bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satisfaction Data Collected by E-mail and Smartphone for Emergency Department Patients
Authors: Strickler Jeffery C. , Lopiano Kenneth K. 
Published: January 2017

OBJECTIVE:
This study profiles an innovative approach to capture patient satisfaction data from emergency department (ED) patients by implementing an electronic survey method. This study compares responders to nonresponders.

BACKGROUND:
Our hypothesis is that the cohort of survey respondents will be similar to nonresponders in terms of the key characteristics of age, gender, race, ethnicity, ED disposition, and payor status.

METHODS:
This study is a cross-sectional design using secondary data from the database and provides an opportunity for univariate analysis of the key characteristics for each group. The data elements will be abstracted from the database and compared with the same key characteristics from a similar sample from the database on nonresponders to the ED satisfaction survey.

FINDINGS:
Age showed a statistically significant difference between responders and nonresponders. Comparison by disposition status showed no substantial difference between responders and nonresponders. Gender distribution showed a greater number of female than male responders. Race distribution showed a greater number and response by white and Asian patients as compared with African Americans. A review of ethnicity showed fewer Hispanics responded. An evaluation by payor classification showed greater number and response rate by those with a commercial or Workers Comp payor source. The response rate by Medicare recipients was stronger than expected; however, the response rate by Medicaid recipients and self-pay could be a concern for underrepresentation by lower socioeconomic groups. Finally, the evaluation of the method of notification showed that notification by both e-mail and text substantially improved response rates.

CONCLUSION:
The evaluation of key characteristics showed no difference related to disposition, but differences related to age, gender, race, ethnicity, and payor classification. These results point to a potential concern for underrepresentation by lower socioeconomic groups. The results showed that notification by both e-mail and text substantially improved response rates.
Philanthropic Donor Perspectives on Supporting Nursing Excellence in a Community Hospital
Authors: Fickley Sharon K. , Mishler Ray R. , Black Amelia S. , DeGuzman Pam B. 
Published: January 2017

OBJECTIVE:
The purpose of this research is to explore donors’ perspectives on support of nursing excellence in a community hospital.

BACKGROUND:
Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals.

METHODS:
Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis.

RESULTS:
Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received.

CONCLUSIONS:
This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.
Changes in the Distribution of Sex Partners in the United States: 2002 to 2011–2013
Authors: Harper Christopher R. , Dittus Patricia J. , Leichliter Jami S. , Aral Sevgi O. 
Published: January 2017

Objective
The purpose of the current analysis is to examine subgroup differences in the distribution of opposite-sex sex partners in the United States across an approximate 10-year period to identify patterns that may inform sexually transmitted infection research and prevention.

Methods
Data were drawn from the 2002 and 2011–2013 National Survey of Family Growth, a US probability-based household survey focusing on sexual and reproductive health. The measures included in this analysis were lifetime opposite-sex sex partners and opposite-sex sex partners in the past year. Analyses were conducted separately for men and women. All analyses were conducted in R and R-studio with the “survey” package, focusing on medians, the 80th, and 95th quartile.

Results
In 2002, there were significant differences between men and women in median number of lifetime sex partners with men reporting more lifetime partners. However, in the 2011–2013 data, these differences are no longer significant. Still, the findings suggest that the top 20% and top 5% of men are reporting significantly more lifetime partners than their female counterparts. In comparison, partners in the past year remain relatively unchanged for both men and women.

Conclusions
These findings suggest that there were important changes in the distribution of sex partners between 2002 and 2011–2013 that have implications for sexually transmitted infection prevention. Median lifetime partners are no longer different for women and men: however, the distribution of lifetime partners among men is becoming even more skewed.
The Human Immunodeficiency Virus Endemic: Maintaining Disease Transmission in At-Risk Urban Areas
Authors: Rothenberg Richard B. , Dai Dajun , Adams Mary Anne , Heath John Wesley 
Published: January 2017

Objectives
A study of network relationships, geographic contiguity, and risk behavior was designed to test the hypothesis that all 3 are required to maintain endemicity of human immunodeficiency virus (HIV) in at-risk urban communities. Specifically, a highly interactive network, close geographic proximity, and compound risk (multiple high-risk activities with multiple partners) would be required.

Methods
We enrolled 927 participants from two contiguous geographic areas in Atlanta, GA: a higher-risk area and lower-risk area, as measured by history of HIV reporting. We began by enrolling 30 “seeds” (15 in each area) who were comparable in their demographic and behavioral characteristics, and constructed 30 networks using a chain-link design. We assessed each individual's geographic range; measured the network characteristics of those in the higher and lower-risk areas; and measured compound risk as the presence of two or more (of 6) major risks for HIV.

Results
Among participants in the higher-risk area, the frequency of compound risk was 15%, compared with 5% in the lower-risk area. Geographic cohesion in the higher-risk group was substantially higher than that in the lower-risk group, based on comparison of geographic distance and social distance, and on the extent of overlap of personal geographic range. The networks in the 2 areas were similar: both areas show highly interactive networks with similar degree distributions, and most measures of network attributes were virtually the same.

Conclusions
Our original hypothesis was supported in part. The higher and lower-risk groups differed appreciably with regard to risk and geographic cohesion, but were substantially the same with regard to network properties. These results suggest that a “minimum” network configuration may be required for maintenance of endemic transmission, but a particular prevalence level may be determined by factors related to risk, geography, and possibly other factors.
Evaluation of the Condom Barriers Scale for Young Black Men Who Have Sex With Men: Reliability and Validity of 3 Subscales
Authors: Crosby Richard A. , Sanders Stephanie A. , Graham Cynthia A. , Milhausen Robin , Yarber William L. , Mena Leandro 
Published: January 2017

Background
Reliable and valid scale measures of barriers to condom use are not available for young black men who have sex with men (YBMSM). The purpose of this study was to evaluate the Condom Barriers Scales for application with YBMSM.

Methods
A clinic-based sample of 600 YBMSM completed a computer-assisted self-interview. The primary measure was a 14-item abbreviated version of the Condom Barriers Scale. Reliability and criterion validity were assessed.

Results
All 3 subscales were reliable: partner-related barriers (Cronbach α=0.73), sensation-related barriers (α=0.70), and motivation-related barriers (α =0.81). A complete absence of barriers was common: 47.0% (partner-related), 30.7% (sensation-related), and 46.5% (motivation-related). Dichotomized subscales were significantly associated with reporting any condomless insertive anal sex (all Ps < 0.001) and any condomless receptive anal sex (all Ps < 0.001). The subscales were significantly associated with these measures of condomless sex preserved at a continuous level (all Ps <0.001, except for sensation barriers associated with condomless receptive anal sex = 0.03). Further, the subscales were significantly associated with reporting any condom use problems (all Ps <0.001) and a measure of condomless oral sex (all Ps <0.001, except for partner-related barriers=0.31). Finally, the sensation-related barriers subscale was significantly associated with testing positive for Chlamydia and/or gonorrhea (P=0.049).

Conclusions
The 3 identified subscales yielded adequate reliability and strong evidence of validity, thereby suggesting the utility of these brief measures for use in observational and experimental research with YBMSM.
Clinical Pathway Effectiveness
Authors: Murray Ashlee Lynn , Alpern Elizabeth , Lavelle Jane , Mollen Cynthia 
Published: January 2017

Objective
Young infants are often treated in emergency departments (EDs) for febrile illnesses. Any delay in care or ineffective management could lead to increased patient morbidity and mortality. A standardized ED clinical pathway may improve care for these patients. The objective of this study is to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care.

Methods
This study used a before-and-after retrospective observational study design comparing 2 separate periods: prepathway from September 2007 through August 2008 and postpathway from September 2009 through August 2010. Subjects were infants aged 56 days or younger presenting with a rectal temperature of 38.0°C or higher. Patients were excluded if they were transferred from another hospital or if they developed a fever after initial presentation.

Results
Five hundred twenty infants were enrolled. The mean time to urine collection and time to the first antibiotic administration were reduced after pathway implementation (23-minute reduction to urine collection vs 36-minute reduction to the first antibiotic administration). There was improvement in the proportion of infants who received the pathway-specific antibiotics based on age (odds ratio, 7.2; 95% confidence interval, 4.4, 11.9) and the proportion of infants who were administered acyclovir based on pathway guidelines (odds ratio, 8.8; 95% confidence interval, 2.9–30.0).

Conclusions
An ED-based febrile young infant clinical pathway improved the timeliness of initiation of work-up as measured by urine collection and of therapy by an earlier administration of the first antibiotic, as well as decreased variability of care.
Outcomes From Referrals and Unscheduled Visits From Community Emergency Departments to a Regional Pediatric Emergency Department in Canada
Authors: Reiner Ethan , Ahmadi Ardalan , Grafstein Eric , Doan Quynh 
Published: January 2017

Objectives
Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care.

Methods
We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver. Our primary outcome measure was the proportion of visits with a subsequent visit to a PED (<7 days) during the 2012 to 2013 fiscal year. Secondary outcomes included reasons for PED consultation, the clinical services accessed, and disposition at the PED.

Results
During the study period, 581 (3.3%) of the 17,824 children seen at GEDs subsequently presented to the PED within 7 days. The top 3 diagnoses among these were fracture, viral infection, and musculoskeletal complaints. Of the 581 children with a visit to the PED, 180 (31.0%) were referred to the PED for a consultation, whereas the rest were family initiated. Referred visits were more frequently associated with pediatric subspecialist consultation than family-initiated visits (45.0% vs 19.5%, P < 0.01). The referred group more frequently resulted in a surgical procedure (13.9% vs 2.5%, P < 0.01) or hospital admission (51.7% vs 8.7%, P < 0.01).

Conclusions
Knowing the proportion, management, and outcomes of children who are treated in a GED and subsequently at a PED may provide an important quality measure and opportunities to improve the management of common pediatric emergencies in the community.
Evaluation of the Association of Early Elevated Lactate With Outcomes in Children With Severe Sepsis or Septic Shock
Authors: Gorgis Noelle , Asselin Jeannette M. , Fontana Cynthia , Heidersbach R. Scott , Flori Heidi R. , Ward Shan L. 
Published: January 2017

Objective
The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis.

Methods
This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay.

Results
Although overall mortality was 10.5% (n = 18), patients with L0 measured (n = 72) had a higher mortality (16% vs 6%, P = 0.03) and higher median PRISM-III risk of mortality scores (P = 0.02) than those who did not. Median L0 was no different between nonsurvivors and survivors (3.6 mmol/L [interquartile range, 2.0–9.0] in nonsurvivors vs 2.3 mmol/L [interquartile range, 1.4–3.5] in survivors, P = 0.11). However, L0 was independently associated with PRISM-III score (coefficient, 1.12; 95% confidence interval, 0.4–1.8; P = 0.003) with an increase in mean PRISM-III score of 1.12 U for every 1 mmol/L increase in L0, with L0 accounting for 12% of the variability in PRISM-III scores between patients. There was no association between L0 and PICU or hospital length of stay.

Conclusions
Although our single center study did not demonstrate that an elevated early lactate is associated with mortality in pediatric severe sepsis, L0 did correlate strongly with PRISM-III, the most robust measure of mortality risk in pediatrics. Therefore, early lactate measurement may be important as an early biomarker of disease severity. These data should be validated in a larger, multicenter, prospective study.
Ex Vivo Assessment of Coronary Atherosclerotic Plaque by Grating-Based Phase-Contrast Computed Tomography
Authors: Habbel Christopher , Hetterich Holger , Willner Marian , Herzen Julia , Steigerwald Kristin , Auweter Sigrid , Schüller Ulrich , Hausleiter Jörg , Massberg Steffen , Reiser Maximilian , Pfeiffer Franz , Saam Tobias , Bamberg Fabian 
Published: January 2017

Objectives
The aim of this study was to determine the diagnostic accuracy of grating-based phase-contrast computed tomography (gb-PCCT) to classify and quantify coronary vessel characteristics in comparison with optical coherence tomography (OCT) and histopathology in an ex vivo setting.

Materials and Methods
After excision from 5 heart specimens, 15 human coronary arteries underwent gb-PCCT examination using an experimental imaging setup consisting of a rotating molybdenum anode x-ray tube, a Talbot-Lau grating interferometer, and a single photon counting detector. Subsequently, all vessels were imaged by OCT and histopathologically processed. Optical coherence tomography, gb-PCCT, and histopathology images were manually matched using anatomical landmarks. Optical coherence tomography and gb-PCCT were reviewed by 2 independent observers blinded to histopathology. Vessel, lumen, and plaque area were measured, and plaque characteristics (lipid rich, calcified, and fibrous) were determined for each section. Measures of diagnostic accuracy were derived, applying histopathology as the standard of reference.

Results
Of a total of 286 assessed cross sections, 241 corresponding sections were included in the statistical analysis. Quantitative measures derived from gb-PCCT were significantly higher than from OCT (P < 0.001) and were strongly correlated with histopathology (Pearson r ≥0.85 for gb-PCCT and ≥0.61 for OCT, respectively). Results of Bland-Altman analysis demonstrated smaller mean differences between OCT and histopathology than for gb-PCCT and histopathology. Limits of agreement were narrower for gb-PCCT with regard to lumen area, for OCT with regard to plaque area, and were comparable with regard to vessel area. Based on histopathology, 228/241 (94.6%) sections were classified as fibrous, calcified, or lipid rich. The diagnostic accuracy of gb-PCCT was excellent for the detection of all plaque components (sensitivity, ≥0.95; specificity, ≥0.94), whereas the results for OCT showed sensitivities of ≥0.73 and specificities of ≥0.66.

Conclusions
In this ex vivo setting, gb-PCCT provides excellent results in the assessment of coronary atherosclerotic plaque characteristics and vessel dimensions in comparison to OCT and histopathology. Thus, the technique may serve as adjunct nondestructive modality for advanced plaque characterization in an experimental setting.
Radiomic Analysis Reveals Prognostic Information in T1-Weighted Baseline Magnetic Resonance Imaging in Patients With Glioblastoma
Authors: Ingrisch Michael , Schneider Moritz Jörg , Nörenberg Dominik , Negrao de Figueiredo Giovanna , Maier-Hein Klaus , Suchorska Bogdana , Schüller Ulrich , Albert Nathalie , Brückmann Hartmut , Reiser Maximilian , Tonn Jörg-Christian , Ertl-Wagner Birgit 
Published: January 2017

Objectives
The aim of this study was to investigate whether radiomic analysis with random survival forests (RSFs) can predict overall survival from T1-weighted contrast-enhanced baseline magnetic resonance imaging (MRI) scans in a cohort of glioblastoma multiforme (GBM) patients with uniform treatment.

Materials and Methods
This retrospective study was approved by the institutional review board and informed consent was waived. The MRI scans from 66 patients with newly diagnosed GBM from a previous prospective study were analyzed. Tumors were segmented manually on contrast-enhanced 3-dimensional T1-weighted images. Using these segmentations, P = 208 quantitative image features characterizing tumor shape, signal intensity, and texture were calculated in an automated fashion. On this data set, an RSF was trained using 10-fold cross validation to establish a link between image features and overall survival, and the individual risk for each patient was predicted. The mean concordance index was assessed as a measure of prediction accuracy. Association of individual risk with overall survival was assessed using Kaplan-Meier analysis and a univariate proportional hazards model.

Results
Mean overall survival was 14 months (range, 0.8–85 months). Mean concordance index of the 10-fold cross-validated RSF was 0.67. Kaplan-Meier analysis clearly distinguished 2 patient groups with high and low predicted individual risk (P = 5.5 × 10−5). Low predicted individual mortality was found to be a favorable prognostic factor for overall survival in a univariate Cox proportional hazards model (hazards ratio, 1.038; 95% confidence interval, 1.015–1.062; P = 0.0059).

Conclusions
This study demonstrates that baseline MRI in GBM patients contains prognostic information, which can be accessed by radiomic analysis using RSFs.
Metal Artifact Reduction Magnetic Resonance Imaging Around Arthroplasty Implants
Authors: Kumar Neil M. , de Cesar Netto Cesar , Schon Lew C. , Fritz Jan 
Published: January 2017

Objectives
Long echo train length (ETL) is an often recommended but unproven technique to decrease metal artifacts on magnetic resonance imaging (MRI) scans. Therefore, we quantitatively and qualitatively assessed the effects of ETL on metal artifact on MRI scans using a cobalt-chromium–containing arthroplasty implant system.

Materials and Methods
Using a total ankle arthroplasty system implanted into a human cadaver ankle and a clinical 1.5 T MRI system, turbo spin echo (TSE) pulse sequences were acquired with ETL ranging from 3 to 23 and receiver bandwidth (BW) from 100 to 750 Hz/pixel, whereas effective echo time and spatial resolution were controlled. A compressed sensing slice encoding for metal artifact correction TSE prototype pulse sequence was used as reference standard. End points included the total implant-related artifact area and implant-related signal void areas. Two raters evaluated the overall image quality and preference across varying BW and ETL. Two-factor analysis of variance, Friedman test, Kruskal-Wallis test, and Pearson correlation were used. P values of less than 0.05 were considered statistically significant.

Results
The total implant-related artifact area ranged from 0.119 for compressed sensing slice encoding for metal artifact correction (BW, 600 Hz/pixel; ETL, 3) to 0.265 for TSE (BW, 100 Hz/pixel; ETL, 23). Longer ETL significantly increases the total implant-related artifact area (P = 0.0004), whereas it decreased with increasing BW (P < 0.0001). Implant-related signal void areas were not significantly affected by larger echo train length, but reduced with higher BW (P < 0.0001). Readers had a significant preference for images with high BW and short ETL (P < 0.0001).

Conclusions
High receiver BW is the most effective parameter for reduction of arthroplasty implant-induced metal artifact on MRI scans, whereas in contradiction to prevalent notions, long echo trains fail to reduce implant-related metal artifacts, but in fact cause degradation of image quality around the implant with resultant larger appearing total metal artifacts.
A Case Study of Hemochromatosis and Conflicting Point Shear Wave Measurements in the Assessment of Liver Fibrosis
Authors: Cohen Tal , Barr Richard G. 
Published: January 2017

Abstract
There are multiple factors that affect the shear wave speed in the assessment of liver stiffness. In this case report, we present a case of hemochromatosis that has elevated liver stiffness suggestive of significant fibrosis or cirrhosis; however on liver biopsy, no fibrosis was identified. This article will discuss the possibility that liver iron deposition may affect SWE measurements of the liver, leading to inaccurate assessment of liver fibrosis. In these cases, a liver biopsy may be required for accurate liver assessment.