bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intertunnel Relationships in Combined Anterior Cruciate Ligament and Posterolateral Corner Reconstruction
Authors: Kim Sung-Jae , Chang Chong Bum , Choi Chong Hyuk , Yoo Yon-Sik , Kim Sung-Hwan , Ko Jae Han , Park Kwan Kyu 
Published: March 2013

Background: Combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) injuries are relatively common, and tunnel convergence could occur in combined ACL and PLC reconstruction. Purpose: This study sought to elucidate the ranges of angles and distances of lateral collateral ligament (LCL) and popliteus tendon (PT) femoral tunnels that do not violate the intercondylar notch distally and ACL tunnels proximally during combined ACL and PLC reconstruction. Study Design: Descriptive laboratory study. Methods: Three-dimensional anatomic knee models were developed using customized software from computed tomography images of 14 patients at 0°, 90°, and 120° of flexion. Single-bundle (SB) and double-bundle (DB) ACL tunnels using the transtibial method for anteromedial bundles and the anteromedial portal method for posterolateral bundles were created. The ranges of safe angles and distances were measured at 10° and 20° posterior, neutral (0°), and 10° and 20° anterior on the horizontal plane relative to the transepicondylar axis from the isometric LCL and PT femoral insertions. The SB ACL reconstruction using the accessory medial portal and LCL reconstruction using the anatomic footprint were also analyzed. Results: Distal and proximal angles from insertions of the LCL and PT, not violating the intercondylar notch or the ACL tunnels, increased as the LCL or PT headed from a posterior to anterior direction. Safe distances from the LCL and PT femoral insertions were approximately over 35 mm distally and 30 mm proximally. For SB ACL reconstruction using the accessory medial portal, safe angles were larger proximally than those of SB ACL reconstruction using the transtibial technique. For LCL reconstruction using the anatomic footprint, proximal angles were significantly smaller than those of the isometric LCL. Conclusion: Considering the relationship between the LCL and PT tunnels and fixation strength, tunneling will be safe when the LCL and PT are positioned at an angle of approximately 20° anterior and 10° proximal to the transepicondylar axis. Clinical Relevance: These results will help to reduce the incidence of tunnel convergence in combined ACL and PLC reconstructions.
Combined Trochleoplasty and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocations in Severe Trochlear Dysplasia
Authors: Nelitz Manfred , Dreyhaupt Jens , Lippacher Sabine 
Published: March 2013

Background: Trochlear dysplasia is an important etiological factor for the development of patellofemoral instability. Because a dislocation of the patella as a result of trochlear dysplasia results in a traumatic disruption of the medial patellofemoral ligament (MPFL), a combined trochleoplasty and patellofemoral ligament reconstruction appears to be the most appropriate procedure to treat patients with severe trochlear dysplasia. Hypothesis: Combined trochleoplasty and anatomic reconstruction of the MPFL will prevent redislocations of the patella and will lead to improved knee function. Study Design: Case series; Level of evidence, 3. Methods: Twenty-three consecutive patients (26 knees) with patellofemoral instability and severe trochlear dysplasia underwent combined trochleoplasty and anatomic reconstruction of the MPFL. Preoperative radiographic examination included anteroposterior and lateral views to assess patella alta. Magnetic resonance imaging was performed to evaluate trochlear dysplasia and the tibial tubercle–trochlear groove (TT-TG) distance. Evaluations included the detection of cartilage injuries, preoperative and postoperative physical examinations, and scores for the visual analog scale (VAS), Kujala knee function, International Knee Documentation Committee (IKDC), activity rating scale (ARS), and Tegner activity scale. Results: The mean age at the time of operation was 19.2 years (range, 15.4-23.6 years). The mean follow-up after operation was 2.5 years after surgery (range, 2.0-3.5 years). No recurrent dislocation occurred postoperatively. Kujala scores improved from 79 to 96, IKDC scores from 74 to 90, and VAS scores from 3 to 1. All improvements were highly statistically significant ( P < .01). The activity level according to the Tegner activity scale and the ARS decreased but was not statistically significant ( P = .06 and P = .21, respectively). There were 95.7% of the patients who were satisfied or very satisfied with the procedure. Conclusion: Combined anatomic reconstruction of the MPFL and trochleoplasty reliably improved the stability of the patellofemoral joint in patients with severe trochlear dysplasia and no or mild degenerative changes. In addition, the described procedure showed significant improvement of knee function and good patient satisfaction without any episode of redislocations of the patella.
Minimally Invasive Reconstruction of Chronic Achilles Tendon Ruptures Using the Ipsilateral Free Semitendinosus Tendon Graft and Interference Screw Fixation
Authors: Maffulli Nicola , Loppini Mattia , Longo Umile Giuseppe , Maffulli Gayle D. , Denaro Vincenzo 
Published: March 2013

Background: Achilles tendon ruptures represent more than 40% of all tendon ruptures requiring surgical management. About 20% of acute Achilles tendon tears are not diagnosed at the time of injury and become chronic, necessitating more complicated management than fresh injuries. Several techniques for the reconstruction of chronic tears of the Achilles tendon have been described, but the superiority of one technique over the others has not been demonstrated. Hypothesis: Mini-invasive reconstruction of the Achilles tendon, with a gap lesion larger than 6 cm, using the ipsilateral free semitendinosus tendon graft will result in improvement of the overall function with a low rate of complications. Study Design: Case series; Level of evidence, 4. Methods: Between 2008 and 2010, the authors prospectively enrolled 28 consecutive patients (21 men and 7 women; median age, 46 years) with chronic closed ruptures of the Achilles tendon who had undergone reconstruction with a free semitendinosus tendon graft. They assessed the Achilles tendon Total Rupture Score (ATRS), maximum calf circumference, and isometric plantarflexion strength before surgery and at the last follow-up. Outcome of surgery and rate of complications were also recorded. The median follow-up after surgery was 31.4 months. Results: The overall result of surgery was excellent/good in 26 (93%) of 28 patients. The ATRS improved from 42 (range, 29-55) to 86 (range, 78-95) ( P < .0001). In the operated leg, the maximum calf circumference and isometric plantarflexion strength were significantly improved after surgery ( P < .0001); however, their values remained significantly lower than those of the opposite side ( P < .0001). All patients were able to walk on tiptoes and returned to their preinjury working occupation. No infections were recorded. Conclusion: Mini-invasive reconstruction of the Achilles tendon, with a gap lesion larger than 6 cm, using the ipsilateral free semitendinosus tendon graft provides a significant improvement of symptoms and function, although calf circumference and ankle plantarflexion strength do not recover fully.
Preparation and properties of novel ultraviolet-cured waterborne polyurethanes
Authors: Fang Zhou , Zhou Meng , Zhong Jianfeng , Qi Yuanchun , Li Lingling , Dong Qingzhi 
Published: March 2013

A new ultraviolet (UV)-cured waterborne polyurethane (WPU) mainly composed of ionic soft segments, imide groups, and a new water-soluble UV-cured cross-linking agent containing both C=C bond and carboxy group was prepared. The ionic soft segments were prepared by 1,6-hexamethylene diisocyanate , poly(propylene glycol)-600, and dimethylol butanoic acid. The imide groups were introduced into polyurethane by extending them with pyromellitic dianhydride (PMDA). The new water-soluble UV-cured cross-linking agent (MLGLY) was synthesized by hydrophilic maleic anhydride and glycerol oligomer. The particle size and the viscosity of the new anionic WPU as well as the water swelling, gel content, mechanical properties, and thermal stability of the UV-cured WPU cast films were investigated. The results showed that the best performance of WPU was obtained with 0.024 mol of PMDA and 5 wt% of MLGLY.
Cesarean section and offspring’s risk of multiple sclerosis: a Danish nationwide cohort study
Authors: Nielsen Nete M , Bager Peter , Stenager Egon , Pedersen Bo V , Koch-Henriksen Nils , Hjalgrim Henrik , Frisch Morten 
Published: March 2013

Background: Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS. Objectives: We studied the association between C-section and risk of MS, in a cohort of 1.7 million Danes born from 1973 to 2005. Methods: Information on C-section and MS was obtained from the Danish Medical Birth Register and the Danish MS Register, respectively. The association between C-section and MS was evaluated by means of MS incidence rate ratios (RR) with 95% confidence intervals (CI) obtained in log-linear Poisson regression analyses. Results: There were 930 cases of MS in the study cohort, of whom 80 (9%) were delivered by C-section. Overall, we found there was no significant association between C-section and risk of MS (RR = 1.17; 0.92–1.46). Analyses stratified by sex revealed no unusual risk of MS for women (RR = 1.08: 0.80–1.42) nor men (RR = 1.37: 0.91–1.98). A supplementary sibling-matched Cox regression analysis likewise suggested there was no excess risk of MS in persons delivered by C-section (HR = 1.03; 0.63–1.69). Conclusions: Mode of delivery appears to be unimportant in relation to MS development in the offspring.
Does Theory Travel?
Authors: Dirani Khalil M. 
Published: March 2013

The Problem The dimensions of the learning organization (LO) culture have been accorded attention and have been assessed quantitatively in different contexts. Using a measurement instrument focusing on these dimensions is important. But qualitative scrutiny of the LO concept provides human resource practitioners a better understanding of the strengths and weaknesses of particular dimensions relevant in the Lebanese context. This can derive value added insights to the applicability of the LO. The Solution This article draws attention to the applicability of the LO concept in an international context. It explores the strengths and weaknesses of using the Dimensions of the Learning Organization Questionnaire (DLOQ) as a LO framework with special focus on particular dimensions most relevant in the Lebanese culture. The article provides suggestions for integrating LO best practices into local organizations, both at the individual and organizational levels. The Stakeholders Intended audience for this article includes human resource development (HRD) scholars, practitioners, and scholar-practitioners interested in the concept of the LO and in increasing the levels of learning climates in the workplace as a strategic leverage point within organizations.
Additional years of Australian Rural Clinical School undergraduate training is associated with rural practice
Authors: Forster Lesley , Assareh Hassan , Watts Lisa D , McLachlan Craig S 
Published: March 2013

Abstract

Background
To understand the influence of the number of years spent at an Australian rural clinical school (RCS) on graduate current, preferred current and intended location for rural workforce practice.

Methods
Retrospective online survey of medical graduates who spent 1–3 years of their undergraduate training in the University of New South Wales (UNSW) Rural Clinical School. Associations with factors (gender, rural versus non-rural entry, conscription versus non-conscript and number of years of RCS attendance) influencing current, preferred current and intended locations were assessed using χ2 test. Factors that were considered significant at P < 0.1 were entered into a logistic regression model for further analysis.

Results
214 graduates responded to the online survey. Graduates with three years of previous RCS training were more likely to indicate rural areas as their preferred current work location, than their colleagues who spent one year at an RCS campus (OR = 3.0, 95% CI = 1.2-7.4, P = 0.015). Also RCS graduates that spent three years at an RCS were more likely to intend to take up rural medical practice after completion of training compared to the graduates with one year of rural placement (OR = 5.1, 95% CI = 1.8-14.2, P = 0.002). Non-rural medicine entry graduates who spent three years at rural campuses were more likely to take up rural practice compared to those who spent just one year at a rural campus (OR = 8.4, 95% CI = 2.1-33.5, P = 0.002).

Conclusions
Increasing the length of time beyond a year at an Australian RCS campus for undergraduate medical students is associated with current work location, preferred current work location and intended work location in a rural area. Spending three years in a RCS significantly increases the likelihood of rural career intentions of non-rural students.
Early cardiac changes in a rat model of prediabetes: brain natriuretic peptide overexpression seems to be the best marker
Authors: Nunes Sara , Soares Edna , Fernandes João , Viana Sofia , Carvalho Eugénia , Pereira Frederico C , Reis Flávio 
Published: March 2013

Abstract

Background
Diabetic cardiomyopathy (DCM) is defined as structural and functional changes in the myocardium due to metabolic and cellular abnormalities induced by diabetes mellitus (DM). The impact of prediabetic conditions on the cardiac tissue remains to be elucidated. The goal of this study was to elucidate whether cardiac dysfunction is already present in a state of prediabetes, in the presence of insulin resistance, and to unravel the underlying mechanisms, in a rat model without obesity and hypertension as confounding factors.

Methods
Two groups of 16-week-old Wistar rats were tested during a 9 week protocol: high sucrose (HSu) diet group (n = 7) – rats receiving 35% of sucrose in drinking water vs the vehicle control group (n = 7). The animal model was characterized in terms of body weight (BW) and the glycemic, insulinemic and lipidic profiles. The following parameters were assessed to evaluate possible early cardiac alterations and underlying mechanisms: blood pressure, heart rate, heart and left ventricle (LV) trophism indexes, as well as the serum and tissue protein and/or the mRNA expression of markers for fibrosis, hypertrophy, proliferation, apoptosis, angiogenesis, endothelial function, inflammation and oxidative stress.

Results
The HSu-treated rats presented normal fasting plasma glucose (FPG) but impaired glucose tolerance (IGT), accompanied by hyperinsulinemia and insulin resistance (P < 0.01), confirming this rat model as prediabetic. Furthermore, although hypertriglyceridemia (P < 0.05) was observed, obesity and hypertension were absent. Regarding the impact of the HSu diet on the cardiac tissue, our results indicated that 9 weeks of treatment might be associated with initial cardiac changes, as suggested by the increased LV weight/BW ratio (P < 0.01) and a remarkable brain natriuretic peptide (BNP) mRNA overexpression (P < 0.01), together with a marked trend for an upregulation of other important mediators of fibrosis, hypertrophy, angiogenesis and endothelial lesions, as well as oxidative stress. The inflammatory and apoptotic markers measured were unchanged.

Conclusions
This animal model of prediabetes/insulin resistance could be an important tool to evaluate the early cardiac impact of dysmetabolism (hyperinsulinemia and impaired glucose tolerance with fasting normoglycemia), without confounding factors such as obesity and hypertension. Left ventricle hypertrophy is already present and brain natriuretic peptide seems to be the best early marker for this condition.
Mast cells and the liver aging process
Authors: Grizzi Fabio , Di Caro Giuseppe , Laghi Luigi , Hermonat Paul , Mazzola Paolo , Nguyen Diane D , Radhi Saba , Figueroa Jose A , Cobos Everardo , Annoni Giorgio , Chiriva-Internati Maurizio 
Published: March 2013

Abstract
It has now ascertained that the clinical manifestations of liver disease in the elderly population reflect both the cumulative effects of longevity on the liver and the generalized senescence of the organism ability to adjust to metabolic, infectious, and immunologic insults. Although liver tests are not significantly affected by age, the presentation of liver diseases such as viral hepatitis may be subtler in the elderly population than that of younger patients.
Human immunosenescence is a situation in which the immune system, particularly T lymphocyte function, deteriorates with age, while innate immunity is negligibly affected and in some cases almost up-regulated.
We here briefly review the relationships between the liver aging process and mast cells, the key effectors in a more complex range of innate immune responses than originally though.
The spatial ecology of free-ranging domestic pigs (Sus scrofa) in western Kenya
Authors: Thomas Lian F , de Glanville William A , Cook Elizabeth A , Fèvre Eric M 
Published: March 2013

Abstract

Background
In many parts of the developing world, pigs are kept under low-input systems where they roam freely to scavenge food. These systems allow poor farmers the opportunity to enter into livestock keeping without large capital investments. This, combined with a growing demand for pork, especially in urban areas, has led to an increase in the number of small-holder farmers keeping free range pigs as a commercial enterprise. Despite the benefits which pig production can bring to a household, keeping pigs under a free range system increases the risk of the pig acquiring diseases, either production-limiting or zoonotic in nature. This study used Global Positioning System (GPS) technology to track free range domestic pigs in rural western Kenya, in order to understand their movement patterns and interactions with elements of the peri-domestic environment.

Results
We found that these pigs travel an average of 4,340 m in a 12 hr period and had a mean home range of 10,343 m2 (range 2,937–32,759 m2) within which the core utilisation distribution was found to be 964 m2 (range 246–3,289 m2) with pigs spending on average 47% of their time outside their homestead of origin.

Conclusion
These are the first data available on the home range of domestic pigs kept under a free range system: the data show that pigs in these systems spend much of their time scavenging outside their homesteads, suggesting that these pigs may be exposed to infectious agents over a wide area. Control policies for diseases such as Taenia solium, Trypanosomiasis, Trichinellosis, Toxoplasmosis or African Swine Fever therefore require a community-wide focus and pig farmers require education on the inherent risks of keeping pigs under a free range system. The work presented here will enable future research to incorporate movement data into studies of disease transmission, for example for the understanding of transmission of African Swine Fever between individuals, or in relation to the life-cycle of parasites including Taenia solium.
Pulmonary artery intimal sarcoma: poor 18F-fluorodeoxyglucose uptake in positron emission computed tomography
Authors: Lee Dong-Hyup , Jung Tae-Eun , Lee Jang-Hoon , Shin Dong-Gu , Park Won-Jong , Choi Jun-Hyuk 
Published: March 2013

Abstract
Intimal sarcoma of the pulmonary artery is a rare malignant tumor that may be misdiagnosed as chronic pulmonary thromboembolism, even if various imaging techniques are used. We report a case of a 58-year-old man with pulmonary artery intimal sarcoma.18F-fleuorodeoxyglucose (FDG) uptake was poor in the mass of the pulmonary artery, and no other hypermetabolic lesions were noted elsewhere. Our presumptive diagnosis was a massive mural thrombus and a concomitant chronic thromboembolism. Intravenous heparin and recombinant human tissue-type plasminogen activator was subsequently administered. However, the patient needed an emergency operation for sudden aggravation of the vital signs, and the tissue diagnosis was intimal sarcoma with poor clinical outcomes.
Histamine up-regulates fibroblast growth factor receptor 1 and increases FOXP2 neurons in cultured neural precursors by histamine type 1 receptor activation: conceivable role of histamine in neurogenesis during cortical development in vivo
Authors: Molina-Hernández Anayansi , Rodríguez-Martínez Griselda , Escobedo-Ávila Itzel , Velasco Iván 
Published: March 2013

Abstract

Background
During rat development, histamine (HA) is one of the first neuroactive molecules to appear in the brain, reaching its maximal value at embryonic day 14, a period when neurogenesis of deep layers is occurring in the cerebral cortex, suggesting a role of this amine in neuronal specification. We previously reported, using high-density cerebrocortical neural precursor cultures, that micromolar HA enhanced the effect of fibroblast growth factor (FGF)-2 on proliferation, and that HA increased neuronal differentiation, due to HA type 1 receptor (H1R) activation.

Results
Clonal experiments performed here showed that HA decreased colony size and caused a significant increase in the percentage of clones containing mature neurons through H1R stimulation. In proliferating precursors, we studied whether HA activates G protein-coupled receptors linked to intracellular calcium increases. Neural cells presented an increase in cytoplasmic calcium even in the absence of extracellular calcium, a response mediated by H1R. Since FGF receptors (FGFRs) are known to be key players in cell proliferation and differentiation, we determined whether HA modifies the expression of FGFRs1-4 by using RT-PCR. An important transcriptional increase in FGFR1 was elicited after H1R activation. We also tested whether HA promotes differentiation specifically to neurons with molecular markers of different cortical layers by immunocytochemistry. HA caused significant increases in cells expressing the deep layer neuronal marker FOXP2; this induction of FOXP2-positive neurons elicited by HA was blocked by the H1R antagonist chlorpheniramine in vitro. Finally, we found a notable decrease in FOXP2+ cortical neurons in vivo, when chlorpheniramine was infused in the cerebral ventricles through intrauterine injection.

Conclusion
These results show that HA, by activating H1R, has a neurogenic effect in clonal conditions and suggest that intracellular calcium elevation and transcriptional up-regulation of FGFR1 participate in HA-induced neuronal differentiation to FOXP2 cells in vitro; furthermore, H1R blockade in vivo resulted in decreased cortical FOXP2+ neurons.