Tag: pubmed

World J Clin Cases. 2025 Jan 6;13(1):99744. doi: 10.12998/wjcc.v13.i1.99744.

ABSTRACT

Machine learning (ML) is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis, thus creating machines that can complete tasks otherwise requiring human intelligence. Among its various applications, it has proven groundbreaking in healthcare as well, both in clinical practice and research. In this editorial, we succinctly introduce ML applications and present a study, featured in the latest issue of the World Journal of Clinical Cases. The authors of this study conducted an analysis using both multiple linear regression (MLR) and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease (NAFLD). Their results implicated age as the most important determining factor in both groups, followed by lactic dehydrogenase, uric acid, forced expiratory volume in one second, and albumin. In addition, for the NAFLD- group, the 5^th and 6^th most important impact factors were thyroid-stimulating hormone and systolic blood pressure, as compared to plasma calcium and body fat for the NAFLD+ group. However, the study’s distinctive contribution lies in its adoption of ML methodologies, showcasing their superiority over traditional statistical approaches (herein MLR), thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.

PMID:39764535 | PMC:PMC11577516 | DOI:10.12998/wjcc.v13.i1.99744

World J Clin Cases. 2025 Jan 6;13(1):94284. doi: 10.12998/wjcc.v13.i1.94284.

ABSTRACT

BACKGROUND: Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure. Some oculoplastic conditions, like nasolacrimal duct obstruction, have been extensively studied, whereas others, like eyelid malposition and thyroid eye disease, have received minimal or no research.

AIM: To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.

METHODS: A cross-sectional survey was disseminated among ophthalmologists all over India. The survey included questions related to pre-operative evaluation, anaesthetic and surgical techniques preferred, post-operative care, the use of adjunctive therapies, and patient follow-up patterns.

RESULTS: A total of 180 ophthalmologists responded to the survey. Most practitioners (89%) felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised. The most common surgical techniques employed were lacrimal drainage procedures (Dacryocystorhinostomy) (63.3%), eyelid malposition repair (36.9%), and ptosis repair (58.7%). Post-operatively, 47.7 % of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries. Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients.

CONCLUSION: Approximately 50% of ophthalmologists handle prevalent oculoplastic issues themselves, seeking the expertise of an oculoplastic surgeon under particular conditions. Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery. Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

PMID:39764534 | PMC:PMC11577510 | DOI:10.12998/wjcc.v13.i1.94284

World J Clin Cases. 2025 Jan 6;13(1):96578. doi: 10.12998/wjcc.v13.i1.96578.

ABSTRACT

Historically, psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders. The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal. There have been several studies that examine brain imaging in psychiatric disorders, but more work is needed to elucidate the complexities of the human brain. In this editorial, we examine two articles by Xu et al and Stoyanov et al, that show developments in the direction of using neuroimaging to examine the brains of people with schizophrenia and depression. Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia, in addition to examining neurotransmitter levels as biomarkers. Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression. These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.

PMID:39764531 | PMC:PMC11577517 | DOI:10.12998/wjcc.v13.i1.96578

J Clin Tuberc Other Mycobact Dis. 2024 Nov 7;37:100495. doi: 10.1016/j.jctube.2024.100495. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR M. leprae and its implications.

METHODS: Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR M. leprae. We included human clinical trials on MDR M. leprae, as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger’s, Begg’s tests, and the trim-fill method.

RESULTS: Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant M. leprae was approximated at 11.7 % (95 % CI: 7.7-17.3; I² : 90.79; p value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR M. leprae was measured at 2.2 % (95 % CI: 1.2-3.9; I² : 82.68; p value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR M. leprae risk (OR: 2.69; 95 % CI: 1.35-2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.

CONCLUSIONS: The increasing prevalence of MDR M. leprae globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.

PMID:39764485 | PMC:PMC11701851 | DOI:10.1016/j.jctube.2024.100495

Cureus. 2025 Jan 4;17(1):e76928. doi: 10.7759/cureus.76928. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: Erectile dysfunction (ED) in men is overlooked and is often linked with psychogenic causes. Due to cultural barriers, this area of research remains neglected.

OBJECTIVE: The study was conducted to determine the factors that can be associated with ED in otherwise apparently healthy men.

METHODS: We conducted our cross-sectional case-control study at the teaching hospital (Mekran Medical College) Turbat for six months from March 2023 to September 2023. After obtaining informed consent, 119 subjects aged less than 48 years were included using a convenient purposive sampling technique. Subjects suffering from any chronic disease like diabetes, hypertension, or chronic renal disease were excluded. The sociodemographic data of the participants were recorded. Patient’s blood samples were taken to analyze serum testosterone levels. IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States) was used for the analysis of data. The chi-square test and an independent sample t-test were applied to analyze the data.

RESULTS: Among 119 study participants, 65 participants had ED. A significant association of ED was found with the area of residence (OR: 1.60, 95% CI: 1.04-2.48, p-value: 0.031) and smoking status (OR: 3.68, 95% CI: 1.66 – 8.12, p-value: 0.001). A significant difference in the mean age, duration of marriage, and testosterone level was found between subjects with and without ED (p < 0.05).

CONCLUSION: Men do suffer from ED. Smoking and low levels of testosterone increase ED in men. Effective healthcare strategies should be implemented to address the issue of ED in men.

PMID:39764481 | PMC:PMC11702912 | DOI:10.7759/cureus.76928

Cureus. 2025 Jan 6;17(1):e77021. doi: 10.7759/cureus.77021. eCollection 2025 Jan.

ABSTRACT

BACKGROUND: Soft tissue specifications and facial values ​​vary depending on the underlying skeletal structures. To achieve the ideal treatment result and patient satisfaction, one must know the attractive soft tissue specifications compatible with each type of malocclusion. This study aims to analyze the facial measurements that contribute to perceived facial attractiveness in patients with vertical growth patterns and skeletal class I malocclusion, focusing on gender-specific differences.

METHODOLOGY: A panel of 30 laypersons, including raters from both genders equally, aged 19-24 years, evaluated extraoral photographs taken before the treatment of 60 patients (evenly divided between males and females employing a disproportionate stratified sampling method through a computer-generated list) with skeletal class I malocclusion, vertical growth pattern based on the Bjork sum, aged 18-25 years (with an average age of 22 ± 1.53 years), with the photographs taken in three positions (frontal relaxed, frontal during a smile, and relaxed profile). The raters utilized the visual analog scale (VAS) to assign an esthetic quality score to each photograph. Based on the average esthetic scores of each photo, two groups were created: the most attractive group, which received the highest esthetic score, and the least attractive group, which received the lowest esthetic score. After selecting 12 patients for each group, the angles and proportions of the frontal and lateral photos were calculated, and the results were compared between the two groups using an independent-sample t-test to see any significant differences.

RESULTS: The most attractive females had a significantly lower value of mouth width to lower facial height than the least attractive females (P = 0.039). In addition, the most attractive males had a substantially greater value of facial convexity angle than the least attractive males (P = 0.041). Regarding other profile and frontal variables, no statistically significant differences existed between the most and least attractive males and females.

CONCLUSIONS: In patients with vertical growth pattern malocclusion, it is important to consider the chin protrusion of male patients during treatment planning and diagnosis because it enhances masculine features in these patients, as well as the lower facial height of female patients.

PMID:39764478 | PMC:PMC11703561 | DOI:10.7759/cureus.77021

J Gastroenterol Hepatol. 2025 Jan 6. doi: 10.1111/jgh.16875. Online ahead of print.

ABSTRACT

BACKGROUND: Guidelines recommend endoscopic surveillance for gastric cancer without therapeutic intervention every 3 years in patients with high-risk gastric intestinal metaplasia (GIM). This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in eradicating high-risk GIM.

METHODS: This randomized self-control trial was conducted between June 2020 and February 2023. Patients with histology-verified high-risk GIM were enrolled. The endoscopist performed a biopsy on both the left and right sides of the stomach (five each) by targeting the suspected GIM area where available; otherwise, a random biopsy was taken. Patients were randomized to receive a unilateral RFA on either the left or right side. A repeated RFA on the assigned side was performed every 2-3 months for a total of two to three times. The primary outcome was complete resolution of GIM at 1 year after RFA.

RESULTS: Forty-six patients with a mean age of 66 ± 8 years were analyzed. The complete resolution rate of overall GIM lesions after RFA was significantly higher (49/142; 34/5%) than that in the observation group (29/127; 22.8%, RR = 0.84, 0.73-0.98, p = 0.03). For the subgroup analysis, the complete resolution rate after RFA revealed a significantly higher value than observation only in the incomplete GIM group (24/87; 27.6% vs. 11/82; 13.4%, RR = 0.83, 0.71-0.97, p = 0.02). The percentage of patients with extensive GIM regression after RFA (15/25; 60%) was higher than in the observation group (9/25; 36%) but did not meet statistical significance (RR = 0.62, 0.35-1.09, p = 0.09).

CONCLUSION: In high-risk GIM, RFA can significantly eradicate incomplete GIM when compared with observation alone.

PMID:39762988 | DOI:10.1111/jgh.16875

Nutr Metab (Lond). 2025 Jan 6;22(1):1. doi: 10.1186/s12986-024-00885-x.

ABSTRACT

BACKGROUND: Intermittent fasting (IF) can be an effective dietary therapy for weight loss and improving cardiometabolic health. However, there is scant evidence regarding the role of IF on indicators of liver function, particularly in adults with metabolic disorders. Therefore, we performed a systematic review and meta-analysis to investigate the effects of IF on liver function in adults with metabolic disorders.

METHODS: Three primary electronic databases including PubMed, Web of Science, and Scopus, were searched from inception to September 2024 to identify original studies that used IF interventions with or without control groups in adults with metabolic disorders. Inclusion criteria were (1) studies of human participants with metabolic diseases, (2) interventions that evaluated the effects of IF, (3) with or without a control group, and (4) measured liver fat, liver steatosis, liver fibrosis, or liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as primary outcomes. Standardized mean differences (SMD) and 95% confidence intervals were calculated using random effects models. Heterogeneity was assessed using the Cochran’s Q statistic and I-squared statistic (I²). Publication bias was assessed using the visual inspection of funnel plots and Egger’s tests. The risk of bias was assessed using the PEDro scale and the NIH quality assessment tool.

RESULTS: A total 21 studies involving 1,226 participants with metabolic disorders were included in the meta-analysis. Overall, IF effectively decreased liver fat with a large effect size [SMD: -1.22 (95% CI: -1.63 to -0.80), p = 0.001], liver steatosis with a medium effect size [SMD: -0.73 (95% CI: -1.12 to -0.35), p = 0.001], ALT with a small effect size [SMD: -0.44 (95% CI: -0.58 to -0.30), p = 0.001], and AST with a small effect size [SMD: -0.30 (95% CI: -0.49 to -0.11), p = 0.001], but not liver fibrosis [SMD: -0.28 (95% CI: -0.59 to 0.02), p = 0.07]. Subgroup analyses showed that IF decreased liver fat and ALT significantly, independent of IF mode, participant age, health status, weight status, and intervention duration. IF significantly decreased liver fibrosis in those with obesity; and decreased AST following 5:2 diets, in middle-aged adults, adults with obesity, and regardless of health status or intervention duration.

CONCLUSIONS: IF seems to be an effective dietary therapy for improving liver function in adults with metabolic disorders, and many of liver function-related benefits occur regardless of IF mode, intervention duration, or participant health status.

LIMITATIONS: Significant heterogeneity, small numbers of studies and inclusion of non-randomized trials or single-group pre-post trials were the main limitation of our meta-analysis. Further randomized clinical trials are needed to elucidate the effects of IF on liver function in adults with metabolic disorders.

PMID:39762987 | DOI:10.1186/s12986-024-00885-x

Alzheimers Res Ther. 2025 Jan 6;17(1):6. doi: 10.1186/s13195-024-01664-9.

ABSTRACT

BACKGROUND: The success of selecting high risk or early-stage Alzheimer’s disease individuals for the delivery of clinical trials depends on the design and the appropriate recruitment of participants. Polygenic risk scores (PRS) show potential for identifying individuals at risk for Alzheimer’s disease (AD). Our study comprehensively examines AD PRS utility using various methods and models.

METHODS: We compared the PRS prediction accuracy in ADNI (N = 568) and BioFINDER (N = 766) cohorts using five disease risk modelling approaches, three PRS derivation methods, two AD genome-wide association study (GWAS) statistics and two sets of SNPs: the whole genome and microglia-selective regions only.

RESULTS: The best prediction accuracy was achieved when modelling genetic risk by using two predictors: APOE and remaining PRS (AUC = 0.72-0.76). Microglial PRS showed comparable accuracy to the whole genome (AUC = 0.71-0.74). The individuals’ risk scores differed substantially, with the largest discrepancies (up to 70%) attributable to the GWAS statistics used.

CONCLUSIONS: Our work benchmarks the best PRS derivation and modelling strategies for AD genetic prediction.

PMID:39762974 | DOI:10.1186/s13195-024-01664-9

Diabetes Obes Metab. 2025 Jan 6. doi: 10.1111/dom.16159. Online ahead of print.

ABSTRACT

AIMS: To explore the relationship between weight loss and insulin sensitivity in response to tirzepatide or semaglutide.

MATERIALS AND METHODS: We conducted a post hoc exploratory analysis of a 28-week, double-blind, randomized trial in people with type 2 diabetes treated with metformin, randomized to tirzepatide 15 mg, semaglutide 1 mg or placebo. We evaluated the relationship between change in body weight and change in insulin sensitivity determined from hyperinsulinemic euglycemic clamp (M value), or from mixed-meal tolerance testing (Matsuda index).

RESULTS: Tirzepatide was associated with a greater improvement than semaglutide in insulin sensitivity assessed using hyperinsulinemic euglycemic clamps (p < 0.001). With tirzepatide, improvements in insulin sensitivity were associated with percent change in weight (R = -0.656, p < 0.0001). With semaglutide, change in insulin sensitivity was less strongly correlated with percent change in weight (R = -0.268, p = 0.0820; p = 0.0242 vs. tirzepatide). In regression analyses, the slope of the relationship between change in M value and change in weight was statistically different between semaglutide and tirzepatide (p = 0.0461). These relationships were also assessed using the Matsuda index as the metric of insulin sensitivity, and using change in fat mass as the determinant of change in insulin sensitivity.

CONCLUSIONS: Improvement in insulin sensitivity was proportional to weight and fat loss, with greater strength of association with tirzepatide. In regression analysis, tirzepatide was associated with greater improvement in insulin sensitivity per unit weight loss than semaglutide. The greater improvement in insulin sensitivity following treatment with tirzepatide was not simply attributable to greater weight or fat loss.

PMID:39762971 | DOI:10.1111/dom.16159