bluuebunny/crossref_metadata_2025_split huggingface dataset:
School-Based Physical Therapy Services: Predicting the Gap Between Ideal and Actual Embedded Services
Authors: Clevenger Valerie D. , Jeffries Lynn M. , Effgen Susan K. , Chen Sixia , Arnold Sandra H. 
Published: March 2020

Purpose:To ascertain the variables predicting the gap between ideal and actual practice in embedding school-based physical therapy services.Methods:School-based physical therapists completed an online survey estimating ideal and actual practice of embedding physical therapy services. Predictive modeling was used to determine whether disability, interventions, goals, families, teachers, workload, billing, and/or contracts predicted the gap between estimated ideal and actual practice.Results:Data from 410 participants revealed that severity of students' disability, billing, written contracts, and families' preferences predicted the gap between estimated ideal and actual services. Actual practice varied based on region, APTA membership, and Academy of Pediatric Physical Therapy membership.Conclusions:Our model predicts the gap between estimates of ideally and actually embedding school-based physical therapy services. While 4 variables predicted the gap, further research is needed to develop a predictive model of actual practice to inform school-based physical therapy practice.
Assessment of Motor Repertoire in 3- to 5-Month-Old Infants With Obstetric Brachial Plexus Lesion
Authors: Kahraman Aysu , Mutlu Akmer , Livanelioğlu Ayşe 
Published: March 2020

Purpose:
The aim of this study was to define the movement characteristics and postures of infants with obstetric brachial plexus lesion.

Methods:
The study group included 20 infants with obstetric brachial plexus lesion and a control group of 20 infants with normal neurological outcome, aged 9 to 17 weeks postterm. Infants were evaluated by global and detailed general movements assessment.

Results:
There were no significant differences between the motor optimality scores of the 2 groups. However, there were some differences in terms of concurrent movements and the posture. Infants with obstetric brachial plexus lesion demonstrated more excitement bursts, head rotation, hand-knee contact, rolling, and few finger posture and postural asymmetry, and performed jerky movements when compared with the control group.

Conclusions:
Obstetric brachial plexus lesion did not affect the quality of fidgety movements of the infants but leads to compensatory movements in concurrent movements on the unaffected sides.
Motor Development and Health-Related Fitness in Trisomy X: A Case Report
Authors: Varela Silvia , Pérez María , González Sara , Diz José , Lemos Iván , Ayán Carlos 
Published: March 2020

Purpose:
This case study provides information regarding the motor development and health-related fitness level of a female with 47,XXX. The Movement Assessment Battery for Children–Second Edition (MABC-2) and the Test of Gross Motor Development-Second Edition (TGMD-2) batteries were used to assess motor competence and gross motor development, respectively. Cardiorespiratory, muscular fitness, and flexibility were assessed by means of field-based tests. Two groups of children developing typically were used for comparison purposes.

Summary of Key Points:
Results from the MABC-2 indicated that the participant was placed in the 37th percentile, whereas the comparison group was placed in the 68th percentile. The participant scored above the 50th percentile in the TGMD-2 and showed lower fitness values than those in the comparison group.

Recommendations for Clinical Practice:
Contrary to what is generally expected, supernumerary 47,XXX does not have to negatively impact motor competence, although a low health-related physical fitness can be present.
EURO-MUSCULUS/USPRM Global Report on Musculoskeletal Ultrasound Publications
Authors: Kara Murat , Gürçay Eda , Ekiz Timur , Sekizkardeş Merve , Yorulmaz Elem , Ata Ayşe Merve , Chang Ke-Vin , Wu Wei-Ting , Akkaya Nuray , Mezian Kamal , Picelli Alessandro , Coraci Daniele , Serrano Simão , Tiftik Tülay , Barotsis Nikolaos , Aydin Gülümser , Giraldo-Prieto Mario , Franchignoni Franco , Özçakar Levent 
Published: March 2020

Abstract
The developments in technology have improved access to the use of musculoskeletal ultrasound (MSUS) in different clinical settings. Accordingly, MSUS has been applied to a wide range of musculoskeletal problems including inflammatory and degenerative diseases, sport injuries, and regional pain syndromes both for clinical practice and research. In this report, the authors aimed to globally examine the publications on MSUS among different specialties, countries, and topics. Sixteen reviewers under the umbrella of the European Musculoskeletal Ultrasonography Society Group and the Ultrasound Study Group of International Society of Physical and Rehabilitation Medicine have evaluated approximately 15,000 publications on MSUS. The authors believe that the results of this comparative analysis may provide a holistic snapshot with regard to the utility of MSUS, not only for clinicians/academicians but also for the industry. Accordingly, while aiming to further increase their awareness, this article would possibly guide future investments as well.
Improvement in Patient Safety May Precede Policy Changes: Trends in Patient Safety Indicators in the United States, 2000–2013
Authors: Tedesco Dario , Moghavem Nuriel , Weng Yingjie , Fantini Maria Pia , Hernandez-Boussard Tina 
Published: March 2020

Objectives
Quality and safety improvement are global priorities. In the last two decades, the United States has introduced several payment reforms to improve patient safety. The Agency for Healthcare Research and Quality (AHRQ) developed tools to identify preventable inpatient adverse events using administrative data, patient safety indicators (PSIs). The aim of this study was to assess changes in national patient safety trends that corresponded to U.S. pay-for-performance reforms.

Methods
This is a retrospective, longitudinal analysis to estimate temporal changes in 13 AHRQ’s PSIs. National inpatient sample from the AHRQ and estimates were weighted to represent a national sample. We analyzed PSI trends, Center for Medicaid and Medicare Services payment policy changes, and Inpatient Prospective Payment System regulations and notices between 2000 and 2013.

Results
Of the 13 PSIs studied, 10 had an overall decrease in rates and 3 had an increase. Joinpoint analysis showed that 12 of 13 PSIs had decreasing or stable trends in the last 5 years of the study. Central-line blood stream infections had the greatest annual decrease (−31.1 annual percent change between 2006 and 2013), whereas postoperative respiratory failure had the smallest decrease (−3.5 annual percent change between 2005 and 2013). With the exception of postoperative hip fracture, significant decreases in trends preceded federal payment reform initiatives.

Conclusions
National in-hospital patient safety has significantly improved between 2000 and 2015, as measured by PSIs. In this study, improvements in PSI trends often proceeded policies targeting patient safety events, suggesting that intense public discourses targeting patient safety may drive national policy reforms and that these improved trends may be sustained by the Center for Medicare and Medicaid Services policies that followed.
Evidence That Nurses Need to Participate in Diagnosis: Lessons From Malpractice Claims
Authors: Gleason Kelly Therese , Jones Rebecca , Rhodes Christopher , Greenberg Penny , Harkless Gene , Goeschel Chris , Cahill Maureen , Graber Mark 
Published: March 2020

Objectives
There is a pressing need for nurses to contribute as equals to the diagnostic process. The purpose of this article is twofold: (a) to describe the contributing factors in diagnosis-related and failure-to-monitor malpractice claims in which nurses are named the primary responsible party and (b) to describe actions healthcare leaders can take to enhance the role of nurses in diagnosis.

Methods
We conducted a review of the Controlled Risk Insurance Company Strategies’ repository of malpractice claims, which contain approximately 30% of United States claims. We analyzed the malpractice claims related to diagnosis (n = 139) and physiologic monitoring (n = 647) naming nurses as the primary responsible party from 2007 to 2016. We used logistic regression to determine the association of contributing factors to likelihood of death, indemnity, and expenses incurred.

Results
Diagnosis-related cases listing communication among providers as a contributing factor were associated with a significantly higher likelihood of death (odds ratio [OR] = 3.01, 95% confidence interval [CI] = 1.50–6.03). Physiologic monitoring cases listing communication among providers as a contributing factor were associated with significantly higher likelihood of death (OR = 2.21, 95% CI = 1.49–3.27), higher indemnity incurred (U.S. $86,781, 95% CI = $18,058–$175,505), and higher expenses incurred (U.S. $20,575, 95% CI = $3685–$37,465).

Conclusions
Nurses are held legally accountable for their role in diagnosis. Raising system-wide awareness of the critical role and responsibility of nurses in the diagnostic process and enhancing nurses’ knowledge and skill to fulfill those responsibilities are essential to improving diagnosis.
Comparison of Patient Safety Incident Reporting Systems in Taiwan, Malaysia, and Indonesia
Authors: Dhamanti Inge , Leggat Sandra , Barraclough Simon , Liao Hsun-Hsiang , Abu Bakar Nor’Aishah 
Published: March 2020

Objectives
Incident reporting is one of the tools used to improve patient safety that has been widely used in health facilities in many countries. Incident reporting systems provide functionality to collect, analyze, and disseminate lessons learned to the wider community, whether at the hospital or national level. The aim of this study was to compare the patient safety incident reporting systems of Taiwan, Malaysia, and Indonesia to identify similarities, differences, and areas for improvement.

Methods
We searched the official Web sites and homepages of the responsible leading patient safety agencies of the three countries. We reviewed all publicly available guidelines, regulatory documents, government reports that included policies, guidelines, strategy papers, reports, evaluation programs, as well as scientific articles and gray literature related to the incident reporting system. We used the World Health Organization components of patient safety reporting system as the guidelines for comparison and analyzed the documents using descriptive comparative analysis.

Results
Taiwan had the most incidents reported, followed by Malaysia and Indonesia. Taiwan Patient Safety Reporting (TPR) and the Malaysian Reporting and Learning System had similar attributes and followed the World Health Organization components for incident reporting. We found differences between the Indonesian system and both of TPR and the Malaysian system. Indonesia did not have an external reporting deadline, analysis and learning were conducted at the national level, and there was a lack of transparency and public access to data and reports. All systems need to establish a clear and structured incident reporting evaluation framework if they are to be successful.

Conclusions
Compared with TPR and Malaysian system, the Indonesian patient safety incident reporting system seemed to be ineffective because it failed to acquire adequate national incident reporting data and lacked transparency; these deficiencies inhibited learning at the national level. We suggest further research on the implementation at the hospital level to see how far national guidelines and policy have been implemented in each country.
Preventing Dental Surgical Fires: Characterizing Nasal-Cannulated Supplemental Oxygen Pooling in an In Situ Dental Procedure
Authors: Cox Bradley W. , Jones James E. , Saxen Mark A. , Yepes Juan F. 
Published: March 2020

Objectives
Surgical operatory fires continue to occur in the United States, often with devastating consequences. Because more than 21% concentrations of oxygen are necessary for the onset of such combustion, this study examined fluctuations of surgical site oxygen levels. Better understanding how these more than 21% concentrations occur will not only add to surgical fire prevention efforts generally but also potentially reduce patient or staff harm and practitioner liability as well.

Methods
Performing an in situ dental procedure with supplemental nasal-cannulated oxygen and a dental dam, we measured oxygen pooling, defined as any fraction of inspired oxygen (FIO2) greater than the 21% FIO2 of air, on top of and behind a dental dam, and during the application of high-volume intraoral suction.

Results
Findings indicated statistically significantly higher concentrations (as much as twice the <30% recommended safe level) behind the dental dam compared with on top of it. During real-time measurements of FIO2 for four 120-second trials per participant, oxygen levels exhibited significant fluctuation above and below a more stringent 24.9% safety threshold established in prior research. Application of high-speed intraoral dental suction reduced FIO2 to near atmospheric levels in 30 (96.7%) of 31 of the cases by 60 seconds.

Conclusions
These results demonstrate the elevated risk associated with above-safe levels of oxygen pooling during a simple dental procedure. Although future research is needed to still more exactly characterize conditions leading to the onset of surgical fires, this study also demonstrates the ability of high-speed intraoral suction to dramatically and rapidly decrease that risk.
Systemic Therapies for Melanoma Brain Metastases: A Primer for Radiologists
Authors: Dodson Cassidy , Smith Daniel A. , Richards Tyler J. , Devita Robert R. , Hoimes Christopher J. , Ramaiya Nikhil H. 
Published: March 2020

Objective
The purpose of this article is to provide a primer for radiologists outlining the modern systemic therapies used in melanoma brain metastases, including tyrosine kinase inhibitors and immune checkpoint inhibitors. The role of radiologic treatment response evaluation will be discussed from the standpoint of both modern systemic therapies and more traditional treatments.

Conclusion
Understanding the role of systemic treatments in melanoma brain metastases is critical for oncologic imaging interpretation in this unique patient population.
Single-Energy Retrospective Metal Artifact Reduction Using Adaptive Thresholding for Metal Implants in the Abdomen and Pelvis
Authors: Dommaraju Sujithraj , Nakhaei Masoud , Zhang Da , Camacho Andres , Boos Johannes , Appel Elisabeth , Brook Olga R. 
Published: March 2020

Objective
To assess impact of single-energy metal artifact reduction (SEMAR) algorithm utilizing retrospective adaptive thresholding in reducing metal artifacts in the abdomen and pelvis.

Methods
In this prospective institutional review board–approved, Health Insurance Portability and Accountability Act–compliant study, 90 patients with various metals (n = 97) on computed tomography of abdomen and pelvis (Canon Medical, Aquilion ONE and PRIME) scanned 07/2017–09/2018 with SEMAR retrospectively applied were included. Density was measured in the near and far field to the metals. Density standard deviation (SD), representing artifact severity, was compared with and without SEMAR applied. Two trained human observers independently evaluated severity of artifacts on a five-point scale (0, no artifact; 5, severe artifact).

Results
The SEMAR significantly decreased artifact severity in the near field of high-density metal implants (SD of 204 ± 101HU without vs. 66 ± 40HU with SEMAR, P < 0.001). In the far field, the artifact severity was similar (40 ± 31HU without vs. 36 ± 27HU with SEMAR, P = 0.41). Artifact severity was decreased adjacent to low-density metal in the near field (SD of 86 ± 56HU without vs 49 ± 30HU with SEMAR, P < 0.001). In the far field to the low-density metals artifact severity was similar (33 ± 29HU without vs. 31 ± 27HU with SEMAR, P = 0.79). Subjectively, artifacts severity decreased for high-density metals in near field by 1.3 ± 1.0, and in far field by 0.7 ± 0.7 and for low-density metals in the near field by 0.7 ± 1.0, far field 0.4 ± 0.5, all P < 0.05.

Conclusions
The SEMAR retrospective algorithm with adaptive thresholding subjectively and objectively reduced near-field artifacts generated by high- and low-density metals.
Anatomy of the Anterior Clinoid Process in Human Fetuses
Authors: Beger Orhan , Hamzaoğlu Vural , Özalp Hakan , Taghipour Pourya , Çakir Salim , Akbulut Şuranur , Vayisoğlu Yusuf , Bağdatoğlu Celal , Öztürk Ahmet Hakan , Talas Derya Ümit 
Published: March 2020

Purpose:
The main objective of this study was to display the morphologic properties of the anterior clinoid process (ACP) in human fetuses in term of early childhood surgeries.

Methods:
Twenty-four (10 females and 14 males) fetal cadavers aged from 16th to 28th weeks of gestation (at mean, 21.54 ± 3.11 weeks) were included in the present study. The dimensions of ACP were measured with a digital image analysis software.

Results:
Taking into account the length, width, and angle of ACP, it was classified as Type 1 in 20.83% (10 cases), Type 2 in 10.42% (5 cases), Type 3 in 10.42% (5 cases), Type 4 in 2.08% (1 case), Type 5 in 8.33% (4 cases), Type 6 in 16.67% (8 cases), Type 7 in 8.33% (4 cases), and Type 8 in 22.92% (11 cases). According to the attachment site of the optic strut (OS) relative to ACP, OS was identified as the anterior 3/5 in 16.67% (8 cases), anterior 4/5 in 68.75% (33 cases), and posterior 1/5 in 14.58% (7 cases). Neither right-left nor male-female significant differences were observed between the quantitative values belonging to ACP and OS.

Conclusion:
The percentage of the most complex and challenging type of ACP (the long, narrow, and narrow-angled ACP) in fetuses was found to be close to adults. Thus, routine adult surgical procedures such as anterior clinoidectomy might be successfully used in young children and infants. The attachment site of OS relative to ACP in adults was more anterior according to fetuses probably due to postnatal development such as the pneumatization of the sphenoid bone. In this regard, for pediatric neurosurgeons to avoid iatrogenic injuries and to select appropriate surgical approaches, further studies conducted on the attachment of OS relative to ACP in children are needed.
A New Bony Anatomical Landmark for Lateral Skull Base Surgery
Authors: Liu Zhen , Yi Zhiqiang 
Published: March 2020

Background and Objective:
The aim of the study was to propose a new bony landmark, point O, which is the junction point of the temporosphenoid suture and the infratemporal ridge; this landmark may improve the identification and preservation of neurovascular structures when approaches are used to access the middle cranial fossa in lateral skull base tumor surgeries.

Methods:
Fifteen cadaveric heads were measured for anatomical analysis. Related surgical landmarks were studied using the Destroscope virtual reality system and during the dissection procedures, and the results were analyzed and compared.

Results:
From the perspective of the middle skull base, the radial lines from point O to the interior point of the superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum are approximately equal in length, with an average length of 23.22 mm, and the above 5 points form a sector with an angle of 66.07° and an area of 310.71 mm2.

Conclusions:
Identification of point O as a landmark for lateral skull base surgery when other landmarks are not recognizable optimizes patient safety and surgeon confidence during complicated operations. The interior points of the superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum are distributed on the arc of a circle whose center is point O. The sector formed by the above 5 points is not only a crucial area for the communication of lesions between the middle skull base and the infratemporal fossa but also a safe avenue through which to remove skull base lesions.
Change in Incisional Design in Primary Unilateral Cleft Lip Repair Under General Anesthesia
Authors: Tsuda Tomoko , Lan Lan , Morioka Daichi , Sato Nobuhiro , Tosa Yasuyoshi , Ohkubo Fumio , Kadomatsu Koichi 
Published: March 2020

Abstract
Nasolabial features of infants with unilateral cleft lip (UCL) are different when they are under general anesthesia for lip repair compared to when they are awake. This study aimed to investigate changes in the incisional design of cheiloplasty according to patient position and anesthesia: upright and awake versus supine and under general anesthesia. Three-dimensional images of 20 infants with UCL were randomly selected. Two different incisional designs were drawn on the images captured while the infants were awake. Those incisional designs were anthropometrically compared to the designs drawn on the images captured while the infants were under general anesthesia. Under general anesthesia, vermillion height of both the medial and lateral sides of the cleft became significantly greater. In the rotation-advancement design, the incisional line of the rotation flap on the medial lip element became significantly shorter under general anesthesia, whereas the advancement flap on the lateral lip element was not significantly altered. In an anatomical subunit approximation, both lengths of the philtral ridge on the noncleft side and incisional line along the philtral ridge on the cleft side became significantly shorter under general anesthesia, but these alterations did not affect the calculation of the width of the small triangular flap on the lateral lip element. These changes in nasolabial features after general anesthesia may cause surgical error, which result in secondary cleft lip deformities. However, because these changes varied among infants, preoperative planning using three-dimensional facial images of infants who are awake may be able to avoid surgical error.
Comparing Hemorrhage in Human Physiology Simulation Tools: How They Compare With Expected Human Physiology and Each Other
Authors: Barnes John Jacob , Kiberenge Kenneth , Sweet Robert , Keller Jon , Konia Mojca R. 
Published: March 2020

Introduction
Several different whole-body physiology simulation tools (PST) using modeling techniques are now available with potential use for healthcare simulation, but these novel technologies lack objective analysis from an independent organization.

Methods
We identified BioGears, HumMod, and Muse as 3 PSTs that met our requirements for testing. We ran mild, moderate, and severe hemorrhage scenarios on each PST and collected outputs for comparison with each other and published human physiology data.

Results
All PSTs tested followed the expected tachycardic and hypotensive response to hemorrhage for all levels of severity with variable qualitative patterns. Complete data for analysis were not available in all PSTs for urine output, stroke volume, blood volume, hemoglobin, and serum epinephrine concentration, but the partial findings are discussed in detail. We determined the predicted time to reach hemorrhage shock based on the hemorrhage guidelines and compared this with time to cardiovascular collapse from each PST. Overall, the differences from known human physiology were much larger than expected before testing and trends show HumMod with the smallest difference for severe (−6.25%) and moderate (−1.42%) and Muse with the smallest difference for mild hemorrhage (27.9%). BioGears demonstrated the largest differences in all classifications of severity.

Conclusions
Our analysis of currently available whole-body PSTs provides insight into the novel, evolving field. We hope our efforts shed light to a wider audience to the exciting developments and uses of mathematical modeling for whole-body simulation and the potential for integration into healthcare simulation for medical education.