World journal of methodology最新文献

{"title":"Surgical paradox: Pen <i>vs</i> scalpel-an opinion review on reforming academic promotion.","authors":"Ahmad Mahamid","doi":"10.5662/wjm.v16.i3.117516","DOIUrl":"10.5662/wjm.v16.i3.117516","url":null,"abstract":"<p><p>The current system for academic promotion in surgery disproportionately favors quantifiable metrics, such as publications and grant funding, over the demonstration of clinical skill, creating a fundamental \"credentialing paradox\". This publication-centric culture, amplified by the use of artificial intelligence (AI) tools, has led to a disconnect where a surgeon's academic rank may not align with their proficiency in the operating room. High publication numbers, often a prerequisite for advancement, can be achieved through statistical analyses of existing data, a trend that may not reflect hands-on surgical experience. The rise of AI further intensifies this dynamic by streamlining research tasks, allowing for high productivity without the \"manual drudgery of data gathering\". This focus on the \"pen\" over the \"scalpel\" places less-funded faculty and those who dedicate time to clinical care and education at a disadvantage, contributing to systemic disparities in promotion. To resolve this paradox, the surgical profession must redefine academic success by adopting a more holistic framework that formally recognizes and rewards excellence in clinical care, education, and mentorship alongside research output. The goal is to ensure that the most skilled and dedicated surgeons are advanced, ultimately benefiting patient care and the future of the profession.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117516"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804176","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":"Methodological strategies for mapping <i>HLA</i> susceptibility loci in vitiligo: A focused minireview.","authors":"Abdellatif Bouayad","doi":"10.5662/wjm.v16.i3.112691","DOIUrl":"10.5662/wjm.v16.i3.112691","url":null,"abstract":"<p><p>Some genes, such as <i>HLA</i> class I and class II genes, play important roles in the pathogenesis of vitiligo and its associated autoimmune diseases. Attempts to identify these genes have involved several approaches, including analysis of <i>HLA</i> expression patterns, genetic association studies, and genome-wide association studies. These strategies employ a variety of laboratory techniques, each with distinct advantages and limitations. This review provides a comprehensive overview of current strategies for identifying <i>HLA</i> genes linked to vitiligo susceptibility, with a critical comparison of study designs and methodological approaches. Enhancing these methods is essential to improve accuracy and reliability, ultimately facilitating the development of therapeutic targets and clinically relevant diagnostic biomarkers for patients with vitiligo.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"112691"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803997","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: Low-energy fractional carbon dioxide laser priming of mesenchymal stem cell-derived exosomes: A photothermal boost for diabetic wound angiogenesis.","authors":"Xu-Jin Wu, Ju-Yu Tang, Nian-Zhe Sun","doi":"10.5662/wjm.116914","DOIUrl":"10.5662/wjm.116914","url":null,"abstract":"<p><p>The study by Chen <i>et al</i> recently published in <i>World Journal of Methodology</i> provides a significant advancement in the field of diabetic wound healing by demonstrating that low-energy fractional carbon dioxide laser preconditioning (40 mJ/cm², 300 Hz, 5% density) significantly enhances the angiogenic potential of adipose-derived mesenchymal stem cell-derived exosomes. This single-exposure, 10 mm × 10 mm Micro-DeepFX protocol raised the culture temperature to 42.7 °C and increased exosomal sphingosine-1-phosphate (S1P) content by about 1.8-fold (enzyme-linked immunosorbent assay: 2.4 ng/10⁹ <i>vs</i> 1.3 ng/10⁹ particles, <i>P</i> < 0.01). Through carefully controlled photothermal stimulation, the authors enriched exosomal S1P) content, thereby activating the S1PR1/AKT/HIF-1α signalling axis in endothelial cells. This mechanistic cascade resulted in improved proliferation, migration, and tube formation, ultimately accelerating wound closure in diabetic mouse models. The work under discussion highlights a clinically feasible, non-chemical strategy for augmenting exosome bioactivity and offers strong translational potential. However, the heterogeneity of donors, the limited mechanistic depth of exosomal lipid remodelling, and the need for validation in larger and more clinically representative models warrant further investigation.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116914"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803774","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: Artificial wisdom and the transience of truth: Ethical and temporal reflections on artificial intelligence-human inquiry into history.","authors":"Prasan Kumar Panda","doi":"10.5662/wjm.116140","DOIUrl":"10.5662/wjm.116140","url":null,"abstract":"<p><p>Zhou <i>et al</i> published a study in the recent issue of the <i>World Journal of Gastroen</i> <i>terology</i>, which aimed to examines the concept of artificial wisdom (AW) as applied to historical medical inquiry, in response to a recent artificial intelligence (AI)-human analysis of Alexander the Great's cause of death. While acknowledging the innovative integration of generative AI with clinical reasoning, the letter highlights key epistemic and ethical limitations. It argues that AI systems, inherently shaped by transient data and iterative obsolescence, cannot access enduring or timeless truths, particularly in historically remote contexts where evidence is fragmentary and context-dependent. The persuasive fluency of large language models risks creating an illusion of certainty, conflating probabilistic synthesis with wisdom. Drawing on principles of ethical AI use, the letter emphasizes transparency, accountability, and human moral stewardship as essential safeguards. Ultimately, it proposes a shift from the notion of AW toward epistemic stewardship, recognizing that truth evolves with time and that wisdom resides not in algorithms, but in ethically grounded human judgment.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116140"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803697","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 ophthalmology: From diagnostic accuracy to clinical application.","authors":"Marco Zeppieri, Matteo Capobianco, Federico Visalli, Marieme Khouyyi, Mutali Musa, Alessandro Avitabile, Inferrera Leandro, Rosa Giglio, Daniele Tognetto, Caterina Gagliano, Fabiana D'Esposito, Francesco Cappellani","doi":"10.5662/wjm.115265","DOIUrl":"10.5662/wjm.115265","url":null,"abstract":"<p><p>Artificial intelligence in ophthalmology encounters a continual challenge: Systems proficient in picture classification seldom yield quantifiable enhancements in patient outcomes. The primary concern is the disparity between pixel-level performance metrics and their clinical significance. Primary obstacles encompass data bias, domain shift, and label noise, exacerbated by the lack of prospective, randomized deployment trials. The frequent disregard for patient-centered objectives, cost-effectiveness, and equity evaluations is significant. Rectifying these deficiencies necessitates stringent external validation, established decision criteria, and ongoing surveillance within actual clinical practices. Transparent reporting criteria and the deliberate incorporation of human-factors engineering are essential. Only by bridging this gap can algorithmic accuracy be converted into significant diagnostic precision for glaucoma, diabetic retinopathy, and macular conditions (specifically diabetic macular edema and age-related macular degeneration). This paper aims to assess the limits of using high-performing artificial intelligence systems in ocular image processing, which seldom lead to enhanced patient outcomes, and to delineate the scientific, clinical, and practical techniques required to close this gap.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"115265"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804225","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":"Impact of different anesthetic agents (propofol, etomidate, ketamine) on seizure duration and cognitive recovery in electroconvulsive therapy.","authors":"Hersh Tilokani, Inshal Jawed, Anmol Shehzadi, Asif Ali, Amna Khan, Umair Qadir, Abu Huraira Bin Gulzar, Remsha Zahid, Suleman Khan, Madho Mal, Mohammad Ali Zakeri, Hobab Aslam, Muhammad Umair Siddique","doi":"10.5662/wjm.116058","DOIUrl":"10.5662/wjm.116058","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is also an ideal treatment alternative when dealing with treatment-resistant depression, together with other severe mental conditions. Localization of seizures and cognitive effects of anesthetic agents is significantly influenced by the anesthetic used, but an optimal anesthetic method/regime remains debatable.</p><p><strong>Aim: </strong>To identify comparative consequences of propofol, etomidate, and ketamine regarding the length of seizures and post-ECT cognition.</p><p><strong>Methods: </strong>The current study involved a methodical search of the literature, based on PRISMA guidelines, to identify randomized controlled trials (RCTs) and observational research studies that evaluate the difference between anesthetics used during ECT. The articles analyzed pertained to seizure durations, cognitive performance, hemodynamic factors, and recovery. The quality evaluation was done on the applicable tools of RCT and observational research. Interpretation of the statistical data, based on IBM SPSS, was conducted with the assistance of qualitative synthesis.</p><p><strong>Results: </strong>There were 24 articles taken into account, 11 RCTs and 13 observational studies identified. Several studies have revealed that etomidate is more effective in reducing seizure duration than propofol in various patient groups. Ketamine also recorded increased efficacy in antidepressant but inconsistent activity in the length of seizures. Propofol was linked with shorter recovery times, although the reduction of seizures was constant and shorter each time. The reviews revealed a significant disparity in cognitive outcomes among the agents, with etomidate exhibiting better cognitive profiles than propofol in several trials.</p><p><strong>Conclusion: </strong>The available evidence in the existing literature suggests that etomidate may be beneficial in terms of seizure duration and could yield satisfactory cognitive outcomes. Ketamine shows signs of greater treatment efficacy, but its application must be carefully evaluated in regard to dosage plans. The effectiveness of seizure control can be influenced by this predictive anesthesia that accompanies the rapid recovery of activities following propofol administration. The choice of anesthetic agent should be individualized, based on the nature of the patient and the motive behind the treatment, as well as institutional policy. Large-scale RCT is needed to provide evidence-based recommendations that may be taken decisively.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116058"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804302","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":"Functional dyspepsia and risk of Barrett's esophagus and dysplasia: A propensity-matched multicenter retrospective cohort study.","authors":"Muhammad Hassaan Arif Maan, Soban Maan, Muhammad Waleed, Muhammad Mursaleen Ahmad, Ritik Mahaveer Goyal, Amir Humza Sohail, Yazan Abboud, Sunnia Khan, Swapna Gayam, Justin Kupec","doi":"10.5662/wjm.117891","DOIUrl":"10.5662/wjm.117891","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) and gastroesophageal reflux disease (GERD) exhibit substantial symptom overlap (40%-50%), and up to one-third of patients diagnosed with FD demonstrate pathologic acid exposure on objective testing. While GERD is a well-established risk factor for Barrett's esophagus (BE), the association between FD diagnosis and BE risk remains unexplored. Understanding this relationship is critical because FD is typically diagnosed symptomatically without routine objective reflux testing in clinical practice, potentially masking undiagnosed GERD or identifying shared pathophysiologic mechanisms. We hypothesized that patients diagnosed with FD demonstrate an elevated risk for BE and Barrett's-associated dysplasia compared to matched controls.</p><p><strong>Aim: </strong>To investigate the association between FD diagnosis and the risk of BE and dysplasia.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the TriNetX Global Collaborative Network database. Patients diagnosed with FD (International Classification of Diseases, 10^th Revision code K30) between January 2006 and December 2022 were identified, and propensity-score matched 1:1 with controls based on demographics, comorbidities, and GERD diagnosis. The primary outcomes were the development of BE and Barrett's-associated dysplasia. Cox proportional hazards regression analysis was performed to calculate hazard ratios (HR) with 95% confidence intervals (CI). A sensitivity analysis was conducted to include patients with documented esophagoduodenoscopy during the study period.</p><p><strong>Results: </strong>After PSM, 384267 patients were included in each cohort. Patients with FD demonstrated significantly higher risk for BE (HR: 1.900, 95%CI: 1.813-1.991), Barrett's associated dysplasia (HR: 3.568, 95%CI: 3.064-4.155), and esophageal cancer (HR: 1.649, 95%CI: 1.450-1.875). Sensitivity analysis confirmed the increased risk of BE and dysplasia but not esophageal cancer.</p><p><strong>Conclusion: </strong>Patients diagnosed with FD demonstrate substantially elevated risk for BE and dysplasia. This association, whether reflecting undiagnosed GERD, shared pathophysiology, or both, identifies FD patients as a higher-risk population warranting consideration of objective reflux testing and selective endoscopic evaluation in appropriate clinical contexts.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117891"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804307","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":"Doctor of osteopathic medicine degree still faces recognition challenges in the United States: Suggested ways to improve awareness.","authors":"Reicelle Garcia, Kevan English","doi":"10.5662/wjm.118145","DOIUrl":"10.5662/wjm.118145","url":null,"abstract":"<p><p>Approximately one-quarter of United States medical students train at osteopathic medical schools, which confer the Doctor of Osteopathic Medicine (DO) degree upon graduation. That number has risen exponentially over the past several years, with the American Association of Colleges of Osteopathic Medicine reporting a 65.7% increase in total enrollment since 2013. This increase is at least partly due to the opening of more DO-granting medical schools. However, despite the growing number of osteopathic physicians entering the United States workforce, the degree remains under recognized by patients, nurses, and ancillary staff within hospital systems across the country. Surprisingly, a portion of DO physicians themselves contribute to this under recognition through degree misrepresentation with the Doctor of Medicine label. These physicians have also been historically marginalized from certain competitive specialties and leadership positions, which play a role in under recognition. We suggest proper degree identification and the promotion of more DOs into leadership roles to ultimately improve awareness. Some perceptual challenges and specific barriers to career advancement persist, particularly in competitive specialties, and the continued under recognition despite more osteopathic physicians than ever in the workforce may further perpetuate biases that limit opportunities for prominent leadership roles.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118145"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804181","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":"Salivary glutathione peroxidase-1 levels in periodontitis.","authors":"Leonardo Lorente, Esther Hernández Marrero, Pedro Abreu-Gonzalez, Angel Daniel Lorente Martín, Marina Lorente Martín, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Alejandro Jiménez, Cándido Manuel Hernández Padilla","doi":"10.5662/wjm.v16.i3.121596","DOIUrl":"10.5662/wjm.v16.i3.121596","url":null,"abstract":"<p><strong>Background: </strong>Periodontitis consists of a chronic inflammatory disease of the periodontal tissue. In addition to inflammation, oxidation is also involved in periodontitis. Glutathione peroxidase (GPx) is an antioxidant enzyme. There are 8 forms of GPx (GPx 1-8) and GPx-1 is the most abundant. The comparison of salivary GPx-1 levels in patients with periodontitis and periodontally healthy subjects has been explored in small sample size studies (the largest including 101 subjects) and the results are contradictory.</p><p><strong>Aim: </strong>To compare salivary GPx-1 concentrations in subjects with and without periodontitis in a study with a larger sample size. In addition, novel aims were exploring the possible association of salivary GPx-1 concentrations with periodontitis by a regression analysis and determining the capability of salivary GPx-1 concentrations to predict the diagnosis of periodontitis by a receiver operating characteristic (ROC) analysis.</p><p><strong>Methods: </strong>Observational and prospective study including subjects with and without periodontitis. Salivary samples were taken to determine GPx-1 concentrations. A multivariate logistic regression analysis was performed to determine whether salivary GPx-1 levels were independently associated with periodontitis. A ROC analysis was carried out to determine the capability for the diagnosis of periodontitis by salivary GPx-1 concentrations.</p><p><strong>Results: </strong>We found lower salivary GPx-1 concentrations in 57 subjects with periodontitis than in 86 without periodontitis. We found that salivary GPx-1 concentrations showed an area under the curve for periodontitis diagnosis of 76% (95%CI: 68%-83%; <i>P</i> < 0.001) in ROC analysis, and that salivary GPx-1 levels < 1214 pg/mL showed an independent association with periodontitis (odds ratio: 6.25; 95%CI: 2.844-13.717; <i>P</i> < 0.001) in regression analysis.</p><p><strong>Conclusion: </strong>To our knowledge, our series has the largest sample size on salivary GPx-1 concentrations in periodontitis. Novel findings of our study were that salivary GPx-1 levels were able to diagnose periodontitis and were independently associated with periodontitis. However, our preliminary study has some limitations as there were significant differences in age between subjects with and without periodontitis, other antioxidant enzymes or total antioxidant capacity were not assessed, other biological samples were not analyzed, and GPx-1 genetic variations were not studied. Nevertheless, we think that the results of our study could encourage further research on the role of salivary biomarkers concentrations (as GPx-1) in the management of periodontitis.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"121596"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804069","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":"Management of constipation: A narrative review of evolving strategies and methodological challenges.","authors":"Manjeet Kumar Goyal, Gayatri Brahmandam, Rishi Chowdhary, Sowmya Durga Subhasri Guna, Dhruvi Shah, Prerna Goyal, Ashita Rukmini Vuthaluru, Omesh Goyal","doi":"10.5662/wjm.118399","DOIUrl":"10.5662/wjm.118399","url":null,"abstract":"<p><p>Constipation is a common multifactorial gastrointestinal disorder with a significant impact on quality of life, healthcare utilization, and economic burden. It encompasses a spectrum of symptoms, including infrequent bowel movements (fewer than three per week), lumpy or hard stools (Bristol Stool Form Scale 1 or 2), straining, difficult stool passage, a sense of incomplete evacuation, <i>etc.</i> When no organic cause is identifiable, the condition is labeled as functional constipation. Pharmacological management of constipation has been extensively explored, with several new therapies added to the armamentarium in the last decade. However, its management remains challenging due to heterogeneous etiologies, varied diagnostic approaches, and the broad spectrum of therapeutic options. This narrative review summarizes contemporary strategies for the management of constipation, encompassing lifestyle and dietary modifications, pharmacological therapies, behavioral interventions, and surgical options for refractory cases. Traditional laxatives continue to form the mainstay of treatment, but newer agents such as prosecretory drugs, serotonergic agonists, and bile acid modulators have expanded therapeutic possibilities, offering targeted mechanisms and improved tolerability. Non-pharmacological approaches, including biofeedback for pelvic floor dysfunction and neuromodulation techniques, provide effective alternatives in selected patients. Despite these advances, substantial methodological variability exists in clinical trials, including differences in diagnostic criteria, endpoints, and follow-up durations, limiting the generalizability of findings. A more standardized framework for defining outcomes and assessing long-term efficacy is needed to strengthen evidence-based practice. Ultimately, the management of constipation requires an individualized approach that integrates symptom severity, underlying pathophysiology, patient preference, and availability of resources. Newer research is focused on tailoring treatment to special groups of patients with refractory constipation, surgical modalities for patients with neurogenic bowel, and microbiome modulation using artificial intelligence.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118399"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804009","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}