مهندسی پزشکی
مقالهها، منابع و پژوهشهای تازه حوزه مهندسی پزشکی
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جستوجوی دقیقمهندسی پزشکی و فناوری سلامت
فناوریهای پزشکی، سلامت دیجیتال و تجهیزات
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مقالهها، منابع و پژوهشهای تازه حوزه تجهیزات پزشکی
ورود به زیرشاخهبیومواد
مقالهها، منابع و پژوهشهای تازه حوزه بیومواد
ورود به زیرشاخهمهندسی بافت
مقالهها، منابع و پژوهشهای تازه حوزه مهندسی بافت
ورود به زیرشاخهفناوری تصویربرداری پزشکی
مقالهها، منابع و پژوهشهای تازه حوزه فناوری تصویربرداری پزشکی
ورود به زیرشاخهسلامت دیجیتال
مقالهها، منابع و پژوهشهای تازه حوزه سلامت دیجیتال
ورود به زیرشاخههوش مصنوعی در پزشکی
مقالهها، منابع و پژوهشهای تازه حوزه هوش مصنوعی در پزشکی
ورود به زیرشاخهتازهترین رکوردها
شواهد مهندسی پزشکی و فناوری سلامت
PubMed2027
Robot-Assisted Partial Nephrectomy in a High-Complexity Renal Tumor in a Horseshoe Kidney.
INTRODUCTION: Horseshoe kidney is an uncommon congenital fusion anomaly that can make renal tumor surgery especially challenging because of altered rotation, limited mobility, variable vascular supply, and an unpredictable collecting system (1-7). This video presents a robot-assisted partial nephrectomy for a high-complexity renal tumor in this setting. CASE PRESENTATION: A 33-year-old man, with ECOG 0 and no relevant comorbidities, was diagnosed with a 7.5-cm solid renal mass in the central posterior portion of the left moiety of a horseshoe kidney. The lesion had a RENAL score of 10p. Contrast-enhanced computed tomography and three-dimensional reconstruction were used to understand the relationship between the tumor, aberrant vessels, renal hilum, and collecting system, supporting the decision to attempt nephron-sparing surgery (5, 8). Surgical technique and results: The procedure was performed through a transperitoneal robotic approach with the patient in right lateral decubitus using the Da Vinci Si platform. Port placement followed a standard renal robotic configuration, with a paramedian supraumbilical camera port, three robotic working ports along a craniocaudal lateral axis, a caudal fourth-arm port, and two medial assistant ports for suction, exposure, and support during renorrhaphy. After exposure of the horseshoe kidney and left hilar dissection, two arterial branches and one renal vein were identified. Tumor excision was performed under vascular control, with 20 minutes of warm ischemia and no collecting system opening, followed by two-layer absorbable renorrhaphy with adjunctive hemostatic agents. The operative time was 150 minutes. No transfusion, conversion, drain placement, or relevant immediate complication occurred. The urinary catheter was removed after 24 hours, and the patient was discharged 72 hours after surgery. Pathology showed clear cell renal cell carcinoma, Fuhrman grade 3, pT2N0M0, with negative surgical margins. During 12 months of oncologic follow-up, renal function remained stable and semiannual imaging showed no evidence of recurrence. Contemporary video reports have also emphasized the feasibility of advanced robotic renal surgery and complex partial nephrectomy strategies in selected patients (9, 10). CONCLUSION: In a carefully selected patient, robot-assisted partial nephrectomy supported by three-dimensional planning was feasible for a complex renal tumor in a horseshoe kidney, with negative surgical margins, preserved renal function, and no recurrence during 12 months of follow-up.
PubMed2026
[THE TRANSFORMATION OF LABOR ACTIVITY OF MEDICAL WORKERS IN CONDITIONS OF DIGITIZATION OF HEALTH CARE].
The implementation of digital technologies in the work of both health care professionals and the industry as a whole is a key factor in improving health care efficiency. The digitization of the Russian health care is implemented in accordance with the strategy of digital transformation. The digital transformations not only condition changes in the existing organization of functioning of medical institutions but also cardinal transformations in content, nature and organization of labor of medical workers. The transformations in labor sphere of health care are related to appearance of telemedicine, digital ecosystems and application of databases, knowledge bases and AI in treatment of patients. The changes in labor sphere in conditions of digitization result in both positive outcomes (development of professional knowledge and skills, expansion of functional, labor enrichment) and negative outcomes (workers overload, resistance to innovations, professional burnout).
PubMed2026
Digital Health Interventions to Improve Medication Adherence Among Older Adults: A Systematic Review.
OBJECTIVE: To review evidence on the type, characteristics and effect of digital health interventions (DHIs) on medication adherence among older people. METHODS: Articles were searched from inception to May 2025 in PubMed, Embase, CINAHL, Scopus and Web of Science. Randomised and non-randomised studies were included if they: involved older people aged 65 years or older; applied any DHI(s); compared the intervention with a comparator group or baseline; and reported medication adherence as an outcome. Risk of bias was assessed using the Cochrane risk of bias tools, and certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). A narrative synthesis was conducted. RESULTS: A total of 35 articles were included, most of which were randomised controlled trials (n = 22). Risk of bias ranged from low to high, and certainty from very low to moderate. Nearly half of the studies (n = 17) reported DHIs improved medication adherence compared with control or baseline. Mobile apps (3/5), electronic reminders (3/3), social assistive robots (1/1), telenursing (1/1) and combined DHIs (2/2) showed the most promise. Interventions that used multiple functionalities or strategies to support behaviour change (reminders or prompts) were most likely to improve adherence. The other DHIs had mixed results or no significant effects. CONCLUSIONS: While findings across DHIs varied, interventions incorporating tailored reminders, multicomponent features and interactivity may have the potential to be more effective in improving medication adherence among older adults. Further research is needed to identify usage patterns and investigate the factors underlying differences in effectiveness.
PubMed2026
Zeolite-Reinforced PVA/Chitosan/Hyaluronic Acid Composite Films as Biocompatible Tissue Patches.
Tissue patches are biomaterial-based structures designed to support the repair of damaged or functionally impaired tissues and are required to exhibit biocompatibility, mechanical integrity, and suitable surface characteristics. In this study, poly(vinyl alcohol) (PVA), chitosan (Chi), and hyaluronic acid (HA)-based composite films reinforced with zeolite (0-0.5% w/v) were developed and evaluated as potential tissue patch materials. The incorporation of zeolite significantly influenced the physicochemical and mechanical properties of the films. The elastic modulus decreased from 293.78 ± 64.47 N/mm2 for the zeolite-free film to 106.21 ± 9.50 N/mm2 at the highest zeolite content, indicating tunable flexibility. Water contact angle values increased from 46.09° to 67.23°, while maintaining overall hydrophilicity. The films exhibited rapid swelling behavior, reaching equilibrium within 30 min, and demonstrated controlled biodegradation with mass losses exceeding 75% after 42 days. Biological evaluations showed that all formulations maintained cell viability above 70%, with values ranging from 87.26% to 78.63%, and supported cell adhesion, confirming their biocompatible nature. The novelty of this study lies in demonstrating that low-concentration zeolite incorporation enables controlled tuning of mechanical, surface, and biological properties within a single PVA-Chi-HA system, without compromising biocompatibility. These findings highlight the potential of zeolite-reinforced composite films as multifunctional and customizable tissue patch candidates for tissue engineering applications.
PubMed2026
Essential Informatics Tools and Computing Infrastructure for Big Data to Advance Artificial Intelligence in Rheumatology.
Rheumatic diseases are chronic, heterogeneous, and longitudinal, and assembling real-world evidence for effectiveness and safety for their study is best served by integrating diverse data types. This article describes the infrastructure required to support scalable, trustworthy artificial intelligence (AI) in rheumatology, emphasizing data acquisition, harmonization, linkage, privacy protection, and computational environments. We outline computing infrastructure considerations relevant to rheumatology, including hybrid on-premises and cloud architectures. Sustained progress for AI applied to rheumatology will depend on deliberate investment in shared infrastructure, longitudinal data ecosystems, and governance models that balance innovation, privacy, reproducibility, and equitable clinical value.
PubMed2026
Improving Resident Knowledge of Artificial Intelligence Ethics and Prompting for Clinical Use.
BACKGROUND: The rapid introduction of AI into clinical practice shifts how we must teach resident trainees so they may become ethical patient-facing clinicians in an AI-integrated healthcare system. Currently, few published innovations assess outcomes beyond learner attitudes. We developed a pilot curricular innovation to equip postgraduate Internal Medicine resident trainees with the attitudes and knowledge needed to responsibly integrate AI tools into patient care decisions. APPROACH: In the 2025-2026 academic year, we piloted a curricular innovation to teach resident physicians the basics of prompting strategies for AI-assisted clinical reasoning, ethical AI use and legal considerations. The innovation consisted of an initial didactic followed by a hands-on, interactive session integrating AI prompts and outputs into clinical vignettes, thereby leveraging near-peer teaching and situated learning to achieve session objectives. EVALUATION: We assessed perceived knowledge and knowledge using a pre-post intervention strategy using the Wilcoxon Rank-Sum test. Fifty-nine/96 (61.5%) and 52/96 (54.2%) of residents participated in the presession and post-session survey, respectively. Perceived knowledge increased significantly across all five learning objectives with a moderate to large effect size. Fifty-one residents participated in the pre- and post-session knowledge test. The median pre-session score was 6/8 (interquartile range [IQR] 4-8), and the median post-session score was 7/8 (IQR: 5-8); p < 0.001, with a moderate effect size = 0.33. IMPLICATIONS: A combined didactic and small-group interaction session improved residents' perceived understanding and knowledge of ethical and legal considerations related to clinical AI use. Future work developing clinical assessments of trainee skills using AI tools is needed.
PubMed2026
Large Language Models for Traumatic Dental Injuries Across Web-Based and Mobile-Based Interfaces: Assessing Accuracy, Quality, and Temporal Consistency.
OBJECTIVES: Traumatic dental injuries (TDIs) are frequent in clinical practice and require rapid, guideline-based decisions, yet accessing accurate and reliable information may be challenging. Large language models (LLMs) such as ChatGPT, Gemini, DeepSeek, and Qwen are increasingly used as quick online information tools; however, evidence regarding their accuracy, consistency, and the influence of different user interfaces is limited. This study aimed to evaluate the performance of several LLMs in answering TDI-related questions through both web-based interfaces and mobile phone applications. MATERIAL AND METHODS: Twenty questions were prepared according to the 2020 International Association of Dental Traumatology (IADT) guidelines, including 10 open-ended and 10 yes-no items. Four LLMs (ChatGPT-4o, DeepSeek-V3, Gemini 2.0 Flash, Qwen2.5-Max) were queried simultaneously via web and mobile interfaces over five consecutive days, generating 800 responses. Open-ended answers were assessed using the Global Quality Score (GQS) and modified DISCERN (mDISCERN), while yes-no responses were compared with a predetermined answer key. Statistical analyses were performed using IBM SPSS v23.0, with significance set at p < 0.05. RESULTS: Qwen2.5-Max demonstrated comparatively higher GQS and mDISCERN scores across both interfaces. Accuracy for yes-no questions ranged from 86% to 91% without significant differences among models. Interface comparisons showed that ChatGPT-4o generated comparatively higher-quality responses on the web, whereas Qwen2.5-Max performed better on mobile. Over the 5-day period, Qwen2.5-Max showed relatively higher temporal consistency, while DeepSeek-V3 exhibited notable day-to-day variation. CONCLUSIONS: LLMs may serve as useful supplementary tools for providing guideline-based information on TDIs, especially for straightforward, closed-ended clinical questions. However, their performance varies by model, interface, and question type. Qwen2.5-Max demonstrated comparatively higher performance across several evaluated measures. Despite these results, LLM-generated information should be interpreted cautiously and verified by dental professionals before being used in clinical decision-making.
PubMed2026
A novel composite hyaluronic acid/chitosan/polyvinyl alcohol ternary hydrogel scaffold for periodontal regeneration: an experimental study.
BACKGROUND: Furcation defects are considered among the most challenging periodontal lesions to regenerate given the complexity of the periodontal apparatus, inaccessibility and the limited blood supply to the area. The aim of the current study was to create and characterize a novel ternary hydrogel composed of hyaluronic acid (HA), chitosan (CS) and polyvinyl alcohol (PVA) and to evaluate its potentials in periodontal regeneration of furcation defects in dogs. MATERIALS AND METHODS: A composite hydrogel scaffold composed of hyaluronic acid, chitosan and polyvinyl alcohol was successfully prepared and characterized in terms of SEM, swelling and mechanical behaviors, FTIR analysis as well as biocompatibility assay and direct cell-scaffold interactions. In an in vivo study, thirty-two critical size class II furcation defects were created in eight mongrel dogs and randomly allocated to group I, hydrogel group and group II, negative control group. Histological analysis and histomorphometric evaluation of percentage of newly formed bone area were used to evaluate the regenerative potential of the novel hydrogel after one and three months, postoperatively. RESULTS: The prepared hydrogel was cytocompatible, had proper degradation rate, water uptake and mechanical strength as well as ease of handling clinically. Histologic results of the hydrogel group revealed superior bone, periodontal ligament and cementum formation compared to the negative control group at both time points. The hydrogel group showed a statistically significant increase in the percentage of newly formed bone surface area compared to the negative control group. CONCLUSIONS: The novel ternary hydrogel prepared using hyaluronic acid, chitosan and polyvinyl alcohol showed adequate cytocompatibility and mechanical properties. The in vivo results support that the novel scaffold might be effective for periodontal regeneration in furcation defects in dogs.
PubMed2026
Controllable preparation of magnesium-hybridized PLA-PEG-PLA porous microspheres with anti-inflammatory function.
Biodegradable polylactic acid-based microspheres have been widely used in biomedical applications such as drug delivery and tissue engineering, however, most of the microspheres typically possess simple surface structures, lacking bioactivity and the ability to promote cell adhesion. Our group previously synthesized poly (L-lactic acid) magnesium-doped microspheres (PMg) with immunomodulatory and osteogenic potential. However, several drawbacks of PMgs, such as high hydrophobicity, a narrow pore distribution and large average particle size, and limited sustainable Mg2+release, can affect cell adhesion and growth and thus restricting their biomedical applications. To address these limitations, in the current study, a poly (lactic acid)-poly (ethylene glycol)-poly (lactic acid) (PLEL) triblock copolymer was synthesized, and magnesium-incorporated PLEL porous microspheres (PEMg) were prepared through emulsion solvent evaporation combined with anin-situdoping method. Benefiting from hydrophilic PEG segments, PEMg displayed significantly improved surface wettability and structural stability. The optimized PEMg possessed nearly half of the average size of PMg. and an interconnected hierarchical larger pore structure (1-30 μm, average: 10 ± 1.4 μm), which effectively promoted cell adhesion and deep infiltration. Moreover, PEMg showed a sustained Mg2+release which is nearly 1.87-fold higher than PMg, capable of neutralizing acidic by-products and stabilizing the local microenvironment. The biocompatible PEMg could upregulate anti-inflammatory biomarkers (Arg-1, CD206) and inhibit pro-inflammatory factors (iNOS, TNF-α), achieving over 1.5 times anti-inflammatory capacity of PMg. In summary, the creatively developed PEMg microspheres integrate optimized structural features and enhanced biological performances. Compared with PMg, PEMg showed much better potential to satisfy the complex demands of tendon soft tissue repair and presents promising prospects for inflammatory microenvironment regulation and soft tissue regeneration.
PubMed2026
Core-shell fibrous threads loaded with VEGF plasmid polyplexes for sustained, threshold-guided gene delivery.
Precise regulation of vascular endothelial growth factor (VEGF) delivery is essential for angiogenesis-oriented tissue engineering, because excessive or poorly controlled VEGF exposure may lead to abnormal and immature vascular structures. In this study, aligned core-shell fibrous threads loaded with deoxycholic acid-modified branched polyethylenimine/plasmid encoding VEGF (bPEI1.8-DA/plasmids encoding vascular endothelial growth factor (pVEGF)) polyplexes were developed as a scaffold-mediated platform for sustained VEGF gene delivery. The polymer/plasmid DNA weight ratio was first optimized in human umbilical vein endothelial cells (HUVECs), and a ratio of 2 was selected based on reporter-gene expression and cytocompatibility. The pVEGF polyplexes were then incorporated into the aqueous core of gelatin/poly(ϵ-caprolactone) (70:30) fibers using modified coaxial electrospinning equipped with a rotating disk collector. Electron and fluorescence microscopy confirmed the formation of bead-free aligned fibers with a core-shell architecture and successful polyplex incorporation. The aligned fibers were twisted into cohesive fibrous threads with an average diameter of approximately 148 μm. Genipin crosslinking preserved the fibrous morphology, improved scaffold stability, and increased Young's modulus from 37.13 to 49.81 cN/Tex while reducing extensibility.In vitrorelease studies showed that the core-shell structure, crosslinking, and compact thread architecture reduced the initial burst release and prolonged polyplex delivery over 33 d. The initial polyplex release from crosslinked threads was 16.59%, approximately 35% lower than that from crosslinked webs, and the released polyplex amount remained below the 100 ng threshold level for up to 16 d. Released polyplexes retained reporter-gene expression capability, and enzyme-linked immunosorbent assay confirmed prolonged VEGF secretion by HUVECs. The scaffolds also supported cell adhesion and metabolic activity. These findings indicate that aligned core-shell fibrous threads can provide sustained plasmid polyplex availability, prolong downstream VEGF secretion, and serve as a promising platform for localized angiogenic gene delivery, particularly in applications requiring directional fibrous architecture and localized vector delivery.
PubMed2026
Efficacy and safety of a novel 532-nm picosecond Nd:YAG laser for the treatment of freckles in Chinese patients: a randomized, split-face, multicenter, noninferiority trial.
BACKGROUND: The picosecond Nd:YAG laser is a standard treatment for freckles. However, factors such as cost and technology barriers may limit accessibility, necessitating evaluation of alternative systems. OBJECTIVES: To evaluate the noninferiority and safety of a novel 532-nm picosecond Nd:YAG laser versus an established system for treating freckles. METHODS: In this randomized, evaluator-blinded, split-face trial, 84 participants received a single treatment session. Contralateral facial sides were randomly assigned to the investigational or control device in a 1:1 ratio. The primary endpoint was the response rate at week 8. Secondary endpoints included the cure rate, investigator-assessed improvement, patient satisfaction and procedural tolerability. Safety was assessed by adverse events monitoring. RESULTS: The investigational device demonstrated noninferiority to the control (response rates: 97.6% vs. 97.6%; difference, 0.0%; 95% confidence interval: -3.30% to 3.30%) with comparable cure rates (13.1% vs. 9.5%, p = .527). Participant satisfaction was significantly higher with the investigational device (72.6% vs. 58.3%, p = .001). Treatment duration suggested an association with superior efficacy (OR = 2.07, 95% CI: 1.14-3.76, p = .016). No serious adverse effects occurred. CONCLUSION: The novel 532-nm picosecond Nd:YAG laser is noninferior to the established system, with comparable short-term efficacy and safety. Further studies are needed to assess long-term safety.
PubMed2026
Engineering the esophagus: advances, challenges, and translational pathways in esophageal tissue reconstruction.
Esophageal reconstruction is one of the most challenging procedures in gastrointestinal surgery. While conventional therapeutic approaches, such as gastric pull-up and intestinal interposition, can restore continuity, they often fail to replicate native physiology. This limitation frequently leads to long-term complications, including dysphagia, stricture, and reflux, which can significantly affect the patients' quality of life. Tissue engineering approaches offer promising alternatives aimed at developing esophageal constructs that restore both structure and function, addressing the shortcomings of current treatment methods. This review highlights recent progress in esophageal tissue engineering (ETE), focusing on the requirements for ideal ETE scaffolds and examining available biomaterials, including natural, synthetic, and hybrid. We discuss advances in fabrication techniques and various cell-based approaches, such as primary cells, stem cells, and organoids. Furthermore, we also review the steps necessary to transition ETE constructs from the laboratory to clinical settings (ongoing human trials), including preclinical studies conducted on rodent, rabbit, canine, and porcine models with the expected functional outcomes and regeneration capabilities. Early translational efforts in ETE are addressed, along with the regulatory and ethical considerations regarding good manufacturing practice (GMP) compliance, traceability, and long-term surveillance. While significant advancements in ETE have been made in preclinical models, the review also discusses the challenges of moving to clinical studies. Potential strategies to address these challenges, such as 4-dimensional printing, smart materials, artificial intelligence-driven scaffold optimization, and organoid-based models, are introduced to help bridge the gap from preclinical research to successful clinical trials. In summary, ETE is transitioning from an experimental advancement to a translational reality by integrating significant achievements in biomaterials, fabrication technologies, and cell biology while following health regulatory standards. These efforts aim to provide regenerative solutions that overcome the limitations of current therapeutic approaches in clinical settings, ultimately facilitating healing and improving the patients' quality of life.
PubMed2026
Noninvasive imaging for the evaluation of JAK inhibitors efficacy in the management of facial vitiligo.
INTRODUCTION: Vitiligo is an acquired depigmenting disorder characterized by white macules resulting from the loss of functional melanocytes. MATERIAL AND METHODS: This multicenter, real-life observational study evaluated the efficacy of topical Ruxolitinib (15 mg/g) in 100 patients with non-segmental facial vitiligo treated twice daily for three months, combining clinical scales and noninvasive imaging techniques. Assessments at baseline, 30 days, and 90 days included Facial Vitiligo Area Scoring Index (F-VASI), Facial Vitiligo Extent Score - Body Surface Area (F-VES BSA), Vitiligo Extent Score (VES) grade, Physician's and Patient's Global Vitiligo Assessments, and Dermatology Life Quality Index. RESULTS: Significant improvements were observed across most clinical indices, with marked reductions in disease extent and severity scores (p < 0.0001). Quality of life also improved substantially, as reflected by DLQI reduction. Although F-VASI showed a smaller mean change, it remained statistically significant. DISCUSSION: Instrumental evaluation, including VISIA imaging, Wood's lamp examination, reflectance confocal microscopy, and LC-OCT, confirmed clinical findings by demonstrating repigmentation and a reduction in affected areas. Overall, topical Ruxolitinib proved effective in reducing facial vitiligo lesions and improving patient-reported outcomes. CONCLUSIONS: These findings support the therapeutic potential of JAK inhibitors, although further controlled studies are warranted to confirm long-term efficacy and safety.
PubMed2026
A systematic review of neuroimaging studies of adults aged 35 and older with clinical, symptomatic and genetic risk for attention-deficit/hyperactivity disorder.
Attention-deficit/hyperactivity disorder (ADHD) affects 2.5% of adults and is associated with cognitive decline and dementia. The neurobiological mechanisms contributing to adverse outcomes in ADHD are poorly understood. ADHD-related brain alterations may persist into later life and interact with ageing-related processes, potentially increasing susceptibility to neuropathology. This preregistered systematic review synthesised neuroimaging findings in adults aged 35 years and older with clinical, symptomatic, or genetic risk for ADHD, and summarised cognitive and clinical correlates. A search of five databases produced 13 included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Most studies (11/13) had low risk of bias. Compared to controls, ADHD groups exhibited alterations in fronto-striatal, fronto-parietal, and limbic systems implicated in executive control and attention. Middle-aged adults with clinical ADHD showed more widespread cortical structural differences, whereas older adults demonstrated abnormalities primarily in frontal regions, possibly reflecting attenuation of differences through ageing. Two functional studies in those with clinical ADHD reported frontal hypoactivation alongside parietal hyperactivation, consistent with compensatory recruitment. Among undiagnosed samples, there were interactions between genetic risk for ADHD and Alzheimer's disease-related pathology affecting brain and cognitive outcomes. Overall, ADHD-associated neurobiological alterations appear to persist into older age. Longitudinal investigations are needed to clarify these relationships.
PubMed2026
Influence of artificial intelligence on xenotransplantation and regenerative medicine on the path toward ending the organ shortage.
The purpose of this review is to summarize the most influential and conceptually significant publications from the past 2 years, including substantial 2026 publications, and to identify emerging directions likely to shape xenotransplantation and regenerative medicine in the near future. Advances in artificial intelligence (AI) now support more structured anticipation of future developments by integrating patterns across experimental, computational, and translational research. The field is approaching a potential inflection point in which increasingly capable AI systems, potentially approaching artificial general intelligence, may accelerate the design of stem-cell-derived tissues and progressively more complex organ constructs. In addition, scientific communication is evolving toward formats that support machine-assisted analysis and AI-driven knowledge synthesis. Multiple developments signal significant expansion across xenotransplantation and regenerative medicine, driven by innovations in gene editing, multimodal data integration, and AI-enabled prediction and decision-support systems. These advances will help to broaden access to transplantable organs and increase the scale and impact of the field across clinical practice, research, and workforce domains. Together, these trends suggest that AI-enabled regenerative and xenogeneic strategies may meaningfully reduce the organ shortage and support future progress toward precision-engineered organ replacement.
PubMed2026
Optimizing Goal Difficulty in a Digital Weight Loss Intervention: The Ignite Pilot Randomized Trial.
BACKGROUND: Goal setting is a key component in behavioral weight loss interventions. Goal setting theory emphasizes having harder goals rather than easier goals. However, few studies have experimentally manipulated goal difficulty levels in digital weight loss interventions. Further, when multiple goals are assigned, it is unclear if harder goals are effective or too overwhelming. METHODS: Ignite was a pilot optimization trial guided by the Multiphase Optimization Strategy. A 24 factorial design was used to randomize 32 participants (U.S. adults with overweight or obesity) to either an easier or harder goal for four goal domains: calories, steps, eating windows, and Red Zone Foods (i.e., high-calorie, low-nutrition foods). All participants received a 10-week fully digital weight loss intervention with daily self-monitoring of goals, weekly lessons, action plans, and feedback. Data were collected via digital tools (daily) and surveys (baseline, 4-, 10 weeks); feasibility and acceptability were assessed descriptively, while proof of concept was assessed via linear mixed models. Findings were compared to a priori benchmarks. RESULTS: Participants had a mean (SD) age of 47.7 (13.3) years and BMI of 30.1 (3.8) kg/m2 and 47% racial/ethnic minority. Feasibility and acceptability benchmarks were largely met, with high engagement, 94% retention (30/32) at 10 weeks, and 97% recommending the program. For proof of concept, the 3%, but not 5%, weight loss benchmark was met (mean (SD) -3.3 (2.5) kg, or -4.0% (3.6%) at 10 weeks). Participants with a harder calorie goal had greater weight loss than those with an easier calorie goal (difference: -2.3 kg [95% CI, -4.1, -0.6 kg]). No main effects were observed for other goals. CONCLUSION: With high feasibility of study procedures, high engagement, and moderate-to-high acceptability, the intervention needs only minor refinements prior to proceeding to a fully powered trial testing the efficacy of easier versus harder goals for weight loss. TRIAL REGISTRATION: ClinicalTrials.gov NCT05715242. Registered on February 6, 2023.
PubMed2026
Efficacy and safety of crisaborole ointment combined with 308-nm excimer laser in the treatment of non-segmental vitiligo: a randomized, intra-patient left-right controlled study protocol.
BACKGROUND: Non-segmental vitiligo is an autoimmune disorder causing melanocyte loss and depigmentation. The 308-nm excimer laser is effective but achieving sustained repigmentation is challenging. Crisaborole, a PDE-4 inhibitor, may synergize with laser therapy. This study evaluates crisaborole 2% ointment plus laser vs. laser monotherapy with vehicle using an intra-patient left-right controlled design. METHODS: This is a single-center, randomized, double-blind, intra-patient controlled trial. Eligible adults (18-65 years) with stable NSV and at least two comparable symmetrical lesions will be enrolled. Lesions will be randomly assigned to receive either crisaborole + 308-nm excimer laser or vehicle + 308-nm excimer laser. Laser treatment will be administered twice weekly, and ointments applied twice daily over 24 weeks. The primary endpoint is the proportion of lesions achieving ≥75% improvement in the Vitiligo Area Scoring Index (VASI/F-VASI) at the end of treatment. Secondary endpoints include mean percentage change in VASI/F-VASI, time to first repigmentation, recurrence at three months post-treatment, and patient-reported satisfaction. Adverse events will be monitored throughout the study. CONCLUSION: This trial aims to provide high-quality evidence regarding the potential synergistic effect of crisaborole combined with excimer laser therapy, potentially establishing a more effective and safe treatment option for NSV. CLINICAL TRIAL NUMBER: ChiCTR2600124948.
PubMed2026
Brain iron deposition mediates cognitive impairment in COPD: A possible imaging marker linking systemic inflammation to neurodegeneration.
BACKGROUND: Cognitive impairment is a relatively prevalent comorbidity in chronic obstructive pulmonary disease (COPD), yet its neuropathological mechanism remains poorly understood. METHODS: We enrolled 48 stable COPD patients, categorized into cognitively normal (CogN, n = 22) and impaired (Cog, n = 26) groups based on Montreal Cognitive Assessment (MoCA) scores, along with 34 matched healthy controls. All participants underwent 3T MRI with quantitative susceptibility mapping (QSM) to quantify regional brain iron content. Group comparisons of whole-brain and region-of-interest susceptibility were performed. Mediation analysis was then used to test whether specific brain iron deposition mediates the relationship of both COPD status and peripheral inflammatory markers with cognitive performance. RESULTS: Cog patients showed increased total iron in the right cerebellum crus I, while CogN patients exhibited higher paramagnetic susceptibility (χpara) in the left orbitofrontal cortex (OFC), right precentral gyrus, and right brainstem. χpara in the left OFC and right brainstem were positively correlated with total MoCA, abstraction, and orientation scores. Mediation analysis demonstrated that χpara of the left OFC mediated the effects of both COPD status and systemic neutrophil counts on impaired abstraction. Additionally, right brainstem χpara mediated the relationship between COPD and deficits in orientation. CONCLUSIONS: COPD patients with cognitive impairment exhibited distinct patterns of brain iron deposition. Importantly, deposition in several key regions served as a potential mediator, linking both COPD and systemic inflammation to specific cognitive deficits. These preliminary findings suggest a possible association between brain iron accumulation and cognitive impairment in COPD, offering candidate neuroimaging markers for early identification. .
PubMed2026
Efficacy and safety of oral finasteride versus dutasteride in moderate-to-severe androgenetic alopecia in males based on trichoscopic and laboratory findings: a clinical comparison in Iran.
BACKGROUND: Androgenetic alopecia (AGA) is the most common type of hair loss in men. Finasteride and dutasteride are oral 5-alpha-reductase inhibitors. This study compared their efficacy and safety in Iranian men with moderate to severe AGA. METHODS: This randomized single-blind clinical trial included 46 men aged 20-50 years. Patients received finasteride 1 mg daily or dutasteride 0.5 mg daily for 24 weeks. Hair density and thickness were measured by trichoscopy and photographs. Satisfaction was recorded with a visual analog scale (VAS). Adverse effects were documented. RESULTS: Both groups improved in hair growth after 24 weeks with no significant difference. Serum PSA fell in the dutasteride group from 0.63 ± 0.18 to 0.42 ± 0.22 (p < 0.001). No significant change appeared in the finasteride group. Dutasteride produced greater PSA reduction than finasteride (B = 0.17, p < 0.01). Age had no effect on PSA (p = 0.58). VAS scores showed no difference. Safety profiles were similar. Sexual side effects were most common, with erectile dysfunction more frequent in the finasteride group. No serious events occurred. CONCLUSION: Finasteride and dutasteride improved hair density with similar safety. Dutasteride caused stronger PSA reduction, suggesting more potent 5-alpha-reductase inhibition.
PubMed2026
Evaluating the quality, understandability, actionability, and readability of ChatGPT-generated patient information on overactive bladder: A cross-sectional study.
This cross-sectional study aimed to evaluate the quality, understandability, actionability, and readability of patient-oriented information generated by ChatGPT regarding overactive bladder (OAB). A total of 32 frequently asked patient questions related to OAB were categorized into 6 domains, including general information, diagnosis, lifestyle and behavioral management, medical treatment, minimally invasive treatments, and surgical treatment, and submitted to ChatGPT-4o. The responses were evaluated independently by 2 researchers using the DISCERN instrument to assess information quality and the Patient Education Materials Assessment Tool - Printable version to evaluate understandability and actionability. Readability was assessed using the Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook formulas. The overall mean DISCERN score was 51, indicating moderate information quality across categories. Patient Education Materials Assessment Tool analysis demonstrated relatively high understandability (81.8%) but limited actionability (45.5%). Readability analysis revealed that the responses exceeded recommended patient education standards, with overall median Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook scores of 14.00 (range: 7.61-17.11) and 12.34 (range: 5.01-14.93), respectively. Category-based analyses demonstrated variability across content domains, with treatment-related responses showing relatively higher information quality and lifestyle-related responses demonstrating greater actionability. Although ChatGPT-generated responses demonstrated moderate information quality and were generally understandable, limitations related to actionability and readability may restrict their practical use in patient education. These findings suggest that ChatGPT may serve as a supportive tool for patient education in OAB; however, it should be considered a complementary resource used under physician supervision rather than a substitute for clinical guidance.
PubMed2026
Metabolic signatures of triple-negative breast cancer.
Triple-negative breast cancer (TNBC), being one of the most aggressive subtypes of breast malignancies, is characterized by poor prognosis and limited treatment options. As a leading cause of cancer-related mortality among women, TNBC poses unique clinical challenges due to the absence of effective targeted therapies. Conventional treatment strategies, including chemotherapy, often suffer from significant drawbacks such as drug resistance and intolerable side effects, underscoring an urgent need for innovative approaches to improve therapeutic outcomes. A defining hallmark of TNBC is its markedly altered cellular metabolism, which not only supports tumor growth and survival but also contributes to therapy resistance. Elucidating these metabolic alterations could provide critical insights into potential vulnerabilities that may be exploited for therapeutic intervention. This review provides a comprehensive overview of the major metabolic pathways that are dysregulated in TNBC and their relevance to disease progression and therapeutic intervention. Finally, we explore recent advances in metabolomics-driven precision medicine, highlighting the integration of artificial intelligence and machine learning approaches, covering aspects such as data processing, feature selection, and model construction that can accelerate the advancement of personalized treatment strategies for TNBC.
PubMed2026
AI-Enhanced Predictive Analytics to Optimize Tele-Oncology Implementation in Rural Settings: Scoping Review.
BACKGROUND: Tele-oncology addresses geographic barriers to cancer care, but implementation challenges persist in rural settings. AI-enhanced predictive analytics offer opportunities for optimizing deployment through personalized, data-driven strategies; however, evidence in rural tele-oncology contexts remains limited, and critical equity considerations remain underexamined. OBJECTIVE: This scoping review aimed to map evidence on AI-enhanced predictive analytics in tele-oncology implementation, with particular attention to rural and underserved populations, to identify research gaps and inform implementation science priorities. METHODS: We searched 5 databases (PubMed, Embase, CINAHL, Web of Science, and IEEE Xplore) using 4 concept domains (tele-oncology, rural implementation barriers, AI or predictive analytics, implementation science) from January 2015 through November 2025. Two independent reviewers screened 330 unique records (title or abstract; Cohen κ=0.78), with the principal investigator resolving conflicts. Of 138 full-text reviews (κ=0.82), 4 studies met inclusion criteria. Data extraction captured study characteristics, AI applications, implementation factors, and outcomes. We used narrative thematic analysis to map findings into three themes: (1) the current tele-oncology implementation landscape in rural and underserved settings, (2) potential AI applications addressing implementation challenges, and (3) implementation considerations for AI systems themselves. RESULTS: Four included studies (1 pilot feasibility study, 1 proof-of-concept validation study, 1 cross-sectional predictive study, and 1 platform development study; published 2019-2025) demonstrated limited evidence at the intersection of AI, tele-oncology, and rural health equity. Patient characteristics predicted telehealth modality preferences with 86.2% accuracy, revealing that male patients exhibited 66% increased odds of video selection versus female patients (P=.004), and urban residents showed 101% increased odds compared to rural counterparts (P<.001). Liu et al demonstrated that disadvantaged populations engaged with AI-generated health literacy content 2.52-fold more frequently than nondisadvantaged counterparts. However, all 4 studies documented substantial implementation barriers (patient, provider, organizational, and system levels) persisting despite technological sophistication. Organizational threshold effects, where remote monitoring interventions succeeded with adequate provider capacity but failed under resource constraints-suggest that algorithmic innovations cannot overcome structural limitations in rural facilities. No studies explicitly examined algorithmic bias, cross-population validation, or potential harms in rural contexts. Geographic concentration in high-resource countries (United States n=2, Greece n=1, and Singapore n=1) and limited oncology-specific focus underscore structural gaps in knowledge generation for underserved populations. CONCLUSIONS: Current evidence remains insufficient to support definitive practice recommendations. The observed evidence gap may reflect broader structural inequities in knowledge generation: populations with the greatest implementation challenges appear to remain substantially underrepresented in AI and digital health literature. Future research should prioritize comparative effectiveness studies in authentic rural contexts with implementation science outcomes, equity-centered cross-population validation, specification of translation mechanisms linking AI predictions to implementation strategies, health economic analyses, and mechanistic research on sociotechnical integration factors, ensuring technological innovation reduces rather than perpetuates disparities in cancer care.
PubMed2026
An Acceptance Criteria Framework for Determining the Implementation Fit of Custom Large Language Models in Public Health Interventions.
Large language models (LLMs) are increasingly embedded in clinical and population health workflows, including conversational agents such as health chatbots. As chatbots evolve from rule-based approaches to hybrid and LLM-enabled designs, risks and concerns about deployment readiness shift. Unlike rule-based chatbots, LLM outputs can be unpredictable, error-prone, and difficult to validate with traditional evaluation methods. Public health teams integrating customized LLMs into interventions face practical and ethical challenges related to performance variability, uncertainties about model behaviors, and inequitable performance across languages. Although existing frameworks address domains such as safety, ethics, effectiveness, engagement, and implementation, they often assume or imply-rather than operationalize-an explicit benchmark for deployment and implementation decisions. We propose an acceptance criteria framework (ACF) to determine implementation fit, defined as meeting prespecified minimum performance standards and demonstrating nonproblematic behavior under anticipated use. The ACF uses project-relevant and off-topic prompts, structured expert review, and prespecified thresholds to produce a documented decision record that can be iteratively rerun after model revisions. We demonstrate the framework through a case application in a tobacco cessation text messaging intervention, illustrating how the ACF can guide deployment decisions.
PubMed2026
Aptamer-functionalized stiff hydrogel for enhanced BMSC enrichment and osteogenesis.
To address the need to both enrich stem cells and direct their osteogenic fate in bone tissue engineering and bone regeneration, we developed a stiffness-gradient hydrogel (~4.5-33 kPa) functionalized with a cell-enriching aptamer (Apt19s). This design forms a combined "enrich-and-differentiate" system: Apt19s actively enriches endogenous bone marrow-derived mesenchymal stem cells (BMSCs) at the scaffold site, while the osteoinductive high-stiffness niche (~33 kPa) directs their differentiation. Crucially, the combined cues produced an enhanced osteogenic outcome-evidenced by significantly greater alkaline phosphatase (ALP) activity (>2-fold increase), upregulated RUNX2/osteocalcin (OCN) gene expression (186.5% relative to control), and enhanced mineralization-that surpassed the additive effects of either cue presented independently. This integrated platform provides a practical strategy for developing cell-free osteogenic materials that actively tackle the dual challenges of endogenous cell sourcing and lineage-specific induction.
PubMed2026
Cost-effectiveness of ferumoxtran-enhanced macrophage-specific-MRI and PSMA-PET/CT versus ePLND for nodal staging in primary prostate cancer: a decision analysis based on updated phase-3 trial data.
BACKGROUND AND OBJECTIVE: Accurate nodal staging in intermediate- to high-risk prostate cancer (PCa) is crucial for treatment decisions. While extended pelvic lymph node dissection (ePLND) is the standard, it is invasive and has a low diagnostic yield. A 2019 analysis suggested that non-invasive imaging such as PSMA-PET/CT and ferumoxtran-enhanced macrophage-MRI (m-MRI) is cost-effective, but at the possible expense of a small QALY loss compared to ePLND, based on limited evidence. Recent Phase 3 trials have provided new data, prompting a reevaluation. Therefore, the aim of this article is to update a model with recent trial data to assess the cost-effectiveness of m-MRI and PSMA-PET/CT versus ePLND in Germany. MATERIAL AND METHODS: We adapted a Markov model to simulate lifetime outcomes for men with intermediate- to high-risk PCa from a German insurer's perspective, with costs updated to 2025 level. Diagnostic accuracy data were derived from recent multicenter trials. Costs and QALYs were calculated using a 3% discount rate. Sensitivity analyses tested uncertainties. A practical interactive online-tool is provided for clinical decision-making and research purposes, which can incorporate various input data (https://macrophage-mri.app). RESULTS: Both imaging options were dominant over ePLND (€37,855; 18.11 QALYs). PSMA-PET/CT was €7,869 cheaper and gained 0.800 QALYs; m-MRI was €9,985 cheaper and gained 0.990 QALYs. m-MRI was superior, saving €2,116 and gaining 0.19 QALYs over PSMA-PET/CT. The probabilistic analysis showed that m-MRI was optimal over 95% of the time at an €80,000/QALY threshold; the probability of PSMA-PET/CT being optimal was less than 5%. CONCLUSIONS: An imaging-first approach outperforms routine ePLND, with m-MRI as a cost-effective option. PSMA-PET/CT's low sensitivity limits its usefulness, though it is still cheaper than ePLND. These results support including m-MRI in guidelines for initial staging.
PubMed2026
Enhancing Emergency Medical Response Education through Generative AI-Powered Game-Based Learning: A Retrospective Comparative Study.
OBJECTIVE: Traditional lecture-based learning (LBL) is often insufficient for cultivating the practical decision-making skills required in high-stakes environments like Emergency Medical Response (EMR). While game-based learning (GBL) offers an immersive alternative, it can lack immediate expert guidance. This study addresses this gap by exploring the integration of generative Artificial Intelligence (AI) as an "intelligent tutor" within GBL. The objective was to evaluate and compare the effectiveness of LBL, GBL, and generative AI-powered game-based learning (AI-GBL) on medical students' knowledge acquisition, retention, learning motivation, and cognitive load in an EMR course. METHODS: A retrospective, comparative study was conducted with 86 medical students from three consecutive cohorts (2022-2024), each exposed to one of the three teaching modalities (n = 29 LBL, n = 28 GBL, n = 29 AI-GBL). Knowledge was assessed via pre-test, post-test, and final-test scores with a maximum score of 10 points. Student feedback was collected for learning motivation, cognitive load, and technology acceptance. RESULTS: For immediate knowledge acquisition, both GBL (mean difference = 1.124/10 points; 95% CI [0.297, 1.952]; P = 0.008) and AI-GBL (mean difference = 0.897/10 points; 95% CI [0.076, 1.717]; P = 0.033) significantly outperformed LBL. For delayed knowledge retention, the AI-GBL group demonstrated significantly superior retention compared to both the GBL group (mean difference = 0.689 points; unadjusted 95% CI [0.080, 1.299]) and the LBL group (mean difference = 1.310 points; unadjusted 95% CI [0.706, 1.915]). The AI-GBL group also reported significantly lower cognitive load than the GBL group (mean difference = -0.273 points; unadjusted 95% CI [-0.456, -0.090]). Finally, students perceived the AI-powered approach as significantly more useful than the standard game-based approach (mean difference = 0.513 points; unadjusted 95% CI [0.137, 0.889]). CONCLUSION: The AI-enhanced GBL model for EMR training improves knowledge acquisition and retention while reducing cognitive load, representing a promising approach for developing proficiency in complex, high-stakes medical competencies.
PubMed2026
Inorganic biomaterials-reinforced printable hydrogel modulating regenerative microenvironments for tissue repair.
Complex tissue/organ regeneration is a well-orchestrated biological process that is orchestrated by the coordinated effort of neural, vascular and immune systems, accompanied by multiple cellular interactions and signal crosstalk. The beneficial pro-regenerative microenvironments are of great significance for regulating tissue-resident cell viability, migration and differentiation to direct tissue repair process. 3D bioprinting is an advanced biomanufacturing strategy that utilizes hydrogel-containing bioinks to fabricate cell-laden scaffolds, but they face the limitations of insufficient bioactivity. Inorganic biomaterials have been recognized as effective bioactive agents owing to their tunable chemical composition, topographical architectures, and physiochemical properties, which can overcome the limitation of printable hydrogel and broaden their potential biological applications. This review primarily focuses on the design of inorganic biomaterials-reinforced printable hydrogel for modulating regenerative microenvironments including neural, vascular, and immune regulation, as well as summarizes the recent progress of their applications for tissue and organ regeneration. It begins with an introduction of inorganic biomaterials augmenting the biophysical and the biochemical properties of 3D-printed hydrogel, especially highlighting the improvement of topographical cues, mechanical strength, external field responsiveness, and bioactive components release for regulating various tissue microenvironments. Subsequently, recent advancements of inorganic biomaterials-reinforced printable hydrogel in regenerating musculoskeletal system, skin, and cardiac tissues are systematically reviewed. Finally, current challenges and future perspectives in the development of inorganic biomaterials-reinforced printable hydrogel are proposed. This review may offer a novel insight for the design of novel bioinks in combination with inorganic biomaterials and printable hydrogel, which shows great potential for engineered biofabrication and complex tissue/organ regeneration.
PubMed2026
Localized stiffness programming enables tunable spatial control of vascular density in 3D hydrogels.
We report an in situ light-mediated reinforcement strategy for spatial microvascular patterning. Laser-patterned stiff zones in AlgMA/fibrin hydrogels suppress capillary formation by >81%. A linear stiffness-density relationship (R2 > 0.78) enables predictable engineering of heterogeneous tissue architecture.
PubMed2026
Stability of first twin presentation in the late third trimester and its implications for delivery planning: a retrospective cohort study.
INTRODUCTION: Fetal presentation of the first twin plays a key role in delivery planning. While vertex presentation is considered favorable for vaginal delivery, presentation changes may occur during the third trimester. However, the factors influencing these changes-particularly in relation to chorionicity-remain poorly defined. MATERIAL AND METHODS: This was a retrospective cohort study including 263 twin pregnancies (166 dichorionic diamniotic (DCDA), 97 monochorionic diamniotic (MCDA)) followed at a tertiary center between 2000 and 2025. Third-trimester ultrasounds were performed at 32 weeks and prior to delivery. We evaluated changes in the presentation of the first twin and analyzed variables that may be associated with fetal dynamics or stability, including parity, amniotic fluid volume, placental location, estimated fetal weight, and second twin presentation. RESULTS: The first twin maintained the same presentation in 53.6% of DCDA and 57.7% of MCDA pregnancies. Among those initially non-vertex, a spontaneous change to vertex presentation occurred in 53.4% of DCDA and 71.4% of MCDA cases. No statistically significant associations were found between presentation changes and the maternal or ultrasound-related variables studied. When vertex presentation was observed in the third trimester, it remained stable in over 95% of cases. CONCLUSIONS: The presentation of the first twin remains dynamic throughout until delivery, especially in non-vertex cases. However, a vertex presentation after 32 weeks is highly predictive of stability until delivery. Serial third-trimester ultrasound are essential for accurate delivery planning and should guide shared decision-making with expectant parents.
PubMed2026
[Limb reconstruction: connotation, extension, and its core value in modern medicine].
Limb reconstruction has emerged as a unique and increasingly important discipline in modern medicine. Limb reconstruction refers to the systematic restoration of complex pathological conditions resulting from various injuries or diseases-such as tissue defects, infections, and deformities-using a combination of surgical and non-surgical approaches. Its technical framework is primarily based on microsurgery, the Ilizarov technique, cement-induced membrane technique (Masquelet technique), engineered tissue regeneration, soft tissue balancing and dynamic reconstruction, and modern prosthetics, supplemented by other surgical modalities including internal and external fixation, joint replacement, sports medicine, and wound management. Limb reconstruction surgery employs these techniques to systematically restore the structure, morphology, and function of the limb, representing a critical component of modern surgery. This discipline overcomes the fragmentation inherent in traditional subspecialty care, providing a definitive clinical pathway for limb reconstruction and serving as the last beacon of hope for salvaging damaged limbs.