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  • 1
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    Online Resource
    Outcomes Following Operative Treatment of Adolescent Mallet Fractures
    SAGE Publications ; 2018
    In:  HSS Journal ® Vol. 14, No. 1 ( 2018-2), p. 83-87
    Details
    In: HSS Journal ®, SAGE Publications, Vol. 14, No. 1 ( 2018-2), p. 83-87
    Type of Medium: Online Resource
    ISSN: 1556-3316 , 1556-3324
    URL: Article
    DOI: 10.1007/s11420-017-9563-7
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2210985-7
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  • 2
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    Are Standard Diagnostic Test Characteristics Sufficient for the Assessment of Continual Patient Monitoring?
    SAGE Publications ; 2013
    In:  Medical Decision Making Vol. 33, No. 2 ( 2013-02), p. 225-234
    Details
    In: Medical Decision Making, SAGE Publications, Vol. 33, No. 2 ( 2013-02), p. 225-234
    Abstract: Background. For diagnostic processes involving continual measurements from a single patient, conventional test characteristics, such as sensitivity and specificity, do not consider decision consistency, which might be a distinct, clinically relevant test characteristic. Objective. The authors investigated the performance of a decision-support classifier for the diagnosis of traumatic injury with blood loss, implemented with three different data-processing methods. For each method, they computed standard diagnostic test characteristics and novel metrics related to decision consistency and latency. Setting. Prehospital air ambulance transport. Patients. A total of 557 trauma patients. Design. Continually monitored vital-sign data from 279 patients (50%) were randomly selected for classifier development, and the remaining were used for testing. Three data-processing methods were evaluated over 16 min of patient monitoring: a 2-min moving window, time averaging, and postprocessing with the sequential probability ratio test (SPRT). Measurements. Sensitivity and specificity were computed. Consistency was quantified through cumulative counts of decision changes over time and the fraction of patients affected by false alarms. Latency was evaluated by the fraction of patients without a decision. Results. All 3 methods showed very similar final sensitivities and specificities. Yet, there were significant differences in terms of the fraction of patients affected by false alarms, decision changes through time, and latency. For instance, use of the SPRT led to a 75% reduction in the number of decision changes and a 36% reduction in the number of patients affected by false alarms, at the expense of 3% unresolved final decisions. Conclusion. The proposed metrics of decision consistency and decision latency provided additional information beyond what could be obtained from test sensitivity and specificity and are likely to be clinically relevant in some applications involving temporal decision making.
    Type of Medium: Online Resource
    ISSN: 0272-989X , 1552-681X
    URL: Article
    DOI: 10.1177/0272989X12451059
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2040405-0
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  • 3
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    Analysis of Stored Osteochondral Allografts at the Time of Surgical Implantation
    SAGE Publications ; 2005
    In:  The American Journal of Sports Medicine Vol. 33, No. 10 ( 2005-10), p. 1479-1484
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 33, No. 10 ( 2005-10), p. 1479-1484
    Abstract: To date, the morphological, biochemical, and biomechanical characteristics of articular cartilage in osteochondral allografts that have been stored have not been fully described. Hypothesis Osteochondral allografts procured and stored commercially for a standard period as determined by tissue banking protocol will have compromised chondrocyte viability but preserved extracellular matrix quality. Study Design Controlled laboratory study. Methods Unused cartilage from 16 consecutive osteochondral allografts was sampled during surgery after tissue bank processing and storage. Ten grafts were examined for cell viability and viable cell density using confocal microscopy, proteoglycan synthesis via 35 SO 4 uptake, and glycosaminoglycan content and compared with fresh cadaveric articular cartilage. Biomechanical assessment was performed on the 6 remaining grafts by measuring the indentation stiffness of the cartilage. Results The mean storage time for the transplanted specimens was 20.3 ± 2.9 days. Chondrocyte viability, viable cell density, and 35 SO 4 uptake were significantly lower in allografts at implantation when compared to fresh, unstored controls, whereas matrix characteristics, specifically glycosaminoglycan content and biomechanical measures, were unchanged. In addition, chondrocyte viability in the stored allografts was preferentially decreased in the superficial zone of cartilage. Conclusion Human osteochondral allografts stored for a standard period (approximately 3 weeks) before implantation undergo decreases in cell viability, especially in the critically important superficial zone, as well as in cell density and metabolic activity, whereas matrix and biomechanical characteristics appear conserved. The exact clinical significance of these findings, however, is unknown, as there are no prospective studies examining clinical outcomes using grafts stored for extended periods. Clinical Relevance Surgeons who perform this procedure should understand the cartilage characteristics of the graft after 21 days of commercial storage in serum-free media.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546505275010
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2063945-4
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  • 4
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    Inherent Differences in Nasal and Tracheal Ciliary Function in Response to Pseudomonas aeruginosa Challenge
    SAGE Publications ; 2011
    In:  American Journal of Rhinology & Allergy Vol. 25, No. 4 ( 2011-07), p. 209-213
    Details
    In: American Journal of Rhinology & Allergy, SAGE Publications, Vol. 25, No. 4 ( 2011-07), p. 209-213
    Abstract: Sinonasal mucosal biofilms are recognized as contributors to the pathogenesis of chronic rhinosinusitis (CRS). Attachment of bacteria to the sinonasal surface is an initial step in biofilm formation. A critical defense against this occurrence is mucociliary clearance (MCC). To ascertain whether the ciliary component of MCC is uniform throughout the airway we compared ciliary beat frequency (CBF) in the murine nasal septum and trachea at baseline and after challenge with Pseudomonas aeruginosa, a common pathogen of CRS. Methods Murine septal and tracheal air–liquid interface cultures were evaluated for basal and stimulated CBF after exposure to control or conditioned media from Pseudomonas. Additionally, the attachment of Pseudomonas to nasal and tracheal cultures was assessed after pretreatment with control or conditioned media. Results Basal CBF is significantly slower in primary nasal airway cultures compared with tracheal airway cultures. Tracheal airway cultures show resistance to Pseudomonas secreted ciliotoxins not evident in nasal septal cultures. Furthermore, after challenge with viable Pseudomonas, significantly more bacteria attach to the nasal cultures compared with the tracheal cultures. Conclusion Using primary murine nasal and tracheal airway cultures we show inherent differences in cilia function and increased susceptibility of the upper airway to attachment by Pseudomonas. Understanding the differences between upper and subglottic airway mucociliary clearance should lead to novel approaches in the management of upper airway infection.
    Type of Medium: Online Resource
    ISSN: 1945-8924 , 1945-8932
    URL: Article
    DOI: 10.2500/ajra.2011.25.3614
    RVK:
    XA 20278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2554548-6
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  • 5
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    Treatment Outcomes in HPV-Negative Oropharyngeal Cancer: Surgery plus Radiotherapy Vs. Definitive Chemoradiotherapy
    SAGE Publications ; 2018
    In:  Ear, Nose & Throat Journal Vol. 97, No. 8 ( 2018-08), p. E1-E7
    Details
    In: Ear, Nose & Throat Journal, SAGE Publications, Vol. 97, No. 8 ( 2018-08), p. E1-E7
    Abstract: We performed a retrospective study to compare clinical outcomes among 51 consecutively presenting patients—38 men and 13 women, aged 46 to 74 years ( median: 57)—with locally advanced human papillomavirus (HPV)-negative oropharyngeal cancer who were treated with either primary surgery followed by postoperative radiotherapy (S/RT group; n = 22) or definitive chemoradiotherapy alone ( CRT group; n = 29). Within the cohort, 45 patients reported a history of tobacco use, with a median intensity of 40 pack-years. In addition, 39 patients (76%) reported moderate to heavy alcohol use. At baseline, there were no statistically significant differences between the two cohorts in sex, median age, cancer stage, intensity of smoking history, and alcohol use (p 〉 0.05 for all). Radiation doses ranged from 40 to 70 Gy (median: 70). Follow-up ranged from 2 to 93 months (median: 29). After treatment, we found no difference between the S/RT group and the CRT group in the incidence of locoregional recurrence (36 vs. 24%; p = 0.43) or distant metastases (14 vs. 21%; p = 0.56). Likewise, the difference in 2-year estimates of progression-free survival in the two groups was not significant (66 vs. 62%; p = 0.64), nor was the difference in 2-year overall survival (75 vs. 76%; p = 0.83). We conclude that treatment with either (1) primary surgery followed by postoperative radiotherapy or (2) CRT for locally advanced HPV-negative oropharyngeal cancer results in similar outcomes. In view of the relatively poor prognosis for patients with HPV-negative disease compared with their HPV-positive counterparts, clinical trials to investigate intensifying treatment may be warranted.
    Type of Medium: Online Resource
    ISSN: 0145-5613 , 1942-7522
    URL: Article
    DOI: 10.1177/014556131809700801
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2067528-8
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  • 6
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    Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19
    SAGE Publications ; 2022
    In:  Journal of Intensive Care Medicine Vol. 37, No. 4 ( 2022-04), p. 500-509
    Details
    In: Journal of Intensive Care Medicine, SAGE Publications, Vol. 37, No. 4 ( 2022-04), p. 500-509
    Abstract: To determine whether surge conditions were associated with increased mortality. Design Multicenter cohort study. Setting U.S. ICUs participating in STOP-COVID. Patients Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020. Interventions None Measurements and Main Results The main outcome was 28-day in-hospital mortality. To assess the association between admission to an ICU during a surge period and mortality, we used two different strategies: (1) an inverse probability weighted difference-in-differences model limited to appropriately matched surge and non-surge patients and (2) a meta-regression of 50 multivariable difference-in-differences models (each based on sets of randomly matched surge- and non-surge hospitals). In the first analysis, we considered a single surge period for the cohort (March 23 – May 6). In the second, each surge hospital had its own surge period (which was compared to the same time periods in matched non-surge hospitals). Our cohort consisted of 4342 ICU patients (average age 60.8 [sd 14.8], 63.5% men) in 53 U.S. hospitals. Of these, 13 hospitals encountered surge conditions. In analysis 1, the increase in mortality seen during surge was not statistically significant (odds ratio [95% CI] : 1.30 [0.47-3.58], p = .6). In analysis 2, surge was associated with an increased odds of death (odds ratio 1.39 [95% CI, 1.34-1.43] , p  〈  .001). Conclusions Admission to an ICU with COVID-19 in a hospital that is experiencing surge conditions may be associated with an increased odds of death. Given the high incidence of COVID-19, such increases would translate into substantial excess mortality.
    Type of Medium: Online Resource
    ISSN: 0885-0666 , 1525-1489
    URL: Article
    DOI: 10.1177/08850666211067509
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2001472-7
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  • 7
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    Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis
    SAGE Publications ; 2021
    In:  Annals of Otology, Rhinology & Laryngology Vol. 130, No. 10 ( 2021-10), p. 1116-1124
    Details
    In: Annals of Otology, Rhinology & Laryngology, SAGE Publications, Vol. 130, No. 10 ( 2021-10), p. 1116-1124
    Abstract: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.S. Census data), and number of close friends (self-reported) as a measure of social support. Main outcomes of interest were time to disease diagnosis (years from symptom onset), treatment selection (endoscopic dilation [ED] vs cricotracheal resection [CTR] vs endoscopic resection with adjuvant medical therapy [ERMT]), and time to recurrent surgical intervention (number of days from initial surgical procedure) as a surrogate for disease recurrence. Results: The total 810 participants were 98.5% female, 97.2% Caucasian, and had a median age of 50 years (IQR, 43-58). The cohort had a median household income of $62 307 (IQR, $50 345-$79 773), a median of 7 close friends (IQR, 4-10), and 64.7% of patients completed college or graduate school. Education, income, and number of friends were not associated with time to diagnosis via multivariable linear regression modeling. Univariable multinominal logistic regression demonstrated an association between education and income for selecting ED versus ERMT, but no associations were noted for CTR. No associations were noted for time to recurrent surgical procedure via Kaplan Meier modeling and Cox proportional hazards regression. Conclusions: Patient education, income, and social support were not associated with time to diagnosis or time to disease recurrence. This suggests additional patient, procedure, or disease-specific factors contribute to the observed variations in iSGS surgical outcomes.
    Type of Medium: Online Resource
    ISSN: 0003-4894 , 1943-572X
    URL: Article
    DOI: 10.1177/0003489421995283
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2033055-8
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  • 8
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    Global impact of COVID-19 on stroke care
    SAGE Publications ; 2021
    In:  International Journal of Stroke Vol. 16, No. 5 ( 2021-07), p. 573-584
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 16, No. 5 ( 2021-07), p. 573-584
    Abstract: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. Aims We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March–31 May 2020) compared with two control three-month periods (immediately preceding and one year prior). Methods Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. Results The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, −19.7 to −18.7), 11.5% (95%CI, −12.6 to −10.6), and 12.7% (95%CI, −13.6 to −11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (−20.5%) had greater declines in mechanical thrombectomy volumes than mid- (−10.1%) and low-volume (−8.7%) centers (p  〈  0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusion The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/1747493021991652
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 9
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    Many Labs 2: Investigating Variation in Replicability Across Samples and Settings
    SAGE Publications ; 2018
    In:  Advances in Methods and Practices in Psychological Science Vol. 1, No. 4 ( 2018-12), p. 443-490
    Details
    In: Advances in Methods and Practices in Psychological Science, SAGE Publications, Vol. 1, No. 4 ( 2018-12), p. 443-490
    Abstract: We conducted preregistered replications of 28 classic and contemporary published findings, with protocols that were peer reviewed in advance, to examine variation in effect magnitudes across samples and settings. Each protocol was administered to approximately half of 125 samples that comprised 15,305 participants from 36 countries and territories. Using the conventional criterion of statistical significance ( p 〈 .05), we found that 15 (54%) of the replications provided evidence of a statistically significant effect in the same direction as the original finding. With a strict significance criterion ( p 〈 .0001), 14 (50%) of the replications still provided such evidence, a reflection of the extremely high-powered design. Seven (25%) of the replications yielded effect sizes larger than the original ones, and 21 (75%) yielded effect sizes smaller than the original ones. The median comparable Cohen’s ds were 0.60 for the original findings and 0.15 for the replications. The effect sizes were small ( 〈 0.20) in 16 of the replications (57%), and 9 effects (32%) were in the direction opposite the direction of the original effect. Across settings, the Q statistic indicated significant heterogeneity in 11 (39%) of the replication effects, and most of those were among the findings with the largest overall effect sizes; only 1 effect that was near zero in the aggregate showed significant heterogeneity according to this measure. Only 1 effect had a tau value greater than .20, an indication of moderate heterogeneity. Eight others had tau values near or slightly above .10, an indication of slight heterogeneity. Moderation tests indicated that very little heterogeneity was attributable to the order in which the tasks were performed or whether the tasks were administered in lab versus online. Exploratory comparisons revealed little heterogeneity between Western, educated, industrialized, rich, and democratic (WEIRD) cultures and less WEIRD cultures (i.e., cultures with relatively high and low WEIRDness scores, respectively). Cumulatively, variability in the observed effect sizes was attributable more to the effect being studied than to the sample or setting in which it was studied.
    Type of Medium: Online Resource
    ISSN: 2515-2459 , 2515-2467
    URL: Article
    DOI: 10.1177/2515245918810225
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2904847-3
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  • 10
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    Tissue-Type Plasminogen Activator Mediates Neuronal Detection and Adaptation to Metabolic Stress
    SAGE Publications ; 2013
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 33, No. 11 ( 2013-11), p. 1761-1769
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 33, No. 11 ( 2013-11), p. 1761-1769
    Abstract: Adenosine monophosphate-activated protein kinase (AMPK) is an energy sensor that regulates cellular adaptation to metabolic stress. Tissue-type plasminogen activator (tPA) is a serine proteinase found in the intravascular space, where its main role is as thrombolytic enzyme, and in neurons, where its function is less well understood. Here, we report that glucose deprivation induces the mobilization and package of neuronal tPA into presynaptic vesicles. Mass spectrometry and immunohistochemical studies show that the release of this tPA in the synaptic space induces AMPK activation in the postsynaptic terminal, and an AMPK-mediated increase in neuronal uptake of glucose and neuronal adenosine 5′(tetrahydrogen triphosphate; ATP) synthesis. This effect is independent of tPA's proteolytic properties, and instead requires the presence of functional N-methyl-D-aspartate receptors (NMDARs). In agreement with these observations, positron emission tomography (PET) studies and biochemical analysis with synaptoneurosomes indicate that the intravenous administration of recombinant tPA (rtPA) after transient middle cerebral artery occlusion (tMCAO) induces AMPK activation in the synaptic space and NMDAR-mediated glucose uptake in the ischemic brain. These data indicate that the release of neuronal tPA or treatment with rtPA activate a cell signaling pathway in the synaptic space that promotes the detection and adaptation to metabolic stress.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.2013.124
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2039456-1
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