Publications by authors named "J Brady Scott"

9,227 Publications

A Multimetric Readability Analysis of Online Patient Educational Materials for Submental Fat Reduction.

Aesthetic Plast Surg 2022 Jan 17. Epub 2022 Jan 17.

Department Chair, Department of Plastic Surgery, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue- A60, Cleveland, OH, 44195, USA.

Background: Patients often utilize the Internet to seek information related to their care. This study assesses the readability of online patient educational materials for submental fat reduction.

Methods: Patient educational materials from the 12 most popular websites related to submental fat reduction were downloaded and assessed for readability grade level using 10 unique scales.

Results: Analysis of the 12 most popular websites (and corresponding 47 articles) revealed that patient educational materials were written, on average, at an 11th grade reading level. The Flesch Reading Ease score was 48.9 (range 39.8-59.2), representing a "difficult" level of reading. Mean readability grade levels (range 9-13th grade for individual websites) were as follows: Coleman-Liau, 11.1; Flesch-Kincaid, 10.8; FORCAST, 10.8; Fry Graph, 10.1; Gunning Fog, 12.7; New Dale-Chall, 10.1; New Fog Count, 11.8; Simple Measure of Gobbledygook, 11.7; Raygor, 6.7. No website was at the 6th grade reading level for patient educational materials recommended by the American Medical Association and National Institutes of Health.

Conclusions: Online patient educational materials for submental fat reduction are written well above the recommended reading level. Recognition of disparities in health literacy is necessary to enable patients to make informed decisions and become active participants in their own care.

Level Of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266.
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http://dx.doi.org/10.1007/s00266-021-02675-9DOI Listing
January 2022

Changing Radiotherapy Paradigms in Penile Cancer.

Eur Urol Open Sci 2022 Feb 4;36:47-48. Epub 2022 Jan 4.

Moffitt Cancer Center and Research Institute, Tampa, FL, USA.

Radiation therapy (RT) has not been prominent in the treatment of penile cancer because of poorly reproducible results when used in the adjuvant setting. A genomic signature has recently been described that assays radiosensitivity of tumors and informs radiotherapy doses in these cases. Clinical validation in more than 1600 patients demonstrated associations with both overall survival and time to first recurrence. In addition, the signature predicted and quantified the therapeutic benefit of RT for each individual patient. Since penile cancer patients were not part of this analysis, we applied the model to patients with primary and nodal penile cancer tissue and clinical outcomes. : Radiotherapy has not been widely used for treatment of penile cancer. New genetic data suggest that radiation doses commonly used to treat penile cancer are too low. This would explain prior poor results using radiation in this disease.
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http://dx.doi.org/10.1016/j.euros.2021.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739469PMC
February 2022

Keratin-Chitosan Microcapsules via Membrane Emulsification and Interfacial Complexation.

ACS Sustain Chem Eng 2021 Dec 1;9(49):16617-16626. Epub 2021 Dec 1.

Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom.

The continuous fabrication via membrane emulsification of stable microcapsules using renewable, biodegradable biopolymer wall materials keratin and chitosan is reported here for the first time. Microcapsule formation was based on opposite charge interactions between keratin and chitosan, which formed polyelectrolyte complexes when solutions were mixed at pH 5.5. Interfacial complexation was induced by transfer of keratin-stabilized primary emulsion droplets to chitosan solution, where the deposition of chitosan around droplets formed a core-shell structure. Capsule formation was demonstrated both in batch and continuous systems, with the latter showing a productivity up to 4.5 million capsules per minute. Keratin-chitosan microcapsules (in the 30-120 μm range) released less encapsulated nile red than the keratin-only emulsion, whereas microcapsules cross-linked with glutaraldehyde were stable for at least 6 months, and a greater amount of cross-linker was associated with enhanced dye release under the application of force due to increased shell brittleness. In light of recent bans involving microplastics in cosmetics, applications may be found in skin-pH formulas for the protection of oils or oil-soluble compounds, with a possible mechanical rupture release mechanism (e.g., rubbing on skin).
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http://dx.doi.org/10.1021/acssuschemeng.1c05304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8735752PMC
December 2021

Patient Factors Associated With Appendectomy Within 30 Days of Initiating Antibiotic Treatment for Appendicitis.

JAMA Surg 2022 Jan 12:e216900. Epub 2022 Jan 12.

University of Michigan Medical Center, Ann Arbor.

Importance: Use of antibiotics for the treatment of appendicitis is safe and has been found to be noninferior to appendectomy based on self-reported health status at 30 days. Identifying patient characteristics associated with a greater likelihood of appendectomy within 30 days in those who initiate antibiotics could support more individualized decision-making.

Objective: To assess patient factors associated with undergoing appendectomy within 30 days of initiating antibiotics for appendicitis.

Design, Setting, And Participants: In this cohort study using data from the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) randomized clinical trial, characteristics among patients who initiated antibiotics were compared between those who did and did not undergo appendectomy within 30 days. The study was conducted at 25 US medical centers; participants were enrolled between May 3, 2016, and February 5, 2020. A total of 1552 participants with acute appendicitis were randomized to antibiotics (776 participants) or appendectomy (776 participants). Data were analyzed from September 2020 to July 2021.

Exposures: Appendectomy vs antibiotics.

Main Outcomes And Measures: Conditional logistic regression models were fit to estimate associations between specific patient factors and the odds of undergoing appendectomy within 30 days after initiating antibiotics. A sensitivity analysis was performed excluding participants who underwent appendectomy within 30 days for nonclinical reasons.

Results: Of 776 participants initiating antibiotics (mean [SD] age, 38.3 [13.4] years; 286 [37%] women and 490 [63%] men), 735 participants had 30-day outcomes, including 154 participants (21%) who underwent appendectomy within 30 days. After adjustment for other factors, female sex (odds ratio [OR], 1.53; 95% CI, 1.01-2.31), radiographic finding of wider appendiceal diameter (OR per 1-mm increase, 1.09; 95% CI, 1.00-1.18), and presence of appendicolith (OR, 1.99; 95% CI, 1.28-3.10) were associated with increased odds of undergoing appendectomy within 30 days. Characteristics that are often associated with increased risk of complications (eg, advanced age, comorbid conditions) and those clinicians often use to describe appendicitis severity (eg, fever: OR, 1.28; 95% CI, 0.82-1.98) were not associated with odds of 30-day appendectomy. The sensitivity analysis limited to appendectomies performed for clinical reasons provided similar results regarding appendicolith (adjusted OR, 2.41; 95% CI, 1.49-3.91).

Conclusions And Relevance: This cohort study found that presence of an appendicolith was associated with a nearly 2-fold increased risk of undergoing appendectomy within 30 days of initiating antibiotics. Clinical characteristics often used to describe severity of appendicitis were not associated with odds of 30-day appendectomy. This information may help guide more individualized decision-making for people with appendicitis.
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http://dx.doi.org/10.1001/jamasurg.2021.6900DOI Listing
January 2022

A mixed methods analysis of cannabis use routines for chronic pain management.

J Cannabis Res 2022 Jan 11;4(1). Epub 2022 Jan 11.

Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, USA.

Background: The wide heterogeneity of available cannabis products makes it difficult for physicians to appropriately guide patients. In the current study, our objective was to characterize naturalistic cannabis use routines and explore associations between routines and reported benefits from consuming cannabis.

Methods: We performed a mixed methods analysis of n=1087 cross-sectional survey responses from adults with self-reported chronic pain using cannabis for symptom management in the USA and Canada. First, we qualitatively analyzed responses to an open-ended question that assessed typical cannabis use routines, including administration routes, cannabinoid content, and timing. We then sub-grouped responses into categories based on inhalation (smoking, vaporizing) vs. non-inhalation (e.g., edibles). Finally, we investigated subgroups perceptions of how cannabis affected pain, overall health, and use of medications (e.g., substituting for opioids, benzodiazepines). Substitutions were treated as a count of medication classes, while responses for both pain and health were analyzed continuously, with - 2 indicating health declining a lot or pain increasing a lot and 2 indicating that health improved a lot or pain decreased a lot.

Results: Routines varied widely in terms of administration routes, cannabinoid content, and use timing. Overall, 18.8%, 36.2%, and 45% used non-inhalation, inhalation, and non-inhalation + inhalation routes, respectively. Those who used inhalation routes were younger (mean age 46.5 [inhalation] and 49.2 [non-inhalation + inhalation] vs. 56.3 [inhalation], F=36.1, p<0.001), while a higher proportion of those who used non-inhalation routes were female (72.5% non-inhalation vs. 48.3% inhalation and 65.3% non-inhalation + inhalation, X=59.6, p<0.001). THC-rich products were typically used at night, while CBD-rich products were more often used during the day. While all participants reported similarly decreased pain, participants using non-inhalation + inhalation administration routes reported larger improvements in health than the non-inhalation (mean difference = 0.32, 95% CI: 0.07-0.37, p<0.001) and inhalation subgroups (mean difference = 0.22, 95% CI: 0.07-0.37, p=0.001). Similarly, the non-inhalation + inhalation group had significantly more medication substitutions than those using non-inhalation (mean difference = 0.62, 95% CI: 0.33-0.90, p<0.001) and inhalation administration routes (mean difference = 0.45, 95% CI: 0.22-0.69, p<0.001), respectively.

Conclusions: Subgrouping medical cannabis patients based on administration route profile may provide useful categories for future studies examining the risks and benefits of medical cannabis.
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http://dx.doi.org/10.1186/s42238-021-00116-7DOI Listing
January 2022
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