Search Results (3,042)

Background: A short cervix in the second trimester significantly increases preterm birth risk, yet no reliable first-trimester prediction method exists. Current guidelines lack consensus on which women should undergo transvaginal ultrasound (TVUS) screening for cost-effective prevention. Therefore, it is vital to establish a highly accurate and economical method for use in the early stages of pregnancy to predict short cervix in mid-pregnancy. Methods: A total of 1480 pregnant women with singleton pregnancies and at least one risk factor for spontaneous preterm birth (<37 weeks) were recruited from January 2020 to December 2020 at the Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine. Cervical length was assessed at 20–24 weeks of gestation, with a short cervix defined as <25 mm. Feature selection employed tree models, regularization, and recursive feature elimination (RFE). Seven machine learning models (logistic regression, linear discriminant analysis, k-nearest neighbors, support vector machine, decision tree, random forest, XGBoost) were trained to predict mid-trimester short cervix. The XGBoost model—an ensemble method leveraging sequential decision trees—was analyzed using Shapley Additive Explanation (SHAP) values to assess feature importance, revealing consistent associations between clinical predictors and outcomes that align with known clinical patterns. Results: Among 1480 participants, 376 (25.4%) developed mid-trimester short cervix. The XGBoost-based prediction model demonstrated high predictive performance in the training set (Recall = 0.838, F1 score = 0.848), test set (Recall = 0.850, F1 score = 0.910), and an independent dataset collected in January 2025 (Recall = 0.708, F1 score = 0.791), with SHAP analysis revealing pre-pregnancy BMI as the strongest predictor, followed by second-trimester pregnancy loss history, peripheral blood leukocyte count (WBC), and positive vaginal microbiological culture results (≥10⁵ CFU/mL, measured between 11⁺⁰ and 13⁺⁶ weeks). Conclusions: The XGBoost model accurately predicts mid-trimester short cervix using first-trimester clinical data, providing a 6-week window for targeted interventions before the 20–24-week gestational assessment. This early prediction could help guide timely preventive measures, potentially reducing the risk of spontaneous preterm birth (sPTB). Full article

Focal therapy for prostate cancer (PCa) provides approaches to treat PCa patients in a less invasive manner than traditional whole-gland surgical or radiation modalities. This manuscript provides a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa at a single institution and cost analysis with a review of the literature. All patients who underwent HIFU, cryoablation, or IRE for localized PCa were retrospectively reviewed, excluding patients who received whole-gland therapy. Functional outcomes were erectile dysfunction and lower urinary tract symptoms. Cost data were collected. A total of 45 patients were included in the study with focal therapy ranging from 2023 to 2025 (4 HIFU, 20 cryoablation, 21 IRE). A total of 30 patients had focally treated lesions, and 15 patients had hemi-gland treatment. The mean preoperative PSA was 7.7 ng/mL. On the paired sample t-test, there was no significant difference between pre-focal and post-focal therapy PSA. Three patients experienced biochemical recurrence requiring prostate biopsy after focal treatment. Mean cost was USD 3804.50 and not significantly different by focal treatment. No metastatic events occurred nor deaths at a median follow-up of 6 months. Patients in this series had largely unaltered functional outcomes. Cost analysis in contemporary publications is lacking. Although follow-up was short, cancer control was adequate. Full article

Background/Objective: Prenatal cytogenetic testing is essential for pregnant women who are at high risk of having a child with a chromosomal abnormality. While conventional karyotyping detects large aneuploidies and structural rearrangements (>5–10 Mb), chromosomal microarray analysis (CMA) identifies smaller copy number variants (CNVs), increasing the diagnostic yield by approximately 5%. CMA is now recommended as the first-line test for evaluating fetal structural anomalies that are detected by ultrasound. Method: From March 2023 to September 2024, we analyzed 344 prenatal samples using conventional karyotyping and SNP-based CMA. Karyotyping was performed via flask culture, and CMA was conducted using the Infinium Global Screening Array Cyto (GSA-Cyto) on the Illumina iScan platform. We interpreted the CNVs using NxClinical v6.0 and curated databases including ClinVar, DECIPHER, OMIM, and ClinGen, among others. Our results aligned with the GRCh37/hg19 reference genome. Results: Chromosomal abnormalities were identified in 57/344 cases (16.5%). Of these, 39 cases were numerical chromosomal anomalies, and 18 cases were pathogenic or likely pathogenic CNVs. Notably, 11 CNVs (3.2%) were undetectable by conventional karyotyping, emphasizing the added value of CMA. Conclusions: CMA enhances the prenatal diagnostic accuracy by detecting submicroscopic CNVs that are not visible with conventional methods, supporting the routine use of this analysis in prenatal genetic evaluation. Full article

Deep eutectic solvents (DESs) have been studied to obtain extracts from medicinal plants, aiming for a more environmentally friendly process. Aligned with this initiative, the use of predictive thermodynamic models for screening the best solvent represents a theoretical action to reduce experimental time and cost. Therefore, this study aimed to perform and validate a relative solubility screening of 5-methoxy-6,7-methylenedioxycoumarin and prenyletin-methyl-ether at 313 K in choline chloride, menthol, and betaine-based DES, using the COSMO-RS model in COSMOThermX software. The density of DES was also predicted with a maximum error of 7.31% for this property. Ultrasound-assisted extraction (UAE) with DES at 313 K, 30 min, and a solid/liquid ratio of 1:20 (w/w) was performed to confirm the theoretical solubility results experimentally, as the extracts were analyzed through ultrafast liquid chromatography (UFLC) for coumarin content. For the results, the coumarin molecules presented intense peaks in the nonpolar region of their σ-profile, and the relative solubility screening indicated the DES Men/Lau (2:1), known for its hydrophobic nature and low polarity, as the best DES to solubilize these coumarins. Nevertheless, the UFLC results, and the complementary solubility screening of pigments, showed an interaction preference of this DES with chlorophylls instead of coumarins. This result was corroborated by spectrophotometric analysis of the extracts in UV-Vis, demonstrating that experimental validation is still mandatory in extraction processes and that predictive methodologies such as COSMO-RS should be used as guiding tools and analyzed in a greater context, considering the complexity of plant matrices in the beginning of simulations. Full article

Background/Objectives: Magnetic resonance imaging (MRI) and MRI–ultrasound (US) fusion-targeted biopsy have improved prostate cancer diagnosis, particularly for clinically significant disease. However, the added value of combining systematic biopsy with targeted biopsy remains debated. This study aimed to evaluate the diagnostic accuracy of MRI–US fusion-targeted and systematic transperineal biopsies in detecting prostate cancer and explore the correlation between PI-RADS score and histology. Methods: We retrospectively analyzed 356 patients with 452 MRI-detected lesions who underwent both MRI–US fusion-targeted and transperineal systematic biopsies between 2020 and 2023. Clinically significant prostate cancer (csPCa) was defined as International Society of Urological Pathology (ISUP) grade ≥ 2. Diagnostic performance metrics (sensitivity, specificity, and accuracy) were calculated for each technique using the combined result as a reference. Subgroup analysis was performed for patients under active surveillance. Results: Prostate cancer was diagnosed in 323 of 452 lesions (71%) and csPCa in 223 lesions (49%). Targeted biopsy demonstrated higher sensitivity (93.7%) and accuracy (79.9%) than systematic biopsy (85.7% sensitivity and 77.6% accuracy), although systematic biopsy provided slightly higher specificity. Systematic biopsy alone identified 8.2% of PCa cases missed by targeted biopsy and upgraded 9.9% of lesions to csPCa. csPCa detection increased with PI-RADS score (23% in PI-RADS 3 and 73% in PI-RADS 5). In active surveillance patients, csPCa was found in 65% of lesions. Conclusions: MRI–US fusion-targeted biopsy improves csPCa detection, but systematic biopsy remains valuable, especially for identifying additional or higher-grade disease. The combined approach provides an optimal diagnostic yield, supporting its continued use in both initial and repeat biopsy settings. Full article

Accurate assessment of histological remission is a critical goal in the management of ulcerative colitis (UC); however, routine evaluation is hindered by the invasiveness of endoscopy and biopsy. Non-invasive alternatives like intestinal ultrasound (IUS) and faecal calprotectin (FC) show promise for monitoring mucosal inflammation, though their ability to predict histological healing remains underexplored. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of IUS, FC, and their combined use for detecting histologic remission in patients with UC. A comprehensive literature search identified two eligible studies comprising 72 patients. Pooled estimates for IUS demonstrated high sensitivity (0.84, 95% CI: 0.35–0.98) but variable specificity (0.78, 95% CI: 0.08–0.99), while FC alone exhibited high sensitivity (0.85, 95% CI: 0.72–0.92) with moderate specificity (0.60, 95% CI: 0.38–0.79). Notably, only one study assessed the combined diagnostic approach, reporting superior performance with sensitivity and specificity of 0.88 and 0.80, respectively. The certainty of the evidence was rated as moderate. These exploratory findings suggest that a multimodal, non-invasive approach combining IUS and FC may improve diagnostic accuracy in detecting histological remission in UC, potentially reducing reliance on invasive procedures. However, given the limited number of studies included and the high degree of heterogeneity, these results should be interpreted with caution. Further large-scale, methodologically robust studies are needed to validate these preliminary findings and establish standardized diagnostic protocols. Full article

Transvaginal ultrasound-guided follicle aspiration remains the gold standard for oocyte retrieval in assisted reproductive technology (ART). This procedure employs either a single-lumen aspiration needle (SLN) or double-lumen aspiration needle (DLN), both of which are effective modalities for oocyte retrieval. The primary objective of this review is to systematically compare the impact and clinical outcomes associated with the use of SLN versus DLN in women undergoing ART. A systematic literature search was conducted across two databases, PubMed and Google Scholar, encompassing publications from their inception until May 2025, and articles published in English. A total of five studies were included in the final analysis. The oocyte yield and the number of MII oocyte did not differ significantly between the groups. Procedural duration was markedly shorter in the SLN group compared to the DLN group. No significant differences were observed in procedure-related complications across groups. Two randomized controlled trials reported comparable fertilization rates and numbers of high-quality embryos between the two needle types. Additionally, clinical pregnancy rates, ongoing pregnancy rates, and live birth rates were similar between the SLN and DLN groups. In conclusion, the utilization ofan SLN for oocyte retrieval demonstrates comparable efficacy to that of a DLN. Full article

Ciprofloxacin (CIP), a persistent fluoroquinolone antibiotic, poses serious environmental concerns due to its low biodegradability and widespread presence in aquatic ecosystems. This study investigates the synergistic application of low-frequency ultrasonic cavitation and biological treatment to enhance CIP removal efficiency. Experiments have shown that under the optimal biological treatment conditions (6 g/L sludge concentration, pH 8), single biological treatment for 48 h can only remove 41.9% CIP and 24.9% total organic carbon (TOC). Ultrasonic pretreatment was conducted under varying frequencies and pH conditions to determine optimal cavitation parameters, while biodegradation performance was evaluated at different sludge concentrations and pH levels. Results indicated that in 10 mg/L CIP wastewater under alkaline conditions (pH 9.0), CIP and TOC removal efficiencies reached 58.9% and 35.2%, respectively, within 30 min using 15 kHz ultrasound irradiation. When ultrasonic pretreatment was followed by biological treatment, overall removal rates increased to 96.3% for CIP and 90.4% for TOC, significantly outperforming either method alone. LC-MS analysis identified several degradation intermediates during ultrasonic pretreatment, revealing key transformation pathways such as piperazine ring cleavage, hydroxylation, and defluorination. Furthermore, toxicity evaluation using the T.E.S.T. model confirmed a substantial reduction in ecological risk after ultrasonic treatment. Overall, the combined ultrasonic–biological process offers a cost-effective and environmentally sustainable strategy for the efficient removal of fluoroquinolone antibiotics from wastewater. Full article

Background: Differentiating acute kidney injury (AKI) from chronic kidney disease (CKD) in children remains a critical unmet need due to the limitations of current clinical and biochemical markers. Conventional ultrasound lacks the sensitivity to discern subtle parenchymal alterations. This study explores the application of ultrasound radiomics—a novel, non-invasive, and quantitative image analysis method—for distinguishing AKI from CKD in pediatric patients. Methods: In this retrospective cross-sectional pilot study, kidney ultrasound images were obtained from 31 pediatric subjects: 8 with oliguric AKI, 14 with CKD, and 9 healthy controls. Renal parenchyma was manually segmented, and 124 advanced texture features were extracted using the open-source ©PyFeats. Features encompassed multiple categories (e.g., GLCM, GLSZM, WP). Statistical comparisons evaluated intergroup differences. Principal Component Analysis identified the top 10 most informative features, which were used to train supervised machine learning models. Model performance used five-fold cross-validation. Results: Radiomic analysis revealed significant intergroup differences (p < 0.05). CKD cases exhibited increased echogenicity and heterogeneity, particularly in GLCM and GLSZM features, consistent with chronic fibrosis. AKI cases displayed more homogeneous texture, likely reflecting edema or acute inflammation. While echogenicity separated diseased from healthy kidneys, it lacked specificity between AKI and CKD. Among ML models, XGBoost achieved the highest macro-averaged F1 score (0.90), followed closely by SVM and Random Forest, demonstrating strong classification performance. Conclusions: Radiomics-based texture analysis of grayscale ultrasound images effectively differentiated AKI from CKD in this pilot study, offering a promising, non-invasive imaging biomarker for pediatric kidney disease. These preliminary findings justify prospective validation in larger, multicenter cohorts. Full article

Stimuli-responsive, cell-mediated drug delivery systems represent a dynamic interface between biological functionality and engineered control. Leveraging the inherent targeting properties of erythrocytes, immune cells, stem cells, and exosomes, these systems offer a promising strategy for precise therapeutic delivery. In this review, we provide a comprehensive analysis of the design principles and biological underpinnings of stimuli-responsive carriers that release payloads in response to endogenous triggers (e.g., pH, redox, enzymatic activity) or external stimuli (e.g., light, ultrasound, magnetic fields). We further examine current strategies for loading and functionalizing cellular carriers, highlight key therapeutic applications across oncology and regenerative medicine, and assess translational progress and regulatory challenges. This review underscores the emerging clinical potential of intelligent cell-based delivery vehicles and outlines future directions for their optimization and implementation. Full article

Tartary buckwheat hulls, a phenolic-rich by-product of buckwheat processing, offer great potential for resource utilization. In this study, ultrasound-assisted enzymatic extraction with two temperatures (40 °C and 50 °C) was employed to obtain phenolics from Tartary buckwheat hulls. Compared with the traditional extraction method (207 mg/100 g), ultrasound-assisted enzymatic extraction increased the total phenolic yield by 91.3% at 50 °C. Numerical simulations based on Fick’s law indicated that enzyme pretreatment concentration positively correlated with the effective diffusion coefficient ($D_e$), which increased from 9.15 × 10⁻⁷ to 2.00 × 10⁻⁶ m²/s at 40 °C. Meanwhile, the neuro-fuzzy inference system (ANFIS) successfully predicted the extraction yield under various ultrasonic conditions (R² > 0.98). Regarding quantitative analysis of phenolic compounds in extracts, the results revealed that catechins and epicatechins were the most abundant in Tartary buckwheat hull. Additionally, phenolic acids rapidly diffused at higher temperatures (50 °C), and flavonoids were highly sensitive to temperature and enzyme synergy. Phenolic extracts exhibit significant potential for value-added applications in food processing, particularly in improving antioxidative stability, prolonging shelf life. This study provides a theoretical basis for green, efficient phenolic extraction from plant residues. Full article

Background and Objectives: Pelvic organ prolapse (POP) is a complex condition affecting the pelvic floor, often requiring imaging for accurate diagnosis and treatment planning. Artificial intelligence (AI), particularly deep learning (DL), is emerging as a powerful tool in medical imaging. This scoping review aims to synthesize current evidence on the use of AI in the imaging-based diagnosis and anatomical evaluation of POP. Materials and Methods: Following the PRISMA-ScR guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2020 and April 2025. Studies were included if they applied AI methodologies, such as convolutional neural networks (CNNs), vision transformers (ViTs), or hybrid models, to diagnostic imaging modalities such as ultrasound and magnetic resonance imaging (MRI) to women with POP. Results: Eight studies met the inclusion criteria. In these studies, AI technologies were applied to 2D/3D ultrasound and static or stress MRI for segmentation, anatomical landmark localization, and prolapse classification. CNNs were the most commonly used models, often combined with transfer learning. Some studies used hybrid models of ViTs, demonstrating high diagnostic accuracy. However, all studies relied on internal datasets, with limited model interpretability and no external validation. Moreover, clinical deployment and outcome assessments remain underexplored. Conclusions: AI shows promise in enhancing POP diagnosis through improved image analysis, but current applications are largely exploratory. Future work should prioritize external validation, standardization, explainable AI, and real-world implementation to bridge the gap between experimental models and clinical utility. Full article

Breast cancer remains a critical global health challenge, with over 2.1 million new cases annually. This review systematically evaluates recent advancements (2022–2024) in machine and deep learning approaches for breast cancer detection and risk management. Our analysis demonstrates that deep learning models achieve 90–99% accuracy across imaging modalities, with convolutional neural networks showing particular promise in mammography (99.96% accuracy) and ultrasound (100% accuracy) applications. Tabular data models using XGBoost achieve comparable performance (99.12% accuracy) for risk prediction. The study confirms that lifestyle modifications (dietary changes, BMI management, and alcohol reduction) significantly mitigate breast cancer risk. Key findings include the following: (1) hybrid models combining imaging and clinical data enhance early detection, (2) thermal imaging achieves high diagnostic accuracy (97–100% in optimized models) while offering a cost-effective, less hazardous screening option, (3) challenges persist in data variability and model interpretability. These results highlight the need for integrated diagnostic systems combining technological innovations with preventive strategies. The review underscores AI’s transformative potential in breast cancer diagnosis while emphasizing the continued importance of risk factor management. Future research should prioritize multi-modal data integration and clinically interpretable models. Full article

Background/Objectives: Cystic hygroma is a congenital lymphatic malformation often identified during early pregnancy and frequently associated with chromosomal abnormalities and adverse outcomes. We aimed to appraise the genetic and clinical characteristics of fetuses diagnosed with cystic hygroma in the first/early second trimester, assess the resolution patterns in chromosomally normal cases, and provide insights into prognosis—based on data collected over a 30-year period. Methods: A retrospective cohort study was conducted on 405 consecutive fetuses diagnosed with nuchal cystic hygroma between 8.0 and 14.0 weeks of gestation from 1993 to 2023 at two tertiary care centers. Diagnoses were established using high-resolution transabdominal and transvaginal 3D/4D ultrasonography. All cases underwent prenatal cytogenetic analysis, including karyotyping. Fetuses with a normal karyotype were observed through serial ultrasounds through the remainder of the pregnancy to verify the eventual resolution of hygromas. Both descriptive and inferential statistical methods were used, with p < 0.05 as a cut-off (two-tailed). Results: Of the 405 fetuses, 210 (51.9%) had chromosomal abnormalities, most commonly trisomy 21, while 195 (48.1%) had a normal karyotype. A significantly higher frequency of trisomy 21 was observed compared to other identified chromosomal abnormalities (p < 0.001). In the chromosomally normal group, 85 (43.6%) showed spontaneous resolution of the hygroma within four weeks, and these pregnancies resulted in phenotypically normal live births. Septated hygromas were significantly more frequent in the abnormal karyotype group (71.4%). Conclusions: The finding and diagnosis of cystic hygroma in first trimester and early second-trimester pregnancy represent a strong predictor of chromosomal aneuploidy and warrant comprehensive prenatal genetic testing and close follow-up. However, in the absence of genetic abnormalities and additional malformations, spontaneous resolution is common, and neonatal outcomes are generally favorable. Health systems should provide equitable access to genetic testing and fetal imaging to support accurate diagnosis and informed decisions. Full article

Photoacoustic tomography (PAT), which combines optical absorption and ultrasonic detection, enables the monitoring of dehydration-driven structural changes in extracted teeth over time. In this proof-of-concept study, 2D photoacoustic images of a wisdom tooth were generated on the same scanning plane at days 0, 1, 3, 6, 10, 15, 21, and 28 post-extraction, using day 0 as the reference. Measurements were performed in forward-detection mode with a single ultrasound transducer and a 532 nm pulsed laser. For the comparative analysis of variations between images, four metrics were used: Pearson correlation coefficient, Structural Similarity Index (SSIM), Mean Squared Error (MSE), and Peak Signal-to-Noise Ratio (PSNR). Structural changes were also examined through radial intensity profiles extracted from each image. The results revealed marked differences in the central region, evidencing progressive structural and acoustic modifications within the tooth. The most significant change occurred on day 1, followed by small but consistent variations on subsequent days. These differences are associated with dehydration-induced changes in tissue density, which affect sound propagation. This study highlights the value of PAT for noninvasive monitoring of post-extraction dental changes, with implications for diagnosis, treatment guidance, and biomaterials research in dentistry. Full article