Journal of investigative medicine : the official publication of the American Federation for Clinical Research最新文献

{"title":"Risk scoring systems to predict in-hospital mortality in patients with cirrhosis admitted with acute upper gastrointestinal bleeding.","authors":"Halim Bou Daher, Mathew J Gregoski, Don C Rockey","doi":"10.1177/10815589251357622","DOIUrl":"10.1177/10815589251357622","url":null,"abstract":"<p><p>Upper gastrointestinal bleeding (UGIB) is associated with poor outcomes in patients with cirrhosis. Here, we developed a new-and examined previous UGIB predictor models-in cirrhotic patients with UGIB. We analyzed consecutive patients with cirrhosis and UGIB admitted to our center from 2011 to 2018. Predictors of mortality during index admissions were identified using logistic regression and existing scoring system were compared using Area Under the Receiver Operating Characteristic Curve (AUROCs). In addition, classification and regression trees (CART) analyses were conducted with v-fold cross-validation. Three hundred thirty-three patients with cirrhosis were admitted with UGIB; 294 (88%) survived and 39 (12%) expired. Those who expired were more likely to have Child-Pugh C cirrhosis (67% vs 32%, p < 0.001), hypotension, hepatic encephalopathy, and hepatocellular carcinoma. Endoscopic sources of bleeding were similar in both groups, with esophageal varices being the most common culprit lesion. Regression analysis yielded a model including systolic blood pressure, model of end-stage liver disease-sodium (MELD-Na), and alanine aminotransferase on admission as having the best mortality predictive capability (AUROC, 0.83). MELD-Na, MELD 3.0, MELD, Lyles-Rockey, AIMS65, Rockall, and Glasgow-Blatchford scores were all significantly higher in patients who expired vs survivors; of these scoring systems, MELD-Na and MELD were the best predictors of death (AUROCs = 0.81 and 0.80), respectively. In addition, CART identified MELD-Na as the strongest predictor of mortality. The MELD score appears to be an accurate predictor of mortality in patients with cirrhosis and UGIB; since the MELD score is well-established and widely used in patients with cirrhosis, we suggest that it be the primary tool utilized to predict mortality in practice.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251357622"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the nexus between myocardial microcirculation perfusion and contractile mechanics in nonobstructive hypertrophic cardiomyopathy.","authors":"Jing Nan, Lina Guan, Chao Yuan, Ya Ba, Yuming Mu","doi":"10.1177/10815589251355176","DOIUrl":"10.1177/10815589251355176","url":null,"abstract":"<p><p>This study quantitatively analyzed myocardial microcirculation perfusion in nonobstructive hypertrophic cardiomyopathy (HCM) patients and evaluated their mechanical properties. A total of 56 individuals were involved, consisting of 28 nonobstructive HCM patients and an equal number of healthy volunteers. Each participant underwent comprehensive diagnostic procedures, including two-dimensional echocardiography, contrast-enhanced myocardial ultrasound (MCE), and two-dimensional speckle tracking imaging. Nonobstructive HCM patients were further classified into two groups based on the extent of myocardial hypertrophy: hypertrophic segmental (HS) myocardium and non-hypertrophic segmental myocardium. The study's findings indicated no significant differences in essential demographic factors such as age, height, and weight between the nonobstructive HCM and control groups. However, significant disparities were observed in myocardial perfusion and mechanical properties between these groups, particularly in aspects such as myocardial thickness, tricuspid regurgitation, and left atrial volume. Notably, the myocardial global longitudinal strain (GLS) is significantly decreased in patients with nonobstructive HCM, whereas the global circumferential strain changes are not easily discernible. A notable positive correlation existed within the HS between myocardial perfusion parameters and mechanical properties. The study concluded that myocardial microcirculation perfusion and GLS are impaired in nonobstructive HCM patients, with more pronounced damage in HS, closely associated with alterations in myocardial mechanical characteristics.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251355176"},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of abdominal aortic calcification in elder adults and its mediating effect for advanced age and all-cause mortality.","authors":"Yulin Zhang, Maoyang Guo, Chen Zhang","doi":"10.1177/10815589251355174","DOIUrl":"10.1177/10815589251355174","url":null,"abstract":"<p><p>The prognostic value of abdominal aortic calcification (AAC) for all-cause mortality and the relationship among severe AAC and other high-risk factors such as age remain uncertain. A total of 1390 participants from the National Health and Nutrition Examination Survey (NHANES, 2013-2014) were enrolled in the final analysis. Based on dual-energy X-ray absorptiometry (DXA) at lateral lumbar spine, the AAC Kauppila score was calculated. There were NHANES Public-Use Linked Mortality Files about mortality follow-up data from the date of survey participation. Kaplan-Meier survival curves and log-rank tests were used to evaluate the association between AAC and all-cause/CV-related mortality. In the group with age < 60 years old (n = 732), 36 participants (4.9%) were accompanied with severe AAC and 696 (95.1%) without. In the group with age > 60 years old (n = 658), 158 participants (24.0%) were accompanied with severe AAC and 500 (76.0%) without. Multivariate Cox proportional hazard regression models and Kaplan-Meier survival curves indicated that the presence of severe AAC was generally associated with an increased risk of all-cause mortality. The mediator analysis was performed to explore the relationships among age, severe AAC, and all-cause mortality. The results revealed the incremental effect of severe AAC on the elevated risk of all-cause mortality associated with advanced age. DXA-based severe AAC screening demonstrates significant prognostic value for all-cause and cardiovascular-related mortality, providing incremental risk stratification for high-risk populations. These findings may inform clinical decision-making and enhance public awareness of cardiovascular health.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251355174"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language model content detectors: Effects of human editing and ChatGPT mimicking individual style-A preliminary study.","authors":"Shigeki Matsubara","doi":"10.1177/10815589251352572","DOIUrl":"10.1177/10815589251352572","url":null,"abstract":"<p><p>The use of large language model (LLM), such as ChatGPT, in academic writing is increasing, but the extent to which LLM-generated content can evade detection remains unclear. This descriptive pilot study investigates whether LLM-generated abstracts, edited by humans or LLM trained to mimic a specific writing style, can escape LLM detectors. Using a previously published original article, ChatGPT-4 generated an abstract (Abstract 1). This abstract underwent three modifications: context-based human editing (Abstract 2), stylistic human editing (Abstract 3), and ChatGPT editing incorporating the author's writing style (Abstract 4). The genuine human-written abstract from the original article served as Abstract 5. Five freely available LLM detectors analyzed these abstracts, providing LLM-generated probability scores. The genuinely LLM-generated manuscript (Abstract 1) was judged as LLM-generated with 82%-100% (median: 100%) probability. The genuinely human-written manuscript (Abstract 5) was judged as human-written with the LLM-generated probability of 0%-13% (median: 0%). Human-edited abstracts (Abstracts 2 and 3) exhibited a decreasing LLM-generated probability 4%-71% (median: 64%) and 2%-65% (median: 61%), respectively, but varied widely among detectors. The LLM-mimicked abstract (Abstract 4) was classified as LLM-generated, with LLM-generated probability ranging 82%-100% (median: 100%). The results showed variations across different LLM detectors. Supplementary experiments demonstrated a similar trend. Human editing reduces LLM-detection probabilities but does not guarantee evasion. LLM-generated content mimicking a specific writing style remains largely detectable. This preliminary experiment provided a novel study concept. Further studies on various manuscripts and different LLM detection methods will enhance understanding of the relationship between LLM-aided paper writing and LLM detectors.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251352572"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiology follow-up in childhood cancer survivors-Recommendations versus compliance.","authors":"Bhavya Talwar, Rittal Mehta, Niti Dham","doi":"10.1177/10815589251352417","DOIUrl":"10.1177/10815589251352417","url":null,"abstract":"<p><p>Childhood cancer survivors are at risk of both early and late-stage cardiotoxicity. Despite these serious sequelae in cancer survivors, it is not known if patients maintain regular cardiology follow-ups throughout life. Our study evaluated if patients continue to follow cardiologists after cancer treatments finish. We noted that after the first routine follow-up visit, the majority of cancer survivors do not continue to follow up with a cardiologist, despite that being a recommendation by the Children's Oncology Group and the American Heart Association. We found the lack of follow-up higher in survivors of leukemia/lymphoma malignancies. Our findings suggest a strong need for the education of patients, families, and primary care providers on the importance of lifelong cardiology evaluations.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251352417"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based biostatistics and value-based biostatistics practices in biomedical research: Application to evaluating the association between phthalate metabolites and sex hormones in US male adults.","authors":"Alok Kumar Dwivedi, Shakeel Ahmed, Pallavi Dubey","doi":"10.1177/10815589251350922","DOIUrl":"10.1177/10815589251350922","url":null,"abstract":"<p><p>The robustness of biostatistical approaches varies according to study design features in prognostic research. Multiple approaches are available for analyzing a specific type of research data. The evidence-based biostatistics (EBB) practice suggests selecting and applying the best statistical approaches and preferred methods aligned with the study objective, study design, and data generation process. The value-based biostatistics (VBB) practice suggests the selection and application of statistical approaches to address multiple questions simultaneously to improve the interpretation of findings. This report highlights the classification of statistical analysis approaches and reporting according to EBB and VBB practices. We explored the relationship between phthalate metabolites and sex hormones in US male adults using the NHANES database. Using statistical approaches, ignoring study design features in data analysis, phthalate metabolites were not consistently associated with sex hormone-binding globulin (SHBG) and testosterone (TT) concentrations. However, most phthalate metabolites were found to be strongly and inversely associated with SHBG and TT concentrations, particularly in younger adults, as per the EBB analyses. In addition, the VBB approaches suggest that the associations between phthalate metabolites and sex hormones varied according to the distribution of SHBG and TT and sociodemographic characteristics. While EBB practice may minimize the statistical controversies and heterogeneity in statistical analysis practices and improve the quality of the research findings, the VBB practice may provide better insights and useful information for the implications of study findings in future studies. As per EBB and VBB approaches, the considered phthalate metabolites were inversely associated with SHBG and TT, particularly among younger males, suggesting prevention and control strategies to avoid exposure to phthalate metabolites.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251350922"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling sarcopenia in Sjögren's syndrome: A hidden comorbidity.","authors":"Reyhan Bilici, Esra Çataltepe, Hasan Satış, Berna Göker","doi":"10.1177/10815589251349099","DOIUrl":"10.1177/10815589251349099","url":null,"abstract":"<p><p>Sarcopenia, a progressive loss of skeletal muscle mass and strength, is an emerging yet under-recognized complication in autoimmune diseases. Although extensively studied in conditions such as rheumatoid arthritis and systemic lupus erythematosus, its prevalence and impact in Sjögren's syndrome (SS) remain largely unexplored. This study aimed to assess muscle mass and strength in patients with SS, investigate the prevalence of probable sarcopenia and sarcopenia, and identify associated risk factors. A cross-sectional study included 79 SS patients and 72 healthy controls. Handgrip strength (HGS) and bioelectrical impedance analysis were used to assess muscle function. Probable sarcopenia and sarcopenia were defined according to the 2018 EWGSOP2 criteria and specific cutoffs for the Turkish population. Probable sarcopenia was significantly more prevalent in SS patients (63.6%) compared to controls (40.5%, p = 0.005), while sarcopenia was detected in 53.7% of SS patients vs 29.4% of controls (p = 0.01). Older age, lower HGS, reduced skeletal muscle mass index, and delayed diagnosis were significantly associated with probable sarcopenia. Sarcopenia is a prevalent yet overlooked complication in Sjögren's syndrome, emphasizing the need for routine muscle function assessments in clinical practice. Targeted interventions and a multidisciplinary approach are crucial to mitigating its impact and improving long-term patient outcomes.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251349099"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Trends In Rumination Syndrome: A Retrospective Analysis.","authors":"Shivangini Duggal, Misbah Jilani, Richard W McCallum","doi":"10.1177/10815589251348936","DOIUrl":"10.1177/10815589251348936","url":null,"abstract":"<p><p>Rumination syndrome is a functional gastrointestinal disorder marked by effortless postprandial regurgitation, typically occurring 10-15 min after meals. The condition, first noted in 1618, is now diagnosed by the Rome IV criteria through clinical symptoms in the absence of structural abnormalities. Diagnostic confirmation through high-resolution manometry reveals characteristic patterns of gastric pressurization and muscle coordination, while treatment primarily involves behavioral and medical therapies. This study evaluates the epidemiology, symptom profiles, time to diagnosis, and treatment outcomes for patients with rumination syndrome, with a focus on the impact of jejunostomy tube placement. A retrospective cohort study at Texas Tech University Gastroenterology Clinic reviewed charts of patients treated for rumination syndrome between July 2016 and February 2024. Outcomes assessed included the efficacy of jejunostomy tube placement in nutritional support and symptom improvement, in addition to behavioral therapy outcomes. Statistical analyses were conducted using STATA, with p < 0.05 considered significant. Among 133 patients (mean age 43.6 years, 78.2% female), 23 required jejunostomy tube (J-tube) placement. Patients with J-tubes had a significantly lower BMI (21.07 vs 28.13, p < 0.001) and experienced greater weight gain and symptom improvement compared to non-J-tube patients (100% vs 48.18%, p < 0.001). The average J-tube duration was 16 weeks, with an average weight gain of 38.8 pounds. This study highlights the efficacy of combined treatment approaches in managing rumination syndrome, particularly for patients requiring enteral nutritional support via jejunostomy tubes. This approach allows for weight stabilization and improved symptom management, facilitating long-term treatment adherence and quality of life improvements.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251348936"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency, predictors, and treatment options of spondyloarthritis in primary Sjögren's syndrome: a single-center experience.","authors":"Beliz Karataş","doi":"10.1177/10815589251349102","DOIUrl":"10.1177/10815589251349102","url":null,"abstract":"<p><p>The aim of this study is to define the frequency and predictors of axial spondyloarthritis and treatment options in patients with Sjögren syndrome. In our study, the frequency of spondyloarthritis according to the International Association for the Assessment of Spondyloarthritis (ASAS) criteria was investigated in 84 patients who were diagnosed with primary Sjögren syndrome according to the 2016 ACR / EULAR (American College of Rheumatology/European Association of Rheumatology Associations) classification criteria in the Internal Medicine Rheumatology clinic of our hospital between November 2023 and January 2025. Patients' age, gender, HLAB-27, anti-nuclear antibody (ANA), anti-SSA, anti-SSB, inflammatory back pain, presence of sacroiliitis on sacroiliac joint magnetic resonance imaging (MRI), medications used, and Sjögren syndrome complications were recorded retrospectively. A total of 94% of the patients were female and 6% were male. The median age was 51 years. Axial spondyloarthritis (axSpA) was detected in 27% of the patients. Among those who developed axial spondyloarthritis, 15 patients received nonsteroidal anti-inflammatory drugs (NSAIDs), 5 patients received sulfasalazine, 1 patient received methotrexate, 1 patient received TNF (tumor necrosis factor) inhibitor, and 1 patient received secukinumab treatment. Four of those who received sulfasalazine had anterior uveitis and 1 had enthesitis. The only variable found to be associated with the presence of axial spondyloarthritis in primary Sjögren syndrome was ANA (p value: 0.006). Spondyloarthritis is not uncommon in primary Sjögren syndrome. ANA has been found to be associated with the presence of axial spondyloarthritis in primary Sjögren syndrome and has the potential for further research.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251349102"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic discrepancies: A retrospective analysis of two antinuclear antibody platforms.","authors":"Mahesheema Ali, Yaqot Baban, Gopal Kumar","doi":"10.1177/10815589251348924","DOIUrl":"10.1177/10815589251348924","url":null,"abstract":"<p><p>To retrospectively examine the outcome of the antinuclear antibody (ANA) screen by comparing the performance of BioPlex 2200 and immunofluorescence assay (IFA). We reviewed the ANA screening results performed on the BioPlex 2200 using multi-bead technology and the IFA using HEp-2 cells. The study encompassed 133 patients, comprising 111 females and 22 males. The average age of lupus patients at the time of diagnosis was approximately 53 years. Among 133 cases tested, 58 were negative, and 75 were positive on the BioPlex. 47% (27 out of 58 negative cases) of the tests performed with a negative result on BioPlex yielded positive results on the IFA. Conversely, 55% (41 out of 75 positive cases) of the multiplex-positive results were negative on the IFA. There were significant discrepancies in double-stranded DNA (27%) and RNP antibodies (51%), where multiplex-positive results turned negative on IFA. The findings reveal a notable disparity between the results of the BioPlex and IFA tests. This challenges the prevailing notion of IFA as the gold standard. Manufacturers should prioritize optimizing assays to minimize variability, while clinicians should consider the ANA results and the patient's clinical history and symptoms when interpreting the findings.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589251348924"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}