Protein dynamics is essential for various biological processes, influencing functions such as enzyme activity, molecular recognition, and signal transduction. However, traditional protein engineering methods often focus on static structures, lacking tools to precisely manipulate dynamic behaviors. Here, we developed Mutational Energy Landscape Trap (MELT), a novel method designed to control protein dynamics by combining Normal Mode Analysis (NMA) and mutagenesis.
View Article and Find Full Text PDFBackground: Although total hip and total knee arthroplasty are highly successful operations, the decision of whether and when to undergo surgery is highly subjective and discretionary, and specific guidelines regarding readiness for surgery remain elusive. The nature of these decisions underscores the importance of shared decision-making, which is founded on the concept that patients substantially contribute to determining their own readiness for surgery. The OPTION survey was developed as a conversation aid to facilitate shared decision-making in the context of total joint arthroplasty.
View Article and Find Full Text PDFBackground: Racial disparities exist in the utilization of total hip arthroplasties (THAs). The social vulnerability index (SVI), which measures geographic-level disadvantage and includes themes, such as socioeconomic status, minority status, and language, may partially explain disparities in THA use. Our objectives were to determine the association of the composite SVI with THA use for (1) White Medicare beneficiaries, (2) Black Medicare beneficiaries, and (3) the difference in THA use between White and Black beneficiaries.
View Article and Find Full Text PDFBackground: Minority patients have been shown to underutilize total knee arthroplasty (TKA) compared to non-Hispanic White patients. Specific drivers of this underutilization have not been identified. We sought to determine if racial concordance between patient and physician is associated with the surgeon's likelihood to recommend TKA.
View Article and Find Full Text PDFObjective: Access to specialized orthopedic care is an important determinant of the decision to undergo total knee replacement (TKR); however, most studies have mainly used distance to the nearest high-volume hospital as the primary proxy for access. We applied the two-step floating catchment area (2SFCA) method to develop a more comprehensive TKR access score that accounts for other potential factors (ie, supply of and demand for this procedure) that also affect access.
Methods: To apply the 2SFCA method, we first estimated TKR demand using the Centers for Disease Control and Prevention estimates of prevalence of osteoarthritis, which were multiplied by estimates of patients who would potentially benefit from TKR.
Background: The authors examined baseline physical functional (PF) impairment among cancer outpatients in the National Cancer Institute Cancer Moonshot study Northwestern University Improving the Management of Symptoms During and Following Cancer Treatment (NU IMPACT). They hypothesized that PF impairment, measured with the Patient Reported Outcome Measurement Information System-Physical Function (PROMIS-PF) survey, would (1) be common and more prevalent for patients receiving treatment compared with no treatment and (2) differ across tumor types, independent of cancer continuum phase.
Methods: Adults who were diagnosed with cancer in NU IMPACT (n = 2273) were sampled, and their PROMIS-PF scores were compared across tumor types and cancer continuum (curative, noncurative, or no treatment), with scores ≤40 indicating moderate-severe impairment.
Background And Purpose: We aimed to systematically review studies of crosswalks for converting patient-reported outcome measure (PROM) scores used in joint replacement, and develop a database of published crosswalks.
Methods: 4 electronic databases were searched from January 2000 to May 2023 to identify studies reporting the development and/or validation of crosswalks to convert PROM scores in patients undergoing elective hip, knee, or shoulder replacement surgery. Data on study and sample characteristics, source and target PROMs, and crosswalk development and validation methods were extracted from eligible studies.
Anthropogenic structures in freshwater systems pose a significant threat by fragmenting habitats. Effective fish passage solutions must consider how environmental changes introduce variability into swimming performance. As temperature is considered the most important external factor influencing fish physiology, it is especially important to consider its effects on fish swimming performance.
View Article and Find Full Text PDFBackground: Australia has experienced extreme fire weather in recent years. Information on the impact of fine particulate matter (PM ) from landscape fires (LFs) on cardiorespiratory hospital admissions is limited.
Methods: We conducted a population-based time series study to assess associations between modelled daily elevated PM at a 1.
Background: The American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee (2016) and Management of Osteoarthritis of the Hip (2017) are intended to provide treatment recommendations for osteoarthritis (OA). This study examined the agreement of AUC appropriateness classifications with arthroplasty surgeon recommendations for total knee arthroplasty (TKA) and total hip arthroplasty (THA).
Methods: The cohort included 558 OA patients (397 knee, 161 hip) referred to a specialty arthroplasty clinic.
Background: Annually, approximately five per cent of dependent children - aged under eighteen years - in the United Kingdom (UK), experience parental death. Nurses and social workers caring for parents with life-limiting illnesses, including cancer, help families support their children. However, these professionals have been found to lack confidence and competence in fulfilling this role.
View Article and Find Full Text PDFBackground: Achieving a minimal clinically important difference (MCID) in patient-reported outcomes following total knee arthroplasty (TKA) is common, yet up to 20% patient dissatisfaction persists. Unmet expectations may explain post-TKA dissatisfaction. No prior studies have quantified patient expectations using the same patient-reported outcome metric as used for MCID to allow direct comparison.
View Article and Find Full Text PDFThe challenge of managing aquatic connectivity in a changing climate is exacerbated in the presence of additional anthropogenic stressors, social factors, and economic drivers. Here we discuss these issues in the context of structural and functional connectivity for aquatic biodiversity, specifically fish, in both the freshwater and marine realms. We posit that adaptive management strategies that consider shifting baselines and the socio-ecological implications of climate change will be required to achieve management objectives.
View Article and Find Full Text PDFLearn Health Syst
January 2024
Seven knowledge domains were originally defined for the learning health system (LHS) scientist. To assess proficiency in each of these domains, we developed and published an assessment tool for use by emerging LHS scientists and training programs. (LHS, October 2022).
View Article and Find Full Text PDFBackground And Objective: Australia introduced a partial ban on asbestos consumption in 1984. There is continuing concern about exposure to asbestos in the built environment and non-occupational exposures. The aim of this study was to describe epidemiological trends of mesothelioma in Western Australia (WA) over the 60 years since the first case was recorded.
View Article and Find Full Text PDFMonitoring for adaptive management (AM) involves collection of data with the aim of reducing uncertainty about links between human pressures (e.g. water abstraction from rivers), consequent stressors (e.
View Article and Find Full Text PDFObjective: To compare the effects of three different rhinoplasty techniques on the postoperative cross-sectional areas (CSAs) of the nares and nasal vestibuli.
Study Design: Experimental study.
Sample Population: Ninety-nine 3D-printed, remolded silicone models of a single French bulldog's rostral nose.
Background: Air pollution is a cause of lung cancer and is associated with bladder cancer. However, the relationship between air pollution and these cancers in regions of low pollution is unclear. We investigated associations between fine particulate matter (PM), nitrogen dioxide, and black carbon (BC), and both these cancers in a low-pollution city.
View Article and Find Full Text PDFObjective: To determine whether county-level or patient-level social risk factors are associated with patient-reported outcomes after total knee replacement when added to the comprehensive joint replacement risk-adjustment model.
Data Sources And Study Setting: Patient and outcomes data from the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement cohort were merged with the Social Vulnerability Index from the Centers for Disease Control and Prevention.
Study Design: This prospective longitudinal cohort measured the change in patient-reported pain and physical function from baseline to 12 months after surgery.
Background: The aim of this study was to examine the racial and ethnic representation in studies included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline relative to their representation of the United States (US).
Methods: The demographic characteristics reported in articles included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline were analyzed. The primary outcome of interest was the representation quotient, which is the ratio of the proportion of a racial/ethnic group in the guideline studies relative to their proportion in the US.
Background: Systematic patient-reported outcome measure (PROM) collection is challenging for clinics, particularly when patients are not in the office. The Arthritis care through Shared Knowledge (ASK) study deployed multimodal approaches to collect PROMs using a clinical microsystem framework.
Conceptual Model: Informed by the clinical microsystem model, the authors coached 12 orthopedic practices to implement shared processes to support best practices for PROM collection and use.
Rationale: Patient-reported outcomes (PROs) are increasingly used in the context of clinical care, but evaluation of patients' perspectives of PRO-based applications in routine care remains limited.
Aims And Objectives: This paper investigates patients' acceptability of a personalized web-based decision report for total knee or hip replacement and identifies opportunities to refine the report.
Method: This qualitative evaluation was embedded in a pragmatic cluster randomized trial of the report.
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