bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Ultrasonography for Assessing Treatment Efficacy in a Case With Ankylosis of the Temporomandibular Joint
Authors: Ho Kai-Yu , Ho Sally , Colletti Patrick M. 
Published: March 2016

The patient was a 32-year-old university lecturer with limited mouth opening for 15 years. The patient was diagnosed with right temporomandibular joint ankylosis 10 years prior. Ultrasonography was employed to assess capsule-condyle distance before and after physical therapy. A treatment plan aiming at mobilizations and exercises was implemented, and the patient reported improvements in eating and speaking. J Orthop Sports Phys Ther 2016;46(3):225. doi:10.2519/jospt.2016.0404
Contribution of combined intraoperative electrophysiological investigation with 3-T intraoperative MRI for awake cerebral glioma surgery: comprehensive review of the clinical implications and radiological outcomes
Authors: Ghinda Diana , Zhang Nan , Lu Junfeng , Yao Cheng-Jun , Yuan Shiwen , Wu Jin-Song 
Published: March 2016

OBJECTIVE
This study aimed to assess the clinical efficiency of combined awake craniotomy with 3-T intraoperative MRI (iMRI)–guided resection of gliomas adjacent to eloquent cortex performed at a single center. It also sought to explore the contribution of iMRI to surgeons' learning process of maximal safe resection of gliomas.

METHODS
All patients who underwent an awake craniotomy and iMRI for resection of eloquent area glioma during the 53 months between January 2011 and June 2015 were included. The cases were analyzed for short- and long-term neurological outcome, progression-free survival (PFS), overall survival (OS), and extent of resection (EOR). The learning curve was assessed after dividing the cohort into Group A (first 27 months) and Group B (last 26 months). Statistical analyses included univariate logistic regression analysis on clinical and radiological variables. Kaplan-Meier and Cox regression models were used for further analysis of OS and PFS. A p value < 0.05 was considered statistically significant.

RESULTS
One hundred six patients were included in the study. Over an average follow-up period of 24.8 months, short- and long-term worsening of the neurological function was noted in 48 (46.2%) and 9 (8.7%) cases, respectively. The median and mean EOR were 100% and 92%, respectively, and complete radiographic resection was achieved in 64 (60.4%) patients. The rate of gross-total resection (GTR) in the patients with low-grade glioma (89.06% ± 19.6%) was significantly lower than that in patients with high-grade glioma (96.4% ± 9.1%) (p = 0.026). Thirty (28.3%) patients underwent further resection after initial iMRI scanning, with a 10.1% increase of the mean EOR. Multivariate Cox proportional hazards modeling demonstrated that the final EOR was a significant predictor of PFS (HR 0.225, 95% CI 0.070–0.723, p = 0.012). For patients with high-grade glioma, the GTR (p = 0.033), the presence of short-term motor deficit (p = 0.027), and the WHO grade (p = 0.005) were independent prognostic factors of OS. Performing further resection after the iMRI (p = 0.083) and achieving GTR (p = 0.05) demonstrated a PFS benefit trend for the patients affected by a low-grade glioma. Over time, the rate of performing further resection after an iMRI decreased by 26.1% (p = 0.005). A nonsignificant decrease in the rate of short-term (p = 0.101) and long-term (p = 0.132) neurological deficits was equally noted.

CONCLUSIONS
Combined awake craniotomy and iMRI is a safe and efficient technique allowing maximal safe resection of eloquent area gliomas with possible subsequent OS and PFS benefits. Although there is a learning curve for applying this technique, it can also improve the surgeon's ability in eloquent glioma surgery.
Adults with myelomeningocele and other forms of spinal dysraphism: hospital care in the United States since the turn of the millennium
Authors: Piatt Joseph H. 
Published: March 2016

OBJECTIVE
The natural history and management of myelomeningocele (MM) in children is fairly well understood. There is a deficiency of knowledge regarding the care of adults, however, even though there are now more adults than children living with MM. The purpose of this study was to characterize the hospital care of adults with MM and hydrocephalus on a nationwide population base. Adults with other forms of spina bifida (SB) were studied for contrast.

METHODS
The Nationwide Inpatient Sample for the years 2001, 2004, 2007, and 2010 was queried for admissions with diagnostic ICD-9-CM codes for MM with hydrocephalus and for other forms of SB.

RESULTS
There were 4657 admissions of patients with MM and 12,369 admissions of patients with SB in the sample. Nationwide rates of admission increased steadily for both MM and SB patients throughout the study period. Hospital charges increased faster than the health care component of the Consumer Price Index. Patients with MM were younger than patients with SB, but annual admissions of MM patients older than 40 years increased significantly during the study period. With respect to hospital death and discharge home, outcomes of surgery for hydrocephalus were superior at high-volume hospitals. Patients with MM and SB were admitted to the hospital more frequently than the general population for surgery to treat degenerative spine disease.

CONCLUSIONS
Patients with MM and SB continue to require neurosurgical attention in adulthood, and the demand for services for older patients with MM is increasing. Management of hydrocephalus at high-volume centers is advantageous for this population. Patients with MM or SB may experience high rates of degenerative spine disease.
The utility of high-resolution intraoperative MRI in endoscopic transsphenoidal surgery for pituitary macroadenomas: early experience in the Advanced Multimodality Image Guided Operating suite
Authors: Zaidi Hasan A. , De Los Reyes Kenneth , Barkhoudarian Garni , Litvack Zachary N. , Bi Wenya Linda , Rincon-Torroella Jordina , Mukundan Srinivasan , Dunn Ian F. , Laws Edward R. 
Published: March 2016

OBJECTIVE
Endoscopic skull base surgery has become increasingly popular among the skull base surgery community, with improved illumination and angled visualization potentially improving tumor resection rates. Intraoperative MRI (iMRI) is used to detect residual disease during the course of the resection. This study is an investigation of the utility of 3-T iMRI in combination with transnasal endoscopy with regard to gross-total resection (GTR) of pituitary macroadenomas.

METHODS
The authors retrospectively reviewed all endoscopic transsphenoidal operations performed in the Advanced Multimodality Image Guided Operating (AMIGO) suite from November 2011 to December 2014. Inclusion criteria were patients harboring presumed pituitary macroadenomas with optic nerve or chiasmal compression and visual loss, operated on by a single surgeon.

RESULTS
Of the 27 patients who underwent transsphenoidal resection in the AMIGO suite, 20 patients met the inclusion criteria. The endoscope alone, without the use of iMRI, would have correctly predicted extent of resection in 13 (65%) of 20 cases. Gross-total resection was achieved in 12 patients (60%) prior to MRI. Intraoperative MRI helped convert 1 STR and 4 NTRs to GTRs, increasing the number of GTRs from 12 (60%) to 16 (80%).

CONCLUSIONS
Despite advances in visualization provided by the endoscope, the incidence of residual disease can potentially place the patient at risk for additional surgery. The authors found that iMRI can be useful in detecting unexpected residual tumor. The cost-effectiveness of this tool is yet to be determined.
Prospective evaluation of the utility of intraoperative confocal laser endomicroscopy in patients with brain neoplasms using fluorescein sodium: experience with 74 cases
Authors: Martirosyan Nikolay L. , Eschbacher Jennifer M. , Kalani M. Yashar S. , Turner Jay D. , Belykh Evgenii , Spetzler Robert F. , Nakaji Peter , Preul Mark C. 
Published: March 2016

OBJECTIVE
This study evaluated the utility, specificity, and sensitivity of intraoperative confocal laser endomicroscopy (CLE) to provide diagnostic information during resection of human brain tumors.

METHODS
CLE imaging was used in the resection of intracranial neoplasms in 74 consecutive patients (31 male; mean age 47.5 years; sequential 10-month study period). Intraoperative in vivo and ex vivo CLE was performed after intravenous injection of fluorescein sodium (FNa). Tissue samples from CLE imaging–matched areas were acquired for comparison with routine histological analysis (frozen and permanent sections). CLE images were classified as diagnostic or nondiagnostic. The specificities and sensitivities of CLE and frozen sections for gliomas and meningiomas were calculated using permanent histological sections as the standard.

RESULTS
CLE images were obtained for each patient. The mean duration of intraoperative CLE system use was 15.7 minutes (range 3–73 minutes). A total of 20,734 CLE images were correlated with 267 biopsy specimens (mean number of images/biopsy location, in vivo 84, ex vivo 70). CLE images were diagnostic for 45.98% in vivo and 52.97% ex vivo specimens. After initiation of CLE, an average of 14 in vivo images and 7 ex vivo images were acquired before identification of a first diagnostic image. CLE specificity and sensitivity were, respectively, 94% and 91% for gliomas and 93% and 97% for meningiomas.

CONCLUSIONS
CLE with FNa provided intraoperative histological information during brain tumor removal. Specificities and sensitivities of CLE for gliomas and meningiomas were comparable to those for frozen sections. These data suggest that CLE could allow the interactive identification of tumor areas, substantially improving intraoperative decisions during the resection of brain tumors.
SOLAR JET–CORONAL HOLE COLLISION AND A CLOSELY RELATED CORONAL MASS EJECTION
Authors: Zheng Ruisheng , Chen Yao , Du Guohui , Li Chuanyang 
Published: March 2016

ABSTRACT
Jets are defined as impulsive, well-collimated upflows, occurring in different layers of the solar atmosphere with different scales. Their relationship with coronal mass ejections (CMEs), another type of solar impulsive events, remains elusive. Using high-quality imaging data from the Atmospheric Imaging Assembly/Solar Dynamics Observatory, we show a well-observed coronal jet event, in which the part of the jet with embedding coronal loops runs into a nearby coronal hole (CH) and gets bounced in the opposite direction. This is evidenced by the flat shape of the jet front during its interaction with the CH and the V-shaped feature in the time-slice plot of the interaction region. About a half-hour later, a CME with an initially narrow and jet-like front is observed by the LASCO C2 coronagraph propagating along the direction of the post-collision jet. We also observe some 304 Å dark material flowing from the jet–CH interaction region toward the CME. We thus suggest that the jet and the CME are physically connected, with the jet–CH collision and the large-scale magnetic topology of the CH being important in defining the eventual propagating direction of this particular jet–CME eruption.
New Delhi metallo-β-lactamase in Jamaica
Authors: Thoms-Rodriguez Camille-Ann , Mazzulli Tony , Christian Nicole , Willey Barbara M , Boyd David A , Mataseje Laura F , Mulvey Michael R , Christie Celia DC , Nicholson Alison M 
Published: February 2016

Introduction: The global dissemination of the New Delhi metallo-beta-lactamase (NDM) gene among certain strains of bacteria has serious implications since the infections caused by such organisms pose a therapeutic challenge. Although the NDM gene has been detected in various parts of the world, this is the first report of its detection in the English-speaking Caribbean. The NDM producing Klebsiella pneumoniae was isolated from an Indian patient who had recently relocated to Jamaica. Methodology: Identification and susceptibility testing of the K. pneumoniae isolate was performed using the Vitek 2 automated system) in keeping with Clinical and Laboratory Standards Institute (CLSI) standards. It was identified as a metallobetalactamase producer using the Rosco KPC+MBL kit. Genotypic screening for common betalactamase (including carbapenemase) genes, was carried out using two multiplex PCRs: one for SHV-, TEM-, CTX-M-, OXA-1-, and CMY-2-types, and one for VIM-, KPC-, IMP-, OXA-48, GES-, and NDM-types. Strain typing was conducted by pulsed-field gel electrophoresis (PFGE) using XbaI and multi-locus sequencing (MLS). Plasmid isolation and analysis was also performed. Results: K. pneumoniae (N11-02395), not previously associated with the dissemination of the NDM in India, Sweden or the UK, was found to harbor the NDM-1 gene on plasmid pNDM112395. Conclusion: The identification of the NDM-1 gene underscores the need for effective surveillance and infection control measures to identify and prevent spread of multidrug resistant Gram negative bacilli. Strict infection control measures implemented for this patient helped to prevent the spread of this organism to other patients.
Improving Surveillance and Prevention of Surgical Site Infection in Pediatric Cardiac Surgery
Authors: Cannon Melissa , Hersey Diane , Harrison Sheilah , Joy Brian , Naguib Aymen , Galantowicz Mark , Simsic Janet 
Published: March 2016

Background
Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs.

Objective
To improve surgical wound surveillance and reduce the incidence of surgical site infections.

Methods
An institutional review of surgical site infections led to implementation of 8 surveillance and process measures: appropriate preparation the night before surgery and the day of surgery, use of appropriate preparation solution in the operating room, appropriate timing of preoperative antibiotic administration, placement of a photograph of the surgical site in the patient’s chart at discharge, sending a photograph of the surgical site to the patient’s primary care physician, 30-day follow-up of the surgical site by an advanced nurse practitioner, and placing a photograph of the surgical site obtained on postoperative day 30 in the patient’s chart.

Results
Mean overall compliance with the 8 measures from March 2013 through February 2014 was 88%. Infections occurred in 10 of 417 total operative cases (2%) in 2012, in 8 of 437 total operative cases (2%) in 2013, and in 7 of 452 total operative cases (1.5%) in 2014.

Conclusions
Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients’ family members and referring physicians.
An Assessment Tool for the Placement of Ultrasound-Guided Peripheral Intravenous Access
Authors: Rice Julie , Crichlow Amanda , Baker Marrissa , Regan Linda , Dodson Adam , Hsieh Yu-Hsiang , Omron Rodney 
Published: March 2016

ABSTRACT Ultrasound-guided peripheral intravenous line (USGPIV) placement is becoming an important tool in current clinical practice. Many residency programs utilize unstructured clinical observation to evaluate residents in this and other procedural skills. Simulation-based assessment permits educators to make objective, standardized observations, and may be ideal for assessment of important procedural competencies.Background We created a simulation-based assessment tool for the skill of USGPIV placement.Objective A checklist tool was developed by a review of relevant literature and an expert review in accordance with established guidelines. Emergency medicine residents were recruited and surveyed on previous experience with USGPIV placement. Blinded, independent reviewers then utilized the checklist to assess residents as they made up to 3 attempts at USGPIV placement on a simulated pediatric arm.Methods Of the 26 residents enrolled in our study, 26 participated (100%). A best attempt checklist score greater than or equal to 9 out of 10 correlated with expert performance (P &lt; .001). Agreement between independent raters on first-attempt USGPIV placement score was determined by weighted kappa statistics to be 0.93 (95% CI 086–1.00).Results The checklist assessment tool has acceptable interrater reliability and ability to distinguish performance at differing levels of competence. We propose this tool as a valuable component in the assessment of USGPIV access, and we hope this article serves as a roadmap for other educators to create similar assessment tools.Conclusions
Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training
Authors: Gil Joseph A , Daniels Alan H , Akelman Edward 
Published: March 2016

ABSTRACT

Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures.Background

The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume.Objective

Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends.Methods

The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group.Results

There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training.Conclusions
Interpreting the ultraviolet aerosol index observed with the OMI satellite instrument to understand absorption by organic aerosols: implications for atmospheric oxidation and direct radiative effects
Authors: Hammer Melanie S. , Martin Randall V. , van Donkelaar Aaron , Buchard Virginie , Torres Omar , Ridley David A. , Spurr Robert J. D. 
Published: March 2016

Abstract. Satellite observations of the ultraviolet aerosol index (UVAI) are sensitive to absorption of solar radiation by aerosols; this absorption affects photolysis frequencies and radiative forcing. We develop a global simulation of the UVAI using the 3-D chemical transport model GEOS-Chem coupled with the Vector Linearized Discrete Ordinate Radiative Transfer model (VLIDORT). The simulation is applied to interpret UVAI observations from the Ozone Monitoring Instrument (OMI) for the year 2007. Simulated and observed values are highly consistent in regions where mineral dust dominates the UVAI, but a large negative bias (−0.32 to −0.97) exists between simulated and observed values in biomass burning regions. We determine effective optical properties for absorbing organic aerosol, known as brown carbon (BrC), and implement them into GEOS-Chem to better represent observed UVAI values over biomass burning regions. The inclusion of absorbing BrC decreases the mean bias between simulated and OMI UVAI values from −0.57 to −0.09 over West Africa in January, from −0.32 to +0.0002 over South Asia in April, from −0.97 to −0.22 over southern Africa in July, and from −0.50 to +0.33 over South America in September. The spectral dependence of absorption after including BrC in the model is broadly consistent with reported observations for biomass burning aerosol, with absorbing Ångström exponent (AAE) values ranging from 2.9 in the ultraviolet (UV) to 1.3 across the UV–Near IR spectrum. We assess the effect of the additional UV absorption by BrC on atmospheric photochemistry by examining tropospheric hydroxyl radical (OH) concentrations in GEOS-Chem. The inclusion of BrC decreases OH by up to 30 % over South America in September, up to 20 % over southern Africa in July, and up to 15 % over other biomass burning regions. Global annual mean OH concentrations in GEOS-Chem decrease due to the presence of absorbing BrC, increasing the methyl chloroform lifetime from 5.62 to 5.68 years, thus reducing the bias against observed values. We calculate the direct radiative effect (DRE) of BrC using GEOS-Chem coupled with the radiative transfer model RRTMG (GC-RT). Treating organic aerosol as containing more strongly absorbing BrC changes the global annual mean all-sky top of atmosphere (TOA) DRE by +0.03 W m−2 and all-sky surface DRE by −0.08 W m−2. Regional changes of up to +0.3 W m−2 at TOA and down to −1.5 W m−2 at the surface are found over major biomass burning regions.
Quantifying the effect of sea level rise and flood defence – a point process perspective on coastal flood damage
Authors: Boettle M. , Rybski D. , Kropp J. P. 
Published: February 2016

Abstract. In contrast to recent advances in projecting sea levels, estimations about the economic impact of sea level rise are vague. Nonetheless, they are of great importance for policy making with regard to adaptation and greenhouse-gas mitigation. Since the damage is mainly caused by extreme events, we propose a stochastic framework to estimate the monetary losses from coastal floods in a confined region. For this purpose, we follow a Peak-over-Threshold approach employing a Poisson point process and the Generalised Pareto Distribution. By considering the effect of sea level rise as well as potential adaptation scenarios on the involved parameters, we are able to study the development of the annual damage. An application to the city of Copenhagen shows that a doubling of losses can be expected from a mean sea level increase of only 11 cm. In general, we find that for varying parameters the expected losses can be well approximated by one of three analytical expressions depending on the extreme value parameters. These findings reveal the complex interplay of the involved parameters and allow conclusions of fundamental relevance. For instance, we show that the damage typically increases faster than the sea level rise itself. This in turn can be of great importance for the assessment of sea level rise impacts on the global scale. Our results are accompanied by an assessment of uncertainty, which reflects the stochastic nature of extreme events. While the absolute value of uncertainty about the flood damage increases with rising mean sea levels, we find that it decreases in relation to the expected damage.