bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of Orthopaedic Volunteers and Their Local Hosts in Low- and Middle-Income Countries: Are We on the Same Page?
Authors: Wassef David W. , Holler Jordan T. , Pinner April , Challa Sravya , Xiong Meng , Zhao Caixia , Sabharwal Sanjeev 
Published: September 2018

Objective:
Our goal was to compare the perceptions of overseas orthopaedic volunteers and their hosts in low- and middle-income countries (LMICs) regarding the role of international volunteerism. We also sought to determine if differences in perception exist between trainee and fully trained orthoapedic surgeon volunteers.

Methods:
Surveys with similar multiple-choice and open-ended questions were administered to 163 Health Volunteers Overseas orthopaedic volunteers (response rate 45%) and 53 members of the host orthopaedic staff (response rate 40%). Fifty-four volunteers and 20 hosts also contributed open-ended responses. Quantitative responses were analyzed for significance using Mantel–Haenzel χ2 tests. Open-ended responses were coded using thematic analysis.

Results:
Both the international volunteers and their LMIC hosts agreed that volunteers learned new skills while volunteering. Both groups believed that international volunteerism had a positive overall impact on the local practice, but hosts viewed these benefits more favorably than volunteers did. LMIC staff believed that, besides altruistic reasons, volunteers were also motivated by professional gains, diverging from volunteer responses. In open-ended responses, hosts desired longer term commitments from volunteers and had some concerns regarding volunteers' qualifications. Between volunteer trainees and fully trained surgeons, trainees were more likely to be motivated by personal benefits.

Conclusion:
Efforts must be made to further align the expectations and goals of volunteers and their hosts in LMICs. Certain measures such as predeparture orientations for volunteers and developing a more longitudinal and bidirectional experience may enhance the impact of orthopaedic volunteerism in LMICs. Further studies are needed to explore the impact of international orthopaedic volunteerism on the host population.
Are We Spending Wisely? Impact of POSNA Grants on Scholarly Productivity and Future Funding Success
Authors: Nhan Derek T. , Schoenecker Jonathan G. , Larson A. Noelle , Sponseller Paul D. 
Published: September 2018

Background:
The Pediatric Orthopaedic Society of North America (POSNA) funds grants to improve pediatric musculoskeletal care and maximize new knowledge through publications, presentations, and further funding. We assessed the productivity of POSNA grants by number and rate of grant-specific publications, citations, and extramural funding; determined whether project type or completion status was associated with extramural funding; and compared the success of POSNA-funded versus all other podium presentations by publication rate and POSNA awards.

Methods:
We reviewed final reports for all 85 POSNA grants from 2003 to 2014. To determine grant productivity, we assessed the publication, presentation, and extramural funding rates, and the percentage of grants that achieved at least 1 scholarly output (publication or presentation). Citation counts were determined within 3 years after publication.

Results:
Overall, each grant achieved ~1.53 publications and 15.4 citations. Thirty-three percent secured extramural funding. However, 25% of grants could not be tracked to a scholarly product. Projects that reached completion and were of the basic science type (compared with clinical) were more likely to receive extramural funding. Compared with all other podiums, a greater proportion of POSNA-funded presentations led to a publication (64% vs. 48%, respectively; P=0.02) and were more likely to receive a POSNA award. Approximately 52% of funded projects were not presented at POSNA meetings.

Conclusions:
Although most POSNA-funded projects led to scholarly output, 25% of them produced no publications or podium presentations. POSNA-funded projects were more likely to lead to a publication and to have a higher chance of winning a POSNA award compared with all other projects. The POSNA grant process is effective at identifying impactful research, but continued process improvement, such as a prospectively maintained database of grant recipient productivity and improved tracking of grant submission histories, are both in development as the first steps to improve accountability of grant recipients in translating their projects to scholarly products.
The Effect of Preoperative Medications on Length of Stay, Inpatient Pain, and Narcotics Consumption After Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Haws Brittany E. , Khechen Benjamin , Patel Dil V. , Bawa Mundeep S. , Guntin Jordan A. , Cardinal Kaitlyn L. , Wiggins Adam B. , Singh Kern 
Published: September 2018

Study Design:
This is a retrospective cohort study.

Objective:
To determine the association between preoperative medications and length of stay, inpatient pain, and narcotics consumption after a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of Background Data:
Previous studies have identified risk factors for increased length of hospital stay, inpatient pain, and narcotics consumption. However, little is known regarding the effects of preoperative medications on outcomes after spine surgery.

Methods:
A prospectively maintained surgical database of patients undergoing primary, single-level MIS TLIF was retrospectively reviewed. Preoperative medications taken within 30 days before surgery were recorded for each patient and categorized by medication type. Poisson regression with robust error variance was used to determine the association between preoperative medications and length of stay, pain scores, and narcotics consumption. Multivariate analysis was performed using a backwards, stepwise regression to identify independent risk factors.

Results:
In total, 138 patients were included in this analysis. On bivariate analysis, benzodiazepines were associated with longer hospital stays [relative risk (RR)=2.03; P=0.031]. Benzodiazepines (RR=3.71; P<0.001) and preoperative narcotics (RR=2.60; P=0.012) were risk factors for pain ≥7 on postoperative day 0. On multivariate analysis, benzodiazepines were an independent risk factor for prolonged stay. Benzodiazepines, narcotics, and nonsteroidal anti-inflammatories were identified as independent risk factors for increased postoperative pain.

Conclusions:
These results suggest that benzodiazepines are a risk factor for increased length of stay and postoperative pain after MIS TLIF. Preoperative narcotics and nonsteroidal anti-inflammatories were also identified as risk factors for postoperative pain though this did not lead to increases in narcotics consumption. Patients taking these medications should undergo more vigilant perioperative monitoring for adequate pain management. More work must be done to further elucidate the association between preoperative medications and postoperative outcomes after MIS TLIF.
Risk Factors for a Long Hospital Stay Following Minimally Invasive Lumbar Discectomy
Authors: Khechen Benjamin , Haws Brittany E. , Patel Dil V. , Narain Ankur S. , Hijji Fady Y. , Bawa Mundeep S. , Cardinal Kaitlyn L. , Guntin Jordan A. , Singh Kern 
Published: September 2018

Study Design:
Retrospective cohort study.

Objective:
The purpose of the study was to determine risk factors for discharge after postoperative day (POD) 0 in patients undergoing 1-level minimally invasive lumbar discectomy (MIS LD).

Summary of Background Data:
MIS LD has proven to be an effective treatment modality for low back pain and radiculopathy associated with intervertebral disc herniations. With increasing focus on cost reduction and value-based care, minimization of postoperative length of stay has become an important topic for physicians and hospital administrators.

Methods:
A prospectively maintained surgical database of patients who underwent 1-level MIS LD by a single surgeon from 2011 to 2016 was reviewed. Long length of stay was defined as discharge after POD 0. Bivariate and stepwise multivariate Poisson regression with robust error variance was used to determine risk factors for discharge after POD 0. Variables analyzed included patient demographics, comorbidities, operative characteristics, preoperative pain scores, postoperative inpatient pain scores, and postoperative narcotics consumption.

Results:
A total of 176 patients were included; 9.7% of included patients were discharged on POD 1 or later. On bivariate analysis, diabetic status (57.1% vs. 7.7%; relative risk [RR]=7.43; P<0.01) and narcotic consumption <6.00 oral morphine equivalents/h (13.1% vs. 1.2%; RR=11.11; P=0.019) were associated with a prolonged length of stay. On stepwise multivariate analysis, diabetic status (RR=10.5; 95% confidence interval, 3.60–30.98; P<0.001) was found to be independently associated with a prolonged length of stay after MIS LD.

Conclusions:
The results indicate that diabetic status is an independent risk factor for increased LOS following single-level MIS LD. Delayed hospital discharge can lead to increased costs, increased risk of complications, and decreased patient satisfaction. Thus, providers can use this information to better counsel diabetic patients and monitor them more closely following MIS LD. Additional work must be done to better understand risk factors for increased length of stay following MIS LD in procedure-specific populations.

Level of Evidence:
Level II.
Eosinophilic Dermatosis of Myeloproliferative Disease in a Young Adult With Diffuse Large B-Cell Lymphoma
Authors: Jencks Amy , Kiavash Katrin , Daveluy Steven , Thompson Andrew D. 
Published: September 2018

Abstract:Exaggerated insect bite reactions present as exuberant papular and vesiculobullous lesions in patients with hematologic malignant neoplasms. The most commonly reported hematological malignancy with exaggerated insect bite reactions is chronic lymphocytic leukemia. Other reported reactions have been seen in patients with mantle cell lymphoma. Clinical presentation may vary with many patients unaware of a previous insect bite. Therefore, the terms “exaggerated bite-like reaction” and “eosinophilic dermatosis of myeloproliferative disease” have been proposed. The lesions may wax and wane or persist for many years, and they seem to be unrelated to the underlying hematologic disorder course or therapy. In some circumstances, the lesions may actually precede the diagnosis of the hematological malignancy. In this study, we describe a case of “eosinophilic eruption of myeloproliferative disease” associated with diffuse large B-cell lymphoma in a young adult. To the best of our knowledge, this is the first case reported in association with diffuse large B-cell lymphoma.
Facial Phaeohyphomycosis in an Immunocompetent Individual: A Rare Presentation of a Rare Fungus
Authors: Kapatia Gargi , Pandey Tushar , Kakkar Nandita , Kaur Harsimran , Verma Roshan 
Published: September 2018

Abstract:
Phaeohyphomycosis is a rare mycotic infection caused by heterogenous groups of dematiaceous fungi involving the skin and subcutaneous tissue. Here, we report a case of cutaneous phaeohyphomycosis presenting as cauliflower-like verrucous lesion over the face in an immunocompetent individual. Histopathology showed suppurative granulomatous inflammation replete with pigmented broad fungal hyphae which is stained with periodic acid–Schiff stain, Grocott's methanamine silver stain, Schmorl's stain, and Masson-Fontana stain. Culture showed black-colored colonies identified as Exophiala spinifera.
Mucinous Metaplasia of the Vulva in Zoon Vulvitis and Lichen Sclerosus et Atrophicus. Description of 3 Additional Cases of a Rarely Reported Histopathologic Finding
Authors: Santonja Carlos , Suárez-Peñaranda José Manuel , Carrasco Loreto , Fariña María del Carmen , Requena Luis 
Published: September 2018

Abstract:
Mucinous metaplasia of the vulva (MMV) is a histopathologic finding that has been reported previously in only 3 patients and needs to be distinguished from vulvar extramammary Paget disease. We report 3 additional instances of MMV associated to Zoon vulvitis and vulvar lichen sclerosus et atrophicus. Histochemical and immunohistochemical studies were performed on biopsies from erythematous and erosive vulvar lesions of 3 women aged 64, 80 and 84 years, with features of Zoon vulvitis (2 cases) and lichen sclerosus et atrophicus (1 case). Mucin-containing epithelial cells were present on the uppermost layers of the squamous epithelium. On immunohistochemical study the metaplastic cells were positive for cytokeratin 7, epithelial membrane antigen and carcinoembryonic antigen, thus mimicking the phenotype of Paget disease. MMV is most likely related to chronic inflammation. Cytological and architectural features allow for distinction from Paget disease because the mucin-containing cells of mucinous metaplasia of the vulva lack atypia and are predominantly located on the most superficial layers of the surface epithelium.
Personal (Self) Perceptions of Submental Fat Among Adults in the United States
Authors: Baumann Leslie , Shridharani Sachin M. , Humphrey Shannon , Gallagher Conor J. 
Published: September 2018

BACKGROUND
Satisfaction with discrete facial areas influences self-perceptions of attractiveness, self-esteem, and quality of life. Currently, there is a lack of understanding of how the submental area impacts feelings and behaviors.

OBJECTIVE
To characterize the effects of submental fat (SMF) on feelings/emotions and actions/behavior among adults in the United States.

METHODS
Online health-based surveys recruited approximately 400 adults (18–65 years) in each of 5 categories based on the respondent's assessment of their SMF. Respondents either agreed or disagreed with 17 statements regarding their feelings/emotions and actions/behaviors related to the area underneath their chin.

RESULTS
Overall, 1996 respondents were included (equal distribution of males/females; mean age, 41.9 years). Even a slight amount of chin fat was associated with negative feelings and behaviors. As SMF increased, so did the number of respondents reporting negative self-perceptions such as being embarrassed by the area under their chin. In general, a greater percentage of female compared with male respondents reported negative feelings and behavioral changes due to their submental area.

CONCLUSION
Excess SMF can have a substantial negative effect on a person's feelings of attractiveness and behaviors. Reduction of SMF may not only improve one's appearance, but also may enhance one's self-esteem.
Noninvasive Atrophic Acne Scar Treatment in Asians With a 755-nm Picosecond Laser Using A Diffractive Optic Lens—A Retrospective Photographic Review
Authors: Huang Ching-Hsin , Chern Erick , Peng Jui-Hui , Hsien-Li Peng Peter 
Published: September 2018

BACKGROUND
The diffractive lens of the picosecond laser is relatively new, and there are few reports on its efficacy in treating atrophic acne scars, especially in Asian populations.

OBJECTIVE
Evaluating the efficacy of diffractive lens 755-nm picosecond laser for atrophic acne scar treatment in Asians.

PATIENTS AND METHODS
Forty-two patients who were treated for facial atrophic acne scars at a private dermatological clinic were enrolled in this retrospective analysis. Mean session count was 4.28. Before and after photographs were assessed by 2 blinded dermatologists, who rated the amount of overall skin quality improvement on a 5-point scale.

RESULTS
All patients experienced improvements in scar texture and overall skin quality after 2 to 6 sessions, with scores of +1.4, 1.45, 1.7, 1.33, 2.3, and 1.66 points after 2, 3, 4, 5, 6, and >6 treatments, respectively. There were no obvious adverse effects after treatment. The postinflammatory hyperpigmentation (PIH) risk was 4.7% (2 of 42, both spontaneously resolved).

CONCLUSION
The 755-nm diffractive lens picosecond laser showed good efficacy and low PIH rates when treating atrophic acne scars in darker skin–type patients. In addition to treatment results, additional improvements in overall skin quality and pigmentation make the picosecond laser an effective and desirable treatment option for Asians.
Efficacy, Safety, and Subject Satisfaction After AbobotulinumtoxinA Treatment of Upper Facial Lines
Authors: Hexsel Doris , Cartier Hugues , Hedén Per , Delmar Henry , Bergentz Per , Camozzato Fernanda , Siega Carolina , Skoglund Cecilia , Edwartz Carolina , Rees Diane , Kestemont Philippe 
Published: September 2018

BACKGROUND
Botulinum toxins are the treatment of choice for wrinkles in the upper third of the face.

OBJECTIVE
The purpose of this study was to evaluate the efficacy, safety, and subject satisfaction of abobotulinumtoxinA (ABO) for treatment of upper facial lines.

MATERIALS AND METHODS
Subjects aged 35 to 50 years with moderate-to-severe upper facial lines were included in this study. Subjects received a maximum of 125 s.U. ABO in at least 2 indications with optional touch-up after 2 weeks. Assessments included wrinkle severity, global aesthetic improvement, subject satisfaction, and adverse events (AEs) 1, 3, and 6 months after treatment.

RESULTS
At Month 1, 100, 94, and 93% of subjects were responders in dynamic glabellar, lateral canthal, and forehead lines, respectively. All subjects were improved 1 month after treatment, and the majority of the subjects were still improved after 6 months. After treatment, most subjects were satisfied with the appearance of their face, felt better about themselves, and agreed that the treatment made them look the way they feel. Seven subjects (22%) had 8 ABO-related AEs (mild–moderate); headache was most commonly reported (9%).

CONCLUSION
AbobotulinumtoxinA effectively treated upper facial lines, with high patient satisfaction. Treatment was generally well-tolerated.
Presidential Perspectives: Women’s Views From the Top
Authors: Roessler Genevieve , McBurney Ruth , Pryor Kathryn H. , Hamrick Barbara , Kirner Nancy P. , Martinez Nicole E. 
Published: September 2018

Abstract
This paper presents the perspectives of past presidents of the Health Physics Society who also happen to be women. Only 6 out of 63 Society presidents have been women, and of these six, five are still living and briefly reflect on their experiences here, alongside a brief discussion of the first female president of the Society. These perspectives provide historical insight into the evolution and happenings of the Society as well as adding personal touches to the office of the president that hopefully will encourage junior Society members to consider serving.
Setup and Characterization of a 137Cs Dosimetry Calibration Source in a Space-constrained Environment
Authors: Mapes Jasmine L. , Liu Kevin , Abraham Sara A. , Wilhelm Andrew S. , Latosz Logan V. , Kearfott Kimberlee J. 
Published: September 2018

Abstract
Proper characterization of 137Cs sources used for dosimeter calibration and performance testing is crucial for accurate and precise knowledge of air kerma rate and delivered dose. A 269 GBq 137Cs source was relocated to a new facility, which had a footprint of approximately 2.8 m × 3.6 m and a 3.4 m high ceiling. A small room size, such as in the new facility, may significantly increase backscatter from the walls or room return. Due to the limited source strength, a relatively close irradiation position of 1.00 m from the source was selected to decrease required exposure times. Proximity to the small but cylindrical source has the potential to alter the 1/r
2 relationship (inverse square law) of air kerma rate with distance associated with point sources. Practical tutorials concerning dosimetry irradiation facilities are largely absent from the archival literature. For those reasons, standard characterization experiments were repeated multiple times, great care was taken with positioning, several experiments were added to the standard ones, an ion chamber and dosimeters were used rather than film for greater accuracy and precision, and practical details of the process were recorded. The impacts of room size and finite source dimensions were quantified and mitigated by the efforts reported here. Recommendations for simple but thorough facility characterization, beam calibration, and quality control resulted.
Trust—what Connects Science to Daily Life
Authors: Ando Ryoko 
Published: September 2018

Abstract
Seven years have passed since the Tokyo Electric Power Company Fukushima Dai-ichi nuclear power plant disaster in March 2011. The actions taken by the Japanese government, such as issuing evacuation orders and setting decontamination and food safety standards, created huge confusion in society that led to a breakdown of trust. The residents of Suetsugi, a small village located about 30 km south of the plant, sought to understand and overcome the effects of radiation by measuring contamination and personal dose, etc. In my work through Ethos in Fukushima (a nonprofit organization in Iwaki, Fukushima), I learned that trust—not just measuring radiation or acquiring more scientific knowledge—has been the critical factor for them to regain a sense of order in their lives. The level of radiation has decreased since 2011; however, the community still struggles with rebuilding the community.
Consolidation of Health Physics Computer Codes: Sustainable Gains in Efficiency, Innovation, and Collaboration
Authors: Bush-Goddard Stephanie P. , Shaffer Vered A. , Norman Kerstun J. 
Published: September 2018

Abstract
A decade ago, the nuclear power industry in the United States was on the verge of a nuclear renaissance with the potential to create jobs, funding streams, and great demand for radiation protection personnel. However, based on the high capital investment cost of building and licensing nuclear reactors and declining fossil fuel prices, the renaissance did not reach its full potential. Radiation protection initiatives were developed to bring attention to the profession in order to increase funding for the health physics community during these times of declining resources. It is now essential that the community be innovative in how it uses existing funds and acquires resources. This paper describes a radiation protection computer code program that uses existing resources and international funding to sustain computer codes and tools used in the health physics profession. The program is called the U.S. Nuclear Regulatory Commission’s Radiation Protection Computer Code Analysis and Maintenance Program or RAMP. This collaborative, innovative, and transformative model can be followed by others seeking to alleviate the resource issues that exist within the health physics field.