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Cost/Charges Appraisal and Clinical Evidence Considerations in Orthopaedic Literature

Open Journal of Orthopedics 2012年第2期2卷 40-46页

作者： joe sam robinson III M. sami Walid Waldo E. Floyd joe sam robinson jr. School of Medicine Mercer University Macon USA Kingsbrook Jewish Medical Center Brooklyn USA OrthoGeorgia Macon USA Georgia Neurosurgical Institute Macon USA.

Introduction: Health care expenditures in the United States have rapidly risen in the last decade, including orthopaedic induced expenses. This paper addresses the methodology by which clinical evidence is obtained to better direct orthopaedic practice and encourage cost-efficiency. Questions: We conducted this inquiry to answer these questions: 1) Have orthopaedic expenses increased in the United States? 2) Does high grade clinical evidence prevail in orthopaedic literature? 3) Does clinical orthopaedic research include cost in outcome analysis? 4) Does the increase in orthopaedic expenses correlate with cost awareness in orthopaedic literature? Methods: The aggregate hospital charges (national bill) associated with three major orthopaedic procedures were extracted from the Nationwide Inpatient sample (NIS) website (data available from 1997 to 2008). Using the biomedical search engine PubMed (launched 1996), different types of literature pertaining to general orthopaedic and three major orthopaedic procedures—hip replacement, knee replacement, and spine fusion, were probed regarding level of evidence and cost inclusion. Results: From 1997 to 2008, the national hospital charges for spine fusion increased by 10.4 times while for total knee replacement it increased by 4.9 times and for total/partial hip replacement by 3.4 times. From 1996 to 2010, PubMed indexed 1113 randomized controlled trials (RCTs) related to hip replacement, 942 related to knee replacement and 357 related to spine fusion. During the same period, RCTs related to total/partial hip replacement, total knee replacement and spine fusion procedures have increased by 3 times, 6 times, and 3.4 times, respectively. The percentage of blinded RCTS with cost analysis among all RCTs related to each procedure were 0%, 0.001% and 0.003% for total/partial hip replacement, total knee replacement and spine fusion procedures respectively. The correlation in the national hospital charges of all three procedures indiv

关键词： Clinical Evidence Randomized Clinical Trial Blinded Cost

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Vitamin B12 Screening in Cervical Spine Surgery Patients

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Neuroscience & Medicine 2011年第2期2卷 149-153页

作者： Abdullah Tolaymat Moataz Abbara M. sami Walid Mohammed Ajjan joe sam robinson jr Georgia Neurosurgical Institute Medical Center of Central Georgia

Introduction Vitamin B12 is very vital for the nervous system. Its deficiency can manifest with neurological symptoms like pain and paresthesias and in severe cases may cause not completely restorable neurological damage, especially in elderly patients. Methods The charts of 702 patients who underwent cervical spine surgery retrospectively reviewed and data collected . All patients were preoperatively seen by an internist who ordered Vit B12 levels for some of them. We used two thresholds for the diagnosis of vitamin B12 deficiency, 200 and 300 pg/mL as recommended by Yao et al. 1992. Data were also collected on gender, payor status, myelopathy, hemoglobin level, corpuscular parameters and glycosylated hemoglobin level (HbA1c). Vitamin B12 levels were compared between patients with HbA1c levels ≥ 6.1% and sample into three age groups, <40, 40-59, and ≥ 60 years, we investigated the trend of cobalamin deficiency by age and found an increase in cobalamin deficiency after 40 from 0% to 7.4% (200 threshold). Uninsured patients (25%) using the 200 pg/mL threshold and workers’ compensation (54.5%) and uninsured patients (50.0%) had the highest rate of Vit B12 deficiency using the 300 pg/mL threshold

关键词： Vitamin B12 cobalamin Cervical Spine Surgery

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Do unemployment and payor category impact length of stay and hospital charges of spine fusion patients?

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Health 2012年第3期4卷 150-154页

作者： Mohammad sami Walid Nadezhda Zaytseva Aaron C. M. Barth joe sam robinson jr. Medical Center of Central Georgia Macon USA

Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Methods: The clinical records of 1599 spine surgery pa-tients counted from 2008-2009 were reviewed. The largest groups of patients belonged to MS-DRG 460 (N = 585) and to MS-DRG 473 (N = 700). These two MS-DRG patient groups were used as the study cohort representing patients who, by definition, did not have serious comor-bidities or complications. Results: Unemployed non-cervical patients tended to stay on average 1.8 days longer in hospital and had on average $5800 higher hospital charges. No major differ-ences were noted in length of stay and hospital cost between government and private insurance patients. However, self-pay non-cervical fusion patients had notable increases in length of stay and hospital cost, especially in the >39 and same group seemingly least able to afford expensive healthcare.

关键词： Spine Fusion Hospital Charges Payor Category

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Paleoecological Response of Corals to the End-Triassic Mass Extinction： An Integrational Analysis

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Journal of Earth Science 2018年第4期29卷 879-885页

作者： George D Stanley jr Hannah M E Shepherd Autumn J robinson University of Montana Paleontology Center Missoula MT 59812 USA

The end-Triassic （also Triassic-Jurassic） mass extinction severely affected life on planet Earth 200 million years ago. Paleoclimate change triggered by the volcanic eruptions of the Central Atlantic Magmatic Province （CAMP） caused a great loss of marine biodiversity, among which 96% coral genera were get lost. However, there is precious little detail on the paleoecology and growth forms lost between the latest Triassic extinction and the Early Jurassic recovery. Here a new pilot study was conducted by analyzing corallite integration levels among corals from the latest Triassic and Early Jurassic times. Integration levels in corals from the Late Triassic and Early Jurassic were determined through both the Paleobiology Database as well as from a comprehensive museum collection of fossil corals. Results suggest that in addition to a major loss of diversity following the end-Triassic mass extinction, there also was a significant loss of highly integrated corals as clearly evidenced by the coral data from the Early Jurassic. This confirms our hypothesis of paleoecological selectivity for corals following the end-Triassic mass extinction. This study highlights the importance of assigning sim- ple to advanced paleoecological characters with integration levels, which opens a useful approach to understanding of mass extinction and the dynamics of the recovery.

关键词： coral loss integration level end-Triassic mass extinction paleoecology

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Cenozoic reactivation along the Late Triassic Ganzi-Litang suture,eastern Tibetan Plateau

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Geoscience Frontiers 2020年第3期11卷 1069-1080页

作者： W.T.Jackson jr. D.M.robinson A.L.Weislogel X.Jian Department of Earth Sciences University of South AlabamaMobileAL36688USA Department of Geological Sciences and Center for Sedimentary Basin Studies The University of AlabamaTuscaloosaAL35487USA Department of Geography and Geology West Virginia UniversityMorgantownWV26506USA State Key Laboratory of Marine Environmental Science College of Ocean and Earth SciencesXiamen UniversityXiamen 361102China

The spatial-temporal development of Cenozoic reactivation along Mesozoic suture zones in the Tibetan Plateau are first-order parameters needed for assessing models of plateau *** Ganzi-Litang suture,in the eastern Tibetan Plateau,developed in the Late Triassic because of subduction and closure along the eastern branch of the Paleo-Tethys *** the city of Litang,the Ganzi-Litang suture is defined by a melange sequence with faultbound,synorogenic nonmarine strata along the western and eastern flanks,suggesting post-Triassic structural *** present detrital zircon U-Pb geochronology and field data to determine the timing and style of reactivation along the Ganzi-Litang suture,as well as sedimentary provenance of nonmarine strata.A reverse fault placing melange rock on top of nonmarine strata along the eastern flank of the Ganzi-Litang suture indicates a contractional deformational regime during *** clast counts indicate a local sediment source of recycled Ganzi-Litang suture and Yidun terrane *** zircons indicate a localized provenance consisting of recycled material from Triassic Yidun Arc plutons and Triassic Yidun Group turbidite rock.A weighted mean average of Cenozoic zircon grains(n=10) establishes a maximum depositional age of41.5 ± 1.2 Ma for nonmarine strata in the Ganzi-Litang *** interpret the maximum depositional age of the nonmarine strata to represent the upper-limit for structural reactivation along the Ganzi-Litang suture while undeformed Neogene strata in the suture zone represent the lower-limit;thereby bracketing structural reactivation from ca.42-25 *** results provide enhanced spatial-temporal resolution for Cenozoic deformation in the eastern Tibetan Plateau.

关键词： Nonmarine strata Yidun terrane Tibetan plateau Zircon Suture zone Reactivation

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High School Students from 157 Countries Convene to Address One of the 14 Grand Challenges for Engineering： Access to Clean Water

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Engineering 2017年第5期3卷 583-584页

作者： joe A. Sestak jr. President FIRST Global

As a former US Navy admiral and congressman, 1 have grown convinced of the importance of education and of how it can, not only address, but fix many of the issues affecting our communities, making it a primary line of defense. I also believe that the greatest power of the United States is the power to convene-to bring nations together in the pursuit of a common goal, showing that what we have in common is far greater than what sets us apart.

关键词：海军上将 Recognition FIRST 主要防线水资源天里工程技术日至 Olympics robotics

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Effects of medically generated electromagnetic interference from medical devices on cardiac implantable electronic devices: A review

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World Journal of Cardiology 2022年第8期14卷 446-453页

作者： Walker Barmore Himax Patel Cassandra Voong Caroline Tarallo joe B Calkins jr Department of Cardiology Augusta University Medical CenterAugustaGA 30912United States Department of Internal Medicine Augusta University Medical CenterAugustaGA 30912United States Medical College of Georgia Medical College of GeorgiaAugustaGA 30912United States

As cardiac implantable electronic devices(CIED)become more prevalent,it is important to acknowledge potential electromagnetic interference(EMI)from other sources,such as internal and external electronic devices and procedures and its effect on these *** from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers(PPM)and implantable cardioverter defibrillators(ICD),*** review analyzes potential EMI amongst CIED and left ventricular assist device,deep brain stimulators,spinal cord stimulators,transcutaneous electrical nerve stimulators,and throughout an array of procedures,such as endoscopy,bronchoscopy,and procedures involving *** there is evidence to support EMI from internal and external devices and during procedures,there is a lack of large multicenter studies,and,as a result,current management guidelines are based primarily on expert opinion and anecdotal *** aim to provide a general overview of PPM/ICD function,review documented EMI effect on these devices,and acknowledge current management of CIED interference.

关键词： Electromagnetic interference Pacemaker Implantable cardioverter defibrillator Permanent pacemakers Cardiac implantable electronic devices Left ventricular assist device Endoscopy Bronchoscopy Electrocautery Capsule endoscopy Transcutaneous electrical nerve stimulators unit Spinal cord stimulator

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Takotsubo cardiomyopathy:A comprehensive review

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World Journal of Cardiology 2022年第6期14卷 355-362页

作者： Walker Barmore Himax Patel Sean Harrell Daniel Garcia joe B Calkins jr Department of Internal Medicine Augusta University Medical CenterAugustaGA 30912United States Department of Cardiovascular Medicine Augusta University Medical CenterAugustaGA 30912United States

Takotsubo cardiomyopathy(TCM),also known as stress cardiomyopathy,occurs in the setting of catecholamine surge from an acute *** cardiomyopathy mimics acute myocardial infarction in the absence of coronary *** classic feature of TCM is regional wall motion abnormalities with characteristic ballooning of the left *** etiology of the stressor is often physical or emotional stress,however iatrogenic causes of TCM have been reported in the *** our review,we discuss medications,primarily the exogenous administration of catecholamines,and a wide array of procedures with subsequent development of iatrogenic *** is unique in that it is transient and has favorable outcomes in most ***,beta-blockers and ACE-inhibitors have been prescribed in individuals with cardiomyopathy;however,unique to TCM,no specific treatment is required other than temporary supportive measures as this process is ***,no improvement in mortality or recurrence have been reported in patients on these *** aim of this review is to elucidate on the iatrogenic causes of TCM,allowing for prompt recognition and management by clinicians.

关键词： Takotsubo Cardiomyopathy Iatrogenic Heart Failure Myocardial Infarction

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Recruitment of endogenous progenitor cells by erythropoietin loaded particles for in situ cartilage regeneration

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Bioactive Materials 2020年第1期5卷 142-152页

作者： Amirhossein Hakamivala Shuxin li Kayti robinson YiHui Huang Shuai Yu Baohong Yuan Joseph Borrelli jr. Liping Tang Bioengineering Department University of Texas Southwestern Medical CenterThe University of Texas at ArlingtonArlingtonTX76019USA Department of Biology The University of Texas at ArlingtonArlingtonTX76019USA

Cartilage injury affects millions of people throughout the world,and at this time there is no *** transplantation of stem cells has shown some success in the treatment of injured cartilage,such treatment is limited by limited cell sources and safety *** overcome these drawbacks,a microscaffolds system was developed capable of targeting,reducing the inflammatory response and recruiting endogenous progenitor cells to ***(EPO)-loaded-hyaluronic acid(HA)microscaffolds(HA+EPO)were fabricated and ***-microscaffolds showed good cell-compatibility and could target chondrocytes via CD44 ***+EPO was designed to slowly release EPO while recruiting progenitor ***,the ability of HA+EPO to repair cartilage-defects was assessed using a rabbit model of full-thickness *** results showed that the intra-articular administration of EPO,HA,and EPO+HA reduced the number of inflammatory cells inside the synovial-fluid,while EPO+HA had the greatest anti-inflammatory ***,among all groups,EPO+HA achieved the greatest progenitor cell recruitment and subsequent *** results of this work support that,by targeting and localizing the release of growthfactors,HA+EPO can reduce inflammatory responses and promote progenitor cells *** new platform represents an alternative treatment to stem-cell transplantation for the treatment of cartilage injury.

关键词： Hyaluronic acid microscaffolds Erythropoietin Progenitor cells recruitment Chondrogenesis Cartilage injury

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激发你的意志力

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青年文学家 2015年第28期 59-62页

作者： joe robinson

有了坚定的决心和良好的自控能力,无论难度多大,创业者都能克服重重挑战,赢得期待已久的回报。但是,尽管我们都知道意志力是创业成功的一大秘密武器,可创业者们又该如何运用它并让它发挥出最大威力呢?希腊神话里,西西弗斯因为惹怒众神... 详细信息

有了坚定的决心和良好的自控能力,无论难度多大,创业者都能克服重重挑战,赢得期待已久的回报。但是,尽管我们都知道意志力是创业成功的一大秘密武器,可创业者们又该如何运用它并让它发挥出最大威力呢?希腊神话里,西西弗斯因为惹怒众神而受罚,每日不断搬运巨石。而过去的四年时间里,Mike Adair俨然和西西弗斯一样,在创业这条山坡上不断奋斗,好在他的速冻玉米煎饼生意终于有所起色了。Adair开了一家墨西

关键词：意志力创业者玉米煎饼

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