bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of different image-registration algorithms for Fourier decomposition MRI in functional lung imaging
Authors: Ljimani Alexandra , Hojdis Malte , Stabinska Julia , Valentin Birte , Frenken Miriam , Appel Elisabeth , Antoch Gerald , Wittsack Hans-Jörg 
Published: July 2020

Background Motion correction is mandatory for the functional Fourier decomposition magnetic resonance imaging (FD-MRI) of the lungs. Therefore, it is important to evaluate the quality of various image-registration algorithms for pulmonary FD-MRI and to determine their impact on FD-MRI outcome. Purpose To evaluate different image-registration algorithms for FD-MRI in functional lung imaging. Material and Methods Fifteen healthy volunteers were examined in a 1.5-T whole-body MR scanner (Magnetom Avanto, Siemens AG) with a non-contrast enhanced 2D TrueFISP pulse sequence in coronal view and free-breathing (acquisition time 45 s, 250 images). Three image-registration algorithms were used to compensate the spatial variation of the lungs (fMRLung 3.0, ANTs, and Elastix). Quality control for image registration was performed by edge detection (ED), quotient image criterion (QI), and dice similarity coefficient (DSC). Ventilation, perfusion, and a ventilation/perfusion quotient (V/Q) were calculated using the three registered datasets. Results Average computing times for the three image-registration algorithms were 1.0 ± 1.6 min, 38.0 ± 13.5 min, and 354 ± 78 min for fMRLung, ANTs, and Elastix, respectively. No significant difference in the quality of motion correction provided by different image-registration algorithms occurred. Significant differences were observed between fMRLung- and Elastix-based perfusion values ​​of the left lung as well as fMRLung- and ANTs-based V/Q quotient of the right and the entire lung ( P < 0.05). Other ventilation and perfusion values were not significantly different. Conclusion The mandatory motion correction for functional FD-MRI of the lung can be achieved through different image-registration algorithms with consistent quality. However, a significantly difference in computing time between the image-registration algorithms still requires an optimization.
Features of breast tuberculosis determined by ultrasound imaging: report of 45 cases
Authors: Zhang Wenzhi , Zhang Ying , Yang Gaoyi , Yu Tianzhuo 
Published: July 2020

Objective This study aimed to characterize the ultrasound (US) imaging features of breast tuberculosis (BTB) to clarify the process of disease progression and provide valuable clinical information. Methods We retrospectively reviewed 45 patients with pathologically or GeneXpert-confirmed BTB from January 2010 to December 2017. We assessed the US features of target lesions including size, shape, orientation, margin, echogenicity, calcification, posterior acoustic features, and blood-flow signal. Results The patients were classified with nodular (55.5%, 25/45), abscess (15.6%, 7/45), or sinus (28.9%, 13/45) type according to their US features. Forty lesions (88.9%, 40/45) extended in a parallel orientation and five extended in a non-parallel orientation. Calcifications were found in eight cases, including six macrocalcifications and two microcalcifications. Enlarged axillary lymph nodes were observed in three cases (6.7%, 3/45). In addition, 44 of the 45 cases (97.8%, 44/45) exhibited hypovascularity or avascularity according to color Doppler flow imaging (CDFI). Conclusion BTB lesions can be classified as nodular, abscess, or sinus type according to their US imaging features. Poor blood supply detected by CDFI might be a common US feature of BTB. Characterization of its US features may facilitate the clinical diagnosis of BTB.
Simulation-Based Comprehensive Cleft Care Workshops: A Reproducible Model for Sustainable Education
Authors: Kantar Rami S. , Breugem Corstiaan C. , Keith Kristen , Kassam Serena , Vijayakumar Charanya , Bow Mikaela , Alfonso Allyson R. , Chahine Elsa M. , Ghotmi Lilian H. , Patel Krishna G. , Shetye Pradip R. , Santiago Pedro E. , Losee Joseph E. , Steinbacher Derek M. , Rossell-Perry Percy , Garib Daniela G. , Alonso Nivaldo , Mann Robert J. , Prada-Madrid Jose Rolando , Esenlik Elçin , Pamplona María del Carmen , Collares Marcus Vinícius Martins , Bennun Ricardo D. , Kummer Ann , Giugliano Carlos , Padwa Bonnie L. , Raposo-Amaral Cassio Eduardo , Tse Raymond , Sommerlad Brian , Flores Roberto L. , Hamdan Usama S. 
Published: July 2020

Objective: Evaluate simulation-based comprehensive cleft care workshops as a reproducible model for education with sustained impact. Design: Cross-sectional survey-based evaluation. Setting: Simulation-based comprehensive cleft care workshop. Participants: Total of 180 participants. Interventions: Three-day simulation-based comprehensive cleft care workshop. Main Outcome Measures: Number of workshop participants stratified by specialty, satisfaction with the workshop, satisfaction with simulation-based workshops as educational tools, impact on cleft surgery procedural confidence, short-term impact on clinical practice, medium-term impact on clinical practice. Results: The workshop included 180 participants from 5 continents. The response rate was 54.5%, with participants reporting high satisfaction with all aspects of the workshop and with simulation-based workshops as educational tools. Participants reported a significant improvement in cleft lip (33.3 ± 5.7 vs 25.7 ± 7.6; P < .001) and palate (32.4 ± 7.1 vs 23.7 ± 6.6; P < .001) surgery procedural confidence following the simulation sessions. Participants also reported a positive short-term and medium-term impact on their clinical practices. Conclusion: Simulation-based comprehensive cleft care workshops are well received by participants, lead to improved cleft surgery procedural confidence, and have a sustained positive impact on participants’ clinical practices. Future efforts should focus on evaluating and quantifying this perceived positive impact, as well reproducing these efforts in other areas of need.
Safety of Glycoprotein IIb-IIIa Inhibitors Used in Stroke-Related Treatment: A Systematic Review and Meta-Analysis
Authors: Zhu Xiaolin , Cao Genmao 
Published: July 2020

Background: Endovascular therapy and intravenous thrombolysis with recombinant tissue plasminogen activator are the 2 most recommended treatments for acute ischemic stroke (AIS). Glycoprotein (GP) IIb-IIIa inhibitors are short-acting selective reversible antiplatelet agents that emerged as promising therapeutic agents for AIS about 10 years ago. Given the unclear safety profile and application coverage of GP inhibitors, we conducted this meta-analysis to explore the same. Methods: We used GP IIb-IIIa inhibitors, intracranial hemorrhage, and mortality as the key words on Medline, Web of Science, and the Embase databases. Randomized controlled trials, prospective literatures, and retrospective studies in English published between 1990 and 2020 were screened. The outcomes were relative risk (RR) of death and 90-day intracerebral hemorrhage (ICH). We pooled the results in 2 categories and conducted a subgroup analysis stratified by different drugs. The choice of the effects model depended on the value of I 2. Results: In all, 3700 patients from 20 studies were included. No GP IIb-IIIa inhibitors were found to have a remarkable influence on the ICH rate. The RR values of symptomatic ICH for abciximab and eptifibatide were 4.26 (1.89, 9.59) and 0.17 (0.04, 0.69), respectively. Both tirofiban and abciximab could decrease the mortality rate within 90 days. Age > 70 years, National Institutes of Health Stroke Scale > 15, and overall dose > 10 mg are risk factors for ICH events with tirofiban usage. Thrombectomy combined with tirofiban was safe for arterial reocclusion prevention. Conclusions: In stroke-related treatment, administration of GP IIb-IIIa inhibitors could be safe, but care should be taken regarding drug species and doses. Abciximab can increase the risk of symptomatic intracranial hemorrhage. Tirofiban and eptifibatide can be considered safe in low doses. Suitable patients should be selected using strict criteria.
Contribution of inflow artery to observed flow in a vascular access: A computational fluid dynamic modeling study of an arteriovenous fistula circuit
Authors: Krampf Jeffrey , Agarwal Ramesh , Shenoy Surendra 
Published: July 2020

Introduction: The volume of blood flowing through the vascular access is an important parameter necessary to provide adequate dialysis for a functional arteriovenous fistula. Higher blood flows are seen in arteriovenous access that receive inflow from larger arteries such as brachial or axillary compared to those based on medium-caliber radial or ulnar arteries. We hypothesized that an anatomic difference in the length and the diameter of the artery is an important determinant of the flow volume in arteriovenous fistula created at different anatomic locations. Methods: Using computational fluid dynamics, we evaluated the contribution of the length and diameter of inflow artery on simulations performed with geometric models constructed to represent arteriovenous fistula circuits. Lengths and diameters of the inflow artery were altered to mimic arteriovenous fistula created at various locations of the upper extremity with standard and variant anatomy. Results: Models of arteriovenous fistula created with variable lengths and diameters of the inflow artery suggest that the length of the vessel has an inverse linear relationship and the diameter has a direct linear relationship to flow volume. Conclusion: Computational fluid dynamic modeling of arteriovenous fistula can be used to understand the physiologic basis of clinical observations of function. Evaluation of the effect of inflow artery length and diameter helps explain the higher flows seen in arteriovenous fistula created using large caliber arteries for inflow. Computational fluid dynamic modeling helps operators understand the contributions of inflow artery in access function and can guide anastomotic site selection.
Modeling the Spatial Distribution of Cancer and Determining the Associated Risk Factors
Authors: Tesfaw Lijalem Melie , Muluneh Essey Kebede 
Published: July 2020

Background: Cancer is the second leading cause of death globally. Despite developing countries including Ethiopia continuing to shoulder the greatest burden, insufficient research has been conducted to determine geographical and other characteristic effects. The main objective of this study was to assess the distribution and risk of cancer and determine the effects of some common clinical patient characteristics on current patient status by taking into account the spatial effect. Methods: The data for this study were obtained from the oncology ward of Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. About 415 cancer patients were included in the study. Spatial mixed ordinal logistic regression model was used to explore the geographical patterns of the incidence of cancer and identify the risk factors. Results: The findings of this study show that only 1.45% of patients were cured and 46.02% improved, whereas the rest have shown no change and even worse status after treatment. The estimated odds of patients who received chemotherapy was 4.284 times the estimated odds of patients who received palliative care. Prognostic factor (stage of cancer tumor), complication of cancer such as anemia during diagnosis, and treatment of patients given in the hospital had significant effect on the patient status. Conclusion: Patients without anemia were more likely to be cured and improved than patients with anemia during diagnosis. Most of the patients had advanced stage (IV) of cancer tumor, which dismantles the capability of the treatment to be less effective. There was negative spatial effect on the incidence of cancer, indicating that districts with higher cancer incidence were usually surrounded by districts with lower incidence.
A Case of an Aggressive Intraosseous Arteriovenous Malformation in the Lower Extremity: Special Considerations for Diagnosis and Management
Authors: Stribling Lacey C. , Abu-Ghname Amjed , Trost Jeffrey , Montgomery Nicole , Desai Sudhen , Maricevich Renata S. 
Published: July 2020

Background: Arteriovenous malformations (AVMs) are rare, congenital vascular anomalies. Intraosseous AVMS most frequently arise in the head and neck, with only a small fraction occurring in the extremities. Herein, we report the findings of a combined soft tissue and intraosseous AVM involving the lower extremity of a 13-year-old child. This case highlights the necessity of an interdisciplinary approach for the effective treatment and management of these rare vascular anomalies. Case Description: A 13-year-old female presented with a 4-year history of intermittent pain and swelling over her right lateral malleolus. The patient was evaluated with radiologic imaging revealing an AVM involving the right distal leg, ankle, and hindfoot with intraosseous involvement of the distal tibia and talus. She was then referred to Vascular and Plastic Surgery and an angiogram was performed demonstrating shunting from the anterior tibial, peroneal, and posterior tibial arteries to the AVM. Venous drainage was to the anterior tibial and greater saphenous veins. Three embolizations were performed over the course of 6 months. Following the third embolization, the patient was taken to the operating room where Plastic and Orthopedic Surgery performed total resection of the nidus and involved bone which was then grafted with injectable synthetic bone graft. Results: Successful resection of the nidus was achieved, and the patient had an uncomplicated recovery. Within 6 months postoperatively, the patient demonstrated full range of lower extremity motion and was able to participate in age appropriate gross motor activities. Radiologic evaluation 7 months postoperatively showed no evidence of nidus recurrence. Conclusion: Intraosseous involvement of AVMS is rare and presents a therapeutic challenge due to its invasive potential and high incidence of recurrence. Wide local excision with bone grafting and interdisciplinary management are paramount for complete resection.
Outcomes of Florida Sleeve Procedure in Patients with Bicuspid Versus Tricuspid Aortic Valve
Authors: Aalaei-Andabili Seyed Hossein , Beaver Thomas M. , Martin Tomas D. , Hess Philip J. , Arnaoutakis George J. 
Published: July 2020

Objective Outcomes of the Florida Sleeve (FS) procedure in patients with bicuspid aortic valve (BAV) have not been reported before. We compared outcomes of the FS procedure between patients with BAV and those with tricuspid aortic valve (TAV). Methods From May 1, 2002 to January 1, 2016, 177 patients including 18 BAV and 159 TAV underwent the FS procedure. Baseline characteristics, perioperative outcomes, and echocardiographic measurements were compared between the 2 groups. Kaplan–Meier and life-table analyses were used to evaluate survival and freedom from reintervention rates. Results Mean ± standard deviation age and aortic root diameter were comparable in BAV and TAV groups, 47.83 ± 11.19 versus 49.59 ± 15.79 years ( P = 0.55) and 56.57 ± 6.18 versus 55.17 ± 8.84 mm ( P = 0.46), respectively. The 30-day mortality and stroke rates were zero in the BAV group and 1.88% ( n = 3) in the TAV group ( P = 1.00). One patient (5.55%) in the BAV group and 8 (5.03%) patients in the TAV group needed permanent pacemaker implantation ( P = 0.62). Freedom from reoperation was 93% in the BAV group and 99% in the TAV group at 8 years ( P = 0.041). Patient survival rate was 100% in the BAV group and 91% in the TAV group at 8 years ( P = 0.42). Freedom from aortic insufficiency greater than mild was 93% in the BAV group and 96.5% in the TAV group at 5 years ( P = 0.61). Conclusions This is the first study reporting outcomes of the FS procedure in patients with BAV. This technique is feasible, and the results appear to be durable when compared to patients with TAV.
Vibrational spectroscopy of liquid biopsies for prostate cancer diagnosis
Authors: Medipally Dinesh K. R. , Cullen Daniel , Untereiner Valérie , Sockalingum Ganesh D. , Maguire Adrian , Nguyen Thi Nguyet Que , Bryant Jane , Noone Emma , Bradshaw Shirley , Finn Marie , Dunne Mary , Shannon Aoife M. , Armstrong John , Meade Aidan D. , Lyng Fiona M 
Published: July 2020

Background: Screening for prostate cancer with prostate specific antigen and digital rectal examination allows early diagnosis of prostate malignancy but has been associated with poor sensitivity and specificity. There is also a considerable risk of over-diagnosis and over-treatment, which highlights the need for better tools for diagnosis of prostate cancer. This study investigates the potential of high throughput Raman and Fourier Transform Infrared (FTIR) spectroscopy of liquid biopsies for rapid and accurate diagnosis of prostate cancer. Methods: Blood samples (plasma and lymphocytes) were obtained from healthy control subjects and prostate cancer patients. FTIR and Raman spectra were recorded from plasma samples, while Raman spectra were recorded from the lymphocytes. The acquired spectral data was analysed with various multivariate statistical methods, principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA) and classical least squares (CLS) fitting analysis. Results: Discrimination was observed between the infrared and Raman spectra of plasma and lymphocytes from healthy donors and prostate cancer patients using PCA. In addition, plasma and lymphocytes displayed differentiating signatures in patients exhibiting different Gleason scores. A PLS-DA model was able to discriminate these groups with sensitivity and specificity rates ranging from 90% to 99%. CLS fitting analysis identified key analytes that are involved in the development and progression of prostate cancer. Conclusions: This technology may have potential as an alternative first stage diagnostic triage for prostate cancer. This technology can be easily adaptable to many other bodily fluids and could be useful for translation of liquid biopsy-based diagnostics into the clinic.
Prevalence of Neurologic Deficits in Combined Facial and Cervical Spine Injuries: A Retrospective Analysis
Authors: Philip Manju Roby , Soumithran C. S. 
Published: July 2020

Study design: A retrospective data analysis of maxillofacial trauma patients with combined cervical spine injuries. Objective: This study is based on investigating the importance of timely diagnosis of patients who suffer with cervical spine injuries along with maxillofacial trauma by estimating the prevalence of neurologic deficits and its relation with etiology. Methods: A database of 4460 patients suffering from maxillofacial injuries and admitted in specialized environment surgery of Government Medical College, Trivandrum, Kerala was taken under consideration. The prevalence and types of neurologic deficits and its relation with etiology were assessed in patients with combined facial and cervical spine injuries. Results: Of 4460 patients, 48 were having cervical spine injury along with facial damage with the prevalence of 0.01%. Neurologic deficits were seen highest with etiology of road traffic accidents followed by falls from height. Most of the accidents occurred in bike riders and helmets were absent. Conclusions: It was concluded that most of the accidents engage bike riders and drivers, due to unethical and unsafe driving. There was no significant correlation found between facial and cervical spine injuries.
Colon capsule endoscopy versus CT colonography after incomplete colonoscopy. Application of artificial intelligence algorithms to identify complete colonic investigations
Authors: Deding U , Herp J , Havshoei A‐L , Kobaek‐Larsen M , Buijs MM , Nadimi ES , Baatrup G 
Published: July 2020

BackgroundGuidelines suggest computed tomography colonography (CTC) following incomplete optical colonoscopy (OC). Colon capsule endoscopies (CCE) have been suggested as an alternative, although completion rates have been unsatisfactory. Introduction of artificial intelligence (AI)‐based localization algorithms of the camera capsules may enable identification of incomplete CCE investigations overlapping with incomplete OCs.ObjectiveThe study aims to investigate relative sensitivity of CCE compared with CTC following incomplete OC, investigate the completion rate when combining results from the incomplete OC and CCE, and develop a forward‐tracking algorithm ensuring a safe completeness of combined investigations.MethodsIn this prospective paired study, patients with indication for CTC following incomplete OC were included for CCE and CTC. Location of CCE abortion and OC abortion were registered to identify complete combined investigations. AI‐based algorithm for localization of capsules were developed reconstructing the passage of the colon.ResultsIn 237 individuals with CTC indication; 105 were included, of which 97 underwent both a CCE and CTC. CCE was complete in 66 (68%). Including CCEs which reached most oral point of incomplete OC, 73 (75%) had complete colonic investigations; 78 (80%) had conclusive investigations. Relative sensitivity of CCE compared with CTC was 2.67 (95% confidence interval (CI) 1.76;4.04) for polyps >5 mm and 1.91 (95% CI 1.18;3.09) for polyps >9 mm. An AI‐based algorithm was developed.ConclusionSensitivity of CCE following incomplete OC was superior to CTC. Introducing and improving algorithm‐based localization of capsule abortion may increase identification of overall complete investigation rates following incomplete OC.ClinicalTrials.gov identifier: NCT02826993
A prospective study of the components of operating room utilisation time for robotic urological surgery in a public teaching hospital setting
Authors: Broe Mark P , Bolger Jarlath M , Norton Sarah , David Silviu , Coffey John C , Giri Subhasis K 
Published: July 2020

Introduction and aim: Although there are several publications on learning curves and patient outcomes in robotic surgery, the literature is lacking in depth analysis of operating room (OR) utilisation time which is an expansive healthcare resource for robotic surgery, especially in urology. Thus, we aimed to study individual operating theatre component times in order to improve performance and efficacy. Method: A cross-specialty robotic-surgery programme was established at our institution in mid-June 2016 using the daVinci Xi dual console robot. A detailed database was established before initiation of the project. The times taken for each element of the preparation and completion of robotic urological procedure were collected by an independent nurse for all the procedures. Primary outcome measures were total OR time, operative time and console time. Secondary outcome measures were port placement time, set-up time and non-operative time. The statistical significance was calculated by using the Student’s t-test, Fisher’s exact test or Wilcoxon matched pairs test where appropriate. Result: Thirty consecutive urological cases were analysed. Mean total OR time, operative time and console time were 320.86 (range 172–485), 235.7 (124–295) and 152.3 min (66–219) respectively. Console time accounted for about less than half of OR time. A significant proportion of OR time was non-operative time (almost one third). After an initial learning curve, set-up time was consistently maintained for most robotic procedures. Conclusions: The findings of this study have three implications for clinical practice. Firstly, console time contributed about half of the OR time. This can be optimised with experience. Secondly robot set-up time is likely to reduce with the experience of the whole team. Finally, non-operative OR time constitute a significant one third of the OR time during robotic surgery. Efforts to reduce non-surgical aspect of OR time will have potential to reduce cost and improve efficiency. Level of Evidence: 4