bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative evaluation of single-photon emission computed tomography findings in lower extremity possible without computed tomography-based attenuation correction
Authors: Tsuchitani Tatsuya , Kitajima Kazuhiro , Takahashi Yoshiyuki , Kotoura Noriko 
Published: May 2021

Objective
For performing accurate quantitative analysis of single-photon emission computed tomography (SPECT)/computed tomography (CT) images, CT-based attenuation correction (CTAC) is considered to be necessary. However, the effect on quantitative values for an examined area close to the body surface, such as in the lower extremity, has yet to be elucidated. We performed the present investigation to determine the possibility of quantitative evaluation using a SPECT standalone device without CT.

Methods
Validation was performed using clinical data of patients who underwent a lower extremity SPECT/CT examination, with grouping based on presence or absence of CTAC, scatter correction and resolution recovery. Using a reference group in which all types of correction were applied, standardized uptake values (SUVs), including maximum (SUVmax) and peak (SUVpeak), were examined in each group and compared.

Results
As compared to the reference group, the difference in quantitative values became smaller in the order of the applied scatter correction and resolution recovery, applied resolution recovery, applied scatter correction, and neither scatter correction or resolution recovery applied groups, with no significant difference between the reference group and that with neither scatter correction or resolution recovery applied. A similar tendency was seen for both SUVmax and SUVpeak.

Conclusions
In bone SPECT quantitative examinations of the lower extremity, quantitative evaluation without CTAC is possible without the use of scatter correction or resolution recovery. Thus, quantitative evaluation can be performed with use of a standalone SPECT device without CT.
Identification of specific SUVmax ratios enhances diagnostic accuracy for staging of intrathoracic nodes in lung cancer
Authors: Pencharz Deborah , Matei Nadia , Jeon Justyn , Myerson James , Marchbank Nigel D 
Published: May 2021

Introduction
Studies demonstrating limited accuracy of ‘positive’ and ‘negative’ lymph nodes on fluorodeoxyglucose (FDG) PET-CT in staging for lung cancer have led to guidelines stating mediastinal nodes enlarged on computed tomography, irrespective of FDG uptake, require endobronchial ultrasound (EBUS)-transbronchial needle aspiration (TBNA). However FDG uptake occurs on a continuous spectrum and the use of standardised uptake value (SUV)max ratios, rather than a binary classification, may have improved diagnostic accuracy.

Methods
This was a retrospective analysis of patients with lung cancer who had PET-CT and EBUS-TBNA in 2015–2018. Results from EBUS and the SUVmax ratio of sampled lymph nodes to mediastinal blood pool (SUVmax LN/MBP) were analysed.

Results
From 99 patients 102 malignant and 54 benign nodes were identified. The SUVmax range was 2.5–52 for malignant and 1.6–5.4 for benign nodes. The SUVmax LN/MBP was 1.3–23 for malignant and 0.7–2.3 for benign nodes. All nodes with SUVmax LN/MBP <1.3 were benign with 100% negative predictive value (NPV). All nodes with SUVmax LN/MBP >2.3 were malignant with 100% positive predictive value (PPV).

Conclusion
In this relatively small sample, SUVmax LN/MBP <1.3 had a NPV of 100% for excluding malignant nodes and SUVmax LN/MBP >2.3 had a PPV of 100% for diagnosing malignant nodes. Using SUVmax ratios could obviate the need for staging EBUS in selected patients with resultant time and cost savings. Selecting different SUVmax ratios, chosen to provide high accuracies for the parameter of interest to change management, is a potentially powerful diagnostic tool that is overlooked when FDG uptake is only classified as ‘positive’ or ‘negative’.
18F-FDG-PET/CT analysis in hospitalized patients affected by pulmonary disease: The experience of the Nuclear Medicine Unit of “Policlinico Tor Vegata”
Authors: Urbano Nicoletta , Scimeca Manuel , Tavolozza Mario , Bonanno Elena , Mauriello Alessandro , Schillaci Orazio 
Published: May 2021

Objective
The main aim of this study was to retrospectively evaluate the clinical data and outcomes of a cohort of 492 hospitalized patients who underwent fluorine-18-fluorodeoxyglucose (F-FDG)-PET/CT analysis at the nuclear medicine unit of ‘Policlinico Tor Vergata’ in Rome during the years 2017 and 2018 with particular emphasis for patients affected by pulmonary diseases.

Methods
Anamnestic data (age and gender), main pathologic conditions, results of F-FDG-PET/CT examination, appropriateness of the request, and medical records of 492 consecutive hospitalized patients who underwent F-FDG-PET/CT analysis (55.38 ± 3.78 years; range 33–81 years) from January 2017 to December 2018 were obtained.

Results
Considering all examinations, positive results were observed in 66.9% of cases whereas it was not possible to perform a diagnosis in 12.7% of cases (doubt results). About 20-fold increase in the percentage of doubt results was observed in F-FDG-PET/CT analysis with no appropriateness as compared to those with double appropriateness (both the request and clinical). Noteworthy, our data showed a 95% higher concordance between the positive results of the F-FDG-PET/CT examination and the histologic diagnosis. Conversely, the concordance between the analysis of the bronchoalveolar lavages and the PET analysis was very low.

Conclusion
Data here reported showed the high accuracy of the F-FDG-PET/CT performed in our department, mainly for pulmonary diseases, also highlighting the importance of continuously updating the selection criteria for patients who need PET examinations.
A New Model for Specific Visualization of Skin Graft Neoangiogenesis Using Flt1-tdsRed BAC Transgenic Mice
Authors: Abdelhakim Mohamed , Dohi Teruyuki , Yamato Mizuho , Takada Hiroya , Sakai Atsushi , Suzuki Hidenori , Ema Masatsugu , Fukuhara Shigetomo , Ogawa Rei 
Published: May 2021

Background:
Neovascularization plays a critical role in skin graft survival. Up to date, the lack of specificity to solely track the newly sprouting blood vessels has remained a limiting factor in skin graft transplantation models. Therefore, the authors developed a new model by using Flt1-tdsRed BAC transgenic mice. Flt1 is a vascular endothelial growth factor receptor expressed by sprouting endothelial cells mediating neoangiogenesis. The authors determined whether this model reliably visualizes neovascularization by quantifying tdsRed fluorescence in the graft over 14 days.

Methods:
Cross-transplantation of two full-thickness 1 × 1-cm dorsal skin grafts was performed between 6- to 8-week-old male Flt1 mice and KSN/Slc nude mice (n = 5). The percentage of graft area occupied by tdsRed fluorescence in the central and lateral areas of the graft on days 3, 5, 9, and 14 was determined using confocal-laser scanning microscopy.

Results:
Flt1+ endothelial cells migrating from the transgenic wound bed into the nude graft were first visible in the reticular dermis of the graft center on day 3 (0.5 ± 0.1; p < 0.05). Peak neovascularization was observed on day 9 in the lateral and central parts, increasing by 2- to 4-fold (4.6 ± 0.8 and 4.2 ± 0.9; p < 0.001). Notably, some limited neoangiogenesis was displayed within the Flt grafts on nude mice, particularly in the center. No neovascularization was observed from the wound margins.

Conclusion:
The ability of the Flt1-tdsRed transgenic mouse model to efficiently identify the origin of the skin-graft vasculature and visualize graft neovascularization over time suggests its potential utility for developing techniques that promote graft neovascularization.
Long Acellular Nerve Allografts Cap Transected Nerve to Arrest Axon Regeneration and Alter Upstream Gene Expression in a Rat Neuroma Model
Authors: Pan Deng , Bichanich Miles , Wood Ian S. , Hunter Daniel A. , Tintle Scott M. , Davis Thomas A. , Wood Matthew D. , Moore Amy M. 
Published: May 2021

Background:
Treatments to manage painful neuroma are needed. An operative strategy that isolates and controls chaotic axonal growth could prevent neuroma. Using long acellular nerve allograft to “cap” damaged nerve could control axonal regeneration and, in turn, regulate upstream gene expression patterns.

Methods:
Rat sciatic nerve was transected, and the distal nerve end was reversed and ligated to generate a model end-neuroma. Three groups were used to assess their effects immediately following this nerve injury: no treatment (control), traction neurectomy, or 5-cm acellular nerve allograft cap attached to the proximal nerve. Regeneration of axons from the injured nerve was assessed over 5 months and paired with concurrent measurements of gene expression from upstream affected dorsal root ganglia.

Results:
Both control and traction neurectomy groups demonstrated uncontrolled axon regeneration revealed using Thy1-GFP rat axon imaging and histomorphometric measures of regenerated axons within the most terminal region of regenerated tissue. The acellular nerve allograft group arrested axons within the acellular nerve allograft, where no axons reached the most terminal region even after 5 months. At 5 months, gene expression associated with regeneration and pain sensitization, including Bdnf, cfos, and Gal, was decreased within dorsal root ganglia obtained from the acellular nerve allograft group compared to control or traction neurectomy group dorsal root ganglia.

Conclusions:
Long acellular nerve allografts to cap a severed nerve arrested axon regeneration within the acellular nerve allograft. This growth arrest corresponded with changes in regenerative and pain-related genes upstream. Acellular nerve allografts may be useful for surgical intervention of neuroma.
The other side of screening: predictors of treatment and follow-up for anal precancers in a large health system
Authors: Silvera Richard , Martinson Tyler , Gaisa Michael M. , Liu Yuxin , Deshmukh Ashish A. , Sigel Keith 
Published: May 2021

Background:
Anal cancer disproportionately affects people with HIV (PWH). High-grade squamous intraepithelial lesions (HSIL) are cancer precursors and treating them might prevent anal cancer. Data on adherence to HSIL treatment and surveillance is limited but needed to identify deficiencies of screening strategies.

Methods:
We collected data on high-resolution anoscopy (HRA) attendance and outcomes from 2009 to 2019 in a large urban anal cancer-screening program. Patients with an initial HSIL diagnosis were followed for return for HSIL electrocautery ablation within 6 months of index HSIL diagnosis, and follow-up HRA within 18 months of index HSIL diagnosis. We also evaluated predictors of these outcomes in univariable and multivariable analyses.

Results:
One thousand one hundred and seventy-nine unique patients with an anal HSIL diagnosis were identified and 684 (58%) returned for electrocautery ablation. Of those treated, only 174 (25%) and only 9% of untreated HSIL patients (47 of 495) underwent surveillance HRA within 18 months of index HSIL diagnosis. In multivariable analyses, black patients and PWH regardless of virologic control were less likely to undergo HSIL ablation within 6 months of HSIL diagnosis whereas patients with commercial insurance were more likely to be treated within 6 months of diagnosis. Among treated HSIL patients, PWH with viremia had a lower likelihood of engaging in post-treatment surveillance within 18 months of HSIL diagnosis.

Discussion:
Even in large specialized anal cancer screening programs adherence to HSIL treatment and surveillance is low. Psychosocial and economic determinants of health may impact retention in care. Addressing both personal and structural barriers to patient engagement may improve the effectiveness of anal cancer screening.
Associations of socioeconomic position and adverse childhood experiences with health-related behaviour changes and changes to employment during the first COVID-19 lockdown in the UK
Authors: Smith Madeleine L , Herbert Annie , Hughes Amanda , Northstone Kate , Howe Laura D 
Published: May 2021

ABSTRACTBackgroundNon-pharmaceutical interventions to reduce the spread of COVID-19 may have disproportionately affected already disadvantaged populations.MethodsWe analysed data from 2710 young adult participants of the Avon Longitudinal Study of Parents and Children. We assessed the associations of socioeconomic position (SEP) and Adverse Childhood Experiences (ACEs, e.g. abuse, neglect, measures of family dysfunction) with changes to health-related behaviours (meals, snacks, exercise, sleep, alcohol and smoking/vaping), and to financial and employment status during the first UK lockdown between March-June 2020.ResultsExperiencing 4 or more ACEs was associated with reporting decreased sleep quantity during lockdown (OR 1.53, 95% CI: 1.07-2.18) and increased smoking and/or vaping (OR 1.85, 95% CI: 0.99-3.43); no other associations were seen between ACEs or SEP and health-related behaviour changes. Adverse financial and employment changes were more likely for people with low SEP and for people who had experienced multiple ACEs; e.g. people who had been in the ‘never worked or long-term unemployed’ or ‘routine and manual occupation’ categories pre-lockdown were almost 3 times more likely to have stopped working during lockdown compared with people who were in a higher managerial, administrative or professional occupation pre-lockdown (OR 2.83, 95% CI: 1.45-5.50 and OR 2.68, 95% CI: 1.63-4.42 respectively).ConclusionAdverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities. Despite this, in this sample of young adults, there was little evidence that lockdown worsened inequalities in health-related behaviours.BOXWhat is already known on this subject?Non-pharmaceutical interventions implemented to mitigate the spread of COVID-19 (e.g. nationwide lockdown) have affected the lifestyles and livelihoods of many, with potential consequences for physical health and financial wellbeing.Existing evidence suggests sociodemographic inequalities in the effects of lockdown, but details of the factors influencing these inequalities remain unclear.What this study adds?A history of adverse childhood experiences may be associated with decreased sleep and increased smoking/vaping during lockdown. SEP and ACEs were not associated with changes in other health-related behaviours in this cohort of young adults.Adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities. Our findings highlight a need for continued support of people who experience ACEs into adulthood, and demonstrate that this need may have increased during the COVID-19 pandemic.
The long-term effects of free care on birth outcomes: Evidence from a national policy reform in Zambia
Authors: Lagarde Mylene , Lepine Aurelia , Chansa Collins 
Published: May 2021

AbstractAs women in many countries still fail to give birth in facilities due to financial barriers, many see the abolition of user fees as a key step on the path towards universal coverage. We exploited the staggered removal of user charges in Zambia from 2006 to estimate the effect of user fee removal over up to five years after the policy change. We used data from the birth histories of two nationally representative Demographic and Health Surveys to implement a difference-in-differences analysis and identify the causal impact of removing user charges on institutional and assisted deliveries, caesarean sections and neonatal deaths. We also used the rich survey data to explore heterogeneous effects of the policy. Removing fees had little effect in the short term but large positive effects appeared about two years after the policy change. Institutional deliveries in treated areas increased by 25 to 35%, driven entirely by a reduction in home births. However, there was no evidence that the reform changed the behaviours of women with lower education, the proportion of caesarean sections or reduced neonatal mortality. Institutional deliveries increased where care quality was high, but not where it was low. While abolishing user charges may reduce financial hardship from healthcare payments, it does not necessarily improve equitable access to care or health outcomes. Shifting away from user fees is a necessary but insufficient step towards universal health coverage, and concurrent reforms are needed to target vulnerable populations and improve quality of care.
Loss of intestinal ChREBP impairs absorption of dietary sugars and prevents glycemic excursion curves
Authors: Charifi W , Fauveau V , Francese L , Grosfeld A , Le Gall M , Ourabah S , Ellero-Simatos S , Viel T , Cauzac M , Gueddouri D , Benhamed F , Tavitian B , Dentin R , Burnol AF , Postic C , Guilmeau S 
Published: May 2021

ABSTRACTIncreased sugar consumption is a risk factor for features of the metabolic syndrome including obesity, hypertriglyceridemia, insulin resistance, diabetes, and nonalcoholic fatty liver disease. The gut epithelium, which plays a central role in dietary sugar digestion, absorption and metabolism has emerged a key actor of metabolic disorders. While the transcription factor ChREBP (Carbohydrate response element binding protein) has been established as a key player of the adaptive reprograming of cellular metabolism in various tissues upon glucose or fructose challenge, its specific contribution to the regulation of blood glucose upon dietary sugar intake was not previously addressed.We demonstrate here that ChREBP is abundantly expressed in the proximal gut epithelium, where carbohydrate digestion and absorption primarily occur and in particular L cells, which produce the glucoincretin GLP-1. The inducible deletion of ChREBP specifically in the mouse gut epithelium (ChΔGUT mice) resulted in the reduction of early glycemic excursion upon oral glucose load. Surprisingly, despite being associated with reduced GLP-1 production, loss of gut ChREBP activity significantly dampened glucose transepithelial flux, and thereby delayed glucose distribution to peripheral tissues. Among the underlying mechanisms, we unveil that ChΔGUT mice show an impaired expression of key intestinal hexose (glucose, galactose, fructose) transporters and metabolic enzymes as well as brush border dissacharidases. In agreement, intestinal ChREBP deficiency was accompanied by a precocious intolerance to both high-lactose and high-sucrose diets concomitant with mild galactose and severe fructose malabsorption syndromes.Altogether, our study demonstrates that, by transcriptionally orchestrating local digestion and absorption of dietary sugars, ChREBP activity in the mouse gut epithelium controls glucose appearance rate into systemic circulation and prevents against intolerance to mono- and disaccharides.
How to Assemble a Scale-Invariant Gradient
Authors: Datta Arnab , Ghosh Sagnik , Kondev Jane 
Published: May 2021

AbstractIntracellular protein gradients serve a variety of functions, such as the establishment of cell polarity and to provide positional information for gene expression in developing embryos. Given that cell size in a population can vary considerably, for the protein gradients to work properly they often have to be scaled to the size of the cell. Here we examine a model of protein gradient formation within a cell that relies on cytoplasmic diffusion and cortical transport of proteins toward a cell pole. We show that the shape of the protein gradient is determined solely by the cell geometry. Furthermore, we show that the length scale over which the protein concentration in the gradient varies is determined by the linear dimensions of the cell, independent of the diffusion constant or the transport speed. This gradient provides scale-invariant positional information within a cell, which can be used for assembly of intracellular structures whose size is scaled to the linear dimensions of the cell, as was recently reported for the cytokinetic ring and actin cables in budding yeast cells.
Strategies that make vaccination easy and promote autonomy could increase COVID-19 vaccination in those who remain hesitant
Authors: Eshun-Wilson Ingrid , Mody Aaloke , Tram Khai Hoan , Bradley Cory , Sheve Alexander , Fox Branson , Thompson Vetta , Geng Elvin H 
Published: May 2021

AbstractThe COVID-19 vaccination campaign in the US has been immensely successful in vaccinating those who are receptive, further increases in vaccination rates however will require more innovative approaches to reach those who remain hesitant, deliberative or indifferent. Phenomena such empty mass vaccination sites and wasted vaccine doses in some regions suggest that in addition to dispelling misinformation and building trust, developing more person-centered vaccination strategies, that are modelled on what people want could further increase uptake. To inform vaccine distribution strategies that are aligned with public preferences for COVID-19 vaccination campaign features we conducted a survey and discrete choice experiment among a representative sample of 2,895 people in the US, between March 15 and March 22, 2021. We found that on average the public prioritized ease, preferring single to two dose vaccinations, vaccinating once rather than annually and reduced waiting times at vaccination sites - for some these were the primary preference drivers. Vaccine enforcement reduced overall vaccine acceptance, with a trend of increasing ‘control aversion’ with increasing vaccine hesitancy, particularly among those who were young, Black/African American or Republican. These data suggest that making vaccination easy and promoting autonomy by offering the public choices of vaccination brands and locations may increase uptake, and that vaccine mandates could compromise autonomy and increase control aversion in those who are hesitant - reducing vaccination in such groups and potentially undermining the goals of COVID-19 vaccination campaigns.SignificanceDCE’s are a novel tool in public health that allow examination of preferences for a product, service or policy, identifying how the public prioritizes personal risks and cost in relation to health behaviors. Using this method to establish preferences for COVID-19 vaccination campaign strategies, our results suggest that: firstly, vaccination should be made as easy as possible for the public, second, that individuals should be offered choices of vaccine brand and vaccination location, and third, that vaccine enforcement could activate ‘control aversion’ in the public and particularly in those who are most hesitant – potentially causing these groups to double down on vaccine resistance, a scenario which would impede the success of vaccination programs in the US.