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Introduction: This study identifies the patient population that may benefit from interprofessional collaboration in the support of patients with cerebrovascular diseases. Method: This study involved 170 patients who received treatment in Japan's recovery rehabilitation wards in December 2019–June 2020. Participants were categorized into three groups based on their functional independence measure (FIM) scores at admission, distinguishing between complete dependence, modified dependence, and independence groups. They were classified into the group with higher collaborative practice (HCP) and the group with lower collaborative practice (LCP) based on the median value of the therapist collaborative practice scale (TCPS). The primary outcomes measured were FIM efficiency and FIM effectiveness. The main effects and interactions of the level of independence with activities of daily living (ADL) and collaboration were examined using a two-way analysis of variance and Bonferroni multiple comparison tests. Results: The level of independence with ADL and collaboration had an interaction effect related to FIM effectiveness (F (2, 164) = 3.191, p = 0.044). Within the independence group, HCP and LCP differed significantly (F (1, 164) = 15.562, p < 0.001). Conclusion: Interprofessional collaboration may improve ADL in patients with high ADL independence at admission. Furthermore, the interprofessional collaboration quality impacted patients' ADL improvement. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

We investigated whether expression of social meaning operationalized as individual gender identitity and politeness moderated pitch range in the two languages of female and male Japanese-English sequential bilinguals. The bilinguals were resident in either London (UK) or Tokyo (Japan) and read sentences to imagined addressees who varied in formality and sex. Results indicated significant differences in the pitch range of the two languages of the bilinguals, and this was confirmed for female and male bilinguals in London and Tokyo, with the language differences being more extreme in the London bilinguals than in the Tokyo bilinguals. Interestingly, self-attribution of masculine gender traits patterned with within-language variation in the English pitch level of the female bilinguals, whereas self-attribution of feminine gender traits patterned with within-language variation in the English pitch level of the male bilinguals. In addition, female and male bilinguals significantly varied their pitch range in Japanese, but not in English, as a function of the imagined addressees. Findings confirmed that bilinguals produce pitch range differently in their languages and suggest that expression of social meaning may affect pitch range of the two languages of female and male bilinguals differently. [ABSTRACT FROM AUTHOR]

Perceptual epenthesis is the perception of illusory vowels in consonantal sequences that violate native phonotactics. The consensus has been that each language has a single, predictable candidate for perceptual epenthesis, that vowel which is most minimal (i.e., shortest and/or quietest). However, recent studies have shown that alternate epenthetic vowels can be perceived when the perceptual epenthesis of the minimal vowel would violate native co-occurrence restrictions. We propose a potential explanation for these observed patterns: speech perception, and thus also vowel perceptual epenthesis, is modulated by transitional probability whereby epenthetic vowels must conform to the language specific expectations of the listener. To test this explanation, we present two experiments examining perceptual epenthesis of two Japanese vowels—/u/ and /i/—against their transitional probability in CV sequences. In Experiment 1, Japanese listeners assigned VCCV tokens to VCuCV and VCiCV categories. In Experiment 2, participants discriminated VCCV tokens from VCuCV and VCiCV tokens. The results show that sequences where /i/ is transitionally probable are more likely to elicit /i/ perceptual epenthesis. [ABSTRACT FROM AUTHOR]

This study examines the perception of Mandarin lexical tones by native speakers of Burmese who use lexical tones in their first language (L1) but are naïve to Mandarin. Unlike Mandarin tones, which are primarily cued by pitch, Burmese tones are cued by phonation type as well as pitch. The question of interest is whether Burmese listeners can utilize their L1 experience in processing unfamiliar Mandarin tones. Burmese listeners' discrimination accuracy was compared with that of Mandarin listeners and Australian English listeners. The Australian English group was included as a control group with a non-tonal background. Accuracy of perception of six tone pairs (T1-T2, T1-T3, T1-T4, T2-T3, T2-T4, T3-T4) was assessed in a discrimination test. Our main findings are 1) Mandarin listeners were more accurate than non-native listeners in discriminating all tone pairs, 2) Australian English listeners naïve to Mandarin were more accurate than similarly naïve Burmese listeners in discriminating all tone pairs except for T2-T4, and 3) Burmese listeners had the greatest trouble discriminating T2-T3 and T1-T2. Taken together, the results suggest that merely possessing lexical tones in L1 may not necessarily facilitate the perception of non-native tones, and that the active use of phonation type in encoding L1 tones may have played a role in Burmese listeners' less than optimal perception of Mandarin tones. [ABSTRACT FROM AUTHOR]

Research in Western countries has indicated that the cognitive distortions of sexual offenders play an etiological and maintenance role in offending. The present study examines whether the cognitive distortions hypothesized by previous Western studies can be found in Japanese sexual offenders against women. This study used the questionnaire administered by probation officers in the special cognitive-behavioral treatment programs for sexual offenders, which have been implemented since 2006 in Japan. Participants in the offender group were 80 Japanese male probationers and parolees (more than 19 years old, M age = 34.6, SD = 8.8) convicted of rape (n = 39) or indecent assault (n = 41). All of them attended special treatment programs at probation offices. The non-offender comparison group consisted of 95 Japanese male probation officers and police officers (M age = 35.5, SD = 11.4). A factor analysis of the questionnaire responses extracted three factors: Blaming the Victim, Minimization, and Avoidance of Responsibility. The data analyses showed that sexual offenders scored significantly higher than non-offender participants on the three subscales. No significant differences were found among four sexual offender groups classified as rapists or indecent assaulters and with or without previous convictions for sexual offenses. In conclusion, the results of this study indicate that rapists and indecent assaulters placed on probation or parole in Japan hold cognitive distortions concerning sexual assaults against women than the control group of probation and police officers. The findings of this study also suggest that cognitive distortions exhibited by sexual offenders against women transcend cultural divides. [ABSTRACT FROM AUTHOR]

Statement of context: A new grip part for the long cane used by visually impaired children was developed and the effect of this grip, using the muscle activity of the upper limbs, investigated. Critical reflection on practice: When using a long cane with this newly designed grip, the upper limb manipulating the cane showed less muscle activity than when using the conventional grip part. Implications for practice: Since long canes with the new grips require less muscle activity in their operation, they are popular, making it possible to encourage their use from the lower grade of elementary school. [ABSTRACT FROM AUTHOR]

Although self-efficacy has been used extensively in the field of nursing (e.g., as an outcome measure of nursing interventions), its underlying nature is poorly understood. Investigation of the relationship between self-efficacy and brain activation will help explain the fundamental nature of self-efficacy. In this study, we compared prefrontal activation measured with near-infrared spectroscopy (NIRS) across 89 undergraduate students categorized into three groups based on their General Self-Efficacy Scale scores: low self-efficacy (n = 59), moderate self-efficacy (n = 17), and high self-efficacy (n = 13). Changes in the hemoglobin levels of the prefrontal cortex (PFC) during a verbal fluency task were assessed using two-channel NIRS. Significant differences in the oxygenated hemoglobin (oxy-Hb) level of the left PFC (LPFC) were observed via analysis of variance. Post hoc Tukey’s test showed a significant difference only between low self-efficacy and moderate self-efficacy groups. We found a medium between-group effect size in the moderate self-efficacy group versus the low self-efficacy group for the changes in oxy-Hb levels of the LPFC (d = .78; 95% confidence interval for effect size [0.22, 1.33]). No significant between-group differences were observed with respect to changes in the oxy-Hb in the right PFC. The results indicate less left prefrontal activation in the low self-efficacy group than in the moderate self-efficacy group. These findings provide evidence to support the fundamental nature of self-efficacy. [ABSTRACT FROM AUTHOR]

Background: Vascular CD34+ cells in anterior cruciate ligament (ACL) tissue have the potential for high proliferation and multilineage differentiation that can accelerate tendon-bone healing. While patient characteristics, such as age, can affect tendon-bone healing, the influence of elapsed time after injury on the healing process is unclear. Hypothesis: Cells obtained during the early phase after injury will exhibit a greater tendon-bone healing potential compared with chronic phase counterparts when applied to an immunodeficient rat model of ACL reconstruction. Study Design: Controlled laboratory study. Methods: Adult human ACL-ruptured tissue was harvested from patients undergoing arthroscopic primary ACL reconstruction and classified into 2 groups based on the time elapsed between injury and surgery: (1) early group (≤3 months from injury) and (2) chronic group (>3 months from injury). In addition, 76 ten-week-old female immunodeficient rats underwent ACL reconstruction, followed by intracapsular administration of one of the following: (1) ACL-derived cells from the early group (n = 5), (2) ACL-derived cells from the chronic group (n = 5), or (3) phosphate-buffered saline (PBS) only (n = 5). During the 8 weeks after surgery, histological (weeks 2, 4, 8), immunohistochemical (week 2), radiographic (weeks 0, 2, 4, 8), and biomechanical (week 8) analyses were performed to evaluate tendon-bone healing. Results: In the early group, the histological evaluation showed early healing, induction of endochondral ossification–like integration, and mature bone ingrowth. Micro–computed tomography showed that the tibial bone tunnels at week 4 and week 8 were significantly reduced in the early group compared with those in the chronic group and PBS group (P < .05). Moreover, biomechanical tensile strength was significantly greater in the early group than in the other groups (P < .05). An accelerated healing potential in the early group was further demonstrated by the enhancement of intrinsic angiogenesis/osteogenesis and human-derived vasculogenesis/osteogenesis. Conclusion: Compared with human ACL-derived cells obtained during the chronic phase, cells obtained during the early phase after injury have a greater tendon-bone healing potential when used in an immunodeficient rat model of ACL reconstruction. Clinical Relevance: During ACL reconstruction surgery, transplanting ACL remnant tissue in the early phase after injury could accelerate and enhance tendon-bone healing. [ABSTRACT FROM AUTHOR]

Background: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation. We hypothesized that remnant preservation improves clinical results and accelerates graft incorporation and that its effect is dependent on the delay between ACL injury and reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 151 consecutive patients who underwent double-bundle ACL reconstruction using a semitendinosus graft were enrolled in this study: 74 knees underwent ACL reconstruction without a remnant (or the remnant was <25% of the intra-articular portion of the graft; NR group), while 77 knees underwent ACL reconstruction with remnant preservation (RP group). These were divided into 4 subgroups based on the time from injury to surgery: phase 1 was <3 weeks (n = 24), phase 2 was 3 to less than 8 weeks (n = 70), phase 3 was 8 to 20 weeks (n = 32), and phase 4 was >20 weeks (n = 25). Clinical measurements, including KT-1000 arthrometer side-to-side anterior tibial translation measurements, were assessed at 3, 6, 12, and 24 months after reconstruction. Magnetic resonance imaging evaluations of graft maturation and graft-tunnel integration of the anteromedial and posterolateral bundles were assessed at 3, 6, and 12 months after reconstruction. Results: There was no difference in side-to-side anterior tibial translation between the NR and RP groups. There was also no difference in graft maturation between the 2 groups. Furthermore, the time from ACL injury until reconstruction did not affect graft maturation, except in the case of very long delays before reconstruction (phase 4). Graft-tunnel integration was significantly increased in both groups in a time-dependent manner. However, there was no difference between the NR and RP groups. Conclusion: Remnant preservation did not improve knee stability at 2 years after ACL reconstruction. Furthermore, remnant preservation did not accelerate graft incorporation, especially during the acute and subacute injury phases. [ABSTRACT FROM AUTHOR]

Characteristics and motor strategies for force generation and force relaxation were examined using graded tasks during isometric force control. Ten female college students (M age = 20.2 yr., SD= 1.1) were instructed to accurately control the force of isometric elbow flexion using their right arm to match a target force level as quickly as possible. They performed: (1) a generation task, wherein they increased their force from 0% maximum voluntary force to 20% maximum voluntary force (0%-20%), 40% maximum voluntary force (0%-40%), or 60% maximum voluntary force (0%-60%) and (2) and a relaxation task, in which they decreased their force from 60% maximum voluntary force to 40% maximum voluntary force (60%-40%), 20% maximum voluntary force (60%-20%), or to 0% maximum voluntary force (60%-0%). Produced force parameters of point of accuracy (force level, error), quickness (reaction time, adjustment time, rate of force development), and strategy (force wave, rate of force development) were analyzed. Errors of force relaxation were all greater, and reaction times shorter, than those of force generation. Adjustment time depended on the magnitude of force and peak rates of force development and force relaxation differed. Controlled relaxation of force is more difficult with low magnitude of force control. [ABSTRACT FROM AUTHOR]

Although video feedback (VF) is shown to improve appraisals of social performance in socially anxious individuals, its impact on state anxiety during a social situation is mixed. The current study investigated the effect of combined video feedback and audience feedback (AF) on self-perceptions of performance and bodily sensations as well as state anxiety pertaining to a speech task. Forty-one socially anxious students were randomly allocated to combined video feedback with audience feedback (VF + AF), video feedback only (VF), audience feedback only (AF), or a control condition. Following a 3-min speech, participants in the VF + AF, VF, and AF conditions watched the videotape of their speech with cognitive preparation in the presence of three confederates who served as audience, and/or received feedback from the confederates, while the control group watched their videotaped speech without cognitive preparation. Both VF + AF and AF conditions improved distorted appraisal of performance and bodily sensations as well as state anxiety. The clinical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

We sought to determine whether serial measurements of oxidative stress levels could serve as a predictive marker for cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (STEMI). Biological antioxidant potential (BAP) levels were measured at admission and at 6, 12, and 24 months in 69 patients with STEMI. The CV events abruptly increased 6 to 10 months after successful percutaneous coronary intervention in patients with STEMI, and the 6-month BAP levels were significantly lower in patients with CV events (2456 μmol/L [interquartile range: 2237-2615 μmol/L]) than in those without (2849 μmol/L [2575-2987 μmol/L], P < .001). A decreased 6-month BAP level was an independent and significant predictor of long-term CV events (hazard ratio = 2.45; 95% confidence intervals 1.10-5.78; P = .04). Our findings suggest that serial changes in antioxidant capacity, assessed by BAP levels, may serve as a predictive marker for CV events after STEMI. [ABSTRACT FROM AUTHOR]

Background: The anterior cruciate ligament (ACL) does not heal spontaneously after injury, and ACL patients of different ages respond differently to treatment. Although ACL-derived CD34-positive cells contribute to bone-tendon healing after ACL reconstruction, the relationship between the healing potential of ACL-derived cells and a patient's age is unknown. Hypothesis: ACL-derived cells from young patients will have a greater effect on the maturation of bone-tendon integration in an immunodeficient rat model of ACL reconstruction compared with cells derived from older patients. Study Design: Controlled laboratory study. Methods: Sixty 10-week-old female immunodeficient rats underwent ACL reconstruction (using the autologous flexor digitorum longus tendon as a graft) followed by intracapsular administration of ACL-derived cells from patients aged 10 to 19 years (younger group) or patients aged 30 to 39 years (older group), or they were given phosphate-buffered saline (PBS; PBS group). Histologic, radiographic, and biomechanical examinations were performed 2 to 8 weeks after surgery. In addition, intrinsic and human cell– derived angiogenesis and osteogenesis were examined by immunohistochemistry. Results: In the younger group, histologic assessment demonstrated early bone-tendon healing, which induced endochondral ossification-like integration. Micro–computed tomography showed a statistically significant reduction in the area of tibial bone tunnel in the younger group (week 4, 20.0% ± 11.2% reduction; week 8, 25.7% ± 5.6% reduction) compared with the older group (week 4, 1.8% ± 3.0% reduction; week 8, 4.0% ± 5.9% reduction) and the PBS group (week 4, -0.5% ± 3.2% reduction; week 8, 3.3% ± 5.2% reduction) (week 4, P<.05; week 8, P<.01). Failure loads during tensile testing demonstrated a significantly higher ultimate load to failure in the younger group (17.52 ± 4.01 N) compared with the older (8.05 ± 2.91 N) and PBS (7.01 ± 3.16 N) groups (P<.05), and isolectin B4 and rat osteocalcin immunostaining indicated enhanced intrinsic angiogenesis and osteogenesis in the younger group. There was no statistically significant difference in the results of radiographic and biomechanical examinations between the older and PBS groups. Double immunohistochemistry for human-specific endothelial cell and osteoblast markers demonstrated a greater ability of differentiation into endothelial cells and osteoblasts in the younger group. Conclusion: ACL-derived cells from younger patients enhanced early bone-tendon healing in an immunodeficient rat model of ACL reconstruction. Clinical Relevance: Surgeons should consider a patient's age when performing ACL reconstruction with remnant preservation or ruptured tissue incorporation, as this can predict healing ability. [ABSTRACT FROM AUTHOR]

We explored the functional units of speech segmentation in Japanese using dichotic presentation and a detection task requiring no intentional sublexical analysis. Indeed, illusory perception of a target word might result from preattentive migration of phonemes, morae, or syllables from one ear to the other. In Experiment 1, Japanese listeners detected targets presented in hiragana and/or kanji. Phoneme migrations did occur, suggesting that orthography-independent sublexical constituents play some role in segmentation. However, syllable and especially mora migrations were more numerous. This pattern of results was not observed in French speakers (Experiment 2), suggesting that it reflects native segmentation in Japanese. To control for the intervention of kanji representations (many words are written in kanji, and one kanji often corresponds to one syllable), in Experiment 3, Japanese listeners were presented with target loanwords that can be written only in katakana. Again, phoneme migrations occurred, while the first mora and syllable led to similar rates of illusory percepts. No migration occurred for the second, “special” mora (/J/ or /N/), probably because this constitutes the latter part of a heavy syllable. Overall, these findings suggest that multiple units, such as morae, syllables, and even phonemes, function independently of orthographic knowledge in Japanese preattentive speech segmentation. [ABSTRACT FROM PUBLISHER]

The article discusses research which investigated osteochondritis dissecans (OCD) prevalence in adolescent baseball players. Topics explored include the elbow disability associated with OCD of the humeral capitellum, symptoms and factors that contribute to OCD such as microtrauma, the results of the ultrasonographic examinations performed on participating patients, and the need to diagnose OCD early to avoid treatment difficulties.

The article presents research which focused on the use of 3-dimensional motion analysis platform to measure the glenoid track. Topics covered include the description of Hill-Sachs lesion as an injury linked with instability of anterior glenohumeral rim as well as application of magnetic resonance imaging (MRI) in the study. Also mentioned are participation of 30 healthy volunteers in this research.

The article presents research which examined the age-related differences in cells derived from the anterior cruciate ligament (ACL). Topics covered include the description of ACL tissues in adolescent and younger patients as well as collection of ACL remnants from 28 patients. Also mentioned is the need for surgeons to consider the age of patients when assessing healing potential of those with ACL injuries.

The article presents a study which investigated the ideal matching patterns of articular surface profiles of donor and recipient sites for autogenous osteochondral grafting of the femur of the knee through the use of three-dimensional laser scanning technique. It claims that the grafting method is broadly used as treatment for focal osteochondral defects. In the study, the FastSCAN Cobra three-dimensional (3D) laser scanner from Polhemus was used to profile the knee.

Introduction: The inability to read quickly can be a disadvantage throughout life. This study focused on the associations of braille reading fluency and individual factors, such as the age at onset of blindness and number of years reading braille, and the tactile sensitivity of people with early and late blindness. The relationship between reading speed and these other factors was examined to identify factors that influence reading speed. Methods: Nine people with early blindness and 10 people with late blindness participated in this study, which included the measurement of accuracy of word recognition, braille reading speed, and tactile sensitivity. Results: We found a significant partial correlation between reading speed and the age at onset of blindness, controlling for number of years reading braille (r=-0.68, p < .005), and no significant partial correlation between tactile sensitivity and reading speed after controlling for the age at onset of blindness (r = -0.08, ns). Discussion: A direct relationship between reading speed and tactile sensitivity was not confirmed, and the age at onset of blindness appears not only to mediate the relationship between reading speed and tactile sensitivity but also may be a crucial factor influencing braille reading fluency. Implications for practitioners: Our results suggested that a crucial factor that influences braille reading fluency was the age at onset of blindness, and that individuals should begin learning braille as early as possible. [ABSTRACT FROM AUTHOR]

Background:A disadvantage of pivot-shift maneuvers is that the examiner has to subjectively evaluate the degree of pivot shift observed. It is unknown whether the various maneuvers are biomechanically identical.Purpose:To compare biomechanical features of 3 clinical maneuvers for the anterior cruciate ligament (ACL)–deficient knee: the pivot-shift test, the jerk test, and the N-test.Study Design:Controlled laboratory study.Methods:A total of 28 patients with an isolated ACL injury were examined by use of 3 pivot-shift maneuvers (pivot-shift test, jerk test, and N-test). An electromagnetic sensor system was used to evaluate the 3-dimensional knee kinematics of each patient’s injured and uninjured knees during each maneuver. Peak coupled anterior tibial translation (pCAT) and maximal acceleration of posterior translation (APT) were measured relative to results during a flexion-extension motion in each test.Results:The pCAT of the pivot-shift test was significantly greater than that of both the jerk test and the N-test (P = .0020 and P < .0001, respectively); there was no statistical difference in pCAT between the jerk test and the N-test. The APT of the N-test was significantly greater than that of both the pivot-shift test and the jerk test (P < .0001), while there was no statistical difference between the pivot-shift and the jerk tests. There was no correlation between pCAT and APT in each test.Conclusion:The pivot-shift test, jerk test, and N-test have different biomechanical characteristics to induce the pivot-shift phenomenon in the ACL-deficient knee. The pivot-shift test produced the largest side-to-side difference in pCAT, whereas the N-test provoked the largest side-to-side difference in APT.Clinical Relevance:The biomechanical differences in pivot-shift maneuvers are caused by technical differences, and clinicians should understand these biomechanical differences while practicing the maneuvers. The electromagnetic sensor system is clinically useful for quantifying the pivot-shift phenomenon. [ABSTRACT FROM AUTHOR]

The article presents a study on articular cartilage degeneration which can develop after anterior cruciate ligament reconstruction (ACLR). It focuses on risk factors in the early postoperative period. The T1ρ spin-lattice relaxation in the rotating frame magnetic resonance imaging is described. The baseline T1ρ value of the medial femoral condyle (MFC) and lateral FC (LFC) was higher in patients with cartilage lesions.

Objectives: We previously reported that many non-psychiatric doctors in Japan believe that treating depression was not part of their duties. Educational interventions must address motivation of physicians to play a role in depression care. In this study, we explored factors associated with perceived feasibility and willingness of non-psychiatric doctors in Japan to treat depression. Methods: The study population included non-psychiatric doctors of the General Physician-Psychiatrist (G-P) Network group in Japan. We explored perceived feasibility and willingness to treat depressed patients, and examined preliminary associations with attitudes toward depression (the Depression Attitude Questionnaire: DAQ) and current depression treatment in routine medical practice. Results: Responses were obtained from 56 non-psychiatric doctors (response rate: 35.4%). The doctors who scored high on the "Professional" and "Pessimism" subscale of the DAQ believed that treating depressed patients was not feasible (χ² = 13.6, p < 0.01; χ² = 7.3, p < 0.05, respectively) and were not willing to treat depressed patients (χ² = 9.4,p < 0.01; χ² = 6.6, p < 0.05, respectively) as part of their routine medical practice. The doctors who scored high on the "Professional" subscale referred fewer depressed patients to psychiatrists (r = -0.33, p < 0.05), and those who scored high on the "Pessimism" subscale recognized fewer depressed patients (r = -0.39, p < 0.01). Conclusions: The present study showed that attitudes toward depression were associated with perceived feasibility and willingness to treat depressed patients and with under-diagnosis of depression. Educational interventions optimized for these attitudes should be developed to improve recognition and treatment of depression in Japan. [ABSTRACT FROM AUTHOR]

Knowledge about aging and the attitudes toward older people were surveyed in undergraduate students (total number of subjects sampled is 1402) in four countries (Japan, China, Taiwan, and Vietnam) in eastern cultures and in two countries (United States and United Kingdom) in western cultures. All participants completed two questionnaires, FAQ1 (for knowledge) and ASD (for attitudes) in their own languages. It was found that within the undergraduate students sampled: (a) the level of knowledge about aging in the western countries is significantly higher than that in the eastern countries, and (b) attitudes toward aging are more positive in the western countries compared to the eastern countries. The data suggest that, within the limits of the sampling: (a) the tradition of respecting older adults in eastern cultures may have weakened gradually, and (b) the modernization theory that assumes industrialization devalues aging populations appears to be supported in eastern countries but not in western countries. An alternative non-linear theory is discussed for the relationship between modernization and the societal views on aging. Educational promotion of knowledge about aging is emphasized for the formation of positive attitudes toward older adults. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle–brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO2): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO2 ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO2 < 10 mmHg (Group C). Heel blood flow was monitored using tcPO2 sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO2 for the first 10 min, and change in tcPO2 after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO2 for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO2 after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO2 < 10 mmHg might be necessary after loading. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to investigate the effect of a forward bilateral pushing movement on postural control in a situation where known, unknown, and unpredictable perturbations may be induced. Participants stood upright and voluntarily pushed a handle with both hands. In the first task, the handle was free to be moved by the participant (perturbation; movable task) and in the second task, the handle was locked (stationary task). For each task, body displacement and observed applied force were recorded. Anticipatory postural control adjustment plays a vital role in body stability; however, in contrast to its role in maintaining stability, adjustment can generate a restricted voluntary movement because motor programming selects a postural control that gives priority to body stability over the target movement. [ABSTRACT FROM AUTHOR]

This study tested the effect of a short-term coordination program focused on improving the agility of school children ages 7 to 8 years. Healthy Japanese children were placed in an experimental group of 26 children (10 girls, 16 boys) and a control group of 20 children (9 girls, 11 boys). The experimental group participated in 10 coordination program sessions during recesses; each session was performed 1 to 3 times per week, for 26 days. No differences were observed between the groups in repeated side-step scores prior to the program, although an interaction was observed after the completion of the treatment. The short-term coordination program was effective in increasing the agility of elementary school children aged 7 to 8 years. [ABSTRACT FROM AUTHOR]

The article discusses a study which compared the frequency and correlates of taijin kyofusho symptoms (TKS) in Japanese adolescents and their parents. The study included 351 adolescents from secondary schools in Miyazaki, Japan. It found that adolescents have significantly more TKS than their parent/guardians. Study authors concluded that self-construals play diverse roles in TKS.

The article presents a whole-cadaver study on the function of acromioclavicular (AC) and coracoclavicular (CC) ligaments in shoulder motion. It evaluates the shoulder girdle motion relative to the thorax of 14 shoulders from 8 whole cadavers after sequential sectioning of the AC and CC ligaments. It highlights that kinematic changes could be the main reason for pain and dysfunction in the shoulder with AC joint dislocation, and hence, certain patients may require surgical reconstruction.

Background: The well-known suture technique configurations used for hamstring tendon autograft preparation in anterior cruciate ligament (ACL) reconstruction are the Krackow locking stitch and nonlocking stitch, such as a baseball stitch and a whipstitch. However, there are few data in the literature regarding biomechanical comparisons of suture techniques. Purpose: The purpose of this study was to determine the properties of several current techniques of tendon graft suture employed in ACL reconstruction. Study Design: Controlled laboratory study. Methods: Forty-two fresh-frozen porcine flexor digitorum tendons were used. Three stitch configurations (Krackow stitch [group K], baseball stitch [group B], and whipstitch [group W]) were assessed with varying suture throws (6 throws, group36; 10 throws, group310) using No. 5 Ethibond sutures. Each group was tested at 1500 loading cycles between 50 and 200 N. After loading cycles, the surviving tendons underwent a load-to-failure test. Results: During the loading cycles, 3 of 7 specimens in group B×6 and all specimens in group W×6 failed by suture pullout. Four of 7 specimens in group B×10 and all specimens in group W×10 showed partial tearing of the tendon. Elongation of group B×10 and group W×10 showed significantly greater elongation than other groups (P < .05). Maximum loads at failure showed significant differences between group K and the other groups (K×6, 436 ± 52 N; K×10, 419 ± 34 N; P < .05). Most specimens failed by rupture of the suture thread in group K. Pullout of the suture from the tendon was observed most in groups B and W. Conclusion: The Krackow stitch was superior to other stitch methods. There was, however, no significant effect of the number of throws on the holding strength. Clinical Relevance: The Krackow stitch could prevent suture slippage by a locking mechanism. The whipstitch is not suitable for clinical application even with an increased number of throws. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff regeneration using tissue engineering techniques is a challenging treatment in elderly patients with irreparable rotator cuff tears.Hypothesis: A polyglycolic acid sheet scaffold with seeded mesenchymal stem cells (MSCs) may enhance the expression of type I collagen products and increase the mechanical strength of the regenerated tendon in vivo.Study Design: Controlled laboratory study.Methods: A surgically created defect of infraspinatus tendons of rabbits was reconstructed with 2 different materials, a polyglycolic acid (PGA) sheet alone (PGA group) (n = 34) and a PGA sheet seeded with autologously cultured MSCs (MSC group) (n = 34). The authors created a tendon defect model without embedding any graft as the control model (control group) (n = 34). The rabbits were sacrificed at 4, 8, and 16 weeks after the operation and then were histologically evaluated. The rabbits were also biomechanically evaluated by measuring the ultimate failure loads and Young’s modulus at 4 and 16 weeks following implantation.Results: In the MSC group, the fibrocartilage layers and Sharpey fibers were found regularly in the insertion site at 8 weeks compared with the PGA group. In control group, thin membranes with many fibroblasts arranged in an irregular pattern linked the end of the torn cuff to the bone without any Sharpey fibers and type I collagen. A large volume of type I collagen was found in comparison with type III collagen at 16 weeks in the MSC group, whereas type III collagen was more prevalent than type I in the PGA group. The tendon maturing score in the MSC group had higher values than the PGA and control groups at 8 and 16 weeks (mean values were 21.0 ± 0.89, 24.0 ± 2.53 in the MSC group; 16.7 ± 2.25, 21.3 ± 2.42 in the PGA group; and 10.2 ± 0.98, 12.2 ± 1.72 in the control group, respectively) (P < .05). The results of the mechanical analysis revealed that the regenerated tendons in the MSC group had better tensile strength than in the PGA and control groups at 16 weeks (mean values were 3.04 ± 0.54 in the MSC group, 2.38 ± 0.63 in the PGA group, and 1.58 ± 0.13 in the control group) (P < .05).Conclusion: Bone marrow–derived MSCs were able to regenerate tendon-bone insertions and the tendon belly, including the production of type I collagen, and increased the mechanical strength of the regenerated rotator cuff tendon.Clinical Relevance: Rotator cuff regeneration using MSCs is a promising treatment for massive rotator cuff defects. [ABSTRACT FROM PUBLISHER]

In everyday life, people communicate not only with another person but also in front of other people. How do people behave during communication when observed by others? Effects of an observer (presence vs absence) and interpersonal relationship (friends vs strangers vs alone) on facial behavior were examined. Participants viewed film clips that elicited positive affect (film presentation) and discussed their impressions about the clips (conversation). Participants rated their subjective emotions and social motives. Durations of smiles, gazes, and utterances of each participant were coded. The presence of an observer did not affect facial behavior during the film presentation, but did affect gazes during conversation. Whereas the presence of an observer seemed to facilitate affiliation in pairs of strangers, communication between friends was exclusive and not affected by an observer. [ABSTRACT FROM AUTHOR]

Objective: To study the effectiveness of electroacupuncture of the spinal nerve root using a selective spinal nerve block technique for the treatment of lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis. Methods: Subjects were 17 patients with spinal canal stenosis who did not respond to 2 months of general conservative treatment and conventional acupuncture. Under x-ray fluoroscopy, two acupuncture needles were inserted as close as possible to the relevant nerve root, as determined by subjective symptoms and x-ray and MRI findings, and low-frequency electroacupuncture stimulation was performed (10 Hz, 10 min). Patients received 3-5 once-weekly treatments, and were evaluated immediately before and after each treatment and 3 months after completion of treatment. Results: After the first nerve root electroacupuncture stimulation, scores for lumbar and lower limb symptoms improved significantly (low back pain, p<0.05; lower limb pain, p<0.05; lower limb dysaesthesia, p<0.01) with some improvement in continuous walking distance. Symptom scores and continuous walking distance showed further improvement before the final treatment (p<0.01), and a significant sustained improvement was observed 3 months after completion of treatment (p<0.01). Conclusion: Lumbar and lower limb symptoms, for which conventional acupuncture and general conservative treatment had been ineffective, improved significantly during a course of electroacupuncture to the spinal nerve root, showing sustained improvement even 3 months after completion of treatment. The mechanisms of these effects may involve activation of the pain inhibition system and improvement of nerve blood flow. [ABSTRACT FROM AUTHOR]

Background: To theoretically minimize complications of osteochondral graft harvest from the knee, grafts should be obtained from the site of lowest stress distribution across the joint.Hypothesis: Long-term stress distribution over the patellofemoral (PF) joint surface is not equal in athletes.Study Design: Cross-sectional study; Level of evidence, 3.Methods: Measurement of subchondral bone density can determine long-term resultant stress acting on an articular surface in living joints. Our analysis was performed using computed tomography (CT) image data obtained from bilateral knees of 10 college baseball fielders (fielder group) and 10 college baseball pitchers (pitcher group) and 2 control groups, including 10 college soccer players (soccer group) and 10 nonathletes (nonathlete group). The distribution pattern of subchondral bone density throughout the articular surface of the PF joint was assessed using the CT osteoabsorptiometry method. The quantitative analysis focused on the location of the low-density area at the articular surface to assess potential osteochondral donor sites.Results: All participants in the pitcher and fielder groups demonstrated a low-density area widely distributed in the proximal part of the lateral trochlea. On the other hand, a high-density area was located in the distal part of the lateral notch, of the medial notch, and of the medial trochlea. No apparent differences in the distribution pattern were found between the baseball groups and the control groups.Conclusion: Our analysis, based on CT osteoabsorptiometry, indicates that the proximal lateral trochlea of the distal femur has the highest percentage area of low bone density at the PF joint level in donor knees of baseball players, soccer players, and nonathlete controls.Clinical Relevance: From a biomechanical viewpoint, the proximal lateral trochlea is the optimal site for harvesting osteochondral grafts in performing mosaicplasty for baseball players. This selection for the donor site may minimize postoperative PF joint symptoms. [ABSTRACT FROM PUBLISHER]

Objectives: Language development is a key issue in hearing-impaired children. However, interpersonal differences complicate our understanding of the situation. The bimodal or trimodal distribution of language scores in our other reports in this publication imply the presence of fundamental differences among these groups. The characteristic aspects of each group were profiled according to language data. Methods: We divided 268 children with prelingual severe to profound hearing impairment into 3 groups according to their trimodal distribution observed on histogram-based analysis of their responses to the Test of Question-Answer Interaction Development. Test results in several language domains, including productive and comprehensive vocabulary, productive and comprehensive syntax, and academic achievement, were profiled and compared among these 3 groups. Results: Significant differences were observed in the results of the Word Fluency Test, the Picture Vocabulary Test-Revised, and the Syntax Test of Aphasia among the 3 groups. No significant difference was observed between groups who were lower-scoring and intermediate-scoring on the academic achievement tests referred to as Criterion Referenced Test- II and the Standardized Comprehension Test for Abstract Words. Only the higher-scoring group showed excellent results. The demographic factors were not significantly different among the 3 groups. Conclusions: Relatively poor academic achievement despite fair language production was the dominant feature of the intermediate-scoring group. This profile might correlate with academic failure in school. [ABSTRACT FROM AUTHOR]

Background: One of the main differences affecting outcome between single-bundle and double-bundle anterior cruciate ligament (ACL) reconstructions may be graft fixation angles and initial force settings; however, there has been little research to investigate these effects in either technique.Hypothesis: Anteroposterior and rotational knee laxities will be less in double-bundle ACL reconstructions than single-bundle reconstructions, and different graft fixation angles affect knee kinematics and pivot-shift phenomenon in double-bundle ACL reconstructions.Study Design: Controlled laboratory study.Methods: Eleven patients who underwent double-bundle ACL reconstruction were included in this study. The anteromedial bundle (AMB) and the posterolateral bundle (PLB) were provisionally fixed to a graft tensioning system during surgery. The graft fixation settings were as follows: (1) AMB only at 20° (A20), (2) PLB only at 20° (P20), (3) AMB at 20° and PLB at 0° (A20P0), (4) AMB at 20° and PLB at 20° (A20P20), and (5) AMB at 20° and PLB at 45° (A20P45). All the grafts were tensioned at a constant stress level. Anterior tibial translation (ATT), internal rotation (IR), and external rotation (ER) at 30° and 90° of knee flexion applied with manual maximum load were measured before graft insertion and in each setting using a navigation system. A pivot-shift test was also evaluated manually with modified International Knee Documentation Committee criteria in each setting.Results: A20 was less constrained than A20P20 and A20P45 in ATT at 30° and less constrained than A20P45 in IR at 30°. P20 was less constrained than any other settings in ATT at 30° and less constrained than A20P45 in IR at 30°. A20P0 was less constrained than A20P45 in IR at 30° and in ER at 30°. Grade 1 pivot-shift phenomenon persisted in 8 cases in P20, in 4 cases in A20, and in 3 cases in A20P0, whereas no case showed a positive pivot-shift result in A20P20 and A20P45.Conclusion: In this in vivo laboratory model, double-bundle ACL reconstruction with fixation of AMB at 20° and PLB at 20° or 45° restored better stability than single AMB or single PLB reconstruction in which the graft was of smaller size.Clinical Relevance: In double-bundle ACL reconstruction, fixation of the PLB at 0° might be looser and function worse compared with that of PLB at 20° or 45° when the AMB is fixed at 20°, with the individual variability that should lead to caution until it can be better assessed by surgeons. [ABSTRACT FROM PUBLISHER]

The article discusses a longitudinal study which examines the impact of Hotz's plate and lip adhesion on patients with bilateral cleft lip and palate (BCLP). Findings reveal that the surgical operations affected the development of the anterior arch width, while dental arch length was affected by the collapse of the premaxilla. It also indicates that the use of Hotz's plate can prevent the fall down of the premaxilla.

Objective: To determine whether any difference exists in responses to indirect moxibustion relative to thermal stimulation sites. Methods: Twenty one healthy men of mean±SD age 22.5±6.1 years were randomly divided into two groups, one receiving a single moxibustion stimulation in three locations (the three-point stimulation group, n=10 participants) and the other receiving three stimulations in one location (the one-point stimulation group, n=11 participants). The thermal stimulation sites were GV14, GV9 and GV4 acupuncture points. A thermograph was used to obtain the skin temperature on the posterior trunks of the participants. To analyse skin temperature, four arbitrary frames (the scapular, interscapular, lumbar and vertebral regions) were made on the posterior trunk. Result: An increase in skin temperature on the posterior trunk was observed following both one- and three-point moxibustion administrations. The skin temperature of the lumbar region showed a significant increase after three-point stimulation compared with single-point stimulation (p=0.011). There was also a significant increase in skin temperature of the spinal region after three-point stimulation compared with one-point stimulation (p=0.046). Conclusion: Administration of single moxibustion doses on the GV14, GV9 and GV4 points produces greater changes in skin temperature than three applications of moxibustion to the GV14 point only. [ABSTRACT FROM AUTHOR]

Objective: To determine the current perception thresholds (CPTs) for arm and mental foramen areas to enable a quantitative evaluation of the effectiveness of acupuncture treatment. Methods: Ninety-eight volunteers enrolled as participants and were randomly assigned to one of three groups: an acupuncture group (34 subjects); a sham acupuncture group (32 subjects) and a waiting group (32 subjects). CPTs for the arm and mental foramen areas were determined before and after acupuncture at LI4 Hegu of the left hand. A Neurometer CPT was used to evaluate the perception threshold at the homolateral mental foramen and arm. For further exploration, thresholds of homolateral and contralateral mental foramina were determined before and after acupuncture in a subgroup of 13 participants in the acupuncture group. Results: Acupuncture at LI4 increased the perception thresholds of the left mental foramen in the acupuncture group significantly (p<0.01). The increases were significantly greater than in the control group for all frequencies, and significantly greater than sham acupuncture for 250 Hz and 5 Hz. In the subgroup, only the CPTs at 5 Hz increased significantly for the contralateral mental foramen. Conclusions: Acupuncture at LI4 increases the perception threshold in the mandibular area, but not in the arm. This finding is probably related to the analgesic effect of acupuncture. [ABSTRACT FROM AUTHOR]

Background: A sheep or goat anterior cruciate ligament (ACL) reconstruction model with the semitendinosus tendon autograft has not as of yet been established.Hypothesis: The semitendinosus tendon graft may be necrotized after ACL reconstruction until 12 weeks. Structural properties of the femur-graft-tibia complex may not be restored to the normal ACL level even at 12 months after surgery.Study Design: Controlled laboratory study.Methods: Thirty-eight mature sheep were used. In each animal, the right knee underwent ACL reconstruction using the semitendinosus tendon autograft. Two of them were not tested because of pneumonia. Twenty of 36 sheep were used for biomechanical evaluations. Five randomly selected animals were sacrificed at 0, 12, 24, or 52 weeks after surgery. In each animal, both the knees were harvested, and the left knee was used to obtain the control data. The remaining 16 sheep were used for histological evaluation. Two or 3 randomly selected animals were sacrificed at 0, 2, 6, 12, 24, or 52 weeks after surgery.Results: The tendon graft was predominantly acellular at 2 weeks. Although cell infiltration increased at 6 weeks, the core portion remained necrotic even at 12 weeks. At 24 and 52 weeks, the necrotic lesion disappeared in the core portion. In each period, the anteroposterior translation of the reconstructed knee remained significantly greater than that of the control (P < .0001). At 52 weeks, the maximum load of the femur-graft-tibia complex was significantly lower than that of the femur-ACL-tibia complex (P < .0001), although there was no significant difference in the cell density, the tissue dimensions, the stiffness, and the elongation at failure between the 2 complexes.Conclusion: The sheep ACL reconstruction model showed predominant intrinsic fibroblast necrosis in the tendon autograft until 12 weeks. Although the structural properties of the femur-graft-tibia complex gradually improved, they were not completely restored to the femur-ACL-tibia complex level even at 52 weeks.Clinical Relevance: Remodeling of the semitendinosus tendon autograft after ACL reconstruction is not different from that of the bone-tendon-bone graft. This study has suggested that vigorous activity should not be permitted for patients in the early periods after ACL reconstruction using semitendinosus tendon autografts, which are necrotized and weakened after surgery. [ABSTRACT FROM PUBLISHER]

This single-blind randomized study investigated the effectiveness of lavender aroma on quality of sleep in healthy Japanese students. The data of seven participants (2 men, 5 women) in the intervention group and eight participants (3 men, 5 women) in the control group were analyzed (M age = 19.0 yr., SD = 0.9). The total procedure comprised 3 days for pre-intervention assessment, 5 days for the intervention, and 3 days for post-intervention assessment. Lavender exposure was compared with the absence of lavender (control). Information regarding the relaxing effect of aromas was provided to examine expectancy effects. Results showed that lavender aroma improved sleepiness at awakening after the intervention. Sex differences and daily variation in quality of sleep during the intervention period were not observed. The findings suggest that nighttime exposure to lavender aroma relieves sleepiness at awakening. [ABSTRACT FROM AUTHOR]

Background: The alterations in blood flow after rotator cuff repair remain unclear. Visualization of vascular patterns could clarify basic and clinical investigations.Purpose: To assess longitudinal blood flow inside the repaired cuff and the surrounding tissue after rotator cuff repair, using contrast-enhanced ultrasonography.Study Design: Descriptive laboratory study.Methods: Fifteen patients (7 men and 8 women; mean age, 65.0 ± 9.8 years) consented to participate. The patients underwent an ultrasound scan before and 1, 2, and 3 months after surgery. Enhanced ultrasound images were recorded for 1 minute after intravenous injection of contrast reagent. Four regions of interest inside the cuff and 2 regions in the anchor hole and subacromial bursa were superimposed on the obtained images. Calculated areas under the time-intensity curves were expressed in acoustic units (AU).Results: We found area-dependent differences in patterns of alteration and magnitude of blood flow inside the repaired cuff and peritendinous tissues. Vascularity in the articular distal and bursal distal region of the repaired cuff at 1 month postoperatively increased significantly compared with that at the preoperative baseline (76 vs 5 AU, P = .0037; 92 vs 7 AU, P = .043). The vascularity peaked at 1 month after surgery in the bursal area within the cuff but at 2 months in the articular area. The vascularity in the articular proximal region of the repaired cuff was significantly lower than that in the bursal proximal (P = .0046), bursal distal (P = .0183), and articular distal regions (P = .0163) 1 month after surgery.Conclusion: Enhancement patterns in intratendinous tissue increased at 1 or 2 months postoperatively and decreased at 3 months. We found area-dependent differences in enhancement patterns inside the repaired cuff and peritendinous tissue.Clinical Relevance: Visualization of vascularization using contrast-enhanced ultrasound could help in deciding on an appropriate repair technique or on the form of postoperative rehabilitation after rotator cuff repair. [ABSTRACT FROM AUTHOR]

Background: Although previous biomechanical research has demonstrated the superiority of the suture-bridge rotator cuff repair over double-row repair from a mechanical point of view, no articles have described the structural and functional outcomes of this type of procedure.Hypothesis: The structural and functional outcomes after arthroscopic rotator cuff repair may be different between the single-row, double-row, and combined double-row and suture-bridge (compression double-row) techniques.Study Design: Cohort study; Level of evidence, 3.Methods: There were 206 shoulders in 201 patients with full-thickness rotator cuff tears that underwent arthroscopic rotator cuff repair. Eleven patients were lost to follow-up. Sixty-five shoulders were repaired using the single-row, 23 shoulders using the double-row, and 107 shoulders using the compression double-row techniques. Clinical outcomes were evaluated at an average of 38.5 months (range, 24-74 months) after rotator cuff repair. Postoperative cuff integrity was determined using Sugaya’s classification of magnetic resonance imaging (MRI).Results: The retear rates after arthroscopic rotator cuff repair were 10.8%, 26.1%, and 4.7%, respectively, for the single-row, double-row, and compression double-row techniques. In the subcategory of large and massive rotator cuff tears, the retear rate in the compression double-row group (3 of 40 shoulders, 7.5%) was significantly less than those in the single-row group (5 of 8 shoulders, 62.5%, P < .001) and the double-row group (5 of 12 shoulders, 41.7%, P < .01). Postoperative clinical outcomes in patients with a retear were significantly lower than those in patients without a retear for all 3 techniques.Conclusion: The additional suture bridges decreased the retear rate for large and massive tears. The combination of the double-row and suture-bridge techniques, which had the lowest rate of postoperative retear, is an effective option for arthroscopic repair of the rotator cuff tendons because the postoperative functional outcome in patients with a retear is inferior to that without retear. [ABSTRACT FROM PUBLISHER]

Background: Suture-button fixation for tibiofibular syndesmosis injuries is a relatively new surgical technique thought to provide semirigid dynamic stabilization. However, adequate information is still not available and there are controversies as to whether it provides enough fixation for syndesmosis injuries.Hypothesis: Optimally directed suture-button fixation brings physiologic dynamic stabilization of the ankle syndesmosis.Study Design: Controlled laboratory study.Methods: Stabilization of the ankle syndesmosis fixed by a suture-button construct was examined using 6 normal fresh-frozen cadaver legs. After initial tests of intact and injured models, suture-button fixation and screw surgical techniques were performed sequentially for each specimen, with single suture-button fixation, double suture-button fixation, anatomic suture-button fixation, and metal screw. Anterior and medial traction forces, as well as external rotation force, were applied to the tibia; the diastasis of the syndesmosis and the rotational angle of the fibula related to the tibia were measured using a magnetic tracking system.Results: Each traction and rotation force significantly increased the diastasis and fibular rotational angles in the created injury models. With single fixation, the diastases increased significantly compared with the intact model with an anterior traction force (P < .001), a medial traction force (P = .005), and an external rotation force (P = .015). The fibular rotational angles increased significantly with a medial traction force (P = .005) and an external rotation force (P < .001). With double fixation, the diastases increased significantly with a medial traction force (P = .004) and an external rotation force (P = .012). The fibular rotational angles increased significantly with a medial traction force (P = .035) and an external rotation force (P = .002). With anatomic fixation, there were no significant differences compared with the intact model. With the metal screw, the diastases decreased significantly with an external rotation force (P = .037).Conclusion: Neither single nor double fixation for syndesmosis injuries provided multidirectionally stabilizing syndesmosis. Anatomic fixation directed from the posterior cortex of the fibula to the anterolateral edge of the tibia allowed dynamic stabilization of intact cadaver specimens. The metal screw provided very rigid fixation.Clinical Relevance: Optimal direction of the suture button can provide adequate stabilization of the ankle and could benefit athletes with syndesmosis injuries. [ABSTRACT FROM PUBLISHER]

The action-sentence compatibility effect (ACE) is a phenomenon in which a reader's response to a sentence is made faster when there is congruity between the action described in the sentence and the action that makes up the response. Previous studies showed the ACE occurs in action-related sentences in several languages. However, all these were SVO (verb-object) languages, in which verbs are placed before object nouns; this order is reversed in SOV languages. Moreover, those studies investigated hand responses. This study assessed the existence of the ACE in Japanese, an SOV language, and in foot responses. 24 female participants judged the sensibility of Japanese sentences that described actions and responded with either their foot or hand as an effector. Reaction times were significantly faster when there was congruity between the effector described in the sentences and the effector actually used for the response. However, sentence dependency was also found in the foot responses. [ABSTRACT FROM AUTHOR]

Background: Although previous studies suggested that female patients are predisposed to increase graft laxity compared with male patients after single-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons, there have been no studies specifically examining gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts.Hypotheses: (1) Female patients have significantly smaller hamstring graft diameters than do men for anatomic double-bundle anterior cruciate ligament reconstruction surgery; (2) female patients will have increased graft laxity compared with male patients after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons.Study Design: Cohort study; Level of evidence, 2.Methods: The consecutive 174 patients who underwent anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons were enrolled. Of these patients, 49 women and 73 men were prospectively evaluated 2 years after surgery.Results: The diameters for anteromedial and posterolateral grafts in the female group were significantly smaller than those in the male group. On Lachman testing, 98% of the female group and 97% of the male group were rated as negative. Regarding the pivot-shift test, 80% of the female group and 85% of the male group were rated as negative. No significant differences were found between the female and male groups in these tests. The average side-to-side differences in the KT-2000 knee ligament arthrometer values were 1.3 mm in the female group and 1.4 mm in the male group; this difference between females and males was not statistically significant. The average Lysholm scores were 96.7 points in the female group and 97.2 points in the male group. Thirty-five cases (73%) in the female group and 54 cases (74%) in the male group were graded as normal on the International Knee Documentation Committee (IKDC) evaluation. There were no significant differences in Lysholm score or IKDC evaluation between the female and male groups.Conclusion: The results of assessment for ligament laxity at the 2-year postoperative evaluation in the female group were approximately identical to those of the male group after anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons. Therefore, the present study suggests that anatomic double-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons provides satisfactory knee stability to female patients as well as male patients. [ABSTRACT FROM AUTHOR]

Background: A no-touch control needle in which the needle tip cannot reach the skin has been designed, and has been validated for practitioner blinding in a previous study but not for participant blinding. Objective: To test whether the no-touch control needle can effectively blind subjects. Methods: An acupuncturist applied, in turn, a no-touch control, skin-touch placebo and penetrating needle in one forearm of 80 healthy subjects. After removing each needle, the subjects were asked to judge the type of needle and rate the sensation of skin penetration/penetration-like or skin pressure/pressure-like pain on a 100 mm visual analogue scale. Results: The subjects correctly identified 67% of needles overall. 17 of the 80 no-touch control needles were judged as skin-touch, and one as penetrating. In addition, six skin-touch placebo needles, and no penetrating needles, were judged as no-touch. Half of the 80 skin-touch placebo needles and 65 of the 80 penetrating needles and two no-touch control needles elicited pain. Of 240 needles, the practitioner identified 120 correctly that did not fit the probability of 1/3 (x2=30.00, p<0.01). Conclusions: The no-touch control needles may be used as a blind control for the acupuncture procedure, or to test the physiological effect of the skin-touch needles, but are not suitable for double-blind testing of the needle effect. [ABSTRACT FROM AUTHOR]