Publications by authors named "MR Allen"

Purpose: This study investigates the relationship between surgical levels and coronal deformity to identify risk factors for failing to achieve a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI) following short-segment isolated decompression or fusion surgery in patients with degenerative scoliosis (DS) and concurrent lumbar canal stenosis (LCS), without severe sagittal deformity malalignment.

Methods: Patients with degenerative scoliosis who underwent 1- or 2-level lumbar isolated decompression or fusion surgery were included. Surgical level was labeled as "Cobb-related" when decompression or surgical levels spanned or were between end vertebrae, and "outside" when the operative levels did not include the end vertebrae.

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Article Synopsis
  • The study was a retrospective cohort review comparing single level (SLD) and dual level (DLD) minimally invasive decompression surgeries for lumbar spinal stenosis (LSS) in patients with adjacent level disease.
  • Findings indicated that patients undergoing single level decompression experienced similar clinical outcomes to those with dual level decompression over a 2-year period, despite longer operative times for DLD procedures.
  • The conclusion suggests that for patients with single level symptoms and adjacent stenosis, treating only the symptomatic level is equally effective, potentially reducing unnecessary risks and surgery time associated with dual level procedures.
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Achieving net zero global emissions of carbon dioxide (CO), with declining emissions of other greenhouse gases, is widely expected to halt global warming. CO emissions will continue to drive warming until fully balanced by active anthropogenic CO removals. For practical reasons, however, many greenhouse gas accounting systems allow some "passive" CO uptake, such as enhanced vegetation growth due to CO fertilisation, to be included as removals in the definition of net anthropogenic emissions.

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Article Synopsis
  • - Climbing sports are growing, but many injuries related to climbing are being misdiagnosed, especially by sports medicine professionals.
  • - A case study identified three patients who were initially misdiagnosed with elbow tendinopathy when they actually had ulnar nerve compression, which was successfully treated with targeted rehab.
  • - The article calls for increased awareness of misdiagnosed climbing injuries and offers clinical recommendations to help correctly diagnose and treat these issues.
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Background Context: Lumbar decompression and short-segment lumbar fusion are standard procedures for short-segment lumbar canal stenosis, even in patients with moderate Cobb angles. Adult degenerative scoliosis is diagnosed at a threshold of 10 degrees, and patients with coronal Cobb angles over 30 degrees are recommended for long fusion due to global spinal deformity. However, there is a lack of research on clinical outcomes in patients with moderate coronal deformity, such as Cobb angles between 20 and 30 degrees.

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Study Design: This retrospective study included patients who underwent primary one-level minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spine conditions.

Objective: To identify early predictors of failing to achieve the Oswestry Disability Index (ODI) minimum clinically important difference (MCID) one-year post-surgery.

Summary Of Background Data: Early identification of patients at risk of failing to achieve ODI-MCID is crucial for early intervention and improved postoperative counseling.

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Quasi-brittle fracture mechanics is used to evaluate fracture of human cortical bone in aging. The approach is demonstrated using cortical bone bars extracted from one 92-year-old human male cadaver. In-situ fracture mechanics experiments in a 3D X-ray microscope are conducted.

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Introduction: A clinical trial of Epidiolex, the only US FDA-approved cannabis-derived consumer product (CDP), discovered an interaction with an immunosuppressant (tacrolimus) that led to drug toxicity, highlighting the unique intersection of prescription and commonly unregulated consumer products.

Objective: We aimed to identify if similar drug-drug interactions (DDIs) are occurring among the consumer CDP market, even though they cannot be identified through trials.

Methods: We searched Reddit for subreddits related to CDPs or health, resulting in 63,561,233 posts.

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Importance: Despite growing interest in psychedelics, there is a lack of routine population-based surveillance of psychedelic microdosing (taking "subperceptual" doses of psychedelics, approximately one-twentieth to one-fifth of a full dose, over prolonged periods). Analyzing Google search queries can provide insights into public interest and help address this gap.

Objective: To analyze trends in public interest in microdosing in the US through Google search queries and assess their association with cannabis and psychedelic legislative reforms.

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Background: Bisphosphonates are widely used in equine athletes to reduce lameness associated with skeletal disorders. Widespread off-label use has led to concern regarding potential negative effects on bone healing, but little evidence exists to support or refute this.

Objectives: To investigate the influence of clinically relevant doses of tiludronate on bone remodelling and bone healing.

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Methodology is described for the synthesis of C derivatives of raloxifene, a prescribed drug for the treatment and prevention of osteoporosis. Studies have explored the incorporation of electron-withdrawing substituents at C of the benzothiophene core. Efficient processes are also examined to introduce hydrogen bond donor and acceptor functionality.

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Patients with chronic kidney disease (CKD) report high pain levels, but reduced renal clearance eliminates many analgesic options; therefore, 30-50% of CKD patients have chronic opioid prescriptions. Opioid use in CKD is associated with higher fracture rates. Opioids may directly alter bone turnover directly through effects on bone cells and indirectly via increasing inflammation.

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Background Context: Robotic spine surgery, utilizing 3D imaging and robotic arms, has been shown to improve the accuracy of pedicle screw placement compared to conventional methods, although its superiority remains under debate. There are few studies evaluating the accuracy of 3D navigated versus robotic-guided screw placement across lumbar levels, addressing anatomical challenges to refine surgical strategies and patient safety.

Purpose: This study aims to investigate the pedicle screw placement accuracy between 3D navigation and robotic arm-guided systems across distinct lumbar levels.

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The 2021 Pacific Northwest heatwave was so extreme as to challenge conventional statistical and climate-model-based approaches to extreme weather attribution. However, state-of-the-art operational weather prediction systems are demonstrably able to simulate the detailed physics of the heatwave. Here, we leverage these systems to show that human influence on the climate made this event at least 8 [2-50] times more likely.

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Study Design: Retrospective cohort study.

Objective: To determine the relationship between preoperative physical therapy (PT) and postoperative mobility, adverse events (AEs), and length of stay (LOS) among patients with low normalized total psoas area (NTPA) undergoing adult spinal deformity (ASD) surgery.

Background: Sarcopenia, as defined by low NTPA, has been shown to predict poor perioperative outcomes of ASD surgery.

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As international incidence of diabetes and diabetes-driven comorbidities such as chronic kidney disease (CKD) continue to climb, interventions are needed that address the high-risk skeletal fragility of what is a complex disease state. Romosozumab (Romo) is an FDA-approved sclerostin inhibitor that has been shown to increase bone mineral density and decrease fracture rates in osteoporotic patients with mild to severe CKD, but its effect on diabetes-weakened bone is unknown. We aimed to test Romo's performance in a model of combined diabetes and CKD.

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Article Synopsis
  • The study analyzes how the length of time patients experience symptoms before cervical disc replacement (CDR) affects their recovery outcomes.* -
  • Researchers found that patients with shorter preoperative symptom durations (<6 months) showed significantly better improvements in pain and function compared to those with longer durations (≥6 months) during early and late recovery.* -
  • Prolonged symptoms before surgery were linked to a higher likelihood of not achieving meaningful improvement in outcomes like neck and arm pain, indicating that timing of surgery may impact overall effectiveness.*
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Chronic heavy alcohol consumption is a risk factor for low trauma bone fracture. Using a non-human primate model of voluntary alcohol consumption, we investigated the effects of 6 months of ethanol intake on cortical bone in cynomolgus macaques (Macaca fascicularis). Young adult (6.

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Spinal cord injury (SCI) leads to significant sublesional bone loss and high fracture rates. While loss of mechanical loading plays a significant role in SCI-induced bone loss, animal studies have demonstrated mechanical loading alone does not fully account for loss of bone following SCI. Indeed, we have shown that bone loss occurs below the level of an incomplete moderate contusion SCI, despite the resumption of weight-bearing and stepping.

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Article Synopsis
  • Patients with chronic kidney disease (CKD) have a significantly higher risk of fractures due to changes in bone structure, specifically increased cortical porosity and diminished matrix hydration.
  • The study involved inducing CKD in mice and testing the effects of mechanical loading and a drug, raloxifene, on bone properties over ten weeks.
  • Results showed that combining mechanical loading with raloxifene treatment improved bone characteristics in CKD mice, leading to lower porosity and enhanced hydration, which could help reduce fracture risk.
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Skeletal fragility and high fracture rates are common in CKD. A key component of bone loss in CKD with secondary hyperparathyroidism is high bone turnover and cortical bone deterioration through both cortical porosity and cortical thinning. We hypothesized that RANKL drives high bone resorption within cortical bone leading to the development of cortical porosity in CKD (study 1) and that systemic inhibition of RANKL would mitigate the skeletal phenotype of CKD (study 2).

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Introduction: Chronic kidney disease (CKD) negatively affects musculoskeletal health, leading to reduced mobility, and quality of life. In healthy populations, carnitine supplementation and aerobic exercise have been reported to improve musculoskeletal health. However, there are inconclusive results regarding their effectiveness and safety in CKD.

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