Diagnostics最新文献

{"title":"First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications.","authors":"Răzvan Grigoraș Căpitănescu, Marius Cristian Marinaș, Larisa Pătru, Dragoș George Popa, Elena Cristina Andrei, Aura Iuliana Popa, Gabriel Florin Răzvan Mogoș, Nicolae Dragoș Mărgăritescu, Ciprian Laurențiu Pătru","doi":"10.3390/diagnostics15101277","DOIUrl":"10.3390/diagnostics15101277","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Over the years, the potential of the first-trimester (FT) ultrasound in the detection of fetal structural defects has increased. The main objectives of the first-trimester fetal screening evaluation are the detection of major structural anomalies and the diagnosis of additional sonographic markers for chromosomal disorders. When a fetal anomaly is diagnosed, patients have the right to be informed about the risks, necessary interventions, or alternatives. Depending on the severity of the anomalies and the pregnancy period, the legality of the pregnancy termination was evaluated. The aim of this study was to assess the impact of the first-trimester morphological screening of the fetus using an ultrasound protocol according to the latest international protocols (the ISUOG protocol). <b>Methods:</b> Between 1 January 2024 and 31 December 2024, 854 pregnancies with gestational ages between 11 weeks and 13 weeks + 6 days were morphologically evaluated during the nuchal scan in the Obstetrics and Gynecology Department of the Emergency County Hospital from Craiova. Both transabdominal and transvaginal ultrasound in 2D and in a color Doppler mode were used in the scanning technique. The ultrasound findings were correlated with the genetic testing results and pregnancy outcome. The medical law implications were related to the cases where the ultrasound was performed at about 13 weeks of gestation, and the screening genetic results showed an increased pregnancy risk, which arose during the FT. In these cases, we performed amniocentesis at about 16-17 weeks of gestation, and especially, the Non-Invasive Prenatal Testing (NIPT)-positive cases were confirmed by karyotyping. Still, at this gestational age of diagnosis, the Romanian law would not allow abortions. <b>Results</b>: By using this extended FT ultrasound protocol, we detected 58 cases with fetal structural anomalies. Eighteen cases were also associated with genetic syndromes after performing chorionic villous sampling (CVS). Three cases detected with minor structural anomalies (two cases with club foot and one case with a cleft upper lip) were lost to follow-up. <b>Conclusions:</b> Fetal morphological ultrasound evaluation is feasible in the late first trimester. By using an extended ultrasound protocol, we can detect most of the fetal structural anomalies and contribute to better medical counseling and improve pregnancy outcomes.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Specific Impact of Inflammation and Nutritional Indices on AVF Blood Flow and Maturation: A Retrospective Analysis.","authors":"Özgür Akkaya, Ümit Arslan","doi":"10.3390/diagnostics15101278","DOIUrl":"10.3390/diagnostics15101278","url":null,"abstract":"<p><p><b>Background</b>: Arteriovenous fistula (AVF) failure rates are consistently higher in females, although the underlying mechanisms remain incompletely understood. Inflammatory processes play a key role in AVF remodeling and venous arterialization, yet their influence may differ by sex. This study aimed to evaluate the impact of inflammatory indices on AVF blood flow and maturation, with a focus on sex-specific differences. <b>Methods</b>: This retrospective analytical study included 110 patients (50 females, 60 males) undergoing initial surgical AVF creation. Postoperative assessments occurred at the fourth and sixth weeks. Patients demonstrating insufficient maturation (blood flow < 600 mL/min) at the fourth week were re-evaluated after two weeks without any intervening procedures or additional interventions. <b>Results</b>: Intraoperative Transit-Time Flow Measurement (TTFM) revealed significantly higher median AVF blood flow in males compared to females (289 mL/min vs. 200 mL/min; <i>p</i> < 0.001). Doppler ultrasonography (DUS) findings confirmed these sex-related differences, demonstrating consistently lower blood flow rates in female patients. An elevated neutrophil-to-lymphocyte ratio (NLR) was associated with approximately a 31% reduction in AVF blood flow among females, whereas an increased C-reactive protein-to-albumin ratio (CrA) correlated with an approximate 9% decline. In males, an elevated systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were significantly associated with decreased AVF blood flow. Conversely, a higher prognostic nutritional index (PNI) positively correlated with AVF blood flow in both sexes. Risk factors associated with inadequate AVF maturation (<600 mL/min at sixth week) included female sex, advanced age, obesity, smoking, anemia, low vitamin D levels, and elevated inflammatory indices (NLR, SII, and SIRI). <b>Conclusions</b>: Inflammatory and nutritional indices derived from routine laboratory tests may assist in estimating AVF maturation likelihood. While DUS reliably assesses AVF blood flow, complementary evaluation methods may be required to assess the broader vascular status. Further research is needed to clarify sex-specific inflammatory mechanisms influencing AVF outcomes and to guide individualized management strategies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in Diagnostic of HIV Drug Resistance in the Mekong Delta Region, Vietnam: A Comparative Analysis Before and After the COVID-19 Pandemic.","authors":"Huynh Hoang Khanh Thu, Alexandr N Schemelev, Yulia V Ostankova, Vladimir S Davydenko, Diana E Reingardt, Ton Tran, Le Chi Thanh, Thi Xuan Lien Truong, Areg A Totolian","doi":"10.3390/diagnostics15101279","DOIUrl":"10.3390/diagnostics15101279","url":null,"abstract":"<p><p><b>Background:</b> Vietnam has made significant strides in reducing the prevalence of HIV infection and achievements in its antiretroviral treatment program. However, the COVID-19 pandemic and financial challenges in the healthcare system have posed significant obstacles to maintaining effective HIV treatment and monitoring, particularly among vulnerable populations. This study aims to evaluate the situation of HIV drug resistance among patients who have experienced treatment failure in the Mekong Delta region and to compare data from 2019 to 2022. <b>Methods:</b> The study material was blood plasma samples from HIV-infected individuals with ART failure: 316 collected in 2019 and 326 collected in 2022. HIV-1 genotyping and mutation detection were performed based on an analysis of the nucleotide sequences of the <i>Pol</i> gene region. A total of 116 HIV-infected individuals with virological failure in 2019 and 2022 were assessed for HIV drug resistance. <b>Results:</b> The study revealed a high proportion of participants with viral loads exceeding 1000 copies/mL, significantly increasing from 12.0% in 2019 to 23.9% in 2022 (OR = 2.3; <i>p</i> = 0.0001). HIV drug resistance mutations were detected in 84.21% of cases in 2019 and 92.59% in 2022. The prevalence of concurrent resistance to NRTIs and NNRTIs was 37.5% and 30.13% in 2019 and 2022, respectively. There was a statistically significant decrease in NNRTI resistance (OR = 0.32, χ² = 5.43, <i>p</i> < 0.05). In contrast, multi-drug resistance to protease inhibitors rose from 18.52% to 45.21% (φ* = 0.00403, <i>p</i> < 0.05). Triple-class resistance was identified only in 2022 (17.81%). The most common mutations included M184I/V, D67N, K103N, Y181C, and V82A/S/T, with D67N rising significantly from 3.13% to 21.92%. The predominant subtype was CRF01_AE. <b>Conclusion:</b> A high prevalence of viral non-suppression and HIV drug resistance was observed among patients in the Mekong Delta region, particularly after the onset of the COVID-19 pandemic. Our study highlights the ongoing challenges that the HIV/AIDS treatment program in Vietnam must address in the post-pandemic period to sustain its success and achieve the goals of the country's HIV prevention strategies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Influencing Right and Left Ventricular Variables Assessed with Gated Cadmium-Zinc-Telluride Equilibrium Radionuclide Angiocardiography in Oncology Patients.","authors":"Olav Monsson, Marc Nielsen, Thomas Kümler, Christian Haarmark, Bo Zerahn","doi":"10.3390/diagnostics15101274","DOIUrl":"10.3390/diagnostics15101274","url":null,"abstract":"<p><p><b>Background</b>: Left ventricular ejection fraction remains the primary focus in cardiac monitoring for oncology patients undergoing potentially cardiotoxic chemotherapy, while right ventricular function is seldom examined. This study evaluates how established risk factors for left ventricular dysfunction affect right ventricular function. <b>Methods</b>: This retrospective cohort study included 1770 patients undergoing cadmium-zinc-telluride equilibrium radionuclide angiocardiography before chemotherapy. Patients were categorized based on risk factors for left ventricular dysfunction-diabetes (DM), atrial fibrillation (AF), coronary heart disease (CHD), and previous oncological therapy-and compared to controls using independent <i>t</i>-tests. <b>Results</b>: Patients with previous oncological therapy exhibited a significantly lower right ventricular end-diastolic volume (RVEDV) (mean difference: -4.4 mL/m², 95% CI: -6.1 to -2.7, <i>p</i> < 0.001), lower right ventricular end-systolic volume (RVESV) (-2.3 mL/m², 95% CI: -3.4 to -1.2, <i>p</i> < 0.001), and lower right ventricular stroke volume (RVSV) (-2.1 mL/m², 95% CI: -3 to -1.2, <i>p</i> < 0.001). In patients with CHD, there was a higher right ventricular ejection fraction (RVEF) (3.0 mL/m², 95% CI: 0.8 to 5.2, <i>p</i> < 0.01), whereas patients with DM had lower RVEDV (-5.1 mL/m², 95% CI: -9.2 to -1, <i>p</i> < 0.05) and RVESV (-3.0 mL/m², 95% CI: -5.5 to -0.4, <i>p</i> < 0.05). No ventricular variables differed from the control group among patients with AF. <b>Conclusions</b>: Risk factors known to affect the left ventricle also impacted the right ventricle, with the exception of AF.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence as a Potential Tool for Predicting Surgical Margin Status in Early Breast Cancer Using Mammographic Specimen Images.","authors":"David Andras, Radu Alexandru Ilies, Victor Esanu, Stefan Agoston, Tudor Florin Marginean Jumate, George Calin Dindelegan","doi":"10.3390/diagnostics15101276","DOIUrl":"10.3390/diagnostics15101276","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Breast cancer is the most common malignancy among women globally, with an increasing incidence, particularly in younger populations. Achieving complete surgical excision is essential to reduce recurrence. Artificial intelligence (AI), including large language models like ChatGPT, has potential for supporting diagnostic tasks, though its role in surgical oncology remains limited. <b>Methods</b>: This retrospective study evaluated ChatGPT's performance (ChatGPT-4, OpenAI, March 2025) in predicting surgical margin status (R0 or R1) based on intraoperative mammograms of lumpectomy specimens. AI-generated responses were compared with histopathological findings. Performance was evaluated using sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), F1 score, and Cohen's kappa coefficient. <b>Results</b>: Out of a total of 100 patients, ChatGPT achieved an accuracy of 84.0% in predicting surgical margin status. Sensitivity for identifying R1 cases (incomplete excision) was 60.0%, while specificity for R0 (complete excision) was 86.7%. The positive predictive value (PPV) was 33.3%, and the negative predictive value (NPV) was 95.1%. The F1 score for R1 classification was 0.43, and Cohen's kappa coefficient was 0.34, indicating moderate agreement with histopathological findings. <b>Conclusions</b>: ChatGPT demonstrated moderate accuracy in confirming complete excision but showed limited reliability in identifying incomplete margins. While promising, these findings emphasize the need for domain-specific training and further validation before such models can be implemented in clinical breast cancer workflows.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid Stump Syndrome: A Case That Highlights the Necessity of Digital Subtraction Angiography for the Prompt Management of the Syndrome.","authors":"Christos Stenos, Aikaterini Anastasiou, Georgia Nikolopoulou, Panagiotis Papanagiotou, Georgios Papagiannis, Aikaterini Koutroumpi, Danai Drakopoulou, Periklis Anastasiou, Konstantina Yiannopoulou","doi":"10.3390/diagnostics15101273","DOIUrl":"10.3390/diagnostics15101273","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Carotid stump syndrome (CSS) is a rare and unexpected cause of recurrent ischemic ipsilateral events in the carotid vascular territory despite the demonstrated occlusion of the internal carotid artery (ICA). It is believed to be caused by microemboli due to turbulent blood flow in the patent stump of the occluded ICA that passes through anastomotic channels and retrograde flow into the middle cerebral artery circulation. <b>Case Presentation:</b> We describe the case of a 65-year-old male patient who suffered multiple concurrent transient ischemic attacks (TIAs) with a totally occluded ipsilateral ICA revealed by computed tomography angiography (CTA). He was diagnosed with CSS, which required the safest therapeutic approach. A further investigation with digital subtraction angiography (DSA) was performed, and a trickle of blood flow was observed in the reportedly occluded ICA. The diagnosis of a true ICA occlusion was withdrawn, and a diagnosis of pseudo-occlusion was established, affecting the final treatment strategy. Therefore, the patient underwent an ipsilateral carotid endarterectomy (CEA), and he has remained asymptomatic since then. <b>Conclusions:</b> The differentiation between a pseudo-occlusion and a true ICA occlusion is essential in promptly managing acute recurrent ipsilateral ischemic strokes in the carotid vascular territory. A further investigation with DSA in cases with a totally occluded ICA using CTA is essential for excluding pseudo-occlusions in ipsilaterally symptomatic patients.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Prognostic Markers in Extracorporeal Cardiopulmonary Resuscitation: 10-Year Experience from a Rural Tertiary Care Center.","authors":"Kamran Namjouyan, Aastha Mittal, Evan Gajkowski, Amanda Young, Sudheer Penupolu, Brendan Carry","doi":"10.3390/diagnostics15101275","DOIUrl":"10.3390/diagnostics15101275","url":null,"abstract":"<p><p><b>Background:</b> Extracorporeal cardiopulmonary resuscitation (eCPR) is a method for initiation of cardiopulmonary bypass during resuscitation of a patient with refractory cardiac arrest to support end-organ perfusion. This retrospective study evaluates which prognostic markers are seen in patients with poor outcomes who underwent eCPR in our rural tertiary care center. <b>Study Design/Methods:</b> All patients who underwent eCPR at our center from May 2013 to January 2023 were analyzed in a retrospective manner. We then compared outcomes in patients who survived to discharge (survivors) versus those who did not survive to discharge (non-survivors). Demographic factors, body mass index, peak serum lactate in 24 h, initial rhythm, lowest mean arterial pressure within the first six hours, a requirement of renal replacement therapy, and the number of blood transfusions required during the hospitalization were analyzed. <b>Results:</b> 37 patients (24 males and 13 females) with a median age of 58 years (IQR: 48-65) were included. The overall mortality rate was 75.7%, and all survivors had good neurological outcomes, which were defined as Cerebral Performance Category (CPC) scores of 1 or 2. The most significant factors seen in non-survivors were obesity as measured by BMI more than 30 (odds ratio = 7.33; 95% CI 1.40-38.33; <i>p</i> = 0.02), and lowest MAP <65 within the first 6 h despite being on extracorporeal membrane oxygenation (0% vs. 74.1%; <i>p</i> = <0.01). <b>Conclusions:</b> This retrospective study demonstrates that initial presentations of patients who underwent eCPR with obesity and MAPS < 65 within the first 6 h despite ECMO support were seen in patients with higher mortality.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Rheumatoid Arthritis Complicated by Compression of the Popliteal Artery and Tibial Nerve Due to an Organized Hematoma in the Popliteal Fossa: A Case Report and Literature Review.","authors":"Gi Beom Kim, Min Cheol Chang, Hyun-Je Kim","doi":"10.3390/diagnostics15101265","DOIUrl":"10.3390/diagnostics15101265","url":null,"abstract":"<p><strong>Background/objectives: </strong>Among the various types of masses that can cause compression, hematomas are a relatively common but often overlooked cause. Rheumatoid arthritis (RA) is associated with bleeding problems due to vascular inflammation, platelet dysfunction, impaired production of clotting factors, and medication use.</p><p><strong>Case presentation: </strong>We report a case of a 76-year-old woman with RA who developed vascular and neurological symptoms in her right lower leg due to compression of the popliteal artery and tibial nerve by an organized hematoma in the popliteal fossa. She experienced swelling, pain, and plantar flexor weakness in the affected leg with no history of trauma. Magnetic resonance imaging revealed a mass measuring 1.2 × 1.0 × 3.0 cm in size in the right popliteal fossa that was in contact with the popliteal artery and tibial nerve on its posterolateral aspect. Electrodiagnostic examination revealed that the right tibial neuropathy developed most probably around the knee level. Surgical excision of the hematoma resulted in almost complete resolution of symptoms, and excisional biopsy disclosed findings of an organized hematoma. We confirmed that the patient's symptoms were induced by compression of the popliteal artery and tibial nerve due to the organized hematoma in the right popliteal fossa.</p><p><strong>Conclusions: </strong>This case report emphasizes the importance of considering space-occupying lesions, such as organized hematomas, in patients with RA who develop neurological and vascular symptoms.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Cell Nuclei Segmentation Based on Computational and Handcrafted Features Using Machine Learning Algorithms.","authors":"Rashadul Islam Sumon, Md Ariful Islam Mozumdar, Salma Akter, Shah Muhammad Imtiyaj Uddin, Mohammad Hassan Ali Al-Onaizan, Reem Ibrahim Alkanhel, Mohammed Saleh Ali Muthanna","doi":"10.3390/diagnostics15101271","DOIUrl":"10.3390/diagnostics15101271","url":null,"abstract":"<p><p><b>Background:</b> Nuclei segmentation is the first stage of automated microscopic image analysis. The cell nucleus is a crucial aspect in segmenting to gain more insight into cell characteristics and functions that enable computer-aided pathology for early disease detection, such as prostate cancer, breast cancer, brain tumors, and other diagnoses. Nucleus segmentation remains a challenging task despite significant advancements in automated methods. Traditional techniques, such as Otsu thresholding and watershed approaches, are ineffective in challenging scenarios. However, deep learning-based methods exhibit remarkable results across various biological imaging modalities, including computational pathology. <b>Methods:</b> This work explores machine learning approaches for nuclei segmentation by evaluating the quality of nuclei image segmentation. We employed several methods, including K-means clustering, Random Forest (RF), Support Vector Machine (SVM) with handcrafted features, and Logistic Regression (LR) using features derived from Convolutional Neural Networks (CNNs). Handcrafted features extract attributes like the shape, texture, and intensity of nuclei and are meticulously developed based on specialized knowledge. Conversely, CNN-based features are automatically acquired representations that identify complex patterns in nuclei images. To assess how effectively these techniques segment cell nuclei, their performance is evaluated. <b>Results:</b> Experimental results show that Logistic Regression based on CNN-derived features outperforms the other techniques, achieving an accuracy of 96.90%, a Dice coefficient of 74.24, and a Jaccard coefficient of 55.61. In contrast, the Random Forest, Support Vector Machine, and K-means algorithms yielded lower segmentation performance metrics. <b>Conclusions:</b> The conclusions suggest that leveraging CNN-based features in conjunction with Logistic Regression significantly enhances the accuracy of cell nuclei segmentation in pathological images. This approach holds promise for refining computer-aided pathology workflows, potentially leading to more reliable and earlier disease diagnoses.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Angio-Seal™ Device as a Simplified and Technically Feasible Alternative for Tract Closure in Percutaneous Portal Vein Access: A Retrospective Study.","authors":"Ismail Karluka, Mustafa Mazıcan","doi":"10.3390/diagnostics15101266","DOIUrl":"10.3390/diagnostics15101266","url":null,"abstract":"<p><p><b>Purpose:</b> This study aimed to evaluate the efficacy and safety of the Angio-Seal™ VIP vascular closure device (VCD) in achieving hemostasis following percutaneous transhepatic portal venous interventions. <b>Methods:</b> This retrospective study evaluated 20 patients (mean age: 52.85 ± 16.18 years; 80% male) who underwent percutaneous transhepatic portal vein interventions followed by tract closure with the Angio-Seal™ device between January 2016 and September 2024. Procedural data, pre- and post-procedural hemoglobin and hematocrit levels, and complications were analyzed. Technical success was defined as the successful deployment of the device with immediate hemostasis and no evidence of bleeding on post-procedural imaging. <b>Results:</b> Technical success, as defined in this study, was achieved in all 20 procedures (100%). The mean hemoglobin level declined from 11.91 ± 2.01 g/dL to 11.09 ± 2.19 g/dL (<i>p</i> < 0.001), and the mean hematocrit level decreased from 36.18 ± 6.03% to 32.98 ± 5.80% (<i>p</i> = 0.001). A hemoglobin drop ≥2 g/dL occurred in two patients (10%) and a hematocrit drop ≥4% in six patients (30%); none were associated with imaging or clinical evidence of hemorrhage. No major complications were observed. Minor complications, including localized pain managed with analgesics, occurred in five patients (25%). Follow-up imaging confirmed the absence of hemoperitoneum or device-related failure. <b>Conclusions:</b> Angio-Seal™ is a technically feasible, safe, and effective option for tract closure following percutaneous transhepatic portal vein access. This single-device approach may offer a cost-effective alternative to traditional embolization techniques. However, more extensive prospective studies are required to validate these findings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}