المؤلفون: Sara N. Kiani, MPH, Daniel Yang, MS, Jenny L. Zheng, BS, David A. Spiegel, MD

المصدر: JBJS Open Access, Vol 8, Iss 3 (2023)

مصطلحات موضوعية: Orthopedic surgery, RD701-811

الوصف: Background:. The aim of the present study was to perform a bibliometric analysis of research articles published on clubfoot to provide a quantitative description of the literature and to gather information on the institutions, journals, researchers, and countries publishing on this topic. Methods:. This bibliometric analysis consisted of 2 Web of Science searches. The first identified all articles published prior to April 25, 2022, with “clubfoot” in the title, abstract, or keywords, and the second identified all articles with “Ponseti.” Studies were exported in BibTeX format and uploaded into Biblioshiny software in RStudio. Descriptive statistics are reported for variables related to the article, author, and country in which the research was conducted. Results:. A total of 2,177 articles identified using the term “clubfoot” were included. The first article was published in 1902, and there was a 3% annual growth rate. A total of 762 articles identified using the term “Ponseti” were included, with the first published in 1992 and a 13.9% annual growth rate. The Journal of Pediatric Orthopaedics accounted for almost one-quarter of all published reports. Conclusions:. The literature on clubfoot has expanded in the past decades, and the percentage of studies concerning the Ponseti method has increased dramatically in the years following adoption in the U.S. and, more recently, globally. While a number of studies involved collaboration between authors in high-income and low- and middle-income countries, further collaboration will be essential to evaluate outcomes and help improve service delivery as adoption of this method increases globally. Clinical Relevance:. This paper explores how the orthopaedic and scientific communities have increasingly contributed to literature on Ponseti casting and clubfoot, and discusses how contributions to the literature are becoming increasingly widespread.

وصف الملف: electronic resource

العلاقة: http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.23.00005Test; https://doaj.org/toc/2472-7245Test

الوصول الحر: https://doaj.org/article/c97bb282ec3c4af2ba0711a5fd336837Test

المؤلفون: Akbar N. Syed, Jenny L. Zheng, Christine Goodbody, Patrick J. Cahill, David A. Spiegel, Keith Baldwin

المصدر: Children, Vol 11, Iss 1, p 63 (2024)

مصطلحات موضوعية: cerebral palsy, pelvis, CP pelvis, cobb angle, neuromuscular scoliosis, axial plane deformity, Pediatrics, RJ1-570

الوصف: Spinopelvic malignment is commonly seen with non-ambulatory cerebral palsy (CP). Axial plane deformation is not well described in the literature. The purpose of this study was to describe and quantify the axial plane deformity in CP using CT scans and compare it to normal controls. We retrospectively collected data using CT scans of the abdomen and pelvis of 40 patients with GMFCS IV/V CP and neuromuscular scoliosis (CPP) and normal controls (NP) matched by age and sex. Pre-operative Cobb angle was recorded for the CP patients. Pelvic anatomy was evaluated at the supra-acetabular region of bone using two angles—iliac wing angle and sacral ala angle, measured for each hemipelvis. The larger of each hemipelvis angle was considered externally rotated while the smaller angle was considered internally rotated, termed as follows—iliac wing external (IWE) and internal (IWI); sacral ala external (SAE), and internal (SAI). Differences were noted using an independent t-test while correlations with Cobb angle were performed using Pearson’s correlation. Iliac wing measurements showed the externally rotated hemipelvis showed a significantly greater magnitude compared with normal controls at 47.3 ± 18.1 degrees vs. 26.4 ± 3.7 degrees in NP (p < 0.001) while no internal rotation was observed (p > 0.05). Sacral ala measurements showed greater magnitude in both external and internal rotation. SAE was 119.5 ± 9.5 degrees in CPP vs. 111.2 ± 7.7 degrees in NP (p < 0.001) while SAI was 114.1 ± 8.5 degrees in CPP vs. 107.9 ± 7.5 degrees in NP (p = 0.001). In the CP cohort, the mean Cobb angle was 61.54 degrees (n = 37/40). Cobb angle correlated with the degree of external iliac wing rotation—IWE (r = 0.457, p = 0.004) and degree of absolute difference in the rotation of the iliac wing (r = 0.506, p = 0.001). The pelvis in a patient with CP scoliosis is asymmetrically oriented exhibiting a greater external rotation of one hemipelvis relative to normal controls. The severity of neuromuscular scoliosis is related to the pelvic axial rotation in CP patients. Axial plane deformity exists in the CP pelvis and this deformity warrants consideration when considering spinopelvic instrumentation strategies and outcomes of supra-pelvic and infra-pelvic pathologies.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9067/11/1/63Test; https://doaj.org/toc/2227-9067Test

الوصول الحر: https://doaj.org/article/ee7bb845373244c3a5fe528ff255e7acTest

المؤلفون: Daniel Badin, MD, Keith D. Baldwin, MD, MSPT, MPH, Patrick J. Cahill, MD, David A. Spiegel, MD, Suken A. Shah, MD, Burt Yaszay, MD, Peter O. Newton, MD, Paul D. Sponseller, MD, MBA

المصدر: JBJS Open Access, Vol 8, Iss 2 (2023)

مصطلحات موضوعية: Orthopedic surgery, RD701-811

الوصف: Background:. Patients with scoliosis secondary to cerebral palsy (CP) are often treated with posterior spinal fusion (PSF) with or without pelvic fixation. We sought to establish criteria to guide the decision of whether or not to perform fusion “short of the pelvis” in this population, and to assess differences in outcomes. Methods:. Using 2 prospective databases, we analyzed 87 pediatric patients who underwent PSF short of the pelvis from 2008 to 2015 to treat CP-related scoliosis and who had ≥2 years of follow-up. Preoperative radiographic and clinical variables were analyzed for associations with unsatisfactory correction (defined as pelvic obliquity of ≥10°, distal implant dislodgement, and/or reoperation for increasing deformity at 2- or 5-year follow-up). Continuous variables were dichotomized using the Youden index, and a multivariable model of predictors of unsatisfactory correction was created using backward stepwise selection. Finally, radiographic, health-related quality-of-life, and clinical outcomes of patients with fusion short of the pelvis who had neither of the 2 factors associated with unsatisfactory outcomes were compared with those of 2 matched-control groups. Results:. Deformity correction was unsatisfactory in 29 of 87 patients with fusion short of the pelvis. The final model included preoperative pelvic obliquity of ≥17° (odds ratio [OR], 6.8; 95% confidence interval [CI], 2.3 to 19.7; p < 0.01) and dependent sitting status (OR, 3.2; 95% CI, 1.1 to 9.9; p = 0.04) as predictors of unsatisfactory correction. The predicted probability of unsatisfactory correction increased from 10% when neither of these factors was present to a predicated probability of 27% to 44% when 1 was present and to 72% when both were present. Among matched patients with these factors who had fusion to the pelvis, there was no association with unsatisfactory correction. Patients with independent sitting status and pelvic obliquity of

وصف الملف: electronic resource

العلاقة: http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.22.00123Test; https://doaj.org/toc/2472-7245Test

الوصول الحر: https://doaj.org/article/40b3a4373a344b92bb58a47364629228Test

المؤلفون: Drake G. LeBrun, Divya Talwar, Tuyetnhi A. Pham, Bibek Banskota, David A. Spiegel

المصدر: Journal of Epidemiology and Global Health, Vol 7, Iss 4 (2019)

مصطلحات موضوعية: Healthcare seeking behavior, Musculoskeletal disorders, Nepal, Public aspects of medicine, RA1-1270

الوصف: Background: Healthcare seeking behaviors among children with musculoskeletal disorders are poorly understood. We sought to analyze healthcare seeking delays among children with chronic musculoskeletal conditions in Nepal and identify predictors of clinically significant delays. Methods: A cross-sectional study was conducted at a large pediatric musculoskeletal rehabilitation center in Nepal. Baseline sociodemographic data and healthcare seeking behaviors were assessed via interviews with 75 randomly selected caregivers. Delays of at least 3 months between disease recognition and presentation to a health worker were considered clinically significant. Predictors of significant delay were assessed via multivariable logistic regression. Results: Clubfoot was the most common condition seen in the study sample (N = 33; 37%). Mean and median presentation delays were 33 months and 14 months, respectively. Sixty-seven percent of children were delayed at least 3 months and 40% were delayed at least 2 years. Caregiver occupation in agriculture or unskilled labor was associated with an increased risk of delayed presentation (adjusted OR = 4.05; 95% CI: 1.36–12.09). Conclusions: Children with chronic musculoskeletal disorders in Nepal face significant delays in accessing healthcare. This poses a major clinical problem as the delayed diagnosis and treatment of childhood musculoskeletal disorders can complicate management options and decrease long-term quality of life.

وصف الملف: electronic resource

العلاقة: https://www.atlantis-press.com/article/125905841/viewTest; https://doaj.org/toc/2210-6006Test

الوصول الحر: https://doaj.org/article/65eb0f26aeec480c8426f7da6b8c2ae6Test

المؤلفون: Drake G. LeBrun, Julius del Rosario, John D. Kelly, Sherry M. Wren, David A. Spiegel, Nyengo Mkandawire, Richard A. Gosselin, Adam L. Kushner

المصدر: Journal of Epidemiology and Global Health, Vol 8, Iss 3 (2018)

مصطلحات موضوعية: Sports, injury, adolescent, Africa, Public aspects of medicine, RA1-1270

الوصف: The extent to which sports injuries contribute to the burden of injury among adolescents in low- and middle-income countries (LMICs) is unknown. The goal of this study was to estimate the incidence of sports injuries among adolescents in Africa. Data from the World Health Organization Global School-Based Student Health surveys were used to estimate the annual number of African adolescents sustaining sports injuries. Gender-stratified injury rates were calculated and applied to every African country’s adolescent population to estimate country-specific and continent-wide injury totals. A total of 21,858 males and 24,691 females from 14 countries were included in the analysis. Country-specific annual sports injury rates ranged from 13.5% to 38.1% in males and 5.2% to 20.2% in females. Weighted average sports injury rates for males and females were 23.7% (95% CI 23.1%–24.2%) and 12.5% (95% CI 12.1%–12.9%), respectively. When these rates were extrapolated to the adolescent populations of the African continent, an estimated 15,477,798 (95% CI 15,085,955–15,804,333) males and 7,943,625 (95% CI 7,689,429–8,197,821) females sustained sports injuries. Our findings suggest that over 23 million African adolescents sustained sports injuries annually. Further work will help to more precisely define the burden of sports injuries in LMICs and the role that surgery can play in mitigating this burden.

وصف الملف: electronic resource

العلاقة: https://www.atlantis-press.com/article/125905594/viewTest; https://doaj.org/toc/2210-6006Test

الوصول الحر: https://doaj.org/article/6ffd3a1201b84bf4b65107c8901d1babTest

المؤلفون: Shailvi Gupta, Thomas A. Groen, Barclay T. Stewart, Sunil Shrestha, David A. Spiegel, Benedict C. Nwomeh, Reinou S. Groen, Adam L. Kushner

المصدر: Geospatial Health, Vol 11, Iss 2 (2016)

مصطلحات موضوعية: Global surgery, Geographic information system, Public health, Topography, Nepal, Geography (General), G1-922

الوصف: Geographic information system modelling can accurately represent the geospatial distribution of disease burdens to inform health service delivery. Given the dramatic topography of Nepal and a high prevalence of unmet surgical needs, we explored the consequences of topography on the prevalence of surgical conditions. The Nepalese Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a validated, countrywide, cluster randomised survey that assesses surgical need in lowand middle-income countries; it was performed in Nepal in 2014. Data on conditions potentially affected by topography (e.g. fractures, hernias, injuries, burns) were extracted from the database. A national digital elevation model was used to determine altitude, aspect, slope steepness and curvature of the SOSAS survey sites. Forward stepwise linear regression was performed with prevalence of each surgical condition as the response variable and topographic data as explanatory variables. The highest correlation coefficient was for models predicting hernias and fractures, both explaining 21% of the variance. The model fitted to death due to fall would become significant when an outlier was excluded (P2=0.27). Excluding the outlier yielded a better-fitted model to burn injury (stepwise regression) without any explanatory variables. Other models trended towards a correlation, but did not have sufficient power to detect a difference. This study identified slight correlation between elevation and the prevalence of hernias and fall injuries. Further investigation on the effects of topography and geography on surgical conditions is needed to help determine if the data would be useful for directing allocation of surgical resources.

وصف الملف: electronic resource

العلاقة: http://www.geospatialhealth.net/index.php/gh/article/view/359Test; https://doaj.org/toc/1827-1987Test; https://doaj.org/toc/1970-7096Test

الوصول الحر: https://doaj.org/article/2a6a38dbf48e4151811aa144439c104eTest

المؤلفون: Dang Pham, Hanno Rein, David S. Spiegel

المصدر: The Open Journal of Astrophysics, Vol 7 (2024)

مصطلحات موضوعية: Astronomy, QB1-991, Astrophysics, QB460-466

العلاقة: https://astro.theoj.org/article/92091-a-new-timestep-criterion-for-n-body-simulationsTest; https://doaj.org/toc/2565-6120Test; https://doaj.org/article/3b4209ea40b246db8fa6a591493509fbTest

الإتاحة: https://doi.org/10.21105/astro.2401.02849Test
https://doaj.org/article/3b4209ea40b246db8fa6a591493509fbTest

المؤلفون: Edward A. deRamon, Venkata R. Sabbasani, Matthew D. Streeter, Yannan Liu, Timothy R. Newhouse, David M. McDonald, David A. Spiegel

المصدر: Journal of the American Chemical Society. 144:21843-21847

مصطلحات موضوعية: Colloid and Surface Chemistry, Humans, General Chemistry, Protein Processing, Post-Translational, Biochemistry, Catalysis

الوصف: Pentosinane is a structurally complex nonenzymatic post-translational modification of proteins believed to be present in all living things. It falls into the category of advanced glycation end products (AGEs) and is structurally related to the other AGEs pentosidine and glucosepane. Although pentosidine and glucosepane have been widely studied for their role in wide-ranging conditions (e.g., diabetes mellitus, Alzheimer's disease, and human aging), relatively little is known about pentosinane. Interestingly, previous reports have suggested that pentosidine may derive from pentosinane. The (patho)physiological significance of pentosinane in humans is largely unexplored. As a first step to address this knowledge gap, we report herein the first total synthesis of pentosinane. Our synthesis is high yielding (1.7% over seven steps), concise, and enantioselective, and it leverages a strategy for synthesizing 2,5-diaminoimidazoles previously developed by our lab. Access to synthetic pentosinane has allowed us to perform additional studies showing that its oxidation to pentosidine is both pH and oxygen dependent and is substantially slower under physiological conditions than previously believed. Additionally, pentosinane rapidly decomposes under harshly acidic conditions typically employed for pentosidine isolation. Taken together, these results suggest that pentosinane is likely to be more abundant

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::698ee075774f44323d7a3b9712808c31Test
https://doi.org/10.1021/jacs.2c09626Test

المؤلفون: David R. Spiegel, Marie Isabelle Yrastorza-Daghma, Shaan S. Sharma, Askar Myrzakhmetov, Faith E. Reid

المصدر: The Primary Care Companion For CNS Disorders. 25

مصطلحات موضوعية: General Medicine

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::ee0256605f852bf4981f30a7b937fdadTest
https://doi.org/10.4088/pcc.22cr03360Test

المؤلفون: Csaba P. Kovesdy, Christopher G. Rowan, Ansgar Conrad, David M. Spiegel, Jeanene Fogli, Nina Oestreicher, Jeffrey J. Connaire, Wolfgang C. Winkelmayer

المصدر: Kidney International Reports, Vol 4, Iss 2, Pp 301-309 (2019)

مصطلحات موضوعية: Diseases of the genitourinary system. Urology, RC870-923

الوصف: Introduction: Patiromer is a potassium (K+) binding polymer indicated for treating hyperkalemia. Among patients receiving chronic hemodialysis (HD), this study aimed to identify patient characteristics associated with patiromer initiation, describe patiromer utilization, and analyze serum K+ pre- and post-patiromer initiation. Methods: In a retrospective cohort study, using electronic health record data from a large dialysis provider in the United States (study period: December 21, 2015, to December 20, 2016), HD patients were included who had a medication order for patiromer, sodium polystyrene sulfonate (SPS), or laboratory evidence of hyperkalemia (no K+ binder [NoKb] cohort). The index date was the first order for patiromer/SPS, or the first K+ ≥5.0 mEq/l (NoKb cohort), respectively. Using multivariable logistic regression, we identified patient characteristics associated with patiromer initiation. We evaluated patiromer utilization using Kaplan-Meier methodology and proportion of days covered. Serum K+ concentrations were assessed pre- versus post-patiromer initiation. Results: Study cohorts included 527 (patiromer), 852 (SPS), and 8747 (NoKb) HD patients. Median follow-up was 141 days. Patiromer initiators were 2.6 times more likely to have had multiple prior episodes of hyperkalemia (odds ratio [OR]: 2.6; 95% confidence interval [CI]: 1.8–3.7). Most (61%) commenced patiromer on 8.4 g once daily; 60% of patients’ first patiromer order remained open after 180 days. Statistically significant reductions in K+, averaging approximately −0.5 mEq/l, were observed post-patiromer initiation (48% pre-patiromer vs. 22% post-patiromer had K+ ≥6.0 mEq/l [P < 0.001]). Conclusion: Patiromer initiators receiving chronic hemodialysis had comparatively more severe, uncontrolled baseline hyperkalemia. Medication order data show long-term patiromer use was associated with significantly reduced K+. Keywords: hemodialysis, hyperkalemia, patiromer

العلاقة: http://www.sciencedirect.com/science/article/pii/S2468024918302912Test; https://doaj.org/toc/2468-0249Test; https://doaj.org/article/2a31e428e71f48d080389241a33b5011Test

الإتاحة: https://doi.org/10.1016/j.ekir.2018.10.020Test
https://doaj.org/article/2a31e428e71f48d080389241a33b5011Test