bluuebunny/crossref_metadata_2025_split huggingface dataset:
18F-FDG PET/CT Incidental Finding of Rare Extrapulmonary Presentation of Mycobacterium tuberculosis
Authors: Ranes Jennifer M. C. , Ormaza Ana J. , Desai Charismas , Tewari Sanjit O. , Flynt Lesley 
Published: November 2024

Abstract
A 41-year-old woman presented with a left breast mass for which mammography was performed. Mammogram revealed a suspicious BI-RADS 4, palpable left breast mass with associated nipple retraction. As malignancy was suspected, the patient underwent breast MRI and 18F-FDG PET/CT for staging. Multiple ultrasound guided biopsies were then performed of the left breast, left axillary lymph nodes, and left cervical lymph nodes. Final pathology was negative for malignancy, but final cultures grew Mycobacterium tuberculosis (Tb). The patient was initially intolerant to frontline medications, but eventually successfully treated with isoniazid, ethambutol, pyrazinamide, and moxifloxacin, as demonstrated by posttreatment mammography.
Diffuse Peritoneal Carcinomatosis of Prostate Cancer Unveiled by [89Zr]Zr-PSMA-617 PET/CT
Authors: Bastian Moritz B. , Burgard Caroline , Blickle Arne , Ezziddin Samer , Rosar Florian 
Published: November 2024

Abstract
We report an interesting case of a 64-year-old man with a history of radical prostatectomy for prostate cancer. The patient presented with steady increasing prostate-specific antigen levels, but with negative findings on previous multiple conventional prostate-specific membrane antigen (PSMA) PET/CT (with [68Ga]Ga-PSMA-11) and [18F]FDG PET/CT. A recently introduced PSMA tracer using long-lived 89Zr (half-life 3.3 days), [89Zr]Zr-PSMA-617, was administered in attempt to localize potential local recurrence or metastasis. [89Zr]Zr-PSMA-617 PET/CT clearly revealed diffuse peritoneal carcinomatosis and local recurrence of the prostate cancer, which were unidentified on previous conventional PET/CT scans. This case highly demonstrates the potential of PET imaging with the novel PSMA tracer [89Zr]Zr-PSMA-617.
Validity of Presurgery cTNM- and UICC-status in Patients With Oral Squamous Cell Carcinoma (OSCC)
Authors: Thoenissen Philipp , Burck Iris , Winkelmann Ria , Sader Robert , Ghanaati Shahram 
Published: November 2024

Aim:
In treating patients with oral squamous cell carcinoma (OSCC), therapy decisions are regularly made in interdisciplinary oncologic board meetings that rely on the synopsis of clinical examinations and structured clinical imaging modalities. In many cases, postsurgical results differed from those of the initial assessment. Therefore, this study compared presurgical and postsurgical tumor stages according to tumor, node, metastasis (TNM), and Union Contre le Cancer (UICC) classifications to find a better assessment of the real tumor stage.

Materials and Methods:
In a retrospective analysis from January 2014 to December 2020, patients who underwent primary tumor resection of OSCC and bilateral neck dissection (ND) according to the recommendations of an interdisciplinary oncologic board meeting at a university head and neck tumor center were included. Patients underwent local and cervical clinical examinations, computed tomography (CT), and magnetic resonance imaging (MRI) of the head and neck, followed by surgery and pathological examination.

Results:
: The cTNM/UICC classification of 168 patients were compared against their postsurgical pTNM and subsequent UICC classifications. In 51.19% of all cases, intra- individual differences in the comparison of the pre- and postsurgery TNM/UICC-classification were found. Testing between cUICC and pUICC shows moderate concordance according to Cohen’s Kappa (95% CI) with 0.42 (0.30-0.55; p<0.001).

Conclusion:
Concordance between pretherapeutic staging and the exact postsurgical status in patients with OSCC is lacking. Therefore, the further development of improved staging modalities is required. The opinion of the surgeon must be considered in the correct therapy proposal.
Next-generation Robotics in Otology: The HEARO Procedure
Authors: Tekin Ahmet M. , Bleys Ronald L. A. W. , Matulic Marco , Assadi Masoud Zoka , van de Heyning Paul , Bahşi İlhan , Topsakal Vedat 
Published: November 2024

Background:
In a world that is globalizing and centered on rapid communication, hearing impairment is one of the most common disabilities. The most effective and successful neural prosthesis in humans for treating the dysfunction of a sensory organ is cochlear implantation. The minimally invasive placement of the array in the cochlea should warrant the rehabilitation of profound hearing loss over all frequencies. Some key factors for structure and hearing preservation consist of minimal invasive drilling in the temporal bone and tailored inner ear access. Next-generation Robotically Assisted Cochlear Implantation Surgery (RACIS) focuses on robotic inner ear access. The purpose of this cadaveric preclinical study was to assess the viability and precision of a novel technology (the HEARO method) for RACIS, or more particularly, personalized robotic inner ear access.

Methods:
The external auditory canal, chorda tympani, ossicles, facial nerve, and other pertinent anatomical components were all 3-dimensional (3D)-reconstructed by the surgeon. The mean intended distance and drilling trajectory to the chorda tympani and facial nerve were, respectively, 0.44±0.13 and 0.35±0.27 mm.

Results:
With a mean insertion percentage of 94%, the surgeon was able to complete the HEARO method in 9 out of 10 procedures. There was no evidence of a collision or damage to vital structures.

Conclusion:
Future iterations of RACIS will prioritize haptic feedback, automated segmentation and trajectory, robotic insertion with adjustable speed, and imaging mobile cone beam computed tomography.
Asymmetrical 5’RACE RNA-based immunoglobulins repertoire sequencing is an accurate and specific tool for diagnosis of POEMS syndrome
Authors: Roussel Murielle , Pascal Virginie , Jaccard Arnaud , Bridoux Frank , Bender Sebastien , Sirac Christophe 
Published: November 2024

ABSTRACTPOEMS syndrome is a rare form of plasma cell dyscrasia with multiple clinical features including polyneuropathy and sclerotic bone lesions. As various signs and symptoms can be observed, diagnosis is often delayed and we need an accurate diagnosis tool for these patients. Vascular endothelial growth factor (VEGF) is known to play a major role in the pathology and is frequently increased in sera of the patients but is not specific. This condition is also associated with the presence of a monoclonal immunoglobulin light chain composed of highly restricted variable domains (IGLV1-40, IGLV1-44, IGLV1-36 and IGJV3*02 genes). Using RNA-based high-throughput sequencing (5’ RACE RepSeq), we previously showed mutated consensus stretches in the CDR1/FR2 regions of the variable domains of the light chains: (P/A)VNWYQ and (D/G)VNWYQ. We have now added 70 light chain sequences to our cohort and confirmed the variable domain restriction, the consensus stretches and found a new YSVNWYQ pattern on IGLV1-44 light chains. When correlated with our clinical database of POEMS patients, these mutation patterns had an accuracy of 89% and a specificity of 100%. 5’RACE RepSeq is an important tool to ensure the diagnosis of patients suspected of having POEMS syndrome, even with a small secretory clone. Samples from an involved organ are mandatory in the case of localized disease.
Physiology Guided Machine Learning Approach to Predict Short and Long Term Outcomes of Obstructive Sleep Apnea
Authors: Wickramaratne Sajila D. , Kam Korey , Tolbert Thomas M. , Varga Andrew , Ayappa Indu , Rapoport David M. , Parekh Ankit 
Published: November 2024

AbstractObstructive Sleep Apnea(OSA) is a chronic condition that affects 1 billion people worldwide. Apnea Hypopnea Index(AHI) is the clinical gold standard to measure the severity of OSA. This study highlights limitations in the apnea-hypopnea index as a predictor for obstructive sleep apnea (OSA) outcomes. Instead, a physiology-guided machine learning (ML) approach was developed using features from ventilatory, hypoxic, and arousal domains, based on polysomnography data from the Sleep Heart Health Study (SHHS). The ML model demonstrated superior predictive performance for all-cause mortality (AUROC-0.93) and daytime sleepiness (AUROC-0.81) compared to AHI. Explainable AI techniques, such as SHAP analysis, provided insights into feature importance, offering a clinically interpretable and scalable tool for OSA outcome prediction.
A network regularized linear model to infer spatial expression pattern for single cell
Authors: Gu Chaohao , Chen Hu , Liu Zhandong 
Published: November 2024

AbstractSpatial transcriptomics, situated at the intersection of genomics and spatial biology, offers profound insights into the spatial organization of gene expression within tissues. However, its potential has been constrained by either limited resolution or throughput. While single-cell RNA-seq allows for in-depth profiling of cellular gene expression, the crucial spatial information is often sacrificed during sample collection. In a groundbreaking fusion of these two techniques, our research introduces the glmSMA computational algorithm. This innovative approach aims to predict cell locations by integrating scRNA-seq data with spatial-omics reference atlases. The essence of glmSMA lies in formulating cell mapping as a convex problem, strategically minimizing differences between cellular expression profiles and location expression profiles through L1 and Generalized L2 regularization. Our algorithm has undergone rigorous testing across diverse tissues, including mouse brain, drosophila embryo, and human PDAC samples. The compelling results validate glmSMA’s efficacy, demonstrating its capability to faithfully recapitulate spatial gene expression and anatomical structures. This marks a significant stride forward in overcoming the limitations of existing spatial transcriptomic techniques.
Improving antibody-mediated protection against HSV infection by eliminating interactions with the viral Fc receptor gE/gI
Authors: Slein Matthew D. , Backes Iara M. , Kelkar Natasha S. , Garland Callaghan R. , Khanwalkar Urjeet S. , Sholukh Anton M. , Johnston Christine M. , Leib David A. , Ackerman Margaret E. 
Published: November 2024

AbstractHerpes simplex virus (HSV) encodes surface glycoproteins that are host defense evasion molecules, allowing the virus to escape immune clearance. In addition to their role in neuropathogenesis and cell-cell spread, glycoproteins E and I (gE/gI) form a viral Fc receptor (vFcR) for most subclasses and allotypes of human IgG and promote evasion of humoral immune responses. While monoclonal antibodies (mAbs) protect mice from neonatal HSV (nHSV) infections, the impact of the vFcR on mAb-mediated protection by binding to IgG is unknown. Using HSV-1 with intact and ablated gE-mediated IgG Fc binding, and Fc-engineered antibodies with modified ability to interact with gE/gI, we investigated the role of the vFcR in viral pathogenesis and mAb-mediated protection from nHSV. The gD-specific human mAb HSV8 modified to lack binding to gE exhibited enhanced neutralization andin vivoprotection compared to its native IgG1 form. This improved protection by the engineered mAbs was dependent on the presence of the vFcR. Human IgG3 allotypes lacking vFcR binding also exhibited enhanced antiviral activityin vivo, suggesting that vaccines that robustly induce IgG3 responses could show enhanced protection. suggesting the value of vaccination strategies that robustly induce this subclass. Lastly, analysis of longitudinal responses to acute primary genital infection in humans raised the possibility that unlike most viruses, HSV may exhibited slow induction of IgG3. In summary, this study demonstrates that mAbs lacking the ability to interact with the vFcR can exhibit improved protection from HSV—offering new prospects for antibody-based interventions.One Sentence Summary:The herpes simplex virus neutralizing antibody HSV8 demonstrates improved activityin vitroandin vivowhen its IgG Fc domain lacks the ability to bind the viral Fc receptor glycoprotein E/I complex through either Fc engineering or natural human IgG3 allotypes.
Extended-spectrum beta-lactamase-producingEscherichia coliandKlebsiella pneumoniaefrom human carriage, the human-polluted environment, and food: molecular epidemiology of two prospective cohorts in five European metropolitan areas
Authors: Verschuuren TD , Guther J , Riccio ME , Martak D , Salamanca E , Göpel S , Conzelmann N , Scharringa J , Musicha P , Autenrieth IB , Cooper BS , Hocquet D , Tacconelli E , Rodríguez-Baño J , Harbarth S , Fluit AC , Peter S , Kluytmans JAJW 
Published: November 2024

ABSTRACTObjectivesFor 475 ESBL-producingEscherichia coli(ESBL-Ec), and 171 ESBL-producingKlebsiella pneumoniae(ESBL-Kp) collected from human carriers, the human-polluted (hp)-environment, and food: (i) to compare the antimicrobial resistance gene (ARG) content, and (ii) to assess clonal relationships between human and non-human isolates.MethodsTwo prospective multicentre cohorts were assessed: colonised hospitalised index-subjects and household contacts, and long-term care facility (LTCF) residents. Additionally, linked hp-environment and food samples were collected. Presence of ARGs were assessed using pairwise comparisons and proportional similarity index (PSI). Clonal relationships were assessed using cgMLST distance visualisations and maximum likelihood phylogeny.ResultsESBL-Ec and ESBL-Kp co-occurred in 14/65 households, 3/6 LTCFs, and in 33/202 of ESBL-positive participants. Thirty-nine percent of detected ARG types were found in both species (36/93). Frequencies of beta-lactamase, ESBL, aminoglycoside, and sulfonamide ARG types from human ESBL-Ec and ESBL-Kp overlapped considerably: PSIs 0.59-0.75, and were equal or higher compared to the overlap between ESBL-Ec from humans and food isolates: PSIs 0.33-0.72. Isolates from humans and the hp-environment were frequently clonally related, indicating human contamination of the environment. Links with food isolates were observed less frequently. For ESBL-Ec both interregional and regional clonal dissemination were observed, while for ESBL-Kp clonal dissemination was mainly regional.ConclusionsESBL-Ec and ESBL-Kp from human carriage showed considerable overlap in ARG content. Furthermore, clonal links were observed frequently between humans and hp-environment, and with lower frequency between humans and food. These findings are consistent with human-to-human transmission as an important driver of ARG spread in humans.
The effectiveness of isoniazid preventive treatment against tuberculosis among contacts of multidrug-resistant tuberculosis: A systematic review and individual-participant meta-analysis
Authors: Martinez Leonardo , Altet Neus , Boulahbal Fadila , Cayla Joan A , Chakhaia Tsira , Chan Pei-Chun , Chen Cheng , Fang Chi-Tai , Fox Greg , Grandjean Louis , Hannoun Djohar , Hesseling Anneke , Horsburgh C. Robert , Huang Li-Min , Liu Qiao , Mazahir Rufaida , Lee Chih-Hsin , Lee Li-Na , Trieu Lisa , Seddon James A 
Published: November 2024

AbstractObjectiveTo evaluate the impact of isoniazid on incident tuberculosis in household contacts of MDR tuberculosis cases.DesignSystematic review and individual-participant meta-analysis.Data sourcesMEDLINE, Web of Science, BIOSIS, and Embase without language restrictions for case-contact cohort studies of tuberculosis contacts.Eligibility criteria and data analysisHousehold contact tracing studies that investigated the development of tuberculosis in persons closely exposed to individuals with tuberculosis and followed for incident disease. Both retrospective and prospective cohort studies were included. Participants were included if they were exposed to someone with multidrug-resistant tuberculosis and were given either 6 months of isoniazid TPT or no TPT. Two reviewers independently assessed quality using a modified quality assessment of tool. We derived adjusted hazard ratios (aHRs) for incident tuberculosis using mixed-effects, multivariable Cox regression models with study-level random effects. The effectiveness of isoniazid TPT against incident tuberculosis was estimated through propensity score matching. We stratified our results by contact age, HIV, andMycobacterium tuberculosisinfection status.Main outcome measuresOur primary outcome was incident tuberculosis in contacts exposed to tuberculosis (defined as a diagnosis >90 days after baseline). We derived adjusted hazard ratios (aHRs) for incident tuberculosis using mixed-effects, multivariable Cox regression models with study-level random effects.ResultsWe included participant-level data from 4,945 contacts exposed to multidrug-resistant tuberculosis from eight countries. The effectiveness of 6 months of isoniazid TPT against tuberculosis in contacts of multidrug-resistant tuberculosis was 70% (aHR, 0.30; 95% CI, 0.16–0.56) and did not appreciably change with adjustment for additional potential confounders. Effectiveness was higher among contacts <18 years of age (aHR, 0.39; 95% CI, 0.18–0.87) compared to adult contacts (aHR, 0.44; 95% CI, 0.14–1.41). Effectiveness was 93% (aHR, 0.07; 95% CI, 0.02–0.52) in the first year of follow-up; effectiveness dropped to 80% (aHR, 0.20; 95% CI, 0.05–0.89) in the second year and was non-significant after two years (26% effectiveness; aHR, 0.74; 95% CI, 0.34–1.59).ConclusionsAmong almost 5,000 contacts of multidrug-resistant tuberculosis cases, isoniazid IPT was 70% effective against incident tuberculosis. Protection waned after 2 years of follow-up. These results have important implications for the clinical management of individuals exposed to multidrug-resistant tuberculosis and future clinical trials.
Virtual reality as a strategy for intra-operatory anxiolysis and pharmacological sparing in patients undergoing breast surgeries: the V-RAPS randomized controlled trial protocol
Authors: Zako Joe , Daccache Nicolas , Burey Julien , Clairoux Ariane , Morisson Louis , Laferrière-Langlois Pascal 
Published: November 2024

AbstractIntroductionVirtual reality (VR) has increasingly found applications beyond leisure and video games, extending into the field of medicine. Recent studies indicate that VR can effectively reduce anxiety and pain in pediatric patients undergoing uncomfortable medical procedures, such as burn wound care. Yet, VR use in the operating room is still rare, despite a growing trend toward regional anesthesia without general anesthesia; physicians still frequently rely on pharmacological sedation to manage procedural anxiety. By leveraging VR’s anxiolytic properties, it may be possible to decrease the need for intravenous (IV) sedation which is associated with risk of adverse events like apnea and hypoxemia and delayed recovery.ObjectivesThis study’s main objective is to explore the impact of VR on IV sedation requirements in adult patients undergoing breast surgery under paravertebral (PV) block without general anesthesia. We hypothesize that VR immersion will reduce the need for intraoperative pharmacological sedation. Secondary objectives include assessing the tolerance of patients to the VR headset, examining the impact of the chosen VR scenario on the primary outcome, evaluating the incidence of adverse effects, measuring patient satisfaction, and analyzing the output of the Nociception Level (NOL) Index among awake surgical patients.Material and methodsThis single center randomized controlled trial will enroll 100 patients aged 18 or above undergoing breast surgery under PV block. Participants will be randomly allocated to the VR group or the control group; both will have access to pharmacological sedation through patient-controlled sedation (PCS). Participants in the VR group will choose between three different VR scenarios and will be allowed to switch between these scenarios during surgery. The primary outcome will be the time-adjusted and weight adjusted dose of self-administered intraoperative propofol. Secondary outcomes will include patient satisfaction, adverse events, and post-anesthesia care unit length of stay (PACU LOS).EthicsThis trial has been approved by the regional ethics committee (Comité d’Éthique de la Recherche du CIUSSS de l’Est de l’Île de Montréal) on September 9th, 2024.Trial registrationClinicalTrials.gov (July 25th, 2024). Unique protocol ID: 2025-3802. Trial identification number:NCT06522711.
Denoising diffusion model for increased performance of detecting structural heart disease
Authors: Streiffer Christopher D. , Levin Michael G. , Witschey Walter R. , Anyanwu Emeka C. 
Published: November 2024

AbstractRecent advancements in generative artificial intelligence have shown promise in producing realistic images from complex data distributions. We developed a denoising diffusion probabilistic model trained on the CheXchoNet dataset, encoding the joint distribution of demographic data and echocardiogram measurements. We generated a synthetic dataset skewed towards younger patients with a higher prevalence of structural left ventricle disease. A diagnostic deep learning model trained on the synthetic dataset performed comparably to one trained on real data producing an AUROC=0.75(95%CI 0.72-0.77), with similar performance on an internal dataset. Combining real data with positive samples from the synthetic data improved diagnostic accuracy producing an AUROC=0.80(95%CI 0.78-0.82). Subgroup analysis showed the largest performance improvement across younger patients. These results suggest diffusion models can increase diagnostic accuracy and fine-tune models for specific populations.
Home-based transcranial direct current stimulation for major depressive disorder: 6-month follow-up from a randomised sham-controlled trial
Authors: Woodham Rachel D. , Selvaraj Sudhakar , Lajmi Nahed , Hobday Harriet , Sheehan Gabrielle , Ghazi-Noori Ali-Reza , Lagerberg Peter J. , Machado-Vieira Rodrigo , Soares Jair C. , Young Allan H. , Fu Cynthia H.Y. 
Published: November 2024

AbstractTranscranial direct current stimulation (tDCS) is a potential home-based treatment for major depressive disorder (MDD). In our randomised controlled trial, a fully remote, 10-week course of home-based active tDCS showed greater clinical efficacy as compared to sham tDCS in a double-blind randomised controlled trial (RCT). tDCS was administered at 2mA for 30-minute sessions in a bifrontal montage with anode over the left dorsolateral prefrontal cortex (DLPFC) and cathode over the right DLPFC. Following the 10-week blinded trial, all participants could receive active tDCS in a 10-week open label phase. Participants who had completed the open-label treatment were invited for additional long term follow-up visits over 6 months. Participants were allowed to keep their tDCS device and could choose to continue stimulation during the follow-up period. In the follow-up phase, 42 participants (27 women) attended at least one visit. Ongoing use of the tDCS device was 59% at 3 months and 55% at 6 months during the follow-up period. The clinical response rate was 64% at 3 months and 76% at 6 months. Participants who had shown a clinical response after open label treatment maintained a response rate of 90% at 6 months. In summary, high rates of clinical response were maintained in 6-month follow-up whether or not participants continued to use the tDCS device.