bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric Analysis of a Survey on Patient Safety Culture–Based Tool for Emergency Medical Services
Authors: Crowe Remle P. , Cash Rebecca E. , Christgen Alex , Hilmas Tina , Varner Lee , Vogelsmeier Amy , Gilmore William S. , Panchal Ashish R. 
Published: June 2018

Objective
Evaluating organizational safety culture is critical for high-stress, high-risk professions such as prehospital emergency medical services (EMS). The aim of the study was to evaluate the psychometric properties of a safety culture instrument for EMS, based on the Agency for Healthcare Research and Quality’s widely used Surveys on Patient Safety Culture (SOPS).

Methods
The final EMS-adapted instrument consisted of 37 items covering 11 safety culture domains including 10 domains from existing SOPS instruments and one new domain for communication while en route to an emergency call. The analysis sample included 23,029 nationally certified EMS providers. Domain structure was evaluated on two separate halves of the data set through confirmatory factor analysis using a polychoric correlation matrix for ordinal data. The reliability and validity of each domain were evaluated using Cronbach α and Pearson correlation coefficients.

Results
The confirmatory factor analysis supported the 11-domain model. All items loaded above the 0.4 threshold (range = 0.508–0.984). Three composite domains exhibited factor variance below the 0.5 threshold: staffing (0.32), communication about incidents (0.26), and handoffs (0.26). Floor and ceiling effects were not detected. Inter-item consistency exceeded 0.6 for all subscales (α = 0.65–0.88). Predictive validity was supported as all domain composites were correlated with the outcome variables of overall safety rating (r = 0.44–0.72) and frequency of event reporting (r = 0.31–0.48).

Conclusions
Overall, the EMS-adapted tool demonstrated adequate psychometric properties consistent with those of existing SOPS instruments. Additional research is needed to evaluate the instrument’s performance at the agency level and its correlation with safety outcomes in the prehospital setting.
Patient Safety Incidents Reported by the General Public in Korea: A Cross-Sectional Study
Authors: Ock Minsu , Jo Min-Woo , Choi Eun Young , Lee Sang-Il 
Published: June 2018

Objectives
Previous studies have demonstrated that the general public can report various patient safety incidents (PSIs) that are not identified by other methods. In this study, we investigated the characteristics of PSIs that the general public experience in Korea.

Methods
In face-to-face surveys, participants were asked to report the frequency and type of PSIs, level of patient harm, and whether the PSIs were perceived as a medical error. We conducted logistic regression analysis to identify the sociodemographic factors of participants associated with their PSI experiences. Additionally, we analyzed relationships between the perception of PSIs as a medical error and both the type of PSIs and level of patient harm.

Results
Among the 700 participants surveyed, 24 (3.4%) and 37 (5.3%) individuals reported that they or their family members experienced PSIs, respectively. Participants with at least a college degree were more likely to report PSI experiences than those with a lower educational level (odds ratio, 3.54; 95% confidence interval, 1.86-6.74). Whereas approximately half of participants (48.2%) involved in PSI experiences that caused no harm thought that there were medical errors in their PSIs, all participants (100%) who experienced PSIs with severe harm responded that medical errors occurred in their PSIs.

Conclusions
The general public can report their experiences with PSIs. Periodic surveys that target the general public will provide additional data that reflect the level of patient safety from the viewpoint of the general public.
Survival Associations Using Perfusion and Diffusion Magnetic Resonance Imaging in Patients With Histologic and Genetic Defined Diffuse Glioma World Health Organization Grades II and III
Authors: Latysheva Anna , Eeg Emblem Kyrre , Server Andrés , Brandal Petter , Meling Torstein R. , Pahnke Jens , Hald John K. 
Published: June 2018

Objective
According to the new World Health Organization 2016 classification for tumors of the central nervous system, 1p/19q codeletion defines the genetic hallmark that differentiates oligodendrogliomas from diffuse astrocytomas. The aim of our study was to evaluate whether relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) histogram analysis can stratify survival in adult patients with genetic defined diffuse glioma grades II and III.

Methods
Sixty-seven patients with untreated diffuse gliomas World Health Organization grades II and III and known 1p/19q codeletion status were included retrospectively and analyzed using ADC and rCBV maps based on whole-tumor volume histograms. Overall survival and progression-free survival (PFS) were analyzed by using Kaplan-Meier and Cox survival analyses adjusted for known survival predictors.

Results
Significant longer PFS was associated with homogeneous rCBV distribution–higher rCBVpeak (median, 37 vs 26 months; hazard ratio [HR], 3.2; P = 0.02) in patients with astrocytomas, and heterogeneous rCBV distribution–lower rCBVpeak (median, 46 vs 37 months; HR, 5.3; P < 0.001) and higher rCBVmean (median, 44 vs 39 months; HR, 7.9; P = 0.003) in patients with oligodendrogliomas. Apparent diffusion coefficient parameters (ADCpeak, ADCmean) did not stratify PFS and overall survival.

Conclusions
Tumors with heterogeneous perfusion signatures and high average values were associated with longer PFS in patients with oligodendrogliomas. On the contrary, heterogeneous perfusion distribution was associated with poor outcome in patients with diffuse astrocytomas.
Is It Possible to Establish the Extent of Resection of Glioblastoma With 18F-Fluorocholine PET/CT?
Authors: García Vicente Ana María , Perez-Beteta Julian , Calvo García Manuel , Villena Martín Maikal , Soriano Castrejón Angel 
Published: June 2018

Abstract
Defining high-grade glioma resectability is a challenge; and currently, it is based on anatomical imaging. However, complete removal of contrast-enhancing tumor is difficult to define in MRI. We present three cases of patients diagnosed with high-grade glioma. Brain MRI and 18F-fluorocholine PET/CT were performed before and after surgery to establish the extent of resection (EOR) and residual volume. Postoperative brain MRI and PET parameters showed discordant results in all the reported cases. PET was able to assess properly the EOR; however, the rules for the EOR establishment and its prognostic implication should be validated in prospective studies.
Sellar Paraganglioma
Authors: Karlekar Manjiri , Kumar Sanjeet , Jadhav Swati , Lila Anurag , Bandgar Tushar , Shah Nalini 
Published: June 2018

Abstract
Sellar and suprasellar paragangliomas are rare. We report the case of a 19-year-old man with sellar paraganglioma with parasellar and posterior pontine extension, requiring multiple transcranial surgeries and radiotherapy. The lesion was avid on 68Ga DOTANOC PET-CT scan substantiating its neuroendocrine nature.
Bronchial Mucosa–Associated Lymphoid Tissue Lymphoma Staged by 11C-Methionine
Authors: Annunziata Salvatore , Cuccaro Annarosa , Rizzo Alessio , Chiesa Silvia , D'Alò Francesco 
Published: June 2018

Abstract
A 57-year-old man had a diagnosis of a bronchial mucosa–associated lymphoid tissue lymphoma in the left lung and monoclonal gammopathy. The patient underwent whole-body 11C-methionine PET/CT, in order to evaluate the amino acid avidity of the lesion and to stage the bronchial mucosa–associated lymphoid tissue lymphoma. 11C-methionine uptake was detected in the lung lesion and in the mediastinal lymph nodes.
Three-Dimensional Stereophotogrammetric Evaluation of the Efficacy of Autologous Fat Grafting in the Treatment of Parry-Romberg Syndrome
Authors: Pucciarelli Valentina , Baserga Camilla , Codari Marina , Beltramini Giada A. , Sforza Chiarella , Giannì Aldo Bruno 
Published: June 2018

Abstract
Autologous fat grafting is a surgical procedure used to correct volumetric defects, atrophies, and sclerosis. Three-dimensional (3D) facial photography may enable researchers to quantify the success of surgical procedures through volumetric and surface assessments. Using 3D photography, the authors assessed the results of autologous fat grafting performed in a 15-year-old patient affected by Parry-Romberg syndrome, a rare condition resulting in progressive hemifacial atrophy of skin, subcutaneous tissues and, ultimately, bone. Stereophotogrammetric acquisitions were performed before and 4 months after the surgical intervention. The obtained results were objectively assessed in terms of facial symmetry through calculation of root mean square deviation point-to-point distance between the treated and healthy side, and volume modifications between pre- and postsurgical 3D facial scans. Four months after surgery, 73% of injected adipose tissue was resorbed, whereas facial symmetry increased up to 63%. The proposed method is not invasive and provides quantitative information about the surgical and esthetic outcomes. Clinicians could better plan surgery, and the patients could be more motivated and compliant to the treatment.
Hidden Scar Dissection of Benign Parotid Gland Tumors via a V-Shaped Minimal Facelift Incision
Authors: Zheng Zhiwei , Li Jun , Wang Jinbing , Sun Jian 
Published: June 2018

Objectives:The purpose of this article was to propose a V-shaped minimal facelift incision (FLI) and analyze its efficacy for improving the esthetic outcomes of parotid gland tumors.Methods:A prospective, nonrandomized study was performed. Forty-six patients with category I benign parotid tumors as to Quer classification (3 cm or less and located superficially and/or peripherally in the gland) were enrolled. The 46 patients who underwent dissection of parotid gland tumors were divided into 2 groups: minimal FLI (group 1) and modified Blair incision (MBI, group 2). The modified minimal FLI was performed via V-shaped preauricular and retroauricular incision with no extension to the hair bearing skin. The operation variables and the cosmetic satisfaction of the patients in each group were compared.Results:Twenty-three patients underwent the minimal FLI approach and 23 underwent the conventional modified Blair incision approach. No recurrence developed in any of the patients at the follow-up for an average of 18.9 ± 2.7 months. Among the operation factors, the authors observed no other significant differences in the size of tumor, operative time, or completeness of resection (P > 0.05). Moreover, facial palsy and Frey syndrome also did not differ between the 2 groups (P > 0.05). However, cosmetic satisfaction evaluated with a graded scale showed much better results in the V-shaped minimal FLI approach group (P < 0.001).Conclusion:V-shaped minimal FLI with excellent cosmetic outcomes could be used as a safe and preferable approach for parotidectomy, especially for the more conservative extracapsular dissection in small tumors.
Conjunctival Melanoma Metastasis to the Contralateral Orbit
Authors: He Fanglin , Wang Yuxin , Jia Renbin 
Published: June 2018

Background:
Malignant melanoma predominantly occurs in whites, and is potentially fatal. Distant metastases often occur in lung, liver, brain, and could occur without prior regional disease. Conjunctival melanoma metastasis to contralateral orbit has never been reported.

Patient Presentation:
A 60-year-old man who underwent a left primary conjunctival neoplasm resection 11 months ago presented for the evaluation of a conjunctival dark-colored mass with a bulging left lower eyelid that directly invaded the orbits bilaterally. A histopathologic examination and immunohistochemistry confirmed metastases from conjunctival melanoma. In addition, the contralateral orbit had metastases without local recurrence after surgery within the authors’ department. The patient was given adjuvant therapy (vincristine + nedaplatin + dacarbazine) for 5 cycles, but he died 8 months after surgery.

Conclusion:
Malignant conjunctival melanoma may metastasize to the contralateral orbit. A histopathologic evaluation should be mandatory in patients with medical histories of malignancy to differentiate new primary tumors, metastases, and benign tumors.
Immediate Implant Placement Into Fresh Extraction Sites Using Single-Drilling Bur and Two Loading Procedures: Follow-Up Results
Authors: Bettach Raphaél , Taschieri Silvio , Mortellaro Carmen , Del Fabbro Massimo 
Published: June 2018

Abstract
Modern clinical protocols in implantology aim at shortening the treatment time and reducing duration and discomfort of the surgical phase, while maintaining optimal treatment outcomes. The purpose of this study was to evaluate clinical outcomes of implants immediately placed in extraction sites, using a single drilling step for implant site preparation. One-hundred thirty-three patients (mean age 55.3 ± 12.7 [SD] years, range 20–83 years) were treated at 2 clinical centers. Two-hundred sixty-one implants were inserted in fresh postextraction sockets. One-hundred sixty-five implants were immediately loaded (IL) and 96 underwent delayed loading (DL). Implant survival, peri-implant bone level change and patients’ satisfaction were assessed after at least 3 years of function. No patient dropout occurred. The mean follow-up was 63.61 ± 11.52 months (range 39.71–85.71 months) from prosthesis delivery. Two IL and 1 DL implant failed in 3 patients. Implant survival was 98.8% and 99% for IL and DL group, respectively. The mean marginal bone loss after 1 year was 0.48 ± 0.40 mm and 0.52 ± 0.34 mm for IL and DL group. No biological nor mechanical complications occurred. All patients demonstrated full satisfaction. The present protocol with single burs for site preparation produced satisfactory clinical outcomes independent of the loading timing. Further long-term comparative studies are needed to confirm the present findings.
Management of Intracranial Condylar Fracture With Intracranial Migration
Authors: Kurimori Kleber Tetsuo , Bastos Endrigo Oliveira , Oliveira Walter Amorim de , Alonso Nivaldo 
Published: June 2018

Abstract
Despite condylar fractures representing one of the most common sites of mandibular fractures, intracranial condylar dislocation is a rare event. In this article, the authors report 2 patients. The first patient is a young female with signs and symptoms as commonly reported in the literature. The second patient reports the consequences of a delayed diagnosis of intracranial condylar fracture dislocation. Both patients underwent surgical treatment. These patients are discussed with a review of the literature, noting biomechanics and mechanism of injury, diagnostic methods, and the treatment for these fractures. Diagnosis also may be challenging at times, though it should always be suspected in patients with bite alterations associated with high energy trauma and the stigmata of direct chin trauma. There is no pathognomonic clinical examination and it is fundamental to use computed tomographic methods for confirmation. Treatment is often open reduction and internal fixation, though it should be tailored for each patient presentation.
Stress Urinary Incontinence Surgery in Washington State Before and After Introduction of the Mesh Midurethral Sling
Authors: Stewart Lauren E. , Eston Michelle A. , Symons Rebecca G. , Fialkow Michael F. , Kirby Anna C. 
Published: June 2018

Objectives
Mesh midurethral slings (MUSs) are safe, effective treatments for female stress urinary incontinence (SUI), but many companies have ceased production because of controversies surrounding transvaginal mesh. To determine if introduction of MUS has increased the complication rate associated with SUI surgery, we compared women undergoing SUI surgery in the MUS era to those who had surgery prior its introduction.

Methods
This was a retrospective cohort study of a statewide hospital discharge database. Stress urinary incontinence surgeries from 1987 to 1996 and 2007 to 2013 were identified using International Classification of Diseases, Ninth Revision codes.

Results
A total of 30,723 SUI surgeries were performed during the study periods. After 2006, slings accounted for 91.8% of SUI surgeries. Patients were older (54.5 vs 53.0 years, P < 0.001) and sicker (22.6% vs 9.7% had ≥1 comorbid condition, P < 0.0001). Blood transfusion was more common in the MUS era (1.2% vs 0.4%, P < 0.001) however, other complications were either similar between groups or less common in the MUS era including 30-day readmission (2.5% vs 2.4%, P = 0.543), reoperation for urinary retention (0.1% vs 0.2%, P < 0.0375), and wound infection (0.1% vs 0.5%, P < 0.001), despite more concomitant prolapse surgeries (69.0 vs 26.9%, P < 0.001) and hysterectomies (53.0 vs 35.4%, P < 0.001) in the MUS era. Hospital stays were shorter after 2006 (1.0 vs 3.0 days, P < 0.001), and fewer women required reoperation for SUI within 2 years (0.5% vs 1.8%, P < 0.001).

Conclusions
Following introduction of MUS, women who underwent SUI surgery were slightly older with more medical comorbidities yet did not appear to experience increased surgical complications. Fewer women underwent reoperation for recurrent SUI, and hospital stays were shorter, suggesting an improvement in care. This study supports the continued availability and use of MUSs.
Co-circulating mumps lineages at multiple geographic scales
Authors: Wohl Shirlee , Metsky Hayden C. , Schaffner Stephen F. , Piantadosi Anne , Burns Meagan , Lewnard Joseph A. , Chak Bridget , Krasilnikova Lydia A. , Siddle Katherine J. , Matranga Christian B. , Bankamp Bettina , Hennigan Scott , Sabina Brandon , Byrne Elizabeth H. , McNall Rebecca J. , Park Daniel J. , Gharib Soheyla , Fitzgerald Susan , Barriera Paul , Fleming Stephen , Lett Susan , Rota Paul A. , Madoff Lawrence C. , MacInnis Bronwyn L. , Yozwiak Nathan L. , Smole Sandra , Grad Yonatan H. , Sabeti Pardis C. 
Published: June 2018

AbstractDespite widespread vaccination, eleven thousand mumps cases were reported in the United States (US) in 2016–17, including hundreds in Massachusetts, primarily in college settings. We generated 203 whole genome mumps virus (MuV) sequences from Massachusetts and 15 other states to understand the dynamics of mumps spread locally and nationally, as well as to search for variants potentially related to vaccination. We observed multiple MuV lineages circulating within Massachusetts during 2016–17, evidence for multiple introductions of the virus to the state, and extensive geographic movement of MuV within the US on short time scales. We found no evidence that variants arising during this outbreak contributed to vaccine escape. Combining epidemiological and genomic data, we observed multiple co-circulating clades within individual universities as well as spillover into the local community. Detailed data from one well-sampled university allowed us to estimate an effective reproductive number within that university significantly greater than one. We also used publicly available small hydrophobic (SH) gene sequences to estimate migration between world regions and to place this outbreak in a global context, but demonstrate that these short sequences, historically used for MuV genotyping, are inadequate for tracing detailed transmission. Our findings suggest continuous, often undetected, circulation of mumps both locally and nationally, and highlight the value of combining genomic and epidemiological data to track viral disease transmission at high resolution.
A hippocampal model for behavioral time acquisition and fast bidirectional replay of spatio-temporal memory sequences
Authors: Gauy Marcelo Matheus , Lengler Johannes , Einarsson Hafsteinn , Meier Florian , Weissenberger Felix , Yanik Mehmet Fatih , Steger Angelika 
Published: June 2018

AbstractThe hippocampus is known to play a crucial role in the formation of long-term memory. For this, fast replays of previously experienced activities during sleep or after reward experiences are believed to be crucial. But how such replays are generated is still completely unclear. In this paper we propose a possible mechanism for this: we present a model that can store experienced trajectories on a behavioral timescale after a single run, and can subsequently bidirectionally replay such trajectories, thereby omitting any specifics of the previous behavior like speed, etc, but allowing repetitions of events, even with different subsequent events. Our solution builds on well-known concepts, one-shot learning and synfire chains, enhancing them by additional mechanisms using global inhibition and disinhibition. For replays our approach relies on dendritic spikes and cholinergic modulation, as supported by experimental data. We also hypothesize a functional role of disinhibition as a pacemaker during behavioral time.
Modulation of voltage-dependent K+conductances in photoreceptors trades off investment in contrast gain for bandwidth
Authors: Heras Francisco JH , Vähäsöyrinki Mikko , Niven Jeremy E 
Published: June 2018

AbstractModulation is essential for adjusting neurons to prevailing conditions and differing demands. Yet understanding how modulators adjust neuronal properties to alter information processing remains unclear, as is the impact of neuromodulation on energy consumption. Here we combine two computational models, one Hodgkin-Huxley type and the other analytic, to investigate the effects of neuromodulation uponDrosophila melanogasterphotoreceptors. Voltage-dependent K+conductances: (i) activate upon depolarisation to reduce membrane resistance and adjust bandwidth to functional requirements; (ii) produce negative feedback to increase bandwidth in an energy efficient way; (iii) produce shunt-peaking thereby increasing the membrane gain bandwidth product; and (iv) inactivate to amplify low frequencies. Through their effects on the voltage-dependent K+conductances, three modulators, serotonin, calmodulin and PIP2, trade-off contrast gain against membrane bandwidth. Serotonin shifts the photoreceptor performance towards higher contrast gains and lower membrane bandwidths, whereas PIP2 and calmodulin shift performance towards lower contrast gains and higher membrane bandwidths. These neuromodulators have little effect upon the overall energy consumed by photoreceptors, instead they redistribute the energy invested in gain versus bandwidth. This demonstrates how modulators can shift neuronal information processing within the limitations of biophysics and energy consumption.
Dynamic Properties of Simulated Brain Network Models and Empirical Resting State Data
Authors: Kashyap Amrit , Keilholz Shella 
Published: June 2018

AbstractBrain Network Models have become a promising theoretical framework in simulating signals that are representative of whole brain activity such as resting state fMRI. However, it has been difficult to compare the complex brain activity between simulated and empirical data. Previous studies have used simple metrics that surmise coordination between regions such as functional connectivity, and we extend on this by using various different dynamical analysis tools that are currently used to understand resting state fMRI. We show that certain properties correspond to the structural connectivity input that is shared between the models, and certain dynamic properties relate more to the mathematical description of the Brain Network Model. We conclude that the dynamic properties that gauge more temporal structure rather than spatial coordination in the rs-fMRI signal seem to provide the largest contrasts between different BNMs and the unknown empirical dynamical system. Our results will be useful in constraining and developing more realistic simulations of whole brain activity.