bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteoporosis Circumscripta on 68Ga-DOTATATE PET CT
Authors: Gandy Nemi , Ordidge Katherine Louise , Arshad Mubarik , Win Zarni 
Published: April 2019

Abstract
Incidental findings on PET CT studies are common. The distribution of 68Ga-DOTATATE is dependent on cell surface expression of somatostatin receptors, which may be pathologic or physiologic. Osteoporosis circumscripta is the early lytic phase of Paget disease associated with well-defined osteopenia, most commonly seen within the skull on imaging. The appearance has been well demonstrated on 99mTc HDP/MDP bone scans. Here, we present the case of a 76-year-old man with a small bowel carcinoid tumor who underwent staging imaging with 68Ga-DOTATATE PET CT with the incidental finding of osteoporosis circumscripta.
Gated Tomographic Radionuclide Angiography Using CZT Gamma Camera in Patients Receiving Cardiotoxic Chemotherapy
Authors: Bailly Matthieu , Le Rouzic Gilles , Metrard Gilles 
Published: April 2019

Abstract
Tomographic radionuclide angiography (TRNA) can monitor cardiac function in patients receiving cardiotoxic chemotherapy. Gamma cameras using CZT detectors enable dose reduction and quicker acquisitions. We report 80 patients who underwent a 7-minute TRNA acquisition after injection of 550-MBq 99mTc–labeled human serum albumin. Data were analyzed full and half. Image quality was not visually decreased. There was no significant difference in left ventricular systolic and diastolic volumes and in left and right ventricular ejection fractions between full and half data acquisitions (P < 0.0001). When injecting half activity, effective dose could be reduced to 1.92 mSv.
Triple Ectopic Thyroid Detected on SPECT/CT
Authors: Agrawal Kanhaiyalal , Patro P. Sai Sradha , Pradhan Pradeep 
Published: April 2019

Abstract
Ectopic thyroid tissue is a rare entity of embryological aberration along the tract of descend of thyroid gland. Accurate localization and characterization are required for deciding management based on clinical features and symptoms. Ectopic thyroid in the absence of normal thyroid gland is uncommon. However, triple ectopic thyroid with absence of normal thyroid gland is very rare, with only a few cases reported previously. We present a case of triple ectopic thyroid, which appeared as single on planar 99mTc-sodium pertechnetate image, but was evident on SPECT/CT images.
Incidental Primary Breast Lymphoma on 99mTc-Sestamibi Myocardial Perfusion Imaging With SPECT/CT
Authors: Deng Zilong , Dong Aisheng , Zhao Min , Tang Youhong , Liu Yutao 
Published: April 2019

Abstract
We present a 53-year-old woman who had shortness of breath and atypical chest pain and underwent 99mTc-sestamibi myocardial perfusion imaging to detect coronary artery disease. The raw data in cine format showed an incidental focus close to the heart, and SPECT/CT fused images revealed a focus of intense uptake in the left breast. The subsequent histopathologic findings and 18F-FDG PET/CT imaging confirmed the diagnosis as primary breast lymphoma. After 3 cycles of chemotherapy, previously visualized abnormal uptake in the left breast disappeared on the follow-up PET/CT.
Ureteral Stone Mimicking Abnormal Sacral Uptake on 99mTc MDP Bone Scintigraphy
Authors: Wang Renjie , Zhao Gege , Chen Bin , Ji Bin 
Published: April 2019

Abstract
Bone tracer uptake related to ureteral stones has been reported several times before. We present a right ureteral stone mimicking abnormal focal sacral uptake on planar scan in a patient with rectal cancer. This case highlights the necessity of performing SPECT/CT to ascertain the origin of abnormal focal sacral uptake on planar scan, especially in patients with a history of kidney stones.
An Unusual False-Positive Uptake of Radioiodine Caused by Metallic Implants
Authors: Liu Lina , Chen Yu , Tian Tian , Huang Rui , Liu Bin 
Published: April 2019

Abstract
A 36-year-old woman with a history of papillary thyroid cancer underwent radioiodine remnant ablation using 131I. Postablation whole body 131I scintigraphy revealed increased activity not only in the thyroid bed but also in the right upper thigh. SPECT/CT images localized the activity to the metallic implants of the right femur, implanted 3 years earlier after the right femoral cyst resection.
Incidental Detection of a Radiation-Induced Soft-Tissue Sarcoma on 68Ga-PSMA PET/CT in a Patient Previously Treated for Prostate Cancer
Authors: Plouznikoff Nicolas , Woff Erwin , Artigas Carlos , Alexiou Jean , Flamen Patrick 
Published: April 2019

Abstract
Radiation-induced sarcoma is a rare complication of radiation therapy. We describe the incidental detection of a radiation-induced undifferentiated soft-tissue sarcoma with increased uptake on 68Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT in a prostate cancer patient previously treated with surgery and external-beam radiotherapy. Results were confirmed by histological analysis. 68Ga-PSMA is known to bind not only to PSMA-expressing prostate cancer cells but also to the neovasculature of various other solid tumors. A careful 68Ga-PSMA PET/CT review of previously irradiated areas is warranted so as not to miss radiation-induced sarcoma in prostate cancer patients.
Use of Static Imaging as a Substitute for Conventional Dynamic Imaging for Salivagrams in Children
Authors: Wu Ha , Zhao Ruifang , Zhao Xiaofei 
Published: April 2019

Objective
Salivagrams are commonly used for detecting pulmonary aspiration. However, conventional dynamic imaging is relatively time-consuming and could be difficult to perform in children with poor compliance. We analyzed the characteristics of conventional dynamic imaging to obtain a simple protocol suitable for use in children.

Methods
We conducted a retrospective analysis of salivagram data from 1163 patients (783 males, 380 females; age, 1 month to 9.0 years; mean age, 5.7 months) obtained in the past 4.5 years (January 2014 to June 2018). The various timepoint images were used for diagnosis. The positivity rate, missed diagnosis rate, and sensitivity were calculated and compared.

Results
Dynamic imaging revealed 353 cases of pulmonary aspiration (248 males, 105 females; age, 1 month to 4.5 years; mean age, 6.2 months). The positivity rate was 30.4% (353/1163), and 95.8% (338/353) of patients presented with continuous positive images after pulmonary aspiration. Only 4.2% (15/353) of positive cases showed clearance of pulmonary aspiration. The positivity rates were 11.8%, 18.2%, 21.9%, 25.0%, 27.0%, and 29.2% at 5, 10, 15, 20, 25, and 30 minutes, respectively. About 4.2% (15/353) of positive cases on earlier images showed clearance of pulmonary aspiration on later images, which indicate both early 15-minute and later 30-minute images were necessary.

Conclusions
Two static images acquired at 15 and 30 minutes might be an effective alternative to conventional salivagram, which mandates dynamic imaging.
Tumor Volume Analysis as a Predictive Marker for Prolonged Survival in Anaplastic Lymphoma Kinase–rearranged Advanced Non–Small Cell Lung Cancer Patients Treated With Crizotinib
Authors: Hida Tomoyuki , Dahlberg Suzanne E. , Lydon Christine A. , Hatabu Hiroto , Johnson Bruce E. , Awad Mark M. , Nishino Mizuki 
Published: April 2019

Purpose:
Targeted inhibition of anaplastic lymphoma kinase (ALK) has been widely used for the treatment of advanced non–small cell lung cancer (NSCLC) with ALK rearrangements. We performed tumor volume analysis of ALK-rearranged advanced NSCLC treated with crizotinib to identify an early predictive marker for prolonged survival.

Materials and Methods:
Cases of 42 patients with ALK-rearranged advanced NSCLC (16 men, 26 women; median age: 55.7 y) treated with crizotinib as their first ALK-directed therapy were retrospectively studied. Tumor volume measurements of dominant lung lesions were performed on baseline computed tomography and follow-up computed tomography at 8 weeks of therapy. The relationships between the 8-week volume change (%) and overall survival (OS) were investigated.

Results:
The 8-week tumor volume change ranged from −99.3% to 117.5% (median: −57.7%). Using the 25th percentile of the 8-week volume change of −74%, 11 patients with >74% volume decrease at 8 weeks had a significantly longer OS compared with 31 patients with ≤74% decrease (median OS: 92.0 vs. 22.8 mo; P=0.0048). In multivariable analyses using Cox proportional hazards models, the 8-week volume decrease of >74% was significantly associated with longer OS (hazard ratio=0.14, 95% confidence interval: 0.03-0.59; Cox P=0.008) after adjusting for tumor stage (stage IV vs. recurrent NSCLC, hazard ratio=5.6, 95% confidence interval: 1.29-24.3; P=0.02).

Conclusions:
The 8-week tumor volume decrease of >74% is significantly associated with longer OS in patients with ALK-rearranged NSCLC treated with crizotinib.
Automatic proximal airway volume segmentation using optical coherence tomography for assessment of inhalation injury
Authors: Miao Yusi , Choi Jae Hyek , Chou Li-Dek , Desai Vineet , Roberts Teryn R. , Beely Brendan M. , Wendorff Daniel S. , Espinoza Mark , Sieck Kyle , Cancio Leopoldo C. , Brenner Matthew , Batchinsky Andriy I. , Chen Zhongping 
Published: April 2019

BACKGROUND
Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury with a mortality rate of up to 40%. Early management of ARDS has been difficult due to the lack of sensitive imaging tools and robust analysis software. We previously designed an optical coherence tomography (OCT) system to evaluate mucosa thickness (MT) after smoke inhalation, but the analysis relied on manual segmentation. The aim of this study is to assess in vivo proximal airway volume (PAV) after inhalation injury using automated OCT segmentation and correlate the PAV to lung function for rapid indication of ARDS.

METHODS
Anesthetized female Yorkshire pigs (n = 14) received smoke inhalation injury (SII) and 40% total body surface area thermal burns. Measurements of PaO2-to-FiO2 ratio (PFR), peak inspiratory pressure (PIP), dynamic compliance, airway resistance, and OCT bronchoscopy were performed at baseline, postinjury, 24 hours, 48 hours, 72 hours after injury. A tissue segmentation algorithm based on graph theory was used to reconstruct a three-dimensional (3D) model of lower respiratory tract and estimate PAV. Proximal airway volume was correlated with PFR, PIP, compliance, resistance, and MT measurement using a linear regression model.

RESULTS
Proximal airway volume decreased after the SII: the group mean of proximal airway volume at baseline, postinjury, 24 hours, 48 hours, 72 hours were 20.86 cm3 (±1.39 cm3), 17.61 cm3 (±0.99 cm3), 14.83 cm3 (±1.20 cm3), 14.88 cm3 (±1.21 cm3), and 13.11 cm3 (±1.59 cm3), respectively. The decrease in the PAV was more prominent in the animals that developed ARDS after 24 hours after the injury. PAV was significantly correlated with PIP (r = 0.48, p < 0.001), compliance (r = 0.55, p < 0.001), resistance (r = 0.35, p < 0.01), MT (r = 0.60, p < 0.001), and PFR (r = 0.34, p < 0.01).

CONCLUSION
Optical coherence tomography is a useful tool to quantify changes in MT and PAV after SII and burns, which can be used as predictors of developing ARDS at an early stage.

LEVEL OF EVIDENCE
Prognostic, level III.
Valproic acid improves survival and decreases resuscitation requirements in a swine model of prolonged damage control resuscitation
Authors: Williams Aaron M. , Bhatti Umar F. , Biesterveld Ben E. , Graham Nathan J. , Chtraklin Kiril , Zhou Jing , Dennahy Isabel S. , Kathawate Ranganath G. , Vercruysse Claire A. , Russo Rachel M. , Li Yongqing , Alam Hasan B. 
Published: April 2019

BACKGROUND
Although damage control resuscitation (DCR) is routinely performed for short durations, prolonged DCR may be required in military conflicts as a component of prolonged field care. Valproic acid (VPA) has been shown to have beneficial properties in lethal hemorrhage/trauma models. We sought to investigate whether the addition of a single dose of VPA to a 72-hour prolonged DCR protocol would improve clinical outcomes.

METHODS
Fifteen Yorkshire swine (40–45 kg) were subjected to lethal (50% estimated total blood volume) hemorrhagic shock (HS) and randomized to three groups: (1) HS, (2) HS-DCR, (3) HS-DCR-VPA (150 mg/kg over 3 hours) (n = 5/cohort). In groups assigned to receive DCR, Tactical Combat Casualty Care guidelines were applied (1 hour into the shock period), targeting a systolic blood pressure of 80 mm Hg. At 72 hours, surviving animals were given transfusion of packed red blood cells, simulating evacuation to higher echelons of care. Survival rates, physiologic parameters, resuscitative fluid requirements, and laboratory profiles were used to compare the clinical outcomes.

RESULTS
This model was 100% lethal in the untreated animals. DCR improved survival to 20%, although this was not statistically significant. The addition of VPA to DCR significantly improved survival to 80% (p < 0.01). The VPA-treated animals also had significantly (p < 0.05) higher systolic blood pressures, lower fluid resuscitation requirements, higher hemoglobin levels, and lower creatinine and potassium levels.

CONCLUSION
VPA administration improves survival, decreases resuscitation requirements, and improves hemodynamic and laboratory parameters when added to prolonged DCR in a lethal hemorrhage model.
Surge or submerge? Predicting nurse staffing, medical hold capacity, and maximal patient care capabilities in the combat environment
Authors: Cassidy Jessica , Munari Dana , Forbes Damon , Remick Kyle , Martin Matthew J. 
Published: April 2019

BACKGROUND
Capabilities for daily operations at medical facilities are determined by routine staffing levels and bed availability. Although all health care facilities must be prepared for mass casualty events, there are few tools or metrics to estimate nursing requirements, medical hold surge capacity, and critical failure points for high-volume events. We sought to create a modifiable and customizable toolkit for producing reliable capability estimates across a range of scenarios.

METHODS
The inputs for key variables (patient volume, acuity, staffing, beds available, and medical evacuation) were extrapolated from the literature and interviews with subject-matter experts. Models were developed for a small austere facility, one large facility, and one expanded large facility. Inputs were serially increased to identify the “failure point” for each and the variables most contributing to failure.

RESULTS
Two scenarios were created, one moderate volume and one for mass casualty events. Variables most affecting capacity were identified as: average daily volume, mass casualty volume and frequency, acuity, and medical evacuation frequency. The large facility reached failure in 13 (43%) of 30 days and was attributed to bed capacity. The small facility did not reach failure point for bed capability or staffing under low volumes; however, it reached failure immediately under moderate volumes. The most significant factor was medical evacuation frequency. An automated dashboard was created to provide immediate estimates based on varying inputs.

CONCLUSION
We developed an automated and customizable toolkit to analyze mass casualty/disaster capabilities in relation to nurse staffing and hold capacity, assess the impact of key variables, and predict resource needs. Total bed capacity and hospital throughput via discharge/medical evacuation are the most critical factors in surge capacity and sustained mass casualty operations. Decreasing medical evacuation frequency is the greatest contributor to reaching “failure point.”

LEVEL OF EVIDENCE
Not Applicable.
Multiple sclerosis: clinical trial design 2019
Authors: Pardini Matteo , Cutter Gary , Sormani Maria Pia 
Published: April 2019

Purpose of review
Recent years have seen the approval of more than 15 disease-modifying drugs for multiple sclerosis (MS), mainly for its relapsing-remitting form (RRMS). The focus of the MS clinical trials is moving toward clinical trials aimed at progressive patients or based on putatively neuroprotective compounds. Here we reviewed the challenges of this paradigm shift.

Recent findings
Progressive MS and neuroprotective drugs trials will both need a change in patients’ enrollment criteria, outcome selection, and clinical trials design. Published ocrelizumab Primary Progressive MS data, as well as translational neuroimaging and clinical research suggest that MRI markers of inflammation could be used to enrich progressive MS trials population, albeit with the risk of overestimating the relevance of antiinflammatory therapeutic effects in this population and that conventional MRI-based metrics need to be complemented with volumetric and multiparametric approaches to disease severity quantification. Lastly, regarding statistical design, Bayesian approaches are at last making their way from oncology to neurology improving our ability to evaluate multiple treatments in the same trials’ population.

Summary
Adequate clinical trials design was one of the key factors in the RRMS treatment success story. Multidisciplinary collaborations are needed to adequately plan the progressive MS and restorative therapies trials that lay ahead in the near future.
Management of Peripapillary Choroidal Neovascular Membrane in Patients With Idiopathic Intracranial Hypertension
Authors: Ozgonul Cem , Moinuddin Omar , Munie Metasebia , Lee Michael S. , Bhatti M. Tariq , Landau Klara , Van Stavern Gregory P. , Mackay Devin D. , Lebas Maud , DeLott Lindsey B. , Cornblath Wayne T. , Besirli Cagri G. 
Published: April 2019

Objective:
To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH).

Methods:
Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH.

Results:
Records were reviewed from 7 different institutions between 2006 and 2016. Ten patients (13 eyes) with a diagnosis of IIH and at least 3 months of follow-up developed CNVM. Three of the total 10 patients developed bilateral CNVM. The mean time from the diagnosis of IIH to CNVM diagnosis was 41 months. Mean follow-up period was 8 months after diagnosis of CNVM. All patients were treated with acetazolamide for IIH. Seven eyes were observed, and 6 eyes were given anti–vascular endothelial growth factor (anti-VEGF) injections, including bevacizumab, ranibizumab, and aflibercept. All CNVMs regressed with subretinal fibrosis, and visual acuity improved in most patients. Papilledema resolved in only 1 eye, while the other 12 eyes had persistent papilledema at last follow-up.

Conclusions:
Peripapillary CNVM, a rare complication of IIH, often resolves spontaneously with treatment of IIH. In vision-threatening and/or persistent cases, intravitreal anti-VEGF treatment may be a safe and effective therapeutic option.
Isolated Abducens Nerve Palsy as Manifestation of Diffuse Intracranial Dolichoectasia
Authors: Benavides Jose I. , Corona Adalgisa , Aguilera Johanna I. , Paliza Jose M. 
Published: April 2019

Abstract:
An 83-year-old man presented with a 1-year history of abducens palsy. Brain MRA revealed arterial dolichoectasia of most cerebral vessels, including the basilar, internal carotid, and middle cerebral arteries. Abducens nerve palsy as a sole manifestation of diffuse intracranial dolichoectasia is unusual but may occur in diffuse intracranial dolichoectasia.
Characterizing key features in the formation of ice and gas hydrate systems
Authors: Liang Shuai , Hall Kyle Wm. , Laaksonen Aatto , Zhang Zhengcai , Kusalik Peter G. 
Published: April 2019

Crystallization in liquids is critical to a range of important processes occurring in physics, chemistry and life sciences. In this article, we review our efforts towards understanding the crystallization mechanisms, where we focus on theoretical modelling and molecular simulations applied to ice and gas hydrate systems. We discuss the order parameters used to characterize molecular ordering processes and how different order parameters offer different perspectives of the underlying mechanisms of crystallization. With extensive simulations of water and gas hydrate systems, we have revealed unexpected defective structures and demonstrated their important roles in crystallization processes. Nucleation of gas hydrates can in most cases be characterized to take place in a two-step mechanism where the nucleation occursviaintermediate metastable precursors, which gradually reorganizes to a stable crystalline phase. We have examined the potential energy landscapes explored by systems during nucleation, and have shown that these landscapes are rugged and funnel-shaped. These insights provide a new framework for understanding nucleation phenomena that has not been addressed in classical nucleation theory.This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.
Salt- and gas-filled ices under planetary conditions
Authors: Bove Livia E. , Ranieri Umbertoluca 
Published: April 2019

In recent years, evidence has emerged that solid water can contain substantial amounts of guest species, such as small gas molecules—in gas hydrate structures—or ions—in salty ice structures—and that these ‘filled’ ice structures can be stable under pressures of tens of Gigapascals and temperatures of hundreds of Kelvins. The inclusion of guest species can strongly modify the density, vibrational, diffusive and conductivity properties of ice under high pressure, and promote novel exotic properties. In this review, we discuss our experimental findings and molecular dynamics simulation results on the structures formed by salt- and gas-filled ices, their unusual properties, and the unexpected dynamical phenomena observed under pressure and temperature conditions relevant for planetary interiors modelling.This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.
Crystal-plane-dependent effects of antifreeze glycoprotein impurity for ice growth dynamics
Authors: Furukawa Yoshinori , Nagashima Ken , Nakatsubo Shunichi , Zepeda Salvador , Murata Ken-ichiro , Sazaki Gen 
Published: April 2019

An impurity effect on ice crystal growth in supercooled water is an important subject in relation to ice crystal formation in various conditions in the Earth's cryosphere regions. In this review, we consider antifreeze glycoprotein molecules as an impurity. These molecules are well known as functional molecules for controlling ice crystal growth by their adsorption on growing ice/water interfaces. Experiments on free growth of ice crystals in supercooled water containing an antifreeze protein were conducted on the ground and in the International Space Station, and the normal growth rates for the main crystallographic faces of ice, namely, basal and prismatic faces, were precisely measured as functions of growth conditions and time. The crystal-plane-dependent functions of AFGP molecules for ice crystal growth were clearly shown. Based on the magnitude relationship for normal growth rates among basal, prismatic and pyramidal faces, we explain the formation of a dodecahedral external shape of an ice crystal in relation to the key principle governing the growth of polyhedral crystals. Finally, we emphasize that the crystal-plane dependence of the function of antifreeze proteins on ice crystal growth relates to the freezing prevention of living organisms in sub-zero temperature conditions.This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.