Clinics最新文献

{"title":"Enhancing tertiary cardiology triage with vectorcardiographic features: a machine learning approach using real-world data","authors":"Lucas José da Costa ,&nbsp;Vinicius Ruiz Uemoto ,&nbsp;Mariana FN de Marchi ,&nbsp;Renato de Aguiar Hortegal ,&nbsp;Renata Valeri de Freitas","doi":"10.1016/j.clinsp.2025.100856","DOIUrl":"10.1016/j.clinsp.2025.100856","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether electrocardiographic markers of Global Electrical Heterogeneity (GEH) improve the identification of patients requiring tertiary care, either alone or combined with an explainable machine learning model, compared with standard ECG features and clinical risk factors in a real-world tertiary cardiology population.</div></div><div><h3>Methods</h3><div>Patients were forwarded to a specific evaluation in a cardiology-specialized hospital performed an ECG and data collection. A series of follow-up attendances occurred in periods of 6-months, 12-months and 15-months to check for cardiovascular-related events (mortality or new nonfatal cardiovascular events (Stroke, MI, PCI, CS), as identified during 1-year phone follow-ups. The first attendance ECG was measured by a specialist and processed in order to obtain the Global Electric Heterogeneity (GEH) using the Kors Matriz. The ECG measurements, GEH parameters, and risk factors were combined for training multiple instances of XGBoost decision tree models. Each instance was optimized for the AUCPR, and the instance with the highest AUC was chosen as representative of the model. The importance of each parameter for the winner tree model was compared to better understand the improvement from using GEH parameters.</div></div><div><h3>Results</h3><div>GEH parameters were statistically significant in this population (<em>p</em> &lt; 0.001), particularly the QRST angle and SVG magnitude. The combined model integrating GEH, standard ECG features, and clinical risk factors achieved the best performance, with a sensitivity of 94.1 %, specificity of 30.8 %, AUC of 67.6 %, and F2 score of 0.62. SVG feature importance and SHAP analyses were consistent with the statistical findings, indicating that the model's decision patterns align with clinically relevant information and reinforce the role of GEH features. The modeling approach was carefully designed to prevent overfitting, ensure generalizability, and facilitate implementation through its decision tree architecture.</div></div><div><h3>Conclusion</h3><div>VCG-derived features may improve the identification of patients requiring tertiary care, either alone or integrated into an explainable and robust machine learning model trained on real-world data. Its clinical value will ultimately depend on prospective validation and seamless integration within existing care pathways.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100856"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of an interdisciplinary one-stop clinic for infant hip dysplasia: A pilot study","authors":"Patricia Moreno Grangeiro ,&nbsp;Giovanna Braga Motta ,&nbsp;Natasha Vogel Majewski Rodrigues ,&nbsp;Daniel Frank Liggio ,&nbsp;Cristiane Aun Bertoldi ,&nbsp;Roberta Coimbra ,&nbsp;Ina Fialho Zürcher ,&nbsp;Yasmin Estefanía González Herrera ,&nbsp;Moisés de Freitas Laurentino ,&nbsp;Lisa Suzuki ,&nbsp;Valdenise Tuma Calil ,&nbsp;Nei Botter Montenegro ,&nbsp;Giovanni Guido Cerri ,&nbsp;Tarcísio Eloy Pessoa de Barros Filho ,&nbsp;Werther Brunow de Carvalho ,&nbsp;Roberto Guarniero","doi":"10.1016/j.clinsp.2026.100864","DOIUrl":"10.1016/j.clinsp.2026.100864","url":null,"abstract":"<div><h3>Objectives</h3><div>The authors hypothesized that establishing a one-stop clinic for the management of Developmental Dysplasia of the Hip (DDH) at our institution would enhance screening procedures, referral processes, patient compliance, early diagnosis, and timely treatment for this condition. To inform clinical practice, the authors conducted a collaborative development of flowcharts for evidence-based patient care protocols, based on the Graf method and patient journey optimization.</div></div><div><h3>Methods</h3><div>A weekly DDH clinic was established in a tertiary/quaternary public teaching hospital in Brazil, integrating pediatrics, radiology, and orthopedics. Flowcharts were collaboratively designed during ten interdisciplinary meetings. As a pilot study, the authors included an initial cohort involved in an observational retrospective study during the period from October 2023 to December 2024.</div></div><div><h3>Results</h3><div>A novel system of grouping Graf types and subtypes was presented, accompanied by a treatment algorithm and phased therapeutic approach, based on the underlying hip pathology and immediate therapeutic requirements to promote hip centralization and acetabular development. A total of 98 infants were examined at the clinic during the specified period, with 22 receiving non-surgical treatment utilizing the Pavlik harness.</div></div><div><h3>Conclusion</h3><div>The establishment of a one-stop DDH clinic demonstrated a successful interdisciplinary approach, contributing to early diagnosis and effective treatment of DDH. The collaborative development of flowcharts facilitated the standardization of patient management protocols. Continued refinement of screening procedures and data collection methods is necessary to optimize care and inform future research on DDH management.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100864"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hybrid AHP and K-means model for biopsychosocial surgical prioritization: validation in a high-complexity ENT unit","authors":"Fabián Silva-Aravena ,&nbsp;Jenny Morales ,&nbsp;Vivian D’Afonseca","doi":"10.1016/j.clinsp.2026.100905","DOIUrl":"10.1016/j.clinsp.2026.100905","url":null,"abstract":"<div><h3>Objective</h3><div>To address the critical challenge of efficiently and ethically managing surgical waiting lists in digital health systems by developing a decision support framework based on biopsychosocial prioritization.</div></div><div><h3>Methods</h3><div>The authors integrate the Analytic Hierarchy Process (AHP) with K-Means clustering to create a hybrid decision support model that prioritizes patients using multidimensional biopsychosocial variables. The model was applied in the otolaryngology (ENT) unit of a high-complexity public hospital in Chile. Expert-informed weightings guided the AHP process, while K-Means clustering enabled data-driven segmentation into clinically coherent patient groups.</div></div><div><h3>Results</h3><div>The proposed methodology significantly outperformed traditional chronological scheduling approaches. Specifically, it achieved a 27 % reduction in mean clinical risk, a 41 % decrease in urgent hospitalizations, a 32 % reduction in urgent bed days, and more than 12-days of acceleration in access for high-priority patients.</div></div><div><h3>Contribution</h3><div>While the AHP-clustering hybrid is established in prior literature, our contribution lies in operationalizing it with ethical safeguards and real-world validation within a high complexity ENT unit.</div></div><div><h3>Conclusion</h3><div>Our hybrid AHP and K-Means approach offers a transparent, scalable, and interpretable decision support tool for surgical prioritization. It aligns with the goals of digital health transformation by improving the fairness, efficiency, and responsiveness of healthcare delivery.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100905"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of intra-abdominal hypertension after liver transplantation with temporary portocaval shunt – A prospective cohort","authors":"Estrella Bianca Melo,&nbsp;Luiz Augusto Carneiro-D’Albuquerque,&nbsp;Wellington Andraus,&nbsp;Rodolpho Augusto Pedro,&nbsp;Bruna Carla Scharank,&nbsp;Paula Sepulveda Mesquita,&nbsp;Daniel Reis Waisberg,&nbsp;Rodrigo Bronze de Martino,&nbsp;Vinicius Rocha-Santos,&nbsp;Liliana Ducatti,&nbsp;Lucia C. Andrade,&nbsp;Alberto Queiroz Farias,&nbsp;Luiz Marcelo Sá Malbouisson","doi":"10.1016/j.clinsp.2026.100900","DOIUrl":"10.1016/j.clinsp.2026.100900","url":null,"abstract":"<div><h3>Background</h3><div>Intra-Abdominal Hypertension (IAH) is reported to be frequent after liver transplantation. Nonetheless, the evolution of surgical techniques improved postoperative care in the last decades, which could lead to a lower incidence of Intra-abdominal hypertension.</div></div><div><h3>Methods</h3><div>The authors prospectively studied 104 patients. The intra-abdominal pressure and abdominal perfusion pressure were measured at the end of surgery and every 6 hours until 72 hours, and patients were divided into two groups: with (IAH⁺) or without (IAH^-) IAH. Outcomes analyzed were death, renal function, reoperation, need for vasopressors, mechanical ventilation, hemodialysis, and graft function measured by indocyanine green.</div></div><div><h3>Results</h3><div>The incidence of Intra-abdominal hypertension was 14.4%, with no abdominal compartment syndrome cases. After 48 hours, 60% of the IAH⁺ group was on mechanical ventilation versus 26.7% in the IAH^- group (<em>p</em> = 0.016). The prevalence of dialysis at the end of the first postoperative week was higher in the IAH⁺ group (31.3% vs. 10.8%, <em>p</em> = 0.047). Both groups had similar indocyanine green clearance on the third and seventh postoperative days. Reoperation rates (12.4% vs. 20%), need for retransplant (10.1% vs. 13.3%), and death (14% vs. 18.2%) were similar in IAH^- and IAH⁺ groups, respectively. The number of blood products transfused (OR = 1.18) and body mass index (OR = 1.10) were associated with the development of intra-abdominal hypertension, while intraoperative ascites (OR = 0.19) was a protective factor.</div></div><div><h3>Conclusions</h3><div>Intra-abdominal hypertension was present in 14.4% of liver transplant patients, and IAH was linked to a greater need for mechanical ventilation and hemodialysis but not to more reoperations, transplants, or deaths.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100900"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The economic impact of COVID-19: a comparative cost analysis of ICU hospitalizations before and during the pandemic","authors":"Heloisa Helena Piva,&nbsp;Anna Miethke-Morais,&nbsp;Alex Jones Flores Cassenote,&nbsp;Luiz Augusto Carneiro-D´Albuquerque,&nbsp;Luciana Bertocco de Paiva Haddad","doi":"10.1016/j.clinsp.2026.100891","DOIUrl":"10.1016/j.clinsp.2026.100891","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 economic impact on health institutions has been discussed since the beginning of the pandemic, and the repercussions in different spheres were enormous. The economic evaluation in health became necessary as a management tool.</div></div><div><h3>Objective</h3><div>To describe and compare the hospitalization costs in Intensive Care Units (ICUs) and the patients' clinical and demographic variables, before and during the COVID-19 pandemic.</div></div><div><h3>Data sources and study setting</h3><div>Partial economic evaluation of patients admitted to four ICUs, in a Brazilian reference center, in two periods: pre-pandemic (03/30/19 ‒ 06/30/19) and pandemic (03/30/20 ‒ 06/30/20).</div></div><div><h3>Study design</h3><div>Observational cohort study.</div></div><div><h3>Data collection/Extraction methods</h3><div>Micro and macro costing methodology; clinical and demographic variables were considered for the comparative analysis.</div></div><div><h3>Results</h3><div>In 2019, 521 hospitalizations were analyzed. Patients were predominantly male (61%), between 31- and 60-years old (48.2%) and of white race (75.4%). In 2020, 610 hospitalizations were analyzed: 60.3% male, 51.6% &gt; 60-years old and 65.2% white race. All ICUs had an increase in deaths (2019: average of 26.9%; 2020: average of 48.8%). The average total hospitalization costs and the average patient-day cost in 2019 was US$ 6051.01 and US$ 787.48, respectively; in 2020, US$ 19,492.73 and US$ 1542.74. Human resources was the component with the highest cost (2019: 51.6%; 2020: 78.2%). Patients who require additional therapeutic procedures had a higher average cost in 2020.</div></div><div><h3>Conclusion</h3><div>During COVID, patients were older (&gt; 60-years), a higher percentage of patients identified as mixed race, the death rate was significantly higher, and the length of stay was significantly higher, resulting in the outcome “discharge”. The COVID cost was significantly higher. The main cost component was human resources, mainly during the COVID pandemic. Additional therapeutic procedures were associated with higher costs.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100891"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternating pressure air mattresses in the intensive care unit as a cost-effective strategy for preventing stage III–IV pressure injuries: a retrospective cohort study","authors":"Serdar Efe ,&nbsp;Coşkun Ateş ,&nbsp;Mehmet Serdar Cengizhan ,&nbsp;Pervin Hancı ,&nbsp;Volkan İnal","doi":"10.1016/j.clinsp.2026.100877","DOIUrl":"10.1016/j.clinsp.2026.100877","url":null,"abstract":"<div><h3>Background</h3><div>Pressure Injuries (PIs) are frequent, preventable complications in Intensive Care Units (ICUs), leading to morbidity, mortality, and increased healthcare costs. Alternating Pressure Air Mattresses (APAMs) have been proposed to reduce PI incidence, but real-world data remain scarce.</div></div><div><h3>Objectives</h3><div>To assess the effectiveness and cost-efficiency of APAMs in preventing PIs among critically ill patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted in a 10-bed tertiary ICU, comparing patients before and after APAM implementation. Multivariate logistic regression identified independent PI risk factors, and a cost-effectiveness model was developed using Number Needed to Treat (NNT) and treatment costs.</div></div><div><h3>Results</h3><div>APAM use reduced overall PI risk by 33% (RR = 0.67; 95% CI 0.45–0.98) and Stage III–IV ulcer risk by 84% (RR = 0.16; 95% CI 0.05–0.53). The NNT was 23, corresponding to net savings of USD 121,750 over five years for a 10-bed ICU, with cost recovery achieved within 4.3-months. Length of Stay (LOS) and prolonged mechanical ventilation independently increased PI risk by 19% and 13% per day, respectively. APAMs’ benefit was attenuated in patients with extended LOS and ventilation. Sepsis and respiratory failure increased PI risk in univariate analysis but lost significance after adjustment, indicating mediation by LOS and ventilation. APAMs eliminated the need for negative pressure wound therapy in this cohort.</div></div><div><h3>Conclusions</h3><div>APAMs significantly reduced severe PI incidence and treatment requirements in critically ill patients, demonstrating cost-effectiveness. Their protective effect was limited in patients with prolonged ICU stay or ventilation. Multicenter randomized trials are warranted, especially in diabetic and septic populations.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100877"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of thiamine (vitamin B1) in sepsis and septic shock: A meta-analysis of randomized controlled trials","authors":"Xiaoqin Xu,&nbsp;Xiaoqi Bai,&nbsp;Wei Cao,&nbsp;Danting Fei,&nbsp;Dandan Yang,&nbsp;Xuning Shen,&nbsp;Jun Xu,&nbsp;Dongjun Xu","doi":"10.1016/j.clinsp.2026.100901","DOIUrl":"10.1016/j.clinsp.2026.100901","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a meta-analysis evaluating thiamine’s efficacy for sepsis and septic shock to support its clinical use.</div></div><div><h3>Methods</h3><div>The meta-analysis of randomized controlled studies on patients with sepsis and septic shock evaluated the efficacy of intravenous thiamine. Articles were retrieved from online databases. Qualities of included studies were assessed.</div></div><div><h3>Results</h3><div>Nine studies enrolling 520 patients were included. Regarding bias risk assessment of studies, two articles were classified as low risk, three were categorized as raising some concerns, and four were identified as high risk. Patients in the thiamine group were significantly associated with decreased proportion of Renal Replacement Therapy (RRT, Odds Ratio [OR = 0.26], <em>p</em> = 0.0007), decreased 24 h lactate level (Mean Difference [MD = -0.35], <em>p</em> = 0.004), and larger 24 h SOFA score change (MD = 1.15, <em>p</em> &lt; 0.00001). No statistical significance was detected in short-time mortality (OR = 0.78, <em>p</em> = 0.18) and 24 h lactate change (MD = 0.09, <em>p</em> = 0.36) between the two groups. In the thiamine-deficient subgroup (2 studies, 51 patients), exploratory analysis indicated a potential short-term mortality reduction with thiamine (OR = 0.18, <em>p</em> = 0.01), though limited by the small sample size.</div></div><div><h3>Conclusion</h3><div>This meta-analysis preliminarily suggested that thiamine may exert a potential role in improving organ dysfunction among patients with sepsis and septic shock. No significant benefit of thiamine in reducing short-term mortality was observed. It is important to note that the total number of patients included in this meta-analysis is relatively small, which limits the statistical power and external validity of the results.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100901"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-collected versus clinician-collected samples for HPV testing: A meta-analysis revealing lower sensitivity for detecting high-grade cervical lesions","authors":"Gabriel Gonçalves Santiago Lima,&nbsp;Annielson de Souza Costa,&nbsp;Mayara Souza Alves,&nbsp;Jose Antonio Orellana Turri,&nbsp;Lea Tami Suzuki Zuchelo,&nbsp;Noely Paula Cristina Lorenzi,&nbsp;Eduardo Carvalho de Arruda Veiga,&nbsp;Isabel C.E. Sorpreso,&nbsp;Edmund C. Baracat,&nbsp;José Maria Soares Junior","doi":"10.1016/j.clinsp.2026.100898","DOIUrl":"10.1016/j.clinsp.2026.100898","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the specificity and sensitivity between self-collection and collection performed by healthcare professionals in testing High-risk oncogenic Human Papillomavirus (HrHPV) to detect high-grade uterine cervical lesions.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Meta-analysis was conducted on STATA-14SE using random effects models for the aggregated values of sensitivity and specificity of studies that evaluated self-collection and collection by healthcare professionals. This review is registered on PROSPERO under CRD42022347731.</div></div><div><h3>Results</h3><div>This study included 17 articles. Regarding the sensitivity of the collection method, self-collection was superior to professional collection in 2 studies, inferior in 8, equivalent in 1, and variable depending on the sample storage medium, HPV DNA analysis method, or CIN grade assessed in 3. The specificity between the methods was higher with self-collection in 5 studies, lower in 5 others, equivalent in 1, not evaluated in 1, and variable depending on the HPV DNA detection method in 2 articles. The results of the meta-analysis of studies that evaluated the sensitivity and specificity of devices used for HPV detection between self-collection and health-professionals collection showed significant differences of sensitivity favorable to the health-professionals (SMD = -0.540; 95% CI -0.595 ‒ -0.486; <em>p</em> &lt; 0.001). The evaluation of the sensitivity and specificity of the type of lesion between self-collection and health professionals’ collection showed significant differences in sensitivity, favorable to the health professionals (SMD = -0.872; 95% CI -1.392 ‒ -0.351; <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>In conclusion, while specificity is comparable, this meta-analysis demonstrates that self-collected samples have significantly lower sensitivity for detecting HR-HPV and high-grade cervical lesions compared to clinician-collected samples. This suggests that self-sampling, in its current form, may be best utilized with complementary triage strategies or in settings where its logistical advantages outweigh the modest reduction in sensitivity for increasing screening coverage.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100898"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between a body shape index and abdominal aortic calcification: a population-based study","authors":"Youfu Wang ,&nbsp;Yiming Su ,&nbsp;Changzhi Luo ,&nbsp;Han Yang ,&nbsp;Xiao Qin","doi":"10.1016/j.clinsp.2026.100910","DOIUrl":"10.1016/j.clinsp.2026.100910","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal Aortic Calcification (AAC) is closely associated with visceral adiposity. The authors aimed to investigate the relationship between a Body Shape Index (ABSI) and AAC.</div></div><div><h3>Methods</h3><div>Data were obtained from the 2013‒2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Weighted multivariable regression, tests for trends, subgroup analysis, and smooth curves were used to explore the association between ABSI and AAC scores, as well as Severe Abdominal Aortic Calcification (SAAC). Receiver Operating Characteristic (ROC) curves were plotted to compare the predictive abilities of ABSI, Weight-adjusted Waist Index (WWI), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist Circumference (WC) for AAC and SAAC.</div></div><div><h3>Results</h3><div>A total of 2741 individuals were included in the present study. The weighted incidence of AAC was 29.12%, and SAAC was 7.94%. After fully adjusting for covariates, each one-unit increase in ABSI was associated with a 0.42-point increase in the AAC score (95% CI: 0.29, 0.63), and the risk of SAAC increased by 37% (95% CI: 1.12, 1.77). Smooth curves showed a nonlinear positive correlation between ABSI and AAC scores, as well as SAAC. No dependence was observed in the subgroup analysis. ROC analysis showed that ABSI was a stronger predictor than WWI, BMI, WHtR, and WC.</div></div><div><h3>Conclusions</h3><div>ABSI has a positive correlation with AAC scores and SAAC. However, prospective studies are required to validate the present results.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100910"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer diagnosis from CT scans using artificial intelligence techniques: A global perspective","authors":"Yuanyuan Wang,&nbsp;Weihong Liu,&nbsp;Yongzhong Cao,&nbsp;Fangxing Chen","doi":"10.1016/j.clinsp.2026.100930","DOIUrl":"10.1016/j.clinsp.2026.100930","url":null,"abstract":"<div><h3>Objective</h3><div>In this research, we conducted a systematic review of artificial intelligence techniques used for the diagnosis of lung cancer.</div></div><div><h3>Methods</h3><div>A systematic search of Web of Science, PubMed, Scopus, Epistemonikos, Cochrane, Medline, and Embase databases was carried out, containing the literature published up to June 2025. Prediction model risk of bias assessment tool (PROBAST) was used to evaluate the risk of bias and applicability of the diagnostic model studies included in the current research.</div></div><div><h3>Results</h3><div>204 studies were included. The included articles utilized various AI techniques, including CNN (Convolutional Neural Network), SVM (Support Vector Machine), RF (Random Forest), KNN (K-Nearest Neighbor), PM-DL (Pattern Matching combined with Deep Learning), ANN (Artificial Neural Network), DNN (Deep Neural Network), CDNs (Convolutional Dense Networks), DLS (Deep Learning System), LSTM (Long Short-Term Memory), NNE (Neural Network Ensemble), and LDA (Linear Discriminant Analysis). The CNN model appears to be the most commonly used model in the papers. It was observed that applying deep learning models to preprocessed and augmented medical images led to improved performance metrics, including AUC, sensitivity, and accuracy. The accuracy of artificial intelligence techniques ranged from 68.4 to 100, while the sensitivity varied from 50.0 to 100. The specificity of the artificial intelligence techniques ranged from 50.0 to 100. The AUC of the artificial intelligence techniques ranged from 61.0 % to 100 %, while the recall varied from 75.0 to 99.82.</div></div><div><h3>Conclusion</h3><div>This research accentuates the potential of artificial intelligence techniques in the diagnosis and detection of lung cancer, with diverse levels of diagnostic accuracy. Additional research is required to optimize these artificial intelligence techniques, as well as to ascertain their clinical relevance and appropriateness in real-world clinical applicability.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100930"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}