bluuebunny/crossref_metadata_2025_split huggingface dataset:
Responsiveness of the PROMIS-29 Scales in Individuals With Chronic Low Back Pain
Authors: Khutok Kornkanok , Janwantanakul Prawit , Jensen Mark P. , Kanlayanaphotporn Rotsalai 
Published: October 2020

Study Design.
Prospective cohort study.

Objective.
To evaluate responsiveness and estimate the minimal clinically important differences (MCIDs) for the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) scales in individuals with chronic low back pain.

Summary of Background Data.
The PROMIS-29 questionnaire assesses seven health-related quality-of-life domains. However, research to evaluate the responsiveness and MCIDs of the PROMS-29 scores in individuals with low back pain is limited.

Methods.
The study was conducted in physical therapy clinics in Thailand, using validated Thai versions of the study measures. One hundred and eighty-three individuals with chronic low back pain completed the PROMIS-29 at baseline and at 4-weeks follow-up. Perceived change in each domain assessed by the PROMIS-29 scales was assessed at 4 weeks using a 7-point measure of Global Perceived Effect (GPE). Responsiveness of the PROMIS-29 scale scores was evaluated by examining the effect sizes, the standardized response means (SRMs) for change over time, and examining these as a function of the GPE ratings. MCIDs for the scales were estimated by computing a half a standard deviation (SD) and standard error of measurement statistic for each scale.

Results.
The mean change scores, effect sizes, and SRMs increased as a function of the GPE ratings. Significant differences in change scores between those who reported that they were very much improved and those who did not improve were found for the PROMIS-29 Pain Intensity, Physical Function, and Anxiety scales. The correlations between changes scores and GPE ratings were mostly weak in magnitude. The MCID estimates computed as 0.50 of a SD unit and as a standard error of measurement showed similar values.

Conclusion.
The PROMIS-29 scale scores assessing pain intensity, physical function, and anxiety evidenced the most responsivity in the study sample. The results, when considered in light of the findings from other investigators, support 5.0 points as a reasonable MCID for most of the PROMIS-29 scales. Further studies are needed to determine the generalizability of the findings.

Level of Evidence: 2
Complication Events After Spinal Surgery Performed by American Board of Orthopaedic Surgery (ABOS) Part II Candidates (2008–2017)
Authors: Yeung Caleb M. , Schoenfeld Andrew J. , Kang James D. , Makhni Melvin C. 
Published: October 2020

Study Design.
Retrospective cohort study.

Objective.
To evaluate complications following spine surgery using American Board of Orthopaedic Surgeons (ABOS) Part II examination data from 2008 to 2017.

Summary of Background Data.
Recent research has demonstrated the importance of surgical experience and clinical volume in minimizing complications after spine surgery. This may be challenging for orthopedic spine surgeons who are just starting their practice.

Methods.
We performed a retrospective review of surgical cases submitted to the ABOS by candidates taking the Part II Spine examination between 2008 and 2017. Complications, including peri-operative mortality as reported by candidates to the ABOS, were tracked over time. Complications were classified as surgical or medical using a predefined algorithm. Multivariable Poisson regression analyses adjusting for confounders were used to assess rates of complications and mortality over time. All analyses controlled for biologic sex, age, surgical diagnosis, and surgical location.

Results.
A total of 37,539 spine surgical patients were analyzed, with an average of 3754 cases performed each year. Following adjusted Poisson analysis, we determined that cases in 2017 had an increased likelihood of complications when compared to those treated in 2008 (IRR 1.20; 95% CI 1.09, 1.32). Similar findings were encountered for surgical complications (IRR 1.20; 95% CI 1.07, 1.34). In contrast, spine surgical cases reported to the ABOS in 2017 had a 55% lower likelihood of mortality when compared to procedures performed in 2008 (IRR 0.45; 95% CI 0.24, 0.84; P = 0.01).

Conclusions.
Our analysis of ABOS Part II candidates demonstrates that reported complication rates may be increasing while mortality is decreasing. The etiologies behind these findings are likely multifactorial. Encouragingly, we believe that observed reductions in mortality suggest overall improvements in patient safety following spine surgery. At a minimum, our data provide benchmarks through which spine surgeons, hospitals, and residency or fellowship programs can evaluate performance.

Level of Evidence: 4
New Pigmentation After Medical Treatment Suggests Increased Efficacy of Dermabrasion and Noncultured Epidermal Cell Suspension Techniques in Stable Vitiligo
Authors: Chen Cheng , Yu Nanze , Liu Zhifei , Tao Yong , Liu Bin 
Published: October 2020

BACKGROUND
Stable vitiligo has been treated by dermabrasion and noncultured epidermal cell suspension (NCES) effectively. However, not all patches respond well.

OBJECTIVE
To investigate the efficacy of new pigmentation after medical treatment in the therapy of stable vitiligo.

MATERIALS AND METHODS
Medical records were retrospectively reviewed from October 2016 to March 2019, and 134 patients with stable vitiligo after medical therapy were further treated with NCES. They were divided into 2 groups: 70 patients in Group 1 had new pigmentation, whereas 64 patients in Group 2 did not. Repigmentation and satisfaction of patients and third-party assessors were evaluated at 3 and 6 months postoperatively.

RESULTS
Repigmentation was scored as excellent (≥76%), good (51%–75%), fair (26%–50%), or poor (≤25%). Repigmentation of the 2 groups at 6 months postoperatively was excellent in 82.9% versus 23.4%, good in 10.0% versus 15.6%, fair in 7.1% versus 13.0%, and poor in 0% versus 48.4%, respectively. A positive correlation between satisfaction and repigmentation was found.

CONCLUSION
New pigmentation after medical treatment suggests increased efficacy of NCES in treating stable vitiligo.
Interim Guidance on the Preparticipation Physical Examination for Athletes During the SARS-CoV-2 Pandemic
Authors: Diamond Alex B. , Narducci Dusty Marie , Roberts William O. , Bernhardt David T. , LaBella Cynthia R. , Moffatt Kody A. , Nuti Rathna , Powell Amy P. , Rooks Yvette L. , Zaremski Jason L. 
Published: October 2020

Abstract:
The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an iterative process and expert consensus to finalize this guidance statement that is intended to provide clinicians with a clinical framework to return athletes of all levels to training and competition during the pandemic. The statement is not intended to address treatment, infection control principles, or public health issues related to SARS-CoV2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.
Antibiotic stewardship: Improving patient-centered right care in urgent care using a shared decision aid and 5 Ds tool
Authors: Forrest Cynthia L. , Verzone Ana 
Published: October 2020

ABSTRACT

Background:
Overuse of antibiotics leads to antibiotic resistance, costing $35 billion and causing approximately 23,000 deaths in the United States annually. Antibiotic stewardship is important in urgent care centers to prevent antibiotic resistance.

Local problem:
Providers prescribed antibiotics to 80% of patients with viral conditions at this urgent care center. The aim of this quality improvement (QI) project was to improve right care for patients of 65 years and younger with upper respiratory infections and/or head, ears, nose, or throat viral illnesses presenting to urgent care from 36.2% to 80% within 90 days.

Methods:
Four rapid Plan-Do-Study-Act cycles were performed every two weeks. Four concurrent focus areas were used for team and patient engagement, antibiotic prescribing, and tracking right care.

Interventions:
There were four core interventions. These included biweekly team meetings, a shared decision aid (SDA), an antibiotic prescribing 5 Ds tool, and a case management log.

Results:
Use of the SDA improved patient engagement from 33% to 93%. The 5 Ds tool improved proper prescribing from 20% to 95%. Pediatric acute otitis media had the greatest improvement, with the proper diagnosis and the use of watchful waiting, delaying the filling of an antibiotic prescription.

Conclusion:
Antibiotic stewardship and standardization of prescribing were improved in urgent care with the use of the 5 Ds tool. This QI project can be replicated for use in urgent care centers for compliance with the Joint Commission standards required.
Predictors of Out-of-Class Mindfulness Practice Adherence During and After a Mindfulness-Based Intervention
Authors: Canby Nicholas K. , Eichel Kristina , Peters Sarah I. , Rahrig Hadley , Britton Willoughby B. 
Published: October 2020

ABSTRACT

Objective
Out-of-class mindfulness meditation practice is a health behavior that is considered to be a crucial ingredient in mindfulness-based interventions (MBIs), yet participant adherence to practice recommendations is often inconsistent. Furthermore, MBIs may enhance factors that lead to greater adherence to medical regimens in other contexts. This study examined baseline factors previously found to relate to adherence to medical regimen, MBI-related changes in these baseline factors, and treatment-related factors as predictors of meditation adherence in an 8-week MBI.

Methods
Baseline traits (personality, depressive symptoms, and executive function) were entered into regression models (n = 96) to predict intervention and postintervention out-of-class meditation adherence. Trait changes and treatment-related factors were entered into models to predict postintervention meditation adherence.

Results
Baseline conscientiousness (β = 0.33, p = .002), openness (β = 0.23, p = .019), and depressive symptoms (β = 0.19, p = .042) predicted intervention meditation adherence, whereas conscientiousness (β = 0.21, p = .044) and depressive symptoms (β = 0.22, p = .020) predicted postintervention meditation adherence. Although all trait variables except for agreeableness changed significantly pre-to-post intervention, these changes did not predict postintervention meditation adherence. Retreat attendance (β = 0.38, p = .029) and instructor/group-related therapeutic factors collectively predicted postintervention meditation adherence (R
2 = 0.21, p = .019).

Conclusions
The identified baseline trait factors could be used to increase adherence in these interventions as a method of increasing their effectiveness. An emphasis on the MBI retreat and social factors during the intervention may be important for participant out-of-class practice postintervention.

Trial Registration:
ClinicalTrials.gov
NCT01831362.
Minimally Invasive Treatment With a Patient Specific Implant in Reconstruction of Isolated Anterior Wall Fracture of the Frontal Sinus
Authors: Helmers Renée , Klop Cornelis , Schreurs Ruud , de Lange Jan , Dubois Leander 
Published: October 2020

Abstract
Isolated fractures of the anterior wall of the frontal sinus are most often treated through a coronal approach. Although the coronal approach is a relatively easy procedure, the size of the incision is causing more problems related to patient morbidity and recovery time than smaller approaches. A novel, minimal invasive procedure for reconstruction of the anterior wall fracture of the frontal sinus is presented in this article. An endoscopic assisted approach to camouflage the defect of the anterior wall and restore the contour of the frontal bone with a titanium patient specific implant is described in 2 patients. The aim of this procedure is to evaluate the effect on the operating time, recovery time, length of hospital stay and facial scarring compared to the conventional coronal approach. Postoperative evaluation was performed by superimposing pre and postoperative 3D stereophotographs and computed tomography scans. A distance map demonstrated an accurate reconstruction of the preoperatively planned contour. Postoperative recovery of both patients was quick and uneventful with no complications. The use of endoscopically inserted patient specific implant for contour reconstruction in anterior wall fractures of the frontal sinus seems to offer a predictable and minimal invasive alternative to the conventional approach.
Surgical counts in open abdominal and pelvic surgeries in a university hospital: a best practice implementation project
Authors: Gomes Eduardo T. , Galvão Mayana C.B. , Shimoda Gilcéria T. , de Oliveira Larissa B. , de Araújo Püschel Vilanice A. 
Published: October 2020

ABSTRACT

Introduction:
Counting of accountable items used during surgery, frequently called ’the count’, is a fundamental practice to ensure that items such as surgical instruments, sponges and sharps are not forgotten within patients. Although inadvertently leaving behind a sponge or instrument at the end of an operation is a rare event, it is an error that may have serious implications.

Objectives:
The aim of this evidence implementation project was to contribute to promoting evidence-based practice in surgical counts in open abdominal and pelvic surgeries and thereby improving the outcomes of the surgical patients at a surgical centre of a university hospital.

Methods:
The current evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice (GRiP) audit and feedback tool. The JBI Practical Application of Clinical Evidence System and GRiP framework for promoting evidence-based healthcare involves three phases of activity: first, establishing a project team and undertaking a baseline audit based on evidence-informed criteria; second, reflecting on the results of the baseline audit and designing and implementing strategies to address non-compliance found in the baseline audit informed by the JBI GRiP framework; third, conducting a follow-up audit to assess the outcomes of the interventions implemented to improve practice, and identify future practice issues to be addressed in subsequent audits. These three phases were performed over a period of 6 months, from August 2017 to March 2018.

Results:
The baseline audit revealed deficits between old and best practice in all criteria. Barriers for implementation of a protocol for surgical counts were identified, and strategies were implemented. The postimplementation (follow-up) audit showed improvement in compliance with best practice in six of the audit criteria selected except two, a multidisciplinary team approach to decrease retained surgical items, and limited staff hand-offs during surgical procedures to ensure the same team is present in all counting episodes.

Conclusion:
The main achievements of the study included substantial increases in compliance with best practice. However, registration and report and commitment of all members of surgical team to apply the entire protocol, avoiding to skip any step, persist as challenges.
Transcriptomic Analyses Throughout Chili Pepper Fruit Development Reveal Novel Insights into Domestication Process
Authors: Martínez Octavio , Arce-Rodríguez Magda L. , Hernández-Godínez Fernando , Escoto-Sandoval Christian , Cervantes-Hernández Felipe , Hayano-Kanashiro Corina , Ordaz-Ortiz José J. , Reyes-Valdés M. Humberto , Razo-Mendivil Fernando G. , Garcés-Claver Ana , Ochoa-Alejo Neftalí 
Published: October 2020

ABSTRACTChili pepper (Capsicumspp.) is both an important crop and a model for domestication studies. Here we performed a time course experiment to estimate standardized gene expression profiles across fruit development for six domesticated and four wild chili pepper ancestors. We sampled the transcriptome every 10 days, from flower to fruit at 60 Days After Anthesis (DAA), and found that the mean standardized expression profile for domesticated and wild accessions significantly differed. The mean standardized expression was higher and peaked earlier for domesticated vs. wild genotypes, particularly for genes involved in the cell cycle that ultimately control fruit size. We postulate that these gene expression changes are driven by selection pressures during domestication and show a robust network of cell cycle genes with a time-shift in expression which explains some of the differences between domesticated and wild phenotypes.
AncestryDNA COVID-19 Host Genetic Study Identifies Three Novel Loci
Authors: Roberts Genevieve H.L. , Park Danny S. , Coignet Marie V. , McCurdy Shannon R. , Knight Spencer C. , Partha Raghavendran , Rhead Brooke , Zhang Miao , Berkowitz Nathan ,   AncestryDNA Science Team, Haug Baltzell Asher K. , Guturu Harendra , Girshick Ahna R. , Rand Kristin A. , Hong Eurie L. , Ball Catherine A. 
Published: October 2020

AbstractHuman infection with SARS-CoV-2, the causative agent of COVID-19, leads to a remarkably diverse spectrum of outcomes, ranging from asymptomatic to fatal. Recent reports suggest that both clinical and genetic risk factors may contribute to COVID-19 susceptibility and severity. To investigate genetic risk factors, we collected over 500,000 COVID-19 survey responses between April and May 2020 with accompanying genetic data from the AncestryDNA database. We conducted sex-stratified and meta-analyzed genome-wide association studies (GWAS) for COVID-19 susceptibility (positive nasopharyngeal swab test,ncases=2,407) and severity (hospitalization,ncases=250). The severity GWAS replicated associations with severe COVID-19 nearABOandSLC6A20(P<0.05). Furthermore, we identified three novel loci withP<5×10−8. The strongest association was nearIVNS1ABP, a gene involved in influenza virus replication1, and was associated only in males. The other two novel loci harbor genes with established roles in viral replication or immunity:SRRM1and the immunoglobulin lambda locus. We thus present new evidence that host genetic variation likely contributes to COVID-19 outcomes and demonstrate the value of large-scale, self-reported data as a mechanism to rapidly address a health crisis.
Post-operative serum procalcitonin vs C reactive Protein as a marker of post-operative infectious complications in pancreatic surgery – A systemic review and meta-analysis
Authors: Vasavada Bhavin , Patel Hardik 
Published: October 2020

AbstractAim of StudyAim of this meta-analysis was to compare diagnostic accuracy of C reactive Protein and Procalcitonin between postoperative day 3 to 5 in predicting infectious complications post pancreatic surgery.MethodsSystemic literature search was performed using MEDLINE, EMBASE and SCOPUS to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) and C-Reactive Protein (CRP) as a predictor for detecting infectious complications between postoperative days (POD) 3 to 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters. Geometric means were calculated for PCT cut offs. The work has been reported in line with PRISMA guidelines.ResultsAfter applying inclusion and exclusion criteria 15 studies consisting of 2212 patients were included in the final analysis according to PRISMA guidelines. Pooled sensitivity, specificity, Area under curve and diagnostic odds ratio (DOR)for day 3 C-reactive protein was respectively 62%,67% 0.772 and 6.54. Pooled sensitivity, specificity, Area under curve and diagnostic odds ratio (DOR)for day 3 procalcitonin was respectively 74%,79%,0.8453 and 11.03. Sensitivity, specificity, Area under curve, and Diagnostic odds ratio for day 4 C-reactive protein was respectively 60%,68%, 0.8022 and 11.90. Pooled Sensitivity, specificity and Diagnostic odds ratio of post-operative day 5 procalcitonin level in predicting infectious complications were respectively 83%,70% and 12.9. Pooled Sensitivity, specificity, AUROC and diagnostic odds ratio were respectively 50%,70%, 0.777 and 10.19.ConclusionPost-operative procalcitonin is better marker to predict post-operative infectious complications after pancreatic surgeries and post-operative day 3 procalcitonin has highest diagnostic accuracy.
Failures of nerve regeneration caused by aging or chronic denervation are rescued by restoring Schwann cell c-Jun
Authors: Wagstaff Laura J. , Gomez-Sanchez Jose A. , Fazal Shaline V. , Otto Georg W. , Kilpatrick Alastair M. , Michael Kirolos , Wong Liam Y.N. , Ma Ki H. , Turmaine Mark , Svaren John , Gordon Tessa , Arthur-Farraj Peter , Velasco-Aviles Sergio , Cabedo Hugo , Benito Cristina , Mirsky Rhona , Jessen Kristjan R 
Published: October 2020

ABSTRACTAfter nerve injury, myelin and Remak Schwann cells reprogram to repair cells specialized for regeneration. Normally providing strong regenerative support, these cells fail in aging animals, and during the chronic denervation that results from the slow growth of axons. This impairs axonal regeneration and causes a significant clinical problem. In mice, we find that repair cells express reduced c-Jun protein as the regenerative support provided by these cells declines in aging animals and during chronic denervation. In both cases, genetically restoring Schwann cell c-Jun levels restores regeneration to that in controls. We identify potential gene candidates mediating this effect and implicate Shh in the control of Schwann cell c-Jun levels. This establishes that a common mechanism, reduced c-Jun in Schwann cells, regulates the success and failure of nerve repair both during aging and chronic denervation. This provides a molecular framework for addressing important clinical problems, and suggests molecular pathways that can be targeted to promote repair in the PNS.
Implementation of an ERAS program in patients undergoing thoracic surgery at a third-level university hospital. An ambispective cohort study
Authors: Bellas-Cotán Soledad , Casans-Francés Rubén , Ibáñez Cristina , Muguruza Ignacio , Muñoz-Alameda Luis E. 
Published: October 2020

ABSTRACTObjetiveTo analyze the effects of the implementation of an ERAS program in patients undergoing pulmonary resection in a tertiary university hospital on the rates of complications and readmission and the length of stay.Methodsambispective cohort study, with a prospective arm of patients undergoing thoracic surgery within an ERAS program versus a retrospective arm of patients before the implementation of the protocol. We recluited 50 patients per arm. The primary outcome was the number of patients with 30-day surgical complications. Secondary outcome included ERAS adherence, no-surgical complications, mortality, readmission, reintervention rates, pain and hospital lenght of stay. We performed a multivariate logistic analysis to study the association of coutcomes with ERAS adherence.ResultsWe found no difference between the two groups in surgical complications [Standard 18 (36%) vs 12 (24%], p =0.19]. ERAS group was significantly lower only in its readmission rate [Standard 15 (30%) vs 6 (12%], p =0.03]. In multivariate analyses, ERAS adherence was the only factor associated with a reduction in surgical complications [OR (95%CI) = 0.02 (0.00, 0.59), p = 0.03] and length of stay [HR (95%CI) = 18.5 (4.39, 78.4), p < 0.001].ConclusionsERAS program was able to decrease the readmission rate at our centre significantly. The adherence to the ERAS protocol influenced the reduction of surgical complications and length of stay.