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Background: Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value due to delayed manifestation of HIBI-related changes. Radiomics analyses present a promising approach to identifying subtle imaging markers, potentially aiding early HIBI detection. Methods: This study retrospectively assessed post-CA patients between 2016 and 2023 who received immediate brain CTs. Patients without acute intracranial pathology on initial scans and who underwent follow-up brain CTs within 14 days post-return of spontaneous circulation (ROSC) were included. Image segmentation involved manual basalganglia segmentation and automated whole-brain segmentation. Radiomics features were calculated using Pyradiomics (v3.0.1) in 3DSlicer (v5.2.2). Feature selection involved reproducibility analysis via ICC and LASSO regression, retaining five features per segmentation method. A logistic regression model for each segmentation method underwent 5-fold cross-validation. Results were summarized with ROC analyses and average sensitivity and specificity. Results: A total of 83 patients (average age: 65 ± 13.3 years, 19 women) with CA and ROSC were included. Follow-up CT scans after 5.2 ± 2.9 days revealed brain edema in 47 patients. The model using manual segmentation achieved an average AUC of 0.76, sensitivity of 0.59, and specificity of 0.78. The automated segmentation model showed an average AUC of 0.66, sensitivity of 0.49, and specificity of 0.68. Conclusions: Radiomics, particularly focused on the basalganglia area in normal-appearing brain CTs after CA and ROSC, may enhance predictive insights for HIBI and the development of brain edema. [ABSTRACT FROM AUTHOR]

Mild breast swelling is frequently observed in newborns during the first postnatal week. Breast enlargement is also observed in a minor proportion of infants beyond the first postnatal week, leading to discussions how to deal with it. Our objective was to review a case series of infants with prolonged breast swelling. We examined five infants with pronounced breast enlargement beyond the first postnatal week and measured human chorionic gonadotropin (HCG), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and progesterone (P4) in blood samples and analyzed breast volume by sonographic volume determination in all infants initially and across time. The regression of breast enlargement positively correlated with serum prolactin levels in infants with breast enlargement beyond the first week of life. Complete regression occurred after several weeks and was characterized by normalization of serum prolactin levels. The present study emphasizes the role of prolactin in neonates with pronounced breast enlargement beyond the first week of life. [ABSTRACT FROM AUTHOR]

This study aimed to assess the feasibility of GPT-4 for answering questions related to contrast media with and without the context of the European Society of Urogenital Radiology (ESUR) guideline on contrast agents. The overarching goal was to determine whether contextual enrichment by providing guideline information improves answers of GPT-4 for clinical decision-making in radiology. A set of 64 questions, based on the ESUR guideline on contrast agents mirroring pertinent sections, was developed and posed to GPT-4 both directly and after providing the guideline using a plugin. Responses were graded by experienced radiologists for quality of information and accuracy in pinpointing information from the guideline as well as by radiology residents for utility, using Likert-scales. GPT-4′s performance improved significantly with the guideline. Without the guideline, average quality rating was 3.98, which increased to 4.33 with the guideline (p = 0036). In terms of accuracy, 82.3% of answers matched the information from the guideline. Utility scores also reflected a significant improvement with the guideline, with average scores of 4.1 (without) and 4.4 (with) (p = 0.008) with a Fleiss´ Kappa of 0.44. GPT-4, when contextually enriched with a guideline, demonstrates enhanced capability in providing guideline-backed recommendations. This approach holds promise for real-time clinical decision-support, making guidelines more actionable. However, further refinements are necessary to maximize the potential of large language models (LLMs). Inherent limitations need to be addressed. [ABSTRACT FROM AUTHOR]

The article discusses the safety concerns surrounding contrast media (CM) used in radiology, particularly focusing on issues related to postcontrast acute kidney injury and hypersensitivity reactions. It highlights recent developments in the use of gadolinium-based contrast agents (GBCAs) and the importance of using macrocyclic-based contrast agents when appropriate. The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology plays a crucial role in providing guidelines and publications on CM safety, addressing topics such as extravasation, waiting times between examinations, and analytical interference with laboratory tests. Future guidelines will focus on hypersensitivity reactions and safe use of CM in specific conditions like myasthenia gravis. [Extracted from the article]

This study investigated general and subject-specific motivational beliefs from the perspectives of self-determination theory (i.e. intrinsic, identified, introjected, and extrinsic motivation) and achievement goal theory (i.e. mastery, performance-approach, and -avoidance goal orientation including the respective classroom goal structures), their interrelations, their stability over time, and their associations with desirable outcomes (i.e. deep-level learning strategies, self-concept of ability). It was hypothesized that motivational beliefs are interrelated but demonstrate a distinct correlational pattern depending on whether they were assessed as general or subject-specific motivation. In addition, motivational beliefs were hypothesized to relate to learning strategies and ability beliefs. Medical students (n = 146) participated in this longitudinal study with measurement points at the beginning and end of a semester. The questionnaire included established motivational scales to assess motivational beliefs and desirable outcomes. Measurement models were tested using confirmatory factor analyses; correlations of scale means were investigated to assess the nomological network of motivational beliefs. As expected, intrinsic and identified motivation were associated with mastery goal orientation and with desirable outcome variables, such as the use of deep-level learning strategies. General and subject-specific motivation exhibited distinct correlational patterns. Motivation was relatively stable over time. Results did not confirm the factor structure of classroom goal structure. The study emphasizes the benefit of a subject-specific conceptualization of motivation and the need for a careful adaptation of theoretical constructs from the secondary school context to make them fruitful for the promotion of medical students' motivation. Medical teachers can use established motivational interventions (e.g. using an individual frame of reference for feedback) to support students' adaptive motivational beliefs (e.g. self-determined motivation, mastery goals). Given the subject specificity of motivation, it seems beneficial to promote adaptive motivation in the respective medical specialty regardless of students' general motivational characteristics. [ABSTRACT FROM AUTHOR]