bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical value of ACR O-RADS combined with CA125 in the risk stratification of adnexal masses
Authors: Pan Rui-Ke , Zhang Shu-Qin , Zhang Xian-Ya , Xu Tong , Cui Xin-Wu , Li Ran , Yu Ming , Zhang Bo 
Published: August 2024

PurposeTo develop a combined diagnostic model integrating the subclassification of the 2022 version of the American College of Radiology (ACR) Ovarian-Adnexal Reporting and Data System (O-RADS) with carbohydrate antigen 125 (CA125) and to validate whether the combined model can offer superior diagnostic efficacy than O-RADS alone in assessing adnexal malignancy risk.MethodsA retrospective analysis was performed on 593 patients with adnexal masses (AMs), and the pathological and clinical data were included. According to the large differences in malignancy risk indices for different image features in O-RADS category 4, the lesions were categorized into groups A and B. A new diagnostic criterion was developed. Lesions identified as category 1, 2, 3, or 4A with a CA125 level below 35 U/ml were classified as benign. Lesions identified as category 4A with a CA125 level more than or equal to 35 U/ml and lesions with a category of 4B and 5 were classified as malignant. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) of O-RADS (v2022), CA125, and the combined model in the diagnosis of AMs were calculated and compared.ResultsThe sensitivity, specificity, PPV, NPV, accuracy, and AUCs of the combined model were 92.4%, 96.5%, 80.2%, 98.8%, 94.1%, and 0.945, respectively. The specificity, PPV, accuracy, and AUC of the combined model were significantly higher than those of O-RADS alone (all P &lt; 0.01). In addition, both models had acceptable sensitivity and NPV, but there were no significant differences among them (P &gt; 0.05).ConclusionThe combined model integrating O-RADS subclassification with CA125 could improve the specificity and PPV in diagnosing malignant AMs. It could be a valuable tool in the clinical application of risk stratification of AMs.
AI-enhanced diagnostic model for pulmonary nodule classification
Authors: Chen Jifei , Ming Moyu , Huang Shuangping , Wei Xuan , Wu Jinyan , Zhou Sufang , Ling Zhougui 
Published: August 2024

BackgroundThe identification of benign and malignant pulmonary nodules (BPN and MPN) can significantly reduce mortality. However, a reliable and validated diagnostic model for clinical decision-making is still lacking.MethodsEnzyme-linked immunosorbent assay and electro chemiluminescent immunoassay were utilized to determine the serum concentrations of 7AABs (p53, GAGE7, PGP9.5, CAGE, MAGEA1, SOX2, GBU4-5), and 4TTMs (CYFR21, CEA, NSE and SCC) in 260 participants (72 BPNs and 188 early-stage MPNs), respectively. The malignancy probability was calculated using Artificial intelligence pulmonary nodule auxiliary diagnosis system, or Mayo model. Along with age, sex, smoking history and nodule size, 18 variables were enrolled for model development. Baseline comparison, univariate ROC analysis, variable correlation analysis, lasso regression, univariate and stepwise logistic regression, and decision curve analysis (DCA) was used to reduce and screen variables. A nomogram and DCA were built for model construction and clinical use. Training (60%) and validation (40%) cohorts were used to for model validation.ResultsAge, CYFRA21_1, AI, PGP9.5, GAGE7, and GBU4_5 was screened out from 18 variables and utilized to establish the regression model for identifying BPN and early-stage MPN, as well as nomogram and DCA for clinical practical use. The AUC of the nomogram in the training and validation cohorts were 0.884 and 0.820, respectively. Moreover, the calibration curve showed high coherence between the predicted and actual probability.ConclusionThis diagnostic model and DCA could provide evidence for upgrading or maintaining the current clinical decision based on malignancy probability stratification. It enables low and moderate risk or ambiguous patients to benefit from more precise clinical decision stratification, more timely detection of malignant nodules, and early treatment.
A model based on C-TIRADS combined with SWE for predicting Bethesda I thyroid nodules
Authors: Wei An , Tang Yu-Long , Tang Shi-Chu , Zhang Xian-Ya , Ren Jia-Yu , Shi Long , Cui Xin-Wu , Zhang Chao-Xue 
Published: August 2024

ObjectivesThis study aimed to explore the performance of a model based on Chinese Thyroid Imaging Reporting and Data Systems (C-TIRADS), clinical characteristics, and shear wave elastography (SWE) for the prediction of Bethesda I thyroid nodules before fine needle aspiration (FNA).Materials and methodsA total of 267 thyroid nodules from 267 patients were enrolled. Ultrasound and SWE were performed for all nodules before FNA. The nodules were scored according to the 2020 C-TIRADS, and the ultrasound and SWE characteristics of Bethesda I and non-I thyroid nodules were compared. The independent predictors were determined by univariate analysis and multivariate logistic regression analysis. A predictive model was established based on independent predictors, and the sensitivity, specificity, and area under the curve (AUC) of the independent predictors were compared with that of the model.ResultsOur study found that the maximum diameter of nodules that ranged from 15 to 20 mm, the C-TIRADS category &lt;4C, and Emax &lt;52.5 kPa were independent predictors for Bethesda I thyroid nodules. Based on multiple logistic regression, a predictive model was established: Logit (p) = -3.491 + 1.630 × maximum diameter + 1.719 × C-TIRADS category + 1.046 × Emax (kPa). The AUC of the model was 0.769 (95% CI: 0.700–0.838), which was significantly higher than that of the independent predictors alone.ConclusionWe developed a predictive model for predicting Bethesda I thyroid nodules. It might be beneficial to the clinical optimization of FNA strategy in advance and to improve the accurate diagnostic rate of the first FNA, reducing repeated FNA.
Anatomical classification of advanced biliary tract cancer predicts programmed cell death protein 1 blockade efficacy
Authors: Huang Lingli , Wang Fang , Wang Fenghua , Jiang Qi , Huang Jinsheng , Li Xujia , Guo Guifang 
Published: August 2024

BackgroundImmune checkpoint blockade (ICB)-based immunotherapy has inspired new hope for advanced biliary tract cancer (BTC) treatment; however, there are no prior studies that primarily focus on different anatomical types of unresectable BTCs reacting differently to ICB.MethodsWe retrospectively collected data on advanced BTC patients who received anti-programmed cell death protein 1 (anti-PD1) therapy from two affiliated hospitals of Sun Yat-Sen university. The effects of anti-PD1 were compared for different anatomical sites. The GSE32225 and GSE132305 datasets were used to further analyze differences in the immune microenvironments between intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC).ResultsA total of 198 advanced BTC patients were enrolled in this study, comprising 142 patients with ICC and 56 with other cancer types (“Others” group), including ECC and gallbladder cancer. In the anti-PD1 treated patients, the ICC group (n = 90) achieved longer median progression-free survival (mPFS) (9.5 vs. 6.2 months, p = 0.02) and median overall survival (mOS) (15.1 vs. 10.7 months, p = 0.02) than the Others group (n = 26). However, chemotherapy did not show different effects between the two groups (mOS: 10.6 vs. 12.1 months, p = 0.20; mPFS: 4.9 vs. 5.7 months, p = 0.83). For the first-line anti-PD1 therapy, the ICC group (n = 70) achieved higher mOS (16.0 vs. 11.8 months, p = 0.04) than the Others group (n = 19). Moreover, most chemokines, chemokine receptors, major histocompatibility complex molecules, immunostimulators, and immunoinhibitors were stronger in ICC than ECC; furthermore, CD8+ T cells and M1 macrophages were higher in ICC than ECC for most algorithms. The immune differential genes were mainly enriched in antigen processing and presentation as well as the cytokine receptors.ConclusionsThis study shows that the efficacy of anti-PD1 therapy was higher in ICC than in other types of BTCs. Differences in the immune-related molecules and cells between ICC and ECC indicate that ICC could benefit more from immunotherapy.
The polychromatic retrigger: a new tool to mitigate pileup in spectral photon-counting computed-tomography
Authors: Amato Carlo , Disch Christian , Zambon Pietro 
Published: August 2024

High photon rates, like the ones required in clinical computed tomography, can generate pulse pileup in photon-counting detectors, and in extreme cases induce system paralysis. The instant retrigger technology has been developed by DECTRIS Ltd. to counteract such phenomena, effectively making detectors non-paralyzable. The instant retrigger behavior is regulated by a quantity named retrigger time, which originally was the same for all the energy thresholds of the detector. We developed a new ASIC that features an improved version of the instant retrigger (polychromatic retrigger) that allows different retrigger times for each of the four energy thresholds. In this work, we investigate how this feature can be exploited in computed tomography to mitigate pileup artifacts. Using a Monte Carlo method, we modeled a full computed tomography system with four energy thresholds (20, 50, 70 and 90 keV), and we simulated head scans from low (1×107 cps/mm2) to high (1×109 cps/mm2) photon count rates for different values of the retrigger time. The quality of the resulting images generally degrades when increasing the photon rates (pileup artifacts) and, at the same time, it becomes strongly dependent on the retrigger time. We show how, even at high incoming rates, it is possible to identify for each energy threshold a retrigger time value that restores almost completely the image quality obtained in the low count-rate scenario. The analysis indicates that the higher the energy threshold, the longer the retrigger time has to be set.
Temporal expression of mitochondrial life cycle markers during acute and chronic overload of rat plantaris muscles
Authors: Hyatt Jon-Philippe K. , Lu Emilie J. , McCall Gary E. 
Published: August 2024

Skeletal muscle hypertrophy is generally associated with a fast-to-slow phenotypic adaptation in both human and rodent models. Paradoxically, this phenotypic shift is not paralleled by a concomitant increase in mitochondrial content and aerobic markers that would be expected to accompany a slow muscle phenotype. To understand the temporal response of the mitochondrial life cycle (i.e., biogenesis, oxidative phosphorylation, fission/fusion, and mitophagy/autophagy) to hypertrophic stimuli, in this study, we used the functional overload (FO) model in adult female rats and examined the plantaris muscle responses at 1 and 10 weeks. As expected, the absolute plantaris muscle mass increased by ∼12 and 26% at 1 and 10 weeks following the FO procedure, respectively. Myosin heavy-chain isoform types I and IIa significantly increased by 116% and 17%, respectively, in 10-week FO plantaris muscles. Although there was a general increase in protein markers associated with mitochondrial biogenesis in acute FO muscles, this response was unexpectedly sustained under 10-week FO conditions after muscle hypertrophy begins to plateau. Furthermore, the early increase in mito/autophagy markers observed under acute FO conditions was normalized by 10 weeks, suggesting a cellular environment favoring mitochondrial biogenesis to accommodate the aerobic demands of the plantaris muscle. We also observed a significant increase in the expression of mitochondrial-, but not nuclear-, encoded oxidative phosphorylation (OXPHOS) proteins and peptides (i.e., humanin and MOTS-c) under chronic, but not acute, FO conditions. Taken together, the temporal response of markers related to the mitochondrial life cycle indicates a pattern of promoting biogenesis and mitochondrial protein expression to support the energy demands and/or enhanced neural recruitment of chronically overloaded skeletal muscle.
Different impacts of parental psychological and behavioral control on the cultivation of advantageous strength in Chinese rural adolescent
Authors: Wang Rong , Liu Min , Sun Yinghong , Li Qian 
Published: August 2024

IntroductionNumerous studies have focused on the mental and behavioral problems or negative emotions of adolescents when examining the impact of parental control. However, limited research has explored the relationship between parental control and adolescents’ future planning, neglecting the distinctions between parental psychological and behavioral control, as well as the significant roles of personal growth initiative and meaning in life. The present study aims to investigate the differential effects of parental psychological control and behavioral control on the future planning of rural adolescents in China.MethodsA sample of 909 individuals (13.60±0.93 years old, 470 boys and 439 girls) completed a self-report questionnaire anonymously. The study utilized the Adolescent Future Orientation Questionnaire, Parental Control Questionnaire, Adolescents’ Personal Growth Initiative Scale, and Meaning in Life Questionnaire.ResultsThe findings revealed that parental control significantly influenced the future planning of Chinese rural adolescents, with psychological control and behavioral control exerting distinct impacts in this process. Specifically, parental psychological control was found to have a direct negative effect on adolescents’ future planning, while also exhibiting a positive influence due to the masking effect of meaning in life; it did not negatively affect adolescents’ future planning through their personal growth initiative. On the other hand, parental behavioral control was observed to directly and positively impact adolescents’ future planning, as well as positively influence it through the mediating role of personal growth initiative and the chain mediating role of personal growth initiative and meaning in life.DiscussionThese results suggest that the influence of parental control on adolescents’ future planning is not a simple, singular mechanism, but rather a multi-layered and complex process, yielding mixed outcomes as a result of psychological control, behavioral control, and other factors. This complexity should be taken into consideration in educational practices and future research endeavors.
Snapshot of knowledge and stigma toward mental health disorders and treatment in Spain
Authors: Varaona Andrea , Molina-Ruiz Rosa M. , Gutiérrez-Rojas Luis , Perez-Páramo Maria , Lahera Guillermo , Donat-Vargas Carolina , Alvarez-Mon Miguel Angel 
Published: August 2024

BackgroundMental disorders significantly impact individuals and societies globally. Addressing societal stigma is crucial, as it affects help-seeking behaviors and the effectiveness of treatment for mental disorders.ObjectiveThis study aims to explore the knowledge and perceptions of the Spanish population toward mental disorders and their treatment, assess changes in mental health stigma over time, and examine variations across sociodemographic variables by comparing current results with previous studies.MethodsA panel of three psychiatrists designed a questionnaire to collect public opinions about various aspects of mental illness in Spain, covering topics such as social perception, diagnostic reliability, causes, symptoms, treatment, suicide, and media influence. The survey, conducted from October to December 2022, involved 1,002 Spanish individuals aged 18–70.ResultsOur results indicated an improved general knowledge of mental health, reduced stigma, and greater acceptance of those affected by these disorders, compared to past research. Almost 80% of the participants have accurate knowledge regarding the complex and multifactorial nature of mental illnesses. Around 90% of the participants share the belief that stigma affects those affected by mental disorders. Psychological and pharmacological treatment are considered to be effective and helpful by more than 70% of the sample. More than 60% of the participants highlighted that suicide needs to be addressed appropriately in the media.ConclusionThese findings suggest a significant shift in how Spanish society views mental disorders, marking progress over decades of discrimination. Reducing the stigma associated with mental health can encourage individuals to seek assistance without the fear of judgment or discrimination, thereby increasing the likelihood of early intervention and treatment. Open conversations about mental health within families, communities, and workplaces can create a supportive environment that enhances recovery. However, continued efforts and awareness campaigns targeted to broader audiences remain necessary. Responsible media portrayals of mental health, avoiding stigmatizing language or sensationalism, are also essential.
The interplay of depressive symptoms and self-efficacy in adolescents: a network analysis approach
Authors: Li Xiang , Xia Bizhen , Shen Guanghui , Dong Renjie , Xu Su , Yang Lingkai 
Published: August 2024

BackgroundSelf-efficacy, a critical psychological construct representing an individual’s belief in their ability to control their motivation, behavior, and social environment. In adolescents, self-efficacy plays a crucial role in mental health, particularly concerning depressive symptoms. Despite substantial research, the complex interplay between self-efficacy and depressive symptoms in adolescents remains incompletely understood.AimsThe aim of this study is to investigate the complex interrelationships between self-efficacy and depressive symptoms in adolescents using psychological network analysis.MethodsThe cross-sectional study involved 3,654 adolescents. Self-efficacy was assessed using the General Self-Efficacy Scale (GSES), and depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). Network analysis, incorporating the least absolute shrinkage and selection operator (LASSO) technique and centrality analysis, constructed and compared self-efficacy networks between depressive symptoms and healthy control groups.ResultsOf the 3,654 participants, 560 (15.32%) met criteria for moderate to severe depressive symptoms (PHQ-9 scores ≥10). Among those with depressive symptoms, 373 (66.61%) had moderate, 126 (22.50%) had moderate–severe, and 61 (10.89%) had severe symptoms. Bivariate correlation analyses revealed a significant negative correlation between depressive symptoms and self-efficacy (r = −0.41, p &lt; 0.001). The results of the network analysis showed significant differences in self-efficacy networks between adolescents with and without depressive symptoms (global strength: S = 0.25, p &lt; 0.05). Depressed participants showed a network with reduced global strength, suggesting diminished interconnectedness among self-efficacy items. Specific connections within the self-efficacy network were altered in the presence of depressive symptoms. Bridge analysis revealed that effort-based problem-solving (bridge strengths = 0.13) and suicidal ideation (bridge strengths = 0.09) were the key bridge nodes.ConclusionAdolescent depressive symptoms significantly impacts the self-efficacy network, resulting in diminished integration of self-efficacy and highlighting the complex interplay between self-efficacy and depressive symptoms. These findings challenge the traditional unidimensional view of self-efficacy and emphasize the need for tailored interventions focusing on unique self-efficacy profiles in adolescents with depressive symptoms.
The posttraumatic growth of fathers of preterm infants: protocol for a qualitative study in China
Authors: Yin Lina , Liu Yanli , Sunzi Kejimu , Huang Dandan , Huang Jing , Tang Liangmei , Liu Minghui 
Published: August 2024

BackgroundPrematurity presents a significant life crisis for families, often exceeding their expectations. Fathers of premature infants face the burden of multiple caregiving roles and undergo psychological changes. When confronted with such crises, individuals often engage in self-evaluation and may experience positive transformations. This study aims to employ a qualitative research methodology to explore the experiences of fathers of preterm infants.Materials and methodsA phenomenological approach design will be utilized, drawing upon semi-structured in-depth interviews informed by existing literature. Thematic analysis will be employed, adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. In-depth individual interviews, lasting 40-60 minutes, will be conducted with fathers of preterm infants to understand their experiences. The thematic analysis process will facilitate a comprehensive understanding of the factors contributing to post-traumatic growth among these fathers. This methodology provides a structured approach to investigating the experiences and influences on post-traumatic growth in fathers of preterm infants.ResultsThis study will highlight changes in post-traumatic growth among fathers of preterm infants.DiscussionResearch on the post-traumatic growth (PTG) of fathers of preterm infants is crucial to understanding the unique challenges and psychological transformations they experience. This study aims to explore the factors contributing to PTG in these fathers and how cultural contexts in China influence this process. By elucidating these aspects, the findings can inform targeted interventions and support systems tailored to the needs of fathers of preterm infants. The results may also contribute to developing guidelines and policies to promote psychological well-being and resilience among this population in the healthcare system.Ethics and disseminationThis study adheres to the International Ethical Guidelines for Biomedical Research and the Declaration of Helsinki. Approval has been obtained from the People’s Hospital of Deyang Human Research Ethics Committee (No: 2019-04-150-K01). The research follows the principles of open science, and the findings will be published while ensuring participants’ confidentiality.