OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi met...OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi method).METHODS:Our study was consistent with T/CACM 1336-2020.We searched the monographs and references published in the past 40 years(1983-2022),and established the diagnostic criteria pool of waterdampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine(TCM)based on literature by using frequency statistics and correlation analysis.Expert investigation(interview method and two rounds of Delphi method)was used to form the diagnostic criteria of water-dampness syndrome and dampnessturbidity syndrome of idiopathic membranous nephropathy.Clinical diagnostic test research was carried out,and compared with“Diagnostic Criteria for dampness syndrome”(T/CACM 1454-2023)to evaluate the authenticity,reliability and clinical application value of the standard.RESULTS:A total of 122 relevant guides,standards,monographs and documents were included through searching books and Chinese databases.Four experts were interviewed and two rounds of delphi method(75 experts nationwide)were carried out.The experts'opinions are relatively concentrated and the differences are small.Based on the weight of each index,the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected.After discussion by the core group members,the diagnostic model of"necessary symptoms and optional symptoms"was established,and the final diagnostic criteria of waterdampness syndrome and dampness-turbidity syndrome were established.One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study.There was no statistical difference in gender,age and course of disease(P>0.05).The sensitivity and specificity of the trial standard were 90.34%and 73.33%respectively,while the sensitivity and specificity of T/CACM 1454-2023 were 99.43%and 6.67%,respectively.CONCLUSIONS:The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.展开更多
Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dim...Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dimensional healthcare data,encompassing genomic,transcriptomic,and other omics profiles,as well as radiological imaging and histopathological slides,makes this approach increasingly important because,when examined separately,these data sources only offer a fragmented picture of intricate disease processes.Multimodal deep learning leverages the complementary properties of multiple data modalities to enable more accurate prognostic modeling,more robust disease characterization,and improved treatment decision-making.This review provides a comprehensive overview of the current state of multimodal deep learning approaches in medical diagnosis.We classify and examine important application domains,such as(1)radiology,where automated report generation and lesion detection are facilitated by image-text integration;(2)histopathology,where fusion models improve tumor classification and grading;and(3)multi-omics,where molecular subtypes and latent biomarkers are revealed through cross-modal learning.We provide an overview of representative research,methodological advancements,and clinical consequences for each domain.Additionally,we critically analyzed the fundamental issues preventing wider adoption,including computational complexity(particularly in training scalable,multi-branch networks),data heterogeneity(resulting from modality-specific noise,resolution variations,and inconsistent annotations),and the challenge of maintaining significant cross-modal correlations during fusion.These problems impede interpretability,which is crucial for clinical trust and use,in addition to performance and generalizability.Lastly,we outline important areas for future research,including the development of standardized protocols for harmonizing data,the creation of lightweight and interpretable fusion architectures,the integration of real-time clinical decision support systems,and the promotion of cooperation for federated multimodal learning.Our goal is to provide researchers and clinicians with a concise overview of the field’s present state,enduring constraints,and exciting directions for further research through this review.展开更多
In a recent case report in the World Journal of Clinical Cases,emphasized the crucial role of rapidly and accurately identifying pathogens to optimize patient treatment outcomes.Laboratory-on-a-chip(LOC)technology has...In a recent case report in the World Journal of Clinical Cases,emphasized the crucial role of rapidly and accurately identifying pathogens to optimize patient treatment outcomes.Laboratory-on-a-chip(LOC)technology has emerged as a transformative tool in health care,offering rapid,sensitive,and specific identification of microorganisms.This editorial provides a comprehensive overview of LOC technology,highlighting its principles,advantages,applications,challenges,and future directions.Success studies from the field have demonstrated the practical benefits of LOC devices in clinical diagnostics,epidemiology,and food safety.Comparative studies have underscored the superiority of LOC technology over traditional methods,showcasing improvements in speed,accuracy,and portability.The future integration of LOC with biosensors,artificial intelligence,and data analytics promises further innovation and expansion.This call to action emphasizes the importance of continued research,investment,and adoption to realize the full potential of LOC technology in improving healthcare outcomes worldwide.展开更多
This study investigates the variability in cancer diagnosis across different tissues and organs, with a focus on the role of diagnostic methods such as Hematoxylin and Eosin (H&E) staining and immunohistochemistry...This study investigates the variability in cancer diagnosis across different tissues and organs, with a focus on the role of diagnostic methods such as Hematoxylin and Eosin (H&E) staining and immunohistochemistry (IHC). The predominance of female breast cancer (30%) aligns with global trends, underscoring the need for robust diagnostic protocols, particularly in developing regions. Other prevalent cancers, including skin, stomach, and cervix uteri, reflect a mix of environmental, genetic, and infectious factors. The underrepresentation of gallbladder and thyroid cancers (<1%) suggests potential underdiagnosis or lower prevalence. Age distribution data indicate peak cancer incidence in individuals aged 31 - 45 years, with gender-specific cancers like breast and cervical cancer predominantly affecting females (63.4%). The analysis also highlights significant diagnostic gaps, as 61.2% of cases did not undergo IHC testing due to resource constraints, leading to potential biases in cancer prevalence and diagnostic accuracy. The study emphasizes the complementary role of IHC in confirming ambiguous H&E findings, with strong alignment observed when both methods were used. However, the absence of IHC in many cases limits the robustness of conclusions, suggesting the need for increased access to IHC testing. The findings advocate for integrating IHC into routine diagnostics, expanding diagnostic capabilities, and improving sample sizes to ensure more reliable and comprehensive cancer data.展开更多
This article provides a short review on the importance of the detailed analysis of a Langmuir probe I-V trace in a multi-Maxwellian plasma,and discuss proper procedures analyzing Langmuir probe I-V traces in bi-Maxwel...This article provides a short review on the importance of the detailed analysis of a Langmuir probe I-V trace in a multi-Maxwellian plasma,and discuss proper procedures analyzing Langmuir probe I-V traces in bi-Maxwellian and triple-Maxwellian Electron Energy Distribution Function(EEDF)plasmas.Discus⁃sion and demonstration of procedures include the treatment of the ion saturation current,electron saturation cur⁃rent,space-charge effects on the I-V trace,and most importantly how to properly isolate and fit for each electron group present in an I-V trace reflecting a mult-Maxwellian EEDF,as well as how having a multi-Maxwellian EEDF affects the procedures of treating the ion and electron saturation currents.Shortcomings of common improp⁃er procedures are discussed and demonstrated with simulated I-V traces to show how these procedures gives false measurements.展开更多
Peritoneal tuberculosis is the most common digestive location of tuberculosis. Its diagnosis is often based on a combination of clinical and biological arguments, and confirmed by bacteriology which is rarely availabl...Peritoneal tuberculosis is the most common digestive location of tuberculosis. Its diagnosis is often based on a combination of clinical and biological arguments, and confirmed by bacteriology which is rarely available. In Congo there is little published data on this entity. Objectives: To describe the epidemiological, diagnostic, and progression characteristics of peritoneal tuberculosis at the university hospital center in Brazzaville. Patients and Methods: This study is a descriptive and retrospective analysis conducted from January 1, 2015, to December 31, 2021, in the Gastroenterology and Internal Medicine department of the CHU of Brazzaville. It included all patients hospitalized during this period with a confirmed diagnosis of peritoneal tuberculosis, encompassing 54 records that met the inclusion criteria. Results: Out of the study period, 54 records that fulfilled the inclusion criteria were analyzed. The annual incidence of peritoneal tuberculosis was 7.7 patients, with a prevalence of 1.4%, showing a male predominance of 61% and an average age of 39.93 ± 14.62 years. The primary symptoms were abdominal bloating and abdominal pain, present in 100% and 74% of cases, respectively. The clinical presentation was primarily characterized by febrile ascites observed in all patients. HIV co-infection was noted in 29.6% of cases. Anemia was present in 79.6% of patients, and an elevated sedimentation rate was observed in 74% of cases. The tuberculin skin test returned positive in 50% of cases. The ascitic fluid was exudative, rich in proteins and white blood cells (exceeding 1000/mm3, predominantly lymphocytes) in the majority of cases (100%, 83.3%, 83.3%, respectively). The diagnosis was deemed highly probable based on the clinical and paraclinical signs and the favorable response to treatment in 79.6% of cases. There were instances of pleural involvement (33.3%) and lymph node involvement (pulmonary 22.2% and lymph node 16.6%). Treatment outcomes were favorable in 37% of cases, with a mortality rate of 9%. Conclusion: Peritoneal tuberculosis is prevalent in Brazzaville, predominantly affecting young males. The diagnosis relies chiefly on a combination of clinical, paraclinical, and progression indicators.展开更多
Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer...Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.展开更多
Radiation doses to patients in diagnostics and interventional radiology need to be optimized to comply with the principles of radiation protection in medical practice. This involves using specific detectors with respe...Radiation doses to patients in diagnostics and interventional radiology need to be optimized to comply with the principles of radiation protection in medical practice. This involves using specific detectors with respective diagnostic beams to carry out quality control/quality assurance tests needed to optimize patient doses in the hospital. Semiconductor detectors are used in dosimetry to verify the equipment performance and dose to patients. This work aims to assess the performance, energy dependence, and response of five commercially available semiconductor detectors in RQR, RQR-M, RQA, and RQT at Secondary Standard Dosimetry for clinical applications. The diagnostic beams were generated using Exradin A4 reference ion chamber and PTW electrometer. The ambient temperature and pressure were noted for KTP correction. The detectors designed for RQR showed good performance in RQT beams and vice versa. The detectors designed for RQR-M displayed high energy dependency in other diagnostic beams. The type of diagnostic beam quality determines the response of semiconductor detectors. Therefore, a detector should be calibrated according to the beam qualities to be measured.展开更多
Introduction: Crohn’s Disease (CD) is a chronic inflammatory disorder with a heterogeneous presentation. While diarrhea, abdominal pain, and weight loss are hallmarks, atypical manifestations can obscure the diagnosi...Introduction: Crohn’s Disease (CD) is a chronic inflammatory disorder with a heterogeneous presentation. While diarrhea, abdominal pain, and weight loss are hallmarks, atypical manifestations can obscure the diagnosis. This report highlights an unusual presentation of CD to emphasize the need for comprehensive diagnostic strategies. Case Report: A 25-year-old male presented with peripheral edema, anorexia, and abdominal distension but lacked classic gastrointestinal (GI) symptoms. Laboratory findings included microcytic anemia and hypoalbuminemia, while imaging revealed ascites and bowel wall thickening. Elevated fecal calprotectin and positive Anti-Saccharomyces cerevisiae antibodies (ASCA) supported the diagnosis. Endoscopy confirmed ileocolic Crohn’s Disease (L3 + L4). Infliximab therapy resulted in marked clinical improvement. Discussion: This case underscores the complexity of atypical CD presentations. Early use of serological markers, imaging, and endoscopy guided the diagnosis. Recognition of CD’s diverse manifestations is critical for timely intervention. Conclusion: Atypical CD presentations require heightened clinical suspicion and a multidisciplinary approach to reduce diagnostic delays and improve patient outcomes.展开更多
Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnos...Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnosis of PCLs.However,evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration(EUS-FNA)and fine-needle biopsy(FNB)remains limited.This study aims to compare the diagnostic yield,adequacy of tissue acquisition,and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice.Methods:A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021.The diagnostic yield,tissue acquisition adequacy,and incidence of adverse events were compared between the 2 groups.Results:A total of 90 patients with PCLs were included(52 in the FNA group and 38 in the FNB group).The diagnostic yield was similar between the FNA and FNB groups(94.2%vs 94.7%,P>0.05).The adequacy of tissue acquisition was 71.2%in the FNA group and 81.6%in the FNB group(P>0.05).No statistically significant difference was observed in the incidence of adverse events between the 2 groups(P>0.05).Conclusion:Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs,with excellent safety profiles.Both methods are safe and effective diagnostic tools for evaluating PCLs.展开更多
Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study...Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.展开更多
Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is k...Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is known about the long-term stability of these biomarker proteins in plasma samples stored at-80°C.We aimed to explore how storage time would affect the diagnostic accuracy of these biomarkers using a large cohort.Plasma samples from 229 cognitively unimpaired individuals,encompassing healthy controls and those experiencing subjective cognitive decline,as well as 99 patients with cognitive impairment,comprising those with mild cognitive impairment and dementia,were acquired from the Sino Longitudinal Study on Cognitive Decline project.These samples were stored at-80°C for up to 6 years before being used in this study.Our results showed that plasma levels of Aβ42,Aβ40,neurofilament light chain,and glial fibrillary acidic protein were not significantly correlated with sample storage time.However,the level of total tau showed a negative correlation with sample storage time.Notably,in individuals without cognitive impairment,plasma levels of total protein and tau phosphorylated protein threonine 181(p-tau181)also showed a negative correlation with sample storage time.This was not observed in individuals with cognitive impairment.Consequently,we speculate that the diagnostic accuracy of plasma p-tau181 and the p-tau181 to total tau ratio may be influenced by sample storage time.Therefore,caution is advised when using these plasma biomarkers for the identification of neurodegenerative diseases,such as Alzheimer's disease.Furthermore,in cohort studies,it is important to consider the impact of storage time on the overall results.展开更多
The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, ...The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.展开更多
Artificial Intelligence(AI)is fundamentally transforming medical diagnostics,driving advancements that enhance accuracy,efficiency,and personalized patient care.This narrative review explores AI integration across var...Artificial Intelligence(AI)is fundamentally transforming medical diagnostics,driving advancements that enhance accuracy,efficiency,and personalized patient care.This narrative review explores AI integration across various diagnostic domains,emphasizing its role in improving clinical decision-making.The evolution of medical diagnostics from traditional observational methods to sophisticated imaging,laboratory tests,and molecular diagnostics lays the foundation for understanding AI’s impact.Modern diagnostics are inherently complex,influenced by multifactorial disease presentations,patient variability,cognitive biases,and systemic factors like data overload and interdisciplinary collaboration.AI-enhanced clinical decision support systems utilize both knowledge-based and non-knowledge-based approaches,employing machine learning and deep learning algorithms to analyze vast datasets,identify patterns,and generate accurate differential diagnoses.AI’s potential in diagnostics is demonstrated through applications in genomics,predictive analytics,and early disease detection,with successful case studies in oncology,radiology,pathology,ophthalmology,dermatology,gastroenterology,and psychiatry.These applications demonstrate AI’s ability to process complex medical data,facilitate early intervention,and extend specialized care to underserved populations.However,integrating AI into diagnostics faces significant limitations,including technical challenges related to data quality and system integration,regulatory hurdles,ethical concerns about transparency and bias,and risks of misinformation and overreliance.Addressing these challenges requires robust regulatory frameworks,ethical guidelines,and continuous advancements in AI technology.The future of AI in diagnostics promises further innovations in multimodal AI,genomic data integration,and expanding access to high-quality diagnostic services globally.Responsible and ethical implementation of AI will be crucial to fully realize its potential,ensuring AI serves as a powerful ally in achieving diagnostic excellence and improving global health care outcomes.This narrative review emphasizes AI’s pivotal role in shaping the future of medical diagnostics,advocating for sustained investment and collaborative efforts to harness its benefits effectively.展开更多
Objectives:College students face increasing mental health challenges.Although Acceptance and CommitmentTherapy(ACT)is effective,the efficacy of Internet-based ACT(iACT)needs further exploration.Methods:This study exam...Objectives:College students face increasing mental health challenges.Although Acceptance and CommitmentTherapy(ACT)is effective,the efficacy of Internet-based ACT(iACT)needs further exploration.Methods:This study examines the efficacy of iACT on college students’mental health through a randomized controlled trial.We recruited 90 college students(19.16±1.02 years old)and randomly divided them into the iACT group,face-to-face ACT group,and control group.The effects of the interventions were evaluated using the comprehensive assessment of ACT processes(CompACT)and the Depression Anxiety Stress Scales(DASS-21).Results:Two-factor repeated measures ANOVA revealed a significant time main effect of iACT.Face-to-face ACT and iACT effectively improved college students’psychological flexibility[F(2,83)=18.78,p<0.001,η^(2)=0.18]and alleviated their negative emotions[F(2,82)=41.17,p<0.001,η^(2)=0.36].Face-to-face ACT exhibited sustained effects on improving participants’psychological flexibility and alleviating their negative emotions(p<0.001),while iACT showed no sustained effect on improving participants’psychological flexibility(p>0.05).Conclusion:While iACT and face-to-face ACT are effective shortterm interventions,face-to-face ACT demonstrates superior sustainability.Integrating guided sessions into iACT may enhance long-term outcomes.These findings advocate for blended interventions to address college students’mental health needs,particularly in resource-limited settings.展开更多
BACKGROUND Papillary thyroid cancer(PTC)often recurs following surgical excision,necessitating reliable long-term screening techniques after initial management.Ultrasound scans have a poor predictive value and biopsy ...BACKGROUND Papillary thyroid cancer(PTC)often recurs following surgical excision,necessitating reliable long-term screening techniques after initial management.Ultrasound scans have a poor predictive value and biopsy and genetic testing have a low sensitivity.Biomarker detection,including thyroglobulin,has reduced accuracy as residual thyroid tissue remains following surgery.Serum/tissue microRNA detection offers a promising alternative to screen for thyroid malignancy.Based on our previous systematic review,miR-146,miR-221 and miR-222 appear most strongly associated with PTC.AIM To perform a systematic review and meta-analysis,evaluating the use of circulating miR-146,miRNA-221 and miR-222 in PTC diagnosis and staging.METHODS A systematic literature search of MEDLINE,Scopus and the EMBASE library was performed.Human participants of any age,sex or geographical distribution were considered.Original studies assessing the diagnostic and prognostic accuracy of circulating serum miRNAs in histologically-confirmed PTC were included.Proportion and regression meta-analyses(logit-transformed)were conducted.PRISMA guidelines were followed throughout the process.RESULTS Among the 1530 studies screened,6 met the inclusion criteria,reporting non-overlapping populations.For the diagnosis of PTC vs benign nodules(BN),the pooled sensitivity of miR-146 was 80.7%(95%CI:65.2%-90.4%),specificity was 66.9%(95%CI:55.5%-76.6%),and false positive rate was 33.1%(95%CI:23.4%-44.5%).Pooled sensitivity,specificity and false positive rate of miR-222 for diagnosis of PTC vs BN was 64.3%(95%CI:50.3%-76.2%),88.8%(95%CI:82.4%-93%)and 11.2%(95%CI:7%-17.6%)respectively.Pooled sensitivity,specificity and false positive rate of miR-221 in this population demonstrated reduced accuracy.Pooled sensitivity and specificity of PTC vs healthy controls for total serum miRNAs were 82%(95%CI:77%-86%)and 84%(95%CI:76%-90%)respectively.The summary area under receiver operating characteristic curve value for the same analysis was 0.89(95%CI:0.86-0.92).CONCLUSION miRNA-146 and miRNA-222 were most sensitive,validating their efficacy in PTC diagnosis.Larger studies are needed for confident population generalisability.Use of two-MRNA types in conjunction needs to be assessed.展开更多
BACKGROUND Brush cytology is the most commonly used technique for tissue acquisition during endoscopic retrograde cholangiopancreatography for the evaluation of biliary strictures.Nonetheless,brush cytology is limited...BACKGROUND Brush cytology is the most commonly used technique for tissue acquisition during endoscopic retrograde cholangiopancreatography for the evaluation of biliary strictures.Nonetheless,brush cytology is limited by its low sensitivity due to insufficient cellular yield.AIM To evaluate the impact of the sheath-rinse technique on improving the cellularity yield.METHODS A total of 112 patients with suspected malignant biliary strictures were enrolled at two tertiary centers in South Korea.The sample cellularity and diagnostic accuracy of brush-wash and sheath-rinse specimens were compared.RESULTS A significantly increased number of total cell clusters per representative 20×field was recorded in the sheath-rinse compared with the brush-wash specimens(median:12 vs 3,P<0.001).This trend persisted when large(>50 cells)clusters(median:8 vs 3,P<0.001),medium(6-49 cells)(median:7 vs 3,P<0.001),and small(2-5 cells)clusters(median:9 vs 3,P<0.001)were evaluated.Diagnostic accuracy and sensitivity for differentiating malignancy were superior with sheath-rinsing than with the brush-wash method(72.3%vs 62.5%,P<0.001 and 69.9%vs 59.2%,P<0.001,respectively).CONCLUSION Incorporating sheath-rinse specimens significantly improved the yield and diagnostic accuracy of biliary brush cytology.Sheath-rinsing should be integrated into routine clinical practice to improve diagnostic performance for biliary strictures.展开更多
As a critical technology for industrial system reliability and safety,machine monitoring and fault diagnostics have advanced transformatively with large language models(LLMs).This paper reviews LLM-based monitoring an...As a critical technology for industrial system reliability and safety,machine monitoring and fault diagnostics have advanced transformatively with large language models(LLMs).This paper reviews LLM-based monitoring and diagnostics methodologies,categorizing them into in-context learning,fine-tuning,retrievalaugmented generation,multimodal learning,and time series approaches,analyzing advances in diagnostics and decision support.It identifies bottlenecks like limited industrial data and edge deployment issues,proposing a three-stage roadmap to highlight LLMs’potential in shaping adaptive,interpretable PHM frameworks.展开更多
BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced rad...BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological,cytological,and microbiological examinations and,therefore,underwent diag-nostic laparoscopy.METHODS This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites.Patients’medical records were obtained from the hospital database.Their age,sex,complaints at admission,laboratory results,radiological imaging results,diagnostic laparoscopy reports,and pa-thology reports were analyzed.RESULTS The serum-ascites albumin gradient was<1.1 in 96.3%of the patients(n=79).Among patients,22(26.8%)had benign diagnoses and 60(73.2%)had malignant diagnoses.In addition,55(67.1%)were deceased,and the median follow-up time from diagnosis to death was four months.The overall follow-up time ranged from 1 to 142 months,with a median of 14 months.Patients’diagnoses were significantly associated with their survival(P<0.05,χ2 test).The mortality rate was 86.7%among patients with malignant diagnoses and 13.6%among patients with benign diagnoses.CONCLUSION Diagnostic laparoscopy is minimally invasive,has a low complication rate,and requires a short hospital stay.It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.展开更多
Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently t...Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.展开更多
基金the Special Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine:Study on Criteria for Diagnosis of Dampness Syndrome of Idiopathic Membranous Nephropathy,Cohort Study on Pathogenesis and Material Basis of Dampness Syndrome of Idiopathic Membranous Nephropathy,Randomized Controlled Clinical Study of Sanqi Qushi Granule in Treatment of Membranous Nephropathy(No.SZ2021ZZ02,SZ2021ZZ09 and SZ2021ZZ36)the 2020 Guangdong Provincial Science and Technology Innovation Strategy Special Fund:Guangdong-Hong Kong-Macao Joint Lab(No.2020B1212030006)+2 种基金the Natural Science Foundation of Guangdong Province:Study on the Mechanism of Sanqi Qushi Prescription Delaying Podocellular Senescence in Membranous Nephropathy based on Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase-Stimulator of Interferon Genes-Nuclear Factor Kappa-B Signaling Pathway(No.2022A1515011628)the Guangzhou Science and Technology Plan Project:to Explore the Mechanism of Treating Membranous Nephropathy from the Perspective of Regulating Amino Acid Metabolism Disorder(No.2023A03J0746)Special Funding for Scientific and Technological Research on Traditional Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine:a Multimodular Machine Learning Prediction Model based on Pathological Image-transcriptomics and Traditional Chinese Medicine Syndromes was Used to Investigate the Prognostic Correlation of Long non-coding RNA Molecules in Nephropathy and the Intervention Mechanism of Sanqi Qushi Formula,to Investigate the Pathogenesis and Microbiological Mechanism of Dampness Syndrome of Membranous Nephropathy based on the Microecological Changes of Tongue Coating(No.YN2023MB02,YN2023MB10)。
文摘OBJECTIVE:To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN)patients by literature research and expert investigation(interviews and a Delphi method).METHODS:Our study was consistent with T/CACM 1336-2020.We searched the monographs and references published in the past 40 years(1983-2022),and established the diagnostic criteria pool of waterdampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine(TCM)based on literature by using frequency statistics and correlation analysis.Expert investigation(interview method and two rounds of Delphi method)was used to form the diagnostic criteria of water-dampness syndrome and dampnessturbidity syndrome of idiopathic membranous nephropathy.Clinical diagnostic test research was carried out,and compared with“Diagnostic Criteria for dampness syndrome”(T/CACM 1454-2023)to evaluate the authenticity,reliability and clinical application value of the standard.RESULTS:A total of 122 relevant guides,standards,monographs and documents were included through searching books and Chinese databases.Four experts were interviewed and two rounds of delphi method(75 experts nationwide)were carried out.The experts'opinions are relatively concentrated and the differences are small.Based on the weight of each index,the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected.After discussion by the core group members,the diagnostic model of"necessary symptoms and optional symptoms"was established,and the final diagnostic criteria of waterdampness syndrome and dampness-turbidity syndrome were established.One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study.There was no statistical difference in gender,age and course of disease(P>0.05).The sensitivity and specificity of the trial standard were 90.34%and 73.33%respectively,while the sensitivity and specificity of T/CACM 1454-2023 were 99.43%and 6.67%,respectively.CONCLUSIONS:The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.
文摘Multimodal deep learning has emerged as a key paradigm in contemporary medical diagnostics,advancing precision medicine by enabling integration and learning from diverse data sources.The exponential growth of high-dimensional healthcare data,encompassing genomic,transcriptomic,and other omics profiles,as well as radiological imaging and histopathological slides,makes this approach increasingly important because,when examined separately,these data sources only offer a fragmented picture of intricate disease processes.Multimodal deep learning leverages the complementary properties of multiple data modalities to enable more accurate prognostic modeling,more robust disease characterization,and improved treatment decision-making.This review provides a comprehensive overview of the current state of multimodal deep learning approaches in medical diagnosis.We classify and examine important application domains,such as(1)radiology,where automated report generation and lesion detection are facilitated by image-text integration;(2)histopathology,where fusion models improve tumor classification and grading;and(3)multi-omics,where molecular subtypes and latent biomarkers are revealed through cross-modal learning.We provide an overview of representative research,methodological advancements,and clinical consequences for each domain.Additionally,we critically analyzed the fundamental issues preventing wider adoption,including computational complexity(particularly in training scalable,multi-branch networks),data heterogeneity(resulting from modality-specific noise,resolution variations,and inconsistent annotations),and the challenge of maintaining significant cross-modal correlations during fusion.These problems impede interpretability,which is crucial for clinical trust and use,in addition to performance and generalizability.Lastly,we outline important areas for future research,including the development of standardized protocols for harmonizing data,the creation of lightweight and interpretable fusion architectures,the integration of real-time clinical decision support systems,and the promotion of cooperation for federated multimodal learning.Our goal is to provide researchers and clinicians with a concise overview of the field’s present state,enduring constraints,and exciting directions for further research through this review.
文摘In a recent case report in the World Journal of Clinical Cases,emphasized the crucial role of rapidly and accurately identifying pathogens to optimize patient treatment outcomes.Laboratory-on-a-chip(LOC)technology has emerged as a transformative tool in health care,offering rapid,sensitive,and specific identification of microorganisms.This editorial provides a comprehensive overview of LOC technology,highlighting its principles,advantages,applications,challenges,and future directions.Success studies from the field have demonstrated the practical benefits of LOC devices in clinical diagnostics,epidemiology,and food safety.Comparative studies have underscored the superiority of LOC technology over traditional methods,showcasing improvements in speed,accuracy,and portability.The future integration of LOC with biosensors,artificial intelligence,and data analytics promises further innovation and expansion.This call to action emphasizes the importance of continued research,investment,and adoption to realize the full potential of LOC technology in improving healthcare outcomes worldwide.
文摘This study investigates the variability in cancer diagnosis across different tissues and organs, with a focus on the role of diagnostic methods such as Hematoxylin and Eosin (H&E) staining and immunohistochemistry (IHC). The predominance of female breast cancer (30%) aligns with global trends, underscoring the need for robust diagnostic protocols, particularly in developing regions. Other prevalent cancers, including skin, stomach, and cervix uteri, reflect a mix of environmental, genetic, and infectious factors. The underrepresentation of gallbladder and thyroid cancers (<1%) suggests potential underdiagnosis or lower prevalence. Age distribution data indicate peak cancer incidence in individuals aged 31 - 45 years, with gender-specific cancers like breast and cervical cancer predominantly affecting females (63.4%). The analysis also highlights significant diagnostic gaps, as 61.2% of cases did not undergo IHC testing due to resource constraints, leading to potential biases in cancer prevalence and diagnostic accuracy. The study emphasizes the complementary role of IHC in confirming ambiguous H&E findings, with strong alignment observed when both methods were used. However, the absence of IHC in many cases limits the robustness of conclusions, suggesting the need for increased access to IHC testing. The findings advocate for integrating IHC into routine diagnostics, expanding diagnostic capabilities, and improving sample sizes to ensure more reliable and comprehensive cancer data.
文摘This article provides a short review on the importance of the detailed analysis of a Langmuir probe I-V trace in a multi-Maxwellian plasma,and discuss proper procedures analyzing Langmuir probe I-V traces in bi-Maxwellian and triple-Maxwellian Electron Energy Distribution Function(EEDF)plasmas.Discus⁃sion and demonstration of procedures include the treatment of the ion saturation current,electron saturation cur⁃rent,space-charge effects on the I-V trace,and most importantly how to properly isolate and fit for each electron group present in an I-V trace reflecting a mult-Maxwellian EEDF,as well as how having a multi-Maxwellian EEDF affects the procedures of treating the ion and electron saturation currents.Shortcomings of common improp⁃er procedures are discussed and demonstrated with simulated I-V traces to show how these procedures gives false measurements.
文摘Peritoneal tuberculosis is the most common digestive location of tuberculosis. Its diagnosis is often based on a combination of clinical and biological arguments, and confirmed by bacteriology which is rarely available. In Congo there is little published data on this entity. Objectives: To describe the epidemiological, diagnostic, and progression characteristics of peritoneal tuberculosis at the university hospital center in Brazzaville. Patients and Methods: This study is a descriptive and retrospective analysis conducted from January 1, 2015, to December 31, 2021, in the Gastroenterology and Internal Medicine department of the CHU of Brazzaville. It included all patients hospitalized during this period with a confirmed diagnosis of peritoneal tuberculosis, encompassing 54 records that met the inclusion criteria. Results: Out of the study period, 54 records that fulfilled the inclusion criteria were analyzed. The annual incidence of peritoneal tuberculosis was 7.7 patients, with a prevalence of 1.4%, showing a male predominance of 61% and an average age of 39.93 ± 14.62 years. The primary symptoms were abdominal bloating and abdominal pain, present in 100% and 74% of cases, respectively. The clinical presentation was primarily characterized by febrile ascites observed in all patients. HIV co-infection was noted in 29.6% of cases. Anemia was present in 79.6% of patients, and an elevated sedimentation rate was observed in 74% of cases. The tuberculin skin test returned positive in 50% of cases. The ascitic fluid was exudative, rich in proteins and white blood cells (exceeding 1000/mm3, predominantly lymphocytes) in the majority of cases (100%, 83.3%, 83.3%, respectively). The diagnosis was deemed highly probable based on the clinical and paraclinical signs and the favorable response to treatment in 79.6% of cases. There were instances of pleural involvement (33.3%) and lymph node involvement (pulmonary 22.2% and lymph node 16.6%). Treatment outcomes were favorable in 37% of cases, with a mortality rate of 9%. Conclusion: Peritoneal tuberculosis is prevalent in Brazzaville, predominantly affecting young males. The diagnosis relies chiefly on a combination of clinical, paraclinical, and progression indicators.
文摘Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.
文摘Radiation doses to patients in diagnostics and interventional radiology need to be optimized to comply with the principles of radiation protection in medical practice. This involves using specific detectors with respective diagnostic beams to carry out quality control/quality assurance tests needed to optimize patient doses in the hospital. Semiconductor detectors are used in dosimetry to verify the equipment performance and dose to patients. This work aims to assess the performance, energy dependence, and response of five commercially available semiconductor detectors in RQR, RQR-M, RQA, and RQT at Secondary Standard Dosimetry for clinical applications. The diagnostic beams were generated using Exradin A4 reference ion chamber and PTW electrometer. The ambient temperature and pressure were noted for KTP correction. The detectors designed for RQR showed good performance in RQT beams and vice versa. The detectors designed for RQR-M displayed high energy dependency in other diagnostic beams. The type of diagnostic beam quality determines the response of semiconductor detectors. Therefore, a detector should be calibrated according to the beam qualities to be measured.
文摘Introduction: Crohn’s Disease (CD) is a chronic inflammatory disorder with a heterogeneous presentation. While diarrhea, abdominal pain, and weight loss are hallmarks, atypical manifestations can obscure the diagnosis. This report highlights an unusual presentation of CD to emphasize the need for comprehensive diagnostic strategies. Case Report: A 25-year-old male presented with peripheral edema, anorexia, and abdominal distension but lacked classic gastrointestinal (GI) symptoms. Laboratory findings included microcytic anemia and hypoalbuminemia, while imaging revealed ascites and bowel wall thickening. Elevated fecal calprotectin and positive Anti-Saccharomyces cerevisiae antibodies (ASCA) supported the diagnosis. Endoscopy confirmed ileocolic Crohn’s Disease (L3 + L4). Infliximab therapy resulted in marked clinical improvement. Discussion: This case underscores the complexity of atypical CD presentations. Early use of serological markers, imaging, and endoscopy guided the diagnosis. Recognition of CD’s diverse manifestations is critical for timely intervention. Conclusion: Atypical CD presentations require heightened clinical suspicion and a multidisciplinary approach to reduce diagnostic delays and improve patient outcomes.
基金supported by the Special Project for the Construction of Innovative Provinces in Hunan Province,China(2020SK2013)。
文摘Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnosis of PCLs.However,evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration(EUS-FNA)and fine-needle biopsy(FNB)remains limited.This study aims to compare the diagnostic yield,adequacy of tissue acquisition,and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice.Methods:A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021.The diagnostic yield,tissue acquisition adequacy,and incidence of adverse events were compared between the 2 groups.Results:A total of 90 patients with PCLs were included(52 in the FNA group and 38 in the FNB group).The diagnostic yield was similar between the FNA and FNB groups(94.2%vs 94.7%,P>0.05).The adequacy of tissue acquisition was 71.2%in the FNA group and 81.6%in the FNB group(P>0.05).No statistically significant difference was observed in the incidence of adverse events between the 2 groups(P>0.05).Conclusion:Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs,with excellent safety profiles.Both methods are safe and effective diagnostic tools for evaluating PCLs.
文摘Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.
基金supported by the National Key Research&Development Program of China,Nos.2021YFC2501205(to YC),2022YFC24069004(to JL)the STI2030-Major Project,Nos.2021ZD0201101(to YC),2022ZD0211800(to YH)+2 种基金the National Natural Science Foundation of China(Major International Joint Research Project),No.82020108013(to YH)the Sino-German Center for Research Promotion,No.M-0759(to YH)a grant from Beijing Municipal Science&Technology Commission(Beijing Brain Initiative),No.Z201100005520018(to JL)。
文摘Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is known about the long-term stability of these biomarker proteins in plasma samples stored at-80°C.We aimed to explore how storage time would affect the diagnostic accuracy of these biomarkers using a large cohort.Plasma samples from 229 cognitively unimpaired individuals,encompassing healthy controls and those experiencing subjective cognitive decline,as well as 99 patients with cognitive impairment,comprising those with mild cognitive impairment and dementia,were acquired from the Sino Longitudinal Study on Cognitive Decline project.These samples were stored at-80°C for up to 6 years before being used in this study.Our results showed that plasma levels of Aβ42,Aβ40,neurofilament light chain,and glial fibrillary acidic protein were not significantly correlated with sample storage time.However,the level of total tau showed a negative correlation with sample storage time.Notably,in individuals without cognitive impairment,plasma levels of total protein and tau phosphorylated protein threonine 181(p-tau181)also showed a negative correlation with sample storage time.This was not observed in individuals with cognitive impairment.Consequently,we speculate that the diagnostic accuracy of plasma p-tau181 and the p-tau181 to total tau ratio may be influenced by sample storage time.Therefore,caution is advised when using these plasma biomarkers for the identification of neurodegenerative diseases,such as Alzheimer's disease.Furthermore,in cohort studies,it is important to consider the impact of storage time on the overall results.
文摘The purpose of this research was to evaluate radiological safety in pediatric radiology in hospitals in the Kongo Central province of the DRC. To this end, we surveyed a convenience sample of 50 health professionals, including 10 radiologists working in the hospitals covered by the survey, to assess the practice of pediatric radiology and the degree of compliance with radiation protection principles for the safety of children and the environment. We collected radiophysical parameters to calculate entrance doses in pediatric radiology in radiology departments to determine the dosimetric level by comparison with the diagnostic reference levels of the International Commission on Radiological Protection (ICRP). All in all, we found that in Kongo Central in the DRC, many health personnel surveyed reported that more than 30% of requested radiological examinations are not justified. Also, after comparing the entrance doses produced in the surveyed departments with those of the International Commission on Radiological Protection (ICRP), a statistically significant difference was found in pediatric radiology between the average doses in five out of six surveyed departments and those of the ICRP. Therefore, almost all of the surveyed departments were found to be highly irradiating in children, while excessive X-ray irradiation in children can have significant effects due to their increased sensitivity to radiation. Among the risks are: increased cancer risks, damage to developing cells, potential genetic effects, and neurological effects. This is why support for implementing radiation protection principles is a necessity to promote the safety of patients and the environment against the harmful effects of X-rays in conventional radiology.
文摘Artificial Intelligence(AI)is fundamentally transforming medical diagnostics,driving advancements that enhance accuracy,efficiency,and personalized patient care.This narrative review explores AI integration across various diagnostic domains,emphasizing its role in improving clinical decision-making.The evolution of medical diagnostics from traditional observational methods to sophisticated imaging,laboratory tests,and molecular diagnostics lays the foundation for understanding AI’s impact.Modern diagnostics are inherently complex,influenced by multifactorial disease presentations,patient variability,cognitive biases,and systemic factors like data overload and interdisciplinary collaboration.AI-enhanced clinical decision support systems utilize both knowledge-based and non-knowledge-based approaches,employing machine learning and deep learning algorithms to analyze vast datasets,identify patterns,and generate accurate differential diagnoses.AI’s potential in diagnostics is demonstrated through applications in genomics,predictive analytics,and early disease detection,with successful case studies in oncology,radiology,pathology,ophthalmology,dermatology,gastroenterology,and psychiatry.These applications demonstrate AI’s ability to process complex medical data,facilitate early intervention,and extend specialized care to underserved populations.However,integrating AI into diagnostics faces significant limitations,including technical challenges related to data quality and system integration,regulatory hurdles,ethical concerns about transparency and bias,and risks of misinformation and overreliance.Addressing these challenges requires robust regulatory frameworks,ethical guidelines,and continuous advancements in AI technology.The future of AI in diagnostics promises further innovations in multimodal AI,genomic data integration,and expanding access to high-quality diagnostic services globally.Responsible and ethical implementation of AI will be crucial to fully realize its potential,ensuring AI serves as a powerful ally in achieving diagnostic excellence and improving global health care outcomes.This narrative review emphasizes AI’s pivotal role in shaping the future of medical diagnostics,advocating for sustained investment and collaborative efforts to harness its benefits effectively.
基金funded by the Education and Teaching Reform Research Major Project of Anhui Province(2022xqhz023)(2023sx170).
文摘Objectives:College students face increasing mental health challenges.Although Acceptance and CommitmentTherapy(ACT)is effective,the efficacy of Internet-based ACT(iACT)needs further exploration.Methods:This study examines the efficacy of iACT on college students’mental health through a randomized controlled trial.We recruited 90 college students(19.16±1.02 years old)and randomly divided them into the iACT group,face-to-face ACT group,and control group.The effects of the interventions were evaluated using the comprehensive assessment of ACT processes(CompACT)and the Depression Anxiety Stress Scales(DASS-21).Results:Two-factor repeated measures ANOVA revealed a significant time main effect of iACT.Face-to-face ACT and iACT effectively improved college students’psychological flexibility[F(2,83)=18.78,p<0.001,η^(2)=0.18]and alleviated their negative emotions[F(2,82)=41.17,p<0.001,η^(2)=0.36].Face-to-face ACT exhibited sustained effects on improving participants’psychological flexibility and alleviating their negative emotions(p<0.001),while iACT showed no sustained effect on improving participants’psychological flexibility(p>0.05).Conclusion:While iACT and face-to-face ACT are effective shortterm interventions,face-to-face ACT demonstrates superior sustainability.Integrating guided sessions into iACT may enhance long-term outcomes.These findings advocate for blended interventions to address college students’mental health needs,particularly in resource-limited settings.
文摘BACKGROUND Papillary thyroid cancer(PTC)often recurs following surgical excision,necessitating reliable long-term screening techniques after initial management.Ultrasound scans have a poor predictive value and biopsy and genetic testing have a low sensitivity.Biomarker detection,including thyroglobulin,has reduced accuracy as residual thyroid tissue remains following surgery.Serum/tissue microRNA detection offers a promising alternative to screen for thyroid malignancy.Based on our previous systematic review,miR-146,miR-221 and miR-222 appear most strongly associated with PTC.AIM To perform a systematic review and meta-analysis,evaluating the use of circulating miR-146,miRNA-221 and miR-222 in PTC diagnosis and staging.METHODS A systematic literature search of MEDLINE,Scopus and the EMBASE library was performed.Human participants of any age,sex or geographical distribution were considered.Original studies assessing the diagnostic and prognostic accuracy of circulating serum miRNAs in histologically-confirmed PTC were included.Proportion and regression meta-analyses(logit-transformed)were conducted.PRISMA guidelines were followed throughout the process.RESULTS Among the 1530 studies screened,6 met the inclusion criteria,reporting non-overlapping populations.For the diagnosis of PTC vs benign nodules(BN),the pooled sensitivity of miR-146 was 80.7%(95%CI:65.2%-90.4%),specificity was 66.9%(95%CI:55.5%-76.6%),and false positive rate was 33.1%(95%CI:23.4%-44.5%).Pooled sensitivity,specificity and false positive rate of miR-222 for diagnosis of PTC vs BN was 64.3%(95%CI:50.3%-76.2%),88.8%(95%CI:82.4%-93%)and 11.2%(95%CI:7%-17.6%)respectively.Pooled sensitivity,specificity and false positive rate of miR-221 in this population demonstrated reduced accuracy.Pooled sensitivity and specificity of PTC vs healthy controls for total serum miRNAs were 82%(95%CI:77%-86%)and 84%(95%CI:76%-90%)respectively.The summary area under receiver operating characteristic curve value for the same analysis was 0.89(95%CI:0.86-0.92).CONCLUSION miRNA-146 and miRNA-222 were most sensitive,validating their efficacy in PTC diagnosis.Larger studies are needed for confident population generalisability.Use of two-MRNA types in conjunction needs to be assessed.
基金Supported by The Catholic Medical Center Research Foundation Made in The Program Year of 2022.
文摘BACKGROUND Brush cytology is the most commonly used technique for tissue acquisition during endoscopic retrograde cholangiopancreatography for the evaluation of biliary strictures.Nonetheless,brush cytology is limited by its low sensitivity due to insufficient cellular yield.AIM To evaluate the impact of the sheath-rinse technique on improving the cellularity yield.METHODS A total of 112 patients with suspected malignant biliary strictures were enrolled at two tertiary centers in South Korea.The sample cellularity and diagnostic accuracy of brush-wash and sheath-rinse specimens were compared.RESULTS A significantly increased number of total cell clusters per representative 20×field was recorded in the sheath-rinse compared with the brush-wash specimens(median:12 vs 3,P<0.001).This trend persisted when large(>50 cells)clusters(median:8 vs 3,P<0.001),medium(6-49 cells)(median:7 vs 3,P<0.001),and small(2-5 cells)clusters(median:9 vs 3,P<0.001)were evaluated.Diagnostic accuracy and sensitivity for differentiating malignancy were superior with sheath-rinsing than with the brush-wash method(72.3%vs 62.5%,P<0.001 and 69.9%vs 59.2%,P<0.001,respectively).CONCLUSION Incorporating sheath-rinse specimens significantly improved the yield and diagnostic accuracy of biliary brush cytology.Sheath-rinsing should be integrated into routine clinical practice to improve diagnostic performance for biliary strictures.
文摘As a critical technology for industrial system reliability and safety,machine monitoring and fault diagnostics have advanced transformatively with large language models(LLMs).This paper reviews LLM-based monitoring and diagnostics methodologies,categorizing them into in-context learning,fine-tuning,retrievalaugmented generation,multimodal learning,and time series approaches,analyzing advances in diagnostics and decision support.It identifies bottlenecks like limited industrial data and edge deployment issues,proposing a three-stage roadmap to highlight LLMs’potential in shaping adaptive,interpretable PHM frameworks.
文摘BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological,cytological,and microbiological examinations and,therefore,underwent diag-nostic laparoscopy.METHODS This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites.Patients’medical records were obtained from the hospital database.Their age,sex,complaints at admission,laboratory results,radiological imaging results,diagnostic laparoscopy reports,and pa-thology reports were analyzed.RESULTS The serum-ascites albumin gradient was<1.1 in 96.3%of the patients(n=79).Among patients,22(26.8%)had benign diagnoses and 60(73.2%)had malignant diagnoses.In addition,55(67.1%)were deceased,and the median follow-up time from diagnosis to death was four months.The overall follow-up time ranged from 1 to 142 months,with a median of 14 months.Patients’diagnoses were significantly associated with their survival(P<0.05,χ2 test).The mortality rate was 86.7%among patients with malignant diagnoses and 13.6%among patients with benign diagnoses.CONCLUSION Diagnostic laparoscopy is minimally invasive,has a low complication rate,and requires a short hospital stay.It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.
文摘Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.
