Category: Nevin Manimala

J Neuroophthalmol. 2025 Aug 28. doi: 10.1097/WNO.0000000000002393. Online ahead of print.

ABSTRACT

BACKGROUND: Multimodal artificial intelligence (AI) models have recently expanded into video analysis. In ophthalmology, one exploratory application is the automated detection of extraocular movement (EOM) disorders. This proof-of-concept study evaluated the feasibility of using Gemini 2.0 to recognize EOM abnormalities, identify the affected eye, and recognize specific movement limitations from publicly available, real-world clinical videos.

METHODS: We retrospectively collected 114 YouTube videos of EOM disorders, including cranial nerve (CN) palsies, internuclear ophthalmoplegia (INO), supranuclear disorders, nystagmus, and ocular myasthenia gravis (MG), alongside 15 control videos demonstrating normal EOMs. Videos were trimmed to include only the pertinent clinical examinations, and audio was removed to avoid diagnostic cues. Using a standardized zero-shot prompt, Gemini 2.0 analyzed each video via the Google AI Studio platform. Gemini 2.0 was evaluated based on its ability to provide the correct diagnosis, identify the affected eye, and recognize the specific movement limitation (if any). Descriptive statistics, Spearman correlations, and comparative analyses were used to assess performance.

RESULTS: Gemini 2.0 correctly identified the primary diagnosis in 43 of 114 videos, yielding an overall diagnostic accuracy of 37.7%. Diagnostic performance varied by condition, with the highest accuracies observed in third nerve palsy (81.1%), INO (80.0%), sixth nerve palsy (66.7%), and ocular MG (20.0%), whereas normal EOMs were correctly classified in 93.3% of cases. In misclassified cases, the correct diagnosis appeared in the differential diagnosis in 15.5% of instances. Laterality was correctly identified in 26.5% of eligible cases overall, 73.1% among correctly diagnosed cases vs. 9.6% in misclassified ones. Similarly, movement limitations were accurately identified in 30.3% of eligible cases overall, with a marked increase to 88.5% accuracy in correctly diagnosed cases compared to 9.6% in misclassified cases. Longer videos moderately correlated with longer processing time (ρ = 0.55, P < 0.001). Significant correlations were observed between correct diagnosis and correct laterality identification (ρ = 0.45, P < 0.001), correct diagnosis and correct movement limitation identification (ρ = 0.61, P < 0.001), and laterality and movement limitation (ρ = 0.51, P < 0.001). Processing time averaged 11.0 seconds and correlated with video length (ρ = 0.55, P < 0.001).

CONCLUSIONS: This proof-of-concept study demonstrates the feasibility of using Gemini 2.0 for automated recognition of EOM abnormalities in clinical videos. Although performance was stronger in overt cases, overall diagnostic accuracy remains limited. Substantial validation on standardized, clinician-annotated datasets is needed before clinical application.

PMID:40867040 | DOI:10.1097/WNO.0000000000002393

Crit Care. 2025 Aug 27;29(1):387. doi: 10.1186/s13054-025-05612-3.

ABSTRACT

BACKGROUND: As global populations age, the number of nonagenarians admitted to intensive care units (ICUs) is rising. Frailty, a multidimensional syndrome marked by diminished physiological reserves, has been associated with adverse outcomes in older ICU patients. However, evidence remains limited regarding its prognostic significance in nonagenarians, who represent a unique and rapidly growing subset of critically ill patients. This study aimed to evaluate the impact of frailty on in-hospital mortality and length of stay among nonagenarian ICU patients in Australia and New Zealand.

METHODS: We conducted a retrospective cohort study using data from the ANZICS Adult Patient Database, including nonagenarians admitted to 211 ICUs between 2017 and 2023 with documented Clinical Frailty Scale (CFS) scores. Patients were classified as frail (CFS ≥ 5) or non-frail (CFS < 5). Propensity score matching (1:1) was applied to adjust for confounders including age, sex, illness severity, admission type, and comorbidities. Outcomes included ICU and hospital mortality, and ICU and hospital lengths of stay (LOS). Statistical analyses included multivariable Cox regression, log-transformed logistic regression, and Fine Gray competing risks models.

RESULTS: Among 16,439 nonagenarians, 8220 patients were propensity matched. In the matched cohort, frailty was independently associated with increased hospital mortality (adjusted HR 1.352, 95% CI 1.192-1.534, p < 0.001) and ICU mortality (adjusted HR 1.242, 95% CI 1.044-1.440, p = 0.017). Each one-point increase in CFS score was associated with a 9% increase in the odds ratio of ICU mortality (OR 1.09, 95% CI 1.01-1.18, p = 0.026) and a 19% increase in the odds ratio of hospital mortality (OR 1.19, 95% CI 1.10-1.28, p < 0.001). Frailty was not associated with ICU LOS after adjustment (p = 0.739) but predicted prolonged hospital LOS (adjusted β = 1.051, 95% CI 1.033-1.070, p < 0.001).

CONCLUSIONS: Frailty is a strong, independent predictor of hospital mortality and prolonged hospitalization in critically ill nonagenarians, even after adjusting for illness severity and comorbidities. These findings support the incorporation of frailty assessment into early risk stratification and clinical decision-making in ICU settings, to facilitate goal-concordant care and optimize resource allocation for the very elderly.

PMID:40867013 | DOI:10.1186/s13054-025-05612-3

Nutr Metab (Lond). 2025 Aug 27;22(1):102. doi: 10.1186/s12986-025-00999-w.

ABSTRACT

BACKGROUND: The association of sugar sweetened beverages (SSBs) and coronary artery disease (CAD) has not been well-established in Asians, where SSBs are the leading ultra-processed food product.

OBJECTIVE: We aim to examine the association between SSBs and premature CAD (PCAD) in Iranian adults.

DESIGN: Case-control.

PARTICIPANTS: A multi-centric study of Iranians including 2006 PCAD and 1131 healthy individuals as control group.

MAIN OUTCOME MEASURES: Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). SSBs consist of artificial juice and sugar -sweetened drinks. The PCAD was determined based on the results of angiography and the occlusion percent of vessels.

STATISTICAL ANALYSIS: The odds of PCAD across the quartiles of SSBs were assessed by binary logistic regression.

RESULTS: The mean (SD) age of participants and SSB consumption was 51.5 years and 46.9 g/d, respectively. In the fully-adjusted model, compared with participants in the first quartile, those in the fourth quartile had higher risk of PCAD (OR = 1.50, 95% CI: 1.12, 2.00; P trend = 0.044). Consistently, SSB consumption was directly associated with the severity of PCAD. The higher SSB consumption, the greater risk for the severe PCAD (OR Q4 vs. Q1 = 1.34, 95% CI: 1.06, 1.68; P < 0.001).

CONCLUSION: This study demonstrated that higher consumption of SSB might be associated with higher risk of PCAD. However, more prospective cohort studies are necessary to confirm this association.

PMID:40867011 | DOI:10.1186/s12986-025-00999-w

BMC Psychol. 2025 Aug 27;13(1):971. doi: 10.1186/s40359-025-03350-3.

ABSTRACT

BACKGROUND: Physical activity has numerous physical and psychological benefits for university students. The present study aims to analyze the influence of physical activity intensity on the variables of physical pain and hyper mental activity.

METHOD: A comparative, descriptive and exploratory design was used in this study. The sample comprises 1900 physical therapy undergraduate students, who were recruited from several universities in the south of Spain using convenience sampling. The International Physical Activity Questionnaire-Short Form, Chronic Pain Assessment Questionnaire and Mental Hyperactivity Questionnaire were used. A structural equation model has been developed. The proposed model analyzes the relationship between physical activity, bodily pain and hyper mental activity.

RESULTS: The model shows satisfactory fit across the different indices (Chi² = 2.853; Df = 5; IFI = 0.948, CFI = 0.903; NFI = 0.900; RMSEA = 0.069). Statistically significant differences were observed in the effect of physical activity intensity on hyper mental activity (p < 0.05). There are also significant differences of hyper mental activity on bodily pain between groups (p < 0.05). A relationship of hyper mental activity on bodily pain was observed for participants performing light-intensity physical activity (β = 0.642). Regarding the effect of physical activity on physical pain, no statistically significant differences between groups were found (p > 0.05). A positive effect between both variables was observed for moderate intensity (β = 0.006).

CONCLUSIONS: Physical activity has a very weak effect on mental hyperactivity, regardless of its intensity. On the other hand, mental hyperactivity significantly influences body pain. No significant effect was found between physical activity and body pain. In terms of applicability, strategies should be designed that integrate physical activity and emotional regulation strategies to prevent pain and reduce mental hyperactivity.

PMID:40867003 | DOI:10.1186/s40359-025-03350-3

Diabetol Metab Syndr. 2025 Aug 27;17(1):359. doi: 10.1186/s13098-025-01929-9.

ABSTRACT

BACKGROUND: The gut-retina axis, an emerging area of research, has uncovered the bidirectional link between the intestines and retina, offering new insights into ophthalmic disease management. Diabetic retinopathy (DR), a common diabetes complication with a digestive-related connection, lacks large-sample retrospective studies on the impact of gut microbiota-related diets. The association between the Dietary Index for Gut Microbiota (DI-GM) and DR requires further investigation.

METHODS: 1,285 diabetic patients from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2018 were analyzed. DI-GM, based on 14 foods or nutrients intake, served as the exposure variable. Associations were assessed via Spearman correlation, weighted logistic regression, restricted cubic spline (RCS) analysis, and subgroup analyses.

RESULTS: Spearman analysis revealed predominantly inverse correlations among DI-GM components. After adjusting for confounders, each 1-point increase in DI-GM was associated with a 12% lower DR risk (OR = 0.88, 95% CI 0.78-0.99, P = 0.039). The Q4 DI-GM exhibited a 67% reduced DR risk compared to Q1 (OR = 0.33, 95%CI 0.12-0.88, P = 0.028). RCS analysis identified a nonlinear dose-response relationship (P-nonlinearity < 0.01), with rapid risk reduction at DI-GM < 4 and diminishing returns thereafter. Subgroup analyses indicated that most subgroup associations showed no statistically significant differences (interaction P > 0.05), except for participants with long-standing diabetes, without hypertension and BMI < 25 (OR = 0.55, 95%CI: 0.33-0.93, P = 0.03).

CONCLUSIONS: Higher DI-GM scores are linked to lower DR risk, supporting dietary optimization (e.g., increased whole grains/vegetables, reduced processed meat) as a potential strategy for DR prevention through gut microbiota modulation. These findings advance gut-retina axis theory and provide actionable dietary guidelines for diabetes complications.

PMID:40867002 | DOI:10.1186/s13098-025-01929-9

Mol Neurodegener. 2025 Aug 27;20(1):93. doi: 10.1186/s13024-025-00882-5.

NO ABSTRACT

PMID:40866991 | DOI:10.1186/s13024-025-00882-5

Nutr Metab (Lond). 2025 Aug 27;22(1):101. doi: 10.1186/s12986-025-01000-4.

ABSTRACT

BACKGROUND: The coexistence of sarcopenia and obesity has been established as a pivotal factor driving the pathological progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study systematically evaluates the prevalence and risk of MASLD in patients with sarcopenic obesity (SO).

METHOD: A comprehensive literature search was conducted in PubMed, Cochrane Library, EMBASE, Web of Science and SCOPUS up to March 2025. All studies investigating the association between SO and MASLD were included in this meta-analysis. Two independent reviewers performed screening and data extraction. ORs and 95% CIs were calculated using random effect models. Subgroup analysis was used to identify the sources of heterogeneity. Heterogeneity was assessed using Cochran’s Q test and quantified via the I² statistic. Quality assessment and publication bias (by Funnel plots and Egger’s test) evaluation were also performed.

RESULTS: Thirteen studies involving 35,373 SO patients (from six countries) were included after screening. Odds ratios (ORs) of the included studies were combined by random effect model. The pooled results revealed that 63.4% of SO patients had MASLD. Compared to non-SO individuals, SO was significantly associated with an increased risk of MASLD (OR = 4.45, 95% confidence interval (CI): 2.57-7.72, P < 0.001). Females exhibited a higher MASLD risk than males (OR = 4.22, 95% CI: 2.10-8.50 vs. OR = 7.56, 95% CI: 2.39-23.92). Substantial heterogeneity was observed across pooled results and subgroups. Additionally, SO patients had a 2.34-fold higher risk of MASLD-related fibrosis than non-SO individuals (OR = 2.34, 95% CI: 1.78-3.08, P < 0.001).

CONCLUSION: SO may be closely associated with a high prevalence of MASLD and accelerated fibrosis progression. These findings highlight SO as a potential high-risk population for MASLD, underscoring the need for targeted screening and intervention strategies. However, more high-quality research with unified definitions and different races is needed.

PMID:40866987 | DOI:10.1186/s12986-025-01000-4

Eur J Med Res. 2025 Aug 27;30(1):814. doi: 10.1186/s40001-025-03097-y.

ABSTRACT

PURPOSE: This meta-analysis aimed to evaluate the incidence and risk factors of intraoperative acquired pressure injuries (IAPIs) in open heart surgical patients, focusing exclusively on prospective studies to address gaps in the existing literature.

METHODS: A systematic search was conducted across PubMed, Embase, and Web of Science up to January 2025. Data on incidence and risk factors were extracted, and statistical analyses were performed using random-effects models. Heterogeneity was assessed using I² statistics; publication bias was assessed by funnel plot and Egger’s test.

RESULTS: Ten prospective studies involving 1311 patients were included. The pooled incidence of IAPIs was 25% (95% CI 16%-35%), with high heterogeneity (I² = 94%). Sensitivity analysis confirmed stable results. Significant risk factors included prolonged surgical duration (SMD: 1.76, 95% CI 0.10-3.42, I² = 98%), advanced age (SMD: 0.30, 95% CI 0.14-0.46, I² = 0%), female sex (RR: 1.36, 95% CI 1.03-1.80, I² = 53%), and perioperative corticosteroid use (RR: 3.63, 95% CI 1.64-8.06, I² = 0%).

CONCLUSION: This study assessed the incidence of IAPIs in open heart surgical patients and identifies key risk factors, including prolonged surgical duration, advanced age, female sex, and perioperative corticosteroid use. However, the results should be interpreted with caution due to the high heterogeneity observed across studies. Future research should focus on larger, multicenter prospective studies to provide more robust evidence.

PMID:40866984 | DOI:10.1186/s40001-025-03097-y

Stem Cell Res Ther. 2025 Aug 27;16(1):463. doi: 10.1186/s13287-025-04601-1.

ABSTRACT

Recent evidence suggests that EpCAM and CD44 could serve as diagnosis or prognosis markers in pancreatic cancer (PC). In this meta-analysis, we evaluated their associations with clinicopathologic features. Specifically, we compared immunohistochemical-positive and -negative PC patients for T stage (T3-T4 vs. T1-T2), N stage (N1 vs. N0), M stage (M1 vs. M0), tumor grade (well/moderately vs. poorly differentiated), UICC Stage (III, IV vs. I, II), and overall survival (OS). The diagnostic meta-analysis was performed analysing the pooled sensitivity and specificity and evaluating overall accuracy to indicate the diagnostic efficacy of the markers. The protocol of this systematic review and meta-analysis was registered on the PROSPERO website under the registration number of CRD42024568390. A systematic search of PubMed, Scopus, and ISI Web of Science was conducted on January 30th, 2025. The statistical analysis was performed using the Review Manager 5.4 software and R language (R package Mada and Metafor). The quality of the studies included was assessed using the Newcastle-Ottawa scale and the QUADAS-2 tool. Data from relevant studies were independently screened and extracted using Rayyan, by at least two authors. A total of 19 studies were eligible (9 studies for EpCAM, 9 studies for CD44, and 2 studies for both EpCAM and CD44), comprising a total of 1370 patients. The diagnostic meta-analysis demonstrated moderate accuracy for EpCAM (AUC, 95% CI of 0.802, 0.69-0.96). A statistically significant association was found for CD44 expression and T-status (OR = 2.04, 95%CI = 1.18-3.51), or N-stage (OR = 2.68, 95%CI = 1.86-3.85), or TNM stage (OR = 3.79, 95%CI = 2.14-6.71). CD44v6 overexpression predicted worse OS (HR = 2.33, p < 0.00001), while EpCAM + CD44 + co-expression was prognostic (HR = 2.02, p = 0.02). Heterogeneity was not observed among the studies included, but further research is warranted to better understand the clinical implications of these markers’ positivity in PC diagnosis and prognosis.

PMID:40866982 | DOI:10.1186/s13287-025-04601-1

Orphanet J Rare Dis. 2025 Aug 27;20(1):458. doi: 10.1186/s13023-025-03993-w.

ABSTRACT

BACKGROUND: Human umbilical cord mesenchymal stem cells (HUMSCs) are effective therapies for inflammatory bowel disease. However, the mechanisms remain unresolved. We found HUMSCs express CD126 (IL-6 receptor), which indicated CD126 sub-populations might show a distinct response to inflammation. In the present study, we explored whether CD126 is a critical molecule for HUMSCs in regulating inflammation.

METHODS: We assessed the regulatory effects of CD126 high (CD126^hi) on the T lymphocyte subpopulations and related cytokines in the dextran sulfate sodium (DSS)-induced colitis model. The effect of CD126^hi was evaluated by Hematoxylin and Eosin (H&E) staining, fluorescence-activated cell sorting (FACS), and enzyme-linked immunosorbent assay (ELISA) analyses. Statistical significance was typically determined using Student’s t-test or one-way analysis of variance (ANOVA) with Tukey test.

RESULTS: The disease symptoms were markedly ameliorated and the interleukin-6 (IL-6), interleukin-17 (IL-17), interferon-γ (IFN-γ), Tumor necrosis factor-α (TNF-α), and interleukin-4 (IL-4) levels were significantly reduced in DSS-treated mice administered with CD126^hi HUMSCs but not in DSS-treated mice administered with CD126 low (CD126^lo) HUMSCs. Intriguingly, CD126^hi HUMSCs significantly increased the levels of transforming growth factor-β (TGF-β1) and interleukin-10 (IL-10) in DSS-treated mice, accompanied by an increase in regulatory T cells (Treg cells). In vitro experiments showed that CD126^hi HUMSCs secreted TGF-β1 in response to IL-6 stimulation, while CD126^lo HUMSCs were latent in the inflammatory environment. We considered that TGF-β1 secreted by CD126^hi HUMSCs regulated the balance of Treg cells and thus promoted the recovery of murine colitis.

CONCLUSION: Our results revealed a mechanism wherein CD126^hi HUMSCs function as inflammatory sensors and secrete anti-inflammatory cytokines to rebalance the population of T cells. This study shed light on the potential therapeutic application of CD126^hi HUMSCs for inflammatory diseases such as inflammatory bowel disease.

PMID:40866981 | DOI:10.1186/s13023-025-03993-w