bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors Associated with Noncontact Injury of the Anterior Cruciate Ligament
Authors: Uhorchak John M. , Scoville Charles R. , Williams Glenn N. , Arciero Robert A. , Pierre Patrick St. , Taylor Dean C. 
Published: July 2017

Background: The causes of noncontact anterior cruciate ligament injury remain an enigma. Purpose: To prospectively evaluate risk factors for noncontact anterior cruciate ligament injuries in a large population of young athletic people. Study Design: Prospective cohort study. Methods: In 1995, 1198 new United States Military Academy cadets underwent detailed testing and many parameters were documented. During their 4-year tenure, all anterior cruciate ligament injuries that occurred were identified. Statistical analyses were used to identify the factors that may have predisposed the cadets to noncontact anterior cruciate ligament injuries. Results: Among the 895 cadets who completed the entire 4-year study, there were 24 noncontact anterior cruciate ligament tears (16 in men, 8 in women). Significant risk factors included small femoral notch width, generalized joint laxity, and, in women, higher than normal body mass index and KT-2000 arthrometer values that were 1 standard deviation or more above the mean. The presence of more than one of these risk factors greatly increased the relative risk of injury. All female cadets who had some combination of risk factors sustained noncontact anterior cruciate ligament injuries, indicating that some combinations of factors are especially perilous to the female knee. Conclusion: Several risk factors may predispose young athletes to noncontact anterior cruciate ligament injury.
Measurement of Posterior Tibial Translation in the Posterior Cruciate Ligament-Reconstructed Knee
Authors: Ma C. Benjamin , Kanamori Akihiro , Vogrin Tracy M. , Woo Savio L-Y. , Harner Christopher D. 
Published: July 2017

Background: The measurement of anterior or posterior tibial translation depends on the existence of a repeatable and accurate reference position of the knee from which the corresponding translation is measured. Hypothesis: Clinical measurements of posterior tibial translation alone do not accurately reflect the laxity of posterior cruciate ligament-reconstructed knees. Study Design: Controlled laboratory study. Methods: Ten human cadaveric knees were tested by using a robotic/universal force-moment sensor testing system. The reference positions and the resulting kinematics in response to a 134-N anterior-posterior tibial load were determined for the intact and reconstructed knees. Posterior cruciate ligament reconstruction was performed with the graft tensioned and fixed at two different positions: 1) 90° of knee flexion with a 134-N anterior tibial load and 2) full extension with no load. Results: Posterior cruciate ligament reconstruction with graft fixation at full extension with no load resulted in anterior shift of the reference position by 1.5 to 3.2 mm. The reconstruction resulted in an overconstrained knee with significantly decreased total anterior-posterior translation of 2.6 to 3.2 mm. However, the posterior tibial translation measured was not significantly different from that of the intact knee. Posterior cruciate ligament reconstruction with graft fixation performed at 90° of flexion with a 134-N anterior tibial load resulted in kinematics similar to those of the intact knee. Conclusion: Posterior tibial translations that are measured clinically can be misleading because the reference position of the knee can be shifted significantly after posterior cruciate ligament reconstruction. Clinical Relevance: The measurement of total anterior-posterior translation may be a more accurate way to assess kinematics of the reconstructed knee.
Biomechanical Evaluation of a New Technique for Rotator Cuff Repair
Authors: Petit Charles J. , Boswell Robert , Mahar Andrew , Tasto James , Pedowitz Robert A. 
Published: July 2017

Background: In recent studies, investigators have used a cyclic loading model to investigate the efficacy of rotator cuff fixation modalities. Hypothesis: A bioabsorbable poly-D-lactic acid screw and toothed washer implant will provide more stable fixation of rotator cuff repairs than standard suture anchor techniques. Study Design: Controlled laboratory study. Methods: Forty bovine shoulders (ages 3 to 6 months) had 1 × 2 cm defects created in the infraspinatus tendon. There were five repair groups (eight specimens per group) consisting of either two screw and washer implants or two suture anchors. Four suture techniques were tested: single-loaded anchors with simple sutures, double-loaded anchors with simple sutures, single-loaded anchors with horizontal mattress sutures, or single-loaded anchors with modified Mason-Allen sutures. Repairs were loaded at 5-second cycles from 10 to 180 N with use of a hydraulic testing machine. The number of cycles to gap formation of 5 and 10 mm was recorded. Results: Gap formation of 5 and 10 mm occurred significantly later for the screw repair group than for any of the suture anchor groups. There was no significant difference between suture groups. Conclusions: The bioabsorbable screw and washer provided more stable fixation than suture anchor techniques under isometric cyclic loading conditions. Clinical Relevance: This is a time-zero study of implant performance. The results indicate that the implant may decrease clinical failures in the early postoperative period under standard rehabilitation protocols.
Physeal-Sparing Intraarticular Anterior Cruciate Ligament Reconstruction in Preadolescents
Authors: Guzzanti Vincenzo , Falciglia Francesco , Stanitski Carl L. 
Published: July 2017

Background: In the very young patient in need of anterior cruciate ligament reconstruction, the option of reconstruction with physeal-sparing techniques is valid because it is not known what percentage of physeal transgression causes adverse growth consequences. Purpose: To report our experience with an intraarticular technique for anterior cruciate ligament reconstruction that spares the open femoral and tibial physes yet allows soft tissue graft fixation in the femoral and tibial tunnels. Methods: Eight preadolescents underwent physeal-sparing intraarticular reconstruction for anterior cruciate ligament insufficiency with the use of semitendinosus and gracilis tendon grafts. All eight patients were in Tanner stage 1 with an average chronologic age of 11.15 years and average bone age of 10.9 years. Preoperative prediction of lower limb growth averaged 10.8 cm. Results: Five of the eight patients had reached skeletal maturity at follow-up, which was at an average of 69.2 months postoperatively. For these five, the Orthopadische Arbeitsgruppe Knie (OAK) score averaged 97 and the average KT-2000 arthrometer difference was 1.8 mm. Average growth in total height from surgery to final follow-up was 21.7 cm. No patient had a leg-length discrepancy or angular deformity, as verified by clinical or teleroentgenogram measurements. Conclusions: The technique presented in this study provided graft isometry and stability without adverse physeal consequences. Additional research is needed to determine the threshold percentage of physeal transgression for avoiding growth disturbances in humans.
Clinical, Functional, and Radiologic Outcome in Team Handball Players 6 to 11 Years after Anterior Cruciate Ligament Injury
Authors: Myklebust Grethe , Holm Inger , Mæhlum Sverre , Engebretsen Lars , Bahr Roald 
Published: July 2017

Background Long-term outcome after anterior cruciate ligament injury among top-level pivoting athletes is unknown. Purpose To evaluate outcome among competitive team handball players after anterior cruciate ligament injury. Study Design Prospective cohort study. Methods A previously studied group of 86 elite players who had an anterior cruciate ligament rupture were invited to participate in follow-up evaluations a mean of 7.8 years later. Results Among the 57 operatively treated patients who returned for follow-up, 33 (58%) returned to team handball at their preinjury level, compared with 18 of 22 (82%) in the nonoperative group. Eleven of the 50 players (22%) who continued playing reinjured their anterior cruciate ligament when playing team handball. The overall Lysholm score was 85 ± 13 in both groups, but the five players classified as poor were all operatively treated. Nearly half of the players had an International Knee Documentation Committee classification of abnormal or severely abnormal. There were significant differences between the injured and uninjured leg in functional (2.5% to 8%), strength (3.8% to 10.1%), and KT-1000 arthrometer tests (27%). In the operatively treated group, 11 developed radiologic gonarthrosis, compared with 6 in the nonoperatively treated group. There was no correlation between radiologic findings and pain scores. Conclusion A more restrictive attitude regarding return to competitive pivoting sports after anterior cruciate ligament injury may be warranted.
Islamism and Political Challenges in the Middle East
Authors: Quamar Md. Muddassir 
Published: July 2017

Jean-Pierre Filiu. (2015). From deep state to Islamic state: The Arab counter-revolution and its Jihadi legacy. New York, NY: Oxford University Press. Tarek Osman. (2016). Islamism: What it means for the Middle East and the world. New Haven, CT: Yale University Press. Fazzur Rahman Siddiqui. (2017). Political Islam and the Arab uprising: Islamist politics in changing times. New Delhi: SAGE Publications.
Civil-Military Relations in Developing Countries
Authors: Kukreja Veena 
Published: July 2017

Students of civil-military relations, particularly those in the developing countries, admit having to work on myopic assumptions, meagre data, sloppy conceptualization and inelegant explanations. The relative newness of this area of studies could be one reason for this. The study of civil-military relations in the narrow sense referring mainly to military coups and interventions, has attained importance after World War II. But the study of civil-military relations in the broader perspective of multiplicity of relationships between military men, institutions and interests, on the one hand, and diverse and often conflicting non-military organizations and political personages and interests on the other, has begun to draw academic interest only in the last two decades or so. In the twentieth century, the armed forces, being an universal and integral part of a nation's political system, no longer remain completely aloof from politics in any nation. If politics is concerned, in David Easton's celebrated words, with the authoritative allocation of values and power within a society, the military as a vital institution in the polity can hardly be wished out of participatory bounds, at least for legitimate influence as an institutional interest group with a stake in the political decision-making. The varying roles the military may play in politics range from minimal legitimate influence by means of recognized channels inherent in their position and responsibilities within the political system to the other extreme of total displacement of the civilian government in the forms of illegitimate overt military intervention in politics. This paper seeks to attempt an overview of the existing scholarship on civil-military relations; second, it examines civil-military relations in the world with special reference to major political systems of the world; third, it surveys the literature on civil-military relations in general, and finally, it attempts to develop a general, complex, and hopefully fruitful causal model for analyzing the dynamics of civil-military relations; exploring implications for future research on civil-military relations.
The Philosophical Basis for Human Rights Claims
Authors: Nwodo Christopher S. 
Published: July 2017

In the majority of cases involving the protection of human rights, the general approach is to give human rights a legal status by incorporating them into some international charter or national constitution, thereby making them justiciable. This establishes two things simultaneously. It imposes certain obligations upon those wielding political power to protect and to promote human rights among their subjects; it also confers a legitimate claim upon those ruled to have their rights respected. There is more to a human rights claim however than the fact of its legal status. It is fundamentally a moral claim imposing a moral obligation. This additional consideration is not just a mere emphasis on the legal argument. It has a specific dimension of its own that most often involves a distinct category—the moral as opposed to the merely legal. The legal aspect as we have seen is established by the fact of these rights being incorporated into some international charter or national constitution. But legality does not always imply morality. For the legal to be at the same time moral, it has to satisfy some conditions that give it a moral status making it more binding a least in conscience. The other, more fundamental, aspect of the human rights issue which gives both the legal and the moral their grounding is the human element. A legitimate claim to certain rights is based on the concept of the human being as a “person”. Only persons have rights, right meaning a certain quality or property of relationship between persons, such that one demands certain things andinsists that he or shemust have them as a matter of legitimacy. From this point of view one cannot strictly speaking, talk about the rights of animals, except in so far as these animals belong to persons. In the same way, moral claims and obligations make sense only in the context of persons. The fundamental assumptions of our human rights arguments therefore rest ultimately on the fact that human beings are persons who by virtue of their very nature have legal and moral claims that are intrinsic to them. A great deal of effort is being made to assign legal grounds to sanctions in case of their infringement. The necessity for these sanctions derives from the fact that people can recognize the moral as well as the ontological basis for human rights and yet refuse to acknowledge, respect, protect or promote them. In this particular case, the sanction imposed by law takes effect. The ideal situation however should have been the recognition as well as the promotion of the legitimate claims of the human person not because of the fear of any sanctions, but because as a human person, he or she ought to be accorded those rights. This paper will therefore try to investigate the philosophical basis for the concept of the human person upon which are founded human rights claims.
Revitalising the evidence base for public health: an assets model
Authors: Morgan Antony , Ziglio Erio 
Published: July 2017

Historically, approaches to the promotion of population health have been based on a deficit model. That is, they tend to focus on identifying the problems and needs of populations that require professional resources and high levels of dependence on hospital and welfare services. These deficit models are important and necessary to identify levels of needs and priorities. But they need to be complemented by some other perspectives as they have some drawbacks. Deficit models tend to define communities and individuals in negative terms, disregarding what is positive and works well in particular populations. In contrast `assets' models tend to accentuate positive capability to identify problems and activate solutions. They focus on promoting salutogenic resources that promote the self esteem and coping abilities of individuals and communities, eventually leading to less dependency on professional services. Much of the evidence available to policy makers to inform decisions about the most effective approaches to promoting health and to tackling health inequities is based on a deficit model and this may disproportionately lead to policies and practices which disempower the populations and communities who are supposed to benefit from them. An assets approach to health and development embraces a `salutogenic' notion of health creation and in doing so encourages the full participation of local communities in the health development process. The asset model presented here aims to revitalise how policy makers, researchers and practitioners think and act to promote a more resourceful approach to tackling health inequities. The model outlines a systematic approach to asset based public health which can provide scientific evidence and best practice on how to maximise the stock of key assets necessary for promoting health. Redressing the balance between the assets and deficit models for evidence based public health could help us to unlock some of the existing barriers to effective action on health inequities. This re-balancing would help in better understanding the factors that influence health and what can be done about them. It would promote a positive and inclusive approach to action. (Promotion & Education, 2007, Supplement (2): pp 17-22).
Enabling health systems transformation: what progress has been made in re-orienting health services?
Authors: Wise Marilyn , Nutbeam Don 
Published: July 2017

The Ottawa Charter has been remarkably influential in guiding the development of the goals and concepts of health promotion, and in shaping global public health practice in the past 20 years. However, of the five action areas identified in the Ottawa Charter, it appears that there has been little systematic attention to the challenge of re-orienting health services, and less than optimal progress in practice. The purposes of re-orienting health services as proposed in the Ottawa Charter were to achieve a better balance in investment between prevention and treatment, and to include a focus on population health outcomes alongside the focus on individual health outcomes. However, there is little evidence that a re-orientation of health services in these terms has occurred systematically anywhere in the world. This is in spite of the fact that direct evidence of the need to re-orient health services and of the potential benefits of doing so has grown substantially since 1986. Patient education, preventive care (screening, immunisation), and organisational and environmental changes by health organisations have all been found to have positive health and environmental outcomes. However, evidence of effectiveness has not been sufficient, on its own, to sway community preferences and political decisions. The lack of progress points to the need for significant re-thinking of the approaches we have adopted to date. The paper proposes a number of ways forward. These include working effectively in partnership with the communities we want to serve to mobilise support for change, and to reinforce this by working more effectively at influencing broader public opinion through the media. The active engagement of clinical health professionals is also identified as crucial to achieving sustainable change. Finally we recognize that by working in partnership with like-minded advocacy organizations, the IUHPE could put its significant knowledge and experience to work in leading action to transform health care systems to make a major contribution to the improvement of public health. (Promotion & Education, 2007, Supplement (2): pp 23-27).
Use of Prescription Medications in an Elderly Rural Population: The Movies Project
Authors: Lassila Holly C , Stoehr Gary P , Ganguli Mary , Seaberg Eric C , Gilby Joanne E , Belle Steven H , Echement Deborah A , Morand Brenda R , Demers Denyse 
Published: July 2017

Objective To determine the pharmacoepidemiology of prescription drug use in a rural elderly community sample, specifically the numbers and categories of medications taken and the factors associated with them. Design Cross-sectional community survey. Setting The mid-Monongahela Valley of southwestern Pennsylvania. Participants An age-stratified random sample of 1360 community-dwelling individuals, aged 65 years and older. Measures Self-reported use of prescription drugs, demographic characteristics, and use of health services. Results Nine hundred sixty-seven participants (71%) reported regularly taking at least one prescription medication and 157 (10%) reported taking five or more medications (median 2.0, range 0–13). Women took significantly more medications than men (median 2.0, range 0–13 and median 1.0, range 0–9, respectively; p = 0.01). The use of a greater number of medications was independently and statistically significantly associated with older age, hospitalization within the previous 6 months, home health care in previous year, visit to a physician within the previous year, and insurance coverage for prescription medication. Individuals older than 85 years were significantly more likely to be taking cardiovascular agents, anticoagulants, vasodilating agents, diuretics, and potassium supplements. Significantly more women than men were taking nonsteroidal antiinflammatory drugs, antidepressants, potassium supplements, and thyroid replacement medications. Conclusions Both the number and the types of prescription medications vary with age and gender. The demographic and health service use variables associated with greater medication use in the community may help define high-risk groups for polypharmacy and adverse drug reactions. Longitudinal studies are needed.
Sequential Parenteral and Oral Ciprofloxacin Regimen versus Parenteral Therapy for Bacteremia: A Pharmacoeconomic Analysis
Authors: Amodio-Groton Maria , Madu Assumpta , Madu Christian N , Briceland Laurie L , Seligman Marissa , McMaster Pamela , Miller Michael H , Monsanto Homero A , Mailhot Claude 
Published: July 2017

Objective To compare, in patients with gram-negative bacteremia, a course of parenteral antibiotic therapy alone with initial parenteral therapy followed by oral ciprofloxacin in terms of the length of hospitalization, clinical effectiveness, toxicity, and cost. Design A prospective, controlled, randomized, open trial in select hospitalized patients. Setting Large metropolitan teaching hospital. Patients Fifty hospitalized patients with proven gram-negative bacteremia were randomized to receive either oral ciprofloxacin (group 1) following a 72-hour initial intravenous antibiotic regimen or to continue parenteral therapy alone (group 2). To compare the length of hospitalization, an additional group of 50 hospitalized patients with bacteremia (not enrolled in the study, group 3) were analyzed. Intervention Parenteral antibiotics for 72 hours followed by continuation of a parenteral regimen or oral ciprofloxacin 750 mg bid. Main Outcome Measures Clinical response, toxicity, and length of hospitalization. Results Clinical resolution was comparable in the 24 group 1 patients receiving intravenous antibiotics followed by oral ciprofloxacin (83%), the 26 group 2 patients receiving parenteral therapy alone (77%), and the 50 comparison patients (76%). There was little toxicity noted in any group, and the initial parenteral antibiotic regimens were similar. The mean numbers of hospital days on antibiotics were 9.1, 11.2, and 10.6 days in groups 1, 2, and 3, respectively (p < 0.05 for group 1 vs. group 2 or 3), and the lengths of hospitalization were 9.8, 15.7, and 12.1 days, respectively (p < 0.05 for group 1 vs. group 2 or 3). Shortening the length of hospitalization and days of antibiotic therapy was associated with a cost savings of up to $78 000 for group 1 patients. Conclusions Parenteral therapy for 72 hours followed by oral ciprofloxacin significantly shortened both the number of hospital days taking antibiotics and the length of stay compared with parenteral therapy alone. Both regimens were equally effective and safe in the therapy of gram-negative bacteremia, and initial parenteral therapy followed by oral ciprofloxacin was cost-effective.