bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of O-RADS MRI Score in Differentiating Benign From Malignant Ovarian Teratomas: MR Feature Analysis for Differentiating O-RADS 4 From O-RADS 2
Authors: Petrocelli Robert , Doshi Ankur , Slywotzky Chrystia , Savino Marissa , Melamud Kira , Tong Angela , Hindman Nicole 
Published: July 2024

Objective
The aim of the study is to evaluate the performance of the ovarian-adnexal reporting and data system magnetic resonance imaging (O-RADS MRI) score and perform individual MRI feature analysis for differentiating between benign and malignant ovarian teratomas.

Methods
In this institutional review board–approved retrospective study, consecutive patients with a pathology-proven fat-containing ovarian mass imaged with contrast-enhanced MRI (1.5T or 3T) from 2013 to 2022 were included. Two blinded radiologists independently evaluated masses per the O-RADS MRI lexicon, including having a “characteristic” or “large” Rokitansky nodule (RN). Additional features analyzed included the following: nodule size/percentage volume relative to total teratoma volume, presence of bulk/intravoxel fat in the nodule, diffusion restriction in the nodule, angular interface, nodule extension through the teratoma border, presence/type of nodule enhancement pattern (solid versus peripheral), and evidence for metastatic disease. An overall O-RADS MRI score was assigned. Patient and lesion features associated with malignancy were evaluated and used to create a malignant teratoma score. χ2, Fisher's exact tests, receiver operating characteristic curve, and κ analysis was performed.

Results
One hundred thirty-seven women (median age 34, range 9–84 years) with 123 benign and 14 malignant lesions were included. Mean teratoma size was 7.3 cm (malignant: 14.4 cm, benign: 6.5 cm). 18/123 (14.6%) of benign teratomas were assigned an O-RADS 4 based on the presence of a “large” (11/18) or “noncharacteristic” (12/18) RN. 12/14 malignant nodules occupied >25% of the total teratoma volume (P = 0.09). Features associated with malignancy included the following: age <18 years, an enhancing noncharacteristic RN, teratoma size >12 cm, irregular cystic border, and extralesional extension; these were incorporated into a malignant teratoma score, with a score of 2 or more associated with area under the curve of 0.991 for reviewer 1 and 0.993 for reviewer 2. Peripheral enhancement in a RN was never seen with malignancy (64/123 benign, 0/14 malignant) and would have appropriated downgraded 9/18 overcalled O-RADS 4 benign teratomas.

Conclusions
O-RADS MRI overcalled 15% (18/123) benign teratomas as O-RADS 4 but correctly captured all malignant teratomas. We propose defining a “characteristic” RN as an intravoxel or bulk fat-containing nodule. Observation of a peripheral rim of enhancement in a noncharacteristic RN allowed more accurate prediction of benignity and should be added to the MRI lexicon for improved O-RADS performance.
Volumetric Analysis: Effect on Diagnosis and Management of Indeterminate Solid Pulmonary Nodules in Routine Clinical Practice
Authors: Lim Robert S. , Rosenberg Jarrett , Willemink Martin J. , Cheng Sarah N. , Guo Henry H. , Hollett Philip D. , Lin Margaret C. , Madani Mohammad H. , Martin Lynne , Pogatchnik Brian P. , Pohlen Michael , Shen Jody , Tsai Emily B. , Berry Gerald J. , Scott Gregory , Leung Ann N. 
Published: July 2024

Objective
To evaluate the effect of volumetric analysis on the diagnosis and management of indeterminate solid pulmonary nodules in routine clinical practice.

Methods
This was a retrospective study with 107 computed tomography (CT) cases of solid pulmonary nodules (range, 6–15 mm), 57 pathology-proven malignancies (lung cancer, n = 34; metastasis, n = 23), and 50 benign nodules. Nodules were evaluated on a total of 309 CT scans (average number of CTs/nodule, 2.9 [range, 2–7]). CT scans were from multiple institutions with variable technique. Nine radiologists (attendings, n = 3; fellows, n = 3; residents, n = 3) were asked their level of suspicion for malignancy (low/moderate or high) and management recommendation (no follow-up, CT follow-up, or care escalation) for baseline and follow-up studies first without and then with volumetric analysis data. Effect of volumetry on diagnosis and management was assessed by generalized linear and logistic regression models.

Results
Volumetric analysis improved sensitivity (P = 0.009) and allowed earlier recognition (P < 0.05) of malignant nodules. Attending radiologists showed higher sensitivity in recognition of malignant nodules (P = 0.03) and recommendation of care escalation (P < 0.001) compared with trainees. Volumetric analysis altered management of high suspicion nodules only in the fellow group (P = 0.008). κ Statistics for suspicion for malignancy and recommended management were fair to substantial (0.38–0.66) and fair to moderate (0.33–0.50). Volumetric analysis improved interobserver variability for identification of nodule malignancy from 0.52 to 0.66 (P = 0.004) only on the second follow-up study.

Conclusions
Volumetric analysis of indeterminate solid pulmonary nodules in routine clinical practice can result in improved sensitivity and earlier identification of malignant nodules. The effect of volumetric analysis on management recommendations is variable and influenced by reader experience.
68Ga-NODAGA–Exendin-4 PET/CT Findings in a Case of Metastatic Insulinoma With Refractory Hypoglycemia Controlled by 90Y Transarterial Radioembolization
Authors: Şahin Rahime , Rakıcı İbrahim Taşkın , Baloğlu Mehmet Can , Şahin Ömer Faruk , Çermik Tevfik Fikret 
Published: July 2024

Abstract
Metastatic insulinomas can cause recurrent hypoglycemia requiring continuous IV glucose infusion. Various medical and chemotherapeutic treatment options are used to reduce the patient’s risk of death due to hypoglycemia. Treatment-resistant hepatic metastatic insulinomas may benefit clinically from 90Y transarterial radioembolization therapy. In this case, we present a case of liver metastatic insulinoma that achieved clinical improvement after 2 cycles of 90Y microspheres transarterial radioembolization, and the presence of active metastases was demonstrated with 68Ga-NODAGA–exendin-4 PET/CT imaging.
177Lu-DOTATATE Uptake in the Lungs of a Patient With COVID-19 Pneumonia
Authors: Matsushita Tomoki , Otomi Yoichi , Okada Naoko , Kawanaka Takashi , Otsuka Hideki 
Published: July 2024

Abstract
A 76-year-old woman with liver and bone metastasis of a duodenal neuroendocrine tumor received peptide receptor radionuclide therapy with 177Lu-DOTATATE. Scintigraphy with SPECT/CT performed 4 days after the treatment demonstrated 177Lu-DOTATATE uptake as multifocal ground glass opacities in the bilateral lungs. This uptake was considered to be due to COVID-19 pneumonia because the patient was infected with the virus 7 days prior to the treatment. The lung opacities became smaller, showing a decreased uptake, 2 months later, after the second treatment. 177Lu-DOTATATE may be taken up during the active phase of COVID-19 pneumonia.
Temporal Changes in 18F-FDG PET/CT in Familial Neuronal Intranuclear Inclusion Disease, Based on the Clinical Course
Authors: Kim Ahro , Park Gyeong Min , Suh Jae Hee , Park Ji-Yun , Seo Minjung 
Published: July 2024

Abstract
We report temporal changes in 18F-FDG PET/CT in neuronal intranuclear inclusion disease (NIID). In a patient with encephalitis-like episodes, PET showed hypermetabolism correlating with EEG alterations. Affected sites later became hypometabolic and showed diffusion changes on MRI. In another patient, hypermetabolic regions correlated well with the EEG, whereas MRI showed changes after only 1 month. One chronic patient had diffuse hypometabolism, which correlated with atrophy on MRI and cerebral dysfunction on EEG. This is the first report of temporal changes in PET in NIID and suggests that it reflects the disease activity of NIID while correlating well with EEG.
Infectious Aortitis on 18F-FDG PET/CT
Authors: El Hoyek Nadine , Chen Wengen , Aktay Recai 
Published: July 2024

Abstract
Infectious aortitis is a challenging radiographic diagnosis due to overlapping features with the noninfectious category. We present a case of a 58-year-old woman who tested positive for SARS-CoV-2 and Streptococcus pneumoniae bacteremia. 18F-FDG PET/CT demonstrated large vessel vasculitis involving the thoracic, abdominal aorta, and the brachiocephalic branches of the aortic arch, and an incidental subcutaneous abscess in the right arm. Standard of care treatment was administered. Within a week, a drastic improvement of the wall thickening was noted, which can be, regardless of the biological markers, a surrogate marker of an infectious aortitis.
Thoracic SMARCA4-Deficient Undifferentiated Tumor Mimicking Malignant Pleural Mesothelioma on FDG PET/CT
Authors: Wu Haibo , Zhou Yinting , Dong Aisheng , Wang Yang , Han Yan 
Published: July 2024

Abstract
We describe contrast-enhanced CT and FDG PET/CT findings in a case of thoracic SMARCA4-deficient undifferentiated tumor with extensive pleural involvement and mediastinal lymph node metastases. Contrast-enhanced CT showed multiple enhancing right-sided pleural masses and soft tissue plaques and enlarged mediastinal lymph nodes. The pleural lesions and mediastinal lymph nodes showed intense FDG uptake mimicking malignant pleural mesothelioma with mediastinal lymph node metastases.
Prognostic Significance of 18F-FDG PET/CT Radiomics in Patients With Resectable Pancreatic Ductal Adenocarcinoma Undergoing Curative Surgery
Authors: Yoo Jang , Hyun Seung Hyup , Lee Jaeho , Cheon Miju , Lee Kwang Hyuck , Heo Jin Seok , Choi Joon Young 
Published: July 2024

Purpose
This study aimed to investigate the prognostic significance of PET/CT radiomics to predict overall survival (OS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC).

Methods
We enrolled 627 patients with resectable PDAC who underwent preoperative 18F-FDG PET/CT and subsequent curative surgery. Radiomics analysis of the PET/CT images for the primary tumor was performed using the Chang-Gung Image Texture Analysis toolbox. Radiomics features were subjected to least absolute shrinkage and selection operator (LASSO) regression to select the most valuable imaging features of OS. The prognostic significance was evaluated by Cox proportional hazards regression analysis. Conventional PET parameters and LASSO score were assessed as predictive factors for OS by time-dependent receiver operating characteristic curve analysis.

Results
During a mean follow-up of 28.8 months, 378 patients (60.3%) died. In the multivariable Cox regression analysis, tumor differentiation, resection margin status, tumor stage, and LASSO score were independent prognostic factors for OS (HR, 1.753, 1.669, 2.655, and 2.946; all P < 0.001, respectively). The time-dependent receiver operating characteristic curve analysis showed that the LASSO score had better predictive performance for OS than conventional PET parameters.

Conclusions
The LASSO score using the 18F-FDG PET/CT radiomics of the primary tumor was the independent prognostic factor for predicting OS in patients with resectable PDAC and may be helpful in determining therapeutic and follow-up plans for these patients.
AI in Neuro-Ophthalmology: Current Practice and Future Opportunities
Authors: Kenney Rachel C. , Requarth Tim W. , Jack Alani I. , Hyman Sara W. , Galetta Steven L. , Grossman Scott N. 
Published: July 2024

Background:
Neuro-ophthalmology frequently requires a complex and multi-faceted clinical assessment supported by sophisticated imaging techniques in order to assess disease status. The current approach to diagnosis requires substantial expertise and time. The emergence of AI has brought forth innovative solutions to streamline and enhance this diagnostic process, which is especially valuable given the shortage of neuro-ophthalmologists. Machine learning algorithms, in particular, have demonstrated significant potential in interpreting imaging data, identifying subtle patterns, and aiding clinicians in making more accurate and timely diagnosis while also supplementing nonspecialist evaluations of neuro-ophthalmic disease.

Evidence Acquisition:
Electronic searches of published literature were conducted using PubMed and Google Scholar. A comprehensive search of the following terms was conducted within the Journal of Neuro-Ophthalmology: AI, artificial intelligence, machine learning, deep learning, natural language processing, computer vision, large language models, and generative AI.

Results:
This review aims to provide a comprehensive overview of the evolving landscape of AI applications in neuro-ophthalmology. It will delve into the diverse applications of AI, optical coherence tomography (OCT), and fundus photography to the development of predictive models for disease progression. Additionally, the review will explore the integration of generative AI into neuro-ophthalmic education and clinical practice.

Conclusions:
We review the current state of AI in neuro-ophthalmology and its potentially transformative impact. The inclusion of AI in neuro-ophthalmic practice and research not only holds promise for improving diagnostic accuracy but also opens avenues for novel therapeutic interventions. We emphasize its potential to improve access to scarce subspecialty resources while examining the current challenges associated with the integration of AI into clinical practice and research.
Reliable Change Indices and Minimum Detectable Change for the Montreal Cognitive Assessment in Electroconvulsive Therapy for Depression
Authors: Whooley Emma , Gusciute Gabriele , Kavanagh Keeva , McDonagh Kelly , McCaffrey Cathal , Doody Eimear , Jelovac Ana , McLoughlin Declan M. 
Published: July 2024

Objective
The Montreal Cognitive Assessment (MoCA) is a commonly used brief cognitive screening tool for monitoring adverse cognitive effects of electroconvulsive therapy (ECT). The aim of this study was to examine three statistical methods for detecting reliable change in the MoCA following ECT.

Methods
In a prospective cohort study, 47 patients (mean age 55.2 [SD = 12.8], 59.6% female) with unipolar or bipolar depression treated with an acute course of brief-pulse ECT (72.3% right unilateral) and 47 depressed controls without ECT exposure were tested on the MoCA at baseline and retested at comparable time intervals. ECT patients' performance was also compared to published normative data from a community-based sample of older adults. We calculated proportions of ECT patients remaining stable, declining, and improving following ECT using practice-corrected reliable change index, standardized regression-based formulas, and minimum detectable change cutoff of ±4 MoCA points.

Results
Using the three methods, 72.3%–78.7% of ECT patients remained stable, 17.0%–23.4% declined, and 4.3% improved in MoCA performance following ECT compared to the two control groups.

Conclusions
All three methods yield consistent estimates of reliable change in MoCA scores from pre– to post–brief-pulse ECT. The minimum detectable change approach may be the most efficient and accessible method of detecting change due to simplicity of calculation.
On the cause and consequences of coinfection:A general mechanistic framework of within-host parasite competition
Authors: Ramesh Ashwini , Hall Spencer R 
Published: July 2024

ABSTRACTCoinfections pose serious threats to health and exacerbate parasite burden. If coinfection is detrimental, then what within-host factors facilitate it? Equally importantly, what hinders it, say via exclusion or priority effects? Such interactions ought to stem from their within-host environment (‘niche’), i.e., resources that parasites steal from hosts and immune cells that kill them. Yet, despite two decades of empirical focus on within-host infection dynamics, we lack a mechanistic framework to understand why coinfection arises and the diverse range of its’ consequences. Hence, we construct a trait-based niche framework, one that illustrates general principles that govern parasite competition for a resource and apparent competition for immune cells. We show that coinfection requires a competition-resistance tradeoff and that each parasite most impacts the niche factor to which it is most sensitive. These predictions then provide mechanistic interpretation for infection outcomes seen in a variety of extant experiments: Why does nutrient supplementation shift relative frequencies of coinfecting parasites? When and how does sequence of parasite invasion allow only early invading parasites to win? How does intrinsic variation in immune response shape coinfection burden? Together, this mechanistic framework of parasite competition offers new perspectives to better predict within-host infection dynamics and improve individual health.
Economic evaluation ofWolbachiadeployment in Colombia: A modeling study
Authors: Shepard Donald S. , Lee Samantha R. , Halasa-Rappel Yara A. , Rincon Perez Carlos Willian , Harker Roa Arturo 
Published: July 2024

ABSTRACTBackground and AimsWolbachiaare bacteria that inhibit dengue virus replication within the mosquito. A cluster-randomized trial foundWolbachiareduced virologically-confirmed dengue cases by 77% and previous models predictedWolbachiato be highly cost-effective in Indonesia, Vietnam, and Brazil. in Colombia,Wolbachiawas introduced in the Aburrá Valley in 2015 and Cali in 2020. To inform decisions about future extensions, we performed economic evaluations of the potential expansion ofWolbachiadeployments to 11 target Colombian cities.MethodsWe assembled quantities and the distribution by severity of reported dengue cases from Colombia’s national disease surveillance system and the health service provision registry (RIPS). An epidemiological panel of three experts estimated the shares of non-medical cases and adjustments for under-reporting and misclassifications. We determined costs (in 2020 US dollars) of treating dengue illness from the benchmark insurance tariff, RIPS data on treatment services per symptomatic dengue case, and the national government database for establishing insurance premiums. A cluster randomized trial quantified the effectiveness ofWolbachiaagainst symptomatic dengue cases.ResultsProjecting impact over 10 years for Cali, we estimated a net health-sector savings of USD4.95 per person. We also estimated averting 369 disability-adjusted life years (DALYs) per 100,000 population. From a societal perspective, at 10 yearsWolbachiadeployment is expected to have highly favorableConclusionsOver 10 years,Wolbachiais highly beneficial on economic grounds, and almost universally cost saving. That is,Wolbachia’ssavings in health care costs alone would more than offset deployment costs nationally and in 9 target cities (those with adjusted annual dengue incidence at least 50/100,000 population). In these 9 target cities,Wolbachiawould generate at least USD3.00 in benefits per dollar invested, giving substantial confidence thatWolbachiadeployment would be cost-beneficial in Colombia.
Seropositivity to Dengue virus (DENV) in three neighborhoods in the periphery of a city with a recent history of outbreaks in Argentina: what can we learn from unreported cases?
Authors: Mendicino Diego Antonio , Ricardo Tamara , Cristaldi Maximiliano Ariel , Maglianese Mariana , Guzmán Gastón , Claussen Sebastián , Chiaraviglio Romina Guadalupe , Ávalos Christian Alberto , Previtali María Andrea 
Published: July 2024

AbstractBackgroundArgentina has experienced several dengue outbreaks since its reemergence in 1998, but cases are underreported due to asymptomatic infections and inadequate access to the healthcare system, particularly in marginalized neighborhoods.MethodsBetween December 2019 and March 2020, we assessed seroprevalence of DENV in three neighborhoods in the periphery of the city of Santa Fe. Serum samples were obtained from one adult per household and analyzed by ELISA for DENV IgG antibodies. Multivariate logistic regression models were used to analyze seropositivity by demographic, socio-economic and environmental variables.ResultsFrom 184 participants,overall seroprevalence was 15.2% (95% CI: 10.7; 21.1%). Proximity to a vacant lot decreased the likelihood of seropositivity by 65% (OR: 0.35; 95% CI: 0.15; 0.80). This aligns with studies suggesting vegetation cover can reduce vector abundance and that DENV transmission is higher in densely populated urban areas. Surprisingly, knowledge of disease symptoms and transmission was not linked to lower seropositivity, echoing findings from other studies.ConclusionsThese findings contribute to building consensus on the factors that increase DENV infection and will be valuable in designing public health interventions in vulnerable neighborhoods during dengue outbreaks.
Human resources for health, service coverage and maternal and perinatal outcomes in Benin, Malawi, Tanzania and Uganda
Authors: Moller Ann-Beth , Welsh Joanne , Petzold Max , Siyam Amani 
Published: July 2024

AbstractA well-performing and competent health workforce (HWF) is at the core of health systems yet many countries are facing a human resources for health (HRH) crisis. A prerequisite for achieving universal health coverage, including fulfilling the Sustainable Development Goals related to women and newborns, is an adequate supply of health workers able to provide quality of care at all levels of the health system. Thus, we evaluated how HRH policies and strategies influenced trends of maternal and newborn workforce densities and assessed the association between HWF densities, service coverage and health outcomes in Benin, Malawi, Tanzania and Uganda. We applied the READ framework (Ready your materials; Extract data; Analyse data and Distil findings) for our HRH policy and strategy document analysis and conducted a comparative analysis including three HWF densities (medical doctors, nursing and midwifery personnel) two health services, and five health outcome variables. Twenty HRH policies and strategies were included in the analysis published from 2010 to 2021. The scope of the HRH policies and strategies were described in four dimensions; availability, accessibility, acceptability and quality. We found that all policies and strategies addressed aspects related to availability and accessibility as well as the need for HRH quality improvements whereas acceptability was poorly represented. The comparative analysis revealed that service coverage and health outcomes appear to be insensitive to the fluctuations in HWF densities and related HRH policies as very little or no reduction was seen in outcomes from 2010 to 2020. There is a need to tackle the availability, accessibility, acceptability and quality of the HWF. Evidence needs to be translated into policy and practice otherwise the HWF in these countries will continue to struggle, affecting progress and realizing womens’ and newborn’s human rights to health.