bluuebunny/crossref_metadata_2025_split huggingface dataset:
Musculoskeletal System (Non-Oncologic Indications)
Authors: Gnanasegaran Gopinath , Usmani Sharjeel , Nadel Helen 
Published: September 2023

AbstractRadionuclide pediatric bone scintigraphy is a useful modality to assess benign diseases of the skeleton. Bone scintigraphy has high sensitivity in assessing bone metabolism in children. Bone scintigraphy is most commonly performed with 99mTc-labelled bisphosphonate SPECT agents and less commonly with 18F-NaFluoride (NaF), a bone-seeking PET tracer with similar biodistribution. The lower protein binding in the blood of NaF results in its more rapid first-pass extraction and faster soft tissue clearance, allowing early image acquisition. Accurate interpretation of bone images is often challenging and requires adequate training and knowledge of pathophysiology to recognize normal variants, patterns, and pitfalls. In general, bone scintigraphy is best interpreted in conjunction with available clinical, laboratory, and radiologic data. In addition, there have been significant advances in hybrid imaging technology such as SPECT/CT, PET/CT, and PET/MRI over the years which have improved accurate localization, and characterization of benign and malignant bone lesions in children.
Central Nervous System: The Brain and Cerebro-Spinal Fluid
Authors: Biassoni Lorenzo , Nadel Helen , Bar-Sever Zvi 
Published: September 2023

AbstractNuclear medicine studies of the central nervous system provide unique information on cerebral perfusion and metabolism and the physiology of cerebro-spinal fluid (CSF) fluid. Diagnosis of brain death is based on clinical findings indicating a complete lack of function of the entire brain. Mandatory additional studies supporting the clinical suspicion are required by most countries, such as electroencephalography (EEG), brainstem evoked response audiometry (BERA), transcranial Doppler, and brain scintigraphy. Brain scans following the administration of perfusion agents are considered to represent the most objective assessment tool. FDG PET and possibly ictal-interictal cerebral perfusion SPECT studies are used to identify an epileptogenic focus in drug-resistant epilepsy. The main indication is in patients with likely unifocal seizures at semiology and EEG, and a negative brain MRI, or with MRI findings not corresponding to clinical signs and symptoms and to EEG findings. CSF shunt patency studies involve injection of a radiopharmaceutical into the reservoir of a ventriculo-peritoneal shunt in children with hydrocephalus. The study shows the transit of labelled CSF through the shunt and may detect shunt obstructions. Radionuclide molecular imaging studies on brain tumors are rare and mainly part of research projects and are not performed in routine clinical settings and therefore will not be dealt with in this section.
Thyroid
Authors: Shulkin Barry , Pascual Thomas Neil 
Published: September 2023

AbstractThyroid imaging, one of the earliest scanning tests, is used in children to determine the cause of congenital and acquired thyroid diseases. It should be interpreted in conjunction with the patient’s clinical picture, thyroid function tests, history of medication and diet, physical examination, thyroid function tests, and ultrasound. Congenital hypothyroidism (CHT) is usually detected on newborn screening. Ectopic thyroid and thyroid aplasia may result in hypothyroidism requiring lifelong hormone replacement therapy. In the presence of a normally positioned, fully developed thyroid, CHT can be transient. Evaluation of acquired benign thyroid disease in children is occasionally supplemented by radioactive iodine uptake tests and can be an aid in therapeutic decisions. Thyroid cancer is the most common endocrine malignancy in children and represents up to 2% of all cancers diagnosed by the age of 20 years, more common in teenagers. It is diagnosed in 25% of thyroid nodules in children, as compared to 10–15% in adults. Children with thyroid cancer present with more advanced disease than adults, including multifocal primary and a higher incidence of regional and distant metastases. Cervical lymph node metastases are diagnosed in 50% and lung metastases in 20% of cases. 131I, a suboptimal agent for imaging, has been largely replaced by 123I and 99mTc-pertechnetate. 131I is at present used mainly for therapeutic purposes in hyperthyroidism, ablation of thyroid remnants following thyroidectomy, and for treatment of thyroid cancer.
Background Independence and the Adler–Bardeen Theorem
Authors: Zahn Jochen 
Published: September 2023

AbstractWe prove that for renormalizable Yang–Mills gauge theory with arbitrary compact gauge group (of at most a single abelian factor) and matter coupling, the absence of gauge anomalies can be established at the one-loop level. This proceeds by relating the gauge anomaly to perturbative agreement, which formalizes background independence.
Simulation of the mortality after different ex ante (secondary) and ex post (tertiary) triage methods in people with disabilities and pre-existing diseases
Authors: Garber Sara , Brunner Jens O. , Heller Axel R. , Marckmann Georg , Bartenschlager Christina C. 
Published: September 2023

AbstractThe significant increase in patients during the COVID-19 pandemic presented the healthcare system with a variety of challenges. The intensive care unit is one of the areas particularly affected in this context. Only through extensive infection control measures as well as an enormous logistical effort was it possible to treat all patients requiring intensive care in Germany even during peak phases of the pandemic, and to prevent triage even in regions with high patient pressure and simultaneously low capacities. Regarding pandemic preparedness, the German Parliament passed a law on triage that explicitly prohibits ex post (tertiary) triage. In ex post triage, patients who are already being treated are included in the triage decision and treatment capacities are allocated according to the individual likelihood of success. Legal, ethical, and social considerations for triage in pandemics can be found in the literature, but there is no quantitative assessment with respect to different patient groups in the intensive care unit. This study addressed this gap and applied a simulation-based evaluation of ex ante (primary) and ex post triage policies in consideration of survival probabilities, impairments, and pre-existing conditions. The results show that application of ex post triage based on survival probabilities leads to a reduction in mortality in the intensive care unit for all patient groups. In the scenario close to a real-world situation, considering different impaired and prediseased patient groups, a reduction in mortality of approximately 15% was already achieved by applying ex post triage on the first day. This mortality-reducing effect of ex post triage is further enhanced as the number of patients requiring intensive care increases.
The Importance of Perceived Barriers to Women Entering and Advancing in Orthopaedic Surgery in the US and Beyond
Authors: Xu Amy L. , Humbyrd Casey J. , De Mattos Camila Bedeschi Rego , LaPorte Dawn 
Published: September 2023

AbstractBackgroundGlobal perceptions of barriers to women in orthopaedics have not been assessed. The purpose of this study was to determine the importance of international barriers to women entering and advancing within orthopaedic surgery.MethodsAn anonymous, online survey was distributed to women medical students, trainees, and practicing surgeons via Women in Orthopaedics Worldwide, the “Women in Ortho” Facebook page, and individual programmes. Participants were asked to rate perceived barriers to (1) pursuing training and (2) career advancement on a scale of 1–5, with 5 being the most important and relative to other barriers. Descriptive statistics and univariate analyses were employed.ResultsThe survey yielded 237 US (84.0%) and 45 international (16.0%) respondents. Per entering orthopaedic surgery, the most important barriers were male‐dominated culture, lack of a strong women mentor, and lack of female representation at home institution. Compared with the US surgeons/trainees, international respondents cited greater societal disapproval (2.8 ± 1.2 vs. 3.4 ± 1.3, P = 0.01). Medical students assigned less importance to lack of exposure, more to lack of resources for creating competitive applications (P < 0.05). Regarding career advancement, lack of women leadership, family responsibilities, and gender‐biased selection for promotion were the most important. International surgeons/trainees noted greater concern for societal disapproval (3.5 ± 1.5 vs. 2.6 ± 1.3, P = 0.003) and were more likely to rank sexual harassment in their top three (17.6 vs. 4.2%, P = 0.02).ConclusionWhile notable differences exist, there is striking similarity across countries and position levels in perceived barriers to women entering and advancing in orthopaedic surgery.Level of evidence: III.
Assessing the Utility of Multiplexed Polymerase Chain Reaction in Detecting Microorganisms Causing Infections in Critically ill Patients
Authors: Garrido Pedro , Gabaldó-Barrios Xavier , Pujol-Bajador Isabel , Fernández Luis , Ballester Frederic , Garrido Raquel , Cueto Pitter , Camps Jordi , Vallverdú Immaculada 
Published: September 2023

AbstractEarly sepsis diagnosis is crucial for implementing adequate antibiotic therapy and for patient survival. This study investigated whether using multiplexed PCR for detecting microorganisms in critical septic patients affects initial antibiotic treatment and compared it to microbiological culture. It also explored scenarios where PCR is more effective in clinical practice. One hundred nineteen specimens (83 blood and 36 respiratory specimens) belonging to 93 patients were analyzed. Multiplexed PCR determinations were performed using the FA-BCID Panel (bioMérieux) for blood samples and the FA-Pneumo for respiratory samples. The mean turnaround times were 1.7 h for the FA-BCID and 1.5h for the FA-Pneumo. Conversely, they were 96.1 h for blood cultures and 72.3 h for respiratory cultures. FA-BCID showed a mean sensitivity of 97% and specificity of 100%. FA-Pneumo showed a sensitivity of 100% and specificity of 90%. However, the positive predictive value was only 39%. Discrepancies were common in polymicrobial samples. Based on the PCR results, initial empirical treatment should have been changed in 71% of patients with bloodstream infections and 61% with respiratory infections. We conclude that multiplexed PCR improves the response time in identifying germs with a high degree of coincidence for blood cultures and moderate for respiratory cultures. These results highlight the importance of PCR in choosing an appropriate antibiotic therapy.
Effect of sacubitril/valsartan on cardiac remodeling compared with other renin–angiotensin system inhibitors: a difference-in-difference analysis of propensity-score matched samples
Authors: Carluccio Erberto , Dini Frank L. , Correale Michele , Dattilo Giuseppe , Ciccarelli Michele , Vannuccini Francesca , Sforna Stefano , Pacileo Giuseppe , Masarone Daniele , Scelsi Laura , Ghio Stefano , Tocchetti Carlo Gabriele , Mercurio Valentina , Brunetti Natale Daniele , Nodari Savina , Ambrosio Giuseppe , Palazzuoli Alberto ,   on behalf of the Working Group on Heart Failure of the Italian Society of Cardiology
Published: September 2023

Abstract
Background
In patients with heart failure with reduced ejection fraction (HFrEF), treatment with sacubitril–valsartan (S/V) may reverse left ventricular remodeling (rLVR). Whether this effect is superior to that induced by other renin–angiotensin system (RAS) inhibitors is not well known.

Methods
HFrEF patients treated with S/V (n = 795) were compared, by propensity score matching, with a historical cohort of 831 HFrEF patients (non-S/V group) treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (RAS inhibitors). All patients were also treated with beta-blockers and shared the same protocol with repeat echocardiogram 8–12 months after starting therapy. The difference-in-difference (DiD) analysis was used to evaluate the impact of S/V on CR indices between the two groups.

Results
After propensity score matching, compared to non-S/V group (n = 354), S/V group (n = 354) showed a relative greater reduction in end-diastolic and end-systolic volume index (ESVI), and greater increase in ejection fraction (DiD estimator =  + 5.42 mL/m2, P = 0.0005; + 4.68 mL/m2, P = 0.0009, and + 1.76%, P = 0.002, respectively). Reverse LVR (reduction in ESVI ≥ 15% from baseline) was more prevalent in S/V than in non-S/V group (34% vs 26%, P = 0.017), while adverse LVR (aLVR, increase in ESVI at follow-up ≥ 15%) was more frequent in non-S/V than in S/V (16% vs 7%, P < 0.001). The beneficial effect of S/V on CR over other RAS inhibitors was appreciable across a wide range of patient’s age and baseline end-diastolic volume index, but it tended to attenuate in more dilated left ventricles (P for interaction = NS for both).

Conclusion
In HFrEF patients treated with beta-blockers, sacubitril/valsartan is associated with a relative greater benefit in LV reverse remodeling indices than other RAS inhibitors.

Graphical abstract
Solid pseudopapillary neoplasms of the pancreas in childhood and adolescence—an analysis of the German Registry for Rare Pediatric Tumors (STEP)
Authors: Jentzsch Christian , Fuchs Jörg , Agaimy Abbas , Vokuhl Christian , Escherich Gabriele , Blattmann Claudia , Warmann Steven W. , Schmidt Andreas , Schäfer Jürgen , Brecht Ines B. , Schneider Dominik T. , Abele Michael 
Published: September 2023

AbstractSolid pseudopapillary neoplasms (SPNs) are the most common entity among pediatric pancreatic tumors. Still, these are rare tumors with an annual incidence of 0.1–0.2/1,000,000, and little is known about their optimal treatment. This analysis aimed to increase knowledge about the occurrence and treatment strategies of SPN in childhood. Data regarding diagnostics, treatment, and outcome of children aged 0–18 years with SPN recorded in the German Registry for Rare Pediatric Tumors (STEP) were analyzed. Thirty-eight patients were identified with a median age of 14.5 years at diagnosis (range: 8–18) and a female preponderance (81.6%). The most frequent location of the tumor was the pancreatic tail. In histopathological and immunohistochemical examination, pseudopapillary, solid, and cystic lesions as well as expression of beta-catenin, progesterone receptors, and cyclin D1 were the most common findings. All patients underwent surgical resection. Most patients underwent open resection, predominantly tail resection for tumors in the tail region and pylorus-preserving pancreaticoduodenectomy for tumors in the head region. The main postoperative sequela was exogenous pancreatic insufficiency (23.7%), especially with SPN in the pancreatic head. No recurrence occurred during follow-up, although two patients underwent resection with microscopic residue.Conclusion: SPN of the pancreas in childhood are low-grade malignancies with usually favorable treatment outcomes. However, therapy can lead to relevant long-term sequelae. To prevent recurrence, complete surgical resection is recommended, sparing as much healthy pancreatic tissue as possible. Interdisciplinary collaboration between specialists is essential to optimize treatment. Molecular genetic analysis of these tumors could improve understanding of their genesis.

What is Known:• Solid pseudopapillary neoplasms (SPNs) of the pancreas are very rare tumors in childhood.• Little is known about tumorigenesis, and there are no specific guidelines for treatment and follow-up in pediatric patients.

What is New:• Characteristics, treatment, and outcome were comprehensively assessed in a large cohort of pediatric patients with SPN.• We propose recommendations for diagnosis, treatment, and follow-up of children with SPN, based on our analysis and considering published experience.
Left Ventricular Myocardial Dysfunction Evaluation in Thalassemia Patients Using Echocardiographic Radiomic Features and Machine Learning Algorithms
Authors: Taleie Haniyeh , Hajianfar Ghasem , Sabouri Maziar , Parsaee Mozhgan , Houshmand Golnaz , Bitarafan-Rajabi Ahmad , Zaidi Habib , Shiri Isaac 
Published: September 2023

AbstractHeart failure caused by iron deposits in the myocardium is the primary cause of mortality in beta-thalassemia major patients. Cardiac magnetic resonance imaging (CMRI) T2* is the primary screening technique used to detect myocardial iron overload, but inherently bears some limitations. In this study, we aimed to differentiate beta-thalassemia major patients with myocardial iron overload from those without myocardial iron overload (detected by T2*CMRI) based on radiomic features extracted from echocardiography images and machine learning (ML) in patients with normal left ventricular ejection fraction (LVEF > 55%) in echocardiography. Out of 91 cases, 44 patients with thalassemia major with normal LVEF (> 55%) and T2* ≤ 20 ms and 47 people with LVEF > 55% and T2* > 20 ms as the control group were included in the study. Radiomic features were extracted for each end-systolic (ES) and end-diastolic (ED) image. Then, three feature selection (FS) methods and six different classifiers were used. The models were evaluated using various metrics, including the area under the ROC curve (AUC), accuracy (ACC), sensitivity (SEN), and specificity (SPE). Maximum relevance-minimum redundancy-eXtreme gradient boosting (MRMR-XGB) (AUC = 0.73, ACC = 0.73, SPE = 0.73, SEN = 0.73), ANOVA-MLP (AUC = 0.69, ACC = 0.69, SPE = 0.56, SEN = 0.83), and recursive feature elimination-K-nearest neighbors (RFE-KNN) (AUC = 0.65, ACC = 0.65, SPE = 0.64, SEN = 0.65) were the best models in ED, ES, and ED&ES datasets. Using radiomic features extracted from echocardiographic images and ML, it is feasible to predict cardiac problems caused by iron overload.
The Structural Response of the Human Head to a Vertex Impact
Authors: Thompson-Bagshaw Darcy W. , Quarrington Ryan D. , Dwyer Andrew M. , Jones Nigel R. , Jones Claire F. 
Published: September 2023

AbstractIn experimental models of cervical spine trauma caused by near-vertex head-first impact, a surrogate headform may be substituted for the cadaveric head. To inform headform design and to verify that such substitution is valid, the force-deformation response of the human head with boundary conditions relevant to cervical spine head-first impact models is required. There are currently no biomechanics data that characterize the force-deformation response of the isolated head supported at the occiput and compressed at the vertex by a flat impactor. The effect of impact velocity (1, 2 or 3 m/s) on the response of human heads (N = 22) subjected to vertex impacts, while supported by a rigid occipital mount, was investigated. 1 and 2 m/s impacts elicited force-deformation responses with two linear regions, while 3 m/s impacts resulted in a single linear region and skull base ring fractures. Peak force and stiffness increased from 1 to 2 and 3 m/s. Deformation at peak force and absorbed energy increased from 1 to 2 m/s, but decreased from 2 to 3 m/s. The data reported herein enhances the limited knowledge on the human head’s response to a vertex impact, which may allow for validation of surrogate head models in this loading scenario.
Blood Flow Energy Identifies Coronary Lesions Culprit of Future Myocardial Infarction
Authors: Lodi Rizzini Maurizio , Candreva Alessandro , Mazzi Valentina , Pagnoni Mattia , Chiastra Claudio , Aben Jean-Paul , Fournier Stephane , Cook Stephane , Muller Olivier , De Bruyne Bernard , Mizukami Takuya , Collet Carlos , Gallo Diego , Morbiducci Umberto 
Published: September 2023

AbstractThe present study establishes a link between blood flow energy transformations in coronary atherosclerotic lesions and clinical outcomes. The predictive capacity for future myocardial infarction (MI) was compared with that of established quantitative coronary angiography (QCA)-derived predictors. Angiography-based computational fluid dynamics (CFD) simulations were performed on 80 human coronary lesions culprit of MI within 5 years and 108 non-culprit lesions for future MI. Blood flow energy transformations were assessed in the converging flow segment of the lesion as ratios of kinetic and rotational energy values (KER and RER, respectively) at the QCA-identified minimum lumen area and proximal lesion sections. The anatomical and functional lesion severity were evaluated with QCA to derive percentage area stenosis (%AS), vessel fractional flow reserve (vFFR), and translesional vFFR (ΔvFFR). Wall shear stress profiles were investigated in terms of topological shear variation index (TSVI). KER and RER predicted MI at 5 years (AUC = 0.73, 95% CI 0.65–0.80, and AUC = 0.76, 95% CI 0.70–0.83, respectively; p < 0.0001 for both). The predictive capacity for future MI of KER and RER was significantly stronger than vFFR (p = 0.0391 and p = 0.0045, respectively). RER predictive capacity was significantly stronger than %AS and ΔvFFR (p = 0.0041 and p = 0.0059, respectively). The predictive capacity for future MI of KER and RER did not differ significantly from TSVI. Blood flow kinetic and rotational energy transformations were significant predictors for MI at 5 years (p < 0.0001). The findings of this study support the hypothesis of a biomechanical contribution to the process of plaque destabilization/rupture leading to MI.
Racial Differences in Self-Report of Mental Illness and Mental Illness Treatment in the Community: An Analysis of Jail Intake Data
Authors: Plummer Narcissa , Guardado Rubeen , Ngassa Yvane , Montalvo Cristina , Kotoujian Peter J. , Siddiqi Kashif , Senst Thomas , Simon Kevin , Acevedo Andrea , Wurcel Alysse G. 
Published: September 2023

AbstractJails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA. We used data from the “Offender Management System,” the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction. We evaluated two primary outcomes (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake, over half (57%) of the sample self-reported history of mental illness and 20% reported the use of psychiatric medications. Among people who self-reported a history of mental illness, Hispanic (AOR: 0.73, 95% CI: 0.60–0.90), Black (AOR: 0.52, 95% CI: 0.43–0.64), Asian/Pacific Islander (Non-Hispanic) people (AOR: 0.31, 95% CI: 0.13–0.74), and people from other racial/ethnic groups (AOR: 0.33, 95% CI: 0.11–0.93) all had decreased odds of reporting psychiatric medications. Mental illness was reported in about one-half of people who entered jail, but only 20% reported receiving medications in the community prior to incarceration. Our findings build on the existing literature on jail-based mental illness and show racial disparities in self-report of psychiatric medications in people who self-reported mental illness. The timing, frequency, and equity of mental health services in both the community and the jail setting deserves further research, investment, and improvement.