Tag: pubmed

J Craniofac Surg. 2025 Sep 10. doi: 10.1097/SCS.0000000000011930. Online ahead of print.

ABSTRACT

BACKGROUND: With the development of artificial intelligence, obtaining patient-centered medical information through large language models (LLMs) is crucial for patient education. However, existing digital resources in online health care have heterogeneous quality, and the reliability and readability of content generated by various AI models need to be evaluated to meet the needs of patients with different levels of cultural literacy.

OBJECTIVE: This study aims to compare the accuracy and readability of different LLMs in providing medical information related to gynecomastia, and explore the most promising science education tools in practical clinical applications.

METHODS: This study selected 10 most frequently searched questions about gynecomastia from PubMed and Google Trends. Responses were generated using 3 LLMs (DeepSeek-R1, OpenAI-O3, Claude-4-Sonnet), with text quality assessed using the DISCERN-AI and PEMAT-AI scales. Text readability and legibility were comprehensively evaluated through metrics including word count, syllable count, Flesch-Kincaid Grade Level (FKGL), Flesch Kincaid Reading Ease (FKRE), SMOG index, and Automated Readability Index (ARI).

RESULTS: In terms of quality evaluation, among the 10 items of the DISCERN-AI scale, only the overall content quality score showed a statistically significant difference (P = 0.001), with DeepSeek-R1 demonstrating the best performance at a median score of 5 (5,5). Regarding readability, DeepSeek-R1 exhibited the highest average word count and syllable count, both with P-values of 0.000. The 3 models showed no significant differences in FKGL, FKRE, or automatic readability indices. Specifically, the averaged FKGL scores of DeepSeek-R1 was 14.08, OpenAI-O3 was 14.1, and Claude-4-sonnet was 13.31. The SOMG evaluation revealed that Claude-4-sonnet demonstrated the strongest readability, the average value is 11 with a P-value of 0.028.

CONCLUSION: DeepSeek-R1 demonstrated the highest overall quality in content generation, followed by Claude-4-sonnet. Evaluations using FKGL, SMOG index, and ARI all indicated that Claude-4-sonnet exhibited the best readability. Given that improvements in quality and readability can enhance patient engagement and reduce anxiety, these 2 models should be prioritized for patient education applications. Future efforts should focus on integrating these advantages to develop more reliable large-scale medical language models.

PMID:40929657 | DOI:10.1097/SCS.0000000000011930

Hum Reprod. 2025 Sep 10:deaf169. doi: 10.1093/humrep/deaf169. Online ahead of print.

ABSTRACT

STUDY QUESTION: Does weight loss from a hypocaloric dietary intervention improve antral follicle dynamics in women with PCOS?

SUMMARY ANSWER: During a 3-month hypocaloric dietary intervention, women with PCOS who experienced clinically meaningful weight loss showed more organized antral follicle development including fewer recruitment events, but no change in the overall frequency of selection, dominance, or ovulation.

WHAT IS KNOWN ALREADY: There is a spectrum of disordered antral follicle development in women with PCOS including excessive follicle recruitment and turnover, decreased frequency of selection and dominance, and failure of ovulation. Lifestyle intervention aimed at weight loss is recommended to improve metabolic health in women with PCOS yet benefits on ovarian follicle development and ovulation are unclear.

STUDY DESIGN, SIZE, DURATION: This was a prospective, single-arm lifestyle intervention study conducted over 4 months including a 1-month baseline assessment period and 3-month hypocaloric dietary intervention. Twenty women were allocated to the intervention with 0% attrition.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Females, ages 18-38 years, with PCOS and obesity (BMI > 30 kg/m2) underwent every-other-day transvaginal ultrasonography and venipuncture at an academic clinical research unit for 4 months. The number and size of all follicles were evaluated at each study visit, with individual growth profiles plotted retrospectively for follicles that grew to at least 7 mm. Gonadotropin and ovarian steroid hormone concentrations were measured every-other-day. Reproductive, anthropometric, and metabolic status markers were assessed at baseline and at the end of the intervention.

MAIN RESULTS AND THE ROLE OF CHANCE: Hypocaloric dietary intervention resulted in an average weight loss of 8 ± 3% with significant reductions in all anthropometric markers assessed including BMI, waist circumference, total percent fat, and trunk fat mass (all P < 0.05). Of the glucoregulatory and cardiovascular risk markers assessed, only diastolic blood pressure (P = 0.040) and 2-h insulin concentrations following a glucose challenge (P = 0.029) were decreased post-intervention. Antral follicle development appeared more cyclic following the intervention with the frequency of recruitment (P = 0.043), and number of follicles recruited per cohort (P < 0.0001), decreasing with weight loss. By contrast, the frequency of selection, dominance, and ovulation did not change with weight loss (all P < 0.05). When ovulation occurred during the intervention, the size at selection for ovulatory follicles decreased with weight loss (P < 0.0001), whereas maximum luteal progesterone levels increased with weight loss (P = 0.036). Participants (35%) who responded to the intervention with a shortened inter-menstrual interval had lower baseline trunk fat mass (P = 0.048), fasting insulin (P = 0.022), and homeostatic model assessment for insulin resistance (P = 0.017) compared to non-responders.

LIMITATIONS, REASONS FOR CAUTION: The duration of the intervention may not have been sufficient to capture an impact of weight loss on ovulatory cyclicity. Analyses were limited to the antral stages of follicle development and any impact of hypocaloric dietary intervention on pre-antral folliculogenesis was not evaluated. The small study sample limits statistical power and generalizability of the findings.

WIDER IMPLICATIONS OF THE FINDINGS: Short-term hypocaloric dietary intervention did not consistently improve ovulation frequency in women with PCOS despite clinically meaningful weight loss. Counseling related to the benefits of short-term hypocaloric dietary intervention on reproductive health outcomes should be tempered as improvements in ovulation are likely only in those with a more favorable metabolic profile at the onset. Improvements in the early stages of antral follicle development with weight loss suggest potential for longer dietary interventions to improve ovulatory cyclicity in women with PCOS.

STUDY FUNDING/COMPETING INTEREST(S): This research was supported by funds from the President’s Council of Cornell Women, United States Department of Agriculture (Grant No. 8106), and National Institutes of Health (R01-HD0937848, R56-HD089962). F.E.C., B.Y.J., and H.V.B. were supported by doctoral training awards from the National Institutes of Health (5 T32-HD087137, T32-DK007158) and Canadian Institutes of Health Research (Grant No. 146182), respectively. The authors have no competing interests.

TRIAL REGISTRATION NUMBER: NCT01785719.

PMID:40929646 | DOI:10.1093/humrep/deaf169

Eur J Gastroenterol Hepatol. 2025 Sep 1. doi: 10.1097/MEG.0000000000003041. Online ahead of print.

ABSTRACT

BACKGROUND: Prior studies have implicated diabetes as a risk factor for pancreatic cancer, yet the impact of diabetes progression on pancreatic cancer incidence remains unclear. We aim to assess pancreatic cancer risk across different stages of diabetes.

METHODS: Employing a predefined search strategy, we conducted a literature review of electronic databases up to 29 February 2024. Extracting odds ratios (OR) and 95% confidence intervals (CIs) relevant to diabetes, we aimed to evaluate pancreatic cancer risk among diabetic patients and conduct subgroup analyses.

RESULTS: Our systematic review comprised 29 observational cohort studies with 25 million participants. We observed a 2.13-fold higher likelihood of pancreatic cancer among diabetic individuals compared with nondiabetic counterparts. Specifically, males with diabetes exhibited a greater pancreatic cancer risk than females; however, regional disparities in pancreatic cancer risk among diabetic patients were NS. Regarding diabetes duration, pooled ORs (95% CI) for pancreatic cancer risk were 2.41 (2.07-2.81) for 1-4 years, 1.67 (1.50-1.85) for 4-10 years, and 2.01 (1.81-2.22) for over 10 years.

CONCLUSION: The results of this study confirm a significant association between diabetes and pancreatic cancer. Although there was no statistically significant difference in risk between different diabetes duration groups, diabetic patients overall face a higher risk of pancreatic cancer. Therefore, diabetic patients should undergo regular pancreatic cancer screening and take appropriate management measures to detect potential pancreatic cancer at an early stage.

PMID:40929644 | DOI:10.1097/MEG.0000000000003041

N Engl J Med. 2025 Sep 11;393(10):994-1003. doi: 10.1056/NEJMsa2415987.

ABSTRACT

BACKGROUND: In 2019, seven county correctional facilities (jails) in Massachusetts initiated pilot programs to provide all Food and Drug Administration-approved medications for opioid use disorder (MOUD).

METHODS: This observational study used linked state data to examine postrelease MOUD receipt, overdose, death, and reincarceration among persons with probable opioid use disorder (OUD) in carceral settings who did or did not receive MOUD from these programs from September 1, 2019, through December 31, 2020. Log-binomial and proportional-hazards models were adjusted for propensity-score weights and baseline covariates that remained imbalanced after propensity-score weighting.

RESULTS: The study cohort included 6400 persons with probable OUD: 2711 (42.4%) received MOUD in jail and 3689 (57.6%) did not. Among persons treated with MOUD in jail, 67.9% received buprenorphine, 25.7% received methadone, and 6.5% received naltrexone. Treated persons were more likely than those not treated to be White (75.4% vs. 58.1%), to be sentenced (31.6% vs. 13.2%), to be receiving MOUD at jail entry (73.7% vs. 17.1%), and to receive MOUD during the first 30 days after community release (60.2% vs. 17.6%; adjusted relative risk, 1.44; 95% confidence interval [CI], 1.38 to 1.50). Only 50.4% of MOUD recipients engaged in MOUD treatment for 75% of the first 90 days after release, and 57.5% were receiving MOUD at 180 days. Receipt of MOUD in jail, as compared with no such receipt, was associated with lower postrelease risks of fatal overdose (adjusted hazard ratio, 0.48; 95% CI, 0.36 to 0.64), nonfatal overdose (adjusted hazard ratio, 0.76; 95% CI, 0.68 to 0.85), death from any cause (adjusted hazard ratio, 0.44; 95% CI, 0.35 to 0.56), and reincarceration (adjusted hazard ratio, 0.88; 95% CI, 0.81 to 0.94). The incidence of hospitalizations did not differ substantially between the two groups.

CONCLUSIONS: Receipt of MOUD in jail was associated with an increased likelihood of postrelease MOUD initiation and decreased risks of overdose, death from any cause, and reincarceration. (Funded by the National Institutes of Health and others.).

PMID:40929634 | DOI:10.1056/NEJMsa2415987

Pain Med Case Rep. 2023 Sep;7(5):275-280.

ABSTRACT

BACKGROUND: Post-traumatic stress disorder (PTSD) is an increasing health concern in both those with and without previous military experience. There is a growing body of evidence for the use of stellate ganglion block (SGB), a procedure performed to treat pain conditions and cardiac arrythmias, in the treatment of PTSD. There have been multiple clinical studies, randomized and nonrandomized, that have demonstrated positive results for the use of SGB.

CASE REPORT: In this case series, we present 3 patients with military background and treatment resistant PTSD who underwent SGBs. All 3 patients experienced a decrease in their clinical symptoms and improved quality of life.

CONCLUSION: Patients with refractory PTSD may benefit from SGB for treatment of their symptoms. PTSD symptoms may be sympathetically mediated, lending to the effect of SGB for symptom management. Data from recent clinical trials demonstrate a statistically significant reduction in PTSD symptoms when compared to sham procedures.

PMID:40929591

JMIR Public Health Surveill. 2025 Sep 10;11:e67115. doi: 10.2196/67115.

ABSTRACT

BACKGROUND: The Brazilian project, launched in 2021, aims to establish a nationwide injury registry that systematically collects detailed information on incidents and individuals across the country, regardless of injury severity. The registry integrates information from prehospital and hospital care, various health systems lacking interoperability, and data from sectors such as firefighters and police. Its primary aim is to enhance health surveillance by providing timely, high-quality information that guides prevention strategies and informs policymaking. In addition, the project seeks to reduce morbidity and mortality associated with injuries.

OBJECTIVE: This study aimed to investigate the effects of injury registry data on policymaking, hospitalization rates or duration, and mortality.

METHODS: The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD42023481528). A total of 5 databases were searched in November 2023, with an update conducted in March 2024, incorporating reference lists from the studies included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale, resolving disagreements with a third reviewer. Studies were eligible if they reported results related to the implementation and use of injury or trauma registry data for at least one outcome of interest, while those based on other sources were excluded. Synthesis of findings was presented in tables, and the observed results were reported as number or percentage differences.

RESULTS: Out of 9100 studies retrieved, 3951 were excluded due to duplication, leaving 5149 for selection, with 15 full texts reviewed. Only 5 studies met the inclusion criteria, highlighting a notable scarcity of research on the effects or results of registry data on injury outcomes. It is important to note that the studies included reflect correlations rather than causalities, and there are currently no publications on impact. The findings suggest that injury and trauma registries have the potential to inform policymaking, which can lead to enhanced health outcomes. One study noted a 3-day reduction in intensive care unit stay (from 16 to 13 days; P<.05) and a 4% reduction in expected hospital mortality (from 17.5% to 21.5%) for patients with an Injury Severity Score ≥16, while another showed a 42% annual decrease in traffic injury hospital admissions (from 45 to 16). Significant methodological heterogeneity and the small number of studies limited the feasibility of a meta-analysis.

CONCLUSIONS: Establishing an injury registry in Brazil presents a significant opportunity to enhance health outcomes through informed policymaking. While it is crucial to set appropriate expectations regarding its effects on morbidity and mortality, particularly concerning the causality and transportability of the findings to the Brazilian context, its role in facilitating preventive measures and improving surveillance capabilities remains valuable.

PMID:40929579 | DOI:10.2196/67115

Cereb Cortex. 2025 Aug 1;35(8):bhaf245. doi: 10.1093/cercor/bhaf245.

ABSTRACT

This Editorial shares with the neuroscience community the signs of progress in making Cerebral Cortex more attractive. Furthermore, the journal commemorates the Statistical Parametric Mapping (SPM), introduced by Karl Friston and his collaborators three decades ago. Over time, SPM has had a profound impact on the way of thinking in neuroscience. The journal offers a magnificent fireworks display of reflections on the past, present and future of SPM. Yet, the debate extends far beyond SPM. It touches on crucial issues such as how to interpret the growing body of neuroimaging data and explain it in a biologically plausible way that echoes the nature of brain function.

PMID:40928750 | DOI:10.1093/cercor/bhaf245

Cereb Cortex. 2025 Aug 1;35(8):bhaf240. doi: 10.1093/cercor/bhaf240.

ABSTRACT

Statistical Parametric Mapping (SPM) adheres to rigorous methodological standards, including: spatial normalization, inter-subject averaging, voxel-wise contrasts, and coordinate reporting. This rigor ensures that a thematically diverse literature is amenable to meta-analysis. BrainMap is a community database (www.brainmap.org; www.portal.brainmap.org) launched contemporaneously with SPM with the goal of efficiently sharing the results and methods of the literature compliant with SPM standards. The SPM-BrainMap symbiosis has motivated the development of coordinate-based meta-analytic methods and a substantial literature of secondary analyses. Collectively this corpus constitutes system-level probabilistic maps and models of the human brain, which details its functional organization, network architecture, and alterations by disease.

PMID:40928749 | DOI:10.1093/cercor/bhaf240

Cereb Cortex. 2025 Aug 1;35(8):bhaf234. doi: 10.1093/cercor/bhaf234.

ABSTRACT

This paper marks the 30th anniversary of the Statistical Parametric Mapping (SPM) software and the journal Cerebral Cortex: two modest milestones that mark the inception of cognitive neuroscience. We take this opportunity to reflect on SPM, a generation after its introduction. Each of the authors of this paper-who represent a small selection of the many contributors to SPM-were asked to consider lessons learned, what has gone well, and where there is room for improvement in future development. We hope that this review of SPM-and its aspirations-will provide some context for current imaging neuroscience and foreground some potential directions for the future of the field.

PMID:40928747 | DOI:10.1093/cercor/bhaf234

Cereb Cortex. 2025 Aug 1;35(8):bhaf243. doi: 10.1093/cercor/bhaf243.

ABSTRACT

Statistical Parametric Mapping is a widely used package of software for brain image analysis. It has also been the vehicle for sustained theoretical innovation and global impact in cognitive neuroscience. What can we learn from its success as it reaches middle age?

PMID:40928746 | DOI:10.1093/cercor/bhaf243