Explore the vast range of titles available.

 To evaluate the incremental diagnostic value of combining free prostate-specific antigen density (FPSAD) with Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) for clinically significant prostate cancer (csPCa,defined as Gleason score≥3+4) in the diagnostic gray zone (tPSA 4-10 ng/mL). This retrospective study analyzed 137 patients (75 with csPCa and 62 with non-clinically significant prostate cancer (ncsPCa) who underwent transperineal prostate biopsy at Xiangtan Central Hospital between January 2022 and January 2024. PI-RADS v2.1 scores were assigned based on magnetic resonance (MR) imaging, and prostate volume (PV) and FPSAD were calculated. Statistical analyses included chi-square/Fisher's exact tests for categorical variables and independent -tests for continuous variables. Logistic regression identified independent predictors of csPCa, and a nomogram model was developed. Model performance was evaluated using calibration curves and receiver operating characteristic (ROC) analysis.  Significant differences were observed in FPSAD, PI-RADS v2.1 scores, and free PSA (fPSA) between the csPCa and ncsPCa groups ( < 0.01). FPSAD (OR = 1.95, 95% CI: 1.22-2.22, < 0.01) and PI-RADS v2.1 scores (OR = 2.41, 95% CI: 1.57-3.70, < 0.01) were independent predictors of csPCa. The combined FPSAD and PI-RADS v2.1 model demonstrated superior diagnostic performance (AUC =0.829) compared to FPSAD alone (AUC = 0.69) or PI-RADS v2.1 alone (AUC = 0.773) ( < 0.01), with 91% sensitivity and 32% fewer unnecessary biopsies than PI-RADS≥3 criteria. In PI-RADS 3 subgroup (n=41), FPSAD correctly reclassified 13/18 (72.2%) indeterminate cases.  For Asian men with tPSA 4-10 ng/mL, the FPSAD+PI-RADS algorithm (cutoffs: >0.017 and ≥4) provides 15-20% higher accuracy than either marker alone, while reducing biopsies by 25%. This approach is particularly valuable for PI-RADS 3 cases, where it resolved >65% of diagnostic uncertainties in our cohort.

The role of chest computed tomography (CT) in distinguishing the causative pathogens of pulmonary infections in patients with hematological malignancies (HM) is unclear. The aim of our study was to compare and assess the clinical characteristics, radiologic features and potential differential diagnostic value of CT in HM patients and other different immune statuses patients with pulmonary infections. Patients were divided into immunocompetent (105 cases) and immunocompromised groups (99 cases) according to immune status. Immunocompromised patients included the HM group (63 cases) and the non-HM group (42 cases). The basic clinical data and CT findings were collected and statistically analyzed. Regarding the pathogen distribution, viral, and mixed infections were more common in the immunocompromised group than the immunocompetent (p < 0.01), but viral infections were more common in the HM group than in the non-HM group (p=0.013). Immunocompromised patients had more diverse CT findings and more serious lesions (mostly graded 2-4) than immunocompetent patients. The most common CT findings in HM patients were consolidation and ground-glass opacities (GGO), which were also found in the non-HM group. The overall diagnostic accuracy of CT was lower in immunocompromised patients than in immunocompetent patients (25.7% vs 50.5%, p< 0.01). CT had better diagnostic efficacy for fungi and in HM patients. CT diagnosis is less efficient in distinguishing the causative pathogens of HM patients. However, CT can help distinguish fungal pneumonia and pneumonia in HM patients. Our study might facilitate clinical decision-making in fungal pneumonia and pneumonia in HM patients.

PurposeTo validate and compare diagnostic value of three newly-released Thyroid Imaging Reporting and Data Systems (TIRADS) for cancer risk determination.MethodsTotal 2031 patients with 2465 thyroid nodules were recruited for this study. Ultrasound (US) images were categorized based on three TIRADS editions established by Korean Society of Thyroid Radiology (KSThR), European Thyroid Association (ETA) and American College of Radiology (ACR). ROC curves were established to compare diagnostic value.ResultsTotal 1460 benign and 1005 malignant nodules were enrolled. The malignancy rates of each category in KSThR-TIRADS were 2.8%, 5.1%, 33.7% and 79.6%, respectively. For European-TIRADS, 0, 3.1, 22.8, and 73.5% of nodules categorized as 2 to 5 were malignant. Distribution of carcinomas among ACR-TIRADS categories was 0%, 2.3%, 7.5%, 40.1% and 81.4%, respectively. In terms of diagnostic value, KSThR-TIRADS had highest AUC (0.855) and specificity (87.4%), while lowest (71.4%) sensitivity. ACR-TIRADS showed best sensitivity (96.6%) with lowest specificity (52.9%) and the AUC (0.846) was slightly lower than KSThR-TIRADS. Total 56.1, 45.4, and 37.4% fine-needle aspiration biopsy (FNAB) were recommended by KSThR, ETA and ACR, revealing 42.8%, 44.5% and 53.6% malignant lesions, respectively. The rate of unnecessary FNAB was lowest with the ACR (17.3%), followed by ETA (25.2%) and KSThR (32.1%).ConclusionAll these US models showed great value in predicting thyroid malignancy. Among them, KSThR-TIRADS showed the most effective diagnostic performance in specificity, while ACR-TIRADS yielded best sensitivity. As for FNAB criteria, ACR-TIRADS showed the lowest rate of unnecessary FNAB and highest rate of malignancy in FNAB.

Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer‐assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.

PurposeTo compare the incremental diagnostic value of amyloid-PET and CSF (Aβ42, tau, and phospho-tau) in AD diagnosis in patients with mild cognitive impairment (MCI) or mild dementia, in order to improve the definition of diagnostic algorithm.MethodsTwo independent dementia experts provided etiological diagnosis and relative diagnostic confidence in 71 patients on 3 rounds, based on (1) clinical, neuropsychological, and structural MRI information alone; (2) adding one biomarker (CSF amyloid and tau levels or amyloid-PET with a balanced randomized design); and (3) adding the other biomarker.ResultsAmong patients with a pre-biomarker diagnosis of AD, negative PET induced significantly more diagnostic changes than amyloid-negative CSF at both rounds 2 (CSF 67%, PET 100%, P = 0.028) and 3 (CSF 0%; PET 78%, P < 0.001); PET induced a diagnostic confidence increase significantly higher than CSF on both rounds 2 and 3.ConclusionsAmyloid-PET should be prioritized over CSF biomarkers in the diagnostic workup of patients investigated for suspected AD, as it provides greater changes in diagnosis and diagnostic confidence.Trial registrationEudraCT no.: 2014-005389-31

Objective To clarify the efficacy of artificial intelligence (AI)-assisted imaging in the diagnosis of developmental dysplasia of the hip (DDH) through a meta-analysis. Methods Relevant literature on AI for early DDH diagnosis was searched in PubMed, Web of Science, Embase, and The Cochrane Library databases until April 4, 2024. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of included studies. Revman5.4 and StataSE-64 software were used to calculate the combined sensitivity, specificity, AUC value, and DOC value of AI-assisted imaging for DDH diagnosis. Results The meta-analysis included 13 studies (6 prospective and 7 retrospective) with 28 AI models and a total of 10,673 samples. The summary sensitivity, specificity, AUC value, and DOC value were 99.0% (95% CI: 97.0-100.0%), 94.0% (95% CI: 89.0–96.0%), 99.0% (95% CI: 98.0-100.0%), and 1342 (95% CI: 469–3842), respectively. Conclusion AI-assisted imaging demonstrates high diagnostic efficacy for DDH detection, improving the accuracy of early DDH imaging examination. More prospective studies are needed to further confirm the value of AI-assisted imaging for early DDH diagnosis.

Lower respiratory tract infections are associated with high morbidity and mortality and significant clinical harm. Due to the limited ability of traditional pathogen detection methods, anti-infective therapy is mostly empirical. Therefore, it is difficult to adopt targeted drug therapy. In recent years, metagenomic next-generation sequencing (mNGS) technology has provided a promising means for pathogen-specific diagnosis and updated the diagnostic strategy for lower respiratory tract infections. This article reviews the diagnostic value of mNGS for lower respiratory tract infections, the impact of different sampling methods on the detection efficiency of mNGS, and current technical difficulties in the clinical application of mNGS.

BackgroundRed blood cell distribution width (RDW) is a common biomarker of bacterial infections, and it can be easily obtained from a routine blood test. We investigate the diagnostic value of RDW for the prediction of mortality in adult sepsis patients through a review and meta-analysis. We registered this review in PROSPERO (Registration Number: CRD42022357712), and the details of the registration are included in Appendix 1.MethodsWe searched PubMed, Cochrane Library, Springer, and Embase between Jan. 1, 2000, and May 30, 2022, for primary studies about this research. We collected articles that investigated RDW for varying degrees of sepsis patients—those who suffered from sepsis, severe sepsis, or sepsis shock. Studies of healthy people and sepsis of children and neonates were excluded from our research. The definition of study characteristics and data extraction were finished by two independent researchers and discrepancies resolved by consensus. The combined sensitivities and specificities were calculated by meta-analysis using STATA14.0. The sensitivity of the included studies was analyzed by excluding studies that had potential heterogeneity. A summary operating characteristic curve was made to evaluate the diagnostic value for the prediction of mortality in adult sepsis patients. The Fagan test was used to explore likelihood ratios and posttest probabilities. Finally, we investigated the source of heterogeneity using meta-regression.ResultsTwenty-four studies, including 40,763 cases altogether, were included in this analysis. Bivariate analysis indicated a combined sensitivity of 0.81 (95% CI 0.73–0.86) and specificity of 0.65 (95% CI 0.54–0.75). The area under the summary receiver operating characteristic curve was 0.81 (95% CI 0.77–0.84). Substantial heterogeneity resided in the studies ( I2 = 96.68, 95% CI 95.95–97.4). Meta-regression showed that the reference description, prospective design, and blinded interpretation of the included studies could be responsible for the heterogeneity.ConclusionsRWD is an available and valuable biomarker for prediction of mortality in adult sepsis patients.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022357712.

MicroRNAs (miRNAs) are a class of short, single-stranded, noncoding RNAs, with a length of about 18–22 nucleotides. Extracellular vesicles (EVs) are derived from cells and play a vital role in the development of diseases and can be used as biomarkers for liquid biopsy, as they are the carriers of miRNA. Existing studies have found that most of the functions of miRNA are mainly realized through intercellular transmission of EVs, which can protect and sort miRNAs. Meanwhile, detection sensitivity and specificity of EV-derived miRNA are higher than those of conventional serum biomarkers. In recent years, EVs have been expected to become a new marker for liquid biopsy. This review summarizes recent progress in several aspects of EVs, including sorting mechanisms, diagnostic value, and technology for isolation of EVs and detection of EV-derived miRNAs. In addition, the study reviews challenges and future research avenues in the field of EVs, providing a basis for the application of EV-derived miRNAs as a disease marker to be used in clinical diagnosis and even for the development of point-of-care testing (POCT) platforms.

Systemic volume changes during acute lung injury (ALI) are closely related to lung injury severity, disease progression, and treatment methods. Twenty-one goats were divided into control, mild injury, and severe injury groups via oleic acid injection. Carotid ultrasound measured carotid diameter and corrected flow time (FTc), while cardiac ultrasound assessed aortic and pulmonary artery velocity–time integral (VTI). Post-euthanasia at 6 h, lung wet-to-dry (W/D) ratio and pathological scores were analyzed. Statistical trends, correlations between ultrasound parameters and lung injury markers, and diagnostic performance via ROC analysis were evaluated. The severe injury group had significantly higher lung W/D ratios and pathological scores than the mild injury group. Carotid ultrasound showed a progressive decrease in carotid diameter and FTc post-injury, with FTc significantly lower in the severe injury group at 6-h. FTc was negatively correlated with lung W/D ratio and pathological scores. Cardiac ultrasound indicated a decreasing trend in aortic and pulmonary artery VTI post-injury, with pulmonary artery VTI significantly lower in the severe injury group at all times and negatively correlated with lung W/D ratio and pathological scores. ROC analysis showed that pulmonary artery VTI had the highest area under the curve (AUC), with values greater than 0.8 at all time points. The combined use of pulmonary artery VTI and carotid FTc had AUC values greater than 0.85 at all time points, peaking at 6-h (AUC = 0.951). In conclusion, pulmonary artery VTI is an excellent indicator for evaluating ALI severity post-injury, and the combination of pulmonary artery VTI and carotid FTc shows strong diagnostic performance for assessing ALI severity.