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Article ; Online: Reliance on metrics is a fundamental challenge for AI.

Thomas, Rachel L / Uminsky, David

Patterns (New York, N.Y.)

2022 Volume 3, Issue 5, Page(s) 100476

Abstract: Through a series of case studies, we review how the unthinking pursuit of metric optimization can lead to real-world harms, including recommendation systems promoting radicalization, well-loved teachers fired by an algorithm, and essay grading software ... ...

Abstract	Through a series of case studies, we review how the unthinking pursuit of metric optimization can lead to real-world harms, including recommendation systems promoting radicalization, well-loved teachers fired by an algorithm, and essay grading software that rewards sophisticated garbage. The metrics used are often proxies for underlying, unmeasurable quantities (e.g., "watch time" of a video as a proxy for "user satisfaction"). We propose an evidence-based framework to mitigate such harms by (1) using a slate of metrics to get a fuller and more nuanced picture; (2) conducting external algorithmic audits; (3) combining metrics with qualitative accounts; and (4) involving a range of stakeholders, including those who will be most impacted.
Language	English
Publishing date	2022-05-13
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2666-3899
ISSN (online)	2666-3899
DOI	10.1016/j.patter.2022.100476
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Article: Bilateral Asynchronous Displaced Olecranon Fractures in a Patient With Osteogenesis Imperfecta.

Thomas, Rachel A / Hennrikus, William

Cureus

2022 Volume 14, Issue 3, Page(s) e23433

Abstract: Olecranon fractures are uncommon in children. Children with osteogenesis imperfecta (OI) are at an increased risk of olecranon fractures. This is a report of a 12-year-old male patient with known osteogenesis imperfecta type 1 who sustained bilateral ... ...

Abstract	Olecranon fractures are uncommon in children. Children with osteogenesis imperfecta (OI) are at an increased risk of olecranon fractures. This is a report of a 12-year-old male patient with known osteogenesis imperfecta type 1 who sustained bilateral asynchronous olecranon metaphyseal avulsion fractures. He sustained a right olecranon avulsion fracture from a fall and underwent open reduction and internal fixation with two Steinman pins and a tension band wire. He was placed in a cast for a month. The Steinman pins were removed at three months. Six months after the first fracture, he sustained a left olecranon avulsion fracture while playing soccer. He underwent open reduction and internal fixation with two Steinman pins and tension band wiring. Hardware was removed at three months. He was returned to full activity due to his type 1 OI. Bilateral asynchronous avulsion fractures of the olecranon are rare, except in children with OI. In the current case, good functional recovery was obtained with tension band wiring.
Language	English
Publishing date	2022-03-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.23433
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Article: Applications of near-infrared spectroscopy in neurocritical care.

Thomas, Rachel / Shin, Samuel S / Balu, Ramani

Neurophotonics

2023 Volume 10, Issue 2, Page(s) 23522

Abstract: Significance: Acute brain injuries are commonly encountered in the intensive care unit. Alterations in cerebrovascular physiology triggered by the initial insult can lead to neurological worsening, further brain injury, and poor outcomes. Robust methods ...

Abstract	Significance: Acute brain injuries are commonly encountered in the intensive care unit. Alterations in cerebrovascular physiology triggered by the initial insult can lead to neurological worsening, further brain injury, and poor outcomes. Robust methods for assessing cerebrovascular physiology continuously at the bedside are limited. Aim: In this review, we aim to assess the potential of near-infrared spectroscopy (NIRS) as a bedside tool to monitor cerebrovascular physiology in critically ill patients with acute brain injury as well as those who are at high risk for developing brain injury. Approach: We first review basic principles of cerebral blood flow regulation and how these are altered after brain injury. We then discuss the potential role for NIRS in different acute brain injuries. We pay specific attention to the potential for NIRS to (1) identify new brain injuries and clinical worsening, (2) non-invasively measure intracranial pressure (ICP) and cerebral autoregulation, and (3) identify optimal blood pressure (BP) targets that may improve patient outcomes. Results: A growing body of work supports the use of NIRS in the care of brain injured patients. NIRS is routinely used during cardiac surgeries to identify acute neurologic events, and there is some evidence that treatment algorithms using cerebral oximetry may result in improved outcomes. In acute brain injury, NIRS can be used to measure autoregulation to identify an "optimum" BP where autoregulation status is best preserved. Finally, NIRS has been utilized to identify oximetry thresholds that correlate with poor outcome as well as identify new focal intracranial hemorrhages. Conclusions: NIRS is emerging as a tool that can non-invasively measure brain function in critically ill patients. Future work will be aimed at technical refinements to improve diagnostic accuracy, as well as larger scale clinical trials that can establish a definitive impact on patient outcomes.
Language	English
Publishing date	2023-06-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2781943-7
ISSN	2329-4248 ; 2329-423X
ISSN (online)	2329-4248
ISSN	2329-423X
DOI	10.1117/1.NPh.10.2.023522
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Article ; Online: Strategies to enhance physical activity in people with Rheumatoid Arthritis: A Delphi survey.

Thomas, Rachel / Berry, Alice / Swales, Caroline / Cramp, Fiona

Musculoskeletal care

2023 Volume 21, Issue 3, Page(s) 723–732

Abstract: Introduction: Managing symptoms, resisting functional decline and maintaining health and independence are key motivators for people with Rheumatoid Arthritis (RA) who successfully engage with physical activity (PA). To inform PA support for people with ... ...

Abstract	Introduction: Managing symptoms, resisting functional decline and maintaining health and independence are key motivators for people with Rheumatoid Arthritis (RA) who successfully engage with physical activity (PA). To inform PA support for people with RA the aim was to determine whether the broader RA population share similar beliefs and strategies regarding PA to those who report successful engagement. Methods: A modified two-stage Delphi approach. 200 patients from four National Health Service rheumatology departments received a postal questionnaire containing statements relating to engagement with PA derived from prior interview data from physically active individuals with RA. Statements rated as agree or strongly agree by >50% of respondents were retained and the same respondents asked to rate and prioritize potential PA intervention components. Ethical approval: Oxford C Research Ethics Committee (ref 13/SC/0418). Results: Questionnaire one received 49 responses (11 males, 37 females, 1 unknown), mean age 65 years (range 29-82). Low levels of PA were reported by 60% of respondents. Questionnaire two responses (n = 36) indicated that a PA intervention should include information about prevention of RA symptoms worsening and benefits of PA for joints; help participants to achieve improved pain management and a feeling of being in control of their RA. For PA maintenance it was important that medication controlled symptoms, and PA instructors understood RA to ensure safety. Conclusions: A key factor to consider when designing a PA intervention for people with RA is that education from a knowledgeable instructor should underpin programme delivery alongside effective medication. Programmes may need tailoring based on demographics; this should be explored in future studies.
MeSH term(s)	Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; State Medicine ; Exercise ; Surveys and Questionnaires ; Arthritis, Rheumatoid
Language	English
Publishing date	2023-03-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1745
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Article: Understanding immunotherapy for the treatment of non-small cell lung cancer.

Thomas, Rachel

British journal of nursing (Mark Allen Publishing)

2016 Volume 25, Issue 16, Page(s) S12–7

Abstract: Patients diagnosed with advanced non-small-cell lung cancer (NSCLC) (either squamous or non-squamous) have previously had limited treatment options after progression on chemotherapy. With the emergence of new drugs, particularly in the immuno-oncology ... ...

Abstract	Patients diagnosed with advanced non-small-cell lung cancer (NSCLC) (either squamous or non-squamous) have previously had limited treatment options after progression on chemotherapy. With the emergence of new drugs, particularly in the immuno-oncology setting, this is now changing. Recent clinical trial evidence demonstrates that compared with docetaxel, patients who received nivolumab had better overall survival and also significantly fewer grade 3-4 adverse events. This article reviews the clinical trial data for nivolumab and provides an overview of how this drug works. The adverse event profile of nivolumab is assessed and compared to that of docetaxel. The important role that nurses can play in supporting patients on nivolumab is also discussed.
MeSH term(s)	Adenocarcinoma/drug therapy ; Adenocarcinoma/immunology ; Adenocarcinoma/nursing ; Antibodies, Monoclonal/therapeutic use ; Antineoplastic Agents/therapeutic use ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/immunology ; Carcinoma, Non-Small-Cell Lung/nursing ; Carcinoma, Squamous Cell/drug therapy ; Carcinoma, Squamous Cell/immunology ; Carcinoma, Squamous Cell/nursing ; Humans ; Immunotherapy ; Lung Neoplasms/drug therapy ; Lung Neoplasms/immunology ; Lung Neoplasms/nursing ; Nurse's Role
Chemical Substances	Antibodies, Monoclonal ; Antineoplastic Agents ; nivolumab (31YO63LBSN)
Language	English
Publishing date	2016-09-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1119191-0
ISSN	0966-0461
ISSN	0966-0461
DOI	10.12968/bjon.2016.25.S12
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Zs.A 3449: Show issues

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Article ; Online: Delaminated Patellar Tendon Rupture in a Pediatric Patient: A Case Report.

Mun, Frederick / Thomas, Rachel A / Kim, Raymond Y / Petfield, Joseph L

JBJS case connector

2023 Volume 13, Issue 4

Abstract: Case: We present a 12-year-old boy with partial delamination of the patellar tendon in the coronal plane and bipolar avulsion fracture of the tibial tubercle and patella after a planting injury while skateboarding. Pediatric patellar tendon rupture with ...

Abstract	Case: We present a 12-year-old boy with partial delamination of the patellar tendon in the coronal plane and bipolar avulsion fracture of the tibial tubercle and patella after a planting injury while skateboarding. Pediatric patellar tendon rupture with associated bipolar avulsion fractures is rare. Furthermore, to the best of our knowledge, a delamination injury pattern of the patellar tendon has not been described. Conclusion: This type of extensor mechanism injury has not been reported in the literature. Repair with Krackow sutures and suture-bone tunnel technique, with consideration of the proximal tibial physis, is a safe and effective way to fix this unique pathology.
MeSH term(s)	Male ; Humans ; Child ; Patellar Ligament/diagnostic imaging ; Patellar Ligament/surgery ; Patellar Ligament/injuries ; Fractures, Bone/surgery ; Tendon Injuries/diagnostic imaging ; Tendon Injuries/surgery ; Tendon Injuries/complications
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	10.2106/JBJS.CC.23.00335
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Article ; Online: Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Henderson, Jillian T / Webber, Elizabeth M / Thomas, Rachel G / Vesco, Kimberly K

JAMA

2023 Volume 330, Issue 11, Page(s) 1083–1091

Abstract: Importance: Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality in the US.: Objective: To conduct a targeted systematic review to update the evidence on the effectiveness of screening for hypertensive ... ...

Abstract	Importance: Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality in the US. Objective: To conduct a targeted systematic review to update the evidence on the effectiveness of screening for hypertensive disorders of pregnancy to inform the US Preventive Services Task Force. Data sources: MEDLINE and the Cochrane Central Register of Controlled Trials for relevant studies published between January 1, 2014, and January 4, 2022; surveillance through February 21, 2023. Study selection: English-language comparative effectiveness studies comparing screening strategies in pregnant or postpartum individuals. Data extraction and synthesis: Two reviewers independently appraised articles and extracted relevant data from fair-or good-quality studies; no quantitative synthesis was conducted. Main outcomes and measures: Morbidity or mortality, measures of health-related quality of life. Results: The review included 6 fair-quality studies (5 trials and 1 nonrandomized study; N = 10 165) comparing changes in prenatal screening practices with usual care, which was routine screening at in-person office visits. No studies addressed screening for new-onset hypertensive disorders of pregnancy in the postpartum period. One trial (n = 2521) evaluated home blood pressure measurement as a supplement to usual care; 3 trials (total n = 5203) evaluated reduced prenatal visit schedules. One study (n = 2441) evaluated proteinuria screening conducted only for specific clinical indications, compared with a historical control group that received routine proteinuria screening. One additional trial (n = 80) only addressed the comparative harms of home blood pressure measurement. The studies did not report statistically significant differences in maternal and infant complications with alternate strategies compared with usual care; however, estimates were imprecise for serious, rare health outcomes. Home blood pressure measurement added to prenatal care visits was not associated with earlier diagnosis of a hypertensive disorder of pregnancy (104.3 vs 106.2 days), and incidence was not different between groups in 3 trials of reduced prenatal visit schedules. No harms of the different screening strategies were identified. Conclusions and relevance: This review did not identify evidence that any alternative screening strategies for hypertensive disorders of pregnancy were more effective than routine blood pressure measurement at in-person prenatal visits. Morbidity and mortality from hypertensive disorders of pregnancy can be prevented, yet American Indian/Alaska Native persons and Black persons experience inequitable rates of adverse outcomes. Further research is needed to identify screening approaches that may lead to improved disease detection and health outcomes.
MeSH term(s)	Female ; Humans ; Infant ; Pregnancy ; Advisory Committees ; Blood Pressure Determination ; Hypertension, Pregnancy-Induced/diagnosis ; Quality of Life ; United States ; Pregnancy Outcome ; Black or African American ; American Indian or Alaska Native
Language	English
Publishing date	2023-09-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2023.4934
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Article ; Online: The impact of remote consultations on the health and wellbeing of first contact physiotherapists in primary care: A mixed methods study.

Anchors, Zoe / Jones, Bethan / Thomas, Rachel / Berry, Alice / Walsh, Nicola

Musculoskeletal care

2023 Volume 21, Issue 3, Page(s) 655–666

Abstract: Background: First Contact Physiotherapists (FCPs) were introduced to reduce demands on GPs by providing improving access to expert musculoskeletal care. FCPs experience similar workplace stressors to GPs and there is an emerging concern that remote ... ...

Abstract	Background: First Contact Physiotherapists (FCPs) were introduced to reduce demands on GPs by providing improving access to expert musculoskeletal care. FCPs experience similar workplace stressors to GPs and there is an emerging concern that remote consultations are causing further impacts to their wellbeing. Aim: To explore the impact of remote consultations on FCPs. Methods: A mixed methods sequential explanatory study with FCPs was conducted. An online survey measured the usage and impact of remote consultations. Semi-structured interviews explored the lived experiences of using remote consultations. Results: The online survey was completed by 109 FCPs. A key benefit of remote consultations was patient convenience; perceived challenges included IT issues, poor efficacy, FCP anxiety, isolation, and increased workload. FCPs viewed remote consultations as a 'challenge' rather than a 'threat'. Nearly two thirds of the FCPs had not received relevant training, yet over half were interested. Follow-up interviews with 16 FCPs revealed 4 themes: (1) Remote consultations provide logistical benefits to the patient; (2) Compromised efficacy is the key challenge of remote consultations; (3) Challenges for FCPs working in areas of high deprivation; and (4) Remote consultations impact the health, wellbeing and work satisfaction of FCPs. Conclusions: Remote consultations offer a convenient alternative for patients, but may add to FCP stress particularly in areas of high socioeconomic deprivation. Further research is required to understand how remote consultations can be enhanced when communication barriers and lower levels of digital literacy exist. Continued monitoring of job satisfaction and resilience levels is important to ensure FCPs remain in their role.
MeSH term(s)	Humans ; Remote Consultation/methods ; Physical Therapists ; Primary Health Care ; Qualitative Research ; Patient Satisfaction
Language	English
Publishing date	2023-02-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1737
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Article: Total Hip Arthroplasty in a Patient With Fascioscapulohumeral Dystrophy.

Thomas, Rachel A / Warfield, Dennis J / Nikkel, Lucas E

Arthroplasty today

2022 Volume 19, Page(s) 101021

Abstract: Facioscapulohumeral dystrophy is an autosomal dominant disorder that results in progressive muscle weakness. Patients most commonly present with facial and periscapular muscle weakness, which progresses to involve their upper and lower extremities as ... ...

Abstract	Facioscapulohumeral dystrophy is an autosomal dominant disorder that results in progressive muscle weakness. Patients most commonly present with facial and periscapular muscle weakness, which progresses to involve their upper and lower extremities as well as truncal muscles. We present a patient with facioscapulohumeral dystrophy who underwent staged bilateral total hip arthroplasties but developed late prosthetic joint infection. This case also reports the management of periprosthetic joint infection after total hip arthroplasties through explant and placement of an articulating spacer as well as both neuraxial and general anesthetic management for this uncommon neuromuscular disorder.
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2352-3441
ISSN	2352-3441
DOI	10.1016/j.artd.2022.08.014
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Article ; Online: Are aged pTreg cells "the more the better"?

Wang, Weikan / Thomas, Rachel / Su, Dong-Ming

Aging

2022 Volume 14, Issue 24, Page(s) 9777–9778

MeSH term(s)	T-Lymphocytes, Regulatory ; Immune Tolerance
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Editorial
ISSN	1945-4589
ISSN (online)	1945-4589
DOI	10.18632/aging.204454
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