bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodality imaging of diseases of the vagina
Authors: Pulappadi Vishnu Prasad , Manchanda Smita , Dhamija Ekta , Jana Manisha 
Published: January 2024

AbstractPathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is the baseline modality used for evaluation of gynaecological complaints. Transperineal USG and MRI are the imaging modalities of choice for evaluation of the vagina. Diseases of the vagina can be grouped depending upon the age group in which they occur. In children and young adults, congenital anomalies like longitudinal or transverse vaginal septum, imperforate hymen, vaginal aplasia or atresia, and rectovaginal fistula can be seen. Malignant tumours can rarely occur in children, rhabdomyosarcoma being the most common one. Common diseases affecting adults include benign lesions like epidermoid, Gartner duct, and Bartholin cysts, and urogenital fistulas involving the vagina. Endometriosis and other benign tumours of vagina including leiomyoma, fibroepithelial polyp, and angiomyxoma are occasionally seen. Malignant tumours can be primary, the most common one being squamous cell carcinoma, or secondary, due to direct extension from cancers involving the adjacent organs. Characteristic morphological changes occur in the vagina after radiotherapy, which can be identified on imaging. Knowledge about the imaging appearances of these diseases is crucial in guiding appropriate management.
Low-dose palliative radiotherapy for malignant peripheral T-cell lymphoma masked by cellulitis and osteomyelitis: a case report
Authors: Alayed Yasir 
Published: January 2024

Abstract
Classic Hodgkin lymphoma is a potentially curable disease. With the advent of effective systemic regimens with adriamycin, bleomycin, vincristine, and dacarbazine, chemotherapy has become the treatment of choice for advanced Hodgkin lymphoma. However, for advanced Hodgkin lymphoma after chemotherapy, disease relapse rates are still high. This case report highlights how low-dose palliative radiotherapy can be used successfully for the management of an unusual case of recurrent lymphoma with a different histology soon after completing systemic therapy, which was further complicated by an ongoing local infection.
Anatomical variations in the circle of Willis on magnetic resonance angiography in a south Trinidad population
Authors: Diljohn Jason , Rampersad Fidel , Maharaj Paramanand , Parmesar Kristyn 
Published: January 2024

AbstractObjectivesThis article seeks to determine the prevalence of a complete circle of Willis (CoW) and its common morphological variations in a south Trinidad population, while also investigating the influence of gender, age, and ethnicity on CoW morphology.MethodsA prospective, descriptive, cross-sectional study was done on the magnetic resonance images for consecutive patients who had a brain MRI/magnetic resonance angiography at a tertiary health institution in south Trinidad between October 2019 and September 2020. Patients with significant cerebrovascular disease and/or a history of prior neurosurgical intervention were excluded.ResultsA complete CoW was seen in 24.3%, with more complete circles observed in younger participants (≤45 years) and Afro-Trinidadians. No gender predilection for a complete CoW was demonstrated. The most common variations in the anterior and posterior parts of the circle were a hypoplastic anterior communicating artery (8.6%, n = 13) and bilateral aplastic posterior communicating arteries (18.4%, n = 28), respectively.ConclusionsSignificant variations exist in the CoW of a south Trinidad population with a frequency of complete in 24.3%, and more complete circles in younger patients and Afro-Trinidadians. Gender did not influence CoW morphology.Advances in knowledgeStructural abnormalities in the CoW may be linked to future incidence of cerebrovascular diseases and should therefore be communicated to the referring physician in the written radiology report. Knowledge of variant anatomy and its frequency for a particular populations is also required by neurosurgeons and neuro-interventional radiologists to help with preprocedural planning and to minimize complications.
Differences of white matter structure for diffusion kurtosis imaging using voxel-based morphometry and connectivity analysis
Authors: Kanazawa Yuki , Ikemitsu Natsuki , Kinjo Yuki , Harada Masafumi , Hayashi Hiroaki , Taniguchi Yo , Ito Kosuke , Bito Yoshitaka , Matsumoto Yuki , Haga Akihiro 
Published: January 2024

Abstract

Objectives
In a clinical study, diffusion kurtosis imaging (DKI) has been used to visualize and distinguish white matter (WM) structures’ details. The purpose of our study is to evaluate and compare the diffusion tensor imaging (DTI) and DKI parameter values to obtain WM structure differences of healthy subjects.

Methods
Thirteen healthy volunteers (mean age, 25.2 years) were examined in this study. On a 3-T MRI system, diffusion dataset for DKI was acquired using an echo-planner imaging sequence, and T1-weghted (T1w) images were acquired. Imaging analysis was performed using Functional MRI of the brain Software Library (FSL). First, registration analysis was performed using the T1w of each subject to MNI152. Second, DTI (eg, fractional anisotropy [FA] and each diffusivity) and DKI (eg, mean kurtosis [MK], radial kurtosis [RK], and axial kurtosis [AK]) datasets were applied to above computed spline coefficients and affine matrices. Each DTI and DKI parameter value for WM areas was compared. Finally, tract-based spatial statistics (TBSS) analysis was performed using each parameter.

Results
The relationship between FA and kurtosis parameters (MK, RK, and AK) for WM areas had a strong positive correlation (FA-MK, R2 = 0.93; FA-RK, R2 = 0.89) and a strong negative correlation (FA-AK, R2 = 0.92). When comparing a TBSS connection, we found that this could be observed more clearly in MK than in RK and FA.

Conclusions
WM analysis with DKI enable us to obtain more detailed information for connectivity between nerve structures.

Advances in knowledge
Quantitative indices of neurological diseases were determined using segmenting WM regions using voxel-based morphometry processing of DKI images.
State of the art: radiomics and radiomics-related artificial intelligence on the road to clinical translation
Authors: Majumder Shweta , Katz Sharyn , Kontos Despina , Roshkovan Leonid 
Published: January 2024

Abstract
Radiomics and artificial intelligence carry the promise of increased precision in oncologic imaging assessments due to the ability of harnessing thousands of occult digital imaging features embedded in conventional medical imaging data. While powerful, these technologies suffer from a number of sources of variability that currently impede clinical translation. In order to overcome this impediment, there is a need to control for these sources of variability through harmonization of imaging data acquisition across institutions, construction of standardized imaging protocols that maximize the acquisition of these features, harmonization of post-processing techniques, and big data resources to properly power studies for hypothesis testing. For this to be accomplished, it will be critical to have multidisciplinary and multi-institutional collaboration.
Statin therapy after elective abdominal aortic aneurysm repair improves long-term survival
Authors: Lilja Fredrik , Wanhainen Anders , Mani Kevin 
Published: January 2024

Abstract

Background
Patients with abdominal aortic aneurysms are at high risk of cardiovascular events. Although statin therapy is indicated for most of these patients, no specific recommendation regarding the intensity of therapy exists. The aim of this study was to assess the possible effect of statin therapy on survival of patients undergoing abdominal aortic aneurysm repair and to investigate if high-intensity statin therapy was superior to low–moderate-intensity therapy.

Methods
Data from nationwide Swedish registers on hospital admissions, operations, and medications for patients undergoing elective abdominal aortic aneurysm repair from 2006 to 2018 were collected. The effect of statin use was evaluated in three separate propensity score matched cohorts: perioperative mortality was analysed according to whether patients were on statins before abdominal aortic aneurysm repair or not; long-term survival was assessed according to whether patients were on statins during follow-up or not; and, for those on statins after surgery, long-term survival was analysed according to whether patients were on high-intensity or low–moderate-intensity statin therapy.

Results
Preoperative statin use did not reduce 90-day perioperative mortality (OR 0.99, 95% c.i. 0.77 to 1.28), whilst there was a marked benefit regarding long-term survival for postoperative statin users (HR 1.43, 95% c.i. 1.34 to 1.54). High-intensity statin therapy had no advantage over low–medium-intensity statin therapy with regards to long-term survival (HR 1.00, 95% c.i. 0.80 to 1.25).

Conclusion
In this nationwide propensity score matched cohort study, preoperative statin treatment had no benefit regarding 90-day perioperative survival, but postoperative statin treatment markedly improved long-term survival. No additional benefit regarding high-dose statin treatment could be confirmed in this analysis.
Diagnostic accuracy of cross-sectional and endoscopic imaging in ampullary tumours: systematic review
Authors: de Wilde Anouk J , de Jong Evelien J M , Gurusamy Kurinchi S , Abu Hilal Mohammad , Besselink Marc G , Dewulf Maxime J L , Geurts Sandra M E , Neumann Ulf P , Olde Damink Steven W M , Poley Jan-Werner , Tjan-Heijnen Vivianne C G , de Vos-Geelen Judith , Wiltberger Georg , Coolsen Mariëlle M E , Bouwense Stefan A W 
Published: January 2024

Abstract

Background
Differentiation between adenomas and carcinomas of the ampulla of Vater is crucial for therapy and prognosis. This was a systematic review of the literature on the accuracy of diagnostic modalities used to differentiate between benign and malignant ampullary tumours.

Methods
A literature search was conducted in PubMed, Embase, CINAHL, and the Cochrane Library. Studies were included if they reported diagnostic test accuracy information among benign and malignant ampullary tumours, and used pathological diagnosis as the reference standard. Risk of bias was assessed using Quality Assessment on Diagnostic Accuracy Studies (QUADAS) 2 and QUADAS-C.

Results
Ten studies comprising 397 patients were included. Frequently studied modalities were (CT; 2 studies), endoscopic ultrasonography (EUS; 3 studies), intraductal ultrasonography (IDUS; 2 studies), and endoscopic forceps biopsy (3 studies). For CT, the reported sensitivity for detecting ampullary carcinoma was 44 and 95%, and the specificity 58 and 60%. For EUS, the sensitivity ranged from 63 to 89% and the specificity between 50 and 100%. A sensitivity of 88 and 100% was reported for IDUS, with a specificity of 75 and 93%. For forceps biopsy, the sensitivity ranged from 20 to 91%, and the specificity from 75 to 86%. The overall risk of bias was scored as moderate to poor. Data were insufficient for meta-analysis.

Conclusion
To differentiate benign from malignant ampullary tumours, EUS and IDUS seem to be the best diagnostic modalities. Sufficient high-quality evidence, however, is lacking.
An observational cohort study on the effects of extended postoperative antibiotic prophylaxis on surgical-site infections in low- and middle-income countries
Authors:   Clean Cut Investigators Group, Nofal Maia R. , Zhuang Alex Y. , Gebeyehu Natnael , Starr Nichole , Haile Sara Taye , Woldeamanuel Habtamu , Tesfaye Assefa , Alemu Senait Bitew , Bekele Abebe , Mammo Tihitena Negussie , Weiser Thomas G. , Abdukadir Abdi Amin , Abebe Belay Mellese , Admasu Ananya K. , Alito Tibebu Abebe , Ambulkar Reshma , Arimino Sedera , Arusi Muhudin , Aynalem Nardos , Bajaj Varnica , Delelo Tilahun Selfago , Gutu Motuma , Habte Feleke , Hurrisa Gezahegn Assefa , Kunte Aditya , Rocabado Karoline , Shiferaw Matiyas Asrat , Harrell-Shreckengost Constance , Tiruneh Agazi , Zamorano Roberto , Abreha Milena , Aguilera Constanza , Lima Bella , Kebede Hillena 
Published: January 2024

Abstract

Background
Worldwide, approximately one in six inpatient antibiotic prescriptions are for surgical-infection prophylaxis, including postoperative prophylaxis. The WHO recommends against prolonged postoperative antibiotics to prevent surgical-site infection. However, in many low- and middle-income countries, postoperative antibiotic prophylaxis is common due to perceptions that it protects against surgical-site infection and data informing recommendations against antibiotic administration are largely derived from high-income countries. The aim of this study was to describe postoperative antibiotic-prescribing patterns and related surgical-site infection rates in hospitals in low- and middle-income countries.

Methods
Patients from 19 hospitals in Ethiopia, Madagascar, India, and Bolivia with wound class I and II operations were included. Data on antibiotic administration, indication, surgical-site infection, length of hospital stay, and adherence to perioperative infection-prevention standards were collected by trained personnel. The association between postoperative antibiotic prophylaxis for greater than or equal to 24 h and surgical-site infection was analysed via modified robust Poisson regression, controlling for patient and procedural factors and degree of adherence to perioperative infection-prevention practices.

Results
Of 8714 patients, 92.9% received antibiotics for prophylaxis after surgery and 27.7% received antibiotics for greater than or equal to 24 h. Patients receiving postoperative prophylaxis for greater than or equal to 24 h did not have lower surgical-site infection rates (Relative risk 1.09 (95% c.i. 0.89 to 1.33); P = 0.399), but the length of hospital stay was 1.4 days longer (P &lt; 0.001).

Conclusion
Prolonged postoperative antibiotics did not reduce surgical-site infection, but pervasive use was associated with a longer length of hospital stay, in resource-limited healthcare systems. With the growing threat of antimicrobial resistance, surgical initiatives to implement antimicrobial stewardship programmes in low- and middle-income countries are critical.
Prevalence of abdominal aortic aneurysm (AAA) in first-degree relatives: detecting AAA in adult offspring of AAA patients
Authors: Fattahi Nina , Linné Anneli , Roy Joy , Stenman Malin , Svensjö Sverker , Nilsson Olga , Hultgren Rebecka 
Published: January 2024

Abstract

Background
First-degree relatives of patients with abdominal aortic aneurysm (AAA) may have an increased risk of developing the disease. The primary aim was to report the prevalence of AAA in adult male and female offspring of patients with AAA. The secondary aim was to explore the efficiency of a registry-based detection route, and the third aim was to report contemporary prevalence in the population.

Methods
Adult offspring of individuals with AAA and matched controls were identified through national registries. The examination included questionnaires and ultrasound examinations of the infrarenal aorta. Aortic pathology was defined as an aortic diameter ≥25 mm, AAA ≥30 mm.

Results
The participation rate among male and female adult offspring was 64% (350/543) and 69% (402/583), respectively. A lower participation rate was found in male and female controls (51% and 52%). No difference in prevalence of AAA was observed between male adult offspring and controls (0.9%, c.i. 0.2 to 2.3%) or in the female population (prevalence of 0.2% in adult offspring and controls). Aortic pathology and previously diagnosed AAA were detected in 5.3% (c.i. 3.3 to 8.0%) of male adult offspring and 2.3% (c.i. 1.1 to 4.2%) in controls. Aortic pathology was more prevalent among adult offspring of females with AAA.

Conclusion
The prevalence of AAA in the general population is low, but aortic pathology is notably higher among male first-degree relatives. Increased awareness should be directed towards individuals with a possible hereditary predisposition, particularly offspring of females with AAA and older smokers. Risk factor-based targeted screening of adult offspring of patients with AAA after registry-based detection should be further explored.

Trial registration
ClinicalTrials.gov identifier, NCT4623268
Huntington’s disease affects mitochondrial network dynamics predisposing to pathogenic mitochondrial DNA mutations
Authors: Neueder Andreas , Kojer Kerstin , Gu Zhenglong , Wang Yiqin , Hering Tanja , Tabrizi Sarah , Taanman Jan-Willem , Orth Michael 
Published: January 2024

Abstract
Huntington’s disease (HD) predominantly affects the brain, causing a mixed movement disorder, cognitive decline and behavioural abnormalities. It also causes a peripheral phenotype involving skeletal muscle. Mitochondrial dysfunction has been reported in tissues of HD models, including skeletal muscle, and lymphoblast and fibroblast cultures from patients with HD. Mutant huntingtin protein (mutHTT) expression can impair mitochondrial quality control and accelerate mitochondrial ageing.
Here, we obtained fresh human skeletal muscle, a post-mitotic tissue expressing the mutated HTT allele at physiological levels since birth, and primary cell lines from HTT CAG repeat expansion mutation carriers and matched healthy volunteers to examine whether such a mitochondrial phenotype exists in human HD. Using ultra-deep mitochondrial DNA (mtDNA) sequencing, we showed an accumulation of mtDNA mutations affecting oxidative phosphorylation. Tissue proteomics indicated impairments in mtDNA maintenance with increased mitochondrial biogenesis of less efficient oxidative phosphorylation (lower complex I and IV activity). In full-length mutHTT expressing primary human cell lines, fission-inducing mitochondrial stress resulted in normal mitophagy. In contrast, expression of high levels of N-terminal mutHTT fragments promoted mitochondrial fission and resulted in slower, less dynamic mitophagy. Expression of high levels of mutHTT fragments due to somatic nuclear HTT CAG instability can thus affect mitochondrial network dynamics and mitophagy, leading to pathogenic mtDNA mutations.
We show that life-long expression of mutant HTT causes a mitochondrial phenotype indicative of mtDNA instability in fresh post-mitotic human skeletal muscle. Thus, genomic instability may not be limited to nuclear DNA, where it results in somatic expansion of the HTT CAG repeat length in particularly vulnerable cells such as striatal neurons. In addition to efforts targeting the causative mutation, promoting mitochondrial health may be a complementary strategy in treating diseases with DNA instability such as HD.
Scaling behaviours of deep learning and linear algorithms for the prediction of stroke severity
Authors: Bourached Anthony , Bonkhoff Anna K , Schirmer Markus D , Regenhardt Robert W , Bretzner Martin , Hong Sungmin , Dalca Adrian V , Giese Anne-Katrin , Winzeck Stefan , Jern Christina , Lindgren Arne G , Maguire Jane , Wu Ona , Rhee John , Kimchi Eyal Y , Rost Natalia S 
Published: January 2024

Abstract
Deep learning has allowed for remarkable progress in many medical scenarios. Deep learning prediction models often require 105–107 examples. It is currently unknown whether deep learning can also enhance predictions of symptoms post-stroke in real-world samples of stroke patients that are often several magnitudes smaller. Such stroke outcome predictions however could be particularly instrumental in guiding acute clinical and rehabilitation care decisions. We here compared the capacities of classically used linear and novel deep learning algorithms in their prediction of stroke severity. Our analyses relied on a total of 1430 patients assembled from the MRI-Genetics Interface Exploration collaboration and a Massachusetts General Hospital–based study. The outcome of interest was National Institutes of Health Stroke Scale–based stroke severity in the acute phase after ischaemic stroke onset, which we predict by means of MRI-derived lesion location. We automatically derived lesion segmentations from diffusion-weighted clinical MRI scans, performed spatial normalization and included a principal component analysis step, retaining 95% of the variance of the original data. We then repeatedly separated a train, validation and test set to investigate the effects of sample size; we subsampled the train set to 100, 300 and 900 and trained the algorithms to predict the stroke severity score for each sample size with regularized linear regression and an eight-layered neural network. We selected hyperparameters on the validation set. We evaluated model performance based on the explained variance (R2) in the test set. While linear regression performed significantly better for a sample size of 100 patients, deep learning started to significantly outperform linear regression when trained on 900 patients. Average prediction performance improved by ∼20% when increasing the sample size 9× [maximum for 100 patients: 0.279 ± 0.005 (R2, 95% confidence interval), 900 patients: 0.337 ± 0.006]. In summary, for sample sizes of 900 patients, deep learning showed a higher prediction performance than typically employed linear methods. These findings suggest the existence of non-linear relationships between lesion location and stroke severity that can be utilized for an improved prediction performance for larger sample sizes.
Nanoarchitectonics: the method for everything in materials science
Authors: Ariga Katsuhiko 
Published: January 2024

Abstract
Nanotechnology has revealed the science of the nanoscale. The global challenge that will follow is to build functional materials with the knowledge of nanoscale phenomena. This task is carried out by nanoarchitectonics as a postnanotechnology concept. The goal of nanoarchitectonics is to build functional material systems by architecting atoms, molecules, and nanomaterials as building blocks. Fundamentally, all materials are made of atoms and molecules. Therefore, nanoarchitectonics, which architects materials from atoms and molecules, can be a universal way to create all materials. It may be said to be the method for everything in materials science. From atoms and molecules, which are basic units, to living cells, which are complex systems, all are components of nanoarchitectonics. This paper presents recent examples of nanoarchitectonics research at various size levels, from the atomic to the cellular level, specifically, (i) atomistic nanoarchitectonics, (ii) molecular nanoarchitectonics, (iii) supramolecular nanoarchitectonics, (iv) inorganic nanoarchitectonics, (v) biomolecular nanoarchitectonics, (vi) cell-mimic nanoarchitectonics, and (vii) cell-based nanoarchitectonics. The possibility of nanoarchitectonics, the method for everything in materials science, as an integrative challenge will then be explored.