{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:17:33Z","timestamp":1778905053671,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U24A2014"],"award-info":[{"award-number":["U24A2014"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cellular Molecular Medi"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Vesicoureteral reflux (VUR) can cause retrograde urine flow under voiding pressure, facilitating ascending bacterial colonisation and recurrent inflammatory responses. These processes trigger a cascade of cellular and molecular events\u2014innate immune activation, pro\u2010inflammatory cytokine release, oxidative stress, apoptosis and extracellular matrix deposition\u2014thereby promoting tubulointerstitial remodelling and increasing the risk of renal parenchymal injury and scarring. Static renal 99mTc\u2010DMSA scintigraphy primarily reflects tracer uptake by proximal tubular cells in the renal cortex and can serve as an integrated phenotypic readout of tubular dysfunction and focal cortical involvement. However, its clinical interpretation remains experience\u2010dependent and lacks reproducible quantitative criteria, while voiding cystourethrography (VCUG), the diagnostic and grading gold standard for VUR, is limited by invasiveness and procedural burden. In this study, we collected DMSA data from 346 children with febrile urinary tract infection treated at the Second Affiliated Hospital of Wenzhou Medical University between January 2019 and January 2023 and developed a deep learning model (MedSwinNet) for VUR risk stratification. Built on a Swin Transformer backbone and enhanced with multi\u2010scale representation fusion, a convolutional block attention module and a gated selection strategy, MedSwinNet was designed to sensitively capture phenotypic signals such as reduced proximal tubular uptake and focal cortical defects while improving robustness. On the test set, the model achieved accuracies of 0.8290 under the severe\u2010side input setting and 0.7997 under the bilateral\u2010side input setting, demonstrating stable discriminative performance and favourable generalisation. Quality control analyses indicated broadly consistent distributions of key image quality metrics across data splits, mitigating potential bias from dataset shift. Collectively, deep learning\u2013based decoding of tubular dysfunction\u2013related phenotypic readouts enables noninvasive quantification of VUR\u2010associated renal involvement, supports decision\u2010making on whether VCUG is warranted and may reduce unnecessary invasive procedures while improving clinical risk\u2010stratified management.<\/jats:p>","DOI":"10.1111\/jcmm.71172","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T03:57:09Z","timestamp":1778471829000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Noninvasive Risk Stratification Based on Renal Tubular Injury Phenotypes: A Deep Learning Study for Predicting Vesicoureteral Reflux in Children"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9563-908X","authenticated-orcid":false,"given":"Hongzhou","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pediatrics The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeyu","family":"Cui","sequence":"additional","affiliation":[{"name":"Wenzhou Medical University  Wenzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhantian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Wenzhou Medical University  Wenzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Luo","sequence":"additional","affiliation":[{"name":"Wenzhou Medical University  Wenzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8712-0544","authenticated-orcid":false,"given":"Jianwei","family":"Shuai","sequence":"additional","affiliation":[{"name":"Joint Medical Engineering Interdisciplinary Research Center of Wenzhou Institute UCAS The Second Affiliated Hospital of Wenzhou Medical 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Children's Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.637"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2023.04.028"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.11.007"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2021.09.010"},{"issue":"2","key":"e_1_2_11_6_1","first-page":"84","article-title":"Radiation Doses to Paediatric Patients Undergoing Voiding Cystourethrography (VCUG) at Siriraj Hospital","volume":"68","author":"Rongviriyapanich C.","year":"2016","journal-title":"Siriraj Medical 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