Graufarrell4951

PURPOSE Medial meniscus posterior root tear (MMPRT) should be repaired to the correct position as possible to maintain hoop tension of the meniscus. In this study, we propose a comparison of the outcome between the medial tunnel and the lateral tunnel in the pullout suture technique using the tibial tunnel for anatomical repair of posterior root tear of medial meniscus. METHODS From April 2010, of patients who underwent pullout suture, 51 cases (24 medial tunnel group (MTG) and 27 lateral tunnel group (LTG)) were able to follow-up with second look arthroscopy. Original Coronal Ratio of Root Attachment (CRORA) was defined as the ratio of the distance from the medial edge of the tibial plateau to the root attach site divided by the entire tibial medial-lateral width on preoperative computed tomography. Error between postoperative CRORA and original CRORA was calculated. We compared this error, clinical outcome, and arthroscopic finding between MTG and LTG. RESULTS The mean error ratio of postoperative CRORA divided by original CRORA was 0.86 ± 0.11 in MTG, which was significantly (p = 0.001) lower than that (1.02 ± 0.06) in LTG. The mean value of the root attach point in the MTG with a post/original CRORA value of 0.86 ± 0.11 means statistically significant medialization after the operation. There was no statistically significant difference in changes of International Knee Documentation Committee (IKDC) and Lysholom score between MTG and LTG. The difference between the two groups of arthritis progression was not statistically significant. CONCLUSION In patients with MMPRT, CRORA may provide a basis for coronal assessment of root repair position before and after surgery, and lateral tibial tunnel technique can help anatomical repair by reducing technical error due to guide pin slip medially compared to medial tibial tunnel technique.This study investigated the deceleration effect of flutter kicking after dolphin kicking before commencing the stroke at swimmer's emersion. Eight male competitive swimmers (age 19.6 ± 1.2 years; Fédération Internationale de Natation points 733.6 ± 57.5) performed 15 m front crawl sprints from wall push-off three times in a row, with two types of underwater kicks [dolphin kick only (dolphin condition) and dolphin kick followed by flutter kick (dolphin-flutter condition)]. Sprint bouts were divided into four phases. Phases 1 and 2 were defined, respectively, as the fourth and fifth dolphin kicks. Phase 3 was defined as the first stroke (dolphin condition) and six beats of the flutter kicking (dolphin-flutter condition). Phase 4 was defined as the second stroke (dolphin condition) and the first stroke (dolphin-flutter condition). Two-way repeated measured analysis of variance on mean swimming velocities demonstrated an interaction of condition and phase (p  less then  0.001) and a simple main effect (p  less then  0.001) at Phase 3. These results indicated greater deceleration due to adding the flutter kick after the dolphin kick before commencing the stroke. Swimmers should use only the underwater dolphin kick before commencing the front crawl in start and turn segments.Combat Veterans (CVs) deployed to Iraq or Afghanistan experience driving difficulty, based on medical conditions and/or deployment exposures, elevating their risk of motor vehicle crash-related injury or death. To address grounded theory rigor and incorporate constructs such as the Person Environment Occupation Performance model, we revised the Hannold et al. (2013) conceptual framework. We conducted two focus groups with seven CVs. Conceptual framework revisions were based on an iterative process and thematic analysis. We elicited CVs' perspectives on deployment training, driving pre- and postdeployment, strategies, and intervention preferences. selleck products Personal, environmental, and task factors underpinned CVs' driving. Participants described triggers (e.g., stressful stimuli), use of environmental (e.g., car controls) or personal (e.g., avoiding traffic) strategies, and outcomes of appropriate or risky driving. Findings illustrated CVs' driving difficulty and informed development of a Veteran-centric driving intervention. Improving driving fitness has implications for Veterans' participation and community integration.Independent learning refers to opportunities in which responsibility for learning shifts to learners. Providing health professions learners with independent learning opportunities can be challenging because of the often highly structured curricula of health professions education. Structured independent learning assignments that give learners the opportunity to begin developing the skills and strategies to take on self-directed opportunities in the future may lend themselves to these contexts. However, in health professions education contexts, few guidelines exist for designing effective assignments that foster independence in learning. These twelve tips provide recommendations for how to improve structured independent learning assignments for health professions learners and help them develop the skills and experience required for more self-directed opportunities and for lifelong learning.Background Fentanyl-associated overdose fatalities have increased dramatically throughout the United States. Fentanyl test strips (FTS) may be used by people who inject drugs (PWID) to lower overdose risks; however, virtually no research has been conducted to understand the perspectives of rural PWID in Appalachia on FTS utilization. Objectives We aim to explore FTS awareness and potential use among PWID in two rural counties in West Virginia (WV). Methods Semi-structured interviews with PWID (n = 48) in two rural counties in WV were conducted to explore FTS awareness, potential use, and possible behavioral changes following FTS utilization. Participants were recruited in areas where PWID congregate in each county. With participants' permission, interviews were audio recorded and transcribed verbatim. Transcripts were analyzed using an iterative, constant comparative approach. Results Very few participants had heard of FTS prior to the interview. Upon learning about FTS, PWID who reported frequently injecting heroin expressed high willingness to use FTS.