Ringdal, K G; Lossius, H M
The organisation of trauma care in Scandinavia has several similarities, including trauma registries, but so far there are limited amount of research on efficiency and outcome. Data and results from trauma outcome studies like the US MTOS are not fully applicable to the Scandinavian trauma population. To reveal the feasibility of using data from existing trauma registries of major hospitals in Scandinavia, for a minimal common dataset, in a joint, prospective Scandinavian MTOS. We collected data points, data point definitions, and inclusion/exclusion criteria, from the major trauma registries of the Swedish trauma registry standard, three university hospitals in Denmark, one university hospital in Finland, and the Norwegian National Trauma Registry. The collected material was compared to reveal common data points, inclusion criteria, and the compatibility of data point definitions. The median number of data points was 147 (range 71-257; interquartile range = 90-205). Most registries lacked precise data definition catalogues. Only 16 data points could be considered as common, of which just a few were core trauma data. Four data points had the same data category options but were not considered having the same data point definitions. The inclusion criteria were not uniform. Trauma registries in Scandinavia have few common core data and data point definitions. There were data points for calculating the Trauma and Injury Severity Score (TRISS) but the inclusion criteria varied too much to ensure a valid comparison. A consensus process for a joint trauma core data set will be initiated by the Scandinavian Networking Group for Trauma and Emergency Management (SCANTEM) to increase research on trauma efficiency and outcome.
Renstrom, P; Ljungqvist, A; Arendt, E
The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert...... 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...
Kjærsgård, Andreas Pihl
The dissertation finds that, compared to people in other western countries, the Scandinavians were exceptionally egalitarian in the period from 1992 to 2009. This Scandinavian egalitarianism seems constituted mostly of an aversion to top-level excess, rather than a wish to spoil the bottom of the...
How does a combined pre-operative and post-operative rehabilitation program influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian Knee Ligament Registry
Grindem, H.; Granan, LP.; Risberg, MA.; Engebretsen, L.; Snyder-Mackler, L.; Eitzen, I.
Background Preoperative knee function is associated with successful postoperative outcome after ACL reconstruction (ACLR). However, there are few longer-term studies of patients who underwent progressive preoperative and postoperative rehabilitation compared to usual care Objectives To compare preoperative and 2 year postoperative patient-reported outcomes (PROs) in patients undergoing progressive preoperative and postoperative rehabilitation at a sports medicine clinic compared with usual care Methods We included patients aged 16–40 years undergoing primary unilateral ACLR. The preoperative and 2 year postoperative KOOS of 84 patients undergoing progressive pre- and postoperative rehabilitation at a sports medicine clinic (Norwegian Research Center for Active Rehabilitation [NAR] cohort) were compared with the scores of 2690 patients from the Norwegian Knee Ligament Registry (NKLR). The analyses were adjusted for sex, age, months from injury to surgery, and cartilage/meniscus injury at ACLR. Results The NAR cohort had significantly better preoperative KOOS in all subscales, with clinically relevant differences (>10 points) observed in KOOS Pain, ADL, Sports and Quality of Life. At 2 years, the NAR cohort still had significantly better KOOS with clinically relevant differences in KOOS Symptoms, Sports and Quality of Life. At 2 years, 85.7–94.0 % of the patients in the NAR cohort scored within the normative range of the different KOOS subscales, compared to 51.4–75.8 % of the patients in the NKLR cohort. Conclusion Patients in a prospective cohort who underwent progressive pre- and postoperative rehabilitation at a sports medicine clinic showed superior patient-reported outcomes both preoperatively and 2 year postoperatively compared to patients in the Norwegian Knee Ligament Registry who received usual care. PMID:25351782
Renstrom, P; Ljungqvist, A; Arendt, E; Beynnon, B; Fukubayashi, T; Garrett, W; Georgoulis, T; Hewett, T E; Johnson, R; Krosshaug, T; Mandelbaum, B; Micheli, L; Myklebust, G; Roos, E; Roos, H; Schamasch, P; Shultz, S; Werner, S; Wojtys, E; Engebretsen, L
The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert 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) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the “knee over toe position” when cutting. PMID:18539658
Renstrom, P; Ljungqvist, A; Arendt, E; Beynnon, B; Fukubayashi, T; Garrett, W; Georgoulis, T; Hewett, T E; Johnson, R; Krosshaug, T; Mandelbaum, B; Micheli, L; Myklebust, G; Roos, E; Roos, H; Schamasch, P; Shultz, S; Werner, S; Wojtys, E; Engebretsen, L
The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert 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) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the "knee over toe position" when cutting.
... blow to the knee A course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees. ACL ...
... is an ACL injury? ACL refers to the anterior cruciate ligament. It is 1 of 4 ligaments in your ... best results. After surgery, you will need intense physical therapy to ... allow the ligament to heal naturally. Living with an ACL injury ...
Amir Ata Rahnemai-Azar
Full Text Available The anterior cruciate ligament (ACL is composed of two bundles, which work together to provide both antero-posterior and rotatory stability of the knee. Understanding the anatomy and function of the ACL plays a key role in management of patients with ACL injury. Anatomic ACL reconstruction aims to restore the function of the native ACL. Femoral and tibial tunnels should be placed in their anatomical location accounting for both the native ACL insertion site and bony landmarks. One main component of anatomical individualized ACL reconstruction is customizing the treatment according to each patient’s individual characteristics, considering preoperative and intraoperative evaluation of the native ACL and knee bony anatomy. Anatomical individualized reconstruction surgery should also aim to restore the size of the native ACL insertion as well. Using this concept, while single bundle ACL reconstruction can restore the function of the ACL in some patients, double bundle reconstruction is indicated in others to achieve optimal outcome.
Strand, Robert; Freeman, R. Edward
. We conclude by endorsing the expression “Scandinavian cooperative advantage” in an effort to draw attention to the Scandinavian context and encourage the field of strategic management to shift its focus from achieving a competitive advantage toward achieving a cooperative advantage....
Iversen, Ole Sejer; Smith, Rachel Charlotte
As Scandinavian Participatory Design (PD) approach is a highly values-led design approach, and is gaining importance in IDC research, we discuss the underlying values of democracy, quality of work and emancipation of this approach. We present a case study, Digital Natives, in which the Scandinavian...... PD approach was put into practice. Here we involved seven teenagers in the design of an interactive museum exhibition. We discuss how this particular approach effects key design activities such as the establishment of the design space, power relations among participants, the dialogical design process......, project evaluation and the final outcome of the project. We conclude that the end goal of Scandinavian PD is not necessarily the final research prototype. Rather, in Scandinavian PD, designers strive to provide children with meaningful alternatives to existing technologies. It is to help children realize...
Nguyen, Joseph; Rodeo, Scott A.
Objectives: Anterior cruciate ligament (ACL) injury has an annual incidence of more than 200,000 cases with almost 100,000 undergoing ACL reconstruction (ACLR). Many institutions have built ACL registries to better understand treatment outcomes and raise overall standards of care. One limitation of these registries is the continued compliance of patients to fill out post-operative patient-reported outcome surveys over time, with most beginning data collection 2 years after surgery. With most ...
and emphasises the need to explore the relationship between the family and the state ( and the family and the economy) in difefrent wefare states. The paper emphasises that the qualitative difference in the organization of care work are important for understanding the institutional differences for between...... the welfare states, and especially the Scandinavian welfare states, where motherhood and care work has to day bef´come part of social citizenship The auther argues that even though women have in important ways been empowered in the Scandinavian woefare states as mothers, workers and citizens, they have...
Grand, Karina Lykke
The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]......The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]...
Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... knee. It prevents the knee from bending out. Anterior cruciate ligament (ACL) is in the middle of the knee. ...
Rasmussen, Lauge Baungaard
The article focus on paradigms, methods and ethics of action research in the Scandinavian countries. The special features of the action research paradigm is identified. A historical overview follows of some main action research projects in Norway, Sweden and Denmark. The tendency towards upsclae...
Ibsen, Christian Lyhne; Larsen, Trine Pernille; Madsen, Jørgen Steen
and employment relations in the Danish, Norwegian and Swedish public sector. In this paper, we argue that although differences exist across the Scandinavian countries, it is evident that they have managed to adopt and implement NPM-inspired reforms without dismantling their universal welfare services and strong...
Strand, Robert; Freeman, R. Edward
In this article we clarify the historical roots of stakeholder theory to establish that a much larger role was played by Scandinavian thinkers in its development than is currently acknowledged. We show that important contributions to the stakeholder concept were being made by Eric Rhenman and his...
D.A. Padua; S.J. Schultz; M. Collins; R.J. Schmitz; A.M. Chaudhari; Anne Benjaminse
It has been well recognized that multiple factors, whether individually or in combination, contribute to noncontact anterior cruciate ligament (ACL) injury. The ongoing mission of the ACL Research Retreat is to bring clinicians and researchers together to present and discuss the most recent advances
Björnsson, Einar S; Ekbom, Anders
In the last decades, a large number of epidemiological studies in gastroenterology and hepatology have originated from the Scandinavian countries. With the help of large health databases, with good validity and other registries related to patient outcomes, researchers from the Scandinavian countries have been able to make some very important contributions to the field. These countries, Sweden, Norway, Finland, Denmark and Iceland, have all universal access to health care and have shown to be ideal for epidemiological research. Population-based studies have been frequent and follow-up studies have been able to describe the temporal trends and changes in phenotypes. Our ability in Scandinavia to follow up defined groups of patients over time has been crucial to learn the natural history of many gastrointestinal and liver diseases and often in a population-based setting. Patient-related outcomes measures will probably gain increasing importance in the future, but Scandinavian gastroenterologists and surgeons are likely to have a better infrastructure for such endeavors compared to most other populations. Thus, there is a bright future for international competitive research within the field of gastrointestinal and liver diseases in Scandinavia.
Within the so-called welfare modeling business Scandinavia stands out as a space with a particular welfare regime. It is a peculiar combination of market, state, and civil societal interventions into people's social life, that define this welfare regime. The particular welfare mix emphasizes...... universal public interventions and a high degree of employment in the formal labor market for all. The thesis promoted in this paper is, that the Scandinavian welfare regime ought to be highly desirable elsewhere, but unfortunately rather difficult to replicate, because it is premised upon a set...
Hansen, Kim Toft
Firstly, I develop a theoretical framework for the discussion of religion i Scandinavian crime fiction where I consider theories of transgression and religion. Secondly, I run through five relatively popular examples of Scandinavian crime fiction to show how this genre trend works. Lastly, I...
Etcheto, H. Rivarola; Zordán, J.; Escobar, G.; Collazo, C.; Palanconi, M.; Autorino, C.; Salinas, E. Alvarez
The development of synthetic grafts as an alternative to biological grafts for reconstruction of the anterior cruciate ligament dates from 1980. The interest is awakened due to the potential advantages of: The absence of morbidity associated with donor site, and early return to sport. However, this surgical technique has had multiple complications associated with graft: mechanical failures (synthetic graft failure, loss of fixation), synovial foreign body reaction, recurrent stroke, recurrent instability and ultimately, early osteoarthritis. Objectives: We describe the synthetic graft failure LCA, intraoperative findings and details of surgical technique. Methods: Patient 35 years old, with a history of ACL reconstruction four years of evolution in another health center, consultation with the Service knee arthroscopy for acute knee pain left knee during secondary sporting event to a rotation mechanism with fixed foot. On physical examination, presents and positive Lachman maneuver Pivot. Radiografia in a widening of the tibial tunnel is observed. NMR shows a discontinuity of fibers of synthetic graft. Results: First time arthroscopic revision where synthetic plastic LCA identifies with Disruption fiber pattern. Intraoperatively, hypertrophic chronic synovitis localized predominantly in intercóndilo is observed. debridement thereof is performed, and proceeds to the extraction of the synthetic ligament. Then he was made prior cruentado and revival of the edges of the tunnel, filling them with non-irradiated structural bone allograft. At four months as planned and after confirmation by studies incorporating bone graft was performed the second time with the new plastic ACL. It was planned like a primary graft surgery with autologous hamstring prepared in fourfold form, and fixation with modified transtibial technique Biotransfix system proximal and distal screw Biocomposite (arthrex®). A quadruple graft 9 mm was obtained, making good positioning of tunnels and stable
... Staying Safe Videos for Educators Search English Español Anterior Cruciate Ligament (ACL) Injuries KidsHealth / For Teens / Anterior Cruciate Ligament (ACL) Injuries What's in this article? What Are ...
E. Otten; K. Postema; S.M. Lephart; M.P. Arnold; P.U. Dijkstra; A. Gokeler; L. Engebretsen; E. Ageberg; T.E. Hewett; Anne Benjaminse; Engelhardt M
OBJECTIVE: To establish the clinical relevance of proprioceptive deficits reported after anterior cruciate ligament (ACL) injury. MATERIAL AND METHODS: A literature search was done in electronic databases from January 1990 to June 2009. Inclusion criteria for studies were ACL deficient (ACL-D) and
Skou, Niels Peter; Munch, Anders V.
to the current international neo-modernism in the form of digitally designed and industrially produced items in often thought-provoking minimalist forms and are directed at an elitist, international audience that wants to engage with these demanding aesthetics and the ideal picture of Nordic cultures—as a nice...... design and gourmet destination. New Nordic Design shows that the image and ideals of Scandinavian Modern are still living, as a subtle version of Scandinavian Retro, a reimagination of the lifestyle and values of Scandinavian Modern....
The working paper discusses some of the major approaches to Scandinavian crime fiction in the light of the dominant features of crime culture, e.g. the broad exposure of crime fiction via different platforms and media. In this connection, the concept of mediatization is considered as well...... as the approach of genre typology and the concept of evil – seemingly disparate concepts and approaches, but all related to the complex processes in the borderlands between crime fiction and society. Using examples from Scandinavian crime fiction, I discuss whether the growing proximity to international genres......, ways of production and standards increasingly removes Scandinavian crime fiction from its original attractions or not....
Freddie H. Fu
Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world
Hansen, Kim Toft
connected with modernity, modern society and ensuing secularity, but the question is, then, what happens to crime fiction if modern societies no longer uphold its trust in secular ideals. The thesis is that this leaves modern Scandinavian media open for a religious discussion which then also seeps...... into popular crime fiction. In novels by Arne Dahl, Henning Mortensen, Gunnar Staalesen, A.J. Kazinski, Gretelise Holm and several other Scandinavian writers of crime fiction it is possible to locate an interest in theology and topics of religious philosophy which reflects this current trend in modern...... Scandinavian media where religion has become mediatized. Consumers of popular culture no longer endorse confidence in institutionalized religion, but that does not mean that people are losing faith: Faith only seem to adjust itself and tiptoe into popular media and popular fiction. Hence, this paper seeks...
Hansen, Kim Toft
This article considers the postsecular turn in Scandinavian crime fiction. Postsecularism describes a renewed openness towards questions of spirituality, while maintaining the practice of critical scrutiny. Since 2000, we have seen an intensive increase in the number of titles treating religion and....../or spirituality in a way which differs from the genre’s usual approach. Firstly, I will frame the traditional attitude towards religion in crime fiction by Scandinavian welfare modernity, outlining the conspicuous absence of religion in the genre. Secondly, I propose a typology of the treatment of religion...... in crime fiction. My examples are all taken from the vast corpus of contemporary Scandinavian crime fiction, but it would be rather unproblematic to stretch the scope of the theory to an analysis of western crime fiction in general. Within this typology, I will introduce the phenomenon of a religious...
Muhammet Hanefi Kutluoğlu
Full Text Available Every country has responsibilities to provide the necessary personnel needed for their archival inheritance by education. Education can be shaped through tradition, historical inheritance and scientifi c necessities by defi ning the right educational method. Scandinavian countries have determined different education models based on their tradition, historical inheritance and requirements. In this article we focused on the formation of archival tradition, application of archival education in Scandinavian countries and the infl uence of the developments taking place in Europe on these countries. The relation between the archival education in European and Scandinavian countries is evaluated through a comparative method, and similarities to other countries are also evaluated. Finally, the present situation of archival education and the measures needed in this fi eld are taken into consideration.
Christensen, Ken Ramshøj
In this paper I argue that the base-position of the infinitive marker in the Scandinavian languages and English share a common origin site. It is inserted as the top-most head in the VP-domain. The cross-linguistic variation in the syntactic distribution of the infinitive marker can be accounted...
Lindsay A. Palmer
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
Giugliano, Danica N; Solomon, Jennifer L
With the growing number of female athletes, an increase is occurring in the number of sports-related injuries, which can cause physical, psychological, academic, and financial suffering. Female athletes are reported to be two to eight times more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Further research on risk factors and preventative strategies for the female ACL is needed, because the cause of the disparity in injury rates remains equivocal and controversial. Individualized treatment for the injured knee is necessary and can include either conservative treatment or reconstructive surgery.
... this page: //medlineplus.gov/ency/patientinstructions/000681.htm Anterior cruciate ligament (ACL) injury - aftercare To use the sharing features ... that connects a bone to another bone. The anterior cruciate ligament (ACL) is located inside your knee joint and ...
Yu, Bing; Garrett, William E.
In soccer one of the most common knee injuries is the anterior cruciate ligament (ACL) tear, which usually occurs through non‐contact mechanisms. Female soccer players are at higher risk of sustaining non‐contact ACL injuries than male soccer players. A good understanding of ACL loading mechanisms is the basis for a good understanding of the mechanisms of non‐contact ACL injuries, which in turn is essential for identifying risk factors and developing prevention strategies. Current literature ...
Ken Ramshøj Christensen
Full Text Available In this paper I argue that the base-position of the infinitive marker in the Scandinavian languages and English share a common origin site. It is inserted as the top-most head in the VP-domain. The cross-linguistic variation in the syntactic distribution of the infinitive marker can be accounted for by assuming that it undergoes head movement. This movement is optional in Danish, English, Norwegian, and Early Modern Danish and is not feature-driven. In Faroese, Icelandic, and Swedish, on the other hand, it is triggered by φ-feature checking on Finº. In Icelandic and Swedish these φ-features are strong and induce obligatory vº→Finº movement, whereas they are weak in Faroese and do not induce vº→Finº movement.
E. Carlos RODRIGUEZ-MERCHAN
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.
Although Scandinavians are often celebrated as the vanguards of human rights and international law, we know little about whether courts and judges in these countries have embraced those international courts and conventions that they themselves helped establish after the Second World War....... This article presents original and comprehensive data on three Scandinavian courts’ citation practice. It demonstrates that not only do Scandinavian Supreme Courts engage surprisingly little with international law, but also that there is great variation in the degree to which they have domesticated...... international law and courts by citing their case law. Building on this author’s previous research, it is argued that Norway sticks out as much more engaged internationally due to a solid judicial review tradition at the national level. It is also argued that Scandinavian legal positivism, has influenced a much...
Although Scandinavians are often celebrated as the vanguards of human rights and international law, we know little about whether courts and judges in these countries have embraced those international courts and conventions that they themselves helped establish after the Second World War....... This article presents original and comprehensive data on three Scandinavian courts' citation practice. It demonstrates that not only do Scandinavian Supreme Courts engage surprisingly little with international law, but also that there is great variation in the degree to which they have domesticated...... international law and courts by citing their case law. Building on this author's previous research, it is argued that Norway sticks out as much more engaged internationally due to a solid judicial review tradition at the national level. It is also argued that Scandinavian legal positivism has influenced a much...
Full Text Available The ACL2 theorem prover is a complex system. Its libraries are vast. Industrial verification efforts may extend this base with hundreds of thousands of lines of additional modeling tools, specifications, and proof scripts. High quality documentation is vital for teams that are working together on projects of this scale. We have developed XDOC, a flexible, scalable documentation tool for ACL2 that can incorporate the documentation for ACL2 itself, the Community Books, and an organization's internal formal verification projects, and which has many features that help to keep the resulting manuals up to date. Using this tool, we have produced a comprehensive, publicly available ACL2+Books Manual that brings better documentation to all ACL2 users. We have also developed an extended manual for use within Centaur Technology that extends the public manual to cover Centaur's internal books. We expect that other organizations using ACL2 will wish to develop similarly extended manuals.
Yu, Bing; Garrett, William E
In soccer one of the most common knee injuries is the anterior cruciate ligament (ACL) tear, which usually occurs through non-contact mechanisms. Female soccer players are at higher risk of sustaining non-contact ACL injuries than male soccer players. A good understanding of ACL loading mechanisms is the basis for a good understanding of the mechanisms of non-contact ACL injuries, which in turn is essential for identifying risk factors and developing prevention strategies. Current literature demonstrates that sagittal plane biomechanical factors, such as small knee flexion angle, great posterior ground reaction force and great quadriceps muscle force, are the major ACL loading mechanisms. A great posterior ground reaction force may be associated with a great quadriceps muscle force, which would cause great anterior draw force at the knee. A small knee flexion is associated with a large patella tendon-tibia shaft angle and ACL elevation angle, which would result in great ACL loading. Current literature also demonstrates that the ACL is not the major structure of bearing knee valgus-varus moment and internal-external rotation loadings. Knee valgus-varus moment and internal-external rotation moment alone are not likely to result in isolated ACL injuries without injuring other knee structures.
This paper presents an ethnolinguistic analysis of how the space between the head and the body is construed in Scandinavian semantic systems vis-a-vis the semantic system of English. With an extensive case study of neck-related meanings in Danish, and with cross-Scandinavian reference, it is demo......This paper presents an ethnolinguistic analysis of how the space between the head and the body is construed in Scandinavian semantic systems vis-a-vis the semantic system of English. With an extensive case study of neck-related meanings in Danish, and with cross-Scandinavian reference......, it is demonstrated that Scandinavian and English systems differ significantly in some aspects of the way in which the construe the human body with words. The study ventures an innovative combination of methods, pairing the Natural Semantic Metalanguage (NSM) approach to linguistic and conceptual analysis...... with empirical evidence from the Evolution of Semantic Systems (EoSS) project. This combination of empirical and interpretative tools helps to integrate evidence from semantics and semiotics, pinning out in great detail the intricacies of the meanings of particular body words. The paper concludes that body words...
Motor learning in ACL injury prevention Anne Benjaminse The physical and psychosocial consequences of an anterior cruciate ligament (ACL) injury are large, for example limitations in daily life, reduction of sports participation, development of osteoarthritis in the knee and increased risk for
Herzberg, Simone D; Motu'apuaka, Makalapua L; Lambert, William; Fu, Rongwei; Brady, Jacqueline; Guise, Jeanne-Marie
Women are at substantially greater risk for anterior cruciate ligament (ACL) injuries than are men. To conduct a systematic review and meta-analysis of the literature to clarify the effect of the menstrual cycle and contraceptives on the laxity of and noncontact injuries to the ACL. Systematic review; Level of evidence, 4. Searches were conducted using MEDLINE (1946-August 2016), the Cochrane Library Database, clinical trial registries, and related reference lists. Search terms included athletic injuries, knee injuries, ligaments, joint instability, menstrual cycle, ovulation, hormones, and contraceptives. Investigators independently dually abstracted and reviewed study details and quality using predefined criteria and evaluated overall strength of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. Twenty-one studies totaling 68,758 participants were included: 5 on the menstrual cycle and ACL injury, 7 on hormonal contraceptives and ACL injury, as well as 13 on menstrual cycle and ligament laxity. Four of 5 studies of women not using hormonal contraception indicated that the luteal phase was the least associated with ACL injuries. The 2 largest and highest quality studies on hormonal contraceptives suggested that hormonal contraceptives may be protective against ACL injury. Six of 12 studies on ACL laxity provided quantitative data for meta-analysis, finding significantly increased laxity during the ovulatory phase compared with the follicular phase. The literature suggests an association between hormonal fluctuations and ACL injury. Recent studies have suggested that oral contraceptives may offer up to a 20% reduction in risk of injury. The literature on ACL injuries and the menstrual cycle has more than doubled over the past decade, permitting quantitative analysis for the first time. However, the overall strength of this evidence is low. Promising potential directions for future research include long
Zander, Pär-Ola; Georgsen, Marianne; Nyvang, Tom
approaches, of which there are many in development research, but to a specific body of work that stems from Scandinavia. Within the research fields relating to design of ICT systems the Scandinavian countries have a rich history of incorporating disadvantaged groups in societies. This paper argues...
This article describes the modern research history of connections between Scandinavian Iron Age societies and the Roman Empire focusing more or less on the last half century. In this time, there has been a significant increase in Danish excavations of Roman Iron Age sites, of which several have...
Dyndahl, Petter; Nielsen, Siw Graabraek
There has been an ongoing tendency, taking place in the Scandinavian countries from the late 1970s onwards, to expand the repertoires and resources of music as an educational matter, an academic field, as well as an area for support and funding from cultural authorities, organisations and institutions. Here, popular music, jazz, folk music and…
Tomescu, Sebastian; Bakker, Ryan; Wasserstein, David; Kalra, Mayank; Nicholls, Micah; Whyne, Cari; Chandrashekar, Naveen
The effectiveness of ACL functional knee braces to reduce meniscal and ACL strain after ACL injury or reconstruction is not well understood. A new dynamic knee tensioning brace system has been designed to apply an active stabilizing force to the knee. The ability of this system to reduce tissue strains is unknown. The purpose of this study was to test the ability of the dynamically tensioned brace to reduce strain in both the ACL and meniscus during rehabilitation activities. A combined in vivo/in silico/in vitro method was used to study three activities: gait, double leg squat, and single leg squat. Muscle forces and kinematics for each activity were derived through in vivo motion capture and applied to seven cadaveric knee specimens fitted with custom braces. Medial meniscal strain and ACL strain were measured in ACL intact, deficient and reconstructed conditions. The brace lowered peak and average meniscal strain in ACL deficient knees (P < 0.05) by an average of 1.7%. The brace was also found to lower meniscal strain in reconstructed knees (1.1%) and lower ACL strain in ACL intact (1.3%) and reconstructed knees (1.4%) (P < 0.05). This study supports the use of a brace equipped with a dynamic tensioning system to lower meniscal strain in ACL-deficient knees. Its use may help decrease the risk of subsequent meniscal tears in chronic ACL deficiency or delayed reconstruction. In ACL-intact and reconstructed knees, the brace may be beneficial in injury prophylaxis or in protecting the ACL graft following reconstruction. These results will aid clinicians make informed recommendations for functional brace use in patients with unstable knees. II.
Gokeler, Alli; Benjaminse, Anne; Hewett, Timothy E.; Lephart, Scott M.; Engebretsen, Lars; Ageberg, Eva; Engelhardt, Martin; Arnold, Markus P.; Postema, Klaas; Otten, Egbert; Dijkstra, Pieter U.
Objective To establish the clinical relevance of proprioceptive deficits reported after anterior cruciate ligament (ACL) injury. Material and methods A literature search was done in electronic databases from January 1990 to June 2009. Inclusion criteria for studies were ACL deficient (ACL-D) and ACL
Bozynski, Chantelle C; Kuroki, Keiichi; Stannard, James P; Smith, Patrick A; Stoker, Aaron M; Cook, Cristi R; Cook, James L
A major hurdle in investigating important clinical questions in knee ligament treatment is a lack of valid translational animal models. This study characterizes the effects of partial transection versus synovial debridement of the anterior (cranial) cruciate ligament (ACL) in dogs. A total of 27 adult purpose-bred research hounds underwent surgery and were assessed over the following 8 weeks. Dogs were randomized into the following three ACL status groups: sham control (n = 9), intact ACL with synovial debridement (exposed ACL) (n = 9), and partial transection of the ACL (partial tear ACL) (n = 9). Dogs in the exposed ACL group and partial tear ACL group had significantly (p canine models were successfully developed to evaluate partial transection versus synovial debridement of the ACL and these models will be used to evaluate treatment options for acute management of ACL injuries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Sørensen, Jannick Kirk
Methods for interaction design have emerged and established themselves first in a Scandinavian context, later in US context and in the rest of the developed world. While good usability and good user experiences are important to all users of ICT, the question is whether the methods and techniques...... that were mainly developed in Scandinavia, Europe and US are suitable for ICT development in West Africa? Can ideals for user-involvement be directly transferred? This paper aims to initiate a discussion of the communication of interaction design knowledge in West Africa by discussing whether insights from...... Scandinavian Participatory design can be used to localize the learning process and make interaction design methods sensitive to the West African context. The paper is based on the author’s reflection on his experiences teaching interaction design in West Africa....
Romani, Laurence; Holck, Lotte; Holgersson, Charlotte
This chapter presents the principal interpretations that took place in Denmark and Sweden regarding the discourse on ‘Diversity Management’. We organise our presentation around three major themes that are central to the local Scandinavian context: gender equality, migration and moral grounds....... This chapter shows the important role of gender equality work practices and how these practices now tend to be progressively incorporated in a broad Diversity Management construct, possibly leading to a less radical stance. Moreover, the comparison between Denmark and Sweden reveals the political associations...... with Diversity Management and migration in Denmark, but not in Sweden. Our third contribution unveils the tensions between the value of equality, which remains strong in the Scandinavian welfare state model, and the actual practices of Diversity Management....
Engels, Eva; Vikner, Sten
This study presents an account of object shift, a word order phenomenon found in most of the Scandinavian languages where an object occurs unexpectedly to the left and not to the right of a sentential adverbial. The book examines object shift across many of the Scandinavian languages and dialects...... and original observations, this book is an important addition to the fields of phonology, optimality theory and theoretical syntax......., and analyses the variation, for example whether object shift is optional or obligatory, whether it applies only to pronouns or other objects as well, and whether it applies to adverbials. The authors show that optimality theory, traditionally used in phonology, is a useful framework for accounting...
Rehfeld, Jens F
Gastrointestinal hormones are peptides released from neuroendocrine cells in the digestive tract. More than 30 hormone genes are currently known to be expressed in the gut, which makes it the largest hormone-producing organ in the body. Modern biology makes it feasible to conceive the hormones un......, but also constitute regulatory systems operating in the whole organism. This overview of gut hormone biology is supplemented with an annotation on some Scandinavian contributions to gastrointestinal hormone research....
Nielsen, Mathias Wullum
This study investigates how Denmark, Norway, and Sweden approach issues of gender equality in research differently. Based on a comparative document analysis of gender equality activities in six Scandinavian universities, together with an examination of the legislative and political frameworks...... surrounding these activities, the article provides new insights into the respective strategies for governing and promoting the advancement of women researchers. In doing so, it exposes some interesting disparities among the cases and shows how Norwegian and Swedish gender equality activities revolve around...
Papalia, Rocco; Vasta, Sebastiano; D'Adamio, Stefano; Giacalone, Antonino; Maffulli, Nicola; Denaro, Vincenzo
Approximately 100,000 anterior cruciate ligament (ACL) reconstructions are performed in the USA each year. Interference screw fixation is considered the standard for rigid fixation of the graft and provides higher fixation strength compared with other devices such as staples or buttons. The present study summarizes the latest evidence comparing the effectiveness of the available classes of interference screws for fixation of ACL grafts. A comprehensive search of the CINAHL, PubMed, Google Scholar, Embase Biomedical databases and the Cochrane Central Registry of Controlled Trials was performed in March 2013. Twelve studies met our inclusion criteria. Most studies showed no intergroup difference in terms of outcomes measured with validated clinical scores such as IKDC (International Knee Documentation Committee), Lysholm score and Tegner activity level. There was no significant difference regarding range of motion. Knee stability as evaluated with pivot shift and KT arthrometer showed a significant difference only in one study, favouring metallic interference screws. Tunnel widening is much more evident and marked patients who underwent ACL reconstruction with bioabsorbable screws, with no influence on the final clinical results achieved. Complication rates between the two screw classes were similar. The average modified Coleman methodology score was 74.67. AREAS OF UNCERTAINTY/RESEARCH NEED: The data comparing the outcomes achieved by two different materials for fixation, bioabsorbable and metallic, to be used during single-bundle ACL reconstruction, showed no significant difference in the final patient outcomes, in terms of clinical scores, clinical evaluation and imaging.
D.A. Padua; S.J. Schultz; M. Collins; R.J. Schmitz; A.M. Chaudhari; Anne Benjaminse
It has been well recognized that multiple factors, whether individually or in combination, contribute to noncontact anterior cruciate ligament (ACL) injury. The ongoing mission of the ACL Research Retreat is to bring clinicians and researchers together to present and discuss the most recent advances
Harsh Raju Chamarthi
Full Text Available We present a data definition framework that enables the convenient specification of data types in ACL2s, the ACL2 Sedan. Our primary motivation for developing the data definition framework was pedagogical. We were teaching undergraduate students how to reason about programs using ACL2s and wanted to provide them with an effective method for defining, testing, and reasoning about data types in the context of an untyped theorem prover. Our framework is now routinely used not only for pedagogical purposes, but also by advanced users. Our framework concisely supports common data definition patterns, e.g. list types, map types, and record types. It also provides support for polymorphic functions. A distinguishing feature of our approach is that we maintain both a predicative and an enumerative characterization of data definitions. In this paper we present our data definition framework via a sequence of examples. We give a complete characterization in terms of tau rules of the inclusion/exclusion relations a data definition induces, under suitable restrictions. The data definition framework is a key component of counterexample generation support in ACL2s, but can be independently used in ACL2, and is available as a community book.
Full Text Available Movements of Scandinavians in period between late 8th AD to middle of 11th AD, called Viking Age, were combined military actions-piracy – and migrations with goal to colonize territories in the West Europe – mainly Insular world of Atlantic and British isles, but also in East Europe, among Finno-Ugrians and Slavs. This activity is seen as the recent, and last, of the Migration Period, the time of great movements of Germanic people in the 4th century AD.
McAloone, Timothy Charles; Andreasen, Mogens Myrup; Boelskifte, Per
competencies. We reflect on our efforts to produce a new type of design professionalism, pointing to new roles and identities for the professional-ism of synthesis and innovation. Finally, we round up by articulating what we see as the future pattern of product development, which should be sup-ported already......The educational systems in the small Scandinavian countries are open to experiments and new education programmes. This paper presents such an initiative from Denmark, showing new interpretations of industrial needs, research insights, educational ideas and identification of core innovative...
Lund, Henrik Hautop; Mayoh, Brian Henry; Perram, John
The book covers the seventh Scandinavian Conference on Artificial Intelligence, held at the Maersk Mc-Kinney Moller Institute for Production Technology at the University of Southern Denmark during the period 20-21 February, 2001. It continues the tradition established by SCAI of being one...... of the most important regional AI conferences in Europe, attracting high quality submissions from Scandinavia and the rest of the world, including the Baltic countries. The contents include robotics, sensor/motor intelligence, evolutionary robotics, behaviour-based systems, multi-agent systems, applications...
Moulton, Samuel G; Steineman, Brett D; Haut Donahue, Tammy L; Fontboté, Cristián A; Cram, Tyler R; LaPrade, Robert F
To further elucidate the direct and indirect fibre insertion morphology within the human ACL femoral attachment using scanning electron microscopy and determine where in the footprint each fibre type predominates. The hypothesis was that direct fibre attachment would be found centrally in the insertion site, while indirect fibre attachment would be found posteriorly adjacent to the posterior articular cartilage. Ten cadaveric knees were dissected to preserve and isolate the entirety of the femoral insertion of the ACL. Specimens were then prepared and evaluated with scanning electron microscopy to determine insertional fibre morphology and location. The entirety of the fan-like projection of the ACL attachment site lay posterior to the lateral intercondylar ridge. In all specimens, a four-phase architecture, consistent with previous descriptions of direct fibres, was found in the centre of the femoral attachment site. The posterior margin of the ACL attachment attached directly adjacent to the posterior articular cartilage with some fibres coursing into it. The posterior portion of the ACL insertion had a two-phase insertion, consistent with previous descriptions of indirect fibres. The transition from the ligament fibres to bone had less interdigitations, and the interdigitations were significantly smaller (p fibre area. The interdigitations of the direct fibres were 387 ± 81 μm (range 282-515 μm) wide, while the interdigitations of indirect fibres measured 228 ± 75 μm (range 89-331 μm). The centre of the ACL femoral attachment consisted of a direct fibre structure, while the posterior portion had an indirect fibre structure. These results support previous animal studies reporting that the centre of the ACL femoral insertion was comprised of the strongest reported fibre type. Clinically, the femoral ACL reconstruction tunnel should be oriented to cover the entirety of the central direct ACL fibres and may need to be customized based on graft type
Liberman, A. S.
This paper is concerned with four Scandinavian prosodemes: accent 1, accent 2, stoed, and no stoed. The aim is to establish the function of each of them, i.e., the role they play in the system of each Scandinavian language. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden. (Author/TL)
McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen
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,…
Hofbauer, M.; Muller, B. [=Bart; Murawski, C. D.; van Eck, C. F.; Fu, F. H.
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
G.D. Myer; E. Otten; Anne Benjaminse; P. Eppinga; A. Gokeler; M. Bisschop
Abstract PURPOSE: To determine the most effective practices for quadriceps strengthening after ACL reconstruction. METHODS: An electronic search has been performed for the literature appearing from January 1990 to January 2012. Inclusion criteria were articles written in English, German or Dutch
Langdorf, Mark I; Strom, Suzanne L; Yang, Luanna; Canales, Cecilia; Anderson, Craig L; Amin, Alpesh; Lotfipour, Shahram
Medical student training and experience in cardiac arrest situations is limited. Traditional Advanced Cardiac Life Support (ACLS) teaching methods are largely unrealistic with rare personal experience as team leader. Yet Postgraduate Year 1 residents may perform this role shortly after graduation. We expanded our ACLS teaching to a "Resuscitation Boot Camp" where we taught 2010 ACLS to 19 pregraduation students in didactic (12 hours) and experiential (8 hours) format. Immediately before the course, we recorded students performing an acute coronary syndrome/ventricular fibrillation (VF) scenario. As a final test, we recorded the same scenario for each student. Primary outcomes were time to cardiopulmonary resuscitation (CPR) and defibrillation (DF). Secondary measures were total scenario score, dangerous actions, proportion of students voicing "ventricular fibrillation," 12-lead ST-elevation myocardial infarction (STEMI) interpretation, and care necessary for return of spontaneous circulation (ROSC). Two expert ACLS instructors scored both performances on a 121-point scale, with each student serving as their own control. We used t tests and McNemar tests for paired data with statistical significance at pmask ventilation before DF. After instruction, students scored 97±4/121 points (p<.0001) with no dangerous actions. Before training, only 4 of 19 (21%) students performed both CPR and DF within 2 minutes, and 3 of these had ROSC. After training, 14 of 19 (74%) achieved CPR+DF≤2 minutes (p=.002), and all had ROSC. Before training, 5 of 19 (26%) students said "VF" and 4 of 19 obtained an ECG, but none identified STEMI. After training, corresponding performance was 13 of 19 "VF" (68%, p=021) and 100% ECG and STEMI identification (p<.05). This course significantly improved knowledge and psychomotor skills. Critical actions required for resuscitation were much more common after training. ACLS training including high-fidelity simulation decreases time to CPR and DF and
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
Scheele, Christian Elling; Little, Ingvild; Diderichsen, Finn
AIMS: Local governments in the Scandinavian countries are increasingly committed to reduce health inequity through 'health equity in all policies' (HEiAP) governance. There exists, however, only very sporadic implementation evidence concerning municipal HEiAP governance, which is the focus...... to health equity goals outside of the health sector and inadequate economic prioritization budget curbs implementation. Concerning evidence, there is a lack of epidemiological data, detailed evidence of health equity interventions as well as indicators relevant for monitoring implementation. Concerted...... administrative action relates to a lack of vertical support and alignment from the national and the regional level to the local level. Horizontally within the municipality, insufficient coordination across policy sectors inhibits effective health equity governance. CONCLUSIONS: A shift away from 'health in all...
Hjalager, Anne Mette; Kwiatkowski, Grzegorz; Østervig Larsen, Martin
that rural tourism has its basis in a dichotomy between authenticity and modernization. New and prospective customer groups, particularly from Germany, demand more diversified and higher quality rural tourism products than current groups, for example, in relation to outdoor opportunities, leisure festivals......© 2017 Informa UK Limited, trading as Taylor & Francis Group Drawing on primary data from a consumer survey (N = 2000), this study demonstrates a clear growth potential in rural tourism in Denmark, Norway, and Sweden, which is, however, hampered by innovation gaps. At the conceptual level......, the study offers a model that identifies the following five innovation gaps in Scandinavian rural tourism: (1) the portfolio gap, (2) the policy departmentalization gap, (3) the knowledge gap, (4) the change motivation gap, and (5) the resource interpretation gap. At the empirical level, the study shows...
Olesen, Søren Maagaard; Poulsen, Jakob L; Drewes, Asbjørn M.
, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database. Patients with definitive or probable CP (M-ANNHEIM diagnostic criteria) were included. Standardised case report......: The study cohort comprised of 910 patients (608 men: 302 women; median age 58 (IQR: 48-67) years with definite 848 (93%) or probable CP 62 (7%). Nicotine (70%) and alcohol (59%) were the most frequent aetiologies and seen in combination in 44% of patients. A history of recurrent acute pancreatitis was seen...... in 49% prior to the development of CP. Pain (69%) and exocrine pancreatic insufficiency (68%) were the most common complications followed by diabetes (43%). Most patients (30%) were classified as clinical stage II (symptomatic CP with exocrine or endocrine insufficiency). Less than 10% of the patients...
Smith, Sean D; Laprade, Robert F; Jansson, Kyle S; Arøen, Asbjørn; Wijdicks, Coen A
Functional braces are commonly prescribed to treat anterior cruciate ligament (ACL) injury. The results of the existing literature on functional brace use are mixed. The purpose of this study was to evaluate the history and current state of functional ACL bracing and to identify design criteria that could improve upon current bracing technologies. A literature search was performed through the PubMed MEDLINE database in April 2013 for the keywords "anterior cruciate ligament" and "brace". Articles published between January 1, 1980, and April 4, 2013, were retrieved and reviewed. Current functional braces used to treat ACL injury were identified. The function of the native ACL was carefully studied to identify design requirements that could improve upon current bracing technologies. Biomechanical evaluations of functional brace effects at time zero have been mixed. Functional brace use reportedly does not improve long-term patient outcomes following ACL reconstruction, but has been shown to reduce subsequent injury rates while skiing in both ACL-deficient and reconstructed skiers. In situ force in the ACL varies with flexion angle and activity. Currently, no brace has been designed and validated to replicate the force-flexion behavior of the native ACL. Biomechanical and clinical evidence suggests current functional bracing technologies do not sufficiently restore normal biomechanics to the ACL-deficient knee, protect the reconstructed ACL, and improve long-term patient outcomes. Further research into a functional brace designed to apply forces to the knee joint similar in magnitude to the native ACL should be pursued. III.
Full Text Available The religions of Scandinavians and Saamis have, for decades of scholarship, functioned as sources of analogies to explain elements in one another. For the study of Saami religion answers to questions about origins were sought in Scandinavian religion, while Saami religion has been seen by students of Scandinavian religion, as a preserver and a faithful witness of Scandinavian concepts and rites that had vanished in the times reflected in the literary sources. This view has now changed. In recent decades the tendency has been to use the loan- explanations more and more sparsely. Elements in Saami religion that were seen earlier as Scandinavian loans are now explained in a Finno-Ugric context, whereas the few elements in Scandinavian religion that were thought of as loans from the Saamis are more often looked upon as inherited from a common origin, a North Eurasian cultural stratum. The search for analogies has, in any case, preoccupied the historian of religions in this field, too. The purpose here is to provide a short and selective résumé of some aspects of a theme in the history of scholarship, a theme where "resemblances" have been found, compared, used as analogies, and — called into question: the comparative study of the religions of the Scandinavians and Saamis.
... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...
Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...
Department of Veterans Affairs — The Converged Registries platform is a hardware and software architecture designed to host individual patient registries and eliminate duplicative development effort...
Cuong K. Chau
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.
M. V. Demesсhenko
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.
Svendsen, Gunnar Lind Haase; Svendsen, Gert Tinggaard
The Scandinavian welfare model is a puzzle to economists: It works economically, even though free-riding should prevail with its explosive cocktail of high taxation and high social benefits. One overlooked solution to the puzzle could be the unique stock of social trust present in Scandinavia. Here......, the four Scandinavian countries (Norway, Denmark, Sweden, and Finland) form the top three with scores above 60 percent social trust on a ranking that covers 94 countries from all over the world....
Frølich, Wenche; Åman, Per; Tetens, Inge
The food-based dietary guidelines in the Scandinavian countries that recommend an intake of minimum 75 g whole grain per 10 MJ (2,388 kcal) per day are mainly derived from prospective cohort studies where quantitative but little qualitative details are available on whole grain products. The objective of the current paper is to clarify possible differences in nutritional and health effects of the types of whole grain grown and consumed in the Scandinavian countries. A further objective is to s...
Hagenblad, Jenny; Olsson, Maria; Parker, Heidi G; Ostrander, Elaine A; Ellegren, Hans
The Scandinavian wolf population represents one of the genetically most well-characterized examples of a severely bottlenecked natural population (with only two founders), and of how the addition of new genetic material (one immigrant) can at least temporarily provide a 'genetic rescue'. However, inbreeding depression has been observed in this population and in the absence of additional immigrants, its long-term viability is questioned. To study the effects of inbreeding and selection on genomic diversity, we performed a genomic scan with approximately 250 microsatellite markers distributed across all autosomes and the X chromosome. We found linkage disequilibrium (LD) that extended up to distances of 50 Mb, exceeding that of most outbreeding species studied thus far. LD was particularly pronounced on the X chromosome. Overall levels of observed genomic heterozygosity did not deviate significantly from simulations based on known population history, giving no support for a general selection for heterozygotes. However, we found evidence supporting balancing selection at a number of loci and also evidence suggesting directional selection at other loci. For markers on chromosome 23, the signal of selection was particularly strong, indicating that purifying selection against deleterious alleles may have occurred even in this very small population. These data suggest that population genomics allows the exploration of the effects of neutral and non-neutral evolution on a finer scale than what has previously been possible.
Irvine, James N.; Thorhauer, Eric; Zheng, Liying; Baidoo, Kevin; Abebe, Ermias; Tashman, Scott; Zhang, Xudong; Vyas, Dharmesh; Harner, Christopher D.; Arner, Justin W.
Objectives: The meniscus plays a vital role in knee load transmission by increasing the tibiofemoral joint contact area and distributing the joint forces within the medial and lateral compartments. Clinically, anterior cruciate ligament (ACL) injuries are commonly concomitant with tears of the lateral meniscus. In isolated ACL tears, it is likely that meniscal behavior is affected as a result of altered tibiofemoral kinematics. However, little is known regarding the effects of acute ACL injur...
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.
Grant, John A; Mohtadi, Nicholas G
Anterior cruciate ligament (ACL) reconstruction is the treatment of choice for patients who experience episodes of instability and a decreased quality of life after ACL rupture. The bone-patellar tendon-bone and hamstring autografts are the current standards for ACL reconstruction. Primary care physicians, especially sports medicine clinicians, are the first-line providers of nonoperative care for patients who have ACL injuries. Care providers need to know the biologic and biomechanic properties of these grafts, clinical indications for each graft, and rehabilitation considerations to appropriately counsel their patients.
Samaan, Michael A; Ringleb, Stacie I; Bawab, Sebastian Y; Greska, Eric K; Weinhandl, Joshua T
Athletes with anterior cruciate ligament (ACL) injuries usually undergo ACL-reconstruction (ACLR) in order to restore joint stability, so that dynamic maneuvers such as the sidestep cut can be performed. Despite restoration of joint stability after ACLR, many athletes do not return to pre-injury levels and may be at a high risk of a second ACL injury. The purpose of this study was to determine whether or not ACL loading, would increase after ACLR. One female Division I collegiate athlete performed bilateral unanticipated sidestep cuts both before ACL injury and 27months after ACLR. Musculoskeletal simulations were used to calculate ACL loading during the deceleration phase of the sidestep cuts. Twenty-seven months after ACLR, the athlete demonstrated higher total ACL loading in the ipsilateral limb as well as altered joint kinematics, moments, and quadriceps muscle force production. In the contralateral limb, there were no increases in total ACL loading or muscle force production yet altered lower extremity joint kinematics and moments were present after ACLR. Higher total ACL loading in the ipsilateral limb of this athlete may suggest an increased risk of second ACL injury. The results of this study provide an initial step in understanding the effects of ACLR on the risk of second ACL injury in an elite athlete and suggest that it is important to develop a better understanding of this surgical intervention on knee joint loading, in order to reduce the risk of second ACL injury while performing dynamic maneuvers. Copyright © 2016 Elsevier B.V. All rights reserved.
Nordahl, Birgitta; Sjöström, Rita; Westin, Maria; Werner, Suzanne; Alricsson, Marie
To explore the experiences of alpine skiing at the elite level after anterior cruciate ligament (ACL) injury and reconstruction. A qualitative approach where semi-structured interviews were conducted, and an analysis of the manifest content was performed. Five ski high school students, two male and three female skiers, who had suffered ACL injuries and undergone ACL reconstructions. Seven categories were identified. The participants described their perceived opportunities with regard to returning to alpine skiing after ACL injury and reconstruction as something positive to do with self-belief, being mentally and physically prepared, regaining confidence in their own ability, being given time and using active strategies. In contrast, perceived barriers to a return to elite alpine skiing gave rise to negative feelings, for example, fear, disheartenment, a total lack of or ambivalent confidence in their own ability and the use of passive strategies. The two male skiers returned to alpine skiing. They reported confidence in their own ability, active strategies and support on all levels, as well as enhanced physical ability. The female skiers did not return to their pre-injury level of competitive alpine skiing. They stated a lack of support on all levels, deterioration in their physical ability and two out of three reported passive strategies and no or ambivalent confidence in their own ability. The most important factors were family support, support on all levels, access to a physiotherapist and time given.
Full Text Available Introduction: Intraosseous access (IO is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications.Methods: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians.Results: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%, difficulties with penetration of periosteum with IO needle (10.3%, difficulties with aspiration of bone marrow (12.3%, and bended/broken needle (4.0%. When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%, slow infusion (despite use of pressure bag (8.8%, displacement after insertion (8.5%, and extravasation (3.7%. Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively.Conclusion: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. [West J Emerg Med. 2013;14(5:440–443.
Hunt, Warren A; Kaufmann, Matt; Moore, J Strother; Slobodova, Anna
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).
Kropf, Eric J; Shen, Wei; van Eck, Carola F; Musahl, Volker; Irrgang, James J; Fu, Freddie H
The purpose of this study was to: (1) define the relationship between the ACL and PCL in normal knees; (2) determine whether ACL-PCL impingement occurs in native knees; and (3) determine whether there is a difference in impingement between double-bundle reconstructed and native knees. Eight subjects were identified (age 20-50; 6 females, 2 males). All were at least 1-year status postanatomic double-bundle ACL reconstruction (allograft; AM = 8 mm; PL = 7 mm) and had no history of injury or surgery to the contralateral knee. MRIs of both knees were performed with the knee at 0 and 30° of flexion. The images were evaluated by a non-treating surgeon and two musculoskeletal radiologists. Coronal and sagittal angles of AM and PL bundles, Liu's PCL index and the distance between ACL and PCL on modified axial oblique images were recorded. Impingement was graded (1) no contact; (2) contact without deformation; or (3) contact and distortion of PCL contour. Seventy-five percent (6) of the native ACL's showed no contact with the roof of the intercondylar notch or PCL, compared to 25 % (2) of the double-bundle reconstructed ACLs. One double-bundle reconstructed ACL showed intercondylar notch roof and ACL-PCL impingement (12.5 %). Significant differences were found between the native ACL and the double-bundle reconstructed ACL for the coronal angle of the AM (79° vs. 72°, p = 0.002) and PL bundle (75° vs. 58°, p = 0.001). No differences in ROM or stability were noted at any follow-up interval between groups based on MRI impingement grade. ACL-PCL contact occurred in 25 % of native knees. Contact between the ACL graft and PCL occurred in 75 % of double-bundle reconstructed knees. ACL-PCL impingement, both contact and distortion of the PCL, occurred in one knee after double-bundle reconstruction. This study offers perspective on what can be considered normal contact between the ACL and PCL and how impingement after ACL reconstruction can be detected on MRI
Palmieri-Smith, Riann M; Thomas, Abbey C
Anterior cruciate ligament (ACL) injury leads to early-onset osteoarthritis. Quadriceps weakness is a consequence of ACL injury and is considered to result from arthrogenic inhibition (AMI). AMI is the neurological "shutdown" of muscles surrounding an injured joint, preventing full activation, reducing strength, and promoting atrophy. As quadriceps function is critical for energy absorption, its dysfunction may contribute to posttraumatic osteoarthritis.
van Eck, C.F.; Martins, C.A.Q.; Vyas, S.M.; Celentano, U.; van Dijk, C.N.; Fu, F.H.
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.
Troelsen, Anders; Malchau, Erik; Sillesen, Nanna Hylleholt
and to analyze age-stratified risk of revision comparing cemented, hybrid, and uncemented fixation as reported by national hip arthroplasty registries. METHODS: Data were extracted from the annual reports of seven national hip arthroplasty registries; we included all national registries for which annual reports...... were available in English or a Scandinavian language, if the registry had a history of more than 5 years of data collection. RESULTS: Current use of uncemented fixation in primary THAs varies between 15% in Sweden and 82% in Canada. From 2006 to 2010 the registries of all countries reported overall...... increases in the use of uncemented fixation; Sweden reported the smallest absolute increase (from 10% to 15%), and Denmark reported the greatest absolute increase (from 47% to 68%). Looking only at the oldest age groups, use of uncemented fixation also was increasing during the period. In the oldest age...
Bregnballe, Vibeke; Erwander, Inger
Aims: SNSG/CF was established to stimulate and improve cooperation between CF nurses from Scandinavian CF centers. Methods: SNSG/CF includes all the CF centers in Norway (Oslo and Bergen), Sweden (Stockholm, Gothenburg, Lund and Uppsala) and Denmark (Copenhagen and Aarhus). The board of SNSG....../CF comprises one CF nurse from each of the centers. The board meets twice a year to plan workshops and courses. SNSG/CF is part of the International Nurse Specialist Group/Cystic Fibrosis (INSG/CF). Results: Within the framework of SNSG/CF a 2-day workshop is held every second year for approximately 40...... Scandinavian CF nurses. A twelve-day CF course equivalent to 5 ECTS has been held once. Twenty-one nurses, physiotherapists and dieticians attended the course and the course will be repeated. SNSG/CF plans to make a common Scandinavian database on nursing interventions in CE SNSG/CF aims to conduct common...
Grid services are the fundamental building blocks of today's Distributed Computing Infrastructures (DCI). The discovery of services in the DCI is a primary function that is a precursor to other tasks such as workload and data management. In this context, a service registry can be used to fulfil such a requirement. Existing service registries, such as the ARC Information Index or UNICORE Registry, are examples that have proven themselves in production environments. Such implementations provide a centralized service registry, however, todays DCIs, such as EGI, are based on a federation model. It is therefore necessary for the service registry to mirror such a model in order for it to seamlessly fit into the operational and management requirements - a DCI built using federated approach. This document presents an architecture for a federated service registry and a prototype based on this architecture, the EMI Registry. Special attention is given to how the federated service registry is robust to environment failu...
Tangen, Jan Ove; Møller, Verner
Why are Scandinavian countries so committed to the cause of antidoping? In this paper, we propose that the Scandinavian mentality, formed by paternalistic welfare models, is a useful framework for understanding anti-doping. We focus on anti-doping policy and work in Norway and Denmark. We start......: the Norwegian self-image and its impact on politics, and Danish amateurism and corrupt idealism. We conclude that Nordic antidoping is pursued with rigour and determination, and suggest this is rooted in the Nordic countries’ exceptional social-welfare ideology and strong paternalism....
Steffen, Kathrin; Nilstad, Agnethe; Kristianslund, Eirik Klami; Myklebust, Grethe; Bahr, Roald; Krosshaug, Tron
This study aimed to prospectively investigate the association between isolated and functional lower extremity muscle strength and the risk for noncontact anterior cruciate ligament (ACL) injury in Norwegian female elite handball and football players. From 2007 through 2015, premier league players participated in strength testing and were prospectively followed for ACL injury risk. At baseline, we recorded player demographics, playing and ACL injury history, and measured peak concentric isokinetic quadriceps and hamstring torques (60°·s), hamstring-to-quadriceps ratio, isometric hip abduction strength, and one-repetition maximum in a seated leg press. We followed a predefined statistical protocol where we generated five separate logistic regression models, one for each of the proposed strength risk factors and adjusted for confounding factors. New ACL injury was the outcome, using the leg as the unit of analysis. A total of 57 (6.6%) of 867 players (age = 21 ± 4 yr, height = 170 ± 6 cm, body mass = 66 ± 8 kg) suffered from a noncontact ACL injury after baseline testing (1.8 ± 1.8 yr). The OR of sustaining a new injury among those with an ACL injury history was 3.1 (95% confidence interval = 1.6-6.1). None of the five strength variables selected were statistically associated with an increased risk of ACL rupture when adjusted for sport, dominant leg, ACL injury history, and height. Peak lower extremity strength was not associated with an increased ACL injury risk among female elite handball and football players. Hence, peak strength, as measured in the present study, cannot be used to screen elite female athletes to predict injury risk.
Fluid resuscitation is a frequent intervention in intensive care. Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units (ICUs...
Eriksson, Dennis; Brinch-Pedersen, Henrik; Chawade, Aakash; Holme, Inger B; Hvoslef-Eide, Trine A K; Ritala, Anneli; Teeri, Teemu H; Thorstensen, Tage
Plant research and breeding has a long and successful history in the Scandinavian countries, Denmark, Finland, Norway and Sweden. Researchers in the region have been early in adopting plant gene technologies as they developed. This review gives a background, as well as discuss the current and future progress of plant gene technology in these four countries. Country-specific details of the regulation of genetically modified plants are described, as well as similarities and differences in the approach to regulation of novel genome-editing techniques. Also, the development of a sustainable bioeconomy may encompass the application of plant gene technology and we discuss whether or not this is reflected in current associated national strategies. In addition, country-specific information about the opinion of the public and other stakeholders on plant gene technology is presented, together with a country-wise political comparison and a discussion of the potential reciprocal influence between public opinion and the political process of policy development. The Scandinavian region is unique in several aspects, such as climate and certain agriculturally related regulations, and at the same time the region is vulnerable to changes in plant breeding investments due to the relatively small market sizes. It is therefore important to discuss the role and regulation of innovative solutions in Scandinavian plant research and breeding. © 2017 The Authors. Physiologia Plantarum published by John Wiley & Sons Ltd on behalf of Scandinavian Plant Physiology Society.
Sollid, S.; Sundstrom, T.; Kock-Jensen, C.
. Evidence-based guidelines already exist that focus on all steps in the process. In the present article members of the Scandinavian Neurotrauma Committee present recommendations on prehospital management of traumatic brain injury adapted to the infrastructure of the Nordic region Udgivelsesdato: 2008/6/26...
Frølich, Wenche; Aman, Per; Tetens, Inge
The food-based dietary guidelines in the Scandinavian countries that recommend an intake of minimum 75 g whole grain per 10 MJ (2,388 kcal) per day are mainly derived from prospective cohort studies where quantitative but little qualitative details are available on whole grain products. The objec...
Nielsen, Mathias Wullum
This study investigates how Denmark, Norway, and Sweden approach issues of gender equality in research differently. Based on a comparative document analysis of gender equality activities in six Scandinavian universities, together with an examination of the legislative and political frameworks surrounding these activities, the article provides new…
Norberg, Katarina; Johansson, Olof
Purpose: Schooling is a significant tool for fostering future generations, which, in turn, implies that the curriculum is an ethical document. It mirrors the society's notion of what is valuable, useful and necessary from a societal and individual perspective. The purpose of this paper is to address the Scandinavian curricula's ethical framework,…
In recent years, there has been a significant growth in the volume of research production in education ethnography in Scandinavia due partly to a regionally financed network. The present article makes some comparisons between Scandinavian and other education research contexts in relation to aspects of general ethnographic design to try to analyse…
appear at first glance. I shall however try to show that this might provide support for what I take to be a more basic difference between Yiddish on one hand and the Scandinavian languages on the other, namely that Yiddish is an OV-language like German and Dutch, not a VO-language like English...
Nils Olav Ǿstrem
Full Text Available The article gives an overview of migration movements in Norway and other Scandinavian countries. The overview most of all focuses on history, but gives also comments on the present situation. The quantitative dimension of Norwegian and Scandinavian emigration in different periods is dealt with, but the article also discusses cultural circumstances in connection with emigration from and immigration to this north European region. Emigration started earlier in Norway than in the other Scandinavian or Nordic countries. Of the Scandinavian countries, “it was only from Norway that emigration to America took place on a larger scale during the 1850s”. Sweden and Denmark “during the 1860s … entered a stage of massive emigration which culminated during the 1880s”. Emigration from Iceland started later, but the country experienced “a veritable flood during the 1880s”, at the same time as Eastern and Western Europe. Finland did not reach “great numbers until the initial decades of the 20th century.” The reasons for emigration from the Scandinavian countries have in traditional migration studies been linked to economic and social factors. In this article, based on the author’s thesis on emigration from the local parish Skjold in Rogaland county, Norway, from 1837 to 1914, the focus is on the cultural factor when discussing underlying causes of Nordic mass emigration. By using the term emigrant culture – a personification of the migrants – a way to employ the individual psychological or motive factor is attempted. Considering migration a process of two sides also strengthens the cultural or psychological individual factor.
... fullstory_167352.html Surgery for ACL Tear Often Successful Over Long Term Even 10 years after procedure, ... were scheduled for presentation Friday at the annual meeting of the AOSSM in Toronto. Findings presented at ...
Trivedi, Vikas; Mishra, Panna; Verma, Deepankar
The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for management of these injuries to frame a dedicated age specific treatment strategy. This article does a systematic evidence based literature review of management of Pediatric ACL injuries seen in several forms: tibial eminence avulsion fractures partial ACL tears and full thickness ligament tears and its outcome analysis. The mechanism of Safe and effective surgical techniques for children and adolescents with ACL injuries continues to evolve. The numerous age matched techniques are extensively discussed. Neuromuscular training can reduce the risk of ACL injury in adolescent girls. This review outlines the current state of knowledge on diagnosis treatment and prevention of ACL injuries in children and adolescents and helps in guiding the treatment through a dedicated algorithm.
Seyed Mohammad Tahami
Full Text Available Background: Articular cartilage injuries are a common clinical problem at the time of ACL reconstruction with an incidence rate of 16-46%. Good results of ACL reconstruction combined with the treatment of chondral lesions have been published in some studies. Method: After statistical analysis 30 patients were selected and divided in 2 groups. TheFfirst group consisted of 15 patients wite isolated ACL tear without any other concomitant injuries and the second group consisted of 15 patients with ACL tear and concomitant high grade (grade 3 or 4 of outerbridge classification contained articular cartilage injuries during arthroscopy. Group 1 underwent ACL reconstruction and group 2 underwent ACL reconstruction combined with chondroplasty via the drilling and microfracture technique. For each patient the Lysholm knee score questionnaire was completed before surgery, 6 months and 1 year after surgery. Results: The mean Lysholm knee score in both groups improves: 9.6 points after 6 months and 16.06 points after 1 year in group 1 and 23.26 points after 6 months and 30.66 after 1 year in group 2, whict was statistically significant (Pvalue
Papalia, Rocco; Osti, Leonardo; Del Buono, Angelo; Denaro, Vincenzo; Maffulli, Nicola
The optimal management for combined anterior cruciate ligament-medial collateral ligament (ACL-MCL) injuries is controversial. We performed a literature search using Medline, Cochrane and Google Scholar using the keywords: 'ACL' and 'MCL' in combination with 'surgery treatment', 'conservative treatment', 'surgery management', 'conservative management', 'surgical treatment' and 'surgical management'. We identified 23 published studies. Conservative and surgical management for combined ACL-MCL injuries resulted in different functional outcomes. The Coleman Methodology Score showed great heterogeneity in terms of study design, patient characteristics, management methods and outcome assessment and generally low methodological quality. Given the heterogeneity in terms of treatment and results, we did not find a univocal trend over the years regarding MCL management (conservative or surgical). The use of several scoring systems did not allow us to compare outcomes in the different studies. There is a need for a common validated scale for clinical measurements for ACL-MCL injuries, so as to allow easier and more reliable comparison of outcomes in different studies. To improve diagnostic certainty of combined ACL-MCL injuries, all patients should have imaging assessment (MR and stress-radiography) in addition to clinical examination. There is a need to perform appropriately powered randomized clinical trials of conservative and surgical treatment of combined ACL-MCL injuries, using standard diagnostic assessment, common and validated scoring system comparing reported outcomes and duration of follow-up more than 2 years.
U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...
Perner, A.; Aneman, A.; Guttormsen, A.B.
BACKGROUND: Fluid resuscitation is a frequent intervention in intensive care. Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units...... (ICUs) are unknown. METHODS: In March-May 2007, 120 Scandinavian ICUs were invited to answer a web-based survey consisting of 18 questions on types of colloids, indications, contraindications and rationale of use. RESULTS: Seventy-three ICUs, of which 31 were university hospital units, answered...... the questionnaire. Most ICUs used both synthetic and natural colloids, and hydroxyethyl starch (HES) 130/0.4 was the preferred colloid in 59 units. Eleven ICUs had protocols for colloid use. The most frequent indication was second-line fluid for hypovolaemia, but one in three ICUs used colloids as first-line fluid...
Jakobsen, Randi Kjelde; Herholdt-Lomholdt, Sine Maria
Review question/objective: The aim of this review is to systematically identify, appraise and synthesize available text and opinion papers from policy-makers and trade unions in Scandinavian countries (Denmark, Sweden and Norway) containing information about nursing talent needed in healthcare...... systems for the future. The overall objective is to identify and synthesize the opinions of various stakeholders of what they believe is required in terms of nursing talent in Scandinavia. In this review, ‘‘nursing talent’’ refers to certain skills or competencies that are essential within nursing to meet...... the challenges and demands of future health care. The purpose of this review is to provide knowledge about the opinions of two key stakeholders (policy-makers and trade unions) on nursing talent needed in future Scandinavian healthcare systems....
Ekedahl, Anders; Lidbeck, Jan; Lithman, T; Noreen, D; Melander, Arne
Sales statistics indicate large variations in benzodiazepine consumption between the Scandinavian countries: the current difference between Denmark (highest) and Sweden (lowest) is almost two-fold. There are also large within-country variations: e.g. benzodiazepine sales in the Swedish city of Helsingborg, which is close to Denmark, were at the average Danish level and were the highest in Sweden. Repeated prescription analyses were carried out in Helsingborg, and register data were used to co...
Mengiste, Shegaw Anagaw; Tjørnehøj, Gitte
IT-driven organizational changes through information systems development and implementation (ISD&I) is highly challenging because of high complexity and many stakeholders and even more so in developing countries, where the failure rates are higher than elsewhere. Unfortunately, since these countr...... we think the Scandinavian approaches to ISD&I can be useful for the African context and in developing countries in general....
Duan, Haiping; Ning, Feng; Zhang, Dongfeng
In 1998, the Qingdao Twin Registry was initiated as the main part of the Chinese National Twin Registry. By 2005, a total of 10,655 twin pairs had been recruited. Since then new twin cohorts have been sampled, with one longitudinal cohort of adolescent twins selected to explore determinants of me...
Gilling, M.; Budtz-Jorgensen, E.; Boonen, S. E.
The Danish Huntington's Disease Registry (DHR) is a nationwide family registry comprising 14 245 individuals from 445 Huntington's disease (HD) families of which the largest family includes 845 individuals in 8 generations. 1136 DNA and/or blood samples and 18 fibroblast cultures are stored...
Schuurman, Ineke; Windhouwer, M.; Shkaravska, O.
Since a few months the CLARIN Concept Registry (CCR;www.clarin.eu/conceptregistry) is operational, the open access, OpenSKOS-based registry replacing ISOcat. Although using ISOcat had been encouraged by CLARIN, it had its drawbacks: a rich data model combined with a very open update strategy turned
Memon, S.; Szigeti, G.; Field, L.
This documents describes the overall development plan of the EMI Registry product, the plan focuses on the realisation of the EMI Registry specification as defined in the document. It is understood that during the course of the development phase the specification will likely evolve and the changes will be fed into the specification document.
Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels
Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DH...
Slagers, Anton J.; Reininga, Inge H. F.; van den Akker-Scheek, Inge
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)).
Full Text Available The food-based dietary guidelines in the Scandinavian countries that recommend an intake of minimum 75 g whole grain per 10 MJ (2,388 kcal per day are mainly derived from prospective cohort studies where quantitative but little qualitative details are available on whole grain products. The objective of the current paper is to clarify possible differences in nutritional and health effects of the types of whole grain grown and consumed in the Scandinavian countries. A further objective is to substantiate how processing may influence the nutritional value and potential health effects of different whole grains and whole grain foods. The most commonly consumed whole grain cereals in the Scandinavian countries are wheat, rye, and oats with a considerable inter-country variation in the consumption patterns and with barley constituting only a minor role. The chemical composition of these different whole grains and thus the whole grain products consumed vary considerably with regard to the content of macro- and micronutrients and bioactive components. A considerable amount of scientific substantiation shows that processing methods of the whole grains are important for the physiological and health effects of the final whole grain products. Future research should consider the specific properties of each cereal and its processing methods to further identify the uniqueness and health potentials of whole grain products. This would enable the authorities to provide more specific food-based dietary guidelines in relation to whole grain to the benefit of both the food industry and the consumer.
Brophy, Robert H.; Schmitz, Leah; Wright, Rick W.; Dunn, Warren R.; Parker, Richard D.; Andrish, Jack T.; McCarty, Eric C.; Spindler, Kurt P.
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
Hansson, Lisa; Lissandrello, Enza; Næss, Petter
model of public transport. The findings are based on public documents, reform evaluations, and statistics. This is the first paper focusing on Scandinavian public transport systems and their governing models per se, taking into account the considerable reforms of the 2000s. The results provide......Scandinavian public transport, especially aspects of how the Scandinavian countries (i.e., Sweden, Denmark, and Norway) have created governing structures for a cohesive public transport system, is often cited positively in international research. Scandinavia is often treated as a homogeneous unit...... in public transport research, which sometimes refers to the “Scandinavian model of public transport”. It is not uncommon for conclusions regarding Scandinavian countries to be based on analyses of just one country. Is there actually such a thing as a Scandinavian model of public transport? All around Europe...
Kanakamedala, Ajay C; Burnham, Jeremy M; Pfeiffer, Thomas R; Herbst, Elmar; Kowalczuk, Marcin; Popchak, Adam; Irrgang, James; Fu, Freddie H; Musahl, Volker
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
Federal Communications Commission — Updated as of 5Oct2017. The Registry lists PSAPs by an FCC assigned identification number, PSAP Name, State, County, City, and provides information on any type of...
U.S. Environmental Protection Agency — Data Element Registry Services (DERS) is a resource for information about value lists (aka code sets / pick lists), data dictionaries, data elements, and EPA data...
Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager; Schaarup, Susanne Zielke; Gyllenborg, Jesper
The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. All patients with acute stroke (from 2003) or TIA (from 2013) treated at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. The registry holds prospectively collected data on key processes of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients with acute stroke and TIA. Patient outcomes are currently monitored using 30-day mortality, unplanned readmission, and for patients receiving revascularization therapy, also functional level at 3 months poststroke. Sociodemographic, clinical, and lifestyle factors with potential prognostic impact are registered. The Danish Stroke Registry is a well-established clinical registry which plays a key role for monitoring and improving stroke and TIA care in Denmark. In addition, the registry is increasingly used for research.
Bernard R. Bach
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
Weiss, Kaitlyn; Whatman, Chris
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
Schliemann, Benedikt; Glasbrenner, Johannes; Rosenbaum, Dieter; Lammers, Katharina; Herbort, Mirco; Domnick, Christoph; Raschke, Michael J; Kösters, Clemens
Dynamic intraligamentary stabilization (DIS) has been introduced as a new technique to repair the torn anterior cruciate ligament (ACL) and to restore knee joint kinematics after an acute ACL tear. Aim of the present study was to compare the early post-operative activity, restoration of gait pattern and functional results after DIS in comparison with primary ACL reconstruction (ACLR) for acute ACL tears. It was hypothesized that functional results, post-operative activity and changes in gait pattern after DIS are comparable to those after ACLR. Sixty patients with acute ACL tears were included in this study and underwent either DIS or ACLR with an anatomic semitendinosus autograft in a randomized manner. Patients were equipped with an accelerometric step counter for the first 6 weeks after surgery in order to monitor their early post-operative activity. 3D gait analysis was performed at 6 weeks and 6 months after surgery. Temporal-spatial, kinematic and kinetic parameters were extracted and averaged for each subject. Functional results were recorded at 6 weeks, 6 months and 12 months after surgery using the Tegner activity scale, International Knee Documentation Committee score and Lysholm score. Patients who underwent DIS showed an increased early post-operative activity with significant differences at week 2 and 3 (p = 0.0241 and 0.0220). No significant differences between groups were found for knee kinematic and kinetic parameters or the functional scores at any time of the follow-up. Furthermore, the difference in anterior tibial translation was not significantly different between the two groups (n.s.). Early functional results and changes in gait pattern after DIS are comparable to those of primary ACLR. Therefore, ACL repair may be an alternative to ACLR in this cohort of patients. I.
David S. Hardin
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.
Magnussen, Robert A.; GRANAN, Lars-Petter; Dunn, Warren R.; Amendola, Annunziato; Andrish, Jack T.; Brophy, Robert; Carey, James L.; Flanigan, David; Huston, Laura J.; Jones, Morgan
Data from large prospectively collected anterior cruciate ligament (ACL) cohorts are being utilized to address clinical questions regarding ACL injury demographics and outcomes of ACL reconstruction. These data are affected by patient and injury factors as well as surgical factors associated with the site of data collection. The aim of this article is to compare primary ACL reconstruction data from patient cohorts in the United States and Norway, demonstrating the similarities and differences...
communication), this study focuses on levels and patterns of categorization in the domain of affectivity. Cross-cultural comparable data collected in several Romance (Spanish, Italian, Romanian) and Scandinavian (Danish, Swedish, Norwegian) languages with the help of a series of experiments inspired by Fehr...... categorizations in the 6 languages, with the Romance languages and Norwegian having 2, and Danish and Swedish only 1. Special attention is devoted, not as much to frequency of mention, order of mention and indexes of salience - parameters that are usually discussed in categorization and cultural domain studies...
Bingham, S; Wiggins, H S; Englyst, H
the survey, thereby implying that dietary habits had not changed as a result of the investigative technique. It is concluded that the dietary data are indicative of current patterns of food consumption and are sufficiently valid for comparison with data on cancer risk in the 4 areas.......Average intakes of nonstarch polysaccharides (dietary fiber), foods, and nutrients were measured in representative samples of 30 men aged 50-59 in 4 Scandinavian populations with a 3-4 fold difference in risk for large bowel cancer. The assessment technique, a 4-day weighed record of food consumed...
Gadegaard Jensen, Anders; Callesen, T; Hagemo, J S
Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care...... influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1-1.5 mg/kg is preferred. Outside...
Bingham, S; Wiggins, H S; Englyst, H
Average intakes of nonstarch polysaccharides (dietary fiber), foods, and nutrients were measured in representative samples of 30 men aged 50-59 in 4 Scandinavian populations with a 3-4 fold difference in risk for large bowel cancer. The assessment technique, a 4-day weighed record of food consume...... the survey, thereby implying that dietary habits had not changed as a result of the investigative technique. It is concluded that the dietary data are indicative of current patterns of food consumption and are sufficiently valid for comparison with data on cancer risk in the 4 areas....
Kragelund, Camilla; Reibel, J; Hietanen, J
as new approaches, treatments and diagnostic possibilities develop. Likewise, the role of the dentist in the community changes and may vary in different countries. As members of the Scandinavian Fellowship for Oral Pathology and Oral Medicine and subject representatives of oral pathology and oral...... medicine, we feel obliged to contribute to the discussion of how the guidelines of the dental curriculum support the highest possible standards of dental education. This article is meant to delineate a reasonable standard of oral pathology and oral medicine in the European dental curriculum and to guide...... subject representatives in curriculum development and planning. We have created an advisory topic list in oral pathology and oral medicine....
Viggen, Erlend Magnus
The 39th Scandinavian Symposium on Physical Acoustics was held at Geilo, Norway from January 31 to February 3, 2016. It was arranged by the Acoustics and Optics group of the Norwegian Physical Society, and was coordinated by Ulf Kristiansen and Erlend Magnus Viggen. This year, there were 48 participants, holding a total of 31 presentations on various topics in physical acoustics, such as ultrasonics, underwater sound propagation, waves in solids, flow acoustics, and sonar. After the conference, 9 of these presentations were submitted as papers to these proceedings.
Toscano, Lisa; Carroll, Brianne
Anterior cruciate ligament (ACL) injuries happen at a frequent rate, especially in girls and women. While there are many factors that contribute to ACL tears, teaching proper landing techniques and strengthening certain muscles can decrease the incidence of ACL tears, especially in women. This article reviews some of the high-risk factors that…
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 ...
Arnold, M.P.; Verdonschot, N.J.J.; Kampen, A. van
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
Arnold, MP; Verdonschot, N; van Kampen, A
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
Arnold, M. P.; Blankevoort, L.; ten Ham, A.; Verdonschot, N.; van Kampen, A.
Graft tension is a controversial topic in anterior cruciate ligament (ACL) surgery. Evidence suggests a narrow range of graft tensions, which allow the graft to remodel to a stable and mature neoligament. In previous cadaver experiments, we showed that twisting the graft could modulate the graft
Full Text Available In this paper, we show how the Contrastivist Hypothesis (Hall 2007, Dresher 2008 can be amended using Element Theory (KLV 1988; Angoujard 1997; Scheer 1999; Backley 2011 and Government Phonology (KLV 1990; Lowenstamm 1996; Scheer 2004. Given the richness of the phenomenology of Nordic languages, this family constitutes our testing ground. While one might expect five different hierarchies, given that Scandinavian languages are distinct languages, what we actually find is one unique hierarchy where the same features are used in the same order. However, if we want a full understanding of the Nordic phenomenology and if we maintain the hierarchy exactly as it is, two difficulties appear: the first one involves motivation, the second one naturalness. In order to overcome the two kinds of difficulties mentioned above, we aim to develop a representation of the obstruent inventory based on unary primes using Element Theory and Government Phonology. The results we get from this hierarchy cannot be considered independently from the syllabic structure. Therefore, we propose a rereading of the phenomenology of Nordic that connects the new elementary representations that we posit to the syllabic constraints. As a consequence, we explore new hypotheses concerning the phonological activity in Scandinavian languages.
Wong, Stephanie E; Feeley, Brian T; Pandya, Nirav K
The purpose of this meta-analysis is to review clinical outcomes and complications following pediatric anterior cruciate ligament (ACL) reconstruction. The PubMed and EMBASE databases were searched for studies on ACL ruptures in the skeletally immature from 1985 to 2016. Full-text studies in English and performed on humans were included (n=5718). Titles included discussed operative intervention on skeletally immature patients with ACL tears (n=160). Studies that reported rerupture and/or complications with ACL reconstruction specific to the pediatric population, specifically growth disturbance, were then included in a secondary analysis (n=45). Complications not specific to the pediatric population were excluded. Demographics, graft type, surgical technique, follow-up, growth disturbance, rerupture, and patient-reported outcome scores were collected. Data were analyzed in aggregate. In total, 45 studies were included with 1321 patients and 1392 knees. The average age was 13.0 years, 67% were male, and mean follow-up was 49.6 months. There were 115 (8.7%) reruptures in the initial 160 studies reviewed. In total, 94.6% of patients with rerupture required revision ACL surgery. There were 58 total growth disturbances (16 required corrective surgery, or 27.6%). Eighteen knees (3.7%) developed angular deformity, most commonly valgus. There were 37 patients (7.5%) had at least a 1 cm limb-length discrepancy. A total of 23 studies reported International Knee Documentation Committee scores (range, 81 to 100, 88% grade A or B). In total, 20 studies reported excellent Lysholm scores with mean scores of 94.6. Growth disturbance can occur with any of the reconstruction techniques. Proper surgical technique is likely more important than the specific reconstruction technique utilized. Patients with rerupture require surgery at much higher rates than those with growth disturbance. Although much attention has been focused on growth disturbance, we suggest that equal attention be
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.
The thesis discusses Object Shift, weak pronoun shift in the Scandinavian languages, from the intonational perspective, by presenting experimental data from all the Scandinavian languages. It is shown that downstep typically occurs in the Object Shift construction but does not occur in the
This exploratory study initially attempts to generate basic understanding regarding how do Chinese tourists evaluate the importance of Scandinavian gastronomies when holidaying the countries. And it further judge the states could whether implement gastronomical development strategy. Additionally, the study generally explores Chinese tourists’ food behavior, motivation and preference in a culturally different environment when holidaying in Scandinavian countries. The study also provides a deta...
Kalpazidou Schmidt, Evanthia
Because there is close cooperation on quality assurance in the Scandinavian countries, one would expect there to be convergence of quality assurance policies and practices in Scandinavian higher education. Few studies have analysed these quality assurance policies and practices from a comparative viewpoint. Based on empirical evidence produced in…
The purpose of this article is to show how the rappers' talk about hip-hop and its connection to pedagogy and social activism parallel the Scandinavian tradition of folkbildning. Scandinavian folkbildning can be seen as a movement to provide voluntary education for the general population. It can also be the name of the process of learning in which…
Hesgaard, Helena; Vinding, Troels; La Cour, Morten
To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population.......To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population....
Abstract This study is part of a Scandinavian research project, Nordfag.net, that investigates Scandinavian mother tongue teachers’ didactic profiles and conceptions of the mother tongue education (MTE) subject through an ethnographic approach. The purpose of the present study is to discuss...
Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager
AIM OF DATABASE: The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. STUDY POPULATION: All patients with acute stroke (from 2003) or TIA (from 2013) treated...... at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. MAIN VARIABLES: The registry holds prospectively collected data on key processes...... of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients...
Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted
AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...
Full Text Available Lone Baandrup,1 Charlotte Cerqueira,2 Lea Haller,3 Lene Korshøj,3 Inge Voldsgaard,4 Merete Nordentoft5 1Centre for Neuropsychiatric Schizophrenia Research (CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, 2Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, 3The Danish Clinical Registries, Registry Support Centre for Health Quality and Informatics (KCKS-West, Aarhus, 4Psychosis Ward, Section P, Aarhus University Hospital, Risskov, 5Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Copenhagen, DenmarkAim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research.Study population: Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients.Main variables: The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning.Descriptive data: The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may
Friel, Nicole A; Chu, Constance R
Acute anterior cruciate ligament (ACL) tears are most frequently sustained by young, physically active individuals. ACL injuries are seen at high incidence in adolescents and young adults performing sports and occupational activities that involve pivoting. Young women participating in pivoting sports have a 3 to 5 times higher risk of ACL injury than men. Studies show that ACL injury increases osteoarthritis (OA) risk with symptomatic OA appearing in roughly half of individuals 10-15 years later. Because the majority of patients sustaining acute ACL tears are younger than 30, this leads to early onset OA with associated pain and disability during premium work and life growth years between ages 30 and 50. Effective strategies to prevent ACL injury and to reduce subsequent OA risk in those sustaining acute ACL tears are needed. Copyright © 2013 Elsevier Inc. All rights reserved.
Kiadaliri, Aliasghar A; Englund, Martin; Stefan Lohmander, L.
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 injury......) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were...... discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Results Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0...
Jordan, Matthew J; Doyle-Baker, Patricia; Heard, Mark
, meniscal tears, and chondral lesions. RESULTS: At the time of primary ACLR, a majority of knees (82%; 23/28) demonstrated concurrent injury compared with isolated ACL tears; 32% of knees sustained multiligament injuries (9/28), and 8 involved the ipsilateral medial collateral ligament (MCL). Of the ACL......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...... ACL reconstruction (ACLR). PURPOSE: To evaluate (1) the involvement of intra-articular and multiligament pathologies at the time of primary ACLR, (2) the subsequent progression in meniscal/chondral injuries, and (3) the occurrence of ACL reinjury in elite alpine ski racers. STUDY DESIGN: Case series...
Dr. Loria Pollack, a Senior Medical Epidemiologist, talks about the importance of cancer registry data to understanding how cancer affects the United Statesânow and in the future. Created: 5/24/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 5/24/2017.
Jorde, P E; Rueness, E K; Stenseth, N C; Jakobsen, K S
In a recent Commentary in this journal, Pamilo (2004) criticized our analysis of the spatial genetic structure of the Eurasian lynx in Scandinavia (Rueness et al. 2003). The analyses uncovered a marked geographical differentiation along the Scandinavian peninsula with an apparent linear gradient in the north-south direction. We used computer simulations to check on the proposition that the observed geographical structure could have arisen by genetic drift and isolation by distance in the approximate 25 generations that have passed since the last bottleneck. Pamilo disapproved of our choice of population model and also how we compared the outcome of the simulations with data. As these issues should be of interest to a wider audience we discuss them in some detail.
The increased mediatization of society since 1960 has lead to a discussion of the mediatization of politics and the role of media for political debate and democracy. Habermas as early as 1962 discussed the rise and potential decline of the public sphere. The role of media in general was central...... in this debate, and the rise of the internet in modern societies has increased the analysis and theories of the mediatization of politics in theories of democracy and in media sociology. Audio–visual media and the new digital media have increased the visibility of all parts of private and public life and changed...... the relation between media, public figures and the citizen. In this article, I will discuss main positions in theories on the mediatization of politics. I will also discuss and analyse three types of film and television genres that reflect this mediatization of politics in Scandinavian film and television...
Management of small and threatened populations may require detailed knowledge about the genetic status of individuals and the genetic relatedness between individuals. I show here that individual heterozygosity at a set of 29 microsatellite loci correlates closely to the degree of inbreeding in a captive grey wolf population. Microsatellite allele sharing similarly correlates closely to known relatedness between pairs of individuals. Genotyping the same markers in a small (60-70 individuals) natural population of grey wolves in Sweden, low individual heterozygosities and high values of allele sharing between some animals were found. Since inbreeding depression has been documented in a captive grey wolf population of Scandinavian origin, the results point out an additional risk for the small Swedish wild population.
Bødker, Susanne; Sundblad, Yngve
, augmented reality, small interfaces, tangible interfaces, etc. are dramatically changing the nature of HCI (human-computer interaction). We witness the creation of ad hoc configurations of large and small user interfaces. The new interfaces are moveable and used in changing locations and contexts; different......Computer use and interaction possibilities are changing quickly, while use contexts and application types are radically broadening. Technology no longer consists of static tools belonging only to the workplace but permeates work on the move, homes and everyday lives. Pervasive technologies...... understanding of usability and interaction design. In particular, we discuss how the Scandinavian tradition of user involvement in development is facing up with the challenges of new work and of non-work contexts. There is a tendency that much recent investigations into non-work settings get stuck in a divide...
Slot, K.B.; Murray, V.; Boysen, G.
(85%) felt that its risks were acceptable. Main barriers were: unawareness of stroke symptoms among patients (82%) and their failure to respond adequately (54%); ambulance services not triaging acute stroke as urgent (23%); and insufficient in-hospital routines (15%). The respondents suggested......Objective - We wanted to describe the use of thrombolytic treatment for stroke in Scandinavia, to assess stroke doctors' opinions on this treatment, to identify barriers against treatment, and to suggest improvements to overcome these barriers. Methods - We sent questionnaires to 493 Scandinavian...... doctors, who were involved in acute stroke care. Results - We received 453 (92%) completed questionnaires. Overall, 1.9% (range per hospital 0-13.9%) of patients received thrombolytic treatment. A majority (94%) of the respondents was convinced of the beneficial effects of thrombolytic treatment and many...
Lilleker, James B; Vencovsky, Jiri; Wang, Guochun
AIMS: The EuroMyositis Registry facilitates collaboration across the idiopathic inflammatory myopathy (IIM) research community. This inaugural report examines pooled Registry data. METHODS: Cross-sectional analysis of IIM cases from 11 countries was performed. Associations between clinical subtyp...
Full Text Available The aim of this paper is to develop and illustrate an analytic approach that brings the active making and makings of green consumer images to the fore. Efforts to "know" the green consumers have generated multiple representations. Enactments of the green consumer are not innocent but also play a role in shaping how we understand and approach sustainable consumption. Because of this it is important to examine and critically discuss how green consumers are enacted today. This paper develops an approach that allows us to examine how green consumers are enacted and discuss the consequences these constructions might have for sustainability. Theoretically, a performativity approach drawing on theories from Science and Technology Studies (STS and economic sociology is used to discuss the enactment of green consumers. Empirically, focus is on Boomerang � a Swedish fashion retailer, brand, and producer � and its marketing practices. The analysis shows how the marketing work of the Boomerang Company leads to the enactment of the Green Scandinavian Preppy. This specific version of the green consumer is a combination of the knowledgeable green connoisseur - a consumer that knows quality when he/she sees it - and the green hedonist in search of the good life. The Green Scandinavian Preppy wants to enjoy nature, go sailing, and do so wearing fashionable quality clothes. This is a consumer that knows quality, appreciates design, and has the means to pay for both. While this is a version of the green consumer that might be appealing and thus have the potential to pro-mote a version of green consumption, it is also a green consumer image that has lost much of its political power as green consumption is framed as simply another source of pleasure and identity-making.
Fuchs, Boris; Zimmermann, Barbara; Wabakken, Petter; Bornstein, Set; Månsson, Johan; Evans, Alina L; Liberg, Olof; Sand, Håkan; Kindberg, Jonas; Ågren, Erik O; Arnemo, Jon M
Sarcoptic mange, a parasitic disease caused by the mite Sarcoptes scabiei, is regularly reported on wolves Canis lupus in Scandinavia. We describe the distribution and transmission of this parasite within the small but recovering wolf population by analysing 269 necropsy reports and performing a serological survey on 198 serum samples collected from free-ranging wolves between 1998 and 2013. The serological survey among 145 individual captured Scandinavian wolves (53 recaptures) shows a consistent presence of antibodies against sarcoptic mange. Seropositivity among all captured wolves was 10.1 % (CI. 6.4 %-15.1 %). Sarcoptic mange-related mortality reported at necropsy was 5.6 % and due to secondary causes, predominantly starvation. In the southern range of the population, seroprevalence was higher, consistent with higher red fox densities. Female wolves had a lower probability of being seropositive than males, but for both sexes the probability increased with pack size. Recaptured individuals changing from seropositive to seronegative suggest recovery from sarcoptic mange. The lack of seropositive pups (8-10 months, N = 56) and the occurrence of seropositive and seronegative individuals in the same pack indicates interspecific transmission of S. scabiei into this wolf population. We consider sarcoptic mange to have little effect on the recovery of the Scandinavian wolf population. Heterogenic infection patterns on the pack level in combination with the importance of individual-based factors (sex, pack size) and the north-south gradient for seroprevalence suggests low probability of wolf-to-wolf transmission of S. scabiei in Scandinavia.
Trivedi, Vikas; Mishra, Panna; Verma, Deepankar
Background: The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for m...
Erickson, Brandon J; Harris, Joshua D; Heninger, Jacob R; Frank, Rachel; Bush-Joseph, Charles A; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R
Anterior cruciate ligament (ACL) rupture is a significant injury in National Football League (NFL) quarterbacks. The purpose of this study was to determine (1) return-to-sport (RTS) rate in NFL quarterbacks following ACL reconstruction, (2) performance upon RTS, and (3) the difference in RTS and performance between players who underwent ACL reconstruction and controls. Thirteen quarterbacks (14 knees) who met inclusion criteria underwent ACL reconstruction while in the NFL. Matched controls were selected from the NFL during the same time span to compare and analyze age, body mass index (BMI), position, performance, and NFL experience. Student t tests were performed for analysis of within- and between-group variables. Bonferroni correction was used in the setting of multiple comparisons. Twelve quarterbacks (13 knees; 92%) were able to RTS in the NFL. Mean player age was 27.2±2.39 years. Mean career length in the NFL following ACL reconstruction was 4.85±2.7 years. Only 1 player needed revision ACL reconstruction. In both cases and controls, player performance was not significantly different from preinjury performance after ACL reconstruction (or index year in controls). There was also no significant performance difference between case and control quarterbacks following ACL reconstruction (or index year in controls). There is a high rate of RTS in the NFL following ACL reconstruction. In-game performance following ACL reconstruction was not significantly different from preinjury or from controls. Copyright 2014, SLACK Incorporated.
Full Text Available The importance of philanthropy for academic exchange cannot be overestimated. Especially in the first half of the twentieth century, scholarships for academic exchange originated from the private sector instead of the state. But what is the relationship between academic exchange and the donations which finance scholarships? How can specific donations and the restrictions placed on them change the flow of exchange? This article investigates donation and scholarship praxis within the American-Scandinavian Foundation (ASF from 1912–1995, a philanthropic organisation devoted to academic exchange between Scandinavia and the United States. The period, 1912–1944, is characterised by various small donations and few scholarships to mostly American fellows. The second period, 1945–1995, represents an era of economic growth created from a surge in large, restricted donations invested in scholarship funds. This led to an increased number of scholarships to a more geographically diverse population.
This article deals with the influence of John Grierson on the development of the Scandinavian documentary film and television movement. Grierson's poetic for a new documentary had a strong influence on the Scandinavian documentary movement from the 1930s and on. The combination of a documentary f...... format that combined a new aesthetic form with a social vision was developed in the early British class society but pointed towards a more democratic wellfare society. Key Scandinavian figures and institutions in this development of a modern, documentary movement is analysed....
Mero, Inger-Lise; Gustavsen, Marte W; Sæther, Hanne S
The presence of oligoclonal bands (OCB) in cerebrospinal fluid (CSF) is a typical finding in multiple sclerosis (MS). We applied data from Norwegian, Swedish and Danish (i.e. Scandinavian) MS patients from a genome-wide association study (GWAS) to search for genetic differences in MS relating...... to OCB status. GWAS data was compared in 1367 OCB positive and 161 OCB negative Scandinavian MS patients, and nine of the most associated SNPs were genotyped for replication in 3403 Scandinavian MS patients. HLA-DRB1 genotypes were analyzed in a subset of the OCB positive (n = 2781) and OCB negative (n...
SKYTTHE, AXEL; KYVIK, KIRSTEN OHM; HOLM, NIELS VILSTRUP; CHRISTENSEN, KAARE
Introduction The Danish Twin Registry is a unique source for studies of genetic, familial and environmental factors on life events, health conditions and diseases. Content More than 85,000 twin pairs born 1870–2008 in Denmark. Validity and coverage Four main ascertainment methods have been employed. Completeness of ascertainment varies according to birth cohorts. For birth cohorts 1870–1930 both twins should survive to age 6 years. From 1931–1968 72% of all twin pairs has been ascertained, with complete ascertainment of all live born twins since 1968. Conclusion Because twins have been identified independent of traits and on a population basis, the Danish Twin Registry is well suited for studies to understand the influence of genetic and environmental factors for a wide variety of diseases and traits. PMID:21775358
Skytthe, Axel; Ohm Kyvik, Kirsten; Vilstrup Holm, Niels
Introduction: The Danish Twin Registry is a unique source for studies of genetic, familial and environmental factors on life events, health conditions and diseases. Content: More than 85,000 twin pairs born 1870-2008 in Denmark. Validity and coverage: Four main ascertainment methods have been...... employed. Completeness of ascertainment varies according to birth cohorts. For birth cohorts 1870-1930 both twins should survive to age 6 years. From 1931-1968 72% of all twin pairs has been ascertained, with complete ascertainment of all live born twins since 1968. CONCLUSION: Because twins have been...... identified independent of traits and on a population basis, the Danish Twin Registry is well suited for studies to understand the influence of genetic and environmental factors for a wide variety of diseases and traits....
Jordan, Matthew J; Doyle-Baker, Patricia; Heard, Mark; Aagaard, Per; Herzog, Walter
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 ACL reconstruction (ACLR). To evaluate (1) the involvement of intra-articular and multiligament pathologies at the time of primary ACLR, (2) the subsequent progression in meniscal/chondral injuries, and (3) the occurrence of ACL reinjury in elite alpine ski racers. Case series; Level of evidence, 4. Primary ACLR operative reports (n = 28) were obtained for 32 elite alpine ski racers along with the reports of 20 operative procedures that occurred subsequent to primary ACLR. Operative reports were evaluated to identify the presence/location of multiligament injury, meniscal tears, and chondral lesions. At the time of primary ACLR, a majority of knees (82%; 23/28) demonstrated concurrent injury compared with isolated ACL tears; 32% of knees sustained multiligament injuries (9/28), and 8 involved the ipsilateral medial collateral ligament (MCL). Of the ACL-injured knees, 54% had chondral lesions, of which 73% were sustained in the lateral knee compartment, and 82% of meniscal tears (14/17) were complex in nature. Bilateral ACL tears were seen in 22% of the participants, and 28% underwent ACL revision. In the case of ACL revision or future meniscal/chondral surgery, 60% of meniscal tears and 80% of chondral lesions had worsened since the time of primary ACLR. 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.
Full Text Available The genetic aspects of population health are critical, but frequently difficult to assess. Of concern has been the genetic constitution of Scandinavian wolves (Canis lupus, which represent an important case in conservation. We examined the incidence of different congenital anomalies for 171 Scandinavian wolves, including the immigrant founder female, born during a 32-year period between 1978 and 2010. The incidence of anomalies rose from 13% to 40% throughout the 32-year study period. Our ability to detect this increase was likely facilitated by having considered multiple kinds of anomaly. Many of the found anomalies are likely associated with inbreeding or some form of genetic deterioration. These observations have implications for understanding the conservation needs of Scandinavian wolves. Moreover, these observations and the history of managing Scandinavian wolves focus attention on a broader question, whether conservation is merely about avoiding extinction of remnant populations, or whether conservation also entails maintaining genetic aspects of population health.
Full Text Available Hilde Jensvoll,1,2 Marianne T Severinsen,3,4 Jens Hammerstrøm,5 Sigrid K Brækkan,1,2 Søren R Kristensen,4,6 Suzanne C Cannegieter,7 Kristine Blix,1,2 Anne Tjønneland,8 Frits R Rosendaal,1,7,9 Olga Dziewiecka,1 Kim Overvad,10,11 Inger Anne Næss,12 John-Bjarne Hansen1,21Department of Clinical Medicine, KG Jebsen – Thrombosis Research and Expertise Center (TREC, UiT – The Arctic University of Norway, 2Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway; 3Department of Hematology, Aalborg University Hospital, 4Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 5Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; 6Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; 7Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 8Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; 9Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands; 10Department of Cardiology, Aalborg University Hospital, Aalborg, 11Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark; 12Department of Hematology, Trondheim University Hospital, Trondheim, NorwayBackground: Although venous thromboembolism (VTE is a known common complication in cancer patients, there is limited knowledge on patient-related and cancer-specific risk factors in the general population. The Scandinavian Thrombosis and Cancer (STAC Cohort was established by merging individual data from three large Scandinavian cohorts (The Tromsø Study, the second Nord-Trøndelag Health Study, and the Danish Diet, Cancer and Health Study. Here, we present the profile of the STAC cohort and provide age-specific incidence rates of VTE and cancerMethods: The STAC cohort includes 144,952 subjects aged 19–101 years
Laursen, Birgitte Schantz; Rasmussen, Philippa; Conroy, Tiffany
REVIEW QUESTION/OBJECTIVE:: The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?......REVIEW QUESTION/OBJECTIVE:: The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?...
Havelin, Leif I; Robertsson, Otto; Fenstad, Anne M
The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research.......The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research....
In the Scandinavian Late Iron Age costume studies plays an important role. The many new finds of gold sheet images comprise an until now unexploited source that can enlight the often fragmented and degraded textile remains.......In the Scandinavian Late Iron Age costume studies plays an important role. The many new finds of gold sheet images comprise an until now unexploited source that can enlight the often fragmented and degraded textile remains....
Coe-Björsell, Emily; Jansson, Linn
It is argued in this thesis that the stigmatization of menstruation and the atypical product features of the menstrual cup constitute a unique marketing challenge for vendors of the menstrual cup. The purpose of this study is therefore to investigate these issues and the ways in which Scandinavian vendors approach them. Further, the possible effects of this approach on the rate of adoption of the menstrual cup are analyzed. In order to do so, interviews with four Scandinavian vendors of the m...
Hornslien, Astrid G; Sandset, Else C; Igland, Jannicke; Terént, Andreas; Boysen, Gudrun; Bath, Philip M W; Murray, Gordon D; Berge, Eivind
Randomized-controlled trials have shown no beneficial short-term effects of blood pressure lowering treatment in the acute phase of stroke. We aimed to see whether blood pressure lowering treatment with candesartan in the acute phase can lead to benefits that become apparent over a longer period of follow-up. The Scandinavian Candesartan Acute Stoke Trial was a randomized- and placebo-controlled trial of candesartan in 2,029 patients with acute stroke and systolic blood pressure ≥140 mmHg. Trial treatment was given for seven-days, and the primary follow-up period was six-months. We have used the national patient registries and the cause of death registries in the Scandinavian countries to collect data on vascular events and deaths up to three-years from randomization. The primary end-point was the composite of stroke, myocardial infarction, or vascular death, and we used Cox proportional hazards regression model for analysis. Long-term data were available for 1,256 of the 1,286 patients (98%) from Scandinavia. The risk of the primary composite end-point did not differ significantly between the groups (candesartan 178/632 events, placebo 203/624 events, hazard ratio = 0·87, 95% confidence interval 0·71-1·07). There were also no statistically significant differences for the secondary end-points stroke and all-cause death, or in any of the pre-specified subgroups. Treatment with candesartan in the acute phase of stroke was not associated with clear long-term clinical benefits. This result supports the conclusion from trials with short-term follow-up, that blood pressure lowering treatment with candesartan should not be given routinely to patients with acute stroke and raised blood pressure. © 2015 World Stroke Organization.
Jordan, Matthew J; Aagaard, Per; Herzog, Walter
Because of 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 were assessed in ski racers with and without ACL reconstruction (ACL-R). Uninjured (n = 13 males, n = 8 females) and ACL-R (n = 3 males, n = 5 females, 25.0 ± 11.3 months after operation) 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 kilogram 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. HAM/QUAD MVC and RTD strength ratios (H/Q ratios) were also compared. The ACL-R limb demonstrated significant HAM and QUAD deficits compared with the contralateral limb for MVC and late-phase RTD (P ski racing, our results suggest the importance of including HAM and QUAD strength assessments in the physical evaluation of uninjured skiers. Furthermore, HAM and QUAD strength should be assessed over a long-term period after surgery to identify chronic strength deficits in ACL-R ski racers.
Grant, John A
To review recent evidence in order to update previous systematic reviews on methods of rehabilitation after anterior cruciate ligament (ACL) reconstruction. PubMed, Embase, and the Cochrane Controlled Trials Register were searched for the period January 2006 to December 2010, using terms related to ACL, rehabilitation, and randomized controlled trial (RCT). The search was done in triplicate, and the results reconciled (85 studies identified). Relevant studies in English that were peer-reviewed RCTs or prospective comparative studies evaluating methods of ACL rehabilitation were included (n = 29). Evidence was evaluated by all 3 authors using the CONSORT criteria. The data extracted included number of patients, ACL reconstruction method, randomization method, intervention, length of, and loss to, follow-up, outcomes assessed, bias, and findings. The review included evidence on postoperative bracing, accelerated rehabilitation, home-based rehabilitation, proprioceptive and neuromuscular training, and miscellaneous topics that were investigated by single trials. In 6 studies of postoperative bracing, no study found a clinically significant benefit of bracing or of restricted range of knee motion for pain control, knee laxity, or rehabilitation. Postoperative treatment without the use of a brace was not associated with less favorable outcomes. In 5 studies of accelerated strengthening, beginning eccentric quadriceps strengthening and isokinetic hamstring strengthening 2 weeks after ACL surgery improved or accelerated strength gains. Immediately postoperative weight-bearing, range of knee motion from 0° to 90° of flexion, and strengthening with closed-chain exercises were probably all safe. Home-based rehabilitation was evaluated in 2 studies. One study demonstrated that this intervention was at least as successful as a standard accelerated program over the long term. The other study included very low compliance expectations and other methodologic problems that
Full Text Available Scandinavian members of the acrocarpous moss genus Oncophorus were revised after field observations had suggested unrecognized diversity. Based on molecular (nuclear: internal transcribed spacers 1 and 2, ITS; plastid: trnGUCC G2 intron, trnG, rps4 gene + trnS-rps4 spacer, rps4 and morphological evidence, four morphologically distinguishable species are recognized, Oncophorus elongatus (I.Hagen Hedenäs, O. integerrimus Hedenäs sp. nov. (syn. O. virens var. elongatus Limpr., O. virens (Hedw. Brid., and O. wahlenbergii Brid. (O. sardous Herzog, syn. nov.. Oncophorus elongatus was earlier recognized, but much of its variation was hidden within O. wahlenbergii. Its circumscription is here expanded to include plants with long leaves having mostly denticulate or sharply denticulate upper margins and with long and narrow marginal cells in the basal portion of the sheathing leaf lamina. The new species O. integerrimus sp. nov. differs from O. virens in having more loosely incurved leaves and entire or almost entire upper leaf margins. Besides these characters, the species in the respective pairs differ in quantitative features of the leaf lamina cells. Several cryptic entities were found, in several cases as molecularly distinct as some of the morphologically recognizable species, and phylogeographic structure is present within O. elongatus and O. virens.
Quatman, Carmen E; Kiapour, Ata M; Demetropoulos, Constantine K; Kiapour, Ali; Wordeman, Samuel C; Levine, Jason W; Goel, Vijay K; Hewett, Timothy E
Strong biomechanical and epidemiological evidence associates knee valgus collapse with isolated, noncontact anterior cruciate ligament (ACL) injuries. However, a concomitant injury to the medial collateral ligament (MCL) would be expected under valgus collapse, based on the MCL's anatomic orientation and biomechanical role in knee stability. Purpose/ The purpose of this study was to investigate the relative ACL to MCL strain patterns during physiological simulations of a wide range of high-risk dynamic landing scenarios. We hypothesized that both knee abduction and internal tibial rotation moments would generate a disproportionate increase in the ACL strain relative to the MCL strain. However, the physiological range of knee abduction and internal tibial rotation moments that produce ACL injuries are not of sufficient magnitude to compromise the MCL's integrity consistently. Controlled laboratory study. A novel in sim approach was used to test our hypothesis. Seventeen cadaveric lower extremities (mean age, 45 ± 7 years; 9 female and 8 male) were tested to simulate a broad range of landings after a jump under anterior tibial shear force, knee abduction, and internal tibial rotation at 25° of knee flexion. The ACL and MCL strains were quantified using differential variable reluctance transducers. An extensively validated, detailed finite element model of the lower extremity was used to help better interpret experimental findings. Anterior cruciate ligament failure occurred in 15 of 17 specimens (88%). Increased anterior tibial shear force and knee abduction and internal tibial rotation moments resulted in significantly higher ACL:MCL strain ratios (P < .05). Under all modes of single-planar and multiplanar loading, the ACL:MCL strain ratio remained greater than 1.7, while the relative ACL strain was significantly higher than the relative MCL strain (P < .01). Relative change in the ACL strain was demonstrated to be significantly greater under combined multiplanar
Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea
Aim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population: Patients diagnosed with schizophrenia and receiving mental health care...... to the data for use in specific research projects by applying to the steering committee. Conclusion: The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time...
Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea
Aim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population: Patients diagnosed with schizophrenia and receiving mental health care...... to the data for use in specific research projects by applying to the steering committee. Conclusion: The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time...
John W. O'Leary
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.
Bojicic, Katherine M; Beaulieu, Mélanie L; Imaizumi Krieger, Daniel Y; Ashton-Miller, James A; Wojtys, Edward M
While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Case-control study; Level of evidence, 3. Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System's archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. PTS (P = .043) and MCS (P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture (P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or MCS were associated with an increased risk of ACL tear.
Emilton Lima Júnior
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.
Frøen, J Frederik; Myhre, Sonja L; Frost, Michael J; Chou, Doris; Mehl, Garrett; Say, Lale; Cheng, Socheat; Fjeldheim, Ingvild; Friberg, Ingrid K; French, Steve; Jani, Jagrati V; Kaye, Jane; Lewis, John; Lunde, Ane; Mørkrid, Kjersti; Nankabirwa, Victoria; Nyanchoka, Linda; Stone, Hollie; Venkateswaran, Mahima; Wojcieszek, Aleena M; Temmerman, Marleen; Flenady, Vicki J
The Global Roadmap for Health Measurement and Accountability sees integrated systems for health information as key to obtaining seamless, sustainable, and secure information exchanges at all levels of health systems. The Global Strategy for Women's, Children's and Adolescent's Health aims to achieve a continuum of quality of care with effective coverage of interventions. The WHO and World Bank recommend that countries focus on intervention coverage to monitor programs and progress for universal health coverage. Electronic health registries - eRegistries - represent integrated systems that secure a triple return on investments: First, effective single data collection for health workers to seamlessly follow individuals along the continuum of care and across disconnected cadres of care providers. Second, real-time public health surveillance and monitoring of intervention coverage, and third, feedback of information to individuals, care providers and the public for transparent accountability. This series on eRegistries presents frameworks and tools to facilitate the development and secure operation of eRegistries for maternal and child health. In this first paper of the eRegistries Series we have used WHO frameworks and taxonomy to map how eRegistries can support commonly used electronic and mobile applications to alleviate health systems constraints in maternal and child health. A web-based survey of public health officials in 64 low- and middle-income countries, and a systematic search of literature from 2005-2015, aimed to assess country capacities by the current status, quality and use of data in reproductive health registries. eRegistries can offer support for the 12 most commonly used electronic and mobile applications for health. Countries are implementing health registries in various forms, the majority in transition from paper-based data collection to electronic systems, but very few have eRegistries that can act as an integrating backbone for health
Torgersen, Espen; Viola, Giulio
The Scandinavian Caledonides are classically interpreted as a fold and thrust belt resulting from the collision between Laurentia and Baltica during the Silurian, which involved the up-to-400 km ESE-wards translation of nappes onto the Baltoscandian platform. It has been suggested that the Caledonian fold and thrust belt formed through several distinct orogenic episodes, from early shortening in the Late Ordovician to orogenic collapse in the Devonian. The classic Caledonian, orogen-perpendicular ESE-ward nappe transport is constrained by abundant and consistently oriented stretching lineations across the entire orogen and unambiguous kinematic indicators. However, there is also a large number of NW-SE-trending and roughly orogen-parallel lineations, particularly in the upper ophiolite- and eclogite-bearing nappes, which are more challenging to interpret with the traditional orogeny evolution model. The analysis of the areal extent, spatial distribution and geometrical relationships of the Caledonian nappes in southern and central Norway, however, offers new insights and allows for new constraints on the bulk kinematic framework of the shortening history of the belt. Here we present new, first-order geological observations that demonstrate a two-fold compressional history and associated strain partitioning during Caledonian convergence. More specifically, we propose that Late Ordovician NNW-SSE shortening caused early compression, followed by WNW-ESE Early Silurian shortening, which resulted in strain partitioning along the planar fabrics and discontinuities from the earlier event. In detail, orogen-parallel dextral wrench tectonics caused significant lateral displacement along at least three, orogen-scale NE-SW striking corridors, wherein the nappes appear to be consistently displaced in a dextral fashion. We propose that the Møre-Trøndelag Fault Complex, which accommodated significant sinistral displacements during the later Devonian orogenic collapse
Eckenrode, Brian J; Carey, James L; Sennett, Brian J; Zgonis, Miltiadis H
The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery. ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissue-healing time frame. Given the evolution of ACL surgical reconstruction techniques and rehabilitation protocols, the risk of post-operative complications can arise both early and late in the recovery process. This paper will discuss the role of preventative measures as it applies to the post-operative patient with ACL reconstruction. Short-term complications following ACL reconstruction include infection and deficits to knee motion and strength, whereas long-term complications include secondary ACL injury to either the involved or contralateral knee and lack of ability to return to high-level sports following this procedure. Future research should continue to address the multifactorial causes of secondary ACL injury and limited ability of patients to return to high level activities.
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)
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.)
Derwin King Chung Chan
Full Text Available Managing rehabilitation for ACL injury is dependent on uptake of, and compliance with, medical and safety recommendations. In this paper, we propose a multi-theory model that integrates self-determination theory and the theory of planned behavior to identify the motivational determinants ACL injury prevention and management behaviors and the processes involved.
Alkjaer, Tine; Henriksen, Marius; Simonsen, Erik B
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...
England, Eric; Wissman, Robert D; Mehta, Kaushal; Burch, Michael; Kaiser, Andrew; Li, Tianyang
Parameniscal cysts have a very high association with meniscal tears in all locations except the anterior horn lateral meniscus (AHLM). The common insertion of the anterior cruciate ligament (ACL) and the AHLM root may provide a pathway for disease. The purpose of our study was to determine if cysts of the ACL are the origin of cysts adjacent to the AHLM. Radiology reports of all magnetic resonance (MR) examinations of the knee over a 7-year period were searched for "cyst", "ganglion", and "ganglia". Two fellowship-trained musculoskeletal radiologists independently reviewed those MR examinations reported to have a possible cyst of the AHLM and/or the ACL. The study group consisted of those patients with a cyst located adjacent to the AHLM but no meniscal tear of the adjacent meniscus. The ACL in each of these patients was evaluated for the presence of a cyst. Comparison with age- and gender-matched controls was performed. Of 708 cases that contained the word "cyst", "ganglion", or "ganglia", 121 reports indicated a possible cyst of the ACL or AHLM. Twelve individuals had a cyst located adjacent to the AHLM with no meniscal tear. Six (50%) of these individuals had a cyst of the ACL; no ACL cysts were identified in the control group (p = 0.014). Interreader agreement for AHLM parameniscal cysts and AHLM tears was substantial. Our results suggest that cysts adjacent to the AHLM may in part be explained by cysts or ganglia of the ACL.
Ericsson, Ylva B; Roos, Ewa M.; Frobell, Richard B
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....
Pace, James Lee; Mueske, Nicole; Zaslow, Tracy; Katzel, Mia; Chua, Matthew; Wren, Tishya
Objectives: This study assessed differences between pediatric athletes? anterior cruciate ligament (ACL) reconstructed limb and non-reconstructed limb compared to limbs with no lower extremity surgical history during a side-step cut. Methods: 28 limbs with an ACL reconstruction within the 12 months prior to testing (operative limbs), 28 contralateral limbs (non-operative limbs) and 56 limbs with no lower extremity surgical history (control limbs; 28 individuals) were included. Lower extremity...
Jordan, Matthew J; Doyle-Baker, Patricia; Heard, Mark
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...... ACL reconstruction (ACLR). PURPOSE: To evaluate (1) the involvement of intra-articular and multiligament pathologies at the time of primary ACLR, (2) the subsequent progression in meniscal/chondral injuries, and (3) the occurrence of ACL reinjury in elite alpine ski racers. STUDY DESIGN: Case series......; Level of evidence, 4. METHODS: Primary ACLR operative reports (n = 28) were obtained for 32 elite alpine ski racers along with the reports of 20 operative procedures that occurred subsequent to primary ACLR. Operative reports were evaluated to identify the presence/location of multiligament injury...
Jordan, Matthew J; Aagaard, Per; Herzog, Walter
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...... to uninjured controls (Pski racing, our results suggest the importance of including HAM and QUAD...
Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen
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...
Comins, J D; Krogsgaard, M R; Kreiner, Svend
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......, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients...... pre- and post-ACL reconstruction completed the pilot PROM. Rasch models were used to assess the psychometric properties (e.g., unidimensionality, local response dependency, and differential item functioning). Forty-one items distributed across seven unidimensional constructs measuring impairment...
Arboe, Bente; Josefsson, Pär; Jørgensen, Judit
AIM OF DATABASE: The Danish National Lymphoma Registry (LYFO) was established in order to monitor and improve the diagnostic evaluation and the quality of treatment of all lymphoma patients in Denmark. STUDY POPULATION: The LYFO database was established in 1982 as a seminational database including...... all lymphoma patients referred to the departments of hematology. The database became nationwide on January 1, 2000. MAIN VARIABLES: The main variables include both clinical and paraclinical variables as well as details of treatment and treatment evaluation. Up to four forms are completed for each......-100 years) and a male/female ratio of 1.23:1. Patients can be registered with any of 42 different subtypes according to the World Health Organization classifications. CONCLUSION: LYFO is a nationwide database for all lymphoma patients in Denmark and includes detailed information. This information is used...
Montgomery, Connor; Blackburn, Jeff; Withers, Daniel; Tierney, Gregory; Moran, Cathal; Simms, Ciaran
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/.
This article introduces guidelines for single- (SB) and double-bundle (DB) ACL reconstruction based on the concept of complete footprint restoration. The goal is to reconstruct a maximum of anterior cruciate ligament (ACL) insertion site area to regain a maximum of ACL function. The concept is based on the hypothesis that the restored biomechanical envelope of the knee is a function of reconstructed ACL insertion site area. Individual combinations of graft diameters and drill angles were calculated and matched for all individual insertion site lengths between 8 and 21 mm to maximize the percentage of anatomical footprint restoration. An "insertion site table" was developed to propose individual guidelines during ACL surgery for SB and DB ACL reconstruction based on the intraoperative measurement of the tibial insertion site length. Our calculations support the use of SB in "small footprints" up to 13 mm, which may restore more than 95% of the native insertion site length. "Intermediate footprints" between 14 and 15 mm may be restored by both a SB or DB ACL reconstruction. For "larger footprints" of 16 mm or more, DB has the potential to replicate 97% or more of the insertion site length which cannot be achieved by a SB ACL reconstruction. The concept of complete footprint restoration aims to reconstruct a maximum of ACL insertion site area to restore a maximum of functional envelope of the knee. Depending on the individual situation, different surgical approaches (SB/DB), graft diameters and drill angles may apply. An "insertion site table" was designed to give guidelines for SB and DB reconstruction during surgery. According to the new concept, DB ACL reconstruction is only considered as a surgical tool for large footprints and is not indicated for smaller ones.
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
Zebis, Mette K.; Andersen, Christoffer H.; Bencke, Jesper
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 i...
Slagers, Anton J; Reininga, Inge H F; van den Akker-Scheek, Inge
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.
Zebis, Mette K; Andersen, Christoffer H; Bencke, Jesper
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 i...
Rosenblum, Amanda M.; Li, Alvin Ho-ting; Roels, Leo; Stewart, Bryan; Prakash, Versha; Beitel, Janice; Young, Kimberly; Shemie, Sam; Nickerson, Peter; Garg, Amit X.
The variability in deceased organ donation registries worldwide has received little attention. We considered all operating registries, where individual wishes about organ donation were recorded in a computerized database. We included registries which recorded an individual's decision to be a donor (donor registry), and registries which only recorded an individual's objection (non-donor registry). We collected information on 15 characteristics including history, design, use and number of regis...
Frobell, R B; Roos, H P; Roos, E M
depression fractures, meniscal injuries and patient characteristics. METHODS: One hundred and twenty-one subjects (26% women, mean age 26 years) with an ACL rupture to a previously un-injured knee were studied using a 1.5T MR imager within 3 weeks from trauma. Meniscal injuries and fractures were classified...... by type, size and location. BML location and volume were quantified using a multi-spectral image data set analyzed by computer software, edited by an expert radiologist. RESULTS: Fractures were found in 73 (60%) knees. In 67 (92%) of these knees at least one cortical depression fracture was found. Uni......-compartmental meniscal tears were found in 44 (36%) subjects and bi-compartmental in 24 (20%). One hundred and nineteen (98%) knees had at least one BML, all but four (97%) located in the lateral compartment. Knees with a cortical depression fracture had larger BML volumes (P
Gerber, Jérôme; Biner, Hans-Peter
Objectif Les ACL sont des ampoules 28V/200W utilisés dans le domaine de l’éclairage professionnel. Habituellement, 8 ampoules sont branchées en série sur le réseau. Suite à ce montage, une commande individuelle de la luminosité n’est pas possible. L’appareil conçu dans ce projet met toutes les ampoules en parallèle sur un bus de tension continue à 28Vdc. La commande individuelle est maintenant possible. Une protection anti-courtcircuit est aussi conçue afin de sécuriser l’installation. Pour a...
Kalpazidou Schmidt, Evanthia
Because there is close cooperation on quality assurance in the Scandinavian countries, one would expect there to be convergence of quality assurance policies and practices in Scandinavian higher education. Few studies have analysed these quality assurance policies and practices from a comparative...... quality assurance. The debate is compelling with regard to the Swedish case in particular, with its ‘one size fits all’ approach and exclusive focus on outcomes which has been heavily criticised by the higher education institutions and has turned out to be controversial from the European viewpoint....... viewpoint. Based on empirical evidence produced in connection with studies of recent quality reforms in Scandinavia and an approach based on linking diffusion and translation theories with institutionalist perspectives focusing on path dependency, the paper contributes to the current debate on Scandinavian...
Sjøvaag, Helle; Stavelin, Eirik; Karlsson, Michael
How does agenda setting work within the hyperlinked Scandinavian news ecology? This paper investigates intermedia agenda setting within and between the local, regional, national and supra-national levels in Sweden, Denmark and Norway; analyses the center/periphery dimensions of hyperlink connecti......How does agenda setting work within the hyperlinked Scandinavian news ecology? This paper investigates intermedia agenda setting within and between the local, regional, national and supra-national levels in Sweden, Denmark and Norway; analyses the center/periphery dimensions of hyperlink...... between news agendas in the three countries, and c) the connectedness enabled by size, resources and central location in the Scandinavian hyperlinked information structure. The network analysis provides new insights into the relationship between centralized political structures, media ownership dispersal...
Secco, Gioel Gabrio; Rittger, Harald; Hoffmann, Stefan; Richardt, Gert; Abdel-Wahab, Mohamed; Reinecke, Holger; Lotan, Chaim; Werner, Gerald; Sievert, Horst; Foin, Nicolas; Di Mario, Carlo
Provisional stenting of the side-branch (SB) is the universally accepted gold standard while there is still controversy on the usefulness of routine dilatation of the SB ostium. Recrossing the struts of a previously deployed stent with a wire and a balloon can prove challenging and is occasionally unsuccessful, mainly because the balloon tip hits a stent strut. This prospective multicenter international registry tested the crossing ability procedural results of a new-dedicated ultrashort balloon specifically designed for side branch dilatation (Glider, TriReme Medical, Pleasanton, CA, USA). One hundred and twenty five patients (for a total of 131 bifurcation lesions) were enrolled in the registry between January 2009 and May 2012. The Glider was used as first choice in alternative to conventional balloon (group I, 72%) or as bail-out after unsuccessful previous attempt at crossing with small conventional low-profile balloons (group II, 28%). Postprocedural coronary artery dissections and in-hospital MACE (death, myocardial infarction and repeat revascularization) were assessed. Technical success was defined as the ability of the Glider to recross the struts of a previously deployed stent while procedural success was defined as less of residual 50% diameter stenosis at the origin of the SB with a final TIMI 3 and/or freedom from in-hospital MACE. Technical success was achieved, respectively, in 92% (group I), and 83% (group II). Clinical and angiographic procedural success was achieved in 98% of the lesions. In Group II, no other balloon of the same size could cross in cases where Glider could not. A total of 13 complications were observed, including nine ostial SB dissection four of which needed a second stent on the SB, one stent loss, two severe coronary spasms, and two by thrombus formation. The unique possibility offered by this short dedicated balloon to orientate its beveled tip provides an effective strategy for recrossing stent struts when conventional low
Setuain, I; Millor, N; Alfaro, J; Gorostiaga, E; Izquierdo, M
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.
Aslani, Hamidreza; Nourbakhsh, Seyed Taghi; Lahiji, Farivar A; Heydarian, Keykavoos; Jabalameli, Mahmood; Ghazavi, Mohammad Taghi; Tahmasebi, Mohammad Naghi; Fayyaz, Mahmoud Reza; Sazegari, Mohammad Ali; Mohaddes, Maziar; Rajabpour, Mojtaba; Emami, Mohammad; Jazayeri, Seyyed Mohammad; Madadi, Firooz; Farahini, Hossein; Mirzatoloee, Fardin; Gharahdaghi, Mohammad; Ebrahimzadeh, Mohammad Hossein; Ebrahimian, Mohammadreza; Mirvakili, Hossein; Bashti, Kaveh; Almasizadeh, Mohtasham; Abolghasemian, Mansour; Taheriazam, Afshin; Motififard, Mehdi; Yazdi, Hamidreza; Mobarakeh, Mahmood Karimi; Shayestehazar, Masoud; Moghtadae, Mehdi; Siavashi, Babak; Sajjadi, Mohammadreza M; Rasi, Alireza Manafi; Chabok, Seyyed Kazem; Zafarani, Zohreh; Salehi, Shahin; Ahmadi, Monireh; Mohammadi, Amin; Shahsavand, Mohammad Ebrahim
Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education.
Approaches 18 19 Primary ADL Registry Contributors Contributor Records Entry Date Navy eLearning (US Navy) 2,086 08/05/2008 Joint Knowledge Development...custom catalog items (content packages) to multiple environments and platforms 2008 21 U.S. Navy Organizational Challenges Lack of consistent...ADL Registry http://adlregistry.adlnet.gov/ Navy eLearning Content Team https://www.netc.navy.mil/ile Joint Knowledge Online http
Lara Gallego, Beatriz; Abaitua Borda, Ignacio; Galán Gil, Genaro; Castillo Villegas, Diego; Casanova Espinosa, Álvaro; Cano Jiménez, Esteban; Ojanguren Arranz, Iñigo; Posada de la Paz, Manuel
This report describes the general characteristics, objectives and organizational aspects of the registries of rare respiratory diseases included in the National Registry of Rare Diseases of the Research Institute for Rare Diseases (ISCIII), in order to publicize their existence and encourage the participation of professionals. Information is collected on the following conditions: alpha-1 antitrypsin deficiency, idiopathic tracheal stenosis, adult pulmonary Langerhans' cell histiocytosis, lymphangioleiomyomatosis, alveolar proteinosis, and sarcoidosis. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.
The Danish Nephrology Registry's (DNR) primary function is to support the Danish public health authorities' quality control program for patients with end-stage renal disease in order to improve patient care. DNR also supplies epidemiological data to several international organizations and supports epidemiological and clinical research. The study population included patients treated with dialysis or transplantation in Denmark from January 1, 1990 to January 1, 2016, with retrospective data since 1964. DNR registers patient data (eg, age, sex, renal diagnosis, and comorbidity), predialysis specialist treatment, details of eight dialysis modalities (three hemodialysis and five peritoneal dialysis), all transplantation courses, dialysis access at first dialysis, treatment complications, and biochemical variables. The database is complete (nutritional and uremia status. Date and cause of death are also included. Six quality indicators are published annually, and have been associated with improvements in patient results, eg, a reduction in dialysis patient mortality, improved graft survival, and earlier referral to specialist care. Approximately, ten articles, mainly epidemiological, are published each year. DNR contains a complete description of end-stage renal disease patients in Denmark, their treatment, and prognosis. The stated aims are fulfilled.
Weinhandl, Joshua T; Hoch, Matthew C; Bawab, Sebastian Y; Ringleb, Stacie I
Computer modeling and simulation techniques have been increasingly used to investigate anterior cruciate ligament (ACL) loading during dynamic activities in an attempt to improve our understanding of injury mechanisms and development of injury prevention programs. However, the accuracy of many of these models remains unknown and thus the purpose of this study was to compare estimates of ACL strain from a previously developed three-dimensional, data-driven model with those obtained via in vitro measurements. ACL strain was measured as the knee was cycled from approximately 10° to 120° of flexion at 20 deg s(-1) with static loads of 100, 50, and 50 N applied to the quadriceps, biceps femoris and medial hamstrings (semimembranosus and semitendinosus) tendons, respectively. A two segment, five-degree-of-freedom musculoskeletal knee model was then scaled to match the cadaver's anthropometry and in silico ACL strains were then determined based on the knee joint kinematics and moments of force. Maximum and minimum ACL strains estimated in silico were within 0.2 and 0.42% of that measured in vitro, respectively. Additionally, the model estimated ACL strain with a bias (mean difference) of -0.03% and dynamic accuracy (rms error) of 0.36% across the flexion-extension cycle. These preliminary results suggest that the proposed model was capable of estimating ACL strains during a simple flexion-extension cycle. Future studies should validate the model under more dynamic conditions with variable muscle loading. This model could then be used to estimate ACL strains during dynamic sporting activities where ACL injuries are more common.
Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.
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
Lepley, Adam S; Gribble, Phillip A; Thomas, Abbey C; Tevald, Michael A; Sohn, David H; Pietrosimone, Brian G
After anterior cruciate ligament (ACL) injury and reconstruction, abnormal biomechanics during daily tasks may have prominent and detrimental long-term consequences on knee joint health. The purpose of this study was to longitudinally evaluate hip and knee joint biomechanics during stair ascent and descent in patients with acute ACL injury and at return to activity after ACL reconstruction. Twenty individuals with unilateral ACL injury (age, 20.9 ± 4.4 yr; height, 172.4 ± 7.5 cm; mass, 76.2 ± 12.2 kg) that were scheduled to undergo surgical reconstruction were compared with 20 healthy matched controls (age, 21.7 ± 3.7 yr; height, 173.7 ± 9.9 cm; mass, 76.1 ± 19.7 kg). Lower extremity biomechanics were recorded using three-dimensional motion analysis during stair ascent and descent at two testing sessions (before surgery and at approximately 6 months after surgery or when they were allowed to return to unrestricted physical activity). Time between sessions for healthy participants was matched on the basis of the ACL group. Peak sagittal and frontal plane knee and hip joint angles and moments, joint angles at initial contact, and joint excursions across stance phase were evaluated. The ACL-injured limb of patients experienced smaller knee extension moments than the uninjured limb and healthy controls during stair ascent and descent (P < 0.05) before and 6 months after ACL reconstruction. During stair ascent, ACL patients experienced more extended knee joint positions and less sagittal plane knee joint excursions, coupled with greater frontal plane hip joint excursions (P < 0.05). Patients with ACL injury experience reductions in knee flexion angle and knee extension moments during stair walking. These alterations were observed both before and after reconstruction, suggesting that early gait retraining interventions may be beneficial in these patients.
Tashman, Scott; Anderst, William; Kolowich, Patricia; Havstad, Suzanne; Arnoczky, Steven
The ACL-deficient dog is a model for investigating the development and progression of mechanically driven osteoarthrosis of the knee. ACL loss creates dynamic instability in the ACL-deficient knee which presumably leads to progressive joint degeneration, but the nature of this instability over the time course of disease development is not well understood. The goal of this study was to characterize three-dimensional motion of the canine knee during gait, before and serially for two years after ACL transection. Canine tibial-femoral kinematics were assessed during treadmill gait before and serially for two years after ACL transection (ACL-D group; 18 dogs) or sham transection (ACL-I group; five dogs). Kinematic data was collected at 250 frames/s using a biplane video-radiographic system. Six degree-of-freedom motions of the tibia relative to the femur were calculated, and values immediately prior to pawstrike as well as the maximum, minimum, midpoint and range of motion during early/mid stance were extracted. Between-group differences relative to baseline (pre-transection) values, as well as changes over time post-transection, were determined with a repeated-measures ANCOVA. In the ACL-D group, peak anterior tibial translation (ATT) increased by 10 mm (p knee adduction also increased significantly over time (mean increase 3.0 degrees; p = 0.036). All changes occurred primarily between 6 and 12 months. There were no significant differences between groups in the transverse plane, and no significant changes over time in the ACL-I group. In summary, peak anterior tibial translation and coronal-plane instability increased immediately after ACL loss, and did not improve with time. ATT just prior to pawstrike and mean knee adduction throughout stance became progressively more abnormal with time, with the greatest changes occurring between 6 and 12 months after ACL transection. This may be due to overload failure of secondary restraints such as the medial meniscus, which has
Flosadottir, Vala; Roos, Ewa M; Ageberg, Eva
extremity muscle function and PROs after ACL injury. METHODS: Fifty-four participants (15 women, mean 30 years) with ACL injury or reconstruction, from the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559), were assessed with hop performance, muscle power......BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower...
Jansen, John D.; Codilean, Alexandru T.; Egholm, David L.; Knudsen, Mads F.; Korup, Oliver; Stroeven, Arjen; Goodfellow, Bradley; Andersen, Jane L.; Ugelvig, Sofie V.; Klein, Josefin
Climatic versus tectonic explanations for Scandinavian topography have sustained a century-long dispute. Here, at high-latitudes, the more recent question of whether Late-Cenozoic cooling has influenced mountain erosion rates is especially apt because glaciations commenced earlier: >10 Myr and possibly ~34 Myr according to marine palaeorecords. Although selective glacial incision along valley troughs is well recognised in Scandinavia, the legacy of glacial cirque erosion has yet to be fully investigated. We examine the topographic legacy of mountain glaciation in seven massifs of the Caledonian Scandes (western Scandinavia ~61-70° N): Lyngen, Kebnekaise, Sarek, Saltfjellet, Dovrefjell, Jostedalsbreen, and Jotunheimen. Glacial cirques are the product of discrete alpine glaciers and so the elevation of ice-free cirques provides a guide to past fluctuations in regional equilibrium line altitude (ELA). The Scandes currently hosts >3400 mountain glaciers and the distribution of >10,000 ice-free cirques indicates that glaciers have extended much lower and farther in the past. Previous workers argue that alpine glaciations focus erosion selectively at and above a zone of cirques, which approximates the long-term average 'palaeo-ELA'. First, we set out to examine the topographic relationships between mountain peak elevation, ELA, cirque-floor elevations, and the distribution of low-slope (<10°) terrain. To estimate the regional ELA for each massif, inclined planar trend-surfaces (first-order polynomial) were fitted to median elevations of existing glaciers. A total of ~4000 ice-free cirques were mapped and plotted relative to the ELA surfaces. For all seven massifs, cirque-floors cluster within a discrete elevational range: 240-490 m (25-75th percentiles) below ELA, suggesting a well-defined 'palaeo-ELA'. Hypsometric analyses show that this 'palaeo-ELA' closely matches the maximum frequency of low-slope terrain. Consistent with studies elsewhere, terrain surface area
Full Text Available James Heaf Department of Medicine, Roskilde Hospital, University of Copenhagen, Roskilde, Denmark Aim of database: The Danish Nephrology Registry's (DNR primary function is to support the Danish public health authorities' quality control program for patients with end-stage renal disease in order to improve patient care. DNR also supplies epidemiological data to several international organizations and supports epidemiological and clinical research. Study population: The study population included patients treated with dialysis or transplantation in Denmark from January 1, 1990 to January 1, 2016, with retrospective data since 1964. Main variables: DNR registers patient data (eg, age, sex, renal diagnosis, and comorbidity, predialysis specialist treatment, details of eight dialysis modalities (three hemodialysis and five peritoneal dialysis, all transplantation courses, dialysis access at first dialysis, treatment complications, and biochemical variables. The database is complete (<1% missing data. Patients are followed until death or emigration. Descriptive data: DNR now contains 18,120 patients, and an average of 678 is added annually. Data for each transplantation course include donor details, tissue type, time to onset of graft function, and cause of graft loss. Registered complications include peritonitis in peritoneal dialysis patients, causes of peritoneal dialysis technique failure, and transplant rejections. Fifteen biochemical variables are registered, mainly describing anemia control, mineral and bone disease, nutritional and uremia status. Date and cause of death are also included. Six quality indicators are published annually, and have been associated with improvements in patient results, eg, a reduction in dialysis patient mortality, improved graft survival, and earlier referral to specialist care. Approximately, ten articles, mainly epidemiological, are published each year. Conclusion: DNR contains a complete description of end
Koyama, Tomohide; Skattum, Jorunn; Engelsen, Peder; Eken, Torsten; Gaarder, Christine; Naess, Pål Aksel
Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. Patients trauma registry and medical records. A total of 66 children were included. The majority was severely injured as reflected by a median injury severity score of 20.5 (mean 22.2). NOM was attempted in 60 (90.9%) patients and was successful in 57, resulting in a NOM success rate of 95.0% [95% CI 89.3 to 100]. Only one of the three NOM failures was liver related, occurred in the early part of the study period, and consisted in operative placement of drains for bile leak. Two (3.0%) patients underwent angiographic embolization (AE). Complications occurred in 18 (27.3% [95 % CI 16.2 to 38.3]) patients. Only 2 (3.0%) patients had liver related complications, in both cases bile leak. Six (9.1%) patients underwent therapeutic laparotomy for non-liver related injuries. Two (3.0%) patients died secondary to traumatic brain injury. This single institution paediatric liver injury cohort confirms high attempted NOM and NOM success rates even in patients with high grade injuries and multiple accompanying injuries. AE can be a useful NOM adjunct in the treatment of paediatric liver injuries, but is seldom indicated. Moreover, bile leak is the most common liver-related complication and the need for liver-related surgery is very infrequent. NOM is the treatment of choice in almost all liver injuries in children, with operative management and interventional radiology very infrequently indicated.
DiMarco, Gabriella; Hill, Dane; Feldman, Steven R
Patient registries are datasets containing information on patients with a particular disease or patients who are undergoing a specific treatment. Our objective was to search for and catalog the types of registries being used in dermatology and investigate their characteristics and uses. We searched Google, the Registry of Patient Registries, Orphanet, and ClinicalTrials.gov to compile a list of dermatology disease registries. We also conducted a literature review on the uses of dermatology registries using PubMed. We identified 48 dermatology patient registries, with 23 distinct diseases represented. We also identified 11 registries used for postmarketing surveillance of skin disease. Our search was limited to registries in English. Registries are commonly used for the study of rare dermatologic diseases and for postsurveillance monitoring of systemic therapies in more common dermatologic diseases, such as psoriasis. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Stanley, Christopher J; Creighton, R Alexander; Gross, Michael T; Garrett, William E; Yu, Bing
... loading.We determined the effects of a knee extension constraint brace on knee flexion angle, peak posterior ground reaction force, and movement speed in functional activities of patients after ACL...
A. Gokeler; Anne Benjaminse; N. Cortes; M. Meier
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
Benjaminse, A.; Meijer, M.; Cortes, N.; Gokeler, A.
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 in jump-landing technique in relation to their neuropsychological capabilities. DESIGN:
Gokeler, Alli; Bisschop, Marsha; Benjaminse, Anne; Myer, Greg D.; Eppinga, Peter; Otten, Egbert
To determine the most effective practices for quadriceps strengthening after ACL reconstruction. An electronic search has been performed for the literature appearing from January 1990 to January 2012. Inclusion criteria were articles written in English, German or Dutch with unilateral
Petersen, Mille Nyboe; Fandt Hansen, Christl
, Sweden and Norway, who have experienced an induced (medical or surgical) abortion without a medical reason, described here as an “abortion on request”. Phenomena of interest: The objective of this review is to investigate Scandinavian women’s experiences in connection with – meaning before, during...
Lorensen, Marlene Ringgaard; Kaufman, Tone Stangeland; Sundberg, Carina
. The crisis situation stirred public debate as well as church-based initiatives trying to deal with the situation. In order to understand the interaction between public discourse and local preaching a group of homileticians from seven European countries collaborated on an empirical study of how the refugee...... crisis impacted preaching. In what follows we present the initial results from the Scandinavian countries....
Juul, Kristen D.
The paper defines the concept of mobbing and notes alternate terms such as bullying, scapegoating, and group violence or aggression. Scandinavian research and literature on mobbing is analyzed, especially as it relates to the incidence of mobbing and characteristics of aggressor and victim. Intervention efforts are described, such as individual…
Engels, Eva; Vikner, Sten
Based on the examination of remnant VP-topicalization constructions, this chapter argues for an order preservation analysis to Scandinavian Object Shift. Reviewing Fox and Pesetsky’s (2003, 2005) cyclic linearization approach and extending the empirical data base, we show that the phenomena...
Nielsen, Jørn Flohr; Bonderup Bjørn, Lars; Søndergaard, Mikael
subsidiaries in Japan and Germany including qualitative perception of problems. In order to trace general effects, this study includes other Scandinavian subsidiaries in East Asia, in total 140 subsidiaries in 1995 and 41 subsidiaries in 2005. Cultural distance is found to be associated with a configuration...
Bjørn-Andersen, Niels; Clemmensen, Torkil
This paper relates stories instrumental in shaping the career of an individual and which have also contributed to shaping of the IS field in general and the ‘Scandinavian Socio-Technical (S/T) Information Systems Research Tradition’ in particular. The method in this paper is an autoethnography (L...
Pedersen, Anette Tønnes; Iversen, Ole-Erik; Løkkegaard, Ellen
or secondary preventive effects of HT on coronary heart disease, and other studies have indicated an increased risk of breast cancer, stroke and venous thromboembolism among HT users. In 2001, we reported on knowledge, attitudes, management strategies and use of HT among Scandinavian gynaecologists. The aim...
Bjørn-Andersen, Niels; Clemmensen, Torkil
This paper relates stories instrumental in shaping the career of an individual and which have also contributed to shaping of the IS field in general and the ‘Scandinavian Socio-Technical (S/T) Information Systems Research Tradition’ in particular. The method in this paper is an autoethnography...
Wolfensberger, Marca; Hogenstijn, Maarten
For decades, Scandinavian culture effectively prohibited the development of special provisions for talented students in higher education. However, in recent years, a cultural shift has gradually made more room for excellence and talent development in the national discourses. This paper analyzes the climate for talent development in Denmark,…
Dr. Maarten Hogenstijn; Dr. Marca Wolfensberger
For decades, Scandinavian culture effectively prohibited the development of special provisions for talented students in higher education. However, in recent years, a cultural shift has gradually made more room for excellence and talent development in the national discourses. This paper analyzes the
The institutional order of organizing in working life is very different in Scandinavia and China. When Scandinavian and Chinese managers and employees meet in concrete work relations they not only work together on a product they also become engaged in institutional work dealing with the inconsist...
Drzewiecki, K T; Piltz-Drzewiecka, J
The quantitative evaluation of DOPA-positive epidermal melanocytes in 16 patients of Scandinavian origin showed both individual and regional differences in the melanocyte count. Our data is in agreement with other published studies. The distribution in the number of melanocytes varies significant...... concerning the presence of the epidermal melanin unit....
Drzewiecki, K T; Piltz-Drzewiecka, J
The quantitative evaluation of DOPA-positive epidermal melanocytes in 16 patients of Scandinavian origin showed both individual and regional differences in the melanocyte count. Our data is in agreement with other published studies. The distribution in the number of melanocytes varies significantly...
Sundqvist, A K; Ellegren, H; Olivier, M; Vilà, C
The analysis of mitochondrial DNA sequences has for a long time been the most extensively used genetic tool for phylogenetic, phylogeographic and population genetic studies. Since this approach only considers female lineages, it tends to give a biased picture of the population history. The use of protein polymorphisms and microsatellites has helped to obtain a more unbiased view, but complementing population genetic studies with Y chromosome markers could clarify the role of each sex in natural processes. In this study we analysed genetic variability at four microsatellite loci on the canid Y chromosome. With these four microsatellites we constructed haplotypes and used them to study the genetic status of the Scandinavian wolf population, a population that now contains 60-70 animals but was thought to have been extinct in the 1970s. In a sample of 100 male wolves from northern Europe we found 17 different Y chromosome haplotypes. Only two of these were found in the current Scandinavian population. This indicates that there should have been at least two males involved in the founding of the Scandinavian wolf population after the bottleneck in the 1970s. The two Scandinavian Y chromosome haplotypes were not found elsewhere in northern Europe, which indicates low male gene flow between Scandinavia and the neighbouring countries.
Engels, Eva; Vikner, Sten
On the basis of an examination of remnant VP-topicalisation constructions, this paper argues for an order preservation analysis of Scandinavian Object Shift. Extending the empirical database, we account for the phenomena in an Optimality Theoretic framework. The paper focusses on two particular...
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
Stetter, Bernd Josef; Stein, Thorsten; Ellermann, Andree; Flechtenmacher, Johannes; Eberle, Christian; Sell, Stefan; Potthast, Wolfgang
This is the first study examining functionality of subjects with anterior cruciate ligament (ACL) tears and a subsequent reconstruction comprehensively by multiple test sessions from pre- to six months post-reconstruction. The purpose was to evaluate if a generally applied rehabilitation program restores functionality to levels of healthy controls. Subjects with unilateral tears of the ACL were compared to matched healthy controls throughout the rehabilitation. 20 recreational athletes were tested: T1 (preoperative), 6 weeks after tear; T2, 6 weeks, T3, 3 months, T4, 6 months post-reconstruction. At all test sessions, subjects self-evaluated their activity level with the Tegner activity score and their knee state with the Knee Injury and Osteoarthritis Outcome Score. Passive range of motion during knee flexion and extension and leg circumference were measured as functional clinical tests. Bilateral countermovement jumps, one-leg jumps for distance and isometric force tests in knee flexion and extension with 90° and 110° knee angle were conducted as functional performance tests. For determination of functionality, leg symmetry indices (LSIs) were calculated by dividing values of the injured by the uninjured leg. In the ACL group most LSIs decreased from T1 to T2, and increased from T2 and T3 to T4. LSIs of ACL subjects remained lower than LSIs of healthy controls at 6 months post-reconstruction in nearly all parameters. Self-evaluation of ACL subjects showed, additionally, that activity level was lower than the pre-injury level at 6 months post-reconstruction. Low LSIs and low self-evaluation indicate that knee joint functionality is not completely restored at 6 months post-reconstruction. The study shows that multiple comprehensive testing throughout the rehabilitation gives detailed images of the functional state. Therefore, the functional state of ACL reconstructed individuals should be evaluated comprehensively and continuously throughout the rehabilitation to
Full Text Available Bente Arboe,1 Pär Josefsson,2 Judit Jørgensen,3 Jacob Haaber,4 Paw Jensen,5 Christian Poulsen,6 Dorthe Rønnov-Jessen,7 Robert S Pedersen,8 Per Pedersen,9 Mikael Frederiksen,10 Michael Pedersen,1 Peter de Nully Brown1 1Department of Hematology, Copenhagen University Hospital, Rigshospitalet, 2Department of Hematology, Copenhagen University Hospital, Herlev Hospital, Copenhagen, 3Department of Hematology, Aarhus University Hospital, Aarhus, 4Department of Hematology, Odense University Hospital, Odense, 5Department of Hematology, Aalborg University Hospital, Aalborg, 6Department of Hematology, Roskilde Hospital, Roskilde, 7Department of Hematology, Vejle Hospital, Vejle, 8Department of Hematology, Holstebro Hospital, Holstebro, 9Department of Hematology, Esbjerg Hospital, Esbjerg, 10Department of Hematology, Haderslev Hospital, Haderslev, Denmark Aim of database: The Danish National Lymphoma Registry (LYFO was established in order to monitor and improve the diagnostic evaluation and the quality of treatment of all lymphoma patients in Denmark. Study population: The LYFO database was established in 1982 as a seminational database including all lymphoma patients referred to the departments of hematology. The database became nationwide on January 1, 2000. Main variables: The main variables include both clinical and paraclinical variables as well as details of treatment and treatment evaluation. Up to four forms are completed for each patient: a primary registration form, a treatment form, a relapse form, and a follow-up form. Variables are used to calculate six result quality indicators (mortality 30 and 180 days after diagnosis, response to first-line treatment, and survival estimates 1, 3, and 5 years after the time of diagnosis, and three process quality indicators (time from diagnosis until the start of treatment, the presence of relevant diagnostic markers, and inclusion rate in clinical protocols. Descriptive data: Approximately 23
Beck, Nicholas A; Lawrence, J Todd R; Nordin, James D; DeFor, Terese A; Tompkins, Marc
Anterior cruciate ligament (ACL) tears are thought to occur with increasing frequency in young patients. No study has shown increased incidence over time. We hypothesized the incidence of ACL tears in young patients has increased over the past 20 years. This descriptive epidemiology study is a retrospective review of insurance billing data of all patients aged 6 to 18 years with Current Procedural Terminology, Fourth Revision codes for ACL tear and reconstruction or International Classification of Diseases, Ninth Revision, Clinical Modification codes from 1994 to 2013. Injuries were normalized to persons per year enrolled in the insurance database based on age and sex. Analysis was performed based on sex and age (6-14, 15-16, and 17-18 years). The rate of ACL tears per 100 000 person-years averaged 121 ± 19 (range 92-151). All trends increased significantly except for the male 6- to 14-year-old and 17- to 18-year-old age groups. Overall there was an annual increase of 2.3%. Females had significantly higher incidence except in the 17- to 18-year-olds. Females peaked at age 16 years and males at age 17 years, with rates of 392 ACL tears and 422 ACL tears per 100 000 person-years, respectively. The incidence of ACL tears in pediatric patients increased over the last 20 years. Females were at higher risk except in the 17- to 18-year -old group. Peak incidence is noted during high school years. These data help target the most at-risk patients for ACL prevention programs. Copyright © 2017 by the American Academy of Pediatrics.
Akbari, Asghar; Ghiasi, Fateme; Mir, Mohsen; Hosseinifar, Mohammad
Background: Proprioception and postural stability play an important role in knee movements. However, there are controversies about the overall recovery time of proprioception following knee surgery and onset of balance and neuromuscular training after ACL reconstruction. Therefore, it is necessary to evaluate the effect of balance training in early stage of knee rehabilitation after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of balanc...
Zampeli, Frantzeska; Terzidis, Ioannis; Mendes, João de Espregueira; Georgoulis, Jim-Dimitris; Bernard, Manfred; Pappas, Evangelos; Georgoulis, Anastasios D.
"Published online: 24 October 2017" PURPOSE: Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of path...
Rabelo,Neiffer Nunes; Rabelo,Nícollas Nunes; Cunha,Aluísio Augusto Gonçalves; Correia,Francisco
We report a case of injury of the medial bucket handle meniscal tears (BH), which resolved spontaneously, in association with anterior cruciate ligament (ACL) injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treat...
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.
Brophy, Robert; Silvers, Holly Jacinda; Gonzales, Tyler; Mandelbaum, Bert R
This study intends to look at the role of leg dominance in anterior cruciate ligament (ACL) injury risk among soccer (football) athletes. The purpose of this study was to test the hypothesis that soccer players rupture the ACL of their preferred support leg more frequently than the ACL in their preferred kicking leg, particularly in non-contact injuries, despite differences in gender. Retrospective observational study. Outpatient orthopaedic practice. Subjects who had sustained an ACL injury due to direct participation in soccer. N=93 (41 male, 52 female). These noncontact injuries were sustained while playing soccer. For non-contact injuries, roughly half of the injuries occurred in the preferred kicking leg (30) and the contralateral leg (28). However, by gender, there was a significant difference in the distribution of non-contact injury, as 74.1% of males (20/27) were injured on the dominant kicking leg compared with 32% (10/31) of females (pnon-contact injury mechanism, females are more likely to injure the ACL in their supporting leg, whereas males tend to injure their kicking leg. This research suggests that limb dominance does serve as an aetiological factor with regard to ACL injuries sustained while playing soccer. If follow-up studies confirm that females are more likely to injure their preferred supporting leg, future research should investigate the cause for this discrepancy, which could result from underlying gender-based anatomical differences as well as differences in neuromuscular patterns during cutting manoeuvres or kicking.
Cordeiro, Nuno; Cortes, Nelson; Fernandes, Orlando; Diniz, Ana; Pezarat-Correia, Pedro
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 angle and RF muscle activation while performing an instep kick. These findings are in accordance with the knee stability recovery process after ACL reconstruction. No differences were observed in the 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.
Goerger, Benjamin M; Marshall, Stephen W; Beutler, Anthony I; Blackburn, J Troy; Wilckens, John H; Padua, Darin A
Information as to how anterior cruciate ligament (ACL) injury and reconstructive surgery (ACLR) alter lower extremity biomechanics may improve rehabilitation and return to play guidelines, reducing the risk for repeat ACL injury. To compare lower extremity biomechanics before ACL injury and after subsequent ACLR for the injured and uninjured leg. Baseline unilateral lower extremity biomechanics were collected on the dominant leg of participants without ACL injury when they entered the Joint Undertaking to Monitor and Prevent ACL (JUMP-ACL) study. Thirty-one participants with subsequent ACL injury, reconstructive surgery and full return to physical activity completed repeat, follow-up biomechanical testing, as did 39 uninjured, matched controls. Not all injured participants suffered injury to the dominant leg, requiring separation of those with ACL injury into two groups: ACLR-injured leg group (n=12) and ACLR-uninjured leg group (n=19). We compared the landing biomechanics of these three groups (ACLR-injured leg, ACLR-uninjured leg, control) before ACL injury (baseline) with biomechanics after ACL injury, surgery and return to physical activity (follow-up). ACL injury and ACLR altered lower extremity biomechanics, as both ACLR groups demonstrated increases in frontal plane movement (increased hip adduction and knee valgus). The ACLR-injured leg group also exhibited decreased sagittal plane loading (decreased anterior tibial shear force, knee extension moment and hip flexion moment). No high-risk biomechanical changes were observed in control group participants. ACL injury and ACLR caused movement pattern alterations of the injured and uninjured leg that have previously shown to increase the risk for future non-contact ACL injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Rosenblum, Amanda M; Li, Alvin Ho-Ting; Roels, Leo; Stewart, Bryan; Prakash, Versha; Beitel, Janice; Young, Kimberly; Shemie, Sam; Nickerson, Peter; Garg, Amit X
The variability in deceased organ donation registries worldwide has received little attention. We considered all operating registries, where individual wishes about organ donation were recorded in a computerized database. We included registries which recorded an individual's decision to be a donor (donor registry), and registries which only recorded an individual's objection (non-donor registry). We collected information on 15 characteristics including history, design, use and number of registrants for 27 registries (68%). Most registries are nationally operated and government-owned. Registrations in five nations expire and require renewal. Some registries provide the option to make specific organ selections in the donation decision. Just over half of donor registries provide legally binding authorization to donation. In all national donor registries, except one, the proportion of adults (15+) registered is modest (donation decision mandatory to obtain a driver's license. Registered objections in non-donor registries are rare (organ donor registries worldwide necessitates public discourse and quality improvement initiatives, to identify and support leading practices in registry use. © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.
Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten
The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D......, HSAS and NRS pain scores were submitted online by the patients pre-operatively and at 1 and 2-years follow-up. 2054 FAI procedures in 1835 patients were included in this study (219 patients had bilateral procedures performed). HAGOS demonstrated significant improvement in all subscales at follow up. EQ...
Relph, N; Herrington, L; Tyson, S
It is suggested the anterior cruciate ligament (ACL) plays a significant role in knee proprioception, however, the effect of ACL injury on knee proprioception is unclear. Studies utilising the two most common measurement techniques, joint position sense and threshold to detect passive motion, have provided evidence both for and against a proprioceptive deficient following ACL injury. The objective of the study was to undertake a meta-analysis investigating the effects of ACL injury, treated conservatively or by reconstruction, on proprioception of the knee, measured using joint position sense and/or threshold to detect passive movement techniques. Seven databases were searched from their inception to September 2013 using the subject headings 'anterior cruciate ligament, proprioception, postural sway, joint position sense, balance, equilibrium or posture' to identify relevant studies. PRISMA guidelines were followed as much as possible. Studies that investigated the effect of ACL injury on either knee joint kinaesthesia or position sense were included in this review. Two reviewers independently extracted data using a standardised assessment form. Comparisons were made using a fixed effect model with an inverse variance method using Review Manager Software (V5.1). Patients with ACL injury have poorer proprioception than people without such injuries (SMD=0.35°; P=0.001 and SMD=0.38°; P=0.03) when measured using joint position sense and threshold to detect passive motion techniques respectively. Patients had poorer proprioception in the injured than uninjured leg (SMD=0.52°; Pproprioception of people whose ACL was repaired was better than those whose ligament was left unrepaired (SMD=-0.62°; Pproprioception deficits compared to uninjured knees and control groups. Although differences were statistically significant, the clinical significance of findings can be questioned. Clinical practitioners using joint position sense or threshold to detect passive motion
Norte, Grant E; Knaus, Katherine R; Kuenze, Chris; Handsfield, Geoffrey G; Meyer, Craig H; Blemker, Silvia S; Hart, Joseph M
Study of muscle volumes in patients after anterior cruciate ligament (ACL) injury and reconstruction (ACL-R) is largely limited to cross-sectional assessment of the thigh musculature, which may inadequately describe post-traumatic and post-surgical muscle function. No studies have prospectively examined the influence of ACL injury and reconstruction on lower extremity muscle volumes. Assess magnetic resonance imaging (MRI) derived lower extremity muscle volumes, and quantify quadriceps strength and activation in patients following ACL injury and reconstruction. Prospective case series. Research laboratory and MRI facility. Patients (or Other Participants): Four patients (2 males, 2 females, age = 27.4 ± 7.4, height = 169.2 ± 8.1 cm, mass = 74.3 ± 18.5 kg) scheduled for ACL-R. 35 muscle volumes were obtained from a bilateral lower extremity MRI before and after ACL-R. Muscle volumes expressed relative to (1) a normative database pre-and-post-surgery, (2) limb symmetry pre-and-post-surgery, and (3) percentage change pre-to-post-surgery. Quadriceps function was quantified by normalized knee extension maximal voluntary isometric contraction (MVIC) torque and central activation ratio (CAR). Involved vastus lateralis and tibialis anterior were consistently smaller than healthy individuals (Zmuscle volumes exceeded 20% asymmetry post-operatively. Involved gracilis and semitendinosus atrophied more than 30% from pre-to-post-surgery. Involved MVIC torque and CAR increased by 12.7% and 12.5% respectively, yet strength remained 33.2% asymmetric post-surgery. Adaptations in lower extremity muscle volumes are present following ACL injury and reconstruction. Anterior thigh and shank muscles were smaller than healthy individuals, and large asymmetries in quadriceps volumes were observed pre- and post-surgery. Selective atrophy of the semitendinosus and gracilis occurred following surgery. Volumetric deficits of the quadriceps musculature may exist despite improvements in
Kvist, J; Österberg, A; Gauffin, H; Tagesson, S; Webster, K; Ardern, C
Psychological factors may be a hindrance for returning to sport after an anterior cruciate ligament (ACL) reconstruction. 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. The aim of this study was to translate the ACL-RSI scale from English to Swedish and to examine some of the measurement properties of the Swedish version. The ACL-RSI was translated and culturally adapted. A professional expert group and five patients evaluated face validity. One hundred and eighty-two patients completed the translated ACL-RSI, a project-specific questionnaire, the Tampa Scale of Kinesiophobia (TSK), the Knee-Self-Efficacy Scale (K-SES), the Multidimensional Health Locus of Control (MHLC-C), the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Anterior Cruciate Ligament-Quality of Life (ACL-QoL) questionnaires. Fifty-three patients answered the ACL-RSI twice to examine reproducibility. The ACL-RSI showed good face validity, internal consistency (Cronbach's alpha = 0.948), low floor and ceiling effects and high construct validity when evaluated against the TSK, K-SES, MHLC-C, KOOS, and ACL-QoL scales. The reproducibility was also high (intra-class correlation = 0.893). Therefore, the ACL-RSI can be used to evaluate psychological factors relevant to returning to sport after ACL reconstruction surgery. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Department of Veterans Affairs — The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and...
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
Jacobi, Matthias; Reischl, Nikolaus; Rönn, Karolin; Magnusson, Robert A; Gautier, Emanuel; Jakob, Roland P
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.
Pappas, Evangelos; Zampeli, Franceska; Xergia, Sofia A; Georgoulis, Anastasios D
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.
Jacobi, Matthias; Magnussen, Robert A; Villa, Vincent; Demey, Guillaume; Neyret, Philippe
There is significant interest in the restoration of the double-bundle anatomy of the native ACL when performing ACL reconstruction. Possible techniques include those utilizing two separate grafts with independent tunnels and those that attempt to mimic this anatomy with a single graft and fewer tunnels. Many of the latter techniques require specific instrumentation and are technically challenging. We demonstrate that the double-bundle anatomy of the native ACL can theoretically be mimicked by a single-bundle reconstruction. We performed single bundle ACL reconstruction with a bone-patellar tendon-bone (BTB) graft in two cadaveric knees. Both grafts were placed to mimic the native ACL footprints - one reconstruction was performed with rectangular bone blocks and oval tunnels and one was performed utilizing a standard BTB graft and round tunnels. Qualitative assessment of graft behavior was made as the knees were taken through a range of motion. The ACL graft was able to qualitatively mimic the behavior of the native ACL in both knees provided the bone blocks were correctly orientated. ACL reconstruction with a single BTB graft can qualitatively mimic the behavior of the two bundles of the native ACL. The key to ensuring this behavior was noted to be appropriate orientation of the graft in the tunnels. Quantitative biomechanical investigations are necessary to evaluate the impact of graft orientation on function.
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.
Full Text Available Abstract Background There is significant interest in the restoration of the double-bundle anatomy of the native ACL when performing ACL reconstruction. Possible techniques include those utilizing two separate grafts with independent tunnels and those that attempt to mimic this anatomy with a single graft and fewer tunnels. Many of the latter techniques require specific instrumentation and are technically challenging. We demonstrate that the double-bundle anatomy of the native ACL can theoretically be mimicked by a single-bundle reconstruction. Methods We performed single bundle ACL reconstruction with a bone-patellar tendon-bone (BTB graft in two cadaveric knees. Both grafts were placed to mimic the native ACL footprints – one reconstruction was performed with rectangular bone blocks and oval tunnels and one was performed utilizing a standard BTB graft and round tunnels. Qualitative assessment of graft behavior was made as the knees were taken through a range of motion. Results The ACL graft was able to qualitatively mimic the behavior of the native ACL in both knees provided the bone blocks were correctly orientated. Conclusions ACL reconstruction with a single BTB graft can qualitatively mimic the behavior of the two bundles of the native ACL. The key to ensuring this behavior was noted to be appropriate orientation of the graft in the tunnels. Quantitative biomechanical investigations are necessary to evaluate the impact of graft orientation on function.
Rasmussen, Jeppe; Jakobsen, John; Brorson, Stig
(70% women) were reported to the registry between January 2006 and December 2008. Mean age at surgery was 69 years (SD 12). The most common indications were a displaced proximal humeral fracture (54%) or osteoarthritis (30%). 61% were stemmed hemiarthroplasties, 28% resurfacing hemiarthroplasties, 8...
Schjødt, Inge; Nakano, Anne; Egstrup, Kenneth
AIM OF DATABASE: The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. STUDY POPULATION: The DHFR includes inpatients and outpatients (≥18 years) with incident HF. Reporting to the DHFR is mandatory for the ...
Brønnum-Hansen, Henrik; Koch-Henriksen, Nils; Stenager, Egon
Introduction: The Danish Multiple Sclerosis (MS) Registry was established in 1956. Content: The register comprises data on all Danes who had MS in 1949 or who have been diagnosed since. Data on new cases and updated information on persons with an MS diagnosis already notified are continuously...
The Breast Cancer Family Registry and the Colon Cancer Family Registry were established by the National Cancer Institute as a resource for investigators to use in conducting studies on the genetics and molecular epidemiology of breast and colon cancer.
Selmer, K K; Egeland, T; Solaas, M H
Background - Mutations in the three genes SCN1A, SCN1B and GABRG2, all encoding subunits of ion channels, have been known to cause generalized epilepsy with febrile seizures plus (GEFS+) in families of different origin. Objective - To study the occurrence of mutations in these genes in families...... identified only one mutation in SCN1A, which seems to be a rare variant with no functional consequence. Conclusion - This suggests that mutations in these three genes are not a prevalent cause of familial cases of FS and epilepsy or GEFS+ in Scandinavia....... with GEFS+ or a GEFS+ resembling phenotype of Scandinavian origin. Material and methods - We performed linkage analysis in 19 Scandinavian families with a history of febrile seizures (FS) and epilepsy or GEFS+. Where linkage could not be excluded, the genes of interest were sequenced. Results - We...
Full Text Available This article provides a first critical overview of the historiography of Jewish immigration and integration in Sweden, Denmark and Norway. While the experience of immigration has been crucial for Scandinavian Jewry, scholarly interest in Jewish migration history only emerged during the 1980s in connection with the focus on migration and ethnicity in Swedish research and the adaptation of sociological concepts of migration in general historiography. By analysing key historio-graphical works, focusing on their approaches and main narratives, this article aims at a critical methodological self-reflection. It identifies two major approaches to Jewish immigration history in current Scandinavian historiography: the demographic and social history approach, focusing in particular on the role of Jewish immigrants in the labour market, their settlement and housing conditions and their social mobility; and the cultural history approach, reconstructing and preserving the vanished world of Yiddish immigrant culture.
Full Text Available Nikolaj Eldrup,1,2 Charlotte Cerqueira,3 Louise de la Motte,2,4 Lisbet Knudsen Rathenborg,2,4 Allan K Hansen2,5 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, 2Karbase, The Danish Vascular Registry, Aarhus, 3Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, 4Department of Vascular Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 5Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark Aim: The Danish Vascular Registry (DVR, Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry for quality assessment and research. Study population: All patients undergoing vascular interventions (surgical and endovascular at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ~9,000 procedures are added. By January 2016, .180,000 procedures have been recorded. Since 2001, data completeness has been .90% (compared to the Danish National Patient Register. Main variables: Variables include information on descriptive patient data (ie, age, sex, height, and weight and comorbidity (ie, previous cardiovascular disease and diabetes. Process variable includes waiting time (time from event to medical contact and treatment and the type of procedures conducted. Outcome variables for in-hospital complications (ie, wound complications, myocardial infarction, stroke, amputation, respiratory complications, and renal insufficiency and 30-day patency are submitted. Variables for medical treatment (antithrombotic and statin treatment, amputation, and survival are extracted from nationwide, administrative registers. Conclusion: The DVR reports outcome on key indicators for
Davidson, S P; McLean, S G
Relations between lower limb muscle strength and female ACL injury risk are well documented. How these relations combine with key ACL geometries however, is unknown. Identifying how these combined factors are impacted by maturation would benefit current risk screening and prevention efforts. This study compared hamstrings and quadriceps strength and ACL cross sectional area (CSA) indices across three maturation groups. Cross-sectional human experimental. MRI scans of the dominant knee were collected in 35 females stratified into early (9.7±0.8yrs), middle (12.9±1.7yrs), and late (14.8±0.6yrs) maturation groups. Hamstring and quadriceps muscle volumes and ACL CSA measures were obtained. Isokinetic strength data were quantified for dominant knee flexors and extensors. Peak hamstring and quadriceps concentric and eccentric strength per unit volume magnitudes (QCSPV, HCSPV, QESPV, HESPV) were determined. Metrics and select ratios were submitted to a one way ANOVA to determine the main effect of maturation. Significant decreases occurred in HESPV (N/cm(3)) and ACL CSA (cm(2)/kgm), respectively, from early (0.188±0.023N/cm(3), 0.007±0.002cm(2)/kgm) to middle (0.157±0.029N/cm(3), 0.005±0.002cm(2)/kgm, p=0.034, p=0.029), and middle to late (0.132±0.031N/cm(3), 0.003±0.001cm(2)/kgm, p=0.044, p=0.018) maturation. A significant decrease in HESPV:QCSPV occurred between early (1.795±0.496) and middle (1.362±0.277, p=0.018) maturation. ACL CSA was significantly greater in late (37.26±13.35) compared to middle (25.81±9.17, p=0.021) maturation. Key ratios between female knee quadriceps and hamstring strength and ACL size parameters, which may directly impact ACL injury risk, are substantially different among three maturation states. The results are potentially hazardous strength mismatches in mid-pubertal females, where a smaller (weaker) ACL may be unable to stabilize quadriceps dominated loading strategies. Copyright © 2015 Sports Medicine Australia. Published by
The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed.......The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed....
Stadtmann, Georg; Hutengs, Oliver
The paper investigates Scandinavian countries and their male and female unemployment rates. Okun’s law is used to estimate age cohort and gender-specific Okun coefficients to make inference about the business-cycle dependence of young peoples’ unemployment across Scandinavian countries. Results...... show that men have higher Okun coefficients in absolute terms. Thus, their unemployment rate reacts more strongly to any change in GDP....
Araujo, Paulo H; van Eck, Carola F; Macalena, Jeffrey A; Fu, Freddie H
To describe the "three-portal technique for anatomical ACL single- or double-bundle reconstruction" and the arthroscopic viewing improvement provided by this technique. A "high" anterolateral portal was placed 1 cm lateral to the patellar tendon and the most inferior portion of the portal at the level of the inferior pole of the patella. A "central" portal was placed using a spinal needle under arthroscopic visualization following the orientation of the previous ACL fibers. An accessory medial portal was also placed using a spinal needle respecting a 2-mm distance to the medial femoral condyle. The "high" anterolateral portal permitted a broad and unobstructed view of the ACL tibial attachment. The "central" portal allowed a straightforward view of the ACL femoral remnant and bony landmarks in the intercondylar notch. The accessory medial portal enabled to reach the femoral native insertion site of the ACL. The three-portal technique provides a proper view of the soft tissue remnants and bony landmarks facilitating an anatomical positioning of the graft.
Tighe, Patrick; Laduzenski, Sarah; Edwards, David; Ellis, Neal; Boezaart, Andre P; Aygtug, Haldun
We report on a classification approach using machine learning (ML) algorithms for prediction of postoperative femoral nerve block (FNB) requirement following anterior cruciate ligament (ACL) reconstruction. FNBs are commonly performed for ACL reconstruction to control postoperative pain. Ideally, anesthesiologists would target preoperative FNB only to ACL reconstruction patients expected to experience severe postoperative pain. Perioperative factors associated with postoperative FNB placement following ACL reconstruction remain unclear, may differ among separate surgical facilities, and render such predictions difficult. We conducted a chart review of 349 patients who underwent ACL reconstruction at a single outpatient surgical facility. Standard perioperative data commonly available during routine preoperative examination were recorded. ML classifiers based on logistic regression, BayesNet, multilayer perceptron, support vector machine, and alternating decision tree (ADTree) algorithms were then developed to predict which patients would require postoperative FNB. Each of the ML algorithms outperformed traditional logistic regression using a very limited data set as measured by the area under the receiver operating curve, with ADTree achieving the highest score of 0.7 in the cross-validated sample. Logistic regression outperformed all other classifiers with regard to kappa statistics and percent correctly classified. All models were prone to overfitting in comparisons of training vs cross-validated samples. ML classifiers may offer improved predictive capabilities when analyzing medical data sets compared with traditional statistical methodologies in predicting severe postoperative pain requiring peripheral nerve block. Wiley Periodicals, Inc.
Moglo, K E; Shirazi-Adl, A
A non-linear 3D finite element model of the passive human tibiofemoral knee joint consisting of two bony structures and their articular cartilage layers, menisci, and four principal ligaments was used to investigate the detailed response of the unconstrained joint under up to 100 N posterior femoral force at different flexion angles from 0 to 90 degrees. The analysis was repeated after the transection of the anterior cruciate ligament (ACL). The boundary conditions were selected to assure a stable and unconstrained response of the joint throughout the range of motion. The results indicated the ACL as the primary structure to resist the drawer load throughout the range of flexion considered and that the joint primary and coupled laxities substantially increased in its absence. At full extension under drawer, forces in collateral ligaments increased significantly resulting in larger overall contact forces as the ACL was transected. In the ACL-deficient joint, such large forces in collateral ligaments, however, diminished as flexion angle varied from 0 to 90 degrees. At full extension or flexion angles up to approximately 30 degrees, the medial meniscus and adjacent medial tibial and femoral cartilage layers were subjected to substantially larger loads and stresses following the transection of the ACL. Adequate consideration of such couplings is important in avoiding further damage to joint structures subsequent to an injury and restoring adequate function following injuries to primary components.
Baima, Simona; Forte, Valentina; Possenti, Marco; Peñalosa, Andrés; Leoni, Guido; Salvi, Sergio; Felici, Barbara; Ruberti, Ida; Morelli, Giorgio
The role of auxin as main regulator of vascular differentiation is well established, and a direct correlation between the rate of xylem differentiation and the amount of auxin reaching the (pro)cambial cells has been proposed. It has been suggested that thermospermine produced by ACAULIS5 (ACL5) and bushy and dwarf2 (BUD2) is one of the factors downstream to auxin contributing to the regulation of this process in Arabidopsis. Here, we provide an in-depth characterization of the mechanism through which ACL5 modulates xylem differentiation. We show that an increased level of ACL5 slows down xylem differentiation by negatively affecting the expression of homeodomain-leucine zipper (HD-ZIP) III and key auxin signaling genes. This mechanism involves the positive regulation of thermospermine biosynthesis by the HD-ZIP III protein Arabidopsis thaliana homeobox8 tightly controlling the expression of ACL5 and BUD2. In addition, we show that the HD-ZIP III protein REVOLUTA contributes to the increased leaf vascularization and long hypocotyl phenotype of acl5 likely by a direct regulation of auxin signaling genes such as like auxin resistant2 (LAX2) and LAX3. We propose that proper formation and differentiation of xylem depend on a balance between positive and negative feedback loops operating through HD-ZIP III genes. © The Author 2014. Published by the Molecular Plant Shanghai Editorial Office in association with Oxford University Press on behalf of CSPB and IPPE, SIBS, CAS.
Schmitt, Laura C.; Paterno, Mark V.; Ford, Kevin R.; Myer, Gregory D.; Hewett, Timothy E.
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, QI.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
Fry, Christopher S; Johnson, Darren L; Ireland, Mary Lloyd; Noehren, Brian
Anterior cruciate ligament (ACL) injuries are associated with significant loss of strength in knee extensor muscles that persists despite physical therapy. The underlying mechanisms responsible for this protracted muscle weakness are poorly understood; however, we recently showed significant myofiber atrophy and altered muscle phenotype following ACL injury. We sought to further explore perturbations in skeletal muscle morphology and progenitor cell activity following an ACL injury. Muscle biopsies were obtained from the injured and non-injured vastus lateralis of young adults (n = 10) following ACL injury, and histochemical/immunohistochemical analyses were undertaken to determine collagen content, abundance of connective tissue fibroblasts, fibrogenic/adipogenic progenitor (FAP) cells, satellite cells, in addition to indices of muscle fiber denervation and myonuclear apoptosis. The injured limb showed elevated collagen content (p injury. The injured limb also displayed reduced satellite cell abundance, increased fiber denervation and DNA damage associated with apoptosis (p muscle itself after the ligament injury. Injury of the ACL induces a myriad of negative outcomes within knee extensor muscles, which likely compromise the restorative capacity and plasticity of skeletal muscle, impeding rehabilitative efforts. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1876-1885, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Pedersen, Anette Tønnes; Iversen, Ole-Erik; Løkkegaard, Ellen
Climacteric medicine has been in focus during the last 2 decades, and an intensive debate has been ongoing regarding the positive and negative aspects of postmenopausal hormone therapy (HT). Recent randomised controlled studies have been unable to confirm data from observational studies of primar...... of the present study was to re-assess the same parameters concerning HT among Scandinavian gynaecologists in 2002-2003, and compare the results with the data collected in 1995-1997....
Nygård, Odd Erik
A simulation model consisting of a representative consumer for each Scandinavian country is constructed and calibrated, in which consumers consume two goods: spirits and 'other goods'. Spirits is exposed to cross-border shopping, and the countries engage in tax competition. The equilibrium tax rates show large price differentials on spirits in Scandinavia. The findings also suggest that Norway and Denmark pay more attention to cross-border shopping and tax competition when setting the tax rat...
Full Text Available The publication of Design in Ireland: Report of the Scandinavian Design Group in Ireland in 1962 has been described as providing the catalyst for change in the approach to design in Ireland. The Report was commissioned by the Irish Export Board and the Scandinavian Design Group was formed for this purpose. It stimulating protracted debate on design education in Ireland, and also afforded a reason for the establishment of the Kilkenny Design Workshops. This paper, which draws on unpublished material from a number of archives, will provide a brief overview of the Report and the rational for commissioning it, followed by an examination of government interventions to improve design standards in Ireland from the founding of the State until the 1960s. It will examine the origins of Scandinavian influence on the evolution of public policy on design in Ireland, question if the Report expanded the discourse on design in industry in Ireland and assess its influence during the early years of the Workshops.
Full Text Available This paper deals with Scandinavian influence in Early Middle English texts and especially with one syntactic phenomenon, stylistic fronting. It is claimed here that the OV/VO word order change in Early Middle English was triggered by language contact with Scandinavian (Kroch & Taylor, 1997 and that the occurrence of syntactic phenomena like stylistic fronting are taken to be evidence for the heavy impact on the English language that led to this change. The focus of the paper lies on the findings from one Early Middle English poetic text, the Ormulum, which shows non-syntactic as well as syntactic evidence for Scandinavian influence. It is shown that the orders that seem to reflect the fronting operation are indeed true instantiations of stylistic fronting. Moreover, in this text stylistic fronting is a phonological phenomenon, because it is used by Orm, its author, whenever the metrical pattern would otherwise be violated. Thus, it was part of Orm's grammar and he could use it for phonological reasons. The fact that the fronting operation is metrically driven supports Holmberg's (2000 analysis of stylistic fronting as a PF-operation.
Granas, Anne Gerd; Nørgaard, Lotte Stig; Sporrong, Sofia Kälvemark
The "Beliefs about Medicines Questionnaire" (BMQ) assess balance of necessity and concern of medicines. The BMQ has been translated from English to many languages. However, the original meaning of statements, such as "My medicine is a mystery to me", may be lost in translation. The aim of this study is to compare three Scandinavian translations of the BMQ. (1) How reliable are the translations? (2) Are they still valid after translation? Translated Norwegian, Swedish and Danish versions of the BMQ were scrutinized by three native Scandinavian researchers. Linguistic differences and ambiguities in the 5-point Likert scale and the BMQ statements were compared. In the Scandinavian translations, the Likert scale expanded beyond the original version at one endpoint (Swedish) or both endpoints (Danish). In the BMQ statements, discrepancies ranged from smaller inaccuracies toward completely different meaning. Some dissimilarities reflect different cultural beliefs about medicines. When translating questionnaires, bilingual researchers should scrutinize translations across similar languages to address content validity across different countries and languages. Our findings are of relevance to other BMQ translations in non-English countries, as direct comparisons between different translations might not be reliable or valid. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Hickey, Graeme L; Grant, Stuart W; Cosgriff, Rebecca; Dimarakis, Ioannis; Pagano, Domenico; Kappetein, Arie P; Bridgewater, Ben
Clinical registries will have an increasingly important role to play in health-care, with a number already established in cardiac surgery. This review covers the fundamentals of establishing and managing clinical registries, including legal and ethical frameworks along with intellectual property attribution. Also discussed are important issues relating to the processing of data, data extraction and conducting analyses using registry data.
... 46 Shipping 2 2010-10-01 2010-10-01 false Registry endorsement. 67.17 Section 67.17 Shipping COAST... DOCUMENTATION OF VESSELS Forms of Documentation; Endorsements; Eligibility of Vessel § 67.17 Registry endorsement. (a) A registry endorsement entitles a vessel to employment in the foreign trade; trade with Guam...
Markström, Jonas L; Tengman, Eva; Häger, Charlotte K
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 (ACLR), solely physiotherapy (ACLPT), 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 ACLR, 34 ACLPT) 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 ACLPT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACLR and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACLR also presented different kinematics to ACLPT 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 provides
Qu, Jin; Thoreson, Andrew R; An, Kai-Nan; Amadio, Peter C; Zhao, Chunfeng
The knee joint is generally characterized by very low friction and high wear resistance. Several previous studies have compared ACL with the commonly used allografts from tensile properties perspective. No study has reported about the graft tendons from a frictional perspective, which is an important parameter for ACL functional performance. Twenty hind legs were used to harvest FDP tendon, ACL, ACH, and patellar tendon. Samples were evaluated with surface friction testing, indentation testing for tendon compressive moduli, lubricin immunohistochemistry, and histologic analysis. Frictional force of FDP tendon and ACL was significantly less than that of patellar tendon and ACH at first and fifth cycles. At the tenth cycle, the FDP tendon, ACL, and ACH showed significantly less frictional force than patellar tendon; after 100 cycles, the FDP tendon and ACL showed significantly less frictional force than patellar tendon. The compressive moduli of the FDP tendon, ACL, and ACH were significantly greater than that of patellar tendon. Histologic results showed that FDP tendon and ACL had a smooth surface with a thin layer of epitenon cells; patellar tendon and ACH had a rough surface and a layer of paratenon. Lubricin was found on the surface and extracellular matrix of FDP tendon and ACL. There was only limited lubricin expression on the surface and extracellular matrix of the ACH and patellar tendon. The FDP tendon has friction force and lubricin expression similar to those of native ACL. However, patellar tendon and ACH show higher friction force and less lubricin expression than ACL. Copyright © 2015 Elsevier Ltd. All rights reserved.
von Porat, Anette; Holmström, Eva; Roos, Ewa
during five functional tests in subjects with an anterior cruciate ligament (ACL) injury. METHOD: Twelve ACL-injured men, mean age 40 years, were video filmed before and after 12 weeks of knee-specific training when performing five different functional tests: walking, knee bending, step activity......, crossover hop on one leg and one-leg hop. The videos were observed by four physiotherapists, and the knee movement pattern quality, a feature of the loading strategy of the lower extremity, was scored on an 11-point rating scale. To assess the criterion validity, the observational rating was correlated...... validity found indicate that the knee movement pattern quality in ACL-injured subjects can be determined by visual observation of more demanding functional tests such as crossover hop on one leg and one-leg hop for distance....
Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars
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...... reconstruction. Forty-nine participated at follow-up in 2010 (82%). Primary outcome was the failure rate after ACL reconstruction. Secondary outcomes were knee injury osteoarthritis outcome score (KOOS) [pain, symptoms, Sport/Rec, quality of life (QOL), daily living function], Tegner activity scale, anterior...... reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included...
Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter
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...... in subjects with anterior cruciate ligament (ACL) deficiency compared to age-matched healthy controls. METHODS: Electromyography (EMG) and net knee joint moments were recorded during maximal concentric quadriceps and eccentric hamstring contractions, performed in an isokinetic dynamometer (ROM: 90......-10°, angular speed: 30°/s). Hamstring antagonist EMG recorded during concentric quadriceps contraction was converted into antagonist moment based on the EMG-moment relationship observed during eccentric agonist contractions. RESULTS: The magnitude of antagonist hamstring EMG was 65.5% higher in ACL deficient...
Ruedl, G; Helle, K; Tecklenburg, K; Schranz, A; Fink, C; Posch, M; Burtscher, M
In recreational alpine skiing, about one third of all injuries affect the knee joint, and the most common diagnosis in adult male and female skiers is a tear of the anterior cruciate ligament (ACL), which makes up 15 - 21 % of all injuries. General preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, it seems unclear to what extent ACL injuries in male and female recreational skiers are related to perceived fatigue. This study was conducted as a prospective questionnaire-based investigation in two Austrian ski injury clinics during the five winter seasons between 2009/2010 and 2013/2014. In total, 588 skiers (67.9 % females) with a mean age of 42.1 ± 10.9 years were interviewed about demographics, skiing ability, skiing behaviour, fitness, day and time of accident, skiing duration and perceived fatigue at the moment of accident. ACL injured males reported a significantly higher skiing ability and fitness level as well as a more risky behaviour on ski slopes compared to females. About one third of males and females injured their ACL within the first day of the ski trip and about 57 % within the first two days, with no sex differences. However, a significantly higher number of female skiers sustained an ACL injury during the first hour of skiing (28 vs. 17 %) as well as during the first two hours of skiing compared to males (52 vs. 44 %). About 81 % of males and females felt no fatigue or just a trace of fatigue in their legs at the time of accident, with no sex differences. Based on the findings of this study, fatigue does not seem to be a major risk factor for an ACL injury among male and female recreational skiers. © Georg Thieme Verlag KG Stuttgart · New York.
Akbari, Asghar; Ghiasi, Fateme; Mir, Mohsen; Hosseinifar, Mohammad
Proprioception and postural stability play an important role in knee movements. However, there are controversies about the overall recovery time of proprioception following knee surgery and onset of balance and neuromuscular training after ACL reconstruction. Therefore, it is necessary to evaluate the effect of balance training in early stage of knee rehabilitation after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of balance exercises on postural stability indices in subjects with anterior cruciate ligament (ACL) reconstruction. The study was a controlled randomized trial study. Twenty four patients who had ACL reconstructed (balance training group) and twenty four healthy adults without any knee injury (control group) were recruited in the study. The balance exercises group performed balance exercises for 2 weeks. Before and after the interventions, overall, anteroposterior, and mediolateral stability indices were measured with a Biodex Balance System in bilateral and unilateral stance positions with the eyes open and closed. T-tests were used for statistical analysis (ptraining and there were not significant differences in static stability indices before and after balance training (p>0.05). Although amount of dynamic stability indices decreased, there were not significant differences in dynamic stability indices before and after balance training (p>0.05). Amount of dynamic stability indices were decreased in balance training group, however, there were not significant differences between groups (p>0.05). These results support that balance exercise could partially improved dynamic stability indices in early stage of ACL reconstruction rehabilitation. The results of this study suggest that balance exercises should be part of the rehabilitation program following ACL reconstruction.
Yahagi, Yoshiyuki; Iriuchishima, Takanori; Horaguchi, Takashi; Suruga, Makoto; Tokuhashi, Yasuaki; Aizawa, Shin
The purpose of this study was to evaluate the difference in the center position of the ACL footprint based on grid placement using the quadrant method according to the morphological variations of the Blumensaat's line. Fifty-nine non-paired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch, and the digital images were evaluated using Image J software. The femoral ACL footprint was periphery outlined and the center position was automatically measured. Following Iriuchishima's classification, the morphology of the Blumensaat's line was classified into straight, small hill, and large hill types. From the images, grid quadrants were placed as: Grid (1) without consideration of hill existence and not including the chondral lesion. Grid (2) without consideration of hill existence and including the chondral lesion. Grid (3) with consideration of hill existence and not including the chondral lesion. Grid (4) with consideration of hill existence and including the chondral lesion. The straight type consisted of 19 knees, the small hill type 13 knees, and the large hill type 27 knees. Depending on the quadrant grid placement, significant center position difference was observed both in the shallow-deep, and high-low direction. When hill existence was considered, the center position of the ACL was significantly changed to a high position. The center position of the ACL footprint exhibited significant differences according to Blumensaat's line morphology. For clinical relevance, when ACL surgery is performed in knees with small or large hill type variations, surgeons should pay close attention to femoral tunnel evaluation and placement, especially when using the quadrant method.
Jakobsen, Erik; Rasmussen, Torben Riis
AIM OF DATABASE: The Danish Lung Cancer Registry (DLCR) was established by the Danish Lung Cancer Group. The primary and first goal of the DLCR was to improve survival and the overall clinical management of Danish lung cancer patients. STUDY POPULATION: All Danish primary lung cancer patients since...... 2000 are included into the registry and the database today contains information on more than 50,000 cases of lung cancer. MAIN VARIABLES: The database contains information on patient characteristics such as age, sex, diagnostic procedures, histology, tumor stage, lung function, performance...... the results are commented for local, regional, and national audits. Indicator results are supported by descriptive reports with details on diagnostics and treatment. CONCLUSION: DLCR has since its creation been used to improve the quality of treatment of lung cancer in Denmark and it is increasingly used...
Eldrup, Nikolaj; Cerqueira, Charlotte; de la Motte, Louise
AIM: The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry...... for quality assessment and research. STUDY POPULATION: All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures...... have been recorded. Since 2001, data completeness has been >90% (compared to the Danish National Patient Register). MAIN VARIABLES: Variables include information on descriptive patient data (ie, age, sex, height, and weight) and comorbidity (ie, previous cardiovascular disease and diabetes). Process...
Lacaze, Paul; Millis, Nicole; Fookes, Megan; Zurynski, Yvonne; Jaffe, Adam; Bellgard, Matthew; Winship, Ingrid; McNeil, John; Bittles, Alan H
When registries collect accurate clinical data over time, they can act as fundamental support structures for patients and their families and powerful cost-effective instruments to support clinical trials and translational research to improve quality of care, quality of life and survival. Registries are critical for rare diseases (RD) with low prevalence and propensity for variation in treatment and outcomes. Rare Voices Australia is leading a call for action to the research and clinical community to prioritise RD data collection and develop an integrated RD Registry strategy for Australia. Financial, operational and governance challenges exist for establishing and maintaining RD registries. As a multidisciplinary team whose interests converge on RD, we highlight the need for the establishment of an Australian RD Registry Alliance. This 'umbrella' organisation will: (i) bring together existing RD registries across Australia; (ii) establish National RD Registry Standards to support interoperability and cohesion across registries; (iii) develop strategies to attract sustainable funding from government and other sources to maximise the utility of existing RD registries and support the development of new RD registries. The most important role for the Alliance would be to use the RD registries for translational research to address current knowledge gaps about RD and to improve the care for the over 1.4 million Australians estimated to live with RD. © 2017 Royal Australasian College of Physicians.
Comins, J D; Krogsgaard, M R; Brodersen, J
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 from...... patients, item relevance and comprehensiveness can only be confirmed by the patient (content validity). Focus group and single interviews were conducted with patients' pre- and post-ACL reconstruction in order to construct a condition-specific PROM for the target patients. One hundred fifty-seven items...
Alkjaer, T; Wieland, MR; Andersen, MS
Context: The forward lunge is widely used among athletes for training and rehabilitation purposes. The forward lunge movement has also been suggested as a model to study functional adaptation to ACL rupture. Previous investigations indicate that the absence of the ACL influences the movement....... 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...
Clinical data registries are platforms to extract, store, analyze, and disseminate large amounts of clinical data. The type of data contained in clinical data registries varies by the registry, and may include patient demographics, clinical examination findings, imaging and laboratory results, procedures performed, and patient-reported outcomes. When large numbers of participants submit data to a clinical data registry the data can then be analyzed in aggregate to answer new clinical questions. Analyses on the data may be performed to show outcomes over time, compare procedures, evaluate care patterns, among others. With the launch of an otolaryngology-specific clinical data registry, Regent, facial plastic and reconstructive surgeons have the opportunity to participate in a clinical data registry for the first time. Through broad participation in the registry, the specialty has a chance to optimize patient outcomes in a manner never before possible. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Bouvy, Jacoline C; Blake, Kevin; Slattery, Jim
in the post-marketing setting. Methodological challenges met in conducting this study highlighted the need for a clarification of definitions and epidemiological concepts around patient registries. The results will inform the EMA Patient Registry initiative to support use of existing patient registries......PURPOSE: Regulatory agencies and other stakeholders increasingly rely on data collected through registries to support their decision-making. Data from registries are a cornerstone of post-marketing surveillance for monitoring the use of medicines in clinical practice. This study was aimed...... for a registry was made as a condition of the marketing authorisation. All centrally authorised products that received a positive opinion of the EMA Committee for Medicinal Products for Human Use between 1 January 2005 and 31 December 2013 were included. Data regarding registry design and experiences were...
Dräger, J; Petzold, S; Ristau, H; Trepte, S
Quality saving measures are required at the execution of extracorporeal LDL apheresis therapy (LDL apheresis) by the NUB guidelines of the national committee of physicians and health insurance. The saving measures apply to specialist, organizational and apparatical conditions for execution and accounting of treatment methods. Furthermore, as a result of the lawful requirements of SGB V, complementary BUB guidelines were introduced in 1999. These ought to engage the therapeutic benefit of a LDL apheresis treatment. Beyond measures for quality assurance at execution a documentation of treatment is explicitly demanded. For two years now the non-profit Quasa gGmbH has been developed the quality assurance registry for LDL apheresis with the background of those requirements. Since March 2003 the apheresis physicians can voluntarily take part in the registry initiative by internet. Beside the clinical patient's medical history, treatment relevant data are recorded. Because of the analysis of the nationally ascertained clinical data, for the first time it will be possible for the medical profession to fulfill the guidelines of quality assurance for LDL apheresis. Moreover the treating apheresis physicians can establish an EDV-based individual patient documentation. All necessary measures of data protection and data security are in process on the technical and logistic realization of this registry initiative. An epidemiological data evaluation is regularly accomplished and the results are provided to the public.
Ghebes, C.A.; Kelder, C.; Schot, T.; Renard, A.J.S.; Pakvis, D.F.M.; Fernandes, H.; Saris, Daniël B.F.
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
Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.
This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.
O'Reilly, Gerard M; Cameron, Peter A; Joshipura, Manjul
The burden of injury is very high in developing countries. Trauma systems reduce mortality; the trauma registry is a key driver of improvements in trauma care. Developing countries have begun to develop trauma systems but the level of local trauma registry activity is unclear. The aim of this study was to determine a global estimate of trauma registry activity. A structured review of the literature was performed. All abstracts referring to a trauma registry over a two-year period were included. For the trauma registry described in each abstract, the source country was recorded. An additional search of web pages posted over a one year period was conducted. Those linked to an active trauma registry website were included and the country of the trauma registry was recorded. A selection of trauma registries from countries of different levels of development were identified and compared. 571 abstracts were included in the review. Most articles utilised "general" trauma registries (436(76%)) and were based at a single hospital (279(49%)). Other registries were limited to military or paediatric populations (36(6%) and 35(6%) articles respectively). Most articles sourced registries from the US (288(50%)), followed by Australia (45(8%)), Germany (32(6%)), Canada (27(5%)), UK (13(2%)), China (13(2%)) and Israel (12(2%)). The Americas produced most trauma registry articles and South East Asia the least. The majority of trauma registry articles originated from very highly developed countries 467(82%). Least developed countries had the fewest (5(1%)). The additional search yielded 37 web pages linked to 27 different trauma registry websites. Most of these were based in the US (16(59%)). The basic features of trauma registries, such as inclusion criteria, number and type of variables and injury severity scoring, varied widely depending on the country's level of development. This review, using a combination of the number of trauma registry articles and web pages to locate active
Welling, Wouter; Benjaminse, Anne; Gokeler, Alli; Otten, Bert
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
Benjaminse, Anne; Welling, Wouter; Otten, Egbert; Gokeler, Alli
Anterior cruciate ligament (ACL) injury prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of
Anne Benjaminse; Bert Otten; A. Gokeler; Wouter Welling
Anterior cruciate ligament (ACL) injury prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of
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)
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.)
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
Spahn, G; Schiltenwolf, M; Hartmann, B; Grifka, J; Hofmann, G O; Klemm, H-T
The aim of this review was to evaluate the time-related risk for knee osteoarthritis in patients after ACL injury. The primary search was carried out in different medical databases with the deadline 12.01.2014. The search strategy for the evaluation was [ACL] AND [osteoarthritis] including "all fields". All 1656 title/abstracts were reviewed by two independent researchers who selected 140 papers for full text review. Finally, a total of 21 relevant publications were identified for inclusion in this current paper. The incidence of knee osteoarthritis rises significantly over time. Two years after injury it was 6.9%, after 5 years 32.2%, after 7 years 36.3%, and after 10 years 79.6%. At the same time, the crude relative risk of OA rises as the time interval since injury increases. The relative risk of OA has already doubled by 2 years after ACL injury). By 7 years it has increased fivefold and compared with OA status at the time of injury it is still increasing significantly after 10 years. The ACL injury is a significant risk factor for the development of early-onset secondary knee osteoarthritis. Within 5 years of the injury the knee shows clear signs of osteoarthritis on MRI. However, these lesions are often not associated with any clinical signs. Knee osteoarthritis as a severe disease starts 8 years or later after the injury, when it requires treatment.
Alkjaer, Tine; Henriksen, Marius; Dyhre-Poulsen, Poul
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...
Hofbauer, Marcus; Muller, Bart; Murawski, Christopher D.; Baraga, Michael; van Eck, Carola Franziska; Fu, Freddie H.
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
Petersen, Wolf; Forkel, Philipp; Achtnich, Andrea; Metzlaff, Sebastian; Zantop, Thore
The purpose of this article was to demonstrate an anterior cruciate ligament (ACL) reconstruction technique using oval tunnels. Aim of this single bundle technique is to fit the footprint anatomy of the ACL as closely as possible. TECHNIQUE AND PATIENTS: The presented technique is a single bundle technique using a semitendinosus graft. For femoral tunnel placement, a specific medial portal aimer (Karl Storz, Tuttlingen, Germany) is used. Aiming and drilling of the femoral tunnel are performed via the medial portal. Oval tunnels are created by stepwise dilatation with ovally shaped dilatators. The position of the femoral tunnel is visualized and controlled with the arthroscope via the medial portal. For the tibial tunnel placement, a specific aimer was used as well. With this technique, 24 patients were operated and all intra- and postoperative complications were analyzed prospectively. The tunnel position was documented postoperatively by CT scan. There were no significant intra- and postoperative complications associated with the oval tunnel technique. The postoperative 3D CT scan revealed that all femoral and tibial tunnels were located within the area of the anatomical ACL insertions. This article presents an ACL reconstruction technique using oval dilatators and medial portal aimers to create oval tunnels. These oval tunnels match the insertion site anatomy much closer than round tunnels do. Level IV, case series.
Aalbersberg, S.; Kingma, I.; van Dieen, J.H.
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
Norman, Daniel G; Getgood, Alan; Thornby, John; Bird, Jonathan; Turley, Glen A; Spalding, Tim; Williams, Mark A
The femoral footprint of the anterior cruciate ligament (ACL) is a much-studied anatomic structure, predominantly due to its importance during ACL reconstruction surgery. A new technique utilising high-resolution micro-computed tomography (micro-CT) is described, allowing detailed three-dimensional (3D) quantitative analysis of this structure. Seven cadaveric knees were scanned using micro-CT, yielding 3D data with a reconstructed voxel size of 60 μm. A novel method of 3D surface extraction was developed and validated, facilitating both qualitative observation of surface details and quantitative topographic assessment using colour-coded relief maps. Images were displayed on an immersive 3D visualisation wall, and ten experienced ACL clinicians were surveyed as to the presence and morphology of osseous landmarks, providing qualitative assessment of whether such features can be reliably identified for navigation during surgery. Both quantitative analysis and qualitative assessment of the footprints in this study showed significant variability in the presence and morphology of osseous landmarks, with the lateral intercondylar ridge being objectively present in four out of seven relief maps, although reportedly seen in six out of seven cases in the qualitative study, suggesting an element of subjectivity and interpretation. This is the first study to utilise micro-CT in the study of ACL anatomy.
Lama, Norsang; Umbaugh, Scott E.; Mishra, Deependra; Dahal, Rohini; Marino, Dominic J.; Sackman, Joseph
Anterior cruciate ligament (ACL) rupture in canines is a common orthopedic injury in veterinary medicine. Veterinarians use both imaging and non-imaging methods to diagnose the disease. Common imaging methods such as radiography, computed tomography (CT scan) and magnetic resonance imaging (MRI) have some disadvantages: expensive setup, high dose of radiation, and time-consuming. In this paper, we present an alternative diagnostic method based on feature extraction and pattern classification (FEPC) to diagnose abnormal patterns in ACL thermograms. The proposed method was experimented with a total of 30 thermograms for each camera view (anterior, lateral and posterior) including 14 disease and 16 non-disease cases provided from Long Island Veterinary Specialists. The normal and abnormal patterns in thermograms are analyzed in two steps: feature extraction and pattern classification. Texture features based on gray level co-occurrence matrices (GLCM), histogram features and spectral features are extracted from the color normalized thermograms and the computed feature vectors are applied to Nearest Neighbor (NN) classifier, K-Nearest Neighbor (KNN) classifier and Support Vector Machine (SVM) classifier with leave-one-out validation method. The algorithm gives the best classification success rate of 86.67% with a sensitivity of 85.71% and a specificity of 87.5% in ACL rupture detection using NN classifier for the lateral view and Norm-RGB-Lum color normalization method. Our results show that the proposed method has the potential to detect ACL rupture in canines.
Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.
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
Mohtadi, Nicholas; Barber, Rhamona; Chan, Denise; Paolucci, Elizabeth Oddone
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
LaPrade, Robert F; Venderley, Melanie B; Dahl, Kimi D; Dornan, Grant J; Turnbull, Travis Lee
A need exists for a functional anterior cruciate ligament (ACL) brace that dynamically supports the knee joint to match the angle-dependent forces of a native ACL, especially in the early postoperative period. The purpose of this study was to quantify the posteriorly directed external forces applied to the anterior proximal tibia by both a static and a dynamic force ACL brace. The proximal strap forces applied by the static force brace were hypothesized to remain relatively constant regardless of knee flexion angle compared with those of the dynamic force brace. Controlled laboratory study. Seven healthy adult males (mean age, 27.4 ± 3.4 years; mean height, 1.8 ± 0.1 m; mean body mass, 84.1 ± 11.3 kg) were fitted with both a static and a dynamic force ACL brace. Participants completed 3 functional activities: unloaded extension, sit-to-stand, and stair ascent. Kinematic data were collected using traditional motion-capture techniques while posteriorly directed forces applied to the anterior aspect of both the proximal and distal tibia were simultaneously collected using a customized pressure-mapping technique. The mean posteriorly directed forces applied to the proximal tibia at 30° of flexion by the dynamic force brace during unloaded extension (80.2 N), sit-to-stand (57.5 N), and stair ascent (56.3 N) activities were significantly larger, regardless of force setting, than those applied by the static force brace (10.1 N, 9.5 N, and 11.9 N, respectively; P brace, compared with the static force brace, applied significantly larger posteriorly directed forces to the anterior proximal tibia in extension, where the ACL is known to experience larger in vivo forces. Further studies are required to determine whether the physiological behavior of the brace will reduce anterior knee laxity and improve long-term patient outcomes. ACL braces that dynamically restrain the proximal tibia in a manner similar to physiological ACL function may improve pre- and postoperative
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.
Leppänen, Mari; Pasanen, Kati; Kujala, Urho M; Vasankari, Tommi; Kannus, Pekka; Äyrämö, Sami; Krosshaug, Tron; Bahr, Roald; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari
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.
Schjødt, Inge; Nakano, Anne; Egstrup, Kenneth
AIM OF DATABASE: The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. STUDY POPULATION: The DHFR includes inpatients and outpatients (≥18 years) with incident HF. Reporting to the DHFR is mandatory......: The main variables recorded in the DHFR are related to the indicators for quality of care in patients with incident HF: performance of echocardiography, functional capacity (New York Heart Association functional classification), pharmacological therapy (angiotensin converting enzyme/angiotensin II...
Andersen, Torben M.
countries been able to reconcile social objectives with a high employment level? It is argued that the Scandinavian welfare model has a strong employment focus both because it is an important element in social policy based on social inclusion, but also because a collective welfare arrangement is only...... financially viable if (private) employment is sufficiently high. To ensure this, the social safety net includes a number of employment conditionalities (active labour market policies/workfare) to balance income protection with an employment focus. These policies are discussed using Denmark as an example...
Ramanathan, Ramshanker; Gram, Jørgen; Feddersen, Søren
BACKGROUND: Dysfibrinogenemia is a rare group of qualitative fibrinogen disorders caused by structural abnormalities in the fibrinogen molecule. The laboratory diagnosis of dysfibrinogenemia is controversial. Fibrinogen Paris V, clinically termed Dusart Syndrome, is a dysfibrinogenemia caused...... by a single base substitution in the gene coding for the Aα-chain of the fibrinogen molecule. OBJECTIVES: To diagnose the first Scandinavian family with Fibrinogen Paris V affecting several family members; the proband, a seven-year-old boy with cerebral vein thrombosis. METHODS: The diagnosis was established...... by significantly reduced fibrin polymerization (p p p p
Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban
The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met. PMID:26955224
Aabo, Tom; Pantzalis, Christos; Sørensen, Helle
External sourcing from foreign suppliers is an important aspect of the firm’s internationalization. However, data on such sourcing is available from neither databases nor annual reports. Thus, the corporate risk implications of such sourcing have not been studied previously. We obtain the necessary...... data by surveying Scandinavian non-financial firms. We find that highly international firms reduce corporate risk by externally sourcing from foreign suppliers both compared to sourcing from own production facilities abroad (due to superior flexibility) and compared to domestic sourcing (due...
Castrén, M; Silfvast, T; Rubertsson, S
studies MTH has been proven to be safe, with few complications and improved survival, and is recommended by the International Liaison of Committee on Resuscitation. The aim of this paper is to recommend clinical practice guidelines for MTH treatment after cardiac arrest from the Scandinavian Society...... fibrillation (GOR A), the SSAITFTH also recommend MTH after restored spontaneous circulation, if active treatment is chosen, in patients with initial pulseless electrical activity and asystole (GOR D). Normal ethical considerations, premorbid status, total anoxia time and general condition should decide...
Full Text Available This special five-volume edition is both Nordlyd number 31 and the Proceedings for the Nineteenth Scandinavian Conference of Linguistics. Here I provide a little background for the conference and the Proceedings. SCL 19 was held in Tromsø on January 10–12, 2002, under the auspices of the Nordic Association of Linguists (NAL and with support from the Nordic Academy for Advanced Study (NorFA, the University of Tromsø, the Faculty of Humanities, and the English Department at the University of Tromsø. The Center for Advanced Study in Theoretical Linguistics (CASTL also contributed to the production of this Proceedings.
Marcacci, Maurilio; Bonanzinga, Tommaso; Grassi, Alberto; Musiani, Costanza; Benzi, Andrea; Marcheggiani Muccioli, Giulio Maria; Vaccari, Vittorio; Zaffagnini, Stefano
A deficiency of posterolateral structures significantly increases the varus load on the ACL, while a chronic ACL lesion, the increased tibial rotation and the repetitive non-physiological knee motion, could affect and damage the integrity of the popliteus tendon. Therefore, the aim of the present study was to report the very long clinical outcomes of a combined single-bundle BPTB ACL reconstruction and popliteus plasty according to Bousquets technique, for the treatment of combined chronic anterior and posterolateral laxities. Fifteen patients that underwent combined ACL reconstruction and popliteal plasty according to Bousquets technique were available at mean 26.8 ± 1.0 years (range 25.4-28.0 years). All the patients were evaluated clinically and 13 by means of KT-1000 Arthrometer as well. Subjective evaluation was performed with the subjective IKDC, WOMAC and a 0-10 VAS for pain scales. At clinical evaluation, 10 patients (67 %) presented a negative anterior drawer test; Lachman test was negative in nine patients (60 %); the varus stress test was negative in eight (53 %); and the dial test was negative in all but one patient (93 %). Only two patients (15 %) presented a side-to-side difference >5 mm at the instrumented laxity evaluation. The combined single-bundle BPTB ACL reconstruction and popliteal plasty according to Bousquets technique were able to produce very good long-term results, in terms of knee stability, subjective outcomes, functional results and return to sport activity, in case of chronic anterior and posterolateral laxities. Retrospective case series, Level IV.
Moon, Dong-Kyu; Jo, Ho-Seung; Lee, Dong-Yeong; Kang, Dong-Geun; Byun, June-Ho; Hwang, Sun-Chul
The purpose of this study was to evaluate the effect of femoral tunnel orientation, drilled through the accessory anteromedial (AAM) portal or the high AM portal in anatomic anterior cruciate ligament (ACL) reconstruction. In 16 cadaver knees, using o'clock method, centers of the ACL femoral footprint were drilled with an 8-mm reamer via an AAM portal (eight knees) or a high AM portal (eight knees). Computed tomography (CT) scans were taken of each knee. Three-dimensional (3D) models were constructed to identify the femoral tunnel orientation and to create femoral tunnel virtual cylinders for measuring tunnel angles and length. In two of the 16 specimens, we observed a posterior femoral cortex blowout (PFCB) when drilling through a high AM portal. When drilled through the high AM portal, the femoral tunnel length was significantly shorter than when using an AAM portal (30.3 ± 3.8 mm and 38.2 ± 3.1 mm, p portal was significantly higher than that of the AAM portal (52.2 ± 5.9° and 43.0 ± 2.3°, p = 0.003). 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. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.
Li, Ling; Shi, Zhen-Ying; Li, Lin; Shen, Ge-Zhi; Wang, Xin-Qi; An, Lin-Sheng; Zhang, Jing-Liu
Understanding the genetic mechanism underlying rice leaf-shape development is crucial for optimizing rice configuration and achieving high yields; however, little is known about leaf abaxial curling. We isolated a rice transferred DNA (T-DNA) insertion mutant, BY240, which exhibited an abaxial leaf curling phenotype that co-segregated with the inserted T-DNA. The T-DNA was inserted in the promoter of a novel gene, ACL1 (Abaxially Curled Leaf 1), and led to overexpression of this gene in BY240. Overexpression of ACL1 in wild-type rice also resulted in abaxial leaf curling. ACL1 encodes a protein of 116 amino acids with no known conserved functional domains. Overexpression of ACL2, the only homolog of ACL1 in rice, also induced abaxial leaf curling. RT-PCR analysis revealed high expressions of ACLs in leaf sheaths and leaf blades, suggesting a role for these genes in leaf development. In situ hybridization revealed non-tissue-specific expression of the ACLs in the shoot apical meristem, leaf primordium, and young leaf. Histological analysis showed increased number and exaggeration of bulliform cells and expansion of epidermal cells in the leaves of BY240, which caused developmental discoordination of the abaxial and adaxial sides, resulting in abaxially curled leaves. These results revealed an important mechanism in rice leaf development and provided the genetic basis for agricultural improvement.
Eldrup, Nikolaj; Cerqueira, Charlotte; de la Motte, Louise; Rathenborg, Lisbet Knudsen; Hansen, Allan K
Aim The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry for quality assessment and research. Study population All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures have been recorded. Since 2001, data completeness has been >90% (compared to the Danish National Patient Register). Main variables Variables include information on descriptive patient data (ie, age, sex, height, and weight) and comorbidity (ie, previous cardiovascular disease and diabetes). Process variable includes waiting time (time from event to medical contact and treatment) and the type of procedures conducted. Outcome variables for in-hospital complications (ie, wound complications, myocardial infarction, stroke, amputation, respiratory complications, and renal insufficiency) and 30-day patency are submitted. Variables for medical treatment (antithrombotic and statin treatment), amputation, and survival are extracted from nationwide, administrative registers. Conclusion The DVR reports outcome on key indicators for monitoring the quality at all vascular departments in Denmark for the purpose of quality improvement. Furthermore, data are available for research and are being used in international collaborations on changes in clinical practices. PMID:27822118
Renström, Per A
Over two million anterior cruciate ligament (ACL) injuries occur worldwide annually, and the greater prevalence for ACL injury in young female athletes is one of the major problems in sports medicine. Optimal treatment of ACL injury requires individualised management. Patient selection is of utmost importance, and so is respect for the patient's functional demands and interests. All patients with an ACL tear may not need surgery, however athletes and persons with an active lifestyle with high knee functional demands including cutting motions need and should be offered surgery. In many cases it may not be the choice of graft or technique that is the key for success, but the choice of surgeon. The surgeon should be experienced and use a reconstructive procedure he/she knows very well and is comfortable with. The development of osteoarthritis after an ACL injury depends very much on the injury mechanism and concurrent meniscal injury, as knee articular cartilage continues to heal for 1-2 years after an ACL injury. Therefore the surgeon and rehabilitation team must pay attention to the rehabilitation process and to the decision when to return to sport. Return to sport must be carefully considered, as top-level sport in itself is one main risk factor for osteoarthritis after ACL injury. The present criteria for return to sport need to be revisited, also due to the fact that recurrent injury seems to be an increasing problem. ACL injury prevention programmes are now available in some sports. The key issue for a prevention programme to be successful is proper implementation. Vital factors for success include the individual coaching of the player and well controlled compliance with the training programme. Preventive activities should be more actively supported by the involved athletic community. Despite substantial advances in the field of ACL injury over the past 40 years, substantial management challenges remain.
Ghebes, Corina Adriana; Kelder, Cindy; Schot, Thomas; Renard, Auke J; Pakvis, Dean F M; Fernandes, Hugo; Saris, Daniel B
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 these differences represents a step forward in the search for new cues that enhance recovery after the reconstruction. The purpose of this study was to characterize the phenotype and multilineage potential of ACL- and HT-derived cells. ACL- and HT-derived cells were isolated from tissue harvest from patients undergoing total knee arthroplasty (TKA) or ACL reconstruction. In total, three ACL and three HT donors were investigated. Cell morphology, self-renewal potential (CFU-F), surface marker profiling, expression of tendon/ligament-related markers (PCR) and multilineage potential were analysed for both cell types; both had fibroblast-like morphology and low self-renewal potential. No differences in the expression of tendon/ligament-related genes or a selected set of surface markers were observed between the two cell types. However, differences in their multilineage potential were observed: while ACL-derived cells showed a high potential to differentiate into chondrocytes and adipocytes, but not osteoblasts, HT-derived cells showed poor potential to form adipocytes, chondrocytes and osteoblasts. Our results demonstrated that HT-derived cells have low multilineage potential compared to ACL-derived cells, further highlighting the need for extrinsic signals to fully restore the function of the ACL upon reconstruction. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Matthiessen, Christian Wichmann; Knowles, Richard D.
The European Round Table of Industrialists identified in the 1980ies 14 missing links in the transportation network of the continent. Three of them were found around the Danish island of Zealand. One link is within the nation, the other two are between nations. One link connects heavy economic....... They concentrate traffic flows and create strong transport corridors. They are the basis of new regional development regimes. “Ferries connect systems, fixed links unite systems”....
Fu Freddie H
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.
Büntgen, Ulf; Raible, Christoph C.; Frank, David; Helama, Samuli; Cunningham, Laura; Hofer, Dominik; Nievergelt, Daniel; Verstege, Anne; Timonen, Mauri; Stenseth, Nils Chr.; Esper, Jan
Tree rings dominate millennium-long temperature reconstructions and many records originate from Scandinavia, an area for which the relative roles of external forcing and internal variation on climatic changes are, however, not yet fully understood. Here we compile 1,179 series of maximum latewood density measurements from 25 conifer sites in northern Scandinavia, establish a suite of 36 subset chronologies, and analyse their climate signal. A new reconstruction for the 1483–2006 period correlates at 0.80 with June–August temperatures back to 1860. Summer cooling during the early 17th century and peak warming in the 1930s translate into a decadal amplitude of 2.9°C, which agrees with existing Scandinavian tree-ring proxies. Climate model simulations reveal similar amounts of mid to low frequency variability, suggesting that internal ocean-atmosphere feedbacks likely influenced Scandinavian temperatures more than external forcing. Projected 21st century warming under the SRES A2 scenario would, however, exceed the reconstructed temperature envelope of the past 1,500 years. PMID:21966436
Rueness, E K; Jorde, P E; Hellborg, L; Stenseth, N C; Ellegren, H; Jakobsen, K S
The Eurasian lynx (Lynx lynx) is an example of a species that has gone through a severe bottleneck, leading to near extinction in Scandinavia around 1930-- a pattern shared with several other large carnivorous mammals. Here we extend previous genetic analyses of northern European lynx, confirming that lynx from the Scandinavian Peninsula represent a distinct clade differing clearly from European conspecifics. Furthermore, and despite a recent bottleneck and subsequent range expansion, we detect marked genetic differentiation within Scandinavia. This differentiation is largely manifested as a north-south gradient, with a linear increase in the quantity FST/(1 - FST). Aided by computer simulations we find that this pattern is unlikely to have arisen by random genetic drift in the short time since lynx started to expand in the 1950s, suggesting that the spatial structure may predate the bottleneck. Individual-based analyses indicate that, instead of a continuous gradient, Scandinavian lynx may be structured into three more or less distinct groups, possibly corresponding to northern, central and southern subpopulations. The presence of such structuring was unknown previously and was unexpected from general considerations on the mobility of the species, historical data and the absence of geographical barriers. Our study demonstrates how molecular markers may be used to detect cryptic population structure, invisible using traditional methods.
Benjamin T. Jones
Full Text Available This study presents the first gaseous formic acid (HC(OOH concentration measurements collected over the Fenno-Scandinavian wetlands (67.9–68.0° N, 22.1–27.8° E as part of the MAMM (Methane and other greenhouse gases in the Arctic-Measurements, process studies and Modelling aircraft campaigns conducted in August and September 2013. A boundary layer box model approach has been used to calculate a regionally representative (~240 km2 surface flux for HC(OOH of 0.0098 (±0.0057 mg[HCOOH]·m−2·h−1. A surface-type classification map was used to estimate proportional source contributions to the observed HC(OOH flux over the measurement region. The removal of expected source contributions (using available literature parameterisations from the calculated surface flux identified that 75% remained unaccounted for. This may suggest that HC(OOH emission from wetland within the Fenno-Scandinavian region could contribute up to 29 times higher per unit area than previous theoretical HC(OOH globally-averaged wetland estimates, highlighting a need for further constrained wetland studies of HC(OOH emission to better understand its potentially significant impact on the Arctic HC(OOH budget and consequent impacts on oxidative capacity.
Julian D. Richards
Full Text Available The presence of Anglian and Anglo-Scandinavian settlements at Cottam, East Yorkshire, was first indicated in 1987 by numerous finds of copper alloy coins, dress pins and strap ends by metal detector users. This report presents the results of fieldwork carried out on behalf of the Department of Archaeology, University of York, between 1993-5, including field walking, geophysical survey, and excavation. This revealed an enclosure of the eighth-ninth centuries, containing traces of a small number of post-built halls. In the late ninth century this settlement was then abandoned, a process which led to the incorporation of a human female skull in a domestic rubbish pit. A new enclosed settlement was laid out nearby, which was occupied briefly in the early tenth century. It is argued that the Anglian settlement may have been part of a royal multiple estate but that as a result of estate reorganisation after the Scandinavian settlement it developed into an independent manor. Cottam is the first so-called "productive site" in the environs of York to be the subject of archaeological investigations. The results suggest that it was a prosperous but not exceptional site, and that the primary activity was farming, with limited evidence for trade or manufacture. This work also prompts a reassessment of the typology of crop mark enclosures and the re-examination of the large number of undated enclosures in the area.
Thoresen, Stein I; Arnemo, Jon M; Liberg, Olof
Scandinavian free-ranging wolves (Canis lupus) are endangered, such that laboratory data to assess their health status is increasingly important. Although wolves have been studied for decades, most biological information comes from captive animals. The objective of the present study was to establish reference intervals for 30 clinical chemical and 8 hematologic analytes in Scandinavian free-ranging wolves. All wolves were tracked and chemically immobilized from a helicopter before examination and blood sampling in the winter of 7 consecutive years (1998-2004). Seventy-nine blood samples were collected from 57 gray wolves, including 24 juveniles (24 samples), 17 adult females (25 samples), and 16 adult males (30 samples). Whole blood and serum samples were stored at refrigeration temperature for 1-3 days before hematologic analyses and for 1-5 days before serum biochemical analyses. Reference intervals were calculated as 95% confidence intervals except for juveniles where the minimum and maximum values were used. Significant differences were observed between adult and juvenile wolves for RBC parameters, alkaline phosphatase and amylase activities, and total protein, albumin, gamma-globulins, cholesterol, creatinine, calcium, chloride, magnesium, phosphate, and sodium concentrations. Compared with published reference values for captive wolves, reference intervals for free-ranging wolves reflected exercise activity associated with capture (higher creatine kinase activity, higher glucose concentration), and differences in nutritional status (higher urea concentration).
Full Text Available For decades, Scandinavian culture effectively prohibited the development of special provisions for talented students in higher education. However, in recent years, a cultural shift has gradually made more room for excellence and talent development in the national discourses. This paper analyzes the climate for talent development in Denmark, Sweden, and Norway. Following a first inventory of honors programs in Scandinavian higher education in which the only programs were found in Denmark, 10 experts were interviewed to analyze their national situation and reflect on the leading role of Denmark. In this country, external incentives, focus on quality, pioneers, and an open atmosphere were found to produce a culture more appreciative of excellence over the last decade. Starting from the Danish experience, the situation in Norway and Sweden is analyzed, showing that the combination of factors leading to change in Denmark is not yet present here. Lessons for other countries are highlighted, notably the importance of sharing information and exchanging knowledge at an international level.
Veldore, Vidyunmala; Luna, Byron Quan
Response of extra-tropical storms to climate change over the Scandinavian coast in high resolution regional climate projection is investigated in the current study. The complex interactions between North Atlantic oscillation, arctic amplification, ocean-atmospheric interactions and changing nature of synoptic waves will affect the generation and extremity of storm types. The nature of these storms is dependent on large-scale systems over this region, and hence higher resolution climate models might be able to represent the structure and intensity of the storms with accuracy. We propose a tracking algorithm for two seasons autumn (September-October-November) and winter season (December-January-February) providing features to detect the frequency and intensity of storm types for a given coast. Our objective is to understand the impact of changing nature of extreme storm types over the Scandinavian coast. Using a spatial assessment, possible impacts due to future storms in RCP8.5 scenario are assessed and hazard levels are represented.
Onipko Tetiana A.
Full Text Available The article generalizes and analyzes the developments by the Scandinavian School of cluster theory (scientists from Sweden, Norway and Denmark on innovative clusters. It has been found that the Scandinavian scientists considered innovative clusters as an integral component of both the regional and the national innovation systems. It has been clarified that the efficiency of an innovative cluster depends largely on the «knowledge base». It was emphasized that innovative clusters, by facilitating interactive training and generating new ideas, stimulate the development of the «economy of training». It has been determined that the coordinating structures of innovative clusters are the institutions of cooperation that facilitate interaction between enterprises, scientific centres, and authorities. It has been specified that innovative clusters contribute to the emerging of benefits for participants, including the growing opportunities for innovation, improved conditions for establishing a business, and increased productivity. It has been concluded that the development of the inner environment of an innovative cluster depends largely on its relationships to the external environment.
Malmström, Helena; Gilbert, M Thomas P; Thomas, Mark G; Brandström, Mikael; Storå, Jan; Molnar, Petra; Andersen, Pernille K; Bendixen, Christian; Holmlund, Gunilla; Götherström, Anders; Willerslev, Eske
The driving force behind the transition from a foraging to a farming lifestyle in prehistoric Europe (Neolithization) has been debated for more than a century [1-3]. Of particular interest is whether population replacement or cultural exchange was responsible [3-5]. Scandinavia holds a unique place in this debate, for it maintained one of the last major hunter-gatherer complexes in Neolithic Europe, the Pitted Ware culture . Intriguingly, these late hunter-gatherers existed in parallel to early farmers for more than a millennium before they vanished some 4,000 years ago [7, 8]. The prolonged coexistence of the two cultures in Scandinavia has been cited as an argument against population replacement between the Mesolithic and the present [7, 8]. Through analysis of DNA extracted from ancient Scandinavian human remains, we show that people of the Pitted Ware culture were not the direct ancestors of modern Scandinavians (including the Saami people of northern Scandinavia) but are more closely related to contemporary populations of the eastern Baltic region. Our findings support hypotheses arising from archaeological analyses that propose a Neolithic or post-Neolithic population replacement in Scandinavia . Furthermore, our data are consistent with the view that the eastern Baltic represents a genetic refugia for some of the European hunter-gatherer populations.
Ottsen, Christina Lundsgaard; Berntsen, Dorthe
Mental time travel is the ability to remember past events and imagine future events. Here, 124 Middle Easterners and 128 Scandinavians generated important past and future events. These different societies present a unique opportunity to examine effects of culture. Findings indicate stronger influence of normative schemas and greater use of mental time travel to teach, inform and direct behaviour in the Middle East compared with Scandinavia. The Middle Easterners generated more events that corresponded to their cultural life script and that contained religious words, whereas the Scandinavians reported events with a more positive mood impact. Effects of gender were mainly found in the Middle East. Main effects of time orientation largely replicated recent findings showing that simulation of future and past events are not necessarily parallel processes. In accordance with the notion that future simulations rely on schema-based construction, important future events showed a higher overlap with life script events than past events in both cultures. In general, cross-cultural discrepancies were larger in future compared with past events. Notably, the high focus in the Middle East on sharing future events to give cultural guidance is consistent with the increased adherence to normative scripts found in this culture. Copyright © 2015 Elsevier Inc. All rights reserved.
Cowan Anne E
Full Text Available Abstract Background Population-based registries have been promoted as an effective method to improve childhood immunization rates, yet rates of registry participation in the private sector are low. We sought to describe, through a national overview, the perspectives of childhood immunization providers in private practice regarding factors associated with participation or non-participation in immunization registries. Methods Two mailed surveys, one for 264 private practices identified as registry non-participants and the other for 971 identified as registry participants, from 15 of the 31 states with population-based statewide immunization registries. Frequency distributions were calculated separately for non-participants and participants regarding the physician-reported factors that influenced decisions related to registry participation. Pearson chi-square tests of independence were used to assess associations among categorical variables. Results Overall response rate was 62% (N = 756. Among non-participants, easy access to records of vaccines provided at other sites (N = 101, 68% and printable immunization records (N = 82, 55% were most often cited as "very important" potential benefits of a registry, while the most commonly cited barriers to participation were too much cost/staff time (N = 36, 38% and that the practice has its own system for recording and monitoring immunizations (N = 35, 37%. Among registry participants, most reported using the registry to input data on vaccines administered (N = 326, 87% and to review immunization records of individual patients (N = 302, 81%. A minority reported using it to assess their practice's immunization coverage (N = 110, 29% or generate reminder/recall notices (N = 54, 14%. Few participants reported experiencing "significant" problems with the registry; the most often cited was cost/staff time to use the registry (N = 71, 20%. Conclusion Most registry participants report active participation with few
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
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 rehabilitation consisting of progressive strengthening and neuromuscular training, followed by a criterion-based postoperative rehabilitation program, had greater functional
Full Text Available Payam Dehghani,1 Varun Chopra,1 Ali Bell,2 Sheila Kelly,1 Lori Zulyniak,2 Jeff Booker,1 Rodney Zimmermann,1 William Semchuk,2 Asim N Cheema,3 Andrea J Lavoie1 1Prairie Vascular Research Network, University of Saskatchewan, Regina, SK, 2Regina Qu’Appelle Health Region, Regina, SK, 3St Michael’s Hospital, University of Toronto, Toronto, ON, Canada Background: As ticagrelor enters into clinical use for acute coronary syndrome, it is important to understand patient/physician behavior in terms of appropriate use, adherence, and event rates. Methods: The Saskatchewan Registry is a prospective, observational, multicenter cohort study that identifies consecutive patients started on ticagrelor. We aimed to evaluate both on- and off-label use, identify characteristics of patients who prematurely stop ticagrelor, and describe patient/physician behavior contributing to inappropriate stoppage of this medication. Results: From April 2012 to September 2013, 227 patients were initiated on ticagrelor, with a mean age of 62.2±12.1 years. The participants were 66% men and had a mean follow up of 157.4±111.7 days. Seventy-four patients (32.4% had off-label indications. Forty-seven patients (20.7% prematurely stopped ticagrelor and were more likely to be older, women, nonwhite, present with shock, and complain of dyspnea. Twenty-six of the 47 patients stopped ticagrelor inappropriately because of patient nonadherence (18 patients and physician advice (eight patients. A composite outcome event of death from vascular causes, myocardial infarction, or stroke occurred in 8.8% of the entire cohort and was more likely to occur in those older then 65 years, those presenting with cardiogenic shock, and those who prematurely stopped ticagrelor. Conclusion: In this real-world registry of patients started on ticagrelor, a third have off-label indications and a fifth prematurely stop the medication. Premature discontinuation was an independent predictor of major
Ferreira Pires, Luis; Wang, J.; van Oostrum, Arjen; Wijnhoven, Alphonsus B.J.M.
A service registry is a Service-Oriented Architecture (SOA) component that keeps a ‘catalogue’ of available services. It stores service specifications so that these specifications can be found by potential users. Discussions on the design of service registries currently focus on technical issues,
da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth
AIM: In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate...
... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Registry process. 600.1410 Section 600.1410 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... United States § 600.1410 Registry process. (a) A person may register through the NMFS web site at www...
... be shown where required on labels and markings of containers or cases filled at the wine premises... OF THE TREASURY LIQUORS WINE Establishment and Operations Application § 24.115 Registry number. Upon..., bonded wine cellar, or taxpaid wine bottling house. The registry number will be used in all...
Jørgensen, Marit Eika; Kristensen, Jette K.; Husted, Gitte Reventlov
Aim of the database: The aim of the Danish Adult Diabetes Registry (DADR) is to provide data from both the primary health care sector (general practice [GP]) and the secondary sector (specialized outpatient clinics) to assess the quality of treatment given to patients with diabetes. The indicators...... represent process and outcome indicators selected from the literature. Study population: The total diabetes population in Denmark is estimated to be ∼300,000 adult diabetes patients. Approximately 10% have type 1 diabetes, which is managed mainly in the secondary sector, and 90% have type 2 diabetes......, glucose-, blood pressure-, and lipid-lowering treatment (yes/no), insulin pump treatment (yes/ no), and date of last eye and foot examination. Descriptive data: In 2014, the annual report included data regarding over 38,000 patients from outpatient clinics, which is assumed to have included almost all...
Schjødt, Inge; Nakano, Anne; Egstrup, Kenneth
AIM OF DATABASE: The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. STUDY POPULATION: The DHFR includes inpatients and outpatients (≥18 years) with incident HF. Reporting to the DHFR is mandatory......: The main variables recorded in the DHFR are related to the indicators for quality of care in patients with incident HF: performance of echocardiography, functional capacity (New York Heart Association functional classification), pharmacological therapy (angiotensin converting enzyme/angiotensin II...... antagonist inhibitors, beta-blockers, and mineralocorticoid receptor antagonist), nonpharmacological therapy (physical training, patient education), 4-week readmission rate, and 1-year mortality. Furthermore, basic patient characteristics and prognostic factors (eg, smoking and alcohol) are recorded...
Harlan Carvey brings readers an advanced book on Windows Registry - the most difficult part of Windows to analyze in forensics! Windows Registry Forensics provides the background of the Registry to help develop an understanding of the binary structure of Registry hive files. Approaches to live response and analysis are included, and tools and techniques for postmortem analysis are discussed at length. Tools and techniques will be presented that take the analyst beyond the current use of viewers and into real analysis of data contained in the Registry. This book also has a DVD containing tools, instructions and videos.
Schwemer, Sebastian Felix
The link of lawful domain names to unlawful content is a phenomenon that until recently has not been very topical. Traditionally, domain registries have been off the radar of content-related debates. Enforcement efforts, public discourse and academic research have focused on other intermediaries...... such as Internet access service providers, hosting platforms, and websites that link to content. This article shows that in recent years, however, that the (secondary) liability of domain registries and registrars, and more specifically country code top-level domain registries (ccTLDs) for website content, has...... been tested in several EU Member States. The article investigates tendencies in the national lower-court jurisprudence and explores to what extent the liability exemption regime of the E-Commerce Directive applies to domain registries. The analysis concludes that whereas domain registries fall under...
Benson, Kevin; Plante, Ray; Auden, Elizabeth; Graham, Matthew; Greene, Gretchen; Hill, Martin; Linde, Tony; Morris, Dave; O`Mullane, Wil; Rixon, Guy; Stébé, Aurélien; Andrews, Kona; Benson, Kevin; Plante, Ray
Registries provide a mechanism with which VO applications can discover and select resources--e.g. data and services--that are relevant for a particular scientific problem. This specification defines the interfaces that support interactions between applications and registries as well as between the registries themselves. It is based on a general, distributed model composed of so-called searchable and publishing registries. The specification has two main components: an interface for searching and an interface for harvesting. All interfaces are defined by a standard Web Service Description Language (WSDL) document; however, harvesting is also supported through the existing Open Archives Initiative Protocol for Metadata Harvesting, defined as an HTTP REST interface. Finally, this specification details the metadata used to describe registries themselves as resources using an extension of the VOResource metadata schema.
Full Text Available Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.
Taradaj, J; Halski, T; Kucharzewski, M; Walewicz, K; Smykla, A; Ozon, M; Slupska, L; Dymarek, R; Ptaszkowski, K; Rajfur, J; Pasternok, M
The aim of this study was to assess the clinical efficacy and safety of NMES program applied in male soccer players (after ACL reconstruction) on the quadriceps muscle. The 80 participants (NMES = 40, control = 40) received an exercise program, including three sessions weekly. The individuals in NMES group additionally received neuromuscular electrical stimulation procedures on both right and left quadriceps (biphasic symmetric rectangular pulses, frequency of impulses: 2500 Hz, and train of pulses frequency: 50 Hz) three times daily (3 hours of break between treatments), 3 days a week, for one month. The tensometry, muscle circumference, and goniometry pendulum test (follow-up after 1 and 3 months) were applied. The results of this study show that NMES (in presented parameters in experiment) is useful for strengthening the quadriceps muscle in soccer athletes. There is an evidence of the benefit of the NMES in restoring quadriceps muscle mass and strength of soccer players. In our study the neuromuscular electrical stimulation appeared to be safe for biomechanics of knee joint. The pathological changes in knee function were not observed. This trial is registered with Australian and New Zealand Clinical Trials Registry ACTRN12613001168741.
Full Text Available The aim of this study was to assess the clinical efficacy and safety of NMES program applied in male soccer players (after ACL reconstruction on the quadriceps muscle. The 80 participants (NMES = 40, control = 40 received an exercise program, including three sessions weekly. The individuals in NMES group additionally received neuromuscular electrical stimulation procedures on both right and left quadriceps (biphasic symmetric rectangular pulses, frequency of impulses: 2500 Hz, and train of pulses frequency: 50 Hz three times daily (3 hours of break between treatments, 3 days a week, for one month. The tensometry, muscle circumference, and goniometry pendulum test (follow-up after 1 and 3 months were applied. The results of this study show that NMES (in presented parameters in experiment is useful for strengthening the quadriceps muscle in soccer athletes. There is an evidence of the benefit of the NMES in restoring quadriceps muscle mass and strength of soccer players. In our study the neuromuscular electrical stimulation appeared to be safe for biomechanics of knee joint. The pathological changes in knee function were not observed. This trial is registered with Australian and New Zealand Clinical Trials Registry ACTRN12613001168741.
da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth; Poulsen, Christian Bjørn; de Nully Brown, Peter; Frederiksen, Henrik; Bergmann, Olav Jonas; Pulczynski, Elisa Jacobsen; Pedersen, Robert Schou; Nielsen, Linda Højberg; Christiansen, Ilse; Niemann, Carsten Utoft
In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate adherence to national guidelines and to provide source data for research purposes. All patients diagnosed with CLL in Denmark from 2008 onward are included in the registry. Patients are followed in one of nine hematology centers. All centers participate in the registry and are all obliged to collect data. Predefined data are collected at the time of diagnosis, and follow-up at the time of significant events: treatment, progression, transplantation, and death. Parameters included in the International Workshop on Chronic Lymphocytic Leukaemia criteria for diagnosis, and for decision on treatment initiation as well as characteristics included in the CLL International Prognostic Index are collected. To ensure full coverage of Danish CLL patients in the registry, both continuous queries in case of missing data, and cross-referencing with the Danish National Patient Registry are performed. Data from the registry are published in an annual report summarizing the collected data, the overall survival for yearly cohorts, and the degree of data coverage. Per year approximately 450 new patients with CLL are registered in the registry, cumulative as of July 1, 2015, 3,082 patients have been registered. The Danish National CLL Registry is based within the Danish National Hematology Database. The registry covers a cohort of all patients diagnosed with CLL in Denmark since 2008. It forms the basis for quality assessment of CLL treatment in Denmark and offers a unique opportunity for population-based research.
Serpell, Benjamin G; Scarvell, Jennie M; Pickering, Mark R; Ball, Nick B; Newman, Phillip; Perriman, Diana; Warmenhoven, John; Smith, Paul N
Many injury prevention and rehabilitation programs aim to train hamstring and quadriceps co-activation to constrain excessive anterior tibial translation and protect the anterior cruciate ligament (ACL) from injury...
Shea, Kevin G; Apel, Peter J; Pfeiffer, Ronald P; Traughber, Paul D
Although the treatment of anterior cruciate ligament (ACL) tears in skeletally immature patients is still controversial, several studies have advocated ACL reconstruction in selected patients to prevent secondary injury. The proximal tibial physis is a structure at risk during ACL reconstruction in young patients, and physeal growth complications have been reported after surgery in this area. The relationship between the ACL and the proximal tibial physeal/apophyseal regions is poorly understood. This study examined the MRI anatomy of the ACL and the proximal tibia apophysis and epiphysis. MRIs of 59 skeletally immature knees were reviewed (Average age = 12.75 years, range 6-15) to define the anatomy of the epiphyseal and apophyseal regions. Measurements were recorded in three parasagittal planes: (1) at the lateral border of the patellar tendon, (2) the lateral edge of the ACL insertion, and (3) the medial edge of the ACL insertion. A single three-dimensional (3D) computed tomography (CT) scan was used to evaluate the position of standard drill holes used in ACL reconstruction to assess for potential degree of injury to the epiphyseal and apophyseal growth plates. In the parasagittal planes, the average height of the epiphysis was 19.6, 20.7, and 21.5 mm at the lateral border of the patellar tendon, the lateral border of the ACL, and the medial border of the ACL, respectively. At the level of the same landmarks, the apophysis extended below the physis at an average of 20.2, 16.8, and 7.0 mm, respectively. Expressed as a percentage of epiphysis height this was an average of 104, 82, and 33%, respectively. Examination of 3D CT images revealed that variations in drill hole placement had effects on the volume of injury to the proximal tibial physis and apophysis. Drill holes that started more medial, distal, and with a steeper angle of inclination reduced the amount of physis and apophysis violated when compared with holes placed more lateral, proximal, and with a
The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction. PMID:21655455
Holm, Lars; Esmarck, B.; Mizuno, M.
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...... 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...... significantly between groups at the distal part, with the PC group demonstrating the largest hypertrophy. Peak torque of the quadriceps muscle at constant velocity 60 degrees.s-1 was significantly elevated in the PC group only, and the time to reach peak torque tended to decrease as well only in the PC group...
Pollard, Christine D; Sigward, Susan M; Powers, Christopher M
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.
William E. Cayley Jr
Full Text Available The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.
Magnussen, Robert A.; Pottkotter, Kristy; DiStasi, Stephanie; PATERNO, MARK V.; Wordeman, Samuel Clayton; Schmitt, Laura; Flanigan, David C.; Kaeding, Christopher C.; Hewett, Timothy E.
Objectives: Femoral nerve block (FNB) has been proposed for pain control following anterior cruciate ligament (ACL) reconstruction. Although numerous high level studies have assessed the efficacy of FNB?s, there has been little to no research into the effect of such blocks on post-operative strength and patient-reported outcomes. Exacerbation of post-operative quadriceps weakness by a FNB could negatively impact recovery, particularly in the early post-operative period. We hypothesized that p...
Nicholson, Jamie A; Sutherland, Alasdair G; Smith, Francis W; Kawasaki, Taku
The ability to quantify in vivo femoro-tibial relations in the knee holds great advantage to further patient care. There is little consensus on the optimal weight-bearing environment and measurement method for MRI assessment of in vivo knee kinematics. This study set out to establish the optimal method of measuring femoro-tibial relations in an upright, weight-bearing environment in normal individuals and those with ACL deficiency. Upright, load bearing, MRI scans of both knees were evaluated by two methods, flexion facet centre (FFC) and femoro-tibial contact point (FTCP), in order to establish femoro-tibial relations in the sagittal plane throughout different angles of knee flexion. A group of healthy volunteers (n=5) and a group with unilateral ACL insufficiency (n=8) were studied. Abnormal femoro-tibial relations were found in all ACL-deficient knees (n=8): the lateral tibial plateau was anteriorly displaced in extension and early flexion and, coupled with smaller changes in the medical compartment, this constitutes internal rotation of the tibia relative to the femur in early flexion. This study found that the FFC measurement technique holds an advantage over the FTCP technique in terms of validity, repeatability and ease of measurements, allowing detection of kinematic changes such as tibial internal rotation in early flexion in ACL-deficient knees in an upright weight-bearing model. We propose that FFC measurement in an upright, weight-bearing position is a reliable and representative tool for the assessment of femoro-tibial movement. Copyright © 2010 Elsevier B.V. All rights reserved.
Olsen, O E; Myklebust, G; Engebretsen, L; Holme, I; Bahr, R
The purpose of this study was to compare the ACL injury rate between two different floor types - wooden floors (parquet, generally having lower friction) and artificial floors (generally having higher friction). ACL injuries have been recorded prospectively from the three top divisions for men and women in Norwegian team handball during seven seasons (1989-2000). A total of 174 ACL injuries have been recorded, and of these 53 occurred in regular league games. The floor types for all regular games from the same seasons have been determined retrospectively based on match schedules. The matches were divided into two groups: those played on wooden floors and those played on artificial floors. A total of nine injuries occurred among men (incidence: 0.24+/-0.09 injuries per 1000 player hours) and 44 among women (0.77+/-0.04 injuries 1000 h(-1); OR vs. men: 3.21 (1.56-6.58); P=0.001). Among men, four injuries occurred on wooden floors (0.32+/-0.13 injuries 1000 h(-1)) and five injuries occurred on artificial floors (0.20+/-0.12 injuries 1000 h(-1); OR vs. wooden floors: 0.63 (0.17-2.37); ns). Among women, eight injuries occurred on wooden floors (0.41+/-0.09 injuries 1000 h(-1); OR vs. men: 1.29 (0.39-4.28); ns) and 36 on artificial floors (0.96+/-0.04 injuries 1000 h(-1); OR vs. wooden floors: 2.35 (1.09-5.07); P=0.03; OR vs. men: 4.77 (1.87-12.18); P=0.001). These results indicate that the risk of ACL injury for women is higher on artificial floors than on wooden floors.
Herrington, LC; Alarifi, SM; Jones, R
Background: Patellofemoral joint pain and degeneration is common in patients who undergo ACL reconstruction (ACLR). The presence of patellofemoral joint pain significantly impacts on the ability to continue to participate in sport and may even have a bearing on participation in activities of daily living. What is currently unclear is the mechanisms behind this process, previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when runn...
Wise, Brent T; Patel, Nick N; Wier, Garrison; Labib, Sameh A
Suspensory femoral fixation of anterior cruciate ligament (ACL) grafts with fixed loop button and variable loop button devices has gained popularity for ACL reconstruction. This study examined these 2 methods of fixation to determine their effect on graft laxity and patient-reported outcome scores. A database search was performed to identify patients who had undergone ACL reconstruction with either a fixed loop or a variable loop button technique performed by the primary surgeon. Lysholm, Tegner, and 12-Item Short Form Health Survey scores were obtained, and KT-1000 knee ligament arthrometer (MEDmetric, San Diego, California) mechanical knee testing was performed. Results were compared with the uninjured knee. Of the 112 patients who were identified, 91 met the study criteria. Of these patients, 57 completed KT-1000 knee testing, 33 in the variable group and 24 in the fixed group. The average KT-1000 value for the variable group was 0.38 mm, and the average for the closed group was 0.92 mm (P=.19; 95% confidence interval, -0.28 to 1.35). Among the 19 patients in the variable group and the 13 in the closed group who completed the subjective outcomes questionnaires, no statistically significant difference was found. Clinically lax knees (KT-1000>3 mm) were found in 6.1% and 12.5% of patients in the variable group and the fixed group, respectively (P=.2). The variable group had a rerupture rate of 4.7%, whereas the fixed group had a rerupture rate of 8.7% (P=.21). The study found no statistical difference in ACL graft laxity or postoperative functional outcomes between grafts fixed with the variable loop or fixed loop button technique. [Orthopedics. 2017; 40(2):e275-e280.]. Copyright 2016, SLACK Incorporated.
Kragelund, C.; Reibel, J.; Hadler-Olsen, E. S.; Hietanen, J.; Johannessen, A. C.; Kenrad, B.; Nylander, K.; Puranen, M.; Rozell, B.; Salo, T.; Syrjanen, S.; Soland, T. M.; van der Waal, I.; van der Wal, J. E.; Warfvinge, G.
Background: For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher
subject of this article is cultural cooperation between the Murmansk region, the Scandinavian countries and Finland. This article will examine cooperation in the field of libraries and literature studies, and cooperation in the exhibition and management of the museums within this Region.
that the use of social constructivist theories with regard to interaction and knowledge sharing may be the way forward. Based on the authors own empirical research involving Scandinavian managers in engaging in cross cultural communication it is shown that barriers to a positive link between cross...
This paper presents a comparative synchronic corpus investigation of Mainland Scandinavian ma, matte and maste 'must, may'. These modals developed a wide range of different meanings and uses within the realm of necessity, possibility and beyond, i.e., ability, capacity, need, desirability,
Møller, Marie Østergaard; Stensöta, Helena
It has been argued that the Scandinavian welfare states have been resilient to trends of globalization and fiscal crises, and that the global pressure of neoliberalism has led to a partial retrenchment rather than a restructuring during last decades. This conclusion is, however, drawn without...
Argintar, Evan; Scherer, Benjamin; Jordan, Tom; Klimkiewicz, John
Anterior cruciate ligament (ACL) tear is a commonly occurring injury that often demands surgical reconstruction. Although the utility of this operation is widely accepted, many specific components, including graft fixation technique, remain controversial. Many clinicians favor transverse femoral implant fixation for soft tissue ACL grafts. This technique can be accomplished successfully; however, in a minority of the cases, the femoral implant can be excessively prominent, leading to iatrogenic postoperative iliotibial band syndrome. This article presents 4 patients that developed postoperative iliotibial band syndrome resulting from transverse femoral implant prominence. Despite achievement of knee ligamentous stability, implant prominence compromised final clinical results following ACL reconstruction. Through change in Lysholm value, we reviewed the clinical outcomes of these patients following femoral implant hardware removal for treatment of iliotibial band syndrome. On hardware removal, all patients demonstrated complete symptomatic improvement, mirroring an average Lysholm value increase of 38. We believe transverse femoral implant prominence is avoidable, and subsequent iliotibial band syndrome is a preventable postoperative complication. Copyright 2010, SLACK Incorporated.
Solano, C; Zerafa, P; Bird, R
The graphical representation of clotting data can provide useful information. A novel feature of the ACL TOP software allows display of clot reaction curves with superimposed first and second derivative curves. We noted atypical derivative plots associated with normal 'S'-shaped clot reaction curves in some abnormal activated partial thromboplastin time (APTT). We tested 179 citrate plasmas with four different APTT reagents on the ACL TOP. We documented the prevalence and utility of these APTT atypical derivative curves in these patients. Ellagic acid APTT reagents commonly produce atypical derivative curves despite normal 'S'-shaped clot reaction curves. Occasionally, these atypical second derivative curves may cause incorrect APTT results. With silica activator APTT reagents, atypical derivative curves were associated with genuine coagulation abnormalities such as single factor deficiencies and lupus anticoagulants (LAs). To our knowledge, this novel finding has not been reported. Atypical derivative curves seen in ellagic acid APTTs are of limited diagnostic use because of the frequency with which they occur. This may be related to the need to optimize the data reduction utilized on the ACL TOP for these reagents. With silica activator APTTs, the presence of atypical derivative curves proved to be a very simple tool when troubleshooting unexpected abnormal APTT results, commonly predicting a factor deficiency or LA that would warrant further investigation. The cause of these aberrant derivative curves is probably related to abnormal thrombin generation in the APTT test and warrants further study. © 2010 Blackwell Publishing Ltd.
Kaseb Mohammad Hasan
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.
Roos, Thomas R.; Roos, Andrew K.; Kleimeyer, John P.; Ahmed, Marwa A.; Goodlin, Gabrielle T.; Fredericson, Michael; Ioannidis, John P. A.; Avins, Andrew L.; Dragoo, Jason L.
Achilles tendinopathy or rupture and anterior cruciate ligament (ACL) rupture are substantial injuries affecting athletes, associated with delayed recovery or inability to return to competition. To identify genetic markers that might be used to predict risk for these injuries, we performed genome-wide association screens for these injuries using data from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort consisting of 102,979 individuals. We did not find any single nucleotide polymorphisms (SNPs) associated with either of these injuries with a p-value that was genome-wide significant (pAchilles tendon injury and ACL rupture, respectively. We then tested SNPs previously reported to be associated with either Achilles tendon injury or ACL rupture. None showed an association in our cohort with a false discovery rate of less than 5%. We obtained, however, moderate to weak evidence for replication in one case; specifically, rs4919510 in MIR608 had a p-value of 5.1x10-3 for association with Achilles tendon injury, corresponding to a 7% chance of false replication. Finally, we tested 2855 SNPs in 90 candidate genes for musculoskeletal injury, but did not find any that showed a significant association below a false discovery rate of 5%. We provide data containing summary statistics for the entire genome, which will be useful for future genetic studies on these injuries. PMID:28358823
Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.
Norouzi, Sadegh; Esfandiarpour, Fateme; Shakourirad, Ali; Salehi, Reza; Akbar, Mohammad; Farahmand, Farzam
A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (P < 0.05). During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (P = 0.002) and 15° (P = 0.012). It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise. PMID:24066288
Dragoo, Jason L; Braun, Hillary J; Harris, Alex H S
Artificial playing surfaces are widely used for American football practice and competition and anterior cruciate ligament (ACL) injuries are common. This study analyzed the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) men's football ACL injury database from 2004-2005 through 2008-2009 to determine the effect of playing surface on ACL injury in NCAA football athletes. This database was reviewed from the 2004-2005 through 2008-2009 seasons using the specific injury code, "Anterior cruciate ligament (ACL) complete tear." The injury rate was computed for competition and practice exposures. Ninety-five percent confidence intervals were calculated using assumptions of a Poisson distribution. Pair-wise, two-sample tests of equality of proportions with a continuity correction were used to estimate the associations of risk factors. There was an incidence rate of 1.73 ACL injuries per 10,000 athlete-exposures (A-Es) (95% CI 1.47-2.0) on artificial playing surfaces compared with a rate of 1.24 per 10,000 A-Es (1.05-1.45, pinjuries occurred more frequently on artificial turf surfaces (44.29%) than on natural grass (36.12%). NCAA football players experience a greater number of ACL injuries when playing on artificial surfaces. Copyright © 2012 Elsevier B.V. All rights reserved.
Månsson, O; Kartus, J; Sernert, N
The life situation of many patients changes after an anterior cruciate ligament (ACL) rupture and subsequent reconstruction, and this may affect their health-related quality of life in many ways. It is well known that the overall clinical results after ACL reconstruction are considered good, but pre-operative predictive factors for a good post-operative clinical outcome after ACL reconstruction have not been studied in as much detail. The purpose of this study was to identify pre-operative factors that predict a good post-operative outcome as measured by the Short Form 36 (SF-36) and Knee Osteoarthritis Outcome Score (KOOS) 3-6 years after ACL reconstruction. Seventy-three patients scheduled for ACL reconstruction were clinically examined pre-operatively. The SF-36 and KOOS questionnaires were sent by mail to these patients 3-6 years after reconstruction. Predictive factors for health-related quality of life were investigated using a stepwise regression analysis. In conclusion, pre-operative factors, such as pivot shift, knee function, and range of motion, may predict a good post-operative outcome and explain up to 25% in terms of health-related quality of life after ACL reconstruction. Furthermore, it appears that the patients' pre-injury and pre-operative Tegner activity levels are important predictors of post-operative health-related quality of life. © 2012 John Wiley & Sons A/S.
Fereshtehnejad, Seyed-Mohammad; Johannsen, Peter; Waldemar, Gunhild
BACKGROUND: Two dementia quality registries have been developed in Denmark and Sweden with the aim to assess quality of dementia care based on adherence to national guidelines. OBJECTIVE: To compare patient characteristics, diagnostics, treatment, and quality indicators of dementia care among.......6% of the Swedish and 87.3% of the Danish cases. Alzheimer's disease (AD) was the most common disorder (47.7% in Denmark and 36.6% in Sweden); however, more cases were diagnosed as mixed AD in Sweden (24.7% versus 10.6% ). More than 80% of patients with AD, dementia with Lewy bodies, and Parkinson's disease...... patients referred to specialist units in Sweden and Denmark. METHODS: Data from the Swedish Dementia Registry (SveDem) and the Danish Dementia Registry were merged. Newly diagnosed dementia cases referred to memory clinics during 2007-2012 were included (19,629 Swedish and 6,576 Danish patients). RESULTS...
[Intra-articular reinforcement of a partially torn anterior cruciate ligament (ACL) using newly developed UHMWPE biomaterial in combination with Hexalon ACL/PCL screws: ex-vivo mechanical testing of an animal knee model].
Fedorová, P; Srnec, R; Pěnčík, J; Dvořák, M; Krbec, M; Nečas, A
PURPOSE OF THE STUDY Recent trends in the experimental surgical management of a partial anterior cruciate ligament (ACL) rupture in animals show repair of an ACL lesion using novel biomaterials both for biomechanical reinforcement of a partially unstable knee and as suitable scaffolds for bone marrow stem cell therapy in a partial ACL tear. The study deals with mechanical testing of the newly developed ultra-high-molecular-weight polyethylene (UHMWPE) biomaterial anchored to bone with Hexalon biodegradable ACL/PCL screws, as a new possibility of intra-articular reinforcement of a partial ACL tear. MATERIAL AND METHODS Two groups of ex vivo pig knee models were prepared and tested as follows: the model of an ACL tear stabilised with UHMWPE biomaterial using a Hexalon ACL/PCL screw (group 1; n = 10) and the model of an ACL tear stabilised with the traditional, and in veterinary medicine used, extracapsular technique involving a monofilament nylon fibre, a clamp and a Securos bone anchor (group 2; n = 11). The models were loaded at a standing angle of 100° and the maximum load (N) and shift (mm) values were recorded. RESULTS In group 1 the average maximal peak force was 167.6 ± 21.7 N and the shift was on average 19.0 ± 4.0 mm. In all 10 specimens, the maximum load made the UHMWPE implant break close to its fixation to the femur but the construct/fixation never failed at the site where the material was anchored to the bone. In group 2, the average maximal peak force was 207.3 ± 49.2 N and the shift was on average 24.1 ± 9.5 mm. The Securos stabilisation failed by pullout of the anchor from the femoral bone in nine out of 11 cases; the monofilament fibre ruptured in two cases. CONCLUSIONS It can be concluded that a UHMWPE substitute used in ex-vivo pig knee models has mechanical properties comparable with clinically used extracapsular Securos stabilisation and, because of its potential to carry stem cells and bioactive substances, it can meet the requirements for
Núria Fandos Esteruelas
Full Text Available In April 2014 and 2015, we noted localized alopecia (neck, forelimbs, and chest and hyperpigmentation on two adult brown bears (Ursus arctos captured in central-south Sweden for ecological studies under the Scandinavian Brown Bear Research Project. In spring 2015, a brown bear was shot because of human-wildlife conflict in the same region. This bear also had extensive alopecia and hyperpigmentation. Ectoparasites were collected from the affected skin areas in all three individuals and preserved in ethanol for identification. Based on morphological characteristics, the lice were identified as Trichodectes spp. and Trichodectes pinguis pinguis. To our knowledge, these are the first reported cases of chewing lice in free-ranging brown bears in Scandinavia.
Bloom-Feshbach, Kimberly; Simonsen, Lone; Viboud, Cecile
Background. Although pregnancy is a recognized risk factor for severe influenza infection, the effect of influenza on miscarriages and births remains unclear. We examined the relationship between influenza and birth rates during the 1918 pandemic in the United States, Denmark, Sweden, and Norway....... Methods. We compiled monthly birth rates from 1911 through 1930 in 3 Scandinavian countries and the United States, identified periods of unusually low or high birth rates, and quantified births as “missing” or “in excess” of the normal expectation. Using monthly influenza data, we correlated the timing...... of peak pandemic exposure and depressions in birth rates, and identified pregnancy stages at risk of influenza-related miscarriage. Results. Birth rates declined in all study populations in spring 1919 by a mean of 2.2 births per 1000 persons, representing a 5%–15% drop below baseline levels (P
Demidov, L.; Houmark-Nielsen, Michael; Kjær, Kurt Henrik
the main ice sheet. During the Lateglacial warming, disintegration and melting took place in a 200-600 km wide zone along the northeastern rim of SIS associated with thick Quaternary accumulations. Deglaciation occurred through aerial downwasting within large fields of dead ice developed during......Advance of the Late Weichselian (Valdaian) Scandinavian Ice Sheet (SIS) in northwestern Russia took place after a period of periglacial conditions. Till of the last SIS, Bobrovo till, overlies glacial deposits from the previous Barents and Kara Sea ice sheets and marine deposits of the Last...... in Russia than previously outlined and the time of termination at 18-16 cal. kyr BP was almost 10 kyr delayed compared to the southwestern part of the ice sheet. We argue that the lithology of the ice sheets' substrate, and especially the location of former proglacial lake basins, influenced the dynamics...
Skoglund, G; Nockert, M; Holst, B
Nowadays most plant textiles used for clothing and household are made of cotton and viscose. Before the 19th century however, plant textiles were mainly made from locally available raw materials, in Scandinavia these were: nettle, hemp and flax. It is generally believed that in Viking and early Middle Ages Scandinavia hemp was used only for coarse textiles (i.e. rope and sailcloth). Here we present an investigation of 10 Scandinavian plant fibre textiles from the Viking and Early Middle Ages, believed to be locally produced. Up till now they were all believed to be made of flax. We show that 4 textiles, including two pieces of the famous Överhogdal Viking wall-hanging are in fact made with hemp (in three cases hemp and flax are mixed). This indicates that hemp was important, not only for coarse but also for fine textile production in Viking and Early Middle Ages in Scandinavia.
Hejrani, Babak; Balling, N.; Jacobsen, B. H.
More than 20000 arrival-times of teleseismic P- and S-waves were measured over a period of more than 10 years in five separate temporary and two permanent seismic networks covering the Scandinavian (Scandes) Mountains and adjacent areas of the Baltic Shield. The relative traveltime residuals were...... inverted to 3D tomograms of P- and S- velocities and the VP/VS ratio. Resolution analysis documents that good 3D resolution is available under the dense network south of 64° latitude (Southern Scandes Mountains), and patchier, but highly useful resolution is available further north, where station coverage...... is more uneven. A pronounced upper-mantle velocity boundary (UMVB), transecting the study region is defined. It runs from SE Norway (east of the Oslo Graben) across the mountains to the Norwegian coast near Trondheim (around the Møre-Trøndelag Fault Complex), from where it follows the coast and runs...
Bentzen, Jan Børsen; Smith, Valdemar
The aim of this paper is to analyse the retail prices of German white wines sold in the Scandinavian countries. German white wines account for approximately 5-6 per cent of the total sale of wines - both red and white wines - in Denmark, Norway and Sweden. However, the market shares of German wines...... in Scandinavia have been declining for a number of years. Diminishing market shares may reflect changes in consumer tastes or simply 'wrong' prices, the latter related to both the level of wine prices (German wines being relatively expensive) and the structure of wine prices. In general, country-specific price...... differences for identical wines are expected to be a sign of differences in taxes, import prices, transportation costs as well as other costs - and also different competitive conditions at the retail level in the respective countries. Differences in wine prices across countries do not always reflect...
Agerholm, Niels; Olesen, Anne Vingaard
Adaptive Traffic Control Systems (ATCS) are aimed at reducing congestion. ATCS adapt to approaching traffic to continuously optimise the traffic flows in question. ATCS have been implemented in many locations, including the Scandinavian countries, with various effects. Due to congestion problems......, ATCS were installed in the eight signalised intersections of a 1.7 km stretch of the ring road in the medium-sized Danish city of Aalborg. To measure the effect of ATCS a with/without study was carried out. GPS data from a car following the traffic, recorded transportation times for buses in service......, and GPS data from a range of cars driving on the ring road formed the basis for the study. The result of ATCS implementation was a significant 17% reduction in transportation time on the ring road in the most congested period, the afternoon peak. Less significant effects were found regarding the morning...
Jensen, Janni; Frøkjær, Johnny; Gerke, Oke
radiography compared with 3D weight-bearing multiplanar reconstructed (MPR) fluoroscopic imaging when diagnosing periprosthetic bone cysts in patients who have undergone TAR. SUBJECTS AND METHODS. Forty-two consecutive patients with a Scandinavian Total Ankle Replacement (STAR) were consecutively enrolled...... and underwent digital radiography and 3D MPR imaging in the same session. All 3D MPR images were interpreted in a blinded fashion, specifically with regard to the presence and extent of periprosthetic bone cysts. Cysts were measured in three planes whenever possible. Interrater and intrarater reliability...... that of cysts diagnosed on digital radiography (1545 mm(3) vs 253 mm(3)) (p analysis based on the presence or absence of cysts in individual patients did not show a significant difference between 3D MPR and digital radiography (p = 0.23). CONCLUSION. The data imply that cysts are better...
Reppe, L. A.; Spigset, O.; Bottiger, Y.
Purpose There is little research-based documentation on the services provided by drug information centres (DICs). The aim of this multi-centre study was to explore for the first time the factors associated with time consumption when answering drug-related queries at eight different but comparable...... DICs. Methods During an 8-week period, staff members at eight Scandinavian DICs recorded the number of minutes during which they responded to queries. Mixed model linear regression analyses were used to explore the factors associated with time consumption when answering queries. Results The mean time...... consumption per query was 178 min (range 4-2540 min). The mean time consumed per query increased by 28 (95 % confidence interval (CI) 23 to 33, p...
Full Text Available Scandinavia represents a particular type of welfare state, characterized by institutionalized social rights, universal access, generous benefits, a high degree of public involvement and comparatively high levels of redistribution. The basically tax-based system, which was designed to constitute a basic safety net for all citizens from cradle to grave, has been remarkably generous - and thereby also costly. It is thus vulnerable in relation to newcomers who cannot support themselves economically. In all of Scandinavia, the welfare state was from the beginning the self-evident instrument for incorporation of newcomers. Gradually, this instrument has turned more controversial, in parallel with general processes of social reform, in which the restructuring of policies has been regarded as necessary in order to avoid dependency traps and "overconsumption". This article spells out the historical background for the specific Scandinavian approach to immigration, and discusses the current dilemmas attached to this normatively complicated policy field.
Poffley, Alison; Thomas, Emma; Grace, Sherry L; Neubeck, Lis; Gallagher, Robyn; Niebauer, Josef; O'Neil, Adrienne
Introduction Despite cardiac rehabilitation being recommended in clinical practice guidelines internationally these services are underutilised, programmes are not standardised and quality improvement methods and outcomes are rarely published. National registries are an important strategy to characterise service delivery, quality and outcomes, yet the number, type and components of national cardiac rehabilitation registries have not been reported. Aims To identify and describe national and international cardiac rehabilitation registries, and summarise their key features. Methods We systematically reviewed the literature reporting on cardiac rehabilitation registries at a national and international level. A search of four databases was conducted in July 2016, with two reviewers independently screening titles/abstracts and full texts for inclusion. Data were extracted from included studies, independently checked by a second reviewer and synthesised qualitatively. Results Eleven articles were included in the review comprising seven national registries and one international registry (of 12 European countries) for a total sample of 265,608 patients. Data were most commonly provided to the registry by a web-based application, and included individual-level data (i.e. sociodemographic characteristics, medical history, and clinical measurements). When reported, service-level data most commonly included wait times, programme enrolment and completion. The overarching governance, funding modes (e.g. industry ( n = 2), government ( n = 1)), and incentives for registry participation (e.g. benchmarking, financial reimbursement, or mandatory requirement) varied widely. Conclusion The use of national and international registries for characterising cardiac rehabilitation and providing a benchmark for quality improvement is in its early stages but shows promise for national and global benchmarking.
Husum, B; Stenqvist, O; Alahuhta, S; Sigurdsson, G H; Dale, O
The use of nitrous oxide in modern anaesthesia has been questioned. We surveyed changes in use of nitrous oxide in Scandinavia and its justifications during the last two decades. All 191 departments of anaesthesia in the Scandinavian countries were requested by email to answer an electronic survey in SurveyMonkey. One hundred and twenty-five (64%) of the departments responded; four were excluded. The 121 departments provided 807.520 general anaesthetics annually. The usage of nitrous oxide was reported in 11.9% of cases, ranging from 0.6% in Denmark to 38.6% in Iceland while volatile anaesthetics were employed in 48.9%, lowest in Denmark (22.6%) and highest in Iceland (91.9%). Nitrous oxide was co-administered with volatile anaesthetics in 21.5% of general anaesthetics [2.4% (Denmark) -34.5% (Iceland)]. Use of nitrous oxide was unchanged in five departments (4%), decreasing in 75 (62%) and stopped in 41 (34%). Reasons for decreasing or stopping use of nitrous oxide were fairly uniform in the five countries, the most important being that other agents were 'better', whereas few put weight on its potential risk for increasing morbidity. Decision to stop using nitrous oxide was made by the departments except in four cases. Of 87 maternity wards, nitrous oxide was used in 72, whereas this was the case in 42 of 111 day-surgery units. The use of nitrous oxide has decreased in the Scandinavian countries, apparently because many now prefer other agents. Difference in practices between the five countries were unexpected and apparently not justified on anticipated evidence only. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Adamczyk, Aleksander; Wysota, Wojciech; Sobiech, Marcin; Piotrowski, Jan A.
The impact of subglacial meltwater erosion on shaping glacial landscapes is contentious and often difficult to constrain due to the lack of unequivocal diagnostic criteria. The same holds for the role of subglacial meltwater in glacier movement processes and sediment transport and deposition. Here we present new evidence of widespread channelized erosion under the southern, soft-bedded fringe of the last Scandinavian Ice Sheet (SIS) based on high-resolution terrain analysis with LiDAR imagery. We identify several tens of sites with "glacial curvilineation" landscapes first recognized by Lesemann et al. (2010, 2014) and considered as evidence of erosion by turbulent meltwater flows at the ice/bed interface. The "glacial curvilineation" landscapes mapped here consist of sets of parallel, winding ridges typically several metres high and up to several kilometres long occupying glacial overdeepenings and tunnel valleys. The ridges are aligned approximately perpendicular to the past ice sheet margins and they are composed of various deposits often pre-dating the last ice advance. We interpret them as erosional remnants of older landscapes dissected by high-energy subglacial meltwater flows. These findings suggest that the palaeoglaciological significance of meltwater drainage under the southern portion of SIS may have been grossly underestimated. References Lesemann, J.-E., Piotrowski, J.A. and Wysota, W., 2010. „Glacial curvilineations": New glacial landforms produced by longitudinal vortices in subglacial meltwater flows. Geomorphology 120, 153-161. Lesemann, J.-E., Piotrowski, J.A. and Wysota, W., 2014. Genesis of the "glacial curvilineation" landscape by meltwater processes under the former Scandinavian Ice Sheet, Poland. Sedimentary Geology 312, 1-18.
Full Text Available In this article, I ask: Is the Scandinavian citizenship regime inclusive and women-friendly in a time of diversity? I approach this question by addressing the intersection of gender and ethnicity in relation to social citizenship with the main concern being childcare. I emphasize Norway as a case but also see Norway in comparison with Sweden and Denmark. In comparative studies, the Scandinavian citizenship regime is presented as being the most ‘women-friendly’. However, faced with an increasingly multicultural population, a pertinent question is whether this citizenship model is able to accommodate diversity. I explore two tensions that are basic to the inclusiveness and women-friendliness of the Scandinavian citizenship regime in diverse societies: 1 The tension between principles of gender equality and cultural diversity, and 2 the tension between liberating and controlling aspects of the welfare state. This article discusses the Norwegian family policy ‘hybrid’, which combines dual-earner support with traditional breadwinner elements. One might say that the Norwegian family ‘hybrid’ can be a solution to the tension between, on the one hand, a specific gender-equality family norm, and, on the other hand, the respect for other family norms. However, I argue that there is a double standard with regard to minority women, and it can be understood in light of a discourse about Norwegianness. Parental choice is considered a good thing – as long as the mother in question is considered ‘fully’ Norwegian. However, assumed cultural and ethnic differences – often based on stereotypical collective categories of difference – are used as boundary-markers between the majority and minorities. I conclude that, despite variations, all the Scandinavian countries grapple with the same tensions, and that there is a Scandinavian double standard regarding minority women.
Li, Laura; Koranne, Rahul
There is little data on the long-term health outcomes of patients with neurological conditions treated at long-term acute care specialty hospitals. In order to learn more about these patients and the most effective way to care for them, Bethesda Hospital in St. Paul created a neuroscience research registry. The registry's target population is patients with complex neurological conditions such as aneurysm or intracranial bleed, stroke, seizures, delirium and confusion and traumatic brain injury. This article describes the development of the registry, which has enrolled 857 patients thus far, and what is being learned about those patients.
A. A. Akhpashev
Full Text Available Materials and methods. The authors studied gait biomechanics in respect of time, velocity and dynamics in 34 patients with verified ACL rupture including 11 patients (first group before the surgery and 23 patients (second group after the surgery. Patients of the first group were followed in the period from 1 week up to 6 years (mean – 18 months, of the second group – from 1.5 months up to 5.5 years (mean – 13 months. Patients of the second group underwent standard arthroscopic ACL reconstruction with semitendinous and gracillis tendon autograft. Biomechanical gait examination was performed using strap down inertial motion sensors that register rotation angles in space. The authors measured time phases of gait cycle, movements in hip and knee joints in three mutually perpendicular planes as well as walking shock load.Results. Time phases of gait cycle in both groups demonstrated normal values both on healthy and affected limbs. Movements in hip and knee joints were within the normal range, no reliable differences in the analogous indices for each limb were reported. Shock load in walking was registered within 1.6 g, symmetrical on both sides; shock load dynamics was absent in the group of patients after the surgery. Study results did not identify functional disorders during random flat surface waking that would be specific for ACL lesion as compared to normal values and to intact limb. However, a certain tendency was observed towards an increase of flexion-extension movement range in the knees following ACL reconstruction. The reported differences were not credible.Conclusion. The authors did not observe any specific functional knee joint instability during normal activities in the first group of patients with ACL rupture. On the one hand, that means that ACL lesion does not manifest in such circumstances, on the other - knee joint instability does not progress during flat surface walking at a random pace. The obtained
van Gijn, Jan; Gijselhart, Joost P
Dirk Hoogendoorn (1914-1990) was a solo general practitioner in the village of Wijhe (eastern part of the Netherlands) from 1941, during the time of the German occupation, until 1971. From the very beginning, he combined his practice with the recording of disease patterns. He first concentrated on infectious diseases, especially whooping cough, which was the subject of his doctoral thesis. He later set up registries in two regional hospitals. When his initiative expanded to a national organisation, he became its advisor. He nonetheless continued to produce statistics on a variety of disorders as well as on surgical procedures, even more so after his retirement. The subjects ranged from traffic accidents and tonsillectomies to the discrepancy between increased body height and the unchanging height of the tennis net, but he had the most affinity with the practice of obstetrics. He stirred up much emotion by showing that a decrease in perinatal mortality was proceeding slower in the Netherlands than in other European countries, especially by suggesting a causal relationship between this lag and the high rate of Dutch home deliveries. This debate has continued to this day.
Nawabi, Danyal H; Tucker, Scott; Schafer, Kevin A; Zuiderbaan, Hendrik Aernout; Nguyen, Joseph T; Wickiewicz, Thomas L; Imhauser, Carl W; Pearle, Andrew D
The femoral insertion of the anterior cruciate ligament (ACL) has direct and indirect fiber types located within the respective high (anterior) and low (posterior) regions of the femoral footprint. The fibers in the high region of the ACL footprint carry more force and are more isometric than the fibers in the low region of the ACL footprint. Controlled laboratory study. Ten fresh-frozen cadaveric knees were mounted to a robotic manipulator. A 134-N anterior force at 30° and 90° of flexion and combined valgus (8 N·m) and internal (4 N·m) rotation torques at 15° of flexion were applied simulating tests of anterior and rotatory stability. The ACL was sectioned at the femoral footprint by detaching either the higher band of fibers neighboring the lateral intercondylar ridge in the region of the direct insertion or the posterior, crescent-shaped fibers in the region of the indirect insertion, followed by the remainder of the ACL. The kinematics of the ACL-intact knee was replayed, and the reduction in force due to each sectioned portion of insertion fibers was measured. Isometry was assessed at anteromedial, center, and posterolateral locations within the high and low regions of the femoral footprint. With an anterior tibial force at 30° of flexion, the high fibers carried 83.9% of the total anterior ACL load compared with 16.1% in the low fibers (P fibers also carried more anterior force than the low fibers at 90° of flexion (95.2% vs 4.8%; P fibers carried 84.2% of the anterior ACL force compared with 15.8% in the low fibers (P fibers placed at the anteromedial portion of the high region of the femoral footprint were the most isometric, with a maximum length change of 3.9 ± 1.5 mm. ACL fibers located high within the femoral footprint bear more force during stability testing and are more isometric during flexion than low fibers. It may be advantageous to create a "higher" femoral tunnel during ACL reconstruction at the lateral intercondylar ridge. © 2016 The
McCullough, Kirk A.; Phelps, Kevin D.; Spindler, Kurt P.; Matava, Matthew J.; Dunn, Warren R.; Parker, Richard D.; Reinke, Emily K.
Background While published studies on return to play for various sports exist in the literature, there is a relative paucity of data regarding the effect of ACL reconstruction on the ability of American high school and collegiate football players to return to play at the same level of competition as before their injury, or to progress to play at the next level of competition. Purpose The purpose of this study was threefold: 1) to identify the percentage of high school and collegiate American football players who successfully returned to play at their previous level of competition; 2) to investigate self-reported performance for those players able to return to play or reason(s) for not returning to play; 3) to elucidate risk factors responsible for players not being able to return to play or not returning to the same level of performance. Study Design Retrospective cohort study; level of evidence, 2. Methods This study was a retrospective analysis of prospective patients taken from the Multicenter Orthopaedic Outcomes Network (MOON) cohort who identified football as their primary or secondary sport. Identified patients were then questioned in a structured interview regarding their ACL injury, participation in football prior to their injury, and factors associated with returning to play. Data was analyzed for player position, concurrent meniscal/ligamentous/chondral pathology, surgical technique and graft used for ACL reconstruction, and issues pertaining to timing and ability to return to play. Results 147 players (68 high school, 26 collegiate) met our criteria and were contacted from the 2002 and 2003 MOON cohorts. Return-to-play rates for all high school and collegiate athletes were similar (63% and 69%, respectively). Based on player perception, 43% of the players were able to return to play at the same self-described performance level. Approximately 27% felt they did not perform at a level attained prior to their ACL tear, and 30% were unable to return to play
This GIS dataset contains data on power plants, based on the Energy Information Administration's EIA-860 dataset and supplemented with data from EPA's Facility Registry Service (FRS) compiled from various EPA programs.
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...
Department of Veterans Affairs — The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local...
U.S. Department of Health & Human Services — Linking Medicare, Medicaid, and Cancer Registry Data to Study the Burden of Cancers in West Virginia In the United States, the elderly carry an unequal burden of...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of non-hazardous waste...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste...
U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Oil...
Hardman, S.; Hughes, J. S.; Joyner, R.; Crichton, D.; Law, E.
The PDS Tool Registry enables search and discovery of tools, services, and APIs for working with data following the PDS standards. Tools and services have been submitted from the broad PDS community and multiple institutions.
U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of sites that link to...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...
Kristensen, Anders Elgaard; Larsen, Jacob Moesgaard; Nielsen, Jens Cosedis
AIMS: The validity of registry data on defibrillator lead performance is described only sparsely, despite its clinical importance. This study investigated the validity of defibrillator lead performance registry data in a nationwide and population-based registry. METHODS AND RESULTS: We identified.......9% (95% CI: 85.2-90.2%) with a κ value of 0.82 (95% CI:0.78-0.86) representing an almost perfect match. CONCLUSION: The validity of data on defibrillator lead performance recorded in the DPIR is excellent for the specific types of lead intervention and good for the specific reasons for defibrillator lead...... intervention. The validity of the less detailed overall reasons for lead interventions commonly used to report lead performance is also excellent. These findings indicate high registry data quality appropriate for scientific analysis and industry-independent post-marketing surveillance....
Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.
U.S. Environmental Protection Agency — The Substance Registry Services (SRS) is the authoritative resource for basic information about substances of interest to the U.S. EPA and its state and tribal...
U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...
... the registry questionnaire. You may try a different browser, or you may try from a different computer. You may also see this problem if you are in a high security environment where this is disabled by a network ...
Tai B; Hu L; Ghitza UE; Sparenborg S; VanVeldhuisen P; Lindblad R
Betty Tai,1 Lian Hu,2 Udi E Ghitza,1 Steven Sparenborg,1 Paul VanVeldhuisen,2 Robert Lindblad2 1Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA; 2The EMMES Corporation, Rockville, MD, USA Abstract: This commentary discusses the need for developing patient registries of substance use disorders (SUD) in general medical settings. A patient registry is a tool that documents the natural history of target diseases. Clinicia...
Parkinson’s Institute Sunnyvale, CA 94085-2934 This registry initiates a program of epidemiological assessments of PS among...Center. Alaska Native; Parkinson’s disease; Registry; Etiology; Epidemiology ; Ascertainment 8 23 June 2012 - 22 June 2013AnnualJuly 2013 ctanner...Investigator 4 A. Introduction Parkinsonism (PS) is a syndrome characterized by tremor , rigidity, slowness of movement, and problems with walking and
Awdish, R; Cajigas, H
Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1-3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmonary artery pressure at rest >OR = 25 mm Hg in the presence of a pulmonary capillary wedge pressure
Puetz, Daniel; Olthoff, Claas; Ewert, Michael K.; Anderson, Molly S.
The Advanced Closed Loop System (ACLS) is currently under development by Airbus Defense and Space and is slated for launch to the International Space Station (ISS) in 2017. The addition of new hardware into an already complex system such as the ISS life support system (LSS) always poses operational risks. It is therefore important to understand the impacts ACLS will have on the existing systems to ensure smooth operations for the ISS. This analysis can be done by using dynamic computer simulations and one possible tool for such a simulation is Virtual Habitat (V-HAB). Based on Matlab (Registered Trademark) V-HAB has been under development at the Institute of Astronautics of the Technical University Munich (TUM) since 2006 and in the past has been successfully used to simulate the ISS life support systems. The existing V-HAB ISS simulation model treated the interior volume of the space station as one large ideally-stirred container. This model was improved to allow the calculation of the atmospheric composition inside the individual modules of the ISS by splitting it into ten distinct volumes. The virtual volumes are connected by a simulation of the inter-module ventilation flows. This allows for a combined simulation of the LSS hardware and the atmospheric composition aboard the ISS. A dynamic model of ACLS is added to the ISS simulation and different operating modes for both ACLS and the existing ISS life support systems are studied to determine the impacts of ACLS on the rest of the system. The results suggest that the US, Russian and ACLS CO2 systems can operate at the same time without impeding each other. Furthermore, based on the results of this analysis, the US and ACLS Sabatier systems can be operated in parallel as well to achieve the highest possible CO2 recycling together with a low CO2 concentration.
Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E
Objective The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Design Systematic review and meta-regression. Data sources The literature search was performed in PubMed and EBSCO. Eligibility criteria Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. Results The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2–17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Conclusions Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. PMID:27251898
Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E
The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Systematic review and meta-regression. The literature search was performed in PubMed and EBSCO. Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2-17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
Hirschmann Michael T
Full Text Available Abstract With the presented case we strive to introduce combined single photon emission computerized tomography and conventional computer tomography (SPECT/CT as new diagnostic imaging modality and illustrate the possible clinical value in patients after ACL reconstruction. We report the case of a painful knee due to a foreign body reaction and delayed degradation of the biodegradable interference screws after ACL reconstruction. The MRI showed an intact ACL graft, a possible tibial cyclops lesion and a patella infera. There was no increased fluid collection within the bone tunnels. The 99mTc-HDP-SPECT/CT clearly identified a highly increased tracer uptake around and within the tibial and femoral tunnels and the patellofemoral joint. On 3D-CT out of the SPECT/CT data the femoral graft attachment was shallow (50% along the Blumensaat's line and high in the notch. At revision arthroscopy a diffuse hypertrophy of the synovium, scarring of the Hoffa fat pad and a cyclops lesion of the former ACL graft was found. The interference screws were partially degraded and under palpation and pressure a grey fluid-like substance drained into the joint. The interference screws and the ACL graft were removed and an arthrolysis performed. In the case presented it was most likely a combination of improper graft placement, delayed degradation of the interference screws and unknown biological factors. The too shallow and high ACL graft placement might have led to roof impingement, chronic intraarticular inflammation and hence the delayed degradation of the screws. SPECT/CT has facilitated the establishment of diagnosis, process of decision making and further treatment in patients with knee pain after ACL reconstruction. From the combination of structural (tunnel position in 3D-CT and metabolic information (tracer uptake in SPECT/CT the patient's cause of the pain was established.
Full Text Available Betty Tai,1 Lian Hu,2 Udi E Ghitza,1 Steven Sparenborg,1 Paul VanVeldhuisen,2 Robert Lindblad2 1Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA; 2The EMMES Corporation, Rockville, MD, USA Abstract: This commentary discusses the need for developing patient registries of substance use disorders (SUD in general medical settings. A patient registry is a tool that documents the natural history of target diseases. Clinicians and researchers use registries to monitor patient comorbidities, care procedures and processes, and treatment effectiveness for the purpose of improving care quality. Enactments of the Affordable Care Act 2010 and the Mental Health Parity and Addiction Equity Act 2008 open opportunities for many substance users to receive treatment services in general medical settings. An increased number of patients with a wide spectrum of SUD will initially receive services with a chronic disease management approach in primary care. The establishment of computer-based SUD patient registries can be assisted by wide adoption of electronic health record systems. The linkage of SUD patient registries with electronic health record systems can facilitate the advancement of SUD treatment research efforts and improve patient care. Keywords: substance use disorders, primary care, registry, electronic health records, chronic care model
Sherman, Simon; Shats, Oleg; Ketcham, Marsha A.; Anderson, Michelle A.; Whitcomb, David C.; Lynch, Henry T.; Ghiorzo, Paola; Rubinstein, Wendy S.; Sasson, Aaron R.; Grizzle, William E.; Haynatzki, Gleb; Feng, Jianmin; Sherman, Alexander; Kinarsky, Leo; Brand, Randall E.
The Pancreatic Cancer Collaborative Registry (PCCR) is a multi-institutional web-based system aimed to collect a variety of data on pancreatic cancer patients and high-risk subjects in a standard and efficient way. The PCCR was initiated by a group of experts in medical oncology, gastroenterology, genetics, pathology, epidemiology, nutrition, and computer science with the goal of facilitating rapid and uniform collection of critical information and biological samples to be used in developing diagnostic, prevention and treatment strategies against pancreatic cancer. The PCCR is a multi-tier web application that utilizes Java/JSP technology and has Oracle 10 g database as a back-end. The PCCR uses a “confederation model” that encourages participation of any interested center, irrespective of its size or location. The PCCR utilizes a standardized approach to data collection and reporting, and uses extensive validation procedures to prevent entering erroneous data. The PCCR controlled vocabulary is harmonized with the NCI Thesaurus (NCIt) or Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). The PCCR questionnaire has accommodated standards accepted in cancer research and healthcare. Currently, seven cancer centers in the USA, as well as one center in Italy are participating in the PCCR. At present, the PCCR database contains data on more than 2,700 subjects (PC patients and individuals at high risk of getting this disease). The PCCR has been certified by the NCI Center for Biomedical Informatics and Information Technology as a cancer Biomedical Informatics Grid (caBIG®) Bronze Compatible product. The PCCR provides a foundation for collaborative PC research. It has all the necessary prerequisites for subsequent evolution of the developed infrastructure from simply gathering PC-related data into a biomedical computing platform vital for successful PC studies, care and treatment. Studies utilizing data collected in the PCCR may engender new approaches
Eberle, Robert; Heinrich, Dieter; Kaps, Peter; Oberguggenberger, Michael; Nachbauer, Werner
A common anterior cruciate ligament (ACL) injury situation in alpine ski racing is landing back-weighted after a jump. Simulated back-weighted landing situations showed higher ACL-injury risk for increasing ski boot rear stiffness (SBRS) without considering muscles. It is well known that muscle forces affect ACL tensile forces during landing. The purpose of this study is to investigate the effect of different SBRS on the maximal ACL tensile forces during injury prone landings considering muscle forces by a two-dimensional musculoskeletal simulation model. Injury prone situations for ACL-injuries were generated by the musculoskeletal simulation model using measured kinematics of a non-injury situation and the method of Monte Carlo simulation. Subsequently, the SBRS was varied for injury prone landings. The maximal ACL tensile forces and contributing factors to the ACL forces were compared for the different SBRS. In the injury prone landings the maximal ACL tensile forces increased with increasing SBRS. It was found that the higher maximal ACL force was caused by higher forces acting on the tibia by the boot and by higher quadriceps muscle forces both due to the higher SBRS. Practical experience suggested that the reduction of SBRS is not accepted by ski racers due to performance reasons. Thus, preventive measures may concentrate on the reduction of the quadriceps muscle force during impact.
Pia M Jungmann
Full Text Available Anterior cruciate ligaments (ACL injuries represent a major risk factor for early osteoarthritis (OA.To evaluate the prevalence and 4-year progression of knee OA measured with 3T MR-imaging in individuals with ruptured, reconstructed or normal ACL and to assess the impact of thigh muscle characteristics.A total of 54 knees (23/54 male, 31/54 female were recruited from the Osteoarthritis Initiative (OAI. At baseline, 15/54 subjects had prevalent ACL ruptures and 15/54 subjects had prevalent ACL reconstruction (24/54 normal ACL. Western Ontario and McMasters Universities Arthritis Index (WOMAC scores, Physical Activity Scores of the Elderly (PASE and thigh muscle characteristics including strength, fat infiltration (Goutallier score and thigh muscle cross-sectional area (CSA MR measurements were obtained at baseline. Whole-organ MR-imaging Scores (WORMS were obtained at baseline and at a 4-year follow-up time-point. Multivariate regression models, adjusting for covariates (age, gender, body mass index, were used for statistical analysis.At baseline, subjects with prevalent ACL ruptures had worse WORMS total scores (mean±SEM, 44.1±3.5 than subjects with ACL reconstruction (30.8±4.0; P = 0.015 and worse than subjects with normal ACL (21.3±3.0; P<0.001. Cartilage scores were worse in both femorotibial compartments in ACL injured knees than in knees with normal ACL (P<0.05. Knees with ACL reconstruction showed an increased degeneration of the medial meniscus (P = 0.036, cartilage degeneration at the medial femoral condyle (P = 0.011. In a multivariate regression model, including both ACL groups and total muscle characteristics as influence parameters, high thigh muscle CSA, high muscle/ fat ratio and low Goutallier scores were associated with less degenerative changes at the knee, independent of ACL status. Knees with ACL reconstruction showed an increased progression of cartilage degeneration at the medial tibia compared to the normal ACL group
Full Text Available Morten Schiodt,1 Cecilia Larsson Wexell,2,3 Bente Brokstad Herlofson,4 Karen Marie Giltvedt,4 Sven Erik Norholt,5 Vera Ehrenstein61Department of Oral and Maxillofacial Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; 2Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, Region Västra Götaland, Borås, 3Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 4Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway; 5Department of Oral and Maxillofacial Surgery, Aarhus University and University Hospital, 6Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkAbstract: Osteonecrosis of the jaw (ONJ is a severe side effect associated with antiresorptive treatment. Monitoring of ONJ using routine databases in Scandinavian countries is a challenge owing to lack of valid algorithms and to heterogeneous referral practices. The aim of this paper is to describe the process of establishing a Scandinavian ONJ Cohort enrolling all ONJ cases related to antiresorptive treatment arising in Denmark, Norway, and Sweden between 2011 and 2019. The initial purpose of the cohort is to support an ongoing pharmacovigilance study of denosumab and zoledronic acid in Denmark, Norway, and Sweden. The three countries, with their 199 clinics, departments, and units of oral and maxillofacial surgery, both hospital-based and freestanding, differ somewhat in referral practices of the ONJ patients. By directly contacting all providers of care to ONJ patients in the three countries, we established a network for reporting incident cases to each country's research database directly or through a member of the Scandinavian ONJ task force as a liaison. The task force includes a Scandinavian coordinator and three national coordinators collaborating directly with the clinics. A uniform ONJ
Janssen, K.W.; Orchard, J.W.; Driscoll, T.R.; van Mechelen, W.
The aim of this paper was to provide a descriptive epidemiology of anterior cruciate ligament (ACL) reconstructions in Australia. Data on all ACL reconstructions were collected from July 1, 2003 till June 30, 2008. Main outcome measures were the incidence of ACL reconstructions for Australia, per
Kawakami, Yohei; Takayama, Koji; Matsumoto, Tomoyuki; Tang, Ying; Wang, Bing; Mifune, Yutaka; Cummins, James H; Warth, Ryan J; Kuroda, Ryosuke; Kurosaka, Masahiro; Fu, Freddie H; Huard, Johnny
Strong graft-bone integration is a prerequisite for successful graft remodeling after reconstruction of the anterior cruciate ligament (ACL) using soft tissue grafts. Novel strategies to accelerate soft tissue graft-bone integration are needed to reduce the need for bone-tendon-bone graft harvest, reduce patient convalescence, facilitate rehabilitation, and reduce total recovery time after ACL reconstruction. The application of ACL-derived stem cells with enhanced expression of bone morphogenetic protein 2 (BMP2) onto soft tissue grafts in the form of cell sheets will both accelerate and improve the quality of graft-bone integration after ACL reconstruction in a rat model. Controlled laboratory study. ACL-derived CD34+ cells were isolated from remnant human ACL tissues, virally transduced to express BMP2, and embedded within cell sheets. In a rat model of ACL injury, bilateral single-bundle ACL reconstructions were performed, in which cell sheets were wrapped around tendon autografts before reconstruction. Four groups containing a total of 48 rats (96 knees) were established (n = 12 rats; 24 knees per group): CD34+BMP2 (100%), CD34+BMP2 (25%), CD34+ (untransduced), and a control group containing no cells. Six rats from each group were euthanized 2 and 4 weeks after surgery, and each graft was harvested for immunohistochemical and histological analyses. The remaining 6 rats in each group were euthanized at 4 and 8 weeks to evaluate in situ tensile load to failure in each femur-graft-tibia complex. In vitro, BMP2 transduction promoted the osteogenic differentiation of ACL-derived CD34+ cells while retaining their intrinsic multipotent capabilities. Osteoblast densities were greatest in the BMP2 (100%) and BMP2 (25%) groups. Bone tunnels in the CD34+BMP2 (100%) and CD34+BMP2 (25%) groups had the smallest cross-sectional areas according to micro-computed tomography analyses. Graft-bone integration occurred most rapidly in the CD34+BMP2 (25%) group. Tensile load to
Tanksley, John A; Werner, Brian C; Conte, Evan J; Lustenberger, David P; Burrus, M Tyrrell; Brockmeier, Stephen F; Gwathmey, F Winston; Miller, Mark D
Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement. To compare the potential for intercondylar roof impingement of ACL grafts with anteriorly positioned tibial tunnels after either transtibial (TT) or independent femoral (IF) tunnel drilling. Controlled laboratory study. Twelve fresh-frozen cadaver knees were randomized to either a TT or IF drilling technique. Tibial guide pins were drilled in the anterior third of the native ACL tibial attachment site after debridement. All efforts were made to drill the femoral tunnel anatomically in the center of the attachment site, and the surrogate ACL graft was visualized using 3-dimensional computed tomography. Reformatting was used to evaluate for roof impingement. Tunnel dimensions, knee flexion angles, and intra-articular sagittal graft angles were also measured. The Impingement Review Index (IRI) was used to evaluate for graft impingement. Two grafts (2/6, 33.3%) in the TT group impinged upon the intercondylar roof and demonstrated angular deformity (IRI type 1). No grafts in the IF group impinged, although 2 of 6 (66.7%) IF grafts touched the roof without deformation (IRI type 2). The presence or absence of impingement was not statistically significant. The mean sagittal tibial tunnel guide pin position prior to drilling was 27.6% of the sagittal diameter of the tibia (range, 22%-33.9%). However, computed tomography performed postdrilling detected substantial posterior enlargement in 2 TT specimens. A significant difference in the sagittal graft angle was noted between the 2 groups. TT grafts were
Xu, Yi; Wang, Ting; Kong, Jian; Wang, Hui-Li
Autolysis of nonstarter lactic acid bacteria (NSLAB) was favorable for the development of flavor compounds during cheese manufacture. Among these bacteria, Lb. casei was regarded as the most important microbiota involved in cheese processes. In this study, a novel autolysin named AclB was identified in the genome of Lb. casei BL23 and its modular structure was predicted through bioinformatic approaches. Subsequently, its transcription profile in the exponential phase, hydrolytic activities against cell walls, enzymatic properties under different conditions, physiological function via gene inactivation and upregulation assays, as well as potential applications to NSLAB's autolysis were fully investigated. According to the results, AclB was recognized as a species-specific cell-separating enzyme, responsible for cell separation after cell division in Lb. casei BL23. The purified AclB showed considerable hydrolyzing activities towards cell walls, indicating its enzymatic nature as peptidoglycan hydrolase, or autolysin. The highest activity of AclB was determined at pH5.0 and 37°C, and the expression vector constructed based on AclB was shown to facilitate the controlled lysis of Lb. casei BL23 hosts. In summary, this study provided insight into the enzymatic properties of a novel autolysin involved in cell separation of Lb. casei BL23, which is promising to accelerate cheese ripening and improve cheese quality. Copyright © 2015 Elsevier B.V. All rights reserved.
Drews, Björn Holger; Seitz, Andreas Martin; Huth, Jochen; Bauer, Gerhard; Ignatius, Anita; Dürselen, Lutz
The purpose of this study was to investigate whether an anterior cruciate ligament (ACL) double-bundle reconstruction with one tibial tunnel displays the same in vitro stability as a conventional double-bundle reconstruction with two tibial tunnels when using the same tensioning protocol. In 11 fresh-frozen cadaveric knees, ACL double-bundle reconstruction with one and two tibial tunnels was performed. The two grafts were tightened using 80 N in different flexion angles (anteromedial-bundle at 60° and posterolateral-bundle at 15°). Anterior tibial translation (134 N) and translation with combined rotatory and valgus loads (10 Nm valgus stress and 4 Nm internal tibial torque) were determined at 0°, 30°, 60° and 90° flexion. Measurements were taken in intact ACL, resected ACL, three-tunnel reconstruction and four-tunnel reconstruction. Additionally, the tension on the grafts was determined. Student's t test was performed for statistical analysis of the related samples. Significance was set at p tunnels in different flexion angles achieved comparable restoration of stability, although there was different load sharing on the bundles. With regard to individualized ACL reconstruction, the double-bundle technique with one tibial tunnel offers a possibility to address small tibial insertion sites without compromising the advantages of a double-bundle procedure.
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.
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.
Guess, Trent M; Razu, Swithin
The menisci of the knee reduce tibiofemoral contact pressures and aid in knee lubrication and nourishment. Meniscal injury occurs in half of knees sustaining anterior cruciate ligament injury and the vast majority of tears in the medial meniscus transpire in the posterior horn region. In this study, computational multibody models of the knee were derived from medical images and passive leg motion for two female subjects. The models were validated against experimental measures available in the literature and then used to evaluate medial meniscus contact force and internal hoop tension. The models predicted that the loss of anterior cruciate ligament (ACL) constraint increased contact and hoop forces in the medial menisci by a factor of 4 when a 100N anterior tibial force was applied. Contact forces were concentrated in the posterior horn and hoop forces were also greater in this region. No differences were found in contact or hoop tension between the intact and ACL deficient (ACLd) knees when only a 5Nm external tibial torque was applied about the long axis of the tibia. Combining a 100N anterior tibial force and a 5Nm external tibial torque increased posterior horn contact and hoop forces, even in the intact knee. The results of this study show that the posterior horn region of the medial meniscus experiences higher contact forces and hoop tension, making this region more susceptible to injury, especially with the loss of anterior tibia motion constraint provided by the ACL. The contribution of the dMCL in constraining posterior medial meniscus motion, at the cost of higher posterior horn hoop tension, is also demonstrated. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
Buescu, Cristian Tudor; Onutu, Adela Hilda; Lucaciu, Dan Osvald; Todor, Adrian
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.
Kostogiannis, Ioannis; Swärd, Per; Neuman, Paul; Fridén, Thomas; Roos, Harald
To explore the effect of different posterior-inferior tibial slope (PITS) angles on ACL injury at non-contact sports, knee laxity and the need for ACL reconstruction. One hundred patients with an acute, arthroscopically verified total ACL rupture were followed prospectively with the intention of treating the injury without reconstruction. Knee laxity was assessed with the Lachman and pivot shift tests with the patients under general anesthesia within 10 days of injury. After 15 years, 22 patients of 94 available for follow-up had undergone reconstruction a mean of 4 years after injury. Reconstruction was performed in case of repeated giving-way episodes (n = 16) or meniscus lesions suitable for fixation (n = 6). Knee radiographs were available from 82 patients. Two independent readers determined the PITS angle. Patients injured in contact sports had a greater mean PITS angle than those injured in non-contact sports (10.5° and 9.3°, respectively, P = 0.03). The mean PITS angle was 10.1 (SD = 2.3) for non-reconstructed knees and 9.1 (SD = 3.0) for reconstructed knees (P = NS). Eight of 17 reconstructed knees showed a PITS angle of less than 7.6° (P = 0.006), and the odds ratio of need for reconstruction was 3.9 (CI 1.26-12.3, P = 0.02). No significant difference in PITS angle was found between patients with low- and high-grade instability. The main finding of the study was that reconstructed knees were overrepresented in knees with extremely low PITS angles. Additionally, patients injured in contact sports had higher PITS angles than those injured in non-contact sports, and PITS angle did not influence knee laxity.
Laborie, M; Klouche, S; Herman, S; Gerometta, A; Lefevre, N; Bohu, Y
Kinesio-Taping(®) (K-Tape) is used in sports traumatology with the aim of reducing pain and improving blood and lymph circulation. The main objective of the present study was to assess the efficacy of K-Tape on early postoperative pain after anterior cruciate ligament (ACL) reconstruction. The study hypothesis was that K-Tape significantly decreases pain. A prospective non-randomized comparative study was conducted in 2013-2014 and included all patients who underwent primary ACL reconstruction by hamstring graft. Analgesia was standardized. Two groups, "K-Tape" and "controls", were formed according to the days on which the study physiotherapist was present. The K-Tape compression/decompression assembly was applied immediately postoperatively and maintained for 3days. Patients filled out online questionnaires. The main assessment criterion was mean postoperative pain (D0-D3) on a 0-to-10 scale. Secondary criteria were analgesia intake on the three WHO levels, awakening during the night of D0 due to pain, signs of postoperative discomfort, and patient satisfaction. Sixty patients (30 per group) were included, 57 of whom could be assessed: 28 K-Tape, 29 controls; 44 male, 13 female; mean age, 30.9±8.9 years. At inclusion, the two groups were comparable. There was no significant difference in mean (D0-D3) knee pain intensity: 3.8±2.2 for K-Tape, and 3.9±2 for controls (P=0.93). Analysis of variance (ANOVA) found no significant intergroup difference in evolution of pain (P=0.34). There were no other significant differences on the other assessment criteria. K-Tape showed no efficacy on early postoperative pain following ACL reconstruction. III; prospective non-randomized comparative study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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
Background 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. Purpose/Hypothesis 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. Study Design Cohort study; Level of evidence, 3. Methods 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. Results 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 rehabilitation consisting of progressive strengthening and neuromuscular training, followed by a criterion
Smolinski, P; O'Farrell, M; Bell, K; Gilbertson, L; Fu, F H
This study examined the change in femoral stress caused by graft tunnels drilled for anterior cruciate ligament (ACL) reconstruction. Using a computational model, the number, geometry and position of the graft tunnels exits were varied to determine the effect on bone stress. A finite element model of the distal femur was developed from a CT scan of a cadaveric knee. To assess the model, the strain calculated computationally was compared to experimentally measured strains in eleven unpaired human cadaver femurs. Using the computational model, the number, geometry and position of the graft tunnel exits were varied to determine the effect on bone stress based on the stress concentration factor: the ratio of bone stress with tunnels to intact bone stress. The results indicated that the second tunnel in double-bundle ACL reconstruction results in approximately a 20 % increase in the maximum femoral stress as compared to single-bundle reconstruction. The highest stresses occur at the tunnel exits. The position of the tunnel exits effects femoral stress with the stress increasing slightly (AM SCR from 0.7 to 1 and PL SCR from 1.2 to 1.3) when the AM tunnel exit is moved anteriorly and having greater increases as the posterior lateral (PL) tunnel exit is moved laterally (PL SCR from 1.2 to 1.7) or posteriorly (PL SCR from 1.2 to 2). In anatomical ACL reconstruction, the tunnel entrances are dictated by anatomy; however, there can be variations in tunnel exit positions. Consideration should be given when positioning tunnel exits on the effect on stress in the femur. Moving the PL tunnel exit laterally or posteriorly increases in the stress at the PL tunnel exit.
Stuart K Kim
Full Text Available Achilles tendinopathy or rupture and anterior cruciate ligament (ACL rupture are substantial injuries affecting athletes, associated with delayed recovery or inability to return to competition. To identify genetic markers that might be used to predict risk for these injuries, we performed genome-wide association screens for these injuries using data from the Genetic Epidemiology Research on Adult Health and Aging (GERA cohort consisting of 102,979 individuals. We did not find any single nucleotide polymorphisms (SNPs associated with either of these injuries with a p-value that was genome-wide significant (p<5x10-8. We found, however, four and three polymorphisms with p-values that were borderline significant (p<10-6 for Achilles tendon injury and ACL rupture, respectively. We then tested SNPs previously reported to be associated with either Achilles tendon injury or ACL rupture. None showed an association in our cohort with a false discovery rate of less than 5%. We obtained, however, moderate to weak evidence for replication in one case; specifically, rs4919510 in MIR608 had a p-value of 5.1x10-3 for association with Achilles tendon injury, corresponding to a 7% chance of false replication. Finally, we tested 2855 SNPs in 90 candidate genes for musculoskeletal injury, but did not find any that showed a significant association below a false discovery rate of 5%. We provide data containing summary statistics for the entire genome, which will be useful for future genetic studies on these injuries.
Aburto, José Manuel; Wensink, Maarten Jan; Lindahl-Jacobsen, Rune
cancers and non-infectious respiratory diseases, offsetting continuous improvement in cardiovascular mortality. Before and after stagnation, life expectancy increased as disparity decreased, as the cardiovascular revolution unfolded. Comparing Denmark and its Scandinavian counterparts, we find...
Demiray, Reviewed By Prof. Dr. Ugur
Prior to year 2000 Scandinavian universities offered selected online courses attracting a few pioneering students. Today, even primary schools offer online services to students, teachers and parents. Online education is becoming mainstream education in Scandinavia.
Marília S. Andrade
Full Text Available Objectives: To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method: Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time at three different workloads (moderate, anaerobic threshold, and maximal. Results: There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm and uninvolved (220.8±40.4 Nm limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively. Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively. No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions: Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and
Grindem, Hege; Eitzen, Ingrid; Engebretsen, Lars; Snyder-Mackler, Lynn; Risberg, May Arna
Background: While there are many opinions about the expected knee function, sports participation, and risk of knee reinjury following nonsurgical treatment of injuries of the anterior cruciate ligament (ACL), there is a lack of knowledge about the clinical course following nonsurgical treatment compared with that after surgical treatment. Methods: This prospective cohort study included 143 patients with an ACL injury. Isokinetic knee extension and flexion strength and patient-reported knee function as recorded on the International Knee Documentation Committee (IKDC) 2000 form were collected at baseline, six weeks, and two years. Sports participation was reported monthly for two years with use of an online activity survey. Knee reinjuries were reported at the follow-up evaluations and in a monthly online survey. Repeated analysis of variance (ANOVA), generalized estimating equation (GEE) models, and Cox regression analysis were used to analyze group differences in functional outcomes, sports participation, and knee reinjuries, respectively. Results: The surgically treated patients (n = 100) were significantly younger, more likely to participate in level-I sports, and less likely to participate in level-II sports prior to injury than the nonsurgically treated patients (n = 43). There were no significant group-by-time effects on functional outcome. The crude analysis showed that surgically treated patients were more likely to sustain a knee reinjury and to participate in level-I sports in the second year of the follow-up period. After propensity score adjustment, these differences were nonsignificant; however, the nonsurgically treated patients were significantly more likely to participate in level-II sports during the first year of the follow-up period and in level-III sports over the two years. After two years, 30% of all patients had an extensor strength deficit, 31% had a flexor strength deficit, 20% had patient-reported knee function below the normal range, and
Redler, Lauren H; Watling, Jonathan P; Dennis, Elizabeth R; Swart, Eric; Ahmad, Christopher S
There is an epidemic of anterior cruciate ligament (ACL) injuries in youth athletes. Poor neuromuscular control is an easily modifiable risk factor for ACL injury, and can be screened for by observing dynamic knee valgus on landing in a drop vertical jump test. This study aims to validate a simple, clinically useful population-based screening test to identify at-risk athletes prior to participation in organized sports. We hypothesized that both physicians and allied health professionals would be accurate in subjectively assessing injury risk in real-time field and office conditions without motion analysis data and would be in agreement with each other. We evaluated the inter-rater reliability of risk assessment by various observer groups, including physicians and allied health professionals, commonly involved in the care of youth athletes. Fifteen athletes age 11-17 were filmed performing a drop vertical jump test. These videos were viewed by 242 observers including orthopaedic surgeons, orthopaedic residents/fellows, coaches, athletic trainers (ATCs), and physical therapists (PTs), with the observer asked to subjectively estimate the risk level of each jumper. Objective injury risk was calculated using normalized knee separation distance (measured using Dartfish, Alpharetta, GA), based on previously published studies. Risk assessments by observers were compared to each other to determine inter-rater reliability, and to the objectively calculated risk level to determine sensitivity and specificity. Seventy one observers repeated the test at a minimum of 6 weeks later to determine intra-rater reliability. Between groups, the inter-rater reliability was high, κ = 0.92 (95% CI 0.829-0.969, p vertical jump screening test to identify athletes at risk for ACL injury. Our study shows good inter- and intra-rater reliability and high sensitivity and suggests that screening can be performed without significant training by physicians as well as allied health professionals
Uldall, P; Michelsen, Susan Ishøy; Topp, M
Cerebral palsy (CP) is the commonest disabling impairment in childhood, with a prevalence of 2-3 per 1000 live births. The Danish Cerebral Palsy Registry is a research registry that contains cases of CP from birth year 1925 and has estimated the birth prevalence since 1950. Data on children with ...
Sernadela, Pedro; González-Castro, Lorena; Carta, Claudio; van der Horst, Eelke; Lopes, Pedro; Kaliyaperumal, Rajaram; Thompson, Mark; Thompson, Rachel; Queralt-Rosinach, Núria; Lopez, Estrella; Wood, Libby; Robertson, Agata; Lamanna, Claudia; Gilling, Mette; Orth, Michael; Merino-Martinez, Roxana; Posada, Manuel; Taruscio, Domenica; Lochmüller, Hanns; Robinson, Peter; Roos, Marco; Oliveira, José Luís
Patient registries are an essential tool to increase current knowledge regarding rare diseases. Understanding these data is a vital step to improve patient treatments and to create the most adequate tools for personalized medicine. However, the growing number of disease-specific patient registries brings also new technical challenges. Usually, these systems are developed as closed data silos, with independent formats and models, lacking comprehensive mechanisms to enable data sharing. To tackle these challenges, we developed a Semantic Web based solution that allows connecting distributed and heterogeneous registries, enabling the federation of knowledge between multiple independent environments. This semantic layer creates a holistic view over a set of anonymised registries, supporting semantic data representation, integrated access, and querying. The implemented system gave us the opportunity to answer challenging questions across disperse rare disease patient registries. The interconnection between those registries using Semantic Web technologies benefits our final solution in a way that we can query single or multiple instances according to our needs. The outcome is a unique semantic layer, connecting miscellaneous registries and delivering a lightweight holistic perspective over the wealth of knowledge stemming from linked rare disease patient registries.
Reppe, Linda Amundstuen; Spigset, Olav; Kampmann, Jens Peter
for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts). In addition, linguistic aspects of the responses were evaluated by a plain language expert. RESULTS: The quality......PURPOSE: The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). METHODS: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded...... of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some...
Als, Thomas D; Jorgensen, Tove H; Børglum, Anders D
Isles ancestry. In the present study we used 122 new and 19 previously published hypervariable region I sequences of the mitochondrial control region to analyse the genetic diversity of the Faroese population and compare it with other populations in the North Atlantic region. The analyses suggested......The Faroe Islands in the North Atlantic Ocean are inhabited by a small population, whose origin is thought to date back to the Viking Age. Historical, archaeological and linguistic evidence indicates that the present population of the Faroe Islands may have a mixture of Scandinavian and British...... the female settlers of the Faroe Islands. Compared to other admixed populations of the North Atlantic region, the population of the Faroe Islands appears to have the highest level of asymmetry in Scandinavian vs British Isles ancestry proportions among female and male settlers of the archipelago....
Jakobsen, K D; Hansen, T; Djurovic, S
Map-selected tagging SNPs across GRIK3 in three independent samples of Scandinavian origin from the Scandinavian Collaboration of Psychiatric Etiology (SCOPE), including a total of 839 cases with schizophrenia spectrum and 1473 healthy controls. Four markers (rs6671364, rs17461259, rs472188, and rs535620) attained......There is considerable evidence of altered glutamatergic signalling in schizophrenia and a polymorphic variant of the GRIK3 glutamate receptor gene on 1p34-33 has previously been associated to this psychotic disorder. We therefore conducted a systematic association study with 30 Hap...... and rs535620) to scores for negative symptoms on the PANSS scale. The present results, although not robust, support the importance of more extensive investigations of GRIK3, given its potential role in mediating risk for schizophrenia....
The purpose of this study was to introduce a combination of the two most adopted multi- stakeholder standards for sustainability reporting as an alternate framework for assessing sustainability performance in Scandinavian corporations. This novel approach leverages numeric measures on the criteria...... Strategies & Policies, Management Systems, Monitoring and Evaluation Mechanisms and Key Outcomes on sustainability defined broadly as the Human Rights, Labour, Environment and Anti-Corruption issues by the UN Global Compact. The study firmly concludes that Scandinavian corporations on average...
Ferm, Cecilia; Zandén, Olle; Vinge, John; Nyberg, Johan; Andersson, Ninnie; Väkevä, Lauri
Assessment as learning in music education - the risk of ‘criteria compliance’ replacing ’learning’ in the Scandinavian countriesRecent reforms in England and USA give evidence that teaching methods and content can change rapidly, given a strong external pressure, for example through economic incentives, inspections, school choice and public display of schools’ and pupils’ performances. Educational activities in the Scandinavian countries have increasingly become dominated by obligations regar...
Heskestad, Ben; Waterloo, Knut; Ingebrigtsen, Tor
The Scandinavian guidelines for management of minimal, mild and moderate head injuries were developed to provide safe and cost effective assessment of head injured patients. In a previous study conducted one year after publication and implementation of the guidelines (2003), we showed low complia...... compliance, involving over-triage with computed tomography (CT) and hospital admissions. The aim of the present study was to investigate guideline compliance after an educational intervention....
Flagstad, Ø; Walker, C W; Vilà, C; Sundqvist, A-K; Fernholm, B; Hufthammer, A K; Wiig, Ø; Koyola, I; Ellegren, H
The grey wolf (Canis lupus) was numerous on the Scandinavian peninsula in the early 19th century. However, as a result of intense persecution, the population declined dramatically and was virtually extinct from the peninsula by the 1960s. We examined historical patterns of genetic variability throughout the period of decline, from 1829 to 1979. Contemporary Finnish wolves, considered to be representative of a large eastern wolf population, were used for comparison. Mitochondrial DNA (mtDNA) variability among historical Scandinavian wolves was significantly lower than in Finland while Y chromosome variability was comparable between the two populations. This may suggest that long-distance migration from the east has been male-biased. Importantly though, as the historical population was significantly differentiated from contemporary Finnish wolves, the overall immigration rate to the Scandinavian peninsula appears to have been low. Levels of variability at autosomal microsatellite loci were high by the early 1800s but declined considerably towards the mid-20th century. At this time, approximately 40% of the allelic diversity and 30% of the heterozygosity had been lost. After 1940, however, there is evidence of several immigration events, coinciding with episodes of marked population increase in Russian Karelia and subsequent westwards migration.
Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B
, 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...
Brekke, Anders Falk
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......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...... 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...
Dacombe, Peter Jonathan; Robinson, James
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.
... your surgery. You may have to wear a knee brace for the first 1 to 4 weeks. You also may need crutches for 1 to 4 weeks. Most people are allowed to move their knee right after surgery. This may help prevent stiffness. ...
A. H. Manson
Full Text Available The "Scandinavian Triangle" is a unique trio of radars within the DATAR Project (Dynamics and Temperatures from the Arctic MLT (60–97km region: Andenes MF radar (69°N, 16°E; Tromsø MF radar (70°N, 19°E and Esrange "Meteor" radar (68°N, 21°E. The radar-spacings range from 125-270km, making it unique for studies of wind variability associated with small-scale waves, comparisons of large-scale waves measured over small spacings, and for comparisons of winds from different radar systems. As such it complements results from arrays having spacings of 25km and 500km that have been located near Saskatoon. Correlation analysis is used to demonstrate a speed bias (MF smaller than the Meteor between the radar types, which varies with season and altitude. Annual climatologies for the year 2000 of mean winds, solar tides, planetary and gravity waves are presented, and show indications of significant spatial variability across the Triangle and of differences in wave characteristics from middle latitudes.
Key words: Meteorology and atmospheric dynamics (middle atmosphere dynamics; waves and tides: instrument and techniques
A. H. Manson
Full Text Available The "Scandinavian Triangle" is a unique trio of radars within the DATAR Project (Dynamics and Temperatures from the Arctic MLT (60–97km region: Andenes MF radar (69°N, 16°E; Tromsø MF radar (70°N, 19°E and Esrange "Meteor" radar (68°N, 21°E. The radar-spacings range from 125-270km, making it unique for studies of wind variability associated with small-scale waves, comparisons of large-scale waves measured over small spacings, and for comparisons of winds from different radar systems. As such it complements results from arrays having spacings of 25km and 500km that have been located near Saskatoon. Correlation analysis is used to demonstrate a speed bias (MF smaller than the Meteor between the radar types, which varies with season and altitude. Annual climatologies for the year 2000 of mean winds, solar tides, planetary and gravity waves are presented, and show indications of significant spatial variability across the Triangle and of differences in wave characteristics from middle latitudes. Key words: Meteorology and atmospheric dynamics (middle atmosphere dynamics; waves and tides: instrument and techniques
Manson, A.; Meek, C.; Hall, C.; Nozawa, S.; Mitchell, N.; Pancheva, D.; Singer, W.; Hoffmann, P.
. The ``Scandinavian Triangle" is a unique trio of radars within the DATAR Project (Dynamics and Temperatures from the Arctic MLT (60-97km) region): Andenes MF radar (N, E); Tromsø MF radar (N, E) and Esrange ``Meteor" radar (N, E). The radar-spacings range from 125-270km, making it unique for studies of wind variability associated with small-scale waves, comparisons of large-scale waves measured over small spacings, and for comparisons of winds from different radar systems. As such it complements results from arrays having spacings of 25km and 500km that have been located near Saskatoon. Correlation analysis is used to demonstrate a speed bias (MF smaller than the Meteor) between the radar types, which varies with season and altitude. Annual climatologies for the year 2000 of mean winds, solar tides, planetary and gravity waves are presented, and show indications of significant spatial variability across the Triangle and of differences in wave characteristics from middle latitudes.
Александр Евгеньевич Маньков
Full Text Available This paper initiates a series of publications on the morphology of the dialect of Staroshvedskoye (Sw. Gammalsvenskby, which is the only surviving Scandinavian dialect on the territory of the former Soviet Union. The village of Staroshvedskoye is located in the Kherson region, Ukraine. Its Swedish dialect historically belongs to the group of Swedish dialects of Estonia and goes back to the dialect of the island of Dagö (Hiiumaa. The dialect of Gammalsvenskby is of interest to slavists as an example of a language island in the Slavonic environment. From around the 1950s, the main spoken language of all village residents, including dialect speakers, has been surzhik. Due to the complete lack of studies of the present-day dialect and because of the severe endangerment in which the dialect is currently situated, the most urgent task is to collect, classify and publish the factual material. This paper introduces comprehensive material on nouns in the conservative variety of the present-day dialect. It lists all masculine nouns of type 1a together with their cognates from Estonian Swedish dialects; comments on the history of the forms are given as well. The sources for the material presented here are interviews with speakers of the conservative variety of the dialect recorded by the author during fieldwork in the village from 2004 to 2012. We plan to publish nouns of other types in later articles.
Alexander E. Mankov
Full Text Available This paper continues the series of publications on the morphology of the dialect of Staroshvedskoye (Sw. Gammalsvenskby, which is the only surviving Scandinavian dialect in the territory of the former Soviet Union. The village of Staroshvedskoye is located in the Kherson region, Ukraine. Its Swedish dialect historically belongs to the group of Swedish dialects of Estonia and goes back to the dialect of the island of Dagö (Hiiumaa. The dialect of Gammalsvenskby is of interest to slavists as an example of a language island in the Slavonic environment. From around the 1950s, the main spoken language of all village residents, including dialect speakers, has been surzhik. Due to the complete lack of studies of the present-day dialect and because of the severe endangerment in which the dialect is currently situated, the most urgent task is to collect, classify, and publish the factual material. This paper introduces comprehensive material on nouns in the conservative variety of the present-day dialect. It lists all masculine nouns of types 1b, c, d, and e together with their cognates from Estonian Swedish dialects; comments on the history of the forms are given as well. The sources for the material presented here are interviews with speakers of the conservative variety of the dialect recorded by the author during ﬁeldwork in the village from 2004 to 2013. We plan to publish nouns of other types in later articles.
Muschitiello, F.; Pausata, F. S. R.; Wohlfarth, B.
Volcanic aerosols play a key role on Earth's climate driving a variety of feedbacks that can potentially affect the mass balance of modern ice sheets. Yet, empirical evidence that highlights the sensitivity of ancient ice sheets to volcanic forcing and the related feedbacks is still missing. Here we present a new annual and continuous glacial clay-varve chronology recording the melting history of the Scandinavian Ice Sheet during the end of the last deglaciation ( 13,200-12,000 years BP). By precisely synchronizing the chronology to the Greenland ice-core time scale, we document a correspondence between anomalous melt events in our varve record and volcanic aerosol emissions as registered in ice cores. Climate model simulations identify a positive feedback between volcanism and summer cloud cover over the North Atlantic. We thus suggest that ice sheet melting could have been enhanced by cloud radiative effects and variations in snow albedo owing to direct ash deposition. The sensitivity of past ice sheets to volcanic aerosols highlights the need for an accurate coupling between atmosphere and ice sheet components in climate model. These results have also important implications with respect to the tremendous amount of meltwater trapped by retreating ice sheets and their pivotal role in the rapid climate shifts of the past.
Stroeven, Arjen P.; Heyman, Jakob; Fabel, Derek; Björck, Svante; Caffee, Marc W.; Fredin, Ola; Harbor, Jonathan M.
An important constraint on the reliability of cosmogenic nuclide exposure dating is the derivation of tightly controlled production rates. We present a new dataset for 10Be production rate calibration from Mount Billingen, southern Sweden, the site of the final drainage of the Baltic Ice Lake, an event dated to 11,620 ± 100 cal yr BP. Nine samples of flood-scoured bedrock surfaces and depositional boulders and cobbles unambiguously connected to the drainage event yield a reference 10Be production rate of 4.09 ± 0.22 atoms g-1 yr-1 for the CRONUS Lm scaling and 3.93 ± 0.21 atoms g-1 yr-1 for the LSD general spallation scaling. We also recalibrate the reference 10Be production rates for four sites in Norway and combine these with the Billingen results to derive a tightly clustered Scandinavian reference 10Be production rate of 4.12 ± 0.10 (4.12 ± 0.25 for altitude scaling) atoms g-1 yr-1 for the Lm scaling scheme and 3.96 ± 0.10 (3.96 ± 0.24 for altitude scaling) atoms g-1 yr-1 for the LSD scaling scheme.
Moen, Inger E; Nilsson, Kristina; Andersson, Anna; Fagerland, Morten W; Fluge, Gjermund; Hollsing, Annika; Gilljam, Marita; Mared, Lena; Pressler, Tacjana; Santi, Henriette; Storrøsten, Olav-Trond; Hjelte, Lena
Malnutrition is a well-known complication in cystic fibrosis (CF). There is good evidence that maintaining a normal body-weight correlates well with improved survival in CF. Energy intake in excess of 120% of the estimated average requirement (EAR) has been advised since 1980s. To investigate the nutritional intake and status in the adult Scandinavian CF-population. A cross-sectional multi-centre study was used to investigate the nutritional status of 456 adult CF-patients (2003 2006). Height and weight were measured and body mass index (BMI) and z-scores were calculated. Pulmonary function was examined by dynamic spirometry. A 7-day pre-coded food record (FR) obtained energy and nutrient intake data in 180 patients. The mean energy intake was 114 (SD 30.0)% of EAR and thus significantly lower than the target of 120% EAR (pnutritional status must still be closely monitored and nutritional advice and intervention should be individualised and adjusted to actual needs.
Pedoia, V; Lansdown, D A; Zaid, M; McCulloch, C E; Souza, R; Ma, C B; Li, X
The aim of this study is to develop a novel 3D magnetic resonance imaging (MRI)-based Statistical Shape Modeling (SSM) and apply it in knee MRIs in order to extract and compare relevant shapes of the tibia and femur in patients with and without acute Anterior cruciate ligament (ACL) injuries. Bilateral MR images were acquired and analyzed for 50 patients with acute ACL injuries and for 19 control subjects. A shape model was extracted for the tibia and femur using an SSM algorithm based on a set of matched landmarks that are computed in a fully automatic manner. Shape differences were detected between the knees in the ACL-injury group and control group, suggesting a common shape feature that may predispose these knees to injury. Some of the detected shape features that discriminate between injured and control knees are related to intercondylar width and posterior tibia slope, features that have been suggested in previous studies as ACL morphological risk factors. However, shape modeling has the great potential to quantify these characteristics with a comprehensive description of the surfaces describing complex 3D deformation that cannot be represented with simple geometric indexes. 3D MRI-based bone shape quantification has the ability to identify specific anatomic risk factors for ACL injury. A better understanding of the role in bony shape on ligamentous injuries could help in the identification of subjects with an increased risk for an ACL tear and to develop targeted prevention strategies, including education and training. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
McDonald, Lucas S; Boorman-Padgett, James; Kent, Robert; Stone, Kyle; Wickiewicz, Thomas L; Pearle, Andrew D; Imhauser, Carl W
The articular surfaces and menisci act with the anterior cruciate ligament (ACL) to stabilize the knee joint. Their role in resisting applied rotatory loads characteristic of instability events is unclear despite commonly observed damage to these intra-articular structures in the acute and chronic ACL injury settings. Ten fresh-frozen human cadaveric knees were mounted to a robotic manipulator. Combined valgus and internal rotation torques were applied in the presence and absence of a 300-N compressive load. Forces carried by the individual menisci and via cartilage-to-cartilage contact on each femoral condyle in ACL-intact and ACL-sectioned states were measured using the principle of superposition. In response to applied valgus and internal rotation torques in the absence of compression, sectioning of the ACL increased the net force carried by the lateral meniscus by at most 65.8 N (p meniscus increased by 25.7 N (p medial femoral condyle by at most 38.9 N (p = 0.006) and 46.7 N (p = 0.040) in the absence and presence of compression, respectively. Additionally, the lateral shear force carried by cartilage-to-cartilage contact on the medial femoral condyle increased by at most 21.0 N (p = 0.005) and by 28.0 N (p = 0.025) in the absence and presence of compression, respectively. Forces carried by the medial meniscus and by cartilage-to-cartilage contact on the lateral femoral condyle changed by meniscus and medial femoral condyle-and the anterior shear and lateral shear forces, respectively-in response to multiplanar valgus and internal rotation torque. These loading patterns provide a biomechanical rationale for clinical patterns of intra-articular derangement such as lateral meniscal injury and osseous remodeling of the medial compartment seen with ACL insufficiency. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.
Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Wojtys, Edward [University of Michigan, Department of Orthopaedic Surgery, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States); University of Michigan Sports Medicine Program, Department of MedSport, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States)
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.)
A. V. Rybin
Full Text Available Purpose of the study – search for morphological cause of failure for free tendon auto and allografts after ACL reconstruction of the knee joint in early postoperative period during in vivo experiment. Materials and methods. Experiment included two groups of rabbits, each group consisting of 9 animals. In the first group the authors performed ACL autografting by semitendinous tendon harvested from operated limb. In the second group, ACL allografting was made by foot flexor tendon harvested earlier in rabbits excluded from present or other experiments after pretreatment and sterilization in modified Belyakov’s medium. Results. The major cause for failure of ACL tendon grafts after reconstruction in early postoperative period is the necrosis of intraarticular portion of auto or allograft on the 15th day after the procedure. In case of overexposure of the graft in early period the authors observed rupture along intraarticular portion or - more probable - along the demarcation area (serrated line rather than graft slipping from bone tunnel with slackening. Intra-tunnel graft portion during first several days after the procedure became surrounded by granulated tissue in contrast to intraarticular portion that remained bare of such support. Conclusion. Comparative experimental and morphological study of two options of ACL reconstruction demonstrated a uniformity of alterations in dynamics with a certain delay in development of compensatory and adaptive processes after allografting. Necrosis (or homogenization of intraarticular portion of auto or allograft is the cause for potential failure of ACL reconstruction in case of an extremely early and unjustified active rehabilitation.