bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Control of Infectious Disease in Orthotics and Prosthetics
Authors: Muller Ashley , Fiedler Goeran 
Published: May 2018

ABSTRACT

Introduction
It is generally expected that medical professionals use methods in their practice to prevent the spread of infectious disease. Although these methods are typically observed in patient examination rooms, practitioners and other professionals in the industry of orthotics and prosthetics (O&P) face the unique challenge that patient care continues without the patient in other locations where disease may spread: the laboratory and the storage room. Orthotics and prosthetics laboratories use tools throughout the day to fabricate and/or modify multiple devices for different patients. Commonly, little to nothing is done to prevent cross-contamination from one device to another. Items kept in storage rooms have potential for use by more than one patient, primarily for sizing or casting purposes, but may not be cleaned in any way before being restocked. Despite the inherent risk of infection spreading as a result of cross-contamination from the laboratory or restocked items, no standard protocol for this issue has been set in place by the Occupational Safety and Health Administration (OSHA) or by any O&P facility accreditation bodies.

Materials and Methods
A survey emailed to subscribers of OANDP-L, an online email discussion list consisting of members of the O&P community, inquired about current O&P infection control methods used outside of patient examination rooms, general knowledge of terms regarding infection control, and perception of risk of infection in the O&P industry. The survey results were used to assess the current climate of infection control in O&P so that future research can lead to a standard protocol designed to protect patients and professionals from infectious disease.

Results
A total of 123 O&P professionals completed the survey. Roughly two-thirds of respondents agreed that cross-contamination from devices poses infection risks. Only about half of the sample reported washing hands for the recommended 15 seconds or longer. A total of 44% and 76c of respondents, respectively, reported mostly not cleaning patient devices and tools.

Discussion
Findings show a deficit in awareness by a substantial number of respondents. Infection control in O&P work environments has potential for improvement. A key aspect in fostering those improvements is, next to educational efforts, a change in reimbursement policies that account for the staff time required to follow recommended procedures.
Physical Therapists' Pursuit of an Academic Doctoral Degree: Strategies for Success
Authors: Santasier Anita M. , Wainwright Susan Flannery 
Published: May 2018

Introduction.
Physical therapy programs are challenged to meet the expectations of a blend of academic and clinical doctorally prepared faculty. The purpose of this qualitative phenomenological study is to reveal the specific knowledge and behaviors of physical therapists pursuing an academic doctoral degree that will lead to a successful journey.

Methods.
An inductive content approach guided data collection and data analysis allowing in-depth exploration of this phenomenon from the participant's perspective. A purposive sampling method was used involving physical therapists with varied experiences with respect to time to completion, program, and institution type in their pursuit of an academic doctoral degree.

Results.
The doctoral journey is described as facilitated by the individual's ability to (theme 1) create a “good fit” between themselves and the program that they select and (theme 2) use effective strategies to sustain pursuit to completion.

Discussion and Conclusion.
The lived experience of these participants is consistent with the metaphor of doctoral education being represented as a quest to “become a PhD” rather than a journey to “get a PhD.” Recommendations emerging from the themes were developed to positively influence the number of physical therapists (PTs) who reach completion, the time to completion, and the quality of the experience.
Increasing the number of PhD PTs will help combat the growing physical therapy faculty shortage, as well as increase the potential for the production of physical therapy research.
Clinical Trials in Gynecologic Oncology: Past, Present, and Future
Authors: Annunziata Christina M. , Kohn Elise C. 
Published: May 2018

(Abstracted from Gynecol Oncol 2018;148(2):393–402)
Groundbreaking, practice-changing clinical trials in women's cancers have historically been run through the Gynecologic Oncology Group (GOG). Clinical trials completed within the GOG group structure have determined the current standard of care for initial treatment of ovarian, endometrial, cervical, and trophoblastic cancers.
Association of Pharmacologic Treatment of Urgency Urinary Incontinence With Sleep Quality and Daytime Sleepiness
Authors: Warsi Qurratul A. , Huang Alison J. , Hess Rachel , Arya Lily A. , Richter Holly E. , Bradley Catherine S. , Rogers Rebecca G. , Myers Deborah L. , Johnson Karen C. , Winkelman William D. , Gregory W. Thomas , Kraus Stephen R. , Schembri Michael , Brown Jeanette S. , Stone Katie L. , Subak Leslee L. 
Published: May 2018

(Abstracted from Obstet Gynecol 2018;131:204–211)
Both incontinence and sleep disturbance are common and bothersome conditions in middle-aged and older women. Any treatment that improves both conditions may provide clinical value.
Vaginal Rejuvenation: A Review of Female Genital Cosmetic Surgery
Authors: Wilkie Gianna , Bartz Deborah 
Published: May 2018

Importance
Female genital cosmetic surgery (FGCS) is a growing area within the field of gynecology with an increasing number of patients asking providers about these services.

Objective
This review aims to increase the knowledge surrounding the types of FGCS performed, the outcomes and complications of these procedures, and the controversy surrounding FCGS.

Evidence Acquisition
This study is a review of the most recent peer-reviewed articles and review articles as well as guidelines and recommendations of the American College of Obstetrics and Gynecology.

Results
Female genital cosmetic surgery is a broad term that encompasses multiple procedures including labiaplasty, vaginoplasty, clitoral hoodectomy, hymenectomy, labia majora augmentation, and G-spot amplification. Minimal data exist regarding the long-term outcomes and complications associated with these procedures. There is also a paucity of literature comparing FGCS to less invasive alternatives. Significant controversy exists regarding FGCS, given the known variation in female genitalia, lack of safety data, and concern for proprietary conflict with these procedures.

Conclusions and Relevance
Cosmetic gynecology surgery has become more popular in recent years, with few studies assessing the long-term benefits and harms of these treatments. Gynecologists should be aware of the lack of evidence supporting the effectiveness of FGCS in light of the growing marketing efforts and patient demand for these procedures.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to compare the various types of female genital cosmetic surgery that are available, assess the outcomes associated with female genital cosmetic surgery, and examine the controversies that surround female genital cosmetic surgery.
Puss Caterpillar Envenomation
Authors: Greene Spencer Corey , Carey John Morgan 
Published: May 2018

Abstract
A 4-year-old female presented to the emergency department with 2 days of abdominal pain, nausea, and vomiting. She was tachycardic and had abdominal tenderness. Laboratory studies revealed a leukocytosis, hypokalemia, and metabolic acidosis. Her Pediatric Appendicitis Score (MDCalc) was calculated as 6, indicating that appendicitis could not be excluded. She was transferred to our pediatric hospital for further evaluation. Her ultrasound at our facility was normal. Upon reexamination, the patient was noted to have a red mark on her left index finger, and the family reported that the patient may have been stung by a puss caterpillar before the onset of her symptoms. The patient was treated with ondansetron, morphine, and intravenous fluids, and her symptoms resolved. Erucism frequently develops after stings from the puss caterpillar, which can be found through the southern United States. The most consistent clinical feature is pain. Numbness, muscle cramping, paresthesias, nausea, vomiting, and chest pain have also been described. Severe abdominal pain is reported rarely and may be mistaken for peritonitis. Analgesia is the mainstay of treatment. Topical icepacks have demonstrated inconsistent benefit in relieving pain. Oral medications, including acetaminophen, nonsteroidal anti-inflammatory drugs, and, rarely, opioids, typically suffice. Severe envenomations may require parenteral narcotics.
Resident Performance of the Rapid Cardiopulmonary Assessment in the Emergency Department
Authors: Sobolewski Brad , Taylor Regina G. , Geis Gary L. , Kerrey Benjamin T. 
Published: May 2018

Objectives
The rapid cardiopulmonary assessment (RCPA) is an essential first step in effective resuscitation of critically ill children. Pediatric residents may not be achieving competency with resuscitative skills, including RCPA. Our objective was to determine how often pediatric residents complete the RCPA for actual patients.

Methods
This was an observational, cross-sectional study of senior residents (≥postgraduate year 2) performing the RCPA in the resuscitation area of a high-volume pediatric emergency department (PED), where pediatric residents are expected to perform the bedside examination and assessment for all medical (nontrauma) patients. Data were collected primarily by video review on a standard form. The primary outcome was completion of the RCPA, defined as both examination and verbalized assessment of the airway, breathing, and circulation. We explored the association between RCPA completion and both residency year and number of previous PED rotations.

Results
Complete data were collected from one randomly selected patient for 71 (95%) of 75 of eligible senior residents who rotated in the PED between January and June 2013. Two residents (3%) performed a complete RCPA. Verbalized assessment of circulation was especially rare (7/71; 10%). There was no association between RCPA completion and year of training or previous PED experience (P > 0.05).

Conclusions
Senior pediatric resident performance of the RCPA in the resuscitation area of a high-volume PED was poor. There was no association between RCPA completion and greater resident experience, including in the PED. These findings add to a growing body of literature suggesting that pediatric residents are not achieving competency with the RCPA and resuscitation skills.
Considerations of trial design and conduct in behavioral interventions for the management of chronic pain in adults
Authors: Edmond Sara N. , Turk Dennis C. , Williams David A. , Kerns Robert D. 
Published: May 2018

Abstract

Introduction:
A growing number and type of nonpharmacological approaches for the management of chronic pain have demonstrated at least modest evidence of efficacy, and for some, there is emerging evidence of their effectiveness in relatively large scale trials. Behavioral approaches are those that generally seek to promote adaptive behavioral change in the service of reducing pain and improving physical and emotional functioning and quality of life. Despite a substantial empirical literature supporting the clinical utility of these approaches, a large number of unanswered questions remain and clinical trials to answer some of these questions are needed. Although considerations for development and enactment of data-analytic plans are generally similar to those in pharmacological trials (eg, intent-to-treat, prespecifying outcomes and time points, and handling of missing data), there may be some important differences to consider when planning and conducting clinical trials examining these behavioral approaches.

Objectives:
The primary objective of this article is to describe some aspects of clinical trials for behavioral approaches for the management of chronic pain that requires special consideration.

Methods:
Important topics discussed include: (1) intervention development, (2) research design considerations (adequate and appropriate control and comparison conditions), (3) appropriate outcomes, (4) recruitment and sampling biases and blinding, (5) intervention fidelity and adherence, and (6) demographic and cultural considerations.

Results and Conclusions:
A number of methodological recommendations are made in the service of encouraging the conduct of high-quality research comparable with that performed for pharmacological and other medical interventions.
External Port Tissue Expansion in the Pediatric Population: Confirming Its Safety and Efficacy
Authors: Azadgoli Beina , Fahradyan Artur , Wolfswinkel Erik M. , Tsuha Michaela , Magee William , Hammoudeh Jeffrey A. , Urata Mark M. , Howell Lori K. 
Published: May 2018

Background:
External filling ports in tissue expander–based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors’ goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction.

Methods:
A retrospective review of all patients undergoing tissue expansion using external ports at Children’s Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed.

Results:
Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction.

Conclusions:
In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Gender Inequality for Women in Plastic Surgery: A Systematic Scoping Review
Authors: Bucknor Alexandra , Kamali Parisa , Phillips Nicole , Mathijssen Irene , Rakhorst Hinne , Lin Samuel J. , Furnas Heather 
Published: May 2018

Background:
Previous research has highlighted the gender-based disparities present throughout the field of surgery. This study aims to evaluate the breadth of the issues facing women in plastic surgery, worldwide.

Methods:
A systematic scoping review was undertaken from October of 2016 to January of 2017, with no restrictions on date or language. A narrative synthesis of the literature according to themed issues was developed, together with a summary of relevant numeric data.

Results:
From the 2247 articles identified, 55 articles were included in the analysis. The majority of articles were published from the United States. Eight themes were identified, as follows: (1) workforce figures; (2) gender bias and discrimination; (3) leadership and academia; (4) mentorship and role models; (5) pregnancy, parenting, and childcare; (6) relationships, work-life balance, and professional satisfaction; (7) patient/public preference; and (8) retirement and financial planning. Despite improvement in numbers over time, women plastic surgeons continue to be underrepresented in the United States, Canada, and Europe, with prevalence ranging from 14 to 25.7 percent. Academic plastic surgeons are less frequently female than male, and women academic plastic surgeons score less favorably when outcomes of academic success are evaluated. Finally, there has been a shift away from overt discrimination toward a more ingrained, implicit bias, and most published cases of bias and discrimination are in association with pregnancy.

Conclusions:
The first step toward addressing the issues facing women plastic surgeons is recognition and articulation of the issues. Further research may focus on analyzing geographic variation in the issues and developing appropriate interventions.
Three-Dimensional Printing in Rhinoplasty
Authors: Suszynski Thomas M. , Serra Jose Maria , Weissler Jason M. , Amirlak Bardia 
Published: May 2018

Summary:
Rhinoplasty is considered one of the most challenging procedures in plastic surgery. The authors introduce a novel concept of translating three-dimensional photographic images into three-dimensionally–printed, patient-specific, life-size models that can be used in preoperative counseling or as an intraoperative reference during rhinoplasty. This article describes the authors’ experience with this new application for three-dimensional printing, a technology that is overall garnering more widespread use and has prospective clinical and research applications in aesthetic surgery.
Semen Quality in Chinese College Students: Associations With Depression and Physical Activity in a Cross-Sectional Study
Authors: Zou Peng , Wang Xiaogang , Sun Lei , Chen Qing , Yang Huan , Zhou Niya , Chen Hongqiang , Zhang Guowei , Ling Xi , Wang Zhi , Gao Jianfang , Mo Min , Huang Linping , Peng Kaige , Chen Sheng , Cui Zhihong , Liu Jinyi , Ao Lin , Cao Jia 
Published: May 2018

ABSTRACTObjectiveBehavioral and psychosocial factors have been associated with a decline of the quality of semen. However, the relationship of depression and physical activity (PA) with semen quality remains unclear.MethodsData were obtained from 587 young male Chinese college students in June 2013. Participants completed a questionnaire assessing life-style factors, the Zung self-rated depression scale, and three items related to PA. They underwent a physical examination and provided a semen sample and a blood sample for reproductive hormones (testosterone, estrogen, progesterone, follicle-stimulating hormone, luteinizing hormone, and prolactin).ResultsMen with high depression scores (n= 63, 10.7%) had lower sperm concentration (M (SD) = 66.9 (74.5) versus 72.6 (56.9) [106/ml],p= .043) and total sperm count (M (SD) = 241.6 (299.7) versus 257.0 (204.0) [106],p= .024) than nondepressed men. Participants with low PA levels (n= 99, 16.9%) had lower total sperm count (M (SD) = 204.4 (153.7) versus 265.8 (225.8) [106/ml],p= .017) than participants with higher activity levels. After adjusting for potential confounders, depressed men had 18.90% (95% confidence interval [CI] = 1.14%–33.47%) lower sperm concentration and 21.84% (95% CI = 3.39%–36.90%) lower total sperm count than nondepressed men. Men with low PA levels had 23.03% (95% CI = 2.80%–46.89%) lower total sperm count than physically active participants. An interaction effect between depression and PA on sperm concentration was detected (p= .033). There were no significant associations of depression and PA with reproductive hormones (p> .05).ConclusionsDepression and low levels of PA are associated with lower levels of semen quality, which may have implications for reproductive health.
Factors Associated With Long Wait Times for Bariatric Surgery
Authors: Alvarez Rafael , Bonham Aaron J. , Buda Colleen M. , Carlin Arthur M. , Ghaferi Amir A. , Varban Oliver A. 
Published: May 2018

Background:
Despite its proven safety and efficacy, bariatric surgery is an underutilized therapy for severe obesity. Wait times for surgery are largely unexplored in the United States and may impact access to care.

Objective:
To determine the amount of time between initial bariatric surgery clinic visit and operative date and identify factors associated with longer wait times.

Methods:
A statewide clinical data registry was queried from 2006 to 2016 and 60,791 patients undergoing primary bariatric surgery were identified. Demographics, comorbidities, 30-day complications, and 1-year patient-reported outcomes were compared between shortest and longest wait time quartiles. Analyses were performed using Chi-square, t-test, and logistic regression.

Results:
Median wait times for bariatric surgery increased from 86 to 159 days during the study period. Median wait times were ≤67 days for the shortest wait time quartile and ≥204 days for the longest wait time quartile. Factors independently associated with longer wait times included Medicaid insurance [odds ratio (OR) 3.02; 95% confidence interval (CI): 2.58–3.53], sleep apnea (OR 1.49; 95% CI: 1.41–1.58), psychological disorder (OR 1.25; 95% CI: 1.18–1.32), hyperlipidemia (OR 1.21; 95% CI: 1.14–1.28), smoking history (OR 1.11; 95% CI: 1.05–1.17), and white race (OR 0.665; 95% CI: 0.614–0.720). Preoperative weight loss, risk adjusted complication rates, postoperative self-reported weight loss, and comorbidity remission were similar between groups.

Conclusions:
Over the past decade, eligible patients are experiencing longer wait times when pursuing bariatric surgery. Complex patients with Medicaid insurance are experiencing the longest delay despite similar outcomes and preoperative weight loss. Policies that delay surgery should be re-examined.
Cortical states control visual spatial perception
Authors: Speed Anderson , Rosario Joseph Del , Burgess Christopher P. , Haider Bilal 
Published: May 2018

SummaryMany factors modulate the state of cortical activity, but the importance of cortical states for sensory perception remains debated. We trained mice to detect spatially localized visual stimuli, and simultaneously measured local field potentials and excitatory and inhibitory neuron populations across layers of primary visual cortex (V1). Cortical states with low firing rates and correlations between excitatory neurons, and reduced oscillatory activity in Layer 4, accurately predicted single trials of visual spatial detection behavior. Our results show that cortical states exert strong effects at the initial stage of cortical processing in V1, and play a decisive role for visual spatial behavior in mice.