CME Activity Research Articles

Incorporating HER2/HER3 targeted therapies across solid tumors: Assessing the impact of digital education on clinician practice patterns.

11036 Background: Improved understanding of the interactions between HER2 and HER3, the heterogeneity of HER-expressing disease, and mechanisms of resistance to anti-HER2 therapy has led to increasing number of treatment options to address clinical needs. Tumor types of interest, impacted by HER2/HER3 expression and pathophysiology were breast cancer, non-small cell lung cancer (NSCLC), gastric cancer, and colorectal cancer (CRC). Increasing competency in these areas is deemed critical to clinician’s ability to individualize treatment plans and improve patient outcomes. Methods: A 2-hour CME activity was broadcast live-online in September 2020 and remains on-demand through September 2021 at OMedLive.com. The educational initiative was divided into one hour addressing HER2 and HER3, testing guidelines, resistance mechanisms and emerging data elucidating recent and ongoing clinical trials across NSCLC, gastric cancer, and CRC. The second hour focused on individualizing metastatic HER2+ breast cancer, HER2-low breast cancer as an emerging subtype, and management of side effects. Knowledge and competence questions were administered pre-, immediate post-, and 2 mos. post-activity. Behavioral impact questions were also asked at follow-up. Data from these questions were analyzed to determine engagement and clinical impact. Results: To date, 448 clinicians participated in the activity. Across the seven CME test questions, improvements in knowledge and competence were observed in the clinical applications of HER2-directed agents and HER3 antibody drug conjugates (ADCs), first-line standard of care for HER2+ breast cancer, and adverse event management for HER2 ADCs. At 2-mos. follow-up, 67% reported improved behavioral impact on both clinical practice and patient experience and outcomes. Clinicians provided specific write-in examples of these changes, noting improved patient-reported outcomes, improved treatment adherence, improved competence developing treatment plans, and increased understanding of HER2/HER3 pathophysiology. Updated and expanded results will be shared. Conclusions: The activity was successful in improving clinician understanding of the relationship between HER2/HER3, pathophysiology across tumor types, and applications of emerging targeted therapies. Open-ended responses to behavioral impact questions illustrated clear improvements in clinician-reported patient experience and outcomes, clinical practice management, and knowledge of emerging HER2/HER3 therapies and their uses across multiple solid tumors.

The Extended Retrosigmoid Approach

Dr. Basma is a Cerebrovascular and Skull Base Fellow, Dr. Cai is Research Fellow, and Dr. Krisht is Director, Arkansas Neuroscience Institute, CHI Saint-Vincent North, 6020 Warden Rd Ste 100, Sherwood, AR 72120; E-mail: [email protected]. The authors, faculty, and staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Category: Skull Base Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on May 14, 2023.

Relationships Between Functionality, Depression, and Anxiety With Community Integration and Quality of Life in Chronic Traumatic Spinal Cord Injury.

The aims of the study were (1) to identify relationships between functional and psychological aspects with community integration and quality of life assessments in people with chronic traumatic spinal cord injury and (2) to analyze clinical and demographic predictors of quality of life dimensions. This is an observational cohort study, and correlation coefficients were calculated between the Functional Independence Measure, the Hospital Anxiety and Depression Scale, the Community Integration Questionnaire, and the World Health Organization Quality of Life-BREF dimensions (physical [D1], psychological [D2], social [D3], and environmental [D4]). Quality of life predictors were identified using multiple linear regression analyses. Nine hundred seventy-five people with traumatic spinal cord injury assessed since 2007-2020 were included. The Community Integration Questionnaire home integration correlated strongly with the Functional Independence Measure self-care (r = 0.74) and transfers (r = 0.62) for participants with tetraplegia. The specific Hospital Anxiety and Depression Scale items (known as the anhedonia subscale) correlated strongly with D1 (r = -0.65), D2 (r = -0.69), D3 (r = -0.53), and D4 (r = -0.51) for participants with paraplegia and D1 (r = -0.53), D2 (r = -0.61), D3 (r = -0.47), and D4 (r = -0.53) for participants with tetraplegia. The Hospital Anxiety and Depression Scale-depression was the most relevant predictor of D1 (β = -0.61) and D2 (β = -0.76). The Functional Independence Measure transfers and self-care were strongly associated with the Community Integration Questionnaire home integration (in participants with tetraplegia). Anhedonia was strongly related to all four World Health Organization Quality of Life-BREF Scale dimensions, being the Hospital Anxiety and Depression Scale-depression the most relevant predictor of D1 and D2. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to (1) Determine the associations between functional and psychological measures with community integration domains and quality of life from a multidimensional perspective (physical, psychological, social, and environmental) in persons with chronic traumatic paraplegia or tetraplegia living in the community; (2) Identify long-term clinical and demographic predictors of specific quality of life dimensions (e.g., physical and psychological) in persons with paraplegia or tetraplegia living in the community; and (3) Illustrate the strength of the identified associations and the impact of the quality of life predictors to suggest possible specific aspects to be addressed by professionals in clinical practice. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Motor Skills Training Improves Function in Chronic Low Back Pain

Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires April 30, 2023. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies relevant to this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Introduction to Endoscopic Spine Surgery

Dr. Derman is a Spine Surgeon, Texas Back Institute, 6020 West Parker Rd, Ste 200, Plano, TX 75201; E-mail: [email protected]. The author, faculty, and all staff in a position to control the content of this CME activity, and their spouses/life partners (if any), have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations related to this CME activity. Dr. Derman has disclosed that he serves as paid teaching faculty for Joimax. Lippincott CME Institute has identified and resolved all conflicts of interest concerning this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on April 30, 2023.

Lumbar Bracing for Chronic Low Back Pain: A Randomized Controlled Trial.

We performed this study to evaluate the effect of back bracing to treat patients with chronic low back pain. This was a prospective, unblinded, randomized controlled trial of 61 adults with uncomplicated chronic low back pain (>12 wks) and imaging findings of degenerative spondylosis, to assess the effectiveness of a semirigid back brace. All study participants received back school instruction. The treatment group also received a lumbar orthosis and was instructed to wear it as needed for symptom relief. At baseline, 6 wks, 12 wks, and 6 mos after intervention, we collected: Numerical Rating Scale to measure pain intensity, Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EuroQol 5-Dimension (EQ-5D) to measure patient-reported function and quality of life. An interim analysis at the halfway point in enrollment (61 of 120 planned participants) revealed the Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EQ-5D scores in the treatment group to be worse than in the control group, but no significant group differences in Numerical Rating Scale scores. Outcome differences between groups analyzed over time revealed (effect [P]): Pain Disability Questionnaire = 0.84 (0.04); Patient-Reported Outcome Measurement Information System = 0.78 (0.005); EQ-5D = 0.06 (0.01); and Numerical Rating Scale = 0.02 (0.6). We halted the study because continuation was unlikely to produce significant changes to the results. In patients with uncomplicated chronic low back pain, a back brace when combined with education and exercise instruction did not provide any pain relief compared with education and exercise instruction alone. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Describe the effect of lumbar back bracing on pain intensity in patients with chronic low back pain; (2) Discuss the effects of lumbar back bracing on pain-related disability, function, and quality of life in patients with chronic low back pain; and (3) Understand the role of lumbar back bracing in the treatment of patients with chronic low back pain. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Transsphenoidal Approach and Its Variants: Part II

Dr. Krisht is Director, Arkansas Neuroscience Institute, CHI Saint-Vincent North, 6020 Warden Rd Suite 100, Sherwood, AR 72120; E-mail: [email protected]. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Category: Tumor This article was published originally in Contemporary Neurosurgery. 2002;24(26):1–6. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on March 29, 2023.

Researchers Explore the Association Between Rheumatoid Arthritis and Comorbid Conditions

Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires March 31, 2023. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies relevant to this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Continuing Bisphosphonate Use and Hip Fracture in Older Women

Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires March 31, 2023. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies relevant to this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Drivers of Costs and Predictors of Health Care Utilization After Elective Spinal Surgery

Dr. Gerlach is a Resident, Mr. Plantz is a Medical Student, and Dr. Patel is Professor, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St, #1350, Chicago IL 60611; E-mail: [email protected]. Dr. Gerlach, Mr. Plantz, and all faculty and staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Dr. Patel has disclosed that he is a consultant for Zimmer Biomet, DePuy Synthes, nView, Amedica, and Kuros Biosciences; is involved with product design for, and receives royalties from, Nuvasive, Zimmer Biomet, Amedica, and Alphatec Spine; is a stock shareholder in Amedica, Vital5, Nocimed, Cytonics, nView, Tissue Differentiation Intelligence, and Endoluxe; and receives fellowship program support from NuVasive and AO Spine North America. Lippincott CME Institute has identified and resolved all conflicts of interest concerning this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on March 31, 2023.

Risk Factors for Pain a Year After Total Knee Arthroplasty

Ms. Hoffmeister is a freelance medical writer in Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires February 28, 2023. Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies relevant to this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Effectiveness of Bioskills Training in Spinal Surgery

Dr. Foley is a Research Fellow, and Dr. Hsu is Clifford C. Raisbeck Distinguished Professor of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 675 North Saint Clair St, Chicago, IL 60611; E-mail: [email protected]. Dr. Foley and all faculty and staff in a position to control the content of this CME activity, and their spouses/life partners (if any), have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Dr. Hsu has disclosed that he is a consultant for Stryker, Asahi, Wright Medical, Medtronic, and Bioventus. Lippincott CME Institute has identified and resolved all conflicts of interest concerning this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on February 28, 2023.

How We Assess Spatial Neglect Matters: Prevalence of Spatial Neglect as Measured by the Catherine Bergego Scale and Impact on Rehabilitation Outcomes.

The aim of this study was to determine the prevalence and functional impact of unilateral spatial neglect on right hemisphere stroke patients in an inpatient rehabilitation facility using a multidimensional, functionally based behavioral measure (Catherine Bergego Scale [CBS]). This was a retrospective cohort study of 742 consecutive admissions of patients with right hemispheric stroke to an inpatient rehabilitation facility. Spatial neglect was assessed using the CBS. Functional impact of neglect was measured by hospital length of stay, Functional Independence Measure change per day, discharge destination, and number of falls. As measured by the CBS, 86% of the right hemisphere stroke patients had symptoms of spatial neglect. Moderate and severe neglect was associated with less Functional Independence Measure change per day and lower rates of community discharge. The presence of neglect was not significantly associated with fall rate or length of hospital stay after controlling for admission Functional Independence Measure scores and age. The "difficulty looking left" CBS item had the strongest relationship with total CBS scores and effectively predicted Functional Independence Measure change per day and discharge destination. Using a sensitive measure, the CBS, rates of spatial neglect are extremely high in right hemisphere stroke patients entering inpatient rehabilitation. Both identification and determination of neglect severity are extremely important given their significant relationship to rehabilitation outcomes and discharge destinations. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to (1) describe why carefully assessing spatial neglect in right hemisphere stroke patients is important; (2) identify multiple dimensions of spatial neglect assessed by the Catherine Bergego Scale and how this approach differs from traditional paper and pencil assessment methods; and (3) describe the relationship between spatial neglect as measured by the Catherine Bergego Scale and functional outcomes of right hemisphere stroke patients in inpatient rehabilitation settings. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Flexor Pollicis Longus Reflex: Interrater and Intrarater Reliability in Comparison With Established Muscle Stretch Reflexes.

The aim of this study was to investigate the interrater reliability and intrarater reliability of the flexor pollicis longus muscle stretch reflex (FPLR) and compare it with clinically established reflexes. A total of 71 healthy volunteers participated. The FPLR, biceps reflex, brachioradialis reflex, and patellar tendon reflex of each participant were tested bilaterally and rated by eight examiners (four experienced, four inexperienced). For intrarater reliability evaluation, five examiners rated the reflexes of four volunteers at four different points in time. Analysis of the interrater reliability with Gwet's AC1 demonstrated almost perfect agreement for FPLR (Gwet's AC1 = 0.90), biceps reflex (Gwet's AC1 = 0.90), and patellar tendon reflex (Gwet's AC1 = 0.95) when using binary data (reflex present vs. absent). Only fair agreement was found for the brachioradialis reflex (Gwet's AC1 = 0.56). Experienced raters had a higher agreement than inexperienced raters did when rating the biceps reflex and the patellar tendon reflex. The intrarater reliability was almost perfect for the patellar tendon reflex (Gwet's AC1 = 0.94), followed by the FPLR (Gwet's AC1 = 0.83) with substantial agreement and the biceps reflex (Gwet's AC1 = 0.57) with moderate agreement. The FPLR is a reliable diagnostic neuromuscular test and may therefore be useful in the clinical examination for C8/T1 nerve root lesions or pathologies of the interosseous anterior nerve. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Elicit the flexor pollicis longus muscle stretch reflex; (2) Discuss the disadvantage of kappa statistics in assessing the interrater reliability when the prevalence of the studied trait is very high or very low; and (3) Name the spinal nerves involved in the innervation of the flexor pollicis longus muscle. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Trial Compares Outpatient Therapist-Led Rehabilitation to Self-Directed Physical Therapy After Total Knee Arthroplasty

Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires January 31, 2023. The author, faculty, and staff in a position to control the content of this CME activity have disclosed that they and their spouses/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies relevant to this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Factors Associated With Symptomatic Rotator Cuff Tears: The Rotator Cuff Outcomes Workgroup Cohort Study.

Although rotator cuff tear is one of the most common musculoskeletal disorders, its etiology is poorly understood. We assessed factors associated with the presence of rotator cuff tears in a cohort of patients with shoulder pain. From February 2011 to July 2016, a longitudinal cohort of patients with shoulder pain was recruited. Patients completed a detailed questionnaire in addition to a magnetic resonance imaging scan and a clinical shoulder evaluation. The association of multiple factors associated with rotator cuff tears was assessed using multivariate logistic regression. In our cohort of 266 patients, 61.3% of patients had a rotator cuff tear. Older age (per 1 yr: odds ratio = 1.03, 95% confidence interval = 1.02-1.07), involvement of the dominant shoulder (odds ratio = 2.02, 95% confidence interval = 1.16-3.52), and a higher body mass index (per 1 kg/m2: odds ratio = 1.06, 95% confidence interval = 1.03-1.12) were independently associated with rotator cuff tears. Sex, depression, smoking status, shoulder use at work, hypertension, and diabetes were not significantly associated with rotator cuff tear. In a cohort of patients with shoulder pain, we identified older age, involvement of the dominant shoulder, and a higher body mass index to be independently associated with rotator cuff tear. The mechanism of how these factors possibly lead to rotator cuff tears needs further research. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Identify factors associated with an increased risk of developing rotator cuff tears in adults; (2) Describe the current epidemiological trends of rotator cuff tears in the United States; and (3) Discuss the pathophysiological role of aging in the development of nontraumatic rotator cuff tears. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Segmental Classification of the Internal Carotid Artery: An Overview

Dr. Bonasia is a Resident, Department of Neurosurgery, Neurocenter of the Southern Switzerland, Lugano, Switzerland; Dr. Bouthillier is Neurosurgeon, Division of Neurosurgery, University of Montreal Hospital Center (CHUM), Montreal, Quebec, Canada; and Dr. Robert is Neurosurgeon, Department of Neurosurgery, Neurocenter of the Southern Switzerland, Via Tesserete 46, 6903 Lugano (TI), Switzerland; E-mail: [email protected]. The authors, faculty, and staff in a position to control the content of this CME activity, and their spouses/life partners (if any), have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on December 29, 2022.

Frontiers in Chronic Pain: Nonpharmacologic Presurgical Management to Reduce the Risk of Chronic Postsurgical Pain—Part 1

Dr. Film is Associate Professor, Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, 100 Penn St, 315B, Baltimore, MD 21201; E-mail: [email protected]. The purpose of this article is to review options to predict, assess, and manage postoperative pain. The author, faculty, and staff in a position to control the content of this CME/NCPD activity, and their spouses/life partners (if any), have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity. CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on December 31, 2022. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this continuing nursing education activity. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This NCPD activity expires on December 2, 2022.

Embryologic Development of the Normal Craniofacial Arterial System: Part 2

Dr. Bertulli is a Resident, and Dr. Robert is a Neurosurgeon, Department of Neurosurgery, Neurocenter of the Southern Switzerland, Via Tesserete 46, 6903 Lugano (TI), Switzerland; E-mail: [email protected]. The authors, faculty, and staff in a position to control the content of this CME activity, and their spouses/life partners (if any), have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this CME activity. Category: Cerebrovascular Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on November 29, 2022.

14286 Online education yields significant gains in dermatologists’ knowledge of management strategies for psoriasis

Physicians face challenges staying up-to-date with the latest research and accessing the ever-growing field of knowledge is time-consuming. Online education can make these clinician’s tasks more efficient and less time-consuming. This study assessed whether the online CME-accredited round-table discussion titled “Targeting psoriatic disease: Treating the patient beyond the skin” improved physicians’ understanding of the optimal management of psoriasis patients considering a holistic disease assessment. The online CME activity (https://www.medscape.org/viewarticle/910807) consisted of 30-minute, 4-experts, video discussion. Educational effect was assessed using 4-question repeated pairs, pre-/post-assessment. Chi-square test was used to determine if a statistically significant improvement (P < .05) existed in the number of pre-/post test correct responses. The activity launched 3/28/2019; data were collected through 5/10/2019. A total of 563 dermatologists participated in this activity; 95 completed the pre- and post-assessment. Overall, the activity had a signficiant impact (P < .001) on dermatologists’ knowledge of management strategies for patients with different psoriatic manifestations: correct responses rose from 64% pre-activity to 81% post-activity. Significant (P < .05) improvements in correct responses were observed pre- vs post-assessment in 2 of the 3 questions presented: (i) prevalance of PsA in psoriasis patients (68% vs 85%), (ii) management of patients with difficult-to-treat psoriasis (59% vs 83%). A non-significant increase was observed regarding the appropriate selection of biologic for a patient with PsA and axial involvement (64% vs75%). A third of dermatologists gained confidence in their ability to choose therapy for patients with psoriasis and PsA. This online CME activity significantly improved dermatologists’ knowledge of management strategies for psoriasis.