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We sought to understand how the coronavirus disease 2019 pandemic has affected the neurosurgical workforce. We created a survey consisting of 22 questions to assess the respondent's operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began. The survey was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. Of the 724 who opened the survey link, 457 completed the survey. The respondents were from throughout the United States and Puerto Rico and represented all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost one half (49.1%) of the respondents had had to downsize their practice staff, office assistants, nurses, schedulers, and other personnel. Overall, 43.6% of survey respondents had experienced a decline in income, and 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic compared with their colleagues. The coronavirus disease 2019 pandemic will likely have a lasting effect on the practice of medicine. Our survey results have described the early effects on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume, which led to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future. [ABSTRACT FROM AUTHOR]

The 6-minute walk distance (6MWD) test is a useful prognostic tool in chronic heart failure. Its usefulness after percutaneous coronary intervention is unknown. In a prospective observational study, patients underwent a 6MWD test within 2 weeks after percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular events (MACE) (death, acute coronary syndrome, and heart failure admission) at one year. Receiver operating characteristic curves and area under the curve were used to determine the 6MWD test's predictive power, and the Youden index was used to measure its effectiveness. A total of 212 patients were enrolled (98% men; mean age, 65 ± 9 yr). Major comorbidities were hypertension in 187 patients (88%), dyslipidemia in 186 (88%), and diabetes mellitus in 95 (45%). Among the 176 patients (83%) who completed the 6MWD test, the incidence of MACE at one year was 22% (acute coronary syndrome in 17%; heart failure admission in 4%; and death in 3%). The area under the curve for MACE was 0.59, and 6MWD was shorter for patients with MACE than for those without (290 vs 326 m; P =0.03). For 39 patients with previous heart failure who completed the 6MWD test, the area under the curve was 0.64 for MACE and 0.78 for heart failure admission. The 6MWD test predicted reasonably well the incidence of MACE one year after percutaneous coronary intervention. In a subgroup of patients with previous heart failure, it fared even better in predicting heart failure admission. Larger studies are needed to confirm these findings., (© 2020 by the Texas Heart® Institute, Houston.)

Purpose: To learn where pediatric physical therapists in the United States are in the process of knowledge translation of the Gross Motor Function Classification System (GMFCS)., Methods: Links to an online survey were distributed electronically., Results: All 283 respondents reported hearing about the GMFCS, 95% agreed it was useful, 81% reported they were confident in their ability to use it, 77% reported they use it, and 42% reported they use it consistently. Therapists primarily used the GMFCS to predict gross motor function, set realistic goals, and anticipate need for assistive technology. The American Physical Therapy Association Section on Pediatrics members were more likely than nonmembers to agree the GMFCS is useful, they are able to use it, that they use it, and that they use it consistently., Conclusions: The majority of therapists responding use the GMFCS, but not consistently., Video Abstract: For more insights from the authors, see Supplemental Digital Content 1, available at http://links.lww.com/PPT/A91.

In this paper we study sample size calculation methods for the asymptotic Wilcoxon-Mann-Whitney test for data with or without ties. The existing methods are applicable either to data with ties or to data without ties but not to both cases. While the existing methods developed for data without ties perform well, the methods developed for data with ties have limitations in that they are either applicable to proportional odds alternatives or have computational difficulties. We propose a new method which has a closed-form formula and therefore is very easy to calculate. In addition, the new method can be applied to both data with or without ties. Simulations have demonstrated that the new sample size formula performs very well as the corresponding actual powers are close to the nominal powers.