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  1. Article ; Online: Obituary: Robert R. Zimmermann (1930-2009).

    Coopman, Stephanie J / Means, John R

    The American psychologist

    2010  Volume 65, Issue 3, Page(s) 227

    MeSH term(s) History, 20th Century ; Humans ; Psychology/history ; United States
    Language English
    Publishing date 2010-04
    Publishing country United States
    Document type Biography ; Historical Article ; Journal Article
    ZDB-ID 209464-2
    ISSN 1935-990X ; 0003-066X
    ISSN (online) 1935-990X
    ISSN 0003-066X
    DOI 10.1037/a0018642
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A Multicenter Prospective Randomized Comparison of Conduits Versus Decellularized Nerve Allograft for Digital Nerve Repairs.

    Isaacs, Jonathan / Nydick, Jason A / Means, Kenneth R / Merrell, Gregory A / Ilyas, Asif / Levin, L Scott

    The Journal of hand surgery

    2023  Volume 48, Issue 9, Page(s) 904–913

    Abstract: Purpose: While there are advantages and disadvantages to both processed nerve allografts (PNA) and conduits, a large, well-controlled prospective study is needed to compare the efficacy and to delineate how each of these repair tools can be best applied ...

    Abstract Purpose: While there are advantages and disadvantages to both processed nerve allografts (PNA) and conduits, a large, well-controlled prospective study is needed to compare the efficacy and to delineate how each of these repair tools can be best applied to digital nerve injuries. We hypothesized that PNA digital nerve repairs would achieve superior functional recovery for longer length gaps compared with conduit-based repairs.
    Methods: Patients (aged 18-69 years) presenting with suspected acute or subacute (less than 24 weeks old) digital nerve injuries were recruited to prticipate at 20 medical centers across the United States. After stratification to short (5-14 mm) and long (15-25 mm) gap subgroups, the patients were randomized (1:1) to repair with either a commercially available PNA or collagen conduit. Baseline and outcomes assessments were obtained either before or immediately after surgery and planned at 3-, 6-, 9-, and 12-months after surgery. All assessors and patients were blinded to the treatment arm.
    Results: In total, 220 patients were enrolled, and 183 patients completed an acceptable last evaluable visit (at least 6 months and not more than 15 months postrepair). At last follow-up, for the short gap repair groups, average static two-point discrimination was 7.3 ± 2.8 mm for PNA and 7.5 ± 3.1 mm for conduit repairs. For the long gap group, average static two-point discrimination was significantly lower at 6.1 ± 3.3 mm for PNA compared with 7.5 ± 2.4 mm for conduit repairs. Normal sensation (American Society for Surgery of the Hand scale) was achieved in 40% of PNA long gap repairs, which was significantly more than the 18% observed in long conduit patients. Long gap conduits had more clinical failures (lack of protective sensation) than short gap conduits.
    Conclusions: Although supporting similar levels of nerve regeneration for short gap length digital nerve repairs, PNA was clinically superior to conduits for long gap reconstructions.
    Type of study/level of evidence: Therapeutic I.
    MeSH term(s) Humans ; Peripheral Nerves/transplantation ; Prospective Studies ; Peripheral Nerve Injuries/surgery ; Transplantation, Homologous ; Nerve Regeneration/physiology ; Allografts
    Language English
    Publishing date 2023-08-02
    Publishing country United States
    Document type Randomized Controlled Trial ; Multicenter Study ; Journal Article
    ZDB-ID 605716-0
    ISSN 1531-6564 ; 0363-5023
    ISSN (online) 1531-6564
    ISSN 0363-5023
    DOI 10.1016/j.jhsa.2023.05.020
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  3. Article ; Online: The statistical fragility of studies on rotator cuff repair with graft augmentation.

    Imbergamo, Casey / Sequeira, Sean B / Patankar, Aneesh / Means, Kenneth R / Stein, Jason A

    Journal of shoulder and elbow surgery

    2023  Volume 32, Issue 5, Page(s) 1121–1125

    Abstract: Background: Clinical decision-making often relies on evidence-based medicine. Our purpose was to determine the fragility index (FI) and fragility quotient (FQ) for studies evaluating rotator cuff repair (RCR) with graft augmentation. A lost to follow-up ...

    Abstract Background: Clinical decision-making often relies on evidence-based medicine. Our purpose was to determine the fragility index (FI) and fragility quotient (FQ) for studies evaluating rotator cuff repair (RCR) with graft augmentation. A lost to follow-up (LTF) value greater than the FI indicates statistical instability for the reported outcomes and conclusions.
    Methods: We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching PubMed, the Cochrane library, and Embase in June 2022 to identify studies of RCR with graft augmentation. Comparative studies with at least 1 statistically analyzed dichotomous outcome were included. Seventeen studies published in seven peer-reviewed journals from 2003 to 2019 were subsequently evaluated. The FI was determined by changing each reported outcome event within 2 × 2 contingency tables until statistical significance or nonsignificance was reversed. The associated FQ was determined by dividing the FI by the sample size. LTF values were also extracted from each included study.
    Results: The included studies had a total of 1098 patients with 36 dichotomous outcomes. The associated median FI was 4 (interquartile range 2-5), indicating that the reversal of 4 patients' outcomes would have reversed the finding of significant difference. The median FQ was 0.08 (interquartile range 0.04-0.15), indicating that in a sample of 100 patients, reversal of 8 patients' outcomes would reverse statistical significance. The median number of patients LTF was 3 (range 0-25), with 56% of reported outcomes having LTF greater than their respective FI.
    Conclusion: Studies of RCR with graft augmentation lack statistical stability, with few altered outcome events required to reverse statistical significance. Larger comparative studies with better follow-up will strengthen the statistical stability of the evidence for RCR with graft augmentation. For future investigations and reports, we recommend including FI and FQ along with traditional statistical significance analyses to provide better context on the strength of conclusions.
    MeSH term(s) Humans ; Arthroplasty ; Research Design ; Rotator Cuff/surgery ; Rotator Cuff Injuries/surgery
    Language English
    Publishing date 2023-01-18
    Publishing country United States
    Document type Systematic Review ; Journal Article
    ZDB-ID 1170782-3
    ISSN 1532-6500 ; 1058-2746
    ISSN (online) 1532-6500
    ISSN 1058-2746
    DOI 10.1016/j.jse.2022.12.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Site of Ambulance Origination and Billing for Out-of-Network Services.

    Gong, Jung Ho / Azad, Chao Long / Zhang, Gongliang / Means, Kenneth R / Aliu, Oluseyi / Giladi, Aviram M

    JAMA network open

    2024  Volume 7, Issue 2, Page(s) e240118

    Abstract: Importance: The No Surprises Act implemented in 2022 aims to protect patients from surprise out-of-network (OON) bills, but it does not include ground ambulance services. Understanding ground ambulance OON and balance billing patterns from previous ... ...

    Abstract Importance: The No Surprises Act implemented in 2022 aims to protect patients from surprise out-of-network (OON) bills, but it does not include ground ambulance services. Understanding ground ambulance OON and balance billing patterns from previous years could guide legislation aimed to protect patients following ground ambulance use.
    Objective: To characterize OON billing from ground ambulance services by evaluating whether OON billing risk differs by the site of ambulance origination (home, hospital, nonhospital medical facility, or scene of incident).
    Design, setting, and participants: Cross-sectional study of the Merative MarketScan dataset between January 1, 2015, and December 31, 2020, using claims-based data from employer-based private health insurance plans in the US. Participants included patients who utilized ground ambulances during the study period. Data were analyzed from June to December 2023.
    Exposure: Medical encounter requiring ground ambulance transportation.
    Main outcomes and measures: Ground ambulance OON billing prevalence was calcuated. Linear probability models adjusted for state-level mixed effects were fit to evaluate OON billing probability across ambulance origins. Secondary outcomes included the allowed payment, patient cost-sharing amounts, and potential balance bills for OON ambulances.
    Results: Among 2 031 937 ground ambulance services (1 375 977 unique patients) meeting the inclusion and exclusion criteria, 1 072 791 (52.8%) rides transported men, and the mean (SD) patient age was 41 (18) years. Of all services, 1 113 676 (54.8%) were billed OON. OON billing probabilities for ambulances originating from home or scene were higher by 12.0 percentage points (PP) (95% CI, 11.8-12.2 PP; P < .001 for home; 95% CI, 11.7-12.2 PP; P < .001 for scene) vs those originating from hospitals. Mean (SD) total financial burden, including cost-sharing and potential balance bills per ambulance service, was $434.70 ($415.99) per service billed OON vs $132.21 ($244.92) per service billed in-network.
    Conclusions and relevance: In this cross-sectional study of over 2 million ground ambulance services, ambulances originating from home, the scene of an incident, and nonhospital medical facilities were more likely to result in OON bills. Legislation is needed to protect patients from surprise billing following use of ground ambulances, more than half of which resulted in OON billing. Future legislation should at minimum offer protections for these subsets of patients often calling for an ambulance in urgent or emergent situations.
    MeSH term(s) Male ; Humans ; Adult ; Ambulances ; Cross-Sectional Studies ; Cost Sharing ; Financial Stress ; Health Facilities
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.0118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Autoimmune Hemolytic Anemia After mRNA COVID Vaccine.

    Fatima, Zainab / Reece, Blair R A / Moore, J Suzanne / Means, Robert T

    Journal of investigative medicine high impact case reports

    2022  Volume 10, Page(s) 23247096211073258

    Abstract: Discussion of the hematologic complications of vaccination for severe acute respiratory syndrome coronavirus-2 (COVID-19) has primarily focused on the development of vaccine-associated immune thrombosis with thrombocytopenia (VITT). Other hematologic ... ...

    Abstract Discussion of the hematologic complications of vaccination for severe acute respiratory syndrome coronavirus-2 (COVID-19) has primarily focused on the development of vaccine-associated immune thrombosis with thrombocytopenia (VITT). Other hematologic complications are uncommon. We report the case of a patient who developed immunoglobulin G (IgG)-mediated autoimmune hemolytic anemia (AIHA) after the Moderna COVID-19 messenger ribonucleic acid (mRNA) vaccine.
    MeSH term(s) Anemia, Hemolytic, Autoimmune/chemically induced ; COVID-19 ; COVID-19 Vaccines ; Humans ; RNA, Messenger/genetics ; SARS-CoV-2 ; Vaccines
    Chemical Substances COVID-19 Vaccines ; RNA, Messenger ; Vaccines
    Language English
    Publishing date 2022-01-19
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2710326-2
    ISSN 2324-7096 ; 2324-7096
    ISSN (online) 2324-7096
    ISSN 2324-7096
    DOI 10.1177/23247096211073258
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  6. Article ; Online: Multichannel mapping of in vivo rat uterine myometrium exhibits both high and low frequency electrical activity in non-pregnancy.

    Garrett, Amy S / Roesler, Mathias W / Athavale, Omkar N / Du, Peng / Means, Shawn A / Clark, Alys R / Cheng, Leo K

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 7316

    Abstract: The uterus exhibits intermittent electrophysiological activity in vivo. Although most active during labor, the non-pregnant uterus can exhibit activity of comparable magnitude to the early stages of labor. In this study, two types of flexible electrodes ... ...

    Abstract The uterus exhibits intermittent electrophysiological activity in vivo. Although most active during labor, the non-pregnant uterus can exhibit activity of comparable magnitude to the early stages of labor. In this study, two types of flexible electrodes were utilized to measure the electrical activity of uterine smooth muscle in vivo in anesthetized, non-pregnant rats. Flexible printed circuit electrodes were placed on the serosal surface of the uterine horn of six anesthetized rats. Electrical activity was recorded for a duration of 20-30 min. Activity contained two components: high frequency activity (bursts) and an underlying low frequency 'slow wave' which occurred concurrently. These components had dominant frequencies of 6.82 ± 0.63 Hz for the burst frequency and 0.032 ± 0.0055 Hz for the slow wave frequency. There was a mean burst occurrence rate of 0.76 ± 0.23 bursts per minute and mean burst duration of 20.1 ± 6.5 s. The use of multiple high-resolution electrodes enabled 2D mapping of the initiation and propagation of activity along the uterine horn. This in vivo approach has the potential to provide the organ level detail to help interpret non-invasive body surface recordings.
    MeSH term(s) Female ; Pregnancy ; Rats ; Animals ; Myometrium/physiology ; Electromyography ; Uterus/physiology ; Labor, Obstetric/physiology ; Electrodes ; Uterine Contraction/physiology
    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-57734-3
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  7. Article ; Online: Steady-state approximations for Hodgkin-Huxley cell models: Reduction of order for uterine smooth muscle cell model.

    Means, Shawn A / Roesler, Mathias W / Garrett, Amy S / Cheng, Leo / Clark, Alys R

    PLoS computational biology

    2023  Volume 19, Issue 8, Page(s) e1011359

    Abstract: Multi-scale mathematical bioelectrical models of organs such as the uterus, stomach or heart present challenges both for accuracy and computational tractability. These multi-scale models are typically founded on models of biological cells derived from ... ...

    Abstract Multi-scale mathematical bioelectrical models of organs such as the uterus, stomach or heart present challenges both for accuracy and computational tractability. These multi-scale models are typically founded on models of biological cells derived from the classic Hodkgin-Huxley (HH) formalism. Ion channel behaviour is tracked with dynamical variables representing activation or inactivation of currents that relax to steady-state dependencies on cellular membrane voltage. Timescales for relaxation may be orders of magnitude faster than companion ion channel variables or phenomena of physiological interest for the entire cell (such as bursting sequences of action potentials) or the entire organ (such as electromechanical coordination). Exploiting these time scales with steady-state approximations for relatively fast-acting systems is a well-known but often overlooked approach as evidenced by recent published models. We thus investigate feasibility of an extensive reduction of order for an HH-type cell model with steady-state approximations to the full dynamical activation and inactivation ion channel variables. Our effort utilises a published comprehensive uterine smooth muscle cell model that encompasses 19 ordinary differential equations and 105 formulations overall. The numerous ion channel submodels in the published model exhibit relaxation times ranging from order 10-1 to 105 milliseconds. Substitution of the faster dynamic variables with steady-state formulations demonstrates both an accurate reproduction of the full model and substantial improvements in time-to-solve, for test cases performed. Our demonstration here of an effective and relatively straightforward reduction method underlines the particular importance of considering time scales for model simplification before embarking on large-scale computations or parameter sweeps. As a preliminary complement to more intensive reduction of order methods such as parameter sensitivity and bifurcation analysis, this approach can rapidly and accurately improve computational tractability for challenging multi-scale organ modelling efforts.
    MeSH term(s) Female ; Humans ; Reed-Sternberg Cells ; Action Potentials ; Cell Membrane ; Heart ; Myocytes, Smooth Muscle
    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2193340-6
    ISSN 1553-7358 ; 1553-734X
    ISSN (online) 1553-7358
    ISSN 1553-734X
    DOI 10.1371/journal.pcbi.1011359
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  8. Article ; Online: Patient Perspectives on Cognitive Behavioral Therapy for Thumb, Hand, or Wrist Pain and Function: A Survey of 98 Patients.

    Imbergamo, Casey M / Durant, Natasha F / Giladi, Aviram M / Means, Kenneth R

    The Journal of hand surgery

    2023  Volume 49, Issue 1, Page(s) 28–34

    Abstract: Purpose: Cognitive behavioral therapy (CBT) is an established option to improve pain and function for many orthopedic conditions. Our purpose was to obtain patient perspectives regarding CBT for thumb, hand, or wrist pain and function.: Methods: ... ...

    Abstract Purpose: Cognitive behavioral therapy (CBT) is an established option to improve pain and function for many orthopedic conditions. Our purpose was to obtain patient perspectives regarding CBT for thumb, hand, or wrist pain and function.
    Methods: Between March and April 2022, we distributed an electronic survey via email to patients in our institution's health system with a diagnosis of arthritic or non-specific thumb, hand, or wrist pain. The survey included the opening statement "Cognitive Behavioral Therapy (CBT) is a non-medication option to help manage pain and improve function" and up to 13 questions pertaining to patients' experiences and perceptions regarding CBT. The survey was anonymous and did not collect protected health information. We used descriptive statistics for the findings.
    Results: We distributed the survey to 327 patients, yielding a 30% response rate (98/327). Of the respondents, 17 reported already using CBT to specifically help with pain/function. Of these, 15 felt it was helpful and agreed it could help others. Of the subset that used CBT for arthritis, all felt it was helpful. Of the 75 respondents with no CBT experience, 42 indicated "I've never heard of it," 28 responded "I never had it recommended as an option," and 16 marked "I don't know enough about it." Small subsets noted potential personal barriers to CBT implementation, such as cost, time involved, or perceived lack of potential efficacy for themselves.
    Conclusions: A small proportion of patients from our institution with thumb, hand, or wrist pain are utilizing CBT, and the majority finds it helpful.
    Clinical relevance: While some patients are already substantially benefiting from CBT to improve their thumb, hand, or wrist pain or function, there is a notable opportunity for providers to increase awareness and recommendations for this option.
    MeSH term(s) Humans ; Thumb ; Wrist ; Carpometacarpal Joints ; Arthralgia/diagnosis ; Pain ; Surveys and Questionnaires ; Cognitive Behavioral Therapy
    Language English
    Publishing date 2023-09-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605716-0
    ISSN 1531-6564 ; 0363-5023
    ISSN (online) 1531-6564
    ISSN 0363-5023
    DOI 10.1016/j.jhsa.2023.08.002
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  9. Article ; Online: Total Joint Arthroplasty of a Proximal Interphalangeal Joint with Proximal Metal Surface Replacement and Distal Hemi-Hamate Autograft: A Long-Term Follow-Up.

    Wu, Caroline / Drake, Matthew / Means, Kenneth R

    Journal of hand surgery global online

    2022  Volume 4, Issue 3, Page(s) 189–193

    Abstract: A 28-year-old female recreational athlete presented with middle finger proximal interphalangeal joint pain, stiffness, and ulnar deviation deformity 2 years after internal fixation of a middle phalanx base fracture-dislocation. Radiographs revealed ... ...

    Abstract A 28-year-old female recreational athlete presented with middle finger proximal interphalangeal joint pain, stiffness, and ulnar deviation deformity 2 years after internal fixation of a middle phalanx base fracture-dislocation. Radiographs revealed posttraumatic changes on both sides of the proximal interphalangeal joint. Having failed nonsurgical measures, she elected to proceed with surgical reconstruction. Intraoperatively, we confirmed substantial articular damage on both sides of the joint. We proceeded with hemi-hamate autograft for 80% of the middle phalanx base. We used a cobalt chrome proximal phalanx component. After healing, the patient returned to all daily-living and athletic activities with resolution of preoperative pain, stiffness, and deformity. Twelve years after surgey, she had no pain or substantial limitations because of the finger. We measured 80° of proximal interphalangeal joint motion. The grip and fingertip-pinch strength were 91% and 73%, respectively, of the contralateral dominant hand. Radiographs showed no progressive changes compared to 3 years after surgery.
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Case Reports
    ISSN 2589-5141
    ISSN (online) 2589-5141
    DOI 10.1016/j.jhsg.2022.02.002
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  10. Article ; Online: Understanding and Measuring Long-Term Outcomes of Fingertip and Nail Bed Injuries and Treatments.

    Means, Kenneth R / Saunders, Rebecca J

    Hand clinics

    2020  Volume 37, Issue 1, Page(s) 125–153

    Abstract: There are many outcome measures to choose from when caring for or studying fingertip and nail bed trauma and treatments. This article outlines general outcome measures principles as well as guidelines on choosing, implementing, and interpreting specific ... ...

    Abstract There are many outcome measures to choose from when caring for or studying fingertip and nail bed trauma and treatments. This article outlines general outcome measures principles as well as guidelines on choosing, implementing, and interpreting specific tools for these injuries. It also presents recent results from the literature for many of these measures, which can help learners, educators, and researchers by providing a clinical knowledge base and aiding study design.
    MeSH term(s) Amputation, Traumatic/surgery ; Finger Injuries/diagnosis ; Finger Injuries/therapy ; Fingers ; Humans ; Nails/injuries ; Nails/surgery ; Outcome Assessment, Health Care
    Language English
    Publishing date 2020-11-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1315374-2
    ISSN 1558-1969 ; 0749-0712
    ISSN (online) 1558-1969
    ISSN 0749-0712
    DOI 10.1016/j.hcl.2020.09.011
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