bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of MRI-R2* in the detection of subclinical pancreatic iron loading among transfusion-dependent sickle cell disease patients and correlation with hepatic and cardiac iron loading
Authors: Raief Mosaad Basant Mohamed , Ibrahim Ahmed Samir , Mansour Mohamed G. , ElAlfy Mohsen Saleh , Ebeid Fatma Soliman Elsayed , Abdeldayem Emad H. 
Published: September 2022

Abstract
Objectives
Pancreatic reserve could be preserved by early assessment of pancreatic iron overload among transfusion-dependent sickle cell disease (SCD) patients. This study aimed to measure pancreatic iron load and correlate its value with patients’ laboratory and radiological markers of iron overload.

Materials and methods
Sixty-six SCD children and young adults underwent MRI T2* relaxometry using a simple mathematical spreadsheet and laboratory assessment.

Results
The results indicated moderate-to-severe hepatic iron overload among 65.2% of studied cases. None had cardiac iron overload. Normal-to-mild iron overload was present in the pancreas in 86% of cases, and 50% had elevated serum ferritin > 2500 ug/L. There was no significant correlation between pancreatic R2* level, serum ferritin, and hepatic iron overload. Patients with higher levels of hemolysis markers and lower pre-transfusion hemoglobin levels showed moderate-to-severe pancreatic iron overload.

Conclusion
Chronically transfused patients with SCD have a high frequency of iron overload complications including pancreatic iron deposition, thereby necessitating proper monitoring of the body’s overall iron balance as well as detection of extrahepatic iron depositions.
Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors
Authors: Wan Yamin , Hao Hui , Chen Yunjin , Zhang Yifan , Yue Qingmei , Li Zhizhen 
Published: September 2022

Abstract
Background
Pancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs.

Methods
From December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined.

Results
The detection rate of spectral CT combined with perfusion was 83.1–96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv.

Conclusion
The one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.
18F-FDG PET/CT-based radiomics nomogram could predict bone marrow involvement in pediatric neuroblastoma
Authors: Feng Lijuan , Yang Xu , Lu Xia , Kan Ying , Wang Chao , Sun Dehui , Zhang Hui , Wang Wei , Yang Jigang 
Published: September 2022

Abstract
Objective
To develop and validate an 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT)-based radiomics nomogram for non-invasively prediction of bone marrow involvement (BMI) in pediatric neuroblastoma.

Methods
A total of 133 patients with neuroblastoma were retrospectively included and randomized into the training set (n = 93) and test set (n = 40). Radiomics features were extracted from both CT and PET images. The radiomics signature was developed. Independent clinical risk factors were identified using the univariate and multivariate logistic regression analyses to construct the clinical model. The clinical-radiomics model, which integrated the radiomics signature and the independent clinical risk factors, was constructed using multivariate logistic regression analysis and finally presented as a radiomics nomogram. The predictive performance of the clinical-radiomics model was evaluated by receiver operating characteristic curves, calibration curves and decision curve analysis (DCA).

Results
Twenty-five radiomics features were selected to construct the radiomics signature. Age at diagnosis, neuron-specific enolase and vanillylmandelic acid were identified as independent predictors to establish the clinical model. In the training set, the clinical-radiomics model outperformed the radiomics model or clinical model (AUC: 0.924 vs. 0.900, 0.875) in predicting the BMI, which was then confirmed in the test set (AUC: 0.925 vs. 0.893, 0.910). The calibration curve and DCA demonstrated that the radiomics nomogram had a good consistency and clinical utility.

Conclusion
The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature and independent clinical risk factors could non-invasively predict BMI in pediatric neuroblastoma.
Imaging of intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data
Authors: Amouei Mehrnam , Momtazmanesh Sara , Kavosi Hoda , Davarpanah Amir H. , Shirkhoda Ali , Radmard Amir Reza 
Published: September 2022

AbstractDiagnosis of intestinal vasculitis is often challenging due to the non-specific clinical and imaging findings. Vasculitides with gastrointestinal (GI) manifestations are rare, but their diagnosis holds immense significance as late or missed recognition can result in high mortality rates. Given the resemblance of radiologic findings with some other entities, GI vasculitis is often overlooked on small bowel studies done using computed tomography/magnetic resonance enterography (CTE/MRE). Hereon, we reviewed radiologic findings of vasculitis with gastrointestinal involvement on CTE and MRE. The variety of findings on MRE/CTE depend upon the size of the involved vessels. Signs of intestinal ischemia, e.g., mural thickening, submucosal edema, mural hyperenhancement, and restricted diffusion on diffusion-weighted imaging, are common in intestinal vasculitis. Involvement of the abdominal aorta and the major visceral arteries is presented as concentric mural thickening, transmural calcification, luminal stenosis, occlusion, aneurysmal changes, and collateral vessels. Such findings can be observed particularly in large- and medium-vessel vasculitis. The presence of extra-intestinal findings, including within the liver, kidneys, or spleen in the form of focal areas of infarction or heterogeneous enhancement due to microvascular involvement, can be another radiologic clue in diagnosis of vasculitis.The link between the clinical/laboratory findings and MRE/CTE abnormalities needs to be corresponded when it comes to the diagnosis of intestinal vasculitis.
Drug rash with eosinophilia and systemic symptoms syndrome masquerading as a lymphoproliferative disorder in a young adult on immunosuppressive therapy for rheumatoid arthritis: a case report
Authors: Hyser Elise 
Published: September 2022

AbstractBackgroundThis case reveals a novel presentation of drug rash with eosinophilia and systemic symptoms syndrome that mimics a lymphoproliferative disorder. The heterogeneous clinical presentation of drug rash with eosinophilia and systemic symptoms syndrome gives rise to a broad differential diagnosis that includes a multitude of infectious, inflammatory, and autoimmune conditions. This patient was diagnosed with drug rash with eosinophilia and systemic symptoms syndrome 4 weeks after starting sulfasalazine and 5 weeks after starting hydroxychloroquine for rheumatoid arthritis. Both of these medications have been shown to cause drug rash with eosinophilia and systemic symptoms syndrome, albeit more rarely in the context of hydroxychloroquine. This patient’s history, physical examination, and workup illuminate a case of drug rash with eosinophilia and systemic symptoms syndrome that masquerades as a lymphoproliferative disorder despite its adherence to the RegiSCAR criteria.Case presentationA 22-year-old African-American female with an atopic history and rheumatoid arthritis presented for evaluation of a rash, unremitting fevers, and syncope. She was found to have drug rash with eosinophilia and systemic symptoms syndrome. A syncope workup was unremarkable. Computed tomography of the chest/abdomen/pelvis confirmed extensive lymphadenopathy and revealed a small right pleural effusion (Fig. 5). These imaging findings accompanied by fevers and a rash in the setting of eosinophilia, leukocytosis, and transaminitis led to the clinical suspicion for drug rash with eosinophilia and systemic symptoms syndrome. Steroids were subsequently initiated. Broad-spectrum antibiotic therapy was implemented to cover for possible skin/soft tissue infection due to initial paradoxical worsening after discontinuation of the culprit drugs. Lymph node biopsy ruled out a lymphoproliferative disorder and instead demonstrated necrotizing lymphadenitis. An extensive infectious and autoimmune workup was noncontributory. Clinical improvement was visualized, antibiotics were discontinued, and she was discharged on a steroid taper.ConclusionThis case reflects how drug rash with eosinophilia and systemic symptoms syndrome can masquerade as a lymphoproliferative disorder. Additionally, it highlights the extent to which rapid identification and treatment optimized the patient’s outcome. It calls into question how immunogenetics may factor into a patient’s susceptibility to acquire drug rash with eosinophilia and systemic symptoms syndrome. This case is unique because of the early onset of visceral organ involvement, the type of internal organ involvement, the hematopoietic features, and the lymphadenopathy associated with a disease-modifying antirheumatic drug.
[18F]FE-PE2I PET is a feasible alternative to [123I]FP-CIT SPECT for dopamine transporter imaging in clinically uncertain parkinsonism
Authors: Marner Lisbeth , Korsholm Kirsten , Anderberg Lasse , Lonsdale Markus N. , Jensen Mads Radmer , Brødsgaard Eva , Denholt Charlotte L. , Gillings Nic , Law Ian , Friberg Lars 
Published: September 2022

Abstract
Background
Dopamine transporter (DAT) imaging of striatum is clinically used in Parkinson’s disease (PD) and neurodegenerative parkinsonian syndromes (PS) especially in the early disease stages. The aim of the present study was to evaluate the diagnostic performance of the recently developed tracer for DAT imaging [18F]FE-PE2I PET/CT to the reference standard [123I]FP-CIT SPECT.

Methods
Ninety-eight unselected patients referred for DAT imaging were included prospectively and consecutively and evaluated with [18F]FE-PE2I PET/CT and [123I]FP-CIT SPECT on two separate days. PET and SPECT scans were categorized independently by two blinded expert readers as either normal, vascular changes, or mixed. Semiquantitative values were obtained for each modality and compared regarding effect size using Glass’ delta.

Results
Fifty-six of the [123I]FP-CIT SPECT scans were considered abnormal (52 caused by PS, 4 by infarctions). Using [18F]FE-PE2I PET/CT, 95 of the 98 patients were categorized identically to SPECT as PS or non-PS with a sensitivity of 0.94 [0.84–0.99] and a specificity of 1.00 [0.92–1.00]. Inter-reader agreement for [18F]FE-PE2I PET with a kappa of 0.97 [0.89–1.00] was comparable to the agreement for [123I]FP-CIT SPECT of 0.96 [0.76–1.00]. Semiquantitative values for short 10-min reconstructions of [18F]FE-PE2I PET/CT were comparable to longer reconstructions. The effect size for putamen/caudate nucleus ratio was significantly increased using PET compared to SPECT.

Conclusions
The high correspondence of [18F]FE-PE2I PET compared to reference standard [123I]FP-CIT SPECT establishes [18F]FE-PE2I PET as a feasible PET tracer for clinical use with favourable scan logistics.
Copper and nanostructured anatase rutile and carbon coatings induce adaptive antibiotic resistance
Authors: Wasa Alibe , Aitken Jack , Jun Hyunwoo , Bishop Catherine , Krumdieck Susan , Godsoe William , Heinemann Jack A. 
Published: September 2022

AbstractContaminated surfaces are vehicles for the spread of infectious disease-causing microorganisms. A strategy to prevent their spread is applying antimicrobial coatings to surfaces. Both nanostructured anatase rutile and carbon (NsARC), a TiO2 formulation, and copper are examples of antimicrobial agents that are used in making or coating door handles and similar surfaces, to reduce microbial loads. Antimicrobial surfaces have been extensively tested for antimicrobial activity but not sublethal effects, such as exposure-associated multiple antibiotic resistance phenotypes usually caused by induction of efflux pump genes. The possibility of NsARC and copper inducing indicative efflux pump pathways was investigated by monitoring the expression of mScarlet fluorescent protein (FP) in two reporter strains of Escherichia coli. There was an increase in the expression of FP in the reporter strains exposed to NsARC and copper relative to the inert control composed of stainless steel. Furthermore we tested E. coli and Staphylococcus aureus following 8 h of exposure to NsARC for changes in resistance to selected antibiotics. E. coli that were exposed to NsARC became more susceptible to kanamycin but there was no significant change in susceptibility of S. aureus to any tested antibiotics. These findings suggests that even though NsARC and copper are antimicrobial, they also have some potential to cause unintended phenotypes.
A study on the productivity and mortality rates of native and blended goats in Dodoma, Tanzania
Authors: Ngongolo Kelvin , Mmbaga Naza Emmanuel 
Published: September 2022

AbstractThe focus of breeding animals such as goats has been to increase productivity and other benefits from domestic animals. A breeding programme for producing blended goats is ongoing in Mpwapwa, Dodoma, Tanzania. However, few studies have been conducted to understand the performance of the produced breed (blended goat) in comparison with local indigenous goats. This study assessed the performance of blended and local indigenous goats in terms of milk and meat productivity while taking into consideration birth type, mortality rate, diseases causing mortality, and management system used. Primary and secondary data collection methods were used in this study. The weight, length, and girth of 2-year-old kids were measured in the morning and evening, and milk production in a lactating doe was recorded. Secondary data on the weight, length, and girth of inborn between 2010 and 2020. The results showed significantly higher productivity for blended goats than for indigenous goats in terms of meat and milk production (P < 0.005). The mortality rate of indigenous goats was not significantly higher than that of blended goats (P > 0.05). Diseases significantly influence goat mortality. Breed, management system, and milking time had a significant impact on goat productivity. For instance, morning milking produced significantly more milk than evening milking (P < 0.05). It is conclusive that the blended goat performs better than the indigenous goats in terms of milk and meat productivity. We recommend and encourage the adoption of blended goats by farmers who want to maximize goat production while considering other factors such as milking time, disease intervention, and management system used.
Breastfeeding challenges and support in a high initiation population
Authors: Zimmerman Deena R. , Kaplan Michael , Shoob Hanna , Freisthler Marlaina , Toledano Monique , Stein-Zamir Chen 
Published: September 2022

Abstract
Background
The breastfeeding initiation rate in Israel is approximately 90%, yet exclusive breastfeeding drops sharply in the early postnatal period. The study objective was to assess early postpartum professional breastfeeding support, its association with breastfeeding success and identification of risk factors for early breastfeeding discontinuation.

Methods
As part of a post-discharge newborn follow-up study, a convenience sample of 868 mothers attending Maternal and Child Health Centers (MCHCs) up to three months post-partum were interviewed using a 26-item questionnaire. Breastfeeding-related questions covered demographic variables, pregnancy and birth details; breastfeeding duration, lactation support in hospital and post-discharge; and problems experienced.

Results
Most mothers, 797 (91.8%), initiated breastfeeding in hospital. All women who initiated breastfeeding in the hospital reported exclusive breastfeeding; by two weeks postpartum, 70 women (13.2%) were supplementing with formula (partial breastfeeding). Kaplan–Meier Survival Analysis revealed an estimated mean duration of exclusive breastfeeding in the sample population of 66.8 ± 1.5 days. This duration was shorter for women with preterm births, low birthweight infants (LBW), cesarean births, and hospitalizations in neonatal intensive care units (NICU). A total of 472 (59.3%) breastfeeding mothers reported receiving in-hospital guidance. Of these, 290 (61.3%) were observed breastfeeding. Of all women who initiated breastfeeding, 280 (35.1%) attended MCHC follow-up within 72 h of hospital discharge. A higher proportion of women experiencing breastfeeding difficulties attended an MCHC within 72 h (131/297, 44.1%) compared to women not experiencing difficulties (148/499, 29.7%). The most frequently reported problems were mechanical (55.2%) or milk supply concerns (18.5%). First-time mothers were more likely to report problems, as were Jewish (vs Arab) mothers.

Conclusions
Even in a population with high initiation rates of breastfeeding, breastfeeding duration, both exclusive and partial, is less than recommended. As much of this drop-off occurs during maternity leave, it is likely related to breastfeeding challenges other than employment. Breastfeeding support needs of women are currently not adequately met; staffing and time for both in-hospital and community-based counseling needs to be funded as well as mandated. Counseling hours should be tailored to assure adequate coverage of high-risk groups such as women after cesarean delivery and newborns requiring intensive care.
The impact of workplace psychosocial factors on menstrual disorders and infertility: a protocol for a systematic review and meta-analysis
Authors: Sasaki Natsu , Imamura Kotaro , Watanabe Kazuhiro , Hidaka Yui , Ando Emiko , Eguchi Hisashi , Inoue Akiomi , Tsuno Kanami , Komase Yu , Iida Mako , Otsuka Yasumasa , Sakuraya Asuka , Asai Yumi , Iwanaga Mai , Kobayashi Yuka , Inoue Reiko , Shimazu Akihito , Tsutsumi Akizumi , Kawakami Norito 
Published: September 2022

Abstract
Introduction
Workplace environment, especially psychosocial factors at work such as job strain, workplace social support, and shift work, may affect the menstrual abnormalities and fertility of female workers. However, the association between psychosocial factors at work and menstrual abnormalities or fertility is not well understood. To address this relationship, we will conduct a systematic review and a meta-analysis of the literature that has utilized a longitudinal or prospective cohort design.

Methods and analysis
The inclusion criteria for this systematic review and meta-analysis are defined as follows: (P) adult female workers (over 18 years old), (E) the presence of adverse psychosocial factors at work, (C) the absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility. The MEDLINE, Embase, PsycINFO, PsycArticles, and Japan Medical Abstracts Society electronic databases will be used to search for published studies. The statistical synthesis of the studies included in the meta-analysis will be conducted to estimate pooled coefficients and 95% CIs. For the main analysis, we will synthesize measures of association between psychosocial factors at work and menstrual-related disorders/symptoms. At least three eligible studies will have to be gathered to conduct a meta-analysis; otherwise (i.e., if only one or two studies will be eligible and included), the results will be presented in a narrative table. We will use the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) to determine the quality of selected studies. To assess meta-bias, Egger’s test, along with a funnel plot, will be used to check for publication bias. Lastly, we will examine heterogeneity using the χ2 test with Cochran’s Q statistic and I2.

Ethics and dissemination
The results and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policymakers interested in the translatability of scientific evidence into good practices.

Systematic review registration
The study protocol was registered at the UMIN registry (registration number: UMIN000039488). The registration date is on 14 Feb 2020.
URL: https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000044704
The Integrated Policy Package Assessment approach: elaborating ex ante knowledge in the field of urban mobility
Authors: Scheer Dirk , Dreyer Marion , Schmidt Maike , Schmieder Lisa , Arnold Annika 
Published: September 2022

AbstractBackgroundIn response to climate change challenges, a main policy emphasis is on transitioning the energy system from high- to low-carbon energy supply. The German energy transition is first and foremost based on political decisions and interventions. These decisions need to be assessed ex ante to ensure a good governance approach to energy policies, for which this paper introduces the Integrated Policy Package Assessment approach (IPPA). IPPA consists of four steps: design, assessment, evaluation and discourse.ResultsThe results section illustrates the IPPA framework by applying it to urban passenger transport as an example case. First, the design phase was used to elaborate two complementary policy packages each consisting of several policy measures in the transformation pathways of “multi- and inter-modality”, and “alternative drive”. Second, the individual measures of the packages were impact-analysed by a large number of individual impact studies from various disciplines. Synthesizing the individual study results, we developed an impact assessment matrix for impact evaluation. The matrix covers the impact categories: technology development, sector integration, environment, social resonance, and institutional factors. In a further step, the key findings of the impact assessment were reflected and reviewed from the perspectives of various stakeholders and practice experts through a practice–science dialogue on transforming the urban passenger transport system.ConclusionsThe discussion and conclusion sections outline the main findings relating to content and process aspects, when applying the IPPA framework to a policy package in urban transport.