bluuebunny/crossref_metadata_2025_split huggingface dataset:
Silicosis as a predictor of tuberculosis mortality and treatment failure and need for incorporation in differentiated TB care models in India
Authors: Rupani Mihir P. 
Published: September 2023

Abstract
Background
Differentiated tuberculosis (TB) care is an approach to improve treatment outcomes by tailoring TB management to the particular needs of patient groups based on their risk profile and comorbidities. In silicosis-prone areas, the coexistence of TB and silicosis may exacerbate treatment outcomes. The objective of the study was to determine predictors of TB-related mortality, treatment failure, and loss to follow-up in a silicosis-prone region of western India.

Methods
A retrospective cohort was conducted among 2748 people with TB registered between January 2006 and February 2022 in Khambhat, a silicosis-prone block in western India. Death, treatment failure, and loss to follow up were the outcome variables. The significant predictors of each outcome variable were determined using multivariable logistic regression and reported as adjusted odds ratios (aOR) with 95% confidence intervals (CIs).

Results
In the cohort of 2,748 people with TB, 5% presented with silicosis, 11% succumbed to the disease, 5% were lost to follow-up during treatment, and 2% encountered treatment failure upon completion of therapy. On multivariable logistic regression, concomitant silicosis [aOR 2.3 (95% CI 1.5–3.5)], advancing age [aOR 1.03 (95% CI 1.02–1.04)], male gender [aOR 1.4 (95% 1.1–1.9)], human immunodeficiency virus (HIV) positive [aOR 2.2 (95% 1.02–4.6)], and previous TB treatment [aOR 1.5 (95% CI 1.1–1.9)] significantly predicted mortality among people with TB. Concomitant silicosis [aOR 3 (95% CI 1.4–6.5)], previous TB treatment [aOR 3 (95% CI 2–6)], and multi-drug resistant TB [aOR 18 (95% CI 8–41)] were the significant predictors of treatment failure on adjusted analysis. Advancing age [aOR 1.012 (1.001–1.023)], diabetes [aOR 0.6 (0.4–0.8)], and multi-drug resistance [aOR 6 (95% CI 3–12)] significantly predicted loss to follow-up after adjusting for confounders.

Conclusions
Controlling silicosis might decrease TB mortality and treatment failure in silicosis-prone regions. The coexistence of HIV and silicosis may point to an increase in TB deaths in silicosis-prone areas. Silicosis should now be acknowledged as a major comorbidity of TB and should be included as one of the key risk factors in the differentiated TB care approach. Primary care physicians should have a high clinical suspicion for silicosis among individuals diagnosed with TB in silicosis-prone blocks.
Disordered eating behaviours and body shape dissatisfaction among adolescents with type 1 diabetes: a cross sectional study
Authors: Daniel Lidiya , Haile Demewoz , Egata Gudina 
Published: September 2023

Abstract
Background
Disordered eating behaviours (DEBs) are variations in regular eating patterns and behaviours and might include symptoms and behaviours of eating disorder with lower level of severity. Such behaviours are common during adolescence at which time several physical and psychological changes occur favouring unhealthy dietary behaviours. Although the magnitude of DEBs is high among high—income countries, similar data are limited among adolescents with diabetes in low-income countries including Ethiopia. This study aimed to assess the magnitude of DEBs and its relationship with body shape dissatisfaction among adolescents with diabetes on follow-up at selected public hospitals in Addis Ababa, Ethiopia.

Methods
Hospital based cross sectional study was conducted among randomly selected 395 adolescents with diabetes attending public hospitals in Addis Ababa from January to December, 2021. Data were collected using structured pretested standard diabetes eating problem survey revised (DEPS-R) questionnaire, body part satisfaction scale of 8 items, and anthropometric measurements. Descriptive statistics such as median alongside interquartile range was used to describe the continuous variables. Binary bivariable and multivariable logistic regression was used for data analysis. Mann–Whitney U-test and Kruskal–Wallis test were used to evaluate the difference between median scores of independent variables. Adjusted odds ratios (AOR) alongside 95% confidence intervals (CIs) were estimated to measure the strength of association between variables of interest.

Results
The magnitude of disordered eating behaviours within the last 30 days was 43.3%, [95% CI: (38%, 48%)]. In multivariable analysis, body shape dissatisfaction [AOR = 2.21, 95% CI (1.28, 3.82, p = 0.0001)], family history of diabetes mellitus [AOR = 1.59, 95% CI (1.03, 2.47, p = 0.038)], late adolescence period [AOR = 2.10, 95% CI (1.33, 3.34, p = 0.002)], having diabetic complication[AOR = 2.32, 95% CI (1.43, 3.75, p = 0.001)],and being overweight [AOR = 2.25, 95% CI (1.32, 3.82, p = 0.003)] were significantly associated with DEBs.

Conclusions
The magnitude of DEBs was high among the study participants. Body shape dissatisfaction, family history of diabetes mellitus, being in late adolescence period, diabetic complication, and nutritional status of adolescents were significantly associated with DEBs. Therefore, preventive interventions need to be designed by all relevant actors working on health promotion of young population to address factors influencing DEBs among adolescent population with diabetes.
Evolution of CT radiation dose in pediatric patients undergoing hybrid 2-[18F]FDG PET/CT between 2007 and 2021
Authors: Skawran Stephan , Sartoretti Thomas , Gennari Antonio G , Schwyzer Moritz , Sartoretti Elisabeth , Treyer Valerie , Maurer Alexander , Huellner Martin W , Waelti Stephan , Messerli Michael 
Published: September 2023

Objectives:
To evaluate the evolution of CT radiation dose in pediatric patients undergoing hybrid 2-[18F]fluoro-2-deoxy-D-glucose (2-[18F]FDG) PET/CT between 2007 and 2021.

Methods and materials:
Data from all pediatric patients aged 0–18 years who underwent hybrid 2-[18F]FDG PET/CT of the body between January 2007 and May 2021 were reviewed. Demographic and imaging parameters were collected. A board-certified radiologist reviewed all CT scans and measured image noise in the brain, liver, and adductor muscles.

Results:
294 scans from 167 children (72 females (43%); median age: 14 (IQR 10–15) years; BMI: median 17.5 (IQR 15–20.4) kg/m2) were included. CT dose index-volume (CTDIvol) and dose length product (DLP) both decreased significantly from 2007 to 2021 (both p &lt; 0.001, Spearman’s rho coefficients −0.46 and −0.35, respectively). Specifically, from 2007 to 2009 to 2019–2021 CTDIvol and DLP decreased from 2.94 (2.14–2.99) mGy and 309 (230-371) mGy*cm, respectively, to 0.855 (0.568–1.11) mGy and 108 (65.6–207) mGy*cm, respectively. From 2007 to 2021, image noise in the brain and liver remained constant (p = 0.26 and p = 0.06), while it decreased in the adductor muscles (p = 0.007). Peak tube voltage selection (in kilovolt, kV) of CT scans shifted from high kV imaging (140 or 120kVp) to low kV imaging (100 or 80kVp) (p &lt; 0.001) from 2007 to 2021.

Conclusion:
CT radiation dose in pediatric patients undergoing hybrid 2-[18F]FDG PET/CT has decreased in recent years equaling approximately one-third of the initial amount.

Advances in knowledge:
Over the past 15 years, CT radiation dose decreased considerably in pediatric patients undergoing hybrid imaging, while objective image quality may not have been compromised.
Effects of EGFR driver mutations on pathologic regression in resectable locally advanced non-small cell lung cancer treated with neoadjuvant chemoradiation and completion surgery
Authors: Appel Sarit , Bar Jair , Saad Akram , Marom Edith Michelle , Urban Damien , Onn Amir , Gantz-Sorotsky Hadas , Kremer Ran Yosef , Ben-Nun Alon , Perelman Marina , Ofek Efrat , Yacobi Rinat , Daher Sameh , Rasco Adi , Symon Zvi , Lawrence Yaacov Richard , Goldstein Jeffrey 
Published: September 2023

Objective
We hypothesized that driver mutations in epidermal growth factor receptor (EGFR) are associated with decreased pathologic response to neoadjuvant chemoradiation (NA-ChRT) in locally advanced non-small cell lung cancer (LA-NSCLC).

Methods
Patients with Stage IIB-IIIA NSCLC treated with NA-ChRT, completion surgery, and underwent molecular profile testing were identified in a lung cancer database. Pathologic response was quantified using: (i) major pathologic response (MPR), (ii) complete pathologic response (pCR), and (iii) mean residual viable tumor cells (MRTC). Two groups were formed based on the presence or absence of driver mutations. Clinical and pathological correlations between the groups were studied.

Results
Forty-seven patients underwent tumor molecular profile testing, NA-ChRT, and completion surgery. Compared to the no-driver mutation group, the driver mutation group had lower MPR (23% vs 71%, p = 0.003), pCR (0% vs 26%, p = 0.02), and higher MRTC (43.4% vs 15.8%, p = 0.009). Univariate analysis showed an increased MPR rate for smokers, squamous cell histology, ChRT-surgery interval &gt;65 days, and no-driver mutations. Multivariate analysis showed that only no-driver mutations (OR 0.39, p = 0.02) remained significant for MPR. PD-L1 status did not affect MPR. At 2 years, the driver mutation group had lower rates of local control (Hazard ration [HR] 0.67, p = 0.17) and disease-free survival (HR 0.5, p = 0.001). Overall survival was similar for both groups (HR = 1.04, p = 0.86).

Conclusion
Following 60 Gray NA-ChRT, tumors with a driver mutation had lower MPR and pCR rates than tumors without a driver mutation. PD-L1 was not associated with tumor regression.

Advances in knowledge
Patients with resectable LA-NSCLC and an EGFR driver mutation treated with neoadjuvant-ChRT and completion surgery have reduced pathologic regression, lower local control rates, and shorter disease-free survival than patients without a driver mutation. Evaluation of molecular testing should be introduced in LA-NSCLC intended for prognostication and treatment decisions.
Automated vertebral bone mineral density measurement with phantomless internal calibration in chest LDCT scans using deep learning
Authors: Pan Yaling , Zhao Fanfan , Cheng Gen , Wang Huogen , Lu Xiangjun , He Dong , Wu Yinbo , Ma Hongfeng , PhD Hui Li , Yu Taihen 
Published: September 2023

Objective:
To develop and evaluate a fully automated method based on deep learning and phantomless internal calibration for bone mineral density (BMD) measurement and opportunistic low BMD (osteopenia and osteoporosis) screening using chest low-dose CT (LDCT) scans.

Methods
A total of 1175 individuals were enrolled in this study, who underwent both chest LDCT and BMD examinations with quantitative computed tomography (QCT), by two different CT scanners (Siemens and GE). Two convolutional neural network (CNN) models were employed for vertebral body segmentation and labeling, respectively. A histogram technique was applied for vertebral BMD calculation using paraspinal muscle and surrounding fat as references. 195 cases (by Siemens scanner) as fitting cohort were used to build the calibration function. 698 cases as validation cohort I (VCI, by Siemens scanner) and 282 cases as validation cohort II (VCII, by GE scanner) were performed to evaluate the performance of the proposed method, with QCT as the standard for analysis.

Results
The average BMDs from the proposed method were strongly correlated with QCT (in VCI: r = 0.896, in VCII: r = 0.956, p &lt; 0.001). Bland–Altman analysis showed a small mean difference of 1.1 mg/cm3, and large interindividual differences as seen by wide 95% limits of agreement (−29.9 to +32.0 mg/cm3) in VCI. The proposed method measured BMDs were higher than QCT measured BMDs in VCII (mean difference = 15.3 mg/cm3, p &lt; 0.001). Osteoporosis and low BMD were diagnosed by proposed method with AUCs of 0.876 and 0.903 in VCI, 0.731 and 0.794 in VCII, respectively. The AUCs of the proposed method were increased to over 0.920 in both VCI and VCII after adjusting the cut-off.

Conclusion:
Without manual selection of the region of interest of body tissues, the proposed method based on deep learning and phantomless internal calibration has the potential for preliminary screening of patients with low BMD using chest LDCT scans. However, the agreement between the proposed method and QCT is insufficient to allow them to be used interchangeably in BMD measurement.

Advances in knowledge:
This study proposed an automated vertebral BMD measurement method based on deep learning and phantomless internal calibration with paraspinal muscle and fat as reference.
Should we share breast density information during breast cancer screening in the United Kingdom? an integrative review
Authors: Best Rebecca , Wilkinson Louise S , Oliver-Williams Clare , Tolani Foyeke , Yates Jan 
Published: September 2023

Objective
Dense breasts are an established risk factor for breast cancer and also reduce the sensitivity of mammograms. There is increasing public concern around breast density in the UK, with calls for this information to be shared at breast cancer screening.

Methods
We searched the PubMed database, Cochrane Library and grey literature, using broad search terms in October 2022. Two reviewers extracted data and assessed the risk of bias of each included study. The results were narratively synthesised by five research questions: desire for information, communication formats, psychological impact, knowledge impact and behaviour change.

Results
We identified 19 studies: three Randomised Controlled Trials (RCTs), three cohort studies, nine cross-sectional studies, one qualitative interview study, one mixed methods study and two 2021 systematic reviews. Nine studies were based in the United States of America (USA), five in Australia, two in the UK and one in Croatia. One systematic review included 14 USA studies, and the other 27 USA studies, 1 Australian and 1 Canadian. The overall GRADE evidence quality rating for each research question was very low to low.
Generally, participants wanted to receive breast density information. Conversations with healthcare professionals were more valued and effective than letters. Breast density awareness after notification varied greatly between studies.
Breast density information either did not impact frequency of mammography screening or increased the intentions of participants to return for routine screening as well as intention to access, and uptake of, supplementary screening. People from ethnic minority groups or of lower socioeconomic status (SES) had greater confusion following notification, and, along with those without healthcare insurance, were less likely to access supplementary screening.

Conclusion
Breast density specific research in the UK, including different communities, is needed before the UK considers sharing breast density information at screening. There are also practical considerations around implementation and recording, which need to be addressed.

Advances in knowledge
Currently, sharing breast density information at breast cancer screening in the UK may not be beneficial to participants and could widen inequalities. UK specific research is needed, and measurement, communication and future testing implications need to be carefully considered.
Spectral CT imaging versus conventional CT post-processing technique in differentiating malignant and benign renal tumors
Authors: Zhu Qingqiang , Sun Jun , Zhu Wenrong , Chen Wenxin , Ye Jing 
Published: September 2023

Objective: Quantitative comparison of the diagnostic value of spectral CT imaging and conventional CT post-processing technique in differentiating malignant and benign renal tumors. Methods: A total of 209 patients with renal tumors who had undergone CT enhancement were assigned to three groups—clear cell renal cell carcinoma (ccRCC, n = 106), non-ccRCC (n = 60), and benign renal tumor (n = 43) groups. Parametric CT enhancement of each tumor based on spectral CT and conventional CT was performed using in-house software, and the iodine concentration, water content, slope, and density values among the three groups were compared. The receiver operating characteristic (ROC) curve analysis was performed to determine the optimum diagnostic thresholds, the area under the ROC curve (AUC), sensitivity, specificity, and accuracy of the above parameters. Results The iodine concentration, slope, and density values were higher in the ccRCCs group compared to the non-ccRCCs and benign renal tumor groups (p < 0.05). Moreover, the iodine concentration, slope, and density values were higher in benign renal tumors compared to non-ccRCCs (p < 0.05). According to the ROC curve analysis, iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors. The pairwise comparisons of the ROC curves and the diagnostic efficacies revealed that ROI-based CT enhancement was worse than the spectral CT imaging analysis in terms of density (p < 0.05). Conclusion: Iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors. Advances in knowledge 1. The iodine concentration, slope, and density values were higher for the ccRCCs compared to non-ccRCCs and benign renal tumors. 2. Iodine concentration presented the highest diagnostic efficacy in differentiating ccRCCs/non-ccRCCs from benign renal tumors. 3. Spectral CT imaging analysis performed better than conventional CT in differentiating malignant and benign renal tumors.
A new path for ultrasound-guided intra-articular hip puncture in patients without hip joint effusion
Authors: Song Mengjie , Li Yingying , Lan Yu , Li Shoupeng , Li Chunbao , Luo Yukun , Zhang Mingbo 
Published: September 2023

Objective:
This study aimed to establish a new path for ultrasound (US)-guided intra-articular hip joint puncture in patients without hip joint effusion.

Methods:
In total, 113 consecutive patients were enrolled from August to October 2021. Moreover, 125 hip joint punctures were performed in 113 consecutive patients. All patients were randomly divided into two groups: the new-puncture path (the puncture of the needle along the long axis of the femoral neck from the proximal to the distal side) and classic-puncture path (the puncture of the needle along the long axis of the femoral neck from the distal to the proximal side) groups. Four outcomes, including single-puncture technical success, visual analog scale (VAS) score during puncture, puncture depth, and puncture time, were compared between the groups. Complications were compared between the groups. Correlation analysis was used to evaluate the factors related to the four outcomes.

Results:
No significant differences in single-puncture technical success, VAS score during puncture, and complications were observed between the two groups. The puncture depth was shorter in the new-puncture path group than in the classic-puncture path group. The puncture time was shorter in the new-puncture path group than in the classic-puncture path group. The puncture depth was correlated with the puncture path, body mass index, and sex. The puncture time was correlated with the puncture path.

Conclusion:
The new-puncture path can be used as a new US-guided hip puncture path for patients without hip joint effusion, with the advantages of shorter puncture path and puncture time.

Advances in knowledge:
The current study introduces a new-puncture path that can be added with the classic-puncture path.
RRIMS: Radiation Risk In Mammography Screening — model evaluation
Authors: Hooshmand Sahand , Reed Warren M. , Suleiman Mo'ayyad E. , Brennan Patrick C. 
Published: September 2023

Objective The Radiation Risk In Mammography Screening (RRIMS) model was introduced as a novel tool to help females accurately calculate their lifetime mean glandular dose (MGD) and estimate their population-level risk of radiation-induced breast cancer incidence and mortality. Methods The model’s accuracy was evaluated by comparing the received MGD of 317 women who had undergone a total of 733 visits across one to four rounds of screening. This was achieved by comparing the RRIMS predicted dose values with the same examination dose calculated manually by hand. Qualitative and quantitative statistical analyses were performed to assess the percentage difference (% diff) or agreement between the two values. Results Qualitative statistical analysis using the Bland–Altman plots demonstrated a statistically significant bias for the % diff between the manually calculated and RRIMS predicted dose values, where the mean (bias) was −2.02% with an upper and lower limit of agreement of 40.24% and −44.27%, respectively. Quantitative statistical analysis revealed an intraclass correlation coefficient (ICC, 3,1) of 0.64 (p-value < 0.001) and a Kendall’s W of 0.83 (p-value < 0.001). Conclusion The results indicate a statistically significant and reasonably good level of agreement between the manually calculated vs RRIMS predicted dose values. This work was focused on one of the major mammography equipment manufacturers that is Hologic, however there is potential for a multivendor applicability study of this model with future iterations. This will further improve upon this innovative dose and risk prediction tool that can empower healthcare professionals when making informed decisions and enhance patient care. Advances in knowledge This paper assesses the precision of the dose and risk model that our team has previously established. The results bring us one step closer to providing females and clinicians with a useful tool that can help explain and contextualise the benefits and risks associated with screening mammography.
Combined conventional ultrasonography with clinicopathological features to predict axillary status after neoadjuvant therapy for breast cancer: A case–control study
Authors: Yan Yuqi , Jiang Tian , Sui Lin , Ou Di , Qu Yiyuan , Chen Chen , Lai Min , Ni Chen , Liu Yuanzhen , Wang Yifan , Xu Dong 
Published: September 2023

Objectives:
This study aimed to evaluate the value of a model combining conventional ultrasonography and clinicopathologic features for predicting axillary status after neoadjuvant therapy in breast cancer.

Methods:
This retrospective study included 329 patients with lymph node-positive who underwent neoadjuvant systemic treatment (NST) from June 2019 to March 2022. Ultrasound and clinicopathological characteristics of breast lesions and axillary lymph nodes were analyzed before and after NST. The diagnostic efficacy of ultrasound, clinicopathological characteristics, and combined model were evaluated using multivariate logistic regression and receiver operator characteristic curve (ROC) analyses.

Results:
The area under ROC (AUC) for the ability of the combined model to predict the axillary pathological complete response (pCR) after NST was 0.882, that diagnostic effectiveness was significantly better than that of the clinicopathological model (AUC of 0.807) and the ultrasound feature model (AUC of 0.795). In addition, eight features were screened as independent predictors of axillary pCR, including clinical N stage, ERBB2 status, Ki-67, and after NST the maximum diameter reduction rate and margins of breast lesions, the short diameter, cortical thickness, and fatty hilum of lymph nodes.

Conclusions:
The combined model constructed from ultrasound and clinicopathological features for predicting axillary pCR has favorable diagnostic results, which allowed more accurate identification of BC patients who had received axillary pCR after NST.

Advances in knowledge:
A combined model incorporated ultrasound and clinicopathological characteristics of breast lesions and axillary lymph nodes demonstrated favorable performance in evaluating axillary pCR preoperatively and non-invasively.