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2. Briefing Paper: Infant and Early Childhood Mental Health and Early Intervention (Part C)--Policies and Practices for Supporting the Social and Emotional Development and Mental Health of Infants and Toddlers in the Context of Parent-Child Relationships
- Author
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Early Childhood Technical Assistance (ECTA) Center and University of North Carolina at Chapel Hill, FPG Child Development Institute
- Abstract
This briefing paper explores Infant and Early Childhood Mental Health (IECMH) policies and practices that state early intervention (Part C) programs may consider implementing to meet the social-emotional and mental health needs of infants and toddlers in the context of relationships with their parents and other caregivers.
- Published
- 2022
3. Earning Full Credit: A Toolkit for Designing Tax-Credit Scholarship Policies. White Paper No. 219
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Pioneer Institute for Public Policy Research and Bedrick, Jason
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For more than two decades, tax-credit scholarship (TCS) policies have helped American families provide their children with the learning environment that meets their individual needs. Now available in 19 states, nearly 300,000 students nationwide use tax-credit scholarships to attend the school of their family's choice. TCS policies create an incentive for taxpayers to contribute to nonprofit scholarship organizations that aid families with tuition and, in some states, other K-12 educational expenses. As with other policies, their ultimate success or failure depends greatly on how they are designed. This paper explores the central design features of TCS policies--such as eligibility, the tax credit value, credit caps, and academic accountability provisions--and outlines the different approaches taken by the TCS policies in each state. The paper also offers suggestions regarding each feature for policymakers who want to design a TCS policy that most likely to succeed at its central purpose: empowering families to provide their children with the education that works best for them. To that end, the paper recommends designing each policy element in such a way that they maximize the incentive that taxpayers have to contribute to scholarship organizations, maximize the number of families that can benefit from the scholarships, and maximize the freedom and flexibility that scholarship organizations have to serve those families. A summary of these suggestions can be found in the conclusion. Finally, the appendix offers policymakers a wide variety of additional resources, including model legislation, parent satisfaction and public opinion surveys, research of fiscal effects, various policy briefs on tax-credit scholarships, information about the constitutional landscape, and public relations resources. [Introduction by Theodor Rebarber. Foreword by Kendra Espinoza.]
- Published
- 2020
4. Appendices for NILOA Occasional Paper 48: 'Program Review and Assessment for Continuous Improvement: Asking the Right Questions'
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National Institute for Learning Outcomes Assessment and Eggleston, Tami
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"Program Review and Assessment for Continuous Improvement: Asking the Right Questions. Occasional Paper No. 48" summarizes essential questions and discussions campuses should have regarding academic program reviews and the integration of assessment into such reviews. This document contains the following Appendices related to that paper: (1) McKendree University Academic Program Review Self-Study Form; (2) Program/Major Level Assessment Report Template; (3) Major Assessment Plan Evaluation Rubric; (4) McKendree University Academic Program Review; (5) Program Review Samples; and (6) McKendree University Academic Program Review Self-Study Form. [For "Program Review and Assessment for Continuous Improvement: Asking the Right Questions. Occasional Paper No. 48," see ED608778.]
- Published
- 2020
5. Program Review and Assessment for Continuous Improvement: Asking the Right Questions. Occasional Paper No. 48
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National Institute for Learning Outcomes Assessment and Eggleston, Tami
- Abstract
In October of 2019, I presented at the IUPUI Assessment Institute in Indianapolis on the topic of academic program review. While almost every campus conducts program reviews, the definition, purpose, structure, and integration of assessment in program reviews is not universally understood, accepted, or implemented. This paper summarizes essential questions and discussions campuses should have regarding program reviews and the integration of assessment into such reviews. Unfortunately, too many campuses simply keep doing the same reviews over and over. The goal for this paper is to cause campuses to pause, reflect, answer some questions, and then revise their reviews to ensure a meaningful product. The paper is organized around the essential topics of definitions, accreditation, processes, continuous improvement and "closing the loop," and potential challenges. This paper concludes with templates from McKendree University that may serve as valuable tools which other campuses may use, edit, or compare to their own processes and practices. [For the related Appendices, see ED608781.]
- Published
- 2020
6. Tracking College-to-Career Pathways for Illinois Foster Youth. Thought Papers Series. Vol. 1, Issue 2
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University of Illinois at Urbana-Champaign, Office of Community College Research and Leadership (OCCRL) and Brown, Chequita S.
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In Illinois, there are more than 21,000 children and youth in foster care. Approximately 26% of these individuals are 13 and older (Illinois Department of Children & Family Services [IDCFS] 2021). Although career and technical education (CTE) programs are offered at both secondary and postsecondary educational levels, little to no data about current and former foster youths' CTE program matriculation and attainment is available. Considering that foster youth are identified as a disadvantaged population under Perkins V, it is imperative to address the need for: (1) an increased awareness of and access to CTE programs among foster youth; and (2) systematic tracking of Illinois foster youths' enrollment, retention, and graduation from CTE programs at the postsecondary educational level. This brief highlights two sections within the Perkins V Act: Section 7, Definitions, which recognizes current and former foster youth as a special population; and Section 112, Accountability, which provides an overview of the state and local reporting requirements relative to CTE program outcomes for identified special populations. The brief then provides recommendations to improve statewide tracking of foster youths' postsecondary educational attempts and attainment in Illinois CTE programs.
- Published
- 2021
7. A Method for Identifying Salary Spiking: An Assessment of Pensionable Compensation and Reform in Illinois. Working Paper No. 238-0620
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National Center for Analysis of Longitudinal Data in Education Research (CALDER) at American Institutes for Research, Goldhaber, Dan, Grout, Cyrus, and Holden, Kristian
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Defined benefit (DB) pension systems determine the size of pension payments using an employee's "final average salary". Thus, employees enrolled in DB pension systems face an incentive to "salary spike" -- strategically increase late career pensionable compensation -- to increase their retirement income. This is an important issue given that public pension systems face increasing scrutiny due to ongoing concerns about their fiscal sustainability. This paper develops an empirical method to quantify the prevalence of salary spiking by identifying cases where end-of-career compensation deviates from expected levels of compensation. We apply this method to the teacher pension systems in Illinois and examine how salary spiking changed in response to policy reform. The results suggest that salary spiking is very common, with about half of late career employees observed as having pensionable compensation that exceeds expectations. Policies designed to dissuade salary spiking by internalizing its costs across districts appear to reduce the prevalence of salary spiking, but there may be unintended consequences for individuals who are "not actually spiking," as such discouraging the assignment of supplementary responsibilities to late career employees.
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- 2020
8. How Much Do Teachers Value Deferred Compensation? Evidence from Defined Contribution Rate Choices. Working Paper No. 242-0920
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National Center for Analysis of Longitudinal Data in Education Research (CALDER) at American Institutes for Research, Goldhaber, Dan, and Holden, Kristian L.
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How much do teachers value compensation that is deferred until retirement? This question is important because the vast majority of public school teachers are covered by defined benefit (DB) pension plans that "backload" a large share of compensation to retirement relative to the compensation structure in the private sector. There is little evidence, other than Fitzpatrick (2015), however, about whether DB pensions are consistent with teacher preferences for current and deferred compensation. This study examines a unique setting in Washington State, where teachers enroll in a hybrid, DB-Defined Contribution (DC) pension system, and have choices over their DC contribute rate. These choices reveal preferences about the value teachers place on current versus retirement compensation. We find that teachers choose to contribute an average of 8.18 percent, significantly more than the minimum required contribution of 5 percent. This suggests that teachers value retirement compensation significantly more than previously estimated by Fitzpatrick. Potential explanations for the difference in findings from prior evidence are discussed, including estimation strategies, differences in state settings, overall plan generosity, and the potential for teachers to view DB and DC pensions as different products.
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- 2020
9. The Common Core Debacle: Results from 2019 NAEP and Other Sources. White Paper No. 205
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Pioneer Institute for Public Policy Research and Rebarber, Theodor
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This study finds that, breaking with decades of slow improvement, U.S. reading and math scores on the National Assessment of Educational Progress (NAEP) and other assessments have seen historic declines since most states implemented national Common Core English and math curriculum standards six years ago. This descriptive analysis is designed to be understood by a general, non-technical readership. It primarily compares student achievement gains on the NAEP after implementation of Common Core to student achievement gains in the years preceding implementation of Common Core. Since test score results, by their nature, tend to "bounce" somewhat from one year to the next and gains are rarely perfectly smooth, a significant part of the analysis determines the average annual gain since implementation of Common Core and compares that to the average annual gain before implementation of Common Core. This report also includes a section addressing defenses by Common Core advocates denying responsibility for the poor results. The following state samples are included: (1) California; (2) Florida; (3) Georgia; (4) Illinois; (5) Kentucky; (6) Massachusetts; and (7) New York.
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- 2020
10. Innovation and Deeper Learning: Volume 2. A White Paper of the Stark Education Partnership
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Stark Education Partnership
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When does a community create and sustain a truly innovative "next generation" high school that not only remains innovative, but also relevant? According to the Carnegie Corporation, this means seizing the opportunity to redesign schools to promote personalized learning. So far, much work has gone into retooling many of these (reform) elements individually. Many states, districts, and schools have made essential progress in changing teacher preparation and professional development to help talented educators enter and stay in the classroom. There have also been pushes for interventions like additional learning time, new curricula, and new technology, much of which has been shown to have a significant impact on student achievement. However, applied individually, each of these fails to get schools and school systems where they need to be to serve every student. This white paper will explore the issues through the perspectives of several members of the Atlantic Rim Collaboratory, who are attempting to share ideas and concepts on system redesign, by examples of schools that are making deep learning a priority through technology and by examples of initiatives and schools that have made personalized learning and mastery the focus of what they do. All these approaches are important for they become part of a comprehensive whole that can drive meaningful change. [For "Innovation and Deeper Learning: Model High Schools," see ED604591.]
- Published
- 2018
11. Apprenticeship in Brief. A Discussion Paper
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Committee for Economic Development of The Conference Board (CED) and Cheney, Gretchen Rhines
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A growing number of U.S. companies across a range of industries are designing apprenticeship programs to give workers access to on-the-job learning opportunities that allow them to transition into in-demand jobs and careers. This discussion paper provides a snapshot of the current state of apprenticeship in the United States based on interviews with national experts and key stakeholders engaged in apprenticeship implementation, including employers, community colleges, unions, and intermediaries. It explores what is needed to build successful programs and highlights current federal and state policy efforts to encourage registered apprenticeship expansion, noting barriers and lessons learned. Four recommendations for how to grow registered apprenticeship opportunities in the United States are: (1) Provide standardized models; (2) Reduce complexity; (3) Measure Value; and (4) Learn from Innovative Models. A sidebar presents examples of state incentives and supports for apprenticeship programs in Colorado, Maryland, and South Carolina. [This paper was produced with funding from the Nestlé USA corporation.]
- Published
- 2017
12. Interpretation and Use of K-12 Language Proficiency Assessment Score Reports: Perspectives of Educators and Parents. WCER Working Paper No. 2016-8
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University of Wisconsin-Madison, Wisconsin Center for Education Research (WCER), Kim, Ahyoung Alicia, Kondo, Akira, Blair, Alissa, Mancilla, Lorena, Chapman, Mark, and Wilmes, Carsten
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A number of English language proficiency exams target grades K-12 English language learners (ELLs) because of the rising need to identify their needs and provide appropriate support in language learning. A good example is the WIDA ACCESS for ELLs (hereafter ACCESS), designed to measure the English language proficiency of students identified as ELLs. Every year approximately two million K-12 ELLs in the WIDA Consortium take ACCESS. After students complete the exam, score reports are provided to relevant stakeholders, including teachers and parents of the students. Because score reports are widely used by stakeholders for many purposes (e.g., placement, reclassification of ELLs), it is necessary to understand how they are interpreted and used in educational and home settings. Such information could be used to understand the usefulness of score reports and also to enhance their quality. However, there is little research on stakeholders' interpretation and use of score reports, especially in the context of K-12 ELL exams in the Unites States. Existing research is limited to teachers' interpretation of score reports (Impara, Divine, Bruce, Liverman, & Gay, 1991; Luecht, 2003; Underwood, Zapata-Rivera, & VanWinkle, 2007). For example, Impara et al. (1991) investigated the extent to which teachers were able to interpret student-level results on a standardized state assessment and the extent to which interpretive information provided on the reverse side of the student score report improved teacher understanding. Findings suggest that interpretive material helped facilitate teachers' understanding of student scores on the assessment. However, few studies have examined how stakeholders actually use the interpreted information. Moreover, very few (Miller & Watkins, 2010) have examined score reports from the parents' perspective. To gain a deeper understanding of the meaningfulness and utility of score reports, it is necessary to examine both educators' and parents' perspectives. The study on which this paper is based investigated how two stakeholder groups--K-12 ELL educators and parents--interpret and use ACCESS score reports. Findings from qualitative interviews offer implications for score report development in general and how to further enhance the quality of ACCESS score reports. In the study, the authors addressed the following research questions: (1) How do K-12 ELL educators and parents interpret the information in an English proficiency exam score report?; and (2) How do K-12 ELL educators and parents use the information in an English proficiency exam score report?
- Published
- 2016
13. Getting to Better Prep: A State Guide for Teacher Preparation Data Systems. Working Paper
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TNTP
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This report is drafted with state leaders and policy makers in mind, including those who work with or support these education leaders. The information shared in this report will likely be most relevant to states that have either not yet considered a new data system on teacher preparation providers, are only now starting to consider the idea, or are currently embarking on plans to design and implement such a system. This report offers two primary functions to readers. First, it illustrates the benefits of teacher preparation data systems as they have been experienced by states who have them or are building them. It makes the case for this work through "real-life" examples. Second, it offers best practices to help states in moving forward on planning and implementing such systems, drawn from the direct experiences of the featured states. Featured states in this report include: Delaware, Massachusetts, New Jersey, Rhode Island, Illinois, and Louisiana. Each best practice is accompanied by at least one example of how a featured state chose to implement it. Readers should use the best practices offered in this report as a set of guideposts that every state that has done this work believes are critical elements of the process. States should execute each guidepost in the way that is most effective for their own needs. The various examples illustrate how a state could choose to execute the best practice while making clear that states take different approaches to the same practice.
- Published
- 2017
14. The Untapped Potential of an Early Childhood Assessment System: A Strategy for Improving Policies and Instruction from Early Childhood through 3rd Grade. White Paper
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National Governors Association, Szekely, Amanda, and Wat, Albert
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Children's academic and social development before third grade is highly predictive of later success in school and beyond. Research shows that during those early years, the gains children make in language and literacy, mathematics and social skills, and their growth as learners and thinkers are associated with a range of benefits, from academic achievement to economic stability to healthy habits and behaviors. "The Untapped Potential of an Early Childhood Assessment System: A Strategy for Improving Policies and Instruction from Early Childhood through 3rd Grade" outlines how state leaders can reduce or streamline the assessments being used in early learning programs and elementary schools, achieve economies of scale for educator training and leverage existing data systems to yield more powerful data to inform decision-making.
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- 2016
15. The Educating Neighborhood: How Villages Raise Their Children. Kettering Foundation Working Paper [2015:01]
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Kettering Foundation and McKnight, John
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Almost everyone is familiar with the African saying, "It takes a village to raise a child." However, there are very few "villages" that actually engage in this practice. The educational assets of the village include the knowledge of neighborhood residents, the clubs, groups, and associations that are citizen-based learning environments and the local institutions (businesses, not-for-profits, and government bodies). They all provide incredible learning opportunities. It is these neighborhood educational assets that are activated in a village that raises its children. In most communities, however, these invaluable resources are unused and disconnected from the lives of young people. It appears that in one to two generations, villages have lost their power to raise children. Their functions have largely been transferred to schools. This transfer is reflected by the fact that in the last generation, schools have been asked to take responsibility for the health, safety, food, recreation, behavior, moral values, and entrepreneurial development of young people. This Kettering Foundation working paper by John McKnight, codirector of the Asset-Based Community Development Institute (ABCD), Northwestern University, presents some of ABCD's research in assisting people in local neighborhoods to identify the local teaching knowledge.
- Published
- 2015
16. Scaling Completion College Services as a Model for Increasing Adult Degree Completion. Lumina Issue Papers
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Lumina Foundation for Education, Johnson, Nate, and Bell, Alli
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An estimated 46 million adults have some college education but have not completed their degrees. For many, especially those who have accumulated several years' worth of credits, the inability to finish college remains a frustration. If the United States is to achieve its ambitious education attainment goals, many more adults with such experience must finish their degrees. While there is a role in this effort for every college and university, "Completion Colleges" offer an extremely cost-effective route to degrees for students who have substantial amounts of prior credit or experiences that can be translated into credit through prior-learning assessment. Serving adults with some college experience, while widely recognized as important, rarely gets the same attention from policymakers, trustee boards, and the news media as other key issues in American higher education. This paper, supported by Lumina Foundation, highlights the potential of Completion College services to help states, higher education systems, and separately accredited institutions to affordably graduate larger numbers of adults who have stepped out of college. There clearly is a market nationally for the types of flexible, student-centered, outcomes-based degree programs Completion Colleges deliver. In the vast majority of states that do not have a Completion College, this demand is often met by for-profit colleges, which market aggressively to recruit non-traditional students. Completion Colleges offer a public or nonprofit alternative to these students, for whom traditional public institutions are not always well suited. States with Completion Colleges are benefiting from a decades-old service model that is as relevant today as when the institutions were created. The potential for scaling these models is strong and should be explored.
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- 2014
17. Foundations for Young Adult Success: A Developmental Framework. Concept Paper for Research and Practice
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University of Chicago Consortium on Chicago School Research, Nagaoka, Jenny, Farrington, Camille A., Ehrlich, Stacy B., and Heath, Ryan D.
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Amid growing recognition that strong academic skills alone are not enough for young people to become successful adults, this comprehensive report offers wide-ranging evidence to show what young people need to develop from preschool to young adulthood to succeed in college and career, have healthy relationships, be engaged citizens, and make wise choices. It concludes that rich experiences combining action and reflection help children develop a set of critical skills, attitudes, and behaviors. And it suggests that policies should aim to ensure that all children have consistent, supportive relationships and an abundance of these developmental experiences through activities inside and outside of school. The Wallace Foundation awarded a competitive grant to UChicago CCSR in 2013 to undertake the project, which included a review of relevant literature spanning decades as well as interviews with national experts in research, policy and practice, and young people and the adults who work with them in schools, programs and agencies throughout Chicago. The report offers evidence to show how, where, and when the "key factors" to success develop from early childhood through young adulthood, emphasizing the kinds of experiences and supportive relationships that guide the positive development of these factors. Recognizing that there are no silver bullets to promoting social-emotional learning, the report emphasizes a range of factors that build on one another over time. It also emphasizes factors that are particularly malleable, as well as the age at which each of the key factors comes into prominence, offering adults the most promising window for positive intervention. A key problem the report identifies is that disadvantaged youth often face extra challenges. For example, they often have fewer in-school and out-of-school opportunities for consistent, positive developmental experiences and relationships and face significant opportunity gaps to developing the essential skills to become productive adults. An appendix provides a list of experts who provided input and feedback throughout this project. [This report was written with David W. Johnson, Sarah Dickson, Ashley Cureton Turner, Ashley Mayo, and Kathleen Hayes.]
- Published
- 2015
18. Unlocking Young Children's Potential: Governors' Role in Strengthening Early Mathematics Learning. NGA Paper
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National Governors Association, Center for Best Practices and Szekely, Amanda
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As governors respond to the need to significantly improve the quality of public education, they should consider incorporating stronger actions to improve mathematics instruction as part of their overall reform agenda. Governors can take the following actions to promote high-quality mathematics instruction for young children: (1) Become a champion for improvements in the quality of early math education with legislators, business leaders, educators, parents, and students; (2) Align high-quality mathematics standards through the educational pipeline, and support appropriate use of student assessments to measure results. State leaders could consider raising standards for the math skills and concepts children should learn in their state's early learning guidelines; and (3) Promote changes in policies that improve educator preparation and that support their capacity to teach mathematics to young children. Although governors are already strong proponents of early reading initiatives, they have an opportunity to become champions for improving early mathematics instruction in their states, as well. Many of the actions described in this brief require no or minimal new state funding and can help lay the groundwork for a state's focus on high-quality early mathematics teaching and learning.
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- 2014
19. The Value of Postsecondary Credentials in the Labor Market: An Experimental Study. A CAPSEE Working Paper
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Center for Analysis of Postsecondary Education and Employment (CAPSEE), Deming, David J., Yuchtman, Noam, Abulafi, Amira, Goldin, Claudia, and Katz, Lawrence F.
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We study employers' perceptions of postsecondary degrees using a field experiment. We randomly assign the sector and selectivity of institution to fictitious resumes and send them to real vacancy postings on a large online job board. According to our results, a bachelor's degree in business from a for-profit "online" institution is 22 percent less likely to receive a callback than a similar degree from a non-selective public institution. Degrees from selective public institutions are relatively more likely to receive callbacks from employers posting higher-salaried jobs, suggesting that employers value college quality and the likelihood of a successful match when contacting applicants. "Measuring Job Quality by Collecting Job Title-Specific Salaries" is appended.
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- 2014
20. The Intersection of Afterschool and Competency-Based Learning: Emerging Trends, Policy Considerations, and Questions for the Future. AYPF White Paper
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American Youth Policy Forum, Lerner, Jennifer Brown, Tomasello, Jenna, Brand, Betsy, and Knowles, George
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Afterschool and competency-based learning are increasingly emerging as student-centered, supportive learning models to prepare students for college and career. This white paper explores the intersection and relationship between these two fields, recommends ideal policy environments for implementing successful programs, provides real-world examples, and shines a spotlight on emerging trends for the future.
- Published
- 2016
21. The Effect of Performance-Based Incentives on Educational Achievement: Evidence from a Randomized Experiment. NBER Working Paper No. 22107
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National Bureau of Economic Research, Levitt, Steven D., List, John A., and Sadoff, Sally
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We test the effect of performance-based incentives on educational achievement in a low-performing school district using a randomized field experiment. High school freshmen were provided monthly financial incentives for meeting an achievement standard based on multiple measures of performance including attendance, behavior, grades and standardized test scores. Within the design, we compare the effectiveness of varying the recipient of the reward (students or parents) and the incentive structure (fixed rate or lottery). While the overall effects of the incentives are modest, the program has a large and significant impact among students on the threshold of meeting the achievement standard. These students continue to outperform their control group peers a year after the financial incentives end. However, the program effects fade in longer term follow up, highlighting the importance of longer term tracking of incentive programs. [This project was made possible by the generous financial support of the Kenneth and Anne Griffin Foundation.]
- Published
- 2016
22. Intergovernmental (Dis)incentives, Free-Riding, Teacher Salaries and Teacher Pensions. Upjohn Institute Working Paper No. 15-220
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W.E. Upjohn Institute for Employment Research and Fitzpatrick, Maria D.
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In this paper, I document evidence that intergovernmental incentives inherent in public sector defined benefit pension systems distort the amount and timing of income for public school teachers. This intergovernmental incentive stems from the fact that, in many states, local school districts are responsible for setting the compensation that determines the size of pensions, but are not required to make contributions to cover the resulting pension fund liabilities. I use the introduction of a policy that required experience-rating on compensation increases above a certain limit in a differences-in-differences framework to identify whether districts are willing to pay the full costs of their compensation promises. In response to the policy, the size and distribution of compensation changed significantly. On average, public school employees received lower wages largely through the removal of retirement bonuses. However, the design of the policy led some districts to increase compensation, rendering the policy less effective than it might have otherwise been. The following tables are appended: (1) Characteristics of Employees of Illinois Public Schools in the Analysis Sample, 2003-2011; and (2) District Characteristics in 2005, by Survey Response.
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- 2015
- Full Text
- View/download PDF
23. Documentation and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records.
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Shear, Torin, Deshur, Mark, Lapin, Brittany, Greenberg, Steven, Murphy, Glenn, Szokol, Joseph, Ujiki, Michael, Newmark, Rebecca, Benson, Jessica, Koress, Cody, Dwyer, Connor, and Vender, Jeffery
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- *
DOCUMENTATION , *ANESTHESIA , *FISHER exact test , *HYPOTENSION , *SURGICAL complications , *T-test (Statistics) , *DATA analysis software , *DESCRIPTIVE statistics , *MANN Whitney U Test - Abstract
In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AIMS. We hypothesized that the type of anesthetic record (paper or AIMS) would lead to differences in the documentation and management of hypotension. Consecutive patients who underwent esophageal surgery between 2009 and 2014 by a single surgeon were eligible for the study. Patients were grouped in to 'paper' or 'AIMS' based on the type of anesthetic record identified in the chart. Pertinent patient identifiers were removed and data collated after collection. Predetermined preoperative and intraoperative data variables were reviewed. Consecutive esophageal surgery patients ( N = 189) between 2009 and 2014 were evaluated. 92 patients had an anesthetic record documented on paper and 97 using AIMS. The median number of unique blood pressure recordings was lower in the AIMS group (median (Q1,Q3) AIMS 30.0 (24.0, 39.0) vs. Paper 35.0 (28.5, 43.5), p < 0.01). However, the median number of hypotensive events (HTEs) was higher in the AIMS group (median (Q1,Q3) 8.0 (4.0, 18.0) vs. 4.0 (1.0, 10.5), p < 0.001), and the percentage of HTEs per blood pressure recording was higher in the AIMS group (30.4 ((Q1, Q3) (9.5, 60.9)% vs. 12.5 (2.4, 27.5)%), p < 0.01). Multivariable regression analysis identified independent predictors of HTEs. The incidence of HTEs was found to increase with AIMS (IRR = 1.88, p < 0.01). Preoperative systolic blood pressure, increased blood loss, and phenylephrine. A phenylephrine infusion was negatively associated with hypotensive events (IRR = 0.99, p = 0.03). We noted an increased incidence of HTEs associated with the institution of an AIMS. Despite this increase, no change in medical therapy for hypotension was seen. AIMS did not appear to have an effect on the management of intraoperative hypotension in this patient population. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
24. ROBBERY ALERT: Bags of bank notes were stolen in Illinois.
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ROBBERY ,PAPER money ,THEFT ,BANKING industry ,VALUE (Economics) - Abstract
Bags of bank notes were stolen in Illinois during the Central States Numismatic Society show. The stolen currency, worth over half a million dollars, includes a variety of coins, notes, and medals from the English Civil War period. The Naseby Cup, a rare artifact commissioned to commemorate the Battle of Naseby, is one of the most exceptional numismatic objects in the world and is currently being sold by the Minnesota-based dealer, Emporium. The company is working with the police and the Numismatic Crime Information Center to recover the stolen collectibles. [Extracted from the article]
- Published
- 2024
25. Paper 09: Postage-Stamp Glenoid Fracture after Bankart Repair. How Many Anchors are Safe? - A Biomechanical Analysis.
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Lobao, Mario
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PREVENTION of surgical complications ,BONE fracture prevention ,SHOULDER injuries ,CONFERENCES & conventions ,SHOULDER joint injuries ,SCAPULA ,BIOMECHANICS ,PATIENT safety - Abstract
Objectives: Fractures of anterior glenoid rim, aka "Postage-Stamp" fractures, are potential complications of arthroscopic Bankart repairs that occur when a fracture line propagates through previous anchor sites producing a serrated edge. (Fig.1: A and J) Placing multiple anchors adjacent to glenoid rim in attempt to recreate the labral bumper was suggested to reduce the risk of recurrent dislocation after surgery,
[Boileau et al 2006] as well as to create a stress riser that may predispose to fracture if another traumatic event may occur. This controlled laboratory study investigated the effect of increased number holes, and different types and sizes of suture anchors on the load necessary to create Postage-Stamp fractures. Our objective was to establish a safe number of anchors that could be inserted in the anterior glenoid rim without incurring in a substantially high risk of fracture. Hypothesis: Increasing the number of holes and anchors and their size would decrease forces necessary to break the anterior glenoid rim. Methods: We tested 46 synthetic scapulae with similar compressive strength and elastic modulus of human glenoid (4th gen. composite scapulae, Sawbones, Pacific Research Laboratories, USA) in a servohydraulic apparatus (Fig.1: B and H) following a previous published biomechanical model.[Farmer et al2014] A guide ensured holes were drilled and anchors were inserted in the same exact angle, depth and location for every specimen. (Fig.1: C to F) A metallic humeral head applied force to the anterior glenoid rim at 1mm/s until fracture occurred. (Fig. 1: G to K) Load-to-fracture of intact glenoid was compared to groups of drilling anchor holes (# 3,4,5,6 and 7) of different diameters (1.6mm and 3mm), and groups with anchors of different sizes and types (1.6mm all-suture and 3mm core anchors).(Fig.1: I to K) One-way ANOVA followed by Turkey post-hoc test compared groups to determine the number of holes necessary to weaken glenoids below 70% of intact value with a p value <0.005. Results: Intact glenoid mean load-to-fracture was 1,238 ± 74N. Drilling 3 to 7 holes of 1.6mm-diameter linearly reduced load to 93%, 89%, 74%, 56% and 52% of intact value respectively, while 3.0mm drill holes reduced load to 87%, 65%, 51%, and 40% respectively.(Fig.2) Directly comparing drill role sizes there were significant differences on the 4, 5 and 7 holes groups (p=0.045, 0.032 and 0.015, respectively), so that a glenoid could safely sustain up to 5 holes of 1.6mm, but no more than 3 holes of 3.0mm-diameter.(Fig.3) Inserting 1.6mm "all-suture" anchors in the 1.6mm-diameter holes did not change the load-to-fracture on the 4 or 5 holes groups (Fig.4A), indicating that the number of drill holes was the main determinant of anterior glenoid rim strength, so that the all-suture anchors did not act as stress risers. Thus, up to 5 "all-suture" 1.6mm anchor could be safely used on a Bankart repair. The 3.0mm "core" anchors increased the load-to-fracture when compared to the group with the same number of holes of the same diameter size. Despite 4 holes of 3.0mm-diameter decreased the load-to-fracture bellow the safety line of 70% of intact value, the group with 4 anchors of 3.0mm-diameter "core" anchors increased load-to-fracture to 85% of intact value (p=0.033).(Fig.4B) This stress shield effect of the 3.0mm core anchor was not noticed on the 5 anchors group, in which the overall strength of the construction was bellow the 70% of intact safety line. Conclusions: Our data call in that up to four 3.0mm "core" anchors or five 1.6mm-diameter "all-suture" anchors could be safely inserted in the anterior glenoid rim without incurring in increased risk of Postage-Stamp fracture. One should prefer small diameter anchors if more than 4 anchors were intended on a Bankart repair. This study contributed to important data about number, size and type of anchors that the anterior glenoid rim could safely sustain in order to avoid postage-stamp fracture in case a new traumatic dislocation episode occur after a Bankart repair, which is of clinical interest in high risk population preoperative planning and selection of implant size, type and number. [ABSTRACT FROM AUTHOR]- Published
- 2022
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26. Paper 04: The Effects of Glenohumeral Osteoarthritis on Early Clinical Outcomes Following Arthroscopic Rotator Cuff Repair.
- Author
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Lam, Patrick, Hackett, Lisa, Murrell, George AC, and Yeo, Wai Weng
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INJURY risk factors ,ROTATOR cuff injuries ,ARTHROSCOPY ,INTRAOPERATIVE care ,CONFERENCES & conventions ,TREATMENT effectiveness ,RISK assessment ,GLENOHUMERAL joint ,OSTEOARTHRITIS ,DISEASE complications ,EVALUATION - Abstract
Objectives: It is unclear if concomitant glenohumeral osteoarthritis is protective or detrimental with respect to rotator cuff integrity after arthroscopic repair surgery. We hypothesized that the associated stiffness might protect the repaired tendon. In the alternate, arthritis might reflect a gradual degeneration of the joint including a degenerative tendon and therefore predispose the repair to re-tear. Therefore, the purpose of this study was to investigate whether concomitant osteoarthritic changes found intra-operatively during arthroscopic rotator cuff repairs (RCR) have a beneficial or detrimental effect on post-operative repair integrity. Methods: This study is a post-hoc analysis of prospectively collected data of patients who underwent primary arthroscopic RCR between 2005 and 2019 by a single surgeon. Patients were divided into an osteoarthritic group and a control group based on the presence or absence of intra- operative osteoarthritic changes respectively. The primary outcome measure was cuff integrity detected by post-operative ultrasound at 6-months. The secondary outcomes were patient-reported outcomes including shoulder pain, stiffness, level of activity at work and level of sport, and physician-reported outcomes including shoulder range of motion and strength. Results: A total of 2155 consecutive patients met the inclusion criteria with a mean age of 59 years (SD=0.2) and there were more males as compared to females (56% vs. 44%). 28% of patients undergoing RCR had osteoarthritic changes detected intra- operatively. Intra-operatively, the osteoarthritic group had more full-thickness tears (64% vs. 59%) (p<.001), a larger mean anteroposterior tear length [20mm (SD=0.5) vs. 17mm (SD=0.4)] (p<.001) and a larger mean mediolateral tear length [17mm (SD=0.5) vs. 15mm (SD=0.4)] (p<.001). Ultrasonographic evaluation at 6-months post-surgery demonstrated that the osteoarthritic group had a higher incidence of cuff re-tear rate as compared to the control group (15% vs. 11%) (p=.016) (Figure 1). However, after performing a multiple logistic regression analysis, osteoarthritis was not found to be an independent predictor of re-tear. There were very marginal differences in patient-reported outcomes at 6-months after surgery between the two groups (Table 1). The osteoarthritic group reported lesser post-operative frequency of activity pain [2.0 (SD=1.46) vs. 2.2 (SD=1.43)] (p=.005), frequency of extreme pain [0.8 (SD=1.35) vs. 1.0 (SD=1.41)] (p=.035) and level of pain during overhead activity [1.7 (SD=1.30) vs. 1.9 (SD=1.30)] (p=.021) as compared to controls. As compared to controls, the osteoarthritic group also experienced lesser post-operative stiffness [1.5 (SD=1.32) vs. 1.6 (SD=1.31)] (p=.019) and reported lower intensities of work-related activities [1.1 (SD=0.88) vs. 1.2 (SD=0.85)] (p=.038) and lower level of sport activity [0.4 (SD=0.62) vs. 0.5 (SD=0.70)] (p=.004). In terms of physical examination at 6-months following surgery (Table 2), the osteoarthritic group were found to have lesser range of motion in forward flexion [146° (SD=33.1) vs. 151° (SD=31.2)] (p=.009), abduction [127° (SD=38.8) vs. 131° (SD=38.1)] (p=.034), external rotation [50° (SD=21.4) vs. 52° (SD=21.0)] (p=.024) and internal rotation (L1 vertebrae (SD=4.2) vs. T12 vertebrae (SD=4.2)] (p=.004) as compared to controls. The osteoarthritic group as weaker internal rotation strength [68N (SD=30.5) vs. 73N (SD=32.9)] (p=.004), external rotation strength [57N (SD=25.3) vs. 60N (SD=27.2)] (p=.026), supraspinatus flexion strength [45N (SD=26.8) vs. 50N (SD=27.9)] (p<.001), lift-off [40N (SD=24.3) vs. 44N (SD=25.3)] (p<.001) and adduction strength [76N (SD=36.5) vs. 81N (SD=39.3)] (p=.008) as compared to the control group. Conclusions: Patients with concomitant glenohumeral osteoarthritis who underwent arthroscopic RCR had higher re-tear rates at 6-months after surgery. However, osteoarthritis is not an independent predictor of rotator cuff re-tear at 6-months. Therefore, arthroscopic RCR is a viable surgical option for these patients. Figure 1: Proportion of intract vs. torn rotator cuff repairs between the osteoarthritic group (n=1552) and control group (n=603) at 6-months post-operative follow-up (p=.016). Table 1: 6-month post-operative pain scares and shoulder function in the osteoarthritic group vs. control group. Table 2: 6-month post-operative shoulder range of motion and strength in the osteoarthritic group vs. control group. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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27. Paper 07: Predictors of Return to Sport in High-Level Athletes Following Hip Arthroscopy for Femoroacetabular Impingement.
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Monahan, Peter, Jimenez, Andrew, Owens, Jade, Maldonado, David, Saks, Benjamin, Sabetian, Payam, Ankem, Hari, Lall, Ajay, and Domb, Benjamin
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SPORTS participation ,FEMORACETABULAR impingement ,HIP surgery ,ARTHROSCOPY ,CONFERENCES & conventions - Abstract
Objectives: The purpose of this study is to identify clinical and radiographic factors that predict return to sport in high-level athletes and to determine thresholds for significant predictors. Methods: Data were reviewed on all patients who underwent primary hip arthroscopy between November 2008 and August 2018. Patients were included if they played professional, college, or high school sports within 1 year before surgery and had preoperative, 3-month, 1-year, and 2-year postoperative patient reported outcome (PRO) scores for modified Harris Hip Score (mHHS), Hip Outcome Score-Sport Specific-Subscale (HOS-SSS), and Non-Arthritic Hip Score (NAHS). Patients were divided into groups based on whether they returned to sport (RTS). Multivariate logistic regression and receiver operator characteristic (ROC) analysis were used to evaluate the correlation between significant variables and RTS. Results: A total of 136 patients with a mean age of 20.8 ± 7.07 years were included. Competition level, postoperative alpha angle, change in alpha angle, and postoperative PROs were significantly different between groups. The multivariate logistic regression model identified postoperative alpha angle as a statistically significant predictor of return to sport [P <.001, S > 9.97 (OR 0.85, CI 0.79-0.91)]. The ROC curve for postoperative alpha angle demonstrated acceptable discrimination between patients returning to sport and patients not returning to sport with an area under the curve of 0.71 and a threshold value of 46˚. Athletes with a postoperative alpha angle ≤ 46˚ returned to sport at a rate of 71.2%, while those with a postoperative alpha angle > 46˚ returned to sport at a rate of 28.1% [(P <.001, S > 9.97 (OR 6.3, CI 2.6-15.2)] Conclusions: Postoperative alpha angle was identified as a predictor of return to sport in high-level athletes. The odds of returning to sport were 6.3 times greater in athletes with postoperative alpha angles ≤ 46˚ compared to athletes with angles > 46˚. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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28. Paper 24: The Natural Course of Recovery for Health-Related Quality of Life Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome.
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Malloy, Phil, Alter, Thomas, Chahla, Jorge, Nho, Shane, Clapp, Ian, and Bodendorfer, Blake
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HIP surgery ,FEMORACETABULAR impingement ,CONVALESCENCE ,ARTHROSCOPY ,HEALTH status indicators ,CONFERENCES & conventions ,QUALITY of life - Abstract
Objectives: To determine if subgroups of patients exist based on the recovery trajectory of health-related quality of life following hip arthroscopy for femoroacetabular impingement syndrome (FAIS), and to determine clinical data predictors for these subgroups of patients. Methods: A clinical hip data repository was queried for patients who underwent primary hip arthroscopy for the treatment of FAIS between January 2012 and May 2018. Patients who completed pre-operative, 1-year, and 2-year International Hip Outcome Tool-12 (iHOT-12) were included in the study. Latent class growth analysis (LCGA) and growth mixture models (GMM) were used to identify subgroups of patients based on trajectories of recovery for iHOT-12 utilizing 3 clinical time points (pre-operative [within 1 week of surgery], one-year postoperative, and two-year postoperative). LCGA and GMM models using 1 – 6 classes were assessed for best model fit according to AIC, BIC, bootstrapped likelihood ratio test, and log-likelihood ratios. Following the final model selection, a multivariable multinomial logistic regression on the final model was performed with the largest class as the reference group to determine clinical predictors of subgroup membership. Results: A total of 443 patients with an average age of 34.25 ± 12.65 and BMI of 25.02 ± 5.11met inclusion criteria. The 3-class GMM was the best fit model, and the resulting subgroups were named based on trajectories of iHOT-12 scores: early progressors, late regressors, and late progressors (Figure 1A). The early progressors comprised 70.0% of the study group and had substantial early improvement between preoperative and 1-year follow-up with further improved 2-year outcomes (Figure 1B). The late regressors comprised 22.3% of the study sample and demonstrated improvement between preoperative and 1-year follow-up with decreasing function between 1-year and 2-years postoperatively (Figure 1C). The late progressors represented the smallest group at 7.7% and only demonstrated improved outcomes after 1-year postoperatively (Figure 1D). Predictors of the late regressor membership were worker's compensation status, psychiatric history, preoperative chronic pain, and lower preoperative iHOT-12 scores. Patients in the late progressor subgroup were less likely to participate in physical hobbies/exercise. Conclusions: Using growth mixture models, three natural courses of health-related quality of life recovery following hip arthroscopy for the treatment of FAIS were identified: early progressors, late regressors, and late progressors. Worker's compensation status, psychiatric history, preoperative chronic pain, and lower preoperative iHOT-12 scores were predictive of less than favorable trajectories of recovery. Figure 1. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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29. Paper 12: Biomechanical Comparison of Anatomic Restoration of the Ulnar Footprint Versus Traditional Ulnar Tunnels in Ulnar Collateral Ligament Reconstruction.
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Chang, Edward, Looney, Austin, Roach, William, Clark, DesRaj, Nagda, Sameer, and Colantonio, Anthony Le Donald
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CONFERENCES & conventions ,ULNA ,COLLATERAL ligament ,BIOMECHANICS - Abstract
Objectives: Current techniques for ulnar collateral ligament (UCL) do not reproduce the anatomic ulnar footprint of the UCL. The purpose of this study was to describe a novel UCL reconstruction technique that utilizes proximal-to-distal ulnar bone tunnels to better recreate the anatomy of the UCL and compare the biomechanical profile at time zero between this technique, the native UCL, and the traditional docking technique. Our hypothesis was that the biomechanical profile of the anatomic technique is similar to the native UCL and traditional docking technique. Methods: Ten matched cadaveric elbows were potted with the forearm in neutral rotation. The palmaris longus tendon graft was harvested, and bones were sectioned 14 cm proximal and distal to the elbow joint. Specimen testing included: (1) native UCL testing performed at 90° flexion with 0.5 Nm valgus moment preload, (2) cyclic loading from 0.5-to-5 Nm valgus moment for 1000 cycles at 1 Hz, and (3) load to failure at 0.2 mm/s. Elbows then underwent UCL reconstruction with one elbow of each pair receiving the classic docking technique using either anatomic (proximal-to-distal) or traditional (anterior-to-posterior) tunnel locations. Specimen testing was then repeated, as described above. Results: There was no difference between maximum load at failure or valgus angle between the anatomic or traditional tunnel location techniques (34.90 ± 10.65 Nm vs. 37.28 ± 14.26 Nm, P = 0.644) or the native UCL (45.83 ± 17.03 Nm, P = 0.099). Additionally, there was no difference in valgus angle after 1000 cycles across the anatomic (4.58 ± 1.47°), traditional (4.08 ± 1.28°), or native UCL (4.07 ± 1.99°). Anatomic group and the native UCL had similar valgus angles at failure (24.13 ± 5.86° vs. 20.13 ± 5.70°, P = 0.083), while the traditional group had a higher valgus angle at failure compared to the native UCL (24.88 ± 6.18° vs. 19.44 ± 5.86°, P = 0.015). Conclusions: UCL reconstruction with the docking technique utilizing proximal-to-distal ulnar tunnels to restore the anatomic ulnar footprint better recreates the anatomy of the UCL while providing valgus stability comparable to reconstruction with docking technique using traditional anterior-to-posterior ulnar tunnel locations. These results suggest that utilization of the anatomic tunnel location in UCL reconstruction has similar biomechanical properties compared to the traditional method at the time of initial fixation (i.e., not accounting for healing following reconstruction in vivo) while keeping the ulnar tunnels further from the ulnar nerve. Further studies are warranted to determine if an anatomically based UCL reconstruction results in differing outcomes compared to traditional reconstruction techniques. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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30. Research Revamped: Using Reflective Blogging throughout the Research-Writing Process
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Billimack, Victoria G.
- Abstract
This study investigated the effects of reflective writing on student writing self-efficacy and on the quality of the final research-based essay. Subjects were 110 students enrolled in a freshman 101 Honors English class in a public high school in northern Illinois. Students in the control and experimental groups wrote two essays requiring the incorporation of research: a diagnostic synthesis essay at the beginning of the semester and a hero research essay at the end of the semester. During the process of researching and writing the hero research essay, the experimental group reflected on their progress via weblog. All subjects completed a Writer Self-Perception Scale (WSPS) after completing each writing assignment. The results of the two administrations of the WSPS were compared between administrations and between control and experimental groups. A discourse analysis of 12 participants' blog entries was conducted to analyze the effects of reflective writing in more depth. The results of the study showed that subjects in the experimental group improved their self-efficacy from the diagnostic essay to the hero research essay at a significantly higher rate than subjects in the control group. There was no significant difference between the improvement of writing skills in the experimental group vs. the control group though qualitative data from the blog entries suggested that blogging reflectively throughout the process not only helped students make gains in self-efficacy, but also helped them work through writing challenges. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]
- Published
- 2017
31. Improving Adolescent Learning: An Action Agenda. A TASC Report
- Author
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ExpandED Schools, The After-School Corporation (TASC), and Duffrin, Elizabeth
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At a recent national forum at the Ford Foundation in New York, 140 education and youth development professionals discussed how to better support adolescent learning. Drawing on the discussion and the latest research in neuroscience, psychology and cognitive learning science, TASC presents an action agenda that can be tailored to circumstances in your own city and state. This document draws on conversations from forum participants and represents the views of professionals who advocate for a variety of models for improved schooling. We hope that this agenda serves as a call to action that unites these separate advocacy efforts. In this report, we describe three ideas to improve adolescent learning, each with practical action steps for significant impact in the near term. We recognize that these ideas will be realized in different ways in different cities and tailored to each location's specific needs and resources.
- Published
- 2014
32. Reading the represented city and society: signs, theory, and the dynamic interpretativeness of Peircean semiotics.
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Goharipour, Hamed and Gibson, Huston
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MOTION pictures ,SENSORY perception ,CRIME ,SOCIAL sciences ,VISUAL perception ,METROPOLITAN areas ,HUMANITIES ,PUBLIC opinion - Abstract
In the era of visual media, cities, and society are represented, experienced, and interpreted through images. The need for interdisciplinary visual approaches, therefore, is indisputable. By focusing on cinema, this paper aims to develop a conceptual, methodological framework through which theory helps a broad range of researchers in social sciences, humanities, and arts interpret the represented phenomenon. Based on Peirce's model of signs, the framework provides the basis for a dynamic interpretation of the city and society. This paper shows that Peircean cinesemiotics takes advantage of theory in three ways: First, as the basis that provides scholars with clues necessary for identifying eligible "image-signs"; second, as the guiding framework that helps them reach a final interpretation; third, as ideas are being criticized from visual perspectives. As an example of its application, using Jane Jacobs' "The Death and Life of Great American Cities," the final part of the paper applies Peircean cinesemiotics to an image-sign from Death Wish (2018) and interprets it as the representation of safety/crime in a neighborhood. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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33. Oxide Strontium-Barium Perovskites Ceramics: Examinations of Structural Phase Transitions and Potential Application as Oxygen Carriers.
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Ksepko, Ewelina, Lysowski, Rafal, and Alifah, Miratul
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OXYGEN carriers ,PEROVSKITE ,PHASE transitions ,CHEMICAL-looping combustion ,LEAD oxides ,X-ray powder diffraction - Abstract
The structural properties of selected (Ba
1−x Srx )PbO3 ceramics were examined at 14–1148 K using X-ray powder diffraction (XRD). These materials are attractive due to their variety of applications, such as, for example, high-temperature thermoelectric energy conversion. Attention was paid to this paper as a continuation of the previous examinations of higher Sr2+ concentrations. The type of perovskite distortion and temperatures of the structural phase transitions (SPTs) were determined from the splitting of certain pseudocubic lines. At this point, for example (Ba0.3 Sr0.7 )PbO3 showed three temperature-induced SPTs. When the amount of Sr increased in the samples, no phase transition was observed, which is contrary to the data previously demonstrated in the literature. The quality of the ceramics was examined by scanning electron microscopy-energy dispersion X-ray spectroscopy (SEM-EDS), demonstrating their homogeneity and uniform elements dispersion. As a result of profound crystal investigations, confirmed by thermogravimetric analysis and quadrupole mass spectroscopy (TGA-QMS), a phase diagram was prepared for the (Ba1−x Srx )PbO3 system based on our former and recent study. Also, the investigation of a new application for the (Ba1−x Srx )PbO3 family is presented in this paper for the first time. The TGA analysis was conducted on Illinois#6 hard coal to evaluate the capability of perovskites to be used in the chemical looping combustion (CLC) process in a range of temperatures 1073–1173 K. Due to its thermal stability and reactivity, Ba0.9 Sr0.1 PbO3 is the material with the greatest potential to be applied as an oxygen carrier. The combination of strontium and barium offers encouraging results compared to the pure barium and strontium lead oxide perovskites. [ABSTRACT FROM AUTHOR]- Published
- 2023
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34. Paper 17: Optimal Tibial Tunnel Placement for Medial and Lateral Meniscal Root Repair in the Setting of Multiligament Reconstructions of the Knee.
- Author
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Perry, Allison, Brady, Alex, Dandu, Navya, Singh, Harsh, Vadhera, Amar, Yanke, Adam, LaPrade, Robert, Chahla, Jorge, and Gursoy, Safa
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SURGICAL complication risk factors ,TIBIA surgery ,MENISCUS surgery ,POSTERIOR cruciate ligament surgery ,PLASTIC surgery ,CONFERENCES & conventions ,RISK assessment ,PATELLAR tendon ,ANTERIOR cruciate ligament surgery - Abstract
Objectives: Although the risk of tibial tunnel convergence in the setting of multiligament reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), and medial and lateral meniscal root repair has not been defined. The purpose of this study was to examine the risk of tunnel convergence and to determine optimal tunnel placement for ACL and PCL reconstruction performed in conjunction with posterior medial and lateral meniscal root repairs in the proximal tibia. Methods: Three-dimensional tibial models were created using computed tomography scans of twenty cadaveric specimens. After determining optimal tunnel entry and exit points for ACL and PCL reconstructions, and medial and lateral meniscal root repair on the models, Mimics software was used to create root tunnels. The meniscal root repair tunnels were then re-oriented to be parallel to the ACL tunnel. The initial and re-oriented configurations are illustrated in Figure 1. Tunnel convergence risk was analyzed with single and double tunnel techniques in both case scenarios. Results: There were no cases of convergence between the ACL and medial meniscal root tunnels in any of the configurations. The greatest distance between the tunnels was achieved with the single tunnel technique in parallel orientation (12.09 ± 2.78 mm). All specimens demonstrated convergence between the ACL and lateral meniscal root tunnels when the sagittal plane entry was not taken into consideration and only the anatomic root attachment was accounted for, for single and double tunnel techniques, but no convergence was seen between these tunnels with the parallel orientation in the sagittal plane. Figure 2 illustrates the reduction in the convergence risk when the meniscal root tunnels are reoriented as parallel to the ACL tunnel. There were no cases of convergence between the PCL and medial meniscal root tunnels in the original orientation, but 2/20 specimens demonstrated convergence in the parallel orientation with the double tunnel technique and no cases of convergence in the single tunnel technique. The PCL and lateral meniscal root tunnels did not demonstrate convergence in any configuration. Table 1 demonstrates the mean, minimum and maximum distances of each tunnel configuration as well as the number of cases where the distance between tunnels was <2mm. A summary of the preferred tunnel configurations for each setting, ranked by greatest tunnel distance conferred and cases of convergence, is reported in Table 2. Conclusions: There is a high risk of convergence between ACL and posterior meniscus root tunnels. Re-orienting meniscal root tunnels parallel to ACL tunnels may help reduce this risk. When PCL reconstruction is performed with ACL reconstruction and medial and lateral meniscal root repair, the single tunnel root repair technique may pose less risk over the double tunnel technique to prevent tunnel convergence between the meniscal root repair and PCL tunnels in the tibia. Figure 1. Illustration of the reconstruction of the tunnels. (A) Initial orientation where the meniscal root tunnels' entry points on the anteromedial aspect of the tibia were created above the ACL tunnel. (B) The meniscal root tunnels re-orientated and were placed parallel to that of the ACL and aimed to exit at the anatomic attachment of the posterior roots of the meniscus. (Gold guide for the creation of the ACL tunnel and silver guide for the creation of the meniscal root tunnel) [ABSTRACT FROM AUTHOR]
- Published
- 2022
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35. Paper 21: Blood Flow Restriction Therapy Improves Early Patient Reported Outcomes Following ACL Reconstruction.
- Author
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Khalil, Lafi, Jildeh, Toufic, Abbas, Muhammad, Buckley, Patrick, Moutzouros, Vasilios, Okoroha, Kelechi, and Tramer, Joseph
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BLOOD flow restriction training ,HEALTH outcome assessment ,CONFERENCES & conventions ,TREATMENT effectiveness ,QUADRICEPS muscle ,MUSCLE strength ,ANTERIOR cruciate ligament surgery ,EVALUATION - Abstract
Objectives: To evaluate the affect of blood flow restriction (BFR) therapy conducted both before and after anterior cruciate ligament (ACL) reconstruction on early quadriceps strength and patient reported outcomes. Methods: A total of 43 patients (24 male, 19 female; age 27.6 ± 11.88 years) presenting with an ACL tear were randomized into two groups, BFR (N=22) and Control (N=21) at their initial clinic visit (ICV). Quadriceps strength was measured utilizing a handheld dynamometer in order to calculate peak force, average force and time to peak force during seated leg extension at the ICV. All patients were provided education on preoperative exercises to be performed 4-5 days per week for two weeks between the ICV and date of surgery. The BFR group was instructed to perform these exercises with a pneumatic cuff set to 80% of limb occlusion pressure placed over the proximal thigh. Following surgery, patients underwent physical therapy utilizing standard post-ACL reconstruction therapy protocols, with exercises performed with and without the use of BFR in each respective group. Patient Reported Outcome Measurement System Physical Function (PROMIS-PF), International Knee Documentation Committee (IKDC) scores, knee range of motion and quadriceps circumference were gathered at the ICV, the day of surgery, 2 weeks and 6 weeks after surgery. Quadriceps strength measurements were repeated the day of surgery and six weeks following ACL reconstruction. Results: No significant differences were noted between the BFR and control groups in peak quadriceps force generation (Figure 1), time to peak force or average force at any timepoints (P>0.05). At six weeks post-surgery, the BFR group had significantly higher PROMIS-PF (43.16 ± 5.29 versus 38.39 ± 5.39, p=0.02) and IKDC (58.22 ± 7.64 versus 47.05 ± 13.50, p=0.01, Figure 2) scores compared to the control group. Conclusions: Blood flow restriction therapy before and after ACL reconstruction results in improved patient reported outcomes scores without objective improvements in strength at six week follow up. Long term follow up is needed to determine if differences arise in quadriceps strength between groups. Figure 1. Peak quadriceps force of the injured leg measured in Newtons during the initial clinic visit (ICV), day of surgery (PreOp) and 6 weeks post ACL reconstructions. No statistically significant differences (p>0.05) Figure 2. International Knee Documentation Committee (IKDC) scores collected at initial clinicvisit (ICV), day of surgery (PreOp), 2 weeks and 6 weeks following ACL reconstruction. * Denotes statistically significant difference between groups (p<0.05) [ABSTRACT FROM AUTHOR]
- Published
- 2022
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36. Paper 19: Outcomes for Primary versus Revision Medial Patellofemoral Ligament Reconstruction with Concomitant Tibial Tubercle Osteotomy.
- Author
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Marmor, William, Gruber, Simone, Nguyen, Joseph, Shubin Stein, Beth, and Dennis, Elizabeth
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TIBIA surgery ,OSTEOTOMY ,PLASTIC surgery ,CONFERENCES & conventions ,TREATMENT effectiveness ,PATELLAR tendon ,REOPERATION ,EVALUATION - Abstract
Objectives: It is not currently understood which subset of patients with recurrent patellofemoral instability require concomitant bony realignment procedures in addition to a soft tissue stabilization. Additionally, the optimal timing of surgical intervention is not well defined by current literature and can be dictated by the skeletal maturity of a patient. If the patient's complete pathology is not addressed at their primary procedure, there can be a high risk of recurrent instability necessitating revision surgery. It is not known if the outcomes of medial patellofemoral reconstruction with concomitant tibial tubercle osteotomy (MPFL+TTO) performed as a revision procedure equate the outcomes of MPFL+TTO performed in the primary setting. This study compares patients who underwent primary MPFL+TTO versus those who underwent the same procedure in the revision setting. Methods: Patients who underwent a MPFL+TTO from March 2014 to December 2018 were identified from an institutional patellofemoral registry. Patients were separated into two groups, those undergoing a primary MPFL+TTO and those undergoing a MPFL+TTO after a previously failed surgical attempt for patellar stabilization. Baseline demographic, radiographic, and knee-specific patient reported outcome measures (PROMs) including KOOS QOL, Pedi-Fabs, IKDC, KOOS-PS, and Kujala were collected prior to surgery and at 1- and 2-years following surgical intervention. Return to sport (RTS) rates and recurrent instability events were also collected. Results: 92 knees (84 patients) were included; 59 in the primary group and 33 in the revision group. No differences were identified between the groups with respect to sex (85% vs. 82%, p=0.715), age (23.7 vs. 22.5, p=0.468), BMI (26.3 vs 24.5, p=0.144), TT-TG (20.3 vs 19.3, p=0.238), or patella alta (33% vs 19%, p=0.354). Previous procedures in the revision cohort included 12 MPFL reconstructions, 3 tibial tubercle transfers, 16 lateral releases, 9 imbrications/reefings/plications, 7 loose body removals and 9 chondroplasties. 53 (90%) patients in the primary group and 29 (88%) patients in the revision group had a minimum of 2-year follow-up. There was no difference between the groups for recurrent dislocation (4% vs 0%, p=0.547), recurrent subluxation (9% vs 0%, p=0.162) and RTS (88% vs 83%, p=0.713). In regard to RTS, 79% of the primary surgery group and 71% of the revision group returned at an equal or higher level (p=0.461). At baseline, the primary group had a higher IKDC (42.0 vs 34.7, p=0.049). At 2-year follow-up both groups had significant improvements from baseline in all PROMs, except Pedi-FABS which had no change. There was no difference between groups at 2-year follow-up in KOOS-QoL (60.8 vs 51.1, p=0.186), Pedi-FABS (8.0 vs 7.3, p=0.796), IKDC (75.2 vs 67.7, p=0.206), KOOS-PS (15.8 vs 20.9, p=0.379), and Kujala (86.5 vs 77.9, p=0.143). Conclusions: Management of patellofemoral instability is complex. The optimal timing of surgical intervention and whether a concomitant bony realignment procedure is indicated has yet to be elucidated. This study demonstrates that primary MPFL+TTO versus revision MPFL+TTO have comparable objective and subjective outcomes at short term follow-up. Ongoing data collection for this patient cohort will determine whether these results are sustained at long term follow-up. [ABSTRACT FROM AUTHOR]
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- 2022
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37. Paper 10: Long-Term Outcomes Following Arthroscopic Posterior Shoulder Stabilization: Minimum 10 Year Follow-up.
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Talentino, Spencer, Arner, Justin, Bradley, James, and Rothrauff, Benjamin
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PATIENT aftercare ,SHOULDER joint ,SHOULDER injuries ,JOINT instability ,ARTHROSCOPY ,TIME ,CONFERENCES & conventions ,TREATMENT effectiveness ,EVALUATION - Abstract
Objectives: Posterior shoulder instability accounts for approximately 2-12% of shoulder instability cases and represents a debilitating if not potentially career-ending injury in athletic populations. Arthroscopic posterior shoulder stabilization through capsulolabral reconstruction has been shown to reduce pain and improve function, facilitating return to sport at short- to medium-term follow-up. However, few long-term follow-up studies (exceeding 10 years) have been performed to assess the persistent benefit in shoulder function achieved by surgical intervention. Therefore, the purpose of this study was to investigate the objective and subjective clinical outcome measures of shoulder function in patients who underwent arthroscopic posterior shoulder stabilization with a minimum follow-up time of 10 years. It was hypothesized that current shoulder function would remain statistically superior to preoperative shoulder function, with diminishing benefit for those who required revision surgery. Methods: A group of 183 patients (200 shoulders) who underwent arthroscopic capsulolabral reconstruction for isolated posterior shoulder instability between January 1998 and December 2009 were recruited via existing contact information within the electronic medical record at a single academic medical institution. Institutional review board approval was obtained prior to study initiation, and all patients signed informed consent. Patient characteristics including age, gender, hand dominance, sports played, level of participation, and length of follow-up, were obtained. Patients completed an online questionnaire containing the American Shoulder and Elbow (ASES) shoulder score and the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow score. Subjective scores of pain, stability, range of motion (ROM), and strength were also obtained. The level of sporting participation after treatment was determined and patients assessed whether the initial surgery was worthwhile. Current shoulder status, as compared to preoperative (but post-injury) shoulder status, was compared according to the above metrics. Subgroup analyses were performed comparing outcomes between athletes whose primary sport did or did not involve overhead throwing. Subgroup analyses were also performed for patients who underwent revision surgery, as compared to those who did not, including additional evaluation of shoulder function after failure but preceding revision surgery. Group means for continuous variables were compared using ANOVA and student's t tests as appropriate, while ordinal or categorical data were compared with Wilcoxon signed rank tests or Fisher's exact test when suitable. Results: 53 patients (55 shoulders) with a mean age of 23 years at surgery were included, with an average follow-up time of 15.4 years. 49 of 53 patients were right-hand dominant, with right shoulder injury in 35 cases. Patient characteristics for subgroup analyses based upon position and need for revision surgery are shown in Table 1. Across all patients (55 shoulders) there was significant improvement in all outcome measures, including scores of ASES, KJOC, pain, stability, ROM, and strength, comparing current to preoperative shoulder status (Table 2). Similar trends were found in subgroup analyses, with throwers and non-throwers demonstrating equivalent improvements. In contrast, patients who underwent revision surgery (n=8) possessed a current shoulder status equivalent to preoperative status, across all outcome measures, although significantly improved when compared to shoulder status after initial failure (Table 2). Across all patients, 60% returned to sport at any level, with 34.5% returning to sport an the same level as prior to injury. 89% of patients felt the initial surgery was worthwhile. Subgroup analysis demonstrated a trend towards compromised return to sport at pre-injury levels in throwing athletes, but statistical significance was not achieved (p =.09). Conclusions: The main finding of this study was that arthroscopic capsulolabral reconstruction produced significant pain relief and improved shoulder function at long-term follow-up, that is, at a mean of 15.4 years following surgery. Of the limited patient population that underwent revision surgery (n=8), current shoulder status did not differ statistically from preoperative status (i.e., no significant improvement compared to preoperative function). Both findings support the hypothesis. No differences in throwing athletes were found in comparison to non-throwing athletes according to the outcome measures explored. The majority of patients were able to return to sport following surgery, but only 64% of non-throwers returned to sport at the same level as prior to injury, with only 21% of throwers returning to pre-injury levels. While some of these findings are attributed to a discontinuation or reduction in sporting activity due to expected life circumstances (e.g. graduation), the results suggest continued opportunity to improve shoulder function following injury entailing a posterior instability event. This study is also limited by the absence of a group that did not undergo operative intervention. While this study is limited by a relatively small sample size, it does represent one of the longest follow-up periods for posterior shoulder stabilization, demonstrating sustained benefit in shoulder pain and function following arthroscopic surgery. [ABSTRACT FROM AUTHOR]
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- 2022
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38. Paper 59: Comparison of Knotless versus Knotted Suture Anchors in the Arthroscopic Management of Adolescent Shoulder Instability.
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Ghetti, Claudio, Michelin, Richard, Fogleman, Sarah, Gornick, Bryn, Carroll, Alyssa, Edmonds, Eric, and Schlechter, John
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SHOULDER injuries ,JOINT instability ,ARTHROSCOPY ,CONFERENCES & conventions ,TREATMENT effectiveness ,TENODESIS ,ADOLESCENCE - Abstract
Objectives: Shoulder instability among adolescent athletes remains a complex challenge with high recurrence rates. Knotted suture anchors have provided consistently reliable biomechanical and clinical results. In recent years, the advent of the knotless suture anchor technology has come with proposed advantages of minimizing technical difficulty and knot migration, as well as reducing subsequent intra-articular cartilage irritation and damage. While several studies have analyzed the utility of knotless suture anchors in the adult population, to our knowledge, there has not been a direct comparison within this more at risk for surgical failure adolescent population. The purpose of this study was to compare the effect of knotted versus knotless suture anchor use on postoperative outcomes of arthroscopic shoulder instability surgery in the adolescent athlete. Methods: A multicenter comparative cohort was conducted of patients that underwent primary arthroscopic shoulder labral repair with suture anchor implants for shoulder instability between June 2015 and November 2017. Additional inclusion criteria included patient age <20 years and minimum follow up duration of 3.5 years. Data collected included demographics, number and type of suture anchor (knotted or knotless), number of instability events, type of instability, and presence of bony Bankart lesions. All included patients had <20% glenoid bone loss at the time of surgery. Type of instability was also recorded and was classified as either: anterior, posterior, or multidirectional (MDI). The primary outcome measure was surgical failure, which was defined as any recurrent instability event post-surgery. Incidence of secondary surgery (including revision or need for additional procedure), surgical times, and return to sport (RTS) data were also recorded. Patient-reported outcomes were evaluated using the Pediatric and Adolescent Shoulder Survey (PASS), SANE (Single Assessment Numeric Evaluation) scores, and the Quick version of Disabilities of the Arm, Shoulder and Hand (QuickDASH) survey. Results: Eighty-eight shoulders (54 male, 34 female) from 84 patients met inclusion criteria and were analyzed. 43 received knotless anchors and 45 received knotted anchors. Mean follow-up duration was 4.5 years (range, 3.5-6 years) for the knotless cohort and 4.8 years (range, 3.7-5.8 years) for the knotted cohort. Demographics and type of instability by suture anchor type is shown in Table 1. Surgical failure rate was significantly lower in the knotless cohort (knotless, 16%; knotted, 53%; P <.001). Patients with knotless suture anchors reported significantly higher mean PASS scores (knotless, 90.2; knotted, 81.3; P =.002). There was no difference in both RTS rates (knotless, 86%; knotted, 68%; P =.055) and incidence of repeat surgery between cohorts (knotless, 9%; knotted, 13%; P =.551). Surgical times, SANE scores, and QuickDASH scores were available for approximately three-quarters of shoulders (total, 65; knotless, 36; knotted, 29) in the cohort. Mean surgical time was approximately 18 minutes shorter for knotless anchors (knotless, 84.4 minutes; knotted, 102.7 minutes; P <.001). SANE scores were significantly higher in the knotless group (knotless, 88.8; knotted, 74.3; P =0.004). QuickDASH scores, of which a lower score is considered a better outcome, were not different (knotless, 5.7; knotted, 11.4; P =.063). Conclusions: Our initial intent was to demonstrate that knotless anchors would be just as successful as labral repairs with knotted anchors, but our results indicate several promising advantages, including: better patient reported outcome measures (PASS and SANE scores), reduced surgical times, and lower failure rates at a mean 4.5 years. There were some non-significant differences in the two cohorts regarding the type of instability that likely contributed to the differences in the number of anchors utilized. Future studies with larger sample sizes may serve to confirm our observed benefits associated with knotless anchors. In summary, the utilization of knotless suture anchor constructs for the repair of labral tears in adolescent shoulder instability may be safely considered with potentially improved outcomes over knotted anchors. Table 1. Demographic characteristics of included patients [ABSTRACT FROM AUTHOR]
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- 2022
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39. Workers' Compensation Electronic and Standardized Paper Billing.
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LEGAL notice ,ADMINISTRATIVE procedure ,WORKERS' compensation - Abstract
The article presents a notice of proposed adopted amendment issued by the Illinois Department of Insurance as of August 2015 regarding workers' compensation electronic and standardized paper billing. Topics includes summary and purpose of rulemaking, effective date of rulemaking and recommendations to contact agency's assistant general counsel Joseph Clennon for information and questions regarding adopted rule.
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- 2015
40. Educational Video Games for Deep Learning: Influences on Student Engagement and Conceptual Understanding
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Shernoff, David J.
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In this paper, we report the results of a 3-year, quasi-experimental study comparing students' engagement and deep learning of course materials between students who took an undergraduate engineering course that used a video game approach to a control group. The video game, EduTorcs, provided challenges in which students devised control algorithms that race virtual cars through a simulated race track. Theoretically, the study is rooted in Mayer and colleague's cognitive theory of multimedia learning. Engagement was measured with the Experience Sampling Method. Students taking the game-based course reported greater intrinsic motivation and engagement than students taking the course in the traditional way; and they performed significantly better on tests of complex course concepts designed to measure deep learning.
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- 2023
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41. Roles of Wireless Networks in Bridging the Rural Smart Infrastructural Divide.
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Chen, Xiaoqian, Chen, Kang, Wang, Minxiao, and Li, Ruopu
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COMMUNICATION infrastructure ,WIRELESS Internet ,INFRASTRUCTURE (Economics) ,INFORMATION & communication technologies ,INTERNET speed - Abstract
The past decade has seen a rise in the availability of modern information and communication technologies (ICTs) for developing smart societies and communities. However, the smart divide, characterized by inequalities in ICT infrastructures, software access, and individual capabilities, remains a significant barrier for rural communities. Limited empirical studies exist that explore what and how ICT infrastructures can be developed to bridge the smart divide. The paper aimed to address rural broadband access in the context of infrastructural dimensions of smart divide (i.e., smart infrastructural divide) in the United States, focusing on the wireless network infrastructure's role in narrowing the gap. It examined the broadband specifications needed for smart applications like smart education and telehealth, emphasizing the importance of wireless network capabilities. While fixed broadband offers higher speeds, wireless networks can support many smart applications with decent flexibility and ease of access. To further understand the implications of wireless broadband to rural communities, we conducted a case study in Carbondale and Cairo, two rural towns in Southern Illinois, using on-site user-inspired speed testing. An Android application was developed to measure download/upload speeds and Reference Signal Received Power (RSRP) for broadband quality. Results suggest both Carbondale and Cairo experienced below-average speeds with high variability among census blocks, which highlights the need for improved wireless network infrastructure. The paper culminated in the technological and policy recommendations to narrow down the smart infrastructural divide. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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42. Paper 18: Treatment of Lateral Meniscus Tears Influences OA Rate following ACL Reconstruction at 9-year Follow-Up.
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Briggs, Karen, Petterson, Stephanie, and Plancher, Kevin
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MENISCECTOMY ,CONFERENCES & conventions ,OSTEOARTHRITIS ,ANTERIOR cruciate ligament surgery ,MENISCUS injuries ,DISEASE risk factors - Abstract
Objectives: Recent studies have described an increased risk of osteoarthritis (OA) following ACL reconstruction (ACLR). Systematic reviews have suggested that meniscal pathology, which occurs in up to 60% of patients with ACL injury, increases this risk. The purpose of this study was to determine the influence of lateral meniscus tears and repair versus partial lateral meniscectomy on the risk of OA in patients following ACLR. Methods: All patients who underwent primary autograft or allograft bone-patellar tendon-bone (BPTB) transtibial ACLR by a single surgeon between 1999-2019, were identified. Revision ACLR, multi-ligamentous reconstructions, and patients with less than 2-year imaging follow-up were excluded. Patients with lateral meniscus pathology at the time of ACLR were identified and treatment (e.g. lateral meniscectomy or lateral meniscus tear) was extracted. OA was defined at follow-up as Kellgren-Lawrence (KL) grade III-IV on plain radiographs. Chi-square tests assessed differences in incidence rates (p<0.05). Results: A consecutive series of 113 patients (57 males, 56 females; age 35.7±11.9 years) with BPTB ACLR were included. The mean follow-up was 9±5 years. The prevalence of lateral meniscus tears was 60.2% (68/113) and the prevalence of lateral compartment OA at follow-up was 14% (16/113) Patients with a lateral meniscus tear were 4.7 times more likely to develop OA compared to patients with no lateral meniscus tear. 20.6% of patients (14/68) with lateral meniscus tear developed lateral OA compared to 4.4% of patients (2/45) without lateral meniscus tear (p=0.0158). Patients who underwent lateral meniscal repair (n=16) had significantly lower prevalence of OA (0/16) compared to patients who underwent lateral meniscectomy (14/52) (p=0.0196). Conclusions: At nine-year follow-up, patients with a lateral meniscus tear at time of ACLR were more likely to develop OA compared to patients with no lateral meniscus tear and patients treated with partial meniscectomy had higher prevalence of OA compared to those treated with meniscus repair. In patients who require ACLR, care should be taken in evaluating and treating the lateral meniscus to decrease the likelihood of the development of OA. We believe lateral meniscal repair is essential for lateral meniscus tears at the time ACL reconstruction to help avoid development of OA. Figure 1. [ABSTRACT FROM AUTHOR]
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- 2022
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43. Paper 22: Increased Lower Extremity Injury Associated with Player Load and Distance in Collegiate Women's Soccer.
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Nguyen, Jessica, Hwang, Calvin, Abrams, Geoffrey, and Xiao, Michelle
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LEG injuries ,RISK assessment ,WEARABLE technology ,GLOBAL Positioning System ,CONFERENCES & conventions ,FOOTBALL injuries ,ATHLETIC ability ,EMPLOYEES' workload ,DISEASE risk factors - Abstract
Objectives: High cumulative workloads and spikes in player workloads have been associated with an increased risk of injury in soccer and other sports. These studies, however, have all been conducted with data from male soccer players or male athletes in other sports, with few studies investigating female athletes. Using metrics collected from GPS units to monitor cumulative load and distance may be valuable for injury prevention. The purpose of this study was to examine the relationship between injury risk and workload as collected from wearable GPS units in NCAA Division I women's soccer players. Methods: Lower extremity injury incidence and GPS workload data (player load, total distance, and high-speed distance) of 65 NCAA Division I women's soccer players were collected over 3 seasons. Accumulated 1-, 2-, 3- and 4-weekly loads and acute: chronic workload ratios (ACWR) were classified into discrete ranges by z-scores. ACWR was calculated using rolling averages and exponentially weighted moving averages (EWMA) models. Binary logistic regression models were used to compare the 7:28 rolling average and EWMA ACWRs between injured and non-injured players for all GPS/accelerometer variables. The prior 1-, 2-, 3-, and 4-weekly accumulated loads for all GPS/accelerometer variables were compared between the injured and uninjured cohorts using two-sample t -tests with an alpha level of 0.05 set as significant. Results: There were a total of 53 lower extremity injuries that resulted in lost time recorded (5.76/1000 hours 'on-field' exposure time; 34 non-contact and 19 contact injuries). The prior 2-week (7,242 vs 6,613; p=0.02), 3-week (10,533 vs 9,718; p=0.02), and 4-week (13,819 vs 12,892; p=0.04) accumulated player loads and 2-week (62.40 vs 57.25 km; p=0.04), 3-week (90.97 vs 84.10 km; p=0.03), and 4-week (119.31 vs 111.38 km; p=0.05) accumulated total distances were significantly higher for injured players compared to non-injured players during the same timeframes. There were no significant differences in player load, total distance, or high-speed distance ACWR between injured and non-injured players for both the rolling averages and EWMA calculations. Conclusions: Higher accumulated player load and total distance, but not ACWR, are associated with injury in women's soccer players. [ABSTRACT FROM AUTHOR]
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- 2022
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44. Paper 16: Clinical Outcomes and Return to Play in Softball Players Following Biceps Tenodesis or SLAP Repair.
- Author
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Rothermich, Marcus
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SPORTS participation ,TENDINITIS ,SHOULDER injuries ,SPORTS injuries ,CONFERENCES & conventions ,SOFTBALL ,BICEPS brachii ,TREATMENT effectiveness ,TENODESIS ,EVALUATION - Abstract
Objectives: Shoulder pain due to labral tears and biceps tendon pathology is commonly found in competitive softball players. Surgical options for treatment of these sources of shoulder pain include labral repair and biceps tenodesis. While past studies comparing these two modalities are limited by mostly heterogeneous study groups from multiple sports, this is the first study to our knowledge that assesses clinical outcomes and return to play rates specifically for softball players. The purpose of this study is to evaluate the clinical outcomes and return to play for softball players treated for a SLAP tear and recalcitrant biceps tendonitis with a biceps tenodesis compared with a traditional SLAP repair. We hypothesized that performing a biceps tenodesis in softball players that have recalcitrant biceps tendonitis or a SLAP tear would have comparable outcomes with a faster return to play compared to SLAP repair. Methods: We performed a retrospective analysis on all patients who were active softball players at the time of injury treated surgically for either a SLAP tear, recalcitrant biceps tendonitis or a combination of both between 2001 and 2019. Inclusion criteria for this study included softball players who underwent biceps tenodesis or a SLAP repair at our institution with greater than 2-year follow-up. Exclusion criteria involved patients with less than 2-year follow-up and patients who had undergone concomitant procedures on the ipsilateral shoulder at the time of SLAP repair or biceps tenodesis. Follow-up was either self-reported through OBERD, a PRO-managing software, or achieved over the phone by three authors using four questionnaires: American Shoulder and Elbow Surgeons (ASES-S), Andrews/Carson KJOC, and our institution-specific VAS visual pain indication and return-to-play questionnaires. Results: After applying the proper inclusion and exclusion criteria, we identified 76 patients who were eligible for this study. From this group of 76 patients, 63 were successfully contacted over the phone or had self-reported outcome scores pulled from our PRO-managing software for a follow-up rate of 83%. The average age for our study group at the time of surgery was 20.6 years and the average post-operative follow-up time was 6.0 years. Of the 76 patients in our study, 34 underwent a biceps tenodesis procedure (45%), 21 underwent a SLAP repair procedure (28%), 6 underwent a combination of both procedures (8%), and 2 underwent a biceps tenotomy (3%). For the 34 patients in our study who underwent biceps tenodesis, the average age at the time of surgery was 20.0 years with a mean follow-up time of 3.7 years. The mean Andrews-Carson score was 82.2 and KJOC score was 73.7 in this group. The mean ASES-S score was 92.0 for the affected shoulder and 97.8 for the unaffected shoulder. The VAS pain indicator score for this group was 1.4 out of 10. The 21 patients in the study who underwent SLAP repair had an average age of 20.9 years at the time of surgery. The average age follow-up time was 8.18 years. This group demonstrated a mean Andrews-Carson score of 86.7 and a KJOC score of 80.7. The mean ASES-S score was 93.3 for the affected shoulder and 96.4 for the unaffected shoulder. The VAS pain indicator score for this group was 1.2 out of 10. Of the 21 SLAP repair patients, 20 (95%) returned to full competition at an average of 7.5 months. Of the 34 patients who underwent biceps tenodesis, 31 (91%) returned to full competition at an average of 7.1 months. Conclusions: In conclusion, this study demonstrated comparable outcomes between SLAP repairs and biceps tenodesis procedures among our study group. Statistical analysis of PRO scores for each group found no significant differences between any of the measures used to evaluate patient outcome post-operatively. There was no significant difference between RTP times between the two groups. Further analysis is needed for additional comparisons, including level of play and position data. [ABSTRACT FROM AUTHOR]
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- 2022
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45. Paper 08: Predicting Clinically Significant Outcomes in Patients Undergoing Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome: Five-Year Results in 453 Patients.
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Knapik, Derrick, Newhouse, Alexander, Alter, Thomas, Chahla, Jorge, Nho, Shane, and Clapp, Ian
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HIP surgery ,FEMORACETABULAR impingement ,PREDICTIVE tests ,ARTHROSCOPY ,HEALTH outcome assessment ,CONFERENCES & conventions - Abstract
Objectives: To determine predictors of clinically significant outcome achievement at a minimum of 5-year follow-up in patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement syndrome with routine capsular closure. Methods: Data were collected and analyzed from consecutive patients who underwent primary hip arthroscopy with routine capsular closure for the treatment of FAIS from a single fellowship-trained surgeon between January 2012 and December 2018. Baseline data, preoperative patient reported outcome measures (PROMs) and 5- year PROMs including Hip Outcome Score-Activities of Daily Living, HOS-Sports Subscale, international Hip Outcome Tool 12 questions, modified Harris Hip Score and visual analog scale pain were recorded. The minimal clinically important difference (MCID) was calculated using the distribution method while patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) were determined from literature defined values. Bivariate correlations with any MCID achievement, any PASS achievement, and any SCB achievement as well as a principle components analysis for variable reduction were used to create three separate multivariate binary logistic regressions to identify significant predictors of achieving a clinically significant outcome. Results: 453 patients with an average age of 34.3 ± 12.5 and average BMI of 25.5 ± 4.9 and majority female (69.1%) were included in the final analysis. There was a significant improvement in all 5-year functional outcomes when compared to preoperative scores (p<0.001 for all). At a minimum of 5-year follow-up, 82.8% of patients achieved any MCID, 69.8% achieved any PASS, and 58.9% achieved any SCB. A total of 23 patients (5.1%) of the study population underwent revision hip arthroscopy or total hip arthroplasty within the follow-up period. Female sex (Odds Ratio (OR), 2.56 [95% confidence interval (CI), 1.47 to 4.45) was a positive predictor of achieving any MCID while higher Tönnis angle (OR, 0.92 [95% CI, 0.87 to 0.98]), Tönnis grade =1 (OR, 0.34 [95% CI, 0.14 to 0.83]) were negative predictors of achieving any MCID. Higher preoperative HOS-ADL (OR, 1.03 [95% CI, 1.01 to 1.05]) and female sex (OR, 2.01 [95% CI, 1.14 to 3.55]) were positive predictors of PASS. With regards to SCB, running (OR, 2.02 [95% CI, 1.31 to 3.14]) was a positive predictor of achievement while a history of back pain (OR, 0.49 [95% CI, 0.28 to 0.86]) and preoperative chronic pain for greater than 2 years (OR, 0.62 [95% CI, 0.36 to 0.98]), were negative predictors of achievement. Conclusions: At a minimum of 5-year follow-up, 82.8% of patients undergoing primary hip arthroscopy for the treatment of FAIS achieved any MCID, 69.8% achieved any PASS, 58.9% achieved any SCB. Female sex, higher preoperative PROs, and participation in running were positive predictors of achieving a clinically significant outcome while a higher Tönnis angle, Tönnis grade = 1, preoperative chronic pain, and back pain were negative predictors of achieving a clinically significant outcome. [ABSTRACT FROM AUTHOR]
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- 2022
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46. Paper 11: Return to Sport Testing vs Time-Based Clearance in Posterior Shoulder Instability.
- Author
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Lin, Albert and Dunn, Robin
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SPORTS participation ,SHOULDER injuries ,JOINT instability ,ARTHROSCOPY ,TIME ,CONFERENCES & conventions ,DISEASE relapse - Abstract
Objectives: Recurrent pain, instability and loss of function is a challenging complication that can occur after arthroscopic treatment of posterior shoulder instability and SLAP tears in athletes. Many surgeons allow return to sport after a designated arbitrary postoperative time point. Recent evidence has demonstrated that a majority of athletes have residual strength and functional limitations at 6 months postoperatively – the time at which most time-based protocols allow full return to sport
1 . Recent data has also been presented that patients undergoing arthroscopic Bankart repair who are required to meet objective return to sport testing criteria have a 4x lower rate of recurrent anterior instability than those who return based on time elapsed since surgery2 . Considering these findings, the purpose of this study is to investigate the use of a similar objective return to sport testing protocol on recurrence rates following arthroscopic surgery for posterior shoulder instability and SLAP tears. We hypothesized that patients who meet objective return to sport criteria would have a lower rate of reoperation and recurrence of symptoms compared to those who did not undergo the testing and were cleared to return based on time from surgery. Methods: Consecutive patients (Group 1) who underwent arthroscopic posterior shoulder stabilization surgery with or without SLAP repair by a single surgeon from 2016 to 2019, had a minimum of 1 year follow up, and completed functional and strength testing to evaluate readiness for return to sport were included in this retrospective case-controlled study. These patients were compared to a control group of historical consecutive cases (Group 2) from 2012-2016 who did not undergo return to sports testing and were cleared for sports after a minimum of 6 months following surgery. Failure was defined as recurrent symptoms of pain or instability requiring reoperation. Exclusion criteria were: patients undergoing isolated anterior stabilization procedures with or without concomitant SLAP tears, multidirectional instability, and open procedures. Chi-square, Fisher exact tests and two-tailed Students T-test were performed. Statistical significance was set at p<0.05. Results: There were 33 patients in Group 1 who underwent return to sport testing, and 90 patients in Group 2, the historical control. There were no differences between groups regarding sex (p=0.46), hand dominance (p=0.16), side affected (p= 0.69. The average age of Group 1 (20.8 +/- 4 yrs) was significantly younger than Group 2 (31.6 +/- 9.1 yrs, p< 0.00001). Patients who underwent return to sport criteria-based testing protocol had a rate of recurrent symptoms of pain or instability of 12.1% compared to 18.9% for those who did not (p= 0.43). Similarly, there were no reoperations for in Group 1, while three patients in group 2 (3.3%) underwent revision surgery for recurrent symptoms. This difference, however, did not reach statistical significance (p= 0.5633). Conclusions: In our cohort of young patients undergoing arthroscopic surgery for posterior shoulder instability, we detected no significant difference in reoperation rate and recurrence of symptoms between athletes who underwent objective return to sport testing and those who were released to sport on a time-based protocol. This may be related to an overall lower rate of reoperation in patients undergoing arthroscopic posterior stabilization or SLAP repairs in general compared to those undergoing arthroscopic anterior stabilization and differences in tolerance and presentation of recurrent posterior instability/SLAP tears versus anterior instability. It is possible that criteria-based return to sport testing prior to clearance to return to sport may be less critical for improving failure rates following arthroscopic posterior stabilization and SLAP repair than for anterior stabilization. Alternatively, given low reoperation rates overall, future studies investigating the role of return to sport testing after arthroscopic surgery for posterior shoulder instability and SLAP repairs may need to include more patients in order to detect differences related to the testing protocol. Objective functional testing may be a viable alternative to arbitrary, time-based criteria for returning to sport in patients who have undergone arthroscopic posterior shoulder stabilization and SLAP repairs. [ABSTRACT FROM AUTHOR]- Published
- 2022
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47. Paper 13: None: Clinical Outcomes of Ulnar Collateral Ligament Surgery in Non-Throwing Athletes.
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Rothermich, Marcus
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THUMB injuries ,ATHLETES ,CONFERENCES & conventions ,TREATMENT effectiveness - Abstract
Objectives: Ulnar collateral ligament (UCL) surgery continues to improve since its inception by Dr. Frank Jobe in 1974. There is now ample data on the outcomes of surgery for throwing athletes, such as baseball players, who undergo either UCL reconstruction or UCL repair. In comparison, there is very little available data regarding outcomes of UCL surgery for non-throwing athletes who are seeking similar benefit from the procedure. The primary objective of this study is to provide clinical outcomes of UCL surgery performed in non-throwing athletes at a single institution with a minimum two-year follow-up. Methods: Forty non-throwing athletes who underwent UCL surgery (repair or reconstruction) between 2011 and 2019 were identified. All surgeries were performed by one of three fellowship-trained sports medicine surgeons at our institution utilizing a uniform technique for repair or reconstruction. Demographics were recorded including age, sex, laterality, arm dominance, sport, level of competition, and type of surgery (UCL repair or reconstruction). Outcomes included return to play (rate and average time), American Shoulder and Elbow Surgeons (ASES) scores, and complications. Results: Thirty-seven patients (92.5%) were available for evaluation with a minimum two-year follow-up consisting of 16 males (43%) and 21 females (57%). Mean age at the time of surgery was 18±3.7 years.28 UCL repairs (76%) and 9 UCL reconstructions (24%) were performed.Sports included football (n=11), gymnastics (11), cheerleading (7), wrestling (4), volleyball (2), basketball (1), and acrobatics (1). Quarterbacks were excluded from the football patients as quarterbacks are throwing athletes. Level of competition included youth (1), high school (26), college (8), and professional (2).Return to play rate was 93% (26 of 28) at a mean of 7.4 months for UCL repair, and 100% (9 of 9) at a mean of 10 months for UCL reconstruction.Mean ASES scores were 94.4 and 98.7 for UCL repair and reconstruction, respectively.Two Patients in the UCL repair group required ulnar neurolysis and revision ulnar nerve transposition. Conclusions: Both UCL reconstruction and UCL repair show favorable outcomes at minimum two-year follow-up in non-throwing athletes.93% or greater returned to play with good functional outcomes and minimal complications. Table 1. Patient Characteristics Table 2. Outcomes Comparison [ABSTRACT FROM AUTHOR]
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- 2022
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48. Paper 02: A Modified Lemaire Lateral Extra-Articular Tenodesis in High Risk Adolescents Undergoing Anterior Cruciate Ligament Reconstruction: Two-Year Clinical Outcomes.
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Cordasco, Frank, Perea, Sofia Hidalgo, Brusalis, Christopher, and Green, Daniel
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CONFERENCES & conventions ,TREATMENT effectiveness ,TREATMENT failure ,ANTERIOR cruciate ligament surgery ,TENODESIS ,PATIENT safety ,CHILDREN ,ADOLESCENCE - Abstract
Objectives: This study aimed to evaluate the safety and efficacy of performing a lateral extra-articular tenodesis (LET) with a modified Lemaire technique (MLT) in conjunction with anterior cruciate ligament reconstruction (ACLR) in children and adolescents at increased risk for failed ACLR. Methods: A consecutive series of patients ≤19 years who underwent simultaneous ACLR and LET with minimum two-year follow-up data were reviewed. Patients were indicated for LET when one or more of the following risk factors were present: participant in high-risk competitive sport such as football, lacrosse, soccer or basketball, grade 3 pivot shift, hyperlaxity (Beighton score > 6), recurvatum, revision ACLR, contralateral ACLR, or chronic ACL insufficiency. ACLR was performed using either full-thickness quadriceps tendon (QUAD) for skeletally immature patients or bone-patellar tendon-bone (BTB) autograft for skeletally mature patients. All-epiphyseal (AE) or complete transphyseal (CT)techniques were used depending on patients' skeletal maturity. At a minimum two-year follow-up, patient-reported outcome measures included Single Assessment Numeric Evaluation (SANE), Pediatric International Knee Documentation Committee (Pedi-IKDC), and the HSS Functional Activity Brief Scale (HSS Pedi-FABS) scores. Return-to-sport (RTS)data and second surgeries were also obtained. Results: Sixty-one consecutive patients (mean age 15.17 ±1.73 years, range 11-19 years, 62% female) were analyzed (Table 1). 59 patients (97%) participated in organized sports including soccer, basketball, football and lacrosse, with soccer being the most popular one. The average grade at the time of surgery was 9
th grade. Ten patients (16%) were revision ACLR procedures. Seven (11%) patients underwent AE and 54 (89%) underwent CT ACLR. Forty-two (69%) cases employed a QUAD autograft, while 19 (31%) utilized a BTB autograft. All patients underwent a LET with a MLT and 2 patients underwent simultaneous implant mediated guided growth with a plate for structural genu valgum. At two-year follow-up, mean SANE score was 95, median Pedi-IKDC score was 91, and median HSS-Pedi Fabs score was 27. RTS rate was 91.8%. Ten patients had subsequent surgical procedures, including two hardware removal procedures for hemiepiphysiodesis, three contralateral ACLR, three meniscus surgeries, one lysis of adhesions, and one revision ACLR for BTB graft re-rupture. Two patients were lost to follow-up and excluded from the study. Conclusions: The findings suggest that concomitant LET and ACLR in adolescent patients with risk factors for failed ACLR is associated with favorable patient-reported outcomes, high return to sports participation, and low ACL re-rupture rate at two years follow-up. [ABSTRACT FROM AUTHOR]- Published
- 2022
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49. Paper 56: Defining Clinically Significant Outcomes After Gluteus Medius Repair at 5-Years.
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Sivasundaram, Lakshmanan, Browning, Robert, Holland, Tai, Paul, Katlynn, Nho, Shane, and Rice, Morgan
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TENDON injuries ,BUTTOCKS ,TIME ,ORTHOPEDIC surgery ,HEALTH outcome assessment ,CONFERENCES & conventions - Abstract
Objectives: To define minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) at a minimum of 5-years for patients undergoing endoscopic and open gluteus medius repair. Methods: A retrospective review was performed of prospectively collected data from all patients undergoing primary open or endoscopic repair of gluteus medius tears between January 2012 and December 2015 with a minimum 5-years follow-up. Patient data collected included patient demographics, preoperative clinical function scores, and pre and postoperative patient-reported outcomes (PROs). Patient reported outcome measures included the Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports Subscale (HOS-SS), Modified Harris Hip Score (mHHS) and Internation Hip Outcome Tool 12 questions (iHOT-12). The minimal clinically important difference (MCID) values were calculated for each PRO using the distribution method while PASS was determined via the anchor-based method utilizing ROC curves and Youden's index using SPSS Statistics (Version 27, IBM, Armonk, NY). Results: A total of 46 patients were included in the study. A majority of patients were female (91.3%), with an average age and BMI of 61.26 ± 9.74 and 27.42 ± 6.02, respectively. Differences in preoperative and 5-year postoperative PROs were statistically significant for each of the four measures (p<0.001). The MCID threshold values for the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Sport-Specific (HOS-SS) subscale, modified Harris Hip Score (mHHS), and the international Hip Outcome Tool-12 (iHOT) were calculated to be 13.1, 14.5, 12.6 and 11.2 respectively. The PASS scores of HOS-ADL, HOS-SS, mHHS and iHOT were calculated to be 85.6, 79.7, 68.2 and 60.5 respectively. In addition, 86.1% of patients achieved either MCID or PASS postoperatively, with 90.9% and 69.8% reaching at least 1 threshold score for achieving MCID and PASS respectively, and 69.7% achieving both any MCID and any PASS. Conclusions: In patients undergoing open or endoscopic gluteus medius repair, our study defines MCID and PASS at mid-term follow-up. A majority of patients achieved any MCID (90.9%) and any PASS (69.7%) at 5-years postoperatively. [ABSTRACT FROM AUTHOR]
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- 2022
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50. THINKING IN CIRCLES.
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WORKMAN, MEGAN
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RECYCLING conferences ,PAPER recycling ,CONFERENCES & conventions - Abstract
The article offers information on the 2015 Paper & Plastics Recycling Conference that will be held in Chicago, Illinois from October 14 to 16, 2015.
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- 2015
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