Miracle-dz/UniFAR-FTUs huggingface dataset:
Altered scapular orientation during arm elevation in patients with insidious onset neck pain and whiplash-associated disorder.

STUDY DESIGN Controlled laboratory study using a cross-sectional design. OBJECTIVES To investigate whether there is a pattern of altered scapular orientation during arm elevation in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD) compared to asymptomatic people. BACKGROUND Altered activity in the axioscapular muscles and impairments in scapular orientation are considered to be important features in patients with cervical disorders. Scapular orientation has until now not been investigated in these patients. METHODS A 3-dimensional tracking device measured scapular orientation during arm elevation in patients with IONP (n = 21) and WAD (n = 23). An asymptomatic group was selected for comparison (n = 20). RESULTS The groups demonstrated a significantly reduced clavicle retraction on the dominant side compared to the nondominant side. The WAD group demonstrated an increased elevation of the clavicle compared to the asymptomatic group and the IONP group, and reduced scapular posterior tilt on the nondominant side compared to the IONP group. CONCLUSION Altered dynamic stability of the scapula may be present in patients with cervical disorders, which may be an important mechanism for maintenance of recurrence or exacerbation of symptoms in these patients. Patients with cervical disorders may demonstrate a difference in impairments, based on their diagnosis of IONP or WAD.
Prevalence of neurocognitive and balance deficits in collegiate aged football players without clinically diagnosed concussion.

STUDY DESIGN Prospective cohort. OBJECTIVES To identify the prevalence of neurocognitive and balance deficits in collegiate football players 48 hours following competition. BACKGROUND Neurocognitive testing, balance assessments, and subjective report of symptoms are a commonly used test battery in examining athletes when concussion is suspected. Previous literature suggests many concussions go unreported. Little research exists examining the prevalence of neurocognitive or balance deficits in athletes who do not report concussion-like symptoms to a health care provider. METHODS Forty-five Division IA collegiate football players participated in this study. Preseason baseline scores using the Balance Error Scoring System, the Immediate Post-Concussion Assessment and Cognitive Testing, and the Postconcussion Symptom Scale were compared to posttest results obtained 48 hours following a game. Prevalence of symptoms was analyzed and reported. RESULTS Thirty-two (71%) of the 45 athletes tested demonstrated at least 1 deficit in either the Postconcussion Symptom Scale, Balance Error Scoring System, or at least 1 composite score of the Immediate Post-Concussion Assessment and Cognitive Testing. Nineteen of the 32 subjects demonstrated a change in 2 or more categories of neurocognitive and balance function. CONCLUSION In a cohort of football players tested 48 hours following their last game of the season, who did not seek medical attention related to a concussion, a significant number demonstrated limitations in neurocognitive and balance performance, suggesting that further research may need to be performed to improve recognition of an athlete's deficits and to improve the ability to assess concussion. LEVEL OF EVIDENCE Differential diagnosis/symptom prevalence, level 3b.
Evaluation of a tool for rating popular diet books

Objective The aim of this study was to develop a questionnaire for use by nutrition professionals to enable evaluation of popular diet books. Design A questionnaire was developed incorporating quantified criteria based on current authoritative nutrition guidelines. Twenty two questions were included, relating to nutritional adequacy, daily energy allowance, recommended rate of weight loss, flexibility and sustainability, physical activity advice, use of supplements, claims, author’s credentials, and scientific evidence. The questionnaire was used to rate 35 diets in 20 popular diet books sold in Australia in 2001, in order to test its practicality, validity and sensitivity. A computerised dietary analysis of three days of menus from each book was used to assess the validity of the questions assessing nutritional adequacy. Main outcome measures Assessment scores of each book and correlation with dietary analyses. Statistical analysis Spearman rank correlation was used to compare the nutritional adequacy of the diets assessed by the dietary assessment scores from the questionnaire and the numbers of nutrients likely to be provided at <70% RDI or <100% RDI. One way ANOVA was used to compare the mean scores of books written by those with nutrition qualifications, medical qualifications, and others. Results The scoring of the questionnaire was found to correlate well with the computerised analysis of the diets. Overall scores for the 20 books tested ranged from 32 to 97 out of a possible 100. Only five of the books were found by the assessment criteria to have diets compatible with current dietary and public health guidelines, with scores of over 80. Three diets provided less than 4200 kJ per day, whilst five books advertised weight loss results of greater than 1kg per week and promoted or used ‘fast’ weight loss as a selling point. The majority of books relied on testimonials rather than supporting their results with data published in peer reviewed journals. Books authored by people with nutrition qualifications rated highest. Conclusion The questionnaire provides a useful standardised method of ranking the nutritional adequacy of popular diets books and evaluating their approach to weight loss, suitable for use by nutrition professionals.
Chronic electrical stimulation of the canine retina

An electronic retinal prosthesis is under development to treat retinitis pigmentosa and age-related macular degeneration, two presently incurable diseases of the outer retina. Previous studies have established the feasibility of the retinal prosthesis. The goal of these experiments was to investigate chronic stimulation of the retina. These effects were measured by direct examination of the implant, electrophysiology of the retina, electrically elicited responses, and examination of histology post-implant. Implants were placed in 6 dogs. The implant featured an implantable stimulator and a 4/spl times/4 array of 460-micron diameter platinum disks positioned on the retina. 6 dogs were chronically stimulated at 0.05 mC/cm/sup 2/ and 0.1 mC/cm/sup 2/ for up to 60 days (10-12 hours/day). No retinal damage was evident from the stimulus. Some mechanical damage of the retina due to array misalignment was apparent in early implants, but this was minimized with improved surgical technique. Bright flash electroretinograms showed no changes in retinal function comparing pre and post implant recordings. Electrically evoked cortical responses were recorded from 1 dog showing that the functional connection between the retina and the remained. Histological analysis revealed normal retina under the array of 1 dog that had been stimulated for 25 days.
Single-Flap Approach With Buccal Access in Periodontal Reconstructive Procedures

Background: New surgical techniques have been developed to optimize primary closure as well as to minimize the surgical trauma in the reconstructive procedures of periodontal intraosseous defects. Recently, we proposed a minimally invasive procedure, the single-flap approach (SFA), specifically indicated when the defect extension is prevalent on the buccal or oral side. The basic principle of the SFA is the elevation of a flap to access the defect only on one side (buccal or oral), leaving the opposite side intact. The present case series reports preliminary data on the clinical effectiveness of SFA with buccal access in conjunction with a collagen membrane and a hydroxyapatite (HA)-based biomaterial in the reconstructive treatment of deep periodontal intraosseous defects.Methods: Ten intraosseous defects in 10 patients were accessed with a buccal SFA and treated with a collagen membrane and an HA-based graft biomaterial. The follow-up period following the regenerative procedure ranged from 6 to 14 months.
Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a delaware-oslo ACL cohort study.

STUDY DESIGN Cohort study, cross-sectional. OBJECTIVES To determine if self-reported knee function assessed with the International Knee Documentation Committee 2000 Subjective Knee Form (IKDC 2000) could discriminate between successful and nonsuccessful performance on return-to-activity criteria (RTAC) tests after anterior cruciate ligament (ACL) reconstruction. BACKGROUND Selecting appropriate performance-based and patient-reported tests that can detect side-to-side asymmetries, assess global knee function, and determine a participant's readiness to return to activity after ACL reconstruction can be a challenge for rehabilitation specialists. A simple tool or questionnaire to identify athletes with neuromuscular impairments or activity limitations could provide rehabilitation specialists with crucial data pertinent to their patients' current knee function and readiness to return to higher-level activities. METHODS One hundred ninety-four level I and level II athletes who underwent ACL reconstruction participated in the study. One hundred fifty-eight athletes at 6 months after ACL reconstruction and 141 of the athletes at 12 months after ACL reconstruction completed a battery of functional tests to determine readiness to return to activity and the IKDC 2000 to determine self-reported knee function. For each athlete, status on the RTAC test battery was dichotomized into "passed" or "failed," and status on the IKDC 2000 scores was dichotomized into "within" or "below" age- and sex-matched normal ranges. Comparisons were made between status on the RTAC test battery and the IKDC 2000 using chi-square tests. Accuracy statistics were also calculated. RESULTS Six months after ACL reconstruction, 112 athletes (70.9%) failed RTAC and 76 (48.1%) were classified as having self-reported knee function below normal ranges. Among the 76 participants with IKDC 2000 scores below normal ranges, 69 (90.8%) failed the RTAC test battery (P<.001). However, among the 82 participants whose IKDC 2000 scores were within normal limits at 6 months, only 39 (47.6%) passed the RTAC test battery (P = .74). Twelve months after ACL reconstruction, 67 athletes (47.5%) failed RTAC and 31 (22.0%) had knee function below normal ranges. Among the 31 participants with IKDC 2000 scores below normal ranges, 25 (80.6%) failed the RTAC test battery (P<.001). However, among the 110 participants whose IKDC 2000 scores were within normal limits at 12 months, only 68 (61.8%) passed the RTAC test battery (P = .017). CONCLUSION The IKDC 2000 may be a clinically relevant tool to determine the timeliness or necessity of RTAC testing. For scores obtained 6 and 12 months after ACL reconstruction, low IKDC 2000 scores were reasonably indicative of failure on the RTAC test battery, whereas normal IKDC 2000 scores were not predictive of passing scores on the RTAC test battery.
Human leukocyte antigen associations in Finnish liver transplantations due to primary sclerosing cholangitis and primary biliary cirrhosis

A genetic predisposition has been suggested in primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC). The aim of the study was to evaluate human leukocyte antigen (HLA) frequencies and HLA associations in Finnish PSC and PBC patients. The relative frequencies of HLA-A,-B, and-DR antigens were compared between patients with PSC (n=50), or PBC (n=89), transplanted due to end-stage liver disease, and healthy members in the Finnish bone marrow donor registry (n=10000). Prevalence differences, prevalence ratios and the associated large-sample significance probabilities (2-sided P-values) and 95% confidence intervals were calculated.We found a strong positive association between PSC and HLA-B8 and-DR3, and a weak positive association between HLA-A1 and PSC. HLA-DR3 also had a weak positive association with PBC, and a weak negative association between HLA-DR5 and PBC was found. In conclusion, HLA-B8, and-DR3 are susceptible for progressive liver disease in PSC, and HLA-DR3 may also be susceptible for disease progression in PBC. HLA-DR5 may be protective against severe PBC.
Prognosis of physical function following ankle fracture: a systematic review with meta-analysis.

STUDY DESIGN Systematic review and meta-analysis of longitudinal studies. OBJECTIVES To quantify the prognosis of physical function following ankle fracture. BACKGROUND Information about the course of recovery of physical function after ankle fracture is essential for patient care and health care policy. The existing data have not previously been included in a meta-analysis. METHODS Studies were identified using searches of electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, PEDro, AMED, SPORTDiscus) and gray literature to September 2012. Studies of people with traumatic ankle fracture were included. Two reviewers independently screened references for inclusion, then extracted data and evaluated risk of bias. The outcome of interest was physical function (physical activity and activity limitation). Outcomes were converted to a common 100-point scale, on which higher scores indicated better outcomes. Meta-regression was conducted using generalized estimating equations. RESULTS Thirty-one studies (37 articles) were included. Adults with ankle fracture, present with significant activity limitation in the short term (mean at 1 month, 31.9; 95% confidence interval [CI]: 18.8, 45.1), recovered markedly but incompletely in the short to medium term (mean at 6 months, 78.3; 95% CI: 70.1, 85.1), and showed little further improvement in the long term (mean at 24 months, 86.6; 95% CI: 78.2, 95.0). Studies with older participants and predominantly male participants tended to report worse functional outcomes. CONCLUSION Adults typically experience a rapid initial recovery of physical function after ankle fracture (approximately 80% function at 6 months), but, on average, recovery remains incomplete 24 months after injury. PROSPERO registration number: 42012002979. LEVEL OF EVIDENCE Prognosis, level 2a.
Diagnostic and procedural imaging curricula in physical therapist professional degree programs.

STUDY DESIGN Descriptive survey. OBJECTIVE To describe the status of diagnostic and procedural imaging curricula within United States physical therapist professional degree programs. BACKGROUND As patient direct access to physical therapy services increases, the ability to refer patients directly for diagnostic imaging could promote more efficient delivery of care. Appropriate patient referral is contingent on physical therapists having the requisite knowledge base and skills. While evidence describing imaging competence of physical therapists with advanced training in military institutions exists, evidence is lacking for other physical therapists, including new graduates of physical therapist professional degree programs. METHODS Faculty members teaching imaging at 206 United States physical therapist professional degree programs recognized by the Commission on Accreditation in Physical Therapy Education were recruited via e-mail correspondence. An e-mail attachment included the survey on which faculty reported imaging curricula and faculty qualifications, attitudes, and experiences. RESULTS Faculty from 155 (75.2%) programs responded to the survey, with imaging being included in the curriculum of 152 programs. Content was integrated by required standalone courses or clinical science track courses, and/or through elective courses. The average reported estimate of imaging contact hours was 24.4 hours (range, 2-75 hours). Emphasis was on the musculoskeletal system, including 76.3% of the required standalone course content. Student competence was assessed in 147 (96.7%) programs, primarily by written (66.7%) and practical (19.7%) examinations. Faculty rated student competence on a scale of 1 (not competent) to 5 (competent), with ratings ranging from a high of 4.0 (identifying normal anatomy on plain-film radiography) to a low of 1.9 (identifying common tissue pathological processes/injuries on ultrasound). CONCLUSION While a majority of programs reported including imaging curricula, variability was noted in all curricular aspects. These results may serve as a benchmark for faculty to assess existing curricula, allow for further development of imaging curricula, and provide a benchmark for the profession regarding current level of training for recent graduates of entry-level physical therapist professional degree programs.
The impact of physical therapy residency or fellowship education on clinical outcomes for patients with musculoskeletal conditions.

STUDY DESIGN A retrospective cohort design was conducted using data from an electronic survey and an existing commercial outcomes database. OBJECTIVE To compare the clinical outcomes of patients with musculoskeletal conditions treated by physical therapists who had completed residency or fellowship programs versus those who had not. BACKGROUND There is an increasing focus on specialization through postprofessional education in physical therapy residency and fellowship programs. Scant evidence exists that evaluates the influence of postprofessional clinical education on actual patient outcomes. METHODS Physical therapists using a national outcomes database were surveyed to determine their level of postprofessional education. Survey responders were categorized into 1 of 3 groups that included no residency or fellowship training, residency trained, or fellowship trained. Outcomes for 25 843 patients with musculoskeletal conditions treated by 363 therapists from June 2012 to June 2013 were extracted from the database. These data were analyzed to identify any differences in functional status change and efficiency achieved between the 3 groups. Potentially confounding variables were controlled for statistically. RESULTS The fellowship-trained group of physical therapists achieved functional status changes and efficiency that were greater than those of the other groups. No difference in functional status change was observed between the residency group and the therapists without residency or fellowship training. The group without residency or fellowship training was more efficient than the residency-trained group. Fellowship-trained therapists were more likely to achieve greater treatment effect sizes than therapists without residency or fellowship training. Residency-trained therapists were less likely to achieve greater treatment effect sizes than the therapists without residency or fellowship training. CONCLUSION These data demonstrate that fellowship training may contribute to statistically greater patient outcomes. Residency training did not appear to contribute to improved patient functional status change or efficiency. It is unknown whether the statistical differences observed would be clinically meaningful for patients.
Reconceptualising e-government as a tool of governance: the UK case

Despite significant investment in G2C e-government across the developed world, citizens are not engaging as enthusiastically as anticipated. Whilst earlier studies cite technophobia, the digital divide, organisational and cultural barriers, this paper proposes that under-utilisation may be a symptom of malaise in citizen-state relations. Analysing G2C e-government development in relation to governance theory within the UK context, this paper argues that the centralised, rational-goal approach may be detrimental to usage and that embracing an open systems mode of governance may accelerate development and enhance usage. This paper concludes by suggesting that the success of G2C may rely upon e-government being reconceptualised as an instrument of devolved, communitarian governance. Empirical research is advocated as a way of exploring whether shifting to an open systems mode of governance might facilitate the development of participative, user-oriented G2C and electronically enabled democracy.
Interprofessional learning for the improvement of health care: why bother?

Two inter-professional initiatives, the Interdisciplinary Professional Education Collaborative in the United States and the Interprofessional Education Programme in the UK, are working to discover how health professionals can gain knowledge and skill in the continuous improvement of health care. They are seeking closer links between health care delivery and health professional education, between the needs of patients and communities, and those of learners. The ultimate goal is to create health care that: (1) seeks to understand and meet patients' needs; (2) organises care as a system focused around that need; (3) takes advantage of what teams of professionals can do when they work well together; and (4) improves constantly through the active efforts and innovative ideas of the health care team. This paper describes the initiatives and identifies common lessons for health care delivery and interprofessional education.
Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management.

Synopsis Gluteal tendinopathy is now believed to be the primary local source of lateral hip pain, or greater trochanteric pain syndrome, previously referred to as trochanteric bursitis. This condition is prevalent, particularly among postmenopausal women, and has a considerable negative influence on quality of life. Improved prognosis and outcomes in the future for those with gluteal tendinopathy will be underpinned by advances in diagnostic testing, a clearer understanding of risk factors and comorbidities, and evidence-based management programs. High-quality studies that meet these requirements are still lacking. This clinical commentary provides direction to assist the clinician with assessment and management of the patient with gluteal tendinopathy, based on currently limited available evidence on this condition and the wider tendon literature and on the combined clinical experience of the authors. J Orthop Sports Phys Ther 2015;45(11):910-922. Epub 17 Sep 2015. doi:10.2519/jospt.2015. 5829.