Tag: nevin manimala

J Craniofac Surg. 2025 Mar 24. doi: 10.1097/SCS.0000000000011258. Online ahead of print.

ABSTRACT

INTRODUCTION: Accurate and efficient medical coding is essential for proper reimbursement and health care management. Current Procedural Terminology (CPT) codes, derived from operative notes, standardize medical billing but are often prone to variability and errors due to the complexity of surgical procedures. With advancements in artificial intelligence (AI), tools like ChatGPT and other large language models (LLMs) are being explored for their potential to automate coding tasks. This study evaluates the ability of LLMs to generate accurate CPT codes for craniofacial surgical procedures based on operative notes.

METHODS: Operative notes for 10 craniofacial surgical cases were collected from a single surgeon at Nemours Children’s Health. The notes were provided to AI tools (ChatGPT 4.0 and Gemini) to generate corresponding CPT codes. These AI-generated codes were compared against manually coded results by expert reviewers. Responses were evaluated for accuracy against manually generated CPT codes and classified as correct, partially correct, or incorrect.

RESULTS: ChatGPT and Gemini demonstrated similar performance in generating CPT codes, with no statistically significant differences in accuracy or correctness between the models (P > 0.999). Gemini produced a slightly higher proportion of correct responses (30% versus 20%), whereas ChatGPT had more partially correct responses (50% versus 40%).

CONCLUSIONS: This study demonstrates that AI may be a clinically valuable resource for craniofacial CPT coding, reducing administrative burden and increasing coding accuracy. Findings from this research could inform the integration of AI into medical billing practices, promoting efficiency in surgical specialties. Future research will explore generalizability to other surgical domains and refinement of AI models for coding tasks.

PMID:40127215 | DOI:10.1097/SCS.0000000000011258

J Am Acad Orthop Surg. 2025 Mar 25. doi: 10.5435/JAAOS-D-24-00372. Online ahead of print.

ABSTRACT

INTRODUCTION: External fixation costs have been identified as a primary driver of initial cost in the care of tibial plateau fractures. Because hospital systems and institutions pursue value-based care, external fixation choices become a uniquely surgeon-dependent driver of cost. Our objective was to determine differences in cost in a prepackaged, single-use, external fixation system compared with standard, modular, knee spanning frames. Secondary objectives were to determine differences in surgical time and loss of distraction between the two types of fixation.

METHODS: This was a retrospective cohort study at an academic level 1 trauma center. Fifty-nine patients were treated with knee spanning external fixation over a 7-year period (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopedic Trauma Association 41-B/C). Patients received either the Zimmer FastFrame external fixator or a conventional-style, modular, external fixator. The primary outcome was implant and supply cost. The secondary outcomes were operating room facility cost, surgical time, and percent of distraction lost.

RESULTS: The FastFrame cohort demonstrated a 24.9% decrease in surgical times (29.2 vs. 38.9 minutes, P = 0.002), with a 37% decrease in supply and implant cost of conventional cohort (0.63x vs. 1x, P < 0.001). Operating room facility cost was less than the conventional cohort (0.72x vs. 1x, P = 0.41), and total cost was 21.8% less (0.78x vs. 1x, P = 0.07), although these did not reach statistical significance. The Fastframe cohort lost less distraction (72.6% vs. 62.8%, P = 0.02).

CONCLUSION: The FastFrame demonstrates a lower supply and implant cost, faster surgical times, and demonstrated clinical equivalence in regard to loss of distraction when compared with conventional, modular, external fixator.

LEVEL OF EVIDENCE: Diagnostic-Level III.

PMID:40127204 | DOI:10.5435/JAAOS-D-24-00372

Eur J Cardiothorac Surg. 2025 Mar 24:ezaf108. doi: 10.1093/ejcts/ezaf108. Online ahead of print.

ABSTRACT

OBJECTIVES: Bilateral endoscopic thoracic sympathectomy is an effective treatment for primary hyperhidrosis, yet the causes of its main side effect, compensatory sweating, remain unclear. This study aimed to identify risk factors for compensatory sweating in a long-term follow-up cohort.

METHODS: Patients who underwent bilateral endoscopic thoracic sympathectomy for primary hyperhidrosis between 2010 and 2023 (n = 98) were interviewed, and preoperative data were collected. Compensatory sweating was classified as mild, moderate, or severe according to the Society of Thoracic Surgeons guidelines. Quality of life was assessed using the Hyperhidrosis Disease Severity Scale from the International Hyperhidrosis Society. Logistic and ordinal Bayesian regression models were applied to analyze associations between predictors, compensatory sweating outcomes, and quality of life.

RESULTS: The procedure achieved an overall effectiveness of 94.38%, with 34.69% of patients reporting compensatory sweating, predominantly mild (26.53%). Nearly all patients (97.95%) experienced a ≥ 50% reduction in sweating, and 94.89% achieved ≥80% reduction. Higher hemoglobin levels and marijuana protected against compensatory sweating incidence and severity. Conversely, smoking and hyperhidrosis involving both hands and axillae increased compensatory sweating risk. Better quality of life outcomes were correlated with higher hemoglobin levels and female sex, while worse outcomes were associated with older age, higher BMI, and axillary involvement.

CONCLUSIONS: Long-term follow-up highlights key predictors for compensatory sweating, emphasizing the importance of tailored preoperative counseling. Identifying at-risk patients, such as smokers and those with low hemoglobin levels, is essential for improving outcomes and managing expectations in the treatment of primary hyperhidrosis.

PMID:40127189 | DOI:10.1093/ejcts/ezaf108

Clin Infect Dis. 2025 Mar 24:ciaf152. doi: 10.1093/cid/ciaf152. Online ahead of print.

ABSTRACT

BACKGROUND: In 2010, the World Health Organization (WHO) increased recommended doses of first-line tuberculosis (TB) drugs for children. This systematic review aimed to determine the proportion of children who develop adverse events (AEs) on first-line TB treatment and to determine whether there has been a change in toxicity observed with WHO 2010 dosing.

METHODS: We searched MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, WHO Global Index Medicus, and ClinicalTrials.gov for studies that reported AEs for children and adolescents ≤19 years old with TB disease receiving first-line medications. A meta-analysis of proportions was performed to generate pooled proportions of AEs. The protocol was registered with the International Prospective Register of Systematic Reviews (CRD42023418496).

RESULTS: Forty studies comprising 5,021 participants were included. 682 (13.6%) participants experienced 712 AEs; 60 (1.2%) participants experienced a change in therapy due to an AE. The proportion of children with any AE was significantly higher with WHO 2010 dosing (26%, 95% CI 18-34%) compared to pre-WHO 2010 dosing (8%, 95% CI 4-15%), as was the proportion of children who developed severe AEs. There was no statistically significant difference in hepatotoxicity before and after 2010 dosing recommendations, however, significant increases in hepatotoxicity were seen in several subgroups with 2010 dosing. There was substantial heterogeneity between studies; none were at high risk of bias.

CONCLUSIONS: Higher dose regimens in children were associated with increased AEs, raising caution for further dose increases and necessitating additional study of treatment tolerability. These findings are limited by publication bias in observational trials.

PMID:40127187 | DOI:10.1093/cid/ciaf152

Brief Bioinform. 2025 Mar 4;26(2):bbaf119. doi: 10.1093/bib/bbaf119.

ABSTRACT

Accurately predicting the pathogenicity of missense variants is crucial for improving disease diagnosis and advancing clinical research. However, existing computational methods primarily focus on general pathogenicity predictions, overlooking assessments of disease-specific conditions. In this study, we propose DS-MVP, a method capable of predicting disease-specific pathogenicity of missense variants in human genomes. DS-MVP first leverages a deep learning model pre-trained on a large general pathogenicity dataset to learn rich representation of missense variants. It then fine-tunes these representations with an XGBoost model on smaller datasets for specific diseases. We evaluated the learned representation by testing it on multiple binary pathogenicity datasets and gene-level statistics, demonstrating that DS-MVP outperforms existing state-of-the-art methods, such as MetaRNN and AlphaMissense. Additionally, DS-MVP excels in multi-label and multi-class classification, effectively classifying disease-specific pathogenic missense variants based on disease conditions. It further enhances predictions by fine-tuning the pre-trained model on disease-specific datasets. Finally, we analyzed the contributions of the pre-trained model and various feature types, with gene description corpus features from large language model and genetic feature fusion contributing the most. These results underscore that DS-MVP represents a broader perspective on pathogenicity prediction and holds potential as an effective tool for disease diagnosis.

PMID:40127180 | DOI:10.1093/bib/bbaf119

Bull Math Biol. 2025 Mar 24;87(5):56. doi: 10.1007/s11538-025-01428-y.

NO ABSTRACT

PMID:40126575 | DOI:10.1007/s11538-025-01428-y

Can J Exp Psychol. 2025 Mar 24. doi: 10.1037/cep0000372. Online ahead of print.

ABSTRACT

The goal of this article was to determine if second language (L2) speakers benefit from living in mixed-language environments and whether said benefit applies across proficiency levels. To this end, we reanalyzed a subset of data from Gilbert et al. (2019) considering language entropy scores as a proxy for linguistic environment predictability. The task involved producing sentences designed around oronyms in French and English. Participants produced sentences in both languages, allowing the comparison of first language and L2 productions. Their results demonstrated the production of L2-appropriate prosodic cues, albeit after having reached a high level of L2 proficiency. Adding language entropy scores to the original statistical models revealed significant interactions suggesting that participants benefited from living in a mixed-languages environment whereby even low-proficiency speakers produced L2-appropriate prosodic cues. However, low-proficiency L2 speakers living in predictable linguistic environments failed to adapt their prosodic production to their L2, as previously observed. These results suggest that, irrespective of proficiency, the language environment has a significant impact on nonnative language production. This has implications for language development and models of language acquisition. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40126574 | DOI:10.1037/cep0000372

Psychol Assess. 2025 Mar 24. doi: 10.1037/pas0001374. Online ahead of print.

ABSTRACT

Gambling disorder (GD) is an officially recognized mental health disorder. However, its conceptualization and diagnostic criteria have changed substantially over the years due to new clinical and epidemiological research supporting its reconceptualization from an impulse control disorder to an addictive disorder. The evolving nature of GD led to changes in its diagnostic approach within the 11^th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11). However, no updated standardized psychometric test reflecting the latest developments exists. Therefore, the goal of the present study was to develop and report the psychometric properties of the Gambling Disorder Test (GDT), a brief and convenient four-item assessment instrument reflecting the current diagnostic criteria for GD in the ICD-11. A nationally representative sample of British adults was recruited (N = 1,028, M_age = 46.54 years, SD_age = 15.71). The results showed a one-factor solution for the GDT and initial support for the scale’s factorial validity, population cross-validity, criterion validity, concurrent validity, and reliability. Further gender-based measurement invariance was conducted, with the GDT exhibiting full scalar invariance and the results of latent mean comparison showing that males had significantly higher GD latent means compared to females (latent mean difference = -0.156; z = -3.844, p < .001, d = -.249). The self-reported prevalence of GD in the sample was 0.49%. The GDT is a promising brief assessment instrument based on the latest conceptualization and diagnostic criteria for GD that can be employed by clinicians and researchers alike. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40126572 | DOI:10.1037/pas0001374

J Med Internet Res. 2025 Mar 24;27:e57537. doi: 10.2196/57537.

ABSTRACT

BACKGROUND: In-person nutrition and exercise interventions improve physical function in chronic diseases, yet the acceptability and effectiveness of web-based delivery, especially with different levels of personnel support, require further investigation.

OBJECTIVE: This study aims to evaluate a web-based nutrition and exercise intervention delivered entirely digitally from recruitment to trial completion.

METHODS: A randomized controlled trial was conducted using the Heal-Me version 1 platform across 2 levels of personnel support (Light and Intensive). Eligible adults with a history of cancer, chronic lung disease, or liver or lung transplant; internet access; and prior participation in a rehabilitation program were enrolled in a fully web-based program to minimize barriers to exercise participation. Participants were randomly assigned (1:1:1) to 1 of 3 study groups. The control group received a detailed, self-directed digital nutrition and exercise guide. The Heal-Me Light group received the web-based intervention alongside dietitian and exercise specialist-led group classes. The Heal-Me Intensive group received web-based intervention, group classes, and one-to-one sessions with the dietitians and exercise specialists. All participants received a wearable activity tracker. The primary acceptability outcome was adherence to the intervention based on a priori targets. The primary effectiveness outcome was the change in Lower Extremity Functional Scale (LEFS) score. Secondary outcomes included physical function tests, which were performed and measured by videoconference. Questionnaires were used to assess well-being, quality of life, and food intake. Analyses adhered to the intention-to-treat principle.

RESULTS: Of 216 participants, 202 (93.5%) completed the intervention (mean 61, SD 11 years; female: 130/202, 64.4%; cancer: 126/202, 62.4%). Adherence exceeded a priori targets, with 82% (105/128) attending >75% of the program elements including postintervention tests. Participants rated the program as “quite a bit” or “very” useful, with similar ratings between Heal-Me Light (56/64, 88%) and Heal-Me Intensive (51/58, 88%) groups (P=.69). No significant differences were found for changes in LEFS scores (control: mean 0.8, SD 7.7; Heal-Me: mean 0.3, SD 6.6; P=.53). Significant benefits were found in favor of the combined Heal-Me intervention groups versus controls for change in the 2-minute step test, World Health Organization-5 Well-Being Index, Short-Form-36 general, physical health role, energy or fatigue scales, and protein intake. While the change in physical function was similar between the 2 intervention arms, the more intensive one-to-one interaction (Heal-Me Intensive) led to greater improvements in perceived nutrition self-management. No serious adverse events occurred.

CONCLUSIONS: The demonstrated satisfaction, adherence, and effectiveness highlight the high acceptability of a web-based, semisupervised nutrition and exercise intervention delivered entirely digitally in individuals with chronic disease. Future studies may benefit from having a baseline physical function inclusion threshold, the use of a more sensitive primary physical function measure, and a higher intensity digital exercise intervention in exercise-experienced participants.

TRIAL REGISTRATION: Clinicaltrials.gov NCT04666558; https://clinicaltrials.gov/study/NCT04666558.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1016/j.cct.2022.106791.

PMID:40126542 | DOI:10.2196/57537

Arch Ital Urol Androl. 2025 Mar 24:13353. doi: 10.4081/aiua.2025.13353. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic inflammation is associated to the pathogenesis of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). This study evaluated the correlation between inflammatory markers fibroblast growth factor-2 (FGF2), interleukin (IL)-8, and IL-6 in PCa and BPH tissues to understand their involvement in disease progression.

METHODS: A cross-sectional investigation was carried out, examining prostate specimens from 62 male patients diagnosed with PCA or BPH. Specimens were taken via transurethral resection of the prostate (TURP) and stained with hematoxylin and eosin to look for inflammatory infiltrates and aggressiveness. The levels of FGF2, IL-8, and IL-6 were evaluated using ELISA. Chi-square and logistic regression tests were used in the statistical analysis.

RESULTS: High-grade inflammation was found in all BPH cases (100%), but not in PCa cases. In BPH tissues, elevated levels of IL-8 and IL-6 had a significant correlation with high-grade inflammation (p < 0.05). On the other hand, PCa tissues had considerably greater FGF2 levels than benign tissues (p < 0.05). Elevated FGF2 levels and the lack of high-grade inflammation in PCa tissues point to different pathogenic processes in PCa and BPH.

CONCLUSIONS: This study emphasizes the importance of chronic inflammation in BPH development, with IL-8 and IL-6 playing essential roles. The results imply that treating BPH by focusing on IL-8 and IL-6 may be beneficial. Increased levels of FGF2 in PCa tissues suggest that this protein may be used as a biomarker and therapeutic target for PCa. These findings highlight the importance of targeting both inflammatory and growth factor pathways for treating prostatic disorders.

PMID:40126506 | DOI:10.4081/aiua.2025.13353