Taiwanese Journal of Obstetrics & Gynecology最新文献

{"title":"Fine-tuning Llama-2-13B with AI-generated medical diagnoses: A novel strategy for optimizing ICD coding in gynecologic oncology","authors":"Yu-Ling Liang ,&nbsp;Chiu-Fan Chen ,&nbsp;Meng-Hsing Wu ,&nbsp;Keng-Fu Hsu ,&nbsp;Po-Ting Chang ,&nbsp;Yuan-Jhe Chuang ,&nbsp;Po-Fan Chen","doi":"10.1016/j.tjog.2025.02.006","DOIUrl":"10.1016/j.tjog.2025.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>Given the substantial advancements in Large Language Models (LLMs), this study aimed to explore the effectiveness of using AI-generated medical diagnoses in the fine-tuning of the Llama-2 model, with the objective of optimizing the ICD10 coding process for gynecologic oncology. This study aimed to fine-tune the Llama-2-13B model using AI-generated diagnostic texts based on ICD10 descriptors, focusing on gynecologic oncology for initial validation.</div></div><div><h3>Materials and methods</h3><div>AI-generated diagnostic texts were rigorously confirmed to ensure medical coherence and reliability for fine-tuning. Four models were established: The original Llama-2-13B (Model 1); a model fine-tuned with basic ICD10 codes (Model 2); a model trained with an additional set of 10 AI-generated diagnosis statements per ICD10 code (Model 3); and the forth model trained with an additional set of 20 AI-generated statements per code (Model 4). Validation involved a set of 83 discharge records related to gynecologic oncology, derived from 2415 discharge records collected from January 1, 2020, and June 30, 2023.</div></div><div><h3>Results</h3><div>Validation results for the models showed significant improvement in the accuracy rates and Kappa scores: Model 1 (native Llama-2-13B) had an accuracy of 0.06 and a Kappa score of 0.04, Model 2 achieved 0.24 and 0.19, Model 3 reached 0.90 and 0.89, and Model 4 greatly improved to 0.95 and 0.94.</div></div><div><h3>Conclusion</h3><div>The use of prompts to generate diagnostic descriptions, coupled with AI-generated data for model fine-tuning, resulted in a substantial enhancement in the Llama-2-13B model’s capability to accurately determine ICD diagnostic codes from medical records. This methodology offers a cost-effective strategy, optimizes model accuracy, and underscores the potential for broader applications due to the LLM’s generative capabilities.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 978-984"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing the future: NOTES as the next evolution in surgical practice","authors":"Chyi-Long Lee","doi":"10.1016/j.tjog.2025.07.021","DOIUrl":"10.1016/j.tjog.2025.07.021","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 949-950"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High percentage of NK count in peripheral blood could be an important clue for the case with recurrent implantation failure","authors":"Kuan-Yu Chen,&nbsp;Chung-Jen Chen","doi":"10.1016/j.tjog.2025.04.023","DOIUrl":"10.1016/j.tjog.2025.04.023","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Page 1128"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sFlt-1/PlGF ratio of high-risk pregnant women for preeclampsia compared in singleton, twin, and triplet pregnancies","authors":"Hyeon Ji Kim ,&nbsp;Da Eun Jeong ,&nbsp;Eun Jin Choi ,&nbsp;Na Young Kim ,&nbsp;Min Jung Lee ,&nbsp;Bo Young Choi ,&nbsp;Jee Yoon Park","doi":"10.1016/j.tjog.2025.07.023","DOIUrl":"10.1016/j.tjog.2025.07.023","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the predictive performance of the soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) ratio for preeclampsia across singleton, twin, and triplet pregnancies.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was performed in pregnant women who had sFlt-1/PlGF testing and delivered at Seoul National University Bundang Hospital from March 2019 to December 2023. Maternal characteristics and obstetric outcomes were reviewed, and patients were classified into singleton, twin, and triplet pregnancies. The predictive performance of the sFlt-1/PlGF ratio was assessed using logistic regression and receiver operating characteristic (ROC) curve analysis. Clinically validated cut-off values from the NICE guideline were applied.</div></div><div><h3>Results</h3><div>Among 773 patients (288 singletons, 469 twins, and 16 triplets), preeclampsia was diagnosed in 55.9 %, 29.4 %, and 62.5 % of cases, respectively. In singleton pregnancies, 81.4 % of preeclampsia cases had an sFlt-1/PlGF ratio &gt;38, and 73.3 % had a ratio &gt;85, compared to 68.1 % and 32.6 % in twins. For preeclampsia before 34 weeks, the sFlt-1/PlGF ratio was significantly lower in twin and triplet pregnancies than in singletons (both p &lt; 0.05). The predictive value of the sFlt-1/PlGF ratio was highest in singleton pregnancies, with an area under the curve (AUC) of 0.870 [95 % Confidence interval (CI) = 0.826–0.914] for preeclampsia before 34 weeks, compared to 0.789 [95 % CI = 0.717–0.862] in twins and 0.813 [95 % CI = 0.592–1.033] in triplets. At the predefined cut-off of 85, logistic regression confirmed that an sFlt-1/PlGF ratio &gt;85 was significantly associated with preeclampsia before 34 weeks in singletons (OR = 16.06, 95 % CI = 8.75–29.49, p &lt; 0.001) and still significant in twins (OR = 3.66, 95 % CI = 1.74–7.69, p = 0.001), but not in triplets.</div></div><div><h3>Conclusions</h3><div>While the sFlt-1/PlGF ratio remains a valuable biomarker for preeclampsia prediction in singleton and twin pregnancies, its clinical utility in triplet pregnancies is limited. Further large-scale studies are needed to establish optimal cut-off values for multifetal pregnancies, particularly in triplets, to enhance risk stratification and clinical application.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 996-1003"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Successful management of a pregnancy women with sudden onset of acute pancreatitis: A case report and literature review”","authors":"Fenglin Jiang","doi":"10.1016/j.tjog.2025.07.026","DOIUrl":"10.1016/j.tjog.2025.07.026","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Page 1129"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of a familial 16p13.11 microduplication with no apparently phenotypic abnormality in the family carrier members","authors":"Chih-Ping Chen","doi":"10.1016/j.tjog.2025.09.009","DOIUrl":"10.1016/j.tjog.2025.09.009","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 1102-1103"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma level of cancer stem cell marker aldehyde dehydrogenase 1 (ALDH1) is higher in locally advance cervical cancer","authors":"I Nyoman Budiana ,&nbsp;Pande Kadek Aditya Prayudi ,&nbsp;I Nyoman Bayu Mahendra ,&nbsp;Ni Putu Sri Indrani Remitha ,&nbsp;I Gede Krisna Arim Sadeva ,&nbsp;I Gede Putu Supadmanaba","doi":"10.1016/j.tjog.2025.01.012","DOIUrl":"10.1016/j.tjog.2025.01.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study is aimed to examine the plasma level of ALDH1 in early and locally advanced cervical cancer (CC) patients and to investigate its association with the presence of prognostic factors for recurrence in early stage.</div></div><div><h3>Material and methods</h3><div>This is a cross-sectional study involving 82 patients with CC (33 patients with early stage IB-IIA and 49 patients with locally advance/LACC stage IIB-IVA) who were admitted to Gynecologic Oncology Clinic, Prof. dr. I G.N.G. Ngoerah Hospital Denpasar from September 2022 to April 2023. Prognostic factors for recurrence were recorded from early-stage CC after radical hysterectomy. Pre-treatment plasma level of ALDH1 was determined using ALDH1 ELISA kit (cat. no. E3259Hu).</div></div><div><h3>Results</h3><div>Plasma level of ALDH1 was significantly higher in patients with LACC as compared to early-stage CC (median: 7.0 vs. 4.3 ng/ml, p &lt; 0.001). In early-stage CC, higher plasma level of ALDH1 was also associated with bulkier tumor mass (≥4 cm) (OR 9.2, 95 % CI 1.3–63.1, p = 0.001; threshold value 4.0 ng/ml, AUC 0.821, p-value = 0.002). However, plasma level of ALDH1 was not associated with the histologic subtype, the presence of LVSI, or status of the vaginal margins (p-value &gt;0.05).</div></div><div><h3>Conclusion</h3><div>Increasing plasma level of ALDH1 in CC patients was associated with more advance stage and bulkier tumor mass. Our finding suggests that in the clinical setting, evaluating the plasma level of ALDH1 may aid in assessing the progression of cervical cancer. Future study such as longer-term longitudinal study with larger sample size is needed to explore the association between ALDH1 expression and the clinical response to treatment (e.g., chemoradiation) or risk of recurrence in early-stage CC patients.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 1050-1055"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of a familial 4q35.1q35.2 microdeletion associated with no apparently phenotypic abnormality in the family carrier members","authors":"Chih-Ping Chen","doi":"10.1016/j.tjog.2025.09.008","DOIUrl":"10.1016/j.tjog.2025.09.008","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 1100-1101"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional analysis of PHLDA2 in ovarian cancer: Effects on tumor cell behavior and autophagy","authors":"Ren Xu ,&nbsp;Luyang Su ,&nbsp;Yanan Ren ,&nbsp;Xinjun Li ,&nbsp;Shuo Xu ,&nbsp;Jianzhi Su","doi":"10.1016/j.tjog.2025.08.003","DOIUrl":"10.1016/j.tjog.2025.08.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to explore the effect of PHLDA2 on the biological behavior of ovarian cancer (OC) cell in vitro.</div></div><div><h3>Materials and methods</h3><div>Validation of PHLDA2 mRNA expression based on the analysis from GEPIA was performed on clinical OC tissues using qPCR. SiRNA-mediated knockdown of PHLDA2 was conducted in OC cells to investigate its potential functions. Afterwards, cell proliferation, migration, and invasion were examined. Moreover, the autophagy level was assessed by the expression of LC3 and P62. The associated protein expression was determined using Western blot.</div></div><div><h3>Results</h3><div>PHLDA2 was highly expressed in OC tissues and cells. PHLDA2 knockdown repressed the cell viability and clone-forming ability of OC cells. PHLDA2 knockdown inhibited migration and invasion, as well as the protein expression of MMP-9 and MMP-2 in OC cells. Moreover, LC3 expression was elevated and P62 expression was reduced after PHLDA2 knockdown. Western blot detection further showed decreased phosphorylation levels of PI3K, AKT, and mTOR in PHLDA2-knockdown cells.</div></div><div><h3>Conclusion</h3><div>These findings reveal that knockdown of PHLDA2 suppresses OC cell proliferation, migration and invasion, while promoting autophagy and inactivating the PI3K/AKT/mTOR pathway, suggesting that PHLDA2 may contribute to OC progression.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Pages 1043-1049"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up of a 4-year-old girl with a favorable outcome and a prenatal history of low-level mosaic trisomy 21 at amniocentesis","authors":"Chih-Ping Chen","doi":"10.1016/j.tjog.2025.09.015","DOIUrl":"10.1016/j.tjog.2025.09.015","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 6","pages":"Page 1121"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}