bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of lumbar spine stabilization with 2-stage surgery and cement augmentation in osteoporosis patients: a randomized clinical trial
Authors: Hajilo Parisa , Imani behzad , Zandi Shirdel , mehrafshan Ali
Published: October 2024

Background
The biggest challenge for osteoporotic patients after spinal stabilization is screw loosening. Therefore, the present study was conducted with the comparative aim of stabilizing the lumbar spine with 2-stage surgery and cement augmentation in osteoporotic patients.
Methods
66 patients selected through convenience sampling and randomly assigned to two groups: CAPS and 2-stage surgery. In the CAPS group, lumbar spine fixation was performed in a single stage, accompanied by cement augmentation. In the 2-stage surgery group, spinal stabilization was conducted in 2 stages. In the first stage, pedicle screws were implanted, followed by the pedicle screw anchoring process six months later. fusion rate, screw loosening, pain levels (VAS), and patients' disability (ODI) were measured in each group.
Results
The fusion rate in the 2-stage Surgery group significantly increased. Screw loosening in the CAPS group showed a significantly higher difference. The rate of pain and disability in patients early postoperatively, in comparison to preoperative measures, significantly decreased in both groups. In the final follow-up, the CAPS group experienced a significant increase in pain and disability.
Conclusions
The 2-stage Surgery stabilization, when compared to the CAPS technique, demonstrates superiority in enhancing the biomechanical stability of screws and achieving successful fusion.
Investigation of the Effect of Humic Acid on Experimental Copper Accumulation in the Liver in Rats
Authors: Cagin Yasir Furkan , Atayan Yahya , Ozhan Onural , Berber Ilhami , Yildiz Azibe , Dogru Feyzi , Kirec Yusuf
Published: October 2024

Objective
There is a need for an affordable oral chelator to reduce the treatment cost in cases of chronic copper intoxication, such as hereditary Wilson's disease. Humic acid (HA) is a naturally occurring molecule found in water and soil, with a longchain and the ability to transfer electrons. It has the capability to eliminate toxic compounds from the body. This study was designed to test chelator effect of HA on copper as well as its anti-oxidant effect against the copper-induced hepatotoxicity, renal toxicity and brain toxicity
Materials and Methods
Forty female Wistar albino rats were randomly divided into four groups (n:10) as follows: Control group; HA group: 536 mg/kg/day HA (po for 14 days); Cu group: 75 mg/kg copper sulfate (po at 12-hour intervals for14 days); Cu + HA group: 75 mg/kg copper sulfate (po at 12-hour intervals for 14 days) and 536 mg/kg/day HA (po for 14 days). Blood and two tissue samples(liver, kidney and brain) were collected for biochemical and histopathological analyses.
Results
The copper-induced hepatotoxicity, renal toxicity and brain toxicity were demonstrated by histopathological and biochemical manner. Histopathological changes in the Cu + HA group were observed to continue similarly to the Cu group. Significant changes were observed in all oxidant and antioxidant parameters except liver MDA, GPx and TAS and kidney GSH and SOD between the copper group and the HA plus copper group (p < 0.05).
Conclusion
The protective effects of humic acid against copper-induced hepatotoxicity, renal toxicity and brain toxicity were shown in our study. However, further research is needed to corroborate the results of our study.
Multimodal imaging for the diagnosis of cardiac alveolar echinococcosis: a case report
Authors: Zhu Mengdie , Gao Xukun , Wang Xiaoping , Meng Li
Published: October 2024

Background: Primary cardiac echinococcosis is rare, and cardiac alveolar echinococcosis is even rarer and more unusual. Reported cases of this disease are extremely limited, and multimodal imaging provides an important guide to treatment and decision-making. We report a case of cardiac alveolar echinococcosis.
Case summary: A 31-year-old male patient with no specific medical history was found to have a cardiac space-occupying lesion on physical examination one day earlier. Transthoracic echocardiography showed a cystic mass anterior to the right lateral aspect of the right atrium, which did not show enhancement on the enhanced scan. Multidetector computed tomography and cardiac magnetic resonance showed a cystic space-occupying lesion in the right lateral aspect of the right atrium, with mild enhancement of the edges of the lesion and multiple small vesicles on the enhancement scan. Surgery was performed on suspicion of cardiac alveolar echinococcosis, and the lesion was successfully excised. Ultimately, postoperative histopathologic examination revealed cardiac alveolar echinococcosis. The patient recovered well and was discharged with regular postoperative oral albendazole tablets and regular follow-up reviews.
Conclusion: We report a case of cardiac alveolar echinococcosis with multimodal imaging features and therapeutic strategies, an extremely rare cardiac occupying disease. Multimodal imaging can be very helpful in diagnosing the disease; however, surgical resection with histopathologic diagnosis is essential. Appropriate postoperative treatment and follow-up are based on histologic findings. This rare case emphasizes the integrated diagnosis of cardiac alveolar echinococcosis with clinical, multimodal imaging and pathologic data.
Digital Narratives of Grief and Resilience: Insights from the Integrating Emotional Stories Online ( IESO) Platform
Authors: Patton Desmond , Kleiner Shana , Miller Shug , Deas Nick , Edwards Fahnmusa , Grieser Jessi , Shephard James , Turcan Elsbeth , McKeown Kathy
Published: October 2024

Social media has altered how humans express emotions, among them, grief. Features unique to social media platforms, such as persistence, replicability, scalability, and searchability have afforded social media users new spaces and larger communities in which to express deep, complex pain and find support. This interdisciplinary study, leveraging insights from social work, computer science, and linguistics, explores how grief and daily stressors are expressed, on a digital platform, among Black Harlem residents and students attending a large university in New York City. Particular attention is given to posts with features that reflect African American English and social media-specific language, seeking to understand challenges associated with interpreting these expressions; misinterpretation can lead to differential support and treatment for those seeking help. To examine the experience, we created the Integrating Emotional Stories Online (IESO) platform, to collect expressions of grief and everyday stress. The platform allowed participants to anonymously post and self-label their emotions; we analyzed posts using qualitative and computational topic modeling methods to identify core themes. We identified four primary themes: expressions of interpersonal grief, systemic grief, everyday stressors and self-care & joy. The computational topic modeling approach validated those themes. The study was conducted in the context of significant events such as the COVID-19 pandemic, protests against police brutality, and mass shootings. Findings reveal the complex ways grief and everyday stress may be communicated in digital space, emphasizing the importance of deep analysis and reflection when examining hyper-local dialects. Findings also underscore the importance of digital platforms in understanding and supporting individuals who experience grief and other forms of stress, providing valuable insights for mental health practitioners.
Risk factors analysis and risk prediction model for failed back surgery syndrome: a prospective cohort study
Authors: Hajilo Parisa , Imani behzad , Zandi Shirdel , mehrafshan Ali , khazaei salman
Published: October 2024

Introduction:
With the growing number of posterior open surgery, the incidence of failed back surgery syndrome (FBSS) increases gradually. Currently, there is a lack of predictive systems and scientific evaluation in clinical practice. This study aimed to risk factors analysis of FBSS and develop a risk prediction model.
Materials and Methods
Baseline data were collected from 512 patients. Patients were followed up for one year. Ultimately, 146 patients were classified in the FBSS group, with an incidence rate of 32.5%. Logistic regression was used to screen for independent risk factors influencing the occurrence of FBSS. The diagnostic power of model was evaluated using the ROC curve.
Findings:
Age, smoking, type of pain, revision surgery, surgical technique, quality of life, and psychological status were significantly associated with the incidence of FBSS. The strongest factor in this model was the selected surgical technique, with an odds ratio of 0.095. The area under the ROC curve for the model's diagnostic and classification power was 0.852.
Conclusion
The causes of FBSS can stem from underlying factors, lifestyle, surgical causes, and patients' psychological factors. Therefore, prevention and treatment for each individual should be based on their specific cause to achieve optimal results.
Dynamic Relationships between Bilirubin Concentrations and the Gut Microbiota in the Neonatal Period: A Prospective Cohort Study
Authors: Li Zhongyuan , Zhang Yan , Peng Lihua , Zou Liping , Wang Yangyang , Luo Xi
Published: October 2024

Neonatal jaundice affects 60% of term infants and 80% of preterm infants and is the leading cause of hospitalization in the first year of life. The gut flora is involved in bilirubin metabolism in the host. We conducted a pilot prospective cohort study in Chinese neonates to investigate the correlation between dynamic changes in the gut microbiota and bilirubin concentrations during the neonatal period. Bilirubin concentrations were monitored daily throughout the neonatal period. Fecal samples were collected from neonates on days 1, 3, 7, 14, 21, and 28 after birth. The composition of the gut microbiome was assessed via 16S rRNA gene amplicon sequencing of fecal samples. Thirty neonates were included in the final analysis. Changes in the abundances of the genera Parabacteroides, Streptococcus, and Rothia were positively correlated with bilirubin concentrations throughout the neonatal period, whereas Comamonas wasnegatively correlated (all p < 0.01). The abundances of the genera Muribaculaceae, Lactobacillus, Gardnerella, Corynebacterium, Clostridium_sensu_stricto_1, Blautia, and Atopobium werepositively correlated with the bilirubin concentration on days 3 to 7, whereas those of Ampullimonas and Rothia were negatively correlated. Additionally, the abundances of the genera Muribaculaceae and Lachnoclostridium were positively correlated with the maximum bilirubin concentration during the neonatal period, whereas Rothia and Ampullimonas were negatively correlated (all p < 0.05). A correlation was found between dynamic changes in the gut microbiome and neonatal bilirubin concentrations during the neonatal period. The identified genera might be potential markers or targets for intervention in hyperbilirubinemia.
Dietary Inflammatory Index is intensity-dependently associated with the Bone Mineral Density at the Lumbar Spine: A Cross- Sectional NHANES Study from 2007 to 2020
Authors: Jiang Ying , Chou Xinyue , Du Siyu , Zeng Yimiao , Zhang Zihao , Yang Tianchang , Sun Zhipeng
Published: October 2024

Background
Bone mineral density (BMD) is a tool to assess bone health. Dietary inflammation index (DII) is an index to reflect the inflammatory effect of a diet. Even though the association between DII and BMD have been extensively studied, the outcome remains controversial. This study aims to reveal the relationship between DII and lumbar spine BMD in both the whole population and in postmenopausal women.
Methods
We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2007–2020 and included 27027 participants after exclusion procedure. Smooth curve fitting and multivariate regression analysis were used both in the entire population and later in the subgroup analysis.
Results
In the entire population, the smooth curve fitting revealed a non-linear association with both declining and increasing trends between DII and lumbar spine BMD. Multivariate regression analysis indicated that, after adjustment, the median DII and BMD was negatively associated and the high DII and BMD was positively associated. In postmenopausal women, smooth curve fitting suggested an inverted U-shaped relationship between DII and BMD. We also observed a positive correlation between low DII and lumbar spine BMD.
Conclusions
DII has both positive and negative relationship with lumbar spine BMD in both the entire population and menopausal women, depending on the intensity of DII. The different trends of the smooth curve fitting may be explained by the low-inflammation state in postmenopausal women mediated by estrogen but more evidence is needed to explain the reason.
Harnessing Large Language Models to Uncover Insights in Diabetes Wearable Data
Authors: Alavi Arash , Cha Kexin , Esfarjani Delara P , Patel Bhavesh , Than Jennifer Li Pook , Lee Aaron Y. , Nebeker Camille , Snyder Michael , Bahmani Amir
Published: October 2024

Large Language Models (LLMs) have gained significant attention and are increasingly used by researchers. Concurrently, publicly accessible datasets containing individual-level health information are becoming more available. Some of these datasets, such as the recently released Artificial Intelligence Ready and Equitable Atlas for Diabetes Insights (AI-READI) dataset, include individual-level data from digital wearable technologies. The application of LLMs to gain insights about health from wearable sensor data specific to diabetes is underexplored. This study presents a comprehensive evaluation of multiple LLMs, including GPT-3.5, GPT-4, GPT-4o, Gemini, Gemini 1.5 Pro, and Claude 3 Sonnet, on various diabetes research tasks using diverse prompting methods to evaluate their performance and gain new insights into diabetes and glucose dysregulation. Notably, GPT-4o showed promising performance across tasks with a chain-of-thought prompt design (aggregate performance score of 95.5%). Moreover, using this model, we identified new insights from the dataset, such as the heightened sensitivity to stress among diabetic participants during glucose level fluctuations, which underscores the complex interplay between metabolic and psychological factors. These results demonstrate that LLMs can enhance the pace of discovery and also enable automated interpretation of data for users of wearable devices, including both the research team and the individual wearing the device. Meanwhile, we also emphasize the critical limitations, such as privacy and ethical risks and dataset biases, that must be resolved for real-world application in diabetes health settings. This study highlights the potential and challenges of integrating LLMs into diabetes research and, more broadly, wearables, paving the way for future healthcare advancements, particularly in disadvantaged communities.
Impact of fruits and vegetables consumption on cardio-metabolic health - a case control study
Authors: El-Shaheed Azza Abd , Mahfouz Nermine N. , Hamid May M. Abdel
Published: October 2024

Background
According to the World Health Organization (WHO), it is recommended to consume more than four hundred grams of (fruits + vegetables) per day to enhance healthful lifestyle and to lower the incidence of cardio-metabolic illnesses. Their low glycemic index helps prevent spikes in blood sugar, consequently controlling hunger. Our aim was to study the reflection of the intake of fruits and that of vegetables on cardio-metabolic risks in obese children.
Results
A case-control research enrolled 90 Egyptian children (44 obese, 46 normal weight control children) aged from 5–11 years. Thirty-three out of forty-six controls (71.7%) consumed vegetables on a daily basis compared to only twenty-seven (61.4%) among cases. As regards fruits, the daily consumption was frequented more among the obese group 25 (58.1%) and less frequented among the control group. Daily intake of vegetables was not associated with lower risks of increased levels of fasting blood glucose, total cholesterol, triglycerides, Low Density Lipoprotein-cholesterol (LDL-C), LDL/HDL ratio, Triglycerides/HDL ratio and Triglycerides/glucose ratio. P values were as follow 0.363, 0.774, 0.947,0.211, 0.714, 0.093 and 0.736. Not only vegetables but also daily intake of fruits was not associated with lower risks of high fasting blood sugar, cholesterol, triglycerides, LDL, LDL/HDL ratio, Triglycerides/HDL ratio and Triglycerides/glucose ratio. P value was as follows: 0.292, 0.663, 0.663, 0.32, 0.34, 0.062 and 0.219 respectively.
Conclusion
The role of fruits and vegetables is still debatable, our findings showed no significant associations between the frequency of their consumption and obesity, hyperglycemia or hyperlipidemia.
THERANOVA-LIM: Improving knowledge of oral therapies for patients and healthcare professionals
Authors: Boucheteil Marion , Leobon Sophie , Baffert Kim-Arthur , HUET Soline , Darbas Tiffany , brun-Ly Valérie Le , Pestre Julia , Peyramaure Clémentine , Thuillier Frédéric , Venat Laurence , Jost Jérémy , Touati Mohamed , Deluche Elise
Published: October 2024

Background
Recent developments in oral chemotherapy and targeted therapies have radically changed the way in which cancer patients are managed. Ambulatory care is now common, associated with the development of organizations that foster, secure home treatments, and reinforce the city hospital link.
Methods
THERANOVA-LIM (NCT04931329), a prospective study, assessed the satisfaction of healthcare professionals and patients who benefited from improved access to information on appropriate drug use imparted by a drug vigilance card or a prescription with a QR code connected to specific website. Patients had access to advice sheets associated with the molecules used in the therapy, and information sheet to help manage side-effects. Before setting up this programme, a practice assessment survey was carried out among healthcare professionals to understand their needs in terms of prescribing oral therapies.
Results
An e-questionnaire was used to explore the practices and expectations of retail pharmacists, Only 40% stated that they felt comfortable when managing patients on oral therapy which was the starting point for the study. A total of 128 patients were included in the study. Patients received one or other of the systems : 55 received “medication vigilance card” group and 73 a “prescription with QR code”. The median age was 69 years (range 37–90 years); 85 women and 43 men. The three most common cancers were breast (37.5%), prostate (14.1%), and brain (10.9%) cancers. The vast majority of patients had metastatic cancer (90%). The four most prescribed drugs were capecitabine (21.1%), ribociclib (11.7%), temozolomide (11.7%), and trifluridine/tipiracil (7.8%). The occasions on which patients presented cards included medical consultations (25.0%), visits to the pharmacy (100%), and when the homecare nurse was in attendance (25.0%).Patients were similarly satisfied with the new systems (p = 0.8) and as professionals. However, health professionals felt that the prescription with a QR code was of greater assistance than the drug vigilance card (p = 0.02).
Conclusion
Both systems help to improve access to knowledge about oral treatments. This encourages us to extend the innovations and evaluate them further.
Trial Registration Number and the date of registration
: ClinicalTrials.gov, NCT04931329. 2021-05-10
Patient Reported Outcomes Measurements (PROM) of Cataract Surgery : Comparison of Outcomes between Hospital-Based versus Outreach Cataract Centre. A Prospective Cohort Study.
Authors: Yeoh Boon Juan , Salowi Mohamad Aziz , Samsudin Amir , Ramli Norlina
Published: October 2024

Objectives: This study aims to compare the outcomes of cataract surgery using Patient reported outcome measures (PROM) between a general tertiary hospital setting and an outreach cataract centre. PROM reports the benefits of surgery from the point of view of the patient instead of a clinical evaluation, which reduces the biases by practitioners.
Methods: Prospective Cohort Analysis. Patients were recruited at Hospital Selayang and The Hospital Selayang-MAIWP Cataract Care Centre (Pusat Pembedahan Katarak Hospital Selayang-MAIWP or PPKM in Malay) prior to their cataract surgery between 1 July 2022 and 30 October 2022. Printed Questionnaires were given to patients according to their language preferences, ie, English, Malay language and Mandarin. The Catquest-9SF questionnaires were completed prior to their cataract surgery and 6 weeks post-surgery. Patient demography, visual acuity and data was retrieved from electronic medical records at both centres. Mean comparisons between centres were made for post-operative visual acuity in LogMar and post-operative Catquest-9SF. Logistics regression analysis was performed for each domain of the Catquest-9SF to the patient’s demographic data, underlying illnesses, first eye surgery, pre- , and post-operative visual acuity.
Results:
Both centres revealed identical demographic constitution of patients. By comparing means of post operative visual acuity and post operative Catquest-9SF scores, there were no significant differences between the two centres. This is also supported by the improvement/ non-improvements of Catquest-9SF scores, which showed no significant difference between the two centres. Patients from Hospital Selayang had higher percentages of improvements with subcategories Ca (difficulty in everyday life), Cb (satisfaction with current sight), C2 (Recognising faces), and C5 (Seeing to do handicrafts, woodwork).
Logistic regression analysis revealed that pre-op visual acuity appears to be associated with an improvement of functional daily fine visual acuity tasks, whilst patients with cardiovascular and cerebrovascular diseases are associated with leisure associated fine visual acuity tasks. Patients with hypertension however are associated with significant improvements in domains Ca (difficulty in everyday life), C3 (seeing prices of goods), C5 (Seeing to do handicrafts, woodwork) and C6 (Reading Subtitles).
Conclusion:
Improvements in patient reported visual functioning were not significantly different between the two centres. This validates the dedicated outreach cataract centres as places where good clinical and patient reported outcomes can be achieved.
Seismicity Induced by the Cajati Open Pit Mine, SE Brazil: a case of stress concentration, weakness zone, and favorable geometry
Authors: Assumpção Marcelo , Nogueira José Alexandre , Dias Leonardo S. , Carvalho Juraci M. , Schirbel Lucas A. , Bianchi Marcelo B.
Published: October 2024

Fluid injection and reservoir-induced seismicity have been studied for decades. However, seismicity induced by crustal unloading in open-pit mines are seldomly reported. We describe a case associated with a large mine in SE Brazil exploiting carbonate rocks. The pit is 1.4 km long, 0.8 km wide, 300 m deep. 440 Mton of rock have been extracted. Eleven earthquakes (magnitudes 2.0 to 3.3 mb) have occurred since 2009. The largest event (3.2 Mw in 2015) caused expressive cracks in the mine benches. Relocated epicenters, using correlated P- and S-waves at regional stations, align in a single NNW-SSE oriented, 0.5 km long fault beneath the pit major axis. Focal mechanism shows reverse faulting, as expected for crustal unloading, with Coulomb stress increase of 2 MPa. In the coastal ranges of SE Brazil, low-velocities at lithospheric depths suggest stress concentration in the upper crust. The coast-parallel NE-SW P axis is consistent with stress rotation due to continent/ocean transition. Aeromagnetic data shows a NNW-SSE regional fault crossing the mine area. The Cajati mine is a classic case where several factors combine to induce seismicity: upper crustal high stresses, favorable orientation of a previous weak zone, and large Coulomb stress changes from unloading.
Machine Learning-Based Prediction of Gleason Grade Group upgrading in Patients with Localized Prostate Cancer Awaiting Surgery
Authors: Mahamongkol Katunyou , Assavavirojekul Pubordee , Liangkobkit Karn , Hoonlor Apirak , Srinual Sittiporn
Published: October 2024

Background: Despite the improved precision of the MRI fusion prostate biopsy, discrepancies persist between the Gleason grade group (GG) biopsy and the pathological Gleason GG. Our study employs machine learning to predict the upgrading of the Gleason GG, aiding treatment decisions.
Material & Methods: Since 2009, we retrospectively reviewed localized prostate cancer patients who underwent prostatectomy, considering seven potential factors contributing to the upgrading: age, prostate specific antigen (PSA) level, PSA density, biopsy GG, Prostate Imaging-Reporting and Data Systems, percent positive cores and surgical waiting time. Pearson'scorrelation and principal component analysis(PCA) were used to explore the data. Various machine learning models were employed for comparison.
Results: Of 418 patients, neither the Pearson correlation nor the PCA revealed strong correlations with GG upgrading. Logistic regression (LR) achieved the best F1 score, though all models had F1 scores below 0.5, indicating prediction challenges. LR and Neural Network analysis identified biopsy GG, age, and percent positive cores as significant predictors.
Conclusions: No specific features strongly correlated with GG upgrading. Despite high accuracy, intelligent concepts struggled to predict upgrades effectively. Physician expertise and patient characteristics remain crucial for management decisions. We agree that machine learning has great potential to improve prediction in the future.
Incidence, Treatment and Outcomes of Patients with Synchronous Lung and Colorectal Malignancies: A Nationwide Inpatient Sample Database (NIS) Analysis
Authors: Cruz Alejandro , Alam Mohammad Afaque , Omesiete Pamela , Saeed Sabina , Assar Manijeh , Hamidi Mohammad , Guerrero Marlon , Nfonsam Valentine
Published: October 2024

Purpose:
Our study aims to describe the incidence, treatment and clinical outcomes of patients with synchronous lung, and colorectal cancer (CRC).
Methods:
We conducted an 11-years analysis of the Nationwide Inpatient Sample (NIS) database (2002–2012). All adult (age ≥ 18y) patients admitted with a diagnosis of CRC were included. Data abstracted include demographics, malignancy-related variables, treatment, and operative interventions. We excluded patients who had lung metastasis from CRC. Our primary outcome measures were the incidence of synchronous CRC and lung cancer, operative treatment patterns, and mortality.
Results:
Out of 1,198,421 patients admitted with a CRC diagnosis, 6,231 (0.52%) had synchronous lung cancer. Overall, mean age was 61 ± 15y, 75% were male, and 63% were white. Most patients with synchronous malignancies (56%) had advanced CRC with non-small cell lung cancer (76%). The majority of CRC patients (79%) had recto-sigmoid tumors. Only 11.2% underwent surgical management. No significant difference was noted in the proportion of patients first treated for their CRC relative to those treated for their lung cancer first (p = 0.21). The overall mortality rate was 54%.
Conclusion:
The incidence of synchronous occurrence of CRC and lung cancer is low, but the mortality is very high. Diagnosis of synchronous cancer is typically incidental. Treatment options for these patients should be tailored to the individual patient. Genetic and epidemiological studies are required to elucidate the potential connection between lung and colon cancer.
Estimating soil profile salinity under vegetation cover based on UAV multi-source remote sensing
Authors: Luo Zhenhai , Deng Meihua , Tang Min , Liu Rui , Feng Shaoyuan , Zhang Chao , Zheng Zhen
Published: October 2024

Soil salinization is the most common land degradation problem in arid, semi-arid and coastal areas of China, which seriously affects local crop yield, economic development, and environmental sustainability. There are few studies on estimating soil salinity at different depths under vegetation cover. In this study, field soil control experiments were employed to collect multi-source remote sensing data under barley growth, and soil salt content (SSC) with various depths. Three types of feature variables were built based on images and were filtered by the boosting decision tree (BDT) method. Besides, four machine learning algorithms coupling with seven variable combination groups were used to comprehensively establish soil salinity estimation model. Finally, the performances of estimation model for different crop over ratios were evaluated. The results showed that the gaussian process regression (GPR) model based on the full variable group at the depths of 0 ~ 10 cm and 30 ~ 40 cm is more accurate than other models. The validation R2 is 0.774 and 0.705, and the RMSE is 0.185% and 0.31%;The random forest (RF) models based on spectral index and texture data at 10 ~ 20 cm and 20 ~ 30 cm depths are more accurate, with R2 of 0.666 and 0.714. SSC may be quantitatively inverted at various depths using the machine learning model based on multi-source remote sensing, which also serves as a guide for monitoring soil salinization.
Predictive value of the triglyceride-glucose index for metabolic-associated fatty liver disease in individuals with different metabolic obese phenotypes
Authors: Lv Dan , Wang Zepu , Liu Huanxin , Meng Cuiqiao
Published: October 2024

Objective: To investigate the relationship between triglyceride-glucose (TyG) index and metabolic-associated fatty liver disease (MAFLD), and to evaluate the predictive value of the TyG index for MAFLD in individuals with different metabolic obese phenotypes. The aim is to provide a novel approach for the screening and early diagnosis of MAFLD in the general population.
Methods: A total of 2614 subjects were recruited and classified into four categories of metabolic obese phenotypes based on their body mass index (BMI) and metabolic status. Basic data and general blood indices were collected and analyzed. The TyG index was calculated, and an abdominal ultrasound was performed to detect the presence of fatty liver disease. The aforementioned data were then subjected to statistical analysis.
Results: The TyG index was significantly higher in the MAFLD group than in the non-MAFLD group (P < 0.001). Furthermore, the TyG index in the metabolically unhealthy and obese (MUO) group and the metabolically unhealthy normal weight (MUNW) group was significantly higher than that in the metabolically healthy and obese (MHO) group and the metabolically healthy normal weight (MHNW) group (P < 0.001). The area under the curve (AUC) of the TyG index for predicting MAFLD in the MHNW, MUNW, MHO, and MUO groups was 0.765, 0.766, 0.659, and 0.650, respectively. The critical values were 8.575, 9.075, 8.795, and 9.165, respectively.
Conclusion: The TyG index is a reliable predictor of MAFLD risk, exhibiting a higher predictive ability for the risk of developing MAFLD in individuals with normal BMI compared to those with abnormal BMI. The findings of this study lend support for the use of the TyG index as a screening tool and for guiding subsequent management of patients with MAFLD.
The diagnostic accuracy of AI-driven opportunistic osteoporosis screening based on routine non-contrast CT
Authors: Zhao Baolian , Sun Ke , Shen Qianhui , Zhang Tianran , Xu Shaochun , Qian Baoxin , Ni Jing , Duan Guangwen , Wang Xiang , Xiao Yi
Published: October 2024

Background
The diagnosis of osteoporosis is of great clinical significance for the prevention of fracture. To evaluate performance of an artificial intelligence (AI) software for opportunistic osteoporosis screening using non-contrast computed tomography (NCCT) compared to dual-energy X-ray absorptiometry (DXA).
Methods
This retrospective study included 518 patients who underwent both DXA and lumbar NCCT (LNCCT). Bone quality was classified into three groups—normal, osteopenia, and osteoporosis—based on DXA. Commercially available AI software was used to automatically segment vertebrae and extract volumetric bone mineral density (vBMD) values from T12 to L2 (thoracic vertebrae 12 to lumbar vertebrae 2) on LNCCT. Four classification methods were devised for AI-based vBMD assessment: method1 (average (avg) vBMD(T12+L1+L2)), method2 (avg vBMD(T12+L1)), method3 (avg vBMD(T12+L2)), and method4 (avg vBMD(L1+L2)). Agreements among AI-based methods and DXA were analyzed using intraclass correlation coefficients (ICCs), Bland-Altman analysis, and Linear Cohen’s weighted kappa statistics. Multi-categorical logistic regression and receiver operating characteristic (ROC) curves were employed to estimate the diagnostic performance of the four AI-based bone quality classification methods. A p-value of less than 0.05 was considered statistically significant.
Results
The AI-based methods from NCCT showed reasonable agreement with one another (ICC [95% confidence interval, CI]: 0.909[0.893–0.923]). The agreement between AI-based methods 1–4 and DXA was good (ICC [95%CI]: 0.689[0.641,0.732], 0.649[0.594,0.698], 0.666[0.616,0.712], 0.680[0.631,0.724], respectively). The decision function exhibited promising performance, with precision of 0.834 and recall of 0.735 for diagnosing osteoporosis in patients compared to those with normal and osteopenic conditions.
Conclusions
The diagnostic performance of all four AI-based bone quality classification methods was found to be good when compared with DXA. Among these methods, avg vBMD(T12+L1+L2) (method 1) showed the best diagnostic performance.
Application of laparoscopic ureterocalicostomy in proximal ureteral stricture: a single- center 5-year experience
Authors: Xia Wei , Ye Miao , Jiang Bo , Xiao Guan Cheng , Zeng Qing Ming , Xu Gang , Zou Jun Rong , Zou Xiao Feng , Huang Ruo Hui , Li Wan , Xu Hui
Published: October 2024

Background
To evaluate the current indications and outcomes of laparoscopic ureterocalicostomy.
Methods
Nine patients with complex proximal ureteral obstruction underwent laparoscopic ureterocalicostomy. Seven patients with previous upper ureteral calculi underwent intracavitary stone surgery (antegrade or retrograde ureteroscopic holmium laser lithotripsy). One patient had previously undergone open pyelolithotomy, while two patients underwent primary UPJ obstruction with complete renal pelvis. Seven patients underwent laparoscopic surgery and 2 patients underwent robotic-assisted laparoscopic surgery. Postoperative outcomes were observed and followed up. Outcome indicators included operation time, hospital stay and blood loss, and blood loss. Ultrasound examination was performed after surgery, and patients were followed up at 6 and 12 months with hypotonic intravenous pyelography imaging to check for obstruction.
Results
All patients underwent successful surgery. One patient had previously undergone open pyelolithotomy. Adhesion around the renal pelvis was evident, dissociation was difficult, and intraoperative bleeding was evident. Open surgery was successful. The mean was 192 min (80 ~ 310 min), blood loss was 77 mL (10 ~ 300 mL), and postoperative hospital stay was 8.3 days (6 ~ 13 days). The colour Doppler ultrasound three months after surgery showed that the hydronephrosis was relieved or stable. Hypotonic intravenous pyelography was performed after surgery and no evidence of ureteral obstruction was found. The median (range) follow-up was 35 (4–59) months. One patient had Clavien-Dindo IIIa complications and required regular stent replacement.
Conclusion
Laparoscopic ureterocalicostomy is essential in modern urology. However, its primary indications have changed. It is a safe and feasible choice for patients with complex proximal ureteral obstructions.
Higher-Order Aberrations and Their Relationship with Choroid in Myopic Patients
Authors: Ruan Kaiming , Cheng Dan , Zhu Xueying , Bao Fangjun , Zhu Jun , Li Fenfen , Shen Meixiao , Ye Yufeng
Published: October 2024

Background：To investigate corneal higher-order aberrations (HOAs) and choroidal characteristics in myopic individuals and explore the association between HOAs and choroidal parameters.
Methods：Myopic participants were categorized into three groups based on axial lengths (ALs). We compared HOAs, including spherical (Z40), comatic (Z3-1 and Z31), and trefoil (Z3-3 and Z33) aberrations, as well as choroidal vascularity index (CVI) and choroidal thickness (CT). Linear regression analysis was used to assess the relationships among HOAs, CVI, CT, spherical equivalent, and AL.
Results：Groups 1, 2, and 3 included 105, 98, and 118 eyes, respectively. Group 3 exhibited lower spherical HOA root mean square and Z40 values than group 1. Group 1 showed lower Z31 levels than other groups. Groups 1 and 2 had higher mean, central, and I2 vertical CVIs than group 3. Group 1 had a larger vertical S1 CVI than group 3. Group 3 had smaller horizontal CVI values in all regions except N2. Both the mean and CT in all regions decreased as AL increased. The comatic (Z31) and trefoil (Z33) components were predictors of mean horizontal CVI, and the comatic (Z31) component was correlated with both mean vertical and horizontal CT.
Conclusion: Longer AL myopic patients exhibited lower absolute values of spherical aberration and horizontal coma. Alterations in choroid in myopic patients correlated with corneal HOAs. Our results suggest a potential connection between the optical quality and ocular perfusion in myopia.
Causal effects of Hirschsprung's disease on psychiatric disorders in the European population: a two-sample Mendelian randomization study
Authors: Jiang Zhengxing , Wang Yujie , Die Xiaohong , Hou Jinping , Feng Wei , Wang Yi
Published: October 2024

Background: Previous studies have suggested a potential association between Hirschsprung's disease (HSCR) and psychiatric disorders. However, the causal relationship between HSCR and psychiatric disorders remains unclear. Therefore, we use Mendelian randomization to explore the causal relationship between HSCR and depression, anxiety, attention deficit and hyperactivity disorder(ADHD), and autism spectrum disorder(ASD).
Methods: Genome-wide association Studies (GWAS) meta-analyses with the largest possible sample size and independent individuals from European ancestry were selected. The genetic data for depression and anxiety are from FinnGen consortium, while the genetic data for ADHD and ASD are from the Psychiatric Genomics Consortium. Inverse variance weighted (IVW) was the main analysis method. The heterogeneity of the instrumental variables (IVs) was assessed using IVW and MR-Egger, and the horizontal pleiotropy of the IVs was assessed using MR-Egger and MR-PRESSO.
Results: The IVW analysis revealed a significant causal relationship between HSCR and ADHD(OR=1.010，95%CI=1.002-1.018；P=0.0119). However, there is no evidence to suggest a causal relationship between HSCR and depression, anxiety, and ASD. Furthermore, our sensitivity analysis did not reveal any evidence of heterogeneity or horizontal pleiotropy.
Conclusion: Our results suggest that HSCR increases the risk of ADHD. Therefore, greater attention should be paid to the psychological health of children with HSCR.
Risk Analysis of Oral Treatment in Hypertensive Patients Under ECG Monitoring: A Single-Center Retrospective Observational Study
Authors: Yang Yifan , Wang Wenying , Xu Xiangliang , Ji Ying , Liu Chengge , Li Jingyi
Published: October 2024

Objectives
This study investigates intraoperative cardiovascular risks in hypertensive patients undergoing oral treatment, focusing on predictive factors for intraoperative hypertension and ECG abnormalities.
Materials and Methods
We retrospectively analyzed patients monitored with ECG during oral procedures. Blood pressure and heart rate were recorded at four key time points. We examined patients requiring antihypertensive intervention and those with new-onset intraoperative ECG abnormalities to identify predictive factors.
Results
Among 1,492 patients (1,511 records), 166 cases (10.99%) required antihypertensive medication. Preoperative systolic blood pressure (OR: 1.146, P < 0.001) and surgical suturing (OR: 2.271, P = 0.034) were significant predictors. Additionally, 625 records (41.36%) noted new-onset ECG abnormalities, with significant associations to age (OR = 1.033, P < 0.001), preoperative systolic blood pressure (OR = 1.021, P < 0.001), cerebrovascular disease (OR = 1.490, P = 0.005), and arrhythmia (OR = 1.020, P = 0.017).
Conclusions
The risk of cardiovascular complications during oral treatment in hypertensive patients is influenced by factors such as age, preoperative systolic blood pressure, comorbidities like cerebrovascular disease and arrhythmia, and the requirement for surgical suturing. Close monitoring and management of these factors are crucial for reducing intraoperative risks.
Clinical Relevance:
This study offers insights for better cardiovascular risk management in hypertensive patients during oral treatment.
Is a rapid MRI abdomen protocol for appendicitis useful for evaluation of ovarian torsion?
Authors: Gould Sharon , Moody Tejal , Gould Mary , Kecskemethy Heidi , Veale Simone , Choudhary Arabinda
Published: October 2024

Background
Diagnosis of adnexal torsion is challenging as presentation and imaging findings are non-specific.
Objective
Evaluate an MRI appendicitis protocol for adnexal torsion identification and determine if torsion can be excluded by limited abdominopelvic MRI.
Materials and methods
This retrospective study of females ages 1–19 who had limited abdominal MRI exams between 2013 and 2019. Radiologists measured ovaries and calculated ovarian volume ratios, stromal T2 signal ratios, and stromal ADC ratios. Adnexal cysts’ size, location, and relationship to the ovary were noted.
Results
Of 699 cases, 650 were included. Eight cases had surgically proven torsion. Significantly higher volume ratios were found in torsed cases (p < 0.001). A volume ratio greater than or equal to 4:1 had 75% sensitivity, 92% specificity, and 11.5% positive predictive value. A volume ratio less than 4:1 had 99.7% negative predictive value. Ovarian volumes greater than or equal to 20 mL had 87.5% sensitivity, 89.5% specificity, and 9.5% positive predictive value. A volume less than 20 mL had 99.8% negative predictive value. Four torsion cases had cysts greater than or equal to 5cm, including 2 cases without elevated ovarian volume ratio. Four of 5 cases with cysts greater than 7cm were torsed. Stromal T2 signal ratios for torsed cases were higher than non-torsed cases (p = 0.01). Stromal ADC ratio differences did not reach statistical significance (p = 0.46).
Conclusion
There was a 1.3% prevalence of torsion. Two cases were not detected by ovarian size or volume ratio but had large paratubal cysts. No torsion cases had normal appearing adnexa.
Density and entropy of immune cells within the tumor microenvironment of primary tumors and matched brain metastases
Authors: Kleinberger Markus , Çifçi Didem , Paiato Christina , Tomasich Erwin , Mair Maximilian Johannes , Steindl Ariane , Spiró Zoltán , Carrero Zunamys I. , Berchtold Luzia , Hainfellner Johannes , Müllauer Leonhard , Heller Gerwin , Preusser Matthias , Kather Jakob Niklas , Berghoff Anna Sophie
Published: October 2024

BACKGROUND Tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs) have increasingly been reported to impact the brain metastatic process of solid tumors. However, data on intra-individual differences between primary tumor and brain metastasis (BM), as well as their correlation with clinical outcome parameters, is scarce.
METHODS We retrospectively identified patients who received resection of the primary tumor and BM between 01/1990 and 10/2022. Density quantification of TAMs (CD68+, CD163+) and TILs (CD3+, CD8+, CD45RO+, FOXP3+) was performed by immunohistochemical staining of matched tumor tissue samples. Images were processed with QuPath software and heterogeneity of generated heatmaps was measured by Shannon Entropy. Time-to-BM (TTBM) was defined as the time from diagnosis of the primary tumor until the first diagnosis of BM.
RESULTS In total, 104 patients (46.2% female; median age 57.3 years at BM diagnosis) were included: 78/104 (75%) non-small cell lung cancer, 18/104 (17%) breast cancer, 8/104 (8%) renal cell carcinomas. Densities of CD3+ (p<0.001), CD8+ (p<0.001) and FOXP3+-TILs (p=0.045) were higher in primary tumor samples, while CD68+ (p=0.025) and CD163+-TAM densities (p<0.001) were higher in the matched BM. Higher CD3+-TILs and CD163+-TAMs densities in primary tumors were associated with shorter TTBM (p=0.039 and p=0.024, respectively). Higher entropies of CD3+ (p<0.001) and FOXP3+ (p=0.002) TILs were observed in primary tumors compared to BM. Longer TTBM was associated with higher entropy of FOXP3+ TILs (p=0.031) and lower entropy in CD163+ TAMs (p=0.040). No significant associations of immune cell densities or entropies with OS after BM diagnosis were found.
DISCUSSION By utilizing a unique cohort of matched primary tumor and BM tissue samples, we could demonstrate higher TIL densities in primary tumors and higher TAM densities in BM, respectively. Higher cell densities of CD3+-TILs and CD163+-TAMs in primary tumors were associated with shorter TTBM, while a larger difference between CD3+ and CD8+ densities between primary tumor and BM was associated with longer TTBM.
Comparative Analysis of Hypofractionated Short-Course Versus Standard Radiation Therapy in Elderly Patients with Glioblastoma: Analysis of Nationwide Database
Authors: Won Yong Kyun , Kim Eun Seog , Jo In Young , Oh Hyuk-jin , Lee Sang Mi , Yoo Ik Dong , Hong Sun-pyo , Lee Jeong Won , Song Jin Ho , Kang Nayoon , Jang Hong Seok
Published: October 2024

Purpose
Hypofractionated short-course radiation therapy (SCRT) is an alternative treatment option for elderly or frail patients with newly diagnosed glioblastoma (GBM) post-surgery. This study compares survival outcomes and treatment costs between patients receiving SCRT and those undergoing standard long-course radiation therapy (LCRT).
Methods
This retrospective study utilized health insurance claims and national cancer registry data from Korea to compare overall survival (OS) and treatment costs between patients receiving SCRT and LCRT across all ages and sub-group analysis within the subgroup of cases aged 65 and older from 2016 onwards, a period when intensity-modulated radiotherapy (IMRT) was widely adopted.
Results
A total of 1,598 patients were included. Median OS since the first day of radiation therapy was 10.4 months (95% CI [9.6; 12.8]) for SCRT (n=197) versus 16.2 months (95% CI [15.5; 16.9]) for (n=1401) for LCRT respectively. Subgroup analysis using stabilized inverse probability of treatment weighting (S-IPTW) showed indicating non-inferiority in elderly patients in median OS for elderly patients (≥65) with 10.6 months (95% CI [8.9; 14.0]) for SCRT (n=147) versus 13.2 months (95% CI [8.9; 14.0]) for LCRT (n=541). Treatment costs were significantly lower for SCRT, with a median saving of 6000 USD. Compliance with the standard TMZ regimen post-radiation significantly improved OS across all age groups.
Conclusion
SCRT is a viable, cost-effective alternative to LCRT for elderly GBM patients, with similar OS outcomes, supporting its adoption of SCRT in appropriate patient populations.