Browsing by Author "Anderson, Paul"
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Item Open Access Reliability and reproducibility of subaxial cervical injury description system: a standardized nomenclature schema.(Spine, 2011-08) Bono, Christopher M; Schoenfeld, Andrew; Gupta, Giri; Harrop, James S; Anderson, Paul; Patel, Alpesh A; Dimar, John; Aarabi, Bizhan; Dailey, Andrew; Vaccaro, Alexander R; Gahr, Ralf; Shaffrey, Christopher; Anderson, David G; Rampersaud, RajStudy design
Radiographic measurement study.Objective
To develop a standardized cervical injury nomenclature system to facilitate description, communication, and classification among health care providers. The reliability and reproducibility of this system was then examined.Summary of background data
Description of subaxial cervical injuries is critical for treatment decision making and comparing scientific reports of outcomes. Despite a number of available classification systems, surgeons, and researchers continue to use descriptive nomenclature, such as "burst" and "teardrop" fractures, to describe injuries. However, there is considerable inconsistency with use of such terms in the literature.Methods
Eleven distinct injury types and associated definitions were established for the subaxial cervical spine and subsequently refined by members of the Spine Trauma Study Group. A series of 18 cases of patients with a broad spectrum of subaxial cervical spine injuries was prepared and distributed to surgeon raters. Each rater was provided with the full nomenclature document and asked to select primary and secondary injury types for each case. After receipt of the raters' first round of classifications, the cases were resorted and returned to the raters for a second round of review. Interrater and intrarater reliabilities were calculated as percent agreement and Cohen kappa (κ) values. Intrarater reliability was assessed by comparing a given rater's diagnosis from the first and second rounds.Results
Nineteen surgeons completed the first and second rounds of the study. Overall, the system demonstrated 56.4% interrater agreement and 72.8% intrarater agreement. Overall, interrater κ values demonstrated moderate agreement while intrarater κ values showed substantial agreement. Analyzed by injury types, only four (burst fractures, lateral mass fractures, flexion teardrop fractures, and anterior distraction injuries) demonstrated greater than 50% interrater agreement.Conclusion
This study demonstrated that, even in ideal circumstances, there is only moderate agreement among raters regarding cervical injury nomenclature. It is hoped that more familiarity with the proposed system will increase reproducibility in the future. Additional research is required to establish the clinical utility of this novel nomenclature schema.Item Open Access The Pediatric Obesity Microbiome and Metabolism Study (POMMS): Methods, Baseline Data, and Early Insights.(Obesity (Silver Spring, Md.), 2021-03) McCann, Jessica R; Bihlmeyer, Nathan A; Roche, Kimberly; Catherine, Cameron; Jawahar, Jayanth; Kwee, Lydia Coulter; Younge, Noelle E; Silverman, Justin; Ilkayeva, Olga; Sarria, Charles; Zizzi, Alexandra; Wootton, Janet; Poppe, Lisa; Anderson, Paul; Arlotto, Michelle; Wei, Zhengzheng; Granek, Joshua A; Valdivia, Raphael H; David, Lawrence A; Dressman, Holly K; Newgard, Christopher B; Shah, Svati H; Seed, Patrick C; Rawls, John F; Armstrong, Sarah CObjective
The purpose of this study was to establish a biorepository of clinical, metabolomic, and microbiome samples from adolescents with obesity as they undergo lifestyle modification.Methods
A total of 223 adolescents aged 10 to 18 years with BMI ≥95th percentile were enrolled, along with 71 healthy weight participants. Clinical data, fasting serum, and fecal samples were collected at repeated intervals over 6 months. Herein, the study design, data collection methods, and interim analysis-including targeted serum metabolite measurements and fecal 16S ribosomal RNA gene amplicon sequencing among adolescents with obesity (n = 27) and healthy weight controls (n = 27)-are presented.Results
Adolescents with obesity have higher serum alanine aminotransferase, C-reactive protein, and glycated hemoglobin, and they have lower high-density lipoprotein cholesterol when compared with healthy weight controls. Metabolomics revealed differences in branched-chain amino acid-related metabolites. Also observed was a differential abundance of specific microbial taxa and lower species diversity among adolescents with obesity when compared with the healthy weight group.Conclusions
The Pediatric Metabolism and Microbiome Study (POMMS) biorepository is available as a shared resource. Early findings suggest evidence of a metabolic signature of obesity unique to adolescents, along with confirmation of previously reported findings that describe metabolic and microbiome markers of obesity.