bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Thyroid Nodule by US Including Elastography versus MRI T2W and Diffusion Sequences
Authors: Mohamed Omar Mohamed Zaki , Maroof Rania , Elia Remon Zaher 
Published: July 2024

Abstract

Background
The thyroid gland frequently develops thyroid nodules. Effective treatment of malignant thyroid nodules depends on an early and accurate diagnosis. Benign and malignant thyroid nodules are typically distinguished using conventional thyroid ultrasonography (US). In order to explore changes in tissue stiffness, strain elastography (SE) uses an external force and a deformation response detector. A promising method for distinguishing between benign and malignant thyroid nodules is ultrasound elastography. Malignant versus benign thyroid nodules might be distinguished using MRI apparent diffusion coefficient (ADC) values. This study compares MRI T2W and diffusion sequences with ultrasound, which includes elastography, to assess thyroid nodules.

Methods
This cross-sectional research was carried out at Ain-Shams University's radiodiagnosis department. It included 23 female or male patients with suspicious thyroid nodule by clinical examination, or ultrasonography including some cases elastography if present for further work up with MR diffusion subjected to DWI and ADC value and results were compared with histopathology if present or follow up of the patients. The duration of the study was 24 months.

Results
Diffusion had an accuracy of 91.3%, while the ADC value and elastography had a greater diagnostic accuracy with an area under the curve of 95.7% in discriminating between benign and malignant cases.

Conclusions
When describing thyroid nodules, ADC value provided better diagnostic performance than US TIRADS rating. Over and above ACR-TIRADS classification, useful information is added by ultrasound elastography and strain ratio analysis of thyroid nodules. It is advised as an auxiliary tool. However, the distinction of cancerous and benign thyroid nodules might potentially be done with greater precision using diffusion weighted MRI.
Comparison of Aspiration versus Non-Aspiration Techniques in Fine-Needle Cytology of Thyroid Lesions
Authors: Ghazy Mohamed Shaker , Allam Allam El-sayed , Sayed Fatma Samy , Ragab Hamed Hassan Hamed 
Published: July 2024

Abstract

Background
Thyroid nodules are frequent among the general population. Ultrasound is the most commonly used imaging technique in the evaluation of thyroid nodules, Fine needle cytology (FNC) has been routinely used as the baseline investigation for diagnosis of nodular thyroid disease. Its advantages include minimal invasion and high sensitivity, specificity, and accuracy.

Objective
To compare the diagnostic quality of FNC sample obtained by aspiration versus non- aspiration techniques, aiming to improve the overall quality of FNC and hence better evaluation of thyroid nodules avoiding repeating FNC and unnecessary thyroidectomies.

Patients and Methods
Our study was conducted on 40 adult patients with thyroid nodules, whose ages range between 25 and 70 years old and were referred to undergo FNA procedures.

Results
40 patients with thyroid nodules were included in this study, our results showed statistically significant improvement in overall quality of the samples obtained by the non-aspiration (FNNAC) technique with less cellular trauma, less background blood, better preservation of cellular architecture and less cellular degeneration, however, there was no significant difference in the amount of the cellular material obtained and shows statistically significant difference regarding the diagnostic quality of the samples with more diagnostically superior samples were acquired by the FNNAC than by FNAC (50% and 5% respectively), while FNAC acquired more diagnostically adequate samples than FNNAC (75% and 50% respectively), non-diagnostic samples were only 20% with FNAC and 0% with FNNAC.

Conclusion
Both aspiration and non-aspiration techniques can be implemented and used for acquiring cytology samples, however, non-aspiration technique (FNNAC) was associated with overall better-quality samples with statistically significant better performance compared to FNAC. Non-aspiration technique is more convenient for both the patient and for the operator.
Positive Predictive Value of Thyroid Imaging, Reporting and Data System (TI-RADS) (3-5) When Compared to Fine Needle Aspiration Cytology Results
Authors: Mohammed Mahmoud Abdulrehman Mohiey , Abdelwahab Sameh Mohammed , Hassan Elhemeily Mohammad Hicham 
Published: July 2024

Abstract

Background
Thyroid nodules are a very common finding in the population. Evaluation of a patient with a thyroid nodule for possibility of malignancy could be challenging. Ultrasound is one tool that could be of help, several scoring systems are utilized to help differentiate benign from malignant nodules. One of the most used is TIRADS as proposed by ACR. Another invasive tool that could help is fine needle aspiration cytology.

Objective
Evaluating and comparing the accuracy of TI-RADS in the assessment of suspicious thyroid nodules by matching their results with the results of FNAC.

Patients and Methods
Our study was conducted on 72 adult patients with thyroid nodules and were referred to undergo FNA procedures in ‘Interventional radiology unit’ at the Radiology Department “Ain Shams University hospitals”, Cairo, Egypt.

Results
The present study concludes that TIRADS classification as proposed by ACR showed less statistical significance in predicting malignancy when compared to results of fine needle aspiration cytology. However, several components of the TIRADS scoring system were better predictors of malignancy than other components, namely the irregular margin, the taller than wider shape and the presence of calcifications within the nodule.

Conclusion
Our study concludes that better applying and implementing the TIRADS scoring system by the sonographer or using other scoring system available in evaluating thyroid nodules like ATA scoring system might result in more reliable ultrasound results decreasing the need to do fine needle aspiration.
The Predictive Value of Trancranial Ultrasound Doppler Parameters for Intracerebral Hemorrhage in Preterm and Low Birth Weight Neonates
Authors: Mohamed Abdulghaffar Marwa Mohamed , Shabana Aya Mohamed , Sayed Abd El-Karim Maha Ahmed , Allam Khaled Esmat 
Published: July 2024

Abstract

Background
Premature and low birth neonates are liable for many medical problems including intracranial hemorrhage. Transcranial Ultrasound examination and using different Doppler parameters of both ACA and MCA is considered as a good tool that is non invasive, cost effective and convenient to neonates to detect any intracerebral hemorrhage that they are risk for.

Aim of the Work
The aim of the current study was the assessment of the transcranial ultrasound as a predictive value of intracereberal hemorrhage in the examined neonates.

Patients and Methods
The study was performed on 33 preterm and low birth weight neonates attending Ain Shams University neonate intensive care unit and Ultrasound examination by B-Mode followed by Doppler examination were performed. Three neonates were died before performing the second examination. Examination was done at one day of birth considered as the first read and after 4-8 days which were considered as the second read to the rest 30 preterm neonates.

Results
Upon examination of 30 preterm and low birth neonates in two settings, they were categorized into hemorrhagic and non hemorrhagic groups. And by detecting the different Doppler parameters of both ACA and MCA in the two groups, it was found that the PSV2, MV, RI and PI gave a statistically significant difference between hemorrhagic and non hemorrhagic group. While ACA compared to MCA being has less branches and smaller diameter, its parameters are more sensitive in detection and prediction of hemorrhage than that of MCA. EDV1 of the ACA more than 8.1 cm/sec. was the most sensitive predictor of intracerebral hemorrhage in the present study.

Conclusion
In the current study, where more details examined upon ACA and MCA separately, it was found that EDV1 of the ACA has more predictive value than that of the EDV1 of MCA which is still can also used as a predictive value for intracranial hemorrhage.
Evaluation of the Prognostic Role of D-dimer in Egyptian Hepatocellular Carcinoma Patients Undergoing Locoregional Treatment
Authors: Zaki Ali Doaa Zakaria , Al fattah Shamkh Mostafa Abd , Abdelrady Maha Ahmed , Allam Allam al Sayed , Ahmed Ahmed Yasmine Saied 
Published: July 2024

Abstract

Background
The blood coagulation function is often abnormal in HCC patients due to hypercoagulatory state, hyperfibrinolytic state, and increased plasma D-dimer. HCC patients treated with locoregional treatment may show changes of D-dimer levels. Several studies explored the validity of D-dimer levels during locoregional treatment in HCC but definitive data are still lacking.

Aim of the Work
Determination of the efficacy of D-dimer profile as a prognostic marker regarding tumor features, and post interventional response in HCC subjects undergoing TACE or RFA.

Patients and Methods
The clinical data of 50HCC patients who underwent TACE or RFA in our hospital from October 2021 to June 2022 were collected, including the CBC, CRP Alfa-fetoproteins and plasma d-dimer level 1 week before TACE or RFA(D0), D-dimer level 1 month (D1) and 4 months(D2) after TACE or RFA. Contrast enhanced CT was performed within 1 week before locoregional treatment and was repeated 1month and 4 months after locoregional treatment to assess for treatment efficacy according to the mRECIST criteria based on change in tumor size as measured by CT scan. One month after TACE or RFA, these patients were divided into four groups according to the mRecist criteria: complete response, partial response, stationary disease and progressive disease. D0, D1 and D2 were compared between the 4 groups and the relation between D-dimer level and the efficacy of locoregional treatment was assessed.

Results
In patients with negative D-dimer before locoregional treatment (D0), there was no significant difference between D0 and D1 (P &gt; 0.05), while patients with elevated pretreatment D-dimer levels (D0), D1 was significantly higher than D0 (P &lt; 0.05) and the D1 is higher than that in patients with negative Do. Progressive rise of D-dimer levels 4months post locoregional treatment (D2) in HCC was associated with tumor progression suggesting aggressive tumor biology and poor outcome(P = 0.02).

Conclusion
The changes in plasma D-dimer level can be used as a potential prognostic biomarker in predicting the efficacy of locoregional treatment in HCC patients and thus, elevated D-dimer levels pre and post locoregional treatment may serve as predictors of adverse tumor profile and poor outcome.
Stimulated photosynthesis of regrowth after fire in coastal scrub vegetation: increased water or nutrient availability?
Authors: Rogers Erin I E , Mehnaz Kazi R , Ellsworth David S 
Published: July 2024

Abstract
Fire-prone landscapes experience frequent fires, disrupting above-ground biomass and altering below-ground soil nutrient availability. Augmentation of leaf nutrients or leaf water balance can both reduce limitations to photosynthesis and facilitate post-fire recovery in plants. These modes of fire responses are often studied separately and hence are rarely compared. We hypothesized that under severe burning, woody plants of a coastal scrub ecosystem would have higher rates of photosynthesis (Anet) than in unburned areas due to a transient release from leaf nutrient and water limitations, facilitating biomass recovery post-burn. To compare these fire recovery mechanisms in regrowing plants, we measured leaf gas exchange, leaf and soil N and P concentrations, and plant stomatal limitations in Australian native coastal scrub species across a burn sequence of sites at 1 year after severe fire, 7 years following a light controlled fire, and decades after any fire at North Head, Sydney, Australia. Recent burning stimulated increases in Anet by 20% over unburned trees and across three tree species. These species showed increases in total leaf N and P as a result of burning of 28% and 50% for these macronutrients, respectively, across the three species. The boost in leaf nutrients and stimulated leaf biochemical capacity for photosynthesis, alongside species-specific stomatal conductance (gs) increases, together contributed to increased photosynthetic rates after burning compared with the long-unburned area. Photosynthetic stimulation after burning occurred due to increases in nutrient concentrations in leaves, particularly N, as well as stomatal opening for some species. The findings suggest that changes in species photosynthesis and growth with increased future fire intensity or frequency may be facilitated by changes in leaf physiology after burning. On this basis, species dominance during regrowth depends on nutrient and water availability during post-fire recovery.
The Impact of Multi-Institution Datasets on the Generalizability of Machine Learning Prediction Models in the ICU
Authors: Rockenschaub Patrick , Hilbert Adam , Kossen Tabea , Elbers Paul , von Dincklage Falk , Madai Vince Istvan , Frey Dietmar 
Published: July 2024

OBJECTIVES:
To evaluate the transferability of deep learning (DL) models for the early detection of adverse events to previously unseen hospitals.

DESIGN:
Retrospective observational cohort study utilizing harmonized intensive care data from four public datasets.

SETTING:
ICUs across Europe and the United States.

PATIENTS:
Adult patients admitted to the ICU for at least 6 hours who had good data quality.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Using carefully harmonized data from a total of 334,812 ICU stays, we systematically assessed the transferability of DL models for three common adverse events: death, acute kidney injury (AKI), and sepsis. We tested whether using more than one data source and/or algorithmically optimizing for generalizability during training improves model performance at new hospitals. We found that models achieved high area under the receiver operating characteristic (AUROC) for mortality (0.838–0.869), AKI (0.823–0.866), and sepsis (0.749–0.824) at the training hospital. As expected, AUROC dropped when models were applied at other hospitals, sometimes by as much as –0.200. Using more than one dataset for training mitigated the performance drop, with multicenter models performing roughly on par with the best single-center model. Dedicated methods promoting generalizability did not noticeably improve performance in our experiments.

CONCLUSIONS:
Our results emphasize the importance of diverse training data for DL-based risk prediction. They suggest that as data from more hospitals become available for training, models may become increasingly generalizable. Even so, good performance at a new hospital still depended on the inclusion of compatible hospitals during training.
Mutational profiling of 103 unresectable pancreatic ductal adenocarcinomas using EUS-guided fine-needle biopsy
Authors: Buchberg Julie , de Stricker Karin , Pfeiffer Per , Mortensen Michael Bau , Detlefsen Sönke 
Published: July 2024

ABSTRACTBackground and ObjectivePancreatic ductal adenocarcinoma (PDAC) is among the most lethal cancers, with a 5-year survival rate of around 9%. Only 20% are candidates for surgery. Most unresectable patients undergo EUS-guided fine-needle biopsy (EUS-FNB) for diagnosis. Identification of targetable mutations using next-generation sequencing (NGS) is increasingly requested. Data on feasibility of EUS-FNB for NGS and knowledge regarding mutational profile of unresectable PDAC are scarce. We evaluated the “technical yield” of EUS-FNB for NGS in unresectable PDAC: relative fraction of diagnostic EUS-FNBs meeting technical criteria. We also investigated the “molecular yield”: relative fraction of EUS-FNBs included in NGS containing sufficient DNA for detection of at least one mutation. Furthermore, we determined the relative frequency of cancer-associated mutations in unresectable PDAC.Patients and MethodsFormalin-fixed and paraffin-embedded EUS-FNBs diagnostic of unresectable PDAC and fulfilling these criteria were included (n= 105): minimum 3-mm2tissue, minimum of 2-mm2tumor area, and minimum 20% relative tumor area. NGS was performed using Ion GeneStudio S5 Prime System and Oncomine™ Comprehensive Assay v.3 including 161 cancer-related genes.ResultsTechnical yield was 48% (105/219) and molecular yield was 98% (103/105). Most frequently mutated genes wereKRAS(89.3%) andTP53(69.9%), followed byCDKN2A(24.3%),ARID1A(9.7%),SMAD4(7.8%),TSC2(7.8%), andCCND3(6.8%).ConclusionEUS-FNB for NGS of unresectable PDAC is feasible. Our technical criteria for NGS, using leftovers in formalin-fixed and paraffin-embedded blocks after routine pathology diagnosis, were met by around half of EUS-FNBs. Almost all EUS-FNBs fulfilling the technical criteria yielded a successful NGS analysis.
Low-Intensity Heparin Infusion Compared With High-Intensity Heparin Infusion Dosing in Patients With Mechanical Mitral Valves: A Retrospective Cohort Study
Authors: Olsen Megumi , Adie Sarah K. , Divens Alyssa , Popova Kayla , Brancaccio Adamo 
Published: July 2024

Abstract:
Patients with a mechanical mitral valve have an increased risk of thrombosis, and guidelines recommend a higher international normalized ratio goal for vitamin K antagonists–based anticoagulation. Guidelines provide recommendations for bridging with unfractionated heparin; however, there is no clear guidance on the heparin infusion intensity that should be used. This study was a retrospective, single-center, cohort study of patients aged ≥18 years or older with a mechanical mitral valve admitted from June 2019 to September 2022 who were maintained on a singular heparin infusion intensity nomogram for at least 48 hours. The patients were stratified into either a low- or a high-intensity heparin infusion nomogram. The exclusion criteria included non-nomogram heparin infusions and patients within 30 days of valve implantation. The primary outcome of this study was a composite of all bleeding events (major, clinically significant nonmajor, and minor bleeding). The secondary outcomes included bleeding events, analyzed individually, and thrombotic events. Seven total bleeding events were observed between the 2 groups, with 1 minor bleeding event in the low-intensity group and 6 bleeding events in the high-intensity group. One thrombotic event occurred in the high-intensity group. No statistically significant differences were found between the primary and secondary outcomes. Future studies are necessary to guide heparin infusion intensity selection in patients with mechanical mitral valves.
Impact of temperature on ophthalmic viscosurgical devices and clinical implications: a pilot study
Authors: Henry Caoimhe , Castro Alejandro Thompson , Belkessa Mohamed , Rycroft Ewan , Syntouka Ioanna M. , Silva Andreia F. , Sillars Fiona , Oliveira Mónica S.N. , Lockington David 
Published: July 2024

Purpose:To evaluate how temperature affects the rheology of common ophthalmic viscosurgical devices (OVDs) and clinical implications.Setting:Tennent Institute of Ophthalmology, Glasgow, with Department of Mechanical and Aerospace Engineering, and Advanced Materials Research Laboratory, University of Strathclyde, Glasgow, United Kingdom.Design:Laboratory pilot study.Methods:The viscous and elastic responses of 3 OVDs (Eyefill-SC/Eyefill-C/Eyefill-HD) were measured using rotational and extensional rheometers at clinically relevant temperatures (5°C, 25°C, 37°C). Thermal properties were evaluated using differential scanning calorimetry and laser-flash analysis.Results:The OVDs tested exhibited viscoelastic properties and shear-thinning behavior. Apparent viscosities and relaxation time were higher at lower temperatures. The Eyefill-C and Eyefill-SC exhibited predominantly viscous character at low frequencies with a transition to predominantly elastic behavior at high frequencies. An increase in temperature led to a decrease in relaxation time under shear and extension. At low frequencies, Eyefill-C and Eyefill-SC moduli increase with decreasing temperatures. Eyefill-HD at 25°C and 37°C displays 2 crossover points, with the storage modulus dominating at low and high frequencies indicating a predominantly elastic behavior. Thermal property analysis revealed Eyefill-C had the lowest thermal conductivity.Conclusions:This pilot study confirms our clinical experience that OVD properties are affected by low temperatures, with increased viscosities at low shear rates and higher relaxation times. Cold OVD can cause greater resistance to initiation of intraocular lens (IOL) injection system forces (compared with warmer OVD). Excessively forced injection using cold OVD could contribute to inadvertent cannula detachment if incorrectly assembled, or uncontrolled IOL release leading to avoidable injury.
Comparison of keratometry and total corneal power, as measured by an SS-OCT–based optical biometer, for intraocular lens power calculation in Asian eyes
Authors: Savini Giacomo , Taroni Leonardo , Jeon Sohee , Koh Kyungmin , Yang Hyun Seung , Abulafia Adi , Lupardi Enrico , Hoffer Kenneth J. , Moramarco Antonio , Schiano-Lomoriello Domenico 
Published: July 2024

Purpose:
To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation.

Setting:
Public hospital.

Design:
Retrospective evaluation of a diagnostic test instrument.

Methods:
Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied.

Results:
Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis (P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold.

Conclusions:
With most formulas, IOL power calculation is not more accurate when TCP is used instead of K.