Utilization of Contrast-Enhanced Ultrasound in Diagnosis of Focal Liver Lesions.

Background and aims: Focal liver lesions (FLL) are one of the most common indications for hepatology and hepatobiliary surgery consultation. In this retrospective study, we aim to assess if contrast-enhanced ultrasound (CEUS) can address diagnostic dilemmas in the evaluation of indeterminate liver lesions by identifying characteristics of indeterminate FLL on CEUS and correlating these with cross-sectional imaging and pathology findings. Methods: We retrospectively reviewed all patients who underwent CEUS evaluation for liver lesions over a 28-month period (Oct 2020 to Jan 2023) at the University of Kentucky. To assess the relationship between CEUS results and the corresponding CT, MRI, and/or pathologic findings, the McNemar-Bowker tests were performed. Results: Twenty-nine patients were included (after two exclusions from a total n of 31). Mean age was 54 years, 62% were female, and 48% had underlying cirrhosis. Of the 29 patients with initial cross-sectional imaging, the initial results showed malignancy or likely malignant lesion in 6 patients and benign or likely benign lesion in 6 patients. The remaining 17 patients had inconclusive/indeterminate results. CEUS clarified an "indeterminate" CT/MRI result 15 times out of 17 (88.2%), moving the diagnosis to "benign" 11 times while suggesting "malignant" only four times. When aggregating indeterminate cross-sectional results with either benign or malignant categories suggested by CEUS, CEUS never reversed a benign CT/MRI diagnosis but often reversed a malignant CT/MRI diagnosis. Conclusion: CEUS provided a definitive diagnosis of indeterminate liver lesions in approximately 90% of patients and avoided the need for biopsy in most patients. In cases where the liver lesions were biopsied, CEUS accurately distinguished malignant versus benign lesions as confirmed by biopsy findings. CEUS, therefore, has the potential to provide a precise diagnosis for the majority of indeterminate lesions.

Disparities in Treatment for Alcohol Use Disorder Among All of Us Participants.

OBJECTIVE: The authors examined racial/ethnic and socioeconomic disparities in receiving treatment for alcohol use disorder (AUD). METHODS: A retrospective cohort study was conducted that included adults (≥18 years) with AUD from the All of Us Controlled Tier database v7. Outcomes were lifetime receipt of FDA-approved medications (disulfiram, acamprosate, and naltrexone), psychotherapy (individual, family, and group-based session), and combination treatment (medication and psychotherapy). The study examined treatment receipt by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, other), insurance (private, Medicare, Medicare and Medicaid, Medicaid, Veteran Affairs [VA], none), income (<$10K, $10-<$50K, $50-$100K, >$100K), and area deprivation index (ADI) quintiles. Multivariable logistic and multinomial logistic regressions were used to assess the association between patient characteristics and treatment receipt. RESULTS: The cohort consisted of 18,692 patients (mean age=57.1 years; 60.7% were male; 47.1% were non-Hispanic White). Almost 70% received no treatment, 11.4% received medication, 24.0% received psychotherapy, and 4.9% received combination treatment. In adjusted analysis, non-Hispanic Black (aOR=0.78, 95% CI=0.69-0.89) and Hispanic (aOR=0.75, 95% CI=0.64-0.88) individuals were less likely to receive medication than non-Hispanic White counterparts. There was no association between race/ethnicity and receipt of psychotherapy or combination treatment. Compared with private insurance, dual eligibility was associated with less use of medication, Medicare and Medicaid with less use of medication and combination treatment, and VA and no insurance with more use of psychotherapy and combination treatment. Higher income and lower ADI were positively associated with all treatment types. CONCLUSIONS: There are disparities in AUD treatment by race/ethnicity, socioeconomic status, and insurance. Systematic approaches are required to improve equitable access to effective treatment.

Wide-based oblique anastomosis reduces urethral stricture rate following the transverse preputial island flap procedure.

Background: The transverse preputial island flap (TPIF) procedure remains one of the classic single-stage procedures for severe hypospadias repairs. The incidence of postoperative complications remained high. This study aims to describe a modified urethral anastomosis technique during the TPIF procedure for severe hypospadias repairs and report its outcomes. Methods: Data were collected retrospectively from consecutive patients who underwent the TPIF procedure by the same pediatric urologist between January 2018 and June 2023. Collected information included age at surgery, operative details, and outcomes at follow-up. Wide-based oblique anastomosis (WOA) technique was used as a modified urethral anastomosis in all cases. In brief, the dorsal edge of anastomosis was breadthwise anchored to the corpus cavernosum with 4-5 stitches, forming a spade-shaped anastomotic surface. Results: A total of 72 patients were included in the study. The location of the corpus spongiosum division was penile in 27 patients (37.5%) and proximal in 45 patients (62.5%). The median glans width was 13 mm (range, 6-30 mm). The median ventral curvature after degloving was 45° (range, 30-150°). At a median follow-up of 4.1 years, complications occurred in 15 patients (20.8%), including nine cases of fistula, seven cases of urethral diverticulum and two cases of meatal stenosis. No cases of urethral stricture (US), urethral dehiscence, or ventral curvature occurred. Subsequent reoperations for diverticulum repairs showed that the dorsal side of the anastomosis was extensively fixed to the corpus cavernosum, forming a wide-based, spacious lumen. Conclusions: WOA technique is straightforward and effective, especially in the prevention of postoperative US.

Comparative Analysis of Drug Shortages in the US and Germany (2016 - 2023).

This article analyzes trends in drug shortages in the US and Germany, the largest pharmaceutical market in Europe, between 2016 and 2023. It assesses the commonalities and differences between the countries in terms of active substances in shortage, time duration in shortage, and cyclic trends.

Correlation Between Medical School Performance and Receiving Awards in General Surgery Residency.

IMPORTANCE: It is uncertain whether current measures of achievement during medical school predict exceptional performance during surgical residency. One surrogate of excellence during residency may be awards, especially those given for teaching and annual overall accomplishment. OBJECTIVE: Determine whether markers of superior performance during medical school documented in the Electronic Residency Application Service (ERAS) application and student record correlated with receiving awards during residency. DESIGN: Data was analyzed from ERAS and student applications of 296 residency graduates. Spearman correlation coefficients were calculated. PARTICIPANTS: 296 residency graduates from 14 US general surgery residency programs. MAIN OUTCOMES AND MEASUREMENTS: The relationship between each residency and preresidency variable and the outcome of receiving any qualifying award. Secondary analysis included the correlation with winning a teaching or annual overall award. RESULTS: Although 140 (48%) residents received an award during residency, only 69 (23.3%) received a teaching award, while 50 (17.6%) received one for annual overall performance. Membership in Alpha Omega Alpha (AOA) and honors in pediatrics rotation correlated with receiving any award. USMLE step 1 score and AOA membership reached statistically significant positively correlation with receiving a teaching award, while completing a sub-internship at that institution was negatively associated. For annual overall awards, only completing a sub-internship at the same institution reached statistical significance. CONCLUSIONS: None of the traditional metrics in the ERAS or global student record consistently correlated with receiving an award during residency. Our findings suggest that preresidency factors available on the global application, including grades, test scores, and honor society membership, poorly correlate with exceptional general surgery residency performance as measured by receiving awards. Residency programs should shift away from using traditional ERAS metrics as the primary criteria for selection, but rather as 1 component of holistic applicant review.

Using the GoogLeNet deep-learning model to distinguish between benign and malignant breast masses based on conventional ultrasound: a systematic review and meta-analysis.

Background: Breast cancer is one of the most common malignancies in women worldwide, and early and accurate diagnosis is crucial for improving treatment outcomes. Conventional ultrasound (CUS) is a widely used screening method for breast cancer; however, the subjective nature of interpreting the results can lead to diagnostic errors. The current study sought to estimate the effectiveness of using a GoogLeNet deep-learning convolutional neural network (CNN) model to identify benign and malignant breast masses based on CUS. Methods: A literature search was conducted of the Embase, PubMed, Web of Science, Wanfang, China National Knowledge Infrastructure (CNKI), and other databases to retrieve studies related to GoogLeNet deep-learning CUS-based models published before July 15, 2023. The diagnostic performance of the GoogLeNet models was evaluated using several metrics, including pooled sensitivity (PSEN), pooled specificity (PSPE), the positive likelihood ratio (PLR), the negative likelihood ratio (NLR), the diagnostic odds ratio (DOR), and the area under the curve (AUC). The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies Scale (QUADAS). The eligibility of the included literature were independently searched and assessed by two authors. Results: All of the 12 studies that used pathological findings as the gold standard were included in the meta-analysis. The overall average estimation of sensitivity and specificity was 0.85 [95% confidence interval (CI): 0.80-0.89] and 0.86 (95% CI: 0.78-0.92), respectively. The PLR and NLR were 6.2 (95% CI: 3.9-9.9) and 0.17 (95% CI: 0.12-0.23), respectively. The DOR was 37.06 (95% CI: 20.78-66.10). The AUC was 0.92 (95% CI: 0.89-0.94). No obvious publication bias was detected. Conclusions: The GoogLeNet deep-learning model, which uses a CNN, achieved good diagnostic results in distinguishing between benign and malignant breast masses in CUS-based images.

A Retrospective Observational Study Examining Physical Activity Among Adults in the United States With Angina or Coronary Heart Disease.

INTRODUCTION:  Coronary heart disease (CHD) involves inadequate blood supply to the myocardium by the coronary arteries due to the formation of atherosclerotic plaque in the vessel lumen. It has a complex etiopathogenesis. Physical activity (PA) and exercise lead to vascular remodeling and improved endothelial function, which, in turn, improves the arterial blood supply to the myocardium. OBJECTIVES: The study aims to determine the prevalence of self-reported PA among CHD patients in the United States based on demographic, socioeconomic, and healthcare access variables for the year 2021. METHODOLOGY:  The data for the study on CHD were extracted using the Behavioral Risk Factor Surveillance System (BRFSS) Web-Enabled Analysis Tool database of the U.S. POPULATION: The control variables used broadly include demographics, socioeconomic, and healthcare access. RESULTS:  In 2021, 433,615 people in the USA participated in the BRFSS study. Among them, 22,819 self-identified as having angina or CHD. In the past month, 62.2% of participants with the disease were involved in PA, and 37.8% were not. Among participants without angina or CHD, 76.5% were involved, and 23.5% were not involved in PA in the past month. CONCLUSION:  This study highlights the need for specific interventions to overcome obstacles preventing PA among CHD patients.

Incidental detection of three testes while evaluating an empty left scrotal sac: a case report.

Introduction and importance: Poly-orchidism is a rare congenital anomaly of the genitourinary system, which is characterized by the presence of more than two testicles, also being termed as "supernumerary testis". Tri-orchidism is the most frequently encountered form of poly-orchidism, which is defined as the presence of more than two intra- or extra-scrotal testicles. Case presentation: The authors present a case of a 16-year-old male who presented with a complaint of an empty left scrotal sac, and was later diagnosed as a case of tri-orchidism with each testis in bilateral hemipelvis confirmed by ultrasound with Doppler and MRI. The patient was kept in regular follow-up for 6 months with radiological assessment, which showed no changes in radiological findings as before. Clinical discussion: The majority of patients are asymptomatic or present with a painless inguinal or scrotal mass, undescended testis, and rarely torsion of the supernumerary testis. Imaging modalities like US, Doppler study, and MRI are required for the diagnosis. Non-scrotal location of poly-orchidism is considered as the most important risk factor for malignancy. The surgical approach is required for any malignant changes in biopsy, US showing features of malignancy, absent spermatogenesis or in cases where regular follow-up is not possible. Otherwise, a conservative approach with regular follow-up is enough if above indications are absent. Conclusion: The complications of poly-orchidism like undescended testes, inguinal hernia, infertility, and possibly malignancy must be borne in mind while diagnosing poly-orchidism. The above-mentioned aspects must also be considered while choosing surgical intervention versus a conservative approach with follow-up, depending upon the position of the supernumerary testicle being scrotal or ectopic.

Association between systemic immune-inflammation index and cataract among outpatient US adults.

Background: While several studies have noted a higher SII correlates with multiple diseases, research on the association between SII and cataract remains limited. Our cross-sectional study seeks to examine the association between SII and cataract among outpatient US adults. Methods: This compensatory cross-sectional study utilized NHANES data from 1999 to 2008 cycles, conducting sample-weighted multivariate logistic regression and stratified analysis of subgroups. Results: Among 11,205 adults included in this study (5,571 [46.2%] male; 5,634 [53.8%] female), 2,131 (15.2%) had cataract and 9,074 (84.8%) did not have cataract. A fully adjusted model showed that SII higher than 500 × 109/L was positively correlated with an increased risk of cataracts among women (OR, 1.27; 95% CI, 1.02-1.59) (p = 0.036). However, no difference was found in the men subgroup, and there was no significant interaction between SII and sex. Conclusion: Our results indicated that a SII higher than 500 × 109/L was positively correlated with an increased risk of cataracts in women. This study is the first to specifically investigate the impact of a high SII on cataract risk in outpatient adults in the United States. By effectively addressing inflammation, it is possible to mitigate cataract progression and significantly enhance patient outcomes.

An Exploration of the Understanding and Experiences of Health in Urban Dominican American Adolescents.

INTRODUCTION: This study explored the understanding and experiences related to health among Dominican American adolescents in an urban setting in the northeastern United States. METHOD: A qualitative descriptive study was conducted, applying thematic analysis to focus group interview data from 23 students. RESULTS: Five themes emerged: (1) Health is All About Healthy Eating, (2) Sugarcoating, (3) Dynamics Affecting Adherence, (4) Dominican Cultural Influences on Health, and (5) Toll of the Immigrant Life. DISCUSSION: Cultural expectations, particularly deference to family members, substantially impact health care providers' interactions with Dominican American adolescents. Limited communication hinders discussion on topics like healthy eating and mental health. Parental reliance on home remedies over seeking professional care adds another layer of complexity. This study establishes a foundational understanding of Dominican American adolescents' health experiences, highlighting areas where pediatric nurse practitioners can target interventions to support Dominican American adolescents' health journeys.

Evaluation of the effect of ultrasound-assisted hot air drying on the drying characteristics and physicochemical properties of cherries based on the entropy-weighted TOPSIS method.

To address the challenges associated with prolonged traditional hot air drying (HAD) times and significant nutrient loss in cherries, this study employs ultrasound-assisted hot air drying (USA-HAD) technology. The study investigates the impacts of various ultrasound (US) frequencies, US powers, and hot air temperatures on the drying kinetics, physicochemical properties, texture attributes, and microstructure of cherries during drying. Cherry physicochemical quality serves as the evaluation criterion, with the entropy-weighted TOPSIS method used to identify the optimal drying parameters. The findings indicate that USA-HAD accelerates the drying process, reduces drying time, and enhances drying efficiency. In comparison to natural drying, USA-HAD significantly preserves polysaccharides, total phenolic content, total flavonoid content, and organic acids in cherries, while boosting antioxidant activity. Concurrently, it reduces color intensity, as well as the hardness, chewiness, and gumminess of dried cherry products. Microstructural observations under different drying methods reveal an increase in surface micropores and relatively intact tissue structure. Under conditions of 55°C, 48 W, and 28 kHz, cherries exhibit superior overall quality based on the TOPSIS relative closeness degree. This study offers practical insights for optimizing post-harvest processing of cherries. PRACTICAL APPLICATION: In this rapidly evolving era, the application of combination drying technology is clearly on the rise. The USA-HAD treated cherries had better nutritional and bioactive than HAD. The conclusions obtained indicate that the USA-HAD technology has more potential for development.

GLCV-NET: An automatic diagnosis system for advanced liver fibrosis using global-local cross view in B-mode ultrasound images.

BACKGROUND AND OBJECTIVE: Advanced liver fibrosis is a critical stage in the evaluation of chronic liver disease (CLD), holding clinical significance in the development of treatment strategies and estimating the disease progression. METHODS: This paper proposes an innovative Global-Local Cross-View Network (GLCV-Net) for the automatic diagnosis of advanced liver fibrosis from ultrasound (US) B-mode images. The proposed method consists of three main components: 1. A Segmentation-enhanced Global Hybrid Feature Extractor for segmenting the liver parenchyma and extracting global features; 2. A Heatmap-weighted Local Feature Extractor for selecting candidate regions and automatically identifying suspicious areas to construct local features; 3. A Scale-adaptive Fusion Module to balance the contributions of global and local scales in evaluating advanced liver fibrosis. RESULTS: The predictive performance of the model was validated on an internal dataset of 1003 chronic liver disease (CLD) patients and an external dataset of 46 CLD patients, both subjected to liver fibrosis staging through pathological assessment. On the internal dataset, GLCV-Net achieved 86.9% accuracy, 85.0% recall, 85.4% precision, and 85.2% F1-score. Further validation on the external dataset confirmed its robustness, with scores of 86.1% in accuracy, 83.1% in recall, 80.8% in precision, and 81.9% in F1-score. CONCLUSION: These results underscore the GLCV-Net's potential as a promising approach for non-invasively and accurately diagnosing advanced liver fibrosis in CLD patients, breaking through the limitations of traditional methods by integrating global and local information of liver fibrosis, significantly enhancing diagnostic accuracy.

Grindr? it's a "Blackmailer's goldmine"! The weaponization of queer data publics Amid the US-China trade conflict.

In March 2019, the Committee on Foreign Investment in the United States (CFIUS) identified Grindr, a hookup app that predominantly caters to men who have sex with men, as a "national security threat" and compelled the Chinese conglomerate Kunlun Tech to divest from it entirely. The CFIUS-Grindr ruling is indicative of larger regulatory debates over increasing datafication trends in the dating app industry. Through a political economy approach to communication, this paper examines how this ruling was predominantly constructed by various stakeholders as a public controversy in light of the ongoing US-China trade conflict. This interpretation of the controversy relies on a prejudicial trope that construes queer dating app users as vulnerable targets of potential blackmail schemes operated by Chinese intelligence agencies. Through the Lavender Scare, a historical period referring to state-led investigations into the presence of LGBTQ+ employees in Western federal workforces, this paper historicizes this blackmail trope to highlight how the politicization of queer vulnerabilities amid global hegemonic conflicts is a tactic that predates the US-China trade conflict. It argues that the CFIUS-Grindr ruling weaponizes Grindr's queer data publics as threats against which the US government should protect itself, while failing to fully recognize the urgency for the state to protect the data privacy rights of the LGBTQ+ communities in the digital economy. In light of the CFIUS-Grindr ruling, this paper examines the implications that datafication raises for the LGBTQ+ communities whose sexual lives and identities are increasingly being datafied and exploited by digital media platforms.

Onychocryptosis Is Associated with Low Income in a Matched Cohort Study Using the All of Us Database.

Introduction: Onychocryptosis is a common and often painful nail condition, but risk factors have been relatively unexplored. We aimed to analyze associations between onychocryptosis, comorbidities, and income level. Methods: Using the National Institute of Health All of Us Research Program Database, a matched case-control study was performed for patients with onychocryptosis diagnosis and comorbidities and lifestyle factors. Results: A total of 6,246 cases of onychocryptosis and 24,984 controls were analyzed. Patients with onychocryptosis versus controls had increased risk of onychogryphosis (OR 5.66; 95% CI 4.87, 6.58), onychomycosis (2.63; 2.06, 3.36), hallux valgus (1.68; 1.50, 1.87), type 2 diabetes mellitus (1.49; 1.40, 1.60), obesity (1.38; 1.30, 1.48), and peripheral vascular disease (1.24; 1.14, 1.35) compared to controls. Patients who reported living in low-income households more often had onychocryptosis (reference group annual income >200 k; annual income <10 k USD, OR: 1.76; 95% CI: 1.46, 2.12, p < 0.001 vs. annual income 150-200 k USD, OR: 1.26; 95% CI: 0.99, 1.61, p = 0.06). Conclusion: Low income, obesity, PVD, and T2DM were associated with onychocryptosis diagnosis. It is recommended that these at-risk populations be screened for onychocryptosis and counseled on proper nail trimming techniques. Future studies are needed to examine the relationship between household income and onychocryptosis risk.

Stage III xanthogranulomatous pyelonephritis with sarcomatoid degeneration.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic condition characterized by destructive granulomatous disease of the kidney with uncertain etiology. Significant risk factors for XGP are represented by the coexistence of history of nephrolithiasis, diabetes mellitus, recurrent urinary tract infections and other immunocompromised conditions. It is also associated with higher risk of malignancy, reported in up to 11% of patients. We report a case of a 76-year-old female who presented to the emergency department with an insidious onset of abdominal and right lower back pain. She had a history of renal stones and diabetes mellitus. On physical examination, a painful fistulous orifice in skin on the right lumbar region was found. CT images showed a nonfunctioning right kidney replaced by multiple necrotic cavities with inflammatory involvement of the right hepatic lobe and a nephron-cutaneous fistula. These CT findings were strongly suggestive of XGP (III state). CT images obtained before and after the administration of intravenous contrast material showed also a hyper-vascularized renal mass with irregularly thickened walls confirmed by a targeted CEUS examination and suspicious for malignancy. Pathologic examination confirmed the chronic pyelonephritis and revealed evidence of a concomitant sarcomatoid lesion. This case underlines the central role of a multimodality imaging approach in the emergency department and how this affects the correct management and treatment of patients. In fact, MDCT is considered the current gold standard for the diagnosis and the staging of XPG but the contrast-enhanced ultrasound (CEUS) in selected patients can increase the diagnostic accuracy in the uncertain small renal masses detected on CT scans.

Favorable Trends in Mortality Among Patients with Concomitant Peripheral Arterial Disease and Diabetes Mellitus Over Past Two Decades.

BACKGROUND: This study examines the temporal trends in diabetes and peripheral artery disease (PAD)-related mortality in the United States, considering sociodemographic and regional factors, using data from death certificates in a national public database. METHODS: Data were extracted from the CDC WONDER (Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research) database from 1999 to 2020. Age-adjusted mortality rates (AAMR) per 100,000 individuals and annual percent changes (APC) with 95% confidence intervals (CI) were calculated. RESULTS: Between 1999 and 2020, there were 2,252,252 PAD-related and 5,413,811 diabetes-related deaths, with 469,699 deaths involving both conditions. The overall AAMR for PAD and diabetes-related mortality (aged ≥ 25 years) decreased from 7.97 in 1999 to 6.37 in 2020, with a notable decline from 2001 to 2010 (APC: -6.16, 95% CI: -7.07, -5.23). The AAMR for PAD-related mortality fell from 40.25 to 30.56, while the AAMR for diabetes-related deaths rose from 76.71 to 93.63. Males and non-Hispanic (NH) Black individuals had higher AAMRs than females and other racial groups. The highest crude mortality rate (CMR) was in the 80-84 age group. Non-metropolitan areas consistently reported higher AAMRs than metropolitan areas, and states like Ohio, Vermont, District of Columbia, and West Virginia had significantly higher rates. CONCLUSION: Over two decades, PAD and diabetes-related mortality trends show a positive overall reduction in AAMR. However, disparities persist, with higher rates among males, NH Black individuals, and residents of non-metropolitan areas. Significant state-level variations highlight the need for targeted interventions and tailored healthcare strategies.

The Friends and Family for Mental Health Program: a pilot study of a cognitive behavioral therapy skills intervention for rural adults.

INTRODUCTION: Limited access to psychological treatment is a pressing problem in the US, especially in more rural areas. One potentially underutilized resource is informal care from friends and family members. Although those in rural areas rely on informal care more than those in urban areas, there is little to guide interested caregivers in how they can be most effective. METHODS: In this study, we conducted a pilot test of the Friends and Family for Mental Health Program, a mental health skills program we developed to enhance informal care and reduce psychological symptoms among informal caregivers. To provide an initial test of the potential benefits of this program, we evaluated the impact of the program on informal care skills, hope, psychological symptoms, and mental health skills. RESULTS: Informal care skills and hope improved. Participants also reported reduced anxiety. We considered intervention feedback to inform intervention development. DISCUSSION: Overall, findings provided preliminary support for the program and provide directions for future refinements. CONCLUSION: Though further research is needed, initial evidence suggests mental health skills programs directed at informal caregivers are both desired and beneficial in rural areas.

CINtec PLUS: A Novel Alternative Screening Method for Detecting High-Risk Cervical Lesions in Romania.

Introduction CINtec PLUS is a relatively recent method introduced in Romania for detecting cervical precancerous lesions. This technique utilizes simultaneous double immunostaining with p16 and Ki67 to identify potentially transformative human papillomaviruses (HPVs). CINtec PLUS has demonstrated superior sensitivity and specificity compared to conventional Papanicolaou (PAP) cytology and PAP liquid-based cytology, allowing for more accurate identification of HPV infections that may progress to malignancy among women with abnormal screening results. The objectives of this study are to evaluate CINtec PLUS test results in comparison with PAP cytology and HPV genotype detection among Romanian women and to assess its potential as a complementary screening method within existing national cervical cancer screening programs. Materials and methods Cases were collected between December 22, 2022, and June 15, 2024. All 96 women enrolled in the study, regardless of the presence of pathological cervical lesions, underwent the CINtec PLUS test. The samples were stained using the Roche CINtec PLUS kit. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA). To assess correlations and compare variables, we utilized crosstabulation tables, frequency tables, the chi-square test, and the Pearson correlation coefficient. Results The age range of participants in our study was from 19 to 64 years, with a mean age of 35.77 years and a standard deviation of 9.608. Among the women who underwent the CINtec PLUS test, over two-thirds were aged between 20 and 39 years. In 7.3% of cases with no history of HPV infection or cervical cytologic lesions, the CINtec PLUS test yielded a positive result. The study also revealed that CINtec PLUS showed a positive result in 23.3% of cases diagnosed with atypical squamous cells of undetermined significance on PAP cytology. Additionally, 36.5% of women who underwent CINtec PLUS testing as a screening method had a positive result, with more than one-fifth of these cases being positive. Conclusions The CINtec PLUS test is a valuable tool for identifying high-risk cervical lesions. Despite the limitations of our study, it provides a foundation for further research into the long-term benefits and cost-effectiveness of this test. Future studies could explore its potential for integration into national screening programs.

An Adaptive SCG-ECG Multimodal Gating Framework for Cardiac CTA.

Cardiovascular disease (CVD) is the leading cause of death worldwide. Coronary artery disease (CAD), a prevalent form of CVD, is typically assessed using catheter coronary angiography (CCA), an invasive, costly procedure with associated risks. While cardiac computed tomography angiography (CTA) presents a less invasive alternative, it suffers from limited temporal resolution, often resulting in motion artifacts that degrade diagnostic quality. Traditional ECG-based gating methods for CTA inadequately capture cardiac mechanical motion. To address this, we propose a novel multimodal approach that enhances CTA imaging by predicting cardiac quiescent periods using seismocardiogram (SCG) and ECG data, integrated through a weighted fusion (WF) approach and artificial neural networks (ANNs). We developed a regression-based ANN framework (r-ANN WF) designed to improve prediction accuracy and reduce computational complexity, which was compared with a classification-based framework (c-ANN WF), ECG gating, and US data. Our results demonstrate that the r-ANN WF approach improved overall diastolic and systolic cardiac quiescence prediction accuracy by 52.6% compared to ECG-based predictions, using ultrasound (US) as the ground truth, with an average prediction time of 4.83 ms. Comparative evaluations based on reconstructed CTA images show that both r-ANN WF and c-ANN WF offer diagnostic quality comparable to US-based gating, underscoring their clinical potential. Additionally, the lower computational complexity of r-ANN WF makes it suitable for real-time applications. This approach could enhance CTA's diagnostic quality, offering a more accurate and efficient method for CVD diagnosis and management.