bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pu-239 Accumulation in E. Coli and P. Putida Grown in Liquid Cultures
Authors: Manglass Lisa , Wintenberg Molly , Blenner Mark , Martinez Nicole 
Published: August 2021

Abstract
Understanding of the behavior and effects of plutonium (Pu) in the environment is an important aspect of developing responsible and effective strategies for remediation and environmental stewardship. This work studies the sorption and uptake of 239Pu by common environmental bacteria, Escherichia coli DH10β and Pseudomonas putida KT-2440. Plutonium was directly incorporated into growth media prior to inoculation (0.12 kBq mL−1), and samples from the liquid cultures of E. coli and P. putida were analyzed over a 15-d growth period through liquid scintillation counting (LSC) of plutonium in cell pellets and cell culture media following centrifugation. To improve its solubility in the liquid cultures, Pu was complexed with citrate prior to inoculation. P. putida cultures were also grown without citrate to examine potential impact of P. putida’s ability to use citrate as a food source. The accumulation of Pu in P. putida cells was found to increase both with and without citrate complexation for the first 5 d and then plateau until the end of the study period (15 d). A higher activity concentration of Pu was found in P. putida cells grown with citrate complexation than without. The activity concentration of plutonium in E. coli cells was greater than that in P. putida cells, which may be the result of a stronger complexing agent made by E. coli for the purpose of iron uptake. There are a variety of factors that influence Pu behavior in bacterial systems, and results confirm that even in a simple system, multiple mechanisms are at play.
Tonic pupil secondary to varicella-zoster-virus (VZV) keratouveitis in a child
Authors: Tsokolas Georgios , Tyradellis Straton , Islam Tahir 
Published: August 2021

Abstract

Introduction:
An unusual case of tonic pupil in a 4-year-old male child secondary to Varicella-Zoster-Virus (VZV) keratouveitis is described in this case report. To the best of our knowledge, our report is the thirtieth case of tonic pupil following chickenpox infection in the literature.

Patient concerns:
A 4-year-old male child presented at our department in June 2019 with anisocoria and feeling generally unwell. The right pupil was noted by his mother to be larger than the left in normal, bright and dim illumination conditions. Of note, the child at the same time was suffering from chickenpox and the symptoms started approximately 4 days prior to the attendance at Accident and Emergency with a generalized vesicular rash. The mother also reported that the right eye was mildly red and uncomfortable and her son was complaining of photophobia.

Diagnosis:
Tonic pupil secondary to VZV keratouveitis.

Interventions:
Full past medical and ocular history was obtained. The patient underwent full ophthalmic examination including dilated fundoscopy. Visual acuity was recorded with Snellen Chart and Keeler chart of Minimum Angle of Resolution chart. Patient had Magnetic Resonance Imaging due to anisocoria to exclude intracranial pathology. The child was treated with intravenous Acyclovir and had a good recovery, though the anisocoria persisted.

Outcomes:
During the follow-ups in the Paediatric Ophthalmology Clinic, 0.125% pilocarpine test revealed profound miosis of the affected right pupil and normal response from the healthy left pupil. In addition, the range of accommodation was reduced in the affected right eye. The child was closely observed to prevent right eye amblyopia and the plan was to issue bifocals to maximize both near and distant visual acuity. Nevertheless, during close follow-up the accommodation reflex in the right eye recovered on its own and the child was eventually discharged from the clinic without executive bifocals.

Conclusion:
VZV keratouveitis leading to tonic pupil is a rare complication. The proposed pathophysiological mechanism is retrograde dissemination of the infection through the parasympathetic nerve fibers from the iris via the inferior branch of the third nerve to the ciliary ganglion. Our case emphasizes the potential amblyogenic consequences of tonic pupil.
Carbohydrate-restricted diets and Type 1 diabetes mellitus: research considerations
Authors: Dikeman David T. , Westman Eric C. 
Published: August 2021

Purpose of review
Type 1 diabetes mellitus (T1DM) is managed via careful control of blood glucose, exogenous insulin, diet, exercise, and other physiologic factors. Interestingly, the dietary recommendations for T1DM have had very little systematic research. Many clinical observations, as well as emerging research studies, have noted that a carbohydrate-restricted diet can lead to normalization of blood glucoses with reduction in hypoglycemic reactions among motivated individuals.

Recent findings
In this paper, we review observations of carbohydrate restriction and propose a series of studies to test two levels of dietary carbohydrate intake for the management of individuals affected by T1DM. We recommend that the studies start in otherwise healthy adults with hemoglobin A1c > 8%, and then progress to more complicated populations including children, those with secondary complications and/or good glycemic control. Larger, long-term studies would then address growth in children, and diabetic complications including cardiovascular outcomes.

Summary
Due to the clinical observations of improvements using carbohydrate-restricted nutrition for T1DM, we recommend that these types of studies addressing the level of dietary carbohydrate be urgently conducted.
Retrospective cohort study of changes in estimated glomerular filtration rate for patients prescribed a low carb diet
Authors: Mitchell Nia S. , Batch Bryan C. , Tyson Crystal C. 
Published: August 2021

Purpose of review
Obesity and diabetes contribute to chronic kidney disease (CKD) and accelerate the loss of kidney function. Low carbohydrate diets (LCDs) are associated with weight loss and improved diabetes control. Compared to the typical Western diet, LCDs contain more protein, so individuals with CKD are not included in studies of LCDs. Therefore, there are no studies of LCDs for weight loss and their effects on kidney function.

Recent findings
Obesity, hyperglycemia, and hyperinsulinemia can be detrimental to kidney function. LCDs may improve kidney function in patients with obesity and diabetes because they are associated with weight loss, improve blood sugar control, and decrease endogenous insulin production and exogenous insulin requirements.

Summary
In this study, for patients with mildly reduced and moderately to severely reduced kidney function who were prescribed an LCD, their estimated glomerular filtration rate (eGFR) was either unchanged or improved. For those with normal or elevated eGFR, their kidney function was slightly decreased. For those without diabetes, greater weight loss was associated with improved eGFR. Future studies should prospectively measure low carbohydrate dietary adherence and physical activity and directly measure changes in GFR and albuminuria for participants with CKD before and during that diet.
The new perspective of PET/CT for axillary nodal staging in early breast cancer patients according to ACOSOG Z0011 trial PET/CT axillary staging according to Z0011
Authors: Kong Eunjung , Choi Jungeun 
Published: August 2021

Objective
Post Z0011 trial, axillary lymph node dissections (ALNDs) can be performed in patients with ≥3 positive axillary lymph nodes (ALNs). We investigated the diagnostic performance of 18F-fluorodeoxyglucose PET/computed tomography (FDG PET/CT) to predict ≥3 metastasis [high nodal burden (HNB)].

Methods
We retrospectively analyzed preoperative FDG PET/CT from January 2010 to June 2012. Patients had clinical T1-2N0 primary invasive breast cancer and underwent breast-conserving surgery with sentinel lymph node biopsy ± ALND. All suspicious ALNs were counted considering FDG-avidity with morphologic changes. Images were considered positive if the axillary basin took up more FDG than the surrounding tissue. On CT, abnormal ALNs were round/ovoid or had cortical thickening with contrast enhancement. PET/CT results were compared with the histology and follow-up findings.

Results
In total, 221 females with 224 axillae were enrolled; 161 had negative, 53 had 1–2 metastasis [low nodal burden (LNB)] and 10 had HNB. The sensitivity, specificity, negative predictive value and positive predictive value of PET/CT for HNB were 70, 100, 98.6 and 100%, respectively. There was a correlation between the number of suspicious ALNs on PET/CT and the metastatic nodes on final histology. There were no significant differences in age, tumor size and FDG-avidity between patients with negative or LNB and HNB. During follow-up, 25 patients had a recurrence. The three false-negative patients did not show recurrence.

Conclusion
Preoperative PET/CT predicts HNB with high accuracy and is useful for evaluating clinical T1-2N0 invasive breast cancer.
Exploring the potential utilities of 99mTc-labeled RBC-equilibrium radionuclide angiocardiography in transfusion-dependent β-thalassemia major patients
Authors: Vadi Shelvin Kumar , Sood Ashwani , Khadwal Alka , Parmar Madan , Bhatia Anmol , Kashyap Sonia , Bahl Ajay , Mittal Bhagwant Rai 
Published: August 2021

Aims

99mTc-labeled RBC-equilibrium radionuclide angiocardiography (ERNA) is done in transfusion-dependent beta-thalassemia major (β-TM) patients routinely for cardiac dysfunction. This prospective study aimed at evaluating the potential of ERNA in demonstrating the bone marrow hyperplasia as an adjunct biomarker for monitoring the adequacy of blood transfusions in transfusion-dependent β-TM patients.

Materials and methods
One hundred and twenty-six patients of β-TM (study group) and 30 nonthalassemic patients (control) underwent ERNA study with an additional whole-body imaging. We quantitated the normalized bone marrow tracer uptake (due to marrow hyperplasia) and hepatic tracer uptake (indicator of hepatic perfusion) in both the groups on whole-body imaging. Liver and myocardial iron deposition were evaluated with T2* MRI in the thalassemic group.

Results
β-TM group showed significantly increased mean normalized marrow count (MN) compared to the control group (P < 0.001) reflecting peripheral marrow hyperplasia (indirect marker for blood transfusion inadequacy). The hematological parameters in the study group showed a negative correlation with MN, without such correlation in the control group. The study group showed greater derangement in hepatic perfusion with significantly less mean normalized hepatic tracer uptake (HN) compared to the control group. Hepatic iron deposition (evaluated with T2* MRI) also showed a negative correlation with hepatic perfusion parameter (HN) assessed by ERNA, though myocardial iron deposition did not show any significant correlation with cardiac systolic/diastolic parameters evaluated by ERNA in the study group.

Conclusion
ERNA study with these novel parameters (MN and HN) may have the potential to assess peripheral marrow hyperplasia and derangement in hepatic perfusion in transfusion-dependent β-TM.
Haralick texture features extracted from Ga-68 PSMA PET/CT to differentiate normal prostate from prostate cancer: a feasibility study
Authors: Sharma Akshima , Kumar Sanjay , Pandey Anil Kumar , Arora Geetanjali , Sharma Anshul , Seth Amlesh , Kumar Rakesh 
Published: August 2021

Objective
Role of texture parameters on the basis of Ga-68 PSMA PET/CT in prostate cancer (Pca) is largely unexplored. Present work done is a preliminary study that aims to evaluate the role of Haralick texture features on the basis of Ga-68 PSMA PET/CT in Pca in which texture features were used to differentiate between normal prostate and Pca tissue.

Methods
The study retrospectively enrolled patients in two groups: group 1 included 30 patients with biopsy-proven adenocarcinoma prostate and median age 64 years (range: 50–82 years) who underwent baseline Ga-68 PSMA PET/CT prior to therapy; group 2 included 24 patients with pathologies other than Pca and median age 53.5 years (range: 18–80 years) who underwent Ga-68 PSMA PET/CT as part of another study in our department. Patients in group 2 did not have any prostate pathology and served as controls for the study. The segmented images of prostate (3-D image) were used to calculate 11 Haralick texture features in MATLAB. SUVmax was also evaluated. All parameters were compared among the two groups using appropriate statistical analysis and P value <0.05 was considered significant.

Results
All 11 Haralick texture features, as well as SUVmax, were significantly different among Pca and controls (P < 0.05). Among the texture features, contrast was most significant (P value of Mann–Whitney U <0.001) in differentiating Pca from normal prostate with AUROC curve of 82.9% with sensitivity and specificity 83.30% and 73.30%, respectively at cut-off 0.640. SUVmax was also significant with AUROC curve 94.0% and sensitivity and specificity 62.5% and 90%, respectively at cut-off 5.7. A significant negative correlation of SUVmax was observed with contrast.

Conclusion
Haralick texture features have a significant role in differentiating Pca and normal prostate.
Efficacy of voxel-based dosimetry map for predicting response to trans-arterial radioembolization therapy for hepatocellular carcinoma: a pilot study
Authors: Yoo Min Young , Paeng Jin Chul , Kim Hyo-Cheol , Lee Min Sun , Lee Jae Sung , Lee Dong Soo , Kang Keon Wook , Cheon Gi Jeong 
Published: August 2021

Objective
Typical clinical dosimetry models for trans-arterial radioembolization (TARE) assume uniform dose distribution in each tissue compartment. We performed simple voxel-based dosimetry using post-treatment 90Y PET following TARE with 90Y-resin microspheres and investigated its prognostic value in a pilot cohort.

Method
Ten patients with 14 hepatocellular carcinoma lesions who underwent TARE with 90Y-resin microspheres were retrospectively included. The partition model-based expected target tumor dose (TDp) was calculated using a pretreatment 99mTc-macroaggregated albumin scan. From post-treatment 90Y-microsphere PET and voxel-wise S-value kernels, voxel-based dose maps were produced and the absorbed dose of each lesion (TDv) was calculated. Heterogeneity of intratumoral absorbed doses was assessed using the SD and coefficient of variation of voxel doses. The response of each lesion was determined based on contrast-enhanced MRI or CT, or both. Lesion responses were classified as local control success or failure. Prognostic values of dosimetry parameters and clinicopathological factors were evaluated in terms of progression-free survival (PFS) of each lesion.

Results
TDv was significantly different between local control success and failure groups, whereas tumor size, TDp and intratumoral dose heterogeneity were not. Univariate survival analysis identified serum aspartate transaminase level ≥40 IU/L, tumor size ≥66 mm and TDv <81 Gy as significant prognostic factors for PFS. However, only TDv was an independent predictive factor in the multivariate analysis (P = 0.022). There was a significant correlation between TDv and PFS (P = 0.009; r = 0.669).

Conclusions
In TARE, voxel-based dose index TDv can be estimated on post-treatment 90Y PET using a simple method. TDv was a more effective prognostic factor for TARE than TDp and clinicopathologic factors in this pilot study. Further studies are warranted on the role of voxel-based dose and dose distribution in TARE.
Compelling Voices of Diversity, Equity, and Inclusion in Prelicensure Nursing Students
Authors: Wright Rebecca , Baptiste Diana-Lyn , Booth Ashley , Addison Helena , Abshire Martha , Alvarez Daisy , Barrett Megan , Hansen Bryan , Jenkins Emerald , Scarborough Sabrina , Wright Erin , Davidson Patricia M. , Ramsey Gloria C. 
Published: August 2021

Background
Diversity, equity, and inclusion are increasingly recognized as core values for guiding nursing education, practice, and research. The conceptual framework of cultural humility has been adapted in a variety of health care settings, fostering a culture of diversity, equity, and inclusion through openness, supportive interaction, self-awareness, self-reflection, and critique.

Problem
Nurse educators have the opportunity, but may find it challenging, to teach students about the changing landscape of health care and the populations we serve.

Approach
This article describes the integration of the cultural humility framework into nursing curricula to teach principles of diversity, equity, and inclusivity. We provide a practical example of a diversity panel, with student and panelist reflections, exploring the intersectionality of experiences in health care and integration of personal accounts and perspectives.

Conclusion
Dialogue about diversity, equity, and inclusion is essential for preparing future nurses to deliver culturally competent care and promote health equity.
Perceptions of Stakeholders Toward “Hospital at Home” Program in Singapore: A Descriptive Qualitative Study
Authors: Chua Crystal Min Siu , Ko Stephanie Qianwen , Lai Yi Feng , Lim Yee Wei , Shorey Shefaly 
Published: August 2021

Objective
Hospital at Home (HaH) programs have been shown to improve quality of care and patient satisfaction, and reduce bed occupancy rate in hospitals. Despite the prevalence of HaH in Western countries, studies in Asia are limited and the perception of HaH remains underexplored in Asian context. Understanding the perceptions of stakeholders is vital before implementing HaH in any new settings. Thus, the aim of this study is to explore the perceptions of referring physicians, care providers, patients, and caregivers on HaH programs in a multiracial country such as in Singapore.

Methods
This study used a descriptive qualitative design. Participants from 2 tertiary hospitals in Singapore, including 13 referring physicians, 10 care providers, 15 patients, and 3 caregivers, were interviewed between June 2020 and September 2020. Data were analyzed using inductive thematic analysis.

Results
The overarching theme titled “The stakeholders’ perception on HaH” was pillared by 4 main themes: (1) patients suitable for HaH; (2) perceived advantages and benefits of HaH; (3) perceived risks, anxiety, and concerns about HaH; and (4) potential enablers of HaH. Overall, the findings reported that most of the stakeholders embraced HaH. Timely medical interventions and support from care providers were reportedly important factors to maintain patient safety and quality of care. The importance of having adequate resources and sound financing mechanisms to develop a successful HaH program was also highlighted.

Conclusions
This study offered insights into HaH from the perspectives of stakeholders in Singapore and facilitate the planning of future HaH pilot programs in multiracial Singapore and other Asian countries.
Incidental 68Ga-DOTATOC PET/CT Uptake in Hemorrhagic Transformation of Stroke in a Patient With Cervical Paraganglioma
Authors: Valhondo-Rama Raquel , Rodríguez Gómez José Carlos , Couto Caro Rosa , Cabrera-Martín María Nieves , Carreras Delgado José Luis 
Published: August 2021

Abstract
We present a case of a 75-year-old woman with clinical suspicion of stroke whose cranial CT showed ischemic changes in right precentral region, without visible vascular occlusion, and a right vagal lesion suggestive of paraganglioma. Two weeks later, 68Ga-DOTATOC PET/CT with IV iodine-based contrast administration (Biograph 6 True Point equipment; Siemens) was performed for characterization of this lesion and staging. Intraparenchymal 68Ga-DOTATOC uptake was visualized in right frontal lobe suggestive of hemorrhagic transformation of the previous stroke.
Incidentally Detected High SSTR Expression in Uterine Leiomyoma on DOTANOC PET/CT
Authors: Datta Gupta Shreya , Kaushik Prateek , Ramteke Prashant , Mallik Abhishek Kumar , Krishna Asuri , Sharma J.B. , Damle Nishikant Avinash 
Published: August 2021

Abstract
A 38-year-old woman with a 2-month history of per vaginal bleeding and episodes of palpitations, headache, and vomiting underwent 68Ga-DOTANOC PET/CT for evaluation, which revealed a left suprarenal mass and a large uterine mass, both of which were intensely tracer avid. Histopathology of the masses after surgery revealed a left pheochromocytoma and uterine leiomyoma. SSTR-expressing leiomyoma is an uncommon finding and must be kept in mind as a differential diagnosis of DOTANOC-avid uterine mass.
Quality and Safety in Healthcare, Part XC
Authors: Harolds Jay A. 
Published: August 2021

Abstract
The A3 form is a structured way of solving problems using a detailed step-by-step methodology using the principles of the Plan-Do-Check-Act cycle. The A3 form supports efforts to organize the thinking of workers about new ways to improve. The form is used as a guide for many project teams to find answers, and then the team arrives at decisions through consensus. Sometimes process mapping, driver diagrams, and gap analysis are included in A3 problem solving. The A3 form is just one of numerous healthcare applications for the Toyota Production System and Lean.
The “Ultimate Triple PET”
Authors: McClenathan Matthew , Peacock Justin G. 
Published: August 2021

Abstract
A 71-year-old man with a history of carcinoid and prostate adenocarcinoma underwent 68Ga-DOTATATE PET/CT to evaluate new mediastinal lymphadenopathy. The scan revealed new carcinoid metastases, but the mediastinal nodes were not avid. 18F-FDG PET/CT was performed to evaluate for cardiac and mediastinal sarcoidosis, revealing a lack of cardiac sarcoidosis, but probable mediastinal sarcoidosis. 18F-Fluciclovine PET/CT was then performed for possible prostate metastases, revealing the patient’s known prostate cancer. Three different PET radiopharmaceuticals revealed 3 different processes in a single patient within a 195-day period, demonstrating the power of nuclear medicine diagnostics.
68Ga-FAPI-04 PET/CT Versus 18F-FDG PET/CT in Malignant Peritoneal Mesothelioma
Authors: Gündoğan Cihan , Güzel Yunus , Kömek Halil , Etem Hülya , Kaplan İhsan 
Published: August 2021

Abstract
An 83-year-old man presented with abdominal pain, vomiting, and bloating. His abdominal CT revealed heterogeneous peritoneal thickening in the lower quadrants, which was more prominent in the pelvic region. 18F-FDG PET/CT performed to locate the primary tumor showed irregular peritoneal and omental thickening with low to moderate FDG uptake. 68Ga–FAPI (fibroblast activation protein–specific inhibitor)–04 PET/CT of the patient, whose primary tumor could not be detected using FDG, showed high radiopharmaceutical uptake in the areas of heterogeneous thickening on peritoneal and serosal surfaces. Peritoneal Tru-Cut biopsy revealed malignant tumoral infiltration indicating mesothelioma. This case showed that 68Ga-FAPI-04 PET/CT could be a promising radiopharmaceutical in the evaluation of peritoneal mesothelioma.
Malignant Melanoma of Glans Penis
Authors: Sachani Hemant , Tripathy Sarthak , Shamim Shamim Ahmed , Rastogi Sameer , Baa Annie K. 
Published: August 2021

Abstract
Melanomas usually arise in the sun exposed parts of the skin. Mucosal melanoma is a rare condition. Melanoma of glans penis is even a rarer phenomenon with less than 250 cases reported in literature so far. Here we present a case of a 55-year-old man diagnosed with melanoma of glans penis with findings on 18F FDG PET/CT scan done for metastatic workup. 18F-FDG PET/CT showed primary in the glans penis with metastases in the right supraclavicular, mediastinal, and abdominal lymph nodes.
Hepatic Lesion of Mucosa-Associated Lymphoid Tissue Lymphoma Revealed by Al18F-NOTA-FAPI-04 PET/CT
Authors: Kou Ying , Yao Zhiwei , Cheng Zhuzhong 
Published: August 2021

Abstract
A middle-aged man was newly diagnosed with mucosa-associated lymphoid tissue lymphoma with secondary liver involvement. The hepatic lesion was not shown on FDG PET/CT but FAPI (fibroblast-activated protein inhibitor) PET/CT, which revealed abnormal FAPI accumulation. This case demonstrated that FAPI PET/CT might provide value in hepatic mucosa-associated lymphoid tissue lymphoma.