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10. Bias in the measurement of the outcome is associated with effect sizes in randomized clinical trials on exercise therapy for chronic low back pain: a meta-epidemiological study

Author

Innocenti, Tiziano, Hayden, Jill A., Salvioli, Stefano, Giagio, Silvia, Piano, Leonardo, Cosentino, Carola, Brindisino, Fabrizio, Feller, Daniel, Ogilvie, Rachel, Gianola, Silvia, Castellini, Greta, Bargeri, Silvia, Twisk, Jos W.R., Ostelo, Raymond W., and Chiarotto, Alessandro

Published
2023
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16. Perceptions and Experiences of Individuals With Neck Pain: A Systematic Critical Review of Qualitative Studies With Meta-Summary and Meta-Synthesis

Author

Maistrello, Luca Falsiroli, Zanconato, Laura, Palese, Alvisa, Geri, Tommaso, Turolla, Andrea, Gianola, Silvia, Dell'Isola, Andrea, and Rossettini, Giacomo

Subjects
Patients -- Beliefs, opinions and attitudes, Neck pain -- Psychological aspects -- Complications and side effects -- Care and treatment
Abstract

Objective. This study aimed at exploring the perspectives and experiences of individuals with neck pain by synthesizing all available qualitative studies. Methods. A systematic, qualitative meta-summary and meta-synthesis was conducted following the 5-step methodology proposed by Sandelowski and Barroso. A systematic search of 9 electronic databases was conducted in May 2021. Methodological quality was assessed using the Critical Appraisal Skills Programme tool. Results. Nine studies were included in the meta-synthesis for a total of 103 participants (73 women). Eleven categories were identified as belonging to 3 main themes: physical ("My neck has gone wrong"); psychological ("I am worried about my recovery"); and social ("Pain limits my life"). In the physical theme, the categories with the highest frequency were symptoms (67%) followed by body perception (44%). The psychological theme frequencies from highest to lowest were psychological consequences (100%), coping strategies (100%), mindset (67%), expectations from health care professionals (44%), and gender influence (22%). In the social theme, frequencies from highest to lowest were social relationships (56%), work, and activities of daily living and physical activity (44%, respectively). Conclusion. An individual's experience with neck pain is a multidimensional phenomenon in which physical, psychological, and social dimensions influence each other. These findings suggested that health care professionals should be aware of recognizing and evaluating all of the individual's experiences to offer a truly patient-centered care pathway. Impact. This qualitative meta-synthesis responded to a call to action to explore perspectives and experiences of individuals with neck pain. These findings can provide crucial guidance for clinicians as they plan and implement evidence-based recommendations for neck pain. Keywords: Neck Pain, Qualitative, Rehabilitation, Introduction Neck pain is defined as "pain located in the anatomic region of the neck, with or without radiation to the head, trunk, and upper limbs." (1) It represents a [...]

Published
2022
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21. Evidence-informed and consensus-based statements about SAFEty of Physical Agent Modalities Practice in physiotherapy and rehabilitation medicine (SAFE PAMP): a national Delphi of healthcare scientific societies

Author

Gianola, Silvia, primary, Bargeri, Silvia, additional, Pellicciari, Leonardo, additional, Gambazza, Simone, additional, Rossettini, Giacomo, additional, Fulvio, Anna, additional, Genovese, Vincenzo, additional, Benedini, Matteo, additional, Proverbio, Emanuele, additional, Cecchetto, Simone, additional, Castellini, Greta, additional, and Turolla, Andrea, additional

Published
2024
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26. Olympic Weightlifting Training for Sprint Performance in Athletes: A Systematic Review with Meta-analysis.

Author

Crenshaw, Kristen, Zeppieri, Giorgio, Hung, Cheng-Ju, Schmitfranz, Tania, McCall, Patti, Castellini, Greta, Gianola, Silvia, and Pozzi, Federico

Subjects
EXERCISE physiology, PLYOMETRICS, RESEARCH funding, SPORTS, HUMAN services programs, CINAHL database, EVALUATION of human services programs, PHYSICAL training & conditioning, META-analysis, INFORMATION storage & retrieval systems, DESCRIPTIVE statistics, ATHLETES, RESISTANCE training, SYSTEMATIC reviews, MEDLINE, SPORTS events, RESEARCH methodology, WEIGHT lifting, ATHLETIC ability, CONFIDENCE intervals, COMPARATIVE studies, HEALTH outcome assessment, SPRINTING
Abstract

This systematic review and meta-analysis aimed to determine whether Olympic weightlifting (OW) exercises would improve sprint performance when compared to a control intervention, (no training, standard sport-specific training, traditional resistance training, or plyometric training). Medline, Web of Science, SportDiscus, CINAHL, and Biological Science from inception to September 2022 was searched. Two authors independently selected the included studies, extracted data, and appraised the risk of bias. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The primary meta-analysis combined the results of the sprint performance over the full length of each sprint test. The secondary meta-analyses combined the results of the sprint performance at 5, 10, and 20 m distance to capture information about the acceleration phase of the sprint tests. Eight studies with 206 athletes (female n=10, age range: 18.9–24.2 years) were identified. Sprint performance did not differ significantly comparing OW to the control intervention, nor at the full length (standardized mean difference=–0.07, 95% CI=–0.47 to 0.34, p =0.75, I2 =46%) or during the acceleration phase (p ≥0.26) of the sprint test. OW training does not improve sprint performance to a greater extent than comparator interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Revolutionizing orthopedic healthcare: a systematic review unveiling recombinant antimicrobial peptides.

Author

Pennone, Vincenzo, Rosini, Elena, Mascheroni, Elena, Gianola, Silvia, Castellini, Greta, Bargeri, Silvia, and Lovati, Arianna B.

Subjects
ANTIMICROBIAL peptides, ARTHROPLASTY, DRUG resistance in bacteria, PEPTIDES, ORTHOPEDIC surgery, DEFENSINS
Abstract

The increasing demand for orthopedic surgeries, including joint replacements, is driven by an aging population and improved diagnosis of joint conditions. Orthopedic surgeries carry a risk of infection, especially in patients with comorbidities. The rise of antibiotic resistance exacerbates this issue, necessitating alternatives like in vitro bioengineered antimicrobial peptides (AMPs), offering broad-spectrum activity and multiple action mechanisms. This review aimed to assess the prevalence of antimicrobial potential and the yield after purification among recombinant AMP families. The antimicrobial potential was evaluated using the Minimum Inhibitory Concentration (MIC) values against the most common bacteria involved in clinical infections. This systematic review adhered to PRISMA guidelines, focusing on in vitro studies of recombinant AMPs. The search strategy was run on PubMed, Scopus and Embase up to 30th March 2023. The Population, Exposure and Outcome model was used to extract the data from studies and ToxRTool for the risk of bias analysis. This review included studies providing peptide production yield data and MIC values against pathogenic bacteria. Non-English texts, reviews, conference abstracts, books, studies focusing solely on chemical synthesis, those reporting incomplete data sets, using non-standard MIC assessment methods, or presenting MIC values as ranges rather than precise concentrations, were excluded. From 370 publications, 34 studies on AMPs were analyzed. These covered 46 AMPs across 18 families, with Defensins and Hepcidins being most common. Yields varied from 0.5 to 2,700 mg/L. AMPs were tested against 23 bacterial genera, with MIC values ranging from 0.125 to >1,152 µg/mL. Arenicins showed the highest antimicrobial activity, particularly against common orthopedic infection pathogens. However, AMP production yields varied and some AMPs demonstrated limited effectiveness against certain bacterial strains. This systematic review emphasizes the critical role of bioengineered AMPs to cope infections and antibiotic resistance. It meticulously evaluates recombinant AMPs, focusing on their antimicrobial efficacy and production yields. The review highlights that, despite the variability in AMP yields and effectiveness, Arenicins and Defensins are promising candidates for future research and clinical applications in treating antibiotic-resistant orthopedic infections. This study contributes significantly to the understanding of AMPs in healthcare, underscoring their potential in addressing the growing challenge of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Published
2024
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28. COVID-19 and Health Care Leaders: How Could Emotional Intelligence Be a Helpful Resource During a Pandemic?

Author

Rossettini, Giacomo, Conti, Cristiana, Suardelli, Martina, Geri, Tommaso, Palese, Alvisa, Turolla, Andrea, Lovato, Andrea, Gianola, Silvia, and Dell'Isola, Andrea

Subjects
Epidemics -- Social aspects -- Psychological aspects -- Italy, Professional development -- Analysis, Emotional intelligence -- Analysis, Health services administrators -- Social aspects -- Psychological aspects, Medical personnel -- Social aspects -- Psychological aspects
Abstract

Background The Coronavirus Disease 2019 (COVID-19) pandemic begun in Wuhan in December 2019 and spread rapidly across the globe, causing millions of deaths. (1) Frontline health care workers (HCWs), including [...]

Published
2021
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29. The Spread of COVID-19 Among 15,000 Physical Therapists in Italy: A Cross-Sectional Study

Author

Gianola, Silvia, Bargeri, Silvia, Campanini, Isabella, Corbetta, Davide, Gambazza, Simone, Innocenti, Tiziano, Meroni, Roberto, Castellini, Greta, and Turolla, Andrea

Subjects
Epidemics -- Statistics -- Risk factors -- Demographic aspects, Physical therapists -- Statistics -- Health aspects
Abstract

Objectives. The purpose of this study was to explore the prevalence, personal- and work-related exposures, and signs and symptoms among physical therapists during the first wave of coronavirus disease 2019 (COVID-19) in Italy. Methods. This cross-sectional, survey-based study collected demographic and exposure data from physical therapists from April to May 2020. All physical therapists working in inpatient and outpatient care in Italy were eligible. A self-administered questionnaire was distributed among all eligible physical therapists to collect (1) demographic characteristics, (2-3) personal-and work-related exposures, and (4) signs and symptoms of COVID-19. Factors associated with a COVID-19-positive nasopharyngeal swab (NPS) were explored through logistic regression models and multivariate methods. Results. A total of 15,566 respondents completed the survey, with a response rate of 43.3%, achieving high statistical precision (99% CI, 1% type I error). Among physical therapists who received NPS testing, 13.1% (95% CI =12.1-14.1%) had a positive result, with a peak reached in March 2020 (36%). The top 5 symptoms were fatigue and tiredness (69.1%), loss of smell (64.5%), aches and pains (60.8%), loss of taste (58.3%), and headache (51.1%). No symptoms were reported by 8.9%. Working in a health care institution (odds ratio [OR] =12.0; 95% CI= 7 . 8 -18.4), being reallocated to a different unit (OR =1.9; 95% CI =1.3 -2.7), and changing job tasks (OR = 1.6; 95% CI =1.2 -2.3) increased the risk of being COVID-19 positive. In therapists with a confirmed diagnosis of COVID-19, comorbidities were associated with male sex and age older than 51 years. Conclusion. During the first wave in Italy, almost 1 out of 7 physical therapists tested positive on the COVID-19 NPS test. Considering personal- and work-related exposures, health care organizations should adopt prevention measures and adequate preparedness to prevent high rate of infections during future pandemics. Impact. This is the largest investigation about the spread of and main risk factors for COVID-19 in the physical therapy field. Keywords: Coronavirus Infections, Coronavirus, COVID-19, Disease Outbreaks, Pandemics, Physical Therapy, Physiotherapy, Prevention and Control, Severe Acute Respiratory Syndrome Coronavirus 2, Surveys and Questionnaires, Transmission, Introduction Severe acute respiratory syndrome coronavirus 2 is a new coronavirus that emerged in 2019 and causes coronavirus disease 2019 (COVID-19). (1) The virus is transmitted from person to person [...]

Published
2021
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37. Performance of ChatGPT Compared to Clinical Practice Guidelines in Making Informed Decisions for Lumbosacral Radicular Pain: A Cross-sectional Study.

Author

GIANOLA, SILVIA, BARGERI, SILVIA, CASTELLINI, GRETA, COOK, CHAD, PALESE, ALVISA, PILLASTRINI, PAOLO, SALVALAGGIO, SILVIA, TUROLLA, ANDREA, and ROSSETTINI, GIACOMO

Abstract

OBJECTIVE: To compare the accuracy of an artificial intelligence chatbot to clinical practice guidelines (CPGs) recommendations for providing answers to complex clinical questions on lumbosacral radicular pain. DESIGN: Cross-sectional study. METHODS: We extracted recommendations from recent CPGs for diagnosing and treating lumbosacral radicular pain. Relative clinical questions were developed and queried to OpenAI's ChatGPT (GPT-3.5). We compared ChatGPT answers to CPGs recommendations by assessing the (1) internal consistency of ChatGPT answers by measuring the percentage of text wording similarity when a clinical question was posed 3 times, (2) reliability between 2 independent reviewers in grading ChatGPT answers, and (3) accuracy of ChatGPT answers compared to CPGs recommendations. Reliability was estimated using Fleiss' kappa (k) coefficients, and accuracy by interobserver agreement as the frequency of the agreements among all judgments. RESULTS: We tested 9 clinical questions. The internal consistency of text ChatGPT answers was unacceptable across all 3 trials in all clinical questions (mean percentage of 49%, standard deviation of 15). Intrareliability (reviewer 1: k = 0.90, standard error [SE] = 0.09; reviewer 2: k = 0.90, SE = 0.10) and interreliability (k = 0.85, SE = 0.15) between the 2 reviewers was "almost perfect." Accuracy between ChatGPT answers and CPGs recommendations was slight, demonstrating agreement in 33% of recommendations. CONCLUSION: ChatGPT performed poorly in internal consistency and accuracy of the indications generated compared to clinical practice guideline recommendations for lumbosacral radicular pain. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Teaching evidence-based practice to physiotherapy students in Italy:a cross sectional study

Author

Piano, Leonardo, Chiarotto, Alessandro, Mascarello, Marco, Turolla, Andrea, Cecchetto, Simone, Gianola, Silvia, Castellini, Greta, Piano, Leonardo, Chiarotto, Alessandro, Mascarello, Marco, Turolla, Andrea, Cecchetto, Simone, Gianola, Silvia, and Castellini, Greta

Abstract

Background: Evidence-based practice (EBP) is being rapidly adopted by the Italian physiotherapy community, although a knowledge gap persists at clinical level with consequent lack of integration of EBP into ground roots practice. Teaching of EBP during the Bachelor of Science (BSc) undergraduate course in physiotherapy likely has a vital role to play in the spread of knowledge, providing a grounding in the fundamental concepts of EBP. The aim of the present study was to investigate the prevalence of EBP educational content in Italian BSc courses in physiotherapy. Methods: This is a cross-sectional study during which characteristics of EBP teaching in BSc degree courses of physiotherapy in Italy were collected from institutional websites during the period May to September 2021 with an update in August 2022. We used the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for our manuscript.Results: Forty-two physiotherapy BSc degree programs were retrieved, accounting for all the BSc delivered in the 2021–2022 academic year. Fourteen of these (33.3%) did not report EBP content. Northern universities provided EBP content in 16 out of 18 (88%) degree courses. Central Italian universities provided EBP content in 6 out of 9 (66.6%) degree courses. Southern universities delivered EBP content in 3 out of 9 (33.3%) degree courses. The universities of Sicily and Sardinia provided EBP content in 2 out of 5 (40%) degree courses. The degree courses taught in public universities were more likely to contain EBP material (25 out of 37, 67.4%), compared to those taught within the private system (3 out of 5, 60%). Conclusions: The prevalence of EBP content within physiotherapy BSc degree programs in Italy can be considered suboptimal, with both regional differences and according to the system (public vs private). The results of this study could be used as a stimulus fo

Published
2023

47. Structured approach with primary and secondary survey for major trauma care: an overview of reviews

Author

Gianola, S, Bargeri, S, Biffi, A, Cimbanassi, S, D'Angelo, D, Coclite, D, Facchinetti, G, Fauci, A, Ferrara, C, Di Nitto, M, Napoletano, A, Punzo, O, Ranzato, K, Tratsevich, A, Iannone, P, Castellini, G, Chiara, O, Gianola, Silvia, Bargeri, Silvia, Biffi, Annalisa, Cimbanassi, Stefania, D'Angelo, Daniela, Coclite, Daniela, Facchinetti, Gabriella, Fauci, Alice Josephine, Ferrara, Carla, Di Nitto, Marco, Napoletano, Antonello, Punzo, Ornella, Ranzato, Katya, Tratsevich, Alina, Iannone, Primiano, Castellini, Greta, Chiara, Osvaldo, Gianola, S, Bargeri, S, Biffi, A, Cimbanassi, S, D'Angelo, D, Coclite, D, Facchinetti, G, Fauci, A, Ferrara, C, Di Nitto, M, Napoletano, A, Punzo, O, Ranzato, K, Tratsevich, A, Iannone, P, Castellini, G, Chiara, O, Gianola, Silvia, Bargeri, Silvia, Biffi, Annalisa, Cimbanassi, Stefania, D'Angelo, Daniela, Coclite, Daniela, Facchinetti, Gabriella, Fauci, Alice Josephine, Ferrara, Carla, Di Nitto, Marco, Napoletano, Antonello, Punzo, Ornella, Ranzato, Katya, Tratsevich, Alina, Iannone, Primiano, Castellini, Greta, and Chiara, Osvaldo

Abstract

Background: A structured approach involves systematic management of trauma patients. We aim to conduct an overview of reviews about the clinical efficacy and safety of structured approach (i.e., primary and secondary survey) by guideline checklist compared to non-structured approach (i.e. clinical examination); moreover, routine screening whole-body computer tomography (WBCT) was compared to non-routine WBCT in patients with suspected major trauma.Methods: We systematically searched MEDLINE (PubMed), EMBASE and Cochrane Database of Systematic Reviews up to 3 May 2022. Systematic reviews (SRs) that investigated the use of a structured approach compared to a non-structured approach were eligible. Two authors independently extracted data, managed the overlapping of primary studies belonging to the included SRs and calculated the corrected covered area (CCA). The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.Results: We included nine SRs investigating two comparisons in stable trauma patients: structured approach vs non-structured approach (n = 1) and routine WBCT vs non-routine WBCT (n = 8). The overlap of included primary studies was generally high across outcomes (CCA ranged between 20.85 and 42.86%) with some discrepancies in the directions of effects across reviews. The application of a structured approach by checklist may improve adherence to guidelines (e.g. Advanced Trauma Life Support) during resuscitation and might lead to a reduction in mortality among severely injured patients as compared to clinical examination (Adjusted OR 0.51; 95% CI 0.30-0.89; p = 0.018; low certainty of evidence). The use of routine WBCT seems to offer little to no effects in reducing mortality and time spent in emergency room or department, whereas non-routine WBCT seems to offer little to no effects in reducing radiation dose, intensive care unit length of stay (LOS) and hospital LOS (low-to-moderate

Published
2023

48. Systemic hemostatic agents initiated in trauma patients in the pre-hospital setting: a systematic review

Author

Biffi, A, Porcu, G, Castellini, G, Napoletano, A, Coclite, D, D'Angelo, D, Fauci, A, Iacorossi, L, Latina, R, Salomone, K, Iannone, P, Gianola, S, Chiara, O, Biffi, Annalisa, Porcu, Gloria, Castellini, Greta, Napoletano, Antonello, Coclite, Daniela, D'Angelo, Daniela, Fauci, Alice Josephine, Iacorossi, Laura, Latina, Roberto, Salomone, Katia, Iannone, Primiano, Gianola, Silvia, Chiara, Osvaldo, Biffi, A, Porcu, G, Castellini, G, Napoletano, A, Coclite, D, D'Angelo, D, Fauci, A, Iacorossi, L, Latina, R, Salomone, K, Iannone, P, Gianola, S, Chiara, O, Biffi, Annalisa, Porcu, Gloria, Castellini, Greta, Napoletano, Antonello, Coclite, Daniela, D'Angelo, Daniela, Fauci, Alice Josephine, Iacorossi, Laura, Latina, Roberto, Salomone, Katia, Iannone, Primiano, Gianola, Silvia, and Chiara, Osvaldo

Abstract

Purpose:The effect of systemic hemostatic agents initiated during pre-hospital care of severely injured patients with ongoing bleeding or traumatic brain injury (TBI) remains controversial. A systematic review and meta-analysis was therefore conducted to assess the effectiveness and safety of systemic hemostatic agents as an adjunctive therapy in people with major trauma and hemorrhage or TBI in the context of developing the Italian National Institute of Health guidelines on major trauma integrated management. Methods:PubMed, Embase, and Cochrane Library databases were searched up to October 2021 for studies that investigated pre-hospital initiated treatment with systemic hemostatic agents. The certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation approach, and the quality of each study was determined with the Cochrane risk-of-bias tool. The primary outcome was overall mortality, and secondary outcomes included cause-specific mortality, health-related quality of life, any adverse effects and blood product use, hemorrhage expansion, and patient-reported outcomes. Results:Five trials of tranexamic acid (TXA) met the inclusion criteria for this meta-analysis. With a high certainty of evidence, when compared to placebo TXA reduced mortality at 24 h (relative risk = 0.83, 95% confidence interval = 0.73-0.94) and at 1 month among trauma patients (0.91, 0.85-0.97). These results depend on the subgroup of patients with significant hemorrhage because in the subgroup of TBI there are no difference between TXA and placebo. TXA also reduced bleeding death and multiple organ failure whereas no difference in health-related quality of life. Conclusion:Balancing benefits and harms, TXA initiated in the pre-hospital setting can be used for patients experiencing major trauma with significant hemorrhage since it reduces the risk of mortality at 24 h and one month with no difference in terms of adverse effects when compared to p

Published
2023

50. European Code against Cancer 4th Edition: 12 ways to reduce your cancer risk

Author

Guha, Neela, Kralikova, Eva, McNeill, Anne, Peruga, Armando, Anderson, Annie, Berrino, Franco, Boutron-Ruault, Marie-Christine, Cecchini, Michele, Key, Tim J., Leitzmann, Michael, Norat, Teresa, Powers, Hilary J, Scoccianti, Chiara, Auvinen, Anssi, de Vries, Esther, Erdmann, Friederike, Greinert, Rüdiger, Harrison, John, Kesminiene, Ausrele, McColl, Neil, Friis, Søren, Kogevinas, Manolis, Saracci, Rodolfo, Straif, Kurt, Vainio, Harri, Almonte, Maribel, Anttila, Ahti, De Vuyst, Hugo, Dillner, Joakim, Franceschi, Silvia, Gonzalez, Paula, Hall, Andrew, Park, Jin Young, Armaroli, Paola, Atkin, Wendy, Dean, Peter B., de Koning, Harry, Dillner, Lena, Kuipers, Ernst, Lansdorp-Vogelaar, Iris, Paci, Eugenio, Regula, Jaroslaw, Suonio, Eero, Törnberg, Sven, Wood, Lynn Faulds, Gaudin, Nicolas, Frie, Kirstin Grosse, Terrasse, Veronique, Winstanley, Kelly, Bellisario, Cristina, Biagioli, Elena, Cinquini, Michela, Gianola, Silvia, Gonzalez Lorenzo, Marien, von Karsa, Lawrence, Lignini, Tracy, Schüz, Joachim, Espina, Carolina, Villain, Patricia, Herrero, Rolando, Leon, Maria E., Minozzi, Silvia, Romieu, Isabelle, Segnan, Nereo, Wardle, Jane, Wiseman, Martin, Belardelli, Filippo, Bettcher, Douglas, Cavalli, Franco, Galea, Gauden, Lenoir, Gilbert, Martin-Moreno, Jose M., Nicula, Florian Alexandru, Olsen, Jørgen H., Patnick, Julietta, Primic-Zakelj, Maja, Puska, Pekka, van Leeuwen, Flora E., Wiestler, Otmar, and Zatonski, Witold

Published
2015
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