bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung Ultrasound Findings and Bronchiolitis Ultrasound Score for Predicting Hospital Admission in Children With Acute Bronchiolitis
Authors: Özkaya Ahmet Kağan , Yilmaz Hayri Levent , Kendir Özlem Tolu , Gökay Sinem Sari , Eyüboğlu İlker 
Published: January 2019

Objectives
The purposes of this study were to determine the benefit of the bronchiolitis ultrasound score (BUS) in predicting hospital admission in children with acute bronchiolitis and to characterize lung sonography findings.

Methods
This prospective observational study was performed in an academic pediatric emergency department. Children younger than 24 months presenting to the emergency department, diagnosed with acute bronchiolitis by 2 independent pediatricians were included in the study. Lung ultrasound was performed by a single sonographer, who was blinded to as much clinical information as possible. In addition, the treating physicians were blinded to the lung ultrasound findings. Logistic regression analysis models were used to identify admission predictors. Receiver operating characteristic analysis was used to evaluate the predictive value for effects of the BUS and the modified Bronchiolitis Severity Score on admission.

Results
The median age of the 76 patients diagnosed with acute bronchiolitis was 6 months (interquartile range, 3.6–10 months). Forty-two (55.3%) of the 76 patients enrolled were admitted. Lung ultrasound was compatible with acute bronchiolitis in 74 patients (97%). A significant correlation was determined between modified Bronchiolitis Severity Score and BUS in children with acute bronchiolitis (r = 0.698, P < 0.001). The most effective parameter in determining admission on logistic regression analysis, independently of other variables, was BUS (P = 0.044; adjusted odds ratio, 1.859; 95% confidence interval, 1.016–3.404). Bronchiolitis ultrasound score values of 3 or greater exhibited 73.81% sensitivity and 73.53% specificity, whereas BUS values of 4 or greater exhibited 50% sensitivity and 91.18% specificity.

Conclusions
Point-of-care lung ultrasound can accurately detect pulmonary anomalies in children with acute bronchiolitis, has a close correlation with clinical findings, and is a useful tool in predicting hospital admission.
The Reliability of Computerized Physician Order Entry Data for Research Studies
Authors: Dexheimer Judith W. , Taylor Regina G. , Kachelmeyer Andrea M. , Reed Jennifer L. 
Published: January 2019

Objectives
In the United States, adolescents account for nearly half of the newly diagnosed sexually transmitted infections annually, and many of these infections are asymptomatic. Adolescents often seek care in pediatric emergency departments; thus, the emergency department is an important setting to implement adolescent sexually transmitted infection screening. Before implementation, baseline data reflecting current screening rates of symptomatic and asymptomatic patients were needed. This study aimed to evaluate the accuracy of provider-reported rates of symptomatic and asymptomatic chlamydia (CT) and gonorrhea (GC) testing in adolescents overall and pre–electronic health record (EHR) and post-EHR order modification in preparation for a research intervention.

Methods
This was a 1-year prospective, observational study. Provider reason for CT/GC testing was added to the existing EHR order. Chart reviews were performed to ensure the accuracy of clinician CT/GC testing choices (symptomatic vs asymptomatic). Frequencies of testing choices were obtained. Order modifications were made to further clarify the definitions. A Student t test was used to compare data preorder and postorder modification.

Results
When relying on providers to report reasons for CT/GC testing (symptomatic vs asymptomatic), many patients were misclassified based on a priori defined testing reasons. After order modification, rates of provider-reported symptomatic testing remained unchanged (P = 0.16). Provider-reported asymptomatic testing significantly declined (P = 0.004); however, 23.2% of those tested continued to be misclassified.

Conclusions
Provider-entered EHR data are increasingly being used in research studies; thus, it is important to ensure its accuracy and reliability before study implementation.
Teaching of chronic pain management in a low- and middle-income setting: a needs assessment survey
Authors: Moyo Nomaqhawe , Madzimbamuto Farai 
Published: January 2019

Abstract

Introduction:
Pain is the most common reason for patients to see their physicians. For this reason, every physician should be able to diagnose and manage pain correctly.

Objectives:
The objective of this survey was to identify gaps in the teaching on chronic pain and its management in the current training programs at the University of Zimbabwe College of Health Sciences (UZCHS).

Methods:
A focused needs assessment using a self-administered questionnaire to collect data from participants was performed. A copy of the English Version of the International Association for the Study of Pain (IASP) curriculum on Pain for Medicine was attached for participants to refer to. Faculty and final-year postgraduate students were eligible. Questions were on the current teaching practice on chronic pain at the UZCHS.

Results:
Faculty members and postgraduates from 15 of 19 departments in the college participated in the study. Only 2 departments have written chronic pain teaching curriculum. Most faculty members, 68% had no knowledge of the IASP curriculum or its existence. Seventy-seven percent of the respondents were strongly dissatisfied with the current pain-related content, teaching or learning strategies in their programs. Most respondents suggested the need for the adoption of an interprofessional education learning strategy and adopting the IASP curriculum.

Conclusion:
The current teaching practice on chronic pain at the UZCHS is inadequate to prepare the health care professionals to independently care for chronic pain patients.
Assessment of Public Perception Regarding Patient Engagement for Patient Safety in Korea
Authors: Lee Hyeon-Jeong , Jang Seung Gyeong , Choi Ji Eun , Lee Won , Pyo Jeehee , Ock Minsu , Lee Sang-Il 
Published: January 2019

Objectives
This study conducted a survey to examine how the general public in Korea perceives patient engagement for patient safety and to identify vulnerable groups and contents priorities of patient engagement education for the general public.

Methods
We developed a questionnaire based on previous studies and conducted one-on-one interviews with 600 individuals from the public. Then, we conducted descriptive statistical analyses (i.e., frequency, percentage, and averages) on the questionnaire items. Furthermore, we examined the individual differences of participants’ sociodemographic characteristics in their responses to the questionnaire.

Results
The general public’s awareness regarding accreditation programs for healthcare organizations was still low (47.4%). Nearly 60% of participants said that they did not agree with the practice of telling their own names and dates of birth before treatment. Approximately 80% of the participants would not ask medical staff to confirm washing their hands. Only half of the participants were aware of medical dispute mediation and arbitration programs. Nearly 90% of the participants agreed that patient safety is important. However, on participants’ confidence in making the correct choice and safety in their treatment, the average score was 68.7 of 100 points. Participants tended to be less confident about engaging in patient safety activities if they were older, less educated, or had poor health status.

Conclusions
Participants in this study believed that patient safety is an important issue, but they were not confident about choosing the correct medical institution or about receiving safe treatment.
Multilevel Analysis of Individual, Organizational, and Regional Factors Associated With Patient Safety Culture: A Cross-Sectional Study of Maternal and Child Health Institutions in China
Authors: Wang Yuanyuan , Fan Yanjun , Wang Xiaoli , Ma Yuanying , Wu Chunmei , Shi Huifeng , Han Hui , Liu Weiwei , Liu Chaojie 
Published: January 2019

Objectives
The aim of this study was to assess patient safety culture (PSC) in maternal and child health (MCH) institutions in China and its individual, organizational, and regional variations.

Methods
Using the PSC survey for MCH institutions (PSCS-MCHI), 2021 valid respondents from 25 participating institutions were investigated in three regions (Beijing, Zhejiang, and Jiangxi) of China. Patient safety culture and its subscale scores (1–5) and factors associated with PSC as revealed by multilevel modeling.

Results
The respondents had an average PSC score of 3.55 (SD = 0.35), with subscale scores ranging between 2.46 (“staffing and workload”) and 4.02 (“work commitment”). There were limited regional differences in PSC: a three-level regression model was only confirmed for the subscale “staff empowerment” (P = 0.006). However, significant organizational variations in PSC were evident: a two-level regression model was assumed for the PSC scale and nine subscales (P < 0.001). The fixed-effect models showed that male respondents, frontline workers, those who were in their mid-career (11–20 y), overloaded (≥9 hours), and had a masters or higher degree reported worse PSC. Frontline workers were less positive than managers in ratings on “managerial response to risks” (−0.11 [−0.20 to −0.02]), “management support” (−0.18 [−0.28 to −0.07]), and “staff empowerment” (−0.23[−0.35 to −0.11]).

Conclusions
Patient safety culture in MCH institutions is shaped by organizational and individual characteristics. We observed a gap in perceived PSC between frontline worker, who are less positive, and managers. Actions for improving PSC should consider interventions on organizational management (such as appropriate staffing and workload management) and engagement of frontline workers in the development of management and training activities.
Artificial Intelligence–Based Classification of Breast Lesions Imaged With a Multiparametric Breast MRI Protocol With Ultrafast DCE-MRI, T2, and DWI
Authors: Dalmiş Mehmet U. , Gubern-Mérida Albert , Vreemann Suzan , Bult Peter , Karssemeijer Nico , Mann Ritse , Teuwen Jonas 
Published: January 2019

Objectives
We investigated artificial intelligence (AI)–based classification of benign and malignant breast lesions imaged with a multiparametric breast magnetic resonance imaging (MRI) protocol with ultrafast dynamic contrast-enhanced MRI, T2-weighted, and diffusion-weighted imaging with apparent diffusion coefficient mapping.

Materials and Methods
We analyzed 576 lesions imaged with MRI, including a consecutive set of biopsied malignant (368) and benign (149) lesions, and an additional set of 59 benign lesions proven by follow-up. We used deep learning methods to interpret ultrafast dynamic contrast-enhanced MRI and T2-weighted information. A random forests classifier combined the output with patient information (PI; age and BRCA status) and apparent diffusion coefficient values obtained from diffusion-weighted imaging to perform the final lesion classification. We used receiver operating characteristic (ROC) analysis to evaluate our results. Sensitivity and specificity were compared with the results of the prospective clinical evaluation by radiologists.

Results
The area under the ROC curve was 0.811 when only ultrafast dynamics was used. The final AI system that combined all imaging information with PI resulted in an area under the ROC curve of 0.852, significantly higher than the ultrafast dynamics alone (P = 0.002). When operating at the same sensitivity level of radiologists in this dataset, this system produced 19 less false-positives than the number of biopsied benign lesions in our dataset.

Conclusions
Use of adjunct imaging and PI has a significant contribution in diagnostic performance of ultrafast breast MRI. The developed AI system for interpretation of multiparametric ultrafast breast MRI may improve specificity.
18F-FDG PET/CT for Prognostic Stratification of Patients With Extranodal Natural Killer/T-Cell Lymphoma
Authors: Qin Chunxia , Yang Shirui , Sun Xun , Xia Xiaotian , Li Chunyan , Lan Xiaoli 
Published: January 2019

Purpose
The prognostic value of PET/CT for extranodal natural killer/T-cell lymphoma (ENKTL) patients is controversial. We sought to investigate the use of pretreatment and interim PET/CT in this disease.

Methods
Sixty-five patients diagnosed with ENKTL who underwent pretreatment (n = 53) and/or interim PET/CT scans (after 2–4 cycles of chemotherapy and/or radiotherapy, n = 33) were retrospectively enrolled. Interim PET/CT images were interpreted according to the Deauville 5-point scale. PET/CT results were assessed for their predictive value of progression-free survival (PFS) and overall survival (OS). Kaplan-Meier estimates were generated to evaluate the predictive value of clinical parameters and PET/CT scans for prognosis evaluation. The Cox proportional hazards model was performed to assess the potential independent predictors for PFS and OS.

Results
Patients with a high score (4/5) according to the Deauville scale had heavier tumor burdens and tended to have elevated serum LDH and β2-microglobulin (β2-MG). In univariate analysis, the following parameters were predictive of PFS: age (≤60 vs > 60 years), stage (I/II vs III/IV), lesion location (nasal vs extranasal), LDH (normal vs elevated), β2-MG (normal vs elevated), SUVmax before treatment (≤8.3 vs > 8.3), and interim PET/CT results. For OS, the predictive factors were composed of stage, lesion location, LDH, β2-MG, and interim PET/CT results. However, in multivariate analysis, only interim PET/CT scan interpreted by the Deauville scale remained as an independent predictor for both PFS and OS.

Conclusions
Interim PET/CT scan displayed potential predictive value for ENKTL patients. Response assessment according to the Deauville 5-point scale may help to improve the accuracy of prediction. Patients with advanced stage (III/IV), elevated LDH or β2-MG, and a high Deauville score of 4 to 5 on the interim PET/CT scan were more likely to have reduced PFS and OS.
Diffuse Skeletal Hemangiomatosis Mimicking Metastastic Disease on 18F-FDG PET/CT
Authors: Huang Dong , Ou Xiaohong , Ye Yunxia , Zhang Wenjie 
Published: January 2019

Abstract
Diffuse skeletal hemangiomatosis is a rare vascular proliferation disorder involving multiple bones and may be confused with metastatic bone malignancy. We present a case of a 53-year-old man suffering back and proximal right femur pain underwent 18F-FDG PET/CT scan. Multiple hypermetabolic lesions of bone were concerning for metastatic carcinoma. Since no primary malignancy was found, open biopsy was performed and histologic examination led to a diagnosis of diffuse skeletal angiomatosis. This case highlighted the importance of including diffuse skeletal hemangiomatosis in the differential diagnosis of multiple hypermetabolic skeletal lesions on 18F-FDG PET/CT.
Gummatous Syphilis Mimicking Malignant Bone Tumor on FDG PET/CT
Authors: Wang Li-juan , Wu Hu-bing , Zhou Wen-lan , Yu Si-rui , Wang Quan-shi 
Published: January 2019

Abstract
A 47-year-old woman suffered worsening pain in the waist and numbness in the right thigh for 1 month. MRI was performed to determine the cause, which detected an osteolytic lesion in the T12 vertebral body, suggestive of possible bone metastasis. FDG PET/CT scan was undertaken to detect the primary tumor, which only showed the same isolated lesion in the T12 without any other abnormal hypermetabolic lesion. The pathology following vertebrectomy revealed granulomatous infection. The diagnosis of osseous syphilis was eventually made following a subsequent positive Treponema pallidum serological test.
Diffuse-Type Tenosynovial Giant Cell Tumor of the Shoulder Evaluated by FDG PET/CT
Authors: Tang Kun , Zheng Xiangwu , Lin Jie , Wang Ling 
Published: January 2019

Abstract
Diffuse-type tenosynovial giant cell tumor is a locally aggressive neoplasm that typically involves the knee and hip but rarely involves the shoulder. In this case, a 74-year-old woman presented a painless mass in the right shoulder. FDG PET/CT demonstrated intense FDG uptake with an SUVmax of 19.2 in the lesion. The mass was dissected and confirmed as diffuse-type tenosynovial giant cell tumor by pathology. Follow-up FDG PET/CT assessment revealed more extensive soft tissue infiltration and adjacent bone erosion 3 years after surgery. Thus, FDG PET/CT well demonstrated the hypermetabolic and local aggressive characteristics of the lesion.
Delayed Response (Partial Remission) 3 Years After Peptide Receptor Radionuclide Therapy in a Patient Participating in the NETTER-1 Trial
Authors: Zhang Jingjing , Kulkarni Harshad R. , Singh Aviral , Baum Richard P. 
Published: January 2019

Abstract
Peptide receptor radionuclide therapy (PRRT) with radiolabeled somatostatin analogues has been shown to be highly efficacious concerning progression-free survival and response rates in patients with advanced, progressive, well-differentiated, somatostatin-receptor–positive neuroendocrine neoplasm. We report here delayed response of a midgut neuroendocrine neoplasm patient, who had stable disease after 4 cycles of PRRT and over a long period of 5 restaging admissions with excellent quality of life (full working hours), persisting for 3 years of follow-up, and presented as further partial remission according to both Response Evaluation Criteria in Solid Tumors and EORTC criteria, respectively, 36 months after the last PRRT cycle.
Spontaneous Regression of Clinically Indolent Lymphomas Revealed by 18F-FDG PET/CT
Authors: Pan Qingqing , Luo Yaping , Cao Xinxin , Zhang Yan , Li Fang 
Published: January 2019

Abstract
A 48-year-old man and a 55-year-old woman, who were diagnosed with follicular lymphoma and small B lymphocytic cell lymphoma, respectively, underwent initial “watch-and-wait” approach against lymphoma. The initial 18F-FDG PET/CT of both patients showed multiple FDG-avid lymph nodes in the neck, mediastinum, abdomen, and inguinal regions. During their active surveillance, the follow-up PET/CT of both patients revealed spontaneous regression of lymphoma.
99mTc-HYNIC-TOC in the Evaluation of Recurrent Tumor-Induced Osteomalacia
Authors: Shi Ximin , Jing Hongli , Li Fang , Zhao Yupei , Wang Zhenghua , Huo Li 
Published: January 2019

Purpose
Tumor-induced osteomalacia (TIO) is rare paraneoplastic disorder generally caused by small benign neoplasm. Somatostatin receptor imaging has emerged as imaging of the choice in the localization of the causative tumors in new patients with clinical diagnosis of TIO. An accurate localization of the causative tumor using somatostatin receptor imaging followed by successful surgical removal offers cure of the disease. In small percentage of the patients, however, there can be recurrent disease after the surgery. In this retrospective investigation, we tried to assess whether somatostatin receptor imaging using 99mTc-HYNIC-TOC (99mTc-hydrazinonicotinyl-Tyr3-octreotide) is also useful in patients with recurrent TIO after initial successful surgery.

Methods
The images of 99mTc-HYNIC-TOC images and clinical charts of total 18 patients with suspected recurrent TIO were retrospectively reviewed. The image findings were compared with the clinical chart, which include clinical follow-up and subsequent imaging and surgery.

Results
Among all 18 patients, 99mTc-HYNIC-TOC imaging results were negative in 5 of them. Among these 5 patients with negative imaging study, the causes of recurrent symptoms and hypophosphatemia in 3 patients were eventually found unrelated to TIO. 99mTc-HYNIC-TOC successfully identified either recurrent causative tumors in the same location (n = 10) or different causative tumor in other locations (n = 3) in 13 patients, which rendered a sensitivity of 86.7% (13 of 15).

Conclusions
The efficacy of 99mTc-HYNIC-TOC imaging in the evaluation of patients with potential recurrent TIO is compatible to that with new patients who never received surgical resection for the culprit tumors. It can play an important role in known TIO patients who were suspected to have recurrent disease.
Measurement of Spleen Stiffness by Shear-Wave Elastography for Prediction of Splenomegaly Etiology
Authors: Batur Abdussamet , Alagoz Sumeyra , Durmaz Fatma , Baran Ali Irfan , Ekinci Omer 
Published: January 2019

Objective
The aim of this study was to evaluate the reproducibility of measurement of spleen stiffness at the time of the initial detection of splenomegaly, whether it is found incidentally or not, in determining the etiology of splenomegaly.

Methods
The pathologies that brought about the diffuse splenomegaly were evaluated in 3 main groups as follows: hepatoportal, myeloproliferative, and infectious causes. In addition, 17 healthy control patients were recruited. All patients were examined with acoustic radiation force impulse imaging with VTQ.

Results
The difference between the splenic parenchymal elasticity values in the hepatoportal group (3.27 ± 0.36 m/s), in the myeloproliferative disease group (2.98 ± 0.33 m/s), in the infectious disease group (2.44 ± 0.21 m/s), and in the control group (2.08 ± 0.19 m/s) was found to be statistically significant (P = 0.001). The intraclass correlation coefficient for shear wave velocity measurement between hepatoportal causes and myeloproliferative causes was 71.2% (95% confidence interval [CI], 54.9%–87.4%), between hepatoportal causes and infective causes was 99.7% (95% CI, 98.6%–100.0%), and between myeloproliferative causes and infective causes was 83.3% (95% CI, 68.8%–97.9%). In the same patient groups, spleen volumes were measured as 64.08 ± 9.66, 78.18 ± 18.52, and 51.57 ± 7.44 cm2, respectively; in the control group, it was 26.75 ± 6.57 cm2. The difference between spleen volumes was found to be statistically significant (P = 0.001).

Conclusions
Distinguishing the causes of splenomegaly is important because the disorders require different management strategies. In diseases that cause splenomegaly, tissue content may change according to pathogenesis. Such changes in the spleen are mechanical properties that can be quantified by elastography.