Automated Deep Learning Pipeline for Callosal Angle Quantification.

Background And Purpose: Normal pressure hydrocephalus (NPH) is a potentially treatable neurodegenerative disorder that remains underdiagnosed due to its clinical overlap with other conditions and the labor-intensive nature of manual imaging analyses. Imaging biomarkers, such as the callosal angle (CA), Evans Index (EI), and Disproportionately Enlarged Subarachnoid Space Hydrocephalus (DESH), play a crucial role in NPH diagnosis but are often limited by subjective interpretations. To address these challenges, we developed a fully automated and robust deep learning framework for measuring the CA directly from raw T1 MPRAGE and non-MPRAGE MRI scans.

Evaluating large language models for drafting emergency department encounter summaries.

Large language models (LLMs) possess a range of capabilities which may be applied to the clinical domain, including text summarization. As ambient artificial intelligence scribes and other LLM-based tools begin to be deployed within healthcare settings, rigorous evaluations of the accuracy of these technologies are urgently needed. In this cross-sectional study of 100 randomly sampled adult Emergency Department (ED) visits from 2012 to 2023 at the University of California, San Francisco ED, we sought to investigate the performance of GPT-4 and GPT-3.

Evaluating Large Language Models for Drafting Emergency Department Discharge Summaries.

Importance: Large language models (LLMs) possess a range of capabilities which may be applied to the clinical domain, including text summarization. As ambient artificial intelligence scribes and other LLM-based tools begin to be deployed within healthcare settings, rigorous evaluations of the accuracy of these technologies are urgently needed.

Objective: To investigate the performance of GPT-4 and GPT-3.

Predictors of fetal delivery in pregnant trauma patients: A multicenter study.

Background: Pregnant trauma patients (PTPs) undergo observation and fetal monitoring following trauma due to possible fetal delivery (FD) or adverse outcome. There is a paucity of data on PTP outcomes, especially related to risk factors for FD. We aimed to identify predictors of posttraumatic FD in potentially viable pregnancies.

Interferon alfa-2b in patients with low-grade lymphomatoid granulomatosis and chemotherapy with DA-EPOCH-R in patients with high-grade lymphomatoid granulomatosis: an open-label, single-centre, phase 2 trial.

Background: Lymphomatoid granulomatosis is a rare Epstein-Barr virus-associated B-cell lymphoproliferative disorder with a median overall survival of less than 2 years. In this study, we hypothesised that low-grade lymphomatoid granulomatosis is immune-dependent and high-grade lymphomatoid granulomatosis is immune-independent. On the basis of this hypothesis, we investigated the activity and safety of new treatment with immunotherapy in patients with low-grade disease and standard chemotherapy in patients with high-grade disease.

Circulating tumor DNA predicts therapeutic outcome in mantle cell lymphoma.

Mantle cell lymphoma (MCL) is biologically and clinically heterogeneous and would benefit from prognostic biomarkers to guide management. Circulating tumor DNA (ctDNA) is a novel prognostic biomarker in diffuse large B-cell lymphoma that may have applicability in MCL. We analyzed ctDNA dynamics in previously untreated patients with MCL who received induction therapy with bortezomib and DA-EPOCH-R for 6 cycles followed by random assignment to observation or bortezomib maintenance in responding patients in a prospective phase 2 study.

Visual inspection with acetic acid screening for cervical cancer among women receiving anti-retroviral therapy for human immunodeficiency virus infection in northern Tanzania.

Aim: To evaluate visual inspection with acetic acid (VIA) screening for cervical cancer among human immunodeficiency virus (HIV)-positive patients in an East African community.

Methods: During a July 2018 cervical cancer screen-and-treat in Mwanza, Tanzania, participants were offered free cervical VIA screening, cryotherapy when indicated, and HIV testing. Acetowhite lesions and/or abnormal vascularity were designated VIA positive in accordance with current guidelines.

Pseudoexfoliation syndrome in a 27-year-old patient: a case report.

Pseudoexfoliation syndrome is more frequent in people aged >50 yeears, and its prevalence increases with age. Few reports have described cases in younger patients, all with a history of ocular surgery, especially iris resection. Herein, we describe the case of a 27-year old man with bilateral advanced glaucoma and pseudoexfoliation material in OS.

Implementation of human papillomavirus video education for women participating in mass cervical cancer screening in Tanzania.

Background: Because the global disease burden of cervical cancer is greatest in Africa, the World Health Organization has endorsed visual inspection with acetic acid screening with cryotherapy triage for the screen-and-treat approach. With the lowest doctor-to-patient ratio worldwide (1:50,000), Tanzania has nearly 10,000 new cases of cervical cancer and 7000 deaths annually.

Objective: We report on the feasibility of visual inspection with acetic acid in the severely resource-limited Mwanza district and on the impact of intervening education on baseline human papillomavirus and cervical cancer knowledge.

Multicenter Study of Risk-Adapted Therapy With Dose-Adjusted EPOCH-R in Adults With Untreated Burkitt Lymphoma.

Purpose: Burkitt lymphoma is an aggressive B-cell lymphoma curable with dose-intensive chemotherapy derived from pediatric leukemia regimens. Treatment is acutely toxic with late sequelae. We hypothesized that dose-adjusted etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, and rituximab (DA-EPOCH-R) may obviate the need for highly dose-intensive chemotherapy in adults with Burkitt lymphoma.

Cervical cancer in Tanzania: A systematic review of current challenges in six domains.

Cervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-to-patient ratio (1:50,000) and nearly 7000 women die each year from this disease.

Bilateral acute angle closure in a patient with dengue fever: a case report.

We report the case of a 46-year-old female patient who presented with bilateral acute angle closure during the course of dengue infection. Dengue diagnosis was confirmed by serological tests. The patient had plateau iris configuration identified by ultrasound biomicroscopy.

Promoting continuing competence and confidence in nurses through high-fidelity simulation-based learning.

In many health care settings, nurses are challenged with higher acuity patients in technical and evolving environments. Practicing nurses are expected to adapt by independently acquiring new clinical knowledge through experience and independent study. However, health care institutions have struggled with providing quality patient care and supporting nurses' learning through experience at the same time.

The effects of the phytoestrogenic isoflavone genistein on the hepatic disposition of preformed and hepatically generated gemfibrozil 1-O-acyl glucuronide in the isolated perfused rat liver.

Foods and complementary medicines contain phytoestrogenic isoflavones such as genistein, which undergo hepatic glucuronidation and excretion into bile and can potentially interfere with the hepatic elimination of other compounds. To investigate this potential, livers from Sprague-Dawley rats were perfused in single-pass mode with preformed gemfibrozil 1-O-acyl glucuronide (GG) (1 microM, n = 12) for 60 min followed by a 30-min washout phase, or with gemfibrozil (1 microM, n = 10) for 120 min. Half of each group of livers were co-perfused with genistein (10 microM) throughout the experiment.

The effects of phytoestrogenic isoflavones on the formation and disposition of paracetamol sulfate in the isolated perfused rat liver.

This study examines the potential for the phytoestrogenic isoflavones, a type of complementary medicine, to be involved in pharmacokinetic interactions in the liver. Rat livers were isolated and perfused to steady state, in single-pass mode, with either 5 microM paracetamol (n = 6), or 5 microM paracetamol with a 50:50 molar mixture of genistein and biochanin A or daidzein and formononetin, at a total isoflavone concentration of 1 and 10 microM (n = 6 for each mixture at each concentration). At 1 microM, neither isoflavone mixture had any effect, while at 10 microM both mixtures decreased the clearance of paracetamol and the formation clearance to paracetamol sulfate.

Comparison of the effects of morphine administered by constant-rate intravenous infusion or intermittent intramuscular injection in dogs.

Objective: To compare physiologic and analgesic effects of morphine when given by IV constant-rate infusion or by IM injection to dogs undergoing laparotomy and to determine pharmacokinetics of morphine in dogs following IV constant-rate infusion.

Design: Prospective randomized controlled trial.

Animals: 20 dogs.