Publications by authors named "Turtle J"

Article Synopsis
  • The paper discusses the importance of structured guidelines for returning to activity after spinal deformity surgery, emphasizing that a consistent approach can improve patient recovery and health outcomes.
  • It categorizes diverse patient groups, including early onset scoliosis, adolescent idiopathic scoliosis, young adults, adult spinal deformity, elite athletes, and general sports participants, offering tailored recommendations for each.
  • The document stems from an educational webinar and aims to standardize postoperative protocols, enhancing both surgeon practice and overall patient care.
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  • Accurate forecasts improve public health responses to seasonal influenza, with 26 teams providing predictions for hospital admissions in 2021-22 and 2022-23.
  • Six out of 23 models performed better than the baseline in 2021-22, while 12 out of 18 models did so in 2022-23, with the FluSight ensemble being highly ranked in both seasons.
  • Despite its accuracy, the FluSight ensemble and other models struggled with longer forecast periods, especially during times of rapid change in influenza patterns.
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In temperate regions, annual preparation by public health officials for seasonal influenza requires early-season long-term projections. These projections are different from short-term (e.g.

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Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. Forecasting teams were asked to provide national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one through four weeks ahead for the 2021-22 and 2022-23 influenza seasons. Across both seasons, 26 teams submitted forecasts, with the submitting teams varying between seasons.

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Study Design: Retrospective cohort study.

Objective: The decision to pursue operative intervention for patients with isthmic spondylolisthesis is complex. Although steroid injections are a well-accepted therapeutic modality that may delay or obviate surgery, little is known regarding their ability to predict surgical outcomes.

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To define appropriate planning scenarios for future pandemics of respiratory pathogens, it is important to understand the initial transmission dynamics of COVID-19 during 2020. Here, we fit an age-stratified compartmental model with a flexible underlying transmission term to daily COVID-19 death data from states in the contiguous U.S.

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Instrumented lumbar spinal fusion is common and results in biomechanical changes at adjacent spinal segments that increase facet load bearing. This can cause facet-mediated pain at levels adjacent to the surgical construct. Medial branch nerve radiofrequency ablation (RFA) exists as a treatment for some cases.

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More than a year since the appearance of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), many questions about the disease COVID-19 have been answered; however, many more remain poorly understood. Although the situation continues to evolve, it is crucial to understand what factors may be driving transmission through different populations, both for potential future waves, as well as the implications for future pandemics. In this report, we compiled a database of more than 28 potentially explanatory variables for each of the 50 U.

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Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models provide specific, quantitative, and evaluable predictions that inform short-term decisions such as healthcare staffing needs, school closures, and allocation of medical supplies. Starting in April 2020, the US COVID-19 Forecast Hub (https://covid19forecasthub.

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Objectives: To present a comprehensive real-world micro-costing analysis of bariatric surgery.

Methods: Patients were included if they underwent primary bariatric surgery (gastric banding [GB], gastric bypass [GBP] and sleeve gastrectomy [SG]) between 2013 and 2019. Costs were disaggregated into cost items and average-per-patient costs from the Australian healthcare systems perspective were expressed in constant 2019 Australian dollars for the entire cohort and subgroup analysis.

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Objectives The aim of this exploratory study was to investigate resource use and predictors associated with critical care unit (CCU) admission after primary bariatric surgery within the Tasmanian public healthcare system. Methods Patients undergoing primary bariatric surgery in the Tasmanian Health Service (THS) public hospital system between 7 July 2013 and 30 June 2019 were eligible for inclusion in this study. The THS provides two levels of CCU support, an intensive care unit (ICU) and a high dependency unit (HDU).

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Introduction: The CoronaVirus Disease 2019 (COVID-19) pandemic remains a formidable threat to populations around the world. The U.S.

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Influenza incidence forecasting is used to facilitate better health system planning and could potentially be used to allow at-risk individuals to modify their behavior during a severe seasonal influenza epidemic or a novel respiratory pandemic. For example, the US Centers for Disease Control and Prevention (CDC) runs an annual competition to forecast influenza-like illness (ILI) at the regional and national levels in the US, based on a standard discretized incidence scale. Here, we use a suite of forecasting models to analyze type-specific incidence at the smaller spatial scale of clusters of nearby counties.

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Article Synopsis
  • Neurons in the spinal cord can adapt behavior based on environmental stimuli, as seen in rats that learned to protect a hind leg from electrical shocks even after spinal cord injury.
  • Blocking spinal neuron activity or disconnecting the sciatic nerve stopped the rats from learning, indicating that spinal neurons are essential for learning, but not for maintaining learned behaviors.
  • Training enhances muscle response at the neuromuscular junction by increasing the number of acetylcholine receptors and strengthening connections, with glutamate signaling playing a role in this plasticity.
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Study Design: Review article.

Objective: A review and update of the treatment of Hangman's fractures including the indications for both nonoperative and operative treatment of typical and atypical fractures.

Summary Of Background Data: Hangman's fractures are the second most common fracture pattern of the C2 vertebrae following odontoid fractures.

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Pain (nociceptive) input caudal to a spinal contusion injury can undermine long-term recovery and increase tissue loss (secondary injury). Prior work suggests that nociceptive stimulation has this effect because it fosters the breakdown of the blood-spinal cord barrier (BSCB) at the site of injury, allowing blood to infiltrate the tissue. The present study examined whether these effects impact tissue rostral and caudal to the site of injury.

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Health planners use forecasts of key metrics associated with influenza-like illness (ILI); near-term weekly incidence, week of season onset, week of peak, and intensity of peak. Here, we describe our participation in a weekly prospective ILI forecasting challenge for the United States for the 2016-17 season and subsequent evaluation of our performance. We implemented a metapopulation model framework with 32 model variants.

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In humans, spinal cord injury (SCI) is often accompanied by additional tissue damage (polytrauma) that can engage pain (nociceptive) fibers. Prior work has shown that this nociceptive input can expand the area of tissue damage (secondary injury), undermine behavioral recovery, and enhance the development of chronic pain. Here, it is shown that nociceptive input given a day after a lower thoracic contusion injury in rats enhances the infiltration of red blood cells at the site of injury, producing an area of hemorrhage that expands secondary injury.

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Pain (nociceptive) input caudal to a spinal contusion injury increases tissue loss and impairs long-term recovery. It was hypothesized that noxious stimulation has this effect because it engages unmyelinated pain (C) fibers that produce a state of over-excitation in central pathways. The present article explored this issue by assessing the effect of capsaicin, which activates C-fibers that express the transient receptor potential vanilloid receptor-1 (TRPV1).

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Prior work has shown that neurons within the spinal cord are sensitive to temporal relations and that stimulus regularity impacts nociceptive processing and adaptive plasticity. Application of brief (80ms) shocks (180-900) in a variable manner induces a form of maladaptive plasticity that inhibits spinally-mediated learning and enhances nociceptive reactivity. In contrast, an extended exposure (720-900) to stimuli given at regular (fixed spaced) intervals has a restorative effect that counters nociceptive sensitization and enables learning.

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More than 90% of spinal cord injuries are caused by traumatic accidents and are often associated with other tissue damage (polytrauma) that can provide a source of continued pain input during recovery. In a clinically relevant spinal cord contusion injury model, prior work has shown that noxious stimulation at an intensity that engages pain (C) fibers soon after injury augments secondary injury and impairs functional recovery. Noxious input increases the expression of pro-inflammatory cytokines (interleukin 1β and 18), cellular signals associated with cell death (caspase 3 and 8), and physiological signs of hemorrhage.

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Article Synopsis
  • Spinal cord injury (SCI) not only causes immediate damage but also makes surrounding tissue more sensitive to pain, leading to increased nociceptive input and heightened pain responses.
  • Unpredictable and uncontrollable pain can result in maladaptive changes in the nervous system, while learning through relational experiences can help counteract these negative effects.
  • The loss of serotonergic fibers following SCI contributes to increased neural excitability and chronic pain, while nociceptive stimulation early after SCI worsens recovery outcomes and tissue damage; treatments like intrathecal lidocaine may help mitigate these issues.
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  • Prior research indicates that the timing of electrical stimulation (fixed vs. variable) affects spinal cord plasticity, with fixed timing having a protective effect compared to variable timing, which impairs learning in spinally transected animals.
  • A study with spinally transected rats revealed that a minimum of 540 shocks is necessary for the protective effects of fixed timing stimulation, while shorter exposures can hinder learning.
  • The findings suggest that repeated fixed timing stimulation can have lasting effects on learning capacity, hinting at the spinal system's ability to recognize and remember specific patterns of stimulation for rehabilitation purposes.
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Article Synopsis
  • Research indicates that spinal circuits can adapt through training and inflammation, similar to plasticity mechanisms in the hippocampus like long-term potentiation and NMDA receptors.
  • Engaging spinal circuits can lead to metaplasticity, where controllable stimulation promotes adaptive plasticity and learning, while uncontrollable stimulation results in maladaptive plasticity that inhibits learning.
  • The balance between adaptive and maladaptive plasticity is influenced by key neurochemicals such as brain derived neurotrophic factor (BDNF) and tumor necrosis factor (TNF), with BDNF playing a crucial role in restoring normal inhibitory functions in spinal circuits.
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Intermittent nociceptive stimulation following a complete transection or contused spinal cord injury (SCI) has been shown to exert several short- and long-lasting negative consequences. These include maladaptive spinal plasticity, enhanced mechanical allodynia, and impaired functional recovery of locomotor and bladder functions. The neurotrophin, brain-derived neurotrophic factor (BDNF) has been shown to play an important role in adaptive plasticity and also to restore functions following SCI.

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