European Journal of Medical Research最新文献

{"title":"Gauze detection and segmentation in laparoscopic liver surgery: a multi-center study.","authors":"Xiang Ao, Yanlin Leng, Yunfan Gan, Zhitao Cheng, Haomin Lin, Jiayi Fan QiaoLi, Junfeng Wang, Tingfang Wu, Linru Zhou, Haoxin Li, Liu Zheng, Yong Tang, Song Su, Jiali Wu","doi":"10.1186/s40001-025-03190-2","DOIUrl":"10.1186/s40001-025-03190-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical gauze is commonly used in laparoscopic procedures. However, due to its small size, limited visibility to the naked eye, and subtle tactile presence, gauze can easily be overlooked during surgery.</p><p><strong>Purpose: </strong>To support surgeons in detecting gauze, reduce the risk of omission, and enhance surgical safety and efficiency, we developed a deep learning framework designed to identify gauze in laparoscopic liver surgeries.</p><p><strong>Methods: </strong>In total, 33 laparoscopic liver surgery videos were collected from 2 hospitals and used as internal and external datasets. Deep learning models were trained on individual video frames to detect and segment gauze, with each frame containing one or more gauze objects. To better evaluate model performance, we introduced a quantitative approach that classified gauze detection difficulty into three categories: easy, moderate, and difficult. Model performance across categories was assessed using data from both centers.</p><p><strong>Results: </strong>Among the tested models, YOLOv8n achieved the highest accuracy in gauze detection. In the internal test set, recall and precision reached 0.8443 and 0.9034, while in the external test set, they were 0.8289 and 0.9103. For gauze segmentation, the FCN-ResNet101 model demonstrated superior performance, achieving Dice scores of 0.9389 in the internal test set and 0.9081 in the external test set.</p><p><strong>Conclusion: </strong>The findings highlight the strong capability of the proposed framework to detect and segment gauze across varying levels of background complexity in laparoscopic liver surgery videos. This approach has the potential to significantly improve gauze management during surgery.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"905"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative carbohydrate fluid intake reduces postoperative nausea and vomiting without increasing gastric volume in neuroendoscopic sellar tumor surgery.","authors":"Ping Shi, Yuanyuan Ma, Yunyan Zhu, Shanshan Ye, Fei Yan, Yanguo Zheng, Shengjin Ge","doi":"10.1186/s40001-025-03136-8","DOIUrl":"10.1186/s40001-025-03136-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effect of preoperative carbohydrate fluid intake on gastric volume (GV), blood glucose (BG), reflux aspiration, and postoperative nausea and vomiting (PONV) in patients with sellar tumors undergoing neuroendoscopic transnasal-sphenoidal sinus resection (NTSR).</p><p><strong>Methods: </strong>Fifty-eight patients scheduled for elective NTSR were randomly assigned to Group A (n = 29), who received 400 mL of 10% glucose solution orally 2 h before anesthesia, or Group B (n = 29), who fasted for at least 8 h. Gastric ultrasound was used to measure antral diameters before induction and after surgery, from which GV was estimated. BG levels were recorded at fasting (T1), before induction (T2), and after surgery (T3). The incidence of PONV within 24 h, reflux aspiration, and hospital stay duration were also assessed.</p><p><strong>Results: </strong>In Group A, the mean GV decreased significantly from 47.81 ± 2.45 mL before induction to 45.71 ± 2.08 mL after surgery (p < 0.05), while no significant change was observed in Group B. Before induction, GV was higher in Group A than in Group B (p < 0.05). No patients experienced reflux aspiration in either group. The incidence of PONV was significantly lower in Group A (23.1%, 6/26) than in Group B (65.4%, 17/26; p < 0.05). BG levels at all time points showed no significant intergroup differences.</p><p><strong>Conclusions: </strong>Carbohydrate fluids taken 2 h before anesthesia do not increase GV or aspiration risk but reduce PONV in NTSR patients without affecting BG levels.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"892"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Baduanjin exercise on cardiac rehabilitation after percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials.","authors":"Yingkun Zhao, Wujiao Wang, Yi Cai, Bo Liu, Peifen Chang, Tianli Li, Peng Yang","doi":"10.1186/s40001-025-03031-2","DOIUrl":"10.1186/s40001-025-03031-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To systematically evaluate the effects of Baduanjin exercise on cardiac rehabilitation after percutaneous coronary intervention (PCI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From the time the database was constructed to May 28, 2025, Eight databases and two registry systems, including Web of Science, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, China Science and Technology Journal Database (VIP), Chinese Biomedical Literature database (CBM), Clinical Trials, and the China Clinical Trials Registry were searched-clinical randomized controlled trials (RCTs) of Baduanjin in treating patients after PCI were retrieved. The primary outcomes were the 6-min walk test (6MWT) and left ventricular ejection fraction (LVEF). Secondary outcomes were Major adverse cardiovascular event (MACE), Seattle Angina Questionnaire (SAQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Anaerobic threshold (AT), Metabolic equivalent of task (METs), and Maximal oxygen consumption (VO&lt;sub&gt;2&lt;/sub&gt; max). The quality of the included studies was assessed using the Cochrane Risk of Bias assessment tool, version 2.0 (RoB 2). Meta-analysis was performed using RevMan 5.4 software. Sensitivity analysis and subgroup analysis were performed using Stata software. In addition, Publication bias was evaluated using funnel plots and Egger's test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 56 RCTs involving 5152 patients were included in the study. Compared with the control group, the Baduanjin group showed superior improvement in LVEF (MD = 5.55%, 95% CI [4.28%, 6.82%], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 94%), 6MWT (MD = 57.68m, 95% CI [40.20m, 75.17m], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 100%), MACE (RR = 0.33, 95% CI [0.26, 0.42], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 0%), SAQ-PL (MD = 7.49 points, 95% CI [4.78 points, 10.20 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 91%), SAQ-AS (MD = 12.88 points, 95% CI [10.76 points, 15.00 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 77%), SAQ-DS (MD = 11.30 points, 95% CI [5.14 points, 17.45 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 98%), SAQ-AF (MD = 10.90 points, 95% CI [6.05 points, 15.75 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 98%), SAQ-TS (MD = 8.04 points, 95% CI [2.30 points, 13.78 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 98%), SAS (MD = - 7.01 points, 95% CI [- 8.05 points, - 5.96 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 58%), SDS (MD = - 6.67 points, 95% CI [- 8.34 points, - 5.00 points], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 89%), VO&lt;sub&gt;2&lt;/sub&gt;peak (MD = 1.81 mL/kg/min, 95% CI [0.82 mL/kg/min, 2.80 mL/kg/min], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 96%), AT (MD = 1.18 mL/kg/min, 95% CI [0.66 mL/kg/min, 1.69 mL/kg/min], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 96%), and METs (MD = 0.61 METs, 95% CI [0.32 METs, 0.90 METs], P &lt; 0.01, I&lt;sup&gt;2&lt;/sup&gt; = 83%) when compared to control groups. Subgroup analysis showed that patients with chronic coronary syndromes (CCS) were more suitable as a target population. Improvement in LVEF was better with intervention du","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"889"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long non-coding RNA HMGCR suppresses vascular remodeling in streptozotocin-induced type 1 diabetic rats via interaction with THOC5.","authors":"Su-Ya Chen, Xu Xie, Wei-Qiang Tong, Bing-Xuan Niu, Wen-Xuan Li, Shuang-Yi He, Nian-Sheng Li, Jun-Lin Jiang","doi":"10.1186/s40001-025-03205-y","DOIUrl":"10.1186/s40001-025-03205-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the role of long non-coding RNA (lncRNA) in vascular smooth muscle cell (VSMC) dysfunction under diabetic conditions, with a specific focus on lncHMGCR and its regulatory effects on VSMC proliferation and migration using streptozotocin-induced type 1 diabetic (T1DM) rat model and primary rat VSMCs stimulated with high glucose.</p><p><strong>Methods: </strong>Transcriptome sequencing (RNA-seq) was performed to identify differentially expressed lncRNAs in the aortic tissues of T1DM rats. Functional enrichment analysis, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, was conducted to elucidate potential biological roles. The expression of lncHMGCR was validated via quantitative real-time polymerase chain reaction (qRT-PCR) in the aortic tissues of T1DM rats and primary rat VSMCs pretreated with high glucose (30 mM). Functional assays were carried out to evaluate the effects of lncHMGCR overexpression and THOC5 silencing on VSMC proliferation and migration under high glucose conditions.</p><p><strong>Results: </strong>RNA-seq analysis identified 229 differentially expressed lncRNAs (180 upregulated and 49 downregulated) in diabetic aortic tissues. GO and KEGG analyses revealed enrichment in transcriptional regulation, metal ion binding, and glycolysis-related pathways. LncHMGCR was significant downregulated in both diabetic aortic tissues and VSMCs stimulated with high glucose. Functional studies demonstrated that lncHMGCR overexpression inhibited high glucose-induced VSMC proliferation and migration by restoring THOC5 expression, whereas THOC5 knockdown exacerbated these effects.</p><p><strong>Conclusions: </strong>This study demonstrates that lncHMGCR suppresses VSMCs dysfunction under diabetic conditions by upregulating THOC5 expression, suggesting its potential as a therapeutic target for vascular remodeling in T1DM. However, these findings are based solely on animal models and in vitro experiments, and further validation in clinical samples is required to confirm translational relevance.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"907"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics associated with septic shock complicating hypothermia: a retrospective cohort study from the MIMIC-IV database.","authors":"Fen Tan, Jinxiu Li, Yang Xiao, Chenfang Wu","doi":"10.1186/s40001-025-03195-x","DOIUrl":"10.1186/s40001-025-03195-x","url":null,"abstract":"<p><strong>Background: </strong>Septic shock, a severe consequence of sepsis, has a high mortality rate. Hypothermia can aggravate the state of septic shock patients, which influences therapeutic response and overall prognosis. Nevertheless, the precise mechanism of action associated with septic shock in hypothermia remains unclear. This study aimed to investigate clinical factors and develop a predictive model for accurately assessing the risk probability of concomitant hypothermia in septic shock patients.</p><p><strong>Methods: </strong>This study utilized the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, which collected data on patients with septic shock from 2008 to 2019. Several covariates were introduced to identify clinical factors related to septic shock patients complicated by hypothermia. The univariate Logistic regression analysis, machine learning, and multivariate Logistic regression analysis identified covariates as significant independent predictors for patients with septic shock complicating hypothermia. Afterwards, a nomogram was constructed on the basis of the identified independent predictors, with predictive performance evaluated via the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>A total of 1640 participants with septic shock (hypothermia:non-hypothermia = 134:1506) were screened after the exclusion of samples. A notable disparity was observed in several covariates between septic shock patients presenting with concomitant hypothermia and those without hypothermia, such as hemoglobin, bicarbonate, and heart rate. Subsequent analyses revealed that hemoglobin, heart rate, respiratory rate, lactate, and dopamine were associated with prognosis in septic shock complicating hypothermia. Moreover, the constructed nomogram displayed promising potential for effectively evaluating septic shock complicated by hypothermia, which exhibited an area under the curve (AUC) of 0.787.</p><p><strong>Conclusions: </strong>Five clinical factors-hemoglobin, heart rate, respiratory rate, lactate, and dopamine-that were significantly associated with hypothermia in septic shock, suggesting that these factors could serve as potential predictors and provide a reference for clinical risk assessment.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"902"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of lateral retinacular release versus no release in total knee arthroplasty: a systematic review and meta-analysis.","authors":"Yue Zou, Cuiqin Cao, Xiujiang Sun, Guodong Zhang","doi":"10.1186/s40001-025-03201-2","DOIUrl":"10.1186/s40001-025-03201-2","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (n = 8 studies, 3,911 patients).</p><p><strong>Exclusion criteria: </strong>incomplete data, combined procedures, cadaveric/artificial models. Random-effects models analyzed outcomes; heterogeneity assessed via I² statistics.</p><p><strong>Results: </strong>Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13-0.42, P < 0.00001; I² = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10-4.89, P = 0.002; I² = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48-8.04, P = 0.004; I² = 26%). Secondary outcomes showed no significant differences (P > 0.05).</p><p><strong>Conclusion: </strong>LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk-benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"911"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HMGB1-mediated macrophage polarization to M2 phenotype promotes ureteral stricture: therapeutic potential of HMGB1 inhibitors.","authors":"Jie Zheng, Lingsong Tao, Yingqing Liu, Yang Zhang, Li Cheng, Zongyao Hao","doi":"10.1186/s40001-025-03137-7","DOIUrl":"10.1186/s40001-025-03137-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ureteral stricture is a common condition characterized by fibrotic narrowing of the ureter, often resulting in obstruction and impaired renal function. The condition is typically associated with chronic inflammation, epithelial injury, and abnormal wound healing responses, leading to excessive deposition of extracellular matrix proteins. High Mobility Group Box 1 (HMGB1), a damage-associated molecular pattern (DAMP) protein, plays a key role in promoting inflammation and fibrosis in various tissues. However, its specific role in the pathogenesis of ureteral stricture remains unclear. Glycyrrhizin, a natural HMGB1 inhibitor, has shown therapeutic potential in alleviating inflammation and fibrosis in preclinical studies of other fibrotic diseases. This study explores the involvement of HMGB1 in ureteral fibrosis and evaluates the efficacy of glycyrrhizin as a potential therapeutic agent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Ureteral tissue samples were collected from seven patients with ureteral stricture, and a rabbit model of ureteral stricture was established using thermal injury to the left ureter. HMGB1 expression in both human and rabbit tissues was analyzed via Western blot. SV-HUC-1 cells were subjected to three distinct injury models: UVB irradiation, radiotherapy, and chemotherapy with cisplatin, to simulate ureteral damage and assess HMGB1 secretion and localization. THP-1 macrophages were treated with recombinant HMGB1 or conditioned medium from injured SV-HUC-1 cells, and macrophage polarization was evaluated using flow cytometry, with IL-4 stimulation serving as a positive control. The role of macrophage polarization in fibroblast activation was investigated using conditioned medium to treat MRC-5 fibroblasts, followed by Western blot and qPCR to measure the expression of activation markers. The impact of the TGF-β inhibitor SB-431542 on fibroblast activation was also assessed. Glycyrrhizin's therapeutic effects and toxicity were evaluated in vitro through biochemical assays and in vivo by histological analysis in rabbit models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;HMGB1 levels were significantly elevated in fibrotic segments of ureteral tissues from both patients and rabbit models. In SV-HUC-1 cells, injury induced HMGB1 translocation from the nucleus to the cytoplasm and extracellular medium. Conditioned medium from injured SV-HUC-1 cells and direct exposure of THP-1 macrophages to recombinant HMGB1 protein both stimulated M2 polarization of macrophages, which secreted TGF-β and activated fibroblasts to upregulate α-SMA, FAP, FN1, and COL1A1. In contrast, direct exposure of fibroblasts to recombinant HMGB1 showed minimal effects on these markers, suggesting an indirect mechanism mediated by macrophages. Treatment with the TGF-β inhibitor SB-431542 effectively suppressed fibroblast activation induced by HMGB1-conditioned medium from macrophages, confirming the critical role of TGF-β in this pathway.","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"893"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel multi-task learning for Alzheimer's stage classification using hippocampal MRI segmentation, feature fusion, and nomogram modeling.","authors":"Wenqi Hu, Qiaohui Du, Lisi Wei, Dawei Wang, Guang Zhang","doi":"10.1186/s40001-025-03204-z","DOIUrl":"10.1186/s40001-025-03204-z","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a comprehensive and interpretable framework for multi-class classification of Alzheimer's disease (AD) progression stages based on hippocampal MRI, integrating radiomic, deep, and clinical features.</p><p><strong>Materials and methods: </strong>This retrospective multi-center study included 2956 patients across four AD stages (Non-Demented, Very Mild Demented, Mild Demented, Moderate Demented). T1-weighted MRI scans were processed through a standardized pipeline involving hippocampal segmentation using four models (U-Net, nnU-Net, Swin-UNet, MedT). Radiomic features (n = 215) were extracted using the SERA platform, and deep features (n = 256) were learned using an LSTM network with attention applied to hippocampal slices. Fused features were harmonized with ComBat and filtered by ICC (≥ 0.75), followed by LASSO-based feature selection. Classification was performed using five machine learning models, including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), Multilayer Perceptron (MLP), and eXtreme Gradient Boosting (XGBoost). Model interpretability was addressed using SHAP, and a nomogram and decision curve analysis (DCA) were developed. Additionally, an end-to-end 3D CNN-LSTM model and two transformer-based benchmarks (Vision Transformer, Swin Transformer) were trained for comparative evaluation.</p><p><strong>Results: </strong>MedT achieved the best hippocampal segmentation (Dice = 92.03% external). Fused features yielded the highest classification performance with XGBoost (external accuracy = 92.8%, AUC = 94.2%). SHAP identified MMSE, hippocampal volume, and APOE ε4 as top contributors. The nomogram accurately predicted early-stage AD with clinical utility confirmed by DCA. The end-to-end model performed acceptably (AUC = 84.0%) but lagged behind the fused pipeline. Statistical tests confirmed significant performance advantages for feature fusion and MedT-based segmentation.</p><p><strong>Conclusions: </strong>This study demonstrates that integrating radiomics, deep learning, and clinical data from hippocampal MRI enables accurate and interpretable classification of AD stages. The proposed framework is robust, generalizable, and clinically actionable, representing a scalable solution for AD diagnostics.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"910"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoriasis and phenotypic age acceleration in relation to all-cause and cardiovascular disease mortality risks in US adults.","authors":"Wen-Qi Zhao, Rui Gao, Jian-Yong Fan, Xiao-Lin Bu","doi":"10.1186/s40001-025-03176-0","DOIUrl":"10.1186/s40001-025-03176-0","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic, immune-mediated inflammatory dermatosis associated with an elevated risk of cardiovascular disease (CVD) due to systemic inflammation and metabolic dysregulation. Phenotypic age acceleration (PhenoAge-accel) quantifies accelerated biological aging by comparing an individual's predicted 'phenotypic age' (based on immune/inflammatory markers and chronological age) to their actual age. Notably, both the onset and progression of psoriasis exhibit strong associations with biological aging process. The aim of this study was to investigate their combined effect on the risk of all-cause and CVD mortality.</p><p><strong>Methods: </strong>This study included 11,443 participants from the National Health and Nutrition Examination Survey (NHANES) conducted during 2003-2006 and 2009-2010. Weighted multivariable logistic regression models were used to evaluate the association between PhenoAge-accel and psoriasis risk. PhenoAge-accel ≥ 0 was defined as PhenoAge-accel+. Furthermore, participants were stratified into four groups: psoriasis-/PhenoAge-accel-, psoriasis+/PhenoAge-accel-, psoriasis-/PhenoAge-accel+, and psoriasis+/PhenoAge-accel+. The Cox proportional hazards models were employed to investigate the joint effects of psoriasis and PhenoAge-accel on all-cause and CVD mortality risk.</p><p><strong>Results: </strong>At baseline, 312 participants were diagnosed with psoriasis. After adjusting for covariates, compared to those with PhenoAge-accel < 0, the odds ratios (95% CI) for psoriasis in the PhenoAge-accel ≥ 0 group was 1.83 (1.36-2.45). During a median follow-up of 10.91 years (interquartile range: 9.83-14.75), 1059 deaths event occurred, including 306 caused by CVD. In the multivariable-adjusted model, compared with the reference group, the hazard ratios and 95% CIs for all-cause mortality in the psoriasis-/PhenoAge-accel+, psoriasis+/PhenoAge-accel-, and psoriasis+/PhenoAge-accel+ groups were 1.80 (1.54-2.10), 0.96 (0.56-1.65), and 2.70 (1.66-4.39), respectively. A similar trend was observed for CVD mortality.</p><p><strong>Conclusions: </strong>PhenoAge-accel is positively associated with psoriasis risk. Furthermore, the coexistence of psoriasis and PhenoAge-accel are significantly associated with an increased risk of all-cause and CVD mortality.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"894"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protective effect of probiotic/prebiotic consumption against fatigue in the general population is modulated by BMI: an analysis of mediating and moderating effects based on NHANES.","authors":"Yan Wang, Zhimeng Yu, Huan Zhang, Zhusong Mei, Lei Wang, Chongxi Fan, Yan Wu, Minghao Yang, Yongquan Shi, Lei Shang, Zheyi Han","doi":"10.1186/s40001-025-03129-7","DOIUrl":"10.1186/s40001-025-03129-7","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue is closely linked to gut microbiota dysbiosis, making probiotics and prebiotics promising candidates for interventions related to fatigue. This study explores the relationship between probiotic/prebiotic consumption and fatigue in the general population, focusing on potential moderating and mediating factors, as most prior research has centered on clinical populations with secondary fatigue.</p><p><strong>Methods: </strong>This study is a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018, and it included 3,791 US residents without underlying health conditions. Fatigue was assessed using the Patient Health Questionnaire-9 (PHQ-9), and probiotic/prebiotic consumption was evaluated via a 30-day dietary supplement questionnaire. Statistical analyses included weighted logistic regression to examine associations, and mediation/moderation models to assess the roles of BMI, sleep duration, depression scores, and exercise hours.</p><p><strong>Results: </strong>A total of 3,791 participants were included in the study, with 46.6% self-reporting fatigue. Probiotic/prebiotic consumers had a significantly lower fatigue risk (OR = 0.738, 95% CI 0.735-0.741, p < 0.001). Among the mediating and moderating factors analyzed, only BMI was found to weakly but significantly moderate the association between probiotic/prebiotic consumption and fatigue, with higher BMI strengthening the association of probiotics and/or prebiotics intake with reduced fatigue odds (p = 0.039).</p><p><strong>Conclusions: </strong>These findings indicate that the consumption of probiotics/prebiotics is correlated with a decreased risk of fatigue in the general population, and this association is further reinforced in individuals with a higher BMI.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"888"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}