Miracle-dz/UniFAR-FTUs huggingface dataset:
Fetal birth weight in Africa

SummaryIn 1243 deliveries among Nigerian Igbo women, fetal birth weight was positively associated with increasing maternal age, parity, gestational age, sex ratio, placental weight and umbilical cord length. The lowest Apgar scores and the highest stillbirth rates were associated with higher and lower extremes of birth weight. The longest duration of labour occurred with low birth weight confinements while the shortest occurred with macrosomic babies. Early resort to caesarean section is recommended for labours in which low birth weight babies are anticipated, especially pre term. Selective induction of labour at or just before term, elective caesarean section at term, or early emergency caesarean section in labour are recommended in anticipated macrosomia.
PET-Based Human Dosimetry of the Dimeric αvβ3 Integrin Ligand 68Ga-DOTA-E-[c(RGDfK)]2, a Potential Tracer for Imaging Tumor Angiogenesis

Peptides containing the Arg-Gly-Asp (RGD) sequence have high affinity for αvβ3 integrin receptors overexpressed in tumor cells. The objective of this research was to determine the biodistribution and estimate the radiation dose from 68Ga-DOTA-E-[c(RGDfK)]2 using whole-body PET scans in humans. Methods: Five healthy volunteers (2 women, 3 men; mean age ± SD, 37.2 ± 15.6 y; range, 28–65 y; mean weight, 79.2 ± 21.0 kg; range, 64–115 kg) were included. After intravenous injection of the tracer (198.3 ± 3.3 MBq), 3 successive whole-body (vertex to mid thigh) PET/CT scans at 3 time points (30, 60, and 120 min) were obtained on a 16-slice PET/CT scanner. The subjects did not void the bladder until the entire series of images was completed. Low-dose CT without contrast agent was used for anatomic localization and attenuation correction. OLINDA/EXM software was applied to calculate human radiation doses using the reference adult model. Results: The highest uptake was in the urinary bladder, followed by the liver, kidneys, and spleen, in descending order. The critical organ was the urinary bladder wall. The mean effective doses (all subjects, men and women) were 34.1 ± 4.9, 31.0 ± 2.4, and 20.9 ± 5.2 μSv/MBq for the no-voiding, 2.5-h-voiding, and 1-h-voiding models, respectively. Conclusion: Of particular interest in this research was the visualization of the choroid plexus and ventricular system, which seems to be a characteristic of RGD–dimeric peptides. Measured absorbed doses and effective doses are comparable to other previously reported RGD-based radiopharmaceuticals labeled with 68Ga and 18F. Therefore, 68Ga-DOTA-E-[c(RGDfK)]2 can safely be used for imaging integrin αVβ3 expression.
Urokinase-Type Plasminogen Activator Receptor as a Potential PET Biomarker in Glioblastoma

Glioblastoma is one of the most malignant types of human cancer, and the prognosis is poor. The development and validation of novel molecular imaging biomarkers has the potential to improve tumor detection, grading, risk stratification, and treatment monitoring of gliomas. The aim of this study was to explore the potential of PET imaging of the urokinase-type plasminogen activator receptor (uPAR) in glioblastoma. Methods: The uPAR messenger RNA expression of tumors from 19 glioblastoma patients was analyzed, and a cell culture derived from one of these patients was used to establish an orthotopic xenograft model of glioblastoma. Tumor growth was monitored using bioluminescence imaging. Five to six weeks after inoculation, all mice were scanned with small-animal PET/CT using two new uPAR PET ligands (64Cu-NOTA-AE105 and 68Ga-NOTA-AE105) and, for comparison, O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET). One MRI scan was obtained for each mouse to confirm tumor location. The uPAR specificity of 64Cu-NOTA-AE105 was confirmed by alignment of hematoxylin- and eosin-stained and uPAR immunohistochemistry–stained slides of the brain with the activity distribution as determined using autoradiography. Results: uPAR expression was found in all 19 glioblastoma patient tumors, and high expression of uPAR correlated with decreased overall survival (P = 0.04). Radiolabeling of NOTA-AE105 with 64Cu and 68Ga was straightforward, resulting in a specific activity of approximately 20 GBq/μmol and a radiochemical purity of more than 98% for 64Cu-NOTA-AE105 and more than 97% for 68Ga-NOTA-AE105. High image contrast resulting in clear tumor delineation was found for both 68Ga-NOTA-AE105 and 64Cu-NOTA-AE105. Absolute uptake in tumor was higher for 18F-FET (3.5 ± 0.8 percentage injected dose [%ID]/g) than for 64Cu-NOTA-AE105 (1.2 ± 0.4 %ID/g) or 68Ga-NOTA-AE105 (0.4 ± 0.1 %ID/g). A similar pattern was observed in background brain tissue, where uptake was 1.9 ± 0.1 %ID/g for 18F-fluorothymidine, compared with 0.05 ± 0.01 %ID/g for 68Ga-NOTA-AE105 and 0.11 ± 0.02 %ID/g for 64Cu-NOTA-AE105. The result was a significantly higher tumor-to-background ratio for both 68Ga-NOTA-AE105 (7.6 ± 2.1, P < 0.05) and 64Cu-NOTA-AE105 (10.6 ± 2.3, P < 0.01) than for 18F-FET PET (1.8 ± 0.3). Autoradiography of brain slides confirmed that the accumulation of 64Cu-NOTA-AE105 corresponded well with uPAR-positive cancer cells. Conclusion: On the basis of our translational study, uPAR PET may be a highly promising imaging biomarker for glioblastoma. Further clinical exploration of uPAR PET in glioblastoma is therefore justified.
Young people’s perceptions of mental and physical health in the context of general wellbeing

Objectives: Increased recognition of the need for health education in schools has seen advances in health literacy in recent years. Most of these have focussed on physical health, whereas education about mental health is generally lacking and focussed on tackling stigma rather than promoting good mental health. This study evaluated a pilot intervention designed to improve young people’s understanding of good mental health as a key aspect of wellbeing and explored their perceptions of health and wellbeing. Methods: A total of 218 13-year-olds participated in an interactive workshop about healthy eating, physical activity and mental health. Young people’s understanding and perceptions were assessed through anonymous questionnaires at the start and end of the workshop. Common themes were identified and differences pre- and post-workshop and between girls and boys were analysed. Results: Nearly all young people (100% before, 97% after) perceived being healthy to mean being physically healthy. A minority (8%) also considered mental health to be a component of general health, which increased to 12% after the workshop. Understandings of mental health broadened after the workshop. Interestingly, many mentioned physical health when asked to describe mental health, both before and after the workshop. Girls’ and boys’ responses were similar except for more girls including social relationships in their descriptions of mental health. Conclusion: In this study, we have discovered much about how young people perceive health in general and mental health. Such information is useful for targeting future interventions. Students’ understanding of mental health and its importance to wellbeing can be improved through short combined health interventions.
An audit of documented preoperative evaluation of surgery patients at Universitas Academic Hospital, Bloemfontein

Background: The anaesthetic preoperative evaluation of a patient is the clinical foundation of perioperative patient management, and can potentially reduce operative morbidity and enhance patient outcomes. Generally, anaesthetists complete a standardised preoperative anaesthetic record (PAR) form to improve the quality of the information obtained during their pre-anaesthetic visit. Previous studies reported an unacceptable standard of preoperative assessment recordkeeping. The aim of the study was to audit the documented preoperative anaesthetic evaluations of surgery patients at Universitas Academic Hospital, Bloemfontein. Methods: For this retrospective study a sample of 81 patients, who underwent surgery during May 2013, was randomly selected. The information obtained from the standardised PAR form in each patient’s file was audited using a self-generated checklist, based on the measures and criteria incorporated in the Global Quality Index. Results: Although 100% of files retrieved contained the PAR form, none of these forms were fully completed according to the study checklist used. Criteria where less than 50% were completed correctly included: ‘per os’ status (1.2%), current medication (37.0%), preoperative diagnosis (38.3%), preoperative vital signs (43.2%), American Society of Anesthesiologists Physical Classification (44.4%), airway assessment (45.7%), anaesthetic history and complications (48.2%) and special investigation results (49.4%). Conclusions: The documented preoperative evaluations were incomplete with regard to a number of criteria, as also found in studies conducted at two other national institutions. Training and evaluation regarding completion of preoperative assessment of patients by anaesthetists is needed at Universitas Academic Hospital.
Predictive Value of 99mTc-MAA SPECT for 90Y-Labeled Resin Microsphere Distribution in Radioembolization of Primary and Secondary Hepatic Tumors

This study analyzed the predictive value of 99mTc-labeled macroaggregated albumin (99mTc-MAA) SPECT for 90Y-labeled resin microsphere therapy (radioembolization) by comparing uptake on pretherapeutic 99mTc-MAA SPECT with uptake on posttherapeutic 90Y-bremsstrahlung SPECT. Methods: We included 502 patients (55% male; mean age ± SD, 62 ± 11 y) who underwent radioembolization between 2005 and 2013 because of primary or secondary liver malignancies (colorectal cancer [n = 195, 38.8%], neuroendocrine tumors [n = 77, 15.3%], breast cancer [n = 68, 13.5%], hepatocellular carcinoma [n = 59, 11.8%], cholangiocellular carcinoma [n = 40, 8.0%], or urologic tumors [n = 14, 2.8%]). Manually drawn regions of interest around tumors and adjacent healthy liver tissue for up to 3 lesions per patient on 99mTc-MAA and 90Y-bremsstrahlung scans were used to quantify mean counts per pixel and evaluate the mean tumor-to-background ratio (TBR). Data were given as mean ± SD. Additionally, uptake in lesions on 99mTc-MAA and 90Y-bremsstrahlung scans was graded visually as homogeneously higher than (grade 1), heterogeneously higher than (grade 2), equal to (grade 3), or lower than (grade 4) uptake in normal liver tissue. The Mann–Whitney U test and Spearman correlation were used to evaluate statistically significant differences between 99mTc-MAA and 90Y-bremsstrahlung SPECT. Results: In total, 1,008 lesions were analyzed. Of the 23% (230/1,008) of lesions that had grade 1 uptake on 99mTc-MAA SPECT, 81% (186/230) remained grade 1 after radioembolization whereas 16% (37/230) were grade 2. Of the lesions with grade 2 uptake on 99mTc-MAA SPECT, 16% had grade 1 uptake and 82% grade 2 uptake after radioembolization. Of the lesions with grade 3 uptake, however, 27% had grade 1 uptake and 47% grade 2 uptake after radioembolization. Even among the lesions with grade 4 uptake on 99mTc-MAA SPECT, 21% had grade 1 uptake and 46% grade 2 uptake after radioembolization. The mean TBR on 99mTc-MAA and 90Y-bremsstrahlung SPECT showed a significant, though low, correlation in the total population (r = 0.26; P < 0.001) and in hepatocellular carcinoma (r = 0.4; P < 0.001), cholangiocellular carcinoma (r = 0.3; P < 0.05), breast cancer (r = 0.3; P < 0.001), colorectal cancer (r = 0.2; P < 0.001), and neuroendocrine tumors (r = 0.2; P < 0.01). Conclusion: Although significant for most lesions, the correlation between 99mTc-MAA and 90Y-microsphere mean TBR was low. Classifying uptake into 4 grades revealed that lesions with high uptake on 99mTc-MAA SPECT maintain high uptake within radioembolization. More than 60% of lesions with a pretherapeutically lower uptake than in healthy liver tissue, however, showed high uptake within radioembolization. Patients with low tumor uptake on pretherapeutic 99mTc-MAA imaging should not be excluded from radioembolization.
Safety, Efficacy, and Prognostic Factors After Radioembolization of Hepatic Metastases from Breast Cancer: A Large Single-Center Experience in 81 Patients

The present study evaluated safety, efficacy, and prognostic factors for 90Y-yttrium microsphere radioembolization of unresectable liver metastases from breast cancer. Methods: Eighty-one patients were treated with radioembolization. Acute toxicity was monitored through daily physical examination and serum tests until 3 d after radioembolization; late toxicity was evaluated until 12 wk after radioembolization. Overall survival and response according to 18F-FDG PET (>30% decrease of tracer uptake) and CA15-3 serum level (any decline) were recorded. Pretherapeutic characteristics, including pretreatment history, liver function tests, and PET/CT parameters, were assessed by univariate and subsequent multivariate Cox regression for predicting patient survival. Results: A toxicity grade of 3 or more based on clinical symptoms, bilirubin, ulcer, pancreatitis, ascites, or radioembolization-induced liver disease occurred in 10% or less of patients. Two patients eventually died from radioembolization-induced liver disease. Sequential lobar treatment and absence of prior angiosuppressive therapy were both associated with a lower rate of serious adverse events. On the basis of PET/CA15-3 criteria, 52/61% of patients responded to treatment. Median overall survival after radioembolization was 35 wk (interquartile range, 41 wk). Pretherapeutic tumor burden of the liver greater than 50% or more (P < 0.001; hazard ratio, 5.67; 95% confidence interval, 2.41–13.34) and a transaminase toxicity grade of 2 or more (P = 0.009; hazard ratio, 2.15; 95% confidence interval, 1.21–3.80) independently predicted short survival. Conclusion: Radioembolization for breast cancer liver metastases shows encouraging local response rates with low incidence of serious adverse events, especially in those patients with sequential lobar treatment or without prior angiosuppressive therapy. High hepatic tumor burden and liver transaminase levels at baseline indicate poor outcome.
Age-Related Sex-Specific Changes in Brain Metabolism and Morphology

With a large database, we aimed to evaluate sex-specific distinctive changes in brain glucose metabolism and morphology during normal aging using MRI and 18F-FDG PET. Methods: A total of 963 cognitively healthy adults were included in this study. All subjects completed a medical questionnaire, took the mini-mental state examination, and underwent brain MRI and whole-body 18F-FDG PET. The MR and PET images were statistically analyzed using 3-dimensional stereotactic surface projection. All images were corrected for whole-brain pixel value to identify the brain regions with significant changes, and regions of interest were set up with reference to Brodmann areas. We evaluated morphologic and glucose metabolic changes by cross-sectional analysis. The baseline database consisted of subjects from 30 to 40 y old, and the age-step for comparison was 5-y ranges. We also compared sex-specific differences in MR and PET images in each age group. Results: Regarding age-related changes, in both sexes brain atrophy was observed in the lateral frontal and parietal regions and glucose hypometabolism in the medial frontal regions. There were significant differences in these parameters between the sexes; parallel changes in volume and metabolism were manifested in the medial frontal cortex in men and in the lateral and medial temporal cortex in women. By contrast, metabolism-dominant reductions were manifested in the lateral and medial parietal cortex in men and in the ventrolateral prefrontal cortex, including the Broca area, in women. These differences became insignificant in individuals 66 y or older. Conclusion: Our brain mapping study with a large number of reference human brain data demonstrated age-related parallel changes between morphology and metabolism in the medial frontal regions and sex-specific hypometabolism in the parietal (male) and ventrolateral prefrontal (female) cortices. These findings may suggest an aging vulnerability in sex-specific brain regions: the parietal cortex for visuospatial ability in men and the Broca area for speech processing in women.
Prospective Study Evaluating Na18F PET/CT in Predicting Clinical Outcomes and Survival in Advanced Prostate Cancer

This prospective pilot study evaluated the ability of Na18F PET/CT to detect and monitor bone metastases over time and its correlation with clinical outcomes and survival in advanced prostate cancer. Methods: Sixty prostate cancer patients, including 30 with and 30 without known bone metastases by conventional imaging, underwent Na18F PET/CT at baseline, 6 mo, and 12 mo. Positive lesions were verified on follow-up scans. Changes in SUVs and lesion number were correlated with prostate-specific antigen change, clinical impression, and overall survival. Results: Significant associations included the following: SUV and prostate-specific antigen percentage change at 6 mo (P = 0.014) and 12 mo (P = 0.0005); SUV maximal percentage change from baseline and clinical impression at 6 mo (P = 0.0147) and 6–12 mo (P = 0.0053); SUV change at 6 mo and overall survival (P = 0.018); number of lesions on Na18F PET/CT and clinical impression at baseline (P < 0.0001), 6 mo (P = 0.0078), and 12 mo (P = 0.0029); and number of lesions on Na18F PET/CT per patient at baseline and overall survival (P = 0.017). In an exploratory analysis, paired 99mTc-methylene diphosphonate bone scans (99mTc-BS) were available for 35 patients at baseline, 19 at 6 mo, and 14 at 12 mo (68 scans). Malignant lesions on Na18F PET/CT (n = 57) were classified on 99mTc-BS as malignant 65% of the time, indeterminate 25% of the time, and negative 10% of the time. Additionally, 69% of paired scans showed more lesions on Na18F PET/CT than on 99mTc-BS. Conclusion: The baseline number of malignant lesions and changes in SUV on follow-up Na18F PET/CT significantly correlate with clinical impression and overall survival. Na18F PET/CT detects more bone metastases earlier than 99mTc-BS and enhances detection of new bone disease in high-risk patients.
SNMMI Procedure Standard/EANM Practice Guideline for Amyloid PET Imaging of the Brain 1.0

1University of Utah, Salt Lake City, Utah; 2University of Cologne, Cologne, Germany; 3University Hospital Leipzig, Leipzig, Germany; 4VA Medical Center, University of Michigan, Ann Arbor, Michigan; 5Yale University, New Haven, Connecticut; 6Harborview Medical Center, Seattle, Washington; 7University of Pittsburgh, Pittsburgh, Pennsylvania; 8Mallinckrodt, St. Louis, Missouri; 9Karolinska Institutet, Stockholm, Sweden; 10University Hospital Leipzig, Leipzig, Germany; 11Institute for Neurodegenerative Disorders, New Haven, Connecticut; 12Beth Israel Deaconess Medical Center, Boston, Massachusetts; and 13University Hospital Leuven, Leuven, Belgium
Sympathetic Innervation of Cold-Activated Brown and White Fat in Lean Young Adults

Recent work in rodents has demonstrated that basal activity of the local sympathetic nervous system is critical for maintaining brown adipocyte phenotypes in classic brown adipose tissue (BAT) and white adipose tissue (WAT). Accordingly, we sought to assess the relationship between sympathetic innervation and cold-induced activation of BAT and WAT in lean young adults. Methods: Twenty adult lean normal subjects (10 women and 10 men; mean age ± SD, 23.3 ± 3.8 y; body mass index, 23.7 ± 2.5 kg/m2) underwent 11C-meta-hydroxyephedrin (11C-HED) and 15O-water PET imaging at rest and after exposure to mild cold (16°C) temperature. In addition, 18F-FDG images were obtained during the cold stress condition to assess cold-activated BAT mass. Subjects were divided into 2 groups (high BAT and low BAT) based on the presence of 18F-FDG tracer uptake. Blood flow and 11C-HED retention index (RI, an indirect measure of sympathetic innervation) were calculated from dynamic PET scans at the location of BAT and WAT. Whole-body daily energy expenditure (DEE) during rest and cold stress was measured by indirect calorimetry. Tissue level oxygen consumption (MRO2) was determined and used to calculate the contribution of cold-activated BAT and WAT to daily DEE. Results: 18F-FDG uptake identified subjects with high and low levels of cold-activated BAT mass (high BAT, 96 ± 37 g; low-BAT, 16 ± 4 g). 11C-HED RI under thermoneutral conditions significantly predicted 18F-FDG uptake during cold stress (R2 = 0.68, P < 0.01). In contrast to the significant increase of 11C-HED RI during cold in BAT (2.42 ± 0.85 vs. 3.43 ± 0.93, P = 0.02), cold exposure decreased the 11C-HED RI in WAT (0.44 ± 0.22 vs. 0.41 ± 0.18) as a consequence of decreased perfusion (1.22 ± 0.20 vs. 1.12 ± 0.16 mL/100 g/min). The contribution of WAT to whole-body DEE was approximately 150 kcal/d at rest (149 ± 52 kcal/d), which decreased to approximately 100 kcal/d during cold (102 ± 47 kcal/d). Conclusion: The level of sympathetic innervation, as determined by 11C-HED RI, can predict levels of functional BAT. Overall, blood flow is the best independent predictor of 11C-HED RI and 18F-FDG uptake across thermoneutral and cold conditions. In contrast to BAT, cold stress reduces blood flow and 18F-FDG uptake in subcutaneous WAT, indicating that the physiologic response is to reduce heat loss rather than to generate heat.
Perceptions of Exercise Among School-Aged Children With Asthma:

This grounded theory–driven study explored the predominant categories and concepts involved with perceptions of exercise among school-aged children with asthma. Data came from 13 in-depth interviews with 10 children. Five boys and 5 girls, ages 8 to 12 years, with varying asthma disease severity, participated. In addition, 9 parents completed a health history questionnaire. The process of creating perceptions of exercise was the grounded theory that emerged from the data. The ongoing creation of perceptions of exercise was influenced by 4 predominant categories: perceived benefits, striving for normalcy, exercise influences, and asthma’s influence. Because process is an ongoing occurrence, the 4 predominant categories may influence the creation of exercise perceptions simultaneously, or at different times and in various ways dependent upon the characteristics of the child and his or her unique situations and experiences. Perceived benefits, striving for normalcy, exercise influences, and asthma’s influenc.
89Zr-Bevacizumab PET: Potential Early Indicator of Everolimus Efficacy in Patients with Metastatic Renal Cell Carcinoma

Currently, biomarkers that predict the efficacy of everolimus in metastatic renal cell carcinoma (mRCC) patients are lacking. Everolimus inhibits vascular endothelial growth factor A (VEGF-A) expression. We performed PET scans on mRCC patients with 89Zr-bevacizumab, a VEGF-A–binding antibody tracer. The aims were to determine a change in tumor tracer uptake after the start of everolimus and to explore whether 89Zr-bevacizumab PET can identify patients with early disease progression. Methods: 89Zr-bevacizumab PET was done before and 2 and 6 wk after the start of everolimus, 10 mg/d, in mRCC patients. Routine CT scans were performed at baseline and every 3 mo thereafter. Tumor tracer uptake was quantified using SUVmax. The endpoints were a change in tumor tracer uptake and treatment response on CT after 3 mo. Results: Thirteen patients participated. The median SUVmax of 94 tumor lesions was 7.3 (range, 1.6–59.5). Between patients, median tumor SUVmax varied up to 8-fold. After 2 wk, median SUVmax was 6.3 (1.7–62.3), corresponding to a mean decrease of 9.1% (P < 0.0001). Three patients discontinued everolimus early. At 6 wk, a mean decrease in SUVmax of 23.4% compared with baseline was found in 70 evaluable lesions of 10 patients, with a median SUVmax of 5.4 (1.1–49.4, P < 0.0001). All 10 patients who continued treatment had stable disease at 3 mo. Conclusion: Everolimus decreases 89Zr-bevacizumab tumor uptake. Further studies are warranted to evaluate the predictive value of 89Zr-bevacizumab PET for everolimus antitumor efficacy.