bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial endophthalmitis following anti-VEGF intravitreal injections: a retrospective case series
Authors: Bergamo Vinicius Campos , Nakayama Luis Filipe , Moraes Nilva Simeren Bueno De , Yu Maria Cecília Zorat , Höfling-Lima Ana Luiza , Maia Maurício 
Published: September 2023

Abstract
Background
To describe the incidence of endophthalmitis and the treatment outcomes of acute bacterial endophthalmitis following intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in a Brazilian hospital. The analysis was based on the timing of infection after intravitreal injection, culture results, visual acuity, and the presence of epiretinal membrane after a 1-year follow-up period, spanning nine years.

Methods
This retrospective case series, conducted over a 9-year period, aimed to evaluate the treatment outcomes of acute endophthalmitis following intravitreal Bevacizumab injections. The inclusion criteria involved a chart review of 25 patients who presented clinical signs of acute endophthalmitis out of a total of 12,441 injections administered between January 2011 and December 2019. Negative culture results of vitreous samples or incomplete data were excluded. Ultimately, 23 patients were enrolled in the study. Eight patients were treated with intravitreal antibiotic injections (IVAI) using vancomycin 1.0 mg/0.05mL and ceftazidime 2.25 mg/0.05mL, while 15 patients underwent pars plana vitrectomy (PPV) followed by intravitreal antibiotic injections at the end of surgery (IVAIES). The main outcome measures were the efficacy of controlling the infection with IVAI as a standalone therapy compared to early PPV followed by IVAIES. Data collected included pre-infection and one-year post-treatment best corrected visual acuity (BCVA), optical coherence tomography (OCT) abnormalities, and enucleation/evisceration rates. To compare groups, Mann-Whitney and ANOVA tests were employed for statistical analysis.

Results
The incidence rate of bacterial endophthalmitis was 0.185% (1/541 anti-VEGF injections), with the highest infection rates observed in 2014 and 2017. Patients presented clinical symptoms between 2 and 7 days after injection. The most common isolated organisms were coagulase-negative Staphylococci and Streptococci spp. Treatment outcomes showed that both IVAI and PPV + IVAIES effectively controlled the infection and prevented globe atrophy. After one year, the PPV group with BCVA better than Light Perception had a significantly better BCVA compared to the IVAI group (p 0.003). However, PPV group had higher incidence of epiretinal membranes formation compared to the IVAI group. (P 0.035)

Conclusion
Anti-VEGF injections carry a risk of developing acute bacterial endophthalmitis. Isolated antibiotic therapy could be an effective treatment to control the infection, but performing PPV + IVAIES as a primary treatment showed promising results in terms of improving BCVA after one year, despite a higher rate of epiretinal membrane formation. Further studies are needed to confirm these findings.
The subjective and objective outcomes of endoscopic sinus surgery for nasal polyposis using microdebrider versus conventional instruments: a randomized controlled trial
Authors: Abdoul Jaleel Ahmad Aboul Wafa , Abo El Magd Esam Ali , El Tahan Abd El Rahman Ahmed , Henry Engy Nagy 
Published: September 2023

Abstract
Background
Since the evolution of the microdebrider technology and its modulations to be suitable for rhinology, many attempts were carried out to replace the conventional instruments with microdebrider especially in cases of nasal polyposis. Also, many studies were conducted to compare the efficacy of both tools in functional endoscopic sinus surgery. Those studies focused on objective outcomes as the duration of surgery and the amount of blood loss.

Aim of the study
Comparing the efficacy of microdebrider in cases of resistant chronic rhinosinusitis with nasal polyposis to conventional instruments. Analysis of subjective outcomes is mainly the quality of life of our patients, and not neglecting the objective outcomes but analyzing them thoroughly.

Method
This is a randomized controlled clinical trial, conducted on 100 patients which were diagnosed to have resistant chronic rhinosinusitis with polyposis. We used the microdebrider in functional endoscopic sinus surgery for 50 patients and conventional instruments for the other 50 cases. We compared the operative time, amount of blood loss, and postoperative improvement of quality of life, the presence of adhesions, crustations, and complications, or recurrence of nasal polyposis in both groups.

Results
We found significant differences in favor of microdebrider mainly in the duration of surgery and the amount of blood loss. Patient satisfaction was better in the microdebrider group, especially in the short-term follow-up, while the postoperative clinical scores were better in the long run.

Conclusion
Using the microdebrider in dealing with nasal polyposis is much preferable to conventional instruments. For patients, they feel much better in a shorter duration postoperatively. For surgeons, the manipulations are easier, and the operative field is bloodless and clear.
Measuring response to treatment in axial spondyloarthritis using quantitative imaging biomarkers: a prospective observational cohort study
Authors: Jones Alexis , Bray Timothy JP , Sakai Naomi S , Bainbridge Alan JP , Ciurtin Coziana , Hall-Craggs Margaret A 
Published: September 2023

Objective
Objective assessments of disease activity and response to treatment in axial spondyloarthritis (axSpA) remain a challenge; quantitative imaging biomarkers (QIBs) of inflammation could enhance assessments of disease activity and therapeutic response. We aimed to determine the responsiveness of QIBs obtained from diffusion-weighted imaging (DW-MRI) and chemical shift-encoded MRI (CSE-MRI) using the partially automated Bone Edema and Adiposity Characterisation with Histograms (BEACH) software tool in axSpA patients undergoing biologic therapy.

Methods
We conducted a prospective longitudinal cohort study, including 30 patients with axSpA undergoing biologic therapy. Patients were scanned before and after biologic therapy using conventional MRI, DWI and CSE-MRI at 3T. Apparent diffusion coefficient (ADC) and proton density fat fraction (PDFF) were assessed using the BEACH tool (https://github.com/TJPBray/BEACH), and conventional MR images were assessed using established visual scoring methods by expert radiologists. Responsiveness – the ability of the MRI measurements to capture changes in disease occurring as a result of biologic therapy – was assessed using the standardized response mean (SRM). Inter-reader reliability of the ADC and PDFF maps was assessed using Bland-Altman limits of agreement analysis and the intraclass correlation coefficient.

Results
Responsiveness to therapy was moderate for ADC-based parameters (SRM 0.50) and comparable to established visual scoring methods for bone marrow oedema (SRM 0.53). Interobserver variability was lower for QIBs compared with conventional visual scores methods.

Conclusions
QIBs measured using the BEACH tool are sensitive to changes in inflammation in axSpA following biologic therapy, with similar responsiveness and lower interobserver variability to visual scoring by expert radiologists.

Advances in knowledge
QIBs measured using the partially automated BEACH tool offer an objective measure of response to biologic therapy in axSpA.
Automated classification of fat-infiltrated axillary lymph nodes on screening mammograms
Authors: Song Qingyuan , diFlorio-Alexander Roberta M. , Sieberg Ryan T. , Dwan Dennis , Boyce William , Stumetz Kyle , Patel Sohum D. , Karagas Margaret R. , MacKenzie Todd A. , Hassanpour Saeed 
Published: September 2023

Objective:Fat-infiltrated axillary lymph nodes (LNs) are unique sites for ectopic fat deposition. Early studies showed a strong correlation between fatty LNs and obesity-related diseases. Confirming this correlation requires large-scale studies, hindered by scarce labeled data. With the long-term goal of developing a rapid and generalizable tool to aid data labeling, we developed an automated deep learning (DL)-based pipeline to classify the status of fatty LNs on screening mammograms.Methods:Our internal data set included 886 mammograms from a tertiary academic medical institution, with a binary status of the fat-infiltrated LNs based on the size and morphology of the largest visible axillary LN. A two-stage DL model training and fine-tuning pipeline was developed to classify the fat-infiltrated LN status using the internal training and development data set. The model was evaluated on a held-out internal test set and a subset of the Digital Database for Screening Mammography.Results:Our model achieved 0.97 (95% CI: 0.94–0.99) accuracy and 1.00 (95% CI: 1.00–1.00) area under the receiver operator characteristic curve on 264 internal testing mammograms, and 0.82 (95% CI: 0.77–0.86) accuracy and 0.87 (95% CI: 0.82–0.91) area under the receiver operator characteristic curve on 70 external testing mammograms.Conclusion:This study confirmed the feasibility of using a DL model for fat-infiltrated LN classification. The model provides a practical tool to identify fatty LNs on mammograms and to allow for future large-scale studies to evaluate the role of fatty LNs as an imaging biomarker of obesity-associated pathologies.Advances in knowledge:Our study is the first to classify fatty LNs using an automated DL approach.
Prospective inter- and intra-tracer repeatability analysis of radiomics features in [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET scans in metastatic prostate cancer
Authors: Kendrick Jake , Francis Roslyn J , Hassan Ghulam Mubashar , Rowshanfarzad Pejman , Ong Jeremy SL , Jeraj Robert , Barry Nathaniel , Hagan Tammy , Ebert Martin A 
Published: September 2023

Objective:
This study aimed to quantify both the intra- and intertracer repeatability of lesion-level radiomics features in [68Ga]Ga-prostate-specific membrane antigen (PSMA)-11 and [18F]F-PSMA-1007 positron emission tomography (PET) scans.

Methods:
Eighteen patients with metastatic prostate cancer (mPCa) were prospectively recruited for the study and randomised to one of three test–retest groups: (i) intratracer [68Ga]Ga-PSMA-11 PET, (ii) intratracer [18F]F-PSMA-1007 PET or (iii) intertracer between [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET. Four conventional PET metrics (standardised uptake value (SUV)max, SUVmean, SUVtotal and volume) and 107 radiomics features were extracted from 75 lesions and assessed using the repeatability coefficient (RC) and the ICC. Radiomic feature repeatability was also quantified after the application of 16 filters to the PET image.

Results:
Test–retest scans were taken a median of 5 days apart (range: 2–7 days). SUVmean demonstrated the lowest RC limits of the conventional features, with RCs of 7.9%, 14.2% and 24.7% for the [68Ga]Ga-PSMA-11 PET, [18F]F-PSMA-1007 PET, and intertracer groups, respectively. 69%, 66% and 9% of all radiomics features had good or excellent ICC values (ICC ≥ 0.75) for the same groups. Feature repeatability therefore diminished considerably for the intertracer group relative to intratracer groups.

Conclusion
In this study, robust biomarkers for each tracer group that can be used in subsequent clinical studies were identified. Overall, the repeatability of conventional and radiomic features were found to be substantially lower for the intertracer group relative to both intratracer groups, suggesting that assessing patient response quantitatively should be done using the same radiotracer where possible.

Advances in knowledge:
Intertracer biomarker repeatability limits are significantly larger than intratracer limits.
Relative fat fraction of malignant bone lesions from breast cancer, prostate cancer and myeloma are significantly lower than normal bone marrow and shows excellent interobserver agreement
Authors: Castagnoli Francesca , Donners Ricardo , Tunariu Nina , Messiou Christina , Koh Dow-Mu 
Published: September 2023

ObjectivesTo compare relative fat fraction (rFF) of active bone lesions from breast, prostate and myeloma malignancies and normal bone marrow; to assess its inter-reader agreement.MethodsPatients with breast (n = 26), myeloma (n = 32) and prostate cancer (n = 52) were retrospectively evaluated. 110 baseline rFF maps from whole-body MRI were reviewed by two radiologists. Regions of interest for up to four focal active lesions in each patient were drawn on rFF maps, one each at the cervicothoracic spine, lumbosacral spine, pelvis and extremity. The mean and standard deviation of rFF were recorded. The rFF of normal marrow was measured in the pelvis for patients without diffuse bone disease (n = 88). We compared the rFF of malignant bone lesions and normal marrow using Mann–Whitney test. Interobserver agreement was assessed by interclass correlation coefficient.ResultsMalignant bone lesions showed significantly lower median rFF (13.87%) compared with normal marrow (89.76%) with little overlap (p &lt; 0.0001). There was no significant difference in the median rFF of malignant lesions from breast (14.46%), myeloma (13.12%) and prostate cancer (13.67%) (p &gt; 0.017, Bonferroni correction) and in the median rFF of bone disease according to their anatomical locations (p &gt; 0.008, Bonferroni correction). There was excellent interobserver agreement (0.95).ConclusionThe low rFF of active bone lesions in breast, prostate and myeloma malignancies provides high image contrast relative to normal marrow that may be used to detect bone metastases.Advances in knowledgeThis study shows the importance of rFF towards detecting bone metastases.
Real-time MRI of the moving wrist at 0.55 tesla
Authors: Chaudhari Abhijit J , Lim Yongwan , Cui Sophia X. , Bayne Christopher O. , Szabo Robert M. , Boutin Robert D. , Nayak Krishna S 
Published: September 2023

Objectives: Magnetic resonance imaging (MRI) using 1.5T or 3.0T systems is routinely employed for assessing wrist pathology; however, due to off-resonance artifacts and high power deposition, these high-field systems have drawbacks for real-time (RT) imaging of the moving wrist. Recently, high-performance 0.55T MRI systems have become available. In this proof-of-concept study, we tested the hypothesis that RT-MRI during continuous, active, and uninterrupted wrist motion is feasible with a high-performance 0.55T system at temporal resolutions below 100 ms and that the resulting images provide visualization of tissues commonly interrogated for assessing dynamic wrist instability. Methods: Participants were scanned during uninterrupted wrist radial-ulnar deviation and clenched fist maneuvers. Resulting images (nominal temporal resolution of 12.7–164.6 ms per image) were assessed for image quality. Feasibility of static MRI to supplement RT-MRI acquisition was also tested. Results: The RT images with temporal resolutions < 100 ms demonstrated low distortion and image artifacts, and higher reader assessment scores. Static MRI scans showed the ability to assess anatomical structures of interest in the wrist. Conclusion: RT-MRI of the wrist at a high temporal resolution, coupled with static MRI, is feasible with a high-performance 0.55T system, and may enable improved assessment of wrist dynamic dysfunction and instability. Advances in knowledge: Real-time MRI of the moving wrist is feasible with high-performance 0.55T and may improve the evaluation of dynamic dysfunction of the wrist.
Towards AI-augmented radiology education: a web-based application for perception training in chest X-ray nodule detection
Authors: Borgbjerg Jens , Thompson John D , Salte Ivar Mjøland , Frøkjær Jens Brøndum 
Published: September 2023

Objectives:
Artificial intelligence (AI)-based applications for augmenting radiological education are underexplored. Prior studies have demonstrated the effectiveness of simulation in radiological perception training. This study aimed to develop and make available a pure web-based application called Perception Trainer for perception training in lung nodule detection in chest X-rays.

Methods:
Based on open-access data, we trained a deep-learning model for lung segmentation in chest X-rays. Subsequently, an algorithm for artificial lung nodule generation was implemented and combined with the segmentation model to allow on-the-fly procedural insertion of lung nodules in chest X-rays. This functionality was integrated into an existing zero-footprint web-based DICOM viewer, and a dynamic HTML page was created to specify case generation parameters.

Results:
The result is an easily accessible platform-agnostic web application available at: https://castlemountain.dk/mulrecon/perceptionTrainer.html.
The application allows the user to specify the characteristics of lung nodules to be inserted into chest X-rays, and it produces automated feedback regarding nodule detection performance. Generated cases can be shared through a uniform resource locator.

Conclusion:
We anticipate that the description and availability of our developed solution with open-sourced codes may help facilitate radiological education and stimulate the development of similar AI-augmented educational tools.

Advances in knowledge:
A web-based application applying AI-based techniques for radiological perception training was developed. The application demonstrates a novel approach for on-the-fly generation of cases in chest X-ray lung nodule detection employing deep-learning-based segmentation and lung nodule simulation.
Aberrant functional and causal connectivity of the amygdala in herpes zoster and post-herpetic neuralgia patients
Authors: Jiang Xiaofeng , Kuang Hongmei , Lv Huiting , Xiong Jiaxin , Li Jiahao , Hong Shunda , Yan YI , Gu Lili , Jiang Jian 
Published: September 2023

Objective
Resting-state functional magnetic resonance imaging (rs-fMRI) and Granger causality analysis (GCA) were used to observe the characteristics of amygdala and whole-brain effect connections in patients with herpes zoster (HZ) and post-herpetic neuralgia (PHN) and to determine their relationship with clinical features.

Methods
Rs-fMRI scans were performed on 50 HZ; 50 PHN; and 50 age-, sex- and education-year-matched healthy controls (HCs). Bilateral amygdala subregions were used as seeds for functional connectivity (FC). GCA was used to analyze the effective connection of brain regions that were significantly different among groups. Then, the correlation between FC, and GCA values and clinical indices was investigated.

Results:
PHN had impaired FC between the amygdala subregion with the putamen, cortex, anterior cingulate cortex (ACC) to HCs and reduced FC of medial amygdala (MeA) with the parieto-occipital lobe and motor cortex to HZ; HZ had reduced FC of the lateral amygdala (LA) with the insula to HCs. GCA values from the bilateral LA to the bilateral ACC, left MeA to the bilateral ACC and left putamen, and right ACC to the bilateral MeA were reduced in PHN patients compared to HCs. Compared with HCs, the GCA values from the left MeA to the left ACC and right putamen were reduced in HZ. The GCA values from the amygdala subregion to the ACC were positively correlated with HAMA or HAMD scores in PHN.

Conclusion:
PHN showed reduced FC between the amygdala subregions and cortico-putamen and decreased effective connectivity from the amygdala subregion to the ACC and putamen.

Advances in knowledge:
HZ and PHN patients had significant changes in effective connectivity in brain regions, including diverse functional areas emanating from and projecting to the amygdala. The current findings will provide a new perspective for understanding the neuropathophysiological mechanism HZ and PHN.
Developing a CT-based radiomics nomogram for predicting post-acute pancreatitis diabetes mellitus incidence
Authors: Zhong Shuting , Du Qinglin , Liu Nian , Chen Yuwei , Yang Tianyue , Qin Shize , Jiang Yu , Huang Xiaohua 
Published: September 2023

Objective
The present study aimed to develop the utility of a nomogram based on clinical and radiomics as a tool for predicting post-acute pancreatitis diabetes mellitus (PPDM-A).

Methods
This retrospective investigation evaluated 244 patients with acute pancreatitis. Patients were randomized in a 7:3 ratio into training and validation cohorts. Radiomics feature selection was then achieved using the variance threshold, select best K, and least absolute shrinkage and selection operator methods. The area under the curve values, decision, and calibration curves have been used to determine the models' predictive value.

Results
The developed nomogram performed superior to the clinical model in the validation (0.815 vs 0.677, p = 0.016) and training cohorts (0.803 vs 0.683, p = 0.002). The calibration curves demonstrated that the expected and actual values were satisfactory. In contrast, decision curve analysis revealed a stronger relationship between the nomogram and net clinical value than with the distinct radiomics or clinical signature effects.

Conclusion
In summary, the findings of this study demonstrated that establishing a predictive nomogram as a non-invasive technique may be useful in predicting the risk of PPDM-A.

Advances in knowledge
This is the first time to use a CT radiomics nomogram to predict PPDM-A. The nomogram is conducive to the personalized prediction of patients. It only needs to input the patient’s information, and a simple addition operation can quantitatively obtain its risk. The resultant tool has the potential to provide new opportunities to treat or prevent PPDM-A more effectively.
The level of school anxiety and the specificity of its manifestations in children with down syndrome
Authors: Sukhonos O. 
Published: September 2023

Children with Down syndrome studying in general schools together with children without this pathology often face an increased risk of maladjustment in the school environment. Due to the inadequacy of general education programs for children with developmental disabilities and the low level of awareness of school teachers and, especially, neurotypical school-age children about effective strategies for interacting with children with Down syndrome, the latter have an increased risk of developing school anxiety.
The aim of the study was to determine the level of school anxiety depending on the ability to verbal communication in children with Down syndrome.
Materials and methods: The research was carried out on the basis of the National Medical Center of ZOR, 97 children with Down's syndrome were thoroughly examined. The patients were divided into two groups according to the criterion of the ability to verbal communication: group 1 (G1) included 77 children capable of verbal communication, group 2 (G2) - 20 children who do not speak.
Results of the study. As a result of the research, the level of school anxiety in its various aspects was established, depending on the ability to verbal communication in children with Down syndrome. Children with Down syndrome who are able to communicate were found to have significantly higher anxiety scores on almost all subscales than children with Down syndrome who are not able to communicate verbally.
In children with Down syndrome who are incapable of verbal communication, a pathological decrease in anxiety in its various aspects is much more often noted, which may indicate a lack of understanding of social situations as a result of the lack of sufficient experience of being in a team (due to the inability to verbally produce the quality and quantity of communicative practices in such children suffer significantly). Children with Down syndrome who are able to talk have shown pathological reductions in school anxiety only in rare cases.