bluuebunny/crossref_metadata_2025 huggingface dataset:
Intermedin/adrenomedullin-2 is a hypoxia-induced endothelial peptide that stabilizes pulmonary microvascular permeability
Authors: Pfeil Uwe , Aslam Muhammad , Paddenberg Renate , Quanz Karin , Chang Chia L. , Park Jae-Il , Gries Barbara , Rafiq Amir , Faulhammer Petra , Goldenberg Anna , Papadakis Tamara , Noll Thomas , Hsu Sheau Y. T. , Weissmann Norbert , Kummer Wolfgang
Published: August 2009

Accumulating evidence suggests a pivotal role of the calcitonin receptor-like receptor (CRLR) signaling pathway in preventing damage of the lung by stabilizing pulmonary barrier function. Intermedin (IMD), also termed adrenomedullin-2, is the most recently identified peptide targeting this receptor. Here we investigated the effect of hypoxia on the expression of IMD in the murine lung and cultured murine pulmonary microvascular endothelial cells (PMEC) as well as the role of IMD in regulating vascular permeability. Monoclonal IMD antibodies were generated, and transcript levels were assayed by quantitative RT-PCR. The promoter region of IMD gene was analyzed, and the effect of hypoxia-inducible factor (HIF)-1α on IMD expression was investigated in HEK293T cells. Isolated murine lungs and a human lung microvascular endothelial cell monolayer model were used to study the effect of IMD on vascular permeability. IMD was identified as a pulmonary endothelial peptide by immunohistochemistry and RT-PCR. Hypoxia caused an upregulation of IMD mRNA in the murine lung and PMEC. As shown by these results, HIF-1α enhances IMD promoter activity. Our functional studies showed that IMD abolished the increase in pressure-induced endothelial permeability. Moreover, IMD decreased basal and thrombin-induced hyperpermeability of an endothelial cell monolayer in a receptor-dependent manner and activated PKA in these cells. In conclusion, IMD is a novel hypoxia-induced gene and a potential interventional agent for the improvement of endothelial barrier function in systemic inflammatory responses and hypoxia-induced vascular leakage.
Diminished Benefits of Drug-Eluting Stents versus Bare Metal Stents in Patients with Severe Renal Insufficiency
Authors: Rosenblum Michael A. , Robbins Michael J. , Farkouh Michael E. , Winston Jonathan A. , Kim Michael C.
Published: August 2009

Background: Since their introduction, the use of drug-eluting stents (DES) has increasingly become standard practice due to their decreased rates of in-stent restenosis and target lesion revascularization (TLR) rates in comparison to bare metal stents (BMS). However, these benefits have not been reproduced in patients with severe renal disease (SRD). This study compared TLR rates in patients with severe renal insufficiency treated with DES vs. BMS. Methods: Between 2003 and 2006, we collected data on 6,220 consecutive patients receiving either DES or BMS. Both groups were similar in angiographic and clinical variables. TLR rates at 270 days and 1 year were then compared between patients receiving DES or BMS with varying creatinine clearance (CrCl). Results: At 1 year after PCI, TLR rates were significantly lower for DES in patients with CrCl >60 (5 vs. 9.3%; p < 0.0001). However, in patients with CrCl <40 ml/min or on dialysis there was no significant difference in TLR rates for DES vs. BMS. Conclusion: While DES showed improved clinical outcomes in patients with normal and mildly impaired renal function, they showed no benefit over BMS in patients with moderate to severe renal insufficiency. Coupled with the possibly increased risk of late stent thrombosis with DES, BMS may be a more appropriate and safer stent in this population.
Incidence of Organic Dust Toxic Syndrome and Allergic Alveolitis in Swedish Farmers
Authors: Malmberg Per , Rask-Andersen Anna , Höglund Sverker , Kolmodin-Hedman Birgitta , Guernsey Judith Read
Published: August 2009

The incidence of allergic alveolitis (AA) and of febrile reactions (FR) to inhaled mold dust in those who did not meet the criteria of AA was investigated in Swedish farmers, and the findings were related to farming methods and exposure type. A questionnaire was completed by 6,702 farmers. A stratified sample of 390 farmers underwent examination comprising spirometry, a skin-prick test, blood tests for precipitating antibodies and total IgE and an interview concerning symptoms, exposure and farming methods. The yearly incidence of AA was 2–3/10,000 farmers. The incidence of FR was 30–50 times higher (1/100 farmers) and the majority of these reactions was of a toxic rather than allergic type (organic dust toxic syndrome). Among farmers with recent FR or AA there was a higher frequency of positive precipitin reactions (p < 0.05). Exposures to moldy grain, straw, wood chips and hay were associated with both AA and FR. A major difference in exposure between 17 farmers with AA and 80 with FR was that AA appeared to require repeated exposure, while FR was associated with occasional heavy exposure to mold dust.
The Influence of Structured Information and Monitoring on the Outcome of Asthma Treatment in Primary Care: A Cluster Randomized Study
Authors: Nokela Mika , Heibert Arnlind Marianne , Ehrs Per-Olof , Krakau Ingvar , Forslund Lennart , Wikström Jonsson Eva
Published: August 2009

Background: In clinical trials of asthma, the outcomes are often good, but when the same treatment regimens are implemented in primary care, equally good results are not obtained. Objective: To investigate if addition of structured patient information and monitoring by an asthma diary in primary care improves asthma control. Methods: 141 patients from 19 primary care centres were studied. The centres were randomised to a standard care group or to an intervention group. The intervention group received structured written and oral information about asthma and asthma medication, and were instructed to keep an asthma diary. The primary outcome was asthma control as assessed by the Asthma Control Questionnaire. Secondary outcomes were costs of asthma medication, the Mini Asthma Quality of Life Questionnaire score and lung function. Results: Asthma Control Questionnaire score changes differed between the study groups (p < 0.05). In the intervention group, these changes (M = –0.45) in asthma control were close to clinical significance (minimal important difference ≈0.5). Both groups improved in disease-specific quality of life scores. For the intervention group, which changed the most (p < 0.05), the change exceeded the threshold for the minimal important difference (0.5). The costs of medications increased significantly in the intervention group, where adjustments of medication were made more often than in controls. Conclusion: Disease-specific quality of life of asthma patients could be improved by adding structured information and monitoring by diary to standard care.
Understanding Parole Officers’ Responses to Sanctioning Reform
Authors: Steiner Benjamin , Travis Lawrence F. , Makarios Matthew D.
Published: August 2009

There are constant calls for reform in the criminal justice system, but observers have often reported that criminal justice reform is an exceptionally challenging task. As with any organizational change, resistance to new policies, procedures, and practices comes from a variety of sources. The relatively broad discretionary authority vested in line-level personnel often contributes to the difficulty associated with implementing change in criminal justice agencies. There is ample evidence that line staff resistance to organizational reform can undermine the implementation of organizational change. In this study, the authors examine the effects of the state of Ohio’s transition to graduated sanctioning guidelines on parole officers—in particular, how these reforms were perceived by the key actors in the sanctioning process: parole officers. Findings from a statewide survey revealed that officers were generally dissatisfied with the restrictions on their discretion resulting from the reform. Analyses revealed that organizational factors such as officers’ perceptions concerning how the sanctioning policy was implemented and its intended purposes were more influential than individual characteristics in shaping officers’ views concerning the efficacy of the reform.
Water Shedding Angle: A New Technique to Evaluate the Water-Repellent Properties of Superhydrophobic Surfaces
Authors: Zimmermann Jan , Seeger Stefan , Reifler Felix A.
Published: August 2009

A new technique is introduced to evaluate the wetting properties of superhydrophobic textiles which are not accessible by classical contact angle measurement techniques. The principle behind the new water shedding angle technique is the ability of a superhydrophobic surface to repel drops of water upon impact. In this sense it shows a strong reference to application and its results are easily understood in terms of water protection. The procedure is simple and straightforward and the experimental setup can be easily built or adapted to most available contact angle measurement systems. In view of the significant potential of superhydrophobic coatings for textile applications, the water shedding angle provides a reliable and comparable measure to judge the quality of a superhydrophobic textile in terms of water repellency. It constitutes a useful addition to existing techniques and has proven to be better suited to evaluate the wetting properties of superhydrophobic textiles than the contemporary methods presently in use.
A Method for the Continuous Measurement of Combing Noil and Its Application in Wool Topmaking
Authors: Atkinson Ken , Stannard Warren , Bagshaw Kevin
Published: August 2009

Noil is waste fiber generated during combing of staple fiber, the level of which is generally a concern due to the associated economic loss. Strategies to reduce noil have not developed because there has not been a reliable, comprehensive, and accurate method of measurement in a combing plant. We describe here a new method for the continuous, automatic monitoring of the total noil without any interference with operator procedures or production. The noil monitoring system was installed on eight combs in a commercial topmaking plant and tested for 24 hours a day for six months. The data obtained from this trial revealed important performance details of the combing operation, such as noil level and noil production, linear density of the prepared and combed slivers, the number of slivers in the feed, production rate of each comb, the feed rate to each comb, machine operating speed, run-time and down-time for each comb, and comb process efficiencies. The data confirmed that this system could be used as a tool for improving management and control of combing.
Multiaxis Three-Dimensional Flat Woven Preforms - Tube Carrier Weaving
Authors: Bilisik Kadir , Mohamed Mansour H.
Published: August 2009

A multiaxis three-dimensional (3D) flat woven preform and a weaving method have been developed. The structure has five yarn sets, which are bias(+) and bias(—), warp, filling and Z-yarns. The weaving method has been introduced to form the structure. An experimental prototype was constructed to trial the method. In this technique, called “tube-carrier weaving”, bias(+) and bias(—) yarns are closely laid all over the surface. The preliminary study shows that the structure and weaving method seem feasible under the test conditions.
Fiber Fly Generation of 100% Acrylic Yarns during Weaving
Authors: Yuksekkaya Mehmet E.
Published: August 2009

At textile mills, the fiber fly generation is a big concern almost at every stages of the production including knitting and weaving operations. Therefore, it is not a surprise that the fiber fly generation is still getting the attention of many workers for decades for either production efficiencies or for health reasons. In this study, the fiber fly generation during the blanket weaving has been studied. Among all of fiber properties, the fiber mean length has the greatest effects on the amount of the fiber fly generated during the weaving processes. Additionally, loom speed and package conicity have also a significant effect on the fiber fly generations during the weaving of blanket fabrics. It was found that the open end yarns with high twist coefficients were generating the minimum amount of the fiber fly during the weaving while the woolen yarns were giving the higher fiber fly generation during the blanket weaving processes.
Identifying Evidence-Based Interventions for Children and Adolescents Using the Range of Possible Changes Model
Authors: De Los Reyes Andres , Kazdin Alan E.
Published: August 2009

The article discusses a study involving a framework (range of possible changes [RPC] Model) developed and applied to identify patterns in consistent and inconsistent intervention outcomes effects by informant, measurement method, and method of statistical analysis to the meta-analytic study of trials testing two evidence-based interventions for children and adolescents (youth-focused cognitive-behavioral treatment for child anxiety problems; parent-focused behavioral parent training for childhood conduct problems). This article illustrates how findings gleaned from applying the RPC Model allow for unique opportunities for hypothesis generation based on the patterns of consistent outcomes effects. Based on the RPC Model, studies can be closely examined to identify the specific instances in which interventions yield robust effects, and the authors illustrate how examining effects in this way can lead to new understandings of interventions and the outcomes they produce. Findings suggest that researchers can employ previously underutilized patterns of consistencies and inconsistencies in outcomes effects as new resources for identifying evidence-based interventions.
Exploring the Role of Filipino Fathers: Paternal Behaviors and Child Outcomes
Authors: Harper Scott E.
Published: August 2009

Using data collected from an urban Southern Visayan province during the Summer of 2006, this study examines a sample of 133 Filipino fathers to consider potential relationships between father behaviors and child outcomes. Increased paternal psychological control predicts increased problematic child outcomes, with sons being more affected than daughters. Furthermore, increased authoritative fathering is associated with decreased externalizing problems of children as well as fewer internalizing problems for sons but not for daughters. Increased father involvement predicts improved sibling relationship quality for children. Other factors predicting problematic child outcomes in the overall regression model include father education and number of children in the household. Overall, findings support the idea that Filipino fathers play a valuable role in the lives of their children.
Factors Associated With Unmarried, Nonresident Fathers’ Perceptions of Their Coparenting
Authors: Bronte-Tinkew Jacinta , Horowitz Allison
Published: August 2009

Using a longitudinal sample of 522 biological, never-married, nonresident fathers from the Fragile Families and Child Wellbeing Study, this article examines the factors associated with fathers’ coparenting 36 months after a birth. Ordinary least squares regression models indicate never-married, nonresident fathers are less likely to perceive high coparental supportiveness if they have ever been incarcerated, if they have completed high school, if they have a greater number of children with the child’s mother, if the mother has lower levels of education, if they are not in a relationship with the focal child’s mother, if they have a new partner, and if they see their child more frequently. In contrast, more supportive coparental relationships are perceived among fathers with higher incomes, with higher education, who are employed, with a male child, and who provide informal support. This study provides continuing evidence that several aspects of nonresident men’s lives have important influences on their coparenting.
Markov Processes for the Prediction of Aircraft Noise Effects on Sleep
Authors: Basner Mathias , Siebert Uwe
Published: August 2009

Background. Aircraft noise disturbs sleep and impairs recuperation. Authorities plan to expand Frankfurt airport. Objective. To quantitatively assess the effects of a traffic curfew (11 PM to 5 AM) at Frankfurt Airport on sleep structure. Design. Experimental sleep study; polysomnography for 13 consecutive nights. Setting. Sleep laboratory. Subjects. 128 healthy subjects, mean age (SD) 38 (13) years, range 19 to 65, 59% female. Intervention. Exposure to aircraft noise via loudspeakers. Measurements. A 6-state Markov state transition sleep model was used to simulate 3 noise scenarios with first-order Monte Carlo simulations: 1) 2005 traffic at Frankfurt Airport, 2) as simulation 1 but flights between 11 PM and 5 AM cancelled, and 3) as simulation 2, with flights between 11 PM and 5 AM from simulation 1 rescheduled to periods before 11 PM and after 5 AM. Probabilities for transitions between sleep stages were estimated with autoregressive multinomial logistic regression. Results. Compared to a night without curfew, models indicate small improvements in sleep structure in nights with curfew, even if all traffic is rescheduled to periods before and after the curfew period. For those who go to bed before 10:30 PM or after 1 AM, this benefit is likely to be offset by the expected increase of air traffic during late evening and early morning hours. Limitations. Limited ecologic validity due to laboratory setting and subject sample. Conclusions. According to the decision analysis, it is unlikely that the proposed curfew at Frankfurt Airport substantially benefits sleep structure. Extensions of the model could be used to evaluate or propose alternative air traffic regulation strategies for Frankfurt Airport.
Robustly Stable Haptic Interaction Control using an Energy-bounding Algorithm
Authors: Kim Jong-Phil , Ryu Jeha
Published: August 2009

Stability is a challenging issue when controlling haptic interaction systems because unstable behavior may injure human operators or deteriorate the realism of the provided cues. Based on the passivity condition for sampled-data haptic systems, we propose a novel energy-bounding algorithm to ensure robustly stable haptic interactions. The proposed algorithm limits the energy generated by a sample-and-hold operator within the energy consumable by the effective damping elements in the haptic system. The algorithm also ensures that the VE and controller are passive. This guarantees robustly stable haptic interactions, regardless of the sampling frequency and its variations, but compromises the displayable impedance range of the VE. Simulations and experiments using a commercial haptic device are used to demonstrate the effectiveness of the proposed algorithm.
Grasping Non-stretchable Cloth Polygons
Authors: Bell Matthew , Balkcom Devin
Published: August 2009

In this paper, we examine non-stretchable two-dimensional polygonal cloth, and place bounds on the number of fingers needed to immobilize it. For any non-stretchable cloth polygon, it is always necessary to pin all of the convex vertices. We show that for some shapes, more fingers are necessary. No more than one-third of the concave vertices need to be pinned for simple polygons, and no more than one-third of the concave vertices plus two fingers per hole are necessary for polygons with holes.
Visual Tracking via Particle Filtering on the Affine Group
Authors: Kwon Junghyun , Park Frank C.
Published: August 2009

We present a particle filtering algorithm for visual tracking, in which the state equations for the object motion evolve on the two-dimensional affine group. We first formulate, in a coordinate-invariant and geometrically meaningful way, particle filtering on the affine group that allows for combined state—covariance estimation. Measurement likelihoods are also calculated from the image covariance descriptors using incremental principal geodesic analysis, a generalization of principal component analysis to curved spaces. Comparative visual tracking studies demonstrate the increased robustness of our tracking algorithm.
Biomechanically Optimized Distributed Tactile Transducer Based on Lateral Skin Deformation
Authors: Qi Wang  , Hayward Vincent
Published: August 2009

In this paper we describe a tactile transducer device that is optimized from biomechanical data and that has a compact, yet modular design. The tactile transducer comprises a 6 × 10 piezoelectric bimorph actuator array with a spatial resolution of 1 .8 mm × 1 .2 mm and has a wide temporal bandwidth. The actuator mounting method was improved from a conventional cantilever method to a dual-pinned method, giving the actuator the ability to deform the glabrous skin maximally during laterotactile stimulation. The results were validated by asking subjects to detect tactile features under a wide range of operating conditions. The tactile display device is modular, makes use of ordinary fabrication methods, and can be assembled and dismantled in a short time for debugging and maintenance. It weighs 60 g, it is self-contained in a 150 cm 3 volume and may be interfaced to most computers, provided that two analog outputs and six digital I/O lines are available. Psychophysical experiments were carried out to assess its effectiveness in rendering virtual tactile features.
Hip Arthroscopy in Athletes
Authors: Thomas Byrd J. W. , Jones Kay S.
Published: August 2009

Background

Arthroscopy is a well-accepted technique in the management of many athletic-related hip disorders, yet little quantitative outcomes data have been reported.

Purpose

To report the results of hip arthroscopy in a consecutive series of athletes with 10-year follow-up.

Study Design

Case series; Level of evidence, 4.

Methods

Since 1993, all patients undergoing hip arthroscopy at our institution have been prospectively assessed with a modified Harris hip score preoperatively and then postoperatively at 1, 3, 6, 12, 24, 60, and 120 months or until a subsequent procedure was performed. The variables studied included age, sex, type of sport, level of sport, diagnosis, duration of symptoms, onset of symptoms, and center edge angle. Fifty-two procedures were performed on 50 patients who had achieved 10-year follow-up. Fifteen patients developed symptoms in the course of athletic activities and their cases represent the substance of this study.

Results

Follow-up information was available for all 15 patients (11 men and 4 women). The average age was 31.7 years (range, 14–70 years). Type of sport involved included football (3), tennis (3), basketball (2), golf (2), and others (5); with 9 recreational, 4 high school, and 2 intercollegiate athletes. Diagnoses included chondral damage (8), labral tear (7), arthritis (5), avascular necrosis (1), loose body (1), and synovitis (1). The median improvement in the modified Harris hip score was 45 points (from 51 preoperatively to 96, on the 100-point scale), with 13 patients (87%) returning to their sport. All 5 athletes with arthritis eventually underwent total hip arthroplasty at an average of 6 years. There were no complications.

Conclusion

Arthroscopy to address hip injuries in athletes can result in substantial improvement with durable results. However, arthritis is a prognostic indicator of poor long-term outcomes.
Comparison of Arthroscopic Medial Meniscal Suture Repair Techniques
Authors: Choi Nam-Hong , Kim Tae-Hyung , Victoroff Brian N.
Published: August 2009

Background

There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures.

Hypothesis

No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon.

Study Design

Cohort study; Level of evidence, 2.

Methods

Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients.

Results

Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in pivot-shift test between groups ( P = .023). There were 2 complications associated with surgery. In the inside-out group, 1 patient required manipulation, and 2 patients had limited motion at final follow-up. Two patients in the inside-out group experienced transient saphenous nerve injury.

Conclusion

There was no significant difference in meniscal healing between inside-out and all-inside repair techniques in combination with anterior cruciate ligament reconstructions.
Application of Bone Marrow-Derived Mesenchymal Stem Cells in a Rotator Cuff Repair Model
Authors: Gulotta Lawrence V. , Kovacevic David , Ehteshami John R. , Dagher Elias , Packer Jonathan D. , Rodeo Scott A.
Published: August 2009

Background

Rotator cuff tendons heal to bone with interposed scar tissue, which makes repairs prone to failure. The purpose of this study was to determine if the application of bone marrow-derived mesenchymal stem cells (MSCs) can improve rotator cuff healing after repair.

Hypothesis

Application of MSCs to the repair site will result in superior results compared with controls on histologic and biomechanical testing.

Study Design

Controlled laboratory study.

Methods

Ninety-eight Lewis rats underwent unilateral detachment and repair of the supraspinatus tendon; 10 rats were used for MSC harvest. Eight animals were used for cell tracking with Ad-LacZ. The remaining animals received either 10 6 MSCs in a fibrin carrier, the carrier alone, or nothing at the repair site. Animals were sacrificed at 2 and 4 weeks for histologic analysis to determine the amount of fibrocartilage formation and the collagen organization at the insertion. Biomechanical testing was also performed.

Results

Specimens treated with Ad-LacZ–transduced MSCs exhibited more β-galactosidase activity at the repair site compared with controls at both 2 and 4 weeks, although activity at 4 weeks was less than that at 2 weeks. There were no differences in the amount of new cartilage formation or collagen fiber organization between groups at either time point. There were also no differences in the biomechanical strength of the repairs, the cross-sectional area, peak stress to failure, or stiffness.

Conclusion

The addition of MSCs to the healing rotator cuff insertion site did not improve the structure, composition, or strength of the healing tendon attachment site despite evidence that they are present and metabolically active.

Clinical Relevance

A biologic solution to the problem of tendon-to-bone healing in the rotator cuff remains elusive. The repair site may lack the cellular and/or molecular signals necessary to induce appropriate differentiation of transplanted cells. Further studies are needed to determine if cell-based strategies need to be combined with growth and differentiation factors to be effective.
Activity Level and Graft Type as Risk Factors for Anterior Cruciate Ligament Graft Failure
Authors: Borchers James R. , Pedroza Angela , Kaeding Christopher
Published: August 2009

Background

Anterior cruciate ligament (ACL) graft failure is an uncommon but devastating event after reconstruction, and risk factors for graft failure are not well understood.

Hypothesis

Returning to a high activity level after ACL reconstruction and use of an allograft are risk factors for ACL graft failure.

Study Design

Case-control study; Level of evidence, 3.

Methods

Twenty-one patients with ACL graft failure were identified over a 2-year period. Forty-two age- and sex-matched controls were identified over the same period. A 1:2 matched case-control design was used to evaluate activity level after reconstruction and graft type as risk factors for ACL graft failure. Logistic regression analysis was used to determine odds ratios for activity level after reconstruction and for graft type among cases and controls. Association (interaction) between activity level after reconstruction and graft type was evaluated comparing stratum-specific odds ratios.

Results

Univariate logistic regression models showed an increased odds of ACL graft failure for those with high activity level compared with low activity level (odds ratio [OR], 5.53; 95% confidence interval [CI], 1.18–28.61; P = .03) and for allografts compared with autografts (OR, 5.56; 95% CI 1.55–19.98; P = .009). A bivariate logistic regression model showed a 35% change in the odds ratio for activity level (OR, 4.33; 95% CI, 0.89–21.16; P = .07) and a 13% change in the odds ratio for allograft compared with autograft (OR, 4.93; 95% CI, 1.34–18.20; P = .02). Stratum-specific odds ratios between activity level and graft type show a multiplicative interaction between higher activity level and allograft for much greater odds of ACL graft failure.

Conclusion

Higher activity level after reconstruction and allograft use for reconstruction are risk factors for ACL graft failure. Stratum-specific odds ratios show a multiplicative interaction between higher activity level after ACL reconstruction and allograft use, greatly increasing the odds for ACL graft failure.
Defining Safe Rehabilitation for Ulnar Collateral Ligament Reconstruction of the Elbow
Authors: Bernas Geoffrey A. , Ruberte Thiele Ramon A. , Kinnaman Karen A. , Hughes Richard E. , Miller Bruce S. , Carpenter James E.
Published: August 2009

Background

Ulnar collateral ligament reconstruction of the elbow using a variety of techniques has been successful in enabling overhead athletes with ulnar collateral ligament insufficiency to return to competition. Most current postoperative rehabilitation programs begin with a period of motion restriction, including limiting elbow extension, that is followed by a transition from elbow strengthening to an interval throwing program, to competition. Motion restrictions early in the postoperative period may increase the risk for contractures. There is limited information to support current motion restrictions.

Purpose

(1) To determine strain on the reconstructed ulnar collateral ligament during a rehabilitation protocol that includes passive range of motion, isometric muscle contraction, and varus and valgus torques. (2) To develop guidelines for a safe initial rehabilitation protocol.

Study Design

Controlled laboratory study.

Methods

Eight cadaveric elbows underwent ulnar collateral ligament reconstruction with the docking technique using a gracilis tendon graft. Differential variable reluctance transducers on the anterior and posterior bands of the reconstructed anterior bundle of the ulnar collateral ligament were used to measure strain, while an optical motion tracking system monitored elbow motion. Strain was measured in the following 3 settings: passive range of motion, 22.2 N isometric flexion and extension contractions, and 3.34 N·m varus and valgus torques with the arm at 90° of flexion.

Results

Range of motion from maximum extension to 50° of flexion produced 3% or less strain in both bands of the reconstructed ligament. Forearm rotation did not significantly affect strain in the anterior or posterior bands ( P = .336 and P = .357). Strain at 90° approached 7% in the posterior band (upper 95% confidence interval). Isometric muscle contractions had no measurable effect on strain. Varus torques decreased and valgus torques increased strain significantly ( P < .05).

Conclusion

In the immediate postoperative period, full extension is safe, while flexion beyond 50° may place deleterious strain on the reconstruction. Isometric flexion and extension exercises do not increase ligament strain but may be unsafe at 90° of flexion, while valgus exercises (internal rotation at the shoulder) can increase strain in the reconstructed ligament.

Clinical Relevance

The results have implications for the development of appropriate rehabilitation protocols after ulnar collateral ligament reconstructive surgery.
Electromechanical Delay of the Knee Flexor Muscles Is Impaired After Harvesting Hamstring Tendons for Anterior Cruciate Ligament Reconstruction
Authors: Ristanis Stavros , Tsepis Elias , Giotis Dimitrios , Stergiou Nicholas , Cerulli Guiliano , Georgoulis Anastasios D.
Published: August 2009

Background

Changes in electromechanical delay during muscle activation are expected when there are substantial alterations in the structural properties of the musculotendinous tissue. In anterior cruciate ligament reconstruction, specific tendons are being harvested for grafts. Thus, there is an associated scar tissue development at the tendon that may affect the corresponding electromechanical delay.

Purpose

This study was conducted to investigate whether harvesting of semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction will affect the electromechanical delay of the knee flexors.

Study Design

Case-control study; Level of evidence, 3.

Methods

The authors evaluated 12 patients with anterior cruciate ligament reconstruction with a semitendinosus and gracilis autograft, 2 years after the reconstruction, and 12 healthy controls. Each participant performed 4 maximally explosive isometric contractions with a 1-minute break between contractions. The surface electromyographic activity of the biceps femoris and the semitendinosus was recorded from both legs during the contractions.

Results

The statistical comparisons revealed significant increases of the electromechanical delay of the anterior cruciate ligament–reconstructed knee for both investigated muscles. Specifically, the electromechanical delay values were increased for both the biceps femoris ( P = .029) and the semitendinosus ( P = .005) of the reconstructed knee when compared with the intact knee. Comparing the anterior cruciate ligament–reconstructed knee against healthy controls revealed similar significant differences for both muscles (semitendinosus, P = .011; biceps femoris, P = .024).

Conclusion

The results showed that harvesting the semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction significantly increased the electromechanical delay of the knee flexors. Increased hamstring electromechanical delay might impair knee safety and performance by modifying the transfer time of muscle tension to the tibia and therefore affecting muscle response during sudden movements in athletic activities. However, further investigation is required to identify whether the increased electromechanical delay of the hamstrings can actually influence optimal sports performance and increase the risk for knee injury in athletes with anterior cruciate ligament reconstructions.
Medial Open Wedge High Tibial Osteotomy
Authors: Wang Joon Ho , Bae Ji Hoon , Lim Hong Chul , Shon Won Yong , Kim Cheol Woong , Cho Jae Woo
Published: August 2009

Background

High tibial osteotomy can affect the posterior tibial slope in the sagittal plane because of the triangular configuration of the proximal tibia. However, the effect of the location of cortical hinge on posterior tibial slope has not been previously described.

Hypothesis

Posterolateral location of the cortical hinge will increase posterior tibial slope after medial open wedge osteotomy, and lateral location of the cortical hinge will not affect the change of the posterior tibial slope.

Study Design

Controlled laboratory study.

Methods

We performed incomplete valgus open wedge osteotomy on 12 paired knees of 6 fresh-frozen human cadavers (age, 63.4 ± 7.5 years) using an OrthoPilot navigation system. The left and right legs of each specimen were randomly assigned to a posterolateral (group A) or a lateral (group B) cortical hinge group. Changes in mean medial proximal tibial angle, posterior tibial slope, and opening wedge angle were measured and compared after surgery.

Results

In group A, mean medial proximal tibial angle changed from 84.37° ± 2.8° to 93.48° ± 3.06° ( P = .028); mean posterior tibial slope increased significantly from 8.71° ± 0.81° to 12.16° ± 0.84° ( P = .031); and mean wedge angle was 1.92° ± 0.46°. In group B, mean medial proximal tibial angle changed from 82.98° ± 2.53° to 90.89° ± 3.25° ( P = .027); mean posterior tibial slope changed from 9.19° ± 1.11° to 9.78° ± 1.27° ( P = .029); and mean wedge angle was 7.25° ± 0.72°.

Conclusion

The location of the intact cortical hinge affects the posterior tibia slope. During medial open wedge osteotomy, the change of posterior tibial slope was larger in the posterolateral than in the lateral cortical hinge group.

Clinical Relevance

To prevent the unintentional increase of the posterior tibial slope, special attention should be paid to locate the intact cortical hinge on the lateral, not the posterolateral, side of the tibia.
Examining Change in Theory-based Physical Activity Beliefs of Culturally Diverse Older Adults
Authors: Antikainen Iina , Ellis Rebecca , Kosma Maria , Allen Priscilla D. , Cherry Katie E. , Monroe Pamela A. , Wood Robert H.
Published: August 2009

Using the theory of planned behavior as the theoretical framework, the purpose of this study was to elicit the salient modal physical activity (PA) beliefs and to examine changes in the modal PA beliefs before and after a 16-week pilot PA intervention in culturally diverse older adults. Participants were 48 adults between the ages of 50 and 93 years (71% Black, 56% ≤ high school education, 65% ≤ US$20,000 annual income) who were recruited for a pilot PA intervention. Beliefs were elicited before and after the intervention, and changes in the beliefs were analyzed qualitatively. Changes were detected in the modal beliefs. Future research should focus on interventions that target salient modal beliefs in this population to determine quantitative changes in ratings of beliefs and behavior.
Neuropsychiatric Manifestations in Late-Onset Urea Cycle Disorder Patients
Authors: Serrano Mercedes , Martins Cecilia , Pérez-Dueñas Belén , Gómez-López Lilian , Murgui Empar , Fons Carmen , García-Cazorla Angels , Artuch Rafael , Jara Fernando , Arranz José A. , Häberle Johannes , Briones Paz , Campistol Jaume , Pineda Mercedes , Vilaseca Maria A.
Published: August 2009

Inherited urea cycle disorders represent one of the most common groups of inborn errors of metabolism. Late-onset urea cycle disorders caused by partial enzyme deficiencies may present with unexpected clinical phenotypes. We report 9 patients followed up in our hospital presenting late-onset urea cycle disorders who initially manifested neuropsychiatric/neurodevelopmental symptoms (the most prevalent neuropsychiatric/neurodevelopmental diagnoses were mental retardation, attention-deficit hyperactivity disorder [ADHD], language disorder, and delirium). Generally, these clinical pictures did not benefit from pharmacological treatment. Conversely, dietary treatment improved the symptoms. Regarding biochemical data, 2 patients showed normal ammonium but high glutamine levels. This study highlights the fact that neuropsychiatric/neurodevelopmental findings are common among the initial symptomatology of late-onset urea cycle disorders. The authors recommend that unexplained or nonresponsive neuropsychiatric/neurodevelopmental symptoms appearing during childhood or adolescence be followed by a study of ammonia and amino acid plasmatic levels to rule out a urea cycle disorder.
Lesbians Surviving Culture
Authors: Russell Amy
Published: August 2009

Because mainstream society privileges and assumes heterosexuality, nonheterosexual persons experience isolation and disconnection, especially lesbian women who may also in turn strategize a corrective form of disconnection. Relational-cultural theory (RCT) is applied to enhance the understanding of how lesbian women cope through connection and disconnection, explained generally and then applied specifically to unique lesbian issues in the creation of relationship, political advocacy, and spirituality. Although RCT is a powerful tool to inform practice, social workers must be mindful of the interpretation of connection. Lesbian strategies of disconnection may be the goal for an enhanced quality of life and a quest for connection.
Parameter Estimation and its Sensitivity Analysis of the MR Damper Hysteresis Model Using a Modified Genetic Algorithm
Authors: Xiaomin Xue , Qing Sun , Ling Zhang , Bin Zhang
Published: August 2009

The recently developed magnetorheological (MR) dampers serve as an ideal candidate for diverse applications including structural vibration suppression, shock absorption, and vibration control in vehicle systems. Previous research indicates that they are characterized with non-linear hysteresis and this was further testified in the present study. Various models have been proposed to interpret the complex characteristic, but they are plagued by certain limitations. In view of this, the present study sets out to propose a more efficient genetic algorithm (GA) and a simplified Bouc—Wen model. And it moves to adopt and improve the GA by some effective methods including effective selection methods, adaptive genetic operators and appropriate termination criteria. Then the simplified Bouc—Wen model is obtained by fixing the values of the insensitive parameters in the original model based on the sensitivity analysis theory. Finally, the experimental data of the MR damper responses verify that the proposed approaches are capable of efficient computations and accurate parameter estimation. Also suggested are the implications of the present study on other novel smart dampers.
On-line Estimation of Effective Bulk Modulus in Fluid Power Systems Using Piezoelectric Transducer Impedance
Authors: Kim Gi Woo , Wang Kon-Well
Published: August 2009

The effective bulk modulus of working fluids plays an important role in the control of hydraulic actuation systems because of its effect on the system response time and performance. Therefore, to ensure good control, monitoring the effective bulk modulus of the working fluids is an important task. Current methods normally require precision test equipment consisting of many complex components. The size of these devices is large and thus makes online measurement impractical. In this research, we develop a new on-line technique to estimate effective bulk modulus of the working fluids based on measurements of the impedance of piezoelectric transducers. The idea is to generate a sensitivity curve characterizing the relationship between the effective bulk modulus and the impedance resonant frequency via either off-line numerical simulation or off-line experimental calibration; the curve can then be used for monitoring the working fluids bulk modulus in an online manner. In this article, a simulation model is utilized to predict the peak resonance frequency of the impedance function and identify its dependency on the variation of the fluid bulk modulus. The new approach is then illustrated and a sensitivity curve is generated through comparing the simulation results with experimental data.
Evolving Beyond Self-Interest? Some Experimental Findings From Simulated International Negotiations
Authors: Niv-Solomon Anat , Janik Laura L. , Boyer Mark A. , Hudson Natalie Florea , Urlacher Brian , Brown Scott W. , Maneggia Donalyn
Published: August 2009

Negotiation is a process of exchange intellectually, socially, and in terms of the items (tangible or not) that provide the focal point for negotiations. In recent years, the English School has discussed international institutions from a normative point of view that emphasizes the development of shared norms and values. Actors are affected by their institutional surroundings and hence learn by doing and come to identify with the norms of the system. Primary institutions have developed over time and the international system is still evolving toward being more intertwined and toward the convergence realm on the spectrum, which ranges from power politics to coexistence to cooperation and then convergence. Thus far, most work in the English School tradition has tended to be normative and historical in approach. This article examines positive empirical evidence to support the theory of institutional development and social interaction. Using data from the GlobalEd project ( www.globaled.uconn.edu ), this article will examine how shared norms and practices become embedded in the operation of actors participating in international, simulated negotiations. Analysis of messages from these negotiations will show that participants adapt to the rules and the norms of the interaction environment. Furthermore, we demonstrate that the norms of the community become part of actors’ behavior and influence, positively, future interactions. Our conclusions indicate that increased interaction leads to positive spillover effects in terms of cooperation and international agreements.
Kinematic Robot-Based Evaluation Scales and Clinical Counterparts to Measure Upper Limb Motor Performance in Patients With Chronic Stroke
Authors: Bosecker Caitlyn , Dipietro Laura , Volpe Bruce , Igo Krebs Hermano
Published: August 2009

Background. Human-administered clinical scales are the accepted standard for quantifying motor performance of stroke subjects. Although they are widely accepted, these measurement tools are limited by interrater and intrarater reliability and are time-consuming to apply. In contrast, robot-based measures are highly repeatable, have high resolution, and could potentially reduce assessment time. Although robotic and other objective metrics have proliferated in the literature, they are not as well established as clinical scales and their relationship to clinical scales is mostly unknown. Objective. To test the performance of linear regression models to estimate clinical scores for the upper extremity from systematic robot-based metrics. Methods. Twenty kinematic and kinetic metrics were derived from movement data recorded with the shoulder-and-elbow InMotion2 robot (Interactive Motion Technologies, Inc), a commercial version of the MIT-Manus. Kinematic metrics were aggregated into macro-metrics and micro-metrics and collected from 111 chronic stroke subjects. Multiple linear regression models were developed to calculate Fugl-Meyer Assessment, Motor Status Score, Motor Power, and Modified Ashworth Scale from these robot-based metrics. Results. Best performance—complexity trade-off was achieved by the Motor Status Score model with 8 kinematic macro-metrics ( R = .71 for training; R = .72 for validation). Models including kinematic micro-metrics did not achieve significantly higher performance. Performances of the Modified Ashworth Scale models were consistently low ( R = .35-.42 for training; R = .08-.17 for validation). Conclusions. The authors identified a set of kinetic and kinematic macro-metrics that may be used for fast outcome evaluations. These metrics represent a first step toward the development of unified, automated measures of therapy outcome.