bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of different classification systems for pulmonary nodules: a multicenter retrospective study in China
Authors: Song Feipeng , Yang Qian , Gong Tong , Sun Kai , Zhang Wenjia , Liu Mengxi , Lv Fajin 
Published: January 2024

Abstract
Background
To compare the diagnostic performance of Lung-RADS (lung imaging-reporting and data system) 2022 and PNI-GARS (pulmonary node imaging-grading and reporting system).

Methods
Pulmonary nodules (PNs) were selected at four centers, namely, CQ Center (January 1, 2018-December 31, 2021), HB Center (January 1, 2021–June 30, 2022), SC Center (September 1, 2021–December 31, 2021), and SX Center (January 1, 2021–December 31, 2021). PNs were divided into solid nodules (SNs), partial solid nodules (PSNs) and ground-glass nodules (GGNs), and they were then classified by the Lung-RADS and PNI-GARS. The sensitivity, specificity and agreement rate were compared between the two systems by the χ2 test.

Results
For SN and PSN, the sensitivity of PNI-GARS and Lung-RADS was close (SN 99.8% vs. 99.4%, P < 0.001; PSN 99.9% vs. 98.4%, P = 0.015), but the specificity (SN 51.2% > 35.1%, PSN 13.3% > 5.7%, all P < 0.001) and agreement rate (SN 81.1% > 74.5%, P < 0.001, PSN 94.6% > 92.7%, all P < 0.05) of PNI-GARS were superior to those of Lung-RADS. For GGN, the sensitivity (96.5%) and agreement rate (88.6%) of PNI-GARS were better than those of Lung-RADS (0, 18.5%, P < 0.001). For the whole sample, the sensitivity (98.5%) and agreement rate (87.0%) of PNI-GARS were better than Lung-RADS (57.5%, 56.5%, all P < 0.001), whereas the specificity was slightly lower (49.8% < 53.4%, P = 0.003).

Conclusion
PNI-GARS was superior to Lung-RADS in diagnostic performance, especially for GGN.
Radiomics signature based on robust features derived from diffusion data for differentiation between benign and malignant solitary pulmonary lesions
Authors: Zhou Jiaxuan , Wen Yu , Ding Ruolin , Liu Jieqiong , Fang Hanzhen , Li Xinchun , Zhao Kangyan , Wan Qi 
Published: January 2024

Abstract
Background
Classifying and characterizing pulmonary lesions are critical for clinical decision-making process to identify optimal therapeutic strategies. The purpose of this study was to develop and validate a radiomics nomogram for distinguishing between benign and malignant pulmonary lesions based on robust features derived from diffusion images.

Material and methods
The study was conducted in two phases. In the first phase, we prospectively collected 30 patients with pulmonary nodule/mass who underwent twice EPI-DWI scans. The robustness of features between the two scans was evaluated using the concordance correlation coefficient (CCC) and dynamic range (DR). In the second phase, 139 patients who underwent pulmonary DWI were randomly divided into training and test sets in a 7:3 ratio. Maximum relevance minimum redundancy, least absolute shrinkage and selection operator, and logistic regression were used for feature selection and construction of radiomics signatures. Nomograms were established incorporating clinical features, radiomics signatures, and ADC(0, 800). The diagnostic efficiency of different models was evaluated using the area under the curve (AUC) and decision curve analysis.

Results
Among the features extracted from DWI and ADC images, 42.7% and 37.4% were stable (both CCC and DR ≥ 0.85). The AUCs for distinguishing pulmonary lesions in the test set for clinical model, ADC, ADC radiomics signatures, and DWI radiomics signatures were 0.694, 0.802, 0.885, and 0.767, respectively. The nomogram exhibited the best differentiation performance (AUC = 0.923). The decision curve showed that the nomogram consistently outperformed ADC value and clinical model in lesion differentiation.

Conclusion
Our study demonstrates the robustness of radiomics features derived from lung DWI. The ADC radiomics nomogram shows superior clinical net benefits compared to conventional clinical models or ADC values alone in distinguishing solitary pulmonary lesions, offering a promising tool for noninvasive, precision diagnosis in lung cancer.
An ampullary adenoma presenting with jaundice caused by duodenal intussusception: a case report
Authors: Nojima Hiroyuki , Shimizu Hiroaki , Hirota Mihono , Murakami Takashi , Yamazaki Masato , Yamazaki Kazuto , Shuto Kiyohiko , Kosugi Chihiro , Mori Mikihito , Usui Akihiro , Sazuka Tetsutaro , Koda Keiji 
Published: January 2024

Abstract
Background
Ampullary adenomas are premalignant lesions. However, biliary obstruction causing jaundice is rare. Duodenal intussusception secondary to an ampullary adenoma rarely occurs because of the fixed position of the duodenum in the retroperitoneum. Herein, we have described a rare case of ampullary adenoma with jaundice caused by duodenal intussusception.

Case presentation
A 40-year-old woman presenting with vomiting and yellowish discoloration of the skin was admitted to another hospital. The patient had experienced recurrent epigastric pain and vomiting for the past 18 months. Blood test results showed elevated levels of bilirubin (3.9 mg/dL), and abdominal computed tomography (CT) showed a 60-mm hypovascular mass in the third part of the duodenum and a left lateral shift of the dilated common bile duct. The patient was referred to our hospital for further evaluation. She recovered from hyperbilirubinemia spontaneously (levels of bilirubin, 1.0 mg/dL), and the CT showed a tumor shift from the third part of the duodenum to the second part and improvement of the dilated common bile duct. Hypotonic duodenography revealed a tumor that moved easily from the second to the third portion of the patient's position. Upper gastrointestinal endoscopy revealed a large papillary tumor occupying the second part of the duodenum, which was diagnosed as an adenoma through biopsy. The possibility of malignancy could not be negated owing to the presence of jaundice and an elevated carbohydrate antigen 19-9 level (76.0 U/mL). Pancreaticoduodenectomy was performed. The resected specimen showed a 60 × 40 × 40-mm pedunculated ampullary mass with submucosal elongation. The pathological examination indicated that the ampullary tumor was a high-grade intestinal adenoma. The postoperative course was uneventful, and the patient was discharged 26 days postoperatively.

Conclusions
This report describes a rare case of a patient with an ampullary adenoma presenting with jaundice resulting from duodenal intussusception. Owing to the possibility of a postoperative cancer diagnosis which may have caused the biliary obstruction and the difficulty in making an accurate preoperative diagnosis, it is imperative to choose the appropriate surgical procedure such as a pancreaticoduodenectomy.
Physiologically based radiopharmacokinetic (PBRPK) modeling to simulate and analyze radiopharmaceutical therapies: studies of non-linearities, multi-bolus injections, and albumin binding
Authors: Fele-Paranj Ali , Saboury Babak , Uribe Carlos , Rahmim Arman 
Published: January 2024

Abstract
Background
We aimed to develop a publicly shared computational physiologically based pharmacokinetic (PBPK) model to reliably simulate and analyze radiopharmaceutical therapies (RPTs), including probing of hot-cold ligand competitions as well as alternative injection scenarios and drug designs, towards optimal therapies.

Results
To handle the complexity of PBPK models (over 150 differential equations), a scalable modeling notation called the “reaction graph” is introduced, enabling easy inclusion of various interactions. We refer to this as physiologically based radiopharmacokinetic (PBRPK) modeling, fine-tuned specifically for radiopharmaceuticals. As three important applications, we used our PBRPK model to (1) study the effect of competition between hot and cold species on delivered doses to tumors and organs at risk. In addition, (2) we evaluated an alternative paradigm of utilizing multi-bolus injections in RPTs instead of prevalent single injections. Finally, (3) we used PBRPK modeling to study the impact of varying albumin-binding affinities by ligands, and the implications for RPTs. We found that competition between labeled and unlabeled ligands can lead to non-linear relations between injected activity and the delivered dose to a particular organ, in the sense that doubling the injected activity does not necessarily result in a doubled dose delivered to a particular organ (a false intuition from external beam radiotherapy). In addition, we observed that fractionating injections can lead to a higher payload of dose delivery to organs, though not a differential dose delivery to the tumor. By contrast, we found out that increased albumin-binding affinities of the injected ligands can lead to such a differential effect in delivering more doses to tumors, and this can be attributed to several factors that PBRPK modeling allows us to probe.

Conclusions
Advanced computational PBRPK modeling enables simulation and analysis of a variety of intervention and drug design scenarios, towards more optimal delivery of RPTs.
Highlights on the link between vitamin D and lipid panel in Egyptian multiple sclerosis patients
Authors: Swelam Mahmoud S. , Abdel Nasser Azza , Masoud Janet , Mamdouh Rasha , Said Shima , Abdel Hafeez Mohamed 
Published: January 2024

Abstract
Background
Diversity of risk factors, namely, vitamin D and lipid panel abnormalities, are connected to multiple sclerosis (MS) etiology and may possess an influential role on disease course. In a cross-sectional study, we correlated the demographic, clinical and radiological characteristics of 111 relapsing–remitting MS (RRMS) patients with their serum levels of vitamin D and lipid profile to evaluate the consequences of their abnormalities on disease activity and/or its progression.

Results
In the study group, the mean serum level of vitamin D was 18.93 ± 9.85 ng/mL, over 80% had insufficient level ( < 30 ng/mL) and significantly lower in females (P = 0.011). Insufficient vitamin D significantly associated with high relapse frequency (P = 0.005). Measurement the direction of this association showed that each 1 ng/mL increase in vitamin D was correlated with both decrease in annualized relapse rate (ARR) of 0.02 relapse/year (P = 0.017) and with decrease in number of relapses during last 2 years of 0.02 relapse (P = 0.045). Analysis of serum lipid panel showed a direct link between higher levels of TC and LDL to increased total number of relapses (P < 0.001 and 0.003, respectively) and EDSS (P = 0.001 and 0.022), also between higher TG and EDSS (P = 0.001). This link became indirect between HDL and both total number of relapse and EDSS (P = 0.001 and 0.001). Radiologically, positively linked confluent brain lesion to elevated TC and TG levels (P = 0.001 and 0.002, respectively) and cord lesions to elevated TC (P = 0.007). Longer disease duration positively associated with all lipids-related variables. As a direct effect on lipid metabolism, each 1 ng/mL increase in vitamin D was associated with reduction in serum TC of 1.48 mg/dL (P = 0.002) and rise in HDL of 0.35 mg/dL (P = 0.028).

Conclusions
Management of vitamin D insufficiency may decrease risk of higher ARR and the same for dyslipidemia in reduction of disability and confluent brain T2 lesion. Increasing vitamin D was positively correlated with HDL but negatively with TC.
Oxidative stress and inflammation: elucidating mechanisms of smoking-attributable pathology for therapeutic targeting
Authors: Addissouky Tamer A. , El Sayed Ibrahim El Tantawy , Ali Majeed M. A. , Wang Yuliang , El Baz Ayman , Elarabany Naglaa , Khalil Ahmed A. 
Published: January 2024

Abstract
Background
Tobacco smoking remains a major preventable cause of disease and death worldwide. Combustible cigarettes release thousands of chemicals that can initiate inflammatory pathways leading to smoking-related illness. This review aims to synthesize current scientific knowledge on mechanisms of smoking-induced disease, epidemiological trends, and clinical strategies from recent literature.

Main body of the abstract
At the cellular level, cigarette smoke triggers oxidative stress through reactive oxygen species (ROS), causing DNA damage. This provokes inflammatory signaling cascades mediated by damage-associated molecular patterns (DAMPs), receptors like RAGE and TLRs, and downstream cytokines. Smoking also disrupts apoptosis and autophagy. In the lungs, oxidative stress and inflammation from smoking play central roles in COPD pathogenesis. Smoking-induced oxidative DNA damage, chronic inflammation, and impaired immunity combine to promote lung carcinogenesis. For cardiovascular disease, smoking triggers endothelial dysfunction, platelet activation, and atherogenesis through oxidized LDL and effects on nitric oxide and adhesion molecules.

Short conclusion
Given the unequivocal evidence of health risks, smoking cessation is critical to reducing preventable death and disability. Both counseling and pharmacotherapy have proven efficacy for quitting, but efficacy remains limited long-term. Emerging nicotine products like e-cigarettes have unknown impacts on cessation and population health. Comprehensive efforts encompassing prevention, screening, treatment innovation, harm reduction, and policy reform focused on curbing smoking-attributable morbidity and mortality are warranted.
Value of S-Detect combined with multimodal ultrasound in differentiating malignant from benign breast masses
Authors: Li Na , Liu Wanling , Zhan Yunyun , Bi Yu , Wu Xiabi , Peng Mei 
Published: January 2024

Abstract
Background
Ultrasonography (US) still has some limitations in the differentiation of benign and malignant breast masses. Therefore, we introduced new technologies such as S-Detect, microvascular flow imaging (MVFI), and strain elastography (SE) into the examination and compared the multimodal method with Breast Imaging Reporting and Data System (BI-RADS).

Objectives
This prospective study aimed to evaluate the value of multimodal diagnostic methods that add S-Detect, MFI, and SR to US in differentiating benign from malignant breast masses.

Methods
We recruited 186 patients with 189 masses between July 2021 and March 2022. The masses were examined using US, S-Detect, SR, and MFI before biopsy, and the benign and malignant differentiation value of each and their combination were assessed compared with surgical pathology results using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Subgroup analysis by lesion size was also performed.

Results
The respective optimal cutoff values of SR and MFI for differentiating benign from malignant masses were 3.15 and 2.45, respectively, and the sensitivity and specificity were 79.3% and 85.6% and 94.6% and 69.1%, respectively. The multimodal AUC (0.907), sensitivity (97.8%), accuracy (90.5%), PPV (84.9%), and NPV (97.6%) were larger than those of each modality (p < 0.05), regardless of the mass size.

Conclusions
The diagnostic method of S-Detect combined with multimodal ultrasound can effectively improve the diagnostic efficiency of breast masses and is expected to become a routine examination for breast in future for better evaluation the benign and malignancy of breast masses.
Reconfigurable flexible metasurfaces: from fundamentals towards biomedical applications
Authors: Tian Jiangtao , Cao Wenhan 
Published: January 2024

AbstractMetamaterials and metasurfaces of artificial micro-/nano- structures functioning from microwave, terahertz, to infrared regime have enabled numerous applications from bioimaging, cancer detection and immunoassay to on-body health monitoring systems in the past few decades. Recently, the trend of turning metasurface devices flexible and stretchable has arisen in that the flexibility and stretchability not only makes the device more biocompatible and wearable, but also provides unique control and manipulation of the structural and geometrical reconfiguration of the metasurface in a creative manner, resulting in an extraordinary tunability for biomedical sensing and detection purposes. In this Review, we summarize recent advances in the design and fabrication techniques of stretchable reconfigurable metasurfaces and their applications to date thereof, and put forward a perspective for future development of stretchable reconfigurable metamaterials and metasurfaces.
Talazoparib (Tala) in patients (pts) with colorectal cancer (CRC) with BRCA1/2 mutations (mut): Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) study.
Authors: Yost Kathleen J , Rothe Michael , Mangat Pam K. , Garrett-Mayer Elizabeth , Duvivier Herbert Leon , Ahn Eugene R. , Cannon Timothy Lewis , Chiu Vi Kien , Khalil Maged F. , Kim Brian , Prinz Allison Marie , Grantham Gina N. , Gregory Abby , Hinshaw Dominique C. , Halabi Susan , Schilsky Richard L. 
Published: January 2024

106 Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with specific genomic alterations. Results in a cohort of pts with CRC with BRCA1/2 mut treated with Tala are reported. Methods: Eligible pts had measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts received 1 mg of Tala orally daily until disease progression. Primary endpoint was disease control (DC) per investigator defined as complete or partial response or stable disease of at least 16 weeks (wks) duration (SD16+) per RECIST v 1.1. Simon 2-stage design tested the null DC rate of 15% vs. 35% (power = 0.85; α = 0.10). If ≥2 of 10 pts in stage 1 have DC, 18 more pts are enrolled; otherwise, the cohort is closed. If ≥7 of 28 pts have DC, the null DC rate is rejected. Secondary endpoints were objective response (OR), progression-free survival (PFS), overall survival (OS), and safety. Results: 10 pts with advanced CRC and BRCA1 mut (n=3), BRCA2 mut (n=5), or both (n=2) were enrolled from February 2020 to June 2021. Germline or somatic status was not reported in 7 of 10 pts, 2 pts had somatic BRCA2 muts and 1 pt had a germline BRCA2 mut. 2 pts had left sided tumors, 2 had right sided, 3 had rectal tumors, and 3 pts had tumors that were site undetermined. All pts were evaluable for efficacy and toxicity. Table summarizes pt demographics and outcomes. No pts experienced DC, median PFS was 8 wks (95% CI, 6 to 8) and median OS was 24 wks (95% CI, 7 to 43). Co-alterations were observed in the following genes: KRAS (3 pts) and BRAF (2 pts). 2 pts had 3 separate grade 3 adverse events of anemia or fatigue at least possibly related to Tala. Conclusions: Monotherapy Tala did not demonstrate sufficient clinical activity in pts with advanced CRC with BRCA1/2 mut. Other tx should be considered for these pts, including tx offered in clinical trials. Clinical trial information: NCT02693535 . [Table: see text]
An ARCAD database nomogram for prognostic prediction of treatment refractory metastatic colorectal cancer.
Authors: Oki Eiji , Bando Hideaki , Yamazaki Kentaro , Misumi Toshihiro , Takeda Yuriko , Suzuki Motoko , Wakabayashi Masashi , Wakabayashi Masashi , Grothey Axel , Mayer Robert J. , Li Jin , Andre Thierry , Shi Qian , De Gramont Aimery , Yoshino Takayuki 
Published: January 2024

107 Background: The "No Placebo Initiative" demonstrated that the survivals of patients (pts) receiving placebo in a salvage-line setting, exhibited no significant difference across trials (CORRECT, RECOURSE, CONCUR and TERRA). Therefore, we believe that a nomogram can be generated using the ARCAD database to predict survival of pts who completed standard therapy. Methods: Of 40,889 Individual patient data (IPD) from 59 studies, 723 pts received placebo from 4 randomized studies were pooled. The potential prognostic factors considered include BMI and Age. Imputed datasets were constructed by a multiple imputation method since the original dataset contains some missing values. Overall survival (OS) was defined as the time from randomization to death from any cause. Multivariate Cox proportional hazards models for OS were estimated based on the variables showing clinically and statistically significant by univariate analysis. Prediction performance of the final model was evaluated using the concordance index for survival data and calibration plots. Results: From univariate and multivariate analysis, ECOG performance status, Royal Marsden Hospital score (calculated by albumin level, LDH level, and number of metastatic site), primary site location, liver meta, peritoneal meta were selected as variables. We successfully developed a highly accurate nomogram to predict post-standard treatment prognosis for pts with mCRC. Concordance index for OS was 0.66. Conclusions: Although further validation in other cohorts is needed, this nomogram could be very useful to estimate the survival for clinical practice and enrolling in clinical trials. [Table: see text]
Short course immunotherapy as curative-intent treatment in stage I-III dMMR rectal cancer.
Authors: Pfeiffer Per , Andersen Per Vadgaard , Salomon Søren , Øgaard Nadia , Demuth Christina , Andersen Claus Lindbjerg , Gögenur Ismail , Justesen Tobias Freyberg , de Lima Vinicius Araujo , Tarpgaard Line Schmidt 
Published: January 2024

121 Background: Neoadjuvant chemo-radiation followed by resection is standard treatment for patients with locally advanced rectal cancer (RC). A subset of RC are mismatch repair deficient (dMMR). Check-point inhibitors (CPI) are the standard of care in dMMR colorectal cancer (CRC) in the metastatic setting, and recent trials have demonstrated impressive efficacy in early CRC, even with a limited number of cycles. In the NICHE-II trial (Chalabi et al, ESMO 2022) 72 of 107 patients (67%) with colon cancer obtained pathological complete response (pCR) after short course CPI. In patients with RC, Cercek et al (NEJM 2022) showed that 12 patients (100%) obtained pCR after 6 months of dostarlimab. The efficacy of CPI in dMMR RC has only been evaluated in few studies. Here we report data from a Danish trial with early dMMR RC. EU CT number 2022-500646-14-00. Methods: The purpose was to evaluate the efficacy and tolerability of 1 cycle of nivolumab (3 mg/kg days 1 and 15 - nivo) and ipilimumab (1 mg/kg day 1 - ipi) in patients with early stage dMMR RC. The primary endpoint was number of patients with clinical complete response (cCR - no visible or palpable tumor) evaluated 4 weeks after nivo-ipi. Patients achieving a clinical, radiological, pathological (representative biopsy without viable tumor cells), and molecular complete response was offered a thorough watchful waiting strategy without surgery. Results: 5 patients were treated, 4 patients received a single cycle of nivo-ipi and 1 patient received 2 cycles of nivo-ipi, as the tumor was still visible at the first endoscopy (Table). All 5 patients were evaluated 4 weeks after completing nivo-ipi and all 5 patients (100%) achieved cCR. All 5 patients were ctDNA positive (Jensen et al, Clin Chem 2020) at diagnosis, 4 patients turned negative after therapy (1 pending). No patient needed radiotherapy and all patients agreed to non-surgical watchful waiting. No patient has had progression or recurrence (1-42 months follow-up). Conclusions: Short-course nivo-ipi is very effective in locally advanced dMMR rectal cancer and may become an alternative to resection. Clinical trial information: 2022-500646-14-00 . [Table: see text]