bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrarater and Interrater Reliability of the Quantification of Knee Cartilage MR Relaxation Metrics
Authors: Liao Tzu-Chieh , Pang Yuxi , Yablon Corrie M. , Lewis Michaela K. , Hyun Jeongmin G. 
Published: October 2024

Abstract

Background
Magnetic resonance (MR) imaging is often used to study osteoarthritis (OA), as advanced MR imaging methods can provide a quantitative assessment of tissue biochemistry or composition. For example, the magnetic relaxation times T1ρ (i.e., 1/R1ρ) and T2 (i.e., 1/R2) of water molecules within articular cartilage have been demonstrated to be imaging biomarkers sensitive to the compositional changes associated with early OA. However, the outcome of MR imaging data analysis depends on relaxation data acquisition methods as well as assessor variability if manual segmentation is performed. Therefore, the goal of the current study was to evaluate the intra- and interrater reliability of established imaging protocols for performing quantitative cartilage MR relaxation metrics of the knee joint.
Methods
Right knee MR images were obtained from five healthy individuals (average age, 24.4 years; 3 females) via a 3.0T MRI scanner equipped with a 16-channel knee T/R coil. A double echo steady state (DESS) sequence was used for anatomical imaging, and the established MAPSS sequences were used for R1ρ and R2 mapping. One assessor performed manual segmentations of the knee cartilage on two separate occasions, whereas a second assessor performed segmentations once. Both the R1ρ and R2 mean values were then calculated for the tibial, patellar, femoral trochlear, central femoral condylar, and posterior femoral condylar cartilages. Intraclass correlation coefficients [ICC (3,1)] and ICCs (2,1) were used to evaluate intra- and interrater reliability, respectively. The standard error of measurement (SEM) was used to assess absolute reliability.
Results
The intrarater knee cartilage relaxation metrics demonstrated good to excellent reliability, ranging between 0.88 and 0.99, with SEMs ranging between 0.16 and 0.80. The interrater reliability similarly ranged from 0.79–0.97, with SEMs ranging between 0.27 and 1.10.
Conclusions
Manual segmentation of specific MR slices and known subregions is highly reliable and repeatable for the quantification of cartilage MR relaxation metrics. This validation paves the way for the large-scale application of this method in prospective trials that longitudinally monitor OA development and progression in the knee joint.
Diffusion-T2 correlated spectroscopy imaging to explore possible placental composition changes over gestation
Authors: Liu Xilong , Huang Chantao , Chen Sijin , Feng Jie , Qiao Wenjun , Liu Bo , Hu Wentao , Dai Yongming , Xu Yikai 
Published: October 2024

Abstract

Background
Placenta plays a vital role for fetal growth and development during pregnancy. Currently, antenatal noninvasive imaging techniques to directly evaluate placental function remains challenge. Diffusion-T2 correlated spectroscopy imaging (DT2SI) can provide compositional information for different organs in-vivo. The aim of this study was to investigate the use of DT2SI as a tool to elucidate the placental composition change over gestation in healthy pregnancy.
Methods
Forty healthy singleton pregnancies was retrieved from our placental MRI research database. MRI was performed at 23.1–36.0 weeks of gestational age (GA) in a 3.0T system. DT2SI measurements were performed using DWI sequence with 7 b-values combining 4 TEs. ROIs were manually defined inside placenta on five cross-sectional slices covering the most central part of placenta. D-T2 Spectra were constructed and segmented into 9 compartments: A1(low D, short T2), A2(low D, medium T2), A3(low D, long T2), B1(medium D, short T2), B2(medium D, medium T2), B3(medium D, long T2), C1(high D, short T2), C2(high D, medium T2), C3(high D, long T2). Volume fraction Vm of each compartment m was obtained voxel by voxel, and general Vm of whole ROI was calculated for each participant. The relationships of Vm to GA were assessed by Pearson correlation.
Results
Four to five peaks could be observed in the spectrum for most subjects. Strong correlation between DT2SI Vm and GA was found. VA1 (r = 0.633, p < 0.001) showed significant increase with GA. VA2 (r=-0.465, p = 0.002) and VA3 (r=-0.653, p < 0.001) showed moderate/remarkable decrease. The perfusion compartment VB1 (r = 0.358, p = 0.023), VC1 (r = 0.411, p = 0.008) illustrate a slight/moderate increase. Other compartments have low concentration (average V < 3%).
Conclusions
Comprehensive information on evolution of placenta composition with gestation could be provided by DT2SI, suggesting its unique value for assessing placental function during pregnancy.
Clinical and Surgical Outcomes of Pediatric Cushing's Disease Following Endoscopic Transsphenoidal Surgery
Authors: Sharifi Guive , Paraandavaji Elham , Nasab Mohammad Mehdi Mousavi , Mohammadi Esmaeil , Sadeghi Neginalsadat , Tehrani Mohammad Reza Mohajeri , Dilmaghani Nader Akbari 
Published: October 2024

Abstract

Background
Cushing's disease (CD) is characterized by hypercortisolism due to excessive adrenocorticotropic hormone (ACTH) secretion from a pituitary adenoma. Though more common in adults, pediatric cases constitute approximately 5% of those seen in adults. Early diagnosis and treatment are critical due to the severe impacts on growth and development in children. Endoscopic transsphenoidal surgery (ETSS) is the preferred first-line treatment for both children and adults.
Methods
From 2011 to 2024, 3,280 patients with pituitary adenoma underwent surgery using the ETSS technique at Loghman Hospital of Tehran, including 213 CD cases, of which 22 were pediatric (under 18 years old). This retrospective study analyzed clinical data such as age, gender, presenting symptoms, family and medical history, imaging characteristics, surgical findings, pathology, follow-up, and postoperative outcomes. Diagnostic criteria included biochemical tests, MRI imaging, and inferior petrosal sinus sampling.
Results
Out of 22 pediatric patients, 16 were females and 6 males, with an average age of 14.73 years. Obesity was the initial clinical manifestation in 59% of the patients. According to the Hardy-Wilson classification, 18.2% of patients were stage E, 9.09% stage C, and the rest (excluding MRI-negative patients) stage A. ETSS was performed on all patients, with total hypophysectomy in 18.2% and hemi-hypophysectomy in 9.09%. Postoperative complications included cerebrospinal fluid leakage in 13.63% of patients. Remission was achieved in 95.45% of patients, with a recurrence rate of 4.54%. Hormone imbalances post-surgery included hypocortisolism (50%), hypothyroidism (45.45%), and hypogonadism (13.63%).
Conclusion
ETSS is an effective and safe treatment for pediatric CD, achieving high remission rates and minimal complications. This study highlights the importance of specialized surgical care in managing pediatric CD and underscores the need for early diagnosis and intervention. Further studies are warranted to evaluate long-term outcomes and optimize treatment protocols.
The role of co-infections on cervical intraepithelial neoplasia prevalence in western Kenya
Authors: Onyango Calleb George , Ogonda Lilian , Guyah Bernard 
Published: October 2024

Abstract

Background
Screening for co-infections with HIV, HSV-2 and Chlamydia trachomatis (CT) among high-risk human papilloma virus (hr-HPV) positive women remains essential in alleviating high morbidity of cervical cancer (CC). The aim of this study was to determine the prevalence of cervical intraepithelial neoplasia (CIN) among women referred for CC screening at a referral hospital in Kisumu County, Kenya; and to establish the role of co-infection on CIN.
Method
In a cross-sectional study, we collected HPV, HIV, HSV-2 and CT data, cervical cytology results, and demographic information from 517 referrals. Blood samples were obtained for HIV and HSV-2 tests; urine for CT test and cervical swabs for hr-HPV test.
Results
The overall prevalence of CIN was 18.4% (95/517) with CIN1 observed in 56(29.6%), CIN2 in 27(`14.3%), CIN3 + in 12(6.3%) and normal biopsy in 94(49.7%) of the patients out of which high grade CIN2 and above (CIN2+) was 7.54% (39/517) equivalent to 32.5 per 100,000 women per year. HPV/HIV co-infection (infected vs. uninfected: OR 2.79; 95% CI 1.56–5.10, p < 0.001); HPV/HSV-2 co-infection (infected vs. uninfected: OR 2.41, 95% CI: 1.12–5.46, p < 0.024); HPV/CT co-infection (infected vs. uninfected: OR 3.83; 95% CI 1.84–8.51, p < 0.001) were found to be significantly associated with CIN.
Conclusion
Overall prevalence of CIN was high in the region although high-grade CIN2 + remained relatively lower as reported earlier. Age factor, widowhood and co-infections with HIV, HSV-2 or Chlamydia trachomatis were associated with increased risk of testing positive for CIN.
Saturated fatty acids-induced neutrophil extracellular traps contribute to exacerbation and biologic therapy resistance in obesity-related psoriasis
Authors: Tao Juan , Xia Yuting , Lan Jiajia , Yang Jing , Yuan Shijie , Xie Xiaorong , Du Qiuyang , Du Hongyao , Nie Wenjia , Jiang Biling , Zhao Liang , Cai Zhen , Zhang Xin , Xiong Yan , Li Yan , He Ran 
Published: October 2024

Abstract

Psoriasis patients with obesity tend to show a serious clinical manifestation and have poor responses to various biological agents in most cases. However, the mechanisms in obesity-exacerbated psoriasis remain enigmatic. In this study, we found that the abundance of systemic and localized cutaneous neutrophil extracellular traps (NETs) in obesity-induced aggravation of psoriasis was positively correlated with disease severity, and inhibition of NETs alleviated psoriatic dermatitis in obese mice. Mechanistically, we found that changes of fatty acid composition in obese subjects resulted in the deposit of saturated fatty acids (SFAs), which promoted the release of NETs via the TLR4-MD2/ROS signaling pathway. We further found that NETs potentiated IL-17 inflammation in obesity-exacerbated psoriasis, especially γδT17-mediated immune responses. Moreover, SFAs induced decreased response to anti-IL17A treatment in psoriasis-like mice, whereas inhibition of NETs improved the beneficial effects of anti-IL17A in psoriasis-like mice with lipid metabolism disorders. Our findings collectively suggest that SFAs-induced NETs play a critical role in the exacerbation of obesity-related psoriasis, and provide potential new strategies for the treatment of refractory psoriasis patients with lipid metabolism disorders clinically.
Enablers and Barriers to Preconception Dietary Behaviours: A Mixed Method Study with Women of Reproductive Age
Authors: Kandel Pragya , Lim Siew , Dever Michelle , Lamichhane Prabhat , Skouteris Helen , Currie Sinead , Hill Briony 
Published: October 2024

Abstract

Background
A healthy diet before conception (preconception) diet is associated with enhanced maternal health, improved cardiometabolic outcomes, reduced risk of pregnancy complications, and effective weight management. Yet, women of reproductive age frequently exhibit suboptimal dietary behaviours before conception. We aimed to investigate the enablers and barriers related to preconception diet among women of reproductive age.
Methods
Using sequential explanatory mixed methods, an online cross-sectional quantitative survey was followed by online qualitative interviews with women of reproductive age (18–45 years). Survey measures included the Healthy Eating Quiz (HEQ), and a pilot-tested new measure, the Preconception Diet Enablers and Barriers Scale (PDEBS) to evaluate barriers and enablers to diet. Linear regression analysed the relationship between Australian Recommended Food Score (ARFS) and barriers/enablers. Qualitative interviews were conducted to understand the reasons behind women’s (non)engagement in healthy dietary habits. A weaving approach, use of joint-display, and the Capability Opportunity Motivation Behaviour (COM-B) model were used to integrate and present the data.
Results
Seven hundred and eighty-eight non-pregnant women (mean [M] age 32.08 years, SD = 7.31) residing in Australia, India, and the US completed the survey. Qualitative interviews (M duration = 30 mins) were conducted with 13 women based in Australia. Women's capability to maintain a healthy preconception diet was influenced by their level of knowledge and awareness of its significance. Opportunities for a healthy preconception diet were shaped by social support, time availability, financial resources, and accessibility. Additionally, motivation to adhere to a healthful preconception diet was influenced by beliefs regarding its potential outcomes, alignment with personal goals, and emotional state.
Conclusion
Our findings advance understanding of the determinants influencing preconception dietary behaviours and provide valuable insights for designing effective interventions to promote healthy preconception dietary habits. By addressing the identified enablers and barriers comprehensively, policymakers, healthcare professionals, and researchers can work together to support women in adopting and maintaining healthy preconception dietary behaviours, ultimately improving maternal and child health outcomes.
Pathology-interpretable radiomic model for predicting clinical outcome in patients with osteosarcoma: a retrospective, multicentre study
Authors: Ren Qiuping , Zhang Xiao , Wu Xuewei , Zhao Heng , Zhang Yongxin , Yao Yubin , Leng Yinping , Zhang Xiaoyang , Liu Yumeng , Xiao Jijie , Liu Wenwen , Xie Xia , Pei Nana , He Rongfang , Tang Na , Wen Ge , Zhang Xiaodong , Zhang Shuixing , Zhang Bin 
Published: October 2024

Abstract

Background: Osteosarcoma is the most prevalent primary malignant bone tumor. Radiomic models demonstrate promise in globally evaluating the prognosis of osteosarcoma; however, they lack biological interpretability. We aimed to develop a radiomic model using MRI to predict disease-free Survival (DFS) in osteosarcoma patients, and to provide underlying pathobiology of the model.
Methods: This retrospective study included 270 patients (training set, n=166; external test set 1, n=56; external test set 2, n=48) with surgically treated and histology-proven osteosarcoma from 14 tertiary centres. A total of 1130 radiomic features were extracted from pre-treatment MRI. After dimensionality reduction, radiomic model was built on the training set and tested on the external test sets. Radiomics interpretability study leveraged the Hematoxylin and eosin (H&E) and Immunohistochemistry (IHC) stained whole slide images (WSIs) of patients from the testing sets. Ten types of nuclear morphological features were extracted from each nucleus in H&E WSIs and aggregated into 150 patient-level features. Moreover, five immune- and hypoxia-related IHC biomarkers—CD3, CD8, CD68, FOXP3, and CAIX—were quantified from IHC WSIs. The correlation between the radiomic features and histopathologic biomarkers was assessed using Spearman correlation analysis.
Results: The radiomic model including 12 features yielded a time-dependent AUC of 0.916 (95% CI: 0.893-0.939), 0.802 (95% CI: 0.763-0.840), and 0.895 (95% CI: 0.869-0.920) in the training set, external test set 1, and external test set 2, respectively. All 12 radiomic features exhibited significant correlations with 109-133 cellular features, totaling 1460 (81.1%) pairs. In detail, there were 574 pairs with absolute coefficient r (|r|) between 0 and 0.1, 516 pairs between 0.1 and 0.2, 241 pairs between 0.2 and 0.3, 99 pairs between 0.3 and 0.4, and 30 pairs exceeding 0.4. Six radiomic features were correlated with CAIX (|r| = 0.03-0.17), 10 features with CD3 (|r| = 0.02-0.71), eight features with CD8 (|r| = 0.05-0.42), nine features with FOXP3 (|r| = 0.01-0.55), 11 features with CD8 / FOXP3 ratio (|r| = 0.004-0.74), and 11 features with CD68 (|r| = 0.02-0.47).
Conclusions: The MRI-based radiomic model effectively predicts DFS in osteosarcoma patients. The correlation strength between radiomic features and histopathologic biomarkers varies.
Correlation between the first-trimester non-traditional lipid parameters with the risk of gestational diabetes mellitus in pregnancy
Authors: Xiang Junmiao , Bao Ruru , Pan Yundong , Cai Zhuhua 
Published: October 2024

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a common complication in pregnancy, linked to adverse outcomes for mothers and infants. Elevated levels of non-traditional lipid parameters have been associated with metabolic disorders. This study investigates these lipid parameters' role in predicting GDM in the first trimester.
Methods: A retrospective study involving 1197 patients from The Third Affiliated Hospital of Wenzhou Medical University (January 2019 - August 2023) examined the correlation between non-traditional lipid parameters and GDM using logistic regression and stratified analyses. The diagnostic performance of the lipid parameters was evaluated using the area under the curve (AUC) method. Pearson correlation analysis clarified the relationship between non-traditional lipid parameters and neonatal birth weight, as well as their association with oral glucose tolerance test (OGTT) glycemic measures.
Results: Among 1197 participants, 201 were diagnosed with GDM. The GDM group exhibited significantly higher levels of non-traditional lipid parameters. Multivariate analysis identified these lipid measures, particularly Non-HDL-C with an AUC of 64.0% (95% CI: 59.6%-68.4%), as independent predictors of GDM across all models (P < 0.05), except for RC/HDL-C in model3. Most non-traditional lipid parameters demonstrated a linear relationship with GDM, with the exception of Non-HDL-C. Strong positive correlations were observed between fasting blood glucose levels and lipid ratios such as Non-HDL-C/HDL-C, LDL/HDL-C, TG/HDL-C, TC/HDL-C, and RC/HDL-C in patients with GDM. No significant differences were found in non-traditional lipid parameters among the single, double, and triple positive groups.
Discussion: First-trimester non-traditional lipid parameters are significant predictors of GDM, particularly when considering fasting blood glucose levels from the OGTT. These parameters offer potential value for early diagnosis.
Modified Robotic Simple Prostatectomy Technique: A Retrospective Analysis of a Series of 162 Surgeries Performed by a High-volume Surgeon
Authors: Bragion¹ Celene Benediti , Cordeiro² Maurício Dener , Faria³ Sandro Mendonça 
Published: October 2024

Abstract

Benign prostatic hyperplasia (BPH) affects up to 80% of men by age 80, with large-gland BPH often treated by simple prostatectomy (SP). This technique significantly improves symptoms but is associated with high rates of complications such as transfusions and infections. Minimally invasive techniques, including robotic-assisted laparoscopic simple suprapubic prostatectomy (RALSP), have emerged as alternatives.
This study reports on 162 patients who underwent RALSP from May 2018 to June 2023. The mean age of the patients was 69 years, mean prostate volume 144.8 cm³, mean robot time 78.7 min, and mean blood loss 183.1mL. Results demonstrated significant improvements in the results: prostate volume (mean decrease from 144.8 to 26.6 cm³), mean PSA level decreased from 7.8 to 0.8 (p < 0.0001), mean IPSS decreased from 23.0 to 4.4 (p < 0.0001), and mean uroflowmetry increased from 6.3 to 22.6 ml/s (p < 0.0001).
No patient experienced worsening erectile function after surgery. All patients showed absence of stress urinary incontinence within 3 months. Catheterization time decreased from 4.2 to 2.6 days over the study period. The postoperative complication rate was 2.29%, with no need for surgical reintervention for complications.
While RALSP showed promising results, further prospective studies are needed to compare it with other techniques. This study highlights RALSP as a viable minimally invasive option for treating large-volume BPH, offering reduced recovery times and fewer complications.
Fractures in children and adolescents with diabetes mellitus during 2001-2020
Authors: Zacay Galia , Gabay Hagit , Tripto-Shkolnik Liana , Gruber Noah , Modan-Moses Dalit , Levy-Shraga Yael 
Published: October 2024

Abstract

Purpose: To compare fracture risk among paediatric patients, between those with diabetes mellitus (DM) and a matched comparison group.
Methods: In this registry-based cohort study, individuals who were diagnosed with DM during 2001-2020, at age 1-17 years, were matched in a 1:5 ratio to a comparison group. Clinical, laboratory and demographic data were obtained from the electronic database of Meuhedet Health Services.
Results: The DM and comparison groups included 1049 and 5245 individuals, respectively. The median age at DM diagnosis was 10.9 years. The median follow-up period of both groups was 5.5 years (IQR 3.6-8.2). We did not find a statistically significant risk for fractures among children with DM (adjusted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.93-1.31, p=0.25). In a subgroup analysis of boys aged >11 years at DM diagnosis, the adjusted HR for fractures was 1.47 (95%CI 1.06-2.04, p=0.02) relative to the comparison group. In a multivariate analysis, male gender (adjusted HR 1.99, 95%CI 1.46-2.73, p<0.001) and recurrent hospitalizations (adjusted HR 1.53 95%CI 1.02-2.30, p=0.04) were associated with increased risks for fractures among children with DM.
Conclusions: We found increased fracture risk among boys aged >11 years at diagnosis of DM compared to a matched comparison group.
Antral follicle count measured any day of the cycle and menstrual cycle length as reliable markers of ovarian reserve
Authors: Peralta Sara , Fabregues Francesc , Barral Yasmina , Mendez Marta , Goday Anna , Borras Aina , Manau Dolors 
Published: October 2024

Abstract

Background
Routine gynaecological screening should incorporate simple and easily available ovarian reserve markers to ensure optimal reproductive health counselling. The purpose of this study is to evaluate whether antral follicle count measured randomly during the menstrual cycle (rAFC) and menstrual cycle length (MCL) can predict ovarian response in women undergoing assisted reproductive technology.
Methods
122 women with regular menstrual cycles undergoing their first in vitro fertilization cycle were included. Transvaginal ultrasound was performed, and previous and posterior menses’ dates, anti-Müllerian hormone (AMH) and body mass index were recorded. Visits were randomly scheduled: 52 patients were screened in the follicular phase (7 early follicular phase 2–4) and 70 in the luteal phase. Poor ovarian response was defined < four oocytes retrieved or cancellation due to impaired or absent follicular growth and high response as ≥ 15 oocytes. The cumulative live birth rate (CLBR) per initiated IVF cycle was also analysed.
Results
16 patients were classified as high (13.1%), 79 (64.8%) as normal and 27 (22.1%) as poor responders. 51 patients achieved at least one live birth (CLBR = 41.8% per started cycle). rAFC and MCL presented a significant positive correlation with the total number of oocytes retrieved. rAFC showed an excellent ability to predict poor, hyper-response and CLB: AUCROC 0.91 (95%CI 0.84–0.95); 0.83 (95%CI 0.76–0.89) and 0.78 (95%CI 0.70–0.85) while MCL was only a good predictor of poor response AUCROC 0.75 (95%CI 0.66–0.82).
Conclusion
The present study demonstrates that low rAFC and short MCL are strongly associated with poor ovarian response, being reliable markers of poor ovarian reserve.