bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
Posterior Shoulder Dislocation Due to an Atypical Trauma Mechanism
Authors: Güzel Şevket Ergun , Baysal Özgür , Eceviz Engin , Elmalı Nurzat 
Published: December 2014

Objectives: A 32 year old man who was admitted to the emergency department with serious pain and absent movement of the right upper extremity due to passing the ball in a basketball game. He had no shoulder dislocation in his medical history. The right shoulder position was flexion and adduction. The shoulder range of motion was restricted and the neurovascular examination was intact. Posterior shoulder dislocation was diagnosed in radiographs.The aim of the study is pointed out an unusual mechanism of the posterior shoulder dislocations which is related microtrauma. The main problem in treatment of this kind of dislocation is correct and timely diagnosis. Methods: After diagnosing the posterior shoulder dislocation, we reducted the shoulder joint immediately and immobilized in abduction and external rotation with Velpeau bandage. We took radiographs and computerized tomography to confirm the reduction of the joint and diagnose the additional bone pathology. Reverse Hill Sacks lesion was diagnosed. Two weeks later after diagnosing passive range of movement exercises were applied. Magnetic resonance imaging was done to diagnose the additional pathology. Results: There was no spesific finding in radiographs and reverse Hill Sachs lesion and anterior labral tear were determined in magnetic images finding. Conclusion: Shoulder joint dislocations are the most seen pathology in the emergency department. On the other hand posterior shoulder dislocations are less common than anterior dislocations, but more commonly missed. Posterior shoulder dislocations are caused by high energy trauma, seizures, electric shocks and microtrauma.
Posterior Ankle and Hind Foot Arthroscopy
Authors: Gökkuş Kemal , Aydın Ahmet Turan 
Published: December 2014

Objectives: While anterior ankle arthroscopy is a widely accepted technique, posterior ankle/hind foot arthroscopy is still a relatively new procedure. The arthroscopic visualisation was often initially limited and vulnerabilty of the posteromedial neurovascular structures to injury scared orthopaedic surgeons. The goal of this review is to highlight the indications, and to present the long term follow up results of posterior ankle/hind foot arthroscopy. Methods: The study included 21 ankles in 21 patients (12 male and 9 female ).The mean age was 37.7 , the mean duration of preoperative symptoms 12.8 months . Arthroscopy performed with the patient prone , under general and spinal anesthesia with tourniquet hemostasis . Preoperative intravenous antibiotic prophylaxis is performed (cefazolin 1g) , sand bag placed under ipsilateral anteresuperior iliac spine to correct natural external rotated posture of the ankle and ankle is left hanging of the table so that it can moved freely during surgery. We applied noninvasive distraction method with simple rope which tied and knotted waist of the surgeon . The posterolateral and posteromedial portals which described by Van Dijk was utilized . The arthroscopic visualisation was often initially limited and careful debritement of some adipose tissue of the kager fat pad (Kager's fat pad, also known as the pre-Achilles fat pad) was necessary to create more space to aid visualization .The most valuable point to stay clear from trouble is to understand , know and aware where the flexor hallucis longus tendon exist .So neurovascular structures located beyond this tendon. Principally the process must advance into lateral to medial manner. The mean follow up period was 55 months. The most common preoperative diagnoses were osteochondral lesions of talus (ten ),painful os trigonum syndrome with (five )or without (three) FHL tenosynovitis (total eight ), posterior talofibular ligament thickenning (two ), Haglund’s deformity (one ) Results: The mean pre operative AOFAS score was 50.75, the mean post operative AOFAS score was 93.75. Complications were noted. Complex regional pain syndrome (CRPS) and oedema was diagnosed during early post operative period in one patient (%4.7), resolved with physical therapy. Conclusion: The most common procedures were osteochondral lesion debritement and curettage with multidrilling /microfracture (10), isolated os trigonum excision (2), tenolysis of the flexor hallucis longus tendon with os trigonum excision (6 ), debritment of the thickened posterior talofibular ligament (2), endoscopic partial calcanectomy for Haglund’s deformity (1) . Our experience demostrated that posterior ankle and hind foot arthroscopy can be performed with low rate of major postoperative complication.
Bearing Weight at the Same Day in Conservatively Treated Acute Achilles Tendon Rupture Patients
Authors: Korkmaz Murat , Yolcu Sadiye , Balbaloğlu Özlem , Öztemur Zekeriya , Karaarslan Fatih 
Published: December 2014

Objectives: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men.. At treating there has been considerable research interest in attempting to identify the optimal treatment strategy, surgical or non-surgical, combined with functional early mobilisation or plaster cast immobilisation. Our aimed to compare the outcomes of bearing weight at the same day in conservatively treated and surgically treated groups of ATR patients. Methods: Thirty-two conservatively treated ATR patients and twenty nine surgically treated ATR patients were included to our study. Patients were over 18 years old who had been followed for 12 months by our clinic. All patients underwent knee supporting cast at four week and both group was asked for walking with bearing weight (%30-40) at same day. Results: In all groups 2nd and 12th months’ AOFAS (American Orthopaedic Foot and Ankle Society) scorings of the patients had significant differences (p<0.001). Return to work time results were significantly different and shorter in conservatively treated group (p= 0.035). This study founded a relatively high complication percentage of (6 patients) 20.6% in the surgically treated group. On the contrary the wound complications non-surgical group has not been be observed. Conclusion: In conclusion, this study adds to evidence that a well conducted non-surgical treatment protocol (early mobilization treatment regimen) gives a good clinical outcome and complication rate is not higher than after surgical treatment.
Ganglion Cyst Contiguity of the Flexor Hallusis Longus Tendon in a National Swimmer
Authors: Çirci Esra , Özyalvaç Osman Nuri , Tüzüner Tolga , Ermutlu Cenk 
Published: December 2014

Objectives: Tendinopathy of the flexor hallusis longus tendon is common in the athletes. This case is intended to be reported diagnose and treatment ganglion cyst contiguity of the flexor hallucis longus tendon that located atypical region and adversely affect the athlete's training program. Methods: 25-year-old male national swimmer was assessed with a left ankle pain. He had an intensive training program in the pool using pallets at the everyday. Pain in the left ankle was localized posterior and distal of the medial malleolus . Ankle range of motion and muscle strength was full. Neurovascular examination was normal. Radiography with anterior posterior, lateral and oblique analysis was not any unusual finding. In the evaluation with magnetic resonance imaging, thickening of the tendon sheath and effusion around the flexor hallucis longus was revealed and tendon integrity was exact. Results: Conservative treatment was planned. It was applied non-steroidal anti-inflammatory medicine, modification of the training (without or low weight pallet), platelet rich plasma (two weeks, two times peer weeks). During the six-month follow-up the patient's symptoms improved, but with the increased intensity of training at follow-up complaints started again. Professional athletes who did not respond adequately to conservative treatment surgical exposure were planned. Patient is approached the flexor hallucis longus musculotendinous junction from the posteromedial ankle at the level of the posterior talar tubercles. During the tendon exposure cyst was found at the level of talocalcaneal joint. Excision of the cyst was achieved; its size was 5x5 mm, looking transparent, well defined and soft consistency. Tenolysis is accomplished from superior to inferior to the level of the superior calcaneus. A histopathologic examination result of the cyst consistent with ganglion cyst was detected. Sport-specific training program started at the 6 weeks. There was no recurrence during the 6 months follow-up. Conclusion: Tendon associated ganglion cyst is not usual although flexor hallucis longus tendinopathy is common in athletes. External pressure causes in addition to the overuse injuries should be remembered in the differential diagnosis of posterior ankle and medial arch pain. Clinical suspicion and magnetic resonance imaging are valuable in establishing the diagnosis. Tenolysis and excision of the associated mass has proven to be a relatively safe and successful procedure especially in highly demanded elite athletes.
Effects of Glucosamine-Chondroitin Sulfate, Glucosamine-Chondroitin Sulfate-Methylsulfonylmethane, or Placebo in Patients with First and Second Grade of Knee Osteoarthritis
Authors: Wonggokusuma Erick , Setyohadi Bambang , Siagian Carles , Lubis Andri M.T. 
Published: December 2014

Objectives: Combination of glucosamine-chondroitin sulfate is often prescribed for patients with first and second grade Kellgren-Lawrence osteoarthritis (OA). Numerous studies have reported significant efficacy of this supplement and also their combinations with methylsulfonylmethane (MSM) for the treatment of OA. However, controversies emerged regarding the effectiveness of these supplements. This current study evaluated the efficacy of glucosamine-chondroitin sulfate and glucosamine-chondroitin sulfate-MSM on improvement of patients with first and second grade knee OA. Methods: This study was a double blind, randomized controlled clinical trial on 147 patients with first and second grade (Kellgren-Lawrence) of knee OA. Subjects were allocated by permuted block randomization to three groups, either glucosamine-chondroitin sulfate (GC) (n=49), or glucosamine-chondroitin sulfate-MSM (GCM) (n=48), or placebo (n=50). The GC group received 1500 mg glucosamine + 1200 mg chondroitin sulfate + 500 mg saccharum lactis; GCM group received 1500 mg glucosamine + 1200 mg chondroitin sulfate + 500 mg MSM; while placebo group received three matching capsules of saccharum lactis. These drugs were administered once a day for three consecutive months. VAS and WOMAC score were measured at the baseline, then at 12th week after treatment. Data was analysed by using t-independent test. Results: At week 12, WOMAC score in placebo group was significantly higher than that in GCM group (mean difference 7.15, CI 12.06-2.23, p=0.005), and it was also higher in GC group compared to GCM group (mean difference 8.17, CI 13.49-2.84, p=0.003). Whereas VAS score at week 12 in placebo group was significantly higher compared to that in GC group (mean difference 0.18, CI 1.18-0.19, p=0.007) and to that in GCM group (mean difference 0.86, CI 1.37-0.35, p=0.001). However, there was no significant difference of WOMAC score at week 12 between placebo and GC groups (p=0.681), and of VAS score between GC and GCM groups (p=0.497). Conclusion: Combinations of glucosamine-chondroitin sulfate and glucosamine-chondroitin sulfate-MSM did not improve WOMAC and VAS scores in patients with grade I and II of knee osteoarthritis, when compared with placebo.
The chiropractic profession in Norway 2011
Authors: Kvammen Ole C , Leboeuf-Yde Charlotte 
Published: December 2014

Abstract
Background
The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors heterogenic characteristics concerning practice routines and clinical settings. However, little is known about what characterizes this profession and how it compares to other chiropractic professions in Europe. The aim of this survey was to describe major characteristics of the chiropractic profession in Norway.

Method
Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading.

Result
Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one physiotherapist and one additional health practitioner. Today, only one in five clinics possessed radiologic equipment and one in ten had access to diagnostic ultrasound equipment. The majority of the chiropractors reported to apply mainly similar treatment modalities. More than 90% reported to use manipulation techniques on most patients, with soft tissue techniques and exercise modalities being almost as common. More than 3/4 of the profession reported that their clinical practice was in accordance with available clinical guidelines and about one third were positive about participating in future clinical research.

Conclusion
The Norwegian chiropractic profession is relatively young and members report being satisfied with their work conditions. There is a clear difference from the earlier practice pattern in that intra- and inter-professional collaboration is more common and it is considered desirable. The profession seems to follow the modern trends in evidence-based practice by using X-rays more sparingly than previously, adhering to guidelines and being positive about research.
Reducing otolaryngology surgical inefficiency via assessment of tray redundancy
Authors: Chin Christopher J , Sowerby Leigh J , John-Baptiste Ava , Rotenberg Brian W 
Published: December 2014

Background Health care costs in Canada continue to rise. As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought. Surgical treatment is the mainstay of therapy for many conditions in the field of Otolaryngology- Head and Neck Surgery. The evidence suggests that room exists to optimize tray efficiency as a novel means of improving operating room throughput. Methods We conducted a review of instruments on surgical trays for 5 commonly performed procedures between July 5th, 2013 and September 20th, 2013 at St Joseph's Hospital. The Instrument Utilization Rate was calculated; we then designed new ‘optimized’ trays based on which instruments were used at least 20% of the time. We obtained tray building times from Central Processing Department, then calculated an overall mean time per instrument (to pack the freshly washed instruments). We then determined the time that could be saved by using our new optimized trays. Results In total, 226 instrument trays were observed ( Table 1 ). The average Instrument Utilization Rate was 27.8% (+/− 13.1). Our optimized trays, on average, reduced tray size by 57%. The average time to pack one instrument was 17.7 seconds. Conclusions By selectively reducing our trays, we plan to reduce tray content by an average of 57%. It is important to remember that this number looks at only 5 procedures in the Department of Otolaryngology- Head and Neck Surgery. If this was expanded city-wide to the rest of the departments, the improved efficiency could potentially be quite substantial.
Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase II Study of the Efficacy and Safety of Apricoxib in Combination With Either Docetaxel or Pemetrexed in Patients With Biomarker-Selected Non–Small-Cell Lung Cancer
Authors: Edelman Martin J. , Tan Ming T. , Fidler Mary J. , Sanborn Rachel E. , Otterson Greg , Sequist Lecia V. , Evans Tracey L. , Schneider Bryan J. , Keresztes Roger , Rogers John S. , de Mayolo Jorge Antunez , Feliciano Josephine , Yang Yang , Medeiros Michelle , Zaknoen Sara L. 
Published: December 2014

Purpose Overexpression of COX-2 correlates with advanced stage and worse outcomes in non–small-cell lung cancer (NSCLC), possibly as a result of elevated levels of COX-2–dependent prostaglandin E2 (PGE2). Exploratory analyses of studies that used COX-2 inhibitors have demonstrated potentially superior outcome in patients in whom the urinary metabolite of PGE2 (PGE-M) is suppressed. We hypothesized that patients with disease defined by PGE-M suppression would benefit from the addition of apricoxib to second-line docetaxel or pemetrexed. Patients and Methods Patients with NSCLC who had disease progression after one line of platinum-based therapy, performance status of 0 to 2, and normal organ function were potentially eligible. Only patients with a ≥ 50% decrease in urinary PGE-M after 5 days of treatment with apricoxib could enroll. Docetaxel 75 mg/m2 or pemetrexed 500 mg/m2 once every 21 days per the investigator was administered with apricoxib or placebo 400 mg once per day. The primary end point was progression-free survival (PFS). Exploratory analysis was performed regarding baseline urinary PGE-M and outcomes. Results In all, 101 patients completed screening, and 72 of the 80 who demonstrated ≥ 50% suppression were randomly assigned to apricoxib or placebo. Toxicity was similar between the arms. No improvement in PFS was seen with apricoxib versus placebo. The median PFS for the control arm was 97 days (95% CI, 52 to 193 days) versus 85 days (95% CI, 67 to 142 days) for the experimental arm (P = .91). Conclusion Apricoxib did not improve PFS, despite biomarker-driven patient selection.
Pigeons produce aerodynamic torques through changes in wing trajectory during low speed aerial turns
Authors: Ros Ivo G. , Badger Marc A. , Pierson Alyssa N. , Bassman Lori C. , Biewener Andrew A. 
Published: December 2014

Abstract
The complexity of low speed maneuvering flight is apparent from the combination of two critical aspects of this behavior: high power and precise control. To understand how such control is achieved we examined the underlying kinematics and resulting aerodynamic mechanisms of low speed turning flight in the pigeon (Columba livia). Three birds were trained to perform 90-degree level turns in a stereotypical fashion and detailed three-dimensional (3D) kinematics were recorded at high speeds. Applying the angular momentum principle, we used mechanical modeling based on time-varying 3D inertia properties of individual sections of the pigeon's body to separate angular accelerations of the torso based on aerodynamics from those based on inertial effects. Directly measured angular accelerations of the torso were predicted by aerodynamic torques, justifying inferences of aerodynamic torque generation based on inside wing versus outside wing kinematics. Surprisingly, contralateral asymmetries in wing speed did not appear to underlie the 90-degree aerial turns, nor did contralateral differences in wing area, angle of attack, wingbeat amplitude, or timing. Instead, torso angular accelerations into the turn were associated with the outside wing sweeping more anteriorly compared to a more laterally directed inside wing. In addition to moving through a relatively more retracted path, the inside wing was also more strongly pronated about its long axis compared with the outside wing, offsetting any difference in aerodynamic angle of attack that might arise from the observed asymmetry in wing trajectories. Therefore, to generate roll and pitch torques into the turn, pigeons simply reorient their wing trajectories toward the desired flight direction. As a result, by acting above the center of mass, the net aerodynamic force produced by the wings is directed inward, generating the necessary torques for turning.
Predator-driven intra-species variation in locomotion, metabolism and water velocity preference in pale chub (Zacco platypus) along a river
Authors: Fu Cheng , Yuan Xing-Zhong , Cao Zhen-Dong , Fu Shi-Jian 
Published: December 2014

AbstractFish inhabit environments that vary greatly in terms of predation intensity, and these predation regimes are generally expected to be a major driver of divergent natural selection. To test whether there is predator-driven intra-species variation in the locomotion, metabolism and water velocity preference of pale chub (Zacco platypus) along a river, we measured unsteady and steady swimming and water velocity preference among fish collected from both high- and low-predation habitats in the Wujiang River. We also measured the routine metabolic rate (RMR), maximum metabolic rate (MMR) and cost of transport (COT) and calculated the optimal swimming speed (Uopt). The fish from the high-predation populations showed a shorter response latency, elevated routine metabolism, lower swimming efficiency at low swimming speed, and lower water velocity preference compared with those from the low-predation populations. Neither of the kinematic parameters fast-start and critical swimming speed (Ucrit) showed a significant difference between the high- and low-predation populations. The fish from the high-predation populations may improve their predator avoidance capacity primarily through an elevated routine metabolism and shorter response latency to achieve advanced warning and escape, rather than an improved fast-start swimming speed or acceleration. Thus, the cost of this strategy is an elevated RMR, and no trade-off between unsteady and steady swimming performance was observed in the pale chub population under various predation stresses. It was interesting to find that the high-predation fish showed an unexpected lower velocity preference, which might represent a compromise between predation avoidance, foraging and energy saving.