bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Aspects of Long-Term Outcome Are Predicted by Positive and Negative Symptoms in Early-Onset Psychosis? An Exploratory Eight-Year Follow-Up Study
Authors: Remberk Barbara , Bażyńska Anna Katarzyna , Bronowska Zofia , Potocki Paweł , Krempa-Kowalewska Anna , Niwiński Piotr , Rybakowski Filip
Published: December 2014

Background: Early-onset psychoses show substantial variability of diagnostic and functional outcome. Finding reliable prognostic factors may allow to allocate resources to those with the worst prognosis. The aim of the study was to gain new insights regarding the potential value of baseline negative and positive symptoms as predictors of outcome in psychoses of early onset. Method: Sixty-three patients with early-onset schizophrenia spectrum psychosis hospitalized in an adolescent psychiatry unit were assessed with the Positive and Negative Syndrome Scale during the index admission. Associations with diagnosis, illness course and functional outcome were analysed in mean 8 years of follow-up (range 3.4-13.5 years). Results: The mean age at the index admission and the follow-up was 16.6 ± 1.2 and 24.5 ± 3.0 years, respectively. A significant majority of subjects continued psychiatric treatment (95%) and had been readmitted (71%). The mortality rate was 3% (suicide and accident). Negative symptoms were related to mental health service utilization during the follow-up. General severity of symptoms, specifically positive and cognitive factors were associated with the diagnosis of schizophrenia and inversely with diagnostic shift outside the schizophrenia spectrum at the catamnesis. Poor impulse control at baseline was associated with worse functional outcome. The drug-free subgroup with no occupational/educational activity compared with the drug-treated subjects showed lower levels of baseline negative symptomatology. Conclusion: The study findings suggest that in patients with early-onset psychosis negative and positive symptoms show a differential prognostic value. Pharmacotherapy may attenuate the effect of symptoms on functional outcome. These hypotheses need to be tested in future studies using confirmatory approaches.
Vestibular Rehabilitation Affects Vestibular Asymmetry among Patients with Fall-Related Wrist Fractures - A Randomized Controlled Trial
Authors: Ekvall Hansson Eva , Dahlberg Leif E. , Magnusson Måns
Published: December 2014

Background: Fall-related fractures are an increasing problem for society. Dizziness is identified as a risk factor for falls and vestibular asymmetry is often found among patients with fall-related fractures. An option to prevent fall-related fractures may be to identify patients with vestibular asymmetry and to improve their balance and asymmetry by exercise. Objective: To examine whether vestibular rehabilitation improves vestibular function, balance and self-rated health among patients with fall-related wrist fractures. Methods: Sixty-eight persons (65 women) with fall-related wrist fractures, mean age 72 years (54-89) participated in this randomized controlled trial. The following tests and measurements were performed: head shake test to evaluate vestibular asymmetry as primary outcome measure, five clinical balance measures, a force plate to measure postural sway, a tuning fork to measure vibration and the EQ5D questionnaire to measure self-rated health. The intervention comprised group-based vestibular rehabilitation sessions conducted twice a week for 9 weeks. Results: Nystagmus occurred in the head shake test in 65% (44 of 68) of the patients, indicating vestibular asymmetry. More patients in the intervention group (6 of 21) than in the control group (0 of 23) changed from having nystagmus in the head shake test at baseline (indicating vestibular asymmetry) to not having nystagmus at follow-up, and more patients in the control group (3 of 9) than in the intervention group (0 of 3) changed from not having nystagmus at baseline to have nystagmus at follow-up (p < 0.00). No other changes occurred between the two groups between baseline and follow-up. At baseline, patients with vestibular asymmetry had more balance deficits and increased postural sway compared to patients without (p = 0.00-0.05). Conclusion: Group sessions with vestibular rehabilitation twice a week for 9 weeks affected the occurrence of vestibular asymmetry positively among patients having vestibular asymmetry. Patients with vestibular asymmetry had more balance deficits and increased postural sway than patients without vestibular asymmetry. Vestibular assessment is important, and, in patients with diagnosed vestibular asymmetry, vestibular rehabilitation may prove beneficial on balance and possibly reduce the risk of future falls.
UCH-L1 S18Y Variant and Risk of Parkinson's Disease in Asian Populations: An Updated Meta-Analysis
Authors: Zhu Ruixia , Zhu Ying , Liu Xu , He Zhiyi
Published: December 2014

The ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) gene has been implicated in the etiology of Parkinson's disease (PD). Several studies have evaluated the association between the UCH-L1 S18Y variant and the risk of PD. However, conflicting results have been reported. Therefore, we performed a meta-analysis to explore whether the UCH-L1 S18Y variant is associated with susceptibility to PD in Asians. A database search in Web of Science, MEDLINE, Embase and PubMed up to March 2014 identified 10 studies comprising 4,897 PD patients and 4,446 controls in total, which were included in this meta-analysis. In an updated meta-analysis, no significant associations between the S18Y polymorphism and PD in Asians were observed in recessive [p = 0.28, odds ratio (OR) = 1.47, 95% confidence interval (CI): 0.86-1.04] or dominant models (p = 0.46, OR = 0.96, 95% CI: 0.88-1.06). In the subgroup analysis by ethnicity, still no significant association was detected in dominant (for Chinese, OR = 0.97, 95% CI: 0.85-1.10; for Japanese, OR = 0.96, 95% CI: 0.83-1.11) and recessive models (for Chinese, OR = 0.99, 95% CI: 0.88-1.11; for Japanese, OR = 0.89, 95% CI: 0.76-1.04). The results of this meta-analysis suggested that the UCHL-1 S18Y polymorphism was not associated with the risk of PD in Asians. To our knowledge, this is the latest and largest meta-analysis assessing the association of the UCHL-1 S18Y variant with the risk of PD in Asian ancestry.
Lipin Family Proteins - Key Regulators in Lipid Metabolism
Authors: Chen Yi , Rui Bei-Bei , Tang Li-Ying , Hu Cheng-Mu
Published: December 2014

Background: Proteins in the lipin family play a key role in lipid synthesis due to their phosphatidate phosphatase activity, and they also act as transcriptional coactivators to regulate the expression of genes involved in lipid metabolism. The lipin family includes three members, lipin1, lipin2, and lipin3, which exhibit tissue-specific expression, indicating that they may have distinct roles in mediating disease. To date, most studies have focused on lipin1, whereas the roles of lipin2 and lipin3 are less understood. Summary: This review introduces the structural characteristics, physiological functions, relationship to lipid metabolism, and patterns of expression of the lipin family proteins, highlighting their roles in lipid metabolic homeostasis. © 2014 S. Karger AG, Basel
Circulating Atrial Natriuretic Peptide Genetic Association Study Identifies a Novel Gene Cluster Associated With Stroke in Whites
Authors: Pereira Naveen L. , Tosakulwong Nirubol , Scott Christopher G. , Jenkins Gregory D. , Prodduturi Naresh , Chai Yubo , Olson Timothy M. , Rodeheffer Richard J. , Redfield Margaret M. , Weinshilboum Richard M. , Burnett John C.
Published: December 2014

Background—

The goal of this study was to identify genetic determinants of plasma N-terminal proatrial natriuretic peptide (NT-proANP) in the general community by performing a large-scale genetic association study and to assess its functional significance in in vitro cell studies and on disease susceptibility.

Methods and Results—

Genotyping was performed across 16 000 genes in 893 randomly selected individuals, with replication in 891 subjects from the community. Plasma NT-proANP
1–98
concentrations were determined using a radioimmunoassay. Thirty-three genome-wide significant single-nucleotide polymorphisms were identified in the
MTHFR-CLCN6-NPPA-NPPB
locus and were all replicated. To assess the significance, in vitro functional genomic studies and clinical outcomes for carriers of a single-nucleotide polymorphism rs5063 (V32M) located in
NPPA
that represented the most significant variation in this genetic locus were assessed. The rs5063 variant allozyme in transfected HEK293 cells was decreased to 55±8% of wild-type protein (
P
=0.01) as assessed by quantitative western blots. Carriers of rs5063 had lower NT-proANP levels (1427 versus 2291 pmol/L;
P
<0.001) and higher diastolic blood pressures (75 versus 73 mm Hg;
P
=0.009) and were at an increased risk of stroke when compared with wild-type subjects independent of age, sex, diabetes mellitus, hypertension, atrial fibrillation, and cholesterol levels (hazard ratio, 1.6;
P
=0.004).

Conclusions—

This is the first large-scale genetic association study of circulating NT-proANP levels performed with replication and functional assessment that identified genetic variants in the
MTHFR-CLCN6-NPPA-NPPB
cluster to be significantly associated with NT-proANP levels. The clinical significance of this variation is related to lower NT-proANP levels, higher blood pressures, and an increased risk of stroke in the general community.
Maternal Diet During Gestation and Lactation Modifies the Severity of Salt-Induced Hypertension and Renal Injury in Dahl Salt-Sensitive Rats
Authors: Geurts Aron M. , Mattson David L. , Liu Pengyuan , Cabacungan Erwin , Skelton Meredith M. , Kurth Theresa M. , Yang Chun , Endres Bradley T. , Klotz Jason , Liang Mingyu , Cowley Allen W.
Published: December 2014

Environmental exposure of parents or early in life may affect disease development in adults. We found that hypertension and renal injury induced by a high-salt diet were substantially attenuated in Dahl SS/JrHsdMcwiCrl (SS/Crl) rats that had been maintained for many generations on the grain-based 5L2F diet compared with SS/JrHsdMcwi rats (SS/Mcw) maintained on the casein-based AIN-76A diet (mean arterial pressure, 116±9 versus 154±25 mm Hg; urinary albumin excretion, 23±12 versus 170±80 mg/d). RNAseq analysis of the renal outer medulla identified 129 and 82 genes responding to a high-salt diet uniquely in SS/Mcw and SS/Crl rats, respectively, along with minor genetic differences between the SS substrains. The 129 genes responding to salt in the SS/Mcw strain included numerous genes with homologs associated with hypertension, cardiovascular disease, or renal disease in human. To narrow the critical window of exposure, we performed embryo-transfer experiments in which single-cell embryos from 1 colony (SS/Mcw or SS/Crl) were transferred to surrogate mothers from the other colony, with parents and surrogate mothers maintained on their respective original diet. All offspring were fed the AIN-76A diet after weaning. Salt-induced hypertension and renal injury were substantially exacerbated in rats developed from SS/Crl embryos transferred to SS/Mcw surrogate mothers. Conversely, salt-induced hypertension and renal injury were significantly attenuated in rats developed from SS/Mcw embryos transferred to SS/Crl surrogate mothers. Together, the data suggest that maternal diet during the gestational–lactational period has substantial effects on the development of salt-induced hypertension and renal injury in adult SS rats.
Stable Water Isotopes across a Transect of the Southern Alps, New Zealand
Authors: Kerr Tim , Srinivasan M. S. , Rutherford Jeremy
Published: December 2014

Stable water isotope concentrations were obtained from samples of stream water at 29 sites in a west–east transect across the Southern Alps of New Zealand, where westerly conditions dominate the precipitation regime. The samples were taken from small catchment streams during a time of extended recession as a means of collecting time and space averages of the source precipitation. The isotopic concentrations from sites at either end of the transect lead to a drying ratio estimate of 22%–34% for this region of the Southern Alps. The isotope concentrations increased from west to east, indicating that precipitation in the lee area originates from higher and/or colder condensation than on the windward side. The transect was divided into three regions according to the deuterium-excess (d excess) results. Increasing d-excess values on the windward side of the mountains were speculated to be a result of some unknown combination of reducing relative evapotranspiration, increasing recycling of water vapor, and increasing nonequilibrating condensation from high-intensity precipitation. Low d-excess values in the region immediately lee of the mountains were consistent with below-cloud evaporation associated with increased hydrometeor drift into the drier lee side. High d excess in the more distant lee side was attributed to a secondary source of moisture (from the east and south). The information gained has supported current concepts of the precipitation processes dominant in the region and has provided additional quantitative measurements with which to validate future precipitation modeling efforts.
Singing over the Wall
Authors: Drummond Tim
Published: December 2014

Music with sacred texts is integral to the historical and modern development of the music education field, yet many who teach in public schools find themselves limited or banned from using sacred music. School divisions do not have a consensus opinion on how to handle this sensitive topic, and the law is not explicit. In this article, I provide an overview of the legal landscape on this subject and advice to help music educators in making informed and ethically sound choices about the role of sacred music in the public school setting.
Concert Programming and Performing as a Model for Lesson Planning and Teaching
Authors: Branscome Eric E.
Published: December 2014

For many novice music teachers, creating and implementing effective music lessons can be a tedious process. Moreover, preparing a music lesson is quite different from lesson planning in other areas, creating a disconnect that music educators may feel when trying to make music lessons fit a classroom lesson-plan model. However, most music teachers have accumulated an extensive array of experiences as performers in their teacher-training programs. These experiences create a significant advantage that music teachers have over teachers with no musical background when it comes to lesson preparation and delivery.
How HANDy are baby signs? A systematic review of the impact of gestural communication on typically developing, hearing infants under the age of 36 months: Response to Howard and Doherty-Sneddon’s commentary
Authors: Fitzpatrick Elizabeth M. , Johnston J. Cyne , Thibert Jonelle , Grandpierre Viviane
Published: December 2014

A systematic review was conducted to synthesize the evidence related to the effectiveness of baby sign language for children with typical development. This response to a Commentary on the review stresses that the primary purpose of the review was to assist caregivers and policy makers with informed decision-making related to the benefits of the intervention. This response reiterates the need for rigorous studies to evaluate whether early exposure to baby sign can enhance children’s development. While there is no conclusive evidence to support the effectiveness of baby sign intervention, this response concludes that there is also no evidence that early exposure to sign language negatively affects typical development.
How HANDy are baby signs? A systematic review of the impact of gestural communication on typically developing, hearing infants under the age of 36 months
Authors: Fitzpatrick Elizabeth M. , Thibert Jonelle , Grandpierre Viviane , Johnston J. Cyne
Published: December 2014

Baby sign language is advocated to improve children’s communication development. However, the evidence to support the advantages of baby sign has been inconclusive. A systematic review was undertaken to summarize and appraise the research related to the effectiveness of symbolic gestures for typically developing, hearing infants with hearing parents. Eight electronic databases, reference lists, and websites were searched for relevant studies published from January 1990 to February 2013. Studies were included if they involved typically developing hearing children who were exposed to symbolic gestures before age 36 months. Of 1902 identified citations, 10 reports met the inclusion criteria. This review shows that the effectiveness of baby sign in improving communication development remains unclear. However, no evidence was identified to suggest that using baby sign interferes with typical child development.
Readability Assessment of Online Tracheostomy Care Resources
Authors: Kong Keonho (Albert) , Hu Amanda
Published: December 2014

Objective

To assess the readability of online tracheostomy care resources.

Study Design

Cross‐sectional study.

Setting:

Academic center.

Subjects and Methods

A Google search was performed for “tracheostomy care” in January 2014. The top 50 results were categorized into major versus minor websites and patient‐oriented versus professional‐oriented resources. These websites were evaluated with the following readability tools: Flesch Reading Ease Score (FRES), Flesch‐Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (GFOG).

Results

Readability scores for the websites were FRES 57.21 ± 16.71 (possible range = 0‐100), FKGL 8.33 ± 2.84 (possible range = 3‐12), SMOG 11.25 ± 2.49 (possible range = 3‐19), and GFOG 11.43 ± 4.07 (possible range = 3‐19). There was no significant difference in all 4 readability scores between major (n = 41) and minor (n = 9) websites. Professional‐oriented websites (n = 19) had the following readability scores: FRES 40.77 ± 11.69, FKGL 10.93 ± 2.48, SMOG 13.29 ± 2.32, and GFOG 14.91 ± 3.98. Patient‐oriented websites (n = 31) had the following readability scores: FRES 67.29 ± 9.91, FKGL 6.73 ± 1.61, SMOG 10.01 ± 1.64, and GFOG 9.30 ± 2.27. Professional‐oriented websites had more difficult readability scores than patient‐oriented websites for FRES (P <. 00), FKGL (P <. 00), SMOG (P <. 00), and GFOG (P <. 00).

Conclusion

Online tracheostomy care resources were written at a level more difficult than the recommended fourth‐ to sixth‐grade level for written health information. There was no significant difference in readability between major and minor websites. Professional‐oriented websites were more difficult to read than patient‐oriented websites.
The Impact of Oversampling with SMOTE on the Performance of 3 Classifiers in Prediction of Type 2 Diabetes
Authors: Ramezankhani Azra , Pournik Omid , Shahrabi Jamal , Azizi Fereidoun , Hadaegh Farzad , Khalili Davood
Published: December 2014

Objective. To evaluate the impact of the synthetic minority oversampling technique (SMOTE) on the performance of probabilistic neural network (PNN), naïve Bayes (NB), and decision tree (DT) classifiers for predicting diabetes in a prospective cohort of the Tehran Lipid and Glucose Study (TLGS). Methods. Data of the 6647 nondiabetic participants, aged 20 years or older with more than 10 years of follow-up, were used to develop prediction models based on 21 common risk factors. The minority class in the training dataset was oversampled using the SMOTE technique, at 100%, 200%, 300%, 400%, 500%, 600%, and 700% of its original size. The original and the oversampled training datasets were used to establish the classification models. Accuracy, sensitivity, specificity, precision, F-measure, and Youden’s index were used to evaluated the performance of classifiers in the test dataset. To compare the performance of the 3 classification models, we used the ROC convex hull (ROCCH). Results. Oversampling the minority class at 700% (completely balanced) increased the sensitivity of the PNN, DT, and NB by 64%, 51%, and 5%, respectively, but decreased the accuracy and specificity of the 3 classification methods. NB had the best Youden’s index before and after oversampling. The ROCCH showed that PNN is suboptimal for any class and cost conditions. Conclusions. To determine a classifier with a machine learning algorithm like the PNN and DT, class skew in data should be considered. The NB and DT were optimal classifiers in a prediction task in an imbalanced medical database.
Have You Won the War on Terror? Military Videogames and the State of American Exceptionalism
Authors: Robinson Nick
Published: December 2014

Videogames matter and they matter for international politics. With popular culture increasingly acknowledged as a valuable site for opening up new ways of interrogating theory, this article argues that important insights for the critical understanding of American exceptionalism can be developed through the study of military videogames. At one level, military videogames illustrate a number of prominent themes within American exceptionalism: they offer the perception that a threatening and hostile environment confronts the USA, thus situating America as an innocent victim, justified in using force in response; they allow exploration of the link between American exceptionalism and debates on the competence of political leadership, and they open up space to analyse the temporal dimension of international relations. Yet videogames also help expose the foundations (what Weber terms ‘the myths’) upon which American exceptionalism is based, here shown to be centred on the importance of the military industrial complex as a source of exceptionalism.
Teaching From Privilege
Authors: Davis Ashley , Mirick Rebecca , McQueen Barbara
Published: December 2014

Three white female social work instructors reflect on our privilege and its manifestations in the classroom. Using examples from our teaching, we describe the limiting effects of our privilege, including making assumptions about our students’ experiences, displaying bias in our choice of teaching materials, and not meeting student learning needs. We also noticed times when we modeled skills for students, held ourselves accountable for our actions, and were allies for students from marginalized backgrounds. Through reflection, we strive to transform the limitations into critical learning opportunities in social work education. Implications are discussed for teaching and institutional support.
Profiling the collocation use in ELT textbooks and learner writing
Authors: Tsai Kuei-Ju
Published: December 2014

The present study investigates the collocational profiles of (1) three series of graded textbooks for English as a foreign language (EFL) commonly used in Taiwan, (2) the written productions of EFL learners, and (3) the written productions of native speakers (NS) of English. These texts were examined against a purpose-built collocation list. Based on the British National Corpus (BNC), the collocation list comprises 43,875 verb–noun collocations, the nodes of which were drawn from a prescribed wordlist (Jeng, Chang, Cheng, & Gu, 2002) to be learned on completion of the secondary education in Taiwan. Findings show that overall the collocational density and diversity of the textbooks are comparable to those of NS essays. Nonetheless, only small proportions of collocations within the repertoire were presented in the textbooks, and these collocations did not recur enough for the learner to consolidate collocational knowledge. Compared with their NS equivalents, learners’ writing exhibited an inordinate degree of collocational density and limited collocational diversity, suggesting that they did have the need to construct utterances with collocations, but were inhibited by a underdeveloped sense of collocational knowledge. Implications for learning/teaching collocations and materials designing are discussed.
Addressing Language Barriers in Client-Centered Health Promotion
Authors: Seth Jennifer Greenberg , Isbell Matthew G. , Atwood Robin Dochen , Ray Tara C.
Published: December 2014

The growing population of nonnative English speakers in the United States challenges program planners to offer services that will effectively reach limited English proficiency (LEP) audiences. This article presents findings from evaluation research conducted with the Special Supplemental Program for Women, Infants, and Children (WIC) to identify best practices and areas of concern for working with LEP clients. Data were collected through online surveys of 338 WIC teaching staff in 2010 and 65 WIC local agency directors in 2011 as part of an implementation evaluation of client-centered nutrition education. Data identified current practices, facilitating factors, and challenges in working with LEP clients. Facilitating factors included cultural competency, material and translation resources, linguistic competency, professional development opportunities, and rapport with clients. Challenges cited included linguistic challenges, lack of cultural competencies, issues related to the client–staff interaction, and insufficient time, materials, and staffing. Best practices inferred from the data relate to developing linguistic standards for bilingual staff, considerations for translating written materials, interpretation services, cultural competency, and staff training. Findings may help inform the development of this and other linguistically and culturally appropriate health promotion programs.
Research Challenges and Lessons Learned From Conducting Community-Based Research With the Hmong Community
Authors: Kue Jennifer , Thorburn Sheryl , Keon Karen Levy
Published: December 2014

Background. Conducting research with underserved communities with little exposure to research presents a number of challenges and opportunities. Our study used a community-based approach to better understand factors that influence breast and cervical cancer screening among Hmong women. Objective. This article shares lessons learned during the process of developing and conducting qualitative research with a Hmong community with limited experience with research. Method. We conducted 17 key informant and 84 in-depth interviews with Hmong women and men. Research team discussions, insights from Hmong research team members, input from our Community Advisory Committee, and project documents were sources of information about the process of conducting research in this community. Results. Lessons learned concern including a cultural insider as an investigator; building community partnerships and support; establishing and working with a community advisory committee; hiring and training bilingual, bicultural staff; and using culturally appropriate materials and methods in a small, kinship-based community. We used multiple strategies to ensure that this study was conducted in a culturally appropriate manner. Conclusion. The lessons learned from our experiences can provide guidance to researchers on methodological and practical issues in conducting research with the Hmong and can inform future research with the Hmong and other similar underserved populations.
Examining the Unique Mediators That Underlie the Effects of Different Dimensions of Transformational Leadership
Authors: Saboe Kristin N. , Taing Meng U. , Way Jason D. , Johnson Russell E.
Published: December 2014

Although transformational leadership has been found to relate favorably to various work outcomes, past research has predominantly focused on overall transformational leadership rather than its dimensions. We addressed this shortcoming by examining how two dimensions of transformational leadership—providing support and emphasizing group goals—relate to follower organizational citizenship behavior and turnover intentions via leader–member exchange and employee commitment. Survey data were collected from 107 triads (employees, supervisors, and coworkers) employed in various organizations and industries. We supported our theoretical model in which the relation of providing support with organizational citizenship behavior is mediated by leader–member exchange and supervisor commitment, whereas the relationship of emphasizing group goals with turnover intentions is mediated by organizational commitment. These findings indicate that the dimensions of transformational leadership operate through unique channels. One implication for leadership development is that, depending on what outcome is desired (e.g., strengthening commitment to the leader vs. the organization), training can be tailored to target the most relevant dimension (e.g., providing support is more important for cultivating commitment to the leader vs. the organization). We discuss these and other implications of our findings.
Rehabilitation Research for Older Adults
Authors: Suleman Salima , Cleary Stuart , Bremault-Phillips Suzette , Hopper Tammy , Jones Allyson , Paslawski Teresa , Brown Cary A.
Published: December 2014

In this article, we describe a knowledge translation symposium focused on rehabilitation research for older adults. The symposium consisted of presentations on rehabilitation research, followed by roundtable discussions designed to solicit perspectives of public stakeholders. Eighty-eight people attended the event, most with backgrounds in health care service provision. The participants evaluated the event and provided feedback on research topics related to rehabilitation of older adults. Lessons learned from this event may be useful in the design of future knowledge translation symposia and to facilitate involvement of public stakeholders in design, implementation, and dissemination of rehabilitation research for older adults.
Evaluation of Short Term Outcomes of Transportal Femoral Cross Pin Fixation in Anterior Cruciate Ligament Reconstruction
Authors: Zehir Sinan , Şahin Ercan , Çalbıyık Murat , Kalem Mahmut , İpek Deniz , Songür Murat
Published: December 2014

Objectives:

Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation.

Methods:

Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treated surgically, in a single center, with at least one year follow up were investigated. Professional athletes, multi-ligamentous instability cases, cases requiring meniscus repair or further treatment for chondral injuries and cases with concomitant medial and lateral meniscus lesions were not included in the study. Femoral tunnel was prepared anatomically through accessory medial portal, opened medially and distally. Reconstruction was performed using double loop hamstring tendon autograft. Femoral side was fixed using double cross pin, whereas tibial side was secured using single biodegradable interference screw and titanium staple. No external immobilization method such as brace was administered. Patients were encouraged to bear weight as tolerated. Standard physiotherapy was instructed to all patients postoperatively. All cases were evaluated clinically at the end of at least one year follow-up. Clinical and functional evaluation consisted of pivot shift and Lysholm, International Knee Documentation Committee (IKDC) scores and Tegner activity evaluation systems.

Results:

Mean age was 28.4 (18-39) years. Mean time between the injury and reconstruction was 13 (3-21) weeks. Average duration of surgery was 48 (35-70) minutes. No case of graft failure or posterior cortical fracture was encountered. In two cases, infection was treated successfully with local debridement and antibiotics with retention of the graft. At the end of follow-up period, none of the cases demonstrated positive pivot shift test. Pre-operative and follow-up Lysholm scores were 58.3±6.7 and 87.1±5.3 (p<0.001) respectively. Pre-operative IKDC scores were evaluated as C at 37 cases and D at 14, whereas, follow-up IKDC scores were evaluated as A at 42 cases, B at 8 and C at 1 case. Pre-operative and follow-up Tegner scores were 3.7±0.6 and 6.7±0.4 (p<0.001) respectively.

Conclusion:

Although fixation strength of transcondylar graft fixation techniques has been questioned over loop systems with cortical fixation, it was reported that transcondylar fixation causes less tunnel widening at long term. Our study revealed successful short term results, with femoral tunnel preparation using accessory medial portal and double cross pin femoral fixation, allowing early weight bearing and rehabilitation without graft and fixation failure.
Results of Meniscus Repair for the Hypermobile Medial Meniscus
Authors: Söylev Serdar , Pınar İbrahim Halit
Published: December 2014

Objectives:

There have been very few studies on hypermobile lateral meniscus, but hypermobility of the medial meniscus has not been reported; the latter is more common in our practice. It is characterized by lax peripheral attachment of the middle 1/3 of the medial meniscus without a tear existing. In its most severe form (grade III) the meniscus can be displaced to the middle of the plateau and everted more than 60 degrees by probing the meniscocapsular attachment. The purpose of the present study is to analyse the clinical features of hypermobile medial meniscus and the results of meniscus repair.

Methods:

14 patients (14 knees; 10 right) underwent arthroscopic meniscal repair for hypermobile medial meniscus. Men and women were equally affected; average age was 28 (14-46). The mean duration of symptoms was 18 (2-96) months. Six cases (43 %) had no history of trauma. The most common symptoms were medial joint line pain (n:14), locking (n:9), giving way (n:9), rest pain (n:9) and inability to squat (n:5). The most common clinical findings were medial joint line tenderness (n:11), positive McMurray’s test (n:9), medial retinacular tenderness (n:6), and effusion (n:3). 13 patients were rated as poor by the Lysholm scale; average 52(35-85), average Tegner activity level was 5.6 (3-9). MRI, available for eight patients, did not show any spesific findings. Arthroscopy did not reveal any other lesions to explain the mechanical symptoms. SPSS 16,00 for Windows (Statistical Program for the Social Services Inc, Chicago, IL, USA) program was used for statistical analysis. Continuous variables were defined as mean ± standard derivation. Variables were tested for normal distribution by using the Kolmogorov–Smirnow test. Differences between the groups were assessed by using unpaired t-test or Mann–Whitney U-test instead, if continuous variables did not have normal distribution. Paired sample t-test was used to compare continuous variables (data of Tegner and Lysholm scores, preoperative and at last control). P < 0.05 was accepted as statistically significant.

Results:

All the patients were available for follow-up; average 32 (6-59) months. 11 patients (78 %) had no mechanical symptoms. Patients’ own evaluation was; 3 very good, 7 good, 3 fair and 1 poor. 13 patients were better. At follow-up, significant improvement was obtained in Lysholm score which was 84(52-100) in average (p<0.01) ; 9 (64 %) good-excellent,4 (28%) fair and 1 (7%) poor. Tegner levels were almost regained: Decrease by 1 grade (4.7 in average (1-9)) (p=0.026). Despite satisfactory results, more than half had minor symptoms and findings.

Conclusion:

Hypermobile medial meniscus is characterized by medial pain and mechanical symptoms. Two types can be distinguished: traumatic and atraumatic. For significant hypermobility, the meniscus should be stabilized by repair. Patients benefit from repair, but more than half continue to have minor symptoms.
Medial Patellofemoral Ligament Reconstruction in Skeletally Immature Patients
Authors: Yercan Hüseyin Serhat , Kale Gürler , Erkan Serkan , Özalp Taçkın , Okcu Güvenir
Published: December 2014

Objectives:

To evaluate the clinical outcome after medial patellofemoral ligament (MPFL) reconstruction for patellofemoral instability in skeletally immature patients.

Methods:

Study participants were 8 patients ( median age, 10 years; range, 5-14 and one male , others female) who had suffered from persistent patellofemoral instability. Our technique preserves femoral and patellar insertion anatomy of MPFL using a free semitendinosus autograft, together with tenodesis to the adductor magnus tendon thus sparing the open physis of distal femur and the patellar attachment of MPFL. The clinical results were evaluated preoperatively and the final follow-up period using the Kujala patellofemoral score. Patellar shift, tilt and height were measured preoperatively and on the latest follow-up on plain radiographs.

Results:

At average 42 months follow-up ( range, 16 to 56), %80 of patients were satisfied with the treatment. Redislocation or instability symptoms occurred in two patients. No apprehension signs or redislocations were seen in the remanining six patients. A significant improvement (p‹0.05) in Kujala score (from 36 to 77) was found. Patellar shift & tilt decreased to anatomic values in six patients but patella alta persisted.

Conclusion:

The result of this study show that MPFL reconstruction with our technique seems to be an effective treatment for recurrent and habitual patellofemoral dislocation in skeletally immature patients; leading to significant increases in stability and functionality.
The Immediate Effects of Kinesiotm Taping on Shoulder External Rotation in People with Shoulder Pain
Authors: Gözbek Arman , Üstün Elif , İnal Habibe Serap
Published: December 2014

Objectives:

Observing the immediate effect of KinesioTMTaping(KT) on dynamic balance(DB) and acceleration(ACC) of athletes and sedentary subjects.

Methods:

The mean ages of athletes(n=25) and sedentary(n=25) were 21,36±2,07 and 21,64±1,62 years, weight 82,36±1,75 and 79,48±7,41kg, height 1,81±0,65 and 1,77±0,56cm, and body mass index were 24,99±4,07 and 25,20±2,12kg/cm2, respectively. They were all male and students of Yeditepe University. The athletes were in the soccer and American football teams of the university. All gave their own written consent to participate in the test protocols of the study voluntarily.Their lower extremity (LE) muscle power (JTech Myometry), and the flexibility of the LE antigravity muscles were assessed before. Their DB (Prokin PK 200) of both sides, speed and acceleration in 30m sprint (Research Tracker RT6) were assessed as before and after the KT applications on both calves to observe their immediate effects on the gastrosoleus group of muscles (p<0.05). The Y shaped KT were used starting from Achilles tendon as one piece and ending over medial and lateral heads of M.Gastrocnemius. Descriptive statistics were used to understand the physical properties of the participants. Wilcoxon and Mann-Whitney-U tests were used for the significance (p< 0.05) of the data and Pearson Correlation was used to understand the relation between the data.

Results:

Athletes’ lower extremity muscles were stronger (p< 0.05) than the sedentary, except the M.Gluteus maximus and ankle invertors. They achieved higher performance in 30m sprint and in DB tests than the sedentary. KT on gastrosoleus group improved the DB of both sides as perimeter length(°) of the centre of pressure (COP) and the area covered (%) by COP (p< 0.05) of the athletes, but not in the ML and AP displacements (°) of COP. The athletes forward (X) and resultant (XYZ) ACC and velocity (m/sec) were significantly higher after KT application (p<0.01). The soleus, ankle invertors-evertors were effective on the forward (X) ACC, but invertors were also effective on mean velocity of the athletes, compared to sedentary.

Conclusion:

The athletes benefited from the immediate effects of KT application during sprinting. It increased the ability of athletes to control the movements of COP in shorter distance and smaller area compared to sedentary. Since there is no difference in AP-ML displacement of COP of both groups, we can conclude that KT does not have immediate effect on ankle strategy for DB.
Is There a Relation Between Shoulder Dysfunction and Core Instability?
Authors: Hazar Zeynep , Ulug Naime , Yuksel Inci
Published: December 2014

Objectives:

Little is known about the relationship between core stability and shoulder dysfunction in shoulder impingement syndrome. The purpose of this study was to analyze the difference between healthy volunteers and patients with shoulder dysfunction in regard to core stability measures. Secondary purpose was to explore the relationship between measures of core stability and measures of shoulder dysfunction.

Methods:

15 patients with shoulder impingement syndrome (mean age: 32.2±4.2 years) and 15 healthy volunteers (mean age: 33.8±6.2 years) participated in this study. Sorenson test, front plank and side bridge exercise was performed to assess anterior, lateral and posterior core endurance, respectively. Simple shoulder test (SSS) and seated medicine ball throw test was used to evaluate the functions of the shoulder joints. Mann-Whitney U test was used for comparison of variables between groups. Analyses of relationships between variables were examined with Spearman correlation test.

Results:

There was a statistically significant difference between patients with shoulder impingement syndrome and healthy controls in core stability and function (p<0.05). A strong positive correlation was found between shoulder functional test (SSS) and lateral bridge test (r= .874, p < .05). Additionally, a modest positive correlation was found between the SSS and the Sorenson test at (r= .695, p < .05), and a weak positive correlation was found between the SSS and the front plank test at (r= .365, p < .05).

Conclusion:

Core stability and functional deficiency was found in patients with subacromial impingement syndrome. According to this study, greater shoulder dysfunction is correlated with greater stability deficiency. Therapists should consider incorporating core strengthening as an integral component of rehabilitation program in patients with shoulder dysfunction.
The Effect of Applying Rigid Taping to Quadriceps Muscles on Knee Extension Strength and Jumping Distance
Authors: Yasar Burak Yasin , Kaplan Tuba , Ercan Sabriye , Alp Erkan , Cetin Cem
Published: December 2014

Objectives:

The scientific literature is insufficient to support the use of elastic or rigid taping for the prevention or treatment of musculoskeletal injury or performance enhancement. The aim of this study was to analyze the effects of applying rigid taping on the knee extension strength and lower limb function in healthy subjects.

Methods:

Twenty eight healthy volunteers (age: 20.9 ± 1.1 years) were randomly assigned to two groups of 14 subjects each: Placebo/sham tape and rigid tape (Rigid tape application over the same muscles). All individuals were assessed for single and double leg hops and peak isometric and concentric isokinetic torque before and after interventions.

Results:

There were no statistically significant differences in jumping distances, isometric peak torque, isokinetic peak torque and total work done between groups.

Conclusion:

Application of rigid tape to quadriceps muscles did not significantly change lower limb functions, jump distance and knee extensor peak torque in healthy sedentary subjects.
Mid-Long Term Results in the Arthroscopic Selective Capsular Release and Manipulation Treatment of Frozen Shoulder
Authors: Celik Haluk , Seckin Mustafa Faik , Kara Adnan , Camur Savas , Kilinc Eray , Akman Senol
Published: December 2014

Objectives:

Our aim was to present mid-long term functional outcomes of patients who underwent arthroscopic selective capsular release and manipulation for frozen shoulder refractory to conservative treatment.

Methods:

Between 2006 and 2012, 32 patients presented to our clinic with the diagnosis of frozen shoulder. 24 shoulders of 22 patients treated with arthroscopic selective capsular release and manipulation were included in the study. Functional results were analyzed with Constant shoulder score. The mean follow-up was 4.3 years (range 1-7 years).

Results:

We detected an average increase in passive range of motion in flexion 72°, abduction 90°, abduction-internal rotation 33°, and abduction-external rotation 38°, adduction-external rotation at 37° compared to the preoperative status. Constant shoulder score increased by an average of 44 points after surgery. Eighteen (82%) patients were satisfied with the operation. Three of four patients whose symptoms persisted had resistant diabetes mellitus.

Conclusion:

Frozen shoulder is one of the most well-known causes of shoulder pain and disability. Although surgery has a good rate of success it does not help in all cases. Unsatisfactory results may be experienced in patients who have diabetes mellitus as a confounding factor.
Different Cyclic Mechanical Loading Patterns Alter Expression of Osteogenic Markers in a Fibroblast-Osteoblast Co-Culture Model Resembling the Tendon-To-Bone Interface After Autologous ACL Reconstruction
Authors: Roessler Philip Peter , Struewer Johannes , Paletta Jürgen Rudolph , Efe Turgay
Published: December 2014

Objectives:

The aim of the study was to evaluate the influence of different cyclical mechanical loading patterns on co-cultures of fibroblasts and osteoblasts in vitro, simulating the conditions of the tendon-to-bone interface after anterior cruciate ligament reconstruction.

Methods:

Tendon-derived rodent fibroblasts (TDF) and osteoblast-like cells (OBL) were co-cultured to simulate the tendon-to-bone interface. Cyclical loading was applied for one hour twice a day for three days, with a frequency of 1 Hz and 3 % strain. Alkaline phosphatase (AP), osteocalcin (OC), collagen type 1 (COL1A1), and bone morphogenetic protein 2 (BMP-2) gene expression and protein deposition were detected by real-time polymerase chain reaction (qPCR) and immunocytochemical analysis.

Results:

Mechanical loading significantly decreased AP, OC, and COL1A1 gene expression in both OBL and TDF, compared to non-loaded cultures. However, mechanical load increased gene expression of the same marker genes including BMP-2 during co-culture. Immunocytochemistry demonstrated increased deposition of corresponding proteins in the same range, independent of culture conditions. Higher depositions of BMP-2 were shown under loading conditions for osteoblast and TDF monocultures. Prolongation of mechanical loading resulted in cell detachment and spheroid formation.

Conclusion:

Cyclical mechanical loading caused downregulation of genes involved in osteointegration and osteoinduction, such as OC, ALP, and COL1A1 in monocultures of osteoblasts and fibroblasts; co-cultures lacked this phenomenon. Immunocytochemistry and qPCR analysis showed slight upregulations of marker genes and corresponding proteins. This might be due to the potential stabilising effects of osteoblast-fibroblast cross talk in the co-culture environment, resembling fibrocartilage formation at the tendon-to-bone interface.