bluuebunny/crossref_metadata_2025_split huggingface dataset:
18F-fluorodeoxyglucose uptake on PET/computed tomography in association with androgen receptor expression and other clinicopathologic factors in surgically resected triple-negative breast cancer
Authors: Lee Hyo-jae , Lim Hyo Soon , Ki So Yeon , Park Hye Mi , Lee Jong Eun , Jeong Won Gi , Shin Sang Soo , Kwon Seong Young , Park Min Ho , Lee Ji Shin 
Published: October 2020

Objective
To evaluate whether androgen receptor expression in triple-negative breast cancer (TNBC) is associated with 18F-fluorodeoxyglucose (FDG) uptake and to identify predictive factors of 18F-FDG uptake in TNBC.

Methods
We retrospectively assessed data of 156 surgically resected primary TNBC in 156 consecutive patients who underwent 18F-FDG PET/computed tomography between July 2013 and May 2017. Clinicopathologic features, including androgen receptor expression, were categorized and the distribution of maximum standardized uptake value (SUVmax) was compared between the groups. We also evaluated the correlations between the predictive factors and SUVmax.

Results
Median SUVmax was higher in the androgen receptor-negative group than in the androgen receptor-positive group (8.8 vs. 7.1, P = 0.026) with negative correlation between androgen receptor and SUVmax (P = 0.041, correlation coefficient (r) = –0.163). On multivariate regression analysis, tumor size (>20 mm), histological grade, Ki-67 (≥14%), and the presence of ductal carcinoma in situ (DCIS) were significantly associated with SUVmax (P < 0.001, P = 0.012, P = 0.017 and P = 0.021, respectively). Tumor size, histological grade and Ki-67 were positively correlated with SUVmax (P < 0.001, r = 0.450; P = 0.004, r = 0.228; P = 0.001, r = 0.269, respectively), while the presence of DCIS showed negative correlation with SUVmax (P < 0.001, r = –0.292).

Conclusion
Androgen receptor-positive TNBC showed lower 18F-FDG uptake than androgen receptor-negative triple-TNBC. Tumor size, histological grade, Ki-67 and the presence of DCIS significantly influenced 18F-FDG uptake in TNBC.
New gender-specific formulae for estimating extracellular fluid volume from height and weight in adults
Authors: Bird Nicholas J. , Peters A. Michael 
Published: October 2020

Aims
First, to derive gender-specific formulae for estimation of extracellular fluid volume (eECV) and second, compare eECV as a scaling metric for slope-intercept glomerular filtration rate (GFR) with estimated body surface area (eBSA), lean body mass (eLBM) and total body water (eTBW).

Methods
GFR and ‘slope-only’ GFR (GFR/ECV), both single compartment-corrected, were measured in a previously published multicentre database of healthy potential kidney transplant donors. Measured ECV (mECV) was obtained as ratio GFR-to-GFR/ECV. Formulae for eECV in men and women were derived from the relationship of mECV with height and weight and expressed as eECV = a.weight
x
.height
y
. In a population of prospective kidney transplant donors from a single centre, eECV was compared with mECV. GFR was scaled to eECV, eBSA, eLBM and eTBW, estimated from previously published formulae.

Results
In men and women, respectively, a was 0.0755 and 0.0399, x was 0.6185 and 0.6065 and y was 0.4982 and 0.6217. In the single centre, biases (±precisions) of eECV against mECV in men and women were 0.26 (±1.68) and 0.31 (±1.67) l. Mean GFR/eBSA was higher in men but mean GFR/eLBM and GFR/eTBW were higher in women. Mean GFR/ECV and mean GFR/eECV were very similar between the two genders. GFR/ECV and GFR/eECV showed correlations with each other that were almost identical between men and women.

Conclusions
New formulae are described for estimating eECV. Scaling GFR to eECV is more physiological than scaling to eBSA and accounts for gender. eECV used for measuring GFR from a single blood sample should be gender-specific.
Examination of metallic impurities of 68Ge/68Ga generators used for radioactive labeling of peptides in clinical PET applications
Authors: Uğur Ayşe , Yaylali Olga , Yüksel Doğangün 
Published: October 2020

Background/aim
Especially suitable for PET due to its nuclear physical and radiochemical properties, the positron emitter Gallium-68 (68Ga) occurs by electron capture from Germanium-68 (68Ge). In such a radionuclide generator, the germanium is bound to an insoluble, inert column matrix and forms a secular radioactive balance with 68Ga obtained in the hour. As a result of the limited radiochemical selectivity of the elution process, the eluate obtained is basically contaminated with the main nuclide traces, so that the eluate becomes a mixture of 68Ga and 68Ge radionuclides. Also, the generator eluate contains a number to metal cations that reduce specific radioactivity and can compete with 68Ga. The presence of toxic metal that can be found in the eluate carries the risks of contamination at every step from the production of generators to radiopharmaceutical production.

Materials and method
In our study, by collecting the eluate of the 68Ge/68Ga generators used with different identities in different centers in Turkey, we report comparative analysis of metal contamination in the generator eluate. The eluates of 68Ge/68Ga generators to five different identities were collected. Eluates were analyzed by inductively coupled plasma–mass spectrometry.

Results and Conclusion
As a result, each generator contains metallic impurities different from its certificate.
Feasibility of prognosis assessment for cancer of unknown primary origin using texture analysis of 18F-fluorodeoxyglucose PET/computed tomography images of largest metastatic lymph node
Authors: Ishiwata Yoshinobu , Kaneta Tomohiro , Nawata Shintaro , Iizuka Hitoshi , Utsunomiya Daisuke 
Published: October 2020

Objective
Cancers of unknown primary origin cannot be staged using images, making the prognosis difficult. We attempted to predict prognosis of patients with unknown primary origin using tumour heterogeneity recently introduced in 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT).

Methods
Overall, 30 patients with unknown primary origin who underwent whole-body 18F-FDG PET/CT scans were retrospectively enrolled for texture analysis. The volume of interest was placed in the largest metastatic lymph nodes and conventional parameters and grey-level co-occurrence matrix (GLCM) were calculated. Statistical analysis of image-based variables was performed using Cox regression analyses. Patients were stratified into two groups based on cutoff values of GLCMentropy obtained using receiver operating characteristics (ROCs). Patients were analyzed, and overall survival (OS) was compared using Kaplan–Meier analysis.

Results
Univariate Cox regression analysis showed significant differences in prognosis for parenchymal organ metastasis (P < 0.01), GLCM homogeneity (P = 0.01), GLCMcontrast (P < 0.01), GLCMentropy (P < 0.01) and GLCMdissimilarity (P < 0.01). Multivariate Cox regression analysis showed a significant difference in reduced prognosis for GLCMentropy positive (P < 0.01). Stratification was performed based on the GLCMentropy cutoff value, determined using ROCs analysis, with smaller groups showing better OS.

Conclusions
Despite previous difficulties in predicting prognosis in patients with unknown primary origin, 18F-FDG PET/CT texture features may enable stratification of prognosis. This could be useful for appropriate patient selection and management and help identify a subset of patients with favourable outcomes. These novel findings may be helpful for prognostication and improving patient care.
Serum Amylase and Lipase for the Prediction of Pancreatic Injury in Critically Ill Children Admitted to the PICU
Authors: Liu Pingping , Xiao Zhenghui , Yan Haipeng , Lu Xiulan , Zhang Xinping , Luo Lan , Long Caixia , Zhu Yimin 
Published: October 2020

Objectives:
Pancreatic injury is multifactorial and potentially devastating for critically ill children. We aimed to evaluate whether serum amylase and lipase among critically ill children could serve as an independent biomarker to predict pancreatic injury.

Design:
Retrospective cohort.

Setting:
PICU of a tertiary, pediatric medical center.

Patients:
Seventy-nine autopsies.

Interventions:
None.

Measurements and Main Results:
A group of 79 children who died of different causes were investigated by autopsy. They were divided into pancreatic injury group and pancreatic noninjury group according to autopsy findings. Data based on patients’ demographics, vital signs, laboratory findings, and clinical features at admission were collected and compared. Logistic regression was used to identify predictive factors for pancreatic injury. Receiver operating characteristic curve was constructed for assessing serum amylase and serum lipase to predicting pancreatic injury. Forty-one patients (51.9%) exhibited the pathologic changes of pancreatic injury. The levels of lactate, erythrocyte sedimentation rate, alanine transaminase, aspartate transaminase, and troponin-I in the injury group were significantly higher than that in the noninjury group, whereas the level of calcium was significantly lower than that in the noninjury group (p < 0.05). Multivariable logistic regression analysis showed that serum amylase, serum lipase, and septic shock were significantly associated with the occurrence rate of pancreatic injury. The statistically significant area under the curve results were as follows: serum amylase: area under the curve = 0.731, at a cutoff value of 97.5, sensitivity = 53.7, and specificity = 81.6; and serum lipase: area under the curve = 0.727, at a cutoff value of 61.1, sensitivity = 36.6, and specificity = 92.1.

Conclusions:
Serum amylase and lipase could serve as independent biomarkers to predict pancreatic injury in critically ill children.
Cardiac Function and Ventricular Interactions in Persistent Pulmonary Hypertension of the Newborn
Authors: Jain Amish , EL-Khuffash Afif F. , van Herpen Claar H. , Resende Maura H. F. , Giesinger Regan E. , Weisz Dany , Mertens Luc , Jankov Robert P. , McNamara Patrick J. 
Published: October 2020

Objectives:
The aim of this study was to use a comprehensive imaging protocol to identify echocardiographic correlations of right and left ventricular size, function, and hemodynamics in neonates with persistent pulmonary hypertension of newborn and describe their relationship with key clinical variables.

Design:
Retrospective case-control echocardiography-based study of persistent pulmonary hypertension of newborn.

Setting:
A tertiary neonatal ICU in Canada.

Patients:
Forty-nine neonates (gestational age ≥ 35 wk old) diagnosed with persistent pulmonary hypertension of newborn within first 3 days after birth and 50 age-matched controls.

Interventions:
None.

Measurements and Main Results:
The echocardiographic measurements comprised of right ventricular and left ventricular functional markers, including tricuspid annular plane systolic excursion, fractional area change, tissue Doppler imaging, and deformation imaging. Sample size was based on detecting an intergroup difference of 10% in tricuspid annular plane systolic excursion, which was considered the primary outcome. Linear correlations between the right and left ventricular indices, as well as their association with the outcome of death or extracorporeal membrane oxygenation were evaluated. Persistent pulmonary hypertension of newborn was associated with lower tricuspid annular plane systolic excursion (6.81 ± 1.92 vs 9.25 ± 1.30 mm), right-ventricular global longitudinal strain (16.9% ± 5.4% vs –21.6% ± 4.6%); left ventricular ejection fraction (49% ± 7% vs 55% ± 6%), left ventricular global longitudinal strain (–16.7% ± 3.3% vs –21.4% ± 2.0%) (all p < 0.01). Right and left ventricular diastolic and global function was also lower in persistent pulmonary hypertension of newborn, with more pronounced changes seen for the right ventricle. Moderate-to-strong linear correlations were observed between the right and left ventricular functional markers, with right ventricular global longitudinal strain and left ventricular global longitudinal strain being the strongest (r = 0.8). Within persistent pulmonary hypertension of newborn group, hypoxic ischemic encephalopathy was associated with lower right and left ventricular systolic and right ventricular diastolic performance. Tricuspid annular plane systolic excursion (p =0.08) and left ventricular systolic velocity (p = 0.09) tended to be lower in patients who subsequently died/needed extracorporeal membrane oxygenation.

Conclusions:
Persistent pulmonary hypertension of newborn is characterized by global cardiac dysfunction, involving both the right and left ventricles, with significant interventricular functional correlation. Cardiac dysfunction early in disease course may identify patients at highest risk of adverse outcome.
Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU
Authors: Suttle Markita , Hall Mark W. , Pollack Murray M. , Berg Robert A. , McQuillen Patrick S. , Mourani Peter M. , Sapru Anil , Carcillo Joseph A. , Startup Emily , Holubkov Richard , Dean J. Michael , Notterman Daniel A. , Meert Kathleen L. 
Published: October 2020

Objectives:
Therapeutic alliance is the collaborative bond that develops between patients/families and healthcare providers. Our objective is to determine the extent of therapeutic alliance bereaved parents perceive to have occurred with their child’s physicians during their child’s PICU stay, and associated factors.

Design:
Multicenter observational study.

Setting:
Eight children’s hospitals affiliated with the Collaborative Pediatric Critical Care Research Network.

Patients:
Parents greater than or equal to 18 years old whose child died in a PICU (including cardiac ICU).

Interventions:
Bereaved parents completed the Human Connection Scale, a 16-item measure of therapeutic alliance, 6 months after their child’s death. Human Connection Scale scores range from 16 to 64 with higher scores indicating greater alliance. Parents provided sociodemographic data, and medical records were reviewed for the child’s clinical characteristics.

Measurements and Main Results:
Two-hundred and thirty-three parents of 157 deceased children responded to the Human Connection Scale with greater than or equal to 80% item completion. Among parents, 146 (62.7%) were female, 155 (66.5%) were White and 46 (19.7%) were Black, 175 (75.1%) were married, and 209 (89.7%) had at least a high-school education. Among children, median age at the time of death was 5.9 years (interquartile range, 0.64–13.9 yr) and 114 (72.6%) died after limitation or withdrawal of life support. Mean Human Connection Scale score was 51.4 ± 11.1 for all parents, 52.6 ± 9.0 for White parents, and 47.0 ± 13.7 for Black parents. In multivariable modeling predicting Human Connection Scale scores, race was the only parent or child characteristic in the final model. Human Connection Scale scores were significantly different (–4.56; 95% CI, –8.53 to –0.6; p = 0.025) between the Black and White parents with items about trust, care, and honest communication showing the greatest mean difference.

Conclusions:
Among parents bereaved in the PICU, therapeutic alliance with physicians is moderately high. Future research should identify strategies to strengthen therapeutic alliance with Black parents and examine the role of alliance on bereaved parents’ health outcomes.
Brazilian Translation, Cross-Cultural Adaptation, Validity, and Reliability of the EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) Questionnaire to Measure Parental Satisfaction in PICUs
Authors: Lessa Alessandra D. , Cabral Felipe C. , Tonial Cristian T. , Costa Caroline A. D. , Andrades Gabriela R. H. , Crestani Francielly , Einloft Paulo R. , Bruno Francisco , Sganzerla Daniel , Matte Maria C. C. , Fiori Humberto H. , Latour Jos M. , Garcia Pedro Celiny R. 
Published: October 2020

OBJECTIVES:
To conduct the Brazilian translation, cross-cultural adaptation, validation, and reliability testing of the EMpowerment of PArents in THe Intensive Care (EMPATHIC-30).

DESIGN:
Prospective study.

SETTING:
PICU of a tertiary-care teaching hospital.

PATIENTS:
Parents (n = 141) completed the translated EMPATHIC-30 questionnaire 72 hours after their child’s PICU discharge.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The translation and cultural adaptation were performed in accordance with the principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures. Sentences were adapted according to the Brazilian syntax. Total content validity coefficient was above the established average (> 0.8). Reliability was evaluated with the coefficients McDonald omega and Cronbach alpha. The lowest Cronbach alpha found was 0.47 (CI 95%, 0.35–0.59) in the organization domain, where the lowest response rate was also concentrated. The values of the other domains were as follows: 0.64 (95% CI, 0.55–0.73) for information, 0.77 (95% CI, 0.71–0.83) for care and treatment, 0.72 (95% CI, 0.66–0.78) for parent participation, and 0.72 (95% CI, 0.65–0.79) for professional attitudes. The total internal consistency independent of the domain was 0.90 (CI 95%, 0.88–0.92). With regard to McDonald Omega, values were identified: 0.68 (95% CI, 0.49–0.88) for information, 0.73 (95% CI, 0.61–0.85) for care and treatment, 0.85 (95% CI, 0.47–0.80) for parent participation, 0.85 (95% CI, 0.76–0.93), and 0.72 (95% CI, 0.58–0.86) for professional attitudes.

CONCLUSIONS:
EMPATHIC-30 has been translated and culturally adapted for the Brazilian population. Validation demonstrated an above-average total content validity coefficient, confirming the instrument content validity. A sufficient reliability was observed in both analyzed coefficients. The results support the use of the Brazilian version of EMPATHIC-30 for the evaluation of parents’ satisfaction of children admitted to the PICU.
Transplacental Transfer of SARS-CoV-2 Antibodies
Authors: Flannery Dustin D. , Gouma Sigrid , Dhudasia Miren B. , Mukhopadhyay Sagori , Pfeifer Madeline R. , Woodford Emily C. , Triebwasser Jourdan E. , Gerber Jeffrey S. , Morris Jeffrey S. , Weirick Madison E. , McAllister Christopher M. , Bolton Marcus J. , Arevalo Claudia P. , Anderson Elizabeth M. , Goodwin Eileen C. , Hensley Scott E. , Puopolo Karen M. 
Published: October 2020

AbstractWe measured SARS-CoV-2 antibody levels in serum samples from 1,471 mother/newborn dyads and found efficient transplacental transfer of SARS-CoV-2 IgG antibodies in 72 of 83 seropositive pregnant women. Transfer ratios >1.0 were observed among women with an asymptomatic SARS-CoV-2 infection as well as those with mild, moderate and severe COVID-19. Our findings demonstrate the potential for maternally-derived antibodies to provide neonatal protection from SARS-CoV-2 infection.
Computerized Cognitive Training in Cognitively Healthy Older Adults: A Systematic Review and Network Meta-Analysis
Authors: Lampit Amit , Gavelin Hanna Malmberg , Sabates Julieta , Launder Nathalie H , Hallock Harry , Finke Carsten , Krohn Stephan , Peeters Geeske 
Published: October 2020

ABSTRACTBackgroundComputerized cognitive training (CCT) is a broad category of drill-and-practice interventions aims to maintain cognitive performance in older adults. Despite a supportive evidence base for general efficacy, it is unclear what types of CCT are most likely to be beneficial and what intervention design factors are essential for clinical implementation.MethodsWe searched MEDLINE, Embase, and PsycINFO to August 2019 for randomized controlled trials (RCTs) of any type of CCT in cognitively healthy older adults. Risk of bias within studies was assessed using the Cochrane Risk of Bias 2 tool. The primary outcome was change in overall cognitive performance between CCT and control groups. Secondary outcomes were individual cognitive domains. A series of meta-regressions were performed to estimates associations between key design factors and overall efficacy using robust variance estimation models. Network meta-analysis was used to compare the main approaches to CCT against passive or common active control conditions.ResultsNinety RCTs encompassing 7219 participants across 117 comparisons were included. The overall cognitive effect size across all trials was small (g=0.18, 95% CI 0.14 to 0.23) with considerable heterogeneity (τ2=0.074, 95% prediction interval −0.36 to 0.73), robust to small-study effect or risk of bias. Effect sizes for individual cognitive domains were small, heterogeneous and statistically significant apart from fluid intelligence and visual processing. Meta-regressions revealed significantly larger effect sizes in trials using supervised training or up to three times per week. Multidomain training was the most efficacious CCT approach against any type of control, with greater benefits in a subset of supervised training studies.ConclusionsThe efficacy of CCT varies substantially across designs, independent of the type of control. Multidomain supervised CCT appears to be the most efficacious approach, and should be developed to accommodate for individual needs and remote delivery settings. Future research should focus on identifying the intervention components and regimens that could attenuate aging-related cognitive decline.
Prevalence and Longevity of SARS-CoV-2 Antibodies in Healthcare Workers: A Single Center Study
Authors: Brant-Zawadzki Michael , Fridman Deborah , Robinson Philip A. , Zahn Matthew , Chau Clayton , German Randy , Breit Marcus , Burke Elmira , Bock Jason R. , Hara Junko 
Published: October 2020

ABSTRACTUnderstanding SARS-CoV-2 antibody prevalence as a marker of prior infection in a spectrum of healthcare workers (HCWs) may guide risk stratification and enactment of better health policies and procedures.The present study reported on cross-sectional study to determine the prevalence and longevity of SARS-CoV-2 antibodies in HCWs at a regional hospital system in Orange County, California, between May and August, 2020.Data from HCWs (n=3,458) were included in the analysis. Data from first responders (n=226) were also analyzed for comparison. A blood sample was collected at study enrollment and 8-week follow-up. Information on job duties, location, COVID-19 symptoms, polymerase chain reaction test history, travel since January 2020, and household contacts with COVID-19 was collected. Comparisons to estimated community prevalence were also evaluated.Observed antibody prevalence was 0.93% and 2.58% at initial and 8-week follow-up, respectively, for HCWs, and 5.31% and 4.35% for first responders. For HCWs, significant differences (p < .05) between negative vs. positive at initial assessment were found for age, race, fever, and loss of smell, and at 8-week follow-up for age, race, and all symptoms. Antibody positivity persisted at least 8 weeks in this cohort. Among 75 HCWs with self-reported prior PCR-confirmed COVID-19, 35 (46.7%) were antibody negative. Significant differences between negative vs. positive were observed in age and frequency of symptoms.This study found considerably lower SARS-CoV-2 antibody prevalence among HCWs compared with prior published studies. This may be explained by better safety measures in the workplace, heightened awareness inside and outside of the workplace, possibly lower susceptibility due to innate immunity and other biological heterogeneity, and low COVID-19 prevalence in the community itself. HCWs with initial positive results had persistent positive serologies at 8 weeks. Further research is warranted to investigate factors influencing such lower prevalence in our HCWs.