bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term effects of endoscopic papillary large balloon dilation in patients with challenging bile duct calculi
Authors: Kamezaki Hidehiro , Iwanaga Terunao , Maeda Takahiro , Senoo Jun-ichi , Sakamoto Dai , Yasui Shin , Sugiyama Harutoshi , Tsuyuguchi Toshio , Kato Naoya 
Published: September 2021

Abstract
Endoscopic papillary large balloon dilation (EPLBD) can be used to treat challenging common bile duct stones. No previous studies have reported intractable cases treated either by EPLBD or mechanical lithotripter use. We aimed to evaluate and compare the long-term effects of EPLBD with mechanical lithotripter use.
This retrospective cohort study reviewed data from 153 patients admitted to the Eastern Chiba Medical Center from April 2014 to March 2020, presenting with common bile duct calculi that could not be removed using a basket or balloon catheter. Patients were divided into groups depending on whether the treatment was performed using a mechanical lithotripter or EPLBD. The primary outcome was the recurrence rate of common bile duct calculi, and the secondary outcome was the rate of postoperative adverse events. The Wilcoxon test was used to compare the 2 groups. Statistical significance was set at P < .05.
The median age of patients included in the lithotripter and EPLBD groups were 73 years and 83 years, respectively (P = .006), while the sex ratio (male:female) in the groups was 18:13 and 55:67, respectively. The EPLBD group showed a statistically larger median bile duct diameter (13 mm [range: 8–24 mm] vs 11 mm [range: 5–16 mm]; P < .001), larger maximal calculus diameter (median, 13.5 mm [range: 8–25 mm] vs 11 mm [range: 7–16 mm]; P < .001), and shorter median cumulative treatment time after reaching the duodenal papilla (35.5 minutes [range: 10–176 minutes] vs 47 minutes [range: 22–321 minutes]; P = .026) in comparison to the lithotripter group. There was no significant difference in the rate of adverse events between the EPLBD and the mechanical lithotripter groups. The recurrence rate was significantly lower (P = .014) in the EPLBD group.
EPLBD increases therapeutic efficacy and reduces treatment duration for patients in whom calculus removal is difficult, without increasing the frequency of adverse events. No serious adverse events were observed. Additionally, EPLBD appears to reduce the risk of long-term recurrence. Future studies are needed to evaluate long-term outcomes in younger patients.
Psychosocial Stress, Social Support, and the Escalation of Schizotypal Symptoms
Authors: Juan Michael A. , Rosenfarb Irwin Ford 
Published: September 2021

Abstract
Although research suggests that psychosocial stress is associated with an increase in schizotypal symptoms, the type of stressor associated with increased symptomatology is unclear, and no study has examined whether social support might mitigate the effects of stress on symptom change. In this study, 131 young adults completed measures of schizotypal symptoms, major life events, daily hassles, and perceptions of social support at baseline, and measures of stress and symptoms again 4 to 6 weeks later. Results indicated, after controlling for baseline measures, that for those scoring low on schizotypal measures at baseline, only low levels of social support were associated with increased symptoms. For those scoring high on the schizotypal scales at baseline, however, both major life events and daily hassles were associated with increased symptomatology, but only when perceptions of social support at baseline were low. The results suggest that it is important to assess both perceptions of social support and baseline symptomatology when examining whether major life events and daily stress are associated with increased psychotic symptoms. Both types of psychosocial stress are associated with an increase in symptoms, but only for those who are already showing above average symptoms and only when social support is low.
99mTc-MIBI SPECT/CT and FDG PET/CT in Isolated Bilateral Renal Metastases From Adenoid Cystic Carcinoma of the Maxilla
Authors: Zhao Qian , Dong Aisheng , Ye Huamao , Zuo Changjing 
Published: September 2021

Abstract
Renal metastasis from adenoid cystic carcinoma of the head and neck is uncommon. We present 99mTc-MIBI SPECT/CT and FDG PET/CT findings in a case with isolated bilateral renal metastases from adenoid cystic carcinoma of the left maxilla. The metastatic adenoid cystic carcinomas of the kidneys showed photopenia on 99mTc-MIBI SPECT/CT and increased FDG uptake on FDG PET/CT mimicking primary renal cell carcinoma.
Impact of Follow-up 18F-FDG PET on the Management in Patients With Lung Cancer
Authors: Yoon Hai-Jeon , Pak Kyoungjune 
Published: September 2021

Purpose
The incidence of lung cancer has increased steadily. We meta-analyzed to assess the impact of 18F-FDG PET on the management of lung cancer to detect recurrence/metastasis.

Materials and Methods
We performed systematic searches of Medline and Embase databases for English-language publications. All published studies regarding the impact of PET on the management of patients with lung cancer in detection of recurrence/metastasis were searched. The proportion of management change (%) defined as the percentage of patients who changed management after FDG PET to patients who had FDG PET was calculated. The data from each study were analyzed using MedCalc Statistical Software version 14.12.0 (MedCalc Software, Ostend, Belgium).

Results
Eight studies including 523 patients were eligible for inclusion in the study. The impact of 18F-FDG PET for the purpose of detecting recurrence/metastasis in patients with lung cancer was evaluated using management change rates, which were ranged from 28.6% to 79.2% with a pooled effect of 61.4% (95% confidence interval, 49.5%–72.7%; I
2 = 85.7%). In a subgroup analysis, impact of 18F-FDG PET was evaluated in studies of patients with non–small cell lung cancer with indication of abnormal findings of conventional imaging, elevated tumor markers, and clinical symptoms with the pooled rate of management change of 62.2% (95% confidence interval, 44.2%–78.5%; I
2 = 88.0%).

Conclusions
We have highlighted that 18F-FDG PET has a major impact on the management of patients with recurrent lung cancer. These findings suggest that 18F-FDG PET should be performed in patients with lung cancer, especially in cases involving equivocal or suspicious recurrence/metastasis on conventional imaging, elevated tumor markers, or clinical symptoms during follow-up.
Recurrence of a Pheochromocytoma With TNEM127 Mutation Negative on 18F-FDOPA and 18F-FDG but Positive on 123I-MIBG and 68Ga-DOTATOC Imaging
Authors: Cottereau Anne-Ségolène , Garcia Cyril , Dousset Bertrand , Libe Rossella , Tenenbaum Florence 
Published: September 2021

Abstract
We report the case of a 75-year-old woman with liver metastasis as a recurrence of a pheochromocytoma resected 10 years ago, with a rare germline mutation in transmembrane protein 127, falsely negative on 18F-FDOPA and 18F-FDG PET/CT scans but strongly positive on 123I-MIBG scintigraphy and on 68Ga-DOTATOC PET/CT. Functional imaging has a key role in diagnosis of pheochromocytoma and paraganglioma, especially 18F-FDOPA shows very high sensitivity and specificity. However, 18F-FDOPA might be falsely negative in some of these tumors, depending on specific mutations, and thus MIBG or 68Ga-DOTATOC imaging could be an alternative.
Supraclavicular and Axillary Lymphadenopathy Induced by COVID-19 Vaccination on 18F-Fluorthanatrace, 68Ga-DOTATATE, and 18F-Fluciclovine PET/CT
Authors: Surasi Devaki Shilpa Sudha , Lin Lilie , Ravizzini Gregory , Wong Franklin 
Published: September 2021

Abstract
COVID-19 vaccination has started in most countries, and postvaccination imaging is inevitable in the oncologic population. The immune response to the vaccination in the form of reactive lymphadenopathy has been well documented on 18F-FDG PET/CT. We present the imaging findings of 3 patients who have undergone non-FDG PET/CT imaging including 18F-fluorthanatrace, 68Ga-DOTATATE, and 18F-fluciclovine PET/CT. It is crucial to recognize the timing and laterality of immunization to avoid false-positive findings.
Key Role of Personalized Dosimetry in Dose Adjustment for Selective Internal Radiotherapy
Authors: Subreville Celine , Pinaquy Jean-Baptiste , Lapuyade Bruno , Blanc Jean-Frederic , Bordenave Laurence , Papadopoulos Panteleimon , Debordeaux Frederic 
Published: September 2021

Purpose
Selective internal radiotherapy with 90Y microspheres is widely used for the treatment of patients with liver cancer. A dosimetric analysis using the dosimetry software Simplicit90y (Boston Scientific, Natick, MA) was conducted to define doses to the tumor and healthy liver, and to determine a threshold tumor dose that could predict progression-free survival.

Methods
Patients experiencing hepatocellular carcinoma and treated with 90Y-labeled resin microspheres were included in a retrospective study. The time-to-progression of the target lesions (TTPLs) and overall survival (OS) were evaluated using Kaplan-Meier tests, and this comparison was based on a log-rank test.

Results
Twenty-four procedures for patients with portal vein thrombosis were realized. Median follow-up was 16 months. A threshold tumor dose of 125 Gy was determined with a sensitivity of 89% and a specificity of 100%. For patients with a tumor dose of less than 125 Gy, the median OS was 7.5 months (95% confidence interval [CI], 5–14 months) and the TTPL was 3 months (95% CI, 2–6 months) versus 33 months (95% CI, 22–39 months) and 23 months (95% CI, 7–38 months), respectively, for those with a tumor dose of 125 Gy or more (P = 0.002 and P = 0.0004).

Conclusions
Personalized dosimetry based on 99mTc-MAA SPECT/CT is predictive of TTPL and OS in patients with hepatocellular carcinoma. Customized dosimetry software is essential to optimize treatment planning.
Immunotherapy (Cemiplimab)-Induced Bullous Pemphigoid
Authors: Grünig Hannes , Skawran Stephan M. , Nägeli Mirjam , Kamarachev Jivko , Huellner Martin W. 
Published: September 2021

Abstract
A 78-year-old man with multiple squamous cell carcinomas of the skin underwent 18F-FDG-PET/CT for restaging after 4 cycles of cemiplimab. The scan showed new disseminated FDG-avid skin lesions. Dermatologic examination and biopsy revealed bullous pemphigoid. Discontinuation of cemiplimab and treatment with corticosteroids led to clinical improvement, after which treatment with cemiplimab was resumed. A broad spectrum of inflammatory adverse events can occur in patients treated with immune checkpoint inhibitors, and FDG avidity of these lesions may mimic metastases. Knowledge of such imaging pitfalls is essential for interpreting 18F-FDG-PET/CT, particularly if they occur in the same organ as the primary tumor.
Effect of Remote Cardiac Monitoring System Design on Response Time to Critical Arrhythmias
Authors: Segall Noa , Joines Jeffrey A. , Baldwin Ron'Nisha D. , Bresch Diane , Coggins Lauren G. , Janzen Suzanne , Engel Jill R. , Wright Melanie C. 
Published: September 2021

Introduction
In many hospitals across the country, electrocardiograms of multiple at-risk patients are monitored remotely by telemetry monitor watchers in a central location. However, there is limited evidence regarding best practices for designing these cardiac monitoring systems to ensure prompt detection and response to life-threatening events. To identify factors that may affect monitoring efficiency, we simulated critical arrhythmias in inpatient units with different monitoring systems and compared their efficiency in communicating the arrhythmias to a first responder.

Methods
This was a multicenter cross-sectional in situ simulation study. Simulation participants were monitor watchers and first responders (usually nurses) in 2 inpatient units in each of 3 hospitals. Manipulated variables included: (1) number of communication nodes between monitor watchers and first responders; (2) central monitoring station location—on or off the patient care unit; (3) monitor watchers' workload; (4) nurses' workload; and (5) participants' experience.

Results
We performed 62 arrhythmia simulations to measure response times of monitor watchers and 128 arrhythmia simulations to measure response times in patient care units. We found that systems in which an intermediary between monitor watchers and nurses communicated critical events had faster response times to simulated arrhythmias than systems in which monitor watchers communicated directly with nurses. Responses were also faster in units colocated with central monitoring stations than in those located remotely. As the perceived workload of nurses increased, response latency also increased. Experience did not affect response times.

Conclusions
Although limited in our ability to isolate the effects of these factors from extraneous factors on central monitoring system efficiency, our study provides a roadmap for using in situ arrhythmia simulations to assess and improve monitoring performance.
Laparoscopic-assisted Open Pyloroduodenostomy Repair of Pyloric Atresia in an Infant: A Rare Congenital Anomaly
Authors: Huerta Carlos Theodore , Sundin Andrew , Gilna Gareth P. , Saberi Rebecca A. , Ramsey Walter A. , O’Neil Christopher F. , Brady Ann-Christina , Perez Eduardo A. 
Published: September 2021

Purpose:
Pyloric atresia is an uncommon congenital anomaly that may present with emesis and dehydration early in infancy. Definitive therapy consists of pyloroplasty or gastroduodenostomy depending on the subtype of atresia involved.

Case Presentation:
We report the case of a 2-day-old girl infant who presented with nonbilious emesis with feeds. Abdominal ultrasound and upper gastrointestinal series were performed and demonstrated a dilated, air-filled stomach with no distal air or passage of contrast. The patient was successfully treated by laparoscopic-assisted open pyloroduodenostomy of a type 2 pyloric atresia.

Conclusion:
Type 2 pyloric atresia is a rare clinical entity that can present with symptoms of gastric outlet obstruction. The patient described was treated by laparoscopic-assisted open pyloroduodenostomy, which has not been previously described for pyloric atresia. This work demonstrates an example of the safety and efficacy of laparoscopic surgery for infants with this anomaly.
Is academic medicine prepared to teach about the intersection of childhood experiences and health across the life course? An exploratory survey of faculty
Authors: Koo Angie , Irwin Jordyn , Sturgis Morgan , Schwartz Alan , Hasnain Memoona , Davis Elizabeth , Stillerman Audrey 
Published: September 2021

AbstractPurposeChildhood experiences affect health across the lifespan. Evidence-based prevention and treatment strategies targeting early-life stress are emerging. Nevertheless, faculty physicians’ preparation to incorporate this science into practice has not been well studied. The purpose of this study was to explore medical faculty knowledge and beliefs, timing and route of knowledge acquisition, perceived relevance and application of topics, and any associated faculty characteristics.MethodThe research team developed and administered a 39-question survey to faculty from six departments at the University of Illinois College of Medicine and Rush Medical College in Chicago. The team employed quantitative and qualitative methods to analyze responses.ResultsEighty-one (8.8%) eligible faculty completed the survey. Of respondents, 53 (65.4%) achieved a high score on knowledge questions, 34 (42.0%) on beliefs questions, and 42 (59.1%) described high concept exposure, but only six (7.4%) through a formal route. Although 78 (96.8%) respondents indicated that survey concepts are relevant, only 18 (22.2%) reported fully incorporating them in their work. Respondents reporting full incorporation of concepts were significantly more likely to attain high concept exposure scores than those not fully incorporating concepts (17 respondents, 94.4%, vs. 25 respondents, 39.7 %, P < .001), whether reporting formal or informal exposure. Both quantitative and qualitative analysis highlighted limited awareness among respondents of trauma prevalence among healthcare workers, lack of familiarity with interventions, and challenges in addressing childhood experiences given time and resource constraints.ConclusionsMost respondents had some familiarity with the impact of childhood experiences on health and perceived the relevance of this science. Nonetheless, many identified the need for additional coaching. Because results suggest that exposure supports full application of concepts, intentional faculty development and establishment of medical education competencies is pivotal to prepare faculty to include these crucial topics in patient care and teaching.
Prevalence of anti-SARS-CoV-2 immunity in Kazakhstan before the launch of COVID-19 vaccination
Authors: Kadyrova Irina , Yegorov Sergey , Negmetzhanov Baurzhan , Kolesnikova Yevgeniya , Kolesnichenko Svetlana , Korshukov Ilya , Vazenmiller Dmitriy , Stupina Yelena , Kabildina Naylya , Ashimova Assem , Raimbekova Aigul , Turmukhambetova Anar , Miller Matthew S. , Hortelano Gonzalo , Babenko Dmitriy 
Published: September 2021

AbstractBackgroundCOVID-19 exposure in Central Asia appears underestimated and SARS-CoV-2 seroprevalence data are urgently needed to inform ongoing vaccination efforts and other strategies to mitigate the regional pandemic. Here, we assessed the prevalence of anti-SARS-CoV-2 antibody-mediated immunity in a heterogeneous cohort of public university employees in Karaganda, Kazakhstan.MethodsAsymptomatic subjects (n=100) were recruited prior to their first COVID-19 vaccination. Questionnaires were administered to capture a range of demographic and clinical characteristics. Nasopharyngeal swabs were collected for SARS-CoV-2 RT-qPCR testing. Serological assays were performed to detect spike (S)-reactive IgG and IgA and to assess virus neutralization. Pre-pandemic samples were used to validate the assay positivity thresholds.ResultsAnti-S IgG and IgA seropositivity rates among SARS-CoV-2 PCR-negative participants (n=100) were 42% (95% CI [32.2-52.3]) and 59% (95% CI [48.8-69.0]), respectively, and 64% (95% CI [53.4-73.1]) of the cohort tested positive for at least one of the antibodies. Anti-S IgG titres correlated with virus neutralization activity, detectable in 49% of the tested subset with prior COVID-19 history. Serologically confirmed history of COVID-19 was associated with Kazakh ethnicity and self-reported history of respiratory illness since March 2020.ConclusionsSARS-CoV-2 exposure in this cohort is ∼15-fold higher compared to the reported all-time national and regional COVID-19 prevalence. Continuous serological surveillance is critical for understanding the COVID-19 transmission dynamics and should be nationally implemented to better inform the public health response in Central Asia.
metaCOVID:An R-Shiny application for living meta-analyses of COVID-19 trials
Authors: Evrenoglou Theodoros , Boutron Isabelle , Chaimani Anna 
Published: September 2021

Abstract“Living” evidence synthesis is of primary interest for decision-makers to overcome the COVID-19 pandemic. The COVID-NMA provides open-access living meta-analyses assessing different therapeutic and preventive interventions. Data are posted on a platform (https://covid-nma.com/) and analyses are updated every week. However, guideline developers and other stakeholders also need to investigate the data and perform their own analyses. This requires resources, time, statistical expertise, and software knowledge. To assist them, we created the “metaCOVID”application which, based on automation processes, facilitates the fast exploration of the data and the conduct of analyses tailored to end-users needs.metaCOVIDhas been created in R and is freely available as an R-Shiny application. The application conducts living meta-analyses for every outcome. Several options are available for subgroup and sensitivity analyses. The results are presented in downloadable forest plots.metaCOVIDis freely available fromhttps://covid-nma.com/metacovid/and the source code fromhttps://github.com/TEvrenoglou/metaCovid.
Methylothon: a versatile course-based high school research experience in microbiology and bioinformatics-- with pink bacteria
Authors: Jones Peyton A. , Frischer David , Mueller Shannon , Le Thomas , Schwanes Anya , Govindaraju Alekhya , Shalvarjian Katie , Leducq Jean-Baptiste , Marx Christopher J. , Martinez-Gomez N. Cecilia , Lee Jessica A. 
Published: September 2021

ABSTRACTMethylothon is an inquiry-based high school learning module in microbial ecology, molecular biology, and bioinformatics that centers around pink-pigmented plant-associated methylotrophic bacteria. Here we present an overview of the module’s learning goals, describe course resources (available for public use on http://methylothon.com), and relate lessons learned from adapting Methylothon for remote learning during the pandemic in spring of 2021. The original in-person version of the module allows students to isolate their own strains of methylotrophic bacteria from plants they sample from the environment, to identify these using PCR, sequencing, and phylogenetic analysis, and to contribute their strains to original research in a university lab. The adapted version strengthens the focus on bioinformatics and increases its flexibility and accessibility by making the lab portion optional and adopting free web-based tools. Student feedback and graded assignments from Spring 2021 revealed that the lesson was especially effective at introducing the concepts of BLAST and phylogenetic trees, and that students valued and felt inspired by the opportunity to conduct hands-on work and to participate in community science.
A HYPOMETABOLIC DEFENSE STRATEGY AGAINSTPLASMODIUMINFECTION
Authors: Ramos Susana , Ademolue Temitope W. , Jentho Elisa , Wu Qian , Guerra Joel , Martins Rui , Pires Gil , Weis Sebastian , Carlos Ana Rita , Mahú Inês , Seixas Elsa , Duarte Denise , Rajas Fabienne , Cardoso Sílvia , Sousa António G. G. , Lilue Jingtao , Mithieux Gilles , Nogueira Fátima , Soares Miguel P. 
Published: September 2021

SUMMARYHypoglycemia is a clinical hallmark of severe malaria, the often-lethal presentation ofPlasmodium falciparuminfection of humans. Here we report that mice reduce blood glucose levels in response toPlasmodiuminfection via a coordinated response whereby labile heme, an alarmin produced via hemolysis, induces anorexia and represses hepatic glucose production (HGP). While protective against unfettered immune-mediated inflammation, organ damage and anemia, when sustained over time heme-driven repression of HGP can progress towards hypoglycemia, compromising host energy expenditure and thermoregulation. This hypometabolic state arrests the development of asexual stages ofPlasmodium spp., which undergo pyknosis and develop mitochondrial dysfunction. In response,Plasmodiumactivates a transcriptional program reducing its virulence and inducing sexual differentiation towards the production of transmissible gametocytes. We infer that malaria-associated hypoglycemia represents a trade-off of an evolutionarily conserved defense strategy restrictingPlasmodium spp. from accessing host-derived glucose and balancing parasite virulence and transmission.