bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Acceptance and Commitment Therapy for Chronic Pain
Authors: Ma Tsz-Wah , Yuen Ada Siu-Kwan , Yang Zuyao 
Published: February 2023

Objectives:
Previous meta-analyses of a small number of trials showed that acceptance and commitment therapy (ACT) might improve chronic pain. Many new trials have been published afterward, and the factors that may impact the efficacy of ACT are less understood. We, therefore, conducted an updated systematic review with meta-analysis to investigate the efficacy of ACT for people with chronic pain.

Methods:
Randomized controlled trials that investigated the efficacy of ACT in clinical or community setting for adult populations with chronic pain were included. The methodological quality of trials was assessed with the Cochrane Risk of Bias tool. Standardized mean differences between ACT and comparison groups in their effects on 6 outcomes (ie, pain acceptance, quality of life, pain-related functioning, pain intensity, anxiety, and depression) were pooled across studies.

Results:
Of the 3171 records identified, 21 trials with 1962 participants were included for analysis. The comparison groups included active treatment and waitlist control/usual care. The standardized mean difference was 0.67 (95% CI: 0.48, 0.87) for pain acceptance, 0.43 (95% CI: 0.29, 0.57) for quality of life, −0.88 (95% CI: −1.14, −0.63) for pain-related functioning, −0.45 (95% CI: −0.62, −0.27) for pain intensity, −0.35 (95% CI: −0.54, −0.15) for anxiety, and −0.74 (95% CI, −0.98, −0.50) for depression, all favoring ACT. Subgroup analyses showed that the effects were statistically significant across almost all subgroups and for some outcomes were greater in the trials conducted in people with a specific diagnosis (as compared with those conducted in people with general chronic pain), the trials with waitlist or usual care control, the trials with a greater number of sessions of ACT, and the trials with a longer ACT intervention.

Discussion:
ACT is effective and comparable to, if not better than, some other available active treatments for chronic pain.
Accuracy of telemedicine for the diagnosis and treatment of patients with shoulder complaints
Authors: Michaelson Evan M. , Wiesel Brent B. , Siedlarz Benjamin , Murthi Anand M. , Sethi Paul M. , Lutton David M. , Nagda Sameer H. 
Published: February 2023

Background:
Minimal data is available on the accuracy of diagnoses for orthopaedic shoulder complaints developed via telemedicine consultations. We hypothesize that evaluating surgeons can accurately diagnose and treat shoulder pathology via telemedicine evaluation.

Methods:
Patient evaluations for new shoulder complaints via telemedicine were retrospectively reviewed. Records were kept of all new patients seen via telemedicine, and all patients were advised to follow-up for in-person evaluation. All patients with in-person follow-up were included in final analysis. Changes in diagnosis or treatments were noted at time of in-person evaluation.

Results:
Eighty-two patients completed both telemedicine and in-person evaluation. 44 (53.6%) had no changes in diagnosis or treatment, and 22 (26.8%) had no change in diagnosis with advancement in treatment. Sixteen patients (19.5%) had a change in diagnosis or treatment. Of the 16 patients where changes were made, 9 patients were given additional diagnoses, and 7 patients had changes in their diagnosis at time of in-person follow-up. Two (2.4%) patients had a change in treatment resulting from the in-person visit. Fifty-seven patients (69.5%) had imaging (X-ray, MRI, or CT) available during the telemedicine visit.

Conclusions:
Telemedicine was an effective platform for evaluating patients with new shoulder complaints, with only 2.4% of treatments altered after in-person evaluation. There may be specific shoulder pathology that is more difficult to diagnose via telemedicine or without advanced imaging. Further research evaluating patient and surgeon satisfaction with telemedicine is underway.

Level of Evidence:
IV, Retrospective Cohort Study.
Did the centers for medicare & medicaid services’ 2018 policy change removing total knee arthroplasty from the inpatient-only list affect overall patient outcomes in the medicare population?
Authors: Yu Jonathan S. , Zeitlin Jacob , Moore Harold G. , Nocon Allina , Sculco Peter 
Published: February 2023

Background:
The 2018 Centers for Medicare & Medicaid Services (CMS) removal of total knee arthroplasty (TKA) from the Inpatient-Only (IPO) list was accompanied by confusion, lack of central guidance on patient selection criteria, payor misinterpretation of the updated policy, and altered payor incentives. The purpose of this study was to assess how the CMS policy change affected overall patient outcomes in the Medicare population after TKA.

Methods:
Using the ACS-NSQIP database, patients 65 years and older who underwent primary, elective, unilateral TKA without any significant medical comorbidity were included. Complication rates before (2014-2017) and after (2018-2019) CMS removal of TKA from the IPO list were compared using interrupted time series analysis to gauge the impact of the policy shift.

Results:
A total 185,294 TKA cases were included in the analysis. Following the CMS removal of TKA from the IPO list in 2018, there were significant decreases in rates of any adverse event (RR 0.90, 95% CI 0.83-0.98, P=0.02), any minor adverse event (RR 0.84, 95% CI 0.73-0.97, P=0.02), and thromboembolic events (RR 0.76, 95% CI 0.64-0.89, P<0.001) significantly decreased There were no significant changes in rates of readmission (RR 0.95, 95% CI 0.87-1.05, P=0.31), reoperation (RR 0.92, 95% CI 0.78-1.09, P=0.33), or any major adverse event (RR 0.92, 95% CI 0.83-1.01, P=0.07).

Conclusions:
Though the CMS removal of TKA from the IPO list in 2018 was accompanied by the emergence of key new issues, the policy change did not adversely affect 30-day postoperative outcomes in the Medicare TKA patient population.

Level of Evidence:
Level IV—retrospective cohort study.
Impact of Preoperative 12-item Short Form Mental Composite Scores on Clinical Outcomes in Cervical Disc Replacement
Authors: Nie James W. , Hartman Timothy J. , Zheng Eileen , MacGregor Keith R. , Oyetayo Omolabake O. , Singh Kern 
Published: February 2023

Study Design:
Retrospective cohort study.

Objective:
We aim to examine the effects of preoperative mental health status on demographic, perioperative characteristics, and postoperative outcomes in patients undergoing cervical disc replacement (CDR).

Summary of Background Data:
The effect of preoperative mental health status has not been widely studied in CDR.

Methods:
Patients undergoing primary CDR were retrospectively collected and stratified into 2 cohorts by 12-item Short Form Survey Mental Composite Score (SF-12 MCS) ≥48.9. Patients without preoperative SF-12 MCS scores or diagnosis of infection, malignancy, or trauma were excluded. Demographic information, perioperative characteristic, and patient reported outcome measures (PROMs) were collected. Patient reported outcome measurement information system physical function (PROMIS-PF)/SF-12 Physical Component Score (PCS)/SF-12 MCS/visual analog scale (VAS) neck/VAS leg/neck disability index (NDI) were collected preoperatively and 6 weeks/12 weeks/6 months/1 year postoperatively.

Results:
Eighty-seven patients were included, (47 having SF-12 MCS≥48.9). For PROMs, both cohorts had significant improvement from preoperative baseline, besides SF-12 PCS/MCS at 1 year for the depressed cohort and SF-12 MCS at all time points. The non-depressed cohort demonstrated significantly higher PROMIS-PF preoperatively and at 12 weeks, SF-12 PCS at 12 weeks, SF-12 MCS at all time points, decreased VAS neck at 12 weeks and NDI preoperatively and at 12 weeks, overall minimal clinically important difference (MCID) in most patients in all PROMs besides SF-12 MCS, and higher MCID for PROMIS-PF at 12 weeks. The depressed cohort demonstrated overall MCID in most patients with PROMIS-PF/SF-12 MCS/VAS neck/NDI, and a higher MCID for 6 weeks/12 weeks/6 months postoperatively and overall SF-12 PCS.

Conclusion:
Whereas both cohorts demonstrated significantly improved PROMs from baseline, the non-depressed cohort demonstrated better physical function, mental health, decreased pain, and disability at various time points, whereas the depressed cohort demonstrated higher mental health MCID achievement at every time point except 1 year. These findings may be useful in managing expectations for patients undergoing cervical surgery.
Driving Pressure, Elastance, and Outcomes in a Real-World Setting: A Bi-Center Analysis of Electronic Health Record Data
Authors: Goodwin Andrew J. , Brinton Daniel L. , Terry Charles , Carter George , Files D. Clark , Kirchoff Katie , Ford Dee W. , Simpson Annie N. 
Published: February 2023

OBJECTIVES:
Emerging evidence suggests the potential importance of inspiratory driving pressure (DP) and respiratory system elastance (ERS) on outcomes among patients with the acute respiratory distress syndrome. Their association with outcomes among heterogeneous populations outside of a controlled clinical trial is underexplored. We used electronic health record (EHR) data to characterize the associations of DP and ERS with clinical outcomes in a real-world heterogenous population.

DESIGN:
Observational cohort study.

SETTING:
Fourteen ICUs in two quaternary academic medical centers.

PATIENTS:
Adult patients who received mechanical ventilation for more than 48 hours and less than 30 days.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
EHR data from 4,233 ventilated patients from 2016 to 2018 were extracted, harmonized, and merged. A minority of the analytic cohort (37%) experienced a Pao
2/Fio
2 of less than 300. A time-weighted mean exposure was calculated for ventilatory variables including tidal volume (VT), plateau pressures (PPLAT), DP, and ERS. Lung-protective ventilation adherence was high (94% with VT < 8.5 mL/kg, time-weighted mean VT = 6. 8 mL/kg, 88% with PPLAT ≤ 30 cm H2O). Although time-weighted mean DP (12.2 cm H2O) and ERS (1.9 cm H2O/[mL/kg]) were modest, 29% and 39% of the cohort experienced a DP greater than 15 cm H2O or an ERS greater than 2 cm H2O/(mL/kg), respectively. Regression modeling with adjustment for relevant covariates determined that exposure to time-weighted mean DP (> 15 cm H2O) was associated with increased adjusted risk of mortality and reduced adjusted ventilator-free days independent of adherence to lung-protective ventilation. Similarly, exposure to time-weighted mean ERS greater than 2 cm H2O/(mL/kg) was associated with increased adjusted risk of mortality.

CONCLUSIONS:
Elevated DP and ERS are associated with increased risk of mortality among ventilated patients independent of severity of illness or oxygenation impairment. EHR data can enable assessment of time-weighted ventilator variables and their association with clinical outcomes in a multicenter real-world setting.
Pharmacological Treatment of Disinhibition in Acquired Brain Injury
Authors: Song Grace , Koro Mira , Berzen Leon , Tung Anthony , Ryan Andrew , Tham Joseph Chun Wearn 
Published: February 2023

Abstract

Purpose/Background
Traumatic brain injury is a major universal public health concern and results in chronic neurobehavioral sequelae including disinhibition. Objectives of this study were to review the literature on pharmacological treatment of disinhibition post–acquired brain injury (ABI), describe a snapshot of pharmacotherapy used in ABI at a tertiary neuropsychiatric unit in British Columbia, Canada, and share expert opinion.

Methods/Procedures
A retrospective chart review of 11 patients from October to December 2021 was conducted based on exclusion criteria: age greater than 18 years, primary neurodegenerative conditions, or aphasia. Patient demographics, behavioral and cognitive test results, and disinhibition treatment were recorded. A brief review of the literature was conducted to find the best available evidence of pharmacological interventions to treat disinhibition post-ABI.

Findings/Results
In ABI, there was a high utilization of antipsychotics and benzodiazepines, at 91% and 64% respectively, in patients with severe cognitive deficit and disinhibition. Mood stabilizers and nonselective β-blockers were less prescribed in this population at 73% and 18%. At the point of data collection, all the patients had responded well to treatment and were in the maintenance phase of their pharmacological treatment.

Implications/Conclusions
A limited number of studies with weak methodology suggest that mood stabilizers and β-blockers should be first line for disinhibition treatment. Our findings are complementary to the literature describing treatment of severe disinhibition. The choice of treatment for disinhibition depends on factors including nature and severity of target symptoms, level of drug evidence, patient-tailored objectives, concurrent psychiatric diagnoses, clinical experience of clinicians, adverse drug reactions, and treatment acuity.
Integrated analysis of RNA-seq in hepatocellular carcinoma reveals competing endogenous RNA network composed of circRNA, lncRNA, and mRNA
Authors: Zhou Fuyin , Kang Qingsong , Ma Junbo , Cai Jie , Chen Ying , Qu Kai , Li Feibo 
Published: February 2023

Background:
Circular RNAs (circRNAs) and long non-coding RNAs (lncRNAs) have been hypothesized to have important roles in the etiology of hepatocellular carcinoma (HCC). However, the synergistic effect of circRNA and lncRNA in the pathogenesis of HCC has rarely been studied.

Methods:
In this study, the Gene Expression Omnibus database was used to get the expression profiles of circRNAs, micro RNAs (miRNAs), lncRNAs, and messenger RNAs (mRNAs) in HCC tissues and normal tissues. The accession numbers for this database are GSE101728, GSE155949, and GSE108724. We found 291 differentially overexpressed lncRNAs and 541 differentially overexpressed mRNA in GSE101728, 30 differentially overexpressed circRNA in GSE155949, and 48 significantly downregulated miRNA in GSE198724. Meanwhile, based on Pearson correlation test, we established lncRNA–mRNA networks. We constructed lncRNA/circRNA–miRNA pairs through Starbase database prediction and identified the common miRNAs. The intersection of co-predicted miRNAs and the 48 significantly low expression miRNAs in GSE198724 were included in the following study. miRDB, Targetscan, miRwalk, and lncRNA-related mRNA jointly determined the miRNA–mRNA portion of the circRNA/lncRNA–miRNA–mRNA co-expression network. And, among 55 differentially expressed mRNA in circRNA/lncRNA–miRNA–mRNA network, CPEB3, EFNB3, FATA4, growth hormone receptor, GSTZ1, KLF8, MFAP4, PAIP2B, PHACTR3, PITPNM3, RPS6KA6, RSPO3, SLITRK6, SMOC1, STEAP4, SYT1, TMEM132E, TSPAN11, and ZFPM2 were intimately related to the prognosis of HCC patients in Kaplan–Meier plotter analysis (P < .05).

Conclusion:
We have discovered that the prognosis-related lncRNAs/circRNAs–miRNA–mRNA network plays a significant role in the pathogenesis of HCC. These findings may offer fresh perspectives for further research into the pathogenesis of HCC and the search for novel treatments for HCC.
Assessment of macular and peripapillary choroidal thickness in non-arteritic anterior ischemic optic neuropathy: A meta-analysis
Authors: Li Xuejiao , Chen Haoliang , Dang Yalong 
Published: February 2023

Background:
Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common optic neuropathy in adults aged ≥ 50 years. Transient non-perfusion or hypoperfusion of the optic nerve head circulation is believed to be the underlying cause of NAION. It has been suggested that peripapillary choroidal thickness (PCT) is altered after ischemic disorders of the optic nerve head, but the results have not always been consistent. To address this issue and provide evidence for the pathogenesis of NAION, we performed a meta-analysis to systematically evaluate macular choroidal thickness (MCT) and PCT in patients with NAION.

Methods:
A comprehensive literature search of PubMed, Embase, Cochrane Library, and Web of Science databases was performed until August 31, 2022. The main inclusion criterion was a case-control study in which MCT and PCT were measured using optical coherence tomography in patients with NAION. Mean difference (MD) and 95% confidence interval were calculated for continuous estimates. The Review Manager (V5.40) was used for the analysis.

Results:
Nine studies comprising 663 eyes (283 NAION eyes and 380 healthy control eyes) were included (Newcastle-Ottawa Scale score ≥ 5). MCT and PCT were higher in eyes with chronic NAION (MD = 19.16, P = .04; MD = 35.36, P < .00001) and NAION fellow eyes (MD = 30.35, P = .0006; MD = 29.86, P = .04) than in healthy controls. No difference was noted in the MCT between eyes with acute NAION and healthy controls (MD = 2.99, P = .87).

Conclusion:
Increased MCT and PCT may be important anatomical and physiological features of the eyes in patients with NAION.
The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis
Authors: Zhang Xu , Xue Tianle , Hou Desheng , Lu Cheng 
Published: February 2023

Background:
Knee osteoarthritis (OA) is a common clinical degenerative disease of the joints, which is prone to occur in middle-aged and elderly people. At present, the disease cannot be cured, it is mostly treated with drugs to relieve symptoms, improve joint function, protect cartilage, such as glucosamine, anti-inflammatory and analgesic drugs, and but the efficacy is not lasting and the recurrence rate is high. Hydrotherapy has become a long-term alternative therapy in China and is receiving increasing attention. We perform a protocol for systematic review and meta-analysis to determine the efficacy and safety of a hydrotherapy program in individuals living with knee OA.

Methods:
This protocol will be designed in accordance with the preferred reporting items for systematic reviews and meta-analysis protocols. It is registered on the international prospective register of systematic reviews (No. CRD42022365564). We will search the following databases: The Cochrane Skin Group Trials Register, MEDLINE, EMBASE, The Cochrane central register of controlled trials, Chinese biomedical literature database, Chinese medical current content and China national knowledge infrastructure. The risk of bias of the included studies will be appraised using the Cochrane collaboration tool. Statistical analysis will be performed using IBM SPSS Statistics (Armonk, NY).

Results:
This systematic review will summarize the short- and long-term clinical outcomes of hydrotherapy for knee OA.

Conclusion:
The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of hydrotherapy in knee OA.
Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients
Authors: Shehta Ahmed , Elshobari Mohamed , Salah Tarek , Sultan Ahmad M. , Yasen Amr , Elsadany Mohamed , Elsarraf Waleed Rifat , Abdel-Khalek Ehab E. , Shiha Usama , Elebidy Gamal , Abdel Wahab Mohamed , Samy Mohamed 
Published: February 2023

Objectives
Endoscopic retrograde cholangiopancreatography (ERCP) has shown great safety and efficacy in the management of post-living-donor liver transplantation (LDLT) biliary complications. Pancreatitis is the most commonest and the most feared complication after ERCP.

Methods
We reviewed the data of liver transplant recipients who underwent ERCP for biliary complications after LDLT between 2011 and 2022.

Results
In total 63 patients underwent ERCP after LDLT. They were targeted to 134 set of ERCP. Pancreatitis occurred in 52 sets (38.8%). We subclassified the patients into two groups, without pancreatitis: 31 patients (49.2%) and with pancreatitis 32 patients (50.8%). A higher incidence of pancreatitis was noticed with the first ERCP set (P = 0.04). Biliary strictures were more noted in the pancreatitis group (P = 0.025). Difficult cannulation requiring precut was more observed in the pancreatitis group (P = 0.007). Also, more frequent sphincterotomy was observed in the pancreatitis group (P = 0.003). Longer hospital stay, more fever, abdominal pain and vomiting were noted in the pancreatitis group (P = 0.001). Higher post-ERCP serum amylase (P = 0.001) and creatinine (P = 0.021), while lower serum calcium (P = 0.21) were noticed in the pancreatitis group. On multivariate analysis, preoperative diabetes, number of biliary anastomoses (single/multiple) and difficult cannulation requiring precut were significant predictors of post-ERCP pancreatitis.

Conclusion
Patient-related risk factors and bedside procedure-related risk factors play an essential role in the development of pancreatitis after ERCP for LDLT recipients. Endoscopists should be mindful by those high-risk patients during ERCP to apply appropriate techniques to prevent the development of this serious complication.
Utility of pre-treatment 18F-fluorodeoxyglucose PET radiomic analysis in assessing nodal involvement in cervical cancer
Authors: Chan Kit Chi , Perucho Jose A.U. , Subramaniam Rathan M. , Lee Elaine Y.P. 
Published: February 2023

Objective
Intratumor heterogeneity has prognostic value in cervical cancer, which can be depicted on 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET/CT) and then quantitatively characterized by texture features. This study aimed to evaluate the discriminative performance and predictive ability of the texture features in determining lymph node involvement in cervical cancer.

Methods
A total of 101 patients with newly diagnosed cervical cancer, who underwent pre-treatment whole-body 18F-FDG PET/CT imaging were retrospectively recruited. Patients were categorized based on their nodal status. Thirty-five radiomic features together with the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary cervical tumors were extracted. Conventional indices were used to build logistic regression model and texture features were used to build random forest model. The performances for differentiating nodal status were assessed by receiver operating characteristic analysis.

Results
Conventional PET indices were significantly higher in patients with nodal involvement compared to those without: SUVmax = 14.22 vs. 10.05; MTV = 57.02 vs. 28.73; TLG = 492.8 vs. 188.8 (P < 0.05). Nineteen radiomic features describing regional heterogeneity were significantly different between nodal involvements. Area under the curves of the models with conventional indices and PET texture features for discriminating nodal status were 0.72 and 0.76, respectively.

Conclusion
PET-derived radiomic features had moderate performance in discriminating nodal involvement in cervical cancer; and they did not outperform model based on conventional indices.
Nurse Staffing and Veteran Outcomes in the Veterans Health Administration's Community Living Centers
Authors: Brown Lana M. , Gauss C. Heath , Billings Pamela , Minor Lisa , Moore Jade T. , Sawyer Linda M. , Sparks Diane , Sullivan Sheila Cox 
Published: February 2023

Background:
The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes.

Purpose:
To assess for associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers.

Methods:
A retrospective data review of NHPPD and quality measures for 134 community living centers was conducted. Linear regression was used to assess for linear associations between average total NHPPD and 6 quality measures.

Results:
A significant linear association was found between average total NHPPD and falls with major injury (P = .02) and help with activities of daily living (P = .01). No associations were found between nurse staffing and 4 other quality measures.

Conclusions:
This study adds to the body of literature regarding the impact of nurse staffing on quality measures.