bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Local Radiation Injury in the Creation of Lichtenburg Art
Authors: Janes Lindsay A , Iqbal Uswa , Vercruysse Gary A
Published: January 2024

Despite the fact that there may be no immediate outward signs of tissue destruction, the ultimate damage caused by radiation exposure is immediate and may be predicted based on the source, length of exposure, and type of tissue to which the radiation is exposed. Although predictable, difficulty in caring for these patients stems from the multiple sources of radiation to which people may be exposed, the various parts of the body exposed, the dose involved, the rarity of the condition, and a general lack of knowledge on the part of treating physicians. Due to these factors, there is significant variation in treatment recommendations. Additionally, knowledge about how to treat these injuries is limited and often very difficult to access, even among healthcare professionals. This report highlights the first known case of localized radiation injury secondary to the utilization of a linear accelerator to generate Lichtenberg art. In this case, an accident occurred while working with a retired accelerator and led to severe local radiation injury to this patient’s bilateral hands, prompting a series of searches and inquiries as to the next best step in management. From consulting clinicians at the Centers for Disease Control and Prevention (CDC) who are experts in managing radiation injury to the eventual need for digit amputation, this case highlights the profound lack of knowledge and accessible resources for clinicians and patients facing localized radiation injury. This is a noninterventional observation case report without the requirement of ethical approval.
Beyond traditional therapies: clinical significance of complex molecular profiling in patients with advanced solid tumours—results from a Turkish multi-centre study
Authors: Olmez Omer Fatih , Bilici Ahmet , Er Ozlem , Bisgin Atil , Sevinc Alper , Akman Tulay , Uslu Ruchan , Mandel Nil Molinas , Yalcin Suayib , Teomete Mehmet , Gorumlu Gurbuz , Demir Atakan , Namal Esat , Alici Suleyman , Selcukbiricik Fatih , Bavbek Sevil , Paksoy Fatma , Basaran Gul , Ozer Leyla , Sener Nur , Harputluoglu Hakan ,   TUMPACT Study Group
Published: January 2024

Objective

The objective of this multi-centre, real-world study was to examine the potential influence of comprehensive molecular profiling on the development of treatment decisions or adjustments for patients with advanced solid malignancies. We then evaluated the impact of these informed choices on patient treatment outcomes.

Methods

The study encompassed 234 adult patients (mean age: 52.7 ± 14.3 years, 54.7% women) who were diagnosed with solid tumours at 21 different medical centres in Turkey. Remarkably, 67.9% of the patients exhibited metastasis at the time of diagnosis. We utilized an OncoDNA (Gosselies, Belgium) platform (OncoDEEP) integrating next-generation sequencing with additional tests to harvest complex molecular profiling data. The results were analyzed in relation with two specific outcomes: (i) the impact on therapeutic decisions, including formulation or modifications, and (ii) associated treatment response.

Results

Out of the 228 patients with final molecular profiling results, 118 (50.4%) had their treatment modified, whilst the remaining 110 (47.0%) did not. The response rates were comparable, with 3.9 versus 3.4% for complete response, 13.6 versus 29.3% for partial response, 66.9 versus 51.7% for progressive disease and 15.5 versus 15.5% for stable disease for treatments informed and not informed by complex molecular profiling, respectively (P = 0.16).

Conclusion

Our real-world findings highlight the significant impact of complex molecular profiling on the treatment decisions made by oncologists for a substantial portion of patients with advanced solid tumours. Regrettably, no significant advantage was detected in terms of treatment response or disease control rates.
Ontogenetic variability in the diel activity pattern of the marine gastropodCassis cornuta(Mollusca: Cassidae)
Authors: Calle Lala Grace , Cabaitan Patrick C , Sayco Sherry Lyn G , Tan Shau Hwai , Conaco Cecilia
Published: January 2024

Examining activity patterns is essential in understanding gastropod feeding and movement ecology. However, the diel activity patterns of large-bodied gastropods, such as Cassis cornuta, remain poorly studied. Here, we conducted outdoor hatchery-based experiments to examine the diel activity patterns of C. cornuta adults and juveniles under natural sunlight and photoperiod. Activities of C. cornuta, such as crawling, hunting, feeding, burrowing and resting on the substratum, were examined every hour for 3 days. Although most individuals were inactive for a greater part of the observation period, active behaviours were recorded for some individuals during both daytime and nighttime, suggesting that C. cornuta is cathemeral, as supported by a nonsignificant result from a Rayleigh's test of uniformity. A higher proportion of adult and juvenile C. cornuta were inactive, either burrowed or resting on the substratum, during the 24-h period. Peak activity time for juveniles started at 20:00, with up to 50% of individuals active, while peak activity time for adults started at 21:00, with up to 20% of active individuals. Adults spent more time resting aboveground, whereas juveniles spent more time burrowed under the sand when not feeding. Juveniles hunted more frequently and spent more time feeding compared to adults. Additionally, juveniles crawled faster and were more successful in capturing sea urchins than adults. The information on variability in the diel activity patterns and movement rates between adult and juvenile C. cornuta would allow further demographic studies, and provide insights into possible conservation strategies for this species.
Volunteer officers’ experiences in law enforcement work in Malaysia and the USA
Authors: Cheah Phaik Kin , Britton Iain , Wolf Ross , Tey Tiny Chiu Yuen , Dobrin Adam , Unnithan N Prabha
Published: January 2024

Volunteer corps serve as vital components of law enforcement agencies worldwide, significantly contributing to community safety and well-being. This study probes the experiences of police volunteers from Malaysia and the United States of America serving as sworn officers vested with a defined sphere of legal policing authority. A rich, descriptive qualitative approach underpinned our exploration, with semi-structured interviews conducted with 18 volunteer officers – nine from each country. Three salient themes were generated: rewarding, challenging, and empowering. This study unveils a blend of shared and unique experiences in law enforcement work among volunteer officers across the two countries, shedding light on the transformative personal impact of volunteer policing. Unearthing a seldom explored dimension of volunteer law enforcement, this study offers a novel, comparative insight into the experiences of volunteer police officers. It thereby provides valuable input on an international scale to enhance our understanding of this crucial aspect of community safety.
Caring for patients with life-threatening hemoptysis
Authors: Chen Leon , Fasolka Brian
Published: January 2024

Life-threatening hemoptysis (formerly called massive hemoptysis), though relatively uncommon, imposes significant mortality risks. This article discusses the etiology, clinical presentation, assessment, treatment, and nursing interventions to promote effective clinical management of patients with this condition.
Trajectories of Opioid Misuse and Opioid Use Disorder Among Adults With Chronic Pain and HIV: An Observational Study
Authors: Perez Hector R. , Deng Yuting , Zhang Chenshu , Groeger Justina L. , Glenn Matthew , Richard Emma , Pazmino Ariana , De La Cruz Ana Alicia , Prinz Melanie , Starrels Joanna L.
Published: January 2024

Objectives

In a longitudinal cohort of patients with HIV and chronic pain, we sought to (1) identify trajectories of opioid misuse and opioid use disorder (OUD) symptoms, and to (2) determine whether prescription opioid dose was associated with symptom trajectories.

Methods

We leveraged an existing 12-month longitudinal observational study, Project PIMENTO, of persons living with HIV and chronic pain who received care at a hospital system in the Bronx, New York. A quota sampling strategy was used to ensure variability of prescribed opioid use in the recruited sample. Research interviews occurred quarterly and assessed opioid behaviors and criteria for OUD. To describe symptom trajectories, we conducted 2 separate longitudinal latent class analyses to group participants into (1) opioid misuse and (2) OUD trajectories. Finally, we used multinomial logistic regression models to examine the relationship between baseline prescription opioid dose and symptom trajectories.

Results

Of 148 total participants, at baseline 63 (42.6%) had an active opioid prescription, 69 (46.6%) met the criteria for current opioid misuse, and 44 (29.7%) met the criteria for current OUD. We found 3 opioid misuse and 3 OUD symptom trajectories, none of which showed worsened symptoms over time. In addition, we found that higher prescription opioid dose at baseline was associated with a greater OUD symptom trajectory.

Conclusions

Opioid misuse and OUD were common but stable or decreasing over time. Although these results are reassuring, our findings also support prior studies that high-dose opioid therapy is associated with greater OUD symptoms.
Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study
Authors: Ramirez Norman , Deliz-Jimenez David , Torres-Lugo Norberto , Olivella Gerardo , Cahill Patrick , Gupta Purnendu , Garg Sumeet , Pahys Joshua , Mac-Thiong Jean-Marc
Published: January 2024

Background:

Back pain, as a clinical marker in scoliosis, has been associated with underlying pathology for many years, warranting further magnetic resonance imaging (MRI). Failures of segmentation, mixed defects, female gender, rib anomalies, congenital thoracic anomalies, and neurocutaneous markers are known risk factors for abnormal MRI pathology findings in patients with congenital early-onset scoliosis (Congenital-EOS). Yet, back pain has not been evaluated as a risk factor for underlying MRI pathology in patients with Congenital-EOS. This study aimed to assess back pain as a risk factor for underlying pathology in Congenital-EOS using MRI as a diagnostic tool.

Methods:

A retrospective database review from the Pediatric Spine Study Group (PSSG) of all patients with Congenital-EOS who reported a back pain complaint, and underwent a spinal MRI study before surgical intervention was performed. Patients were divided into those with an underlying MRI pathology and those without. Demographics were compared between groups.

Results:

From a total of 2355 patients with Congenital-EOS registered in PSSG, 107 patients reported a back pain complaint, with only 42 patients fulfilling the inclusion criteria (being evaluated with an MRI study). Overall group mean age was 8.1±4.5 years, with 25 of the 42 patients (60%) being females. Twenty-four of 42 patients (57%) had a comorbidity reported such as cardiac problems, musculoskeletal complaints, neurological deficits/myelopathy, gastrointestinal symptoms, developmental delay, respiratory problems, craniofacial abnormalities, and chromosomal conditions. An underlying MRI pathology was found in 21 of 42 patients with Congenital-EOS (50%) with back pain. The underlying MRI pathologies found were tethered spinal cord, spinal canal stenosis, syringomyelia, Arnold-Chiari malformation, and arachnoid cyst.

Conclusions:

Abnormal MRI findings are common in patients with Congenital-EOS who report back pain. Gender, age, major coronal curve angle, thoracic or lumbar predominance deformity, and comorbidities type or amount were not associated with abnormal MRI findings.

Level of Evidence:

Level II—Prognostic study.
Treatment of Delbet II/III Pediatric Femoral Neck Fractures With Proximal Femoral Locking Plate Versus Cannulated Screws
Authors: Haider Shamrez , Harris Timothy J. , Turner Alexander C. , Podeszwa David A. , Hartman Courtney A. , Morris William Z.
Published: January 2024

Introduction:

Complications following operative treatment of pediatric femoral neck fractures include nonunion, coxa vara, and avascular necrosis (AVN). Proximal femoral locking plates (PFLPs) provide a fixed-angle construct that may reduce the rates of coxa vara, but their use in pediatric femoral neck fractures has not been studied. The purpose of this study was to evaluate rates of union, coxa vara, and AVN in traumatic pediatric femoral neck fractures treated with PFLP or cannulated screws (CS).

Methods:

We retrospectively reviewed all traumatic, nonpathologic Delbet II/III femoral neck fractures in patients below 18 years of age treated with PFLP or CS. All cases had ≥6 months of radiographic follow-up to evaluate for osseous union and AVN. Changes in proximal femoral alignment were determined by measuring injured and contralateral femoral neck-shaft angle and articulotrochanteric distance (ATD) between 6 and 12 months postoperatively.

Results:

Forty-two patients were identified with mean age at surgery of 10.7±2.9 years (range 3.3 to 16.3 years) and mean follow-up of 36±27 months. Sixteen patients (38%) underwent PFLP fixation, whereas 26 patients (62%) underwent CS fixation. When compared with the CS cohort, the PFLP cohort had a greater proportion of males (87.5% vs. 50%, P=0.02) and Delbet III fractures (68.8% vs. 15.4%, P<0.001). There was no difference between PFLP and CS cohorts with respect to rates of union (81% vs. 88%, respectively, P=0.66), AVN (25% vs. 35%, respectively, P=0.73), or secondary surgery (62% vs 62%, P=0.95). There was no significant difference in neck-shaft angle between injured and contralateral hips in those patients treated with PFLP (P=0.93) or CS (P=0.16). However, the ATD was significantly decreased in hips treated with CS compared with the contralateral hip (18.4±4.6 vs. 23.3±4.2 mm, P=0.001), with no significant difference in the PFLP group (P=0.57).

Conclusions:

This study suggests that the use of a PFLP in Delbet II/III femoral neck fractures does not appear to significantly increase nonunion rates or AVN and maintains anatomic ATD when compared with screw fixation.

Level of Evidence:

Level III—therapeutic study.
Ketamine for Primary Analgosedation in Critically Ill Surgery and Trauma Patients Requiring Mechanical Ventilation
Authors: Peters Bradley J. , Kooda Kirstin J. , Brown Caitlin S. , Miles Todd M. , Kangas Corrie A. , Mara Kristin C. , Rivera Mariela , Skrupky Lee P.
Published: January 2024

OBJECTIVES:

Evaluate effectiveness and safety outcomes associated with the use of ketamine for primary analgosedation in the surgical/trauma ICU setting.

DESIGN:

Retrospective cohort study.

SETTING:

Academic medical center in Minnesota.

PATIENTS:

Patients admitted to the surgical ICU between 2015 and 2019 requiring mechanical ventilation and meeting one of three definitions for ketamine primary analgosedation were included: 1) no concomitant opioid infusion, 2) ketamine monotherapy for greater than or equal to 6 hours with subsequent opioid infusion, or 3) ketamine initiated concomitantly or within 4 hours of opioid and total opioid duration less than 4 hours.

INTERVENTIONS:

None.

MEASUREMENTS:

Use of ketamine, analgesics, and sedatives were evaluated. Pain, sedation, and delirium assessments immediately before and during ketamine infusion were collected and compared with reported goals. Concomitant analgesics, sedatives, and psychotropics were recorded. Reported failures due to ineffectiveness and toxicity were collected.

MAIN RESULTS:

Of 164 included patients, 88% never received a concomitant opioid infusion (primary analgosedation definition 1), 12% met alternative criteria for primary analgosedation (definitions 2 and 3). A majority, 68%, were surgical admissions and mean Acute Physiology and Chronic Health Evaluation III score was 90 (± 30). Median mechanical ventilation duration was 2.5 days (1.1–4.5) and ICU length of stay of 4.9 days (3–8). The median ketamine infusion dose and duration were 0.18 mg/kg/hr (0.1–0.3) and 30 hours (15.1–51.8). Concomitant infusions of propofol and dexmedetomidine were administered in 49% and 29% of patients, respectively. During ketamine infusion, the median percent of total pain scores at goal was 62% (33–96%), while 64% (37–91%) of Richmond Agitation Sedation Scale scores were at goal, and 47% of patients were Confusion Assessment Method-ICU positive during the ketamine infusion. Hallucinations were documented in 14% of patients and ketamine failure occurred in 11% of patients.

CONCLUSIONS:

Ketamine may be an effective primary analgosedation option in intubated surgical ICU patients, but prospective randomized studies are needed to evaluate this strategy.
Individualized brain mapping for navigated neuromodulation
Authors: Gao Chaohong , Wu Xia , Cheng Xinle , Madsen Kristoffer Hougaard , Chu Congying , Yang Zhengyi , Fan Lingzhong
Published: January 2024

The brain is a complex organ that requires precise mapping to understand its structure and function. Brain atlases provide a powerful tool for studying brain circuits, discovering biological markers for early diagnosis, and developing personalized treatments for neuropsychiatric disorders. Neuromodulation techniques, such as transcranial magnetic stimulation and deep brain stimulation, have revolutionized clinical therapies for neuropsychiatric disorders. However, the lack of fine-scale brain atlases limits the precision and effectiveness of these techniques. Advances in neuroimaging and machine learning techniques have led to the emergence of stereotactic-assisted neurosurgery and navigation systems. Still, the individual variability among patients and the diversity of brain diseases make it necessary to develop personalized solutions. The article provides an overview of recent advances in individualized brain mapping and navigated neuromodulation and discusses the methodological profiles, advantages, disadvantages, and future trends of these techniques. The article concludes by posing open questions about the future development of individualized brain mapping and navigated neuromodulation.
Strengthening Public Health Through Primary Care and Public Health Collaboration: Innovative State Approaches
Authors: Baum Nancy M. , Iovan Samantha , Udow-Phillips Marianne
Published: January 2024

Objective:

Partnerships are increasingly critical to achieve the mission of public health. We sought to understand the levers and tools that states use to better connect public health and primary care in efforts to strengthen public health.

Design:

We reviewed literature focused on collaborative or integrative efforts between primary care and public health and examined strategies employed by 4 innovative states: North Carolina, Oregon, Rhode Island, and Washington. Using a purposive convenience sample, we conducted semistructured interviews with 17 state experts from January to March 2023. We asked leaders to describe their approaches to data sharing, communication, and systems change that could be adopted or adapted by other states interested in better connecting primary care and public health systems. We recorded and coded interviews.

Participants:

Seventeen state leaders from North Carolina, Oregon, Rhode Island, and Washington.

Main Outcome Measures:

Key experiences, strategies, policy levers, and lessons for integration or collaboration between primary care and public health sectors, both common and divergent, across the states.

Results:

State activity can be categorized by 3 actions: (1) endeavors to support relationship building, both formal and informal; (2) efforts to employ coordinating bodies and champions to ensure all necessary actors are included in planning and communications with clear roles; and (3) approaches to identifying and elevating essential system elements and the change levers to support them. The integration is built primarily on the well-resourced medical care system rather than the public health system.

Conclusion:

States are engaged in creative approaches to collaboration between public health and primary care. Building blocks include backbone organizations, leadership training programs, payment reform spheres, interoperable data platforms, and intentional efforts to build relationships. Collaboration between primary care, public health, and community-based organizations is an opportunity to strengthen public health systems while staying focused on improving the public's health.
An Interactive Modeling Tool for Projecting the Health and Direct Medical Cost Impact of Changes in the Sexually Transmitted Diseases Prevention Program Budgets
Authors: Martin Erika G. , Ansari Bahareh , Gift Thomas L. , Johnson Britney L. , Collins Dayne , Williams Austin M. , Chesson Harrell W.
Published: January 2024

Context:

Estimating the return on investment for public health services, tailored to the state level, is critical for demonstrating their value and making resource allocation decisions. However, many health departments have limited staff capacity and expertise to conduct economic analyses in-house.

Program:

We developed a user-friendly, interactive Excel-based spreadsheet model that health departments can use to estimate the impact of increases or decreases in sexually transmitted infection (STI) prevention funding on the incidence and direct medical costs of chlamydia, gonorrhea, syphilis, and STI-attributable HIV infections. Users tailor results to their jurisdictions by entering the size of their population served; the number of annual STI diagnoses; their prior annual funding amount; and their anticipated new funding amount. The interface was developed using human-centered design principles, including focus groups with 15 model users to collect feedback on an earlier model version and a usability study on the prototype with 6 model users to finalize the interface.

Implementation:

The STI Prevention Allocation Consequences Estimator (“SPACE Monkey 2.0”) model will be publicly available as a free downloadable tool.

Evaluation:

In the usability testing of the prototype, participants provided overall positive feedback. They appreciated the clear interpretations, outcomes expressed as direct medical costs, functionalities to interact with the output and copy charts into external applications, visualization designs, and accessible information about the model's assumptions and limitations. Participants provided positive responses to a 10-item usability evaluation survey regarding their experiences with the prototype.

Discussion:

Modeling tools that synthesize literature-based estimates and are developed with human-centered design principles have the potential to make evidence-based estimates of budget changes widely accessible to health departments.
Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients
Authors: Kim Hyun Jin , Jeong Won Gi , Lee Jeong Yeop , Lee Hyo-Jae , Lee Byung Chan , Lim Hyo Soon , Kim Yun-Hyeon
Published: January 2024

Objective

Prostate cancer and interstitial lung abnormality (ILA) share similar risk factor, which is men and older age. The purpose of this study was to investigate the prevalence of pretreatment ILA among prostate cancer patients who underwent abdominal computed tomography (CT) within 1 year at their first visit to the urology department. In addition, we aimed to assess the association between pretreatment ILA and long-term survival in prostate cancer patients.

Methods

This study was conducted in patients who had a first visit for prostate cancer at urology department between 2005 and 2016 and underwent an abdominal CT within 1 year. A thoracic radiologist evaluated the presence of ILA through inspecting the lung base scanned on an abdominal CT. The association between pretreatment ILA and survival was assessed using Kaplan-Meier analysis with log-rank test. Specific survival rates at 12, 36, and 60 months according to the presence of ILA were evaluated usingz-test. Cox regression analysis was used to assess the risk factors of mortality.

Results

A total of 173 patients were included (mean age, 70.23 ± 7.98 years). Pretreatment ILA was observed in 10.4% of patients. Patients with ILA were more likely to be older and current smokers. Pretreatment ILA was associated with poor survival (P< 0.001). Age ≥70 years (hazards ratio [HR], 1.98; 95% confidence interval [CI], 1.24–3.16;P= 0.004), metastatic stage (HR, 2.26; 95% CI, 1.36–3.74;P= 0.002), and ILA (HR, 1.96; 95% CI, 1.06–3.60;P= 0.031) were the independent risk factors of mortality. An ILA (HR, 3.94; 95% CI, 1.78–8.72;P= 0.001) was the only independent risk factor of mortality in localized stage prostate cancer patients.

Conclusions

This study provides important insights into the unexplored effect of pretreatment ILA in prostate cancer patients. Pretreatment ILAs were observed considerably in the lung bases scanned on the abdominal CT scans among prostate cancer patients. Furthermore, pretreatment ILAs were the risk factor of mortality. Therefore, lung bases should be routinely inspected in the abdominal CT scans of prostate cancer patients. This result may help clinicians in establishing personalized management strategy of prostate cancer patients.
Visual Knowledge Domain of Artificial Intelligence in Computed Tomography: A Review Based on Bibliometric Analysis
Authors: Zhu Kunshu , Shen Zefang , Wang Min , Jiang Lufang , Zhang Ye , Yang Tiantong , Zhang Haidong , Zhang Mengzhou
Published: January 2024

Artificial intelligence (AI)–assisted medical imaging technology is a new research area of great interest that has developed rapidly over the last decade. However, there has been no bibliometric analysis of published studies in this field. The present review focuses on AI-related studies on computed tomography imaging in the Web of Science database and uses CiteSpace and VOSviewer to generate a knowledge map and conduct the basic information analysis, co-word analysis, and co-citation analysis. A total of 7265 documents were included and the number of documents published had an overall upward trend. Scholars from the United States and China have made outstanding achievements, and there is a general lack of extensive cooperation in this field. In recent years, the research areas of great interest and difficulty have been the optimization and upgrading of algorithms, and the application of theoretical models to practical clinical applications. This review will help researchers understand the developments, research areas of great interest, and research frontiers in this field and provide reference and guidance for future studies.
Measurement of Neutrophil Extracellular Traps as a Biomarker for the Differential Diagnosis Between Antineutrophil Cytoplasmic Antibody–Positive Individuals With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis and Nonautoimmune Diseases
Authors: Menezes Pâmella Indira da Silva Oliveira , Veras Flávio Protásio , Cunha Fernando de Queiroz , Silva Lucienir Maria da , Louzada-Júnior Paulo , Oliveira Renê Donizeti Ribeiro
Published: January 2024

Background/Objective

Neutrophil extracellular traps (NETs) have a correlation with disease activity in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV). However, it is not known whether there is an association between NETs and the presence of ANCA in other diseases. This study aimed to assess the occurrence of NETs in individuals with ANCA and whether serum NET quantitation is capable of distinguishing them with regard to the diagnosis.

Methods

This was a cross-sectional, observational study. From the positive ANCA by indirect immunofluorescence, 94 individuals were divided into groups: AAV, infectious diseases, and neoplastic diseases. Healthy controls served for comparisons. Neutrophil extracellular traps were evaluated through the investigation of NET remnants, by detecting cell-free DNA bound to proteins such as histone, myeloperoxidase, and neutrophil elastase (NE).

Results

In patients with perinuclear ANCA (p-ANCA) the detection of NETs by NE was able to distinguish AAV from infection/neoplasia and healthy controls. Receiver operating characteristic curves for serum NETs by NE in patients with p-ANCA were drawn in 2 situations: AAV versus infection/neoplasia, showing a sensitivity of 0.65 and specificity of 0.84, with an area under the curve of 65%; and AAV versus controls, showing a sensitivity of 0.84 and a specificity of 0.88, with an area under the curve of 96%.

Conclusions

For p-ANCA–positive individuals, we found higher serum NETs detected by NE-DNA in those with chronic infectious and neoplastic diseases than in AAV individuals and healthy controls. This allows us to infer that the evaluation of serum NETs may be of value as a biomarker for differential diagnosis.
Comparison of the 68Ga-FAPI Versus 18F-FDG in Gastric Adenocarcinoma and Anthracosis-Associated Lymph Nodes: FAPI Unmasking False-Negatives and False-Positives
Authors: Babacan Gündüzalp Buğrahan , Öner Tamam Müge , Şengiz Erhan Selma , Şahin Mehmet Can , Acar Tayyar Merve Nur
Published: January 2024

A 73-year-old woman with poorly differentiated gastric adenocarcinoma was referred to 18F-FDG PET/CT for evaluation of the disease. FDG PET/CT showed intense uptake in the disseminated lymph nodes. However, there was no uptake in the primary tumoral lesion. Subsequently, 68Ga-FAPI-04 PET/CT was performed with the decision of the tumor board and demonstrated intense uptake in the tumoral lesion. However, there was low or no uptake in disseminated lymph nodes. Tru-cut biopsy results revealed that all the lymph nodes were associated with anthracosis.
18F-FDG PET/CT Findings of Ovarian Myxoid Chondrosarcoma
Authors: Ou Lei , Zhou Yue , Deng Hao , Chen XiaoLiang
Published: January 2024

Ovarian myxoid chondrosarcoma is a rare and aggressive tumor. We present 18F-FDG PET/CT findings of ovarian myxoid chondrosarcoma. The images not only demonstrated a pelvic mass with increased FDG uptake, but also a mass with increased FDG uptake in the right lower abdominal wall. Ovarian malignancy with abdominal wall metastases was suspected. An extraskeletal myxoid chondrosarcoma was diagnosed histopathologically after the mass excision.
Pattern of Bone Marrow Hypometabolism on 18F-FDG PET CT in Systemic Lupus Erythematous–Associated Aplastic Anemia
Authors: Dudek Alexandra , Riaz Saima , Priftakis Dimitrios , Bomanji Jamshed
Published: January 2024

We present the case of a 23-year-old woman with juvenile onset systemic lupus erythematous on a background of thrombotic thrombocytopenic purpura, who was referred for18F-FDG PET CT scan due to pyrexia of unknown origin with raised inflammatory markers, severe thrombocytopenia, and anemia. An interesting pattern of predominantly photopenic hypometabolic bone marrow activity was demonstrated on18F-FDG PET CT.
Cerebral and Muscular Metastases From Prostate Adenocarcinoma Initially Depicted by 177Lu-PSMA SPECT/CT
Authors: Al-Ibraheem Akram , Istatieh Feras , Abdlkadir Ahmed Saad , Shahait Mohammed , Khreish Fadi
Published: January 2024

Cerebral and muscular metastases from prostatic adenocarcinoma occur rarely. Patients who develop such metastatic pattern exhibit noticeable symptoms. Herein, we present a 68-year-old man diagnosed with metastatic castrate-resistant prostate cancer. The patient received multiple177Lu-PSMA cycles. After the last cycle, a posttreatment SPECT/CT suggested disease progression with uncommon metastatic pattern in the right temporal brain lobe and muscles.68Ga-PSMA PET/CT and brain MRI confirmed these findings. Surprisingly, the patient remained asymptomatic up until the conclusion of the follow-up, which lasted for 3 months. This case emphasizes the importance of posttreatment scintigraphic imaging when other biomarkers are inconclusive.
PSMA Avidity in the Heterotropic Ossification—An Incidental Finding on PSMA PET/CT
Authors: Jain Tarun Kumar , Vohra Mansha , Sharma Bhawani Shankar , Dhal Shikha , Sharma Lalit Mohan
Published: January 2024

The upregulations of prostate-specific membrane antigen (PSMA) antigen are used for the presence of prostate cancer. However, published literature shows incidentally detected PSMA uptake in various nonprostatic benign and malignant conditions, which led to questioning the specificity of PSMA-targeted PET. In present case, we highlighted the abnormal PSMA expression in the benign bone abnormality.
Calyceal Diverticulum Found Incidentally on 18F-FDG PET/CT Imaging
Authors: Kashiwagi Nobuo , Nakaya Yasuhiro , Yoshino Yutaro , Tatsumi Mitsuaki , Tomiyama Noriyuki
Published: January 2024

A 69-year-old man with pancreatic cancer underwent 18F-FDG PET/CT examination for tumor staging. The PET images showed a focal mass-like FDG accumulation in the left kidney mimicking malignancy, whereas simultaneous CT and fused PET/CT images suggested a cystic lesion. On subsequent MR examination, the lesion appeared cystic on T2-weighted, contrast-enhanced arterial phase, and contrast-enhanced venous phase images. In addition, excretory phase images showed filling contrast medium to the cystic cavity, leading to a diagnosis of calyceal diverticulum. This report suggests that the possibility of a calyceal diverticulum should be considered in cases with focal FDG accumulation in renal cystic lesions.
Metastatic Renal Cell Carcinoma in a Patient With Autosomal Dominant Polycystic Kidney Disease
Authors: Rumrill Wyatt M. , Ballard David H.
Published: January 2024

Autosomal dominant polycystic kidney disease (ADPKD) manifests as multiple cysts in the kidneys and liver but can also present with musculoskeletal and cardiovascular abnormalities. ADPKD patients are at increased risk for renal cell carcinoma development. We show the FDG PET/CT findings in a patient with renal cell carcinoma secondary to ADPKD and complicated by worsening pulmonary metastasis. The primary renal tumor shows intense FDG uptake despite no suspicious features with contrast CT.
Internal and external validation of an updated ICD-10-CA to AIS-2005 update 2008 algorithm
Authors: Tillmann Bourke W. , Guttman Matthew P. , Thakore Jaimini , Evans David C. , Nathens Avery B. , McMillan Jennifer , Gezer Recep , Phillips Andrea , Yanchar Natalie L. , Pequeno Priscila , Scales Damon C. , Pechlivanoglou Petros , Haas Barbara
Published: January 2024

BACKGROUND

Administrative data are a powerful tool for population-level trauma research but lack the trauma-specific diagnostic and injury severity codes needed for risk-adjusted comparative analyses. The objective of this study was to validate an algorithm to derive Abbreviated Injury Scale (AIS-2005 update 2008) severity scores from Canadian International Classification of Diseases (ICD-10-CA) diagnostic codes in administrative data.

METHODS

This was a retrospective cohort study using data from the 2009 to 2017 Ontario Trauma Registry for the internal validation of the algorithm. This registry includes all patients treated at a trauma center who sustained a moderate or severe injury or were assessed by a trauma team. It contains both ICD-10-CA codes and injury scores assigned by expert abstractors. We used Cohen's kappa (𝜅) coefficient to compare AIS-2005 Update 2008 scores assigned by expert abstractors to those derived using the algorithm and the intraclass correlation coefficient to compare assigned and derived Injury Severity Scores. Sensitivity and specificity for detection of a severe injury (AIS score, ≥ 3) were then calculated. For the external validation of the algorithm, we used administration data to identify adults who either died in an emergency department or were admitted to hospital in Ontario secondary to a traumatic injury (2009–2017). Logistic regression was used to evaluate the discriminative ability and calibration of the algorithm.

RESULTS

Of 41,869 patients in the Ontario Trauma Registry, 41,793 (99.8%) had at least one diagnosis matched to the algorithm. Evaluation of AIS scores assigned by expert abstractors and those derived using the algorithm demonstrated a high degree of agreement in identification of patients with at least one severe injury (𝜅 = 0.75; 95% confidence interval [CI], 0.74–0.76). Likewise, algorithm-derived scores had a strong ability to rule in or out injury with AIS ≥ 3 (specificity, 78.5%; 95% CI, 77.7–79.4; sensitivity, 95.1; 95% CI, 94.8–95.3). There was strong correlation between expert abstractor-assigned and crosswalk-derived Injury Severity Score (intraclass correlation coefficient, 0.80; 95% CI, 0.80–0.81). Among the 130,542 patients identified using administrative data, the algorithm retained its discriminative properties.

CONCLUSION

Our ICD-10-CA to AIS-2005 update 2008 algorithm produces reliable estimates of injury severity and retains its discriminative properties with administrative data. Our findings suggest that this algorithm can be used for risk adjustment of injury outcomes when using population-based administrative data.

LEVEL OF EVIDENCE

Diagnostic Tests/Criteria; Level II.
Enhancement of cellular immunity following needle-free vaccination of mice with SARS-CoV-2 spike protein
Authors: McMillan Christopher L. D. , Wijesundara Danushka K. , Choo Jovin J. Y. , Amarilla Alberto A. , Modhiran Naphak , Fernando Germain J. P. , Khromykh Alexander A. , Watterson Daniel , Young Paul R. , Muller David A.
Published: January 2024

The COVID-19 pandemic has highlighted the need for vaccines capable of providing rapid and robust protection. One way to improve vaccine efficacy is delivery via microarray patches, such as the Vaxxas high-density microarray patch (HD-MAP). We have previously demonstrated that delivery of a SARS-CoV-2 protein vaccine candidate, HexaPro, via the HD-MAP induces potent humoral immune responses. Here, we investigate the cellular responses induced by HexaPro HD-MAP vaccination. We found that delivery via the HD-MAP induces a type one biassed cellular response of much greater magnitude as compared to standard intramuscular immunization.
Longitudinal study of immunity to SARS-CoV2 in Ocrelizumab-treated multiple sclerosis patients up to 2 years after COVID-19 vaccination
Authors: Kister Ilya , Curtin Ryan , Piquet Amanda L. , Borko Tyler , Pei Jinglan , Banbury Barbara L , Bacon Tamar E. , Kim Angie , Tuen Michael , Velmurugu Yogambigai , Nyovanie Samantha , Selva Sean , Samanovic Marie I. , Mulligan Mark J. , Patskovsky Yury , Priest Jessica , Cabatingan Mark , Winger Ryan C. , Krogsgaard Michelle , Silverman Gregg J.
Published: January 2024

Objectives

1 To plot the trajectory of humoral and cellular immune responses to the primary (two-dose) COVID-19 mRNA series and the third/booster dose in B-cell-depleted multiple sclerosis (MS) patients up to 2 years post-vaccination; 2. to identify predictors of immune responses to vaccination; and 3. to assess the impact of intercurrent COVID-19 infections on SARS CoV-2-specific immunity.

Methods

60 Ocrelizumab-treated MS patients were enrolled from NYU (New York) and University of Colorado (Anschutz) MS Centers. Samples were collected pre-vaccination, and then 4, 12, 24, and 48 weeks post-primary series, and 4, 12, 24, and 48 weeks post-booster. Binding anti-Spike antibody responses were assessed with multiplex bead-based immunoassay (MBI) and electrochemiluminescence (Elecsys®, Roche Diagnostics), and neutralizing antibody responses with live-virus immunofluorescence-based microneutralization assay. Spike-specific cellular responses were assessed with IFNγ/IL-2 ELISpot (Invitrogen) and, in a subset, by sequencing complementary determining regions (CDR)-3 within T-cell receptors (Adaptive Biotechnologies). A linear mixed effect model was used to compare antibody and cytokine levels across time points. Multivariate analyses identified predictors of immune responses.

Results

The primary vaccination induced an 11-208-fold increase in binding and neutralizing antibody levels and a 3-4-fold increase in IFNγ/IL-2 responses, followed by a modest decline in antibody but not cytokine responses. Booster dose induced a further 3-5-fold increase in binding antibodies and 4-5-fold increase in IFNγ/IL-2, which were maintained for up to 1 year. Infections had a variable impact on immunity.

Interpretation

Humoral and cellular benefits of COVID-19 vaccination in B-cell-depleted MS patients were sustained for up to 2 years when booster doses were administered.
WITHDRAWN: Comparative effectiveness of extended release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients
Authors: Ross Rachael K. , Nunes Edward V. , Olfson Mark , Shulman Matisyahu , Krawczyk Noa , Stuart Elizabeth A. , Rudolph Kara E.
Published: January 2024

Withdrawal Statement

This version of the manuscript and associated files have been removed owing to concerns of data privacy. The paper has been published and is available at doi:10.1111/add.16630.
Maternal fluoxetine impairs synaptic transmission and plasticity in the medial prefrontal cortex and alters the structure and function of dorsal raphe nucleus neurons in offspring mice
Authors: Bobula Bartosz , Bąk Joanna , Kania Agnieszka , Siwiec Marcin , Kiełbiński Michał , Tokarski Krzysztof , Pałucha-Poniewiera Agnieszka , Hess Grzegorz
Published: January 2024

Selective serotonin (5-HT) reuptake inhibitors (SSRIs) are a class of antidepressant drugs commonly prescribed to women during pregnancy and breastfeeding to treat depression. There is evidence that prenatal exposure to SSRIs may be associated with a higher risk of adverse cognitive outcomes and affective disorders in later life. In animal models, exposure to SSRIs during brain development results in behavioral alterations as well as structural abnormalities of cerebral cortical neurons. Little is known about the consequences of SSRI- induced excess of 5-HT during development on the brain serotonergic system itself. In this study, an SSRI - fluoxetine (FLX) - was administered to C57BL/6J mouse dams during pregnancy and lactation. We found that maternal FLX decreased field potentials, impaired long-term potentiation, facilitated induction of long-term depression and tended to increase the density of 5-HTergic fibers in the medial prefrontal cortex (mPFC) of female but not male adolescent offspring. These effects were accompanied by deteriorated performance in the temporal order memory task and reduced sucrose preference with no change in marble burying behavior in FLX-exposed female offspring. We also found that maternal FLX reduced the axodendritic tree complexity of 5-HT dorsal raphe nucleus (DRN) neurons in female but not male offspring. Whole-cell recordings demonstrated no changes in the excitability of DRN 5-HT neurons in FLX-exposed offspring of either sex. While no effects of maternal FLX on inhibitory postsynaptic currents (sIPSCs) in DRN neurons were found, we observed a significant influence of FLX exposure on kinetic characteristics of spontaneous excitatory postsynaptic currents (sEPSCs) in DRN neurons. Finally, we report that no changes in field potentials and synaptic plasticity were evident in the mPFC of the offspring after maternal exposure during pregnancy and lactation to a new antidepressant, vortioxetine. These findings show that in contrast to the mPFC, long-term consequences of maternal FLX exposure on the structure and function of DRN 5-HT neurons are mild and suggest a sex-dependent, distinct sensitivity of cortical and brainstem neurons to FLX exposure in early life. Regarding side effects on brain development, vortioxetine might be a safer alternative to FLX.
Repeated Hand Grip Strength is an Objective Marker for Disability and Severity of Key Symptoms in Post-COVID ME/CFS
Authors: Paffrath Anna , Kim Laura , Kedor Claudia , Stein Elisa , Rust Rebekka , Freitag Helma , Hoppmann Uta , Hanitsch Leif G , Bellmann-Strobl Judith , Wittke Kirsten , Scheibenbogen Carmen , Sotzny Franziska
Published: January 2024

Post-COVID Syndrome (PCS) refers to a diverse array of symptoms that persist beyond 3 months of the acute phase of a SARS-CoV-2 infection. The most frequent symptom is fatigue, which can manifest both mentally and physically. In this study, handgrip strength (HGS) parameters were determined as an objective measure of muscle fatigue and fatigability. HGS parameters were correlated with other frequent symptoms among 144 female PCS patients suffering from fatigue, exertional intolerance, and cognitive impairment. Seventy-eight patients met the Canadian Consensus Criteria (CCC) for post-infectious myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The severity of disability and key symptoms were evaluated utilizing self-reported questionnaires. Notably, patients diagnosed with ME/CFS exhibited a higher overall severity of symptoms, including lower physical function (p< 0.001), a greater degree of disability (p< 0.001), more severe fatigue (p< 0.001), post-exertional malaise (p< 0.001), and autonomic dysfunction (p= 0.004). While HGS was similarly impaired in both PCS and ME/CFS patients, the associations between HGS and the severity of symptoms and disability revealed striking differences. We observed significant correlations of HGS parameters with physical function across all patients, but with the key symptoms PEM, fatigue, cognitive impairment, and autonomic dysfunction in ME/CFS patients only. This points to a common mechanism for these symptoms in the ME/CFS subtype, distinct from that in other types of PCS. Further HGS provides an objective marker of disease severity in ME/CFS.
Metasurface-Based Hybrid Optical Cavities for Chiral Sensing
Authors: Baßler Nico S. , Aiello Andrea , Schmidt Kai P. , Genes Claudiu , Reitz Michael
Published: January 2024

Quantum metasurfaces, i.e., two-dimensional subwavelength arrays of quantum emitters, can be employed as mirrors towards the design of hybrid cavities, where the optical response is given by the interplay of a cavity-confined field and the surface modes supported by the arrays. We show that stacked layers of quantum metasurfaces with orthogonal dipole orientation can serve as helicity-preserving cavities. These structures exhibit ultranarrow resonances and can enhance the intensity of the incoming field by orders of magnitude, while simultaneously preserving the handedness of the field circulating inside the resonator, as opposed to conventional cavities. The rapid phase shift in the cavity transmission around the resonance can be exploited for the sensitive detection of chiral scatterers passing through the cavity. We discuss possible applications of these resonators as sensors for the discrimination of chiral molecules. Our approach describes a new way of chiral sensing via the measurement of particle-induced phase shifts.

Published by the American Physical Society
2024