Publications by authors named "Rowley E"

Background: Nerve wraps composed of various autologous and bioengineered materials have been used to bolster nerve repair sites. In this study, we describe the novel use of autologous fascia nerve wraps (AFNW) as an adjunct to epineurial repair and evaluate their effect on inflammatory cytokine expression, intraneural collagen deposition and end-organ reinnervation in rats and use of AFNW in a patient case series.

Methods: Lewis rats received sciatic transection with repair either with or without AFNW, sciatic-to-common peroneal nerve transfer with or without AFNW, or sham surgery (n=14/group).

View Article and Find Full Text PDF

Background: Respiratory syncytial virus vaccines first recommended for use during 2023 were efficacious against lower respiratory tract disease in clinical trials. Limited real-world data regarding respiratory syncytial virus vaccine effectiveness are available. To inform vaccine policy and address gaps in evidence from the clinical trials, we aimed to assess the effectiveness against respiratory syncytial virus-associated hospitalisations and emergency department encounters among adults aged at least 60 years.

View Article and Find Full Text PDF

Purpose: Sensory nerve transfers may be performed to restore protective sensation and tactile perception after peripheral nerve injury in the upper extremity. There is a paucity of literature on the available donor-recipient configurations for sensory nerve transfers. This article presents a systematic review of reported sensory nerve transfers in the upper extremity.

View Article and Find Full Text PDF

Background: Entrapment or injury of the lateral femoral cutaneous nerve (LFCN) is being recognized with increasing frequency, often requiring a surgical approach to relieve symptoms. The presence of anatomic variations can lead to errors in diagnosis and intraoperative decision-making.

Methods: This study presents the experience of a single surgeon (T.

View Article and Find Full Text PDF
Article Synopsis
  • The CDC recommended the updated 2023-2024 COVID-19 vaccination (monovalent XBB.1.5) for everyone aged 6 months and older to help prevent severe disease caused by COVID-19.
  • For individuals with immunocompromising conditions, additional vaccine doses may be needed due to their increased risk of severe illness and potentially weaker vaccine responses.
  • Vaccine effectiveness for the updated dose was about 38% for hospitalized adults with immunocompromising conditions 7-59 days post-vaccination and 34% between 60-119 days, but only 18% of this high-risk group had received the updated vaccine.
View Article and Find Full Text PDF
Article Synopsis
  • In September 2023, the CDC recommended the updated 2023-2024 monovalent XBB.1.5 COVID-19 vaccine for everyone aged 6 months and older to help prevent COVID-19, including severe cases.
  • An analysis of vaccine effectiveness (VE) found that during the first 59 days after vaccination, the VE against COVID-19-related emergency department visits was 51%, which dropped to 39% after 60-119 days.
  • The updated COVID-19 vaccine showed increased protection, with VE against hospitalizations being 52% and 43% between two networks, supporting CDC's guidelines for vaccination.
View Article and Find Full Text PDF

COVID-19 disproportionately affects people experiencing homelessness or incarceration. While homelessness or incarceration alone may not impact vaccine effectiveness, medical comorbidities along with social conditions associated with homelessness or incarceration may impact estimated vaccine effectiveness. COVID-19 vaccines reduce rates of hospitalization and death; vaccine effectiveness (VE) against severe outcomes in people experiencing homelessness or incarceration is unknown.

View Article and Find Full Text PDF

Test-negative-design COVID-19 vaccine effectiveness (VE) studies use symptomatic SARS-CoV-2-positive individuals as cases and symptomatic SARS-CoV-2-negative individuals as controls to evaluate COVID-19 VE. To evaluate the potential bias introduced by the correlation of COVID-19 and influenza vaccination behaviors, we assessed changes in estimates of VE of bivalent vaccines against COVID-19-associated hospitalizations and emergency department/urgent care (ED/UC) encounters when considering influenza vaccination status or including or excluding influenza-positive controls using data from the multi-state VISION vaccine effectiveness network. Analyses included encounters during October 2022 - February 2023, a period of SARS-CoV-2 and influenza cocirculation.

View Article and Find Full Text PDF
Article Synopsis
  • - A study analyzed COVID-19 vaccine effectiveness among 521,206 emergency department visits and 139,548 hospitalizations between June 2021 and September 2022, focusing on adults with disabilities.
  • - Of the encounters, only 2% had documented disabilities, but those individuals represent a significant portion of hospitalizations (12%).
  • - The results showed that COVID-19 vaccines worked similarly for both disabled and non-disabled adults, highlighting the need for disabled individuals to keep their vaccinations current to protect against severe disease.
View Article and Find Full Text PDF
Article Synopsis
  • - On June 19, 2022, the FDA approved mRNA COVID-19 vaccines for young children based on safety and efficacy data from trials, with Pfizer-BioNTech for ages 6 months-4 years and Moderna for ages 6 months-5 years.
  • - The CDC updated vaccine recommendations on December 9, 2022, including the use of bivalent vaccines for children aged 6 months and older, after assessing their effectiveness against hospital visits for COVID-19-like illness.
  • - Effectiveness of two Moderna doses was found to be 29%, while three Pfizer doses showed 43% effectiveness; however, children who received at least one bivalent dose had an 80% effectiveness in preventing
View Article and Find Full Text PDF
Article Synopsis
  • Immunocompromised (IC) individuals face a higher risk of severe COVID-19 and have reduced vaccine effectiveness compared to non-immunocompromised (non-IC) individuals.
  • A study analyzed emergency department visits and hospitalizations among IC and non-IC adults, finding that vaccine effectiveness was significantly lower in IC patients, particularly for those who received 3 doses of mRNA vaccines or 1-2 doses of viral-vector vaccines.
  • Despite some protection from vaccines, the results indicate a pressing need for additional safeguards for IC adults, especially transplant recipients who showed the lowest vaccine effectiveness.
View Article and Find Full Text PDF

Importance: There is a paucity of pediatric-specific comparative data to guide duration of therapy recommendations in children with urinary tract infection (UTI).

Objective: To compare the efficacy of standard-course and short-course therapy for children with UTI.

Design, Setting, Participants: The Short Course Therapy for Urinary Tract Infections (SCOUT) randomized clinical noninferiority trial took place at outpatient clinics and emergency departments at 2 children's hospitals from May 2012, through, August 2019.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to evaluate the effectiveness of COVID-19 booster doses in preventing hospitalizations and emergency department visits, providing insight for public health policies.
  • Data was collected from over 1.2 million adults at five health systems during the Omicron variant's rise, showing that approximately 37% received a booster dose.
  • The median number needed to vaccinate (NNV) to prevent one hospitalization was 205, with lower NNV for adults aged 65 and older and those with health conditions, indicating booster effectiveness varies by age and health status.
View Article and Find Full Text PDF

Objectives: This study explored the experiences of clinical academics during the COVID-19 pandemic. The aim was to identify challenges and benefits associated with returning to, or increasing hours at, the clinical frontline.

Design: Qualitative data were gathered from a combination of written responses to questions posed in an email and 10 semi-structured interviews between May and September 2020.

View Article and Find Full Text PDF
Article Synopsis
  • A study evaluated the effectiveness of the BNT162b2 COVID-19 vaccine on children and adolescents during the Omicron BA.4/BA.5 period, focusing on its ability to protect against mild to moderate and severe cases of COVID-19.
  • The research compared data from nearly 10,000 emergency department cases and over 70,000 controls, finding that vaccine effectiveness decreased over time, especially during the Omicron variant's spread.
  • It concluded that while the vaccine offered significant protection initially, especially against hospitalizations, booster doses enhanced effectiveness, highlighting the importance of completing the vaccination schedule for children and adolescents.
View Article and Find Full Text PDF
Article Synopsis
  • - During mid-2022, the Omicron BA.5 variant was the dominant strain of SARS-CoV-2 in the U.S., and bivalent mRNA vaccines were introduced containing both the original virus strain and components targeting Omicron BA.4/BA.5.
  • - A single bivalent booster was recommended for adults who had completed their primary vaccination and had not received a dose in the past two months, with effectiveness being evaluated from September to November 2022.
  • - Results showed that the bivalent booster significantly reduced the risk of COVID-19-related emergency visits (56% effectiveness) and hospitalizations (59% effectiveness) compared to those unvaccinated or with only monovalent vaccines, highlighting the importance
View Article and Find Full Text PDF

Background: Coronavirus disease 2019 (COVID-19) vaccination coverage remains lower in communities with higher social vulnerability. Factors such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure risk and access to healthcare are often correlated with social vulnerability and may therefore contribute to a relationship between vulnerability and observed vaccine effectiveness (VE). Understanding whether these factors impact VE could contribute to our understanding of real-world VE.

View Article and Find Full Text PDF
Article Synopsis
  • - During June-October 2022, the Omicron BA.5 sublineage dominated COVID-19 cases in the U.S., leading to the introduction of bivalent mRNA vaccines that target both the original virus and the Omicron BA.4/BA.5 variants.
  • - A single bivalent booster dose was recommended for adults who had their last vaccination at least two months prior, and its effectiveness was evaluated from September to November 2022 compared to no vaccination or previous monovalent vaccinations.
  • - Results showed that the bivalent booster significantly reduced emergency department visits and hospitalizations for COVID-19, with effectiveness increasing depending on how long it had been since the last monovalent dose was received.
View Article and Find Full Text PDF

Background: Electronic health record (EHR) data provide a unique opportunity to study the epidemiology of COVID-19, clinical outcomes of the infection, comparative effectiveness of therapies, and vaccine effectiveness but require a well-defined computable phenotype of COVID-19-like illness (CLI).

Objective: The objective of this study was to evaluate the performance of pathogen-specific and other acute respiratory illness (ARI) International Statistical Classification of Diseases-9 and -10 codes in identifying COVID-19 cases in emergency department (ED) or urgent care (UC) and inpatient settings.

Methods: We conducted a retrospective observational cohort study using EHR, claims, and laboratory information system data of ED or UC and inpatient encounters from 4 health systems in the United States.

View Article and Find Full Text PDF
Article Synopsis
  • CDC recommends a single COVID-19 booster dose for individuals aged 18 and older who received the Janssen vaccine, ideally with a different mRNA vaccine for better protection.
  • This recommendation is based on observed serious risk factors associated with the Janssen vaccine and data showing improved immunity with heterologous boosters.
  • A study comparing vaccine effectiveness showed that booster strategies significantly increased protection against COVID-19-related emergency visits and hospitalizations, particularly during the Omicron variant surge.
View Article and Find Full Text PDF

Objectives: This study aimed to explore the barriers and facilitators to career progression for female medical clinical academics from the perspectives of female associate professors and professors, with a particular focus on women with caring responsibilities.

Design: An exploratory qualitative approach was adopted. Data from semistructured interviews conducted via video calls were analysed using thematic analysis.

View Article and Find Full Text PDF
Article Synopsis
  • - The BNT162b2 (Pfizer-BioNTech) vaccine showed over 90% efficacy in clinical trials for children and adolescents aged 5-17, but real-world effectiveness, especially against the Omicron variant, is still being evaluated.
  • - In a study analyzing data from over 39,000 encounters, vaccine effectiveness (VE) for children aged 5-11 was 46% shortly after the second dose, while adolescents aged 12-15 had a VE of 83% and those aged 16-17 had a VE of 76% during similar timeframes.
  • - VE significantly decreased after 150 days post-second dose during the Omicron variant's dominance, but improved to
View Article and Find Full Text PDF
Article Synopsis
  • Estimates of COVID-19 mRNA vaccine effectiveness (VE) are declining due to factors such as waning immunity and increased immune evasion by variants like Delta and Omicron.
  • The CDC recommends a booster for everyone aged 12 and over, highlighting that the third dose can significantly enhance antibody levels and overall vaccine efficacy.
  • A study analyzing data from multiple states found that while VE against COVID-19 was high during the Delta variant phase, effectiveness dropped significantly during the Omicron phase, especially after two doses.
View Article and Find Full Text PDF

Immunocompromised persons, defined as those with suppressed humoral or cellular immunity resulting from health conditions or medications, account for approximately 3% of the U.S. adult population (1).

View Article and Find Full Text PDF