bluuebunny/crossref_metadata_2025_split huggingface dataset:
New proposal for a multimodal imaging approach for the subclinical detection of hydroxychloroquine-induced retinal toxicity in patients with systemic lupus erythematosus
Authors: Araújo Olga , Casaroli-Marano Ricardo P , Hernández-Rodríguez José , Figueras-Roca Marc , Budi Vanesa , Morató Montse , Hernández-Negrín Halbert , Ríos José , Adan Alfredo , Espinosa Gerard , Pelegrín Laura , Cervera Ricard 
Published: March 2024

ObjectiveTo compare multimodal structural and functional diagnostic methods in patients with systemic lupus erythematosus (SLE) treated with hydroxychloroquine, to identify the best complementary approach for detecting subclinical retinal toxicity.MethodsA cross-sectional, unicentric study was conducted on patients with SLE treated with hydroxychloroquine. Each patient underwent a comprehensive ophthalmic evaluation, comprising structural tests (spectral-domain optical coherence tomography (SD-OCT),en faceOCT,en faceOCT angiography (OCTA), fundus autofluorescence (FAF)) and functional tests (automated perimetry for visual field (VF) testing, multifocal electroretinography (mfERG)). A diagnosis of macular toxicity required the presence of abnormalities in at least one structural and functional test. The Kappa Concordance Index was used to assess the concordance among the different tests in detecting potential macular toxicity-associated alterations.ResultsSixty-six patients with SLE (132 eyes) were consecutively enrolled. Four (6.1%) patients developed subclinical hydroxychloroquine-induced retinal toxicity without visual acuity impairment. The proportion of abnormal results was 24% for bothen faceOCT anden faceOCTA. Regarding functional analysis, VF was less specific than mfERG in detecting subclinical retinal toxicity (VF specificity 47.5%).En faceOCT anden faceOCTA structural findings showed better concordance, with akappaindex >0.8, and both identified the same cases of toxicity as FAF.ConclusionAlthough structural OCT and VF are frequently used to screen for hydroxychloroquine-induced retinal toxicity, our findings suggest that a combination of mfERG,en faceOCT anden faceOCTA could improve the diagnostic accuracy for subclinical retinal damage. This study emphasises the importance of a multimodal imaging strategy to promptly detect signs of hydroxychloroquine-induced retinal toxicity.
Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach
Authors: Ahmmed Foyez , Hasan Md Nahid , Hossain Md Faruk , Khan Md Tareq Ferdous , Rahman Mohammod Mahmudur , Hussain Md Parvej , Hossain Md. Jamal 
Published: March 2024

ObjectivesThis study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent forms of child malnutrition (MCFCM) and at least one form of child malnutrition (ALOFCM) using propensity score matching (PSM).MethodsThis study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women’s empowerment, education and economic status (women’s 3E index)–constructed based on women’s decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence.ResultsThe prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years.ConclusionSBS was significantly associated with child malnutrition, and the effect was modified by factors such as women’s autonomy and age at marriage.
Low-dose ketamine infusion to facilitate opioid tapering in chronic non-cancer pain with opioid-use disorder: a historical cohort study
Authors: Elyn Antoine , Roussin Anne , Lestrade Cécile , Franchitto Nicolas , Jullian Bénédicte , Cantagrel Nathalie 
Published: March 2024

BackgroundLong-term opioid use is associated with pharmacological tolerance, a risk of misuse and hyperalgesia in patients with chronic pain (CP). Tapering is challenging in this context, particularly with comorbid opioid-use disorder (OUD). The antihyperalgesic effect of ketamine, through N-methyl-D-aspartate (NMDA) antagonism, could be useful. We aimed to describe the changes in the dose of opioids consumed over 1 year after a 5-day hospitalisation with ketamine infusion for CP patients with OUD.MethodsWe performed a historical cohort study using a medical chart from 1 January 2014 to 31 December 2019. Patients were long-term opioid users with OUD and CP, followed by the Pain Center of the University Hospital of Toulouse, for which outpatient progressive tapering failed. Ketamine was administered at a low dose to initiate tapering during a 5-day hospitalisation.Results59 patients were included, with 64% of them female and a mean age of 48±10 years old. The most frequent CP aetiologies were back pain (53%) and fibromyalgia (17%). The baseline opioid daily dose was 207 mg (±128) morphine milligram equivalent (MME). It was lowered to 92±72 mg MME at discharge (p<0.001), 99±77 mg at 3 months (p<0.001) and 103±106 mg at 12 months. More than 50% tapering was achieved immediately for 40 patients (68%), with immediate cessation for seven patients (12%). 17 patients were lost to follow-up.ConclusionsA 5-day hospitalisation with a low-dose ketamine infusion appeared useful to facilitate opioid tapering in long-term opioid users with CP and OUD. Ketamine was well tolerated, and patients did not present significant withdrawal symptoms. Prospective and comparative studies are needed to confirm our findings.
Intravenous versus oral acetaminophen for pain and quality of recovery after ambulatory spine surgery: a randomized controlled trial
Authors: Schwenk Eric S , Ferd Polina , Torjman Marc C , Li Chris J , Charlton Alex R , Yan Vivian Z , McCurdy Michael A , Kepler Christopher K , Schroeder Gregory D , Fleischman Andrew N , Issa Tariq 
Published: March 2024

IntroductionAs ambulatory spine surgery increases, efficient recovery and discharge become essential. Multimodal analgesia is superior to opioids alone. Acetaminophen is a central component of multimodal protocols and both intravenous and oral forms are used. While some advantages for intravenous acetaminophen have been touted, prospective studies with patient-centered outcomes are lacking in ambulatory spine surgery. A substantial cost difference exists. We hypothesized that intravenous acetaminophen would be associated with fewer opioids and better recovery.MethodsPatients undergoing ambulatory spine surgery were randomized to preoperative oral placebo and intraoperative intravenous acetaminophen or preoperative oral acetaminophen. All patients received general anesthesia and multimodal analgesia. The primary outcome was 24-hour opioid use in intravenous morphine milligram equivalents (MMEs), beginning with arrival to the postanesthesia care unit (PACU). Secondary outcomes included pain, Quality of Recovery (QoR)-15 scores, postoperative nausea and vomiting, recovery time, and correlations between pain catastrophizing, QoR-15, and pain.ResultsA total of 82 patients were included in final analyses. Demographics were similar between groups. For the primary outcome, the median 24-hour MMEs did not differ between groups (12.6 (4.0, 27.1) vs 12.0 (4.0, 29.5) mg, p=0.893). Postoperative pain ratings, PACU MMEs, QoR-15 scores, and recovery time showed no differences. Spearman’s correlation showed a moderate negative correlation between postoperative opioid use and QoR-15.ConclusionIntravenous acetaminophen was not superior to the oral form in ambulatory spine surgery patients. This does not support routine use of the more expensive intravenous form to improve recovery and accelerate discharge.Trial registration numberNCT04574778.
Metal complexes with thiazyl chloride: single or double bond?
Authors: Vilarrubias Pere 
Published: March 2024

Many metal complexes are known with thiazyl chloride as a ligand. In some complexes, the structure of the metal–ligand bond can be described as M=N=S–Cl, whereas in other cases the structure is described as M–N≡S–Cl. The metal–nitrogen bond length goes from 1.76 to 2.28 Å. In this study, density functional theory was used to search for the reasons for these differences, taking into account both mononuclear and binuclear complexes.
On thermodynamic stability of black holes. Part I: classical stability
Authors: Avramov V. , Dimov H. , Radomirov M. , Rashkov R. C. , Vetsov T. 
Published: March 2024

AbstractWe revisit the classical thermodynamic stability of the standard black hole solutions by implementing the intrinsic necessary and sufficient conditions for stable global and local thermodynamic equilibrium. The criteria for such equilibria are quite generic and well-established in classical thermodynamics, but they have not been fully utilized in black hole physics. We show how weaker or incomplete conditions could lead to misleading or incorrect results for the thermodynamic stability of the system. We also stress the importance of finding all possible local heat capacities in order to fully describe the classical equilibrium picture of black holes. Finally, we thoroughly investigate the critical and phase transition curves and the limits of the classical analysis. This paper is the first in the line of intended works on thermodynamic stability of black holes in modified theories of gravity and holography.
An operational approach for accurate 177Lu and 177mLu activity quantifications to comply with the environmental release criteria: the role of GEANT4 for efficiency curve and True Coincidence Summing effect estimation
Authors: Sarnelli Anna , Guidi Claretta , Pandola Luciano , Contessa Gian Marco , Loi Emiliano , Bianchini David , Mezzenga Emilio , Negrini Matteo 
Published: March 2024

AbstractThe increasing use of 177Lu-labelled agents for targeted radionuclide cancer therapy highlights the radiation protection challenges in the management of radioactive waste due to 177mLu impurities. To ensure safe disposal, compliance with clearance criteria must be verified using calibrated systems, such as Hyper Pure Germanium (HPGe) spectrometers. This work aims to validate a customized GEANT4 model of our HPGe system in Marinelli beaker geometry to propose an operational approach properly quantifying 177Lu and 177mLu in waste samples. The system's efficiency curve was calculated by modelling gamma sources in the energy range of interest and validated by spectra measurements of 177Lu and 99mTc sources. Correction factors accounting for true coincidence summing (TCS) effect were simulated for 177Lu, 177mLu and 99mTc and they were applied to the spectrum measurement of a waste sample model with known activities of 177Lu and 177mLu. Thus, an operational approach for activities quantification was tested comparing the results with the nominal values. No significant differences were observed between simulated and measured efficiency values. TCS correction factors are significant only for 177mLu (1.6 at 112.95 keV and 204.11 keV). Eventually, the proposed framework to quantify 177Lu in a waste sample allowed to estimate the 177Lu and 177mLu component activities within a maximum 16% uncertainty. Results show that the HPGe model could be a powerful resource for a wide range of applications in daily clinical routine and it could be used to build a simple quality assurance program to monitor the detector response constancy in time.
Secondary Intention Healing for Fingertip Amputations in a Tropical Climate
Authors: NAH Jie Hui , TANG Camelia Qian Ying , CHOUDHURY Muntasir Mannan , CHIA Dawn Sinn Yii , MCGROUTHER Duncan Angus , JIANG Jackson Kian Hong 
Published: March 2024

Background: Various studies have examined occlusive dressings in fingertip amputations and reported good outcomes. Occlusive dressing preserves appropriate pH, cell accumulation and moisture for healing, thereby limiting scar formation and deformity. To our knowledge, no study was performed in tropical Asia. This study aims to demonstrate the viability of healing fingertip amputations through secondary intention using an effective dressing technique, even in warm tropical climates. Methods: All patients who presented to our institution with fingertip amputations from 1 July 2020 to 31 July 2022 were analysed retrospectively. Seventeen patients (15 male, 2 female) of mean age 37.2 ± 9.4 years old with 18 injured digits were retrospectively analysed. Twelve (66.7%) were Allen Type III injuries, and one patient required distal phalangeal K-wire fixation. During the patient’s final review, static 2-point discrimination, pulp sensation, fingertip contour and nail deformities alongside the last measured range of motion (ROM) of the injured finger was recorded. Treatment duration and days of leave taken were also summed and assessed. Results: Patients were dressed with semi-occlusive dressing for an average of 20.1 ± 6.83 days. The average total duration of dressing is 36.78 ± 18.88 days over an average of 7.18 ± 4.03 dressing visits. Mean duration of follow-up was 108 ± 63.46 days. Good outcome measures in sensation, pulp contour, nail deformity and ROM similar to existing literature were reported. Conclusions: Occlusive dressing remains a viable and feasible treatment option for fingertip amputation even in a tropical climate. While this simple treatment method may require more effort from patient, wound healing was attained after 36.8 ± 18.9 days of dressing. Level of Evidence: Level IV (Therapeutic)
Measurement of Radiological Parameters of Distal Radius Fracture Using the Ulnar Axis Compared with the Radial Axis
Authors: KITIDUMRONGSOOK Pravit , LUANGJARMEKORN Pobe , KUPTNIRATSAIKUL Vanasiri , TEERAGANANAN Theephop , CHAITANTIPONGSE Sirisak 
Published: March 2024

Background: The long axis of the radius is a standard reference for measuring radiological parameters in distal radius fractures. However, in patients with severe comminution and anatomical variation with distal radius bowing, it is challenging to assess using the long axis of the radius. The long axis of the ulna can be used as an alternative reference. The aim of this study is to assess the reliability and level of agreement using the long axis of the ulna as an alternative reference in comparison to the long axis of the radius. Methods: Posteroanterior (PA) radiography of the wrist in patients with acute distal radius fractures was evaluated in two rounds by four observers. Radial height, radial inclination and ulnar variance were measured using radial and ulnar long axis as references. The intraobserver and interobserver reliability of the measurements with two reference axes was assessed using intraclass correlation coefficient (ICC). The level of agreement was determined using the Bland–Altman plot. Results: In total, 59 patients who underwent PA radiography of the wrist were included in this study. All parameters exhibited good agreement between the two methods, with a mean difference of nearly zero (radial height = −0.03 mm, radial inclination = −0.14° and ulnar variance = 0.03 mm). The limits of agreement in radial height (−2.87, 2.82 mm) and ulnar variance (−0.81, 0.87 mm) were narrow. However, for the radial inclination, it was wider (−6.21, 5.94°). Intraobserver reliability between the long axis of radius and ulna (ICC = 0.85–0.99 and 0.84–0.98, respectively) was good to excellent. The interobserver reliability of each parameter was excellent (ICC = 0.94–0.97). Conclusions: The ulnar long axis can be used as an alternative reference for measuring radial height, radial inclination and ulnar variance in PA radiography of the wrist in acute distal radius fracture, particularly if the radial long axis is distorted. Level of Evidence: Level III (Diagnostic)
Noninvasive Stratification of Colon Cancer by Multiplex PET Imaging
Authors: Malviya Gaurav , Lannagan Tamsin R.M. , Johnson Emma , Mackintosh Agata , Bielik Robert , Peters Adam , Soloviev Dmitry , Brown Gavin , Jackstadt Rene , Nixon Colin , Gilroy Kathryn , Campbell Andrew , Sansom Owen J. , Lewis David Y. 
Published: March 2024

Abstract

Purpose:
The current approach for molecular subtyping of colon cancer relies on gene expression profiling, which is invasive and has limited ability to reveal dynamics and spatial heterogeneity. Molecular imaging techniques, such as PET, present a noninvasive alternative for visualizing biological information from tumors. However, the factors influencing PET imaging phenotype, the suitable PET radiotracers for differentiating tumor subtypes, and the relationship between PET phenotypes and tumor genotype or gene expression–based subtyping remain unknown.

Experimental Design:
In this study, we conducted 126 PET scans using four different metabolic PET tracers, [18F]fluorodeoxy-D-glucose ([18F]FDG), O-(2-[18F]fluoroethyl)-l-tyrosine ([18F]FET), 3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT), and [11C]acetate ([11C]ACE), using a spectrum of five preclinical colon cancer models with varying genetics (BMT, AKPN, AK, AKPT, KPN), at three sites (subcutaneous, orthograft, autochthonous) and at two tumor stages (primary vs. metastatic).

Results:
The results demonstrate that imaging signatures are influenced by genotype, tumor environment, and stage. PET imaging signatures exhibited significant heterogeneity, with each cancer model displaying distinct radiotracer profiles. Oncogenic Kras and Apc loss showed the most distinctive imaging features, with [18F]FLT and [18F]FET being particularly effective, respectively. The tissue environment notably impacted [18F]FDG uptake, and in a metastatic model, [18F]FET demonstrated higher uptake.

Conclusions:
By examining factors contributing to PET-imaging phenotype, this study establishes the feasibility of noninvasive molecular stratification using multiplex radiotracer PET. It lays the foundation for further exploration of PET-based subtyping in human cancer, thereby facilitating noninvasive molecular diagnosis.
Predicting High‐Risk Fetal Cardiac Disease Anticipated to Need Immediate Postnatal Stabilization and Intervention with Planned Pediatric Cardiac Operating Room Delivery
Authors: Moray Amol , Mugaba Proscovia M. , Joynt Chloe , McBrien Angela , Eckersley Luke G. , Phillipos Ernest , Holinski Paula , Ryerson Lindsay , Coe James Yashu , Chandra Sujata , Wong Billy , Derbyshire Michele , Lefebvre Maria , Al Aklabi Mohammed , Hornberger Lisa K. 
Published: March 2024

Background
Distances between delivery and cardiac services can make the care of fetuses with cardiac disease at risk of acute cardiorespiratory instability at birth a challenge. In 2013 we implemented a fetal echocardiography‐based algorithm targeting fetuses considered high risk for acute cardiorespiratory instability at ≤2 hours of birth for delivery in our pediatric cardiac operating room of our children's hospital, and, herein, examine our experience.

Methods and Results
We reviewed maternal and postnatal medical records of all fetuses with cardiac disease encountered January 2013 to March 2022 considered high risk for acute cardiorespiratory instability. Secondary analysis was performed including all fetuses with diagnoses of d‐transposition of the great arteries/intact ventricular septum (d‐TGA/IVS) and hypoplastic left heart syndrome (HLHS) encountered over the study period. Forty fetuses were considered high risk for acute cardiorespiratory instability: 15 with d‐TGA/IVS and 7 with HLHS with restrictive atrial septum, 4 with absent pulmonary valve syndrome, 3 with obstructed anomalous pulmonary veins, 2 with severe Ebstein anomaly, 2 with thoracic/intracardiac tumors, and 7 others. Pediatric cardiac operating room delivery occurred for 33 but not for 7 (5 with d‐TGA/IVS, 2 with HLHS with restrictive atrial septum). For high‐risk cases, fetal echocardiography had a positive predictive value of 50% for intervention/extracorporeal membrane oxygenation/death at ≤2 hours and 70% at ≤24 hours. Of “low‐risk” cases, 6/46 with d‐TGA/IVS and 0/45 with HLHS required intervention at ≤2 hours. Fetal echocardiography for predicting intervention/extracorporeal membrane oxygenation/death at ≤2 hours had a sensitivity of 67%, specificity 93%, and positive and negative predictive values of 80% and 87%, respectively, for d‐TGA/IVS, and 100%, 95%, 71%, and 100% for HLHS, respectively.

Conclusions
Fetal echocardiography can predict the need for urgent intervention in a majority with d‐TGA/IVS and HLHS and in half of the entire spectrum of high‐risk cardiac disease.
CircALMS1 Alleviates Pulmonary Microvascular Endothelial Cell Dysfunction in Pulmonary Hypertension
Authors: Hu Xiaoyi , Sun Yuanyuan , Wang Shang , Zhao Hui , Wei Yaqin , Fu Jiaqi , Huang Yuxia , Wu Wenhui , Li Jinling , Liu Jinming , Gong Sugang , Zhao Qinhua , Wang Lan , Jiang Rong , Song Xiao , Yuan Ping 
Published: March 2024

Background
Circular RNAs can serve as regulators influencing the development of pulmonary hypertension (PH). However, their function in pulmonary vascular intimal injury remains undefined. Thus, we aimed to identify specifically expressed circular RNAs in pulmonary microvascular endothelial cells (PMECs) under hypoxia and PH.

Methods and Results

Deep RNA sequencing and quantitative real‐time polymerase chain reaction revealed that circALMS1 (circular RNA Alstrom syndrome protein 1) was reduced in human PMECs under hypoxia (
P
<0.0001). Molecular biology and histopathology experiments were used to elucidate the roles of circALMS1 in regulating PMEC dysfunction among patients with PH. The circALMS1 expression was decreased in the plasma of patients with PH (
P
=0.0315). Patients with lower circALMS1 levels had higher risk of death (
P
=0.0006). Moreover, the circALMS1 overexpression of adeno‐associated viruses improved right ventricular function and reduced pulmonary vascular remodeling in monocrotaline‐PH and sugen/hypoxia‐PH rats (
P
<0.05). Furthermore, circALMS1 overexpression promoted apoptosis and inhibited PMEC proliferation and migration under hypoxia by directly downregulating miR‐17‐3p (
P
<0.05). Dual luciferase assay confirmed the direct binding of circALMS1 to miR‐17‐3p and miR‐17‐3p binding to its target gene YT521‐B homology domain‐containing family protein 2 (YTHDF2) (
P
<0.05). The YTHDF2 levels were also downregulated in hypoxic PMECs (
P
<0.01). The small interfering RNA YTHDF2 reversed the effects of miR‐17‐3p inhibitors on PMEC proliferation, migration, and apoptosis. Finally, the results indicated that, although YTHDF2, as an N(6)‐methyladenosine reader protein, contributes to the degradation of many circular RNAs, it could not regulate the circALMS1 levels in PMECs (
P
=0.9721).

Conclusions
Our study sheds new light on circALMS1‐regulated dysfunction of PMECs by the miR‐17‐3p/YTHDF2 pathway under hypoxia and provides insights into the underlying pathogenesis of PH.