Publications by authors named "E Danielle Dean"

816 Publications

Clinical outcomes related to glenosphere overhang in reverse shoulder arthroplasty using a lateralized humeral design.

J Shoulder Elbow Surg 2022 Apr 23. Epub 2022 Apr 23.

Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA. Electronic address:

Background: Previous studies have demonstrated that decreased impingement-free range of motion (ROM) can adversely influence clinical outcomes following reverse shoulder arthroplasty (RSA). Inferior placement of the glenosphere is thought to minimize impingement and its associated sequelae. This study evaluates the relationship between inferior overhang of the glenosphere and clinical outcomes in patients undergoing primary RSA using a lateralized humeral implant design.

Methods: Using a prospectively collected shoulder arthroplasty database, all primary RSAs performed at our institution between 2007 and 2015 with a single implant design (lateralized humerus, medialized glenoid) and minimum 2-year follow-up were evaluated. Glenosphere overhang in relation to the inferior rim of the glenoid was measured in millimeters (mm) on postoperative Grashey radiographs of the shoulder and categorized into tertiles (low, ≤7.1 mm; medium >7.1 to ≤9.9 mm; high, >9.9 mm). Clinical outcomes of interest comprised of the change between preoperative and postoperative values for the following ROM and outcome score measures: active forward elevation (aFE), active external rotation, the American Shoulder and Elbow Surgeons (ASES) score, the Constant-Murley score (CMS), the Shoulder Pain and Disability Index (SPADI), and the Simple Shoulder Test (SST) score. Random effects linear models were used to assess univariate and multivariable associations between overhang tertile and change in patient outcomes. Differences in outcomes were further compared to the minimal clinically important difference (MCID).

Results: The study identified 284 shoulders in 265 patients. Median follow-up was 36 months (range, 24-108 months). Median glenosphere inferior overhang was 8.4 mm with an interquartile range (IQR) of 6.3-10.6 mm. Plots demonstrated a non-linear relationship between overhang, outcome scores, and ROM. Patients with a high overhang experienced significantly greater improvements in aFE compared to patients with low overhang (p=0.019) which exceeded the MCID. No other differences in ROM and outcome scores between overhang groups exceeded the MCID. For other outcome scores and ROM measurements, there was no significant relationship with glenosphere overhang. Increased overhang was associated with a significantly lower incidence of scapular notching (p = 0.005).

Conclusion: Patients undergoing RSA using a lateralized humerus design with greater inferior overhang of the glenosphere demonstrated significantly greater improvement in aFE and lower rates of notching compared to those with low overhang. No ideal glenosphere overhang range was identified to maximize function in this study.
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http://dx.doi.org/10.1016/j.jse.2022.03.014DOI Listing
April 2022

A health and lifestyle framework: An evidence-informed basis for contemporary physical therapist clinical practice guidelines with special reference to individuals with heart failure.

Physiother Res Int 2022 Apr 25:e1950. Epub 2022 Apr 25.

Women´s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.

Background And Purpose: This study proposes contemporary physical therapist clinical practice guidelines (CPGs) with special reference to heart failure (HF) be grounded in an evidence-informed integrative health and lifestyle framework to not only better reflect the totality and weighting of the literature, but also in the interest of superior patient, clinical, and economic outcomes.

Methods: As an illustration, a health and lifestyle framework is described to underpin, thereby complement, recently published physical therapist CPGs for individuals with HF.

Results: The case for the framework, an alternative to a single-disease biomedical perspective, is consistent with 21st century professional and epidemiologic indicators. Four themes that emerged from the HF CPGs and further support such a framework, emerged that is, limitations of conventionally constructed CPGs; physical therapists' scope of practice as "health" professionals; "best" practice in an era of NCDs including HF; and superior economic benefit.

Discussion: A health and lifestyle framework underpinning contemporary physical therapist CPGs will enable clinicians to better appreciate the power of lifestyle change in maximizing the health of the heart, its healing and repair, and in mitigating and reversing signs and symptoms of cardiac dysfunction. Further, a focus on health and lifestyle will augment the benefits of the core, evidence-based, key action statements related to exercise in the HF CPGs.
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http://dx.doi.org/10.1002/pri.1950DOI Listing
April 2022

Phase 1b study of berzosertib and cisplatin in patients with advanced triple-negative breast cancer.

NPJ Breast Cancer 2022 Apr 7;8(1):45. Epub 2022 Apr 7.

Newcastle University and Northern Centre for Cancer Care, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Platinum derivatives are commonly used for the treatment of patients with metastatic triple-negative breast cancer (TNBC). However, resistance often develops, leading to treatment failure. This expansion cohort (part C2) of the previously reported phase 1b trial (NCT02157792) is based on the recommended phase 2 dose of the combination of the ataxia-telangiectasia and Rad3-related (ATR) inhibitor berzosertib and cisplatin observed in patients with advanced solid tumors, including TNBC. Forty-seven patients aged ≥18 years with advanced TNBC received cisplatin (75 mg/m; day 1) and berzosertib (140 mg/m; days 2 and 9), in 21-day cycles. Berzosertib was well tolerated, with a similar toxicity profile to that reported previously for this combination. The overall response rate (90% confidence interval) was 23.4% (13.7, 35.8). No relevant associations were observed between response and gene alterations. Further studies combining ATR inhibitors with platinum compounds may be warranted in highly selected patient populations.
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http://dx.doi.org/10.1038/s41523-022-00406-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991212PMC
April 2022

Broadband-NIRS System Identifies Epileptic Focus in a Child with Focal Cortical Dysplasia-A Case Study.

Metabolites 2022 Mar 17;12(3). Epub 2022 Mar 17.

Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.

Epileptic seizures are transiently occurring symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Previous functional near-infrared spectroscopy (fNIRS) studies during seizures have focused in only monitoring the brain oxygenation and haemodynamic changes. However, few tools are available to measure actual cellular metabolism during seizures, especially at the bedside. Here we use an in-house developed multichannel broadband NIRS (or bNIRS) system, that, alongside the changes in oxy-, deoxy- haemoglobin concentration (HbO, HHb), also quantifies the changes in oxidised cytochrome-c-oxidase Δ(oxCCO), a marker of cellular oxygen metabolism, simultaneously over 16 different brain locations. We used bNIRS to measure metabolic activity alongside brain tissue haemodynamics/oxygenation during 17 epileptic seizures at the bedside of a 3-year-old girl with seizures due to an extensive malformation of cortical development in the left posterior quadrant. Simultaneously Video-EEG data was recorded from 12 channels. Whilst we did observe the expected increase in brain tissue oxygenation (HbD) during seizures, it was almost diminished in the area of the focal cortical dysplasia. Furthermore, in the area of seizure origination (epileptic focus) ΔoxCCO decreased significantly at the time of seizure generalization when compared to the mean change in all other channels. We hypothesize that this indicates an incapacity to sustain and increase brain tissue metabolism during seizures in the region of the epileptic focus.
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http://dx.doi.org/10.3390/metabo12030260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951122PMC
March 2022

Understanding Career Goals Set by Autistic Youth.

Am J Occup Ther 2022 May;76(3)

Karrie A. Shogren, PhD, is Director, Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence.

Importance: Recent years have seen a shift to strengths-based approaches promoting self-determination and career-related interests among autistic youth. Research is needed to understand the career-related goals set by autistic youth on the basis of their interests.

Objective: To descriptively explore the career design goals set by autistic youth engaged in the self-determined career design model (SDCDM) intervention.

Design: Content analysis was used to analyze the types of goals set by youth during intervention. Two researchers separately reviewed the goal set by each autistic youth (one goal per youth) and determined categories for each goal.

Setting: Preferred community location (usually the youth's home) in an urban Midwestern city.

Participants: Twenty-one autistic youth.

Intervention: SDCDM.

Outcomes And Measures: Participants set goals as part of the SDCDM, which were recorded using Goal Attainment Scaling (GAS). Researchers used GAS to support each participant in setting a measurable and objective goal and describing criteria for meeting the goal.

Results: Categories included enhancing self-management, obtaining employment, exploring career opportunities, enhancing learning, and enhancing self-advocacy.

Conclusions And Relevance: The findings from this study indicate that autistic youth set goals related to obtaining employment and enhancing generalizable 21st-century skills, such as self-advocacy and self-management. What This Article Adds: The SDCDM is a tool occupational therapy practitioners can use to support youth in setting and working toward career goals.
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http://dx.doi.org/10.5014/ajot.2022.046102DOI Listing
May 2022
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