bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of glucagon-like peptide-1 receptor agonists on 24-hour ambulatory blood pressure: a confirmatory meta-analysis
Authors: Patoulias Dimitrios , Papadopoulos Christodoulos , Siskos Fotios , Stavropoulos Konstantinos , Doumas Michael 
Published: March 2021

Objective
Hypertension augments overall cardiovascular risk in patients with type 2 diabetes mellitus (T2DM); however, control rates remain suboptimal. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the field of T2DM therapeutic management due to their multiple pleiotropic effects. Therefore, we sought to determine the effect of this class on ambulatory blood pressure monitoring (ABPM), pooling data from relevant randomized controlled trials (RCTs).

Methods
We searched major electronic databases, namely PubMed and Cochrane Library, along with gray literature sources, for RCTs assessing the effect of various GLP-1RAs on ambulatory BP in patients with T2DM.

Results
We pooled data from seven RCTs in total. GLP-1RA treatment compared to placebo or active control resulted in a nonsignificant decrease in 24-h SBP (mean difference = −1.57 mm Hg; 95% CI,−4.12 to 0.98; I
2 = 63%) and in 24-h DBP (mean difference = 1.28 mmHg; 95% CI,−0.31 to 2.87; I
2 = 49%). No subgroup differences between the various GLP-1RAs were detected.

Conclusion
GLP-1RAs treatment does not influence either systolic or diastolic ambulatory BP in patients with T2DM.
Acute-on-chronic liver failure in Egypt: an underestimated complication of liver cirrhosis
Authors: Medhat Mohammed A. , Gushken Fernanda , Khaled Tasneem , Hassan Elham , El-Rehim Abeer Abd , Kamel Sherif 
Published: March 2021

Background
Acute-on-chronic liver failure (ACLF) is a severe liver cirrhosis complication with high mortality rates. Despite that chronic liver diseases are prevalent in Egypt, there is no available data about patients with ACLF. We aimed to evaluate the pattern of ACLF in Egypt.

Methods
This prospective cohort study included all patients with ACLF, according to the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver, admitted to Al-Rajhi liver Hospital, Egypt, between November 2018 and October 2019. We recorded data at admission, days 3, 7, 14 and 28, and calculated ACLF grades and Chronic Liver Failure Consortium scores until discharge or death. Kaplan–Meier survival analysis was used for survival analysis.

Results
We analyzed 52 patients with ACLF. Liver cirrhosis was secondary to hepatitis C virus in 46 patients (88.9%), and hepatitis B virus in 4 (7.4%). The main ACLF precipitating factors were infection in 38 (73.1%) and variceal bleeding in 9 (17.3%). The most common infections were spontaneous bacterial peritonitis (44.7%) and chest infection (31.6%). The 28 and 90-day mortality rates were 86.5 and 96.2%. None of the patients who survived >28 days had ACLF 3 at admission or day 7. Among those who died <28 days, ACLF 3 was reported in 7 at admission and 19 on day 7. Living donor liver transplantation was not offered in any case.

Conclusion
In this study, the 28-day mortality rate was higher than in the literature. Egypt urgently needs to develop specific protocols for the proper management of ACLF.
Rate of incidental central nervous system meningioma detected in patients undergoing 18F-fluciclovine PET/CT imaging for evaluation of prostate cancer
Authors: Baiomy Ali , Schellingerhout Dawid , Chapin Brian F. , Weinberg Jeffrey S. , Raza Shaan M. , Macapinlac Homer , Ravizzini Gregory 
Published: March 2021

Objective
To evaluate the rate of incidental detection of central nervous system (CNS) meningioma in patients undergoing 18F-fluciclovine PET/computed tomography (CT) imaging for the evaluation of prostate cancer.

Methods
The reports of 850 18F-fluciclovine PET/CT scans in 566 patients with pathologically proven prostate cancer performed from April 2017 to July 2019, were retrospectively reviewed for the presence of CNS meningioma.

Results
A total of 14 patients (2.8%) (age range: 54–82 years old) had abnormal focal intracranial 18F-fluciclovine uptake, all extra-axial in location (SUVmax range: 3.2–19.3). Two cases out of 14 (0.35%) were diagnosed as metastatic lesions. Twelve out of the 14 patients, had 18F-fluciclovine PET/CT imaging findings suspicious for CNS meningioma, 2 of them received another diagnosis on further imaging, and only 10 cases (2%) had the diagnosis of meningioma according to follow-up MRI and 18F-fluciclovine PET/CT.

Conclusion
Focal 18F-fluciclovine avid intracranial lesions incidentally detected in patients undergoing PET/CT imaging for prostate cancer are most often CNS meningiomas.
Performance of SwiftScan planar and SPECT technology using low-energy high-resolution and sensitivity collimator compared with Siemens SPECT system
Authors: Shibutani Takayuki , Onoguchi Masahisa , Yoneyama Hiroto , Konishi Takahiro , Nakajima Kenichi 
Published: March 2021

Purpose
A new low-energy high-resolution-sensitivity (LEHRS) collimator was developed by General Electric (GE) Healthcare. SwiftScan planar and single photon emission computed tomography (SPECT) systems using LEHRS collimator were developed to achieve the low-dose and/or short-time acquisition. We demonstrated the performance of SwiftScan planar and SPECT system with LEHRS collimator using phantoms.

Methods
Line source, cylindrical and flat plastic dish phantoms were used to evaluate the performance of planar and SPECT images for four patterns of Siemens LEHR, GE LEHR, GE LEHRS and SwiftScan using two SPECT-CT scanners. Each phantom was filled with 99mTc solution, and the spatial resolution, sensitivity and image uniformity were calculated from the planar and SPECT data.

Results
The full-width at half maximum (FWHM) values as a system spatial resolution of Siemens LEHR, GE LEHR and GE LEHRS were approximately 7.4 mm. GE LEHRS showed a lower FWHM value by increasing the blend ratio in Clarity2D processing. The system sensitivity of GE LEHRS increased by approximately 30% compared with that of GE LEHR and was similar to that of Siemens LEHR. The FWHM values of SPECT with an filtered back projection (FBP) method were approximately 10.3 mm. The FWHM values of the ordered subset expectation maximization (OSEM) method were better with an increase in iteration values. The differential uniformities of Siemens LEHR, GE LEHR, GE LEHRS and GE SwiftScan using the FBP method were approximately 15.1%. The differential uniformity of OSEM method was higher with an increase in the iteration value.

Conclusion
The SwiftScan planar and SPECT have a high sensitivity while maintaining the spatial resolution compared with the conventional system.
Automated classification of increased uptake regions in bone single-photon emission computed tomography/computed tomography images using three-dimensional deep convolutional neural network
Authors: Tsujimoto Masakazu , Teramoto Atsushi , Dosho Masakazu , Tanahashi Shingo , Fukushima Ayami , Ota Seiichiro , Inui Yoshitaka , Matsukiyo Ryo , Obama Yuuki , Toyama Hiroshi 
Published: March 2021

Objective
This study proposes an automated classification of benign and malignant in highly integrated regions in bone single-photon emission computed tomography/computed tomography (SPECT/CT) using a three-dimensional deep convolutional neural network (3D-DCNN).

Methods
We examined 100 regions of 35 patients with bone SPECT/CT classified as benign and malignant by other examinations and follow-ups. First, SPECT and CT images were extracted at the same coordinates in a cube, with a long side two times the diameter of a high concentration in SPECT images. Next, we inputted the extracted image to DCNN and obtained the probability of benignity and malignancy. Integrating the output from DCNN of each SPECT and CT image provided the overall result. To validate the efficacy of the proposed method, the malignancy of all images was assessed using the leave-one-out cross-validation method; besides, the overall classification accuracy was evaluated. Furthermore, we compared the analysis results of SPECT/CT, SPECT alone, CT alone, and whole-body planar scintigraphy in the highly integrated region of the same site.

Results
The extracted volume of interest was 50 benign and malignant regions, respectively. The overall classification accuracy of SPECT alone and CT alone was 73% and 68%, respectively, while that of the whole-body planar analysis at the same site was 74%. When SPECT/CT images were used, the overall classification accuracy was the highest (80%), while the classification accuracy of malignant and benign was 82 and 78%, respectively.

Conclusions
This study suggests that DCNN could be used for the direct classification of benign and malignant regions without extracting the features of SPECT/CT accumulation patterns.
Enhancing cardiovascular research with whole-organ imaging
Authors: Rios Coronado Pamela E. , Red-Horse Kristy 
Published: March 2021

Purpose of review
There have been tremendous advances in the tools available for surveying blood vessels within whole organs and tissues. Here, we summarize some of the recent developments in methods for immunolabeling and imaging whole organs and provide a protocol optimized for the heart.

Recent findings
Multiple protocols have been established for chemically clearing large organs and variations are compatible with cell type-specific labeling. Heart tissue can be successfully cleared to reveal the three-dimensional structure of the entire coronary vasculature in neonatal and adult mice. Obtaining vascular reconstructions requires exceptionally large imaging files and new computational methods to process the data for accurate vascular quantifications. This is a continually advancing field that has revolutionized our ability to acquire data on larger samples as a faster rate.

Summary
Historically, cardiovascular research has relied heavily on histological analyses that use tissue sections, which usually sample cellular phenotypes in small regions and lack information on whole tissue-level organization. This approach can be modified to survey whole organs but image acquisition and analysis time can become unreasonable. In recent years, whole-organ immunolabeling and clearing methods have emerged as a workable solution, and new microscopy modalities, such as light-sheet microscopy, significantly improve image acquisition times. These innovations make studying the vasculature in the context of the whole organ widely available and promise to reveal fascinating new cellular behaviors in adult tissues and during repair.
Oligometastatic prostatic cancer recurrence: role of salvage lymph node dissection (sLND) and radiation therapy-stereotactic body radiation therapy (RT-SBRT)
Authors: Ahmed Mohamed E. , Phillips Ryan M. , Sharma Vidit , Davis Brian J. , Karnes R. Jeffrey 
Published: March 2021

Purpose of review
Metastases directed therapy (MDT) is an increasingly utilized modality in patients with oligometastatic prostate cancer (OMPC) recurrence. The purpose of our review is to discuss the recent literature on the safety and oncologic outcomes of this treatment approach.

Recent findings
Metastases directed therapy, in particular, stereotactic body radiation therapy (SBRT) and salvage lymph node dissection (sLND), has shown promising efficacy in patients with OMPC. Many case series report favorable outcomes with MDT as compared to hormonal deprivation therapy alone or surveillance. Of the few case series investigating the use of MDT as part of a multimodality approach in castrate-resistant OMPC, more favorable outcomes in comparison to the use of systemic treatment alone are reported.

Summary
With the recent advances in imaging techniques, particularly molecular imaging, management of OMPC has progressed rapidly in the last few years. The feasibility and benefits of MDT in OMPC have been demonstrated in prospective and retrospective series. Further prospective studies investigating the role of MDT to define optimal patient subgroups and management strategies are warranted.
What is next in second- and later-line treatment of metastatic renal cell carcinoma? review of the recent literature
Authors: Mori Keiichiro , Schmidinger Manuela , Quhal Fahad , Egawa Shin , Shariat Shahrokh F. , Grünwald Viktor 
Published: March 2021

Purpose of review
The current treatment landscape of metastatic renal cell carcinoma has changed dramatically from the dominance of single-agent tyrosine kinase inhibitor (TKI) therapy to immune-checkpoint inhibitor (ICI)-based combinations in recent years. However, the optimal subsequent therapy remains ill-defined owing to the novelty of this approach.

Recent findings
Treatment with TKIs after failure of single or dual ICI therapies may result in robust clinical efficacy. Nonetheless, there is a trend toward lower efficacy of TKIs after previous ICI–TKI combination therapy. Currently, tivozanib is the only drug whose third- and later-line use after failure of TKI and ICI is supported by evidence, with significantly longer progression-free survival and higher objective response rates than sorafenib. Data from retrospective studies highlight the safety and clinical activity of ICI rechallenge.

Summary
Overall, the level of evidence remains low. Treatment after failure of dual ICI therapy is not well defined and may consist of any available TKI. Although first-line use of TKI is less common, strong evidence suggests cabozantinib or nivolumab as standard options in that setting. The recommendations after first-line TKI–ICI therapy failure mirror this recommendation, although the data are less robust.
Metastatic nonclear renal cell carcinoma current review in evolving treatment strategies
Authors: Suárez Cristina , Díaz-Mejía Nely , Morales-Barrera Rafael , González Macarena , Mateo Joaquin , Carles Joan 
Published: March 2021

Purpose of review
Renal cell carcinoma (RCC) is the 6th most often diagnosed cancer in men and the 10th in women. Nearly 75% of the renal cancer cases are clear cell histologic subtype, whereas nonclear cell histologies represent the remaining 25%. Treatment options for clear renal type are well established. However, as nonclear RCC represents a heterogenous and less frequent group. Current treatment options for these tumors are limited and mostly based on evidence derived from small phase II clinical trials. The present review aims to provide an update of the available treatment options for nonclear RCC.

Recent findings
In the past decade, the vascular endothelial growth factor tyrosine kinase inhibitor, sunitinib, and mammalian target of rapamycin inhibitors, everolimus, and temsirolimus, have demonstrated limited efficacy in nonclear RCC. Recent studies with MET inhibitors and immunotherapy-based combinations have proven promising activity, especially in certain subgroups of patients, such as patients with MET-driven disease or patients with sarcomatoid features RCC.

Summary
Here, we report currently available data about biology and treatment of nonclear cell RCC.
Individualizing renal cell carcinoma treatment through biomarkers discovery in the era of immune checkpoint inhibitors: where do we stand?
Authors: Porta Camillo , Cosmai Laura , Rizzo Mimma 
Published: March 2021

Purpose of review
The treatment landscape of metastatic renal cell carcinoma has greatly evolved over the past fifteen years, leading to a significant improvement in the outcome of our patients. However, there is still an urgent need for predictive biomarkers that could guide our treatment selection, especially in the present era of immune-based treatments.

Recent findings
A number of putative biomarkers of immunotherapy activity have been proposed over the past few years, including PD-L1 immunohistochemical expression, tumor mutational burden, neoantigens load, insertions and deletions, complex gene signatures, as well as lymphocytic subpopulations (either circulating or tumor-infiltrating). However, despite preliminary intriguing findings, no biomarker for immune checkpoint activity has emerged so far, that could be used in everyday clinical practice, mainly due to preliminary, or frankly, conflicting results.

Summary
The quest for an ‘ideal’ biomarker, which should be characterized by adequate specificity, sensibility, predictive (and not just prognostic) value, robustness, reproducibility, ease of evaluation and low cost, is still ongoing.
Salvage therapy for localized recurrences of penile cancer
Authors: Saidian Ava , Ceballos Brian , Necchi Andrea , Baumgarten Adam S. , Spiess Philippe E. 
Published: March 2021

Purpose of review
To review the current literature and guidelines regarding salvage therapy for local and regional recurrence of primary penile cancer.

Recent findings
While invasive surgical management has not significantly changed, penile sparing treatments (PSTs) may have a promising role in the management of local recurrence. Penile sparing surgeries do appear to have higher rates of recurrence. However, the overall survival rate is comparable to that of partial and total penectomies. Additionally, a combination of therapies may have a more profound effect on management of penile cancer.

Summary
Clinicians must discuss the role of each type of therapy for penile cancer with their patients, and tailor their management to the extent of disease in each patient. While it is important to discuss the balance between quality of life and rates of relapse, one must also emphasize the rates of overall survival in patients with local recurrence who are treated with PSTs.
How Do We Meet the Challenge of Chimeric Antigen Receptor T-Cell Therapy for Solid Tumors?
Authors: Schoenfeld Adam J. , O'Cearbhaill Roisin E. 
Published: March 2021

Abstract
Immune checkpoint inhibition has vastly improved the treatment of solid tumors, but most patients do not experience durable clinical benefit, so novel immunotherapeutic approaches are needed. Autologous T cells genetically engineered to express chimeric antigen receptors (CARs) have led to unprecedented clinical success in hematologic malignancies, and increasing efforts are actively being pursued to translate these benefits to the solid tumor arena. However, solid tumors present unique challenges for CAR T-cell development. In this review, we examine the potential barriers to progress and present emerging approaches to overcome these challenges with CAR therapy in solid tumors.
Central nervous system infections associated with neurologic devices
Authors: Bloch Karen , Hasbun Rodrigo 
Published: March 2021

Purpose of review
To review recent data on the epidemiology, microbiology, diagnosis, and management of central nervous system (CNS) infections associated with neurologic devices.

Recent findings
The increasing use of implanted neurologic devices has led to an increase in associated infections. Cerebrospinal fluid (CSF) inflammation may be present after a neurosurgical procedure, complicating the diagnosis of CNS infection. Newer biomarkers such as CSF lactate and procalcitonin show promise in differentiating infection from other causes of CSF inflammation. Molecular diagnostic tests including next-generation or metagenomic sequencing may be superior to culture in identifying pathogens causing healthcare-associated ventriculitis and meningitis.

Summary
Neurologic device infections are serious, often life-threatening complications. Rapid recognition and initiation of antibiotics are critical in decreasing morbidity. Device removal is usually required for cure.
Neuroradiology of infectious diseases
Authors: Singh Sonia Kaur , Hasbun Rodrigo 
Published: March 2021

Purpose of review
Early diagnosis of central nervous system (CNS) infections is crucial given high morbidity and mortality. Neuroimaging in CNS infections is widely used to aid in the diagnosis, treatment and to assess the response to antibiotic and neurosurgical interventions.

Recent findings
The Infectious Diseases Society of America (IDSA) guidelines have clear recommendations for obtaining a computerized tomography of the head (CTH) prior to lumbar puncture (LP) in suspected meningitis. In the absence of indications for imaging or in aseptic meningitis, cranial imaging is of low utility. In contrast, cranial imaging is of utmost importance in the setting of encephalitis, bacterial meningitis, ventriculitis, bacterial brain abscess, subdural empyema, epidural abscess, neurobrucellosis, neurocysticercosis, and CNS tuberculosis that can aid clinicians with the differential diagnosis, source of infection (e.g., otitis, sinusitis), assessing complications of meningitis (e.g., hydrocephalus, venous sinus thrombosis, strokes), need for neurosurgical interventions and to monitor for the response of therapy. Novel imaging techniques such as fast imaging employing steady-state acquisition (FIESTA), susceptibility-weighted imaging (SWI), and chemical exchange saturation transfer (CEST) contrast are briefly discussed.

Summary
Though the radiological findings in CNS infections are vast, certain patterns along with clinical clues from history and examination often pave the way to early diagnosis. This review reiterates the importance of obtaining cranial imaging when necessary, and the various radiological presentations of commonly encountered CNS infections.
Facial Nerve Paraganglioma Masquerading as Bell palsy: A Reconstructive Pitfall
Authors: Seu Michelle , Eggerstedt Michael , Ghai Ritu , Dorafshar Amir H. , Wiet R. Mark 
Published: March 2021

Background:Facial paralysis can drastically diminish satisfaction in one's social interactions and overall quality of life. Bell palsy is the most common cause of facial palsy, however, a diagnosis of “atypical” BP may originate from an entirely different pathological process. This case highlights a rare case of facial nerve paraganglioma, initially misdiagnosed as BP, that resulted in facial paralysis from neoplastic invasion of the facial nerve.Case presentation:A 66-year old Hispanic woman with systemic lupus erythematosus presented to the plastic surgery clinic with complaints of drooling and being unable to smile. She experienced several episodes of left facial paralysis and was diagnosed with BP at an outside institution. Each episode was only partially responsive to steroid therapy. Imaging at our institution demonstrated lobulated enhancement along the vertical and extratemporal segments of the facial nerve, which prompted surgical intervention. The patient underwent left transmastoid approach for removal of the lesion involving the facial nerve followed by facial nerve reanimation via gracilis free flap without complication.Conclusions:This report outlines an extraordinarily rare case of a patient with facial nerve paraganglioma. This case represents the importance of reconstructive surgeons in considering a thorough diagnostic work-up with imaging and histopathology in the setting of idiopathic facial paralysis. Successful collaboration between otolaryngology and plastic surgery made streamlined diagnosis and surgical treatment of this unique case possible.