Crit Rev Biomed Eng. 2025;53(3):v-vi. doi: 10.1615/CritRevBiomedEng.v53.i3.10.
NO ABSTRACT
PMID:40749191 | DOI:10.1615/CritRevBiomedEng.v53.i3.10
ATS Sch. 2025 Aug 1:1-13. doi: 10.34197/ats-scholar.2024-0136OC. Online ahead of print.
ABSTRACT
Background: The gold standard for interstitial lung disease (ILD) diagnosis is multidisciplinary discussion (MDD); however, access is often limited by geographic barriers, time constraints, and the number of centers with ILD expertise. Objective: To assess the educational and clinical impact of a novel videoconferencing MDD program for the diagnosis and management of ILD. Methods: We performed a retrospective observational study of the Multidisciplinary Interstitial Lung Disease Discussion with Experts Remotely (MILDDER) program, a videoconferencing MDD platform initiated by the Toronto General Hospital in Toronto, Canada. We used anonymized survey data from attendees (trainees and practicing physicians) and referring physicians who attended MILDDER between 2018 and 2023. Self-reported ILD confidence before and after MILDDER participation and general program satisfaction were assessed using a 10-point Likert scale. ILD confidence questions were stratified by clinical practice experience. Wilcoxon signed-rank testing for paired data was used to determine statistical significance in the subgroup that completed a MILDDER semester (bimonthly sessions for 6 mo). Written survey responses were assessed qualitatively and grouped by theme. Clinical outcomes, including patient characteristics, new or changed ILD diagnoses, new investigations requests, and new treatment suggestions, were assessed. Results: Three hundred seventeen attendees and referring physicians completed pre-MILDDER questionnaires. Overall, they reported low confidence in their ability to diagnose and manage ILD. After they attended a MILDDER semester ILD, their confidence increased by a median of 3 to 4 points in the overall group. Among respondents with ⩾5 years of clinical practice experience, there was no change in ILD diagnostic confidence after MILDDER; however, management confidence increased by a median of 2 points. A statistically significant increase in all areas of ILD confidence assessed was noted in the subgroup of 70 participants with complete pre- and post-MILDDER semester surveys. Respondents were generally very satisfied with MILDDER. New or changed ILD diagnoses occurred in 86 (50.6%) presented cases, new investigation requests occurred in 40 (22.7%) cases, and new medications were recommended for 30 (17%) cases. Conclusion: Videoconferencing MDD platforms such as MILDDER are feasible and can be used as a tool for physician education and remote management of ILD.
PMID:40749108 | DOI:10.34197/ats-scholar.2024-0136OC
Evolution. 2025 Aug 1:qpaf160. doi: 10.1093/evolut/qpaf160. Online ahead of print.
ABSTRACT
The distribution of pleiotropic mutational effects impacts phenotypic adaptation. However, small effect sizes and high sampling error of covariances hinder investigations of the factors influencing this distribution. Here, we explored the potential for shared information across traits affected by the same mutations to counter sampling error, allowing robust characterisation of patterns of mutational input. Exploiting a published dataset representing 12 samples of the same mutation accumulation experiment in Drosophila serrata, we inferred robust signals of mutational effects from the concordance across samples. Krzanowski common subspace analysis identified a multivariate wing trait with statistically supported mutational variance in all samples. Importantly, this multivariate trait was aligned with the major axis of among-line (mutational) variance within most population samples. That is, despite considerable heterogeneity among samples in individual (co)variance parameter estimates, the predominant pattern of correlated mutational effects was identified in each dataset. Two other multivariate traits were statistically supported across most samples. Smaller effect sizes (lower mutational variance) with concomitant larger sampling error or other factors (e.g., microenvironmental dependence of effects) may reduce the robustness of estimated mutational input for these traits. Overall, our results suggest that multivariate analyses of mutation accumulation experiments can detect the true signal of pleiotropic mutation, and that sampling error does not preclude such studies from extending our knowledge of pleiotropic mutational effects.
PMID:40748662 | DOI:10.1093/evolut/qpaf160
JAMA Netw Open. 2025 Aug 1;8(8):e2524557. doi: 10.1001/jamanetworkopen.2025.24557.
ABSTRACT
IMPORTANCE: Epilepsy is a common complication of brain abscess. However, the effectiveness of antiseizure medications (ASMs) in preventing epilepsy in brain abscess survivors is unknown.
OBJECTIVE: To assess whether the initiation of ASMs is associated with a reduced risk of epilepsy.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study conducted a target trial emulation using US commercial insurance claims data from October 1, 2016, to June 30, 2022, and followed up patients for 180 days. The study population was restricted to those with a diagnosis of brain abscess using International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes associated with an acute care visit. Only patients aged 18 years or older at the time of the brain abscess with at least 1 year of prior enrollment were included. Statistical analysis was performed from May to December 2024.
EXPOSURE: A priori selected study ASMs were levetiracetam, valproate, and phenytoin. A clone-censor-weight approach was used to compare the initiation of ASMs within a 45-day grace period (treatment arm) with no initiation of ASMs (control arm). Inverse probability weights were used to control for treatment selection.
MAIN OUTCOMES AND MEASURES: Study outcome was a diagnosis of epilepsy or seizure (with ICD-10-CM code) occurring 15 days or more after the index date. Weighted Kaplan-Meier models were fitted to estimate risk differences (RDs) at 90, 135, and 180 days accompanied by nonparametric bootstrapped 95% CIs. Sensitivity analyses were conducted to assess internal threats to validity.
RESULTS: Among the 572 patients included, the mean (SD) age was 61.5 (16.6) years and 353 (61.7%) were male. Of those in the treatment arm, 83 (88.3%) initiated ASMs within the first 30 days. Overall, 129 patients (22.5%) developed epilepsy during follow-up. There was no statistically significant risk difference in the probability of epilepsy incidence at each follow-up time point (RD at 90 days, -0.02% [95% CI, -4.9% to 4.8%]; RD at 135 days, 1.9% [95% CI, -5.0% to 8.5%]; RD at 180 days, 3.5% [95% CI, -4.4% to 10.8%]). Sensitivity analyses agreed with the primary findings.
CONCLUSIONS AND RELEVANCE: In this cohort study of brain abscess survivors, initiation of ASMs was not associated with a reduced risk of epilepsy. Future studies should replicate the findings and consider alternative treatment protocols.
PMID:40748638 | DOI:10.1001/jamanetworkopen.2025.24557
Nanoscale. 2025 Aug 1. doi: 10.1039/d5nr02033f. Online ahead of print.
ABSTRACT
Advancements in disease understanding have led to a shift towards personalized medicine, which has driven the development of an approach called theranostics. This approach combines diagnostics and therapy in one integrated system. Radiopaque biomaterials allow for non-invasive imaging using X-ray and computed tomography (CT). However, conventional contrast agents like gold nanoparticles are costly and are not well-suited for drug encapsulation. In this study, new block and statistical copolymers were synthesized using reversible addition-fragmentation chain-transfer (RAFT) polymerization comprising poly(N-isopropylacrylamide) (PNIPAM) and poly(5-acrylamido-2,4,6-triiodoisophthalic acid) (PAATIPA), designed to combine radiopacity with drug delivery capabilities. PAATIPA’s high iodine content provides strong contrast in CT scans, while PNIPAM’s thermoresponsiveness allows for self-assembly at higher temperatures. The anionic nature of PAATIPA allows the efficient encapsulation of the cationic small-molecule rhodamine 6G. The copolymers exhibited an enhanced encapsulation of cationic rhodamine 6G (>90% at 35 w/w% of rhodamine) and excellent biocompatibility, as demonstrated in cytotoxicity assays. This study emphasizes the potential of PAATIPA-based copolymer materials as multifunctional, radio-opaque and stimuli-responsive materials for theranostic applications.
PMID:40748606 | DOI:10.1039/d5nr02033f
J Sports Med Phys Fitness. 2025 Aug 1. doi: 10.23736/S0022-4707.25.16844-8. Online ahead of print.
ABSTRACT
INTRODUCTION: This systematic review and meta-analysis aim to evaluate the efficacy and safety of exercise intervention in improving the rehabilitation outcomes of advanced lung cancer patients.
EVIDENCE ACQUISITION: According to PRISMA’s statement, we searched the Web of Science, Medline, Embase, Cochrane Library, and ClinicalTrials.gov databases to collect randomized controlled trials on the efficacy and safety of exercise intervention in improving rehabilitation outcomes for lung cancer patients. These studies were established from the database until their publication in September 2024. A supplementary search was conducted on October 1, 2024. Perform statistical analysis using Review Manager 5.3.
EVIDENCE SYNTHESIS: A total of 14 randomized controlled trials with 756 participants were included. The meta-analysis results showed that exercise intervention significantly improved quality of life (such as EORTC-QLQ-C30 scale MD=5.26, 95% CI: 2.41 to 8.11, P=0.0003; FACT-L scale MD-5.03, 95% CI: 0.51-9.55, P=0.03), fatigue (MD=-6.29, 95% CI: 9.94 to -2.65, P=0.0007), anxiety and depression (MD=-110, 95% CI: 1.67 to -0.54, P<0.0001; MD=1.96, 95% CI: 1.22 to 2.70, P<0.001), and exercise ability (MD=15.34, 95% CI: 4.07-26.61, P=0.008). However, exercise intervention did not improve dyspnea (MD=-0.86, 95% CI: -3.34~1.62, P=0.50 >0.05) in lung cancer patients.
CONCLUSIONS: Exercise intervention can significantly improve patients’ quality of life, alleviate symptoms of fatigue, anxiety, and depression, enhance functional status and physical function. Therefore, it is recommended to include exercise intervention as part of the comprehensive treatment plan for cancer patients and further explore its best practices and potential mechanisms in future research.
PMID:40748599 | DOI:10.23736/S0022-4707.25.16844-8
Biol Trace Elem Res. 2025 Aug 1. doi: 10.1007/s12011-025-04770-3. Online ahead of print.
ABSTRACT
The heavy metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) were quantified in 26 roasted coffee samples (19 Arabica and 7 Robusta) consumed in Turkey using ICP-OES. Cd and Pb were not detected in any sample. Cr was found only in Robusta samples, with a mean concentration of 0.58 mg/kg. The average concentrations of Cu, Fe, Mn, Ni, and Zn were 12.34 and 13.10 mg/kg, 13.67 and 14.69 mg/kg, 23.37 and 11.66 mg/kg, 0.04 and 1.17 mg/kg, and 8.31 and 7.19 mg/kg in Arabica and Robusta coffee samples, respectively. The heavy metal concentrations were compared with international limits and literature values. To assess the human health risk posed by heavy metals in the coffee samples, the estimated daily intake (EDI), hazard quotient (HQ), and hazard index (HI) were calculated based on average coffee consumption. All the EDI values were below the oral reference doses (RfDs), and both the HQ and HI values were less than 1, indicating no significant non-carcinogenic health risk associated with coffee consumption. Descriptive statistics summarized heavy metal levels, while inferential statistical tests evaluated differences among the coffee-growing regions and between the coffee bean species.
PMID:40748591 | DOI:10.1007/s12011-025-04770-3
Geochem Trans. 2025 Aug 1;26(1):7. doi: 10.1186/s12932-025-00102-5.
ABSTRACT
The present research work aims to understand the geochemistry of groundwater resources of the Yamuna-Hindon interfluve region of Bagpat district, Western Uttar Pradesh, India. The region is a part of Indo-Gangetic belt, one of the world’s most fertile and intensely farmed areas. To investigate the geochemical processes governing groundwater quality, a total of 105 groundwater samples were collected during pre-monsoon season and analyzed for various physico-chemical parameters, namely, pH, electrical conductivity (EC), total dissolved solid (TDS), total hardness (TH), turbidity, major anions (HCO3–, SO42-, F–, Cl–, NO3–), cations (Ca2+, Mg2+, Na+, K+) following the methods outlined in the American Public Health Association (APHA). The dissolved heavy metals (Fe, Mn, Zn, Pb, Cu, Cr, Ni, As, Se, Co, Cd and Al) in groundwater were analyzed by ICP-MS following the instrument manual. The analysis results revealed that the groundwater is pre-dominantly neutral to mildly alkaline in nature. The major cation chemistry majorly followed the occurrence pattern of Na+ > Mg2+ > Ca2+ > K+, while for anions it was HCO3– > Cl– > SO42- > NO3– > F–. The data plotted on Piper triangular diagram indicated that Ca2+-Mg2+-HCO3– and Na+-K+-HCO3–-Cl– were major hydrogeochemical facies. Weathering of rock-forming minerals mainly governed the groundwater geochemistry in this region, although part of the cations associated with Cl–, F– and NO3– may originate from anthropogenic sources. TDS, TH, turbidity and F– were identified as the major parameters that violated the prescribed limits for drinking water. Most of the heavy metals were found within the drinking water prescribed limits except for Fe, Mn, Al and Se. Elevated salinity, %Na, and magnesium hazard (MH) at certain sites limit its suitability for agricultural use. The assessment of selected organochlorine and organophosphorus pesticides in five samples indicated presence of lindane, β-endosulfan and DDT isomers in few samples. However, a detailed investigation of possible pesticide contamination in this intensive agriculture area is required before drawing any final conclusions.
PMID:40748577 | DOI:10.1186/s12932-025-00102-5
Obes Surg. 2025 Aug 1. doi: 10.1007/s11695-025-08115-w. Online ahead of print.
ABSTRACT
BACKGROUND: Large language models (LLMs) can generate human-like, empathetic responses within seconds. Their potential in terms of comprehensibility, empathy, and completeness to support physician-patient communication in bariatric surgery care needs to be evaluated.
METHODS: We collected 200 real-world questions from patient support groups, initial consultations, and follow-up visits, which were answered by GPT-4o and two human bariatric experts. An independent bariatric expert then blindly evaluated the responses for their overall quality, accuracy, and comprehensiveness. If needed, the responses were corrected, and the correction time was documented. Afterwards, bariatric patients (n = 189) across Germany rated the responses, assessing each one on its clarity, empathy, and completeness.
RESULTS: The LLM required significantly less time (2.7 vs. 87.2 s, p < 0.0001) and generated longer responses (607 vs. 262 characters, p = 0.001) than human experts. LLM-generated responses were rated significantly higher by patients in terms of clarity (4.8 vs. 4.6), completeness (4.5 vs. 3.4), and empathy (4.1 vs. 3.2, all p < 0.0001). In total, 64.9% of patients preferred LLM-generated responses, while 18.5% preferred physician responses. Notably, patients with a lower degree of education showed a stronger preference for LLM responses over physician responses.
CONCLUSION: LLMs could possibly act as an assistant for physicians and help improve their response efficiency while maintaining accuracy under physicians’ oversight. This approach could optimize physician time management and enhance patient satisfaction in bariatric care communication.
PMID:40748576 | DOI:10.1007/s11695-025-08115-w
Clin Drug Investig. 2025 Aug 1. doi: 10.1007/s40261-025-01465-4. Online ahead of print.
ABSTRACT
BACKGROUND: Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist with favorable safety and side effect profiles. There is a growing body of evidence for memantine as an adjunctive therapy for the positive, negative, and cognitive symptoms of schizophrenia.
OBJECTIVE: This meta-analysis examined the efficacy of memantine as an add-on to treatment with antipsychotic(s) for the primary negative symptoms (PNS) of schizophrenia.
METHODS: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched for relevant publications in PubMed, Cochrane Library, PsycINFO, Embase, and China Journal Net databases from inception using the following search terms: memantine, schizophrenia, randomized controlled trials (RCTs), RCT, and clinical trial. Searches were limited to English- and Chinese-language articles to date. Standardized mean differences (SMDs) with 95% confidence intervals were calculated using RevMan 5.4 to assess the effect size. Risk of bias was assessed using RoB 2.0.
RESULTS: In total, 13 RCTs were identified (N = 681). Memantine was superior to placebo in treating negative symptoms, with an SMD of 0.79 (p = 0.0001, N = 631, 12 RCTs). Analysis of three studies whose corresponding authors provided original datasets showed an SMD of 2.16 (p = 0.25, N = 97) after adjusting for change in psychosis, depression, and extrapyramidal symptoms, suggesting that memantine is efficacious in treating PNS. Additionally, cognitive testing significantly improved, with an SMD of 0.66 (p = 0.0001, N = 395, eight RCTs). Positive symptoms were not significantly improved (SMD = 0.24, p = 0.1, N = 631, 12 RCTs).
CONCLUSIONS: To our knowledge, this is the first study showing a large effect size for treating PNS with memantine. Although statistical significance was not reached because of the small sample size (N = 97), the results were as expected because drugs such as memantine that act at NMDA receptors are unlikely to be effective as stand-alone treatments. Future RCTs should evaluate NMDAergic drugs in combination with complementary medications to optimize therapeutic effects for all three domains of schizophrenia psychopathology.
PMID:40748569 | DOI:10.1007/s40261-025-01465-4