bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning Quantitative Analysis of FDG PET Images of Medial Temporal Lobe Epilepsy Patients
Authors: Shih Yen-Cheng , Lee Tse-Hao , Yu Hsiang-Yu , Chou Chien-Chen , Lee Cheng-Chia , Lin Po-Tso , Peng Syu-Jyun 
Published: January 2022

Purpose

18F-FDG PET is widely used in epilepsy surgery. We established a robust quantitative algorithm for the lateralization of epileptogenic foci and examined the value of machine learning of 18F-FDG PET data in medial temporal lobe epilepsy (MTLE) patients.

Patients and Methods
We retrospectively reviewed patients who underwent surgery for MTLE. Three clinicians identified the side of MTLE epileptogenesis by visual inspection. The surgical side was set as the epileptogenic side. Two parcellation paradigms and corresponding atlases (Automated Anatomical Labeling and FreeSurfer aparc + aseg) were used to extract the normalized PET uptake of the regions of interest (ROIs). The lateralization index of the MTLE-associated regions in either hemisphere was calculated. The lateralization indices of each ROI were subjected for machine learning to establish the model for classifying the side of MTLE epileptogenesis.

Result
Ninety-three patients were enrolled for training and validation, and another 11 patients were used for testing. The hit rate of lateralization by visual analysis was 75.3%. Among the 23 patients whose MTLE side of epileptogenesis was incorrectly determined or for whom no conclusion was reached by visual analysis, the Automated Anatomical Labeling and aparc + aseg parcellated the associated ROIs on the correctly lateralized MTLE side in 100.0% and 82.6%. In the testing set, lateralization accuracy was 100% in the 2 paradigms.

Conclusions
Visual analysis of 18F-FDG PET to lateralize MTLE epileptogenesis showed a lower hit rate compared with machine-assisted interpretation. While reviewing 18F-FDG PET images of MTLE patients, considering the regions associated with MTLE resulted in better performance than limiting analysis to hippocampal regions.
Tumor Imaging With 68Ga-DOTA-FAPI-04 PET/CT
Authors: Çermik Tevfik Fikret , Ergül Nurhan , Yılmaz Burçak , Mercanoğlu Güldem 
Published: January 2022

Introduction and Aim
Cancer-associated fibroblasts, which are densely found in tumor tissue, express high levels of fibroblast activation protein (FAP), and FAP inhibitors (FAPIs) labeled with radionuclides can be used in the diagnosis and treatment of cancer. In this study, the role of 68Ga-DOTA-FAPI-04 PET/CT in imaging of primary, metastatic, and recurrent cancers was investigated.

Patients and Methods
A total of 42 patients (16 females, 26 males; mean age, 58.5 years; range, 31–84 years) with 22 different types of malignant diseases were included in the study. 68Ga-DOTA-FAPI-04 PET/CT imaging was performed 1 to 7 days after 18F-FDG PET/CT. Pathological uptake levels in primary tumoral lesions, lymph nodes, skeletal system, liver, peritoneal surfaces, and other body parts were compared between 2 PET/CTs. In addition, physiological uptake levels of 18F-FDG and 68Ga-FAPI were defined measuring the liver, thoracic aorta, gluteal muscle activities, and uterus activity in female patients.

Results
Of the 42 patients in the study group, 33 patients were included for staging, 8 patients for restaging, and 1 patient for evaluation of treatment response. 68Ga-DOTA-FAPI-04 PET/CT showed intense uptake in 94.2% of primary tumoral lesions. In patients with multiple myeloma, 18F-FDG uptake in the bone marrow was significantly higher than 68Ga-FAPI uptake, whereas in gastric signet ring cell tumors, 68Ga-FAPI uptake was found to be significantly higher than 18F-FDG uptake. It was observed that 68Ga-DOTA-FAPI-04 PET/CT detected bone, liver, and peritoneum metastases with higher sensitivity and accuracy compared 18F-FDG PET/CT.

Conclusions
The preliminary findings of this study showed that 68Ga-DOTA-FAPI-04 PET/CT can contribute to the diagnostic process in solid tumors. Especially in malignancies with mild uptake on 18F-FDG PET/CT, it stands out in diagnosis, staging, and restaging. It is also predicted that FAPI molecules can be used for radionuclide therapy in patients with metastatic disease and unresponsive to other treatments showing intense uptake on 68Ga-DOTA-FAPI-04 PET/CT.
18F-FDG PET/CT Image Analysis of Penicilliosis Marneffei in an Immunocompetent Child Patient
Authors: Cheng You , Li Wen-Min , Huang Jian-Jiang , Wang Shu-Xia , Shao Dan 
Published: January 2022

Abstract
Penicilliosis marneffei is an extremely rare fungal infectious disease that often occurs in hosts with immunodeficiency or immune dysfunction. Penicilliosis marneffei has been seldom reported in children with multiple infiltrations throughout the body. We report a case of a boy with normal immune function who had multiple infiltrations of penicilliosis marneffei and was misdiagnosed with lymphoma by PET/CT.
Visualization of Tumor Heterogeneity in Advanced Medullary Thyroid Carcinoma by Dual-Tracer Molecular Imaging
Authors: Hasenauer Natalie , Higuchi Takahiro , Deschler-Baier Barbara , Hartrampf Philipp E. , Pomper Martin G. , Rowe Steven P. , Fassnacht Martin , Buck Andreas K. , Werner Rudolf A. 
Published: January 2022

Abstract
We present the case of a 60-year-old man with medullary thyroid carcinoma and hepatic, osseous, and lymph node metastases who underwent peptide receptor radionuclide therapy with 177Lu-DOTATOC. After 2 cycles, 68Ga-DOTATOC PET/CT revealed multiple nonavid lesions. To assess whether the patient would be eligible for prostate-specific membrane antigen (PSMA)–targeted radioligand therapy, a PSMA PET/CT was conducted. PSMA PET/CT identified increased PSMA expression in both 68Ga-DOTATOC–avid and nonavid lesions. As such, dual-radiotracer PET/CT may allow for insights into the complexities of tumor heterogeneity in patients with medullary thyroid carcinoma, which may pave the way for subsequent therapeutic algorithms.
Role of FDG PET/CT in the Evaluation of Therapy Response in Systemic Juvenile Xanthogranuloma
Authors: Mavi Mehmet Emin , Turan Basak Soydas , Salanci Bilge Volkan , Bozkurt Murat Fani 
Published: January 2022

Abstract
Juvenile xanthogranuloma, a rare type of non-Langerhans cell histiocytosis, is mostly seen in childhood and adolescence and generally manifests as widespread skin lesions. It rarely shows systemic involvement. Although the cutaneous form is often self-limited, systemic form is quite aggressive. Here we report the findings of FDG PET/CT scans during the course of cladribine therapy in a 6-year-old girl with systemic juvenile xanthogranuloma.
A Systematic Review of Subsurface Radiofrequency Treatments in Plastic Surgery
Authors: Swanson Eric 
Published: January 2022

Background
Subsurface radiofrequency (RF) treatments produce skin contraction by causing coagulation of the underlying subcutaneous fat. This method is marketed to fill a treatment gap for patients who do not wish to have surgery. A systematic review of this subject has not been previously published.

Methods
An electronic search was performed using PubMed to identify the literature describing subsurface RF treatments.

Results
Thirty articles were evaluated. An InMode device was used in 23 studies, and a Thermi device was used in 6 studies, with or without liposuction. Treatment areas included the face, neck, body, breasts, and labia. Most studies relied on patient satisfaction scores and physician review of photographs. The most frequent complications were induration and nodules. Most patients experienced prolonged swelling and numbness. Several studies reported marginal mandibular neuropraxias. The skin response after treatment of the abdomen was poor, and seromas were common. The incidence of burns improved after modification of the InMode device. Breast treatment did not appear to be effective in treating ptosis. Patient satisfaction scores were modest. Most studies (77%) were published by authors with a known conflict of interest. In some studies, the photographs did not accurately depict the treatment result. Institutional review board approval and disclosure of off-label regulatory status were often missing.

Discussion
Thermal treatment of the subcutaneous tissue introduces extra risks without a compensatory benefit. Comparisons in terms of safety, cost, recovery time, results, and complications do not favor energy-based devices. A treatment gap may be fictitious; properly informed patients may be treated with existing surgical procedures at all ages.

Conclusions
Little evidence supports the efficacy and safety of subcutaneous RF treatments as an improvement over results that may be obtained using traditional surgical methods such as submental lipectomy, liposuction, and abdominoplasty. Photographic integrity is often lacking. Financial conflict of interest is pervasive. Marketing precedes the science. Plastic surgeons need to be aware of these serious limitations and the off-label regulatory status of these devices, before purchasing expensive equipment and recommending subsurface RF treatments to patients.
Long-term Outcomes of Persistent Postoperative Opioid Use
Authors: Aalberg Jeffrey J. , Kimball Marc D. , McIntire Timothy R. , McCullen Geoffrey M. 
Published: January 2022

Objective:
To determine the association between PPOU and the long-term risk of OUD and opioid overdose.

Summary Background Data:
PPOU is a commonly used outcome in the surgical literature; its incidence and risk factors have been well described. However, its association to long term outcomes, including OUD and opioid overdose, is unknown.

Methods:
A retrospective cohort study utilizing the Veterans Health Administration corporate data warehouse. Patients undergoing any surgery between January 1, 2008 and December 31, 2018 were included and followed until December 31, 2020. Univariate and multivariate survival analysis were used to determine the association between PPOU and OUD and overdose. Sensitivity analyses were conducted to determine the impact of different definitions of persistent opioid use and the effect of preoperative opioid use.

Results:
A total of 344,745 patients undergoing surgery were included and followed for a median of 6.18 years (IQR 3.53–9.12). PPOU was associated with an increased hazard of developing both OUD (HR = 1.88, CI: 1.81–1.95, P < 0.001) and overdose (HR = 1.83, CI: 1.72–1.94, P < 0.001). This association remained consistent after adjustment for comorbidities and across all sensitivity analyses.

Conclusions:
Surgical patients who develop PPOU are at increased risk of both OUD and overdose as compared to surgical patients who do not develop persistent use.
Treatment of Surgical Scars With Combination Pulsed Dye and Fractional Nonablative Laser
Authors: Kang Bianca Y. , Ibrahim Sarah A. , Weil Alexandra , Reynolds Kelly A. , Johnson Tyler , Wilson Sarah , Lee Ming H. , Kim John Y.S. , Dirr McKenzie A. , Poon Emily , Alam Murad 
Published: January 2022

Objective:
To assess the effectiveness and safety of combined pulsed-dye laser (PDL) and NAFL for treatment of surgical scars.

Summary Background Data:
PDL and NAFL have not been compared to healing by time alone.

Methods:
Randomized controlled, single-blinded clinical trial at an urban, university hospital. Healthy adults' status post skin surgery with primary closure were randomized to either 3 sessions of combination PDL and NAFL every 2 to 8 weeks, or control of no treatment. At baseline and 36-week follow-up, Patient and observer Scar Assessment Scale and Scar Cosmesis Assessment and Rating were completed by participants and blinded physicians. The primary outcome was scar improvement, as measured by the score difference over time.

Results:
Of 76 participants, 52 completed the study (July 2017 to June 2019). No severe adverse events were reported. Patient and observer Scar Assessment Scale assessments demonstrated improvement in total score in the laser group compared to controls, as reported by patients [mean difference (standard deviation), laser: 12.86 (6.91) vs control: 7.25 (6.34); P = 0.004] and blinded physicians [18.32 (8.69) vs 13.08 (9.63); P = 0.044]. Patients observed a greater improvement in scar thickness [3.68 (2.04) vs 1.88 (1.85); P = 0.002] and stiffness [3.57 (2.78) vs 1.50 (2.11); P = 0.004] with lasers, and physicians reported greater improvement in vascularity [3.71 (1.98) vs 1.71 (1.52); P = 0.0002]. The live Scar Cosmesis Assessment and Rating subscore for erythema improved significantly with lasers [1.04 (0.79) vs 0.42 (0.50); P = 0.001].

Conclusions and Relevance:
Combined PDL and NAFL resulted in scar improvement. Scar thickness, stiffness, and erythema were improved.

Trial Registration:
ClinicalTrials.gov (NCT03057964).
Coronary Revascularization for Patients with Diabetes Mellitus
Authors: EL-Andari Ryaan , Bozso Sabin J. , Fialka Nicholas M. , Kang Jimmy J. H. , Nagendran Jayan , Nagendran Jeevan 
Published: January 2022

Objective:
This systematic review and meta-analysis aims to review the contemporary literature comparing CABG and PCI in diabetic patients providing an up-to-date perspective on the differences between the interventions.

Background:
Diabetes is common and diabetic patients are at a 2-to-4-fold increased risk of developing coronary artery disease. Approximately 75% of diabetic patients die of cardiovascular disease. Previous literature has identified CABG as superior to PCI for revascularization in diabetic patients with complex coronary artery diseas.

Methods:
PubMed and Medline were systematically searched for articles published from January 1, 2015 to April 15, 2021. This systematic review included all retrospective, prospective, and randomized trial studies comparing CABG and PCI in diabetic patients. 1552 abstracts were reviewed and 25 studies were included in this review. The data was analyzed using the RevMan 5.4 software.

Results:
Diabetic patients undergoing CABG experienced significantly reduced rates of 5-year mortality, major adverse cardiovascular and cerebrovascular events, myocardial infarction, and required repeat revascularization. Patients who underwent PCI experienced improved rates of stroke that trended toward significance.

Conclusions:
Previous literature regarding coronary revascularization in diabetic patients has consistently demonstrated superior outcomes for patients undergoing CABG over PCI. The development of 1st and 2nd generation DES have narrowed the gap between CABG and PCI, but CABG continues to be superior. Continued investigation with large randomized trials and retrospective studies including long term follow-up comparing CABG and 2nd generation DES is necessary to confirm the optimal intervention for diabetic patients.
Serum DUPAN-2 could be an Alternative Biological Marker for CA19-9 Nonsecretors with Pancreatic Cancer
Authors: Omiya Kojiro , Oba Atsushi , Inoue Yosuke , Kobayashi Kosuke , Wu Y.H. Andrew , Ono Yoshihiro , Sato Takafumi , Sasaki Takashi , Ozaka Masato , Sasahira Naoki , Ito Hiromichi , Saiura Akio , Takahashi Yu 
Published: January 2022

Objective:
This study investigates the use of serum DUPAN-2 in predicting the PC progression in CA19-9 nonsecretors.

Background:
Although we previously reported that serum CA19-9 >500U/ mL is a poor prognostic factor and an indication for enhanced neoadjuvant treatment, there is not a biomarker surrogate that equivalently predicts prognosis for CA19-9 nonsecretors.

Methods:
We evaluated consecutive PC patients who underwent pancreatectomy from 2005 to 2019. All patients were categorized as either nonsecretor or secretor (CA19-9 ≤ or >2.0U/mL).

Results:
Of the 984 resected PC patients, 94 (9.6%) were nonsecretors and 890 (90.4%) were secretors. The baseline characteristics were not statistically different between the 2 groups except for the level of DUPAN-2 (720 vs. 100U/mL, P < 0.001). Survival curves after resection were similar between the 2 groups (29.4 months vs. 31.3 months, P = 0.900). Survival curves of patients with DUPAN-2 >2000U/mL in the nonsecretors and patients with CA19-9 >500U/mL in the secretors were nearly equivalent as well (hazard ratio 2.08 vs. 1.89). In the multivariate analysis, DUPAN-2 >2000U/mL (hazard ratio 2.53, P = 0.010) was identified as independent prognostic factor after resection.

Conclusion:
DUPAN-2 >2000U/mL in CA19-9 nonsecretors can be an unfavorable factor that corresponds to CA19-9 >500U/mL in CA19-9 secretors which is an indicator for enhanced neoadjuvant treatment. The current results shed light on the subset of nonsecretors with poor prognosis that were traditionally categorized in a group with a more favorable prognosis group.
A Population-based Analysis of the COVID-19 Generated Surgical Backlog and Associated Emergency Department Presentations for Inguinal Hernias and Gallstone Disease
Authors: Gomez David , Nantais Jordan , Telesnicki Teagan , de Mestral Charles , Wilton Andrew S. , Stukel Therese A. , Urbach David R. , Baxter Nancy N. 
Published: January 2022

Objective:
To evaluate the downstream effects of the COVID-19 generated surgical backlog.

Background:
Delayed elective surgeries may result in emergency department (ED) presentations and the need for urgent interventions.

Methods:
Population-based repeated cross-sectional study utilizing administrative data. We quantified rates of elective cholecystectomy and inguinal hernia repair and rates of ED presentations, urgent interventions, and outcomes during the first and second waves of COVID-19 (March 1, 2020- February 28, 2021) as compared to a 3-year pre-COVID-19 period (January 1, 2017-February 29, 2020) in Ontario, Canada. Poisson generalized estimating equation models were used to predict expected rates during COVID-19 based on the pre-COVID-19 period. The ratio of observed (actual events) to expected rates was generated for surgical procedures (SRRs) and ED visits (ED-RRs).

Results:
We identified 74,709 elective cholecystectomies and 60,038 elective inguinal hernia repairs. During the COVID-19 period, elective inguinal hernia repairs decreased by 21% (SRR 0.791; 0.760–0.824) whereas elective cholecystectomies decreased by 23% (SRR 0.773; 0.732–0.816). ED visits for inguinal hernia decreased by 17% (ED-RR 0.829; 0.786 - 0.874) whereas ED visits for gallstones decreased by 8% (ED-RR 0.922; 0.878 - 0.967). A higher population rate of urgent cholecystectomy was observed, particularly after the first wave (SRR 1.076; 1.000–1.158). No difference was seen in inguinal hernias.

Conclusions:
An over 20% reduction in elective surgeries and an increase in urgent cholecystectomies was observed during the COVID-19 period suggesting a rebound effect secondary to the surgical backlog. The COVID-19 generated surgical backlog will have a heterogeneous downstream effect with significant implications for surgical recovery planning.
Individual and neighborhood level characteristics of pediatric firearm injuries presenting at trauma centers in Colorado
Authors: Stevens Jenny , Leonard Jan , Reppucci Marina L. , Schroeppel Thomas , Bensard Denis , Haasz Maya 
Published: January 2022

BACKGROUND
Firearm injuries are the second leading cause of death among children and adolescents in the United States. In Colorado, firearm injuries have surpassed motor vehicle accidents as the leading cause of death in youth. Local research is necessary to characterize risk factors associated with pediatric firearm injuries. We sought to categorize demographics, neighborhood characteristics, and trends in pediatric firearm injuries in Colorado.

METHODS
A review of pediatric firearm-injured patients (18 years or younger) evaluated at four trauma centers in Colorado from 2008 to 2019 was conducted. Clinical information, injury intent, and demographics were collected. Patient addresses were geocoded to census tracts to obtain neighborhood-level characteristics. Annual trends in firearm injury incidence per trauma evaluation were analyzed using regression modeling.

RESULTS
There were 446 firearm injuries during the study period. The median age was 16 years, and 87.0% were male. Assault was the most common injury intent (64.6%), and 92.0% of patients were from metropolitan (rural-urban continuum code 1–3) areas. Neighborhoods associated with firearm injuries were characterized by lower median household income ($47,112 vs. $63,443, p < 0.001) and higher levels of poverty (19.1% vs. 9.4%, p < 0.001) compared with median state levels. There was a 14.0% increase in firearm injuries compared with overall trauma evaluations for each year in the study period (incidence rate ratio, 1.14; 95% confidence interval, 1.08–1.20; p < 0.001).

CONCLUSION
The incidence of pediatric firearm injuries increased significantly from 2008 to 2019 compared with overall trauma evaluations in Colorado. Children and adolescents who live in more socially vulnerable neighborhoods are disproportionately impacted, and injury prevention resources should be focused on these communities.

LEVEL OF EVIDENCE
Prognostic and Epidemiolgic; Level III.
Design and Methods of the Validating Injury to the Renal Transplant Using Urinary Signatures (VIRTUUS) Study in Children
Authors: Kumar Juhi , Contrepois Kévin , Snyder Michael , Grimm Paul C. , Moudgil Asha , Smith Jodi M. , Bobrowski Amy E. , Verghese Priya S. , Hooper David , Ingulli Elizabeth , Lestz Rachel , Weng Patricia , Reason Janaiya L. , Blydt-Hansen Tom D. , Suthanthiran Manikkam , Keating Brendan , Amaral Sandra 
Published: January 2022

Background.
Lack of noninvasive diagnostic and prognostic biomarkers to reliably detect early allograft injury poses a major hindrance to long-term allograft survival in pediatric kidney transplant recipients.

Methods.
Validating Injury to the Renal Transplant Using Urinary Signatures Children’s Study, a North American multicenter prospective cohort study of pediatric kidney transplant recipients, aims to validate urinary cell mRNA and metabolite profiles that were diagnostic and prognostic of acute cellular rejection (ACR) and BK virus nephropathy (BKVN) in adult kidney transplant recipients in Clinical Trials in Organ Transplantation-4. Specifically, we are investigating: (1) whether a urinary cell mRNA 3-gene signature (18S-normalized CD3ε, CXCL10 mRNA, and 18S ribosomal RNA) discriminates biopsies with versus without ACR, (2) whether a combined metabolite profile with the 3-gene signature increases sensitivity and specificity of diagnosis and prognostication of ACR, and (3) whether BKV-VP1 mRNA levels in urinary cells are diagnostic of BKVN and prognostic for allograft failure.

Results.
To date, 204 subjects are enrolled, with 1405 urine samples, including 144 biopsy-associated samples. Among 424 urine samples processed for mRNA, the median A260:280 ratio (RNA purity) was 1.91, comparable with Clinical Trials in Organ Transplantation-4 (median 1.82). The quality control failure rate was 10%. Preliminary results from urine supernatant showed that our metabolomics platform successfully captured a broad array of metabolites. Clustering of pool samples and overlay of samples from various batches demonstrated platform robustness. No study site effect was noted.

Conclusions.
Multicenter efforts to ascertain urinary biomarkers in pediatric kidney transplant recipients are feasible with high-quality control. Further study will inform whether these signatures are discriminatory and predictive for rejection and infection.