bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Evaluation of Galactomannan and (1→3) β-d-Glucan Assays as Diagnostic Tools for Invasive Fungal Disease in Children, Adolescents, and Young Adults With Acute Myeloid Leukemia Receiving Fungal Prophylaxis
Authors: Fisher Brian T , Westling Ted , Boge Craig L K , Zaoutis Theoklis E , Dvorak Christopher C , Nieder Michael , Zerr Danielle M , Wingard John R , Villaluna Doojduen , Esbenshade Adam J , Alexander Sarah , Gunn Suphansa , Wheat Lawrence J , Sung Lillian 
Published: April 2021

Abstract

Background
Patients receiving chemotherapy for acute myeloid leukemia (AML) are at high risk for invasive fungal disease (IFD). Diagnosis of IFD is challenging, leading to interest in fungal biomarkers. The objective was to define the utility of surveillance testing with Platelia Aspergillus galactomannan (GM) enzyme immunoassay (EIA) and Fungitell β-d-glucan (BDG) assay in children with AML receiving antifungal prophylaxis.

Methods
Twice-weekly surveillance blood testing with GM EIA and BDG assay was performed during periods of neutropenia in the context of a randomized trial of children, adolescents, and young adults with AML allocated to fluconazole or caspofungin prophylaxis. Proven or probable IFD was adjudicated using blinded central reviewers. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for Platelia and Fungitell assays alone and in combination for the outcomes of proven and probable invasive aspergillosis (IA) or invasive candidiasis (IC).

Results
Among 471 patients enrolled, 425 participants (209 fluconazole and 216 caspofungin) contributed ≥1 blood specimen. In total, 6103 specimens were evaluated, with a median of 15 specimens per patient (range 1–43). The NPV was &gt;99% for GM EIA and BDG assay alone and in combination. However, there were no true positive results, resulting in sensitivity and PPV for each assay of 0%.

Conclusions
The GM EIA and the BDG assay alone or in combination were not successful at detecting IA or IC during periods of neutropenia in children, adolescents, and young adults with AML receiving antifungal prophylaxis. Utilization of these assays for surveillance in this clinical setting should be discouraged.
Synthesis of 3,3-dimethyl-6-oxopyrano[3,4-c]pyridines and their antiplatelet and vasodilatory activity
Authors: Sirakanyan Samvel N , Hrubša Marcel , Spinelli Domenico , Dias Patrícia , Kartsev Victor , Carazo Alejandro , Hovakimyan Anush A , Pourová Jana , Hakobyan Elmira K , Karlíčková Jana , Parvin Shamima , Fadraersada Jaka , Macáková Kateřina , Geronikaki Athina , Mladěnka Přemysl 
Published: April 2021

Abstract

Objectives
Both pyridine and pyrano derivatives have been previously shown to possess biologically relevant activity. In this study, we report the incorporation of these two scaffolds into one molecule.

Methods
The designed 3,3-dimethyl-6-oxopyrano[3,4-c]pyridines were synthesized by the acylation of enamine under Stork conditions followed by condensation of formed β-diketones with 2-cyanoacetamide. The structures of these compounds were confirmed by using a wide spectrum of physico-chemical methods. Their antiplatelet, anticoagulant and vasodilatory activity together with toxicity were evaluated.

Key findings
A series of 6-oxopyrano[3,4-c]pyridines 3a–j was obtained. Four of these compounds were reported for the first time. None of the tested compounds demonstrated anticoagulant effect but 8-methyl derivative (3a) was a potent antiplatelet compound with IC50 numerically twice as low as the clinically used acetylsalicylic acid. A series of further mechanistic tests showed that 3a interferes with calcium signaling. The compound is also not toxic and in addition possesses vasodilatory activity as well.

Conclusions
Compound 3a is a promising inhibitor of platelet aggregation, whose mechanism of action should be studied in detail.
Right hemicolectomy for ileocolonic intussusception in an adult with active COVID-19 infection: a case report
Authors: Jackson Katherine M , Sabbota Aaron L 
Published: April 2021

Abstract
The most common symptoms of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are fevers, fatigue and dry cough. However, growing data suggest gastrointestinal (GI) manifestations occur in the majority of patients. Small bowel obstruction remains a significant cause of surgical abdominal emergencies in the adult population, although most cases are secondary to adhesive disease. We present a case of ileocolonic intussusception in an adult with active COVID-19 infection. Our patient presented with small bowel obstruction 4 days after diagnosis of COVID-19 with typical respiratory symptoms. Imaging revealed ileocolonic intussusception and possible cecal mass for which a right hemicolectomy was performed. Recovery was unremarkable. Pathology suggested necrosis without an identifiable mass. To the best of our knowledge, this is the first documented case of small bowel obstruction secondary to ileocolonic intussusception in an adult related to GI manifestation of COVID-19.
Duodenal recurrence of endometrial carcinoma: report of a rare metastatic site
Authors: Pinheiro João L , Marques Marisa , Daniel Carlos , Pereira Jorge , Casimiro Carlos 
Published: April 2021

Abstract
Endometrial carcinoma is one of the most common gynaecologic malignancies in the western society. Treatment of recurrent disease became more refined, with the study of molecular and hormonal receptors playing a central role. A 76-year-old caucasian woman presented to the emergency department with growing tiredness, and melaena. Past medical history included an endometrioid adenocarcinoma. The patient had undergone a hysterectomy with bilateral salpingo-oophorectomy with pelvic and paraaortic lymphadenectomy and was disease-free for 2 years. The endoscopy revealed an ulcerated lesion involving the second and third portions of the duodenum. Histopathologic examination confirmed a poorly differentiated adenocarcinoma of endometrial origin. She started palliative chemotherapy, remaining with adequate symptomatic control. Endometrial cancer recurrence typically occurs locally. The liver is the intra-abdominal organ most commonly involved. There are scarce reports of duodenal metastasis of malignancies originated in distant organs. The duodenum remains an uncommon metastization site and is rarely associated with endometrial cancer.
Use of a Digital Cognitive Aid Improves Memorization of Military Caregivers After High-Fidelity Simulations of Combat Casualty Care
Authors: Paraschiv Andrei-Petru , Balança Baptiste , Lilot Marc , Aigle Luc , Lehot Jean-Jacques , Cejka Jean-Christophe 
Published: April 2021

ABSTRACT

Introduction
High-fidelity simulation is widely used in the ongoing education of caregivers. However, the complex high-stakes simulated crisis environment affects memorization. This study investigated whether participants would remember more key training messages 3 months after a simulated complex emergency situation if they had used a digital cognitive aid (CA) during the simulations.

Materials and Methods
This randomized controlled trial was performed during a combat casualty training course for military physicians and nurses. Each pair of care providers completed two scenarios randomized to be undertaken either with or without a digital CA. At the end of each debriefing, instructors gave five scenario-specific key messages aloud. Three months later, learners were asked to recall the messages from their two scenarios and were scored for each scenario. The primary endpoint was the number of key messages recalled. The secondary endpoints were the influence on the results of the profession and the scenario block and age of the leader.

Results
Thirty-six pairs of participants were included. Due to operational constraints, only 34 completed the study. The use of the digital CA was associated with a positive effect on memorization at 3 months (F = 82.2, P &lt; .001), unrelated to the leader’s profession, age, or the scenario block. The median of the memorization scores was 2/5 [1-3] with the digital CA and 1/5 [1-1] without it, which represents a difference of one memorized element (95% CI, 1-2; η2 = 0.39).

Conclusions
The digital CA allowed learners to remember twice as many key elements 3 months after simulated training of medical care for military combat casualties. A dedicated digital CA might be an asset for better care in a combat environment and for learning and memorizing critical care procedures following complex emergency situations.
Deep generative models for galaxy image simulations
Authors: Lanusse François , Mandelbaum Rachel , Ravanbakhsh Siamak , Li Chun-Liang , Freeman Peter , Póczos Barnabás 
Published: April 2021

ABSTRACT
Image simulations are essential tools for preparing and validating the analysis of current and future wide-field optical surveys. However, the galaxy models used as the basis for these simulations are typically limited to simple parametric light profiles, or use a fairly limited amount of available space-based data. In this work, we propose a methodology based on deep generative models to create complex models of galaxy morphologies that may meet the image simulation needs of upcoming surveys. We address the technical challenges associated with learning this morphology model from noisy and point spread function (PSF)-convolved images by building a hybrid Deep Learning/physical Bayesian hierarchical model for observed images, explicitly accounting for the PSF and noise properties. The generative model is further made conditional on physical galaxy parameters, to allow for sampling new light profiles from specific galaxy populations. We demonstrate our ability to train and sample from such a model on galaxy postage stamps from the HST/ACS COSMOS survey, and validate the quality of the model using a range of second- and higher order morphology statistics. Using this set of statistics, we demonstrate significantly more realistic morphologies using these deep generative models compared to conventional parametric models. To help make these generative models practical tools for the community, we introduce galsim-hub, a community-driven repository of generative models, and a framework for incorporating generative models within the galsim image simulation software.
Revisiting the structure function of PSR B0950+08 scintillations
Authors: Goldman Itzhak 
Published: April 2021

ABSTRACT
The observational structure function of the scintillations of the radio pulsar PSR B0950+08 was fitted, a decade ago, with a power law with index 1 ± 0.05. This was interpreted as an appreciable deviation from the commonly observed index of 5/3, expected for Kolmogorov turbulence. In this paper, it is suggested that the observations are consistent with a Kolmogorov turbulence and that the apparent deviation is due to a turbulent region with an effective depth, which is comparable to the observed lateral scales on the plane of the sky, spanned by the pulsar beam. Alternatively, the fitted index of 1 is consistent with an underlying compressive turbulence and an even smaller depth. In the first interpretation, the depth is (5.5 ± 1.8) × 108 cm. In the second one, the depth is ≲4 × 107 cm. These estimates lend support for the existence of extremely thin, ionized scattering screens in the local interstellar cloud that have been proposed a decade ago.
Precise diffusion coefficients for white dwarf astrophysics
Authors: Caplan M E , Freeman I F 
Published: April 2021

ABSTRACT
Observations of Galactic white dwarfs with Gaia have allowed for unprecedented modelling of white dwarf cooling, resolving core crystallization, and sedimentary heating from neutron-rich nuclei. These cooling sequences are sensitive to the diffusion coefficients of nuclei in Coulomb plasmas which have order 10 per cent uncertainty and are often not valid across coupling regimes. Using large-scale molecular dynamics simulations we calculate diffusion coefficients at high resolution in the regime relevant for white dwarf modelling. We present a physically motivated law for diffusion with a semi-empirical correction which is accurate at the percent level. Implemented along with linear mixing in stellar evolution codes, this law should reduce the error from diffusion coefficients by an order of magnitude.
Evaluation of a Commercial Culture-Free Neutralization Antibody Detection Kit for Severe Acute Respiratory Syndrome-Related Coronavirus-2 and Comparison With an Antireceptor-Binding Domain Enzyme-Linked Immunosorbent Assay
Authors: Papenburg Jesse , Cheng Matthew P , Corsini Rachel , Caya Chelsea , Mendoza Emelissa , Manguiat Kathy , Lindsay L Robbin , Wood Heidi , Drebot Michael A , Dibernardo Antonia , Zaharatos Gerasimos , Bazin Reneé , Gasser Romain , Benlarbi Mehdi , Gendron-Lepage Gabrielle , Beaudoin-Bussières Guillaume , Prévost Jérémie , Finzi Andrés , Ndao Momar , Yansouni Cedric P 
Published: April 2021

Abstract

Background
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) surrogate neutralization assays that obviate the need for viral culture offer substantial advantages regarding throughput and cost. The cPass SARS-CoV-2 Neutralization Antibody Detection Kit (GenScript) is the first such commercially available assay that detects antibodies that block receptor-binding domain (RBD)/angiotensin-converting enzyme (ACE)-2 interaction. We aimed to evaluate cPass to inform its use and assess its added value compared with anti-RBD enzyme-linked immunosorbent assays (ELISAs).

Methods
Serum reference panels comprising 205 specimens were used to compare cPass to plaque-reduction neutralization test (PRNT) and a pseudotyped lentiviral neutralization (PLV) assay for detection of neutralizing antibodies. We assessed the correlation of cPass with an ELISA detecting anti-RBD immunoglobulin (Ig)G, IgM, and IgA antibodies at a single timepoint and across intervals from onset of symptoms of SARS-CoV-2 infection.

Results
Compared with PRNT-50, cPass sensitivity ranged from 77% to 100% and specificity was 95% to 100%. Sensitivity was also high compared with the pseudotyped lentiviral neutralization assay (93%; 95% confidence interval [CI], 85–97), but specificity was lower (58%; 95% CI, 48–67). Highest agreement between cPass and ELISA was for anti-RBD IgG (r = 0.823). Against the pseudotyped lentiviral neutralization assay, anti-RBD IgG sensitivity (99%; 95% CI, 94–100) was very similar to that of cPass, but overall specificity was lower (37%; 95% CI, 28–47). Against PRNT-50, results of cPass and anti-RBD IgG were nearly identical.

Conclusions
The added value of cPass compared with an IgG anti-RBD ELISA was modest.
Thrombectomy and Clip Occlusion of a Giant, Stent-Coiled Basilar Bifurcation Aneurysm: 3-Dimensional Operative Video
Authors: Frisoli Fabio A , Catapano Joshua S , Farber S Harrison , Baranoski Jacob F , Singh Rohin , Benet Arnau , Cole Tyler S , Mooney Michael A , Srinivasan Visish M , Lawton Michael T 
Published: April 2021

Abstract
Giant basilar apex aneurysms are associated with significant therapeutic challenges.
1–6
Multiple techniques exist to treat giant basilar apex aneurysms, including direct clipping, stent-assisted coil embolization, and proximal occlusion with bypass revascularization.
7–9
Hypothermic circulatory arrest was a useful adjunct for surgical repair of these aneurysms but has been abandoned because of associated risks.
10,11
Rapid ventricular pacing can achieve similar aneurysm softening with minimal risks and assist in clip occlusion. This case illustrates clip occlusion of a giant, partially thrombosed, previously stent-coiled basilar apex aneurysm in a 15-yr-old boy with progressive cranial neuropathies and sensorimotor impairment. Although a wire was placed preoperatively for ventricular pacing, it was not needed during the procedure. Patient consent was obtained. A right-sided orbitozygomatic craniotomy transcavernous approach with anterior and posterior clinoidectomies was performed. The basilar quadrification was dissected, and proximal control was obtained. After aneurysm trapping, the aneurysm was incised and thrombectomized using an ultrasonic aspirator. Back-bleeding from the aneurysm was anticipated, and ventricular pacing was ready, but back-bleeding was minimal. With the coil mass left in place, stacked, fenestrated clips were applied in a tandem fashion to occlude the aneurysm neck. Indocyanine green videoangiography confirmed occlusion of the aneurysm and patency of parent and branch arteries. The patient was at a neurological baseline after the operation, with improvement in motor skills and cognition at 3-mo follow-up. This case demonstrates the use of trans-sylvian-transcavernous exposure, rapid ventricular pacing, and thrombectomy amid previous coils and stents to clip a giant, thrombotic basilar apex aneurysm. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
Carotid Stenting: Flow Reversal Technique: 2-Dimensional Operative Video
Authors: Domingo Ricardo A , Ravindran Krishnan , Tawk Rabih G ,   Endovascular Neurosurgery Research Group (ENRG), Arthur Adam , Bain Mark , Bendock Bernard , Jo Binning Mandy , Boulos Alan S , Crowley Webster , Fessler Richard , Grande Andrew , Guterman Lee , Hanel Ricardo , Hoit Daniel , Hopkins L Nelson , Howington Jay , James Robert , Jankowitz Brian , Kan Peter , Khalessi Alex A , Kim Louis , Langer David , Lanzino Giuseppe , Levitt Michael , Levy Elad I , Lopes Demetrius , Mack William , Mericle Robert , Mocco J , Ogilvy Chris , Pandey Aditya , Replogle Robert , Riina Howard , Ringer Andrew , Rodriguez Rafael , Saugaveau Eric , Schirmer Clemens , Siddiqui Adnan H , Spiotta Alex , Sultan Ali , Tawk Rabih , Thomas Ajith , Turner Raymond , Veznedaroglu Erol , Welch Babu , White Jonathan 
Published: April 2021

Abstract
Management options for carotid stenosis include medical management, carotid endarterectomy, carotid stenting with distal filter protection, or stenting with either flow arrest or flow reversal techniques.
1
Flow reversal with transcarotid artery revascularization (TCAR) technique represents a hybrid approach with surgical access to the common carotid for endovascular placement of a stent in the internal carotid artery. This direct access to the carotid artery avoids navigating the challenging anatomy of the aortic arch with endovascular devices.
2
Compared to transfemoral stenting, TCAR possesses lower risk of transient ischemic attack and stroke, and compared to carotid endarterectomy, there is less risk of cranial neuropathy.
3,4

We present the case of an 87-yr-old man with recurrent severe stenosis (85%) of the right internal carotid artery. The patient had a remote history of bilateral endarterectomies for asymptomatic stenosis and was found with recurrence and progression of right internal carotid artery stenosis. Options were discussed and decision was made to proceed with TCAR after he consented for the procedure. The patient tolerated the procedure well with satisfactory revascularization. Exam remained unremarkable prior to discharge on postoperative day 1 and during follow-up at 1 mo. Patient consented to the publication of their image.
Dissecting Fusiform PICA Aneurysm Repair With Trapping and an Unconventional End-to-Side Reanastomosis: 2-Dimensional Operative Video
Authors: Frisoli Fabio A , Catapano Joshua S , Singh Rohin , Lawton Michael T 
Published: April 2021

Abstract
Dissecting fusiform posterior inferior cerebellar artery (PICA) aneurysms are rare and challenging.
1,2
One common treatment is occlusion of the aneurysm and parent artery via an endovascular approach without revascularization.
3
Revascularization of the artery requires an open microsurgical bypass or endovascular placement of a newer-generation flow diverter.
4
We present an end-to-side reanastomosis of the PICA for treatment of a dissecting fusiform left PICA aneurysm with anatomy deemed unfavorable for endovascular treatment in a 62-yr-old man with subarachnoid hemorrhage. After discussions regarding risks, benefits, and alternatives to the procedure, the family consented to surgical treatment.
A far-lateral craniotomy was performed, with partial condylectomy to widen the exposure. The cisterna magna was opened, and the dentate ligament was cut to visualize the vertebral artery. The PICA was identified and traced distally to the aneurysmal segment, which was circumferentially diseased. Perforators were noted immediately distal to the aneurysm. The aneurysm was then trapped, and the afferent artery was transected and brought to the sidewall of the distal artery. The recipient site was trapped with temporary clips, and a linear arteriotomy was made. An end-to-side reanastomosis was performed, temporary clips were removed, and hemostasis was achieved. Postoperative angiography confirmed bypass patency and preservation of the PICA perforators.
Conventional reanastomosis of the parent artery after aneurysm excision is achieved by end-to-end reanastomosis. In contrast, we performed an unconventional end-to-side reanastomosis to revascularize the PICA while leaving the efferent artery in situ to protect its medullary perforators. This bypass is an example of a fourth-generation bypass.
5,6
Used with permission from the Barrow Neurological Institute, Phoenix, Arizona.
Combining quantitative and qualitative magnetic resonance imaging features to differentiate anorectal malignant melanoma from low rectal cancer
Authors: Xu Zeyan , Zhao Ke , Han Lujun , Li Pinxiong , Shi Zhenwei , Huang Xiaomei , Han Chu , Wang Huihui , Chen Minglei , Liu Chen , Liang Yanting , Li Suyun , Huang Yanqi , Chen Xin , Liang Changhong , Cao Wuteng , Liu Zaiyi 
Published: April 2021

Abstract

Background
Distinguishing anorectal malignant melanoma from low rectal cancer remains challenging because of the overlap of clinical symptoms and imaging findings. We aim to investigate whether combining quantitative and qualitative magnetic resonance imaging (MRI) features could differentiate anorectal malignant melanoma from low rectal cancer.

Methods
Thirty-seven anorectal malignant melanoma and 98 low rectal cancer patients who underwent pre-operative rectal MRI from three hospitals were retrospectively enrolled. All patients were divided into the primary cohort (N = 84) and validation cohort (N = 51). Quantitative image analysis was performed on T1-weighted (T1WI), T2-weighted (T2WI), and contrast-enhanced T1-weighted imaging (CE-T1WI). The subjective qualitative MRI findings were evaluated by two radiologists in consensus. Multivariable analysis was performed using stepwise logistic regression. The discrimination performance was assessed by the area under the receiver operating characteristic curve (AUC) with a 95% confidence interval (CI).

Results
The skewness derived from T2WI (T2WI-skewness) showed the best discrimination performance among the entire quantitative image features for differentiating anorectal malignant melanoma from low rectal cancer (primary cohort: AUC = 0.852, 95% CI 0.788–0.916; validation cohort: 0.730, 0.645–0.815). Multivariable analysis indicated that T2WI-skewness and the signal intensity of T1WI were independent factors, and incorporating both factors achieved good discrimination performance in two cohorts (primary cohort: AUC = 0.913, 95% CI 0.868–0.958; validation cohort: 0.902, 0.844–0.960).

Conclusions
Incorporating T2WI-skewness and the signal intensity of T1WI achieved good performance for differentiating anorectal malignant melanoma from low rectal cancer. The quantitative image analysis helps improve diagnostic accuracy.