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Tudor Parfitt BLACK JEWS IN AFRICA AND THE AMERICAS 240pp. Harvard University Press. 22.95 [pounds sterling] (US $29.95). 978 0 674 06698 4 In 1836, the missionary Joseph Wolff met [...]

Purpose: 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.Methods: 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.Results: 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).Conclusions: 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.Level Of Evidence: II. [ABSTRACT FROM AUTHOR]

Franz Rosenzweig thought of converting to Christianity and decided to adapt to the religion as a Jew observing the religion. He remained a Jew even after observing Christianity after going through the Yom Kippur. Details on Rosenzweig commitment to Judaism are discussed.

Background: Clinical practice guidelines (CPGs) are published by several sports medicine institutions. A systematic evaluation can help identify the highest quality CPGs for clinical use and identify any deficiencies that remain. Purpose: To identify and appraise CPGs relevant to clinical sports medicine professionals. Study Design: Systematic review. Methods: Predetermined selection criteria were utilized by 2 reviewers who independently identified published CPGs before January 1, 2014. CPGs were excluded if they focused on injured workers, radiological criteria, medical pathology, or the axial skeleton (back/neck). The remaining guidelines were scored by 6 reviewers with different clinical backgrounds using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Scores lower than 50% indicated deficiency. Scores were also stratified by the publishing institution and anatomic location and compared using Kruskal-Wallis tests. The Spearman correlation coefficient was used to assess the range of interobserver agreement between the evaluators. Results: Seventeen CPGs met the inclusion criteria. The majority of guidelines pertained to the knee, ankle, or shoulder. Interobserver agreement was strong (r = 0.548-0.740), and mean total scores between nonsurgical (107.8) and surgical evaluators (109.3) were not statistically different. Overall guideline quality was variable but not deficient for 16 of 17 guidelines (>50%), except regarding clinical “applicability” and “editorial independence.” No difference was found between CPGs of the knee, shoulder, foot/ankle, or chronic conditions. However, CPG publishing institutions had significantly different scores; the American Academy of Orthopaedic Surgeons (AAOS) guidelines scored significantly higher (141.4) than the total mean score (108.0). Conclusion: The overall quality of sports medicine CPGs was variable but generally not deficient, except regarding applicability and editorial independence. Bias through poor editorial independence is a concern. To improve future guideline quality, authors should pay particular attention to these areas and use existing highest quality guidelines, or the AGREE II instrument, as templates. CPGs dedicated to anatomic areas other than the knee, ankle, and shoulder are needed. [ABSTRACT FROM AUTHOR]

Background: The time between an anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) may influence baseline knee-related and general health-related patient-reported outcome measures (PROMs). Despite the common use of PROMs as main outcomes in clinical studies, this variable has never been evaluated. Purpose: To compare baseline health-related quality of life measures and the prevalence/pattern of meniscal and articular cartilage lesions between patients who underwent acute and chronic ACLR so as to provide clinicians with benchmark PROMs in 2 different patient populations with ACL injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 1192 patients from the MOON (Multicenter Orthopaedic Outcomes Network) cohort who underwent primary ACLR were eligible. “Acute” ACLR was defined as <3 months (n = 853; 71.6%) and “chronic” ACLR as >6 months (n = 339; 28.4%) from injury. Patient demographics, surgical characteristics (articular cartilage injury, medial meniscal [MM] and lateral meniscal [LM] tears), and baseline PROM scores (Marx activity rating scale, International Knee Documentation Committee [IKDC] subjective form, Knee injury and Osteoarthritis Outcome Score [KOOS], and Short Form–36 Health Survey [SF-36]) were collected to determine whether the time from injury to ACLR influences (1) baseline PROMs and (2) the pattern and prevalence of concurrent articular cartilage and meniscal injuries. Analysis of covariance models were used to adjust for confounders on baseline outcome scores (age, sex, body mass index [BMI], smoking status, competition level, education). Results: The median patient age was 23 years (interquartile range [IQR], 17-35 years), 530 (44.5%) were female, and the median BMI was 25.0 kg/m2 (IQR, 22.3-27.9 kg/m2); however, the chronic group was older, had a higher BMI, and consisted of fewer collegiate athletes. A significantly greater number of partial LM tears were seen in the acute group versus the chronic group (14.2% vs 6.5%, respectively; P < .001), but there were more meniscal tears overall (73.5% vs 63.2%, respectively; P = .001), complete MM tears (49.0% vs 22.5%, respectively; P < .001), and articular cartilage injuries (54.0% vs 32.8%, respectively; P < .001) in the chronic group versus the acute group. After controlling for confounders, patients in the chronic ACLR group reported a significantly lower baseline Marx score (7.75 vs 12.10, respectively; P < .001) but higher baseline IKDC, SF-36 physical functioning, and all KOOS subscale scores except the KOOS–quality of life subscale score compared to those in the acute ACLR group; however, only the KOOS–sports and recreation subscale exceeded the minimum clinically importance difference of 8 points (62.30 vs 48.26, respectively; P < .001). Conclusion: After controlling for age, sex, competition level, smoking, and BMI, patients in the chronic ACLR group participated in less pivoting and cutting sports but reported better pain/function. Whether decreased activity is deliberate after an ACL injury or patients who undergo chronic ACLR are simply less active and may be treated successfully without surgery warrants further investigation. Nonrandomized studies that utilize PROMs should consider time from injury in study design and data interpretation. [ABSTRACT FROM AUTHOR]

A stray surface find in excavations at Corinth of an Abbasid coin, clipped into the shape of an octagon, presents a puzzle, both methodologically and historically. The possible date and manner of its arrival in the city are studied and the reasons and context of its clipping are considered. A link with octagonal specimens from Trebizond and Antioch-on-the-Orontes is suggested. Another stray find, this time a Chinese coin, also from Corinth, is studied here for comparison. [ABSTRACT FROM AUTHOR]