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279 results on '"Moran, Jay"'

28. Establishing a Consensus Definition of a Knee Fracture-Dislocation (Schenck Knee Dislocation V) Using a Global Modified Delphi Method

Author

Medvecky, Michael J., Kahan, Joseph B., Richter, Dustin L., McLaughlin, William M., Moran, Jay, Islam, Wasif, Miller, Mark D., Wascher, Daniel C., Treme, Gehron P., Campos, Túlio V.O., Held, Michael, Schenck, Robert C., Jr, Abrams, Geoffrey, Alaia, Michael, Arciero, Robert A., Barenius, Björn, Brady, Jacqueline M., Ferrer, Gonzalo, Franciozi, Carlos E., Gelber, Pablo E., Getgood, Alan, Hantes, Michael, Harner, Christopher D., Jazrawi, Laith M., Krych, Aaron J., Lagae, Koen C., LaPrade, Robert F., Levy, Bruce A., Lind, Martin, Lording, Timothy, Maestu, Rodrigo, Matava, Matthew, Moatshe, Gilbert, Monllau, Joan C., Murray, Iain R., Musahl, Volker, Ooka, Nelson H.M., Owens, Brett D., Parker, David A., Percope de Andrade, Marco A., Pimenta, Frederico S., Pujol, Nicolas, Rincón, Gustavo A., Robinson, James, Safran, Marc, Saltzman, Bryan M., Stannard, James, Stuart, Michael J., Tischer, Thomas, Uchida, Soshi, Villascusa, Silvio, von Bormann, Richard PB, and Waterman, Brian R.

Published
2023
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31. Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees: Treatment and Schenck Classification Recommendations Based on a Global Delphi Method

Author

Medvecky, Michael J., Kahan, Joseph B., Richter, Dustin L., Islam, Wasif, McLaughlin, William M., Moran, Jay, Alaia, Michael J., Miller, Mark D., Wascher, Daniel C., Treme, Gehron P., Campos, Túlio V.O., Held, Michael, Schenck, Robert C., Jr., Abrams, Geoffrey D., Arciero, Robert A., Barenius, Björn, Brady, Jacqueline M., Ferrer, Gonzalo, Franciozi, Carlos E., Gelber Ghertner, Pablo E., Getgood, Alan, Hantes, Michael, Harner, Christopher D., Jazrawi, Laith M., Krych, Aaron J., Lagae, Koen C., LaPrade, Robert F., Levy, Bruce A., Lind, Martin, Lording, Timothy, Maestu, Rodrigo, Matava, Matthew, Moatshe, Gilbert, Monllau, Joan C., Murray, Iain R., Musahl, Volker, Ooka, Nelson H.M., Owens, Brett D., Parker, David A., Percope Andrade, Marco A., Pimenta, Frederico S., Pujol, Nicolas, Rincón, Gustavo A., Robinson, James, Safran, Marc R., Saltzman, Bryan M., Stannard, James, Stuart, Michael J., Tischer, Thomas, Uchida, Soshi, Villascusa, Silvio, von Bormann, Richard P.B., and Waterman, Brian R.

Published
2023
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37. Physical Therapy Utilization After Single-level Posterior Lumbar Fusion.

Author

Gouzoulis, Michael J., Moran, Jay, Seongho Jeong, Galivanche, Anoop R., Kammien, Alexander J., Jabbouri, Sahir S., and Grauer, Jonathan N.

Subjects
*BUSINESS insurance, *PHYSICAL therapy, *DATABASES, *ODDS ratio, *EXPERIMENTAL design
Abstract

Study Design. Retrospective cohort study. Objective. Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF). Summary of Background Data. PLF is a common procedure that is increasing in frequency. After such surgeries, PT may be considered to facilitate mobilization and return to activities. However, the usage of such therapy has not been well-characterized in the literature. Materials and Methods. Patients undergoing single-level PLF were identified from the 2010 to 2021 PearlDiver administrative database. These patients were stratified based on usage of therapy, home versus outpatient therapy, and timing of therapy within the year after surgery. To determine predictors of therapy, patient characteristics were determined and multivariable regressions were performed. Results. A total of 213,240 patients undergoing single-level PLF were identified, of which therapy was done in the year after surgery for 63,231 (29.0%, of which home therapy accounted for 16.5% of therapy visits). Of those who utilized PT, the average number of visits was 10.6±10.6. Home therapy peaked within the first month after surgery and outpatient therapy peaked at month two. Factors associated with any PT following PLF in decreasing odds ratio (OR) were having commercial insurance (OR: 1.68), being from the Northeast (OR: 1.41), age (OR: 1.13 for 70+ of age) female sex (OR: 1.09), and ECI (OR: 1.04 per point) (P< 0.001 for all). Of those who received therapy, factors associated with home PT utilization were being from the Northeast (OR: 2.55), age (OR: 1.91 for 70+ of age), Medicaid insurance (OR: 1.48), female sex (OR: 1.39), and interbody fusion (OR:1.07) (P<0.001 for all). Conclusions. After single-level PLF, the minority of patients received home or outpatient PT. Of those who did, there was significant variation in the number of visits, with nonmedical factors such as insurance plan and geographic region being strongly associated suggesting room for more consistent practice patterns. [ABSTRACT FROM AUTHOR]

Published
2024
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42. KRAGEN: a knowledge graph-enhanced RAG framework for biomedical problem solving using large language models.

Author

Matsumoto, Nicholas, Moran, Jay, Choi, Hyunjun, Hernandez, Miguel E, Venkatesan, Mythreye, Wang, Paul, and Moore, Jason H

Subjects
*LANGUAGE models, *PROBLEM solving, *KNOWLEDGE graphs, *DATABASES, *TRUST, *GRAPH algorithms
Abstract

Motivation Answering and solving complex problems using a large language model (LLM) given a certain domain such as biomedicine is a challenging task that requires both factual consistency and logic, and LLMs often suffer from some major limitations, such as hallucinating false or irrelevant information, or being influenced by noisy data. These issues can compromise the trustworthiness, accuracy, and compliance of LLM-generated text and insights. Results Knowledge Retrieval Augmented Generation ENgine (KRAGEN) is a new tool that combines knowledge graphs, Retrieval Augmented Generation (RAG), and advanced prompting techniques to solve complex problems with natural language. KRAGEN converts knowledge graphs into a vector database and uses RAG to retrieve relevant facts from it. KRAGEN uses advanced prompting techniques: namely graph-of-thoughts (GoT), to dynamically break down a complex problem into smaller subproblems, and proceeds to solve each subproblem by using the relevant knowledge through the RAG framework, which limits the hallucinations, and finally, consolidates the subproblems and provides a solution. KRAGEN's graph visualization allows the user to interact with and evaluate the quality of the solution's GoT structure and logic. Availability and implementation KRAGEN is deployed by running its custom Docker containers. KRAGEN is available as open-source from GitHub at: https://github.com/EpistasisLab/KRAGEN. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Relationships between throwing mechanics and shoulder anterior force in high school and professional baseball pitchers.

Author

Manzi, Joseph E, Nicholson, Allen, Dowling, Brittany, Black, Grant G, Krichevsky, Spencer, Quan, Theodore, Moran, Jay, Kunze, Kyle N, and Dines, Joshua S

Subjects
SHOULDER, HIGH school baseball, PITCHERS (Baseball), HIGH school athletes, ABDUCTION (Kinesiology), GLENOHUMERAL joint, ROTATOR cuff
Abstract

Background: Excessive shoulder anterior force has been implicated in pathology of the rotator cuff in little league and professional baseball pitchers; in particular, anterior laxity, posterior stiffness, and glenohumeral joint impingement. Distinctly characterized motions associated with excessive shoulder anterior force remain poorly understood. Methods: High school and professional pitchers were instructed to throw fastballs while being evaluated with 3D motion capture (480 Hz). A supplementary random forest model was designed and implemented to identify the most important features for regressing to shoulder anterior force, with subsequent standardized regression coefficients to quantify directionality. Results: 130 high school pitchers (16.3 ± 1.2 yrs; 179.9 ± 7.7 cm; 74.5 ± 12.0 kg) and 322 professionals (21.9 ± 2.1 yrs; 189.7 ± 5.7 cm; 94.8 ± 9.5 kg) were included. Random forest models determined nearly all the variance for professional pitchers (R2 = 0.96), and less than half for high school pitchers (R2 = 0.41). Important predictors of shoulder anterior force in high school pitchers included: trunk flexion at maximum shoulder external rotation (MER) (X.IncMSE = 2.4, β = −0.23, p < 0.001), shoulder external rotation at ball release (BR)(X.IncMSE = 1.7, β = −0.34, p < 0.001), and shoulder abduction at BR (X.IncMSE = 3.1, β = 0.17, p < 0.001). In professional pitchers, shoulder horizontal adduction at foot contact (FC) was the highest predictor (X.IncMSE = 13.9, β = 0.50, p < 0.001), followed by shoulder external rotation at FC (X.IncMSE = 3.6, β = 0.26, p < 0.001), and maximum elbow extension velocity (X.IncMSE = 8.5, β = 0.19, p < 0.001). Conclusion: A random forest model successfully selected a subset of features that accounted for the majority of variance in shoulder anterior force for professional pitchers; however, less than half of the variance was accounted for in high school pitchers. Temporal and kinematic movements at the shoulder were prominent predictors of shoulder anterior force for both groups. Clinical relevance: : Our statistical model successfully identified a combination of features with the ability to adequately explain the majority of variance in anterior shoulder force among high school and professional pitchers. To minimize shoulder anterior force, high school pitchers should emphasize decreased shoulder abduction at BR, while professionals can decrease shoulder horizontal adduction at FC. [ABSTRACT FROM AUTHOR]

Published
2024
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50. High Rate of Clinically Meaningful Achievement in Outcomes After Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis.

Author

Kunze, Kyle N., Moran, Jay, Cecere, Robert, Taylor, Samuel A., Fu, Michael C., Warren, Russell F., Dines, David M., Gulotta, Lawrence V., and Dines, Joshua S.

Subjects
*ROTATOR cuff injuries, *PROSTHETICS, *ONLINE information services, *MEDICAL databases, *META-analysis, *ORTHOPEDIC surgery, *SYSTEMATIC reviews, *ARTIFICIAL implants, *HEALTH outcome assessment, *QUALITATIVE research, *QUESTIONNAIRES, *MEDLINE
Abstract

Background: Subacromial balloon spacers have been introduced as a potential treatment option for patients with massive irreparable rotator cuff tears. However, it is important to comprehensively assess the clinical efficacy of this procedure in the context of an increasing amount of contemporary literature. Purpose: To perform a systematic review of the contemporary literature to understand the propensity for clinically meaningful improvements after subacromial balloon spacer implantation for massive irreparable rotator cuff tears. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: The PubMed, Ovid/MEDLINE, and Cochrane databases were queried in July 2022 for data pertaining to studies reporting clinically significant outcomes after subacromial balloon spacer implantation. Freeman-Tukey double arcsine transformation was used to quantify the pooled rate of clinically meaningful improvements in outcomes as evaluated using the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB). Qualitative analysis was performed when data were variably presented to avoid misleading reporting. Results: There were 10 studies included, all of which reported MCID achievement. The overall pooled rate of MCID achievement for the Constant-Murley score was 83% (95% CI, 71%-93%; range, 40%-98%), with 6 of 8 studies reporting rates equal to or exceeding 85%. One study reported a 98% rate of PASS achievement for the Constant-Murley score at 3-year follow-up. The rate of MCID achievement for the American Shoulder and Elbow Surgeons (ASES) score ranged between 83% and 87.5%. The rate of PASS achievement for the ASES score was 56% at 2-year follow-up, while the rate of SCB achievement for the ASES score was 83% and 82% at 1- and 2-year follow-up, respectively. At 1-year follow-up, 74% and 78% of patients achieved the MCID for the Numeric Rating Scale and Oxford Shoulder Score, respectively. At 3 years, 69% of patients achieved the MCID for the Numeric Rating Scale and 87% achieved it for the Oxford Shoulder Score. Conclusion: Patients who underwent isolated subacromial balloon spacer implantation for massive irreparable rotator cuff tears demonstrated a high rate of clinically significant improvement in outcomes at short- to mid-term follow-up. A paucity of literature exists to appropriately define and evaluate the rates of achieving the PASS and SCB after subacromial balloon spacer implantation, necessitating further study. [ABSTRACT FROM AUTHOR]

Published
2024
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