Citations

e14008 Background: Lung cancer is the most common cancer to metastasize to the brain. Identifying the EGFR mutation is critical for determining treatment strategies and prognosis. However, 17.26% of patients show EGFR mutation discordance between the primary tumor and CNS metastasis. On the other hand, it is not always feasible to obtain brain samples. Many studies have developed deep learning (DL) models to predict the existence of EGFR mutations using radiomics. In this paper, we aim to measure the accuracy of diagnostic tests in those studies. Methods: PubMed, Scopus, Cochrane Library and Web of Science databases were searched from inception to January 2025, to identify studies measuring the ability of DL models in differentiating between the types of EGFR mutation in patients with lung cancer brain metastases. The quality assessment of the included studies was performed using QUIPS tool. The diagnostic accuracy meta-analysis was conducted using Meta-DiSc software. Results: Nine studies were included in our systematic review and meta-analysis, encompassing 260 patients with EGFR mutant type and 264 patients with EGFR wild type. Our analysis revealed that DL approaches exhibit a high ability to differentiate between EGFR mutation types, with a sensitivity of 0.82 (95% CI: 0.73–0.88) and a specificity of 0.88 (95% CI: 0.78–0.94). Additionally, the positive likelihood ratio and negative likelihood ratio were 6.87 (95% CI: 3.5–13.3) and 0.20 (95% CI: 0.13–0.31), respectively. The diagnostic odds ratio was 33.4 (95% CI: 13.5–82.5), which is indicative of excellent diagnostic accuracy. Conclusions: DL models demonstrate exceptional diagnostic accuracy in detecting EGFR mutations in brain metastases from lung cancer. These findings highlight the potential of AI-driven approaches to enhance personalized treatment strategies and improve outcomes for patients with EGFR-mutant NSCLC brain metastases.

Background: The application of artificial intelligence (AI) in cardiac imaging has rapidly evolved, offering enhanced accuracy and efficiency in the diagnosis and management of cardiovascular diseases. This bibliometric study aimed to evaluate research trends, impact, and scholarly output in this expanding field. Methods: A systematic search was conducted on 14 August 2024 using the Web of Science Core Collection database. VOSviewer, CiteSpace, and Biblioshiny were utilized for data analysis. Results: The findings revealed a significant increase in publications on AI in cardiovascular imaging, particularly from 2018 to 2023, with the United States leading in research output. England and the United States have emerged as central hubs in the global research network, highlighting their role in generating high-quality and impactful publications. The University of London was identified as the top contributing institution, while Frontiers in Cardiovascular Medicine was the most prolific journal. Keyword analysis highlighted machine learning, echocardiography, and diagnosis as the most frequently occurring terms. A time trend analysis showed a shift in research focus toward AI applications in cardiac computed tomography (CT) and magnetic resonance imaging (MRI), with recent keywords like ejection fraction, risk, and heart failure reflecting emerging areas of interest. Conclusion: Healthcare providers should consider integrating AI tools into cardiovascular imaging practice, as AI has demonstrated the potential to enhance diagnostic accuracy and improve patient outcomes. This study highlights the rising importance of AI in personalized and predictive cardiovascular care, urging healthcare providers to stay informed about these advancements to enhance clinical decision-making and patient management.

Objective: This study aims to conduct a bibliometric analysis of the triglyceride-glucose (TyG) index in relation to cardiovascular disorders. Methods: Data for the analysis were extracted from the Web of Science Core Collection database on 13 July 2024. We utilized VOSviewer, CiteSpace, and Biblioshiny tools for the analysis. Results: The study revealed a marked increase in research outputs on the TyG index in recent years, peaking with 137 publications in 2023. China emerged as the leading contributor, followed by the USA. The Chinese Academy of Medical Sciences and Peking Union Medical College were among the top contributing institutions. Shouling Wu and Shuohua Chen emerged as the leading authors, with the journal Cardiovascular Diabetology publishing the most articles on this topic. Keyword analysis identified “insulin-resistance” as the most frequently occurring term, followed by “risk.” Cluster analysis identified eleven key research areas, including “percutaneous coronary intervention,” “obesity indicators,” “arterial stiffness,” and “heart failure.” Conclusion: This bibliometric analysis highlights the expanding role of the TyG index in metabolic and cardiovascular research. Key clusters such as percutaneous coronary intervention, obesity indicators, arterial stiffness, heart failure, new-onset hypertension, predicting outcomes, and subclinical coronary artery disease emphasize its wide applicability across diverse clinical settings. The keyword “risk” was the most frequently occurring term, underscoring the importance of the TyG index in cardiovascular risk assessment, alongside its growing use in prognostic applications. These findings reflect the increasing recognition of the TyG index as a pivotal biomarker in cardiovascular medicine and encourage further exploration of its clinical integration.

AbstractBackgroundScleroderma, also referred to as systemic sclerosis, is a multifaceted autoimmune condition characterized by abnormal fibrosis and impaired vascular function. Pathologically, it encompasses the persistent presence of inflammation, abnormal collagen buildup, and restructuring of blood vessels in various organs, resulting in a wide range of clinical symptoms. This review incorporates the most recent scientific literature on scleroderma, with a particular emphasis on its pathophysiology, clinical manifestations, diagnostic approaches, and treatment options.MethodologyA comprehensive investigation was carried out on numerous databases, such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar, to collect pertinent studies covering diverse facets of scleroderma research.ResultsScleroderma presents with a range of systemic manifestations, such as interstitial lung disease, gastrointestinal dysmotility, Raynaud's phenomenon, pulmonary arterial hypertension, renal complications, neurological symptoms, and cardiac abnormalities. Serological markers, such as antinuclear antibodies, anti‐centromere antibodies, and anti‐topoisomerase antibodies, are important for classifying diseases and predicting their outcomes.DiscussionThe precise identification of scleroderma is crucial for promptly and correctly implementing effective treatment plans. Treatment approaches aim to improve symptoms, reduce complications, and slow down the progression of the disease. An integrated approach that combines pharmacological agents, including immunosuppressants, endothelin receptor antagonists, and prostanoids, with nonpharmacological interventions such as physical and occupational therapy is essential for maximizing patient care.ConclusionThrough the clarification of existing gaps in knowledge and identification of emerging trends, our goal is to improve the accuracy of diagnosis, enhance the effectiveness of therapeutic interventions, and ultimately enhance the overall quality of life for individuals suffering from scleroderma. Ongoing cooperation and creative research are necessary to advance the field and achieve improved patient outcomes and new therapeutic discoveries.

Juvenile multiple sclerosis (JMS) is a rare but significant subtype of multiple sclerosis (MS) that affects a small percentage of patients under the age of 10 and 3–5% of all MS patients. Despite its rarity, JMS poses unique challenges in terms of diagnosis, treatment, and management, as it can significantly impact a child or adolescent’s physical, cognitive, and emotional development. JMS presents with a varying spectrum of signs and symptoms such as coordination difficulties and permanent cognitive dysfunctions and may include atypical clinical features such as seizures, acute disseminated encephalomyelitis, and optic neuritis, making diagnostic evaluations challenging. Whilst the biology of JMS shares similarities with adult-onset MS, there exist notable distinctions in disease progression, clinical manifestations, and ultimate prognoses. The International Pediatric MS Study Group (IPMSSG) was founded in 2005 to improve understanding of JMS, but there remains a lack of knowledge and guidelines on the management of this condition. This review summarizes the current knowledge on JMS, including its epidemiology, clinical presentations, diagnostic challenges, current treatment options, and outcomes. Current treatment options for JMS include disease-modifying therapies, but JMS can also result in impaired quality of life and psychiatric comorbidity, highlighting the need for comprehensive care for affected children. Through gathering and analyzing scattered studies and recent updates on JMS, the authors aim to address the gaps in current knowledge on JMS and provide an improved understanding of appropriate care for affected children. By doing so, this review hopes to contribute to improving the quality of life and outcomes for JMS patients.

Multiple sclerosis (MS) is a chronic inflammatory disease that damages the myelin sheath around the axons of the central nervous system. While there are periods of inflammation and remyelination in MS, the latter can sometimes be insufficient and lead to the formation of lesions in the brain and spinal cord. Environmental factors such as vitamin D deficiency, viral or bacterial infections, tobacco smoking, and anxiety have been shown to play a role in the development of MS. Dysbiosis, where the composition of the microbiome changes, may also be involved in the pathogenesis of MS by affecting the gut’s microbial population and negatively impacting the integrity of the epithelia. While the cause of MS remains unknown, genetic susceptibility, and immunological dysregulation are believed to play a key role in the development of the disease. Further research is needed to fully understand the complex interplay between genetic, environmental, and microbial factors in the pathogenesis of MS.

Dysfunction in the epithelium, breakdown of the blood–brain barrier, and consequent leukocyte and T-cell infiltration into the central nervous system define Vascular Multiple Sclerosis. Multiple sclerosis (MS) affects around 2.5 million individuals worldwide, is the leading cause of neurological impairment in young adults, and can have a variety of progressions and consequences. Despite significant discoveries in immunology and molecular biology, the root cause of MS is still not fully understood, as do the immunological triggers and causative pathways. Recent research into vascular anomalies associated with MS suggests that a vascular component may be pivotal to the etiology of MS, and there can be actually a completely new entity in the already available classification of MS, which can be called ‘vascular multiple sclerosis’. Unlike the usual other causes of MS, vascular MS is not dependent on autoimmune pathophysiologic mechanisms, instead, it is caused due to the blood vessels pathology. This review aims to thoroughly analyze existing information and updates about the scattered available findings of genetics, pro-angiogenetic factors, and vascular abnormalities in this important spectrum, the vascular facets of MS.

Multiple sclerosis (MS) and myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) share the symptom of fatigue, and might even coexist together. Specifically focusing on genetics, pathophysiology, and neuroimaging data, the authors discuss an overview of the parallels, correlation, and differences in fatigue between MS and ME/CFS along with ME/CFS presence in MS. Studies have revealed that the prefrontal cortex and basal ganglia regions, which are involved in fatigue regulation, have similar neuroimaging findings in the brains of people with both MS and ME/CFS. Additionally, in both conditions, genetic factors have been implicated, with particular genes known to enhance susceptibility to MS and CFS. Management approaches for fatigue in MS and ME/CFS differ based on the underlying factors contributing to fatigue. The authors also focus on the recent updates and the relationship between MS and sleep disorders, including restless legs syndrome, focusing on pathophysiology and therapeutic approaches. Latest therapeutic approaches like supervised physical activity and moderate-intensity exercises have shown better outcomes.

AbstractBackgroundPrimary‐progressive multiple sclerosis (PPMS) and relapsing‐remitting multiple sclerosis (RRMS) are two frequent multiple sclerosis (MS) subtypes that involve 10%–15% of patients. PPMS progresses slowly and is diagnosed later in life. Both subtypes are influenced by genetic and environmental factors such as smoking, obesity, and vitamin D insufficiency. Although there is no cure, ocrelizumab can reduce symptoms and delay disease development. RRMS is an autoimmune disease that causes inflammation, demyelination, and disability. Early detection, therapy, and lifestyle changes are critical. This study delves into genetics, immunology, biomarkers, neuroimaging, and the usefulness of ocrelizumab in the treatment of refractory patients of PPMS.MethodIn search of published literature providing up‐to‐date information on PPMS and RRMS, this review conducted numerous searches in databases such as PubMed, Google Scholar, MEDLINE, and Scopus. We looked into genetics, immunology, biomarkers, current breakthroughs in neuroimaging, and the role of ocrelizumab in refractory cases.ResultsOur comprehensive analysis found considerable advances in genetics, immunology, biomarkers, neuroimaging, and the efficacy of ocrelizumab in the treatment of refractory patients.ConclusionEarly detection, timely intervention, and the adoption of lifestyle modifications play pivotal roles in enhancing treatment outcomes. Notably, ocrelizumab has demonstrated potential in symptom control and mitigating the rate of disease advancement, further underscoring its clinical significance in the management of MS.