bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Structure and Composition of 5 Ezra
Authors: Bergren Theodore A. 
Published: February 2010

Abstract5 Ezra (2 Esdras 1-2), an early Christian pseudepigraphical writing, describes God’s decision to abandon his originally chosen people and transfer his patrimony to a new, “coming” people. This paper argues that 5 Ezra represents a radically revisionist, Christian supersessionist reading of the apocryphal book of Baruch (1 Baruch). This reading was influenced by a number of other biblical sources, most notably Psalm 78, the synoptic gospels, Galatians 4:21-31, and the book of Revelation. The author of 5 Ezra drew overarching structural frameworks for his book from both the book of Baruch and Galatians 4:21-31, melding these two sets of structural principles into an integrated literary whole.
Implantation of Autogenous Meniscal Fragments Wrapped with a Fascia Sheath Enhances Fibrocartilage Regeneration in Vivo in a Large Harvest Site Defect
Authors: Kobayashi Yasukazu , Yasuda Kazunori , Kondo Eiji , Katsura Taro , Tanabe Yoshie , Kimura Masashi , Tohyama Harukazu 
Published: February 2010

Background Concerning meniscal tissue regeneration, many investigators have studied the development of a tissue-engineered meniscus. However, the utility still remains unknown. Hypothesis Implantation of autogenous meniscal fragments wrapped with a fascia sheath into the donor site meniscal defect may significantly enhance fibrocartilage regeneration in vivo in the defect. Study Design Controlled laboratory study. Methods Seventy-five mature rabbits were used in this study. In each animal, an anterior one-third of the right medial meniscus was resected. Then, the animals were divided into the following 3 groups of 25 rabbits each: In group 1, no treatment was applied to the meniscal defect. In group 2, the defect was covered with a fascia sheath. In group 3, after the resected meniscus was fragmented into small pieces, the fragments were grafted into the defect. Then, the defect with the meniscal fragments was covered with a fascia sheath. In each group, 5 rabbits were used for histological evaluation at 3, 6, and 12 weeks after surgery, and 5 rabbits were used for biomechanical evaluation at 6 and 12 weeks after surgery. Results Histologically, large round cells in group 3 were scattered in the core portion of the meniscus-shaped tissue, and the matrix around these cells was positively stained by safranin O and toluisin blue at 12 weeks. The histological score of group 3 was significantly higher than that of group 1 and group 2. Biomechanically, the maximal load and stiffness of group 3 were significantly greater than those of groups 1 and 2. Conclusion This study clearly demonstrated that implantation of autogenous meniscal fragments wrapped with a fascia sheath into the donor site meniscal defect significantly enhanced fibrocartilage regeneration in vivo in the defect at 12 weeks after implantation in the rabbit. Clinical relevance This study proposed a novel strategy to treat a large defect after a meniscectomy.
Treatment of the Unstable Ankle with an Osteochondral Lesion
Authors: Gregush Ronald V. , Ferkel Richard D. 
Published: February 2010

Background Few reports have studied the treatment of osteochondral lesions of the talus (OLTs) in the setting of lateral ankle instability. Hypothesis Arthroscopic treatment of an OLT and lateral ankle stabilization in the same sitting is safe and leads to reliable improvement of symptoms. Study Design Case series; Level of evidence, 4. Methods Of 37 patients who underwent concomitant treatment of an OLT and lateral ankle stabilization, 31 (84%) were evaluated at a mean of 7.3 years postoperatively. Patients were evaluated by physical examination, the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, the modified Weber Scale, the Single Assessment Numeric Evaluation, the Berndt and Harty Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Results The average postoperative ankle-hindfoot score was 89, the mean modified Weber score was 85, and the mean Single Assessment Numeric Evaluation was 86. In sum, 74% of patients had a good result on the Berndt and Harty Scale, 23% had a fair result, and 3% had a poor result. Of the short-form survey, the mean physical function score was 86.5, and the mean summary physical component score was 52.3. For the 13 patients for whom prospective ankle-hindfoot scores were available, a statistically significant improvement was seen, from 75 points preoperatively to 91 points postoperatively (P < .001). Conclusion Simultaneous arthroscopic treatment of an OLT and open lateral ankle stabilization is a safe and effective procedure. The presence of an osteochondral lesion had a negative effect on the overall result when compared to that of patients who underwent lateral ankle stabilization as an isolated procedure.
Combined Flexor-Pronator Mass and Ulnar Collateral Ligament Injuries in the Elbows of Older Baseball Players
Authors: Osbahr Daryl C. , Swaminathan Swarup S. , Allen Answorth A. , Dines Joshua S. , Coleman Struan H. , Altchek David W. 
Published: February 2010

Background Ulnar collateral ligament reconstruction techniques have afforded baseball players up to a reported 90% return to prior or higher level of play. A subpopulation exists with less impressive clinical outcomes potentially related to the presence of a concomitant flexor-pronator mass injury. Hypothesis/Purpose Combined flexor-pronator and ulnar collateral ligament injuries occur in older players, and results in this group are inferior to those reported for isolated ulnar collateral ligament reconstructions. Study Design Case Series; Level of evidence, 4. Methods All baseball players who had ulnar collateral ligament reconstructions by 1 surgeon over a 6-year period were identified, and the authors studied those treated for a combined flexor-pronator and ulnar collateral ligament injury. The ulnar collateral ligament reconstruction was accomplished using the docking technique, and the flexor-pronator injury was treated with debridement if tendinotic or reattachment if torn. A 2-sample t test was conducted to evaluate the likelihood of developing the combined flexor-pronator/ulnar collateral ligament compared with ulnar collateral ligament injury based on age, while a Pearson χ 2 test was used to evaluate the likelihood of a patient being ≥30 years of age in the combined flexor-pronator/ulnar collateral ligament versus ulnar collateral ligament groups. Outcome was assessed using a modified Conway classification. Results A total of 187 male baseball players between 14 and 42 years of age (mean, 20.7 years) had an ulnar collateral ligament reconstruction by 1 surgeon. Eight (4%) of 187 baseball players were treated for the combined flexor-pronator/ulnar collateral ligament injury. There was a statistically significant difference in age between the ulnar collateral ligament group (20.1 years) and the flexor-pronator/ulnar collateral ligament group (33.4 years) (P < .001). Age ≥30 years was a statistically significant age limit to predict the presence of a combined flexor-pronator/ulnar collateral ligament injury (88%) compared with an isolated ulnar collateral ligament injury (1%) (P < .001). Outcomes were 1 excellent (12.5%), 2 fair (25%), and 5 poor (62.5%). Conclusion Combined fflexor-pronator and ulnar collateral ligament injuries in baseball players may portend a worse prognosis, with a 12.5% return to prior level of play. Older age (≥30 years) is a risk factor in the development of this combined injury. When combined flexor-pronator/ulnar collateral ligament injury is suspected preoperatively, patients should be counseled on expected outcomes appropriately.
Epidemiology of Weight Training-Related Injuries Presenting to United States Emergency Departments, 1990 to 2007
Authors: Kerr Zachary Y. , Collins Christy L. , Dawn Comstock R. 
Published: February 2010

Background As participation in weight training in the United States increases, the number of persons at injury risk increases. Purpose To examine weight training-related injuries in patients presenting to US emergency departments from 1990 to 2007. Study Design Descriptive epidemiology study. Methods Weight training-related injury data were analyzed from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System. Sample weights provided by this organization calculated national estimates of weight training-related injuries from the 100-hospital sample. Results From 1990 to 2007, 25 335 weight training injuries were seen in US emergency departments, correlating to an estimated 970 801 injuries nationwide. Patients’ mean age was 27.6 years (range, 6-100 years); 82.3% were male. The upper trunk (25.3%) and lower trunk (19.7%) were the most commonly injured body parts. The most common diagnosis was sprain/strain (46.1%). The most common mechanism of injury was weights dropping on the person (65.5%). A large number of injuries occurred with free weights (90.4%). Males had a larger proportion of upper trunk injuries (26.8%; injury proportion ratio [IPR], 1.45; 95% confidence interval [CI]: 1.36-1.57; P < .001) than females (18.4%). Females had a larger proportion of foot injuries (22.9%; IPR, 2.09; 95% CI: 1.93-2.26; P < .001) than males (11.0%). Persons 12 years and younger had a larger proportion of hand (37.9%; IPR, 2.08; 95% CI: 1.76-2.46; P < .001) injuries than persons 13 years or older (18.2%). Persons 55 years and older were injured more when using machines (18.2%; IPR, 1.96; 95% CI: 1.47-2.61, P < .001) than persons 54 years and younger (9.3%). Persons using free weights sustained a greater proportion of fractures/dislocations (23.6%; IPR, 2.44; 95% CI: 1.92-3.09; P < .001) than persons using machines (9.7%). Conclusion Further research is needed to drive development of targeted, age- and gender-specific, evidence-based injury prevention strategies to decrease injury rates among weight training participants.
Tunnel Position and Relationship to Postoperative Knee Laxity after Double-Bundle Anterior Cruciate Ligament Reconstruction with a Transtibial Technique
Authors: Tsuda Eiichi , Ishibashi Yasuyuki , Fukuda Akira , Yamamoto Yuji , Tsukada Harehiko , Ono Shuichi 
Published: February 2010

Background Several laboratory studies have pointed out a potential risk of femoral tunnel misplacement in anterior cruciate ligament reconstruction with a transtibial technique. The tunnel malposition away from the anatomic attachment may result in increased postoperative knee laxity in double-bundle reconstruction. Purpose This study was conducted to evaluate the femoral and tibial tunnel positions in transtibial double-bundle reconstruction, and to determine the relationship between the tunnel positions and the results of the postoperative knee laxity examinations. Study Design Case series; Level of evidence, 4. Methods Fifty-three of 71 patients who underwent transtibial double-bundle reconstruction from 2004 to 2005 were followed more than 24 months. The tunnel positions for the anteromedial and posterolateral grafts were measured using 3-dimensional computed tomography images applying the quadrant method. The postoperative knee laxity was examined with the KT-1000 arthrometer manual maximum test, anterior drawer test, and pivot-shift test. Results The deep-shallow position (parallel to Blumensaat's line) and high-low position (perpendicular to Blumensaat's line) of the femoral tunnels were 27.7% ± 5.6% from the most posterior condylar contour and 16.3% ± 5.2% from Blumensaat's line for the anteromedial graft, and 35.5% ± 6.4% and 48.0% ± 5.4% for the posterolateral graft. The medial-lateral and anterior-posterior positions of the tibial tunnels were 46.1% ± 2.6% from the most medial contour and 36.5% ± 4.9% from the most anterior contour for the anteromedial graft, and 47.5% ± 3.1% and 51.6% ± 5.0% for the posterolateral graft. There was no statistical correlation between any parameters of the femoral or tibial tunnel position and the results of the knee laxity tests. Conclusion The femoral tunnels placed in transtibial double-bundle reconstruction were located appropriately in high-low and deep-shallow orientation, but had larger variability than the previously reported data of the anatomic femoral attachment. However, the variability of the femoral tunnel position was not so large as to result in graft insufficiency with increased postoperative knee laxity.
Chronic Ankle Instability Alters Central Organization of Movement
Authors: Hass Chris J. , Bishop Mark D. , Doidge Douglas , Wikstrom Erik A. 
Published: February 2010

Background Chronic ankle instability alters spinal level sensorimotor function and is hypothesized to alter supraspinal motor control mechanisms. Gait initiation is a functional task modulated by supraspinal pathways, but the effect of chronic ankle instability, a peripheral musculoskeletal impairment, on gait initiation and thus supraspinal motor control mechanisms remains unknown. Purpose This study was conducted to determine if supraspinal aspects of motor control are altered in subjects with chronic ankle instability. Study Design Controlled laboratory study. Methods Subjects with chronic ankle instability (5 males, 15 females; age, 20.5 ± 1.0 years; height, 169.8 ± 9.8 cm; weight, 74.2 ± 20.2 kg) and uninjured controls (4 males, 16 females; age, 20.85 ± 1.6 years; height, 164.3 ± 7.9 cm; weight, 64.2 ± 10.62 kg) completed 5 gait initiation trials for each leg at a self-selected pace. The resulting trajectory of the center of pressure trace was investigated and peak center of pressure excursions in the anteroposterior and mediolateral directions, peak resultant center of pressure excursions, and average direction-specific velocities were calculated. Results Significant group × limb interactions were noted during the first (resultant center of pressure displacement [F1,37 = 4.60, P = .04]) and second (mediolateral center of pressure displacement [F1,37 = 3.82, P = .05]) period of gait initiation. Center of pressure displacement was reduced (impaired) in the involved limb of the chronic ankle instability group (resultant, 0.29 ± 0.02; mediolateral, 0.72 ± 0.02) relative to the uninvolved limb of the chronic ankle instability group (resultant, 0.32 ± 0.02; mediolateral, 0.76 ± 0.02) and both limbs of the control group (resultant, 0.32 ± 0.02; mediolateral, 0.74 ± 0.02) when the involved limb of the chronic ankle instability group served as the initial stance limb. Conclusion These interactions suggest that supraspinal motor control mechanisms are altered in subjects with chronic ankle instability to place a greater emphasis on reducing the postural demands on the involved limb. Clinical Relevance These changes suggest that supraspinal adaptations to motor control may be an important contributor to the underlying neurophysiologic mechanism of chronic ankle instability. The presence of supraspinal adaptations in subjects with chronic ankle instability also indicates that health care providers and rehabilitation specialists treat chronic ankle instability as a global/central and not just a local/peripheral injury.
Single-Tunnel Double-Bundle Anterior Cruciate Ligament Reconstruction with Anatomical Placement of Hamstring Tendon Graft
Authors: Gadikota Hemanth R. , Wu Jia-Lin , Seon Jong Keun , Sutton Karen , Gill Thomas J. , Li Guoan 
Published: February 2010

Background Anatomical reconstruction techniques that can restore normal joint kinematics without increasing surgical complications could potentially improve clinical outcomes and help manage anterior cruciate ligament injuries more efficiently. Hypothesis Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can more closely restore normal knee anterior-posterior, medial-lateral, and internal-external kinematics than can conventional single-bundle anterior cruciate ligament reconstruction. Study Design Controlled laboratory study. Methods Kinematic responses after single-bundle anterior cruciate ligament reconstruction and single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft were compared with the intact knee in 9 fresh-frozen human cadaveric knee specimens using a robotic testing system. Kinematics of each knee were determined under an anterior tibial load (134 N), a simulated quadriceps load (400 N), and combined torques (10 N·m valgus and 5 N·m internal tibial torques) at 0°, 15°, 30°, 60°, and 90° of flexion. Results Anterior tibial translations were more closely restored to the intact knee level after single-tunnel double-bundle reconstruction with anatomical placement of hamstring tendon graft than with a single-bundle reconstruction under the 3 external loading conditions. Under simulated quadriceps load, the mean internal tibial rotations after both reconstructions were lower than that of the anterior cruciate ligament—intact knee with no significant differences between these 3 knee conditions at 0° and 30° of flexion (P > .05). The increased medial tibial shifts of the anterior cruciate ligament—deficient knees were restored to the intact level by both reconstruction techniques under the 3 external loading conditions. Conclusion Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can better restore the anterior knee stability compared with a conventional single-bundle reconstruction. Both reconstruction techniques are efficient in restoring the normal medial-lateral stability but overcorrect the internal tibial rotations. Clinical Relevance Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft could provide improved clinical outcomes over a conventional single-bundle reconstruction.
Effects of Fatigue Due to Contraction of Evertor Muscles on the Ankle Joint Position Sense in Male Soccer Players
Authors: Mohammadi Farshid , Roozdar Arash 
Published: February 2010

Background The high incidence of ankle sprains that occur later in matches suggests that fatigue may contribute to altered neuromuscular control of the ankle. Moreover, deficits in ankle joint position sense (JPS) were seen in patients with a history of recurrent ankle sprains. It has been hypothesized that ankle sprains may be related to altered ankle JPS as a consequence of fatigue. Purpose To evaluate if fatiguing contractions of evertor muscles alter the ankle JPS. Study Design Controlled laboratory study. Methods Thirty-six soccer players (age, 24.7 ± 1.3 years; height, 183.7 ± 8.2 cm; weight, 78.9 ± 7.9 kg) were recruited. Subjects were asked to recognize 2 positions (15° of inversion and maximal active inversion minus 5°) for 2 conditions: normal and fatigue. Muscular fatigue was induced in evertor muscles of the dominant leg by using isometric contractions. The average of the absolute and variable errors of 3 trials were recorded for both fatigue and nonfatigue conditions. A matched control group of 36 soccer players (age, 23.9 ± 0.9 years; height, 181.2 ± 6.9 cm; weight, 77.8 ± 6.5 kg) was asked to recognize the same positions, before a soccer match and after 45 minutes of playing, and their same scores were recorded. Finally, results of the 2 groups were compared. Results There was significant decrease in subjects’ ability to recognize passive and active repositioning of their ankle after a fatigue protocol (P < .001). Passive and active JPS were reduced after playing (P < .001). There was no significant difference between 2 groups in the results of JPS before and after the intervention (P > .1). Conclusion The acuity of the ankle JPS is reduced subsequent to a fatigue protocol and after a soccer match. Clinical Relevance Evaluation of athletes’ ankle JPS before returning to physical activity may prevent further injuries.
Expression of Sensory Neuropeptides in Tendon is Associated with Failed Healing and Activity-Related Tendon Pain in Collagenase-Induced Tendon Injury
Authors: Lui Pauline Po-Yee , Chan Lai-shan , Fu Sai-chuen , Chan Kai-ming 
Published: February 2010

Background Increase in expression of substance P (SP) and calcitonin gene-related peptide (CGRP) has been reported in clinical samples of tendinopathy. Purpose To examine the spatial-temporal expression of these neuropeptides as well as their association with activity-related tendon pain, matrix degeneration, failed healing, and pathologic calcification in an established collagenase-induced tendon injury rat model. Study Design Controlled laboratory study. Methods Collagenase or saline was injected into the patellar tendon of rats. At weeks 2, 4, 8, 12, and 16, just before the rats were sacrificed, the double-stance duration of rats was examined by gait analysis method. After sacrifice, the patellar tendons were harvested for histologic analysis and immunohistochemical staining of SP and CGRP. Results There was an increase of SP and CGRP immunopositivity in tendon fibroblasts at week 2. The immunopositive signals decreased at weeks 4 and 8 and were observed in chondrocyte-like cells. At weeks 12 and 16, the immunopositive staining increased again and was observed in cells embedded in calcific deposits in addition to tendon fibroblasts and chondrocyte-like cells. The expression pattern was consistent with matrix degeneration, calcification, and failed healing in the animal model. There were significant positive correlations of immunopositivity of SP (rho = .502, P = .002) and CGRP (rho = .483, P = .003) with double-stance duration after collagenase injection. Conclusion There was increased expression of SP and CGRP after collagenase-induced tendon injury, and their expression was positively associated with double-stance duration. Clinical Relevance Substance P and CGRP might be involved in the pathogenesis and origin of pain of tendinopathy and could be the targets for future intervention.
Gas6 deficiency in recipient mice of allogeneic transplantation alleviates hepatic graft-versus-host disease
Authors: Burnier Laurent , Saller François , Kadi Linda , Brisset Anne C. , Sugamele Rocco , Baudino Lucie , Bono Françoise , Herbert Jean-Marc , Carmeliet Peter , Schapira Marc , Izui Shozo , Angelillo-Scherrer Anne 
Published: February 2010

AbstractGrowth arrest-specific gene 6 (Gas6) is expressed in antigen-presenting cells and endothelial cells (ECs) but not in T cells. When wild-type (WT) or Gas6−/− mice received allogeneic non–T cell–depleted bone marrow cells, hepatic graft-versus-host disease (GVHD) was alleviated in Gas6−/− recipients regardless of donor genotype, but not in WT recipients. T-cell infiltration was more prominent and diffuse in WT than in Gas6−/− recipients' liver. When mice received 0.5 × 106 allogeneic T cells with T cell–depleted allogeneic bone marrow, clinical signs indicated that GVHD was less severe in Gas6−/− than in WT recipients, as shown by a significant improvement of the survival and reduced liver GVHD. These data demonstrate that donor cells were not involved in the protection mechanism. In addition, lack of Gas6 in antigen-presenting cells did not affect WT or Gas6−/− T-cell proliferation. We therefore assessed the response of WT or Gas6−/− ECs to tumor necrosis factor-α. Lymphocyte transmigration was less extensive through Gas6−/− than WT ECs and was not accompanied by increases in adhesion molecule levels. Thus, the lack of Gas6 in ECs impaired donor T-cell transmigration into the liver, providing a rationale for considering Gas6 pathway as a potential nonimmunosuppressive target to minimize GVHD in patients receiving allogeneic hematopoietic stem cell transplantation.