bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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.
Neutrophil extracellular traps are involved in the occurrence of rheumatoid arthritis-associated interstitial lung disease
Authors: Xue Jing , Nian Miaomiao , Zhu Zeqin , Liang Yangyang , Hu Zhenyu , Jia Yuanyuan , Chi Shuhong , Chen Juan 
Published: October 2024

Abstract

Background
The excessive formation of neutrophil extracellular traps (NETs) has been demonstrated to be a pathogenic mechanism in both rheumatoid arthritis (RA) and interstitial lung disease (ILD). However, whether NETs contribute to RA-associated ILD (RA-ILD) and the underlying mechanisms driving NETs formation remain unclear. This study aimed to assess the involvement of NETs in RA-ILD and elucidate the underlying mechanisms.
Methods
Single-cell sequencing was used to identify changes in the quantity and function of neutrophils in the lung tissue of a zymosan A (ZYM)-induced interstitial pneumonia arthritis model, along with the detection of NETs components in the lung tissues. Additionally, nuclear receptor 4A3 (NR4A3) expression in HL-60 cells was interfered with to detect the effects on NETs components and the transformation of MRC-5 cells into myofibroblasts. The clinical relevance of plasma myeloperoxidase-DNA (MPO-DNA), citrullinated histone 3 (Cit-H3), and cell-free DNA was evaluated in patients with RA-nonspecific interstitial pneumonia (NSIP) and RA-usual interstitial pneumonia (UIP), RA-organizing pneumonia (OP), RA-other patterns, and healthy cohorts using commercial enzyme-linked immunosorbent assay (ELISA).
Results
In the ZYM-treated SKG mouse model, which recapitulates key features of RA-ILD, an increased neutrophils population in lung tissue was primarily responsible for NETs formation. Mechanistically, interference with NR4A3 expression was found to promoted NETs formation in HL-60 cells, subsequently enhancing MRC-5 cell differentiation into myofibroblasts. Clinically, plasma levels of MPO-DNA and Cit-H3 were elevated in patients with RA-NSIP and RA-UIP compared to healthy subjects. ROC curve analysis further revealed that plasma MPO-DNA combined with RF and anti-CCP, as well as Cit-H3 combined with RF and anti-CCP, served as superior diagnostic panels for NSIP and UIP in RA-ILD patients, respectively.
Conclusions
These findings suggest that targeting NETs could provide a novel therapeutic approach for ILD in RA patients.
Utility of Serum Matrix Metalloproteinase-7 as a Biomarker in Cholestatic Infants with Congenital Heart Disease
Authors: Pandurangi Sindhu , Kim Michael E. , Noriega Nicolas , Conant Bradley , Seo JangDong , Mourya Reena , Shivakumar Pranavkumar , Peters Anna L. , Misfeldt Andrew , Chlebowski Meghan 
Published: October 2024

Abstract

Background:Matrix metalloproteinase 7 (MMP-7) is a novel biomarker for diagnosis of biliary atresia (BA), the most common cholestatic liver disease in infancy. There is a pressing need to determine the utility of MMP-7 levels in infants with congenital heart disease (CHD) to avoid unnecessary invasive diagnostic procedures in this high-risk population. We investigated the utility of MMP-7 in discriminating BA from non-BA cholestasis in infants with CHD and whether MMP-7 elevation was present in infants requiring treatment for clinically significant PH.
Methods: This is a single center cross sectional study including infants <180 days of age with cholestasis and serum MMP-7 levels collected from 2019-2023. Demographic data and descriptive statistics were summarized with medians with interquartile ranges and frequencies with percentages. Median MMP-7 levels were assessed via Wilcoxon rank-sum test.
Results: A total of 149 patients were included. Patients with CHD had significantly elevated MMP-7 levels relative to the non-CHD cohort (50 vs. 34 ng/mL, p=0.009). Sub-analysis comparing infants with and without PH revealed significantly elevated median MMP-7 levels in those with clinically significant PH (125 vs. 39 ng/mL, p=0.010). CHD patients with PH had greater median MMP-7 compared to CHD patients without PH (154 vs 43 ng/mL, p=0.028).
Conclusions:Serum MMP-7 levels in infants with CHD-C were significantly elevated compared to those with cholestasis alone. MMP-7 may help identify non-BA cholestatic infants who have concurrent clinically significant pulmonary hypertension. Larger, prospective studies are needed to validate this finding and establish CHD-specific MMP-7 cutoffs.
Genetic Evidence Supporting Causal Associations Between Viral Infections and Sjogren's Syndrome
Authors: Zhang Sheng-Xiao , Fan Chang-Hui , Jing Zhi-Nan , Zhang Yi-Wen , Zhang He-Yi , Cheng Ting , Wang Cai-Hong , Li Xiao-Feng 
Published: October 2024

Abstract

Background
Sjogren's syndrome (SS) is a chronic inflammatory autoimmune disorder that mainly targets exocrine glands. Previous studies have suggested potential associations between Epstein-Barr virus (EBV), hepatitis virus (HAV), and other viruses with SS, but the causal nature of these relationships remains uncertain. This study used Mendelian randomisation (MR) to examine the genetic causal association between viral infections and SS.
Methods
Genetic data for SS was sourced from a genome-wide association study (GWAS) database of individuals of European ancestry (1290 patients and 213,415 healthy controls). Genetic data for nine viruses, including EBV, HAV, COVID-19, human immunodeficiency virus(HIV), cytomegalovirus, influenza virus, Coxsackie virus, measles virus, and retrovirus, were obtained from the IEU Open GWAS. Inverse variance weighting (IVW) served as the primary analysis method for MR Analysis, with Wald ratio, MR Egger, and weighted as supplementary analyses.
Results
MR analysis revealed causal associations between SS and five viral infections. Elevated VCA p18 antibodies against EBV, HAV, and COVID-19 were associated with increased SS risk, with respective odds ratios (OR) of 1.270 (95% CI: 1.043–1.550, p = 0.016), 1.163 (95% CI: 1.035–1.317, p = 0.009), and 1.109 (95% CI: 1.024–1.209, p = 0.013). Conversely, IgG antibodies against EBV and human immunodeficiency virus were associated with the reduction of SS risk, with ORs of 0.632 (95% CI: 0.430–0.921, p = 0.016) and 0.875 (95% CI: 0.787–0.972, p = 0.016) respectively. Sensitivity analysis did not reveal significant heterogeneity or horizontal pleiotropy. No statistically significant associations were found between the other four viruses and SS risk (all p > 0.05).
Conclusion
Our findings suggest that genetically predicted elevated levels of VCA p18 antibodies against EBV, HAV, and COVID-19 increase the risk of SS, while IgG antibody levels against EBV and HIV may confer protection. This study provides additional evidence for a link between viral infection and SS, aiding clinicians in identifying potential causative factors and thereby enhancing diagnostic specificity and sensitivity.