Tag: pubmed

Cancer J. 2025 Nov-Dec 01;31(6):e0797. doi: 10.1097/PPO.0000000000000797. Epub 2025 Nov 18.

ABSTRACT

Generative artificial intelligence (Gen-AI) powered technologies are increasingly integrated across virtually all fields, including oncology, poised to fundamentally transform human-machine interaction (HMI). In biomedicine and oncology, Gen-AI tools are forming the foundation for intuitive patient-facing and clinician-facing interfaces that increase accessibility and efficiency of health care applications, enhance patient experience, and improve clinical workflows, ultimately optimizing patient outcomes. Despite Gen-AI’s great potential in health care, limitations related to data quality and learning algorithms can create persistent challenges to patient safety, warranting a thorough HMI evaluation by end-users and experts that goes beyond traditional statistical validation. In parallel, a legal framework for assigning liability among developers, deployers, maintainers, and end-users is essential to ensure fairness and promote safe and beneficial application of clinical AI.

PMID:41252128 | DOI:10.1097/PPO.0000000000000797

Anat Sci Int. 2025 Nov 18. doi: 10.1007/s12565-025-00909-3. Online ahead of print.

ABSTRACT

This study aims to elucidate the morphometric and morphological details of teeth in the Syrian hamster (Mesocricetus auratus, Waterhouse, 1839) and guinea pig (Cavia porcellus, Linnaeus, 1758) using µ-CT and stereology (n = 5). Notably, the hamsters exhibited distinctive roots in their cheek teeth, in contrast to the guinea pigs, where the tooth body extended as a dental root into the alveolar socket, making anatomical diagnosis challenging. The first and second cheek teeth of the hamster had four roots, but the last one had three roots. The hamster incisor teeth had a more voluminous pulp cavity compared to those of guinea pigs. While the ratio differences of arch parameters and enamel thickness were not statistically significant (P ≥ 0.05). The enamel layer in guinea pig incisor teeth were significantly thicker than that in the hamster teeth (P ≤ 0.05). Regarding the dentine-tooth width, the difference between the upper incisor teeth of the hamster and guinea pig was significant (P ≤ 0.05). The ratio of pulp-tooth volume in all incisor teeth of the hamster was significantly higher than that in the guinea pig’s teeth (P ≤ 0.05) indicating hamsters might have better regenerative dental health despite dietary variances. These insights contribute to deeper understanding of the evolutionary adaptations in rodent dentition and suggest improved information and methodologies for translational dental studies and selecting more appropriate animal models in dental research.

PMID:41252122 | DOI:10.1007/s12565-025-00909-3

J Racial Ethn Health Disparities. 2025 Nov 18. doi: 10.1007/s40615-025-02734-w. Online ahead of print.

ABSTRACT

INTRODUCTION: COVID-19 disproportionately affected Black Americans, and social determinants of health (SDOH) likely contributed to this disparity, yet their impact remains unclear. This study investigated the association between race and COVID-19-related hospitalization, assessing the added explanatory value of SDOH and clinical factors.

METHODS: In this observational study, we invited 22,895 adult (≥ 18 years) Kaiser Permanente Georgia (KPGA) members with a COVID-19 diagnosis between Jan. 2020 and Jun. 2021 to take a survey of which 482 participated (response rate = 2.1%). We included non-Hispanic Black or non-Hispanic White KPGA members with complete data (n = 306). Surveys were linked to KPGA’s electronic medical records. Multivariable logistic regression assessed the relationship between race (non-Hispanic Black compared with White) and likelihood of 30-day hospitalization post-COVID-19 diagnosis adjusting for clinical factors (demographics, comorbidities) and SDOH (neighborhood SDOH, pre-COVID-19 health behaviors, and COVID-19 social impacts). Max-scaled R-squares and likelihood ratio tests assessed model variation and covariate significance.

RESULTS: Our study population was 39.2% Black, 32.4% male, and mean age was 52.3 ± 13.3 years. Overall, 20.0% of Black and 12.4% of White members were hospitalized within 30 days of COVID-19 diagnosis. While not statistically significant, Black (compared with White) members were 72% (aOR: 1.72 [95% CI: 0.75 3.91]) more likely to be hospitalized. Race, clinical factors, and SDOH explained 1.8%, 18.6%, and 14.4% of the variation in hospitalization risk, respectively, and cumulatively explained 34.8%.

CONCLUSION: No significant racial differences in 30-day hospitalization were observed; however, we found that clinical factors and SDOH explained similar variation in hospitalization risk.

PMID:41252118 | DOI:10.1007/s40615-025-02734-w

Eur J Health Econ. 2025 Nov 18. doi: 10.1007/s10198-025-01847-7. Online ahead of print.

ABSTRACT

BACKGROUND: Transthyretin amyloid cardiomyopathy (ATTR-CA) is a progressive, fatal disease that often presents as heart failure with preserved ejection fraction (HFpEF). To date, scarce evidence about the economic burden of ATTR-CA has been published. This study compared the economic impact of HFpEF in patients with and without ATTR-CA in Spain.

METHODS: The PRACTICA study was a cross-sectional, multicenter, nationwide study in twenty sites in Spain. A total of 387 consecutive ambulatory or hospitalized patients aged ≥ 50 years with HFpEF and LVH ≥ 12 mm were included and screened for ATTR-CA. Healthcare resource utilization (HRU), except specific pharmacologic treatments, non-HRU and its associated average cost per-patient per-year were assessed in year 2021 for ATTR-CA and non-ATTR-CA patients.

RESULTS: Patients were classified as: ATTR-CA (n = 65), non-ATTR-CA (n = 306) and inconclusive (n = 16). Mean total cost per-patient per-year was higher in ATTR-CA patients: €3,407 (Min-Max: €1,067-€6,473) in ATTR-CA, €3,203 (€1,168-€5,646) in non-ATTR-CA and €2,920 (€1,165-€5,080) in inconclusive patients (p < 0.001, Kruskal-Wallis). Determinants of differential cost favoring ATTR-CA were hospitalizations, genetic testing, implantable cardiac defibrillator, and scintigraphy. No statistical differences were observed between patients with and without ATTR-CA in non-healthcare resources paid by patients themselves, although inconclusive patients showed significantly higher home adaptation (shower, bed rail) and crutch utilization (p = 0.031, Kruskal-Wallis).

CONCLUSIONS: This is the first multicenter nationwide study assessing the economic impact on Spanish society of ATTR-CA patients with HFpEF and LVH ≥ 12 mm. The cost was substantial, with negative implications particularly for the Spanish National Health System.

PMID:41252105 | DOI:10.1007/s10198-025-01847-7

Eur J Health Econ. 2025 Nov 18. doi: 10.1007/s10198-025-01872-6. Online ahead of print.

ABSTRACT

BACKGROUND: Despite its increasing prevalence, the economic impact of eosinophilic esophagitis (EoE) in Europe is understudied and direct economic costs remain unknown.

OBJECTIVE: To assess contemporaneous direct medical costs during the first year after EoE diagnosis in Spain to identify key cost determinants and assess variables that could affect these costs.

METHODS: Observational study of Spanish participants in the EUREOS EoE CONNECT registry with incident EoE in 2017-2018. We assessed average costs/year in Euros for endoscopic procedures, out-patient visits, medication, emergency room visits and hospitalizations, 2018 being our base year. Official regional tariffs were used to estimate direct costs from a healthcare provider perspective; official price lists were used for drug therapies. Cost differences and determinants were assessed with multivariate models.

RESULTS: The mean annual direct cost of EoE per person among 302 patients (76.5% male, 77.5% adults) was €1,842.07 (SD €795.69). Endoscopic procedures accounted for 68% of this, followed by outpatient visits (15.9%) and drug prescriptions (10.8%). Cost was higher for pediatric compared to adult patients (€2,101.51 vs. €1,784.29, p < 0.01), for those with higher EREFS score (€1,979.36 vs. €1,794.49; p < 0.01), and in high-volume hospitals (€1,941.48 vs. €1,723.92; p = 0.02). Early response to first-line treatment reduced annual costs by -€368.95 (p < 0.01), by avoiding further medical procedures.

CONCLUSION: First year after EoE diagnosis produces significant direct costs in Spain, mainly due to endoscopic procedures, which are reduced in early responders to first-line therapy. Research for non-invasive methods for EoE assessment and identifying predictors of response are, therefore, key.

PMID:41252104 | DOI:10.1007/s10198-025-01872-6

J Ophthalmic Inflamm Infect. 2025 Nov 18;15(1):86. doi: 10.1186/s12348-025-00541-2.

ABSTRACT

BACKGROUND: Multidrug-resistant (MDR) bacteria are an escalating global public health concern and represent a cross-cutting issue affecting multiple sectors. In ophthalmic care, broad-spectrum antimicrobial agents are frequently prescribed empirically by healthcare professionals, often without culture-based evidence. This practice contributes to the development of drug-resistant pathogens. Therefore, routine surveillance of bacterial profiles and multidrug resistance in external ocular infections is crucial for effective treatment, prevention, and control efforts. The primary objective of this study was to determine the prevalence of multidrug resistance among bacterial isolates from external ocular infections and to identify associated risk factors.

METHOD: A cross-sectional study was conducted among 360 external ocular infection suspected patients between May 1 and July 30, 2023, at the University of Gondar Comprehensive Specialized Hospital’s Tertiary Eye Care and Training Center. Systematic random sampling was employed to recruit participants. Sociodemographic and clinical data were collected using structured questionnaires. Ocular specimens were collected aseptically and processed using standard microbiological techniques according to CLSI. Data were entered into EpiData version 25 and analyzed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed to assess the risk factors, with a 95% confidence interval. A p-value of less than 0.05 was considered statistically significant. A total of 360 patients participated in the study.

RESULTS: Bacterial pathogens were isolated in 59.7% (215/360) of the external ocular infection samples. Gram-positive bacteria were the most frequently identified, comprising 46.7% (168/222) of isolates. Staphylococcus aureus was the most common isolate (43.7%, 97/222), followed by coagulase-negative Staphylococcus species (29.7%, 66/222), Pseudomonas aeruginosa (10.8%, 24/222), and Escherichia coli (5.4%, 12/222). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 21.6%. Overall, multidrug resistance was observed in 62.2% (138/222) of the isolates. Notably, dental infections were significantly associated with the presence of bacterial external ocular infections.

CONCLUSIONS: This study highlights a high prevalence of bacterial and multidrug-resistant organisms in external ocular infections. Gentamicin and ciprofloxacin are effective antimicrobial agents against the isolated pathogens. These findings underscore the need for continuous monitoring of bacterial profiles and antimicrobial susceptibility patterns to support evidence-based antibiotic use and mitigate the rise of antimicrobial resistance in ocular infections.

PMID:41252093 | DOI:10.1186/s12348-025-00541-2

Health Econ Rev. 2025 Nov 18;15(1):98. doi: 10.1186/s13561-025-00693-w.

ABSTRACT

BACKGROUND: While out-of-pocket health expenses continue to rise, households’ coping strategies remain largely unexplored. When individuals and families rely on unsustainable mechanisms such as borrowing, they may face heightened financial vulnerability, which can be particularly severe among certain socio-economic groups. This study examined the determinants of medical borrowing and the associated inequalities in Saudi Arabia.

METHODS: Nationally representative data from the 2021 World Bank Global Financial Inclusion (Global Findex) database were analysed. Descriptive statistics summarized respondents’ characteristics, and Chi-squared tests assessed bivariate associations between socio-economic factors and medical borrowing. Multivariate logistic regression models were then estimated to identify independent determinants of medical borrowing. Socioeconomic inequalities were further evaluated using concentration curves and concentration indices.

RESULTS: Approximately 16.3% of the 1019 respondents from the KSA reported borrowing money for medical purposes within the preceding 12 months. Medical borrowing was less common among higher-income and more educated individuals [Model 3 odds ratio = 0.561; 95% confidence interval: 0.391-0.807; p < 0.01). Borrowing incidence was slightly lower for males than for females. Across all models, government employees showed consistently higher odds of borrowing for medical expenses. Inequality analysis showed a negative education-based concentration index (-0.117, p ˂ 0.01), indicating that medical borrowing was disproportionately concentrated among individuals with lower educational attainment.

CONCLUSION: Socio-economic inequalities in borrowing for medical purposes exist in Saudi Arabia, highlighting the need to curb distress financing, particularly among lower-income groups, less-educated individuals, and public sector employees. These findings underscore the importance of expanding equitable insurance coverage and reducing reliance on out-of-pocket spending. Strengthening public healthcare quality and aligning reforms with Vision 2030 goals will be critical to curbing medical indebtedness and enhancing financial protection for all in Saudi Arabia.

PMID:41252078 | DOI:10.1186/s13561-025-00693-w

Eat Weight Disord. 2025 Nov 18;30(1):87. doi: 10.1007/s40519-025-01793-6.

ABSTRACT

PURPOSE: Carotid-femoral pulse wave velocity (cfPWV), an index of arterial stiffness, is one of the earliest indicators of cardiovascular risk. Studies of adolescents with anorexia nervosa have demonstrated increased arterial stiffness compared to healthy controls. Little information is available on the effect of weight restoration on arterial stiffness in adolescents with anorexia nervosa.

METHODS: This pilot longitudinal study examined changes in arterial stiffness during weight restoration in adolescent females admitted to an inpatient eating disorder unit. Female adolescents aged 15-19 years with a diagnosis of anorexia nervosa and a body mass index (BMI) < 85% of median BMI for age and sex, were recruited from consecutive eating disorder admissions at Westmead Hospital, Australia. Weekly measurements of cfPWV were performed for up to 4 consecutive weeks.

RESULTS: 12 participants were included, with an average follow-up of 3.2 ± 1.1 weeks. Using mixed-effects models, we observed a significant increase in BMI (95% CI 0.60, 0.80; p < 0.01) along with a modest but statistically significant decrease in cfPWV. The rate of change in cfPWV observed was – 0.2 m/s per week (95% CI – 0.37, – 0.03; p = 0.03). Mean arterial pressure (MAP) was significantly associated with cfPWV (p < 0.01). There was a borderline association between cfPWV and BMI (p = 0.05).

CONCLUSIONS: Our findings suggest a possible reduction in arterial stiffness with weight restoration, although results must be interpreted with caution due to the small sample. Nevertheless, serial measurements of cfPWV in this population are feasible, supporting the need for larger longitudinal studies in this population.

LEVEL OF EVIDENCE: Level III.

PMID:41252061 | DOI:10.1007/s40519-025-01793-6

J Gastrointest Cancer. 2025 Nov 18;56(1):224. doi: 10.1007/s12029-025-01350-5.

ABSTRACT

PURPOSE: Colorectal cancer remains a leading cause of cancer deaths, highlighting the need for early detection. Cologuard^®, a non-invasive stool DNA test, detects biomarkers for CRC and precancerous lesions but requires follow-up colonoscopy and has a high false-positive rate. This study evaluates colonoscopy follow-up rates and diagnostic outcomes after positive Cologuard^® results.

METHODS: We conducted a retrospective cohort study using the TriNetX database, a global federated real-world data platform, to analyze patients aged ≥ 18 years who tested positive on Cologuard. The primary outcome was whether patients underwent an endoscopic procedure (colonoscopy) within 12 months of a positive result. The secondary outcome was the diagnoses made during follow-up colonoscopy, including malignant neoplasms (colorectal cancer) and benign neoplasms (polyps).

RESULTS: A total of 3,916 patients underwent Cologuard^® testing, with 61.3% being female, 35% male, and 3.7% other genders. Of the 385 patients who tested positive for Cologuard^® (mean age 65 ± 8.75 years), 171 (44%) underwent follow-up colonoscopy within 12 months. Of these, 10 cases (5.8%) were diagnosed with malignant neoplasms, and 56 cases (32.7%) were diagnosed with benign neoplasms (polyps).

CONCLUSION: The study found poor follow-up adherence, with only 44% completing colonoscopy and a high false positive rate with just 38.5% of positive Cologuard^® results showing significant lesions. These findings emphasize the need for better patient education, streamlined care pathways, and improved communication to enhance follow-up compliance.

PMID:41252050 | DOI:10.1007/s12029-025-01350-5

Adv Exp Med Biol. 2026;1489:485-492. doi: 10.1007/978-3-032-03394-9_46.

ABSTRACT

This study aims to provide a brief review on the subject of aesthetic procedures. Worldwide information from 26 scientific articles and nineteen other sources was used. Definitions were sought, a historical review of cosmetic procedures was carried out, and the types of cosmetic procedures were separately analyzed; statistical data, the legal and ethical framework, and factors associated with cosmetic procedures were analyzed. Cosmetic procedures are at the individual’s choice and are aimed at improving a person’s appearance for cosmetic rather than medical reasons. Adolescents, on the other hand, experience changes that occur at a biological and psychosocial level; adolescents indulge in a multitude of cosmetic procedures worldwide despite legal and ethical restrictions due to psychological and social factors. Cosmetic procedures have multivalent physical, mental, and financial effects upon the well-being and life of adolescents. Therefore, concerns and questions arise.

PMID:41252033 | DOI:10.1007/978-3-032-03394-9_46