bluuebunny/crossref_metadata_2025_split huggingface dataset:
Online learning as a staff risk management education option
Authors: Oppenberg Andrew A. , Walters Clifford A. , Stottlemyer Debra L. 
Published: July 2009

AbstractAs clinicians face growing responsibilities to keep up with continuing medical education offerings, they have less time to learn fundamental risk management knowledge to practice safely. To meet their clinicians' needs and time constraints, the authors developed, implemented and assessed 15 lessons in three online risk management courses for resident physicians in an academic center. This report demonstrates that Internet‐based learning can provide a practical alternative to formal classroom teaching of a risk management curriculum to busy resident physicians and potentially to other healthcare professionals.
Integrating disclosure, patient safety and risk management activities
Authors: Fasler Karen 
Published: July 2009

AbstractNational Quality Forum safe‐practice guidelines encourage hospitals to integrate disclosure, patient safety and risk management activities. Combining collaborative law with a patient safety program in a parallel process makes it possible to achieve this integration. This combination provides for physician‐led guidance in determining whether disclosure is required — and, if so, provides mentor assistance with actual disclosure. It offers proactive error prevention by offering a means to quickly utilize information to make safety changes. Additionally, the combination provides an opportunity to access collaborative law at a time when it is still possible to resolve issues without resort to litigation.
The ECG Dilemma: Guidelines on improving interpretation
Authors: Mele Paul F. 
Published: July 2009

AbstractThe “ECG Dilemma” was recognized by the American College of Cardiology (ACC) and the American Heart Association more than 10 years ago. Estimates put the number of patients suffering from significant ECG interpretation errors every year in the same range as deaths from diabetes. Missed MI ranks in the top tier of malpractice dollars lost. Guidelines have been put forth to reduce these losses and improve patient safety and quality of care. These guidelines, and suggestions towards implementing them, are discussed.
Preventing and responding to medical identity theft
Authors: Amori Geraldine 
Published: July 2009

AbstractMedical identity theft is a crime with two victims: patients and providers. It is easy to commit and lucrative because healthcare record keeping and business interactions are complex and mainly electronic. Patients whose identity has been stolen are vulnerable to both medical error and financial loss. Providers may suffer both reputation loss and financial loss. There are steps to help prevent and to respond appropriately to medical identity theft.
3T versus 1.5T phased‐array MRI in the presurgical work‐up of patients with partial epilepsy of uncertain focus
Authors: Zijlmans Maeike , de Kort Gérard A.P. , Witkamp Theodore D. , Huiskamp Geertjan M. , Seppenwoolde Jan‐Henry , van Huffelen Alexander C. , Leijten Frans S.S. 
Published: July 2009

AbstractPurposeTo study 3T compared to 1.5T phased array magnetic resonance imaging (MRI) in the presurgical work‐up of patients with epilepsy with complex focus localization.Materials and MethodsIn all, 37 patients (>10 years) in preoperative work‐up for epilepsy surgery were offered 3T in addition to 1.5T MRI if ambiguity existed about the epileptic focus. Scans were randomly reviewed by two observers, blinded for prior imaging, patient‐identifying information, and each other's assessments, followed by a consensus meeting. The number of abnormal scans, detected lesions, and interobserver agreement were calculated and compared. The final consensus was compared to original scan reports.ResultsOne observer identified 22 lesions in both 3 and 1.5T scans, while the second identified more lesions in 1.5T scans (28 vs. 20). 3T MRI had better interobserver agreement. 3T revealed more dysplasias, while 1.5T revealed more tissue loss and mesial temporal sclerosis (MTS). The final consensus yielded 29 lesions, whereas original reports identified only 17 lesions.ConclusionThe 3T scans revealed different lesions compared to 1.5T. Patients can benefit most from 3T scans when a dysplasia is suspected. Reevaluation by another experienced neuroradiologist is advised in case of negative or equivocal MRIs. J. Magn. Reson. Imaging 2009;30:256–262. © 2009 Wiley‐Liss, Inc.
Rapid production of specialized animal handling devices using computer‐aided design and solid freeform fabrication
Authors: Howles Gabriel P. , Nouls John C. , Qi Yi , Johnson G. Allan 
Published: July 2009

AbstractPurposeTo develop a process for rapidly and inexpensively producing customized animal handling devices for small animal imaging.Materials and MethodsTo meet the specific needs of a particular imaging experiment, measurements are taken from imaging data and the animal handling devices are designed using 3D computer‐aided design (CAD) software. Parts are produced in a few days using solid freeform fabrication (SFF, a.k.a. rapid prototyping).ResultsThis process is illustrated with the production of an animal handling system for stereotaxically prescribed therapeutic ultrasound and MRI of the mouse brain. The device provides integrated head‐fixation, anesthesia delivery, and physiological monitoring in a modular system. Design and production took ≈1 week and the cost was a small fraction of a traditional machine shop.ConclusionCommercial animal handling products typically have limited functionality and are not integrated with other laboratory infrastructure. However, using CAD and SFF, sophisticated animal handling devices can be produced to meet the specific experimental needs. This process is typically faster and less expensive than using a traditional machine shop, and the products are more robust than typical homemade devices. Using high‐quality purpose‐built devices permits experiments to be executed with greater consistency and higher throughput. J. Magn. Reson. Imaging 2009;30:466–471. © 2009 Wiley‐Liss, Inc.
MRI‐guided vacuum‐assisted breast biopsy: A phantom and patient evaluation of targeting accuracy
Authors: El Khouli Riham H. , Macura Katarzyna J. , Barker Peter B. , Elkady Laila M. , Jacobs Michael A. , Vogel‐Claussen Jens , Bluemke David A. 
Published: July 2009

AbstractPurposeTo determine the spatial localization errors of magnetic resonance imaging (MRI)‐guided core biopsy for breast lesions using the handheld vacuum‐assisted core biopsy device in phantoms and patients.Materials and MethodsBiopsies were done using a 10‐gauge handheld vacuum‐assisted core biopsy system (Vacora, Bard, AZ, USA) on a 1.5T MRI scanner (Philips Achieva, Best, The Netherlands). A standardized biopsy localization protocol was followed by trained operators for multiplanar planning of the biopsy on a separate workstation. Biopsy localization errors were determined as the distance from needle tip to center of the target in three dimensions.ResultsTwenty MRI‐guided biopsies of phantoms were performed by three different operators. The biopsy target mean size was 6.8 ± 0.6 mm. The overall mean three‐dimensional (3D) biopsy targeting error was 4.4 ± 2.9 mm. Thirty‐two MRI breast biopsies performed in 22 patients were reviewed. The lesion mean size was 10.5 ± 9.4 mm. The overall mean 3D localization error was 5.7 ± 3.0 mm. No significant differences between phantom and patients biopsy errors were found (P > 0.5).ConclusionMRI‐guided handheld vacuum‐assisted core biopsy device shows good targeting accuracy and should allow localization of lesions to within ∼5 to 6 mm. J. Magn. Reson. Imaging 2009;30:424–429. © 2009 Wiley‐Liss, Inc.
Multi‐echo acquisition of MR angiography and venography of the brain at 3 Tesla
Authors: Du Yiping P. , Jin Zhaoyang , Hu Yuzheng , Tanabe Jody 
Published: July 2009

AbstractPurposeTo improve the visibility of veins in susceptibility‐weighted imaging (SWI) using a multi‐gradient echo acquisition.Materials and MethodsA three‐dimensional multi‐echo gradient‐echo pulse sequence was developed for simultaneous acquisition of MR angiography and multiple volumes of MR venography (MRV) of the brain. The first echo was acquired for MR angiography using the time‐of‐flight in‐flow effect. The subsequent echoes were acquired for SWI‐based MRV at different echo times (TEs).ResultsMultiple MRV datasets acquired at different TEs were complementary in depicting the venous vasculature. MRV data acquired at a longer TE had a higher venous contrast and stronger susceptibility weighting, whereas MRV data acquired at a shorter TE had a higher signal‐to‐noise ratio and less severe off‐resonance artifacts. Three‐dimensional mapping of local field gradients was calculated and the transverse relaxivity (R2*) at each voxel was quantified using multi‐TE exponential fitting.ConclusionMulti‐echo acquisition of MR angiography and venography demonstrated improved visibility of venous vasculature especially in regions with severe field inhomogeneity compared with conventional acquisition of SWI and dual‐echo acquisition of MR angiography and venography. J. Magn. Reson. Imaging 2009;30:449–454. © 2009 Wiley‐Liss, Inc.
Accurate liver T measurement of iron overload: A simulations investigation and in vivo study
Authors: Beaumont Marine , Odame Isaac , Babyn Paul S. , Vidarsson Logi , Kirby‐Allen Melanie , Cheng Hai‐Ling Margaret 
Published: July 2009

AbstractPurposeTo investigate the accuracy of T liver iron quantification using different curve‐fitting models under varying acquisition conditions, and to compare in iron‐overloaded patients the reliability of rapid T measurements against approved and slower T2 protocols.Materials and MethodsSimulations were conducted to assess the influence of various factors on the accuracy of T measurement: curve‐fitting model, signal‐to‐noise ratio (SNR), and echo time (TE) spacing. Fifty‐four iron‐overloaded pediatric patients were assessed using a standard T2 and two variations of T acquisitions. In both simulations and in vivo data, three analysis models were evaluated: monoexponential, constant offset, and truncated.ResultsSimulations show the truncated model provides the best accuracy but is susceptible to underestimating high iron species under low SNR or high minimum TE. In contrast, the offset model tends to overestimate but maintains the most reliable measurements across the relevant range of iron levels. Furthermore, a much lower SNR can be tolerated if the acquisition uses a low minimum TE. In vivo results confirm theoretical findings and show that T measurements can be as reliable as those from approved and slower T2 protocols.ConclusionGuidelines are provided on choosing an appropriate model under specific noise conditions and acquisition schemes to ensure accurate and rapid T liver iron quantification. J. Magn. Reson. Imaging 2009;30:313–320. © 2009 Wiley‐Liss, Inc.
High‐field MRSI of the prostate using a transmit/receive endorectal coil and gradient modulated adiabatic localization
Authors: Near Jamie , Romagnoli Cesare , Curtis Andrew T. , Klassen L. Martyn , Izawa Jonathan , Chin Joseph , Bartha Robert 
Published: July 2009

AbstractPurposeTo demonstrate in vivo magnetic resonance spectroscopic imaging (MRSI) of the human prostate at 4.0T using a transmit/receive endorectal coil and a pulse sequence designed specifically for this application.Materials and MethodsA solid, reusable endorectal probe was designed for both radiofrequency transmission and reception. Finite difference time domain (FDTD) simulations were performed to characterize the coil's electric field distribution, and temperature measurements were performed in a beef tissue phantom to determine the coil's safe operating limit. The localization by selective adiabatic refocusing (LASER) pulse sequence was implemented using six gradient modulated offset independent adiabatic (GOIA) pulses for very sharp, B1‐insensitive voxel localization.ResultsBased on the simulations and temperature measurements, the coil's safe operating limit was conservatively estimated to be 1.0W for 15 minutes. The transition width of the GOIA pulse selection profiles was only 6% of the bandwidth, compared with 22% for a specific absorption rate (SAR)‐matched conventional adiabatic pulse. Using the coil and pulse sequence described here, MRSI data were successfully acquired from a patient with biopsy‐proven prostate cancer, with a nominal voxel size of 0.34 cc in a scan time of 15 minutes.ConclusionThis work demonstrates the safe and effective use of a transmit/receive endorectal coil for in vivo MRSI of the prostate. J. Magn. Reson. Imaging 2009;30:335–343. © 2009 Wiley‐Liss, Inc.
Modulated repetition time look‐locker (MORTLL): A method for rapid high resolution three‐dimensional T1 mapping
Authors: Gai Neville D. , Butman John A. 
Published: July 2009

AbstractPurposeTo demonstrate a modification of the Look‐Locker (LL) technique that enables rapid high resolution T1 mapping over the physiologic range of intracranial T1 values, ranging from white matter to cerebrospinal fluid (CSF). This is achieved by use of a three‐dimensional (3D) balanced steady‐state free precession (b‐SSFP) acquisition (for high signal‐to‐noise and resolution) along with variable repetition time to allow effective full recovery of longitudinal magnetization.Materials and MethodsTwo modifications to the Look‐Locker technique were made to realize high resolution imaging in a clinically reasonable scan time. The 3D b‐SSFP acquisition after an initial inversion pulse was followed by a variable repetition time. This technique makes it possible to image a volume of thin contiguous slices with high resolution and accuracy using a simple fitting procedure and is particularly useful for imaging long T1 species such as CSF. The total scan time is directly proportional to the number of slices to be acquired. The scan time was reduced by almost half when the repetition time was modified using a predesigned smooth function. Phantoms and volunteers were imaged at different resolutions on a 3 Tesla scanner. Results were compared with other accepted techniques.ResultsT1 values in the brain corresponded well with full repetition time imaging as well as inversion recovery spin echo imaging. T1 values for white matter, gray matter, and CSF were measured to be 755 ± 10 ms, 1202 ± 9 ms, and 4482 ± 71 ms, respectively. Scan times were reduced by approximately half over full repetition time measurements.ConclusionHigh resolution T1 maps can be obtained rapidly and with a relatively simple postprocessing method. The technique is particularly well suited for long T1 species. For example, changes in the composition of proteins in CSF are linked to various pathologies. The T1 values showed excellent agreement with values obtained from inversion recovery spin‐echo imaging. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.
Mediastinal lymph nodes: Assessment with diffusion‐weighted MR imaging
Authors: Koşucu Polat , Tekinbaş Celal , Erol Muharrem , Sari Ahmet , Kavgaci Halil , Öztuna Funda , Ersöz Şafak 
Published: July 2009

AbstractPurposeTo prospectively determine whether the diffusion‐weighted magnetic resonance imaging is useful to distinguish between malignant and benign mediastinal lymph nodes.Materials and MethodsThirty‐five patients (14 women, 21 men; mean age 52 years) with 91 lymph nodes in the mediastinum detected by computed tomography underwent 1.5 Tesla (T) diffusion‐weighted MR imaging before mediastinoscopy (n = 29) and mediastinotomy (n = 6). Diffusion‐weighted MR images were acquired with a b factor of 50, and 400 s/mm2 using single‐shot echo‐planar sequence.ResultsOf the 35 patients, 18 had diagnosis of malignant tumor. Of the 18 patients with tumor, 8 had nonsmall cell carcinoma, and 10 had small cell carcinoma. Ninety‐one mediastinal lymph nodes were detected in the 35 untreated patients: 19 were pathologically diagnosed as metastatic lymph nodes, and 72 lymph nodes were diagnosed as nonmetastatic lymph nodes, including 50 sarcoidosis, 14 reactive lymphoid hyperplasia, and 8 necrotizing granulamatous lymphadenitis. The apparent diffusion coefficient (ADC) was significantly lower in metastatic lymph nodes (1.012 ± 0.025 × 10−3 mm2/s; P < 0.0005) than in benign lymph nodes (1.511 ± 0.075 × 10−3 mm2/s). On the ADC map, malignant nodes showed hyperintense (n = 2, 10.52%), hypointense (n = 14, 73.68%), and mixed intensity (n = 3; 15.78%), whereas benign nodes showed hyperintense (n = 57; 79.16%), hypointense (n = 3; 41.6%), isointense (n = 6; 8.33%), and mixed intensity (n = 6; 8.33%).ConclusionDiffusion‐weighted MR with ADC value and signal intensity can be useful in differentiation of malignant and benign mediastinal lymph nodes. J. Magn. Reson. Imaging 2009;30:292–297. © 2009 Wiley‐Liss, Inc.
Simultaneous temperature and magnetization transfer (MT) monitoring during high‐intensity focused ultrasound (HIFU) treatment: Preliminary investigation on ex vivo porcine muscle
Authors: Peng Hsu‐Hsia , Huang Teng‐Yi , Tseng Wen‐Yih Isaac , Lin En‐Li , Chung Hsiao‐Wen , Wu Chih‐Ching , Wang Yu‐Shun , Chen Wen‐Shiang 
Published: July 2009

AbstractPurposeTo measure temperature change and magnetization transfer ratio (MTR) simultaneously during high‐intensity focused ultrasound (HIFU) treatment.Materials and MethodsThis study proposed an interleaved dual gradient‐echo technique to monitor the heat and tissue damage brought to the heated tissue. The technique was applied to tissue samples to test its efficacy.ResultsEx vivo experiments on the porcine muscle demonstrated that both temperature changes and MTR exhibited high consistency in localizing the heated regions. As the heat dissipated after the treatment, the temperature of the heated regions decreased rapidly but MTR continued to be elevated. Moreover, thermal dose (TD) maps derived from the temperature curves demonstrated a sharp margin in the heated regions, but MTR maps may show a spatial gradient of tissue damage, suggesting complimentary information provided by these two measures.ConclusionIn a protocol of spot‐by‐spot heating over a large volume of tissue, MTR provides additional values to mark the locations of previously heated regions. By continuously recording the locations of heated spots, MTR maps could help plan the next target spots appropriately, potentially improving the efficiency of HIFU treatment and reducing undesirable damage to the normal tissue. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.
Quantitative MRI measurement of lung density must account for the change in T with lung inflation
Authors: Theilmann Rebecca J. , Arai Tatsuya J. , Samiee Ahsan , Dubowitz David J. , Hopkins Susan R. , Buxton Richard B. , Prisk G. Kim 
Published: July 2009

AbstractPurposeTo evaluate lung water density at three different levels of lung inflation in normal lungs using a fast gradient echo sequence developed for rapid imaging.Materials and MethodsTen healthy volunteers were imaged with a fast gradient echo sequence that collects 12 images alternating between two closely spaced echoes in a single 9‐s breathhold. Data were fit to a single exponential to determine lung water density and T. Data were evaluated in a single imaging slice at total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV). Analysis of variance for repeated measures was used to statistically evaluate changes in T and lung water density across lung volumes, imaging plane, and spatial locations in the lung.ResultsIn normal subjects (n = 10), T (and [lung density/water density]) was 1.2 ± 0.1 msec (0.10 ± 0.02), 1.8 ± 0.2 ms (0.25 ± 0.04), and 2.0 ± 0.2 msec (0.27 ± 0.03) at TLC, FRC, and RV, respectively. Results also show that there is a considerable intersubject variability in the values of T.ConclusionData show that T in the lung is very short, and varies considerably with lung volume. Thus, if quantitative assessment of lung density within a breathhold is to be measured accurately, then it is necessary to also determine T. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.
Fast left ventricular mass and volume assessment in mice with three‐dimensional guide‐point modeling
Authors: Young Alistair A. , Barnes Hannah , Davison Dan , Neubauer Stefan , Schneider Jurgen E. 
Published: July 2009

AbstractPurposeTo investigate the accuracy (vs. standard manual analysis) and precision (scan–rescan reproducibility) of three‐dimensional guide‐point modeling (GPM) for the assessment of left ventricular (LV) function in mice.MethodsSix male wildtype C57/Bl6 mice (weight 26.2 ± 1.1 g) were scanned twice, 3 days apart. Each scan was performed twice, at 0.2 mm/pixel with one average and at 0.1 mm/pixel with two averages. The 24 studies were anonymized and analyzed in blinded fashion using GPM and standard manual slice summation.ResultsThe average error between GPM and standard analysis was 2.3 ± 5.8 mg in mass, 1.7 ± 3.2 μL in end‐diastolic volume, 2.3 ± 3.1 μL in end‐systolic volume, −2.7 ± 4.3% in ejection fraction, −0.6 ± 3.3 μL in stroke volume, and −0.31 ± 1.56 ml · min−1 in cardiac output (mean difference ± SD of differences, n = 24). The average time taken was 8.0 ± 2.5 minutes for 3D GPM and 48.5 ± 8.9 minutes for standard analysis (n = 24). Scan–rescan reproducibility results were similar to the standard analysis. No significant differences were found using linear mixed effects modeling in either accuracy or precision between scan resolutions or analysis method.Conclusion3D GPM enables fast analysis of mouse LV function, with similar accuracy and reproducibility to standard analysis. An image resolution of 0.2 mm/pixel with one average is adequate for LV function studies. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.
Examination of wind storms over Central Europe with respect to circulation weather types and NAO phases
Authors: Donat Markus G. , Leckebusch Gregor C. , Pinto Joaquim G. , Ulbrich Uwe 
Published: July 2009

AbstractThe occurrence of wind storms in Central Europe is investigated with respect to large‐scale atmospheric flow and local wind speeds in the investigation area. Two different methods of storm identification are applied for Central Europe as the target region: one based on characteristics of large‐scale flow (circulation weather types, CWT) and the other on the occurrence of extreme wind speeds. The identified events are examined with respect to the NAO phases and CWTs under which they occur. Pressure patterns, wind speeds and cyclone tracks are investigated for storms assigned to different CWTs. Investigations are based on ERA40 reanalysis data.It is shown that about 80% of the storm days in Central Europe are connected with westerly flow and that Central European storm events primarily occur during a moderately positive NAO phase, while strongly positive NAO phases (6.4% of all days) account for more than 20% of the storms. A storm occurs over Central Europe during about 10% of the days with a strong positive NAO index. The most frequent pathway of cyclone systems associated with storms over Central Europe leads from the North Atlantic over the British Isles, North Sea and southern Scandinavia into the Baltic Sea. The mean intensity of the systems typically reaches its maximum near the British Isles. Differences between the characteristics for storms identified from the CWT identification procedure (gale days, based on MSLP fields) and those from extreme winds at Central European grid points are small, even though only 70% of the storm days agree. While most storms occur during westerly flow situations, specific characteristics of storms during the other CWTs are also considered. Copyright © 2009 Royal Meteorological Society