Total Ankle Replacement, Then and Now: A Review

Total ankle replacement (TAR) for treating end-stage osteoarthritis of the ankle joint has been evolving since the early 1960s. Increased understanding of the biomechanics and kinematics of the foot and ankle, postoperative results of implant use, and advances in technology have led to improved implant designs and treatment outcomes. The current study reviews associated historical perspectives, kinematics, biomechanics, patient selection, imaging procedures, modern surgical techniques, postoperative complications, and comparison studies with arthrodesis to help evaluate TAR in successfully treating osteoarthritis of the ankle joint. Although arthrodesis remains the gold standard for treatment, findings of new studies have suggested that TAR may be comparable in outcomes, gait mechanics, and complications

The history and development of the shoe industry in Haverhill.

Thesis (Ed.M.)--Boston Universit

The short-run dynamics of long-run inflation policy

An examination of the short- and long-term implications of an inflation policy on real output, using a method that allows structural interpretation of a simple VAR applied to a macroeconomic system that includes real output and inflation.Inflation (Finance) ; Monetary policy ; Gross national product

Isolated Traumatic Subscapularis Tear in a 12-Year-Old Male Gymnast: A Case Report

Isolated avulsion fractures of the lesser tuberosity are rarely encountered in younger and older populations. However, because the tendon of the subscapularis insertion is stronger in skeletally immature individuals, isolated tears to the tendon occur more commonly in adults than children and adolescents. Most studies have been limited to case reports that mainly describe traumatic subscapularis tears in adolescent athlete-patients. We present a 12-year-old male gymnast who reported to our clinic with pain and weakness in the right shoulder at 2 months after the initial injury. We performed open repair with suture anchor fixation for treatment of an isolated subscapularis tear. At 6 months postoperatively, the child felt no pain, regained full range of shoulder motion and strength, and returned to highly competitive physical activity. Isolation of the subscapularis insertion during physical examination can be essential to initial diagnosis, allowing for successful and early operative treatment

Review of Health Services Available for Persons who Contracted Hepatitis C through the Administration within the State of Blood or Blood Products. Implementation of Recommendations.

the State of infected blood and blood products. The Report examines progress on the recommendations published in 2000, and recognizes the evolution in service needs since then with the addition of 4 new recommendations. The Report will assist health service providers, the Department of Health and Children and the support groups to continue working together to ensure that the future service needs of this Hepatitis C group are met. It is timely that this review has come at a time when the health services are entering a new phase of restructuring and renewal. The Consultative Council welcomes this process and is confident that it will bring benefits to both service users and service providers. The Council has assured the Health Service Executive and the National Hospitals Office that we will be happy to co-operate with them and to continue playing a positive role in shaping Hepatitis C services for this cohort of patients in the future. As with the first Review the four support groups - Positive Action, Transfusion Positive, the Irish Haemophilia Society and the Irish Kidney Association - all of which are represented on the Consultative Council, are to be commended for the important role they play, and for encouraging their members to participate in this progress report

Online Sovereignty: The Law and Economics of Tribal Electronic Commerce

In 1886, the US Supreme Court wrote that, for Indian tribes, the people of the states where they are found are often their deadliest enemies. Recently, state agencies and regulators have continued that tradition of hostility by improperly attempting to regulate electronic commerce businesses operated by tribal governments that are more properly subject to regulations established by tribal law and subject to federal oversight. Despite the fact that these online businesses operate exclusively under tribal law and make their tribal affiliation clear to customers, certain state regulators have demanded absolute compliance with state law, even when such laws are from states thousands of miles away. Not only does this over reaching by uninformed state regulators limit the products available to consumers, it also severely undercuts on-reservation economic development, imperils tribal electronic commerce, and challenges basic notions of tribal sovereignty. Businesses and consumers entering into commercial contracts rely heavily on consistency and predictability in contracting, including when the parties mutually agree to apply tribal law or utilize tribal courts to resolve disputes. Uniform interpretation and enforcement of such agreements are critical to ensuring continued investment in tribal businesses. With over one quarter of American Indians living in poverty--nearly twice the national average--it has never been more important to promote confidence in the Indian economy. When courts do not give full force and effect to contracting parties\u27 desires to resolve their private disputes using tribal courts and tribal law, this confidence is threatened. While it is unclear how this controversy will ultimately play out, one thing is certain: states are not only undermining tribal innovation and harming tribal economies but also attacking tribal sovereignty itself. Perhaps lost in the legal rancor, however, are the very real human and economic consequences of the loss of tribal revenues from e-commerce business, as well as the potential damage to tribal e-commerce as a whole. This Article presents results of empirical research into the economic impact of tribal online lending in Indian Country. The Article first frames the issue with a brief summary of the legal foundations for tribal e-commerce and tribal lending in particular. Next, the Article presents several case studies of tribes that have engaged in online lending, focusing on the direct economic impact to those tribal communities. Finally, the Article concludes with policy arguments as to why state and federal regulators should support rather than suppress tribal e-commerce, including tribal small-dollar online lending

Childhood trauma and post-trauma environment affect fear memory and alcohol use differently in male and female mice

Background: Childhood trauma is associated with the development of adult mental health and substance use disorders, with females generally being more at risk. Alcohol is commonly used for coping with trauma, and alcohol use disorder (AUD) affects ~14.4 million adult Americans annually. Research investigating sex differences in the environmental modification of anxiety and alcohol use following childhood trauma will extend our understanding of the etiology of AUD. Here, we sought to model the interacting effects of a single-episode late childhood trauma with post-trauma environment on adult alcohol use using male and female mice. Methods: C57Bl6/J mice (d22) exposed to predator odor (TMT) or water were reared in standard environments (SE) or environmental enrichment (EE). Mice were assessed for adolescent anxiety and conditioned fear, and for adult alcohol use in a limited access, response non-contingent, alcohol exposure paradigm. Results: A single exposure to predator odor was an effective stressor, inducing long-term sex- dependent changes in conditioned fear and alcohol behaviors that interacted with post-trauma environment. Adolescent EE females showed more conditioned freezing to the trauma-associated context. Adult EE mice consumed less total alcohol than SE mice. However, alcohol use across time differed for males and females. Exposure to a childhood stressor increased alcohol use significantly in females, but not males. EE males, but not EE females, drank less than SE counterparts. Conclusions: Findings from this model recapitulate greater vulnerability to childhood trauma in females and support sex differences in post-trauma development of conditioned fear and alcohol use that are modified by environment

Stable incidence rates of tuberculosis (TB) among human immunodeficiency virus (HIV)-negative South African gold miners during a decade of epidemic HIV-associated TB.

During the last decade, annual tuberculosis (TB) case-notification rates increased 4-fold, to >4000 cases/100000 person-years, in the study workforce, among whom prevalence of human immunodeficiency virus (HIV) was 30% in 2000. Three separate cohort studies, totalling 6454 HIV-negative participants, were combined and analyzed for time trends. Observed incidence of TB varied between 962 (1991-1994) and 1589 (1999-2000) cases/100000 person-years (P=.17, test for trend). There was, however, a progressive increase in age, and, for each period, older age was associated with increased incidence rates of TB (P<.001). Having adjusted for age differences, there was no significant association between incidence of TB and calendar period (P=.81, test for trend). Relative to 1991-1994, multivariate-adjusted incidence-rate ratios were 0.94, for 1995-1997, 0.96, for 1998-1999, and 1.05, for 1999-2000. Preventing a secondary epidemic of TB among HIV-negative individuals may be achievable with conventional means, even in settings with a high burden of HIV-associated TB

Maturational and social factors contributing to relative age effects in school sports: Data from the London Youth Games

Few studies have investigated whether relative age effects (RAEs) exist in school sport. None have sought to test the competing maturational and social‐agent hypotheses proposed to explain the RAE. We aimed to determine the presence of RAEs in multiple school sports and examine the contribution of maturational and social factors in commonplace school sports. We analyzed birth dates of n=10645 competitors (11‐18 years) in the 2013 London Youth Games annual inter‐school multisport competition and calculated odds ratio (OR) for students competing based on their yearly birth quarter (Q1‐Q4). Multivariate logistic regression was used to determine the relative contribution of constituent year (Grade) and relative age in netball and football which used multiyear age groupings. In girls, RAEs were present in the team sports including hockey, netball, rugby union, cricket and volleyball but not football. In boys, RAEs were stronger in common team sports (football, basketball cricket) as well as athletics and rowing. In netball and football teams with players from two constituent years, birth quarter better‐predicted selection than did constituent year. Relatively older players (Q1) from lower constituent years were overrepresented compared with players from Q3 and Q4 of the upper constituent years. RAEs are present in the many sports commonplace in English schools. Selection of relatively older players ahead of chronologically older students born later in the selection year suggests social agents contribute to RAEs in school sports