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Herb CC, Custer L, Blemker S, Saliba S, Hart J, Hertel J. Gait kinematics and kinetics in patients with chronic ankle instability and healthy controls: A statistical parametric mapping analysis. Foot (Edinb) 2024; 59:102089. [PMID: 38593519 DOI: 10.1016/j.foot.2024.102089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/27/2023] [Accepted: 03/10/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is associated with changes in gait biomechanics which may be related to chronic dysfunction. Traditional statistical models may be limited in their ability to assess the complex 3D movement of the lower extremity during gait. Multivariate analysis of the lower extremity kinematics may reveal unique biomechanical differences associated with CAI. RESEARCH QUESTION Do patients with CAI differ from healthy controls in their lower extremity biomechanics and GRF when comparing 3D biomechanics? METHODS Thirty-nine young, active adults participated in this study. Data was collected using a 3D motion analysis system while patients walked and jogged. Statistical parametric mapping (SPM) was used to explore 3D GRF, kinematics and kinetics of the of the lower extremity of CAI and healthy patients. RESULTS During walking, patients with CAI had greater inversion from 68-100% of gait cycle (p < 0.001, mean difference=3.2°). During jogging, patients with CAI had greater inversion from 20-92% (p < 0.001, mean difference=4.6°). Greater plantar flexion moments were found from 65-71% (p = 0.05, mean difference=347.4Nm/kg) and greater eversion moments were found from 95-100% (p = 0.03, mean difference=74.6Nm/kg) in the CAI group. No differences in GRF were found. SIGNIFICANCE Greater inversion may present a potentially injurious position. A faulty position of the rearfoot may require greater muscle function in order to correct the position of the joint resulting in greater eversion moments at the ankle. However, this kinetic change does not appear to correct the ankle position.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitative Science, Highland Heights, KY, USA.
| | - L Custer
- Towson University, Department of Kinesiology, Towson, MD, USA
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Testard C, Shergold C, Acevedo-Ithier A, Hart J, Bernau A, Negron-Del Valle JE, Phillips D, Watowich MM, Sanguinetti-Scheck JI, Montague MJ, Snyder-Mackler N, Higham JP, Platt ML, Brent L. Natural disaster alters the adaptive benefits of sociality in a primate. bioRxiv 2024:2023.07.17.549328. [PMID: 37503170 PMCID: PMC10370068 DOI: 10.1101/2023.07.17.549328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Weather-related disasters can radically alter ecosystems. When disaster-driven ecological damage persists, the selective pressures exerted on individuals can change, eventually leading to phenotypic adjustments. For group-living animals, social relationships are believed to help individuals cope with environmental challenges and may be a critical mechanism enabling adaptation to ecosystems degraded by disasters. Yet, whether natural disasters alter selective pressures on patterns of social interactions and whether group-living animals can, as a result, adaptively change their social relationships remains untested. Here, we leveraged unique data collected on rhesus macaques from 5 years before to 5 years after a category 4 hurricane, leading to persistent deforestation which exacerbated monkeys' exposure to intense heat. In response, macaques increased tolerance for and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival for 5 years after the hurricane, but not before it, revealing a clear shift in the adaptive function of social relationships in this population. We demonstrate that an extreme climatic event altered selection on sociality and triggered substantial and persistent changes in the social structure of a primate species. Our findings unveil the function and adaptive flexibility of social relationships in degraded ecosystems and identify natural disasters as potential evolutionary drivers of sociality. One-Sentence Summary Testard et al. show that a natural disaster altered selection on sociality in group-living primates triggering persistent changes in their social structure.
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Polovneff AO, Olowofela AS, Rossi PJ, Hart J, Malinowski MJ, Lewis BJ, Brown KR, Mansukhani NA. Development and Evaluation of an Enhanced Recovery Protocol to Reduce Length of Stay Following Elective Endovascular Aneurysm Repair. Ann Vasc Surg 2023:S0890-5096(23)00328-X. [PMID: 37356651 DOI: 10.1016/j.avsg.2023.05.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Elective endovascular abdominal aortic aneurysm repair (EVAR) can be performed safely with a short postoperative length of stay (LOS). We aimed to develop and assess the impact of an enhanced recovery protocol (ERP) on LOS after elective EVAR. METHODS Pre ERP development single center retrospective review of elective EVAR procedures from January 2012 to December 2019. ERP was developed by targeting factors associated with prolonged LOS (>2 days) elucidated from semi-structured interviews and Bayesian additive regression tree analysis. Post ERP development a subsequent retrospective review of elective EVAR performed from January 2018 to June 2021 was performed to evaluate LOS before and after ERP. Primary outcome was LOS. RESULTS 216 patients underwent elective infrarenal EVAR from 2012-2019. periprocedural factors identified associated with LOS > 2 days included non-commercial insurance, (43.6% vs 26.5%; P = 0.01), preoperative anemia (hemoglobin 12.56 g/dL vs 13.57g/dL; P = 0.001), worse renal function (creatinine 1.31mg/dL vs 1.01/dL; P = 0.004), open femoral access (74.4% vs 26.5%; P < 0.001), ICU stay (2.7 days vs 0.9 days; P <0.001), postoperative anemia (9.8g/dL vs 11.9 g/dL; P < 0.001), postoperative creatinine (1.55mg/dL vs 0.97mg/dL vs; P <0.001), and beta blocker need on discharge (45.5% vs 25%; P = 0.003) as significant between patients with short and prolonged LOS groups. Semi-structured interviews revealed postoperative day 1 CBC/chemistry, postoperative physical therapy (PT) evaluation, ICU admission, urinary retention, patient expectations, and unavailability of transportation home as modifiable factors that delayed early discharge. A 14 component ERP was created to target the factors identified from combined qualitative and quantitative results. Post ERP development, 74 elective EVAR patients were reviewed from 2018-2021 (37 pre-ERP and 37 post-ERP). Following ERP development, the mean LOS reduced from 2.6 (SD: 1.9) to 1.3 days (SD: 1.3); P < 0.01. There were no significant differences in 30-day readmission, postoperative complications, emergency room visits, or 90-day mortality before and after the ERP was used. CONCLUSION Practice and procedural factors can be modified through an informed and safe process to reduce LOS after elective EVAR. LOS following elective EVAR was safely reduced following the use of a systematically developed ERP.
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Affiliation(s)
- Alexandra O Polovneff
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Ayokunle S Olowofela
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Peter J Rossi
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Joseph Hart
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Michael J Malinowski
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Brian J Lewis
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Kellie R Brown
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Neel A Mansukhani
- Department of Surgery, Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, WI.
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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Seadler BD, Smith-Roberts TQ, Hart J, Gasparri M, Rossi P, Joyce DL, Joyce LD. Percutaneous Dembitsky Bridge Utilizing a Dual-Lumen Cannula. JTCVS Tech 2023; 18:78-80. [PMID: 37096085 PMCID: PMC10122154 DOI: 10.1016/j.xjtc.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
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Moran TE, Taleghani ER, Ruland JR, Ignozzi AJ, Hart J, Diduch DR. An analysis of the incidence, risk factors, and timing of development of cyclops lesions after anterior cruciate ligament reconstruction. Knee 2023; 40:1-7. [PMID: 36403394 DOI: 10.1016/j.knee.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/21/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cyclops lesions are a known complication following anterior cruciate ligament reconstruction (ACLR) with a described incidence between 1.9% to 10.9%. The objective of this study was to identify the incidence, timing, and variables that correlated with development of a cyclops lesion, and if objective functional testing differed between patients with and without cyclops lesions. METHODS 313 consecutive patients who underwent ACLR and participated in Lower-Extremity Assessment Protocol (LEAP) testing at a single, academic institution were analyzed. Retrospective chart review was performed to identify patient demographic factors, medical comorbidities, and potential peri-operative risk factors. Postoperative functional outcome metrics and patient reported outcomes were collected per the institution's LEAP testing protocol. Binary logistic regression was utilized to identify risk factors for cyclops lesions. Objective functional outcomes and patient reported outcomes were compared between patients with and without cyclops lesions. RESULTS 23/313 (7.35%) patients developed a cyclops lesion following ACLR, of which 17 (73.91%) were found to be symptomatic. Concomitant meniscal repair correlated with an increased likelihood of developing a cyclops lesion (p = 0.040); no other risk factors significantly differed between cohorts. There were no clinically relevant extension deficits or differences in objective functional performance measures at six months post-operatively between study cohorts. CONCLUSIONS Concomitant meniscal repair may be associated with the development of cyclops lesions due to restrictive postoperative range of motion protocols; however no other pre- or intra-operative factors demonstrated significant correlation. Presence of a cyclops lesion should be considered with late loss of knee extension after ACLR.
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Affiliation(s)
- Thomas E Moran
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA
| | - Eric R Taleghani
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA.
| | - Jeffrey R Ruland
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA
| | - Anthony J Ignozzi
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA
| | - Joseph Hart
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA
| | - David R Diduch
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22903, USA
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Hart J, Okoro U, Mohr N, Ahmed A. 84 Bystander CPR Rates for Out-of-Hospital Cardiac Arrest Higher in Rural Areas Versus Urban Areas. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Hopper H, Bruce A, Hart J. Factors From Time Of Injury Effect On Psychological Readiness Prior To Return-to-Play Following ACLR. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876636.99029.c4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bruce AS, Thompson X, Kaur M, Hart J. The Relationship Between Lower Extremity Strength Ratios And Patient Reported Function After Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877616.83058.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Heiderscheit BC, Blemker SS, Opar D, Stiffler-Joachim MR, Bedi A, Hart J, Mortensen B, Kliethermes SA. The development of a HAMstring InjuRy (HAMIR) index to mitigate injury risk through innovative imaging, biomechanics, and data analytics: protocol for an observational cohort study. BMC Sports Sci Med Rehabil 2022; 14:128. [PMID: 35841053 PMCID: PMC9288010 DOI: 10.1186/s13102-022-00520-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/06/2022] [Indexed: 11/19/2022]
Abstract
Background The etiology of hamstring strain injury (HSI) in American football is multi-factorial and understanding these risk factors is paramount to developing predictive models and guiding prevention and rehabilitation strategies. Many player-games are lost due to the lack of a clear understanding of risk factors and the absence of effective methods to minimize re-injury. This paper describes the protocol that will be followed to develop the HAMstring InjuRy (HAMIR) index risk prediction models for HSI and re-injury based on morphological, architectural, biomechanical and clinical factors in National Collegiate Athletic Association Division I collegiate football players. Methods A 3-year, prospective study will be conducted involving collegiate football student-athletes at four institutions. Enrolled participants will complete preseason assessments of eccentric hamstring strength, on-field sprinting biomechanics and muscle–tendon volumes using magnetic-resonance imaging (MRI). Athletic trainers will monitor injuries and exposure for the duration of the study. Participants who sustain an HSI will undergo a clinical assessment at the time of injury along with MRI examinations. Following completion of structured rehabilitation and return to unrestricted sport participation, clinical assessments, MRI examinations and sprinting biomechanics will be repeated. Injury recurrence will be monitored through a 6-month follow-up period. HAMIR index prediction models for index HSI injury and re-injury will be constructed. Discussion The most appropriate strategies for reducing risk of HSI are likely multi-factorial and depend on risk factors unique to each athlete. This study will be the largest-of-its-kind (1200 player-years) to gather detailed information on index and recurrent HSI, and will be the first study to simultaneously investigate the effect of morphological, biomechanical and clinical variables on risk of HSI in collegiate football athletes. The quantitative HAMIR index will be formulated to identify an athlete’s propensity for HSI, and more importantly, identify targets for injury mitigation, thereby reducing the global burden of HSI in high-level American football players. Trial Registration The trial is prospectively registered on ClinicalTrials.gov (NCT05343052; April 22, 2022).
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Affiliation(s)
- Bryan C Heiderscheit
- Badger Athletic Performance Program, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1685 Highland Avenue, 6136 Medical Foundation Centennial Building, Madison, WI, 53705, USA.
| | | | - David Opar
- Sports Performance, Recovery, Injury and New Technologies Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Mikel R Stiffler-Joachim
- Badger Athletic Performance Program, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1685 Highland Avenue, 6136 Medical Foundation Centennial Building, Madison, WI, 53705, USA
| | - Asheesh Bedi
- NorthShore Orthopedic and Spine Institute, Skokie, IL, USA
| | - Joseph Hart
- University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | | | - Stephanie A Kliethermes
- Badger Athletic Performance Program, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1685 Highland Avenue, 6136 Medical Foundation Centennial Building, Madison, WI, 53705, USA.,American Medical Society for Sports Medicine Collaborative Research Network, Leawood, KS, USA
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Conley M, Schaffert J, Cullum CM, Hart J, Didehbani N. A-10 Influence of Different Normative Reference Standards among Cognitively Normal Former NFL Players. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: Demographic adjustments (e.g., age, sex, race/ethnicity) to neuropsychological tests can assist clinical interpretation and avoid false-positive diagnoses of cognitive impairment. The issue of “race” as a criterion for normative adjustment has been highlighted in recent cases among former NFL players. We examined the impact of different normative reference comparisons on neuropsychological scores among cognitively normal Black and White NFL retirees. Methods: Cognitively normal Black (n = 20) and White (n = 20) retirees were age- and education-matched. Measures of attention (Digit Span), processing speed (Coding, TMTA), memory (ROCFT, CVLT), language (FAS, Animals, BNT), and executive function (TMTB) were examined. Independent samples t-tests (using p < 0.01) were conducted between raw and normative scores of Black and White retirees that adjusted for 1) age/education (Mitrushina); 2) age/education/sex (NACC); and 3) age/education/sex/race (Heaton, MOANS/MOAANS). An additional ANCOVA evaluated group differences controlling for baseline estimated IQ. Results: Raw scores differed between groups on TMTB, Coding, and BNT. Mitrushina normative data showed differences on TMTB (p = 0.007) and BNT (p < 0.001). NACC normative data showed differences on the BNT (p < 0.001). ANCOVA (controlling for IQ) of raw scores between groups differed on the BNT (p = 0.002). Heaton and MOANS/MOAANS normative scores did not reveal differences between groups on any test. Conclusions: As expected, the use of different neuropsychological norms influences findings across different sociodemographic groups to various degrees, depending on the test. The underlying contributors to group differences using “race” as a proxy need to be disentangled and understood. Cautious use of demographically-adjusted norms as interpretive guidelines is warranted until these factors are identified.
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Harkey MS, Baez S, Lewis J, Grindstaff TL, Hart J, Driban JB, Schorfhaar A, Kuenze C. Prevalence of Early Knee Osteoarthritis Illness Among Various Patient-Reported Classification Criteria After Anterior Cruciate Ligament Reconstruction. Arthritis Care Res (Hoboken) 2022; 74:377-385. [PMID: 34738341 DOI: 10.1002/acr.24809] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/02/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the prevalence of participants meeting different patient-reported criteria for early osteoarthritis (OA) illness after anterior cruciate ligament reconstruction (ACLR). METHODS Participants completed the Knee Injury and Osteoarthritis Outcomes Score (KOOS) at a single time point 5.0-7.9 months post-ACLR. We used established KOOS subscale criteria (i.e., Luyten original and Englund original) to define patient-reported early OA illness. A two-by-two contingency table and McNemar's test were used to compare the prevalence of participants who met the Luyten original versus Englund original KOOS criteria for early OA illness. These analyses were repeated using KOOS subscale thresholds based on established population-specific patient acceptable symptom state (PASS) within the Luyten and Englund KOOS criteria (i.e., Luyten PASS and Englund PASS). RESULTS A greater prevalence of participants with ACLR met the Luyten original criteria (n = 165 [54%]) compared to those who met the Englund original criteria (n = 128 [42%]; χ2 = 19.3, P < 0.001). When using the KOOS subscale PASS as thresholds, a significantly greater prevalence of participants with ACLR met the Luyten PASS criteria (n = 133 [43%]) compared to those who met the Englund PASS criteria (n = 85 [28%]; χ2 = 48.0, P < 0.001). When combining the Luyten and Englund KOOS criteria and using the original/PASS subscale thresholds, respectively, 40%/57% of participants met neither, 24%/15% met only 1, and 36%/28% met both KOOS criteria. CONCLUSION Regardless of the classification criteria used to define early OA illness, it is concerning that 28-54% of patients report considerable symptoms ~6 months post-ACLR. Our findings will improve the classification criteria to define early OA illness, which may raise awareness for the need of population-specific criteria.
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Doherty S, Knight JG, Backhouse T, Tran TST, Paterson R, Stahl F, Alharbi HY, Chamberlain TW, Bourne RA, Stones R, Griffiths A, White JP, Aslam Z, Hardare C, Daly H, Hart J, Temperton RH, O'Shea JN, Rees NH. Highly efficient and selective aqueous phase hydrogenation of aryl ketones, aldehydes, furfural and levulinic acid and its ethyl ester catalyzed by phosphine oxide-decorated polymer immobilized ionic liquid-stabilized ruthenium nanoparticles. Catal Sci Technol 2022. [DOI: 10.1039/d2cy00205a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Phosphine oxide-decorated polymer immobilized ionic liquid stabilized RuNPs catalyse the hydrogenation of aryl ketones with remarkable selectivity for the CO bond, complete hydrogenation to the cyclohexylalcohol and hydrogenation of levulinic acid to γ-valerolactone.
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Affiliation(s)
- S. Doherty
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - J. G. Knight
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. Backhouse
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. S. T. Tran
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - R. Paterson
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - F. Stahl
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - H. Y. Alharbi
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. W. Chamberlain
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. A. Bourne
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. Stones
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - A. Griffiths
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - J. P. White
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - Z. Aslam
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - C. Hardare
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - H. Daly
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - J. Hart
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - R. H. Temperton
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - J. N. O'Shea
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - N. H. Rees
- Inorganic Chemistry Laboratory, University of Oxford, South Parks Road, Oxford OX1 3QR, UK
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14
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Drummond C, Drummond M, Fennell M, Hart J, Kamaludin M, Keith C, Lange B, Paparella L, Ramos J, Wallen M, Williams H. The relationship between cardiorespiratory fitness and chronic pelvic pain in women with endometriosis: a preliminary cross-sectional analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Limited evidence exists comparing running biomechanics between individuals with chronic ankle instability (CAI) and those who fully recover (copers). The purpose of this study was to simultaneously analyse running gait kinematics, kinetics, and surface electromyography (sEMG) between ankle sprain copers and individuals with CAI. Twenty-six (13 CAI, 13 Coper) recreationally active females participated and ran shod on an instrumented treadmill at 2.68 m/s. We assessed lower extremity kinematics and kinetics and sEMG amplitude for the fibularis longus, tibialis anterior, medial gastrocnemius, and gluteus medius muscles. Ten consecutive strides from the beginning of the trial were analysed using statistical parametric mapping (SPM) independent t-test. The CAI group had significantly more ankle inversion during 0-6%, 42-53%, and 96-100% of the running stride cycle compared to the coper group. At initial contact (0%), the CAI group was in an inverted ankle position (5.9°±6.8°) and the coper group was in an everted ankle position (-3.2°±5.5°; p = 0.01, d = 1.5). There were no significant differences identified for any other outcome measures. Increased ankle inversion during the swing phase leading into the loading phase is concerning because the ankle is in an open packed position and inversion is a primary mechanism of injury for sustaining a lateral ankle sprain.
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Affiliation(s)
- Rachel M Koldenhoven
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
| | - Joseph Hart
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Mark F Abel
- Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, USA
| | - Susan Saliba
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
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16
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Curtis MA, Kupperman N, Weltman AL, Hertel J, Hart J. Workload Characteristics During A Collegiate Ncaa D1 Men’S Basketball Season. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000759628.94069.2b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Neipp MC, Martínez-González MC, Chisholm A, Peters S, Hart J. Translation and application of an obesity behavior change technique training in a Spanish nursing undergraduate setting. An Sist Sanit Navar 2021; 44:51-59. [PMID: 33853227 DOI: 10.23938/assn.0938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The TEnT PEGS framework is a behavior change communication toolkit which has been shown to be useful in increasing health professional trainees' skills and knowledge about obesity-related behavior change techniques. There is no version of the behavioral change intervention toolkit in Spanish. Therefore, the objectives of this study were 1) to translate the TEnT PEGS framework into Spanish and apply it to a Spanish nursing student population; 2) To analyze whether training with the Spanish toolkit (DEPREMIO) had a positive impact on students' skills in encouraging obesi-ty-related behavioral change. METHODS First year nursing students (n=95) attended two face-to-face (2 hours per session) obesity management training sessions. A specifically designed pre-post test was carried out. Data were collected using an ad-hoc questionnaire of fourteen items, ten of them evaluated the student's knowledge and attitude about behavior change techniques, and four evaluated the student's perception of their skills in developing different strategies. RESULTS Training significantly increased most students' knowledge and attitudes with a 0.05 level of significance and effect sizes were between 0.36 and 0.77. It also increased students' skills, although not to any significant extent. CONCLUSION The DEPREMIO toolkit helped nursing students to acquire more knowledge, attitudes and skills in obesity management. It therefore seems that this adaptation is an acceptable and feasible training tool for the Spanish nursing student population.
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Affiliation(s)
- M C Neipp
- Department of Health Psychology. University Miguel Hernández. Elche. Spain.
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18
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Krull AA, Setter DO, Gendron TF, Hrstka SCL, Polzin MJ, Hart J, Dudakovic A, Madigan NN, Dietz AB, Windebank AJ, van Wijnen AJ, Staff NP. Alterations of mesenchymal stromal cells in cerebrospinal fluid: insights from transcriptomics and an ALS clinical trial. Stem Cell Res Ther 2021; 12:187. [PMID: 33736701 PMCID: PMC7977179 DOI: 10.1186/s13287-021-02241-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background Mesenchymal stromal cells (MSCs) have been studied with increasing intensity as clinicians and researchers strive to understand the ability of MSCs to modulate disease progression and promote tissue regeneration. As MSCs are used for diverse applications, it is important to appreciate how specific physiological environments may stimulate changes that alter the phenotype of the cells. One need for neuroregenerative applications is to characterize the spectrum of MSC responses to the cerebrospinal fluid (CSF) environment after their injection into the intrathecal space. Mechanistic understanding of cellular biology in response to the CSF environment may predict the ability of MSCs to promote injury repair or provide neuroprotection in neurodegenerative diseases. Methods In this study, we characterized changes in morphology, metabolism, and gene expression occurring in human adipose-derived MSCs cultured in human (hCSF) or artificial CSF (aCSF) as well as examined relevant protein levels in the CSF of subjects treated with MSCs for amyotrophic lateral sclerosis (ALS). Results Our results demonstrated that, under intrathecal-like conditions, MSCs retained their morphology, though they became quiescent. Large-scale transcriptomic analysis of MSCs revealed a distinct gene expression profile for cells cultured in aCSF. The aCSF culture environment induced expression of genes related to angiogenesis and immunomodulation. In addition, MSCs in aCSF expressed genes encoding nutritional growth factors to expression levels at or above those of control cells. Furthermore, we observed a dose-dependent increase in growth factors and immunomodulatory cytokines in CSF from subjects with ALS treated intrathecally with autologous MSCs. Conclusions Overall, our results suggest that MSCs injected into the intrathecal space in ongoing clinical trials remain viable and may provide a therapeutic benefit to patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02241-9.
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Affiliation(s)
- Ashley A Krull
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Deborah O Setter
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Sybil C L Hrstka
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Michael J Polzin
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Joseph Hart
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Amel Dudakovic
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nicolas N Madigan
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Allan B Dietz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Anthony J Windebank
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Andre J van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nathan P Staff
- Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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Kim S, Brady J, Al-Badani F, Yu S, Hart J, Jung S, Tran TT, Myung NV. Nanoengineering Approaches Toward Artificial Nose. Front Chem 2021; 9:629329. [PMID: 33681147 PMCID: PMC7935515 DOI: 10.3389/fchem.2021.629329] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/05/2021] [Indexed: 12/16/2022] Open
Abstract
Significant scientific efforts have been made to mimic and potentially supersede the mammalian nose using artificial noses based on arrays of individual cross-sensitive gas sensors over the past couple decades. To this end, thousands of research articles have been published regarding the design of gas sensor arrays to function as artificial noses. Nanoengineered materials possessing high surface area for enhanced reaction kinetics and uniquely tunable optical, electronic, and optoelectronic properties have been extensively used as gas sensing materials in single gas sensors and sensor arrays. Therefore, nanoengineered materials address some of the shortcomings in sensitivity and selectivity inherent in microscale and macroscale materials for chemical sensors. In this article, the fundamental gas sensing mechanisms are briefly reviewed for each material class and sensing modality (electrical, optical, optoelectronic), followed by a survey and review of the various strategies for engineering or functionalizing these nanomaterials to improve their gas sensing selectivity, sensitivity and other measures of gas sensing performance. Specifically, one major focus of this review is on nanoscale materials and nanoengineering approaches for semiconducting metal oxides, transition metal dichalcogenides, carbonaceous nanomaterials, conducting polymers, and others as used in single gas sensors or sensor arrays for electrical sensing modality. Additionally, this review discusses the various nano-enabled techniques and materials of optical gas detection modality, including photonic crystals, surface plasmonic sensing, and nanoscale waveguides. Strategies for improving or tuning the sensitivity and selectivity of materials toward different gases are given priority due to the importance of having cross-sensitivity and selectivity toward various analytes in designing an effective artificial nose. Furthermore, optoelectrical sensing, which has to date not served as a common sensing modality, is also reviewed to highlight potential research directions. We close with some perspective on the future development of artificial noses which utilize optical and electrical sensing modalities, with additional focus on the less researched optoelectronic sensing modality.
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Affiliation(s)
- Sanggon Kim
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, United States
| | - Jacob Brady
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, United States
| | - Faraj Al-Badani
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, United States
| | - Sooyoun Yu
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Joseph Hart
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Sungyong Jung
- Department of Electrical Engineering, University of Texas at Arlington, Arlington, TX, United States
| | - Thien-Toan Tran
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Nosang V. Myung
- Department of Chemical and Environmental Engineering, University of California-Riverside, Riverside, CA, United States
- Department of Chemical and Biomolecular Engineering, University of Notre Dame, Notre Dame, IN, United States
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20
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Gilmore S, Hart J, Geddes J, Olsen CH, Mehlsen J, Gremaud P, Olufsen MS. Classification of orthostatic intolerance through data analytics. Med Biol Eng Comput 2021; 59:621-632. [PMID: 33582941 DOI: 10.1007/s11517-021-02314-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022]
Abstract
Imbalance in the autonomic nervous system can lead to orthostatic intolerance manifested by dizziness, lightheadedness, and a sudden loss of consciousness (syncope); these are common conditions, but they are challenging to diagnose correctly. Uncertainties about the triggering mechanisms and the underlying pathophysiology have led to variations in their classification. This study uses machine learning to categorize patients with orthostatic intolerance. We use random forest classification trees to identify a small number of markers in blood pressure, and heart rate time-series data measured during head-up tilt to (a) distinguish patients with a single pathology and (b) examine data from patients with a mixed pathophysiology. Next, we use Kmeans to cluster the markers representing the time-series data. We apply the proposed method analyzing clinical data from 186 subjects identified as control or suffering from one of four conditions: postural orthostatic tachycardia (POTS), cardioinhibition, vasodepression, and mixed cardioinhibition and vasodepression. Classification results confirm the use of supervised machine learning. We were able to categorize more than 95% of patients with a single condition and were able to subgroup all patients with mixed cardioinhibitory and vasodepressor syncope. Clustering results confirm the disease groups and identify two distinct subgroups within the control and mixed groups. The proposed study demonstrates how to use machine learning to discover structure in blood pressure and heart rate time-series data. The methodology is used in classification of patients with orthostatic intolerance. Diagnosing orthostatic intolerance is challenging, and full characterization of the pathophysiological mechanisms remains a topic of ongoing research. This study provides a step toward leveraging machine learning to assist clinicians and researchers in addressing these challenges. Graphical abstract Machine learning tools utilized to analyze heart rate (HR) and blood pressure (BP) time-series data from syncope and control patients. Results show that machine learning can provide accurate classification of disease groups for 98% of patients and we identified two subgroups within the control patients differentiated by their BP response.
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Affiliation(s)
- Steven Gilmore
- North Carolina State University, Raleigh, NC, 27695, USA
| | - Joseph Hart
- Sandia National Laboratories, Albuquerque, NM, 87123, USA
| | - Justen Geddes
- North Carolina State University, Raleigh, NC, 27695, USA
| | | | - Jesper Mehlsen
- Rigshospitalet, University of Copenhagen, 2100, Copenhagen Ø, Denmark
| | - Pierre Gremaud
- North Carolina State University, Raleigh, NC, 27695, USA
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21
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Hart J, Cox CL, Kuhn I, Fritz Z. Communicating diagnostic uncertainty in the acute and emergency medical setting: A systematic review and ethical analysis of the empirical literature. Acute Med 2021; 20:204-218. [PMID: 34679138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND diagnostic uncertainty is ubiquitous. Its communication to patients requires further investigation. AIMS To determine: 1) What is known about how and why diagnostic uncertainty is communicated in acute care; 2) evidence of the effects of (not) communicating diagnostic uncertainty in the acute setting; 3) associated ethical issues. METHODS systematic review of Medline, Web of Science and SCOPUS for (acute or emergency care) AND (diagnostic uncertainty) AND (ethics OR behaviours). Critical interpretive synthesis and ethical analysis were conducted. RESULTS AND CONCLUSION Nine studies (primarily surveys and interviews) were identified. Doctors are not trained in communicating diagnostic uncertainty and perceive it to have negative effects on patients; however not communicating diagnostic uncertainty can disempower patients, resulting in delayed/missed diagnoses or inappropriate use of resource.
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Affiliation(s)
- J Hart
- MB BChir, MA (Cantab), North Middlesex University Hospital NHS Trust, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - C L Cox
- MB BChir, MA (Cantab), The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - I Kuhn
- MA, MSc, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - Z Fritz
- MBBS, MA (Cantab), PhD, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
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22
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Koldenhoven RM, Jaffri AH, DeJong AF, Abel M, Hart J, Saliba S, Hertel J. Gait biofeedback and impairment‐based rehabilitation for chronic ankle instability. Scand J Med Sci Sports 2020; 31:193-204. [DOI: 10.1111/sms.13823] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/30/2023]
Affiliation(s)
- Rachel M. Koldenhoven
- Department of Health and Human Performance Texas State University San Marcos TX USA
- Department of Kinesiology University of Virginia Charlottesville VA USA
| | - Abbis H. Jaffri
- Department of Physical Therapy Creighton University Omaha NE USA
| | | | - Mark Abel
- Department of Orthopedic Surgery University of Virginia Charlottesville VA USA
| | - Joseph Hart
- Department of Kinesiology University of Virginia Charlottesville VA USA
| | - Susan Saliba
- Department of Kinesiology University of Virginia Charlottesville VA USA
| | - Jay Hertel
- Department of Kinesiology University of Virginia Charlottesville VA USA
- Department of Orthopedic Surgery University of Virginia Charlottesville VA USA
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23
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Niculescu AB, Le-Niculescu H, Roseberry K, Wang S, Hart J, Kaur A, Robertson H, Jones T, Strasburger A, Williams A, Kurian SM, Lamb B, Shekhar A, Lahiri DK, Saykin AJ. Blood biomarkers for memory: toward early detection of risk for Alzheimer disease, pharmacogenomics, and repurposed drugs. Mol Psychiatry 2020; 25:1651-1672. [PMID: 31792364 PMCID: PMC7387316 DOI: 10.1038/s41380-019-0602-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/25/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
Short-term memory dysfunction is a key early feature of Alzheimer's disease (AD). Psychiatric patients may be at higher risk for memory dysfunction and subsequent AD due to the negative effects of stress and depression on the brain. We carried out longitudinal within-subject studies in male and female psychiatric patients to discover blood gene expression biomarkers that track short term memory as measured by the retention measure in the Hopkins Verbal Learning Test. These biomarkers were subsequently prioritized with a convergent functional genomics approach using previous evidence in the field implicating them in AD. The top candidate biomarkers were then tested in an independent cohort for ability to predict state short-term memory, and trait future positive neuropsychological testing for cognitive impairment. The best overall evidence was for a series of new, as well as some previously known genes, which are now newly shown to have functional evidence in humans as blood biomarkers: RAB7A, NPC2, TGFB1, GAP43, ARSB, PER1, GUSB, and MAPT. Additional top blood biomarkers include GSK3B, PTGS2, APOE, BACE1, PSEN1, and TREM2, well known genes implicated in AD by previous brain and genetic studies, in humans and animal models, which serve as reassuring de facto positive controls for our whole-genome gene expression discovery approach. Biological pathway analyses implicate LXR/RXR activation, neuroinflammation, atherosclerosis signaling, and amyloid processing. Co-directionality of expression data provide new mechanistic insights that are consistent with a compensatory/scarring scenario for brain pathological changes. A majority of top biomarkers also have evidence for involvement in other psychiatric disorders, particularly stress, providing a molecular basis for clinical co-morbidity and for stress as an early precipitant/risk factor. Some of them are modulated by existing drugs, such as antidepressants, lithium and omega-3 fatty acids. Other drug and nutraceutical leads were identified through bioinformatic drug repurposing analyses (such as pioglitazone, levonorgestrel, salsolidine, ginkgolide A, and icariin). Our work contributes to the overall pathophysiological understanding of memory disorders and AD. It also opens new avenues for precision medicine- diagnostics (assement of risk) as well as early treatment (pharmacogenomically informed, personalized, and preventive).
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Affiliation(s)
- A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indianapolis VA Medical Center, Indianapolis, IN, USA.
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J Hart
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Kaur
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - H Robertson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Jones
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Strasburger
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Williams
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - S M Kurian
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - B Lamb
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Shekhar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D K Lahiri
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
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24
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Schaffet J, Didehbani N, LoBue C, Hart J, Cullum CM. A-37 Neuropsychological Functioning In Cognitively Normal And Impaired Aging NFL Retirees. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Identify differences in neuropsychological (NP) functioning between older (≥ 50) National Football League (NFL) retirees and age-matched controls, and examine whether differences correlate to head-injury exposure.
Method
NFL retirees were diagnosed with normal cognition (n = 20), mild cognitive impairment (n = 19), or dementia (n = 5) using Jak and Bondi (2009) criteria and clinical consensus. Retirees were age-matched to either healthy controls (n = 18) or clinical controls with MCI (n = 21) or dementia (n = 5). MANCOVAs and partial correlations covarying for age and education compared retiree’s NP performances to controls, and examined whether differences in NP measures were correlated with number of concussions, or games and years played in the NFL.
Results
Cognitively normal (CN) retirees displayed lower processing speed, naming, and verbal memory (p’s < .05) than CN controls. Impaired retirees displayed worse processing speed and naming than impaired controls, but better verbal memory (p’s < .05). Only lower verbal memory performance in CN retirees significantly correlated with number of games (r = −.60) and years played (r = −.54).
Conclusions
Aging CN and impaired retirees performed worse on single measures of processing speed and naming, but their performances did not correlate to head-injury exposure. Verbal memory performance varied between CN (worse than controls) and impaired retirees (better than controls). Overall, results suggest some aging NFL players may be at risk for reduced verbal memory, but this relationship could diminish following onset of MCI. No clear dose-response relationship was observed between head-injury exposure and NP functioning. Future studies should examine longitudinal trajectories of NP performances in larger samples to elucidate these findings.
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25
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Kaur M, Hart J. Hamstring To Quadriceps Ratio After ACL Reconstruction In Males And Females. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000683912.18267.ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Powell R, Brown K, Davies M, Hart J, Hsu J, Johnson B, Makaroun M, Schanzer A, Shutze W, Weaver F, White J. The value of the modern vascular surgeon to the health care system: A report from the Society for Vascular Surgery Valuation Work Group. J Vasc Surg 2020; 73:359-371.e3. [PMID: 32585182 DOI: 10.1016/j.jvs.2020.05.056] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/30/2022]
Abstract
Vascular surgeons provide an important service to the health care system. They are capable of treating a wide range of disease processes that affect both the venous and arterial systems. Their presence broadens the complexity and diversity of services that a health care system can offer both in the outpatient setting and in the inpatient setting. Because of their ability to control hemorrhage, they are critical to a safe operating room environment. The vascular surgery service line has a positive impact on hospital margin through both the direct vascular profit and loss and the indirect result of assisting other surgical and medical services in providing care. The financial benefits of a vascular service line will hold true for a wide range of alternative payment models, such as bundled payments or capitation. To fully leverage a modern vascular surgeon's skill set, significant investment is required from the health care system that is, however, associated with substantial return on the investment.
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Affiliation(s)
- Richard Powell
- Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Geisel School of Medicine at Dartmouth, Hanover, NH.
| | - Kellie Brown
- Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, Wisc
| | - Mark Davies
- Division of Vascular and Endovascular Surgery, Department of Surgery, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Tex; South Texas Center for Vascular Care, South Texas Medical Center, San Antonio, Tex
| | - Joseph Hart
- Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, Wisc
| | - Jeffrey Hsu
- Kaiser Permanente-Southern California Permanente Medical Group, Fontana, Calif; Loma Linda University School of Medicine, Loma Linda, Calif
| | - Brad Johnson
- Division of Vascular Surgery, University of South Florida, Tampa, Fla
| | - Michel Makaroun
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Worcester, Mass
| | - Andres Schanzer
- Division of Vascular Surgery, UMass Memorial Center for Complex Aortic Disease, Worcester, Mass; UMass Memorial Heart and Vascular Center, University of Massachusetts Medical School, Worcester, Mass
| | - William Shutze
- Division of Vascular Surgery, The Heart Hospital Plano, Plano, Tex
| | - Fred Weaver
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - John White
- Department of Surgery, Advocate Lutheran General Hospital, Park Ridge, Ill; Rosalind Franklin University Chicago Medical School, North Chicago, Ill
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Lilaonitkul M, Mishra S, Pritchard N, Andhoga J, Olang' P, Kibet EB, Walker IA, Hart J, Byrne-Davis L. Mixed methods analysis of factors influencing change in clinical behaviours of non-physician anaesthetists in Kenya following obstetric anaesthesia training. Anaesthesia 2020; 75:1331-1339. [PMID: 32436211 DOI: 10.1111/anae.15091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Abstract
Maternal mortality rates in low-middle income countries remain high, with sub-Saharan Africa accounting for two-thirds of global maternal deaths. Inadequate staff training is one of the main contributors to anaesthesia-related deaths and the Association of Anaesthetists developed the Safe Anaesthesia from Education course in collaboration with the World Federation of Societies of Anaesthesiologists to address this training gap. We aimed to evaluate the impact of this course among Kenyan participants. Mixed methodologies and secondary analyses of anonymised data were used to study translation of learning into practice. In total, 103 participants from 66 facilities who attended courses between 2016 and 2017 were analysed. Ninety (87%) participants who were followed up completed knowledge tests. Baseline median (IQR [range]) knowledge test score was 41 (37-43 [21-46]). There was a significant improvement in median (IQR [range]) knowledge test score immediately post-course (43 (41-45 [33-48]); p < 0.001) which was sustained at 3-6 month follow-up (43 (41-45 [32-50]); p < 0.001 compared with baseline). Eighty-four of the 103 participants were observed in their workplace and capability, opportunity and motivation-behaviour framework was used to study the barriers and facilitators to practice change. Psychological capability and reflective motivation were the main factors enabling positive behaviour change such as team communication and pre-operative assessment, whereas physical and social opportunity accounted for the main barriers to behaviours such as performing the surgical safety checklist. Our study demonstrates that the Safe Anaesthesia from Education obstetric course is relevant in the low-resource setting and may lead to knowledge translation in clinical practice.
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Affiliation(s)
- M Lilaonitkul
- Department of Anesthesia and Peri-operative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Mishra
- Department of Internal Medicine, Lincoln Medicine Center, New York, NY, USA
| | - N Pritchard
- Department of Anaesthesia, St George's University Hospitals NHS Foundation Trust, London, UK
| | - J Andhoga
- Department of Anaesthesia, Jomo Kenyatta University of Agriculture and Technology, Kiambu, Kenya
| | - P Olang'
- Department of Anaesthesia, University of Nairobi, Nairobi, Kenya
| | - E B Kibet
- Department of Anaesthesia, Kenyatta National Hospital, Nairobi, Kenya
| | - I A Walker
- University College London Institute of Child Health, London, UK
| | - J Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Division of Medical Education, University of Manchester, UK
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Willett NJ, Boninger ML, Miller LJ, Alvarez L, Aoyama T, Bedoni M, Brix KA, Chisari C, Christ G, Dearth CL, Dyson-Hudson TA, Evans CH, Goldman SM, Gregory K, Gualerzi A, Hart J, Ito A, Kuroki H, Loghmani MT, Mack DL, Malanga GA, Noble-Haeusslein L, Pasquina P, Roche JA, Rose L, Stoddart MJ, Tajino J, Terzic C, Topp KS, Wagner WR, Warden SJ, Wolf SL, Xie H, Rando TA, Ambrosio F. Taking the Next Steps in Regenerative Rehabilitation: Establishment of a New Interdisciplinary Field. Arch Phys Med Rehabil 2020; 101:917-923. [PMID: 32035141 DOI: 10.1016/j.apmr.2020.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/13/2019] [Accepted: 01/05/2020] [Indexed: 12/25/2022]
Abstract
The growing field of regenerative rehabilitation has great potential to improve clinical outcomes for individuals with disabilities. However, the science to elucidate the specific biological underpinnings of regenerative rehabilitation-based approaches is still in its infancy and critical questions regarding clinical translation and implementation still exist. In a recent roundtable discussion from International Consortium for Regenerative Rehabilitation stakeholders, key challenges to progress in the field were identified. The goal of this article is to summarize those discussions and to initiate a broader discussion among clinicians and scientists across the fields of regenerative medicine and rehabilitation science to ultimately progress regenerative rehabilitation from an emerging field to an established interdisciplinary one. Strategies and case studies from consortium institutions-including interdisciplinary research centers, formalized courses, degree programs, international symposia, and collaborative grants-are presented. We propose that these strategic directions have the potential to engage and train clinical practitioners and basic scientists, transform clinical practice, and, ultimately, optimize patient outcomes.
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Affiliation(s)
- Nick J Willett
- Emory University School of Medicine, Atlanta, GA; The Atlanta Veterans Affairs Medical Center, Decatur, GA.
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; VA Pittsburgh Health Care System, Pittsburgh, PA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Laura J Miller
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Luis Alvarez
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Tomoki Aoyama
- Human Health Sciences, Kyoto University, Kyoto, Japan
| | | | - Kelley Ann Brix
- Department of Defense Health Agency, Research and Development Directorate, Falls Church, VA
| | | | - George Christ
- Departments of Biomedical Engineering and Orthopaedic Surgery, University of Virginia, Charlottesville, VA
| | - Christopher L Dearth
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Defense Health Headquarters, Falls Church, VA; Department of Surgery, Uniformed Services University of the Health Sciences - Walter Reed National Military Medical Center, Bethesda, MD
| | | | - Christopher H Evans
- Department of Physical Medicine and Rehabilitation, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN
| | - Stephen M Goldman
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Defense Health Headquarters, Falls Church, VA; Department of Surgery, Uniformed Services University of the Health Sciences - Walter Reed National Military Medical Center, Bethesda, MD
| | - Kenton Gregory
- Center for Regenerative Medicine, Oregon Health Sciences University, Portland, OR
| | | | - Joseph Hart
- Departments of Orthopedic Surgery and Kinesiology, University of Virginia, Charlottesville, VA
| | - Akira Ito
- Human Health Sciences, Kyoto University, Kyoto, Japan
| | | | - M Terry Loghmani
- Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN
| | - David L Mack
- Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Gerard A Malanga
- Kessler Foundation, West Orange, NJ; Rutgers New Jersey Medical School, Newark, NJ
| | - Linda Noble-Haeusslein
- Departments of Neurology and Psychology and the Institute of Neuroscience, University of Texas at Austin, Austin, TX
| | - Paul Pasquina
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Joseph A Roche
- Physical Therapy Program, Department of Health Care Sciences, Wayne State University, Detroit, MI
| | - Lloyd Rose
- Warfighter Expeditionary Medicine and Treatment, U. S. Army Medical Materiel Development Activity, U. S. Army Medical Research and Development Command, Fort Detrick, MD
| | | | | | - Carmen Terzic
- Department of Physical Medicine and Rehabilitation, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN
| | - Kimberly S Topp
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA
| | - William R Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Stuart J Warden
- Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Steven L Wolf
- Emory University School of Medicine, Atlanta, GA; The Atlanta Veterans Affairs Medical Center, Decatur, GA
| | - Hua Xie
- Center for Regenerative Medicine, Oregon Health Sciences University, Portland, OR
| | - Thomas A Rando
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, Palo Alto, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Fabrisia Ambrosio
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA
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Herb CC, Blemker S, Saliba S, Hart J, Hertel J. Chronic ankle instability patients exhibit higher variability in lower extremity joint-coupling variability during drop vertical jumps. J Biomech 2020; 99:109479. [PMID: 31744598 DOI: 10.1016/j.jbiomech.2019.109479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/26/2022]
Abstract
Chronic ankle instability (CAI) has been associated with biomechanical alterations during landing tasks. While joint coupling differences have been reported during gait in patients with CAI, there is no known research assessing joint coupling during a drop-vertical jumping (DVJ). Joint coupling variability measure may provide information on the sensorimotor health of these patients. The purpose of this study was to compare lower extremity joint coupling variability during a DVJ between patients with CAI and controls. Twenty-eight young, active individuals (CAI:n = 14, Control:n = 14) participated in the study. A 3D motion capture system was used to collect kinematics during 15 drop-vertical jump trials. A vector coding analysis was used to assess the variability in the following joint couples: knee sagittal-ankle frontal, knee sagittal-ankle sagittal, hip frontal-ankle frontal, and hip frontal-ankle sagittal. The CAI group had higher joint coupling variability in hip frontal-ankle sagittal, knee sagittal-ankle frontal and knee sagittal-ankle sagittal planes both prior to and following ground contact during the drop vertical jumps. These changes indicate potential adaptations to the constraint of CAI and the task of the DVJ. Higher variability may reflect an attempt by the subjects to explore alternate movement strategies or reflect poor sensorimotor control strategies. Clinicians should consider the challenges of DVJ during rehabilitation as they create a unique task constraint.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitation Sciences, Highland Heights, KY, USA.
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Atasoy D, Kandasamy N, Hart J, Lynch J, Yang SH, Walsh D, Tolias C, Booth TC. Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU). AJNR Am J Neuroradiol 2019; 40:2094-2101. [PMID: 31727754 DOI: 10.3174/ajnr.a6314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/20/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The recently introduced Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is the third generation of Pipeline flow-diverter devices. It has a new stent-surface modification, which reduces thrombogenicity. We aimed to evaluate clinical and radiographic (safety and efficacy) outcomes of the Pipeline Shield. MATERIALS AND METHODS The 30-day and 1-year mortality and morbidity rates and the 6- and 18-month radiographic aneurysm occlusion outcomes for procedures performed between March 2016 and January 2018 were analyzed. 3D-TOF-MRA was used for follow-up. RESULTS Forty-four attempted Pipeline Shield procedures were performed for 41 patients with 44 target aneurysms (total of 52 aneurysms treated). A total of 88.5% of devices were inserted in the anterior circulation, and 11.5%, in the posterior circulation; 49/52 (94.2%) aneurysms were saccular; and 1/52 (1.9%) was fusiform. One (1.9%) aneurysm was an iatrogenic pseudoaneurysm, and 1 (1.9%) was a dissecting aneurysm. Seventy-one percent (35/49) of the saccular aneurysms were wide-neck (neck, >4 mm), 34.6% (18/52) were large (≥10 mm), and 3.8% (2/52) were giant (≥25 mm). The mean aneurysm sac maximal diameter was 9.0 mm, and the mean neck width was 5.0 mm. The cumulative mortality and morbidity rates were 2.3% and 6.8% at 1 year, respectively. The adequate occlusion rate was 78.8% at 6 months and 90.3% at 18 months. CONCLUSIONS In this pragmatic and non-industry-sponsored study, the occlusion rates and safety outcomes were similar to those seen in previously published studies with flow-diverter devices and earlier generation Pipeline Embolization Devices.
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Affiliation(s)
- D Atasoy
- From Karadeniz Technical University (D.A.), Farabi Hospital, Trabzon, Turkey
| | - N Kandasamy
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Hart
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Lynch
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - S-H Yang
- Department of Radiology (S.-H.Y.), Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology (S.-H.Y.), School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - D Walsh
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - C Tolias
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - T C Booth
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.) .,School of Biomedical Engineering and Imaging Sciences (T.C.B.), King's College London, London, UK
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Koldenhoven RM, Hart J, Saliba S, Abel MF, Hertel J. Gait kinematics & kinetics at three walking speeds in individuals with chronic ankle instability and ankle sprain copers. Gait Posture 2019; 74:169-175. [PMID: 31525655 DOI: 10.1016/j.gaitpost.2019.09.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/30/2019] [Accepted: 09/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with CAI have demonstrated a more inverted foot position during walking when compared to a healthy control group. Copers are individuals who have had an ankle sprain but learn to cope and return to pre-injury levels of function and may be a better comparison group than healthy controls because they have had the same initial injury. RESEARCH QUESTION A controlled laboratory study was performed to simultaneously analyze differences in lower extremity walking gait kinematics, kinetics, and surface electromyography (EMG) between individuals with CAI and copers at a preferred walking speed (PWS), 120% preferred walking speed (120WS), and standardized walking speed (SWS) of 1.34 m/s. METHODS Thirty-six (18 coper, 18 CAI) physically active individuals participated. Three-dimensional kinematics and kinetics at the ankle, knee, and hip and EMG amplitude for fibularis longus, tibialis anterior, medial gastrocnemius, and gluteus medius muscles were analyzed. Ten consecutive strides from each speed were analyzed using statistical parametric mapping (SPM). A 2 × 3 group by speed ANOVA and post-hoc t-tests were used to compare differences between the coper and CAI groups. RESULTS The CAI group had more ankle inversion at IC (PWS: MD = 4.2°, d = 1.08; 120WS: MD = 5.0°, d = 1.28; SWS: MD = 6.6°, d = 1.37) and greater peak inversion throughout swing at all three walking speeds (PWS: MD = 4.2°, d = 0.89; 120WS: MD = 4.4°, d = 0.91; SWS: MD = 6.2°, d = 1.21). The CAI group had greater peak hip adduction during swing (PWS: MD = 4.5°, d = 0.96; 120WS: MD = 4.1°, d = 1.04; SWS: MD = 3.6°, d = 0.98). SIGNIFICANCE The CAI group demonstrated greater ankle inversion at IC and during the swing phase and greater peak hip adduction during the swing phase compared to the copers. As the speed increased, ankle inversion in the CAI group also increased which could be linked to greater risk of recurrent sprains. Therefore, modeling gait training programs after the coper mechanics may be advantageous.
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Affiliation(s)
- Rachel M Koldenhoven
- Texas State University, Department of Health and Human Performance, San Marcos, TX, United States.
| | - Joseph Hart
- University of Virginia, Department of Kinesiology, Charlottesville, VA, United States
| | - Susan Saliba
- University of Virginia, Department of Kinesiology, Charlottesville, VA, United States
| | - Mark F Abel
- University of Virginia, Department of Orthopedic Surgery, Charlottesville, VA, United States
| | - Jay Hertel
- University of Virginia, Department of Kinesiology, Charlottesville, VA, United States
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Erdman, AT N, Jimenez J, Howell D, Buckley T, Hart J, Resch J. Sex Differences in Performance of a Clinically-Relevant Dual-Task Assessment in Healthy College Students. Neurology 2019. [DOI: 10.1212/01.wnl.0000581152.88011.d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo determine if biological sex influenced performance on a novel dual-task (DT) assessment which consisted of commonly used clinical measures of sport concussion (SC) in healthy college students.BackgroundDT assessments consist of motor and cognitive tasks administered simultaneously and show promise as clinical measures of SC.Design/MethodsOur cross-sectional study included 60 (53.3% female) healthy, recreationally active college students (age = 20.5 ± 1.34 years, height = 171.7 ± 9.33 cm, mass = 69.25 ± 12.23 kg). Participants completed the Standardized Assessment of Concussion (SAC) and timed tandem gait (TTG) test independently (single task [ST]) and concurrently (DT). The revised SAC (45 points) which included a 10-word list was utilized. The TTG composite score was a sum of the average time to completion for each SAC task (3 trials for immediate memory [10-word list], up to 5 trials for the digits-backwards task, and one trial for the months in reverse order and delayed recall tasks). Independent t-tests were used to assess for sex differences for SAC and TTG performance during ST and DT administration. 2 × 2 factorial analyses of variance (ANOVA) were used to assess for sex (male, female) by task (ST, DT) interaction effects with effect sizes calculated using Cohen’s d. All analyses were assessed at α = 0.05.ResultsNo sex differences were observed for ST performance of the SAC (males = 37.1 ± 3.45 points, females = 37.4 ± 3.74 points; t[58] = 0.28, p = 0.78) or TTG (males = 44.3 ± 7.09 seconds, females = 46.1 ± 8.88 seconds; t[58] = 0.88, p = 0.38). No sex differences were observed for DT performance of the SAC (males = 39.7 ± 4.50 points, females = 39.2 ± 3.12 points; t[58] = 0.46, p = 0.64) or TTG (males = 52.1 ± 8.56 seconds, females = 52.1 ± 10.28 seconds; t[58] = 0.02, p = 0.98). No sex by task interaction effects were observed for SAC (F = 0.74, p = 0.39, d = 0.23) or TTG (F = 1.1, p = 0.30, d = 0.28) performance for ST or DT assessment.ConclusionsOur results indicate that our novel DT assessment was robust to sex differences in healthy college students which supports the utilization of our DT assessment across sexes without adjustment for interpretation.
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Smith E, Schaffert J, LoBue C, Hart J, Rossetti H, Lacritz L. Annualized Decline in Instrumental Activities of Daily Living Is Slower in Hispanics Compared to Non-Hispanics in an Alzheimer’s Disease Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Research examining the course of Alzheimer’s disease (AD) in Hispanics is lacking. This study examined demographic, psychiatric, cognitive, and genetic predictors of longitudinal functional change in Hispanics and non-Hispanics with AD.
Method
Longitudinal change in instrumental activities of daily living (IADL) was examined over 10 years (M = 4.15 years) in 292 subjects (Hispanic = 67, non-Hispanic = 225). All were part of the Texas Alzheimer’s Research & Care Consortium and included those with AD (n = 217) and those with mild cognitive impairment at baseline who progressed to AD at follow-up (n = 75). Baseline comparisons were conducted between ethnic groups for demographics, Geriatric Depression Scale (GDS-30) score, Mini Mental State Examination (MMSE) score, presence of apolipoprotein ɛ4 alleles (APOE4), and annualized IADL change scores and then entered into a multiple linear regression model as predictors of annualized IADL change.
Results
The Hispanic group had significantly more females (χ2 = 5.71, p = .017), lower education [MH = 9.96(4.39), MNH = 15.26(2.70)], higher depression scores [GDS-30; MH = 9.45(5.89), MNH = 5.51(4.29)], lower MMSE scores [MH = 23.31(4.33), MNH = 24.65(3.21)], and slower annualized IADL change [MH = 1.19(1.42), MNH = 2.02(1.60)]. Regression results were significant (F = 3.66, p = .001, R2 = .08 ), with higher baseline MMSE (p = .007) and Hispanic origin (p = .010) predicting slower annualized IADL change. Demographics, APOE4 status, and depression did not significantly predict IADL change.
Conclusions
Higher cognitive functioning at baseline and Hispanic origin was associated with slower functional decline over an average 4-year period of time. Despite having lower MMSE scores at baseline, greater depression, and less education, the Hispanic group had a slower decline in IADLs compared to non-Hispanics. Further research is needed to better understand how/why Hispanic origin is associated with slower functional decline.
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Schaffert J, LoBue C, Presley C, Hynan L, Wilmoth K, Lacritz L, Hart J, Cullum CM. Predictors of Life Expectancy After an Alzheimer’s Disease Diagnosis in a National Multi-Center Autopsy-Confirmed Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Life expectancy varies between 3-12 years following the diagnosis of Alzheimer’s disease (AD) and is an important clinical question for patients and families. Current literature is limited by relatively small sample sizes and a reliance on clinical diagnoses. This study sought to evaluate predictors of AD life expectancy in a large autopsy-confirmed sample.
Methods
Baseline data from individuals 50 years and older clinically and neuropathologically diagnosed with AD (N=764) were obtained from the National Alzheimer’s Coordinating Center. Life expectancy was calculated in months from AD diagnosis to death. Nineteen variables (demographic, medical/health, disease severity, and psychiatric) obtained at dementia diagnosis were examined. Variables that showed significant differences in life expectancy using t-tests and Pearson correlations (14 of 19) were then entered into a forward multiple regression.
Results
Seven predictors in the model explained 27% of the variance in life expectancy (F= 40.7, R-squared= 0.267). Lower MMSE scores (β= 0.339, p < .001), male sex (β= -0.144, p < .001), older age (β= -0.130, p < .001), non-Hispanic Caucasian race/ethnicity (β= 0.115, p < .001), greater impairment on the Functional Activities Questionnaire (β= -0.091, p=.042), abnormal neurological/physical exam (β= -0.083, p=.011), and higher Neuropsychiatric Inventory Questionnaire total scores (β= -0.079, p=.016) predicted shorter life expectancy.
Conclusions
Global cognitive impairment, sex, age, race/ethnicity, functional impairment, abnormal neurological exam findings, and psychiatric symptoms explain a significant proportion of life expectancy following an AD diagnosis. Future studies should explore the relationship between life expectancy, specific neurological abnormalities, and psychiatric symptoms. These 7 predictors could potentially be used to predict life expectancy in individuals diagnosed with AD.
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Boyd N, Sharkey E, Nabukenya M, Tumukunde J, Sipuka N, Zyambo M, Walker I, Hart J, Byrne-Davis L. The Safer Anaesthesia from Education (SAFE) ® paediatric anaesthesia course: educational impact in five countries in East and Central Africa. Anaesthesia 2019; 74:1290-1297. [PMID: 31350856 DOI: 10.1111/anae.14778] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2019] [Indexed: 11/28/2022]
Abstract
There is an urgent need to improve access to safe surgical and anaesthetic care for children living in many low- and middle-income countries. Providing quality training for healthcare workers is a key component of achieving this. The 3-day Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course was developed to address the specific skills and knowledge required in this field. We undertook a project to expand this course across five East and Central African countries (Ethiopia, Kenya, Malawi, Uganda and Zambia) and train local faculty. This study reports the outcomes from course evaluation data, exploring the impact on knowledge, skills and behaviour change in participants. Eleven courses were conducted in a 15-month period, with 381 participants attending. Fifty-nine new faculty members were trained. Knowledge scores (0-50 scale) increased significantly from mean (SD) 37.5 (4.7) pre-course to 43.2 (3.5) post-course (p < 0.0001). Skills scores (0-10 scale) increased significantly from 5.7 (2.0) pre-course to 8.0 (1.5) post-course (p < 0.0001). One hundred and twenty-six participants in Malawi, Uganda and Zambia were visited in their workplace 3-6 months later. Knowledge and skills were maintained at follow-up, with scores of 41.5 (5.0) and 8.3 (1.4), respectively (p < 0.0001 compared with pre-course scores). Content analysis from interviews with these participants highlighted positive behaviour changes in the areas of preparation, peri-operative care, resuscitation, management of the sick child, communication and teaching. This study indicates that the SAFE paediatric anaesthesia course is an effective way to deliver training, and could be used to help strengthen emergency and essential surgical care for children as a component of universal health coverage.
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Affiliation(s)
- N Boyd
- Department of Anaesthesia, Bristol Royal Hospital for Children, Bristol, UK
| | - E Sharkey
- Department of Anaesthesia, University College Hospital, London, UK
| | - M Nabukenya
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Tumukunde
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - N Sipuka
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - M Zyambo
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - I Walker
- Department of Anaesthesia, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,Department of Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - J Hart
- Department of Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Department of Education, University of Manchester, Manchester, UK
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Krepkovich E, Magnum C, Saliba S, Lichter M, Olowin A, Richardson N, Hart J. Feasibility Of A Novel Video Game-based EMG Biofeedback System In Patients With Knee Osteoarthritis. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000563177.56698.cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Morris K, Wagner S, Reddy Y, Salerno C, Ravichandran A, Garcia-Cortes R, Patel A, Plotner S, Hart J, Neawedde K, Walsh M, Chaudhry S. SIPAT Scores Do Not Correlate with Outcomes in Patients with Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kuenze C, Pietrosimone B, Lisee C, Rutherford M, Birchmeier T, Lepley A, Hart J. Demographic and surgical factors affect quadriceps strength after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2019; 27:921-930. [PMID: 30327821 DOI: 10.1007/s00167-018-5215-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/12/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the effects of graft source, time since surgery, age, and sex on unilateral and symmetry-based measures of knee extension strength among individuals with ACL reconstruction (ACLR). METHODS Three hundred and eight individuals aged 13-40 years old with primary, unilateral ACLR in the last 60 months were enrolled in this multi-site clinical measurement study. Participants completed bilateral knee extension maximal voluntary isometric contraction (MVIC) torque assessments which were normalized to body mass (Nm/kg) and limb symmetry indices (LSI) were calculated. The effects of graft source (patellar tendon autograft; hamstring tendon autograft), time since surgery (≤ 12 months; >12 mo.), age (≤ 18 years; >18 years), and sex were evaluated using separate ANCOVAs. RESULTS A significant interaction was present between time since surgery and graft source for LSI (P = 0.01) as participants with patellar tendon autografts ≤ 12 months post-ACLR experienced the greatest asymmetry (LSI = 69.2 ± 24.5%). Significant interactions were present between time since surgery and sex for involved limb (P = 0.01) and uninvolved limb MVIC torque (P = 0.05) with females ≤ 12 months post-ACLR being weakest (involved MVIC = 1.81 ± 0.70 N m/kg; uninvolved MVIC = 2.40 ± 0.68 N m/kg). Participants ≤ 18-year-old displayed weaker involved limb (P < 0.001) and contralateral limb (P < 0.001) MVIC torque as compared to participants > 18-year-old during the first year after ACLR. CONCLUSIONS Graft source, sex, age, and time since surgery effect quadriceps strength and symmetry after ACLR. Surgical and demographic factors should be considered when developing treatment approaches to optimize quadriceps function prior to re-integration into pre-injury levels of physical activity. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Christopher Kuenze
- Department of Kinesiology, College of Education, Michigan State University, 308 W. Circle Drive #105c, East Lansing, MI, 48824, USA. .,Division of Sports Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
| | - Brian Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Caroline Lisee
- Department of Kinesiology, College of Education, Michigan State University, 308 W. Circle Drive #105c, East Lansing, MI, 48824, USA
| | | | - Tom Birchmeier
- Department of Kinesiology, College of Education, Michigan State University, 308 W. Circle Drive #105c, East Lansing, MI, 48824, USA
| | - Adam Lepley
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Joseph Hart
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA.,Department of Orthopaedics, University of Virginia, Charlottesville, VA, USA
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Keyworth C, Hart J, Armitage CJ, Tully MP. What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review. BMC Med Inform Decis Mak 2018; 18:93. [PMID: 30404638 PMCID: PMC6223001 DOI: 10.1186/s12911-018-0661-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/27/2018] [Indexed: 02/02/2023] Open
Abstract
Background Technological support may be crucial in optimizing healthcare professional practice and improving patient outcomes. A focus on electronic health records has left other technological supports relatively neglected. Additionally, there has been no comparison between different types of technology-based interventions, and the importance of delivery setting on the implementation of technology-based interventions to change professional practice. Consequently, there is a need to synthesise and examine intervention characteristics using a methodology suited to identifying important features of effective interventions, and the barriers and facilitators to implementation. Three aims were addressed: to identify interventions with a technological component that are successful at changing professional practice, to determine if and how such interventions are theory-based, and to examine barriers and facilitators to successful implementation. Methods A literature review informed by realist review methods was conducted involving a systematic search of studies reporting either: (1) behavior change interventions that included technology to support professional practice change; or (2) barriers and facilitators to implementation of technological interventions. Extracted data was quantitative and qualitative, and included setting, target professionals, and use of Behaviour Change Techniques (BCTs). The primary outcome was a change in professional practice. A thematic analysis was conducted on studies reporting barriers and facilitators of implementation. Results Sixty-nine studies met the inclusion criteria; 48 (27 randomized controlled trials) reported behavior change interventions and 21 reported practicalities of implementation. The most successful technological intervention was decision support providing healthcare professionals with knowledge and/or person-specific information to assist with patient management. Successful technologies were more likely to operationalise BCTs, particularly “instruction on how to perform the behavior”. Facilitators of implementation included aligning studies with organisational initiatives, ensuring senior peer endorsement, and integration into clinical workload. Barriers included organisational challenges, and design, content and technical issues of technology-based interventions. Conclusions Technological interventions must focus on providing decision support for clinical practice using recognized behavior change techniques. Interventions must consider organizational context, clinical workload, and have clearly defined benefits for improving practice and patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12911-018-0661-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.
| | - J Hart
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK
| | - C J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - M P Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PL, UK
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Pakpoor J, Seminatore B, Graves J, Schreiner T, Waldman A, Lotze T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema J, McDonald J, Hart J, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Mar S, Kahn I, Rose J, Carmichael S, Roalstad S, Waltz M, Casper T, Waubant E. Dietary factors and pediatric multiple sclerosis: A case-control study. Mult Scler 2018; 24:1067-1076. [PMID: 28608728 PMCID: PMC5711616 DOI: 10.1177/1352458517713343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease. OBJECTIVE To determine the association between dietary factors and MS in children. METHODS Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011-2016. Chi-squared test compared categorical variables, Kruskal-Wallis test compared continuous variables, and multivariable logistic regression analysis was performed. RESULTS In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01). CONCLUSION Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.
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Affiliation(s)
- J. Pakpoor
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - B. Seminatore
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Graves
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - T. Schreiner
- University of Colorado School of Medicine, Neurology
| | - A. Waldman
- Children’s Hospital of Philadelphia, Neurology
| | - T. Lotze
- Texas Children’s Hospital, Child Neurology
| | - A. Belman
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | | | | | - G. Aaen
- Loma Linda University, Neurology
| | | | - J. McDonald
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Hart
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
| | - J. Ness
- University of Alabama at Birmingham, Pediatrics
| | - Y. Harris
- University of Alabama at Birmingham, Pediatrics
| | - J. Rubin
- Ann & Robert Lurie Children's Hospital of Chicago, Neurology
| | | | - L. Krupp
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | - M. Gorman
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | - L. Benson
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | | | | | - S. Mar
- Washington University St. Louis, Neurology
| | - I. Kahn
- Children’s National Medical Center, Washington, D.C
| | - J. Rose
- University of Utah, Neurology
| | - S.L. Carmichael
- Department of Pediatrics Division of Neonatal and Developmental Medicine, Stanford University, California, USA
| | | | | | | | - E. Waubant
- Multiple Sclerosis Center, University of California, San Francisco, CA
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
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Chisholm A, Ang-Chen P, Peters S, Hart J, Beenstock J. Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation. J Public Health (Oxf) 2018; 41:e70-e77. [DOI: 10.1093/pubmed/fdy094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Chisholm
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - P Ang-Chen
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - S Peters
- Division of Psychology and Mental Health, University of Manchester, UK
| | - J Hart
- Division of Medical Education, University of Manchester, UK
| | - J Beenstock
- Medical Directorate, Lancashire Care NHS Foundation Trust, UK
- Faculty of Health & Medicine, Lancaster University, UK
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Abstract
Background Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown. Aims To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers. Methods The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome. Results The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status. Conclusions The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers.
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Affiliation(s)
- G Kinman
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - A J Clements
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - J Hart
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
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Lee S, Van Ha T, Yassan L, Hart J, Ostdiek A, Zhu Y, Yi S, Scott E, Ameer G. 3:45 PM Abstract No. 317 Thermoresponsive Nanonet as a carrier for transarterial immunomodulatory chemoembolization: an experimental study for rabbit liver cancer model. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Chang MC, Souter LH, Kamel-Reid S, Rutherford M, Bedard P, Trudeau M, Hart J, Eisen A. Clinical utility of multigene profiling assays in early-stage breast cancer. ACTA ACUST UNITED AC 2017; 24:e403-e422. [PMID: 29089811 DOI: 10.3747/co.24.3595] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND This clinical practice guideline was developed to determine the level of evidence supporting the clinical utility of commercially available multigene profiling assays and to provide guidance about whether certain breast cancer patient populations in Ontario would benefit from alternative tests in addition to Oncotype dx (Genomic Health, Redwood City, CA, U.S.A.). METHODS A systematic electronic Ovid search of the medline and embase databases sought out systematic reviews and primary literature. A systematic review and practice guideline was written by a working group and was then reviewed and approved by Cancer Care Ontario's Molecular Oncology Advisory Committee. RESULTS Twenty-four studies assessing the clinical utility of Oncotype dx, Prosigna (NanoString Technologies, Seattle, WA, U.S.A.), EndoPredict (Myriad Genetics, Salt Lake City, U.S.A.), and MammaPrint (Agendia, Irvine, CA, U.S.A.) were included in the evidence base. CONCLUSIONS The clinical utility of multigene profiling assays is currently established for an appropriate subset of patients with estrogen receptor-positive, her2-negative, node-negative breast cancer for whom a decision to give chemotherapy is difficult to make. For patients with estrogen receptor-positive tumours who receive tamoxifen alone, Oncotype dx, Prosigna, and EndoPredict validly identify a low-risk population with favourable outcomes, indicating that a low-risk assay result is actionable and the decision to withhold chemotherapy is supported. Clinical evidence indicates that a high Oncotype dx recurrence score can predict for chemotherapy benefit, but a high Prosigna or EndoPredict score, although prognostic, is not, based on clinical trial evidence, directly actionable. Prosigna and EndoPredict are statistically more likely to identify a population at risk for recurrence beyond 5 years, but that information is currently not actionable because of a lack of interventional studies.
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Affiliation(s)
- M C Chang
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto
| | - L H Souter
- Juravinski Hospital, Hamilton.,Department of Oncology, McMaster University, Hamilton
| | - S Kamel-Reid
- Department of Pathology, University Health Network, Toronto
| | - M Rutherford
- Department of Molecular Diagnostics, Health Sciences North, Sudbury
| | - P Bedard
- Princess Margaret Cancer Centre, Toronto
| | | | - J Hart
- Cancer Care Ontario, Toronto, ON
| | - A Eisen
- Odette Cancer Centre, Toronto; and
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Foster C, Lee A, Hart J, Alpert L, Furtado L, Xiao S, Liauw S. Long-Term Outcomes and HPV Characteristics for an Institutional Cohort of Patients With Anal Cancer Receiving Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schaffert J, LoBue C, Nguyen T, Lacritz L, Womack K, Hart J, Cullum C. A-40Risk Factors for Earlier Age at Onset of Dementia with Lewy Bodies. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schaffert J, Lobue C, White C, Chiang H, Dieppa M, Lacritz L, Didehbani N, Hart J, Cullum C. Aging and Dementia-4Traumatic Brain Injury History is Associated with an Earlier Age of Dementia Onset in Autopsy-confirmed Alzheimer Disease. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx075.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hart J, Miriyala K. Neural tube defects in Waardenburg syndrome: A case report and review of the literature. Am J Med Genet A 2017; 173:2472-2477. [PMID: 28686331 DOI: 10.1002/ajmg.a.38325] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 05/08/2017] [Accepted: 05/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Joseph Hart
- Joan C Edwards School of Medicine; Marshall University; Huntington West Virginia
| | - Kalpana Miriyala
- Joan C Edwards School of Medicine; Marshall University; Huntington West Virginia
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Abstract
Chronic ankle instability (CAI) is a condition resulting from a lateral ankle sprain. Shank-rearfoot joint-coupling variability differences have been found in CAI patients; however, joint-coupling variability (VCV) of the ankle and proximal joints has not been explored. Our purpose was to analyse VCV in adults with and without CAI during gait. Four joint-coupling pairs were analysed: knee sagittal-ankle sagittal, knee sagittal-ankle frontal, hip frontal-ankle sagittal and hip frontal-ankle frontal. Twenty-seven adults participated (CAI:n = 13, Control:n = 14). Lower extremity kinematics were collected during walking (4.83 km/h) and jogging (9.66 km/h). Vector-coding was used to assess the stride-to-stride variability of four coupling pairs. During walking, CAI patients exhibited higher VCV than healthy controls for knee sagittal-ankle frontal in latter parts of stance thru mid-swing. When jogging, CAI patients demonstrated lower VCV with specific differences occurring across various intervals of gait. The increased knee sagittal-ankle frontal VCV in CAI patients during walking may indicate an adaptation to deal with the previously identified decrease in variability in transverse plane shank and frontal plane rearfoot coupling during walking; while the decreased ankle-knee and ankle-hip VCV identified in CAI patients during jogging may represent a more rigid, less adaptable sensorimotor system ambulating at a faster speed.
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Affiliation(s)
- Thomas Lilley
- a Department of Kinesiology , Curry School of Education, University of Virginia , Charlottesville , VA , USA
| | - Christopher C Herb
- b Department of Athletic Training and Nutrition , Moyes College of Education, Weber State University , Ogden , UT , USA
| | - Joseph Hart
- a Department of Kinesiology , Curry School of Education, University of Virginia , Charlottesville , VA , USA
| | - Jay Hertel
- a Department of Kinesiology , Curry School of Education, University of Virginia , Charlottesville , VA , USA
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Pietrosimone B, Kuenze C, Hart J, Thigpen C, Lepley A, Blackburn JT, Padua D, Grindstaff T, Davis H, Bell D. Association between Body Mass Index and Disability in Individuals with Unilateral Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518028.27091.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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