bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Dynamic Contrast Enhanced MRI and DWI in the Pre-operative Assessment of Endometrial & Cervical Carcinoma
Authors: Mohammed F S , Chalabi N A , Halim N N , Metwally Z M M , Elsayed A A M E 
Published: May 2020

Abstract

Purpose
of this study is : To assess the efficacy of dynamic contrast enhanced MRI and diffusion weighted imaging in the preoperative assessment & staging of endometrial & cervical carcinoma and accordingly stratification of best treatment options.

Methods
The study included 40 patients having uterine malignancy 20 with endometrial carcinoma and 20 with cervical carcinoma (between 32 and 76 years) referred from Gynecologists to Radiodiagnosis Department after histologic diagnosis. Each patient was subjected to full history taking, routine laboratory investigations, preliminary trans-vaginal ultrasound and MR examination including: Conventional MRI, DCE-MRI and DWI. All cases were staged with the aid of T2WIs, DCE-MRI & DWI. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips).

Results
The study showed that DCE-MRI & DWI improve the accuracy of T2WI in staging of endometrial & cervical cancer.

Conclusion
Using DCE-MRI & DWI improves differentiation of tumor & non-tumor tissue in cervical and endometrial cancer, thus improves the accuracy of pre-surgical mapping, assessment of treatment response and prediction of treatment outcome. That will be without increasing the expected morbidity from unnecessary procedures and accordingly increase the overall patient’s survival.
Role of high resolution ultrasonography in ankle overuse and sports injuries
Authors: Monib A M , Sakr H M , Allam A E , Mahmoud M A 
Published: May 2020

Abstract

Purpose
of this study is : To emphasize the role of high resolution USG in ankle sports and overuse injuries. thus assessing its ability to detect early abnormalities at diffusion level.

Methods
This study was conducted at the radiology department, faculty of medicine, Ain-Shams University following the approval by the scientific and ethics committee on 30 patients between 22 and 59 years suffering from ankle soft tissue injuries. The patients were referred from the orthopedic department, outpatient clinics of El-Demerdash hospital or private clinics.

Results
The study showed that, in Tendinous pathology, Achilles tendon is the most commonly injured ankle tendon, followed by tibialis posterior and the tendinitis/teno-synovitis was the most encountered tendons pathology. In ligamentous injuries, anterior talo-fibular ligament and calcaneo-fibular ligaments were the most frequently injured ligaments. Associated pathology included effusion and retro-calcaneal bursitis. Comparison to clinical data ultrasonography proved to be more accurate tool in diagnosis and characterization of ankle soft tissue injuries.

Conclusion
Ultrasound is an excellent tool for imaging focal soft tissue abnormalities, and used as primary tool of investigation.
Role of Magnetic Resonance defecography in assessment of pelvic floor dysfunction
Authors: Moussa M S , Abdelkhaleq Y I , Botros S M , Montasser A A 
Published: May 2020

Abstract

Purpose
to assess the role of the role of MR defecography in assessment of pelvic floor failure .

Methods and Material
Thirty-six patients (twenty-seven female and nine male) with female and male patients, complaining of stress urinary incontinence, constipation, fecal incontinence or pelvic organ prolapse.

Results
MRI revealed 18 cystocele (50%), compared to physical examination 2 cases(5.6%),MRI revealed 28 rectocele ( 77.8%) compared to physical examination that showed 13 (36.1%) , MRI revealed 10 uterine descent (40.7%), compared to physical examination 6 (22.2%) I, MRI revealed 7 enterocele (19.4%) compared to physical examination that was negative. MRI revealed level I/II facial defect in and level III facial defect in, 19 cases of Intussusception (52.8%), urethral hypermobility in 14 (38.9%), sphincteric defect 7 (19.4%), levator angle weakness in 30 cases (83.3%), iliococcygeaus muscle tear in 5 cases (13.9%), puborectalis tear in 3 cases (8.3%),anorectal decent in 26 cases (72.2%), genital hiatus width in 23 (63.9%)

Conclusion
Dynamic MR imaging is a necessary tool in the diagnosis of multicompartment pelvic organ prolapse and it provides good concordance with clinical examination
Role of diffusion weighted MRI in differentiation between benign and malignant hepatic focal lesions
Authors: Abdurrahman L A , Ali A H , Abdelmotelb E M 
Published: May 2020

Abstract

Background
Magnetic resonance imaging (MRI) is playing an increasing role in the assessment of patients with liver disease due to its high soft tissue resolution, lack of ionizing radiation and ability to provide functional data. Diffusion-weighted (DW)-MRI is a functional imaging technique that is now widely used as a standard imaging sequence, together with unenhanced T1/T2 weighted imaging and contrast-enhanced imaging for liver evaluation.

Objective
The aim of this study is to clarify the role of Diffusion Weighted Magnetic Resonance Imaging (DW MRI) in the detection of hepatic focal lesions and its ability to differentiate benign from malignant hepatic focal lesions.

Patients and Methods
This study carried out in Radiology Department of Ain Shams University Hospitals. This study included 25 patients. All patients were subjected to careful history taking, abdominal US, laboratory examinations, and liver MRI.

Result
The difference between the mean ADC values of benign and malignant lesions was significant. No significant differences in ADC values among the different benign lesions or among the different malignant lesions.

Conclusion
Diffusion-weighted imaging (DWI) offers the possibility to obtain criteria for characterization of focal liver lesions with subsequent differentiation between benign and malignant hepatic focal lesions without the need for contrast agent administration-by quantifying diffusion effects via apparent diffusion coefficient (ADC) measurements.
The Privilege of Proton Magnetic Resonance Spectroscopy in Evaluating Ovarian Tumors
Authors: Hafez A A , Nasr M A , Salman N L 
Published: May 2020

Abstract

Background
Exclusion of malignancy in ovarian mass is of paramount importance. It is the most crucial step after identification of a mass and it has a profound effect on the patient's management. So, a reliable method with which to differentiate a benign from a malignant ovarian mass would provide a basis for optimal preoperative planning and may also reduce the number of unnecessary laparotomies for patients undergoing treatment for benign disease.

Objective
The aim of our study is to highlight the role of magnetic resonance spectroscopy as a non-invasive technique which may effectively assist in differentiating benign from malignant ovarian masses.

Patients and Methods
This study included 20 patients with adnexal masses as suggested by preliminary pelvic ultrasound examination. referred from the Gynecology Department to the Radiology Department at Ain shams university hospitals. nine were benign, two were borderline, and six were malignant tumors and 3 were hemorrhagic cyst. Endometriosis, tubo-ovarian abscess.

Results
Our study revealed sharp choline peak in some benign as well as some malignant cases and so Cho peak could not help in the differential diagnosis between benign and malignant tumors, creatine, lipid and NAA were detected in both benign and malignant tumors, also Choline/Creatine Ratio fairly can differentiate between benign and malignant tumors with cut off point = 3.750 at sensitivity = 75.0% & specificity = 100.0% .

Conclusion
Our study had some factors that affect the results. First, the sample size were not enough to achieve a good results, second, diversity of samples and the complicated tumor histopathologic and morphologic features.
T83. SUBSTANCE-INDUCED PSYCHOSIS LINKED TO BOTH INFECTIONS AND SCHIZOPHRENIA
Authors: Hjorthøj Carsten , Starzer Marie , Benros Michael , Nordentoft Merete 
Published: May 2020

Abstract

Background
Substance-induced psychosis is an under-researched phenomenon, and little is known about its etiology (other than exposure to substances) and long-term prognosis. In this presentation, we aim to present results from two recent studies, one of which was recently published and the other is currently in the process of being analyzed. The first study investigates rates and predictors of conversion from substance-induced psychosis; the second study investigates the association between severe infections and substance-induced psychosis, including the contribution of infections on conversion to schizophrenia.

Methods
Both studies utilized the nationwide Danish registers.
In study 1, we included all people diagnosed with substance-induced psychosis from 1994 to 2014 (n=6,788). These were followed using the Kaplan-Meier method and Cox proportional hazards regression to estimate rates and predictors of conversion to schizophrenia or bipolar disorder.
In study 2, we included the entire Danish population born since 1981 (n=2,256,779). These were followed in Cox proportional hazards regression models, linking hospital-requiring infections as time-varying covariates to development of substance-induced psychosis. In further analyses, we followed those who had developed substance-induced psychosis to determine whether infections would influence the risk of converting to schizophrenia.

Results
Study 1: Overall, 32.2% (95% CI 29.7–34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI 42.7–52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder.
Study 2: Infections increased the risk of substance-induced psychosis (HR=1.30, 95% CI 1.22–1.39) in the fully adjusted model. Hepatitis was the infection most strongly associated with substance-induced psychosis, at HR=3.42 (95% CI 2.47–4.74). Different sites of infections showed associations with different types of substance-induced psychosis. Finally, hepatitis increased the risk of conversion to schizophrenia with HR=1.87 (95% CI 1.07–3.26).

Discussion
Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases. Infections appear to play a role in the etiology of substance-induced psychosis which is very similar to the role infections play in the etiology of schizophrenia. This lends strong support to the existence of an immune-related component to psychosis in general, and not just to schizophrenia.
T86. RELEVANCE OF CANNABIS USE AS A PREDICTOR OF CLINICAL OUTCOME IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDER PATIENTS OVER 24 MONTHS OF TREATMENT
Authors: Scheffler Frederika , Luckhoff Hilmar , du Plessis Stefan , Phahladira Lebogang , Asmal Laila , Kilian Sanja , Emsley Robin 
Published: May 2020

Abstract

Background
Cannabis use is generally associated with an unfavourable course of illness in first-episode schizophrenia, including non-remission of psychopathology symptoms, higher rates of relapse and re-hospitalization, and poorer functioning. The aim of this study was to explore the influence of cannabis use on clinical and treatment outcomes in first-episode schizophrenia spectrum disorder patients over 24 months of assured antipsychotic treatment.

Methods
The present longitudinal study included 123 minimally treated or antipsychotic-naive first-episode patients assessed over 24 months of treatment with flupenthixol decanoate according to a standardized regimen. Time to relapse, rates of symptomatic and functional remission, as well as recovery were compared between cannabis users (n=41) and non-users (n=82) stratified based on a combination of self-report and urine toxicology results over the course of treatment. In addition, visit-wise changes in psychopathology severity and overall functioning were compared between these two study groups. We hypothesized that 1) ongoing cannabis use would present with more severe psychopathology and poorer overall level of functioning, and 2) rates of remission and recovery would be lower in cannabis users compared to their non-using counterparts.

Results
At study entry, cannabis-using patients were younger, more likely to be male and to use methamphetamine, and scored lower in social and occupational functioning. Moreover, while cannabis users were more likely to relapse at any point over 24 months of treatment, cannabis non-users were more likely to achieve remission within the first six months, although this effect was not statistically significant. However, our most important finding was the interaction between cannabis use and time for total psychopathology as well as for the PANSS positive factor. While differences were not evident at either study entry or endpoint, cannabis users recovered at a slower rate than non-users.

Discussion
These results suggest a poorer treatment response in cannabis users compared to non-users in the context of assured adherence to antipsychotic medication. Therefore, regardless of the neurobiological impact of cannabis use in schizophrenia, the behaviour of substance use itself needs to be targeted as part of first-line treatment in order to improve the treatment outcomes of substance-using patients.
T100. BELIEFS ABOUT THE SELF AND OTHERS IN PARANOIA
Authors: Brown Poppy , Waite Felicity , Rovira Aitor , Nickless Alecia , Freeman Daniel 
Published: May 2020

Abstract

Background
Compassionate imagery may be one method of targeting the negative beliefs about the self and others that paranoid thoughts build upon. This talk presents two interventionist-causal studies testing this hypothesis, one targeting compassion for the self and one targeting compassion for others. These studies form part of the programme of work testing the manipulation of putative causal factors in paranoia, in individuals from the general population scoring highly for current paranoid ideation.

Methods
Two hundred such individuals were recruited. The studies used a randomised controlled experimental design, with embedded tests for mediation. Study one targeted self-compassion via creation of a compassionate coach image. Study two targeted compassion for others via loving kindness meditation. Individuals repeatedly entered neutral virtual reality social environments and changes in compassion and paranoia were assessed.

Results
Study one showed that, in comparison to the control group, those who practised compassionate coach imagery significantly increased in self-compassion (group difference=2.12, C.I.=1.57;2.67, p=&lt;0.0001, d=1.4) and decreased in paranoia (group difference=-1.73, C.I.=-2.48;-0.98, p=&lt;0.0001, d=0.8). Mediation analysis indicated that change in self-compassion explained 57% of the change in paranoia. Study two showed that in comparison to the control group, those who practised loving kindness meditation significantly increased their compassion for others (group difference=3.26, 95% C.I.: 2.72;3.80, p=&lt;0.0001, d=1.7), and decreased their paranoia (group difference=-1.70, C.I.=-2.51;-0.89, p=&lt;0.0001, d=0.8). Change in compassion for others explained 63% of the change in paranoia.

Discussion
Together, the studies suggest that targeting negative beliefs about the self and others using compassionate imagery causes reductions in paranoia, which may have benefits in clinical populations.
T102. TELEPROM-Y: IMPROVING ACCESS AND EXPERIENCE OF MENTAL HEALTHCARE FOR YOUTH THROUGH VIRTUAL MODELS OF CARE
Authors: Forchuk Cheryl , Collins Kerry , Eichstedt Julie , Reiss Jeffrey , Booth Richard , Fisman Sandra , Rudnick Abraham , Hoch Jeffrey , Lizotte Daniel , Isaranuwatchai Wanrudee , Wang Xianbin 
Published: May 2020

Abstract

Background
About 1 in 5 youth have a mental illness, with 75 percent of all mental illnesses having their onset in childhood or adolescence (Kim-Cohen et al., 2003). In Ontario, 157,900 youth rated their mental health as fair or poor, a significant increase from 2007 (Boak et al., 2014). Not only do mental health concerns cause difficulties at onset, they can also disrupt important life transitions and developmental milestones, as well as being burdensome throughout the individual’s lifespan (Ratnasingham et al., 2012). Consequently, new care approaches are needed.
The TELEPROM-Y project will evaluate outpatient health care delivery using InputHealth’s electronic Collaborative Health Record (CHR) at London Health Sciences Centre, St. Joseph’s Health Care London, Woodstock General Hospital, and community agencies including Youth Opportunities Unlimited, WAYS Mental Health Support, and Leads Employment Services.

Methods
120 youth (ages 14–25) will be recruited from the caseloads of 46 mental healthcare providers. Participants will use a smartphone application (app) to connect to the Collaborative Health Record. Semi-structured interviews will be conducted at baseline, 6, and 12 months. This is a participatory action research project utilizing a pre-post, mixed-methods design. A standardized evaluation framework will be instituted to facilitate systematic effectiveness, economic, ethical, and policy analyses.
Some of the functions of the app, available for Apple and Android phones, include: making/changing/cancelling appointments; text messaging; emailing, and filling out questionnaires/surveys. If the youth are unable to attend a scheduled appointment in person, the care-provider and youth can have a virtual visit, similar to FaceTime or Skype. Virtual visits should reduce missed appointments.

Results
Descriptive information thus far of 104 participants: Psychotic Disorder (e.g. schizophrenia) (13, 12.6%), Developmental handicap (e.g. Autism) (7, 6.8%), Anxiety Disorder (e.g. PTSD) (73, 70.9%), Disorder of childhood/adolescence (e.g. ADHD) (37, 35.9%), Substance-related disorder (13, 12.6%), Personality Disorder (17, 16.5%), Mood Disorder (e.g. depression, bipolar mood disorder) (70, 68.0%), Unknown (4, 3.9%), Other (19, 18.4%).

Discussion
We anticipate that through the usage of the TELEPROM-Y app the participant and care-provider experience will be enhanced, leading to 1) improved healthcare outcomes and patient quality of life, and 2) reduced healthcare costs by preventing hospitalization and reducing the need for face-to-face outpatient visits.
T112. PTSD AS A MEDIATOR OF THE RELATIONSHIP BETWEEN TRAUMA AND PSYCHOTIC EXPERIENCES
Authors: Strelchuk Daniela , Hammerton Gemma , Croft Jazz , Heron Jon , Zammit Stanley , Wiles Nicola , Turner Katrina 
Published: May 2020

Abstract

Background
Trauma exposure is linked to the development of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. Despite the high prevalence of PTSD symptoms in psychotic illnesses, only a few studies have examined the role of PTSD as a mediator, and these were all cross-sectional. This study aims to examine whether PTSD symptoms mediate the relationship between trauma and psychotic experiences (PE), using data from a large birth cohort study.

Methods
We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to test whether: a) PTSD symptoms (at age 15) mediate the relationship between childhood trauma (age 0–14 years) and adolescent frequent or distressing psychotic experiences (age 12–18 years) (study of adolescent PE; n = 2,952), and b) PTSD symptoms (reported at age 24 for traumatic event occurring before age 19) mediate the relationship between childhood/adolescent trauma (age 0–17 years) and incident frequent or distressing psychotic experiences in early adulthood (age 19–24 years) (study of adult PE; n = 2,492).
Associations between the variables of interest were examined with logistic regression, and mediation with the parametric g-computation formula. As sensitivity analyses, we i) examined broader and narrower psychotic outcomes, ii) included a measure of psychotic-like experiences at age 14 years as an intermediate confounder in the mediation model for adolescent psychotic experiences, and iii) repeated analyses using imputed data.

Results
Exposure to trauma was associated with increased odds of psychotic experiences and PTSD symptoms both in adolescence and early adulthood (p&lt;0.001). The association between PTSD and psychotic experiences was stronger in adolescence (p&lt;0.001) than in adulthood (p=0.03). There was moderate evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent psychotic experiences (proportion mediated 14%), though evidence of mediation was much weaker for adult PE (proportion mediated 8%).
In sensitivity analyses we observed similar results when using imputed data, and when modelling psychotic experiences at age 14 as an intermediate confounding for the adolescent PE outcome. The proportion mediated increased when examining more narrowly defined outcomes (19% for adolescent psychotic disorder).

Discussion
These findings provide some evidence consistent with the thesis that psychotic experiences and disorder can occur consequent to PTSD symptoms after trauma exposure. Targeting PTSD symptoms might help prevent the occurrence of psychotic experiences and disorder in people with a trauma history.
T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS
Authors: Bird Jessica , Evans Robin , Taylor Kathryn M , Molodynski Andrew , Waite Felicity , Freeman Daniel 
Published: May 2020

Abstract

Background
A cognitive account identifies six key psychological maintenance factors for persecutory delusions. However, a complex system of causation is likely where these factors interact in their influence on paranoid ideas. We set out to evaluate the causal dynamics of paranoia with theory-driven network approaches.

Methods
1809 patients with non-affective psychosis attending UK mental health services completed assessments of paranoia, hallucinations, insomnia, self-esteem, worry, anxious avoidance, analytic reasoning, and psychological well-being. To assess causal patterns, we estimated, first, an undirected partial correlation network and then, second, adopted a Bayesian approach with Directed Acyclic Graphs to discover the directed causal pathways best supported by the data.

Results
The networks showed that with all other variables controlled, paranoia had direct causal interactions with hallucinations, negative self-beliefs, insomnia, worry, and avoidance. Hallucinations and negative self-beliefs were most directly linked to paranoia, whereas indirect paths had prominent influences on the causal effects for insomnia, worry, and avoidance. The direction of these interactions was uncertain, but negative self-beliefs and insomnia were more likely to influence paranoia than vice versa. Self-report reasoning was likely unrelated to paranoia once other factors were controlled. Causal factors were highly interconnected, with insomnia, negative self-beliefs, avoidance, and worry most directly linked to other variables. Most interactions were likely reciprocal, except for hallucinations which were unlikely to influence other variables and significantly caused by insomnia and avoidance.

Discussion
The findings are consistent with a complex system of interacting causation in the maintenance of paranoia. The patterns observed support the cognitive model of persecutory delusions, highlighting multiple pathways of causal interaction between paranoia and theoretically important factors. Interventions directly targeting these factors are likely to lead to multiple benefits, alleviating paranoia both directly and indirectly through connections with other causally related symptoms.