bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptance and Commitment Therapy for Chronic Pain: Does Post-traumatic Stress Disorder Influence Treatment Outcomes?
Authors: Herbert Matthew S , Malaktaris Anne L , Dochat Cara , Thomas Michael L , Wetherell Julie Loebach , Afari Niloofar 
Published: November 2018

AbstractObjectiveThe aim of this study was to determine whether post-traumatic stress disorder (PTSD) moderates treatment outcomes in Acceptance and Commitment Therapy for chronic pain.DesignLongitudinal.SettingVeterans Affairs San Diego Healthcare System.SubjectsA total of 126 veterans with chronic pain participating in an Acceptance and Commitment Therapy intervention for chronic pain. A structured clinical interview was used at baseline to designate PTSD-positive (N = 43) and -negative groups (N = 83).MethodsLinear mixed-effects models to determine whether PTSD moderated change in pain interference, pain severity, pain acceptance, depressive symptoms, or pain-related anxiety at post-treatment and six-month follow-up.ResultsParticipants with co-occurring PTSD reported greater pain interference, pain severity, depressive symptoms, and pain-related anxiety at baseline. PTSD status did not moderate treatment effects post-treatment. Rather, there were significant improvements on all study measures across groups (P &lt; 0.001). PTSD status moderated change in depressive symptoms at six-month follow-up (P &lt; 0.05). Specifically, participants with chronic pain alone demonstrated improvement in depressive symptoms compared with pretreatment levels, whereas participants with PTSD regressed to pretreatment levels.ConclusionsPTSD status did not significantly affect treatment outcomes, with the exception of depressive symptoms at six-month follow-up. Overall, Acceptance and Commitment Therapy for chronic pain appears helpful for improving outcomes among veterans with co-occurring PTSD; however, veterans with co-occurring PTSD may experience fewer long-term gains compared with those with chronic pain alone.
The geometry of corank 1 surfaces in ℝ4
Authors: Benedini Riul P , Ruas M A S , Oset Sinha R 
Published: November 2018

Abstract
We study the geometry of surfaces in ℝ4 with corank 1 singularities. For such surfaces, the singularities are isolated and, at each point, we define the curvature parabola in the normal space. This curve codifies all the second-order information of the surface. Also, using this curve, we define asymptotic and binormal directions, the umbilic curvature and study the flat geometry of the surface. It is shown that we can associate to this singular surface a regular one in ℝ4 and relate their geometry.
Methotrexate achieves major cDAPSA response, and improvement in dactylitis and functional status in psoriatic arthritis
Authors: Appani Sravan Kumar , Devarasetti Phani Kumar , Irlapati Rajendra Vara Prasad , Rajasekhar Liza 
Published: November 2018

AbstractObjectiveDespite the widespread clinical use of MTX in PsA, data from published randomized controlled studies suggest limited efficacy. The objective of the present study was to document the efficacy of MTX.MethodsThis was an open-label, prospective study of patients satisfying the ClASsification criteria for Psoriatic ARthritis study (CASPAR) criteria for PsA who received MTX in doses of ⩾15 mg/week throughout the follow-up period of 9 months. Disease activity was assessed across various domains by tender and swollen joint count, physician and patient global assessment, DAS-28 ESR, Clinical Disease Activity Index for PsA (cDAPSA), Leeds Dactylitis Instrument basic, Leeds Enthesitis Index (LEI), Psoriasis Area and Severity Index (PASI), Minimal Disease Activity and HAQ (CRD Pune version) at baseline and at 3, 6 and 9 months of follow-up. Response to therapy was assessed by EULAR DAS28 ESR, Disease Activity Index for PsA (cDAPSA) response, HAQ response and PASI75. MTX dose escalation and the use of combination DMARDS were dictated by disease activity.ResultsA total of 73 patients were included, with mean (s.d.) age 44 (9.7) years. The mean (s.d.) dose of MTX used was 17.5 (3.8) mg/week. Seven patients received additional DMARDS (LEF/SSZ). At the end of 9 months, significant improvement (P < 0.05) was noted in the tender joint count, swollen joint count, global activity, DAS-28ESR, cDAPSA, Leeds Dactylitis Index basic, LEI, PASI and HAQ. Major cDAPSA response was achieved in 58.9% of patients. EULAR DAS28 moderate and good response was achieved in 74% and 6.8% of patients, respectively. Minimal Disease Activity was achieved in 63% of patients. A PASI75 response and HAQ response was achieved in 67.9% and 65.8% of patients, respectively.ConclusionMTX initiated at ⩾15 mg/week with targeted escalation resulted in significant improvement in the skin, joint, dactylitis, enthesitis and functional domains of PsA.
Factors Associated With Marijuana Use Among Treatment-seeking Adult Cigarette Smokers in the Criminal Justice Population
Authors: Montgomery LaTrice , Schiavon Samantha , Cropsey Karen 
Published: November 2018

Objectives:
Due to the elevated rates of cigarette use and marijuana use within the criminal justice system, it is critical to develop a stronger understanding of tobacco and marijuana co-use among this population to inform future interventions.

Methods:
This study is a secondary analysis of baseline data from a smoking cessation randomized clinical trial of adults (n = 500) in a community correction program. Participants were classified as using cigarettes only or both cigarettes and marijuana through either self-report or positive urine drug screening. Demographics and measures regarding legal, drug use, smoking, mental health, and interpersonal histories were assessed. Logistic regression analyses were conducted to assess factors associated with co-use.

Results:
Among adults who smoked cigarettes, 25% reported current marijuana use. Individuals who used both cigarettes and marijuana were more likely than those who only used cigarettes to be African American (80%), male (73.6%), and younger (M = 32.4 [SD = 11.0]). Increasing difficulties with last quit attempt was associated with a reduction in the likelihood of co-use (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.60–0.94, P < 0.05), and benzodiazepine (OR 9.09, 95% CI 1.25–65.94, P < 0.05) and opioid (OR 8.17, 95% CI 2.03–32.93, P < 0.01) use was significantly associated with an increased likelihood of co-use.

Conclusions:
This study identified several factors that are associated with an increased risk of cigarette and marijuana co-use among a community correction population. These findings will be valuable for informing targeted prevention and treatment interventions.
Quality of Information Available Online for Abortion Self-Referral
Authors: Dodge Laura E. , Phillips Sharon J. , Neo Dayna T. , Nippita Siripanth , Paul Maureen E. , Hacker Michele R. 
Published: November 2018

OBJECTIVE:
To assess the quality of information available online for abortion self-referral and to determine whether quality varies by region or distance to an abortion provider.

METHODS:
This was a cross-sectional study. We used a standard protocol to perform internet searches from August 2016 to June 2017 for abortion services in the 25 most populous U.S. cities and the 43 state capitals that were not one of the 25 most populous cities. We classified the first 10 webpage results and the first five map results and advertisements as facilitating abortion referral (local independent abortion provider, local Planned Parenthood facility, national abortion provider or organization, prochoice website, or abortion directory), not facilitating abortion referral (nonproviding physician office, nonmedical website, abortion provider greater than 50 miles from the location, news article, general directory, other), or hindering abortion referral (crisis pregnancy center or antichoice website). We used U.S. Census Bureau subregions to examine geographic differences. We made comparisons using a χ2 test.

RESULTS:
Overall, from 612 searches from 68 cities, 52.9% of webpage results, 67.3% of map results, and 34.4% of advertisements facilitated abortion referral, whereas 12.9%, 21.7%, and 29.9%, respectively, hindered abortion referral. The content of the searches differed significantly based on U.S. Census Bureau subregion (all P≤.001) and distance to an abortion provider (all P≤.02).

CONCLUSION:
Two thirds of map results facilitated abortion self-referral, whereas only half of webpage results did so. Advertisements were the least likely to facilitate and the most likely to hinder self-referral. Quality was lowest in areas that were farthest from abortion providers.
Induced Abortion in a Population Entitled to Free-of-Charge Long-Acting Reversible Contraception
Authors: Gyllenberg Frida K. , Saloranta Tuire H. , But Anna , Gissler Mika , Heikinheimo Oskari 
Published: November 2018

OBJECTIVE:
To study the rate of induced abortion in a population in whom long-acting reversible contraceptive (LARC) methods are offered free of charge as part of primary health care services.

METHODS:
We conducted a register-based cohort study on females aged 15–44 years in the city of Vantaa, Finland. We assessed the rate of abortion among females entitled to LARC methods free of charge by survival analysis in four cohorts: those visiting public family planning clinics and initiating free-of-charge LARC methods during 2013–2014 (LARC cohort, n=2,035); those visiting public family planning clinics not choosing LARC methods (no LARC cohort, n=7,634); and three age-matched control participants for every LARC and no LARC participant from the general population not using the services (nonservice users, n=5,981 and 22,748). The patients were followed up by means of Finnish national registers until February 28, 2016.

RESULTS:
During the 78,500 woman-years accumulated, altogether 996 patients in Vantaa underwent an abortion (12.3 abortions/1,000 woman-years, 95% CI 11.6–13.1). Of these, 16 abortions occurred in the LARC cohort (3.9/1,000, 95% CI 2.4–6.0), 243 in the no LARC cohort (15.3/1,000, 95% CI 13.5–17.2), and 737 (12.6/1,000, 95% CI 11.7–13.5) among matched nonservice users. The adjusted abortion rate in the LARC cohort was 80% lower than in the no LARC cohort (risk ratio [RR] 0.20, 95% CI 0.11–0.32) and 74% lower than among their matched control participants (RR 0.26, 95% CI 0.15–0.43). In contrast, there was no difference in the abortion rate between the no LARC cohort and the control participants (adjusted RR 1.01, 95% CI 0.87–1.18).

CONCLUSION:
When providing a population with free-of-charge LARC methods, the abortion rate was markedly lower among patients initiating free-of-charge LARC compared with patients using the services but not initiating a LARC method. Programs of this kind could be of major importance in populations with high rates of unintended pregnancy.
An update on the nomenclature for cutaneous vasculitis
Authors: Caproni Marzia , Verdelli Alice 
Published: November 2018

Purpose of review
Cutaneous vasculitis reflects a spectrum ranging from skin limited to severe systemic forms. To date, there is still no generally acknowledged nomenclature for cutaneous vasculitis. This review aims to summarize the recent advances in the nomenclature of cutaneous vasculitis.

Recent findings
The most widely adopted vasculitis classification system is the one of 2012 Revised Chapel Hill Consensus Conference (CHCC) which represent not such a classification but a nomenclature system that name vasculitis on the basis of the size of the vessel affected. The CHCC 2012 did not deal with the special features of cutaneous vasculitis and did not explicitly discuss the presence of skin-limited or skin-dominant forms of vasculitis. Therefore, a consensus group was formed to propose an Addendum to CHCC 2012, focusing on cutaneous vasculitis. The Addendum better clarify the main aspects of some single-organ vasculitis, including IgM/IgG vasculitis, nodular vasculitis, erythema elevatum et diutinum and recurrent macular vasculitis in hypergammaglobulinemia. Moreover, it differentiated normocomplementemic from hypocomplementemic urticarial vasculitis. Finally, it recognized cutaneous polyarteritis nodosa as a distinct subtype of polyarteritis nodosa.

Summary
Classification criteria are useful tools to standardize names and definitions for cutaneous vasculitis; however, they do not represent diagnostic criteria. Collaborative efforts are still needed to get a shared classification and valid diagnostic criteria for cutaneous vasculitis.
Gross Motor Function Classification System Specific Growth Charts—Utility as a Risk Stratification Tool for Surgical Site Infection Following Spine Surgery
Authors: Baranek Eric S. , Maier Stephen P. , Matsumoto Hiroko , Hyman Joshua E. , Vitale Michael G. , Roye David P. , Roye Benjamin D. 
Published: November 2018

Background:
There is currently minimal evidence that preoperative malnutrition increases surgical site infection (SSI) risk in children with cerebral palsy (CP) undergoing spinal deformity surgery. Growth charts specifically for patients with CP have been created to aid in the clinical interpretation of body mass index (BMI) as a marker of nutritional status, but to our knowledge these charts have never been used to risk stratify patients before orthopaedic surgery. We hypothesize that patients with CP who have BMI-for-age below the 10th percentile (BMI≤10) on CP-specific growth charts are at increased risk of surgical site infection following spinal deformity surgery compared with patients with BMI-for-age above the 10th percentile (BMI>10).

Methods:
Single-center, retrospective review comparing the rate of SSI in patients with CP stratified by BMI-for-age percentiles on CP-specific growth charts who underwent spinal deformity surgery. Odds ratios with 95% confidence intervals and Pearson χ2 tests were used to analyze the association of the measured nutritional indicators with SSI.

Results:
In total, 65 patients, who underwent 74 procedures, had complete follow-up data and were included in this analysis. Ten patients (15.4%) were GMFCS I-III and 55 (84.6%) were GMFCS IV-V; 39 (60%) were orally fed and 26 (40%) were tube-fed. The rate of SSI in this patient population was 13.5% with 10 SSIs reported within 90 days of surgery. There was a significant association between patients with a BMI below the 10th percentile on GMFCS-stratified growth charts and the development of SSI (OR, 13.6; 95% CI, 2.4-75.4; P=0.005). All SSIs occurred in patients that were GMFCS IV-V. There was no association between height, weight, feeding method, or pelvic instrumentation and development of SSI.

Conclusions:
CP-specific growth charts are useful tools for identifying patients at increased risk for SSI following spinal instrumentation procedures, whereas standard CDC growth charts are much less sensitive. There is a strong association between preoperative BMI percentile on GMFCS-stratified growth charts and SSI following spinal deformity surgery.

Level of Evidence:
Level III—Retrospective Study.
Bridging Continuing Medical Education and Quality Improvement Efforts: A Qualitative Study on a Health Care System in the Kingdom of Saudi Arabia
Authors: Alsabban Wid , Kitto Simon 
Published: November 2018

Introduction:
There have been initial efforts to link continuing medical education (CME), quality improvement (QI), and patient safety in North America. However, limited empirical research has been performed to characterize the relationship and integration between CME and QI/patient safety in the Kingdom of Saudi Arabia (KSA). To explore health care leaders' perceptions and experiences of collaboration between the CME department (CME-D) and the quality management administration (QMA), we conducted an exploratory qualitative study at a large governmental health care center – King Abdullah Medical City (KAMC) in Makkah, KSA.

Methods:
The health care managers at KAMC were asked to identify their perception on the state of collaboration between the CME-D and QMA. Data collection, in the form of one-to-one semistructured interviews, was directed by an interview guide. Interviews were transcribed verbatim, and the participants' perspectives were analyzed thematically using a theoretical framework.

Results:
Fifteen participants were recruited: one top manager of the CME-D, three top managers from the QMA, seven representatives from the medical board, and four representatives from the executive board. Key findings of the interviews were the presence of some shared ad hoc goals between the CME-D and QMA. However, insufficiency of other collaborative factors reflected a “potential collaboration” (level 1) based on D'Amour's model of collaboration.

Discussion:
This is the first qualitative study to explore the perceptions and experiences of CME and QI health care managers on their collaboration at one of the largest health centers in the KSA. Further research should investigate the feasibility of implementing interventions to intensify collaboration between CME and QI.
Multiple Pilomatricomas: A Retrospective Study and Literature Review
Authors: Mesa-Álvarez Laura , Batalla Ana , Iglesias-Puzas Álvaro , Álvarez Carlos , Flórez Ángeles 
Published: November 2018

Abstract:
Pilomatricoma is usually a single lesion. However, some patients present with more than one, a fact that has been reported in association with several systemic diseases. The aim of this analysis is to determine the prevalence of multiple pilomatricomas (MP) in our institution as well as to describe their clinical features and associated comorbidities. This is a retrospective analysis reviewing patients with a histological diagnosis of pilomatricoma registered in the database of the Pathology Department of our institution, from January 2005 to March 2017. One hundred ninety-five patients with histological criteria for pilomatricoma were registered. Fourteen (0.7%) of those patients suffered from MP. Among them, the most relevant findings were: 9 (64%) patients were women and 5 (36%) were men. The median age at diagnosis was 16 years. Seven (50%) had 2 pilomatricomas and 7 (50%) had more than 2. Two (14%) suffered from Steinert myotonic dystrophy (SMD). Regarding family background, 3 of them had relatives with pilomatricomas, one of them with pancreatic cancer, and another one with SMD. A total of 36 pilomatricomas were excised from those 14 patients with the following characteristics: The mean lesion size was 12 mm. The majority of the lesions (53%) were located on the head and neck. There was no recurrence or malignant transformation in any patient. Articles reporting on MP are scarce. We communicate 2 new familial MP without associated comorbidities. We would like to highlight that 2 of our patients with MP also developed SMD, an association previously reported. Thus, a thorough physical examination and inquiring about family history are of utmost importance for an early diagnosis of possible associated diseases.
A Rare Chest Wall Deformity after Usage of a Tissue Expander for Breast Reconstruction
Authors: Kuramoto Yukiko , Yano Tomoyuki , Sawaizumi Masayuki , Tanakura Kenta , Miyashita Hiroki 
Published: November 2018

Summary:
A 2-stage breast reconstruction using a breast tissue expander and prosthesis is a simple method of breast reconstruction with little donor-site morbidity and short surgery time. In this report, we present a rare case of chest wall deformity, which appeared during breast skin expansion with tissue expander. We present a case of a 31-year-old woman who underwent a 2-stage breast reconstruction with a tissue expander and breast prosthesis. She had a former history of autologous microtia reconstruction using costal cartilages to create a framework of the ear at the age of 10. During expansion, the woman developed an abnormal hollowing of the chest wall. Even though it was difficult to select an ideal size for the breast prosthesis, an excellent breast shape was obtained by measuring the actual breast projection that we needed, using ultrasound sonography. The patient was satisfied with the final result. In this case, the patient suffered from a postoperative chest wall deformity due to cartilage harvesting. This unfavorable result highlights the need for careful preoperative evaluation of risk factors that may lead to chest wall deformity when patients will have tissue expansion as a part of breast reconstruction. When thoracic deformity occurs, surgeons should realize that choosing an adequate implant becomes rather difficult. Ultrasound sonography helps surgeons in measuring the actual breast projection preoperatively.
RANIBIZUMAB 0.5 MG TREATMENT IN ADOLESCENTS WITH CHOROIDAL NEOVASCULARIZATION: SUBGROUP ANALYSIS DATA FROM THE MINERVA STUDY
Authors: Hykin Philip G. , Staurenghi Giovanni , Wiedemann Peter , Wolf Sebastian , Liew Shiao Hui Melissa , Desset-Brethes Sabine , Staines Harry , Li Jun , Lai Timothy Y. Y. ,   on behalf of the MINERVA study group
Published: November 2018

Purpose:
To evaluate the efficacy and safety of ranibizumab 0.5 mg in adolescent patients with any choroidal neovascularization etiology enrolled in the 12-month MINERVA study.

Methods:
In the open-label, non-randomized study arm, ranibizumab 0.5 mg was administered to five adolescents (aged 13–17 years). The findings were assessed descriptively as individual case reports at Month 12. Best-corrected visual acuity changes, central subfield thickness, treatment exposure, and safety were described over 12 months.

Results:
Baseline choroidal neovascularization etiologies of the study eye included choroidal neovascularization secondary to Best disease (n = 2), idiopathic chorioretinopathy (n = 2), and optic disk drusen (n = 1). At Months 2, 6, and 12, the observed mean best-corrected visual acuity changes in the study eye from baseline were +9.2, +16.6, and +16.6 letters, respectively, and the observed mean central subfield thickness change from baseline was −31.4, −87.6, and −116.4 μm, respectively. Adolescent patients received a mean of three (range, 2–5) ranibizumab injections in the study eye. No adverse events or serious adverse events related to ranibizumab were reported.

Conclusion:
Ranibizumab 0.5 mg treatment was beneficial in improving visual acuity and stabilizing or reducing central subfield thickness in five adolescents with differing choroidal neovascularization etiologies requiring infrequent injection. No new safety findings were observed over 12 months.
BULL'S EYE MACULOPATHY POSSIBLY DUE TO IRON OVERLOAD IN A CHILD WITH THALASSEMIA MAJOR: A CASE OF POSSIBLE “FERRITIN RETINOPATHY”
Authors: Abraham Anina 
Published: November 2018

Purpose:
To report a case of bull's eye maculopathy probably caused by iron overload in a child with thalassemia major.

Methods:
Case report.

Results:
A 6-year-old girl with thalassemia major who was on chronic multiple blood transfusions since 2 years of age presented with blurred vision in both eyes for 2 months. Blood reports showed very high serum ferritin levels in the range 400 to 2,250 ng/mL (checked every 3 months) since 4 years of age. She was on oral iron chelator deferasirox for 2 years, which was stopped a month ago. Fundus examination of both eyes showed a characteristic bull's eye macula with a purplish hue in the outer ring probably due to iron deposition. The center of the bull's eye had a beaten bronze appearance.

Conclusion:
Careful history-taking is important in children with bull's eye maculopathy because all such retinopathies need not be hereditary fundus dystrophies. Further progression can be arrested by identifying and removing the cause vision loss.