bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Physical Therapy for Low Back Pain by Medicaid Enrollees
Authors: Fritz Julie M. , Kim Jaewhan , Thackeray Anne , Dorius Josette 
Published: August 2015

Background
Medicaid insures an increasing proportion of adults in the United States. Physical therapy use for low back pain (LBP) in this population has not been described.

Objective
The study objectives were: (1) to examine physical therapy use by Medicaid enrollees with new LBP consultations and (2) to evaluate associations with future health care use and LBP-related costs.

Design
The study was designed as a retrospective evaluation of claims data.

Methods
A total of 2,289 patients with new LBP consultations were identified during 2012 (mean age=39.3 years [SD=11.9]; 68.2% women). The settings in which the patients entered care and comorbid conditions were identified. Data obtained at 1 year after entry were examined, and physical therapy use was categorized with regard to entry setting, early use (within 14 days of entry), or delayed use (&gt;14 days after entry). The 1-year follow-up period was evaluated for use outcomes (imaging, injection, surgery, and emergency department visit) and LBP-related costs. Variables associated with physical therapy use and cost outcomes were evaluated with multivariate models.

Results
Physical therapy was used by 457 patients (20.0%); 75 (3.3%) entered care in physical therapy, 89 (3.9%) received early physical therapy, and 298 (13.0%) received delayed physical therapy. Physical therapy was more common with chronic pain or obesity comorbidities and less likely with substance use disorders. Entering care in the emergency department decreased the likelihood of physical therapy. Entering care in physical medicine increased the likelihood. Relative to primary care entry, physical therapy entry was associated with lower 1-year costs.

Limitations
A single state was studied. No patient-reported outcomes were included.

Conclusions
Physical therapy was used often by Medicaid enrollees with LBP. High rates of comorbidities were evident and associated with physical therapy use. Although few patients entered care in physical therapy, this pattern may be useful for managing costs.
Inter district variation in child health promotion practices: A comparative study between the two districts in a South Indian state
Authors: Baliga B Shantharam , Rao Suchetha , Jain Animesh , Nagaraj K , Srikanth BK 
Published: August 2015

Background: Inter district variations in health parameters can be conducive for policy making with regards to child health status and healthcare utilization.Aims and Objectives: We carried out this study to understand district-wide variations in child health promotion practices in well performing Dakshina Kannada (DK) and poorly performing Bellary districts of Karnataka state of South India.Materials and Methods: Data was collected by cross sectional door to door community survey carried out among 2203 households of DK district and 2158 households of Bellary district. The Institutional Ethics Committee had approved this studyResult: Initiation of breast feeding within 2 hours was seen in 92.2% mothers in DK and 43.2% mothers in Bellary. Higher rates of prelacteal feeds (DK 16% Bellary 68.1 %) and delayed complementary feeding (DK 39.2 % Bellary 64.9%) was observed in Bellary. Home deliveries were negligible in DK but in Bellary almost half of the mothers had delivered at home .Fever was recognized as danger sign in majority, while awareness of all danger signs was seen in 44.4 % in DK and 14.8 % in Bellary. 28 % in Bellary had delayed health seeking.Conclusion: There is inter district variation child health promotional practices and health seeking and need due consideration by health policy makers.Asian Journal of Medical Sciences Vol.7(1) 2015 88-92
Qanat System at Bidar District in Karnataka, India
Authors: Raghubans Kishore 
Published: August 2015

A preliminary investigation on hydraulic system for revitalization of qanat system and emphasis model study at Bidar, Karnataka in India and in future such studies to be carried out to the other water structures. HYDRO Nepal JournalJournal of Water, Energy and EnvironmentIssue: 17, July 2015
Effect of Sand Erosion on Turbine Components: A Case Study of Kali Gandaki “A” Hydroelectric Project (144 MW), Nepal
Authors: Chhetry Balendra , Rana Kumar 
Published: August 2015

In high sediment laden river projects or silt affected power stations, the frequency of repair and maintenance of underwater parts is comparatively higher which leads to increase the overall forced outages per year for repair The extent of the major maintenance will depend on the operating condition such as suspended sediment load passing through the turbine and how the machine was loaded during the operation. This paper illustrates the analysis of sediments, effect of sand erosion and maintenance of turbine of Kali Gandaki “A” Hydroelectric Plant (144 MW). The paper also describes the repair methods used for different turbine components to minimize the effects induced by sediment erosion. HYDRO Nepal JournalJournal of Water, Energy and EnvironmentIssue: 17, July 2015
Ecosystem-based Adaptation Planning in the Panchase Mountain Ecological Region
Authors: Park Jaeyoon , Alam Mozaharul 
Published: August 2015

As part of numerous efforts on adapting to climate change in Nepal, an approach of Ecosystem-based Adaptation (EbA) is being demonstrated in the Panchase Mountain Ecological Region (PMER). Partners under the project entitled Ecosystem-based Adaptation in Mountain Ecosystems in Nepal have been implementing activities to reduce vulnerability of the PMER to climate change and enhance resilient capacity of communities and ecosystems in the region to cope with adverse impacts of climate change already being witnessed. This article places focus on the process of EbA planning and preliminary lessons learned through the project activities in particular at local and ecological level. Reflection and suggestion on EbA planning presented in the article is expected to help all stakeholders in the Himalayan region and beyond design and implement future climate change adaptation activities to be more effective and efficient while empowering local communities and ensuring social, economic and environmental sustainability. HYDRO Nepal JournalJournal of Water, Energy and EnvironmentIssue: 17, July 2015
Diurnal Air Quality Monitoring in Khumaltar Area, Lalitpur, Nepal
Authors: Shrestha Sujen Man , Thapa Kanchan , Joshi Tista Prasai 
Published: August 2015

Air pollution is becoming a serious matter of concern from different aspects of our lives. It adversely affects the well being of the individuals or cause damages to properties. Pollutants identification requires measurements by standard methods of sampling and analysis. In this study, monitoring of TSP, PM10, SO2 and NO2 were performed during the months of April – August, 2008 by using high volume sampler, i. e. Envirotech APM 451 Model. Four hours (11:00 am to 3:00 pm) of monitoring for SO2 and NO2 , 24 hours of monitoring for TSP and PM10 were carried out. SO2 concentration ranged from 4.8 ?g/m3 to 20.5 ?g/m3 and NO2 concentration ranged from 1.2 ?g/m3 to 8.8 ?g/m3 for four hour monitoring period. TSP concentration ranged from 24.7 ?g/m3 to 82.0 ?g/m3 whereas PM10 concentration ranged from 25.4 ?g/m3 to 152.4 ?g/m3 for 24 hours of monitoring. Present study concluded that the air quality of Khumaltar area in Lalitpur, Nepal met WHO as well as NAAQS standards during the study period. Nepalese cities/towns have always been thought to be serious in terms of particulate matter pollution but consideration of the trend of gasesous pollutants emitted from vehicle exhaust is recommended for future research. HYDRO Nepal JournalJournal of Water, Energy and EnvironmentIssue: 17, July 2015
Randomized controlled trials and neurosurgery: the ideal fit or should alternative methodologies be considered?
Authors: Mansouri Alireza , Cooper Benjamin , Shin Samuel M. , Kondziolka Douglas 
Published: August 2015

OBJECT
Randomized-controlled trials (RCTs) are advocated to provide high-level medical evidence. However, in neurosurgery, there are barriers to conducting RCTs. The authors of this study sought to analyze the quality of neurosurgical RCTs since 2000 to determine the adequacy of their design and reporting.

METHODS
A search of the MEDLINE and EMBASE databases (2000–2014) was conducted. The medical subject heading (MeSH) terms used in the search included: “neurosurgery” OR “neurosurgical procedure,” “brain neoplasms,” “infarction” and “decompression,” “carotid stenosis,” “cerebral hemorrhage,” and “spinal fusion.” These studies were limited to RCTs, in humans, and in the English language. The Consolidated Standards for Reporting of Trials (CONSORT) and Jadad scales were used to assess the quality of RCT design and reporting. The standardized median times cited (median citations divided by years since publication) were used to assess impact. A pragmatic-explanatory continuum indicator summary-based scale was used to assess the design of the studies as primarily pragmatic or explanatory.

RESULTS
Sixty-one articles were identified, and the following subspecialties were the most common: vascular (23, 37%), followed by functional neurosurgery and neurooncology (both 13, 21%). The following nations were the primary leaders in RCTs: US (25 studies, 41%), Germany (8 studies, 13%), and the United Kingdom (7 studies, 11%). Median sample size was 100 (interquartile range [IQR] 41.5–279). The majority of the studies (40, 66%) had pragmatic objectives. The median number of times cited overall was 69 (IQR 20.5–193). The combined median CONSORT score was 36 (IQR 27.5–39). Blinding was most deficiently reported. Other areas with a relatively low quality of reporting were sample size calculation (34.2% of surgical, 38.5% of drug, and 20% of device studies), allocation concealment (28.9% of surgical, 23.1% of drug, and 50% of device studies), and protocol implementation (18.4% of surgical, 23% of drug, and 20% of device studies). The quality of reporting did not correlate with the study impact. All studies had a median Jadad score ≤ 3. Thirty-three pragmatic studies (83%) and 5 explanatory studies (25%) met the design objectives. All pragmatic studies based on drug and device trials met their objectives, while 74% of pragmatic surgical trials met their objectives.

CONCLUSIONS
The prevalence of neurosurgical RCTs is low. The quality of RCT design and reporting in neurosurgery is also low. Many study designs are not compatible with stated objectives. Pragmatic studies were more likely to meet design objectives. Given the role of RCTs as one of the highest levels of evidence, it is critical to improve on their methodology and reporting.
Comparison of endoscope- versus microscope-assisted resection of deep-seated intracranial lesions using a minimally invasive port retractor system
Authors: Hong Christopher S. , Prevedello Daniel M. , Elder J. Bradley 
Published: August 2015

OBJECT
Tubular brain retractors may improve access to deep-seated brain lesions while potentially reducing the risks of collateral neurological injury associated with standard microsurgical approaches. Here, microscope-assisted resection of lesions using tubular retractors is assessed to determine if it is superior to endoscope-assisted surgery due to the technological advancements associated with modern tubular ports and surgical microscopes.

METHODS
Following institutional approval of the tubular port, data obtained from the initial 20 patients to undergo transportal resection of deep-seated brain lesions were analyzed in this study. The pathological entities of the resected tissues included metastatic tumors (8 patients), glioma (7), meningioma (1), neurocytoma (1), radiation necrosis (1), primitive neuroectodermal tumor (1), and hemangioblastoma (1). Surgery incorporated endoscopic (5 patients) or microscopic (15) assistance. The locations included the basal ganglia (11 patients), cerebellum (4), frontal lobe (2), temporal lobe (2), and parietal lobe (1). Cases were reviewed for neurological outcomes, extent of resection (EOR), and complications. Technical data for the port, surgical microscope, and endoscope were analyzed.

RESULTS
EOR was considered total in 14 (70%), near total (> 95%) in 4 (20%), and subtotal (< 90%) in 2 (10%) of 20 patients. Incomplete resection was associated with the basal ganglia location (p < 0.05) and use of the endoscope (p < 0.002). Four of 5 (80%) endoscope-assisted cases were near-total (2) or subtotal (2) resection. Histopathological diagnosis, presenting neurological symptoms, and demographics were not associated with EOR. Complication rates were low and similar between groups.

CONCLUSIONS
Initial experience with tubular retractors favors use of the microscope rather than the endoscope due to a wider and 3D field of view. Improved microscope optics and tubular retractor design allows for binocular vision with improved lighting for the resection of deep-seated brain lesions.
Anterior cingulate implants for tinnitus: report of 2 cases
Authors: De Ridder Dirk , Joos Kathleen , Vanneste Sven 
Published: August 2015

Tinnitus can be distressful, and tinnitus distress has been linked to increased beta oscillatory activity in the dorsal anterior cingulate cortex (dACC). The amount of distress is linked to alpha activity in the medial temporal lobe (amygdala and parahippocampal area), as well as the subgenual (sg)ACC and insula, and the functional connectivity between the parahippocampal area and the sgACC at 10 and 11.5 Hz.
The authors describe 2 patients with very severely distressing intractable tinnitus who underwent transcranial magnetic stimulation (TMS) with a double-cone coil targeting the dACC and subsequent implantation of electrodes on the dACC. One of the patients responded to the implant and one did not, even though phenomenologically they both expressed the same tinnitus loudness and distress.
The responder has remained dramatically improved for more than 2 years with 6-Hz burst stimulation of the dACC. The 2 patients differed in functional connectivity between the area of the implant and a tinnitus network consisting of the parahippocampal area as well as the sgACC and insula; that is, the responder had increased functional connectivity between these areas, whereas the nonresponder had decreased functional connectivity between these areas. Only the patient with increased functional connectivity linked to the target area of repetitive TMS or implantation might transmit the stimulation current to the entire tinnitus network and thus clinically improve.
Cost minimization in treatment of adult degenerative scoliosis
Authors: Uddin Omar M. , Haque Raqeeb , Sugrue Patrick A. , Ahmed Yousef M. , El Ahmadieh Tarek Y. , Press Joel M. , Koski Tyler , Fessler Richard G. 
Published: August 2015

OBJECT
Back pain is an increasing concern for the aging population. This study aims to evaluate if minimally invasive surgery presents cost-minimization benefits compared with open surgery in treating adult degenerative scoliosis.

METHODS
Seventy-one patients with adult degenerative scoliosis received 2-stage, multilevel surgical correction through either a minimally invasive spine surgery (MIS) approach with posterior instrumentation (n = 38) or an open midline (Open) approach (n = 33). Costs were derived from hospital and rehabilitation charges. Length of stay, blood loss, and radiographic outcomes were obtained from electronic medical records. Functional outcomes were measured with Oswestry Disability Index (ODI) and visual analog scale (VAS) surveys.

RESULTS
Patients in both cohorts were similar in age (AgeMIS = 65.68 yrs, AgeOpen = 63.58 yrs, p = 0.28). The mean follow-up was 18.16 months and 21.82 months for the MIS and Open cohorts, respectively (p = 0.34). MIS and Open cohorts had an average of 4.37 and 7.61 levels of fusion, respectively (p < 0.01). Total inpatient charges were lower for the MIS cohort ($269,807 vs $391,889, p < 0.01), and outpatient rehabilitation charges were similar ($41,072 vs $49,272, p = 0.48). MIS patients experienced reduced length of hospital stay (7.03 days vs 14.88 days, p < 0.01) and estimated blood loss (EBL) (EBLMIS = 470.26 ml, EBLOpen= 2872.73 ml, p < 0.01). Baseline ODI scores were lower in the MIS cohort (40.03 vs 48.04, p = 0.03), and the cohorts experienced similar 1-year improvement (ΔODIMIS = −15.98, ΔODIOpen = −21.96, p = 0.25). Baseline VAS scores were similar (VASMIS = 6.56, VASOpen= 7.10, p = 0.32), but MIS patients experienced less reduction after 1 year (ΔVASMIS = −3.36, ΔVASOpen = −4.73, p = 0.04). Preoperative sagittal vertical axis (SVA) were comparable (preoperative SVAMIS = 63.47 mm, preoperative SVAOpen = 71.3 mm, p = 0.60), but MIS patients had larger postoperative SVA (postoperative SVAMIS = 51.17 mm, postoperative SVAOpen = 28.17 mm, p = 0.03).

CONCLUSIONS
Minimally invasive surgery demonstrated reduced costs, blood loss, and hospital stays, whereas open surgery exhibited greater improvement in VAS scores, deformity correction, and sagittal balance. Additional studies with more patients and longer follow-up will determine if MIS provides cost-minimization opportunities for treatment of adult degenerative scoliosis.
Minimally invasive anterior lumbar interbody fusion for adult degenerative scoliosis with 1 or 2 dislocated levels
Authors: Flouzat-Lachaniette Charles-Henri , Ratte Louis , Poignard Alexandre , Auregan Jean-Charles , Queinnec Steffen , Hernigou Philippe , Allain Jérôme 
Published: August 2015

OBJECT
Frequent complications of posterolateral instrumented fusion have been reported after treatment of degenerative scoliosis in elderly patients. Considering that in some cases, most of the symptomatology of adult degenerative scoliosis (ADS) is a consequence of the segmental instability at the dislocated level, the use of minimally invasive anterior lumbar interbody fusion (ALIF) to manage symptoms can be advocated to reduce surgical morbidity. The purpose of this study was to evaluate the midterm outcomes of 1- or 2-level minimally invasive ALIFs in ADS patients with 1- or 2-level dislocations.

METHODS
A total of 47 patients (average age 64 years; range 43–80 years) with 1- or 2-level ALIF performed for ADS (64 levels) in a single institution were included in the study. An independent spine surgeon retrospectively reviewed all the patients’ medical records and radiographs to assess operative data and surgery-related complications. Clinical outcome was reported using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) for lumbar and leg pain. Intraoperative data and complications were collected. Fusion and risk for adjacent-level degeneration were assessed.

RESULTS
The mean follow-up duration was 3 years (range 1–10 years). ODI, and back and leg pain VAS scores were significantly improved at last follow-up. A majority of patients (74%) had a statistically significant improvement in their ODI score of more than 20 points at latest follow-up and 1 had a worsening of his disability. The mean operating time was 166 minutes (range 70–355 minutes). The mean estimated blood loss was 410 ml (range 50–1700 ml). Six (5 major and 1 minor) surgical complications (12.7% of patients) and 13 (2 major and 11 minor) medical complications (27.7% of patients) occurred without death or wound infection. Fusion was achieved in 46 of 47 patients. Surgery resulted in a slight but significant decrease of the Cobb angle, and improved the pelvic parameters and lumbar lordosis, but had no effect on the global sagittal balance. At latest follow-up, 9 patients (19.1%) developed adjacent-segment disease at a mean of 2 years’ delay from the index surgery; 4 were symptomatic but treated medically, and none required iterative surgery.

CONCLUSIONS
Single- or 2-level minimally invasive fusion through a minimally invasive anterior approach in some selected cases of ADS produced a good functional outcome with a high fusion rate. They were associated with a significantly lower rate of complications in this study than the historical control.
The Demography of Royal Navy Surgeons: Some Views on the Process of Prosopography
Authors: Myers Christopher H 
Published: August 2015

This study is a brief social biography and demography of British naval doctors during the nineteenth century, asking why Scottish-educated surgeons were so prominent. Understanding the demography and changing dynamics of naval surgeons’ labor illuminates the complex relationship among the military, discrimination, and nationalism that shaped this influential labor market. This study reviews how to collect demographic information from multiple types of sources: university archives, matriculation records, digitized medical journals, and student rolls. It also uses chi-square tests to show the significance of the demographic information collected. The results show us the entangled relationship between database conceptualization, data collection, and data analysis.
Examining the Validity of EKC in Western Africa: Different Pollutants Option
Authors: Ogundipe Adeyemi A. , Olurinola Oluranti I. , Odebiyi John T. 
Published: August 2015

<p class="emsd"><span lang="EN-GB">The Environmental Kuznets Curve hypothesized pollution as a monotonic function of income which implies that as an economy develops, pollution level starts to increase but reaching a certain threshold the relation reverses. This study investigates the relationship between GDP per capita income and environmental degradation in Western Africa region using panel data analysis for the period 1990-2012. Our specific objective was to estimate EKC for four indicators of environmental quality such as CO<sub>2</sub> emissions, Suspended particulate matter (PM10), lack of access to sanitation facilities and lack of access to safe drinking water; and establish whether these pollutants exhibit an inverted u-shape function. Likewise, we subject our estimated relationship to sensitivity checks to ensure robustness to changes in assumption and estimation techniques, an aspect inherently lacking in most EKC literature. The study could not find an unambiguous evidence of an inverted u-shaped relationship for CO<sub>2</sub> emissions while the other point source pollutants confirmed the EKC theory. We subjected our estimation to further robustness checks by ascertaining the statistical properties of the variables used and examined the long run sustainability; results were found to be consistent and suitable for policy inferences. </span></p>
Institutionalism and the Normative Study of Politics:
Authors: Diermeier Daniel 
Published: August 2015

Abstract
We discuss the role of institutionalism in the normative analysis of public policy. In contrast to existing approaches to policy analysis, institutionalism focuses on the policy process rather than a specific policy outcome. Historically, institutionalism has been developed within the rational choice paradigm. This has led to sustained criticism by behaviorally oriented political scientists. We show that this dependence on rational choice is not a necessary component of institutionalism and discuss examples of behavioral approaches to institutional analysis.
On Attempts to Gerrymander “Positive” and “Normative” Political Theory:
Authors: Knight Jack , Johnson James 
Published: August 2015

AbstractWe aim to cast doubt on the now conventional distinction between “positive” and “normative political theory by shifting the burden of argument. We do not claim it is impossible to categorically differentiate political theory into “positive” and “normative” varieties. We do suggest the most familiar, extant strategies for approaching that task are implausible. We hope in the process to show that there are perfectly good reasons to set the task aside as counterproductive.