Objectives To evaluate the ability of large language models (LLMs) to simulate multidisciplinary team (MDT) decision-making in colorectal cancer, a malignancy that often requires complex treatment planning.Methods We retrospectively analysed 1423 colorectal cancer cases discussed at MDT meetings at Peking University Cancer Hospital between January 2023 and December 2024. Three LLMs—OpenAI o3-mini-2025-01-31, DeepSeek-R1 671b and Qwen qwq-plus-2025-03-05—were tested for their ability to replicate MDT recommendations using a standardised treatment categorisation framework. Each case was processed three times per model; only cases with consistent outputs across all three runs were included. Concordance between AI-generated decisions and expert MDT consensus was assessed using agreement percentages and Cohen’s kappa.Results O3 demonstrated the highest intramodel stability, with an agreement rate of 81.0% (Fleiss’ kappa=0.794), yielding 1153 cases with consistent outputs. Concordance with MDT consensus was comparable across the three models, ranging from 62.5% to 65.4%. Multivariable analysis of O3 outputs identified treatment-naïve status, non-metastatic disease and colon tumour location as independent predictors of higher concordance with experts.Discussion LLMs showed fair overall agreement with expert MDT decisions, with stronger performance in standardised and less complex clinical scenarios. Areas of higher concordance included treatment-naïve non-metastatic colon cancer, treated non-metastatic rectal cancer and treated non-metastatic colon cancer.Conclusion LLMs can partially replicate expert MDT recommendations in colorectal cancer. Their integration into clinical workflows should aim to complement, rather than replace, human expertise.
Computer applications to medicine. Medical informatics
Aura Mažuolytė-Binderienė, Viktorija Grigaitė, Erika Krasinskė
et al.
Purpose: This study aimed to investigate the impact of moderate-intensity physical activity, performed before and after an 8-hour simulated workday, on hormonal responses and cognitive efficiency, and to compare these effects between women and men.
Methods: Twenty healthy men and women aged 18–36 years were randomly assigned to control (n = 20) and exercise (n = 20) protocols. During the exercise protocol, participants performed 30 minutes of moderate-intensity aerobic activity on a cycle ergometer before and after a simulated 8-hour workday. The simulated workday consisted of eight cognitive test sessions from the Automated Neuropsychological Assessment Metrics 4 (ANAM4), with each session lasting 45–50 minutes. To assess psycho-emotional changes, participants completed a Visual Analogue Scale (VAS) on a 10 cm horizontal line. Salivary samples were collected, and biochemical analysis of cortisol and testosterone levels was performed using enzyme-linked immunosorbent assay (ELISA) methodology.
Results: The study demonstrated significantly higher testosterone levels in men compared to women (p < 0.05) in both the exercise and control protocols, along with a tendency towards higher cortisol levels in women. Testosterone levels increased in both men and women following two hours of cognitive work and after the 8-hour workday in the exercise protocol. Although no significant gender differences were observed in subjective psycho-emotional responses (p > 0.05), both men and women reported increased mental fatigue (p < 0.05) and decreased motivation (p < 0.05) after eight hours of cognitive work. Significant decreases in memory and cognitive efficiency (p < 0.05) were observed in both genders and across both protocols. However, a tendency towards better cognitive efficiency was noted in the exercise protocol.
Conclusion: Moderate-intensity physical activity before and after prolonged cognitive work may support hormonal balance and help preserve cognitive performance. While both women and men showed increased mental fatigue and reduced motivation, the exercise protocol was associated with a tendency towards better cognitive efficiency, highlighting the potential benefits of physical activity during mentally demanding days. More data is needed to confirm the results.
Support/Funding Source: Study was funded by Lithuanian Sports University.
Background: Runner’s dystonia (RD), a rare task-specific lower-limb dystonia affecting high-mileage runners, presents as abnormal lower-extremity muscle contractions during running. Treatment of RD is challenging and often confounded by significant diagnostic delays due to overlapping symptomatology with other conditions. This case series examines the relationship between stiff knee gait RD and musculoskeletal (MSK) knee pathology. Methods: Eight RD cases, evaluated at the NIH Movement Disorders Clinic since 2018, were retrospectively reviewed. Patients underwent neurological, biomechanical, and MSK evaluations, including 3D motion analysis, surface electromyography, and knee ultrasound. Therapeutic interventions, including botulinum neurotoxin (BoNT) injections, were assessed. Results: Seven patients demonstrated stiff knee gait subtypes, with all having ipsilateral and/or contralateral knee effusions or tendinopathies. Three patients who received MSK interventions (e.g., aspiration, corticosteroid injections) combined with BoNT therapy experienced significant symptom improvement. One patient with isolated foot dystonia displayed different biomechanical patterns without knee pathology. Conclusions: RD patients with stiff knee gait often exhibit knee pathology, most likely due to altered biomechanics and running history. Addressing both issues is essential for optimizing treatment outcomes, reducing pain, and improving function, especially since pain can trigger dystonia. Future research should determine the ideal sequence of interventions for RD patients with MSK issues to develop effective, personalized treatment algorithms.
Introduction: To our knowledge, indirect mechanism injuries of the Vastus medialis (VM) are still not reported in literature. The aim of this case series study is to describe indirect mechanism VM injuries in football, suggest the best clinical assessment, imaging tests and guidelines for a safe return-to-play (RTP). Materials and methods: Over a period of 3 years, four professional football players diagnosed with VM injury by indirect mechanism, were included in the series. Magnetic resonance imaging (MRI) was performed to control the injuries evolution. Results: In this series, Myofascial injuries presented higher frequency and shorter RTP time (16 days mean) than myotendinous injury (26 days). Two injury mechanisms were identified: Deceleration and progressive loading. Conclusion: The VM is a muscle that can also be injured by indirect mechanism. These are a good prognosis injury, if managed correctly, as they are clinically well tolerated injuries. The series findings should be taken wisely, requiring further sampling and studies.
Introduction The WADA requires the National Antidoping Organisations (NADOs) to annually evaluate its education plan and activities to accomplish the International Standard for Education of the WADA Code (2021), preferably done in cooperation with an independent external partner from the field of science and research. Therefore, Swiss Sport Integrity (SSI) and Institute of Sport Science (ISPW) entered into a cooperation agreement in 2020 for annual evaluating SSI’s education plan and activities from 2021 to 2024. This contribution aims to reporting the process of such a science-practice cooperation and identifying factors that are critical for effective cooperative evaluation.
Methods The evaluation concept was developed on sound theoretical considerations following evaluation critieria guidelines (e.g., Sander, 2006). The evaluation focus of SSI’s education plan and activities covers three aspects: basic principles, long-term aims, and key areas for action according to WADA Code. For data gathering, a questionnaire to Swiss elite athletes (Swiss Olympic Card holder) and a questionnaire to their respective coaches as instruments were applied. The questionnaires were conducted during the year as part of the SSI education courses, which are mandatory for all Swiss elite athletes. Additionally, internal data from SSI and Swiss Olympic were gathered. The analysed data were merged and summarised in the annual management report for WADA. The process of cooperation was then reflected among the actors involved in the evaluation with identifying phases approached and assessing critical factors, both restricting and promoting, for effective cooperation.
Results As large part of the results – the athletes’ responses – are confidential and limited to internal use of SSI and reporting to WADA, the presentation is limited to displaying the athletes’ and coaches’ questionnaires and pointing to the methodological challenges and limitations faced. The presentation’s focus is on reporting the cooperation process and determing factors. Results reveal that accepting and including external perspectives, understanding of the framework conditions, mutual trust and engagement, dedicated task specification and distrubition, knowledge and data sharing are perceived beneficial for co-operating.
Discussion/Conclusion The discussion highlights the identified key points for effective processing in a science-practice co-cooperation and point to how to ensure this (good practice). Then transferability to other science-practice co-operations is briefly discussed. Concluding, the continuation and expansion of the existing cooperation with the entry into force of the new WADA Code 2027 will be briefly outlined.
References
WADA. (2021). World Anti-Doping Code 2021 (Art. 18 Education). Montreal: WADA. https://www.wada-ama.org
Sanders, J. R. (Ed.). (2006). Handbuch der Evaluationsstandards: Die Standards des "Joint Committee on Standards for Educational Evaluation". VS Verlag für Sozialwissenschaften.
Introduction
Sport is regularly used as a policy-led tool to facilitate outcomes aligned with resettlement and integration of refugees. However, the understanding of the role of sport in the resettlement of refugees is limited by a narrow focus on policy-led integration outcomes and player participation (Nunn et al., 2021). Moreover, refugee men prevail as the dominant participants, in not only sporting programs, but also within the research that informs the sport resettlement agenda (Ekholm et al., 2019). Therefore, the participation of refugee women in sport policy and programming is largely understood through refugee men's experiences, where the role of sport in resettlement and the daily lives of refugee women is less well understood. This research, guided by postcolonial feminism, examined how sport is deployed as a resettlement and integration policy tool for refugee backgrounded women living in Melbourne, Australia, and aimed to determine the relevance of sport in the lives of refugee backgrounded women.
Methods
Bacchi (2009) framework for policy analysis examined three government sport policies texts that represented refugee integration as a ‘problem’ to be managed through sport. Interviews with policy actors and sport program providers investigated practices and discourses underpinning refugee women’s inclusion in sport programming. Ethnographic fieldwork conducted over a 12-month period with a culturally diverse community football club, explored the role of sport in the lives of refugee backgrounded mothers and their children. Data was analysed using critical discourse analysis and thematic analysis.
Results
Factors at policy level, i.e. the tokenistic presence of women and girls in policy texts, and programming level, i.e. their inclusion into male dominated spaces shaped by neoliberal agendas, continue to resist refugee women’s participation in mainstream sport. Refugee women’s secondary presence in policy and programming was reinforced by temporary, sporadic and competitive funding opportunities that were heavily reliant on participation numbers and hegemonic masculinity, preserving the privilege of the status-quo. Integration in the policy texts was understood as belonging to the dominant Anglo-Australian culture, but belonging was contested, and the refugee mothers in this study understood belonging as being to their own cultures. Their sporting club was a space of belonging, stress relief, social connection, agency and cultural maintenance. The sport club was an important part of their lives as individuals, and was an important aspect of parenting and motherhood.
Discussion/Conclusion
Our study indicates that policy level and policy actors that promote the inclusion and integration of refugees through sport regularly marginalise refugee women and place them as tokenistic participants. Our findings suggest that ethno-specific, community driven sporting spaces are not oppositional, but play a complementary role in policy-led integration agendas. Sport can play an important role in resettlement among refugee backgrounded mothers and their families, where it offers a stable foundation from which other outcomes and benefits are able to facilitated. If sport has the capacity to facilitate positive social outcomes in line with settlement and integration, then greater efforts must be made to ensure women and girls are included and represented in the sport rhetoric (Ekholm et al., 2019).
References
Bacchi, C. (2009). Analysing Policy: What’s the problem represented to be? Pearson.
Ekholm, D., Dahlstedt, M., & Rönnbäck, J. (2019). Problematizing the absent girl: Sport as a means of emancipation and social inclusion. Sport in Society, 22(6), 1043-1061. https://doi.org/10.1080/17430437.2018.1505870
Nunn, C., Spaaij, R., & Luguetti, C. (2021). Beyond integration: Football as a mobile, transnational sphere of belonging for refugee-background young people. Leisure Studies, 41(1), 42-55. https://doi.org/10.1080/02614367.2021.1962393
Ayaka Yasuda, Shuhei Sasajima, Takehiro Kosaka
et al.
The purpose of this study was to investigate the effects of stimulation conditions (pressing force and frequency) and subcutaneous tissue properties (thickness and hardness) on the changes in tendon blood circulation caused by acupressure. Before and after acupressure, blood circulation of the Achilles tendon was measured using red laser lights. Acupressure was applied to the Achilles tendon for 3-min under three conditions. The following four conditions (including no stimulation condition) with different combinations of pressing forces and frequencies were established: 1) 50N and 1.5Hz, 2) 25N and 3.0Hz, 3) 25N and 1.5Hz, and 4) no stimulation. In addition, the thickness and hardness of subcutaneous tissue at the acupressure-stimulated site were measured. The change in total hemoglobin (corresponding to blood volume) showed a significant main effect of condition, but the effects of time and the interaction between conditions and time were not significant. On average, the most significant increase in tendon blood volume was observed in the 50N and 1.5Hz condition, although the post-hoc test showed no significant difference. The subcutaneous tissue thickness and hardness were not significantly correlated with tendon blood volume changes after stimulation in any of the three conditions. In conclusion, the present results indicate that acupressure under the conditions of pressing force 50N and frequency 1.5Hz changed tendon blood circulation the most, though not based on exact statistical results. Furthermore, the subcutaneous tissue thickness and hardness (including tendon) have no effect on tendon blood circulation induced by stimulation.
Anna Pawlikowska-Gorzelańczyk, Ewa Szuster, Paulina Kostrzewska
et al.
Introduction and purpose
Nowadays obesity has become a main problem in the world’s population and it is beginning to replace undernutrition and infectious diseases. Over the years perception of obesity has diametrically changed. Obesity is no longer the result of bad choices but serious medical problem. The aim of this study is to show how changes in perception of obesity affect the obesity pandemic.
Review methods
The literature review included articles available on the websites of health-related organizations and databasis on PubMed. As a part of analysis systematic search of current scientific data was performed.
Description of the state of knowledge
Obesity is defined as an abnormal or excessive fat accumulation and in adults BMI ≥30 is necessary to recognize it. Obesity has plenty of consequences such as diabetes, hypertension, cancers etc. In June 2013 the American Medical Association made a decision to recognize obesity as a disease. That changed the perception of obesity by the public and caused many actions in prevention and treatment. Management of obese patient consists of diagnosis the obesity-causing diseases, recognition of eating and physicall activity habits. Surgical as well pharmacological treatment is available and should be individually considered.
Summary
Recognition of obesity as a disease requires health organisations to build special prevention and treatment programs. Nowadays there is an array of treatment methods for obesity. However the most important method to stop the pandemic is education and promotion of a healthy lifestyle, according to the motto, prevention is better than cure.
Objective Obesity and overweight have changed to very important factors in people movements in the modern world. Therefore, the present study was carried out to examine the effects of overweight on gait kinematic factors in children, young adults, middle-aged, and older adults.
Methods The present study was a causal-comparative study in which 40 participants aged 9-85 were selected based on purposive sampling and were divided into eight groups (four normal groups and four overweight groups) based on body mass index (BMI). All the participants were healthy and had no physical abnormalities. The participants gait was normal. The 3D motion analysis system was used for measuring gait parameters such as walking speed, stride length, stride width, single support phase duration, double support and swing phase duration. Two-way ANOVA was run for the purpose of data analysis. SPSS 19 was used for statistical analyses at a significance level of p<0.05.
Results Result showed that there was not significant differences between parameters of gait such as walking speed [age effect (0/364) and body position (0/478)], double support-phase duration [age effect (0/304) and body position (0/092)] and stance-phases duration [age effect (0/094) and body position (0/271)], while significant differences were observed in stride length [age effect (00001) and body position (0/038)], stride width [age effect (0/01) and body position (0/017)] and swing phase [age effect (0/0001) and body position (0/731)], between normal and overweight groups in different ages. The result of present study show that overweightness can affect some of the spatiotemporal parameters in people’s gait which can cause changes in the obese people’s gait pattern.
Conclusion It seems that age and body status through height, weight and balance can affect some spatiotemporal parameters of gait.
This editorial reviews the rationale for development of Women’s Sports Medicine Programs in the United States. Current issues surrounding the lack of sex-specific analysis in the published literature are reviewed. There is an ongoing need for basic, translational, and clinical research in optimizing care of female athletes and active women of all ages. The importance of the newly established Journal of Women’s Sports Medicine in fulfilling that need is discussed.
Corrosion technique is one of the basic and widely used methods of visualization of vascularization of organs in the anatomy of humans and animals. It consists in filling vascular (blood or lymph), wires or cavernous organs material, e.g., injection. Mass based on wax or putty material based on rubber, synthetic resin and subsequently etching the soft tissues. Ultimately obtained castings of these structures. The aim of the study was to evaluate the usefulness of this technique in morphological studies. In retrospect, corrosion technique has been used already in the seventeenth century, however, because of the use of filler materials such as water, liquid dyes, and even air, obtained anatomical specimens were unstable, therefore, did not yield the desired effect of the test. With time, however, the corrosion technician went through some modifications and new solutions in the embodiment and above all in the chemical composition of the filling material. In the twentieth century, they began to use compounds such as polyester resins, methyl methacrylate or polyvinyl chloride, the specific properties of these compounds allowed the visualization and consolidation of fine anatomic structures in the vascular system, the bronchial tree or the bile ducts. Extensive use of this technique in medicine, veterinary and comparative anatomy of vertebrates underlines its usefulness and the need to use.