bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creating a Policy for Coverage of Lymphatic Surgery: Addressing a Critical Unmet Need
Authors: Johnson Anna Rose , Otenti Desiree , Bates Kathy D. , Repicci William , Dallow Katherine , Deterling William , Lee Bernard T. , Singhal Dhruv 
Published: February 2023

SUMMARY:
Our paper will describe the key stakeholders and process involved in developing an insurance policy in the United States to establish medical necessity criteria for lymphatic surgery procedures. Lymphedema is a chronic health issue that impacts over 1.2 million patients and is associated with lifelong health, economic, and psychosocial costs. Patients affected have been described as “medical nomads”, as they often interface with multiple providers before receiving an accurate diagnosis and treatment. This underscores the lack of attention and understanding about this disease across all sectors of the medical system. Unlike nations including Sweden and the United Kingdom, which provide insurance coverage for treatment, the United States has lagged behind. As a country, we have neglected to fully recognize the consequences of inadequate treatment of lymphedema, including chronic morbidities such as loss of mobility, psychosocial sequelae, recurrent infections, and even death. Recently, our Lymphatic Center had the unique opportunity to help develop a policy that merged our clinical experience, recently established lymphatic care center of excellence criteria, and third-party payer policy expertise. This experience spanned one year from June 2018 to June 2019. We identify how key partnerships helped fill evidentiary gaps that ultimately resulted in policy change.
Mental nerve distribution and connections in the lower lip: Anatomical basis for the recovery of sensation following inferior alveolar nerve damage
Authors: Toure Gaoussou 
Published: February 2023

Background:
Inferior alveolar nerve damage is one of the most common complications of surgery on the lower third of the face. It can have a significant psychological and social impact, and its evolution varies in terms of the duration and degree of recovery. In the literature, few studies adequately explain this phenomenon. We therefore aim to establish the anatomical basis of recovery and its variability.

Methods:
We studied 60 mental nerves on 30 lips. A total of 25 lips were studied in situ, including five receiving an intra-arterial injection of latex, while five lips were removed and dissected under transillumination.

Results:
We identified three types of intralabial distribution of the mental nerves: type I: Absence of connections ; type II : connections on the upper third of the lower lip; type III: Connections on the upper, middle, and lower third of the lower lip. Some cases also had a dominant side with more numerous fibers and a larger diameter than the contralateral side.

Conclusions:
Rapid or total recovery after inferior alveolar nerve damage is well known. Our study showed the nerve map to repair nerve damage, and for the first time to our knowledge, it highlighted the connections between the mental nerves in the lip. Types II and III allow the
Hospital Mortality and Trainee Experiences: How General Medical Council Survey Findings Correlate With Summary Hospital-Level Mortality Indicator
Authors: Barton Jack Charles , Richardson Daniel , Corrigan Amber Elyse , Kuri Ashvin , Round Jonathan 
Published: February 2023

Objectives
This study aimed to investigate whether components of junior doctor satisfaction are associated with patient mortality within the United Kingdom.

Methods
We conducted a cross-sectional study of publicly available data (the General Medical Council [GMC] National Survey and the Summary Hospital-level Mortality Indicator [SHMI]) pertaining to subjective physician trainee satisfaction and patient mortality within 80 United Kingdom–based healthcare institutions. The direction and strength of correlation between components of the GMC National Survey and relative patient mortality as described by the SHMI were calculated. Additional outcomes included mean GMC survey scores for reported domains and mean SHMI by healthcare institution.

Results
SHMI for included healthcare institutions ranged from 0.69 to 1.21 (mean [SD], 1.01 [0.1]). Mean GMC domain scores ranged between 44.61 and 88.62 (mean [SD], 71.16 [10.84]). Statistically significant correlations were observed for clinical supervision, clinical supervision out of hours, rota design, overall satisfaction, and teamwork. After application of Bonferroni correction, statistically significant correlations remained for both clinical supervision and clinical supervision out of hours.

Conclusions
There is a significant association between components of subjective trainee satisfaction and patient mortality within the United Kingdom. Further investigation to examine these relationships, perhaps to target intervention, may prevent avoidable patient harm.
Fracture prevalence and its association with bone density among children living with HIV in Zimbabwe
Authors: Rukuni Ruramayi , Simms Victoria , Rehman Andrea M. , Mukwasi-Kahari Cynthia , Mujuru Hilda , Ferrand Rashida A. , Gregson Celia L. 
Published: February 2023

Objectives:
HIV infection impairs bone density in children living with HIV (CLWH). We aimed to determine the prevalence of self-reported fracture (past or current), associated risk factors and disability, by HIV status in Zimbabwean children.

Design:
Cross-sectional study.

Methods:
We recruited CLWH aged 8–16 years taking antiretroviral therapy (ART) for ≥2 years from HIV clinics, and HIV-uninfected children from schools in Harare. Interviewer-administered questionnaires collected data on fracture site and management, sociodemographics, dietary calcium and vitamin D, physical activity and HIV history. Dual-energy X-ray absorptiometry (DXA) measured size-adjusted bone density.

Results:
We recruited 303 CLWH [mean (SD) age 12.5 (2.5) years; 50% female] and 306 children without HIV [12.5 (2.5) years; 51% female]. Median age at HIV diagnosis in CLWH was 3.0 years [interquartile range (IQR) 1.2, 5.9], and median ART duration 8.1 years [IQR 6.2, 9.5]. 53.8% CLWH had self-reported disability and/or functional impairment, vs. 29.4% children without HIV. Fracture prevalence was 5.9% with no difference by HIV status [21/306 (6.9%) vs. 14/303 (4.6%), P = 0.24]. Male sex was associated with fractures. Low size-adjusted bone density (Z-score < −2) was associated with prevalent fractures in CLWH {risk ratio [RR] 1.14 (95% confidence interval (CI) −0.02, 2.29]}, but not in children without HIV [RR −0.04 (−2.00, 1.91)], P-interaction = 0.27. All sought medical attention for their fracture(s), but CLWH were less often admitted to hospital [2/14 (14.3%) vs. 7/21 (33.3%)].

Conclusion:
Prevalent fractures may be associated with low lumbar spine bone density in CLWH. Fracture surveillance and strategies to reduce future fracture risk are warranted as CLWH enter adulthood.
Adverse events and SARS-CoV-2 antibody responses after immunization with Sputnik V, ChAdOx1-S, and BBIBP-CorV vaccines in people with HIV
Authors: Mauas Romina , Urueña Analia , Cecchini Diego , Strada Maria L. , Arietti Soledad , Cassetti Isabel , Nogueira Nicholas F. , Salazar Ana S. , Rodriguez Violeta J. , Jones Deborah L. , Alcaide Maria L. 
Published: February 2023

Objective:
This study describes adverse events following immunization (AEFIs) and the development of SARS-COV-2 antibodies after Sputnik V, AstraZeneca, and Sinopharm COVID-19 vaccination in people with HIV (PWH).

Methods:
In total, 595 adult PWH at an HIV center in Argentina from March to December 2021 were enrolled. Analysis included participants who received COVID-19 vaccination with Sputnik V, AstraZeneca, and Sinopharm, and did not receive mRNA COVID-19 vaccines. Clinical data, and local or systemic AEFI variables were collected using an online questionnaire after the first dose. Detection of S1-RBD IgG antibodies was performed between days 28 and 60 after the second dose in a subsample (SARS-CoV-2 IgG chemiluminescent immunoassay; Siemens). A multivariable logistic regression and spearman test were used for analyses.

Results:
Mean age was 46.1 years (SD = 11.8); 70.4% were men; and median CD4+ T cells count was 659 (500–852) cells/μl. AEFIs were reported in 214 (36.0%) participants. More participants reported AEFIs after Sputnik V (29.4%) and AstraZeneca (47.5%) than Sinopharm (13.9%) (χ2 = 35.85, P < 0.001). Higher odds of reporting an AEFIs were associated with receiving Sputnik V [aOR = 2.90; 95% confidence interval (95% CI) = 1.40–6.04; P = 0.004] and AstraZeneca (aOR = 5.38; 95% CI = 2.63–11.01; P < 0.001) compared with Sinopharm. Lower odds were associated with age (aOR = 0.97; 95% CI = 0.95–0.99; P < 0.001). Overall, 76 (95.0%) individuals assessed for the presence of SARS-CoV-2 antibody reached S1-RBD IgG antibody titers at least 1 U/ml; mean titer was 51.3 (SD = 51.07) U/ml. Higher antibody titers correlated with higher CD4+ T cells count (Rho = 0.280; P = 0.012).

Conclusion:
NonmRNA vaccines showed a good safety profile and adequate SARS-CoV-2 antibody responses among PWH suggesting adequate protection to SARS-CoV-2.
Decentralized, Integrated Treatment of RR/MDR-TB and HIV Using a Bedaquiline-Based, Short-Course Regimen Is Effective and Associated With Improved HIV Disease Control
Authors: Govender Thiloshini , Jham Menal A. , Zhang Justin C. , Pillay Selvan , Pak Youngju , Pillay Prenisha , Furin Jennifer , Malenfant Jason , Murphy Richard A. 
Published: February 2023

Background:
In decentralized sites, with fewer resources and a high prevalence of advanced HIV, the effectiveness of the new short-course, bedaquiline-based regimen for rifampicin-resistant and multidrug-resistant tuberculosis (RR/MDR-TB) is not well-described.

Setting:
Adults with pulmonary RR/MDR-TB initiating the short-course regimen in KwaZulu-Natal, South Africa were prospectively enrolled at a decentralized program that integrated person-centered TB care.

Methods:
In addition to standard of care monitoring, study visits occurred at enrollment and months 1, 2, 4, 6, and 9. Favorable RR/MDR-TB outcome was defined as cure or treatment completion without loss to follow-up, death, or failure by treatment. In patients with HIV, we assessed antiretroviral therapy (ART) uptake, virologic and immunologic outcomes.

Results:
Among 57 patients, HIV was present in 73.7% (95% CI: 60.3–84.5), with a median CD4 count of 170 cells/mm3 (intraquartile range 49–314). A favorable RR/MDR-TB outcome was achieved in 78.9% (CI: 67.1–87.9). Three deaths occurred, all in the setting of baseline advanced HIV and elevated viral load. Overall, 21.1% (95% CI: 12.1–32.9) experienced a severe or life-threatening adverse event, the most common of which was anemia. Among patients with HIV, enrollment resulted in increased ART uptake by 24% (95% CI: 12.1%–39.4%), a significant improvement from baseline (P = 0.004); virologic suppression during concomitant treatment was observed in 71.4% (n = 30, 95% CI: 55.4–84.3).

Conclusion:
Decentralized, person-centered care for RR/MDR-TB in patients with HIV using the short-course, bedaquiline-based regimen is effective and safe. In patients with HIV, enrollment led to improved ART use and reassuring virologic outcomes.
Beyond Antiretroviral Treatment: Patterns and Factors Associated With Composite Medication Adherence Before and During the COVID-19 Pandemic in Patients With HIV With Multiple Chronic Conditions
Authors: Miller Michael J. , Eberhart Lindsay G. , Jefferson Celeena R. , Horberg Michael A. 
Published: February 2023

Background:
Polypharmacy for multiple chronic conditions (MCCs) poses an increasing challenge in people with HIV (PWH). This research explores medication adherence in PWH with MCCs before and during COVID-19.

Setting:
Kaiser Permanente Mid-Atlantic States.

Methods:
Medical and pharmacy records of a continuously enrolled cohort (September 2018–September 2021) of adult PWH were used. To estimate medication adherence, monthly proportion of days covered (PDC) was measured individually for antiretrovirals (ARVs), diabetes medications (DMs), renin–angiotensin antagonists (RASMs), and statins (SMs) and combined into composite measures (CMs) with and without ARVs. Descriptive statistics, time-series models, and multivariable population-averaged panel general estimating equations were used to profile trends, effects, and factors associated with adherence.

Results:
The cohort (n = 543) was predominantly 51–64 years old (59.3%), Black (73.1%), male (69.2%), and commercially insured (65.4%). Two-thirds (63.7%) of patients were taking medications in 2 medication groups (ie, ARVs and either DMs, RASMs, or SMs), 28.9% were taking medications in 3 medication groups, and 7.4% were taking medications in all 4 medication groups. Overall, PDC for CMs without ARVs was 77.2% and 70.2% with ARVs. After March 2020, negative monthly trends in PDC were observed for CMs without ARVs (β = −0.1%, P = 0.003) and with ARVs (β = −0.3%, P = 0.001). For CMs with ARVs, Black race (aOR = 0.5; P < 0.001; ref: White) and taking medications for 3 medication groups (aOR = 0.8; P < 0.02; ref: 2) were associated with lower adherence.

Conclusion:
Decreasing medication adherence trends were observed during the COVID-19 pandemic with variations among population subgroups. Opportunity exists to improve medication adherence for non-White populations and those taking medications for MCCs beyond ARVs.
The Effects of Participation in an Intensive HIV Prevention Trial on Long-Term Socio-Demographic Outcomes Among Young Women in Rural South Africa
Authors: Stoner Marie C.D. , Browne Erica N. , Kabudula Chodziwadziwa , Rosenberg Molly , Gomez- Olive F. Xavier , Neilands Torsten B. , Kang Dufour Mi-Suk , Ahern Jennifer , Kahn Kathleen , Lippman Sheri A. , Pettifor Audrey E. 
Published: February 2023

Background:
Research trial participation may influence health outcomes regardless of the intervention assigned, but is often not assessed.

Setting:
We investigated how participation in an HIV prevention trial (the HIV Prevention Trials Network (HPTN) 068 study) affected health outcomes 4 years after the study in adolescent girls and young women in South Africa beyond effects of the tested intervention.

Methods:
We developed an analytical cohort that included the HIV Prevention 068 trial (HPTN 068) trial participants from the Agincourt Health and Demographic Surveillance System and resembled HPTN 068 trial enrollees (aged 13–20 years and in grades 8–11 in 2011) using inverse probability of treatment weights. We estimated risk differences for the association between trial participation and education and early parity (age <20 years) in 2019, after accounting for differences at baseline between the trial participants and nonparticipants.

Results:
There were 3442 young women enrolled in grades 8–11 in 2011; 1669 were in the HPTN 068 trial. Trial participants were more likely to have completed secondary school by 2019 (adjusted RD (aRD) 5.0%, 95% confidence interval (CI) 2.2%, 7.9%; 82.3% in trial participants vs. 77.2% in nonparticipants). Trial participants had similar risk of parity before age 20 compared with nontrial participants (aRD 2.3%, 95% CI: −0.8%, 5.5%).

Conclusions:
Trial participation did not seem to influence early parity, but did increase educational attainment. Our results are compatible with an explanation of Hawthorne effects from trial participation on schooling behaviors that were small, but observable even 4 years after the end of the trial.
Multimodal In Vivo Tracking of Chimeric Antigen Receptor T Cells in Preclinical Glioblastoma Models
Authors: Wu Wei Emma , Chang Edwin , Jin Linchun , Liu Shiqin , Huang Ching-Hsin , Kamal Rozy , Liang Tie , Aissaoui Nour Mary , Theruvath Ashok J. , Pisani Laura , Moseley Michael , Stoyanova Tanya , Paulmurugan Ramasamy , Huang Jianping , Mitchell Duane A. , Daldrup-Link Heike E. 
Published: February 2023

Objectives
Iron oxide nanoparticles have been used to track the accumulation of chimeric antigen receptor (CAR) T cells with magnetic resonance imaging (MRI). However, the only nanoparticle available for clinical applications to date, ferumoxytol, has caused rare but severe anaphylactic reactions. MegaPro nanoparticles (MegaPro-NPs) provide an improved safety profile. We evaluated whether MegaPro-NPs can be applied for in vivo tracking of CAR T cells in a mouse model of glioblastoma multiforme.

Materials and Methods
We labeled tumor-targeted CD70CAR (8R-70CAR) T cells and non–tumor-targeted controls with MegaPro-NPs, followed by inductively coupled plasma optical emission spectroscopy, Prussian blue staining, and cell viability assays. Next, we treated 42 NRG mice bearing U87-MG/eGFP-fLuc glioblastoma multiforme xenografts with MegaPro-NP-labeled/unlabeled CAR T cells or labeled untargeted T cells and performed serial MRI, magnetic particle imaging, and histology studies. The Kruskal-Wallis test was conducted to evaluate overall group differences, and the Mann-Whitney U test was applied to compare the pairs of groups.

Results
MegaPro-NP-labeled CAR T cells demonstrated significantly increased iron uptake compared with unlabeled controls (P < 0.01). Cell viability, activation, and exhaustion markers were not significantly different between the 2 groups (P > 0.05). In vivo, tumor T2* relaxation times were significantly lower after treatment with MegaPro-NP-labeled CAR T cells compared with untargeted T cells (P < 0.01). There is no significant difference in tumor growth inhibition between mice injected with labeled and unlabeled CAR T cells.

Conclusions
MegaPro-NPs can be used for in vivo tracking of CAR T cells. Because MegaPro-NPs recently completed phase II clinical trial investigation as an MRI contrast agent, MegaPro-NP is expected to be applied to track CAR T cells in cancer immunotherapy trials in the near future.
Functional Imaging Evidence of Tumor Response to High-Specific-Activity 131I-MIBG Therapy in an 84-Year-Old Patient With Metastatic Pheochromocytoma/Paraganglioma
Authors: Jimenez Camilo , Lu Yang 
Published: February 2023

Abstract
An 84-year-old man with history of metastatic pheochromocytoma/paraganglioma (mPPGL) received surgery 13 years ago, with recent biopsy-proven mPPGL in the T11. 123I-MIBG scan showed MIBG-avid liver and osseous. Given his medical condition and body habitus (weight, 45 kg; height, 140 cm), the patient was treated with high-specific-activity 131I-MIBG (Azedra) 300 mCi ×2. He tolerated the medication and was totally asymptomatic. Series 123I-MIBG scan showed good responses till 22 months after the first treatment at the last visit. This is probably the oldest and smallest adult mPPGL patient treated with Azedra and with prolonged good response.
Increased PSMA Expression in 177Lu-PSMA-617 Scan in Metastatic Castrate-Resistant Prostate Cancer Patient Treated With PSMA Radioligand Therapy and Enzalutamide
Authors: Aggarwal Piyush , Kaur Komalpreet , Sood Ashwani , Periasamy Kannan , Nagi Shreya , Mittal Bhagwant Rai 
Published: February 2023

Abstract
Androgen deprivation therapy plays an integral role in the treatment algorithm of advanced prostate cancer. Enzalutamide has shown great benefit in castrate-sensitive as well as resistant prostate cancer. Few studies have shown that enzalutamide can potentially increase the PSMA expression on 68Ga-PSMA-11 PET/CT imaging in patients with metastatic castrate-resistant prostate cancer. We present an interesting case where addition of short course of enzalutamide resulted in increased localization of 177Lu-PSMA-617 in metastatic lesions on posttherapy scan pointing to the added benefit of PSMA RLT.
FDG PET/CT in a Case of Lung Adenocarcinoma With Diffuse Cavitary Intrapulmonary Metastases
Authors: Guo Jia , Liao Zhongjian , Dong Aisheng 
Published: February 2023

Abstract
We describe FDG PET/CT findings in a case of lung adenocarcinoma with diffuse cavitary intrapulmonary metastases at initial diagnosis. High-resolution CT of the chest showed the primary solid tumor in the right upper lobe and numerous cavitating metastases ranging from a few millimeters to 1 cm in the bilateral lungs. FDG PET/CT showed intense activity of the primary tumor, diffuse activity of the lung metastases, and hypermetabolic metastases in the mediastinal lymph nodes and bones. Familiarity with this atypical intrapulmonary metastatic pattern of lung cancer may be helpful for the diagnosis and differential diagnosis.
Incidental Diagnosis of Metastatic Breast Cancer in a Man With 99mTc-PSMA SPECT/CT
Authors: Zárate-García César D. , Cardoza-Ochoa David R. , Sánchez-Vera Yazmín , González-Díaz Jorge Iván 
Published: February 2023

Abstract
Breast cancer in men is a rare and unsuspected malignancy. A 48-year-old man begins with disabling low back pain. The CT scan reported a compression fracture in L2 and diffuse skeletal lesions suggestive of metastatic disease. The serum prostate-specific antigen was 6.2 ng/mL. He was referred for SPECT/CT with 99mTc-EDDA/HYNIC-inhibitor prostate-specific membrane antigen due to clinical suspicion of prostate cancer. SPECT/CT with 99mTc-EDDA/HYNIC-inhibitor prostate-specific membrane antigen showed a primary lesion in the left breast and multiple bone lesions. Biopsy confirmed infiltrating ductal carcinoma with positive hormone receptors and indeterminate HER2 (human epidermal growth factor receptor 2).
Cervix Abscess Mimicking Cervical Cancer Explored With 18F-FDG PET/CT and MRI
Authors: Dhomps Anthony , Trecourt Alexis , Tordo Jeremie 
Published: February 2023

Abstract
We report the case of a 32-year-old woman gravida 2 para 2 with pelvic pain evolving for 2 months, who underwent imaging examinations, including 18F-FDG PET/CT and MRI, which showed a tumor-like cervix tissular mass with pathological lymph nodes and pelviperitonitis. An endocervical curettage with conization revealed a bacterial infection with cervical abscess and without neoplastic component. The follow-up 18F-FDG PET/CT 3 months after starting antibiotherapy confirmed a complete metabolic and morphological response of the cervical abscess.
Brain Nocardiosis Defined by 18F-Fluorocholine PET/CT
Authors: García Vicente Ana María , Noriega Álvarez Edel , González Rodríguez Jose Carlos , Soriano Castrejón Ángel María 
Published: February 2023

Abstract

Nocardia infection (nocardiosis) is usually acquired by inhalation; so pulmonary nocardiosis is the most common clinical presentation. Extrapulmonary localization occurs through hematogenous dissemination or contiguous spread. Nocardia can involve the central nervous system in a very reduced number of patients, mainly in immunocompromised. We present a case of a 56-year-old woman with a history of aggressive systemic mastocytosis, treated with chemotherapy 1 year ago. Patient reported intense headache, disorientation, and blurry vision without other symptoms being diagnosed with a rare brain nocardiosis by Nocardia cerradoensis. Neither bacteremia nor pulmonary involvement was detected. Brain PET/CT illustrated 18F-fluorocholine avidity on brain abscesses.
Comparison of 68Ga-DOTATATE PET/CT and 68Ga-Pentixiafor PET/CT Imaging in a Case of Merkel Cell Carcinoma
Authors: Rao Zijuan , Zhang Yu , Liu Liyi , Wang Min , Zhang Chunyin 
Published: February 2023

Abstract
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis and mortality. We present 68Ga-DOTATATE PET/CT and 68Ga-pentixiafor PET/CT findings of MCC in a 62-year-old man. Both 68Ga-DOTATATE PET/CT and 68Ga-pentixiafor PET/CT revealed increased radioactive uptake of lesions in the scan range. Compared with 68Ga-DOTATATE PET/CT, the lesions showed higher uptake in 68Ga-pentixiafor PET/CT. Our case showed that 68Ga-pentixiafor might be a promising radiotracer in the evaluation of MCC.