Search Results (2,243)

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating a growing cohort of younger survivors for whom post-treatment quality of life—notably reproductive function—is paramount. Curative treatments such as radical prostatectomy, pelvic radiotherapy, androgen-deprivation therapy (ADT), and chemotherapy often cause irreversible infertility via multiple mechanisms, including surgical disruption of the ejaculatory tract, endocrine suppression of spermatogenesis, direct gonadotoxic injury to the testes, and oxidative sperm DNA damage. Despite these risks, fertility preservation is frequently overlooked in pre-treatment counseling, leaving many patients unaware of their options. This narrative review synthesizes current evidence on how PCa therapies impact male fertility, elucidates the molecular and physiological mechanisms of iatrogenic infertility, and evaluates both established and emerging strategies for fertility preservation and restoration. Key interventions covered include sperm cryopreservation, microsurgical testicular sperm extraction (TESE), and assisted reproductive technologies (ART). Psychosocial factors influencing decision-making, novel biomarkers predictive of post-treatment spermatogenic recovery, and long-term offspring outcomes are also examined. The review underscores the urgent need for timely, multidisciplinary fertility consultation as a routine component of PCa care. As PCa increasingly affects men in their reproductive years, proactively integrating preservation into standard oncologic practice should become a standard survivorship priority. Full article

This study develops and validates an artificial intelligence (AI)-assisted internship learning platform for automotive electronics based on the Llama 3 large language model, aiming to enhance pedagogical effectiveness within vocational training contexts. Addressing critical issues such as the persistent theory–practice gap and limited innovation capability prevalent in existing curricula, we leverage the natural language processing (NLP) capabilities of Llama 3 through fine-tuning based on transfer learning to establish a specialized knowledge base encompassing fundamental circuit principles and fault diagnosis protocols. The implementation employs the Hugging Face Transformers library with optimized hyperparameters, including a learning rate of 5 × 10⁻⁵ across five training epochs. Post-training evaluations revealed an accuracy of 89.7% on validation tasks (representing a 12.4% improvement over the baseline model), a semantic comprehension precision of 92.3% in technical question-and-answer assessments, a mathematical computation accuracy of 78.4% (highlighting this as a current limitation), and a latency of 6.3 s under peak operational workloads (indicating a system bottleneck). Although direct trials involving students were deliberately avoided, the platform’s technical feasibility was validated through multidimensional benchmarking against established models (BERT-base and GPT-2), confirming superior domain adaptability (F1 = 0.87) and enhanced error tolerance (σ² = 1.2). Notable limitations emerged in numerical reasoning tasks (Cohen’s d = 1.15 compared to human experts) and in real-time responsiveness deterioration when exceeding 50 concurrent users. The study concludes that Llama 3 demonstrates considerable promise for automotive electronics skills development. Proposed future enhancements include integrating symbolic AI modules to improve computational reliability, implementing Kubernetes-based load balancing to ensure latency below 2 s at scale, and conducting longitudinal pedagogical validation studies with trainees. This research provides a robust technical foundation for AI-driven vocational education, especially suited to mechatronics fields that require close integration between theoretical knowledge and practical troubleshooting skills. Full article

Neuromuscular hip dysplasia (NHD) is a common deformity in children with cerebral palsy (CP). Although some predictive factors of NHD are known, the prediction of NHD is in its infancy. We present a Clinical Decision Support System (CDSS) designed to calculate the probability of developing NHD in children with CP. The system utilizes an ensemble of three machine learning (ML) algorithms: Neural Network (NN), Support Vector Machine (SVM), and Logistic Regression (LR). The development and evaluation of the CDSS followed the DECIDE-AI guidelines for AI-driven clinical decision support tools. The ensemble was trained on a data series from 182 subjects. Inclusion criteria were age between 12 and 18 years and diagnosis of CP from two specialized units. Clinical and functional data were collected prospectively between 2005 and 2023, and then analyzed in a cross-sectional study. Accuracy and area under the receiver operating characteristic (AUROC) were calculated for each method. Best logistic regression scores highlighted history of previous orthopedic surgery (p = 0.001), poor motor function (p = 0.004), truncal tone disorder (p = 0.008), scoliosis (p = 0.031), number of affected limbs (p = 0.05), and epilepsy (p = 0.05) as predictors of NHD. Both accuracy and AUROC were highest for NN, 83.7% and 0.92, respectively. The novelty of this study lies in the development of an efficient Clinical Decision Support System (CDSS) prototype, specifically designed to predict future outcomes of neuromuscular hip dysplasia (NHD) in patients with cerebral palsy (CP) using clinical data. The proposed system, PredictMed-CDSS, demonstrated strong predictive performance for estimating the probability of NHD development in children with CP, with the highest accuracy achieved using neural networks (NN). PredictMed-CDSS has the potential to assist clinicians in anticipating the need for early interventions and preventive strategies in the management of NHD among CP patients. Full article

The objectives of the present work were as follows: (i) the detection of cathelicidin biomolecules in the milk of individual goats during the early stages of mastitis and their potential use for the diagnosis of mastitis at its early stage and (ii) the evaluation of the presence of cathelicidin proteins in the bulk-tank milk from goat and sheep farms. In an experimental study, after inoculation of Staphylococcus simulans into a mammary gland of goats, bacteriological and cytological examinations of milk samples, as well as proteomics examinations [two-dimensional gel electrophoresis analysis (2-DE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS) analysis] were performed sequentially, from 4 to 48 h post-challenge. Cathelicidin-1 and cathelicidin-2 were detected consistently in milk samples obtained throughout the study, and spot optical densities obtained from PDQuest v.8.0 were recorded. Associations were calculated between the presence of mastitis in a mammary gland at a given timepoint and the detection of cathelicidin proteins in the respective milk sample. All inoculated mammary glands developed mastitis, confirmed by the consistent bacterial isolation from milk samples and the increased somatic cell content therein. Spot optical density of cathelicidin proteins was higher than in samples from contralateral mammary glands. There was a significant association between the presence of mastitis in a mammary gland and the detection of cathelicidin biomolecules in the respective milk sample; the overall accuracy was 81.8% (95% confidence interval: 70.4–90.2%). In a field investigation, the presence of cathelicidin proteins was evaluated in the bulk-tank milk of 32 dairy goat and 57 dairy sheep farms. In this part of the work, no cathelicidin proteins were detected in any bulk-tank milk sample of goat, 0.0% (95% confidence interval: 0.0–10.7%), or sheep, 0.0% (95% confidence interval: 0.0–6.3%), farms. Full article

Knowledge graph technology holds significant importance for efficient fault diagnosis in household appliances. However, the scarcity of public fault diagnosis data and the lack of automated knowledge extraction pose major challenges to knowledge graph construction. To address issues such as ambiguous entity boundaries, severe entity nesting, and poor entity extraction performance in fault diagnosis texts, this paper proposes a dual-strategy progressive knowledge extraction framework. First, to tackle the high complexity of fault diagnosis texts, an entity recognition model named RoBERTa-zh-BiLSTM-MUL-CRF is designed, improving the accuracy of nested entity extraction. Second, leveraging the semantic understanding capability of large language models, a progressive prompting strategy is adopted for ontology alignment and relation extraction, achieving automated knowledge extraction. Experimental results show that the proposed named entity recognition model outperforms traditional models, with improvements of 3.87%, 5.82%, and 2.05% in F1-score, recall, and precision, respectively. Additionally, the large language model demonstrates better performance in ontology alignment compared to traditional machine learning models. The constructed knowledge graph for household appliance fault diagnosis integrates structured fault diagnosis information. It effectively processes unstructured fault texts and supports visual queries and entity tracing. This framework can assist maintenance personnel in making rapid judgments, thereby improving fault diagnosis efficiency. Full article

Background/Objectives: The diagnosis of pediatric dental conditions from panoramic radiographs is uniquely challenging due to the dynamic nature of the mixed dentition phase, which can lead to subjective and inconsistent interpretations. This study aims to develop and rigorously validate an advanced deep learning model to enhance diagnostic accuracy and efficiency in pediatric dentistry, providing an objective tool to support clinical decision-making. Methods: An initial comparative study of four state-of-the-art YOLO variants (YOLOv8, v9, v10, and v11) was conducted to identify the optimal architecture for detecting four common findings: Dental Caries, Deciduous Tooth, Root Canal Treatment, and Pulpotomy. A stringent two-tiered validation strategy was employed: a primary public dataset (n = 644 images) was used for training and model selection, while a completely independent external dataset (n = 150 images) was used for final testing. All annotations were validated by a dual-expert team comprising a board-certified pediatric dentist and an experienced oral and maxillofacial radiologist. Results: Based on its leading performance on the internal validation set, YOLOv11x was selected as the optimal model, achieving a mean Average Precision (mAP50) of 0.91. When evaluated on the independent external test set, the model demonstrated robust generalization, achieving an overall F1-Score of 0.81 and a mAP50 of 0.82. It yielded clinically valuable recall rates for therapeutic interventions (Root Canal Treatment: 88%; Pulpotomy: 86%) and other conditions (Deciduous Tooth: 84%; Dental Caries: 79%). Conclusions: Validated through a rigorous dual-dataset and dual-expert process, the YOLOv11x model demonstrates its potential as an accurate and reliable tool for automated detection in pediatric panoramic radiographs. This work suggests that such AI-driven systems can serve as valuable assistive tools for clinicians by supporting diagnostic workflows and contributing to the consistent detection of common dental findings in pediatric patients. Full article

The search for the biomarkers of Alzheimer’s disease (AD) may prove essential in the diagnosis and prognosis of the pathology, and the differential expression of key proteins may assist in identifying new therapeutic targets. In this proof-of-concept (POC) study, a new approach of data mining and matching combined with the biochemical analysis of proteins was applied to AD investigation. Three influential online open databases (UniProt, AlzGene, and Allen Human Brain Atlas) were explored to identify the genes and encoded proteins involved in AD linked to mitochondrial and iron dysmetabolism. The databases were searched using specific keywords to collect information about protein composition, and function, and meta-analysis data about their correlation with AD. The extracted datasets were matched to yield a list of relevant proteins in AD. The biochemical analysis of their amino acid content suggested a defective synthesis of these proteins in poorly oxygenated brain tissue, supporting their relevance in AD progression. The result of our POC study revealed several potential new markers of AD that deserve further molecular and clinical investigation. This novel database search approach can be a valuable strategy for biomarker search that can be exploited in many diseases. Full article

Background: Congenital diarrhea is persistent diarrhea that manifests during the neonatal period. Mutations in DGAT1, which is crucial for triglyceride synthesis and lipid absorption in the small intestine, are causal factors for congenital diarrhea. In this study, we aimed to determine the value of tissue RNA sequencing (RNA-seq) for assisting with the clinical diagnosis of some genetic variants of uncertain significance. Methods: We clinically evaluated a patient with watery diarrhea, vomiting, severe malnutrition, and total parenteral nutrition dependence. Possible pathogenic variants were detected using whole-exome sequencing (WES). RNA-seq was utilized to explore the transcriptional alterations in DGAT1 variants identified by WES with unknown clinical significance, according to the American College of Medical Genetics guidelines. Systemic examinations, including endoscopic and histopathological examinations of the intestinal mucosa, were conducted to rule out other potential diagnoses. Results: We successfully diagnosed a patient with congenital diarrhea and protein-losing enteropathy caused by a DGAT1 mutation and reviewed the literature of 19 cases of children with DGAT defects. The missense mutation c.620A>G, p.Lys207Arg located in exon 15, and the intronic mutation c.1249-6T>G in DGAT1 were identified by WES. RNA-seq revealed two aberrant splicing events in the DGAT1 gene of the patient’s small intestinal tissue. Both variants lead to loss-of-function consequences and are classified as pathogenic variants of congenital diarrhea. Conclusions: Rare DGAT1 variants were identified as pathogenic evidence of congenital diarrhea, and the detection of tissue-specific mRNA splicing and transcriptional effects can provide auxiliary evidence. Full article

Objective: To develop and validate a ResNet-50-based deep learning model for automatic detection of osteomyelitis (DFO) in plain radiographs of patients with diabetic foot ulcers (DFUs). Research Design and Methods: This retrospective study included 168 patients with type one or type two diabetes and clinical suspicion of DFO confirmed via a surgical bone biopsy. An experienced clinician and a pretrained ResNet-50 model independently interpreted the radiographs. The model was developed using Python-based frameworks with ChatGPT assistance for coding. The diagnostic performance was assessed against the histopathological findings, calculating sensitivity, specificity, the positive predictive value (PPV), the negative predictive value (NPV), and the likelihood ratios. Agreement between the AI model and the clinician was evaluated using Cohen’s kappa coefficient. Results: The AI model demonstrated high sensitivity (92.8%) and PPV (0.97), but low-level specificity (4.4%). The clinician showed 90.2% sensitivity and 37.8% specificity. The Cohen’s kappa coefficient between the AI model and the clinician was −0.105 (p = 0.117), indicating weak agreement. Both the methods tended to classify many cases as DFO-positive, with 81.5% agreement in the positive cases. Conclusions: This study demonstrates the potential of IA to support the radiographic diagnosis of DFO using a ResNet-50-based deep learning model. AI-assisted radiographic interpretation could enhance early DFO detection, particularly in high-prevalence settings. However, further validation is necessary to improve its specificity and assess its utility in primary care. Full article

Recent advancements in deep learning have significantly enhanced brain tumor segmentation from MRI data, providing valuable support for clinical diagnosis and treatment planning. However, challenges persist in effectively integrating prior medical knowledge, capturing global multimodal features, and accurately delineating tumor boundaries. To address these challenges, the Hybrid Network for Multimodal Brain Tumor Segmentation (HN-MBTS) is proposed, which incorporates prior medical knowledge to refine feature extraction and boundary precision. Key innovations include the Two-Branch, Two-Model Attention (TB-TMA) module for efficient multimodal feature fusion, the Linear Attention Mamba (LAM) module for robust multi-scale feature modeling, and the Residual Attention (RA) module for enhanced boundary refinement. Experimental results demonstrate that this method significantly outperforms existing approaches. On the BraT2020 and BraT2023 datasets, the method achieved average Dice scores of 87.66% and 88.07%, respectively. These results confirm the superior segmentation accuracy and efficiency of the approach, highlighting its potential to provide valuable assistance in clinical settings. Full article

Background and Objectives: this pilot study aimed to evaluate the diagnostic accuracy of ChatGPT-4o in analyzing oral mucosal lesions from clinical images. Materials and Methods: a total of 110 clinical images, including 100 pathological lesions and 10 healthy mucosal images, were retrieved from Google Images and analyzed by ChatGPT-4o using a standardized prompt. An expert panel of five clinicians established a reference diagnosis, categorizing lesions as benign or malignant. The AI-generated diagnoses were classified as correct or incorrect and further categorized as plausible or not plausible. The accuracy, sensitivity, specificity, and agreement with the expert panel were analyzed. The Artificial Intelligence Performance Instrument (AIPI) was used to assess the quality of AI-generated recommendations. Results: ChatGPT-4o correctly diagnosed 85% of cases. Among the 15 incorrect diagnoses, 10 were deemed plausible by the expert panel. The AI misclassified three malignant lesions as benign but did not categorize any benign lesions as malignant. Sensitivity and specificity were 91.7% and 100%, respectively. The AIPI score averaged 17.6 ± 1.73, indicating strong diagnostic reasoning. The McNemar test showed no significant differences between AI and expert diagnoses (p = 0.084). Conclusions: In this proof-of-concept pilot study, ChatGPT-4o demonstrated high diagnostic accuracy and strong descriptive capabilities in oral mucosal lesion analysis. A residual 8.3% false-negative rate for malignant lesions underscores the need for specialist oversight; however, the model shows promise as an AI-powered triage aid in settings with limited access to specialized care. Full article

Background: Despite significant advancements in diabetes care, many individuals with type 2 diabetes (T2D) do not receive optimal care and treatment. Digital interventions promoting behavioral changes have shown promising long-term results in supporting healthier lifestyles but are not implemented in most healthcare offerings, maybe due to lack of general practice support and collaboration. This study evaluates the efficacy of the Digital, Individualized, and Collaborative Treatment of T2D in General Practice Based on Decision Aid (DICTA), a randomized controlled trial integrating a patient-centered smartphone application for lifestyle support in conjunction with a clinical decision support (CDS) tool to assist general practitioners (GPs) in optimizing antidiabetic treatment. Methods: The present randomized controlled trial aims to recruit 400 individuals with T2D from approximately 70 GP clinics (GPCs) in Denmark. The GPCs will be cluster-randomized in a 2:3 ratio to intervention or control groups. The intervention group will receive one year of individualized eHealth lifestyle coaching via a smartphone application, guided by patient-reported outcomes (PROs). Alongside this, the GPCs will have access to the CDS tool to optimize pharmacological decision-making through electronic health records. The control group will receive usual care for one year, followed by the same intervention in the second year. Results: The primary outcome is the one-year change in estimated ten-year cardiovascular risk, assessed by SCORE2-Diabetes calculated from age, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, age at diabetes diagnosis, HbA1c, and eGFR. Conclusions: If effective, DICTA could offer a scalable, digital-first approach for improving T2D management in primary care by combining patient-centered lifestyle coaching with real-time pharmacological clinical decision support. Full article

The increasing complexity and scale of electronic health records (EHRs) demand advanced tools for efficient data retrieval, summarization, and comparative analysis in clinical practice. MERA (Medical Electronic Records Assistant) is a Retrieval-Augmented Generation (RAG)-based AI system that addresses these needs by integrating domain-specific retrieval with large language models (LLMs) to deliver robust question answering, similarity search, and report summarization functionalities. MERA is designed to overcome key limitations of conventional LLMs in healthcare, such as hallucinations, outdated knowledge, and limited explainability. To ensure both privacy compliance and model robustness, we constructed a large synthetic dataset using state-of-the-art LLMs, including Mistral v0.3, Qwen 2.5, and Llama 3, and further validated MERA on de-identified real-world EHRs from the MIMIC-IV-Note dataset. Comprehensive evaluation demonstrates MERA’s high accuracy in medical question answering (correctness: 0.91; relevance: 0.98; groundedness: 0.89; retrieval relevance: 0.92), strong summarization performance (ROUGE-1 F1-score: 0.70; Jaccard similarity: 0.73), and effective similarity search (METEOR: 0.7–1.0 across diagnoses), with consistent results on real EHRs. The similarity search module empowers clinicians to efficiently identify and compare analogous patient cases, supporting differential diagnosis and personalized treatment planning. By generating concise, contextually relevant, and explainable insights, MERA reduces clinician workload and enhances decision-making. To our knowledge, this is the first system to integrate clinical question answering, summarization, and similarity search within a unified RAG-based framework. Full article

Precise medical image segmentation is crucial for advancing computer-aided diagnosis. Although deep learning-based medical image segmentation is now widely applied in this field, the complexity of human anatomy and the diversity of pathological manifestations often necessitate the use of image annotations to enhance segmentation accuracy. In this process, the scarcity of annotations and the lightweight design requirements of associated text encoders collectively present key challenges for improving segmentation model performance. To address these challenges, we propose MedLangViT, a novel language–vision multimodal model for medical image segmentation that incorporates medical descriptive information through lightweight text embedding rather than text encoders. MedLangViT innovatively leverages medical textual information to assist the segmentation process, thereby reducing reliance on extensive high-precision image annotations. Furthermore, we design an Enhanced Channel-Spatial Attention Module (ECSAM) to effectively fuse textual and visual features, strengthening textual guidance for segmentation decisions. Extensive experiments conducted on two publicly available text–image-paired medical datasets demonstrated that MedLangViT significantly outperforms existing state-of-the-art methods, validating the effectiveness of both the proposed model and the ECSAM. Full article

Purpose: To review parental pre-pregnancy and pregnancy exposures in relation to pediatric cancer (diagnosis before age 20). Methods: We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 17 March 2021. Results: Strong evidence links increased risk of childhood cancer with maternal diabetes, age, and alcohol and coffee consumption during pregnancy. Both paternal and maternal cigarette smoking before and during pregnancy are associated with childhood cancers. Diethylstilbestrol (DES) exposure in utero has long been known to be causally associated with increased risk of vaginal/cervical cancers in adolescent girls. More recent evidence implicates in utero DES exposure to testicular cancer in young men and possible intergenerational effects on ovarian cancer in the granddaughters of women exposed to DES during pregnancy. There is strong evidence that childhood cancer risk is also associated with both high and very low birth weight and with gestational age. Evidence is also strong for the protective effects of maternal vitamin consumption and a healthy diet during pregnancy. Unlike early studies, those reviewed here show no association between in utero exposure to medical ionizing radiation, which may be explained by reductions over time in radiation doses, avoidance of radiation during pregnancy, and/or by inadequate statistical power to detect small increases in risk, rather than a lack of causal association. Evidence is mixed or conflicting for an association between childhood cancer and maternal obesity, birth order, cesarean/instrumental delivery, and prenatal exposure to diagnostic medical radiation. Evidence is weak or absent for associations between childhood cancer and multiple gestations or assisted reproductive therapies, as well as prenatal exposure to hormones other than DES, and medications. Full article