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11. Ballistic injuries of the humerus: A matched cohort analysis.

Author

Smith, Walter, Schick, Samuel, Arthur, Rodney, Paul, Kyle, Elphingstone, Joseph, Prahad, Srihari, Luque-Sanchez, Kevin, Momaya, Amit, Spitler, Clay, and Brabston, Eugene

Subjects
BLUNT trauma, SOFT tissue infections, RISK assessment, WOUNDS & injuries, T-test (Statistics), AFRICAN Americans, BLOOD vessels, DESCRIPTIVE statistics, CHI-squared test, GUNSHOT wounds, LONGITUDINAL method, ODDS ratio, HUMERAL fractures, CONVALESCENCE, COMPARATIVE studies, EPIDEMIOLOGY, COMPARTMENT syndrome, HUMERUS, DISEASE risk factors
Abstract

Introduction: Ballistic fractures of the humerus secondary to gunshot wounds are increasingly common injuries that pose challenges for orthopedic surgeons. The primary purpose of this study was to examine the rates of neurovascular injury, compartment syndrome, and infection of ballistic humerus fractures relative to blunt, non-penetrating fractures. Methods: A consecutive cohort of 135 patients with ballistic humerus fractures and 167 patients with blunt humerus fractures treated at a level 1 trauma center were identified. A review of patient medical records and radiographic studies was performed to obtain demographic information, injury mechanism, fracture location, choice of treatment, and complications. Statistical analysis was performed using independent sample t -tests, chi-square tests, and odds ratios (p < 0.05 significance). Results: Compared with blunt fractures, patients in the ballistic fracture cohort were younger, male, African American, test positive for illicit drug use, and sustain proximal fractures. Ballistic fractures had significantly lower Injury Severity Scores and New Injury Severity Scores. Ballistic fractures were three times as likely to present with neurovascular injury than blunt fractures (OR: 2.927, p < 0.001). The overall rate of spontaneous recovery of significant motor function for ballistic fractures with neurologic injury was 55%. There were no statistically significant differences in rates of vascular injury, compartment syndrome, infection, non-union, or the need for soft tissue reconstruction. Conclusion: Compared with blunt humeral fractures, ballistic fractures appear to have a significantly higher rate of neurologic injury but no increased risk for compartment syndrome or infection. Surgical treatment of ballistic humeral injuries was not associated with increased neurological recovery compared to non-operatively managed fractures. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Ballistic injuries of the humerus: A matched cohort analysis

Author

Smith, Walter, primary, Schick, Samuel, additional, Arthur, Rodney, additional, Paul, Kyle, additional, Elphingstone, Joseph, additional, Prahad, Srihari, additional, Luque-Sanchez, Kevin, additional, Momaya, Amit, additional, Spitler, Clay, additional, and Brabston, Eugene, additional

Published
2023
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21. Orthopedic consequences of modern gladiators: a systematic review of lower extremity musculoskeletal issues in retired NFL players.

Author

McClure, Mark, Cooke, Brett, Elphingstone, Joseph, Schick, Samuel, Paul, Kyle, Jardaly, Achraf, Brabston, Eugene, Momaya, Amit, and Ponce, Brent

Abstract

The stressors that National Football League (NFL) athletes face are well-described and documented with regard to multisystem afflictions and injury prevalence. However, the majority of literature discusses the short-term effects rather than long-term outcomes of playing professional football. The purpose of this study was to characterize the long-term musculoskeletal issues in the retired NFL population. Publications from CENTRAL, Scopus, Medline, PubMed, Embase, and Google Scholar were searched from database inception to February 2021. A total of 9 cohort studies evaluating lower extremity arthritis in retired NFL athletes were included for review. Two reviewers extracted data from the individual studies, including demographic information (age, body mass index, length of career, position), injury descriptions (location of injury, number of injuries, diagnoses), and procedure (total knee and or hip arthroplasty) frequency. Arthritis in retired NFL players was more than twice as prevalent than the general United States male population (95% CI: 2.1–2.3). Ankle osteoarthritis was directly correlated with the number of foot and ankle injuries. Players <50 years of age had a 16.1 and 13.8 times higher risk of undergoing TKA and THA, respectively, when compared to the general population. In older age groups, this trend held with retired NFL players being at least 4.3 and 4.6 times more likely than members of the general population to undergo TKA and THA, respectively. This review demonstrates that the effects of NFL-related lower extremity injuries extend beyond the players' careers and present a higher risk for early-onset osteoarthritis and overall frequency of undergoing total knee and hip arthroplasty. [ABSTRACT FROM AUTHOR]

Published
2023
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40. Celebrity Diplomacy

Author

Paul, Kyle David

Subjects
Celebrity Diplomacy (Book) -- Cooper, Andrew F., I Am America (and So Can You!) (Novel) -- Book reviews, I Am America and So Can You! (Book) -- Colbert, Stephen, Books -- Book reviews, International relations
Abstract

CELEBRITY DIPLOMACY Andrew F. Cooper London: Paradigm Publishers, 2007. 160pp, US$18.95 paperback (ISBN 978-1594514791) I AM AMERICA And So Can You! Stephen Colbert New York: Grand Central Publishing, 2007. 240pp, [...]

Published
2008

41. Hiding in Plain Sight? Japan’s Militarization of Space and Challenges to the Yoshida Doctrine

Author

Christopher W. Hughes and Paul Kyle Kallender

Subjects
050502 law, Grand strategy, 05 social sciences, Security policy, 050601 international relations, 0506 political science, Procurement, Alliance, Political economy, Political science, Political Science and International Relations, Yoshida Doctrine, JZ, China, Safety Research, Administration (government), 0505 law, Militarization
Abstract

Japan’s security discourse – despite accelerating shifts in its security stance over the last two decades, and more recently, under the Abe administration – remains dominated by views of essential continuity and maintenance of the “Yoshida Doctrine.” The case of Japan’s militarization of space is used to create a framework for systematically dismantling default assumptions about the durability of the Yoshida Doctrine. The militarization of space serves as a driver of broader trends in Japan’s security policy manifested in the procurement of dual-use assets in launch systems, communications and intelligence satellites, and counterspace capabilities necessary for active internal and external balancing with the US–Japan alliance; the strengthening domestically of security policymaking institutions; and the jettisoning of anti-militaristic norms. Japan’s increasingly assertive military stance, bolstering of the US–Japan alliance and cessation of hedging, facing down of China’s rise, and departure from the Yoshida Doctrine as grand strategy are thus revealed as hiding in plain sight.\ud \ud

Published
2018

42. Quantification of Chimerism and Graft Immune Cell Composition with Alloseq HCT, a Wide Range Next-Generation Sequencing Assay with High Sensitivity, Accuracy and Precision for Routine Monitoring in Patients Post-Hematopoietic Stem Cell Transplantation

Author

Thierry Viard, Paul Kyle, Zuleika Calderin-Sollet, Jean Villard, and Sylvia Casas

Subjects
Oncology, Transplantation, medicine.medical_specialty, Accuracy and precision, Molecular composition, business.industry, medicine.medical_treatment, Cell Biology, Hematology, Hematopoietic stem cell transplantation, DNA sequencing, Immune system, Internal medicine, medicine, Molecular Medicine, Immunology and Allergy, In patient, business
Published
2021

43. Quantification of Chimerism and Graft Immune Cell Composition with Alloseq HCT, a Highly Sensitive and Precise Next-Generation Sequencing Assay, in Patients Post-Hematopoietic Stem Cell Transplantation

Author

Paul Kyle, Silvia Casas, Thierry Viard, Jean Villard, Zuleika Calderin-Sollet, and Marica Grskovic

Subjects
Molecular composition, medicine.medical_treatment, Immunology, Cell Biology, Hematology, Hematopoietic stem cell transplantation, Biology, Biochemistry, DNA sequencing, Highly sensitive, Immune system, medicine, Cancer research, In patient
Abstract

Introduction: Chimerism changes post hematopoietic cell transplant (HCT) can be an early indication of disease relapse. Graft immune cell fraction composition has been seen associated with clinical outcome of hematopoietic cell transplantation patients (Saliba et al., Haematologica February 2020). AlloSeq HCT (CareDx Inc., CA, USA) is the latest innovation in chimerism testing, an NGS-based chimerism assay that uses a targeted SNP panel and provides standardized workflow with automated data analyses. Objectives: We aimed to analyze graft immune cell composition using the AlloSeq HCT assay and compared it to the current standard laboratory method based on Short Tandem Repeat (STR) analysis. Methods: A total of 8 post HCT samples from peripheral blood were taken at the same time point for cellular subfraction and isolation of CD15+, CD33+, granulocytes (GR) and monocytes (MN) cells prior to genomic DNA (gDNA) extraction. For each recipient, donor gDNA was input as a reference sample. The kit-based test AlloSeq HCT was used to prepare libraries and sequenced on the Illumina MiSeq platform. AlloSeq Software performed the QC and data analysis for the evaluation of percent chimerism (median ± CI 95%). Results below limit of detection (LOD of 0.32% for AlloSeq HCT and 3% for STR) were excluded in the Mann-Whitney and Spearman correlation analyses. For inter-assay variation 3 subfraction samples with results along the dynamic range were repeated 2-3 times on AlloSeq HCT and the coefficient of variation (CV) was calculated. Results: CD3+ cells dominated graft cellular composition with a chimerism of 31.6% (10.4 to 44.3%), followed by MN cells at 10.0% (1.4 to 18.6%) and GR cells at 7.3% (0.56 to 13.9%), and CD15+ was the smallest fraction with 2.9% (-4.0 to 9.8%). Median levels of chimerism in each cellular subfraction of the grafts were not statistically significant different when comparing AlloSeq HCT and STR (p>0.5) (Fig. 1A). Results of percent of chimerism obtained for each cell fraction using both methods exhibited an overall correlation of r=0.96 (CI 95%: 0.88 to 0.98) (Fig. 1B). LOD results were reported in 5 with AlloSeq HCT compared to 9 with STR out of the total 26 subfraction tested (19% vs 35%). The inter-run CV was 1.7, 14.5 and 1.6 with a means percent chimerism of 0.8, 17.0 and 14.3, respectively. Conclusion: The immune cell composition of the graft can be characterized in clinical practice with NGS-based chimerism assay. Evaluation of AlloSeq HCT showed excellent assay performance and a larger dynamic range compared with STR, as well as increased sensitivity by reporting 4 cases where percent chimerism was undetectable by STR. NGS-based medicine shows great promise for better detection and definition of HCT graft with a streamlined workflow. Figure 1 Disclosures Kyle: CareDx: Current Employment. Casas:CareDx: Current Employment. Grskovic:CareDx: Current Employment, Current equity holder in publicly-traded company, Patents & Royalties, Research Funding. Viard:CareDx: Current Employment, Current equity holder in publicly-traded company, Research Funding.

Published
2020

44. Japan’s Emerging Trajectory as a ‘Cyber Power’: From Securitization to Militarization of Cyberspace

Author

Christopher W. Hughes and Paul Kyle Kallender

Subjects
021110 strategic, defence & security studies, National security, Sociology and Political Science, business.industry, 05 social sciences, 0211 other engineering and technologies, Global commons, 02 engineering and technology, Computer security, computer.software_genre, 050601 international relations, 0506 political science, Power (social and political), Alliance, Political economy, Political science, Political Science and International Relations, Securitization, business, Cyberspace, China, computer, Militarization
Abstract

Japan has been overlooked as a ‘cyber power’ but it now becoming a serious player in this new strategic domain. Japanese policy-makers have forged a consensus to move cybersecurity to the very core of national security policy, to create more centralized frameworks for cybersecurity, and for Japan’s military institutions to build dynamic cyberdefense capabilities. Japan’s stance has moved rapidly toward the securitization and now militarization of responses to cyber challenges. Japan’s cybersecurity stance has bolstered US–Japan alliance responses to securing all dimensions of the ‘global commons’ and extended its defense perimeter to further deter but potentially raise tensions with China.

Published
2016

45. Warheads

Author

Paul, Kyle David

Subjects
Warheads: Cable News And the Fog of War (Book) -- Allard, Kenneth, Books -- Book reviews, International relations
Abstract

WARHEADS Cable News and the Fog of War Kenneth Allard Annapolis, MD: Naval Institute Press, 2006. 166pp, $26.95 cloth. In writing this book from the vantage point of a 'warhead' [...]

Published
2007

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