bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential properties of KRAS transversion and transition mutations in non-small cell lung cancer: associations with environmental factors and clinical outcomes
Authors: Sato Koichi , Akamatsu Hiroaki , Koh Yasuhiro , Ogawa Koichi , Isa Shun-ichi , Ando Masahiko , Tamiya Akihiro , Kubo Akihito , Kitagawa Chiyoe , Kawaguchi Tomoya , Yamamoto Nobuyuki 
Published: November 2022

Abstract
Background
KRAS-mutated non-small cell lung cancer (NSCLC) accounts for 23–35% and 13–20% of all NSCLCs in white patients and East Asians, respectively, and is therefore regarded as a major therapeutic target. However, its epidemiology and clinical characteristics have not been fully elucidated because of its wide variety of mutational subtypes. Here, we focused on two distinct base substitution types: transversion mutations and transition mutations, as well as their association with environmental factors and clinical outcome.

Methods
Dataset from the Japan Molecular Epidemiology Study, which is a prospective, multicenter, and molecular study epidemiology cohort study involving 957 NSCLC patients who underwent surgery, was used for this study. Questionnaire-based detailed information on clinical background and lifestyles was also used to assess their association with mutational subtypes. Somatic mutations in 72 cancer-related genes were analyzed by next-generation sequencing, and KRAS mutations were classified into three categories: transversions (G > C or G > T; G12A, G12C, G12R, G12V), transitions (G > A; G12D, G12S, G13D), and wild-type (WT). Clinical correlations between these subtypes have been investigated, and recurrence-free survival (RFS) and overall survival (OS) were evaluated.

Results
Of the 957 patients, KRAS mutations were detected in 80 (8.4%). Of these, 61 were transversions and 19 were transitions mutations. Both pack-years of smoking and smoking duration had significant positive correlation with the occurrence of transversion mutations (p = 0.03 and < 0.01, respectively). Notably, transitions showed an inverse correlation with vegetable intake (p = 0.01). Patients with KRAS transitions had the shortest RFS and OS compared to KRAS transversions and WT. Multivariate analysis revealed that KRAS transitions, along with age and stage, were significant predictors of shorter RFS and OS (HR 2.15, p = 0.01; and HR 2.84, p < 0.01, respectively).

Conclusions
Smoking exposure positively correlated with transversions occurrence in a dose-dependent manner. However, vegetable intake negatively correlated with transitions. Overall, KRAS transition mutations are significantly poor prognostic factors among resected NSCLC patients.
Functional MRI radiomics-based assessment of pelvic bone marrow changes after concurrent chemoradiotherapy for cervical cancer
Authors: Qin Xiaohang , Wang Cong , Gong Guanzhong , Wang Lizhen , Su Ya , Yin Yong 
Published: November 2022

Abstract
Objectives
To quantify the dose-response relationship of changes in pelvic bone marrow (PBM) functional MR radiomic features (RF) during concurrent chemoradiotherapy (CCRT) for patients with cervical cancer and establish the correlation with hematologic toxicity to provide a basis for PBM sparing.

Methods
A total of 54 cervical cancer patients who received CCRT were studied retrospectively. Patients underwent MRI IDEAL IQ and T2 fat suppression (T2fs) scanning pre- and post-CCRT. The PBM RFs were extracted from each region of interest at dose gradients of 5–10 Gy, 10–15 Gy, 15–20 Gy, 20–30 Gy, 30–40 Gy, 40–50 Gy, and > 50 Gy, and changes in peripheral blood cell (PBC) counts during radiotherapy were assessed. The dose-response relationship of RF changes and their correlation with PBC changes were investigated.

Results
White blood cell, neutrophils (ANC) and lymphocyte counts during treatment were decreased by 49.4%, 41.4%, and 76.3%, respectively. Most firstorder features exhibited a significant dose-response relationship, particularly FatFrac IDEAL IQ, which had a maximum dose-response curve slope of 10.09, and WATER IDEAL IQ had a slope of − 7.93. The firstorder-Range in FAT IDEAL IQ and firstorder-10Percentile in T2fs, showed a significant correlation between the changes in ANC counts under the low dose gradient of 5–10 Gy (r = 0.744, -0.654, respectively, p < 0.05).

Conclusion
Functional MR radiomics can detect microscopic changes in PBM at various dose gradients and provide an objective reference for bone marrow sparing and dose limitation in cervical cancer CCRT.
Evaluating diagnostic and management agreement between audiology and ENT: a prospective inter-rater agreement study in a paediatric primary contact clinic
Authors: Eakin Jennifer , Michael Simone , Payten Christopher , Smith Tamsin , Stewart Vicky , Noonan Elle , Weir Kelly A. 
Published: November 2022

Abstract
Background
Ear, Nose and Throat (ENT) primary contact models of care use audiologists as the first triage point for children referred to ENT for middle ear and hearing concerns; and have shown reduced waiting time, improved ENT surgical conversion rates and increased service capacity. This study aimed to investigate ‘safety and quality’ of the model by looking at agreement between audiologists’ and an ENT’s clinical decisions.

Methods
We performed an inter-rater agreement study on diagnosis and management decisions made by audiologists and an ENT for 50 children seen in an Australian hospital’s ENT primary contact service, and examined the nature and patterns of disagreements.

Results
Professionals agreed on at least one site-of-lesion diagnosis for all children (100%) and on the primary management for 74% (Gwet’s AC1 = 0.67). Management disagreements clustered around i) providing ‘watchful waiting’ versus sooner medical opinion (18%), and ii) providing monitoring versus discharge for children with no current symptoms (8%). There were no cases where the audiologist recommended discharge when the ENT recommended further medical opinion.

Conclusions
Our novel research provides further evidence that Audiologist-led primary contact models for children with middle ear and hearing concerns are safe as well as efficient.
A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature
Authors: Sheng Huixue , Chen Guiling , Yang Ming , Guan Hongmei 
Published: November 2022

Abstract
Background
Duplication of the common bile duct (CBD) is extremely rare among the anatomical variations in the biliary tract system, which presents a septum within the CBD or an accessory CBD. In our study, we report a rare case of duplication of the common bile duct combined congenital biliary dilatation.we present a rare case of a septum in the dilated biliary tract.

Case presentation
We reported a 5-year-old Asian girl who had history of repeated abdominal pain for 4 days and aggravated for 1 day. Magnetic resonance cholangiopancreatography (MRCP) examination revealed duplicated common bile duct (DCBD) malformation with congenital biliary dilatation and distal cholelithiasis. The patient underwent choledochal cyst resection and biliary tract reconstruction and abdominal cavity irrigation and drainage under general anesthesia. A septum was found within the common bile duct during the operation. The septum divided the extrahepatic bile duct into two parts connected to the left and right hepatic ducts respectively and the gallbladder is attached to the repeated right bile duct which was not previously reported in the literature.

Conclusions
We complement and adjust the classification of common bile duct duplication by reviewing the literature.
Effect of AI-assisted software on inter- and intra-observer variability for the X-ray bone age assessment of preschool children
Authors: Zhao Kai , Ma Shuai , Sun Zhaonan , Liu Xiang , Zhu Ying , Xu Yufeng , Wang Xiaoying 
Published: November 2022

Abstract
Background
With the rapid development of deep learning algorithms and the rapid improvement of computer hardware in the past few years, AI-assisted diagnosis software for bone age has achieved good diagnostic performance. The purpose of this study was to investigate the effect of AI-assisted software on residents’ inter-observer agreement and intra-observer reproducibility for the X-ray bone age assessment of preschool children.

Methods
This prospective study was approved by the Institutional Ethics Committee. Six board-certified residents interpreted 56 bone age radiographs ranging from 3 to 6 years with structured reporting by the modified TW3 method. The images were interpreted on two separate occasions, once with and once without the assistance of AI. After a washout period of 4 weeks, the radiographs were reevaluated by each resident in the same way. The reference bone age was the average bone age results of the three experts. Both TW3-RUS and TW3-Carpal were evaluated. The root mean squared error (RMSE), mean absolute difference (MAD) and bone age accuracy within 0.5 years and 1 year were used as metrics of accuracy. Interobserver agreement and intraobserver reproducibility were evaluated using intraclass correlation coefficients (ICCs).

Results
With the assistance of bone age AI software, the accuracy of residents’ results improved significantly. For interobserver agreement comparison, the ICC results with AI assistance among 6 residents were higher than the results without AI assistance on the two separate occasions. For intraobserver reproducibility comparison, the ICC results with AI assistance were higher than results without AI assistance between the 1st reading and 2nd reading for each resident.

Conclusions
For preschool children X-ray bone age assessment, in addition to improving diagnostic accuracy, bone age AI-assisted software can also increase interobserver agreement and intraobserver reproducibility. AI-assisted software can be an effective diagnostic tool for residents in actual clinical settings.
Public preferences regarding the priority setting criteria of health interventions for budget allocation: results of a survey of Iranian adults
Authors: Darvishi Ali , Daroudi Rajabali , Yaseri Mehdi , Sari Ali Akbari 
Published: November 2022

Abstract
Objectives
Priority setting in health directly impacts the general public as payers and final consumers, so the public preferences must be considered. The present study aimed to provide public preferences about health intervention allocation criteria for the optimal allocation of public health budget in Iran.

Methods
A choice-based survey method was used to assess the general public’s preferences regarding 8 critical criteria with a societal aspect. One thousand sixty-four adult citizens of Tehran, Iran, participated in the study. Participants were asked to allocate a hypothetical budget between the two groups with differences in allocation criteria. Public preferences were inferred from absolute majority responses i.e., more than 50% of participants’ allocation for a criterion. The Logistic Regression Model was used to investigate the factors affecting the preferences regarding the importance of allocation criteria.

Results
Based on expressed participants’ preferences, criteria of disease severity, age, daily care needs, Number of alternative interventions, individual’s economic status, and diseases with absence from work were important. Thus, 77, 69, 61, 57, 54, and 51% of participants preferred to allocate the hypothetical budget to the treatment of patients with poor economic status, treatment of patients with diseases leading to absence from work, treating patients with severe diseases, treatment of diseases in need of daily care and treatment of children’s diseases, respectively. Findings from the factors affecting participants’ preferences regarding allocation criteria also showed that people with different characteristics had different preferences.

Conclusions
Iranian general public pays special attention to the criteria of equitable allocation, including patients’ economic status, criteria with societal aspects such as absenteeism from work and the need for daily care, as well as criteria with medical aspects such as disease severity and access to alternative interventions which may sometimes be less considered in decision making.
Developmental disparities in sedentary time by period of the day among US youth: a cross-sectional study
Authors: Santiago-Rodríguez María Enid , Chen Jinsong , Pfeiffer Karin A. , Marquez David X. , Odoms-Young Angela , Bustamante Eduardo Esteban 
Published: November 2022

AbstractBackgroundDefinitive evidence shows sedentary time (ST) is an independent risk factor for chronic disease, irrespective of physical activity. Despite calls to limit youth ST, studies demonstrate a spike in ST at the transition from childhood to adolescence. Identifying periods of the day (e.g., before school, during school, afterschool, and evenings) during which ST is higher in adolescents vs. children—that is, specifying when within daily routines ST disparities emerge—may be important to inform intervention strategies, as periods of the day correspond with variations in setting and supervision. The purpose of this study was to examine device-assessed ST engagement by period of day and developmental stage in a nationally representative sample of United States youth.MethodsYouth (N = 2,972 between 6–18 years) from the 2003–2004 and 2005–2006 waves of NHANES reported demographic variables and wore an accelerometer for seven consecutive days to determine ST. Linear regression analyses were applied to study associations between ST and developmental stage (childhood or adolescence) by period of the week and weekend days, while controlling for sex, race/ethnicity, annual family income, and body mass index.ResultsAdjusted linear regressions (p-values < 0.0001) showed that adolescents were more sedentary than children during school, afterschool, and weekday evening periods as well as all the weekend periods. However, during school (36.3 ± 7.3 vs. 28.2 ± 7.2 min/hour; b = -7.4 [-8.1, -6.6]) and afterschool periods (31.1 ± 7.7 vs. 22.7 ± 7.0 min/hour; b = -7.8 [-8.6, -7.0]) showed the largest weekly ST disparities by developmental stage. Overall, the during school and after school hours constitute most (during school = 35% and afterschool = 16%) of the weekly ST disparity between children and adolescents.ConclusionsOur data provide interventionists with estimates of the potential for ST reduction in each setting and period of the day among US adolescents. Future research should gather information about the barriers and facilitators of ST in adolescents by period of the day to help understand factors driving disparities.
Prediction of exercise-induced desaturation in COPD patients without resting hypoxemia: a retrospective study
Authors: Yang Lulu , Shi Minghui , Situ Xuanming , He Jiaze , Qumu Shiwei , Yang Ting 
Published: November 2022

AbstractBackgroundThere is no universally accepted criterion for assessing exercise-induced desaturation (EID). The purpose of this study is to compare the two methods regularly used for determining EID in COPD patients, as well as to explore the risk factors and predictors related to EID.MethodsThe 6MWT was performed with continuous SpO2monitoring on patients with stable COPD. Using two methods (method A: “SpO2rest–SpO2min ≥ 4% and/or SpO2min < 90%”, method B: “SpO2rest–SpO2end ≥ 4% and/or SpO2end < 90%”) as EID determination criteria to assess the incidence of EID. The differences and consistency of the two methods are compared. Moreover, we collected data through the pulmonary function test, mMRC dyspnea score, COPD assessment test, BODE index and CT-defined emphysema. Univariate and multivariate logistic regression analyses were used to identify factors affecting the EID. For the parameters that predict EID in 6MWT, a receiver operating characteristic (ROC) curve analysis was employed.ResultsThe analysis included 124 patients. The overall incidence of EID was 62.1% by using method A as the criterion and 51.6% by method B. All of the EID patients found by method B were included in the EID patients identified by method A, as well as 13 new-EID patients. The difference in diagnostic outcomes between the two approaches was not statistically significant (P > 0.05), but they were in excellent agreement (Kappa = 0.807,P = 0.001). Logistic regression analyses found that DLCO SB% pred, DLCO/VA% pred, CAT score, mean density, PD15, emphysema volume and %LAA were significant determinants of the EID. For predicting EID, the ROC analysis produced AUC and cutoffs of 0.689 and 50.45% (DLCO SB% pred), 0.707 and 75.0% (DLCO/VA% pred), 0.727 and 15 points (CAT score), 0.691 and − 955.00HU (PD15), 0.671 and − 856.46HU (mean density), 0.668 and 338.14 ml (emphysema volume) and 0.656 and 7.63% (%LAA), respectively.ConclusionsTwo methods evaluating EID in this research are in a good agreement, method A can find more EID patients by focusing on SpO2min.When conditions are constrained, it is also sufficient to assess EID in COPD patients by method B. In terms of the predictors of EID, DLCO SB% pred, DLCO/VA% pred, CAT score and CT-defined emphysema are all statistically significant test variables to determine EID.
The use of video consultations to support orthopedic patients' treatment at the interface of a clinic and general practitioners
Authors: K Estel , L Richter , G Weber , F Fellmer , S Märdian , C Willy , DA Back 
Published: November 2022

Abstract
Introduction
Video consultations have proven to be a powerful support tool for patient–doctor interactions in general, not only during the COVID-19 pandemic. This study analyzed the feasibility and usefulness of orthopedic telemedical consultations (OTCs) for orthopedic patients at the interface of a clinic and general practitioners.

Methods
The study was carried out at an orthopedic department of a German hospital between April 2020 and October 2020. After written informed consent was obtained, general practitioners (GPs) of a large adjunct health region could present their patients with orthopedic pathologies to specialists at the hospital via OTCs instead of the usual live consultation (LC). The patients, specialists and GPs were evaluated for their OTC experience and attitude (5-point Likert-scale and open questions, 19 to 27 items).

Results
A total of 89 video consultations took place with 76 patients, 16 GPs and six specialists. The average distance between the GPs/patients and the hospital was 141.9 km. The OTCs were rated as pleasant, and the experience was rated as very satisfying (average Likert-Scale rating, with 5 as strong agreement: specialists = 4.8; GPs = 4.9; patients = 4.7). Following the OTC, a LC was not necessary in 76.4% of cases. Patients with a necessary LC after an OTC showed significantly lower satisfaction with the OTC (p = 0.005). Time savings, the elimination of travel and quick contact with orthopedic consultants were positively highlighted by the participants. A total of 123 recommendations for further treatment were given, such as the initiation of physiotherapy/medication and the use of imaging diagnostics. Different technical and organizational challenges could be identified and addressed.

Discussion
The vast majority of the participants stated they had a very positive impression. In particular, the potential savings in travel and time as well as straightforward contact with specialists were rated positively. However, limitations in the assessment of initial presentations of complex medical conditions were also highlighted. Further studies on OTCs with a consultative health professional may show other fields of use for this mode of interdisciplinary remote communication.
Sagittal intervertebral rotational motion: a deep learning-based measurement on flexion–neutral–extension cervical lateral radiographs
Authors: Yan Yuting , Zhang Xinsheng , Meng Yu , Shen Qiang , He Linyang , Cheng Guohua , Gong Xiangyang 
Published: November 2022

AbstractBackgroundThe analysis of sagittal intervertebral rotational motion (SIRM) can provide important information for the evaluation of cervical diseases. Deep learning has been widely used in spinal parameter measurements, however, there are few investigations on spinal motion analysis. The purpose of this study is to develop a deep learning-based model for fully automated measurement of SIRM based on flexion–neutral–extension cervical lateral radiographs and to evaluate its applicability for the flexion–extension (F/E), flexion–neutral (F/N), and neutral–extension (N/E) motion analysis.MethodsA total of 2796 flexion, neutral, and extension cervical lateral radiographs from 932 patients were analyzed. Radiographs from 100 patients were randomly selected as the test set, and those from the remaining 832 patients were used for training and validation. Landmarks were annotated for measuring SIRM at five segments from C2/3 to C6/7 on F/E, F/N, and N/E motion. High-Resolution Net (HRNet) was used as the main structure to train the landmark detection network. Landmark performance was assessed according to the percentage of correct key points (PCK) and mean of the percentage of correct key points (MPCK). Measurement performance was evaluated by intra-class correlation coefficient (ICC), Pearson correlation coefficient, mean absolute error (MAE), root mean square error (RMSE), and Bland-Altman plots.ResultsAt a 2-mm distance threshold, the PCK for the model ranged from 94 to 100%. Compared with the reference standards, the model showed high accuracy for SIRM measurements for all segments on F/E and F/N motion. On N/E motion, the model provided reliable measurements from C3/4 to C6/7, but not C2/3. Compared with the radiologists’ measurements, the model showed similar performance to the radiologists.ConclusionsThe developed model can automatically measure SIRM on flexion–neutral–extension cervical lateral radiographs and showed comparable performance with radiologists. It may provide rapid, accurate, and comprehensive information for cervical motion analysis.
Nonunion of humeral medial condyle fracture caused by excessive functional exercise: a case report and review of the literature
Authors: Yang Liu , Xia Feng , Guo Jia-chao , Wang Xiao-lin , He Jin-peng , Shao Jing-fan 
Published: November 2022

Abstract
Background
Medial epicondyle fractures are one of the more common humerus fractures, but humeral medial condyle fracture (HMCF) is rare. Nonunion of medial humeral condyle fractures due to functional exercise is less common.

Case presentation
We report a 5-year-old patient with a nonunion HMCF due to excessive functional exercise, who bruised the elbow 1 year ago and had no positive findings on all imaging studies. On this physical examination, there was a snapping and palpable lump in the elbow joint during movement, but the patient did not feel any discomfort and the range of motion of the joint was normal. X rays and computed tomography (CT) showed that the left HMCF was discontinuous, the broken ends were dislocated, and the joint alignment was poor. Open reduction (OR) and screw fixation was used during the operation, and the patient recovered well at 3-month follow-up.

Conclusions
The rarity and low radiographic appearance of displaced HMCF are easily overlooked and can eventually lead to nonunion HMCF, especially when radiographically difficult to visualize before age 5 years. Therefore, regardless of whether there are signs or imaging abnormalities in the growth process of adolescents, they should be vigilant, shorten the time interval for re-examination, and early detection and timely treatment can avoid some complications caused by this.