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\"Fourteen-year-old Maximum Ride knows what it's like to soar above the world. She and all the members of her 'flock'-- Fang, Iggy, Nudge, Gasman, and Angel-- are just like ordinary kids, except they have wings and can fly! It may seem like a dream come true to some, but for the flock it's more like a living nightmare when the mysterious lab known as the 'School' turns up and kidnaps their youngest member. Now it's up to Max to organize a rescue, but will help come in time?\" -- p. [4] of cover.

We assessed the field-scale stabilization efficiency of lead (Pb) and copper (Cu) in contaminated soils using powdered (WOS-P) and granular (WOS-G) waste oyster shell (WOS) amendments. A 9-month monitoring was conducted using geochemical leaching tests Toxicity Characteristic Leaching Procedure (TCLP), Mehlich-3, and Diethylenetriaminepentaacetic acid (DTPA) besides sequential extraction and geophysical methods. WOS-treated soils exhibited significant reductions in leaching ratios, with WOS-P showing greater efficacy. Pb and Cu leaching ratios decreased by up to 1.21 and 2.00% points, respectively. Fractional analysis confirmed the redistribution of Pb into carbonate-bound forms, with the F2 fraction increasing from 6.46 to 12.89%, and Cu into Fe–Mn oxide-bound forms (F3), which increased from 11.29 to 15.88%. Electrical resistivity (ER) and induced polarization (IP) surveys visualized the spatial evolution of stabilization. In WOS-P plots, lower ER and elevated IP responses were initially observed, consistent with those of increased ionic strength. Over time, signal attenuation suggested precipitation and geochemical fixation. WOS-G plots showed delayed IP enhancement, reflecting slower dissolution and ion release. Our results suggest that WOS can serve as an effective and sustainable stabilizer, and that combined ER and IP with geochemical monitoring offers valuable complementary insights. Future work should expand the spatial and temporal scope to validate these findings and advance integrated interpretation frameworks for more robust field applicability and quantitative stabilization assessment.

Primary bone tumors encompass a heterogeneous spectrum ranging from benign entities to highly aggressive sarcomas. This review aims to summarize the current role and future perspectives of nuclear medicine in the diagnosis, staging, and management of primary bone tumors. Accurate diagnosis and staging are critical yet challenging due to histologic heterogeneity and overlapping imaging features. While radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) remain essential, nuclear medicine provides a complementary functional perspective by assessing bone turnover, vascularity, and glucose metabolism. Bone scintigraphy is highly sensitive for skeletal lesions and useful for detecting skip lesions or multifocal disease, although its specificity is limited. Hybrid single-photon emission computed tomography (SPECT)/CT enhances diagnostic confidence through precise anatomic localization and quantitation. [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET)/CT, by directly visualizing tumor metabolism, has become a cornerstone in osteosarcoma and Ewing sarcoma management, demonstrating superiority over bone scintigraphy for detecting skeletal metastases. In chondrosarcoma, [18F]FDG uptake correlates with histologic grade, although overlap with benign cartilage tumors complicates interpretation. Future directions include the integration of quantitative SPECT, artificial intelligence, and novel tracers such as [18F]sodium fluoride and [68Ga]Ga-fibroblast activation protein inhibitor (FAPI). Collectively, nuclear medicine imaging is becoming a key element in musculoskeletal oncology, offering unique biological insights that complement anatomic imaging and contribute to improved patient management.

Delayed phase 18 F-FP-CIT PET (dCIT) can assess the striatal dopamine transporter binding to detect degenerative parkinsonism (DP). Early phase 18 F-FP-CIT (eCIT) can assess the regional brain activity for differential diagnosis among parkinsonism similar with 18 F-FDG PET. We evaluated the diagnostic performance of dual phase 18 F-FP-CIT PET (dual CIT) and 18 F-FDG PET compared with clinical diagnosis in 141 subjects [36 with idiopathic Parkinson’s disease (IPD), 77 with multiple system atrophy (MSA), 18 with progressive supranuclear palsy (PSP), and 10 with non-DP)]. Visual assessment of eCIT, dCIT, dual CIT, 18 F-FDG and 18 F-FDG PET with dCIT was in agreement with the clinical diagnosis in 61.7%, 69.5%, 95.7%, 81.6%, and 97.2% of cases, respectively. ECIT showed about 90% concordance with non-DP and MSA, and 8.3% and 27.8% with IPD and PSP, respectively. DCIT showed ≥ 88% concordance with non-DP, IPD, and PSP, and 49.4% concordance with MSA. Dual CIT showed ≥ 90% concordance in all groups. 18 F-FDG PET showed ≥ 90% concordance with non-DP, MSA, and PSP, but only 33.3% concordance with IPD. The combination of 18 F-FDG and dCIT yielded ≥ 90% concordance in all groups. Dual CIT may represent a powerful alternative to the combination of 18 F-FDG PET and dCIT for differential diagnosis of parkinsonian disorders.

The 2021 World Health Organization classification includes telomerase reverse transcriptase promoter (TERTp) mutation status as a factor for differentiating meningioma grades. Therefore, preoperative prediction of TERTp mutation may assist in clinical decision making. However, no previous study has applied fractal analysis for TERTp mutation status prediction in meningiomas. The purpose of this study was to assess the utility of three-dimensional (3D) fractal analysis for predicting the TERTp mutation status in grade 2 meningiomas. Forty-eight patients with surgically confirmed grade 2 meningiomas (41 TERTp-wildtype and 7 TERTp-mutant) were included. 3D fractal dimension (FD) and lacunarity values were extracted from the fractal analysis. A predictive model combining clinical, conventional, and fractal parameters was built using logistic regression analysis. Receiver operating characteristic curve analysis was used to assess the ability of the model to predict TERTp mutation status. Patients with TERTp-mutant grade 2 meningiomas were older (P = 0.029) and had higher 3D FD (P = 0.026) and lacunarity (P = 0.004) values than patients with TERTp-wildtype grade 2 meningiomas. On multivariable logistic analysis, higher 3D FD values (odds ratio = 32.50, P = 0.039) and higher 3D lacunarity values (odds ratio = 20.54, P = 0.014) were significant predictors of TERTp mutation status. The area under the curve, accuracy, sensitivity, and specificity of the multivariable model were 0.84 (95% confidence interval 0.71-0.93), 83.3%, 71.4%, and 85.4%, respectively. 3D FD and lacunarity may be useful imaging biomarkers for predicting TERTp mutation status in grade 2 meningiomas.

Background and Objectives: Transpyloric (TP) feeding tube placement is a viable nutritional strategy in low birth weight infants (LBWIs) with severe gastroesophageal reflux or feeding intolerance. However, technical challenges are encountered in patients of this age group due to their small body size and the limited availability of appropriately sized equipment. Materials and Methods: We retrospectively reviewed 15 endoscopic TP tube placements performed in 12 LBWIs weighing less than 2.5 kg between May 2017 and March 2025. Emphasis was placed on procedural techniques, equipment selection, and troubleshooting strategies for successful bedside execution. Results: All procedures were performed without the use of additional accessories, by advancing a feeding tube preloaded with a guidewire under direct visualization provided by a 5.5 mm outer diameter endoscope. All procedures were technically successful, including 14 performed at the bedside using a portable endoscope. A 6 or 8 Fr feeding tube loaded with a soft-tipped guidewire was advanced through the pylorus under direct endoscopic visualization. The average body weight at the time of the procedure was 1950 ± 296 g. No complications such as mucosal injury, perforation, or tube dislodgement occurred during the procedure. The average enteral feeding volume increased from 33.4 ± 52.8 cc/kg to 92.0 ± 44.4 cc/kg within 7 days. Full enteral nutrition was achieved in all surviving patients within three weeks. The feeding tube remained in place for a mean duration of 26.1 ± 19.2 days. Conclusions: Endoscopic TP tube placement in LBWIs can be safely and reliably performed at the bedside with appropriate technical modifications. It facilitates earlier advancement to full enteral nutrition and may serve as a viable option for LBWIs unresponsive to standard feeding methods.

Objectives: This study aimed to evaluate the consistency of Centiloid (CL) values calculated using three commercially available software platforms: BTXBrain (v1.1.2), MIM (v7.3.7), and SCALE PET (v2.0.1). Methods: A total of 239 patients who underwent amyloid PET/CT with either F-18 flutemetamol (FMM) or F-18 florbetaben (FBB) were retrospectively analyzed. CL values were calculated using BTXBrain, MIM, and SCALE PET. Linear regression, Passing–Bablok regression, and Bland–Altman analysis were performed to assess the agreement between CL values. Subgroup analyses were conducted for each radiotracer. CL values were compared according to visual interpretation status. Results: Strong correlations were observed between CL values derived from the three software platforms (R2 > 0.95). However, Passing–Bablok regression revealed significant proportional bias, with CL values from BTXBrain being lower than others, and CL values from SCALE PET being higher than others as CL values increased. Bland–Altman plots visualized the proportional bias, particularly between BTXBrain and SCALE PET. Subgroup analyses by radiotracer showed similar results. CL values in visually positive scans were significantly higher than those in visually negative scans across all platforms. Conclusions: The three commercial software programs demonstrated high consistency in CL quantification. However, a notable systematic bias was observed. Further evaluation of various scanner effects and CL calculation methods is warranted to improve the consistency and reproducibility of CL quantification in clinical practice.

Background Only 10 cases of cecal epidermoid cyst (CEC) have been reported in the literature. Furthermore, its pathogenesis remains unclear. We report a rare case of congenital CEC in neonate, and discuss its clinicopathological findings. Case presentation A cystic lesion was incidentally identified in the retroperitoneal area of the abdominal right lower quadrant during a routine prenatal ultrasonography (US), prompting an ileocolectomy 3 days after birth. This congenital cyst was composed of mucosal lining cells and submucosal connective tissues, and the inner lining mucosa was composed of stratified squamous epithelium and focally mucin-producing ciliated epithelium. Based on the macroscopic and microscopic findings, the cystic lesion was diagnosed as a congenital cecal epidermoid cyst. Conclusions The management of a fetal abdominal mass should be tailored individually, considering that epidermoid cysts can occur in the cecum during the perinatal period. We report the clinicopathological findings in this case, including its possible pathogenesis.

Background Respiratory support is crucial for newborns with underdeveloped lung. The clinical outcomes of patients depend on the clinician’s ability to recognize the status underlying the presented symptoms and signs. With the increasing number of high-risk infants, artificial intelligence (AI) should be considered as a tool for personalized neonatal care. Continuous monitoring of vital signs is essential in cardiorespiratory care. In this study, we developed deep learning (DL) prediction models for rapid and accurate detection of mechanical ventilation requirements in neonates using electronic health records (EHR). Methods We utilized data from the neonatal intensive care unit in a single center, collected between March 3, 2012, and March 4, 2022, including 1,394 patient records used for model development, consisting of 505 and 889 patients with and without invasive mechanical ventilation (IMV) support, respectively. The proposed model architecture includes feature embedding using feature-wise fully connected (FC) layers, followed by three bidirectional long short-term memory (LSTM) layers. Results A mean gestational age (GA) was 36.61 ± 3.25 weeks, and the mean birth weight was 2,734.01 ± 784.98 g. The IMV group had lower GA, birth weight, and longer hospitalization duration than the non-IMV group ( P  < 0.05). Our proposed model, tested on a dataset from March 4, 2019, to March 4, 2022. The mean AUROC of our proposed model for IMV support prediction performance demonstrated 0.861 (95%CI, 0.853–0.869). It is superior to conventional approaches, such as newborn early warning score systems (NEWS), Random Forest, and eXtreme gradient boosting (XGBoost) with 0.611 (95%CI, 0.600–0.622), 0.837 (95%CI, 0.828–0.845), and 0.0.831 (95%CI, 0.821–0.845), respectively. The highest AUPRC value is shown in the proposed model at 0.327 (95%CI, 0.308–0.347). The proposed model performed more accurate predictions as gestational age decreased. Additionally, the model exhibited the lowest alarm rate while maintaining the same sensitivity level. Conclusion Deep learning approaches can help accurately standardize the prediction of invasive mechanical ventilation for neonatal patients and facilitate advanced neonatal care. The results of predictive, recall, and alarm performances of the proposed model outperformed the other models.

Background Early extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short- and long-term outcomes. Therefore, the present study aimed to identify differences in risk factors and clinical outcomes between ES and EF in very early preterm infants. Methods This retrospective study was conducted between January 2017 and December 2021. Premature infants born at 32 weeks’ gestational age in whom extubation had failed at least once were assigned to the EF group. Successfully extubated patients with a similar gestational age and birth weight as those in the EF group were assigned to the ES group. EF was defined as the need for re-intubation within 120 h of extubation. Various variables were compared between groups. Results The EF rate in this study was 18.6% (24/129), and approximately 80% of patients with EF required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12 [63.2%] vs. 22 [91.7%], p  = 0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks (1.72 vs. 2.5, p  = 0.026; 1.73 vs. 2.92, p  = 0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p  = 0.020). There was a higher severity of bronchopulmonary dysplasia BPD (3 [15.8%] vs. 14 [58.3%], p  = 0.018), longer duration of oxygen supply (66.5 vs. 92.9, p  = 0.042), and higher corrected age at discharge (39.6 vs. 42.5, p  = 0.043) in the EF group. The cutoff value, sensitivity, and specificity of the respiratory severity score (RSS) at 1 week were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks were 2.22, 0.67, and 0.47, respectively. Conclusions EF caused adverse short-term outcomes such as a higher BPD severity and longer hospital stay. Therefore, extubation in very early preterm infants should be carefully evaluated. Using inotropes, feeding, and RSS at 1 week of age can help predict extubation success.