Tag: nevin manimala

Neurosurg Rev. 2025 May 29;48(1):455. doi: 10.1007/s10143-025-03597-9.

ABSTRACT

BACKGROUND: Artificial Intelligence (AI) has emerged as a transformative tool in medicine, particularly addressing neurosurgical challenges such as complex anatomical delineation and intraoperative decision-making. Despite advancements in diagnostic and prognostic algorithms, obstacles including algorithmic bias, data privacy, and model interpretability continue to limit its widespread clinical adoption.

OBJECTIVE: This systematic review aims to evaluate the current applications of AI in neurosurgery, compare the performance of various AI models, and examine the ethical challenges associated with their integration into clinical practice.

METHODS: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases, following PRISMA guidelines. Studies from 2015 to 2025 focusing on AI applications in diagnostic, prognostic, surgical, and intraoperative neurosurgical contexts were included. Statistical outcomes, model performance metrics, and ethical considerations were analyzed.

RESULTS: Thirteen studies met the inclusion criteria. AI models, particularly ML and DL, demonstrated superior diagnostic accuracy (AUC > 0.90) and improved prognostic predictions by up to 15%. AI-assisted surgical planning enhanced precision and reduced complication rates by 10-20%. However, algorithmic bias, limited transparency, and lack of external validation remain key barriers to clinical adoption.

CONCLUSION: AI improves diagnostic accuracy, prognostic predictions, and surgical precision while reducing complication rates. However, challenges such as bias, limited interpretability, and the need for external validation must be addressed for widespread clinical integration.

PMID:40439939 | DOI:10.1007/s10143-025-03597-9

Indian J Gastroenterol. 2025 May 29. doi: 10.1007/s12664-025-01771-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The potential impact of opium addiction on medical procedures has not been thoroughly investigated. In the present study, we aimed at investigating the potential association between opium addiction and the outcomes of endoscopic retrograde cholangiopancreatography (ERCP).

METHODS: In this retrospective case-control study, patients who underwent ERCP between July 2021 and October 2023 at a tertiary care center were screened and patients with opium addiction were matched with non-addict patients based on age, sex, ERCP indication and the cannulation approach at 1:1 ratio. The analysis compared the ERCP findings and post-ERCP complications between the two groups.

RESULTS: Overall, 276 patients with and without opium addiction were included (n = 138 for each group). The overall complication rate in the opium group was 10.1%, significantly higher than the control group (1.4%) (p = 0.003). Post-ERCP pancreatitis (5.8% vs. 1.4%, p = 0.046), bleeding (2.9% vs. 0%, p = 0.044) and perforation (1.4% vs. 0%, p = 0.156) were more common in the opium group. The procedural success rate of ERCP was 79.0% in opium group, while patients without opium addiction had a success rate of 85.5%, but it was not statistically significant (p = 0.207).

CONCLUSION: ERCP could be associated with higher rate of complications in opium-addict patients. Accurate procedural techniques and appropriate prophylaxis should be considered to reduce the risk of complications.

PMID:40439935 | DOI:10.1007/s12664-025-01771-x

Arch Dermatol Res. 2025 May 29;317(1):786. doi: 10.1007/s00403-025-04282-z.

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, which primarily affects the gut, but is not restricted to the intestinal tract. IBD is result of a complex interplay between a dysfunctional host immune response and environmental triggers. Extraintestinal manifestations (EIMs) are frequently observed in patients with IBD. The aim of this study was to evaluate the prevalence and features of the major cutaneous manifestations and associating factors in patients with IBD. This cross-sectional study was conducted on patients with IBD who were referred to gastroenterology and dermatology outpatient clinics in Imam Khomeini Hospital Complex, in Tehran, Iran, between March 2020 and March 2021. All patients underwent a body examination by a gastroenterologist and dermatologist. We used SPSS (version 25) to run appropriate statistical tests to analyze any relationship between skin diseases, and socio-demographic and disease-related characteristics of the patients, as well as medications used. A total of 226 patients were included in this study of which 59 (26.1%) were diagnosed with CD and 167 (73.9%) with UC. Eighty-six participants (38.1%) of all IBD patients (52.5% of CD patients and 32.9% of UC patients) had skin disease at the time of examination. Patients with CD were significantly more likely to have skin disease at the time of examination or while IBD was active (p = 0.008 and p = 0.019, respectively). Aphthous stomatitis and atopic dermatitis were the most frequent skin disease observed in all IBD patients (11.1% for both) as well as UC patients, whereas perianal fissure was the most frequent cutaneous manifestation in CD patients. Psoriasis and aphthous stomatitis were more common in female patients (p = 0.046 and p = 0.004, respectively). Skin diseases were generally more frequent in female (p = 0.001) and married patients (p = 0.015). Our research revealed that aphthous stomatitis and atopic dermatitis were the most common skin-related extraintestinal manifestations (EIMs) observed in all patients with inflammatory bowel disease (IBD). Furthermore, individuals with Crohn’s disease (CD) were more prone to developing skin manifestations. Women and married individuals are considered high-risk groups for skin lesions, and it is advisable for these patients to undergo regular skin examinations.

PMID:40439921 | DOI:10.1007/s00403-025-04282-z

Gastroenterol Nurs. 2025 May-Jun 01;48(3):191-202. doi: 10.1097/SGA.0000000000000868. Epub 2025 May 28.

ABSTRACT

This study investigated the current occurrence of hypoglycemia during bowel preparation of outpatients undergoing colonoscopy in endoscopy centers. A total of 399 outpatients from an eastern province of China participated in the survey. Participants’ characteristics and health information, colonoscopy information questionnaire and the state-trait anxiety inventory (STAI) were used as the study tools. Terminal blood glucose was measured by trained nurses before and after colonoscopy. The results showed that the incidence of hypoglycemia during bowel preparation was 17%. Mildly coughing when eating food (odds ratio [OR] = 3.821, 95% confidence interval [CI] = 1.570-9.299, p = .003), drinking alcohol 4-6 times per week (OR = 5.776, 95% CI = 1.794-18.600, p = .003), a history of hypoglycemia (OR = 2.275, 95% CI = 1.135-4.557, p = .020), fasting time ≥ 10 h (OR = 2.933, 95% CI = 1.118-7.699, p = .029), waiting time ≥ 12 h (OR = 0.446, 95% CI = 0.226-0.879, p = .020), subjective hunger (OR = 4.742, 95% CI = 2.255-9.972, p < .001), and STAI score (OR = 1.051, 95% CI = 1.012-1.090, p < .001), were the influencing factors of hypoglycemia in outpatients. It is suggested that clinical staff in endoscopy centers should identify the above risk factors as soon as possible, and conduct timely intervention to prevent hypoglycemia and avoid more serious consequences.

PMID:40439905 | DOI:10.1097/SGA.0000000000000868

Gastroenterol Nurs. 2025 May-Jun 01;48(3):174-181. doi: 10.1097/SGA.0000000000000867. Epub 2025 May 28.

ABSTRACT

This randomized clinical trial was conducted with the aim of comparing the effect of self-care education through two methods, a smartphone application (app) and teach-back (TB), on lifestyle and quality of life (QoL) in patients with inflammatory bowel diseases (IBD). This three-stage randomized clinical trial was conducted among 90 patients with IBD in Mashhad, Iran. Eligible patients were allocated to three groups (app, TB, and control) using simple blocked randomization. In each group, data were collected by a demographic checklist, the Crohn’s Disease and Ulcerative Colitis questionnaire, and the Miller-Smith Lifestyle questionnaire. Before the intervention, the results of one-way analysis of variance showed that there was no statistically significant difference between the three groups in terms of the mean scores of lifestyle and QoL (p > .05). However, a significant difference was observed between the three groups after the intervention (p < .05). The results of this study show that self-care education through two methods of an app and TB has a significant effect on improving IBD patients’ lifestyle and QoL, and there is no significant difference between the two methods in terms of effectiveness. Considering the advantages of apps, it is suggested to apply this method for patient education.

PMID:40439903 | DOI:10.1097/SGA.0000000000000867

Gastroenterol Nurs. 2025 May-Jun 01;48(3):153-160. doi: 10.1097/SGA.0000000000000874. Epub 2025 May 28.

ABSTRACT

Colonoscopy is a primary diagnostic method for colorectal cancer screening. Ensuring completeness is critical for its effectiveness. The aim of this study is to explores patient and procedure-related contributors to incomplete colonoscopy in a Danish high volume endoscopy unit. A population-based register study was conducted, using data from electronic health records from a Danish hospital was analyzed, covering all colonoscopies performed between July 2015 and August 2019. The primary outcome assessed was the completeness of the index colonoscopy, with incomplete cases further classified based on the causes for incompleteness that were assessed and documented in real-time by the endoscopist. Data also included patient demographics and comorbidities, and profession of the endoscopist. Among 33,128 colonoscopies, prevalence of incomplete colonoscopies was 6.55%, with inadequate bowel preparation as the leading cause (60.3%). Men were more prone to inadequate bowel preparation, while procedural pain, non-passability, and stenosis were associated with women. Physician endoscopists exhibited higher incomplete colonoscopy rates compared to nurse endoscopists, and patients with higher comorbidity scores were more likely to have incomplete colonoscopy. This study highlights the prevalence of incomplete colonoscopy and recognizes modifiable risk factors like inadequate bowel preparation and procedural pain. Findings underscore the need for personalized interventions, stressing ongoing endoscopist education and targeted strategies to improve colonoscopy effectiveness.

PMID:40439900 | DOI:10.1097/SGA.0000000000000874

Eur J Prev Cardiol. 2025 May 29:zwaf304. doi: 10.1093/eurjpc/zwaf304. Online ahead of print.

ABSTRACT

AIMS: There is an overabundance of cardiovascular disease (CVD) risk-prediction models applicable to patients with Type 2 diabetes (T2D), but most of them still require external validation. Our aim was to assess the performance of 18 CVD risk scores in a Spanish cohort of patients with T2D.

METHODS AND RESULTS: The CARdiovascular Risk in patients with DIAbetes in Navarra (CARDIANA) cohort, which includes 20 793 individuals with T2D and no history of CVD, was used to externally validate 13 models developed in patients with T2D [Action in Diabetes and Vascular Disease (ADVANCE), Atherosclerosis Risk in Communities, Basque Country Prospective Complications and Mortality Study risk engine, Cardiovascular Healthy Study, Diabetes Cohort Study, DIAL2, DIAL2-extended, Fremantle, Kaasenbrood, Swedish National Diabetes Register (NDR), PREDICT1-diabetes, SCORE2-diabetes, and Wan] and 5 models developed in the general population (ASCVD, PREVENT-basic, PREVENT-full, QRISK2, and SCORE2). Harrell’s C-statistic and calibration plots were used as measures of discrimination and calibration, respectively. There were 991 incident CVD events within 5 years of follow-up, resulting in a cumulative incidence of 5.0% (95% confidence interval 4.7-5.3). Discrimination ability was moderate for all the models, with SCORE2-diabetes, NDR, PREDICT1-diabetes, PREVENT-full, Wan, ADVANCE, and both DIAL2 models showing the highest C-index values. All models showed good calibration, although most of them required recalibration, with the exception of ADVANCE-, DIAL2-, and SCORE2-related models.

CONCLUSION: In our context, models derived for or adapted to diabetes patients, as well as models derived in the general population but incorporating diabetes-related metabolic measures (such as Hb1Ac) as predictors, demonstrated better performance than the others. DIAL2, DIAL2-extended, SCORE2-diabetes, and ADVANCE showed optimal calibration even without recalibration, which implies greater applicability, especially for SCORE2-diabetes and ADVANCE because of their simplicity.

PMID:40439899 | DOI:10.1093/eurjpc/zwaf304

Planta. 2025 May 29;262(1):10. doi: 10.1007/s00425-025-04703-3.

ABSTRACT

A model predicting the level of resistance of basil to downy mildew was developed. The model integrates plant age, genetic background, sporulation, disease intensity, pathogen races, and environmental data at an early stage of disease. These results can be used to select and develop new basil cultivars and accelerate the time needed in breeding for basil downy mildew resistance. Basil downy mildew (BDM) caused by the oomycete Peronospora belbahrii emerged as a global threat, rapidly becoming the most devastating disease of sweet basil (Ocimum basilicum) and other Ocimum spp. worldwide. Despite advancements in understanding its biology and epidemiology, and the availability of approved fungicides and management strategies, BDM remains economically destructive and an ongoing risk to basil production worldwide. Recently, the development and introduction of resistant cultivars have emerged as crucial tools in BDM management and the emergence of new BDM races creates new challenges to controlling this disease. The present study aimed to provide growers and breeders with insights into the survival capabilities of resistant basil cultivars under varying genetic backgrounds, pathogen races, growth stages, and various environmental conditions. Through a series of lab and field experiments, we evaluated the response of multiple resistant sources and their lineages to various isolates of P. belbahrii across different locations, using multiple indices to assess their resistance. Entries carrying the R genes Pb1/Pb2 exhibited complete resistance across all races, growth stages, and environmental conditions. Those harboring the R-gene Pb2 showed similar resistance levels, with minor variability due to growth stage. Responses of Pb1 plants varied with pathogen race, displaying full resistance to race 0 at all growth stages but displaying susceptibility to race 1. Plant cultivars possessing MRI resistance genes and their recombinant inbred lines (RIL’s) exhibited variable responses to pathogen attacks, ranging from high tolerance to complete susceptibility. Some MRI RIL’s showed high resistance similar to Pb2 entries. Pb0 cultivars and ‘Eleonora’ (unknown background) were susceptible to all races and growth stages in all experiments. Comprehensive analysis across all genetic backgrounds revealed a significant correlation (R = 0.73) between disease intensity (D.I) at the seedling stage under controlled conditions and D.I in adult plants under field conditions. Principal Component Analysis (PCA) across six experiments indicated that the primary components influencing disease outcomes were the accession, race, and growth stage, explaining 65%, 22%, and 7% of the variability, respectively. A prediction model based on the statistical parameters residual (%) and root-mean-square error (RMSE) demonstrated strong predictability, particularly regarding pathogen sporulation and daily disease development rates. The model predicted resistance probabilities with R² values of 0.81, 0.91, and 0.93 at the second, third, and final disease score readings, respectively, significantly earlier (~ 14-21 days post-infection) than traditional assessments (~ 42 days). These findings demonstrate that resistance in basil entries against current pathogen races can be effectively assessed within weeks of disease onset, facilitating more timely and informed management decisions for growers and providing an important tool for plant breeders in search of improved BDM resistance.

PMID:40439895 | DOI:10.1007/s00425-025-04703-3

Health Serv Res. 2025 Jun;60(3):e14422. doi: 10.1111/1475-6773.14422. Epub 2024 Dec 29.

ABSTRACT

OBJECTIVE: To evaluate the data consistency and quality of Medicaid claims data on opioid use disorder (OUD) treatment, benchmarking the Transformed Medicaid Statistical Information System Analytic Files (TAF) against metrics reported by the Medicaid Outcomes Distributed Research Network (MODRN), which analyzed data obtained directly from 11 state Medicaid agencies.

DATA SOURCES AND STUDY SETTING: The primary data source was TAF claims for the years 2017 and 2018, limited to non-dual, full-benefit Medicaid beneficiaries aged 12-64 in one of the 11 states in our study sample.

STUDY DESIGN: Using TAF data, we replicated performance on the following five OUD quality metrics reported by MODRN: number of enrollees receiving any OUD medication, receipt of behavioral health counseling, completion of urine drug screens, receipt of any opioid analgesic fill, and receipt of any benzodiazepine fill.

DATA COLLECTION/EXTRACTION METHODS: Access to TAF data was facilitated through the Chronic Conditions Warehouse.

PRINCIPAL FINDINGS: There were 11% fewer Medicaid enrollees with OUD in TAF compared to MODRN (912,478 vs. 1,034,412). Patient characteristics were largely similar across the two datasets, with the exception of more missing race information in TAF (20.9% vs. 7.1%). Across the 11 states, performance on the six quality measures was similar. For example, the rate of use of any OUD medication in 2018 was 57.1% in MODRN and 58.6% in TAF. However, there were important discrepancies in the TAF data in individual states for single years.

CONCLUSIONS: TAF data may undercount patients with OUD, but otherwise exhibited consistency with MODRN benchmarks, suggesting suitability of TAF for research on OUD treatment. Our results highlight several data quality issues with TAF that researchers who use these data should be aware of, including reporting of race and ethnicity.

PMID:40438998 | DOI:10.1111/1475-6773.14422

Biomark Med. 2025 May 29:1-15. doi: 10.1080/17520363.2025.2511466. Online ahead of print.

ABSTRACT

INTRODUCTION: MicroRNA (miRNA) single nucleotide polymorphisms (miRNA-SNPs) have been associated with pediatric acute lymphoblastic leukemia (ALL). However, since the results of these individual studies have been inconsistent, we performed a meta-analysis to help establish a statistical significance for the association between miRNA-SNPs and pediatric ALL risk. We also analyzed whether they confer susceptibility across country-specific studies by using different genetic models.

METHODS: Articles published from 2001 to 2023 were collected from PubMed and Google Scholar databases. Through MetaGenyo, the association between miRNA- SNPs and pediatric ALL risk was calculated by pooled odds ratio [ORs] and 95% CI. A subgroup analysis of pooled ORs in country-specific studies was also performed.

RESULTS: Based on the inclusion and exclusion criteria, 14 studies were analyzed to extract data on miR146 rs2910164, miR-196a2 rs11614913, miR-612 rs12803915 and mir-499 rs3746444. While the pooled data analysis did not reveal any association, a subgroup analysis demonstrated country-specific differences in allele frequencies of all the four miRNAs in various genetic models, implying ethnicity-based risk.

CONCLUSION: Our results suggested that miRNA-SNPS can still be considered as a potential risk factor to be explored in more populations.

PMID:40438964 | DOI:10.1080/17520363.2025.2511466