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Article ; Online: Osteoporosis: Recent Recommendations and Positions of the American Society for Bone and Mineral Research and the International Society for Clinical Densitometry.

Anderson, Paul A / Freedman, Brett A / Brox, W Timothy / Shaffer, William O

The Journal of bone and joint surgery. American volume

2021 Volume 103, Issue 8, Page(s) 741–747

Abstract: Osteoporosis is common in orthopaedic patients, not only in those sustaining fragility fractures but also in patients ≥50 years old who are having elective orthopaedic surgery.: ➤: The American Society for Bone and Mineral Research (ASBMR) has ... ...

Abstract	➤: Osteoporosis is common in orthopaedic patients, not only in those sustaining fragility fractures but also in patients ≥50 years old who are having elective orthopaedic surgery. ➤: The American Society for Bone and Mineral Research (ASBMR) has developed consensus-based recommendations for secondary fracture prevention for all patients who are ≥65 years old with a hip or spine fracture. ➤: The ASBMR encourages orthopaedic surgeons to "Own the Bone," by beginning prevention of a secondary fracture during hospitalization for a fragility fracture, if practicable, and arranging follow-up for continued bone health care after discharge. ➤: The International Society for Clinical Densitometry (ISCD) recognized that many poor outcomes and complications of elective orthopaedic surgery are related to osteoporosis. ➤: The ISCD used an evidence-based approach to create official positions to identify which patients ≥50 years old who are having elective orthopaedic surgery should undergo assessment of bone health and how this should be performed.
MeSH term(s)	Absorptiometry, Photon/methods ; Absorptiometry, Photon/standards ; Elective Surgical Procedures/methods ; Elective Surgical Procedures/standards ; Humans ; Orthopedic Procedures/methods ; Orthopedic Procedures/standards ; Osteoporosis/complications ; Osteoporosis/diagnostic imaging ; Osteoporosis/therapy ; Osteoporotic Fractures/etiology ; Osteoporotic Fractures/prevention & control ; Osteoporotic Fractures/surgery ; Outcome Assessment, Health Care ; Perioperative Care/methods ; Perioperative Care/standards ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Complications/surgery ; Practice Guidelines as Topic ; Risk Assessment ; Secondary Prevention/methods ; Secondary Prevention/standards
Language	English
Publishing date	2021-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.20.01248
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Zs.MO 464: Show issues

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Article ; Online: The Impact of On-Target Resistance Mediated by EGFR-T790M or EGFR-C797S on EGFR Exon 20 Insertion Mutation Active Tyrosine Kinase Inhibitors.

Kobayashi, Ikei S / Shaffer, William / Viray, Hollis / Rangachari, Deepa / VanderLaan, Paul A / Kobayashi, Susumu S / Costa, Daniel B

JTO clinical and research reports

2023 Volume 5, Issue 1, Page(s) 100614

Abstract: Introduction: Mechanisms of resistance to EGFR exon 20 insertion mutation active inhibitors have not been extensively studied in either robust preclinical models or patient-derived rebiopsy specimens. We sought to characterize on-target resistance ... ...

Abstract	Introduction: Mechanisms of resistance to EGFR exon 20 insertion mutation active inhibitors have not been extensively studied in either robust preclinical models or patient-derived rebiopsy specimens. We sought to characterize on-target resistance mutations identified in Methods: We identified mechanisms of resistance to EGFR exon 20 insertion mutation active inhibitors and then used preclinical models of EGFR exon 20 insertion mutations (A767_V769dupASV, D770_N771insSVD, V773_C774insH) plus common EGFR mutants to probe inhibitors in the absence/presence of EGFR-T790M or EGFR-C797S. Results: Mobocertinib had a favorable therapeutic window in relation to EGFR wild type for EGFR exon 20 insertion mutants, but the addition of EGFR-T790M or EGFR-C797S negated the observed window. Zipalertinib had a favorable therapeutic window for cells driven by EGFR-A767_V769dupASV or EGFR-D770_N771insSVD in the presence or absence of EGFR-T790M. Furmonertinib and sunvozertinib had the most favorable therapeutic windows in the presence or absence of EGFR-T790M in all cells tested. Conclusions: This report highlights that poziotinib and mobocertinib are susceptible to on-target resistance mediated by
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Journal Article
ISSN	2666-3643
ISSN (online)	2666-3643
DOI	10.1016/j.jtocrr.2023.100614
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Article ; Online: Understanding Value-based Reimbursement Models and Trends in Orthopaedic Health Policy: An Introduction to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

Saleh, Khaled J / Shaffer, William O

The Journal of the American Academy of Orthopaedic Surgeons

2016 Volume 24, Issue 11, Page(s) e136–e147

Abstract: In 2015, the US Congress passed legislation entitled the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA), which led to the formation of two reimbursement paradigms: the merit-based incentive payment system (MIPS) ...

Abstract	In 2015, the US Congress passed legislation entitled the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA), which led to the formation of two reimbursement paradigms: the merit-based incentive payment system (MIPS) and alternative payment models (APMs). The MACRA effectively repealed the Centers for Medicare and Medicaid Services (CMS) sustainable growth rate (SGR) formula while combining several CMS quality-reporting programs. As such, MACRA represents an unparalleled acceleration toward reimbursement models that recognize value rather than volume. The first pathway, MIPS, consolidates several Medicare quality-reporting programs into one composite score that will be derived by four performance categories, including quality (30%), resource utilization (30%), meaningful use (25%), and clinical practice improvement activities (15%). The APM pathway includes the following programs: Medicare accountable care organizations as part of the Medicare Shared Savings Program, Bundled Payments for Care Improvement, and Comprehensive Primary Care initiative. Existing APMs have yet to be determined as eligible. We provide a contextual framework of the healthcare legislation that has led to the formation of current health policy and offer recommendations regarding SGR how orthopaedic surgeons may best steer through such reimbursement models.
MeSH term(s)	Accountable Care Organizations/economics ; Arthroplasty, Replacement/economics ; Children's Health Insurance Program/legislation & jurisprudence ; Health Policy/trends ; Health Resources/utilization ; Humans ; Meaningful Use/economics ; Medicare/legislation & jurisprudence ; Models, Economic ; Orthopedics/economics ; Orthopedics/standards ; Patient Care Bundles/economics ; Quality Improvement/economics ; Quality of Health Care/economics ; Quality of Health Care/standards ; Registries ; Reimbursement, Incentive ; United States ; Value-Based Insurance/economics
Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-16-00283
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Zs.A 4048: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 274: Show issues

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Article ; Online: Heritability and variance component estimation for feed and water intake behaviors of feedlot cattle.

Dressler, Elizabeth A / Shaffer, William / Bruno, Kelsey / Krehbiel, Clint R / Calvo-Lorenzo, Michelle / Richards, Chris J / Place, Sara E / DeSilva, Udaya / Kuehn, Larry A / Weaber, Robert L / Bormann, Jennifer M / Rolf, Megan M

Journal of animal science

2023 Volume 101

Abstract: Feed and water intake are two important aspects of cattle production that greatly impact the profitability, efficiency, and sustainability of producers. Feed and, to a lesser degree, water intake have been studied previously; however, there is little ... ...

Abstract	Feed and water intake are two important aspects of cattle production that greatly impact the profitability, efficiency, and sustainability of producers. Feed and, to a lesser degree, water intake have been studied previously; however, there is little research on their associated animal behaviors and there is a lack of standardized phenotypes for these behaviors. Feed and water intakes obtained with an Insentec system (Hokofarm Group, The Netherlands) from 830 crossbred steers were used to compute five intake behaviors for both feed and water: daily sessions (DS), intake rate (IR), session size (SS), time per session (TS), and session interval (SI). Variance components and heritabilities were estimated for each trait. Heritabilities for feed intake behaviors were 0.50 ± 0.12, 0.63 ± 0.12, 0.40 ± 0.13, 0.35 ± 0.12, and 0.60 ± 0.12 for DS, IR, SS, TS, and SI, respectively. Heritabilities for water intake behaviors were 0.56 ± 0.11, 0.88 ± 0.07, 0.70 ± 0.11, 0.54 ± 0.12, and 0.80 ± 0.10 for NS, IR, SS, TS, and SI, respectively. Daily dry matter intake (DDMI) and daily water intake (DWI) had heritabilities of 0.57 ± 0.11 and 0.44 ± 0.11. Phenotypic correlations varied between pairs of traits (-0.83 to 0.82). Genetic correlations between DDMI and feed intake behaviors were moderate to high, while genetic correlations between DWI and water intake behaviors were low to moderate. Several significant single nucleotide polymorphisms (SNP) were identified for the feed and water intake behaviors. Genes and previously reported quantitative trait loci near significant SNPs were evaluated. The results indicated that feed and water intake behaviors are influenced by genetic factors and are heritable, providing one additional route to evaluate or manipulate feed and water intake.
MeSH term(s)	Cattle/genetics ; Animals ; Drinking ; Animal Feed ; Eating/genetics ; Behavior, Animal ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2023-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	390959-1
ISSN	1525-3163 ; 0021-8812
ISSN (online)	1525-3163
ISSN	0021-8812
DOI	10.1093/jas/skad386
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Article ; Online: EGFR exon 19 insertion EGFR-K745_E746insIPVAIK and others with rare XPVAIK amino-acid insertions: Preclinical and clinical characterization of the favorable therapeutic window to all classes of approved EGFR kinase inhibitors.

Shaffer, William / Kobayashi, Ikei S / Sentana-Lledo, Daniel / Sundararaman, Shriram / Lee, Meghan D / Rangachari, Deepa / VanderLaan, Paul A / Kobayashi, Susumu S / Costa, Daniel B

Lung cancer (Amsterdam, Netherlands)

2023 Volume 181, Page(s) 107250

Abstract: Background: The epidermal growth factor receptor (EGFR)-K745_E746insIPVAIK and others with XPVAIK amino-acid insertions are exon 19 insertion mutations, which, at the structural modeling level, resemble EGFR tyrosine kinase inhibitor (TKI)-sensitizing ... ...

Abstract	Background: The epidermal growth factor receptor (EGFR)-K745_E746insIPVAIK and others with XPVAIK amino-acid insertions are exon 19 insertion mutations, which, at the structural modeling level, resemble EGFR tyrosine kinase inhibitor (TKI)-sensitizing mutants. An important unmet need is the characterization of therapeutic windows plus clinical outcomes of exon 19 XPVAIK amino-acid insertion mutations to available EGFR TKIs. Methods: We used preclinical models of EGFR-K745_E746insIPVAIK and more typical EGFR mutations (exon 19 deletion, L858R, L861Q, G719S, A763_Y764insFQEA, other exon 20 insertion mutations) to probe representative 1st (erlotinib), 2nd (afatinib), 3rd generation (osimertinib), and EGFR exon 20 insertion active (mobocertinib) TKIs. We also compiled outcomes of EGFR exon 19 insertion mutated lung cancers-from our institution plus the literature-treated with EGFR TKIs. Results: Exon 19 insertions represented 0.3-0.8% of all EGFR kinase domain mutation in two cohorts (n = 1772). Cells driven by EGFR-K745_E746insIPVAIK had sensitivity to all classes of approved EGFR TKIs when compared to cells driven by EGFR-WT in proliferation assays and at the protein level. However, the therapeutic window of EGFR-K745_E746insIPVAIK driven cells was most akin to those of cells driven by EGFR-L861Q and EGFR-A763_Y764insFQEA than the more sensitive patterns seen with cells driven by an EGFR exon 19 deletion or EGFR-L858R. The majority (69.2%, n = 26) of patients with lung cancers harboring EGFR-K745_E746insIPVAIK and other mutations with rare XPVAIK amino-acid insertions responded to clinically available EGFR TKIs (including icotinib, gefitinib, erlotinib, afatinib and osimertinib), with heterogeneous periods of progression-free survival. Mechanisms of acquired EGFR TKI resistance of this mutant remained underreported. Conclusions: This is the largest preclinical/clinical report to highlight that EGFR-K745_E746insIPVAIK and other mutations with exon 19 XPVAIK amino-acid insertions are rare but sensitive to clinically available 1st, 2nd, and 3rd generation as well as EGFR exon 20 active TKIs; in a pattern that mostly resembles the outcomes of models with EGFR-L861Q and EGFR-A763_Y764insFQEA mutations. These data may help with the off-label selection of EGFR TKIs and clinical expectations of outcomes when targeted therapy is deployed for these EGFR mutated lung cancers.
MeSH term(s)	Humans ; Afatinib/therapeutic use ; Amino Acids/genetics ; Carcinoma, Non-Small-Cell Lung/drug therapy ; ErbB Receptors/genetics ; Erlotinib Hydrochloride/therapeutic use ; Exons ; Lung Neoplasms/drug therapy ; Mutation ; Protein Kinase Inhibitors/therapeutic use
Chemical Substances	Afatinib (41UD74L59M) ; Amino Acids ; EGFR protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; Erlotinib Hydrochloride (DA87705X9K) ; mobocertinib ; osimertinib (3C06JJ0Z2O) ; Protein Kinase Inhibitors
Language	English
Publishing date	2023-05-13
Publishing country	Ireland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	632771-0
ISSN	1872-8332 ; 0169-5002
ISSN (online)	1872-8332
ISSN	0169-5002
DOI	10.1016/j.lungcan.2023.107250
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Zs.A 2135: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 423: Show issues

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Article: Persistent Sciatic Artery: A Favorable Anatomic Variant in a Setting of Trauma.

Shaffer, William / Maher, Mary / Maristany, Michael / Ustunsoz, Bahri / Spieler, Bradley

The Ochsner journal

2017 Volume 17, Issue 2, Page(s) 189–194

Abstract: Background: Persistent sciatic artery (PSA) is a rare congenital anomaly of the circulation of the lower limb that results from the persistence of an artery that normally regresses early in embryonic development. PSA is usually an incidental finding and ...

Abstract	Background: Persistent sciatic artery (PSA) is a rare congenital anomaly of the circulation of the lower limb that results from the persistence of an artery that normally regresses early in embryonic development. PSA is usually an incidental finding and is exceedingly rare to find bilaterally. Case report: We present the case of a rare presentation of PSA that resulted in a favorable outcome for a patient who sustained a gunshot wound to his midthigh and discuss the history, embryology, anatomy, classification schema, imaging evaluation, complications, diagnosis, and management of PSA. Conclusion: PSAs are of doubtful clinical significance when found incidentally at imaging; however, individual patient symptoms, unique arterial anatomy, and the PSA classification best determine the appropriate treatment options.
Language	English
Publishing date	2017-06-15
Publishing country	United States
Document type	Case Reports
ISSN	1524-5012
ISSN	1524-5012
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Article ; Online: The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015: What's New?

Sayeed, Zain / El-Othmani, Mouhanad / Shaffer, William O / Saleh, Khaled J

The Journal of the American Academy of Orthopaedic Surgeons

2017 Volume 25, Issue 6, Page(s) e121–e130

Abstract: The Centers for Medicare and Medicaid Services (CMS) released its Final Rule on the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA) in November 2016. The Rule finalizes the details of the merit-based incentive ... ...

Abstract	The Centers for Medicare and Medicaid Services (CMS) released its Final Rule on the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA) in November 2016. The Rule finalizes the details of the merit-based incentive payment system (MIPS) and the alternative payment model (APM), which will now collectively be referred to as the Quality Payment Program (QPP). This article offers the orthopaedic community a summary of the alterations in healthcare policy that will affect practices nationwide.
Language	English
Publishing date	2017-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-17-00151
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Zs.A 4048: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 274: Show issues

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Article: Mitochondrial Encephalomyopathy With Lactic Acidosis and Stroke-Like Episodes-MELAS Syndrome.

Henry, Caitlin / Patel, Neema / Shaffer, William / Murphy, Lillian / Park, Joe / Spieler, Bradley

The Ochsner journal

2017 Volume 17, Issue 3, Page(s) 296–301

Abstract: Background: Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare inherited disorder that results in waxing and waning nervous system and muscle dysfunction. MELAS syndrome may overlap with other ... ...

Abstract	Background: Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare inherited disorder that results in waxing and waning nervous system and muscle dysfunction. MELAS syndrome may overlap with other neurologic disorders but shows distinctive imaging features. Case report: We present the case of a 28-year-old female with atypical stroke-like symptoms, a strong family history of stroke-like symptoms, and a relapsing-remitting course for several years. We discuss the imaging features distinctive to the case, the mechanism of the disease, typical presentation, imaging diagnosis, and disease management. Conclusion: This case is a classic example of the relapse-remitting MELAS syndrome progression with episodic clinical flares and fluctuating patterns of stroke-like lesions on imaging. MELAS is an important diagnostic consideration when neuroimaging reveals a pattern of disappearing and relapsing cortical brain lesions that may occur in different areas of the brain and are not necessarily limited to discrete vascular territories. Future studies should investigate disease mechanisms at the cellular level and the value of advanced magnetic resonance imaging techniques for a targeted approach to therapy.
Language	English
Publishing date	2017-10-04
Publishing country	United States
Document type	Case Reports
ISSN	1524-5012
ISSN	1524-5012
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Article: Charcot arthropathy because of congenital insensitivity to pain in an adult.

Cassidy, R Carter / Shaffer, William O

The spine journal : official journal of the North American Spine Society

2008 Volume 8, Issue 4, Page(s) 691–695

Abstract: Background: Congenital insensitivity to pain is a rare disorder that can lead to neuropathic arthropathy of any joint including the spine. Most of the case reports in the literature are in the pediatric population.: Purpose: This case report ... ...

Abstract	Background: Congenital insensitivity to pain is a rare disorder that can lead to neuropathic arthropathy of any joint including the spine. Most of the case reports in the literature are in the pediatric population. Purpose: This case report emphasizes the importance of anterior and posterior fusion in patients with congenital insensitivity to pain. The patient was initially treated as if the deformity was postinfectious. STUDY DESIGN SETTING: The patient was treated in a university-based tertiary care center. Methods: The patient underwent an anterior decompression and fusion with instrumentation that failed with ambulation. An anterior and posterior revision with instrumentation was then performed to stabilize the Charcot spine. Results: The patient had an excellent final outcome. At 2 years postoperatively, he is solidly fused and back to his normal occupation. Conclusion: Anterior and posterior fusion is essential in neuropathic spinal arthropathy. Congenital insensitivity to pain can manifest problems into adulthood.
MeSH term(s)	Adult ; Arthropathy, Neurogenic/etiology ; Arthropathy, Neurogenic/surgery ; Decompression, Surgical ; Hospitals, University ; Humans ; Male ; Pain Insensitivity, Congenital/complications ; Pain Insensitivity, Congenital/surgery ; Spinal Fusion/instrumentation ; Spinal Fusion/methods ; Treatment Outcome
Language	English
Publishing date	2008-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2037072-6
ISSN	1529-9430
ISSN	1529-9430
DOI	10.1016/j.spinee.2007.04.005
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Article: Atypical Presentation of Extramedullary Plasmacytoma.

Wallace, Eric / Stewart, Zachary / Theriot, David / Shaffer, William / Guillory, Shane / Hanemann, Michael / Danrad, Raman / Spieler, Bradley

The Ochsner journal

2018 Volume 18, Issue 1, Page(s) 101–103

Abstract: Background: Plasmacytomas are monoclonal proliferations of plasma cells that typically affect the intramedullary axial skeleton. Imaging findings of an extramedullary plasmacytoma on radiograph and computed tomography can be nonspecific and can resemble ...

Abstract	Background: Plasmacytomas are monoclonal proliferations of plasma cells that typically affect the intramedullary axial skeleton. Imaging findings of an extramedullary plasmacytoma on radiograph and computed tomography can be nonspecific and can resemble other entities such as lymphoma, metastases, chondrosarcomas, or giant cell tumors. Case report: A 60-year-old female with a medical history of partial complex seizures, hypertension, diabetes, glaucoma, and hyperlipidemia presented with complaints of superficial abdominal pain associated with erythema and swelling for 3 weeks. Computed tomography of her abdomen at time of presentation revealed a 5.8 × 2.7-cm irregularly marginated soft-tissue density just below the umbilicus with an adjacent defect in the midline rectus abdominis. The final pathologic diagnosis was extramedullary plasmacytoma. Treatment during the next year included local radiation, systemic chemotherapy, and an autologous peripheral blood stem cell transplant. Three years after initial diagnosis, the patient presented to the emergency department, and testing revealed new plasmacytomas. The decision was made to proceed with palliative care. Conclusion: This case is a unique example of a patient with an extramedullary plasmacytoma with no diagnostic signs of multiple myeloma.
Language	English
Publishing date	2018-03-20
Publishing country	United States
Document type	Case Reports
ISSN	1524-5012
ISSN	1524-5012
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