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Abstract Objective To investigate the clinical application value of microfluidic-based in vitro diagnostic (IVD) technology in pathogenic detection of respiratory tract infections. Methods A total of 300 clinical samples, including blood, bronchoalveolar lavage fluid, and pleural effusion, were collected from patients with respiratory tract infections. The samples were randomly divided into three groups: A, B, and C, with 100 cases in each group. Group A used traditional microbiological detection methods, Group B used metagenomic next-generation sequencing (mNGS) technology, and Group C used both microfluidic-based IVD technology and traditional microbiological detection methods to detect pathogenic microorganisms in the clinical samples. The positive detection rate, detection time, and detection cost were compared among the groups. The diagnostic performance of each group was compared using the Receiver Operating Characteristic (ROC) curve. Results Traditional microbiological detection identified 38 positive samples (38%), including 45 pathogens; mNGS technology identified 95 positive samples (95%), including 210 pathogens; microfluidic-based IVD technology identified 96 positive samples (96%), including 158 pathogens. Microfluidic-based IVD technology had a significantly higher positive detection rate for pathogenic microorganisms compared to traditional culture techniques (96% vs 38%, χ2 = 122.0, P

Abstract Background The current diagnostic strategy for hepatitis C virus (HCV) infection involves a two-step approach: antibody HCV screening followed by confirmatory nucleic acid testing. This study aimed to evaluate the diagnostic performance of the Abbott ARCHITECT HCV Ag assay in serum/plasma samples as a potential one-step alternative for diagnosing active HCV infection in people living with hepatitis B virus (PLWHB) through a systematic review and meta-analysis. Methods A systematic review and meta-analysis were conducted following PRISMA-DTA guidelines. This protocol was registered on PROSPERO (CRD42023402093). A comprehensive search of electronic databases identified studies published up to 1 November 2024, comparing the ARCHITECT HCV Ag assay to an HCV-RNA reference standard. Sensitivity, specificity, and likelihood ratios were pooled using a random-effects model within the MIDAS module of Stata software. Study quality was assessed using QUADAS-2. Heterogeneity was evaluated using the Q statistic, quantified using the I², and further explored through meta-regression. Results Ten studies (n = 494 participants) met inclusion criteria. The Abbott ARCHITECT HCV Ag assay demonstrated high sensitivity [91%, 95% confidence interval (CI): 76–97%] and specificity (99%, 95% CI: 99–100%). The positive likelihood ratio (PLR) was 81.20 (95% CI: 12.34–534.36), and the negative likelihood ratio (NLR) was 0.09 (95% CI: 0.03–0.27). The area under the summary receiver operating characteristic curve (AUC-SROC) was 99% (95% CI 98–100%). In regions with high HCV prevalence (≥ 10%), the test accurately confirmed active HCV infection in over 90% of cases. However, confirmatory testing remains necessary in low-prevalence settings (≤ 5%). The assay demonstrated an excellent ability to identify individuals without HCV infection, with a low false-negative rate (≤ 2%) regardless of HCV prevalence. Heterogeneity analysis revealed moderate to substantial variation in test performance (I² = 72.09% for sensitivity, 35.47% for PLR, and 78.33% for NLR). QUADAS-2 applicability concerns predicted heterogeneity, but differences were likely insignificant due to minimal variations and limited studies. Conclusions The Abbott ARCHITECT HCV Ag assay exhibited promising accuracy in detecting active HCV infection among PLWHB. This test might help diagnose active HCV infection in high-prevalence scenarios (≥ 10%) but needs further confirmation in low-prevalence settings (≤ 5%). Graphical Abstract

Haemophilia presents challenges in joint pathology assessment, prompting exploration of point-of-care ultrasonography (POC-US) as a diagnostic tool. Aims: The study aimed to assess the diagnostic performance of point-of-care ultrasonography (POC-US) compared to magnetic resonance imaging (MRI) in detecting synovial hypertrophy, cartilage abnormality, and bony abnormality among people with haemophilia (PWH) treated at Assam Medical College Hospital.

Abstract Background The contrast-enhanced US (CEUS) Bosniak classification, proposed by the European Federation for Ultrasound in Medicine and Biology (EFSUMB) in 2020, predicts malignancy in cystic renal masses (CRMs). However, intra- and inter-rater reproducibility for CEUS features has not been well investigated. Purpose To explore intra- and inter-rater agreement for US features, identify confounding features, and assess the diagnostic performance of CEUS Bosniak classification. Materials and methods This retrospective study included patients with complex CRMs who underwent CEUS examination from January 2013 to August 2023. Radiologists (3 experts and 3 novices) evaluated calcification, echogenic content, wall, septa, and internal nodules of CRMs using CEUS Bosniak classification. Intra- and inter-rater agreements were assessed using the Gwet agreement coefficient (Gwet’s AC). Linear regression identified features associated with discrepancies in Bosniak category assignment. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC). Results A total of 103 complex CRMs were analyzed in 103 patients (mean age, 50 ± 15 years; 66 males). Intra-rater agreement for the Bosniak category was substantial to almost perfect (Gwet’s AC 0.73–0.87). Inter-rater agreement was substantial for the Bosniak category (Gwet’s AC 0.75) and moderate to almost perfect for US features (Gwet’s AC 0.44–0.94). Nodule variation (i.e., absence vs. obtuse margin vs. acute margin) explained 84% of the variability in the Bosniak category assignment. CEUS Bosniak classification showed good diagnostic performance, with AUCs ranging from 0.78 to 0.90 for each rater. Conclusions CEUS Bosniak classification demonstrated substantial intra- and inter-rater reproducibility and good diagnostic performance in predicting the malignancy potential of CRMs. Nodule variations significantly predicted differences in Bosniak category assignments. Critical relevance statement Contrast-enhanced US Bosniak classification reliably predicts malignancy in cystic renal masses, demonstrating substantial reproducibility and diagnostic accuracy. This improves clinical decision-making and patient management. Key Points Intra- and inter-rater reproducibility for contrast-enhance US features for Bosniak classification have not been well investigated. Substantial inter-rater agreements for the Bosniak category and variable agreements for determining imaging features were found. Contrast-enhanced US Bosniak classification is reproducible and has good diagnostic performance for predicting malignancy in cystic renal masses. Graphical Abstract

Background: Diagnosing perioperative anaphylaxis (POA) is often challenging. Although a guideline recommends measuring tryptase rather than histamine, there is little evidence for this. We aimed to examine the diagnostic performance and appropriate timing of tryptase and histamine measurements for diagnosing anaphylaxis, and the association between Hypersensitivity Clinical Scoring Scheme (HCSS) scores and elevated biomarkers. Methods: We measured tryptase and histamine levels thrice: 30 min, 2 h, and at least 24 h after an anaphylactic event for patients with suspected anaphylaxis, and at the induction of general anesthesia and 30 min and 2 h after the start of surgery for control patients without a reaction. Absolute values and the magnitude and rate of change from baseline were evaluated. We determined the thresholds of tryptase and histamine levels with the best diagnostic performance and compared their performance. Results: Forty-five patients with perioperative anaphylaxis were included in this study. The control group included 30 patients with uneventful general anesthesia and 12 patients with a suspected but unconfirmed diagnosis of perioperative anaphylaxis. Comparison at the same measurement timings showed that tryptase generally had better diagnostic performance than histamine. Both showed better diagnostic performance when assessed using multiple measurements rather than a single measurement. The best diagnostic performance was seen with the percentage change in the higher tryptase value, whether measured at 30 min or 2 h after anaphylaxis onset, as compared to baseline. However, neither tryptase nor histamine levels correlated with HCSS scores. Conclusions: Overall, tryptase showed better diagnostic performance than histamine. When multiple tryptase measurements are possible, parameters calculated using two acute phase measurements and the baseline level have better diagnostic performance.

Abstract Background A new pathogen detection tool, metagenomic next-generation sequencing (mNGS), has been widely used for infection diagnosis, but the clinical and diagnostic value of mNGS in urinary tract infection (UTI) remains inconclusive. This systematic review with meta-analysis aimed to investigate the efficacy of mNGS in treating UTIs. Methods A comprehensive literature search was performed in PubMed, Web of Science, Embase, and the Cochrane Library, and eligible studies were selected based on the predetermined criteria. The quality of the included studies was assessed via the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, and the certainty of evidence (CoE) was measured by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) score. Then, the positive detection rate (PDR), pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve of the summary receiver operating characteristic curve (AUROC) was estimated in Review Manager, Stata, and MetaDisc. Subgroup analysis, meta-regression, and sensitivity analysis were performed to reveal the potential factors that influence internal heterogeneity. Results A total of 17 studies were selected for further analysis. The PDR of mNGS was markedly greater than that of culture (odds ratio (OR) = 2.87, 95% confidence interval [CI]: 1.72–4.81, p

Abstract Background Prostate cancer is one of the most common malignant tumors in middle-aged and elderly men and carries significant prognostic implications, and recent studies suggest that dual-energy computed tomography (DECT) utilizing new virtual monoenergetic images can enhance cancer detection rates. This study aimed to assess the impact of virtual monoenergetic images reconstructed from DECT arterial phase scans on the image quality of prostate lesions and their diagnostic performance for prostate cancer. Methods We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People’s Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40–100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images. Results Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P

Abstract Background The accuracy of traditional knee MR imaging in diagnosing anterior cruciate ligament tears, especially partial tears, is relatively low, which may lead to misdiagnosis and missed diagnosis. This study aimed to assess the diagnostic performance of a novel imaging method, high-resolution oblique coronal MRI at an optimal flexed-knee Angle, for ACL tears. Methods 50 healthy volunteers were scanned with a scan-assisted device for the optimal flexion angle of ACL. For 92 knee trauma patients selected strictly according to inclusion and exclusion criteria, conventional extended-knee scans (control group) and high-resolution oblique coronal scans based on the optimal flexed-knee angle (experimental group) were conducted. Two observers rated ACL visibility blindly on a 5-point scale. Arthroscopy-defined outcomes determined diagnostic metrics for each method and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results The average optimal flexion angle for healthy volunteers was approximately 30° (30.3° ± 5.0°). Imaging demonstrated complete visualization of the ACL in 96.7% of images in the experimental group versus 12.0% in the control group. The diagnostic indicators of the experimental group surpassed those of the control group: sensitivity (94.9% vs. 76.3%), specificity (97.0% vs. 81.8%), positive predictive value (98.2% vs. 88.2%), negative predictive value(91.4% vs. 65.9%), and accuracy (95.7% vs. 78.3%). ROC analysis indicated superior diagnostic performance in the experimental group, with an AUC of 0.945 compared with 0.776 for the control group (p

Background: The available evidence suggests that urinary calprotectin may be a potential biomarker in distinguishing between intrinsic acute kidney injury (AKI) and prerenal AKI. Objectives: The aim of this study was to determine the diagnostic value of calprotectin in identifying pediatric acute renal impairment. Methods: A search of the Medline, Embase, Scopus and Web of Science electronic databases was conducted on April 27, 2024. Diagnostic studies conducted on the value of urinary calprotectin in AKI were included. Two independent reviewers assessed the search records and any disagreements were resolved by discussion. The risk of bias was assessed using quality assessment of diagnostic accuracy studies (QUADAS-2) guidelines. The performance of urinary calprotectin in diagnosing AKI and its discriminatory ability between intrinsic and prerenal AKI were evaluated by calculating the pooled standardized mean difference (SMD) and 95% confidence interval (CI), as well as sensitivity, specificity and area under the curve (AUC). Results: Seven studies were included. The mean urinary levels of calprotectin in AKI were significantly higher than those in the non-AKI group (SMD=0.73; 95% CI, 0.50%, 0.97%; I2=0.00%). The mean urinary levels of calprotectin in pediatrics with intrinsic AKI were significantly higher than in those with prerenal AKI (SMD=0.76; 95% CI, 0.48%, 1.05%; 95% CI, 0%). Urinary calprotectin exhibited a sensitivity of 0.937 (95% CI, 0.829%, 0.978%) and a specificity of 0.252 (95% CI, 0.126%, 0.442%) for distinguishing intrinsic AKI from prerenal AKI. Additionally, the AUC of urinary calprotectin in differentiating intrinsic AKI from prerenal AKI was 0.691 (95% CI, 0.541%, 0.809%). Conclusions: Urinary calprotectin demonstrates fair screening performance characteristics for differentiating intrinsic from prerenal AKI in children. However, the low specificity necessitates additional diagnostic testing in cases with positive results.

Abstract Background Chagas disease (CD), a neglected parasitic disease caused by Trypanosoma cruzi, poses a significant health threat in Latin America and has emerged globally because of human migration. Trypanosoma cruzi infects humans and over 100 other mammalian species, including dogs, which are important sentinels for assessing the risk of human infection. Nonetheless, the serodiagnosis of T. cruzi in dogs is still impaired by the absence of commercial tests. In this study, we investigated the diagnostic accuracy of four chimeric recombinant T. cruzi IBMP antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) for detecting anti-T. cruzi antibodies in dogs, using latent class analysis (LCA). Methods We examined 663 canine serum samples, employing indirect ELISA with the chimeric antigens. LCA was utilized to establish a latent variable as a gold standard for T. cruzi infection, revealing distinct response patterns for each antigen. Results The IBMP (Portuguese acronym for the Molecular Biology Institute of Paraná) antigens achieved area under the ROC curve (AUC) values ranging from 90.9% to 97.3%. The highest sensitivity was attributed to IBMP-8.2 (89.8%), while IBMP-8.1, IBMP-8.3, and IBMP-8.4 achieved 73.5%, 79.6%, and 85.7%, respectively. The highest specificity was observed for IBMP-8.4 (98.6%), followed by IBMP-8.2, IBMP-8.3, and IBMP-8.1 with specificities of 98.3%, 94.4%, and 92.7%, respectively. Predictive values varied according to prevalence, indicating higher effectiveness in endemic settings. Conclusions Our findings underscore the remarkable diagnostic performance of IBMP-8.2 and IBMP-8.4 for the serodiagnosis of Trypanosoma cruzi in dogs, representing a promising tool for the diagnosis of CD in dogs. These chimeric recombinant antigens may not only enhance CD surveillance strategies but also hold broader implications for public health, contributing to the global fight against this neglected tropical disease. Graphical Abstract

Abstract The objective of this study was to evaluate semi-quantitatively the diagnostic performance of PET/CT metabolic parameters in differentiating benign or malignant cardiac or pericardial masses. A total of forty-one patients with newly diagnosed cardiac/pericardial masses who underwent 18F-FDG PET/CT were recruited. PET/CT metabolic parameters including the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), total lesion glycolysis (TLG), tumor metabolic volume (MTV), the maximum tumor-to-mediastinal background ratio (TMR) and the maximum tumor-to-liver background ratio (TLR) is measured or calculated to evaluate the benign or malignant nature of cardiac/pericardial masses. Compared with benign cardiac/pericardial lesions, cardiac/pericardial malignancies had higher SUVmax, SUVmean, TLG, MTV, TMR, and TLR. All these PET/CT metabolic parameters showed high diagnostic performance in semi-quantitative evaluation of benign or malignant cardiac or pericardial masses, and SUVmean and MTV had the highest diagnostic accuracy. Therefore, PET/CT metabolic parameters can semi-quantitatively evaluate the benign or malignant cardiac/pericardial masses.

Abstract The purpose of the present study is to evaluate whether an online reference system (ORS, STATdx Elsevier, Amsterdam, Netherlands) impacts finding the histologically confirmed diagnosis of rare or atypical abdominal tumors and lesions in radiologic imaging. In total, 101 patients with rare tumor entities or lesions and atypical manifestations of common tumors were enrolled retrospectively. Blinded readings were performed by four radiologists with varying levels of experience, who reported on: (a) correct diagnosis (CD), (b) time needed to find the diagnosis, and (c) diagnostic confidence, initially without followed by the assistance of the ORS. The experienced reader (3 years of experience post-residency, CD 49.5%), as well as the advanced reader with 1 year of experience post-residency (CD 43.6%), and a resident with 5 years of experience (CD 46.5%) made the correct diagnosis more frequently compared to the less experienced reader (CD 25.7%). A significant improvement in making the correct diagnosis was only achieved by the advanced reader, the resident with 5 years of experience (CD with ORS 58.4%; p

IntroductionDiffusion weighted MRI (DWI) has emerged as a promising adjunct to reduce unnecessary biopsies prompted by breast MRI through use of apparent diffusion coefficient (ADC) measures. The purpose of this study was to investigate the effects of different lesion ADC measurement approaches and ADC cutoffs on the diagnostic performance of breast DWI in a high-risk MRI screening cohort to identify the optimal approach for clinical incorporation.MethodsConsecutive screening breast MRI examinations (August 2014–Dec 2018) that prompted a biopsy for a suspicious breast lesion (BI-RADS 4 or 5) were retrospectively evaluated. On DWI, ADC (b=0/100/600/800s/mm2) measures were calculated with three different techniques for defining lesion region-of-interest (ROI; single slice(‘2D’), whole volume(‘3D’) and lowest ADC region(‘hotspot’)). An optimal data-derived ADC cutoff for each technique was retrospectively identified to reduce benign biopsies while avoiding any false negatives, inherently producing cutoffs with 100% sensitivity in this particular cohort. Further, diagnostic performance of these measures was validated using two prespecified ADC cutoffs: 1.53x10-3mm2/s from the ECOG-ACRIN A6702 trial and 1.30x10-3mm2/s from the international EUSOBI group. Diagnostic performance was compared between ADC maps generated with 2(0/800s/mm2) and 4(0/100/600/800s/mm2) b-values. Benign biopsy reduction rate was calculated (number of benign lesions with ADC >cutoff)/(total number of benign lesions).Results137 suspicious lesions (in 121 women, median age 44 years [range, 20-75yrs]) were detected on contrast-enhanced screening breast MRI and recommended for biopsy. Of those, 30(21.9%) were malignant and 107(78.1%) were benign. Hotspot ADC measures were significantly lower (p

The aim of this experiment is to investigate the bioinspired diagnostic performance of color Doppler ultrasound (CDUS) and two-dimensional (2D) echocardiography (ECG) for fetal congenital heart disease (FCHD). The research subjects were 33 expectant mothers with a diagnosis of FCHD at Xiangyang No. 1 People's Hospital between January 2017 and January 2021. The accuracy, sensitivity, and specificity of the two detection techniques were computed to ascertain and compare the diagnostic efficiency after CDUS and ECG examinations of all pregnant women. According to the findings, the prenatal CDUS detection rate was 92.61% higher than the 2D ECG detection rate (64.32%). The CDUS had an accuracy of 93.94%, sensitivity of 93.55%, and specificity of 100%, detecting 29 true positives, 0 false positives, 2 false negatives, and 2 true negatives. At 84.85% accuracy, 88.89% sensitivity, and 80% specificity, the 2D ECG identified 16 true positives, 3 false positives, 2 false positives, and 12 true negatives. There was a statistically significant (P < 0.05) difference between the accuracy, sensitivity, and specificity of 2D ECG and CDUS. In summary, CDUS was more effective than 2D ECG in diagnosing prenatal FCHD, and it also had a lower rate of missed and incorrect diagnoses.

Lack of appropriate early diagnostic tools for drug-resistant tuberculosis (DR-TB) and their incomplete drug susceptibility testing (DST) profiling is concerning for TB disease control. Existing methods, such as phenotypic DST (pDST), are time-consuming, while Xpert MTB/RIF (Xpert) and line probe assay (LPA) are limited to detecting resistance to few drugs. Targeted next-generation sequencing (tNGS) has been recently approved by WHO as an alternative approach for rapid and comprehensive DST. We aimed to investigate the performance and feasibility of tNGS for detecting DR-TB directly from clinical samples in Bangladesh. pDST, LPA and tNGS were performed among 264 sputum samples, either rifampicin-resistant (RR) or rifampicin-sensitive (RS) TB cases confirmed by Xpert assay. Resistotypes of tNGS were compared with pDST, LPA and composite reference standard (CRS, resistant if either pDST or LPA showed a resistant result). tNGS results revealed higher sensitivities for rifampicin (RIF) (99.3%), isoniazid (INH) (96.3%), fluoroquinolones (FQs) (94.4%), and aminoglycosides (AMGs) (100%) but comparatively lower for ethambutol (76.6%), streptomycin (68.7%), ethionamide (56.0%) and pyrazinamide (50.7%) when compared with pDST. The sensitivities of tNGS for INH, RIF, FQs and AMGs were 93.0%, 96.6%, 90.9%, and 100%, respectively and the specificities ranged from 91.3 to 100% when compared with CRS. This proof of concept study, conducted in a high-burden setting demonstrated that tNGS is a valuable tool for identifying DR-TB directly from the clinical specimens. Its feasibility in our laboratory suggests potential implementation and moving tNGS from research settings into clinical settings.

ObjectiveThis study aimed to assess the efficacy of innovative Chemiluminescence Immunoassay (CLIA) in testing Cryptococcal Antigen (CrAg) across two medical centers, employing the FDA-approved CrAg Lateral Flow Assay (LFA) by IMMY as a reference standard.MethodsThe study encompassed patients diagnosed with cryptococcosis at West China Hospital of Sichuan University (HX) between July 2022 and May 2023, and Suzhou Fifth People’s Hospital (SZ) from September 2020 to September 2023. All specimens underwent simultaneous detection using the LFA (IMMY, Norman, USA) and CLIA (Chuanglan, Suzhou, China).ResultsA total of 628 patients were enrolled, revealing a remarkable 99.20% concordance between LFA and CLIA (623/628, 99.20%). The LFA exhibited a sensitivity of 96.83% (244/252) and specificity of 98.35% (179/182). Among the 42 patients with unaltered CrAg titers, the changes of Signal-to-Cut-Off ratio (ΔS/CO) results exhibited a noteworthy discrepancy, with 71.43% (30/42) demonstrating a decreasing trend in ΔS/CO of at least 10%.ConclusionsThe CLIA method demonstrated commendable specificity and sensitivity, exhibiting a high level of agreement with the FDA-approved LFA method. Additionally, CLIA demonstrated superior utility for treatment monitoring compared to LFA, offering continuous insight into the fluctuation of CrAg concentrations.

Background: Hookworm infestation is an important public health concern especially in regions with poor sanitation and limited resources. In healthcare institutions in Ethiopia, wet mount microscopy with low performance has been used as the sole diagnostic technique. Sensitive diagnostic methods are essential for the proper identification of hookworm infection in national strategies for hookworm prevention and management. Thus, the objective of the article was to evaluate the performance of diagnostic techniques in the detection of hookworm infestation among school children in the Gozamin district, Northwest Ethiopia. Methods: A cross-sectional study with 530 school children was conducted from February to April 2022 in Ethiopia. The study participants were selected by using systematic random sampling technique. Direct wet mount (DWM), Richie’s, Kato-Katz (KK), and spontaneous tube sedimentation (STS) diagnostic techniques were utilized to process the stool samples. The data were entered into the Epi-data version 4.2 and the data was analyzed using SPSS version 25.0. The sensitivity, specificity, predictive values and test efficiency of the test were calculated with respect to the Composite Reference Standard (CRS) as the reference method. The degree of agreement with the methods of diagnosis was assessed by the Kappa value. Results: The overall prevalence of hookworm was 34.9 %. The detection rate of STS, Richie’s, KK and DWM techniques in hookworm detection was 30.2 %, 27.0 %, 22.3 % and 15.1 %, respectively. The sensitivity and test efficiency of STS to detect hookworm were 86.5 % and 95.3 %, for Richie’s 77.3 % and 92.1 %, for KK 63.8 % and 87.4 %, for DWM method 43.2 % and 80.2 %, respectively. The agreement of STS, Richie’s, KK and DWM techniques with CRS were perfect (κ = 0.893), perfect (κ = 0.816), substantial (κ = 0.696) and moderate (κ = 0.498), respectively in detecting hookworm parasites. Conclusion: The prevalence of hookworm among school children was high. The STS method is superior to other methods for detecting hookworm infections. The Richie’s technique was more successful in detecting the hookworm parasite than the KK and DWM techniques. It is important to implement the STS technique in routine diagnostic methods and in endemic areas of hookworm infection because it cheaper, easy to perform, and identifies a wide range of parasitic species.

Background Diagnosing periprosthetic joint infection (PJI) remains a significant challenge for healthcare professionals. Commonly utilized inflammatory markers include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cells (WBC). Human β-defensin 1 (β-defensin) is an antimicrobial peptide elevated in infection, yet its diagnostic value for PJI has not been explored. The purpose of this study was to evaluate the efficacy of synovial β-defensin as a diagnostic marker for PJI and to compare its performance with ESR, serum CRP, and WBC. Methods We conducted a single-center retrospective study from October 2022 to June 2023. A total of 105 joint fluid samples from revision patients at the Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra were collected intraoperatively (71 hips, 34 knees) and frozen. According to MSIS criteria, 64 patients were defined as positive for PJI and the remaining 41 were negative. Synovial β-defensin levels were quantified using ELISA, serum CRP levels by immunoturbidimetry, and blood ESR and WBC were analyzed. Sensitivity and specificity were determined using ROC curves, and diagnostic performance was compared using the area under the curve (AUC). Cut-off values for diagnosing PJI were established. Results Levels of synovial β-defensin, ESR, serum CRP, and WBC were significantly higher in the PJI group compared to the non-PJI (P

ObjectiveOral cancer is a widespread global health problem characterised by high mortality rates, wherein early detection is critical for better survival outcomes and quality of life. While visual examination is the primary method for detecting oral cancer, it may not be practical in remote areas. AI algorithms have shown some promise in detecting cancer from medical images, but their effectiveness in oral cancer detection remains Naïve. This systematic review aims to provide an extensive assessment of the existing evidence about the diagnostic accuracy of AI-driven approaches for detecting oral potentially malignant disorders (OPMDs) and oral cancer using medical diagnostic imaging.MethodsAdhering to PRISMA guidelines, the review scrutinised literature from PubMed, Scopus, and IEEE databases, with a specific focus on evaluating the performance of AI architectures across diverse imaging modalities for the detection of these conditions.ResultsThe performance of AI models, measured by sensitivity and specificity, was assessed using a hierarchical summary receiver operating characteristic (SROC) curve, with heterogeneity quantified through I2 statistic. To account for inter-study variability, a random effects model was utilized. We screened 296 articles, included 55 studies for qualitative synthesis, and selected 18 studies for meta-analysis. Studies evaluating the diagnostic efficacy of AI-based methods reveal a high sensitivity of 0.87 and specificity of 0.81. The diagnostic odds ratio (DOR) of 131.63 indicates a high likelihood of accurate diagnosis of oral cancer and OPMDs. The SROC curve (AUC) of 0.9758 indicates the exceptional diagnostic performance of such models. The research showed that deep learning (DL) architectures, especially CNNs (convolutional neural networks), were the best at finding OPMDs and oral cancer. Histopathological images exhibited the greatest sensitivity and specificity in these detections.ConclusionThese findings suggest that AI algorithms have the potential to function as reliable tools for the early diagnosis of OPMDs and oral cancer, offering significant advantages, particularly in resource-constrained settings.Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42023476706).

Objectives: Respiratory infections are among the most common infectious diseases, resulting in significant morbidity and mortality. C-reactive protein (CRP), serum amyloid A (SAA), procalcitonin (PCT), and interleukin-6 (IL-6) are advantageous for diagnosing respiratory tract infections. This study assessed the analytical performance and accuracy of new kits for Eu3+-based CRP/SAA and PCT/IL-6 lateral flow immunoassay and its diagnostic value in respiratory tract infections. Methods: This study evaluated the detection performance of a test kit using guidelines from the Center for Medical Device Evaluation (CMDE) and the Clinical and Laboratory Standards Institute (CLSI). The test results were compared to those of the commercial kits (CRP: Mindray; SAA: Norman; PCT: Shanghai Upper; IL-6: Wantai BioPharm). A total of 156 patients with respiratory tract infections (53 with bacterial infections (Bac group); 50 with viral infections (Vir group); and 53 with co-infections (Bac + Vir group)) were enrolled, along with 50 healthy controls (HC group). Venous blood samples were collected to measure levels of SAA, PCT, CRP, and IL-6 using both the test and commercial kits. The diagnostic value of these biomarkers was assessed using receiver operating characteristic (ROC) curves. Results: Correlation analysis demonstrated a strong concordance between the test kits and commercial kits (CRP: r = 0.9396, P

Background: Red cell distribution width (RDW) is an inflammatory biomarker and a component of complete blood count that gains increased attention. Pre-eclampsia (PE) is a unique pregnancy syndrome for which inflammation was proposed for pathogenesis.Objective: We aimed to examine RDW's role in PE and explore confounders that limit its implication in practice.Materials and Methods: A case-control study recruited 120 participants matched in body mass index (BMI) and gestational age into 3 subgroups; late-onset severe PE cases (30/120), late-onset non-severe PE cases (30/120), and healthy controls (60/120). Participants' demographics (age, BMI, systolic and diastolic blood pressure (SBP, and DBP), hematological and biochemical parameters were evaluated.Results: RDW was significantly higher in PE cases (P-value < 0.01 ); In addition, RDW was positively correlated to SBP, DBP, and protein urea, r =0.5, r = 0.46, and r = 0.47 ; P-value < 0.0001, respectively. Liver enzymes, hemoglobin, and white blood cell count were all significantly linked to RDW (r = 0.27, P-value = 0.015), (r = 0.32, P-value = 0.005), (r = -0.27, P-value = 0.02) and (r = 0.39; P-value = 0.0004) respectively. Applying ROC Curve analysis showed that RDW cut-off value of > 14.4% discriminated PE cases from healthy controls (P-value < 0.001). At a cut-off value > 15.6% RDW distinguished severe from non-severe PE cases (P-value < 0.001).Conclusion: RDW was significantly correlated to PE predictors and severity markers independent of gestational age and BMI. The ROC curve showed that RDW distinguished PE from healthy controls in addition to non-severe from severe PE cases with high sensitivity and specificity. Being an inexpensive, reliable test with good predictive and prognostic value warrants further studies for RDW's role in PE screening and follow-up.

Abstract Background To assess MRI-based morphological features in improving the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) for categorizing thyroid nodules. Methods A retrospective analysis was performed on 728 thyroid nodules (453 benign and 275 malignant) that postoperative pathology confirmed. Univariate and multivariate logistic regression analyses were used to find independent predictors of MRI morphological features in benign and malignant thyroid nodules. The improved method involved increasing the ACR-TIRADS level by one when there are independent predictors of MRI-based morphological features, whether individually or in combination, and conversely decreasing it by one. The study compared the performance of conventional ACR-TIRADS and different improved versions. Results Among the various MRI morphological features analyzed, restricted diffusion and reversed halo sign were determined to be significant independent risk factors for malignant thyroid nodules (OR = 45.1, 95% CI = 23.2–87.5, P

To assess the efficacy of a nomogram model derived from extraprostatic extension (EPE) grade on magnetic resonance imaging (MRI) and clinical features in forecasting pathological EPE in prostate cancer. We conducted a retrospective analysis of the clinical data from 232 prostate cancer patients. Patients were categorized into EPE and non-EPE groups based on the presence of pathological EPE. Subsequently, they were randomly allocated into a training set (162 cases) and a validation set (70 cases) at a 7:3 ratio. We gathered clinical attributes and EPE grades for all patients. Three predictive models—clinic, magnetic resonance (MR) and clinic + MR—were developed within the training set. The clinic + MR model was visualized through a nomogram. The models’ performance was assessed using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Both univariate and multivariate logistic regression analyses identified the biopsy International Society of Urological Pathology (ISUP) category and biopsy maximum unilateral positive percentage as independent risk factors for EPE within the training set. The EPE grade exhibited consistent inter-observer agreement, evidenced by weighted Kappa values of 0.72 and 0.71 in the training and validation sets, respectively. Compared to the clinic and MR models, the clinic + MR model was the most effective in predicting pathological EPE, boasting area under the curves (AUCs) of 0.85 and 0.82 in the training and validation sets, respectively. Calibration curves from both sets demonstrated that the clinic + MR model provided accurate predictions for pathological EPE. Within the DCA, the clinic + MR model surpassed the clinic and MR models in terms of clinical net benefit in both sets. The clinic + MR model excels in predicting the pathological EPE of prostate cancer. Its superiority over the clinic model underscores its clinical relevance and the potential for broader implementation.

Abstract Background While numerous studies have evaluated the real-world performance of rapid antigen tests (RATs), data on the effect of Omicron sublineages such as XBB and reinfections on RAT performance is limited. We assessed the performance of RATs and factors associated with RAT-negative results among individuals who tested SARS-CoV-2-positive by reverse transcription-polymerase chain reaction (RT-PCR). Methods We conducted a retrospective study among Singapore residents who underwent testing for SARS-CoV-2 with RAT (Acon Flowflex or SD Biosensor) and RT-PCR in the same clinical encounter between 9 May 2022 and 21 November 2022. RT-PCR served as a reference standard for RAT performance. Logistic regression was used to estimate the odds ratios (OR) of factors associated with negative RAT results among RT-PCR-positive cases. Results Of 8,620 clinical encounters analysed, 3,519 (40.8%) were SARS-CoV-2-positive on RT-PCR. Overall sensitivity and specificity of RAT was 84.6% (95% CI 83.3–85.7%) and 99.4% (95% CI 99.1–99.6%) respectively. Acon Flowflex consistently achieved higher sensitivity and specificity than SD Biosensor test kit. Among RT-PCR-positive cases, individuals who had a previous documented SARS-CoV-2 infection, coinfection with another respiratory pathogen or tested ≥ 6 days from symptom onset had higher odds of testing RAT-negative, but the associations were attenuated after adjustment for cycle threshold values (proxy for viral load). There was no significant difference in RAT performance between Omicron sublineages BA.2, BA.5 and XBB.1. Conclusion Diagnostic performance of RAT was not affected by changes in predominant circulating Omicron sublineages. However, reinfection cases may be under ascertained by RAT. In individuals with a previous SARS-CoV-2 infection episode or symptom onset ≥ 6 days prior to testing, a confirmatory RT-PCR may be considered if there is high clinical suspicion.

Background: Acute coronary syndromes (ACS) require prompt diagnosis through initial electrocardiograms (ECG), but ECG machines are not always accessible. Meanwhile, smartwatches offering ECG functionality have become widespread. This study evaluates the feasibility of an image-based ECG analysis artificial intelligence (AI) system with smartwatch-based multichannel, asynchronous ECG for diagnosing ACS. Methods: Fifty-six patients with ACS and 15 healthy participants were included, and their standard 12-lead and smartwatch-based 9-lead ECGs were analyzed. The ACS group was categorized into ACS with acute total occlusion (ACS-O(+), culprit stenosis ≥ 99 %, n = 44) and ACS without occlusion (ACS-O(−), culprit stenosis 70 % to 0.1 ng/mL). Results: The AI-driven qSTEMI, qACS, and qMI demonstrated correlation coefficients of 0.882, 0.874, and 0.872 between standard and smartwatch ECGs (all P

Background: Osteoporotic Vertebral Compression Fracture (OVCF) substantially reduces a person's health-related quality of life. Computer Tomography (CT) scan is currently the standard for diagnosis of OVCF. The aim of this paper was to evaluate the OVCF detection potential of artificial neural networks (ANN). Methods: Models of artificial intelligence based on deep learning hold promise for quickly and automatically identifying and visualizing OVCF. This study investigated the detection, classification, and grading of OVCF using deep artificial neural networks (ANN). Techniques: Annotation techniques were used to segregate the sagittal images of 1,050 OVCF CT pictures with symptomatic low back pain into 934 CT images for a training dataset (89%) and 116 CT images for a test dataset (11%). A radiologist tagged, cleaned, and annotated the training dataset. Disc deterioration was assessed in all lumbar discs using the AO Spine-DGOU Osteoporotic Fracture Classification System. The detection and grading of OVCF were trained using the deep learning ANN model. By putting an automatic model to the test for dataset grading, the outcomes of the ANN model training were confirmed. Results: The sagittal lumbar CT training dataset included 5,010 OVCF from OF1, 1942 from OF2, 522 from OF3, 336 from OF4, and none from OF5. With overall 96.04% accuracy, the deep ANN model was able to identify and categorize lumbar OVCF. Conclusions: The ANN model offers a rapid and effective way to classify lumbar OVCF by automatically and consistently evaluating routine CT scans using AO Spine-DGOU osteoporotic fracture classification system.

Background: Tuberculosis (TB) is one of the leading causes of death worldwide. However, an accurate diagnosis contributes to timely treatment, reducing its adverse consequences. The aim of this research was to determine the diagnostic accuracy of the molecular test Xpert MTB/RIF and Xpert MTB/RIF Ultra (Xpert Ultra) for the diagnosis of pulmonary and extrapulmonary TB compared to Löwenstein-Jensen culture. Methods: We conducted a cross-sectional study of diagnostic accuracy. We included samples from patients who attended a Peruvian laboratory between 2011 and 2022. The index test was the Xpert MTB/RIF and Xpert Ultra and the reference standard was Löwenstein-Jensen solid culture for Mycobacterium tuberculosis. We calculated sensitivity, specificity, and positive and negative likelihood ratios. Results: We evaluated 1023 samples, of which 737 were pulmonary samples, 197 tested positive for the Xpert MTB/RIF and Xpert Ultra tests; and 151 tested positive for culture. The Xpert (MTB/RIF and Ultra) showed a joint sensitivity and specificity of: 97 % (95%CI: 93–99) and 93 % (95%CI: 91–95) in pulmonary samples, 100 % (95%CI: 29.2–100) and 98.3 % (95%CI: 94.1–99.8) in cerebrospinal fluid, 66.7 % (95%CI: 22.3–95.7) and 96.8 % (95%CI: 91–99.3) in pleural fluid, 100 % (95%CI: 15.8–100) and 94.3 % (95%CI: 80.8–99.3) in urine. For the detection of pulmonary TB, the Xpert MTB/RIF had a sensitivity and specificity of 97.1 % (95%CI: 89.9–99.6) and 95.6 % (95%CI: 92.9–97.5) and the Xpert Ultra of 97 % (95%CI: 88.5–99.6) 89.5 % (95%CI: 84.9–93.1) respectively. Conclusion: Our results suggest that the Xpert MTB/RIF and the Xpert Ultra are tests with high diagnostic performance for the detection of pulmonary TB and adequate specificity in pulmonary, cerebrospinal fluid, pleural, and urine samples. However, the results for other samples were imprecise.

BackgroundPatients who were infected by the Human Immunodeficiency Virus (HIV) could have weakened immunity that is complicated by opportunistic infections, especially for Mycobacterium tuberculosis (MTB). Notably, the HIV-MTB co-infection will accelerate the course of disease progress and greatly increase the mortality of patients. Since the traditional diagnostic methods are time-consuming and have low sensitivity, we aim to investigate the performance of mNGS (metagenomic Next-Generation Sequencing) and mNPS (metagenomic NanoPore Sequencing) for the rapid diagnosis of tuberculosis in HIV-infected patients.MethodsThe 122 HIV-infected patients were enrolled for the retrospective analysis. All of the patients underwent traditional microbiological tests, mNGS, and (or) mNPS tests. The clinical comprehensive diagnosis was used as the reference standard to compare the diagnostic performance of culture, mNGS, and mNPS on tuberculosis. We also investigate the diagnostic value of mNGS and mNPS on mixed-infection. Furthermore, the treatment adjustment directed by mNGS and mNPS was analyzed.ResultsCompared with the composite reference standard, the culture showed 42.6% clinical sensitivity and 100% specificity, and the OMT(other microbiological testing) had 38.9% sensitivity and 100% specificity. The mNGS had 58.6% clinical sensitivity and 96.8% specificity, and the mNPS had 68.0% clinical sensitivity and 100% specificity. The proportion of mixed-infection cases (88.9%) in the TB group was higher than those in the non-TB group (54.8%) and the mNGS and mNPS are more competitive on mixed-infection diagnosis compared with the traditional methods. Furthermore, there are 63 patients (69.2%) and 36 patients (63.2%) achieved effective treatment after receiving the detection of mNPS and mNGS, respectively.ConclusionOur study indicated that mNPS and mNGS have high sensitivity and specificity for TB diagnosis compared with the traditional methods, and mNPS seems to have better diagnostic performance than mNGS. Moreover, mNGS and mNPS showed apparent advantages in detecting mixed infection. The mNPS and mNGS-directed medication adjustment have effective treatment outcomes for HIV-infected patients who have lower immunity.

BackgroundHepatocellular carcinoma (HCC) is a common primary liver cancer that requires early diagnosis due to its poor prognosis. Recent advances in artificial intelligence (AI) have facilitated hepatocellular carcinoma detection using multiple AI models; however, their performance is still uncertain.AimThis meta-analysis aimed to compare the diagnostic performance of different AI models with that of clinicians in the detection of hepatocellular carcinoma.MethodsWe searched the PubMed, Scopus, Cochrane Library, and Web of Science databases for eligible studies. The R package was used to synthesize the results. The outcomes of various studies were aggregated using fixed-effect and random-effects models. Statistical heterogeneity was evaluated using I-squared (I2) and chi-square statistics.ResultsWe included seven studies in our meta-analysis;. Both physicians and AI-based models scored an average sensitivity of 93%. Great variation in sensitivity, accuracy, and specificity was observed depending on the model and diagnostic technique used. The region-based convolutional neural network (RCNN) model showed high sensitivity (96%). Physicians had the highest specificity in diagnosing hepatocellular carcinoma(100%); furthermore, models-based convolutional neural networks achieved high sensitivity. Models based on AI-assisted Contrast-enhanced ultrasound (CEUS) showed poor accuracy (69.9%) compared to physicians and other models. The leave-one-out sensitivity revealed high heterogeneity among studies, which represented true differences among the studies.ConclusionModels based on Faster R-CNN excel in image classification and data extraction, while both CNN-based models and models combining contrast-enhanced ultrasound (CEUS) with artificial intelligence (AI) had good sensitivity. Although AI models outperform physicians in diagnosing HCC, they should be utilized as supportive tools to help make more accurate and timely decisions.

Background: Anti-citrullinated protein antibodies (ACPA) are a specific serological biomarker used in the diagnosis of rheumatoid arthritis (RA). In clinical practice ACPA can be identified using immunoassays targeting synthetic cyclic citrullinated peptides (CCP). The 3rd generation anti-CCP IgG antibody (CCP3) offers improved sensitivity compared to the earlier versions. Recently, CCP3.1, capable of detecting both IgG and IgA antibodies, was introduced to enhance sensitivity, especially in patients with early RA. Methods: We assessed serum CCP3.1 against CCP3 in 331 subjects undergoing RA panel serology, comprising 136 patients with RA and 195 patients without RA. Sera were tested for anti-CCP IgG (CCP3) and anti-CCP IgG/IgA (CCP3.1) antibodies. Clinical performance of these tests was compared at manufacturer-suggested cutoffs. A separate set of 81 patients with a diagnosis of RA by 2010 criteria and whose samples were obtained from within 1-year of RA diagnosis was similarly assessed to evaluate assay performance in an independent clinical RA cohort. Results: Overall diagnostic accuracy was similar; CCP3 had an area under the curve (AUC) of 0.88, CCP3.1 had an AUC of 0.89. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CCP3 were 79 %, 91 %, 86 %, and 86 %, respectively. For CCP3.1, sensitivity was 78 %, specificity 93 %, PPV 89 %, NPV 86 %. Both assays demonstrated excellent agreement; positive percent agreement of 94 % and negative percent agreement of 99 %. Conclusion: Our findings indicate comparable diagnostic accuracy between CCP3 and CCP3.1 assays in these clinical cohorts.

Introduction: Artificial intelligence (AI), particularly ChatGPT developed by OpenAI, has shown the potential to improve diagnostic accuracy and efficiency in emergency department (ED) triage. This study aims to evaluate the diagnostic performance and safety of ChatGPT in prioritizing patients based on urgency in ED settings. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive literature searches were performed in Scopus, Web of Science, PubMed, and Embase. Studies evaluating ChatGPT's diagnostic performance in ED triage were included. Quality assessment was conducted using the QUADAS-2 tool. Pooled accuracy estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Results: Fourteen studies with a total of 1,412 patients or scenarios were included. ChatGPT 4.0 demonstrated a pooled accuracy of 0.86 (95% CI: 0.64-0.98) with substantial heterogeneity (I² = 93%). ChatGPT 3.5 showed a pooled accuracy of 0.63 (95% CI: 0.43-0.81) with significant heterogeneity (I² = 84%). Funnel plots indicated potential publication bias, particularly for ChatGPT 3.5. Quality assessments revealed varying levels of risk of bias and applicability concerns. Conclusion: ChatGPT, especially version 4.0, shows promise in improving ED triage accuracy. However, significant variability and potential biases highlight the need for further evaluation and enhancement.

Serological detection of hepatitis B virus markers plays a vital role in the diagnosis, treatment, prognosis, and therapeutic surveillance of hepatitis B. To compare the diagnostic performance of Autolumo A2000Plus and Abbott Architect i2000 systems in the detection of hepatitis B infection markers. A total of 6 HBV seroconversion panels and 743 participants were enrolled in this study, including 383 HBV-infected patients and 360 healthy adults. Clinical diagnostic information, laboratory results, and HBV genotyping were collected to evaluate the diagnostic performance of the A2000Plus and i2000 systems in detecting HBV infection markers. The results showed that the total percent agreement of HBV markers was all >90 % in both detection systems among the six seroconversion panels and 743 serum samples from the population. The χ2 values of the Chi-square test among hepatitis B virus serological markers in both analyzers were between 550.7 and 743.0, p

ABSTRACT Chronic obstructive pulmonary disease (COPD) is one of the primary causes of mortality and morbidity worldwide. The gut microbiome, particularly the bacteriome, has been demonstrated to contribute to the progression of COPD. However, the influence of gut virome on the pathogenesis of COPD is rarely studied. Recent advances in viral metagenomics have enabled the rapid discovery of its remarkable role in COPD. In this study, deep metagenomics sequencing of fecal virus-like particles and bacterial 16S rRNA sequencing was performed on 92 subjects from China to characterize alterations of the gut virome in COPD. Lower richness and diversity of the gut virome were observed in the COPD subjects compared with the healthy individuals. Sixty-four viral species, including Clostridium phage, Myoviridae sp., and Synechococcus phage, showed positive relationships with pulmonary ventilation functions and had markedly declined population in COPD subjects. Multiple viral functions, mainly involved in bacterial susceptibility and the interaction between bacteriophages and bacterial hosts, were significantly declined in COPD. In addition, COPD was characterized by weakened viral-bacterial interactions compared with those in the healthy cohort. The gut virome showed diagnostic performance with an area under the curve (AUC) of 88.7%, which indicates the potential diagnostic value of the gut virome for COPD. These results suggest that gut virome may play an important role in the development of COPD. The information can provide a reference for the future investigation of diagnosis, treatment, and in-depth mechanism research of COPD.IMPORTANCEPrevious studies showed that the bacteriome plays an important role in the progression of chronic obstructive pulmonary disease (COPD). However, little is known about the involvement of the gut virome in COPD. Our study explored the disease-specific virome signatures of patients with COPD. We found the diversity and compositions altered of the gut virome in COPD subjects compared with healthy individuals, especially those viral species positively correlated with pulmonary ventilation functions. Additionally, the declined bacterial susceptibility, the interaction between bacteriophages and bacterial hosts, and the weakened viral-bacterial interactions in COPD were observed. The findings also suggested the potential diagnostic value of the gut virome for COPD. The results highlight the significance of gut virome in COPD. The novel strategies for gut virome rectifications may help to restore the balance of gut microecology and represent promising therapeutics for COPD.

Abstract Background Timely and accurate identification of pathogens is crucial for appropriate treatment and prognosis of infectious diseases. As an increasingly popular pathogen detection method, the performance of metagenomic next-generation sequencing (mNGS) in detecting pathogens in febrile patients with suspected infection requires further exploration. Methods This study included 368 febrile patients with suspected infections who were admitted to the Infectious Disease Department of Qilu Hospital, Shandong University between January 5, 2021 and April 14, 2023. Both mNGS testing and conventional culture were performed in all patients. Clinical data of enrolled patients were collected, and the diagnostic performances of mNGS and culture were compared. Results Of the 368 enrolled patients, 231 were finally diagnosed with infection and 137 were with diseases other than infection. The sensitivity (58.01% vs. 21.65%, p

Objective Hand clumsiness and reduced hand dexterity can signal early signs of degenerative cervical myelopathy (DCM). While the 10-second grip and release (10-s G&R) test is a common clinical tool for evaluating hand function, a more accessible method is warranted. This study explores the use of deep learning-enhanced hand grip and release test (DL-HGRT) for predicting DCM and evaluates its capability to reduce the duration of the 10-s G&R test. Methods The retrospective study included 508 DCM patients and 1,194 control subjects. Propensity score matching (PSM) was utilized to minimize the confounding effects related to age and sex. Videos of the 10-s G&R test were captured using a smartphone application. The 3D-MobileNetV2 was utilized for analysis, generating a series of parameters. Additionally, receiver operating characteristic curves were employed to assess the performance of the 10-s G&R test in predicting DCM and to evaluate the effectiveness of a shortened testing duration. Results Patients with DCM exhibited impairments in most 10-s G&R test parameters. Before PSM, the number of cycles achieved the best diagnostic performance (area under the curve [AUC], 0.85; sensitivity, 80.12%; specificity, 74.29% at 20 cycles), followed by average grip time. Following PSM for age and gender, the AUC remained above 0.80. The average grip time achieved the highest AUC of 0.83 after 6 seconds, plateauing with no significant improvement in extending the duration to 10 seconds, indicating that 6 seconds is an adequate timeframe to efficiently evaluate hand motor dysfunction in DCM based on DL-HGRT. Conclusion DL-HGRT demonstrates potential as a promising supplementary tool for predicting DCM. Notably, a testing duration of 6 seconds appears to be sufficient for accurate assessment, enhancing the test more feasible and practical without compromising diagnostic performance.

Abstract This study intended to evaluate the diagnostic accuracy of the prostate imaging reporting and data system (PI-RADS) and prostate-specific antigen density (PSAD) for clinically significant prostate cancer (csPCa) with PSA levels of 4–10 ng/ml. Between July 2018 and June 2022, a total of 453 patients with PSA levels of 4–10 ng/ml were retrospectively included, which were randomly assigned to the training group (323 patients) and validation group (130 patients). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with their 95% CI were calculated. The overall diagnostic performance was determined with area under the receiver operating characteristic curve (AUC), and an integrated nomogram combining PI-RADS score and PSAD was constructed and tested in a validation cohort. In the training group, the AUC for PI-RADS 2.1 and PSAD alone were 0.875 (95% CI 0.834–0.916) and 0.712 (95% CI 0.648–0.775). At the cutoff PI-RADS score ≥ 4, the sensitivity and specificity were 86.2% (95% CI 77.4–1.9%) and 84.7% (95% CI 79.6–88.8%), respectively. For PSAD, the sensitivity and specificity were 73.3% (95% CI 63.0–82.4%) and 62.1% (95% CI 55.8–68.5%) at the cutoff 0.162 ng/ml/ml. While combining PI-RADS with PSAD, the diagnostic performance was improved significantly, with AUC of 0.893 (95% CI 0.853–0.933). In the validation group, the nomogram yielded a AUC of 0.871 (95% CI 0.807–0.934), which is significantly higher than PI-RADS alone (0.829, 95% CI 0.759–0.899, P = 0.02). For patients with PSA levels of 4–10 ng/ml, PSAD demonstrated moderate diagnostic accuracy whereas PI-RADS showed high performance. By combination of PSAD and PI-RADS together, the diagnostic performance could be improved significantly.

The type 1 abomasal ulcer (AU1) does not have specific clinical signs, so there is a need to identify some early biochemical markers for its diagnosis in cattle and buffaloes. The plasma gastrin is re-ported to reflect the gastric mucosa damage but its utility for the diagnosis of AU1 in buffaloes has not been evaluated. The objective of this study was to investigate the test performance of plasma gas-trin to distinguish between healthy buffaloes and the buffaloes with AU1. Twenty-three buffaloes with AU1 and six buffaloes without any abomasal ulcer were used. The blood samples were collected from buffaloes, slaughtered in a buffalo specific slaughterhouse for estimation of the plasma gastrin. After slaughter the abomasa were examined for the presence of AU1 and the blood samples were collected for estimation of plasma gastrin. The mean plasma gastrin concentration of the ulcer-positive buffaloes was significantly (P

Abstract Background 18F-FDG positron emission tomography (PET) plays a crucial part in the evaluation for pediatric epileptic patients prior to therapy. Short-term scanning holds significant importance, especially for pediatrics epileptic individuals who exhibited involuntary movements. The aim was to evaluate the effects of short acquisition time on image quality and lesion detectability in pediatric epileptic patients using total-body (TB) PET/CT. A total of 25 pediatric patients who underwent TB PET/CT using uEXPLORER scanner with an 18F-FDG administered dose of 3.7 MBq/kg and an acquisition time of 600 s were retrospectively enrolled. Short acquisition times (60 s, 150 and 300 s) were simulated by truncating PET data in list mode to reduce count density. Subjective image quality was scored on a 5-point scale. Regions of interest analysis of suspected epileptogenic zones (EZs), corresponding locations contralateral to EZs, and healthy cerebellar cortex were used to compare the semi-quantitative uptake indices of short-time images and then were compared with 600 s images. The comparison of EZs detectability based on time-dependent PET images was performed. Results Our study demonstrated that a short acquisition time of 150 s is sufficient to maintain subjective image quality and lesion significance. Statistical analysis revealed no significant difference in subjective PET image quality between imaging at 300 s and 150 s (P > 0.05). The overall impression scores of image quality and lesion conspicuity in G60s were both greater than 3 (overall quality, 3.21 ± 0.46; lesion conspicuity, 4.08 ± 0.74). As acquisition time decreased, the changes of SUVmax and SD in the cerebellar cortex gradually increased (P 15% in all groups. In 26 EZs of 25 patients, the lesion detection rate was still 100% when the time was reduced to 60 s. Conclusions This study proposed that TB PET/CT acquisition time could be reduced to 60 s with acceptable lesion detectability. Furthermore, it was suggested that a 150 s acquisition time would be sufficient to achieve diagnostic performance and image quality for children with epilepsy.

Abstract Background Detecting pathogens in pediatric central nervous system infection (CNSI) is still a major challenge in medicine. In addition to conventional diagnostic patterns, metagenomic next-generation sequencing (mNGS) shows great potential in pathogen detection. Therefore, we systematically evaluated the diagnostic performance of mNGS in cerebrospinal fluid (CSF) in pediatric patients with CNSI. Methods Related literature was searched in the Web of Science, PubMed, Embase, and Cochrane Library. We screened the literature and extracted the data according to the selection criteria. The quality of included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool and the certainty of the evidence was measured by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) score system. Then, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odd’s ratio (DOR), and area under the curve (AUC) of the summary receiver operating characteristic curve (sROC) were estimated in Stata Software and MetaDisc. Subgroup analyses were performed to investigate the potential factors that influence the diagnostic performance. Results A total of 10 studies were included in the meta-analysis. The combined sensitivity was 0.68 (95% confidence interval [CI]: 0.59 to 0.76, I 2 = 66.77%, p

Ziran Wang,1,&ast; Lingjun Kong,1,&ast; Rui Zhang,1 Xiaobo Yang,2 Zhe Cao,3 Tengda Xu,4 Han Zhang,1 Yaling Dou1 1Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Hunan Light of Life Biotechnology Co., Ltd., Ningxiang, Hunan, People’s Republic of China; 4Department of Health Management, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yaling Dou, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China, Email douyl@pumch.cnObjective: To evaluate the diagnostic performance of aldo-keto reductase family 1 member B10 (AKR1B10) in a Beijing cohort with hepatocellular carcinoma (HCC).Methods: This study included 521 subjects who visited Peking Union Medical College Hospital from June 2017 to May 2023, including 109 cases of HCC, 165 cases of healthy controls, 106 cases of benign liver diseases, and 141 cases of other cancers. Serum AKR1B10 levels were measured and compared across various groups. Diagnostic performances of serum AKR1B10 and other tumor markers were assessed using receiver operator characteristic (ROC) curves. In addition, a subset of HCC patients who underwent surgical resection were recruited for clinical follow-up study.Results: We found that serum AKR1B10 expression was higher in patients with HCC relative to other control groups. The association between serum AKR1B10 and clinical features of HCC was not observed. Serum AKR1B10 showed a high diagnostic performance for HCC, and when combined with AFP, the diagnostic effectiveness was significantly improved. Specifically, serum AKR1B10 showed superior diagnostic effectiveness for AFP-negative HCC. The clinical follow-up study indicated a gradual decrease in serum AKR1B10 after surgery.Conclusion: Our study demonstrated that serum AKR1B10 is a promising biomarker for HCC, and when used in combination with AFP can significantly improve the detection rate of HCC.Keywords: AKR1B10, AFP, hepatocellular carcinoma, diagnostic performance

Objectives. The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging. Methods. This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were staged using radiolabeled PSMA PET/CT to evaluate the extent of the disease before initiating appropriate treatment. The study included patients from the Nuclear Medicine Units of the Humanitas group between 2021 and 2024. The change in management due to the PSMA PET/CT examination was assessed. Results. A total of 181 patients were enrolled across all three centers. Histopathological assessment from biopsy revealed that 51.4% of patients had favorable PCa, while 48.6% had unfavorable disease. PET/CT was positive for the primary lesions in all patients, but it revealed a positivity rate in 23 (12.7%) patients for nodes and distant organs, with a positivity rate of 0.21 in the unfavorable group and 0.05 in the favorable group (p < 0.005). Based on follow-up data, diagnostic accuracy was higher than 90% in both the favorable and unfavorable groups for lymph node and distant metastases. The inclusion of PSMA PET/CT in the diagnostic algorithm for patients with intermediate-risk PCa impacted patient management in 24 (13.3%) cases, based on the multidisciplinary team decision. Conclusions. PSMA PET/CT can affect the management of patients with intermediate-risk PCa in up to 13% of cases, mainly for unfavorable diseases. New imaging techniques as a first-line imaging procedure can help to plan the correct therapeutic approach in the intermediate-risk PCa group.

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control. Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis, as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test. Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 103 to 1 × 105 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1–4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples. Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice.

BackgroundEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for biopsy of lung, peri-pulmonary tissue and lymph nodes under real-time ultrasound-guided biopsy. It is used in the diagnosis and/or staging of benign and malignant pulmonary and non-pulmonary diseases. Our study is based on a large sample size, in a diversified population which provides a representative real-world cohort for analysis.MethodsPatients who underwent EBUS-TBNA procedure between September 2019 and August 2022 were included in this retrospective study. For cases diagnosed as benign and unclassified lesions by EBUS-TBNA, the final diagnosis was determined by further invasive surgery or a combination of therapy and clinical follow-up for at least 6 months.ResultsA total of 618 patients were included in the study, including 182 females (29.4%) and 436 males (70.6%). The mean age of all patients was 61.9 ± 10.5 years. These patients were successfully punctured by EBUS-TBNA to obtain pathological results. The pathological diagnosis results of EBUS-TBNA were compared with the final clinical diagnosis results as follows: 133 cases (21.5%) of benign lesions and 485 cases (78.5%) of malignant lesions were finally diagnosed. Among them, the pathological diagnosis was obtained by EBUS-TBNA in 546 patients (88.3%) (464 malignant lesions and 82 benign conditions), while EBUS-TBNA was unable to define diagnosis in 72 patients (11.6%). 20/72 non-diagnostic EBUS-TBNA were true negative. The overall diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA were 91.3%, 100%, 100%, 27.8%, and 91.6% [95% confidence interval (CI): 89.1–93.6%], respectively. In this study, only one case had active bleeding without serious complications during the EBUS-TBNA procedure.ConclusionGiven its low invasiveness, high diagnostic accuracy, and safety, EBUS-TBNA is worth promoting in thoracic lesions.

ObjectiveTo compare image quality and diagnostic performance using different b-values for the zooming technique with diffusion-weighted imaging (ZOOMit-DWI) in thyroid nodulesMaterials and methodsA total of 51 benign thyroid nodules and 50 thyroid papillary carcinomas were included. ZOOMit-DWI was performed with b-values of 0, 500, 1000, 1500 and 2000 s/mm2. The sharpness was evaluated as subjective index. The signal intensity ratio (SIR), signal-to-noise ratio (SNR) and apparent diffusion coefficient (ADC) were measured as objective indices. Pairwise comparisons were performed among the different b-value groups using the Friedman test. A receiver operating characteristic curve of the ADC value was used to evaluate diagnostic performance. The DeLong test was used to compare diagnostic effectiveness among the different b-value groupsResultsIn both the papillary carcinoma group (P = 0.670) and the benign nodule group (P = 0.185), the sharpness of nodules was similar between b-values of 1000 s/mm2and 1500 s/mm2. In the papillary carcinoma group, the SIRnodule was statistically higher in DWI images with a b-value of 1500 s/mm2than in DWI images with b-values of 500 s/mm2(P = 0.004), 1000 s/mm2(P = 0.002), and 2000 s/mm2(P = 0.003). When the b-values were 1500 s/mm2(P = 0.008) and 2000 s/mm2(P = 0.009), the SIRnodule significantly differed between the papillary carcinoma group and the benign nodule group. When b = 500 s/mm2, the ADC had an AUC of 0.888. When b = 1000 s/mm2, the ADC had an AUC of 0.881. When b = 1500 s/mm2, the ADC had an AUC of 0.896. When b = 2000 s/mm2, the ADC had an AUC of 0.871. The DeLong test showed comparable diagnostic effectiveness among the different b-value groups except for between b-values of 2000 s/mm2and 1500 s/mm2, with a b-value of 2000 s/mm2showing lower effectivenessConclusionThis study suggests that 1500 s/mm2may be a suitable b-value to differentiate benign and malignant thyroid nodules in ZOOMit-DWI images, which yielded better image quality

Background: WHO recommends the use of COVID-19 antigen rapid diagnostic tests (Ag-RDT) with at least 80 % sensitivity and 97 % specificity. In the era of Omicron variants, we sought to ascertain the performance of the INDICAID™ Ag-RDT compared to real-time PCR (RT-PCR) as the gold standard. Methods: A laboratory-based study was conducted among consenting individuals tested for COVID-19 at the virology laboratory of the Chantal BIYA International Reference Centre, Yaoundé-Cameron. The samples were processed by INDICAID™ Ag-RDT and DaAn Gene real-time PCR according to the manufacturer's instructions, and PCR-results were interpreted as per cycle thresholds (CT). The sensitivity, specificity, positive and negative predictive values (PPV and NVP) of INDICAID™ Ag-RDT were evaluated according to PCR CT-values. Results: A total of 565 nasopharyngeal swabs were collected from participants (median age [IQR]: 40 [31–75]; M/F sex-ratio was 1.2 and 380 were vaccinated). Following PCR, overall COVID-19 positivity was 5.66 %. For CT < 37, INDICAID™ Ag-RDT sensitivity was 21.9 % (95%CI: [8.3–39.9]), specificity 100 % (95%CI: [99.3–100]); PPV 100 % (95%CI: [59.0–100]), NPV 95.5 % (95%CI: [93.4–97.1]) and kappa = 0.34 (95%CI: [0.19–0.35]). For CT < 25, sensitivity was 100 % (95%CI: [47.8–100.0]), specificity 99.6 % (95%CI: [98.7–99.9]); PPV 94.4 % (95%CI: [51.7–100]), NPV 100 % (95%CI: [99.3–100]) and kappa = 0.83 (95%CI: [0.6–1.0]). COVID-19 sequences generated were all Omicron BA.1 subvariants. Conclusion: For patients infected with high viral loads (CT < 25), INDICAID™ Ag-RDT has high intrinsic (sensitivity and specificity) and extrinsic (predictive values) performances for COVID-19 diagnosis. Due to its simplicity and short turnaround time, INDICAID™ Ag-RDT is, therefore a reliable tool to prevent the spread of COVID-19 at community level in the current era of Omicron subvariants.

Abstract Introduction and Aim Small fibre neuropathy (SFN) is a peripheral neuropathy, leading to neuropathic pain and autonomic dysfunction. An evidence‐based standardized patient diagnostic SFN service has been implemented in the Netherlands for improving patient‐centred SFN care. However, the quality of care of this diagnostic SFN service has never been assessed from a patient perspective. The aim of this study was to develop and validate an SFN‐Patient Satisfaction Questionnaire (SFN‐PSQ) to measure the quality performance of a standardized diagnostic SFN service. Methods A descriptive qualitative study to create the SFN‐PSQ was performed using the (COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. For item generation and content development, domains and/or items from validated PSQs were selected. The content development and content validity were performed using a Delphi method with SFN expert caregivers with different backgrounds. By using the three‐step‐test method in individual cognitive interviews, the content validity by patients was finalized. Results In one online Delphi panel round, the content of the first concept of the SFN‐PSQ was validated, which resulted in the second concept of the SFN‐PSQ. From July 2019 till March 2020, nine patients consented to participate in the individual cognitive interviews. The most significant changes of the new questionnaire were adding domains and items concerning the waiting list, the diagnostic services and consultation by the hospital psychiatrist. Also, a differentiation was made for both an inpatient and outpatient diagnostic SFN service. Furthermore, the clarity and intelligibility of the domains/items were improved, resulting in an increased comprehension of the SFN‐PSQ. Ultimately, the new developed SFN‐PSQ consisted of 10 domains and 51 items, suitable for measuring patient satisfaction of the neurological analysis in patients with SFN. Conclusion Through item generation, expert opinions and interviews with patients, the SFN‐PSQ was developed and validated, and feasibility was confirmed. The structure of the questionnaire, based on the logistic and diagnostic SFN pathway, could be used as a model in other hospitals to improve the quality, continuity and access of SFN care and other chronic diseases taking into account potential cross‐cultural differences. Patient or Public Contribution Caregivers were involved in the item generation and content development of the questionnaire. Patients were directly involved in testing the content validity and feasibility of the SFN‐PSQ. Clinical Trial Registration Not applicable.

PurposeEvaluating the performance of the Gallbladder Reporting and Data System (GB-RADS) combined with Color Doppler Flow Imaging (CDFI) for the diagnosis of gallbladder wall thickening disease in an Asian population.MethodsIn this study, the lesions were classified and the actual incidence rate of malignant tumors was calculated for each GB-RADS category, following the guidelines provided by GB-RADS. To evaluate the diagnostic performance of GB-RADS and GB-RADS combined with CDFI, we plotted Receiver Operator Characteristic (ROC) curves. The sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy (AC) were also calculated. Inter-observer agreement (IRA) between the two observers was assessed using Kappa values.ResultsThe incidence of malignancy risk for GB-RADS 2, 3, 4, and 5 was 9%, 12.5%, 72.2%, and 100%. The AUC for GB-RADS was 0.855 (95% CI: 0.800-0.900), with a sensitivity of 82.5%, a specificity of 84.6%, and an accuracy of 83.8%. The AUC of GB-RADS combined with CDFI was 0.965 (95% CI: 0.930-0.985), with a sensitivity of 96.2%, a specificity of 94.6%, and an accuracy of 95.2%. The AUC, sensitivity, specificity, and accuracy of GB-RADS combined with CDFI for diagnosing gallbladder malignancy were higher than those of GB-RADS alone, and the differences were statistically significant (all P < 0.05). The IRA was excellent between the two observers (Kappa = 0.870).ConclusionsGB-RADS combined with CDFI demonstrated excellent diagnostic accuracy when it comes to distinguishing various diseases that caused gallbladder wall thickening in the Asian population, which has good clinical value and can improve the detection rate of malignant tumors in patients with gallbladder wall thickening.

Nongnong Yang,1,&ast; Haiyan Ma,1,2 Mengyi Huang,1,&ast; Esther Yuet Ying Lau,3– 5 Daniel Yee Tak Fong,6 Meng Wang,7 Pengqiao Wang,1 Siyi Xu,8 Jiale Xu,1 Chen Jiang,1 Yi Luo,9 Runtang Meng1,2,&ast; 1School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China; 2Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, People’s Republic of China; 3Sleep Laboratory, Department of Psychology, The Education University of Hong Kong, Hong Kong, People’s Republic of China; 4Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, People’s Republic of China; 5Centre for Religious and Spirituality Education, The Education University of Hong Kong, Hong Kong, People’s Republic of China; 6School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China; 7Ophthalmology Center, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, People’s Republic of China; 8School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China; 9School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Runtang Meng; Haiyan Ma, School of Public Health, Hangzhou Normal University, No. 2318, Yuhangtang Road, Yuhang District, Hangzhou, Zhejiang, 311121, People’s Republic of China, Email mengruntang@hznu.edu.cn; mahaiyan@hznu.edu.cnPurpose: The World Health Organization-Five Well-Being Index (WHO-5) is widely used to assess subjective well-being. Nevertheless, measurement invariance and optimal cutoff point of the WHO-5 have not been examined in Chinese samples. We aimed to assess measurement properties of the Chinese version of the WHO-5 (WHO-5-C) among healthcare students.Patients and Methods: A two-wave longitudinal assessment was conducted among 343 Chinese healthcare students from September to November 2022. Measurement properties of the WHO-5-C were assessed through structural validity using confirmatory factor analysis (CFA), measurement invariance using multigroup CFA (MGCFA) and longitudinal CFA (LCFA), convergent validity using correlation analysis with the Self-Rated Health Questionnaire (SRHQ) and Patient Health Questionnaire-4 (PHQ-4), reliability using internal consistency and test–retest reliability, and optimal cutoff point using receiver operating characteristic (ROC) analysis.Results: The WHO-5-C demonstrated satisfactory structural validity with comparative fit index (CFI) of 0.968 at baseline and 0.980 at follow-up, and adequate measurement invariance in different sociodemographic variables at baseline (gender, age, major, home location, being only child, monthly household income, part-time job, physical exercise, hobby, frequency of visiting home, and stress coping strategy) (CFI changes [ΔCFI] = − 0.009– 0.003) and over a week (ΔCFI = − 0.006– 0.000). The WHO-5-C also had good internal consistency (Cronbach’s α = 0.907– 0.934; McDonald’s ω = 0.908– 0.935) and test–retest reliability (intraclass correlation coefficient [ICC] = 0.803). Convergent validity was supported by moderate correlations of the WHO-5-C with the SRHQ and PHQ-4. The optimal cutoff point of the WHO-5-C was found to be 50, with an area under the ROC curve of 0.882 at baseline data, with sensitivity of 0.803 and specificity of 0.762 at follow-up.Conclusion: The WHO-5-C demonstrated adequate measurement properties, especially concerning cross-sectional and longitudinal measurement invariance, with a recommended optimal cutoff point of ≥ 50 for assessing adequate level of psychological well-being in healthcare students.Keywords: WHO-5 Well-Being Index, subjective well-being, measurement properties, diagnostic performance, observational longitudinal design, healthcare students

الملخص: أهداف البحث: لتحديد الأداء التشخيصي والعوامل المؤثرة في التصوير الوعائي المقطعي المحوسب للشريان التاجي المكون من 128 شريحة مقارنة بتصوير الأوعية التاجية المجتاحة في مرضى الشريان التاجي. طريقة البحث: سجلت دراسة تحليلية مقطعية 139 مريضا يشتبه في إصابتهم بمرض الشريان التاجي والذين خضعوا لـ 128 شريحة للتصوير المقطعي المحوسب للأوعية وكذلك تصوير الأوعية التاجية المجتاحة. النتائج: أظهر النموذج المعتمد على المريض حساسية عالية بنسبة 93.2٪ وقيمة تنبؤية إيجابية بنسبة 95.3٪ للتضيق ≥ 50٪. ومع ذلك ، كانت هذه القيم أقل عند تحليلها من خلال النماذج المستندة إلى الشرايين (حساسية عالية بنسبة 85.6٪ وقيمة تنبؤية إيجابية بنسبة 81.1٪) والقطاعات (حساسية عالية بنسبة 73.9٪ وقيمة تنبؤية إيجابية بنسبة 66.6٪). كانت الخصوصية والقيمة التنبؤية السلبية هي الأعلى في النموذج المعتمد على القطعة ، وانخفضت في النماذج المستندة إلى الأوعية والمرضى بنسبة 96.4٪ و 95.4٪ ؛ 90.5٪ و 90.0٪ ؛ و 36.4٪ و 42.1٪ على التوالي (للتضيق ≥ 70٪). انخفضت جميع القيم التشخيصية عندما كانت درجة الكالسيوم 400 وحدة أغاتستون. الاستنتاجات: يظهر التصوير الوعائي المقطعي المحوسب للشريان التاجي المكون من 128 شريحة الطريقة المثلى وذات الحد الأدنى من الاجتياح وعالي الأداء لتشخيص تضيق وتشكل آفات الشريان التاجي. كان الأداء التشخيصي لتصوير الأوعية المقطعي المحوسب للشريان التاجي المكون من 128 شريحة مرتفعا جدا. لم يؤثر معدل ضربات القلب ومؤشر كتلة الجسم على دقة التشخيص، بينما تم العثور على درجة الكالسيوم البالغة 400 وحدة أغاتستون كعامل يتسبب في انخفاض الأداء التشخيصي. Abstract: Objectives: To determine the diagnostic performance and influencing factors of 128-slice coronary computed tomography angiography (CCTA) compared with invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD). Methods: A cross-sectional analysis study enrolled 139 patients suspected of having CAD, who underwent and received a 128-slice CCTA and ICA. Results: The patient-based model showed high sensitivity and a positive predictive value of 93.2% and 95.3%, respectively (for stenosis ≥50%). However, these values were lower when analyzed using vessel-based (85.6% and 81.1%) and segment-based (73.9% and 66.6%) models. Specificity and negative predictive value were highest in the segment-based model, decreasing in vessel- and patient-based models at 96.4% and 95.4%, 90.5% and 90.0%, and 36.4% and 42.1%, respectively (for stenosis ≥70%). All diagnostic values were reduced when the calcium score was ≥400 Agatston units. Conclusion: 128-slice CCTA is an optimal, minimally invasive, and high-performance method to diagnose the stenosis and morphology of coronary artery lesions. The diagnostic performance of 128-slice CCTA is very high. Heart rate and body mass index do not affect diagnostic accuracy, whereas a calcium score ≥400 Agatston units is a factor that causes a decrease in diagnostic performance.

Background: This study aimed to identify the clinical and endoscopic factors that determined the diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for mass lesions in the pancreatic head. Methods: A total of 78 consecutive patients with suspected mass lesions in the pancreatic head detected by contrast-enhanced multi-detector-row computed tomography and/or magnetic resonance imaging, who underwent EUS-FNA for cytologic and/or histologic confirmation in our institution between June 2012 and April 2017 were enrolled in the current study. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EUS-FNA for mass lesions in the pancreatic head in our series was 61/69 (88.4%), 9/9 (100.0%), 61/61 (100.0%), 9/17 (52.9%), and 70/78 (89.7%), respectively. In univariate analyses, the clinical and endoscopic factors for determining the diagnostic performance of EUS-FNA were the echoendoscope position during needle puncture (long vs. short scope position) and the distance from the echoendoscope to the mass lesion (< 1 cm vs. ≥ 1 cm). In the multivariate logistic regression analysis, the echoendoscope position during needle puncture was the only independent and significant determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head. Conclusion: The echoendoscope position during needle puncture is a determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head.