bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-transplant HBV reactivation impacts the prognosis of patients with hepatitis B-related hepatocellular carcinoma: a dual-center retrospective cohort study in China
Authors: Li Huigang , Lu Di , Chen Jingyan , Zhang Junchi , Zhuo Jianyong , Lin Zuyuan , Cao Chenghao , Shen Wei , He Chiyu , Chen Hao , Hu Zhihang , Sun Yiyang , Wei Xuyong , Zhuang Li , Zheng Shusen , Xu Xiao 
Published: February 2024

Background:
Highly active hepatitis B virus (HBV) is known to be associated with poor outcomes in patients with hepatocellular carcinoma (HCC). This study aims to investigate the relationship between HBV status and HCC recurrence after liver transplantation.

Methods:
The study retrospectively analyzed HCC patients undergoing liver transplantation in two centers between January 2015 and December 2020. We reviewed post-transplant HBV status and its association with outcomes.

Results:
The prognosis of recipients with hepatitis B surface antigen (HBsAg) reappearance (n=58) was poorer than those with HBsAg persistent negative (n=351) and positive (n=53). In HBsAg persistent positive group, recipients with HBV DNA reappearance or > 10-fold increase above baseline had worse outcomes than those without (P<0.01). HBV reactivation was defined as (a) HBsAg reappearance or (b) HBV DNA reappearance or > 10-fold increase above baseline. After propensity score matching, the 5-year overall survival rate and recurrence-free survival rate after liver transplantation in recipients with HBV reactivation were significantly lower than those without (32.0% vs 62.3%; P<0.01, and 16.4% vs 63.1%; P<0.01, respectively). Moreover, HBV reactivation was significantly related to post-transplant HCC recurrence, especially lung metastasis. Cox regression analysis revealed that beyond Milan criteria, microvascular invasion and HBsAg positive graft were independent risk factors for post-transplant HBV reactivation, and a novel nomogram was established accordingly with a good predictive efficacy (AUROC=0.78, C-index =0.73).

Conclusions:
Recipients with HBV reactivation had worse outcomes and higher tumor recurrence rates than those without. The nomogram could be used to evaluate the risk of post-transplant HBV reactivation effectively.
A CT-based multitask deep learning model for predicting tumor stroma ratio and treatment outcomes in patients with colorectal cancer: a multicenter cohort study
Authors: Cui Yanfen , Zhao Ke , Meng Xiaochun , Mao Yun , Han Chu , Shi Zhenwei , Yang Xiaotang , Tong Tong , Wu Lei , Liu Zaiyi 
Published: February 2024

Background:
Tumor-stroma interactions, as indicated by tumor-stroma ratio (TSR), offer valuable prognostic stratification information. Current histological assessment of TSR is limited by tissue accessibility and spatial heterogeneity. We aimed to develop a multitask deep learning (MDL) model to noninvasively predict TSR and prognosis in colorectal cancer (CRC).

Materials and Methods:
In this retrospective study including 2268 patients with resected CRC recruited from four centers, we developed an MDL model using preoperative CT images for the simultaneous prediction of TSR and overall survival. Patients in the training cohort (n=956) and internal validation cohort (IVC, n=240) were randomly selected from center I. Patients in the external validation cohort1(EVC1, n=509), EVC2 (n=203), and EVC3 (n=360) were recruited from other three centers. Model performance was evaluated with respect to discrimination and calibration. Furthermore, we evaluated whether the model could predict the benefit from adjuvant chemotherapy.

Results:
The MDL model demonstrated strong TSR discrimination, yielding areas under the receiver operating curves (AUCs) of 0.855 (95%CI, 0.800-0.910), 0.838(95% CI, 0.802-0.874), and 0.857(95% CI, 0.804-0.909) in the three validation cohorts, respectively. The MDL model was also able to predict overall survival and disease-free survival across all cohorts. In multivariable Cox analysis, the MDL score (MDLS) remained an independent prognostic factor after adjusting for clinicopathological variables (all P<0.05). For stage II and stage III disease, patients with a high MDLS benefited from adjuvant chemotherapy (hazard ratio [HR] 0.391 [95%CI, 0.230–0.666], P=0.0003; HR=0.467[95%CI, 0.331-0.659], P<0.0001, respectively), whereas those with a low MDLS did not.

Conclusion:
The multitask DL model based on preoperative CT images effectively predicted TSR status and survival in CRC patients, offering valuable guidance for personalized treatment. Prospective studies are needed to confirm its potential to select patients who might benefit from chemotherapy.
Deep learning combining mammography and ultrasound images to predict the malignancy of BI-RADS US 4A lesions in women with dense breasts：a diagnostic study
Authors: Yang Yaping , Zhong Ying , Li Junwei , Feng Jiahao , Gong Chang , Yu Yunfang , Hu Yue , Gu Ran , Wang Hongli , Liu Fengtao , Mei Jingsi , Jiang Xiaofang , Wang Jin , Yao Qinyue , Wu Wei , Liu Qiang , Yao Herui 
Published: February 2024

Objectives:
We aimed to assess the performance of a deep learning (DL) model, based on a combination of ultrasound (US) and mammography (MG) images, for predicting malignancy in breast lesions categorized as Breast Imaging Reporting and Data System (BI-RADS) US 4A in diagnostic patients with dense breasts.

Methods:
A total of 992 patients were randomly allocated into the training cohort and the test cohort at a proportion of 4:1. Another, 218 patients were enrolled to form a prospective validation cohort. The DL model was developed by incorporating both US and MG images. The predictive performance of the combined DL model for malignancy was evaluated by sensitivity, specificity and area under the receiver operating characteristic curve (AUC). The combined DL model was then compared to a clinical nomogram model and to the DL model trained using US image only and to that trained MG image only.

Results:
The combined DL model showed satisfactory diagnostic performance for predicting malignancy in breast lesions, with an AUC of 0.940 (95% confidence interval [95%CI], 0.874~1.000) in the test cohort, and an AUC of 0.906 (95%CI, 0.817~0.995) in the validation cohort, which was significantly higher than the clinical nomogram model, and the DL model for US or MG alone (P<0.05).

Conclusions:
The study developed an objective DL model combining both US and MG imaging features, which was proven to be more accurate for predicting malignancy in the BI-RADS US 4A breast lesions of patients with dense breasts. This model may then be used to more accurately guide clinicians’ choices about whether performing biopsies in breast cancer diagnosis.
Missed Opportunities in HIV Testing in Turkiye: Implications for Late Diagnoses
Authors: Özkaya Hacer Deniz , Elazab Khaled , Turan Bülent , Nazlı Arzu , Öztürk Barçın , Pullukçu Hüsnü , Gökengin Deniz 
Published: February 2024

Background:
Late diagnosis of HIV infection is a major global problem. In Turkiye, only 41%–50% of people living with HIV are diagnosed, suggesting that many opportunities for HIV testing might be missed.

Setting:
The aim of this study was to determine the missed testing opportunities for HIV in healthcare settings in Turkiye and the predictors for missed opportunities (MOs).

Methods:
The study included patients with a new HIV diagnosis, presenting to care between January 2018 and December 2020. They were given a verbal questionnaire face to face, by a telephone call or an online meeting for visits to a health care setting within the year before their diagnosis. Electronic medical records were also examined.

Results:
The sample included 198 patients with at least 1 visit to any health care setting, with a total of 1677 visits. Patients had an indication for HIV testing in 51.3% (861/1677) of the visits; an HIV test was not offered in 77.9% (671/861) and was considered a MO. The highest number of MOs was in emergency departments (59.8%) (180/301). The most common reason for visiting was constitutional symptoms and indicator conditions (55.4%) (929/1677). University graduates and those with a CD4+ T-cell count <200/mm3 were more likely to have a MO.

Conclusions:
Many opportunities to diagnose HIV at an early stage are missed in health care settings in Turkiye. Considering the rapidly increasing number of new diagnoses in the last decade, urgent action needs to be taken.
Brief Report: Lower Self-Reported Antiretroviral Therapy Adherence Among Adolescents in Boarding Schools Compared to Day Schools
Authors: Wandika Brenda , Nyapara Florence , Aballa Calvince , Richardson Barbra A. , Wamalwa Dalton , John-Stewart Grace , Inwani Irene , Njuguna Irene 
Published: February 2024

Introduction:
Adolescents living with HIV (ALH) have poorer adherence to antiretroviral therapy (ART) than adults. Many ALH in sub-Saharan Africa are enrolled in boarding schools where stigma is pervasive and may impact adherence.

Methods:
We collected sociodemographic data, school information, medical history, and viral load data from ALH aged 14–19 years in 25 HIV clinics in 3 counties in Kenya. Using generalized estimating equations, we compared ART adherence in ALH attending day and boarding schools.

Results:
Of 880 ALH, 798 (91%) were enrolled in school, of whom 189 (24%) were in boarding schools. Of those in school, the median age was 16 years (interquartile range: 15–18), 55% were female, 78% had a parent as a primary caregiver, and 74% were on DTG-based ART. The median age at ART initiation was 6 years (interquartile range: 3–10). Overall, 227 (29%) ALH self-reported missing ART when school was in session (40% in boarding and 25% in day school). After adjusting for sociodemographic and HIV care characteristics, ALH in boarding schools were significantly more likely to self-report missing ART than those in day schools (adjusted prevalence ratio: 1.47, 95% CI: 1.18 to 1.83, P = 0.001). Among 194 ALH, only 60% had undetectable (<20 copies/mL) HIV viral load (62% day schools and 51% boarding schools; P = 0.097).

Conclusions:
ALH had high self-reported nonadherence overall, with worse adherence among those in boarding schools. Schools remain a critical untapped resource for improving ALH outcomes.
How Early Can Checkpoint Inhibitors Induce a Complete Metabolic Response in Chemorefractory Hodgkin Lymphoma?
Authors: Georgopoulou Angeliki N. , Zerzi Calliope , Samaras Vaios , Rondogianni Phivi , Vassilakopoulos Theodoros P. 
Published: February 2024

Abstract
A 24-year-old man with classical Hodgkin lymphoma was lost to follow-up after metabolic complete remission (mCR). He presented 4 years later with B-symptoms and impaired clinical condition. Relapsed classical Hodgkin lymphoma was diagnosed. PET/CT revealed stage IVB with liver and spleen involvement. Two liver function–adjusted salvage attempts were ineffective. Pembrolizumab was instituted with gradual clinical improvement. PET was missed before treatment for a life-threatening condition and was performed on day +10 showing a near mCR. A mCR was confirmed before cycle 2, on day +21, underlining—for the first time in the literature—the possibility to achieve very early mCR with pembrolizumab.
68Ga-Pentixafor PET/CT for In Vivo Imaging of CXCR4 Receptors in Glioma Demonstrating a Potential for Response Assessment to Radiochemotherapy: Preliminary Results
Authors: Waheed Abdul , Singh Baljinder , Watts Ankit , Kaur Harneet , Singh Harmandeep , Dhingra Kirti , Ahuja Chirag , Madan Renu , Singh Apinderpreet , Radotra Bishan D. 
Published: February 2024

Purpose
The aim of this study was to evaluate the diagnostic potential of 68Ga-pentixafor PET/CT for in vivo CXCR4 receptors imaging in glioma and its possible role in response assessment to radiochemotherapy (R-CT).

Methods
Nineteen (12 men, 7 women) patients with glioblastoma multiforme (GBM) underwent 68Ga-pentixafor PET/CT, contrast-enhanced MR, and MR spectroscopy. Patients were divided in to 2 groups, that is, group I was the presurgical (n = 9) group in which the scanning was done before surgery, and PET findings were correlated with CXCR4 receptors’ density. The group II was the postsurgical (n = 10) group in which the scanning was done before and after R-CT and used for treatment response evaluation. The quantitative analysis of 68Ga-pentixafor PET/CT evaluated the mean SUVmax, SUVmean, SUVpeak, and T/B values. MR spectroscopy data evaluated the ratios of tumor metabolites (choline, NAA, creatine).

Results

68Ga-Pentixafor uptake was noted in all (n = 19) the patients. In the group I, the mean SUVmax, SUVmean, SUVpeak, and T/B values were found to be 4.5 ± 1.6, 0.60 ± 0.26, 1.95 ± 0.8, and 6.9 ± 4.6, respectively. A significant correlation (P < 0.005) was found between SUVmean and choline/NAA ratio. Immunohistochemistry performed in 7/9 showed CXCR4 receptors’ positivity (intensity 3+; stained cells >50.0%). In the group II, the mean SUVmax at baseline was 4.6 ± 2.1 and did not differ (4.4 ± 1.6) significantly from the value noted at post–R-CT follow-up PET/CT imaging. At 6 months’ clinical follow-up, 4 patients showed stable disease. SUVmax and T/B ratios at follow-up imaging were lower (3.70 ± 0.90, 2.64 ± 1.35) than the corresponding values (4.40 ± 2.8; 2.91 ± 0.93) noted at baseline. Six (6/10) patients showed disease progression, and the mean SUVmax, and T/B ratio in these patients were significantly (P < 0.05) higher than the corresponding values at baseline and also higher than that noted in the stable patients.

Conclusions

68Ga-Pentixafor PET/CT can be used for in vivo mapping of CXCR4 receptors in GBM. The technique after validation in a large cohort of patients may have added diagnostic value for the early detection of GBM recurrence and for treatment response evaluation.
Identifying Mixed Dementia With Lewy Bodies and Alzheimer Disease Using Multitracer PET Imaging
Authors: Li Qijun , Wang Junshan , Cui Ruixue , Yuan Jing 
Published: February 2024

Abstract
We reported imaging findings with complex signs that were corresponded with both dementia with Lewy bodies (DLB) and Alzheimer disease (AD) in the case of a 78-year-old woman. Initially suspected as DLB due to cognitive and movement issues, diagnostic support included the cingulate island sign on 18F-FDG PET, positive 131I-MIBG cardiac scintigraphy, and DAT PET. However, MRI indicated hippocampal atrophy, and 18F-FDG PET showed hypometabolism in the medial temporal lobe, suggesting the possibility of concomitant AD. Subsequent detection of β-amyloid pathology and tau accumulation in the brain further supported the concurrent presence of AD pathology.
Aneurysmal 99mTc-HMPAO Uptake in Brain Death
Authors: Do Danka , Suhaj Petr , Benes Jiri , Matej Radoslav , Lang Otto 
Published: February 2024

Abstract
A 41-year-old man was admitted to hospital due to sudden loss of consciousness. A regional brain perfusion SPECT/low-dose CT showed abnormal 99mTc-HMPAO uptake in the right hemisphere frontotemporally without any other supratentorial or infratentorial radiotracer uptake. A neuropathological examination disclosed a middle cerebral artery aneurysm. Presumably, vessel wall fibrosis prevented collapse. Multiple transmural dissections of the fibrotic aneurysmal wall were the source of the subarachnoid hemorrhage. This interesting image shows that radiotracer accumulation in cerebral artery aneurysms can be a diagnostic pitfall in brain death scintigraphy assessment.
Pulmonary Mucoepidermoid Carcinoma Mimicking Carcinoid Lung on 18F-FDG and 68Ga-DOTANOC PET/CT
Authors: Jaleel Jasim , Damle Nishikant Avinash , Khurana Aditi , Joshi Mohit , Jain Deepali 
Published: February 2024

Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare pulmonary neoplasm. Although 18F-FDG PET/CT has been shown to present with increased metabolic activity in PMEC, literature does not report increased somatostatin receptor expression in these tumors. We present the case of a 15-year-old boy where PMEC mimicked a typical carcinoid of the lung on DOTANOC PET/CT by showing significant uptake on 68Ga-DOTANOC.
Perioperative Changes in Serum Transaminase Levels
Authors: Wang Fumin , Lu Jingming , Yang Tian , Ren Yaoxing , Ratti Francesca , Marques Hugo P. , Silva Silvia , Soubrane Olivier , Lam Vincent , Poultsides George A. , Popescu Irinel , Grigorie Razvan , Alexandrescu Sorin , Martel Guillaume , Workneh Aklile , Guglielmi Alfredo , Hugh Tom , Aldrighetti Luca , Endo Itaru , Lv Yi , Zhang Xu-Feng , Pawlik Timothy M. 
Published: February 2024

Objectives:
To define how dynamic changes in pre- versus post-operative serum aspartate aminotransferase (AST) and alanine aminotransaminase (ALT) levels may impact postoperative morbidity after curative-intent resection of hepatocellular carcinoma (HCC).

Background:
Hepatic ischemia/reperfusion can occur at the time of liver resection and may be associated with adverse outcomes following liver resection.

Methods:
Patients who underwent curative resection for HCC between 2010-2020 were identified from an international multi-institutional database. Changes in AST and ALT (CAA) on postoperative day (POD) 3 versus preoperative values (

) were calculated using the formula:

based on a fusion index via Euclidean norm, which was examined relative to the comprehensive complication index (CCI). The impact of CAA on CCI was assessed by the restricted cubic spline regression and Random Forest analyses.

Results:
A total of 759 patients were included in the analytic cohort. Median CAA was 1.7 (range, 0.9 to 3.25); 431 (56.8%) patients had a CAA<2, 215 (28.3%) patients with CAA 2-5, and 113 (14.9%) patients had CAA ≥5. The incidence of post-operative complications was 65.0% (n=493) with a median CCI of 20.9 (IQR, 20.9-33.5). Spline regression analysis demonstrated a non-linear incremental association between CAA and CCI. The optimal cutoff value of CAA=5 was identified by the recursive partitioning technique. After adjusting for other competing risk factors, CAA≥5 remained strongly associated with risk of post-operative complications (Ref. CAA<5, OR 1.63, 95%CI 1.05-2.55, P=0.03). In fact, the use of CAA to predict post-operative complications was very good in both the derivative (AUC 0.88) and external (ACU 0.86) cohorts (n=1137).

Conclusions:
CAA was an independent predictor of CCI after liver resection for HCC. Use of routine labs such as AST and ALT can help identify patients at highest risk of post-operative complications following HCC resection.
Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery
Authors: SenthilKumar Gopika , Verhagen Nathaniel B , Nimmer Kaitlyn , Yang Xin , Figueroa Castro Carlos E , Szabo Aniko , Taylor Bradley W , Wainaina Njeri , Gould Jon C , Kothari Anai N ,   on behalf of the N3C Consortium
Published: February 2024

BACKGROUND:
As the COVID-19 pandemic shifts to an endemic phase, an increasing proportion of patients with cancer and a preoperative history of COVID-19 will require surgery. This study aimed to assess the influence of preoperative COVID-19 on postoperative risk for major adverse cardiovascular and cerebrovascular events (MACEs) among those undergoing surgical cancer resection. Secondary objectives included determining optimal time-to-surgery guidelines based on COVID-19 severity and discerning the influence of vaccination status on MACE risk.

STUDY DESIGN:
National COVID Cohort Collaborative Data Enclave, a large multi-institutional dataset, was used to identify patients that underwent surgical cancer resection between January 2020 and February 2023. Multivariate regression analysis adjusting for demographics, comorbidities, and risk of surgery was performed to evaluate risk for 30-day postoperative MACE.

RESULTS:
Of 204,371 included patients, 21,313 (10.4%) patients had a history of preoperative COVID-19. History of COVID-19 was associated with an increased risk for postoperative composite MACE as well as 30-day mortality. Among patients with mild disease who did not require hospitalization, MACE risk was elevated for up to 4 weeks after infection. Postoperative MACE risk remained elevated more than 8 weeks after infection in those with moderate disease. Vaccination did not reduce risk for postoperative MACE.

CONCLUSIONS:
Together, these data highlight that assessment of the severity of preoperative COVID-19 infection should be a routine component of both preoperative patient screening as well as surgical risk stratification. In addition, strategies beyond vaccination that increase patients’ cardiovascular fitness and prevent COVID-19 infection are needed.
Effects of a diverse prebiotic fibre blend on inflammation, the gut microbiota, and affective symptoms: A pilot open label randomised controlled trial
Authors: Hall C.V. , Hepsomali P , Dalile B , Scapozza L , Gurry T. 
Published: February 2024

AbstractEmerging evidence suggests that low-grade systemic inflammation plays a key role in altering brain activity, behaviour, and affect. Modulation of the gut microbiota using prebiotic fibre offers a potential therapeutic tool to regulate inflammation, mediated via the production of short-chain fatty acids (SCFAs). However, the impact of prebiotic consumption on affective symptoms, and the possible contribution from inflammation, gut symptoms, and the gut microbiome, is currently underexamined. In this 12-week study, the effects of a diverse prebiotic blend on inflammation, gut microbiota profiles, and affective symptoms in a population with Metabolic Syndrome (MetS) was examined. Sixty patients meeting the criteria for MetS were randomised into a treatment group (n = 40), receiving 10g per day of a diverse prebiotic blend and healthy eating advice and a control group (n = 20), receiving healthy eating advice only. Our results showed a significant reduction in C-reactive protein (CRP), alongside improvements in self-reported affective scores in the treatment compared to the control group. While there were no differences in relative abundance between groups at week 12, there was a significant increase from baseline to week 12 inBifidobacteriumandParabacteroidesin the treatment group, both of which are recognised as SCFA producers. Multivariate regression analyses further revealed that changes in affective scores were positively associated with both gastrointestinal symptoms and CRP. Together, this study provides preliminary support for the use of a diverse prebiotic blend for mood, stress, and anxiety.