bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeted Temperature Management After Pediatric Cardiac Arrest: A Quality Improvement Program With Multidisciplinary Implementation in the PICU
Authors: McMullin Mason P. , Cadotte Noelle B. , Fuchs Erin M. , Kartchner Cory A. , Vincent Brian , Parker Gretchen , Sweney Jill S. , Flaherty Brian F. 
Published: November 2024

OBJECTIVES:
We aimed to implement a post-cardiac arrest targeted temperature management (TTM) bundle to reduce the percent of time with a fever from 7% to 3.5%.

DESIGN:
A prospective, quality improvement (QI) initiative utilizing the Method for Improvement. The pre-intervention historical control period was February 2019 to March 2021, and the intervention test period was April 2021 to June 2022.

SETTING:
The PICU of a freestanding, tertiary children’s hospital, in the United States.

PATIENTS:
Pediatric patients 2 days old or older to 18 young or younger than years old who experienced cardiac arrest, received greater than or equal to 2 minutes of chest compressions, required invasive mechanical ventilation post-resuscitation, and had no documented limitations of care.

INTERVENTIONS:
We developed and implemented a TTM bundle that included standard temperature goals, instructions and training on cooling blanket use, scheduled prescription of antipyretics, an algorithm for managing shivering, and standardized orders in our electronic health record.

MEASUREMENTS AND RESULTS:
We reviewed data from 29 patients in the pre-intervention period and studied 46 in the intervention period. In comparison with historical controls, the reduction in median (interquartile range [IQR]) percentage of febrile (> 38°C) time per patient associated with the TTM bundle was 0% (IQR, 0–3%) vs. 7% (IQR, 0–13%; p < 0.001). The intervention period, vs. pre-intervention, was associated with fewer patients with fever at any time (16/46 vs. 21/29; mean reduction, 37%; 95% CI, 13.8–54.8%; p = 0.002). We failed to identify an association between the intervention period, vs. pre-intervention, and the development of hypothermia (< 35°C; 8/46 vs. 3/29; mean change, 7%; 95% CI, –10.9% to 21.8%; p = 0.40).

CONCLUSIONS:
In this QI project, we have demonstrated that implementation of a TTM bundle is associated with reduced duration and frequency of fever in patients who survive cardiac arrest.
Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation
Authors: McMichael Ali , Weller Jamie , Li Xilong , Hatton Laura , Zia Ayesha , Raman Lakshmi 
Published: November 2024

OBJECTIVES:
To test feasibility of a randomized controlled trial (RCT) with an endpoint of time at goal anticoagulation in children on extracorporeal membrane oxygenation (ECMO) randomized to receive bivalirudin vs. unfractionated heparin.

DESIGN:
Open-label pilot RCT (NCT03318393) carried out 2018–2021.

SETTING:
Single-center quaternary U.S. pediatric hospital.

PATIENTS:
Children 0 days to younger than 18 years old supported with ECMO in the PICU or cardiovascular ICU.

INTERVENTIONS:
Randomization to bivalirudin vs. unfractionated heparin while on ECMO.

MEASUREMENTS AND MAIN RESULTS:
Sixteen patients were randomized to bivalirudin, and 14 patients were randomized to heparin. There was no difference in the primary outcome, time spent at goal anticoagulation, for patients randomized to bivalirudin compared with those randomized to heparin. While hemorrhagic complications were similar between study groups, thrombotic complications were higher with six of 16 patients in the bivalirudin group having one or more circuit changes compared with 0 of 14 patients in heparin group (mean difference, 37.5% [95% CI, 8.7–61.4%]; p = 0.02). Patients in the bivalirudin group received less packed RBC transfusions vs. those receiving heparin (median [interquartile range], 6.3 mL/kg/d [2.5–8.4 mL/kg/d] vs. 12.2 mL/kg/d [5.5–14.5 mL/kg/d]; p = 0.02).

CONCLUSIONS:
In this single-center pilot RCT carried out 2018–2021, we found that the test of anticoagulation therapy of bivalirudin vs. heparin during ECMO was feasible. Larger multicenter studies are required to further assess the safety and efficacy of bivalirudin for pediatric ECMO.
Effective Personalization of Stereotactic Radiosurgery for Brain Metastases in the Modern Era
Authors: Edwards Donna M. , Kim Michelle M. 
Published: November 2024

Abstract
As survival rates improve for patients with metastatic disease, more patients are requiring complex treatment for brain metastases. Stereotactic radiosurgery (SRS) is a conformal radiotherapy technique that allows high ablative dose to be delivered to a specific target and is a standard effective local therapy for the treatment of patients with limited brain metastases. This review highlights the current landscape of SRS treatment in the context of modern therapeutic advances and identifies new research frontiers to personalize SRS and maximize the therapeutic ratio.
The steady-state pharmacokinetics of fixed-dose combination dolutegravir+rilpivirine in hemodialysis
Authors: Gupta Samir K. , Friedman Allon N. , Desta Zeruesenay 
Published: November 2024

Objective:
Fixed dose combination (FDC) dolutegravir (DTG) plus rilpivirine (RPV) is an approved antiretroviral treatment regimen for people with HIV. The steady-state pharmacokinetics of FDC DTG+RPV in hemodialysis has not been previously studied.

Design:
We performed a single-center, prospective evaluation of the steady-state pharmacokinetics of FDC DTG +RPV in four adults without HIV either requiring hemodialysis and in four matched participants with normal renal function.

Methods:
All participants received FDC DTG (50 mg)+RPV (25 mg) daily for 10–14 days with food before undergoing an intensive 24 h pharmacokinetic evaluation (performed between dialysis days for those requiring HD). Plasma drug and metabolite concentrations were measured using a validated UHPLC/MS/MS. Descriptive pharmacokinetic parameters were calculated.

Results:
The hemodialysis and normal renal function participants (each group with two men and two women) were of similar ages (range, 50-60 years) and BMI (range, 18.5–34.5 kg/m2). No participant experienced serious or grade 3–4 adverse events; there were no study discontinuations. The AUC0–τ mean (SD) ratios of hemodialysis to normal renal function for DTG and RPV were 1.1 (0.4) and 1.1 (0.9), respectively. The mean (SD) C
min for DTG and RPV in the hemodialysis group were 1033 (252) and 49 (18) ng/ml, respectively.

Conclusion:
Hemodialysis did not lead to clinically appreciable differential exposures to DTG and RPV. Exposures throughout the dosing interval were greater than the reported protein-binding-adjusted IC90 efficacy values for DTG (64 ng/ml) and RPV (12 ng/ml) in all participants. These data suggest no dosing modifications are needed for the FDC DTG+RPV regimen in hemodialysis.
SNMMI PIC case competition finalist: Subcutaneous Panniculitis-Like T-Cell Lymphoma on 18F-FDG PET/CT
Authors: Oztek Murat Alp , Elhussein Wala , Parisi Marguerite T. 
Published: November 2024

Abstract
A 9-month-old girl was evaluated for recurrent fevers, rash, and indurated plaques, with laboratories demonstrating hyperferritinemia, hypertriglyceridemia, and pancytopenia, concerning for hemophagocytic lymphohistiocytosis. Biopsy of thigh lesion ultimately demonstrated subcutaneous panniculitis-like T-cell lymphoma. In a rare neoplasm of cytotoxic T-cells, subcutaneous panniculitis-like T-cell lymphoma presents with subcutaneous nodules in all age groups including children. Prognosis is generally good with immunosuppressive drugs being first line of treatment. 18F-FDG PET/CT demonstrates hypermetabolic lesions and is used to determine the extent of disease burden, identify sites of occult disease, and assess response to treatment.
Pelvic Desmoplastic Small Round Cell Tumor on 18F-PSMA PET/CT
Authors: Wang Yuan , Ding Xiaohui , Wang Ruimin , Liu Yachao 
Published: November 2024

Abstract
Desmoplastic small round cell tumor (DSRCT) as a subtype of sarcoma is rare and aggressive. We present the case of a 23-year-old man with a histologically confirmed DSRCT who underwent 18F-PSMA PET/CT before prostate biopsy and surgical resection of the tumor. It is well known that PSMA PET has a high accuracy for detecting clinically significant prostate adenocarcinoma and is useful in guiding prostate biopsy. This case signifies DSRCT can also exhibit intermediate PSMA expression on 18F-PSMA PET/CT.
Improving the Diagnostic Performance and Breast Imaging Reporting and Data System Category Agreement of Less Experienced Radiologists by Utilizing Computer-Aided Diagnosis Software for Breast Ultrasound
Authors: Wang Peilei , Xia Hansheng , Liu Limin , Wang Xi , Yan Lixia , Kong Zusuan , Xu Huixiong , Huang Beijian 
Published: November 2024

Abstract
This study aimed to assess the effectiveness of intelligence-based computer-aided diagnosis (CAD) software in ultrasound (US) and its potential to improve the diagnostic performance of less experienced radiologists, as well as the agreement on Breast Imaging Reporting and Data System (BI-RADS) categories with the experienced radiologist. Images of 385 breast lesions in 351 female taken from January 2019 to December 2020 were included. Two less experienced radiologists independently reviewed US images with and without CAD assistance, recording final assessments using the BI-RADS category. The diagnostic performance of CAD and radiologists were calculated and compared. Kappa statistics were used to determine agreement between the experienced radiologist and the less experienced radiologists, based on BI-RADS category before and after using CAD software. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CAD software were 95.5%, 71.5%, 81.3%, 69.8%, and 95.9%, respectively, and those were improved in junior radiologist and intermediate-level radiologist after the addition of CAD. Additionally, with the assistance of CAD, the area under the curve was improved for both the junior radiologist and radiologist (0.704 vs 0.847 and 0.876 vs 0.900, P = 0.009, 0.005), although it remained lower than the senior radiologist. The agreement of BI-RADS category between the less experienced and the experienced radiologists showed a significant improvement (P = 0.04, 0.000). The CAD on US could improve less experienced radiologists' diagnostic performance and agreement on BI-RADS categories, making it an effective decision-making tool in clinical practice.
Success of Bone Ossification After Posterior Vault Distraction Osteogenesis in Patients With Craniosynostosis
Authors: Sayadi Jamasb J. , Lujan-Hernandez Jorge , Givechian Kevin B. , Mackay Duncan , Lorenz H. Peter , Grant Gerald , Mahaney Kelly , Hong David S. , Khosla Rohit K. 
Published: November 2024

Background:
Posterior vault distraction osteogenesis (PVDO) is an effective treatment for multisuture and syndromic craniosynostosis. It remains unclear how well the calvarium ossifies after PVDO, especially in older patients when they have plateaued in their cranial growth phase. The purpose of this study is to report outcomes associated with PVDO across a wide range of ages at our institution.

Methods:
Operative details, distraction parameters, complications, and details of cranioplasty, if applicable, were obtained for all patients who underwent PVDO between March 2016 and July 2022. The surface areas of distraction sites and residual cranial defects were measured from computed tomography scans after a consolidation phase, and the percentages of the distraction regions with ossification were subsequently calculated.

Results:
Fifteen patients underwent PVDO at a mean age of 5.1 years (0.5–18.7 y). The mean percentage of ossification among all patients was 80.4% (59.1%–95.3%). The degree of ossification was not significantly associated with age at the time of surgery at the univariate level (Pearson-r=−0.15, P=0.573). Three patients (20.0%) required titanium mesh cranioplasty for definitive reconstruction, which was significantly more likely in patients who were >4 years old at the time of PVDO (P=0.04).

Conclusions:
Complete ossification of the distracted area of the cranium is unlikely after PVDO. Ossification appears less robust with increasing age, although not statistically significant in our study population, likely due to the limited sample size. Future studies should assess the role of age, latency period, and distraction rate in minimizing residual defects.
Improving Hair Scar Defects Through the Integration of Autologous Fat Transplantation and Hair Follicle Unit Transplantation
Authors: Gao Hai , Chen Zhixiong , Gu Xianbin , Yi Yangyan , Yang Juanmin 
Published: November 2024

Objective:
To assess the clinical efficacy of combining autologous fat grafting with hair follicle unit transplantation.

Methods:
The authors conducted a retrospective analysis involving 30 patients at the Department of Plastic Surgery, Second Affiliated Hospital of Nanchang University, between January 2021 and January 2023. Granular fat was harvested from the thigh’s posterior aspect using liposuction. The fat was then filtered through cotton pads, fascia was excised, and the fat was implanted into the scar tissue. Postoperatively, beyond the 3-month mark, hair follicle units were harvested from the posterior occipital region of the scalp using an electric device, and these units were transplanted into the scarred alopecic zones. At 1 year postoperatively, the authors evaluated the survival rate of the transplanted hair follicles and the cosmetic outcomes. In addition, patient satisfaction data were compiled.

Results:
Among the 30 patients, 22 males and 8 females with an age range of 18 to 43 years and a mean age of 29 years were included. Complete coverage was achieved in 23 cases, and substantial coverage in 7 cases. High satisfaction was reported by 28 patients, whereas 2 expressed moderate satisfaction.

Conclusion:
The integration of autologous fat grafting with hair follicle unit transplantation for the treatment of scar-related alopecia demonstrates significant efficacy and high patient satisfaction, recommending its broader clinical application.
Cranial Base Changes After Trans-sutural Distraction Osteogenesis in Growing Patients With Cleft Lip/Palate and Midface Hypoplasia
Authors: Zhou Binyi , Li Guan , Zhang Peiyang , Zhao Zhenmin 
Published: November 2024

Background:
Transesutural distraction osteogenesis (TSDO) is a method of correcting midfacial hypoplasia (MH) secondary to cleft lip and palate (CLP) without osteotomy. However, there has been little research on how the morphology of the cranial base changes postoperatively or whether any correction of the cranial base occurs.

Materials and Methods:
This retrospective study included 35 pediatric patients with MH secondary to CLP, who underwent TSDO treatment. Pre-treatment and post-treatment cranial computed tomography (CT) images were collected for cranial base measurements using 3-dimensional (3D) modeling reconstruction. For the comparative analysis, 102 children with normal craniofacial CT images were selected after matching for age and sex.

Results:
Comparison with normal children of the same age showed that the lengths and angles of several cranial base segments approached normal levels after treatment. In total, the authors found extreme extension in the anterior segment of the sphenoid bone, and in the middle cranial fossa. Simultaneously, TSDO therapy led to the anteroposterior diameter of the lateral pterygoid processes and vomer bone greatly exceeding the normal range, thus causing forward development of the midface skeleton.

Conclusion:
After the TSDO procedure, the cranial base length and angles approached normal dimensions, accompanied by the forward advancement of the midfacial skeleton. Among the cranial base structures, TSDO resulted in the most noticeable increase in the sphenoid bone in terms of linear measurements and angles, thus promoting midfacial development in children.
Triple network dynamics and future alcohol consumption in adolescents
Authors: McIntyre Clayton C. , Khodaei Mohammadreza , Lyday Robert G. , Weiner Jeffrey L. , Laurienti Paul J. , Shappell Heather M. 
Published: November 2024

AbstractBackgroundHuman neuroimaging increasingly suggests that the brain is best modeled as a highly interconnected and dynamic system. However, novel methodology for studying functional brain network dynamics have never been applied to the study of adolescent alcohol consumption. We sought to determine whether brain network dynamics are related to future drinking behavior in teenagers.MethodsResting-state functional magnetic resonance imaging (fMRI) time series from 17-year-old non/low drinking participants (n=295) of the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study were used to fit a Hidden Semi-Markov Model (HSMM). Regions of the default mode network (DMN), salience network (SN), and central executive network (CEN), collectively known as the Triple Network, were included in modeling. The HSMM identified the most-likely state sequence for each participant, a trajectory through distinct brain network states over the course of their fMRI scan. Poisson regression models were used to assess relationships between state sequence metrics and future drinking frequency. Potential sex differences in state sequence metrics or the relationship between sequence metrics and future drinking were assessed with permutation testing and interactions in regression models.ResultsNo sex differences in state sequence metrics were observed. However, the relationship between occupancy times and future drinking frequency differed by sex for two brain states. In the full sample, occupancy time in a state characterized by high interconnectivity between the SN and CEN was negatively associated with drinking. Occupancy time in a separate state characterized by high activation in the DMN and SN, but low activation in the CEN, was negatively associated with future drinking.ConclusionsBrain network dynamics may be useful neural markers of predisposition to drinking in adolescents. Brain states which make teens vulnerable or resilient to drinking may differ between sexes.
Dual-BONCAT Reveals Distinct Day- and Night-Active Microbial Populations in Salt Marsh Sediments
Authors: Maierhaba Yasheng , Momjian Claire , Mankel Dylan , Calabrese Federica , Duhamel Solange , Marlow Jeffrey 
Published: November 2024

AbstractBio-Orthogonal Non-Canonical Amino Acid Tagging (BONCAT) has emerged as a prominent molecular technique that enables microbial ecologists to visualize and identify metabolically active taxa within complex microbial communities. To date, researchers have used just one non-canonical amino acid (ncAA) in a given experiment; here, we validate a novel approach using two different ncAAs in a single experiment. This advancement facilitates the detection of differentially active subpopulations within the same experimental context, thereby reducing the uncertainty and variability associated with parallel treatments, and providing precise spatial information about organisms that are active under distinct conditions or at different times. We show that both ncAAs can be taken up byE. colicultures and by constituents of the Little Sippewissett Salt Marsh (LSSM) microbiome, resulting in fluorescence signals that are significantly higher than background and ncAA-free control experiments. As a proof of concept experiment, we implemented this “Dual-BONCAT” approach in LSSM sediments, adding one ncAA during daytime hours and the other at night. Subpopulations of cells that were anabolically active during the day and/or night were distinguishable by both fluorescence microscopy, and by fluorescence-activated cell sorting. Subsequent high-throughput 16S rRNA gene amplicon sequencing of active subpopulations revealed thatMethylobacterium, potentially feeding on plant exudate carbon molecules, was preferentially active during the day, while sulfur-cycling taxa dominated the night-active population. Dual-BONCAT offers an important advancement in multiplexing substrate-analog probing techniques, providing a more realistic understanding of metabolic activity under distinct environmental conditions.
Diverse phage defence systems define West African South American pandemicVibrio cholerae
Authors: Adams David W. , Jaskólska Milena , Lemopoulos Alexandre , Stutzmann Sandrine , Righi Laurie , Bader Loriane , Blokesch Melanie 
Published: November 2024

SummaryOur understanding of the factors underlying the evolutionary success of different lineages of pandemicVibrio choleraeremains incomplete. Interestingly, two unique genetic signatures define the West African South American (WASA) lineage ofV. choleraeresponsible for the 1991-2001 Latin American cholera epidemic. Here we show these signatures encode diverse anti-phage defence systems. Firstly, the WASA-1 prophage encodes a 2-gene abortive-infection system WonAB that renders the lineage resistant to the major predatory vibriophage ICP1, which alongside other phages, is thought to restrict cholera epidemics and has potential for use in prophylaxis. Secondly, a unique set of genes on theVibrioseventh pandemic island II encodes an unusual modification-dependent restriction system targeting phages with modified genomes, and a new member of the Shedu defence family that defends against vibriophage X29. Taken together, we propose that these anti-phage defence systems have likely contributed to the success of a major epidemic lineage of the ongoing seventh cholera pandemic.
Adaptive denoising quantum state preparation in a dynamic environment
Authors: Wang Zhao-Ming , Chen Tuo-Zhi 
Published: November 2024

Quantum state preparation (QSP) is an essential step in many quantum information processing tasks and has been deeply studied in a closed system. However, environmental noise inevitably destroys the quantumness of the system, resulting in decreased fidelity. In this work, we investigate the enhancement of fidelity by pulse control for arbitrary single or two-qubit QSP in a noisy environment. The control pulses are designed by leveraging supervised learning. The environment is modeled as a collection of bosons, and we use the quantum state diffusion equation technique to deal with the dynamics of the system. We consider two types of noise: quasistatic noise and dynamic noise. We propose active and adaptive denoising schemes for the quasistatic and dynamic noise, respectively. The environmental parameters are required to construct the dataset when training the neural network (NN) in adaptive denoising, while they are not needed in active denoising. The adaptive denoising scheme is universal in that it can be effectively applied to both quasistatic and dynamic noises. High-fidelity QSP has been obtained by the well-trained NN. Our work demonstrates that machine learning has great potential in optimal pulse design in a dynamic environment.

Published by the American Physical Society
2024