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Ítem Cognitive behavioral therapy reduces illness perceptions and anxiety symptoms in patients with unruptured intracranial aneurysm(Churchill Livingstone, 2020-01-01) Lemos M.; Román-Calderón J.P.; Restrepo J.; Gómez-Hoyos J.F.; Jimenez C.M.The main purpose of this study was to assess the relation between cognitive behavioral therapy and possible changes in illness perceptions and anxiety in patients diagnosed with unruptured intracranial aneurysm. An observational study of an intervention with 67 patients with an unruptured intracranial aneurysm from two medical centers in a Colombian city (n = 35 on the intervention group) was carried out. To assess changes, measurements were taken at baseline and at one-year follow-up with the Beck Anxiety Inventory and the Illness Perception Questionnaire, brief version, taking into account the importance of perceptions in the process of adjusting to illness and acquiring healthy life habits. Hypotheses were tested by a structural model. The results obtained from this study showed that illness perceptions were related to anxiety levels at both time points; however, the relations were stronger before cognitive behavioral therapy (ßt0 = 0.61, p < 0.01; ßt1 = 0.37, p < 0.01). Cognitive behavioral therapy was found to be a moderator of changes in both illness perceptions and anxiety at the time of follow-up (ß = -0.31, p < 0.01; ß = -0.26, p < 0.01). The structural model suggests that cognitive behavioral therapy is associated with less anxiety (ß = -0.17, p < 0.05) and better illness perceptions (ß = -0.35, p < 0.01) in patients diagnosed with unruptured intracranial aneurysms. © 2020 Elsevier LtdÍtem Cognitive behavioral therapy reduces illness perceptions and anxiety symptoms in patients with unruptured intracranial aneurysm(Churchill Livingstone, 2020-01-01) Lemos M.; Román-Calderón J.P.; Restrepo J.; Gómez-Hoyos J.F.; Jimenez C.M.; Lemos M.; Román-Calderón J.P.; Restrepo J.; Gómez-Hoyos J.F.; Jimenez C.M.; Universidad EAFIT. Departamento de Humanidades; Estudios en PsicologíaThe main purpose of this study was to assess the relation between cognitive behavioral therapy and possible changes in illness perceptions and anxiety in patients diagnosed with unruptured intracranial aneurysm. An observational study of an intervention with 67 patients with an unruptured intracranial aneurysm from two medical centers in a Colombian city (n = 35 on the intervention group) was carried out. To assess changes, measurements were taken at baseline and at one-year follow-up with the Beck Anxiety Inventory and the Illness Perception Questionnaire, brief version, taking into account the importance of perceptions in the process of adjusting to illness and acquiring healthy life habits. Hypotheses were tested by a structural model. The results obtained from this study showed that illness perceptions were related to anxiety levels at both time points; however, the relations were stronger before cognitive behavioral therapy (ßt0 = 0.61, p < 0.01; ßt1 = 0.37, p < 0.01). Cognitive behavioral therapy was found to be a moderator of changes in both illness perceptions and anxiety at the time of follow-up (ß = -0.31, p < 0.01; ß = -0.26, p < 0.01). The structural model suggests that cognitive behavioral therapy is associated with less anxiety (ß = -0.17, p < 0.05) and better illness perceptions (ß = -0.35, p < 0.01) in patients diagnosed with unruptured intracranial aneurysms. © 2020 Elsevier LtdÍtem Creation of a three-dimensional model of the mandible and the TMJ in vivo by means of the finite element method.(Quintessenz Verlags GmbH, 2002-04-01) Castaño MC; Zapata U; Pedroza A; Jaramillo JD; Roldán S; Universidad EAFIT. Departamento de Ingeniería Mecánica; Bioingeniería GIB (CES – EAFIT)The aim of this study was to develop a three-dimensional finite element model of the mandible, including its TMJ. The model consisted of 7942 nodes and 41,010 elements, which were obtained from a convergence test, done to minimize the result error. It included cancellous and cortical bone, periodontal ligament, masticatory muscles (masseters, temporalis, lateral and internal pterygoids), teeth and the articular disk. All characteristics such as dental, mandibular, and muscle geometry were obtained from a computerized tomography (CT) of a living person. CT sections were scanned and digitized with a CAD software program. After images were adequately assembled, a vertical tracing was done which allowed the definition of a three-dimensional mesh. Modeling of teeth was carried out independently and the periodontal ligament was later included, limiting the alveolar area. Muscles were modeled based on flat-scale photographs and total muscle force was distributed in multiple vectors. The articular disk was generated having 2 mm of thickness with the combination of spring-type (axial stiffness) and gap-type (contact) elements. The model was then analyzed with finite element method (FEM) software where a mesh was generated and values for Poisson's ratio, elasticity, and shear modulus were assigned. These were orthotropic for cancellous and cortical bone, and isotropic for dentin, periodontal ligament, articular disk, and temporal bone. The boundary conditions were defined restricting the nodes on the periphery of the temporal bone. It was therefore possible to generate a three-dimensional finite element model based on information obtained in vivo.Ítem Indentation damage and crack repair in human enamel.(ELSEVIER SCIENCE BV, 2013-05-01) Rivera C; Arola D; Ossa A; Rivera C; Arola D; Ossa A; Universidad EAFIT. Departamento de Ingeniería de Producción; Materiales de IngenieríaTooth enamel is the hardest and most highly mineralized tissue in the human body. While there have been a number of studies aimed at understanding the hardness and crack growth resistance behavior of this tissue, no study has evaluated if cracks in this tissue undergo repair. In this investigation the crack repair characteristics of young human enamel were evaluated as a function of patient gender and as a function of the distance from the Dentin Enamel Junction (DEJ). Cracks were introduced via microindentation along the prism direction and evaluated as a function of time after the indentation. Microscopic observations indicated that the repair of cracks began immediately after crack initiation and reaches saturation after approximately 48 h. During this process he crack length decreased up to 10% of the initial length, and the largest degree of reduction occurred in the deep enamel, nearest the DEJ. In addition, it was found that the degree of repair was significantly greater in the enamel of female patients.Ítem Material properties of the skull layers of the primate parietal bone: A single-subject study(Public Library of Science, 2020-01-01) Zapata, U.; Wang, Q.; Universidad EAFIT. Departamento de Ingeniería Mecánica; Bioingeniería GIB (CES – EAFIT)The outer cortical table of the parietal bone has been commonly used as a calvarial bone graft site for the craniofacial reconstruction. However, little is known about how removing the outer table may affect the function and structure of the inner table, and how the knowledge of the biomechanics and material properties of cortical bones will help the calvarial graft to better integrate into the biological and mechanical functions of its surrounding native tissues. In this study, it was hypothesized that there were significant differences in both density and material properties between inner and outer cortical plates in cranial bones. Twelve cylindrical specimens, including inner-outer layers, of cortical parietal bone of a female baboon were collected. Cortical thicknesses and densities were measured, and elastic properties were assessed using an ultrasonic technique. Results demonstrated remarkable difference in both thickness (t = 8.248, p .0.05) and density (t = 4.926, p.0.05) between inner and outer cortical paired samples. Orthotropic characteristics of the cortical plates were detected as well, these findings suggest that there are differences in biomechanical properties between two surfaces of cranial bones at both tissue and organ levels. How these differences are linked to the stress environments of the inner and outer cranial cortical layers awaits further studies. Further study will greatly enhance our ability to address questions derived from both morphological and craniofacial medicine fields about the development and biomechanics of craniofacial skeletons. © 2020 Zapata, Wang.Ítem Material properties of the skull layers of the primate parietal bone: A single-subject study(Public Library of Science, 2020-01-01) Zapata, U.; Wang, Q.; Zapata, U.; Wang, Q.; Universidad EAFIT. Departamento de Ingeniería de Producción; Materiales de IngenieríaThe outer cortical table of the parietal bone has been commonly used as a calvarial bone graft site for the craniofacial reconstruction. However, little is known about how removing the outer table may affect the function and structure of the inner table, and how the knowledge of the biomechanics and material properties of cortical bones will help the calvarial graft to better integrate into the biological and mechanical functions of its surrounding native tissues. In this study, it was hypothesized that there were significant differences in both density and material properties between inner and outer cortical plates in cranial bones. Twelve cylindrical specimens, including inner-outer layers, of cortical parietal bone of a female baboon were collected. Cortical thicknesses and densities were measured, and elastic properties were assessed using an ultrasonic technique. Results demonstrated remarkable difference in both thickness (t = 8.248, p .0.05) and density (t = 4.926, p.0.05) between inner and outer cortical paired samples. Orthotropic characteristics of the cortical plates were detected as well, these findings suggest that there are differences in biomechanical properties between two surfaces of cranial bones at both tissue and organ levels. How these differences are linked to the stress environments of the inner and outer cranial cortical layers awaits further studies. Further study will greatly enhance our ability to address questions derived from both morphological and craniofacial medicine fields about the development and biomechanics of craniofacial skeletons. © 2020 Zapata, Wang.Ítem Personality and anxiety are related to health-related quality of life in unruptured intracranial aneurysm patients selected for non-intervention: A cross sectional study(Public Library of Science, 2020-03-12) Lemos, M.; Roman, J.Background Personality traits and mental health problems have been previously reported in unruptured intracranial aneurysm (UIA) patients; however, few studies have clarified the relations between these variables and health-related quality of life (HRQoL). This study was designed to characterize the personality traits, HRQoL and mental health of patients with UIA and to evaluate whether personality has an influence on HRQoL and whether this is mediated by the patients’ emotional symptoms. Methods Sixty-three patients with UIAs (mean age 62.6 years, 83.9% women) answered questionnaires for depression, anxiety, HRQoL and personality traits between June 2016 and May 2019. Results Eight percent of the sample had depression, and 27.4% had anxiety. Participants showed high levels of responsibility, kindness and neuroticism and low levels of extraversion and openness. HRQoL scores were normal compared with the Colombian population. Structural equation analysis showed that patients’ HRQoL was negatively affected by anxiety levels and that the latter are associated with the patient’s personality, where neuroticism is directly associated with symptomatology and inversely associated with extraversion. Conclusions The results of this study showed the importance of personality and emotional symptoms in the HRQoL of UIA patients. These results are important for developing strategies for psychological counseling in patients with UIAs. © 2020 Lemos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Ítem Personality and anxiety are related to health-related quality of life in unruptured intracranial aneurysm patients selected for non-intervention: A cross sectional study(Public Library of Science, 2020-03-12) Lemos, M.; Roman, J.; Lemos, M.; Roman, J.; Universidad EAFIT. Departamento de Humanidades; Estudios en PsicologíaBackground Personality traits and mental health problems have been previously reported in unruptured intracranial aneurysm (UIA) patients; however, few studies have clarified the relations between these variables and health-related quality of life (HRQoL). This study was designed to characterize the personality traits, HRQoL and mental health of patients with UIA and to evaluate whether personality has an influence on HRQoL and whether this is mediated by the patients’ emotional symptoms. Methods Sixty-three patients with UIAs (mean age 62.6 years, 83.9% women) answered questionnaires for depression, anxiety, HRQoL and personality traits between June 2016 and May 2019. Results Eight percent of the sample had depression, and 27.4% had anxiety. Participants showed high levels of responsibility, kindness and neuroticism and low levels of extraversion and openness. HRQoL scores were normal compared with the Colombian population. Structural equation analysis showed that patients’ HRQoL was negatively affected by anxiety levels and that the latter are associated with the patient’s personality, where neuroticism is directly associated with symptomatology and inversely associated with extraversion. Conclusions The results of this study showed the importance of personality and emotional symptoms in the HRQoL of UIA patients. These results are important for developing strategies for psychological counseling in patients with UIAs. © 2020 Lemos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Ítem The Techniques for Overcoming Depression Questionnaire: Mokken Scale Analysis, Reliability, and Concurrent Validity in Depressed Cardiac Patients(SPRINGER/PLENUM PUBLISHERS, 2017-02-01) Freedland, K.E.; Lemos, M.; Doyle, F.; Steinmeyer, B.C.; Csik, I.; Carney, R.M.; Universidad EAFIT. Departamento de Ingeniería Mecánica; Bioingeniería GIB (CES – EAFIT)The Techniques for Overcoming Depression (TOD) questionnaire assesses the frequency with which patients being treated for depression use cognitive-behavioral techniques in daily life. This study examined its latent structure, reliability and concurrent validity in depressed cardiac patients. The TOD was administered at the initial and final treatment sessions in three trials of cognitive behavior therapy (CBT) (n = 260) for depression in cardiac patients. Mokken scaling was used to determine its dimensionality. The TOD is unidimensional in depressed cardiac patients, both at the initial evaluation (H = .46) and the end of treatment (H = .47). It is sensitive to change and the total score correlates with therapist ratings of the patient’s socialization to CBT (r = .40, p < .05), homework adherence (r = .36, p < .05), and use of cognitive-behavioral techniques (r = .51, p < .01). TOD scores were associated with post-treatment depression scores in two of the trials (p < .01 in both analyses). The TOD is a unidimensional, reliable, valid, and clinically informative measure of self-reported use of cognitive-behavioral techniques for overcoming depression in cardiac patients. Studies of the TOD in other depressed patient populations are needed. © 2016, Springer Science+Business Media New York.Ítem The Techniques for Overcoming Depression Questionnaire: Mokken Scale Analysis, Reliability, and Concurrent Validity in Depressed Cardiac Patients(SPRINGER/PLENUM PUBLISHERS, 2017-02-01) Freedland, K.E.; Lemos, M.; Doyle, F.; Steinmeyer, B.C.; Csik, I.; Carney, R.M.; Freedland, K.E.; Lemos, M.; Doyle, F.; Steinmeyer, B.C.; Csik, I.; Carney, R.M.; Universidad EAFIT. Departamento de Humanidades; Estudios en PsicologíaThe Techniques for Overcoming Depression (TOD) questionnaire assesses the frequency with which patients being treated for depression use cognitive-behavioral techniques in daily life. This study examined its latent structure, reliability and concurrent validity in depressed cardiac patients. The TOD was administered at the initial and final treatment sessions in three trials of cognitive behavior therapy (CBT) (n = 260) for depression in cardiac patients. Mokken scaling was used to determine its dimensionality. The TOD is unidimensional in depressed cardiac patients, both at the initial evaluation (H = .46) and the end of treatment (H = .47). It is sensitive to change and the total score correlates with therapist ratings of the patient’s socialization to CBT (r = .40, p < .05), homework adherence (r = .36, p < .05), and use of cognitive-behavioral techniques (r = .51, p < .01). TOD scores were associated with post-treatment depression scores in two of the trials (p < .01 in both analyses). The TOD is a unidimensional, reliable, valid, and clinically informative measure of self-reported use of cognitive-behavioral techniques for overcoming depression in cardiac patients. Studies of the TOD in other depressed patient populations are needed. © 2016, Springer Science+Business Media New York.Ítem Time dependent deformation behavior of dentin(PERGAMON-ELSEVIER SCIENCE LTD, 2017-04-01) Montoya C; Arola D; Ossa EA; Montoya C; Arola D; Ossa EA; Universidad EAFIT. Departamento de Ingeniería de Producción; Materiales de IngenieríaObjective The viscoelastic behavior of dentin and its ability to undergo time dependent deformation are considered to be important to oral functions and its capacity to resist fracture. There are spatial variations in the microstructure of dentin within the crown, which could be important to the viscous behavior. However, a spatially resolved description for the viscoelastic behavior of coronal dentin has not been reported. Methods In this investigation spherical indentations were made in three regions of coronal dentin including the outer, middle and inner regions. Power law relations were developed to quantitatively describe the stress-strain responses of the tissue. Results Results showed that the deformation behavior was strongly dependent on the composition (mineral to collagen ratio) and microstructure (tubule density), which contributed to an increase in the rate of viscous deformation with increasing proximity to the pulp. Conclusions A model accounting for spatial variations in composition and microstructure was developed to describe the steady-state time dependent deformation behavior of coronal dentin, and a good agreement was found with the experimental results. © 2017 Elsevier Ltd