bluuebunny/crossref_metadata_2025_split huggingface dataset:
Test Performance and Test-Retest Reliability of the Vestibular/Ocular Motor Screening and King-Devick Test in Adolescent Athletes During a Competitive Sport Season
Authors: Worts Phillip R. , Schatz Philip , Burkhart Scott O. 
Published: May 2018

Background: The Vestibular/Ocular Motor Screening (VOMS) and King-Devick (K-D) test are tools designed to assess ocular or vestibular function after a sport-related concussion. Purpose: To determine the test-retest reliability and rate of false-positive results of the VOMS and K-D test in a healthy athlete sample. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Forty-five healthy high school student-athletes (mean age, 16.11 ± 1.43 years) completed self-reported demographics and medical history and were administered the VOMS and K-D test during rest on day 1 (baseline). The VOMS and K-D test were administered again once during rest (prepractice) and once within 5 minutes of removal from sport practice on day 2 (removal). The Borg rating of perceived exertion scale was administered at removal. Intraclass correlation coefficients were used to determine test-retest reliability on the K-D test and the average near point of convergence (NPC) distance on the VOMS. Level of agreement was used to examine VOMS symptom provocation over the 3 administration times. Multivariate base rates were used to determine the rate of false-positive results when simultaneously considering multiple clinical cutoffs. Results: Test-retest reliability of total time on the K-D test (0.91 [95% CI, 0.86-0.95]) and NPC distance (0.91 [95% CI, 0.85-0.95]) was high across the 3 administration times. Level of agreement ranged from 48.9% to 88.9% across all 3 times for the VOMS items. Using established clinical cutoffs, false-positive results occurred in 2% of the sample using the VOMS at removal and 36% using the K-D test. Conclusion: The VOMS displayed a false-positive rate of 2% in this high school student-athlete cohort. The K-D test’s false-positive rate was 36% while maintaining a high level of test-retest reliability (0.91). Results from this study support future investigation of VOMS administration in an acutely injured high school athletic sample. Going forward, the VOMS may be more stable than other neurological and symptom report screening measures and less vulnerable to false-positive results than the K-D test.
How Variable Are Achilles Allografts Used for Anterior Cruciate Ligament Reconstruction? A Biomechanical Study
Authors: Weber Alexander E. , Mayer Erik N. , Nathani Amit , Chen Dan X. , Kelly Anne M. , Rodeo Scott A. , Bedi Asheesh 
Published: May 2018

Background: Allograft tendon used in anterior cruciate ligament reconstruction (ACLR) requires sterilization before implantation. Low-dose gamma irradiation is a means of sterilization that may minimize tissue damage. Purpose: To quantify the variability in mechanical properties between low-dose irradiated Achilles tendon allografts used for ACLR. Study Design: Descriptive laboratory study. Methods: A total of 15 intact outer-third Achilles tendon allograft specimens were collected from the remains of full Achilles allografts used for intraoperative ACLR at a single hospital. All grafts were obtained from a single tissue bank and underwent proprietary disinfection and low-dose gamma irradiation (1.5-2.5 Mrad). Biomechanical testing was carried out to measure tendon elongation, failure location during tensile testing, maximum stress, maximum strain, and modulus of elasticity. The mean and standard deviation were calculated for each outcome measure, and the variability between specimens was calculated by the coefficient of variation (CV). The effect of donor age on graft material properties was examined by use of linear regression. One-way analysis of variance was performed to compare differences in the mechanical properties across failure locations. Results: During cyclic testing, tendon elongation averaged 1.4% ± 1.6% with a CV of 118%. During failure testing, the maximum stress averaged 12.2 ± 4.1 MPa, maximum strain averaged 21.0% ± 6.3%, and modulus of elasticity averaged 95.5 ± 30.8 MPa. The CVs for maximum stress, maximum strain, and modulus of elasticity were 34%, 30%, and 32%, respectively. Ten tendons failed in the midsubstance and 5 failed at the tendon-bone enthesis. No differences were noted in mechanical properties between grafts that failed in the midsubstance versus those that failed at the enthesis. Donor age did not correlate with allograft elongation during cyclic load or any of the material property measures during failure testing. Conclusion: The variabilities in the material properties and graft elongation during cyclic loading of Achilles tendon allografts used in ACLR fall within the range of properties reported in the literature for other ACLR allografts. Material properties do not differ by donor age or graft failure location observed during failure testing. Clinical Relevance: Surgeons should be aware that there exists considerable variation in the mechanical properties of Achilles allograft tendons used for ACLR. This variability is difficult to detect by tissue bank screening or the treating surgeon’s inspection and may contribute to the heterogeneity in outcomes of allograft ACLR.
Criteria for Defining Program and Emphasis in the Family Agency
Authors: Scherz Frances H. 
Published: May 2018

Casework treatment that is goal directed implies that the caseworker takes active responsibility for methods and techniques used in implementing the treatment aim with the client's conscious and active participation. It is understood that all aims, methods, and techniques may shift during the course of treatment, depending on continuing diagnostic study and evaluation of the treatment plan. While the individual member of a family is the direct focus of treatment, family needs and balance are always an integral and continuing part of the diagnostic study and treatment plan. Certainly, psychiatric consultation is advisable, at present, for help in the diagnostic process and in selection of treatment aim and method. Caseworkers have become increasingly competent in diagnosing and treating those people and their situations that require maintenance of current social functioning or redirection of ego adaptations. The closest collaboration between caseworker and psychiatrist is required for the treatment aim of changing basic ego adaptations. From the viewpoint of programing in a family agency, in order to meet the treatment needs of people who require some basic reorganization of the personality for better social functioning, it is necessary for the family agency, in collaboration with schools of social work and psychiatrists, to take responsibility for providing appropriate special training for the casework staff. I have attempted to describe those criteria for program and emphasis which, I believe, relate to any family agency. The family agency in some communities is in a more advantageous position than in others to meet its two major responsibilities: direct help to people, through casework diagnostic service, casework administration of social services, and casework treatment service; and participation and leadership in community planning and social action. Through special projects in the casework administration of social services, the family agency attempts to meet its traditional and generic responsibilities—family centered in its specialization, and community centered in its identification of new and unmet social needs and in demonstration and interpretation of ways of meeting these needs. The richness and variety of other community resources should make it more possible for the family agency in such a setting to work carefully on the selection of cases for its own casework treatment service, thereby refining casework methodology in the interest of better service to people in the community.
Establishing Psychiatric Consultation for Agency Program
Authors: Tanenbaum David E. 
Published: May 2018

This complete clarification of details with the staff, board, and consultant is a cardinal factor in the development of an integrated consultation service. Only when these details are definitely outlined and accepted can the service be used efficaciously by both disciplines as a means of obtaining a competent “diagnostic synthesis”13 and a form of treatment in which each has contributed his respective skill and ability. These are the elements on which a smoothly functioning consultation service rests: (1) The community must have knowledge about the service and support it. To achieve this, it needs to understand its meaning; this suggests a strong educative endeavor by the agency through various methods of effective and continuous interpretation. (2) In the worker-consultant relationship there must be an acceptance by the psychiatrist and caseworker of each other's differentiated roles, and an adherence to agency function and scope of work. Recognizing that their diagnostic and treatment procedures, albeit derived from the same stem (concern for the individual's total adaptive function), have taken the form of different offshoots, the worker will be less apt to feel in a threatened or, perhaps, competitive position.14 (3) Understanding of their respective roles determines the procedures through which their duties can be effectively discharged in service to the client, safeguards their professional identities, and adds to further differentiation. This means that the psychiatrist will not assume supervisory or agency-representative duties, nor will the worker assume obligations ancillary to the psychiatrist. Their complementary activities and the administration of them will be structuralized within the agency in such a way that consistency, radier than diffusion, of agency definition and function is steadfastly maintained. (4) Particularly important are the complete understanding and acceptance among the board, staff, executive, and psychiatrist of the meanings of the consultation service, their responsibilities in this team relationship, and the agency policies through which such service will be discharged. The element of consonance in this is the basis for integration which, in turn, becomes the keystone for an efficient consultation service.
A Study of Techniques Used in Supportive Treatment
Authors: Schmidl Fritz 
Published: May 2018

In our efforts in supportive therapy our team set-up has been extremely important and helpful. One person takes the basic responsibility for the patient, and he consults other team members freely. We have felt that the less formal the relationships within the team have been, the more effective has been our work. Through using this flexible team approach, the social workers in this clinic have been able to take responsibility for a great many cases of supportive treatment, including cases of rather severe psychosis. We have gained the conviction that supportive treatment is an excellent tool in helping severely disturbed patients make an adjustment and in preventing hospitalization or rehospitalization. We have recognized, however, that warmth of interest for the patient and willingness to offer a relationship to him are only conditions to successful treatment. Concrete techniques based upon understanding of the patient's dynamics are necessary in order to do an adequate job.
Group Study of the Transfer of Cases
Authors: Grossman Martha , Guignon Harriet 
Published: May 2018

Transfer, when it is necessary and realistic, need not be traumatic for the client, but in most instances can even be helpful. The focus in treatment is always on understanding the dynamics of the client's disturbance. The treatment relationship must be understood in its twofold significance—its reality aspect and its transference aspect—if transfer is to be accomplished successfully. With the next worker, the transference factors in operation may be different and thus may initiate a different phase in treatment. The caseworker remains the therapist, in distinction to the “friend,” in all his dealings with the client. Usually, focusing on understanding the dynamics of the client will help the worker to handle his own feelings about the change so that he can make the transfer a constructive experience for the client. It is understandable that a worker may have feelings about transferring a case, or of taking on a case in which his work can be compared with that of the previous worker. Usually the supervisor can help the worker to carry through the transfer constructively. The supervisor can accelerate the understanding of the less experienced worker by reviewing with him the diagnosis and the treatment plan. Together, worker and supervisor can identify the specific trauma that is being re-enacted, can anticipate on the basis of the recorded material what the transference reactions may be, and can plan how to handle these reactions. Open discussion of a worker's feelings about leaving a client or taking on a client should be encouraged. The worker who is negatively critical of the previous worker's handling of a case, the worker who is convinced that no worker but he can really help the client, and the worker who is painfully self-conscious about his lack of casework skill, can usually learn to handle their feelings about transferring a case through exploring with true professional zeal what this change means to the client. In conclusion, it was the conviction of this group of supervisors that the majority of workers will need, at one point or another, supervisory help to effect the transfer of cases in a constructive manner. We believe, too, that there is sufficient similarity in workers’ typical reactions to transfer of cases to warrant the use of group teaching as an effective technique for giving supervisory help to workers when transfer is necessary.
Cable plating with a single strut allograft in the treatment of periprosthetic fractures of the femur
Authors: Manara Jonathan R , Mathews John A , Sandhu Harvey S 
Published: May 2018

Background: Hip arthroplasties are increasing worldwide resulting in an increasing number of periprosthetic fractures. These fractures are difficult to treat with various the different fixation or revision options described, many of which have high complication rates. Purpose: To investigate whether our described method of treating periprosthetic fractures is an effective, safe and reproducible method of treating patients. Methods: We describe the largest series of a cable plate fixation system combined with a single cortical strut allograft to treat patients with periprosthetic fractures of the hip (Unified Classification System B1 and selected B2, C and D). Results: Between July 2006 and March 2015, 28 patients were treated using this method. The mean follow-up was 2.2 years (3 months to 9 years). The mean Oxford Hip Score (OHS) at final follow-up was 32 and the mean modified Harris Hip Score (mHHS) 67. There were 3 complications including 1 failure that required revision surgery, 1 case of infection successfully treated with debridement, antibiotics and retention, and a case of discomfort from the metalwork which we managed conservatively. Conclusion: This method of anatomical restoration of the femur with dual-plane fixation is a highly effective method of treating this complex group of patients, and should be considered as a first line of treatment. It shows that there is a role for successful treatment with internal fixation of certain B2, C and D fractures with this technique.
Incidence, risk factors and prognosis of transient pseudosubluxation after total hip arthroplasty
Authors: Cha Yong-Han , Jo Woo-Lam , Lee Young-Kyun , Ha Yong-Chan , Parvizi Javad , Koo Kyung-Hoi 
Published: May 2018

Introduction: Pseudosubluxation is a transient separation of the prosthetic femoral head from the acetabular liner during the anaesthetic period after total hip arthroplasty (THA). However, little is known about the frequency, pathomechanism, risk factors or natural history. Methods: To determine the incidence, direction of the displacement, risk factors and subsequent instability of pseudosubluxation, we evaluated 1099 primary cementless THAs (943 patients), which were performed during 8 years at one institution. Immediately after THA, postoperative radiographs were obtained for all hips. If a subluxation was noted, the operated hip was examined by fluoroscope within 1 hour of the detection and repeat radiographs were taken on the postoperative day 1. Results: The pseudosubluxation was identified in 2.6% (28/1059). All of the 28 heads subluxed anteriorly and reduced in flexion-internal rotation. In multivariate analysis: (1) operative decrease of the femoral offset (odds ratio; 1.161 (95% confidence interval [CI]; 1.077–1.251), p = 0.001); and (2) medialisation of acetabular cup (odds ratio; 3.402 (95% CI; 1.482–7.813), p = 0.009) were found as risk factors for pseudosubluxation. None of the 28 hips dislocated during 3- to 8-year follow-up. Conclusions: Our results provide information about the incidence, risk factors and natural history of pseudosubluxation after primary THA. Surgeons should be aware of the risk of pseudosubluxation when performing THA in patients with coxa vara, who have a large femoral offset, and in those with dysplastic or deficient acetabulum, who have a lateral centre of rotation.
Isokinetic dynamometry and gait analysis reveal different hip joint status in patients with hip dysplasia
Authors: Sørensen Henrik , Nielsen Dennis B , Jacobsen Julie S , Søballe Kjeld , Mechlenburg Inger 
Published: May 2018

Background: Objective assessment of hip dysplasia patients’ functional hip joint status routinely involves gait analysis or isokinetic dynamometry. However, these methods have shown equivocal results and have not been employed in the same groups of patients and controls. Purpose: To assess hip flexor and abductor moments by isokinetic dynamometry in the dysplasia patient and controls, for which we previously reported smaller flexor and slightly larger abductor moments during gait in patients compared to controls. Methods: The study was designed as a prospective cohort study (Level of Evidence II) and conducted in a biomechanics laboratory at Aarhus University, Denmark, during 2011. Participants comprised 32 dysplasia patients and 32 age and gender matched controls. Outcome measures were static peak hip flexion moment at 15, 45 and 75° hip flexion; dynamic eccentric and concentric peak hip flexion moment at 60° and 120°/second; dynamic eccentric and concentric hip abductor moment at 30° and 60°/second. Results: Hip dysplasia patients had smaller eccentric peak flexion moments and smaller eccentric and concentric peak abduction moments at all tested velocities. Conclusion: Although dysplasia patients have weaker hip flexion and abductor muscles than controls, their abductor muscles are sufficiently strong to ensure normal function during gait. Hence, gait analysis alone might not reveal the true, subnormal hip joint status in dysplasia patients. We suggest that comprehensive assessment of hip joint function in dysplasia patients should include more strenuous activities than gait, particularly in young(er) patients who are likely to prefer a more active lifestyle.
Is Delayed Weightbearing After Matrix-Associated Autologous Chondrocyte Implantation in the Knee Associated With Better Outcomes? A Systematic Review of Randomized Controlled Trials
Authors: Kraeutler Matthew J. , Belk John W. , Carver Trevor J. , McCarty Eric C. 
Published: May 2018

Background: Proper rehabilitation after matrix-associated autologous chondrocyte implantation (MACI) is essential to restore a patient’s normal function without overloading the repair site. Purpose: To evaluate the current literature to assess clinical outcomes of MACI in the knee based on postoperative rehabilitation protocols, namely, the time to return to full weightbearing (WB). Study Design: Systematic review; Level of evidence, 1. Methods: A systematic review was performed to locate studies of level 1 evidence comparing the outcomes of patients who underwent MACI with a 6-week, 8-week, or 10/11-week time period to return to full WB. Patient-reported outcomes assessed included the Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity scale, Short Form Health Survey–36 (SF-36), and visual analog scale (VAS) for pain frequency and severity. Results: Seven studies met the inclusion criteria, including a total of 136 patients (138 lesions) who underwent MACI. Treatment failure had occurred in 0.0% of patients in the 6-week group, 7.5% in the 8-week group, and 8.3% in the 10/11-week group at a mean follow-up of 2.5 years ( P = .46). KOOS, SF-36, and VAS scores in each group improved significantly from preoperatively to follow-up ( P < .001). Conclusion: Patients undergoing MACI in the knee can be expected to experience improvement in clinical outcomes with the rehabilitation protocols outlined in this work. No significant differences were seen in failure rates based on the time to return to full WB.
Cavernous sinus involvement in human papillomavirus associated oropharyngeal squamous cell carcinoma: Case report of an atypical site of distant metastasis
Authors: Forner David , Wilke Derek , Rigby Matthew H. , Croul Sidney , Mishra Anuradha , Massoud Emad , Clarke David B. , Lamond Nathan 
Published: May 2018

Background HPV-associated OSCC (HPV-OSCC) has been determined to be a distinct disease entity from non-HPV associated OSCC. Patients affected by HPV-OSCC generally have a more favourable prognosis, with improved rates of locoregional control and survival compared with their non-HPV counterparts. Despite this, HPV-OSCC has a similar rate of distant metastases. Interestingly, recent evidence has emerged that demonstrates more frequent atypical metastasis patterns when compared to non-HPV associated disease. To the best of our knowledge, this report describes the first case of a confirmed HPV-OSCC with distant metastasis to the cavernous sinus. Case Presentation A 62-year-old non-smoking male presented to the head and neck oncology clinic with a five-month history of enlarging right neck mass causing neck pain, dysphagia, and dysphonia. HPV-associated base of tongue squamous cell carcinoma (cT4aN2c) was diagnosed, and he was treated with primary chemoradiation. Shortly after treatment, he presented with progressive bilateral cranial nerve palsies including left cranial nerve III and right cranial nerve VI involvement. Imaging identified masses in the left cavernous sinus with extension of tumor into the sella and in the right cavernous sinus at the level of Dorello's canal. Endoscopic Image Guided Transsphenoidal biopsy of the left sellar mass confirmed distant metastases from the previously treated HPV-OSCC primary to the cavernous sinus. The patient was palliated with carboplatin and paclitaxel. Conclusion The presented report is the first documented case of confirmed HPV-associated oropharyngeal squamous cell carcinoma metastasizing to the cavernous sinus, and the only HPV confirmed head and neck cancer case to present with metastasis to the cavernous sinus and limited extracranial disease. This case demonstrates the importance of recognizing presentations of atypical metastasis that are possible in HPV-associated oropharyngeal cancer. Given the rarity of metastasis to this region, vigilance in follow up is instrumental in early identification and treatment for these patients.