bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Endoscopic Dacryocystorhinostomy in Secondary Acquired Nasolacrimal Duct Obstruction: A Case–Control Study
Authors: Sweeney Adam R. , Davis Greg E. , Chang Shu-Hong , Amadi Arash J. 
Published: December 2016

Introduction:
Secondary acquired nasolacrimal duct obstruction (SANDO), where the obstruction is caused by a known process, is becoming more commonly treated by endoscopic dacryocystorhinostomy (endoDCR). This study evaluates outcomes of endoDCR for cases of SANDO in comparison to endoDCR outcomes treating primary acquired nasolacrimal duct obstruction (PANDO).

Methods:
All patients undergoing endoDCR from 2006 to 2015 at a tertiary referral center were reviewed for etiology of nasolacrimal duct obstruction (NLDO) and success of procedure. Inclusion criteria were preoperative determination of NLDO via probing and irrigation, greater than 60-day follow up with assessment of duct patency via probing and irrigation after silicone tube removal, and postoperative survey for recurrent epiphora. Exclusion criteria were cases treating partial NLDO, patients undergoing concurrent conjunctivodacryocystorhinostomy, and patients lost to follow up or with incomplete records. Preanalysis stratification was performed for the following preexisting conditions: PANDO, granulomatosis with polyangiitis, sarcoidosis, midfacial radiotherapy, radioactive iodine therapy, severe prolonged sinusitis, prior failed DCR, and midface trauma. The primary outcome was postoperative anatomical patency of the nasolacrimal system with resolution of epiphora. Fisher–Freeman–Halton exact tests were performed comparing each SANDO group to the PANDO group with statistical significance set at p < 0.05.

Results:
Fifty-nine cases of NLDO underwent endoDCR in this series, 21 of which had a diagnosis consistent with SANDO. All patients treated with the aggressive perioperative management protocol the authors describe achieved anatomical patency. Patients with history of radioactive iodine therapy and radiotherapy had statistically worse outcomes compared with patients with PANDO, p = 0.011, p = 0.045, respectively. Stratified groups with increased intranasal sinus inflammation trended toward worse outcomes, but were not statistically different.

Conclusions:
EndoDCR is a viable approach for the treatment of SANDO. In patients with history of radiotherapy or radioactive iodine therapy, however, endoDCR demonstrated decreased success rates as compared with patients with PANDO. Modifications of operative and postoperative management based on underlying etiology of NLDO may improve outcomes of endoDCR in SANDO cases. The authors describe an aggressive protocol for perioperative management of patients with pathologic nasal inflammation undergoing endoDCR.
Brief telephone-delivered cognitive behavioral therapy targeted to parents of children with functional abdominal pain: a randomized controlled trial
Authors: Levy Rona L. , Langer Shelby L. , van Tilburg Miranda A.L. , Romano Joan M. , Murphy Tasha B. , Walker Lynn S. , Mancl Lloyd A. , Claar Robyn L. , DuPen Melissa M. , Whitehead William E. , Abdullah Bisher , Swanson Kimberly S. , Baker Melissa D. , Stoner Susan A. , Christie Dennis L. , Feld Andrew D. 
Published: December 2016

Abstract
Pediatric functional abdominal pain disorders (FAPDs) are associated with increased health care utilization, school absences, and poor quality of life (QoL). Cost-effective and accessible interventions are needed. This multisite study tested the effects of a 3-session cognitive behavioral intervention delivered to parents, in-person or remotely, on the primary outcome of pain severity and secondary outcomes (process measures) of parental solicitousness, pain beliefs, catastrophizing, and child-reported coping. Additional outcomes hypothesized a priori and assessed included functional disability, QoL, pain behavior, school absences, health care utilization, and gastrointestinal symptoms. The study was prospective and longitudinal (baseline and 3 and 6 months' follow-up) with 3 randomized conditions: social learning and cognitive behavioral therapy in-person (SLCBT) or by phone (SLCBT-R) and education and support condition by phone (ES-R). Participants were children aged 7 to 12 years with FAPD and their parents (N = 316 dyads). Although no significant treatment effect for pain severity was found, the SLCBT groups showed significantly greater improvements compared with controls on process measures of parental solicitousness, pain beliefs, and catastrophizing, and additional outcomes of parent-reported functional disability, pain behaviors, child health care visits for abdominal pain, and (remote condition only) QoL and missed school days. No effects were found for parent and child-reported gastrointestinal symptoms, or child-reported QoL or coping. These findings suggest that for children with FAPD, a brief phone SLCBT for parents can be similarly effective as in-person SLCBT in changing parent responses and improving outcomes, if not reported pain and symptom report, compared with a control condition.
Significant Improvement of Mobility Recovery in Acute Care Patients After Total Knee Arthroplasty With Liposomal Bupivacaine Injectable Suspension
Authors: Kirkness Carmen S. , Ren Jinma , Asche Carl V. 
Published: December 2016

Purpose:
The study objective was to compare the walking distance after total knee arthroplasty (TKA) between patients who received liposomal bupivacaine (LB) or a femoral knee block (control group) for pain control in the acute care setting and explore clinical and patient factors related to walking distance.

Methods:
This study included patients with a TKA between October 2011 and April 2014. The LB group was determined and matched to a control group using propensity scores. Clinical and patient factors were also evaluated in multivariable modeling.

Results:
A total of 268 patients received 1520 physical therapy visits. Compared with the control group, the LB group had 98 fewer physical therapy visits, had a significantly shorter hospital length of stay (mean, 3.1; standard deviation, 1.7; vs mean, 3.6; standard deviation, 1.6; P < .05), on the day of surgery had 7 times more patients walked and walked a farther distance (4.4; 95% confidence interval, 2.6-7.5 m; vs 2.6; 95% confidence interval, 1.5-4.4 m; P < .01). Aside from the type of pain management, clinical and patient characteristics significantly influenced the distance walked.

Conclusion:
Patients' recovery of mobility after TKA was dependent on the type of pain management, the clinical and patient factors. These findings will aid in the personalization of patient treatment plans after TKA.
Accelerating Research Impact in a Learning Health Care System
Authors: Kilbourne Amy M. , Elwy A. Rani , Sales Anne E. , Atkins David 
Published: December 2016

Background:
Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice.

Objectives:
With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA’s transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act.

Design:
QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations.

Results:
QUERI’s national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law’s further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks.

Conclusions:
Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health.
Impact of State Legislation on Hospital Breastfeeding Support in New York
Authors: Dennison Barbara A. , Nguyen Trang Q. , Xu Changning , Fan Wei , Jurkowski Janine M. 
Published: December 2016

Objective:
The purpose of this study was to evaluate whether 2 state mandates, both implemented in 2010, had an impact on NY hospitals providing maternity care. Specifically, we measured changes in hospital staff's awareness, attitudes, and promotion of breastfeeding (BF), maternity care practices, and hospital breastfeeding policies and tested whether they were related to implementation of the Breastfeeding Mothers' Bill of Rights or the mandate for public reporting of hospital-specific BF measures.

Design:
In 2009 and 2011, written hospital BF policies were collected and evaluated using a 28-item review tool and hospital BF surveys were conducted. The surveys assessed hospital culture and staff attitudes associated with BF promotion and support and recommended maternity care practices.

Setting and Participants:
NY hospitals providing maternity care services and hospital staff.

Main Outcomes Measure:
Changes over time in hospital BF policies (BF policy score) and implementation of recommended maternity care practices (9 of Ten Steps to Successful BF) were evaluated. The relationships and correlations between these changes in staff awareness, hospital culture, and BF promotion were determined.

Results:
Between 2009 and 2011, there were increases in BF policy scores, maternity care practices implemented, and lactation staff (P < .001). Greater awareness by hospital administrators of BF measures was associated with more emphasis in promoting BF (P = .02). Hospitals reporting much more emphasis in promoting BF or reporting large changes in organizational culture had greater increases in BF policy scores and the recommended maternity care practices implemented (P < .05).

Conclusion:
These findings suggest that state mandates requiring key BF policies and support in hospitals and public reporting of BF rates may have led to increased emphasis and promotion of BF, improvement in hospital BF policies, and increased implementation of maternity care practices supporting BF. Implementation of similar policies by other states, combined with rigorous evaluation, is needed to replicate these findings and assess the long-term impact on maternal and infant health outcomes.
Potential for Pharmacy–Public Health Collaborations Using Pharmacy-Based Point-of-Care Testing Services for Infectious Diseases
Authors: Gubbins Paul O. , Klepser Michael E. , Adams Alex J. , Jacobs David M. , Percival Kelly M. , Tallman Gregory B. 
Published: December 2016

Context:
Health care professionals must continually identify collaborative ways to combat antibiotic resistance while improving community health and health care delivery. Clinical Laboratory Improvement Amendments of 1988 (CLIA)-waived point-of-care (POC) testing (POCT) services for infectious disease conducted in community pharmacies provide a means for pharmacists to collaborate with prescribers and/or public health officials combating antibiotic resistance while improving community health and health care delivery.

Objective:
To provide a comprehensive literature review that explores the potential for pharmacists to collaborate with public health professionals and prescribers using pharmacy-based CLIA-waived POCT services for infectious diseases.

Design:
Comprehensive literature review.

Setting:
PubMed and Google Scholar were searched for manuscripts and meeting abstracts for the following key words: infectious disease, community pharmacy, rapid diagnostic tests, rapid assay, and POC tests.

Intervention:
All relevant manuscripts and meeting abstracts utilizing POCT in community pharmacies for infectious disease were reviewed.

Outcome Measure:
Information regarding the most contemporary evidence regarding CLIA-waived POC infectious diseases tests for infectious diseases and their use in community pharmacies was synthesized to highlight and identify opportunities to develop future collaborations using community pharmacy-based models for such services.

Results:
Evidence demonstrates that pharmacists in collaboration with other health care professionals can leverage their knowledge and accessibility to provide CLIA-waived POCT services for infectious diseases. Testing for influenza may augment health departments' surveillance efforts, help promote rationale antiviral use, and avoid unnecessary antimicrobial therapy. Services for human immunodeficiency virus infection raise infection status awareness, increase access to health care, and facilitate linkage to appropriate care. Testing for group A streptococcal pharyngitis may curb inappropriate outpatient antibiotic prescribing. However, variance in pharmacy practice statues and the application of CLIA across states stifle collaboration.

Conclusion:
CLIA-waived POCT services for infectious diseases are a means for pharmacists, public health professionals, and prescribers to collaboratively combat antibiotic resistance and improve community health.
Bringing Healthy Aging to Scale: A Randomized Trial of a Quality Improvement Intervention to Increase Adoption of Evidence-Based Health Promotion Programs by Community Partners
Authors: Ford James H. , Abramson Betsy , Wise Meg , Dattalo Melissa , Mahoney Jane E. 
Published: December 2016

Objective:
To evaluate the effectiveness of a quality improvement intervention to increase delivery of 2 evidence-based health promotion workshops, Stepping On and Chronic Disease Self-Management Program (CDSMP), in rural communities.

Design:
A cluster-randomized wait-list control group design.

Setting:
Rural Wisconsin counties with trained workshop leaders but no workshops in the prior year were eligible to participate.

Intervention:
Sixteen counties were randomized to receive the NIATx intervention or wait-list control. The 1-year intervention consisted of training and coaching county aging unit staff to apply NIATx methods to increase and sustain the number of Stepping On or CDSMP workshops in their community.

Main Outcomes:
Mann-Whitney tests examined effect on workshops held, participants, and workshop completers. The paired Wilcoxon signed rank test explored change in participants' health behaviors and health care utilization.

Results:
Counties receiving the NIATx intervention significantly increased the number of workshops per county per year as compared with baseline (1.5 vs 0.19, P < .001) and sustained improvements during the year following the intervention. Stepping On participants, during the 6 months postintervention, had reduced falls risk behaviors (P < .001), 0.43 fewer falls (P < .01), and 0.028 fewer medical record–verified emergency department visits for falls-related injuries (P < .05) compared with the 6 months before the intervention. CDSMP participants had reduced social isolation (P = .018) and improved physician communication skills (P = .005).

Implications:
Our study demonstrates that coaching rural service organizations in use of the quality improvement process, NIATx, may increase implementation reach of evidence-based health promotion/disease prevention programs. Initiative findings indicate that this approach may be a new and potentially important strategy to increase reach of health promotion programs for older adults in community settings.

Conclusion:
A quality improvement approach effectively increases and sustains delivery of evidence-based health promotion/workshops for older adults in rural communities. Counties or states struggling to engage older adults in evidence-based health promotion workshops could integrate quality improvement into policies and practices to increase workshop availability. Once engaged, older adults experience improved health behaviors from both programs and reduced falls and emergency department utilization from Stepping On.
The Prospective Association of the Diurnal Cortisol Rhythm With Sleep Duration and Perceived Sleeping Problems in Preschoolers: The Generation R Study
Authors: Saridjan Nathalie S. , Kocevska Desana , Luijk Maartje P.C. M. , Jaddoe Vincent W.V. , Verhulst Frank C. , Tiemeier Henning 
Published: December 2016

ABSTRACT

Objective
Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood.

Methods
This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior.

Results
The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = −0.12, 95% confidence interval = −0.19 to −0.05, p = .001; β per nmol/L CAR = −0.01, 95% confidence interval = −0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems.

Conclusions
The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.
Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging of Cervical Cancer With Different b-Values
Authors: Wu Qingxia , Wang Yan , Shi Ligang , Dong Li , Liu Mingbo , Dou Shewei , Zhu Shaocheng , Wang Meiyun , Shi Dapeng 
Published: December 2016

Objective
The aims of this study were to evaluate the dependence of diffusion parameters on the b values adopted for intravoxel incoherent motion diffusion-weighted magnetic resonance imaging and to investigate the application value of multiple diffusion parameters obtained from monoexponential and biexponential models in subjects with a normal cervix and in cervical cancer patients.

Methods
A total of 120 female patients with cervical cancer and 21 female control subjects with a normal cervix underwent diffusion-weighted magnetic resonance imaging with 13 b values (0–2000 s/mm2) at 3 T. The standard apparent diffusion coefficient (Dst), diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were calculated by fitting with monoexponential and biexponential models at 2 different ranges of b values: 0 to 1000 and 0 to 2000 s/mm2. A univariate analysis was performed to identify factors that could distinguish cervical carcinoma from normal cervical tissue. Parameters that correlated with the pathological grade and stage of cervical cancer were also evaluated. Receiver operating characteristic curves were used to evaluate the diagnostic efficiency of every parameter.

Results
All the tested parameters, except the D* of the 2 different ranges of b value groups, significantly differed between the patients with cervical carcinoma and control subjects (P < 0.01). D2000, Dst2000, and D1000 showed comparable diagnostic value, with an area under the curve of 0.923, 0.909, and 0.907, respectively. Dst2000, D2000, Dst1000, and D1000 differed significantly among the 3 degrees of cervical stromal infiltration depth (P < 0.05).

Conclusions

D2000 and Dst2000 tended to outperform D1000 in terms of diagnostic efficiency, but there was no significant difference in their ability to differentiate cervical carcinoma from normal cervix. Cervical cancers with lower Dst and D values tended to have greater infiltration depth.
Intrasession and Intersession Repeatability of Diffusion Tensor Imaging in Healthy Human Liver
Authors: Wong Oi Lei , Leung Thomas Wai Tong , Lo Gladys Goh , Yuan Jing , Li Wing Wa , Noseworthy Michael D. 
Published: December 2016

Objective
The aim of this study was to evaluate the effect of signal to noise ratio (SNR) and number of gradient directions (NGD) on intra- and intersession repeatability of liver diffusion tensor imaging (DTI) metrics.

Methods
At each of 3 liver DTI scan sessions, liver diffusion was assessed in 5 healthy volunteers using a 6-direction DTI scan performed 9 separate times (ie, number of signal averages [NSA]). In addition, 4 combinations of NSA and NGD were acquired (NSA/NGD = 1/30, 3/10, 3/12, and 5/6) to determine the combined effect to DTI metrics, which was based on intersubject variability and intrasession (V
intra) and intersession (V
inter) repeatability.

Results
Intersubject variability was less than 20%, whereas V
intra and V
inter repeatability were less than 5% and less than 10%, respectfully. V
inter was not affected by the NGD used. Decreases in V
inter(FA), V
inter(λ1), V
inter(RD), and V
inter(MD) were observed with increasing NSA, and hence SNR.

Conclusion
Increased SNR may improve intrasession and intersession repeatability of liver DTI metrics. Scan repeatability was not influenced by NGD.
Cryo-EM structure of the ATP-sensitive potassium channel illuminates mechanisms of assembly and gating
Authors: Martin Gregory M. , Yoshioka Craig , Rex Emily A. , Fay Jonathan F. , Xie Qing , Whorton Matt R. , Chen James Z. , Shyng Show-Ling 
Published: December 2016

AbstractATP-sensitive potassium (KATP) channels are metabolic sensors that couple cell energetics to membrane excitability. In pancreatic β-cells, channels formed by SUR1 and Kir6.2 regulate insulin secretion and are the targets of antidiabetic sulfonylureas. Here, we used cryo-EM to elucidate structural basis of channel assembly and gating. The structure, determined in the presence of ATP and the sulfonylurea glibenclamide, at ~6Å resolution reveals a closed Kir6.2 tetrameric core with four peripheral SUR1s each anchored to a Kir6.2 by its N-terminal transmembrane domain (TMD0). Intricate interactions between TMD0, the loop following TMD0, and Kir6.2 near the proposed PIP2binding site, and where ATP density is observed, suggest SUR1 may contribute to ATP and PIP2binding to enhance Kir6.2 sensitivity to both. The SUR1-ABC core is found in an unusual inward-facing conformation whereby the two nucleotide binding domains are misaligned along a two-fold symmetry axis, revealing a possible mechanism by which glibenclamide inhibits channel activity.