Publications by authors named "H W Gordon Baker"

1,932 Publications

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Safety and Treatment Outcomes of Nivolumab for the Treatment of Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: Retrospective Multicenter Cohort Study.

Cancers (Basel) 2021 Mar 19;13(6). Epub 2021 Mar 19.

Guys Cancer Centre, Guy's and St. Thomas NHS Foundation Trust, London SE1 9RT, UK.

Nivolumab is an anti-PD-1 monoclonal antibody currently used as immunotherapy for patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) with evidence of disease progression after platinum-based chemotherapy. This study evaluates real-world safety and treatment outcomes of non-trial nivolumab use. A retrospective multicenter cohort study of patients with recurrent/metastatic HNSCC treated with nivolumab between January 2017 and March 2020 was performed. Overall, 123 patients were included. The median age was 64 years, the majority of patients were male (80.5%) and had a smoking history (69.9%). Primary outcomes included overall response rate (ORR) of 19.3%, median progression-free survival (PFS) of 3.9 months, 1-year PFS rate of 16.8%, a median overall survival (OS) of 6.5 months and 1-year OS rate of 28.6%. These results are comparable to the CHECKMATE-141 study. Of 27 patients who had PD-L1 status tested, positive PD-L1 status did not significantly affect PFS ( = 0.86) or OS ( = 0.84). Nivolumab was well tolerated with only 15.1% experiencing immune-related toxicities (IRT) and only 6.7% of patients stopping due to toxicity. The occurrence of IRT appeared to significantly affect PFS ( = 0.01) but not OS ( = 0.07). Nivolumab in recurrent/metastatic HNSCC is well tolerated and may be more efficacious in patients who develop IRT.
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http://dx.doi.org/10.3390/cancers13061413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003537PMC
March 2021

The targeting rule does not increase the rate of lower extremity injuries in NFL players over two seasons.

Phys Sportsmed 2021 Apr 5:1-5. Epub 2021 Apr 5.

, Department of Orthopaedic Surgery, The University of Chicago, Chicago, IL, USA.

: In 2018 the NFL instituted playing rule article 8, which aimed to help decrease sport related concussion (SRC) by broadening the helmet-hit rule, making it a foul when a player lowers his head to make contact with his helmet against an opponent. Previous studies have demonstrated that the rate of lower extremity injuries increased following the institution of the targeting rule in NCAA football. The objective of this study was to determine if playing rule article 8 unintentionally led to a significant increase in the rate of lower extremity injuries sustained by NFL players during regular season games.: This study was a retrospective review of all NFL players who were placed on the publically available injury reports for a lower extremity injury from the 2016-2017 through 2019-2020 regular seasons. With article 8 taking effect starting with the 2018-2019 season, players were assigned to a pre- or post-rule cohort based on date of injury for purposes of injury rate comparison. Injury rates were calculated per 1000 athletic exposures (AE). Incidence rate ratio (RR) with 95% confidence intervals (CI) compared injury rates between the two cohorts.: There was a 3% decrease in the lower extremity injury rate in 2018-2019 to 2019-2020 compared with 2016-2017 to 2017-2018, however this was not statistically significant (33.6 versus 34.3/1000 AEs, respectively; RR, 0.97; 95% CI 0.92-1.04). There was a 40% decrease in the SRC rate when comparing the post- to the pre-article-8 cohort (3.3 vs. 5.5/1000 AEs, respectively; RR 0.60; 95% CI 0.50-0.73).: The rate of lower extremity injuries and players placed on the injury reserve over the past two NFL seasons following the enactment of playing rule article 8 has not significantly increased. However, the average games missed due to lower extremity injuries significantly increased under playing rule article 8, which suggests that the severity of lower extremity injuries possibly increased. IV Diagnostic.
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http://dx.doi.org/10.1080/00913847.2021.1910873DOI Listing
April 2021

It's not just a phase; ubiquitination in cytosolic protein quality control.

Biochem Soc Trans 2021 Feb;49(1):365-377

Michael Smith Laboratories, University of British Columbia, Vancouver, Canada.

The accumulation of misfolded proteins is associated with numerous degenerative conditions, cancers and genetic diseases. These pathological imbalances in protein homeostasis (termed proteostasis), result from the improper triage and disposal of damaged and defective proteins from the cell. The ubiquitin-proteasome system is a key pathway for the molecular control of misfolded cytosolic proteins, co-opting a cascade of ubiquitin ligases to direct terminally damaged proteins to the proteasome via modification with chains of the small protein, ubiquitin. Despite the evidence for ubiquitination in this critical pathway, the precise complement of ubiquitin ligases and deubiquitinases that modulate this process remains under investigation. Whilst chaperones act as the first line of defence against protein misfolding, the ubiquitination machinery has a pivotal role in targeting terminally defunct cytosolic proteins for destruction. Recent work points to a complex assemblage of chaperones, ubiquitination machinery and subcellular quarantine as components of the cellular arsenal against proteinopathies. In this review, we examine the contribution of these pathways and cellular compartments to the maintenance of the cytosolic proteome. Here we will particularly focus on the ubiquitin code and the critical enzymes which regulate misfolded proteins in the cytosol, the molecular point of origin for many neurodegenerative and genetic diseases.
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http://dx.doi.org/10.1042/BST20200694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924994PMC
February 2021

Fully Integrated Readiness for Service Training (FIRST): An Accelerated Medical Training Program for Rural and Underserved North Carolina.

Acad Med 2021 Feb 2. Epub 2021 Feb 2.

C.L. Coe is assistant professor of family medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0003-3851-0295. H.M. Baker is program manager, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina. J.S. Byerley is vice dean for academic affairs, chief education officer, and professor of pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina. C.P. Page is executive dean and William B. Aycock Distinguished Professor of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Problem: The U.S. primary care workforce remains inadequate to meet the health needs of the U.S. population. Effective programs are needed to provide workforce development for rural and other underserved areas.

Approach: At the University of North Carolina (UNC) School of Medicine (SOM), between November 2014 and July 2015, the authors developed and implemented the Fully Integrated Readiness for Service Training (FIRST) Program, an accelerated curriculum focused on rural and underserved care that links 3 years of medical school with a conditional acceptance into UNC's 3-year family medicine residency, followed by 3 years of practice support post-graduation. Students are recruited to the FIRST Program during the fall of their first year of medical school. The FIRST Program promotes close faculty mentorship and familiarity with the health care system, includes a longitudinal quality improvement project with an assigned patient panel, includes early integration into the clinic, and fosters a close cohort of fellow students.

Outcomes: As of March 2020, the FIRST Program had successfully recruited 5 classes of medical students and 3 of those classes had matched into residency. In total, as of March 2020, 18 students had participated in the FIRST Program.

Next Steps: The FIRST Program will be expanded to additional clinical sites across North Carolina and to specialties beyond family medicine, including pediatrics, general surgery, and psychiatry.
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http://dx.doi.org/10.1097/ACM.0000000000003946DOI Listing
February 2021

The role of bone marrow microRNA (miR) in erythropoietic dysfunction after severe trauma.

Surgery 2021 Jan 4. Epub 2021 Jan 4.

Department of Surgery and Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, FL. Electronic address:

Background: Previous data has shown that severe traumatic injury is associated with bone marrow dysfunction, which manifests as persistent injury-associated anemia. This study sought to identify whether the expression of erythropoiesis-related microRNAs were altered in the bone marrow of trauma patients to determine if these microRNAs play a role in persistent injury-associated anemia.

Methods: Bone marrow was collected from severely injured trauma patients who underwent fracture fixation as well as patients who underwent elective hip replacement. There were 27 trauma patients and 10 controls analyzed. Total RNA and microRNA were isolated from CD34-positive cells using the RNeasy Plus Mini kit, and genome-wide microRNA expression patterns were assayed. Genes with significant expression differences were found using BRB-ArrayTools with a significance of P < .01.

Results: There were marked differences in expression of 108 microRNAs in the trauma group when compared with hip replacement patients. Four of these microRNAs play a role in regulating erythropoiesis: microRNA-150, microRNA-223, microRNA15a, and microRNA-24. These microRNAs were all upregulated significantly, with trauma/hip replacement fold changes of 1.7, 1.8, 1.2, and 1.2 respectively, and all act to suppress or regulate erythropoiesis.

Conclusion: Assessment of the bone marrow microRNA profile in trauma patients compared to those undergoing elective hip replacement revealed the differential expression of microRNA-150, microRNA-223, microRNA-15a, and microRNA-24. These microRNAs all play a role in decreased erythroid progenitor cell growth and provide important insight to the erythropoietic dysfunction seen after trauma.
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http://dx.doi.org/10.1016/j.surg.2020.11.029DOI Listing
January 2021

Playing Rule Article Eight Decreases the Rate of Sport Related Concussion in NFL Players Over Two Seasons.

Phys Sportsmed 2020 Dec 31:1-6. Epub 2020 Dec 31.

Department of Orthopaedic Surgery, The University of Chicago , Chicago, IL, USA.

Objectives: The objectives of this study were to determine if rule article 8 significantly reduced (1) the rate of concussions sustained by NFL players during regular season games, (2) the average games missed secondary to concussion injury, and (3) the number of players placed on the injury reserve for sport-related concussions (SRC).

Methods: This study was a retrospective review of all NFL players who were placed on the publically available injury reports for a concussion from the 2016-2017 to 2019-2020 regular seasons. Player's date of injury was cross-referenced with an absence of statistics from the respective games for which they were ruled out to ensure accuracy. With article 8 taking effect starting with the 2018-2019 season, players were assigned to a pre- or postrule cohort based on date of injury for purposes of injury rate comparison. Injury rates were calculated per 1000 athletic exposures (AE). Relative risk (RR) with 95% confidence intervals (CI) compared injury rates between the two cohorts. Average number of games missed and number of players placed on injury reserve (IR) per year were also calculated. Continuous variables were statistically compared using two-tailed -test, while categorical variables were compared using Chi-squared test. Statistical significance was set at ≤ 0.05.

Results: There was a 40% decrease in the SRC rate when comparing the post- to the pre-article-8 cohort (3.3 vs 5.5/1000 AEs, respectively; RR 0.60; 95% CI 0.50-0.73). There was no significant difference in average games missed per concussion or percentage of players placed on the IR due to SRC between the two cohorts.

Conclusions: The rate of SRC over the past two NFL seasons following the enactment of playing rule article 8 has significantly decreased when compared with the two seasons prior. The average games missed per concussion and the number of players placed on the IR due to SRC has not significantly changed under playing rule article 8.
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http://dx.doi.org/10.1080/00913847.2020.1836945DOI Listing
December 2020

Fifth-order two-quantum absorptive two-dimensional electronic spectroscopy of CdSe quantum dots.

J Chem Phys 2020 Dec;153(23):234703

Department of Chemistry, McGill University, Montreal, Quebec H3A 0B8, Canada.

Two-quantum variants of two-dimensional electronic spectroscopy (2DES) have previously been used to characterize multi-exciton interactions in molecules and semiconductor nanostructures though many implementations are limited by phasing procedures or non-resonant signals. We implement 2DES using phase-cycling to simultaneously measure one-quantum and two-quantum spectra in colloidal CdSe quantum dots. In the pump-probe geometry, fully absorptive spectra are automatically acquired by measuring the sum of the rephasing and nonrephasing signals. Fifth-order two-quantum spectroscopy allows for direct access to multi-exciton states that may be obscured in excited state absorption signals due to population relaxation or third-order two-quantum spectra due to the non-resonant response.
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http://dx.doi.org/10.1063/5.0021381DOI Listing
December 2020

The Role of Nurses and Midwives in Expanding and Sustaining Voluntary Medical Male Circumcision Services for HIV Prevention: A Systematic and Policy Review.

J Assoc Nurses AIDS Care 2021 Jan-Feb 01;32(1):3-28

Stephanie M. Davis, MD, MPH, is a Medical Epidemiologist, Division of Global HIV & TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Helen Baker, PhD, MSc, FNP-BC, is the Global and Community Engagement Coordinator, Lillian Carter Center for Global Health and Social Responsibility, and is an Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Jessica M. Gross, MSN, MPH, is a Nurse Consultant, Division of Global HIV & TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Sharon L. Leslie, MSLS, AHIP, is the Nursing Informationist, Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia, USA.Cynthia M. Z. Chasokela, PhD, Med, BScN, SRN, RMN, SCM, is Director of Nursing Services, Ministry of Health and Child Care, Harare, Zimbabwe. Julia Samuelson, BSN, MPH, is a Nurse Epidemiologist, Department of HIV, Hepatitis, and STIs, World Health Organization, Geneva, Switzerland. Carlos Toledo, PhD, is a Health Scientist, Division of Global HIV & TB, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Abstract: Male circumcision reduces men's risk of acquiring HIV through heterosexual sex, and voluntary medical male circumcision (VMMC) is central to HIV prevention strategies in 15 sub-Saharan African countries. Nurses have emerged as primary VMMC providers; however, barriers remain to institutionalizing nurse-led VMMC. Patient safety concerns have hindered task sharing, and regulations governing nurse-performed VMMC are not always supportive or clear. We performed a systematic review on VMMC safety by provider cadre and a desk review of national policies governing the VMMC roles of nurses and midwives. Also, VMMC by nurses is safe and has become standard practice. Countries had multiple policy combinations among different documents, with only one disallowing VMMC by these cadres. Countries with alignment between policies often ensured that nursing workforces were equipped with clinical competencies through national certification. Regulatory clarity and formalized certification for nurse-performed VMMC can increase program sustainability and build nursing capacity to meet other critical basic surgical needs.
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http://dx.doi.org/10.1097/JNC.0000000000000222DOI Listing
December 2020

A Substance Use Disorder Service-Learning Immersion Experience for Prelicensure Nursing Students.

Nurse Educ 2020 Dec 2. Epub 2020 Dec 2.

Author Affiliations: Assistant Clinical Professor/Global and Community Engagement Coordinator (Dr Baker) and Clinical Instructor (Ms Pfeiffer), Lillian Carter Center for Global Health and Social Responsibility, and Students (Mss Field, Nasatir-Hilty, Doiev, Worland, and Clark-Youngblood), Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; RN (Ms Harrell), Aurora Medical Center, Kenosha, Wisconsin; Nurse Case Manager for Substance Use Disorders (Ms Mascorro), Chapa-De Indian Health, Auburn, California.

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http://dx.doi.org/10.1097/NNE.0000000000000952DOI Listing
December 2020

The 'third wave': impending cognitive and functional decline in COVID-19 survivors.

Br J Anaesth 2021 01 21;126(1):44-47. Epub 2020 Oct 21.

Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA; St. Vincent's Hospital, Melbourne, Australia; Centre for Integrated Critical Care, Department of Medicine & Radiology, University of Melbourne, Melbourne, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2020.09.045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577658PMC
January 2021

Ballistic Supracondylar Distal Femur Fractures Have Lower Rates of Intra-Articular Extension than Blunt Distal Femur Fractures.

J Orthop Trauma 2020 Nov 9. Epub 2020 Nov 9.

1The University of Chicago Department of Orthopaedic Surgery, Chicago, IL, 60637.

Objectives: To compare the relative frequencies of intra-articular extension of supracondylar distal femur fractures in blunt versus ballistic trauma, as well as the diagnostic accuracy of conventional radiography in identifying intra-articular extension in these fractures.

Design: Retrospective review.

Setting: Urban academic trauma center.

Study Group: Thirty-eight patients were included for analysis, with 19 blunt and 19 ballistic mechanism distal femur fractures.

Intervention: Fleiss' kappa score was calculated in determining interobserver reliability of OTA/AO classification. Radiographic specificity and sensitivity were compared using Fischer's exact testing. Quantitative data were compared using two-tailed t-testing for continuous variables and chi-square tests for proportions.

Main Outcome Measurements: Rate of intra-articular extension of ballistic versus blunt supra-condylar femur fractures.

Results: 17 out of 19 patients (89.5%) with blunt trauma had intra-articular involvement compared to 5 out of 19 patients (26.3%) with ballistic trauma (p=0.001). For blunt fractures, pre-operative radiographs were 94% sensitive for the detection of intra articular extension compared to 100% sensitive for ballistic fractures (p=1.000). We identified one case, in the blunt cohort, where the operative plan changed from intramedullary nail to open reduction and internal fixation as a result of the additional coronal plane fracture pattern identified on CT. There were no such occurrences in the ballistic cohort.

Conclusions: The rate of intra-articular extension for ballistic supracondylar femur fractures is lower than blunt distal femur fracture. There were low rates of missed intra-articular fractures and changes in operative plans after reviewing CT imaging for both blunt and ballistic distal femur fractures.

Level Of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.1097/BOT.0000000000002004DOI Listing
November 2020

Transcriptomic responses from improved murine sepsis models can better mimic human surgical sepsis.

FASEB J 2021 Feb 2;35(2):e21156. Epub 2020 Nov 2.

Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.

Historically, murine models of inflammation in biomedical research have been shown to minimally correlate with genomic expression patterns from blood leukocytes in humans. In 2019, our laboratory reported an improved surgical sepsis model of cecal ligation and puncture (CLP) that provides additional daily chronic stress (DCS), as well as adhering to the Minimum Quality Threshold in Pre-Clinical Sepsis Studies (MQTiPSS) guidelines. This model phenotypically recapitulates the persistent inflammation, immunosuppression, and catabolism syndrome observed in adult human surgical sepsis survivors. Whether these phenotypic similarities between septic humans and mice are replicated at the circulating blood leukocyte transcriptome has not been demonstrated. Our analysis, in contrast with previous findings, demonstrated that genome-wide expression in our new murine model more closely approximated human surgical sepsis patients, particularly in the more chronic phases of sepsis. Importantly, our new model of murine surgical sepsis with chronic stress did not reflect well gene expression patterns from humans with community-acquired sepsis. Our work indicates that improved preclinical murine sepsis modeling can better replicate both the phenotypic and transcriptomic responses to surgical sepsis, but cannot be extrapolated to other sepsis etiologies. Importantly, these improved models can be a useful adjunct to human-focused and artificial intelligence-based forms of research in order to improve septic patients' morbidity and mortality.
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http://dx.doi.org/10.1096/fj.202002150RDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855423PMC
February 2021

Transcriptomic responses from improved murine sepsis models can better mimic human surgical sepsis.

FASEB J 2021 Feb 2;35(2):e21156. Epub 2020 Nov 2.

Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.

Historically, murine models of inflammation in biomedical research have been shown to minimally correlate with genomic expression patterns from blood leukocytes in humans. In 2019, our laboratory reported an improved surgical sepsis model of cecal ligation and puncture (CLP) that provides additional daily chronic stress (DCS), as well as adhering to the Minimum Quality Threshold in Pre-Clinical Sepsis Studies (MQTiPSS) guidelines. This model phenotypically recapitulates the persistent inflammation, immunosuppression, and catabolism syndrome observed in adult human surgical sepsis survivors. Whether these phenotypic similarities between septic humans and mice are replicated at the circulating blood leukocyte transcriptome has not been demonstrated. Our analysis, in contrast with previous findings, demonstrated that genome-wide expression in our new murine model more closely approximated human surgical sepsis patients, particularly in the more chronic phases of sepsis. Importantly, our new model of murine surgical sepsis with chronic stress did not reflect well gene expression patterns from humans with community-acquired sepsis. Our work indicates that improved preclinical murine sepsis modeling can better replicate both the phenotypic and transcriptomic responses to surgical sepsis, but cannot be extrapolated to other sepsis etiologies. Importantly, these improved models can be a useful adjunct to human-focused and artificial intelligence-based forms of research in order to improve septic patients' morbidity and mortality.
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http://dx.doi.org/10.1096/fj.202002150RDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855423PMC
February 2021

Discovery and Validation of Urinary Molecular Signature of Early Sepsis.

Crit Care Explor 2020 Oct 25;2(10):e0195. Epub 2020 Sep 25.

Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL.

Identify alterations in gene expression unique to systemic and kidney-specific pathophysiologic processes using whole-genome analyses of RNA isolated from the urinary cells of sepsis patients.

Design: Prospective cohort study.

Setting: Quaternary care academic hospital.

Patients: A total of 266 sepsis and 82 control patients enrolled between January 2015 and February 2018.

Interventions: Whole-genome transcriptomic analysis of messenger RNA isolated from the urinary cells of sepsis patients within 12 hours of sepsis onset and from control subjects.

Measurements And Main Results: The differentially expressed probes that map to known genes were subjected to feature selection using multiple machine learning techniques to find the best subset of probes that differentiates sepsis from control subjects. Using differential expression augmented with machine learning ensembles, we identified a set of 239 genes in urine, which show excellent effectiveness in classifying septic patients from those with chronic systemic disease in both internal and independent external validation cohorts. Functional analysis indexes disrupted biological pathways in early sepsis and reveal key molecular networks driving its pathogenesis.

Conclusions: We identified unique urinary gene expression profile in early sepsis. Future studies need to confirm whether this approach can complement blood transcriptomic approaches for sepsis diagnosis and prognostication.
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http://dx.doi.org/10.1097/CCE.0000000000000195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523873PMC
October 2020

Pharmacologic Thromboprophylaxis Other Than Aspirin Is Associated With Increased Risk for Procedural Intervention for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction.

Arthroscopy 2021 02 22;37(2):619-623. Epub 2020 Sep 22.

Department of Orthopaedic Surgery and Rehabilitation, University of Chicago Medicine, Chicago, Illinois, U.S.A.

Purpose: To compare rates of procedural intervention for arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) among patients who were not prescribed any pharmacologic thromboprophylaxis compared with patients who were prescribed aspirin and to patients who were prescribed other agents.

Methods: A search of a national insurance claims database was performed to identify all patients who underwent ACLR from 2007 to 2017 who were active within the database at a minimum of 6 months before and 18 months after their surgery. The primary outcome studied was a subsequent procedure for arthrofibrosis, manipulation under anesthesia, and lysis of adhesions (MUA/LOA). Patients who filled a prescription for aspirin, low-molecular weight heparin, direct factor Xa inhibitors, fondaparinux, and warfarin within 2 days after their surgery were included and those who filled a prescription within 3 months before surgery were excluded. Thromboprophylaxis status was defined as no thromboprophylaxis, aspirin, and any agent other than aspirin. Logistic regression analysis was performed to determine the association between prophylaxis status and MUA/LOA.

Results: Of the 14,081 patients in our final surgical population, 191 patients had MUA/LOA and 13,890 patients did not. In total, 499 patients were prescribed pharmacologic prophylaxis. Rates of MUA/LOA across groups were 1.3% in the group with no thromboprophylaxis, 1.9% in the group prescribed aspirin, and 4.3% in the group prescribed any agent other than aspirin. Only the group prescribed an agent other than aspirin was significantly associated with subsequent procedure for arthrofibrosis (odds ratio 2.6, 95% confidence interval 1.3-4.8, P = .004).

Conclusions: Patients who were prescribed a pharmacologic agent other than aspirin had a 2.6 times greater likelihood of requiring a procedural intervention for arthrofibrosis following ACLR compared with patients who were not prescribed a thromboprophylaxis agent LEVEL OF EVIDENCE: III, Retrospective Cohort Study.
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http://dx.doi.org/10.1016/j.arthro.2020.09.019DOI Listing
February 2021

The cost-effectiveness of TheraSphere in patients with hepatocellular carcinoma who are eligible for transarterial embolization.

Eur J Surg Oncol 2021 02 14;47(2):401-408. Epub 2020 Sep 14.

The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK. Electronic address:

Introduction: The aim of the study is to estimate the cost-effectiveness of TheraSphere against other embolic treatments in a population with early to intermediate stage hepatocellular carcinoma (HCC) who are unresectable at presentation and are eligible for transarterial embolization (TAE), conventional transarterial chemoembolization (cTACE) or drug-eluting bead TACE (DEB-TACE).

Materials And Methods: A Markov model was constructed using a UK National Health Service (NHS) perspective, a 20-year time horizon, and four-week cycles. The eight health states included 'watch and wait', 'transplantation' (pre-, post and post (No HCC)), 'resection', 'no HCC other', 'pharmacological management' and 'death'. Clinical data were sourced from literature and expert opinion. Resource use and costs were reflective of the NHS, and benefits were quantified using Quality-Adjusted Life Years (QALYs), with utility weights sourced from literature. Comparators were TAE, cTACE and DEB-TACE. The primary output was the Incremental Cost-Effectiveness Ratio (ICER) expressed as cost per QALY gained. An ICER of under £20,000/QALY gained for an intervention is cost-effective and represents efficient use of healthcare resources. Extensive deterministic and probabilistic sensitivity analyses were undertaken.

Results: TheraSphere patients were predicted to gain 0.7 additional QALYs compared to all other treatments. The base case ICERs for TheraSphere were £17,300, £17,279 and £23,020 per QALY gained compared to TAE, cTACE and DEB-TACE, respectively. In the TheraSphere cohort, 87% more patients were predicted to achieve downstaging compared to all other treatment options.

Conclusions: This study indicates that treatment with TheraSphere is a potentially cost-effective option for patients with early to intermediate stage HCC.
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http://dx.doi.org/10.1016/j.ejso.2020.08.027DOI Listing
February 2021

Therapeutic benefit after intracranial gene therapy delivered during the symptomatic stage in a feline model of Sandhoff disease.

Gene Ther 2020 Sep 3. Epub 2020 Sep 3.

Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.

Sandhoff disease (SD) is an autosomal recessive lysosomal storage disease caused by defects in the β-subunit of β-N-acetylhexosaminidase (Hex), the enzyme that catabolizes GM2 ganglioside. Hex deficiency causes neuronal storage of GM2 and related glycoconjugates, resulting in progressive neurodegeneration and death, typically in infancy. No effective treatment exists for human patients. Adeno-associated virus (AAV) gene therapy led to improved clinical outcome and survival of SD cats treated before the onset of disease symptoms. Most human patients are diagnosed after clinical disease onset, so it is imperative to test AAV-gene therapy in symptomatic SD cats to provide a realistic indication of therapeutic benefits that can be expected in humans. In this study, AAVrh8 vectors injected into the thalamus and deep cerebellar nuclei of symptomatic SD cats resulted in widespread central nervous system enzyme distribution, although a substantial burden of storage material remained. Cats treated in the early symptomatic phase showed delayed disease progression and a significant survival increase versus untreated cats. Treatment was less effective when administered later in the disease course, although therapeutic benefit was still possible. Results are encouraging for the treatment of human patients and provide support for the development AAV-gene therapy for human SD.
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http://dx.doi.org/10.1038/s41434-020-00190-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925702PMC
September 2020

Is average club head speed a risk factor for lower back injuries in professional golfers? A retrospective case control study.

Phys Sportsmed 2021 May 20;49(2):214-218. Epub 2020 Sep 20.

Department of Orthopaedic Surgery, The University of Chicago, Chicago, IL, USA.

Background: Our hypothesis was that higher average club head speed is correlated with lower back injuries in professional golfers.

Methods: This was a retrospective case control study of male professional golfers who suffered lower back injuries while playing golf. The injured group was composed of 14 Professional Golfers' Association (PGA) golfers who withdrew from a PGA tour event due to a back injury during the years 2017-2019. The case-control matching procedure was used to randomly match cases and controls with a 2:1 allocation ratio, respectively, based on age. Variables were chosen based on currently proposed risk factors. Data was statistically analyzed using SPSS 25.

Results: There were 14 PGA golfers who suffered lower back injuries during the years 2017-2019 who were included in this study. There was no significant difference in age, height, weight or BMI between the injured and control group. The injured group had a higher mean club head speed than the control group (P < 0.01).

Conclusion: This study found that average club head speed was significantly higher in PGA golfers who suffered back injuries while golfing during a two-year period (2017-2019) when compared with age-matched controls.
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http://dx.doi.org/10.1080/00913847.2020.1809968DOI Listing
May 2021

Identification of Unique mRNA and miRNA Expression Patterns in Bone Marrow Hematopoietic Stem and Progenitor Cells After Trauma in Older Adults.

Front Immunol 2020 24;11:1289. Epub 2020 Jun 24.

Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States.

Older adults have significantly worse morbidity and mortality after severe trauma than younger cohorts. The competency of the innate immune response decreases with advancing age, especially after an inflammatory insult. Subsequent poor outcomes after trauma are caused in part by dysfunctional leukocytes derived from the host's hematopoietic stem and progenitor cells (HSPCs). Our objective was to analyze the bone marrow (BM) HSPC transcriptomic [mRNA and microRNA (miR)] responses to trauma in older and younger adults. BM was collected intraoperatively <9 days after initial injury from trauma patients with non-mild injury [ISS ≥ 9] with shock (lactate ≥ 2, base deficit ≥ 5, MAP ≤ 65) who underwent operative fixation of a pelvic or long bone fracture. Samples were also analyzed based on age (<55 years and ≥55 years), ISS score and transfusion in the first 24 h, and compared to age/sex-matched controls from non-cancer elective hip replacement or purchased healthy younger adult human BM aspirates. mRNA and miR expression patterns were calculated from lineage-negative enriched HSPCs. 924 genes were differentially expressed in older trauma subjects vs. age/sex-matched controls, while 654 genes were differentially expressed in younger subjects vs. age/sex-matched control. Only 68 transcriptomic changes were shared between the two groups. Subsequent analysis revealed upregulation of transcriptomic pathways related to quantity, function, differentiation, and proliferation of HSPCs in only the younger cohort. miR expression differences were also identified, many of which were associated with cell cycle regulation. In summary, differences in the BM HSPC mRNA and miR expression were identified between older and younger adult trauma subjects. These differences in gene and miR expression were related to pathways involved in HSPC production and differentiation. These differences could potentially explain why older adult patients have a suboptimal hematopoietic response to trauma. Although immunomodulation of HSPCs may be a necessary consideration to promote host protective immunity after host injury, the age related differences further highlight that patients may require an age-defined medical approach with interventions that are specific to their transcriptomic and biologic response. Also, targeting the older adult miRs may be possible for interventions in this patient population.
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http://dx.doi.org/10.3389/fimmu.2020.01289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326804PMC
April 2021

Functional recovery in older women undergoing surgery for gynaecological malignancies: A systematic review and narrative synthesis.

J Geriatr Oncol 2020 09 27;11(7):1087-1095. Epub 2020 Jun 27.

Perioperative Medicine for Older People Undergoing Surgery (POPS), Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Primary Care and Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Objectives: Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. This systematic review and narrative synthesis describes functional recovery after gynaeoncology surgery with respect to baseline characteristics.

Materials And Methods: Systematic search of MEDLINE and EMBASE databases and Cochrane Library between 1974 to 2018. Two reviewers independently reviewed abstracts/papers for inclusion against the following criteria: Results analysed and presented using narrative synthesis.

Results: Fifteen studies identified (8 Endometrial, 2 Ovarian, 2 Vulval, 3 mixed cancer types). 1/15 used a standalone functional assessment tool, 14/15 used Health-Related Quality of Life tools (EORTC QLQ C30 (8), FACT-G (3), SF-36 (3)) comprising items describing function. More studies showed full recovery to baseline (n = 13) than incomplete recovery (n = 2). Four studies reported a negative association between older age and functional trajectory. Recovery was more likely and occurred faster in minimally-invasive surgery. Few studies reported baseline characteristics including cognition, frailty or comorbidities and none examined associations with functional recovery.

Conclusion: There is inadequate data on functional recovery of older women following gynaeoncology surgery. Future studies are needed to identify factors associated with poorer/better outcomes. This may enable identification of opportunities for risk reduction, improve equity of access and better shared-decision making.
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http://dx.doi.org/10.1016/j.jgo.2020.06.006DOI Listing
September 2020

Injury in the Women's National Basketball Association (WNBA) From 2015 to 2019.

Arthrosc Sports Med Rehabil 2020 Jun 16;2(3):e213-e217. Epub 2020 Apr 16.

Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, Illinois, U.S.A.

Purpose: To provide an overview of the injuries suffered by Women's National Basketball Association (WNBA) athletes and to analyze the demographic data, injury rates, and games missed as a result of individual injuries.

Methods: Using publicly available data on WNBA player's injury history, we generated a database cataloguing the quantity, location, frequency, and longitudinal impact of injuries sustained during the WNBA regular season from 2015 to 2019. We analyzed the data using SPSS-25 data manipulation software to assess the number of injuries per athletic exposure.

Results: Lower-extremity injuries (n = 143, 73%) were the most common injury by body area and resulted in the greatest number of games missed (n = 1189, 88%). Lateral ankle sprains were the most frequent injury (n = 39, 20%), with a rate of 1.19 injuries per 1000 athletic exposures. Torn anterior cruciate ligaments (n = 18, 9.2%) were the most devastating, resulting in the greatest number of games missed (n=376, 28%).

Conclusions: Our findings corroborate previous notions that lower-extremity injuries are the greatest source of injury in this population. Ankle injuries were the most frequent injury reported by pathology, while knee injuries carried the most long-term impact on games missed due to injury.

Level Of Evidence: IV, Epidemiological study.
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http://dx.doi.org/10.1016/j.asmr.2020.02.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283941PMC
June 2020

Frequency of overtime and consecutive games and their impact on injury rate in the National Hockey League (NHL).

Phys Sportsmed 2021 Feb 27;49(1):100-105. Epub 2020 Jun 27.

Department of Orthopaedics, Northwestern University , Chicago, IL, USA.

Objectives: Ice hockey is a high-intensity contact sport that places athletes at an elevated risk for injury relative to other sports. The purpose of the current study was to analyze factors contributing to fatigue and decreased recovery time and their associations with injury incidence among professional athletes in the National Hockey League (NHL).

Methods: A retrospective review of all injuries suffered by NHL athletes during six consecutive seasons from 2013 to 2019 was performed. Team schedules were analyzed to assess (1) the number of instances with games on consecutive calendar days, (2) the number of overtime games, and (3) the number of overtime games within three calendar days of a previous overtime game. A Spearman's rank correlation coefficient was calculated from this data to assess the association between these factors and injury rates.

Results: In total, 4886 injuries were suffered by NHL players during the period of study, with the 2013-2014 regular season highest injury rate per 1000 athletic exposures (15.8). The lower body was the most frequently injured body area (25.0% of all injuries), followed by injuries to the upper body (23.7%). In an analysis of the number of overtime games and games on consecutive days and their relationships to injury rate, only overtime games within three calendar days and total injuries were found to have a significant association (ρ = 0.19,  = 0.01).

Conclusion: The weak positive correlation between the number of overtime games within threedays of a previous overtime game and total injuries in professional ice hockey players suggests that overtime games played within a short period of time place athletes at increased risk for injury. Further studies are necessary to address this on an athlete-by-athlete level.
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http://dx.doi.org/10.1080/00913847.2020.1782715DOI Listing
February 2021

Concurrent multi-lineage differentiation of mesenchymal stem cells through spatial presentation of growth factors.

Biomed Mater 2020 08 31;15(5):055035. Epub 2020 Aug 31.

Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742, United States of America. Center for Engineering Complex Tissues, University of Maryland and Rice University, College Park, MD 20742, United States of America.

Severe tendon and ligament injuries are estimated to affect between 300 000 and 400 000 people annually. Surgical repairs of these injuries often have poor long-term clinical outcomes because of resection of the interfacial tissue-the enthesis-and subsequent stress concentration at the attachment site. A healthy enthesis consists of distinct regions of bone, fibrocartilage, and tendon, each with distinct cell types, extracellular matrix components, and architecture, which are important for tissue function. Tissue engineering, which has been proposed as a potential strategy for replacing this tissue, is currently limited by its inability to differentiate multiple lineages of cells from a single stem cell population within a single engineered construct. In this study, we develop a multi-phasic gelatin methacrylate hydrogel construct system for spatial presentation of proteins, which is then validated for multi-lineage differentiation towards the cell types of the bone-tendon enthesis. This study determines growth factor concentrations for differentiation of mesenchymal stem cells towards osteoblasts, chondrocytes/fibrochondrocytes, and tenocytes, which maintain similar differentiation profiles in 3D hydrogel culture as assessed by qPCR and immunofluorescence staining. Finally, it is shown that this method is able to guide heterogeneous and spatially confined changes in mesenchymal stem cell genes and protein expressions with the tendency to result in osteoblast-, fibrochondrocyte-, and tenocyte-like expression profiles. Overall, we demonstrate the utility of the culture technique for engineering other musculoskeletal tissue interfaces and provide a biochemical approach for recapitulating the bone-tendon enthesis in vitro.
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http://dx.doi.org/10.1088/1748-605X/ab9bb0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648258PMC
August 2020

The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians.

Child Adolesc Ment Health 2020 09 23;25(3):135-142. Epub 2020 Feb 23.

School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.

Background: Panic disorder is experienced by around 1% of adolescents and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder-specific treatment in adolescents with panic disorder; however, panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents.

Method: CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem.

Results: Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT), and around a fifth had received no training in delivering psychological treatments.

Conclusions: Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS.

Key Practitioner Message: Panic disorder affects around 1% of adolescents, adversely impacting social, academic and long-term life functioning. There is preliminary evidence for the effectiveness of a panic disorder-specific treatment of panic disorder in adolescents. Clinicians struggle to identify panic disorder or suitable treatment protocols for treating adolescents, although most would use CBT as the treatment approach. There is a vital need for clinician training, tools that aid identification of young people with panic disorder and evidence-based treatments that can be delivered in routine clinical settings.
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http://dx.doi.org/10.1111/camh.12372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496854PMC
September 2020

The cost and quality of life impact of glaucoma in Tanzania: An observational study.

PLoS One 2020 1;15(6):e0232796. Epub 2020 Jun 1.

Dr Agarwals Eye Hospital, Dar Es Salaam, Tanzania, East Africa.

Aims: To determine the cost and quality of life impact imposed by glaucoma in Tanzania, East Africa.

Methods: An expert panel of eye health professionals was convened to agree current glaucoma practice in Tanzania. In addition a structured patient survey was developed and administered. Supplemental cost and quality of life information was collected using cost questionnaires and validated quality of life measures, including the EQ5D and VFQ-25.

Results: Key findings include following. Non-adherence is a major issue, especially in rural settings where over 50% of the patients may fail to return for review. Whilst medical therapy is overwhelmingly the first line treatment, the cost of maintaining this represents up to 25% of a patient's income. There is an impact of glaucoma on patients general well-being as determined by the EQ-5D and more tellingly on visual function with particular impact on role limitations as determined by the VF25. Despite our sample being taken in a private clinic and thus containing a much larger proportion of professionals than the general population, one third of the population earned Tanzanian Shillings (TZS) 170,000 per month which is below the minimum wage.

Conclusion: These findings are of great importance for health care planners seeking to determine cost-effective, acceptable methods of both identifying and treating this major cause of preventable blindness.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232796PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263578PMC
August 2020

Human Regulatory T Cells From Umbilical Cord Blood Display Increased Repertoire Diversity and Lineage Stability Relative to Adult Peripheral Blood.

Front Immunol 2020 15;11:611. Epub 2020 Apr 15.

Department of Pathology, Immunology and Laboratory Medicine, Diabetes Institute, College of Medicine, University of Florida, Gainesville, FL, United States.

The human T lymphocyte compartment is highly dynamic over the course of a lifetime. Of the many changes, perhaps most notable is the transition from a predominantly naïve T cell state at birth to the acquisition of antigen-experienced memory and effector subsets following environmental exposures. These phenotypic changes, including the induction of T cell exhaustion and senescence, have the potential to negatively impact efficacy of adoptive T cell therapies (ACT). When considering ACT with CD4CD25CD127 regulatory T cells (Tregs) for the induction of immune tolerance, we previously reported expanded umbilical cord blood (CB) Tregs remained more naïve, suppressed responder T cells equivalently, and exhibited a more diverse T cell receptor (TCR) repertoire compared to expanded adult peripheral blood (APB) Tregs. Herein, we hypothesized that upon further characterization, we would observe increased lineage heterogeneity and phenotypic diversity in APB Tregs that might negatively impact lineage stability, engraftment capacity, and the potential for Tregs to home to sites of tissue inflammation following ACT. We compared the phenotypic profiles of human Tregs isolated from CB versus the more traditional source, APB. We conducted analysis of fresh and expanded Treg subsets at both the single cell (scRNA-seq and flow cytometry) and bulk (microarray and cytokine profiling) levels. Single cell transcriptional profiles of pre-expansion APB Tregs highlighted a cluster of cells that showed increased expression of genes associated with effector and pro-inflammatory phenotypes (, , and NKG7) with low expression of Treg markers ( and ). CB Tregs were more diverse in TCR repertoire and homogenous in phenotype, and contained fewer effector-like cells in contrast with APB Tregs. Interestingly, expression of canonical Treg markers, such as FOXP3, TIGIT, and IKZF2, were increased in CB CD4CD127 conventional T cells (Tconv) compared to APB Tconv, post-expansion, implying perinatal T cells may adopt a default regulatory program. Collectively, these data identify surface markers (namely CXCR3) that could be depleted to improve purity and stability of APB Tregs, and support the use of expanded CB Tregs as a potentially optimal ACT modality for the treatment of autoimmune and inflammatory diseases.
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http://dx.doi.org/10.3389/fimmu.2020.00611DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174770PMC
March 2021

Utilizing the F3App to Capture Learner Feedback About Faculty Teaching.

Fam Med 2020 04;52(4):262-269

Department of Family Medicine, University of North Carolina, Chapel Hill.

Background And Objectives: The Accreditation Council for Graduate Medical Education requires soliciting learner feedback on faculty teaching, although gathering meaningful feedback is challenging in the medical education environment. We developed the Faculty Feedback Facilitator (F3App), a mobile application that allows for real-time capture of narrative feedback by residents. The purpose of our study was to assess efficacy, usability, and acceptability of the F3App in family medicine residency programs.

Methods: Residents, faculty, and program directors (PDs) from eight residency programs participated in a beta test of the F3App from November 2017 to May 2018; participants completed pre- and postimplementation surveys about their evaluation process and the F3App. We interviewed PDs, and analyzed responses using a thematic analysis approach.

Results: Survey results showed significant postimplementation increases in faculty agreement that accessing evaluations is easy (42%), evaluations are an effective way to communicate feedback (34%), feedback is actionable and meaningful (24%), and the current system provides meaningful data for promotion (33%). Among residents, agreement that the current system allows meaningful information sharing and is easy to use increased significantly, by 17% each. The proportion of residents agreeing they were comfortable providing constructive criticism increased significantly (22%). PDs generally reported that residents were receptive to using the F3App, found it quick and easy to use, and that feedback provided was meaningful.

Conclusions: Participating programs reviewed the F3App positively as a tool to gather narrative feedback from learners on faculty teaching.
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http://dx.doi.org/10.22454/FamMed.2020.225169DOI Listing
April 2020

Arthroscopic treatment of type II superior labral anterior to posterior (SLAP) lesions in a younger population: minimum 2-year outcomes are similar between SLAP repair and biceps tenodesis.

Knee Surg Sports Traumatol Arthrosc 2021 Jan 6;29(1):257-265. Epub 2020 Apr 6.

Department of Orthopaedic Surgery, Northwestern University, Lavin Family Pavilion, 259 E. Erie St. 13th Fl., Chicago, IL, 60611, USA.

Purpose: Compared to a relatively older population over 30-40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population.

Methods: Patients aged 15-40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included. Shoulders with intraarticular chondral damage, full thickness rotator cuff tear, rotator cuff repair, labral repair outside of the superior labrum, bony subacromial decompression, and acromioclavicular joint resection were excluded. Patient-reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand Sports/Performing Arts Module (DASH-sport), visual analog scale (VAS) for pain, and satisfaction. Return to sport rates were also recorded.

Results: Fifty-three patients (20 tenodesis, 33 repair) were available for minimum 2-year follow-up. Postoperatively, there were no significant differences in mean ASES, DASH-sport, VAS, and satisfaction between groups [ASES: tenodesis 86.3 vs. repair 86.4 (n.s.); DASH-sport: 11.0 vs. 22.5 (n.s.); VAS: 1.85 vs. 1.64 (n.s.); satisfaction: 8.50 vs. 8.00 (n.s.)]. Rate of return to pre-injury level of performance/competition in sport/physical activity was also similar between groups [tenodesis 63% vs. repair 50% (n.s.)].

Conclusions: In a young active population, primary arthroscopic biceps tenodesis is a viable surgical alternative to labral repair for type II SLAP lesions. The results of this study suggest that indications for arthroscopic tenodesis can safely be expanded to a younger patient group than has previously been demonstrated in the literature.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-020-05971-0DOI Listing
January 2021

Treatment of patellar and hamstring tendinopathy with platelet-rich plasma in varsity collegiate athletes: A case series.

J Orthop 2020 Mar-Apr;18:91-94. Epub 2019 Oct 31.

Department of Orthopaedic Surgery, Northwestern University, 259 East Erie Street, Chicago, IL, 60611, USA.

Patellar and hamstring tendinopathy are common injuries among elite athletes. Platelet-rich plasma (PRP) has emerged as a promising new therapy for accelerating healing and shortening recovery in patients with these conditions. We present 15 cases of PRP injection used for either patellar or hamstring tendinopathy in varsity collegiate athletes at a single institution. All of the athletes in our case series with hamstring or patellar tendinopathy were fully able to return to sport. Three of the athletes with patellar tendinopathy were referred for surgery, while none of the athletes with hamstring strain underwent a subsequent surgical procedure.
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http://dx.doi.org/10.1016/j.jor.2019.10.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068016PMC
October 2019

Investigating the electronic structure of confined multiexcitons with nonlinear spectroscopies.

J Chem Phys 2020 Mar;152(10):104710

Department of Chemistry, McGill University, 801 Sherbrooke Street W, Montréal, Québec H3A 0B8, Canada.

Strong confinement in semiconductor quantum dots enables them to host multiple electron-hole pairs or excitons. The excitons in these materials are forced to interact, resulting in quantum-confined multiexcitons (MXs). The MXs are integral to the physics of the electronic properties of these materials and impact their key properties for applications such as gain and light emission. Despite their importance, the electronic structure of MX has yet to be fully characterized. MXs have a complex electronic structure arising from quantum many-body effects, which is challenging for both experiments and theory. Here, we report on the investigation of the electronic structure of MX in colloidal CdSe QDs using time-resolved photoluminescence, state-resolved pump-probe, and two-dimensional spectroscopies. The use of varying excitation energy and intensities enables the observation of many signals from biexcitons and triexcitons. The experiments enable the study of MX structures and dynamics on time scales spanning 6 orders of magnitude and directly reveal dynamics in the biexciton manifold. These results outline the limits of the simple concept of binding energy. The methods of investigations should be applicable to reveal complex many-body physics in other nanomaterials and low-dimensional materials of interest.
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http://dx.doi.org/10.1063/1.5142180DOI Listing
March 2020