Isr J Health Policy Res. 2025 Jul 14;14(1):43. doi: 10.1186/s13584-025-00702-7.
NO ABSTRACT
PMID:40653492 | DOI:10.1186/s13584-025-00702-7
J Clin Neurosci. 2025 Jul 12;140:111467. doi: 10.1016/j.jocn.2025.111467. Online ahead of print.
ABSTRACT
Prolapsed intervertebral disc (PIVD) of the lumbar region is a major cause of low back pain, accounting for a large proportion of morbidity and healthcare expenditure. While MRI is the gold standard for diagnosis, its unavailability and high cost in developing nations require a clinical method for the identification of PIVD. Artificial intelligence (AI) based diagnostic systems provide an alternative, but current models are based largely on radiological rather than clinical parameters. Therefore, this study aims to identify key clinical determinants for diagnosing lumbar PIVD, forming the basis for an AI-driven diagnostic model. Prospective cross-sectional research was performed between October 2023 and January 2024 at a Haryana-based tertiary care hospital. The three-stage methodology adopted for the study included: (1) thorough review of the literature, (2) patient interviews (n = 12) with established lumbar PIVD, and (3) a survey of expert opinion (n = 12) among physiotherapists, neurologists, and neurosurgeons with special interest in spinal disorders. The data were analyzed based on frequency distribution and descriptive statistics. Clinical determinants were grouped into four categories: demographic (age 25-50 years), anthropometric (height, Body Mass Index > 25 kg/m2), symptomatic (low back pain, radiating pain, neurological deficits, abnormal posture, limited lumbar range of motion), and occupational (sitting > 6 h, heavy lifting). Expert verification attested to their relevance in PIVD diagnosis. The identification of these clinical determinants allows for a transition from MRI-dependent diagnosis to AI-assisted clinical evaluation. Incorporating these tested parameters within AI algorithms can improve diagnostic accuracy, maximize patient management, and decrease the dependency on expensive imaging methods.
PMID:40652579 | DOI:10.1016/j.jocn.2025.111467
Clin Exp Dent Res. 2025 Aug;11(4):e70172. doi: 10.1002/cre2.70172.
ABSTRACT
OBJECTIVES: The relationship between tinnitus and temporomandibular disorders (TMD) over the years has continued to be widely debated in literature and not yet fully understood. Several causes have been associated with tinnitus including altered mandibular posture and disorders at the muscle, joint and periodontal receptors. This study aimed to investigate masseter and temporalis muscle activity in patients with TMD with and without somatosensory tinnitus (ST).
MATERIAL AND METHODS: A total of 105 patients (mean age 50.49 ± 11.7 years) with TMD classified according to Axis I DC/TMD diagnostic criteria were enrolled and then divided into two groups: 53 subjects with ST and 52 without ST. Electromyographic and kinesiographic instrumental examinations were used for data collection. Statistical analyses, including Levene’s test and independent t-test, were performed to evaluate and compare muscle activity abnormalities between the two groups.
RESULTS: The study showed a higher incidence of abnormal masticatory muscle activity in habitual resting position in TMD without ST patients compared to those with TMD and ST. A statistically significant difference in muscle activity between the two groups was observed.
CONCLUSIONS: The results suggest a potential link between masticatory muscle activity and tinnitus in TMD patients. Neuroplasticity may play a role in modulating the psychoacoustic characteristics of tinnitus.
PMID:40652553 | DOI:10.1002/cre2.70172
J Eval Clin Pract. 2025 Aug;31(5):e70194. doi: 10.1111/jep.70194.
ABSTRACT
RATIONALE: Powerlessness is a negative perception that can affect all people throughout their lives. Individuals are particularly vulnerable in times of illness and are prone to experience powerlessness. It is therefore important to learn about powerlessness, recognize the symptoms and take action.
AIMS AND OBJECTIVES: This study aimed to develop a measurement tool that can evaluate the powerlessness of patients.
METHODS: In this methodological study, face and content validity, construct validity and reliability analyses were examined to develop the scale and determine its psychometric properties. The scale’s psychometric properties were tested with 1044 nurses and patients in different sample groups. Data were collected between 22 November 2022 and 2 December 2023.
RESULTS: The content validity index of the scale is 0.75. According to principal components analysis, the scale consisted of 24 items and four sub-dimensions. The total variance of the scale was 64.62%, and the factor loading values were in the range of 0.649-0.882. In confirmatory factor analysis, fit indices were acceptable or good. According to the reliability analysis, the scale’s reliability is high. Test-retest showed that the scale made stable measurements over time.
CONCLUSION: In conclusion, the patient powerlessness assessment scale is a valid and reliable measurement tool for patients and nurses.
PMID:40652539 | DOI:10.1111/jep.70194
Psychol Health Med. 2025 Jul 13:1-25. doi: 10.1080/13548506.2025.2522930. Online ahead of print.
ABSTRACT
The Regional Comprehensive Economic Partnership (RCEP) brings together Asia-Pacific nations to enhance economic ties. Traditional Chinese Medicine (TCM) faces changes due to Technological Innovation (TI), presenting economic opportunities and challenges for member states. This study explored the impacts of technology on TCM production and exportation within the RCEP framework. A purposive sampling technique is used in this study to choose the samples for data collection. Utilizing a mixed method approach, valid responses were gathered from 450 participants. The collected data were subjected to analysis using the Statistical Package for the Social Sciences (SPSS) software. The study revealed that TI in TCM production indeed has significant positive implications for RCEP member states. The study found that the adoption of advanced technology in TCM production promotes innovation and sustainability within the industry, driving long-term growth for RCEP member states. The study highlights the potential for RCEP member states to leverage their collective expertise and resources to establish themselves as leaders in the global TCM industry, creating new avenues for economic development and cooperation. The study’s contribution lies in highlighting how technology in TCM production can boost economic resilience and competitiveness within the RCEP framework, emphasizing its role in fostering collaboration and knowledge-sharing among member states.
PMID:40652536 | DOI:10.1080/13548506.2025.2522930
Diagn Cytopathol. 2025 Jul 13. doi: 10.1002/dc.25497. Online ahead of print.
ABSTRACT
AIM: There are studies suggesting that the use of a uterine manipulator during minimally invasive surgery (MIS) may lead to tumor spread in endometrial cancer patients, and there is no clear consensus on the safety of uterine manipulator use. The aim of this study was to investigate the effect of uterine manipulator use on peritoneal cytology (PC) results obtained before and after hysterectomy in endometrial cancer patients.
METHODS: A single-center, prospective observational study was conducted, including 108 patients who were diagnosed with endometrial cancer and underwent surgical intervention. The patients were divided into three groups: Group 1 (n = 36), total abdominal hysterectomy (TAH); Group 2 (n = 41) laparoscopic hysterectomy with intrauterine manipulator (TLH with IUM); and Group 3 (n = 31) laparoscopic hysterectomy without IUM (TLH without IUM). PC samples were taken before and after the hysterectomy, and cytology results were compared among the groups.
RESULTS: Of the 108 patients included in the study, 33.3% (36/108) were in Group 1, 38% (41/108) were in Group 2, and 28.7% (31/108) were in Group 3. The clinical and demographic data among the groups were similar (p > 0.05). PC was positive in six of the 108 patients. In the TLH with IUM group, one patient with a negative cytology sample before the manipulation showed a positive result after the hysterectomy.
CONCLUSIONS: Although statistical significance was not reached, utilizing an IUM to manage endometrial cancer with MIS may enhance cytology positivity. This finding requires further validation through larger prospective studies.
PMID:40652525 | DOI:10.1002/dc.25497
J Med Entomol. 2025 Jul 13:tjaf082. doi: 10.1093/jme/tjaf082. Online ahead of print.
ABSTRACT
A Bayesian Procrustes analysis (BPA) was used to discriminate livestock-associated species: Culicoides innoxius Sen and Das Gupta, Culicoides peregrinus Kieffer, and Culicoides oxystoma Kieffer. BPA results were compared with classical geometric morphometric analysis (CGMA). Markov Chain Monte Carlo (MCMC) parameters, Kullback-Leibler (KL) divergence, Hellinger distance, and total variation distance were considered. BPA validation was further done using CGMA. BPA depicted significant differences at 95% credible intervals (CrIs) in their posterior distribution of Procrustes variance (σ) between the species with minimum overlap between closely related ones, C. innoxius and C. peregrinus, and no overlap between distantly related C. oxystoma and C. peregrinus; C. innoxius. MCMC posterior convergence plots supported the accuracy of the BPA. In the trace plots, the MCMC explored the parameter space effectively. For the estimation of divergence between the distribution of species, KL divergence, Hellinger distance, and total variance distance were calculated, which exhibited the highest dissimilarity between C. oxystoma and C. innoxius, followed by C. oxystoma and C. peregrinus and the lowest was between C. peregrinus and C. innoxius. The effectiveness of the BPA over CGMA was assessed by incorporating Culicoides regalis individuals within the analysis. In BPA, an erratic convergence plot indicated the presence of C. regalis within the C. innoxius dataset, whereas CGMA could not separate C. regalis. This is probably the first time the Bayesian approach has been used in Culicoides taxonomy. So far, the results have yielded reliable, sensitive, and accurate species identification.
PMID:40652506 | DOI:10.1093/jme/tjaf082
Neurol India. 2025 Jan 1;73(1):102-109. doi: 10.4103/neurol-india.Neurol-India-D-24-00350. Epub 2025 Feb 7.
ABSTRACT
OBJECTIVE: To use machine learning tool to predict visual outcomes.
METHODS: A retrospective cohort of 284 consecutive pituitary adenoma patients with preoperative visual deficit was used. Patient variables were collected. Preprocessing and classification was done in the open source ML tool box Weka (Ver 3.8.4). Four algorithms were used for classification-the J48 trees, LMT algorithm, the REP tree algorithm, and the Random Forest.
RESULTS: The study included a total of 284 patients. The mean duration of visual symptoms was 10.09 ± 4.3 months. There were 24 patients with uniocular involvement and 260 patients with binocular visual impairment: Vision improved in 89.78% patients, remained same in 9.86% and deteriorated in 0.3% patients and were same in 9.86% patients and deteriorated in 0.3% patient. Factors like extent of resection, preoperative visual acuity, tumor volume, and duration of symptoms were found to have statistically significant effect on postoperative visual outcome. The model predicting visual improvement had an AUC of 0.846; 88.94% accuracy, 78.4% specificity, and 93.7% sensitivity; 90.5% and 85.04% positive and negative predictive value, respectively; an F1 score of 0.921; and a Brier score of 0.291.
CONCLUSIONS: Postoperative visual outcomes of pituitary adenoma surgery and factors affecting it can be predicted with 88.94% accuracy using a machine learning approach. Based on this preliminary evaluation, ML appears promising in predicting visual outcomes after endoscopic resection of pituitary adenomas, thus improving patient-tailored care and counselling.
PMID:40652476 | DOI:10.4103/neurol-india.Neurol-India-D-24-00350
Neurol India. 2025 Jan 1;73(1):49-54. doi: 10.4103/ni.ni_1155_22. Epub 2025 Feb 7.
ABSTRACT
BACKGROUND: Traumatic brain injuries (TBI) pose a major public health challenge to the Indian health system. The trajectory of patients from the site of injury to definitive management needs to be understood to improve prehospital management.
OBJECTIVE: We conducted a prospective survey to review the epidemiological and pre-hospital characteristics of TBI patients requiring emergency surgical intervention at a level I neuro-trauma care center.
METHODS AND MATERIALS: Patients who underwent emergency neurosurgical management for TBI at the National Institute of Mental Health and Neurosciences (NIMHANS, Bangalore) between June 2021 and December 2021 were included in the study.
RESULTS: A total of 214 patients were included in the study (86% males). The most common cause of TBI was road traffic accidents (70%) which involved a motorized two-wheeler in 87% of the cases. No safety gear was used in 87% of the road traffic accidents. The median delay in first contact with any medical facility was 60 min. The median time of seeking care at NIMHANS was 6 h and 50 min after the injury. More than one-third of the patients had visited two or more health facilities before reaching NIMHANS for treatment.
CONCLUSION: Road traffic accidents without safety gear constitute the major cause of TBIs requiring emergency surgery. A major challenge exists in prehospital care and organized hospital transfer of acute TBI patients requiring emergency surgery.
PMID:40652468 | DOI:10.4103/ni.ni_1155_22
Neurol India. 2025 Jan 1;73(1):17-28. doi: 10.4103/neurol-india.Neurol-India-D-24-00263. Epub 2025 Feb 7.
ABSTRACT
Chronic subdural hematoma (cSDH) is a prevalent neurosurgical disorder with increasing incidence, especially among the geriatric population. Although surgical management has been the conventional approach, the optimal strategy remains debated. Tranexamic acid (TXA), an antifibrinolytic agent, has emerged as a potential alternative, but its efficacy and safety require thorough investigation. This systematic review and meta-analysis aimed to evaluate the role of TXA in the management of cSDH, focusing on its impact on recurrence rates, clinical outcomes, and adverse events. Randomized controlled trials (RCTs) reporting on the safety and efficacy of TXA in adult patients with cSDH were systematically searched in multiple databases. Primary outcomes included clinical and radiological recurrence requiring re-surgery, while secondary outcomes encompassed adverse events and mortality associated with TXA treatment. A comprehensive search yielded 35 articles, with four RCTs meeting the inclusion criteria. The meta-analysis, involving 148 patients, demonstrated no significant reduction in mean postoperative volume at follow-up or recurrence rates with TXA use. Heterogeneity was low to moderate, and no significant adverse events were observed. Although there is a trend toward early and more complete resolution of cSDH with TXA acid after burr hole drainage, the results lack statistical significance to advocate its routine use in post-surgical management. TXA appears safe in cSDH, emphasizing the need for further research to establish its definitive role in reducing recurrence rates.
PMID:40652463 | DOI:10.4103/neurol-india.Neurol-India-D-24-00263