bluuebunny/crossref_metadata_2025_split huggingface dataset:
30 mCi exploratory scan for two-step dosimetric 131I therapy in differentiated thyroid cancer patients: A novel approach and case report
Authors: Wu Di , Gomes-Lima Cristiane , Kulkarni Kanchan , Burman Kenneth , Wartofsky Leonard , Van Nostrand Douglas 
Published: September 2020

AbstractDifferentiated thyroid cancer patients with significantly elevated or rapidly rising serum thyroglobulin (Tg) levels and negative diagnostic radioiodine scans (DxScan) often present a therapeutic dilemma in deciding whether or not to administer an 131I treatment. In this report, we describe a novel two-step approach of a 30 mCi 131I exploratory scan before a dosimetric 131I therapy to help “un-blind” the treating physician of the benefit/risk ratio of a further “blind”131I treatment. A 51-year-old man presented with rising Tg levels, a negative DxScan, and a history of widely metastatic follicular thyroid cancer. He had undergone total thyroidectomy, remnant ablation with 3.8 GBq (103.5 mCi) of 131I, Gammaknife®, and treatment with 12.1 GBq (326 mCi) of 131I for multiple metastases. However, at 19 months after the treatments, his Tg levels continued to rise, and scans demonstrated no evidence of radioiodine-avid metastatic disease. In anticipation of a “blind”131I treatment, the medical team and the patient opted for a 30 mCi exploratory scan. The total dosimetrically guided prescribed activity (DGPA) was decided based on the whole-body dosimetry. The patient was first given 30 mCi of 131I, and the exploratory scan was performed 22 h later, which demonstrated 131I uptake in the left lung, left humeral head, T10, and right proximal thigh muscle. Based on the positive exploratory scan, the remainder of the DGPA was administered within several hours after the scan. On the post-DGPA treatment scan performed at 5—7 days, the lesions seen on the ~ 22 h exploratory scan were confirmed, and an additional lesion was observed in the left kidney. The 30 mCi exploratory scan suggested the potential for a response in the radioiodine-avid lesions despite a negative diagnostic scan. This method allows 131I treatment to be administered to patients who may have a greater potential for a therapeutic response while avoiding unwarranted side effects in those patients with nonavid disease.
Clinically occult image revelations of fluorodeoxyglucose positron emission tomography/computed tomography in a peculiar case of sinonasal myeloid sarcoma
Authors: Mathew Shema , Muthukrishnan Indirani , Simon Shelley 
Published: September 2020

AbstractMyeloid sarcoma (MS) is a sparse association of acute myeloid leukemia (AML) with poor overall survival. Sinonasal involvement in MS is rarer and meagerly studied. Recent prospective studies have underlined the importance of positron emission tomography/computed tomography (PET/CT) in disease assessment and relapse detection in extramedullary (EM) AML. Herein, we report a case of MS with sinonasal, orbital, dural, breast, pleural extent of disease with sacral neural foraminal compression. Initial histopathologic and clinicoradiologic features had pointed toward lymphoma. Immunohistochemistry (IHC) on the contrary revealed MS. Although the role of IHC in asserting the diagnosis of MS is remarkable, PET/CT surpasses other modalities in early detection of EM sites of involvement, overall assessment of disease burden, targeting therapy, prognostication, and relapse recognition. Inclusion of PET/CT as a baseline imaging modality can be beneficial in tailoring patient management to improve survival and overall quality of life.
Monte Carlo simulation and performance assessment of GE Discovery 690 VCT positron emission tomography/computed tomography scanner
Authors: Kashian Elham , Ahangari Hadi , Dehlaghi Vahab , Khoshgard Karim , Ghafarian Pardis , Ghorbani Raheb 
Published: September 2020

AbstractThe aim of this study is to simulate GE Discovery 690 VCT positron emission tomography/computed tomography (PET/CT) scanner using Geant4 Application for Tomographic Emission (GATE) simulation package (version 8). Then, we assess the performance of scanner by comparing measured and simulated parameter results. Detection system and geometry of PET scanner that consists of 13,824 LYSO crystals designed in 256 blocks and 24 ring detectors were modeled. In order to achieve a precise model, we verified scanner model. Validation was based on a comparison between simulation data and experimental results obtained with this scanner in the same situation. Parameters used for validation were sensitivity, spatial resolution, and contrast. Image quality assessment was done based on comparing the contrast recovery coefficient (CRC) of simulated and measured images. The findings demonstrate that the mean difference between simulated and measured sensitivity is <7%. The simulated spatial resolution agreed to within <5.5% of the measured values. Contrast results had a slight divergence within the range below 4%. The image quality validation study demonstrated an acceptable agreement in CRC for 8:1 and 2:1 source-to-background activity ratio. Validated performance parameters showed good agreement between experimental data and simulated results and demonstrated that GATE is a valid simulation tool for simulating this scanner model. The simulated model of this scanner can be used for future studies regarding optimization of image reconstruction algorithms and emission acquisition protocols.
Rest/stress intradermal lymphoscintigraphy in diagnosis of lipedema
Authors: Tartaglione Girolamo , Visconti Giuseppe , Bartoletti Roberto , Ieria Francesco , Salgarello Marzia 
Published: September 2020

AbstractLipedema is a chronic and progressive disease characterized by a symmetrical and bilateral swelling of the lower extremities. In general, the feet are not involved. Lipedema is believed to affect nearly 1 in 9 adult women worldwide. Despite this relatively common disease, lipedema is often confused with primary lymphedema or obesity. In clinically advanced lipedema stages, fat continues to build up and may block the lymphatic vessels causing a secondary lymphedema (Lipo-Lymphedema). We consecutively evaluated 54 women with a clinical diagnosis of lower limbs lipedema. Two doses of 99mTc-nanocolloid were injected intradermally at the first intermetatarsal space and in the lateral malleolar area. Two static planar scans were taken at rest immediately following the intradermal injection. Subsequently, all patients were asked to perform an isotonic muscular exercise (stepping) for 2 min. Then, post exercise scans were performed to monitor the tracer pathway. Subsequently, the patient was asked to take a 30–40 min walk (prolonged exercise) and delayed scans were acquired. In early clinical stages, the lymphatic flow is usually preserved and the rest/stress intradermal lymphoscintigraphy may visualize a normal lymphatic drainage with a frequent pattern (tortuous course) of the leg lymphatic pathway. In clinically advanced stages, lymph stagnation areas were observed. Unlike obesity, lipedema fat storage is resistant to dietary regimen, bariatric surgery, and physical activity. Surgical treatment (tumescent liposuction and reductive surgery) is the most effective treatment to remove adipose tissue. Complex decongestive therapies are helpful in reducing the lymph stagnation, especially in patients with advanced lipolymphedema.
Evaluation of estrogen expression of breast cancer using 18F-FES PET CT-A novel technique
Authors: Seenu Vuthaluru , Sharma Ankit , Kumar Rakesh , Suhani Suhani , Prashanth Arun , Mathur Sandeep , Parshad Rajinder 
Published: September 2020

AbstractEstrogen receptor (ER) expression in breast cancer is routinely studied on immunohistochemistry (IHC) of tissue obtained from core biopsy or surgical specimen. Sampling error and heterogeneity of tumor may incorrectly label a breast tumor as ER negative, thus denying patient hormonal treatment. Molecular functional ER imaging can assess the in-vivo ER expression of primary tumor and metastases at sites inaccessible for biopsy and also track changes in expression over time. The aim was to study ER expression using 16α-18F-fluoro-17β-estradiol or 18F-fluoroestradiol (18F FES) positron emission tomography (PET) computed tomography (CT). Twenty-four biopsy-proven breast cancer patients consenting to participate in the study underwent FES PET CT. Standard uptake value (SUVmean) of maximum of 7 lesions/patient was analyzed, and tumor-to-background ratio was calculated for each lesion. Visual interpretation score was calculated for lesion on FES PET and correlated with the Allred score on IHC of tumor tissue samples for ER expression. The diagnostic indices of FES PET CT were assessed taking IHC as “gold standard.” On FES PET CT, the mean SUV for ER+ tumors was 4.75, whereas the mean SUV for ER − tumors was 1.41. Using receiver operating characteristic curve, tumors with an SUV of ≥ 1.8 on FES PET could be considered as ER+. The overall accuracy of FES PET CT to detect ER expression was 91.66%, with two false negatives noted in this study. 18F-FES PET CT appears promising in evaluating ER expression in breast cancer. It is noninvasive and has potential to assess the in-vivo ER expression of the entire primary tumor and metastasis not amenable for biopsy.
18F-fluorodeoxyglucose positron emission tomography/computed tomography as a metabolic marker for functional assessment of spinal tuberculosis after early decompression surgery
Authors: Rangan Kasturi , Israrahmed Amrin , Suraj Ajay , Gambhir Sanjay 
Published: September 2020

AbstractTuberculosis (TB) of the spine is the most important extra pulmonary form of TB. The lytic destructive variant of spinal TB can destroy the intervertebral discs, vertebral body, collapse, kyphotic deformity, and spinal cord compression. Complicated Pott's disease if not managed early can lead to neurological deficits, so there is a need for early surgical decompression, compliant anti-tubercular therapy, and response evaluation tool. We present two cases of multilevel dorsal spinal TB diagnosed on magnetic resonance imaging spine and baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan. They underwent early decompression with internal fixation and were followed up for 18 months with serial 18F-FDG PET/CT at 3rd and 18th month, respectively. One patient showed an early complete metabolic response and excellent functional recovery. Another patient showed progressive disease (drug-resistant status) and delayed functional recovery. 18F-FDG PET/CT has an excellent role in assessing response to therapy and thus helps to achieve therapeutic endpoint.
Precise localization of biliary leak post laparoscopic cholecystectomy with hepatobiliary scintigraphy and adjunct single-photon emission tomography/computed tomography fusion imaging
Authors: Shikare Shekhar , El Hakeem Ahmed 
Published: September 2020

AbstractLaparoscopic cholecystectomy is commonly performed as the treatment of choice for symptomatic gallstone diseases. Bile leak is a potential complication of this procedure and the cystic duct stump is the most common site of leakage. Early diagnosis and treatment of bile leak is crucial in decreasing the morbidity and mortality related to this complication. We present a case of biliary leak following laparoscopic cholecystectomy, diagnosis of active biliary leak, and accurate localization of the site of biliary leak on hepatobiliary scintigraphy and adjunct single-photon emission computed tomography/computed tomography fusion imaging.
Homology supported in Lagrangian submanifolds in mirror quintic threefolds
Authors: López Garcia Daniel 
Published: September 2020

AbstractIn this note, we study homology classes in the mirror quintic Calabi–Yau threefold that can be realized by special Lagrangian submanifolds. We have used Picard–Lefschetz theory to establish the monodromy action and to study the orbit of Lagrangian vanishing cycles. For many prime numbers

$p,$
we can compute the orbit modulo p. We conjecture that the orbit in homology with coefficients in

$\mathbb {Z}$
can be determined by these orbits with coefficients in

$\mathbb {Z}_p$
.
Pariwisata Berbasis Alam: Memahami Perilaku Wisatawan
Authors: Novianti Evi , Larasati Ajeng Ramadhita , Asy'ari Rifqi , Pribadi Teguh Imam , Sariadi Sarmoko , Hadian Mohammad Sapari Dwi , Wulung Shandra Rama Panji 
Published: September 2020

Tujuan dari penelitian ini adalah memahami perilaku wisatawan dalam fungsi interaksi di suatu destinasi pariwisata khususnya kepariwisataan di Indonesia dengan menggunakan metode bibliometric study atau dengan metode penelitian dari data sekunder. Hasil dari penelitian ini menunjukkan bahwa interpretasi yang baik akan sangat mempengaruhi suatu destinasi dan calon wisatawan yang akan mengunjunginya. Semakin tinggi nilai tambah suatu destinasi yang ditawarkan kemudian ditambah interpretasi yang baik maka semakin menarik calon wisatawan untuk melakukan perjalanan, khususnya Nature-Based Tourismyang sejatinya memiliki banyak hal untuk dipelajari oleh wisatawan.
Hubungan Jumlah Kunjungan Wisatawan Mancanegara dengan Rata-Rata Tingkat Penghunian Kamar Hotel Provinsi DKI Jakarta Tahun 2012—2018
Authors: Suwanto Suwanto 
Published: September 2020

Penelitian ini membahas masalah hubungan jumlah kunjungan wisatawan mancanegara dengan rata-rata tingkat penghunian kamar hotel Provinsi DKI Jakarta. Riset ini dilakukan untuk menganalisis hubungan jumlah kunjungan wisatawan mancanegara dengan rata-rata tingkat penghunian kamar hotel Provinsi DKI Jakarta. Penelitian kuantitatif ini menggunakan sumber data sekunder dan jenis data times series dengan skala ratio. Data jumlah kunjungan wisatawan mancanegara dan data rata-rata tingkat penghunian kamar hotel Provinsi DKI Jakarta tahun 2012—2018 diperoleh dari Badan Pusat Statistik Provinsi DKI Jakarta dalam bentuk data bulanan. Pengolahan dan analisis data menggunakan teknik korelasi Pearson. Analisis temuan penelitian menunjukkan bahwa terdapat hubungan yang kuat, dan arah hubungan yang searah (positif) antara jumlah kunjungan wisatawan mancanegara dengan rata-rata tingkat penghunian kamar hotel Provinsi DKI Jakarta. Terdapat kecenderungan jika jumlah kunjungan wisatawan mancanegara naik maka rata-rata tingkat penghunian kamar hotel juga naik, begitu pula sebaliknya. Rekomendasi yang dapat disampaikan adalah memperhatikan faktor-faktor yang relevan selain jumlah kunjungan wisatawan mancanegara, seperti jumlah kunjungan wisatawan nusantara dari berbagai daerah di Indonesia, daya tarik wisata, aksesibilitas tempat wisata, serta keamanan dan kenyamanan wisatawan dalam pengembangan usaha di bidang perhotelan sebagai upaya untuk menaikkan rata-rata tingkat penghunian kamar hotel.
Progressive Ataxia and Cognitive Decline in a 67-Year-Old Male: A Diagnostic Challenge
Authors: Osman Dina , Weidner Alice , Madhra Mayuri 
Published: September 2020

We report the case of a 67-year-old male who presented with a six-week history of progressive unsteadiness, cognitive impairment and weight loss, in the context of a recent bereavement. Magnetic resonance imaging (MRI) performed several weeks earlier excluded acute stroke. Examination revealed gross bilateral ataxia, bradyphrenia and physical manifestations of depression. Collateral history suggested rapidly progressing symptoms over three months. Repeat MRI head showed features suggestive of Creutzfeldt-Jakob disease (CJD) including T2 hyperintensities in the basal ganglia. Cerebrospinal fluid (CSF) samples were positive for 14-3-3 protein, S100b and real-time quaking-induced conversion (RT-QuIC) proteins confirming the diagnosis of sporadic CJD (sCJD).
The impact of ship emissions on air quality and human health in the Gothenburg area – Part II: Scenarios for 2040
Authors: Ramacher Martin O. P. , Tang Lin , Moldanová Jana , Matthias Volker , Karl Matthias , Fridell Erik , Johansson Lasse 
Published: September 2020

Abstract. Shipping is an important source of air pollutants, from
the global to the local scale. Ships emit substantial amounts of
sulfur dioxides, nitrogen dioxides, and particulate matter in the vicinity
of coasts, threatening the health of the coastal population, especially in
harbour cities. Reductions in emissions due to shipping have been targeted
by several regulations. Nevertheless, effects of these regulations come into
force with temporal delays, global ship traffic is expected to grow in the
future, and other land-based anthropogenic emissions might decrease. Thus,
it is necessary to investigate combined impacts to identify the impact of
shipping activities on air quality, population exposure, and health effects
in the future. We investigated the future effect of shipping emissions on air quality and
related health effects considering different scenarios of the development of
shipping under current regional trends of economic growth and already
decided regulations in the Gothenburg urban area in 2040. Additionally, we
investigated the impact of a large-scale implementation of shore electricity
in the Port of Gothenburg. For this purpose, we established a one-way nested
chemistry transport modelling (CTM) system from the global to the urban
scale, to calculate pollutant concentrations, population-weighted
concentrations, and health effects related to NO2, PM2.5, and O3. The simulated concentrations of NO2 and PM2.5 in future scenarios
for the year 2040 are in general very low with up to 4 ppb for NO2 and
up to 3.5 µg m−3 PM2.5 in the urban areas which
are not close to the port area. From 2012 the simulated overall exposure to
PM2.5 decreased by approximately 30 % in simulated future scenarios;
for NO2 the decrease was over 60 %. The simulated concentrations of
O3 increased from the year 2012 to 2040 by about 20 %. In general, the
contributions of local shipping emissions in 2040 focus on the harbour area
but to some extent also influence the rest of the city domain. The simulated
impact of onshore electricity implementation for shipping in 2040 shows
reductions for NO2 in the port of up to 30 %, while increasing
O3 of up to 3 %. Implementation of onshore electricity for ships at
berth leads to additional local reduction potentials of up to 3 % for
PM2.5 and 12 % for SO2 in the port area. All future scenarios
show substantial decreases in population-weighted exposure and health-effect
impacts.
Current glacier recession causes significant rockfall increase: the immediate paraglacial response of deglaciating cirque walls
Authors: Hartmeyer Ingo , Delleske Robert , Keuschnig Markus , Krautblatter Michael , Lang Andreas , Schrott Lothar , Otto Jan-Christoph 
Published: September 2020

Abstract. In the European Alps, almost half the glacier volume has disappeared over the past 150 years. The loss is reflected in glacier retreat and ice surface
lowering even at high altitude. In steep glacial cirques, surface lowering exposes rock to atmospheric conditions probably for the very first time in
several millennia. Instability of rockwalls has long been identified as one of the direct consequences of deglaciation, but so far cirque-wide
quantification of rockfall at high resolution is missing. Based on terrestrial lidar, a rockfall inventory for the permafrost-affected rockwalls of
two rapidly deglaciating cirques in the Central Alps of Austria (Kitzsteinhorn) is established. Over 6 years (2011–2017), 78 rockwall scans were
acquired to generate data of high spatial and temporal resolution. Overall, 632 rockfalls were registered, ranging from 0.003 to 879.4 m3, mainly
originating from pre-existing structural rock weaknesses. A total of 60 % of the rockfall volume detached from less than 10 vertical metres above the
glacier surface, indicating enhanced rockfall activity over tens of years following deglaciation. Debuttressing seems to play a minor effect only.
Rather, preconditioning is assumed to start inside the randkluft (void between cirque wall and glacier) where measured sustained freezing and ample
supply of liquid water likely cause enhanced physical weathering and high quarrying stresses. Following deglaciation, pronounced thermomechanical
strain is induced and an active layer penetrates into the formerly perennially frozen bedrock. These factors likely cause the observed paraglacial
rockfall increase close to the glacier surface. This paper, the first of two companion pieces, presents the most extensive dataset of high-alpine
rockfall to date and the first systematic documentation of a cirque-wide erosion response of glaciated rockwalls to recent climate warming.
A 6-year lidar survey reveals enhanced rockwall retreat and modified rockfall magnitudes/frequencies in deglaciating cirques
Authors: Hartmeyer Ingo , Keuschnig Markus , Delleske Robert , Krautblatter Michael , Lang Andreas , Schrott Lothar , Prasicek Günther , Otto Jan-Christoph 
Published: September 2020

Abstract. Cirque erosion contributes significantly to mountain
denudation and is a key element of glaciated mountain topography. Despite
long-standing efforts, rates of rockwall retreat and the proportional
contributions of low-, mid- and high-magnitude rockfalls have remained
poorly constrained. Here, a unique, terrestrial-lidar-derived rockfall
inventory (2011–2017) of two glaciated cirques in the Hohe Tauern range,
Central Alps, Austria, is analysed. The mean cirque wall retreat
rate of 1.9 mm a−1 ranks in the top range of reported values and is
mainly driven by enhanced rockfall from the lowermost, freshly deglaciated
rockwall sections. Retreat rates are significantly elevated over decades
subsequent to glacier downwasting. Elongated cirque morphology and recorded
cirque wall retreat rates indicate headward erosion is clearly outpacing
lateral erosion, most likely due to the cataclinal backwalls, which are
prone to large dip-slope failures. The rockfall magnitude–frequency
distribution – the first such distribution derived for deglaciating cirques
– follows a distinct negative power law over 4 orders of magnitude.
Magnitude–frequency distributions in glacier-proximal and glacier-distal
rockwall sections differ significantly due to an increased occurrence of
large rockfalls in recently deglaciated areas. In this paper, the second of
two companion pieces, we show how recent climate warming shapes glacial
landforms, controls spatiotemporal rockfall variation in glacial
environments and indicates a transient signal with decadal-scale exhaustion
of rockfall activity immediately following deglaciation crucial for future
hazard assessments.