Search Results (189)

Background: Artificial intelligence (AI) is rapidly transforming clinical medicine by enabling earlier disease detection, personalized risk stratification, precision diagnostics, and optimized therapeutic decision-making across multiple specialties. Methods: This narrative review synthesizes the most recent evidence from prospective randomized controlled trials, large cohort studies, and real-world implementations of AI in cardiology, pulmonology, neurology, hepatology, pancreatic diseases, and other key areas of internal medicine. Studies were selected based on clinical impact, external validation, and regulatory approval status where applicable. Results: AI systems now outperform traditional clinical tools in numerous high-stakes applications: >88% freedom from atrial fibrillation at 1 year with AI-guided ablation, noninferior stent optimization versus OCT guidance, >95% sensitivity for atrial fibrillation and low ejection fraction detection on single-lead ECG, substantial increases in adenoma detection rate and melanoma triage accuracy, automated pancreatic cancer detection on routine CT with 89–90% sensitivity, and significant improvements in palliative care consultation rates and post-PCI outcomes using AI-supported telemedicine. Over 850 FDA-cleared AI devices exist as of November 2025, with cardiology and radiology dominating clinical adoption. Conclusions: AI has transitioned from experimental to clinically indispensable in multiple specialties, delivering measurable reductions in mortality, morbidity, hospitalizations, and healthcare resource utilization. Remaining challenges include external validation gaps, bias mitigation, and the need for large-scale prospective trials before universal implementation. Full article

Radiology report generation, which aims to relieve the heavy workload of radiologists and reduce the risks of misdiagnosis and overlooked diagnoses, is of great significance in current clinical medicine. Most existing methods mainly formulate radiology report generation as a problem similar to image captioning. Nevertheless, in the medical domain, these data-driven methods are plagued by two key issues: the insufficient utilization of expert knowledge and visual–textual biases. To solve these problems, this study presents a novel knowledge-augmented adaptive mechanism (KAM) for radiology report generation. In detail, our KAM first introduces two distinct types of medical knowledge: prior knowledge, which is input-independent and reflects the accumulated expertise of radiologists, and posterior knowledge, which is input-dependent and mimics the process of identifying abnormalities, thereby mitigating the issue of visual–textual bias. To optimize the utilization of both types of knowledge, this study develops a knowledge-augmented adaptive mechanism, which integrates the visual characteristics of radiological images with prior and posterior knowledge into the decoding process. Experimental evaluations on the publicly accessible IU X-ray and MIMIC-CXR datasets indicate that our approach is on par with the current common methods. Full article

Latent tuberculosis infection (LTBI) represents a biologically active yet clinically asymptomatic stage of Mycobacterium tuberculosis (Mtb) persistence. This condition is characterized by subtle immunometabolic alterations reflecting the host–pathogen equilibrium. Understanding the mechanisms and biomarkers associated with the preclinical phase of LTBI is crucial for preventing progression to active tuberculosis (ATB). Recent advances have identified multiple immunological, transcriptomic, metabolic, and imaging-based approaches that enable stratification of individuals at increased risk of LTBI reactivation. Quantitative assays such as IGRA, multiplex and T-cell activation marker (TAM) tests, as well as interferon-related transcriptional signatures, demonstrate predictive potential when combined with functional assays (MGIA) and metabolic imaging (PET/CT). Experimental primate models faithfully reproduce the spectrum from latency to reactivation, allowing for validation of biomarkers and vaccine or immunomodulatory strategies. The review also highlights the particular challenges of multidrug-resistant LTBI (MDR-LTBI), where standard chemoprophylaxis is less effective and immune control plays a decisive role. The preclinical phase of LTBI constitutes a key point in the TB control cascade. Integrating immunological, transcriptomic, and radiological data into risk-based screening algorithms could substantially improve early detection and targeted prevention. Translating research-derived signatures into clinically applicable, standardized, and cost-effective diagnostic tools requires coordinated international efforts, technological transfer, and policy-level support to reduce TB reactivation and transmission, including MDR-TB. Full article

Objective: To investigate the safety and efficacy of Hassab’s surgery as a salvage treatment for patients with secondary prophylaxis failure for acute variceal bleeding (AVB), and to determine the role of Hassab’s surgery in the recompensation of cirrhosis and nutritional improvement. Methods: This study retrospectively analyzed data of 19 patients with AVB caused by cirrhosis and portal hypertension who underwent Hassab’s surgery as a salvage treatment after secondary prophylaxis failure in our center from March 2018 to June 2021. In addition, 47 patients with esophageal and gastric varices who underwent secondary prophylaxis during the same period were assigned to the control group to assess the safety and efficacy of the surgery. The objective laboratorial index and L3-SMA (the L3 skeletal muscle area, cm², a radiological index for assessing whole-body skeletal muscle mass via CT measurement at the third lumbar vertebra level) of patients in the experimental group before and after surgery were compared to evaluate re-compensation of cirrhosis and nutritional improvement. Results: There was no significant difference in the incidence of perioperative complications and severe complications (Clavien–Dindo grade ≥ IIIb) between the experimental group and the control group. The 5-year re-bleeding-free survival rate and the 5-year overall survival rate in the experimental group were 73.7% and 94.7%, respectively, which were not significantly different from those in the control group. In addition, compared with before surgery, the white blood cell count, platelet count, hemoglobin level, model for end-stage liver disease (MELD) score, Child–Pugh grades, prothrombin time (PT), international normalized ratio (INR), and L3-SMA significantly increased in the experimental group after surgery. Conclusions: Hassab’s surgery proves to be a safe and effective salvage treatment for patients with AVB caused by liver cirrhosis and portal hypertension who failed to undergo secondary prophylaxis. Meanwhile, it was found that after surgery, not only were hypersplenism and coagulation abnormalities relieved, but also cirrhosis was compensated and nutritional status was improved significantly. Thus, this study revealed that Hassab’s surgery with safety and long-term survival effects can be used for patients with secondary prophylaxis failure for AVB in eligible patients Full article

Background: Aneurysms are life-threatening vascular conditions that require early and accurate detection to prevent fatal outcomes. Methods: Advances in deep learning have demonstrated significant potential in medical image analysis, particularly for automated aneurysm detection. This review paper provides an overview of selected deep-learning approaches for aneurysm detection, with an emphasis on YOLO (You Only Look Once) models and their architectural characteristics, comparative performance, and applicability. Results: Existing YOLO-based studies are examined and compared, highlighting their strengths, limitations, dataset usage, performance metrics, and clinical relevance. To complement this overview, we include test using an annotated dataset of 1342 angiograms. Of these, 1074 angiograms were used for model training and 10% (approximately 107 angiograms) were reserved for validation; the remaining 268 were used for evaluation, with all annotations provided by a radiology specialist. Conclusions: These tests were conducted solely to provide practical examples and a limited comparative demonstration of the selected YOLO variants, rather than to constitute a full original experimental study. The findings underscore the potential of integrating detection models to improve accuracy and robustness in aneurysm identification, paving the way for more reliable and validated computer-aided diagnostic systems. Full article

Background: Simulation-based teaching is increasingly important in veterinary training, especially for learning anatomy and interventional techniques where real-life exposure is limited. Methods: A handcrafted 3D simulator replicating the canine abdominal arterial system was developed and tested with 80 veterinary students and graduates. A quasi-experimental pre–post design evaluated theoretical knowledge, practical skills, and self-perceived competence after a structured training session including anatomical identification, catheter navigation, and the Seldinger technique. Results: Post-training results showed significant improvements in all domains. Theoretical test scores increased by over 25% (p < 0.001), and more than 85% of participants correctly identified target arteries after training. Navigation success rose to 90%, with shorter execution times and fewer errors. Participants reported increased confidence and satisfaction with the realism and educational value of the simulator. Conclusions: The 3D vascular simulator effectively enhanced learning outcomes and confidence in interventional radiology. Its low-cost, handcrafted design makes it a feasible and valuable educational tool for veterinary institutions lacking access to high-fidelity commercial simulators. Full article

Background/Objectives: Knee osteoarthritis (KOA) is a common pathology characterized by impaired joint cartilage. Mesenchymal stromal cell (MSC)-based treatments, such as stromal vascular fraction (SVF), are increasingly being used for their potential cartilage-generating capabilities; however, there is still insufficient evidence to confirm their effectiveness. The aim of the study was to assess the efficacy of SVF treatment in KOA in terms of pain relief. Methods: An experimental clinical trial was performed. We included adults with symptomatic KOA who attended Celular Clinic (Andorra). A laboratory-manufactured and standardized SVF product (Celstem^®) was applied to selected patients. Clinical, functional, and radiological assessments using the visual analog scale, KOOS (Knee Injury and Osteoarthritis Outcome Score), SF-36 scale, and MOCART classification (Magnetic Resonance Observation of Cartilage Repair Tissue) were performed. Variables were compared before treatment and at one, six, and twelve months after treatment. Adverse effects were reported. Results: In total, 184 patients were included in the clinical trial, 78 of whom were finally analyzed. There were statistically significant differences in both resting and activity-related pain and in all KOOS subscales after SVF treatment (p < 0.001). The quality of life also showed significant changes (p = 0.021). No significant changes were observed in MOCART values. However, a positive association was found between MOCART and cell yield. Few adverse effects were reported. Conclusions: Our nonrandomized uncontrolled clinical trial showed that SVF treatment has promise to reduce pain in patients with KOA. Improvements in functionality and quality of life were also observed. Future randomized controlled trials regarding SVF versus placebo therapies will further clarify this potential. Full article

Natural or synthetic scaffolds are essential for developing three-dimensional (3D) cell culture models, as they provide structural stability and accurately replicate the cellular microenvironment. When integrated into optimized setups, scaffold-supported cellular aggregates, such as spheroids, can be non-destructively characterized and monitored using 3T Magnetic Resonance Imaging (MRI). However, a significant technical limitation is the presence of MR artifacts generated by scaffolds, which can severely obscure the visualization of the embedded spheroids. This study systematically evaluated the suitability of various scaffolds and matrices (including Matrigel^®, fibrin glue, and several hydrogels) for MRI and MR spectroscopy (MRS). The materials were investigated both native and seeded with chondrosarcoma cells (SW1353). Our findings revealed considerable variability in MR compatibility across different materials. Specifically, fibrin glue proved unsuitable for MR applications due to substantial artifact generation that interfered with the visualization of cellular components. Furthermore, the results emphasize the importance of the observation period, as material degradation processes can introduce confounding factors in longitudinal MR studies. The choice of scaffold material is paramount for the successful analysis of 3D cell models via MRI. Careful selection is required, as the materials’ properties and temporal stability directly impact the interpretability of the acquired data. Full article

The field of experimental radiooncology and the quality assessment (QA) aimed at patient safety both profit from the utilisation of biomimetic principles. The work with phantoms based on biological structures of animals or humans, utilising the principles of anatomic mimicry, has a long tradition in radiotherapy research. When phantoms are produced from tissue-equivalent materials, they mimic the radiological properties of tissues and organs, allowing researchers and clinicians to study dose distribution and optimise treatment plans without exposing real patients to radiation. Biomechanical mimicry would take this a step further by creating phantoms that replicate the movement and deformation of organs during physiological movement, such as heartbeat or breathing, enabling a more accurate simulation of dynamic treatment scenarios. Bioinspired sensor technologies, such as artificial skin or integrated detectors, can be used to monitor radiation exposure, organ motion or temperature changes during therapy with high precision. The utility of such a phantom could be further enhanced by creating a realistic tumour microenvironment as an irradiation target, following the principles of microenvironmental biomimicry. Thus, biomimetic strategies can be exploited in the validation of radiotherapy technologies and open new perspectives for adaptive radiotherapy and real-time monitoring. Full article

Background/Objectives: Spinal fusion with static fixation—surgically joining two or more vertebrae to eliminate motion—is commonly employed to treat degenerative spinal disease. However, the rigidity imposed by static constructs and the increased load on the adjacent segments frequently result in complications such as disc or facet degeneration, spinal stenosis (SS), and segmental instability. This study investigates the effectiveness of pedicle-based dynamic stabilization using the Dynesys system, particularly in a dynamic-transitional optima (DTO) hybrid configuration, in mitigating adjacent segment disease (ASD) and improving clinical outcomes. In this work, we analyzed the mechanical performance and intermediate-term clinical effects of the DTO hybrid lumbar device, focusing on how the load-sharing properties of the Dynesys cord–spacer stabilizers may contribute to junctional complications in individuals with diverse grades of intervertebral disc degeneration. Study Design/Setting: We designed a combined biomechanical finite element (FE) and experimental analysis to predict the clinical outcomes. Patient Sample: Among 115 patients with lumbar SS enrolled for analysis, 31 patients (mean age: 68.5 ± 7.5 years), with or without grade I spondylolisthesis (18/13), underwent a two-level DTO hybrid procedure—L4–L5 static fixation and L3–L4 dynamic stabilization—with minimal decompression to preserve the posterior tension band. Post-surgical follow-ups were conducted for over 48 months (range: 49–82). Outcome Measures: Radiological assessments were performed by two neurosurgeons, one orthopedic surgeon, and one neuroradiologist. The posterior disc height, listhesis distance, and dynamic angular changes were measured pre- and postoperatively to evaluate ASD progression. Methods: Dynamic instrumentation was assigned to the L3–L4 motion segment with lesser disc deterioration, in contrast to the L4–L5 segment, where static fixation was applied due to its greater degree of degeneration. FE analysis was performed under displacement-controlled conditions. Intersegmental motion analysis was conducted under load-controlled conditions in a synthetic model. Results: The DTO hybrid devices reduced stress and motion at the transition segment. However, compensatory biomechanical effects were more pronounced at the adjacent cephalad than the caudal segments. In the biomechanical trade-off zone—where balance between motion preservation and stabilization is critical—the flexible Dynesys cord significantly mitigated stiffness-related issues during flexion. At the L3–L4 transition level, the cord–spacer configuration enhanced dynamic function, increasing motion by 2.7% (rotation) and 12.7% (flexion), reducing disc stress by 4.1% (flexion) and 12.9% (extension), and decreasing the facet contact forces by 4.9% (rotation) and 15.6% (extension). The optimal cord stiffness (50–200 N/mm) aligned with the demands of mild disc degeneration, whereas stiffer cords were more effective for segments with higher degeneration. The pedicle screw motion in dynamic Dynesys systems—primarily caused by axial translation rather than vertical displacement—contributed to screw–vertebra interface stress, influenced by the underlying disc or bone degeneration. Conclusions: Modulating the cord pretension in DTO instrumentation effectively lessened the interface stress occurring at the screw–vertebra junction and adjacent facet joints, contributing to a reduced incidence of pedicle screw loosening, ASD, and revision rates. The modified DTO system, incorporating minimal decompression and preserving the posterior complex at the dynamic level, may be biomechanically favourable and clinically effective for managing transitional degeneration over the mid-term. Full article

The storage and monitoring of nuclear fuel, whether spent or fresh, are key components of the nuclear energy life cycle, with significant implications for safety and sustainability. With the global focus on carbon neutrality, interest in advanced management solutions is rising. This paper provides a comprehensive analysis of modern technologies for the design, storage, and monitoring of nuclear fuel, highlighting current trends and future challenges. The study encompasses both spent and fresh nuclear fuel, with a focus on radiological safety, structural integrity, and digital monitoring. Data were organized into the following categories: storage types (wet/dry), monitored parameters, surveillance technologies (sensors, AI, IoT, and Digital Twin), simulation models, and emerging directions. A comparison between fresh and spent fuel shows a clear shift toward intelligent systems using non-invasive sensors, deep-learning algorithms, and decentralized architectures (e.g., blockchain-IoT). Despite progress, challenges remain, such as limited interoperability across system generations and insufficient experimental validation. This paper provides a solid foundation for researchers, suggesting future directions that include the full integration of AI in monitoring, broader numerical simulations for reliability, and the standardization of digital interfaces. These measures could significantly enhance the safety and efficiency of nuclear fuel storage systems. Full article

Moyamoya disease (MMD) is primarily associated with genetic variants in RNF213. RNF213 p.R4810K (c.14429G>A, p.Arg4810Lys) is a founder variant predominantly found in East Asian populations and is strongly associated with MMD, a rare cerebrovascular condition characterized by progressive stenosis of intracranial arteries and the development of abnormal collateral networks. Recent evidence suggests that RNF213 variants are also enriched in non-moyamoya intracranial arteriopathies, such as large-artery atherosclerotic stroke and intracranial arterial stenosis/occlusion (ICASO), particularly in east Asian individuals with early-onset or cryptogenic stroke. This expanded phenotypic spectrum, termed RNF213-related vasculopathy (RRV), represents a distinct pathogenic entity that may involve unique pathogenic processes separate from traditional atherosclerosis. In this review, we synthesize current genetic, clinical, radiological, and experimental findings that delineate the unique features of RRV. Patients with RRV typically exhibit a lower burden of traditional vascular risk factors, negative vascular remodeling in the absence of atheromatous plaques, and an increased propensity for disease progression. RNF213 variants may compromise vascular resilience by impairing adaptive responses to hemodynamic stress. Furthermore, emerging cellular and animal model data indicate that RNF213 influences angiogenesis, lipid metabolism, and stress responses, offering mechanistic insights into its role in maintaining vascular integrity. Recognizing RRV as a distinct clinical entity has important implications for diagnosis, risk stratification, and the development of genome-informed therapeutic strategies. Full article

This study evaluates the accuracy of ²²²Rn exhalation rates from building materials using two standard experimental protocols, thus addressing the increasing importance of rapid radon assessment due to health concerns and regulatory limits. In detail, six types of natural stones frequently employed for the construction of buildings of historical-artistic relevance were analyzed using the closed chamber method (CCM) combined with the Durridge Rad7 system, by using two experimental protocols that differed in the measurement duration: 10 days (Method 1) versus 24 h (Method 2). Obtained results revealed that the radon exhalation rates ranged from 0.004 to 0.072 Bq h⁻¹, which are moderate to low if compared to studies in other regions. Statistical comparison using the u-test confirmed equivalence between protocols (u-test ≤ 2), thus supporting the validity of the faster Method 2 for practical applications. Furthermore, to estimate the potential indoor radon levels and determine the associated radiological risks to human health, for the investigated natural stones, the Markkanen room model was employed. As a result, simulated indoor radon concentrations remained well below regulatory thresholds (maximum value: 37.3 Bq m⁻³), thus excluding any significant health concerns under typical indoor conditions. Full article

This computational study using MCNP5 evaluated the feasibility of replacing 6061-T6 aluminum with 316L stainless steel (SS-316L) for the tubes hosting the uranium slugs in the subcritical nuclear reactor Nuclear Chicago model 9000, thereby contributing to its preservation as a key resource for nuclear research and education in Mexico. Simulations and dosimetric analyses (ICRP/ICRU) confirmed subcriticality in both configurations. Notably, SS-316L demonstrated an effective attenuation of peripheral gamma radiation and a reduction in the ambient neutron dose, indicating a considerable improvement in radiological safety. Although a reduction in thermal and epithermal neutron fluence was observed, the similarity in the gamma spectrum suggests no significant alteration for gamma spectroscopic experiments. In conclusion, SS-316L presents a promising alternative that enhances radiological safety and reactor longevity, making it a worthy consideration as a replacement material. Further experimental investigation is recommended to assess material activation and the gamma dose in the vicinity of the fuel. Full article

Medical image segmentation, especially in chest X-ray (CXR) analysis, encounters substantial problems such as class imbalance, annotation inconsistencies, and the necessity for accurate pathological region identification. This research aims to improve the precision and clinical reliability of pulmonary abnormality segmentation by developing NCT-CXR, a framework that combines anatomically constrained data augmentation with expert-guided annotation refinement. NCT-CXR applies carefully calibrated discrete-angle rotations (±5°, ±10°) and intensity-based augmentations to enrich training data while preserving spatial and anatomical integrity. To address label noise in the NIH Chest X-ray dataset, we further introduce a clinically validated annotation refinement pipeline using the OncoDocAI platform, resulting in multi-label pixel-level segmentation masks for nine thoracic conditions. YOLOv8 was selected as the segmentation backbone due to its architectural efficiency, speed, and high spatial accuracy. Experimental results show that NCT-CXR significantly improves segmentation precision, especially for pneumothorax (0.829 and 0.804 for ±5° and ±10°, respectively). Non-parametric statistical testing (Kruskal–Wallis, H = 14.874, p = 0.0019) and post hoc Nemenyi analysis (p = 0.0138 and p = 0.0056) confirm the superiority of discrete-angle augmentation over mixed strategies. These findings underscore the importance of clinically constrained augmentation and high-quality annotation in building robust segmentation models. NCT-CXR offers a practical, high-performance solution for integrating deep learning into radiological workflows. Full article