bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Much Is Too Much? Estimating Effective Price-Hikes to Affect Smoking Behavior in Vietnam
Authors: Tran Binh Thang , Tran Dinh Trung , Nguyen Khac Minh , Nguyen Xuan Trinh Thi , Lim Min Kyung , Cho Sung-il , Oh Jin-Kyoung 
Published: February 2019

Abstract

Introduction
Raising the price of cigarettes is one of the most effective strategies to reduce cigarette smoking. The Vietnamese government is working toward the tobacco control goal of a 10% reduction in smoking prevalence by 2020. However, cigarette prices in Vietnam have not increased in the last two decades. The aim of this study was to estimate what cigarette prices would make smokers attempt to quit smoking, and to identify predictors of the price to quit and the intention to quit.

Methods
A cross-sectional survey was conducted with 822 male current smokers in Da Nang, Vietnam. A structured questionnaire was adapted from the International Tobacco Control project survey. Bayesian quantile regression was applied to predict factors associated with expected cigarette price.

Results
Fifty-six percent of smokers suggested a price to quit. Their median suggested price to quit per pack, 62 000 VND (2.8 USD), was 2.8 times higher than the actual current price, 22 000 VND (1.01 USD). Suggesting a lower price to quit was significantly associated with awareness of warning labels and smoke-free policies. In contrast, being a heavy smoker was significantly associated with a higher suggested price to quit across all quantiles.

Conclusions
There may be sufficient room to increase cigarette prices in Vietnam. The price to quit is associated with various factors, including non-pricing policies.

Implications
Evidence suggests that a steep increase in cigarette prices, setting a high minimum tax, and introducing a large specific tax, which are policy-induced price increases that can raise prices substantially in Vietnam, are preferable strategies. In addition to increasing price and taxes, the government should also strengthen non-pricing policies.
Psychometric Evaluation of 2 New Upper Extremity Functional Strength Tests in Children With Cerebral Palsy
Authors: Dekkers Koen J F M , Smeets Rob J E M , Janssen-Potten Yvonne J M , Gordon Andrew M , Speth Lucianne A W M , Rameckers Eugene A A 
Published: February 2019

Abstract

Background
For children with unilateral spastic cerebral palsy (USCP), reduced muscle strength can lead to activity limitations. However, none of the existing measures of upper extremity strength measure strength in the context of functional activities in which strength must be maintained for several seconds.

Objective
The objective of this study was to evaluate the psychometric properties of 2 newly developed functional hand and upper extremity muscle-strength tests (Cup-Task and Box-Task) in children aged 7 to 12 years with USCP.

Design
A longitudinal study design was used.

Methods
A standardized protocol with detailed descriptions of all procedures and measurements was used to determine test-retest reliability, interrater reliability, and criterion validity.

Results
A total of 86 children (53 males, 33 females, mean age = 9.3 years) with USCP participated in this study, with a subset performing each measurement. Only the results of children who were able to perform the measurement were included for analysis. Excellent test-retest reliability (intraclass correlation coefficients = 0.887–0.944; 95% confidence intervals = 0.713–0.969) and interrater reliability (intraclass correlation coefficients = 0.896–0.960; 95% confidence intervals = 0.813–0.980) were observed. The Cup-Task Affected-Hand and Box-Task were moderately correlated with maximum isometric grip strength. The Cup-Task Nonaffected-Hand had a low correlation with maximum isometric grip strength.

Limitations
Age, sex, and manual ability were not normally distributed, which could have influenced the results.

Conclusions
For children with USCP who can perform the tasks, the Cup-Task and Box-Task are reliable and valid instruments for measuring functional upper extremity muscle strength.
“Everything that I’ve Done Has Always Been Multiethnic”: Biographical Work among Leaders of Multiracial Churches
Authors: Okuwobi Oneya Fennell 
Published: February 2019

AbstractBiographical work is the process of shaping a cohesive life story by selectively giving meaning to past events. The resulting biographies are not simple recitations of life events but narratives that illuminate what is valued in a person’s social context and how the person makes sense of life events and experiences over time. Drawing on 121 interviews from the Religious Leadership and Diversity Project (RLDP), this article investigates biographical work among head clergy of multiracial churches. I find that pastors of multiracial churches pattern their biographies after two predominant formula stories, laying claim to being people who are experienced with diversity and/or experienced with racial injustice. These formula stories reveal institutionalized understandings of biographies acceptable for pastors of multiracial churches that cut across denominational lines. The biographies of these leaders also reveal a shift toward diversity and away from recognition of racial injustice that has implications for the racial structure.
Advances in the pathogenesis representing definite outcomes in chronic urticaria
Authors: Ensina Luis Felipe , Cusato-Ensina Ana Paula , Cardona Ricardo 
Published: February 2019

Purpose of review
We reviewed in this article, the recent advances in CSU physiopathology and potential clinical and laboratory biomarkers in CSU.

Recent findings
In addition to the central role of mast cells in urticaria physiopathology, increased interest in basophils has arisen. Recent data corroborate the autoimmunity pathway as one of the main pathways in mast cell activation. The association of inflammatory cytokines, heat shock proteins and staphylococcal infection with CSU are also reviewed. C-reactive protein, D-dimers, autologous serum skin test, IgE levels and FcεRI expression in basophils have shown their potential as biomarkers for disease duration, activity, severity and/or response to treatment.

Summary
A comprehensive understanding of chronic spontaneous urticaria mechanisms is essential to find novel biomarkers and treatments. The use of these biomarkers in clinical practice will guide us in choosing the best treatment option for our patients.
High-Value Care Culture Among the Future Physician Workforce in Internal Medicine
Authors: Gupta Reshma , Steers Neil , Moriates Christopher , Wali Soma , Braddock Clarence H. , Ong Michael 
Published: February 2019

Purpose
Training in high-spending regions correlates with higher spending patterns among practicing physicians. This study aimed to evaluate whether trainees’ exposure to a high-value care culture differed based on type of health system in which they trained.

Method
In 2016, 517 internal medicine residents at 12 California graduate medical education programs (university, community, and safety-net medical centers) completed a cross-sectional survey assessing perceptions of high-value care culture within their respective training program. The authors used multilevel linear regression to assess the relationship between type of medical center and High-Value Care Culture Survey (HVCCS) scores. The correlation between mean institutional HVCCS and Centers for Medicare and Medicaid Services’ Value-Based Purchasing (VBP) scores was calculated using Spearman rank coefficients.

Results
Of 517 residents, 306 (59.2%), 83 (16.1%), and 128 (24.8%) trained in university, community, and safety-net programs, respectively. Across all sites, the mean HVCCS score was 51.2 (standard deviation [SD] 11.8) on a 0–100 scale. Residents reported lower mean HVCCS scores if they were from safety-net-based training programs (β = −4.4; 95% confidence interval: −8.2, −0.6) with lower performance in the leadership and health system messaging domain (P < .001). Mean institutional HVCCS scores among university and community sites positively correlated with institutional VBP scores (Spearman r = 0.71; P < .05).

Conclusions
Safety-net trainees reported less exposure to aspects of high-value care culture within their training environments. Tactics to improve the training environment to foster high-value care culture include training, increasing access to data, and improving open communication about value.
Looking to the Future: Medical Students’ Views on Health Care Reform and Professional Responsibility
Authors: Rook Jordan M. , Winkelman Tyler N.A. , Fox Jacob A. , Pierce Jacob B. , Oot Antoinette R. , Blum James R. , Feuerbach Alec M. , Shahu Andi , Goldman Max L. , Kopp Zoe , Duffy Eamon , Robledo-Gil Talia , Tran Nhi , Davey Cynthia S. , Henschen Bruce L. 
Published: February 2019

Purpose
Although medical students will influence the future U.S. health care system, their opinions on the Patient Protection and Affordable Care Act (ACA) have not been assessed since the 2016 presidential election and elimination of key ACA provisions. Understanding medical students’ views on health care policy and professional obligations can provide insight into issues that will be shaped by the next generation of physicians.

Method
From October 2017 to November 2017, the authors conducted an electronic survey of medical students from seven U.S. institutions to elicit opinions regarding the ACA and their professional responsibility to address health policy. Participant demographics and responses were tabulated, and multiple logistic regression models were used to assess the associations of demographic characteristics with student opinions.

Results
Completed surveys were returned by 1,660/4,503 (36.9%) eligible medical students. Respondent demographics were similar to national estimates. In total, 89.1% (1,475/1,660) supported the ACA, and 82.0% (1,362/1,660) reported that they understood the health care law. Knowledge of the law’s provisions was positively associated with support for the ACA (P < .001). Most students (85.8%; 1,423/1,660) reported addressing health policy to be a professional responsibility. Political affiliation was consistently associated with student opinions.

Conclusions
Most medical students support the ACA, with greater levels of support among medical students who demonstrated higher levels of objective knowledge about the law. Furthermore, students indicated a professional responsibility to engage in health policy, suggesting that tomorrow’s physicians are likely to participate in future health care reform efforts.
Massage and Medicine: An Interprofessional Approach to Learning Musculoskeletal Anatomy and Enhancing Personal Wellness
Authors: Hoffmann Darren S. , Dancing Dede , Rosenbaum Marcy 
Published: February 2019

PurposeTo investigate the impact of a unique curriculum combining learning of surface anatomy and massage therapy for medical and physician assistant students.MethodThe authors conducted a randomized controlled trial in 2014 at University of Iowa Carver College of Medicine with 20 first-year students who viewed 4 hours of educational videos and participated in 11 hours of hands-on massage practice and 20 first-year students who only viewed the educational videos. Participants completed pre- and postcourse assessments of knowledge, attitudes, and personal wellness and completed a validated assessment of four dimensions of personal wellness.ResultsHands-on group participants outscored the online-only group in postcourse knowledge assessments of surface anatomy and massage therapy principles (P< .05). Students in the hands-on group reported higher agreement with statements about perceived knowledge and beliefs about referrals and advising patients regarding massage therapy (P< .05). Students also frequently reported greater comfort administering physical examinations. Hands-on group participants had statistically significant improvements in psychological wellness during the study (P= .03), whereas online-only participants had a slight decrease (P= .09). Physical wellness was also slightly improved in the hands-on group (P= .06).ConclusionsFindings show that integrating surface anatomy and massage therapy in an experiential course resulted in significant gains in knowledge of anatomy, understanding about interprofessional health care roles, increased confidence in clinical practice, and improved wellness. Accordingly, further development of learning experiences that incorporate basic science, interprofessional education, and techniques that promote student wellness should be encouraged.
Mapping the Mission Statements of U.S. LCME-Accredited Medical Schools: An Exploration of Organizational Communalities
Authors: Hafferty Frederic W. , Grbic Douglas , Hafferty Philip K. 
Published: February 2019

Purpose
Mission statements (MSs) express an organization’s purpose and reflect the broader social environment in which they function. The authors analyze MS text to explore how medical schools can be relationally viewed and how particular thematic narratives within MSs can be deployed to associate schools in hithertofore unexplored ways.

Method
The authors analyzed the MSs (as of 1/1/2017) of 144 U.S. Liaison Committee on Medical Education–accredited schools. Using schools as their unit of analysis, they coded MSs using 44 themes. They employed content analysis to identify themes within MSs, factor analysis to identify core thematic dimensions embedded in MSs, and network analysis to examine relationships among schools based on these thematic dimensions. The authors used four standard school characteristics to examine the validity of their results.

Results
Content analysis revealed 20 core themes. Factor analysis identified four thematic dimensions: Primary Care/Diversity; Future Learning–External; Traditional; and Learning Environment–Internal. Based on the 20 core themes and using the MSs of 125 schools with nonextreme MS code counts, the authors found that schools form a complete network, and that schools form distinctive network-based clusters based on the identified factors. The four thematic dimensions were significantly differentiated across the four standard school characteristics.

Conclusions
The authors found distinctive patterns of MS linkages among schools along with thematic linkages within MS themes, supporting the contentions that medical schools can be both differentiated and connected based on their MSs and that understanding MS content must move beyond simple frequency counts of MS attributes.
Understanding the Pathophysiology, Implications, and Treatment Options of Patent Ductus Arteriosus in the Neonatal Population
Authors: Conrad Cristin , Newberry Desi 
Published: February 2019

Background:
Patent ductus arteriosus (PDA) is the persistence of a fetal shunt between the pulmonary artery and the aorta. This structure normally closes in the first 3 days after birth; however, closure is delayed in up to 80% of infants born at 25 to 28 weeks of gestation. Persistent PDA results in pulmonary overcirculation and systemic hypoperfusion.

Purpose:
The purpose of this article is to review pathophysiology and treatment options for PDA.

Methods:
A literature review was conducted using PubMed, CINAHL, and Google Scholar (2013-2018). Search terms included neonate, PDA, pathophysiology, pharmacotherapy, nursing, ligation, indomethacin, ibuprofen, and acetaminophen (paracetamol).

Results:
Optimal treatment remains contentious. Options include conservative/medical, pharmacologic, and surgical management. Conservative/medical management includes mild fluid restriction, increased airway pressures, and supportive care. Pharmacologic treatment is accomplished using indomethacin, ibuprofen, or acetaminophen. Surgical intervention is by direct closure or by percutaneous ligation. Treatment may be prophylactic, presymptomatic, or symptomatic. Long-term morbidities associated with PDA include chronic lung disease, retinopathy of prematurity, and neurodevelopmental delay.

Implications for Research:
Absence of a universal scoring system for severity of PDA limits accuracy of comparisons among research studies. Lack of a consistent definition also makes it difficult to aggregate data for meta-analyses. Adoption of a consistent scoring system for hemodynamic significance would facilitate comparisons of outcomes among research studies.

Implications for Practice:
Clinicians should be aware of treatment options for PDA and their implications on neonatal outcomes. For nurses, anticipation of possible side effects is important for performance of focused assessments.
Humeral Simple Bone Cysts: Observational Versus Interventional Management
Authors: Green Natalie M. , Pagkalos Joseph , Jeys Lee M. , Stevenson Jonathan D. , Gregory Jonathan J. 
Published: February 2019

Aims:
Our study aims to review the outcomes of conservative and interventional management of simple bone cysts (SBC) in the humerus.

Methods:
We retrospectively reviewed our center’s prospectively collected database. All patients with a diagnosis of a humeral SBC and a minimum of 1-year follow-up or complete healing and discharge within the first year were included. Cyst radiographic measurements were collected for all patients with available radiographs. A successful outcome included fully or partially healed cysts with persistent and recurrent cysts marked as unsuccessful.

Results:
In total, 91 patients were included in the study. Within the observational group, 44 patients (95.7%) achieved a successful outcome versus 38 patients (84.4%) in the interventional group. The 15/61 (25%) patients who were treated with observation at presentation required intervention at a later stage. The 9/30 (30%) of patients who had intervention at presentation required further additional intervention. Seven patients (11%) presenting with a fracture through a SBC went on to complete consolidation of the cystic lesion following the injury at a mean of 92.9 days (maximum, 176 d).

Conclusions:
We observed similar outcomes with conservative and interventional management in our retrospective series. We recommend observational management when a radiologic diagnosis is possible with intervention reserved for cases of diagnostic uncertainty and intrusive symptoms.

Level of Evidence:
Level III—a retrospective case comparison study.
Perioperative Ketorolac for Supracondylar Humerus Fracture in Children Decreases Postoperative Pain, Opioid Usage, Hospitalization Cost, and Length-of-Stay
Authors: Adams Alexander J. , Buczek Matthew J. , Flynn John M. , Shah Apurva S. 
Published: February 2019

Background:
There is a need for improved opioid stewardship in orthopedic surgery through multimodal analgesia strategies. Perioperative administration of ketorolac in children undergoing closed reduction and percutaneous pinning (CRPP) for displaced supracondylar humerus (SCH) fracture may decrease pain, reduce opioid requirements, and decrease hospitalization costs.

Methods:
Retrospective case-control investigation of children (aged, 1 to 14) treated with CRPP for closed, modified Gartland type III extension-type SCH fractures at a single children’s hospital between 2011 and 2017. Patients that received ketorolac perioperatively (cases) were randomly matched 1:2 by sex and age (±1 y) with patients that did not receive ketorolac (controls). Data abstraction included demographic and perioperative details including inpatient Wong-Baker FACES pain ratings and analgesic requirements. Analysis included 2-tailed Mann-Whitney U and χ2 tests.

Results:
In total, 342 patients were studied including 114 cases and 228 controls. Age (mean, 6.2±2.4 y), sex ratio (M:F, 1.28:1), operative time, and number of pins used were equivalent between groups. Mean pain rating at 0 to 29 minutes postoperatively was lower in the ketorolac group (0.7±1.9) than in controls (1.4±2.6, P=0.017), as well as at 30 to 120 minutes postoperatively (1.1±2.3 and 1.7±2.8, respectively, P=0.036), as seen in Figure 1. Patients in the ketorolac group received a lower number of inpatient oxycodone doses (1.0±0.6) than control patients (1.2±0.5, P=0.003). Mean postoperative length-of-stay (LOS) was 50.0% longer for control patients (20.4±11.3 h) than the ketorolac patients (13.6±8.8 h, P<0.001). Ketorolac administration was associated with 40.4% lower inpatient hospitalization cost compared to control patients, providing a 33.8 times return on investment. There was no difference in the 90-day complication rate between patient groups (P=0.905).

Conclusions:
The complementary administration of ketorolac reduces postoperative pain and opioid use in children with displaced supracondylar humerus fractures. Perioperative ketorolac is also associated with reduced LOS following CRPP for supracondylar humerus fractures and offers significant cost savings opportunities.

Level of Evidence:
Level 3—Therapeutic: Case-Control Study.
Evolution of the Picosecond Laser: A Review of Literature
Authors: Torbeck Richard L. , Schilling Laura , Khorasani Hooman , Dover Jeffrey S. , Arndt Kenneth A. , Saedi Nazanin 
Published: February 2019

BACKGROUND
Picosecond pulse duration lasers (PS) have altered the field of dermatology. PS were initially used in tattoo removal, to optimize efficacy and reduce side effects with nanosecond domain lasers. More recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring, and photoaging.

OBJECTIVE
In this article, we critically analyze the published data on the many uses of picosecond lasers in dermatology.

MATERIALS AND METHODS
A systematic review of PubMed was conducted using the following search terms: “picosecond,” “picosecond laser,” “picosecond laser dermatology,” “picosecond laser pigment/pigmentation,” and “picosecond laser tattoo removal.” Articles ranged from 1988 until 2017.

RESULTS
Forty-one articles were identified, and 27 met inclusion criteria for review. Indications for the PS included a variety of dermatologic applications include tattoo removal, benign pigmented lesions/pigmentary disorders, acne scarring, and photoaging. Most studies demonstrated safe and effective treatment.

CONCLUSION
The development of the picosecond pulse duration is a breakthrough innovation in laser technology, changing the scope of laser treatment. Encouraging findings in tattoo pigment clearance spurred the use of PS in a wider array of dermatologic issues. The increasingly positive results and low incidence of adverse effects further substantiates PS efficacy for a variety of dermatologic uses.
Safety Studies in the Field of Liposuction: A Systematic Review
Authors: Halk Anne B. , Habbema Louis , Genders Roel E. , Hanke C. William 
Published: February 2019

BACKGROUND
There is an increasing demand for safety standards for cosmetic treatments. With regard to liposuction, interdisciplinary consensus is lacking, especially regarding treatment setting and physician specialty.

OBJECTIVE
A solid, independent interpretation of scientific data on safety requires a systematic approach, which is the aim of this study.

METHODS
A systematic literature search was conducted for safety studies about liposuction through April 2017. Fatalities and/or reported serious adverse events served as outcome measures for safety.

RESULTS
Twenty-four studies were included. Factors that contributed to increased serious complication and mortality risk were: use of the (super)wet technique; use of systemic anesthetics, especially general anesthesia and intravenous sedation; execution by a plastic surgeon; execution in an operating room; and combination with other procedures.

CONCLUSION
Liposuction using tumescent local anesthesia has been shown to be the safest method of fat removal, especially if no or only minimal systemic anesthesia is used. Performance of this technique in an office-based setting has been proven to be safe beyond doubt. When systemic anesthesia is used, an outpatient or ambulatory surgery facility seems also safe. Regardless of the physician specialty, knowledge and training on the execution of the tumescent procedure are vital to ensure optimal safety.