bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of [68 Ga]Ga-DOTATATE PET/CT in wild-type KIT/PDGFRA gastrointestinal stromal tumours (GIST)
Authors: Aloj Luigi , Giger Olivier , Mendichovszky Iosif A. , Challis Ben G. , Ronel Meytar , Harper Ines , Cheow Heok , Hoopen Rogier ten , Pitfield Deborah , Gallagher Ferdia A. , Attili Bala , McLean Mary , Jones Robin L. , Dileo Palma , Bulusu Venkata Ramesh , Maher Eamonn R. , Casey Ruth T. 
Published: January 2021

Abstract
Background
[68 Ga]Ga-DOTATATE PET/CT is now recognised as the most sensitive functional imaging modality for the diagnosis of well-differentiated neuroendocrine tumours (NET) and can inform treatment with peptide receptor radionuclide therapy with [177Lu]Lu-DOTATATE. However, somatostatin receptor (SSTR) expression is not unique to NET, and therefore, [68 Ga]Ga-DOTATATE PET/CT may have oncological application in other tumours. Molecular profiling of gastrointestinal stromal tumours that lack activating somatic mutations in KIT or PDGFRA or so-called ‘wild-type’ GIST (wtGIST) has demonstrated that wtGIST and NET have overlapping molecular features and has encouraged exploration of shared therapeutic targets, due to a lack of effective therapies currently available for metastatic wtGIST.

Aims
To investigate (i) the diagnostic role of [68 Ga]Ga-DOTATATE PET/CT; and, (ii) to investigate the potential of this imaging modality to guide treatment with [177Lu]Lu-DOTATATE in patients with wtGIST.

Methods
[68 Ga]Ga-DOTATATE PET/CT was performed on 11 patients with confirmed or metastatic wtGIST and one patient with a history of wtGIST and a mediastinal mass suspicious for metastatic wtGIST, who was subsequently diagnosed with a metachronous mediastinal paraganglioma. Tumour expression of somatostatin receptor subtype 2 (SSTR2) using immunohistochemistry was performed on 54 tumour samples including samples from 8/12 (66.6%) patients who took part in the imaging study and 46 tumour samples from individuals not included in the imaging study.

Results
[68 Ga]Ga-DOTATATE PET/CT imaging was negative, demonstrating that liver metastases had lower uptake than background liver for nine cases (9/12 cases, 75%) and heterogeneous uptake of somatostatin tracer was noted for two cases (16.6%) of wtGIST. However, [68 Ga]Ga-DOTATATE PET/CT demonstrated intense tracer uptake in a synchronous paraganglioma in one case and a metachronous paraganglioma in another case with wtGIST.

Conclusions
Our data suggest that SSTR2 is not a diagnostic or therapeutic target in wtGIST. [68 Ga]Ga-DOTATATE PET/CT may have specific diagnostic utility in differentiating wtGIST from other primary tumours such as paraganglioma in patients with sporadic and hereditary forms of wtGIST.
Management of cytomegalovirus corneal endotheliitis
Authors: Wong Angela H. Y. , Kua Wee Nie , Young Alvin L. , Wan Kelvin H. 
Published: January 2021

Abstract
Background
Cytomegalovirus (CMV) can manifest as corneal endotheliitis in immunocompetent individuals. Early diagnosis is prudent to prevent endothelial cell loss, which could ultimately lead to corneal decompensation. CMV DNA was first detected in an eye with corneal endotheliitis in 2006; since then, clinical evidence from numerous case reports and case series have accumulated.

Main text
In this narrative review, we identified several drugs, including ganciclovir, valganciclovir, and their combination in oral, intravenous, intravitreal, and topical forms in different concentrations, together with the judicious use of topical steroids, have reported variable success. There has yet to be any prospective comparative study evaluating the efficacy and safety of these assorted forms of treatment; clinical evidence is based on case reports and case series. CMV endotheliitis presenting with corneal edema can masquerade as other corneal diseases and thus poses a great challenge especially in post-keratoplasty eyes. Heightened awareness is needed before and after keratoplasty to start prompt prophylaxis and treatment.

Conclusion
There is no consensus on the management of CMV endotheliitis. Further studies are much needed to elucidate the optimal treatment modality, regime, and duration in the treatment and prophylaxis of CMV endotheliitis.
No wrong door: addressing injustices and achieving better mental healthcare provision for under-18s in acute physical healthcare settings
Authors: Davies Virginia 
Published: January 2021

Summary
The distressing reality that mental healthcare for children and young people in acute trust settings in the UK is woefully underprovided is not news. But with acute trust debts being written off, hospital trusts and commissioners of services have a timely opportunity to address this age- and condition-based discrimination.
Delivering a just service for under-18s depends on attitude, resources and adequate knowledge of the tasks involved. This article aims to describe the current landscape, summarise the arguments for better integrating mental healthcare into physical healthcare settings, articulate the tasks involved and the challenges for commissioning and providing, and finally share examples of current service models across the country.
Ultimately, commissioning and provider choices will be constrained by resource pressures, but this article aims to underscore why commissioning and providing a portmanteau ‘no wrong door’ hospital service for children, young people and families is worth the headache of thinking outside old commissioning and provider boxes.
Development and Validation of a Risk Tool for Predicting Severe Toxicity in Older Adults Receiving Chemotherapy for Early-Stage Breast Cancer
Authors: Magnuson Allison , Sedrak Mina S. , Gross Cary P. , Tew William P. , Klepin Heidi D. , Wildes Tanya M. , Muss Hyman B. , Dotan Efrat , Freedman Rachel A. , O'Connor Tracey , Dale William , Cohen Harvey J. , Katheria Vani , Arsenyan Anait , Levi Abrahm , Kim Heeyoung , Mohile Supriya , Hurria Arti , Sun Can-Lan 
Published: January 2021

PURPOSE Limited tools exist to predict the risk of chemotherapy toxicity in older adults with early-stage breast cancer. METHODS Patients of age ≥ 65 years with stage I-III breast cancer from 16 institutions treated with neoadjuvant or adjuvant chemotherapy were prospectively evaluated for geriatric and clinical features predictive of grade 3-5 chemotherapy toxicity. Logistic regression with best-subsets selection was used to identify and incorporate independent predictors of toxicity into a model with weighted variable scoring. Model performance was evaluated using area under the ROC curve (AUC) and goodness-of-fit statistics. The model was internally and externally validated. RESULTS In 473 patients (283 in development and 190 in validation cohort), 46% developed grade 3-5 chemotherapy toxicities. Eight independent predictors were identified (each assigned weighted points): anthracycline use (1 point), stage II or III (3 points), planned treatment duration > 3 months (4 points), abnormal liver function (3 points), low hemoglobin (3 points), falls (4 points), limited walking (3 points), and lack of social support (3 points). We calculated risk scores for each patient and defined three risk groups: low (0-5 points), intermediate (6-11 points), or high (≥ 12 points). In the development cohort, the rates of grade 3-5 chemotherapy toxicity for these three groups were 19%, 54%, and 87%, respectively ( P < .01). In the validation cohort, the corresponding toxicity rates were 27%, 45%, and 76%. The AUC was 0.75 (95% CI, 0.70 to 0.81) in the development cohort and 0.69 (95% CI, 0.62 to 0.77) in the validation cohort. Risk groups were also associated with hospitalizations and reduced dose intensity ( P < .01). CONCLUSION The Cancer and Aging Research Group-Breast Cancer (CARG-BC) score was developed and validated to predict grade 3-5 chemotherapy toxicity in older adults with early-stage breast cancer.
Insights for Quantifying the Long-Term Benefit of Immunotherapy Using Quantile Regression
Authors: Mboup Bassirou , Le Tourneau Christophe , Latouche Aurélien 
Published: January 2021

PURPOSEImmunotherapy has been approved to treat many tumor types. However, one characteristic of this therapeutic class is that survival benefit is due to late immune response, which leads to a delayed treatment effect. Quantifying the benefit, if any, of such treatment, will thus require other metrics than the usual hazard ratio and different approaches have been proposed to quantify the long-term response of immunotherapy.METHODIn this paper, we suggest to use quantile regression for survival data to quantify the long-term benefit of immunotherapy. Our motivation is that this approach is not trial-specific and provides clinically understandable results without specifying arbitrary time points or the necessity to reach median survival, as is the case with other methods. We use reconstructed data from published Kaplan-Meier curves to illustrate our method.RESULTSOn average, patients from the immunotherapy group have 60% chance to survive 5.46 months (95% CI, 2.57 to 9.02) more than patients in the chemotherapy group.
Demographic Trends From 2005 to 2015 Among Physicians With Accreditation Council for Graduate Medical Education–Accredited Anesthesiology Training and Active Medical Licenses
Authors: Zhou Yan , Sun Huaping , Wang Ting , Harman Ann E. , Keegan Mark T. , Macario Alex , Minhaj Mohammed M. , Chaudhry Humayun J. , Young Aaron , Warner David O. 
Published: January 2021

BACKGROUND:
A temporary decrease in anesthesiology residency graduates that occurred around the turn of the millennium may have workforce implications. The aims of this study are to describe, between 2005 and 2015, (1) demographic changes in the workforce of physicians trained as anesthesiologists; (2) national and state densities of these physicians, as well as temporal changes in the densities; and (3) retention of medical licenses by mid- and later-career anesthesiologists.

METHODS:
Using records from the American Board of Anesthesiology and state medical and osteopathic boards, the numbers of licensed physicians aged 30–59 years who had completed Accreditation Council for Graduate Medical Education–accredited anesthesiology residency training were calculated cross-sectionally for 2005, 2010, and 2015. Demographic trends were then described. Census data were used to calculate national and state densities of licensed physicians. Individual longitudinal data were used to describe retention of medical licenses among older physicians.

RESULTS:
The number of licensed physicians trained as anesthesiologists aged 30–59 years increased from 32,644 in 2005 to 36,543 in 2010 and 36,624 in 2015, representing a national density of 1.10, 1.18, and 1.14 per 10,000 population in those years, respectively. The density of anesthesiologists among states ranged from 0.37 to 3.10 per 10,000 population. The age distribution differed across the years. For example, anesthesiologists aged 40–49 years predominated in 2005 (47%), but by 2015, only 31% of anesthesiologists were aged 40–49 years. The proportion of female anesthesiologists grew from 22% in 2005, to 24% in 2010, and to 28% in 2015, particularly among early-career anesthesiologists. For anesthesiologists with licenses in 2005, the number who still had active licenses in 2015 decreased by 9.6% for those aged 45–49 years, by 14.1% for those aged 50–54 years, and by 19.7% for those aged 55–59 years.

CONCLUSIONS:
The temporary decrease in anesthesiology residency graduates around the turn of the 21st century decreased the proportion of anesthesiologists who were midcareer as of 2015. This may affect the future availability of senior leaders as well as the future overall workforce in the specialty as older anesthesiologists retire. National efforts to plan for workforce needs should recognize the geographical variability in the distribution of anesthesiologists.
War Frenzy
Authors: Thobani Sunera 
Published: January 2021

Abstract
Following a speech against the war on terror the author presented at a conference on Violence Against Women, she was publicly attacked and threatened for “hate-mongering.” This paper was written in the aftermath of the controversy that followed. The author’s speech highlighted the history of U.S. foreign policy and sought to mobilize feminist opposition to the invasion of Afghanistan. The war, she argued, was reviving the colonial/imperial global divide and would be catastrophic. The author explores here how a number of carefully considered words used in the speech were treated in the public controversy that followed as too “incendiary” and used to shut down political opposition to the invasion of Afghanistan. By publicly branding her an ungrateful and hate-filled immigrant woman, and an apologist for terrorism, the media provided a platform to shut down political opposition and advance the racist and Islamophobic political ideology of the war.
“All That You Can’t Leave Behind”
Authors: Brooks Daphne A. 
Published: January 2021

Abstract
As numerous scholars have shown, Hurricane Katrina exacerbated the already-ongoing precarity of African American communities in New Orleans. The crisis demanded a reckoning with the afterlives of slavery at the national and global level. This article focuses on the work of Black women popular music artists whose early twenty-first century recordings and stirring performances addressed the traumas, the challenges, and the spectacular subjugation of Black women who fell victim to brutal disenfranchisement in the midst of the disaster. Beyonce’s B-Day album and Mary J. Blige’s history-making Katrina telethon performance are central to this discussion. The original title of this article was “‘All That You Can’t Leave Behind’: Black Female Soul Singing and the Politics of Surrogation in the Age of Catastrophe.”
Queering Puerto Rican Women’s Narratives
Authors: Torres Lourdes 
Published: January 2021

Abstract
While in the last decades there has been a proliferation of writings by Latina lesbians who theorize issues of intersectionality, missing still are the voices and analyses of Puerto Rican lesbians who articulate the specificity of Puerto Rican sexual, racial, national, and class dynamics. It is within this context that the author examines Memoir of a Visionary (2002) by Antonia Pantoja and The Noise of Infinite Longing (2004) by Luisita López Torregrosa; the article considers how these recent memoirs engage with intersecting issues in the lives of Puerto Rican women and suggest how shame implicitly conditions the articulation of Puerto Rican identity.
Mel-han-cholia as Political Practice in Theresa Hak Kyung Cha’s Dictée
Authors: Cho Jennifer 
Published: January 2021

Abstract
Turning to extant theories of melancholy, this article uses Theresa Hak Kyung Cha’s Dictée to reevaluate the linear trajectory of Asian American identity formation in the United States. In particular, the author develops the term mel-han-choly—a hybrid form of melancholy and Korean han (a culturally specific grief)—to show how Cha uses it as a subversive political tool to defer historical closure and to refuse her quiet assimilation. Cha’s remembrance of the histories of Japanese colonialism in the Korean peninsula and the Korean War defies the expectation that minority populations somehow transcend their grievous pasts in becoming model American citizens. The author claims that Cha’s mel-han-cholic gestures disrupt the United States’ discursive power in narrating Korean history, especially as one contingent on accepting America’s “liberating” charge. This article also proposes that mel-han-choly serves a healing function within the diasporic Korean community, offering transnational connectivity through the shared experience of grief.
Refined tooth and pulp segmentation using U-Net in CBCT image
Authors: Duan Wei , Chen Yufei , Zhang Qi , Lin Xiang , Yang Xiaoyu 
Published: January 2021

Objectives The aim of this study was extracting any single tooth from a CBCT scan and performing tooth and pulp cavity segmentation to visualize and to have knowledge of internal anatomy relationships before undertaking endodontic therapy. Methods: We propose a two-phase deep learning solution for accurate tooth and pulp cavity segmentation. First, the single tooth bounding box is extracted automatically for both single-rooted tooth (ST) and multirooted tooth (MT). It is achieved by using the Region Proposal Network (RPN) with Feature Pyramid Network (FPN) method from the perspective of panorama. Second, U-Net model is iteratively performed for refined tooth and pulp segmentation against two types of tooth ST and MT, respectively. In light of rough data and annotation problems for dental pulp, we design a loss function with a smoothness penalty in the network. Furthermore, the multi-view data enhancement is proposed to solve the small data challenge and morphology structural problems. Results: The experimental results show that the proposed method can obtain an average dice 95.7% for ST, 96.2% for MT and 88.6% for pulp of ST, 87.6% for pulp of MT. Conclusions This study proposed a two-phase deep learning solution for fast and accurately extracting any single tooth from a CBCT scan and performing accurate tooth and pulp cavity segmentation. The 3D reconstruction results can completely show the morphology of teeth and pulps, it also provides valuable data for further research and clinical practice.
Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model
Authors: Vediappan Rajan Sundaresan , Bennett Catherine , Cooksley Clare , Finnie John , Trochsler Markus , Quarrington Ryan D. , Jones Claire F. , Bassiouni Ahmed , Moratti Stephen , Psaltis Alkis J. , Maddern Guy , Vreugde Sarah , Wormald P. J. 
Published: January 2021

Introduction
Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in preventing adhesion formation after abdominal surgery.

Materials and methods
112 adult (8–10 week old) male Wistar albino rats were subjected to midline laparotomy and caecal abrasion, with 48 rats having an additional enterotomy and suturing. Kaolin (0.005g/ml) was applied to further accelerate adhesion formation. The abrasion model rats were randomized to receive saline, Chitogel, or Chitogel plus Deferiprone (5, 10 or 20 mM), together with Gallium Protoporphyrin (250μg/mL). The abrasion with enterotomy rats were randomised to receive saline, Chitogel or Chitogel with Deferiprone (1 or 5 mM). At day 21, rats were euthanised, and adhesions graded macroscopically and microscopically; the tensile strength of the repaired caecum was determined by an investigator blinded to the treatment groups.

Results
Chitogel with Deferiprone 5 mM significantly reduced adhesion formation (p<0.01) when pathologically assessed in a rat abrasion model. Chitogel with Deferiprone 5 mM and 1 mM also significantly reduced adhesions (p<0.05) after abrasion with enterotomy. Def-Chitogel 1mM treatment did not weaken the enterotomy site with treated sites having significantly better tensile strength compared to control saline treated enterotomy rats.

Conclusions
Chitogel with Deferiprone 1 mM constitutes an effective preventative anti-adhesion barrier after abdominal surgery in a rat model. Moreover, this therapeutic combination of agents is safe and does not weaken the healing of the sutured enterotomy site.
Economic model to examine the cost-effectiveness of FlowOx home therapy compared to standard care in patients with peripheral artery disease
Authors: Ezeofor Victory ‘Segun , Bray Nathan , Bryning Lucy , Hashmi Farina , Hoel Henrik , Parker Daniel , Edwards Rhiannon Tudor 
Published: January 2021

Background
Critical limb ischaemia is a severe stage of lower limb peripheral artery disease which can lead to tissue loss, gangrene, amputation and death. FlowOx™ therapy is a novel negative-pressure chamber system intended for home use to increase blood flow, reduce pain and improve wound healing for patients with peripheral artery disease and critical limb ischaemia.

Methods
A Markov model was constructed to assess the relative cost-effectiveness of FlowOx™ therapy compared to standard care in lower limb peripheral artery disease patients with intermittent claudication or critical limb ischaemia. The model used data from two European trials of FlowOx™ therapy and published evidence on disease progression. From an NHS analysis perspective, various FlowOx™ therapy scenarios were modelled by adjusting the dose of FlowOx™ therapy and the amount of other care received alongside FlowOx™ therapy, in comparison to standard care.

Results
In the base case analysis, consisting of FlowOx™ therapy plus nominal care, the cost estimates were £12,704 for a single dose of FlowOx™ therapy per annum as compared with £15,523 for standard care. FlowOx™ therapy patients gained 0.27 additional quality adjusted life years compared to standard care patients. This equated to a dominant incremental cost-effectiveness ratio per QALY gained. At the NICE threshold WTP of £20,000 and £30,000 per QALY gained, FlowOx™ therapy in addition to standard care had a 0.80 and 1.00 probability of being cost-effectiveness respectively.

Conclusions
FlowOx™ therapy delivered as a single annual dose may be a cost-effective treatment for peripheral artery disease. FlowOx™ therapy improved health outcomes and reduced treatment costs in this modelled cohort. The effectiveness and cost-effectiveness of FlowOx™ therapy is susceptible to disease severity, adherence, dose and treatment cost. Research assessing the impact of FlowOx™ therapy on NHS resource use is needed in order to provide a definitive economic evaluation.