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1. Evidence-based interventions to treat chronic low back pain: treatment selection for a personalized medicine approach

Author

Matthew C. Mauck, Aileen F. Aylward, Chloe E. Barton, Brandon Birckhead, Timothy Carey, Diane M. Dalton, Aaron J. Fields, Julie Fritz, Afton L. Hassett, Anna Hoffmeyer, Sara B. Jones, Samuel A. McLean, Wolf E. Mehling, Conor W. O'Neill, Michael J. Schneider, David A. Williams, Patricia Zheng, and Ajay D. Wasan

Subjects
Anesthesiology, RD78.3-87.3
Abstract

Abstract. Introduction:. Chronic low back pain (cLBP) is highly prevalent in the United States and globally, resulting in functional impairment and lowered quality of life. While many treatments are available for cLBP, clinicians have little information about which specific treatment(s) will work best for individual patients or subgroups of patients. The Back Pain Research Consortium, part of the National Institutes of Health Helping to End Addiction Long-termSM (HEAL) Initiative, will conduct a collaborative clinical trial, which seeks to develop a personalized medicine algorithm to optimize patient and provider treatment selection for patients with cLBP. Objective:. The primary objective of this article is to provide an update on evidence-based cLBP interventions and describe the process of reviewing and selecting interventions for inclusion in the clinical trial. Methods:. A working group of cLBP experts reviewed and selected interventions for inclusion in the clinical trial. The primary evaluation measures were strength of evidence and magnitude of treatment effect. When available in the literature, duration of effect, onset time, carryover effect, multimodal efficacy, responder subgroups, and evidence for the mechanism of treatment effect or biomarkers were considered. Conclusion:. The working group selected 4 leading, evidence-based treatments for cLBP to be tested in the clinical trial and for use in routine clinical treatment. These treatments include (1) duloxetine, (2) acceptance and commitment therapy, (3) a classification-based exercise and manual therapy intervention, and (4) a self-management approach. These interventions each had a moderate to high level of evidence to support a therapeutic effect and were from different therapeutic classes.

Published
2022
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2. Bibliometrics approach to evaluating the research impact of CTSAs: A pilot study

Author

Fei Yu, Allison Alicia Van, Tanha Patel, Nandita Mani, Andrea Carnegie, Giselle M. Corbie-Smith, Timothy Carey, John Buse, and Gaurav Dave

Subjects
CTSA evaluation, translational research, bibliometrics, network analysis, research impact measurement, Medicine
Abstract

AbstractIntroduction:To enhance the performance evaluation of Clinical and Translational Science Award (CTSA) hubs, we examined the utility of advanced bibliometric measures that go beyond simple publication counts to demonstrate the impact of translational research output.Methods:The sampled data included North Carolina Translational and Clinical Science Institute (NC TraCS)-supported publications produced between September 2008 and March 2017. We adopted advanced bibliometric measures and a state-of-the-art bibliometric network analysis tool to assess research productivity, citation impact, the scope of research collaboration, and the clusters of research topics.Results:Totally, 754 NC TraCS-supported publications generated over 24,000 citation counts by April 2017 with an average of 33 cites per article. NC TraCS-supported research papers received more than twice as many cites per year as the average National Institute of Health-funded research publications from the same field and time. We identified the top productive researchers and their networks within the CTSA hub. Findings demonstrated the impact of NC TraCS in facilitating interdisciplinary collaborations within the CTSA hub and across the CTSA consortium and connecting researchers with right peers and organizations.Conclusion:Both improved bibliometrics measures and bibliometric network analysis can bring new perspectives to CTSA evaluation via citation influence and the scope of research collaborations.

Published
2020
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3. IMMUNO-COV v2.0: Development and Validation of a High-Throughput Clinical Assay for Measuring SARS-CoV-2-Neutralizing Antibody Titers

Author

Rianna Vandergaast, Timothy Carey, Samantha Reiter, Chase Lathrum, Patrycja Lech, Clement Gnanadurai, Michelle Haselton, Jason Buehler, Riya Narjari, Luke Schnebeck, Anne Roesler, Kara Sevola, Lukkana Suksanpaisan, Alice Bexon, Shruthi Naik, Bethany Brunton, Scott C. Weaver, Grace Rafael, Sheryl Tran, Alina Baum, Christos A. Kyratsous, Kah Whye Peng, and Stephen J. Russell

Subjects
Microbiology, QR1-502
Abstract

Since its emergence at the end of 2019, SARS-CoV-2, the causative agent of COVID-19, has caused over 100 million infections and 2.4 million deaths worldwide. Recently, countries have begun administering approved COVID-19 vaccines, which elicit strong immune responses and prevent disease in most vaccinated individuals.

Published
2021
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4. Evaluating a CTSA-funded pilot grant program

Author

Kalene Morozumi, Tanha Patel, Paul Kerr, Mary Beth Cassely, Timothy Carey, John Buse, Andrea Carnegie, Tom Egan, and Gaurav Dave

Subjects
CTSA, evaluation, pilot funding, pilot program, translational research, Medicine
Abstract

Abstract Introduction: Pilot programs are integral to catalyzing and accelerating research at Clinical and Translational Science Award (CTSA) hubs. However, little has been published about the structure and operationalization of pilot programs or how they impact the translational research enterprise at CTSAs. The North Carolina Translational and Clinical Science Institute (NC TraCS), the CTSA hub at the University of North Carolina at Chapel Hill (UNC-CH) conducted an evaluation case study to describe the pilot program structure, assess process outcomes, and provide a framework for other institutions to utilize for the evaluation of their respective pilot programs. Methods: We describe the operationalization of our pilot program, the evaluation framework utilized to evaluate the program, and how we analyzed available data to understand how our pilot funding opportunities were utilized by investigators. We calculated application volumes and funding rates by investigator position title and pilot application type. We also reviewed feedback provided by pilot Principal Investigators (PIs) to understand how many pilot projects were completed, NC TraCS service utilization, and barriers to research. Limited data on publications and subsequent funding was also reviewed. Results: Between 2009 and 2019 the NC TraCS Pilot Program received 2343 applications and funded 933 projects, ranging from $2000 to $100,000 in amount, with an overall funding rate of 39.8%. Utilization of NC TraCS services had positive impacts on both resubmission funding and project completion rates. Conclusion: This process evaluation indicates that the program is being operationalized in a way that successfully fulfills the program mission while meeting the needs of a diverse group of researchers.

Published
2021
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5. Seroprevalence of anti-SARS-CoV-2 antibodies in a cohort of New York City metro blood donors using multiple SARS-CoV-2 serological assays: Implications for controlling the epidemic and 'Reopening'.

Author

Daniel K Jin, Daniel J Nesbitt, Jenny Yang, Haidee Chen, Julie Horowitz, Marcus Jones, Rianna Vandergaast, Timothy Carey, Samantha Reiter, Stephen J Russell, Christos Kyratsous, Andrea Hooper, Jennifer Hamilton, Manuel Ferreira, Sarah Deng, Donna Straus, Aris Baras, Christopher D Hillyer, and Larry L Luchsinger

Subjects
Medicine, Science
Abstract

Projections of the stage of the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic and local, regional and national public health policies to limit coronavirus spread as well as "reopen" cities and states, are best informed by serum neutralizing antibody titers measured by reproducible, high throughput, and statically credible antibody (Ab) assays. To date, a myriad of Ab tests, both available and FDA authorized for emergency, has led to confusion rather than insight per se. The present study reports the results of a rapid, point-in-time 1,000-person cohort study using serial blood donors in the New York City metropolitan area (NYC) using multiple serological tests, including enzyme-linked immunosorbent assays (ELISAs) and high throughput serological assays (HTSAs). These were then tested and associated with assays for neutralizing Ab (NAb). Of the 1,000 NYC blood donor samples in late June and early July 2020, 12.1% and 10.9% were seropositive using the Ortho Total Ig and the Abbott IgG HTSA assays, respectively. These serological assays correlated with neutralization activity specific to SARS-CoV-2. The data reported herein suggest that seroconversion in this population occurred in approximately 1 in 8 blood donors from the beginning of the pandemic in NYC (considered March 1, 2020). These findings deviate with an earlier seroprevalence study in NYC showing 13.7% positivity. Collectively however, these data demonstrate that a low number of individuals have serologic evidence of infection during this "first wave" and suggest that the notion of "herd immunity" at rates of ~60% or higher are not near. Furthermore, the data presented herein show that the nature of the Ab-based immunity is not invariably associated with the development of NAb. While the blood donor population may not mimic precisely the NYC population as a whole, rapid assessment of seroprevalence in this cohort and serial reassessment could aid public health decision making.

Published
2021
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6. Evaluation of primary caregivers' perceptions on home trampoline use

Author

Supriya Singh, Kamary Coriolano, Jacob Davidson, Megan Cashin, Timothy Carey, and Debra Bartley

Subjects
Medicine
Abstract

Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children.Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention. The educational intervention was a pamphlet outlining trampoline safety data. Data analysis occurred in 2016.From the 100 primary caregivers recruited, 39 caregivers owned a trampoline, and 10 had presented to the emergency department with their child for an injury related to trampoline use. After educational intervention, caregivers had higher rating of perceived danger associated with trampolines (6/10 vs. 8/10, p

Published
2018
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7. Beyond patient-centered care: Enhancing the patient experience in mental health services through patient-perspective care

Author

Timothy Carey

Subjects
patient-centered care, patient-perspective-care, mental health, treatment effectiveness and efficiency, Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To improve the effectiveness and efficiency of mental health services a move from patient-centered care to patient-perspective care is recommended. An attitude of patient-perspective care would require service providers recognizing that help can only ever be defined by the helpee rather than the helper. A patient-perspective service that was structured around the preferences and perspectives of patients might finally help to end the long-term suffering of many people who experience mental health problems.

Published
2016

8. Longitudinal monitoring of SARS-CoV-2 neutralizing antibody titers and its impact on employee personal wellness decisions

Author

Rianna Vandergaast, Timothy Carey, Lukkana Suksanpaisan, Chase Lathrum, Riya Narjari, Michelle Haselton, Luke Schnebeck, Aroshi Wijesekara, Andrew Duncan, Luke Russell, Shruthi Naik, Kah-Whye Peng, Patrycja Lech, and Stephen J. Russell

Abstract

Virus neutralizing antibody (vnAb) titers are the strongest laboratory correlate of protection from SARS-CoV-2. Providing individuals with real-time measures of their vnAb titers is predicted to improve their ability to make personal wellness decisions. Yet, widespread commercial testing of SARS-CoV-2 vnAbs does not currently occur. Here, we examined whether knowing their vnAb titer impacted wellness decision-making among individuals. To this end, starting on January 1, 2021, we offered all employees from two companies free IMMUNO-COV™ testing and conducted a survey to assess their behaviors and decisions regarding booster vaccination. IMMUNO-COV is a clinically validated, surrogate virus assay that quantitates serum titers of SARS-CoV-2 vnAbs. To help participants gauge their level of protection based on their vnAb titer, we calibrated IMMUNO-COV titers to the World Health Organization (WHO) International Standard (IU/mL), making them comparable to published reports of correlates of protection, and we fit historical IMMUNO-COV vnAb titer values into predictive models of immune protection from COVID-19. As expected, data for the 56 program participants showed variability in vnAb titers post vaccination, rates vnAb decay, and fold-increases in vnAb titers after booster vaccination. Based on the participant survey, the majority (66%) of participants indicated that knowing their vnAb titer impacted their social behaviors and/or their decision on the timing of a booster vaccination. Several participants indicated that knowing their vnAb titer contributed to their peace of mind regarding their high level of protection from COVID-19. Together, these data demonstrate that regular determination of SARS-CoV-2 neutralizing antibody titers can significantly impact decisions regarding social interactions and timing of booster vaccinations.

Published
2022

10. Accelerated surgery versus standard care in hip fracture (HIP ATTACK-1) : a kidney substudy of a randomized clinical trial

Author

Flavia K. Borges, P.J. Devereaux, Meaghan Cuerden, Jessica M. Sontrop, Mohit Bhandari, Ernesto Guerra-Farfán, Ameen Patel, Alben Sigamani, Masood Umer, John Neary, Maria Tiboni, Vikas Tandon, Mmampapatla Thomas Ramokgopa, Parag Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Richard Jenkinson, Paweł Ślęczka, Aamer Nabi Nur, Gavin C.A. Wood, Robert J. Feibel, John Stephen McMahon, Bruce M. Biccard, Alessandro Ortalda, Wojciech Szczeklik, Chew Yin Wang, Jordi Tomás-Hernández, Jessica Vincent, Valerie Harvey, Shirley Pettit, Kumar Balasubramanian, Gerard Slobogean, Amit X. Garg, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean C. Yombi, Nassim Touil, Jigme T. Bhutia, Carol Clinckaert, Dirk De Clippeleir, Maike Reu, Leslie P. Gauthier, Victoria RA. Avram, Mitchell Winemaker, Daniel M. Tushinski, Justin de Beer, Andrew Worster, Diane L. Simpson, Kim A. Alvarado, Krysten K. Gregus, Kelly H. Lawrence, Darryl P. Leong, Philip G. Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J. Wood, David AJ. Wilson, Sandra N. Ofori, Jessica Spence, Emmanuelle Duceppe, Maria E. Tiboni, John D. Neary, Anthony Adili, David D. Cowan, Vickas Khanna, Amna Zaki, Janet C. Farrell, Anne Marie MacDonald, David Conen, Steven CW. Wong, Arsha Karbassi, Douglas S. Wright, Harsha Shanthanna, Javier Ganame, Andrew Cheung, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A. Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D. Macleod, David W. Sanders, Edward Vasarhelyi, Debra Bartley, George K. Dresser, Christina Tieszer, Richard J. Jenkinson, Steven Shadowitz, Jacques S. Lee, Stephen Choi, Hans J. Kreder, Markku Nousiainen, Monica R. Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David J.G. Stephen, Diane Nam, Patrick D.G. Henry, Gavin CA. Wood, Stephen M. Mann, Melanie T. Jaeger, Marco LA. Sivilotti, Christopher A. Smith, Christopher C. Frank, Heather Grant, Leone Ploeg, Jeff D. Yach, Mark M. Harrison, Aaron R. Campbell, Ryan T. Bicknell, Davide D. Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J. Hadden, Brian PJ. Chen, Stephanie A. Coupal, Stephen J. McMahon, Lisa M. McLean, Hemant R. Shirali, Syed Y. Haider, Crystal A. Smith, Evan Watts, David J. Santone, Kevin Koo, Allan J. Yee, Ademilola N. Oyenubi, Aaron Nauth, Emil H. Schemitsch, Timothy R. Daniels, Sarah E. Ward, Jeremy A. Hall, Henry Ahn, Daniel B. Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J. Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P. Coles, Kelly Trask, Shelley MacDonald, J.A.I. Trenholm, William Oxner, C.G. Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J. White, Loretta Olivieri, Stephen B. Hunt, Thomas R. Turgeon, Eric R. Bohm, Sarah Tran, Stephen M. Giilck, Tom Hupel, Pierre Guy, Peter J. O'Brien, Andrew W. Duncan, Gordon A. Crawford, Junlin Zhou, Yanrui Zhao, Yang Liu, Lei Shan, Anshi Wu, Juan M. Muñoz, Philippe Chaudier, Marion Douplat, Michel Henri Fessy, Vincent Piriou, Lucie Louboutin, Jean Stephane David, Arnaud Friggeri, Anthony Viste, Charles Hervé Vacheron, Frankie Ka Li Leung, Christian Xinshuo Fang, Dennis King Hang Yee, Parag K. Sancheti, Chetan V. Pradhan, Atul A. Patil, Chetan P. Puram, Madhav P. Borate, Kiran B. Kudrimoti, Bharati A. Adhye, Himanshu V. Dongre, Bobby John, Valsamma Abraham, Ritesh A. Pandey, Arti Rajkumar, Preetha E. George, Manesh Stephen, Nitheesh Chandran, Mohammed Ashraf, A.M. Georgekutty, Ahamad S. Sulthan, S. Adinarayanan, Deep Sharma, Satish P. Barnawal, Srinivasan Swaminathan, Prasanna U. Bidkar, Sandeep K. Mishra, Jagdish Menon, M. Niranjan, Z.K. Varghese, Santosh A. Hiremath, N.C. Madhusudhan, Abhijit Jawali, Kingsly R. Gnanadurai, Carolin E. George, Tatarao Maddipati, K.P. Mary, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem H. Menon, Mandeep S. Dhillon, Devendra K. Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth N. Bilchod, Surya U. Singh, Uttam V. Gattu, Ravi P. Dashputra, Prashant V. Rahate, Maurizio Turiel, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Giuseppe De Blasio, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Francesco De Donato, Eleonora Colnaghi, Vincenzo Salini, Giacomo Placella, Giuseppe Giardina, Gaetano Lombardi, Anna Marcato, Luca Guzzetti, Ilaria Rivetti, Massimiliano Greco, H.M. Khor, Hou Yee Lai, C.S. Kumar, K.H. Chee, P.S. Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL. Ngim, Huck Wee Boon, Im Im Chin, Ydo V. Kleinlugtenbelt, Ellie BM. Landman, Elvira R. Flikweert, Herbert W. Roerdink, Roy BG. Brokelman, Hannie F. Elskamp-Meijerman, Bas Staffhorst, Jan-Hein MG. Cobben, Dilshad Begum, Anila Anjum, Pervaiz M. Hashmi, Tashfeen Ahmed, Haroon U. Rashid, Mujahid J. Khattak, Rizwan H. Rashid, Riaz H. Lakdawala, Shahryar Noordin, Naveed M. Juman, Robyna I. Khan, Muhammad M. Riaz, Syedah S. Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad N. Khan, Eraj K. Khan, Kholood A. Janjua, Sajjad H. Orakzai, Abdus S. Khan, Khawaja J. Mustafa, Mian A. Sohail, Muhammad Umar, Siddra A. Khan, Muhammad Ashraf, Muhammad K. Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Ilona Nowak-Kózka, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla T. Ramokgopa, Gregory B. Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad N. Iqbal, Ryan J. Campbell, Matimba L. Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B. Nejthardt, Sean Chetty, Stephen Venter, Ernesto Guerra-Farfan, Jordi Tomas-Hernandez, Yaiza Garcia-Sanchez, Miriam Garrido Clua, Vicente Molero-Garcia, Jordi Teixidor-Serra, Maria del Mar Villar-Casares, Jordi Selga Marsa, Juan A. Porcel-Vazquez, Jose-Vicente Andres- Peiro, Jaume Mestre-Torres, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Carlos Piedra Calle, Diego Soza Leiva, Maria Garcia Carrasco, Montsant Jornet-Gibert, Montserrat Monfort-Mira, Alfons Gasset-Teixidor, Francesc Antoni Marcano-Fernández, Isabel Simó- Sánchez, Begoña Mari-Alfonso, Christian Yela-Verdú, Raúl Pellejero-García, Júlia Casas-Codina, Ruben Iglesias- Sanjuan, Pau Balcells-Nolla, Oriol Vila-Sánchez, Mercè Bertrana de Bustos, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javier Abarca, Cristina Estrada, Marga Novellas, Francesc Anglès, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, J.L. Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J. Aguado, Virginia García-Virto, Clarisa Simón-Pérez, Sergio Chavez, María Bragado, María Plata, Enrique Guerado, Encarnacion Cruz, Juan R. Cano, Jose M. Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam A. Kadry, Surendini Thayaparan, Victor Babu, Arash Aframian, Souad Bentoumi, Amrinder Sayan, Ihab Abdlaziz, Marcela P. Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE. Mayor, Sally Dillingham, Laura Nicholson, Ben T. Brooke, Joby John, Shashi K. Nanjayan, Martyn J. Parker, Susan O'Sullivan, Meir T. Marmor, Amir Matityahu, Robert T. McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Robert O’Toole, Marcus Sciadini, Jason Nascone, Nathan O’Hara, Scott P. Ryan, Molly E. Clark, Charles Cassidy, Konstantin Balonov, Tristan Weaver, Laura S. Phieffer, Sergio D. Bergese, Andrew J. Marcantonio, Shrikant I. Bangdiwala, Michael H. McGillion, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R. Wells, Patrice Forget, Paul Landais, Giovanni Landoni, Ekaterine Popova, Iain K. Moppett, Robin Roberts, null Chairperson, Finlay McAlister, David Sackett, James Wright, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale

Subjects
Hip Fractures, Nephrology, Humans, Pelvic Bones, Kidney
Abstract

To the Editor: Acute kidney injury (AKI) is a lesser-known complication of hip fracture that may come about owing to decreased kidney perfusion and heightened inflammation from trauma, pain, bleeding, and fasting. Approximately 15%-20% of patients undergoing surgery for a hip fracture develop AKI, with 0.5%-1.8% receiving dialysis. [...]

Published
2022

11. Boosting of SARS-CoV-2 immunity in nonhuman primates using an oral rhabdoviral vaccine

Author

Timothy Carey, Sabarinathan Ramachandran, Lukkana Suksanpaisan, Samantha Reiter, Rachael M Z Lee, Chase Lathrum, Riya Narjari, Rianna Vandergaast, Alina Baum, Christopher D. Petro, Miguel Ángel Muñoz-Alía, Stephen J. Russell, Michelle Haselton, Christos A. Kyratsous, Patrcyja Lech, Lianwen Zhang, Melanie L. Graham, Jody L. Janecek, Karina Krotova, Clement W. Gnanadurai, Mulu Z. Tesfay, Nandakumar Packiriswamy, Toshie Sakuma, Kah Whye Peng, Kara Sevola, Jordan Recker, Luke Russell, Baskar Balakrishnan, Scott Waniger, and Christopher Ziegler

Subjects
Primates, viruses, T cells, Antibodies, Viral, Article, law.invention, Herd immunity, Vesicular Stomatitis, Immune system, Immunity, law, Animals, neutralizing antibodies, Neutralizing antibody, Tropism, General Veterinary, General Immunology and Microbiology, biology, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, Viral Vaccines, Antibodies, Neutralizing, Virology, stomatognathic diseases, Titer, Infectious Diseases, VSV, Liposomes, Spike Glycoprotein, Coronavirus, biology.protein, Recombinant DNA, Nanoparticles, Molecular Medicine, Rhabdoviridae, oral vaccine, rhabdovirus
Abstract

An orally active vaccine capable of boosting SARS-CoV-2 immune responses in previously infected or vaccinated individuals would help efforts to achieve and sustain herd immunity. Unlike mRNA-loaded lipid nanoparticles and recombinant replication-defective adenoviruses, replicating vesicular stomatitis viruses with SARS-CoV-2 spike glycoproteins (VSV-SARS2) were poorly immunogenic after intramuscular administration in clinical trials. Here, by G protein trans-complementation, we generated VSV-SARS2(+G) virions with expanded target cell tropism. Compared to parental VSV-SARS2, G-supplemented viruses were orally active in virus-naive and vaccine-primed cynomolgus macaques, powerfully boosting SARS-CoV-2 neutralizing antibody titers. Clinical testing of this oral VSV-SARS2(+G) vaccine is planned.

Published
2021

12. Group A Streptococcal Septic Hip Arthritis in a Child With Spastic Triplegic Cerebral Palsy

Author

Michelle Barton Forbes, Timothy Carey, Megan Cashin, Jacob Davidson, and Supriya Singh

Subjects
Male, Pediatrics, medicine.medical_specialty, Gross motor skill, Population, Arthritis, Case Report, Irritability, Group A, Cerebral palsy, Spastic, Humans, Medicine, Family, Orthopedics and Sports Medicine, Child, education, Arthritis, Infectious, education.field_of_study, business.industry, Cerebral Palsy, medicine.disease, Triplegic cerebral palsy, Muscle Spasticity, Surgery, medicine.symptom, business
Abstract

Reports of septic hip arthritis in children with cerebral palsy are exceedingly rare. This case report describes a 10-year-old boy with spastic triplegic cerebral palsy (Gross Motor Functional Classification System), who presented with fever and irritability. This case highlights the difficulties in diagnosing septic joint arthritis in patients with cerebral palsy who are nonverbal and have limited mobility. A high index of suspicion is necessary in this population when presented with fever and new limitations in mobility.

Published
2021

13. The creation of a national coalition to target adolescent idiopathic scoliosis: a meeting report

Author

Devin Peterson, Ron El-Hawary, Laura Banfield, Lehana Thabane, Timothy Carey, Paul Missiuna, Milena Cioana, M. Constantine Samaan, and Murray A. Potter

Subjects
Medical education, business.industry, Mechanical Engineering, Energy Engineering and Power Technology, Idiopathic scoliosis, Management Science and Operations Research, 3. Good health, 03 medical and health sciences, Intervention (law), Identification (information), 0302 clinical medicine, 030225 pediatrics, Medicine, Clinical care, business, Dissemination
Abstract

In this report, we document the discussions and recommendations of a national conference designed to create a coalition to tackle adolescent idiopathic scoliosis (AIS) held on June 6 and 7, 2017 in Hamilton, ON, Canada. The goal of the establishment of this coalition is to join the efforts of patients, parents, physicians, researchers and other stakeholders to identify stakeholders' perspectives and to categorize gaps in knowledge and target further AIS research and clinical care priorities. The participants' main priorities included focus on shared decision making regarding clinical and research priorities between the stakeholders on the clinical, research and policy sides with patients and families. In addition, improvements in the dissemination of information via digital platforms and identification of cost-effective screening strategies that may help early identification and intervention were also recognized as a priority. Commitment was reached to form a national coalition to understand the determinants of this condition and enhance patient outcomes through improved clinical care and research efforts.

Published
2019

14. Development and validation of IMMUNO-COV™: a high-throughput clinical assay for detecting antibodies that neutralize SARS-CoV-2

Author

Bethany Brunton, Shruthi Naik, Rianna Vandergaast, Sheryl Tran, Scott C. Weaver, Christos A. Kyratsous, Timothy Carey, Alina Baum, Grace H. Rafael, John Mills, Samantha Reiter, Kah-Whye Peng, Jason Buehler, Alice Bexon, Michelle Haselton, Christopher Ziegler, Elitza S. Theel, Anne Roesler, Stephen J. Russell, Clement W. Gnanadurai, Rosa Maria Diaz, Lukkana Suksanpaisan, Clavin Jerde, Jordan Recker, Mulu Z. Tesfay, Matthew M. Roforth, and Patrycja J. Lech

Subjects
medicine.drug_class, viruses, Antibodies, Viral, Recombinant virus, Monoclonal antibody, Severity of Illness Index, antibody titer, Article, Serology, Plaque reduction neutralization test, surrogate virus, Limit of Detection, Neutralization Tests, Chlorocebus aethiops, medicine, Animals, Humans, neutralizing antibodies, skin and connective tissue diseases, Neutralizing antibody, Vero Cells, high-throughput assay, biology, SARS-CoV-2, Chemistry, fungi, COVID-19, Editor's Pick, biology.organism_classification, Antibodies, Neutralizing, Virology, respiratory tract diseases, High-Throughput Screening Assays, Vesicular stomatitis virus, Monoclonal, biology.protein, Antibody, clinical validation, Research Article
Abstract

Neutralizing antibodies are key determinants of protection from future infection, yet well-validated high-throughput assays for measuring titers of SARS-CoV-2-neutralizing antibodies are not generally available. Here, we describe the development and validation of IMMUNO-COV v2.0, a scalable surrogate virus assay, which titrates antibodies that block infection of Vero-ACE2 cells by a luciferase-encoding vesicular stomatitis virus displaying SARS-CoV-2 spike glycoproteins (VSV-SARS2-Fluc). Antibody titers, calculated using a standard curve consisting of stepped concentrations of SARS-CoV-2 spike monoclonal antibody, correlated closely (P

Published
2020

15. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial

Author

Flavia K Borges, Mohit Bhandari, Ernesto Guerra-Farfan, Ameen Patel, Alben Sigamani, Masood Umer, Maria E Tiboni, Maria del Mar Villar-Casares, Vikas Tandon, Jordi Tomas-Hernandez, Jordi Teixidor-Serra, Victoria RA Avram, Mitchell Winemaker, Mmampapatla T Ramokgopa, Wojciech Szczeklik, Giovanni Landoni, Chew Yin Wang, Dilshad Begum, John D Neary, Anthony Adili, Parag K Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Paweł Ślęczka, Richard J Jenkinson, Aamer Nabi Nur, Gavin CA Wood, Robert J Feibel, Stephen J McMahon, Alen Sigamani, Ekaterine Popova, Bruce M Biccard, Iain K Moppett, Patrice Forget, Paul Landais, Michael H McGillion, Jessica Vincent, Kumar Balasubramanian, Valerie Harvey, Yaiza Garcia-Sanchez, Shirley M Pettit, Leslie P Gauthier, Gordon H Guyatt, David Conen, Amit X Garg, Shrikant I Bangdiwala, Emilie P Belley-Cote, Maura Marcucci, Andre Lamy, Richard Whitlock, Yannick Le Manach, Dean A Fergusson, Salim Yusuf, PJ Devereaux, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean Cyr Yombi, Nassim Touil, Maike Reul, Jigme Tshering Bhutia, Carol Clinckaert, Dirk De Clippeleir, Justin de Beer, Diane L Simpson, Andrew Worster, Kim A Alvarado, Krysten K Gregus, Kelly H Lawrence, Darryl P Leong, Philip G Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J Wood, Daniel M Tushinski, David AJ Wilson, Clive Kearon, David D Cowan, Vickas Khanna, Amna Zaki, Janet C Farrell, Anne Marie MacDonald, Steven CW Wong, Arsha Karbassi, Douglas Steven Wright, Harsha Shanthanna, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D Macleod, David W Sanders, Edward Vasarhelyi, Debra Bartley, George K Dresser, Christina Tieszer, Steven Shadowitz, Jacques S Lee, Stephen Choi, Hans J Kreder, Markku Nousiainen, Monica R Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David JG Stephen, Diane Nam, Patrick DG Henry, Stephen M Mann, Melanie T Jaeger, Marco LA Sivilotti, Christopher A Smith, Christopher C Frank, Heather Grant, Leone Ploeg, Jeff D Yach, Mark M Harrison, Aaron R Campbell, Ryan T Bicknell, Davide D Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J Hadden, Brian P-J Chen, Stephanie A Coupal, Lisa M McLean, Hemant R Shirali, Syed Y Haider, Crystal A Smith, Evan Watts, David J Santone, Kevin Koo, Allan J Yee, Ademilola N Oyenubi, Aaron Nauth, Emil H Schemitsch, Timothy R Daniels, Sarah E Ward, Jeremy A Hall, Henry Ahn, Daniel B Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P Coles, Kelly Trask, Shelley MacDonald, J Andrew I Trenholm, William Oxner, C Glen Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J White, Loretta Olivieri, Stephen B Hunt, Thomas R Turgeon, Eric R Bohm, Sarah Tran, Stephen M Giilck, Tom Hupel, Pierre Guy, Peter J O'Brien, Andrew W Duncan, Gordon A Crawford, Junlin Zhou, Yanrui Zhao, Yang Liu, Lei Shan, Anshi Wu, Juan Manuel Muñoz, Philippe Chaudier, Marion Douplat, Michel Henri Fessy, Vincent Piriou, Lucie Louboutin, Jean Stephane David, Arnaud Friggeri, Sebastien Beroud, Jean Marie Fayet, Frankie Ka Li Leung, Christian Xinshuo Fang, Dennis King Hang Yee, Parag Kantilal Sancheti, Chetan Vijay Pradhan, Atul Ashok Patil, Chetan Prabhakar Puram, Madhav Pandurang Borate, Kiran Bhalchandra Kudrimoti, Bharati Anil Adhye, Himanshu Vijaykumar Dongre, Bobby John, Valsamma Abraham, Ritesh Arvind Pandey, Arti Rajkumar, Preetha Elizabeth George, Manesh Stephen, Nitheesh Chandran, Mohammed Ashraf, AM Georgekutty, Ahamad Shaheel Sulthan, S Adinarayanan, Deep Sharma, Satish Prasad Barnawal, Srinivasan Swaminathan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Jagdish Menon, Niranjan M, Varghese Zachariah K, Santosh Angad Hiremath, Madhusudhan NC, Abhijit Jawali, Kingsly Robert Gnanadurai, Carolin Elizabeth George, Tatarao Maddipati, Mary KP KP, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem Haridas Menon, Mandeep S Dhillon, Devendra K Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth Nabhirajappa Bilchod, Surya Udai Singh, Uttam Vaidya Gattu, Ravi Prabhakar Dashputra, Prashant Vitthal Rahate, Maurizio Turiel, Giuseppe De Blasio, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Eleonora Colnaghi, Vincenzo Salini, Giuseppe Denaro, Luigi Beretta, Giacomo Placella, Giuseppe Giardina, Mirko Binda, Anna Marcato, Luca Guzzetti, Fabio Piccirillo, Maurizio Cecconi, HM Khor, Hou Yee Lai, CS Kumar, KH Chee, PS Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL Ngim, Huck Wee Boon, Im Im Chin, Ydo V Kleinlugtenbelt, Ellie BM Landman, Elvira R Flikweert, Herbert W Roerdink, Roy B.G. Brokelman, Hannie F Elskamp-Meijerman, Maarten R Horst, Jan-Hein MG Cobben, Anila Anjum, Pervaiz Mehmood Hashmi, Tashfeen Ahmed, Haroon Ur Rashid, Mujahid Jamil Khattak, Rizwan Haroon Rashid, Riaz Hussain Lakdawala, Shahryar Noordin, Naveed Muhammed Juman, Robyna Irshad Khan, Muhammad Mehmood Riaz, Syedah Saira Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad Naqi Khan, Eraj Khurshid Khan, Kholood Abid Janjua, Sajjad Hassan Orakzai, Abdus Salam Khan, Khawaja Junaid Mustafa, Mian Amjad Sohail, Muhammad Umar, Siddra Ahmed Khan, Muhammad Ashraf, Muhammad Kashif Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla Thomas Ramokgopa, Gregory Bodley Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad Nasir Iqbal, Ryan Jonathan Campbell, Matimba Lenny Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B Nejthardt, Sean Chetty, Rubendren Naidoo, Miriam Garrido Clua, Vicente Molero-Garcia, Joan Minguell-Monyart, Jordi Selga Marsa, Juan A Porcel-Vazquez, Jose-Vicente Andres-Peiro, Marc Aguilar, Jaume Mestre-Torres, Maria J Colomina, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pedro Martinez-Ripol, MA Gonzalez Posada, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Pere Torner, Monsant Jornet-Gibert, Jorge Serrano-Sanz, Jaume Cámara-Cabrera, Mònica Salomó-Domènech, Christian Yela-Verdú, Anna Peig-Font, Laura Ricol, Anna Carreras-Castañer, Luis Martínez-Sañudo, Susana Herranz, Carlos Feijoo-Massó, Mònica Sianes-Gallén, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javiera Abarca, Cristina Estrada, Marga Novellas, Mercè Torra, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, JL Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J Aguado, Gonzalo Martinez-Municio, Ricardo León, Silvia Santiago-Maniega, Ana Zabalza, Gregorio Labrador, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Jose Manuel Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam Adel Kadry, Surendini Thayaparan, Ihab Abdlaziz, Arash Aframian, Arjuna Imbuldeniya, Souad Bentoumi, Sherif Omran, Marcela Paola Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE Mayor, Sally Dillingham, Laura Nicholson, Mohamed Elnaggar, Joby John, Shashi Kumar Nanjayan, Martyn J Parker, Susan O'Sullivan, Meir T Marmor, Amir Matityahu, Robert Trigg McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Gerard Slobogean, Katherine Joseph, Robert O'Toole, Marcus Sciadini, Scott P Ryan, Molly E Clark, Charles Cassidy, Konstantin Balonov, Sergio D Bergese, Laura S Phieffer, Alicia A Gonzalez Zacarias, Andrew J Marcantonio, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R Wells, Sandra N Ofori, Stephen S Yang, Michael K Wang, Emmanuelle Duceppe, Jessica Spence, Javiera P Vasquez, Francesc Marcano-Fernández, Hyungjoo Ham, Carlos Prada, Terence CH Yung, Isidro Sanz Pérez, Michael J Bosch, Michael R Prystajecky, Chinmoy Chowdhury, James S Khan, Steffan F Stella, Behrouz Heidary, Allen Tran, Katarzyna Wawrzycka-Adamczyk, Yu Chiao Peter Chen, Aránzazu González-Osuna, Grzegorz Biedroń, Anna Wludarczyk, Marco Lefebvre, Jaclyn A Ernst, Bas Staffhorst, Jason D Woodfine, Emad M Alwafi, Marko Mrkobrada, Simon Parlow, Robin Roberts, Finlay McAlister, David Sackett, James Wright, (HIP ATTACK, Investigators), Landoni, G., Faculty of Medicine and Pharmacy, Orthopaedics - Traumatology, Supporting clinical sciences, Emergency Medicine, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale

Subjects
Postoperative Complications/epidemiology, Male, Internationality, Femoral Neck Fractures/epidemiology, Arthroplasty, Replacement, Hip, Myocardial Ischemia, Comorbidity, Time-to-Treatment/statistics & numerical data, 030204 cardiovascular system & hematology, law.invention, Fracture Fixation, Internal, Postoperative Complications, 0302 clinical medicine, Randomized controlled trial, Residence Characteristics, law, Activities of Daily Living, Fracture fixation, Risk of mortality, Medicine and Health Sciences, Fracture Fixation, Internal/methods, Sepsis/epidemiology, 030212 general & internal medicine, Cardiovascular Diseases/mortality, Stroke, Aged, 80 and over, Hip fracture, Residence Characteristics/statistics & numerical data, Infections/epidemiology, General Medicine, Middle Aged, Open Fracture Reduction, Treatment Outcome, Cardiovascular Diseases, Diabetes Mellitus/epidemiology, Female, medicine.medical_specialty, Hip Fractures/epidemiology, Postoperative Hemorrhage, Infections, Early Medical Intervention/methods, Time-to-Treatment, 03 medical and health sciences, Arthroplasty, Replacement, Hip/methods, Early Medical Intervention, Sepsis, Diabetes Mellitus, medicine, Humans, Mortality, Myocardial Ischemia/epidemiology, Aged, Proportional Hazards Models, Postoperative Hemorrhage/epidemiology, Hip Fractures, Proportional hazards model, business.industry, Hemiarthroplasty/methods, Dementia/epidemiology, Delirium, Delirium/epidemiology, medicine.disease, Femoral Neck Fractures, Nursing Homes, Surgery, Open Fracture Reduction/methods, Dementia, Observational study, Hemiarthroplasty, business
Abstract

© 2020 Elsevier Ltd Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p

Published
2020

16. Wound Surface Area as a Risk Factor for Flap Complications among Patients with Open Fractures

Author

Bernhard Flatøy, Dominique M. Rouleau, Ripley Worman, Eric Ritchie, Brian Drew, Hilde Apold, J. Adam Smitherman, Kyle J. Jeray, P Beaumont, Kim Madden, Arjun Patil, Karine Tardif, Brad Pilkey, Cathrine Aga, Alexandre Denault, Fathima Adamsahib, Joseph O'Neill, James R. Ringler, Claude T. Moorman, Brian Mullis, Håvard Furunes, Jason Stoneback, Paul A. Martineau, S. Brennan McClure, Karyn Moon, Greg Etherington, Rejean Dumais, Ivan S. Tarkin, Stephanie L. Tanner, Terry Axelrod, Joy M. Bradford-Johnson, Chantal Théorêt, Ellen Langslet, Ali Al-Ashtari, Valda Frizzell, Ria De Gorter, Michel Malo, M.M. (Molly M.) Moore, Andrew R. Evans, Ramnov Andreson, Lauren C. Leffler, Nigar Sultana, Michelle Arakgi, Richard Freeman, Scott E Porter, John Murnaghan, Lisa K. Cannada, Joseph Alderete, Desmond Kwok, Michael D. McKee, Deepali Nassikars, Michael J. Bosse, Richard Jenkinson, Kevin Kuhn, Michael H. Weber, David R. Goetz, Robert Marien, Eric Lenczner, Katrine Milner, Gregory J. Della Rocca, Ajay Gupta, Farhad Moola, Torben Ianssen, Saam Morshed, Meir Marmor, Stephen P. Kingwell, Chetan Metha, Michael Connally, J. David Amirault, François Vézina, Oliver Muller, Joseph R. Hsu, Catherine Coady, Grant E. Garrigues, Diane Nam, Lori Kramer Clark, Taylor Vlack, J. Scott Broderick, Bang Hoang, Rebecca G. Snider, Anne Christine Brekke, Richard T. Laughlin, Ida Sletten, Lisa Buckingham, Jason Vourazeris, Gordon H. Guyatt, Darius Viskontas, Asgeir Amundsen, Travis C. Burns, Elton R Edwards, Edward J. Harvey, David Stephen, Eugene Wai, Michael R. Jabara, Andrea Garza, Austin D. Hill, Kevin R. Gurr, Stephen D. Walter, David J. Bielema, Karl D Shively, John Sadler, Mark D Macleod, Geir Aasmund Hjorthaug, Anthony Beardmore, Markku T Nousiainen, Vivek V. Jabade, Rani Rai, Kelly Trask, Julia Lee, Rena L. Stewart, Paula McKay, Emil H. Schemitsch, Sheila Sprague, Allen Diane, Sebastian Rodriguez-Elizalde, Ryan T. Bicknell, Nicolas Patenaude, Kevin L. Kirk, Paul Tornetta, Joshua A. Baumfeld, Christopher S. Bailey, Douglas G. Altman, Monica Kunz, Robert E. Turcotte, Kristen Walick, David P. Zamorano, Vinod Arora, Bernard Laliberté, Max Talbot, Jerald R. Westberg, Tore Fjalestad, Benjamin B. Barden, Chetan Prabhakar Puram, Andrew Gong, Shalini Ramasunder, Petter Iversen, R. Lee Murphy, Jean François Joncas, Timothy J. Miller, Raymond A. Pensy, Michael J. Maughon, Lori Wood, Robert G. McCormack, Dmitry Tuder, Veronica M R Wadey, Timothy Carey, Kristoff Reid, Patrick Henry, Anthony S. Rhorer, Marc André Magalhaes-Grave, Vinit Yadav, Michael J. Prayson, John Clarke-Jenssen, Vera Halvorsen, Kerry Tai, Narayan J. Karne, Stéphane Leduc, Kathryn Hornbuckle, Melissa M. Earles, Joel S. Finkelstein, Robin R. Richards, Joseph Cox, Tor Nicolaysen, Lisa Blackrick, Arthur Kreitenberg, Aaron T. Creek, Debra L. Sietsema, Peder Bogsti, Mark Glazebrook, Donna Lopez, Martin Bédard, Michael L. Beckish, Jonathan Kwong, Peter A. Siska, John A. Tanksley, Brett D. Crist, François Cabana, Mary Fan, Annie Deshaies, Debra Bartley, Nurit Shadmi, Wesley G. Lackey, Henry Ahn, Rachel M. Reilly, Linda K. Anderson, Dustin M. Price, Frede Frihagen, Brian E. Brigman, David Nelles, Mickey S Cho, Jeff Anglen, Kevin K. Kruse, Melanie MacNevin, Jonathan L. Foret, Jan Egil Brattgjerd, John F. Tilzey, Garland K. Gudger, Steve Rocha, G. Yves Laflamme, Kelly L. Apostle, Utku Kandemir, Aaron Nauth, Ivan Wong, Brian J. Miller, Rudy Reindl, Krishan Rajaratnam, Marie Eve Roger, William D. Fisher, Ash Moaveni, Patrick Yoon, David Sanders, Julia Foxall, Otis Wang, Shea A. Bielby, Maria Manson, Yvonne M. Murtha, Nikoletta Leontaritis, Russell Miller, Terrence J. Endres, Andrew H. Schmidt, Laurie Barron, David Alexander, Dennis W. Mann, H. Michael Lemke, Benjamin S. Koch, Gilbert Ortega, Nikia Hawkins Malone, Rina L. Harman, A. Navaladi Shankar, Parag Sancheti, Mauri Zomar, Dave Brown, Matthan Mammen, Dana J. Farrell, Piotr A Blachut, John D. Adams, Zoe Murdoch, Tom Treseder, Scott T. Watson, Fredrik Nilsen, Matthew Denkers, Wade Gofton, Jennifer Downey, Raymond Topp, Garth Johnson, Sissel Knuts, Raman Johal, Prerana N. Patel, Harvinder Bedi, Milena R. Vicente, Michael Tanzer, Markus Bischoff, Anders Lippert, Pascale Lévesque-Bernier, Hélène Côté, Brian Jolley, Gilbert Moatshe, Christina Tieszer, Richard C. Mather, Roman Trimba, Mohit Bhandari, Henry M Broekhuyse, Janos P. Ertl, Patrick M. Osborn, Michael Biddulph, Neeraj Jain, Grant W. Bennett, Gerard P. Slobogean, Samuel B. Adams, Kelly M. Sullivan, Atul Patil, Warren Kactmas, Mahesh Bhatia, Murat Pekmezci, Siraj Sayeed, David S. Ruch, Lawrence K. O'Malley, Jonas Rydinge, Michael Charlton, Michael S. Kain, Vivek Tyagi, Kathleen Markley, Rajiv Gandhi, Pierre Ranger, Mathias Russ, Dale Williams, Peter Jarzem, Lauren A. Nastoff, Craig Donohue, Gunnar B. Flugsrud, Bernard LaRue, Shelley MacDonald, Trevor Stone, Amy Svotelis, Stéphane Pelet, Mark J. Lemos, Michael Gross, Dean C. Taylor, Matthew Ross, Luc Petitclerc, Robert K. Lark, Jane E. Walker, Pierre Lavallée, Wesley Ghent, Fraser J. Leversedge, C. Glen Richardson, Deanna Lawson, Martin Tynan, Eric Meinberg, Stephen Doig, Jason A. Lowe, Veronica Place, Tim Dwyer, Jeffrey T. Leary, J Andrew I Trenholm, Andrew Chia, William M. Oxner, Richard Holtby, Thomas F. Varecka, Justin W. Langan, Ted Tufescu, Melanese Leonard, Lu Ton, Jeremy A. Hall, S. Samuel Bederman, Steve Csongvay, Bertrand Perey, Adam Dowrick, Stephen H. Finley, Steven A. Olson, Katherine M. Bedigrew, James P. Stannard, Phelan Shea, Leslie Dillender, Dory Boyer, Damian Rispoli, Ashley Carr, Steven Papp, Trigg McClellan, Clifford B. Jones, Erik Nott, Nitin N. Bhatia, Deeba Pourmand, Kelly A Lefaivre, Michael J. Dunbar, Peter J O'Brien, Luc Bédard, Chad P. Coles, Doug Li, Drew Bednar, Albert Yee, Bill Ristevski, Tod Gerlinger, Benoit Benoit, Aaron R. Campbell, Mette Renate Andersen, James P. Waddell, Jean Lamontagne, David A. Volgas, Diane Heels-Ansdell, Andrew J. Marcantonio, Alison P. Toth, David R. Pichora, Min Zhan, Harsha Malempati, Lars Nordsletten, Richard W. Gurich, Kiran M. Doshi, Robert J. Teasdall, Earl R. Bogoch, Matthew D. Karam, David M. Conner, Hans J. Kreder, Guri Ranum Ekås, Dylan J. Watson, Linda Lépine, Tanya Nix, Chris Graham, Tigist Belaye, Are Haukåen Stødle, Aravin Duraikannan, John Magne Hoseth, Nathan N O'Hara, Erick G. Torres, Elise Berg Vesterhus, Anthony E. Johnson, William Min, Michael Ford, Leslie Barnes, Jessica Goldstein, Anil Rai, Samuel G. Agnew, Thomas M. Schaller, Hamish Curry, S. Matthew Hollenbeck, Lorra M. Sharp, Fiona Howells, Abdel Lawendy, Donald Gajewski, Richard Coughlin, Max Esser, Chard Harbour, Stéphane Ricard, Gerald Reardon, Luc Lemire, Julie Fournier, Raely Moon, Brad Petrisor, James R. Ficke, Greg Berry, David Johnston, Allan Hammond, Jennifer T. Hidy, K. Rai, Daniel B. Whelan, Marius Molund, John S. Garfi, Greg Maytok, R. Saravana, Eugene Ek, Matthew Robinson, Emily Keener, Mark Burman, Frédéric Balg, Jeffrey O. Anglen, Fiona Houghton, Stacee W. Clawson, Morten Smedsrud, Claire Sage, Ross Leighton, Timothy R. Daniels, Lyle T. Jackson, Susan Liew, Neelam Jhangiani, Anoop Dubey, Richard M. Wilk, Robert D. Zura, Julian Sernik, Kim Hemlock, and Michael P. Bolognesi

Subjects
Adult, Male, medicine.medical_specialty, Soft Tissue Injuries, Limb salvage, Treatment outcome, Aftercare, Wound surface, Surgical Flaps, Fractures, Open, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Medicine and Health Sciences, medicine, Humans, 030212 general & internal medicine, Risk factor, Aged, integumentary system, business.industry, Open surgery, Trauma center, Middle Aged, Limb Salvage, Surgery, Logistic Models, Treatment Outcome, 030220 oncology & carcinogenesis, Shock (circulatory), Female, medicine.symptom, business
Abstract

Copyright © 2018 by the American Society of Plastic Surgeons. Background: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm2 are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft-tissue reconstruction with a rotational flap or free tissue transfer. Methods: This study was a secondary analysis of Fluid Lavage in Open Wounds trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture. The primary outcome was flap-related reoperation within 12 months of injury. The secondary outcome was wound complication, which included events treated operatively or nonoperatively. Multivariable logistic regression was used to assess the association between wound size and outcomes, adjusting for confounders. Results: Seventeen percent of the 112 patients required a flap-related reoperation. A wound size greater than 200 cm2 was not associated with reoperation in an unadjusted model (p = 0.64) or adjusting for Gustilo type (p = 0.70). The sample had an overall wound complication rate of 47.3 percent. Patients with a wound size of greater than 200 cm2 were three times more likely to experience wound complications (OR, 3.05; 95 percent CI, 1.08 to 8.62; p = 0.04) when adjusting for moderate to severe wound contamination and wound closure in the operating room. Conclusion: The findings of this study demonstrate that wound surface area is an integral determinant for wound complication following soft-tissue flap treatment, but found no association between wound surface area and flap-related reoperation rates.

Published
2018

17. Evaluation of primary caregivers' perceptions on home trampoline use

Author

Kamary Coriolano, Supriya Singh, Megan Cashin, Timothy Carey, Debra L. Bartley, and Jacob Davidson

Subjects
medicine.medical_specialty, Future studies, media_common.quotation_subject, lcsh:Medicine, Health Informatics, Injury, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, Trampoline, 030225 pediatrics, Intervention (counseling), Perception, medicine, Children, media_common, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Regular Article, 030208 emergency & critical care medicine, Emergency department, Hospital care, Orthopedics, Family medicine, Orthopedic clinic, business
Abstract

Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children. Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention. The educational intervention was a pamphlet outlining trampoline safety data. Data analysis occurred in 2016. From the 100 primary caregivers recruited, 39 caregivers owned a trampoline, and 10 had presented to the emergency department with their child for an injury related to trampoline use. After educational intervention, caregivers had higher rating of perceived danger associated with trampolines (6/10 vs. 8/10, p, Highlights • Rating of perceived danger of trampolines increased after educational intervention. • Educational intervention improved knowledge of safe trampoline practices. • Caregivers are receptive to recommendations against trampoline use from physicians. • Two-thirds agreed that trampolines are dangerous after educational intervention. • After education half of caregivers would still allow their child to use trampolines.

Published
2018

18. Questions of condom use in the Muslim and Catholic response to HIV and AIDS in Nairobi, Kenya

Author

Timothy Carey

Subjects
030219 obstetrics & reproductive medicine, business.industry, Perspective (graphical), Religious studies, Human immunodeficiency virus (HIV), Gender studies, Human sexuality, Bioethics, medicine.disease, medicine.disease_cause, law.invention, Gender Studies, 03 medical and health sciences, Grassroots, 0302 clinical medicine, Condom, Acquired immunodeficiency syndrome (AIDS), law, Capital city, Medicine, 030212 general & internal medicine, business
Abstract

Religious leaders in Roman Catholic and Sunni Muslim communities in Kenya’s capital city of Nairobi are charged with responding in an official capacity to the pressing concerns facing their respective communities both theologically and practically. However, speaking about sexuality from a religious perspective particularly on the use of condoms in AIDS prevention has been rather troublesome topic many leaders and clergy find problematic discussing openly. This paper offers a comparative analysis of Muslim and Catholic views on sexuality by establishing the parameters within which to consider the presence and activity of Catholic and Muslim leaders in Kenya and the holistic, grassroots approach in responding to the AIDS epidemic in Nairobi regarding condom use.

Published
2017

19. The creation of a national coalition to target adolescent idiopathic scoliosis: a meeting report

Author

Milena, Cioana, Devin, Peterson, Paul, Missiuna, Ron, El-Hawary, Timothy, Carey, Murray A, Potter, Laura, Banfield, Lehana, Thabane, and M Constantine, Samaan

Subjects
pediatric, adolescent idiopathic scoliosis, Meeting Report, childhood scoliosis, coalition
Abstract

In this report, we document the discussions and recommendations of a national conference designed to create a coalition to tackle adolescent idiopathic scoliosis (AIS) held on June 6 and 7, 2017 in Hamilton, ON, Canada. The goal of the establishment of this coalition is to join the efforts of patients, parents, physicians, researchers and other stakeholders to identify stakeholders’ perspectives and to categorize gaps in knowledge and target further AIS research and clinical care priorities. The participants’ main priorities included focus on shared decision making regarding clinical and research priorities between the stakeholders on the clinical, research and policy sides with patients and families. In addition, improvements in the dissemination of information via digital platforms and identification of cost-effective screening strategies that may help early identification and intervention were also recognized as a priority. Commitment was reached to form a national coalition to understand the determinants of this condition and enhance patient outcomes through improved clinical care and research efforts.

Published
2019

20. Rigid intramedullary nail fixation of traumatic femoral fractures in the skeletally immature

Author

Megan Cashin, Abdel Lawendy, Debra Bartley, Christopher Del Balso, and Timothy Carey

Subjects
medicine.medical_specialty, Greater trochanter, complications, pediatrics, business.industry, osteonecrosis, Nonunion, medicine.disease, law.invention, Surgery, Clinical/Basic Science Research Article, Intramedullary rod, Femoral head, medicine.anatomical_structure, skeletally immature, law, medicine, femur, Femur, Heterotopic ossification, Malunion, intramedullary nail, business, Fixation (histology)
Abstract

Objective: To determine the rate of femoral head osteonecrosis, and other complications following rigid intramedullary (IM) nail fixation of traumatic diaphyseal femur fractures through the greater trochanter in the skeletally immature. Design: Retrospective review, case series. Setting: Level I academic trauma center. Patients/Participants: One hundred forty-eight traumatic pediatric diaphyseal femur fractures in 145 patients treated with rigid IM nail fixation from November 1, 2004 to December 31, 2018. Intervention: Rigid intramedullary nail fixation of traumatic diaphyseal femur fractures through a trochanteric start point in the skeletally immature. Main outcome measurement: Rate of osteonecrosis of the femoral head. Results: Sixty-five fractures in 64 skeletally immature patients met inclusion criteria. Motor vehicle collisions were implicated in 32 fractures. Of the 65 fractures, 5 were open. All rigid IM nails were anterograde with a trochanteric start point. Mean radiographic follow-up was 27.4 ± 8.1 months. Twenty-two patients experienced postoperative pain and/or hardware irritation, with 24 patients (36.9%) undergoing reoperation for hardware removal. No occurrences of infection, malunion, nonunion, refracture, venous thromboembolism, fat embolism, significant leg length discrepancy, or femoral head osteonecrosis were documented. Two cases of heterotopic ossification were observed, 1 requiring surgical excision, yielding a complication rate of 3.1%. Conclusions: No cases of femoral head osteonecrosis were observed following treatment of 65 traumatic diaphyseal femur fractures with rigid IM nailing through the greater trochanter with a mean radiographic follow-up of 27 months. Rigid IM nail fixation with a trochanteric start point is both safe and efficacious for management of diaphyseal femur fractures in the skeletally immature.

Published
2021

22. Fracture and Nonaccidental Injury: A Case Report of a Lateral Condylar Fracture in a 13 Month Old

Author

Rodrick Lim, Helen Levin, Gurinder Sangha, and Timothy Carey

Subjects
Child abuse, Pediatrics, medicine.medical_specialty, Fractures, Multiple, Radiography, Primary care, Condyle, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Battered Child Syndrome, medicine, Risk of mortality, Humans, 030212 general & internal medicine, Child Abuse, business.industry, Infant, General Medicine, Emergency department, Surgery, Pediatrics, Perinatology and Child Health, Emergency Medicine, Female, business, Emergency Service, Hospital
Abstract

Pediatric nonaccidental injury (NAI) is an important entity that is commonly seen in a variety of medical settings. These children often present to the emergency department or primary care physicians as the first point of contact after an NAI. There is a major risk associated with nonrecognition of an NAI, including a 35% chance of subsequent injury and a 5% to 10% risk of mortality. Therefore, it is essential for physicians to be vigilant when assessing injuries compatible with NAI, especially in infants and young children who are not able to independently express themselves. As fracture is the second most common manifestation of NAI, practitioners should be vigilant to recognize unusual fractures in atypical age ranges to aid in its diagnosis. Here, we present a novel case of a lateral condylar fracture in an almost 13-month-old-child that has not been previously associated with NAI.

Published
2016

23. Prevalence of Radiographic Findings Consistent With Femoroacetabular Impingement in Military Personnel With Femoral Neck Stress Fractures

Author

John Bojescul, Timothy Carey, Timothy Biega, David L. Oliver, and Christian Key

Subjects
Male, medicine.medical_specialty, Fractures, Stress, Radiography, Risk Factors, Femoracetabular Impingement, medicine, Humans, Femoroacetabular impingement, Retrospective Studies, Femoral neck, Stress fractures, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Magnetic resonance imaging, Retrospective cohort study, General Medicine, medicine.disease, Femoral Neck Fractures, Surgery, Military Personnel, medicine.anatomical_structure, Cohort, Female, Stress, Mechanical, business
Abstract

A femoral neck stress fracture is a serious condition that affects military personnel and endurance athletes. There is increasing evidence that femoroacetabular impingement contributes to significant hip pathology. This study investigates the prevalence of radiographic abnormalities associated with impingement in military personnel treated for femoral neck stress fractures. The radiographs of 69 consecutive soldiers being treated for a femoral neck stress fracture identified on magnetic resonance imaging were reviewed for radiographic signs of femoroacetabular impingement. In the cohort, the average incidence of a crossover sign was 51% (27/53). The incidence of a center edge angle greater than 40° was 47% (25/53). The alpha angle was greater than 50° in 55% (29/53). In conclusion, it appears that young patients with femoral neck stress fractures have a high prevalence of radiographic abnormalities suggestive of hip impingement. Hip impingement may lead to abnormal stress across the femoral neck, predisposing individuals to stress fractures.

Published
2013

24. Does Participation in a Randomized Clinical Trial Change Outcomes? An Evaluation of Patients Not Enrolled in the SPRINT Trial

Author

Pamela Leece, Diane Heels-Ansdell, Marc F. Swiontkowski, Rudolf W. Poolman, Kevin R. Gurr, Sheila Sprague, Michael J. Bosse, Mohit Bhandari, Tashay Mignott, Bruce D. Browner, Paul Tornetta, K. Kellie Leitch, Stuart Bailey, Carol Lin, Lisa Buckingham, Peter J O'Brien, Alan L. Jones, David W. Sanders, Mark D Macleod, Natalie Sidorkewicz, Jesse A. Berlin, Claire Bombardier, Charlene Bartha, Gordon H. Guyatt, Ken Konito, Helena Viveiros, Julie Agel, Timothy Carey, Brenda Gillespie, David Sanders, Emil H. Schemitsch, Natalie Ansell, Stephen D. Walter, Amsterdam Movement Sciences, Surgery, Other Research, Emergency Department, Orthopedic Surgery and Sports Medicine, and Other departments

Subjects
Male, medicine.medical_specialty, Canada, Nonunion, law.invention, Intramedullary rod, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Fracture fixation, Medicine and Health Sciences, Prevalence, Medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, reamed, Netherlands, Randomized Controlled Trials as Topic, business.industry, Patient Selection, General Medicine, Odds ratio, tibia fracture, Middle Aged, medicine.disease, unreamed, Confidence interval, United States, Surgery, Fracture Fixation, Intramedullary, Clinical trial, Tibial Fractures, Treatment Outcome, Sprint, nonunion, 030220 oncology & carcinogenesis, Female, Patient Participation, business, human activities
Abstract

© Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. Objectives: To determine the extent to which knowledge from clinical trial protocols is transferred to nonparticipating patients. Design: Retrospective review of prospectively collected data from a large clinical trial. Setting: Six level-1 international trauma centers. Methods: We compared rates and timing of reoperation in a subset of patients enrolled in the Study to Prospectively evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) to concurrent patients who were eligible but not enrolled. This was a retrospective review of prospectively collected trial data. The records of 6 of the original SPRINT centers were searched for non-SPRINT patients who underwent intramedullary nailing of a closed tibial fracture. The rate and timing of reoperation were compared. A P < 0.05 was considered significant. Results: One hundred fourteen non-SPRINT patients were compared with 328 patients enrolled in SPRINT from those same sites. There were 7 reoperations (6.1%) in non-SPRINT patients versus 18 (5.2%) in SPRINT patients [odds ratio (OR) 1.19, 95% confidence interval (CI) 0.41 to 3.13; P 0.811]. There was no difference in the time to reoperation between the SPRINT and non-SPRINT patients (6.2 vs. 6.8 months, 95% CI of the difference -3.8 to 2.6; P 0.685) or in the proportion of patients who underwent reoperation before 6 months (29% vs. 43%; OR 1.75; 95% CI 0.18 to 15.41; P 0.647). Conclusions: Patients not enrolled in SPRINT had similarly low rates of reoperation for nonunion, and the average time to reoperation for both groups was longer than 6 months. A 6-month waiting period may have allowed slow-to-heal fractures adequate time to heal, thereby reducing the rate of diagnosis of nonunion. As such, this waiting period could contribute to lower-than-expected reoperation rates for nonunion. It is possible that clinical trials may beneficially influence the care of nonenrolled patients.

Published
2016

25. Development of a Competence-Based Spine Surgery Fellowship Curriculum Set of Learning Objectives in Canada

Author

Douglas Hedden, Joel S. Finkelstein, Eugene Wai, Sean Christie, Jerome Paquet, Donald Chow, Eve C. Tsai, Robert Broad, Richard C. Fox, Jeremie Larouche, Hamilton Hall, Veronica M R Wadey, Kris Lundine, John Hurlbert, Andrew Nataraj, Christopher S. Bailey, Paul J. Moroz, Iain Dommisse, Michael G. Fehlings, Michael Goytan, Jan Splawinski, Albert Yee, Eric M. Massicotte, Timothy Carey, Michael P. Chapman, Scott Paquette, Charles G. Fisher, Jacques Bouchard, Henry Ahn, and Brian Wheelock

Subjects
medicine.medical_specialty, Canada, media_common.quotation_subject, education, 03 medical and health sciences, 0302 clinical medicine, Spine surgery, Voting, Medicine, Humans, Orthopedics and Sports Medicine, Orthopedic Procedures, 030212 general & internal medicine, Fellowships and Scholarships, Curriculum, Competence (human resources), media_common, Medical education, business.industry, Background data, Cognition, Preceptor, Spine, Surgery, Spine Fellowship, Neurology (clinical), Clinical Competence, business, 030217 neurology & neurosurgery
Abstract

STUDY DESIGN Modified-Delphi expert consensus method. OBJECTIVE The aim of this study was to develop competence-based spine fellowship curricula as a set of learning goals through expert consensus methodology in order to provide an educational tool for surgical educators and trainees. Secondarily, we aimed to determine potential differences among specialties in their rating of learning objectives to defined curriculum documents. SUMMARY OF BACKGROUND DATA There has been recent interest in competence-based education in the training of future surgeons. Current spine fellowships often work on a preceptor-based model, and recent studies have demonstrated that graduating spine fellows may not necessarily be exposed to key cognitive and procedural competencies throughout their training that are expected of a practicing spine surgeon. METHODS A consensus group of 32 spine surgeons from across Canada was assembled. A modified-Delphi approach refined an initial fellowship-level curriculum set of learning objectives (108 cognitive and 84 procedural competencies obtained from open sources). A consensus threshold of 70% was chosen with up to 5 rounds of blinded voting performed. Members were asked to ratify objectives into either a general comprehensive or focused/advanced curriculum. RESULTS Twenty-eight of 32 consultants (88%) responded and participated in voting rounds. Seventy-eight (72%) cognitive and 63 (75%) procedural competency objectives reached 70% consensus in the first round. This increased to 82 cognitive and 73 procedural objectives by round 4. The final curriculum document evolved to include a general comprehensive curriculum (91 cognitive and 53 procedural objectives), a focused/advanced curriculum (22 procedural objectives), and a pediatrics curriculum (22 cognitive and 9 procedural objectives). CONCLUSION Through a consensus-building approach, the study authors have developed a competence-based curriculum set of learning objectives anticipated to be of educational value to spine surgery fellowship educators and trainees. To our knowledge, this is one of the first nationally based efforts of its kind that is also anticipated to be of interest by international colleagues.

Published
2016

26. The origins ofEleocharis(Cyperaceae) and the status ofWebsteria,Egleria, andChillania

Author

Ariel Lliully, Eric H. Roalson, Timothy Carey, and Cody E. Hinchliff

Subjects
Paraphyly, biology, Phylogenetic tree, Ecology, Genus, Range (biology), Eleocharis, Plant Science, Cyperaceae, Clade, biology.organism_classification, Ecology, Evolution, Behavior and Systematics, NdhF
Abstract

Eleocharis R. Br. is an ecologically and economically important genus that contains about 250 species of annual and perennial sedges, with centers of diversity in seasonally wet tropical to subtropical regions. Phylogenetic relationships in the genus are poorly understood, particularly in relation to three monotypic genera—Egleria L.T. Eiten, Chillania Roivainen, and Websteria (Poir.) S. Hooper—which have been variously included or excluded from Eleocharis in different classifications. These genera, while morphologically distinct, show characteristics that fall within the range of variation seen in Eleocharis. The relationship between the clade containing Eleocharis and these segregate genera (i.e., Eleocharideae) and the rest of Cyperaceae has also been difficult to determine from previous studies, and numerous conflicting hypotheses have been suggested. To address these uncertainties, we sequenced cpDNA from the ndhF and psbB-psbH marker regions and used it to reconstruct the phylogenetic history of Eleocharis and a broad sample of other Cyperaceae. We found that Egleria and Websteria are derived from within Eleocharis, and that this clade, representing the Eleocharideae, is sister to the Abildgaardieae. Chillania could not be included in the molecular dataset, but its morphology suggests it should be included in Eleocharis. New nomenclature is suggested to place the species of Chillania, Egleria, and Websteria in Eleocharis. Our phylogenetic reconstructions also indicate several other instances of generic paraphyly in other Cyperaceae lineages.

Published
2010

27. Anterior cruciate ligament augmentation for rotational instability following primary reconstruction with an accelerated physical therapy protocol

Author

Timothy Carey, John Bojescul, David L. Oliver, Terry L. Mueller, and Josh E Pniewski

Subjects
Adult, Joint Instability, Male, Reoperation, medicine.medical_specialty, Anterior cruciate ligament reconstruction, Rotation, medicine.medical_treatment, Anterior cruciate ligament, Arthroscopy, Young Adult, medicine, Humans, Rating system, Anterior Cruciate Ligament, Physical Therapy Modalities, medicine.diagnostic_test, Anterior Cruciate Ligament Reconstruction, business.industry, Joint instability, General Medicine, Lower Extremity Functional Scale, musculoskeletal system, Combined Modality Therapy, Surgery, Accelerated rehabilitation, surgical procedures, operative, medicine.anatomical_structure, Treatment Outcome, Physical therapy, Female, Augment, business
Abstract

The purpose of the present study is to present the results of anterior cruciate ligament (ACL) augmentation for patients having rotational instability despite an intact vertical graft in lieu of conventional revision ACL reconstruction. ACL augmentation surgery with a horizontal graft was performed to augment a healed vertical graft on five patients and an accelerated rehabilitation protocol was instituted. Functional outcomes were assessed by the Lower Extremity Functional Scale (LEFS) and the Modified Cincinnati Rating System (MCRS). All patients completed physical therapy within 5 months and were able to return to full military duty without limitation. LEFS and MCRS were significantly improved. ACL augmentation with a horizontal graft provides an excellent alternative to ACL revision reconstruction for patients with an intact vertical graft, allowing an earlier return to duty for military service members.

Published
2013

28. Pediatric clavicular fractures: assessment of fracture patterns and predictors of complicated outcome

Author

Timothy Carey, Rodrick Lim, Jamie A. Seabrook, and Benjamin Jacob Strauss

Subjects
medicine.medical_specialty, Pediatrics, Adolescent, Radiography, Nonunion, Dermatitis, Logistic regression, Fractures, Bone, Sex Factors, Risk Factors, Confidence Intervals, Odds Ratio, Medicine, Humans, Malunion, Child, Fractures, Malunited, Fractures, Comminuted, Retrospective Studies, business.industry, Age Factors, medicine.disease, Clavicle, Surgery, Logistic Models, Radiological weapon, Child, Preschool, Fractures, Ununited, Emergency Medicine, Diaphyses, Presentation (obstetrics), business, Complication, Biomedical sciences
Abstract

Background Clavicular fractures are the most common pediatric long-bone fracture, and although the vast majority heal with supportive treatment, complications do occur and can lead to pain and disability. Although many studies have characterized adult complication rates and risk factors, to our knowledge no comparable studies to date have looked at clavicular fractures in the pediatric population. Study Objectives The study aim was to identify the radiological and clinical variables that increase the complication rate of clavicular fractures. Identification of these variables would help emergency physicians identify patients who require more thorough follow-up or surgical intervention. Methods We analyzed radiographs of 537 clavicular fractures on initial presentation to the Pediatric Emergency Department at the Children's Hospital at London Health Sciences Center over a 4-year period, collecting data on variables such as displacement, angulation, and comminution, as well as demographic data such as age and gender. We then determined the outcome of each fracture by reviewing each patient’s chart, and through a logistic regression analysis, determined the variables associated with complications. Results Of all the fractures treated supportively (i.e., non-operatively), only 2.5% resulted in a complication. Our analysis determined that patient age was an independent predictor of complications, with each year past zero conferring an 18.1% increase in risk of complication. Furthermore, completely displaced fractures were shown to increase the odds of complication by a factor of 3.2. Conclusion These findings help the emergency physician identify a group of high-risk pediatric patients with clavicular fractures for which more thorough follow-up should be considered.

Published
2010

29. Changes in dendritic cell phenotype after a new high-dose weekly schedule of interleukin-2 therapy for kidney cancer and melanoma

Author

Mary Dunn, Dawn Goetz, Adil Daud, Mayer Fishman, Scott J. Antonia, Ingo Fricke, Timothy Carey, P. Urbas, Ronald C. DeConti, Daohai Yu, Steven E. Finkelstein, Dmitry I. Gabrilovich, and Megan Gratz

Subjects
Interleukin 2, Oncology, Adult, Male, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Immunology, Biomarkers, Pharmacological, Immunophenotyping, Internal medicine, medicine, Immunology and Allergy, Humans, Myeloid Cells, Neoplasm Metastasis, Antigen-presenting cell, Melanoma, Aged, Pharmacology, business.industry, Cancer, Antineoplastic Protocols, Cell Differentiation, Immunotherapy, Dendritic Cells, Middle Aged, medicine.disease, Prognosis, Kidney Neoplasms, Cytokine, Treatment Outcome, Feasibility Studies, Interleukin-2, Female, business, Kidney cancer, medicine.drug, Kidney disease
Abstract

High-dose intravenous interleukin-2 (IL-2) therapy (14 doses/course, 2 courses/cycle) for metastatic melanoma or kidney cancer induces infrequent, although major responses. In this trial, we evaluated a new schedule (dose of 600,000 IU/kg, 8 h between doses, 5 doses/course, 4 courses at weekly intervals/cycle) of high-dose IL-2, in which we inserted more planned breaks while maintaining high cumulative dose delivery, and investigated the relationship between dendritic cells (DC) and response to treatment. Target dose delivery was attained: median IL-2 cumulative dose per patient was 11.4 and 10.8 million units/kg (cycles 1 and 2, respectively). Major responses were observed in patients with kidney cancer (n=20; 3 complete and 2 partial responses) and melanoma (n=16; 1 partial response). Adverse events appeared comparable with those typically associated with high-dose IL-2. From this data set, we introduce the hypothesis-generating observation that patients who had more favorable outcomes had high pretreatment DC-to-myeloid-derived suppressor cell (MDSC) ratios, similar to the ratio observed in healthy individuals. However, even in patients with the most favorable outcome, after treatment, there were IL-2-induced changes in the DC-to-MDSC ratio, specifically increases in MDSCs. This modified IL-2 schedule is a feasible option, with a more uniform dose delivery over the treatment cycle, a similar toxicity profile, and observed complete, durable response in patients with renal cancer. Pretreatment assessment of DC phenotypic or maturational status may be a starting point to predicting response to high-dose IL-2 cytokine immunotherapy in patients with melanoma and kidney cancer.

Published
2010

30. Predicting gender differences as latent variables: summed scores, and individual item responses: a methods case study

Author

Ricardo, Pietrobon, Marcus, Taylor, Ulrich, Guller, Laurence D, Higgins, Danny O, Jacobs, and Timothy, Carey

Subjects
Male, Models, Statistical, Outcome Assessment, Psychometrics, Statistical Models, Research, Gender, lcsh:Computer applications to medicine. Medical informatics, Disability Evaluation, Sex Factors, Low-back pain, Back Pain, Research Design, Data Interpretation, Statistical, Sickness Impact Profile, Surveys and Questionnaires, Outcome Assessment, Health Care, Confidence Intervals, North Carolina, Humans, Regression Analysis, lcsh:R858-859.7, Female, Forecasting, Probability
Abstract

Background Modeling latent variables such as physical disability is challenging since its measurement is performed through proxies. This poses significant methodological challenges. The objective of this article is to present three different methods to predict latent variables based on classical summed scores, individual item responses, and latent variable models. Methods This is a review of the literature and data analysis using "layers of information". Data was collected from the North Carolina Back Pain Project, using a modified version of the Roland Questionnaire. Results The three models are compared in relation to their goals and underlying concepts, previous clinical applications, data requirements, statistical theory, and practical applications. Initial linear regression models demonstrated a difference in disability between genders of 1.32 points (95% CI 0.65, 2.00) on a scale from 0–23. Subsequent item analysis found contradictory results across items, with no clear pattern. Finally, IRT models demonstrated three items were demonstrated to present differential item functioning. After these items were removed, the difference between genders was reduced to 0.78 points (95% CI, -0.99, 1.23). These results were shown to be robust with re-sampling methods. Conclusions Purported differences in the levels of a latent variable should be tested using different models to verify whether these differences are real or simply distorted by model assumptions.

Published
2004

31. Computer Validation

Author

Timothy Horgan and Timothy Carey

Subjects
Focus (computing), Process management, Computer science, Compliance (psychology)
Published
2003

32. Point of View

Author

Timothy Carey

Subjects
Orthopedics and Sports Medicine, Neurology (clinical)
Published
1995

33. Inhaled No Vs. Intravenous Nitroprusside in Neonatal Pulmonary Hypertension: Randomized Trial at a Center Without ECMO 1723

Author

Timothy Carey and Joaquim M.B. Pinheiro

Subjects
Pediatrics, medicine.medical_specialty, surgical procedures, operative, Randomized controlled trial, law, business.industry, Anesthesia, Pediatrics, Perinatology and Child Health, medicine, Neonatal pulmonary hypertension, business, law.invention
Abstract

Inhaled No Vs. Intravenous Nitroprusside in Neonatal Pulmonary Hypertension: Randomized Trial at a Center Without ECMO 1723

Published
1998

34. Clinical procedures manual for remote and rural practice: supporting clinical practice in the bush

Author

Sabina Knight, Andrew White, Caitlin Steiner, Chris Del Mar, Christine Connors, Frances Vaughan, Janet Struber, Jo Wright, Kerrie Gell, Nick Williams, George Tripe, Peter McCormack, Rosemary Schmidt, Andrew Lee, Carolyn MacLennan, Gaynor Garstone, Graeme Maguire, Jane Smith, Malcolm Mcdonald, Nathan Ryder, Paul Lawton, Peter May, Rachael Lockley, Rosalie Schultz, Shelley Crowther, Simon Kane, Steve Margolis, Timothy Carey, Ahmed Latif, Alan Cass, Alison Mustapha, Amanda Sanburg, Andrew Bezzina, Andrew Crowhurst, Andrew McCallum, Anne Bromhead, Anne Chang, Anne Davis, Annie Tangey, Anthony Brown, Bart Currie, Belinda Davis, Beth Amega, Bronwyn Silver, Bruce Simmons, Buddhima Lokuge, Phillips, Dr Cameron J., Cherian Sajiv, Dale Edgar, Damien Fagan, Daniel Ewald, Darryl Maybery, David Hockley, Dennis Pashen, Dion Dionysopoulos, Don Boldiston, Elise Beachley, Erik Tikoft, Fiona Wood, Geri Malone, Glenda Gleeson, Gregory Perry, Helen Vaughan, Hugh Taylor, Jason Warnock, Jennifer Alison, Joanna Keily, Joshua Davis, Julia Stewart, Keith Edwards, Lin Davis, Lisa Wallace, Louise Roufeil, Megan Halliday, Lesley Scott, Linda Medlin, Louise Maple-Brown, Lucy Little, Michele Luey, Patrick AhKit, Paul Torzillo, Peter Morris, Pippa Tessmann, Pippa Travers-Mason, Rae-Lin Huang, Ral Antic, Rita Apelt, Robert Parker, Rose Fahy, Rosemary Lee, Sandra Meihubers, Sarah Jackson, Sarah Larkins, Selina Taylor, Sharon Johnson, Rourke, Sharon O., Sheila Kavanagh, Sheryl Alexander, Sridhar Chitturi, Sue Kruske, Sue Orsmond, Sue Roth, Suzanne Connor, Timothy Henderson, Tina Hourigan, Tracy Johns, Warwick Beever, Alison Dawes, Allan Donnelly, Andrew Bisits, Anne Sneddon, Claire Boardman, David Ellwood, Donna Chung, Duncan Reed, Greg McHugh, Hannah Dahlen, Heather Mumme, Helen Land, Jenny May, Jonathon Ball, Judith Gardiner, Kathy Currie, Katie Sullivan, Koen De Decker, Libby Bowell, Lukas Arkapaw, Lyn Byers, Lyndall Young, Brien, Margaret O., Michael Nicholl, Pamela Wood, Peter Markey, Raelene Carroll, Rishi Narasimhan, Shaun Soloman, Shona Sandford, Steve Milanese, Steven Doherty, Susan Gordon, Sue Kildea, Susan Howell, Wendy Bowyer, Zi Li, Adeline Drogemuller, Alanna Watson, Andrew Urquhart, Anna Ralph, Anna Whitehead, Annie Hepner, Anton Drover, Antony Veale, Beverley Hamerton, Breanna Monk, Brycen Brook, Catherine Moody, Charles Douglas, Clare Golding, Colin Watson, Deborah Hales, Denise Sheedy, Diane Griffin, Dy Kelaart, Emslie Lankin, Evonne Thompson, Fabian Schwarz, Fay Clark, Frances Squires, Gayle Woodford, Graham Clegg, Holi Catton, Jacqueline Boyd, Jane Giles, Jeannie Campbell, Jennie McDowall, Jennifer Peters, Jeremy Downes, John Wright, Josephine Appoo, Joy Hussain, Kenneth McNeil, Keppel Schafer, Larissa Meneri, Laura Edwards, Lenaire Keatch, Lesley Woolf, Lynette Flynn, Marcel Campbell, Marjie Middleton, Mark Ramjan, Matthew Steer, Monica Ostigh, Noelene Simmonds, Patricia Woolven, Perry Burstin, Philip Hungerford, Rachael Charles, Rebecca Numina, Ree Dunn, Renita Kantawara, Sally Foxley, Sandra Bell, Sandra McElligott, Sharon Marchant, Stephen Permezel, Suzanne Lenthall, Tanya Gardner, Terrie Ivanhoe, Thea Nungala, Vicki Gordon, Stephanie MacKie-Schneider, Melinda Barlow, Allison Gray, Andrew Lal, Brenda Thornley, Dianne Bell, Erin Emmons, Georgina Brunsdon, Jessica Lopes, Sally Herring, and Sandeep Reddy

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