Tag: pubmed

Br J Nutr. 2025 Apr 10:1-13. doi: 10.1017/S0007114525000522. Online ahead of print.

ABSTRACT

One of the most significant challenges in research related to nutritional epidemiology is the achievement of high accuracy and validity of dietary data to establish an adequate link between dietary exposure and health outcomes. Recently, the emergence of artificial intelligence (AI) in various fields has filled this gap with advanced statistical models and techniques for nutrient and food analysis. We aimed to systematically review available evidence regarding the validity and accuracy of AI-based dietary intake assessment methods (AI-DIA). In accordance with PRISMA guidelines, an exhaustive search of the EMBASE, PubMed, Scopus and Web of Science databases was conducted to identify relevant publications from their inception to 1 December 2024. Thirteen studies that met the inclusion criteria were included in this analysis. Of the studies identified, 61·5 % were conducted in preclinical settings. Likewise, 46·2 % used AI techniques based on deep learning and 15·3 % on machine learning. Correlation coefficients of over 0·7 were reported in six articles concerning the estimation of calories between the AI and traditional assessment methods. Similarly, six studies obtained a correlation above 0·7 for macronutrients. In the case of micronutrients, four studies achieved the correlation mentioned above. A moderate risk of bias was observed in 61·5 % (n 8) of the articles analysed, with confounding bias being the most frequently observed. AI-DIA methods are promising, reliable and valid alternatives for nutrient and food estimations. However, more research comparing different populations is needed, as well as larger sample sizes, to ensure the validity of the experimental designs.

PMID:40207441 | DOI:10.1017/S0007114525000522

Epilepsia Open. 2025 Apr 10. doi: 10.1002/epi4.70036. Online ahead of print.

ABSTRACT

OBJECTIVE: Temporal encephaloceles (TEs) are increasingly recognized as a cause of MRI-negative temporal lobe epilepsy (TLE). The optimal surgical approach for TE-related refractory epilepsy remains unclear, particularly regarding the necessity of excluding mesiotemporal structures such as the hippocampus, which may lead to worse neuropsychological outcomes. This study evaluates the impact of hippocampectomy on achieving seizure freedom in patients with TE-related epilepsy through a systematic review and individual participant data (IPD) meta-analysis.

METHODS: A systematic literature review was conducted across Medline, Google Scholar, Embase, and Web of Science, identifying studies reporting surgical outcomes in TE-related epilepsy. Studies were included if they provided at least 12 months of follow-up and reported seizure outcomes using Engel or ILAE classification. The primary outcome was postsurgical seizure freedom (Engel Class IA or ILAE Class 1). A mixed-effects logistic regression model was used to compare outcomes between patients who underwent hippocampectomy and those who did not. Heterogeneity was assessed using τ² and I² statistics.

RESULTS: The meta-analysis included 23 studies with a total of 155 surgically treated patients. The primary analysis did not identify a statistically significant difference in seizure freedom between patients who underwent hippocampectomy and those who did not (Risk Ratio [RR] = 0.66, 95% Confidence Interval [CI]: 0.29-1.52, p = 0.329). Other covariates, including sex, duration of epilepsy, presence of additional epileptogenic lesions, and the use of invasive presurgical evaluation, were not significant predictors of seizure freedom. The I² statistic indicated moderate heterogeneity (54.68%).

SIGNIFICANCE: This IPD meta-analysis suggests that hippocompectomy does not significantly impact seizure freedom in patients with TE-related epilepsy and should not be part of a universal approach when determining the optimal surgical strategy. These results reinforce the need for an individualized approach, considering patient-specific factors to optimize surgical decision-making in TE-related epilepsy.

PLAIN LANGUAGE SUMMARY: Temporal encephaloceles (TEs) can cause drug-resistant epilepsy, often requiring surgical management for seizure control. Given the variety of surgical techniques available, the optimal approach remains uncertain, particularly regarding the necessity of hippocampectomy, which may impact neuropsychological outcomes. This one-stage individual participant data meta-analysis found no significant difference in seizure freedom between patients who underwent hippocampectomy and those who did not. These findings suggest that hippocampectomy should not be routinely performed and highlight the importance of individualized surgical decision-making for patients with TEs.

PMID:40207440 | DOI:10.1002/epi4.70036

Alzheimers Dement. 2025 Apr;21(4):e70144. doi: 10.1002/alz.70144.

ABSTRACT

INTRODUCTION: Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities are among the fastest growing segments of older adults in the United States yet remain underrepresented in aging, dementia, and caregiving research.

METHODS: The Collaborative Approach for AANHPI Research & Education (CARE), a recruitment registry, aims to improve the representation of AANHPI older adults in research. We describe activity to date, as well as planned expansions in cultural groups, language capacity, and data collection in the registry.

RESULTS: Between October 15, 2020, and November 4, 2024, 10,367 total AANHPI adults enrolled in the CARE registry, including 50.0% with limited English proficiency, 35.1% age ≥ 65, and 80.2% with no prior participation in research. CARE has made more than 13,954 referrals of 6868 unique registrants to at least one study.

DISCUSSION: Through collaborative partnerships with AANHPI communities and researchers, the CARE Registry is achieving its goal of increasing AANHPI representation in research.

HIGHLIGHTS: The CARE registry has enrolled 10,367 AANHPI adults. More than 80% of those enrolled had no prior research experience. As of November 4, 2024, CARE had referred 6868 unique participants to at least one study. In total, CARE has made 13,954 referrals to requesting studies.

PMID:40207420 | DOI:10.1002/alz.70144

Stat Med. 2025 Mar 30;44(7):e70050. doi: 10.1002/sim.70050.

ABSTRACT

Various statistical and machine learning algorithms can be used to predict treatment effects at the patient level using data from randomized clinical trials (RCTs). Such predictions can facilitate individualized treatment decisions. Recently, a range of methods and metrics were developed for assessing the accuracy of such predictions. Here, we extend these methods, focusing on the case of survival (time-to-event) outcomes. We start by providing alternative definitions of the participant-level treatment benefit; subsequently, we summarize existing and propose new measures for assessing the performance of models estimating participant-level treatment benefits. We explore metrics assessing discrimination and calibration for benefit and decision accuracy. These measures can be used to assess the performance of statistical as well as machine learning models and can be useful during model development (i.e., for model selection or for internal validation) or when testing a model in new settings (i.e., in an external validation). We illustrate methods using simulated data and real data from the OPERAM trial, an RCT in multimorbid older people, which randomized participants to either standard care or a pharmacotherapy optimization intervention. We provide R codes for implementing all models and measures.

PMID:40207416 | DOI:10.1002/sim.70050

Vet Med Sci. 2025 May;11(3):e70331. doi: 10.1002/vms3.70331.

ABSTRACT

BACKGROUND: Client satisfaction surveys present a chance to find out which services offered by a provider meet or exceed the expectations of clients, and therefore should be maintained, while services that fall short of expectations are identified for improvement.

OBJECTIVES: The aims were to determine if correlations existed between dimensions of service quality (tangibles, reliability, responsiveness, assurance and empathy) and client satisfaction, find out which of 15 selected indicators of service delivery performance were significantly associated with client satisfaction and serve as predictors for satisfaction and determine client satisfaction indices for services rendered at a companion animal hospital.

METHODS: A questionnaire, covering background information and indicators and dimensions of satisfaction, was administered to 208 respondents. Data analyses involved proportions, mean scores, Cronbach reliability test, relative importance indices, correlations, multiple regressions and client satisfaction indices.

RESULTS: For indicators, the prediction equation was as follows: Overall satisfaction = -44.1 + 15.3 × Drugs availability. For dimensions, the equation was as follows: Overall satisfaction (mean score) = 2.39 + 0.19 × Reliability mean score. The customer satisfaction score was 97.5%, and the mean satisfaction rate was 84.3%. The composite customer satisfaction score was also 84.3%. The customer satisfaction index was 81.5%.

CONCLUSION: The study provides, for the first time, attributes considered by clients as contributing to satisfaction with veterinary services delivery for pets in Accra, Ghana. Regression analyses revealed that for dimensions, the reliability mean score, and for indicators, the availability of drugs were the main predictors of overall satisfaction with services delivery. Client satisfaction indices were very high.

PMID:40207403 | DOI:10.1002/vms3.70331

J Int Adv Otol. 2025 Mar 25;21(2):1-8. doi: 10.5152/iao.2025.241759.

ABSTRACT

BACKGROUND: Glycated hemoglobin A1c (HbA1c) is an indicator of blood glucose levels, but the impact of hyperglycemia on Bell’s palsy (BP) remains unclear. This study aims to assess the influence of high and low HbA1c levels on the prognosis of patients with BP.

METHODS: This monocentric, retrospective study included 712 patients with BP, divided into 103 patients with HbA1c ≥ 6.5% and 609 patients with HbA1c < 6.5%. Receiver operating characteristic curve analysis was used to evaluate the main factors affecting HbA1c levels. Propensity score matching (PSM) was further utilized to avoid selection bias and disproportionate distributions of confounding factors between the 2 groups. The House-Brackmann (H-B) facial nerve grading system was employed to assess the severity of facial motor dysfunction.

RESULTS: Analysis showed that high HbA1c patients were older, had higher body mass index, less frequently suffered from dysgeusia, and more often had hypertension (P < .05). According to the area under the curve, age had the greatest impact on HbA1c levels (95% CI=0.748-0.803, P <.001). After PSM 1 : 1 matching, there was no statistical difference in initial H-B grade between the 2 groups, but there was a statistical difference in final H-B grade (P = .023), indicating a worse prognosis for patients with BP in the high HbA1c group.

CONCLUSION: The study, after controlling for confounding factors, showed that patients with BP and high HbA1c have a worse prognosis, suggesting that controlling blood glucose levels has a positive significance for the recovery of patients with BP.

PMID:40207389 | DOI:10.5152/iao.2025.241759

Stroke. 2025 Apr 10. doi: 10.1161/STROKEAHA.124.048057. Online ahead of print.

ABSTRACT

BACKGROUND: Urinary incontinence after a stroke significantly affects patient outcomes and quality of life. It is commonly associated with uninhibited detrusor contractions, but the underlying neural mechanisms remain poorly understood. This study aimed to explore the brain activity patterns associated with volitional and involuntary bladder contractions in stroke survivors.

METHODS: This cohort study enrolled 15 stroke survivors with documented urinary incontinence and 9 healthy controls. Participants underwent simultaneous blood oxygen level-dependent functional magnetic resonance imaging of the brain and urodynamics, capturing 25 involuntary and 23 volitional bladder emptying events in patients with stroke and 35 volitional voiding events in healthy individuals. We used general linear modeling in functional magnetic resonance imaging analysis to discern neural activity patterns during these events and in the phases leading up to them, aiming to identify neural mechanisms underlying involuntary versus volitional urinary control. Statistical significance for neuroimaging analyses was set at P<0.005 with a minimum cluster size of 25 voxels.

RESULTS: During volitional emptying events, both healthy controls and stroke survivors exhibited increases in activation in regions implicated in sensorimotor control and executive decision-making, such as the brainstem, cingulate cortex, prefrontal cortex, and motor areas. In contrast, involuntary emptying events were associated with minimal changes in brain activity, suggesting minimal cortical involvement. Bladder filling preceding volitional contractions was associated with activity in the salience network (insula, anterior cingulate gyrus) in stroke survivors and healthy controls. Conversely, although there was an increase in overall blood oxygen level-dependent signal, activation of the salience network was conspicuously absent during bladder filling preceding involuntary contractions.

CONCLUSIONS: The findings suggest that the salience network plays an important role in maintaining urinary continence in stroke survivors. The inability to activate the salience network may underpin the pathophysiology of poststroke urinary incontinence. Interventions aimed at modulating this network could potentially ameliorate lower urinary tract symptoms in this patient population.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05301335.

PMID:40207355 | DOI:10.1161/STROKEAHA.124.048057

Arthrosc Tech. 2024 Sep 21;14(3):103243. doi: 10.1016/j.eats.2024.103243. eCollection 2025 Mar.

ABSTRACT

Osteochondral knee defects typically affect young, active patients, altering knee biomechanics and eventually leading to joint degeneration. There are several treatment methods; one less expensive and potentially effective option is the combination of autologous impaction bone grafting with autologous matrix-induced chondrogenesis (BG-AMIC). BG-AMIC is a safe and effective treatment for deep knee osteochondral lesions, with a statistically significant and clinically relevant improvement in patient-reported outcomes. We describe a single-stage, safe, and efficient approach whose efficacy has already been proven.

PMID:40207341 | PMC:PMC11977119 | DOI:10.1016/j.eats.2024.103243

Front Cardiovasc Med. 2025 Mar 26;12:1569904. doi: 10.3389/fcvm.2025.1569904. eCollection 2025.

ABSTRACT

BACKGROUND: Serum uric acid (SUA) and lipid metabolism disorders are closely associated with atrial fibrillation (AF) and its prognosis. In patients with non-valvular AF (NAF), we evaluated the combined predictive value of SUA, triglycerides (TG), and low-density lipoprotein (LDL) for stroke to enhance stroke risk prediction and management.

METHODS AND RESULTS: We included 3,176 NAF patients treated at the First Affiliated Hospital of Dalian Medical University from January 2020 to December 2023. We analyzed SUA concentration and lipid profile, along with relevant clinical data, to assess their impact on the occurrence of ischemic stroke (IS) in NAF patients. Due to gender differences in TG (1.39 mmol/L vs. 1.28 mmol/L for males, P = 0.031;1.57 mmol/L vs. 1.28 mmol/L for females, P = 0.001) and SUA levels (424 µmol/L vs. 397 µmol/L for males, P = 0.008; 361 µmol/L vs. 328 µmol/L for females, P = 0.004), we determined the thresholds for SUA (400 µmol/L in males and 330 µmol/L in females) and TG (1.28 mmol/L in males and 1.29 mmol/L in females) that predict stroke events in NAF patients by restricted cubic spline curves. Kaplan-Meier cumulative risk analysis indicates that a gender-based combined assessment of SUA and TG enhances stroke risk stratification in NAF patients. Compared to patients with low levels of SUA and TG, those with high levels of these biomarkers have a higher risk of IS (HR = 1.98). On multivariable Cox regression analysis with potential confounders, elevated SUA and low-density lipoprotein (LDL) levels were significantly associated with an increased risk of stroke. In summary, we developed the CHA₂DS₂-VASc+SUA+TG+LDL stroke risk prediction model. Its clinical predictive value was assessed using Harrell’s C-statistic (C-index), integrated discrimination improvement (IDI) statistics, and net reclassification index (NRI) analysis.

CONCLUSIONS: SUA, TG and LDL were strongly associated with stroke for NAF. The combination of SUA, TG, and LDL effectively enhanced the predictive value of the CHA₂DS₂-VASc score for IS.

PMID:40207305 | PMC:PMC11979146 | DOI:10.3389/fcvm.2025.1569904

Comput Appl Math. 2025;44(5):227. doi: 10.1007/s40314-025-03139-5. Epub 2025 Apr 5.

ABSTRACT

For the Abelian sandpile model on Sierpiński graphs, we investigate several statistics such as average height, height probabilities and looping constant. In particular, we calculate the expected average height of a recurrent sandpile on the finite iterations of the Sierpiński gasket and we also give an algorithmic approach for calculating the height probabilities of recurrent sandpiles under stationarity by using the connection between recurrent configurations of the Abelian sandpile Markov chain and uniform spanning trees. We also calculate the expected fraction of vertices of height i for i ∈ { 0 , 1 , 2 , 3 } of sandpiles under stationarity and relate the bulk average height to the looping constant on the Sierpiński gasket.

PMID:40207288 | PMC:PMC11980430 | DOI:10.1007/s40314-025-03139-5