Category: Nevin Manimala

Acad Radiol. 2025 Sep 26:S1076-6332(25)00865-7. doi: 10.1016/j.acra.2025.09.012. Online ahead of print.

ABSTRACT

BACKGROUND: With increasing imaging demands, radiologists face growing workload pressures, often resulting in delays and reduced diagnostic efficiency. Recent advances in artificial intelligence (AI) have introduced tools for automated report generation, particularly in simpler imaging modalities, such as X-rays. However, limited research has assessed AI performance in complex studies such as MRI and CT scans, where report accuracy and clinical interpretation are critical.

OBJECTIVE: To evaluate the performance of a semi-automated AI-based reporting platform in generating radiology reports for complex imaging studies, and to compare its accuracy, efficiency, and user confidence with the traditional dictation method.

METHODOLOGY: This study involved 100 imaging cases, including MRI knee (n=21), MRI lumbar spine (n=30), CT head (n=23), and CT Abdomen and Pelvis (n=26). Consultant musculoskeletal radiologists reported each case using both traditional dictation and the AI platform. The radiologist first identified and entered the key positive findings, based on which the AI system generated a full draft report. Reporting time was recorded, and both methods were evaluated on accuracy, user confidence, and overall reporting experience (rated on a scale of 1-5). Statistical analysis was conducted using two-tailed t-tests and 95% confidence intervals.

RESULTS: AI-generated reports demonstrated significantly improved performance across all parameters. The mean reporting time reduced from 6.1 to 3.43 min (p<0.0001) with AI-assisted report generation. Accuracy improved from 3.81 to 4.65 (p<0.0001), confidence ratings increased from 3.91 to 4.67 (p<0.0001), and overall reporting experience favored using the AI platform for generating radiology reports (mean 4.7 vs. 3.69, p<0.0001). Minor formatting errors and occasional anatomical misinterpretations were observed in AI-generated reports, but could be easily corrected by the radiologist during review.

CONCLUSION: The AI-assisted reporting platform significantly improved efficiency and radiologist confidence without compromising accuracy. Although the tool performs well when provided with key clinical findings, it still requires expert oversight, especially in anatomically complex reporting. These findings support the use of AI as a supportive tool in radiology practice, with a focus on data integrity, consistency, and human validation.

PMID:41015710 | DOI:10.1016/j.acra.2025.09.012

ISA Trans. 2025 Sep 16:S0019-0578(25)00517-8. doi: 10.1016/j.isatra.2025.09.012. Online ahead of print.

ABSTRACT

The present study explores the stability problem of nonlinear time-delay systems subject to delayed impulses. Specifically, this paper addresses the dual aspects of both delayed impulsive control and perturbation issues on nonlinear systems with time-varying delays. In particular, by employing Halanay-type inequality techniques, we establish some sufficient criteria to ensure the exponential stability of the aforementioned time-delay systems. Moreover, we remove previous restrictions on the relative sizes of time delays in both continuous dynamics and impulses. It is shown that, under certain conditions, the delays in impulses may be arbitrarily finite and even exceed the duration of the impulsive intervals, but such delayed impulses solely affect the convergence rate of the addressed system without undermining its stability. Furthermore, this study’s theoretical results are applied to the stabilization of sewage treatment systems and the impulsive synchronization of Chua’s circuits. Two illustrative examples are given to demonstrate the effectiveness and validity of the derived results.

PMID:41015707 | DOI:10.1016/j.isatra.2025.09.012

Vet Anaesth Analg. 2025 Sep 8:S1467-2987(25)00218-1. doi: 10.1016/j.vaa.2025.09.002. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the anesthetic and analgesic protocols and techniques used in cats undergoing elective neutering in Ontario, Canada and to obtain veterinarians’ opinions regarding their choices.

STUDY DESIGN: Cross-sectional survey.

ANIMALS: Client-owned cats undergoing elective neutering in Ontario, Canada.

METHODS: A confidential mixed-mode survey about anesthetic and analgesic management practices used in client-owned cats undergoing elective neutering was distributed to veterinarians (n = 2921) working in companion animal practice in Ontario. Descriptive statistics were generated. Logistic regression was used to identify associations between demographic factors and protocols. Chi-square analysis was used to compare protocols used in cats undergoing ovariohysterectomy (OVH) versus castration.

RESULTS: Four hundred and thirty-one individuals (14.8%) completed the survey. Most respondents used a sedative before induction of anesthesia (OVH: 368/387; 95.1% and castration 360/381; 94.5%) and gave an opioid and/or a non-steroidal anti-inflammatory drug perioperatively (OVH: 379/381; 99.7% and castration: 379/382; 99.2%). Respondents placed an intravenous catheter and performed orotracheal intubation more frequently in cats undergoing OVH (catheter: 366/387; 94.6% and intubation: 379/386; 98.2%) compared with castration (catheter: 219/380; 57.6% and intubation: 166/375; 44.3%) (p < 0.001). Respondents more closely followed current anesthesia guidelines relative to their peers if they: graduated during or after 2000, were women, performed 1-10 OVHs per week, worked in an urban setting, in a companion animal practice, with three or more veterinarians or three to five registered veterinary technicians. Most respondents were very satisfied or satisfied with their current anesthetic drug protocol for cats undergoing elective OVH (396/412; 96.1%) and castration (386/413; 93.4%).

CONCLUSIONS AND CLINICAL RELEVANCE: Most veterinarians in Ontario who participated in the survey follow many of the current guidelines regarding anesthetic and analgesia management practices for cats undergoing elective neutering. Anesthetic protocols varied with respondent demographics; however, most respondents were satisfied with their choices.

PMID:41015686 | DOI:10.1016/j.vaa.2025.09.002

J Racial Ethn Health Disparities. 2025 Sep 27. doi: 10.1007/s40615-025-02660-x. Online ahead of print.

ABSTRACT

BACKGROUND: The sexual partner’s HIV status trajectory of young men who have sex with men (YMSM) has a significant impact on HIV prevention. There are some potential associations between adverse experiences and HIV status trajectories of sexual partners among YMSM. This study aimed to examine the trajectory of HIV status in sexual partners and to investigate effects of adversity experiences on the sexual partner’s HIV status trajectories.

METHOD: Study data (N = 411) were derived from a 5-year YMSM cohort conducted in Central China from 2017 to 2021. The adversity experiences, including adverse childhood experiences (ACEs), sexual minority discrimination, everyday discrimination, and internalized discrimination, were measured at baseline. Other psychosocial variables including resilience and social support were measured at baseline. The HIV status of YMSM partners was examined at baseline and each follow-up survey. The group-based trajectory modeling (GBTM) was used to derive trajectories of partners’ HIV status, and the multinomial logistic regression was used to examine the association between adversity experiences and the trajectories.

RESULTS: The GBTM categorized the HIV status of YMSM sexual partners into four groups, including Group I (low risk), Group II (risk reduction), Group III (increased risk) and Group IV (high risk). The ACEs among YMSM were associated with a higher risk of their sexual partners being categorized into Group III (OR [95% CI] = 1.353 [1.012, 1.808], p = 0.041) and Group IV (OR [95% CI] = 1.268 [1.023, 1.571], p = 0.030). Among YMSM, older age (OR [95% CI] = 1.245 [1.041, 1.489], p = 0.016) and lower education level (OR [95% CI] = 4.053 [1.710, 9.606], p < 0.001) were associated with a higher risk of their sexual partners being categorized into Group IV. Other adversity experiences and psychosocial variables did not show significant impacts on the trajectories.

CONCLUSIONS: ACEs among YMSM exerted a significant impact on the HIV status trajectories of their sexual partners. Our findings underscore that YMSM with a history of ACEs were more likely to have sexual partners in higher-risk HIV status groups, which implies a greater potential for HIV transmission within their sexual networks.

PMID:41015657 | DOI:10.1007/s40615-025-02660-x

Pediatr Res. 2025 Sep 27. doi: 10.1038/s41390-025-04411-4. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Limited post-menstrual age (PMA) stratified data are available for the morbidities and length of stay (LOS) for the largest group of preterm infants. We investigated the incidence, types and interactions of morbidities that prolong the LOS at 33-36 weeks PMA.

METHODS: Electronic and bedside charts of 1209 infants were visually reviewed. Major outcomes included respiratory support, achievement of gavage-free feeding and maternal/infant variables associated with shorter/longer than Median LOS. Fisher’s exact tests/ANOVA/logistic regression were used for statistical analyses.

RESULTS: The Median (IQR, Range) of the LOS were distinct at each and even within PMA between 33 and 36 weeks (P < 0.001). 63% of infants born at 33-weeks received respiratory support vs. 46, 39 and 7% born at 34-, 35- and 36-weeks, respectively (P < 0.001). Multiple births, BW within a given PMA, SGA status, respiratory support, RDS, delayed gavage-free feeds and birthplace were associated with longer than Median LOS at each PMA (P ≤ 0.04). Achievement of gavage-free feeding was consistently the main determinant of early discharge home across all PMAs (P < 0.001).

CONCLUSIONS: Our newer approach in identifying relationship among morbidities in infant born at 33-36 weeks PMA fills important knowledge gaps. These data will facilitate evidence-based clinical care, educational-needs, health care resource planning and parental counseling.

IMPACT: Either grouped and/or fragmented data are available for morbidities in infants born between 33 and 36 weeks post-menstrual age (PMA), which represents >80% of all preterm infants. We demonstrate that respiratory insufficiency, type of respiratory support, delayed gavage-free feedings and length of stay (LOS) are inter-dependent and PMA-specific. Using a novel approach, we provide new significant data that identify clinical variables, associated with shorter and longer than Median LOS at each and even within a given PMA. Comprehensive analysis of morbidities suggests that preterm infants should neither be grouped, nor PMA alone be used for discharge planning and parental counseling.

PMID:41015648 | DOI:10.1038/s41390-025-04411-4

Intern Emerg Med. 2025 Sep 27. doi: 10.1007/s11739-025-04114-y. Online ahead of print.

NO ABSTRACT

PMID:41015639 | DOI:10.1007/s11739-025-04114-y

Musculoskelet Surg. 2025 Sep 27. doi: 10.1007/s12306-025-00926-5. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the radiographic and functional outcomes of scaphoid fractures and nonunions treated with volar locked plate fixation, with or without autologous bone grafting, and to explore whether graft use was associated with improved consolidation or function.

METHODS: This retrospective cohort study included 19 adult patients who underwent surgical treatment with volar anatomical plates for scaphoid fractures or nonunions. Radiographic union was assessed at 3, 6, and 12 months. Functional outcomes were measured using the QuickDASH score preoperatively and at 12 months postoperatively. Graft use was determined intraoperatively based on defect characteristics. Statistical analyses included non-parametric tests and multivariable models.

RESULTS: The mean patient age was 24.5 ± 5.4 years, and 94.7% were male. Scaphoid nonunion was present in 11 patients (57.9%), and autologous bone grafting was performed in 15 (78.9%). Radiographic consolidation was achieved in 94.7% of cases at 12 months. QuickDASH scores improved significantly (mean change: 20.6 points; p < 0.001). There were no significant differences in union or functional outcomes between grafted and non-grafted patients (p = 1.000 and p = 0.115, respectively). Interestingly, patients with nonunions demonstrated significantly better postoperative function than those with acute fractures (p = 0.034), although this did not exceed the minimal clinically important difference. Multivariable analysis failed to identify predictors of union or function, explaining only 37% of the variance.

CONCLUSION: Volar locked plate fixation provides high union rates and significant functional improvement in scaphoid fractures and nonunions. Bone grafting did not confer additional benefit, supporting selective rather than routine use. Further studies are warranted to clarify prognostic factors and optimize treatment strategies.

PMID:41015638 | DOI:10.1007/s12306-025-00926-5

J Therm Biol. 2025 Sep 23;133:104281. doi: 10.1016/j.jtherbio.2025.104281. Online ahead of print.

ABSTRACT

Knee osteoarthritis is a degenerative joint disease, causing pain and reduced mobility, especially in older adults. Current imaging methods like CT, MRI, and bone scintigraphy mainly reveal structural changes, but have limitations such as radiation exposure, high cost, and limited repeatability. In contrast, infrared thermal imaging is a non-invasive, radiation-free technique that detects temperature changes linked to joint inflammation. It offers real-time, repeatable results, making it useful for monitoring and guiding timely interventions. This cross-sectional study was conducted on 56 participants diagnosed with knee osteoarthritis to evaluate the role of infrared thermal imaging in assessment and immediate monitoring. Thermal imaging measurements were obtained from both affected and contralateral knees using standardized protocols. Clinical assessment included Kellgren-Lawrence grading, Western Ontario and McMaster Universities Osteoarthritis Index, and Visual Analogue Scale pain scores. Statistical analysis included receiver operating characteristic curve analysis, correlation analysis, and diagnostic performance metrics. Result showed that the mean temperature difference between affected and contralateral knees was 1.80 ± 0.64 °C (p < 0.001, Cohen’s d = 2.81). Thermal temperature differences showed significant correlation with Kellgren-Lawrence grade severity (r = 0.442, p < 0.001). Using an optimal cutoff of 1.16 °C, thermal imaging demonstrated 95 % sensitivity and 43 % specificity for detecting clinically significant osteoarthritis. The area under the receiver operating characteristic curve was 0.65. This research concluded that Infrared thermal imaging provides a non-invasive method for detecting knee osteoarthritis with high sensitivity. The technique shows promise as an adjunctive diagnostic tool, particularly for screening and monitoring disease progression.

PMID:41014663 | DOI:10.1016/j.jtherbio.2025.104281

Physiother Res Int. 2025 Oct;30(4):e70114. doi: 10.1002/pri.70114.

ABSTRACT

BACKGROUND AND PURPOSE: Assessment of physiotherapy undergraduate students in clinical placement is academically important and holds practical value. This study aimed to translate the Assessment of Physiotherapy Practice (APP) tool, which is widely used for this purpose, into Turkish and to verify the factor validity and examine the reliability of this version using a cross-sectional design on senior physiotherapy students.

METHODS: The APP and performance indicators were translated into Turkish in accordance with the recommended protocol. Exploratory and confirmatory factor analyses were conducted using scale data from 100 students. For reliability analyses, 10 clinical supervisors from a Turkish university assessed 63 students using the Turkish version of the Assessment of Physiotherapy Practice (APP-TR) tool. Supervisors performed the APP-TR assessment for each student at week 3 and at the end of the 6-week clinical placement, yielding a score for analysis.

RESULTS: In both assessments, the scale demonstrated high levels of internal consistency (Cronbach’s α = 0.961 for the first assessment, 0.959 for final assessment). Two factors were identified by exploratory factor analysis explaining 65.84% of the total variance and a two-factor model was confirmed to fit by confirmatory factor analysis. Test-retest reliability was assessed by ICC and was high for all subheadings and total score. For all items, the close agreement was at least 98.41% and the exact agreement was at least 88.89% in the percentile analysis between the two assessments.

DISCUSSION: The results of this study suggest that the APP-TR is a reliable and valid tool for evaluating final year physiotherapy students in a clinical placement in Turkey.

PMID:41014636 | DOI:10.1002/pri.70114

Probl Endokrinol (Mosk). 2025 Sep 14;71(4):77-82. doi: 10.14341/probl13545.

ABSTRACT

BACKGROUND: To optimize androgen replacement therapy for male hypogonadism to improve reproductive prospects.

AIM: To compare the effectiveness of restoring the quality of ejaculate in men receiving androgen replacement therapy (AZT) and patients receiving course combination therapy with testosterone and chorionic gonadotropin (AZT/HG).

MATERIALS AND METHODS: In observational prospective study was included 53 men observed at The National Medical Research Center for Endocrinology and AZT (n=19) or AZT/HG (n=34) more than 5 years, followed by stimulating gonadotropin therapy. The qualitative parameters of ejaculate were evaluated in all patients. The basic level of statistical significance was p&lt;0,05.

RESULTS: The patient groups were comparable in age, BMI, duration of therapy used, type of testosterone preparation, as well as the etiology of hypogonadism. Sperm concentration in the AZT group there was a statistically significant negative dynamics, while in the ART/HG group, there were no statistically significant differences in the dynamics of sperm concentration. Statistically significant differences in the value of sperm concentration change were revealed. In both groups was observed statistically significant negative dynamics for sperm motility and morphology. There were no statistically significant differences in the value of changes motility and sperm morphology in both studied groups.

CONCLUSION: Course combination therapy with testosterone and chorionic gonadotropin is characterized by better results for sperm concentration restoration compared with androgenic replacement therapy. For the restoration of sperm motility and morphology both methods do not show satisfactory results.

PMID:41014618 | DOI:10.14341/probl13545