tbuckley/cabot-search huggingface dataset:
Rationale and design of the <scp>FAIR</scp>‐<scp>HF</scp>2‐<scp>DZHK</scp>05 trial: Ferric carboxymaltose assessment of morbidity and mortality in patients with iron deficiency and chronic heart failure
Authors: Stefan D. Anker, Tim Friede, Javed Butler, Khawaja M. Talha, Monika Diek, Anna Nosko, Marius Placzek, Gerd Hasenfuß, Piotr Ponikowski, Mahir Karakas
Journal: European Journal of Heart Failure (2025)

Abstract Aims While it is widely accepted that intravenous (IV) iron improves functional capacity, symptoms, and cardiovascular outcomes in patients with heart failure (HF) with reduced ejection fraction (HFrEF) diagnosed with iron deficiency (ID), three recently published cardiovascular outcome trials (AFFIRM‐AHF, IRONMAN and HEART‐FID) of IV iron supplementation in HF failed to demonstrate a significant benefit on their respective primary endpoints. Dosing of IV iron after the initial correction of baseline ID – by design or as a result of trial circumstances – was relatively low (i.e. &lt;500 mg/year). The primary objective of the FAIR‐HF2 trial is to evaluate the treatment effect of ferric carboxymaltose (FCM) compared with placebo in ambulatory patients with HFrEF using a higher dose of IV iron during follow‐up (i.e. &gt;1000 mg/year). The second objective of the study is to create prospective evidence for patients fulfilling the new definition of ID for patients with HF, i.e. for those with a transferrin saturation &lt;20%. Methods FAIR‐HF2 is an investigator‐initiated, multicentre, randomized, double‐blind, placebo‐controlled trial that has recruited 1105 patients with chronic HF with a left ventricular ejection fraction of ≤45% and concomitant ID, defined as serum ferritin &lt;100 ng/ml or serum ferritin 100–299 ng/ml with a transferrin saturation &lt;20%. Patients were consented and randomized to receive either IV FCM (treatment) or saline (placebo). During an estimated median follow‐up of over 2 years, patients underwent a placebo‐controlled repletion and maintenance phase, with an initial iron supplementation of up to 2000 mg, followed by 500 mg every 4 months unless stop criteria of haemoglobin &gt;16 mg/dl or serum ferritin &gt;800 ng/ml are met on repeat visits. The trial will evaluate three primary hypotheses: (i) time to first event of cardiovascular death or hospitalization for HF, (ii) the rate of total (first and recurrent) HF hospitalizations (both analysed in the full study population), and (iii) the time to first event of cardiovascular death or hospitalization for HF in patients with a transferrin saturation &lt;20% at baseline. The familywise type I error rate across the three primary endpoint hypotheses will be controlled using the Hochberg procedure (alpha 0.05). Conclusion The FAIR‐HF2 will evaluate the efficacy of FCM in patients with HFrEF in improving cardiovascular outcomes by utilizing a more aggressive approach towards iron supplementation ensuring prevention of transitional ID after initial repletion targets have been met.
Spaced Transcranial Direct Current Stimulation for Major Depression
Authors: Maxime Couture, Véronique Desbeaumes Jodoin, Emma Bousseau, Arash Sarshoghi, Michael A. Nitsche, Daniel M. Blumberger, Chantal Bolduc, Cory R. Weissman, Lawrence G. Appelbaum, Zafiris J. Daskalakis, Mohsen Poorganji, Paul Lespérance, Jean-Philippe Miron
Journal: American Journal of Psychiatry (2025)

This study investigated spaced transcranial direct current stimulation for major depressive disorder, focusing on feasibility.
Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis
Authors: Konstantinos N. Fountoulakis, Athanasios Saitis, Alan F. Schatzberg
Journal: American Journal of Psychiatry (2025)

Intranasal esketamine has been approved as an adjunctive therapy for treatment-resistant major depressive disorder with acute suicidal ideation and behavior. The authors conducted a systematic review and meta-analysis of the available data on its efficacy against depression and suicidality as well as its side effects. MEDLINE was searched with the keyword "esketamine" on March 24, 2024, using the PRISMA method. Data processing and statistical analysis were performed with R, version 4.3.3, and the meta-analysis was performed with the METAFOR package. Of 1,115 articles initially identified, 87 were included for analysis and discussion. At weeks 2-4, randomized controlled trials were mostly negative or failed; however, the meta-analysis returned a weak but significant positive effect for depression (effect size range, 0.15-0.23 at weeks 2-4), similar to augmentation strategies with atypical antipsychotics for treatment-resistant depression. The effect size concerning suicidality was not significant at any time point. The sensitivity analysis produced the same results. The study findings suggest that esketamine's efficacy as an add-on to antidepressants is modest in treatment-resistant depression (similar to augmentation strategies with atypical antipsychotics) and is absent against suicidality itself. These findings need to be considered in light of esketamine's abuse potential and the fact that long-term effects are still not fully known. Some alarming signs concerning deaths and emerging suicidality during the testing phase are discussed, along with other regulatory issues.
Fluoropolymer‐Single Crystal Nanocomposite Based Transducer Fabrication for Bio‐Imaging
Authors: Nagendra Singh, S K Biswas
Journal: Advanced Healthcare Materials (2025)

Abstract Fluoropolymer alone, as an alternative to lead‐based piezoelectric materials, has shown multiple challenges to develop useful sensors for solving real‐world problems such as photoacoustic, ultrasound pulse echo, and other non‐destructive testing. This work demonstrates the fabrication of high frequency and wide bandwidth transducers with fluoropolymer and highly polarizing cubic single crystal Barium titanate (BaTiO 3 ) ceramic composite for high resolution in‐vivo photo‐acoustic and ultrasound imaging. For transducer fabrication, a customized bio‐compatible nanocomposite sensor film of PVDF‐TrFE (Polyvinylidene fluoride trifluoroethylene)/BaTiO 3 (BTO) is synthesized by drop and dry in heating‐cum‐electro‐poling system for advancing polarization, crystallinity, and higher charge generation. The ratio of nanofiller cubic single crystal BTO and PVDF‐TrFE is optimized using characterization techniques such as FTIR, XRD and electrometer. Thereafter, SEM and TGA analyses are performed to study the surface morphology and thermal stability of the sensing film. Transducers with central frequencies varying from 17 to 42MHz are fabricated and tested for both pulse‐echo mode and receiving photoacoustic signals. These transducers are used for sensing photoacoustic signals generated from hemoglobin and eumelanin and further for ultrasound and photoacoustic imaging. The imaging results are compared with the results obtained using a commercial ultrasound and photoacoustic imaging device. To the best of the knowledge and available literature, for the first time, the fabrication of ultrasound/photoacoustic transducers with cubic single‐crystal nanofiller and fluoropolymer nanocomposite is showed. The detailed transducer fabrication method, characterization results, and imaging of biological tissue using photoacoustic and ultrasound are presented.
Engineered Cell Membrane‐Coated Keratin Nanoparticles Attenuated Intervertebral Disc Degeneration by Remodeling the Disc Microenvironment
Authors: Hongyuan Xing, Run Li, Zizhan Huang, Zhongyang Gao, Qijiang Mao, Yifan Shen, Guanrui Huang, Guangyu Chu, Yue Wang
Journal: Advanced Healthcare Materials (2025)

Abstract Characterized by a cascade of profound changes in nucleus pulposus (NP) cells, extracellular matrix (ECM), and biomechanics, intervertebral disc degeneration is a common multifactorial condition that may lead to various degenerative lumbar disorders. Therapeutic strategies targeting a single factor have shown limited efficacy in treating disc degeneration, and approaches that address multiple pathological ingredients are barely reported. In this study, engineered cell membrane‐encapsulated keratin nanoparticles are developed to simultaneously alleviate NP cell senescence and promote ECM remodeling. To achieve this, salivary acid glycoengineered adipose mesenchymal stem cell membranes are used to coat keratin, a core protein for structural support and cellular protection. The synthesized cell membrane‐coated keratin nanoparticles (MKNs) effectively protected mitochondrial integrity in NP cells from oxidative stress‐induced damage. Moreover, MKNs modulate mitochondrial metabolism and attenuate NP cell senescence. In addition, MKNs activate integrins at the cell membrane and enhance the interactions between NP cells and ECM, resulting in increased ECM anabolism and decreased catabolism. The proposed multi‐targeted strategy to block the degenerative cycle inside the disc is efficacious for treating disc degeneration and may have the potential for clinical application.
Lived experiences: Exploring detransition narratives
Authors: Amy C. Maragos, Chris Brown, Luke R. Allen
Journal: International Journal of Transgender Health (2025)

Many people who have experienced gender incongruence decide to go through the process of transitioning. A small number of people who transition will decide to stop or reverse some or all aspects of their transition process and detransition. To bridge the gap in the psychology literature and the emerging yet poorly understood phenomenon of gender detransition, the aim of the current study was to explore the lived experiences of this unique population. Thirteen adults who detransitioned participated in semi-structured interviews regarding the external and internal stressors that contributed to their decision to detransition. The authors used Meyer's minority stress model as a theoretical framework and consensual qualitative research methods to conceptualize and analyze the data. Results of the interview data highlighted that the factors contributing to a person's decision to transition and detransition are multifaceted and unique. Participants' decision to transition were influenced by others who suggested or encouraged them to transition, gender dysphoria, body image concerns, and poor mental health. Participants reported several external (e.g. negative experiences with health service providers) and internal (e.g. regret regarding insufficient exploration) stressors with being transgender. Outcomes of detransitioning were explored and included relational change, increased self-acceptance, improved well-being, and loss of trans community. Study limitations, implications for counseling, and future research are discussed.
Tumor Lesion Uptake of [177Lu]Lu-DOTA-Rituximab in Skeletal and Splenic Disease in Diffuse Large B-Cell Lymphoma
Authors: Yeshwanth Edamadaka, Rahul V. Parghane, Sandip Basu
Journal: Clinical Nuclear Medicine (2025)

Abstract Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, and a sizable fraction of the DLBCL patients presents with advanced, relapsed, and refractory disease, demonstrating poor response to standard chemotherapy regimens. Radioimmunotherapy (RIT) has shown to be clinically effective in refractory DLBCL. We present the case of a patient with DLBCL with [ 18 F]FDG-avid widespread skeletal as well as splenic involvement as poor prognostic extranodal disease on FDG PET/CT. RIT based on [ 177 Lu]Lu-DOTA-rituximab was explored to study the biodistribution and dosimetry of [ 177 Lu]Lu-DOTA-rituximab in CD20-positive lymphoma. An exceptionally high tracer concentration in skeletal and splenic disease was observed, supporting its potential RIT application in relapsed and refractory DLBCL patients in the future.
Isolated Lymph Node Metastasis as Initial Presentation of Collecting Duct Carcinoma on 68Ga-Pentixafor PET/CT
Authors: Zibei Wan, Feiyu Zhang, Kan Wang, Ya Liu, Zhanwen Huang
Journal: Clinical Nuclear Medicine (2025)

Abstract A 64-year-old man was admitted to the hospital with low back pain. Enhanced CT imaging revealed an isolated retroperitoneal mass. Since primary retroperitoneal lymphoma could not be ruled out, the patient was enrolled in our clinical trial of 68 Ga-pentixafor PET/CT. The mass exhibited intense uptake of 68 Ga-pentixafor and was subsequently confirmed as lymph node metastasis originating from collecting duct carcinoma. Our case demonstrated that 68 Ga-pentixafor may lack specificity in distinguishing primary retroperitoneal lymphomas from other conditions.
Head-to-Head Comparison Between [68Ga]Ga-DOTA.SA.FAPi And [18F]F-FDG PET/CT Imaging in Patients With Sarcoma
Authors: Mohammad Sakir, Sanjana Ballal, Sameer Rastogi, Madhav Prasad Yadav, Frank Roesch, Kunal Chandekar, Priyanka GB, Madhavi Tripathi, Ayan Dhiman, Mehul Taggar, Marcel Martin, Chandrasekhar Bal
Journal: Clinical Nuclear Medicine (2025)

Purpose This study aimed to compare the diagnostic efficacy of [ 68 Ga]Ga-DOTA.SA.FAPi and [ 18 F]F-FDG PET/CT for detecting primary and metastatic lesions in sarcoma patients. Materials and Methods The analysis included both patient-based and lesion-based comparisons of PET/CT scans in individuals with histologically confirmed sarcoma. Results A total of 23 sarcoma patients (mean age 43.0 ± 16.5 years; range: 21–76 years) underwent both [ 18 F]F-FDG and [ 68 Ga]Ga-DOTA.SA.FAPi PET/CT scans. Histological distribution included 30% synovial sarcoma, 13% liposarcoma, and 21.7% leiomyosarcoma, with 70% of patients presenting with distant metastases. Detection rates for primary tumors were similar between [ 68 Ga]Ga-DOTA.SA.FAPi and [ 18 F]F-FDG PET/CT (85.7% vs 100%, P = 0.149). Lymph node detection rates were also comparable (80% vs 100%, P = 0.146). Lesion-based analysis revealed that [ 68 Ga]Ga-DOTA.SA.FAPi detected 220 lesions (83% efficiency) compared with 249 lesions (94% efficiency) for [ 18 F]F-FDG ( P &lt; 0.0001). Notably, [ 68 Ga]Ga-DOTA.SA.FAPi demonstrated superior detection of liver (54 vs 38 lesions, P &lt; 0.0001) and bone metastases (125 vs 102 lesions, P &lt; 0.0001). Conclusion Our study shows that although [ 18 F]F-FDG PET/CT offers superior overall lesion detection efficiency, [ 68 Ga]Ga-DOTA.SA.FAPi PET/CT excels in identifying specific metastatic sites, particularly in bone and liver. These findings highlight the complementary roles of both imaging modalities in sarcoma evaluation.
Parathyroid Adenoma at the Parapharyngeal Space Detected on 99mTc-Sestamibi SPECT/CT
Authors: Wai Ip Li, Tak Kwong Chan, Boom Ting Kung
Journal: Clinical Nuclear Medicine (2025)

Abstract A 77-year-old woman was diagnosed with primary hyperparathyroidism, and initial cervical ultrasonography found no parathyroid lesion, and she was referred to the nuclear medicine unit for dual-phase 99m Tc-sestamibi (MIBI) scan. The scintigraphy unveiled heterogeneous uptake patterns across bilateral thyroid lobes, corresponding to the thyroid nodules, alongside a marked focal uptake with delayed tracer washout in the right oral region. The SPECT/CT pinpointed a MIBI-avid nodule within the right parapharyngeal space, indicative of parathyroid ectopia. An ectopic parapharyngeal parathyroid adenoma is exceptionally rare. MIBI scan plays a pivotal role in detection of ectopic parathyroid adenoma at unexpected sites.
Deep Learning–Based Precontrast CT Parcellation for MRI-Free Brain Amyloid PET Quantification
Authors: Kyobin Choo, Jaehoon Joo, Sangwon Lee, Daesung Kim, Hyunkeong Lim, Dongwoo Kim, Seongjin Kang, Seong Jae Hwang, Mijin Yun
Journal: Clinical Nuclear Medicine (2025)

Purpose This study aimed to develop a deep learning (DL) model for brain region parcellation using CT data from PET/CT scans to enable accurate amyloid quantification in 18 F-FBB PET/CT without relying on high-resolution MRI. Patients and Methods A retrospective dataset of PET/CT and T1-weighted MRI pairs from 226 individuals (157 with mild cognitive impairment or dementia and 69 healthy controls) was used. The dataset was split into training/validation (60%) and test (40%) sets. Utilizing auto-generated segmentation labels, 3 UNets were independently trained for multiplanar brain parcellation on CT and subsequently ensembled. Amyloid load was measured across 46 volumes of interest (VOIs), derived from the Desikan-Killiany-Tourville atlas. Dice similarity coefficient between the proposed CT-based DL model and MRI-based (FreeSurfer) method was calculated, with SUVR comparison using linear regression analysis and intraclass correlation coefficient. Global SUVRs were also compared within groups with clinical dementia ratings (CDRs) of 0, 0.5, and 1. Results The DL-based CT parcellation achieved mean Dice similarity coefficients of 0.80 for all 46 VOIs, 0.72 for 16 cortical and limbic VOIs, and 0.83 for 30 subcortical VOIs. For regional and global SUVR comparisons, the linear regression yielded a slope, y-intercept, and R 2 of 1 ± 0.027, 0 ± 0.040, and ≧0.976, respectively ( P &lt; 0.001), and the intraclass correlation coefficient was ≧0.988 ( P &lt; 0.001). For global SUVRs in each CDR group, these values were 1 ± 0.020, 0 ± 0.026, ≧0.993, and ≧0.996, respectively ( P &lt; 0.001). Both MRI-based and CT-based global SUVR showed a consistent increase as the CDR score increased. Conclusions The DL-based CT parcellation agrees strongly with MRI-based methods for amyloid PET quantification.
Could less be enough: sublobar resection vs lobectomy for clinical stage IA non-small cell lung cancer patients with visceral pleural invasion or spread through air spaces
Authors: Zhang-Yi Dai, Cheng Shen, Xinwei Wang, Fu-Qiang Wang, Yun Wang
Journal: International Journal of Surgery (2025)

While recent randomized controlled trials have demonstrated that sublobar resection is non-inferior to lobectomy, the comparative efficacy of these procedures remains uncertain for early-stage non-small cell lung cancer (NSCLC; ≤ 3 cm) exhibiting invasive features postoperatively, such as visceral pleural invasion (VPI) or spread through air spaces (STAS). To identify eligible studies, a comprehensive search of PubMed, Embase, MEDLINE, the Cochrane Library, and Web of Science was conducted through 25 July 2024. Studies were screened according to predefined criteria in accordance with PRISMA guidelines. The primary endpoints were 5-year overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) and 95% confidence intervals (CI) were used to perform a meta-analysis. The final analysis included 14 retrospective studies and 1 randomized controlled trial, encompassing a total of 8,054 patients with NSCLC (tumors ≤3 cm) exhibiting VPI or STAS. The meta-analysis revealed that sublobar resection was associated with impaired 5-year OS (HR: 1.25; 95% CI: 1.10-1.41) and slightly inferior RFS (HR: 1.25; 95% CI: 0.99-1.58) compared to lobectomy for pT2a (VPI) NSCLC patients with tumor ≤3 cm. Similarly, sublobar resection was associated with significantly worse 5-year OS (HR: 2.58; 95% CI: 1.92-3.45) and 5-year RFS (HR: 2.42; 95% CI: 1.69-3.46) compared to lobectomy for stage IA NSCLC patients with STAS. Subgroup analysis revealed that statistically significant differences in 5-year OS (HR: 1.13; 95% CI: 0.92-1.38) and 5-year RFS (HR: 0.87; 95% CI: 0.56-1.36) were not observed between the sublobar resection and lobectomy groups for pT2a (VPI) NSCLC patients with tumor ≤2 cm. Additionally, no statistically significant survival difference was observed between the segmentectomy and lobectomy groups for NSCLC patients (≤3 cm) with VPI (5-year OS: HR: 1.16; 95% CI: 0.89-1.52; 5-year RFS: HR: 1.07; 95% CI: 0.88-1.30) or STAS (5-year OS: HR: 3.88; 95% CI: 0.82-18.31; 5-year RFS: HR: 1.64; 95% CI: 0.70-3.80). For early-stage (≤3 cm) NSCLC with VPI or STAS, sublobar resection was associated with worse survival outcomes compared to lobectomy. However, segmentectomy achieved survival outcomes comparable to those of lobectomy. For pT2a (VPI) NSCLC patients with tumor ≤2 cm, the differences in survival outcomes between sublobar resection and lobectomy were not statistically significant.
Burden of bacterial antimicrobial resistance among hospitalised patients in Spain: findings from three nationwide prospective studies
Authors: Germán Peñalva, Rafael Cantón, María Teresa Pérez-Rodríguez, Juan José González-López, Jesús Rodríguez-Baño, Ester Del Barrio-Tofiño, Cristina Kirkegaard-Biosca, Isabel Sánchez-Romero, Andrea Gutiérrez-Villanueva, Teresa Marrodán-Ciordia, José Manuel Guerra-Laso, Cristóbal Del Rosario-Quintana, Laura Suárez-Hormiga, Jordi Cámara, Mireia Puig-Asensio, Eva Heredero, María Antonia Sepúlveda, Juan Carlos Rodríguez-Díaz, Esperanza Merino, Emilia Cercenado, Sofia de la Villa, María Siller, Francisco Arnaiz, Cristina Seral, José Antonio Lepe, José Miguel Cisneros, José Ramón Paño-Pardo
Journal: The Lancet Regional Health - Europe (2025)
The effects of extracorporeal shock wave therapy in children with cerebral palsy: a systematic review
Authors: Eline G. de Roo, Sanne B. Koopman, Thijs W. Janssen, Wendy F.M. Aertssen
Journal: International Journal of Surgery (2025)

Introduction: Spastic Cerebral Palsy (CP) is a major cause of movement disorders in pediatric rehabilitation. Current treatments are often invasive and may lead to substantial discomfort. Extracorporeal shockwave therapy (ESWT) presents a potential alternative, offering a less invasive approach with a reduced side effect profile. However, the impact of ESWT on children with CP remains unclear. This systematic review aims to summarize the current evidence on ESWT’s impact in children with spastic CP across various domains of the International Classification of Functioning, Disability, and Health for Children and Youth. Method: To answer the main question, a systematic literature study is used. The studies, collected from four databases, were screened and data on outcome measures and methodological quality were extracted. Effect sizes were calculated to facilitate study comparison. Results: In total, twelve randomized controlled trials met inclusion criteria, with PEDro scores ranging from three to eight. The combined study population included 421 children. Positive effects were observed on resistance to passive movements, passive range of motion, and gross motor skills, with effect sizes ranging from moderate (0.65) to very large (7.69). Conclusion: ESWT demonstrated positive effects across multiple domains in children with spastic CP.