bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns and outcomes of invasive management of type 2 myocardial infarction in the United States
Authors: Smilowitz Nathaniel R. , Shah Binita , Lorin Jeffrey , Berger Jeffrey S. 
Published: January 2022

Background
Type 2 myocardial infarction (MI) occurs due to a mismatch in myocardial oxygen supply and demand without unstable coronary artery disease. We sought to identify patterns, predictors and outcomes of invasive management of type 2 MI in the USA.

Methods
Adults aged ≥18 years hospitalized with type 2 MI were identified in a cross-sectional study from the 2018 National Inpatient Sample. Invasive management was defined as invasive coronary angiography or revascularization. Patient, hospital and geographic characteristics associated with invasive management were identified by multivariable logistic regression. Propensity-matched cohorts were generated to evaluate associations between invasive vs. conservative management and mortality.

Results
We identified 268 850 admissions with type 2 MI in 2018. Type 2 MI patients had a high burden of comorbidities and were commonly admitted with diagnoses of circulatory (39.7%), infectious (23.1%) or respiratory (10.8%) illness. Only 11.2% of type 2 MI were managed invasively, of which 17.9% underwent coronary revascularization. Odds of invasive management were higher with commercial insurance [adjusted OR (aOR) 1.39; 95% confidence interval (CI), 1.27–1.52] and lower with Medicaid (aOR 0.86; 95% CI, 0.76–0.96) vs. Medicare. Significant heterogeneity in invasive management of type 2 MI was observed by geographic region (range 7.2–13.8%), independent of patient and hospital factors. Invasive management was associated with lower in-hospital mortality than conservative management overall (3.9 vs. 9.1%; P < 0.001) and in propensity-matched analyses (OR, 0.70; 95% CI, 0.59–0.84).

Conclusion
Invasive management of type 2 MI varies by insurance status and geography, highlighting uncertainty regarding optimal management and potential disparities in clinical care.
F-18 DOPA PET/CT in pediatric patients with hyperinsulinemic hypoglycemia: A correlation with genetic analysis
Authors: Sagar Sambit , Arora Geetanjali , Damle Nishikant , Sharma Rajni , Jain Vandana , Jana Manisha , Tripathi Madhavi , Bal Chandrasekhar , Goel Prabudh 
Published: January 2022

Aim
Persistent hyperinsulinemic hypoglycemia is a rare but life-threatening disease of infancy and childhood. 18F-DOPA PET/CT has been shown to be a useful modality in the localization of focal pancreatic lesions in these patients. We aimed to assess the role of 18F-DOPA PET/CT in such patients at our institution.

Materials and methods
In this prospective study, 18F-DOPA PET/CT scans and clinical details of 20 children with clinical diagnosis of hyperinsulinemic hypoglycemia were reviewed. Scans were acquired at 5 min postinjection of 2-3 mCi of 18F-DOPA on dedicated PET/CT scanners (Biograph mCT, Siemens Inc and Discovery PET/CT, GE). Abdominal spot images over 1–2 bed positions were acquired. Additionally, genetic mutation status, where available, was correlated to the scan findings.

Results
Out of 20 children (7 female and 13 male), 13 were infants. The age of the children ranged from 3 months to 8 years. Fifteen children had undergone gene analysis, 12 were positive for mutation in ABCC8, 1 for GLUD-1, 1 for GCK mutations and 1 had not shown any mutation. 18F-DOPA PET/CT scan showed 5 focal pancreatic lesions in 5 children (1 in each), two focal lesions in 1 child and diffuse pancreatic uptake in 14 children.

Conclusion

18F-DOPA PET/CT is a useful modality for localizing focal pancreatic lesions in children with persistent hyperinsulinemic hypoglycemia. The detection rate is significantly higher in patients with ABCC8 paternal monoallelic recessive gene mutation. 18F-DOPA PET/CT scan consequent to findings on genetic analysis appears to be useful in planning the management of children with hyperinsulinism.
Optimization of pediatric FDG-PET/CT examinations based on physical indicators using the SiPM-PET/CT system
Authors: Owaki Yoshiki , Minamishima Kazuya , Nakajima Kiyotaka 
Published: January 2022

Objective:
This study aimed to investigate the appropriate Silicon photomultiplier -PET/CT acquisition and image reconstruction conditions for each age group.

Methods:
The original phantom was developed to reflect the thickness and width of the torso in each age group (neonates, 1-year-olds, 5-year-olds, 10-year-olds, 15-year-olds, and adults). The ratio of hot spheres to background radioactivity was 4:1, and the radioactivity concentration was adjusted according to the Japanese consensus guidelines for appropriate implementation of pediatric nuclear medicine examinations. We evaluated the root mean square error (RMSE) as an assessment/function of the standardized uptake value of each hot sphere, the background variability (N
10 mm), the % contrast of the hot sphere (Q
H, 10 mm/N
10 mm), and the noise equivalent counts to determine the optimal reconstruction parameters and the appropriate acquisition time.

Results:
The minimum RMSE was obtained by setting the half-width of the Gaussian filter to 0-2 mm for iteration 1 or 2 and to 2-4 mm for iteration 3 or more. The acquisition times that satisfied the image quality equivalent to 120 s acquisitions in the adult phantoms were 30 s in the neonatal and 1-year-old phantoms, 60 s in the 5- and 10-year-old phantoms, and 75 s in the 15-year-old phantoms.

Conclusion:
This study demonstrated that good PET images could be obtained with short acquisition times when the examination is performed under appropriate reconstruction conditions.
Comparison of 99mTc-methyl diphosphonate bone scintigraphy and 68Ga-DOTANOC PET/computed tomography in articular manifestation of rheumatoid arthritis
Authors: Shamim Shamim Ahmed , Arora Geetanjali , Kumar Naresh , Behera Abhishek , Hussain Jhangir , Gupta Ranjan , Kumar Rakesh , Bal Chandrasekhar 
Published: January 2022

Objective
Tc-99m methyl diphosphonate (MDP) bone scintigraphy is used to assess disease activity in rheumatoid arthritis (RA). Somatostatin receptor (SSTR) expression in RA has been reported previously. SSTR-based PET/computed tomography (CT) may be superior to bone scintigraphy to know disease extent and in locating inflammatory joints that can be further targeted with peptide receptor radionuclide therapy thereby opening up new theranostic avenues. Based on these facts, the present study was designed to compare Tc-99m MDP bone scintigraphy and Ga-68 DOTANOC PET/CT in patients with RA.

Materials and methods
Patients with a clinical diagnosis of RA were injected with 111–185 MBq of Ga-68 DOTANOC and 740 MBq of Tc-99m MDP intravenously. Images were acquired 30–45 min postinjection for Ga-68 DOTANOC on dedicated PET/CT scanners. Triple-phase bone scans were acquired on a dual-head gamma camera. PET/CT and MDP scan images were visually assessed by two experienced nuclear medicine physicians.

Results
Nineteen patients (16 women and 3 men) with a clinical diagnosis of RA were included in the study. Clinically, 196 joints in these 19 patients were diagnosed positive for RA. Of these 196 joints, Tc-99m MDP uptake was seen in 157 joints (80%). On Ga-68 DOTANOC scan, tracer uptake was seen in 151 of 196 joints (77%) with a lesion to background ratio of at least 2 in most of the joints.

Conclusion
Ga-68 DOTANOC is equally good as an MDP scan for detection of RA with the added advantage of being used as a theranostic modality. However, further evaluation with a larger sample size and joint-to-joint comparison is warranted.
Predicting pathological response and overall survival in locally advanced gastric cancer patients undergoing neoadjuvant chemotherapy: the role of PET/computed tomography
Authors: Güç Zeynep Gülsüm , Turgut Bülent , Avci Arzu , Cengiz Fevzi , Eren Kalender Mehmet , Alacacioğlu Ahmet 
Published: January 2022

Background
Gastric cancer is the second leading cause of cancer-related deaths, with a 5-year survival rate of about 20–25%. The ability to predict pathological response (PR) to neoadjuvant chemotherapy (NACT); hence, overall survival (OS) probability of patients can allow the clinician to individualize treatment strategies. We investigated the role of F-18 fluorodeoxyglucose PET-computed tomography (F-18 FDG PET/CT) in predicting histopathologic response and prognosis in locally advanced gastric cancer (LAGC) patients undergoing NACT.

Methods
F-18FDG PET/CT images taken before and after NACT, adenocarcinoma histopathology and operation pyesis reports of 43 LAGC patients were analyzed. Maximum (SUVmax) and mean (SUVmean) standardized uptake values, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of lesions were measured before and after NACT. Changes in percentage were calculated for ΔSUVmax%, ΔSUVmean%, ΔMTV%, ΔTLG%, and cutoff values were determined by receiver operating characteristic curve analysis. NACT response in pathology pyesis was determined according to the College of American Pathologists classification. PR and OS were analyzed with Kaplan–Meier and Cox proportional hazards regression models based on cutoffs found with PET measurements.

Results
Cutoffs were ΔSUVmax = 33.31%, ΔSUVmean = 42.96%, ΔMTV = 30.38%, and ΔTLG = 28.14%, and all patients showed significance in PR and OS based on these cutoffs (all P < 0.01). PET/CT findings before and after NACT (ΔMTV > 30.38%, ΔTLG > 28.14%) predicted PR with 100% sensitivity and specificity. Multivariate analysis showed ΔSUVmean as an independent risk factor predicting OS (hazard ratio 0.348, 95% confidence interval 2.91–22.3, P = 0.03).

Conclusions
Metabolic parameters obtained with F-18 FDG PET/CT scanning before and after NACT in LAGC patients can accurately predict PR and OS.
Dosimetry in Lu-177-PSMA-617 prostate-specific membrane antigen targeted radioligand therapy: a systematic review
Authors: Nautiyal Amit , Jha Ashish K , Mithun Sneha , Rangarajan Venkatesh 
Published: January 2022

Background

177Lu-prostate-specific membrane antigen (PSMA) gained popularity as a choice of agent in the treatment of patients with advanced prostate cancer or metastatic castration-resistant stage of prostate carcinoma (mCRPC) diseases. However, this treatment may cause fatal effects, probably due to unintended irradiation of normal organs. We performed an extensive systematic review to assess the organs at risk and the absorbed dose received by tumor lesions in 177Lu-PSMA therapy.

Design
In this review, published peer-reviewed articles that cover clinical dosimetry in patients following peptide radionuclide ligand therapy using 177Lu-PSMA have been included. Two senior researchers independently checked the articles for inclusion. A systematic search in the database was made using PubMed, Publons and DOAJ. All selected articles were categorized into three groups: (1) clinical studies with the technical description of dosimetry in 177Lu-PSMA therapy (2) organ dosimetry in 177Lu-PSMA therapy or (3) tumor dosimetry in 177Lu-PSMA therapy.

Result
In total, 182 citations were identified on PSMA therapy and 17 original articles on 177Lu-PSMA dosimetry were recognized as eligible for review. The median absorbed dose per unit of administered activity for kidneys, salivary, liver, spleen, lacrimal and bone marrow was 0.55, 0.81, 0.1, 0.1, 2.26 and 0.03 Gy/GBq, respectively. The median absorbed dose per unit of activity for tumor lesions was found in a range of 2.71–10.94 Gy/GBq.

Conclusion

177Lu-PSMA systemic radiation therapy (SRT) is a well-tolerated and reliable treatment option against the management of the mCRPC stage of prostate carcinoma. Lacrimal glands and salivary glands are the major critical organs in 177Lu-PSMA SRT. Besides, tumors receive 3–6 times higher absorbed doses compared to organs at risk.
The Effectiveness of Emotion Regulation Therapy for Adolescent Females With Nonsuicidal Self-Injury Disorder
Authors: Ataie Shima , Gharraee Banafsheh , Shahboulaghi Farahnaz Mohammadi 
Published: January 2022

Abstract
Given the prevalence and consequences of the nonsuicidal self-injury disorder (NSSID) among adolescents, this study aimed to analyze the effectiveness of emotion regulation therapy (ERT) among adolescents with NSSID. The present study is an after-trial, mixed-method intervention design. Six participants completed questionnaires at baseline, during their treatment, and follow-up. In-depth interviews were made after the intervention. The quantitative findings were consistent with the pattern of the qualitative findings that prominently supported the treatment efficiency concerning the difficulties in emotion regulation. The research findings indicated that ERT had a positive effect on adolescents with NSSID.
Optimization of Preoperative Anemia in Lower Limb Joint Replacement Surgery
Authors: Maki Sara , Verma Neil , Morris Winifred , Smith Jay 
Published: January 2022

BACKGROUND:
Orthopaedic procedures such as total hip and total knee replacements carry a significant risk of postoperative anemia, necessitating allogenic blood transfusions (ABTs), and an increased hospital length of stay.

AIM:
Our aim was to investigate whether the implementation of a local protocol designed to detect and treat preoperative anemia resulted in reduced ABT rates and a shorter duration of length of hospital stay (LOS).

METHODS:
We retrospectively audited 683 patients undergoing primary hip and knee replacements. We collated data for all patients about hospital length of stay and blood transfusions received. Both descriptive statistics and univariate analysis were performed.

RESULTS:
Approximately 21.6% of the cohort within the study who were anemic at preoperative clinic had a significantly increased median LOS of 2 days (p < .001) and an increased packed red cell transfusion rate compared with non-anemic patients (26.1% vs. 2.21%, p < 001). However, treatment of preoperative anemia did not show any significant difference in transfusion rates compared with patients who did not receive corrective treatment. The median LOS was higher by 1 day in the treated group compared with the nontreated cohort (p = .005).

CONCLUSION:
There is significant evidence to suggest that preoperative anemia can increase LOS and increase the risk of requiring postoperative blood transfusions. However, anemia should be regarded as a characteristic that can add to the outcome in a cumulative manner, as opposed to an isolated factor. Further research is needed on how to better manage preoperative anemia in order to improve patients' outcomes.
Direct Discharge to Home From the Pediatric Cardiovascular ICU
Authors: Gal Dana B. , Kwiatkowski David M. , Cribb Fabersunne Camila , Kipps Alaina K. 
Published: January 2022

OBJECTIVES:
To describe direct discharge to home from the cardiovascular ICU.

DESIGN:
Mixed-methods including retrospective Pediatric Cardiac Critical Care Consortium and Pediatric Acute Care Cardiology Collaborative data and survey.

SETTING:
Tertiary pediatric heart center.

PATIENTS:
Patients less than 25 years old, with a cardiovascular ICU stay of greater than 24 hours and direct discharge to home from January 1, 2016, to December 8, 2020, were included. Select data describing patients discharged from acute care internally and nationally from Pediatric Acute Care Cardiology Collaborative sites were compared with the direct discharge to home cohort.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Encounter- and patient-specific characteristics. Seven-day and 30-day readmission and 30-day mortality served as surrogate safety markers. A survey of cardiovascular ICU frontline providers assessed comfort and skills related to direct discharge to home.
There were 364 direct discharge to home encounters that met inclusion criteria. The majority of direct discharge to home encounters were associated with a surgery or procedure (305; 84%). There were 27 encounters (7.4%) for medical technology–dependent patients requiring direct discharge to home. Unplanned 7-day readmissions among direct discharge to home patients was 1.9% compared with 4.6% (p = 0.04) of patients discharged from acute care internally. Readmission among those discharged from acute care internally did not differ from those at Pediatric Acute Care Cardiology Collaborative sites nationally. Frontline cardiovascular ICU providers had mixed levels of confidence in technical aspects and low levels of confidence in logistics of direct discharge to home.

CONCLUSIONS:
Cardiovascular ICU direct discharge to home was not associated with increased unplanned readmissions compared with patients discharged from acute care and may be safe in select patients. Frontline cardiovascular ICU providers feel time constraints challenge direct discharge to home. Further research is needed to identify patient characteristics associated with safe direct discharge to home and systems needed to support this practice.
Summary statistics are described using proportions or medians with interquartile ranges (IQRs) and were performed using Microsoft Excel (Microsoft, Redmond, WA). Two-sample tests of proportions were used to compare readmission frequency of the DDH cohort compared with internal and national PAC3 data using STATA Version 15 (StataCorp, College Station, TX).
Local Health Departments' Characteristics and Their Performance Scores in PHAB Accreditation Standards
Authors: Dada Oluwatosin Omolara , Bekemeier Betty , Flaxman Abraham , de Castro Butch 
Published: January 2022

Context:
Local health departments (LHDs) function to promote and protect population health by executing programs and activities through the 10 essential public health (PH) services in their operationalization of the core functions of PH systems—assessment, policy development, and assurance. PH accreditation supports LHDs by assessing their ability to promote community well-being through a set of standards and measures based on the 10 essential PH services. Prior studies show variation in LHD characteristics relative to their likelihood of participating in accreditation, but no studies have examined the variation in LHD accreditation scores to understand how LHD characteristics relate to performance improvement.

Objective:
This work examines variation in LHD accreditation scores relative to their organizational and jurisdiction characteristics.

Design:
Cross-sectional data were obtained from 250 LHDs from 38 states that underwent Public Health Accreditation Board (PHAB) accreditation review.

Analysis:
We used exploratory cluster analysis to identify and group LHDs with similar performance scores in PHAB accreditation standards. Descriptive analyses were undertaken to characterize each LHD cluster group's organizational structure, jurisdiction characteristics, and core PH function activity levels. We then employed multivariate regression analysis to confirm the cluster analysis results.

Results:
The analysis showed 3 clusters of PHAB accreditation performance scores (cluster 1 = 0.95; cluster 2 = 0.87; and cluster 3 = 0.71). Subtle differences in organizational and jurisdiction characteristics across clusters, notably in population size of the jurisdictions served, were observed. LHDs in cluster 3 tended to have jurisdictions with less than 250000 population size and serve more than 1 county.

Conclusions:
Performance scores in PHAB accreditation can be a useful standardized metric for assessing LHD ability to promote community well-being. LHDs serving less than 20000 population size, which exhibit relatively lower performance than other LHDs, may require more targeted supports to close the gap in their performance score.
Brief Report: Blood and Genital Fluid Viral Load Trajectories Among Treated and Untreated Persons With Acute HIV Infection in Malawi
Authors: Chen Jane S. , Pettifor Audrey E. , Nelson Julie A.E. , Phiri Sam , Pasquale Dana K. , Kumwenda Wiza , Kamanga Gift , Cottrell Mackenzie L. , Sykes Craig , Kashuba Angela D.M. , Tegha Gerald , Krysiak Robert , Thengolose Isaac , Cohen Myron S. , Hoffman Irving F. , Miller William C. , Rutstein Sarah E. 
Published: January 2022

Background:
Persons with acute HIV infection (AHI) are highly infectious and responsible for a disproportionate share of incident infections. Immediate antiretroviral therapy (ART) rapidly reduces blood viral loads (VLs), but genital VLs after ART initiation during AHI are less well described.

Setting:
Lilongwe, Malawi, 2012–2014.

Methods:
HIV-seronegative and HIV-serodiscordant persons aged ≥18 years were screened for AHI (RNA positive) and randomized to standard of care, behavioral intervention, or behavioral intervention plus short-term ART (raltegravir/emtricitabine/tenofovir) (1:2:2). Persons who were ART eligible under Malawi guidelines could receive first-line therapy. Blood and genital VLs were assessed at weeks 1, 4, 8, and 12. Fisher's Exact test was used to compare viral suppression by ART status.

Results:
Overall, 46 persons with AHI were enrolled; of whom, 17 started ART within 12 weeks. Median blood VL at AHI diagnosis was 836,115 copies/mL. At week 12, 7% (1/14) of those who initiated ART had a blood VL of ≥400 copies/mL, compared with 100% (23/23; P < 0.0001) of those who did not initiate ART (median VL: 61,605 copies/mL). Median genital VL at week 1 was 772 copies/mL, with 13 of 22 (59%) having VL of ≥400 copies/mL. At week 12, 0 of 10 (0%) of those who initiated ART had genital VL of ≥400 copies/mL, compared with 7 of 15 (47%) of those who did not initiate ART (P = 0.02).

Conclusion:
Although highly correlated, VLs in blood and genital fluids occupy discrete biological compartments with distinct virologic dynamics. Our results corroborate the dramatic reduction in both compartments after ART initiation. Increasing AHI screening and rapidly initiating treatment is key to interrupting transmission.
How common is ventilator-associated pneumonia after coronavirus disease 2019?
Authors: Wicky Paul-Henri , d’Humières Camille , Timsit Jean-François 
Published: January 2022

Purpose of review
The first studies on COVID-19 patients with acute respiratory distress syndrome (ARDS) described a high rate of secondary bacterial ventilator-associated pneumonia (VAP). The specificity of VAP diagnoses in these patients are reviewed, including their actual rate.

Recent findings
Published studies described high rates of bacterial VAP among COVID-19 patients with ARDS, and these VAP episodes are usually severe and of specifically poor prognosis with high mortality. Indeed, Severe acute respiratory syndrome - coronavirus disease 19 (SARS-CoV2) infection elicits alterations that may explain a high risk of VAP. In addition, breaches in the aseptic management of patients might have occurred when the burden of care was heavy. In addition, VAP in these patients is more frequently suspected, and more often investigated with diagnostic tools based on molecular techniques.

Summary
VAP is frequented and of particularly poor prognosis in COVID-19 patients with ARDS. It can be explained by SARS-CoV-2 pathophysiology, and also breaches in the aseptic procedures. In addition, tools based on molecular techniques allow an early diagnosis and unmask VAP usually underdiagnosed by traditional culture-based methods. The impact of molecular technique-based diagnostics in improving antibacterial therapy and COVID-19 prognosis remain to be evaluated.