World journal of methodology最新文献

Background: Systematic review focuses on the visual patient avatar (VPA) technology, a tool designed to enhance situational awareness in anesthesia by transforming traditional numerical data into intuitive visual displays.

Aim: To explore how VPA can improve perceptual performance, reduce cognitive load, and increase user acceptance, potentially leading to better patient outcomes.

Methods: The review is based on 14 studies conducted between 2018 and 2023 in five different hospitals across Europe.

Results: These studies demonstrate that VPA allows clinicians to perceive and recall vital signs more efficiently than conventional monitoring methods. The technology's intuitive design helps reduce cognitive workload, indicating less mental effort required for patient monitoring. Users' feedback on VPA was generally positive, highlighting its potential to enhance monitoring and decision-making in high-stress environments. However, some users noted the need for further development, particularly in visualization design and data integration.

Conclusion: Review concludes that VPA technology represents a significant advancement in patient monitoring, promoting better situational awareness and potentially improving safety in perioperative care.

Background: Cognitive impairment is a major cause of disability in patients who have suffered from a stroke, and cognitive rehabilitation interventions show promise for improving memory.

Aim: To examine the effectiveness of virtual reality (VR) and non-VR (NVR) cognitive rehabilitation techniques for improving memory in patients after stroke.

Methods: An extensive and thorough search was executed across five pertinent electronic databases: Cumulative Index to Nursing and Allied Health Literature; MEDLINE (PubMed); Scopus; ProQuest Central; and Google Scholar. This systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses guideline. Studies that recruited participants who experienced a stroke, utilized cognitive rehabilitation interventions, and published in the last 10 years were included in the review.

Results: Thirty studies met the inclusion criteria. VR interventions significantly improved memory and cognitive function (mean difference: 4.2 ± 1.3, P < 0.05), whereas NVR (including cognitive training, music, and exercise) moderately improved memory. Compared with traditional methods, technology-driven VR approaches were particularly beneficial for enhancing daily cognitive tasks.

Conclusion: VR and NVR reality interventions are beneficial for post-stroke cognitive recovery, with VR providing enhanced immersive experiences. Both approaches hold transformative potential for post-stroke rehabilitation.

Background: Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations. This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas, integrating neurosurgery, endocrinology, radiology, and pathology perspectives.

Aim: To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis, management, and rehabilitation of individuals with pituitary adenomas, to add to already preexisting knowledge, in managing these cases enhancing better ocular and systemic outcomes.

Methods: A search was conducted on an online publication database (PubMed) using the term "pituitary adenoma" including all results published over twenty years (2004-2024). Results were sorted for relevance, language, and completeness.

Results: A total of 176 records were returned. The guidelines of the PRISMA 2020 statement were followed in this study. A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates. Another 17 records were not available as full-length articles and were also excluded. The references of each included record was further searched for relevant publications. A total of 141 records were therefore used in this minireview.

Conclusion: Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact, modern therapeutic strategies offer effective management options. Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life. Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.

Background: Artificial intelligence (AI) has become significantly integrated into healthcare, particularly in the diagnosing of neurological disorders. This advancement has enabled neurologists and physicians to diagnose conditions more quickly and effectively, ultimately benefiting patients.

Aim: To explore the current status and key highlights of AI-related articles in diagnosing of neurological disorders.

Methods: A systematic literature review was conducted in the Web of Science Core Collection database using the following strategy: TS = ("Artificial Intelligence" OR "Computational Intelligence" OR "Machine Learning" OR "AI") AND TS = ("Neurological disorders" OR "CNS disorder" AND "diagnosis"). The search was limited to articles and reviews. Microsoft Excel 2019 and VOSviewer were utilized to identify major contributors, including authors, institutions, countries, and journals. Additionally, VOSviewer was employed to analyze and visualize current trends and hot topics through network visualization maps.

Results: A total of 276 publications from 2000 to 2024 were retrieved. The United States, India, and China emerged as the top contributors in this field. Major institutions included Johns Hopkins University, King's College London, and Harvard Medical School. The most prolific author was U. Rajendra Acharya from the University of Southern Queensland (Australia). Among journals, IEEE Access, Scientific Reports, and Sensors were the most productive, while Frontiers in Neuroscience led in total citations. Central topics in AI-related articles on neurological disorders diagnosis included Alzheimer's disease, Parkinson's disease, dementia, epilepsy, autism, attention deficit hyperactivity disorder, and their intersections with deep learning and AI.

Conclusion: Research on AI's role in diagnosing neurological disorders is becoming widely recognized for its growing importance. AI shows promise in diagnosing various neurological disorders, yet requires further improvement and extensive future research.

Background: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is the most common modality for tissue acquisition from pancreatic masses. Despite high specificity, sensitivity remains less than 90%. Auxiliary techniques like elastography and contrast-enhanced EUS may guide tissue acquisition from viable tumor tissue and improve the diagnostic outcomes theoretically. However, data regarding the same have shown conflicting results.

Aim: To compare the diagnostic outcomes of auxiliary-EUS-FNA/B to standard EUS-FNA/B for pancreatic lesions.

Methods: The electronic databases of MEDLINE, EMBASE, and Scopus were searched from inception to February 2024 for all relevant studies comparing diagnostic outcomes of auxiliary-EUS-FNA/B to standard EUS-FNA/B for pancreatic lesions. A bivariate hierarchical model was used to perform the meta-analysis.

Results: A total of 10 studies were identified. The pooled sensitivity, specificity, and area under the receiver-operated curve (AUROC) for standard EUS-FNA/B were 0.82 (95%CI: 0.79-0.85), 1.00 (95%CI: 0.96-1.00), and 0.97 (95%CI: 0.95-0.98), respectively. The pooled sensitivity, specificity, and AUROC for EUS-FNA/B with auxiliary techniques were 0.86 (95%CI: 0.83-0.89), 1.00 (95%CI: 0.94-1.00), and 0.96 (95%CI: 0.94-0.98), respectively. Comparing the two diagnostic modalities, sensitivity [Risk ratio (RR): 1.04, 95%CI: 0.99-1.09], specificity (RR: 1.00, 95%CI: 0.99-1.01), and diagnostic accuracy (RR: 1.03, 95%CI: 0.98-1.09) were comparable.

Conclusion: Analysis of the currently available literature did not show any additional advantage of EUS-FNA/B with auxiliary techniques for pancreatic solid lesions over standard EUS-FNA/B. Further randomized studies are required to demonstrate the benefit of auxiliary techniques before they can be recommended for routine practice.

Third-space endoscopy (TSE) has emerged as an effective treatment modality for various gastrointestinal motility diseases and gastrointestinal tumors. TSE is based on the concept of working in the submucosa using a mucosal flap valve technique, which is the underlying premise for all TSE procedures; thus, some complications are shared across the spectrum of TSE procedures. Despite the high safety profiles of most TSE procedures, studies have reported various adverse events, including insufflation-related complications, bleeding, perforation, and infection. Although the occurrence rate of those complications is not very high, they sometimes result in critical conditions. No reports of chylous effusion following TSE procedures, particularly per-oral endoscopic myotomy, have been documented previously. We are presenting the first reported case of chylous pleural effusion after per-oral endoscopic myotomy. Additionally, we aim to present a comprehensive overview, discuss the existing data, and provide insights into pulmonary post-endoscopic complications in light of recent advancements in endoscopic procedures, especially TSE.

Background: Emergency medical care is essential in preventing morbidity and mortality, especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.

Aim: To assess the treatment rates of eye emergencies in Africa. Ocular emergencies are particularly delicate due to the eye's intricate structure and the necessity for its refractive components to remain transparent.

Methods: This review examines the low treatment rates of eye emergencies in Africa, drawing on 96 records extracted from the PubMed database using predetermined search criteria.

Results: The epidemiology of ocular injuries, as detailed in the studies, reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age, gender, and occupation. The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks. Management approaches reported in the review include both surgical and non-surgical interventions, from medication to evisceration or enucleation of the eye. Preventive measures emphasize eye health education and the use of protective eyewear and facial protection. However, inadequate healthcare infrastructure and personnel, cultural and geographical barriers, and socioeconomic and behavioral factors hinder the effective prevention, service uptake, and management of eye emergencies.

Conclusion: The authors recommend developing eye health policies, enhancing community engagement, improving healthcare personnel training and retention, and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.

Background: Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve. Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins, alongside anterior and posterior ischemic optic neuropathy. With the advent of optical coherence tomography angiography (OCTA), it is easy to identify these macular subclinical microvascular and structural changes.

Aim: To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura (MA), migraine without aura (MW), and healthy control (HC) participants using OCTA.

Methods: In this observational cross-sectional study, we studied a total of 100 eyes: (1) 32 eyes of 16 patients with MA; (2) 36 eyes of 18 patients with MW, recruited based on the International Classification of Headache Disorders; and (3) 32 eyes of 16 age and sex-matched healthy participants. Foveal flux, foveal avascular zone (FAZ), peripapillary flux obtained from OCTA, and foveal and peripapillary ganglion cell layer (GCL) thickness calculated via optical coherence tomography were compared among the groups.

Results: The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants (P = 0.002). However, there was no significant difference between the FAZ of the MA and MW groups. Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW (P = 0.0018) and HCs (P = 0.002). There was also significant thinning of the GCL in patients with MA and MW (P = 0.001) compared to HCs. However, there was no significant difference in temporal GCL thickness between the MA and MW groups.

Conclusion: Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs. OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances, aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.

The rise of the "fishing reviewer" phenomenon presents a significant threat to the integrity of academic publishing, undermining the credibility of the peer review process and eroding trust in scientific journals. This editorial explores the risk factors contributing to this troubling trend and identifies key indicators to recognize such reviewers. To address this issue, we propose strategies, including enhanced reviewer vetting, comprehensive training, and transparent recognition policies to foster a culture of accountability and ethical conduct in scholarly review. By implementing these measures, we can safeguard the quality and credibility of academic research.

Background: Duchenne muscular dystrophy (DMD) is a severe lethal X-linked monogenic recessive congenital muscular dystrophy caused by various types of mutations in the dystrophin gene (DG). It is one of the most common human genetic diseases and the most common type of muscular dystrophy, in part because DG is one of the largest protein-coding genes in the human genome with a relatively high risk of being affected by a large palette of mutations. Long-term corticosteroid therapy (LTCT) with deflazacort started at age 4 is the most accessible and used pharmacological therapy for DMD in Romania. "Asea^® redox supplement" (ARS) is an approved dietary supplement in the European Union. Several studies have shown that it is a very potent selective NRF2 activator, and thus a very potent, albeit indirect, antioxidant, with no toxicity up to high doses, in contrast to LTCT.

Case summary: This paper presents a 3-case series on the effects of ARS in a 4-year-old, 5-year-old and 3-year-old boy all with DMD from Bucharest or Slobozia (Romania). This is the first report of this type worldwide. The parents of these boys had refused LTCT. They were treated with relatively high doses of ARS (3-7 mL/kg/day). For two patients, ARS was administered in combination with medium doses of L-carnitine and omega-3 fatty acids for various intellectual disabilities. Periodic consults and assessments for rhabdomyolysis, medullar and liver toxicity markers (blood count, gamma-glutamyl transferase, aspartate aminotransferase, alanine transaminase, lactate dehydrogenase, creatine kinase, creatine kinase-MB and serum myoglobin) were performed. In vitro studies showed that ARS is a very potent and selective NRF2 activator, and thus a very potent indirect antioxidant. The in vivo studies also support this main pharmacological mechanism of ARS, with no toxicity at high doses, in contrast with much more toxic corticosteroids which are often refused by parents for their children with DMD. Although they were three distinct ages and carried three distinct DG mutations, from the first months of ARS-based treatment, the children responded similarly to ARS. The rhabdomyolysis markers, which were initially very high, significantly dropped, and there was no evidence for medullar and/or hepatic toxicity in any of the 3 patients.

Conclusions: ARS has significant indirect antioxidant effects via NRF2 and deserves extensive trials in children with DMD, as an adjuvant to corticoids or as a substitute in DMD patients who refuse corticoids. Future trials should also focus on ARS as an adjuvant in many types of acute/chronic infectious/non-infectious diseases where cellular oxidative stress is involved.