Impact of AI on radiology: a EuroAIM/EuSoMII 2024 survey among members of the European Society of Radiology.

In order to assess the perceptions and expectations of the radiology staff about artificial intelligence (AI), we conducted an online survey among ESR members (January-March 2024). It was designed considering that conducted in 2018, updated according to recent advancements and emerging topics, consisting of seven questions regarding demographics and professional background and 28 AI questions. Of 28,000 members contacted, 572 (2%) completed the survey. AI impact was predominantly expected on breast and oncologic imaging, primarily involving CT, mammography, and MRI, and in the detection of abnormalities in asymptomatic subjects. About half of responders did not foresee an impact of AI on job opportunities. For 273/572 respondents (48%), AI-only reports would not be accepted by patients; and 242/572 respondents (42%) think that the use of AI systems will not change the relationship between the radiological team and the patient. According to 255/572 respondents (45%), radiologists will take responsibility for any AI output that may influence clinical decision-making. Of 572 respondents, 274 (48%) are currently using AI, 153 (27%) are not, and 145 (25%) are planning to do so. In conclusion, ESR members declare familiarity with AI technologies, as well as recognition of their potential benefits and challenges. Compared to the 2018 survey, the perception of AI's impact on job opportunities is in general slightly less optimistic (more positive from AI users/researchers), while the radiologist's responsibility for AI outputs is confirmed. The use of large language models is declared not only limited to research, highlighting the need for education in AI and its regulations. CRITICAL RELEVANCE STATEMENT: This study critically evaluates the current impact of AI on radiology, revealing significant usage patterns and clinical implications, thereby guiding future integration strategies to enhance efficiency and patient care in clinical radiology. KEY POINTS: The survey examines ESR member's views about the impact of AI on radiology practice. AI use is relevant in CT and MRI, with varying impacts on job roles. AI tools enhance clinical efficiency but require radiologist oversight for patient acceptance.

Innovative system to maximize methane production from fruit and vegetable waste.

Anaerobic digestion of fruit and vegetable waste (FVW) offers an environmentally friendly alternative for waste disposal, converting it into methane for energy recovery. Typically, FVW digestion is conducted in a continuously stirred tank reactor (CSTR) due to its ease of use and stability with solid concentrations between 5 and 10%. However, CSTRs are limited to organic loading rates (OLRs) of about 3 kg COD/m3.day, resulting in large reactor volumes, low methane productivity, and costly wet digestate handling. This work introduces a novel method for methane production from FVW using a high-rate reactor system. The proposed approach involves grinding, centrifuging, and/or pressing the FVW to separate it into liquid and solid phases. The liquid phase is then digested in an up-flow anaerobic sludge blanket (UASB) reactor, while the solid phase undergoes digestion in a dry methanization reactor. A model incorporating all biological reactors was implemented in the Anaerobic Digestion Model 1 (ADM1) to provide a theoretical basis for the experimental development of this system. The current simulation scenarios offer initial references for operating the experimental system, which will, in turn, generate data for further model refinement. For instance, constrained liquid-gas mass transfer was considered for dry fermentation, with additional potential biochemical kinetic limitations to be incorporated following on experimental evidence. The success of this system could enable energy recovery in 72 Central Wholesale Markets across Brazil, offering a critical tool for planning, operating, and optimizing such systems.

ESR Essentials: radiomics-practice recommendations by the European Society of Medical Imaging Informatics.

Radiomics is a method to extract detailed information from diagnostic images that cannot be perceived by the naked eye. Although radiomics research carries great potential to improve clinical decision-making, its inherent methodological complexities make it difficult to comprehend every step of the analysis, often causing reproducibility and generalizability issues that hinder clinical adoption. Critical steps in the radiomics analysis and model development pipeline-such as image, application of image filters, and selection of feature extraction parameters-can greatly affect the values of radiomic features. Moreover, common errors in data partitioning, model comparison, fine-tuning, assessment, and calibration can reduce reproducibility and impede clinical translation. Clinical adoption of radiomics also requires a deep understanding of model explainability and the development of intuitive interpretations of radiomic features. To address these challenges, it is essential for radiomics model developers and clinicians to be well-versed in current best practices. Proper knowledge and application of these practices is crucial for accurate radiomics feature extraction, robust model development, and thorough assessment, ultimately increasing reproducibility, generalizability, and the likelihood of successful clinical translation. In this article, we have provided researchers with our recommendations along with practical examples to facilitate good research practices in radiomics. KEY POINTS: Radiomics' inherent methodological complexity should be understood to ensure rigorous radiomic model development to improve clinical decision-making. Adherence to radiomics-specific checklists and quality assessment tools ensures methodological rigor. Use of standardized radiomics tools and best practices enhances clinical translation of radiomics models.

Resveratrol-coated gold nanorods produced by green synthesis with activity against Candida albicans.

Candida albicans is an opportunistic yeast capable of causing a wide range of mucosal, cutaneous, and systemic infections. However, therapeutic strategies are limited to a few antifungal agents. Inorganic nanoparticles have been investigated as carrier systems for antifungals as potential new treatments. In this study, we focused on the antifungal activity of gold nanorods, a specific rod-shaped gold nanoparticle, produced by green synthesis using resveratrol as a metal-reducing agent. The synthesis method resulted in stable control nanoparticles (AuNp) and resveratrol-coated gold nanoparticles (AuNpRSV) with medium sizes of 32.4 × 15.9 nm for AuNp, and 33.5 × 15.3 nm for AuNpRSV. Both AuNp and AuNpRSV inhibited the C. albicans grown at 2.46 µg/mL, exhibited fungicidal effects at 4.92 µg/mL, and significantly decreased filamentation, biofilm viability, reactive oxygen species production and ergosterol levels of C. albicans. In addition, exposure to AuNpRSV reduced the ability of C. albicans to grow in the presence of cell membrane stressors. Transmission electron microscopy revealed enlargement of the cell wall and retraction of the cell membrane after treatment with AuNp and AuNpRSV. Promisingly, in vivo toxicity analysis demonstrated that both nanoparticles maintained the full viability of Galleria mellonella larvae at 49.20 µg/mL. In conclusion, both gold nanoparticles exhibited antifungal activity; however, these effects were enhanced by AuNpRSV. Altogether, AuNps and AuNpRSVs are potential antifungal agents for the treatment of C. albicans infections.

Mapping vulnerability for increased COVID-19 susceptibility and worse outcomes: a scoping review.

Introduction: Infectious diseases can spread rapidly in the globalized world, and the complex intersection of individual, social, economic, and cultural factors make it difficult to identify vulnerabilities in the face of pandemics. Methods: Therefore, this study aimed to identify vulnerability factors to infection and worse outcomes associated with COVID-19. This is a scoping review study of six databases that selected publications between 2019 and 2023, focusing on individual, social, and programmatic dimensions of vulnerability. The results were recorded in a spreadsheet and analyzed, considering the interrelationships among these dimensions. Results: A total of 45 articles were included in the review. Content analysis was conducted using the theoretical framework of health vulnerability, which divides vulnerability into individual, social, and programmatic dimensions. Race/ethnicity, homelessness, incarceration, socioeconomic level, food insecurity, and remote areas were classified as social dimensions. On the other hand, cancer, cardiovascular disease, HIV/AIDS, alcoholism, advanced age, obesity, mental disorders, diabetes, kidney disease, and pregnancy were classified as individual dimensions. None of the publications found explicitly mentioned programmatic vulnerabilities. Discussion: The research found that social vulnerabilities reinforce individual vulnerabilities, creating a vicious cycle. In addition, programmatic vulnerabilities reinforce this relationship. This study emphasizes that public policies should address these different dimensions of vulnerability. It suggests that this information should be incorporated into health surveillance and future decision-making to face new pandemics. Systematic review registration: https://archive.org/details/osf-registrations-wgfmj-v1.

The Germination Performance After Dormancy Breaking of Leucaena diversifolia (Schltdl.) Benth. Seeds in a Thermal Gradient and Its Distribution Under Climate Change Scenarios.

Climate change models predict temperature increases, which may affect germination, an important stage in the recruitment of individuals in agroecosystems. Therefore, it is crucial to conduct research on how temperature will impact the germination of multipurpose native species. Leucaena diversifolia (Schltdl.) Benth. is native to America and is commonly cultivated around the world due to having a high protein content in seeds, and their trees are used in agrosilvopastoral systems because they fix nitrogen and provide shade and cattle feed. However, climate change affects the critical phases of its life cycle and influences its growth, reproduction, phenology, and distribution. To assess the germination performance of Leucaena diversifolia under different temperatures throughout thermal times, we estimated germination variables and determined cardinal temperatures and thermal time; we also analysed germination and potential distribution under two climate change scenarios. We found significant variations in seed germination (78-98%) and differences in cardinal temperatures (Tb = 5.17 and 7.6 °C, To = 29.42 and 29.54 °C, and Tc = 39.45 and 39.76 °C). On the other hand, the sub-optimal and supra-optimal temperature values showed little differences: 51.34 and 55.57 °Cd. The models used showed variations in germination time for the analysed scenarios and the potential distribution. We confirm that the populations and distribution of L. diversifolia will be altered due to climate changes, but the species retains the ability to germinate under warmer conditions.

Histopathological and immunohistochemical analysis of a suspected extraskeletal osteosarcoma in a rabbit (Oryctolagus cuniculus).

An 8-year-old male rabbit (Oryctolagus cuniculus) presented with a subcutaneous mass in the proximal region of the fourth and accessory digit measuring 5.5 x 3.5 x 5.2cm. The mass was non-alopecic and exhibited irregular surface, ulceration and necrosis with predominantly pale and light brown coloring. Radiography revealed no involvement of bone and adjacent periosteum. The mass was marginally resected and the electrochemotherapy (ECT) was performed on the surgical bed. Histopathology and immunohistochemical analysis revealed positive reactions for Vimentin, Runx-2 and ki-67, leading to a diagnosis of extraskeletal osteosarcoma (ESOS). This report described a case of ESOS in a rabbit, thereby delineating its clinical presentation, anatomopathological characteristics, diagnostic modalities and recommended therapeutic interventions.

Um coelho macho de 8 anos (Oryctolagus cuniculus) apresentava uma massa subcutânea na região proximal do quarto e acessório dígitos medindo 5,5 x 3,5 x 5,2 cm. A massa não era alopécica e exibia superfície irregular, ulceração e necrose com coloração predominantemente pálida e marrom clara. A radiografia não revelou envolvimento de tecido ósseo ou periósteo adjacente. A massa foi submetida à excisão marginal e foi realizada eletroquimioterapia do leito cirúrgico. Histopatologia e análise imuno-histoquímica revelaram reações positivas para vimentina, Runx-2 e ki-67, levando ao diagnóstico de osteossarcoma extraesquelético. Este relato descreve um caso de osteossarcoma extraesquelético em um coelho, delineando sua apresentação clínica, características anatomopatológicas, modalidades diagnósticas e intervenções terapêuticas recomendadas.

Malignancy predictors and treatment strategies for adult intestinal intussusception.

Intussusception in adult patients is a rare medical finding, which is accompanied by an underlying tumor in some cases. However, no accepted method has been established to identify patients at risk for tumor-related intussusception. This study aimed to identify imaging features as predictors for tumor-related intussusception.CT images of patients with confirmed intussusception were retrospectively acquired between 01/2008 and 12/2022. Available follow-up images and medical health records were evaluated to identify various imaging features, the cause of intussusception, and treatment strategies. Imaging interpretation was conducted by two blinded radiologists. A third radiologist was consulted in cases of disagreement.A total of 71 consecutive patients were included in this study (42 males, 29 females) with a median age of 56 years (interquartile range: 40.5-73.8 years). Enteroenteric intussusceptions in the small bowel were the most common type observed in adult patients. In contrast, colocolic intussusception was more frequently associated with malignancy, and this association was statistically significant (p < 0.05). Among the malignant tumors, adenocarcinoma was the most common, followed by metastases and lymphoma. Additionally, bowel obstruction and wall thickening were significantly correlated with malignancy (p < 0.05). The high negative predictive values (NPVs) and high specificities for ileus (NPV 88.5%, specificity 82.1%), bowel wall thickening (NPV 90.9%, specificity 71.4%), and acute abdomen (NPV 84.6%, specificity 78.8%) suggest that the absence of these features strongly predicts a low probability of malignancy in cases of adult intussusception.Active surveillance with follow-up exams is suitable for asymptomatic and transient intussusception when imaging features suggest a low likelihood of a neoplasm. Additionally, malignancy predictors such as ileus and thickening of the bowel wall in the affected segment could guide tailored treatment. Surgical interventions are essential for symptomatic cases, with adenocarcinoma being the most common malignancy found in colocolic intussusceptions.Intussusception in adults is rare and is often associated with underlying tumors, particularly in colocolic intussusceptions. Key imaging predictors for malignancy include bowel obstruction, wall thickening in the affected segment, and the presence of acute abdomen, with high NPVs and specificities indicating low malignancy risk when these features are absent. Active surveillance is recommended for asymptomatic cases with low neoplasm probability, while surgical intervention is the method of choice for symptomatic patients. · Reschke P, Le Hong QA, Gruenewald LD et al. Malignancy predictors and treatment strategies for adult intestinal intussusception. Fortschr Röntgenstr 2024; DOI 10.1055/a-2434-7932.

Large language models for structured reporting in radiology: past, present, and future.

Structured reporting (SR) has long been a goal in radiology to standardize and improve the quality of radiology reports. Despite evidence that SR reduces errors, enhances comprehensiveness, and increases adherence to guidelines, its widespread adoption has been limited. Recently, large language models (LLMs) have emerged as a promising solution to automate and facilitate SR. Therefore, this narrative review aims to provide an overview of LLMs for SR in radiology and beyond. We found that the current literature on LLMs for SR is limited, comprising ten studies on the generative pre-trained transformer (GPT)-3.5 (n = 5) and/or GPT-4 (n = 8), while two studies additionally examined the performance of Perplexity and Bing Chat or IT5. All studies reported promising results and acknowledged the potential of LLMs for SR, with six out of ten studies demonstrating the feasibility of multilingual applications. Building upon these findings, we discuss limitations, regulatory challenges, and further applications of LLMs in radiology report processing, encompassing four main areas: documentation, translation and summarization, clinical evaluation, and data mining. In conclusion, this review underscores the transformative potential of LLMs to improve efficiency and accuracy in SR and radiology report processing. KEY POINTS: Question How can LLMs help make SR in radiology more ubiquitous? Findings Current literature leveraging LLMs for SR is sparse but shows promising results, including the feasibility of multilingual applications. Clinical relevance LLMs have the potential to transform radiology report processing and enable the widespread adoption of SR. However, their future role in clinical practice depends on overcoming current limitations and regulatory challenges, including opaque algorithms and training data.

Automatic structuring of radiology reports with on-premise open-source large language models.

OBJECTIVES: Structured reporting enhances comparability, readability, and content detail. Large language models (LLMs) could convert free text into structured data without disrupting radiologists' reporting workflow. This study evaluated an on-premise, privacy-preserving LLM for automatically structuring free-text radiology reports. MATERIALS AND METHODS: We developed an approach to controlling the LLM output, ensuring the validity and completeness of structured reports produced by a locally hosted Llama-2-70B-chat model. A dataset with de-identified narrative chest radiograph (CXR) reports was compiled retrospectively. It included 202 English reports from a publicly available MIMIC-CXR dataset and 197 German reports from our university hospital. Senior radiologist prepared a detailed, fully structured reporting template with 48 question-answer pairs. All reports were independently structured by the LLM and two human readers. Bayesian inference (Markov chain Monte Carlo sampling) was used to estimate the distributions of Matthews correlation coefficient (MCC), with [-0.05, 0.05] as the region of practical equivalence (ROPE). RESULTS: The LLM generated valid structured reports in all cases, achieving an average MCC of 0.75 (94% HDI: 0.70-0.80) and F1 score of 0.70 (0.70-0.80) for English, and 0.66 (0.62-0.70) and 0.68 (0.64-0.72) for German reports, respectively. The MCC differences between LLM and humans were within ROPE for both languages: 0.01 (-0.05 to 0.07), 0.01 (-0.05 to 0.07) for English, and -0.01 (-0.07 to 0.05), 0.00 (-0.06 to 0.06) for German, indicating approximately comparable performance. CONCLUSION: Locally hosted, open-source LLMs can automatically structure free-text radiology reports with approximately human accuracy. However, the understanding of semantics varied across languages and imaging findings. KEY POINTS: Question Why has structured reporting not been widely adopted in radiology despite clear benefits and how can we improve this? Findings A locally hosted large language model successfully structured narrative reports, showing variation between languages and findings. Critical relevance Structured reporting provides many benefits, but its integration into the clinical routine is limited. Automating the extraction of structured information from radiology reports enables the capture of structured data while allowing the radiologist to maintain their reporting workflow.

Economic Analysis of Falls in a Private Hospital in Southern Brazil-A Case-Control Study.

INTRODUCTION: In-hospital falls represent significant health and economic concerns, but previous studies regarding the economic cost of falls do not account for other cofounders (comorbidities and clinical aspects) in this cost evaluation. AIM: The aim of this study is to analyse the cost of in-hospital falls comparing those who had falls to nonfalls patients while accounting for several risk factors associated with falls. METHODS: Data were collected from January 2020 to December 2022, in a private hospital in Brazil. The sample was divided into two groups: one with patients who fell and the other with nonfallers on a 1:2 ratio, and these groups were matched to avoid confounding variables. RESULTS: The median cost for patients who experienced falls was US$7520.26 compared to US$6144.24 for those without falls (p < 0.01). This trend was especially marked in men aged 20-40 who suffered falls and showed a significantly elevated median cost of US$29 722.02 distinguishing them from those without falls with a median cost of US$1179.48 (p < 0.01). CONCLUSION: Hospital falls significantly increase financial costs compared to nonfall cases, irrespective of comorbidities, length of stay or case-mix variations. The findings recommend a universal precautions approach to fall prevention in hospitals, targeting all hospitalised patients to effectively minimise the economic burden associated with in-hospital falls.

A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group.

Chromoblastomycosis, an implantation mycosis, is a neglected tropical disease that causes decreased quality of life, stigma, and disability. The global burden of disease is unknown and data on disease epidemiology and outcomes are severely limited by a lack of access to needed diagnostic tools and therapeutics. The World Health Organization outlined targets for chromoblastomycosis in the Road Map for Neglected Tropical Diseases 2021-2030, but little progress has been made in initiating and implementing an effective control program globally. This lack of guiding policy and progress led to the recent formation of a Global Chromoblastomycosis Working Group which has developed a global chromoblastomycosis strategy. We describe this strategy, which outlines specific steps needed to improve technical progress, strategy and service delivery, and enablers. Clinicians, researchers, public and government officials, patients, and policy makers can align their time, expertise, and resources to improve the lives of communities affected by chromoblastomycosis through this strategy.

A systematic review and meta-analysis of the prevalence of Parkinson's disease in lower to upper-middle-income countries.

Parkinson's disease (PD) is a common neurodegenerative disease that is a growing public health challenge. Estimates of the burden of PD have focused on data from high-income countries, with lower-income countries poorly described. We reviewed and examined the prevalence of PD reported by studies in low- to upper-middle-income countries. A systematic literature search was performed in the Medline/PubMed, Embase, LILACS, and Web of Science databases. Age group, sex, and geographic region were considered when analyzing the data. Of the 4327 assessed articles, 57 met the inclusion criteria for qualitative review, and 36 were included in the meta-analysis. Heterogeneity measures were high both as a whole and in each geographic region. Data analysis by geographic region showed that reported prevalence differed across regions, ranging from 49 per 100,000 (Sub-Saharan Africa) to 1081 per 100,000 (Latin America and the Caribbean). There was an increasing prevalence of PD with advancing age (per 100,000): 7 in 40-49 years, 158 in 50-59 years, 603 in 60-69 years, 1251 in 70-79 years, and 2181 in over the age of 80. The prevalence of PD in men and women was similar. There was a greater PD prevalence in populations with a higher 5-year GDP per capita and a higher life expectancy. Our findings suggest a higher prevalence of PD in lower and upper-middle-income countries than previously reported. Comparisons between regions are difficult, as the sociocultural differences and lack of methodological standardization hinder understanding key epidemiological data in varied populations.

Oral Chagas disease outbreak by bacaba juice ingestion: A century after Carlos Chagas' discovery, the disease is still hard to manage.

BACKGROUND: Orally transmitted acute Chagas disease (ACD) primarily affects low-visibility and low-income individuals in tropical and subtropical zones. Managing ACD remains challenging even after more than 100 years of its discovery. Its spread to non-endemic areas has made it a global health issue. The aim of this work is to demonstrate the difficulties encountered in handling a real-life situation. METHODOLOGY AND FINDINGS: This report examines an outbreak of 39 cases of ACD due to oral transmission by bacaba juice ingestion that occurred in Pedro do Rosário, Maranhão, Brazil. A clinical and epidemiological investigation, including an entomological search, was conducted. Diagnosis criteria included positive peripheral blood smear (PBS), seroconversion of IgG, and a two-fold increase in IgG titer (laboratory criteria); and clinical findings, epidemiological exposure, and at least one positive IgG test (clinical-epidemiological criteria). In-house conventional polymerase chain reaction (PCR) was performed on 33 samples. All patients were treated with benznidazole. After 4.5 years, IgG levels were reassessed in 26 individuals. The mean age was 33.6 years, with no gender difference. The mean incubation period was 13.8 days, and the mean between symptom onset and treatment was 16.6 days. The most common symptoms were fever and lymphadenopathy (90%). Diagnostic success rates were 66.6% (laboratory criteria), 23% (clinical-epidemiological criteria), and 10.2% (high clinical suspicion despite negative tests). Test positivity rates were 69.7% (PBS), 91.4% (serology), and 100% (PCR). There were no deaths. Serological cure was achieved in 34.6% of cases, and IgG titers decreased in 15.3%. CONCLUSIONS AND SIGNIFICANCE: We encountered several barriers in managing ACD, including population vulnerability, reliance on outdated diagnostic techniques, lack of standardized molecular biology methods, and limited therapeutic options. This report underscores the importance of rapid surveillance and early treatment to prevent fatalities. We recommend the standardization of conventional PCR in diagnostic routines.

Susceptibility of Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae) Mediterranean Populations Found in São Paulo, Brazil to 11 Insecticides and Characterization of Their Endosymbionts.

The silverleaf whitefly, Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae), is a significant agricultural pest worldwide, impacting a variety of crop yields. Since the introduction of B. tabaci Mediterranean (MED) species in Brazil, limited research has measured the relative efficacy of the primary insecticides used in whitefly management. This study evaluated the susceptibility of three distinct B. tabaci MED populations to 11 insecticide active ingredients and characterized the bacterial endosymbionts within each population. The insecticides tested were acetamiprid, bifenthrin, cyantraniliprole, diafenthiuron, spiromesifen, imidacloprid, pymetrozine, pyriproxyfen, sulfoxaflor, and thiamethoxam. Results showed varying LC50 and LC90 values among tested insecticides and populations. Notably, populations varied in response to imidacloprid and thiamethoxam with some populations having a 6× higher tolerance. Sequencing data of endosymbionts revealed that individuals from the most susceptible B. tabaci population harbored Rickettsia and Arsenophonus, whereas these bacteria were not detected in the resistant populations. These findings highlight the need for frequent insecticide toxicity bioassays of distinct B. tabaci populations and the adoption of integrated pest management strategies to preserve the efficacy of insecticides for B. tabaci control. Additionally, the role of infection by endosymbionts to alter susceptibility should be further explored.

Over twenty years of publications in Ecology: Over-contribution of women reveals a new dimension of gender bias.

Biographical features like social and economic status, ethnicity, sexuality, care roles, and gender unfairly disadvantage individuals within academia. Authorship patterns should reflect the social dimension behind the publishing process and co-authorship dynamics. To detect potential gender biases in the authorship of papers and examine the extent of women's contribution in terms of the substantial volume of scientific production in Ecology, we surveyed papers from the top-ranked journal Ecology from 1999 to 2021. We developed a Women's Contribution Index (WCI) to measure gender-based individual contributions. Considering gender, allocation in the author list, and the total number of authors, the WCI calculates the sum of each woman's contribution per paper. We compared the WCI with women's expected contributions in a non-gender-biased scenario. Overall, women account for 30% of authors of Ecology, yet their contribution to papers is higher than expected by chance (i.e., over-contribution). Additionally, by comparing the WCI with an equivalent Men's Contribution Index, we found that women consistently have higher contributions compared to men. We also observed a temporal trend of increasing women's authorship and mixed-gender papers. This suggests some progress in addressing gender bias in the field of ecology. However, we emphasize the need for a better understanding of the pattern of over-contribution, which may partially stem from the phenomenon of over-compensation. In this context, women might need to outperform men to be perceived and evaluated as equals. The WCI provides a valuable tool for quantifying individual contributions and understanding gender biases in academic publishing. Moreover, the index could be customized to suit the specific question of interest. It serves to uncover a previously non-quantified type of bias (over-contribution) that, we argue, is the response to the inequitable structure of the scientific system, leading to differences in the roles of individuals within a scientific publishing team.

AI-derived body composition parameters as prognostic factors in patients with HCC undergoing TACE in a multicenter study.

Background & Aims: Body composition assessment (BCA) parameters have recently been identified as relevant prognostic factors for patients with hepatocellular carcinoma (HCC). Herein, we aimed to investigate the role of BCA parameters for prognosis prediction in patients with HCC undergoing transarterial chemoembolization (TACE). Methods: This retrospective multicenter study included a total of 754 treatment-naïve patients with HCC who underwent TACE at six tertiary care centers between 2010-2020. Fully automated artificial intelligence-based quantitative 3D volumetry of abdominal cavity tissue composition was performed to assess skeletal muscle volume (SM), total adipose tissue (TAT), intra- and intermuscular adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue (SAT) on pre-intervention computed tomography scans. BCA parameters were normalized to the slice number of the abdominal cavity. We assessed the influence of BCA parameters on median overall survival and performed multivariate analysis including established estimates of survival. Results: Univariate survival analysis revealed that impaired median overall survival was predicted by low SM (p <0.001), high TAT volume (p = 0.013), and high SAT volume (p = 0.006). In multivariate survival analysis, SM remained an independent prognostic factor (p = 0.039), while TAT and SAT volumes no longer showed predictive ability. This predictive role of SM was confirmed in a subgroup analysis of patients with BCLC stage B. Conclusions: SM is an independent prognostic factor for survival prediction. Thus, the integration of SM into novel scoring systems could potentially improve survival prediction and clinical decision-making. Fully automated approaches are needed to foster the implementation of this imaging biomarker into daily routine. Impact and implications: Body composition assessment parameters, especially skeletal muscle volume, have been identified as relevant prognostic factors for many diseases and treatments. In this study, skeletal muscle volume has been identified as an independent prognostic factor for patients with hepatocellular carcinoma undergoing transarterial chemoembolization. Therefore, skeletal muscle volume as a metaparameter could play a role as an opportunistic biomarker in holistic patient assessment and be integrated into decision support systems. Workflow integration with artificial intelligence is essential for automated, quantitative body composition assessment, enabling broad availability in multidisciplinary case discussions.

Primordial Odontogenic Tumor: A Review of the Literature and Report of Three New Patients.

The primordial odontogenic tumor (POT) is a rare mixed odontogenic tumor composed of mesenchymal cells, columnar odontogenic epithelium, and fibromyxoid stroma affecting the posterior mandible of children and adolescents. Herein, we report 3 patients with POT and the clinicopathological features of POT previously reported in the literature. A 12-year-old, 19-year-old, and 4-year-old patient presented an asymptomatic swelling in the posterior maxilla and posterior mandible. Imaging exams revealed radiolucent lesions associated with unerupted teeth. The lesions were surgically removed, and the histopathological examination revealed spindle-to-ovoid mesenchymal cells in a fibromyxoid stroma surfaced by columnar odontogenic epithelial cells with reverse nuclear polarization. Deposition of mineralized tissue was observed. The final diagnosis was POT, and patients did not exhibit signs of recurrence. POT should be included in the differential diagnoses of intraosseous lesions in the posterior mandible in pediatric patients.