bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Physical Match Performance and Injury Occurrence Before and After the COVID-19 Break in Professional European Soccer Leagues: A Systematic Review
Authors: Thron Maximiliane , Düking Peter , Härtel Sascha , Woll Alexander , Altmann Stefan 
Published: September 2022

AbstractBackgroundDue to the COVID-19 pandemic, matches and soccer-specific training were suspended for several weeks, matches after resumption were congested, and substitutions per team and game increased from three to five.ObjectiveThe aim of this review was to examine possible differences in physical match performance and injuries between before and after the COVID-19 induced break of matches and training in professional male European soccer leagues during the 2019/2020 season.MethodsA systematic search identified all scientifically peer-reviewed publications involving elite male soccer players competing in the European leagues which reported physical match performance variables such as total running distance and running distance at different speed zones and/or injury parameters pre- and post-COVID-19 induced break.ResultsIn total, 11 articles were included, which were coming from German Bundesliga, Polish Ekstraklasa, Croatian HNL, Spanish La Liga, and Italian Serie A. In all studies investigating the German Bundesliga, most parameters of physical match performance remained unaffected (0.08 ≤ p ≤ 0.82; − 0.15 ≤ ES 0.15), while studies investigating the Polish Ekstraklasa (p ≤ 0.03; − 0.27 ≤ ES − 0.18), Croatian HNL (p ≤ 0.04; − 1.42 ≤ ES ≤ 1.44), Spanish La Liga (p ≤ 0.017; − 0.32 ≤ ES ≤ 5.5), and Italian Serie A (p ≤ 0.014; − 1.01 ≤ ES 0.24) showed a decrease in most parameters of physical match performance after the COVID-19 break. Injury rates were only investigated by studies targeting the German Bundesliga and Italian Serie A. In the majority of studies (3 out of 4 studies), there occurred no difference in injuries between pre- and post-COVID-19 break (p > 0.05; ES = N/A).ConclusionResults indicate that Bundesliga teams maintained physical match performance during the 9-weeks break in matches and 3-weeks break in group training, whereas a longer match and group training interruption up to 15 weeks and 8 weeks, respectively, in the other leagues appeared to lead to a decreased physical match performance. Regarding injuries, we speculate that the increase in substitutions from 3 to 5 substitutions per game might prevent an increase in injury occurrence during matches. The underlying studies’ results provide hints for possible upcoming unexpected interruptions with respect to optimal physical preparations for the resumption of matches and a congested schedule to maintain physical match performance, or for possible rule changes such as 5 instead of 3 substitutions to avoid physical overload during congested match schedules.
Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis
Authors: Szigiato Andrei-Alexandru , Antaki Fares , Javidi Simon , Touma Samir , Duval Renaud , Cordahi Ghassan , Olivier Sebastien , Rezende Flavio A. 
Published: September 2022

Abstract
Background
To evaluate the rate and risk factors of epiretinal membrane (ERM) formation and need for ERM peeling after pars plana vitrectomy (PPV) for uncomplicated primary rhegmatogenous retinal detachment (RRD).

Methods
Retrospective, single-center, cohort study of 119 consecutive patients (119 eyes) that underwent RRD repair using PPV. The primary outcomes were ERM formation, classified using an optical coherence tomography grading system, and the rate of ERM peeling. Visual acuity, postoperative complications, and risk factors for ERM formation and peeling were also identified.

Results
Postoperative ERM formation occurred in 69 eyes (58.0%); 56 (47.1%) were stage 1, 9 (7.6%) stage 2, 3 (2.5%) stage 3, and 1 (0.8%) stage 4. Only 6 (5.0%) eyes required secondary PPV for a visually significant ERM, with a mean time to reoperation of 488 ± 351 days. Risk factors for ERM formation included intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment (p < 0.01). Eyes with more than 3 tears had a trend towards increased ERM surgery (p = 0.10).

Conclusions
Visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%). Half of the ERMs were detected after the first post-operative year, indicating that this complication may be underreported in studies with only 1-year follow-up.
Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis
Authors: El Garhy Mohammad , Owais Tamer , Lauten Philipp 
Published: September 2022

Abstract
Background
Most of TAVR centers evaluate the calcium score in contrast-enhanced (ce) CT. We compared in this study between different methodologies to measure calcium score. We studied also the difference between patients with low-gradient (LG) and high-gradient (HG) severe aortic stenosis (AS) as regard the burden of aortic valve calcium (AVC).

Results
We measured the calcium volume and score using Agatston methodology in non-contrast (nc) CT and with modified and fixed 850 Hounsfield unit (HU) thresholds in ce CT. The calcium score and volume in ceCT using even with modified thresholds is significantly lower than the assessed score and volume in ncCT. The median (IQR) of calcium score in nc CT and in cc CT were 1288 AU (750–1815) versus 947 HU (384–2202). The median (IQR) of calcium volume in nc CT and in cc CT with modified thresholds were 701 mm3 (239–1632) versus 197 mm3 (139–532). Agatston score and calcium volume were lower in patients with LG AS than HG AS; 2069 AU (899–2477) versus 928AU (572–1284) and 1537 mm3 (644–1860) versus 286 mm3 (160–700), respectively. Only 20% of patients with LGAS had Agatston score higher than the previously supposed AVC score threshold for the diagnosis of severe AS (> 2000AU in men and > 1200 in women).

Conclusions
The diagnosis of severe LGAS should not depend on a single parameter as calcium score. In these patients, calcium score should be measured in nc CT and not in ce CT.
Complex post-traumatic stress disorder: a much needed diagnosis
Authors: Cloitre Marylene 
Published: September 2022

Summary
This commentary conveys appreciation for a recent review of the rates of complex post-traumatic stress disorder (CPTSD) among refugees, describes the relevance of CPTSD to the refugee experience and discusses implications for assessment and treatment, the effective development of which requires collaboration among researchers, clinicians and individuals with lived experience.
Design and Evaluation of a Computational Phenotype to Identify Patients With Metastatic Breast Cancer Within the Electronic Health Record
Authors: Neely Benjamin , Shahsahebi Mohammad , Marks Caitlin E. , Power Steve , Kanter Andrew , Howell Claire , Hyslop Terry , Plichta Jennifer K. 
Published: September 2022

PURPOSE Outcomes for patients with metastatic breast cancer (MBC) are continually improving as more effective treatments become available. Granular data sets of this unique population are lacking, and the standard method for data collection relies largely on chart review. Therefore, using electronic health records (EHR) collected at a tertiary hospital system, we developed and evaluated a computational phenotype designed to identify all patients with MBC, and we compared the effectiveness of this algorithm against the gold standard, clinical chart review. METHODS A cohort of patients with breast cancer were identified according to International Classification of Diseases codes, the institutional tumor registry, and SNOMED codes. Chart review was performed to determine whether distant metastases had occurred. We developed a computational phenotype, on the basis of SNOMED concept IDs, which was applied to the EHR to identify patients with MBC. Contingency tables were used to aggregate and compare results. RESULTS A total of 1,741 patients with breast cancer were identified using data from International Classification of Diseases codes, the tumor registry, and/or SNOMED concept identifiers. Chart review of all patients classified each patient as having MBC (n = 416; 23.9%) versus not (n = 1,325; 75.9%). The final computational phenotype successfully classified 1,646 patients (95% accuracy; 82% sensitivity; 99% specificity). CONCLUSION Hospital systems with robust EHRs and reliable mapping to SNOMED have the ability to use standard codes to derive computational phenotypes. These algorithms perform reasonably well and have the added ability to be run at disparate health care facilities. Better tooling to navigate the polyhierarchical structure of SNOMED ontology could yield better-performing computational phenotypes.
Development and Adaptation of a Patient-Centered Communication Survey for Parents of Children With Cancer in Guatemala
Authors: Graetz Dylan E. , Rivas Silvia Elena , Fuentes Ana Lucia , Caceres-Serrano Annie , Antillon-Klussmann Federico , Rodriguez-Galindo Carlos , Mack Jennifer W. 
Published: September 2022

PURPOSE Surveys to assess patient and family experiences of pediatric cancer care have been primarily developed and validated in high-income Western settings with English-speaking participants. However, 90% of children with cancer live in low- and middle-income countries. We sought to develop a survey focused on pediatric cancer communication for use in a low-literacy population in Guatemala, including adaptation of many previously validated items. METHODS A multidisciplinary team developed a quantitative survey on the basis of a theoretical model of important components and influences on pediatric cancer communication. The original survey included established items previously used in high-income settings and novel questions designed for this study. The survey was translated into Spanish and pilot tested with parents of children receiving treatment at Unidad Nacional de Oncologia Pediatrica in Guatemala City, Guatemala, from April-June 2019. Cognitive interviews were used during pilot testing, and the survey was iteratively revised throughout this process. RESULTS Early in testing, Guatemalan parents tended to choose answers at the extreme ends of response categories and socially desirable responses. Ultimately, a visual aid was developed to accompany three-item Likert scale response options. This allowed for successful administration of the survey instrument, resulting in moderate variation of response options and similar proportions to those generated when the original five-item responses were used in parent populations from the United States. CONCLUSION Appropriately adapted surveys are necessary to understand patient-centered communication among pediatric oncology populations in low- and middle-income countries. Eventual validation of such tools will enable cross-cultural studies and comparative analysis of results.
Oncology-hospitalist co-management: A model for efficient, high-quality care and education.
Authors: Morris Jensa Catherine , Prsic Elizabeth Horn , Parker Nathaniel , Weber Urs , Gombos Erin Ann , Kottarathara Mathew , Gould Rothberg Bonnie Elyssa , Adelson Kerin B. 
Published: September 2022

1 Background: Our inpatient oncology service at Smilow Cancer Hospital had long lengths of stay, high readmission rates and burnout among outpatient oncologists who rotated as inpatient attendings. With a proposal to improve length of stay by.25 days in the first year, the health system funded the integration of internal medicine hospitalists. Methods: Patients were randomly assigned to one of two oncology teams, allowing for real time outcome comparisons. Hospitalists were added to the Intervention Team and served as the primary attending with oncologists as consultants; Oncologists served as the primary attending on the Traditional Team. The intervention began in July 2021. Outcome metrics included LOS, readmission rate, case volume, early discharge rate, educational rankings, and oncologist satisfaction. A multidisciplinary steering group met to review data, study, and act on outcome metrics. Using Quality Improvement PDSA cycles, outcomes were reported at 3 months (PDSA 1), followed by improvement interventions; then reported again at 6 months (PDSA 2). Results: The Intervention Team achieved a 1.0-day reduction in LOS compared to Traditional team. There was no difference in Severity of Illness score in comparator groups, demonstrating no imbalance in patient population. The Intervention team cared for a 29% higher volume of patients and improved early discharge rate without an increase in readmissions from baseline. Oncologists reported a high level of satisfaction with the program. Housestaff overall educational rankings increased after the introduction of hospitalists (Table). Discussion: Hospitalist comanagement exceeded business plan LOS reduction target without compromise in quality or educational metrics. PDSA 1 identified need for role clarity among physicians, increased oncology teaching, and preservation of resident autonomy; PDSA 2 identified need for increased nursing-physician collaboration. Conclusions: Hospitalist comanagement can effectively reduce oncology LOS without adverse effect on readmission rates, educational outcomes, or oncologist satisfaction with care.[Table: see text]
Evaluating the effect of a scalable cancer-navigation program on total cost of care.
Authors: Worland Scott Campbell , Albin Margot , Dorsey Brian , Fosnocht Kevin , Gomez Juan , Johnstone Denise , Kirayoglu Alphan , Licitra Edward , Parikh Ravi Bharat , Sachdeva Kush , Thompson Keith , Voigt Scott , Woerner Shannon , Green Robert Jeffrey 
Published: September 2022

4 Background: Cancer-patient navigation programs have been shown to reduce total cost of care while improving outcomes. Previous research has focused on navigation programs embedded within a single institution or a single network of practices. We explore whether an independent cancer-patient navigation program deployed in collaboration with a Medicare Advantage (MA) plan can demonstrate similar cost savings when deployed across a wide variety of practice settings in the state of New Jersey. Methods: We conducted a retrospective observational study to determine the per member per month (PMPM) total cost of care (TCOC) difference between cancer patients with and without a navigation intervention provided by Thyme Care, a technology-enabled virtual cancer-navigation platform. The team, staffed by both lay-health workers and nurses, was assigned members of a single MA plan’s population in NJ beginning on March 2, 2021. Patients with a cancer-specific ICD-10 code who received systemic antineoplastic therapy were eligible for the program. The navigation team coordinated care, addressed barriers to care, facilitated goals of care discussions, and conducted proactive and reactive symptom assessment. The cadence of the symptom assessment was determined by both patient and disease-specific criteria. Concerning responses were triaged to the patient’s oncology team the same day. The study period was from January 1, 2018 to June 13, 2022. The primary outcome was TCOC excluding part D drug spend. We compared TCOC for patients who received the intervention to a control group of eligible individuals that were matched using propensity scores derived from clinical and demographic covariates. We used a repeated measure generalized linear model to estimate the monthly effect of navigation on TCOC. Additionally, we conducted a monte-carlo sensitivity analysis to provide an upper and lower bound on the cost savings. Results: Of 4,172 eligible members, 662 were in the treatment group (across 25 community practices and 45 hospital based practices) and 3,510 were in the control group (across 58 community practices and 73 hospitals). The propensity matching resulted in 188 members in both the treatment and the control group (376 total). The mean TCOC declined $459 more PMPM for the navigated group compared to the non-navigated group. The sensitivity analysis suggested a plausible range of $209-708 PMPM savings in the intervention group. Conclusions: This is the first study to demonstrate that a cancer-navigation program can reduce overall costs when deployed in collaboration with a health plan across a wide geography and range of practice types.
Health care costs among men with metastatic castration-resistant prostate cancer (mCRPC) in the U.S. Medicare population.
Authors: Freedland Stephen J. , Davis Matthew , Epstein Andrew J. , Arondekar Bhakti , Ivanova Jasmina I. 
Published: September 2022

10 Background: Studies have reported healthcare costs before and after mCRPC diagnosis in commercially insured populations, but no information is available about costs with progression through lines of therapy after mCRPC diagnosis. This study describes healthcare costs among men with mCRPC in the US Medicare population before mCRPC diagnosis, after diagnosis, and with progression through lines of therapy. Methods: Men newly diagnosed with mCRPC were identified in Medicare fee-for-service claims during 1/1/2014–6/30/2019. Adult men were required to have a diagnosis of prostate cancer, metastasis diagnosis, castration-resistance using a published claims-based algorithm, and continuous insurance coverage for ≥1 year before and ≥6 months after index mCRPC diagnosis unless patients died. Unadjusted all-cause healthcare costs (medical and pharmacy) per patient per year (PPPY) to Medicare inflated to 2019 dollars were described for the periods before mCRPC diagnosis, after diagnosis, and from the start of first-line (1L), second-line (2L), and third-line (3L) therapy with mCRPC life-prolonging treatments to the start of subsequent therapy or end of follow up. Results: Among 14,780 men with mCRPC, median age was 75 years, and the mean Quan-Charlson Comorbidity Index was 2.1. Median follow-up after mCRPC diagnosis was 17 months. During the follow up, 3,252 men had no life-prolonging treatment, 11,528 men initiated 1L mCRPC therapy, 6,275 initiated 2L, and 2,945 initiated 3L. Mean all-cause healthcare costs PPPY were $27,468 in the year before mCRPC diagnosis, $124,379 after mCRPC diagnosis, $102,380 among men without life-prolonging treatment after mCRPC diagnosis, $148,325 from the start of 1L to subsequent therapy or end of follow up, $160,118 from the start of 2L therapy, and $165,186 from the start of 3L therapy. Conclusions: Mean healthcare costs increased over 4-fold from before to after mCRPC diagnosis and increased steadily as patients progressed from first through third lines of mCRPC therapy. These findings help quantify the economic burden of mCRPC and contextualize the economic value of treatments that delay disease progression.[Table: see text]
Low-risk episode characteristics with an impact on total cost of care and performance in the Oncology Care Model.
Authors: Indurlal Puneeth , Garey Jody S. , Hoverman John Russell , Mills Lydia , Payne-De Bock Judi , Staggs Stuart , Wilfong Lalan S. 
Published: September 2022

12 Background: The Oncology Care Model (OCM) is an episode-based, Medicare value-based care program, that rewards providers for decreasing the total cost of care (TCOC) compared to a benchmark price. The model differentiates breast & prostate cancer treated with hormone-only therapy, and bladder cancer treated with Bacillus Calmette-Guérin and/or mitomycin as low-risk episodes (LRE). All other qualifying cancers, including breast, prostate & bladder cancer treated with chemotherapy are designated as high-risk episodes (HRE). Independent evaluation of OCM Performance Periods (PP) 1-6 suggests that reductions in TCOC predominantly occurred in HRE but were offset by increased TCOC in LRE. We seek to evaluate the episode characteristics that have a bearing on LRE performance in OCM. Methods: Episode claims data for 14 practices in The US Oncology Network (The Network) participating in OCM during PP 1-6 were assessed. Several episode characteristics including patient age, gender, comorbidities, cancer type, oncology touchpoints, etc. were evaluated. Results: LRE accounted for 30.5% of total episodes for The Network in OCM from PP1-6, with average benchmark price of $6,700. 85% of LRE were breast cancer patients with average benchmark of $5,800. Only 30% of LRE had increased TCOC exceeding benchmark. Average TCOC increased gradually with increasing age, with highest TCOC at extremes of patient age (18-64 and 80+). Episodes with multiple comorbidities (defined as Hierarchical Condition Category (HCC) flags 3, 4-5, 6+) had an average TCOC 3-times higher than episodes with fewer-or-no comorbidities (HCC flags 0, 1, 2). Episode expenses beyond cancer care (inpatient, nursing facility, home health, long term care, durable medical equipment, and inpatient rehabilitation) were 2.5 times higher for patients with advancing age (75-79 or 80+) and multiple comorbidities. Additionally, these patients had lower physician services expenses, fewer oncology care touchpoints (defined as visits with the Oncology practice), and a four-fold higher death rate. Conclusions: In the OCM, LRE for older patients with multiple comorbidities had higher TCOC, with fewer oncology touchpoints, higher death rates, and episode expenses beyond cancer care contributing the most to TCOC. Incorporating a comprehensive geriatric assessment (composed of physical, functional, cognitive, mental, and socioenvironmental factors) could guide oncologic therapeutic choices, and appropriate clinical management of these patients to improve outcomes. In addition, a modified, resource utilization-based risk adjustment approach could better fit this population.