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Keywords = opportunistic imaging

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16 pages, 1827 KiB  
Article
Mixed Candida albicansStaphylococcus aureus Biofilm Is Reduced by Light-Activated Nanocomposite with Phloxine B
by Jarmila Czucz Varga, Juraj Bujdák and Helena Bujdáková
J. Fungi 2025, 11(8), 582; https://doi.org/10.3390/jof11080582 (registering DOI) - 5 Aug 2025
Abstract
Candida albicans and Staphylococcus aureus are opportunistic pathogens that cause life-threatening infections. This study focused on using photodynamic inactivation (PDI) to eliminate mixed biofilms of C. albicans–S. aureus formed on poly (urethane) (PU) discs functionalized with a nanocomposite layer containing phloxine B (PhB). [...] Read more.
Candida albicans and Staphylococcus aureus are opportunistic pathogens that cause life-threatening infections. This study focused on using photodynamic inactivation (PDI) to eliminate mixed biofilms of C. albicans–S. aureus formed on poly (urethane) (PU) discs functionalized with a nanocomposite layer containing phloxine B (PhB). Additionally, the effect of PDI on the ALS3 and HWP1 genes of C. albicans was examined in mixed biofilms. Spectral analysis showed a continuous release of PhB from the nanocomposite in Mueller–Hinton broth within 48 h, with a released amount of PhB < 5% of the total amount. The anti-biofilm effectiveness of the light-activated nanocomposite with PhB showed a reduction in the survival rate of biofilm cells to 0.35% and 31.79% for S. aureus and C. albicans, respectively, compared to the control biofilm on PU alone. Scanning electron microscopy images showed that the nanocomposite effectively reduced the colonization and growth of the mixed biofilm. While PDI reduced the regulation of the ALS3 gene, the HWP1 gene was upregulated. Nevertheless, the cell survival of the C. albicansS. aureus biofilm was significantly reduced, showing great potential for the elimination of mixed biofilms. Full article
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9 pages, 6176 KiB  
Case Report
Concurrent Leydig and Sertoli Cell Tumors Associated with Testicular Mycosis in a Dog: A Case Report and Literature Review
by Mirosław Kuberka, Przemysław Prządka and Stanisław Dzimira
Pathogens 2025, 14(8), 752; https://doi.org/10.3390/pathogens14080752 (registering DOI) - 31 Jul 2025
Viewed by 168
Abstract
Mycosis is caused by, among other factors, filamentous fungi, ubiquitous molds belonging to Aspergillus spp. which are often opportunistic pathogens. Over 100 species of Aspergillus have been described. The most common species responsible for diseases in humans and animals are Aspergillus fumigatus and [...] Read more.
Mycosis is caused by, among other factors, filamentous fungi, ubiquitous molds belonging to Aspergillus spp. which are often opportunistic pathogens. Over 100 species of Aspergillus have been described. The most common species responsible for diseases in humans and animals are Aspergillus fumigatus and Aspergillus niger, with Aspergillus flavus and Aspergillus clavatus being somewhat rarer. Aspergillus causes a range of diseases, from localized colonization and hypersensitivity reactions, through chronic necrotizing infections, to rapidly progressing angioinvasion and dissemination, leading to death. Testicular mycosis is extremely rarely described in both humans and animals. No studies in the literature report a simultaneous occurrence of testicular tumors and fungal infection of the organ, so the aim of this paper was to describe, for the first time, a case of two independent testicular tumors coexisting with testicular mycosis. A histopathological examination was performed on the left testicle of a male dog, specifically a mixed-breed dog resembling a husky weighing 22 kg and with an age of 8 years. Bilateral orchidectomy was performed for medical reasons due to the altered outline of the left testicle, leading to scrotal deformation. The dog did not show any clinical signs of illness, and the testicles were not painful. The right testicle, according to the operating veterinarian, showed no macroscopic changes, so histopathological verification was not performed. Microscopic imaging of the changes clearly indicated the coexistence of a tumor process involving Leydig cells (Leydigoma, interstitial cell tumor, ICT), Sertoli cells (Sertolioma), and fungal infection of the testis. The case suggests the possibility of the coexistence of tumor processes, which may have impaired local immune response of the tissue, with an infectious, in this case fungal, inflammatory process. Based on the literature, this paper is the first report on the occurrence of two independent histotype testicular tumors and their associated mycosis. Full article
(This article belongs to the Special Issue Rare Fungal Infection Studies)
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23 pages, 1197 KiB  
Article
The Dark Side of the Carbon Emissions Trading System and Digital Transformation: Corporate Carbon Washing
by Yuxuan Wang and Chan Lyu
Systems 2025, 13(8), 619; https://doi.org/10.3390/systems13080619 - 22 Jul 2025
Viewed by 376
Abstract
Although carbon emissions trading systems are universally acknowledged as one of the most potent policy instruments for counteracting hazardous climate trends, and digitalization is seen as a favorable technological means to promote corporate green and low-carbon transformation, few studies have investigated the dark [...] Read more.
Although carbon emissions trading systems are universally acknowledged as one of the most potent policy instruments for counteracting hazardous climate trends, and digitalization is seen as a favorable technological means to promote corporate green and low-carbon transformation, few studies have investigated the dark side of both. Using data on Chinese listed companies from 2011 to 2020 and adopting a multi-period DID methodology, this research reveals that, in response to the carbon emissions trading system, firms often adopt low-cost, strategic environmental governance behaviors—namely, carbon washing—to reduce compliance costs and maintain their reputation and image. Furthermore, the study reveals that the information advantages of digital transformation create conditions for the opportunistic manipulation of carbon disclosure. Digitalization amplifies the positive influence of the carbon trading system on corporate carbon washing behavior. Mechanism analysis confirms that the carbon emissions trading system increases the production costs of regulated firms, thereby increasing their carbon washing behavior. Economic consequence analysis confirms that firms engage in carbon washing to gain legitimacy and maintain their reputation and image, which may allow them to obtain opportunistic benefits in the capital market. Finally, this study suggests that the government should adopt supplementary policy tools, such as environmental subsidies, enhanced use of digital technologies to strengthen regulatory capacity, and increased media oversight, to mitigate the unintended consequences of the carbon trading system on corporate behavior. Full article
(This article belongs to the Section Systems Practice in Social Science)
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11 pages, 1403 KiB  
Article
Clinical Features of Pulmonary Nocardiosis and Diagnostic Value of Metagenomic Next-Generation Sequencing: A Retrospective Study
by Yanbin Chen, Hailong Fu, Qiongfang Zhu, Yalu Ren, Jia Liu, Yining Wu and Jie Xu
Pathogens 2025, 14(7), 656; https://doi.org/10.3390/pathogens14070656 - 2 Jul 2025
Viewed by 505
Abstract
Pulmonary nocardiosis (PN) is a rare, opportunistic, and potentially life-threatening infection, especially in disseminated cases. This retrospective study aimed to characterize the clinical features of PN and assess the diagnostic utility of metagenomic next-generation sequencing (mNGS). We reviewed data from 19 patients diagnosed [...] Read more.
Pulmonary nocardiosis (PN) is a rare, opportunistic, and potentially life-threatening infection, especially in disseminated cases. This retrospective study aimed to characterize the clinical features of PN and assess the diagnostic utility of metagenomic next-generation sequencing (mNGS). We reviewed data from 19 patients diagnosed with PN between September 2019 and August 2022, including 3 with disseminated disease. Common symptoms included fever, cough, and sputum production, while chest imaging frequently revealed nodules, consolidations, exudates, cavities, and pleural effusions. The sensitivity of mNGS for detecting Nocardia was significantly higher than that of culture (100% vs. 36.84%, p < 0.001). mNGS successfully identified Nocardia species and co-infected pathogens. The most common species was Nocardia farcinica. Four PN cases were co-infected with Rhizomucor pusillus, Cryptococcus neoformans, Lichtheimia ramosa, and Aspergillus spp. Eighteen patients (94.7%) received trimethoprim-sulfamethoxazole (TMP-SMZ). Sixteen cases (84.2%) were improved or cured. Misdiagnosis is common due to the nonspecificity of clinical and imaging presentations of pulmonary nocardiosis. The timely combination of mNGS represents a promising approach to enhance the diagnosis of pulmonary nocardiosis and inform targeted antimicrobial therapy. TMP-SMZ is the first line of treatment. Full article
(This article belongs to the Section Bacterial Pathogens)
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11 pages, 1751 KiB  
Article
Opportunistic Diagnostics of Dental Implants in Routine Clinical Photon-Counting CT Acquisitions
by Maurice Ruetters, Holger Gehrig, Christian Mertens, Sinan Sen, Ti-Sun Kim, Heinz-Peter Schlemmer, Christian H. Ziener, Stefan Schoenberg, Matthias Froelich, Marc Kachelrieß and Stefan Sawall
J. Imaging 2025, 11(7), 215; https://doi.org/10.3390/jimaging11070215 - 30 Jun 2025
Viewed by 335
Abstract
Two-dimensional imaging is still commonly used in dentistry, but does not provide the three-dimensional information often required for the accurate assessment of dental structures. Photon-counting computed tomography (PCCT), a new three-dimensional modality mainly used in general medicine, has shown promising potential for dental [...] Read more.
Two-dimensional imaging is still commonly used in dentistry, but does not provide the three-dimensional information often required for the accurate assessment of dental structures. Photon-counting computed tomography (PCCT), a new three-dimensional modality mainly used in general medicine, has shown promising potential for dental applications. With growing digitalization and cross-disciplinary integration, using PCCT data from other medical fields is becoming increasingly relevant. Conventional CT scans, such as those of the cervical spine, have so far lacked the resolution to reliably evaluate dental structures or implants. This study evaluates the diagnostic utility of PCCT for visualizing peri-implant structures in routine clinical photon-counting CT acquisitions and assesses the influence of metal artifact reduction (MAR) algorithms on image quality. Ten dental implants were retrospectively included in this IRB-approved study. Standard PCCT scans were reconstructed at multiple keV levels with and without MAR. Quantitative image analysis was performed with respect to contrast and image noise. Qualitative evaluation of peri-implant tissues, implant shoulder, and apex was performed independently by two experienced dental professionals using a five-point Likert scale. Inter-reader agreement was measured using intraclass correlation coefficients (ICCs). PCCT enabled high-resolution imaging of all peri-implant regions with excellent inter-reader agreement (ICC > 0.75 for all structures). Non-MAR reconstructions consistently outperformed MAR reconstructions across all evaluated regions. MAR led to reduced clarity, particularly in immediate peri-implant areas, without significant benefit from energy level adjustments. All imaging protocols were deemed diagnostically acceptable. This is the first in vivo study demonstrating the feasibility of opportunistic dental diagnostics using PCCT in a clinical setting. While MAR reduces peripheral artifacts, it adversely affects image clarity near implants. PCCT offers excellent image quality for peri-implant assessments and enables incidental detection of dental pathologies without additional radiation exposure. PCCT opens new possibilities for opportunistic, three-dimensional dental diagnostics during non-dental CT scans, potentially enabling earlier detection of clinically significant pathologies. Full article
(This article belongs to the Section Medical Imaging)
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13 pages, 2699 KiB  
Article
Development of AI-Based Predictive Models for Osteoporosis Diagnosis in Postmenopausal Women from Panoramic Radiographs
by Francesco Fanelli, Giuseppe Guglielmi, Giuseppe Troiano, Federico Rivara, Giovanni Passeri, Gianluca Prencipe, Khrystyna Zhurakivska, Riccardo Guglielmi and Elena Calciolari
J. Clin. Med. 2025, 14(13), 4462; https://doi.org/10.3390/jcm14134462 - 23 Jun 2025
Viewed by 495
Abstract
Objectives: The aim of this study was to develop AI-based predictive models to assess the risk of osteoporosis in postmenopausal women using panoramic radiographs (OPTs). Methods: A total of 301 panoramic radiographs (OPTs) from postmenopausal women were collected and labeled based [...] Read more.
Objectives: The aim of this study was to develop AI-based predictive models to assess the risk of osteoporosis in postmenopausal women using panoramic radiographs (OPTs). Methods: A total of 301 panoramic radiographs (OPTs) from postmenopausal women were collected and labeled based on DXA-assessed bone mineral density. Of these, 245 OPTs from the Hospital of San Giovanni Rotondo were used for model training and internal testing, while 56 OPTs from the University of Parma served as an external validation set. A mandibular region of interest (ROI) was defined on each image. Predictive models were developed using classical radiomics, deep radiomics, and convolutional neural networks (CNNs), evaluated based on AUC, accuracy, sensitivity, and specificity. Results: Among the tested approaches, classical radiomics showed limited predictive ability (AUC = 0.514), whereas deep radiomics using DenseNet-121 features combined with logistic regression achieved the best performance in this group (AUC = 0.722). For end-to-end CNNs, ResNet-50 using a hybrid feature extraction strategy achieved the highest AUC in external validation (AUC = 0.786), with a sensitivity of 90.5%. While internal testing yielded high performance metrics, external validation revealed reduced generalizability, highlighting the challenges of translating AI models into clinical practice. Conclusions: AI-based models show potential for opportunistic osteoporosis screening from OPT images. Although the results are promising, particularly those obtained with deep radiomics and transfer learning strategies, further refinement and validation in larger and more diverse populations are essential before clinical application. These models could support the early, non-invasive identification of at-risk patients, complementing current diagnostic pathways. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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14 pages, 2229 KiB  
Brief Report
The Heterogenous Presentation of Hepatic Mucormycosis in Adults: A Case Report and Review of the Literature
by Hazim Allos, Rachel S. Hicklen, Takahiro Matsuo, Javier Adachi, Sebastian Wurster and Dimitrios P. Kontoyiannis
J. Fungi 2025, 11(6), 408; https://doi.org/10.3390/jof11060408 - 26 May 2025
Viewed by 679
Abstract
Hepatic mucormycosis is a rare but often fatal opportunistic fungal infection, primarily affecting immunocompromised patients. Herein, we report such a case from MD Anderson Cancer Center (Houston, TX, USA) and systematically review published cases in patients ≥ 19 years of age to better [...] Read more.
Hepatic mucormycosis is a rare but often fatal opportunistic fungal infection, primarily affecting immunocompromised patients. Herein, we report such a case from MD Anderson Cancer Center (Houston, TX, USA) and systematically review published cases in patients ≥ 19 years of age to better characterize clinical presentation, diagnostic challenges, and treatment outcomes of hepatic mucormycosis. Among the 40 identified cases (including ours), hematologic malignancies (55%) and solid organ transplantation (30%) were the most common underlying conditions. Fever (70%) and abdominal pain (63%) were the predominant symptoms. Imaging revealed multiple hepatic lesions in 72% of cases. Diagnosis was primarily based on histopathology (73%), whereas culture positivity was low (36%), underscoring the difficulty of pathogen isolation. Mucorales-active antifungal therapy was often delayed but eventually used in 85% of cases (all amphotericin B +/− Mucorales-active triazoles), while 45% underwent additional surgical intervention. Despite treatment, 1-year all-cause mortality remained high at 46%, with a trend towards lower mortality for those who underwent surgery compared to non-surgical management (35% vs. 55%, p = 0.334). These findings highlight the aggressive nature of hepatic mucormycosis and the importance of early recognition as well as the need for non-culture-based diagnostics and multimodal treatment approaches. Improved awareness and further research into optimized management strategies are crucial to improve the outcomes of this challenging infection. Full article
(This article belongs to the Special Issue Multidrug-Resistant Fungi, 2nd Edition)
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20 pages, 3028 KiB  
Article
Multitemporal Analysis Using Remote Sensing and GIS to Monitor Wetlands Changes and Degradation in the Central Andes of Ecuador (Period 1986–2022)
by Juan Carlos Carrasco Baquero, Daisy Carolina Carrasco López, Jorge Daniel Córdova Lliquín, Adriana Catalina Guzmán Guaraca, David Alejandro León Gualán, Vicente Javier Parra León and Verónica Lucía Caballero Serrano
Resources 2025, 14(4), 61; https://doi.org/10.3390/resources14040061 - 4 Apr 2025
Viewed by 1622
Abstract
Wetlands are transitional lands between terrestrial and aquatic systems that provide various ecosystem services. The objective of this study was to evaluate the change in wetlands in the Chimborazo Wildlife Reserve (CR) in the period 1986–2022 using geographic information systems (GISs), multitemporal satellite [...] Read more.
Wetlands are transitional lands between terrestrial and aquatic systems that provide various ecosystem services. The objective of this study was to evaluate the change in wetlands in the Chimborazo Wildlife Reserve (CR) in the period 1986–2022 using geographic information systems (GISs), multitemporal satellite data, and field data from the 16 wetlands of the reserve. Images from Landsat satellite collections (five from Thematic Mapper, seven from Enhanced Thematic Mapper, and eight from Operational Land Imager and Thermal Infrared Sensor) were used. Image analysis and processing was performed, and the resulting maps were evaluated in a GIS environment to determine the land cover change and growth rate of hydrophilic opportunistic vegetation (HOV) according to hillside orientation. The results show that there are negative annual anomalies in the water-covered areas, which coincide with the increase in HOV. This shows that the constancy or increase in the rate of increase in HOV, which varies between 0.0018 and 0.0028, causes the disappearance of these ecosystems. The importance of the study lies in its potential contribution to the decision-making process in the management of the CR. Full article
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20 pages, 1231 KiB  
Article
Cryptococcus neoformans: Brain Preference, Gender Bias, and Interactions with Mycobacterium tuberculosis and Toxoplasma gondii in HIV-Positive Patients
by Ruxandra Moroti, Adriana Hristea, Georgiana Neagu, Irina Penescu, Dragos Florea, Catalin Tiliscan and Serban Nicolae Benea
Microorganisms 2025, 13(3), 481; https://doi.org/10.3390/microorganisms13030481 - 21 Feb 2025
Cited by 1 | Viewed by 1513
Abstract
Cryptococcus neoformans, a high-priority pathogen (WHO, 2022) and ubiquitous fungus, is responsible for hundreds of thousands of meningoencephalitis cases annually, with a high fatality rate. Its distribution is uneven: it primarily affects immunocompromised individuals (especially HIV-positive patients). Our study aims to explore [...] Read more.
Cryptococcus neoformans, a high-priority pathogen (WHO, 2022) and ubiquitous fungus, is responsible for hundreds of thousands of meningoencephalitis cases annually, with a high fatality rate. Its distribution is uneven: it primarily affects immunocompromised individuals (especially HIV-positive patients). Our study aims to explore the Cryptococcus’ brain tropism in immunosuppressed patients, its gender preference and the possible interactions with other opportunistic neurotropic microorganisms, such as Mycobacterium tuberculosis (MTB) and the brain microbiota, with a particular focus on Toxoplasma gondii (T. gondii). Methods: We conducted a retrospective descriptive analysis of all cases diagnosed with central nervous system cryptococcosis (Crypto-CNS) in HIV-positive patients admitted over 10 years (2010–2019) in a tertiary Romanian hospital. We examined their demographic, clinical, immunobiological, and imaging data, as well as their medical history, comorbidities, and coinfections. Results: Forty-two cases were admitted, with a male predominance (3.6:1) and a mean age of 33.3 years; 24% were diagnosed concomitantly with HIV infection and Crypto-CNS. All patients were severely immunosuppressed, with CD4 counts <200 cells/mm3 (median = 20.5 [1–163], mean = 31.6). Recent/concomitant tuberculosis was found in 10 (27.7%). T. gondii-seropositive patients developed Crypto-CNS at a lower immunological state than seronegative ones (27.1 CD4 cells/mm3 vs. 46.7 cells/mm3, means). Of 25 cases with available brain imagery, 28% had high intracranial pressure. Twelve patients (28.5%) died during the hospitalization within 26.3 days (mean, SD = 21.4); 1-year mortality increased to 50%. In-hospital mortality was associated with lower CD4 counts, increased intracranial pressure, and T. gondii-seropositivity. Conclusions: Crypto-CNS in HIV-positive patients mainly affects men and may be promoted by concomitant or recent tuberculosis. T. gondii may confer some protection even at low immune levels but increases mortality when immunity is critically low. Full article
(This article belongs to the Special Issue Infectious Disease Surveillance in Romania)
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17 pages, 6073 KiB  
Article
Opportunistic Osteoporosis Assessment and Fracture Risk Determination Using Cancellous Density Measurement in Hounsfield Units of Native Lumbar Computed Tomography Images—A Comparative Study with Conventional Bone Density Evaluation
by Julian Ramin Andresen, Guido Schröder, Thomas Haider and Reimer Andresen
J. Clin. Med. 2025, 14(4), 1226; https://doi.org/10.3390/jcm14041226 - 13 Feb 2025
Cited by 1 | Viewed by 1251
Abstract
Background/Objectives: Osteoporosis is a global problem that will increase as the population increases and ages, requiring prevention, early detection, and appropriate treatment. An increasing loss in bone mineral density (BMD) is the hallmark of osteoporosis, leading to an increased risk for insufficiency fractures. [...] Read more.
Background/Objectives: Osteoporosis is a global problem that will increase as the population increases and ages, requiring prevention, early detection, and appropriate treatment. An increasing loss in bone mineral density (BMD) is the hallmark of osteoporosis, leading to an increased risk for insufficiency fractures. We aimed to investigate and analyze the applicability of native lumbar spine computed tomography (CT) scans for the evaluation of bone density compared with standard bone density measurements with quantitative computed tomography (QCT) and computed tomography X-ray absorptiometry of the hip (CTXA). Methods: Patients who were referred to our institution for diagnostic investigations and underwent CT imaging of the lumbar spine, as well as standard osteoporosis assessments including QCT and CTXA, were included in the study, resulting in a total of 240 patients (mean age: 65.9 years, range: 24–91). An ANOVA test was used to compare patient groups without a fracture, with one fracture, with more than one fracture, and with additional sacral fractures. An ROC analysis was performed to assess the predictive power of fracture risk estimation considering HU, QCT, and CTXA values. Results: At least one fracture was detected in 42.9% of these patients. For the lumbar spine, the median HU was 89.9 (range 67.9–126.9) and the median BMD was 73.7 (range 57.1–104.2) mg/cm3. With a correlation coefficient of 0.98 (p < 0.001), the HU values obtained from native lumbar CT scans can be calculated using the following formula: BMDspine = 0.84 + (0.81 × HU). With HU values < 80 and a BMD of the lumbar spine < 66 mg/cm3, a significantly increased number of osteoporotic vertebral fractures were found in the mid-thoracic, thoracolumbar, and sacral regions with an effect size of 0.89. In 32 patients (13.3%), additional sacral fractures were found; these patients showed the lowest density values with a median HU value of 31.8 (12.7–58.2). An ROC analysis of HU revealed a 93% sensitivity for the coincidence of a vertebral fracture. There was no significant difference compared with the AUC of QCT (p = 0.395) for concomitant vertebral body fractures. CTXA values also allowed for risk assessment but showed a significantly lower AUC. We found a negative correlation of BMD with age and a positive correlation of BMD with body mass index. Conclusions: Cancellous density measurements in HU values can be effectively converted into quantitative BMD values in mg/cm3, enabling a reliable assessment of osteoporosis severity and fracture risk prediction. Further quantitative density evaluation of the hip does not add value to fracture risk assessment for the axial skeleton. Based on this study’s findings, using HU values in native CT of the lumbar spine alone offers a viable, opportunistic approach towards fracture risk evaluation of the spine. Full article
(This article belongs to the Section Orthopedics)
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20 pages, 1147 KiB  
Review
The Future of Breast Cancer Organized Screening Program Through Artificial Intelligence: A Scoping Review
by Emma Altobelli, Paolo Matteo Angeletti, Marco Ciancaglini and Reimondo Petrocelli
Healthcare 2025, 13(4), 378; https://doi.org/10.3390/healthcare13040378 - 10 Feb 2025
Cited by 1 | Viewed by 1889
Abstract
Objective: The aim of this scoping review was to evaluate whether artificial intelligence integrated into breast cancer screening work strategies could help resolve some diagnostic issues that still remain. Methods: PubMed, Web of Science, and Scopus were consulted. The literature research [...] Read more.
Objective: The aim of this scoping review was to evaluate whether artificial intelligence integrated into breast cancer screening work strategies could help resolve some diagnostic issues that still remain. Methods: PubMed, Web of Science, and Scopus were consulted. The literature research was updated to 28 May 2024. The PRISMA method of selecting articles was used. The articles were classified according to the type of publication (meta-analysis, trial, prospective, and retrospective studies); moreover, retrospective studies were based on citizen recruitment (organized screening vs. spontaneous screening and a combination of both). Results: Meta-analyses showed that AI had an effective reduction in the radiologists’ reading time of radiological images, with a variation from 17 to 91%. Furthermore, they highlighted how the use of artificial intelligence software improved the diagnostic accuracy. Systematic review speculated that AI could reduce false negatives and positives and detect subtle abnormalities missed by human observers. DR with AI results from organized screening showed a higher recall rate, specificity, and PPV. Data from opportunistic screening found that AI could reduce interval cancer with a corresponding reduction in serious outcome. Nevertheless, the analysis of this review suggests that the study of breast density and interval cancer still requires numerous applications. Conclusions: Artificial intelligence appears to be a promising technology for health, with consequences that can have a major impact on healthcare systems. Where screening is opportunistic and involves only one human reader, the use of AI can increase diagnostic performance enough to equal that of double human reading. Full article
(This article belongs to the Special Issue Breast Cancer Prevention in Healthcare: A Comprehensive Overview)
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13 pages, 6684 KiB  
Review
The Importance of MRI in the Early Diagnosis of Acute Invasive Fungal Rhinosinusitis
by François Voruz, Dionysios Neofytos, Christian Van Delden, Johannes Lobrinus, Claudio De Vito, Sonia Macario, Dimitrios Daskalou, Julien W. Hsieh, Minerva Becker and Basile N. Landis
Diagnostics 2025, 15(3), 311; https://doi.org/10.3390/diagnostics15030311 - 28 Jan 2025
Cited by 1 | Viewed by 1502
Abstract
Acute invasive fungal rhinosinusitis (AIFR) is a rare, severe, and life-threatening opportunistic infection associated with high mortality and morbidity. Rapid and accurate diagnosis and treatment are crucial for survival and effective disease management. Diagnosing AIFR is challenging because no single pathognomonic feature exists [...] Read more.
Acute invasive fungal rhinosinusitis (AIFR) is a rare, severe, and life-threatening opportunistic infection associated with high mortality and morbidity. Rapid and accurate diagnosis and treatment are crucial for survival and effective disease management. Diagnosing AIFR is challenging because no single pathognomonic feature exists other than surgical biopsy showing fungal angioinvasion and necrosis. This narrative review focuses on the diagnostic challenges and pitfalls, emphasizing the critical clinical value of magnetic resonance imaging (MRI) for early diagnosis of AIFR. It includes selected cases that illustrate the significance of MRI. When AIFR is suspected, clinical symptoms, nasal endoscopy, blood samples, and facial computed tomography all provide non-specific information. In contrast, MRI can identify signs of devitalized sinonasal mucosa consistent with AIFR. The absence of mucosal enhancement on T1-weighted images, combined with restricted diffusivity, are characteristic MRI features of AIFR. The cases presented underscore the usefulness of MRI in supporting clinical suspicion of AIFR and accurately determining its topography, thereby guiding early surgical biopsies and debridement. In suspected cases of AIFR, MRI serves as a valuable supplementary, non-invasive tool to help determine whether prompt surgical biopsy or debridement is necessary, thereby enhancing early diagnosis and improving survival rates. Therefore, the threshold for conducting an MRI in these cases should be low. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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12 pages, 469 KiB  
Article
Efficacy of Prostate Biopsies via Transperineal and Transrectal Routes for Significant Prostate Cancer Detection: A Multicenter Paired–Matched Study
by Nahuel Paesano, Natàlia Picola, Jesús Muñoz-Rodriguez, Xavier Ruiz-Plazas, Marta V. Muñoz-Rivero, Ana Celma, Gemma García-de Manuel, Berta Miró, Pol Servian, José M. Abascal, Enrique Trilla and Juan Morote
Diagnostics 2025, 15(3), 288; https://doi.org/10.3390/diagnostics15030288 - 26 Jan 2025
Cited by 1 | Viewed by 1067
Abstract
Background: A transperineal approach to prostate biopsy is now recommended to reduce the risk of infectious complications associated with the transrectal route. Our aim is to compare the efficacy of transrectal- and transperineal-guided biopsies involving the magnetic resonance imaging (MRI) of index [...] Read more.
Background: A transperineal approach to prostate biopsy is now recommended to reduce the risk of infectious complications associated with the transrectal route. Our aim is to compare the efficacy of transrectal- and transperineal-guided biopsies involving the magnetic resonance imaging (MRI) of index lesions in detecting significant prostate cancer (sPCas), and to evaluate the role of systematic biopsies. Methods: In a prospective and multicenter trial conducted in an opportunistic early detection program for sPCa in Catalonia (Spain), between 2021 and 2023, 4029 men suspected of having PCa underwent multiparametric MRI followed by guided and systematic biopsies. From this cohort, we retrospectively selected 1376 men with reports of the size and localization of their index lesions. A matched group of 325 pairs of men subjected to transrectal and transperineal biopsy were chosen to account for confounding variables. We compared sPCa detection rates determined via index lesions and systematic biopsies, as well as by lesion localization. Results: Transperineal and transrectal biopsies detected sPCa in 49.5% vs. 40.6% overall (p = 0.027), 44.6% vs. 30.8% from index lesions (p = 0.001), and 24.3% vs. 35.1% from systematic biopsies (p = 0.003). SPCa detection rates were higher in transperineal biopsies across all index lesion localizations, with significant increases in the anterior zone (47.8% vs. 20.8% at the mid-base, p = 0.039, and 52.9% vs. 24.2% at the apex, p = 0.024) and central zone (33.3% vs. 5.9%, p = 0.003). With regards to SPCa detected only in systematic biopsies, 10.5% of cases were detected in transrectal biopsies and 4.9% of cases were detected in transperineal biopsies (p = 0.012). Conclusions: Targeted biopsies conducted via the transperineal route showed higher sPCa detection rates than transrectal biopsies, particularly for anterior and apical lesions, with systematic biopsies showing reduced utility. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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14 pages, 3560 KiB  
Article
Enhancing the Opportunistic Bone Status Assessment Using Radiomics Based on Dual-Energy Spectral CT Material Decomposition Images
by Qiye Cheng, Jingyi Zhang, Mengting Hu, Shigeng Wang, Yijun Liu, Jianying Li and Wei Wei
Bioengineering 2024, 11(12), 1257; https://doi.org/10.3390/bioengineering11121257 - 12 Dec 2024
Cited by 1 | Viewed by 1342
Abstract
The dual-energy spectral CT (DEsCT) employs material decomposition (MD) technology, opening up novel avenues for the opportunistic assessment of bone status. Radiomics, a powerful tool for elucidating the structural and textural characteristics of bone, aids in the detection of mineral loss. Therefore, this [...] Read more.
The dual-energy spectral CT (DEsCT) employs material decomposition (MD) technology, opening up novel avenues for the opportunistic assessment of bone status. Radiomics, a powerful tool for elucidating the structural and textural characteristics of bone, aids in the detection of mineral loss. Therefore, this study aims to compare the efficacy of bone status assessment using both bone density measurements and radiomics models derived from MD images and to further explore the clinical value of radiomics models. Methods: Retrospective data were collected from 307 patients who underwent both quantitative computed tomography (QCT) and full-abdomen DEsCT scans at our institution. Based on QCT measurements, patients were divided into three categories: normal bone mineral density (BMD), osteopenia, and osteoporosis. Using the abdominal DEsCT data, six types of MD images were reconstructed, including HAP (Water), HAP (Fat), Ca (Water), Ca (Fat), Fat (Ca), and Fat (HAP). Patients were randomly divided into a training cohort (n = 214) and a validation cohort (n = 93) at a ratio of 7:3. Focusing on the L1 to L3 vertebrae, density values from the six MD images were measured. Six density value models and six radiomics models were constructed using a random forest (RF) classifier. The performance of these models in assessing bone status was evaluated using the receiver operating characteristic (ROC) curves, and the DeLong test was employed to compare performance differences between the models. Results: The macro-area under the curve (AUC) values for the density value models based on HAP (Water), HAP (Fat), Ca (Water), and Ca (Fat) MD images were 0.870, 0.870, 0.847, and 0.765, respectively, which outperformed those of Fat (Ca) (AUC = 0.623) and Fat (HAP) (AUC = 0.618) density value models. In the comparison of radiomics models, the trends of model performance were consistent with the density value models across the six MD images. However, the models based on HAP (Water), Ca (Water), HAP (Fat), Ca (Fat), Fat (Ca), and Fat (HAP) images exhibited superior performance than those of the density value models with the corresponding MD images, with values of 0.946, 0.941, 0.934, 0.926, 0.831, and 0.824, respectively. Conclusions: Bone status assessment can be accurately conducted using density values from HAP (Water), HAP (Fat), Ca (Water), and Ca (Fat) MD images. However, radiomics models derived from MD images surpass traditional density measurement methods in evaluating bone status, highlighting their superior diagnostic potential. Full article
(This article belongs to the Section Biosignal Processing)
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Article
Regulatory Standard for Determining Preoperative Skin Preparation Efficacy Underreports True Dermal Bioburden in a Porcine Model
by Hannah R. Duffy, Nicholas N. Ashton, Abbey Blair, Nathanael Hooper, Porter Stulce and Dustin L. Williams
Microorganisms 2024, 12(11), 2369; https://doi.org/10.3390/microorganisms12112369 - 20 Nov 2024
Cited by 1 | Viewed by 1029
Abstract
Medical device companies and regulatory bodies rely on a nondestructive bacterial sampling technique specified by the American Society for Testing and Materials (ASTM E1173-15) to test preoperative skin preparations (PSPs). Despite the widespread use of PSPs, opportunistic skin-flora pathogens remain the most significant [...] Read more.
Medical device companies and regulatory bodies rely on a nondestructive bacterial sampling technique specified by the American Society for Testing and Materials (ASTM E1173-15) to test preoperative skin preparations (PSPs). Despite the widespread use of PSPs, opportunistic skin-flora pathogens remain the most significant contributor to surgical site infections, suggesting that the ASTM testing standard may be underreporting true dermal bioburden. We hypothesized that ASTM E1173-15 may fail to capture deep skin-dwelling flora. To test this hypothesis, we applied ASTM E1173-15 and a full-thickness skin sampling technique, which we established previously through application to the backs of seven pigs (Yorkshire/Landrace hybrid) following a clinically used PSP (4% chlorhexidine gluconate). The results showed that samples quantified using the full-thickness skin method consistently cultured more bacteria than the ASTM standard, which principally targeted surface-dwelling bacteria. Following PSP, the ASTM standard yielded 1.05 ± 0.24 log10 CFU/cm2, while the full-thickness tissue method resulted in 3.24 ± 0.24 log10 CFU/cm2, more than a 2 log10 difference (p < 0.001). Immunofluorescence images corroborated the data, showing that Staphylococcus epidermidis was present in deep skin regions with or without PSP treatment. Outcomes suggested that a full-thickness sampling technique may better evaluate PSP technologies as it resolves bioburdens dwelling in deeper skin regions. Full article
(This article belongs to the Special Issue Antimicrobial Testing (AMT), Third Edition)
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