Tag: nevin manimala

J Med Internet Res. 2025 Jul 2;27:e65226. doi: 10.2196/65226.

ABSTRACT

BACKGROUND: The use of web-based search and social media can help identify epidemics, potentially earlier than clinical methods or even potentially identifying unreported outbreaks. Monitoring for eye-related epidemics, such as conjunctivitis outbreaks, can facilitate early public health intervention to reduce transmission and ocular comorbidities. However, monitoring social media content for conjunctivitis outbreaks is costly and laborious. Large language models (LLMs) could overcome these barriers by assessing the likelihood that real-world outbreaks are being described. However, public health actions for likely outbreaks could benefit more by knowing additional epidemiological characteristics, such as outbreak type, size, and severity.

OBJECTIVE: We aimed to assess whether and how well LLMs can classify epidemiological features from social media posts beyond conjunctivitis outbreak probability, including outbreak type, size, severity, etiology, and community setting. We used a validation framework comparing LLM classifications to those of other LLMs and human experts.

METHODS: We wrote code to generate synthetic conjunctivitis outbreak social media posts, embedded with specific preclassified epidemiological features to simulate various infectious eye disease outbreak and control scenarios. We used these posts to develop effective LLM prompts and test the capabilities of multiple LLMs. For top-performing LLMs, we gauged their practical utility in real-world epidemiological surveillance by comparing their assessments of Twitter/X, forum, and YouTube conjunctivitis posts. Finally, human raters also classified the posts, and we compared their classifications to those of a leading LLM for validation. Comparisons entailed correlation or sensitivity and specificity statistics.

RESULTS: We assessed 7 LLMs for effectively classifying epidemiological data from 1152 synthetic posts, 370 Twitter/X posts, 290 forum posts, and 956 YouTube posts. Despite some discrepancies, the LLMs demonstrated a reliable capacity for nuanced epidemiological analysis across various data sources and compared to humans or between LLMs. Notably, GPT-4 and Mixtral 8x22b exhibited high performance, predicting conjunctivitis outbreak characteristics such as probability (GPT-4: correlation=0.73), size (Mixtral 8x22b: correlation=0.82), and type (infectious, allergic, or environmentally caused); however, there were notable exceptions. Assessing synthetic and real-world posts for etiological factors, infectious eye disease specialist validations revealed that GPT-4 had high specificity (0.83-1.00) but variable sensitivity (0.32-0.71). Interrater reliability analyses showed that LLM-expert agreement exceeded expert-expert agreement for severity assessment (intraclass correlation coefficient=0.69 vs 0.38), while agreement varied by condition type (κ=0.37-0.94).

CONCLUSIONS: This investigation into the potential of LLMs for public health infoveillance suggests effectiveness in classifying key epidemiological characteristics from social media content about conjunctivitis outbreaks. Future studies should further explore LLMs’ potential to support public health monitoring through the automated assessment and classification of potential infectious eye disease or other outbreaks. Their optimal role may be to act as a first line of documentation, alerting public health organizations for the follow-up of LLM-detected and -classified small, early outbreaks, with a focus on the most severe ones.

PMID:40601927 | DOI:10.2196/65226

JMIR Res Protoc. 2025 Jul 2;14:e77927. doi: 10.2196/77927.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a recurrent, inflammatory, and chronic skin disease that influences over 200 million individuals around the world and is viewed as an important health problem due to its elevated prevalence, long course of disease, and heavy disease burden. WuSheZhiYang (WSZY) pills are composed of 11 Chinese herbs and have the effects of nourishing the blood, drying dampness, and relieving itching. In clinical practice, WSZY pills are recommended for itching skin diseases, but high-quality clinical trial evidence is still limited.

OBJECTIVE: In this study, we will implement a double-blind, randomized, placebo-controlled trial to evaluate the efficacy of WSZY pills for mild-to-moderate AD. We hypothesized that WSZY pills can effectively alleviate the disease condition of patients with mild-to-moderate AD.

METHODS: In this study, we will recruit 60 patients with mild-to-moderate in Shanghai Skin Diseases Hospital from December 2024 through December 2025. In this study, 60 male and female patients with AD aged 18 years to 65 years will be randomly assigned (2:1) to the treatment group (urea ointment and WSZY pills; n=40) or control group (urea ointment and placebo WSZY pills; n=20), and both groups will receive 4 weeks of treatment and 4 weeks of follow-up. The treatment group will receive 3 sessions of urea ointment and 7.5 g of WSZY pills each day for 4 weeks, and the control group will also receive 3 sessions of urea ointment and 7.5 g of placebo WSZY pills each day for 4 weeks. The primary indicator is the change in the objective Scoring Atopic Dermatitis (SCORAD) score between baseline and week 4. The secondary indicators include SCORAD at week 2 and week 8; Peak Pruritus Numerical Rating Scale (PP-NRS), Investigator’s Global Assessment (IGA), Patient-Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI) at week 2, week 4, and week 8; and the proportion of participants receiving remedial treatment, amount of levocetirizine tablets used, and recurrence rate at week 8. In this study, we will analyze the full analysis set and per-protocol set using SAS software version 9.4, and a 2-tailed alpha level of .05 will be viewed as statistically significant.

RESULTS: The study received ethics permission in September 2024, and trial registration was completed in October 2024. Recruitment started in December 2024 and is expected to be completed by December 2025. As of June 2025, 30 participants with mild-to-moderate AD were enrolled. Data analysis will begin in January 2026. The main results of the trial are expected to be submitted for publication in peer-reviewed scientific journals in the summer of 2026.

CONCLUSIONS: This study will evaluate the efficacy of WSZY pills for AD and provide additional evidence, suggest new therapeutic options for patients, and reduce their disease burden.

TRIAL REGISTRATION: International Traditional Medicine Clinical Trial Registry ITMCTR2024000724; http://itmctr.ccebtcm.org.cn/zh-CN/Home/ProjectView?pid=bda070f8-a733-4f52-87b0-39e4be57ac00.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/77927.

PMID:40601920 | DOI:10.2196/77927

Am J Phys Med Rehabil. 2025 Jul 2. doi: 10.1097/PHM.0000000000002793. Online ahead of print.

ABSTRACT

OBJECTIVE: Stroke is a major cause of disability, impacting mobility worldwide. Overground robotic-assisted gait training (o-RAGT) uses wearable exoskeletons to improve walking. This systematic review and meta-analysis assess its effectiveness versus conventional gait training in enhancing gait velocity and balance in post-stroke patients.

DESIGN: Our search was conducted in the Pubmed, Cochrane, ScienceDirect, Scopus and PEDro electronic databases for English journal articles about human randomized controlled trials (RCTs) of the last two decades, investigating o-RAGT effects on gait parameters of poststroke patients compared with conventional gait training.

RESULTS: A comprehensive literature search identified seven RCTs with a total of 288 participants. Meta-analysis results indicated that o-RAGT significantly improved post-intervention gait velocity (summary mean difference: 0.09 m/sec, 95% CI: 0.02-0.17), while other gait parameters, such as stride length and cadence, showed no statistically significant differences. The intervention was well-tolerated, with no major adverse events reported.

CONCLUSION: Despite the positive impact on gait speed, challenges remain, including high device costs and the need for further research to optimize training parameters. These findings support the potential of o-RAGT as an effective tool for gait rehabilitation in stroke survivors, highlighting the need for larger studies with long-term follow-up to refine its clinical application.

PMID:40601918 | DOI:10.1097/PHM.0000000000002793

Glob Public Health. 2025 Dec;20(1):2525960. doi: 10.1080/17441692.2025.2525960. Epub 2025 Jul 2.

ABSTRACT

Equitable access to healthcare is essential for achieving Universal Health Coverage (UHC) and improving health outcomes. This cross-sectional study examines patients’ perceived access to healthcare services in the West Bank, providing insights into patients’ perceptions of health disparities. Data were collected using stratified convenient sampling of 486 chronic patients at governmental primary healthcare centers in three governorates. A 5-points Likert scale questionnaire was used, based on the ‘6A’ dimensions for healthcare access: affordability, acceptability, accommodation, accessibility, availability, and awareness. The overall healthcare access mean score was 3.29 (SD = 0.46), with only 38.5% of participants reporting satisfactory access levels. Only acceptability (mean =3.75, SD = 0.55), and awareness (mean = 3.66, SD = 0.61) dimensions demonstrated significantly positive perceptions. Bivariate analysis identified income as the main significant determinant for access disparities (Kruskal-Wallis Test χ²= 75.9, p < 0.001). Place of residency, education and income significantly contributed to the disparities within the different access dimensions. The findings highlight significant challenges in healthcare access in the West Bank, particularly regarding services availability and financial affordability. These barriers extremely affect vulnerable populations, exacerbating existing health inequities and undermining efforts toward UHC. The findings emphasise the urgent need for policy interventions to address financial protection, expand service availability, and strengthen healthcare provision.

PMID:40601916 | DOI:10.1080/17441692.2025.2525960

Blood Adv. 2025 Jul 2:bloodadvances.2024015659. doi: 10.1182/bloodadvances.2024015659. Online ahead of print.

ABSTRACT

Measurement of patient-reported outcomes (PROs) and health-related quality of life (HrQOL) are crucial for comprehensive, patient-centered cancer care. Both PROs and HrQOL have been under-studied in patients with Erdheim-Chester disease (ECD), a rare cancer with protean manifestations, dense symptomatology, and frequent diagnostic delay. We sought to evaluate the longitudinal evolution of symptom burden and unmet supportive care needs in patients with ECD, and to identify associations between these PROs and HrQOL. A registry-based cohort of patients with ECD completed a PRO battery including the Functional Assessment of Cancer Therapy-General (FACT-G) and other validated PRO measures. Descriptive statistics were used to characterize the distribution of PROs and FACT-G scores; PROs were modeled by univariable linear regression with FACT-G total score as the dependent variable at (1) registry enrollment and (2) 12-month time points. Changes in FACT-G total score (the difference between the 12-month and enrollment scores) were correlated with changes in PROs using univariable linear regression analysis. In 158 patients, mean total FACT-G was 70.8, lower than observed across multiple cancer cohorts. Higher levels of pain and fatigue, presence of neurologic symptoms, and greater number of unmet needs were all associated with worse HrQOL. Improvement in pain, fatigue, and unmet needs over 12 months was significantly associated with improvement in HrQOL. In patients with ECD, HrQOL is substantially diminished, even when considering other patients with cancer. Mitigation of symptoms and addressing unmet supportive care needs represent opportunities for intervention to improve HrQOL in ECD.

PMID:40601910 | DOI:10.1182/bloodadvances.2024015659

J Clin Oncol. 2025 Jul 2:JCO2501041. doi: 10.1200/JCO-25-01041. Online ahead of print.

NO ABSTRACT

PMID:40601891 | DOI:10.1200/JCO-25-01041

JCO Oncol Pract. 2025 Jul 2:OP2500462. doi: 10.1200/OP-25-00462. Online ahead of print.

ABSTRACT

PURPOSE: Advances in breast cancer treatment have reduced mortality and toxicity, but it remains unclear which patients receive updated care and when. We aimed to identify factors associated with receiving updated breast cancer care.

METHODS: We analyzed patients age 65-85 years with local or regional breast cancer, diagnosed between 2010 and 2018, using the SEER-Medicare database. We included patients who were continuously enrolled in Medicare for 1 year after diagnosis and were eligible for one of four updated treatments: (1) adjuvant paclitaxel-trastuzumab (APT) for human epidermal growth factor receptor 2 (HER2)-positive local disease, (2) pertuzumab for HER2-positive regional disease, (3) neoadjuvant chemotherapy for triple-negative or HER2-positive regional disease, and (4) omission of chemotherapy for hormone receptor-positive, HER2-negative regional disease. We examined the association between treating oncologist specialization (percent of SEER-Medicare patients with breast cancer) and receipt of updated care using multivariable analysis.

RESULTS: Of the 21,575 patients eligible for one of these four updated care approaches, use of the APT regimen increased from 30% (95% CI, 23% to 37%) to 72% (95% CI, 67% to 77%), pertuzumab from 0% to 71% (95% CI, 66% to 76%), neoadjuvant chemotherapy from 23% (95% CI, 18% to 28%) to 60% (95% CI, 56% to 65%), and omission of chemotherapy from 54% (95% CI, 52% to 57%) to 61% (95% CI, 59% to 64%) from 2010 to 2018. In multivariable analyses, higher median income of residence county and greater specialization of treating oncologist were statistically significantly associated with receipt of updated care for all four treatment scenarios. Patients from lower-income areas who received care from more specialized oncologists were as likely to receive updated care as those from higher-income areas.

CONCLUSION: Patients from lower-income areas were less likely to receive updated care, but specialized oncologists helped mitigate this disparity. Care models that expand consultative access to specialized oncologists should be prioritized for evaluation.

PMID:40601879 | DOI:10.1200/OP-25-00462

Ocul Immunol Inflamm. 2025 Jul 2:1-9. doi: 10.1080/09273948.2025.2519851. Online ahead of print.

ABSTRACT

OBJECTIVE: We conducted this present meta-analysis to examine the difference in efficacy and safety of intravitreal dexamethasone implant (DEXI) in vitrectomized and non-vitrectomized eyes.

METHODS: All types of comparative studies published on PubMed, CENTRAL, Scopus, and Embase databases till March 10, 2025 were included. We conducted a random-effects meta-analysis for change in central macular thickness (CMT), best corrected visual acuity (BCVA) (as logMar), and rise in intraocular pressure (IOP).

RESULTS: Thirteen studies were included comparing 365 vitrectomized eyes with 778 non-vitrectomized eyes. Studies included mixed etiologies of macular edema. Meta-analysis showed that change in CMT was not significantly different between the two groups at 1 month (MD: -11.34 95% CI: -47.51, 24.82 I² = 2%), 3 months (MD: -0.43 95% CI: -33.36, 32.5 I² = 44%), 6 months (MD: -0.69 95% CI: -33.57, 34.95 I² = 18%) or 12 months ((MD: 37.46 95% CI: -4.86, 79.77 I² = 86%). The pooled analysis found no statistically significant difference between the two groups for change in BCVA at 1 month (MD: 0.04 95% CI: -0.01, 0.09 I² = 32%), 3 months (MD: 0.04 95% CI: -0.02, 0.09 I² = 0%) and 6 months (MD: 0.06 95% CI: 0.00, 0.11 I² = 0%). However, change in BCVA was significantly higher in the vitrectomized group at 12 months (MD: 0.17 95% CI: 0.13, 0.22 I² = 54%). The meta-analysis found no statistically significant difference in the risk of a rise in IOP between the two groups (OR: 1.26 95% CI: 0.81, 1.95 I² = 0%). Subgroup analysis based on etiology did not change the results.

CONCLUSIONS: DEXI may be equally efficacious and safe in vitrectomized and non-vitrectomized eyes.

PMID:40601878 | DOI:10.1080/09273948.2025.2519851

J Am Chem Soc. 2025 Jul 2. doi: 10.1021/jacs.5c08517. Online ahead of print.

ABSTRACT

Chirality-induced spin selectivity (CISS), which refers to the ability of chiral molecules to preferentially select spins during electron transfer, has attracted great attention during the past two decades. However, the theoretical and experimental understanding of the CISS effect remains preliminary. In this study, we demonstrate that there is no distinguishable CISS effect in the case of coherent electron transport through single chiral molecular junctions for a set of four molecule studied here. Our conclusion is based on statistical evaluations of thousands of single-molecule junctions across four different molecules with different origins of chirality measured by the scanning tunneling microscope-based break-junction technique. The experimental results for all molecules show no dependence on external magnetic field or chirality in both conductance and current-voltage measurements. In addition, ab initio Hartree-Fork calculations combined with the nonequilibrium Green’s function method reveal that the spin-orbit coupling within chiral junctions bound to a few gold atoms is generally too weak to induce detectable spin polarizations from spin flipping or spin filtering during the ultrafast electron-transport time scale. The absence of an observable CISS effect in the coherent electron-transport regime suggests that the effect may only be found in other electron-transfer regimes and requires further experimental and theoretical efforts to achieve a comprehensive understanding.

PMID:40601876 | DOI:10.1021/jacs.5c08517

Bioconjug Chem. 2025 Jul 2. doi: 10.1021/acs.bioconjchem.5c00168. Online ahead of print.

ABSTRACT

Glioblastoma Multiforme (GBM) represents a significant clinical challenge among central nervous system tumors, with a dismal mean survival rate of less than 8 months, a statistic that has remained largely unchanged for decades (National Brain Society, 2022). The specialized intricate anatomical features of the brain, notably the blood-brain barrier (BBB), pose significant challenges to effective therapeutic interventions, limiting the potential reach of modern advancements in immunotherapy to impact these types of tumors. This study introduces an innovative, actively targeted immunotherapeutic nanoconjugate (P-12/AP-2/NCs) designed to serve as an immunotherapeutic agent capable of traversing the BBB via LRP-1 receptor-mediated transcytosis. P-12/AP-2/NCs exert their immune-modulating effects by inhibiting the PD-1/PD-L1 axis through a small-sized PD-L1/PD-L2 antagonist peptide, Aurigene NP-12 (P-12). P-12/AP-2/NCs are synthesized from completely biodegradable, functionalized high molecular weight β-poly(l-malic acid) (PMLA) polymer conjugated with P-12 and Angiopep-2 (AP-2) to yield P-12/AP-2/NCs. Evaluating nanoconjugates for BBB permeability and 3D tumor model efficacy using an in vitro BBB-Transwell spheroid-based model demonstrated successful crossing of the BBB and internalization in brain 3D tumor environments. In addition, the nanoconjugate mediated T cells’ cytotoxicity on 3D tumor region death in a U87 GBM 3D spheroid model. AP-2/P-12/NCs are selectively inhibited in PD1/PDL1 interaction on T cells and the tumor site, increasing inflammatory cytokine secretion and T cell proliferation. In an in vivo murine brain environment, rhodamine fluorophore-labeled AP-2/P-12/NCs displayed significantly increased accumulation in the brain during 2-6 h time intervals postinjection with a prolonged bioavailability over unconjugated peptides. AP-2/P-12/NCs demonstrated a safety profile at both low and high doses based on major organ histopathology evaluations. Our findings introduce a novel, programmable nanoconjugate platform capable of penetrating the BBB for directed delivery of small peptides and significant immune environment modulation without utilizing antibodies, offering promise for treating challenging brain diseases such as glioblastoma multiforme and beyond.

PMID:40601862 | DOI:10.1021/acs.bioconjchem.5c00168