ACL Rupture in Collegiate Wrestler

Directory of Open Access Journals (Sweden)

Lindsay A. Palmer

2016-05-01

Full Text Available Objective: To educate others on unique Anterior Cruciate Ligament tears and percentage of usage of the ACL in normal daily function. Background: Patient is an eighteen year old male participating in wrestling and football at the time of the injury. Patient now only participates in wrestling. No previous knee or chronic injuries were reported prior to this injury. Patient was playing football during the time of injury. The patient stated that he planted his foot down and was tackled at the same time when the injury occurred. The patient felt his knee twist and buckle. Patient complained of clicking inside the knee and had minimal swelling. He also complained of it being difficult to bear weight at the time. The patient did not seek further treatment until two months after the injury occurred when he received an MRI. His MRI showed a positive finding for an Anterior Cruciate Ligament rupture. His previous Athletic Trainer could not find a positive diagnosis for the patient prior to the MRI. Differential Diagnosis: Possible meniscal or ACL injury. Treatment: Doctors officially diagnosed the injury as a complete rupture of the ACL. The patient did not receive surgery immediately. Doctors have stated that he only uses about 50% of his ACL on a daily basis compared to a normal person who uses about 95% of their ACL daily. Because of this, the patient played on his rupture for seven months before receiving surgery. He played a whole season of high school football and a whole season of wrestling his senior year with the ACL ruptured. The patient only used a brace for better comfort during the seven months. The patient then received reconstructive surgery to repair the rupture. A hamstring tendon graft was used to repair the ruptured ACL. Because a tendon was taken from the hamstring, patient experienced a tight ACL and hamstring of the left leg post-surgery. The patient participated in Physical Therapy for five months to strengthen and stretch the new

Développement d'un système visualisation des taux du HLT dans le système de supervision PVSS du LHCb

CERN Document Server

Menou, J-F

2008-01-01

At CERN, the Online group of the LHCb team is in charge of data acquisition and of the control system. Intersting data are selected by different triggers. The HLT, for High Level Trigger, is a distributed system which should reduce the rate of selected events from 1 MHz to 2 kHz. In order to monitor the HLT's work, some rates are published at different levels of the HLT using the DIM system. The purpose of the presented work is to provide a way to display and archive this rates in PVSS. This work involves a server converting rates published by the HLT into a format that PVSS can handle. This server, called RateService, is written in C++. A client, called RateCtrl, developed as a PVSS project, is in charge of displaying and archiving this converted rates using standard components developped by CERN. Communication between the server and the client is also provided by DIM. The server is now working and has been commissioned in the pit. The client has been installed and tested. It is available as an LHCb FrameWor...

Technology audit: the state of human language technologies (HLT) R&D in South Africa

CSIR Research Space (South Africa)

Grover, AS

2011-07-01

Full Text Available of indexes developed to provide a landscape overview. They found that a number of HLT LRs are available in South Africa but are of a very basic and exploratory nature and there are many areas that lie fallow in terms of the variety, number, technology...

Anterior cruciate ligament (ACL) injury

Science.gov (United States)

... joint Quickly stop moving and change direction while running, landing from a jump, or turning Basketball, football, soccer, and skiing are common sports linked to ACL tears. ACL injuries often occur with other injuries. For example, an ...

Evidence-Based ACL Reconstruction

Directory of Open Access Journals (Sweden)

E. Carlos RODRIGUEZ-MERCHAN

2015-01-01

Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

Industrial hardware and software verification with ACL2.

Science.gov (United States)

Hunt, Warren A; Kaufmann, Matt; Moore, J Strother; Slobodova, Anna

2017-10-13

The ACL2 theorem prover has seen sustained industrial use since the mid-1990s. Companies that have used ACL2 regularly include AMD, Centaur Technology, IBM, Intel, Kestrel Institute, Motorola/Freescale, Oracle and Rockwell Collins. This paper introduces ACL2 and focuses on how and why ACL2 is used in industry. ACL2 is well-suited to its industrial application to numerous software and hardware systems, because it is an integrated programming/proof environment supporting a subset of the ANSI standard Common Lisp programming language. As a programming language ACL2 permits the coding of efficient and robust programs; as a prover ACL2 can be fully automatic but provides many features permitting domain-specific human-supplied guidance at various levels of abstraction. ACL2 specifications and models often serve as efficient execution engines for the modelled artefacts while permitting formal analysis and proof of properties. Crucially, ACL2 also provides support for the development and verification of other formal analysis tools. However, ACL2 did not find its way into industrial use merely because of its technical features. The core ACL2 user/development community has a shared vision of making mechanized verification routine when appropriate and has been committed to this vision for the quarter century since the Computational Logic, Inc., Verified Stack. The community has focused on demonstrating the viability of the tool by taking on industrial projects (often at the expense of not being able to publish much).This article is part of the themed issue 'Verified trustworthy software systems'. © 2017 The Author(s).

Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

Science.gov (United States)

Bartel, Billie J

2014-08-01

This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

ACL Graft Healing and Biologics

NARCIS (Netherlands)

Muller, Bart; Bowman, Karl F.; Bedi, Asheesh

2013-01-01

Operative reconstruction of a torn anterior cruciate ligament (ACL) has become the most broadly accepted treatment. An important, but underreported, outcome of ACL reconstruction is graft failure, which poses a challenge for the orthopedic surgeon. An understanding of the tendon-bone healing and the

Anatomic Double-bundle ACL Reconstruction

NARCIS (Netherlands)

Schreiber, Verena M.; van Eck, Carola F.; Fu, Freddie H.

2010-01-01

Rupture of the anterior cruciate ligament (ACL) is one of the most frequent forms of knee trauma. The traditional surgical treatment for ACL rupture is single-bundle reconstruction. However, during the past few years there has been a shift in interest toward double-bundle reconstruction to closely

Heat Flux Tests of the ITER FWQMs at KoHLT-1

International Nuclear Information System (INIS)

Bae, Young Dug; Kim, Suk Kwon; Shin, Hee Yun; Lee, Dong Won; Hong, Bong Guen

2009-05-01

As a party of the ITER, especially as a procurement party of the ITER blanket, we have designed the First Wall Qualification Mockup (FWQM) and fabricated five FWQMs. Two of them have been tested up to 12,690/12,020 cycles at a heat flux higher than 0.625 MW/m 2 at the KoHLT-1 facility established in the Korea Atomic Energy Research Institute (KAERI). Two KO FWQMs successfully passed the normal heat flux tests, and there was no indication of defect in the Be-to-CuCrZr joints

Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: implications for ACL injury risk.

Science.gov (United States)

Mizuno, Kiyonori; Andrish, Jack T; van den Bogert, Antonie J; McLean, Scott G

2009-12-01

While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (approximately 10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen-specific models predicted ACL strain within 0.51%+/-0.10% and 0.52%+/-0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities.

ACL Surgical Technique — Staying Out of Trouble

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Predescu Vlad

2016-11-01

Full Text Available The incidence of ACL tear and reconstruction has increased over time, and failure of ACL reconstruction is not perfectly defined among surgeons. Atraumatic failure of ACL surgery represents approximately 70% of causes, and occurs in diagnostic errors, technical errors and problems of ACL graft integrations. Regarding surgical technique, we should answer certain questions about our choice of surgery, tunnel position, graft type, graft suture, tensioning the graft, and how we deal with certain incidents or intraoperative accidents. The purpose of this article is to review the current information and trends of ACL reconstruction, and presents some tips and tricks we use in our current practice.

Return to Play and Future ACL Injury Risk Following ACL Reconstruction In Soccer Athletes From the MOON Group

Science.gov (United States)

Brophy, Robert H.; Schmitz, Leah; Wright, Rick W.; Dunn, Warren R.; Parker, Richard D.; Andrish, Jack T.; McCarty, Eric C.; Spindler, Kurt P.

2013-01-01

Background There is limited information on outcomes and return to play (RTP) after ACL reconstruction (ACLR) in soccer athletes. Hypothesis The purpose of this study was to (i) test the hypotheses that player sex, side of injury and graft choice do not influence RTP, and (ii) define the risk for future ACL injury in soccer players after ACLR. Study design Retrospective cohort study, Level II. Methods Soccer players in a prospective cohort were contacted to determine RTP following ACLR. Information regarding if and when they returned to play, their current playing status, the primary reason they stopped playing soccer (if relevant) and incidence of subsequent ACL surgery was recorded. Results Initially, 72% of 100 soccer athletes (55 male, 45 female) with a mean age of 24.2 years at the time of ACL reconstruction returned to soccer. At average follow up of 7.0 years, 36% were still playing, a significant decrease compared to initial RTP (psoccer athletes had undergone further ACL surgery, including 9 on the contralateral knee and 3 on the ipsilateral knee. In a univariate analysis, females were more likely to have future ACL surgery (20% v. 5.5%, p=0.03). Soccer athletes who underwent ACLR on their non-dominant limb had a higher future rate of contra-lateral ACLR (16%) than soccer athletes who underwent ACLR on their dominant limb (3.5%) (p=0.03). Conclusion Younger and male soccer players are more likely to return to play after ACL reconstruction. Return to soccer following ACLR declines over time. PMID:23002201

MRI of normal anterior cruciate ligament (ACL) and reconstructed ACL: comparison of when the knee is extended with when the knee is flexed

International Nuclear Information System (INIS)

Nakanishi, K.; Horibe, S.; Shiozaki, Y.; Ishida, T.; Narumi, Y.; Ikezoe, J.; Nakamura, H.

1997-01-01

The purpose of this study was to evaluate, using MRI, the morphology of normal anterior cruciate ligament (ACL) and ACL grafts when the knee was extended compared with when the knee was flexed. Eighteen normal controls and 22 ACL graft patients were studied. Spin-echo (SE) T1-weighted images (TR 330 ms/TE 15 ms, NEX 1) were obtained with a slice thickness of 3 mm. Oblique sagittal images parallel to the ACL were obtained at various flexed angles of the knee joint. In 12 of the 18 normal controls the ACL appeared convex toward the posterior side when the knee was extended and gradually became straight when the knee was flexed. In 15 of the 22 ACL graft patients the grafts appeared straight when the knee was extended and became convex toward the anterior side when the knee was flexed. It is concluded that the morphological changes seen on MR images of ACL grafts from when the knee is extended to when the knee is flexed are different from those in the normal ACL. (orig.). With 7 figs., 1 tab

ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury.

Science.gov (United States)

Markström, Jonas L; Tengman, Eva; Häger, Charlotte K

2018-02-01

Little is known regarding movement strategies in the long term following injury of the anterior cruciate ligament (ACL), and even less about comparisons of reconstructed and deficient knees in relation to healthy controls. The present purpose was to compare trunk, hip, and knee kinematics during a one-leg vertical hop (VH) ~20 years post-ACL injury between persons treated with surgery and physiotherapy (ACL R ), solely physiotherapy (ACL PT ), and controls (CTRL). Between-leg kinematic differences within groups were also investigated. Sixty-six persons who suffered unilateral ACL injury on average 23 ± 2 years ago (32 ACL R , 34 ACL PT ) and 33 controls performed the VH. Peak trunk, hip, and knee angles during Take-off and Landing phases recorded with a 3D motion capture system were analysed with multivariate statistics. Significant group effects during both Take-off and Landing were found, with ACL PT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACL R and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACL R also presented different kinematics to ACL PT and CTRL in Take-off with a combination of greater trunk flexion, hip flexion, hip internal rotation, and less knee abduction, and in Landing with greater trunk flexion and hip internal rotation. Further, different kinematics and hop height were found between legs within groups in both Take-off and Landing for both ACL groups, but not for CTRL. Different kinematics for the injured leg for both ACL groups compared to CTRL and between treatment groups, as well as between legs within treatment groups, indicate long-term consequences of injury. Compensatory mechanisms for knee protection seem to prevail over time irrespective of initial treatment, possibly increasing the risk of re-injury and triggering the development of osteoarthritis. Detailed investigation of movement strategies during the VH

ACL Reconstruction

Science.gov (United States)

... in moderate exercise and recreational activities, or play sports that put less stress on the knees. ACL reconstruction is generally recommended if: You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or ...

Proceedings 10th International Workshop on the ACL2 theorem prover and its applications (ACL2 2011), Austin TX, USA, November 3-4, 2011

NARCIS (Netherlands)

Hardin, D.S.; Schmaltz, J.

2011-01-01

This volume contains the proceedings of ACL2 2011, the International Workshop on the ACL2 Theorem Prover and its Applications. The workshop was held in Austin, Texas, USA, on November 3-4 2011. ACL2 2011 is the tenth in a series of workshops on the ACL2 Theorem Prover and its Applications. The

Proof Pad: A New Development Environment for ACL2

Directory of Open Access Journals (Sweden)

Caleb Eggensperger

2013-04-01

Full Text Available Most software development projects rely on Integrated Development Environments (IDEs based on the desktop paradigm, with an interactive, mouse-driven user interface. The standard installation of ACL2, on the other hand, is designed to work closely with Emacs. ACL2 experts, on the whole, like this mode of operation, but students and other new programmers who have learned to program with desktop IDEs often react negatively to the process of adapting to an unfamiliar form of interaction. This paper discusses Proof Pad, a new IDE for ACL2. Proof Pad is not the only attempt to provide ACL2 IDEs catering to students and beginning programmers. The ACL2 Sedan and DrACuLa systems arose from similar motivations. Proof Pad builds on the work of those systems, while also taking into account the unique workflow of the ACL2 theorem proving system. The design of Proof Pad incorporated user feedback from the outset, and that process continued through all stages of development. Feedback took the form of direct observation of users interacting with the IDE as well as questionnaires completed by users of Proof Pad and other ACL2 IDEs. The result is a streamlined interface and fast, responsive system that supports using ACL2 as a programming language and a theorem proving system. Proof Pad also provides a property-based testing environment with random data generation and automated interpretation of properties as ACL2 theorem definitions.

Automated Inventory and Monitoring of the ALICE HLT Cluster Resources with the SysMES Framework

International Nuclear Information System (INIS)

Ulrich, J; Lara, C; Böttger, S; Kebschull, U; Haaland, Ø; Röhrich, D

2012-01-01

The High-Level-Trigger (HLT) cluster of the ALICE experiment is a computer cluster with about 200 nodes and 20 infrastructure machines. In its current state, the cluster consists of nearly 10 different configurations of nodes in terms of installed hardware, software and network structure. In such a heterogeneous environment with a distributed application, information about the actual configuration of the nodes is needed to automatically distribute and adjust the application accordingly. An inventory database provides a unified interface to such information. To be useful, the data in the inventory has to be up to date, complete and consistent. Manual maintenance of such databases is error-prone and data tends to become outdated. The inventory module of the ALICE HLT cluster overcomes these drawbacks by automatically updating the actual state periodically and, in contrast to existing solutions, it allows the definition of a target state for each node. A target state can simply be a fully operational state, i.e. a state without malfunctions, or a dedicated configuration of the node. The target state is then compared to the actual state to detect deviations and malfunctions which could induce severe problems when running the application. The inventory module of the ALICE HLT cluster has been integrated into the monitoring and management framework SysMES in order to use existing functionality like transactionality and monitoring infrastructure. Additionally, SysMES allows to solve detected problems automatically via its rule-system. To describe the heterogeneous environment with all its specifics, like custom hardware, the inventory module uses an object-oriented model which is based on the Common Information Model. The inventory module provides an automatically updated actual state of the cluster, detects discrepancies between the actual and the target state and is able to solve detected problems automatically. This contribution presents the current implementation

Rapid Hamstrings/Quadriceps strength in ACL-reconstructed elite alpine ski racers

DEFF Research Database (Denmark)

Jordan, Matthew J; Aagaard, Per; Herzog, Walter

2015-01-01

PURPOSE: Due to the importance of hamstrings (HAM) and quadriceps (QUAD) strength for anterior cruciate ligament (ACL) injury prevention, and the high incidence of ACL injury in ski racing, HAM and QUAD maximal and explosive strength was assessed in ski racers with and without ACL reconstruction...... (ACL-R). METHODS: Uninjured (n=13 males; n=8 females) and ACL-R (n=3 males; n=5 females; 25.0±11.3 months post-op) elite ski racers performed maximal voluntary isometric HAM and QUAD contractions to obtain maximal torque (MVC) and rate of torque development (RTD) at 0-50, 0-100, 0-150 and 0-200 ms. MVC...... and RTD (per kg body mass) were calculated for the uninjured group to compare between sexes, and to compare the control group with the ACL-R limb and unaffected limb of the ACL-R skiers. H/Q MVC and RTD strength ratios were also compared RESULTS: The ACL-R limb demonstrated significant HAM and QUAD...

Report of the Primary Outcomes for Gait Mechanics in Men of the ACL-SPORTS Trial: Secondary Prevention With and Without Perturbation Training Does Not Restore Gait Symmetry in Men 1 or 2 Years After ACL Reconstruction.

Science.gov (United States)

Capin, Jacob John; Zarzycki, Ryan; Arundale, Amelia; Cummer, Kathleen; Snyder-Mackler, Lynn

2017-10-01

°; 2 years: 16° ± 5°) and SAP+PERT (1 year: 16° ± 5°; 2 years: 15° ± 4°) athletes was not different between groups at 1 year (mean difference: -1°; 95% confidence interval [CI], -5° to 2°; p = 0.49) or 2 years (mean difference: 1°; 95% CI, -2° to 4°; p = 0.54). There were no differences between SAP and SAP+PERT athletes regarding the elimination of gait asymmetries, and gait asymmetries persisted to a large degree in both groups 1 and 2 years postoperatively. At 1 year, 11 of 18 SAP and 11 of 20 SAP+PERT athletes walked with truncated knee excursions during weight acceptance (odds ratio: 0.8, p = 0.70) and midstance (SAP 12 of 18, SAP+PERT 12 of 20; odds ratio: 0.8, p = 0.67), whereas at 2 years postoperatively, truncated knee excursions during weight acceptance (SAP seven of 17, SAP+PERT eight of 19; odds ratio: 1.0, p = 0.96) and midstance (SAP five of 17, SAP+PERT 11 of 19; odds ratio: 3.3, p = 0.09) remained prevalent. We found that a comprehensive, progressive return-to-sport training program with or without perturbation was not effective at restoring interlimb symmetry among men 1 or 2 years after ACL reconstruction. Although gait asymmetries improved from 1 to 2 years postoperatively, meaningful asymmetries persisted in both groups. To restore gait symmetry after ACL reconstruction, additional interventions likely are necessary. Level II, therapeutic study.

Knee extension torque variability after exercise in ACL reconstructed knees.

Science.gov (United States)

Goetschius, John; Kuenze, Christopher M; Hart, Joseph M

2015-08-01

The purpose of this study was to compare knee extension torque variability in patients with ACL reconstructed knees before and after exercise. Thirty two patients with an ACL reconstructed knee (ACL-R group) and 32 healthy controls (control group) completed measures of maximal isometric knee extension torque (90° flexion) at baseline and following a 30-min exercise protocol (post-exercise). Exercise included 30-min of repeated cycles of inclined treadmill walking and hopping tasks. Dependent variables were the coefficient of variation (CV) and raw-change in CV (ΔCV): CV = (torque standard deviation/torque mean x 100), ΔCV = (post-exercise - baseline). There was a group-by-time interaction (p = 0.03) on CV. The ACL-R group demonstrated greater CV than the control group at baseline (ACL-R = 1.07 ± 0.55, control = 0.79 ± 0.42, p = 0.03) and post-exercise (ACL-R = 1.60 ± 0.91, control = 0.94 ± 0.41, p = 0.001). ΔCV was greater (p = 0.03) in the ACL-R group (0.52 ± 0.82) than control group (0.15 ± 0.46). CV significantly increased from baseline to post-exercise (p = 0.001) in the ACL-R group, while the control group did not (p = 0.06). The ACL-R group demonstrated greater knee extension torque variability than the control group. Exercise increased torque variability more in the ACL-R group than control group. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Reducing the Risk of ACL Injury in Female Athletes

Science.gov (United States)

McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen

2010-01-01

The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical,…

Update on rehabilitation following ACL reconstruction

Science.gov (United States)

Nyland, John; Brand, Emily; Fisher, Brent

2010-01-01

As anterior cruciate ligament (ACL) reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. PMID:24198553

The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction

NARCIS (Netherlands)

Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.

2014-01-01

To describe the concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. The PubMed/Medline database was searched using keywords pertaining to ACL reconstruction. Relevant articles were reviewed in order to summarize important concepts of individualized surgery in ACL

ACL2 Meets the GPU: Formalizing a CUDA-based Parallelizable All-Pairs Shortest Path Algorithm in ACL2

Directory of Open Access Journals (Sweden)

David S. Hardin

2013-04-01

Full Text Available As Graphics Processing Units (GPUs have gained in capability and GPU development environments have matured, developers are increasingly turning to the GPU to off-load the main host CPU of numerically-intensive, parallelizable computations. Modern GPUs feature hundreds of cores, and offer programming niceties such as double-precision floating point, and even limited recursion. This shift from CPU to GPU, however, raises the question: how do we know that these new GPU-based algorithms are correct? In order to explore this new verification frontier, we formalized a parallelizable all-pairs shortest path (APSP algorithm for weighted graphs, originally coded in NVIDIA's CUDA language, in ACL2. The ACL2 specification is written using a single-threaded object (stobj and tail recursion, as the stobj/tail recursion combination yields the most straightforward translation from imperative programming languages, as well as efficient, scalable executable specifications within ACL2 itself. The ACL2 version of the APSP algorithm can process millions of vertices and edges with little to no garbage generation, and executes at one-sixth the speed of a host-based version of APSP coded in C – a very respectable result for a theorem prover. In addition to formalizing the APSP algorithm (which uses Dijkstra's shortest path algorithm at its core, we have also provided capability that the original APSP code lacked, namely shortest path recovery. Path recovery is accomplished using a secondary ACL2 stobj implementing a LIFO stack, which is proven correct. To conclude the experiment, we ported the ACL2 version of the APSP kernels back to C, resulting in a less than 5% slowdown, and also performed a partial back-port to CUDA, which, surprisingly, yielded a slight performance increase.

A-B Hourglass Technique in Anterior Cruciate Ligament (ACL) Reconstruction

International Nuclear Information System (INIS)

Abuhamella, Tamer M.; Batterjee, Khaled A.

2006-01-01

Within a period of 2 years starting from April 2000 to November 2002, fifty (50) cases of torn anterior cruciate ligament (ACL) were treated and followed up using our simple modified technique in a retrospective non-randomized study conducted in Saudi-German Hospital, Saudi Arabia. All of which had torn ACL either isolated or associated with meniscal tear. Some of our study group was subjected arthroscopic interference in the same knee before either in the form of ACL reconstruction using P-T-B graft or for menisectomy. During this study per-operative evaluation, intra-operative technique and post-operative follow-up were standardized, with maximum follow-up period of 19 months and minimum follow-up period of 9 month. The final outcome was graded according to Lyshom knee score (1982). The mean age at surgery was 26.5 (from 17 to 36 years). The study group included 11 isolated torn ACL, 29 torn ACL with tear in the medial meniscus, 4 torn ACL with lateral meniscus tear and 6 cases with torn ACL associated with tear in both menisci. All of the cases were treated using the same technique. (author)

Geometric Characteristics of the Knee Are Associated With a Noncontact ACL Injury to the Contralateral Knee After Unilateral ACL Injury in Young Female Athletes.

Science.gov (United States)

Levins, James G; Argentieri, Erin C; Sturnick, Daniel R; Gardner-Morse, Mack; Vacek, Pamela M; Tourville, Timothy W; Johnson, Robert J; Slauterbeck, James R; Beynnon, Bruce D

2017-12-01

Contralateral anterior cruciate ligament (CACL) injury after recovery from a first-time ACL rupture occurs at a high rate in young females; however, little is known about the risk factors associated with bilateral ACL trauma. The geometric characteristics of the contralateral knee at the time of the initial ACL injury are associated with risk of suffering a CACL injury in these female athletes. Case-control study; Level of evidence, 3. Sixty-two female athletes who suffered their first noncontact ACL injury while participating in sports at the high school or college level were identified, and geometry of the femoral notch, ACL, tibial spines, tibial subchondral bone, articular cartilage surfaces, and menisci of the contralateral, uninjured, knee was characterized in 3 dimensions. We were unable to contact 7 subjects and followed the remaining 55 until either a CACL injury or an ACL graft injury occurred or, if they were not injured, until the date of last contact (mean, 34 months after their first ACL injury). Cox regression was used to identify risk factors for CACL injury. Ten (18.2%) females suffered a CACL injury. Decreases of 1 SD in femoral intercondylar notch width (measured at its outlet and anterior attachment of the ACL) were associated with increases in the risk of suffering a CACL injury (hazard ratio = 1.88 and 2.05, respectively). Likewise, 1 SD decreases in medial-lateral width of the lateral tibial spine, height of the medial tibial spine, and thickness of the articular cartilage located at the posterior region of the medial tibial compartment were associated with 3.59-, 1.75-, and 2.15-fold increases in the risk of CACL injury, respectively. After ACL injury, subsequent injury to the CACL is influenced by geometry of the structures that surround the ACL (the femoral notch and tibial spines). This information can be used to identify individuals at increased risk for CACL trauma, who might benefit from targeted risk-reduction interventions.

Fast TPC Online Tracking on GPUs and Asynchronous Data Processing in the ALICE HLT to facilitate Online Calibration

International Nuclear Information System (INIS)

Rohr, David; Gorbunov, Sergey; Krzewicki, Mikolaj; Breitner, Timo; Kretz, Matthias; Lindenstruth, Volker

2015-01-01

ALICE (A Large Heavy Ion Experiment) is one of the four major experiments at the Large Hadron Collider (LHC) at CERN, which is today the most powerful particle accelerator worldwide. The High Level Trigger (HLT) is an online compute farm of about 200 nodes, which reconstructs events measured by the ALICE detector in real-time. The HLT uses a custom online data-transport framework to distribute data and workload among the compute nodes.ALICE employs several calibration-sensitive subdetectors, e.g. the TPC (Time Projection Chamber). For a precise reconstruction, the HLT has to perform the calibration online. Online- calibration can make certain Offline calibration steps obsolete and can thus speed up Offline analysis. Looking forward to ALICE Run III starting in 2020, online calibration becomes a necessity.The main detector used for track reconstruction is the TPC. Reconstructing the trajectories in the TPC is the most compute-intense step during event reconstruction. Therefore, a fast tracking implementation is of great importance. Reconstructed TPC tracks build the basis for the calibration making a fast online-tracking mandatory.We present several components developed for the ALICE High Level Trigger to perform fast event reconstruction and to provide features required for online calibration.As first topic, we present our TPC tracker, which employs GPUs to speed up the processing, and which bases on a Cellular Automaton and on the Kalman filter. Our TPC tracking algorithm has been successfully used in 2011 and 2012 in the lead-lead and the proton-lead runs. We have improved it to leverage features of newer GPUs and we have ported it to support OpenCL, CUDA, and CPUs with a single common source code. This makes us vendor independent.As second topic, we present framework extensions required for online calibration. The extensions, however, are generic and can be used for other purposes as well. We have extended the framework to support asynchronous compute chains

Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction

OpenAIRE

Cvjetkovic, Dragana Dragicevic; Bijeljac, Sinisa; Palija, Stanislav; Talic, Goran; Radulovic, Tatjana Nozica; Kosanovic, Milkica Glogovac; Manojlovic, Slavko

2015-01-01

Introduction: Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol. Subjects and methods: In prospective study, we evalua...

Update on rehabilitation following ACL reconstruction

Directory of Open Access Journals (Sweden)

John Nyland

2010-09-01

Full Text Available John Nyland, Emily Brand, Brent FisherDepartment of Orthopaedic Surgery, Division of Sports Medicine, University of Louisville, Louisville, KY, USAAbstract: As anterior cruciate ligament (ACL reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare

CURBSIDE CONSULTATION OF THE ACL: 49 CLINICAL QUESTIONS

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Bernard R. Bach

2008-09-01

Full Text Available DESCRIPTION A unique reference that offers opinions, preferences and expert advice associated with management of ACL injuries in the questions and answers format which enhanced by images, diagrams and references. PURPOSE "Curbside Consultation of the ACL" aims to provide some knowledge more than the basic information in the evaluation and the management of ACL injuries. This information is based on the opinion or the advice of an expert. Quick access of audience to these pearl and pit-falls and evidence-based expert advice for complicated cases in ACL reconstruction in the form of brief answers including current concepts is targeted by the authors. FEATURES 49 Clinical questions are outlined in 5 sections. In the first section is about preoperative questions including indications, diagnostic measures, combined ligament injuries, graft choice, preparation before surgery, avulsion of the eminence, examination in posterolateral corner injury. In the second section is preoperative questions are subjected including dropping the graft to the floor, posterior wall blowout, knees without hamstring tendon, graft amputation by interference screw, to avoid vertical tunnel in tibia, fixation methods of graft, femoral and tibial tunnel positioning. Third section is about postoperative questions including postoperative management, differences in postoperative rehabilitation protocols in different type of grafts, postoperative man-agement of meniscal repair, management in difficulties in gaining extension, infection, patellar pain, timing of reop-eration in motion problems, criteria returning to sports, outcome measures, outcome in using different grafts, role of bracing. The fourth section is about failed ACL recon-struction including causes, indications for revision, ex-panded tunnels, graft choice in revision surgery, contro-lateral patellar tendon graft for revision, rehab protocol after revision surgery, hardware removal, early degenera-tive joint disease

TIBIAL LANDMARKS IN ACL ANATOMIC REPAIR

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M. V. Demesсhenko

2016-01-01

Full Text Available Purpose: to identify anatomical landmarks on tibial articular surface to serve as reference in preparing tibial canal with respect to the center of ACL footprint during single bundle arthroscopic repair.Materials and methods. Twelve frozen knee joint specimens and 68 unpaired macerated human tibia were studied using anatomical, morphometric, statistical methods as well as graphic simulation.Results. Center of the tibial ACL footprint was located 13,1±1,7 mm anteriorly from posterior border of intercondylar eminence, at 1/3 of the distance along the line connecting apexes of internal and external tubercles and 6,1±0,5 mm anteriorly along the perpendicular raised to this point.Conclusion. Internal and external tubercles, as well as posterior border of intercondylar eminence can be considered as anatomical references to determine the center of the tibial ACL footprint and to prepare bone canals for anatomic ligament repair.

Success of Meniscal Repair at ACL Reconstruction

Science.gov (United States)

Toman, Charles; Spindler, Kurt P.; Dunn, Warren R.; Amendola, Annunziata; Andrish, Jack T.; Bergfeld, John A.; Flanigan, David; Jones, Morgan; Kaeding, Christopher C.; Marx, Robert G.; Matava, Matthew J.; McCarty, Eric C.; Parker, Richard D.; Wolcott, Michelle; Vidal, Armando; Wolf, Brian R.; Huston, Laura J.; Harrell, Frank E.; Wright, Rick W.

2013-01-01

Background Meniscal repair is performed in an attempt to prevent posttraumatic arthritis resulting from meniscal dysfunction after meniscal tears. The socioeconomic implications of premature arthritis are significant in the young patient population. Investigations and techniques focusing on meniscus preservation and healing are now at the forefront of orthopaedic sports medicine. Hypothesis Concomitant meniscal repair with ACL reconstruction is a durable and successful procedure at two year follow-up. Study Design Case Series; Level of evidence, 4. Methods All unilateral primary ACL reconstructions entered in 2002 in a prospective cohort who had meniscal repair at the time of ACLR were evaluated. Validated patient oriented outcome instruments were completed preoperatively and then again at the two-year postoperative time point. Reoperation after the index procedure was also documented and confirmed by operative reports. Results 437 unilateral primary ACL reconstructions were performed with 86 concomitant meniscal repairs (57 medial, 29 lateral) in 84 patients during the study period. Patient follow-up was obtained on 94% (81/86) of the meniscal repairs, allowing confirmation of meniscal repair success (defined as no repeat arthroscopic procedure) or failure. The overall success rate for meniscal repairs was 96% (76/79 patients) at two-year follow-up. Conclusions Meniscal repair is a successful procedure in conjunction with ACL reconstruction. When confronted with a “repairable” meniscal tear at the time of ACL reconstruction, orthopaedic surgeons can expect an estimated >90% clinical success rate at two-year follow-up using a variety of methods as shown in our study. PMID:19465734

ACL Return to Sport Guidelines and Criteria.

Science.gov (United States)

Davies, George J; McCarty, Eric; Provencher, Matthew; Manske, Robert C

2017-09-01

Because of the epidemiological incidence of anterior cruciate ligament (ACL) injuries, the high reinjury rates that occur when returning back to sports, the actual number of patients that return to the same premorbid level of competition, the high incidence of osteoarthritis at 5-10-year follow-ups, and the effects on the long-term health of the knee and the quality of life for the patient, individualizing the return to sports after ACL reconstruction (ACL-R) is critical. However, one of the challenging but unsolved dilemmas is what criteria and clinical decision making should be used to return an athlete back to sports following an ACL-R. This article describes an example of a functional testing algorithm (FTA) as one method for clinical decision making based on quantitative and qualitative testing and assessment utilized to make informed decisions to return an athlete to their sports safely and without compromised performance. The methods were a review of the best current evidence to support a FTA. In order to evaluate all the complicated domains of the clinical decision making for individualizing the return to sports after ACL-R, numerous assessments need to be performed including the biopsychosocial concepts, impairment testing, strength and power testing, functional testing, and patient-reported outcomes (PROs). The optimum criteria to use for individualizing the return to sports after ACL-R remain elusive. However, since this decision needs to be made on a regular basis with the safety and performance factors of the patient involved, this FTA provides one method of quantitatively and qualitatively making the decisions. Admittedly, there is no predictive validity of this system, but it does provide practical guidelines to facilitate the clinical decision making process for return to sports. The clinical decision to return an athlete back into competition has significant implications ranging from the safety of the athlete, to performance factors and actual

3D-Printed Patient-Specific ACL Femoral Tunnel Guide from MRI.

Science.gov (United States)

Rankin, Iain; Rehman, Haroon; Frame, Mark

2018-01-01

Traditional ACL reconstruction with non-anatomic techniques can demonstrate unsatisfactory long-term outcomes with regards instability and the degenerative knee changes observed with these results. Anatomic ACL reconstruction attempts to closely reproduce the patient's individual anatomic characteristics with the aim of restoring knee kinematics, in order to improve patient short and long-term outcomes. We designed an arthroscopic, patient-specific, ACL femoral tunnel guide to aid anatomical placement of the ACL graft within the femoral tunnel. The guide design was based on MRI scan of the subject's uninjured contralateral knee, identifying the femoral footprint and its anatomical position relative to the borders of the femoral articular cartilage. Image processing software was used to create a 3D computer aided design which was subsequently exported to a 3D-printing service. Transparent acrylic based photopolymer, PA220 plastic and 316L stainless steel patient-specific ACL femoral tunnel guides were created; the models produced were accurate with no statistical difference in size and positioning of the center of the ACL femoral footprint guide to MRI ( p =0.344, p =0.189, p =0.233 respectively). The guides aim to provide accurate marking of the starting point of the femoral tunnel in arthroscopic ACL reconstruction. This study serves as a proof of concept for the accurate creation of 3D-printed patient-specific guides for the anatomical placement of the femoral tunnel during ACL reconstruction.

Science and Technology Text Mining: Mexico Core Competencies

Science.gov (United States)

2002-01-01

government created a Researchers Fellowship ( Sistema Nacional de Investigadores-SNI). In this system, the government recognizes the research...Semantic Networks from Text using Leximancer. HLT-NAACL 2003 Human Language Technology Conference of the North American Chapter of the Association for Computational Linguistics - Companion Volume. ACL, May 2003. Demo23-Demo24. 117

Optimizing the HLT Buffer Strategy with Monte Carlo Simulations

CERN Document Server

AUTHOR|(CDS)2266763

2017-01-01

This project aims to optimize the strategy of utilizing the disk buffer for the High Level Trigger (HLT) of the LHCb experiment with the help of Monte-Carlo simulations. A method is developed, which simulates the Event Filter Farm (EFF) -- a computing cluster for the High Level Trigger -- as a compound of nodes with different performance properties. In this way, the behavior of the computing farm can be analyzed at a deeper level than before. It is demonstrated that the current operating strategy might be improved when data taking is reaching a mid-year scheduled stop or the year-end technical stop. The processing time of the buffered data can be lowered by distributing the detector data according to the processing power of the nodes instead of the relative disk size as long as the occupancy level of the buffer is low enough. Moreover, this ensures that data taken and stored on the buffer at the same time is processed by different nodes nearly simultaneously, which reduces load on the infrastructure.

Performance of the HLT muon reconstruction used in CMS

CERN Document Server

Ferreres Sole, Silvia

2017-01-01

The Large Hadron Collider (LHC) generates millions of collision per second. These collisions take place inside the detector, which should read out the data and store it for further analysis. However, there is no possible way of storing all the data generated at the LHC and, if it was, not all the events are interesting for further analysis since the majority of them are low-momenta events. Therefore, detectors need a trigger system to select which events are interested for further analysis and store them. In order to achieve that, the CMS trigger system is a two-level system composed by the Level1 and the High Level Trigger (HLT) that reduces the event rate from the collision rate at the LHC (30GHz) to what is stored and analyzed offline (around 1KHz). When a collision takes place, the Level1 trigger performs a fast readout of the detector. From the information of the detector, basic quantities are created and a pure hardware decision is taken on whether the event should be accepted or not. The Level1 reduces...

MRI diagnosis of ACL bundle tears: value of oblique axial imaging

Energy Technology Data Exchange (ETDEWEB)

Ng, Alex W.H.; Griffith, James F.; Hung, Esther H.Y. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China); Law, Kan Yip; Yung, Patrick S.H. [Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China)

2013-02-15

To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance. Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

Relationship Between the Risk of Suffering a First-Time Noncontact ACL Injury and Geometry of the Femoral Notch and ACL: A Prospective Cohort Study With a Nested Case-Control Analysis.

Science.gov (United States)

Whitney, Darryl C; Sturnick, Daniel R; Vacek, Pamela M; DeSarno, Mike J; Gardner-Morse, Mack; Tourville, Timothy W; Smith, Helen C; Slauterbeck, James R; Johnson, Robert J; Shultz, Sandra J; Hashemi, Javad; Beynnon, Bruce D

2014-08-01

The morphometric characteristics of the anterior cruciate ligament (ACL) and the femoral intercondylar notch within which it resides have been implicated as risk factors for injuries to this important stabilizer of the knee. Prior research has produced equivocal results with differing methodologies, and consequently, it is unclear how these characteristics affect the injury risk in male and female patients. The morphometric characteristics of the ACL and femoral intercondylar notch are individually and independently associated with the risk of suffering a noncontact ACL injury, and these relationships are different in male and female patients. Case-control study; Level of evidence, 3. Magnetic resonance imaging scans of the bilateral knees were obtained on 88 case-control pairs (27 male, 61 female) matched for age, sex, and participation on the same sports team. Patients had suffered a grade III, first-time, noncontact ACL tear. The femoral notch width at 4 locations, the thickness of the bony ridge at the anteromedial outlet of the femoral notch, the femoral notch volume, ACL volume, and ACL cross-sectional area were measured. Multivariate analysis of combined data from male and female patients revealed that decreased ACL volume (odds ratio [OR], 0.829), decreased femoral notch width (OR, 0.700), and increased bony ridge thickness at the anteromedial outlet of the femoral notch (OR, 1.614) were significant independent predictors of an ACL injury. Separate analyses of male and female patients indicated that the femoral notch ridge may be more strongly associated with a risk in female patients, while ACL volume is more strongly associated with a risk in male patients. However, statistical analysis performed with an adjustment for body weight strengthened the association between ACL volume and the risk of injuries in female patients. Morphometric features of both the ACL and femoral notch combine to influence the risk of suffering a noncontact ACL injury. When

Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures.

Science.gov (United States)

Koch, Matthias; Matteo, Berardo Di; Eichhorn, Jürgen; Zellner, Johannes; Mayr, Felix; Krutsch, Werner; Achenbach, Leonard; Woehl, Rebecca; Nerlich, Michael; Angele, Peter

2018-05-01

Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique. Twenty-four patients (mean age 41.8 years) affected by partial rupture of one or both ACL bundles were included in the present trial. The partial ACL tears were arthroscopically assessed and classified according to a new five step grading system. All patients were treated by trephination of the femoral ACL stump and intra-ligamentary application of ACP. The postoperative outcome was evaluated by both subjective scores and stability testing up to a mean of 25.1 months' follow-up. Adverse events and failure rate were also documented. Clinical outcome was good to excellent with IKDC subjective 82.7 (SD 11.8), Lysholm 87.6 (SD 8.1), Tegner 5.3 (SD 2.1), Cincinnati 88.7 (SD 14.8). The failure rate (i.e. persisting knee instability assessed clinically or by rolimeter) was 12.5%. At objective measurements, knee joints showed a firm endpoint in Lachman test, negative pivot shift phenomenon and a significant reduction in AP-laxity compared to pre-operative status by rolimeter testing (p = 0.002). Return to sport practice was achieved after mean 4.8 months (SD 4.1). ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.

Self-Reported Fear Predicts Functional Performance and Second ACL Injury After ACL Reconstruction and Return to Sport: A Pilot Study.

Science.gov (United States)

Paterno, Mark V; Flynn, Kaitlyn; Thomas, Staci; Schmitt, Laura C

Outcomes after anterior cruciate ligament reconstruction (ACLR) are highly variable. Previous studies have failed to report the relationship between fear, objective measures of function, and reinjury rates. The purpose of this study was to determine whether fear was related to functional performance measures and risk of second ACL injury after ACLR and return to sport (RTS). Fear will be associated with performance on functional testing and second ACL injury rate. Prospective cohort study. Level 2. A total of 40 patients cleared to RTS after ACLR completed the Tampa Scale of Kinesiophobia (TSK-11), hop testing, and quadriceps strength testing, bilaterally. Patients were tracked for 12 months after RTS to identify the incidence of second ACL injury. Chi-square analyses determined whether patients with high fear (TSK-11, ≥17) were more likely to have lower levels of activity, greater asymmetry on functional testing, and higher reinjury rates. Patients with greater fear on the TSK-11 (≥17) at RTS were 4 times (odds ratio [OR], 3.73; 95% CI, 0.98-14.23) more likely to report lower levels of activity, 7 times (OR, 7.1; 95% CI, 1.5-33.0) more likely to have a hop limb symmetry lower than 95%, and 6 times (OR, 6.0; 95% CI, 1.3-27.8) more likely to have quadriceps strength symmetry lower than 90%. Patients who went on to suffer an ipsilateral second ACL injury had a greater TSK-11 score at the time of RTS (mean, 19.8 ± 4.0) than those who did not suffer a second ACL injury (mean, 16.4 ± 3.6) ( P = 0.03). Patients with a TSK-11 score of 19 or greater at the time of RTS were 13 times (relative risk, 13.0; 95% CI, 2.1-81.0) more likely to suffer a second ACL tear within 24 months after RTS. Patients with greater self-reported fear were less active, presented with lower single-leg hop performance and isometric quadriceps strength, and had an increased risk of suffering a second ACL injury in the 24 months after RTS. Self-reported fear of movement/reinjury after ACLR at

Is current training in basic and advanced cardiac life support (BLS & ACLS) effective? A study of BLS & ACLS knowledge amongst healthcare professionals of North-Kerala.

Science.gov (United States)

Nambiar, Madavan; Nedungalaparambil, Nisanth Menon; Aslesh, Ottapura Prabhakaran

2016-01-01

Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support (BLS/ACLS) guidelines to revive unresponsive patients. A cross-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire. Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed. Among 461 healthcare professionals, 141 (30.6%) were practicing physicians, 268 (58.1%) were nurses and 52 (11.3%) supporting staff. The maximum achievable score was 20 (BLS 15/ACLS 5). The mean score amongst all healthcare professionals was 8.9±4.7. The mean score among physicians, nurses and support staff were 8.6±3.4, 9±3.6 and 9±3.3 respectively. The majority of healthcare professionals scored ≤50% (237, 51.4%); 204 (44.3%) scored 51%-80% and 20 (4.34%) scored >80%. Mean scores decreased with age, male sex and across occupation. Nurses who underwent BLS/ACLS training previously had significantly higher mean scores (10.2±3.4) than untrained (8.2±3.6, P =0.001). Physicians with <5 years experience ( P =0.002) and nurses in the private sector ( P =0.003) had significantly higher scores. One hundred and sixty three (35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt, chin lift and jaw thrust. Only 54 (11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79 (17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms. The majority of healthcare professionals (356, 77.2%) suggested that BLS/ACLS be included in academic curriculum. Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals, especially physicians, illuminate lacunae in existing training systems and merit urgent redressal.

Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction.

Science.gov (United States)

Cvjetkovic, Dragana Dragicevic; Bijeljac, Sinisa; Palija, Stanislav; Talic, Goran; Radulovic, Tatjana Nozica; Kosanovic, Milkica Glogovac; Manojlovic, Slavko

2015-02-01

Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol. In prospective study, we evaluated 40 subjects which were divided into two groups. Experimental group consisted of 20 recreational males which underwent ACL reconstruction with hamstring tendon and rehabilitation protocol 6 months before isokinetic testing. Control group (20 subjects) consisted of healthy recreational males. In all subjects knee muscle testing was performed on a Biodex System 4 Pro isokinetic dynamo-meter et velocities of 60°/s and 180°/s. We followed average peak torque to body weight (PT/BW) and classic H/Q ratio. In statistical analysis Student's T test was used. There were statistically significant differences between groups in all evaluated parameters except of the mean value of PT/BW of the quadriceps et velocity of 60°/s (p>0.05). Isokinetic testing of dynamic stabilizers of the knee is need in diagnostic and treatment thigh muscle imbalance. We believe that isokinetic testing is an objective parameter for return to sport activities after ACL reconstruction.

Reconstruction of ACL Ligament rupture: results of 96 operation

Directory of Open Access Journals (Sweden)

Tahmasebi MN

2009-04-01

Full Text Available "nBackground: Anterior Cruciate Ligament (ACL is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph. "nMethods: The study group included 96 patients (3 female and 93 male with ACL teared who had been referred to our center in 5 years period (2002-2007. The subject which were Accessed in this study included meniscal injury concomitant chondral injury, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang of motion of knee post operation. "nResults: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48. Mean surgical delay was 18 month (1-77. The most common cause of tear was playing soccer. Meniscal injury was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients Concommitent chondral injury was in 54 patients (56.25%. 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96. "nConclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after injury. Reconstruction of ACL in older patients in the abscense of DJD is effective.

POST-OPERATIVE REHABILITATION PROGRAM AFTER SURGERY ACL RECONSTRUCTION

Directory of Open Access Journals (Sweden)

Zoran Đokić

2013-07-01

Full Text Available ACL (anterior cruciate ligament are small ligaments inside the knee capsule that connect the femur tibia, main function is to prevent movement of the femur in front of tibia and to provide stability, it also helps in controlling the movement of the knee, in direction back-forward. Injuries of ACL appear in an increasing number of athletes. Per year, from 100,000 people who have an injury of the knee joint, 30% have the reconstruction surgery of ACL. ACL injury accounts about 40% of all sports injuries. The greatest number of injuries just happens in the most popular sports, such as: basketball, football and handball, often in female athlete. After the injury, about 25% of athletes fail to return to the sport. Recovery time after surgery is usually 6-12 months, depending on individual characteristics, as well as technical and tactical demands of specific sports activities. Choosing an appropriate and efficient rehabilitation protocols, and training is of great importance. The aim of this paper is to present training protocol of 60 days, 3 months after ACL reconstruction surgery, of top handball female athletes. In the first 30 days, a total of 74 training sessions were done, 39 trainings and 21 EMS (Electrical Muscle Stimulation treatments, at the end of each workout. Functional abilities and morphological status were measured at the beginning and end of the treatment program. After the training protocol athlete got individual exercise program of 26 days (30 training sessions. After 20 days began with normal training, the 26th day of the first game played. The applied protocol has proven successful, as the third competition season there is no problem with an injury.

Femoral intercondylar notch shape and dimensions in ACL-injured patients

NARCIS (Netherlands)

van Eck, Carola F.; Martins, Cesar A. Q.; Vyas, Shail M.; Celentano, Umberto; van Dijk, C. Niek; Fu, Freddie H.

2010-01-01

The femoral intercondylar notch has been an anatomic site of interest as it houses the anterior cruciate ligament (ACL). The objective of this study was to arthroscopically evaluate the femoral notch in patients with known ACL injury. This evaluation included establishing a classification for notch

High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury?

Science.gov (United States)

Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E

2015-01-01

Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. The 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p15 Nm of knee abduction load

In vitro comparison of human fibroblasts from intact and ruptured ACL for use in tissue engineering

Directory of Open Access Journals (Sweden)

T Brune

2007-12-01

Full Text Available The present study compares fibroblasts extracted from intact and ruptured human anterior cruciate ligaments (ACL for creation of a tissue engineered ACL-construct, made of porcine small intestinal submucosal extracellular matrix (SIS-ECM seeded with these ACL cells. The comparison is based on histological, immunohistochemical and RT-PCR analyses. Differences were observed between cells in a ruptured ACL (rACL and cells in an intact ACL (iACL, particularly with regard to the expression of integrin subunits and smooth muscle actin (SMA. Despite these differences in the cell source, both cell populations behaved similarly when seeded on an SIS-ECM scaffold, with similar cell morphology, connective tissue organization and composition, SMA and integrin expression. This study shows the usefulness of naturally occurring scaffolds such as SIS-ECM for the study of cell behaviour in vitro, and illustrates the possibility to use autologous cells extracted from ruptured ACL biopsies as a source for tissue engineered ACL constructs.

Current use of navigation system in ACL surgery: a historical review.

Science.gov (United States)

Zaffagnini, S; Urrizola, F; Signorelli, C; Grassi, A; Di Sarsina, T Roberti; Lucidi, G A; Marcheggiani Muccioli, G M; Bonanzinga, T; Marcacci, M

2016-11-01

The present review aims to analyse the available literature regarding the use of navigation systems in ACL reconstructive surgery underling the evolution during the years. A research of indexed scientific papers was performed on PubMed and Cochrane Library database. The research was performed in December 2015 with no publication year restriction. Only English-written papers and related to the terms ACL, NAVIGATION, CAOS and CAS were considered. Two reviewers independently selected only those manuscripts that presented at least the application of navigation system for ACL reconstructive surgery. One hundred and forty-six of 394 articles were finally selected. In this analysis, it was possible to review the main uses of navigation system in ACL surgery including tunnel positioning for primary and revision surgery and kinematic assessment of knee laxity before and after different surgical procedures. In the early years, until 2006, navigation system was mainly used to improve tunnel positioning, but since the last decade, this tool has been principally used for kinematics evaluation. Increased accuracy of tunnel placement was observed using navigation surgery, especially, regarding femoral, 42 of 146 articles used navigation to guide tunnel positioning. During the following years, 82 of 146 articles have used navigation system to evaluate intraoperative knee kinematic. In particular, the importance of controlling rotatory laxity to achieve better surgical outcomes has been underlined. Several applications have been described and despite the contribution of navigation systems, its potential uses and theoretical advantages, there are still controversies about its clinical benefit. The present papers summarize the most relevant studies that have used navigation system in ACL reconstruction. In particular, the analysis identified four main applications of the navigation systems during ACL reconstructive surgery have been identified: (1) technical assistance for tunnel

Comparision of treatment outcomes in isolated injuries of anterior cruciate ligament (ACL and injuries of ACL connected with damages of menisci, conducted with use of KOOS scale

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Piotr Piech

2017-03-01

Full Text Available Introduction: Anterior cruciate ligament (ACL rupture is one of the most common knee injuries. Such trauma is caused by sudden hyperextension and internal rotation above physiological range of movement. It is most commonly diagnosed in young and physically active people. ACL injury is often accompanied by damages of menisci. Aim: The aim of this study was to compare treatment outcomes in patients with isolated rupture of ACL and with both ACL and menisci damages Materials and Methods: In this retrospective study subjective opinions of 46 patients of Orthopedics and Traumatology Clinic of SPSK4 in Lublin were evaluated. Subjects were 19-59 years old, 28 of them had isolated ACL injury, while 18 suffered also with menisci damages. The study was conducted using KOOS questionnaires. Complications, hospitalization time and reconstruction technique were also taken into account. Results: Maximum rating in KOOS scale is 100 points for each of the parameters. This rating characterizes the most favorable state. For pain average rating in isolated ACL injury was 82,31 while in ACL injury with meniscus damage it was 84,37. For other parameters results were respectively: quality of life – 63,59 and 61,81; remaining symptoms 74,57 and 74,09; daily activities 86.61 and 83.84;  sport 70.71 and 65.56. The data have been developed with the help of non-compliance test chi2. Conclusions: The results of the work show that there is a correlation between the type of injury and the assessment of the patient in three parameters: remaining symptoms, daily functioning and sport. The other two parameters (quality of life, pain were irrelevant.

Does the lateral intercondylar ridge disappear in ACL deficient patients?

NARCIS (Netherlands)

van Eck, C.F.; Martins, C.A.Q.; Vyas, S.M.; Celentano, U.; van Dijk, C.N.; Fu, F.H.

2010-01-01

The aim of this study was to determine whether there is a difference in the presence of the lateral intercondylar ridge and the lateral bifurcate ridge between patients with sub-acute and chronic ACL injuries. We hypothesized that the ridges would be present less often with chronic ACL deficiency.

Lower extremity performance following ACL rehabilitation in the KANON-trial

DEFF Research Database (Denmark)

Ericsson, Ylva B; Roos, Ewa M.; Frobell, Richard B

2013-01-01

The additional effect of anterior cruciate ligament (ACL) reconstruction on muscle strength and physical performance after a structured exercise programme is not well understood.......The additional effect of anterior cruciate ligament (ACL) reconstruction on muscle strength and physical performance after a structured exercise programme is not well understood....

No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears

DEFF Research Database (Denmark)

Kiadaliri, Aliasghar A; Englund, Martin; Stefan Lohmander, L.

2016-01-01

Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injur...

The Dutch language anterior cruciate ligament return to sport after injury scale (ACL-RSI) - validity and reliability.

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Slagers, Anton J; Reininga, Inge H F; van den Akker-Scheek, Inge

2017-02-01

The ACL-Return to Sport after Injury scale (ACL-RSI) measures athletes' emotions, confidence in performance, and risk appraisal in relation to return to sport after ACL reconstruction. Aim of this study was to study the validity and reliability of the Dutch version of the ACL-RSI (ACL-RSI (NL)). Total 150 patients, who were 3-16 months postoperative, completed the ACL-RSI(NL) and 5 other questionnaires regarding psychological readiness to return to sports, knee-specific physical functioning, kinesiophobia, and health-specific locus of control. Construct validity of the ACL-RSI(NL) was determined with factor analysis and by exploring 10 hypotheses regarding correlations between ACL-RSI(NL) and the other questionnaires. For test-retest reliability, 107 patients (5-16 months postoperative) completed the ACL-RSI(NL) again 2 weeks after the first administration. Cronbach's alpha, Intraclass Correlation Coefficient (ICC), SEM, and SDC, were calculated. Bland-Altman analysis was conducted to assess bias between test and retest. Nine hypotheses (90%) were confirmed, indicating good construct validity. The ACL-RSI(NL) showed good internal consistency (Cronbach's alpha 0.94) and test-retest reliability (ICC 0.93). SEM was 5.5 and SDC was 15. A significant bias of 3.2 points between test and retest was found. Therefore, the ACL-RSI(NL) can be used to investigate psychological factors relevant to returning to sport after ACL reconstruction.

Jumping performance differences among elite professional handball players with or without previous ACL reconstruction.

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Setuain, I; Millor, N; Alfaro, J; Gorostiaga, E; Izquierdo, M

2015-10-01

Handball is one of the most challenging sports for the knee joint. Persistent strength and jumping capacity alterations may be observed among athletes who have suffered anterior cruciate ligament (ACL) injury. The aim of this study was to examine unilateral and bilateral jumping ability differences between previously ACL-reconstructed rehabilitated elite handball athletes and sex, age and uninjured sport activity level-pairs of control players. It was a Cross-sectional study with one factor: previous ACL injury. We recruited 22 male (6 ACL-reconstructed and 16 uninjured control players) and 21 female (6 ACL-reconstructed and 15 uninjured control players) elite handball players who were evaluated 6.2±3.4 years after surgical ACL reconstruction. A battery of jump tests, including both bilateral and unilateral maneuvers, was performed. Two-tailed unpaired (intergroup comparison) and paired (intragroup comparison) t-tests were performed for mean comparisons. The P-value cut-off for significance was set at handball athletes demonstrated both lower vertical bilateral drop jump (VBDJ) contact times and lower UTHD scores for the injured leg several years after injury. These deficits could contribute to an increase in ACL re-injury risk.

Remodeling of ACL Allografts is Inhibited by Peracetic Acid Sterilization

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Gonnermann, Johannes; Kamp, Julia; Przybilla, Dorothea; Pruss, Axel

2008-01-01

Sterilization of allografts for anterior cruciate ligament (ACL) reconstruction has become an important prerequisite to prevent disease transmission. However, current sterilization techniques impair the biological or mechanical properties of such treated grafts. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without these disadvantages and does not impair the mechanical properties of soft tissue grafts in vitro. We asked whether PAA sterilization would influence recellularization, restoration of crimp length and pattern, and revascularization of ACL grafts during early healing. We used an in vivo sheep model for open ACL reconstruction. We also correlated the histologic findings with the restoration of anteroposterior stability and structural properties during load-to-failure testing. PAA slowed remodeling activity at 6 and 12 weeks compared to nonsterilized allografts and autografts. The mechanical properties of PAA grafts were also reduced compared to these control groups at both time points. We conclude PAA sterilization currently should not be used to sterilize soft tissue grafts typically used in ACL reconstruction. PMID:18491201

Torn ACL: A New Bioengineered Substitute Brought from the Laboratory to the Knee Joint

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Francine Goulet

2004-01-01

Full Text Available Anterior cruciate ligament (ACL injuries occur at an annual rate of 120 000 in the USA, and many need reconstructive surgery. We report successful results at 1–13 months following implantation of bioengineered ACL (bACL in goats. A bACL has been developed using autologous ACL cells, a collagen matrix and bone plugs. The extremities of the bACL were fully integrated into the femur and tibia of the host. Vascularisation of the grafts was extensive 1 month post-surgery and improved with time. At 6 months post-grafting, histological and ultrastructural observations demonstrated a highly organised ligamentous structure, rich in type I collagen fibres and fibroblasts. At the implants' insertion sites, characteristic fibrocartilage was observed having well aligned chondrocytes and collagen fibrils. After a year, mechanical rupture of the grafts demonstrated a major gain in strength. Eventual applications of this new technology in humans include multiple uses in orthopaedic, dental and reconstructive surgeries.

Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.

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Wright, Rick W; Huston, Laura J; Spindler, Kurt P; Dunn, Warren R; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton J; Stuart, Michael J

2010-10-01

Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Cross-sectional study; Level of evidence, 2. After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

A RETROSPECTIVE ANALYSIS OF ARTHROSCOPIC ACL RECONSTRUCTION WITH HAMSTRING TENDON GRAFT

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Ashish R. Agarwal

2017-08-01

Full Text Available BACKGROUND ACL reconstruction is one of the commonest knee surgeries done. Young adults are the commonest patients; thus, this injury has a large impact on socioeconomic status of the family. The aim of the study is to study the outcome of arthroscopic ACL reconstruction with hamstring tendon graft. MATERIALS AND METHODS 50 patients following up in the OPD who had undergone ACL reconstruction with hamstring tendon graft are evaluated. Patients who had other lesions, such meniscal injuries or collateral injuries were discarded. These patients were evaluated by using Tegner and Lysholm score of 6 months, 12 months and 24 months. Settings- It is a retrospective analysis of the data collected from the patients who were opiated at Nair Hospital. RESULTS 90% of patients in the study were males. Mean age of the study population is 30.7 years. All the patients in the study had instability as a symptom, while 80% of them also had pain. Six months after surgery, according to Tegner and Lysholm score, 52% patients had good outcome, while 48% had fair outcome. At 2 years, 98% of study population had excellent outcome. CONCLUSION Arthroscopic ACL reconstruction with hamstring graft is an effective way of treating ACL tear.

A Retrospective Analysis of Concurrent Pathology in ACL-Reconstructed Knees of Elite Alpine Ski Racers

DEFF Research Database (Denmark)

Jordan, Matthew J; Doyle-Baker, Patricia; Heard, Mark

2017-01-01

/chondral surgery, 60% of meniscal tears and 80% of chondral lesions had worsened since the time of primary ACLR. CONCLUSION: Concurrent injury was common in this group of elite ski racers. Primary ACL tears were typically accompanied by lateral compartment chondral lesions and complex meniscal tears that worsened...... over time. ACL/MCL tears were the most common multiligament injury pattern.......BACKGROUND: Anterior cruciate ligament (ACL) tear is the most frequent injury in alpine ski racing, and there is a high prevalence of ACL reinjury. Limited data exist on the concurrent pathology with primary ACL tears in elite alpine ski racers and the magnitude of injury progression after primary...

Muscular activity during dynamic squats in patients with ACL reconstruction.

Science.gov (United States)

Ceaglio, Sebastian; Alberto, Federico; Catalfamo, Paola Andrea; Braidot, Ariel Andres

2010-01-01

One of the most frequent injuries in subjects who practice sport is the rupture of the anterior cruciate ligament (ACL). Appropriate reconstruction and rehabilitation are key issues in full recovery of patients and their return to previous activities. This paper presents a new method to estimate muscle strength during a dynamic exercise from kinematic and electromyographic (EMG) data. Recovery of patients with ACL rupture and reconstruction was evaluated 4 and 6 months after surgery by assessing the differences in knee extensor and flexor muscle activity between the unimpaired and injured limbs. The results show that squat EMGs from the extensor muscles of the knee from the injured and unimpaired limb could help assess rehabilitation outputs in patients who had undergone an ACL reconstructive surgery.

Biomechanics Associated with Patellofemoral Pain and ACL Injuries in Sports.

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Weiss, Kaitlyn; Whatman, Chris

2015-09-01

Knee injuries are prevalent among a variety of competitive sports and can impact an athlete's ability to continue to participate in their sport or, in the worst case, end an athlete's career. The aim was to evaluate biomechanics associated with both patellofemoral pain syndrome (PFPS) and anterior cruciate ligament (ACL) injuries (in sports involving landing, change in direction, or rapid deceleration) across the three time points frequently reported in the literature: pre-injury, at the time of injury, and following injury. A search of the literature was conducted for research evaluating biomechanics associated with ACL injury and PFPS. The Web of Science, SPORTDiscus, EBSCO, PubMed, and CINAHL databases, to March 2015, were searched, and journal articles focused on ACL injuries and PFPS in sports that met the inclusion criteria were reviewed. The search methodology was created with the intent of extracting case-control, case, and cohort studies of knee injury in athletic populations. The search strategy was restricted to only full-text articles published in English. These articles were included in the review if they met all of the required selection criteria. The following inclusion criteria were used: (1) The study must report lower extremity biomechanics in one of the following settings: (a) a comparison of currently injured and uninjured participants, (b) a prospective study evaluating risk factors for injury, or (c) a study reporting on the injury event itself. (2) The study must include only currently active participants who were similar at baseline (i.e. healthy, high school level basketball players currently in-season) and include biomechanical analysis of either landing, change in direction, or rapid deceleration. (3) The study must include currently injured participants. The studies were graded on the basis of quality, which served as an indication of risk of bias. An adapted version of the 'Strengthening the Reporting of Observational Studies in

Influence of the different anteromedial portal on femoral tunnel orientation during anatomic ACL reconstruction

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Dong-Kyu Moon

2017-05-01

Conclusions: In anatomic ACL reconstruction, a mal-positioned AM portal can cause abnormal tunnel orientation, which may lead to mechanical failure during ACL reconstruction. Therefore, it is important to select accurate AM portal positioning, and possibly using an AAM portal by measuring an accurate position when drilling a femoral tunnel in anatomic ACL reconstruction.

Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases.

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Montgomery, Connor; Blackburn, Jeff; Withers, Daniel; Tierney, Gregory; Moran, Cathal; Simms, Ciaran

2016-12-30

The mechanisms of ACL injury in rugby are not well defined. To describe the mechanisms of ACL injury in male professional rugby players using systematic video analysis. 36 cases from games played in top professional leagues and international matches were analysed. 5 analysts independently assessed all videos to record the estimated frame/time of initial ground contact, frame/time of ACL tear and a range of play specific variables. This included contact versus non-contact ACL injuries, injury timing, joint flexion angles and foot contact with the ground. 37 side-stepping manoeuvres from a control game were analysed to allow comparison of non-injury versus injury situations. 57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury. The majority of non-contact ACL injuries resulted from a side-stepping manoeuvre. In most non-contact cases, initial ground contact was through heel strike. Statistical assessment of heel strike at initial ground contact versus non-heel strike cases showed a significant difference in injury versus non-injury outcomes, with heel strike associated with higher injury risk. Non-contact ACL injuries had lower median knee flexion angles and a more dorsiflexed ankle when compared with a control group (10° vs 20°, p≤0.001 and 10° vs 0°, p=0.033 respectively). Over half of ACL injuries in rugby in our analysis resulted from a contact mechanism. For non-contact injuries, lower knee flexion angles and heel-first ground contact in a side-stepping manoeuvre were associated with ACL injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An Athlete's Nightmare: Tearing the ACL

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... on the balls of their feet. "If the calf muscles are not absorbing the force, and if the knee is not in the proper position, the knee buckles and tears the ACL," explains Dr. Boden. After her initial ...

Mechanisms, Prediction, and Prevention of ACL Injuries: Cut Risk With Three Sharpened and Validated Tools

Science.gov (United States)

Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.

2017-01-01

Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195

Comparing the effects of mechanical perturbation training with a compliant surface and manual perturbation training on joints kinematics after ACL-rupture.

Science.gov (United States)

Nawasreh, Zakariya; Failla, Mathew; Marmon, Adam; Logerstedt, David; Snyder-Mackler, Lynn

2018-05-23

Performing physical activities on a compliant surface alters joint kinematics and increases joints stiffness. However, the effect of compliant surface on joint kinematics after ACL-rupture is yet unknown. To compare the effects of mechanical perturbation training with a compliant surface to manual perturbation training on joint kinematics after ACL-rupture. Sixteen level I/II athletes with ACL-rupture participated in this preliminary study. Eight patients received mechanical perturbation with compliant surface (Mechanical) and 8 patients received manual perturbation training (Manual). Patients completed standard gait analysis before (Pre) and after (Post) training. Significant group-by-time interactions were found for knee flexion angle at initial contact (IC) and peak knee flexion (PKF) (pMechanical:27.68+4.08°, p = 0.011), hip rotation angle at PKE (Manual:-3.40+4.78°, Mechanical:5.43+4.78°, p Mechanical:0.55+2.23°, p = 0.039). Main effects of time were found for hip adduction angle at PKE (Pre:6.98+4.48°, Post:8.41+4.91°, p = 0.04), knee adduction angle at IC (Pre:-2.90+3.50°, Post:-0.62+2.58°, p = 0.03), ankle adduction angle at IC (Pre:2.16+3.54, Post:3.8+3.68, p = 0.008), and ankle flexion angle at PKF (Pre:-4.55+2.77°, Post:-2.39+3.48°, p = 0.01). Training on a compliant surface induces different effects on joint kinematics compared to manual perturbation training after ACL-rupture. Manual perturbation improved hip alignment and increased knee flexion angles, while mechanical training decreased knee flexion angles throughout the stance phase. Administering training on a compliant surface after ACL-rupture may help improving dynamic knee stability, however, long-term effects on knee health needs to be determined. Copyright © 2018 Elsevier B.V. All rights reserved.

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review

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Jesper Bencke

2018-05-01

Full Text Available Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1 to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2 to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies (n = 6 examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings. Only a single study examined the association between muscle activation deficits and ACL

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review.

Science.gov (United States)

Bencke, Jesper; Aagaard, Per; Zebis, Mette K

2018-01-01

Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1) to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2) to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies ( n = 6) examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings). Only a single study examined the association between muscle activation deficits and ACL injury risk

ACL-RSI and KOOS Measures Predict Normal Knee Function after ACL-SPORTS Training

OpenAIRE

White, Kathleen; Zeni, Joseph; Snyder-Mackler, Lynn

2014-01-01

Objectives: After anterior cruciate ligament reconstruction (ACLR) athletes commonly report increased fear of re-injury and below normal knee function. Implementing a post-operative training protocol (ACL-SPORTS Training) to improve patient perceived knee function, may improve short term outcomes after surgery. Identifying pre-training measures that predict normal knee function after training may allow us to determine who may respond to the treatment intervention. The purpose of this study wa...

ACL ideal graft: MRI correlation between ACL and humstrings, PT and QT

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Fabiano Kupczik

2013-09-01

Full Text Available OBJECTIVE: The objective of this study was to measure in MRI scans, the size of the origin, insertion and length of the anterior cruciate ligament and possible graft for reconstruction surgery in case of injury. Besides this, there was a cross between statistical data to test the hypothesis of proportional relationship between these anatomical extent. MATERIALS AND METHODS: 52 MRI examinations performed between 2008 and 2011 were valued at random in a longitudinal retrospective epidemiological study. To measure the width of the ACL was used coronal oblique to the length of the sagittal section, for inserting the tibial coronal femoral insertion and was also used oblique coronal section. RESULTS: The average diameter of the ACL was 4.80 mm (3.1-8.3 mm, with a length of 3.8 cm (2.85-4.5 cm. The origin ranged from 9.7 mm to 15.4 mm. The average insertion on the tibia was 13.3 mm. The average diameter of the semi-tendinous was 4.38 mm and the average diameter was 3.42 mm gracilis. The quadriceps presented diameter of 7.67 mm, a length of 35.34 mm and 4.54 mm patellar tendon diameter and 26.62 mm in average length. CONCLUSION: These data provide important information for the pre-operative surgeon, facilitating preoperative planning and providing viable alternatives and avoiding inadequate grafts.

Fourier Series Formalization in ACL2(r

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Cuong K. Chau

2015-09-01

Full Text Available We formalize some basic properties of Fourier series in the logic of ACL2(r, which is a variant of ACL2 that supports reasoning about the real and complex numbers by way of non-standard analysis. More specifically, we extend a framework for formally evaluating definite integrals of real-valued, continuous functions using the Second Fundamental Theorem of Calculus. Our extended framework is also applied to functions containing free arguments. Using this framework, we are able to prove the orthogonality relationships between trigonometric functions, which are the essential properties in Fourier series analysis. The sum rule for definite integrals of indexed sums is also formalized by applying the extended framework along with the First Fundamental Theorem of Calculus and the sum rule for differentiation. The Fourier coefficient formulas of periodic functions are then formalized from the orthogonality relations and the sum rule for integration. Consequently, the uniqueness of Fourier sums is a straightforward corollary. We also present our formalization of the sum rule for definite integrals of infinite series in ACL2(r. Part of this task is to prove the Dini Uniform Convergence Theorem and the continuity of a limit function under certain conditions. A key technique in our proofs of these theorems is to apply the overspill principle from non-standard analysis.

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes

DEFF Research Database (Denmark)

Bencke, Jesper; Aagaard, Per; Zebis, Mette K

2018-01-01

, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific......, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts......Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury...

Does Donor Age of Nonirradiated Achilles Tendon Allograft Influence Mid-Term Results of Revision ACL Reconstruction?

Science.gov (United States)

Zaffagnini, Stefano; Roberti di Sarsina, Tommaso; Bonanzinga, Tommaso; Nitri, Marco; Macchiarola, Luca; Stefanelli, Federico; Lucidi, Gianandrea; Grassi, Alberto

2018-01-01

Purpose  The purpose of the present study was to investigate if the donor age of nonirradiated Achilles tendon allograft could influence the clinical results of revision anterior cruciate ligament (ACL) reconstruction. Methods  All patients that underwent ACL revision between 2004 and 2008 with at least 4 years of follow-up were included. For all the patients that met the inclusion criteria, the age of the graft donor was obtained from the tissue bank. Lysholm score was administered to patients that met inclusion criteria. In addition, patients were divided in two groups based on the donor age (<45 years vs. ≥45 years), and the baseline characteristics and outcomes were compared. Results  Fifty-two patients were evaluated at a mean 4.8 ± 0.8 years follow-up with Lysholm score. The Lysholm significantly improved from 62.3 ± 6.6 at preoperative status to 84.4 ± 12.3 at final follow-up. The mean donor age was 48.7 ± 8.4 years; a significant difference in Lysholm score was noted between patients that received an allograft with a donor age <45 years (14 patients; 27%) and those receiving an allograft with a donor age ≥45 years (38; 73%) (89.5 ± 3.2 vs. 80.1 ± 11.1, respectively; p  = 0.0469). The multiple regression model showed the donor age, the final follow-up, and the preoperative Lysholm score as significant predictors of postoperative Lysholm score ( p  < 0.0002). Conclusion  Donor age of nonirradiated Achilles tendon allograft influenced the mid-term results of revision ACL reconstruction, thus advising the use of grafts from young donors. Level of Evidence  Level III, retrospective comparative study. PMID:29675501

Differential properties of human ACL and MCL stem cells may be responsible for their differential healing capacity

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Fu Freddie H

2011-06-01

Full Text Available Abstract Background The human anterior cruciate ligament (hACL and medial collateral ligament (hMCL of the knee joint are frequently injured, especially in athletic settings. It has been known that, while injuries to the MCL typically heal with conservative treatment, ACL injuries usually do not heal. As adult stem cells repair injured tissues through proliferation and differentiation, we hypothesized that the hACL and hMCL contain stem cells exhibiting unique properties that could be responsible for the differential healing capacity of the two ligaments. Methods To test the above hypothesis, we derived ligament stem cells from normal hACL and hMCL samples from the same adult donors using tissue culture techniques and characterized their properties using immunocytochemistry, RT-PCR, and flow cytometry. Results We found that both hACL stem cells (hACL-SCs and hMCL stem cells (hMCL-SCs formed colonies in culture and expressed stem cell markers nucleostemin and stage-specific embryonic antigen-4 (SSEA-4. Moreover, both hACL-SCs and hMCL-SCs expressed CD surface markers for mesenchymal stem cells, including CD44 and CD90, but not those markers for vascular cells, CD31, CD34, CD45, and CD146. However, hACL-SCs differed from hMCL-SCs in that the size and number of hACL-SC colonies in culture were much smaller and grew more slowly than hMCL-SC colonies. Moreover, fewer hACL-SCs in cell colonies expressed stem cell markers STRO-1 and octamer-binding transcription factor-4 (Oct-4 than hMCL-SCs. Finally, hACL-SCs had less multi-differentiation potential than hMCL-SCs, evidenced by differing extents of adipogenesis, chondrogenesis, and osteogenesis in the respective induction media. Conclusions This study shows for the first time that hACL-SCs are intrinsically different from hMCL-SCs. We suggest that the differences in their properties contribute to the known disparity in healing capabilities between the two ligaments.

Healing of the Acutely Injured Anterior Cruciate Ligament: Functional Treatment with the ACL-Jack, a Dynamic Posterior Drawer Brace

Directory of Open Access Journals (Sweden)

Matthias Jacobi

2016-01-01

Full Text Available Background. The injured anterior cruciate ligament (ACL has a limited healing capacity leading to persisting instability. Hypothesis/Purpose. To study if the application of a brace, producing a dynamic posterior drawer force, after acute ACL injury reduces initial instability. Study Design. Cohort study. Methods. Patients treated with the ACL-Jack brace were compared to controls treated with primary ACL reconstruction und controls treated nonsurgically with functional rehabilitation. Measurements included anterior laxity (Rolimeter, clinical scores (Lysholm, Tegner, and IKDC, and MRI evaluation. Patients were followed up to 24 months. Results. Patients treated with the ACL-Jack brace showed a significant improvement of anterior knee laxity comparable to patients treated with ACL reconstruction, whereas laxity persisted after nonsurgical functional rehabilitation. The failure risk (secondary reconstruction necessary of the ACL-Jack group was however 21% (18 of 86 within 24 months. Clinical scores were similar in all treatment groups. Conclusion. Treatment of acute ACL tears with the ACL-Jack brace leads to improved anterior knee laxity compared to nonsurgical treatment with functional rehabilitation.

Lessons learned from the last 20 years of ACL-related in vivo-biomechanics research of the knee joint.

Science.gov (United States)

Pappas, Evangelos; Zampeli, Franceska; Xergia, Sofia A; Georgoulis, Anastasios D

2013-04-01

Technological advances in recent years have allowed the easy and accurate assessment of knee motion during athletic activities. Subsequently, thousands of studies have been published that greatly improved our understanding of the aetiology, surgical reconstruction techniques and prevention of anterior cruciate ligament (ACL) injuries. The purpose of this review is to summarize the evidence from biomechanical studies on ACL-related research. High-impact articles that enhanced understanding of ACL injury aetiology, rehabilitation, prevention and adaptations after reconstruction were selected. The importance of restoring internal tibial rotation after ACL reconstruction has emerged in several studies. Criteria-based, individualized rehabilitation protocols have replaced the traditional time-based protocols. Excessive knee valgus, poor trunk control, excessive quadriceps forces and leg asymmetries have been identified as potential high risk biomechanical factors for ACL tear. Injury prevention programmes have emerged as low cost and effective means of preventing ACL injuries, particularly in female athletes. As a result of biomechanical research, clinicians have a better understanding of ACL injury aetiology, prevention and rehabilitation. Athletes exhibiting neuromuscular deficits predisposing them to ACL injury can be identified and enrolled into prevention programmes. Clinicians should assess ACL-reconstructed patients for excessive internal tibial rotation that may lead to poor outcomes.

A new knee arthrometer, the GNRB: experience in ACL complete and partial tears.

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Robert, H; Nouveau, S; Gageot, S; Gagnière, B

2009-05-01

Clinical diagnosis of anterior cruciate ligament (ACL) tears (Lachman test and Pivot shift test in valgus and internal rotation) is reliable in case of complete ACL tear but reveals elusive in case of partial tears. Quantitative assessment of anterior tibial translation proves to be imprecise, subjective and poorly reproducible especially with the KT-1000 arthrometer. We developed the GNRB, an alternative original anterior knee laxity measurement device. The lower limb is placed in a rigid support with the knee at 0 degrees of rotation, the restraining power being recorded. A 0-250 N thrust force is transmitted by a jack to the upper segment of the calf. This force is only applied in the absence of hamstring muscles contraction. Displacement of the anterior tibial tubercle is recorded using a sensor with a 0.1mm precision. We hypothesize that this knee laxity measurement device is more reliable and reproducible than other currently available arthrometers. During a first validation study, the GNRB was compared to the KT-1000 arthrometer, in 20 pairs of healthy knees, measurements being performed by two investigators. Variance analyses were carried out at 134 N. In a second clinical study, 21 complete ACL tears (the notch is devoid of ACL) and 24 partial ACL tears (anterior or posterior bundle tear and cicatricial ACL remnant in continuity) were tested with these arthrometers to exact a differential laxity threshold value between both knees at 250 N. Statistical analysis was subsequently performed using variance and ROC curves analysis. The GNRB arthrometer reveals to be significantly more reproducible than the KT-1000, irrespectively of the tester's experience level. Moreover, unlike the KT-1000, the achieved measurement is independent from the uninvolved side. Reproducibility of laximetry proves to be significantly better with the GNRB than with the KT-1000, wherever the examiner's experience stands and whatever the evaluated side condition could be. When

The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotary stability

DEFF Research Database (Denmark)

Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen

2016-01-01

Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insuffici......Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction...... of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured...... with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability...

ACL rupture is a single leg injury but a double leg problem

DEFF Research Database (Denmark)

Benjaminse, Anne; Holden, Sinead; Myer, Gregory D.

2018-01-01

The authors present their thoughts on the focus on targeting asymmetry in rehabilitation after ACL reconstruction, which they think may not be rich enough to identify deficits.......The authors present their thoughts on the focus on targeting asymmetry in rehabilitation after ACL reconstruction, which they think may not be rich enough to identify deficits....

Abnormal tibiofemoral contact stress and its association with altered kinematics following center-center ACL reconstruction: an in vitro study

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Imhauser, Carl; Mauro, Craig; Choi, Daniel; Rosenberg, Eric; Mathew, Stephen; Nguyen, Joseph; Ma, Yan; Wickiewicz, Thomas

2014-01-01

Background Abnormal tibiofemoral contact stress and aberrant kinematics may influence the progression of osteoarthritis in the ACL-deficient and the ACL-reconstructed knee. However, relationships between contact stress and kinematics following ACL reconstruction are poorly understood. Therefore, we posed the following research questions: (1) How do ACL deficiency and reconstruction affect kinematics of and contact stress in the tibiofemoral joint? (2) What kinematic differences are associated with abnormal contact stress following ACL reconstruction? Hypothesis/Purpose Center-center ACL reconstruction will not restore knee kinematics and contact stress. Correlations will exist between abnormal contact stress and aberrant kinematics following ACL reconstruction will exist. Study Design Controlled laboratory study Methods Clinical tests of anterior and rotational stability were simulated on eleven cadaveric knees using an industrial robot. Tests were conducted with the ACL intact, sectioned, and after single bundle ACL reconstruction using a quadrupled hamstring autograft with tunnels drilled through the center of the native footprints. Kinematics were recorded during the tests. Contact stress was continuously recorded from a stress transducer fixed to the tibial plateau and mean contact stress was calculated regionally. Results ACL deficiency resulted in increased mean contact stress in the posterior sectors of the medial and lateral compartments under anterior and rotational loads, respectively. Reconstruction reduced stress in these locations; however contact stress abnormalities remained. On average, kinematics were overconstrained following ACL reconstruction (≤1.8mm and ≤2.6° in all directions). However, combinations of overconstrained and underconstrained motions in ab/adduction and medial-lateral translation in response to combined moments, and axial rotation, anterior-posterior and medial-lateral translation in response to an anterior load were

Strength Asymmetry and Landing Mechanics at Return to Sport after ACL Reconstruction

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Schmitt, Laura C.; Paterno, Mark V.; Ford, Kevin R.; Myer, Gregory D.; Hewett, Timothy E.

2014-01-01

Purpose Evidence-based quadriceps femoris muscle (QF) strength guidelines for return to sport following anterior cruciate ligament (ACL) reconstruction are lacking. This study investigated the impact of QF strength asymmetry on knee landing biomechanics at the time of return to sport following ACL reconstruction. Methods Seventy-seven individuals (17.4 years) at the time of return to sport following primary ACL reconstruction (ACLR group) and 47 uninjured control individuals (17.0 years) (CTRL group) participated. QF strength was assessed and Quadriceps Index calculated (QI = [involved strength/uninvolved strength]*100%). The ACLR group was sub-divided based on QI: High Quadriceps (HQ, QI≥90%) and Low-Quadriceps (LQ, QIkinetic variables were collected during a drop vertical jump maneuver. Limb symmetry during landing, and discrete variables were compared among the groups with multivariate analysis of variance and linear regression analyses. Results The LQ group demonstrated worse asymmetry in all kinetic and ground reaction force variables compared to the HQ and CTRL groups, including reduced involved limb peak knee external flexion moments (p.05). In the ACLR group, QF strength estimated limb symmetry during landing after controlling for graft type, meniscus injury, knee pain and symptoms. Conclusion At the time of return to sport, individuals post-ACL reconstruction with weaker QF demonstrate altered landing patterns. Conversely, those with nearly symmetrical QF strength demonstrate landing patterns similar to uninjured individuals. Consideration of an objective QF strength measure may aid clinical decision-making to optimize sports participation following ACL reconstruction. PMID:25373481

One-stage Revision ACL reconstruction with hamstring autograft results in satisfactory outcome

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Kejriwal, Ritwik; Buelow, Jens

2017-01-01

Objectives: Revision anterior cruciate ligament (ACL) reconstruction is associated with poorer outcomes and higher rerupture rates when compared to primary ACL reconstruction. There is also a significant heterogeneity in surgical technique, number of stages, and graft options. We report a large single surgeon case series with hamstring autograft as a graft option. Methods: Observational series of revision ACL reconstructions performed by the senior author between 2005 and 2015 was carried out. Chart reviews and clinic follow-ups were performed with the following recorded – re-rupture rate, radiographic grading of osteoarthritis, KT-1000 arthrometer test, IKDC outcome scores and knee range of motion. All patients underwent single bundle four-strand hamstring autograft performed in one stage with use of new tunnels in majority of the cases. Results: 66 patients underwent hamstring autograft one-stage revision ACL reconstruction by Dr Jens Buelow. Chart review was carried out on all patients, and 26 (39%) were followed up in clinic and/or by phone with a mean follow up of 4.7 years. Outcomes included re-rupture rate of 4.5%, reoperation rate of 12%, mean visual analogue scale score of 7.6, mean side-to-side difference of 2.6 mm for KT-1000 arthrometer test, and mean IKDC score of 79. Of the 17 patients with radiographs, 40% had moderate osteoarthritis (grade 2 or 3) at follow-up. Conclusion: Revision ACL reconstruction can result in a satisfactory outcome when performed with a hamstring autograft in one stage.

Internet-based interface for STRMDEPL08

Science.gov (United States)

Reeves, Howard W.; Asher, A. Jeremiah

2010-01-01

The core of the computer program STRMDEPL08 that estimates streamflow depletion by a pumping well with one of four analytical solutions was re-written in the Javascript software language and made available through an internet-based interface (web page). In the internet-based interface, the user enters data for one of the four analytical solutions, Glover and Balmer (1954), Hantush (1965), Hunt (1999), and Hunt (2003), and the solution is run for constant pumping for a desired number of simulation days. Results are returned in tabular form to the user. For intermittent pumping, the interface allows the user to request that the header information for an input file for the stand-alone executable STRMDEPL08 be created. The user would add the pumping information to this header information and run the STRMDEPL08 executable that is available for download through the U.S. Geological Survey. Results for the internet-based and stand-alone versions of STRMDEPL08 are shown to match.

Different knee joint loading patterns in ACL deficient copers and non-copers during walking

DEFF Research Database (Denmark)

Alkjaer, Tine; Henriksen, Marius; Simonsen, Erik B

2011-01-01

Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces...

Pseudocyclops: two cases of ACL graft partial tears mimicking cyclops lesions on MRI

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Simpfendorfer, Claus; Subhas, Naveen; Winalski, Carl S.; Ilaslan, Hakan [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Miniaci, Anthony [Cleveland Clinic, Department of Orthopedics, Cleveland, OH (United States)

2015-08-15

Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is a common surgical procedure, particularly in young athletes. Although the procedure has excellent success rates, complications such as mechanical impingement, graft rupture, and arthrofibrosis can occur, often necessitating additional surgery. Magnetic resonance (MR) imaging has become a valuable tool in evaluating complications after ACL reconstruction. We report two cases of ACL reconstruction complicated by arthroscopically proven partial graft tears. In both cases the torn anterior graft fibers were flipped into the intercondylar notch, mimicking anterior arthrofibrosis, i.e., a ''cyclops lesion,'' on MR imaging. Careful review of the direction of graft fibers on MR imaging in the ''pseudocyclops'' lesions can help differentiate these partial tears from the fibrosis of a true cyclops. The ''pseudocyclops'' lesion is a previously undescribed MR imaging sign of partial ACL graft tear. Larger studies are required to determine the sensitivity and specificity of the sign, as well as the clinical importance of these partial graft tears. (orig.)

ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task.

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Pollard, Christine D; Sigward, Susan M; Powers, Christopher M

2017-09-01

Injury prevention training has been shown to be effective in reducing the incidence of noncontact anterior cruciate ligament (ACL) injury; however, the underlying reason for the success of these training programs is unclear. To investigate whether an ACL injury prevention program that has been shown to reduce the incidence of ACL injury alters sagittal plane hip and knee biomechanics during a drop-landing task. Descriptive laboratory study. Thirty female club soccer players (age range, 11-17 years) with no history of knee injury participated in this study. Kinematics and ground-reaction forces were collected while each participant performed a drop-landing task prior to and immediately after participation in a 12-week ACL injury prevention training program. After ACL injury prevention training, participants demonstrated decreased knee extensor moments ( P = .03), increased energy absorption at the hip ( P = .04), decreased knee-to-hip extensor moment ratios ( P = .05), and decreased knee-to-hip energy absorption ratios ( P = .03). Participation in an ACL injury prevention training program decreased reliance on the knee extensor muscles and improved use of the hip extensor muscles, which may explain the protective effect of this type of training program on ACL injury. Based on these findings, clinicians can better understand how ACL injury prevention training, such as the Prevent Injury and Enhance Performance (PEP) Program, may change movement behavior at both the hip and knee. Furthermore, the study findings may support the implementation of the PEP Program, or a similar program, for clinicians aiming to improve use of the hip in an effort to reduce knee loading and consequent injuries.

Dynamic augmentation restores anterior tibial translation in ACL suture repair: a biomechanical comparison of non-, static and dynamic augmentation techniques.

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Hoogeslag, Roy A G; Brouwer, Reinoud W; Huis In 't Veld, Rianne; Stephen, Joanna M; Amis, Andrew A

2018-02-03

There is a lack of objective evidence investigating how previous non-augmented ACL suture repair techniques and contemporary augmentation techniques in ACL suture repair restrain anterior tibial translation (ATT) across the arc of flexion, and after cyclic loading of the knee. The purpose of this work was to test the null hypotheses that there would be no statistically significant difference in ATT after non-, static- and dynamic-augmented ACL suture repair, and they will not restore ATT to normal values across the arc of flexion of the knee after cyclic loading. Eleven human cadaveric knees were mounted in a test rig, and knee kinematics from 0° to 90° of flexion were recorded by use of an optical tracking system. Measurements were recorded without load and with 89-N tibial anterior force. The knees were tested in the following states: ACL-intact, ACL-deficient, non-augmented suture repair, static tape augmentation and dynamic augmentation after 10 and 300 loading cycles. Only static tape augmentation and dynamic augmentation restored ATT to values similar to the ACL-intact state directly postoperation, and maintained this after cyclic loading. However, contrary to dynamic augmentation, the ATT after static tape augmentation failed to remain statistically less than for the ACL-deficient state after cyclic loading. Moreover, after cyclic loading, ATT was significantly less with dynamic augmentation when compared to static tape augmentation. In contrast to non-augmented ACL suture repair and static tape augmentation, only dynamic augmentation resulted in restoration of ATT values similar to the ACL-intact knee and decreased ATT values when compared to the ACL-deficient knee immediately post-operation and also after cyclic loading, across the arc of flexion, thus allowing the null hypotheses to be rejected. This may assist healing of the ruptured ACL. Therefore, this study would support further clinical evaluation of dynamic augmentation of ACL repair.

Comparison between clinical grading and navigation data of knee laxity in ACL-deficient knees

Directory of Open Access Journals (Sweden)

Yamamoto Yuji

2010-11-01

Full Text Available Abstract Background The latest version of the navigation system for anterior cruciate ligament (ACL reconstruction has the supplementary ability to assess knee stability before and after ACL reconstruction. In this study, we compared navigation data between clinical grades in ACL-deficient knees and also analyzed correlation between clinical grading and navigation data. Methods 150 ACL deficient knees that received primary ACL reconstruction using an image-free navigation system were included. For clinical evaluation, the Lachman, anterior drawer, and pivot shift tests were performed under general anesthesia and were graded by an examiner. For the assessment of knee stability using the navigation system, manual tests were performed again before ACL reconstruction. Navigation data were recorded as anteroposterior (AP displacement of the tibia for the Lachman and anterior drawer tests, and both AP displacement and tibial rotation for the pivot shift test. Results Navigation data of each clinical grade were as follows; Lachman test grade 1+: 10.0 mm, grade 2+: 13.2 ± 3.1 mm, grade 3+: 14.5 ± 3.3 mm, anterior drawer test grade 1+: 6.8 ± 1.4 mm, grade 2+: 7.4 ± 1.8 mm, grade 3+: 9.1 ± 2.3 mm, pivot shift test grade 1+: 3.9 ± 1.8 mm/21.5° ± 7.8°, grade 2+: 4.8 ± 2.1 mm/21.8° ± 7.1°, and grade 3+: 6.0 ± 3.2 mm/21.1° ± 7.1°. There were positive correlations between clinical grading and AP displacement in the Lachman, and anterior drawer tests. Although positive correlations between clinical grading and AP displacement in pivot shift test were found, there were no correlations between clinical grading and tibial rotation in pivot shift test. Conclusions In response to AP force, the navigation system can provide the surgeon with correct objective data for knee laxity in ACL deficient knees. During the pivot shift test, physicians may grade according to the displacement of the tibia, rather than rotation.

Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study.

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Grindem, Hege; Snyder-Mackler, Lynn; Moksnes, Håvard; Engebretsen, Lars; Risberg, May Arna

2016-07-01

Knee reinjury after ACL reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population. To assess the relationship between knee reinjury after ACL reconstruction and (1) return to level I sports, (2) timing of RTS and (3) knee function prior to return. 106 patients who participated in pivoting sports participated in this prospective 2-year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey-Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria were defined as scores >90 on all tests, failure as failing any. Patients who returned to level I sports had a 4.32 (p=0.048) times higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2% of those who failed RTS criteria suffered reinjuries versus 5.6% of those who passed (HR 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate. Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. RTS 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduce the reinjury rate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Histological characteristics of ligament healing after bio-enhanced repair of the transected goat ACL

NARCIS (Netherlands)

Nguyen, D. Tan; Dellbrügge, Sietske; Tak, Paul P.; Woo, Savio L.-Y.; Blankevoort, Leendert; van Dijk, Niek C.

2015-01-01

Recently, healing of a ruptured anterior cruciate ligament (ACL) is reconsidered. In a previous study, we have shown that the transected ACL can heal after treatment with the triple X locking suture alone or combined with small intestine submucosa (SIS). The first research question of this study was

When to Stop CPR and When to Perform Rhythm Analysis: Potential Confusion Among ACLS Providers.

Science.gov (United States)

Giberson, Brandon; Uber, Amy; F Gaieski, David; Miller, Joseph B; Wira, Charles; Berg, Katherine; Giberson, Tyler; Cocchi, Michael N; S Abella, Benjamin; Donnino, Michael W

2016-09-01

Health care providers nationwide are routinely trained in Advanced Cardiac Life Support (ACLS), an American Heart Association program that teaches cardiac arrest management. Recent changes in the ACLS approach have de-emphasized routine pulse checks in an effort to promote uninterrupted chest compressions. We hypothesized that this new ACLS algorithm may lead to uncertainty regarding the appropriate action following detection of a pulse during a cardiac arrest. We conducted an observational study in which a Web-based survey was sent to ACLS-trained medical providers at 4 major urban tertiary care centers in the United States. The survey consisted of 5 multiple-choice, scenario-based ACLS questions, including our question of interest. Adult staff members with a valid ACLS certification were included. A total of 347 surveys were analyzed. The response rate was 28.1%. The majority (53.6%) of responders were between 18 and 32 years old, and 59.9% were female. The majority (54.2%) of responders incorrectly stated that they would continue CPR and possibly administer additional therapies when a team member detects a pulse immediately following defibrillation. Secondarily, only 51.9% of respondents correctly chose to perform a rhythm check following 2 minutes of CPR. The other 3 survey questions were correctly answered an average of 89.1% of the time. Confusion exists regarding whether or not CPR and cardiac medications should be continued in the presence of a pulse. Education may be warranted to emphasize avoiding compressions and medications when a palpable pulse is detected. © The Author(s) 2014.

Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

DEFF Research Database (Denmark)

Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

2018-01-01

BACKGROUND: In people with anterior cruciate ligament (ACL) injury, high self-efficacy facilitates recovery, indicated by improved muscle function, reduced knee symptoms and increased physical activity. Impact of treatment on future self-efficacy is however not well investigated. The aims...... of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...

Tibialis anterior volumes and areas in ACL-injured limbs compared with unimpaired.

Science.gov (United States)

Binder-Macleod, Benjamin I; Buchanan, Thomas S

2006-09-01

Past research has shown that subjects with ACL injuries show activation differences and atrophy in the muscles that cross the knee, including the gastrocnemii, which predominately act at the ankle. However, it is not known how the other ankle muscles that do not cross the knee are affected. We focused on the two muscles that control the ankle, the soleus and tibialis anterior muscles, to see how they were affected by an ACL injury. We hypothesized that the ankle muscles of subjects with ACL injuries that did not require surgery (copers) would be more like normals and that the muscles of subjects with ACL injuries who required surgery to return to normal activity (noncopers) would atrophy. Twenty-seven subjects were divided into three even categories: unimpaired subjects, copers, and noncopers. Axial spin-echo T1-weighted MRI images were used to digitally reconstruct the tibialis anterior and the soleus. We used the digitally reconstructed muscles to determine the peak cross-sectional area and volume of each muscle. The copers' tibialis anterior muscles were similar to the unimpaired subjects, but, surprisingly, the noncoper's tibialis anterior muscles of the injured leg were larger than those of their uninjured legs (P heel strike or from the inversion of the foot causing external rotation of the tibia as a stabilizing technique for the knee.

The acutely ACL injured knee assessed by MRI

DEFF Research Database (Denmark)

Frobell, R B; Roos, H P; Roos, E M

2008-01-01

OBJECTIVES: To map by magnetic resonance imaging (MRI) and quantitative MRI (qMRI) concomitant fractures and meniscal injuries, and location and volume of traumatic bone marrow lesions (BMLs) in the acutely anterior cruciate ligament (ACL) injured knee. To relate BML location and volume to cortic...

Neuromuscular coordination deficit persists 12 months after ACL reconstruction but can be modulated by 6 weeks of kettlebell training

DEFF Research Database (Denmark)

Zebis, Mette K.; Andersen, Christoffer H.; Bencke, Jesper

2017-01-01

The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL...... for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high...

Mediolateral Differences of Proteoglycans Distribution at the ACL Tibial Footprint: Experimental Study of 16 Cadaveric Knees

Directory of Open Access Journals (Sweden)

Joon Ho Wang

2018-01-01

Full Text Available This study aimed to identify the staining pattern of ACL attachment blended with cartilage of the medial tibial plateau at the tibial insertion and histologically characterize the tibial footprint. Sixteen fresh frozen cadaveric knees (mean age: 52.0±6.2 years were used for this study. The specimens were bisected in the coronal plane, in accordance with the fiber orientation of the ACL tibial attachment. Adjacent sections were then stained with hematoxylin and eosin (H&E to observe the morphology of the ACL insertion and with fast green and Safranin-O protocols to evaluate for collagen and proteoglycans (PG. The insertion area on the tibial footprint was divided into five zones in the medial to lateral direction, which was determined by division of the section from most prominent medial tibial spine to most lateral margin of ACL attachment. Then rectangular area with a vertical length that is twice the width of respective five zones was set. Stained areas of all images were quantified positively by using ImageJ software, and the value for staining area measured was defined in percentage by multiplying whole image area by 100. The mean proportion of Safranin-O staining is significantly greater nearer to the medial tibial spine (59% in zone 1, 32% in zone 2, 13% in zone 3, 13% in zone 4, and 4% in zone 5, P<0.001. The medial section of the tibial insertion area grew in size and increased in PG staining with more densely organized collagen arrangement with more fibrocartilage cells. The ACL tibial insertion showed a medially eccentric staining pattern by histological evaluation of the ACL attachment to cartilage. Our histological results of the eccentric biomaterial property in the medial tibial spine of ACL insertion area can be considered in making a more functional anatomic tibial tunnel placement.

Dynamic knee stability and ballistic knee movement after ACL reconstruction: an application on instep soccer kick.

Science.gov (United States)

Cordeiro, Nuno; Cortes, Nelson; Fernandes, Orlando; Diniz, Ana; Pezarat-Correia, Pedro

2015-04-01

The instep soccer kick is a pre-programmed ballistic movement with a typical agonist-antagonist coordination pattern. The coordination pattern of the kick can provide insight into deficient neuromuscular control. The purpose of this study was to investigate knee kinematics and hamstrings/quadriceps coordination pattern during the knee ballistic extension phase of the instep kick in soccer players after anterior cruciate ligament reconstruction (ACL reconstruction). Seventeen players from the Portuguese Soccer League participated in this study. Eight ACL-reconstructed athletes (experimental group) and 9 healthy individuals (control group) performed three instep kicks. Knee kinematics (flexion and extension angles at football contact and maximum velocity instants) were calculated during the kicks. Rectus femoris (RF), vastus lateralis, vastus medialis, biceps femoralis, and semitendinosus muscle activations were quantified during the knee extension phase. The ACL-reconstructed group had significantly lower knee extension angle (-1.2 ± 1.6, p ballistic control movement pattern between normal and ACL-reconstructed subjects. Performing open kinetic chain exercises using ballistic movements can be beneficial when recovering from ACL reconstruction. The exercises should focus on achieving multi-joint coordination and full knee extension (range of motion). III.

Knee functional recovery and limb-to-limb symmetry restoration after anterior cruciate ligament (ACL) rupture and ACL reconstruction

Science.gov (United States)

Nawasreh, Zakariya Hussein

Anterior cruciate ligament (ACL) rupture is a common sport injury of young athletes who participate in jumping, cutting, and pivoting activities. Although ACL reconstruction (ACLR) surgery has the goal of enabling athletes to return to preinjury activity levels, treatment results often fall short of this goal. The outcomes after ACLR are variable and less than optimal with low rate of return to preinjury activity level and high risk for second ACL injury. Factors related to the knee functional limitations, strength deficits, and limb-to-limb movement asymmetry may be associated with poor outcomes after ACLR. Additionally, the criteria that are used to determine a patient's readiness to return to the preinjury activity level are undefined which may also be associated with poor outcomes after ACLR. The clinical decision-making to clear patients' for safe and successful return to high physical activities should be based on a universal comprehensive set of objective criteria that ensure normal knee function and limb-to-limb symmetry. A battery of return to activity criteria (RTAC) that emphases normal knee function and limb-to-limb movement symmetry has been constituted to better ensure safe and successful return to preinjury activity level. Yet, only variables related to patients' demographics, concomitant injuries, and treatment measures have been used to predict return to preinjury activity levels after ACLR. However, the ability of RTAC variables that ensure normal knee function and limb movement symmetry to predict the return to participate in the same preinjury activity level after ACLR has not been investigated. In light of this background, the first aim of the present study was to compare functional knee performance-based and patient-reported measures of those who PASS and who FAIL on RTAC at 6 months (6-M) following ACLR with those at 12 months (12-M) and 24 months (24-M) following ACLR and to determine how performance-based and patient-reported measures

High Variability in Outcome Reporting Patterns in High-Impact ACL Literature.

Science.gov (United States)

Makhni, Eric C; Padaki, Ajay S; Petridis, Petros D; Steinhaus, Michael E; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2015-09-16

ACL (anterior cruciate ligament) reconstruction is one of the most commonly performed and studied procedures in modern sports medicine. A multitude of objective and subjective patient outcome measures exists; however, nonstandardized reporting patterns of these metrics may create challenges in objectively analyzing pooled results from different studies. The goal of this study was to document the variability in outcome reporting patterns in high-impact orthopaedic studies of ACL reconstruction. All clinical studies pertaining to ACL reconstruction in four high-impact-factor orthopaedic journals over a five-year period were reviewed. Biomechanical, basic science, and imaging studies were excluded, as were studies with fewer than fifty patients, yielding 119 studies for review. Incorporation of various objective and subjective outcomes was noted for each study. Substantial variability in reporting of both objective and subjective measures was noted in the study cohort. Although a majority of studies reported instrumented laxity findings, there was substantial variability in the type and method of laxity reporting. Most other objective outcomes, including range of motion, strength, and complications, were reported in <50% of all studies. Return to pre-injury level of activity was infrequently reported (24% of studies), as were patient satisfaction and pain assessment following surgery (8% and 13%, respectively). Of the patient-reported outcomes, the International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were most often reported (71%, 63%, and 42%, respectively). Substantial variability in outcome reporting patterns exists among high-impact studies of ACL reconstruction. Such variability may create challenges in interpreting results and pooling them across different studies. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Factors that influence the intra-articular rupture pattern of the ACL graft following single-bundle reconstruction

NARCIS (Netherlands)

van Eck, Carola F.; Kropf, Eric J.; Romanowski, James R.; Lesniak, Bryson P.; Tranovich, Michael J.; van Dijk, C. Niek; Fu, Freddie H.

2011-01-01

The number of revision anterior cruciate ligament (ACL) surgeries performed annually continues to rise. The purpose of this study was to determine the most common rupture pattern in ACL revision cases after previous single-bundle reconstruction. The second aim was to determine the relationship

Knee stabiligy after ACL reconstruction through graft fixation in femoral tunnel: transfemoral pinning versus endobutton techniques

Directory of Open Access Journals (Sweden)

Tahmasebi MN

2011-05-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament (ACL. Reconstruction of the torn ACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel in ACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopic ACL reconstruction by examining knee stability and use of other relevant functional tests. "n"nMethods : Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years 2008-2009 and were being followed up were evaluated at least 15 months post-operatively by physical examination and the use of an arthrometer made by the Faculty of Mechanics of Sharif Technical University."n"nResults : The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and

THE ASSOCIATIONS BETWEEN HIP STRENGTH AND HIP KINEMATICS DURING A SINGLE LEG HOP IN RECREATIONAL ATHLETES POST ACL RECONSTRUCTION COMPARED TO HEALTHY CONTROLS.

Science.gov (United States)

Tate, Jeremiah; Suckut, Tell; Wages, Jensen; Lyles, Heather; Perrin, Benjamin

2017-06-01

Only a small amount of evidence exists linking hip abductor weakness to dynamic knee valgus during static and dynamic activities. The associations of hip extensor strength and hip kinematics during the landing of a single leg hop are not known. Purpose: To determine if relationships exist between hip extensor and abductor strength and hip kinematics in both involved and uninvolved limb during the landing phase of a single leg hop in recreational athletes post anterior cruciate ligament (ACL) reconstruction. The presence of similar associations was also evaluated in healthy recreational athletes. Controlled Laboratory Study; Cross-sectional. Twenty-four recreational college-aged athletes participated in the study (12 post ACL reconstruction; 12 healthy controls). Sagittal and frontal plane hip kinematic data were collected for five trials during the landing of a single leg hop. Hip extensor and abductor isometric force production was measured using a hand-held dynamometer and normalized to participants' height and weight. Dependent and independent t-tests were used to analyze for any potential differences in hip strength or kinematics within and between groups, respectively. Pearson's r was used to demonstrate potential associations between hip strength and hip kinematics for both limbs in the ACL group and the right limb in the healthy control group. Independent t-tests revealed that participants post ACL reconstruction exhibited less hip extensor strength (0.18 N/Ht*BW vs. 0.25 N/Ht*BW, p=hip adduction (9.0 º vs. 0.8 º, p=hip extensor strength and maximum hip abduction/adduction angle in the involved limb. A moderate and direct relationship between hip abductor strength and maximum hip flexion angle was demonstrated in the both the involved ( r =.62) and uninvolved limb ( r =.65, p=.02). No significant associations were demonstrated between hip extensor or abductor strength and hip flexion and/or abduction/adduction angles in the healthy group. The

Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction.

Science.gov (United States)

Arundale, Amelia J H; Cummer, Kathleen; Capin, Jacob J; Zarzycki, Ryan; Snyder-Mackler, Lynn

2017-10-01

Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation. The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve self-reported normal knee function; and (4) the time from surgery to passing return to sport criteria. Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3-9 months after ACL reconstruction, > 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, single-legged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators blind to group. Athletes were categorized as having normal or abnormal knee function at each time point based on IKDC score, and the time until athletes passed strict return

Complications and Adverse Events of a Randomized Clinical Trial Comparing 3 Graft Types for ACL Reconstruction.

Science.gov (United States)

Mohtadi, Nicholas; Barber, Rhamona; Chan, Denise; Paolucci, Elizabeth Oddone

2016-05-01

Complications/adverse events of anterior cruciate ligament (ACL) surgery are underreported, despite pooled level 1 data in systematic reviews. All adverse events/complications occurring within a 2-year postoperative period after primary ACL reconstruction, as part of a large randomized clinical trial (RCT), were identified and described. Prospective, double-blind randomized clinical trial. Patients and the independent trained examiner were blinded to treatment allocation. University-based orthopedic referral practice. Three hundred thirty patients (14-50 years; 183 males) with isolated ACL deficiency were intraoperatively randomized to ACL reconstruction with 1 autograft type. Graft harvest and arthroscopic portal incisions were identical. Patients were equally distributed to patellar tendon (PT), quadruple-stranded hamstring tendon (HT), and double-bundle (DB) hamstring autograft ACL reconstruction. Adverse events/complications were patient reported, documented, and diagnoses confirmed. Two major complications occurred: pulmonary embolism and septic arthritis. Twenty-four patients (7.3%) required repeat surgery, including 25 separate operations: PT = 7 (6.4%), HT = 9 (8.2%), and DB = 8 (7.3%). Repeat surgery was performed for meniscal tears (3.6%; n = 12), intra-articular scarring (2.7%; n = 9), chondral pathology (0.6%; n = 2), and wound dehiscence (0.3%; n = 1). Other complications included wound problems, sensory nerve damage, muscle tendon injury, tibial periostitis, and suspected meniscal tears and chondral lesions. Overall, more complications occurred in the HT/DB groups (PT = 24; HT = 31; DB = 45), but more PT patients complained of moderate or severe kneeling pain (PT = 17; HT = 9; DB = 4) at 2 years. Overall, ACL reconstructive surgery is safe. Major complications were uncommon. Secondary surgery was necessary 7.3% of the time for complications/adverse events (excluding graft reinjury or revisions) within the first 2 years. Level 1 (therapeutic studies

Stiff Landings Are Associated With Increased ACL Injury Risk in Young Female Basketball and Floorball Players.

Science.gov (United States)

Leppänen, Mari; Pasanen, Kati; Kujala, Urho M; Vasankari, Tommi; Kannus, Pekka; Äyrämö, Sami; Krosshaug, Tron; Bahr, Roald; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari

2017-02-01

Few prospective studies have investigated the biomechanical risk factors of anterior cruciate ligament (ACL) injury. To investigate the relationship between biomechanical characteristics of vertical drop jump (VDJ) performance and the risk of ACL injury in young female basketball and floorball players. Cohort study; Level of evidence, 3. At baseline, a total of 171 female basketball and floorball players (age range, 12-21 years) participated in a VDJ test using 3-dimensional motion analysis. The following biomechanical variables were analyzed: (1) knee valgus angle at initial contact (IC), (2) peak knee abduction moment, (3) knee flexion angle at IC, (4) peak knee flexion angle, (5) peak vertical ground-reaction force (vGRF), and (6) medial knee displacement. All new ACL injuries, as well as match and training exposure, were then recorded for 1 to 3 years. Cox regression models were used to calculate hazard ratios (HRs) and 95% CIs. Fifteen new ACL injuries occurred during the study period (0.2 injuries/1000 player-hours). Of the 6 factors considered, lower peak knee flexion angle (HR for each 10° increase in knee flexion angle, 0.55; 95% CI, 0.34-0.88) and higher peak vGRF (HR for each 100-N increase in vGRF, 1.26; 95% CI, 1.09-1.45) were the only factors associated with increased risk of ACL injury. A receiver operating characteristic (ROC) curve analysis showed an area under the curve of 0.6 for peak knee flexion and 0.7 for vGRF, indicating a failed-to-fair combined sensitivity and specificity of the test. Stiff landings, with less knee flexion and greater vGRF, in a VDJ test were associated with increased risk of ACL injury among young female basketball and floorball players. However, although 2 factors (decreased peak knee flexion and increased vGRF) had significant associations with ACL injury risk, the ROC curve analyses revealed that these variables cannot be used for screening of athletes.

Time from ACL injury to reconstruction and the prevalence of additional intra-articular pathology: is patient age an important factor?

Science.gov (United States)

Magnussen, Robert A; Pedroza, Angela D; Donaldson, Christopher T; Flanigan, David C; Kaeding, Christopher C

2013-09-01

Meniscus and cartilage lesions have been reported to be prevalent during delayed reconstruction of anterior cruciate ligament (ACL) injuries. Relatively, little work has been done exploring the influence of patient age on this relationship. The purpose of this study is to determine whether the effect of time from ACL injury to reconstruction on the prevalence of associated meniscal and chondral injury is influenced by patient age. It was hypothesized that patients in whom the time from ACL injury to reconstruction exceeds 12 weeks will exhibit an increased prevalence of medial compartment pathology relative to those reconstructed within 12 weeks of injury in patients of all ages. Data detailing time from ACL injury to reconstruction and the prevalence of intra-articular findings were obtained in 311 of 489 consecutive patients undergoing primary isolated ACL reconstruction. Patients were divided into two groups based on whether the time from ACL injury to reconstruction was time from ACL injury to reconstruction exceeded 12 weeks. The prevalence of lateral meniscal injury did not increase with increasing time ACL injury to surgery. Among patients aged 22 years and under, there was no increase in the prevalence of intra-articular pathology in any compartment in the late reconstruction group. In contrast, among patients over the age of 22, there was a significant increase in the prevalence of medial chondral injury (p = 0.042) in the late reconstruction group. The prevalence of injuries to the meniscus and articular cartilage in the medial compartment of the knee is increased with increasing time from ACL injury to reconstruction. This relationship may vary depending on patient age. Patients over the age of 22 exhibit a higher prevalence of intra-articular injury with delayed reconstruction, while no such differences are noted among younger patients. Retrospective comparative study, level III.

Bit-Blasting ACL2 Theorems

Directory of Open Access Journals (Sweden)

Sol Swords

2011-10-01

Full Text Available Interactive theorem proving requires a lot of human guidance. Proving a property involves (1 figuring out why it holds, then (2 coaxing the theorem prover into believing it. Both steps can take a long time. We explain how to use GL, a framework for proving finite ACL2 theorems with BDD- or SAT-based reasoning. This approach makes it unnecessary to deeply understand why a property is true, and automates the process of admitting it as a theorem. We use GL at Centaur Technology to verify execution units for x86 integer, MMX, SSE, and floating-point arithmetic.

Pain in donor site after BTB-ACL reconstruction with PRGF: a randomized trial.

Science.gov (United States)

Seijas, Roberto; Cuscó, Xavier; Sallent, Andrea; Serra, Iván; Ares, Oscar; Cugat, Ramón

2016-06-01

Anterior cruciate ligament (ACL) tears are highly incident injuries in young athletes within our work area. The use of the patellar graft, despite being the treatment of choice, presents post-operative problems such as anterior knee pain, which limits its use and leads to preference being taken for alternative grafts. Our aim was to evaluate if the application of PRGF reduces anterior knee pain in donor site in BTB-ACL reconstruction. 43 patients were included in the double-blinded and randomized clinical trial comparing two patient groups who underwent ACL reconstruction using patellar tendon graft, comparing anterior knee pain with and without the application of PRGF at the donor site after harvesting the graft. The PRGF group showed decreased donor site pain in comparison to the control group, with significant differences in the first two months of follow-up. The application of PRGF decreased donor site pain compared to the control group.

Longitudinal analysis of tibiofemoral cartilage contact area and position in ACL reconstructed patients.

Science.gov (United States)

Chen, Ellison; Amano, Keiko; Pedoia, Valentina; Souza, Richard B; Ma, C Benjamin; Li, Xiaojuan

2018-04-18

Patients who have suffered ACL injury are more likely to develop early onset post-traumatic osteoarthritis despite reconstruction. The purpose of our study was to evaluate the longitudinal changes in the tibiofemoral cartilage contact area size and location after ACL injury and reconstruction. Thirty-one patients with isolated unilateral ACL injury were followed with T 2 weighted Fast Spin Echo, T 1ρ and T 2 MRI at baseline prior to reconstruction, and 6 months, 1 year, and 2 years after surgery. Areas were delineated in FSE images with an in-house Matlab program using a spline-based semi-automated segmentation algorithm. Tibiofemoral contact area and centroid position along the anterior-posterior axis were calculated along with T 1ρ and T 2 relaxation times on both the injured and non-injured knees. At baseline, the injured knees had significantly smaller and more posteriorly positioned contact areas on the medial tibial surface compared to corresponding healthy knees. These differences persisted 6 months after reconstruction. Moreover, subjects with more anterior medial centroid positions at 6 months had elevated T 1ρ and T 2 measures in the posterior medial tibial plateau at 1 year. Changes in contact area and centroid position after ACL injury and reconstruction may characterize some of the mechanical factors contributing to post-traumatic osteoarthritis. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury

NARCIS (Netherlands)

van Eck, Carola F.; Kropf, Eric J.; Romanowski, James R.; Lesniak, Bryson P.; Tranovich, Michael J.; van Dijk, C. Niek; Fu, Freddie H.

2011-01-01

To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Forty patients who presented

Review of CD Rom: The Virtual Surgeon: ACL Reconstruction ...

African Journals Online (AJOL)

THE VIRTUAL SURGEON: ACL RECONSTRUCTION Professor George Bentley ChM FRCS, Russell E LVindsor MD, Mr Andrew Williams FRCS(0rth); 4150 + VAT(UK) The Virtual Surgeon - 3D Anatomy of the Knee 469 + VAT(UK). TVF Multimedia Ltd, 375 City Road, London, EClV lNB, UK ...

Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

International Nuclear Information System (INIS)

Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica; Wojtys, Edward

2007-01-01

We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing.

Science.gov (United States)

Oh, Youkeun K; Kreinbrink, Jennifer L; Wojtys, Edward M; Ashton-Miller, James A

2012-04-01

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring, and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment, and internal or external tibial torque) was applied to the distal tibia while recording the 3D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3 mm DVRT. In this repeated measures experiment, the Wilcoxon signed-rank test was used to test the null hypotheses with p < 0.05 considered significant. The mean (±SD) peak AM-ACL relative strains were 5.4 ± 3.7% and 3.1 ± 2.8% under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4 ± 160.1%/s and 179.4 ± 109.9%/s, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70 and 42% greater under internal than under external tibial torque, respectively (p = 0.023, p = 0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. Copyright © 2011 Orthopaedic Research Society.

Transportal femoral drilling creates more horizontal ACL graft orientation compared to transtibial drilling: A 3D CT imaging study.

Science.gov (United States)

Clockaerts, S; Van Haver, A; Verhaegen, J; Vuylsteke, K; Leenders, T; Lagae, K C; Verdonk, P

2016-06-01

The principle of anatomic anterior cruciate ligament (ACL) reconstruction is to create a femoral and tibial tunnel that resembles the insertion of the native ACL. Anatomic reconstruction leads to a more horizontal graft orientation that provides more rotational stability. The aim of this study is to investigate the best method to achieve anatomical reconstruction of femoral insertion of the ACL and thus, a more horizontal orientation of the ACL. We compared tunnel position and orientation between transportal femoral drilling technique and transtibial technique. Thirty-two patients were included. Post-operative CT scans were obtained and femur, tibia and ACL tunnels were reconstructed. The position and orientation of tibial and femoral tunnels were quantified using the quadrant method, and femoral tunnel length, ellipticity and posterior wall breakage were assessed. We also investigated clinical outcome. Analyses show that transportal drilled femoral tunnels were situated significantly lower than transtibial drilled tunnels (p<0.0001), resulting in a significantly more horizontal oriented ACL in the transportal group in coronal (p<0.0001) and sagittal plane (p=0.01). No differences were observed in depth of femoral tunnel position (p=0.44). Femoral tunnel length was shorter in the transportal group (p=0.01) with a more ellipsoidal femoral aperture (p=0.01). There were no differences between both groups in tibial position. There were no differences in clinical outcome measure between the transportal and transtibial groups. This study indicates that transportal drilling of the femoral tunnel leads to a more horizontal graft orientation of the ACL, without differences in clinical outcome. Copyright © 2016 Elsevier B.V. All rights reserved.

Anterior cruciate ligament- and hamstring tendon- derived cells: in vitro differential properties of cells involved in ACL reconstruction

NARCIS (Netherlands)

Ghebes, C.A.; Kelder, C.; Schot, T.; Renard, A.J.S.; Pakvis, D.F.M.; Fernandes, H.; Saris, Daniël B.F.

2015-01-01

Anterior cruciate ligament (ACL) reconstruction involves the replacement of the torn ligament with a new graft, often a hamstring tendon (HT). Described as similar, the ACL and HT have intrinsic differences related to their distinct anatomical locations. From a cellular perspective, identifying

Association between maximal hamstring strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury

DEFF Research Database (Denmark)

Skov Husted, Rasmus; Bencke, Jesper; Thorborg, Kristian

2014-01-01

Introduction Reduced hamstring pre-activity during side-cutting may predispose for non-contact ACL injury. During the last decade resistance training of the lower limb muscles has become an integral part of ACL injury prevention in e.g. soccer and handball. However, it is not known whether a strong...... hamstring (ACL-agonist) musculature is associated with a high level of hamstring muscle pre-activity during high risk movements such as side-cutting. The purpose of this study was to examine the relationship between hamstring muscle pre-activity recorded during a standardized sidecutting maneuver...... translate into high levels of muscle pre-activity during movements like the sidecutting maneuver. Thus, other exercise modalities (i.e. neuromuscular training) are needed to optimize hamstring muscle pre-activity during movements associated with non-contact ACL injury....

Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

DEFF Research Database (Denmark)

Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

2018-01-01

of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...... of delayed ACLR. In this ancillary study, participants with knee self-efficacy data at 6 years (n = 89) were analyzed as treated; exercise therapy alone (n = 20), exercise therapy plus early ACLR (n = 46), and exercise therapy plus delayed ACLR (n = 23). The participants performed physical performance tests...

Altered lower extremity joint mechanics occur during the star excursion balance test and single leg hop after ACL-reconstruction in a collegiate athlete.

Science.gov (United States)

Samaan, Michael A; Ringleb, Stacie I; Bawab, Sebastian Y; Greska, Eric K; Weinhandl, Joshua T

2018-03-01

The effects of ACL-reconstruction on lower extremity joint mechanics during performance of the Star Excursion Balance Test (SEBT) and Single Leg Hop (SLH) are limited. The purpose of this study was to determine if altered lower extremity mechanics occur during the SEBT and SLH after ACL-reconstruction. One female Division I collegiate athlete performed the SEBT and SLH tasks, bilaterally, both before ACL injury and 27 months after ACL-reconstruction. Maximal reach, hop distances, lower extremity joint kinematics and moments were compared between both time points. Musculoskeletal simulations were used to assess muscle force production during the SEBT and SLH at both time points. Compared to the pre-injury time point, SEBT reach distances were similar in both limbs after ACL-reconstruction except for the max anterior reach distance in the ipsilateral limb. The athlete demonstrated similar hop distances, bilaterally, after ACL-reconstruction compared to the pre-injury time point. Despite normal functional performance during the SEBT and SLH, the athlete exhibited altered lower extremity joint mechanics during both of these tasks. These results suggest that measuring the maximal reach and hop distances for these tasks, in combination with an analysis of the lower extremity joint mechanics that occur after ACL-reconstruction, may help clinicians and researchers to better understand the effects of ACL-reconstruction on the neuromuscular system during the SEBT and SLH.

Postinfectious ankylosis of the knee after bacterial arthritis following routine anterior cruciate ligament (ACL) reconstruction

OpenAIRE

Mester, Bastian; Schoepp, Christian; Glombitza, Martin; Rixen, Dieter

2016-01-01

Aims and Objectives: Knee arthroscopy is a very common surgical procedure. It belongs to the most frequently performed procedures in orthopedics and traumatology and is considered to have a low complication rate. The risk of postoperative knee infection following ACL reconstrucion is estimated 1-2 %. Thereby the ACL reconstruction cannot always be preserved. Persistent defects after healing and postinfectios osteoarthritis are observed. We present the case of an adolescent patient suffering f...

Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement

DEFF Research Database (Denmark)

Renstrom, P; Ljungqvist, A; Arendt, E

2008-01-01

clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery...... and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3...

Dimensionality of the Knee Numeric-Entity Evaluation Score (KNEES-ACL)

DEFF Research Database (Denmark)

Comins, J D; Krogsgaard, M R; Kreiner, Svend

2013-01-01

The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs...

ACL graft can replicate the normal ligament's tension curve

NARCIS (Netherlands)

Arnold, MP; Verdonschot, N; van Kampen, A

2005-01-01

The anatomical femoral insertion of the normal anterior cruciate ligament (ACL) lies on the deep portion of the lateral wall of the intercondylar fossa. Following the deep bone-cartilage border, it stretches from 11 o'clock high in the notch all the way down to its lowest border at 8 o'clock. The

Electrospinning polymer blends for biomimetic scaffolds for ACL tissue engineering

Science.gov (United States)

Garcia, Vanessa Lizeth

The anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. Current ACL reconstructive strategies consist of using an autograft or an allograft to replace the ligament. However, limitations have led researchers to create tissue engineered grafts, known as scaffolds, through electrospinning. Scaffolds made of natural and synthetic polymer blends have the potential to promote cell adhesion while having strong mechanical properties. However, enzymes found in the knee are known to degrade tissues and affect the healing of intra-articular injuries. Results suggest that the natural polymers used in this study modify the thermal properties and tensile strength of the synthetic polymers when blended. Scanning electron microscopy display bead-free and enzyme biodegradability of the fibers. Raman spectroscopy confirms the presence of the natural and synthetic polymers in the scaffolds while, amino acid analysis present the types of amino acids and their concentrations found in the natural polymers.

Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture.

Science.gov (United States)

Dejour, David; Saffarini, Mo; Demey, Guillaume; Baverel, Laurent

2015-10-01

Revision ACL reconstruction requires careful analysis of failure causes particularly in cases of two previous graft ruptures. Intrinsic factors as excessive tibial slope or narrow femoral notch increase failure risks but are rarely addressed in revision surgery. The authors report outcomes, at minimum follow-up of 2 years, for second revision ACL reconstructions combined with tibial deflexion osteotomy for correction of excessive slope (>12°). Nine patients that underwent second revision ACL reconstruction combined with tibial deflexion osteotomy were retrospectively studied. The mean age was 30.3 ± 4.4 years (median 28; range 26-37), and mean follow-up was 4.0 ± 2.0 years (median 3.6; range 2.0-7.6). Autografts were harvested from the quadriceps tendon (n = 8) or hamstrings (n = 1), and tibial osteotomy was done by anterior closing wedge, without detachment of the patellar tendon, to obtain a slope of 3° to 5°. All patients had fused osteotomies, stable knees, and there were no intraoperative or postoperative complications. The mean posterior tibial slope decreased from 13.2° ± 2.6° (median 13°; range 12°-18°) preoperatively to 4.4° ± 2.3° (median 4°; range 2°-8°) postoperatively. The mean Lysholm score was 73.8 ± 5.8 (median 74; range 65-82), and the IKDC-SKF was 71.6 ± 6.1 (median 72.8; range 62.2-78.5). The satisfactory results of second revision ACL reconstruction combined with tibial deflexion osteotomy at minimum follow-up of 2 years suggest that tibia slope correction protects reconstructed ACL from fatigue failure in this study. The authors stress the importance of careful analysis failure causes prior to revision ACL reconstruction, and recommend correction of tibial slope if it exceeds 12°, to reduce the risks of graft retear. III.

Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

Directory of Open Access Journals (Sweden)

Navin Kumar Karn

2015-12-01

Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

Dynamics of muscle strength improvement during isokinetic rehabilitation of athletes with ACL rupture and chondromalacia patellae.

Science.gov (United States)

Desnica Bakrac, N

2003-03-01

To assess quantitatively dynamics and extent of the increase in muscle strength during isokinetic rehabilitation. daily measurements of muscle strength; detailed testing at the beginning and at the end of rehabilitation. Cybex Rehabilitation Center, Zagreb. 44 athletes (31 m, 13 F, age 16-35), 3 injury-defined groups: athletes with ACL rupture (non-reconstructed and reconstructed) and chondromalacia patellae. all subjects underwent isokinetic rehabilitation on Cybex Orthotron KT2 device, using individually designed protocols (extension and flexion exercises, concentric muscle contractions, 15 treatments). monitoring of daily progress on rehabilitation device and detailed testing on diagnostic device. All patients showed considerable improvement. Muscle strength improved on average 141% (SD=110) in ACL-reconstructed group, 144% (SD=130) for chondromalacia patellae group and 150% (SD=74) for ACL-non-reconstructed group, comparing to initial strength. Dynamic status tested on Cybex Otrhotron diagnostic device prior and after rehabilitation strongly correlated with final progress monitored on the rehabilitation device. Isokinetic rehabilitation is a quick and effective method in treating knee injuries in athletes. Both types of objective criteria have shown significant increase in muscle strength. The improvement of muscle strength was on the average 149% (SD=101), which is about 10% daily for 15 treatments. The greatest progress, 19% per day, occurred during first five days. The athletes were able to resume their sport activities as follows: patients from chondromalacia patellae group, and most of them from the non-reconstructed ACL group were back in competition within a month, while 75% from the ACL reconstructed group came back within 3 months, and the rest of them within 5 months.

Copy number variation in CEP57L1 predisposes to congenital absence of bilateral ACL and PCL ligaments.

Science.gov (United States)

Liu, Yichuan; Li, Yun; March, Michael E; Nguyen, Kenny; Kenny, Nguyen; Xu, Kexiang; Wang, Fengxiang; Guo, Yiran; Keating, Brendan; Glessner, Joseph; Li, Jiankang; Ganley, Theodore J; Zhang, Jianguo; Deardorff, Matthew A; Xu, Xun; Hakonarson, Hakon

2015-11-11

Absence of the anterior (ACL) or posterior cruciate ligament (PCL) are rare congenital malformations that result in knee joint instability, with a prevalence of 1.7 per 100,000 live births and can be associated with other lower-limb abnormalities such as ACL agnesia and absence of the menisci of the knee. While a few cases of absence of ACL/PCL are reported in the literature, a number of large familial case series of related conditions such as ACL agnesia suggest a potential underlying monogenic etiology. We performed whole exome sequencing of a family with two individuals affected by ACL/PCL. We identified copy number variation (CNV) deletion impacting the exon sequences of CEP57L1, present in the affected mother and her affected daughter based on the exome sequencing data. The deletion was validated using quantitative PCR (qPCR), and the gene was confirmed to be expressed in ACL ligament tissue. Interestingly, we detected reduced expression of CEP57L1 in Epstein-Barr virus (EBV) cells from the two patients in comparison with healthy controls. Evaluation of 3D protein structure showed that the helix-binding sites of the protein remain intact with the deletion, but other functional binding sites related to microtubule attachment are missing. The specificity of the CNV deletion was confirmed by showing that it was absent in ~700 exome sequencing samples as well as in the database of genomic variations (DGV), a database containing large numbers of annotated CNVs from previous scientific reports. We identified a novel CNV deletion that was inherited through an autosomal dominant transmission from an affected mother to her affected daughter, both of whom suffered from the absence of the anterior and posterior cruciate ligaments of the knees.

No association between static and dynamic postural control and ACL injury risk among female elite handball and football players: a prospective study of 838 players.

Science.gov (United States)

Steffen, Kathrin; Nilstad, Agnethe; Krosshaug, Tron; Pasanen, Kati; Killingmo, Aleksander; Bahr, Roald

2017-02-01

Research on balance measures as potential risk factors for ACL injury is limited. To assess whether postural control was associated with an increased risk for ACL injuries in female elite handball and football players. Premier league players were tested in the preseason and followed prospectively for ACL injury risk from 2007 through 2015. At baseline, we recorded player demographics, playing experience, ACL and ankle injury history. We measured centre of pressure velocity in single-leg stabilisation tests and reach distances in the Star Excursion Balance Test. To examine the stability of postural control measures over time, we examined their short-term and long-term reproducibility. We generated logistic regression models, 1 for each of the proposed risk factors. A total of 55 (6.6%) out of 838 players (age 21±4 years; height 170±6 cm; body mass 66±8 kg) sustained a non-contact ACL injury after baseline testing (1.8±1.8 years). When comparing normalised balance measures between injured and uninjured players in univariate analyses, none of the variables were statistically associated with ACL injury risk. Short-term and long-term reproducibility of the selected variables was poor. Players with a previous ACL injury had a 3-fold higher risk of sustaining a new ACL injury compared with previously uninjured players (OR 2.9, CI 1.4 to 5.7). None of postural control measures examined were associated with increased ACL injury risk among female elite handball and football players. Hence, as measured in the current investigation, the variables included cannot be used to predict ACL injury risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture

Energy Technology Data Exchange (ETDEWEB)

Frois Temponi, Eduardo [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Honorio de Carvalho, Lucio Jr. [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Universidade Federal de Minas Gerais, Departamento do Aparelho Locomotor, Faculdade de Medicina, Belo Horizonte, Minas Gerais (Brazil); Saithna, Adnan [Southport and Ormskirk Hospitals, Southport (United Kingdom); University of Liverpool, Department of Clinical Engineering, Liverpool (United Kingdom); Thaunat, Mathieu; Sonnery-Cottet, Bertrand [Centre Orthopedic Santy, FIFA Medical Center of Excellence, Ramsay-Generale de Sante, Hopital Prive Jean Mermoz, Lyon (France)

2017-08-15

To determine the incidence and MRI characteristics of the spectrum of posterolateral corner (PLC) injuries occurring in association with anterior cruciate ligament (ACL) rupture. We carried out a level IV, retrospective case series study. All patients clinically diagnosed with an ACL rupture between July 2015 and June 2016 who underwent MRI of the knee were included in the study. In addition to standard MRI knee reporting, emphasis was placed on identifying injury to the PLC and a description of involvement of these structures by two musculoskeletal radiologists. Association with PLC involvement was sought with concomitant injuries using correlation analysis and logistic regression. One hundred sixty-two patients with MRI following ACL rupture were evaluated. Thirty-two patients (19.7%) had an injury to at least one structure of the PLC, including the inferior popliteomeniscal fascicle (n = 28), arcuate ligament (n = 20), popliteus tendon (n = 20), superior popliteomeniscal fascicle (n = 18), lateral collateral ligament (n = 8), popliteofibular ligament (n = 7), biceps tendon (n = 4), iliotibial band (n = 3), and fabellofibular ligament (n = 1). Seventy-five percent of all patients with combined ACL and PLC injuries had bone contusions involving the lateral compartment of the knee. The presence of these contusions strongly correlated with superior popliteomeniscal fascicle lesions (p < 0.05). There was no correlation between injuries to other structures of the PLC and other intra-articular lesions. Missed injuries of the PLC lead to considerable morbidity. The relevance of this study is to highlight that these injuries occur more frequently than previously described and that an appropriate index of suspicion, clinical examination, and MRI are all required to reduce the risk of missed diagnoses. The results of this study support previous suggestions that the rate of concomitant PLC injury in the ACL-deficient knee is under-reported. The rate of combined injuries in

Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome

DEFF Research Database (Denmark)

Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B

2017-01-01

, body mass index, preinjury activity level, education and smoking. RESULTS: For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone......AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory...... was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse...

Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model.

Science.gov (United States)

Blaker, Carina L; Little, Christopher B; Clarke, Elizabeth C

2017-08-01

Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p < 0.001) but age was not significant when controlling for mass. Sex had no effect. In contrast, the mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p < 0.01). This data compliments studies in human cadaveric knees, and provides a basis for determining the severity of joint injury relative to a major ACL tear in mice, and for selecting joint loading conditions in future experiments using this model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1754-1763, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Retention of movement technique : Implications for primary prevention of ACL injuries

NARCIS (Netherlands)

Welling, Wouter; Benjaminse, Anne; Gokeler, Alli; Otten, Bert

2017-01-01

Background: Retention of movement technique is crucial in anterior cruciate ligament (ACL) injury prevention programs. It is unknown if specific instructions or video instructions result in changes in kinematic and kinetic measures during a relatively short training session, and in a retention test

Development of the Knee Numeric-Entity Evaluation Score (KNEES – ACL)

DEFF Research Database (Denmark)

Comins, J D; Krogsgaard, M R; Brodersen, J

2013-01-01

Patient-related outcome measures (PROMs) are commonly used to gauge treatment effects in patients with anterior cruciate ligament (ACL) deficiency. Valid measures of specific conditions depend on relevant item content. While item content can be derived either from clinicians (face validity) or fr...

Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

DEFF Research Database (Denmark)

Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars

2014-01-01

PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi...

Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students.

Science.gov (United States)

Lee, Christopher C; Im, Mark; Kim, Tae Min; Stapleton, Edward R; Kim, Kyuseok; Suh, Gil Joon; Singer, Adam J; Henry, Mark C

2010-01-01

Current Advanced Cardiac Life Support (ACLS) course instruction involves a 2-day course with traditional lectures and limited team interaction. We wish to explore the advantages of a scenario-based performance-oriented team instruction (SPOTI) method to implement core ACLS skills for non-English-speaking international paramedic students. The objective of this study was to determine if scenario-based, performance-oriented team instruction (SPOTI) improves educational outcomes for the ACLS instruction of Korean paramedic students. Thirty Korean paramedic students were randomly selected into two groups. One group of 15 students was taught the traditional ACLS course. The other 15 students were instructed using a SPOTI method. Each group was tested using ACLS megacode examinations endorsed by the American Heart Association. All 30 students passed the ACLS megacode examination. In the traditional ACLS study group an average of 85% of the core skills were met. In the SPOTI study group an average of 93% of the core skills were met. In particular, the SPOTI study group excelled at physical examination skills such as airway opening, assessment of breathing, signs of circulation, and compression rates. In addition, the SPOTI group performed with higher marks on rhythm recognition compared to the traditional group. The traditional group performed with higher marks at providing proper drug dosages compared to the SPOTI students. However, the students enrolled in the SPOTI method resulted in higher megacode core compliance scores compared to students trained in traditional ACLS course instruction. These differences did not achieve statistical significance due to the small sample size. Copyright 2010 Elsevier Inc. All rights reserved.

Tibial and Femoral Tunnel Changes After ACL Reconstruction: A Prospective 2-Year Longitudinal MRI Study.

Science.gov (United States)

Weber, Alexander E; Delos, Demetris; Oltean, Hanna N; Vadasdi, Katherine; Cavanaugh, John; Potter, Hollis G; Rodeo, Scott A

2015-05-01

Tunnel widening after anterior cruciate ligament reconstruction (ACL-R) is a well-accepted and frequent phenomenon, yet little is known regarding its origin or natural history. To prospectively evaluate the cross-sectional area (CSA) changes in tibial and femoral bone tunnels after ACL-R with serial MRI. Case series; Level of evidence, 4. Patients underwent arthroscopic ACL-R with the same surgeon, surgical technique, and rehabilitation protocol. Each patient underwent preoperative dual-energy x-ray absorptiometry and clinical evaluation, as well as postoperative time zero MRI followed by subsequent MRI and clinical examination, including functional and subjective outcome tests, at 6, 12, 24, 52, and 104 weeks. Tibial and femoral tunnel CSA was measured on each MRI at tunnel aperture (ttA and ftA), midsection (ttM and ftM), and exit (ttE and ftE). Logistic regression modeling was used to examine the predictive value of demographic data and preoperative bone quality (as measured by dual-energy x-ray absorptiometry) on functional outcome scores, manual and instrumented laxity measurements, and changes in tunnel area over time. Eighteen patients (including 12 men), mean age 35.5±8.7 years, underwent ACL-R. There was significant tunnel expansion at ttA and ftA sites 6 weeks postoperatively (P=.024 and .0045, respectively). Expansion continued for 24 weeks, with progressive tunnel narrowing thereafter. Average ttA CSA was significantly larger than ftA CSA at all times. The ttM significantly expanded after 6 weeks (P=.06); continued expansion to week 12 was followed by 21 months of reduction in tunnel diameter. The ftM and both ttE and ftE sites decreased in CSA over the 2 years. Median Lysholm and International Knee Documentation Committee scores significantly improved at final follow-up (P=.0083 and 1 year from time of injury) predicted increased tunnel widening and accelerated expansion in CSA (Pclinical outcome. Younger age, male sex, and delay from injury to ACL

Concurrent assessments of lower limb loading patterns, mechanical muscle strength and functional performance in ACL-patients - A cross-sectional study

DEFF Research Database (Denmark)

Holsgaard-Larsen, Anders; Jensen, C; Mortensen, N H M

2014-01-01

Full recovery in muscle strength and functional performance may not be achieved after ACL-injury. Aim: The aim of this study is to investigate loading patterns during jumping, muscle function and functional performance in ACL-reconstructed patients and to investigate the origin of between...

The angle of inclination of the native ACL in the coronal and sagittal planes.

Science.gov (United States)

Reid, Jonathan C; Yonke, Bret; Tompkins, Marc

2017-04-01

The purpose of this cross-sectional study was to evaluate the angle of inclination of the native anterior cruciate ligament (ACL) in both the sagittal and coronal planes and to evaluate these findings based on sex, height, BMI, and skeletal maturity. Inclusion criteria for the study included patients undergoing routine magnetic resonance imaging (MRI) of the knee at a single outpatient orthopedic center who had an intact ACL on MRI. Measurements of the angle of inclination were made on MRIs in both the sagittal and coronal planes. Patients were compared based on sex, height, BMI, and skeletal maturity. One-hundred and eighty-eight patients were included (36 skeletally immature/152 skeletally mature; 98 male/90 female). The overall angle of inclination was 74.3° ± 4.8° in the coronal plane and 46.9° ± 4.9° in the sagittal plane. Skeletally immature patients (coronal: 71.8° ± 6.1°; sagittal: 44.7° ± 5.5°) were significantly different in both coronal and sagittal planes (P = 0.04 and 0.01, respectively) from skeletally mature patients (coronal: 75.3° ± 4.7°; sagittal: 47.4° ± 4.7°). There were no differences based on sex, height, or BMI. There are differences between the angle of inclination findings in this study and other studies, which could be due to MRI and measurement techniques. Clinically, skeletal maturity may be important to account for when using the ACL angle of inclination to evaluate anatomic ACL reconstruction. Prognostic retrospective study, Level of evidence III.

Current Status and Performance Tests of Korea Heat Load Test Facility KoHLT-EB

Energy Technology Data Exchange (ETDEWEB)

Kim, Sukkwon; Jin, Hyunggon; Shin, Kyuin; Choi, Boguen; Lee, Eohwak; Yoon, Jaesung; Lee, Dongwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Duckhoi; Cho, Seungyon [National Fusion Research Institute, Daejeon (Korea, Republic of)

2013-05-15

A commissioning test has been scheduled to establish the installation and preliminary performance experiments of the copper hypervapotron mockups. And a qualification test will be performed to evaluate the CuCrZr duct liner in the ITER neutral beam injection facility and the ITER first wall small-scale mockups of the semi-prototype, at up to 1.5 and 5 MW/m{sup 2} high heat flux. Also, this system will be used to test other PFCs for ITER and materials for tokamak reactors. Korean high heat flux test facility(KoHLT-EB; Korea Heat Load Test facility - Electron Beam) by using an electron beam system has been constructed in KAERI to perform the qualification test for ITER blanket FW semi-prototype mockups, hypervapotron cooling devices in fusion devices, and other ITER plasma facing components. The commissioning and performance tests with the supplier of e-gun system have been performed on November 2012. The high heat flux test for hypervapotron cooling device and calorimetry were performed to measure the surface heat flux, the temperature profile and cooling performance. Korean high heat flux test facility for the plasma facing components of nuclear fusion machines will be constructed to evaluate the performance of each component. This facility for the plasma facing materials will be equipped with an electron beam system with a 60 kV acceleration gun.

An Integrated Approach to Change the Outcome Part II: Targeted Neuromuscular Training Techniques to Reduce Identified ACL Injury Risk Factors

Science.gov (United States)

Myer, Gregory D.; Ford, Kevin R.; Brent, Jensen L.; Hewett, Timothy E.

2014-01-01

Prior reports indicate that female athletes who demonstrate high knee abduction moments (KAMs) during landing are more responsive to neuromuscular training designed to reduce KAM. Identification of female athletes who demonstrate high KAM, which accurately identifies those at risk for noncontact anterior cruciate ligament (ACL) injury, may be ideal for targeted neuromuscular training. Specific neuromuscular training targeted to the underlying biomechanical components that increase KAM may provide the most efficient and effective training strategy to reduce noncontact ACL injury risk. The purpose of the current commentary is to provide an integrative approach to identify and target mechanistic underpinnings to increased ACL injury in female athletes. Specific neuromuscular training techniques will be presented that address individual algorithm components related to high knee load landing patterns. If these integrated techniques are employed on a widespread basis, prevention strategies for noncontact ACL injury among young female athletes may prove both more effective and efficient. PMID:22580980

Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts.

Science.gov (United States)

Failla, Mathew J; Logerstedt, David S; Grindem, Hege; Axe, Michael J; Risberg, May Arna; Engebretsen, Lars; Huston, Laura J; Spindler, Kurt P; Snyder-Mackler, Lynn

2016-10-01

Rehabilitation before anterior cruciate ligament (ACL) reconstruction (ACLR) is effective at improving postoperative outcomes at least in the short term. Less is known about the effects of preoperative rehabilitation on functional outcomes and return-to-sport (RTS) rates 2 years after reconstruction. The purpose of this study was to compare functional outcomes 2 years after ACLR in a cohort that underwent additional preoperative rehabilitation, including progressive strengthening and neuromuscular training after impairments were resolved, compared with a nonexperimental cohort. We hypothesized that the cohort treated with extended preoperative rehabilitation would have superior functional outcomes 2 years after ACLR. Cohort study; Level of evidence, 3. This study compared outcomes after an ACL rupture in an international cohort (Delaware-Oslo ACL Cohort [DOC]) treated with extended preoperative rehabilitation, including neuromuscular training, to data from the Multicenter Orthopaedic Outcomes Network (MOON) cohort, which did not undergo extended preoperative rehabilitation. Inclusion and exclusion criteria from the DOC were applied to the MOON database to extract a homogeneous sample for comparison. Patients achieved knee impairment resolution before ACLR, and postoperative rehabilitation followed each cohort's respective criterion-based protocol. Patients completed the International Knee Documentation Committee (IKDC) subjective knee form and Knee injury and Osteoarthritis Outcome Score (KOOS) at enrollment and again 2 years after ACLR. RTS rates were calculated for each cohort at 2 years. After adjusting for baseline IKDC and KOOS scores, the DOC patients showed significant and clinically meaningful differences in IKDC and KOOS scores 2 years after ACLR. There was a significantly higher (P < .001) percentage of DOC patients returning to preinjury sports (72%) compared with those in the MOON cohort (63%). The cohort treated with additional preoperative

Anatomic single-bundle ACL surgery: consequences of tibial tunnel diameter and drill-guide angle on tibial footprint coverage.

Science.gov (United States)

Van der Bracht, H; Verhelst, L; Stuyts, B; Page, B; Bellemans, J; Verdonk, P

2014-05-01

To investigate the consequences of differences in drill-guide angle and tibial tunnel diameter on the amount of tibial anatomical anterior cruciate ligament (ACL) footprint coverage and the risk of overhang of the tibial tunnel aperture over the edges of the native tibial ACL footprint. Twenty fresh-frozen adult human knee specimens with a median age of 46 years were used for this study. Digital templates mimicking the ellipsoid aperture of tibial tunnels with a different drill-guide angle and a different diameter were designed. The centres of these templates were positioned over the geometric centre of the tibial ACL footprint. The amount of tibial ACL footprint coverage and overhang was calculated. Risk factors for overhang were determined. Footprint coverage and the risk of overhang were also compared between a lateral tibial tunnel and a classic antero-medial tibial tunnel. A larger tibial tunnel diameter and a smaller drill-guide angle both will create significant more footprint coverage and overhang. In 45% of the knees, an overhang was created with a 10-mm diameter tibial tunnel with drill-guide angle 45°. Furthermore, a lateral tibial tunnel was found not to be at increased risk of overhang. A larger tibial tunnel diameter and a smaller drill-guide angle both will increase the amount of footprint coverage. Inversely, larger tibial tunnel diameters and smaller drill-guide angles will increase the risk of overhang of the tibial tunnel aperture over the edges of the native tibial ACL footprint. A lateral tibial tunnel does not increase the risk of overhang.

Noninjured Knees of Patients With Noncontact ACL Injuries Display Higher Average Anterior and Internal Rotational Knee Laxity Compared With Healthy Knees of a Noninjured Population.

Science.gov (United States)

Mouton, Caroline; Theisen, Daniel; Meyer, Tim; Agostinis, Hélène; Nührenbörger, Christian; Pape, Dietrich; Seil, Romain

2015-08-01

Excessive physiological anterior and rotational knee laxity is thought to be a risk factor for noncontact anterior cruciate ligament (ACL) injuries and inferior reconstruction outcomes, but no thresholds have been established to identify patients with increased laxity. (1) To determine if the healthy contralateral knees of ACL-injured patients have greater anterior and rotational knee laxity, leading to different laxity profiles (combination of laxities), compared with healthy control knees and (2) to set a threshold to help discriminate anterior and rotational knee laxity between these groups. Case-sectional study; Level of evidence, 3. A total of 171 healthy contralateral knees of noncontact ACL-injured patients (ACL-H group) and 104 healthy knees of control participants (CTL group) were tested for anterior and rotational laxity. Laxity scores (measurements corrected for sex and body mass) were used to classify knees as hypolax (score 1). Proportions of patients in each group were compared using χ(2) tests. Receiver operating characteristic curves were computed to discriminate laxity between the groups. Odds ratios were calculated to determine the probability of being in the ACL-H group. The ACL-H group displayed greater laxity scores for anterior displacement and internal rotation in their uninjured knee compared with the CTL group (P knees of patients with noncontact ACL injuries display different laxity values both for internal rotation and anterior displacement compared with healthy control knees. The identification of knee laxity profiles may be of relevance for primary and secondary prevention programs of noncontact ACL injuries. © 2015 The Author(s).

Terrorism and Politics Predominate on the Front Pages of the Basque Press. Content and Area Analysis of the Front Pages of the Regional Newspapers

Directory of Open Access Journals (Sweden)

Dr. Jesús A. Pérez Dasilva

2010-01-01

Full Text Available This paper offers the results of research project 08/20 of the University of the Basque Country on the news published on the front pages of the Basque press during the years 1996, 2001 and 2006.The researchers analyse the front pages of the Basque press to determine if their content matches the demand and interests of their readers. The study shows what are the most relevant topics for these newspapers. The research involved a detailed analysis of 2,448 front pages of the five main Basque newspapers, with a total of 19,156 news items. A specific methodology was developed for this work, enabling both a quantitative and qualitative analysis of the news stories to be made. The data shown in this paper are a summary of the more detailed results that emerged in the different fields of the research.

Relationship jump-landing technique and neuropsychological characteristics, implications for ACL injury prevention

NARCIS (Netherlands)

A. Gokeler; Anne Benjaminse; N. Cortes; M. Meier

2014-01-01

Abstract from the IOC World Conference on Prevention of Injury & Illness in Sport, Monaco 2014 Background: Neuropsychological capabilities in athletes may be associated with a predisposition to anterior cruciate ligament (ACL) injuries. Objective: Assess differences between male and female athletes

Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

Directory of Open Access Journals (Sweden)

Kaseb Mohammad Hasan

2009-05-01

Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

DEFF Research Database (Denmark)

Bohn, Marie Bagger; Petersen, Annemette Krintel; Nielsen, Dennis Brandborg

2016-01-01

BACKGROUND: Anterior cruciate ligament (ACL) deficiency leads to altered stability of the knee. The purpose of this study was to compare the dynamic, rotational stability of the knee, expressed as rotational stiffness, between anterior cruciate ligament-deficient (ACLD) knees, their contralateral......: The tibial internal rotation of the ACLD knee was not significantly different from the ACLI knee during all three tasks. During walking and running, the tibial rotation of the control group was significantly different from both legs of the ACL-injured patient. For pivoting, no difference in tibial rotation...... group. During running, the ACLI knee displayed a higher external moment than the ACLD and the healthy control group. This could indicate some type of protective strategy or muscular adaptation in the ACL-injured patients....

The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

DEFF Research Database (Denmark)

Bieler, Theresa; Sobol, Nanna Aue; Andersen, Lars L

2014-01-01

OBJECTIVE: Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. METH...

Differences in mechanisms of failure, intraoperative findings, and surgical characteristics between single- and multiple-revision ACL reconstructions: a MARS cohort study.

Science.gov (United States)

Chen, James L; Allen, Christina R; Stephens, Thomas E; Haas, Amanda K; Huston, Laura J; Wright, Rick W; Feeley, Brian T

2013-07-01

The factors that lead to patients failing multiple anterior cruciate ligament (ACL) reconstructions are not well understood. Multiple-revision ACL reconstruction will have different characteristics than first-time revision in terms of previous and current graft selection, mode of failure, chondral/meniscal injuries, and surgical charactieristics. Case-control study; Level of evidence, 3. A prospective multicenter ACL revision database was utilized for the time period from March 2006 to June 2011. Patients were divided into those who underwent a single-revision ACL reconstruction and those who underwent multiple-revision ACL reconstructions. The primary outcome variable was Marx activity level. Primary data analyses between the groups included a comparison of graft type, perceived mechanism of failure, associated injury (meniscus, ligament, and cartilage), reconstruction type, and tunnel position. Data were compared by analysis of variance with a post hoc Tukey test. A total of 1200 patients (58% men; median age, 26 years) were enrolled, with 1049 (87%) patients having a primary revision and 151 (13%) patients having a second or subsequent revision. Marx activity levels were significantly higher (9.77) in the primary-revision group than in those patients with multiple revisions (6.74). The most common cause of reruptures was a traumatic, noncontact ACL graft injury in 55% of primary-revision patients; 25% of patients had a nontraumatic, gradual-onset recurrent injury, and 11% had a traumatic, contact injury. In the multiple-revision group, a nontraumatic, gradual-onset injury was the most common cause of recurrence (47%), followed by traumatic noncontact (35%) and nontraumatic sudden onset (11%) (P < .01 between groups). Chondral injuries in the medial compartment were significantly more common in the multiple-revision group than in the single-revision group, as were chondral injuries in the patellofemoral compartment. Patients with multiple-revision ACL

Translation, cultural adaptation and validation of simplified Chinese version of the anterior cruciate ligament return to sport after injury (ACL-RSI scale.

Directory of Open Access Journals (Sweden)

Tianwu Chen

Full Text Available To translate and cross-culturally adapt the anterior cruciate ligament-return to sport after injury (ACL-RSI into simplified Chinese [ACL-RSI (Cn].In this diagnostic study, the translation, cross-culturally adaptation, and validation of the ACL-RSI was performed according to international guidelines. A total of 112 patients with ACL reconstruction participated in this study. All were capable of competitive sports before the injury and completed the Knee Injury and Osteoarthritis Outcome (KOOS, the International Knee Documentation Committee (IKDC, the Tampa Scale of Kinesiophobia (TSK, and the Tegner activity score. Forty-eight patients completed the ACL-RSI (Cn twice within two weeks. The validity was tested using seven premade hypotheses. Internal consistency, reliability, and measurement error was assessed.At meanly 15.6 months postoperative, 81 (72.3% patients returned to sport, with 57 (50.9% to competitive sport and 24 (21.4% to recreational sport. Thirty-one (27.7% patients didn't return to any sport, with 19 (17.0% still had planned to return, and 12 (10.7% gave up sport. The ACL-RSI (Cn demonstrated excellent validity with all hypotheses confirmed. The outcome of ACL-RSI (Cn was strongly correlated the KOOS subscale quality of life (r = 0.66, p<0.001, the TSK (r = -0.678, p<0.001, the Tegner score (r = 0.695, p<0.001. There was statistic difference between cases returned (68.6 ± 10.1 and didn't return to sport (41.3 ± 17.7, p<0.001; between cases returned to competitive (71.1 ± 8.9 and recreational sport (62.9 ± 10.5, (P = 0.002; between cases who planned to return (50.7 ± 14.1 and gave up sport (26.5 ± 11.7, (P<0.001. The internal consistency (Cronbach's α = 0.96 and test-retest reliability [intra-class correlation coefficient (ICC = 0.90] was excellent. The measurement error, floor and ceiling effect was satisfactory. Administration time was 3.2 minutes, and no item was missed.The ACL-RSI (Cn scale was confirmed as a valid

Post-operative 3D CT feedback improves accuracy and precision in the learning curve of anatomic ACL femoral tunnel placement.

Science.gov (United States)

Sirleo, Luigi; Innocenti, Massimo; Innocenti, Matteo; Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio

2018-02-01

To evaluate the feedback from post-operative three-dimensional computed tomography (3D-CT) on femoral tunnel placement in the learning process, to obtain an anatomic anterior cruciate ligament (ACL) reconstruction. A series of 60 consecutive patients undergoing primary ACL reconstruction using autologous hamstrings single-bundle outside-in technique were prospectively included in the study. ACL reconstructions were performed by the same trainee-surgeon during his learning phase of anatomic ACL femoral tunnel placement. A CT scan with dedicated tunnel study was performed in all patients within 48 h after surgery. The data obtained from the CT scan were processed into a three-dimensional surface model, and a true medial view of the lateral femoral condyle was used for the femoral tunnel placement analysis. Two independent examiners analysed the tunnel placements. The centre of femoral tunnel was measured using a quadrant method as described by Bernard and Hertel. The coordinates measured were compared with anatomic coordinates values described in the literature [deep-to-shallow distance (X-axis) 28.5%; high-to-low distance (Y-axis) 35.2%]. Tunnel placement was evaluated in terms of accuracy and precision. After each ACL reconstruction, results were shown to the surgeon to receive an instant feedback in order to achieve accurate correction and improve tunnel placement for the next surgery. Complications and arthroscopic time were also recorded. Results were divided into three consecutive series (1, 2, 3) of 20 patients each. A trend to placing femoral tunnel slightly shallow in deep-to-shallow distance and slightly high in high-to-low distance was observed in the first and the second series. A progressive improvement in tunnel position was recorded from the first to second series and from the second to the third series. Both accuracy (+52.4%) and precision (+55.7%) increased from the first to the third series (p process to improve accuracy and precision of femoral

Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).

Science.gov (United States)

Lekkas, Christina; Clarnette, Richard; Graves, Stephen E; Rainbird, Sophia; Parker, David; Lorimer, Michelle; Paterson, Roger; Roe, Justin; Morris, Hayden; Feller, Julian A; Annear, Peter; Forster, Ben; Hayes, David

2017-05-01

Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent

Abnormal Mechanical Loading Induces Cartilage Degeneration by Accelerating Meniscus Hypertrophy and Mineralization After ACL Injuries In Vivo.

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Du, Guoqing; Zhan, Hongsheng; Ding, Daofang; Wang, Shaowei; Wei, Xiaochun; Wei, Fangyuan; Zhang, Jianzhong; Bilgen, Bahar; Reginato, Anthony M; Fleming, Braden C; Deng, Jin; Wei, Lei

2016-03-01

Although patients with an anterior cruciate ligament (ACL) injury have a high risk of developing posttraumatic osteoarthritis (PTOA), the role of meniscus hypertrophy and mineralization in PTOA after an ACL injury remains unknown. The purpose of this study was to determine if menisci respond to abnormal loading and if an ACL injury results in meniscus hypertrophy and calcification. The hypotheses were that (1) abnormal mechanical loading after an ACL injury induces meniscus hypertrophy and mineralization, which correlates to articular cartilage damage in vivo, and (2) abnormal mechanical loading on bovine meniscus explants induces the overexpression of hypertrophic and mineralization markers in vitro. Controlled laboratory study. In vivo guinea pig study (hypothesis 1): Three-month-old male Hartley guinea pigs (n = 9) underwent ACL transection (ACLT) on the right knee; the left knee served as the control. Calcification in the menisci was evaluated by calcein labeling 1 and 5 days before knee harvesting at 5.5 months. Cartilage and meniscus damage and mineralization were quantified by the Osteoarthritis Research Society International score and meniscus grade, respectively. Indian hedgehog (Ihh), matrix metalloproteinase-13 (MMP-13), collagen type X (Col X), progressive ankylosis homolog (ANKH), ectonucleotide pyrophosphatase/phosphodiesterase-1 (ENPP1), alkaline phosphatase (ALP), inorganic pyrophosphate (PPi), and inorganic phosphate (Pi) concentrations were evaluated by immunohistochemistry and enzyme-linked immunosorbent assay. In vitro bovine meniscus explant study (hypothesis 2): Bovine meniscus explants were subjected to 25% strain at 0.3 Hz for 1, 2, and 3 hours. Cell viability was determined using live/dead staining. The levels of mRNA expression and protein levels were measured using real-time quantitative reverse transcription polymerase chain reaction and Western blot after 24, 48, and 72 hours in culture. The conditioned medium was collected for sulfated

Relationship between knee kinetic outcome measures in vertical counter movement jumps and self-reported function in ACL reconstructed subjects

DEFF Research Database (Denmark)

Brekke, Anders Falk

2014-01-01

Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF1,2, Nielsen DB2, Holsgaard-Larsen A2 1School of physiotherapy, University College Zealand, Denmark 2Orthopaedic Research Unit, Department of Orthopaedics...... and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark Introduction: Altered loading pattern of the medial aspect of the knee has been associated with the development of knee osteoarthritis (OA). Anterior cruciate ligament (ACL) injuries are associated...... with early-onset OA with associated pain, functional limitations, and decreased quality of life. However, specific knee loading pattern of the medial aspect has not been investigated during different jump-tasks in ACL-reconstructed patients. The purpose was to investigate potential kinetic differences...

Hamstrings co-activation in ACL-deficient subjects during isometric whole-leg extensions

NARCIS (Netherlands)

Aalbersberg, S.; Kingma, I.; van Dieen, J.H.

2009-01-01

It has been reported that anterior cruciate ligament (ACL)-deficient subjects increase the level of hamstrings activation and this has been interpreted as a means to cope with increased anterior tibial laxity in the knee. This study aimed to establish to what extent co-activation strategies in

Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

International Nuclear Information System (INIS)

Cha, Ji Hyeon; Shin, Myung Jin; Choi, Byeong Kyoo; Lee, Sang Hoon; Bin, Sung Il

2008-01-01

The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm 2 /7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm 2 /4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm 2 /4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

EXERCISES THAT FACILITATE OPTIMAL HAMSTRING AND QUADRICEPS CO-ACTIVATION TO HELP DECREASE ACL INJURY RISK IN HEALTHY FEMALES: A SYSTEMATIC REVIEW OF THE LITERATURE.

Science.gov (United States)

Dedinsky, Rachel; Baker, Lindsey; Imbus, Samuel; Bowman, Melissa

2017-01-01

Background Anterior cruciate ligament (ACL) injury is common among females due to many anatomic, hormonal, and neuromuscular risk factors. One modifiable risk factor that places females at increased risk of ACL injury is a poor hamstrings: quadriceps (H:Q) co-activation ratio, which should be 0.6 or greater in order to decrease the stress placed on the ACL. Exercises that produce more quadriceps dominant muscle activation can add to the tension placed upon the ACL, potentially increasing the risk of ACL injury. Hypothesis/Purpose The purpose of this systematic review was to compare quadriceps and hamstring muscle activation during common closed kinetic chain therapeutic exercises in healthy female knees to determine what exercises are able to produce adequate H:Q co-activation ratios. Study Design Systematic Review Methods Multiple online databases were systematically searched and screened for inclusion. Eight articles were identified for inclusion. Data on mean electromyography (EMG) activation of both quadriceps and hamstring muscles, % maximal voluntary isometric contraction (MVIC), and H:Q co-activation ratios were extracted from the studies. Quality assessment was performed on all included studies. Results Exercises analyzed in the studies included variations of the double leg squat, variations of the single leg squat, lateral step-up, Fitter, Stairmaster® (Core Health and Fitness, Vancouver, WA), and slide board. All exercises, except the squat machine with posterior support at the level of the scapula and feet placed 50 cm in front of the hips, produced higher quadriceps muscle activation compared to hamstring muscle activation. Conclusion Overall, two leg squats demonstrate poor H:Q co-activation ratios. Single leg exercises, when performed between 30 and 90 degrees of knee flexion, produce adequate H:Q ratios, thereby potentially reducing the risk of tensile stress on the ACL and ACL injury. Level of Evidence 2a- Systematic Review of Cohort Studies PMID

Experimental and mathematical methods for representing relative surface elongation of the ACL

NARCIS (Netherlands)

Pioletti, D. P.; Heegaard, J. H.; Rakotomanana, R. L.; Leyvraz, P. F.; Blankevoort, L.

1995-01-01

The common approach to assess the stabilizing role of the ACL in the knee has been to measure the elongation of a few marked fibers in the ligament. A comparison of the relative elongation (RE) of these marked fibers between different specimens and studies is delicate due to the difficulty of

Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction

NARCIS (Netherlands)

Hofbauer, Marcus; Muller, Bart; Murawski, Christopher D.; Baraga, Michael; van Eck, Carola Franziska; Fu, Freddie H.

2013-01-01

The purpose of this article was to discuss pre- and intra-operative considerations as well as surgical strategies for different femoral and tibial tunnel scenarios in revision surgery following primary double-bundle anterior cruciate ligament (ACL) reconstruction. Based on the current literature of

Modeling Algorithms in SystemC and ACL2

Directory of Open Access Journals (Sweden)

John W. O'Leary

2014-06-01

Full Text Available We describe the formal language MASC, based on a subset of SystemC and intended for modeling algorithms to be implemented in hardware. By means of a special-purpose parser, an algorithm coded in SystemC is converted to a MASC model for the purpose of documentation, which in turn is translated to ACL2 for formal verification. The parser also generates a SystemC variant that is suitable as input to a high-level synthesis tool. As an illustration of this methodology, we describe a proof of correctness of a simple 32-bit radix-4 multiplier.

Influence of proprioceptive training in the improvement of neuromuscular performance after ACL reconstruction

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Dubljanin-Raspopović Emilija

2005-01-01

Full Text Available ACL injury leads to a decrease in proprioceptive abilities, which can be improved with ACL surgery and postoperative rehabilitation. The goal of our study was to investigate whether the impact of coordinative training can be differentiated from the influence of surgery on proprioceptive improvement, and whether there is a correlation between improvement in coordinative abilities and other objective parameters of functional recovery. This follow-up study included 45 patients who had undergone ACL reconstruction and who were randomized into a conservative (TH-C and an intensive (TH-I rehabilitation group. In the TH-I group, coordinative training began earlier due to unrestricted weight-bearing. The groups were first compared preoperatively, then postoperatively, after 6 weeks, 4,6,9, and 12 months via the single leg stance test, the one leg hop test, the Lysholm knee score, and the Tegner score. A faster recovery of coordinative skills was registered in the TH-I group. Already after 6 weeks, highly statistically significant progress in one leg stance abilities was noticed, while in the TH-C group the same was not noticed until 4 months after surgery (p<0.01. Such a result speaks for the distinct influence of proprioceptive training on coordinative abilities. Also, a highly statistically significant correlation was noticed between the single leg stance, one leg hop, Lysholm, and Tegner tests (p<0.01, which points out the importance of a good rehabilitation programme, since neuromuscular performance cannot be separated from other parameters of functional recovery.

Antagonist muscle moment is increased in ACL deficient subjects during maximal dynamic knee extension

DEFF Research Database (Denmark)

Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter

2012-01-01

INTRODUCTION: Coactivation of the hamstring muscles during dynamic knee extension may compensate for increased knee joint laxity in anterior cruciate ligament (ACL) deficient subjects. This study examined if antagonist muscle coactivation during maximal dynamic knee extension was elevated...

Selection and protein sds-page identification of a new high-producing polysaccharide strain of Spirulina platensis

International Nuclear Information System (INIS)

Wang Zhiping; Liu Yanhui

2004-01-01

The relationship between anti-radiation capacity and polysaccharide contents of ten Spirulina platensis strains were studied. The results showed that the correlation coefficient between 60 Co γ-ray half-lethal dose (LD 50 ) and polysaccharide contents of the 10 strains was 0.9873. After the single cells or spheroplasts of Sp-08 were treated by 0.6%EMS and 2.4 kGy 60 Co γ-ray irradiation, four morphological mutant named Sp-08A, Sp-08B, Sp-08C and Sp-08D, which could endure about 7.0 kGy γ-ray irradiation, were obtained. The polysaccharide contents of Sp-08A, Sp-08B, Sp-08C and Sp-08D, were 32.8%, 17.3%, 3.4% and 42.3% higher than that of their parent Sp-08, respectively. The results of protein SDS-PAGE analysis showed that the heredity of Sp-08A, Sp-08C and Sp-08D were mutated. Therefore, Sp-08A was a perfect high-producing polysaccharide strain with excellent characteristics of morphology and growth. Now, Sp-08A is applied in mass cultivation and industrialization. (authors)

Evaluation of an intact, an ACL-deficient, and a reconstructed human knee joint finite element model.

Science.gov (United States)

Vairis, Achilles; Stefanoudakis, George; Petousis, Markos; Vidakis, Nectarios; Tsainis, Andreas-Marios; Kandyla, Betina

2016-02-01

The human knee joint has a three-dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Understanding the complex mechanical interactions of these load-bearing structures is of use when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament (ACL) in the knee is one of four main ligaments that connects the femur to the tibia and is often torn during sudden twisting motions, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint and evaluate the differences in its response for three different states, i.e., intact, ACL-deficient, and surgically treated (reconstructed) knee. The finite element models corresponding to these states were developed. For the reconstructed model, a novel repair device was developed and patented by the author in previous work. Static load cases were applied, as have already been presented in a previous work, in order to compare the calculated results produced by the two models the ACL-deficient and the surgically reconstructed knee joint, under the exact same loading conditions. Displacements were calculated in different directions for the load cases studied and were found to be very close to those from previous modeling work and were in good agreement with experimental data presented in literature. The developed finite element model for both the intact and the ACL-deficient human knee joint is a reliable tool to study the kinematics of the human knee, as results of this study show. In addition, the reconstructed human knee joint model had kinematic behavior similar to the intact knee joint, showing that such reconstruction devices can restore human knee stability to an adequate extent.

Effect of an internally versus externally focused acl injury prevention program on injury risk

NARCIS (Netherlands)

Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.

2014-01-01

BACKGROUND: Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. OBJECTIVE: Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors

Morphological size evaluation of the mid-substance insertion areas and the fan-like extension fibers in the femoral ACL footprint.

Science.gov (United States)

Suruga, Makoto; Horaguchi, Takashi; Iriuchishima, Takanori; Yahagi, Yoshiyuki; Iwama, Genki; Tokuhashi, Yasuaki; Aizawa, Shin

2017-08-01

The purpose of this study was to evaluate the detailed anatomy of the femoral anterior cruciate ligament (ACL) insertion site, with special attention given to the morphology of the mid-substance insertion areas and the fan-like extension fibers. Twenty-three non-paired human cadaver knees were used (7 Males, 16 Females, median age 83, range 69-96). All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in macroscopic tension patterns. The ACL was carefully dissected and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibers. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The area of each bundle, including and excluding the fan-like extension fibers, was measured with Image J software (National Institution of Health). The width and length of the mid-substance insertion sites were also evaluated using same image. The femoral ACL footprint was divided into four regions (mid-substance insertion sites of the AM and PL bundles, and fan-like extensions of the AM and PL bundles). The measured areas of the mid-substance insertion sites of the AM and PL bundles were 35.5 ± 12.5, and 32.4 ± 13.8 mm 2 , respectively. Whole width and length of the mid-substance insertion sites were 5.3 ± 1.4, and 15.5 ± 2.9 mm, respectively. The measured areas of the fan-like extensions of the AM and PL bundles were 27 ± 11.5, and 29.5 ± 12.4 mm 2 , respectively. The femoral ACL footprint was divided into quarters of approximately equal size (mid-substance insertion sites of the AM and PL bundles, and fan-like extensions of the AM and PL bundles). For clinical relevance, to perform highly reproducible anatomical ACL reconstruction, the presence of the fan-like extension

No difference between mechanical perturbation training with compliant surface and manual perturbation training on knee functional performance after ACL rupture.

Science.gov (United States)

Nawasreh, Zakariya; Logerstedt, David; Failla, Mathew; Snyder-Mackler, Lynn

2017-10-27

Manual perturbation training improves dynamic knee stability and functional performance after anterior cruciate ligament rupture (ACL-rupture). However, it is limited to static standing position and does not allow time-specific perturbations at different phase of functional activities. The purpose of this study was to investigate whether administering mechanical perturbation training including compliant surface provides effects similar to manual perturbation training on knee functional measures after an acute ACL-rupture. Sixteen level I/II athletes with ACL-ruptures participated in this preliminary study. Eight patients received mechanical (Mechanical) and eight subjects received manual perturbation training (Manual). All patients completed a functional testing (isometric quadriceps strength, single-legged hop tests) and patient-reported measures (Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS), Global Rating Score (GRS), International Knee Documentation Committee 2000 (IKDC 2000) at pre- and post-training. 2 × 2 ANOVA was used for data analysis. No significant group-by-time interactions were found for all measures (p > 0.18). Main effects of time were found for single hop (Pre-testing: 85.14% ± 21.07; Post-testing: 92.49% ± 17.55), triple hop (Pre-testing: 84.64% ± 14.17; Post-testing: 96.64% ± 11.14), KOS-ADLS (Pre-testing: 81.13% ± 11.12; Post-testing: 88.63% ± 12.63), GRS (Pre-testing: 68.63% ± 15.73; Post-testing: 78.81% ± 13.85), and IKDC 2000 (Pre-testing: 66.66% ± 9.85; Post-testing: 76.05% ± 14.62) (p training using compliant surfaces induce effects similar to manual perturbation training on knee functional performance after acute ACL-rupture. The clinical significance is both modes of training improve patients' functional-performance and limb-to-limb movement symmetry, and enhancing the patients' self-reported of knee functional measures after ACL rupture. Mechanical

A comparison of hamstring muscle activity during different screening tests for non-contact ACL injury

DEFF Research Database (Denmark)

Husted, Rasmus S; Bencke, Jesper; Andersen, Lars Louis

2016-01-01

phenomenon and thereby observable independently of the type of clinical screening tests used is not known. This cross sectional study investigated the rank correlation of knee joint neuromuscular activity between three different ACL injury risk screening tests. METHODS: Sixty-two adolescent female elite......BACKGROUND: Reduced ability to activate the medial hamstring muscles during a sports-specific sidecutting movement has been found to be a potential risk factor for non-contact ACL injury. However, whether a reduced ability to activate the medial hamstring muscle is a general neuromuscular...... football and handball players (16.7±1.3years) participated in the study. Using surface electromyography (EMG) assessment, the neuromuscular activity of medial hamstring muscle (semitendinosus, ST), lateral hamstring muscle (biceps femoris, BF) and quadriceps muscle (vastus lateralis, VL) were monitored...

Falling up the stairs: the equivalent of 'bashing it with a bible' for an ACL ganglion cyst of the knee.

Science.gov (United States)

Dacombe, Peter Jonathan; Robinson, James

2012-03-27

Intra-articular anterior cruciate ligament (ACL) cysts are rare, the pathogenesis remains unknown, with trauma often implicated. Often asymptomatic, incidental MRI findings, 11% produce symptoms such as pain, locking or instability. Treatment of intra-articular ganglia differs from the traditional 'bash it with a bible' mantra for ganglia elsewhere with surgical debridement generally indicated for symptomatic cases. This case report describes a 43-year-old male car mechanic who presented with a symptomatic ACL cyst diagnosed on MRI. While waiting for surgery the patient fell up his stairs at home, causing forced hyperflexion of his knee. After an initial sharp pain, within 24 h the patient experienced complete resolution of symptoms. Postfall MRI showed no evidence of the initial lesion, leading to our conclusion that for this patient, a fall up the stairs was the equivalent of 'bashing it with a bible' for an ACL ganglion cyst of the knee.

Magnetic resonance imaging in evaluation of tunnel diameters prior to revision ACL reconstruction: a comparison to computed tomography

Energy Technology Data Exchange (ETDEWEB)

Drews, Bjoern Holger; Gulkin, Daniel; Guelke, Joachim; Gebhard, Florian [University of Ulm, Center of Surgery, Department for Orthopedic Trauma, Hand and Reconstructive Surgery, Ulm (Germany); Merz, Cornelia; Huth, Jochen; Mauch, Frieder [Sportklinik Stuttgart GmbH, Stuttgart (Germany)

2017-10-15

Revision ACL reconstruction is becoming more frequent because of a 10% rate of re-ruptures and insufficiencies. Currently, computed tomography (CT) represents the gold standard in detecting and measuring the tunnels of the initial ACL reconstruction. The purpose of this study was to compare measurement results of CT and thin-sliced MRI sequences, which were modified to a high soft tissue-bone contrast. Prior to an ACL revision surgery, 16 consecutive patients had an MRI in addition to the standard CT scan. A dedicated 0.25-T Esaote G-Scan (Esaote Biomedica, Cologne, Germany) with a Turbo 3D T1 sequence was used for MRI. Tunnel diameters were measured at 11 defined points of interest. For the statistical evaluation, the Mann-Whitney U test for connected samples was used. Inter- and intraobserver reliability was additionally calculated. All measured diameters showed significant to highly significant correlations between both diagnostic tools (r = 0.7-0.98). In addition, there was no significant difference (p > 0.5) between the two techniques. Almost all diameters showed nearly perfect intraobserver reliability (ICC 0.8-0.97). Interobserver reliability showed an ICC of 0.91/0.92 for only one diameter in MRI and CT. Prior to ACL revision surgery, bone tunnel measurements can be done using a 3D T1-MRI sequence in low-field MRI. MRI measurements show the same accuracy as CT scans. Preoperative radiation exposure in mainly young patients could be reduced. Also the costs of an additional CT scan could be saved. (orig.)

Anterior-Posterior Instability of the Knee Following ACL Reconstruction with Bone-Patellar Tendon-Bone Ligament in Comparison with Four-Strand Hamstrings Autograft

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A. G. Angoules

2013-01-01

Full Text Available Purpose. To evaluate anterior-posterior knee laxity using two different autografts. Material-Methods. 40 patients, (34 males and 6 women, 17–54 years old (mean: 31, were included in the present study. Group A (4SHS = 20 underwent reconstruction using four-strand hamstrings, and group B (BPBT = 20 underwent reconstruction using bone-patellar tendon-bone autograft. Using the KT-1000 arthrometer, knee instability was calculated in both knees of all patients preoperatively and 3, 6, and 12 months after surgery at the ACL-operated knee. The contralateral healthy knee was used as an internal control group. Results. Anterior-posterior instability using the KT1000 Arthrometer was found to be increased after ACL insufficiency. The recorded laxity improved after arthroscopic ACL reconstruction in both groups. However, statistically significant greater values were detected in the bone-patellar tendon-bone group, which revealed reduction of anteroposterior stability values to an extent, where no statistical significance with the normal values even after 3 months after surgery was observed. Conclusions. Anterior-Posterior instability of the knee improved significantly after arthroscopic ACL reconstruction. The bone-patellar tendon-bone graft provided an obvious greater stability.

The Vertical Drop Jump Is a Poor Screening Test for ACL Injuries in Female Elite Soccer and Handball Players: A Prospective Cohort Study of 710 Athletes.

Science.gov (United States)

Krosshaug, Tron; Steffen, Kathrin; Kristianslund, Eirik; Nilstad, Agnethe; Mok, Kam-Ming; Myklebust, Grethe; Andersen, Thor Einar; Holme, Ingar; Engebretsen, Lars; Bahr, Roald

2016-04-01

The evidence linking knee kinematics and kinetics during a vertical drop jump (VDJ) to anterior cruciate ligament (ACL) injury risk is restricted to a single small sample. Still, the VDJ test continues to be advocated for clinical screening purposes. To test whether 5 selected kinematic and kinetic variables were associated with future ACL injuries in a large cohort of Norwegian female elite soccer and handball players. Furthermore, we wanted to assess whether the VDJ test can be recommended as a screening test to identify players with increased risk. Cohort study; Level of evidence, 2. Elite female soccer and handball players participated in preseason screening tests from 2007 through 2014. The tests included marker-based 3-dimensional motion analysis of a drop-jump landing. We followed a predefined statistical protocol in which we included the following candidate risk factors in 5 separate logistic regression analyses, with new ACL injury as the outcome: (1) knee valgus angle at initial contact, (2) peak knee abduction moment, (3) peak knee flexion angle, (4) peak vertical ground-reaction force, and (5) medial knee displacement. A total of 782 players were tested (age, 21 ± 4 years; height, 170 ± 7 cm; body mass, 67 ± 8 kg), of which 710 were included in the analyses. We registered 42 new noncontact ACL injuries, including 12 in previously ACL-injured players. Previous ACL injury (relative risk, 3.8; 95% CI, 2.1-7.1) and medial knee displacement (odds ratio, 1.40; 95% CI, 1.12-1.74 per 1-SD change) were associated with increased risk for injury. However, among the 643 players without previous injury, we found no association with medial knee displacement. A receiver operating characteristic curve analysis of medial knee displacement showed an area under the curve of 0.6, indicating a poor-to-failed combined sensitivity and specificity of the test, even when including previously injured players. Of the 5 risk factors considered, medial knee displacement was the

Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training: A Case Study in Women’s Elite Soccer

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Mette K. Zebis

2017-01-01

Full Text Available The aim of the present single-case study was to investigate the effect of 6 weeks’ kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years with no previous history of ACL injury went through neuromuscular screening as measured by EMG preactivity of vastus lateralis and semitendinosus during a standardized sidecutting maneuver. Subsequently, the player experienced a noncontact ACL injury. The player was screened again following postreconstruction rehabilitation, then underwent 6-week kettlebell training, and was subsequently screened again at 6-week follow-up. Prior to and after postreconstruction rehabilitation the player demonstrated a neuromuscular profile during sidecutting known to increase the risk for noncontact ACL injury, that is, reduced EMG preactivity for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high-risk neuromuscular profile changed to low-risk in response to 6 weeks of kettlebell training. Thus, short-term kettlebell exercise with documented high levels of medial hamstring activation was found to transfer into high medial hamstring preactivation during a sidecutting maneuver.

CORE STABILIZATION EXERCISES AFTER ACL RECONSTRUCTION SURGERY PROVIDES BETTER OUTCOMES: A RANDOMIZED CONTROLLED TRIAL

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Dilpreet Kaur

2015-12-01

Full Text Available Background: Decreased core stability displaces center of gravity away from base of support reducing activity participation of athlete. Present study was conducted to study the effect of core stabilization exercises after reconstruction surgery of ACL on functional outcomes. Methods: 30 subjects following 5 months of ACL reconstruction were randomly assigned to either group that performed (study group or did not performed (control group additional core stabilization exercises in conjugation with standard rehabilitation protocol. Outcome measures were: activity level using Tegnar activity level scale and functional performance using triple hop test. Outcome measures were compared at day 1 and day 42 of the treatment. Result: Significant improvement was seen in the study group for Tegnar score with mean difference changing from 4.5 to 1.5 from day 1 to day 42 of treatment (p=0.039 while the control group showed improvement in mean difference changing from 3.8 to 1.4 (p=.045 from day 1 to day 42 of treatment. Highly significant improvement was seen in the study group for triple hop test with mean difference changing from 25 to 6.7 (p<.001 compared to the control group with mean difference changing from 15.2 to 9.7(p=.005 from day 1 to day 42 of treatment. Conclusions: Both the groups showed improvement for activity level and functional performance but highly significant improvement was seen in the study group for functional performance. Core stabilization exercises in conjugation with the standard ACL rehabilitation protocol results better improvement in the triple hop test.

The effect of protein and carbohydrate supplementation on strength training outcome of rehabilitation in ACL patients

DEFF Research Database (Denmark)

Holm, Lars; Esmarck, Birgitte; Mizuno, Masao

2006-01-01

supplementation groups: Protein+Carbohydrate (PC), Isocaloric-Carbohydrate (IC), or Placebo (PL), ingesting the supplementation immediately after each of 36 training sessions. Determined from images of thigh cross-sections (magnetic resonance imaging) the hypertrophy of the quadriceps muscle differed....... The results from this study demonstrate that restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions. Thus, exercise-related protein supplementation may...... was therefore to investigate if nutrient supplementation during 12 weeks of conservative rehabilitation strength training could enhance hypertrophy and strength of the quadriceps muscle in ACL-injured patients. Twenty-six ACL-injured men and women were included and randomly distributed into three...

Acceleration and Orientation Jumping Performance Differences Among Elite Professional Male Handball Players With or Without Previous ACL Reconstruction: An Inertial Sensor Unit-Based Study.

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Setuain, Igor; González-Izal, Miriam; Alfaro, Jesús; Gorostiaga, Esteban; Izquierdo, Mikel

2015-12-01

Handball is one of the most challenging sports for the knee joint. Persistent biomechanical and jumping capacity alterations can be observed in athletes with an anterior cruciate ligament (ACL) injury. Commonly identified jumping biomechanical alterations have been described by the use of laboratory technologies. However, portable and easy-to-handle technologies that enable an evaluation of jumping biomechanics at the training field are lacking. To analyze unilateral/bilateral acceleration and orientation jumping performance differences among elite male handball athletes with or without previous ACL reconstruction via a single inertial sensor unit device. Case control descriptive study. At the athletes' usual training court. Twenty-two elite male (6 ACL-reconstructed and 16 uninjured control players) handball players were evaluated. The participants performed a vertical jump test battery that included a 50-cm vertical bilateral drop jump, a 20-cm vertical unilateral drop jump, and vertical unilateral countermovement jump maneuvers. Peak 3-dimensional (X, Y, Z) acceleration (m·s(-2)), jump phase duration and 3-dimensional orientation values (°) were obtained from the inertial sensor unit device. Two-tailed t-tests and a one-way analysis of variance were performed to compare means. The P value cut-off for significance was set at P handball athletes with previous ACL reconstruction demonstrated a jumping biomechanical profile similar to control players, including similar jumping performance values in both bilateral and unilateral jumping maneuvers, several years after ACL reconstruction. These findings are in agreement with previous research showing full functional restoration of abilities in top-level male athletes after ACL reconstruction, rehabilitation and subsequent return to sports at the previous level. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Hydrogel fibers for ACL prosthesis: design and mechanical evaluation of PVA and PVA/UHMWPE fiber constructs.

Science.gov (United States)

Bach, Jason S; Detrez, Fabrice; Cherkaoui, Mohammed; Cantournet, Sabine; Ku, David N; Corté, Laurent

2013-05-31

Prosthetic devices for anterior cruciate ligament (ACL) reconstruction have been unsuccessful due to mechanical failure or chronic inflammation. Polymer hydrogels combine biocompatibility and unique low friction properties; however, their prior use for ligament reconstruction has been restricted to coatings due to insufficient tensile mechanics. Here, we investigate new constructs of polyvinyl alcohol (PVA) hydrogel fibers. In water, these fibers swell to an equilibrium water content of 50% by weight, retaining a tensile modulus greater than 40 MPa along the fiber axis at low strain. Rope constructs were assembled for ACL replacement and mechanical properties were compared with data from the literature. Pure PVA hydrogel constructs closely reproduce the non-linear tensile stiffness of the native ACL with an ultimate strength of about 2000 N. An additional safety factor in tensile strength was achieved with composite braids by adding ultrahigh molecular weight polyethylene (UHMWPE) fibers around a core of PVA cords. Composition and braiding angle are adjusted to produce a non-linear tensile behavior within the range of the native ligament that can be predicted by a simple rope model. This design was found to sustain over one million cycles between 50 and 450 N with limited damage and less than 20% creep. The promising mechanical performances of these systems provide justification for more extensive in vivo evaluation. Copyright © 2013. Published by Elsevier Ltd.

Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation.

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Biscarini, Andrea; Contemori, Samuele; Busti, Daniele; Botti, Fabio M; Pettorossi, Vito E

2016-12-08

Quadriceps strengthening exercises designed for the early phase of anterior cruciate ligament (ACL) rehabilitation should limit the anterior tibial translation developed by quadriceps contraction near full knee extension, in order to avoid excessive strain on the healing tissue. We hypothesize that knee-flexion exercises with simultaneous voluntary contraction of quadriceps (voluntary quadriceps cocontraction) can yield considerable levels of quadriceps activation while preventing the tibia from translating forward relative to the femur. Electromyographic activity in quadriceps and hamstring muscles was measured in 20 healthy males during isometric knee-flexion exercises executed near full knee extension with maximal voluntary effort of quadriceps cocontraction and external resistance (R) ranging from 0% to 60% of the 1-repetition maximum (1RM). Biomechanical modeling was applied to derive the shear (anterior/posterior) tibiofemoral force developed in each exercise condition. Isometric knee-flexion exercises with small external resistance (R=10% 1RM) and maximal voluntary effort of quadriceps cocontraction yielded a net posterior (ACL-unloading) tibial pull (P=0.005) and levels of activation of 32%, 50%, and 45% of maximum voluntary isometric contraction, for the rectus femoris, vastus medialis, and vastus lateralis, respectively. This exercise might potentially rank as one of the most appropriate quadriceps strengthening interventions in the early phase of ACL rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

Science.gov (United States)

Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Witvrouw, Erik; Engebretsen, Lars

2018-01-01

In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. PMID:29478021

The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

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Theresa Bieler

2014-01-01

Full Text Available Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL- reconstruction. This study investigated the effects of high-intensity (HRT versus low-intensity (LRT resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n=24 or LRT (n=26 from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94% of the noninjured leg, decreasing to 64% (95% CI 60–69% 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P=0.020. Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P=0.027 and at week 20 (98% versus 83% of noninjured leg, resp.; P=0.006 without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity.

Stress During ACLS Courses: Is it Important for Learning Skills?

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Emilton Lima Júnior

2002-12-01

Full Text Available OBJECTIVE: To determine the influence of stress on teaching medical emergencies in an Advanced Cardiac Life Support (ACLS course and to verify this influence on learning, and the efficiency of emergency care training. METHODS: Seventeen physicians signed up for an ACLS course. Their pulses were taken and blood pressure (BP verified on the first day, before the beginning of the course, and on the second day, during the theoretical and practical test (TPT. Variations in pulse rates and BP were compared with students' test grades. Then, students answered a questionnaire of variables (QV about the amount of sleep they had during the course, the quantity of study material and the time spent studying for the course, and a stress scale graphic. RESULTS: Seven students had a pulse variation less than 10% between the 2 periods and 10 had a 10% or more variation. Grades on TPT were, respectively, 91.4±2.4 and 87.3±5.2 (p<0.05. Six students had a BP variation less than 20 mmHg, and in 11 it varied more than 21 mmHg. Grades on the TPT were 92.3±3.3 and 86.2± 8.1, respectively (p<0.05. The QV dates did not significantly influence grades. CONCLUSION: Stress, as an isolated variable, had a negative influence on the learning process and on the efficiency of emergency training in this situation.

Double incision iso-anatomical ACL reconstruction: the freedom to place the femoral tunnel within the anatomical attachment site without exception.

Science.gov (United States)

Arnold, Markus P; Duthon, Victoria; Neyret, Philippe; Hirschmann, Michael T

2013-02-01

The present paper describes the rationale behind the surgical technique and the clinical results of the iso-anatomical, single bundle bone patellar-tendon bone anterior cruciate ligament (ACL) reconstruction. Using a second incision on the distal lateral femur an outside-in femoral tunnel is drilled. Guided by a special aiming device it is possible to place the femoral tunnel in the centre of the ACL footprint in every single case. Since every crucial step of the procedure is under visual control, the technique is safe and reliable, which is mirrored by good clinical results.

Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis.

Science.gov (United States)

Kanakamedala, Ajay C; Burnham, Jeremy M; Pfeiffer, Thomas R; Herbst, Elmar; Kowalczuk, Marcin; Popchak, Adam; Irrgang, James; Fu, Freddie H; Musahl, Volker

2018-05-01

A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears. ACL-injured patients enrolled in a prospective ACL registry from 2014 to 2016 were analyzed. To limit confounders, patients were only included if they had primary ACL tears, no concurrent ligamentous or bony injuries requiring operative treatment, and no previous knee injuries or surgeries to either knee. Eighty-four patients were included in the final analysis. A standardized quantitative pivot shift test was performed pre-operatively under anesthesia in both knees, and rotatory instability, specifically lateral compartment translation and tibial acceleration, was quantified using tablet image analysis software and accelerometer sensors. Standard lateral radiographs and sagittal magnetic resonance images (MRI) of the injured knee were evaluated for LFN depth. There were no significant correlations between LFN depth on either imaging modality and ipsilateral lateral compartment translation or tibial acceleration during a quantitative pivot shift test or side-to-side differences in these measurements. Patients with lateral meniscus tears were found to have significantly greater LFN depths than those without on conventional radiograph and MRI (1.0 vs. 0.6 mm, p quantitative measures of rotatory instability. Concomitant lateral meniscus injury was associated with significantly greater LFN depth. Based on

Physiotherapy in patients with rupture LCA

OpenAIRE

Čížková, Karolína

2012-01-01

Author: Karolína Čížková Institution: Rehab clinic LF UK in Hradec Králové Topic of bachelor's thesis: Physiotherapy in patiens with rupture of ACL Supervisor: Mgr. Zuzana Hamarová Number of pages: 108 Number of annex: 11 Year of vindication 2012 Key words: ACL, knee, rupture of ACL, rehabilitation In general part of this bachelor's thesis is described anatomy, kinesiology and biomechanics of the knee joint, mostly anterior cruciate ligament. It contents causes of injury of anterior cruciate ...

Do ground reaction forces during unilateral and bilateral movements exhibit compensation strategies following ACL reconstruction?

NARCIS (Netherlands)

Baumgart, Christian; Schubert, Markus; Hoppe, Matthias W.; Gokeler, Alli; Freiwald, Juergen

The aims of the study were (1) to evaluate the leg asymmetry assessed with ground reaction forces (GRFs) during unilateral and bilateral movements of different knee loads in anterior cruciate ligament (ACL) reconstructed patients and (2) to investigate differences in leg asymmetry depending on the

PAGING IN COMMUNICATIONS

DEFF Research Database (Denmark)

2016-01-01

A method and an apparatus are disclosed for managing paging in a communications system. The method may include, based on a received set of physical resources, determining, in a terminal apparatus, an original paging pattern defining potential time instants for paging, wherein the potential time...... instants for paging include a subset of a total amount of resources available at a network node for paging....

Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery.

Science.gov (United States)

Bareka, Metaxia; Hantes, Michael; Arnaoutoglou, Eleni; Vretzakis, George

2018-02-01

The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. I.

The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres.

Science.gov (United States)

Iriuchishima, Takanori; Ryu, Keinosuke; Aizawa, Shin; Fu, Freddie H

2016-01-01

The purpose of this study was to compare the centre position of each anterior cruciate ligament bundle in its femoral footprint in measurements including and excluding the fan-like extension fibres. Fourteen non-paired human cadaver knees were used. All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in tension patterns. The ACL was carefully dissected, and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibres. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The centre position of each bundle, including and excluding the fan-like extension fibres, was measured with ImageJ software (National Institution of Health). Evaluation of the centre position was performed using the modified quadrant method. The centre of the femoral AM bundle including the fan-like extension was located at 28.8% in a shallow-deep direction and 37.2% in a high-low direction. When the AM bundle was evaluated without the fan-like extension, the centre was significantly different at 34.6% in a shallow-deep direction (p = 0.000) and 36% in a high-low direction. The centre of the PL bundle including the fan-like extension was found at 37.1% in a shallow-deep direction and 73.4% in a high-low direction. When the PL bundle was evaluated without the fan-like extension, the centre was significantly different at 42.7% in a shallow-deep direction (p = 0.000) and 69.3% in a high-low direction (p = 0.000). The centre position of the AM and PL bundles in the femoral ACL footprint was significantly different depending on the inclusion or exclusion of the fan-like extension fibres. For the clinical relevance, to reproduce the direct femoral insertion in the anatomical ACL reconstruction, tunnels should be

Cyclops lesions detected by MRI are frequent findings after ACL surgical reconstruction but do not impact clinical outcome over 2 years

Energy Technology Data Exchange (ETDEWEB)

Facchetti, Luca [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); University of Brescia, Department of Radiology, Brescia (Italy); Schwaiger, Benedikt J.; Gersing, Alexandra S.; Nardo, Lorenzo; Majumdar, Sharmila; Link, Thomas M.; Li, Xiaojuan [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Guimaraes, Julio Brandao [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Federal University of Sao Paulo (UNIFESP), Department of Radiology, Sao Paulo (Brazil); Ma, Benjamin C. [University of California, Department of Orthopedic Surgery, San Francisco, CA (United States); Collaboration: UCSF-P50-ACL Consortium; AF-ACL Consortium

2017-08-15

To assess the impact of cyclops lesions with MRI in patients treated for anterior cruciate ligament (ACL) tears on clinical outcome. In 113 patients (age 29.8 ± 10.5y; 55 females; BMI 24.8 ± 3.7 kg/m{sup 2}) with complete ACL tear, 3 T-MRI scans were obtained before, 6-months, 1-year (n = 75) and 2-years (n = 33) after ACL reconstruction. Presence and volume of cyclops lesions were assessed. Clinical outcomes were measured using the Knee injury and Osteoarthritis Outcome Score (KOOS) and differences between time points (∇KOOS) were calculated. Changes of KOOS subscales were compared between patients with and without cyclops lesion. KOOS was also correlated with lesion volume. Cyclops lesions were found in 25% (28/113), 27% (20/75) and 33% (11/33) of patients after 6-months, 1- and 2-years, respectively. The lesion volume did not change significantly (P > 0.05) between time points, measuring 0.65 ± 0.59, 0.81 ± 0.70 and 0.72.9 ± 0.96 cm{sup 3}, respectively. Clinical outcomes based on KOOS subscales were not significantly different in patients with cyclops lesions compared to those without cyclops lesions (each comparison P > 0.05), and no significant associations of clinical outcomes with lesion volume were found (P > 0.05). Neither presence nor size of cyclops lesions within the first 2-years after ACL surgery were associated with inferior clinical outcome. (orig.)

MRI of double-bundle ACL reconstruction: evaluation of graft findings

Energy Technology Data Exchange (ETDEWEB)

Kiekara, Tommi; Paakkala, Antti [Tampere University Hospital, Medical Imaging Centre, Tampere (Finland); Jaervelae, Timo [Sports Clinic and Hospital Mehilaeinen, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Health Sciences, Tampere (Finland)

2012-07-15

To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

Anterior cruciate ligament (ACL) injury -- aftercare

Science.gov (United States)

... Quickly stop moving and change direction while running, landing from a jump, or turning Skiers and people ... Health and Human Services National Institutes of Health Page last updated: 30 April 2018

Peak stresses shift from femoral tunnel aperture to tibial tunnel aperture in lateral tibial tunnel ACL reconstructions: a 3D graft-bending angle measurement and finite-element analysis.

Science.gov (United States)

Van Der Bracht, Hans; Tampere, Thomas; Beekman, Pieter; Schepens, Alexander; Devriendt, Wouter; Verdonk, Peter; Victor, Jan

2018-02-01

To investigate the effect of tibial tunnel orientation on graft-bending angle and stress distribution in the ACL graft. Eight cadaveric knees were scanned in extension, 45°, 90°, and full flexion. 3D reconstructions with anatomically placed anterior cruciate ligament (ACL) grafts were constructed with Mimics 14.12 ® . 3D graft-bending angles were measured for classic medial tibial tunnels (MTT) and lateral tibial tunnels (LTT) with different drill-guide angles (DGA) (45°, 55°, 65°, and 75°). A pivot shift was performed on 1 knee in a finite-element analysis. The peak stresses in the graft were calculated for eight different tibial tunnel orientations. In a classic anatomical ACL repair, the largest graft-bending angle and peak stresses are seen at the femoral tunnel aperture. The use of a different DGA at the tibial side does not change the graft-bending angle at the femoral side or magnitude of peak stresses significantly. When using LTT, the largest graft-bending angles and peak stresses are seen at the tibial tunnel aperture. In a classic anatomical ACL repair, peak stresses in the ACL graft are found at the femoral tunnel aperture. When an LTT is used, peak stresses are similar compared to classic ACL repairs, but the location of the peak stress will shift from the femoral tunnel aperture towards the tibial tunnel aperture. the risk of graft rupture is similar for both MTTs and LTTs, but the location of graft rupture changes from the femoral tunnel aperture towards the tibial tunnel aperture, respectively. I.

Long-Term Data Reveal Rate and Risk Factors for Subsequent Surgeries Following Initial ACL Reconstruction

Science.gov (United States)

... Rupture of the knee’s ACL is a common sports-related injury. It is associated with other knee problems, such as meniscal tears and knee instability. ... after anterior cruciate ligament reconstruction. Am J of Sports Med. 2013; ... treatment and prevention of arthritis and musculoskeletal and skin diseases; the ...

TRANSTIBIAL VERSUS ANTEROMEDIAL PORTAL TECHNIQUES IN ACL RECONSTRUCTION

Directory of Open Access Journals (Sweden)

Luiz Gabriel Betoni Guglielmetti

Full Text Available Abstract Introduction: Although the results of anterior cruciate ligament (ACL reconstruction are well documented in many studies, with good to excellent outcomes in most cases, some issues like tunnel positioning are still discussed and studied. Objective: To compare the objective and subjective clinical outcomes of ACL reconstruction using the transtibial and anteromedial portal techniques. Methods: Prospective randomized study of 80 patients undergoing anterior cruciate ligament reconstruction by the same surgeon, with 40 patients operated by the transtibial technique and 40 by anteromedial portal technique. The patients, 34 in the transtibial group and 37 in the anteromedial portal group (nine dropouts, were reassessed during a 2-year follow-up period. The clinical assessment consisted of physical examination, KT-1000TM evaluation, Lysholm score, and objective and subjective International Knee Documentation Committee - IKDC scores. Results: Regarding the Lachman and pivot shift tests, we observed more cases of instability in the transtibial group, but with no statistical significance (p=0.300 and p=0.634, respectively. Regarding the anterior drawer test, the groups presented similar results (p=0.977. Regarding KT-1000TM evaluation, the mean results were 1.44 for the transtibial group and 1.23 for the anteromedial portal group, with no statistical significance (p=0.548. We separated the objective IKDC scores into two groups: Group 1, IKDC A, and Group 2, IKDC B, C, or D, with no statistical significance (p=0.208. Concerning the Lysholm score, the transtibial group had a mean score of 91.32, and the anteromedial portal group had a mean score of 92.81. The mean subjective IKDC scores were 90.65 for the transtibial group and 92.65 for the anteromedial portal group. Three re-ruptures were encountered in the transtibial group and three in the anteromedial portal group. Conclusions: There were no significant differences in the subjective and

A comparison of hamstring muscle activity during different screening tests for non-contact ACL injury.

Science.gov (United States)

Husted, Rasmus S; Bencke, Jesper; Andersen, Lars L; Myklebust, Grethe; Kallemose, Thomas; Lauridsen, Hanne B; Hölmich, Per; Aagaard, Per; Zebis, Mette K

2016-06-01

Reduced ability to activate the medial hamstring muscles during a sports-specific sidecutting movement has been found to be a potential risk factor for non-contact ACL injury. However, whether a reduced ability to activate the medial hamstring muscle is a general neuromuscular phenomenon and thereby observable independently of the type of clinical screening tests used is not known. This cross sectional study investigated the rank correlation of knee joint neuromuscular activity between three different ACL injury risk screening tests. Sixty-two adolescent female elite football and handball players (16.7±1.3years) participated in the study. Using surface electromyography (EMG) assessment, the neuromuscular activity of medial hamstring muscle (semitendinosus, ST), lateral hamstring muscle (biceps femoris, BF) and quadriceps muscle (vastus lateralis, VL) were monitored during three standardized screening tests - i.e. one-legged horizontal hop (OLH), drop vertical jump (DJ) and sidecutting (SC). Neuromuscular pre-activity was measured in the time interval 10ms prior to initial contact on a force plate. For neuromuscular hamstring muscle pre-activity, correlation analysis (Spearman correlation coefficient) showed low-to-moderate correlations between SC and 1) DJ (rs=0.34-0.36, Phamstring pre-activity share some common variance during the examined tests. However, a lack of strong correlation suggests that we cannot generalize one risk factor during one test to another test. The present data demonstrate that one-legged horizontal hop and drop vertical jump testing that are commonly used in the clinical setting does not resemble the specific neuromuscular activity patterns known to exist during sidecutting, a well known high risk movement for non-contact ACL injury. Copyright © 2016 Elsevier B.V. All rights reserved.

Dynamic Displays for Tactical Planning. Volume 3. Software Documentation

Science.gov (United States)

1979-12-01

Figure 3-7. High-Level Flow of Data. -18- I 4.0 MAJOR SOFTWARE MODULES This section contains write -ups on the major subprograms in TOMM. Criteria for...pages, arranged in alphabetical order. Each write -up includes the name of the subprogram at the top of the page, followed by: (1) a list of the overlays...IEN1, iELt ,0tl.3) CALL 6HLT 900 F IM AT (13) IEL= IEL*5 GO TO 20 10 CALL tPUT(IELrII4,-3Gp0J CALL GCHA(lFNfIEIL~l*009I) CALL tIiL I vA 11H15,99*J) CLAd

Quantitative comparison of the microscopic anatomy of the human ACL femoral and tibial entheses.

Science.gov (United States)

Beaulieu, Mélanie L; Carey, Grace E; Schlecht, Stephen H; Wojtys, Edward M; Ashton-Miller, James A

2015-12-01

The femoral enthesis of the human anterior cruciate ligament (ACL) is known to be more susceptible to injury than the tibial enthesis. To determine whether anatomic differences might help explain this difference, we quantified the microscopic appearance of both entheses in 15 unembalmed knee specimens using light microscopy, toluidine blue stain and image analysis. The amount of calcified fibrocartilage and uncalcified fibrocartilage, and the ligament entheseal attachment angle were then compared between the femoral and tibial entheses via linear mixed-effects models. The results showed marked differences in anatomy between the two entheses. The femoral enthesis exhibited a 3.9-fold more acute ligament attachment angle than the tibial enthesis (p<0.001), a 43% greater calcified fibrocartilage tissue area (p<0.001), and a 226% greater uncalcified fibrocartilage depth (p<0.001), with the latter differences being particularly pronounced in the central region. We conclude that the ACL femoral enthesis has more fibrocartilage and a more acute ligament attachment angle than the tibial enthesis, which provides insight into why it is more vulnerable to failure. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Broken Bioabsorbable Tibial Interference Screw after Anterior Cruciate Ligament (ACL Reconstruction using a Semitendinosus-gracilis Graft: A Case Report

Directory of Open Access Journals (Sweden)

Huang ME Deborah

2012-07-01

Full Text Available When a patient presents with knee pain and locking after an anterior cruciate ligament (ACL reconstruction, a new meniscal injury or an osteochondral loose body are usually considered for differential diagnosis. We present the case of a 22-year-old female with just these complaints 6 months after ACL reconstruction surgery. Magnetic resonance imaging (MRI of the knee showed a broken screw tip which was later arthroscopically removed. At arthroscopy, an 11mm long broken bioabsorbable interference screw tip was found lying in the intercondylar notch; this resulted in a 0.5cm Outerbridge grade II chondral ulcer located at mid- patella. Both menisci and cruciate ligaments were intact and no other loose bodies were found in the knee joint.

The effects of attentional focus on jump performance and knee joint kinematics in patients after ACL reconstruction

NARCIS (Netherlands)

Gokeler, Alli; Benjaminse, Anne; Welling, Wouter; Alferink, Malou; Eppinga, Peter; Otten, Bert

Objectives: The purpose of this study was to determine the effect of an internal and external attentional focus on single leg hop jump distance and knee kinematics in patients after ACL reconstruction (ACLR). Design: Experimental. Setting: Outpatient physical therapy facility. Participants: Sixteen

Utilization of ACL Injury Biomechanical and Neuromuscular Risk Profile Analysis to Determine the Effectiveness of Neuromuscular Training.

Science.gov (United States)

Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

2016-12-01

The widespread use of anterior cruciate ligament (ACL) injury prevention interventions has not been effective in reducing the injury incidence among female athletes who participate in high-risk sports. The purpose of this study was to determine if biomechanical and neuromuscular factors that contribute to the knee abduction moment (KAM), a predictor of future ACL injuries, could be used to characterize athletes by a distinct factor. Specifically, we hypothesized that a priori selected biomechanical and neuromuscular factors would characterize participants into distinct at-risk profiles. Controlled laboratory study. A total of 624 female athletes who participated in jumping, cutting, and pivoting sports underwent testing before their competitive season. During testing, athletes performed drop-jump tasks from which biomechanical measures were captured. Using data from these tasks, latent profile analysis (LPA) was conducted to identify distinct profiles based on preintervention biomechanical and neuromuscular measures. As a validation, we examined whether the profile membership was a significant predictor of the KAM. LPA using 6 preintervention biomechanical measures selected a priori resulted in 3 distinct profiles, including a low (profile 1), moderate (profile 2), and high (profile 3) risk for ACL injuries. Athletes with profiles 2 and 3 had a significantly higher KAM compared with those with profile 1 (P risk profiles. Three distinct risk groups were identified based on differences in the peak KAM. These findings demonstrate the existence of discernable groups of athletes that may benefit from injury prevention interventions. ClinicalTrials.gov NCT identifier: NCT01034527. © 2016 The Author(s).

Entertainment Pages.

Science.gov (United States)

Druce, Mike

1981-01-01

Notes that the planning of an effective entertainment page in a school newspaper must begin by establishing its purpose. Examines all the elements that contribute to the makeup of a good entertainment page. (RL)

ACL deficient potential copers and non-copers reveal different isokinetic quadriceps strength profiles in the early stage after injury

Science.gov (United States)

Eitzen, I; Eitzen, TJ; Holm, I; Snyder-Mackler, L; Risberg, MA

2011-01-01

Background Isokinetic muscle strength tests using the peak torque value is the most frequently included quadriceps muscle strength measurement for anterior cruciate ligament (ACL) injured subjects. Aims The purpose of this study was to investigate quadriceps muscle performance during the whole isokinetic curve in ACL deficient subjects classified as potential copers or non-copers, and investigate whether these curve profiles were associated with single-leg hop performance. We hypothesized that quadriceps muscle torque at other knee flexion angles than peak torque would give more information about quadriceps muscle strength deficits. Furthermore, we hypothesized that there would be significant torque differences between potential copers and non-copers, and a significant relationship between angle specific torque values and single-leg hop performance. Study Design Cross-sectional study; Level of evidence, 2 Methods Seventy-six individuals with a complete unilateral ACL rupture within the last 3 months were included. The subjects were classified into potential copers and non-copers according to the criteria from Fitzgerald et al12. Isokinetic quadriceps muscle tests were performed at 60°/sec (Biodex 6000). Mean torque values were calculated for peak torque as well as for specific knee flexion angles. The one-leg hop and the 6 meter timed hop tests were included and symmetry indices were used. Results The peak torque value did not identify the largest quadriceps muscle strength deficit. Rather, these were established at knee flexion angles of less than 40°. There were significant differences in angle specific torque values between potential copers and non-copers (p<0.05). Moderate to strong associations were disclosed between angle specific torque values and single-leg hop performance, but only for non-copers (r≥0.32– 0.58). Conclusions Angle specific quadriceps muscle torque values of less than 40° of knee flexion provide more information on the quadriceps

Sidestep cutting technique and knee abduction loading: implications for ACL prevention exercises.

Science.gov (United States)

Kristianslund, Eirik; Faul, Oliver; Bahr, Roald; Myklebust, Grethe; Krosshaug, Tron

2014-05-01

Sidestep cutting technique is essential in programmes to prevent anterior cruciate ligament (ACL) injury. A better understanding of how technique affects potentially harmful joint loading may improve prevention programmes. The purpose of this study was to investigate the effect of sidestep cutting technique on maximum knee abduction moments. Cross-sectional study. Whole-body kinematics and knee joint kinetics were calculated in 123 female handball players (mean±SD, 22.5±7.0 years, 171±7 cm, 67±7 kg) performing sidestep cutting. Three cuts from each side were analysed. Linear regression was applied between selected technique factors and maximum knee abduction moment during the first 100 ms of the contact phase. Furthermore, we investigated to what degree the abduction moment originated from the magnitude of the ground reaction force (GRF) or the knee abduction moment arm of the GRF. Technique factors explained 62% of the variance in knee abduction moments. Cut width, knee valgus, toe landing, approach speed and cutting angle were the most significant predictors. An increase in one of these factors of 1 SD increased the knee abduction moment from 12% to 19%. The effect of the moment arm of the GRF was more important than the force magnitude for maximum knee abduction moments. Lower knee abduction loads during sidestep cutting may be achieved if cuts are performed as narrow cuts with low knee valgus and toe landings. These factors may be targeted in ACL injury prevention programmes.

Full page insight

DEFF Research Database (Denmark)

Cortsen, Rikke Platz

2014-01-01

Alan Moore and his collaborating artists often manipulate time and space by drawing upon the formal elements of comics and making alternative constellations. This article looks at an element that is used frequently in comics of all kinds – the full page – and discusses how it helps shape spatio......, something that it shares with the full page in comics. Through an analysis of several full pages from Moore titles like Swamp Thing, From Hell, Watchmen and Promethea, it is made clear why the full page provides an apt vehicle for an apocalypse in comics....

Longitudinal Changes in Hip Strength and Range of Motion in Female Youth Soccer Players: Implications for ACL Injury, A Pilot Study.

Science.gov (United States)

Nguyen, Anh-Dung; Zuk, Emma F; Baellow, Andrea L; Pfile, Kate R; DiStefano, Lindsay J; Boling, Michelle C

2017-09-01

Risk of anterior cruciate ligament (ACL) injuries in young female athletes increases with age, appearing to peak during maturation. Changes in hip muscle strength and range of motion (ROM) during this time may contribute to altered dynamic movement patterns that are known to increase risk of ACL injuries. Understanding the longitudinal changes in hip strength and ROM is needed to develop appropriate interventions to reduce the risk of ACL injuries. To examine the longitudinal changes in hip strength and ROM in female youth soccer players. Longitudinal descriptive study. Field setting. 14 female youth soccer athletes (14.1 ± 1.1 y, 165.8 ± 5.3 cm, 57.5 ± 9.9 kg) volunteered as part of a multiyear risk factor screening project. Clinical measures of hip strength and ROM were collected annually over 3 consecutive years. Passive hip internal rotation (IR), external rotation (ER), abduction (ABD), and adduction (ADD) ROM were measured with a digital inclinometer. Isometric hip ABD and extension (EXT) strength were evaluated using a hand-held dynamometer. Separate repeated-measures ANOVAs compared hip strength and ROM values across 3 consecutive years (P hip ABD (P = .830) or EXT strength (P = .062) across 3 consecutive years. Longitudinal changes in hip ROM were observed with increases in hip IR (P = .001) and ABD (P hip ADD (P = .009) and ER (P hip occur as youth female soccer players increase in age. While there are no changes in hip strength, there is an increase in hip IR and ABD ROM with a concomitant decrease in hip ER and ADD ROM. The resulting asymmetries in hip ROM may decrease the activation and force producing capabilities of the hip muscles during dynamic activities, contributing to altered lower extremity mechanics known to increase the risk of ACL injuries.

Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts.

Science.gov (United States)

Buescu, Cristian Tudor; Onutu, Adela Hilda; Lucaciu, Dan Osvald; Todor, Adrian

2017-03-01

The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test. Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group. The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft. Level I Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Transphyseal ACL Reconstruction in Skeletally Immature Patients: Does Independent Femoral Tunnel Drilling Place the Physis at Greater Risk Compared With Transtibial Drilling?

Science.gov (United States)

Cruz, Aristides I; Lakomkin, Nikita; Fabricant, Peter D; Lawrence, J Todd R

2016-06-01

Most studies examining the safety and efficacy of transphyseal anterior cruciate ligament (ACL) reconstruction for skeletally immature patients utilize transtibial drilling. Independent femoral tunnel drilling may impart a different pattern of distal femoral physeal involvement. To radiographically assess differences in distal femoral physeal disruption between transtibial and independent femoral tunnel drilling. We hypothesized that more oblique tunnels associated with independent drilling involve a significantly larger area of physeal disruption compared with vertically oriented tunnels. Cross-sectional study; Level of evidence, 3. We analyzed skeletally immature patients aged between 10 and 15 years who underwent transphyseal ACL reconstruction utilizing an independent femoral tunnel drilling technique between January 1, 2008, and March 31, 2011. These patients were matched with a transtibial technique cohort based on age and sex. Radiographic measurements were recorded from preoperative magnetic resonance imaging and postoperative radiographs. Ten patients in each group were analyzed. There were significant differences between independent drilling and transtibial drilling cohorts in the estimated area of physeal disruption (1.64 vs 0.74 cm(2); P drilling technique disrupt a larger area of the distal femoral physis and create more eccentric tunnels compared with a transtibial technique. As most studies noting the safety of transphyseal ACL reconstruction have utilized a central, vertical femoral tunnel, surgeons should be aware that if an independent femoral tunnel technique is utilized during transphyseal ACL reconstruction, more physeal tissue is at risk and tunnels are more eccentrically placed across the physis when drilling at more horizontal angles. Prior studies have shown that greater physeal involvement and eccentric tunnels may increase the risk of growth disturbance.

Motor learning strategies in basketball players and its implications for ACL injury prevention : a randomized controlled trial

NARCIS (Netherlands)

Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L.; Lemmink, Koen A. P. M.

Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during

Radiographic positions of femoral ACL, AM and PL centres : accuracy of guidelines based on the lateral quadrant method

NARCIS (Netherlands)

Luites, Joan W.H.; Verdonschot, Nico

2017-01-01

Purpose: Femoral tunnel positioning is an important factor in anatomical ACL reconstructions. To improve accuracy, lateral radiographic support can be used to determine the correct tunnel location, applying the quadrant method. Piefer et al. (Arthroscopy 28:872–881, 2012) combined various outcomes

A protocol of rehabilitation after ACL reconstruction using a hamstring autograft in the first month after surgery--a preliminary report.

Science.gov (United States)

Biernat, Ryszard; Wołosewicz, Mariusz; Tomaszewski, Wiesław

2007-01-01

The purpose of this paper is to present a protocol of rehabilitation after ACL reconstruction using a hamstring autograft in the first month after surgery. The program enables the patient to return early to everyday activities (school, sedentary work) without crutches or a stabilizer. The program has been developed in accordance with rehabilitation protocols employed at Karolinska Institute in Sweden and Prof. Shelbourne's Clinic in the USA. The study group included 31 patients (18 men and 13 women). Patients rehabilitated in the Department according to our program achieved stable gait patterns and were able to step up and down within four to seven weeks. Early patient mobilization after ACL reconstruction is possible and does not cause any negative effects provided that the patient, doctor and physiotherapist cooperate very closely.

Users page feedback

CERN Multimedia

2010-01-01

In October last year the Communication Group proposed an interim redesign of the users’ web pages in order to improve the visibility of key news items, events and announcements to the CERN community. The proposed update to the users' page (right), and the current version (left, behind) This proposed redesign was seen as a small step on the way to much wider reforms of the CERN web landscape proposed in the group’s web communication plan.   The results are available here. Some of the key points: - the balance between news / events / announcements and access to links on the users’ pages was not right - many people asked to see a reversal of the order so that links appeared first, news/events/announcements last; - many people felt that we should keep the primary function of the users’ pages as an index to other CERN websites; - many people found the sections of the front page to be poorly delineated; - people do not like scrolling; - there were performance...

Sleep Apnea Information Page

Science.gov (United States)

... Page You are here Home » Disorders » All Disorders Sleep Apnea Information Page Sleep Apnea Information Page What research is being done? ... Institutes of Health (NIH) conduct research related to sleep apnea in laboratories at the NIH, and also ...

Comparison of new ELISA method with established SDS-PAGE method for determination of muscle myosin heavy chain isoforms

Czech Academy of Sciences Publication Activity Database

Říčný, Jan; Soukup, Tomáš

2011-01-01

Roč. 60, č. 6 (2011), s. 899-904 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA304/08/0256 Grant - others:EC(XE) LSH-CT-2004-511978 Institutional research plan: CEZ:AV0Z50110509 Keywords : muscle fiber types * myosin heavy chains * SDS - PAGE * immunoreactions * thyroid hormones * ELISA Subject RIV: EA - Cell Biology Impact factor: 1.555, year: 2011

Accidental perforation of the lateral femoral cortex in ACL reconstruction: an investigation of mechanical properties of different fixation techniques.

Science.gov (United States)

Herbort, Mirco; Heletta, Sebastian; Raschke, Michael J; Schliemann, Benedikt; Osada, Nani; Petersen, Wolf; Zantop, Thore

2012-03-01

The aim of this study was to evaluate the mechanical properties of anterior cruciate ligament (ACL) reconstruction using the medial portal technique with cortical fixation and hybrid fixation after penetration of the lateral cortex by use of different drill sizes. In this biomechanical study a porcine in vitro model was used. The testing protocol consisted of a cyclic loading protocol (1,000 cycles, 50 and 250 N) and subsequent ultimate failure testing. Number of cyclic loadings survived, stiffness, yield load, maximum load, and graft elongation, as well as failure mode, were analyzed after ACL reconstruction with 5- to 9-mm soft-tissue grafts. In the control group, conventional penetration of the lateral cortex with a 4.5-mm drill and cortical fixation were performed. In the tested groups, the lateral cortex was penetrated with a drill matching the graft size. In the first part of the study, we used cortical fixation. In the second part, we used hybrid fixation with an interference screw. In the first part of the study, ACL reconstruction with 5- to 6-mm perforation of the lateral cortex showed no significant differences in ultimate failure load after cyclic loading compared with the control group (P > .05). Specimens with reconstruction with 7- to 9-mm perforation of the lateral cortex and cortical fixation did not survive the cyclic loading protocol. In the second part of the study, with a hybrid fixation technique, ultimate failure testing after cyclic loading of specimens with 7- to 9-mm penetration showed no significant differences in tested parameters compared with the control group (P > .05). After penetration of the lateral cortex with a drill size of more than 6 mm, cortical ACL fixation results in poor mechanical properties. Hybrid fixation increases the mechanical properties significantly after penetration with a 7- to 9-mm drill. We advise caution to avoid penetration of the lateral femoral cortex when using cortical flip-button fixation. In case of

MUSCLE STRENGTH AND QUALITATIVE JUMP-LANDING DIFFERENCES IN MALE AND FEMALE MILITARY CADETS: THE JUMP-ACL STUDY

Directory of Open Access Journals (Sweden)

Barry P. Boden

2009-12-01

Full Text Available Recent studies have focused on gender differences in movement patterns as risk factors for ACL injury. Understanding intrinsic and extrinsic factors which contribute to movement patterns is critical to ACL injury prevention efforts. Isometric lower- extremity muscular strength, anthropometrics, and jump-landing technique were analyzed for 2,753 cadets (1,046 female, 1,707 male from the U.S. Air Force, Military and Naval Academies. Jump- landings were evaluated using the Landing Error Scoring System (LESS, a valid qualitative movement screening tool. We hypothesized that distinct anthropometric factors (Q-angle, navicular drop, bodyweight and muscle strength would predict poor jump-landing technique in males versus females, and that female cadets would have higher scores (more errors on a qualitative movement screen (LESS than males. Mean LESS scores were significantly higher in female (5.34 ± 1.51 versus male (4.65 ± 1.69 cadets (p < 0.001. Qualitative movement scores were analyzed using factor analyses, yielding five factors, or "patterns", contributing to poor landing technique. Females were significantly more likely to have poor technique due to landing with less hip and knee flexion at initial contact (p < 0.001, more knee valgus with wider landing stance (p < 0. 001, and less flexion displacement over the entire landing (p < 0.001. Males were more likely to have poor technique due to landing toe-out (p < 0.001, with heels first, and with an asymmetric foot landing (p < 0.001. Many of the identified factor patterns have been previously proposed to contribute to ACL injury risk. However, univariate and multivariate analyses of muscular strength and anthropometric factors did not strongly predict LESS scores for either gender, suggesting that changing an athlete's alignment, BMI, or muscle strength may not directly improve his or her movement patterns

A Survey on PageRank Computing

OpenAIRE

Berkhin, Pavel

2005-01-01

This survey reviews the research related to PageRank computing. Components of a PageRank vector serve as authority weights for web pages independent of their textual content, solely based on the hyperlink structure of the web. PageRank is typically used as a web search ranking component. This defines the importance of the model and the data structures that underly PageRank processing. Computing even a single PageRank is a difficult computational task. Computing many PageRanks is a much mor...

In-Degree and PageRank of web pages: why do they follow similar power laws?

NARCIS (Netherlands)

Litvak, Nelli; Scheinhardt, Willem R.W.; Volkovich, Y.

2009-01-01

PageRank is a popularity measure designed by Google to rank Web pages. Experiments confirm that PageRank values obey a power law with the same exponent as In-Degree values. This paper presents a novel mathematical model that explains this phenomenon. The relation between PageRank and In-Degree is

In-degree and pageRank of web pages: Why do they follow similar power laws?

NARCIS (Netherlands)

Litvak, Nelli; Scheinhardt, Willem R.W.; Volkovich, Y.

The PageRank is a popularity measure designed by Google to rank Web pages. Experiments confirm that the PageRank obeys a 'power law' with the same exponent as the In-Degree. This paper presents a novel mathematical model that explains this phenomenon. The relation between the PageRank and In-Degree

Performance Test of Korea Heat Load Test Facility (KoHLT-EB) for the Plasma Facing Components of Fusion Reactor

International Nuclear Information System (INIS)

Kim, Suk-Kwon; Jin, Hyung Gon; Lee, Eo Hwak; Yoon, Jae-Sung; Lee, Dong Won; Cho, Seungyon

2014-01-01

The main components of the plasma facing components (PFCs) in the tokamak are the blanket first wall and divertor, which include the armour materials, the heat sink with the cooling mechanism, and the diagnostics devices for the temperature measurement. The Korea Heat Load Test facility by using electron beam (KoHLT-EB) has been operating for the plasma facing components to develop fusion engineering. This electron beam facility was constructed using a 300 kW electron gun and a cylindrical vacuum chamber. Performance tests were carried out for the calorimetric calibrations with Cu dummy mockup and for the heat load test of large Cu module. For the simulation of the heat load test of each mockup, the preliminary thermal-hydraulic analyses with ANSYS-CFX were performed. For the development of the plasma facing components in the fusion reactors, test mockups were fabricated and tested in the high heat flux test facility. To perform a beam profile test, an assessment of the possibility of electron beam Gaussian power density profile and the results of the absorbed power for that profile before the test starts are needed. To assess the possibility of a Gaussian profile, for the qualification test of the Gaussian heat load profile, a calorimeter mockup and large Cu module were manufactured to simulate real heat. For this high-heat flux test, the Korean high-heat flux test facility using an electron beam system was constructed. In this facility, a cyclic heat flux test will be performed to measure the surface heat flux, surface temperature profile, and cooling capacity

Performance Test of Korea Heat Load Test Facility (KoHLT-EB) for the Plasma Facing Components of Fusion Reactor

Energy Technology Data Exchange (ETDEWEB)

Kim, Suk-Kwon; Jin, Hyung Gon; Lee, Eo Hwak; Yoon, Jae-Sung; Lee, Dong Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Cho, Seungyon [National Fusion Research Institute, Daejeon (Korea, Republic of)

2014-10-15

The main components of the plasma facing components (PFCs) in the tokamak are the blanket first wall and divertor, which include the armour materials, the heat sink with the cooling mechanism, and the diagnostics devices for the temperature measurement. The Korea Heat Load Test facility by using electron beam (KoHLT-EB) has been operating for the plasma facing components to develop fusion engineering. This electron beam facility was constructed using a 300 kW electron gun and a cylindrical vacuum chamber. Performance tests were carried out for the calorimetric calibrations with Cu dummy mockup and for the heat load test of large Cu module. For the simulation of the heat load test of each mockup, the preliminary thermal-hydraulic analyses with ANSYS-CFX were performed. For the development of the plasma facing components in the fusion reactors, test mockups were fabricated and tested in the high heat flux test facility. To perform a beam profile test, an assessment of the possibility of electron beam Gaussian power density profile and the results of the absorbed power for that profile before the test starts are needed. To assess the possibility of a Gaussian profile, for the qualification test of the Gaussian heat load profile, a calorimeter mockup and large Cu module were manufactured to simulate real heat. For this high-heat flux test, the Korean high-heat flux test facility using an electron beam system was constructed. In this facility, a cyclic heat flux test will be performed to measure the surface heat flux, surface temperature profile, and cooling capacity.

Creating Web Pages Simplified

CERN Document Server

Wooldridge, Mike

2011-01-01

The easiest way to learn how to create a Web page for your family or organization Do you want to share photos and family lore with relatives far away? Have you been put in charge of communication for your neighborhood group or nonprofit organization? A Web page is the way to get the word out, and Creating Web Pages Simplified offers an easy, visual way to learn how to build one. Full-color illustrations and concise instructions take you through all phases of Web publishing, from laying out and formatting text to enlivening pages with graphics and animation. This easy-to-follow visual guide sho

76 FR 19929 - Magnuson-Stevens Fishery Conservation and Management Act Provisions; Fisheries of the...

Science.gov (United States)

2011-04-11

..., including: A revision of the overfishing definition (OFD); modification of the essential fish habitat (EFH... by LAGC vessels as they continue to fish would count toward that stock area's sub-ACL for the scallop...: Fishing [[Page 19934

Identification of types of landings after blocking in volleyball associated with risk of ACL injury.

Science.gov (United States)

Zahradnik, David; Jandacka, Daniel; Farana, Roman; Uchytil, Jaroslav; Hamill, Joseph

2017-03-01

Landing with a low knee flexion angle after volleyball block jumps may be associated with an increased risk of anterior cruciate ligament (ACL) injury. The aim of the present study was to identify the types of volleyball landings after blocks where the knee flexion angle is found to be under a critical knee flexion angle value of 30° at the instant of the first peak of the ground reaction force (GRF). Synchronized kinematic and kinetic data were collected for each trial. T-tests were used to determine if each knee flexion angle at the instant of the peak GRF was significantly different from the critical value of 30°. A repeated measures ANOVA was used to compare knee flexion angle, time to first peak and the magnitude of the first peak of the resultant GRF and knee stiffness. Significantly lower knee flexion angles were found in the "go" landing (p = .01, ES = 0.6) and the "reverse" landing (p = .02, ES = 0.6) only. The results for knee flexion angle and GRF parameters indicated a significant difference between a "reverse" and "go" and other types of landings, except the "side stick" landing for GRF. The "reverse" and "go" landings may present a risk for ACL injury due to the single-leg landing of these activities that have an associated mediolateral movement.

Flash-Aware Page Replacement Algorithm

Directory of Open Access Journals (Sweden)

Guangxia Xu

2014-01-01

Full Text Available Due to the limited main memory resource of consumer electronics equipped with NAND flash memory as storage device, an efficient page replacement algorithm called FAPRA is proposed for NAND flash memory in the light of its inherent characteristics. FAPRA introduces an efficient victim page selection scheme taking into account the benefit-to-cost ratio for evicting each victim page candidate and the combined recency and frequency value, as well as the erase count of the block to which each page belongs. Since the dirty victim page often contains clean data that exist in both the main memory and the NAND flash memory based storage device, FAPRA only writes the dirty data within the victim page back to the NAND flash memory based storage device in order to reduce the redundant write operations. We conduct a series of trace-driven simulations and experimental results show that our proposed FAPRA algorithm outperforms the state-of-the-art algorithms in terms of page hit ratio, the number of write operations, runtime, and the degree of wear leveling.

The changing pages of comics : Page layouts across eight decades of American superhero comics

NARCIS (Netherlands)

Pederson, Kaitlin; Cohn, Neil

2016-01-01

Page layouts are one of the most overt features of comics’ structure. We hypothesized that American superhero comics have changed in their page layout over eight decades, and investigated this using a corpus analysis of 40 comics from 1940 through 2014. On the whole, we found that comics pages

ACL injuries – treatment and patients´ experiences of outpatient surgery at UNN 2008-2010

OpenAIRE

Pada, Marika Teresia

2013-01-01

Background: Since 2003 anterior cruciate ligament reconstructions have been done as outpatient surgery at the University Hospital of North Norway, UNN. Previously, the surgeries required overnight hospital stay. In 2010 a survey was done to see the experiences of the patients to whom ACL reconstruction was done 2004-2007. Thesis aims: This master thesis will focus on the patients that underwent surgery during 2008-2010, to see if the routines at UNN have improved over the past few years. Impo...

Does the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players?

Science.gov (United States)

Silvers-Granelli, Holly J; Bizzini, Mario; Arundale, Amelia; Mandelbaum, Bert R; Snyder-Mackler, Lynn

2017-10-01

The FIFA 11+ injury prevention program has been shown to decrease the risk of soccer injuries in men and women. The program has also been shown to decrease time loss resulting from injury. However, previous studies have not specifically investigated how the program might impact the rate of anterior cruciate ligament (ACL) injury in male soccer players. The purpose of this study was to examine if the FIFA 11+ injury prevention program can (1) reduce the overall number of ACL injuries in men who play competitive college soccer and whether any potential reduction in rate of ACL injuries differed based on (2) game versus practice setting; (3) player position; (4) level of play (Division I or II); or (5) field type. This study was a prospective cluster randomized controlled trial, which was conducted in 61 Division I and Division II National Collegiate Athletic Association men's soccer teams over the course of one competitive soccer season. The FIFA 11+ is a 15- to 20-minute on-the-field dynamic warm-up program used before training and games and was utilized as the intervention throughout the entire competitive season. Sixty-five teams were randomized: 34 to the control group (850 players) and 31 to the intervention group (675 players). Four intervention teams did not complete the study and did not submit their data, noting insufficient time to complete the program, reducing the number for per-protocol analysis to 61. Compliance to the FIFA 11+ program, athletic exposures, specific injuries, ACL injuries, and time loss resulting from injury were collected and recorded using a secure Internet-based system. At the end of the season, the data in the injury surveillance system were crosshatched with each individual institution's internal database. At that time, the certified athletic trainer signed off on the injury collection data to confirm their accuracy and completeness. A lower proportion of athletes in the intervention group experienced knee injuries (25% [34 of

Clinical Efficacy of Jump Training Augmented With Body Weight Support After ACL Reconstruction: A Randomized Controlled Trial.

Science.gov (United States)

Elias, Audrey R C; Harris, Kari J; LaStayo, Paul C; Mizner, Ryan L

2018-06-01

Limited knee flexion and increased muscle co-contraction during jump landing are believed to diminish outcomes after anterior cruciate ligament (ACL) reconstruction. The efficacy of jump training to improve patients' mechanical and neuromuscular deficits is understudied. Jump training will improve functional, mechanical, and neuromuscular outcomes and higher repetition training augmented by body weight support will result in better retention of gains. Randomized controlled trial; Level of evidence, 1. Thirty athletes (18 months after surgery) were screened, and 19 with mechanical deficits and limited clinical outcomes were enrolled in the trial. Testing included the International Knee Documentation Committee (IKDC) questionnaire, leg landing mechanics via motion analysis, knee joint effusion using a stroke test, and a surface electromyography-generated co-contraction index during a single-legged landing. Participants were randomly assigned to 1 of 2 groups: jump training with normal body weight (JTBW) and high-repetition jump training with body weight support (JTBWS). Knee effusion grading throughout training was used to assess joint tolerance. Changes in outcomes over time were analyzed with mixed-effects modeling. Immediate outcomes were compared with retention testing at 8 weeks after training by use of 2-way analyses of variance with effects of time and group. Significant effects of time were found during the training phase for all outcome measures, but no effects of group or sex were found. IKDC score (pooled; mean ± SD) increased from 76 ± 12 to 87 ± 8 ( P Jump training mitigated some risk factors for second injury and osteoarthritis in patients after ACL reconstruction. Training made lasting improvements in physical function measures as well as mechanical and neuromuscular coordination deficits. Higher repetitions used with body weight support did not improve retention but substantially reduced risk for effusion. Jump training is an efficacious

Realistic page-turning of electronic books

Science.gov (United States)

Fan, Chaoran; Li, Haisheng; Bai, Yannan

2014-01-01

The booming electronic books (e-books), as an extension to the paper book, are popular with readers. Recently, many efforts are put into the realistic page-turning simulation o f e-book to improve its reading experience. This paper presents a new 3D page-turning simulation approach, which employs piecewise time-dependent cylindrical surfaces to describe the turning page and constructs smooth transition method between time-dependent cylinders. The page-turning animation is produced by sequentially mapping the turning page into the cylinders with different radii and positions. Compared to the previous approaches, our method is able to imitate various effects efficiently and obtains more natural animation of turning page.

On Page Rank

NARCIS (Netherlands)

Hoede, C.

In this paper the concept of page rank for the world wide web is discussed. The possibility of describing the distribution of page rank by an exponential law is considered. It is shown that the concept is essentially equal to that of status score, a centrality measure discussed already in 1953 by

An ACL2 Mechanization of an Axiomatic Framework for Weak Memory

Directory of Open Access Journals (Sweden)

Benjamin Selfridge

2014-06-01

Full Text Available Proving the correctness of programs written for multiple processors is a challenging problem, due in no small part to the weaker memory guarantees afforded by most modern architectures. In particular, the existence of store buffers means that the programmer can no longer assume that writes to different locations become visible to all processors in the same order. However, all practical architectures do provide a collection of weaker guarantees about memory consistency across processors, which enable the programmer to write provably correct programs in spite of a lack of full sequential consistency. In this work, we present a mechanization in the ACL2 theorem prover of an axiomatic weak memory model (introduced by Alglave et al.. In the process, we provide a new proof of an established theorem involving these axioms.

PageRank of integers

International Nuclear Information System (INIS)

Frahm, K M; Shepelyansky, D L; Chepelianskii, A D

2012-01-01

We up a directed network tracing links from a given integer to its divisors and analyze the properties of the Google matrix of this network. The PageRank vector of this matrix is computed numerically and it is shown that its probability is approximately inversely proportional to the PageRank index thus being similar to the Zipf law and the dependence established for the World Wide Web. The spectrum of the Google matrix of integers is characterized by a large gap and a relatively small number of nonzero eigenvalues. A simple semi-analytical expression for the PageRank of integers is derived that allows us to find this vector for matrices of billion size. This network provides a new PageRank order of integers. (paper)

The Faculty Web Page: Contrivance or Continuation?

Science.gov (United States)

Lennex, Lesia

2007-01-01

In an age of Internet education, what does it mean for a tenure/tenure-track faculty to have a web page? How many professors have web pages? If they have a page, what does it look like? Do they really need a web page at all? Many universities have faculty web pages. What do those collective pages look like? In what way do they represent the…

Association between maximal hamstring muscle strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury

DEFF Research Database (Denmark)

Zebis, M. K.; Sorensen, R. S.; Thorborg, K.

2015-01-01

Background: Reduced hamstring pre-activity during sidecutting increases the risk for non-contact ACL injury. During the last decade resistance training of the lower limb muscles has become an integral part ofACLinjury prevention in e.g. soccer and handball. However, it is not known whether a stro...

75 FR 9391 - Caribbean Fishery Management Council; Public Meeting

Science.gov (United States)

2010-03-02

... - Trap Reduction Programs - USVI Meeting Report - ACLs Discussion - Other Business The meeting is open to the public, and will be conducted in English. However, simultaneous interpretation (from English to... agenda may come before this group for discussion, those [[Page 9392

Research of Subgraph Estimation Page Rank Algorithm for Web Page Rank

Directory of Open Access Journals (Sweden)

LI Lan-yin

2017-04-01

Full Text Available The traditional PageRank algorithm can not efficiently perform large data Webpage scheduling problem. This paper proposes an accelerated algorithm named topK-Rank，which is based on PageRank on the MapReduce platform. It can find top k nodes efficiently for a given graph without sacrificing accuracy. In order to identify top k nodes，topK-Rank algorithm prunes unnecessary nodes and edges in each iteration to dynamically construct subgraphs，and iteratively estimates lower/upper bounds of PageRank scores through subgraphs. Theoretical analysis shows that this method guarantees result exactness. Experiments show that topK-Rank algorithm can find k nodes much faster than the existing approaches.

Global molecular changes in a tibial compression induced ACL rupture model of post-traumatic osteoarthritis.

Science.gov (United States)

Chang, Jiun C; Sebastian, Aimy; Murugesh, Deepa K; Hatsell, Sarah; Economides, Aris N; Christiansen, Blaine A; Loots, Gabriela G

2017-03-01

Joint injury causes post-traumatic osteoarthritis (PTOA). About ∼50% of patients rupturing their anterior cruciate ligament (ACL) will develop PTOA within 1-2 decades of the injury, yet the mechanisms responsible for the development of PTOA after joint injury are not well understood. In this study, we examined whole joint gene expression by RNA sequencing (RNAseq) at 1 day, 1-, 6-, and 12 weeks post injury, in a non-invasive tibial compression (TC) overload mouse model of PTOA that mimics ACL rupture in humans. We identified 1446 genes differentially regulated between injured and contralateral joints. This includes known regulators of osteoarthritis such as MMP3, FN1, and COMP, and several new genes including Suco, Sorcs2, and Medag. We also identified 18 long noncoding RNAs that are differentially expressed in the injured joints. By comparing our data to gene expression data generated using the surgical destabilization of the medial meniscus (DMM) PTOA model, we identified several common genes and shared mechanisms. Our study highlights several differences between these two models and suggests that the TC model may be a more rapidly progressing model of PTOA. This study provides the first account of gene expression changes associated with PTOA development and progression in a TC model. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. J Orthop Res 35:474-485, 2017. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc.

Global molecular changes in a tibial compression induced ACL rupture model of post‐traumatic osteoarthritis

Science.gov (United States)

Chang, Jiun C.; Sebastian, Aimy; Murugesh, Deepa K.; Hatsell, Sarah; Economides, Aris N.; Christiansen, Blaine A.

2016-01-01

ABSTRACT Joint injury causes post‐traumatic osteoarthritis (PTOA). About ∼50% of patients rupturing their anterior cruciate ligament (ACL) will develop PTOA within 1–2 decades of the injury, yet the mechanisms responsible for the development of PTOA after joint injury are not well understood. In this study, we examined whole joint gene expression by RNA sequencing (RNAseq) at 1 day, 1‐, 6‐, and 12 weeks post injury, in a non‐invasive tibial compression (TC) overload mouse model of PTOA that mimics ACL rupture in humans. We identified 1446 genes differentially regulated between injured and contralateral joints. This includes known regulators of osteoarthritis such as MMP3, FN1, and COMP, and several new genes including Suco, Sorcs2, and Medag. We also identified 18 long noncoding RNAs that are differentially expressed in the injured joints. By comparing our data to gene expression data generated using the surgical destabilization of the medial meniscus (DMM) PTOA model, we identified several common genes and shared mechanisms. Our study highlights several differences between these two models and suggests that the TC model may be a more rapidly progressing model of PTOA. This study provides the first account of gene expression changes associated with PTOA development and progression in a TC model. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. J Orthop Res 35:474–485, 2017. PMID:27088242

Over-the-top ACL Reconstruction Plus Extra-articular Lateral Tenodesis With Hamstring Tendon Grafts: Prospective Evaluation With 20-Year Minimum Follow-up.

Science.gov (United States)

Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Grassi, Alberto; Roberti di Sarsina, Tommaso; Raggi, Federico; Signorelli, Cecilia; Urrizola, Francisco; Spinnato, Paolo; Rimondi, Eugenio; Marcacci, Maurilio

2017-12-01

There are few published studies with very long-term follow-up of combined intra- and extra-articular anterior cruciate ligament (ACL) reconstruction. To analyze clinical and radiographic outcomes of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with autologous hamstrings at minimum 20-year follow-up. Case series; Level of evidence, 4. Of 60 originally eligible patients who underwent over-the-top ACL reconstruction with double-stranded hamstring tendon (leaving intact graft tibial insertions) and extra-articular lateral plasty (performed with the remnant part of tendons), 52 were prospectively evaluated at a minimum 20-year follow-up (mean follow-up, 24 years; 41 men, 11 women; mean age at time of surgery, 25.5 ± 7.6 years). Twenty-nine patients were available for prospective evaluations: clinical (Lysholm, Tegner, and objective International Knee Documentation Committee [IKDC]), instrumented (KT-2000), and radiographic (standard, long-standing, and Merchant views). Subjective KOOS (Knee injury and Osteoarthritis Outcome Score) and objective inertial sensor pivot-shift analysis (KiRA) were carried out at final follow-up. Twenty-three patients were investigated by phone interview for subjective Tegner score and documented complications, rerupture, or revision surgery. At final follow-up, mean Lysholm score was 85.7 ± 14.6; median Tegner score, 4 (range, 3-5); sport activity resumption, 86.2%; and objective IKDC score, good or excellent in 86% of patients (31%, A; 55%, B). Only 3 of 26 patients (12%) had >5-mm manual maximum KT-2000 side-to-side difference. KiRA system documented positive pivot-shift (>0.9-m/s 2 tibial acceleration side-to-side difference) in these 3 of 26 patients (12%). Statistically significant changes were as follows: decrease in Tegner score from 7 (range, 6-8) at 5-year follow-up to 4 (range, 3-5) at 10 years ( P < .0001) and decrease in Lysholm score from 96.1 ± 7.3 at 10-year follow-up to 85.7 ± 14.6 at 20 years

Page sample size in web accessibility testing: how many pages is enough?

NARCIS (Netherlands)

Velleman, Eric Martin; van der Geest, Thea

2013-01-01

Various countries and organizations use a different sampling approach and sample size of web pages in accessibility conformance tests. We are conducting a systematic analysis to determine how many pages is enough for testing whether a website is compliant with standard accessibility guidelines. This

Technical evaluation of the novel preanalytical module on instrumentation laboratory ACL TOP: advancing automation in hemostasis testing.

Science.gov (United States)

Lippi, Giuseppe; Ippolito, Luigi; Favaloro, Emmanuel J

2013-10-01

Automation in hemostasis testing is entering an exciting and unprecedented phase. This study was planned to assess the performance of the new preanalytical module on the hemostasis testing system Instrumentation Laboratory ACL TOP. The evaluation included interference studies to define reliable thresholds for rejecting samples with significant concentrations of interfering substances; within-run imprecision studies of plasma indices on four different interference degrees for each index; comparison studies with reference measures of hemolysis index, bilirubin, and triglycerides on clinical chemistry analyzers; and calculation of turnaround time with and without automatic performance of preanalytical check. The upper limits for sample rejection according to our interference studies were 3.6 g/L for hemoglobin, 13.6 mg/dL for bilirubin, and 1454 mg/dL for triglycerides. We found optimal precision for all indices (0.6% to 3.1% at clinically relevant thresholds) and highly significant correlations with reference measures on clinical chemistry analyzers (from 0.985 to 0.998). The limited increase of turnaround time (i.e., +3% and +5% with or without cap-piercing), coupled with no adjunctive costs over performance of normal coagulation assays, contribute to make the automatic check of plasma indices on ACL TOP a reliable and practical approach for improving testing quality and safeguarding patient safety.

Unit Testing for the Application Control Language (ACL) Software

Science.gov (United States)

Heinich, Christina Marie

2014-01-01

In the software development process, code needs to be tested before it can be packaged for release in order to make sure the program actually does what it says is supposed to happen as well as to check how the program deals with errors and edge cases (such as negative or very large numbers). One of the major parts of the testing process is unit testing, where you test specific units of the code to make sure each individual part of the code works. This project is about unit testing many different components of the ACL software and fixing any errors encountered. To do this, mocks of other objects need to be created and every line of code needs to be exercised to make sure every case is accounted for. Mocks are important to make because it gives direct control of the environment the unit lives in instead of attempting to work with the entire program. This makes it easier to achieve the second goal of exercising every line of code.

Early integration of a bone plug in the femoral tunnel in rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: a prospective computed tomography analysis.

Science.gov (United States)

Suzuki, Tomoyuki; Shino, Konsei; Nakagawa, Shigeto; Nakata, Ken; Iwahashi, Takehiko; Kinugasa, Kazutaka; Otsubo, Hidenori; Yamashita, Toshihiko

2011-12-01

The purpose of this prospective study was to evaluate how early the bone plug was integrated into the rectangular femoral tunnel after anatomical ACL reconstruction using a bone-patellar tendon-bone (BTB) graft via a rectangular tunnel (RT BTB ACL-R). Twenty consecutive patients who had undergone the reconstruction procedure were evaluated by CT scans at 4 and 8 weeks postoperatively. In each scan, 30 slices for multiplanar reconstruction were collected parallel to the long axis of the parallelepiped femoral tunnel and perpendicular to the tendinous plane of the bone plug. Each slice was classified as "complete," indicating no visible gap between the plug and the tunnel wall or trabecular continuity or "incomplete," showing a visible gap. Bone plug-tunnel integration was evaluated as "excellent," "good," "fair," or "poor" for >20, 11-20, 5-10, and values at the anterior interface between the bone plug and the tunnel wall were also measured on both scans. The mean changes in CT value at 8 weeks were significantly lower than those at 4 weeks. This study shows that bone plug-femoral tunnel integration was almost complete by 8 weeks after surgery using RT BTB ACL-R.

The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year

DEFF Research Database (Denmark)

Frobell, R B; Le Graverand, M-P; Buck, R

2008-01-01

OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify fac...

Return to sport after ACL reconstruction: a survey between the Italian Society of Knee, Arthroscopy, Sport, Cartilage and Orthopaedic Technologies (SIGASCOT) members.

Science.gov (United States)

Grassi, Alberto; Vascellari, Alberto; Combi, Alberto; Tomaello, Luca; Canata, Gian Luigi; Zaffagnini, Stefano

2016-07-01

A worldwide consensus for timing and criteria for return to sport after anterior cruciate ligament (ACL) reconstruction is lacking. The aim of the study was to survey among the Italian Society of Knee, Arthroscopy, Sport, Cartilage and Orthopaedic Technologies (SIGASCOT) members in order to evaluate their approaches to the return to sport after ACL reconstruction regarding timing and criteria. A web survey among the SIGASCOT members was performed, including 14 questions regarding technical and graft preferences, timing for return to training and competitive activity for contact and non-contact sports and criteria to allow return to sport. Totally, 123 members completed the questionnaire. Return to training sports was allowed within 6 month by 87 % for non-contact sports and by 53 % for contact sports. Return to competitive activity was allowed within 6 months by 48 % for non-contact sports and by 13 % for contact sports. Full ROM (77 %), Lachman test (65 %) and Pivot-Shift test (65 %) were the most used criteria to allow return to sport. The 90 % used at least one clinical score. The SIGASCOT members showed various approaches in the return to sport after ACL reconstruction, with differences between return to training or competitive activity, and between contact and non-contact sports. Six months was generally considered adequate by most of the members for the most demanding activities. The most used criteria to allow return to sport were manual testing. A clear definition of sport activities and more objective criteria for the return to sport are needed. Level V, expert opinion.

Diffusion chamber system for testing of collagen-based cell migration barriers for separation of ligament enthesis zones in tissue-engineered ACL constructs.

Science.gov (United States)

Hahner, J; Hoyer, M; Hillig, S; Schulze-Tanzil, G; Meyer, M; Schröpfer, M; Lohan, A; Garbe, L-A; Heinrich, G; Breier, A

2015-01-01

A temporary barrier separating scaffold zones seeded with different cell types prevents faster growing cells from overgrowing co-cultured cells within the same construct. This barrier should allow sufficient nutrient diffusion through the scaffold. The aim of this study was to test the effect of two variants of collagen-based barriers on macromolecule diffusion, viability, and the spreading efficiency of primary ligament cells on embroidered scaffolds. Two collagen barriers, a thread consisting of a twisted film tape and a sponge, were integrated into embroidered poly(lactic-co-caprolactone) and polypropylene scaffolds, which had the dimension of lapine anterior cruciate ligaments (ACL). A diffusion chamber system was designed and established to monitor nutrient diffusion using fluorescein isothiocyanate-labeled dextran of different molecular weights (20, 40, 150, 500 kDa). Vitality of primary lapine ACL cells was tested at days 7 and 14 after seeding using fluorescein diacetate and ethidium bromide staining. Cell spreading on the scaffold surface was measured using histomorphometry. Nuclei staining of the cross-sectioned scaffolds revealed the penetration of ligament cells through both barrier types. The diffusion chamber was suitable to characterize the diffusivity of dextran molecules through embroidered scaffolds with or without integrated collagen barriers. The diffusion coefficients were generally significantly lower in scaffolds with barriers compared to those without barriers. No significant differences between diffusion coefficients of both barrier types were detected. Both barriers were cyto-compatible and prevented most of the ACL cells from crossing the barrier, whereby the collagen thread was easier to handle and allowed a higher rate of cell spreading.

Fixation strength of biocomposite wedge interference screw in ACL reconstruction: effect of screw length and tunnel/screw ratio. A controlled laboratory study

Directory of Open Access Journals (Sweden)

Herrera Antonio

2010-06-01

Full Text Available Abstract Background Primary stability of the graft is essential in anterior cruciate ligament surgery. An optimal method of fixation should be easy to insert and provide great resistance against pull-out forces. A controlled laboratory study was designed to test the primary stability of ACL tendinous grafts in the tibial tunnel. The correlation between resistance to traction forces and the cross-section and length of the screw was studied. Methods The tibial phase of ACL reconstruction was performed in forty porcine tibias using digital flexor tendons of the same animal. An 8 mm tunnel was drilled in each specimen and two looped tendons placed as graft. Specimens were divided in five groups according to the diameter and length of the screw used for fixation. Wedge interference screws were used. Longitudinal traction was applied to the graft with a Servohydraulic Fatigue System. Load and displacement were controlled and analyzed. Results The mean loads to failure for each group were 295,44 N (Group 1; 9 × 23 screw, 564,05 N (Group 2; 9 × 28, 614,95 N (Group 3; 9 × 35, 651,14 N (Group 4; 10 × 28 and 664,99 (Group 5; 10 × 35. No slippage of the graft was observed in groups 3, 4 and 5. There were significant differences in the load to failure among groups (ANOVA/P Conclusions Longer and wider interference screws provide better fixation in tibial ACL graft fixation. Short screws (23 mm do not achieve optimal fixation and should be implanted only with special requirements.

Exploiting link structure for web page genre identification

KAUST Repository

Zhu, Jia

2015-07-07

As the World Wide Web develops at an unprecedented pace, identifying web page genre has recently attracted increasing attention because of its importance in web search. A common approach for identifying genre is to use textual features that can be extracted directly from a web page, that is, On-Page features. The extracted features are subsequently inputted into a machine learning algorithm that will perform classification. However, these approaches may be ineffective when the web page contains limited textual information (e.g., the page is full of images). In this study, we address genre identification of web pages under the aforementioned situation. We propose a framework that uses On-Page features while simultaneously considering information in neighboring pages, that is, the pages that are connected to the original page by backward and forward links. We first introduce a graph-based model called GenreSim, which selects an appropriate set of neighboring pages. We then construct a multiple classifier combination module that utilizes information from the selected neighboring pages and On-Page features to improve performance in genre identification. Experiments are conducted on well-known corpora, and favorable results indicate that our proposed framework is effective, particularly in identifying web pages with limited textual information. © 2015 The Author(s)

Exploiting link structure for web page genre identification

KAUST Repository

Zhu, Jia; Xie, Qing; Yu, Shoou I.; Wong, Wai Hung

2015-01-01

As the World Wide Web develops at an unprecedented pace, identifying web page genre has recently attracted increasing attention because of its importance in web search. A common approach for identifying genre is to use textual features that can be extracted directly from a web page, that is, On-Page features. The extracted features are subsequently inputted into a machine learning algorithm that will perform classification. However, these approaches may be ineffective when the web page contains limited textual information (e.g., the page is full of images). In this study, we address genre identification of web pages under the aforementioned situation. We propose a framework that uses On-Page features while simultaneously considering information in neighboring pages, that is, the pages that are connected to the original page by backward and forward links. We first introduce a graph-based model called GenreSim, which selects an appropriate set of neighboring pages. We then construct a multiple classifier combination module that utilizes information from the selected neighboring pages and On-Page features to improve performance in genre identification. Experiments are conducted on well-known corpora, and favorable results indicate that our proposed framework is effective, particularly in identifying web pages with limited textual information. © 2015 The Author(s)

Insights into Facebook Pages: an early adolescent health research study page targeted at parents.

Science.gov (United States)

Amon, Krestina L; Paxton, Karen; Klineberg, Emily; Riley, Lisa; Hawke, Catherine; Steinbeck, Katharine

2016-02-01

Facebook has been used in health research, but there is a lack of literature regarding how Facebook may be used to recruit younger adolescents. A Facebook Page was created for an adolescent cohort study on the effects of puberty hormones on well-being and behaviour in early adolescence. Used as a communication tool with existing participants, it also aimed to alert potential participants to the study. The purpose of this paper is to provide a detailed description of the development of the study Facebook Page and present the fan response to the types of posts made on the Page using the Facebook-generated Insights data. Two types of posts were made on the study Facebook Page. The first type was study-related update posts and events. The second was relevant adolescent and family research and current news posts. Observations on the use of and response to the Page were made over 1 year across three phases (phase 1, very low Facebook use; phase 2, high Facebook use; phase 3, low Facebook use). Most Page fans were female (88.6%), with the largest group of fans aged between 35 and 44 years. Study-related update posts with photographs were the most popular. This paper provides a model on which other researchers could base Facebook communication and potential recruitment in the absence of established guidelines.

A pair-matched comparison of return to pivoting sports at 1 year in ACL-injured patients after a nonoperative versus operative treatment course

Science.gov (United States)

Grindem, Hege; Eitzen, Ingrid; Moksnes, Håvard; Snyder-Mackler, Lynn; Risberg, May Arna

2013-01-01

Background The wish to return to level I pivoting sports is a major indication of ACL-reconstruction. Patients usually return to pivoting sports between 6 months and 1 year postoperatively, but no matched study has so far examined 1-year return to sport rates in nonoperatively and operatively treated ACL-injured patients. Hypothesis ACL-injured patients following a nonoperative treatment course, including recommendation of activity modification, will have lower return to pivoting sport rates than operatively treated patients 1 year after baseline testing/surgery, when matched by preinjury sports activity, age and sex. Study Design Pair-matched cohort study Methods Sixty-nine nonoperatively treated ACL-injured patients were pair-matched with 69 operatively treated patients (n=138), based on specific preinjury sport, age and sex. Nonoperatively treated patients were recommended not to return to level I sports. Patients were defined as nonoperatively or operatively treated according to their status at follow-up. The baseline and follow-up testing included registration of sports participation, KT-1000 measurements, 4 hop tests, and patient-reported outcome measures. McNemar’s test and paired t-tests or Wilcoxon’s test were used to compare outcomes of nonoperatively and operatively treated patients. Results No significant baseline differences were found. At 12.9±1.2 months (mean ± standard deviation) after baseline testing (nonoperative) and 12.7±1.2 months after surgery (operative), there was no significant difference in overall return to sport rates (nonoperative: 68.1 %, operative: 68.1 %, p=1.000), or in return to level I sport rates (nonoperative: 54.8 %, operative: 61.9 %, p=0.664). Nonoperatively treated patients who participated in level I sports prior to injury had a significantly lower return to sport rate (54.8 %) than nonoperatively treated patients who participated in level II sports (88.9 %, p=0.003). The nonoperatively treated patients had

Performance of PROMIS Physical Function Compared with KOOS, SF-36, Eq5d And Marx Activity Scale in Patients Who Undergo ACL Reconstruction

Science.gov (United States)

Scott, Elizabeth; Glass, Natalie; Wolf, Brian R.; Hettrich, Carolyn M.; Bollier, Matthew

2018-01-01

Objectives: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Our goal was to compare the responsiveness and construct validity of the PROMIS physical function (PF) computer adaptive test (CAT) with current PRO instruments utilized in patients who undergo anterior cruciate ligament reconstruction. Methods: A total of 174 patients ages 14-53 scheduled to undergo anterior cruciate ligament reconstruction were asked to complete PROMIS PF-CAT, Short Form-36 Health Survey (SF36-PF and -GH), Marx activity rating scale (Marx), Knee Injury and Osteoarthritis Score (KOOS-ADL, -Sport, -QOL), and the EuroQol five dimensions questionnaire (EQ5D) at their preoperative visit. These surveys were repeated at six weeks and six months after surgery. Correlations between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3) using Spearman Correlation Coefficients. The effect size (Cohen d) and standardized response mean (SRM) were used to describe the responsiveness of each PRO at the 6 week and 6 month follow-up visits and were defined as small (0.2), medium (0.5) and large (0.8). Ceiling and floor effects were defined as present if ≥15% of participants scored the highest or lowest score on a PRO, respectively. Subgroup analyses were performed comparing change in PRO scores at follow-up between participants with and without additional arthroscopic procedures (meniscal debridement and/or repair, microfracture, or OATS vs ACL reconstruction only) using linear mixed models. Results: There were excellent and excellent-good correlations between the PROMIS PF-CAT and physical function PROs including the SF36-PF (r=0.75-0.80, p0.05) to poor correlation with

Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort

Science.gov (United States)

Wright, Rick W.; Huston, Laura J.; Haas, Amanda K.; Spindler, Kurt P.; Nwosu, Sam K.; Allen, Christina R.; Anderson, Allen F.; Cooper, Daniel E.; DeBerardino, Thomas M.; Dunn, Warren R.; Lantz, Brett (Brick) A.; Stuart, Michael J.; Garofoli, Elizabeth A.; Albright, John P.; Amendola, Annunziato (Ned); Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler, J. Brad; Campbell, John D.; Carey, James L.; Carpenter, James E.; Cole, Brian J.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O'Neill, Daniel F.; Owens, Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur C.; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Svoboda, Steven J.; Taft, Timothy N.; Tenuta, Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.

2015-01-01

Background Most surgeons believe that graft choice for ACL reconstruction is an important factor related to outcome. Although graft choice may be limited in the revision setting based on previously used grafts, it is still felt to be important. Hypothesis The purpose of this study was to determine if revision ACL graft choice predicts outcomes related to sports function, activity level, OA symptoms, graft re-rupture, and reoperation at two years following revision reconstruction. We hypothesized that autograft use would result in increased sports function, increased activity level, and decreased OA symptoms (as measured by validated patient reported outcome instruments). Additionally, we hypothesized that autograft use would result in decreased graft failure and reoperation rate 2 years following revision ACL reconstruction. Study Design Prospective cohort study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled by 83 surgeons over 52 sites. Data collected included baseline demographics, surgical technique and pathology, and a series of validated patient reported outcome instruments (IKDC, KOOS, WOMAC, and Marx activity rating score). Patients were followed up at 2 years, and asked to complete the identical set of outcome instruments. Incidence of additional surgery and reoperation due to graft failure were also recorded. Multivariate regression models were used to determine the predictors (risk factors) of IKDC, KOOS, WOMAC, Marx scores, graft re-rupture, and reoperation rate at 2 years following revision surgery. Results 1205 patients were successfully enrolled with 697 (58%) males. Median age was 26. In 88% this was their first revision. 341 (28%) were undergoing revision by the surgeon that had performed the previous reconstruction. 583 (48%) underwent revision reconstruction utilizing an autograft, 590 (49%) allograft, and 32 (3%) both autograft and allograft. Median time since their last ACL

Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

International Nuclear Information System (INIS)

Leguizamon, J H; Braidot, A; Catalfamo Formento, P

2011-01-01

There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

Finding Specification Pages from the Web

Science.gov (United States)

Yoshinaga, Naoki; Torisawa, Kentaro

This paper presents a method of finding a specification page on the Web for a given object (e.g., ``Ch. d'Yquem'') and its class label (e.g., ``wine''). A specification page for an object is a Web page which gives concise attribute-value information about the object (e.g., ``county''-``Sauternes'') in well formatted structures. A simple unsupervised method using layout and symbolic decoration cues was applied to a large number of the Web pages to acquire candidate attributes for each class (e.g., ``county'' for a class ``wine''). We then filter out irrelevant words from the putative attributes through an author-aware scoring function that we called site frequency. We used the acquired attributes to select a representative specification page for a given object from the Web pages retrieved by a normal search engine. Experimental results revealed that our system greatly outperformed the normal search engine in terms of this specification retrieval.

Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury – the effects of twelve weeks of knee-specific training

Directory of Open Access Journals (Sweden)

Holmström Eva

2007-04-01

Full Text Available Abstract Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament (ACL. Little is known, however, of the influence of this training on knee stiffness during loading. Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces. Increased or altered joint loads contribute to the development of osteoarthritis. The aim of the study was to determine if knee stiffness, defined by changes in knee kinetics and kinematics of gait, step activity and cross-over hop could be reduced through a knee-specific 12-week training programme. Methods A 3-dimensional motion analysis system (VICON and a force plate (AMTI were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier. Twelve uninjured males matched for age, sex, BMI and activity level served as a reference group. Self-reported patient-relevant data were obtained by the KOOS questionnaire. Results There were no significant changes in knee stiffness during gait and step activity after training. For the cross-over hop, increased peak knee flexion during landing (from 44 to 48 degrees, p = 0.031 and increased internal knee extensor moment (1.28 to 1.55 Nm/kg, p = 0.017 were seen after training, indicating reduced knee stiffness. The KOOS sport and recreation score improved from 70 to 77 (p = 0.005 and was significantly correlated with the changes in knee flexion during landing for the cross-over hop (r = 0.6, p = 0.039. Conclusion Knee-specific training improved lower extremity kinetics and kinematics, indicating reduced knee stiffness during demanding hop activity. Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the

Musculoskeletal Modeling of a Forward Lunge Movement:Implications for ACL Loading

DEFF Research Database (Denmark)

Alkjaer, T; Wieland, MR; Andersen, MS

2010-01-01

are loaded during forward lunge? 2) Does the mechanical equilibrium cause ACL loads? Design: Computational modeling. Setting: The biomechanical forward lunge model was based on experimental motion capture data. Patients or Other Participants: One healthy female subject (height 5 169 cm, weight 5 59.6 kg, age....... The model and the pelvis. The hips were modeled as spherical joints, the knees as hinge joints, and the ankles as universal joints. Each according to a minimum fatigue criterion. Main Outcome Measures: Muscle and joint reaction forces that pulled the tibia in anterior or posterior direction. The forces were...... at the time of peak knee flexion. At peak knee flexion, the knee reaction was the only force that pulled the tibia anteriorly (2880 N). This was primarily counterbalanced by the musculus gluteus maximus (21940 N). Conclusions: The loading of the knee joint during lunging never required any stabilization...

Classifying web pages with visual features

NARCIS (Netherlands)

de Boer, V.; van Someren, M.; Lupascu, T.; Filipe, J.; Cordeiro, J.

2010-01-01

To automatically classify and process web pages, current systems use the textual content of those pages, including both the displayed content and the underlying (HTML) code. However, a very important feature of a web page is its visual appearance. In this paper, we show that using generic visual

Reliability of 3-Dimensional Measures of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications for Multicenter Biomechanical and Epidemiological Research on ACL Injury Prevention.

Science.gov (United States)

DiCesare, Christopher A; Bates, Nathaniel A; Barber Foss, Kim D; Thomas, Staci M; Wordeman, Samuel C; Sugimoto, Dai; Roewer, Benjamin D; Medina McKeon, Jennifer M; Di Stasi, Stephanie; Noehren, Brian W; Ford, Kevin R; Kiefer, Adam W; Hewett, Timothy E; Myer, Gregory D

2015-12-01

Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach. To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions. Controlled laboratory study. Twenty-five female high school volleyball players participated in this study. Three-dimensional motion data of each participant performing the single-leg cross drop were collected at 3 institutions over a period of 4 weeks. Coefficients of multiple correlation were calculated to assess the reliability of kinematic and kinetic measures during the landing phase of the movement. Between-centers reliability for kinematic waveforms in the frontal and sagittal planes was good, but moderate in the transverse plane. Between-centers reliability for kinetic waveforms was good in the sagittal, frontal, and transverse planes. Based on these findings, the single-leg cross drop task has moderate to good reliability of kinematic and kinetic measures across institutions after implementation of a standardized testing protocol. Multicenter collaborations can increase study numbers and generalize results, which is beneficial for studies of relatively rare phenomena, such as ACL injury. An important step is to determine the reliability of risk assessments across institutions before a multicenter collaboration can be initiated.

Reliability of tunnel angle in ACL reconstruction: two-dimensional versus three-dimensional guide technique.

Science.gov (United States)

Leiter, Jeff R S; de Korompay, Nevin; Macdonald, Lindsey; McRae, Sheila; Froese, Warren; Macdonald, Peter B

2011-08-01

To compare the reliability of tibial tunnel position and angle produced with a standard ACL guide (two-dimensional guide) or Howell 65° Guide (three-dimensional guide) in the coronal and sagittal planes. In the sagittal plane, the dependent variables were the angle of the tibial tunnel relative to the tibial plateau and the position of the tibial tunnel with respect to the most posterior aspect of the tibia. In the coronal plane, the dependent variables were the angle of the tunnel with respect to the medial joint line of the tibia and the medial and lateral placement of the tibial tunnel relative to the most medial aspect of the tibia. The position and angle of the tibial tunnel in the coronal and sagittal planes were determined from anteroposterior and lateral radiographs, respectively, taken 2-6 months postoperatively. The two-dimensional and three-dimensional guide groups included 28 and 24 sets of radiographs, respectively. Tibial tunnel position was identified, and tunnel angle measurements were completed. Multiple investigators measured the position and angle of the tunnel 3 times, at least 7 days apart. The angle of the tibial tunnel in the coronal plane using a two-dimensional guide (61.3 ± 4.8°) was more horizontal (P guide (64.7 ± 6.2°). The position of the tibial tunnel in the sagittal plane was more anterior (P guide group compared to the three-dimensional guide group (43.3 ± 2.9%). The Howell Tibial Guide allows for reliable placement of the tibial tunnel in the coronal plane at an angle of 65°. Tibial tunnels were within the anatomical footprint of the ACL with either technique. Future studies should investigate the effects of tibial tunnel angle on knee function and patient quality of life. Case-control retrospective comparative study, Level III.

Computer-assisted anatomical placement of a double-bundle ACL through 3D-fitting of a statistically generated femoral template into individual knee geometry

NARCIS (Netherlands)

Luites, J. W. H.; Wymenga, A. B.; Sati, M.; Bourquin, Y.; Blankevoort, L.; van der Venne, R.; Kooloos, J. G. M.; Staubli, H. U.

2000-01-01

Femoral graft placement is an important factor in the success of ACL-reconstruction. Besides improving the accuracy of femoral tunnel placement, Computer Assisted Surgery (CAS) can be used to determine the anatomical Location. This requires a 3D femoral template with the position of the anatomical

A Multisport Epidemiologic Comparison of Anterior Cruciate Ligament Injuries in High School Athletics

Science.gov (United States)

Joseph, Allan M.; Collins, Christy L.; Henke, Natalie M.; Yard, Ellen E.; Fields, Sarah K.; Comstock, R. Dawn

2013-01-01

Background: The knee joint is the second most commonly injured body site after the ankle and the leading cause of sport-related surgeries. Knee injuries, especially of the anterior cruciate ligament (ACL), are among the most economically costly sport injuries, frequently requiring expensive surgery and rehabilitation. Objective: To investigate the epidemiology of ACL injuries among high school athletes by sport and sex. Design: Descriptive epidemiology study. Main Outcome Measure(s): Using an Internet-based data-collection tool, Reporting Information Online (RIO), certified athletic trainers from 100 nationally representative US high schools reported athlete-exposure and injury data for athletes from 9 sports during the 2007/08–2011/12 academic years. The outcome of interest in this study was ACL injuries. Results: During the study period, 617 ACL injuries were reported during 9 452 180 athlete exposures (AEs), for an injury rate of 6.5 per 100 000 AEs. Nationally, in the 9 sports studied, an estimated 215 628 ACL injuries occurred during the study period. The injury rate was higher in competition (17.6) than practice (2.4; rate ratio [RR] = 7.3, 95% confidence interval [CI] = 6.08, 8.68). Girls' soccer had the highest injury rate (12.2) followed by boys' football (11.1), with boys' basketball (2.3) and boys' baseball (0.7) having the lowest rates. In sex-comparable sports, girls had a higher rate (8.9) than boys (2.6; RR = 3.4, 95% CI = 2.64, 4.47). Overall, 76.6% of ACL injuries resulted in surgery. The most common mechanisms of injury were player-to-player contact (42.8%) and no contact (37.9%). Conclusions: Anterior cruciate ligament injury rates vary by sport, sex, and type of exposure. Recognizing such differences is important when evaluating the effectiveness of evidence-based, targeted prevention efforts. PMID:24143905

Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

DEFF Research Database (Denmark)

In this paper, single wake characteristics have been studied both experimentally and numerically. Firstly, the wake is studied experimentally using full-scale measurements from an adapted focused pulsed lidar system, which potentially gives more insight into the wake dynamics as compared to class...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....

Single Wake Meandering, Advection and Expansion - An analysis using an adapted Pulsed Lidar and CFD LES-ACL simulations

DEFF Research Database (Denmark)

Machefaux, Ewan; Larsen, Gunner Chr.; Troldborg, Niels

2013-01-01

In this paper, single wake characteristics have been studied both experimentally and numerically. Firstly, the wake is studied experimentally using full-scale measurements from an adapted focused pulsed lidar system, which potentially gives more insight into the wake dynamics as compared to class...... using the EllipSys3D flow solver using Large Eddy Simulation (LES) and Actuator Line Technique (ACL) to model the rotor. Discrepancies due to the uncertainties on the wake advection velocity are observed and discussed....

Development of the ATLAS High-Level Trigger Steering and Inclusive Searches for Supersymmetry

CERN Document Server

Eifert, T

2009-01-01

The presented thesis is divided into two distinct parts. The subject of the first part is the ATLAS high-level trigger (HLT), in particular the development of the HLT Steering, and the trigger user-interface. The second part presents a study of inclusive supersymmetry searches, including a novel background estimation method for the relevant Standard Model (SM) processes. The trigger system of the ATLAS experiment at the Large Hadron Collider (LHC) performs the on-line physics selection in three stages: level-1 (LVL1), level-2 (LVL2), and the event filter (EF). LVL2 and EF together form the HLT. The HLT receives events containing detector data from high-energy proton (or heavy ion) collisions, which pass the LVL1 selection at a maximum rate of 75 kHz. It must reduce this rate to ~200 Hz, while retaining the most interesting physics. The HLT is a software trigger and runs on a large computing farm. At the heart of the HLT is the Steering software. The HLT Steering must reach a decision whether or not to accept ...

The effect of new links on Google PageRank

NARCIS (Netherlands)

Avrachenkov, Konstatin; Litvak, Nelli

2004-01-01

PageRank is one of the principle criteria according to which Google ranks Web pages. PageRank can be interpreted as a frequency of visiting a Web page by a random surfer and thus it reflects the popularity of a Web page. We study the effect of newly created links on Google PageRank. We discuss to

Commissioning of the CMS High-Level Trigger with Cosmic Rays

CERN Document Server

Chatrchyan, S; Sirunyan, A M; Adam, W; Arnold, B; Bergauer, H; Bergauer, T; Dragicevic, M; Eichberger, M; Erö, J; Friedl, M; Frühwirth, R; Ghete, V M; Hammer, J; Hänsel, S; Hoch, M; Hörmann, N; Hrubec, J; Jeitler, M; Kasieczka, G; Kastner, K; Krammer, M; Liko, D; Magrans de Abril, I; Mikulec, I; Mittermayr, F; Neuherz, B; Oberegger, M; Padrta, M; Pernicka, M; Rohringer, H; Schmid, S; Schöfbeck, R; Schreiner, T; Stark, R; Steininger, H; Strauss, J; Taurok, A; Teischinger, F; Themel, T; Uhl, D; Wagner, P; Waltenberger, W; Walzel, G; Widl, E; Wulz, C E; Chekhovsky, V; Dvornikov, O; Emeliantchik, I; Litomin, A; Makarenko, V; Marfin, I; Mossolov, V; Shumeiko, N; Solin, A; Stefanovitch, R; Suarez Gonzalez, J; Tikhonov, A; Fedorov, A; Karneyeu, A; Korzhik, M; Panov, V; Zuyeuski, R; Kuchinsky, P; Beaumont, W; Benucci, L; Cardaci, M; De Wolf, E A; Delmeire, E; Druzhkin, D; Hashemi, M; Janssen, X; Maes, T; Mucibello, L; Ochesanu, S; Rougny, R; Selvaggi, M; Van Haevermaet, H; Van Mechelen, P; Van Remortel, N; Adler, V; Beauceron, S; Blyweert, S; D'Hondt, J; De Weirdt, S; Devroede, O; Heyninck, J; Kalogeropoulos, A; Maes, J; Maes, M; Mozer, M U; Tavernier, S; Van Doninck, W; Van Mulders, P; Villella, I; Bouhali, O; Chabert, E C; Charaf, O; Clerbaux, B; De Lentdecker, G; Dero, V; Elgammal, S; Gay, A P R; Hammad, G H; Marage, P E; Rugovac, S; Vander Velde, C; Vanlaer, P; Wickens, J; Grunewald, M; Klein, B; Marinov, A; Ryckbosch, D; Thyssen, F; Tytgat, M; Vanelderen, L; Verwilligen, P; Basegmez, S; Bruno, G; Caudron, J; Delaere, C; Demin, P; Favart, D; Giammanco, A; Grégoire, G; Lemaitre, V; Militaru, O; Ovyn, S; Piotrzkowski, K; Quertenmont, L; Schul, N; Beliy, N; Daubie, E; Alves, G A; Pol, M E; Souza, M H G; Carvalho, W; De Jesus Damiao, D; De Oliveira Martins, C; Fonseca De Souza, S; Mundim, L; Oguri, V; Santoro, A; Silva Do Amaral, S M; Sznajder, A; Fernandez Perez Tomei, T R; Ferreira Dias, M A; Gregores, E M; Novaes, S F; Abadjiev, K; Anguelov, T; Damgov, J; Darmenov, N; Dimitrov, L; Genchev, V; Iaydjiev, P; Piperov, S; Stoykova, S; Sultanov, G; Trayanov, R; Vankov, I; Dimitrov, A; Dyulendarova, M; Kozhuharov, V; Litov, L; Marinova, E; Mateev, M; Pavlov, B; Petkov, P; Toteva, Z; Chen, G M; Chen, H S; Guan, W; Jiang, C H; Liang, D; Liu, B; Meng, X; Tao, J; Wang, J; Wang, Z; Xue, Z; Zhang, Z; Ban, Y; Cai, J; Ge, Y; Guo, S; Hu, Z; Mao, Y; Qian, S J; Teng, H; Zhu, B; Avila, C; Baquero Ruiz, M; Carrillo Montoya, C A; Gomez, A; Gomez Moreno, B; Ocampo Rios, A A; Osorio Oliveros, A F; Reyes Romero, D; Sanabria, J C; Godinovic, N; Lelas, K; Plestina, R; Polic, D; Puljak, I; Antunovic, Z; Dzelalija, M; Brigljevic, V; Duric, S; Kadija, K; Morovic, S; Fereos, R; Galanti, M; Mousa, J; Papadakis, A; Ptochos, F; Razis, P A; Tsiakkouri, D; Zinonos, Z; Hektor, A; Kadastik, M; Kannike, K; Müntel, M; Raidal, M; Rebane, L; Anttila, E; Czellar, S; Härkönen, J; Heikkinen, A; Karimäki, V; Kinnunen, R; Klem, J; Kortelainen, M J; Lampén, T; Lassila-Perini, K; Lehti, S; Lindén, T; Luukka, P; Mäenpää, T; Nysten, J; Tuominen, E; Tuominiemi, J; Ungaro, D; Wendland, L; Banzuzi, K; Korpela, A; Tuuva, T; Nedelec, P; Sillou, D; Besancon, M; Chipaux, R; Dejardin, M; Denegri, D; Descamps, J; Fabbro, B; Faure, J L; Ferri, F; Ganjour, S; Gentit, F X; Givernaud, A; Gras, P; Hamel de Monchenault, G; Jarry, P; Lemaire, M C; Locci, E; Malcles, J; Marionneau, M; Millischer, L; Rander, J; Rosowsky, A; Rousseau, D; Titov, M; Verrecchia, P; Baffioni, S; Bianchini, L; Bluj, M; Busson, P; Charlot, C; Dobrzynski, L; Granier de Cassagnac, R; Haguenauer, M; Miné, P; Paganini, P; Sirois, Y; Thiebaux, C; Zabi, A; Agram, J L; Besson, A; Bloch, D; Bodin, D; Brom, J M; Conte, E; Drouhin, F; Fontaine, J C; Gelé, D; Goerlach, U; Gross, L; Juillot, P; Le Bihan, A C; Patois, Y; Speck, J; Van Hove, P; Baty, C; Bedjidian, M; Blaha, J; Boudoul, G; Brun, H; Chanon, N; Chierici, R; Contardo, D; Depasse, P; Dupasquier, T; El Mamouni, H; Fassi, F; Fay, J; Gascon, S; Ille, B; Kurca, T; Le Grand, T; Lethuillier, M; Lumb, N; Mirabito, L; 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Jarvis, C; Mumford, J; Plager, C; Rakness, G; Schlein, P; Tucker, J; Valuev, V; Wallny, R; Yang, X; Babb, J; Bose, M; Chandra, A; Clare, R; Ellison, J A; Gary, J W; Hanson, G; Jeng, G Y; Kao, S C; Liu, F; Liu, H; Luthra, A; Nguyen, H; Pasztor, G; Satpathy, A; Shen, B C; Stringer, R; Sturdy, J; Sytnik, V; Wilken, R; Wimpenny, S; Branson, J G; Dusinberre, E; Evans, D; Golf, F; Kelley, R; Lebourgeois, M; Letts, J; Lipeles, E; Mangano, B; Muelmenstaedt, J; Norman, M; Padhi, S; Petrucci, A; Pi, H; Pieri, M; Ranieri, R; Sani, M; Sharma, V; Simon, S; Würthwein, F; Yagil, A; Campagnari, C; D'Alfonso, M; Danielson, T; Garberson, J; Incandela, J; Justus, C; Kalavase, P; Koay, S A; Kovalskyi, D; Krutelyov, V; Lamb, J; Lowette, S; Pavlunin, V; Rebassoo, F; Ribnik, J; Richman, J; Rossin, R; Stuart, D; To, W; Vlimant, J R; Witherell, M; Apresyan, A; Bornheim, A; Bunn, J; Chiorboli, M; Gataullin, M; Kcira, D; Litvine, V; Ma, Y; Newman, H B; Rogan, C; Timciuc, V; Veverka, J; Wilkinson, R; Yang, Y; Zhang, L; Zhu, K; Zhu, R Y; Akgun, B; Carroll, R; Ferguson, T; Jang, D W; Jun, S Y; Paulini, M; Russ, J; Terentyev, N; Vogel, H; Vorobiev, I; Cumalat, J P; Dinardo, M E; Drell, B R; Ford, W T; Heyburn, B; Luiggi Lopez, E; Nauenberg, U; Stenson, K; Ulmer, K; Wagner, S R; Zang, S L; Agostino, L; Alexander, J; Blekman, F; Cassel, D; Chatterjee, A; Das, S; Gibbons, L K; Heltsley, B; Hopkins, W; Khukhunaishvili, A; Kreis, B; Kuznetsov, V; Patterson, J R; Puigh, D; Ryd, A; Shi, X; Stroiney, S; Sun, W; Teo, W D; Thom, J; Vaughan, J; Weng, Y; Wittich, P; Beetz, C P; Cirino, G; Sanzeni, C; Winn, D; Abdullin, S; Afaq, M A; Albrow, M; Ananthan, B; Apollinari, G; Atac, M; Badgett, W; Bagby, L; Bakken, J A; Baldin, B; Banerjee, S; Banicz, K; Bauerdick, L A T; Beretvas, A; Berryhill, J; Bhat, P C; Biery, K; Binkley, M; Bloch, I; Borcherding, F; Brett, A M; Burkett, K; Butler, J N; Chetluru, V; Cheung, H W K; Chlebana, F; Churin, I; Cihangir, S; Crawford, M; Dagenhart, W; Demarteau, M; Derylo, G; Dykstra, D; Eartly, D P; Elias, J E; Elvira, V D; Evans, D; Feng, L; Fischler, M; Fisk, I; Foulkes, S; Freeman, J; Gartung, P; Gottschalk, E; Grassi, T; Green, D; Guo, Y; Gutsche, O; Hahn, A; Hanlon, J; Harris, R M; Holzman, B; Howell, J; Hufnagel, D; James, E; Jensen, H; Johnson, M; Jones, C D; Joshi, U; Juska, E; Kaiser, J; Klima, B; Kossiakov, S; Kousouris, K; Kwan, S; Lei, C M; Limon, P; Lopez Perez, J A; Los, S; Lueking, L; Lukhanin, G; Lusin, S; Lykken, J; Maeshima, K; Marraffino, J M; Mason, D; McBride, P; Miao, T; Mishra, K; Moccia, S; Mommsen, R; Mrenna, S; Muhammad, A S; Newman-Holmes, C; Noeding, C; O'Dell, V; Prokofyev, O; Rivera, R; Rivetta, C H; Ronzhin, A; Rossman, P; Ryu, S; Sekhri, V; Sexton-Kennedy, E; Sfiligoi, I; Sharma, S; Shaw, T M; Shpakov, D; Skup, E; Smith, R P; Soha, A; Spalding, W J; Spiegel, L; Suzuki, I; Tan, P; Tanenbaum, W; Tkaczyk, S; Trentadue, R; Uplegger, L; Vaandering, E W; Vidal, R; Whitmore, J; Wicklund, E; Wu, W; Yarba, J; Yumiceva, F; Yun, J C; Acosta, D; Avery, P; Barashko, V; Bourilkov, D; Chen, M; Di Giovanni, G P; Dobur, D; Drozdetskiy, A; Field, R D; Fu, Y; Furic, I K; Gartner, J; Holmes, D; Kim, B; Klimenko, S; Konigsberg, J; Korytov, A; Kotov, K; Kropivnitskaya, A; Kypreos, T; Madorsky, A; Matchev, K; Mitselmakher, G; Pakhotin, Y; Piedra Gomez, J; Prescott, C; Rapsevicius, V; Remington, R; Schmitt, M; Scurlock, B; Wang, D; Yelton, J; Ceron, C; Gaultney, V; Kramer, L; Lebolo, L M; Linn, S; Markowitz, P; Martinez, G; Rodriguez, J L; Adams, T; Askew, A; Baer, H; Bertoldi, M; Chen, J; Dharmaratna, W G D; Gleyzer, S V; Haas, J; Hagopian, S; Hagopian, V; Jenkins, M; Johnson, K F; Prettner, E; Prosper, H; Sekmen, S; Baarmand, M M; Guragain, S; Hohlmann, M; Kalakhety, H; Mermerkaya, H; Ralich, R; Vodopiyanov, I; Abelev, B; Adams, M R; Anghel, I M; Apanasevich, L; Bazterra, V E; Betts, R R; Callner, J; Castro, M A; Cavanaugh, R; Dragoiu, C; Garcia-Solis, E J; Gerber, C E; Hofman, D J; Khalatian, S; Mironov, C; Shabalina, E; Smoron, A; Varelas, N; Akgun, U; Albayrak, E A; Ayan, A S; Bilki, B; Briggs, R; Cankocak, K; Chung, K; Clarida, W; Debbins, P; Duru, F; Ingram, F D; Lae, C K; McCliment, E; Merlo, J P; Mestvirishvili, A; Miller, M J; Moeller, A; Nachtman, J; Newsom, C R; Norbeck, E; Olson, J; Onel, Y; Ozok, F; Parsons, J; Schmidt, I; Sen, S; Wetzel, J; Yetkin, T; Yi, K; Barnett, B A; Blumenfeld, B; Bonato, A; Chien, C Y; Fehling, D; Giurgiu, G; Gritsan, A V; Guo, Z J; Maksimovic, P; Rappoccio, S; Swartz, M; Tran, N V; Zhang, Y; Baringer, P; Bean, A; Grachov, O; Murray, M; Radicci, V; Sanders, S; Wood, J S; Zhukova, V; Bandurin, D; Bolton, T; Kaadze, K; Liu, A; Maravin, Y; Onoprienko, D; Svintradze, I; Wan, Z; Gronberg, J; Hollar, J; Lange, D; Wright, D; Baden, D; Bard, R; Boutemeur, M; Eno, S C; Ferencek, D; Hadley, N J; Kellogg, R G; Kirn, M; Kunori, S; Rossato, K; Rumerio, P; Santanastasio, F; Skuja, A; Temple, J; Tonjes, M B; Tonwar, S C; Toole, T; Twedt, E; Alver, B; Bauer, G; Bendavid, J; Busza, W; Butz, E; Cali, I A; Chan, M; D'Enterria, D; Everaerts, P; Gomez Ceballos, G; Hahn, K A; Harris, P; Jaditz, S; Kim, Y; Klute, M; Lee, Y J; Li, W; Loizides, C; Ma, T; Miller, M; Nahn, S; Paus, C; Roland, C; Roland, G; Rudolph, M; Stephans, G; Sumorok, K; Sung, K; Vaurynovich, S; Wenger, E A; Wyslouch, B; Xie, S; Yilmaz, Y; Yoon, A S; Bailleux, D; Cooper, S I; Cushman, P; Dahmes, B; De Benedetti, A; Dolgopolov, A; Dudero, P R; Egeland, R; Franzoni, G; Haupt, J; Inyakin, A; Klapoetke, K; Kubota, Y; Mans, J; Mirman, N; Petyt, D; Rekovic, V; Rusack, R; Schroeder, M; Singovsky, A; Zhang, J; Cremaldi, L M; Godang, R; Kroeger, R; Perera, L; Rahmat, R; Sanders, D A; Sonnek, P; Summers, D; Bloom, K; Bockelman, B; Bose, S; Butt, J; Claes, D R; Dominguez, A; Eads, M; Keller, J; Kelly, T; Kravchenko, I; Lazo-Flores, J; Lundstedt, C; Malbouisson, H; Malik, S; Snow, G R; Baur, U; Iashvili, I; Kharchilava, A; Kumar, A; Smith, K; Strang, M; Alverson, G; Barberis, E; Boeriu, O; Eulisse, G; Govi, G; McCauley, T; Musienko, Y; Muzaffar, S; Osborne, I; Paul, T; Reucroft, S; Swain, J; Taylor, L; Tuura, L; Anastassov, A; Gobbi, B; Kubik, A; Ofierzynski, R A; Pozdnyakov, A; Schmitt, M; Stoynev, S; Velasco, M; Won, S; Antonelli, L; Berry, D; Hildreth, M; Jessop, C; Karmgard, D J; Kolberg, T; Lannon, K; Lynch, S; Marinelli, N; Morse, D M; Ruchti, R; Slaunwhite, J; Warchol, J; Wayne, M; Bylsma, B; Durkin, L S; Gilmore, J; Gu, J; Killewald, P; Ling, T Y; Williams, G; Adam, N; Berry, E; Elmer, P; Garmash, A; Gerbaudo, D; Halyo, V; Hunt, A; Jones, J; Laird, E; Marlow, D; Medvedeva, T; Mooney, M; Olsen, J; Piroué, P; Stickland, D; Tully, C; Werner, J S; Wildish, T; Xie, Z; Zuranski, A; Acosta, J G; Bonnett Del Alamo, M; Huang, X T; Lopez, A; Mendez, H; Oliveros, S; Ramirez Vargas, J E; Santacruz, N; Zatzerklyany, A; Alagoz, E; Antillon, E; Barnes, V E; Bolla, G; Bortoletto, D; Everett, A; Garfinkel, A F; Gecse, Z; Gutay, L; Ippolito, N; Jones, M; Koybasi, O; Laasanen, A T; Leonardo, N; Liu, C; Maroussov, V; Merkel, P; Miller, D H; Neumeister, N; Sedov, A; Shipsey, I; Yoo, H D; Zheng, Y; Jindal, P; Parashar, N; Cuplov, V; Ecklund, K M; Geurts, F J M; Liu, J H; Maronde, D; Matveev, M; Padley, B P; Redjimi, R; Roberts, J; Sabbatini, L; Tumanov, A; Betchart, B; Bodek, A; Budd, H; Chung, Y S; de Barbaro, P; Demina, R; Flacher, H; Gotra, Y; Harel, A; Korjenevski, S; Miner, D C; Orbaker, D; Petrillo, G; Vishnevskiy, D; Zielinski, M; Bhatti, A; Demortier, L; Goulianos, K; Hatakeyama, K; Lungu, G; Mesropian, C; Yan, M; Atramentov, O; Bartz, E; Gershtein, Y; Halkiadakis, E; Hits, D; Lath, A; Rose, K; Schnetzer, S; Somalwar, S; Stone, R; Thomas, S; Watts, T L; Cerizza, G; Hollingsworth, M; Spanier, S; Yang, Z C; York, A; Asaadi, J; Aurisano, A; Eusebi, R; Golyash, A; Gurrola, A; Kamon, T; Nguyen, C N; Pivarski, J; Safonov, A; Sengupta, S; Toback, D; Weinberger, M; Akchurin, N; Berntzon, L; Gumus, K; Jeong, C; Kim, H; Lee, S W; Popescu, S; Roh, Y; Sill, A; Volobouev, I; Washington, E; Wigmans, R; Yazgan, E; Engh, D; Florez, C; Johns, W; Pathak, S; Sheldon, P; Andelin, D; Arenton, M W; Balazs, M; Boutle, S; Buehler, M; Conetti, S; Cox, B; Hirosky, R; Ledovskoy, A; Neu, C; Phillips II, D; Ronquest, M; Yohay, R; Gollapinni, S; Gunthoti, K; Harr, R; Karchin, P E; Mattson, M; Sakharov, A; Anderson, M; Bachtis, M; Bellinger, J N; Carlsmith, D; Crotty, I; Dasu, S; Dutta, S; Efron, J; Feyzi, F; Flood, K; Gray, L; Grogg, K S; Grothe, M; Hall-Wilton, R; Jaworski, M; Klabbers, P; Klukas, J; Lanaro, A; Lazaridis, C; Leonard, J; Loveless, R; Magrans de Abril, M; Mohapatra, A; Ott, G; Polese, G; Reeder, D; Savin, A; Smith, W H; Sourkov, A; Swanson, J; Weinberg, M; Wenman, D; Wensveen, M; White, A

2010-01-01

The CMS High-Level Trigger (HLT) is responsible for ensuring that data samples with potentially interesting events are recorded with high efficiency and good quality. This paper gives an overview of the HLT and focuses on its commissioning using cosmic rays. The selection of triggers that were deployed is presented and the online grouping of triggered events into streams and primary datasets is discussed. Tools for online and offline data quality monitoring for the HLT are described, and the operational performance of the muon HLT algorithms is reviewed. The average time taken for the HLT selection and its dependence on detector and operating conditions are presented. The HLT performed reliably and helped provide a large dataset. This dataset has proven to be invaluable for understanding the performance of the trigger and the CMS experiment as a whole.

Commissioning of the CMS High-Level Trigger with cosmic rays

International Nuclear Information System (INIS)

2010-01-01

The CMS High-Level Trigger (HLT) is responsible for ensuring that data samples with potentially interesting events are recorded with high efficiency and good quality. This paper gives an overview of the HLT and focuses on its commissioning using cosmic rays. The selection of triggers that were deployed is presented and the online grouping of triggered events into streams and primary datasets is discussed. Tools for online and offline data quality monitoring for the HLT are described, and the operational performance of the muon HLT algorithms is reviewed. The average time taken for the HLT selection and its dependence on detector and operating conditions are presented. The HLT performed reliably and helped provide a large dataset. This dataset has proven to be invaluable for understanding the performance of the trigger and the CMS experiment as a whole.

Importance of intrinsic and non-network contribution in PageRank centrality and its effect on PageRank localization

OpenAIRE

Deyasi, Krishanu

2016-01-01

PageRank centrality is used by Google for ranking web-pages to present search result for a user query. Here, we have shown that PageRank value of a vertex also depends on its intrinsic, non-network contribution. If the intrinsic, non-network contributions of the vertices are proportional to their degrees or zeros, then their PageRank centralities become proportion to their degrees. Some simulations and empirical data are used to support our study. In addition, we have shown that localization ...

Muscle function is associated with future patient-reported outcomes in young adults with ACL injury

DEFF Research Database (Denmark)

Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva

2016-01-01

performance and worse postural orientation were associated with worse KOOS scores 2 years later (rsp≥0.280, p≤0.045). Worse muscle power was associated with lower future ARS scores (rsp=0.281, p=0.044). CONCLUSIONS: The moderate associations suggest that improving muscle function during rehabilitation could...... and postural orientation 3 years (SD 0.85) after ACL injury. PROs at 3 and 5 years after injury included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales Function in sport and recreation (KOOS Sport/rec) and Knee-related Quality of life (KOOS QoL), KOOS item Q3 (KOOS Q3), Tegner Activity Scale...... improve present and future PROs....

Universal emergence of PageRank

Energy Technology Data Exchange (ETDEWEB)

Frahm, K M; Georgeot, B; Shepelyansky, D L, E-mail: frahm@irsamc.ups-tlse.fr, E-mail: georgeot@irsamc.ups-tlse.fr, E-mail: dima@irsamc.ups-tlse.fr [Laboratoire de Physique Theorique du CNRS, IRSAMC, Universite de Toulouse, UPS, 31062 Toulouse (France)

2011-11-18

The PageRank algorithm enables us to rank the nodes of a network through a specific eigenvector of the Google matrix, using a damping parameter {alpha} Element-Of ]0, 1[. Using extensive numerical simulations of large web networks, with a special accent on British University networks, we determine numerically and analytically the universal features of the PageRank vector at its emergence when {alpha} {yields} 1. The whole network can be divided into a core part and a group of invariant subspaces. For {alpha} {yields} 1, PageRank converges to a universal power-law distribution on the invariant subspaces whose size distribution also follows a universal power law. The convergence of PageRank at {alpha} {yields} 1 is controlled by eigenvalues of the core part of the Google matrix, which are extremely close to unity, leading to large relaxation times as, for example, in spin glasses. (paper)

Universal emergence of PageRank

International Nuclear Information System (INIS)

Frahm, K M; Georgeot, B; Shepelyansky, D L

2011-01-01

The PageRank algorithm enables us to rank the nodes of a network through a specific eigenvector of the Google matrix, using a damping parameter α ∈ ]0, 1[. Using extensive numerical simulations of large web networks, with a special accent on British University networks, we determine numerically and analytically the universal features of the PageRank vector at its emergence when α → 1. The whole network can be divided into a core part and a group of invariant subspaces. For α → 1, PageRank converges to a universal power-law distribution on the invariant subspaces whose size distribution also follows a universal power law. The convergence of PageRank at α → 1 is controlled by eigenvalues of the core part of the Google matrix, which are extremely close to unity, leading to large relaxation times as, for example, in spin glasses. (paper)

Data Extraction Based on Page Structure Analysis

Directory of Open Access Journals (Sweden)

Ren Yichao

2017-01-01

Full Text Available The information we need has some confusing problems such as dispersion and different organizational structure. In addition, because of the existence of unstructured data like natural language and images, extracting local content pages is extremely difficult. In the light of of the problems above, this article will apply a method combined with page structure analysis algorithm and page data extraction algorithm to accomplish the gathering of network data. In this way, the problem that traditional complex extraction model behave poorly when dealing with large-scale data is perfectly solved and the page data extraction efficiency is also boosted to a new level. In the meantime, the article will also make a comparison about pages and content of different types between the methods of DOM structure based on the page and HTML regularities of distribution. After all of those, we may find a more efficient extract method.

A thorough spring-clean for CERN's Web pages

CERN Multimedia

2001-01-01

This coming Tuesday will see the unveiling of CERN's new user pages on the Web. Their simplified layout and design will make everybody's lives a whole lot easier. Stand by for Tuesday 17 April when, as announced in the Weekly Bulletin of 2 April (n°14/2001), the new newly-designed users welcome page will be hitting our screens as the default CERN home page. But don't worry, if you've got the blues for the good old blue-green home page it's still in service and, to ensure a smooth transition, will be maintained in parallel until 25 May. But in all likelihood you'll be quickly won over by the new-look pages, which are so much simpler to use. Welcome to the new Web! The aim of this revamp, led by the WPE (Web Public Education) group, is to simplify and introduce a more logical hierarchy into the menus and welcome pages on CERN's Intranet. In a second stage, the 'General Public' pages will get a similar makeover. The fact is that the number of links on the user pages, and in particular the welcome page...

Page 5

African Journals Online (AJOL)

ezra

Page 5. Stress Management By Library And Information Science Professionals In Nigerian University Libraries. BY ... relationships, and other considerations that can be ... Building a dynamic ... and maintaining current awareness of emerging.

Probabilistic relation between In-Degree and PageRank

NARCIS (Netherlands)

Litvak, Nelli; Scheinhardt, Willem R.W.; Volkovich, Y.

2008-01-01

This paper presents a novel stochastic model that explains the relation between power laws of In-Degree and PageRank. PageRank is a popularity measure designed by Google to rank Web pages. We model the relation between PageRank and In-Degree through a stochastic equation, which is inspired by the

Telomere length of anterior crucial ligament after rupture

DEFF Research Database (Denmark)

Ponsot, Elodie; Langberg, Henning; Krogsgaard, Michael R

2011-01-01

The regeneration of ligaments following injury is a slow process compared to the healing of many other tissues and the underlying mechanisms remain unknown. The purpose of the study was to evaluate the proliferative potential of ligaments by assessing telomere length within three distinct parts...... of human anterior cruciate ligament (ACL) obtained during ACL reconstruction: the macroscopically injured proximal part and macroscopically noninjured mid- and distal portions in eight subjects (age 28 ± 8 years). The mean telomere length in ACL was within normal range of values usually reported for other...... tissues indicating that the endogenous machinery responsible for the proliferative potential of ligament is not implicated in its poor healing capacity. The three ACL parts showed similar mean TRF lengths (distal part: 11.5 ± 0.8 kbp, mid-portion: 11.8 ± 1.2 kbp, proximal part: 11.9 ± 1.6 kbp...

Supervision of the ATLAS High Level Trigger System

CERN Document Server

Wheeler, S.; Meessen, C.; Qian, Z.; Touchard, F.; Negri, France A.; Zobernig, H.; CHEP 2003 Computing in High Energy Physics; Negri, France A.

2003-01-01

The ATLAS High Level Trigger (HLT) system provides software-based event selection after the initial LVL1 hardware trigger. It is composed of two stages, the LVL2 trigger and the Event Filter. The HLT is implemented as software tasks running on large processor farms. An essential part of the HLT is the supervision system, which is responsible for configuring, coordinating, controlling and monitoring the many hundreds of processes running in the HLT. A prototype implementation of the supervision system, using tools from the ATLAS Online Software system is presented. Results from scalability tests are also presented where the supervision system was shown to be capable of controlling over 1000 HLT processes running on 230 nodes.

75 FR 35443 - North Pacific Fishery Management Council; Public Meeting

Science.gov (United States)

2010-06-22

... may not reflect the productive capacity of these stocks. The teleconference will review existing methods for determining ACLs for these stocks and also consider methods being proposed in other regions of the U.S. to evaluate if these can be applied to groundfish stocks of the Bering Sea and [[Page 35444...

Personal and Public Start Pages in a library setting

NARCIS (Netherlands)

Kieft-Wondergem, Dorine

Personal and Public Start Pages are web-based resources. With these kind of tools it is possible to make your own free start page. A Start Page allows you to put all your web resources into one page, including blogs, email, podcasts, RSSfeeds. It is possible to share the content of the page with

Monte Carlo methods of PageRank computation

NARCIS (Netherlands)

Litvak, Nelli

2004-01-01

We describe and analyze an on-line Monte Carlo method of PageRank computation. The PageRank is being estimated basing on results of a large number of short independent simulation runs initiated from each page that contains outgoing hyperlinks. The method does not require any storage of the hyperlink

Recent experience and future evolution of the CMS High Level Trigger System

CERN Document Server

Bauer, Gerry; Branson, James; Bukowiec, Sebastian Czeslaw; Chaze, Olivier; Cittolin, Sergio; Coarasa Perez, Jose Antonio; Deldicque, Christian; Dobson, Marc; Dupont, Aymeric; Erhan, Samim; Gigi, Dominique; Glege, Frank; Gomez-Reino Garrido, Robert; Hartl, Christian; Holzner, Andre Georg; Masetti, Lorenzo; Meijers, Franciscus; Meschi, Emilio; Mommsen, Remigius; Nunez Barranco Fernandez, Carlos; O'Dell, Vivian; Orsini, Luciano; Paus, Christoph Maria Ernst; Petrucci, Andrea; Pieri, Marco; Polese, Giovanni; Racz, Attila; Raginel, Olivier; Sakulin, Hannes; Sani, Matteo; Schwick, Christoph; Spataru, Andrei Cristian; Stoeckli, Fabian; Sumorok, Konstanty

2012-01-01

The CMS experiment at the LHC uses a two-stage trigger system, with events flowing from the first level trigger at a rate of 100 kHz. These events are read out by the Data Acquisition system (DAQ), assembled in memory in a farm of computers, and finally fed into the high-level trigger (HLT) software running on the farm. The HLT software selects interesting events for offline storage and analysis at a rate of a few hundred Hz. The HLT algorithms consist of sequences of offline-style reconstruction and filtering modules, executed on a farm of 0(10000) CPU cores built from commodity hardware. Experience from the 2010-2011 collider run is detailed, as well as the current architecture of the CMS HLT, and its integration with the CMS reconstruction framework and CMS DAQ. The short- and medium-term evolution of the HLT software infrastructure is discussed, with future improvements aimed at supporting extensions of the HLT computing power, and addressing remaining performance and maintenance issues.

Training Activity Summary Page (TASP) Campus

Data.gov (United States)

U.S. Department of Health & Human Services — The Training Activity Summary Page (formerly the Training Exit Survey Cover Page) dataset contains data about each training event. This dataset includes information...

Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial.

Science.gov (United States)

Zebis, Mette K; Andersen, Lars L; Brandt, Mikkel; Myklebust, Grethe; Bencke, Jesper; Lauridsen, Hanne Bloch; Bandholm, Thomas; Thorborg, Kristian; Hölmich, Per; Aagaard, Per

2016-05-01

Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical risk factors for non-contact ACL injury. 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual training 3 times weekly for 12 weeks. The CON group completed their regular warm-up exercise programme before training. Players were tested while performing a side cutting movement at baseline and 12-week follow-up, using surface electromyography (EMG) and three-dimensional movement analysis. We calculated: (1) EMG amplitude from vastus lateralis (VL), semitendinosus (ST) and biceps femoris 10 ms prior to initial contact (IC) normalised to peak EMG amplitude recorded during maximal voluntary isometric contraction and (2) VL-ST EMG preactivity difference during the 10 ms prior to foot contact (primary outcome). We measured maximal knee joint valgus moment and knee valgus angle at IC. There was a difference between groups at follow-up in VL-ST preactivity (43% between-group difference; 95% CI 32% to 55%). No between-group differences were observed for kinematic and kinetic variables. A 12-week injury prevention programme in addition to training and match play in adolescent females altered the pattern of agonist-antagonist muscle preactivity during side cutting. This may represent a more ACL-protective motor strategy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PageRank in scale-free random graphs

NARCIS (Netherlands)

Chen, Ningyuan; Litvak, Nelli; Olvera-Cravioto, Mariana; Bonata, Anthony; Chung, Fan; Pralat, Paweł

2014-01-01

We analyze the distribution of PageRank on a directed configuration model and show that as the size of the graph grows to infinity, the PageRank of a randomly chosen node can be closely approximated by the PageRank of the root node of an appropriately constructed tree. This tree approximation is in

Banner Pages on the New Printing Infrastructure

CERN Multimedia

2006-01-01

Changes to the printing service were announced in CERN Bulletin No. 37-38/2006. In the new infrastructure, the printing of the banner page has been disabled in order to reduce paper consumption. Statistics show that the average print job size is small and the paper savings by not printing the banner page could be up to 20 %. When each printer is moved onto the new infrastructure banner page printing will be disabled. In the case of corridor printers which are shared by several users, the Helpdesk can re-enable banner page printing upon request. We hope ultimately to arrive at a situation where banner page printing is enabled on fewer than 10% of printers registered on the network. You can still print banner pages on printers where it has been centrally disabled by using Linux. Simply add it to your print job on the client side by adding the -o job-sheets option to your lpr command. Detailed documentation is available on each SLC3/4 under the following link: http://localhost:631/sum.html#4_2 Please bea...

Women's Pages or People's Pages: The Production of News for Women in the "Washington Post" in the 1950s.

Science.gov (United States)

Yang, Mei-ling

1996-01-01

Examines the women's pages of the "Washington Post" in the 1950s that were edited by Marie Sauer. States that the newspaper turned down Sauer's request in 1952 to change from traditional women's pages to a unisex "lifestyle" section. Analyzes how women's pages were shaped by factors such as advertising, professional values, and…

Alginate based nanocomposite for microencapsulation of probiotic: Effect of cellulose nanocrystal (CNC) and lecithin.

Science.gov (United States)

Huq, Tanzina; Fraschini, Carole; Khan, Avik; Riedl, Bernard; Bouchard, Jean; Lacroix, Monique

2017-07-15

Probiotic (Lactobacillus rhamnosus ATCC 9595) was encapsulated in alginate-CNC-lecithin microbeads to produce nutraceutical microcapsules. Addition of CNC and lecithin in alginate microbeads (ACL-1) improved the viability of L. rhamnosus during gastric passage and storage. The compression strength of the freeze-dried ACL-1 microbeads improved 40% compared to alginate microbeads alone. Swelling studies revealed that addition of CNC and lecithin in alginate microbeads decreased (around 47%) the gastric fluid absorption but increased the dissolution time by 20min compared to alginate microbeads (A-0). During transition through the gastric passage, the viability of L. rhamnosus in dried ACL-1 microbeads was increased 37% as compared to A-0 based beads. At 25 and 4°C storage conditions, the viability of L. rhamnosus encapsulated in ACL-1 microbeads decreased by 1.23 and 1.08 log respectively, whereas the encapsulation with A-0 microbeads exhibited a 3.17 and 1.93 log reduction respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using Power-Law Degree Distribution to Accelerate PageRank

Directory of Open Access Journals (Sweden)

Zhaoyan Jin

2012-12-01

Full Text Available The PageRank vector of a network is very important, for it can reflect the importance of a Web page in the World Wide Web, or of a people in a social network. However, with the growth of the World Wide Web and social networks, it needs more and more time to compute the PageRank vector of a network. In many real-world applications, the degree and PageRank distributions of these complex networks conform to the Power-Law distribution. This paper utilizes the degree distribution of a network to initialize its PageRank vector, and presents a Power-Law degree distribution accelerating algorithm of PageRank computation. Experiments on four real-world datasets show that the proposed algorithm converges more quickly than the original PageRank algorithm.

Comparing classical and quantum PageRanks

Science.gov (United States)

Loke, T.; Tang, J. W.; Rodriguez, J.; Small, M.; Wang, J. B.

2017-01-01

Following recent developments in quantum PageRanking, we present a comparative analysis of discrete-time and continuous-time quantum-walk-based PageRank algorithms. Relative to classical PageRank and to different extents, the quantum measures better highlight secondary hubs and resolve ranking degeneracy among peripheral nodes for all networks we studied in this paper. For the discrete-time case, we investigated the periodic nature of the walker's probability distribution for a wide range of networks and found that the dominant period does not grow with the size of these networks. Based on this observation, we introduce a new quantum measure using the maximum probabilities of the associated walker during the first couple of periods. This is particularly important, since it leads to a quantum PageRanking scheme that is scalable with respect to network size.

Optimizing TLB entries for mixed page size storage in contiguous memory

Science.gov (United States)

Chen, Dong; Gara, Alan; Giampapa, Mark E.; Heidelberger, Philip; Kriegel, Jon K.; Ohmacht, Martin; Steinmacher-Burow, Burkhard

2013-04-30

A system and method for accessing memory are provided. The system comprises a lookup buffer for storing one or more page table entries, wherein each of the one or more page table entries comprises at least a virtual page number and a physical page number; a logic circuit for receiving a virtual address from said processor, said logic circuit for matching the virtual address to the virtual page number in one of the page table entries to select the physical page number in the same page table entry, said page table entry having one or more bits set to exclude a memory range from a page.

Forward lunge as a functional performance test in ACL deficient subjects: test-retest reliability

DEFF Research Database (Denmark)

Alkjaer, Tine; Henriksen, Marius; Dyhre-Poulsen, Poul

2009-01-01

The forward lunge movement may be used as a functional performance test of anterior cruciate ligament (ACL) deficient and reconstructed subjects. The purposes were 1) to determine the test-retest reliability of a forward lunge in healthy subjects and 2) to determine the required numbers...... of repetitions necessary to yield satisfactory reliability. Nineteen healthy subjects performed four trials of a forward lunge on two different days. The movement time, impulses of the ground reaction forces (IFz, IFy), knee joint kinematics and dynamics during the forward lunge were calculated. The relative...... reliability was determined by calculation of Intraclass Correlation Coefficients (ICC). The IFz, IFy and the positive work of the knee extensors showed excellent reliability (ICC >0.75). All other variables demonstrated acceptable reliability (0.4>ICCreliability increased when more than...

The Importance of Prior Probabilities for Entry Page Search

NARCIS (Netherlands)

Kraaij, W.; Westerveld, T.H.W.; Hiemstra, Djoerd

An important class of searches on the world-wide-web has the goal to find an entry page (homepage) of an organisation. Entry page search is quite different from Ad Hoc search. Indeed a plain Ad Hoc system performs disappointingly. We explored three non-content features of web pages: page length,

Coming to Life: A Review of Movie Comics: Page to Screen/Screen to Page

OpenAIRE

Labarre, Nicolas

2017-01-01

This book review provides an overview of 'Movie Comics: Page to Screen/Screen to Page' by Blair Davis (Rutgers University Press, 2017) a book which examines the reciprocal adaptations of film into comics and comics into films from 1930 to 1960. This review argues that 'Movie Comics' provides a useful and finely-textured cultural history of that phenomenon, which help contextualize scholarly studies of contemporary adaptations and transmedia constructions.

An Improved Approach to the PageRank Problems

Directory of Open Access Journals (Sweden)

Yue Xie

2013-01-01

Full Text Available We introduce a partition of the web pages particularly suited to the PageRank problems in which the web link graph has a nested block structure. Based on the partition of the web pages, dangling nodes, common nodes, and general nodes, the hyperlink matrix can be reordered to be a more simple block structure. Then based on the parallel computation method, we propose an algorithm for the PageRank problems. In this algorithm, the dimension of the linear system becomes smaller, and the vector for general nodes in each block can be calculated separately in every iteration. Numerical experiments show that this approach speeds up the computation of PageRank.

JERHRE's New Web Pages.

Science.gov (United States)

2006-06-01

JERHRE'S WEBSITE, www.csueastbay.edu/JERHRE/ has two new pages. One of those pages is devoted to curriculum that may be used to educate students, investigators and ethics committee members about issues in the ethics of human subjects research, and to evaluate their learning. It appears at www.csueastbay.edu/JERHRE/cur.html. The other is devoted to emailed letters from readers. Appropriate letters will be posted as soon as they are received by the editor. Letters from readers appear at www.csueastbay.edu/JERHRE/let.html.

The CMS High Level Trigger System: Experience and Future Development

CERN Document Server

Bauer, Gerry; Bowen, Matthew; Branson, James G; Bukowiec, Sebastian; Cittolin, Sergio; Coarasa, J A; Deldicque, Christian; Dobson, Marc; Dupont, Aymeric; Erhan, Samim; Flossdorf, Alexander; Gigi, Dominique; Glege, Frank; Gomez-Reino, R; Hartl, Christian; Hegeman, Jeroen; Holzner, André; Y L Hwong; Masetti, Lorenzo; Meijers, Frans; Meschi, Emilio; Mommsen, R K; O'Dell, Vivian; Orsini, Luciano; Paus, Christoph; Petrucci, Andrea; Pieri, Marco; Polese, Giovanni; Racz, Attila; Raginel, Olivier; Sakulin, Hannes; Sani, Matteo; Schwick, Christoph; Shpakov, Dennis; Simon, M; Spataru, A C; Sumorok, Konstanty

2012-01-01

The CMS experiment at the LHC features a two-level trigger system. Events accepted by the first level trigger, at a maximum rate of 100 kHz, are read out by the Data Acquisition system (DAQ), and subsequently assembled in memory in a farm of computers running a software high-level trigger (HLT), which selects interesting events for offline storage and analysis at a rate of order few hundred Hz. The HLT algorithms consist of sequences of offline-style reconstruction and filtering modules, executed on a farm of 0(10000) CPU cores built from commodity hardware. Experience from the operation of the HLT system in the collider run 2010/2011 is reported. The current architecture of the CMS HLT, its integration with the CMS reconstruction framework and the CMS DAQ, are discussed in the light of future development. The possible short- and medium-term evolution of the HLT software infrastructure to support extensions of the HLT computing power, and to address remaining performance and maintenance issues, are discussed.

Google Analytics: Single Page Traffic Reports

Science.gov (United States)

These are pages that live outside of Google Analytics (GA) but allow you to view GA data for any individual page on either the public EPA web or EPA intranet. You do need to log in to Google Analytics to view them.

Uniform Page Migration Problem in Euclidean Space

Directory of Open Access Journals (Sweden)

Amanj Khorramian

2016-08-01

Full Text Available The page migration problem in Euclidean space is revisited. In this problem, online requests occur at any location to access a single page located at a server. Every request must be served, and the server has the choice to migrate from its current location to a new location in space. Each service costs the Euclidean distance between the server and request. A migration costs the distance between the former and the new server location, multiplied by the page size. We study the problem in the uniform model, in which the page has size D = 1 . All request locations are not known in advance; however, they are sequentially presented in an online fashion. We design a 2.75 -competitive online algorithm that improves the current best upper bound for the problem with the unit page size. We also provide a lower bound of 2.732 for our algorithm. It was already known that 2.5 is a lower bound for this problem.

Web page classification on child suitability

NARCIS (Netherlands)

C. Eickhoff (Carsten); P. Serdyukov; A.P. de Vries (Arjen)

2010-01-01

htmlabstractChildren spend significant amounts of time on the Internet. Recent studies showed, that during these periods they are often not under adult supervision. This work presents an automatic approach to identifying suitable web pages for children based on topical and non-topical web page

Coming to Life: A Review of Movie Comics: Page to Screen/Screen to Page

Directory of Open Access Journals (Sweden)

Nicolas Labarre

2017-03-01

Full Text Available This book review provides an overview of 'Movie Comics: Page to Screen/Screen to Page' by Blair Davis (Rutgers University Press, 2017 a book which examines the reciprocal adaptations of film into comics and comics into films from 1930 to 1960. This review argues that 'Movie Comics' provides a useful and finely-textured cultural history of that phenomenon, which help contextualize scholarly studies of contemporary adaptations and transmedia constructions.

The ICAP (Interactive Course Assignment Pages Publishing System

Directory of Open Access Journals (Sweden)

Kim Griggs

2008-03-01

Full Text Available The ICAP publishing system is an open source custom content management system that enables librarians to easily and quickly create and manage library help pages for course assignments (ICAPs, without requiring knowledge of HTML or other web technologies. The system's unique features include an emphasis on collaboration and content reuse and an easy-to-use interface that includes in-line help, simple forms and drag and drop functionality. The system generates dynamic, attractive course assignment pages that blend Web 2.0 features with traditional library resources, and makes the pages easier to find by providing a central web page for the course assignment pages. As of December 2007, the code is available as free, open-source software under the GNU General Public License.

17 CFR 8.08 - Disciplinary committee.

Science.gov (United States)

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Disciplinary committee. 8.08 Section 8.08 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION EXCHANGE PROCEDURES FOR DISCIPLINARY, SUMMARY, AND MEMBERSHIP DENIAL ACTIONS Disciplinary Procedure § 8.08 Disciplinary...

Knee temperatures measured in vivo after arthroscopic ACL reconstruction followed by cryotherapy with gel-packs or computer controlled heat extraction.

Science.gov (United States)

Rashkovska, Aleksandra; Trobec, Roman; Avbelj, Viktor; Veselko, Matjaž

2014-09-01

To obtain in vivo data about intra- and extra-articular knee temperatures to assess the effectiveness of two cryotherapeutic methods-conventional cooling with gel-packs and computer controlled cryotherapy following anterior cruciate ligament (ACL) reconstructive surgery. Twenty patients were arbitrarily assigned for cryotherapy after ACL reconstruction: 8 patients with frozen gel-packs and 12 patients with computer controlled cryotherapy with constant temperatures of the cooling liquid in the knee pads. The treatment was performed for 12 h. Temperatures were measured with two thermo sensors in catheters placed intraarticularly and subcutaneously, four sensors on the skin and one sensor under protective bandage, every second for 16 h after surgery. In the first 2 h of treatment, there were no significant differences (n.s.) between the groups in temperatures in the intracondylar notch. After 4 h of cryotherapy, the temperatures were significantly lower on the skin (24.6 ± 2.8 and 31.4 ± 1.3 °C, p cryotherapy group compared to the gel-pack group. The cooling effect of the arthroscopy irrigation fluid on the knee temperature is evident in the first 2 h of treatment. The energy extraction is significantly more effective and controllable by computer controlled cryotherapy than with frozen gel-packs. Prospective comparative study, Level II.

Discovering author impact: A PageRank perspective

OpenAIRE

Yan, Erjia; Ding, Ying

2010-01-01

This article provides an alternative perspective for measuring author impact by applying PageRank algorithm to a coauthorship network. A weighted PageRank algorithm considering citation and coauthorship network topology is proposed. We test this algorithm under different damping factors by evaluating author impact in the informetrics research community. In addition, we also compare this weighted PageRank with the h-index, citation, and program committee (PC) membership of the International So...

Global tracker for the ALICE high level trigger

International Nuclear Information System (INIS)

Vik, Thomas

2006-01-01

This thesis deals with two main topics. The first is the implementation and testing of a Kalman filter algorithm in the HLT (High Level Trigger) reconstruction code. This will perform the global tracking in the HLT, that is merging tracklets and hits from the different sub-detectors in the central barrel detector. The second topic is a trigger mode of the HLT which uses the global tracking of particles through the TRD (Transition Radiation Detector), TPC (Time Projection Chamber) and the ITS (Inner Tracking System): The dielectron trigger. Global tracking: The Kalman filter algorithm has been introduced to the HLT tracking scheme. (Author)

Page 28

African Journals Online (AJOL)

ezra

7 (2)2007. Page 28. Serials Management In Polytechnic Libraries in Nigeria: A Comparative ... Despite the strategic position of serials publications amongst the materials .... the formulation of routines and procedures for ..... other professional librarian in the section classify ... probably due to dwindling finance given to both.

The (Untold) Drama of the Turning Page: The Role of Page Breaks in Understanding Picture Books

Science.gov (United States)

Jacobs, Katrina Emily Bartow

2016-01-01

While scholars have recognized the importance of page breaks in both the construction and comprehension of narrative within picture books, there has previously been limited research that focused directly on how children discuss and make sense of these spaces in the text. Yet, because of their nature as dramatic gaps in the narrative, page breaks…

Operational experience with the ALICE High Level Trigger

Science.gov (United States)

Szostak, Artur

2012-12-01

The ALICE HLT is a dedicated real-time system for online event reconstruction and triggering. Its main goal is to reduce the raw data volume read from the detectors by an order of magnitude, to fit within the available data acquisition bandwidth. This is accomplished by a combination of data compression and triggering. When HLT is enabled, data is recorded only for events selected by HLT. The combination of both approaches allows for flexible data reduction strategies. Event reconstruction places a high computational load on HLT. Thus, a large dedicated computing cluster is required, comprising 248 machines, all interconnected with InfiniBand. Running a large system like HLT in production mode proves to be a challenge. During the 2010 pp and Pb-Pb data-taking period, many problems were experienced that led to a sub-optimal operational efficiency. Lessons were learned and certain crucial changes were made to the architecture and software in preparation for the 2011 Pb-Pb run, in which HLT had a vital role performing data compression for ALICE's largest detector, the TPC. An overview of the status of the HLT and experience from the 2010/2011 production runs are presented. Emphasis is given to the overall performance, showing an improved efficiency and stability in 2011 compared to 2010, attributed to the significant improvements made to the system. Further opportunities for improvement are identified and discussed.

Operational experience with the ALICE High Level Trigger

International Nuclear Information System (INIS)

Szostak, Artur

2012-01-01

The ALICE HLT is a dedicated real-time system for online event reconstruction and triggering. Its main goal is to reduce the raw data volume read from the detectors by an order of magnitude, to fit within the available data acquisition bandwidth. This is accomplished by a combination of data compression and triggering. When HLT is enabled, data is recorded only for events selected by HLT. The combination of both approaches allows for flexible data reduction strategies. Event reconstruction places a high computational load on HLT. Thus, a large dedicated computing cluster is required, comprising 248 machines, all interconnected with InfiniBand. Running a large system like HLT in production mode proves to be a challenge. During the 2010 pp and Pb-Pb data-taking period, many problems were experienced that led to a sub-optimal operational efficiency. Lessons were learned and certain crucial changes were made to the architecture and software in preparation for the 2011 Pb-Pb run, in which HLT had a vital role performing data compression for ALICE's largest detector, the TPC. An overview of the status of the HLT and experience from the 2010/2011 production runs are presented. Emphasis is given to the overall performance, showing an improved efficiency and stability in 2011 compared to 2010, attributed to the significant improvements made to the system. Further opportunities for improvement are identified and discussed.

Metadata Schema Used in OCLC Sampled Web Pages

Directory of Open Access Journals (Sweden)

Fei Yu

2005-12-01

Full Text Available The tremendous growth of Web resources has made information organization and retrieval more and more difficult. As one approach to this problem, metadata schemas have been developed to characterize Web resources. However, many questions have been raised about the use of metadata schemas such as which metadata schemas have been used on the Web? How did they describe Web accessible information? What is the distribution of these metadata schemas among Web pages? Do certain schemas dominate the others? To address these issues, this study analyzed 16,383 Web pages with meta tags extracted from 200,000 OCLC sampled Web pages in 2000. It found that only 8.19% Web pages used meta tags; description tags, keyword tags, and Dublin Core tags were the only three schemas used in the Web pages. This article revealed the use of meta tags in terms of their function distribution, syntax characteristics, granularity of the Web pages, and the length distribution and word number distribution of both description and keywords tags.

Quantitative Comparison of the Microscopic Anatomy of the Human ACL Femoral and Tibial Entheses

Science.gov (United States)

Beaulieu, Mélanie L.; Carey, Grace E.; Schlecht, Stephen H.; Wojtys, Edward M.; Ashton-Miller, James A.

2015-01-01

The femoral enthesis of the human anterior cruciate ligament (ACL) is known to be more susceptible to injury than the tibial enthesis. To determine whether anatomic differences might help explain this difference, we quantified the microscopic appearance of both entheses in 15 unembalmed knee specimens using light microscopy, toluidine blue stain and image analysis. The amount of calcified fibrocartilage and uncalcified fibrocartilage, and the ligament entheseal attachment angle were then compared between the femoral and tibial entheses via linear mixed-effects models. The results showed marked differences in anatomy between the two entheses. The femoral enthesis exhibited a 3.9-fold more acute ligament attachment angle than the tibial enthesis (p fibrocartilage tissue area (p fibrocartilage depth (p fibrocartilage and a more acute ligament attachment angle than the tibial enthesis, which provides insight into why it is more vulnerable to failure. PMID:26134706

SDS-PAGE analysis of high molecular weight glutenin subunits in SP3 from spaceflight carried wheat

International Nuclear Information System (INIS)

Zhang Su'na; Lv Jinyin

2009-01-01

The compositions of high molecular weight glutenin subunits (HMW-GS) of the third generation (SP 3 ) of two wheat varieties spaceflight carried were analyzed by SDS-PAGE. The quality score of Glu-1 of each site was calculated according to the quality rating system. The results showed that the space flight carried could result in a higher frequency of HMW-GS gene mutation. The variance frequency of HMW-GS in SP 3 of Shaan253 and Xinong1043 were 27.08% and 27.45%, and the quality score in SP 3 of Shaan253 and Xinong1043 were 7 and 6, respectively. Shaan253 SP 3 generation mutants were considered as high-quality wheat. (authors)

40 CFR 1502.7 - Page limits.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Page limits. 1502.7 Section 1502.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT § 1502.7 Page limits. The text of final environmental impact statements (e.g., paragraphs (d) through (g) of § 1502.10...

Contact area between femoral tunnel and interference screw in anatomic rectangular tunnel ACL reconstruction: a comparison of outside-in and trans-portal inside-out techniques.

Science.gov (United States)

Hiramatsu, Kunihiko; Mae, Tatsuo; Tachibana, Yuta; Nakagawa, Shigeto; Shino, Konsei

2018-02-01

The purpose of this study was to compare the femoral tunnel length, the femoral graft bending angle at the femoral tunnel aperture, and the contact area between the femoral tunnel wall and an interference screw used for fixation in anatomic rectangular tunnel anterior cruciate ligament (ACL) reconstruction (ART ACLR). The study included 149 patients with primary ACL injury who underwent ART ACLR. Preoperatively, flexion angle of the index knee was checked under general anaesthesia. Those of less than 130° of passive flexion were assigned to the outside-in (OI) technique (78 patients), while the others to the trans-portal inside-out (TP) technique (71 patients). The patients underwent computed tomography with multiplanar reconstruction at 3-5 weeks post-operatively. Femoral tunnel length, graft bending angle, and contact ratio between the IFS and femoral tunnel were assessed. P contact ratio in the OI technique was significantly larger than that in the TP technique at every point in the femoral tunnel (P contact ratio than the TP technique after ART ACLR. Retrospective comparative study, Level III.

Page Recognition: Quantum Leap In Recognition Technology

Science.gov (United States)

Miller, Larry

1989-07-01

No milestone has proven as elusive as the always-approaching "year of the LAN," but the "year of the scanner" might claim the silver medal. Desktop scanners have been around almost as long as personal computers. And everyone thinks they are used for obvious desktop-publishing and business tasks like scanning business documents, magazine articles and other pages, and translating those words into files your computer understands. But, until now, the reality fell far short of the promise. Because it's true that scanners deliver an accurate image of the page to your computer, but the software to recognize this text has been woefully disappointing. Old optical-character recognition (OCR) software recognized such a limited range of pages as to be virtually useless to real users. (For example, one OCR vendor specified 12-point Courier font from an IBM Selectric typewriter: the same font in 10-point, or from a Diablo printer, was unrecognizable!) Computer dealers have told me the chasm between OCR expectations and reality is so broad and deep that nine out of ten prospects leave their stores in disgust when they learn the limitations. And this is a very important, very unfortunate gap. Because the promise of recognition -- what people want it to do -- carries with it tremendous improvements in our productivity and ability to get tons of written documents into our computers where we can do real work with it. The good news is that a revolutionary new development effort has led to the new technology of "page recognition," which actually does deliver the promise we've always wanted from OCR. I'm sure every reader appreciates the breakthrough represented by the laser printer and page-makeup software, a combination so powerful it created new reasons for buying a computer. A similar breakthrough is happening right now in page recognition: the Macintosh (and, I must admit, other personal computers) equipped with a moderately priced scanner and OmniPage software (from Caere

Instant PageSpeed optimization

CERN Document Server

Jaiswal, Sanjeev

2013-01-01

Filled with practical, step-by-step instructions and clear explanations for the most important and useful tasks. Instant PageSpeed Optimization is a hands-on guide that provides a number of clear, step-by-step exercises for optimizing your websites for better performance and improving their efficiency.Instant PageSpeed Optimization is aimed at website developers and administrators who wish to make their websites load faster without any errors and consume less bandwidth. It's assumed that you will have some experience in basic web technologies like HTML, CSS3, JavaScript, and the basics of netw

Comparison of femoral tunnel widening between outside-in and trans-tibial double-bundle ACL reconstruction.

Science.gov (United States)

Lee, Yong Seuk; Lee, Beom Koo; Oh, Won Seok; Cho, Yong Kyun

2014-09-01

The objectives of this study were to compare (1) the degree of widening by comparing the diameter at the most widened area and the site of widening by measuring the distance from the tunnel entrance to the most widened area in two femoral tunnels (anteromedial and posterolateral), and (2) the morphologic change at the tunnel entrance between outside-in and trans-tibial double-bundle anterior cruciate ligament (ACL) reconstruction. A retrospective study that included 17 trans-tibial and 19 outside-in double-bundle ACL reconstructed patients was conducted for evaluation of serial computed tomography (CT) scan (immediate post-operation and post-operative 1 year). Digital image communication in medicine (DICOM) data was extracted from the PiViewSTAR and imported into OsiriX, which was installed on a Macbook Pro laptop computer. Diameter of the most widened area and distance from the entrance to this point were measured from each of two perpendicular (sagittal and coronal) planes that were accurately realigned parallel to the tunnel direction. Change in the morphology of the tunnel entrance between immediate post-operation and 1-year post-operation was evaluated. Widening was observed in both planes of both tunnels in the two techniques. However, no statistical significances in the diameter of most widened area and distance from the tunnel entrance to the most widened point were observed between the both techniques (n.s.). Distances from the centre point to each four sections showed an increase in all four sections of all both tunnels in both techniques. However, no statistical significance was observed between the two techniques (n.s.). Widening was observed in all tunnels using both techniques and degrees, and sites of the widening did not differ between groups. Morphologic change at the tunnel entrance was not limited to the specific direction and occurred in all directions without significant difference between groups. Retrospective comparative study, Level III.

An Efficient PageRank Approach for Urban Traffic Optimization

Directory of Open Access Journals (Sweden)

Florin Pop

2012-01-01

to determine optimal decisions for each traffic light, based on the solution given by Larry Page for page ranking in Web environment (Page et al. (1999. Our approach is similar with work presented by Sheng-Chung et al. (2009 and Yousef et al. (2010. We consider that the traffic lights are controlled by servers and a score for each road is computed based on efficient PageRank approach and is used in cost function to determine optimal decisions. We demonstrate that the cumulative contribution of each car in the traffic respects the main constrain of PageRank approach, preserving all the properties of matrix consider in our model.

Educational use of World Wide Web pages on CD-ROM.

Science.gov (United States)

Engel, Thomas P; Smith, Michael

2002-01-01

The World Wide Web is increasingly important for medical education. Internet served pages may also be used on a local hard disk or CD-ROM without a network or server. This allows authors to reuse existing content and provide access to users without a network connection. CD-ROM offers several advantages over network delivery of Web pages for several applications. However, creating Web pages for CD-ROM requires careful planning. Issues include file names, relative links, directory names, default pages, server created content, image maps, other file types and embedded programming. With care, it is possible to create server based pages that can be copied directly to CD-ROM. In addition, Web pages on CD-ROM may reference Internet served pages to provide the best features of both methods.

CMS High Level Trigger Timing Measurements

International Nuclear Information System (INIS)

Richardson, Clint

2015-01-01

The two-level trigger system employed by CMS consists of the Level 1 (L1) Trigger, which is implemented using custom-built electronics, and the High Level Trigger (HLT), a farm of commercial CPUs running a streamlined version of the offline CMS reconstruction software. The operational L1 output rate of 100 kHz, together with the number of CPUs in the HLT farm, imposes a fundamental constraint on the amount of time available for the HLT to process events. Exceeding this limit impacts the experiment's ability to collect data efficiently. Hence, there is a critical need to characterize the performance of the HLT farm as well as the algorithms run prior to start up in order to ensure optimal data taking. Additional complications arise from the fact that the HLT farm consists of multiple generations of hardware and there can be subtleties in machine performance. We present our methods of measuring the timing performance of the CMS HLT, including the challenges of making such measurements. Results for the performance of various Intel Xeon architectures from 2009-2014 and different data taking scenarios are also presented. (paper)

ACL graft constructs: In-vitro fatigue testing highlights the occurrence of irrecoverable lengthening and the need for adequate (pre)conditioning to avert the recurrence of knee instability.

Science.gov (United States)

Blythe, A; Tasker, T; Zioupos, P

2006-01-01

The performance of ACL grafts in both the short and long term is only as good as the condition of the graft at the time of surgery. If the graft lengthens under load at the two fixation ends incorporation will take longer to occur. Previous studies have shown that the various grafts currently used are strong enough. However, data on strength came primarily from quasistatic single pull to failure tests with, in some cases, modest cycling to precondition the grafts. The present study examined the in-vitro biomechanical behaviour of model ACL grafts, which have been fatigue cycled to failure over a wide range of loads in physiological ambient conditions. Load/deformation curves and the stretch of the grafts was continuously recorded until final rupture. The grafts demonstrated typical creep-rupture like behaviour with elongation (non-recoverable stretch) and loss of stiffness leading to gradual failure. Some of the graft designs were consistently shown to elongate up to 20 mm in length within the first 2000 cycles at moderate physiological loads and a further 10 mm of elongation occurred between the initial preconditioned state and just prior to complete rupture. Not enough attention has been paid previously to the likely long term elongation patterns of ACL grafts post-surgery and even after the usual empirical preconditioning has been performed by the surgeon. Increased graft dimensions may result in recurrent knee instability and may also lead to failure of the graft to incorporate. Preconditioning in-vitro may still be a way to remove some slack and prepare the graft for its operational environment by stiffening in particular the tissue/fixation interface for those grafts that use soft polymer fixation ends.

Migrating Multi-page Web Applications to Single-page AJAX Interfaces

NARCIS (Netherlands)

Mesbah, A.; Van Deursen, A.

2006-01-01

Recently, a new web development technique for creating interactive web applications, dubbed AJAX, has emerged. In this new model, the single-page web interface is composed of individual components which can be updated/replaced independently. With the rise of AJAX web applications classical

Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial.

Science.gov (United States)

Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L; Lemmink, Koen A P M

2017-08-01

Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time. Ninety experienced basketball athletes performed sidestep cutting manoeuvres in three sessions (S1, S2 and S3). In this randomized controlled trial, athletes were allocated to three groups: visual (VIS), verbal (VER) and control (CTRL). Kinematics and kinetics were collected at the time of peak knee frontal plane moment. Males in the VIS group showed a larger vertical ground reaction force (S1: 25.4 ± 3.1 N/kg, S2: 25.8 ± 2.9 N/kg, S3: 25.2 ± 3.2 N/kg) and knee flexion moments (S1: -3.8 ± 0.9 Nm/kg, S2: -4.0 ± 1.2 Nm/kg, S3: -3.9 ± 1.3 Nm/kg) compared to the males in the VER and CTRL groups and to the females in the VIS group (p knee valgus moment and the females in the VER group reduced knee varus moment over time (n.s.). Male subjects clearly benefit from visual feedback. Females may need different feedback modes to learn a correct movement pattern. Sex-specific learning preferences may have to be acknowledged in day by day practice. Adding video instruction or feedback to regular training regimens when teaching athletes safe movement patterns and providing individual feedback might target suboptimal long-term results and optimize ACL injury prevention programmes. I.

Monte Carlo methods in PageRank computation: When one iteration is sufficient

NARCIS (Netherlands)

Avrachenkov, K.; Litvak, Nelli; Nemirovsky, D.; Osipova, N.

2005-01-01

PageRank is one of the principle criteria according to which Google ranks Web pages. PageRank can be interpreted as a frequency of visiting a Web page by a random surfer and thus it reflects the popularity of a Web page. Google computes the PageRank using the power iteration method which requires

Monte Carlo methods in PageRank computation: When one iteration is sufficient

NARCIS (Netherlands)

Avrachenkov, K.; Litvak, Nelli; Nemirovsky, D.; Osipova, N.

PageRank is one of the principle criteria according to which Google ranks Web pages. PageRank can be interpreted as a frequency of visiting a Web page by a random surfer, and thus it reflects the popularity of a Web page. Google computes the PageRank using the power iteration method, which requires

Assessing participation in the ACL injured population: Selecting a patient reported outcome measure on the basis of measurement properties.

Science.gov (United States)

Letchford, Robert; Sparkes, Valerie; van Deursen, Robert W M

2015-06-01

A return to pre injury activity participation remains a common but often elusive goal following ACL injury. Investigations to improve our understanding of participation restrictions are limited by inconsistent use of insufficiently investigated measurement tools. The aim of this study was to follow the consensus based standards for the selection of health measurement instruments (COSMIN) guideline to provide a comparative evaluation of four patient reported outcomes (PROMs) on the basis of measurement properties. This will inform recommendations for measuring participation of ACL injured subjects, particularly in the United Kingdom (UK) National Health Service (NHS). Thirteen criteria were compiled from the COSMIN guideline. These included reliability, measurement error, content validity, construct validity, responsiveness and interpretability. Data from 51 subjects collected as part of a longitudinal observational study of recovery over the first year following ACLR was used in the analysis. Of the thirteen criteria, the required standard was met in 11 for Tegner, 11 for International Knee Documentation Committee (IKDC), 6 for Cincinnati Sports Activity Scale (CSAS) and 6 for Marx. The two weaknesses identified for the Tegner are more easily compensated for during interpretation than those in the IKDC; for this reason the Tegner is the recommended PROM. The Tegner activity rating scale performed consistently well in respect of all measurement properties in this sample, with clear benefits over the other PROMs. The measurement properties presented should be used to inform implementation and interpretation of this outcome measure in clinical practice and research. Level II prospective study. Copyright © 2015 Elsevier B.V. All rights reserved.

ALICE high-level trigger readout and FPGA processing in Run 2

Energy Technology Data Exchange (ETDEWEB)

Engel, Heiko; Kebschull, Udo [IRI, Goethe-Universitaet Frankfurt (Germany); Collaboration: ALICE-Collaboration

2016-07-01

The ALICE experiment uses the optical Detector Data Link (DDL) protocol to connect the detectors to the computing clusters of Data Acquisition (DAQ) and High-Level Trigger (HLT). The interfaces between the clusters and the optical links are realized with FPGA boards. HLT has replaced all of its interface boards with the Common Read-Out Receiver Card (C-RORC) for Run 2. This enables the read-out of detectors at higher link rates and allows to extend the data pre-processing capabilities, like online cluster finding, already in the FPGA. The C-RORC is integrated transparently into the existing HLT data transport framework and the cluster monitoring and management infrastructure. The board is in use since the start of LHC Run 2 and all ALICE data from and to HLT as well as all data from the TPC and the TRD is handled by C-RORCs. This contribution gives an overview on the firmware and software status of the C-RORC in the HLT.

Electrons and photons at High Level Trigger in CMS for Run II

CERN Document Server

Bin Anuar, Afiq Aizuddin

2015-01-01

The CMS experiment has been designed with a 2-level trigger system. The first level is implemented using custom-designed electronics. The second level is the so-called High Level Trigger (HLT), a streamlined version of the CMS offline reconstruction software running on a computer farm. For Run II of the Large Hadron Collider, the increase in center-of-mass energy and luminosity will raise the event rate to a level challenging for the HLT algorithms. New approaches have been studied to keep the HLT output rate manageable while maintaining thresholds low enough to cover physics analyses. The strategy mainly relies on porting online the ingredients that have been successfully applied in the offline reconstruction, thus allowing to move HLT selection closer to offline cuts. Improvements in HLT electron and photon definitions will be presented, focusing in particular on updated clustering algorithm and the energy calibration procedure, new Particle-Flow-based isolation approach and pileup mitigation techniques, a...

A Note on the PageRank of Undirected Graphs

OpenAIRE

Grolmusz, Vince

2012-01-01

The PageRank is a widely used scoring function of networks in general and of the World Wide Web graph in particular. The PageRank is defined for directed graphs, but in some special cases applications for undirected graphs occur. In the literature it is widely noted that the PageRank for undirected graphs are proportional to the degrees of the vertices of the graph. We prove that statement for a particular personalization vector in the definition of the PageRank, and we also show that in gene...

Dicty_cDB: FC-AI08 [Dicty_cDB

Lifescience Database Archive (English)

Full Text Available FC (Link to library) FC-AI08 (Link to dictyBase) - G01729 DDB0233148 Contig-U14939-1 FC-AI...08P (Link to Original site) FC-AI08F 654 FC-AI08Z 563 FC-AI08P 1217 - - Show FC-AI08 Library FC (Link... to library) Clone ID FC-AI08 (Link to dictyBase) Atlas ID - NBRP ID G01729 dictyBase ID DDB0233148 Link to ...Contig Contig-U14939-1 Original site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI...08Q.Seq.d/ Representative seq. ID FC-AI08P (Link to Original site) Representative DNA sequence >FC-AI08 (FC-AI

Optimization of the muon reconstruction algorithms for LHCb Run 2

CERN Document Server

Aaij, Roel; Dettori, Francesco; Dungs, Kevin; Lopes, Helder; Martinez Santos, Diego; Prisciandaro, Jessica; Sciascia, Barbara; Syropoulos, Vasileios; Stahl, Sascha; Vazquez Gomez, Ricardo

2017-01-01

The muon identification algorithm in the LHCb HLT software trigger and offline reconstruction has been revisited in view of the LHC Run 2. This software has undergone a significant refactorisation, resulting in a modularized common code base between the HLT and offline event processing. Because of the latter, the muon identification is now identical in HLT and offline. The HLT1 algorithm sequence has been updated given the new rate and timing constraints. Also, information from the TT subdetector is used in order to reduce ghost tracks and optimize for low $p_T$ muons. The current software is presented here together with performance studies showing improved efficiencies and reduced timing.

Digital Ethnography: Library Web Page Redesign among Digital Natives

Science.gov (United States)

Klare, Diane; Hobbs, Kendall

2011-01-01

Presented with an opportunity to improve Wesleyan University's dated library home page, a team of librarians employed ethnographic techniques to explore how its users interacted with Wesleyan's current library home page and web pages in general. Based on the data that emerged, a group of library staff and members of the campus' information…

Web page sorting algorithm based on query keyword distance relation

Science.gov (United States)

Yang, Han; Cui, Hong Gang; Tang, Hao

2017-08-01

In order to optimize the problem of page sorting, according to the search keywords in the web page in the relationship between the characteristics of the proposed query keywords clustering ideas. And it is converted into the degree of aggregation of the search keywords in the web page. Based on the PageRank algorithm, the clustering degree factor of the query keyword is added to make it possible to participate in the quantitative calculation. This paper proposes an improved algorithm for PageRank based on the distance relation between search keywords. The experimental results show the feasibility and effectiveness of the method.

MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

Energy Technology Data Exchange (ETDEWEB)

Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

2011-12-15

Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

CrazyEgg Reports for Single Page Analysis

Science.gov (United States)

CrazyEgg provides an in depth look at visitor behavior on one page. While you can use GA to do trend analysis of your web area, CrazyEgg helps diagnose the design of a single Web page by visually displaying all visitor clicks during a specified time.

DAQ

CERN Multimedia

F. Meijers

2011-01-01

Operation for the 2011 physics run For the 2011 run, the HLT farm has been extended with additional PCs comprising 288 system boards with two 6-core CPUs each. This brought the total HLT capacity from 5760 cores to 9216 cores and 18 TB of memory. It provides a capacity for HLT of about 100 ms/event (on a 2.7 GHz E5430 core) at 100 kHz L1 rate in pp collisions. All central DAQ nodes have been migrated to SLC5/64-bit kernel and 64-bit applications. The DAQ system has been deployed for pp physics data-taking in 2011 and performed with high efficiency (downtime for central DAQ was less than 1%). For pp physics data-taking, the DAQ was operating with a L1 trigger rate up to ~100 kHz and, typically, a raw event size of ~500 kB, and ~400 Hz recording of stream-A (which includes all physics triggers) with a size of ~250 kB after compression. The event size increases linearly with the pile-up, as expected. The CPU load on the HLT reached close to 100%, depending on L1 and HLT menus. By changing the L1 and HLT pre-...

An Adaptive Reordered Method for Computing PageRank

Directory of Open Access Journals (Sweden)

Yi-Ming Bu

2013-01-01

Full Text Available We propose an adaptive reordered method to deal with the PageRank problem. It has been shown that one can reorder the hyperlink matrix of PageRank problem to calculate a reduced system and get the full PageRank vector through forward substitutions. This method can provide a speedup for calculating the PageRank vector. We observe that in the existing reordered method, the cost of the recursively reordering procedure could offset the computational reduction brought by minimizing the dimension of linear system. With this observation, we introduce an adaptive reordered method to accelerate the total calculation, in which we terminate the reordering procedure appropriately instead of reordering to the end. Numerical experiments show the effectiveness of this adaptive reordered method.

Using shadow page cache to improve isolated drivers performance.

Science.gov (United States)

Zheng, Hao; Dong, Xiaoshe; Wang, Endong; Chen, Baoke; Zhu, Zhengdong; Liu, Chengzhe

2015-01-01

With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users' virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver's write operations by the method of combining a driver's write operation capture and a driver's private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver's write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages' write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot's reliability too much.

Training Activity Summary Page (TASP) State and Tribe

Data.gov (United States)

U.S. Department of Health & Human Services — The Training Activity Summary Page (formerly the Training Exit Survey Cover Page) dataset contains data about each training event. This dataset includes information...

stage/page/play

DEFF Research Database (Denmark)

context. Contributors: Per Brask, Dario Fo, Jette Barnholdt Hansen, Pil Hansen, Sven Åke Heed, Ulla Kallenbach, Sofie Kluge, Annelis Kuhlmann, Kela Kvam, Anna Lawaetz, Bent Flemming Nielsen, Franco Perrelli, Magnus Tessing Schneider, Antonio Scuderi. stage/page/play is published as a festschrift...

Give your feedback on the new Users’ page

CERN Multimedia

CERN Bulletin

If you haven't already done so, visit the new Users’ page and provide the Communications group with your feedback. You can do this quickly and easily via an online form. A dedicated web steering group will design the future page on the basis of your comments. As a first step towards reforming the CERN website, the Communications group is proposing a ‘beta’ version of the Users’ pages. The primary aim of this version is to improve the visibility of key news items, events and announcements to the CERN community. The beta version is very much work in progress: your input is needed to make sure that the final site meets the needs of CERN’s wide and mixed community. The Communications group will read all your comments and suggestions, and will establish a web steering group that will make sure that the future CERN web pages match the needs of the community. More information on this process, including the gradual 'retirement' of the grey Users' pages we are a...

Classroom Web Pages: A "How-To" Guide for Educators.

Science.gov (United States)

Fehling, Eric E.

This manual provides teachers, with very little or no technology experience, with a step-by-step guide for developing the necessary skills for creating a class Web Page. The first part of the manual is devoted to the thought processes preceding the actual creation of the Web Page. These include looking at other Web Pages, deciding what should be…

OnlineMin: A Fast Strongly Competitive Randomized Paging Algorithm

DEFF Research Database (Denmark)

Brodal, Gerth Stølting; Moruz, Gabriel; Negoescu, Andrei

2012-01-01

approach that both has optimal competitiveness and selects victim pages in subquadratic time. In fact, if k pages fit in internal memory the best previous solution required O(k 2) time per request and O(k) space, whereas our approach takes also O(k) space, but only O(logk) time in the worst case per page...

Functional Multiplex PageRank

Science.gov (United States)

Iacovacci, Jacopo; Rahmede, Christoph; Arenas, Alex; Bianconi, Ginestra

2016-10-01

Recently it has been recognized that many complex social, technological and biological networks have a multilayer nature and can be described by multiplex networks. Multiplex networks are formed by a set of nodes connected by links having different connotations forming the different layers of the multiplex. Characterizing the centrality of the nodes in a multiplex network is a challenging task since the centrality of the node naturally depends on the importance associated to links of a certain type. Here we propose to assign to each node of a multiplex network a centrality called Functional Multiplex PageRank that is a function of the weights given to every different pattern of connections (multilinks) existent in the multiplex network between any two nodes. Since multilinks distinguish all the possible ways in which the links in different layers can overlap, the Functional Multiplex PageRank can describe important non-linear effects when large relevance or small relevance is assigned to multilinks with overlap. Here we apply the Functional Page Rank to the multiplex airport networks, to the neuronal network of the nematode C. elegans, and to social collaboration and citation networks between scientists. This analysis reveals important differences existing between the most central nodes of these networks, and the correlations between their so-called pattern to success.

Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions.

Science.gov (United States)

Koutras, Georgios; Bernard, Manfred; Terzidis, Ioannis P; Papadopoulos, Pericles; Georgoulis, Anastasios; Pappas, Evangelos

2016-07-01

Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Recognition of pornographic web pages by classifying texts and images.

Science.gov (United States)

Hu, Weiming; Wu, Ou; Chen, Zhouyao; Fu, Zhouyu; Maybank, Steve

2007-06-01

With the rapid development of the World Wide Web, people benefit more and more from the sharing of information. However, Web pages with obscene, harmful, or illegal content can be easily accessed. It is important to recognize such unsuitable, offensive, or pornographic Web pages. In this paper, a novel framework for recognizing pornographic Web pages is described. A C4.5 decision tree is used to divide Web pages, according to content representations, into continuous text pages, discrete text pages, and image pages. These three categories of Web pages are handled, respectively, by a continuous text classifier, a discrete text classifier, and an algorithm that fuses the results from the image classifier and the discrete text classifier. In the continuous text classifier, statistical and semantic features are used to recognize pornographic texts. In the discrete text classifier, the naive Bayes rule is used to calculate the probability that a discrete text is pornographic. In the image classifier, the object's contour-based features are extracted to recognize pornographic images. In the text and image fusion algorithm, the Bayes theory is used to combine the recognition results from images and texts. Experimental results demonstrate that the continuous text classifier outperforms the traditional keyword-statistics-based classifier, the contour-based image classifier outperforms the traditional skin-region-based image classifier, the results obtained by our fusion algorithm outperform those by either of the individual classifiers, and our framework can be adapted to different categories of Web pages.

WebScore: An Effective Page Scoring Approach for Uncertain Web Social Networks

Directory of Open Access Journals (Sweden)

Shaojie Qiao

2011-10-01

Full Text Available To effectively score pages with uncertainty in web social networks, we first proposed a new concept called transition probability matrix and formally defined the uncertainty in web social networks. Second, we proposed a hybrid page scoring algorithm, called WebScore, based on the PageRank algorithm and three centrality measures including degree, betweenness, and closeness. Particularly,WebScore takes into a full consideration of the uncertainty of web social networks by computing the transition probability from one page to another. The basic idea ofWebScore is to: (1 integrate uncertainty into PageRank in order to accurately rank pages, and (2 apply the centrality measures to calculate the importance of pages in web social networks. In order to verify the performance of WebScore, we developed a web social network analysis system which can partition web pages into distinct groups and score them in an effective fashion. Finally, we conducted extensive experiments on real data and the results show that WebScore is effective at scoring uncertain pages with less time deficiency than PageRank and centrality measures based page scoring algorithms.

Buying a Constant Competitive Ratio for Paging

NARCIS (Netherlands)

Csirik, János; Imreh, Csanád; Noga, John; Seiden, Steve S.; Woeginger, Gerhard; Meyer auf der Heide, Friedhelm

2001-01-01

We consider a variant of the online paging problem where the online algorithm may buy additional cache slots at a certain cost. The overall cost incurred equals the total cost for the cache plus the number of page faults. This problem and our results are a generalization of both, the classical

Buying a constant competitive ratio for paging

NARCIS (Netherlands)

Csirik, J.; Imreh, Cs.; Noga, J.; Seiden, S.S.; Woeginger, G.J.; Meyer auf der Heide, F.

2001-01-01

We consider a variant of the online paging problem where the online algorithm may buy additional cache slots at a certain cost. The overall cost incurred equals the total cost for the cache plus the number of page faults. This problem and our results are a generalization of both, the classical

THE INFLUENCE OF SEX AND MATURATION ON LANDING BIOMECHANICS: IMPLICATIONS FOR ACL INJURY

Science.gov (United States)

Sigward, S. M.; Pollard, C. D.; Powers, C. M.

2010-01-01

During landing and cutting, females exhibit greater frontal plane moments at the knee (internal knee adductor moments or external knee abduction moments) and favor use of the knee extensors over the hip extensors to attenuate impact forces when compared to males. However, it is not known when this biomechanical profile emerges. The purpose of this study was to compare landing biomechanics between sexes across maturation levels. One hundred and nineteen male and female soccer players (9–22 years) participated. Subjects were grouped based on maturational development. Lower extremity kinematics and kinetics were obtained during a drop-land task. Dependent variables included the average internal knee adductor moment and sagittal plane knee/hip moment and energy absorption ratios during the deceleration phase of landing. When averaged across maturation levels, females demonstrated greater internal knee adductor moments (0.06±0.03 vs. 0.01±0.02 Nm/kg*m; Pbiomechanical pattern that increases ACL loading. This biomechanical strategy already was established in pre-pubertal female athletes. PMID:21210853

Exploring the use of a Facebook page in anatomy education.

Science.gov (United States)

Jaffar, Akram Abood

2014-01-01

Facebook is the most popular social media site visited by university students on a daily basis. Consequently, Facebook is the logical place to start with for integrating social media technologies into education. This study explores how a faculty-administered Facebook Page can be used to supplement anatomy education beyond the traditional classroom. Observations were made on students' perceptions and effectiveness of using the Page, potential benefits and challenges of such use, and which Insights metrics best reflect user's engagement. The Human Anatomy Education Page was launched on Facebook and incorporated into anatomy resources for 157 medical students during two academic years. Students' use of Facebook and their perceptions of the Page were surveyed. Facebook's "Insights" tool was also used to evaluate Page performance during a period of 600 days. The majority of in-class students had a Facebook account which they adopted in education. Most students perceived Human Anatomy Education Page as effective in contributing to learning and favored "self-assessment" posts. The majority of students agreed that Facebook could be a suitable learning environment. The "Insights" tool revealed globally distributed fans with considerable Page interactions. The use of a faculty-administered Facebook Page provided a venue to enhance classroom teaching without intruding into students' social life. A wider educational use of Facebook should be adopted not only because students are embracing its use, but for its inherent potentials in boosting learning. The "Insights" metrics analyzed in this study might be helpful when establishing and evaluating the performance of education-oriented Facebook Pages. © 2013 American Association of Anatomists.

Three results on the PageRank vector: eigenstructure, sensitivity, and the derivative

OpenAIRE

Gleich, David; Glynn, Peter; Golub, Gene; Greif, Chen

2007-01-01

The three results on the PageRank vector are preliminary but shed light on the eigenstructure of a PageRank modified Markov chain and what happens when changing the teleportation parameter in the PageRank model. Computations with the derivative of the PageRank vector with respect to the teleportation parameter show predictive ability and identify an interesting set of pages from Wikipedia.

PageRank tracker: from ranking to tracking.

Science.gov (United States)

Gong, Chen; Fu, Keren; Loza, Artur; Wu, Qiang; Liu, Jia; Yang, Jie

2014-06-01

Video object tracking is widely used in many real-world applications, and it has been extensively studied for over two decades. However, tracking robustness is still an issue in most existing methods, due to the difficulties with adaptation to environmental or target changes. In order to improve adaptability, this paper formulates the tracking process as a ranking problem, and the PageRank algorithm, which is a well-known webpage ranking algorithm used by Google, is applied. Labeled and unlabeled samples in tracking application are analogous to query webpages and the webpages to be ranked, respectively. Therefore, determining the target is equivalent to finding the unlabeled sample that is the most associated with existing labeled set. We modify the conventional PageRank algorithm in three aspects for tracking application, including graph construction, PageRank vector acquisition and target filtering. Our simulations with the use of various challenging public-domain video sequences reveal that the proposed PageRank tracker outperforms mean-shift tracker, co-tracker, semiboosting and beyond semiboosting trackers in terms of accuracy, robustness and stability.

Upgrade of CERN OP Webtools IRRAD Page

CERN Document Server

Vik, Magnus Bjerke

2017-01-01

CERN Beams Department maintains a website with various tools for the Operations Group, with one of them being specific for the Proton Irradiation Facility (IRRAD). The IRRAD team use the tool to follow up and optimize the operation of the facility. The original version of the tool was difficult to maintain and adding new features to the page was challenging. Thus this summer student project is aimed to upgrade the web page by rewriting the web page with maintainability and flexibility in mind. The new application uses a server--client architecture with a REST API on the back end which is used by the front end to request data for visualization. PHP is used on the back end to implement the API's and Swagger is used to document them. Vue, Semantic UI, Webpack, Node and ECMAScript 5 is used on the fronted to visualize and administrate the data. The result is a new IRRAD operations web application with extended functionality, improved structure and an improved user interface. It includes a new Status Panel page th...

No Hawking-Page phase transition in three dimensions

International Nuclear Information System (INIS)

Myung, Y.S.

2005-01-01

We investigate whether or not the Hawking-Page phase transition is possible to occur in three dimensions. Starting with the simplest class of Lanczos-Lovelock action, thermodynamic behavior of all AdS-type black holes without charge falls into two classes: Schwarzschild-AdS black holes in even dimensions and Chern-Simons black holes in odd dimensions. The former class can provide the Hawking-Page transition between Schwarzschild-AdS black holes and thermal AdS space. On the other hand, the latter class is exceptional and thus the Hawking-Page transition is hard to occur. In three dimensions, a second-order phase transition might occur between the non-rotating BTZ black hole and the massless BTZ black hole (thermal AdS space), instead of the first-order Hawking-Page transition between the non-rotating BTZ black hole and thermal AdS space

The impact of Arizona Highways Magazine's facebook page.

Science.gov (United States)

2014-02-01

This project examined the relationship between use of the Arizona Highways magazine (AHM) Facebook Page and the decision to : travel to or within Arizona. Key purposes were to: (1) provide a thorough understanding of AHM Facebook Page users, includin...

Customisation of Indico pages - Layout and Menus

CERN Multimedia

CERN. Geneva; Ferreira, Pedro

2017-01-01

In this tutorial you are going to learn how to customize the layout of your Indico pages (for example you can change the color of the background images or change the logo) and the menus on your Indico pages  (for example you can add or hide certain blocks, or change their name and order).  

EDUCATIONAL PAGES IN FACEBOOK - A STUDY

OpenAIRE

Dr.N.Ramakrishnan; Mrs. R.PrasithaIndhumathy

2017-01-01

Facebook Pages are a great resource for educational technology professionals to find companies, thought leaders, groups and organizations to share ideas and experiences with peers while expanding industry knowledge and increasing connections. Like most Facebook users, many educators use Facebook to connect with friends new and old, but the Internet's most popular site can also be a great learning and teaching tool. There are many Facebook pages that have been created as a resource to collect,...

Required Discussion Web Pages in Psychology Courses and Student Outcomes

Science.gov (United States)

Pettijohn, Terry F., II; Pettijohn, Terry F.

2007-01-01

We conducted 2 studies that investigated student outcomes when using discussion Web pages in psychology classes. In Study 1, we assigned 213 students enrolled in Introduction to Psychology courses to either a mandatory or an optional Web page discussion condition. Students used the discussion Web page significantly more often and performed…

Automatically annotating web pages using Google Rich Snippets

NARCIS (Netherlands)

Hogenboom, F.P.; Frasincar, F.; Vandic, D.; Meer, van der J.; Boon, F.; Kaymak, U.

2011-01-01

We propose the Automatic Review Recognition and annO- tation of Web pages (ARROW) framework, a framework for Web page review identification and annotation using RDFa Google Rich Snippets. The ARROW framework consists of four steps: hotspot identification, subjectivity analysis, in- formation

Web Page Recommendation Using Web Mining

OpenAIRE

Modraj Bhavsar; Mrs. P. M. Chavan

2014-01-01

On World Wide Web various kind of content are generated in huge amount, so to give relevant result to user web recommendation become important part of web application. On web different kind of web recommendation are made available to user every day that includes Image, Video, Audio, query suggestion and web page. In this paper we are aiming at providing framework for web page recommendation. 1) First we describe the basics of web mining, types of web mining. 2) Details of each...

Electrical conductivity of cobalt doped La 0.8Sr 0.2Ga 0.8Mg 0.2O 3- δ

Science.gov (United States)

Wang, Shizhong; Wu, Lingli; Liang, Ying

La 0.8Sr 0.2Ga 0.8Mg 0.2O 3- δ (LSGM8282), La 0.8Sr 0.2Ga 0.8Mg 0.15Co 0.05O 3- δ (LSGMC5) and La 0.8Sr 0.2Ga 0.8Mg 0.115Co 0.085O 3- δ (LSGMC8.5) were prepared using a conventional solid-state reaction. Electrical conductivities and electronic conductivities of the samples were measured using four-probe impedance spectrometry, four-probe dc polarization and Hebb-Wagner polarization within the temperature range of 973-1173 K. The electrical conductivities in LSGMC5 and LSGMC8.5 increased with decreasing oxygen partial pressures especially in the high (>10 -5 atm) and low oxygen partial pressure regions (lanthanum gallate samples increased with increasing concentration of cobalt, suggesting that the concentration of cobalt should be optimized carefully to maintain a high electrical conductivity and close to 1 oxygen ion transference number.

The CMS High Level Trigger System

CERN Document Server

Afaq, A; Bauer, G; Biery, K; Boyer, V; Branson, J; Brett, A; Cano, E; Carboni, A; Cheung, H; Ciganek, M; Cittolin, S; Dagenhart, W; Erhan, S; Gigi, D; Glege, F; Gómez-Reino, Robert; Gulmini, M; Gutiérrez-Mlot, E; Gutleber, J; Jacobs, C; Kim, J C; Klute, M; Kowalkowski, J; Lipeles, E; Lopez-Perez, Juan Antonio; Maron, G; Meijers, F; Meschi, E; Moser, R; Murray, S; Oh, A; Orsini, L; Paus, C; Petrucci, A; Pieri, M; Pollet, L; Rácz, A; Sakulin, H; Sani, M; Schieferdecker, P; Schwick, C; Sexton-Kennedy, E; Sumorok, K; Suzuki, I; Tsirigkas, D; Varela, J

2007-01-01

The CMS Data Acquisition (DAQ) System relies on a purely software driven High Level Trigger (HLT) to reduce the full Level-1 accept rate of 100 kHz to approximately 100 Hz for archiving and later offline analysis. The HLT operates on the full information of events assembled by an event builder collecting detector data from the CMS front-end systems. The HLT software consists of a sequence of reconstruction and filtering modules executed on a farm of O(1000) CPUs built from commodity hardware. This paper presents the architecture of the CMS HLT, which integrates the CMS reconstruction framework in the online environment. The mechanisms to configure, control, and monitor the Filter Farm and the procedures to validate the filtering code within the DAQ environment are described.

SPAX - PAX with Super-Pages

Science.gov (United States)

Bößwetter, Daniel

Much has been written about the pros and cons of column-orientation as a means to speed up read-mostly analytic workloads in relational databases. In this paper we try to dissect the primitive mechanisms of a database that help express the coherence of tuples and present a novel way of organizing relational data in order to exploit the advantages of both, the row-oriented and the column-oriented world. As we go, we break with yet another bad habit of databases, namely the equal granularity of reads and writes which leads us to the introduction of consecutive clusters of disk pages called super-pages.

Decomposition of the Google PageRank and Optimal Linking Strategy

NARCIS (Netherlands)

Avrachenkov, Konstatin; Litvak, Nelli

We provide the analysis of the Google PageRank from the perspective of the Markov Chain Theory. First we study the Google PageRank for a Web that can be decomposed into several connected components which do not have any links to each other. We show that in order to determine the Google PageRank for

Enhancing the Ranking of a Web Page in the Ocean of Data

Directory of Open Access Journals (Sweden)

Hitesh KUMAR SHARMA

2013-10-01

Full Text Available In today's world, web is considered as ocean of data and information (like text, videos, multimedia etc. consisting of millions and millions of web pages in which web pages are linked with each other like a tree. It is often argued that, especially considering the dynamic of the internet, too much time has passed since the scientific work on PageRank, as that it still could be the basis for the ranking methods of the Google search engine. There is no doubt that within the past years most likely many changes, adjustments and modifications regarding the ranking methods of Google have taken place, but PageRank was absolutely crucial for Google's success, so that at least the fundamental concept behind PageRank should still be constitutive. This paper describes the components which affects the ranking of the web pages and helps in increasing the popularity of web site. By adapting these factors website developers can increase their site's page rank and within the PageRank concept, considering the rank of a document is given by the rank of those documents which link to it. Their rank again is given by the rank of documents which link to them. The PageRank of a document is always determined recursively by the PageRank of other documents.

Automatic Hidden-Web Table Interpretation by Sibling Page Comparison

Science.gov (United States)

Tao, Cui; Embley, David W.

The longstanding problem of automatic table interpretation still illudes us. Its solution would not only be an aid to table processing applications such as large volume table conversion, but would also be an aid in solving related problems such as information extraction and semi-structured data management. In this paper, we offer a conceptual modeling solution for the common special case in which so-called sibling pages are available. The sibling pages we consider are pages on the hidden web, commonly generated from underlying databases. We compare them to identify and connect nonvarying components (category labels) and varying components (data values). We tested our solution using more than 2,000 tables in source pages from three different domains—car advertisements, molecular biology, and geopolitical information. Experimental results show that the system can successfully identify sibling tables, generate structure patterns, interpret tables using the generated patterns, and automatically adjust the structure patterns, if necessary, as it processes a sequence of hidden-web pages. For these activities, the system was able to achieve an overall F-measure of 94.5%.

Multiplex PageRank.

Directory of Open Access Journals (Sweden)

Arda Halu

Full Text Available Many complex systems can be described as multiplex networks in which the same nodes can interact with one another in different layers, thus forming a set of interacting and co-evolving networks. Examples of such multiplex systems are social networks where people are involved in different types of relationships and interact through various forms of communication media. The ranking of nodes in multiplex networks is one of the most pressing and challenging tasks that research on complex networks is currently facing. When pairs of nodes can be connected through multiple links and in multiple layers, the ranking of nodes should necessarily reflect the importance of nodes in one layer as well as their importance in other interdependent layers. In this paper, we draw on the idea of biased random walks to define the Multiplex PageRank centrality measure in which the effects of the interplay between networks on the centrality of nodes are directly taken into account. In particular, depending on the intensity of the interaction between layers, we define the Additive, Multiplicative, Combined, and Neutral versions of Multiplex PageRank, and show how each version reflects the extent to which the importance of a node in one layer affects the importance the node can gain in another layer. We discuss these measures and apply them to an online multiplex social network. Findings indicate that taking the multiplex nature of the network into account helps uncover the emergence of rankings of nodes that differ from the rankings obtained from one single layer. Results provide support in favor of the salience of multiplex centrality measures, like Multiplex PageRank, for assessing the prominence of nodes embedded in multiple interacting networks, and for shedding a new light on structural properties that would otherwise remain undetected if each of the interacting networks were analyzed in isolation.

Multiplex PageRank.

Science.gov (United States)

Halu, Arda; Mondragón, Raúl J; Panzarasa, Pietro; Bianconi, Ginestra

2013-01-01

Many complex systems can be described as multiplex networks in which the same nodes can interact with one another in different layers, thus forming a set of interacting and co-evolving networks. Examples of such multiplex systems are social networks where people are involved in different types of relationships and interact through various forms of communication media. The ranking of nodes in multiplex networks is one of the most pressing and challenging tasks that research on complex networks is currently facing. When pairs of nodes can be connected through multiple links and in multiple layers, the ranking of nodes should necessarily reflect the importance of nodes in one layer as well as their importance in other interdependent layers. In this paper, we draw on the idea of biased random walks to define the Multiplex PageRank centrality measure in which the effects of the interplay between networks on the centrality of nodes are directly taken into account. In particular, depending on the intensity of the interaction between layers, we define the Additive, Multiplicative, Combined, and Neutral versions of Multiplex PageRank, and show how each version reflects the extent to which the importance of a node in one layer affects the importance the node can gain in another layer. We discuss these measures and apply them to an online multiplex social network. Findings indicate that taking the multiplex nature of the network into account helps uncover the emergence of rankings of nodes that differ from the rankings obtained from one single layer. Results provide support in favor of the salience of multiplex centrality measures, like Multiplex PageRank, for assessing the prominence of nodes embedded in multiple interacting networks, and for shedding a new light on structural properties that would otherwise remain undetected if each of the interacting networks were analyzed in isolation.

Page: a program for gamma spectra analysis in PC microcomputers

International Nuclear Information System (INIS)

Goncalves, M.A.; Yamaura, M.; Costa, G.J.C.; Carvalho, E.I. de; Matsuda, H.T.; Araujo, B.F. de.

1991-04-01

PAGE is a software package, written in BASIC language, to perform gamma spectra analysis. It was developed to be used in a high-purity intrinsic germanium detector-multichannel analyser-PC microcomputer system. The analysis program of PAGE package accomplishes functions as follows: peak location; gamma nuclides identification; activity determination. Standard nuclides sources were used to calibrate the system. To perform the efficiency x energy calibration a logarithmic fit was applied. Analysis of nuclides with overlapping peaks is allowed by PAGE program. PAGE has additional auxiliary programs for: building and list of isotopic nuclear data libraries; data acquisition from multichannel analyser; spectrum display with automatic area and FWHM determinations. This software is to be applied in analytical process control where time response is a very important parameter. PAGE takes ca. 1.5 minutes to analyse a complex spectrum from a 4096 channels MCA. (author)

PageRank, HITS and a unified framework for link analysis

Energy Technology Data Exchange (ETDEWEB)

Ding, Chris; He, Xiaofeng; Husbands, Parry; Zha, Hongyuan; Simon, Horst

2001-10-01

Two popular webpage ranking algorithms are HITS and PageRank. HITS emphasizes mutual reinforcement between authority and hub webpages, while PageRank emphasizes hyperlink weight normalization and web surfing based on random walk models. We systematically generalize/combine these concepts into a unified framework. The ranking framework contains a large algorithm space; HITS and PageRank are two extreme ends in this space. We study several normalized ranking algorithms which are intermediate between HITS and PageRank, and obtain closed-form solutions. We show that, to first order approximation, all ranking algorithms in this framework, including PageRank and HITS, lead to same ranking which is highly correlated with ranking by indegree. These results support the notion that in web resource ranking indegree and outdegree are of fundamental importance. Rankings of webgraphs of different sizes and queries are presented to illustrate our analysis.

Patients With Ligament Hiperlaxity With Rupture Of Previous Plastic For ACL. Reconstruction With Intra-articular And Extra-articular Combined Technics

Science.gov (United States)

Astore, Ignacio; Agotegaray, Juan Ignacio; Comba, Ignacio; Bisiach, Luciana

2017-01-01

Introduction: In cases of patients with ligament hiperlaxity with rupture of ACL, the use of a BTB graft is recommended for its reconstruction. Our job consists of the clinical and functional assessment of a group of 10 patients with ligament laxaty according to Beighton scale, who, after surgery for ACL rupture with BTB technique, suffered a rupture of the plastic. For its reconstruction a combination of intra-articular and extra-articular techniques was used with a BTB graft in the contralateral knee, associated with a modified Lemaire technique. Methods: The series consists of 10 patients, male, average age of 24.2 years, amateur athletes, operated for a second time in March, 2011 and November, 2013, with a minimum follow-up of 24 months. They were evaluated before surgery and 24 months after surgery based on Lysholm scale, IKDC evaluation form and a physical exam (Lachman - Pivot Shift). Results: After surgery, the average in Lysholm scale was of 87.6 and 86.3 for the IKDC subjetive form. In the physical exam, 8 patients showed Lachman 1+, while none of the patients showed Pivot Shift positive. 7 patients were able to return to their usual sport activities. As a postoperative disadvantage, 6 patients reported pain in the external face of the knee in the first 6 months. And 4 patients reported a subjetive loss of full extension that did not interfere with their sport activities. Conclusion: Based on our experience and literature, we believe that the combination of both techniques, intra-articular (BTB) and extra-articular (Lemaire), is a good alternative for patients with ligament laxaty, providing positive clinical and functional results.

Dynamic Web Pages: Performance Impact on Web Servers.

Science.gov (United States)

Kothari, Bhupesh; Claypool, Mark

2001-01-01

Discussion of Web servers and requests for dynamic pages focuses on experimentally measuring and analyzing the performance of the three dynamic Web page generation technologies: CGI, FastCGI, and Servlets. Develops a multivariate linear regression model and predicts Web server performance under some typical dynamic requests. (Author/LRW)

The relative worst order ratio applied to paging

DEFF Research Database (Denmark)

Boyar, Joan; Favrholdt, Lene Monrad; Larsen, Kim Skak

2007-01-01

The relative worst order ratio, a new measure for the quality of on-line algorithms, was recently defined and applied to two bin packing problems. Here, we apply it to the paging problem and obtain the following results: We devise a new deterministic paging algorithm, Retrospective-LRU, and show...

#NoMorePage3

DEFF Research Database (Denmark)

Glozer, Sarah; McCarthy, Lauren; Whelan, Glen

2015-01-01

Fourth wave feminists are currently seeking to bring an end to The Sun’s Page 3, a British institution infamous for featuring a topless female model daily. This paper investigates the No More Page 3 (NMP3) campaign through which feminist activists have sought to disrupt the institutionalized...... the institutional work and political corporate social responsibility literatures, we document the manner in which feminist activists have used The Co- operative’s social media site to publicly disrupt entrenched gender norms. Through identifying symbiotic yet competing discourses we discover themes of disruption...... and maintenance amongst and between interlocutors, facilitated by The Co-operative’s arena of citizenship and its notion of suspended discourse. Our analysis contributes to the institutional work literature by demonstrating the mutual need for disruption to ‘meet’ or contest maintenance work in corporate practice...

The mediating role of facebook fan pages.

Science.gov (United States)

Chih, Wen-Hai; Hsu, Li-Chun; Wang, Kai-Yu; Lin, Kuan-Yu

2014-01-01

Using the dual mediation hypothesis, this study investigates the role of interestingness (the power of attracting or holding one's attention) attitude towards the news, in the formation of Facebook Fan Page users' electronic word-of-mouth intentions. A total of 599 Facebook fan page users in Taiwan were recruited and structural equation modeling (SEM) was used to test the research hypotheses. The results show that both perceived news entertainment and informativeness positively influence interestingness attitude towards the news. Interestingness attitude towards the news subsequently influences hedonism and utilitarianism attitudes towards the Fan Page, which then influence eWOM intentions. Interestingness attitude towards the news plays a more important role than hedonism and utilitarianism attitudes in generating electronic word-of-mouth intentions. Based on the findings, the implications and future research suggestions are provided.

21 CFR 1310.08 - Excluded transactions.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Excluded transactions. 1310.08 Section 1310.08 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RECORDS AND REPORTS OF LISTED...) Colombia (6) Ecuador (7) French Guiana (8) Guyana (9) Panama (10) Paraguay (11) Peru (12) Suriname (13...

Identify Web-page Content meaning using Knowledge based System for Dual Meaning Words

OpenAIRE

Sinha, Sukanta; Dattagupta, Rana; Mukhopadhyay, Debajyoti

2012-01-01

Meaning of Web-page content plays a big role while produced a search result from a search engine. Most of the cases Web-page meaning stored in title or meta-tag area but those meanings do not always match with Web-page content. To overcome this situation we need to go through the Web-page content to identify the Web-page meaning. In such cases, where Webpage content holds dual meaning words that time it is really difficult to identify the meaning of the Web-page. In this paper, we are introdu...

Anterior Cruciate Ligament Injuries in the National Hockey League: Epidemiology and Performance Impact.

Science.gov (United States)

Longstaffe, Robert; Leiter, Jeff; MacDonald, Peter

2018-03-27

To determine the incidence of anterior cruciate ligament (ACL) injuries in the National Hockey League (NHL) and to examine the effects of this injury on return-to-play status and performance. Case series; level of evidence, 4. This was a 2-phase study. Phase I used the NHL electronic injury surveillance system and Athlete Health Management System to collect data on ACL injuries and man games lost over 10 seasons (2006/2007-2015/2016). Data collected in phase I were received in deidentified form. Phase II examined the performance impact of an ACL injury. Players were identified through publically available sources, and performance-related statistics were analyzed. Data collected in phase II were not linked to data collected in phase I. A paired t test was used to determine any difference in the matching variables between controls and cases in the preinjury time period. A General linear model (mixed) was used to determine the performance impact. Phase I: 67 ACL injuries occurred over 10 seasons. The incidence for all players was 0.42/1000 player game hours (forward, 0.61; defenseman, 0.32, goalie, 0.08) and by game exposure was 0.2/1000 player game exposures (forward, 0.33; defenseman, 0.11; goalie, 0.07). Forwards had a greater incidence rate of ACL tears with both game hours and game exposures when compared with defensemen and goalies (P game (P game (0.001). Number of games and seasons played after an ACL injury did not differ compared with controls (P = 0.068, 0.122, respectively). Anterior cruciate ligament injuries occur infrequently, as it relates to other hockey injuries. Despite a high return to play, the performance after an ACL injury demonstrated a decrease in points and goals per game and per season.

Poisson statistics of PageRank probabilities of Twitter and Wikipedia networks

Science.gov (United States)

Frahm, Klaus M.; Shepelyansky, Dima L.

2014-04-01

We use the methods of quantum chaos and Random Matrix Theory for analysis of statistical fluctuations of PageRank probabilities in directed networks. In this approach the effective energy levels are given by a logarithm of PageRank probability at a given node. After the standard energy level unfolding procedure we establish that the nearest spacing distribution of PageRank probabilities is described by the Poisson law typical for integrable quantum systems. Our studies are done for the Twitter network and three networks of Wikipedia editions in English, French and German. We argue that due to absence of level repulsion the PageRank order of nearby nodes can be easily interchanged. The obtained Poisson law implies that the nearby PageRank probabilities fluctuate as random independent variables.

Using Shadow Page Cache to Improve Isolated Drivers Performance

Directory of Open Access Journals (Sweden)

Hao Zheng

2015-01-01

Full Text Available With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users’ virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver’s write operations by the method of combining a driver’s write operation capture and a driver’s private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver’s write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages’ write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot’s reliability too much.

The quadrant method measuring four points is as a reliable and accurate as the quadrant method in the evaluation after anatomical double-bundle ACL reconstruction.

Science.gov (United States)

Mochizuki, Yuta; Kaneko, Takao; Kawahara, Keisuke; Toyoda, Shinya; Kono, Norihiko; Hada, Masaru; Ikegami, Hiroyasu; Musha, Yoshiro

2017-11-20

The quadrant method was described by Bernard et al. and it has been widely used for postoperative evaluation of anterior cruciate ligament (ACL) reconstruction. The purpose of this research is to further develop the quadrant method measuring four points, which we named four-point quadrant method, and to compare with the quadrant method. Three-dimensional computed tomography (3D-CT) analyses were performed in 25 patients who underwent double-bundle ACL reconstruction using the outside-in technique. The four points in this study's quadrant method were defined as point1-highest, point2-deepest, point3-lowest, and point4-shallowest, in femoral tunnel position. Value of depth and height in each point was measured. Antero-medial (AM) tunnel is (depth1, height2) and postero-lateral (PL) tunnel is (depth3, height4) in this four-point quadrant method. The 3D-CT images were evaluated independently by 2 orthopaedic surgeons. A second measurement was performed by both observers after a 4-week interval. Intra- and inter-observer reliability was calculated by means of intra-class correlation coefficient (ICC). Also, the accuracy of the method was evaluated against the quadrant method. Intra-observer reliability was almost perfect for both AM and PL tunnel (ICC > 0.81). Inter-observer reliability of AM tunnel was substantial (ICC > 0.61) and that of PL tunnel was almost perfect (ICC > 0.81). The AM tunnel position was 0.13% deep, 0.58% high and PL tunnel position was 0.01% shallow, 0.13% low compared to quadrant method. The four-point quadrant method was found to have high intra- and inter-observer reliability and accuracy. This method can evaluate the tunnel position regardless of the shape and morphology of the bone tunnel aperture for use of comparison and can provide measurement that can be compared with various reconstruction methods. The four-point quadrant method of this study is considered to have clinical relevance in that it is a detailed and accurate tool for

Automatic comic page image understanding based on edge segment analysis

Science.gov (United States)

Liu, Dong; Wang, Yongtao; Tang, Zhi; Li, Luyuan; Gao, Liangcai

2013-12-01

Comic page image understanding aims to analyse the layout of the comic page images by detecting the storyboards and identifying the reading order automatically. It is the key technique to produce the digital comic documents suitable for reading on mobile devices. In this paper, we propose a novel comic page image understanding method based on edge segment analysis. First, we propose an efficient edge point chaining method to extract Canny edge segments (i.e., contiguous chains of Canny edge points) from the input comic page image; second, we propose a top-down scheme to detect line segments within each obtained edge segment; third, we develop a novel method to detect the storyboards by selecting the border lines and further identify the reading order of these storyboards. The proposed method is performed on a data set consisting of 2000 comic page images from ten printed comic series. The experimental results demonstrate that the proposed method achieves satisfactory results on different comics and outperforms the existing methods.

Calculating PageRank in a changing network with added or removed edges

Science.gov (United States)

Engström, Christopher; Silvestrov, Sergei

2017-01-01

PageRank was initially developed by S. Brinn and L. Page in 1998 to rank homepages on the Internet using the stationary distribution of a Markov chain created using the web graph. Due to the large size of the web graph and many other real world networks fast methods to calculate PageRank is needed and even if the original way of calculating PageRank using a Power iterations is rather fast, many other approaches have been made to improve the speed further. In this paper we will consider the problem of recalculating PageRank of a changing network where the PageRank of a previous version of the network is known. In particular we will consider the special case of adding or removing edges to a single vertex in the graph or graph component.

Block models and personalized PageRank.

Science.gov (United States)

Kloumann, Isabel M; Ugander, Johan; Kleinberg, Jon

2017-01-03

Methods for ranking the importance of nodes in a network have a rich history in machine learning and across domains that analyze structured data. Recent work has evaluated these methods through the "seed set expansion problem": given a subset [Formula: see text] of nodes from a community of interest in an underlying graph, can we reliably identify the rest of the community? We start from the observation that the most widely used techniques for this problem, personalized PageRank and heat kernel methods, operate in the space of "landing probabilities" of a random walk rooted at the seed set, ranking nodes according to weighted sums of landing probabilities of different length walks. Both schemes, however, lack an a priori relationship to the seed set objective. In this work, we develop a principled framework for evaluating ranking methods by studying seed set expansion applied to the stochastic block model. We derive the optimal gradient for separating the landing probabilities of two classes in a stochastic block model and find, surprisingly, that under reasonable assumptions the gradient is asymptotically equivalent to personalized PageRank for a specific choice of the PageRank parameter [Formula: see text] that depends on the block model parameters. This connection provides a formal motivation for the success of personalized PageRank in seed set expansion and node ranking generally. We use this connection to propose more advanced techniques incorporating higher moments of landing probabilities; our advanced methods exhibit greatly improved performance, despite being simple linear classification rules, and are even competitive with belief propagation.

Navigation To and From a Page: Which Links Get Clicked From Where

Science.gov (United States)

Use Google Analytics navigation summary data to find out what page users most frequently click your Contact Us link from (Previous Page Path), or which links on your homepage are popular or unpopular (Next Page Path).

Anticardiolipin and antinuclear antibodies in the adult healthy Omani individuals

International Nuclear Information System (INIS)

Al-Jabri, Ali A.; Al-Buloshi, Mohamed S.

2004-01-01

To investigate the prevalence and normal versus abnormal levels of anticardiolipin antibodies (aCL) in a healthy adult popultion of Omani's and whether a correlation exists in between aCL and antinuclear antibodies (ANA) in this Omani population. A total of 521 healthy Omani individuals (333 males and 188) females aged between 17-54 years were investigated for the presence and quntities of aClL (immunoglubolin G (IgG)) and IgM isotypesusing a conventional enzyme linked immunosobrent assay. ANA were were detacted in this group, using standard indirect immunofloresence techniques. This study was conducted during the period 2002 through 2003 at the Immunology Laboratories, College of Medicine and Health Sciences, Sultan Qaboos University, Al Khod, Muscat, Sultanate of Oman. The prevalence of of aCL in healthy Omani population was estimated to be 2.5% for IgG 3.1% for IgM. The cut off points for IgG and IgM were determined for the whole population as 22.5 IgG phospholipid (GPL) units and 15.7 IgM phospholipid (MPL) units, using the mean plus 5 standard deviations. Using these cut off values, aCL were not detected in the the majority of individuals (97%) and in the remainig 3% the levels were not very high. There was no significant difference between the levels of aCL in either the male or female groups and no significant correlation for the presence of aCL with the age in this studied population. ANA were detected in 76/521 (14.6%)of the population studied, with some individuals studied, with some individuals (0.8%) showing titers of 1:640, but there was no association with aCL. Although ANA is present in this healthy Omani population at high frequency and some individuals at high levels of aCL do not occur and their presence may be an indicator of autoimmune mediated pathalogy. (author)

Is Domain Highlighting Actually Helpful in Identifying Phishing Web Pages?

Science.gov (United States)

Xiong, Aiping; Proctor, Robert W; Yang, Weining; Li, Ninghui

2017-06-01

To evaluate the effectiveness of domain highlighting in helping users identify whether Web pages are legitimate or spurious. As a component of the URL, a domain name can be overlooked. Consequently, browsers highlight the domain name to help users identify which Web site they are visiting. Nevertheless, few studies have assessed the effectiveness of domain highlighting, and the only formal study confounded highlighting with instructions to look at the address bar. We conducted two phishing detection experiments. Experiment 1 was run online: Participants judged the legitimacy of Web pages in two phases. In Phase 1, participants were to judge the legitimacy based on any information on the Web page, whereas in Phase 2, they were to focus on the address bar. Whether the domain was highlighted was also varied. Experiment 2 was conducted similarly but with participants in a laboratory setting, which allowed tracking of fixations. Participants differentiated the legitimate and fraudulent Web pages better than chance. There was some benefit of attending to the address bar, but domain highlighting did not provide effective protection against phishing attacks. Analysis of eye-gaze fixation measures was in agreement with the task performance, but heat-map results revealed that participants' visual attention was attracted by the highlighted domains. Failure to detect many fraudulent Web pages even when the domain was highlighted implies that users lacked knowledge of Web page security cues or how to use those cues. Potential applications include development of phishing prevention training incorporating domain highlighting with other methods to help users identify phishing Web pages.

Improving Interdisciplinary Provider Communication Through a Unified Paging System.

Science.gov (United States)

Heidemann, Lauren; Petrilli, Christopher; Gupta, Ashwin; Campbell, Ian; Thompson, Maureen; Cinti, Sandro; Stewart, David A

2016-06-01

Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported. House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project. House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%). Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

The effect of targeted exercise on knee-muscle function in patients with persistent hamstring deficiency following ACL reconstruction

DEFF Research Database (Denmark)

Bregenhof, Bo; Jørgensen, Uffe; Aagaard, Per

2018-01-01

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction, using hamstring auto-graft is a common surgical procedure, which often leads to persistent hamstring muscle-strength deficiency and reduced function. The purpose of this randomized controlled trial (RCT) is to investigate the effect...... at 12-24 months' post surgery, will be recruited through outpatient clinics and advertisements. Patients will be randomized to a 12-week progressive, strength and neuromuscular exercise group (SNG) with supervised training twice weekly or a control intervention (CON) consisting of a home-based, low......-intensity exercise program. Outcome measures include between-group change in maximal isometric knee-flexor strength (primary outcome) and knee-extensor muscle strength, hamstring-to-quadriceps strength ratios of the leg that has been operated on and Knee injury and Osteoarthritis Outcome Score (KOOS) (secondary...

PageRank (II): Mathematics

African Journals Online (AJOL)

maths/stats

... GAUSS SEIDEL'S. NUMERICAL ALGORITHMS IN PAGE RANK ANALYSIS. ... The convergence is guaranteed, if the absolute value of the largest eigen ... improved Gauss-Seidel iteration algorithm, based on the decomposition. U. L. D. M. +. +. = ..... This corresponds to determine the eigen vector of T with eigen value 1.

Begonia semperflorens FB08-59 and FB08-163 clonal germplasm

Science.gov (United States)

FB08-59 is a dark-foliage, red-flowered wax begonia clone adapted to hot humid summers. It is the product of a recurrent selection breeding procedure to combine and improve the environmental tolerances identified in B. semperflorens ’Kaylen’ and B. cucullata arenosicola into a dark-foliaged, perenn...

Home Page of Richard Talaga

Science.gov (United States)

bottom of the page is a (planned) link to one of my favorite hobbies. Current Experiments MINOS Neutrino Argonne efforts to join this (existing) experiment * Talaga's Presentations Hobbies and Photos Dive Photos

Quality of drug information on the World Wide Web and strategies to improve pages with poor information quality. An intervention study on pages about sildenafil.

Science.gov (United States)

Martin-Facklam, Meret; Kostrzewa, Michael; Martin, Peter; Haefeli, Walter E

2004-01-01

The generally poor quality of health information on the world wide web (WWW) has caused preventable adverse outcomes. Quality management of information on the internet is therefore critical given its widespread use. In order to develop strategies for the safe use of drugs, we scored general and content quality of pages about sildenafil and performed an intervention to improve their quality. The internet was searched with Yahoo and AltaVista for pages about sildenafil and 303 pages were included. For assessment of content quality a score based on accuracy and completeness of essential drug information was assigned. For assessment of general quality, four criteria were evaluated and their association with high content quality was determined by multivariate logistic regression analysis. The pages were randomly allocated to either control or intervention group. Evaluation took place before, as well as 7 and 22 weeks after an intervention which consisted of two letters with individualized feedback information on the respective page which were sent electronically to the address mentioned on the page. Providing references to scientific publications or prescribing information was significantly associated with high content quality (odds ratio: 8.2, 95% CI 3.2, 20.5). The intervention had no influence on general or content quality. To prevent adverse outcomes caused by misinformation on the WWW individualized feedback to the address mentioned on the page was ineffective. It is currently probably the most straight-forward approach to inform lay persons about indicators of high information quality, i.e. the provision of references.

Network and User-Perceived Performance of Web Page Retrievals

Science.gov (United States)

Kruse, Hans; Allman, Mark; Mallasch, Paul

1998-01-01

The development of the HTTP protocol has been driven by the need to improve the network performance of the protocol by allowing the efficient retrieval of multiple parts of a web page without the need for multiple simultaneous TCP connections between a client and a server. We suggest that the retrieval of multiple page elements sequentially over a single TCP connection may result in a degradation of the perceived performance experienced by the user. We attempt to quantify this perceived degradation through the use of a model which combines a web retrieval simulation and an analytical model of TCP operation. Starting with the current HTTP/l.1 specification, we first suggest a client@side heuristic to improve the perceived transfer performance. We show that the perceived speed of the page retrieval can be increased without sacrificing data transfer efficiency. We then propose a new client/server extension to the HTTP/l.1 protocol to allow for the interleaving of page element retrievals. We finally address the issue of the display of advertisements on web pages, and in particular suggest a number of mechanisms which can make efficient use of IP multicast to send advertisements to a number of clients within the same network.

Digital marketing in travel industry. Case: Hotel landing page optimization

OpenAIRE

Bitkulova, Renata

2017-01-01

Landing page optimization is implementation of the principles of digital service design to improve the website’s user experience. Well done landing page optimization can have a significant positive effect on the usability and profitability of the website. The objective of the study was to optimize the Russian language version of Vuokatti landing page in order to increase conversion, defined as the number of clicks to accommodation search button. A literature survey was made to determine ...

Hiding in Plain Sight: The Anatomy of Malicious Facebook Pages

OpenAIRE

Dewan, Prateek; Kumaraguru, Ponnurangam

2015-01-01

Facebook is the world's largest Online Social Network, having more than 1 billion users. Like most other social networks, Facebook is home to various categories of hostile entities who abuse the platform by posting malicious content. In this paper, we identify and characterize Facebook pages that engage in spreading URLs pointing to malicious domains. We used the Web of Trust API to determine domain reputations of URLs published by pages, and identified 627 pages publishing untrustworthy info...

Physics at the FMQT'08 conference

Czech Academy of Sciences Publication Activity Database

Špička, Václav; Nieuwenhuizen, T.M.; Keefe, P.D.

2010-01-01

Roč. 42, č. 3 (2010), s. 207-227 ISSN 1386-9477. [International Conference on Frontiers of Quantum and Mesoscopic Thermodynamics (FQMT '08). Praha, 28.07.2008-02.08.2008] Institutional research plan: CEZ:AV0Z10100502 Keywords : foundations of quantum physics * quantum optics * quantum gases * quantum computing and information * thermodynamics Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 1.304, year: 2010

Employing Deceptive Dynamic Network Topology Through Software-Defined Networking

Science.gov (United States)

2014-03-01

actions. From [64] . . . . . 37 xi THIS PAGE INTENTIONALLY LEFT BLANK xii List of Acronyms and Abbreviations ACL Access Control List API Application...can be extremely useful in topology mapping through various latency-based geolocation methods [35], [36], [37]. PING 1 7 2 . 2 0 . 5 . 2 ( 1 7 2 . 2 0...defined northbound Applica- tion Programming Interfaces ( APIs ). Figure 3.1: Software-Defined Network Architecture. From [8] 29 3.3 SDN OpenFlow

Pembelajaran Menemukan Nilai PHI(π melalui Pendekatan Matematika Realistik di Sekolah Dasar

Directory of Open Access Journals (Sweden)

Rahmah Johar

2016-12-01

Full Text Available Tujuan penelitian ini adalah untuk mengetahui dampak implementasi Hypothetical Learning Trajectory (HLT dalam mengajarkan nilai  melalui pendekatan matematika realistik. Penelitian ini mendeskripsikan implementasi Hypothetical Learning Trajectory (HLT melalui penelitian Design Research yang terdiri atas tiga tahap yaitu (i preparing for the experiment, (ii the teaching experiment, dan (iii the retrospective analysis. Penelitian ini melibatkan satu orang guru dan 28 siswa kelas V MIN Rukoh, Banda Aceh. Data dikumpulkan melalui lembar observasi, video pembelajaran, dan catatan lapangan. Hasil penelitian menunjukkan bahwa HLT yang dikembangkan dapat membantu siswa melukis titik pusat dan diameter benda berbentuk lingkaran, menemukan nilai yang paling akurat hasil pembagian keliling dengan diameter lingkaran yaitu  Kendala  dalam penelitian ini adalah siswa kesulitan melakukan operasi pembagian bilangan desimal.The purpose of this study was to determine the impact of the implementation Hypothetical Learning Trajectory (HLT in teaching the value of π through realistic mathematics approach. This study describes the implementation Hypothetical Learning Trajectory (HLT through research Design Research, which consists of three stages: (i preparing for the experiment, (ii the teaching experiment, and (iii the retrospective analysis. The study involved one teacher and 28 students of class V MIN Rukoh, Banda Aceh. Data were collected through observation sheets, instructional videos, and field notes. The results showed that the HLT developed to help students paint the center and diameter of a circle-shaped object, find the most accurate value of the division of the circumference to the diameter of the circle is π = 3.14. Constraints in this study were students’ difficulty performing division operation decimals.

[An evaluation of the quality of health web pages using a validated questionnaire].

Science.gov (United States)

Conesa Fuentes, Maria del Carmen; Aguinaga Ontoso, Enrique; Hernández Morante, Juan José

2011-01-01

The objective of the present study was to evaluate the quality of general health information in Spanish language web pages, and the official Regional Services web pages from the different Autonomous Regions. It is a cross-sectional study. We have used a previously validated questionnaire to study the present state of the health information on Internet for a lay-user point of view. By mean of PageRank (Google®), we obtained a group of webs, including a total of 65 health web pages. We applied some exclusion criteria, and finally obtained a total of 36 webs. We also analyzed the official web pages from the different Health Services in Spain (19 webs), making a total of 54 health web pages. In the light of our data, we observed that, the quality of the general information health web pages was generally rather low, especially regarding the information quality. Not one page reached the maximum score (19 points). The mean score of the web pages was of 9.8±2.8. In conclusion, to avoid the problems arising from the lack of quality, health professionals should design advertising campaigns and other media to teach the lay-user how to evaluate the information quality. Copyright © 2009 Elsevier España, S.L. All rights reserved.

An Analysis of Academic Library Web Pages for Faculty

Science.gov (United States)

Gardner, Susan J.; Juricek, John Eric; Xu, F. Grace

2008-01-01

Web sites are increasingly used by academic libraries to promote key services and collections to teaching faculty. This study analyzes the content, location, language, and technological features of fifty-four academic library Web pages designed especially for faculty to expose patterns in the development of these pages.

Folding worlds between pages

CERN Multimedia

Meier, Matthias

2010-01-01

"We all remember pop-up books form our childhood. As fascinated as we were back then, we probably never imagined how much engineering know-how went into these books. Pop-up engineer Anton Radevsky has even managed to fold a 27-kilometre particle accelerator into a book" (4 pages)

Building interactive simulations in a Web page design program.

Science.gov (United States)

Kootsey, J Mailen; Siriphongs, Daniel; McAuley, Grant

2004-01-01

A new Web software architecture, NumberLinX (NLX), has been integrated into a commercial Web design program to produce a drag-and-drop environment for building interactive simulations. NLX is a library of reusable objects written in Java, including input, output, calculation, and control objects. The NLX objects were added to the palette of available objects in the Web design program to be selected and dropped on a page. Inserting an object in a Web page is accomplished by adding a template block of HTML code to the page file. HTML parameters in the block must be set to user-supplied values, so the HTML code is generated dynamically, based on user entries in a popup form. Implementing the object inspector for each object permits the user to edit object attributes in a form window. Except for model definition, the combination of the NLX architecture and the Web design program permits construction of interactive simulation pages without writing or inspecting code.

Ranking nodes in growing networks: When PageRank fails.

Science.gov (United States)

Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng

2015-11-10

PageRank is arguably the most popular ranking algorithm which is being applied in real systems ranging from information to biological and infrastructure networks. Despite its outstanding popularity and broad use in different areas of science, the relation between the algorithm's efficacy and properties of the network on which it acts has not yet been fully understood. We study here PageRank's performance on a network model supported by real data, and show that realistic temporal effects make PageRank fail in individuating the most valuable nodes for a broad range of model parameters. Results on real data are in qualitative agreement with our model-based findings. This failure of PageRank reveals that the static approach to information filtering is inappropriate for a broad class of growing systems, and suggest that time-dependent algorithms that are based on the temporal linking patterns of these systems are needed to better rank the nodes.

Ranking nodes in growing networks: When PageRank fails

Science.gov (United States)

Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng

2015-11-01

PageRank is arguably the most popular ranking algorithm which is being applied in real systems ranging from information to biological and infrastructure networks. Despite its outstanding popularity and broad use in different areas of science, the relation between the algorithm’s efficacy and properties of the network on which it acts has not yet been fully understood. We study here PageRank’s performance on a network model supported by real data, and show that realistic temporal effects make PageRank fail in individuating the most valuable nodes for a broad range of model parameters. Results on real data are in qualitative agreement with our model-based findings. This failure of PageRank reveals that the static approach to information filtering is inappropriate for a broad class of growing systems, and suggest that time-dependent algorithms that are based on the temporal linking patterns of these systems are needed to better rank the nodes.

South African human language technology audit

CSIR Research Space (South Africa)

Grover, AS

2011-06-01

Full Text Available was conducted for the South African HLT landscape, to create a systematic and detailed inventory of the status of the HLT components across the eleven official languages. Based on the Basic Language Resource Kit (BLaRK) framework (Krauwer, 1998), we used various...

South African human language technologies audit

CSIR Research Space (South Africa)

Grover, AS

2010-05-01

Full Text Available Human language technologies (HLT) can play a vital role in bridging the digital divide and thus the HLT field has been recognised as a priority area by the South African government. The authors present the work on conducting a technology audit...

The ATLAS high level trigger region of interest builder

International Nuclear Information System (INIS)

Blair, R.; Dawson, J.; Drake, G.; Haberichter, W.; Schlereth, J.; Zhang, J.; Ermoline, Y.; Pope, B.; Aboline, M.; High Energy Physics; Michigan State Univ.

2008-01-01

This article describes the design, testing and production of the ATLAS Region of Interest Builder (RoIB). This device acts as an interface between the Level 1 trigger and the high level trigger (HLT) farm for the ATLAS LHC detector. It distributes all of the Level 1 data for a subset of events to a small number of (16 or less) individual commodity processors. These processors in turn provide this information to the HLT. This allows the HLT to use the Level 1 information to narrow data requests to areas of the detector where Level 1 has identified interesting objects

FPGA Co-processor for the ALICE High Level Trigger

CERN Document Server

Grastveit, G.; Lindenstruth, V.; Loizides, C.; Roehrich, D.; Skaali, B.; Steinbeck, T.; Stock, R.; Tilsner, H.; Ullaland, K.; Vestbo, A.; Vik, T.

2003-01-01

The High Level Trigger (HLT) of the ALICE experiment requires massive parallel computing. One of the main tasks of the HLT system is two-dimensional cluster finding on raw data of the Time Projection Chamber (TPC), which is the main data source of ALICE. To reduce the number of computing nodes needed in the HLT farm, FPGAs, which are an intrinsic part of the system, will be utilized for this task. VHDL code implementing the Fast Cluster Finder algorithm, has been written, a testbed for functional verification of the code has been developed, and the code has been synthesized

Avaliação do resultado da reconstrução artroscópica do ligamento cruzado anterior do joelho com enxerto dos tendões flexores Evaluation of the results of arthroscopic ACL reconstruction with autogenous flexor tendons

Directory of Open Access Journals (Sweden)

Alexandre Almeida

2010-01-01

Full Text Available OBJETIVO: Avaliar o resultado da reconstrução do ligamento cruzado anterior (LCA com o autoenxerto dos tendões flexores da coxa. Serão analisados os dados com relação ao sexo, ao índice de massa corporal (IMC e a associação com fratura no membro inferior (MI. MÉTODOS: Foi analisado um grupo de 265 pacientes submetidos à artroscopia do joelho para fins de reconstrução do LCA com enxerto ipsilateral dos tendões flexores da coxa no período de 6 de julho de 2000 a 19 de novembro de 2007. RESULTADOS: 176 pacientes foram avaliados com média de 34,95 ± 18,8 meses (mediana 31 meses (IIQ: 20-48 meses. A avaliação mínima foi aos 12 meses e a máxima aos 87 meses. Obtivemos 138 (78,4% pacientes com resultado excelente, 22 (12,5% com resultado bom, oito (4,5% com resultado regular e oito (4,5% pacientes apresentaram resultado ruim. Não foi considerada significativa a maior incidência de bons e excelentes resultados para o sexo masculino (p = 0,128, para os pacientes com IMC OBJETIVE: To evaluate the results of single band arthroscopic anterior cruciate ligament (ACL reconstruction with flexor tendon autografts. We analyzed data about sex, body mass index (BMI and lower limb fracture associated with the initial trauma. METHODS: Two hundred and sixty-five patients who underwent arthroscopic anterior cruciate ligament (ACL reconstruction with ipsilateral thigh flexor tendon autografts from July 6, 2000, to November 19, 2007, were evaluated. RESULTS: One hundred and seventy-six patients were evaluated at an average follow up time of 34.95 ± 18.8 months (Median 31 months (IIQ: 20 - 48 months. The minimum evaluation time was 12 months and the maximum 87 months. One hundred and thirty-eight (78.4% patients had excellent results, 22 (12.5% patients good, 8 (4.5% patients fair, and 8 (4.5% poor results. No statistical significance was found for the better results for males (p = 0.128, for patients with a BMI < 25 (p = 0.848, or for patients

Determining factors behind the PageRank log-log plot

NARCIS (Netherlands)

Volkovich, Y.; Litvak, Nelli; Donato, D.

We study the relation between PageRank and other parameters of information networks such as in-degree, out-degree, and the fraction of dangling nodes. We model this relation through a stochastic equation inspired by the original definition of PageRank. Further, we use the theory of regular variation

Project Management - Development of course materiale as WEB pages

DEFF Research Database (Denmark)

Thorsteinsson, Uffe; Bjergø, Søren

1997-01-01

Development of Internet pages with lessons plans, slideshows, links, conference system and interactive student section for communication between students and to teacher as well.......Development of Internet pages with lessons plans, slideshows, links, conference system and interactive student section for communication between students and to teacher as well....

40 CFR 600.007-08 - Vehicle acceptability.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Vehicle acceptability. 600.007-08... FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-General Provisions § 600.007-08 Vehicle acceptability. (a) All...

AUTOMATIC TAGGING OF PERSIAN WEB PAGES BASED ON N-GRAM LANGUAGE MODELS USING MAPREDUCE

Directory of Open Access Journals (Sweden)

Saeed Shahrivari

2015-07-01

Full Text Available Page tagging is one of the most important facilities for increasing the accuracy of information retrieval in the web. Tags are simple pieces of data that usually consist of one or several words, and briefly describe a page. Tags provide useful information about a page and can be used for boosting the accuracy of searching, document clustering, and result grouping. The most accurate solution to page tagging is using human experts. However, when the number of pages is large, humans cannot be used, and some automatic solutions should be used instead. We propose a solution called PerTag which can automatically tag a set of Persian web pages. PerTag is based on n-gram models and uses the tf-idf method plus some effective Persian language rules to select proper tags for each web page. Since our target is huge sets of web pages, PerTag is built on top of the MapReduce distributed computing framework. We used a set of more than 500 million Persian web pages during our experiments, and extracted tags for each page using a cluster of 40 machines. The experimental results show that PerTag is both fast and accurate

Practice Audit in Gastroenterology (PAGE) program: A novel approach to continuing professional development

Science.gov (United States)

Armstrong, David; Hollingworth, Roger; Gardiner, Tara; Klassen, Michael; Smith, Wendy; Hunt, Richard H; Barkun, Alan; Gould, Michael; Leddin, Desmond

2006-01-01

BACKGROUND: Practice audit is an important component of continuing professional development that may more readily be undertaken if it were less complex. This qualitative study assessed the use of personal digital assistants to facilitate data collection and review. METHODS: Personal digital assistants programmed with standard questionnaires related to upper gastrointestinal endoscopies (Practice Audit in Gastroenterology-Endoscopy [‘PAGE-Endo’]) and colonoscopies (PAGE-Colonoscopy [‘PAGE-Colo’]) were provided to Canadian gastroenterologists, surgeons and internists. Over a three-week audit period, participants recorded indications, and the expected (E) and reported (R) findings for each procedure. Thereafter, participants recorded compliance with reporting, the ease of use and value of the PAGE program, and their willingness to perform another audit. RESULTS: Over 15 to 18 months, 173 participants completed PAGE-Endo (6168 procedures) and 111 completed PAGE-Colo (4776 procedures). Most respondents noted that PAGE was easy to use (99%), beneficial (88% to 95%), and that they were willing undertake another audit (92% to 95%). In PAGE-Endo, alarm features were prevalent (55%), but major reported findings were less common than expected: esophagitis (E 29.9%, R 14.8%), esophageal stricture (E 8.3%, R 3.6%), gastric ulcer (E 17.0%, R 4.7%), gastric cancer (E 4.3%, R 1.0%) and duodenal ulcer (E 11.5%, R 5.7%). In PAGE-Colo, more colonoscopies were performed for symptom investigation (55%) than for screening (25%) or surveillance (20%). There were marked interprovincial variations with respect to sedation, biopsies and technical aspects of colonoscopy. CONCLUSION: Secure, real-time data entry with review of aggregate and individual data in the PAGE program provided an acceptable, straightforward methodology for accredited practice audit activities. PAGE has considerable potential for continuing professional development in gastroenterology and other specialties

CT paging arteriography with a multidetector-row CT. Advantages in splanchnic arterial imaging

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Seiji [Keio Univ., Tokyo (Japan). School of Medicine

1999-11-01

The purpose of this study is to assess the utility of CT paging arteriography with a multidetector-row CT as a replacement for conventional angiography in the evaluation of splanchnic arterial anomalies. Sixty-three patients underwent CT paging arteriography with a multidetector-row CT. In the 56 patients with conventional angiographic correlation, there was only one minor disagreement with CT paging arteriography. In the 7 patients who underwent IVDSA (intra venous digital subtraction angiography), CT paging arteriography defined four hepatic arterial anomalies which could not be depicted by IVDSA. In conclusion, CT paging arteriography provides noninvasive means to identify splanchnic arterial anomalies. (author)

NOAA History - Main Page

Science.gov (United States)

NOAA History Banner gold bar divider home - takes you to index page about the site contacts noaa americas science and service noaa legacy 1807 - 2007 NOAA History is an intrinsic part of the history of Initiative scroll divider More NOAA History from Around the Nation scroll divider drawing of a tornado NOAA

TRIGGER

CERN Multimedia

Roberta Arcidiacono

2013-01-01

Trigger Studies Group (TSG) The Trigger Studies Group has just concluded its third 2013 workshop, where all POGs presented the improvements to the physics object reconstruction, and all PAGs have shown their plans for Trigger development aimed at the 2015 High Level Trigger (HLT) menu. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger menu development, path timing, Trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – this last task in collaboration with PdmV (Physics Data and Monte Carlo Validation group). In the last months the group has delivered several HLT rate estimates and comparisons, using the available data and Monte Carlo samples. The studies were presented at the Trigger workshops in September and December, and STEAM has contacted POGs and PAGs to understand the origin of the discrepancies observed between 8 TeV data and Monte Carlo simulations. The most recent results show what the...

Operational performance of the ATLAS trigger and data acquisition system and its possible evolution

CERN Document Server

Negri, A; The ATLAS collaboration

2012-01-01

The experience accumulated in the ATLAS DAQ/HLT system operation during these years stimulated interest to explore possible evolutions, despite the success of the current design. One attractive direction is to merge three systems - the second trigger level (L2), the Event Builder (EB), and the Event Filter (EF) - within a single homogeneous one in which each HLT node executes all the steps required by the trigger and data acquisition process. Each L1 event is assigned to an available HLT node which executes the L2 algorithms using a subset of the event data and, upon positive selection, builds the event, which is further processed by the EF algorithms. Appealing aspects of this design are: a simplification of the software architecture and of its configuration, a better exploitation of the computing resources, the caching of fragments already collected for L2 processing, the automated load balancing between L2 and EF selection steps, the sharing of code and services on HLT nodes. Furthermore, the full treatmen...

Real-time configuration changes of the ATLAS High Level Trigger

CERN Document Server

Winklmeier, F

2010-01-01

The ATLAS High Level Trigger (HLT) is a distributed real-time software system that performs the final online selection of events produced during proton-proton collisions at the Large Hadron Collider (LHC). It is designed as a two-stage trigger and event filter running on a farm of commodity PC hardware. Currently the system consists of about 850 processing nodes and will be extended incrementally following the expected increase in luminosity of the LHC to about 2000 nodes. The event selection within the HLT applications is carried out by specialized reconstruction algorithms. The selection can be controlled via properties that are stored in a central database and are retrieved at the startup of the HLT processes, which then usually run continuously for many hours. To be able to respond to changes in the LHC beam conditions, it is essential that the algorithms can be re-configured without disrupting data taking while ensuring a consistent and reproducible configuration across the entire HLT farm. The technique...

Cloaked Facebook pages: Exploring fake Islamist propaganda in social media

DEFF Research Database (Denmark)

Farkas, Johan Dam; Schou, Jannick; Neumayer, Christina

2017-01-01

This research analyses cloaked Facebook pages that are created to spread political propaganda by cloaking a user profile and imitating the identity of a political opponent in order to spark hateful and aggressive reactions. This inquiry is pursued through a multi-sited online ethnographic case...... study of Danish Facebook pages disguised as radical Islamist pages, which provoked racist and anti-Muslim reactions as well as negative sentiments towards refugees and immigrants in Denmark in general. Drawing on Jessie Daniels’ critical insights into cloaked websites, this research furthermore analyses...

Sources and Coverage of Medical News on Front Pages of US Newspapers

Science.gov (United States)

Lai, William Y. Y.; Lane, Trevor; Jones, Alison

2009-01-01

Background Medical news that appears on newspaper front pages is intended to reach a wide audience, but how this type of medical news is prepared and distributed has not been systematically researched. We thus quantified the level of visibility achieved by front-page medical stories in the United States and analyzed their news sources. Methodology Using the online resource Newseum, we investigated front-page newspaper coverage of four prominent medical stories, and a high-profile non-medical news story as a control, reported in the US in 2007. Two characteristics were quantified by two raters: which newspaper titles carried each target front-page story (interrater agreement, >96%; kappa, >0.92) and the news sources of each target story (interrater agreement, >94%; kappa, >0.91). National rankings of the top 200 US newspapers by audited circulation were used to quantify the extent of coverage as the proportion of the total circulation of ranked newspapers in Newseum. Findings In total, 1630 front pages were searched. Each medical story appeared on the front pages of 85 to 117 (67.5%–78.7%) ranked newspaper titles that had a cumulative daily circulation of 23.1 to 33.4 million, or 61.8% to 88.4% of all newspapers. In contrast, the non-medical story achieved front-page coverage in 152 (99.3%) newspaper titles with a total circulation of 41.0 million, or 99.8% of all newspapers. Front-page medical stories varied in their sources, but the Washington Post, Los Angeles Times, New York Times and the Associated Press together supplied 61.7% of the total coverage of target front-page medical stories. Conclusion Front-page coverage of medical news from different sources is more accurately revealed by analysis of circulation counts rather than of newspaper titles. Journals wishing to widen knowledge of research news and organizations with important health announcements should target at least the four dominant media organizations identified in this study. PMID:19724643

JavaScript: Convenient Interactivity for the Class Web Page.

Science.gov (United States)

Gray, Patricia

This paper shows how JavaScript can be used within HTML pages to add interactive review sessions and quizzes incorporating graphics and sound files. JavaScript has the advantage of providing basic interactive functions without the use of separate software applications and players. Because it can be part of a standard HTML page, it is…

Measuring consistency of web page design and its effects on performance and satisfaction.

Science.gov (United States)

Ozok, A A; Salvendy, G

2000-04-01

This study examines the methods for measuring the consistency levels of web pages and the effect of consistency on the performance and satisfaction of the world-wide web (WWW) user. For clarification, a home page is referred to as a single page that is the default page of a web site on the WWW. A web page refers to a single screen that indicates a specific address on the WWW. This study has tested a series of web pages that were mostly hyperlinked. Therefore, the term 'web page' has been adopted for the nomenclature while referring to the objects of which the features were tested. It was hypothesized that participants would perform better and be more satisfied using web pages that have consistent rather than inconsistent interface design; that the overall consistency level of an interface design would significantly correlate with the three elements of consistency, physical, communicational and conceptual consistency; and that physical and communicational consistencies would interact with each other. The hypotheses were tested in a four-group, between-subject design, with 10 participants in each group. The results partially support the hypothesis regarding error rate, but not regarding satisfaction and performance time. The results also support the hypothesis that each of the three elements of consistency significantly contribute to the overall consistency of a web page, and that physical and communicational consistencies interact with each other, while conceptual consistency does not interact with them.

Code AI Personal Web Pages

Science.gov (United States)

Garcia, Joseph A.; Smith, Charles A. (Technical Monitor)

1998-01-01

The document consists of a publicly available web site (george.arc.nasa.gov) for Joseph A. Garcia's personal web pages in the AI division. Only general information will be posted and no technical material. All the information is unclassified.

Reporting on post-menopausal hormone therapy: an analysis of gynaecologists' web pages.

Science.gov (United States)

Bucksch, Jens; Kolip, Petra; Deitermann, Bernhilde

2004-01-01

The present study was designed to analyse Web pages of German gynaecologists with regard to postmenopausal hormone therapy (HT). There is a growing body of evidence, that the overall health risks of HT exceed the benefits. Making one's own informed choice has become a central concern for menopausal women. The Internet is an important source of health information, but the quality is often dubious. The study focused on the analysis of basic criteria such as last modification date and quality of the HT information content. The results of the Women's Health Initiative Study (WHI) were used as a benchmark. We searched for relevant Web pages by entering a combination of key words (9 x 13 = 117) into the search engine www.google.de. Each Web page was analysed using a standardized questionnaire. The basic criteria and the quality of content on each Web page were separately categorized by two evaluators. Disagreements were resolved by discussion. Of the 97 websites identified, basic criteria were not met by the majority. For example, the modification date was displayed by only 23 (23.7%) Web pages. The quality of content of most Web pages regarding HT was inaccurate and incomplete. Whilst only nine (9.3%) took up a balanced position, 66 (68%) recommended HT without any restrictions. In 22 cases the recommendation was indistinct and none of the sites refused HT. With regard to basic criteria, there was no difference between HT-recommending Web pages and sites with balanced position. Evidence-based information resulting from the WHI trial was insufficiently represented on gynaecologists' Web pages. Because of the growing number of consumers looking online for health information, the danger of obtaining harmful information has to be minimized. Web pages of gynaecologists do not appear to be recommendable for women because they do not provide recent evidence-based findings about HT.

Social media for physiotherapy clinics: considerations in creating a Facebook page

OpenAIRE

Ahmed, Osman; Claydon, L.S.; Ribeiro, D.C.; Arumugam, A.; Higgs, C.; Baxter, G.D.

2013-01-01

Social media websites play a prominent role in modern society, and the most popular of these websites is Facebook. Increasingly, physiotherapy clinics have begun to utilize Facebook in order to create pages to publicize their services. There are many factors to consider in the planning, implementing, and maintenance of Facebook pages for physiotherapy clinics, including ethical and privacy issues. The primary purpose of creating a page must be clearly defined, with dedicated clinicians given ...

Exon: CBRC-DMEL-08-0024 [SEVENS

Lifescience Database Archive (English)

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Creating a Facebook Page for the Seismological Society of America

Science.gov (United States)

Newman, S. B.

2009-12-01

In August, 2009 I created a Facebook “fan” page for the Seismological Society of America. We had been exploring cost-effective options for providing forums for two-way communication for some months. We knew that a number of larger technical societies had invested significant sums of money to create customized social networking sites but that a small society would need to use existing low-cost software options. The first thing I discovered when I began to set up the fan page was that an unofficial SSA Facebook group already existed, established by Steven J. Gibbons, a member in Norway. Steven had done an excellent job of posting material about SSA. Partly because of the existing group, the official SSA fan page gained fans rapidly. We began by posting information about our own activities and then added links to activities in the broader geoscience community. While much of this material also appeared on our website and in our publication, Seismological Research Letters (SRL), the tone on the FB page is different. It is less formal with more emphasis on photos and links to other sites, including our own. Fans who are active on FB see the posts as part of their social network and do not need to take the initiative to go to the SSA site. Although the goal was to provide a forum for two-way communication, our initial experience was that people were clearly reading the page but not contributing content. This appears to be case with fan pages of sister geoscience societies. FB offers some demographic information to fan site administrators. In an initial review of the demographics it appeared that fans were younger than the overall demographics of the Society. It appeared that a few of the fans are not members or even scientists. Open questions are: what content will be most useful to fans? How will the existence of the page benefit the membership as a whole? Will the page ultimately encourage two-way communication as hoped? Web 2.0 is generating a series of new

Near-Duplicate Web Page Detection: An Efficient Approach Using Clustering, Sentence Feature and Fingerprinting

Directory of Open Access Journals (Sweden)

J. Prasanna Kumar

2013-02-01

Full Text Available Duplicate and near-duplicate web pages are the chief concerns for web search engines. In reality, they incur enormous space to store the indexes, ultimately slowing down and increasing the cost of serving results. A variety of techniques have been developed to identify pairs of web pages that are aldquo;similarardquo; to each other. The problem of finding near-duplicate web pages has been a subject of research in the database and web-search communities for some years. In order to identify the near duplicate web pages, we make use of sentence level features along with fingerprinting method. When a large number of web documents are in consideration for the detection of web pages, then at first, we use K-mode clustering and subsequently sentence feature and fingerprint comparison is used. Using these steps, we exactly identify the near duplicate web pages in an efficient manner. The experimentation is carried out on the web page collections and the results ensured the efficiency of the proposed approach in detecting the near duplicate web pages.

The impact of visual layout factors on performance in Web pages: a cross-language study.

Science.gov (United States)

Parush, Avi; Shwarts, Yonit; Shtub, Avy; Chandra, M Jeya

2005-01-01

Visual layout has a strong impact on performance and is a critical factor in the design of graphical user interfaces (GUIs) and Web pages. Many design guidelines employed in Web page design were inherited from human performance literature and GUI design studies and practices. However, few studies have investigated the more specific patterns of performance with Web pages that may reflect some differences between Web page and GUI design. We investigated interactions among four visual layout factors in Web page design (quantity of links, alignment, grouping indications, and density) in two experiments: one with pages in Hebrew, entailing right-to-left reading, and the other with English pages, entailing left-to-right reading. Some performance patterns (measured by search times and eye movements) were similar between languages. Performance was particularly poor in pages with many links and variable densities, but it improved with the presence of uniform density. Alignment was not shown to be a performance-enhancing factor. The findings are discussed in terms of the similarities and differences in the impact of layout factors between GUIs and Web pages. Actual or potential applications of this research include specific guidelines for Web page design.

ACL status in arthroplasty patients, why not to preserve?

Directory of Open Access Journals (Sweden)

Abdelbadie Ahmed

2018-01-01

Full Text Available Introduction: Only 70–85% of patients that had total knee arthroplasty (TKA are satisfied with their knees. The need for a near to normal knee kinematics is crucial and maybe the solution to their needs. Addressing the cruciate ligaments during surgery along with the extent of arthrosis may give a solution to this problem. Material and methods: One hundred consecutive patients in whom a total knee arthroplasty was indicated and performed were prospectively documented. During the knee replacement surgery, the condition of the anterior and posterior cruciate ligaments and the degree of osteoarthritis (OA in the medial and lateral compartments as well as in the patello-femoral joint were documented using the Outerbridge classification. The patients’ average age was 72.3 years, with the majority being female. In all patients, a total bi-compartmental knee replacement was indicated. Results: Our results showed that in 78% of all patients the anterior, and in 98% the posterior cruciate ligament was still intact. Seventy-one percent of cases suffered from grade 4 medial osteoarthritis, 19% from grade 3 and 10% from grade 2. Thirty-six of patients suffered from grade 4 lateral osteoarthritis, 36% from grade 3, 24% from grade 2 and 4% from grade 1. Grade 4 patello-femoral osteoarthritis was present in 32% of all patients, grade 3 in 60% and grade 2 in 8% of all patients. Discussion: The goal of arthroplasty is to approximate the function of a normal knee. The retention of the anterior cruciate ligament (ACL allows for better knee, kinematics, improved proprioception, increased flexion and an overall improvement in knee function. The decreased constraint that is possible with retention of both cruciates may decrease implant stresses and improve the implant survivorship. The distribution of OA shows that the medial and patello-femoral compartments of the joint are primarily affected. This could also allow for a more conservative and patient

Effect of Hip-Focused Injury Prevention Training for Anterior Cruciate Ligament Injury Reduction in Female Basketball Players: A 12-Year Prospective Intervention Study.

Science.gov (United States)

Omi, Yorikatsu; Sugimoto, Dai; Kuriyama, Setsurou; Kurihara, Tomohisa; Miyamoto, Kenji; Yun, Songjo; Kawashima, Tatsuhiro; Hirose, Norikazu

2018-03-01

Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported. To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players. Cohort study; Level of evidence, 2. A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed. There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0

Exon: CBRC-RNOR-08-0271 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-RNOR-08-0339 [SEVENS

Lifescience Database Archive (English)

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HEALTH SCENARIO IN INDIA

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. HEALTH SCENARIO IN INDIA. Health Doctor / Hospital Infant expenditure 1000 beds / 1000 mortality / % GDP 1000. India 0.8 0.47 0.8 71. World 2.6 1.5 3.3 54. Developed 6.1 2.8 7.2 6 Countries.

Exon: CBRC-RNOR-08-0336 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-MMUS-08-0013 [SEVENS

Lifescience Database Archive (English)

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Analysis and Testing of Ajax-based Single-page Web Applications

NARCIS (Netherlands)

Mesbah, A.

2009-01-01

This dissertation has focused on better understanding the shifting web paradigm and the consequences of moving from the classical multi-page model to an Ajax-based single-page style. Specifically to that end, this work has examined this new class of software from three main software engineering

An Optimization Model for Product Placement on Product Listing Pages

Directory of Open Access Journals (Sweden)

Yan-Kwang Chen

2014-01-01

Full Text Available The design of product listing pages is a key component of Website design because it has significant influence on the sales volume on a Website. This study focuses on product placement in designing product listing pages. Product placement concerns how venders of online stores place their products over the product listing pages for maximization of profit. This problem is very similar to the offline shelf management problem. Since product information sources on a Web page are typically communicated through the text and image, visual stimuli such as color, shape, size, and spatial arrangement often have an effect on the visual attention of online shoppers and, in turn, influence their eventual purchase decisions. In view of the above, this study synthesizes the visual attention literature and theory of shelf-space allocation to develop a mathematical programming model with genetic algorithms for finding optimal solutions to the focused issue. The validity of the model is illustrated with example problems.

Association of rumination time with subclinical ketosis in transition dairy cows.

Science.gov (United States)

Kaufman, E I; LeBlanc, S J; McBride, B W; Duffield, T F; DeVries, T J

2016-07-01

The objective of this study was to characterize the relationship between rumination and subclinical ketosis (SCK) in transition dairy cows. A study was conducted on 4 commercial dairy farms in eastern Ontario, Canada. A total of 339 Holstein dairy cows (107 primiparous and 232 multiparous) were monitored for rumination activity and SCK from 14 d before calving until 28 d after calving. Rumination was recorded daily using an automated monitoring system. A blood sample was taken from the coccygeal vein of each cow for measurement of β-hydroxybutyrate (BHB) once weekly throughout the 6-wk observation period. Cows with BHB ≥1.2mmol/L in any of the 4 postpartum samples were considered to have SCK. Cases of retained placenta, metritis, milk fever, or mastitis during the study period were also recorded. Cows were categorized into 1 of 4 groups: healthy cows (HLT) that had no SCK or any other recorded health problem (n=139); cows treated for at least one health issue other than SCK (HLT+; n=50); cows with SCK (hyperketonemia; HYK) with no other health problems during transition (n=97); or cows (HYK+) that had SCK and one or more other health problems (n=53). Daily rumination time was summarized by week and comparisons were made between HLT and HYK and HYK+. From 2 wk before calving (wk -2) to 4 wk after calving (wk +4), there was no difference in rumination time (409±9.8min/d) among HLT, HYK, and HYK+ cows in their first lactation. Multiparous cows in HLT spent an average of 459±11.3min/d ruminating from wk -2 to wk +4. Multiparous HYK cows ruminated 25±12.8min/d less than HLT cows, whereas HYK+ cows ruminated 44±15.6min/d less than HLT cows. The largest differences in rumination time between HLT and HYK+ cows were seen during wk -1, +1, and +2, when HYK+ cows ruminated 48±17.2, 73±16.0, and 65±19.4min/d less than HLT cows, respectively. In multiparous cows, increased odds of HYK were associated with greater milk yield in the previous lactation, greater loss of

Exon: CBRC-RNOR-08-0339 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-CBRI-08-0163 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-MMUS-08-0013 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-MMUS-08-0051 [SEVENS

Lifescience Database Archive (English)

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75 FR 56145 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

Science.gov (United States)

2010-09-15

... 74545 HAVI Logistics, North Bloomingdale, IL 08/23/10 08/11/10 America (Workers). 74546 Medline Industries, Inc. Oldsmar, FL 08/23/10 08/16/10 (Company). 74547 HAVI Logistics NA-DAVIS Davis, CA 08/23/10 08... (Workers). [[Page 56146

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

Science.gov (United States)

Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

-: 0.08; 95%CI: 0.03–0.24). Conclusion Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders. PMID:29894492

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

Science.gov (United States)

Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical

Fiches « En une page » | CRDI - Centre de recherches pour le ...

International Development Research Centre (IDRC) Digital Library (Canada)

10 nov. 2010 ... Fiche « En une page » de MCP no 1. Un IED sans envergure, une croissance stagnante : le Mercosur peut-il faire mieux ? Fiche « En une page » de MCP no 2. Impôts, taxes et équité entre les sexes : codes, comportements et conséquences, voulues ou non. Fiche « En une page » de MCP no 3.

Student Library Pages: Valuable Resource for the Library Media Center.

Science.gov (United States)

Crowther, Eleanor

1993-01-01

Describes the use of students as library pages at the Loudoun Country Day School (Virginia). Highlights include student selection procedures, including interviews; parental consent form; library page duties; benefits to students; benefits to the library; and parent attitudes. Copies of the student interview form and parental consent form are…

Exon: CBRC-HSAP-08-0044 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-MMUS-08-0013 [SEVENS

Lifescience Database Archive (English)

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Exon: CBRC-RNOR-08-0342 [SEVENS

Lifescience Database Archive (English)

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Detection of spam web page using content and link-based techniques

Indian Academy of Sciences (India)

Spam pages are generally insufficient and inappropriate results for user. ... kinds of Web spamming techniques: Content spam and Link spam. 1. Content spam: The .... of the spam pages are machine generated and hence tech- nique of ...

Characterizing Microseismicity at the Newberry Volcano Geothermal Site using PageRank

Science.gov (United States)

Aguiar, A. C.; Myers, S. C.

2015-12-01

The Newberry Volcano, within the Deschutes National Forest in Oregon, has been designated as a candidate site for the Department of Energy's Frontier Observatory for Research in Geothermal Energy (FORGE) program. This site was stimulated using high-pressure fluid injection during the fall of 2012, which generated several hundred microseismic events. Exploring the spatial and temporal development of microseismicity is key to understanding how subsurface stimulation modifies stress, fractures rock, and increases permeability. We analyze Newberry seismicity using both surface and borehole seismometers from the AltaRock and LLNL seismic networks. For our analysis we adapt PageRank, Google's initial search algorithm, to evaluate microseismicity during the 2012 stimulation. PageRank is a measure of connectivity, where higher ranking represents highly connected windows. In seismic applications connectivity is measured by the cross correlation of 2 time windows recorded on a common seismic station and channel. Aguiar and Beroza (2014) used PageRank based on cross correlation to detect low-frequency earthquakes, which are highly repetitive but difficult to detect. We expand on this application by using PageRank to define signal-correlation topology for micro-earthquakes, including the identification of signals that are connected to the largest number of other signals. We then use this information to create signal families and compare PageRank families to the spatial and temporal proximity of associated earthquakes. Studying signal PageRank will potentially allow us to efficiently group earthquakes with similar physical characteristics, such as focal mechanisms and stress drop. Our ultimate goal is to determine whether changes in the state of stress and/or changes in the generation of subsurface fracture networks can be detected using PageRank topology. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under

PageRank as a method to rank biomedical literature by importance.

Science.gov (United States)

Yates, Elliot J; Dixon, Louise C

2015-01-01

Optimal ranking of literature importance is vital in overcoming article overload. Existing ranking methods are typically based on raw citation counts, giving a sum of 'inbound' links with no consideration of citation importance. PageRank, an algorithm originally developed for ranking webpages at the search engine, Google, could potentially be adapted to bibliometrics to quantify the relative importance weightings of a citation network. This article seeks to validate such an approach on the freely available, PubMed Central open access subset (PMC-OAS) of biomedical literature. On-demand cloud computing infrastructure was used to extract a citation network from over 600,000 full-text PMC-OAS articles. PageRanks and citation counts were calculated for each node in this network. PageRank is highly correlated with citation count (R = 0.905, P PageRank can be trivially computed on commodity cluster hardware and is linearly correlated with citation count. Given its putative benefits in quantifying relative importance, we suggest it may enrich the citation network, thereby overcoming the existing inadequacy of citation counts alone. We thus suggest PageRank as a feasible supplement to, or replacement of, existing bibliometric ranking methods.

What’s New? Deploying a Library New Titles Page with Minimal Programming

Directory of Open Access Journals (Sweden)

John Meyerhofer

2017-01-01

Full Text Available With a new titles web page, a library has a place to show faculty, students, and staff the items they are purchasing for their community. However, many times heavy programing knowledge and/or a LAMP stack (Linux, Apache, MySQL, PHP or APIs separate a library’s data from making a new titles web page a reality. Without IT staff, a new titles page can become nearly impossible or not worth the effort. Here we will demonstrate how a small liberal arts college took its acquisition data and combined it with a Google Sheet, HTML, and a little JavaScript to create a new titles web page that was dynamic and engaging to its users.

A Software Data Transport Framework for Trigger Applications on Clusters

CERN Document Server

Steinbeck, T M; Tilsner, H; Steinbeck, Timm M.; Lindenstruth, Volker; Tilsner, Heinz

2003-01-01

In the future ALICE heavy ion experiment at CERN's Large Hadron Collider input data rates of up to 25 GB/s have to be handled by the High Level Trigger (HLT) system, which has to scale them down to at most 1.25 GB/s before being written to permanent storage. The HLT system that is being designed to cope with these data rates consists of a large PC cluster, up to the order of a 1000 nodes, connected by a fast network. For the software that will run on these nodes a flexible data transport and distribution software framework has been developed. This framework consists of a set of separate components, that can be connected via a common interface, allowing to construct different configurations for the HLT, that are even changeable at runtime. To ensure a fault-tolerant operation of the HLT, the framework includes a basic fail-over mechanism that will be further expanded in the future, utilizing the runtime reconnection feature of the framework's component interface. First performance tests show very promising res...

TRIGGER

CERN Multimedia

R. Arcidiacono

2013-01-01

  In 2013 the Trigger Studies Group (TSG) has been restructured in three sub-groups: STEAM, for the development of new HLT menus and monitoring their performance; STORM, for the development of HLT tools, code and actual configurations; and FOG, responsible for the online operations of the High Level Trigger. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger Menu development, path timing, trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – in collaboration and with the technical support of the PdmV group. Since the end of proton-proton data taking, the group has started preparing for 2015 data taking, with collisions at 13 TeV and 25 ns bunch spacing. The reliability of the extrapolation to higher energy is being evaluated comparing the trigger rates on 7 and 8 TeV Monte Carlo samples with the data taken in the past two years. The effect of 25 ns bunch spacing is being studied on the d...

Performance and development for the Inner Detector Trigger algorithms at ATLAS

CERN Document Server

Penc, O; The ATLAS collaboration

2014-01-01

The performance of the ATLAS Inner Detector (ID) Trigger algorithms being developed for running on the ATLAS High Level Trigger (HLT) processor farm during Run 2 of the LHC are presented. During the 2013-14 LHC long shutdown modifications are being carried out to the LHC accelerator to increase both the beam energy and luminosity. These modifications will pose significant challenges for the ID Trigger algorithms, both in terms execution time and physics performance. To meet these challenges, the ATLAS HLT software is being restructured to run as a more flexible single stage HLT, instead of two separate stages (Level2 and Event Filter) as in Run 1. This will reduce the overall data volume that needs to be requested by the HLT system, since data will no longer need to be requested for each of the two separate processing stages. Development of the ID Trigger algorithms for Run 2, currently expected to be ready for detector commissioning near the end of 2014, is progressing well and the current efforts towards op...

DAQ

CERN Multimedia

P. Schieferdecker

ConfDB: CMS HLT Configuration Database The CMS High Level Trigger (HLT) is based on the CMSSW reconstruction framework and is therefore configured in much the same way as any offline or analysis job: by passing a document to the internal event processing machinery which is valid according to the CMSSW configuration grammar. For offline reconstruction or analysis, this document can be formatted as a text file or a Python script, which CMSSW can both interpret as to which specific software modules to load, which value to assign to each of their parameters, and in which succession to apply them to a given event. The configuration of the HLT is very complex: saving the most recent version of it into a single text file results in more than 8000 lines of instructions, amounting to more than 350kB in size. As for any other subsystem of the CMS data acquisition system (DAQ), the record of the state of the HLT during data-taking must be meticulously kept and archived. It is crucial that several versions of a part...

Content and Design Features of Academic Health Sciences Libraries' Home Pages.

Science.gov (United States)

McConnaughy, Rozalynd P; Wilson, Steven P

2018-01-01

The goal of this content analysis was to identify commonly used content and design features of academic health sciences library home pages. After developing a checklist, data were collected from 135 academic health sciences library home pages. The core components of these library home pages included a contact phone number, a contact email address, an Ask-a-Librarian feature, the physical address listed, a feedback/suggestions link, subject guides, a discovery tool or database-specific search box, multimedia, social media, a site search option, a responsive web design, and a copyright year or update date.

75 FR 48566 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Administrative and Non...

Science.gov (United States)

2010-08-11

... Regulation 1146 governing the control of mercury emissions. C. Summary of Administrative Changes The...]. Section 4.0 Restrictions on 9/11/08 8/11/10 [Insert page Secondary Metal number where the Operations... the document begins]. Section 19.0 Coating of Metal 9/11/08 8/11/10 [Insert page Furniture. number...

Default Parallels Plesk Panel Page

Science.gov (United States)

services that small businesses want and need. Our software includes key building blocks of cloud service virtualized servers Service Provider Products Parallels® Automation Hosting, SaaS, and cloud computing , the leading hosting automation software. You see this page because there is no Web site at this

ISS Expedition 08 Press Kit

Data.gov (United States)

National Aeronautics and Space Administration — Press kit for ISS mission Expedition 08 from 10/2003-04/2004. Press kits contain information about each mission overview, crew, mission timeline, benefits, and media...

"I didn't know her, but…": parasocial mourning of mediated deaths on Facebook RIP pages

Science.gov (United States)

Klastrup, Lisbeth

2015-04-01

This article examines the use of six Danish "Rest in Peace" or (RIP) memorial pages. The article focuses on the relation between news media and RIP page use, in relation to general communicative practices on these pages. Based on an analysis of press coverage of the deaths of six young people and a close analysis of 1,015 comments extracted from the RIP pages created to memorialize them, it is shown that their deaths attracted considerable media attention, as did the RIP pages themselves. Comment activity seem to reflect the news stories in the way the commenters refer to the context of death and the emotional distress they experience, but mainly comments on the RIP pages are conventional expressions of sympathy and "RIP" wishes. The article concludes that public RIP pages might be understood as virtual spontaneous shrines, affording an emerging practice of "RIP-ing."

A biplex approach to PageRank centrality: From classic to multiplex networks.

Science.gov (United States)

Pedroche, Francisco; Romance, Miguel; Criado, Regino

2016-06-01

In this paper, we present a new view of the PageRank algorithm inspired by multiplex networks. This new approach allows to introduce a new centrality measure for classic complex networks and a new proposal to extend the usual PageRank algorithm to multiplex networks. We give some analytical relations between these new approaches and the classic PageRank centrality measure, and we illustrate the new parameters presented by computing them on real underground networks.

A biplex approach to PageRank centrality: From classic to multiplex networks

Science.gov (United States)

Pedroche, Francisco; Romance, Miguel; Criado, Regino

2016-06-01

In this paper, we present a new view of the PageRank algorithm inspired by multiplex networks. This new approach allows to introduce a new centrality measure for classic complex networks and a new proposal to extend the usual PageRank algorithm to multiplex networks. We give some analytical relations between these new approaches and the classic PageRank centrality measure, and we illustrate the new parameters presented by computing them on real underground networks.

KEMAJUAN BELAJAR SISWA PADA GEOMETRI TRANSFORMASI MENGGUNAKAN AKTIVITAS REFLEKSI GEOMETRI

Directory of Open Access Journals (Sweden)

Irkham Ulil Albab

2014-10-01

Full Text Available Abstrak: Penelitian ini bertujuan untuk mendeskripsikan kemajuan belajar siswa pada materi geometri transformasi yang didukung dengan serangkaian aktivitas belajar berdasarkan Pendidikan Matematika Realistik Indonesia. Penelitian didesain melalui tiga tahap, yaitu tahapan perancangan desain awal, pengujian desain melalui pembelajaran awal dan pembelajaran eksperimental, dan tahap analisis retrospektif. Dalam penelitian ini, Hypothetical Learning Trajectory, HLT (HLT berperan penting sebagai desain pembelajaran sekaligus instrumen penelitian. HLT diujikan terhadap 26 siswa kelas VII. Data dikumpulkan dengan teknik wawancara, pengamatan, dan catatan lapangan. Hasil penelitian menunjukkan bahwa desain pembelajaran ini mampu menstimulasi siswa untuk memberikan karakteristik refleksi dan transformasi geometri lainnya secara informal, mengklasifikasikannya dalam transformasi isometri pada level kedua, dan menemukan garis bantuan refleksi pada level yang lebih formal. Selain itu, garis bantuan refleksi digunakan oleh siswa untuk menggambar bayangan refleksi dan pola pencerminan serta memahami bentuk rotasi dan translasi sebagai kombinasi refleksi adalah level tertinggi. Keyword: transformasi geometri, kombinasi refleksi, rotasi, translasi, design research, HLT STUDENTS’ LEARNING PROGRESS ON TRANSFORMATION GEOMETRY USING THE GEOMETRY REFLECTION ACTIVITIES Abstract: This study was aimed at describing the students’ learning progress on transformation geometry supported by a set of learning activities based on Indonesian Realistic Mathematics Education. The study was designed into three stages, that is, the preliminary design stage, the design testing through initial instruction and experiment, and the restrospective analysis stage. In this study, Hypothetical Learning Trajectory (HLT played an important role as an instructional design and a research instrument. HLT was tested to 26 seventh grade students. The data were collected through interviews

Page | 133 LEGISLATIVE APPROVAL OF EXECUTIVE ...

African Journals Online (AJOL)

Fr. Ikenga

NAUJILJ 9 (2) 2018. Page | 133 ... Keywords: Executive appointments, Legislative approval, National Assembly, Constitutional duty. 1. ... Representatives is led by a Speaker.6 The election of the leadership of the senate is entirely the affair of.

A teen's guide to creating web pages and blogs

CERN Document Server

Selfridge, Peter; Osburn, Jennifer

2008-01-01

Whether using a social networking site like MySpace or Facebook or building a Web page from scratch, millions of teens are actively creating a vibrant part of the Internet. This is the definitive teen''s guide to publishing exciting web pages and blogs on the Web. This easy-to-follow guide shows teenagers how to: Create great MySpace and Facebook pages Build their own unique, personalized Web site Share the latest news with exciting blogging ideas Protect themselves online with cyber-safety tips Written by a teenager for other teens, this book leads readers step-by-step through the basics of web and blog design. In this book, teens learn to go beyond clicking through web sites to learning winning strategies for web design and great ideas for writing blogs that attract attention and readership.

Representation of Tinnitus in the US Newspaper Media and in Facebook Pages: Cross-Sectional Analysis of Secondary Data.

Science.gov (United States)

Manchaiah, Vinaya; Ratinaud, Pierre; Andersson, Gerhard

2018-05-08

When people with health conditions begin to manage their health issues, one important issue that emerges is the question as to what exactly do they do with the information that they have obtained through various sources (eg, news media, social media, health professionals, friends, and family). The information they gather helps form their opinions and, to some degree, influences their attitudes toward managing their condition. This study aimed to understand how tinnitus is represented in the US newspaper media and in Facebook pages (ie, social media) using text pattern analysis. This was a cross-sectional study based upon secondary analyses of publicly available data. The 2 datasets (ie, text corpuses) analyzed in this study were generated from US newspaper media during 1980-2017 (downloaded from the database US Major Dailies by ProQuest) and Facebook pages during 2010-2016. The text corpuses were analyzed using the Iramuteq software using cluster analysis and chi-square tests. The newspaper dataset had 432 articles. The cluster analysis resulted in 5 clusters, which were named as follows: (1) brain stimulation (26.2%), (2) symptoms (13.5%), (3) coping (19.8%), (4) social support (24.2%), and (5) treatment innovation (16.4%). A time series analysis of clusters indicated a change in the pattern of information presented in newspaper media during 1980-2017 (eg, more emphasis on cluster 5, focusing on treatment inventions). The Facebook dataset had 1569 texts. The cluster analysis resulted in 7 clusters, which were named as: (1) diagnosis (21.9%), (2) cause (4.1%), (3) research and development (13.6%), (4) social support (18.8%), (5) challenges (11.1%), (6) symptoms (21.4%), and (7) coping (9.2%). A time series analysis of clusters indicated no change in information presented in Facebook pages on tinnitus during 2011-2016. The study highlights the specific aspects about tinnitus that the US newspaper media and Facebook pages focus on, as well as how these aspects change

PageFocus: Using paradata to detect and prevent cheating on online achievement tests.

Science.gov (United States)

Diedenhofen, Birk; Musch, Jochen

2017-08-01

Cheating threatens the validity of unproctored online achievement tests. To address this problem, we developed PageFocus, a JavaScript that detects when participants abandon test pages by switching to another window or browser tab. In a first study, we aimed at testing whether PageFocus could detect and prevent cheating. We asked 115 lab and 186 online participants to complete a knowledge test comprising items that were difficult to answer but easy to look up on the Internet. Half of the participants were invited to look up the solutions, which significantly increased their test scores. The PageFocus script detected test takers who abandoned the test page with very high sensitivity and specificity, and successfully reduced cheating by generating a popup message that asked participants not to cheat. In a second study, 510 online participants completed a knowledge test comprising items that could easily be looked up and a reasoning task involving matrices that were impossible to look up. In a first group, a performance-related monetary reward was promised to the top scorers; in a second group, participants took part in a lottery that provided performance-unrelated rewards; and in a third group, no incentive was offered. PageFocus revealed that participants cheated more when performance-related incentives were offered. As expected, however, this effect was limited to items that could easily be looked up. We recommend that PageFocus be routinely employed to detect and prevent cheating on online achievement tests.