bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Rehabilitation
Authors: Fehlings Michael G. , Tetreault Lindsay A. , Aarabi Bizhan , Anderson Paul , Arnold Paul M. , Brodke Darrel S. , Chiba Kazuhiro , Dettori Joseph R. , Furlan Julio C. , Harrop James S. , Hawryluk Gregory , Holly Langston T. , Howley Susan , Jeji Tara , Kalsi-Ryan Sukhvinder , Kotter Mark , Kurpad Shekar , Kwon Brian K. , Marino Ralph J. , Martin Allan R. , Massicotte Eric , Merli Geno , Middleton James W. , Nakashima Hiroaki , Nagoshi Narihito , Palmieri Katherine , Singh Anoushka , Skelly Andrea C. , Tsai Eve C. , Vaccaro Alexander , Wilson Jefferson R. , Yee Albert , Burns Anthony S. 
Published: September 2017

Introduction: The objective of this study is to develop guidelines that outline the appropriate type and timing of rehabilitation in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to rehabilitation in patients with acute SCI. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the type and timing of rehabilitation. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest. Results: Based on the findings from the systematic review, our recommendations were: (1) We suggest rehabilitation be offered to patients with acute spinal cord injury when they are medically stable and can tolerate required rehabilitation intensity (no included studies; expert opinion); (2) We suggest body weight–supported treadmill training as an option for ambulation training in addition to conventional overground walking, dependent on resource availability, context, and local expertise (low evidence); (3) We suggest that individuals with acute and subacute cervical SCI be offered functional electrical stimulation as an option to improve hand and upper extremity function (low evidence); and (4) Based on the absence of any clear benefit, we suggest not offering additional training in unsupported sitting beyond what is currently incorporated in standard rehabilitation (low evidence). Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in patients with SCI by promoting standardization of care, decreasing the heterogeneity of management strategies and encouraging clinicians to make evidence-informed decisions.
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Anticoagulant Thromboprophylaxis
Authors: Fehlings Michael G. , Tetreault Lindsay A. , Aarabi Bizhan , Anderson Paul , Arnold Paul M. , Brodke Darrel S. , Burns Anthony S. , Chiba Kazuhiro , Dettori Joseph R. , Furlan Julio C. , Hawryluk Gregory , Holly Langston T. , Howley Susan , Jeji Tara , Kalsi-Ryan Sukhvinder , Kotter Mark , Kurpad Shekar , Kwon Brian K. , Marino Ralph J. , Martin Allan R. , Massicotte Eric , Merli Geno , Middleton James W. , Nakashima Hiroaki , Nagoshi Narihito , Palmieri Katherine , Singh Anoushka , Skelly Andrea C. , Tsai Eve C. , Vaccaro Alexander , Wilson Jefferson R. , Yee Albert , Harrop James S. 
Published: September 2017

Introduction: The objective of this study is to develop evidence-based guidelines that recommend effective, safe and cost-effective thromboprophylaxis strategies in patients with spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions relating to thromboprophylaxis in SCI. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: Based on conclusions from the systematic review and expert panel opinion, the following recommendations were developed: (1) “We suggest that anticoagulant thromboprophylaxis be offered routinely to reduce the risk of thromboembolic events in the acute period after SCI;” (2) “We suggest that anticoagulant thromboprophylaxis, consisting of either subcutaneous low-molecular-weight heparin or fixed, low-dose unfractionated heparin (UFH) be offered to reduce the risk of thromboembolic events in the acute period after SCI. Given the potential for increased bleeding events with the use of adjusted-dose UFH, we suggest against this option;” (3) “We suggest commencing anticoagulant thromboprophylaxis within the first 72 hours after injury, if possible, in order to minimize the risk of venous thromboembolic complications during the period of acute hospitalization.” Conclusions: These guidelines should be implemented into clinical practice in patients with SCI to promote standardization of care, decrease heterogeneity of management strategies and encourage clinicians to make evidence-informed decisions.
Type and Timing of Rehabilitation Following Acute and Subacute Spinal Cord Injury: A Systematic Review
Authors: Burns Anthony S. , Marino Ralph J. , Kalsi-Ryan Sukhvinder , Middleton James W. , Tetreault Lindsay A. , Dettori Joseph R. , Mihalovich Kathryn E. , Fehlings Michael G. 
Published: September 2017

Objectives: The objective of this study was to conduct a systematic review of the literature to address the following clinical questions: In adult patients with acute and subacute complete or incomplete traumatic SCI, (1) does the time interval between injury and commencing rehabilitation affect outcome?; (2) what is the comparative effectiveness of different rehabilitation strategies, including different intensities and durations of treatment?; (3) are there patient or injury characteristics that affect the efficacy of rehabilitation?; and (4) what is the cost-effectiveness of various rehabilitation strategies? Methods: A systematic search was conducted for literature published through March 31, 2015 that evaluated rehabilitation strategies in adults with acute or subacute traumatic SCI at any level. Studies were critically appraised individually and the overall strength of evidence was evaluated using methods proposed by the GRADE (Grades of Recommendation Assessment, Development and Evaluation) working group. Results: The search strategy yielded 384 articles, 19 of which met our inclusion criteria. Based on our results, there was no difference between body weight–supported treadmill training and conventional rehabilitation with respect to improvements in Functional Independence Measure (FIM) Locomotor score, Lower Extremity Motor Scores, the distance walked in 6 minutes or gait velocity over 15.2 m. Functional electrical therapy resulted in slightly better FIM Motor, FIM Self-Care, and Spinal Cord Independence Measure Self-Care subscores compared with conventional occupational therapy. Comparisons using the Toronto Rehabilitation Institute Hand Function Test demonstrated no differences between groups in 7 of 9 domains. There were no clinically important differences in Maximal Lean Test, Maximal Sidewards Reach Test, T-shirt Test, or the Canadian Occupational Performance Measure between unsupported sitting training and standard in-patient rehabilitation. Conclusion: The current evidence base for rehabilitation following acute and subacute spinal cord injury is limited. Methodological challenges have contributed to this and further research is still needed.
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Use of Methylprednisolone Sodium Succinate
Authors: Fehlings Michael G. , Wilson Jefferson R. , Tetreault Lindsay A. , Aarabi Bizhan , Anderson Paul , Arnold Paul M. , Brodke Darrel S. , Burns Anthony S. , Chiba Kazuhiro , Dettori Joseph R. , Furlan Julio C. , Hawryluk Gregory , Holly Langston T. , Howley Susan , Jeji Tara , Kalsi-Ryan Sukhvinder , Kotter Mark , Kurpad Shekar , Kwon Brian K. , Marino Ralph J. , Martin Allan R. , Massicotte Eric , Merli Geno , Middleton James W. , Nakashima Hiroaki , Nagoshi Narihito , Palmieri Katherine , Skelly Andrea C. , Singh Anoushka , Tsai Eve C. , Vaccaro Alexander , Yee Albert , Harrop James S. 
Published: September 2017

Introduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: The main conclusions from the systematic review included the following: (1) there were no differences in motor score change at any time point in patients treated with MPSS compared to those not receiving steroids; (2) when MPSS was administered within 8 hours of injury, pooled results at 6- and 12-months indicated modest improvements in mean motor scores in the MPSS group compared with the control group; and (3) there was no statistical difference between treatment groups in the risk of complications. Our recommendations were: (1) “We suggest not offering a 24-hour infusion of high-dose MPSS to adult patients who present after 8 hours with acute SCI”; (2) “We suggest a 24-hour infusion of high-dose MPSS be offered to adult patients within 8 hours of acute SCI as a treatment option”; and (3) “We suggest not offering a 48-hour infusion of high-dose MPSS to adult patients with acute SCI.” Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in SCI patients.
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Role of Baseline Magnetic Resonance Imaging in Clinical Decision Making and Outcome Prediction
Authors: Fehlings Michael G. , Martin Allan R. , Tetreault Lindsay A. , Aarabi Bizhan , Anderson Paul , Arnold Paul M. , Brodke Darrel , Burns Anthony S. , Chiba Kazuhiro , Dettori Joseph R. , Furlan Julio C. , Hawryluk Gregory , Holly Langston T. , Howley Susan , Jeji Tara , Kalsi-Ryan Sukhvinder , Kotter Mark , Kurpad Shekar , Kwon Brian K. , Marino Ralph J. , Massicotte Eric , Merli Geno , Middleton James W. , Nakashima Hiroaki , Nagoshi Narihito , Palmieri Katherine , Singh Anoushka , Skelly Andrea C. , Tsai Eve C. , Vaccaro Alexander , Wilson Jefferson R. , Yee Albert , Harrop James S. 
Published: September 2017

Introduction: The objective of this guideline is to outline the role of magnetic resonance imaging (MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI. This review focused on longitudinal studies that controlled for baseline neurologic status. A multidisciplinary Guideline Development Group (GDG) used this information, their clinical expertise, and patient input to develop recommendations on the use of MRI for SCI patients. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: Based on the limited available evidence and the clinical expertise of the GDG, our recommendations were: (1) “We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention, when feasible, to facilitate improved clinical decision-making” (quality of evidence, very low) and (2) “We suggest that MRI should be performed in adult patients in the acute period following SCI, before or after surgical intervention, to improve prediction of neurologic outcome” (quality of evidence, low). Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI.
Efficacy and Safety of Methylprednisolone Sodium Succinate in Acute Spinal Cord Injury: A Systematic Review
Authors: Fehlings Michael G. , Wilson Jefferson R. , Harrop James S. , Kwon Brian K. , Tetreault Lindsay A. , Arnold Paul M. , Singh Jeffrey M. , Hawryluk Gregory , Dettori Joseph R. 
Published: September 2017

Study Design: Systematic review and meta-analysis. Objective: The objective of this study was to conduct a systematic review to assess the comparative effectiveness and safety of high-dose methylprednisolone sodium succinate (MPSS) versus no pharmacological treatment in patients with traumatic spinal cord injury (SCI). Methods: A systematic search was performed in PubMed and the Cochrane Collaboration Library for literature published between January 1956 and June 17, 2015. Included studies were critically appraised, and Grades of Recommendation Assessment, Development and Evaluation methods were used to determine the overall quality of evidence for primary outcomes. Previous systematic reviews on this topic were collated and evaluated using the Assessment of Multiple Systematic Reviews scoring system. Results: The search yielded 723 citations, 13 of which satisfied inclusion criteria. Among these, 6 were primary research articles and 7 were previous systematic reviews. Based on the included research articles, there was moderate evidence that the 24-hour NASCIS II (National Acute Spinal Cord Injury Studies) MPSS regimen has no impact on long-term neurological recovery when all postinjury time points are considered. However, there is also moderate evidence that subjects receiving the same MPSS regimen within 8 hours of injury achieve an additional 3.2 points (95% confidence interval = 0.10 to 6.33; P = .04) of motor recovery compared with patients receiving placebo or no treatment. Conclusion: Although safe to administer, a 24-hour NASCIS II MPSS regimen, when all postinjury time points are considered, has no impact on indices of long-term neurological recovery. When commenced within 8 hours of injury, however, a high-dose 24-hour regimen of MPSS confers a small positive benefit on long-term motor recovery and should be considered a treatment option for patients with SCI.
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury and Central Cord Syndrome: Recommendations on the Timing (≤24 Hours Versus >24 Hours) of Decompressive Surgery
Authors: Fehlings Michael G. , Tetreault Lindsay A. , Wilson Jefferson R. , Aarabi Bizhan , Anderson Paul , Arnold Paul M. , Brodke Darrel S. , Burns Anthony S. , Chiba Kazuhiro , Dettori Joseph R. , Furlan Julio C. , Hawryluk Gregory , Holly Langston T. , Howley Susan , Jeji Tara , Kalsi-Ryan Sukhvinder , Kotter Mark , Kurpad Shekar , Marino Ralph J. , Martin Allan R. , Massicotte Eric , Merli Geno , Middleton James W. , Nakashima Hiroaki , Nagoshi Narihito , Palmieri Katherine , Singh Anoushka , Skelly Andrea C. , Tsai Eve C. , Vaccaro Alexander , Yee Albert , Harrop James S. 
Published: September 2017

Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome. Based on GRADE, a strong recommendation is worded as “we recommend,” whereas a weak recommendation is presented as “we suggest.” Results: Conclusions from the systematic review included (1) isolated studies reported statistically significant and clinically important improvements following early decompression at 6 months and following discharge from inpatient rehabilitation; (2) in one study on acute central cord syndrome without instability, a marginally significant improvement in total motor scores was reported at 6 and 12 months in patients managed with early versus late surgery; and (3) there were no significant differences in length of acute care/rehabilitation stay or in rates of complications between treatment groups. Our recommendations were: “We suggest that early surgery be considered as a treatment option in adult patients with traumatic central cord syndrome” and “We suggest that early surgery be offered as an option for adult acute SCI patients regardless of level.” Quality of evidence for both recommendations was considered low. Conclusions: These guidelines should be implemented into clinical practice to improve outcomes in patients with acute SCI and central cord syndrome by promoting standardization of care, decreasing the heterogeneity of management strategies, and encouraging clinicians to make evidence-informed decisions.
Operationalizing Relative Customer Value
Authors: Keiningham Timothy , Aksoy Lerzan , Cadet Fabienne 
Published: September 2017

The construct of “value” has been central to explaining economic exchange since the time of Adam Smith. Despite its central importance, debate still exists as to what value entails. Absent a comprehensive understanding of value, researchers and managers have grappled with how to measure and manage value. Not surprisingly, absent a definition, no comprehensive, robust approach has emerged. We argue that value first must be viewed as a dual construct, i.e. value to the customer and value to the firm, that must be balanced to be sustainable. Given that value to the customer is clearly assessed as relative to competitive alternatives, we also argue that any robust measurement of value must account for competitive alternatives. We propose applying recent research on the use of relative metrics in linking to share of category spending as the foundation of assessing value to the customer (particularly since customers in most categories divide their spending across competing firms). This allows firms to assess the monetary value customers’ assign to their offerings, and to estimate changes in this value from different market actions. As value to the firm is ultimately about the net present value of customers’ economic contributions to the firm, this allows firms to balance value to the customer with value to the firm.
The effect of different combinations of vascular, dependency and cognitive endpoints on the sample size required to detect a treatment effect in trials of treatments to improve outcome after lacunar and non-lacunar ischaemic stroke
Authors: Makin Stephen DJ , Doubal Fergus N , Quinn Terence J , Bath Philip MW , Dennis Martin S , Wardlaw Joanna M 
Published: September 2017

Background Endpoints that are commonly used in trials of moderate/severe stroke may be less frequent in patients with minor, non-disabling stroke thus inflating sample sizes. We tested whether trial efficiency might be improved with composite endpoints. Methods We prospectively recruited patients with lacunar and minor non-lacunar ischaemic stroke (NIHSS ≤ 7) and assessed recurrent vascular events (stroke, transient ischaemic attack (TIA), ischemic heart disease (IHD)), modified Rankin Score (mRS) and cognitive testing with the Addenbrooke’s Cognitive Examination (ACE-R) one year post-stroke. For a potential secondary prevention randomised controlled trial (RCT), we estimated sample sizes using individual or combined outcomes, at power 80% (and 90%), alpha 5%, required to detect a relative 10% risk reduction. Results Amongst 264 patients (118 lacunar, 146 non-lacunar), at one year, 30/264 (11%) patients had a recurrent vascular event, 5 (2%) had died, 3 (1%) had clinically-diagnosed dementia, 53/264 (20%) had mRS ≥ 3 and 29/158 (19%) had ACE-R ≤ 82 (57 could not attend for cognitive testing). For a potential trial, at 80% power, using mRS ≥ 3 alone would require n > 5000 participants, recurrent vascular events alone n = 9908 participants, and a composite of any recurrent vascular event, ACE-R ≤ 82, dementia or mRS ≥ 2 (present in 56% of patients) n = 2224 patients. However, including cognition increased missing data. Results were similar for lacunar and non-lacunar minor ischaemic stroke. Conclusions Composite outcomes including vascular events, dependency, and cognition reduce sample size and increase efficiency, feasibility, and relevance to patients of RCTs in minor ischaemic stroke. Efficiency might be improved further with more practical cognitive test strategies.
Contraception and fertility transition in AMHARA National Regional State of ETHIOPIA: an application of BONGAARTS’ model
Authors: Alazbih Nega Mihret , Tewabe Getachew Nibret , Demissie Tariku Dejene 
Published: September 2017

Abstract
Background
The overall decline of fertility in Amhara National Regional State between 2000 and 2011 was the highest in Ethiopia. The aim of the present study was to determine the most significant proximate determinant of fertility change during the last decade in the region using Bongaarts’ model.

Methods
The sources of data were the 2000, 2005, and 2011 Ethiopia Demographic and Health Surveys. The model indices were calculated for each survey. Decomposition of fertility change into components of proximal determinants was also carried out. An index value close to 1 is a negligible inhibiting effect while a large inhibiting effect when the value very closes to 0.

Results
The fertility-constraining effect of contraception increased from 0.93 in 2000 to 0.65 in 2011; however, it was lower than the effect of postpartum insusceptibility at all given times. The index of marriage remained unchanged in constraining fertility over the period (0.71 in 2000 and 0.70 in 2011) while the influence of postpartum insusceptibility slightly declined from 0.49 in 2000 to 0.54 in 2011 but was stronger than contraception and marriage. The contribution of contraception was most important in urban areas (0.46 in 2011 from 0.52 in 2005 and 0.64 in 2000); however, in rural areas, it became an important determinant over the period (0.95 in 2000 and 0.69 in 2011). The effect of postpartum insusceptibility in rural areas showed a decreasing trend (0.48 in 2000 and 0.53 in 2011). The index of marriage in rural areas was stable overtime (0.75 in 2000 and 0.73 in 2011) while in urban areas the effect declined from 0.42 in 2000 to 0.65 in 2011. Marriage was the most important proximate determinant of fertility among women with secondary and above education but the impact declined during the period (0.41 in 2000 and 0.61 in 2011). The importance of postpartum insusceptibility in limiting fertility among women with secondary and above education declined overtime (0.77 in 2000 and 0.87 in 2011) whereas the contribution of contraception became more important (0.44 in 2000 and 0.35 in 2011).

Conclusions
An increase in the level of contraceptive use and effectiveness overtime was the single most important contributing factor for the recent fertility decline in the region.