bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness Research in Neurosurgery: We Can and We Must
Authors: Stein Sherman C 
Published: November 2017

Abstract
Rapid advancement of medical and surgical therapies, coupled with the recent preoccupation with limiting healthcare costs, makes a collision of the 2 objectives imminent. This article explains the value of cost-effectiveness analysis (CEA) in reconciling the 2 competing goals, and provides a brief introduction to evidence-based CEA techniques. The historical role of CEA in determining whether new neurosurgical strategies provide value for cost is summarized briefly, as are the limitations of the technique. Finally, the unique ability of the neurosurgical community to provide input to the CEA process is emphasized, as are the potential risks of leaving these important decisions in the hands of others.
The role of vitamin D in adipogenesis
Authors: Dix Clare F , Barclay Johanna L , Wright Olivia R L 
Published: November 2017

Abstract
Vitamin D, a secosteroid predominately obtained by endogenous production, has in recent years been linked to obesity and its comorbidities. The purpose of this review is to draw conclusions from animal and human studies on the effects of vitamin D on adipogenesis to identify the molecular links between vitamin D and obesity. The information presented herein was obtained from 4 databases (PubMed, CINAHL, Cochrane Library, Scopus) using predefined search terms, as well as research literature and other reviews. The effects of vitamin D on adipogenesis have been researched in several animal models, and the majority of these studies suggest vitamin D plays an inhibitory role in adipogenesis. Studies into vitamin D status and obesity in humans are limited, with the majority being observational epidemiological studies that provide no conclusions on cause and effect or clear links on the molecular mechanisms. The few cell culture and supplementation studies that have investigated adipogenesis in human cells indicate that, in contrast to findings from rodent studies, vitamin D is proadipogenic. There is insufficient evidence to determine whether 1) vitamin D deficiency is associated with a lean or obese phenotype, 2) vitamin D deficiency is a consequence of obesity, or (3) the effects of vitamin D on fat tissue are due to interactions with calcium.
Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial
Authors: Keogh Alison , Matthews James , Segurado Ricardo , Hurley Deirdre A 
Published: November 2017

Abstract

Background
Provider training programs are frequently underevaluated, leading to ambiguity surrounding effective intervention components.

Objective
The purpose of this study was to assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385), using a communication style underpinned by self–determination theory (SDT).

Design
This was an assessment of the intervention arm training program using quantitative methods.

Methods
Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reaction—physical therapists’ satisfaction with training, (2) Learning—therapists’ confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training, and (3) Behavior—8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure.

Results
Reaction: Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.7–5.0). Learning: Physical therapists’ confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.9–6.0; median CCBS = 6.6 ([0.5]; 6.1–6.8; median intervention specific measure = 4.0 [1.2]; 3.2–4.9). However, “goal setting” was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.0–4.0).

Limitations
The intervention group only was assessed as part of the process evaluation of the feasibility trial.

Conclusions
Training effectively guided physical therapists to be needs-supportive during delivery of the SOLAS intervention. Refinements were outlined to improve future similar training programs, including greater emphasis on goal setting.
The Revised Body Awareness Rating Questionnaire: Development Into a Unidimensional Scale Using Rasch Analysis
Authors: Dragesund Tove , Strand Liv Inger , Grotle Margreth 
Published: November 2017

Abstract

Background
The Body Awareness Rating Questionnaire (BARQ) is a self-report questionnaire aimed at capturing how people with long-lasting musculoskeletal pain reflect on their own body awareness. Methods based on classical test theory were applied to the development of the instrument and resulted in 4 subscales. However, the scales were not correlated, and construct validity might be questioned.

Objective
The primary purpose of this study was to explore the possibility of developing a unidimensional scale from items initially collected for the BARQ using Rasch analysis. A secondary purpose was to investigate the test-retest reliability of a revised version of the BARQ.

Design
This was a methodological study.

Methods
Rasch and reliability analyses were performed for 3 samples of participants with long-lasting musculoskeletal pain. The first Rasch analysis was carried out on 66 items generated for the original BARQ and scored by 300 participants. The items supported by the first analysis were scored by a new group of 127 participants and analyzed in a second Rasch analysis. For the test-retest reliability analysis, 48 participants scored the revised BARQ items twice within 1 week.

Results
The 2-step Rasch analysis resulted in a unidimensional 12-item revised version of the BARQ with a 4-point response scale (scores from 0 to 36). It showed a good fit to the Rasch model, with acceptable internal consistency, satisfactory fit residuals, and no disordered thresholds. Test-retest reliability was high, with an intraclass correlation coefficient of .83 (95% CI = .71–.89) and a smallest detectable change of 6.3 points.

Limitations
The small sample size in the second Rasch analysis was a study limitation.

Conclusions
The revised BARQ is a unidimensional and feasible measurement of body awareness, recommended for use in the context of body-mind physical therapy approaches for musculoskeletal conditions.
Teaching study skills in mathematics service courses—how to cope with students’ refusal?
Authors: Feudel Frank , Dietz Hans M 
Published: November 2017

Abstract
Many freshmen entering university have difficulties with finishing their mathematics courses successfully in the first year due to insufficient study skills and learning strategies, which on the one hand include general skills and strategies and on the other hand context-specific skills and strategies for university mathematics. In mathematics service courses for students of disciplines other than mathematics, for example engineering or economics, the effect of poor study skills is even worse due to large course sizes and great diversity regarding the students’ prior knowledge. Therefore, since 2010, first-year students of economics at the University of Paderborn are offered a methodological support program named CAT, which is integrated into the regular course context. The name CAT emerges from three important support-tools of the program (called instruments): Checklist, Ampel (English: Traffic Lights), Toolbox. Although some students claimed that CAT was helpful from the beginning (and a positive effect on academic achievement had also been proven in an experimental tutorial) the majority of students did not use the strategies provided by CAT at first. This was the initial point for a research project with the aim to raise the acceptance of CAT and thus to get more students to use the effective study skills provided by CAT. With the help of this research project, it was possible to identify reasons why students did not use the skills and strategies of CAT, to draw adequate conclusions concerning the implementation of CAT in the course and to raise the acceptance of CAT considerably in the following year. The results of the research project can be useful especially for developers of similar support programs and for teachers and lecturers, who also try to integrate study skills into mathematics courses at university.
Effectiveness and Safety of a Thermosensitive Hydrogel Cultured Epidermal Allograft for Burns
Authors: Yoon Jaechul , Yang Hyeong-Tae , Yim Haejun , Cho Yong-Suk , Kym Dohern , Hur Jun , Chun Wook , Lee Jong-Wook , Yoon Chunjae 
Published: November 2017

ABSTRACT

OBJECTIVE:
To retest the safety and effectiveness of a thermosensitive hydrogel-type cultured epithelial allograft (KeraHeal-Allo; MCTT, Seoul, South Korea) and identify the subjective experience of patients and doctors with this product.

DESIGN AND SETTING:
Prospective interventional phase 3 study in 3 burn centers near Seoul, South Korea.

PATIENTS:
Thirty-three patients with deep second-degree burns larger than 200 cm2 (for intervention and control sites of 100 cm2 each) were enrolled.

INTERVENTION:
A cultured epithelial allograft containing 2 × 107/1.5 mL keratinocytes was applied to each patient’s intervention site. Three principal investigators (1 in each institution) evaluated the effectiveness of the allograft at their institution and the others’. Researchers administered a subjective satisfaction survey during each patient’s last visit.

MAIN OUTCOME MEASURE:
The primary end point of the study was the re-epithelialization period.

MAIN RESULTS:
The re-epithelialization period for the intervention was 2.8 ± 2.2 days faster than that of control sites at other institutions (P < .001) and 2.5 ± 3.4 days faster than that of control sites in the same institution (P < .001). There were no reported adverse events. Satisfaction scores provided by patients and doctors showed significantly high scores on all items.

CONCLUSUIONS:
This type of cultured epithelial allograft is safe and well received by patients and providers and promotes re-epithelialization.
Optimizing Pregnancy Treatment Interventions for Moms (OPTI-Mom): A Pilot Study
Authors: Cochran Gerald T. , Hruschak Valerie , Abdullah Walitta , Krans Elizabeth , Douaihy Antoine B. , Bobby Stephanie , Fusco Rachel , Tarter Ralph 
Published: November 2017

Objectives:The public health burden of opioid use disorder (OUD) among pregnant women has significantly increased in recent years. The Optimizing Pregnancy Treatment Interventions for Moms study was a pilot project that examined the feasibility of a patient navigation (PN) intervention model to reduce substance use and improve mental health, quality of life, and to increase engagement with treatment services among pregnant women with OUD.Methods:A 1-group repeated-measures pilot study was conducted with treatment-seeking pregnant women with opioid dependence initiating buprenorphine maintenance treatment. Participants received the PN intervention delivered as 10 sessions before delivery and 4 sessions postpartum. Participants completed assessments at baseline and after the prenatal and postnatal portions of the intervention. Demographics were assessed using descriptive statistics, and general estimating equation analyses were employed to examine changes in health and service engagement across time.Results:in all, 21 women were enrolled and completed the PN intervention and follow-up assessments. Participants reported improvements in abstinence from illicit opioids (B = 0.15, 95% confidence interval [CI] 0.1–0.2), drug use (odds ratio [OR] 5.25, 95% CI 2.1–13.0), and depression (OR 7.70, 95% CI 2.4–25.1). Results also showed nonsignificant trends suggesting enhancements in general health (B = 0.17, 95% CI 0.0–0.3,P = 0.06) and increases in substance use treatment attendance (B = 2.15, 95% CI −0.2 to 4.5,P = 0.07). Most study participants achieved adequate or better prenatal care.Conclusions:These findings provide support that PN is a feasible adjunctive intervention that shows promise for health improvements and service engagement among treatment-seeking pregnant women with opioid dependence initiating buprenorphine.
Positive and Negative Impacts of a Continuing Professional Development Intervention on Pharmacist Practice
Authors: Sidhu Sukhjinder , Gorman Sean K. , Slavik Richard S. , Ramsey Tasha , Bruchet Nicole , Murray Sarah 
Published: November 2017

Introduction:
Evaluations of behavior change interventions aimed at improving professional practice are increasingly focused on impacts at the practice and patient outcome levels. Many of these evaluations assume that if the intended changes occur, the result represents an improvement. However, given the systemic nature of clinical practice, a change in one area can produce changes in other areas as well, some of which may adversely affect the patient. Balancing measures are used to determine whether unintended consequences of an intervention have been introduced into other areas of the system. The aims of this study were to evaluate the impact of behavior change intervention-based continuing professional development (CPD) on pharmacist interventions (resolution of drug therapy problems—DTPs) and resolution of quality indicator DTPs and knowledge change for urinary tract infections (UTI) and pneumonia. As a balancing measure, we aimed to determine whether delivery of behavior change interventions targeting pneumonia and UTI practice results in a negative impact on other important pharmacist interventions, specifically the resolution of heart failure DTPs.

Methods:
A quasiexperimental study was conducted at a Canadian health authority that evaluated the impacts of an 8-week multifaceted behavior change intervention delivered to 58 ward-based pharmacists. The primary outcome was change in proportion of UTI and pneumonia DTPs resolved from the 6-month preintervention to 6-month postintervention phase. Secondary outcomes were changes in proportion of UTI and pneumonia quality indicator DTPs resolved, knowledge quiz scores, and proportion of quality indicator DTPs resolved for heart failure as a balancing measure.

Results:
A total of 58 pharmacists were targets of the intervention. The proportion of resolved UTI and pneumonia DTPs increased from 17.8 to 27.2% (relative risk increase 52.8%, 95% confidence interval [CI] 42.8–63.6%; P < 0.05). The proportion of resolved UTI and pneumonia quality indicator DTPs increased from 12.2% to 18.2% (relative risk increase 49.9%, 95% CI 34.5–67.0%; P < 0.05). Resolved heart failure DTPs decreased from 14.3 to 8.5% (RRR 40.4%, 95% CI 33.9–46.2%; P < 0.05). Thirty-six pharmacists completed the pre- and post-quiz. Scores increased from 11.3/20 ± 3.2/20 to 14.8/20 ± 2.9/20 (P < 0.05).

Discussion:
CPD using a multifaceted behavior change intervention improved pharmacist behavior and knowledge for UTI and pneumonia. However, these improvements may be offset by reduced interventions for other disease states, such as heart failure. Strategies to mitigate the unintended effects on other professional behaviors should be implemented when delivering CPD focused on changing one aspect of professional behavior.
Retroprosthetic Membrane Formation in Boston Keratoprosthesis: A Case–Control-Matched Comparison of Titanium Versus PMMA Backplate
Authors: Talati Rushi K. , Hallak Joelle A. , Karas Faris I. , de la Cruz Jose , Cortina M. Soledad 
Published: November 2017

Purpose:
Retroprosthetic membrane (RPM) formation is the most common complication after Boston type 1 keratoprosthesis (KPro) implantation. It affects visual acuity and can predispose to corneal melt. Two KPro backplate materials are available: titanium and polymethyl methacrylate (PMMA). This study investigates the influence of the KPro backplate material on visually significant RPM formation.

Methods:
A retrospective case–control-matched study involving 40 patients; 20 eyes implanted with a titanium backplate KPro were case-matched with 20 eyes implanted with a PMMA backplate KPro between 2007 and 2015 with 1-year minimum follow-up.

Results:
The mean follow-up duration was 28.1 ± 8.9 and 53.6 ± 24.3 months in the titanium and PMMA groups, respectively. At 12 months postoperatively, 7 eyes with titanium and 6 eyes with PMMA backplates developed a visually significant RPM. By the end of the study, a total of 11 eyes with titanium and 9 eyes with PMMA KPros developed a visually significant RPM. There was no statistically significant difference between both groups. Three of 11 eyes with titanium KPros that had a visually significant RPM required surgical membranectomy, whereas all eyes with PMMA KPros were successfully treated with the yttrium-aluminum-garnet laser. Recurrence of RPMs was found in 7/11 eyes in the titanium group and 2/9 eyes in the PMMA group with no statistical significance.

Conclusions:
Titanium backplate KPros do not significantly reduce RPM formation compared with PMMA backplate KPros in a case–control-matched setting. A larger prospective study is warranted to evaluate comparative long-term performance and guide newer designs.
Effect of Long-Term Diving on the Morphology and Growth of the Distal Radial Epiphyseal Plate of Young Divers: A Magnetic Resonance Imaging Study
Authors: Zhang Cici , Shen Si , Zhang Wen , Qiu Lin , Wu Qingying , Wang Fei , Liu Sirun 
Published: November 2017

Objective:
To investigate the effects of long-term diving on the morphology and growth of the distal radial epiphyseal plate in young divers.

Study Design:
Cohort study.

Setting:
Guangzhou Sport University.

Participants:
Thirty-eight professional divers, aged 10 to 17 years, and 25 age-matched volunteers.

Interventions:
Each subject received a physical examination at the beginning of the study and underwent bilateral magnetic resonance imaging of the wrist. The divers were divided into 2 groups depending on the status of the epiphyseal plate: group A (positive distal radial epiphyseal plate injury) and group B (no positive distal radial epiphyseal plate injury). A third group, group C, consisted of the 25 volunteers.

Main Outcome Measures:
The frequency of distal radial epiphyseal plate injury and the thickness of the distal radial epiphyseal plate were analyzed across the 3 groups.

Results:
Twenty-nine cases (29/76, 38.15%) of distal radial epiphyseal plate injury were observed in 20 divers (20/38, 52.63%). The incidence of injury to the right hand was higher than that for the left (P = 0.009). There were statistically significant differences (P = 0.000) among the 3 groups in terms of epiphyseal plate thickness; group A > group B > group C.

Conclusions:
Distal radial epiphyseal plate injury is common in divers, and more injuries are seen in the right hand. Moreover, growth of the radius was impaired in divers relative to controls. We consider that loading during diving may influence growth of the epiphyseal plate in either a transient or permanent manner.
Risks and Benefits of Salpingectomy at the Time of Sterilization
Authors: Castellano Tara , Zerden Matthew , Marsh Laura , Boggess Kim 
Published: November 2017

Importance
Bilateral salpingectomy reduces the risk ovarian cancer. The Society of Gynecologic Oncology has recommended surgeons discuss salpingectomy with patients desiring sterilization.

Objective
This review summarizes current literature on the benefits and risks of bilateral salpingectomy to reduce ovarian cancer risk. Areas of insufficient evidence and directions for further research are discussed.

Evidence Acquisition
We examined the benefits and risks of bilateral salpingectomy for female surgical sterilization, using a PubMed and EMBASE literature review. Search parameters included articles in English language and keywords “salpingectomy” or “ovarian cancer” combined with “contraception,” “sterilization,” or “tubal ligation.”

Results
We reviewed 4 high-quality studies that investigated the increased risk reduction of bilateral salpingectomy compared with traditional sterilization. Overall, evidence shows that salpingectomy moderately decreases the risk of ovarian cancer compared with traditional sterilization. An additional 4 studies, including a meta-analysis, showed salpingectomy likely does not have significant long-term impact on ovarian reserve. Additional benefits include improved contraceptive efficacy and elimination of subsequent ectopic pregnancies. Risks include need for in vitro fertilization for patients experiencing sterilization regret, increases in operative time, and potential increases in surgical risks.

Conclusions
Bilateral salpingectomy can reduce ovarian cancer risk compared with traditional sterilization; however, research regarding other outcomes is limited. Challenges to implementation include physician concern regarding surgical risks and patient education. Studies investigating patient-based outcomes are lacking.

Relevance
Bilateral salpingectomy for surgical sterilization is a reasonable option when patients are appropriately informed. Ovarian cancer risk reduction should be one of several factors considered when patients choose a surgical sterilization method.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to discuss the epidemiology and etiology of ovarian cancer and its subtypes, describe the risks and benefits of risk-reducing bilateral salpingectomy at the time of surgical sterilization, and identify challenges associated with the widespread adoption of risk-reducing salpingectomy.
Trends in Ambulatory Management of Urinary Incontinence in Women in the United States
Authors: Forde James C. , Chughtai Bilal , Cea Meagan , Stone Benjamin V. , Te Alexis , Bishop Tara F. 
Published: November 2017

(Abstracted from Female Pelvic Med Reconstr Surg 2017;23:250–255)
The importance of urinary incontinence (UI) to quality of life and the substantial costs of its treatment are well known. Guidelines on the assessment and subsequent management of the different types of UI have been published by various professional societies.