bluuebunny/crossref_metadata_2025_split huggingface dataset:
Six Externally Validated Prognostic Models Have Potential Clinical Value to Predict Patient Health Outcomes in the Rehabilitation of Musculoskeletal Conditions: A Systematic Review
Authors: Naye Florian , Décary Simon , Houle Catherine , LeBlanc Annie , Cook Chad , Dugas Michèle , Skidmore Becky , Tousignant-Laflamme Yannick 
Published: March 2023

Abstract

Objective
The purpose of this systematic review was to identify and appraise externally validated prognostic models to predict a patient’s health outcomes relevant to physical rehabilitation of musculoskeletal (MSK) conditions.

Methods
We systematically reviewed 8 databases and reported our findings according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. An information specialist designed a search strategy to identify externally validated prognostic models for MSK conditions. Paired reviewers independently screened the title, abstract, and full text and conducted data extraction. We extracted characteristics of included studies (eg, country and study design), prognostic models (eg, performance measures and type of model) and predicted clinical outcomes (eg, pain and disability). We assessed the risk of bias and concerns of applicability using the prediction model risk of bias assessment tool. We proposed and used a 5-step method to determine which prognostic models were clinically valuable.

Results
We found 4896 citations, read 300 full-text articles, and included 46 papers (37 distinct models). Prognostic models were externally validated for the spine, upper limb, lower limb conditions, and MSK trauma, injuries, and pain. All studies presented a high risk of bias. Half of the models showed low concerns for applicability. Reporting of calibration and discrimination performance measures was often lacking. We found 6 externally validated models with adequate measures, which could be deemed clinically valuable [ie, (1) STart Back Screening Tool, (2) Wallis Occupational Rehabilitation RisK model, (3) Da Silva model, (4) PICKUP model, (5) Schellingerhout rule, and (6) Keene model]. Despite having a high risk of bias, which is mostly explained by the very conservative properties of the PROBAST tool, the 6 models remain clinically relevant.

Conclusion
We found 6 externally validated prognostic models developed to predict patients’ health outcomes that were clinically relevant to the physical rehabilitation of MSK conditions.

Impact
Our results provide clinicians with externally validated prognostic models to help them better predict patients’ clinical outcomes and facilitate personalized treatment plans. Incorporating clinically valuable prognostic models could inherently improve the value of care provided by physical therapists.
Effects of Exercise Training on Cognitive Function in Individuals With Heart Failure: A Meta-Analysis
Authors: Peng Jing-Ya , Chen Yung-Hsin , Yen Ju-Hsin , Huang Wei-Ming , Chen Chiao-Nan 
Published: March 2023

AbstractObjectiveCognitive function is critical for disease self-management; however, it is poorer in individuals with heart failure (HF) than in age-matched people who are healthy. Aging and disease progression collectively threaten the cognitive function of individuals with HF. Exercise has been shown to improve the mobility and mortality risk factors of this population, but the effects of exercise on the cognitive function of individuals with HF are unclear. This meta-analysis aimed to examine these potential effects.MethodsA systematic literature search was conducted in PubMed, MEDLINE, CINAHL, Cochrane Library, Physiotherapy Evidence Database, and ClinicalKey on literature published until January 2022. Studies examining the effects of exercise training on cognitive function in individuals with HF were included. Characteristics of participants and details of interventions were extracted. Effects of exercise training on global cognitive function, attention, and executive function were analyzed using the Comprehensive Meta-Analysis software.ResultsSix studies were included. Individuals with chronic HF were examined in most studies. The average ejection fraction of participants was 23 to 46%. Aerobic exercise was used in most studies. All included studies had exercise frequency of 2 to 3 times per week and a duration of 30 to 60 minutes per session for 12 to 18 weeks. Compared with the control group, exercise training benefited the global cognitive function of individuals with HF and cognitive impairments (standardized mean difference = 0.44; 95% CI = 0.01–0.87). The attention of individuals with HF improved after exercise training compared with that before the intervention.ConclusionExercise may improve cognitive function in individuals with HF and cognitive impairments. However, due to large heterogeneity in the study design, more studies are needed to support clinical application.ImpactThese findings should raise clinicians’ awareness about the role of exercise on the cognitive function of individuals with HF, in addition to benefits in physical domains.
Spine Surgical Subspecialty and Its Effect on Patient Outcomes
Authors: Lambrechts Mark J. , Canseco Jose A. , Toci Gregory R. , Karamian Brian A. , Kepler Christopher K. , Smith Michael L. , Schroeder Gregory D. , Hilibrand Alan S. , Heller Joshua E. , Grasso Giovanni , Gottfried Oren , Kebaish Khaled M. , Harrop James S. , Shaffrey Christopher , Vaccaro Alexander R. 
Published: March 2023

Study Design.
Systematic review and meta-analysis.

Objective.
To perform a systematic review and meta-analysis to identify if intraoperative or postoperative differences in outcomes exist between orthopedic and neurological spine surgeons.

Summary of Background Data.
Spine surgeons may become board certified through orthopedic surgery or neurosurgical residency training, and recent literature has compared surgical outcomes between surgeons based on residency training background with conflicting results.

Materials and Methods.
Using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a search of PubMed and Scopus databases was conducted and included articles comparing outcomes between orthopedic spine surgeons and neurosurgeons. The Newcastle-Ottawa scale was used to determine the quality of studies. Forest plots were generated using mean differences (MD) for continuous variables and odds ratios (OR) for binomial variables, and 95% CI was reported.

Results.
Of 615 search term results, 16 studies were identified for inclusion. Evaluation of the studies found no differences in readmission rates [OR, ref: orthopedics: 0.99 (95% CI: 0.901, 1.09); I

2
= 80%], overall complication rates [OR, ref: orthopedics: 1.03 (95% CI: 0.97, 1.10); I

2
= 70%], reoperation rates [OR, ref: orthopedics: 0.91 (95% CI: 0.82, 1.00); I

2
= 86%], or overall length of hospital stay between orthopedic spine surgeons and neurosurgeons [MD: −0.19 days (95% CI: −0.38, 0.00); I

2
= 98%]. However, neurosurgeons ordered a significantly lower rate of postoperative blood transfusions [OR, ref: orthopedics: 0.49 (95% CI: 0.41, 0.57); I

2
= 75%] while orthopedic spine surgeons had shorter operative times [MD: 14.28 minutes, (95% CI: 8.07, 20.49), I

2
= 97%].

Conclusions.
Although there is significant data heterogeneity, our meta-analysis found that neurosurgeons and orthopedic spine surgeons have similar readmission, complication, and reoperation rates regardless of the type of spine surgery performed.
Vertebral Body Sliding Osteotomy as a Surgical Strategy for the Treatment of Cervical Myelopathy: Outcomes at Minimum Five years Follow-up
Authors: Lee Dong-Ho , Park Sehan , Lee Choon Sung , Hwang Chang Ju , Cho Jae Hwan , Cho Sung Tan 
Published: March 2023

Study Design.
A retrospective cohort study.

Objective.
To evaluate the outcomes of vertebral body sliding osteotomy (VBSO) with a minimum follow-up of five years and compare the results with those of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF).

Summary of Background Data.
VBSO reportedly results in fewer complications, better lordosis restoration, and faster bone union than corpectomy. Although previous studies demonstrate the outcomes of VBSO with follow-up of two years or longer, results in longer term surveillance remain unknown.

Methods.
This study included 128 patients who underwent VBSO (n=38), ACDF (n=62), or ACCF (n=28) as a treatment for cervical myelopathy and was followed up for five years or more. Fusion, subsidence, C0-2 lordosis, C2-7 lordosis, segmental lordosis, C2-7 sagittal vertical axis, surgical complications, and neck pain visual analog scale, Neck Disability Index, and Japanese Orthopedic Association (JOA) scores were assessed. Comparisons between continuous variables in each group were made using independent sample t tests. For nominal variables, the Fisher exact test or the χ2 test was used. Paired t test was used to analyze the changes in postoperative values compared with preoperative values.

Results.
The reoperation rate (0.0%) after VBSO was significantly lower than that after ACCF (14.3%; P=0.028). VBSO had a higher fusion rate at six-month and one-year follow-up, but the fusion rate at five years (97.4%) was not significantly different from that of ACDF (85.5%; P=0.054) and ACCF (85.7%; P=0.077). Segmental lordosis at the five-year follow-up was significantly higher in the VBSO group (16.1°) than in the ACDF (11.9°; P=0.002) and ACCF (6.5°; P<0.001) groups. C2-7 lordosis at five-year follow-up was significantly higher in the VBSO group than in the ACCF group (P=0.017). Neck pain visual analog scale, Neck Disability Index, and JOA scores and the JOA recovery rate did not show significant intergroup differences during the five-year study period.

Conclusions.
VBSO showed promising long-term results in terms of low revision rate, fast solid union, and effective segmental lordosis restoration when compared with other anterior reconstruction techniques.
Short-Course Radiotherapy Followed By Consolidation Chemotherapy Is Safe and Effective In Locally Advanced Rectal Cancer: Comparative Short-term Results of Multicenter Propensity Score Case-Matched Study
Authors: Benlice Cigdem , Koc Mehmet Ali , Gulcu Baris , Bilgin Ismail Ahmet , Akyol Cihangir , Baca Bilgi , Ozturk Ersin , Guney Yildiz , Utkan Gungor , Er Ozlem , Agaoglu Fulya , Yildirim Ibrahim , Avci Nilufer , Elhan Atilla Halil , Kuzu Mehmet Ayhan 
Published: March 2023

BACKGROUND:
Consolidation chemotherapy strategies has demonstrated improved pathological complete response and tumor downstaging rates for patients diagnosed with rectal cancer.

OBJECTIVE:
To compare perioperative outcomes and pathological complete response rates among different neoadjuvant treatment strategies in patients undergoing total mesorectal excision for locally advanced rectal cancer.

DESIGN:
Propensity score case-matched study.

SETTING:
High-volume tertiary care centers.

PATIENTS:
Consecutive patients undergoing curative total mesorectal excision for locally advanced rectal cancer between January-2014 and June-2021 were queried.

INTERVENTIONS:
Patients were divided into three groups based on the neoadjuvant treatment modality: Long-course chemoradiation therapy with (N = 128) or without (N = 164) consolidation chemotherapy or short-course radiotherapy (N = 53) followed by consolidation chemotherapy.

MAIN OUTCOME MEASURES:
Primary end-point was pathological complete response. Demographics, preoperative tumor characteristics, histopathologic outcomes and postoperative complication rates were reviewed and compared among the study groups. Propensity score match analysis was conducted.

RESULTS:
A total of 345 patients (mean age of 58±12 and female: 36%) met the study inclusion criteria. Time interval from neoadjuvant treatment until surgery was longer for patients receiving consolidation chemotherapy (p < 0.001). Pathological complete response rates were comparable among patients receiving long-course chemoradiation therapy with consolidation chemotherapy (20.3%) and short-course radiotherapy with consolidation chemotherapy (20.8%) when compared to long-course chemoradiation therapy alone (14.6%)(p = 0.36). After the propensity case-matched analysis, 48 patients in long-course chemoradiation therapy with consolidation chemotherapy group were matched to 48 patients in the short-course radiotherapy with consolidation chemotherapy group. Groups were comparable with respect to age, gender, clinical stage, tumor location, type of surgical approach and technique. Pathological complete response rate was comparable between the groups (20.8% and 18.8%, p = 0.99). Postoperative 30-day morbidity and anastomotic leak rates were similar.

LIMITATIONS:
Study was limited by its retrospective nature.

CONCLUSIONS:
Among recent neoadjuvant treatment modalities, pathological complete response rates and short-term clinical outcomes were comparable. Short-course radiotherapy with consolidation chemotherapy is safe and effective as long-course chemoradiation therapy in a short-term period.
Long-term Outcomes of Perianal Fistulas in Pediatric Crohn’s Disease
Authors: Vu Joceline V. , Kurowski Jacob A. , Achkar Jean-Paul , Hull Tracy L. , Lipman Jeremy , Holubar Stefan D. , Steele Scott R. , Lightner Amy L. 
Published: March 2023

BACKGROUND:
Approximately 30% of Crohn’s-related perianal fistulas heal in the adult population with conventional medical and surgical interventions. This healing rate remains unknown in pediatric patients.

OBJECTIVE:
Determine the healing rate of pediatric perianal Crohn’s fistula(s) and identify factors associated with healing.

DESIGN:
Retrospective case series.

SETTING:
A quaternary referral center.

PATIENTS:
Patients age <18 years old with Crohn’s perianal fistula(s), seen between January 1, 1991 and August 1, 2021.

INTERVENTIONS:
Multivariable logistic regression to identify factors independently associated with perianal fistula healing.

MAIN OUTCOME MEASURES:
Healing of Crohn’s perianal fistula at the date of last clinical encounter, defined as the clinical note reporting a healed fistula or normal perianal exam.

RESULTS:
A total of 91 patients < 18 years of age with a Crohn’s-related perianal fistula were identified (59% Female, 76% White). Mean (SD) age at Crohn’s diagnosis was 12 (±4) years. The mean follow-up after Crohn’s diagnosis was 10 (±7) years. Overall, 89% of patients had perianal fistula, 2% had anovaginal fistula, and 10% of patients had ileal pouch-associated fistulas. Patients underwent a median (IQR) of 2 (1-5) operations. A seton was placed in 60% of patients, 47% underwent abscess drainage, and 44% underwent fistulotomy or fistulectomy. Fistula healing occurred in 71% of patients over a median of 1.3 (0.4 – 2.5) years. Seven patients (7%) underwent proctectomy, and 3 (3%) underwent ileal pouch excision. After multivariable adjustment, younger age at diagnosis of perianal fistula was associated with increased likelihood of healing (OR 0.56 for each increased year, 95% CI, 0.34-0.92).

LIMITATIONS:
Retrospective, single institution.

CONCLUSIONS:
Over two-thirds of fistula(s) heal in pediatric Crohn’s disease patients with conventional surgical and medical intervention. Younger age at time of fistula development is associated with increased likelihood of healing.
Community-Based Hospitals Benefit From Restrictive Transfusion Practices
Authors: Hill James L. , Dawson Jennifer L. , Ramic Meghan , Manzo Julia , Pronovost Peter J. 
Published: March 2023

ABSTRACT
Blood availability was uncertain during the COVID-19 pandemic, yet transfusion remained a common and sometimes necessary procedure. Substantial work on optimizing transfusion practices is centered in tertiary hospitals as high utilizers of blood while the care delivered in smaller community hospitals comprises more than half the nation's transfusions. Improving transfusion practices in community hospitals represents a substantial opportunity to enhance patient safety and the availability of blood resources. Clinical specialists developed a dashboard to retrospectively examine transfusion events including an evidence-based analysis of the patient's clinical situation at the time of transfusion to more accurately identify how appropriately blood was used. The compiled data were discussed and shared with transfusing providers. It was hypothesized that the data provided and communication strategies used would educate providers to current evidence-based practice, leading to more appropriate transfusion with an overall reduction in packed red blood cell utilization. There was an 11% increase in transfusion appropriateness (p = <.001) and a 14% decrease in the units transfused (p = .004). Improvement in transfusion practices demonstrates a significant impact on patient safety and the availability of blood resources. Although absolute opportunity may be less in a community hospital, fewer resources are needed to achieve meaningful change.
A patient reminder to improve colorectal cancer screenings
Authors: Breedlove Shirley Rene’ , McCraney Paige , Chalmers Sharon 
Published: March 2023

ABSTRACT

Background:
Colorectal cancer screenings detect the early, treatable, and often curable stages of the disease. Screenings are now recommended beginning at 45 years of age. Health care providers are expected to have patient’s complete screenings, and reimbursement rates can be affected if results are not documented.

Local Problem:
An independent review of expected organizational core measures revealed inadequate colorectal cancer screenings completed and no formal patient outreach program for patients who had not completed ordered screenings. The lack of a formal reminder to patients resulted in a cumulative completion rate of 19%.

Methods:
A phone call intervention was designed to notify patients of the need to complete colorectal cancer screenings. A preimplementation and postimplementation design was used to compare completed colorectal cancer screenings.

Intervention:
Patients with ordered colorectal cancer screenings received one reminder phone call to complete the screening. Preintervention and postintervention completion rates were evaluated using data from the electronic medical record.

Results:
Results revealed a colorectal cancer screening rate of 19% preimplementation and 43% postimplementation and reflected a 61.9% increase in cumulative completion rates over a 12-week intervention period.

Conclusion:
The colorectal cancer patient reminder intervention showed clinical significance in improving completion rates of colorectal cancer screenings. The intervention was a successful method to improve patient compliance with the expected screening and helped improve provider core measure expectations.
Nonpharmaceutical interventions for managing SARS-CoV-2
Authors: Murphy Caitriona , Wong Jessica Y. , Cowling Benjamin J. 
Published: March 2023

Purpose of review
Initial response strategies to the COVID-19 pandemic were heavily reliant on nonpharmaceutical interventions (NPIs), a set of measures implemented to slow or even stop the spread of infection. Here, we reviewed key measures used during the COVID-19 pandemic.

Recent findings
Some NPIs were successful in reducing the transmission of SARS-CoV-2. Personal protective measures such as face masks were widely used, and likely had some effect on transmission. The development and production of rapid antigen tests allowed self-diagnosis in the community, informing isolation and quarantine measures. Community-wide measures such as school closures, workplace closures and complete stay-at-home orders were able to reduce contacts and prevent transmission. They were widely used in the pandemic and contributed to reduce transmission in the community; however, there were also negative unintended consequences in the society and economy.

Summary
NPIs slowed the spread of SARS-CoV-2 and are essential for pandemic preparedness and response. Understanding which measures are more effective at reducing transmission with lower costs is imperative.
Doula Care: A Review of Outcomes and Impact on Birth Experience
Authors: Ramey-Collier Khaila , Jackson Maya , Malloy Angela , McMillan Cindy , Scraders-Pyatt Andora , Wheeler Sarahn M. 
Published: March 2023

Importance
Doulas are trained professionals that provide comprehensive support during the perinatal period. Doula-supported care is associated with improved maternal and infant outcomes including decreased preterm birth, increased breastfeeding initiation, and higher patient satisfaction. In addition, research suggests that doula support is a promising strategy to mitigate racial disparities in maternal and infant health outcomes.

Objective
This article reviews doulas' scope of practice, perinatal outcomes associated with doula-assisted care, and their impact on alleviating racial disparities in maternal-infant outcomes.

Evidence Acquisition
A literature search using the search engine PubMed was done. The search terms included ([Doula OR doulas OR labor coach] AND [Preterm OR prenatal care OR race OR racial OR racism OR Black OR African American]). Studies had to be written in English.

Results
The search resulted 90 articles of which 18 original articles and 16 review articles were reviewed. The literature demonstrates that doula support increases vaginal delivery while decreasing preterm birth and low birth weight. Studies also show that doula support is uniquely effective for Black patients and is a promising strategy to reduce health care inequities.

Conclusions and Relevance
Doulas may provide significant perinatal benefit for birthing patients and their infants, with advantages also noted for Black patients. The current article provides an overview of the literature focused on doula support.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to describe the role of doulas during labor and postpartum period; discuss the improved perinatal outcomes that are associated with doula-supported care; and identify the benefits of doula care for Black birthing individuals, who are disproportionately affected by adverse outcomes.