bluuebunny/crossref_metadata_2025_split huggingface dataset:
Return to Sports and Subsequent Injury Rates After Revision Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft
Authors: Shelbourne K. Donald , Benner Rodney W. , Gray Tinker 
Published: March 2014

Background: The return-to-sport and reinjury rates are not well defined after revision anterior cruciate ligament (ACL) reconstruction. Hypothesis: School-age athletes would have a higher rate of return to sports and reinjury to either knee after revision ACL surgery compared with college or recreational athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Patients were prospectively studied after revision ACL reconstruction with bone-patellar tendon-bone (BPTB) autograft. Participants were grouped by competitive sport levels of school age (mean age, 16.6 ± 0.9 years; n = 84), college (19.6 ± 1.2 years; n = 58), or recreational adult (27.6 ± 4.1 years; n = 117). An activity survey was used to determine the specific sport and sport level patients participated in before and after surgery. The International Knee Documentation Committee (IKDC) knee survey and Cincinnati Knee Rating System (CKRS) survey responses were also obtained. Results: The rate of return to the same sport at the same level was 62 of 84 school-age athletes (74%), 43 of 58 college athletes (74%), and 73 of 117 recreational athletes (62%) ( P = .1065). The number of patients who had a subsequent ACL graft tear rate after revision surgery was 2 of 84 (2.3%) in the high school group, 3 of 58 (5.1%) in the college group, and 4 of 117 (3.4%) in the recreational group ( P = .6706). The number of patients who had a subsequent ACL tear in the contralateral knee was 1 of 84 (1.1%) in the school-age group, 1 of 58 (1.7%) in the college group, and 2 of 117 (1.7%) in the recreational group ( P = .9501). At 2 years postoperatively, the mean IKDC subjective total score was 86.1 ± 11.7 points and the mean CKRS total score was 89.7 ± 11.1 points. Conclusion: Revision ACL reconstruction with BPTB autograft and perioperative rehabilitation allowed high school and college athletes to return to sports at the preinjury level at a rate of 74%; the return rate for recreational-level adults was 62%. Reinjury rates in the first 5 years after revision surgery ranged from 2% to 5%, which is lower than what has been reported for young competitive athletes after primary surgery.
Breastfeeding Knowledge, Attitudes, and Intention in a Sample of Undergraduate Students in Mainland China
Authors: Lou Zixin , Zeng Guo , Orme John G. , Huang Lujiao , Liu Fang , Pang Xuehong , Kavanagh Katherine F. 
Published: March 2014

Background: Despite the high breastfeeding initiation rate in China (> 90%), the low exclusivity rate is of concern. Some traditional behaviors, combined with increasing popularity of infant formula, may negatively affect future breastfeeding rates. As suggested by the theory of planned behavior, understanding breastfeeding beliefs of young adults may help identify and address misperceptions of future parents, supporting maintenance of the current initiation rate while increasing rates of exclusivity and duration. No research has evaluated these factors among young adults in Mainland China. Objective: The objective was to explore any relationships between breastfeeding knowledge, attitudes, previous experiences, and future intention among undergraduate students in Mainland China. Methods: This was a cross-sectional, quantitative study conducted from May to June 2012. A convenience sample of 395 students from a major public university in southwest China participated in the survey. Results: Breastfeeding knowledge was moderate (76.7% of total score), and breastfeeding was considered to be painful (34.2%), to make breasts sag (43.1%), and to restrict the freedom of mothers (52.5%). In addition, 58.2% of students reported that they would feel embarrassed if they or their partners were to breastfeed in public, and acceptability of breastfeeding in public was low (34.7%). Three-fourths of the students (75.1%) expressed future breastfeeding intent, though males were more likely to report this intention (ie, to support a partner in breastfeeding) than were females (81.3% vs 71.7%, P = .04). Conclusion: To create a more breastfeeding-friendly culture, future research is warranted to explore these negative beliefs about breastfeeding and to counter misunderstandings among future parents in Mainland China.
A qualitative analysis of barriers to accessing HIV/AIDS-related services among newly diagnosed HIV-positive men who have sex with men in China
Authors: Li Haochu (Howard) , Holroyd Eleanor , Li Xiaoming , Lau Joseph 
Published: March 2014

Summary In China, specific HIV/AIDS-related services have been in place since 2004. However, utilisation of these services remains limited among people living with HIV. We explored barriers to accessing HIV/AIDS-related services from the perspective of newly diagnosed HIV-positive men who have sex with men. We conducted repeated in-depth interviews with 31 newly diagnosed HIV-positive men who have sex with men, using the socio-ecological framework and thematic content analysis. Multiple barriers for utilisation of HIV/AIDS-related services were identified, including perceptions of subjective health and poor quality of services, mental and emotional health problems, lack of trust and understanding of the services on offer, low economic status, lack of insurance, and high medical fees, being refused access to services, and restrictive attendance policies. The findings provide information on potential multi-level obstacles preventing newly diagnosed HIV-positive men who have sex with men to use services that they need. It is recommended that policy makers should create a trustful and non-discriminating environment and services integrating physical and mental healthcare.
ICT Based Health Governance Practices
Authors: Nair Pradeep 
Published: March 2014

Electronic health commonly described as the health sector use of information and communication technology (ICT), has rapidly spread around the world. Increased use of ICT is stimulating the technology insertion into the health sector and is enabling the effective functioning of public health systems. A steering committee on health constituted by the Planning Commission suggested in its report for the 12th Plan (2012–17) that all the district hospitals, primary health centres and sub centres should be linked to leading tertiary care centres through telemedicine, Skype and similar audio visual media. The committee also urged to give utmost importance to M-health, that is, use of mobile phones as communication tool for health development. The study intends to discuss the promotion of increased use of information and communication technologies in health care systems to improve efficiency, access and accountability of health care services in India. The study deals with some references from India which underscore the developments of ICT based health governance and discuss the policies at both national and regional level to shed light on the potential of e-health in improvising the delivery of health care services at domestic level. The purpose of this study is to relay that the effective implementation of information and communication technologies can make health care services more accessible to the all the sections of the society and will help the government and other stake holders in health services to align their services with the increasing needs of good health.
What Motivates Government Doctors in India to Perform Better in their Job?
Authors: Bhatia Shalini , Purohit Bhaskar 
Published: March 2014

Objectives: Addressing the issue of poor motivation of Medical Officers (MOs) to join and continue service in rural India is a major challenge faced by the health system. The present study aimed at assessing the driving factors of motivation for MOs working with rural government health centres in India. The study also aimed at finding out the differences in the preferred factors of motivation based on various job-related aspects of the respondents. Methods: The study participants included MOs from Gujarat, India. The study asked the participants to rank 20 factors of motivation (10 intrinsic and 10 extrinsic motivation factors) important for them to continue in their current job. The factors for the study were selected using Herzberg’s two factor theory of motivation and the data was collected with the help of an instrument that has an established reliability and validity. Distribution of ranks of different motivating factors was studied using average ranks assigned by respondents based on different job-related aspects. Average scores were also calculated to see whether the respondents are motivated more by extrinsic factors or by intrinsic factors. Results: The results indicate that ‘job security’ was the most preferred factor of motivation followed by ‘adequate salary’ while, the least preferred factor for motivation was ‘local political interference’. Adequate salary and job security also emerged as the two most important motivation factors for all the three groups of respondents based on number of years of work experience. For Ad hoc MOs, ‘adequate salary’ and ‘interesting work’ were the most important motivation factors while for bonded category of MOs, ‘adequate salary’ and ‘opportunities for promotion’ were the two most important factors for motivation. Conclusion: The current study concludes that MOs motivation to continue with the current job is driven both by extrinsic and intrinsic factors. Hence, the health departments and systems need to pay close attention to devising strategies that address both the extrinsic as well as intrinsic factors. However, according to study findings, more attention needs to be paid to providing Job security and better salaries and monetary benefits to MOs. The study results may be useful to health departments and systems to design management strategies that are based on motivational needs of MOs to improve their attraction and retention.
Using Campaigns to De-stigmatize Leprosy in India
Authors: Shrivastava Sangeeta 
Published: March 2014

Both health communication scholars and practitioners concede the seriousness of stigma in several disease contexts. But the literature on how to deal with it and possibly reduce or remove it is thin. The case of leprosy in the Indian state of Madhya Pradesh, however, illustrates a simple, innovative and community-grown strategy to combat stigma. Supported by the government and designed by the Danish International Development Agency’s Leprosy Unit (DANLEP), the strategy relied upon a small band of trained and motivated leprosy workers. Their main task, among other things, was mobilizing the community. The community was at first cautious, but it began to perceive the benefits in leprosy worker’s effort and argument, and began approaching the afflicted. The community’s concern transformed the patients’ worldview. They grew to be less ashamed of their health condition and themselves. The growing participation of the community in the state transformed leprosy into an ordinary treatable disease. This transformation did not come about at one go, but in slow, sometimes tentative, but measured steps. This article describes the process of demystifying leprosy. It shows how the three important stakeholders (3Ps)—persons with leprosy, persons with concern and providers of health services—forged a strategic alliance that not only helped eradicate leprosy but also deal with the more intractable issue of social stigma attached to the disease. If leprosy is a common ailment today, it is to a large extent due to community participation. The article emphasizes that if health problems are identified and approached through the community, not only are fears and misconceptions of community removed, but the community reinvents itself to bring about desirable changes.
Understanding Lunasin’s biology and potential as a cancer therapeutic by utilizingDrosophilagenetics
Authors: Jones Gillian , Srivastava Ajay 
Published: March 2014

Soy contains many bioactive molecules known to elicit anticancer effects. One such peptide, Lunasin, has been shown to selectively act on newly transformed cells while having no cytotoxic effect on non-tumorigenic or established cancer cell lines. While this effect on in vitro systems is promising, Lunasin’s efficacy in an in vivo system is yet to be assessed. In this review, we discuss the state of knowledge with respect to Lunasin and then review some of the powerful genetic tools available in Drosophila. The availability of a sophisticated genetic tool box makes Drosophila an excellent genetic model well suited to studying the biology of Lunasin and its effect on tumor progression in an in vivo model organism.
The Use of Computed Tomography Attenuation to Evaluate Osteoporosis Following Acute Fractures of the Thoracic and Lumbar Vertebra
Authors: Emohare Osa , Cagan Amanda , Morgan Robert , Davis Rick , Asis Martin , Switzer Julie , Polly David W. 
Published: March 2014

Background: Relatively few patients have dual-energy x-ray absorptiometry to quantify the magnitude of bone loss as they age. Recent work correlates mean computed tomography (CT) attenuation in the level I (L1) vertebra with bone mineral density (BMD), making it possible to objectively evaluate the magnitude of bone loss in osteoporosis by this method. The aims of this study were to evaluate the utility of using CT scans in patients with acute thoracic and lumbar spine fractures to diagnose osteoporosis and using CT attenuation to evaluate the association between age and BMD. Methods: We performed a retrospective study of patients with acute fractures of the thoracic or lumbar spine who had also undergone an abdominal (or L1) CT scan and compared mean CT attenuation in L1 against threshold values. We also compared differences in CT attenuation between younger (<65 years) and older (≥65 years) and older patients. Results: A total of 124 patients were evaluated (74 thoracic and 50 lumbar fractures). Overall, there was a strong correlation between age and bone density as measured by CT attenuation ( r = −.76). Among those with thoracic fractures (<65 years), mean CT attenuation was 196.51 HU. Forty-one patients were ≥65 years and had mean CT attenuation of 105.90 HU ( P < .001). In patients with lumbar fractures, 27 patients were <65 years and had a mean CT attenuation of 192.26 HU and 23 patients were ≥65 years and had mean CT attenuation of 114.31 HU ( P < .001). At the threshold of 110 HU, set for specificity, the magnitude of difference between the age-stratified cohorts was greater in the thoracic spine ( P < .0001 vs P = .003). Discussion: Using opportunistic CT, we demonstrate the relative frequency of osteoporosis in patients with acute fractures of the thoracic and lumbar spine and confirm that the association increases with age. The CT attenuation may provide a cheap and convenient method to help confirm a clinical diagnosis of osteoporosis in patients with fractures.
A Preliminary In Vivo Assessment of Anterior Cruciate Ligament–Deficient Knee Kinematics With the KneeM Device
Authors: Tardy Nicolas , Marchand Philippe , Kouyoumdjian Pascal , Blin Dominique , Demattei Christophe , Asencio Gérard 
Published: March 2014

Background: Methods of objectively measuring rotational knee laxity are either experimental or difficult to use in daily practice. A new method has been developed to quantitatively assess rotatory laxity using an open MRI system and new tool, the KneeM device. Purpose/Hypothesis: To perform a preliminary evaluation of a novel knee rotation measurement device to assess knee kinematics during flexion in an MRI field, in both anterior cruciate ligament (ACL)–deficient and healthy contralateral knees. The hypothesis was that the KneeM device would allow in vivo reproduction and analysis of knee kinematics during flexion in healthy and ACL-deficient knees. Study Design: Controlled laboratory study. Methods: Ten subjects (7 men and 3 women; mean age ± standard deviation, 32.3 ± 9.4 years) with ACL-deficient knees and contralateral uninjured knees participated in the study. An open MRI was performed with the KneeM device at a mean 4.9 months (range, 3.0-7 months) after ACL injury. The device exerted on the knee an anterior drawer force of 100 N, with an internal rotation of 20°, through the range of flexion (0°, 20°, 40°, and 60°). Both ACL-deficient and healthy contralateral knees were analyzed using the Iwaki method. Results: There was no statistical difference of anterior translation in the medial compartment between intact and ACL-deficient knees at all degrees of flexion. However, significant differences in the anterior translation of the lateral compartment were observed between ACL-deficient and intact contralateral knees at 0° and 20° of flexion ( P = .005 and P = .002, respectively). Between 20° and 40°, the lateral plateau of ACL-deficient knees translated 7.7 mm posteriorly, whereas the medial compartment remained stable, reflecting a sudden external rotation of the lateral plateau under the femoral condyle. Conclusion: This preliminary study suggests that measurement of tibiofemoral movements in both compartments during flexion using the KneeM device was useful for quantifying rotatory laxity in ACL-deficient knees. Moreover, this device seemed to allow a “mechanized pivot shift” and allowed reproduction of the “pivot” phase in the MRI field between 20° and 40° of flexion. Clinical Relevance: This device could be used for diagnostic purposes or to investigate the outcomes of ACL reconstructions.
Glucocorticoids induce the production of the chemoattractant CCL20 in airway epithelium
Authors: Zijlstra G. Jan , Fattahi Fatemeh , Rozeveld Dennie , Jonker Marnix R. , Kliphuis Nathalie M. , van den Berge Maarten , Hylkema Machteld N. , ten Hacken Nick H.T. , van Oosterhout Antoon J.M. , Heijink Irene H. 
Published: March 2014

Th17-mediated neutrophilic airway inflammation has been implicated in decreased response to glucocorticoids in asthma. We aimed to investigate the effect of glucocorticoids on the airway epithelial release of the neutrophilic and Th17-cell chemoattractant CCL20.We studied CCL20 and CXCL8 sputum levels in asthmatic subjects using inhaled glucocorticoids or not, and the effect of budesonide on CCL20 and CXCL8 production in primary bronchial epithelial cells. The mechanism behind the effect of budesonide-induced CCL20 production was studied in 16HBE14o- cells using inhibitors for the glucocorticoid receptor, intracellular pathways and metalloproteases.We observed higher levels of CCL20, but not CXCL8, in the sputum of asthmatics who used inhaled glucocorticoids. CCL20 levels correlated with inhaled glucocorticoid dose and sputum neutrophils. Budesonide increased tumour necrosis factor (TNF)-α-induced CCL20 by primary bronchial epithelium, while CXCL8 was suppressed. In 16HBE14o- cells, similar effects were observed at the CCL20 protein and mRNA levels, indicating transcriptional regulation. Although TNF-α-induced CCL20 release was dependent on the ERK, p38 and STAT3 pathways, the increase by budesonide was not. Inhibition of glucocorticoid receptor or ADAM17 abrogated the budesonide-induced increase in CCL20 levels.We show that glucocorticoids enhance CCL20 production by bronchial epithelium, which may constitute a novel mechanism in Th17-mediated glucocorticoid-insensitive inflammation in asthma.
Bismuth-induced effects on optical, lattice vibrational, and structural properties of bulk GaAsBi alloys
Authors: Sarcan Fahrettin , Dönmez Ömer , Kara Kamuran , Erol Ayse , Akalın Elif , Çetin Arıkan Mehmet , Makhloufi Hajer , Arnoult Alexandre , Fontaine Chantal 
Published: March 2014

Abstract
Bulk GaAs1 - x
Bi
x
/GaAs alloys with various bismuth compositions are studied using power- and temperature-dependent photoluminescence (PL), Raman scattering, and atomic force microscopy (AFM). PL measurements exhibit that the bandgap of the alloy decreases with increasing bismuth composition. Moreover, PL peak energy and PL characteristic are found to be excitation intensity dependent. The PL signal is detectable below 150 K at low excitation intensities, but quenches at higher temperatures. As excitation intensity is increased, PL can be observable at room temperature and PL peak energy blueshifts. The quenching temperature of the PL signal tends to shift to higher temperatures with increasing bismuth composition, giving rise to an increase in Bi-related localization energy of disorders. The composition dependence of the PL is also found to be power dependent, changing from about 63 to 87 meV/Bi% as excitation intensity is increased. In addition, S-shaped temperature dependence at low excitation intensities is observed, a well-known signature of localized levels above valence band. Applying Varshni’s law to the temperature dependence of the PL peak energy, the concentration dependence of Debye temperature (β) and thermal expansion coefficient (α) are determined. AFM observations show that bismuth islands are randomly distributed on the surface and the diameter of the islands tends to increase with increasing bismuth composition. Raman scattering spectra show that incorporation of Bi into GaAs causes a new feature at around 185 cm-1 with slightly increasing Raman intensity as the Bi concentration increases. A broad feature located between 210 and 250 cm-1 is also observed and its intensity increases with increasing Bi content. Furthermore, the forbidden transverse optical (TO) mode becomes more pronounced for the samples with higher bismuth composition, which can be attributed to the effect of Bi-induced disorders on crystal symmetry.

PACS

78.55Cr 78.55-m 78.20-e 78.30-j
Efficacy of a triage system to reduce length of hospital stay
Authors: Williams P. , Csipke E. , Rose D. , Koeser L. , McCrone P. , Tulloch A. D. , Salaminios G. , Wykes T. , Craig T. 
Published: March 2014

BackgroundAttempts have been made to improve the efficiency of in-patient acute care. A novel method has been the development of a ‘triage system’ in which patients are assessed on admission to develop plans for discharge or transfer to an in-patient ward.AimsTo compare a triage admission system with a traditional system.MethodLength of stay and readmission data for all admissions in a 1-year period between the two systems were compared using the participating trust's anonymised records.ResultsDespite reduced length of stay on the actual triage ward, the average length of stay was not reduced and the triage system did not lead to a greater number of readmissions. There was no significant difference in costs between the two systems.ConclusionsBased on our findings we cannot conclude that the triage system reduced length of stay, but we can conclude that it does not increase the number of readmissions as some have feared.