bluuebunny/crossref_metadata_2025_split huggingface dataset:
PURE conversations: Enhancing communication and teamwork
Authors: Veltman Larry , Larison Kristine 
Published: July 2009

AbstractCommunications failures have been identified as a significant cause of adverse outcomes in obstetrics. Following the lead of some high reliability organizations, healthcare has introduced structured communication such as SBAR as a way to make sure communications between professionals are direct, complete and effective. The authors have observed, however, that structured communication in healthcare often requires a cultural change in the way that professionals relate to each other; PURE conversations (Purposeful/prepared/productive, Unambiguous, Respectful and Effective) can facilitate this cultural shift. PURE conversations stress the mental processes necessary to conduct and monitor structured communications in real time by taking into account the context and relationships that exist among professionals. This article describes the elements of a multidisciplinary workshop based on clinical scenarios incorporating the PURE concept to improve the effectiveness and adoption of structured communication by the perinatal team.
The timing of early resolution: Working at the patient's pace
Authors: Amori Geraldine , Popp Pamela L. 
Published: July 2009

AbstractIn recent years, risk managers have been charged with educating providers who need to know how to communicate to a patient that an unanticipated or adverse event has occurred. Much has been written about the elements that should be part of a disclosure conversation: who should be involved, what should be said and when it should be said. Patients have acknowledged their desire to have early, and complete, information where possible. However, what is lacking is an understanding of what happens after the initial disclosure conversation, when the time comes to discuss accommodation or compensation with the patient or family. This article will look at the post‐disclosure status of the patient or family, the steps of the grieving process, and the mechanisms for both the risk manager and the provider to successfully bring closure to the event.
The five a's: What do patients want after an adverse event¿
Authors: Cox Wendy 
Published: July 2009

AbstractAfter an adverse event, Five A's: Acknowledgment, Apology, All the Facts, Assurance and Appropriate Compensation, serve to meet the essential needs of patients and their families. This simple mnemonic creates a clear framework of understanding for the actions health professionals need to take to manage errors and adverse events in an empathic and patient‐oriented fashion. While not all patients demand or need compensation, most need at least the first four A's. Patient‐centered communication using this simple framework following an adverse event will foster a climate of understanding and frank discussion, addressing the emotional and physical needs of the whole patient and family.
Cyber risk and privacy liability: A click in the right direction¿
Authors: McDonough William J. 
Published: July 2009

AbstractCyber risk and privacy exposure exert an impact upon virtually every aspect of a healthcare organization (HCO) — assets, clinical operations, finances and reputation. Exposure is enterprise‐wide and includes risk to both physical and non‐physical assets in increasing degrees. The consequences of a cyber attack or privacy breach could be operationally and financially catastrophic, so an HCO's move toward an enterprise‐wide approach at identifying and minimizing risk, cyber and privacy liability should be on the radar screen for risk managers and leadership.
Technological iatrogenesis: New risks force heightened management awareness
Authors: Palmieri Patrick A. , Peterson Lori T. , Ford Eric W. 
Published: July 2009

AbstractIatrogenesis is a term typically reserved to express the state of ill health or the adverse outcome resulting from a medical intervention, or lack thereof. Three types of iatrogenesis are described in the literature: clinical, social and cultural. This paper introduces a fourth type, technological iatrogenesis, or emerging errors stimulated by the infusion of technological innovations into complex healthcare systems. While health information technologies (HIT) have helped to make healthcare safer, this has also produced contemporary varieties of iatrogenic errors and events. The potential pitfalls of technological innovations and risk management solutions to address these concerns are discussed. Specifically, failure mode effect analysis and root cause analysis are discussed as opportunities for risk managers to prevent problems and avert errors from becoming sentinel events.
Considerations for implementing pre‐dispute arbitration agreements in provider contracts
Authors: Desmond Joseph M. 
Published: July 2009

AbstractDue in part to the historical increase in large compensatory awards and punitive damages in jury verdicts in medical malpractice/long‐term care cases and the concomitant increase in the costs of defending these claims, healthcare providers have sought to reduce litigation costs and avoid exposure to runaway jury verdicts in medical malpractice trials by implementing arbitration agreements in healthcare admission contracts. Risk managers should be aware of the evolving law in this area and recognize that a successful arbitration program requires a commitment to ensuring that the program is administered in accordance with evolving laws.
Minimizing the legal risk with ‘curbside’ consultation
Authors: Kreichelt Ray , Hilbert Mary Lou , Shinn Deidre 
Published: July 2009

Abstract“Curbside consultations” — in which a physician obtains insights on a medical case from another physician who has not seen the patient or reviewed the record — can yield advantages to the requesting physician. However, shortcomings are inherent in this common type of exchange and pose legal risk to the curbside consultant. This article provides background and practical tips that might help avoid being caught up in a lawsuit by surprise, or if named as a party, avoid being held culpable when the only involvement was a brief conversation with a colleague.
Measurement of glutathione in normal volunteers and stroke patients at 3T using J‐difference spectroscopy with minimized subtraction errors
Authors: An Li , Zhang Yan , Thomasson David M. , Latour Lawrence L. , Baker Eva H. , Shen Jun , Warach Steven 
Published: July 2009

AbstractPurposeTo develop and optimize a 1H magnetic resonance spectroscopy (MRS) method for measuring brain glutathione (GSH) levels.Materials and MethodsPhantom experiments and density operator simulations were performed to determine the optimal TE for measuring GSH at 3T using J‐difference spectral editing. In vivo data collected from 11 normal volunteers (43 measurements) and five stroke patients (10 measurements) were processed using a new spectral alignment method (adaptive spectral registration).ResultsIn phantom experiments and density operator simulations where relaxation effects were ignored, close to maximum GSH signal (2.95 ppm) was obtained at TE ≈ 131 msec with minimum N‐acetyl‐aspartate (NAA) signal interference. Using adaptive spectral registration, GSH levels in healthy volunteers were found to be 1.20 ± 0.14 mM (mean ± standard deviation [SD]). GSH levels in stroke patients were found to be 1.19 ± 0.24 mM in lesion and 1.25 ± 0.19 mM in contralateral normal tissue. In comparison, the SDs were significantly larger when only the NAA singlet (2.01 ppm) was used as a navigator for spectral alignment.ConclusionSpectral editing using J‐differences is a reliable method for measuring GSH levels in volunteers and stroke patients. J. Magn. Reson. Imaging 2009;30:263–270. © 2009 Wiley‐Liss, Inc.
Reproducibility of 3.0 Tesla magnetic resonance spectroscopy for measuring hepatic fat content
Authors: van Werven Jochem R. , Hoogduin Johannes M. , Nederveen Aart J. , van Vliet Andre A. , Wajs Ewa , Vandenberk Petra , Stroes Erik S.G. , Stoker Jaap 
Published: July 2009

AbstractPurposeTo investigate reproducibility of proton magnetic resonance spectroscopy (1H‐MRS) to measure hepatic triglyceride content (HTGC).Materials and MethodsIn 24 subjects, HTGC was evaluated using 1H‐MRS at 3.0 Tesla. We studied “between‐weeks” reproducibility and reproducibility of 1H‐MRS in subjects with fatty liver. We also studied within liver variability and within day reproducibility. Reproducibility was assessed by coefficient of variation (CV), repeatability coefficient (RC), and intraclass correlation coefficient (ICC).ResultsThe CV of between weeks reproducibility was 9.5%, with a RC of 1.3% HTGC (ICC 0.998). The CV in fatty livers was 4.1%, with a RC of 1.3% HTGC (ICC 0.997). Within day CV was 4.5%, with a RC of 0.4% HTGC (ICC 0.999). CV for within liver variability was 14.5%.ConclusionReproducibility of 1H‐MRS to measure HTGC for “between‐weeks” measurements and in fatty livers is high, which is important for follow‐up studies. Within liver variability displays a larger variation, meaning that liver fat is not equally distributed and during consecutive measurements the same voxel position should be used. J. Magn. Reson. Imaging 2009;30:444–448. © 2009 Wiley‐Liss, Inc.
Application of a biodegradable macromolecular contrast agent in dynamic contrast‐enhanced MRI for assessing the efficacy of indocyanine green‐enhanced photothermal cancer therapy
Authors: Feng Yi , Emerson Lyska , Jeong Eun‐Kee , Parker Dennis L. , Lu Zheng‐Rong 
Published: July 2009

AbstractPurposeTo investigate the effectiveness of a polydisulfide‐based biodegradable macromolecular contrast agent, (Gd‐DTPA)‐cystamine copolymers (GDCC), in assessing the efficacy of indocyanine green‐enhanced photothermal cancer therapy using dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI).Materials and MethodsBreast cancer xenografts in mice were injected with indocyanine green and irradiated with a laser. The efficacy was assessed using DCE‐MRI with GDCC of 40 kDa (GDCC‐40) at 4 hours and 7 days after the treatment. The uptake of GDCC‐40 by the tumors was fit to a two‐compartment model to obtain tumor vascular parameters, including fractional plasma volume (fPV), endothelium transfer coefficient (KPS), and permeability surface area product (PS).ResultsGDCC‐40 resulted in similar tumor vascular parameters at three doses, with larger standard deviations at lower doses. The values of fPV, KPS, and PS of the treated tumors were smaller (P < 0.05) than those of untreated tumors at 4 hours after the treatment and recovered to pretreatment values (P > 0.05) at 7 days after the treatment.ConclusionDCE‐MRI with GDCC‐40 is effective for assessing tumor early response to dye‐enhanced photothermal therapy and detecting tumor relapse after the treatment. GDCC‐40 has a potential to noninvasively monitor anticancer therapies with DCE‐MRI. J. Magn. Reson. Imaging 2009;30:401–406. © 2009 Wiley‐Liss, Inc.
Intraprocedural diffusion‐weighted PROPELLER MRI to guide percutaneous biopsy needle placement within rabbit VX2 liver tumors
Authors: Deng Jie , Virmani Sumeet , Yang Guang‐Yu , Tang Richard , Woloschak Gayle , Omary Reed A. , Larson Andrew C. 
Published: July 2009

AbstractPurposeTo test the hypothesis that diffusion‐weighted (DW)‐PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) magnetic resonance imaging (MRI) can be used to guide biopsy needle placement during percutaneous interventional procedures to selectively target viable and necrotic tissues within VX2 rabbit liver tumors.Materials and MethodsOur institutional Animal Care and Use Committee approved all experiments. In six rabbits implanted with 15 VX2 liver tumors, baseline DW‐PROPELLER images acquired prior to the interventional procedure were used for apparent diffusion coefficient (ADC) measurements. Next, intraprocedural DW‐PROPELLER scans were performed with needle position iteratively adjusted to target viable, necrotic, or intermediate border tissue regions. DW‐PROPELLER ADC measurements at the selected needle tip locations were compared with the percentage of tumor necrosis qualitatively assessed at histopathology.ResultsDW‐PROPELLER images demonstrated intratumoral tissue heterogeneity and clearly depicted the needle tip position within viable and necrotic tumor tissues. Mean ADC measurements within the region‐of‐interest encompassing the needle tip were highly correlated with histopathologic tumor necrotic tissue assessments.ConclusionDW‐PROPELLER is an effective method to selectively position the biopsy needle tip within viable and necrotic tumor tissues. The DW‐PROPELLER method may offer an important complementary tool for functional guidance during MR‐guided percutaneous procedures. J. Magn. Reson. Imaging 2009;30:366–373. © 2009 Wiley‐Liss, Inc.
Active two‐channel 0.035″ guidewire for interventional cardiovascular MRI
Authors: Kocaturk Ozgur , Kim Ann H. , Saikus Christina E. , Guttman Michael A. , Faranesh Anthony Z. , Ozturk Cengizhan , Lederman Robert J. 
Published: July 2009

AbstractPurposeTo develop an “active” (receiver‐coil) clinical‐grade guidewire with enhanced visibility for magnetic resonance imaging (MRI) and favorable mechanical characteristics for interventional MRI procedures that require conspicuous intravascular instruments distinguishable from surrounding tissues.Materials and MethodsWe designed a 0.035‐inch guidewire combining two antenna designs on separate channels. A loop antenna visualizes the tip and a dipole antenna visualizes the whole shaft. We compared mechanical characteristics of this guidewire with x‐ray alternatives and tested MRI performance at 1.5T in vitro and in vivo in swine.ResultsImages reflected tip position within 0.97 ± 0.42 mm and afforded whole‐shaft visibility under expected conditions without sacrificing device size or handling. We report tip stiffness, torquability, and pushability comparable to commercial interventional guidewires.ConclusionOur clinical‐grade 0.035‐inch active guidewire is conspicuous under MRI and has mechanical performance comparable to x‐ray interventional guidewires. This may enable a range of interventional procedures using real‐time MRI. J. Magn. Reson. Imaging 2009;30:461–465. © 2009 Wiley‐Liss, Inc.
Quantification of aortic compliance in mice using radial phase contrast MRI
Authors: Zhao Xuandong , Pratt Ron , Wansapura Janaka 
Published: July 2009

AbstractPurposeTo investigate the feasibility of radial phase contrast MR imaging to measure in vivo pulse wave velocity (PWV) and wall shear stress (WSS) in small animals on a 7 Tesla scanner.Materials and MethodsThe aortic compliance of 9‐month‐old ApoE deficient (ApoE‐KO) mice (n = 10) on a normal diet was studied in comparison to that of wild‐type (WT) mice (n = 10). An undersampled, asymmetric echo radial phase contrast MR technique was developed to measure through plane blood flow velocity at axial slices along the descending aorta. The PWV and the time averaged WSS was calculated from the spatiotemporal flow data. The reproducibility of PWV and WSS was evaluated by taking multiple measures on a separate cohort of WT (n = 4) mice.ResultsThe mean percentage standard deviation among repeated measures was 10.1% for PWV and 24.8% for WSS. The PWV of ApoE‐KO mice (5.84 ± 2.15 m/s) was significantly higher (p = 0.02) than that of WT (3.55 ± 0.97 m/s), whereas WSS was lower in ApoE‐KO mice (1.44 ± 0.31Pa) compared with WT (1.55 ± 0.36Pa).ConclusionThis study demonstrates that in vivo PWV derived from radial phase contrast MR imaging can be potentially used as a surrogate marker for impaired vascular function in mice. J. Magn. Reson. Imaging 2009;30:286–291. © 2009 Wiley‐Liss, Inc.
Measurements from image‐based three dimensional pelvic floor reconstruction: A study of inter‐ and intraobserver reliability
Authors: Hoyte Lennox , Brubaker Linda , Fielding Julia R. , Lockhart Mark E. , Heilbrun Marta E. , Salomon Caryl G. , Ye Wen , Brown Morton B. 
Published: July 2009

AbstractPurposeTo describe inter‐ and intraobserver reliability of 3D measurements of female pelvic floor structures.Materials and MethodsTwenty reconstructed MR datasets of primiparas at 6–12 months postpartum were analyzed. Pelvic organ measurements were independently made twice by three radiologists blinded to dataset order. A “within‐reader” analysis, a “between‐reader” analysis, and the intraclass correlation (ICC), and standard deviation ratio (SDR) were computed for each parameter. Fifteen continuous variables and one categorical variable were measured.ResultsEight continuous parameters showed excellent agreement (ICC >0.85 / SDR <0.40), five parameters showed relatively good agreement (ICC >0.70 / SDR ≥0.40, <0.60). Two parameters showed poor agreement (ICC ≤0.70 and/or SDR ≥0.60). The categorical variable showed poor agreement.ConclusionAgreement was best where landmark edges were well defined, acceptable where more “reader judgment” was needed, and poor where levator defects made landmarks difficult to identify. Automated measurement algorithms are under study and may improve agreement in the future. J. Magn. Reson. Imaging 2009;30:344–350. © 2009 Wiley‐Liss, Inc.
Spatiotemporal dynamics of low frequency fluctuations in BOLD fMRI of the rat
Authors: Majeed Waqas , Magnuson Matthew , Keilholz Shella D. 
Published: July 2009

AbstractPurposeTo examine spatiotemporal dynamics of low frequency fluctuations in rat cortex.Materials and MethodsGradient‐echo echo‐planar imaging images were acquired from anesthetized rats (repetition time = 100 ms). Power spectral analysis was performed to detect different frequency peaks. Functional connectivity maps were obtained for the frequency peaks of interest. The images in the filtered time‐series were displayed as a movie to study spatiotemporal patterns in the data for frequency bands of interest.ResultsHigh temporal and spectral resolution allowed separation of primary components of physiological noise and visualization of spectral details. Two low frequency peaks with distinct characteristics were observed. Selective visualization of the second low frequency peak revealed waves of activity that typically began in the secondary somatosensory cortex and propagated to the primary motor cortex.ConclusionTo date, analysis of these fluctuations has focused on the detection of functional networks assuming steady state conditions. These results suggest that detailed examination of the spatiotemporal dynamics of the low frequency fluctuations may provide more insight into brain function, and add a new perspective to the analysis of resting state fMRI data. J. Magn. Reson. Imaging 2009;30:384–393. © 2009 Wiley‐Liss, Inc.
Transverse relaxation time (T2) mapping in the brain with off‐resonance correction using phase‐cycled steady‐state free precession imaging
Authors: Deoni Sean C.L. 
Published: July 2009

AbstractPurposeTo investigate a new approach for more completely accounting for off‐resonance affects in the DESPOT2 (driven equilibrium single pulse observation of T2) mapping technique.Materials and MethodsThe DESPOT2 method derives T2 information from fully balanced steady‐state free precession (bSSFP) images acquired over multiple flip angles. Off‐resonance affects, which present as bands of altered signal intensity throughout the bSSFP images, results in erroneous T2 values in the corresponding calculated maps. Radiofrequency (RF) phase‐cycling, in which the phase of the RF pulse is incremented along the pulse train, offers a potential method for eliminating these artifacts. In this work we present a general method, referred to as DESPOT2, with full modeling (DESPOT2‐FM), for deriving T2, as well as off‐resonance frequency, from dual flip angle bSSFP data acquired with two RF phase increments.ResultsThe method is demonstrated in vivo through the acquisition of whole‐brain, 1 mm3 isotropic T2 maps at 3T and shown to provide near artifact‐free maps, even in areas with steep susceptibility‐induced gradients.ConclusionDESPOT2‐FM offers an efficient method for acquiring high spatial resolution, whole‐brain T2 maps at 3T with high precision and free of artifact. J. Magn. Reson. Imaging 2009;30:411–417. © 2009 Wiley‐Liss, Inc.
Detection of bone metastases in non‐small cell lung cancer patients: Comparison of whole‐body diffusion‐weighted imaging (DWI), whole‐body MR imaging without and with DWI, whole‐body FDG‐PET/CT, and bone scintigraphy
Authors: Takenaka Daisuke , Ohno Yoshiharu , Matsumoto Keiko , Aoyama Nobukazu , Onishi Yumiko , Koyama Hisanobu , Nogami Munenobu , Yoshikawa Takeshi , Matsumoto Sumiaki , Sugimura Kazuro 
Published: July 2009

AbstractPurposeTo prospectively compare the capability for bone metastasis assessment of whole‐body diffusion‐weighted imaging (DWI), magnetic resonance imaging (MRI) without and with DWI, [18F] fluoro‐2‐D‐glucose positron emission tomography with computed tomography (FDG‐PET/CT) and bone scintigraphy in non‐small cell carcinoma (NSCLC) patients.Materials and MethodsIn all, 115 consecutive NSCLC patients (66 men, 49 women; mean age 72 years) prospectively underwent whole‐body MRI, PET/CT, and bone scintigraphy before treatment. For each method, probability of metastasis was independently assessed by using a 5‐point visual scoring system on a per‐site basis. Receiver operating characteristic (ROC)‐based positive tests were used to determine the practical threshold value for each method on a per‐site basis. Sensitivities, specificities, and accuracies were then compared on a per‐site and per‐patient basis by means of McNemar's test.ResultsWhen the practical threshold values were adapted, specificity and accuracy of whole‐body MRI with DWI were significantly higher than those of bone scintigraphy and PET/CT (P < 0.05). On a per‐patient basis, specificity and accuracy of whole‐body MRI with DWI were significantly higher than those of bone scintigraphy (P < 0.05).ConclusionWhole‐body MRI with DWI can be used for bone metastasis assessment of NSCLC patients as accurate as bone scintigraphy and/or PET/CT. J. Magn. Reson. Imaging 2009;30:298–308. © 2009 Wiley‐Liss, Inc.
Prediction of cell necrosis with sequential temperature mapping after radiofrequency ablation
Authors: Rempp Hansjörg , Clasen Stephan , Boss Andreas , Roland Jörg , Kickhefel Antje , Schraml Christina , Claussen Claus D. , Schick Fritz , Pereira Philippe L. 
Published: July 2009

AbstractPurposeTo assess the feasibility of magnetic resonance (MR) thermometry after thermoablative therapy and to quantitatively evaluate the ability of two sequence types to predict cell necrosis.MethodsTwenty patients with hepatic tumors were treated by MR‐guided radiofrequency ablation. For each 10 patients, postinterventionally performed gradient echo and segmented echo planar imaging sequences were used to calculate temperature maps based on the proton resonance frequency shift method. Contrast‐enhanced images acquired 1 month after therapy were registered on the temperature maps and the necrotic, nonenhanced area was segmented and compared to the area with a displayed temperature above 60°C. Sensitivity and positive predictive value of the temperature map was calculated, using the follow‐up imaging as the gold standard.ResultsTemperature mapping reached acceptable image quality in 45/47 cases. Sensitivity, ie, the rate of correctly detected coagulated tissue was 0.82 ± 0.08 for the gradient echo imaging (GRE) sequence and 0.81 ± 0.14 for the echo planar imaging (EPI) sequence. Positive predictive value, ie, the rate of voxel in the temperature map over 60°C that actually developed necrosis, was 0.90 ± 0.07 for the GRE sequence and 0.84 ± 0.11 for the EPI sequence.ConclusionSequential MR temperature mapping allows for the prediction of the coagulation zone with an acceptable sensitivity and positive predictive value using EPI and GRE sequences. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.