bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive Need as a Mediator Between Psychological Stress and Quality of Life Among Caregivers of Patients With Cancer
Authors: Lin Danna , Ying Wenjuan , Zhang Hong , Xiu Yuqi , Li E , Zheng Ruihua , Wu Yanchun 
Published: November 2023

Background
Caregivers of patients with cancer are susceptible to profound psychological distress and low quality of life owing to the substantial demands of caregiving. The comprehensive needs of caregivers are closely linked to their quality of life. However, little is known about the relationship between these factors.

Objective
This study aimed to determine whether comprehensive needs mediate the relationships between psychological stress and quality of life in caregivers of patients with cancer.

Methods
A cross-sectional design was used to recruit 382 participants through convenience sampling. Psychological stress, comprehensive needs, and quality of life were measured using a questionnaire.

Results
Psychological stress was associated with higher comprehensive needs (r = 0.30, P < .01) and lower quality of life (r = −0.20, P < .01). Comprehensive needs were negatively associated with quality of life (r = −0.28, P < .01). Mediation analysis findings revealed that both the indirect effect of psychological stress on quality of life via comprehensive needs (β = −0.10; P < .001) and its direct effect on quality of life (β = −0.16; P < .01) were statistically significant, suggesting a partial mediatory effect of comprehensive needs between psychological stress and quality of life.

Conclusions
Our findings suggest that reducing psychological stress can improve quality of life by promoting satisfaction with comprehensive needs.

Implications for Practice
Interventions that help reduce psychological stress and meet the comprehensive needs of caregivers of patients with cancer can improve their quality of life.
Compared With Conventional Insemination, Intracytoplasmic Sperm Injection Provides No Benefit in Cases of Nonmale Factor Infertility as Evidenced by Comparable Euploidy Rate
Authors: Patel Karishma , Vaughan Denis A. , Rodday Angie Mae , Penzias Alan , Sakkas Denny 
Published: November 2023

(Abstracted from Fertil Steril 2023;120(2))
Intracytoplasmic sperm injection (ICSI) has dramatically improved fertilization rates for couples with male factor infertility and those with prior failed in vitro fertilization (IVF) cycles. Although several international academic organizations and the cumulative evidence do not suggest the routine use of ICSI for nonmale factor infertility, it is now used frequently for all cases of IVF regardless of the indication.
Association of Clinical Trial Participation With Improved Overall Survival for Recurrent, Platinum-Resistant Ovarian Cancer
Authors: Yao Molly Morton Meng , Chalif Julia , Lampert Erika J. , Chau Danielle , Rose Peter G. , Debernardo Robert , Michener Chad M. , Vargas Roberto , Chambers Laura M. 
Published: November 2023

(Abstracted from Obstet Gynecol 2023;1(00):00)
Despite recent advancements in treatment, ovarian cancer remains the leading cause of gynecologic cancer death in the United States. Advanced ovarian cancer is treated using surgery and platinum-based chemotherapy but ultimately recurs in most patients and becomes resistant to platinum chemotherapy.
Comparison of Maternal Labor-Related Complications and Neonatal Outcomes Following Elective Induction of Labor at 39 Weeks of Gestation vs Expectant Management: A Systematic Review and Meta-analysis
Authors: Hong James , Atkinson Jessica , Mitchell Alexandra Roddy , Tong Stephen , Walker Susan P. , Middleton Anna , Lindquist Anthea , Hastie Roxanne 
Published: November 2023

(Abstracted from JAMA Network Open 2023;6(5):e2313162)
Induction of labor historically has been discouraged when there is no medical indication, such as for postterm pregnancies, suspected cases of poor fetal growth, prelabor rupture of membranes, or hypertension. This is because elective induction is associated with a higher risk of cesarean delivery (CD) and adverse birth outcomes than spontaneous labor.
National Survey on the Emergency Department Management of Febrile Infants 29 to 60 Days Old With an Abnormal Urinalysis
Authors: Chapur Jeronimo , Meckler Garth , Doan Quynh , Bone Jeffrey N. , Burstein Brett , Sabhaney Vikram ,   on behalf of Pediatric Emergency Research Canada
Published: November 2023

Objectives
Recent clinical practice guidelines recommend that decisions regarding lumbar puncture (LP) for febrile infants older than 28 days should no longer be based on urinalysis results, but rather independently determined by inflammatory markers and sometimes guided by shared decision-making (SDM). This study sought to assess management decisions for febrile infants aged 29 to 60 days with an abnormal urinalysis.

Methods
A scenario-based survey was sent to emergency department physicians at all 15 Canadian tertiary pediatric centers. Participants were asked questions regarding management decisions when presented with a well-appearing febrile infant in the second month of life with either an abnormal or normal urinalysis.

Results
Response rate was 50.2% (n = 116/231). Overall, few respondents would perform an LP based on either an abnormal or normal urinalysis alone (10.3% and 6.0%, respectively). However, regression analysis demonstrated that decisions regarding LP were influenced by urinalysis results (P < 0.001), with respondents more likely to defer to inflammatory marker results for infants with a normal urinalysis result (57.8%) compared with those with an abnormal urinalysis (28.4%). Hospitalization (62.1%) and empiric antibiotic treatment by intravenous route (87.9%) were both frequent for low-risk infants with an abnormal urinalysis. Nearly half of respondents reported rarely (<25% of encounters) engaging families in SDM regarding LP decisions.

Conclusions
Knowledge translation initiatives reflecting current evidence should target use of inflammatory markers rather than urinalysis results to guide decisions regarding LP. Efforts emphasizing outpatient management with oral antibiotics and SDM for low-risk infants with an abnormal urinalysis could also further align management with current evidence and guidelines.
Predictors for Dental Intervention in Children After Dental Injury: A Retrospective Analysis and Literature Review
Authors: Cohen Neta , Via -Kagan Renana , Haberman Shira , Gigi Dana , Ianculovici Clariel , Rimon Ayelet 
Published: November 2023

Objective
This study aimed to explore risk factors for dental intervention in patients presenting to the pediatric emergency department (PED) after dental injury.

Methods
We retrospectively explored patients aged 0 to 18 years who presented to our PED between 2017 and 2021 after dental injury.

Results
Of the total of 830 patients (mean age 7.1 ± 3.9 years, 589 [71.0%] male patients), 237 (28.5%) required dental intervention. All patients with alveolar fractures and those with involvement of permanent teeth with extrusive luxation mandated urgent dental consultation. Additional independent predictors for dental intervention for primary tooth injury were: root fracture (adjusted odds ratio [aOR] 38.4; 95% confidence interval [CI], 3.95–373.22; P = 0.002), facial bone involvement (aOR 12.40; 95% CI, 2.33–65.93; P = 0.003), lateral luxation (aOR 6.9; 95% CI, 4.27–11.27; P < 0.001), extrusive luxation (aOR 6.44; 95% CI, 2.74–15.14; P < 0.001), and avulsion (aOR 2.06; 95% CI, 1.23–3.45; P = 0.006). Additional independent predictors for permanent tooth injury were lateral luxation (aOR 27.8; 95% CI, 6.1–126.6; P < 0.001) and avulsion (aOR 6.8; 95% CI, 2.9–15.9; P < 0.001).

Conclusions
Alveolar fracture is a severe dental injury, requiring intervention, for primary and permanent teeth injuries. Tooth luxation with significant mobility or malocclusion, incomplete avulsion, a suspected root involvement, or facial bone injury in the primary teeth and tooth luxation (extrusive/lateral) and avulsion in the permanent teeth dictate urgent dental consultation and intervention. Clinical algorithms for dental injury management are suggested.
Clonal hematopoiesis of indeterminate potential in persons with HIV
Authors: Knudsen Andreas D. , Eskelund Christian Winther , Benfield Thomas , Zhao Yanan , Gelpi Marco , Køber Lars , Trøseid Marius , Kofoed Klaus F. , Ostrowski Sisse R. , Reilly Cavan , Borges Álvaro H. , Grønbæk Kirsten , Nielsen Susanne D. 
Published: November 2023

Background:
Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with older age, inflammation and with risk of coronary artery disease (CAD). We aimed to characterize the burden of CHIP, and to explore the association between CHIP, inflammatory markers, and CAD in older persons with HIV (PWH).

Methods:
From the Copenhagen Comorbidity in HIV Infection (COCOMO) study, we included 190 individuals older than 55 years of age. We defined CHIP as variant allele fraction at least 2%. CAD was categorized according to the most severe coronary artery lesion on coronary computed tomography (CT) angiography as no coronary atherosclerosis; any atherosclerosis defined as at least 1% stenosis and obstructive CAD defined as at least 50% stenosis.

Results:
In the entire population (median age 66 years, 87% men), we identified a total of 62 mutations distributed among 49 (26%) participants. The three most mutated genes were DNMT3A, TET2, and ASXL1, accounting for 49, 25, and 16% of mutations, respectively. Age and sex were the only variables associated with CHIP. IL-1β, IL-1Ra, IL-2, IL-6, IL-10, soluble CD14, soluble CD163 and TNF-α were not associated with CHIP, and CHIP was not associated with any atherosclerosis or with obstructive CAD in adjusted analyses.

Conclusion:
In older, well treated, Scandinavian PWH, more than one in four had at least one CHIP mutation. We did not find evidence of an association between CHIP and inflammatory markers or between CHIP and CAD. CHIP is an unlikely underlying mechanism to explain the association between inflammation and CAD in treated HIV disease.
Geographic variations of pre-exposure prophylaxis reversal and abandonment among United States counties
Authors: Dawit Rahel , Goedel William C. , Reid Sean C. , Doshi Jalpa A. , Nunn Amy S. , Chan Philip A. , Dean Lorraine T. 
Published: November 2023

Objective:
In the United States, one in five newly insurer-approved pre-exposure prophylaxis (PrEP) prescriptions are reversed with over 70% of those reversed, being abandoned. Given the Ending the HIV Epidemic (EHE) initiative's goals, we assessed geographic variations of PrEP reversal and abandonment across EHE and non-EHE counties in the United States.

Design:
This was a cross-sectional analysis of secondary data.

Methods:
Data were collected from Symphony Analytics for adults 18 years and older, with a newly prescribed PrEP claim. Using the proportion of PrEP prescriptions by county, hotspot analysis was conducted utilizing Getis Ord Gi∗ statistics stratified by EHE and non EHE counties. Multivariable logistic regression was used to identify factors associated with residing in hotspots of PrEP reversal or PrEP abandonments.

Results:
Across 516 counties representing 36,204 patients, the overall PrEP reversal rate was 19.4%, whereas the PrEP abandonment rate was 13.7%. Reversals and abandonments were higher for non-EHE (22.7 and 17.1%) than EHE (15.6 and 10.5%) counties. In both EHE and non-EHE counties, younger age, less education, females, and an out-of-pocket cost of greater than $100, were significantly associated with greater likelihood of residing in hotspots of PrEP reversal or abandonment, while Hispanics, Medicaid recipients, and an out-of-pocket cost of $10 or less had lower likelihood of residing in hotspots of reversal and abandonment.

Conclusion:
Findings indicate the need for implementation of focused interventions to address disparities observed in PrEP reversal and abandonment. Moreover, to improve primary PrEP adherence, national PrEP access programs should streamline and improve PrEP accessibility across different geographic jurisdictions.
Subnodal Correspondence of PSMA Expression and USPIO-MRI in Metastatic Pelvic Lymph Nodes in Prostate Cancer
Authors: Schilham Melline Gabrielle Maria , Somford Diederik M. , Veltien Andor , Zamecnik Patrik , Barentsz Jelle O. , Sedelaar Michiel J.P.M. , Kusters-Vandevelde Heidi V.N. , Gotthardt Martin , Rijpkema Mark , Scheenen Tom W.J. 
Published: November 2023

Objectives
Two advanced imaging modalities used to detect lymph node (LN) metastases in prostate cancer patients are prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography and ultrasmall superparamagnetic iron oxide (USPIO)–enhanced magnetic resonance imaging (MRI). As these modalities use different targets, a subnodal comparison is needed to interpret both their correspondence and their differences. The aim of this explorative study was to compare ex vivo 111In-PSMA μSPECT images with high-resolution 7 T USPIO μMR images and histopathology of resected LN specimens from prostate cancer patients to assess the degree of correspondence at subnodal level.

Materials and Methods
Twenty primary prostate cancer patients who underwent pelvic LN dissection were included and received USPIO contrast and 111In-PSMA. A total of 41 LNs of interest (LNOIs) were selected for ex vivo imaging based on γ-probe detection or palpation. μSPECT and μMRI acquisition were performed immediately after resection. Overlay of μSPECT images on MR images was performed, and the level of correspondence (LoC) between μSPECT and μMR findings was assessed according to a 4-point Likert classification scheme.

Results
Forty-one LNOIs could be matched to an LN on ex vivo μMRI. Coregistration of μSPECT and USPIO-enhanced water-selective multigradient echo MR images was successful for all 41 LNOIs. Ninety percent of the lesions showed excellent correspondence regarding the presence of metastatic tissue and affected subnodal site (LoC 4; 37/41). In only 1 of 41 LNOIs, a small metastasis was misclassified by both techniques. Three LNOIs were classified as LoC 3 (7%) and 1 LNOI as LoC 2. All LoC 2 and LoC 3 lesions had PSMA-expressing metastases on final histopathology

Conclusions
Coregistration of μSPECT and USPIO-μMRI showed excellent subnodal correspondence in the majority (90%) of LNs. Ex vivo imaging may thus help localize small cancer deposits within resected LNs and could contribute to improved interpretation of in vivo imaging of LNs.
68Ga-PSMA-11 PET/CT and 64CuCl2 PET/CT Help in Identifying Rare Metastatic Site of Penile Shaft in a Patient of Carcinoma Prostate
Authors: Verma Priyanka , Nazar Aamir , Jadhav Sonali , Basu Sandip 
Published: November 2023

AbstractA 71-year-old man, presenting with complaints of burning sensation and pain during urination, finally diagnosed with prostate carcinoma. Ultrasonography of the abdomen and pelvis revealed prostatomegaly. Serum PSA level was elevated, and TRUS-guided biopsy demonstrated acinar adenocarcinoma (Gleason score: 5 + 4 = 9).68Ga-PSMA-11 PET/CT for initial staging showed PSMA-avid enlarged prostate, pelvic lymphadenopathy, and focal PSMA uptake in the left side of the shaft of the penis. The patient also underwent a64CuCl2PET/CT, which demonstrated similar findings of enlarged prostate and adenopathy with focally increased tracer uptake in the shaft of the penis coinciding with the lesion observed on68Ga-PSMA-11 PET/CT, thereby detecting a rare metastatic site from carcinoma prostate.
“Hepatic Superscan” Revealed on 18F-FDG PET Due to Drug-Induced Fulminant Hepatitis
Authors: Qiu Guigang , Shao Fuqiang , Xie Peng 
Published: November 2023

Abstract
“Hepatic superscan” could be caused by a variety of etiologies. Here we report a 68-year-old woman with a medication history of cefoperazone and azithromycin for pneumonia recently who underwent 18F-FDG PET/CT to detect underlying malignancy due to unexplained liver damage and fever of unknown origin. Unexpectedly, “hepatic superscan” without morphologic changes was noted. Unfortunately, aggressive treatment did not reverse the damaged liver function, and the patient rapidly died. Drug-induced fulminant hepatitis was diagnosed clinically. Our case demonstrates that fulminant hepatitis could result in “hepatic superscan” on 18F-FDG PET despite negative findings on the ultrasonography, CT, and MRI.
FDG PET/CT in Pancreatic Ductal Adenocarcinoma Arising From a Heterotopic Pancreas of the Pylorus
Authors: Ji Xia , Dong Aisheng , Wang Yang 
Published: November 2023

Abstract
Malignant transformation of heterotopic pancreas is extremely rare. We describe FDG PET/CT findings in a case of pancreatic ductal adenocarcinoma arising from a heterotopic pancreas in the submucosa of the pylorus with peripyloric lymph node metastasis and elevated serum carbohydrate antigen 19-9 level. The heterotopic pancreatic adenocarcinoma showed intense FDG uptake, and the peripyloric lymph node metastasis showed mild FDG uptake. This case indicates that heterotopic pancreatic adenocarcinoma should be included in the differential diagnosis of FDG-avid gastric submucosal lesions, especially in patients with elevated serum carbohydrate antigen 19-9 level.
FAPI Uptake in Gallbladder Is It Normal Biodistribution?
Authors: Behnam-Manesh Hossein , Doroudinia Abtin , Bayat Mohadeseh , Bakhshayesh Karam Mehrdad , Salimi Babak , Nejabat Marzieh , Mehrian Payam 
Published: November 2023

Abstract
Radiolabeled fibroblast activation protein inhibitors (FAPIs) have been extensively used in different types of cancers, although not yet FDA approved. Normal patterns of FAPI biodistribution have been investigated, and it is known that FAPI is expressed in nonmalignant pathophysiological lesions, characterized by tissue remodeling such as atherosclerosis, arthritis, and scar/fibrotic tissues. In this interesting image, we are presenting the accumulation of 68Ga-FAPI in the gallbladder. This finding could be related to a normal distribution of the radiotracer as a physiologic finding. This is a potentially important finding as FAPI may be used as theragnostic agent in the future.
Deep Learning-based Assessment of Facial Asymmetry Using U-Net Deep Convolutional Neural Network Algorithm
Authors: Jeon Sang-Min , Kim Seojeong , Lee Kyungmin Clara 
Published: November 2023

Objectives:
This study aimed to evaluate the diagnostic performance of a deep convolutional neural network (DCNN)-based computer-assisted diagnosis (CAD) system to detect facial asymmetry on posteroanterior (PA) cephalograms and compare the results of the DCNN with those made by the orthodontist.

Materials and Methods:
PA cephalograms of 1020 patients with orthodontics were used to train the DCNN-based CAD systems for autoassessment of facial asymmetry, the degree of menton deviation, and the coordinates of its regarding landmarks. Twenty-five PA cephalograms were used to test the performance of the DCNN in analyzing facial asymmetry. The diagnostic performance of the DCNN-based CAD system was assessed using independent t-tests and Bland-Altman plots.

Results:
Comparison between the DCNN-based CAD system and conventional analysis confirmed no significant differences. Bland-Altman plots showed good agreement for all the measurements.

Conclusions:
The DCNN-based CAD system might offer a clinically acceptable diagnostic evaluation of facial asymmetry on PA cephalograms.
Clinical impact of molecular profiling in rare brain tumors
Authors: Pratt Drew , Penas-Prado Marta , Gilbert Mark R. 
Published: November 2023

Purpose of review
The purpose of this review is to describe the commonly used molecular diagnostics and illustrate the prognostic importance to the more accurate diagnosis that also may uncover therapeutic targets.

Recent findings
The most recent WHO Classification of Central Nervous System Tumours (2021) lists over 100 distinct tumor types. While traditional histology continues to be an important component, molecular testing is increasingly being incorporated as requisite diagnostic criteria. Specific molecular findings such as co-deletion of the short arm of chromosome 1 (1p) and long arm of chromosome 19 (19q) now define IDH-mutant gliomas as oligodendroglioma. In recent years, DNA methylation profiling has emerged as a dynamic tool with high diagnostic accuracy. The integration of specific genetic (mutations, fusions) and epigenetic (CpG methylation) alterations has led to diagnostic refinement and the discovery of rare brain tumor types with distinct clinical outcomes. Molecular profiling is anticipated to play an increasing role in routine surgical neuropathology, although costs, access, and logistical concerns remain challenging.

Summary
This review summarizes the current state of molecular testing in neuro-oncology highlighting commonly used and developing technologies, while also providing examples of new tumor types/subtypes that have emerged as a result of improved diagnostic precision.
The relationship between the number of COVID-19 vaccines and infection with Omicron ACE2 inhibition at 18-months post initial vaccination in an adult cohort of Canadian paramedics
Authors: Yap Justin , Kayda Iryna , Asamoah-Boaheng Michael , Haig Scott , Kirkham Tracy , Cheskes Sheldon , Demers Paul , Goldfarb David , Grunau Brian 
Published: November 2023

The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, has rapidly evolved since late 2019, due to highly transmissible Omicron variants. While most Canadian paramedics have received COVID-19 vaccination, the optimal ongoing vaccination strategy is unclear. We investigated neutralizing antibody (NtAb) response against wild-type (WT) Wuhan Hu-1 and Omicron BA.4/5 lineages based on the number of doses and past SARS-CoV-2 infection, at 18 months post initial vaccination (with a Wuhan Hu-1 platform mRNA vaccine [BNT162b2 or mRNA-1273}). Demographic information, previous COVID-19 vaccination, infection history, and blood samples were collected from paramedics 18 months post initial mRNA COVID-19 vaccine dose. Outcome measures were ACE2 percent inhibition against Omicron BA.4/5 and WT antigens. We compared outcomes based on number of vaccine doses (two vs. three) and previous SARS-CoV-2 infection status, using the Mann-Whitney U test. Of 657 participants, the median age was 40 years (IQR 33-50) and 251 (42%) were females. Overall, median percent inhibition to BA.4/5 and WT was 71.61% (IQR 39.44-92.82) and 98.60% (IQR 83.07-99.73), respectively. Those with a past SARS-CoV-2 infection had a higher median percent inhibition to BA.4/5 and WT, when compared to uninfected individuals overall and when stratified by two or three vaccine doses. When comparing two vs. three WT vaccine doses among SARS-CoV-2 negative participants, we did not detect a difference in BA.4/5 percent inhibition, but there was a difference in WT percent inhibition. Among those with previous SARS-CoV-2 infection(s), when comparing two vs. three WT vaccine doses, there was no observed difference between groups. These findings demonstrate that additional Wuhan Hu-1 platform mRNA vaccines did not improve NtAb response to BA.4/5, but prior SARS-CoV-2 infection enhances NtAb response.