bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung ultrasound in heart failure: Lessons from re‐analysis of Lung Ultrasound 2011 database
Authors: Baker Kylie , Mitchell Geoffrey , Thompson Angus G , Stieler Geoffrey , Rippey James 
Published: December 2015

AbstractIntroduction: In the setting of patients presenting with shortness of breath to an Emergency Department a simple lung ultrasound protocol aimed at detecting pulmonary oedema has been shown to have diagnostic accuracy of 85%. This article reviews data from the original study, in an attempt to determine whether adjusting the protocol and/or interpretive criteria would improve results.Method: A large lung ultrasound project provided the dataset. Inter‐rater and intertest discrepancies were reviewed. Then original stored images and comments were retrospectively analysed using alternate interpretive criteria. Specific variations included changing the number of B‐lines required to define ‘wet lung’ and assessing other pleural line abnormalities. Where they had been acquired cardiac loops were reviewed in addition to the lung images.Results: The 204 original studies available were reviewed. Some disagreement could be attributed to inexperience and unclear definitions. Adjusting the number of B‐lines did not improve diagnostic accuracy. All positive scans, with numerous B‐lines were reviewed using more advanced diagnostic criteria (pleural line abnormalities) and the number of false positives was decreased. In cases where cardiac views were available, their inclusion was beneficial.Conclusion: A simple lung ultrasound protocol to assess for ‘wet lung’ in patients presenting to Emergency Departments provides diagnostic accuracy of around 85% in the hands of relative novices. More advanced interpretation of the same_ultrasound images, and the addition of cardiac views, is likely to further improve diagnostic accuracy.
Use of bedside ultrasound to diagnose dislodged gastric band
Authors: Bass Dirk , Telfah Malek , Bowra Justin 
Published: December 2015

AbstractIntroduction: Obesity levels mean an increased presentation of patients with Laparoscopic adjustable gastric banding (LAGB).Method: Literature search revealed a paucity of information on ultrasonography to diagnose a slipped LAGB.Conclusion: 2D Ultrasonography with a standard low frequency curvilinear probe proved to be a simple, effective method of diagnosing slipped Laparoscopic adjustable gastric banding (LAGB). We suggest the inclusion of routine abdominal ultrasound (after drinking water to improve sensitivity of the test) as part of the routine workup of suspected LAGB slippage.
Can we measure the spiral and uterine artery blood flow by real‐time sonography and Doppler indices to predict spontaneous miscarriage in a normal‐risk population?
Authors: Özkan Mehmet Burak , Ozyazici Elif , Emiroglu Baris , Özkara Enis 
Published: December 2015

AbstractIntroduction: The predictive value of spiral artery flow Doppler measurements of a subsequent early miscarriage in first trimester pregnancy is explored here.Objective: The aim of this study is to determine uterine and spiral artery blood flow changes in first trimester subsequent miscarriages and correlate within the mechanisms of the Doppler indicies.Study design: The uterine artery and spiral artery pulsatility and resistance indexes, systolic and diastolic ratios, acceleration times, and blood flow of both the right and left uterine arteries were obtained by trans vaginal color Doppler ultrasonography in consecutive viable pregnancies between 5 and 12 gestational week. Women were subsequently classified as having continuing pregnancies or pregnancy loss before 20 weeks gestation. To predict subsequent pregnancy loss, Doppler findings were adjusted for maternal age, history of previous abortion, presence of subchorionic hematoma, embryonic bradycardia, and gestational age by means of multivariate logistic regression analysis. The cut‐off values are used for the ROC curve.Results: Twenty‐five pregnancies (11.7%) were spontaneously aborted before 20 weeks of gestational age. In 29 (13.6%) cases there were previously abortion history, 30 (14%) had bradycardia, and 37 (17.3%) had subchoronic hematoma. Regarding the parameters of uterine and spiral artery pulsatility and resistive index, acceleration time, systolic/diastolic ratios and blood flows, only uterine artery S/D low values were significantly associated with pregnancy loss in the multivariate logistic regression analysis (P = 0.0001,95% CI: 4.968–55.675).Conclusion: The uterine artery systolic/diastolic ratios have a predictive value for early pregnancy loss and seem to be useful as a marker. On the other hand, spiral artery changes could be so local that they cannot be determined by the parameters of spectral Doppler techniques. This suggests that uterine vascular bed alterations should be measured to understand the prognosis of early pregnancy loss during the first trimester.
Persistent median artery thrombosis: A rare cause of carpal tunnel syndrome
Authors: Srivastava Ankur , Sharma Praneal , Pillay Sugnedran 
Published: December 2015

AbstractBackground: Carpal tunnel syndrome (CTS) is a sporadic event with compression of the median nerve (MN). Persistent median artery (PMA) thrombosis is an exceptionally rare cause of CTS.Case report: 38‐year‐old male presented with acute on subacute right wrist pain with positive Tinel's sign. An ultrasound and computed angiography study confirmed a PMA with thrombosis. The patient was treated with intravenous heparin then discharged home on enoxaparin and warfarin crossover. Discussion: PMA can lead to CTS by compression from the adjacent median nerve. Thrombosis of the PMA can also lead to CTS. Surgical intervention is needed in cases of severe CTS. Carpal tunnel release is usually successful. Excision of the PMA can risk vascular compromise of the digits. Ultrasound is excellent for detecting rare causes of CTS.Conclusion: Ultrasound examination for CTS should include search for PMA and associated anatomical variations.
A comparison of ultrasonic measurement techniques for the maternal cervix in the second trimester
Authors: O'Hara Sandra , Zelesco Marilyn , Sun Zhonghua 
Published: December 2015

AbstractIntroduction: The appropriate ultrasound technique to assess the maternal cervical length in women at low risk of preterm birth is yet to be established. This study aimed to determine the accuracy of different ultrasound approaches for measuring the maternal cervix in patients between 17 and 22 weeks gestation.Methods: The prospective study recruited 50 patients who were at a low risk of preterm birth. All measurements were acquired by one operator who was blind to the measurements being acquired in all approaches. The cervical length was registered using the transabdominal approach with a full and empty bladder, the transperineal approach and the transvaginal. The transvaginal approach was used as the reference measurement.Results: The transabdominal full bladder, post void, transperineal and transvaginal measurements were obtainable in 50, 49, 45 and 50 participants respectively. The transabdominal post void measurements showed a bias of −0.06 mm from perfect agreement with transvaginal. The transperineal measurements showed a bias of −0.16 mm. The transabdominal full bladder measurements were positively biased by 14.05 mm (p < 0.05). All transabdominal post void cervical lengths of 30 mm or greater registered a transvaginal cervical length greater than 25 mm in this study.Conclusion: The cervix should not be assessed in the transabdominal approach with a full maternal bladder due to overestimation of cervical length. Transvaginal cervical length can be reproduced accurately by post void transabdominal cervical length in most cases. Transperineal cervical length should be considered if transvaginal cervical length is contraindicated.
Renal transplant ultrasound: The nephrologist's perspective
Authors: Leong Khai Gene , Coombs Peter , Kanellis John 
Published: December 2015

AbstractOne of the principal roles of a nephrologist is to closely monitor renal transplant allograft function and promptly evaluate any dysfunction. Renal transplant sonography has a major role in this assessment process given its ability to easily define renal transplant anatomy and surrounding structures. Abnormalities can be extrarenal or involve vascular, parenchymal and urological components of the graft and these can acutely or chronically influence graft function and survival. Procedural guidance as is required during allograft biopsy, as well as routine surveillance and screening for post transplant complications such as malignancy are also important applications of ultrasound in the management of renal transplant recipients. This article outlines key ultrasound findings and applications in renal transplantation from the clinician's perspective.
Sensitivity, specificity and diagnostic accuracy of novices integrating lung ultrasound into the care of breathless older patients
Authors: Baker Kylie , Soong Luke , Harding Timothy , Wain Amy , Cheah Jon , Mitchell Geoffrey , Brierley Stephen 
Published: December 2015

AbstractBackground: Lung ultrasound is frequently used to identify pulmonary oedema, using the ‘B line’ artefact. A small study in 2011 suggested that novice sonologists had a potential diagnostic accuracy of 85%, when performing the test without reference to other patient information.Aim: We aimed to test the overall diagnostic accuracy of novice clinician sonologists incorporating the 2011 protocol into routine assessment of the patient.Method: A prospective convenience sample of breathless older patients presenting to ED received an 8‐view lung scan early in management. Initial ED diagnoses, utilising all information including ultrasound result, were compared against the opinion of a medical expert auditing the patient records after discharge from hospital.Results: The cohort of five novices scanned 63 cases, from which eleven were excluded.Novices using ultrasound differentiated between pulmonary oedema and other causes of breathlessness with a sensitivity of 71% (95%CI 44 to 87), Specificity of 91% (76 to 98), a diagnostic accuracy of 85% (72 to 92), a positive LR of 8.2 (2.7 to 25) and a negative LR of 0.32 (0.15 to 0.68).Discussion: The diagnostic accuracy of emergency department clinicians incorporating novice lung ultrasound into the investigation of breathlessness is consistent with the diagnostic accuracy of scanning performed in parallel to patient care, and is likely to be an improvement on current estimates of conventional ED diagnostic strategies. Clinicians should not be afraid that their learning curve would disadvantage the patient.
Catastrophic consequences of a caesarean scar pregnancy missed on ultrasound
Authors: Collins Kelly , Kothari Alka 
Published: December 2015

AbstractEctopic pregnancy that implants within the scar tissue of a previous caesarean scar is a situation that is seldom encountered and is almost invariably incompatible with a successful pregnancy. Caesarean scar ectopic pregnancies are fraught with life threatening complications such as scar rupture, significant haemorrhage, disseminated intravascular coagulation and the need for emergency life saving hysterectomy. The clinical diagnosis can be elusive, particularly in the early stages; therefore clinicians should be familiar with the condition's sonographic hallmarks. Early diagnosis and management is the key to preventing these complications. We describe a case of caesarean scar pregnancy which was initially misdiagnosed as “a spontaneous miscarriage in progress”, resulting in uncontrollable bleeding, necessitating an emergency abdominal hysterectomy. We also endeavour to review the literature with regards to the use of ultrasound in its management, treatment and follow up.
Assessing Conceptual Knowledge Using Three Concept Map Scoring Methods
Authors: Watson Mary Katherine , Pelkey Joshua , Noyes Caroline R. , Rodgers Michael O. 
Published: December 2015

AbstractBackgroundConceptual understanding is a prerequisite for engineering competence. Concept maps may be effective tools for assessing conceptual knowledge, yet further work is needed to examine scoring methods.PurposeOur purpose was to evaluate the efficacy of three concept map scoring methods. Traditional scoring requires judges to count concept map components. Holistic scoring requires judges to analytically evaluate concept maps using a rubric. Categorical scoring requires judges to categorize concepts according to relevant categories before quantification of overall complexity.Design/MethodIn this study, concept maps were collected from 72 undergraduates before and after a capstone design course. Judges analyzed the concept maps using three methods. Using statistical analyses, we examined the comparability, interrater reliability, and convergent/divergent validity of scoring methods.ResultsWhile traditional scoring allowed judges to score concept maps relatively quickly, holistic scoring allowed judges to better capture changes in knowledge structure, because ranking of data was required without assuming hierarchical concept arrangement. Only categorical scoring provided insight into content and structure of student knowledge. For all methods, interrater reliability was acceptable, and convergent/divergent validity was established.ConclusionsDue to its applicability to concept maps of varying structures, holistic scoring is best if more than one judge is available; traditional scoring is appropriate if there are time constraints or if multiple methods are used. Categorical scoring has potential as a supplemental or stand‐alone method, depending on the needs of the instructor or researcher.
Mood and Creativity over Time in a Bipolar Participant
Authors: Glicksohn Joseph , Boikova Ola 
Published: December 2015

AbstractWhen depression alternates with mania, as in a bipolar affective disorder, creativity might be enhanced. To investigate this, we employed a single‐subject design, looking at both affective space and the spectral covariation of mood and creativity in a participant presenting with bipolar affective disorder. The study was conducted over a period of 54 days, and employed a standard measure of mood (the Brief Mood Introspection Scale) and a standard task of creativity (Alternative Uses Task). Both positive affect and negative affect appear to be somewhat undifferentiated for this participant, and her mood space does not conform to that described by the accepted major dimensions of Arousal and Pleasure. Conceivably, this is because of her rapid mood fluctuations. A 2.7‐day periodicity was found for Tired, Peppy, Nervous, and Calm, on the one hand, and ideational fluency, ideational flexibility, and originality, on the other. In addition, a 9‐day periodicity was common to Happy, Sad, and Gloomy—all three affects clustering in the same affective space—together with both ideational flexibility and originality. This finding brings into question the relationship between creativity and both positive and negative mood.
Automated 3D bone ablation with 1,070 nm ytterbium‐doped fiber laser enabled by inline coherent imaging
Authors: Yin Chenman , Ruzzante Sacha W. , Fraser James M. 
Published: December 2015

Background and ObjectiveLaser osteotomy bears well‐identified advantages over conventional techniques. However, lack of depth control and collateral thermal damage are barriers to wide clinical implementation. Flexible fiber delivery and economical benefits of ytterbium‐doped fiber lasers make them desirable for laser osteotomy. In this work, we demonstrate automated bone ablation with a 1,070 nm industrial‐scale fiber laser to create 3D target structures with minimal thermal side‐effects.Materials and MethodsFresh and dry ex vivo cortical bone samples are ablated using 50–100 µs laser pulses of 15–30 mJ. In situ inline coherent imaging monitors ablation dynamics with micron precision and on microsecond timescales. Ablation depth is extracted by on‐the‐fly processing of ICI data, enabling feedback control of depth (via laser pulse number). Final ablated morphology, measured by an ex situ stylus profiler, is compared to the target shape. Histological examination is performed to quantify the thermal side‐effects of laser ablation.ResultsPercussion drilled hole depth is highly variable for fixed laser parameters (880 ± 151 µm on fresh bone and 1038 ± 148 µm on dry bone) due to nondeterministic ablation. ICI‐enabled depth control is implemented to achieve precise ablation of complex 3D features. The RMS deviation between target and ablated morphology is 12.6 µm. The heat‐affected zone is found to be 5–10 µm on fresh and dry bone.ConclusionsAn ytterbium‐doped fiber laser is utilized for cortical bone ablation with limited thermal side‐effects. In situ real‐time ICI measurement enables characterization of bone ablation dynamics. Furthermore, ICI closed‐loop feedback realizes depth‐controlled ablation on heterogeneous bone. This proof‐of‐principle study shows great promise for ICI‐guided laser osteotomy. Lasers Surg. Med. 48:288–298, 2016. © 2015 Wiley Periodicals, Inc.
Assessment of circular wound healing in rats after exposure to 808‐nm laser pulses during specific healing phases
Authors: Tabakoglu Hasim O. , Sani Musbahu M. , Uba Abdullahi I. , Abdullahi Umar A. 
Published: December 2015

Background and ObjectivesLow‐level laser therapy (LLLT), is an important application modality for the advancement of wound healing processes. In this study, histological and morphometric analyses have been made to understand and compare effects of high‐power 808‐nm pulses on circular skin wounds among groups irradiated immediately after wounding and groups irradiated at specific stages of the healing period.Study DesignExperimental groups were as follows: Laser Therapy (LT) was received as three sessions of laser irradiation (6.38 J/cm2, 1.276 W/cm2, 808 nm) immediately after wounding (Inflammatory group, n = 12), 24 hours post‐wounding (Proliferative group, n = 12), and 72 hours post‐wounding (Remodeling group, n = 12); the Control group (n = 12) received no irradiation. Histological analyses were performed on the 3rd, 7th, and 14th days post‐wounding.ResultsMean wound diameters were 5 mm for all groups. On Day 7, wound diameters were measured as 2.99 ± 0.17, 2.95 ± 0.3, 2.52 ± 0.11, and 2.41 ± 0.34 mm for the Control, Inflammatory, Proliferative, and Remodeling groups, respectively. At 2 weeks post‐wounding, dermal tissue in the Inflammatory and Proliferative groups closed superficially, while 1.30 ± 0.1 mm and 1.30 ± 0.06 mm openings remained in the Control and Remodeling groups, respectively. Mean wound healing rates (WHR) for all treatment groups were found to differ significantly from the control group (P < 0.05). Upon comparing the Proliferative group with the other treatment groups, a significant difference was found. However, no significant difference was found between the Inflammatory and Remodeling groups, with the former having a slightly higher mean value.ConclusionHistological and morphometric results showed that high‐power, low‐energy application has the best effect when first applied 24 hours post‐wounding (late inflammatory, early proliferative stage) as demonstrated by increases in granulation tissue, fibroblasts and collagen deposition, which lead to faster rates of wound contraction and thus accelerated healing. Lasers Surg. Med. 48:409–415, 2016. © 2015 Wiley Periodicals, Inc.
Utilizing confocal laser endomicroscopy for evaluating the adequacy of laparoscopic liver ablation
Authors: Schneider Crispin , Johnson Sean P. , Walker‐Samuel Simon , Gurusamy Kurinchi , Clarkson Matthew J. , Thompson Stephen , Song Yi , Totz Johannes , Cook Richard J. , Desjardins Adrien E. , Hawkes David J. , Davidson Brian R. 
Published: December 2015

BackgroundLaparoscopic liver ablation therapy can be used for the treatment of primary and secondary liver malignancy. The increased incidence of cancer recurrence associated with this approach, has been attributed to the inability of monitoring the extent of ablated liver tissue.MethodsThe feasibility of assessing liver ablation with probe‐based confocal laser endomicroscopy (CLE) was studied in a porcine model of laparoscopic microwave liver ablation. Following the intravenous injection of the fluorophores fluorescein and indocyanine green, CLE images were recorded at 488 nm and 660 nm wavelength and compared to liver histology. Statistical analysis was performed to assess if fluorescence intensity change can predict the presence of ablated liver tissue.ResultsCLE imaging of fluorescein at 488 nm provided good visualization of the hepatic microvasculature; whereas, CLE imaging of indocyanine green at 660 nm enabled detailed visualization of hepatic sinusoid architecture and interlobular septations. Fluorescence intensity as measured in relative fluorescence units was found to be 75–100% lower in ablated compared to healthy liver regions. General linear mixed modeling and ROC analysis found the decrease in fluorescence to be statistically significant.ConclusionLaparoscopic, dual wavelength CLE imaging using two different fluorophores enables clinically useful visualization of multiple liver tissue compartments, in greater detail than is possible at a single wavelength. CLE imaging may provide valuable intraoperative information on the extent of laparoscopic liver ablation. Lasers Surg. Med. 48:299–310, 2016. © 2015 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
Preliminary study of optical coherence tomography imaging to identify microscopic extrathyroidal extension in patients with papillary thyroid carcinoma
Authors: Lee Hyoung Shin , Shin Sung Won , Bae Jung Kweon , Jung Woong Gyu , Kim Sung Won , Oak Chulho , Chun Bong Kwon , Ahn Yeh‐Chan , Lee Byung‐Joo , Lee Kang Dae 
Published: December 2015

Background and ObjectivesWe evaluated the feasibility of using optical coherence tomography (OCT), to identify microscopic extrathyroidal extension (mETE) in ex vivo thyroidectomy specimens of patients who underwent thyroidectomy for the treatment of papillary thyroid carcinoma (PTC).MethodsA total of 170 ex vivo OCT images of the tumor, were acquired just after completion of thyroidectomy in 17 patients. The OCT images of each patient were separately evaluated by two blinded investigators, and the outcomes were compared with the histopathology reports.ResultsThe sensitivity and specificity of mETE identification from the OCT images were 81.4% and 86.0%, respectively, for the first investigator, and 82.9% and 87.0%, respectively, for the second investigator. Substantial agreement between the investigators was verified by Cohen's κ (Cohen's κ = 0.772).ConclusionIn this preliminary study of a limited series of ex vivo thyroidectomy specimens, we verified the feasibility of OCT as a method of identifying mETE in patients with PTC. Lasers Surg. Med. 48:371–376, 2016. © 2015 Wiley Periodicals, Inc.