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Article ; Online: Difficult Conversations.

Lin, I-Chun F / Kane, Robert L / Chung, Kevin C

2022 Volume 150, Issue 2, Page(s) 237–241

MeSH term(s)	Communication ; Humans ; Physician-Patient Relations
Language	English
Publishing date	2022-07-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000009087
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Article ; Online: Collaboration in Hand Surgery: Experiences From Silicone Arthroplasty in Rheumatoid Arthritis, Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness, Wrist and Radius Injury Surgical Trial, and Surgery of the Ulnar Nerve.

Kane, Robert L / Chung, Kevin C

The Journal of the American Academy of Orthopaedic Surgeons

2020 Volume 28, Issue 15, Page(s) e670–e678

Abstract: Outcomes research has historically been driven by single-center investigations. However, multicenter studies represent an opportunity to overcome challenges associated with single-center studies, including generalizability and adequate power. In hand ... ...

Abstract	Outcomes research has historically been driven by single-center investigations. However, multicenter studies represent an opportunity to overcome challenges associated with single-center studies, including generalizability and adequate power. In hand surgery, most clinical trials are single-center studies, with few having randomized controls and blinding of both participants and assessors. This pervasive issue jeopardizes the integrity of evidence-based practice in the field. Because healthcare payers emphasize applying the best available evidence to justify medical services, multicenter research collaborations are increasingly recognized as an avenue for efficiently generating high-quality evidence. Although no study design is perfect, the potential advantages of multicenter trials include generalizability of the results, larger sample sizes, and a collaboration of experienced investigators poised to optimize protocol development and study conduct. As the era of single-center studies shifts toward investment in multicenter trials and clinical registries, investigators will inevitably be faced with the challenges of conducting or contributing to multicenter research collaborations. We present our experiences in conducting multicenter investigations to provide insight into this demanding and rewarding frontier of research.
MeSH term(s)	Amputation ; Arthritis, Rheumatoid/surgery ; Arthroplasty/methods ; Evidence-Based Medicine ; Fingers/surgery ; Fingers/transplantation ; Hand/surgery ; Humans ; Intersectoral Collaboration ; Multicenter Studies as Topic ; Personal Satisfaction ; Radius/injuries ; Radius/surgery ; Replantation ; Silicones ; Treatment Outcome ; Ulnar Nerve/surgery ; Wrist Injuries/surgery
Chemical Substances	Silicones
Language	English
Publishing date	2020-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-20-00102
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Zs.MO 274: Show issues

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Article ; Online: Adjuvant and neoadjuvant therapies for hepatocellular carcinoma.

Vogel, Arndt / Grant, Robert C / Meyer, Tim / Sapisochin, Gonzalo / O'Kane, Grainne M / Saborowski, Anna

Hepatology (Baltimore, Md.)

2023

Abstract: Immune-oncology-based regimens have shown efficacy in advanced HCC and have been implemented as standard of care as first-line therapy. Their efficacy, including high response rates, and safety justify their evaluation in earlier disease stages. ... ...

Abstract	Immune-oncology-based regimens have shown efficacy in advanced HCC and have been implemented as standard of care as first-line therapy. Their efficacy, including high response rates, and safety justify their evaluation in earlier disease stages. Following negative results for adjuvant sorafenib in the global STORM trial in 2015, 4 global phase 3 trials, featuring different immune checkpoint inhibitor combinations, entered in parallel the race in the adjuvant setting. The IMbrave050 trial, comparing adjuvant atezolizumab in combination with bevacizumab to active surveillance following curative-intent resection or ablation, was the first to report, fast-tracking the results of the first interim analysis and demonstrating an improvement in recurrence-free survival. The trial has provoked a discussion on the horizon of expectations from adjuvant treatment and the clinical relevance of efficacy endpoints. Moreover, major pathological responses reported from early phase 2 data in the neoadjuvant setting provide a strong rationale for the evaluation of these concepts in phase 3 trials. In this review, we summarize current evidence and outline future directions for systemic therapies in early-stage HCC.
Language	English
Publishing date	2023-12-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000726
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Article ; Online: Inhibition of Toll-like Receptor 4 Using Small Molecule, TAK-242, Protects Islets from Innate Immune Responses.

Mattke, Jordan / Darden, Carly M / Vasu, Srividya / Lawrence, Michael C / Kirkland, Jeffrey / Kane, Robert R / Naziruddin, Bashoo

Cells

2024 Volume 13, Issue 5

Abstract: Islet transplantation is a therapeutic option to replace β-cell mass lost during type 1 or type 3c diabetes. Innate immune responses, particularly the instant blood-mediated inflammatory reaction and activation of monocytes, play a major role in the loss ...

Abstract	Islet transplantation is a therapeutic option to replace β-cell mass lost during type 1 or type 3c diabetes. Innate immune responses, particularly the instant blood-mediated inflammatory reaction and activation of monocytes, play a major role in the loss of transplanted islet tissue. In this study, we aimed to investigate the inhibition of toll-like receptor 4 (TLR4) on innate inflammatory responses. We first demonstrate a significant loss of graft function shortly after transplant through the assessment of miR-375 and miR-200c in plasma as biomarkers. Using in vitro models, we investigate how targeting TLR4 mitigates islet damage and immune cell activation during the peritransplant period. The results of this study support the application of TAK-242 as a therapeutic agent to reduce inflammatory and innate immune responses to islets immediately following transplantation into the hepatic portal vein. Therefore, TLR4 may serve as a target to improve islet transplant outcomes in the future.
MeSH term(s)	Immunity, Innate/drug effects ; Islets of Langerhans Transplantation/methods ; MicroRNAs ; Sulfonamides/pharmacology ; Toll-Like Receptor 4/antagonists & inhibitors ; Islets of Langerhans/drug effects ; Islets of Langerhans/immunology ; Humans
Chemical Substances	ethyl 6-(N-(2-chloro-4-fluorophenyl)sulfamoyl)cyclohex-1-ene-1-carboxylate ; MicroRNAs ; Sulfonamides ; Toll-Like Receptor 4
Language	English
Publishing date	2024-02-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells13050416
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Article ; Online: Toll-like receptor 4 in pancreatic damage and immune infiltration in acute pancreatitis.

Mattke, Jordan / Darden, Carly M / Lawrence, Michael C / Kuncha, Jayachandra / Shah, Yumna Ali / Kane, Robert R / Naziruddin, Bashoo

Frontiers in immunology

2024 Volume 15, Page(s) 1362727

Abstract: Acute pancreatitis is a complex inflammatory disease resulting in extreme pain and can result in significant morbidity and mortality. It can be caused by several factors ranging from genetics, alcohol use, gall stones, and ductal obstruction caused by ... ...

Abstract	Acute pancreatitis is a complex inflammatory disease resulting in extreme pain and can result in significant morbidity and mortality. It can be caused by several factors ranging from genetics, alcohol use, gall stones, and ductal obstruction caused by calcification or neutrophil extracellular traps. Acute pancreatitis is also characterized by immune cell infiltration of neutrophils and M1 macrophages. Toll-like receptor 4 (TLR4) is a pattern recognition receptor that has been noted to respond to endogenous ligands such as high mobility group box 1 (HMGB1) protein and or exogenous ligands such as lipopolysaccharide both of which can be present during the progression of acute pancreatitis. This receptor can be found on a variety of cell types from endothelial cells to resident and infiltrating immune cells leading to production of pro-inflammatory cytokines as well as immune cell activation and maturation resulting in the furthering of pancreatic damage during acute pancreatitis. In this review we will address the various mechanisms mediated by TLR4 in the advancement of acute pancreatitis and how targeting this receptor could lead to improved outcomes for patients suffering from this condition.
MeSH term(s)	Humans ; Acute Disease ; Endothelial Cells/metabolism ; Pancreas ; Pancreatitis/metabolism ; Toll-Like Receptor 4/metabolism
Chemical Substances	Toll-Like Receptor 4 ; TLR4 protein, human
Language	English
Publishing date	2024-03-22
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2024.1362727
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Article ; Online: Dupuytren contracture: using qualitative data to inform a conceptual framework for shared decision-making.

Cichocki, Meghan N / Chung, William T / Kane, Robert L / Chung, Kevin C

The Journal of hand surgery, European volume

2022 Volume 48, Issue 2, Page(s) 123–130

Abstract: Multiple treatment options are available to patients with Dupuytren contracture, making shared decision-making complex. Our rigorous qualitative analysis sought to understand patient perceptions of shared decision-making in Dupuytren contracture ... ...

Abstract	Multiple treatment options are available to patients with Dupuytren contracture, making shared decision-making complex. Our rigorous qualitative analysis sought to understand patient perceptions of shared decision-making in Dupuytren contracture treatment and create a conceptual framework to optimize patient-physician communication. We interviewed 30 patients with Dupuytren contracture to learn about their experience with treatment selection. The following themes were integral to shared decision-making for Dupuytren contracture treatment: discussing disease progression and treatment initiation, presenting all available treatment options, assessing patients' pre-existing biases towards treatment, patient values and preferences for treatment trade-offs, treatment risks and benefits, physician recommendation and active patient participation. This model can optimize communication about treatment options and expectations for relevant outcomes including, recovery time, contracture recurrence, complications, and treatment-related expenses.
MeSH term(s)	Humans ; Dupuytren Contracture/therapy ; Decision Making, Shared ; Physician-Patient Relations ; Patient Participation ; Communication ; Decision Making
Language	English
Publishing date	2022-11-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2272801-6
ISSN	2043-6289 ; 1753-1934
ISSN (online)	2043-6289
ISSN	1753-1934
DOI	10.1177/17531934221133992
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Zs.A 1940: Show issues

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Article ; Online: Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Pregnancy.

Kane, Robert C

Annals of internal medicine

2015 Volume 163, Issue 5, Page(s) 399–400

MeSH term(s)	Anemia, Iron-Deficiency/prevention & control ; Dietary Supplements ; Female ; Humans ; Iron/administration & dosage ; Mass Screening ; Pregnancy ; Pregnancy Complications, Hematologic/prevention & control
Chemical Substances	Iron (E1UOL152H7)
Language	English
Publishing date	2015-09-01
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/L15-5132
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Article ; Online: Representation of Ethics in COVID-19 Research: A Systematic Review.

Seyferth, Anne V / Wood, Shannon M / Kane, Robert L / Chung, Kevin C

Plastic and reconstructive surgery

2022 Volume 149, Issue 5, Page(s) 1237–1244

Abstract: Background: Ethical discourse in the scientific community facilitates the humane conduct of research. The urgent response to COVID-19 has rapidly generated a large body of literature to help policymakers and physicians address novel pandemic challenges. ...

Abstract	Background: Ethical discourse in the scientific community facilitates the humane conduct of research. The urgent response to COVID-19 has rapidly generated a large body of literature to help policymakers and physicians address novel pandemic challenges. Plastic surgeons, in particular, have to manage the postponement of elective procedures and safely provide care for non-COVID-19 patients. Although COVID-19 research may provide guidance on these challenges, the extent to which ethical discussions are present in these publications remains unknown. Methods: Articles were identified systematically by searching the PubMed, Embase, Central, and Scopus databases using search terms related to ethics and COVID-19. The search included articles published during the first 9 months of the COVID-19 pandemic. The following data were extracted: presence of an ethical discussion, date of publication, topic of ethical discussion, and scientific discipline of the article. Results: One thousand seven hundred fifty-three articles were included, of which seven were related to plastic surgery. The ethical principle with the greatest representation was nonmaleficence, whereas autonomy had the least representation. Equity and access to care was the most common topic of ethical discussion; the mental health effects of COVID-19 were the least common. The principle of justice had the greatest variation in representation. Conclusions: In a systematic review of COVID-19-related articles that were published during the first 9 months of the pandemic, the ethical principles of autonomy and justice are neglected in ethical discussions. As ethical dilemmas related to COVID-19 remain prevalent in plastic surgery, attention to ethical discourse should remain a top priority for leaders in the field.
MeSH term(s)	Beneficence ; COVID-19/epidemiology ; Humans ; Pandemics ; Social Justice ; Surgery, Plastic
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000009027
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Article ; Online: Evaluating Shared Decision-Making in Treatment Selection for Dupuytren Contracture: A Mixed Methods Approach.

Kane, Robert L / Wood, Shannon M / Cichocki, Meghan N / Chung, Kevin C

Plastic and reconstructive surgery

2022 Volume 151, Issue 2, Page(s) 255e–266e

Abstract: Background: Patients with Dupuytren contracture can receive a variety of surgical and nonsurgical treatments. The extent to which patients participate in the shared decision-making process is unclear.: Methods: An explanatory-sequential mixed-methods ...

Abstract	Background: Patients with Dupuytren contracture can receive a variety of surgical and nonsurgical treatments. The extent to which patients participate in the shared decision-making process is unclear. Methods: An explanatory-sequential mixed-methods study was conducted. Participants completed the Nine-Item Shared Decision-Making Questionnaire and the brief Michigan Hand Outcomes Questionnaire before completing semi-structured interviews in which they described their experience with selecting treatment. Results: Thirty participants [25 men (83%) and five women (17%); mean age, 69 years (range, 51 to 84 years)] received treatment for Dupuytren contracture (11 collagenase injection, six needle aponeurotomy, and 13 limited fasciectomy). Adjusted mean scores for the Shared Decision-Making Questionnaire and brief Michigan Hand Outcomes Questionnaire were 71 (SD 20) and 77 (SD 16), respectively, indicating a high degree of shared decision-making and satisfaction. Patients who received limited fasciectomy accepted invasiveness and prolonged recovery time because they believed it provided a long-term solution. Patients chose needle aponeurotomy and collagenase injection because the treatments were perceived as safer and more convenient and permitted rapid return to daily activities, which was particularly valued by patients who were employed or had bilateral contractures. Conclusions: Physicians should help patients choose a treatment that aligns with the patient's preferences for long-term versus short-term results, recovery period and postoperative rehabilitation, and risk of complications, because patients used this information to assist in their treatment selection. Areas of improvement for shared decision-making include equal presentation of all treatments and ensuring realistic patient expectations regarding the chronic and recurrent nature of Dupuytren contracture regardless of treatment received.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Aponeurosis/surgery ; Collagenases ; Dupuytren Contracture/psychology ; Dupuytren Contracture/surgery ; Dupuytren Contracture/therapy ; Fasciotomy/methods ; Injections, Intralesional ; Orthopedic Procedures/methods ; Treatment Outcome ; Decision Making, Shared ; Patient Participation/psychology
Chemical Substances	Collagenases (EC 3.4.24.-)
Language	English
Publishing date	2022-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000009849
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Uk I Zs.142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery.

Jayaram, Mayank / Wu, Hao / Yoon, Alfred P / Kane, Robert L / Wang, Lu / Chung, Kevin C

JAMA network open

2023 Volume 6, Issue 2, Page(s) e2255786

Abstract: Importance: Casting is recommended for adults older than 65 years with distal radius fractures (DRFs) because similar long-term outcomes are achieved regardless of treatment. However, physiologically younger adults could benefit from operative DRF ... ...

Abstract	Importance: Casting is recommended for adults older than 65 years with distal radius fractures (DRFs) because similar long-term outcomes are achieved regardless of treatment. However, physiologically younger adults could benefit from operative DRF management despite advanced chronologic age. Objective: To examine how chronologic age compares with measures of physiologic age in DRF treatment recovery. Design, setting, and participants: This retrospective secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST) was performed from May 1 to August 31, 2022. WRIST was a 24-center randomized clinical trial that enrolled participants older than 60 years with unstable DRFs from April 1, 2012, to December 31, 2016. Interventions: Participants selected casting or surgery. Patients who selected surgery were randomly assigned to volar lock plating, percutaneous pinning, or external fixation. Participants were stratified by chronologic age, number of comorbidities, and activity status. Main outcomes and measures: The primary outcome was Michigan Hand Outcomes Questionnaire (MHQ) score assessed at 6 weeks, 3 months, 6 months, and 1 year. Partial correlation (PC) analysis adjusted for confounding. Results: The final cohort consisted of 293 participants (mean [SD] age, 71.1 [8.89] years; 255 [87%] female; 247 [85%] White), with 109 receiving casting and 184 receiving surgery. Increased chronologic age was associated with increased MHQ scores in the surgery group at all time points but decreased MHQ scores in the casting group at 12 months (mean [SD] score, -0.46 [0.21]; P = .03). High activity was associated with improved MHQ scores in the surgical cohort at 6 weeks (mean [SD] score, 12.21 [5.18]; PC = 0.27; P = .02) and 12 months (mean [SD] score, 13.25 [5.77]; PC = 0.17; P = .02). Comorbidities were associated with decreased MHQ scores at all time points in the casting group. Clinically significant differences in MHQ scores were associated with low physical activity, 4 or more comorbidities, or increased age by 15 years. Conclusions and relevance: In this retrospective secondary analysis of WRIST, chronologic age was not associated with functional demand. These findings suggest that physicians should counsel active older adults with few comorbidities on earlier return to daily activities after surgery compared with casting. Trial registration: ClinicalTrials.gov Identifier: NCT01589692.
MeSH term(s)	Humans ; Female ; Aged ; Infant ; Adolescent ; Male ; Treatment Outcome ; Wrist Fractures ; Retrospective Studies ; Radius Fractures/surgery ; Radius Fractures/complications ; Fracture Fixation, Internal
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.55786
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