bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Dual Antiplatelet Therapy Duration on Unruptured Aneurysm Occlusion After Flow Diversion: A Multicenter Study
Authors: Vranic Justin E. , Harker Pablo , Stapleton Christopher J. , Regenhardt Robert W. , Dmytriw Adam A. , Doron Omer M. , Alotaibi Naif M. , Leslie-Mazwi Thabele M. , Gupta Rajiv , Berglar Inka K. , Tan Can Ozan , Koch Matthew J. , Raymond Scott B. , Mascitelli Justin R. , Patterson T. Tyler , Seinfeld Joshua , White Andrew , Case David , Roark Christopher , Gandhi Chirag D. , Al-Mufti Fawaz , Cooper Jared , Matouk Charles , Sujijantarat Nanthiya , Devia Diego A. , Ocampo-Navia Maria I. , Villamizar-Torres Daniel E. , Puentes Juan C. , Patel Aman B. 
Published: August 2023

Objective
Endoluminal flow diversion reduces blood flow into intracranial aneurysms, promoting thrombosis. Postprocedural dual antiplatelet therapy (DAPT) is necessary for the prevention of thromboembolic complications. The purpose of this study is to therefore assess the impact that the type and duration of DAPT has on aneurysm occlusion rates and iatrogenic complications after flow diversion.

Methods
A retrospective review of a multicenter aneurysm database was performed from 2012 to 2020 to identify unruptured intracranial aneurysms treated with single device flow diversion and ≥12-month follow-up. Clinical and radiologic data were analyzed with aneurysm occlusion as a function of DAPT duration serving as a primary outcome measure.

Results
Two hundred five patients underwent flow diversion with a single pipeline embolization device with 12.7% of treated aneurysms remaining nonoccluded during the study period. There were no significant differences in aneurysm morphology or type of DAPT used between occluded and nonoccluded groups. Nonoccluded aneurysms received a longer mean duration of DAPT (9.4 vs 7.1 months, P = 0.016) with a significant effect of DAPT duration on the observed aneurysm occlusion rate (F(2, 202) = 4.2, P = 0.016). There was no significant difference in the rate of complications, including delayed ischemic strokes, observed between patients receiving short (≤6 months) and prolonged duration (>6 months) DAPT (7.9% vs 9.3%, P = 0.76).

Conclusions
After flow diversion, an abbreviated duration of DAPT lasting 6 months may be most appropriate before transitioning to low-dose aspirin monotherapy to promote timely aneurysm occlusion while minimizing thromboembolic complications.
Computed Tomography–Guided Prostate Sampling and Fiducial Marker Insertion in Patients With Absent Rectums
Authors: Chau Matthew , Saluja Manmeet , Anderson James 
Published: August 2023

Objectives
We aimed to present our experience and the outcomes of a novel technique, computed tomography (CT)–guided prostate biopsy and fiducial marker insertion in patients with absent rectums.

Methods
Patients who underwent CT-guided prostate biopsy at a single institution from November 2010 to November 2022 were retrospectively reviewed. Patients were included if they had a clinical suspicion of prostate cancer and had absent rectums from previous surgical resection. Contrast-enhanced CT scan was used to perform transgluteal prostate biopsy. Patient demographics, multiparametric magnetic resonance imaging, and biopsy details were recorded.

Results
Thirteen biopsy procedures and 1 CT-guided fiducial marker insertion were performed on 12 unique patients. The reasons for the absence of rectums included surgical resection for rectal cancer (n = 10) and surgical resection for inflammatory bowel disease (n = 2). Clinically significant cancer was found in 7 of 13 biopsy results (52.8%), clinically insignificant cancer in 3 of 13 (23.1%), and benign cancer in 3 of 13 (23.1%). No complications were recorded.

Conclusions
Our data support CT-guided prostate biopsy as an accurate and effective technique for investigating prostate cancer that requires tissue sampling in patients with absent rectums.
Comparative Study of the Diagnostic Value of Zero-Echo-Time Magnetic Resonance Angiography With Time-of-Flight Magnetic Resonance Angiography for Intracranial Aneurysm
Authors: Li Yushi , Zhu Yifeng , Liu Yajie , Li Ge , Qu Xiaofeng 
Published: August 2023

Objective
Intracranial aneurysm (IAN) is a class of cerebrovascular diseases with a serious threat to patients, and an accurate diagnosis of IAN is very important for both selection of the appropriate therapy and prediction of the prognosis. This study aimed to evaluate the diagnostic values of zero-echo-time magnetic resonance angiography (ZTE-MRA) and time-of-flight magnetic resonance angiography (TOF-MRA) in patients with IAN.

Methods
Digital subtraction angiography, ZTE-MRA, and TOF-MRA were performed in 18 patients diagnosed with IAN. The images of ZTE-MRA and TOF-MRA were compared for image quality, qualitative diagnosis, detailed diagnosis, number of thrombi, and residual aneurysm lumen, with digital subtraction angiography as the reference.

Results
Zero-echo-time MRA and TOF-MRA did not show a significant difference in image quality or detailed information (including aneurysm size, growth direction, and angle with the aneurysm-carrying vessel) (P > 0.05). However, ZTE-MRA showed advantages over TOF-MRA in terms of qualitative diagnosis (sensitivity and specificity), intra-aneurismal thrombus detection, and residual aneurysm lumen detection after embolization (P < 0.05).

Conclusions
Compared with TOF-MRA, ZTE-MRA showed greater diagnostic value for IAN patients in terms of qualitative diagnosis, as well as the detection of intra-aneurysm thrombi and residual aneurysm lumen after embolization.
Methods and Reproducibility of Liver Fat Measurement Using 3-Dimensional Liver Segmentation From Noncontrast Computed Tomography in EVAPORATE Cohort
Authors: Ding Kimberly R. , Lakshmanan Suvasini , Holda Mateusz , Kinninger April , Manubolu Venkat S. , Joshi Tej , Golub Ilana , Mao Song S. , Budoff Matthew J. , Roy Sion K. 
Published: August 2023

Objective
Nonalcoholic fatty liver disease not only shares multiple risk factors with cardiovascular disease but also independently predicts its increased risk and related outcomes. Here, we evaluate reproducibility of 3-dimensional (3D) liver volume segmentation method to identify fatty liver on noncontrast cardiac computed tomography (CT) and compare measures with previously validated 2-dimensional (2D) segmentation CT criteria for the measurement of liver fat.

Methods
The study included 68 participants enrolled in the EVAPORATE trial and underwent serial noncontrast cardiac CT. Liver attenuation < 40 Hounsfield units (HU) was used for diagnosing fatty liver, as done in the MESA study. Two-dimensional and 3D segmentation of the liver were performed by Philips software. Bland-Altman plot analysis was used to assess reproducibility.

Results
Interreader reproducibility of 3D liver mean HU measurements was 96% in a sample of 111 scans. Reproducibility of 2D and 3D liver mean HU measurements was 93% in a sample of 111 scans. Reproducibility of change in 2D and 3D liver mean HU was 94% in 68 scans. Kappa, a measure of agreement in which the 2D and 3D measures both identified fatty liver, was excellent at 96.4% in 111 scans.

Conclusions
Fatty liver can be reliably diagnosed and measured serially in a stable and reproducible way by 3D liver segmentation of noncontrast cardiac CT scans. Future studies need to explore the sensitivity and stability of measures for low liver fat content by 3D segmentation, over the current 2D methodology. This measure can serve as an imaging biomarker to understand mechanistic correlations between atherosclerosis, fatty liver, and cardiovascular disease risk.
The Feasibility of Using a Deep Learning–Based Model to Determine Cardiac Computed Tomographic Contrast Dose
Authors: Kobayashi Naoki , Masuda Takanori , Nakaura Takeshi , Shiraishi Kaori , Uetani Hiroyuki , Nagayama Yasunori , Kidoh Masafumi , Funama Yoshinori , Hirai Toshinori 
Published: August 2023

Purpose
This study aimed to predict contrast effects in cardiac computed tomography (CT) from CT localizer radiographs using a deep learning (DL) model and to compare the prediction performance of the DL model with that of conventional models based on patients' physical size.

Methods
This retrospective study included 473 (256 men and 217 women) cardiac CT scans between May 2014 and August 2017. We developed and evaluated DL models that predict milligrams of iodine per enhancement of the aorta from CT localizer radiographs. To assess the model performance, we calculated and compared Pearson correlation coefficient (r) between the actual iodine dose that was necessary to obtain a contrast effect of 1 HU (iodine dose per contrast effect [IDCE]) and IDCE predicted by DL, body weight, lean body weight, and body surface area of patients.

Results
The model was tested on 52 cases for the male group (mean [SD] age, 63.7 ± 11.4) and 44 cases for the female group (mean [SD] age, 69.8 ± 11.6). Correlation coefficients between the actual and predicted IDCE were 0.607 for the male group and 0.412 for the female group, which were higher than the correlation coefficients between the actual IDCE and body weight (0.539 for male, 0.290 for female), lean body weight (0.563 for male, 0.352 for female), and body surface area (0.587 for male, 0.349 for female).

Conclusions
The performance for predicting contrast effects by analyzing CT localizer radiographs with the DL model was at least comparable with conventional methods using the patient's body size, notwithstanding that no additional measurements other than CT localizer radiographs were required.
Gallstones Detection on Dual-Energy Computerized Tomography–Is It Ready for Real-World Use? A Retrospective Observational Study
Authors: Guha Roy Shambo , Gulati Vaibhav , Machado Pichardo Laura , Chaker Salama , Brody Marion , Rotenberg Scott , Hayeri Reza , Poot Jeffrey , Teytelboym Oleg 
Published: August 2023

Aims
The aims of the study are to evaluate the performance of dual-energy computed tomography (DECT) imaging in the detection of noncalcified gallstones (GSs) and to assess its performance relative to transabdominal ultrasound (US) in identifying cholelithiasis.

Method
This study is a retrospective review of radiology records and images to find all patients who had both US and DECT scans within a 6-month period and were found to have GSs. Patients who did not have GSs on US served as the control group. The CT scans were reviewed by 4 radiologists who did not have access to the US results when assessing the presence or absence of GSs on the DECT scans. In case of any discrepancies among the radiologists, the majority opinion was considered. If there was a split opinion, a fifth reviewer was consulted. The data were analyzed to calculate sensitivity, specificity, positive and negative predictive values, as well as overall accuracy and to evaluate interreader variability. The absolute Hounsfield unit (HU) differences of the GSs and bile were compared between polychromatic (PC), virtual noncontrast (VNC), and virtual monochromatic (VMC) images.

Results
Considering at least 3-reader agreement, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were found to be 92%, 96%, 96%, 92%, and 94%, respectively. Individual reader sensitivity varied between 87% and 92%. There was good interobserver agreement with a Fleiss’ kappa of 0.76. Quantification of the whole data set showed that no significant difference was observed in the HU values for the stones between the PC images and the VNC images. A significant increase was observed on the 50-keV VMC images compared with the PC and VNC images. In the study group, 17% stones were visualized only on the VNC or/and 50-keV VMC images, and not on the PC images. On quantitative analysis of these cases, there was a significant increase of HU in the VNC images as compared with PC images and a significant decrease of HU in the 50-keV VMC images as compared with PC images.

Conclusions
Low-keV images increase stone-bile contrast. Evaluation of cholelithiasis using VNC and 50-keV VMC images demonstrated a 14% increase in sensitivity relative to conventional CT.
Human A2-CAR T Cells Reject HLA-A2+ Human Islets Transplanted Into Mice Without Inducing Graft-Versus-Host Disease
Authors: Ellis Cara E. , Mojibian Majid , Ida Shogo , Fung Vivian C.W. , Skovsø Søs , McIver Emma , O’Dwyer Shannon , Webber Travis D. , Braam Mitchell J.S. , Saber Nelly , Sasaki Shugo , Lynn Francis C. , Kieffer Timothy J. , Levings Megan K. 
Published: August 2023

Background.
Type 1 diabetes is an autoimmune disease characterized by T-cell–mediated destruction of pancreatic beta-cells. Islet transplantation is an effective therapy, but its success is limited by islet quality and availability along with the need for immunosuppression. New approaches include the use of stem cell–derived insulin-producing cells and immunomodulatory therapies, but a limitation is the paucity of reproducible animal models in which interactions between human immune cells and insulin-producing cells can be studied without the complication of xenogeneic graft-versus-host disease (xGVHD).

Methods.
We expressed an HLA-A2-specific chimeric antigen receptor (A2-CAR) in human CD4+ and CD8+ T cells and tested their ability to reject HLA-A2+ islets transplanted under the kidney capsule or anterior chamber of the eye of immunodeficient mice. T-cell engraftment, islet function, and xGVHD were assessed longitudinally.

Results.
The speed and consistency of A2-CAR T-cell–mediated islet rejection varied depending on the number of A2-CAR T cells and the absence/presence of coinjected peripheral blood mononuclear cells (PBMCs). When <3 million A2-CAR T cells were injected, coinjection of PBMCs accelerated islet rejection but also induced xGVHD. In the absence of PBMCs, injection of 3 million A2-CAR T cells caused synchronous rejection of A2+ human islets within 1 wk and without xGVHD for 12 wk.

Conclusions.
Injection of A2-CAR T cells can be used to study rejection of human insulin–producing cells without the complication of xGVHD. The rapidity and synchrony of rejection will facilitate in vivo screening of new therapies designed to improve the success of islet-replacement therapies.
A Pilot Study of Adjunctive Group Therapy to Enhance Coping With Cognitive Challenges and Support Cognitive Health After Electroconvulsive Therapy
Authors: Copersino Marc L. , DeTore Nicole R. , Piltch Cynthia , Bolton Paula , Henderson Teresa , Davis Vona F. , Eberlin Elizabeth S. , Kadden Lynn , McGurk Susan R. , Seiner Stephen J. , Mueser Kim T. 
Published: August 2023

Objectives
Concerns about the cognitive adverse effects of electroconvulsive therapy (ECT) are common among recipients of the treatment despite its relatively small adverse effects on cognitive functioning. Interventions aimed at remediating or improving coping with cognitive adverse effects of ECT have not been developed. The Enhancing Cognitive Domains after ECT (ENCODE) program is a new group intervention aimed at teaching self-management strategies to cope with the cognitive challenges and associated anxiety that often accompanies ECT.

Methods
This pilot study used a pretest-posttest design to examine the feasibility and clinical utility of delivering ENCODE to 20 adults who had received ECT in a hospital-based ECT program.

Results
The program was found to be both feasible and acceptable as indicated by the attainment of recruitment targets, high rates of attendance (85% of participants attended at least 5 of the 6 group sessions), and high participant satisfaction ratings (88% reported that ENCODE helped or helped very much to manage their cognitive challenges). The clinical utility of the program was suggested by reductions in depressive symptom severity and subjective memory complaints. Nonsignificant improvements were observed in global cognitive function and cognitive self-efficacy.

Conclusions
This study provides preliminary evidence for the feasibility and clinical utility of ENCODE based on program demand, strong participant satisfaction, and postgroup reductions in distress and subjective memory complaints.
Receipt of Electroconvulsive Therapy in Outpatient Settings in a National Sample of Privately Insured Patients With Mood Disorders
Authors: Agbese Edeanya , Leslie Douglas L. , Rosenheck Robert 
Published: August 2023

Purpose
Electroconvulsive therapy (ECT), an effective treatment for bipolar and major depressive disorder, is underused. Little information is available on use of ECT in potentially less costly outpatient settings, possibly reducing cost barriers.

Methods
Insurance claims from the 2008 to 2017 MarketScan Commercial Database for patients diagnosed with mood disorders were used to compare 4 groups of ECT users in each year: those receiving (1) exclusively outpatient ECT, (2) first inpatient and subsequently outpatient, (3) outpatient and subsequently inpatient, and (4) exclusively inpatient ECT. Groups were compared on the proportion receiving ECT in each group over time as well as on the total numbers of treatments received along with group differences in sociodemographic and diagnostic characteristics and health care costs.

Results
Among 2.9 million patients diagnosed with mood disorders, the proportion who received ECT (n = 8859) was small (0.30%) and declined over the decade to 0.17%. Among those who received ECT, most did so exclusively as outpatients (52.3%), the group with fewest comorbidities and lowest costs. This proportion increased by 19.7% over the decade, whereas the proportion receiving ECT exclusively in an inpatient setting (12.1%) fell by 30.6%. The total number of treatments per patient averaged 11.7 per year and increased by 28.0% over the decade, with outpatients decreasing to slightly less than average. Health care costs were greatest for those who started ECT as inpatients.

Conclusions
Although the proportion of privately insured patients receiving ECT in outpatient settings has increased, reducing cost barriers, the use of ECT continued to be extremely limited and declining.
A Retrospective Matched Comparison Study of Prolonged Seizures in ECT
Authors: Isenberg Keith , Dinwiddie Stephen H. , Song Jing , North Carol S. 
Published: August 2023

Objective
This study assessed the incidence of and risk factors for prolonged seizures (>180 sec) in electroconvulsive therapy (ECT).

Method
In 611 adult patients undergoing 6697 ECT treatments administered over a 2.5-year study period, 29 individuals experienced 42 prolonged seizures. A comparison sample (n = 29) was matched on sex, age, and treatment, and compared on psychiatric and medical diagnoses, as well as current medications. To examine the association between the characteristics and prolonged seizure, conditional logistic regression models or exact McNemar tests were conducted.

Results
Prolonged seizures occurred on average in 1 of every 167 treatments. No specific psychiatric disorders or medical conditions were associated with the prolonged seizure group. Antipsychotic drugs were used in a higher proportion of the comparison group than in the prolonged seizure group, suggesting a protective effect. Atropine was used in a lower proportion of the long seizure group than in the comparison group. No untoward sequelae occurred, and no progression to status epilepticus was observed.

Conclusions
Prolonged seizures appear to be an uncommon complication of ECT in adults. The characteristics examined in this study suggest limited association of psychotropic medications with prolonged seizures. Treatment of prolonged seizures was straightforward. Prolonged seizures had no impact on the course of treatment. Further exploration of prolonged seizures would enhance the generalizability of the findings from this single site study.
Sale of critically endangered sharks in the United States
Authors: Ryburn Savannah J. , Yu Tammy , Ong Kelly Jia-Wei , Alston Meggan A. , Howie Ella , LeRoy Peyton , Giang Sarah Elizabeth , Ball William , Benton Jewel , Calhoun Robert , Favreau Isabella , Gutierrez Ana , Hallac Kayla , Hanson Dakota , Hibbard Teagan , Loflin Bryson , Lopez Joshua , Mock Gracie , Myers Kailey , Pinos-Sánchez Andrés , Suarez Garcia Alejandra Maria , Romero Adriana Retamales , Thomas Audrey , Williams Rhiannon , Zaldivar Anabel , Bruno John Francis 
Published: August 2023

AbstractShark meat is widely available in the United States in grocery stores and seafood markets. The meat is often mislabeled or generically labeled as “shark”. The ambiguity of these generic labels makes it challenging to assess the conservation implications of this practice and for consumers to avoid species with high mercury concentrations. For this study we purchased and DNA barcoded 30 shark products purchased in the United States to determine their species identity and conservation status. These samples consisted of 19 filets sold in grocery stores, seafood markets, and Asian specialty markets (mostly in North Carolina) and 11 ordered online as “jerky”. 70% of samples were “soft mislabeled” (i.e., labeled generically as shark but not as a specific species). Of the nine samples labeled to species, eight were mislabeled (e.g., spinner shark labeled as mako shark). Only one sample was correctly labeled. All 30 samples were identified as shark and came from 11 different species, including three species listed by the IUCN as Critically Endangered: great hammerhead, scalloped hammerhead, and tope. The first two species have been found to contain very high levels of mercury, illustrating the implications of seafood mislabeling for human health. The widespread availability of shark meat in U.S. grocery stores is surprising given the dramatic decline of shark populations globally. Moreover, the fact that nearly all shark meat is either mislabeled or not labeled to species amplifies the problem. Accurate, verified product labels for shark meat would benefit consumers and shark conservation efforts, and should be a priority for the seafood industry.
SARS-CoV-2 Viral Clearance and Evolution Varies by Extent of Immunodeficiency
Authors: Li Yijia , Choudhary Manish C. , Regan James , Boucau Julie , Nathan Anusha , Speidel Tessa , Liew May Yee , Edelstein Gregory E. , Kawano Yumeko , Uddin Rockib , Deo Rinki , Marino Caitlin , Getz Matthew A. , Reynold Zahra , Barry Mamadou , Gilbert Rebecca F. , Tien Dessie , Sagar Shruti , Vyas Tammy D. , Flynn James P. , Hammond Sarah P. , Novack Lewis A. , Choi Bina , Cernadas Manuela , Wallace Zachary S. , Sparks Jeffrey A. , Vyas Jatin M. , Seaman Michael S. , Gaiha Gaurav D. , Siedner Mark J. , Barczak Amy K. , Lemieux Jacob E. , Li Jonathan Z. 
Published: August 2023

AbstractDespite vaccination and antiviral therapies, immunocompromised individuals are at risk for prolonged SARS-CoV-2 infection, but the immune defects that predispose to persistent COVID-19 remain incompletely understood. In this study, we performed detailed viro-immunologic analyses of a prospective cohort of participants with COVID-19. The median time to nasal viral RNA and culture clearance in the severe hematologic malignancy/transplant group (S-HT) were 72 and 40 days, respectively, which were significantly longer than clearance rates in the severe autoimmune/B-cell deficient (S-A), non-severe, and non-immunocompromised groups (P<0.001). Participants who were severely immunocompromised had greater SARS-CoV-2 evolution and a higher risk of developing antiviral treatment resistance. Both S-HT and S-A participants had diminished SARS-CoV-2-specific humoral, while only the S-HT group had reduced T cell-mediated responses. This highlights the varied risk of persistent COVID-19 across immunosuppressive conditions and suggests that suppression of both B and T cell responses results in the highest contributing risk of persistent infection.