World journal of methodology最新文献

{"title":"Correlation of diaphragm thickness with pulmonary function test in Parkinson's disease.","authors":"Zeliha Cosgun, Emine Afsin, Ramazan Kurul, Sule Aydin Turkoglu, Melike Elif Kalfaoglu, Gulali Aktas","doi":"10.5662/wjm.v16.i3.115087","DOIUrl":"10.5662/wjm.v16.i3.115087","url":null,"abstract":"<p><strong>Background: </strong>Dopaminergic neurons are lost in Parkinson's disease (PD), a degenerative neurological condition. While the effects of PD on motor functions are well understood, its impact on respiratory function is less clear. In PD patients with suspicious pulmonary symptoms, the presence and degree of impairment in lung function often cannot be optimally assessed through pulmonary function tests (PFTs) due to the patients' neurological symptoms.</p><p><strong>Aim: </strong>To examine the relationship between diaphragmatic thickness as determined by ultrasonography (US) and conventional PFTs in PD patients. Additionally, we evaluated the potential use of diaphragmatic thickness as an alternative measure for assessing respiratory function in PD patients who are unable to perform PFTs.</p><p><strong>Methods: </strong>A total of 43 PD patients who presented to the clinics between June 15, 2021, and June 30, 2022, were included. Patients with coronavirus disease 2019 infection history, conditions affecting diaphragmatic motility, recent thoracic or abdominal surgery, or imaging showing restrictive masses were excluded. Demographic data, disease duration, Hoehn-Yahr stage, and medication use were recorded. PFTs were used to evaluate forced vital capacity, forced expiratory volume in the first second, and other parameters, while US was used to measure diaphragmatic thickness. Breathlessness was assessed using the modified medical research council dyspnea scale.</p><p><strong>Results: </strong>Significant correlations were found between peak expiratory flow (PEF) and diaphragm fraction (<i>P</i> = 0.019), as well as between PEF percentage and diaphragmatic thickness during expiration (<i>P</i> = 0.023). In early-stage PD, diaphragmatic thickness during inspiration correlated with oxygen saturation (<i>P</i> = 0.048). In advanced-stage PD, PEF and PEF% were significantly correlated with diaphragm thickness during expiration [<i>r</i> = 0.405, <i>P</i> = 0.049 (for PEF); <i>r</i> = 0.463, <i>P</i> = 0.023 (for PEF%)] and diaphragm fraction [<i>r</i> = -0.476, <i>P</i> = 0.019 (for PEF); <i>r</i> = -0.617, <i>P</i> = 0.001 (for PEF%)].</p><p><strong>Conclusion: </strong>Present study assessed the relationship between PFTs and diaphragmatic thickness in PD patients. Diaphragmatic thickness measured by US was found to correlate with certain PFT parameters, suggesting it could be used as an alternative measure for assessing respiratory function in Parkinson's patients who have difficulty performing PFTs.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"115087"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical assessment of nail and skin lesions in indoor climbers: A clinic-based cross-sectional study.","authors":"Gabriele Carioti, Irene Brighenti, Niccolò Le Donne, Carlo Banfi, Lina Azzahrani, Luca Galassi","doi":"10.5662/wjm.121149","DOIUrl":"10.5662/wjm.121149","url":null,"abstract":"<p><strong>Background: </strong>Indoor climbing has grown substantially in popularity; however, clinically assessed data on climbing-related nail and skin conditions remain limited. Tight, performance-oriented climbing shoes and repetitive training exposure may contribute to mechanical stress affecting the toes and forefoot, but evidence derived from direct clinical examination is scarce.</p><p><strong>Aim: </strong>To characterize the frequency, typology, and anatomical distribution of nail and skin lesions in a clinic-based sample of indoor climbers, and to assess associations with footwear compression and training exposure.</p><p><strong>Methods: </strong>A retrospective cross-sectional analysis was conducted from data on 156 indoor climbers attending a single outpatient podiatric clinic. Lesions were classified by type, anatomical location, laterality, and affected digit. Demographic, anthropometric, footwear-related (shoe size discrepancy), and training-related variables were also recorded. Associations between lesion burden and continuous variables were assessed using Spearman's rank correlation and non-parametric tests, with statistical significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Patients showed a mean of 6.6 lesions per individual (range 0-21), most exhibiting multiple nail and skin lesions. Hyperkeratosis accounted for approximately two-thirds of recorded lesions and was mostly localized to the first toe and periungual regions. Traumatic nail disorders, including Beau's lines, longitudinal ridges, onycholysis, and subungual hematomas, were predominantly hallux-related. Shoe size discrepancy showed a weak but statistically significant positive correlation with total lesion burden (<i>ρ</i> = 0.195, <i>P</i> = 0.015), as did weekly training frequency (<i>ρ</i> = 0.180, <i>P</i> = 0.025). No significant associations were observed for age, sex, body mass index, or session duration.</p><p><strong>Conclusion: </strong>In the selected population of the study, footwear compression and training frequency showed weak but statistically significant associations with lesion burden, while demographic variables showed no significant correlation. Although causal inference is not possible from this cross-sectional design, findings highlight the potential clinical relevance of modifiable sport-specific factors and warrant longitudinal investigation.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"121149"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic nerves across species: Anatomical and functional disparities and their metabolic ramifications.","authors":"Si-Yu Zhuang, Lu-Jin Xu, Hai-Xia Yang, Qi-Wei Yang, Geng Chen, Bin Xu, Zhi Yu, Yun Liu, Tian-Cheng Xu","doi":"10.5662/wjm.118207","DOIUrl":"10.5662/wjm.118207","url":null,"abstract":"<p><p>Pancreatic nerves exhibit significant anatomical and functional disparities across species, with profound implications for metabolism and clinical practices like pancreatic transplantation and disease treatment. In humans, pancreatic nerves feature a complex distribution of sympathetic and parasympathetic fibers, forming intricate plexuses that closely interact with surrounding organs, playing a crucial role in regulating both endocrine (<i>e.g.</i>, insulin and glucagon release) and exocrine secretions to maintain metabolic balance. Rodents, such as rats and mice-common experimental models-have relatively simpler pancreatic nerve architectures; for instance, mice show more concentrated nerve fibers around islets, while rats display greater variability in nerve density across pancreatic regions, which influences their responses to metabolic stimuli and makes them valuable but not fully analogous to human models. Canines and felines, often used in translational studies, possess pancreatic nerve systems that share some similarities with humans, such as comparable nerve plexus organization, yet differ in fiber type proportions, affecting their susceptibility to metabolic abnormalities like pancreatitis-related glucose dysregulation. These species-specific differences in pancreatic nerves directly impact metabolic processes: In humans, impaired nerve function is linked to metabolic disorders like diabetes and obesity, whereas in animal models, variations in neural control of hormone release and pancreatic homeostasis lead to differences in disease progression and response to interventions. Understanding these discrepancies is vital: It not only helps interpret findings from animal studies when translating to human therapies but also guides pancreatic transplantation by highlighting the need for species-specific considerations in nerve reconstruction to restore metabolic function, and identifies potential therapeutic targets tailored to the unique neural-metabolic interactions of each species.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118207"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do bots provide correct and adequate guidance regarding acidity: A blinded comparison rated by patients and physicians.","authors":"Kartikay Goyal, Manjeet Kumar Goyal, Varna Taranikanti, Praneet Wander, Rishi Chowdhary, Shivam Kalra, Gargi Prashar, Ashita Rukmini Vuthaluru, Omesh Goyal","doi":"10.5662/wjm.v16.i3.116022","DOIUrl":"10.5662/wjm.v16.i3.116022","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are increasingly accessed by patients for gastrointestinal health information. Despite their growing use, concerns persist regarding accuracy, empathy, actionability, and readability of responses generated by LLMs.</p><p><strong>Aim: </strong>To assess the responses generated by ChatGPT-5, Gemini-2.5, and Claude-4 for common patient questions on \"acidity\" (heartburn/dyspepsia/gastroesophageal reflux disease).</p><p><strong>Methods: </strong>Thirty-nine frequently asked questions were submitted to each model. Responses were independently rated by three gastroenterologists for accuracy, comprehensiveness, empathy, and actionability; and by 20 patients for empathy, comprehensiveness, actionability, compassion, and usefulness. Readability indices were also analyzed.</p><p><strong>Results: </strong>Significant inter-model differences were observed across multiple physician-rated domains. Gemini-2.5 and Claude-4 achieved higher mean scores for accuracy, comprehensiveness, and actionability compared with ChatGPT-5 (<i>P</i> < 0.05), while Claude-4 demonstrated the highest empathy scores. Patient ratings indicated uniformly high comprehensibility across all models; however, Gemini-2.5 and Claude-4 responses were perceived as more actionable than those generated by ChatGPT-5. Readability analysis showed that ChatGPT-5 produced the most accessible responses, corresponding approximately to a high-school reading level, whereas Gemini-2.5 and Claude-4 generated more linguistically complex content.</p><p><strong>Conclusion: </strong>These findings underscore the need for careful model selection and suggest that hybrid approaches integrating complementary model strengths may optimize safe and effective artificial intelligence -assisted patient education in gastroenterology.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116022"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic-liver crosstalk, novel molecular mediators, and 2025 therapeutic breakthroughs.","authors":"Hao-Yao Pan, Wei-Wei Chen, Jia-Xin Liang, Yi-Yang Sheng, Wen-Jing Zhang, Xue-Wen Zhu, Shuai-Yan Wang, Guan-Hu Yang, Yun Liu, Tian-Cheng Xu","doi":"10.5662/wjm.v16.i3.118728","DOIUrl":"10.5662/wjm.v16.i3.118728","url":null,"abstract":"<p><p>Obesity, a global public health crisis driven by dysregulated systemic energy homeostasis, is increasingly recognized as a disorder of interorgan communication, with the pancreas and liver serving as central interconnected metabolic hubs. Their bidirectional crosstalk, mediated through neural and humoral pathways, is a key driver of disease progression. Recent breakthroughs have uncovered novel molecular mechanisms amplifying this pathogenic axis: Adipocyte-derived exosomes carrying miR-138-5p directly target pancreatic β-cell SOX4, suppressing insulin secretion and promoting apoptosis, while hepatic RNA demethylase ALKBH5 stabilizes glucagon receptor mRNA and activates lipogenic pathways, exacerbating hyperglycemia and steatosis. Further, colonic inflammation activates hepatic ERK signaling, which is converted into neural signals by the liver and precisely delivered to the pancreas through the liver-pancreas vagus nerve circuit, driving adaptive β-cell proliferation in early obesity by releasing neurotransmitters such as acetylcholine. Traditional pathogenic loops persist: Pancreatic exocrine insufficiency disrupts gut-liver homeostasis, inducing systemic inflammation, and hepatic free fatty acid flux exerts direct and immune-mediated lipotoxicity on pancreatic β-cells, forming a self-perpetuating vicious cycle. Emerging interventions target this axis: GLP-1/GIP dual agonists (<i>e.g.</i>, tirzepatide) demonstrate remarkable efficacy in weight loss and non-alcoholic steatohepatitis remission, while time-restricted feeding (<i>e.g.</i>, 16:8 regimen) reduces liver fat through circadian and metabolic pathway activation, independent of caloric restriction. This review synthesizes novel interorgan signaling mechanisms and 2025 therapeutic breakthroughs, emphasizing the pancreas-liver axis as a critical target for obesity management.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118728"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Revisiting salt restriction in hyponatremic cirrhosis - a paradigm in need of refinement?","authors":"Cheng-Long Zou","doi":"10.5662/wjm.118971","DOIUrl":"10.5662/wjm.118971","url":null,"abstract":"<p><p>The management of decompensated cirrhosis is fraught with clinical dilemmas, often requiring a delicate balance between opposing physiological principles. One such enduring controversy is the role of dietary sodium restriction, long considered a cornerstone in the management of ascites and fluid overload. The study by Marrapu <i>et al</i> published in the <i>World Journal of Methodology</i>, directly challenges this convention in a specific and vulnerable population: Patients with cirrhosis and moderate to severe hyponatremia. Their open-label randomized controlled trial provides compelling evidence that a salt-restricted diet (5 g/day) may be harmful compared to a more liberal, salt-unrestricted diet (10 g/day), associating salt-restricted diet with a significantly higher risk of acute kidney injury, poorer nutritional and hemodynamic profiles, and increased short-term mortality, without offering a clear benefit in ascites control.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118971"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepwise model to differentiate pathogenic from non-pathogenic organisms in lower-respiratory isolates: Effectiveness and feasibility prospective cohort study.","authors":"Shivnarayan Sahu, Balram Ji Omar, Mukesh Bairwa, Prakhar Sharma, Partha Sahu, Prasan Kumar Panda","doi":"10.5662/wjm.115598","DOIUrl":"10.5662/wjm.115598","url":null,"abstract":"<p><strong>Background: </strong>Lower respiratory tract infections remain a major cause of morbidity and mortality among hospitalized patients. However, isolating organisms from respiratory samples often leads to diagnostic uncertainty due to the coexistence of colonizers, commensals, and contaminants. To address this challenge, this study employed a structured, stepwise exploratory model to differentiate true pathogens from non-pathogens in aerobic respiratory cultures and multiplex polymerase chain reaction (Biofire FilmArray) results.</p><p><strong>Aim: </strong>To determine pathogen <i>vs</i> non-pathogen in lower respiratory tract isolates.</p><p><strong>Methods: </strong>This prospective, longitudinal time-bound study was conducted over three months (August 2024 to October 2024) at a tertiary care center in Northern India. Adult patients (≥ 18 years) with positive lower respiratory tract samples were enrolled. Each isolate was independently classified by the treating clinician, microbiologist, and study investigator using a six-step clinical-microbiological algorithm that incorporated clinical signs, Sequential Organ Failure Assessment score trends, alternative infection sources, host factors, and outcome data. The final classification was determined by the investigator. Outcomes, including treatment response and mortality at 28 days, were compared across pathogen and non-pathogen groups.</p><p><strong>Results: </strong>Of the 145 included patients, 131 (90.3%) were classified as pathogens and 14 (9.7%) as non-pathogens. Cohen's Kappa between investigator and microbiologist classifications was 0.28, indicating fair agreement. Among pathogen cases, 68 (51.9%) responded to treatment. In contrast, 12 of 14 non-pathogen cases (85.7%) were not treated, with favorable outcomes in most, and only one unrelated death (7.1%).</p><p><strong>Conclusion: </strong>The structured clinico-microbiological model strongly correlates with treatment outcomes, making it useful for differentiating infection from colonization. Crucially, microbiological detection alone doesn't determine pathogenicity. Integrating clinical, laboratory, and outcome data is essential for rational antibiotic use and effective antimicrobial stewardship.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"115598"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation of the strength, assistance in walking, rising from a chair, climbing stairs, and falls questionnaire into Hindi.","authors":"Harsha S Prakash, Amit Sehrawat, Arti Rana, Anusha Mruthyunjaya Swamy, Sai Prasath, Mahesh Koulagi, Deepak Sundriyal","doi":"10.5662/wjm.120002","DOIUrl":"10.5662/wjm.120002","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is common among cancer patients and is associated with adverse clinical outcomes. The strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire is a simple screening tool for evaluating sarcopenia; however, no validated Hindi version is currently available for use in Indian oncology practice.</p><p><strong>Aim: </strong>To translate and culturally adapt the SARC-F questionnaire into Hindi and assess its reliability and content validity.</p><p><strong>Methods: </strong>This single-center cross-sectional study was conducted at a tertiary cancer center in India. The questionnaire was translated using forward-backward translation following World Health Organization and International Society for Pharmacoeconomics and Outcomes Research guidelines. Pilot testing assessed clarity and cultural relevance. Adult Hindi-speaking cancer patients completed the finalized questionnaire. Reliability and content validity were evaluated using Cronbach's alpha and content validity indices, and descriptive statistics with Pearson correlation analyses were performed.</p><p><strong>Results: </strong>A total of 100 patients were included (mean age 50.9 ± 12.6 years; 63% female). The Hindi SARC-F demonstrated acceptable internal consistency (Cronbach's α = 0.70). Content validity was excellent, with a scale-level content validity index of 0.92 and item-level indices ranging from 0.80 to 1.00. The median SARC-F score was 1 (interquartile range 0-3). No statistically significant correlations were observed between SARC-F scores and age, performance status, or body composition parameters (all <i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The Hindi SARC-F is linguistically valid, culturally appropriate, and suitable for functional sarcopenia screening in Hindi-speaking cancer patients.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"120002"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone-based mobile health impact on oral anticoagulation adherence, quality of life, and healthcare utilization in adult atrial fibrillation.","authors":"Muhammad Farhan, Tirath Patel, Waleed Harazeen, Yara Mohamed, Abdullah Al Azzawi, Heba Intabli, Nada Ahmed, Mohammed Al-Hadi Naseer Obais, Mohammad Riyad Alkhazali, Bhumi Daishik Patel, Asfaq Ahmad, Ayoola Awosika","doi":"10.5662/wjm.117065","DOIUrl":"10.5662/wjm.117065","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent arrhythmia associated with increased stroke risk, morbidity, and healthcare burden. Oral anticoagulation (OAC) is essential for stroke prevention, but adherence is often suboptimal. Smartphone-based mobile health (mHealth) applications offer potential to enhance adherence, quality of life (QoL), and reduce healthcare utilization.</p><p><strong>Aim: </strong>To systematically review randomized controlled trials (RCTs) evaluating the impact of smartphone-based mHealth interventions on OAC adherence, health-related QoL, and healthcare utilization in adults with AF.</p><p><strong>Methods: </strong>Following PRISMA guidelines and a PROSPERO-registered protocol (CRD420251169904), databases (PubMed, Scopus, Web of Science, EMBASE, Cochrane CENTRAL, CINAHL, ClinicalTrials.gov) were searched from January 1, 2000, to July 30, 2025. Eligible studies were RCTs of mHealth apps for AF management in adults (≥ 18 years). Two reviewers screened records, extracted data, and assessed risk of bias using Cochrane risk of bias 2. Narrative synthesis was used due to heterogeneity.</p><p><strong>Results: </strong>Of 968 records, 16 RCTs (<i>n</i> = 209-3324 participants) were included, primarily from China, United States, Taiwan, and South Korea. Integrated interventions (<i>e.g.</i>, mAFA-II aligning with AF better care pathway) improved OAC adherence (<i>e.g.</i>, higher self-reported scores, <i>P</i> < 0.05; increased OAC persistence, <i>P</i> < 0.001), enhanced QoL (<i>e.g.</i>, EQ-5D improvements, <i>P</i> < 0.001), and reduced healthcare utilization (<i>e.g.</i>, rehospitalizations hazard ratio = 0.32, <i>P</i> < 0.001) without increasing bleeding risks. Simpler apps showed inconsistent benefits. Heterogeneity in designs, adherence measures, and follow-up (3 months to 2 years) limited generalizability. Risk of bias was high in 10 studies due to open-label designs and post-hoc analyses.</p><p><strong>Conclusion: </strong>mHealth apps, especially comprehensive ones, can improve OAC adherence, QoL, and reduce utilization in AF patients. Future research should focus on long-term efficacy, cost-effectiveness, and equitable implementation for diverse populations.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117065"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in onco-anaesthesia: Current applications, challenges, and future directions.","authors":"Prashant Sirohiya, Prateek Maurya, Nishkarsh Gupta, Brajesh Kumar Ratre, Saurabh Vig, Sidharth Puri, Balbir Kumar, Raghav Gupta, Shweta Bhopale, Anuja Pandit","doi":"10.5662/wjm.117916","DOIUrl":"10.5662/wjm.117916","url":null,"abstract":"<p><p>Artificial intelligence (AI) is transforming onco-anaesthesia by shifting practice from reactive physiological management toward predictive and precision-based care. This review outlines current AI applications across the perioperative cancer pathway. Preoperatively, machine learning and deep learning models enhance risk stratification through automated frailty assessment, electronic health record phenotyping, and prediction of cancer-specific outcomes. Intraoperatively, AI-enabled technologies such as closed-loop anaesthesia delivery systems, predictive haemodynamic monitoring, and automated depth-of-anaesthesia control optimize drug dosing, reduce physiological stress, and may help preserve perioperative immune function, with potential implications for long-term oncologic outcomes. Postoperatively, AI-driven integration of multimodal data-including genomics, radiomics, wearable biosignals, and high-resolution physiological waveforms-facilitates early detection of complications such as delirium, persistent pain, acute kidney injury, and anastomotic leakage. The review also examines the role of AI in evaluating the \"onco-anaesthesia hypothesis\" by clarifying links between anaesthetic techniques, inflammation, and cancer recurrence. Despite these advances, significant challenges persist, including data heterogeneity, limited generalisability, algorithmic opacity, regulatory uncertainty, and ethical concerns related to equity and clinical implementation. Future progress will depend on explainable AI, federated learning, real-time clinical decision-support systems, and validation through large, prospective studies to fully realise AI's potential in personalised onco-anaesthetic care.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117916"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}