Journal Description
Diagnostics
Diagnostics
is an international, peer-reviewed, open access journal on medical diagnosis published semimonthly online by MDPI. The British Neuro-Oncology Society (BNOS), the International Society for Infectious Diseases in Obstetrics and Gynaecology (ISIDOG) and the Swiss Union of Laboratory Medicine (SULM) are affiliated with Diagnostics and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Inspec, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.7 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journal: LabMed.
Impact Factor:
3.6 (2022);
5-Year Impact Factor:
3.7 (2022)
Latest Articles
Assessing the Efficacy of Radioactive Iodine Seed Localisation in Targeted Axillary Dissection for Node-Positive Early Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy: A Comprehensive Review and Pooled Analysis
Diagnostics 2024, 14(11), 1175; https://doi.org/10.3390/diagnostics14111175 (registering DOI) - 2 Jun 2024
Abstract
Targeted axillary dissection (TAD), employing marked lymph node biopsy (MLNB) alongside sentinel lymph node biopsy (SLNB), is increasingly recognised for its efficacy in reducing false negative rates (FNRs) in node-positive early breast cancer patients receiving neoadjuvant systemic therapy (NST). One such method, 125
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Targeted axillary dissection (TAD), employing marked lymph node biopsy (MLNB) alongside sentinel lymph node biopsy (SLNB), is increasingly recognised for its efficacy in reducing false negative rates (FNRs) in node-positive early breast cancer patients receiving neoadjuvant systemic therapy (NST). One such method, 125I radioactive seed localisation (RSL), involves implanting a seed into a biopsy-proven lymph node either pre- or post-NST. This systematic review and pooled analysis aimed to assess the performance of RSL in TAD among node-positive patients undergoing NST. Six studies, encompassing 574 TAD procedures, met the inclusion criteria. Results showed a 100% successful deployment rate, with a 97.6% successful localisation rate and a 99.8% retrieval rate. Additionally, there was a 60.0% concordance rate between SLNB and MLNB. The FNR of SLNB alone was significantly higher than it was for MLNB (18.8% versus 5.3%, respectively; p = 0.001). Pathological complete response (pCR) was observed in 44% of cases (248/564). On average, the interval from 125I seed deployment to surgery was 75.8 days (range: 0–272). These findings underscore the efficacy of RSL in TAD for node-positive patients undergoing NST, enabling precise axillary pCR identification and facilitating the safe omission of axillary lymph node dissection.
Full article
(This article belongs to the Special Issue Updates on Breast Cancer: Diagnosis and Management)
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TSSG-CNN: A Tuberculosis Semantic Segmentation-Guided Model for Detecting and Diagnosis Using the Adaptive Convolutional Neural Network
by
Tae Hoon Kim, Moez Krichen, Stephen Ojo, Meznah A. Alamro and Gabriel Avelino Sampedro
Diagnostics 2024, 14(11), 1174; https://doi.org/10.3390/diagnostics14111174 (registering DOI) - 1 Jun 2024
Abstract
Tuberculosis (TB) is an infectious disease caused by Mycobacterium. It primarily impacts the lungs but can also endanger other organs, such as the renal system, spine, and brain. When an infected individual sneezes, coughs, or speaks, the virus can spread through the air,
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Tuberculosis (TB) is an infectious disease caused by Mycobacterium. It primarily impacts the lungs but can also endanger other organs, such as the renal system, spine, and brain. When an infected individual sneezes, coughs, or speaks, the virus can spread through the air, which contributes to its high contagiousness. The goal is to enhance detection recognition with an X-ray image dataset. This paper proposed a novel approach, named the Tuberculosis Segmentation-Guided Diagnosis Model (TSSG-CNN) for Detecting Tuberculosis, using a combined semantic segmentation and adaptive convolutional neural network (CNN) architecture. The proposed approach is distinguished from most of the previously proposed approaches in that it uses the combination of a deep learning segmentation model with a follow-up classification model based on CNN layers to segment chest X-ray images more precisely as well as to improve the diagnosis of TB. It contrasts with other approaches like ILCM, which is optimized for sequential learning, and explainable AI approaches, which focus on explanations. Moreover, our model is beneficial for the simplified procedure of feature optimization from the perspectives of approach using the Mayfly Algorithm (MA). Other models, including simple CNN, Batch Normalized CNN (BN-CNN), and Dense CNN (DCNN), are also evaluated on this dataset to evaluate the effectiveness of the proposed approach. The performance of the TSSG-CNN model outperformed all the models with an impressive accuracy of 98.75% and an F1 score of 98.70%. The evaluation findings demonstrate how well the deep learning segmentation model works and the potential for further research. The results suggest that this is the most accurate strategy and highlight the potential of the TSSG-CNN Model as a useful technique for precise and early diagnosis of TB.
Full article
(This article belongs to the Special Issue Fifth Anniversary of "Machine Learning and Artificial Intelligence in Diagnostics" Section)
Open AccessArticle
Right Bundle Branch Block Predicts Appropriate Implantable Cardioverter Defibrillator Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy and a Prophylactic Implantable Cardioverter Defibrillator
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Marta Jiménez-Blanco Bravo, Gonzalo Luis Alonso Salinas, Carolina Parra Esteban, Jorge Toquero Ramos, Miguel Amores Luque, Jose Luis Zamorano Gómez, Eusebio García-Izquierdo, Jesús Álvarez-García, Ignacio Fernández Lozano and Víctor Castro Urda
Diagnostics 2024, 14(11), 1173; https://doi.org/10.3390/diagnostics14111173 (registering DOI) - 1 Jun 2024
Abstract
Background: The benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: We retrospectively reviewed all consecutive patients
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Background: The benefit of prophylactic implantable cardioverter defibrillators (ICDs) in patients with severe systolic dysfunction of non-ischemic origin is still unclear, and the identification of patients at risk for sudden cardiac death remains a major challenge. Aims/Methods: We retrospectively reviewed all consecutive patients with non-ischemic dilated cardiomyopathy (NICM) who underwent prophylactic ICD implantation between 2008 and 2020 in two tertiary centers. Our main goal was to identify the predictors of appropriate ICD therapies (anti-tachycardia pacing [ATP] and/or shocks) in this cohort of patients. Results: A total of 224 patients were included. After a median follow-up of 51 months, 61 patients (27.2%) required appropriate ICD therapies. Patients with appropriate ICD therapies were more frequently men (87% vs. 69%, p = 0.006), of younger age (59 years, (53–65) vs. 64 years, (57–70); p = 0.02), showed more right bundle branch blocks (RBBBs) (15% vs. 4%, p = 0.007) and less left bundle branch blocks (LBBBs) (26% vs. 47%, p = 0.005) in the ECG, and had higher left ventricular end-diastolic (100 mL/m2, (90–117) vs. 86, (71–110); p = 0.011) and systolic volumes (72 mL/m2, (59–87) vs. 61, (47–81), p = 0.05). In a multivariate competing-risks regression analysis, RBBB (HR 2.26, CI 95% 1.02–4.98, p = 0.043) was identified as an independent predictor of appropriate ICD therapies. Conclusion: RBBBs may help to identify patients with NICM at high risk of ventricular arrhythmias and requiring ICD intervention.
Full article
(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)
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Open AccessReview
Struma Ovarii during Pregnancy
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Gabriela Dumachița-Șargu, Răzvan Socolov, Teodora Ana Balan, Dumitru Gafițanu, Mona Akad and Raluca Anca Balan
Diagnostics 2024, 14(11), 1172; https://doi.org/10.3390/diagnostics14111172 (registering DOI) - 1 Jun 2024
Abstract
Struma ovarii is a rare type of ovarian teratoma primarily composed of over 50% thyroid tissue. Its occurrence is reported in 2–5% of all ovarian teratomas, with approximately 0.5% to 10% showing malignant transformation. Managing it during pregnancy poses significant challenges as pregnancy
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Struma ovarii is a rare type of ovarian teratoma primarily composed of over 50% thyroid tissue. Its occurrence is reported in 2–5% of all ovarian teratomas, with approximately 0.5% to 10% showing malignant transformation. Managing it during pregnancy poses significant challenges as pregnancy can promote the growth of malignant struma ovarii due to elevated levels of ovarian and pregnancy-related hormones, including estrogen, progesterone, and human chorionic gonadotrophin (hCG). Most ovarian tumors, including struma ovarii, are detected during routine ultrasonography in the first and second trimesters, often as acute emergencies. Diagnosis during pregnancy is rare, with some cases incidentally discovered during cesarean section when inspecting the adnexa for ovarian cysts. This review explores the diagnostic, management, and therapeutic approaches to struma ovarii during pregnancy.
Full article
(This article belongs to the Special Issue Advancements in Maternal–Fetal Medicine)
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Open AccessArticle
Orthodontic System Modeled and Simulated with the Lingual Technique to Assess Tooth Forces
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Abbas Hazem, Felicia Ileana Mărășescu, Mihaela Jana Țuculină, Alexandru Dan Popescu, Dragoș Laurențiu Popa, Lelia Laurența Mihai, Cristian Niky Cumpătă, Alexandru Iliescu, Petre Mărășescu and Ionela Teodora Dascălu
Diagnostics 2024, 14(11), 1171; https://doi.org/10.3390/diagnostics14111171 (registering DOI) - 31 May 2024
Abstract
CBCT (cone beam computed tomography) is an imaging investigation that provides three-dimensional (3D) images of craniofacial structures. The purpose of this study is to determine the mechanical behavior of an orthodontic system where the lingual treatment technique was used in a 25-year-old female
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CBCT (cone beam computed tomography) is an imaging investigation that provides three-dimensional (3D) images of craniofacial structures. The purpose of this study is to determine the mechanical behavior of an orthodontic system where the lingual treatment technique was used in a 25-year-old female patient from whom a set of CBCT scans was used. CBCT images were processed through software programs such as Invesalius, Geomagic, and Solid Works, to create models containing virtual solids. These models were then imported into Ansys Workbench 2019 R3 (a finite element method software program) for successive simulations to generate displacement maps, deformations, stress distributions, and diagrams. We observed that in the lingual technique, the lowest force occurring on the maxillary teeth is at 1.1, while the highest force appears at 2.3. In the mandible, the lowest force occurs at 4.6, and the highest force at 3.1. The values of the forces and the results of the finite element method can represent a basis for the innovation of new orthodontic springs and also of bracket elements. Thus, by using new technologies, orthodontic practice can be significantly improved for the benefit of patients. Other virtual methods and techniques can be used in future studies, including the application of virtual reality for orthodontic diagnosis.
Full article
(This article belongs to the Special Issue Advanced Diagnosis and Treatment Plan for Orthodontic and Oro-Facial Rehabilitations)
Open AccessArticle
A Magnetic Resonance Spectroscopy Study on Polarity Subphenotypes in Bipolar Disorder
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Georgios D. Argyropoulos, Foteini Christidi, Efstratios Karavasilis, Peter Bede, Georgios Velonakis, Anastasia Antoniou, Ioannis Seimenis, Nikolaos Kelekis, Nikolaos Smyrnis, Olympia Papakonstantinou, Efstathios Efstathopoulos and Panagiotis Ferentinos
Diagnostics 2024, 14(11), 1170; https://doi.org/10.3390/diagnostics14111170 - 31 May 2024
Abstract
Although magnetic resonance spectroscopy (MRS) has provided in vivo measurements of brain chemical profiles in bipolar disorder (BD), there are no data on clinically and therapeutically important onset polarity (OP) and predominant polarity (PP). We conducted a proton MRS study in BD polarity
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Although magnetic resonance spectroscopy (MRS) has provided in vivo measurements of brain chemical profiles in bipolar disorder (BD), there are no data on clinically and therapeutically important onset polarity (OP) and predominant polarity (PP). We conducted a proton MRS study in BD polarity subphenotypes, focusing on emotion regulation brain regions. Forty-one euthymic BD patients stratified according to OP and PP and sixteen healthy controls (HC) were compared. 1H-MRS spectra of the anterior and posterior cingulate cortex (ACC, PCC), left and right hippocampus (LHIPPO, RHIPPO) were acquired at 3.0T to determine metabolite concentrations. We found significant main effects of OP in ACC mI, mI/tNAA, mI/tCr, mI/tCho, PCC tCho, and RHIPPO tNAA/tCho and tCho/tCr. Although PP had no significant main effects, several medium and large effect sizes emerged. Compared to HC, manic subphenotypes (i.e., manic-OP, manic-PP) showed greater differences in RHIPPO and PCC, whereas depressive suphenotypes (i.e., depressive-OP, depressive-PP) in ACC. Effect sizes were consistent between OP and PP as high intraclass correlation coefficients (ICC) were confirmed. Our findings support the utility of MRS in the study of the neurobiological underpinnings of OP and PP, highlighting that the regional specificity of metabolite changes within the emotion regulation network consistently marks both polarity subphenotypes.
Full article
(This article belongs to the Special Issue Clinical Applications and Potential of Magnetic Resonance Spectroscopy)
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Open AccessReview
Neurosurgical Intervention for Nerve and Muscle Biopsies
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Ali A. Mohamed, Thomas Caussat, Edwin Mouhawasse, Rifa Ali, Phillip M. Johansen and Brandon Lucke-Wold
Diagnostics 2024, 14(11), 1169; https://doi.org/10.3390/diagnostics14111169 - 31 May 2024
Abstract
(1) Background: Neurologic and musculoskeletal diseases represent a considerable portion of the underlying etiologies responsible for the widely prevalent symptoms of pain, weakness, numbness, and paresthesia. Because of the subjective and often nonspecific nature of these symptoms, different diagnostic modalities have been explored
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(1) Background: Neurologic and musculoskeletal diseases represent a considerable portion of the underlying etiologies responsible for the widely prevalent symptoms of pain, weakness, numbness, and paresthesia. Because of the subjective and often nonspecific nature of these symptoms, different diagnostic modalities have been explored and utilized. (2) Methods: Literature review. (3) Results: Nerve and muscle biopsy remains the gold standard for diagnosing many of the responsible neurological and musculoskeletal conditions. However, the need for invasive tissue sampling is diminishing as more investigations explore alternative diagnostic modalities. Because of this, it is important to explore the current role of neurosurgical intervention for nerve and muscle biopsies and its current relevance in the diagnostic landscape of neurological and musculoskeletal disorders. With consideration of the role of nerve and muscle biopsy, it is also important to explore innovations and emerging techniques for conducting these procedures. This review explores the indications and emerging techniques for neurological intervention for nerve and muscle biopsies. (4) Conclusions: The role of neurosurgical intervention for nerve and muscle biopsy remains relevant in diagnosing many neurological and musculoskeletal disorders. Biopsy is especially relevant as a supportive point of evidence for diagnosis in atypical cases. Additionally, emerging techniques have been explored to guide diagnostics and biopsy, conduct less invasive biopsies, and reduce risks of worsening neurologic function and other symptoms secondary to biopsy.
Full article
(This article belongs to the Special Issue Musculoskeletal Disorders: Diagnosis, Management, and Rehabilitation)
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Open AccessReview
A Comprehensive Review of the Global Epidemiology, Clinical Management, Socio-Economic Impacts, and National Responses to Long COVID with Future Research Directions
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Xiufang Song, Weiwei Song, Lizhen Cui, Tim Q. Duong, Rajiv Pandy, Hongdou Liu, Qun Zhou, Jiayao Sun, Yanli Liu and Tong Li
Diagnostics 2024, 14(11), 1168; https://doi.org/10.3390/diagnostics14111168 - 31 May 2024
Abstract
Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a literature review,
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Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management; Conclusions: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Addressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.
Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
Open AccessArticle
Is There an Immunohistochemical PD-L1 Cut-Off Point That Serves as a Prognostic Indicator for Large B-Cell Lymphomas?
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Selcuk Cin, Suat Hilal Aki, Tugrul Elverdi, Deniz Ozmen and Ayse Salihoglu
Diagnostics 2024, 14(11), 1167; https://doi.org/10.3390/diagnostics14111167 - 31 May 2024
Abstract
The aim of this study is to investigate whether there is a cut-off value for PD-L1 expression in large B-cell lymphomas that predicts prognosis, and to clarify the relationship between PD-L1 expression and histopathological as well as clinical parameters. The study included a
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The aim of this study is to investigate whether there is a cut-off value for PD-L1 expression in large B-cell lymphomas that predicts prognosis, and to clarify the relationship between PD-L1 expression and histopathological as well as clinical parameters. The study included a total of 130 patients who were diagnosed with large B-cell lymphoma at Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Pathology Department. Biopsy samples were assessed using the PD-L1 immunohistochemical antibody (Dako, 22C3 clone). The patients had a mean age of 54 ± 17 years, with a median age of 56 years. No statistically significant difference was observed between the groups in terms of survival when the 30% cut-off value was used. However, a noteworthy discrepancy in survival became apparent when the cut-off point was established at 70%. Among the diffuse large B-cell lymphoma-not otherwise specified (DLBCL-NOS) category, the activated B-cell-like (ABC-like) phenotype showed higher PD-L1 expression compared to the germinal center B-cell-like (GCB-like) phenotype. Immunohistochemical PD-L1 expression emerged as a prognostic factor, particularly significant in the ABC-like phenotype.
Full article
(This article belongs to the Special Issue New Promising Diagnostic Signatures in Histopathological Diagnosis)
Open AccessArticle
Clinical and Analytical Comparison of Monoclonal and Polyclonal Immunoassays for Fecal Pancreatic Elastase
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Jasna Lenicek Krleza, Merica Aralica, Lara Milevoj Kopcinovic and Renata Zrinski Topic
Diagnostics 2024, 14(11), 1166; https://doi.org/10.3390/diagnostics14111166 - 31 May 2024
Abstract
Background: Numerous immunoassays have been commercialized to determine pancreatic elastase (PE) in feces in screening for exocrine pancreatic insufficiency (EPI), but how the different assays compare to one another is controversial, especially in the context that all methods use the same cut-off values
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Background: Numerous immunoassays have been commercialized to determine pancreatic elastase (PE) in feces in screening for exocrine pancreatic insufficiency (EPI), but how the different assays compare to one another is controversial, especially in the context that all methods use the same cut-off values for interpreting the results obtained on the presence or absence of EPI or the degree of insufficiency if it is present. Our aim was to analytically verify a new method for determining PE, compare the results with a previous method, and verify the declared cut-off values for interpretation of the results. Methods: PE in the stool was assayed using a previous monoclonal enzyme-linked immunosorbent assay (“ScheBo ELISA”) and a new polyclonal particle-enhanced turbidimetric immunoassay (“Bühlmann PETIA”). The direct method comparison of two immunoassays was performed in 40 samples. Clinical comparisons were conducted against each other for the binary determination of “abnormal/normal” elastase levels and the three-way determination of “severe/moderate/no” EPI in 56 samples. The indirect comparison method used external quality assessment (EQA) data to compare the monoclonal and polyclonal immunoassays for PE, and additionally compare the monoclonal ScheBo ELISA to a monoclonal chemiluminescence immunoassay (“DiaSorin CLIA”). Results: Precision in the series and intra-laboratory precision for Bühlmann PETIA met the manufacturer’s specifications for the concentration range of limit/lower values and the range of normal values. The Bühlmann PETIA immunoassay on different analytical platforms yielded comparable results and nearly perfect agreement in the case of three-way classification (kappa = 0.89 with 95%CI from 0.79 to 1.00. ScheBo ELISA tends to generate higher values of pancreatic elastase than the Bühlmann PETIA; agreement between the methods was moderate in the case of binary classification (kappa = 0.43; 95% CI 0.25 to 0.62), and substantial in the case of three-way classification (kappa = 0.62; 95% CI 0.50 to 0.75). EQA data analysis showed a statistically significant difference between ScheBo ELISA and Bühlmann PETIA peer groups (p = 0.031), as well as the DiaSorin CLIA and ScheBo ELISA peer groups (p = 0.010). Conclusion: The ScheBo ELISA and Bühlmann PETIA do not appear to be commutable in the analytical and clinical context. Our data address a discordance between different mono- and polyclonal immunoassays for pancreatic elastase and the potential of misclassification using its universal cut-off values in screening suspected patients for exocrine pancreatic insufficiency.
Full article
(This article belongs to the Special Issue Exploring the Role of Diagnostic Biochemistry)
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Can Artificial Intelligence “Hold” a Dermoscope?—The Evaluation of an Artificial Intelligence Chatbot to Translate the Dermoscopic Language
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Emmanouil Karampinis, Olga Toli, Konstantina-Eirini Georgopoulou, Elli Kampra, Christina Spyridonidou, Angeliki-Victoria Roussaki Schulze and Efterpi Zafiriou
Diagnostics 2024, 14(11), 1165; https://doi.org/10.3390/diagnostics14111165 - 31 May 2024
Abstract
This survey represents the first endeavor to assess the clarity of the dermoscopic language by a chatbot, unveiling insights into the interplay between dermatologists and AI systems within the complexity of the dermoscopic language. Given the complex, descriptive, and metaphorical aspects of the
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This survey represents the first endeavor to assess the clarity of the dermoscopic language by a chatbot, unveiling insights into the interplay between dermatologists and AI systems within the complexity of the dermoscopic language. Given the complex, descriptive, and metaphorical aspects of the dermoscopic language, subjective interpretations often emerge. The survey evaluated the completeness and diagnostic efficacy of chatbot-generated reports, focusing on their role in facilitating accurate diagnoses and educational opportunities for novice dermatologists. A total of 30 participants were presented with hypothetical dermoscopic descriptions of skin lesions, including dermoscopic descriptions of skin cancers such as BCC, SCC, and melanoma, skin cancer mimickers such as actinic and seborrheic keratosis, dermatofibroma, and atypical nevus, and inflammatory dermatosis such as psoriasis and alopecia areata. Each description was accompanied by specific clinical information, and the participants were tasked with assessing the differential diagnosis list generated by the AI chatbot in its initial response. In each scenario, the chatbot generated an extensive list of potential differential diagnoses, exhibiting lower performance in cases of SCC and inflammatory dermatoses, albeit without statistical significance, suggesting that the participants were equally satisfied with the responses provided. Scores decreased notably when practical descriptions of dermoscopic signs were provided. Answers to BCC scenario scores in the diagnosis category (2.9 ± 0.4) were higher than those with SCC (2.6 ± 0.66, p = 0.005) and inflammatory dermatoses (2.6 ± 0.67, p = 0). Similarly, in the teaching tool usefulness category, BCC-based chatbot differential diagnosis received higher scores (2.9 ± 0.4) compared to SCC (2.6 ± 0.67, p = 0.001) and inflammatory dermatoses (2.4 ± 0.81, p = 0). The abovementioned results underscore dermatologists’ familiarity with BCC dermoscopic images while highlighting the challenges associated with interpreting rigorous dermoscopic images. Moreover, by incorporating patient characteristics such as age, phototype, or immune state, the differential diagnosis list in each case was customized to include lesion types appropriate for each category, illustrating the AI’s flexibility in evaluating diagnoses and highlighting its value as a resource for dermatologists.
Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Melanocytic and Non-melanocytic Skin Cancers)
Open AccessArticle
Private Doctors’ Perspective Towards “Patient First” in TB Diagnostic Cascade, Hisar, India
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Sanjeev Saini, Banuru Muralidhara Prasad, Ajay Mahajan, Akshay Duhan, Anuj Jangra, Jitendra Gauttam, Mandeep Malik, Jyoti Kayesth, Bhavin Vadera and Reeti Desai Hobson
Diagnostics 2024, 14(11), 1164; https://doi.org/10.3390/diagnostics14111164 - 31 May 2024
Abstract
TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors’ “patient first” approach toward early diagnosis; however, costs remain high. India’s NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors
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TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors’ “patient first” approach toward early diagnosis; however, costs remain high. India’s NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors to participate. Drawing from this context led to the design and implementation of the One-Stop TB Diagnostic Solution model, which was conducted in the Hisar district, Haryana, allowing specimens from presumptive TB patients from private doctors to be collected and tested as per NTEPs diagnostic algorithm. A subset of data pertaining to private doctors was analyzed for the project period. Qualitative data were also collected by interviewing doctors using a snowball method to capture doctors’ perception about the model. Out of 1159 specimens collected from 60 facilities, MTB was detected in 32% and rifampicin resistance was detected in 7% specimens. All specimens went through the diagnostic algorithm. Thirty doctors interviewed were satisfied with the services offered and were appreciative of the program that implements this “patient centric” model. Results from implementation indicate the need to strengthen private diagnostics through a certification process to ensure provision of quality TB diagnostic services.
Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
Open AccessArticle
Human Papillomavirus Infection of the Oropharyngeal and Laryngeal Squamous Papilloma: Disparities in Prevalence and Characteristics
by
Jihye Kwak, Dongbin Ahn and Mee-seon Kim
Diagnostics 2024, 14(11), 1163; https://doi.org/10.3390/diagnostics14111163 - 31 May 2024
Abstract
Human papillomavirus (HPV) infection has emerged as an etiologic factor of squamous papilloma (SP). The oropharynx and larynx are common sites of SP, but studies on the prevalence of HPV infection in these sites are lacking. This study aimed to evaluate and compare
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Human papillomavirus (HPV) infection has emerged as an etiologic factor of squamous papilloma (SP). The oropharynx and larynx are common sites of SP, but studies on the prevalence of HPV infection in these sites are lacking. This study aimed to evaluate and compare the prevalence and characteristics of HPV infection in oropharyngeal SP (OPSP) and laryngeal SP (LSP). HPV detection and genotyping data of patients with pathologically confirmed OPSP and LSP were retrospectively analyzed. A total of 119 patients were enrolled, consisting of 93 patients with OPSP and 26 patients with LSP. Of those patients, 13 patients with OPSP and 14 patients with LSP were positive for HPV infection, accounting for a prevalence of 14.0% and 53.8%, respectively (p < 0.001). The most prevalent genotype was HPV16 in OPSP and HPV6 in LSP. Over two-thirds (69.2%) of HPV(+)-OPSP infections were high-risk types compared with 14.3% of HPV(+)-LSP infections (p = 0.004). The prevalence of HPV infection in patients with OPSP and LSP demonstrated no differences in terms of age, sex, and smoking status. These results could provide a better understanding of HPV infection in OPSP and LSP and serve as a background for the epidemiology of HPV-related tumorigenesis of the oropharynx and larynx.
Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Ectopic “Ectopic” Gastric Mucosa
by
Adeel Haq and Amin Haghighat Jahromi
Diagnostics 2024, 14(11), 1162; https://doi.org/10.3390/diagnostics14111162 - 31 May 2024
Abstract
Meckel’s diverticulum is a developmental GI anomaly. It is a remnant of the omphalomesenteric duct (vitelline duct) and the most common congenital anomaly found in the small intestine. It contains ectopic/heterotopic gastric mucosa in half of the cases. Imaging investigations for diagnosing Meckel’s
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Meckel’s diverticulum is a developmental GI anomaly. It is a remnant of the omphalomesenteric duct (vitelline duct) and the most common congenital anomaly found in the small intestine. It contains ectopic/heterotopic gastric mucosa in half of the cases. Imaging investigations for diagnosing Meckel’s diverticulum may include a plain radiography; however, this has a very limited diagnostic value. A blind-ending fluid-filled structure can sometimes be seen with sonography, but again, this technique’s diagnostic value is limited due to multiple factors. A CT scan may be helpful in localizing the bleeding diverticulum, which can be better visualized with CT enterography. Diverticula containing gastric mucosa can be diagnosed with a higher sensitivity with Tc-99 scintigraphy. The typical location of Meckel’s diverticulum is within two feet of the ileocecal valve; thus, ectopic gastric mucosal uptake is typically seen in the lower right quadrant in scintigraphy. We present a rare case of Tc-99 pertechnetate scintigraphy showing ectopic gastric mucosa in the upper mid abdomen, which was surgically proven to be at the mid ileum. To our knowledge, there is no ectopic Meckel’s diverticulum case published in the literature. Familiarity with this atypical imaging presentation of relatively common ectopic gastric mucosa may help the radiologists in the timely diagnosis and management of the patient.
Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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The Pterygomandibular Space: A Volumetric Evaluation Using the Novel A-Silicone Injections Method
by
Hadi Darawsheh, Ali Alsaegh, Elena Kanukoeva, Rinat Saleev, Gulshat Saleeva, Beatrice Volel, Natalia Kireeva, Ekaterina Rebrova and Yuriy L. Vasil’ev
Diagnostics 2024, 14(11), 1161; https://doi.org/10.3390/diagnostics14111161 - 31 May 2024
Abstract
Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to
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Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to use A-silicone injections to evaluate the volume of the PM. This study was conducted using 46 human cadaver heads (25 males and 21 females). A craniometric analysis was performed using the cadavers’ ages, the number of silicone cartridges (carpules) used to fill the pterygomandibular space, Izard’s Facial Index (FI), and the Cranial Index (CI). A Halstead mandibular block was performed by injecting 1.7 mL A-silicone cartridges (as an equivalent to standard local aesthetic carpules volume) into the PM. The cured silicone was extracted from the dissected mandibles. The volume (length, width, and thickness) of the extracted silicone and the number of silicone cartridges used to fill the space were evaluated. The results showed that there are statistically significant positive correlations between the CI and the width of the right PM, as well as the width and length of the left PM. A statistically significant correlation was found between the width of the left PM and the age of the cadaveric heads; the higher the age, the thicker the space on both sides. The volume of the PM corresponded to 1.5 cartridges on average.
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(This article belongs to the Special Issue Advances in Anatomy—Third Edition)
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FOT Technique Applied for Monitoring of COVID-19 Pneumonia Reveals Small Airways Involvement
by
Immanuels Taivans, Laura Grima, Normunds Jurka, Ligita Zvaigzne, Valentina Gordjušina and Gunta Strazda
Diagnostics 2024, 14(11), 1160; https://doi.org/10.3390/diagnostics14111160 - 31 May 2024
Abstract
The fact that some SARS-CoV-2 pneumonia patients benefit from changing body position, and some from continuous positive airways pressure (CPAP), indicates the functional character of hypoxia. We hypothesize that such effects could be explained by the closure of small airways. To prove the
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The fact that some SARS-CoV-2 pneumonia patients benefit from changing body position, and some from continuous positive airways pressure (CPAP), indicates the functional character of hypoxia. We hypothesize that such effects could be explained by the closure of small airways. To prove the hypothesis, we evaluated the patency of small airways in 30 oxygen-dependent, spontaneously breathing patients with SARS-CoV-2 pneumonia during their hospital stay using the FOT method and then compared the results with data obtained three months later. During the acute period, total resistance (R5) and peripheral resistance (R5-20) rose above the upper limit of normal (ULN) in 28% and 50% of all patients, respectively. Reactance indices X5, AX and Fres exceeded ULN in 55%, 68% and 66% of cases. Significant correlations were observed between PaO2/FiO2, the time spent in the hospital and R5, X5, AX and Fres. After 3 months, 18 patients were re-examined. During the hospital stay, 11 of them had risen above the upper limit of normal (ULN), for both resistance (R5-20) and reactance (X5, AX) values. Three months later, ULN for R5-20 was exceeded in only four individuals, but ULN for X5 and AX was exceeded in five individuals. Lung function examination revealed a combined restrictive/obstructive ventilatory failure and reduced CO transfer factor. We interpret these changes as lung tissue remodeling due to the process of fibrosis. We conclude that during acute period of SARS-CoV-2 pneumonia, dilated pulmonary blood vessels and parenchymal oedema induce functional closure of small airways, which in turn induce atelectasis with pulmonary right-to-left shunting, followed by the resulting hypoxemia.
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(This article belongs to the Topic Post COVID-19: Latest Advances, Challenges and Methodologies)
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Venous Thromboembolism Prophylaxis in Gynecologic Oncology: A MITO-MaNGO Survey
by
Michele Mongelli, Domenica Lorusso, Vanna Zanagnolo, Sandro Pignata, Nicoletta Colombo and Gennaro Cormio
Diagnostics 2024, 14(11), 1159; https://doi.org/10.3390/diagnostics14111159 - 31 May 2024
Abstract
Cancer-associated thrombosis is the second leading cause of death in cancer patients, and its incidence has been increasing in recent years. This survey was aimed at gathering information regarding the management of thromboembolic prophylaxis within the MITO (Multicenter Italian Trials in Ovarian Cancer)-MaNGO
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Cancer-associated thrombosis is the second leading cause of death in cancer patients, and its incidence has been increasing in recent years. This survey was aimed at gathering information regarding the management of thromboembolic prophylaxis within the MITO (Multicenter Italian Trials in Ovarian Cancer)-MaNGO (Mario Negri Gynecologic Oncology) groups. We designed a self-administered, multiple-choice online questionnaire available only for MITO-MaNGO members for one month, starting in May 2022 and ending in June 2022. We processed one response form per center, and 50 responses were analyzed, with most of the respondents (78%) over 40 years old. We found that 82% of them consider thromboembolic prophylaxis in gynecologic oncology to be relevant. In 82% of the centers, a standardized protocol on venous thromboembolism (VTE) prophylaxis is used, which is applied to both patients undergoing surgery and those undergoing chemotherapy. In the remaining 18% of centers, prophylaxis is used exclusively for patients undergoing chemotherapy treatment. Prophylaxis of patients undergoing surgery and chemotherapy treatment is managed in most cases by the surgeon (72%) and oncologist (76%), respectively. Only 26% of respondents use a thromboembolic risk assessment scale, and of these, those used are the Caprini Score (6%), Khorana Score (6%), and Wells Score (2%). The respondents have good knowledge of low-molecular-weight heparin (90%) and average knowledge of dicumarolics (40%), direct oral anticoagulants (DOACs) (68%), and antiplatelet agents (40%). The results of our survey indicate that there is a good awareness of thromboembolic prophylaxis in gynecologic oncology. Nevertheless, it is used less in outpatients than in patients undergoing surgery. Moreover, the thromboembolic risk assessment scores are barely used.
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(This article belongs to the Special Issue Trends and Controversies in Global Gynecologic Oncology: Diagnosis and Management)
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Development and Validation of an Ultrasonography-Based Machine Learning Model for Predicting Outcomes of Bruxism Treatments
by
Kaan Orhan, Gokhan Yazici, Merve Önder, Cengiz Evli, Melek Volkan-Yazici, Mehmet Eray Kolsuz, Nilsun Bağış, Nihan Kafa and Fehmi Gönüldaş
Diagnostics 2024, 14(11), 1158; https://doi.org/10.3390/diagnostics14111158 - 31 May 2024
Abstract
Background and Objectives: We aimed to develop a predictive model for the outcome of bruxism treatments using ultrasonography (USG)-based machine learning (ML) techniques. This study is a quantitative research study (predictive modeling study) in which different treatment methods applied to bruxism patients are
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Background and Objectives: We aimed to develop a predictive model for the outcome of bruxism treatments using ultrasonography (USG)-based machine learning (ML) techniques. This study is a quantitative research study (predictive modeling study) in which different treatment methods applied to bruxism patients are evaluated through artificial intelligence. Materials and Methods: The study population comprised 102 participants with bruxism in three treatment groups: Manual therapy, Manual therapy and Kinesio Tape or Botulinum Toxin-A injection. USG imaging was performed on the masseter muscle to calculate muscle thickness, and pain thresholds were evaluated using an algometer. A radiomics platform was utilized to handle imaging and clinical data, as well as to perform a subsequent radiomics statistical analysis. Results: The area under the curve (AUC) values of all machine learning methods ranged from 0.772 to 0.986 for the training data and from 0.394 to 0.848 for the test data. The Support Vector Machine (SVM) led to excellent discrimination between bruxism and normal patients from USG images. Radiomics characteristics in pre-treatment ultrasound scans of patients, showing coarse and nonuniform muscles, were associated with a greater chance of less effective pain reduction outcomes. Conclusions: This study has introduced a machine learning model using SVM analysis on ultrasound (USG) images for bruxism patients, which can detect masseter muscle changes on USG. Support Vector Machine regression analysis showed the combined ML models can also predict the outcome of the pain reduction.
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(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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Frozen Section of Placental Membranes and Umbilical Cord: A Valid Diagnostic Tool for Early-Onset Neonatal Sepsis Management
by
Veronica Parrella, Michele Paudice, Michela Pittaluga, Alessandra Allodi, Ezio Fulcheri, Francesca Buffelli, Fabio Barra, Simone Ferrero, Cesare Arioni and Valerio Gaetano Vellone
Diagnostics 2024, 14(11), 1157; https://doi.org/10.3390/diagnostics14111157 - 31 May 2024
Abstract
Early-onset neonatal sepsis (EONS), a serious infection in newborns within 3 days, is challenging to diagnose. The current methods often lack accuracy, leading to unnecessary antibiotics or delayed treatment. This study investigates the role of the frozen section examination of placental membranes and
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Early-onset neonatal sepsis (EONS), a serious infection in newborns within 3 days, is challenging to diagnose. The current methods often lack accuracy, leading to unnecessary antibiotics or delayed treatment. This study investigates the role of the frozen section examination of placental membranes and umbilical cord (FSMU) to improve EONS diagnosis in the daily lab practice. This retrospective study reviewed data from 59 neonates with EONS risk factors who underwent FSMU according to our institutional protocol. Concordance between the FSMU and the Final Pathological Report (FPR) was assessed. The FSMU demonstrated a high concordance (Kappa = 0.88) for funisitis diagnosis, with excellent accuracy (98.3%). A moderate concordance was observed for chorioamnionitis stage and grade. The FSMU shows promise as a rapid and accurate tool for diagnosing EONS, particularly for funisitis. This study suggests that the FSMU could be a valuable tool for EONS diagnosis, enabling a more judicious antibiotic use and potentially improving outcomes for newborns.
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(This article belongs to the Special Issue Insights in Maternal-Fetal Medicine—Preventing Preterm Births)
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Role of Endoscopic Ultrasound in Pancreatic Cancer Diagnosis and Management
by
Hayley K. Rogers and Shawn L. Shah
Diagnostics 2024, 14(11), 1156; https://doi.org/10.3390/diagnostics14111156 - 31 May 2024
Abstract
The emergence of endoscopic ultrasound (EUS) has significantly impacted the diagnosis and management of pancreatic cancer and its associated sequelae. While the definitive role of EUS for pancreatic cancer remains incompletely characterized by currently available guidelines, EUS undoubtedly offers high diagnostic accuracy, the
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The emergence of endoscopic ultrasound (EUS) has significantly impacted the diagnosis and management of pancreatic cancer and its associated sequelae. While the definitive role of EUS for pancreatic cancer remains incompletely characterized by currently available guidelines, EUS undoubtedly offers high diagnostic accuracy, the precise staging of pancreatic neoplasms, and the ability to perform therapeutic and palliative interventions. However, current challenges to EUS include limited specialized expertise and variability in operator proficiency. As the technology and techniques continue to evolve and become more refined, EUS is poised to play an increasingly integral role in shaping pancreatic cancer care.
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(This article belongs to the Special Issue Pancreas Diseases: Diagnosis and Management)
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