bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between resistance to cerebrospinal fluid flow and cardiac-induced brain tissue motion for Chiari malformation type I
Authors: Mohsenian Saeed , Ibrahimy Alaaddin , Al Samman Mohamad Motaz F. , Oshinski John N. , Bhadelia Rafeeque A. , Barrow Daniel L. , Allen Philip A. , Amini Rouzbeh , Loth Francis 
Published: August 2023

Abstract
Purpose
Chiari malformation type I (CMI) patients have been independently shown to have both increased resistance to cerebrospinal fluid (CSF) flow in the cervical spinal canal and greater cardiac-induced neural tissue motion compared to healthy controls. The goal of this paper is to determine if a relationship exists between CSF flow resistance and brain tissue motion in CMI subjects.

Methods
Computational fluid dynamics (CFD) techniques were employed to compute integrated longitudinal impedance (ILI) as a measure of unsteady resistance to CSF flow in the cervical spinal canal in thirty-two CMI subjects and eighteen healthy controls. Neural tissue motion during the cardiac cycle was assessed using displacement encoding with stimulated echoes (DENSE) magnetic resonance imaging (MRI) technique.

Results
The results demonstrate a positive correlation between resistance to CSF flow and the maximum displacement of the cerebellum for CMI subjects (r = 0.75, p = 6.77 × 10−10) but not for healthy controls. No correlation was found between CSF flow resistance and maximum displacement in the brainstem for CMI or healthy subjects. The magnitude of resistance to CSF flow and maximum cardiac-induced brain tissue motion were not statistically different for CMI subjects with and without the presence of five CMI symptoms: imbalance, vertigo, swallowing difficulties, nausea or vomiting, and hoarseness.

Conclusion
This study establishes a relationship between CSF flow resistance in the cervical spinal canal and cardiac-induced brain tissue motion in the cerebellum for CMI subjects. Further research is necessary to understand the importance of resistance and brain tissue motion in the symptomatology of CMI.
Prognostic impact of soluble PD-L1 derived from tumor-associated macrophages in non-small-cell lung cancer
Authors: Teramoto Koji , Igarashi Tomoyuki , Kataoka Yoko , Ishida Mitsuaki , Hanaoka Jun , Sumimoto Hidetoshi , Daigo Yataro 
Published: August 2023

AbstractProgrammed cell death-ligand 1 (PD-L1) on tumor cells can be degraded to soluble form (sPD-L1) and enter circulation, however, the clinical significances of sPD-L1 in peripheral blood remains to be elucidated in non-small-cell lung cancer (NSCLC). We monitored plasma sPD-L1 levels during perioperative periods and evaluated PD-L1-positive cells in tumor tissues in patients with operable NSCLC. Then the correlation between preoperative plasma sPD-L1 levels and relapse-free survival (RFS) was analyzed retrospectively. In patients who underwent radical surgery (n = 61), plasma sPD-L1 levels (median; 63.5 pg/mL) significantly increased 1 month after surgery (72.2 pg/mL, P < 0.001). The combined score of PD-L1-positive cells including tumor cells and tumor-associated macrophages (TAMs) was significantly associated with preoperative plasma sPD-L1 levels. In patients with high levels of preoperative plasma sPD-L1, the probability of 5-year RFS was significantly poor for patients with low PD-L1 expression intensity of tumor cells (tcPD-L1) compared with those with high tcPD-L1 (33.3% vs. 87.5%, respectively, P = 0.016; 95% CI, 0.013–0.964). In former group, PD-L1-positive TAMs were markedly infiltrating compared with those from latter group (246.4 vs. 76.6 counts/mm2, respectively, P = 0.003). In NSCLC, plasma sPD-L1 can reflect the accumulation of PD-L1-posotive TAMs, not just PD-L1-positive tumor cells. In patients with high levels of preoperative plasma sPD-L1, the prognoses after surgery depends on which PD-L1-positive cells, tumor cells or TAMs, are the primary source of the sPD-L1. Thus, measuring both plasma sPD-L1 levels and PD-L1 expression status of tumor cells and TAMs is of benefit for assessment of postoperative prognosis in operable NSCLC.
Fully automated computational measurement of noise in positron emission tomography
Authors: Sartoretti Thomas , Skawran Stephan , Gennari Antonio G. , Maurer Alexander , Euler André , Treyer Valerie , Sartoretti Elisabeth , Waelti Stephan , Schwyzer Moritz , von Schulthess Gustav K. , Burger Irene A. , Huellner Martin W. , Messerli Michael 
Published: August 2023

Abstract
Objectives
To introduce an automated computational algorithm that estimates the global noise level across the whole imaging volume of PET datasets.

Methods
[18F]FDG PET images of 38 patients were reconstructed with simulated decreasing acquisition times (15–120 s) resulting in increasing noise levels, and with block sequential regularized expectation maximization with beta values of 450 and 600 (Q.Clear 450 and 600). One reader performed manual volume-of-interest (VOI) based noise measurements in liver and lung parenchyma and two readers graded subjective image quality as sufficient or insufficient. An automated computational noise measurement algorithm was developed and deployed on the whole imaging volume of each reconstruction, delivering a single value representing the global image noise (Global Noise Index, GNI). Manual noise measurement values and subjective image quality gradings were compared with the GNI.

Results
Irrespective of the absolute noise values, there was no significant difference between the GNI and manual liver measurements in terms of the distribution of noise values (p = 0.84 for Q.Clear 450, and p = 0.51 for Q.Clear 600). The GNI showed a fair to moderately strong correlation with manual noise measurements in liver parenchyma (r = 0.6 in Q.Clear 450, r = 0.54 in Q.Clear 600, all p < 0.001), and a fair correlation with manual noise measurements in lung parenchyma (r = 0.52 in Q.Clear 450, r = 0.33 in Q.Clear 600, all p < 0.001). Classification performance of the GNI for subjective image quality was AUC 0.898 for Q.Clear 450 and 0.919 for Q.Clear 600.

Conclusion
An algorithm provides an accurate and meaningful estimation of the global noise level encountered in clinical PET imaging datasets.

Clinical relevance statement
An automated computational approach that measures the global noise level of PET imaging datasets may facilitate quality standardization and benchmarking of clinical PET imaging within and across institutions.

Key Points
• Noise is an important quantitative marker that strongly impacts image quality of PET images.
• An automated computational noise measurement algorithm provides an accurate and meaningful estimation of the global noise level encountered in clinical PET imaging datasets.
• An automated computational approach that measures the global noise level of PET imaging datasets may facilitate quality standardization and benchmarking as well as protocol harmonization.
Evaluation of standard breast ultrasonography by adding two-dimensional and three-dimensional shear wave elastography: a prospective, multicenter trial
Authors: Xu Jinshun , Zhang Lei , Wen Wen , He Yushuang , Wei Tianci , Zheng Yanling , Pan Xiaofang , Li Yuhong , Wu Yiyun , Dong Fenglin , Zhang Heqing , Cheng Wen , Xu Hongchun , Zhang Yingchun , Bao Lingyun , Zhang Xinguo , Tang Shichu , Liao Jintang , Luo Honghao , Zhao Haina , Tian Jiawei , Peng Yulan 
Published: August 2023

Abstract
Objective
To reduce the number of biopsies performed on benign breast lesions categorized as BI-RADS 4–5, we investigated the diagnostic performance of combined two-dimensional and three-dimensional shear wave elastography (2D + 3D SWE) with standard breast ultrasonography (US) for the BI-RADS assessment of breast lesions.

Methods
A total of 897 breast lesions, categorized as BI-RADS 3–5, were subjected to standard breast US and supplemented by 2D SWE only and 2D + 3D SWE analysis. Based on the malignancy rate of less than 2% for BI-RADS 3, lesions assessed by standard breast US were reclassified with SWE assessment.

Results
After standard breast US evaluation, 268 (46.1%) participants underwent benign biopsies in BI-RADS 4–5 lesions. By using separated cutoffs for upstaging BI-RADS 3 at 120 kPa and downstaging BI-RADS 4a at 90 kPa in 2D + 3D SWE reclassification, 123 (21.2%) participants underwent benign biopsy, resulting in a 54.1% reduction (123 versus 268).

Conclusion
Combining 2D + 3D SWE with standard breast US for reclassification of BI-RADS lesions may achieve a reduction in benign biopsies in BI-RADS 4–5 lesions without sacrificing sensitivity unacceptably.

Clinical relevance statement
Combining 2D + 3D SWE with US effectively reduces benign biopsies in breast lesions with categories 4–5, potentially improving diagnostic accuracy of BI-RADS assessment for patients with breast lesions.

Trial registration
ChiCTR1900026556

Key Points
• Reduce benign biopsy is necessary in breast lesions with BI-RADS 4–5 category.
• A reduction of 54.1% on benign biopsies in BI-RADS 4–5 lesions was achieved using 2D + 3D SWE reclassification.
• Adding 2D + 3D SWE to standard breast US improved the diagnostic performance of BI-RADS assessment on breast lesions: specificity increased from 54 to 79%, and PPV increased from 54 to 71%, with slight loss in sensitivity (97.2% versus 98.7%) and NPV (98.1% versus 98.7%).
Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer
Authors: Sassi Antti , Salminen Annukka , Jukkola Arja , Tervo Maija , Mäenpää Niina , Turtiainen Saara , Tiainen Leena , Liimatainen Timo , Tolonen Teemu , Huhtala Heini , Rinta-Kiikka Irina , Arponen Otso 
Published: August 2023

Abstract
Objectives
To assess whether mammographic breast density in women diagnosed with breast cancer correlates with the total number of incidental magnetic resonance imaging (MRI)-detected lesions and the likelihood of the lesions being malignant.

Methods
Patients diagnosed with breast cancer meeting the EUSOBI and EUSOMA criteria for preoperative breast MRI routinely undergo mammography and ultrasound before MRI at our institution. Incidental suspicious breast lesions detected in MRI are biopsied. We included patients diagnosed with invasive breast cancers between 2014 and 2019 who underwent preoperative breast MRI. One reader retrospectively determined breast density categories according to the 5th edition of the BI-RADS lexicon.

Results
Of 946 patients with 973 malignant primary breast tumors, 166 (17.5%) had a total of 175 (18.0%) incidental MRI-detected lesions (82 (46.9%) malignant and 93 (53.1%) benign). High breast density according to BI-RADS was associated with higher incidence of all incidental enhancing lesions in preoperative breast MRIs: 2.66 (95% confidence interval: 1.03–6.86) higher for BI-RADS density category B, 2.68 (1.04–6.92) for category C, and 3.67 (1.36–9.93) for category D compared to category A (p < 0.05). However, high breast density did not predict higher incidence of malignant incidental lesions (p = 0.741). Incidental MRI-detected lesions in the contralateral breast were more likely benign (p < 0.001): 18 (27.3%)/48 (72.7%) vs. 64 (58.7%)/45 (41.3%) malignant/benign incidental lesions in contralateral vs. ipsilateral breasts.

Conclusion
Women diagnosed with breast cancer who have dense breasts have more incidental MRI-detected lesions, but higher breast density does not translate to increased likelihood of malignant incidental lesions.

Clinical relevance statement
Dense breasts should not be considered as an indication for preoperative breast MRI in women diagnosed with breast cancer.

Key Points
• The role of preoperative MRI of patients with dense breasts diagnosed with breast cancer is under debate.
• Women with denser breasts have a higher incidence of all MRI-detected incidental breast lesions, but the incidence of malignant MRI-detected incidental lesions is not higher than in women with fatty breasts.
• High breast density alone should not indicate preoperative breast MRI.
CT acquisition parameter selection in the real world: impacts on radiation dose and variation amongst 155 institutions
Authors: Wang Yifei , Chu Philip , Szczykutowicz Timothy P. , Stewart Carly , Smith-Bindman Rebecca 
Published: August 2023

Abstract
Objective
Quantify the relationship between CT acquisition parameters and radiation dose, how often parameters are adjusted in real-world practice, and their degree of contribution to real-world dose distribution. Identify discrepancies between parameters that are impactful in theory and impactful in practice.

Methods
This study analyses 1.3 million consecutive adult routine abdomen exams performed between November 2015 and Jan 2021 included in the University of California, San Francisco International CT Dose Registry of 155 institutions. We calculated geometric standard deviation (gSD) for five parameters (kV, mAs, spiral pitch, number of phases, scan length) to assess variation in practice. A Gaussian mixed regression model was performed to predict the radiation dose-length product (DLP) using the parameters. Three conceptualizations of “impact” were computed for each parameter. To reflect the theoretical impact, we predict the increase in DLP per 10% (and 15%) increase in the parameter. To reflect the real-world practical impact, we predict the increase in DLP per gSD increase in the parameter.

Results
Among studied examinations, mAs, number of phases, and scan length were frequently manipulated (gSD 1.52–1.70); kV was rarely manipulated (gSD 1.07). Theoretically, kV is the most impactful parameter (29% increase in DLP per 10% increase in kV, versus 5–9% increase for other parameters). In real-world practice, kV is less impactful; for each gSD increase in kV, the DLP increases by 20%, versus 22–69% for other parameters.

Conclusion
Despite the potential impact of kV on radiation dose, this parameter is rarely manipulated in common practice and this potential remains untapped.

Clinical relevance statement
CT beam energy (kV) modulation has the potential to strongly reduce radiation over-dosage to the patient, theoretically more so than similar degrees of modulation in other CT acquisition parameters. Despite this, beam energy modulation rarely occurs in practice, leaving its potential untapped.

Key Points
• The relationship between CT acquisition parameter selection and radiation dose roughly coincided with established theoretical understanding.
• CT acquisition parameters differ from each other in frequency and magnitude of manipulation, with beam energy (kV) being rarely manipulated.
• Beam energy (kV) has the potential to substantially impact radiation dose, but because it is rarely manipulated, it is the least impactful CT acquisition parameter affecting radiation dose in practice.
Outcomes and potential impact of a virtual hands-on training program on MRI staging confidence and performance in rectal cancer
Authors: El Khababi Najim , Beets-Tan Regina G. H. , Tissier Renaud , Lahaye Max J. , Maas Monique , Curvo-Semedo Luís , Dresen Raphaëla C. , van Griethuysen Joost J. M. , Nougaret Stephanie , Beets Geerard L. , van Triest Baukelien , Taylor Stuart A. , Lambregts Doenja M. J. 
Published: August 2023

Abstract
Objectives
To explore the potential impact of a dedicated virtual training course on MRI staging confidence and performance in rectal cancer.

Methods
Forty-two radiologists completed a stepwise virtual training course on rectal cancer MRI staging composed of a pre-course (baseline) test with 7 test cases (5 staging, 2 restaging), a 1-day online workshop, 1 month of individual case readings (n = 70 cases with online feedback), a live online feedback session supervised by two expert faculty members, and a post-course test. The ESGAR structured reporting templates for (re)staging were used throughout the course. Results of the pre-course and post-course test were compared in terms of group interobserver agreement (Krippendorf’s alpha), staging confidence (perceived staging difficulty), and diagnostic accuracy (using an expert reference standard).

Results
Though results were largely not statistically significant, the majority of staging variables showed a mild increase in diagnostic accuracy after the course, ranging between + 2% and + 17%. A similar trend was observed for IOA which improved for nearly all variables when comparing the pre- and post-course. There was a significant decrease in the perceived difficulty level (p = 0.03), indicating an improved diagnostic confidence after completion of the course.

Conclusions
Though exploratory in nature, our study results suggest that use of a dedicated virtual training course and web platform has potential to enhance staging performance, confidence, and interobserver agreement to assess rectal cancer on MRI virtual training and could thus be a good alternative (or addition) to in-person training.

Clinical relevance statement
Rectal cancer MRI reporting quality is highly dependent on radiologists’ expertise, stressing the need for dedicated training/teaching. This study shows promising results for a virtual web-based training program, which could be a good alternative (or addition) to in-person training.

Key Points
• Rectal cancer MRI reporting quality is highly dependent on radiologists’ expertise, stressing the need for dedicated training and teaching.
• Using a dedicated virtual training course and web-based platform, encouraging first results were achieved to improve staging accuracy, diagnostic confidence, and interobserver agreement.
• These exploratory results suggest that virtual training could thus be a good alternative (or addition) to in-person training.
Analysis of inflammatory markers and tau deposits in an autopsy series of nine patients with anti-IgLON5 disease
Authors: Berger-Sieczkowski Evelyn , Endmayr Verena , Haider Carmen , Ricken Gerda , Jauk Philipp , Macher Stefan , Pirker Walter , Högl Birgit , Heidbreder Anna , Schnider Peter , Bradley-Zechmeister Eszter , Mariotto Sara , Koneczny Inga , Reinecke Raphael , Kasprian Gregor , Weber Corinna , Bergmann Melanie , Milenkovic Ivan , Berger Thomas , Gaig Carles , Sabater Lidia , Graus Francesc , Gelpi Ellen , Höftberger Romana 
Published: August 2023

AbstractAnti-IgLON5 disease is a rare neurological, probably autoimmune, disorder associated in many cases with a specific tauopathy. Only a few post-mortem neuropathological studies have been reported so far. Little is known about the pathogenic mechanisms that result in neurodegeneration. We investigated the neuropathology of anti-IgLON5 disease and characterized cellular and humoral inflammation. We included nine cases (six of them previously published). Median age of patients was 71 years (53–82 years), the median disease duration was 6 years (0.5–13 years), and the female to male ratio was 5:4. Six cases with a median disease duration of 9 years presented a prominent tauopathy. Five of them had a classical anti-IgLON5-related brainstem tauopathy and another presented a prominent neuronal and glial 4-repeat tauopathy, consistent with progressive supranuclear palsy (PSP). Three cases with short disease duration (median 1.25 years) only showed a primary age-related neurofibrillary pathology. Inflammatory infiltrates of T and B cells were mild to moderate and did not significantly differ between anti-IgLON5 disease cases with or without tauopathy. In contrast, we found an extensive neuropil deposition of IgG4 in the tegmentum of the brainstem, olivary nucleus, and cerebellar cortex that was most prominent in two patients with short disease duration without the typical IgLON5-related tauopathy. The IgG4 deposits were particularly prominent in the cerebellar cortex and in these regions accompanied by mild IgG1 deposits. Activated complement deposition (C9neo) was absent. Our study indicates that IgLON5-related tau pathology occurs in later disease stages and may also present a PSP-phenotype with exclusively 4-repeat neuronal and glial tau pathology. The prominent deposition of anti-IgLON5 IgG4 at predilection sites for tau pathology suggests that anti-IgLON5 antibodies precede the tau pathology. Early start of immunotherapy might prevent irreversible neuronal damage and progression of the disease, at least in a subgroup of patients.
A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery
Authors: Danese Carla , Di Bin Francesco , Lanzetta Paolo 
Published: August 2023

Abstract
Purpose
To examine the feasibility and outcomes of a modified technique for the implantation of scleral fixated Carlevale intraocular lens (IOL) (I71 FIL SSF. Soleko IOL Division, Pontecorvo, Italy), and to analyze the occurrence of adverse events.

Methods
This is a retrospective observational study conducted revising patients charts from 2018 to 2023. Thirty-five eyes of 33 patients were included. Patients requiring IOL explantation had either IOL dislocation or opacification. The implantation of the Carlevale IOL was performed with the subconjunctival positioning of the anchors without any scleral flap. All maneuvers were performed transconjunctivally. The anatomical outcomes considered were IOL positioning, and the absence of postoperative complications. The functional outcomes analyzed were best correctedvisual acuity (BCVA) and refraction.

Results
In all the cases, the IOL was well positioned and centered postoperatively. No cases of conjunctival erosion were recorded. The best corrected visual acuity (BCVA) was 0.9±0.6 logMar (mean±standard deviation) preoperatively and 0.5±0.5 logMar (mean±standard deviation) postoperatively. The mean preoperative spherical equivalent was +6.8±7.7 dioptres, while postoperatively it was -1.1±1.6 dioptres. The most frequent procedure associated to secondary IOL implantation was posterior vitrectomy (25 eyes, 71.4%), which was performed with 25-gauge transconjunctival cannulas in the ciliary sulcus. The follow-up period was 24.5±16.9 months (mean±standard deviation).

Conclusion
The described mini-invasive technique for Carlevale IOL implantation is safe and effective. It can be recommended either as a stand-alone operation or associated to concurrent surgical procedures.
Constructing childhood depression: a qualitative study with international experts in child psychiatry
Authors: Rayapoullé Alexis , de Chassey Marine , Benoit Laelia , Hassler Christine , Falissard Bruno 
Published: August 2023

AbstractAfter decades of controversy, the concept of childhood depression now seems to be part of standard medical knowledge. Yet the form and content of this nosological entity, like many psychiatric diseases, is continuously shaped by the scientific, clinical, and political communities involved in child psychiatry. In this qualitative study, we explored how the concept of childhood depression is constructed in early twenty-first century child psychiatry. We conducted a series of 18 interviews with practising child psychiatrists, international experts in the field, and interpreted them with thematic analysis informed by discourse analysis. We identified five overarching discourse themes across interviews, relating to the definition of depression, the diagnostic process, the causes of this condition, the therapeutic strategy, and the scientific role of child psychiatry. Most participants agreed that childhood depression was a mental disorder where irritability prevailed, heavily influenced by psychosocial factors, and for which psychotherapy was the ideal treatment. However, subtle points of dissent also surfaced: whether depression is primarily a mood state or psychological suffering, whether categories or dimensions are more suitable to make the diagnosis, and whether there is a genetic predisposition were some of the most controversial topics. Theoretical considerations regarding childhood depression may have significant scientific, moral, and socio-political implications beyond child psychiatry and should be addressed appropriately.