Tag: pubmed

Acad Radiol. 2024 Dec 6:S1076-6332(24)00891-2. doi: 10.1016/j.acra.2024.11.046. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Multi-parametric MRI (mpMRI) studies of the body are routinely acquired in clinical practice. However, a standardized naming convention for MRI protocols and series does not exist currently. Conflicts in the series descriptions present in the DICOM headers arise due to myriad MRI scanners from various manufacturers used for imaging, wide variations in imaging practices across institutions, and technologist preferences. These conflicts affect the hanging protocol, which dictates the arrangement of sequences for the reading radiologist. At present, clinician supervision is necessary to ensure that the correct sequence is being read and used for diagnosis. This pilot work seeks to classify five different series in mpMRI studies acquired at the levels of the chest, abdomen, and pelvis.

MATERIALS AND METHODS: First, 2D and 3D classification networks were compared using data acquired by Siemens scanners and the optimal network was identified. Then, its performance was analyzed when trained with different training data quantities. The out-of-distribution (OOD) robustness on data acquired by a Philips scanner was also measured. In addition, the effect of data augmentation on model training was studied. The model was also tested with smaller input volumes through downsampling or cropping. Finally, the model was trained on combined data from both Siemens and Philips scanners to bridge the performance gap between different scanners.

RESULTS: Among 2D and 3D networks of ResNet-50, ResNet-101, DenseNet- 121, and EfficientNet-BN0, the 3D DenseNet-121 ensemble achieved an F₁ score of 99.5% when tested on data from the Siemens scanners. The model performed well on OOD data from the Philips scanner and achieved an F₁ score of 86.5%. There was no statistically significant difference between the models trained with and without data augmentation, and between the models trained with original-sized input and with smaller-sized input. When training the model with combined data, the F₁ score improved to 98.8% for the Philips test set and 99.3% for the Siemens test set respectively.

CONCLUSION: Our pilot work is useful for the classification of MRI sequences in studies acquired at the level of the chest, abdomen, and pelvis. It has the potential for robust automation of hanging protocols and the creation of large-scale data cohorts for pre-clinical research.

PMID:39645459 | DOI:10.1016/j.acra.2024.11.046

Radiography (Lond). 2024 Dec 6:S1078-8174(24)00348-1. doi: 10.1016/j.radi.2024.11.017. Online ahead of print.

ABSTRACT

INTRODUCTION: Simulation based education (SBE) and creatively designed placements are becoming increasingly well established in radiography pedagogy and allow a more efficient use of clinical resources in the training of new radiographers to meet workforce demands. Student radiographers have expressed concern about striking a balance between providing patient centered care and developing their radiographic competency. A co-designed simulated placement was developed with a focus on these two aspects of radiography education aiming to increase the competence and confidence of level 4 students while incorporating patient centred care (PCC) into their practice.

METHODS: A multidisciplinary approach was used to develop a nine-day simulation where activities were scaffolded to help student radiographers to learn, develop and revisit critical skills. The students completed a reflective journal during this placement, the contents of which were thematically analysed.

RESULTS: Students reported a statistically significant improvement in perceived confidence levels related to both radiographic and broad-based skills after simulation sessions. Several additional themes emerged from the reflective data related to communication skills, preparation for practice, perceptions of simulation and an empowered identity as a student radiographer. The students’ reflective diaries also explored students’ perceptions of their roles in the promotion patient centred care and they reported that the addition of realistic stressors inspired by the clinical environment, allowed them to practice dealing with these situations in a safe space.

CONCLUSION: SBE effects students’ perceptions of their competence and confidence in the clinical environment. By providing a safe space, SBE empowers students to respond to some stressors that might be encountered in clinical practice. A carefully scaffolded, multidisciplinary approach to simulated placement is good for confidence and competence building.

IMPLICATIONS FOR PRACTICE: The multi-professional dynamic partnership enabled effective collaboration to deliver a positively evaluated simulation package. Students were motivated to deliver enhanced PCC and had a strong desire to drive change, to guarantee patient safety and high-quality care.

PMID:39645446 | DOI:10.1016/j.radi.2024.11.017

J Sci Med Sport. 2024 Nov 26:S1440-2440(24)00581-4. doi: 10.1016/j.jsams.2024.11.008. Online ahead of print.

ABSTRACT

OBJECTIVES: This study assessed the test-retest reliability of athletic performance tests in a cohort of trained Norwegian female handball players, as well as a sub-analysis of the test-retest reliability for naturally menstruating players.

DESIGN: Eighteen handball players (naturally menstruating: n = 8) completed performance test batteries on three separate occasions.

METHODS: The performance test battery included: a 1-repetition Smith machine back squat, maximal handgrip strength tests, counter-movement jumps, squat jumps, a modified agility T-test, and 15-m linear sprints. For the naturally menstruating players, the testing sessions were completed at three hormonally-distinct points within a menstrual cycle (i.e., early follicular, ovulation, and mid-luteal phases). Reliability statistics (intraclass correlations, standard error of measurement, minimum difference, and coefficient of variation) were calculated for each performance test.

RESULTS: Good-to-excellent test-retest reliability was found for all performance measures (intraclass correlation_2,1 point estimates = 0.82 to 0.94), although max squat jumps were somewhat lower (intraclass correlation_2,1 = 0.75 [95 % confidence interval = 0.55, 0.88]). Subgroup analysis for naturally menstruating players also revealed consistently high reliability values for all tests (intraclass correlation_2,1 point estimate = 0.83 to 0.74).

CONCLUSIONS: These reliability data support the periodic use of selected athletic tests in routine handball assessments, in order to identify changes in sporting performance and monitor player progress. As test reliability does not appear to be influenced by the menstrual cycle phase, coaches and sports practitioners may schedule testing sessions for all athletes, without concern of a confounding effect from menstrual phases.

PMID:39645439 | DOI:10.1016/j.jsams.2024.11.008

J Prosthet Dent. 2024 Dec 6:S0022-3913(24)00743-1. doi: 10.1016/j.prosdent.2024.11.001. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Restoring endodontically treated premolars with noncircular canals presents a significant challenge.

PURPOSE: The purpose of this study was to compare the in vitro fracture resistance and the finite element computational calculation-based stress and safety factor of noncircular-shaped, endodontically treated premolars restored with 5 different prefabricated and custom computer-aided design and computer-aided manufactured post-and-core systems.

MATERIAL AND METHODS: Fifty single-rooted oval-shaped canal maxillary premolars were endodontically treated and post spaces were prepared. The specimens were divided into 5 categories on the basis of the post-and-core system used: Group CN composite resin core without a post, Group CF prefabricated fiber-reinforced composite resin post and composite resin core, Group IC interpenetrating phase composite post-and-core, Group LS lithium disilicate post-and-core, and Group ZR zirconia post-and-core. Lithium disilicate crowns were fabricated and cemented on the 5 different post-and-core systems and subjected to a fracture resistance test using a spherical indenter with static loading. Differences in fracture resistance were evaluated using a 1-way analysis of variance (ANOVA) (α=.05). The 3-dimensional finite element method was used to determine the von Mises stress and safety factors, defined as the ratio of the material’s strength to the von Mises stress experienced, within different compartments of the restored tooth model.

RESULTS: In the in vitro fracture resistance test, the mean ±standard deviation fracture loads of the 5 groups were 2144 ±515 N, 1801 ±600 N, 1690 ±312 N, 1612 ±545 N, and 1487 ±600 N, respectively and were statistically similar (P=.078). All specimens within the ZR group exhibited restorable fractures. In contrast, only 30% of the CN group specimens showed restorable fractures. The incidence of restorable fractures in the CF, IC, and LS groups was 70%, 80%, and 70%, respectively. Although all groups showed similar maximum von Mises stress and stress distribution, safety factors in the models varied significantly. The ceramic crown was the weakest component in the LS and ZR groups, with much lower safety factors than dentin and post-and-core regions. Additionally, the CN group’s wider dentin area had a demonstrably lower safety factor.

CONCLUSIONS: Endodontically treated noncircular-shaped canal premolars showed minimal effect on fracture resistance regardless of post type. However, for teeth with sufficient ferrule, using any post-and-core system significantly reduced the incidence of nonrestorable fractures compared with just a coronal foundation restoration, with custom zirconia offering the potential of achieving a restorable outcome after fracture.

PMID:39645437 | DOI:10.1016/j.prosdent.2024.11.001

J Prosthet Dent. 2024 Dec 6:S0022-3913(24)00777-7. doi: 10.1016/j.prosdent.2024.11.010. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Adhesives play an essential role in restorative dentistry, and Universal Bond Quick (UBQ) has been marketed as having a short application time and long-term resistance to hydrolysis. However, research on its biocompatibility is lacking.

PURPOSE: The purpose of this in vitro study was to compare the biocompatibility of 3 recently introduced universal dental adhesives: UBQ, Single Bond Universal (SBU), and Prime&Bond Universal (PBU), and the popular clinical dental adhesive SE Bond.

MATERIAL AND METHODS: The CCK-8 assay, Calcein AM-PI, Real-time qPCR, DNA damage, and Cell cycle were used to evaluate the biocompatibility of each adhesive. Microleakage of the dental adhesives was also tested through immediate and chemical aging dye penetration in vitro experiments. An ANOVA, t test, Kruskal-Wallis, and Mann-Whitney tests were used for the statistical analyses (α=.05).

RESULTS: The biocompatibility results showed that the inhibitory effect of UBQ and SBU on the proliferation of L929 cells was lower than that of PBU and SE. The proportion of viable cells in the SBU group decreased when the concentration reached 25%, while the proportion of viable cells in the UBQ group remained unchanged at this concentration. Concentrations of PBU and SE of 6.25% caused DNA damage in L929 cells. After chemical aging, the gingival microleakage of specimens in the UBQ and PBU groups was more obvious than that of occlusal microleakage, and the difference was statistically significant (P<.05).

CONCLUSIONS: The biocompatibility of UBQ and SBU was similar and better than that of PBU and SE. However, after aging, the microleakage of the UBQ and PBU was slightly poorer in the thin enamel area near the gingival margin.

PMID:39645435 | DOI:10.1016/j.prosdent.2024.11.010

Farm Hosp. 2024 Dec 6:S1130-6343(24)00158-2. doi: 10.1016/j.farma.2024.09.009. Online ahead of print.

ABSTRACT

BACKGROUND: Polypharmacy, using 6 or more medications, may increase the risk of high medication regimen complexity index (MRCI). We aimed to identify the interrelationship between trajectories of polypharmacy and MRCI.

METHODS: People living with HIV (PLWH) (aged ≥18) were included in from 2010 to 2021. Group-based trajectory modeling (GBTM) was used to identify polypharmacy trajectories and the complexity index of the medication regimen and the dual GBTM to identify their interrelationship.

RESULTS: In total, 789 participants who met the eligibility criteria were included in the study, with a median age of 47 years. GBTM analysis was used to reveal latent polypharmacy trajectories among PLWH. The findings disclosed four distinctive trajectories, with the majority (50.8%) of the PLWH falling into the ‘low increasing’ trajectory. Furthermore, GBTM identified 2 trajectories characterized by high MRCI, and a substantial proportion (80.2%) was assigned to the ‘slightly increasing low’ trajectory group. The study revealed that younger age (<50 years) was a significant predictor of membership in the ‘consistently low’ trajectory, while male gender was associated with the groups of ‘low increasing’ and ‘moderately decreasing’ polypharmacy trajectory.

CONCLUSIONS: GBTM failed to discern a discernible interrelationship between polypharmacy and the high MRCI. It is imperative to undertake future studies within this research domain, considering potential effect modifiers, notably the specific type of concomitant drug. This approach is crucial due to the outcomes induced by both polypharmacy and the magnitude of the pharmacotherapeutic complexity in PLWH.

PMID:39645427 | DOI:10.1016/j.farma.2024.09.009

Med Dosim. 2024 Dec 6:S0958-3947(24)00058-X. doi: 10.1016/j.meddos.2024.10.006. Online ahead of print.

ABSTRACT

This article aims to compare the dosimetric performance between knowledge-based plan (KBP) libraries with and without trade-off (TO) exploration using multicriterial optimization (MCO) for tongue cancer patients. The trade-off optimized library (KBP_MCO) contains a minimal number of constituent plans, whereas two nontrade-off optimized libraries contain a minimal and a large number of treatment plans, respectively. Three KBP libraries were created: KBP_100 and KBP_20, each comprising of 100 and 20 manually optimized plans, respectively. Additionally, another KBP library (KBP_MCO_20) was created by reoptimizing the constituent plans from KBP_20 using MCO techniques. A total of 70 tongue plans were validated through these libraries. Validation plans were evaluated for PTV and organ at risk (OAR) doses. Greenhouse-Geisser analysis (ANOVA) and the Bonferroni procedure (t-test) were used for statistical evaluation. The mean PTVD95% for KBP_100, KBP_20, and KBP_MCO_20 was 98.4% ± 0.3%, 98.9% ± 0.2%, and 98.7% ± 0.2%, respectively. The statistical significance of PTVD95% for the 3 possible combinations-KBP_100 vs KBP_20, KBP_100 vs KBP_MCO_20, and KBP_20 vs KBP_MCO_20 were statistically significant with p < 0.001. Spinal cord doses for KBP_100, KBP_20, and KBP_MCO_20 were 29.6 ± 1.8 Gy, 31.2 ± 2.5 Gy, and 26.8 ± 1.9 Gy, respectively, with p(KBP_100 vs KBP_20) = 0.14, p(KBP_100 vs KBP_MCO_20) = 0.001, and p(KBP_20 vs KBP_MCO_20) < 0.001. Only the first comparison showed a statistically insignificant variation. A trade-off optimized plan library with a minimal number of patients (20) yields better performance for serial structures (spinal cord and brainstem) compared to large manually optimized KBP libraries. For other organs at risk (OARs) and target dose coverage, although statistical differences were significant in most instances, the differences in physical dose were small and probably will not yield any significant clinical differences.

PMID:39645424 | DOI:10.1016/j.meddos.2024.10.006

J Craniomaxillofac Surg. 2024 Dec 6:S1010-5182(24)00329-9. doi: 10.1016/j.jcms.2024.11.019. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare the different outcomes of mandibular distraction osteogenesis (MDO) using computer-aided design and manufacturing (CAD/CAM) surgical guides accompanied by pre-bent distractors versus CAD/CAM surgical guides with commercial distractors.

METHODS: Twenty-eight patients with severe dentofacial deformities secondary to unilateral temporomandibular joint ankylosis (TMJA) were retrospectively enrolled. Ten parameters associated with MDO were measured preoperatively, virtually, and postoperatively. The hard-tissue digital model was reconstructed using Mimics Research 17.0, and imaging data were collected and analyzed using Freeform Plus software 12.0, Geomagic Studio 12.0, and IBM SPSS Version 20.0.

RESULTS: Twenty-eight patients underwent MDO with subsequent adjunctive surgery and were evaluated. Thirteen patients underwent CAD/CAM surgical guides with pre-bent distractors (group A), while fifteen underwent CAD/CAM guides with commercial distractors (group B). Both techniques achieved optimal occlusion and satisfactory appearance. Statistical analysis showed group A demonstrated a more accurate control of vector direction during MDO compared to group B (p < 0.05). Additionally, group A also exhibited a shorter subsequent treatment duration and less relapse compared to group B (p < 0.05).

CONCLUSIONS: CAD/CAM surgical guides with pre-bent distractors can significantly enhance surgical accuracy in controlling the vector direction of MDO for correcting dentofacial deformities secondary to TMJA, leading to a reduction in subsequent treatment duration and occurrence.

PMID:39645421 | DOI:10.1016/j.jcms.2024.11.019

Hipertens Riesgo Vasc. 2024 Dec 6:S1889-1837(24)00111-9. doi: 10.1016/j.hipert.2024.10.003. Online ahead of print.

ABSTRACT

INTRODUCTION: This study investigates the perceptions and knowledge of specialized Argentine physicians regarding renal denervation (RDN) as a treatment for resistant hypertension (R-HT).

METHOD: A survey was conducted among 206 physicians, mainly cardiologists and internists, to assess their awareness and perceptions of RDN. Data were analyzed using descriptive statistics and Spearman’s Rho correlation.

RESULTS: The survey revealed that 83% of the responders are aware of RDN. Despite this high awareness, only 60% believe in its safety, while 33.2% are uncertain, and 6.8% consider it unsafe. Significant correlations were found between the awareness of RDN and perceptions of its efficacy and safety.

CONCLUSIONS: The study highlights a gap between knowledge and confidence in RDN among specialized Argentine physicians. Continuous education and shared decision-making are crucial to improve the adoption of RDN in clinical practice. Long-term safety and efficacy data support RDN as a valuable tool for managing R-HT. Addressing safety concerns through targeted educational initiatives is essential.

PMID:39645419 | DOI:10.1016/j.hipert.2024.10.003

Clin Transl Med. 2024 Dec;14(12):e70119. doi: 10.1002/ctm2.70119.

NO ABSTRACT

PMID:39644148 | DOI:10.1002/ctm2.70119