Standard Methodology Research Articles

Comprehensive Echocardiographic Protocol for Pigs with Emphasis on Diastolic Function: Advantages over MRI Assessment.

Swine are increasingly utilized in cardiovascular research due to their anatomical and physiological similarities to humans, particularly for studying diastolic dysfunction. While MRI offers excellent structural imaging, echocardiography provides superior real-time assessment of diastolic parameters. To address the lack of standardized methods and reduce variability across studies, we present a comprehensive guide for performing echocardiography in Yorkshire pigs, detailing anatomical considerations, equipment requirements, and technical approaches. We describe systematic approaches for obtaining and optimizing right parasternal long and short-axis views, apical four-chamber, and subcostal imaging windows, with specific attention to anatomical variations from human cardiac orientation and standard clinical transducer positioning. These tomographic views enable comprehensive assessment of systolic and diastolic function, including ventricular volumes, wall thicknesses, chamber dimensions, ejection fraction, and Doppler measurements of blood flow and tissue velocities. This standardized methodology for echocardiographic images acquisition enhances data reliability in cardiovascular pig models, improving the interpretation of preclinical study results and strengthening translational research outcomes. The protocol also provides consistency for veterinary applications, making echocardiography a preferred modality for longitudinal studies in this valuable translational model.

Dynamic Contrast-enhanced MRI Processing Comparison for Distinguishing True Progression From Pseudoprogression in High-grade Glioma.

Treatment-related changes may occur due to radiation and temozolomide in glioblastoma and can mimic tumor progression on conventional MRI. DCE-MRI enables quantification of the extent of blood-brain barrier (BBB) disruption, providing information about areas of suspicious postcontrast T1 enhancement. We compared DCE-MRI processing methods for distinguishing true disease progression from pseudoprogression in high-grade gliomas (HGGs). We identified 110 patients with HGG treated with surgery and chemoradiation who underwent DCE-MRI to further interrogate areas of new/increasing enhancement. All patients had confirmatory surgery/biopsy with pathology-confirmed progression or pseudoprogression. Scans were performed at 3T and analyzed using nordicICE. The MCA, SSS, and Parker models are three standardized processing methodologies used to create ktrans maps, a parameter that quantifies BBB permeability. Three equal regions of interest were placed at sites of peak contrast enhancement within each lesion. Data from each method was processed for mean and maximum ktrans. We conducted several rounds of analysis and finalized a strategy on penalized support vector machines based on engineered features with bootstrap sampling. The Parker method was significant for ktrans maximum in the combined pathology and clinical as well as the pathology-only data sets. MCA and SSS did not perform well under the SVM classifier for pathology only. For clinical follow-up subjects, the Parker method yielded statistically significant results for maximum and mean ktrans. The Parker method was effective in distinguishing PD and PsP for pathology and clinical data sets. MCA and SSS techniques were effective for the clinical data set.

Extracellular vesicles in malaria: proteomics insights, in vitro and in vivo studies indicate the need for transitioning to natural human infections.

Globally, an estimated 2.1 billion malaria cases and 11.7 million malaria deaths were averted in the period 2000-2022. Noticeably, despite effective control measurements, in 2022 there were an estimated 249 million malaria cases in 85 malaria-endemic countries and an increase of 5 million cases compared with 2021. Further understanding the biology, epidemiology, and pathogenesis of human malaria is therefore essential for achieving malaria elimination. Extracellular vesicles (EVs) are membrane-enclosed nanoparticles pivotal in intercellular communication and secreted by all cell types. Here, we will review what is currently known about EVs in malaria, from biogenesis and cargo to molecular insights of pathophysiology. Of relevance, a meta-analysis of proteomics cargo, and comparisons between in vitro and in vivo human studies revealed striking differences with those few studies reported from patients. Thus, indicating the need for rigor standardization of methodologies and for transitioning to human infections to elucidate their physiological role. We conclude with a focus on translational aspects in diagnosis and vaccine development and highlight key gaps in the knowledge of EVs in malaria research.

T1 signal intensity ratio variability based on sampling strategies in the pancreas of children and young adults.

T1-weighted signal intensity ratios (SIR) comparing pancreas to spleen (SIRps) or muscle (SIRpm) can semiquantitatively assess T1 signal change associated with pancreatitis. However, there is no standardized methodology for generating these ratios. We set out to determine the impact of MRI sequence as well as region of interest (ROI) location, shape, and size on T1 SIR. Retrospective analysis of T1-weighted MR images from 118 patients acquired 2018-2023. A single observer placed ovoid ROIs in the pancreas body/tail and head/uncinate, spleen, and left erector spinae muscle and large irregular ROIs in the pancreas tail and spleen. ROIs were placed on images from two sequences: 3D radial 2 point mDIXON RF spoiled gradient recalled echo sequence (radial) and breath-hold 3D 2-point mDIXON RF spoiled gradient echo (BH). T1 SIR were calculated from mean signal intensity, and agreement was calculated with intraclass correlations coefficients (ICC) and Bland-Altman difference analyses. 118 participants, 57 (48%) female, withmean age 13.7 ± 5.6years (48%) were included. Agreement was good for SIRps based on irregular versus round ROIs (radial: ICC = 0.90; BH: ICC = 0.91). Agreement was moderate for SIR based on sampling the pancreas body/tail versus head/uncinate (ICC = 0.67-0.76) and poor to moderate based on reference organ (muscle vs. spleen) (ICC = 0.41-0.61). Between sequences, agreement was moderate (ICC = 0.55-0.72, mean difference 0.04-0.09). The size and shape of the ROI used to sample the pancreas does not meaningfully change T1 SIR but the location sampled, the reference organ used, and the MRI sequence used meaningfully change T1 SIR, potentially impacting disease diagnosis and staging.

Life Cycle Sustainability Assessment of Buildings: A Scientometric Analysis

The significant environmental impact of the built environment, particularly concerning energy use, carbon emissions, and material consumption, coupled with its economic and social implications, has driven the demand for sustainable buildings. Life Cycle Sustainability Assessment (LCSA) offers a comprehensive approach to evaluating sustainability performance by integrating environmental, economic, and social dimensions across the building life cycle. However, the application of LCSA frameworks in the buildings sector remains limited due to the challenges in harmonizing different sustainability dimensions and addressing methodological inconsistencies. This study employs a scientometric analysis to systematically examine the research landscape on LCSA for buildings. Bibliographic records from the Scopus and Web of Science databases (1999–2024) were systematically analyzed using science mapping techniques and tools, including VOSviewer, CiteSpace, and Gephi. The analysis identifies key research trends, conceptual developments, influential academic sources, and collaboration patterns at the country level. The findings reveal a multi-faceted research landscape characterized by a predominance of environmental assessments, increasing attention to economic and social dimensions, the development of BIM-related methodologies, and emerging trend towards dynamic LCSA. Persistent barriers include insufficient standardization of methodologies, limited data availability, and the fragmented incorporation of the environmental, economic, and social dimensions of sustainability. The findings emphasize the need for advancing LCSA frameworks to achieve more effective integration of the triple bottom line, enabling robust decision-making and advancing sustainability in the built environment.

Abstract IA08: Theragnostics & external beam radiation dose absorbed - Similarities, differences and thoughts for the future

Abstract External Beam Radiotherapy (EBRT) and theragnostics share a key core characteristic – the use of radiation to exert its therapeutic benefit. However, the role radiation dose absorbed plays is significantly different between these two modalities in clinical practice. On the one hand it is a critical element of EBRT prescriptions (e.g. cGy), while on the other it is not even a requirement to document in theragnostic practices, where prescriptions are expressed as administered activities (e.g. GBq). Radiation dose absorbed by tumor and normal tissues is recognized to be variable across patients. It is acknowledged to be a critical metric in the safe use of radiopharmaceuticals and is required for all first in human studies and a priority for the development of any novel radiopharmaceutical. The process of individualized dosimetry is well described, enabling radiation dose absorbed estimates to regions of interest. There is an active debate currently as to when, in whom and how individualized dosimetry should be incorporated into clinical practice. The lack of high quality evidence to support radiation dose absorbed to patient outcomes, the lack of standardized methodologies to enable comparability of dose absorbed data across institutions, the burden on patients to return for dosimetry scans post treatment, the burden on the health care system to incorporate individualized dosimetry into treatment workflows and the lack of reimbursement codes for these activities are the main barriers cited against routine clinical use. In this session, we will review some of the theoretical and logistic considerations as well as evidence behind this debate. We will also take a broader view, of theragnostics as a rapidly growing modality, that patients and their oncology teams would need radiation absorbed dose information when considering “re-irradiation”, be it re-challenge with theragnostics, or to provide safety estimates when using different forms of radiation along patients’ cancer journey in the real world. Through a recently completed multi-center trial as a case study, we will review the processes involved in setting up individualized dosimetry across four academic institutions and our subsequent transition into standard of care. We will discuss the value of radiation dose information for our patients, at the systems and academic levels. Finally, we will consider radiation dose absorbed in the future of theragnostics - as a prognostic factor for response and toxicity, as a factor in understanding the mechanism of treatment resistance, as a strategy to create novel dosing approaches and as part of combined modality to strive for superior patient outcomes. We propose that we are at a critical time, where a collaborative strategy across theragnostic practices is critical. The adoption of the reporting of radiation dose absorbed as a quality metric, blending lessons learned across theragnostics and EBRT will set the stage for the future with excellent quality of care and accelerated discoveries for our patients. (458 words). Citation Format: Rebecca K.S. Theragnostics & external beam radiation dose absorbed - Similarities, differences and thoughts for the future. [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Targeted Therapies in Combination with Radiotherapy; 2025 Jan 26-29; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(2_Suppl):Abstract nr IA08

Postoperative accuracy quantification of corrective osteotomies: standardisation of Q3D-CT methodology

PurposeCurrently, no gold standard exists for 3D analysis of virtually planned surgery accuracy postoperatively. The aim of this study was to present a new, validated and standardised methodology for 3D postoperative assessment of surgical accuracy in patients undergoing 3D virtually planned and guided corrective osteotomies.MethodsAll patients who underwent 3D planned corrective osteotomy in 2021–2022 at our center with a postoperative CT were included. Postoperative surgical outcome was analysed with a postoperative CT and compared to the preoperative virtual surgical planning to determine achieved accuracy. Validation of the analysis was performed by evaluating the individual assessment of six experienced observers. A postoperative quantification was performed according to the proposed innovative methodology based on rotation axes of a virtual postoperative bone model aligned to the virtual preoperative bone model and virtual surgical planned bone model. To evaluate the intra-observer variability, one observer performed the assessment twice.ResultsQuantification of 13 patients according resulted in measurements with a median range (and its interquartile range) for 3D translation of: 2.43 mm (3.17), for the angle deviations: 3D rotation, 2D coronal, 2D sagittal and 2D axial were: 0.66° (1.66°), 0.74° (0.44°), 0.99° (1.27°), 2.37° (5.00°), respectively. The inter- and intraobserver reliability established with the Intraclass correlation coefficient was for all measurements excellent (> 0.76).ConclusionThe proposed 3D CT technique provides an significant more accurate and objective method for assessment of surgical outcome of a guided corrective osteotomy. The present proposed novel methodology showed excellent inter- and intra-observer reliability with clinically acceptable absolute surgical outcome measurements.

The role of ultrasound combined with water bath in the establishment of animal models of rat urethral stricture

Urinary tract injuries represent a significant clinical challenge, necessitating precise diagnosis and effective treatment strategies. Rat models are preferred for studying urinary tract injuries due to their size, visibility of external genitalia, and robust reproductive and growth capabilities. However, there is a lack of standardized methodologies for evaluating the endpoints of rat urinary tract injury models. This study aimed to investigate the methodology of model establishment, imaging evaluation techniques, and endpoint effectiveness. Twenty-four male Sprague-Dawley rats were randomly assigned to groups, including a blank control group and surgical groups. The surgical groups underwent urethral injury induced by recombinant transforming growth factor-β1 (TGF-β1) solution, followed by the random selection of one surgical group (n = 6) to receive treatment with mesenchymal stem cell (MSC) exosomes. High-frequency ultrasonography using a GE E10 device combined with a water bath method was employed to evaluate the urethral conditions of all rats. Ultrasonographic characteristics were scored for all surgical group rats, and an intergroup analysis was conducted between the surgical group and the control group rats. Statistical analysis was conducted using SPSS 22.0 software. Ultrasonographic assessment revealed significant differences in urethral echogenicity between the normal group and the surgical group, with noticeable changes in urethral morphology post-injury. Histopathological examination confirmed more severe urethral stenosis in the TGF group compared to the MSC group. High-frequency ultrasound could effectively differentiate between the two groups of rats. Additionally, there were significant differences in the scoring of ultrasonographic characteristics between the two groups. Urethral stricture presents a complex challenge in urology, often requiring invasive treatment modalities. The establishment of animal models plays a crucial role in understanding and addressing this condition. TGF-β1 induced fibrosis and MSC therapy represent promising avenues for urethral stricture management. High-frequency ultrasound combined with the immersion method offers a non-invasive and cost-effective approach for evaluating rat urethral stricture models. This study highlights the practicality of high-frequency ultrasound combined with the water bath method in evaluating rat urethral stricture models, as it can effectively differentiate between rats in the pure TGF-β1 induced group and those in the MSC treatment group based on urethral changes. The results underscore the importance of standardized methodologies for model assessment and the potential of non-invasive imaging techniques in preclinical research. Overall, this study contributes to advancing our understanding of urinary system injuries and holds implications for future therapeutic interventions in urology.

Systematic review of multidrug-resistant Klebsiella pneumoniae in the Arabian Peninsula: molecular epidemiology and resistance patterns

BackgroundThe rapid emergence of multidrug-resistant Klebsiella pneumoniae (MDR K. pneumoniae) is a major public health and economic burden worldwide. Various resistance mechanisms complicate treatment, leading to increased morbidity and mortality. Despite numerous studies conducted in Gulf Health Council (GHC) countries, the molecular epidemiology of MDR K. pneumoniae remains not clearly defined. This systematic review aims to analyze the emergence of antimicrobial resistance genes in MDR K. pneumoniae across GHC countries.MethodsA systematic search was conducted using PubMed, ScienceDirect, and OpenMD for articles published up to March 15, 2023. The search strategy focused on the bacterial name, drug-resistance genotypes, and GHC countries. The review followed PRISMA guidelines, with two independent reviewers assessing the risk of bias using NIH Study Quality Assessment tools.ResultsThe primary search yielded 1,663 studies, of which 67 met the inclusion criteria. Saudi Arabia contributed the most studies, with 41 (61.1%), followed by Kuwait with 7 (10.4%), and the UAE with 6 (9%) studies. Oman and Qatar each contributed 4 studies (6%), and Bahrain contributed three studies (4.5%). The remaining 4 studies (4.4%) were from multiple GHC countries. The studies exhibited considerable heterogeneity in detection methods, target genes, and resistance mechanisms. Notably, only one environmental study was conducted in the UAE, and one community-based study in Kuwait, while the remaining studies focused on clinical samples. Various resistance mechanisms and patterns were observed between countries and across different years within the same country. The review highlighted the widespread prevalence of ESBL genes, particularly blaTEM and blaCTX-M-15, and the emergence of carbapenemase genes such as blaOXA-48 and blaNDM-1 and blaKPC-2. Additionally, colistin resistance through the mcr-1 gene and mgrB mutations was reported in Saudi Arabia and the UAE, posing a significant public health challenge.ConclusionData from GHC countries shows significant gaps, particularly in community and environmental and molecular epidemiology studies. Limited molecular and genome-based investigations hinder comprehensive AMR surveillance. Implementing standardized methodologies and fostering molecular and genome-based AMR surveillance programs at both national and regional levels within the GHC are essential for effectively combating the spread of MDR K. pneumoniae and improving public health outcomes in the region.

Worldwide epidemiology of paediatric multiple sclerosis: data from the Multiple Sclerosis International Federation Atlas of MS, third edition

BackgroundLimited data are available on the global rates of paediatric multiple sclerosis. Here, we report on the estimated worldwide prevalence of paediatric MS.MethodsWe included paediatric prevalence data in 2020–2022 (Multiple...

Translation of PET radiotracers for cancer imaging: recommendations from the National Cancer Imaging Translational Accelerator (NCITA) consensus meeting

BackgroundThe clinical translation of positron emission tomography (PET) radiotracers for cancer management presents complex challenges. We have developed consensus-based recommendations for preclinical and clinical assessment of novel and established radiotracers, applied to image different cancer types, to improve the standardisation of translational methodologies and accelerate clinical implementation.MethodsA consensus process was developed using the RAND/UCLA Appropriateness Method (RAM) to gather insights from a multidisciplinary panel of 38 key stakeholders on the appropriateness of preclinical and clinical methodologies and stakeholder engagement for PET radiotracer translation. Panellists independently completed a consensus survey of 57 questions, rating each on a 9-point Likert scale. Subsequently, panellists attended a consensus meeting to discuss survey outcomes and readjust scores independently if desired. Survey items with median scores ≥ 7 were considered ‘required/appropriate’, ≤ 3 ‘not required/inappropriate’, and 4–6 indicated ‘uncertainty remained’. Consensus was determined as ~ 70% participant agreement on whether the item was ‘required/appropriate’ or ‘not required/not appropriate’.ResultsConsensus was achieved for 38 of 57 (67%) survey questions related to preclinical and clinical methodologies, and stakeholder engagement. For evaluating established radiotracers in new cancer types, in vitro and preclinical studies were considered unnecessary, clinical pharmacokinetic studies were considered appropriate, and clinical dosimetry and biodistribution studies were considered unnecessary, if sufficient previous data existed. There was ‘agreement without consensus’ that clinical repeatability and reproducibility studies are required while ‘uncertainty remained’ regarding the need for comparison studies. For novel radiotracers, in vitro and preclinical studies, such as dosimetry and/or biodistribution studies and tumour histological assessment were considered appropriate, as well as comprehensive clinical validation. Conversely, preclinical reproducibility studies were considered unnecessary and ‘uncertainties remained’ regarding preclinical pharmacokinetic and repeatability evaluation. Other consensus areas included standardisation of clinical study protocols, streamlined regulatory frameworks and patient and public involvement. While a centralised UK clinical imaging research infrastructure and open access federated data repository were considered necessary, there was ‘agreement without consensus’ regarding the requirement for a centralised UK preclinical imaging infrastructure.ConclusionsWe provide consensus-based recommendations, emphasising streamlined methodologies and regulatory frameworks, together with active stakeholder engagement, for improving PET radiotracer standardisation, reproducibility and clinical implementation in oncology.

Efficacy and Safety of Endovenous Microwave Ablation versus Endovenous Laser Ablation for Varicose Veins in Chronic Great Saphenous Vein Insufficiency: A Meta-Analysis.

Although guidelines have established endovenous laser ablation (EVLA) as the first-line option for patients with varicose veins (VVs) in chronic Great saphenous vein (GSV) insufficiency, however, Chronic Vein Insufficiency (CVI) remains a significant healthcare burden. Endovenous microwave ablation (EMA) is a promising alternative. This review aims to analyze the Endovenous Microwave Ablation versus Endovenous Laser Ablation for Varicose Veins in Chronic Great Saphenous Vein Insufficiency METHODS: Randomized controlled trials (RCTs) and cohort studies across PubMed, Scopus, Science Direct, and the Cochrane Library up to November 11, 2024 was searched. Risk of bias was evaluated using Cochrane Risk of Bias Tool for RCT and Newcastle-Ottawa Scale (NOS) for Cohort studies. Meta-analysis was done using RevMan 5.4.0 using an inverse-variance random-effects model with Duval and Tweedie trim-and-fill sensitivity analysis. Overall, a total of 2 RCTs and 1 cohort study included. In treating GSV VVs, EMA has proven to have shorter duration of operation significantly compared to EVLA (MD: -6.62 [95% CI: -11.91, -1.32, p = 0.01]) although heterogeneity is high. EMA have similar profiles in efficacy compared to EVLA (Aberdeen score of QoL, VAS Score, length of hospital stays, and recanalization rate in 6-months). In terms of safety, the incidence of ecchymosis was found to be lower in the EMA group compared to the EVLA group significantly (OR: 0.58). Other safety profiles were found to be similar. EMA might lower operating time, potentially reducing procedure risks, and is equally effective as EVLA in treating VVs in chronic GSV insufficiency. Further research comparing these techniques with extended follow-up periods (over 12 months) and standardized study methodologies are still needed.

Lymph Node Staging and Treatment in Pediatric Patients With Soft Tissue Sarcomas: A Consensus Opinion from the Children's Oncology Group, European paediatric Soft tissue sarcoma Study Group, and the Cooperative Weichteilsarkom Studiengruppe.

Accurate staging of nodal involvement in pediatric sarcoma patients is important to determine correct systemic and local therapy, with the goal to reduce subsequent recurrences. However, differences in lymph node staging strategies, definitions, and treatment protocols between the Children's Oncology Group (COG), European paediatric Soft tissue sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS) complicate comparisons. In this article, we aim to establish internationally recognized recommendations for lymph node assessment and treatment of children and adolescents diagnosed with rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) according to the Consensus Conference Standard Operating Procedure methodology.

Unveiling the silent battle: suicide rates among law enforcement personnel

ABSTRACT Accurately calculating suicide rates among law enforcement officers has been a longstanding challenge. Since 2016, the nonprofit organization First H.E.L.P. has implemented a standardized and rigorous methodology to collect data on public safety personnel suicides. This study utilizes First H.E.L.P.‘s data to examine suicide rates among sworn law enforcement officers from 2016 to 2022, disaggregated by year, sex, and geographic region and division. Findings reveal an average suicide rate of 21.4 per 100,000 officers over the seven-year period, with male officers showing a significantly higher rate (22.7) than their female counterparts (12.7). Regionally, the Midwest (27.5) and Northeast (24.0) had higher suicide rates than the South (19.4) and West (19.7), although variation was noted across divisions within these regions. The paper concludes by exploring potential reasons for these discrepancies and highlighting the potential benefits of systematic data collection in improving our understanding of law enforcement officer suicides.

Leveraging Epigenetic Alterations in Pancreatic Ductal Adenocarcinoma for Clinical Applications.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy characterized by late detection and poor prognosis. Recent research highlights the pivotal role of epigenetic alter- ations in driving PDAC development and progression. These changes, in conjunction with genetic mutations, contribute to the intricate molecular landscape of the disease. Specific modifications in DNA methylation, histone marks, and non-coding RNAs are emerging as robust predictors of disease progression and patient survival, offering the potential for more precise prognostic tools compared to conventional clinical staging. Moreover, the detection of epigenetic alterations in blood and other non-invasive samples holds promise for earlier diagnosis and improved manage- ment of PDAC. This review comprehensively summarises current epigenetic research in PDAC and identifies persisting challenges. These include the complex nature of epigenetic profiles, tumour hetero- geneity, limited access to early-stage samples, and the need for highly sensitive liquid biopsy technologies. Addressing these challenges requires the standardisation of methodologies, integra- tion of multi-omics data, and leveraging advanced computational tools such as machine learning and artificial intelligence. While resource-intensive, these efforts are essential for unravelling the functional consequences of epigenetic changes and translating this knowledge into clinical appli- cations. By overcoming these hurdles, epigenetic research has the potential to revolutionise the management of PDAC and improve patient outcomes.

Determining the Role of Urban Greenery in Soil Hydrology: A Bibliometric Analysis of Nature-Based Solutions in Urban Ecosystem

Nature-based solutions play an essential role in enhancing urban soil hydrology by improving water retention properties, reducing surface runoff, and improving water infiltration. This bibliometric analysis study reviewed the literature and identified the current trends in research related to nature-based solutions in urban soil hydrology. The study has the potential to highlight current research areas and future hot topics in this specific field. The research used the Scopus database to collect published articles from 1973 to 2023. The keywords (“trees” OR “vegetation” OR “green infrastructure” OR “blue green infrastructure” OR “greenery” OR “nature-based solutions” AND “hydrolog*” AND “urban” OR “city” OR “soil”) were searched in the Scopus database, and 13,276 articles were retrieved. The obtained publications were analyzed for bibliometric analysis by using Bibliometrix (v4.3.0) and VOSviewer (v1.6.20) software. The maximum number of publications (970) related to nature-based solutions and urban soil hydrology was published in 2023. Additionally, countries such as the United States and China published 54.2% of articles of the global research in the field of nature-based solutions and urban soil hydrology, with 36% from the USA and 18.2% of articles from China. The bibliometric analysis depicted that Beijing Normal University led this specific research field with 540 articles. The top country in terms of collaboration was the USA, with 26.17% as compared to the global countries. The most productive researcher identified was Jackson, T.J., as he had the highest number of publications, showing his considerable contribution to the field. Furthermore, the most frequent keywords used in this research area were hydrology, ecosystem services, urban hydrology, remote sensing, nature-based solutions, climate change, runoff, stormwater management, water quality, vegetation, green roof, bioretention, and land use. The early research trending topics in this field from 2015 to 2023 were remote sensing, soil moisture, climate change, drought, green infrastructure, machine learning, and nature-based solutions. The bibliometric analysis identified limited interdisciplinary research integrations, not using well-significant and standardized methodologies for the evaluation of urban soil hydrology, and under-representation of research from developing countries as current research gaps. Future research directions highlight advanced methods such as combining data-driven technologies with traditional hydrological approaches, and increasing international collaboration, specifically in developing nations, to address urban soil hydrological problems properly.

Radiomics for prediction of perineural invasion in colorectal cancer: a systematic review and meta-analysis.

Perineural invasion (PNI) in colorectal cancer (CRC) is a significant prognostic factor associated with poor outcomes. Radiomics, which involves extracting quantitative features from medical imaging, has emerged as a potential tool for predicting PNI. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of radiomics models in predicting PNI in CRC. A comprehensive literature search was conducted across PubMed, Embase, and Web of Science for studies published up to July 28, 2024. Inclusion criteria focused on studies using radiomics models to predict PNI in CRC with sufficient data to construct diagnostic accuracy metrics. The quality of the included studies was assessed using QUADAS-2 and METRICS tools. Pooled estimates of sensitivity, specificity, and area under the curve (AUC) were calculated. Subgroup analyses were performed based on imaging modalities, segmentation methods, and other variables. Twelve studies comprising 2853 patients were included in the systematic review, with ten studies contributing to the meta-analysis. The pooled sensitivity and specificity for radiomics models in predicting PNI were 0.74 (95% CI: 0.63-0.82) and 0.85 (95% CI: 0.79-0.90), respectively, in the training cohorts. In the validation cohorts, the sensitivity was 0.65 (95% CI: 0.57-0.72), and specificity was 0.85 (95% CI: 0.81-0.89). The AUC was 0.87 (95% CI: 0.63-0.82) for the training cohorts and 0.84 (95% CI: 0.81-0.87) for the validation cohorts, indicating good diagnostic accuracy. The METRICS scores for the included studies ranged from 65.8 to 85.1%, with an overall average score of 67.25%, reflecting good methodological quality. However, significant heterogeneity was observed across studies, particularly in sensitivity and specificity estimates. Radiomics models show promise as a non-invasive tool for predicting PNI in CRC, with moderate to good diagnostic accuracy. However, the current study's limitations, including reliance on retrospective data, geographic concentration in China, and methodological variability, suggest that further research is needed. Future studies should focus on prospective designs, standardization of methodologies, and the integration of advanced machine-learning techniques to improve the clinical applicability and reliability of radiomics models in CRC management.

The prognostic significance of tertiary lymphoid structures in oral squamous cell carcinomas: a systematic review

IntroductionUpper aerodigestive tract cancers are prevalent, with a global incidence surpassing 500,000 new cases in 2018. Among these, oral squamous cell carcinomas (OSCC) constitute the majority. OSCC has a low 5-year survival rate due to late-stage diagnosis. Risk factors include alcohol and tobacco use. However, non-smokers and non-drinkers are also affected, especially young patients with tongue cancer. The impact of tumor microenvironment (TME) and tumor-infiltrating lymphocytes (TILs) on OSCC prognosis remains debated. Remarkably, Tertiary Lymphoid Structures (TLS) identified in solid tumors have shown associations with favorable outcomes, yet their prognostic significance in OSCC remains understudied.ObjectiveThus, this systematic review aims to explore the value of TLS in OSCC reported in the literature.MethodA scoping review was conducted and six retrospective cohort studies involving 1,203 patients met the inclusion criteria.ResultsPredominantly male patients, with an average age of 49.3 years were included. Immunohistochemistry was the primary method to identify TLS, present in 21% up to 100% of cases. TLS were predominantly located in the peri-tumoral area (75.4%–84.8%) compared to the intra-tumoral area (33.8%–33.9%). Our review shows that the presence of TLS is associated with improved survival in OSCC.DiscussionHowever, variations in TLS detection and classification methods across studies introduce potential biases, hindering direct comparisons between findings. For instance, reports that are based solely on examining HES-stained slides for TLS identification may raise reliability concerns. Standardization of methodologies is imperative to ensure consistency in criteria utilization, thereby facilitating meaningful data comparisons.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428010, PROSPERO (CRD42023428010).

P0785 Protocol for a Priority Setting Partnership to identify the top 10 global research priorities for perianal Crohn’s disease

Abstract Background Perianal Crohn’s disease (pCD) occurs in around 18.7% of patients with Crohn’s disease (1). This manifestation is associated with significant morbidity and impact on the quality of life of affected patients, as well as high healthcare resource utilisation and costs (2). Perianal Crohn’s disease often requires prolonged treatment and multiple interventions. Options for treatments and their efficacy, impact on QoL, use of setons, stomas and proctectomy need further investigation to establish optimal methods (3). A collaborative and patient-centred process is required to prioritise research questions so that limited funding resources can be more efficiently directed to the areas where it is needed most. Methods A priority setting partnership (PSP) with the James Lind Alliance (JLA) has been established in order to identify the “Top 10” most important global research priorities in pCD. The project will follow standard JLA methodology and collaborative principles. An international steering group has been formed, with representation from colorectal surgeons, gastroenterologists, radiologists, researchers, nurses, and patient experts. An initial survey will be distributed over several months to key stakeholders globally, in order to gather “unanswered research questions” relating to pCD, which will then be checked against the evidence base. A prioritisation exercise will be carried out to create a shortlist of research questions, which will be taken to a final consensus workshop involving patients, carers and healthcare professionals to identify the top 10 research priorities. Results There have been 200 responses to the initial survey in the first 4 weeks. 66% of responses were from healthcare professionals, 31% responses from patients, parents or carers, and 3% from other sources. Responses have been received from 27 countries globally, with 27% of responses from the UK, 21% from Brazil, 10% from Iran, 7% from Belgium, 5% from the Netherlands, 5% from the USA, 4% from Colombia, and 21% from a range of other countries. Responses thus far include a diverse range of questions relating to the causes, assessment, treatment and prognosis of pCD, as well as its impact on quality of life. The final top 10 research priorities will be established in the final workshop, and disseminated globally to better inform the development of research questions for basic science and clinical research. Conclusion This project will provide an opportunity for all key global stakeholders, including underrepresented end-users to collaborate and contribute to research prioritisation in pCD. Engagement in the initial survey and this process will aim to shape the future research agenda in perianal Crohn’s disease.

The proper application of logistic regression model in complex survey data: a systematic review

BackgroundLogistic regression is a useful statistical technique commonly used in many fields like healthcare, marketing, or finance to generate insights from binary outcomes (e.g., sick vs. not sick). However, when applying logistic regression to complex survey data, which includes complex sampling designs, specific methodological issues are often overlooked.MethodsThe systematic review extensively searched the PubMed and ScienceDirect databases from January 2015 to December 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, focusing primarily on the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). 810 articles met the inclusion criteria and were included in the analysis. When discussing logistic regression, the review considered multiple methodological problems such as the model adequacy assessment, handling dependence of observations, utilization of complex survey design, dealing with missing values, outliers, and more.ResultsAmong the selected articles, the DHS database was used the most (96%), with MICS accounting for only 3%, and both DHS and MICS accounting for 1%. Of these, it was found that only 19.7% of the studies employed multilevel mixed-effects logistic regression to account for data dependencies. Model validation techniques were not reported in 94.8% of the studies with limited uses of the bootstrap, jackknife, and other resampling methods. Moreover, sample weights, PSUs, and strata variables were used together in 40.4% of the articles, and 41.7% of the studies did not use any of these variables, which could have produced biased results. Goodness-of-fit assessments were not mentioned in 75.3% of the articles, and the Hosmer–Lemeshow and likelihood ratio test were the most common among those reported. Furthermore, 95.8% of studies did not mention outliers, and only 41.0% of studies corrected for missing information, while only 2.7% applied imputation techniques.ConclusionsThis systematic review highlights important gaps in the use of logistic regression with complex survey data, such as overlooking data dependencies, survey design, and proper validation techniques, along with neglecting outliers, missing data, and goodness-of-fit assessments, all of which point to the need for clearer methodological standards and more thorough reporting to improve the reliability of results. Future research should focus on consistently following these standards to ensure stronger and more dependable findings.