bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge-based iterative reconstructions for imaging of coronary artery stents: first in-vitro experience and comparison of different radiation dose levels and kernel settings
Authors: Hickethier Tilman , Baeßler Bettina , Kroeger Jan Robert , Müller Dirk , Maintz David , Michels Guido , Bunck Alexander C 
Published: August 2019

Background Advanced knowledge-based iterative model reconstructions (IMR) became recently available for routine computed tomography (CT). Using more realistic physical models it promises improved image quality and potential radiation dose reductions, both possibly beneficial for non-invasive assessment of coronary stents. Purpose To evaluate the influence of different IMR settings at different radiation doses on stent lumen visualization in comparison to filtered back projection (FBP) and first-generation (hybrid) iterative reconstruction (HIR). Material and Methods Ten coronary stents in a coronary phantom were examined at four different dose settings (120 kV/125 mAs, 120 kV/75 mAs, 100 kV/125 mAs, 100 kV/75 mAs). Images were reconstructed with stent-specific FBP and HIR kernels and with IMR using CardiacRoutine (CR) and CardiacSharp (CS) settings at three different iteration levels. Image quality was evaluated using established parameters: image noise; in-stent attenuation difference; and visible lumen diameter. Results Image noise was significantly lower in IMR than in corresponding HIR and FBP images. At lower radiation doses, image noise increased significantly except with IMR CR3 and IMR CS3. Visible lumen diameters were significantly larger with IMR CS than with FBP, HIR, and IMR CR. IMR CR showed the smallest attenuation difference, while attenuation was artificially decreased extensively with IMR CS. FBP and HIR showed moderately increased in-stent attenuations. No relevant influence of used radiation doses on visible lumen diameters or attenuation differences was found. Conclusion IMR CR reduces image noise significantly while offering comparable stent-specific image quality in comparison to FBP and HIR and therefore potentially facilitates stent lumen delineation. Utilization of IMR CS for stent evaluation seems unfavorable due to artificial image alterations.
Hypothalamic activation discriminates painful and non-painful initiation of the trigeminal autonomic reflex – an fMRI study
Authors: Möller Maike , Mehnert Jan , May Arne 
Published: August 2019

Background The role of the trigeminal autonomic reflex in headache syndromes, such as cluster headache, is undisputed but sparsely investigated. The aim of the present study was therefore, to identify neural correlates that play a role in the initiation of the trigeminal autonomic reflex. We further aimed to discriminate between components of the reflex that are involved in nociceptive compared to non-nociceptive processing. Methods Kinetic Oscillation Stimulation (KOS) in the left nostril was applied in order to provoke autonomic symptoms (e.g. lacrimation) via the trigeminal autonomic reflex in 26 healthy participants using functional magnetic resonance imaging. Unpleasantness and painfulness were assessed on a visual analog scale (VAS), in order to assess the quality of the stimulus (e.g. pain or no pain). Results During non-painful activation, specific regions involved in the trigeminal autonomic reflex became activated, including several brainstem nuclei but also cerebellar and bilateral insular regions. However, when the input leading to activation of the trigeminal autonomic reflex was perceived as painful, activation of the anterior hypothalamus, the locus coeruleus (LC), the ventral posteriomedial nucleus of the thalamus (VPM), as well as an activation of ipsilateral insular regions, was observed. Conclusion Our results suggest the anterior hypothalamus, besides the thalamus and specific brain stem regions, play a significant role in networks that mediate autonomic output (e.g. lacrimation) following trigeminal input, but only if the trigeminal system is activated by a stimulus comprising a painful component.
Establishing Safe Extra-articular Parameters for Cortical Button Distal Fixation During Ulnar Collateral Ligament Reconstruction
Authors: Hooper Perry O. , Warren Jared , Silko Christopher , Frangiamore Salvatore J. , King Dominic , Farrow Lutul D. , Schickendantz Mark S. 
Published: August 2019

Background: A variety of methods exist for fixation during ulnar collateral ligament (UCL) reconstruction on the ulna for the overhead throwing athlete. Current biomechanical evidence suggests that cortical button fixation may fail at a higher load and under more cycles than interference screw fixation alone, while also minimizing the risk of fracture. A safe angle for placement of this cortical button has not yet been determined. Purpose: To define a safe angle for cortical button deployment during UCL reconstruction to avoid violation of the proximal radioulnar joint (PRUJ). Study Design: Descriptive laboratory study. Methods: Measurements on 100 cadaveric ulna bones, 50 women and 50 men, were obtained referencing the entry point for ulnar fixation, which is 1 cm distal to the ulnar humeral joint line along the medial UCL ridge. Ulnar width at the entry point and distance to the PRUJ were obtained to calculate safe distal angulation, while distance from the entry point to the posterior ulnar crest ulnarly and distance from the PRUJ to the posterior ulnar crest radially were obtained to calculate safe posterior angulation. Ten bony measurements on the same group of specimens were performed by 3 authors to establish an interobserver reliability. Means, quartiles, and outliers were obtained for the calculated angles. Finally, recommended angles of entry were determined to be approximately 1 interquartile range above the upper limit. Results: The mean distal angle of entry that was obtained was 11.32° (SD, ±4.80°; 95% CI, 10.37°-12.27°; P < .001). Three upper limit outliers were discovered: 24.20°, 23.4°, and 21.1°. The mean posterior angle of entry was 40.44° (SD, ±6.18°; 95% CI, 39.22°-41.67°; P < .001). There were no outliers for the posterior angle of entry. Interobserver reliabilities were strong for the 4 measurements. Conclusion: To be safely outside of the PRUJ utilizing a cortical button construct, we recommend 30° distal angulation and 60° posterior angulation for ulnar fixation during UCL reconstruction. Both parameters are 1 quartile above the highest calculated angle of entry. Clinical Relevance: These data define safe parameters for distal fixation during UCL reconstruction and highlight a clear entry point for reference.
Comparison of Fluid Dynamics Variations Between Chimney and Fenestrated Endografts for Pararenal Aneurysms Repair: A Patient Specific Computational Study as Motivation for Clinical Decision-Making
Authors: Moulakakis Konstantinos G. , Kakisis John , Gonidaki Eleni , Lazaris Andreas M. , Tsangaris Sokrates , Geroulakos George , Manopoulos Christos 
Published: August 2019

Background-Aim: Limited data exist concerning the fluid dynamic changes induced by endovascular aortic repair with fenestrated and chimney graft modalities in pararenal aneurysms. We aimed to investigate and compare the wall shear stress (WSS) and flow dynamics for the branch vessels before and after endovascular aortic repair with fenestrated and chimney techniques. Methods: Modeling was done for patient specific pararenal aortic aneurysms employing fenestrated and chimney grafts (Materialise Mimics 10.0) before and after the endovascular procedure, using computed tomography scans of patients. Surface and spatial grids were created using the ANSYS CFD meshing software 2019 R2. Assessment of blood flow, streamlines, and WSS before and after aneurysm repair was performed. Results: The endovascular repair with chimney grafts leaded to a 43% to 53% reduction in perfusion in renal arteries. In fenestrated reconstruction, we observed a 15% reduced perfusion in both renal arteries. In both cases, we observed a decrease in the recirculation phenomena of the aorta after endovascular repair. Concerning the grafts of the renal arteries, we observed in both the transverse and longitudinal axes low WSS regions with simultaneous recirculation of the flow 1 cm distal to the ostium sites in both aortic graft models. High WSS regions appeared in the sites of ostium. Conclusions: We observed reduced renal perfusion in chimney grafts compared to fenestrated grafts, probably caused by the long and kinked characteristics of these devices.
An in-vitro biomechanical assessment of humeral head migration following irreparable rotator cuff tear and subacromial balloon reconstruction
Authors: Reeves Jacob M , Singh Supriya , Langohr G Daniel G , Athwal George S , Johnson James A 
Published: August 2019

Background A resorbable subacromial balloon has been developed to address humeral head migration following posterosuperior rotator cuff tears. The purpose of this experimental assessment was to quantify the effect of balloon augmentation on humeral head position. Methods Eight cadaveric shoulders were subjected to 0°, 30°, 60° and 90° of abduction via a shoulder simulator. The deltoid was activated at 40N, then 80N. The subscapularis and infraspinatus with teres minor were then applied independently and together to create four muscle activation states for each deltoid load. The shoulder was tested intact, torn, then with the balloon. The centre of the humeral head was tracked using active optical markers. Results When the rotator cuff was torn, the humeral head translated superior by 1.4 ± 1 mm overall (P = 0.009). Following balloon augment, the humeral head translated inferiorly by 2 ± 2 mm relative to the intact state (P = 0.042), and significantly more anterior than the intact (3 ± 2 mm; P = 0.005) state. Rotator cuff variation was only significantly different when the balloon was used, with the subscapularis translating the humeral head posteriorly (P = 0.006). Discussion The subacromial balloon inferiorized the humeral head compared to the torn state. Unexpected anterior humeral head translation was attributed to the posterosuperior balloon placement relative to the humeral head.
Compositional analysis of the association between mortality and 24-hour movement behaviour from NHANES
Authors: McGregor Duncan E , Palarea-Albaladejo Javier , Dall Philippa M , del Pozo Cruz Borja , Chastin Sebastien F M 
Published: August 2019

AbstractAimsPrevious prospective studies of the association between mortality and physical activity have generally not fully accounted for the interplay between movement behaviours. A compositional data modelling approach accounts for relative scale and co-dependency in time-use data across physical activity behaviours of the 24-hour day.MethodsA prospective analysis of the National Health and Nutrition Examination Survey 2005–2006 on N = 1468 adults (d = 135 deaths) in ages 50–79 years was undertaken using compositional Cox regression analysis. Daily time spent in sedentary behaviour, light intensity (LIPA) and moderate-to-vigorous physical activity (MVPA) was determined from waist-mounted accelerometer data (Actigraph 7164) and supplemented with self-reported sleep data to determine the daily time-use composition.ResultsThe composition of time spent in sedentary behaviour, LIPA, MVPA and sleep was associated with mortality rate after allowing for age and sex effects (p &lt; 0.001), and remained significant when other lifestyle factors were added (p &lt; 0.001). This was driven primarily by the preponderance of MVPA; however, significant changes are attributable to LIPA relative to sedentary behaviour and sleep, and sedentary behaviour relative to sleep. The final ratio ceased to be statistically significant after incorporating lifestyle factors. The preponderance of MVPA ceased to be statistically significant after incorporating health at outset and physical limitations on movement.ConclusionsAn association is inferred between survival rate and the physical activity composition of the day. The MVPA time share is important, but time spent in LIPA relative to sedentary behaviour and sleep is also a significant factor. Increased preponderance of MVPA may have detrimental associations at higher levels of MVPA.
Discovery of a CD10-negative B-progenitor in human fetal life identifies unique ontogeny-related developmental programs
Authors: O’Byrne Sorcha , Elliott Natalina , Rice Siobhan , Buck Gemma , Fordham Nicholas , Garnett Catherine , Godfrey Laura , Crump Nicholas T. , Wright Gary , Inglott Sarah , Hua Peng , Psaila Bethan , Povinelli Benjamin , Knapp David J. H. F. , Agraz-Doblas Antonio , Bueno Clara , Varela Ignacio , Bennett Phillip , Koohy Hashem , Watt Suzanne M. , Karadimitris Anastasios , Mead Adam J. , Ancliff Phillip , Vyas Paresh , Menendez Pablo , Milne Thomas A. , Roberts Irene , Roy Anindita 
Published: August 2019

AbstractBy comparing fetal and adult B-lymphopoiesis, the authors identify a prepro–B-cell subset in humans that marks the origin of B-cell lineage commitment in utero.
Estimation of contrast-to-noise ratio in CT and CBCT images with varying scan settings in presence of different implant materials
Authors: Kursun-Cakmak Emine Şebnem , Demirturk Kocasarac Husniye , Bayrak Seval , Ustaoğlu Gülbahar , Noujeim Marcel 
Published: August 2019

Objectives: To assess the contrast-to-noise ratio (CNR) of four different types of dental implant materials in CT and cone beam CT (CBCT) images with varying scan settings. Methods: Four different types of implants: zirconium (Zr), titanium (Ti) Grade 4 and 5 and titanium–zirconium (Ti–ZrO2) alloy were placed in a 3% gelatin phantom in a cylindrical plastic container and scanned with two different CT machines (GE Medical systems and Toshiba Medical Systems) and one CBCT machine (I-CAT, Imaging Sciences International) with different voxel sizes of 0.2, 0.25, 0.3 and 0.4 mm. Images were analyzed using ImageJ software with the purpose of estimating the CNR. Results: The CNR obtained from images acquired with CT was lower than the CBCT with all voxel sizes tested. 0.3 and 0.4 mm voxel sizes exhibited the highest CNR (p < 0.05) that gives the best image quality. Among the implant materials tested, titanium Grade 5 has the highest levels of CNR while Zirconium has the lowest (p < 0.05). Conclusions: The optimum protocol for radiographic follow-up in areas near implants on the I-CAT is low-resolution settings (0.3 and 0.4 mm voxel sizes) which gave the highest CNR thus image quality. In presence of Zr implants, an alternative imaging modality (i.e., MRI) may be considered to avoid low-quality images.
Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore
Authors: Ahmed Hina , Manzoor Iram - 
Published: August 2019

Background and Objectives: During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore.
Methods: Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken.
Results: Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p<0.05). These females coming for the antenatal checkup delivered uneventfully by normal vaginal route and preferred government and private hospital for delivery and were vaccinated against Tetanus Toxoid (p<0.05).
Conclusion: The females of child bearing age during the last pregnancy had adequate knowledge about the importance of antenatal care which played an important role in prevention of comorbid conditions like anemia, hypertension, diabetes and risk of abortion. Moreover, they had the perception of importance of institutionalized deliveries, tetanus Toxoid vaccination coverage during pregnancy.
doi: https://doi.org/10.12669/pjms.35.5.1256
How to cite this:Ahmed H, Manzoor I. Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore. Pak J Med Sci. 2019;35(5):1344-1348. doi: https://doi.org/10.12669/pjms.35.5.1256
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Psychological well-being of substance use patient: Role of religious therapy as the treatment
Authors: Bano Zaqia , Naz Iram , Leghari Naeem , Ahmed Ishtiaq 
Published: August 2019

Objective: To evaluate the psychological well-being of substance use patients in comparison of combined religious therapy and pharmacotherapy effects with that of pharmacotherapy effects alone and also to assess the psychological well-being of drug addicts in comparison of demographics characteristics.
Methods: This experimental study was conducted at Department of Psychology, University of Gujrat from July 5th 2016 to July 25th 2017. A sample of 140 drug addicted patients was taken from different hospital. The pre and post-test of experimental and control group was done. Experimental group received standard pharmacotherapy along with religious therapy while patients in the control group only induced standard pharmacotherapy. The effectiveness of therapy was judged on their psychological well-being using California Psychological Inventory Well-being sub-scale.
Results: The results of the study confirmed that there was significant difference in the psychological well-being of control and experimental group (p-value <0.01). After the treatment a difference exists in the means of control and experimental (16.24 and 26.44 respectively) groups. An increase in the psychological well-being of those having religious therapy comparing to those not having religious therapy was observed. Further, comparing the demographic variables the means indicated that treatment affected all age groups, marital status and education level equally. Whereas, in the rural area (mean, 27.04) psychological well-being was better than the urban (mean=26.11) and with the income levels of 21,000 to 30,000 (mean, 27.57) there was more improvement as compared with other income levels (mean, 26.35 and mean, 26.03).
Conclusion: The religious therapy had a significant therapeutic effect on psychological well-being of the substance use patients and it is equally effective for all age group, marital status and educational level.
doi: https://doi.org/10.12669/pjms.35.5.561
How to cite this:Bano Z, Naz I, Leghari N, Ahmed I. Psychological well-being of substance use patient: Role of religious therapy as the treatment. Pak J Med Sci. 2019;35(5):1376-1381. doi: https://doi.org/10.12669/pjms.35.5.561
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus
Authors: Khalid Muhammad , Hanif Muhammad Kashif , Islam Qamar ul , Mehboob Muhammad Asim 
Published: August 2019

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients.
Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed.
Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant.
Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery.
doi: https://doi.org/10.12669/pjms.35.5.596
How to cite this:Khalid M, Hanif MK, Qamar ul Islam, Mehboob MA. Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019;35(5):1366-1369. doi: https://doi.org/10.12669/pjms.35.5.596
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.