Publications by authors named "Ryan Paul"

Background: Antimicrobial resistance is a significant global health challenge, exacerbated by inappropriate antibiotic prescribing, particularly in primary care where up to 50% of antibiotic prescriptions prescribed by general practitioners (GPs) and dispensed by community pharmacists (CPs) are deemed inappropriate. Respiratory tract infections (RTIs) are among the most common conditions leading to GP consultations and subsequent antibiotic prescribing, much of which is inappropriate as most RTIs are viral in nature or self-limiting bacterial infections. Point-of-care tests (POCTs) have emerged as tools to improve the diagnosis and appropriate treatment of RTIs.

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Context: Screening programs to identify negative ulnar nerve adaptations in throwing athletes can help minimize injury risk and individualize treatment programs prior to the onset of symptoms. However, it is currently unclear how the ulnar nerve structurally adapts chronically in professional baseball pitchers. Objective: To compare ulnar nerve ultrasound structural characteristics between the throwing (dominant) and non-throwing control (non-dominant) elbows in professional pitchers, with a secondary purpose of comparing ultrasound structural characteristics between subluxating and non-subluxating ulnar nerves.

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Purpose: To determine, using multivariate regression, whether patient-reported outcomes are associated with surgical timing to account for differences between groups.

Methods: Patients who underwent acromioclavicular (AC) joint surgery from 2010 to 2019 were included if they underwent primary AC joint surgery for a Rockwood grade III-V AC joint separation. Chart review was conducted to determine time from injury to surgery, Rockwood injury grade, and surgical technique.

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Purpose: To compare revision rates and functional outcomes between patients who underwent staged versus simultaneous bilateral rotator cuff repair (RCR).

Methods: This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with no institutional review board approval or funding required. The PubMed, SportDiscus, and Ovid Medline databases were queried to identify original research studies evaluating preoperative characteristics and postoperative outcomes of staged or simultaneous RCR.

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Background: Understanding clinical and tissue adaptations to the throwing shoulder is important for optimizing injury prevention and rehabilitation programs in baseball players.

Purpose/hypothesis: The purpose of this study was to determine the chronic clinical (range of motion [ROM] and strength) and tissue adaptations of the throwing shoulder in baseball pitchers. It was hypothesized that the throwing shoulder would have increased external rotation (ER) ROM and decreased internal rotation (IR) ROM compared with the nonthrowing shoulder, but that calculations of soft tissue glenohumeral IR deficit (GIRD) and soft tissue ER gain (ERG) would show that the true soft tissue restrictions were instead in the direction of ER ROM.

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Purpose: To report the return to sport (RTS) rate, RTS time, and performance outcomes in professional baseball pitchers and position players who underwent isolated posterior labrum repair.

Methods: The MLB Health and Injury Tracking System (HITS) database was queried for all major league and minor league baseball players who underwent isolated posterior labrum repair from 2011-2022. Players were excluded if they underwent labrum débridement instead of repair, if they underwent concomitant SLAP or anterior labrum repair, or if they had multi-directional instability.

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Purpose: To report the return to sport (RTS) rate, RTS time, and performance outcomes in professional baseball pitchers and position players who underwent isolated SLAP repair.

Methods: The MLB Health and Injury Tracking System (HITS) database was queried for all major league and minor league baseball players who underwent isolated SLAP repair without treatment of the biceps from 2011-2022. Outcomes of interest included RTS rate, time until RTS, workload statistics, and performance outcomes.

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Rapid improvements in glucose control may lead to early worsening of diabetic retinopathy (EWDR). There is a need to demonstrate safety in people commencing automated insulin delivery (AID) due to the known efficacy in rapid glycemic improvement. We aimed to investigate short-term DR outcomes in people (aged ≥13 years) with type 1 diabetes after initiation of AID (use ≥6 months).

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Background: Pitchers with deficits in total shoulder rotation range of motion (ROM) are 2.6 times more likely to experience an elbow injury. Despite the effects of shoulder ROM on elbow injury, it is currently unclear whether specific tissue adaptations of the shoulder relate to the tissue adaptations of the elbow in baseball pitchers.

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Introduction: Surveys such as the Shoulder Instability-Return to Sport after Injury (SIRSI) scores can help identify athletes who are better prepared to return to sport (RTS) after arthroscopic Bankart repair (ABR). Therefore, the purpose of this systematic review was to clarify how psychologically ready athletes are to RTS after ABR, with the secondary purpose of evaluating the impact of psychological readiness on athletes' ability to RTSS after ABR.

Methods: The Ovid Medline, PubMed, and SportDiscus databases were searched from inception until January 2023 using keywords such as Bankart, anterior labral repair, shoulder stabilization, return to play, and return to sport.

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Background: Combined posterior and posterior superior (PPS) injuries (6:30-12:00; right shoulder) have a much higher incidence than isolated superior labral anterior to posterior (SLAP) injuries (11:00-1:00; right shoulder). However, it is unclear how PPS injuries affect glenohumeral (GH) biomechanics and how they should be treated. This study evaluated if: (1) PPS injuries alter GH kinematics and joint characteristics; (2) standard repair techniques restore GH kinematics and contact characteristics towards their intact state; (3) there are differences between repair techniques.

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Objectives: This study investigates whether the intra-operative administration of intravenous tranexamic acid (TXA), known for its hemostatic and potential anti-inflammatory properties, affects the incidence of heterotopic ossification (HO) following surgery for elbow fracture-dislocations.

Methods: Design: Prospective, randomized clinical trial.

Setting: Hand and Upper Extremity Surgery Unit.

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Aims: This study aimed to identify key factors with the greatest influence on glycaemic outcomes in young individuals with type 1 diabetes (T1D) and very elevated glycaemia after 3 months of automated insulin delivery (AID).

Materials And Methods: Data were combined and analysed from two separate and previously published studies with similar inclusion criteria assessing AID (MiniMed 780G) efficacy among young individuals naïve to AID (aged 7-25 years) with glycated haemoglobin A1c (HbA1c) ≥69 mmol/mol (≥8.5%).

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Background: Baseball pitching injuries can be related to fatigue. Changes in grip and pinch strength over the course of professional baseball games are unknown.

Hypothesis: Grip and pinch strength will decrease as the number of innings pitched increases; injured pitchers will have a lower grip strength than uninjured pitchers.

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The prevalence of diabetes mellitus among children, youth, and young adults is increasing, yet limited information is known about the characteristics and management of these groups with Type 1 (T1D) and Type 2 (T2D) diabetes in primary care. The aim of the study is to explore the characteristics of people with T1D and T2D aged < 25 years across the Auckland and Waikato regions of New Zealand. : Sociodemographic and clinical data were collected from electronic primary care records (February 2021-July 2022) of four primary healthcare organisations, with medication data sourced from the National Pharmaceutical dataset.

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The Colorado Potato Beetle, Leptinotarsa decemlineata Say, is the principal defoliator of potato crops globally. It is well known for its propensity to rapidly develop resistance. Thus, new control options which are resilient to the pest's resistance capabilities are a critical need.

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The psychological burden of type 1 diabetes (T1D) can negatively impact health outcomes. This study evaluates the prevalence of low mood (WHO-5), disordered eating (DEPS-R), diabetes distress (PAID) and fear of hypoglycaemia (HFS-II), in a sample of 250 New Zealand adults (8.4% Māori/91.

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Background: Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.

Purpose: To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.

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Water-solid interfaces pervade the natural environment and modern technology. On some surfaces, water-water interactions induce the formation of partially dissociated interfacial layers; understanding why is important to model processes in catalysis or mineralogy. The complexity of the partially dissociated structures often makes it difficult to probe them quantitatively.

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Purpose: The purpose of this study was to validate the clinical accuracy of the lift-off screw (LOS) technique for volar tilt correction (VTC) in patients undergoing corrective osteotomy for dorsally angulated distal radius fracture malunions.

Methods: We conducted a retrospective review of 23 patients with dorsally angulated distal radius fracture malunions treated with corrective osteotomy using the LOS technique. The LOS equation L = [tan(T) ∗ L + C]/[cos(⍬)] and standardized intraoperative fluoroscopic images were used to determine and compare the calculated and clinical VTC and final volar tilt.

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Background: Automated insulin delivery is the treatment of choice in adults with type 1 diabetes. Data are needed on the efficacy and safety of automated insulin delivery for children and youth with diabetes and elevated glycated hemoglobin levels.

Methods: In this multicenter, open-label randomized controlled trial, we assigned patients with type 1 diabetes in a 1:1 ratio either to use an automated insulin delivery system (MiniMed 780G) or to receive usual diabetes care of multiple daily injections or non--automated pump therapy (control).

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Aim: To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care.

Background: T2D is a significant health concern in NZ, particularly among Māori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care.

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Bacterial synthetic multicellular systems are promising platforms for engineered living materials (ELMs) for medical, biosynthesis, environmental, and smart materials applications. Recent advancements in genetically encoded adhesion toolkits have enabled precise manipulation of cell-cell adhesion and the design and patterning of self-assembled multicellular materials. However, in contrast to gene regulation in synthetic biology, the characterization and control of synthetic adhesins remains limited.

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Background: Since various social determinants of health (SDOH) have the potential to impact the utilization and postoperative outcomes of rotator cuff repair (RCR), a review of the literature is warranted. Therefore, the purpose of this systematic review was to evaluate the effects of SDOH on RCR utilization and postoperative outcomes in order to recognize external factors that may influence patients' access to RCR and optimal clinical outcomes.

Methods: Search terms related to RCR, utilization, outcomes, and SDOH were used to identify studies that reported associations between any SDOH (as defined by the World Health Organization) and RCR utilization, access, cost, or postoperative outcomes.

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Article Synopsis
  • Professional pitchers often experience anterior shoulder pain, which may relate to a smaller coracohumeral distance (CHD) and disorganization of the subscapularis tendon, particularly in their dominant arm.
  • The study hypothesized that pitcher's dominant arm would show these adaptations compared to the nondominant arm and that humeral retroversion (HR) would relate to both CHD and tendon organization.
  • Results indicated that the dominant arm had a significantly narrower CHD, more scapular protraction, and greater tendon disorganization than the nondominant arm, with HR influencing these factors.
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