedure, with the majority being very satisfied.

Conclusion: Arthroscopic SLAP repairs show excellent results and a high rate of overall satisfaction; however, the outcomes are less reliable in throwers. The KJOC score provides a more stringent assessment of overhead athletes’ function after SLAP repair than the ASES score. Our findings also indicate that SLAP repairs lead to improved shoulder function during routine daily activities but that consistent return to elite throwing sports may still remain somewhat problematic.
Prevalence of Jumper’s Knee Among Nonelite Athletes From Different Sports
Authors: Zwerver Johannes , Bredeweg Steven W. , van den Akker-Scheek Inge
Published: July 2011

Background: The prevalence of jumper’s knee among nonelite athletes from different sports is unknown.

Purpose: This study was undertaken to determine the prevalence of jumper’s knee in nonelite athletes from different sports and to determine potential risk factors for jumper’s knee.

Design: Cohort study (prevalence); Level of evidence, 2.

Methods: The authors interviewed 891 male and female nonelite athletes from 7 popular sports in The Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey, and track and field. Using a specially developed questionnaire, information was obtained about individual characteristics (age, height, and weight), training background, previous and actual knee problems, and the VISA-P (Victorian Institute of Sport Assessment–Patella) score.

Results: The overall prevalence of current jumper’s knee was 8.5% (78 of 891 athletes), showing a significant difference between sports with different loading characteristics. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 of 502 [10.2%]) than female athletes (25 of 389 [6.4%]) (χ2 = 3.91, P = .048). The mean duration of symptoms was 18.9 months (standard deviation [SD], 21.6; median value, 12.0; range, 2.0-59.8). The mean VISA-P score of the athletes with jumper’s knee was 71.4 (SD, 13.8). Athletes with jumper’s knee were significantly younger, taller, and heavier than those without jumper’s knee.

Conclusion: Prevalence of jumper’s knee is high among nonelite athletes and varies between 14.4% and 2.5% for different sports. Jumper’s knee is almost twice as common among male nonelite athletes compared with female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, a younger age, a taller body stature, and higher body weight seem to be risk factors associated with patellar tendinopathy.
When Do Rotator Cuff Repairs Fail? Serial Ultrasound Examination After Arthroscopic Repair of Large and Massive Rotator Cuff Tears
Authors: Miller Bruce S. , Downie Brian K. , Kohen Robert B. , Kijek Theresa , Lesniak Bryson , Jacobson Jon A. , Hughes Richard E. , Carpenter James E.
Published: July 2011

Background: Despite advances in arthroscopic repair of rotator cuff tears, recurrent tears after repair of large and massive tears remain a significant clinical problem. The primary objective of this study was to define the timing of structural failure of surgically repaired large and massive rotator cuff tears by serial imaging with ultrasound. The secondary objective of this study was to investigate the association between recurrent tears and clinical outcome after rotator cuff repair.

Hypothesis: Recurrent tear after arthroscopic repair of large rotator cuff tears is more likely to occur late (>3 months) in the postoperative period and will be associated with inferior clinical outcome scores.

Study Design: Cohort study; Level of evidence, 3.

Methods: Twenty-two consecutive patients with large (>3 cm) rotator cuff tears underwent arthroscopic repair with a standardized technique. Serial ultrasound examinations were performed at 2 days, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. Western Ontario Rotator Cuff (WORC) Index scores were also collected at these time points.

Results: Nine (41%) of the 22 arthroscopically repaired rotator cuff tears demonstrated recurrent tears. Seven of the 9 retears occurred within 3 months of surgery, and the other 2 occurred between 3 and 6 months. No retears occurred after 6 months. At 24-month follow-up, WORC scores favoring intact rotator cuffs over retears approached statistical significance (mean WORC intact 123.9 vs retear 659.8; P = .07).

Conclusion: Recurrent rotator cuff tears are not uncommon after arthroscopic repair of large and massive tears. These recurrent tears appear to occur more frequently in the early postoperative period (within the first 3 months) and are associated with inferior clinical outcomes.
Prospective Correlation Between Serum Relaxin Concentration and Anterior Cruciate Ligament Tears Among Elite Collegiate Female Athletes
Authors: Dragoo Jason L. , Castillo Tiffany N. , Braun Hillary J. , Ridley Bethany A. , Kennedy Ashleigh C. , Golish S. Raymond
Published: July 2011

Background: The female anterior cruciate ligament may be more susceptible to injury than the male anterior cruciate ligament because of the gender-specific expression of receptors for relaxin, a collagenolytic hormone that promotes remodeling of the anterior cruciate ligament.

Purpose: This study was undertaken to investigate whether collegiate female athletes with elevated serum relaxin concentrations (SRC) sustain anterior cruciate ligament tears at an increased rate compared with those with lower SRC.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Methods: From 2005 to 2010, 143 Division I female athletes from 2 universities participating in sports at high risk for anterior cruciate ligament tears (basketball, lacrosse, field hockey, soccer, gymnastics, and volleyball) were recruited to participate. Questionnaires and urine luteinizing hormone (LH) tests were used to determine participants’ anterior cruciate ligament injury and menstrual history and to identify their mid-luteal phase or projected cycle days 21 to 24. Serum samples were obtained for progesterone and relaxin ELISA (enzyme-linked immunosorbent assay) analysis. Participants were monitored for anterior cruciate ligament injury over their 4-year National Collegiate Athletic Association athletic career.

Results: A total of 128 participants completed the study and were eligible for data analysis. The cumulative incidence of complete anterior cruciate ligament tear over the 4-year study period was 21.9%, and varied significantly by sport ( P < .001). The mean SRC for athletes with anterior cruciate ligament tears (6.0 ± 8.1 pg/mL) was significantly higher than that for those without anterior cruciate ligament tears (1.8 ± 3.4 pg/mL; P = .013). In subgroup analysis of the 46 athletes who had detectable SRC, the cumulative incidence of anterior cruciate ligament tear was 14 of 46 (30.4%); the mean SRC among athletes with anterior cruciate ligament tears (14 of 46) was 12.1 ± 7.7 pg/mL and without anterior cruciate ligament tears (32 of 46), 5.7 ± 3.6 pg/mL ( P = .002). When 6.0 pg/mL was set as the SRC cutoff for screening athletes for risk of anterior cruciate ligament tear in the subgroup with detectable relaxin levels, the test had 71% sensitivity, 69% specificity, 52% positive predictive value, 88% negative predictive value, and a relative risk of 4.4. These values were significant by χ2 test ( P = .003) and receiver operating characteristic analysis ( P = .002).

Conclusion: Elite female athletes with anterior cruciate ligament tears have higher SRC than those without tears. Those with an SRC greater than 6.0 pg/mL had over 4 times increased risk for a tear.

Clinical Relevance: Females with higher serum relaxin levels may be at increased risk for anterior cruciate ligament tears. Further investigation of the clinical utility of SRC testing is warranted.
Territorial Threat, Mobilization, and Political Participation in Africa
Authors: Hutchison Marc L.
Published: July 2011

The link between territorial issues and incidents of militarized conflict is one of the most consistent patterns found in the empirical study of international relations. Consequently, disputes over territory are generally perceived to be more salient to state decision-makers than other types of issues. Given this relative issue salience, state elites are thought to be more likely to engage in domestic mobilization efforts when territory is externally threatened. The political participation literature observes wide cross-national differences in participatory behavior and contends that the level and timing of participation is partially a function of elite-led strategic mobilization. I propose that these phenomena are connected and that territorial threats are associated with overall patterns in non-voting political participation across countries. I assess this relationship with cross-national, multilevel models using 27 Afrobarometer surveys collected in 16 different countries from 1999 to 2003. As expected, if salient external threats are triggering domestic mobilization efforts, I find that territorial threats are positively associated with most forms of non-voting political participation. However, I also observe lower levels of protest behavior in states that recently experienced a territorial threat—a finding that corresponds with previous research linking salient external threats to increased societal cohesion.
They Say It’s in the Genes: Decoding Racial Ideology in Genomics
Authors: Williams Johnny E.
Published: July 2011

Science is delving into genetics more deeply and thoroughly than ever before, and in the process, scientists are uncovering new layers of “truth” about the essence of humanity and human disease. But in a social world colored by inequalities and value judgments that place some members of humanity above others, to what degree is genome science codifying ideology in our very genes? Thirty secondary interviews with genome researchers from various subfields are analyzed to determine the extent to which the ideology of “race” enters their discourse on genome variation. Findings suggest that unexamined and unrecognized racial thinking is an integral part of genetic researchers’ interpretations and understandings of genetic variation.
Leading curriculum innovation in primary schools
Authors: Brundrett Mark , Duncan Diane
Published: July 2011

This article reports on a study of 40 primary school leaders from ten very successful primary schools who were interviewed in order to find out the skills, processes and practices that are required for the leadership of successful curriculum innovation in primary schools. Findings suggest that school leaders need to create an ‘ethos for change’ if successful innovation is to take place. A new four-stage model of curriculum innovation is offered.
Just four little grades: 1, 2, 3 or 4?
Authors: Page Lorna
Published: July 2011

Teacher observation takes on a myriad of forms and serves a multitude of purposes. Within UK further education (FE) colleges, lesson observations play a vital role in monitoring a college’s provision for the purpose of its annual self-assessment report; this in turn lays the foundations for its overarching quality improvement strategies. This short ‘thought piece’ identifies some of the current problems with the system of observing and grading teachers within UK FE colleges as viewed by a lecturer in teacher education for in-service teacher training programmes. Problems include observation validity, grading consistencies and teacher anxieties. It poses questions of observation reporting and whether what is seen by observers is a true reflection of a teacher’s practice. Furthermore, it considers some of the wider unseen consequences and implications that being observed can create. It concludes with the notion that more research needs undertaking if teachers and observers are to fully appreciate, celebrate and learn from observations.
In the ‘best interest’ of the student: perceptions and implications for leadership practices in secondary schools in Kenya
Authors: Ouma Jwan Julius
Published: July 2011

This paper discusses the contrasting views of what constitutes the ‘best interests’ of students and the implications of such perceptions for leadership practices in secondary schools in Kenya. The paper is based on a study conducted to establish the students’, teachers’ and principals’ perceptions of democratic school leadership — in line with the current policy requirement of the Kenyan government that students be involved in decision-making on some of the issues in school that directly affect them. The study was in two phases. The first phase included interviews with twelve school principals to explore their perspectives on democratic school leadership and provide a rationale for selecting the two case schools. The second phase was a case study of two schools. The findings suggest that the leadership practices perceived by most principals and teachers to be in the ‘best interests’ of students were contentious and in direct contrast to what the students considered to be in their best interests.
Patterns in the Lives of African American Women with Diabetes
Authors: Pierre-Louis Berline , Akoh Vivian , White Pandora , Pharris Margaret Dexheimer
Published: July 2011

The experience of African American women with diabetes has not been fully understood to guide meaningful practice. This community-based collaborative action research, based on Newman’s nursing theory of health as expanding consciousness, sought to understand the experience of African American women living with diabetes, and to envision new patterns of health by engaging women in dialogue about the meaning of their experiences. Interviews with 7 women revealed the multi-faceted nature of living with diabetes; blood sugars rise and fall with stress, depression, and trauma, as well as spiritual strength, mentors, and sister friends balance energy demands. Findings were woven into a spoken word narrative to engage the wider community in dialogue to gain new insights into how to live and relate in healthier ways. These findings give rise to a different model of community health and guide nurses to focus holistically on what is meaningful in the lives of their patients.
Human Dignity
Authors: Condon Barbara Backer , Hegge Margaret
Published: July 2011

Human dignity is foundational to nursing ethics in both the practice and educational arena. It is implicitly and explicitly woven throughout all ethical dialogue. This column offers insight into the ubiquitous nature of human dignity as it surfaced during a doctoral level ethics course. These examples are shared in light of the humanbecoming human dignity ethical tenets: reverence, awe, betrayal, and shame. The prevalence of dignity in ethical discussion serves as a reminder for nurses to carve out time for meaningful discussions regarding its importance to the nursing profession as a whole.
Health as Expanding Consciousness
Authors: Brown Janet Witucki
Published: July 2011

Margaret Newman’s theory of health as expanding consciousness provides an excellent nursing perspective for nursing grounded theory research studies. Application of this nursing theory to grounded theory research provides a unitary-transformative paradigm perspective to the sociological underpinnings of grounded theory methodology. The fit between this particular nursing theory and grounded theory methodology is apparent when purpose, timing, process, and health outcomes of the two are compared. In this column, the theory of health as expanding consciousness is described and the theory’s research as praxis methodology is compared to grounded theory methodology. This is followed by a description of how the theory of health as expanding consciousness can be utilized as a perspective for nursing grounded theory research.
Rigor
Authors: Florczak Kristine L.
Published: July 2011

The purpose of this column is to bring to light a lack of rigor in the design of randomized controlled trials. In this effort, basic tenets of quantitative design are considered including delineation of populations along with probability and non-probability sampling techniques in addition to defining random selection and random assignment. The idea that randomized controlled trials, considered the pièce de résistance of the evidence-based practice movement, lack rigor because of their use of randomly assigned groups without random selection of subjects is presented.