Acta Informatica Medica[JOURNAL]
Sun
200 papers
Legal Frameworks for AI-driven Diagnostics and Robotic Surgery.
Shakhatreh HJM, Alazzam FAF
Acta Inform Med · 2025 · PMID 41281679 · Full text
BACKGROUND: As technological advancements grow, so does its impact. Humans are seeing more and more computerization, a lot of it is being used for surgery. Their merger results in various legal problems relating to regul...
BACKGROUND: As technological advancements grow, so does its impact. Humans are seeing more and more computerization, a lot of it is being used for surgery. Their merger results in various legal problems relating to regulation, patient safety, and governance. OBJECTIVES: The main objectives of this article are to study and join together legal rules and systems as it pertains to the use of artificial intelligence in medical situations for all main countries. METHODS: A narrative legal review was conducted to see what's been going on since 2010. Their sources were official documents like drug administration and legislation along articles written by numerous professors. Researchers in government are finding new ways to monitor themselves. RESULTS: Most AI health diagnosis had a regulated path if having to be approved, though one diagnostic system challenged that. The high-risk method of using robotic surgery leaves room for error between the overseeing surgeon and the manufacturer of the robot to be liable. Cross-cutting subject consist of the GDPR, HIPAA, the post-market and the surveillance, cybersecurity, and ethical considerations, which consist of the legal and privacy issue we have to take and apply into our lives every day. The progress in regulations has been noticed, but remains unclear for its implementation across different parts of the world. CONCLUSION: A cohesive framework is required to balance innovative advancements with safety precautions for patients. Future governance must combine technology standards, medical testing, and safety rules to improve how artificial intelligence and robots are used in medical centers.
Clinical Outcomes of Off-Pump Coronary Artery Bypass Grafting With and Without Posterior Pericardiotomy: Impact on Pleural and Pericardial Effusions.
Karic A, Tabakovic M, Krajnovic A … +4 more , Busevac E, Malesic N, Milaimi A, Sljivo A
Acta Inform Med · 2025 · PMID 41281678 · Full text
BACKGROUND: Posterior pericardiotomy has been proposed to prevent postoperative pericardial effusion and tamponade in coronary artery bypass grafting, but its effect on pleural fluid accumulation during off-pump CABG (OP...
BACKGROUND: Posterior pericardiotomy has been proposed to prevent postoperative pericardial effusion and tamponade in coronary artery bypass grafting, but its effect on pleural fluid accumulation during off-pump CABG (OPCAB) is not well defined. OBJECTIVE: To compare intraoperative metrics and early postoperative outcomes-particularly rates of pleural and pericardial effusions-between OPCAB with and without posterior pericardiotomy. METHODS: In this retrospective cohort, 68 patients underwent OPCAB from January to March 2025 and were stratified into pericardiotomy (n = 38) and control (n = 30) groups. Baseline demographics, comorbidities, left ventricular ejection fraction, operative time, and graft count were recorded. Postoperative outcomes included incidence of pericardial and pleural effusions (confirmed by echocardiography or chest radiography), new-onset atrial fibrillation (within seven days), chest-tube drainage volume, and in-hospital mortality. RESULTS: Groups were similar in age (mean 66.5 ± 7.1 years), sex, and major comorbidities, though peripheral artery disease and multi-vessel coronary disease were more prevalent in the pericardiotomy group (p = 0.002 and p = 0.017). Operative time and ICU stay did not differ significantly. Mediastinal drainage was higher after pericardiotomy (861 ± 551 vs. 764 ± 347 mL; p = 0.03). Pericardial effusion rates were low and comparable (10.5% vs. 13.3%; p = 0.72), and no tamponade occurred. Pleural effusions were significantly more frequent with pericardiotomy (42.1% vs. 6.6%; p = 0.001). Atrial fibrillation incidence and in-hospital mortality were similar between groups. CONCLUSIONS: Posterior pericardiotomy in OPCAB effectively prevents clinically significant pericardial effusion and tamponade, though it redirects fluid into the pleural space, increasing pleural effusion rates. These effusions are manageable with routine drainage and do not prolong recovery. Prospective studies should further define patient selection and long-term implications.
Physicians' Knowledge and Barriers to Opioid Prescribing for Cancer Pain At a Tertiary Hospital in the Eastern Province, Saudi Arabia: a Cross-sectional Study.
AlMarri AS, Eltayeb NS
Acta Inform Med · 2025 · PMID 41281677 · Full text
BACKGROUND: Cancer pain is common and often undertreated. Although opioids are effective when prescribed appropriately, clinical practice remains cautious and variable. OBJECTIVE: The aim of this study was to assess phys...
BACKGROUND: Cancer pain is common and often undertreated. Although opioids are effective when prescribed appropriately, clinical practice remains cautious and variable. OBJECTIVE: The aim of this study was to assess physicians' knowledge and identify barriers to opioid prescribing for cancer pain in a tertiary hospital in Saudi Arabia's Eastern Province. METHODS: A cross-sectional survey was conducted during March-April 2025 among physicians managing cancer pain. An anonymous REDCap questionnaire, adapted from Ayoub et al. (2022), collected data on demographics, practice patterns, guideline use, access to the national monitoring system (Raqeeb), opioid-prescribing knowledge, and perceived barriers at staff, system, and patient levels. Descriptive statistics summarized the data. RESULTS: Of 132 respondents (median age 38 years; 5 years' experience), 47.0% always and 31.1% often managed cancer pain, yet only 31.1% routinely initiated opioids. Morphine (86.4%) and tramadol (74.2%) were most used. Awareness of the local guideline was 23.5%, and 62.9% had Raqeeb access. Only 32.5% received training within five years. Foundational knowledge was adequate (opioids for moderate-severe pain 95.7%; co-prescribing laxatives 81.0%), while advanced topics were limited (no ceiling dose for morphine 25.9%; titration 45.7%; rotation 46.6%). Major barriers included limited protocol familiarity (57.6%), insufficient training (56.1%), e-prescribing workload (40.2%), perceived over-regulation (39.4%), and patient fears of addiction (51.5%) or side effects (44.7%). CONCLUSION: Physicians frequently encounter cancer pain but demonstrate gaps in guideline awareness, training, and system access. Unified guidelines, structured training, and improved Raqeeb functionality are priorities for safer opioid use.
Science or Forgery?
Maric M, Slavkovic F, Kamber A … +1 more , Masic I
Acta Inform Med · 2025 · PMID 41281676 · Full text
Abstract loading — click title to view on PubMed.
From Boomers to Zoomers: Bridging the Generational Gap in Medical Conferences.
Alghamdi M, Alkhadra F, Alswaimil N … +6 more , Alzahrani A, Althawadi H, Saeed FA, Elnour A, Makkawi MA, Alsayed T
Acta Inform Med · 2025 · PMID 41281675 · Full text
BACKGROUND: Emergency medicine conferences play a pivotal role in advancing clinical knowledge, fostering professional networks, and improving patient outcomes. However, traditional large-scale formats face challenges in...
BACKGROUND: Emergency medicine conferences play a pivotal role in advancing clinical knowledge, fostering professional networks, and improving patient outcomes. However, traditional large-scale formats face challenges in ensuring diversity, inclusivity, and participant engagement. This study investigates the effect of different medical conference experiences - traditional versus interactive - on the overall experience ratings of 143 healthcare professionals. The research also examines how professional role, experience level, and primary motivation for attendance influence these ratings. OBJECTIVE: This study aims to assess the impact of alternative conference formats on engagement, inclusivity, and knowledge dissemination, with the goal of informing strategies to design more equitable and impactful emergency medicine conferences. METHODS: Data were analyzed using a two-way mixed-design analysis of variance (ANOVA) and a paired-samples t-test. The findings indicate a statistically significant preference for interactive sessions over traditional ones across the entire sample (M=4.06 vs. M=3.75, p<.001). This preference was particularly strong among participants motivated by networking. RESULTS: However, the study also revealed a nuanced relationship between professional experience and satisfaction, with late-career professionals (20+ years) rating their overall experience significantly lower than their less-experienced counterparts. The consistently high ratings for hands-on workshops across all groups highlight their universal value. These results suggest that tailoring conference content to meet the diverse needs of attendees, especially by incorporating more interactive and applied learning opportunities, can significantly enhance engagement and satisfaction. CONCLUSION: The results revealed generational differences in satisfaction between "Millennials" and " Generation X" suggesting that future conferences should be tailored to diverse audience needs. Ultimately, the findings provide strong evidence that prioritizing interactive, applied learning can significantly boost engagement and knowledge retention.
Early Closure of Diverting Ileostomy After Rectal Resection: Are We Ready to Make the Shift?
Busbait SA
Acta Inform Med · 2025 · PMID 41281674 · Full text
BACKGROUND: Diverting ileostomy is widely used to mitigate the consequences of anastomotic leakage after low anterior resection for rectal cancer. While its protective role is well established, the optimal timing of ileo...
BACKGROUND: Diverting ileostomy is widely used to mitigate the consequences of anastomotic leakage after low anterior resection for rectal cancer. While its protective role is well established, the optimal timing of ileostomy closure remains controversial, with traditional delayed reversal exposing patients to stoma-related morbidity and potential permanent diversion. OBJECTIVE: The aim of this review is to synthesize randomized controlled trial (RCT) and meta-analysis evidence on early ileostomy closure, assess safety and outcomes, and evaluate whether a shift toward earlier reversal is justified in selected patients. METHODS: A narrative review of the published literature was conducted, including randomized trials, prospective studies, and systematic reviews identified through PubMed, Scopus, and Google Scholar. Outcomes of interest included perioperative morbidity, stoma-related complications, quality of life, and functional results. RESULTS AND DISCUSSION: Evidence from RCTs shows heterogeneity. Trials such as EASY, Kłęk, and Lasithiotakis support early closure, reporting comparable morbidity and reduced stoma-related complications, whereas Bausys, Elsner, and Fukudome caution against indiscriminate application due to increased septic and wound-related morbidity. Meta-analyses consistently indicate that early closure reduces stoma-related complications but increases wound infections, with overall morbidity largely comparable between groups. Patient selection, confirmation of anastomotic integrity, and oncologic treatment schedules are central to outcomes. Cost-effectiveness analyses and retrospective series further support potential system-level and quality-of-life benefits. CONCLUSION: Current evidence suggests that early ileostomy closure is feasible and safe in carefully selected patients, reducing the burden of stoma-related morbidity without compromising oncologic treatment. However, it should not yet be routine practice, as risks of septic complications persist in unselected populations. Future multicenter RCTs with standardized definitions, uniform imaging protocols, and long-term functional and cost-effectiveness endpoints are needed to guide practice.
MRI-Derived Radiomics For Classifying Breast Cancer Molecular Subtypes: a Modeling Approach.
Hue TT, Huong NT, Long TQ … +1 more , Hung ND
Acta Inform Med · 2025 · PMID 41281673 · Full text
BACKGROUND: Breast cancer is a biologically heterogeneous disease with four major molecular subtypes that determine prognosis and treatment strategies. MRI-based radiomics provides a non-invasive method to predict these...
BACKGROUND: Breast cancer is a biologically heterogeneous disease with four major molecular subtypes that determine prognosis and treatment strategies. MRI-based radiomics provides a non-invasive method to predict these subtypes by quantifying tumor heterogeneity. OBJECTIVE: To develop and validate a logistic-regression model using MRI-derived radiomic features to predict four molecular subtypes of invasive breast cancer: luminal A (LA), luminal B (LB), HER2-enriched (HER2), and triple-negative breast cancer (TNBC). METHODS: A retrospective cohort of 169 patients with histologically proven invasive breast carcinoma who underwent pre-treatment dynamic contrast-enhanced MRI (DCE-MRI, 3.0 T) was analyzed. Tumors were manually segmented; radiomic texture features were extracted with LIFEx and standardized by z-score normalization. Feature selection was performed using L1-regularized logistic regression (LASSO). Four one-vs-rest logistic-regression models were trained with 5-fold cross-validation. Performance metrics included AUC, sensitivity, specificity, accuracy, and precision. RESULTS: The models achieved AUCs of 0.840 (TNBC), 0.788 (HER2), 0.661 (LA), and 0.635 (LB). TNBC showed the highest accuracy (0.923), whereas LB had the lowest sensitivity (0.393). Confusion matrices revealed good classification for TNBC and HER2 but frequent misclassification between LA and LB. TNBC-related features were largely intensity- and entropy-based. CONCLUSION: MRI-derived radiomic signatures can non-invasively differentiate breast-cancer molecular phenotypes, with particularly strong performance for TNBC and HER2. Although LA-LB separation remains limited, the LASSO-logistic-regression framework offers moderate-to-high diagnostic accuracy and potential value as a complementary precision-oncology decision-support tool.
The Accuracy And Clinical Relevance of Chat GPT-4 in Triple Negative Breast Cancer Research.
Gummadi R, Pindiprolu SKSS, Kumar CSP
Acta Inform Med · 2025 · PMID 41281672 · Full text
BACKGROUND: Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by the lack of estrogen receptor(ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER...
BACKGROUND: Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by the lack of estrogen receptor(ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). The absence of these receptors reduces the effectiveness of targeted treatment approaches. With the increasing use of artificial intelligence (AI) in medical research and clinical decision- making, there is growing interest in evaluating the accuracy and reliability of large language models (LLMS), such as chatGPT-4, in oncology related applications. OBJECTIVE: The research aims to systematically assess the reliability of ChatGPT-4 in addressing frequently asked questions related to TNBC in four critical areas: diagnosis, treatment, prognosis and survival, and quality of life. Expert evaluations and statistical analyses are employed to measure the accuracy of the models responses. METHODS: A set of 100 questions related to TNBC was gathered from credible medical sources, including peer-reviewed journals and clinical oncology specialists evaluated the response generated by ChatGPT-4 using a structured assessment framework, classifying each answer into one of four accuracy levels, completely inaccurate, partially accurate, accurate but lacking depth and highly accurate. RESULTS: To evaluate the consistency among reviewers, Cohen's kappa coefficient was calculated, and descriptive statistical analysis was conducted to identify overall accuracy patterns. The findings indicated that 73% of the responses were classified as either "Accurate" or "Highly Accurate", suggesting the potential of ChatGPT-4 as a supplementary resource for obtaining information on TNBC. However, 27% of the responses were categorized as "partially accurate" or 'Completely Inaccurate, "highlighting gaps in contextual understanding and instances of misinformation.. Cohen's kappa coefficient was recorded at 0.007, reflecting a week level of agreement among evaluators and highlighting the impact of subjective interpretation. The model demonstrated strong performance in well-established areas such as chemotherapy protocols and diagnostic procedures but faced challenges with emerging research topics, personalized treatment recommendations, and fertility related concerns. CONCLUSION: ChatGPT-4 exhibits significant potential in summarizing information on TNBC; however, the accuracy of its responses varies depending on the complexity and specificity of the queries. Due to inconsistencies and low inter-rater reliability, AI-generated medical content requires verification by medical professionals before being applied to patient care or clinical decision-making. Future developments in large language models should focus on reducing inaccuracies, incorporating the latest medical data, and improving adaptability to better support personalized medicine.
Longitudinal Evaluation of Lower Urinary Tract Symptoms up to Six Months after COVID-19 Infection in a Jordanian Cohort.
Sawaqed F, Talahmeh G, Tarawneh A … +5 more , Sawaqed S, Kufoof T, Al-Tamimi M, Alahmad I, Abu-Jeyyab M
Acta Inform Med · 2025 · PMID 41281671 · Full text
BACKGROUND: Aortic Lower Urinary Tract Symptoms (LUTS) refer to a range of urinary symptoms affecting both men and women. These symptoms include increased frequency of urination, urgency, weak urine flow, incomplete empt...
BACKGROUND: Aortic Lower Urinary Tract Symptoms (LUTS) refer to a range of urinary symptoms affecting both men and women. These symptoms include increased frequency of urination, urgency, weak urine flow, incomplete emptying of the bladder, and nocturia. OBJECTIVE: LUTS encompass various urinary issues, with emerging evidence suggesting a potential connection to COVID-19. This study aimed to evaluate the occurrence and long-term effects of COVID-19 on LUTS and IPSS across different infection severities. METHODS: The prospective observational study enrolled 85 COVID-19 patients. IPSS was used to assess LUTS before, during, and 3 and 6 months after infection. Data collection included demographics and clinical characteristics, with follow-up assessments of all participants, highlighting significant differences between severity groups through statistical analysis. RESULTS: The highest IPSS values occurred during the acute phase of infection in all groups. Patients with severe or critical COVID-19 exhibited the highest IPSS, while asymptomatic or mild cases had the lowest scores. IPSS scores showed a significant association across all phases in patients with a history of urological disorders compared to those without. Age was positively correlated with IPSS before and during infection. Long-term bladder dysfunction associated with COVID-19 may cause persistent LUTS in patients with mild cases. CONCLUSION: A significant association exists between COVID-19 and LUTS, indicating that LUTS should be considered in COVID-19 cases. Monitoring LUTS is recommended throughout COVID-19 and during recovery. However, pre-infection LUTS were assessed retrospectively through recall of IPSS scores, which may be subject to recall bias and could affect the accuracy of pre- and post-infection comparisons. This study is among the first to provide a 6-month longitudinal follow-up with predictors such as age and urological history. Limitations include the lack of control for confounding factors and potential recall bias, though the within-subject repeated design enhances the strength of the results.
In Silico Screening of Secondary Metabolites from Scorodocarpus Borneensis as Hepatitis B Virus Inhibitors.
Darmadi D, Halim S, Lubis IND
Acta Inform Med · 2025 · PMID 41281670 · Full text
BACKGROUND: The Hepatitis B Virus (HBV) is a major global health concern, primarily due to its potential to cause chronic liver disease and cancer. The HBV core protein (HBc) is essential for the viral life cycle, specif...
BACKGROUND: The Hepatitis B Virus (HBV) is a major global health concern, primarily due to its potential to cause chronic liver disease and cancer. The HBV core protein (HBc) is essential for the viral life cycle, specifically in the assembly of the viral capsid, making it a prime target for antiviral drug development. Scorodocarpus borneensis, a plant native to Southeast Asia, is rich in diverse phytochemicals but its potential as a source for antiviral agents against HBV remains largely unexplored. OBJECTIVE: This study aimed to identify and evaluate secondary metabolites from S. borneensis as potential inhibitors of the HBV core protein through a comprehensive in silico screening and analysis pipeline. METHODS: Thirty-two compounds derived from S. borneensis were computationally evaluated. The process began with drug-likeness screening based on Lipinski's Rule of Five and initial toxicity predictions. Compounds that passed this filter were then subjected to molecular docking studies against the active site of the HBV core protein (PDB ID: 6J10) to determine their binding affinities and interaction modes. The most promising candidates were selected for in-depth ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) analysis and 20 ns molecular dynamics (MD) simulations to assess the stability of the protein-ligand complexes. RESULTS: From the initial screening, 17 of the 32 compounds successfully met Lipinski's criteria and showed no significant toxicity. The molecular docking analysis identified three compounds-Scodopin (12), Cadalen-15-oic acid (13), and Icariside B (15)-as the strongest candidates due to their low binding affinities and their occupation of the same active site as the native ligand. Subsequent ADMET prediction highlighted compound 13 for its favorable safety and bioavailability profile. The MD simulation further confirmed that the complex formed between the HBV protein and compound 13 was highly stable, whereas the complexes with compounds 12 and 15 were not. CONCLUSION: The combined results from drug-likeness prediction, molecular docking, ADMET analysis, and molecular dynamics simulations strongly suggest that Cadalen-15-oic acid (13) is a highly promising lead compound from S. borneensis for developing a novel drug to inhibit the HBV core protein.
Legal Liability for AI-Assisted Radiographic Diagnosis Errors: a Comparative Review of French, Jordanian, and UAE Law.
Gourari FM, Alazzam FAF, Shakhatreh HJM … +2 more , Alhajeri SAH, Al Mansoori SAA
Acta Inform Med · 2025 · PMID 41281669 · Full text
BACKGROUND: Artificial intelligence has become an important aspect in medicine, especially in radiology. OBJECTIVE: The aim of this article was to investigate the legal liability for AI-assisted radiographic diagnosis er...
BACKGROUND: Artificial intelligence has become an important aspect in medicine, especially in radiology. OBJECTIVE: The aim of this article was to investigate the legal liability for AI-assisted radiographic diagnosis errors in view of French, Jordanian, and UAE Law. METHODS: The authors analyze medical liability in the U.A.E, France and Jordan, focusing on how errors in diagnosis are handled, and if artificial intelligence plays a role in the diagnosis. The researchers tested many jurisdictions for demonstrating wrong doing so nothing happens to the person. RESULTS: In the United Arab Emirates, fault is closely tied to the idea of "critical doctor mistakes," where a tool is accidentally used which leads to great harm. In France the penalties of a law are made up of the bias comment and how well professionally they knew how to do their job. In Jordan, the outdate laws reflects a change in the way the government is running things. They got another used law to government things correctly. The criminal liability framework including Penal Code and Medical Liabilidad Law protect the patient more than protecting the doctors. While these systems are supposed to balance how well you will take care of the patient and you, the caregiver, something goes wrong and the machines aren't perfect and we cannot keep trusting in them. CONCLUSION: Because of the fact that this is an important emergent technology, a bunch of recommendations must be met for several reasons. Some of these guidelines are to review important regulatory actions to give a setting for this kind of technology.
Effectiveness of Interventional Pain Management on Disc Herniation Resorption: Radiological Evidence.
Abdalla K, Alawneh K, Raffee L … +9 more , Hamed S, Ababneh GE, Alkhawaldeh AM, Jaradat MB, Alomari SA, Mohammed AA, Alawneh R, Alawneh H, Ibrahim A
Acta Inform Med · 2025 · PMID 41281668 · Full text
BACKGROUND: The purpose of this study is to evaluate the change in disc herniation over time, as assessed on MRI images, in those patients who are receiving epidural steroid injections. The concept of reduction in the si...
BACKGROUND: The purpose of this study is to evaluate the change in disc herniation over time, as assessed on MRI images, in those patients who are receiving epidural steroid injections. The concept of reduction in the size of the disc, in other words, spontaneous resorption/regression will be explored and whether it has any link with administration of epidural steroid injections. OBJECTIVE: The purpose of this study is to evaluate the change in disc herniation over time, as assessed on MRI images, in those patients who are receiving epidural steroid injections. The concept of reduction in the size of the disc, in other words, spontaneous resorption/regression will be explored and whether it has any link with administration of epidural steroid injections. METHODS: This retrospective study investigates the potential link between changes in the natural history of disc morphology, specifically disc resorption, and various IPM treatments. For 449 patients the inclusion criteria encompassed LDH patients who Underwent IPM at KAUH from the period between January 2022 and January 2024 for the patient who had at least two lumbar spine MRI scans (one before and one after IPM). Patients with disc surgery after IPM and pre-or post-MRI follow-up exceeding two years were excluded. RESULTS: Among the 128 LDH patients included in the study, 48 cases (37.5%) exhibited varying degrees of LDH resorption following IPM treatments, while 80 cases (62.5%) showed no significant change in LDH size. CONCLUSION: The findings suggest that IPM therapies may influence the natural history of LDH morphology by decreasing disc size in a subset of patients. These results underscore the potential benefits of IPM treatments in LDH management and warrant further exploration in clinical practice and research settings.
Access Site and Pacemaker Outcomes After TAVR in HFrEF Patients: Axillary vs Femoral Approach.
Rhabneh L, Ababneh R, Algorani E … +5 more , Wafi J, Alkhanafsa M, Ababneh H, Alwardat AR, Aloqaily M
Acta Inform Med · 2025 · PMID 41281667 · Full text
BACKGROUND: Aortic stenosis is a prevalent disease affecting approximately 10% of the population by the eighth decade, it is a fatal disease without treatment, with an annual mortality rate reaching 25%. Valve replacemen...
BACKGROUND: Aortic stenosis is a prevalent disease affecting approximately 10% of the population by the eighth decade, it is a fatal disease without treatment, with an annual mortality rate reaching 25%. Valve replacement, either through surgical or transcatheter approach, is the only therapeutic option. Over the last 15 years, the indications for transcatheter aortic valve replacement (TAVR) have spread to include young and low surgical risk patients. OBJECTIVE: Our study aims to address this gap in the literature by comparing the adverse outcome after TAVR through axillary versus femoral access in heart failure reduce ejection fraction (HFrEF) patients who underwent TAVR within 30 days of the procedure. METHODS: We used data from TriNetX US collaborative network database, including HFrEF patients who had TAVR through axillary or femoral access between 2015 and 2025. Propensity score matching was done to minimize the difference in baseline characteristics between the two cohorts. Outcomes were observed within the first 30 days of TAVR. RESULTS: A total of 206 patients in each cohort (axillary vs. femoral) were studied after propensity score matching. The incidence of permanent pacemaker (PPM) insertion was comparable between groups (5.0% vs. 5.1%; OR: 0.984, 95% CI: 0.400-2.419; HR: 0.365, 95% CI: 0.097-1.376; p = 0.157). Secondary outcomes showed no significant differences between the axillary and femoral approaches, including major vascular complications (OR: 0.542, 95% CI: 0.238-1.231; HR: 0.448, 95% CI: 0.192-1.046), acute kidney injury (OR: 0.922, 95% CI: 0.430-1.976; HR: 0.940, 95% CI: 0.459-1.922), all-cause mortality (OR: 1.010, 95% CI: 0.411-2.482; HR: 1.040, 95% CI: 0.433-2.498), cerebrovascular accident (OR: 0.980, 95% CI: 0.390-2.460; HR: 1.142, 95% CI: 0.384-3.399), and acute coronary syndrome (OR: 0.885, 95% CI: 0.355-2.208; HR: 1.211, 95% CI: 0.271-5.412). CONCLUSION: Our study finding showed no difference in the permanent pacemaker insertion or secondary outcomes (Major vascular complications, Acute Kidney Injury, Cerebrovascular accident, Acute coronary syndrome, and All-cause mortality) within the first 30 days of TAVR in patients with HFrEF, whether the access axillary or femoral.
Clinical Outcomes of Out-of-Hospital Cardiac Arrest with ROSC: Insights from a Specialized Referral Center in Vietnam.
Hung TP, Vi DT, Kha NM … +4 more , Tai NN, Sang LQ, Hoa T, Sy HV
Acta Inform Med · 2025 · PMID 41019365 · Full text
BACKGROUND: Anti-N-Out-of-hospital cardiac arrest (OHCA) remains a condition with high morbidity and mortality despite advancements in resuscitation strategies. Identifying prognostic factors in OHCA patients who achieve...
BACKGROUND: Anti-N-Out-of-hospital cardiac arrest (OHCA) remains a condition with high morbidity and mortality despite advancements in resuscitation strategies. Identifying prognostic factors in OHCA patients who achieve a return of spontaneous circulation (ROSC) is critical for optimizing post-resuscitation care and improving survival outcomes. OBJECTIVE: This study evaluates clinical outcomes and predictors of in-hospital mortality in OHCA patients admitted to a tertiary referral center in Southern Vietnam. METHODS: A retrospective cohort study was conducted on OHCA patients with ROSC admitted to Cho Ray Hospital, Ho Chi Minh City, Vietnam, from January 1, 2019, to June 15, 2024. Demographic characteristics, clinical variables, and survival outcomes were analyzed. Predictors of in-hospital mortality were identified through multivariate logistic regression. RESULTS: Among 482 OHCA cases, 86 patients met the inclusion criteria. The mean age was 49.1 ± 17.2 years, with a male predominance (79.1%, male-to-female ratio: 3.8:1). Most cardiac arrests were witnessed (84.9%), and 32.5% presented with an initial shockable rhythm. Cardiac etiology was the predominant cause (67.4%). The overall in-hospital survival rate was 44.2%, with 25.6% achieving good neurological outcomes (Cerebral Performance Category [CPC] 1-2). Multivariate analysis identified lower Glasgow Coma Scale (GCS) scores (OR 1.42, 95% CI 1.01-2.00, p = 0.045), decreased estimated glomerular filtration rate (eGFR) (OR 1.03, 95% CI 1.00-1.06, p = 0.042), and higher cumulative epinephrine dose (OR 1.10, 95% CI 1.01-1.19, p < 0.05) as independent predictors of mortality. A predictive model incorporating these variables demonstrated strong discriminatory performance (AUC = 0.91). An epinephrine threshold of 7 mg was identified as a predictor of in-hospital mortality, with a sensitivity of 0.68 and specificity of 0.91. CONCLUSION: In OHCA patients with ROSC, the in-hospital survival rate was 44.2%, with 25.6% achieving good neurological outcomes (CPC 1-2). Lower GCS scores, reduced eGFR, and higher total epinephrine doses were independently associated with increased mortality. These findings underscore the need for early risk stratification and individualized post-resuscitation management to improve patient outcomes.
Thirty-five Years from Accepting Former Yugoslavia Association of Medical Informatics (YAMI) at EFMI and IMIA During MIE'90 in Glasgow, Scotland.
Masic I
Acta Inform Med · 2025 · PMID 40606251 · Full text
This review is remembrance on occasion of 35 years of MIE '90 held in Glasgow which organized by UK and Scottish Association of Medical Informatics, and chaired by John Bryden and his team with support by European Federa...
This review is remembrance on occasion of 35 years of MIE '90 held in Glasgow which organized by UK and Scottish Association of Medical Informatics, and chaired by John Bryden and his team with support by European Federation for Medical Informatics (EFMI). It was my first participation at MIE Conferences, in that time as General Secretary of Yugoslav Association of Medical Informatics (YAMI) and officially accepted as a member of EFMI and IMIA. Besides our President of YAMI, Professor Gjuro Dezelic, one of founders YAMI (with Izet Masic, Stefan Adamic, Rajko Vukasinovic, as presidents of Bosnia and Herzegovina, Slovenian and Serbian Societies of Medical Informatics in 1987) participants at MIE '90 have been, also, our colleagues: Josipa Kern, Nada Dezelic, Silvije Vuletic, Visnja Lovrek, Miroslav Madjaric, etc. It was my first active participation at MIE Conferences, and after this meeting, year by year I continued until today. Let me say some important facts about it as my personal story -"Medical Informatics Journey", during the last 35 years, from Glasgow 1990 until today.
Reassessing Cardiovascular Risk Stratification in Vietnam: Insights from SCORE2 and the Original SCORE Model.
Hai TNP, Tai NN, Kha NM … +6 more , Sang LQ, Son PTT, Hung NM, Nhan LT, Hiep TT, Sy HV
Acta Inform Med · 2025 · PMID 40606250 · Full text
BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, especially in low- and middle-income countries like Vietnam. Risk stratification models such as the original SCORE mo...
BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, especially in low- and middle-income countries like Vietnam. Risk stratification models such as the original SCORE model have been widely used to guide preventive strategies. Recently, the updated SCORE2 model has been developed to enhance prediction accuracy by incorporating non-fatal events and recalibration for different European regions. OBJECTIVE: This study aims to compare the performance and applicability of SCORE2 versus the original SCORE in a Vietnamese population undergoing general health check-ups. METHODS: We conducted a cross-sectional study on individuals attending general health check-ups at Cho Ray Hospital, a leading tertiary hospital in Vietnam, from January 2024 to July 2024. Demographic, clinical, and laboratory data were collected to calculate cardiovascular risk scores using both the original SCORE and the updated SCORE2 models. RESULTS: Among 477 individuals undergoing general health check-ups, 317 patients met the inclusion criteria with a median age of 54.5 years (IQR: 47-62) and 35% were male. Risk stratification using the original SCORE model classified 87.1% as low-to-moderate risk, 9.1% as high risk, and 3.8% as very high risk. In contrast, SCORE2 reclassified 48.6% as low-to-moderate risk, while high and very high-risk categories increased to 35.6% and 15.8%, respectively (p < 0.001). Notably, 122 out of 276 patients (44.2%) initially classified as low-to-moderate risk by SCORE were reclassified by SCORE2 into higher risk categories - 101 (high risk) and 21 (very high risk). Similarly, 58.6% (n = 17) of patients classified as high risk by SCORE were upgraded to very high risk by SCORE2. SCORE2 also identified more high and very high-risk individuals under 50 years old, particularly among male patients. CONCLUSION: Compared to the original SCORE model, SCORE2 significantly increased the detection of high and very high cardiovascular risk in Vietnamese individuals undergoing routine health check-ups. The findings suggest that SCORE2 may provide improved risk stratification, especially in younger and male populations, and may better support preventive cardiovascular strategies in clinical practice.
State, Trait Anxiety and Insomnia in Hospitalized Patients With Cardiovascular Disease.
Aroniada P, Gerogianni G, Stamou A … +6 more , Zaka M, Tsoulou V, Tsami A, Chamodraka E, Poulimenos L, Polikandrioti M
Acta Inform Med · 2025 · PMID 40606249 · Full text
BACKGROUND: Hospitalized patients experience significant physical, emotional burden mainly due to a wide range of stressors, related to the hospital environment and their disease including the procedures they undergo. OB...
BACKGROUND: Hospitalized patients experience significant physical, emotional burden mainly due to a wide range of stressors, related to the hospital environment and their disease including the procedures they undergo. OBJECTIVE: was to explore prevalence of anxiety and insomnia in hospitalized patients with cardiovascular disease and the associated factors with anxiety. METHODS: In the present cross-sectional study were enrolled were enrolled 140 hospitalized patients with cardiovascular disease. The data collection was carried out via interviews using the "State-Trait Anxiety Inventory (STAI)" scale and the "Athens Insomnia scale AIS" which included patients' characteristics. RESULTS: Regarding state and trait anxiety, half of participants scored below 43 and 49 respectively (median), while 25% scored above 52 and 53, respectively. These values indicate moderate levels of anxiety. Regarding insomnia, at least 50% of patients scored below 6 (median). These values indicate moderate levels of insomnia. The correlation between patients' anxiety and insomnia was positive linear (rho>0.2, p<0.05), meaning that an increase in the insomnia score implies an increase in the state and trait anxiety score (more anxiety). State anxiety was found to be statistically significantly related to family status (p=0.008), occupation (p=0.005), type of disease (p=0.048), and whether they suffered from other disease (p=0.005). Trait anxiety was found to be statistically significantly associated only with marital status (p=0.043). CONCLUSION: Improving mental health of hospitalized patients in a general hospital requires the attention by clinical health professionals. Knowledge of the association between insomnia and anxiety in hospitalized patients with cardiovascular diseases is important for identifying potential high-risk groups and implementing interventions to alleviate this burden.
Prognostic Models for Mortality in Elderly Patients with Stenotrophomonas Maltophilia Bacteremia.
Quang HV, Nhung LK, Thuy PT … +2 more , Loc HV, Dung HS
Acta Inform Med · 2025 · PMID 40606248 · Full text
BACKGROUND: This study was to determine risk factors and prognostic models for mortality in elderly patients with Stenotrophomonas maltophilia bacteremia. OBJECTIVE: The aim of this study was to address this gap, we cond...
BACKGROUND: This study was to determine risk factors and prognostic models for mortality in elderly patients with Stenotrophomonas maltophilia bacteremia. OBJECTIVE: The aim of this study was to address this gap, we conducted this study to investigate the predictors of mortality and develop prognostic models for clinical practice. METHODS: A retrospective study was conducted on 195 patients ≥ 60 years of age (median age 78 (68-85) years, 59.5 % male) at Thong Nhat National Teaching Hospital in Vietnam between January 1st, 2017 and December 31st, 2022. Patients who were treated in the hospital with the first positive blood culture for Stenotrophomonas maltophilia bacteremia were chosen for enrolment in this study. This investigation evaluated demographic and clinical characteristics and prognostic models for mortality. RESULTS: The mortality rate was 37.4 %. Multivariate analysis showed that the significant independent risk factors for mortality were age (aOR, 1.08; 95 % CI, 1.04-1.13; p < 0.001), SOFA score (aOR, 1.38; 95 % CI, 1.14-1.68; p < 0.001), and APACHE II score (aOR, 1.10, 95 % CI, 1.03-1.17; p = 0.005). Bayesian model averaging method identified four clinically applicable models: age combined with both SOFA score and APACHE II score (AUC 0.884, R2 0.564), age combined SOFA score (AUC 0.874, R2 0.516), age combined APACHE II score (AUC 0.800, R2 0.340), SOFA score combined APACHE II (AUC 0.846, R2 0.507). CONCLUSION: Stenotrophomonas maltophilia bacteremia was severe in elderly patients with high mortality. Risk factors for mortality included age, SOFA, and APACHE II scores. The model comprising age, SOFA, and APACHE II scores has the best predictive ability. However, the model including age and SOFA score was also clinically valid and simple.
Assessing the Relation Between Problem-based Learning Methods and Critical Thinking Skills of Undergraduate Nursing Students in Mental Health Sector.
Kriki MN, Christodoulou NG, Fradelos EC … +6 more , Paralikas T, Kleisiaris C, Malliarou M, Tsaras K, Moisoglou I, Papathanasiou IV
Acta Inform Med · 2025 · PMID 40606247 · Full text
BACKGROUND: Mental health nurses often deal with complex clinical situations and face difficulties with the decision-making process. The development of educational techniques during nurses' clinical practice is crucial t...
BACKGROUND: Mental health nurses often deal with complex clinical situations and face difficulties with the decision-making process. The development of educational techniques during nurses' clinical practice is crucial to improve nurses' skills in communication, assessment and effective intervention in patients with mental disorders. Problem Based Learning (PBL) teaching method is a student-centered educational method based on the integration of a real problem into the learning process. OBJECTIVE: The aim of this study was to investigate the effect of the PBL on the development of critical thinking in undergraduate nursing students, in mental health clinical practice. METHODS: A quasi - experimental study was conducted with a pre- and post-test design in an experimental group and a control group, in Greece, at the Larissa School of Nursing of the University of Thessaly. The study was conducted throughout the 6th spring semester of an undergraduate nursing program, in the course Psychiatry - Mental Health Nursing (clinical practice) during the academic year 2022-2023. RESULTS: The study samples were comprised 67 students each. None of the students in either group had received PBL training previously. CTΑSS scores in intervention group differed statistically significantly in all subscales before and after the experimental procedure, p<0.05). Intervention group achieved significantly higher scores compared with the control group in certain subscales (interpretation, analysis, inference, and explanation-p=0.037, p=0.025, p=0.036 and p=0.001, respectively). Gender had an effect on explanation and inference; Women improved significantly their scores, whereas men had worse performance (p=0.001 and p=0.043 respectively). CONCLUSION: Our study confirms the effect of PBL on critical thinking development and implies a role of gender in PBL education process. Future research should assess the viability of PBL effects on critical thinking by monitoring and re-assessing the trajectories of critical thinking development in subsequent years.
Laboratory Parameters and Clinical Presentation of Children with Measles on Hospital Admission: Single-center Study from Sarajevo, Bosnia and Herzegovina.
Hasanefendic B, Avdagic L, Hrvo S … +6 more , Muratspahic A, Pasic A, Mutevelic S, Sehercehajic E, Beharic S, Murtic S
Acta Inform Med · 2025 · PMID 40606246 · Full text
BACKGROUND: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the...
BACKGROUND: T Measles is a viral, highly contagious disease from the group of rash fevers, which mainly affects children. Persons suffering from measles are considered contagious four days before and four days during the period of the appearance of measles, which favors its faster spread. Clinical observation and laboratory diagnostics are essential for monitoring the course of the disease in order to prevent complications. OBJECTIVE: Our study aimed to analyze the significance and usefulness of laboratory tests on admission to hospital in pediatric patients with measles. METHODS: This prospective study included children with confirmed measles infection who came accompanied by parents to the Infectious Disease Clinic of the Clinical Center of the University of Sarajevo during nine months. Data on age, sex, symptoms and results of laboratory analyzes (biochemical, hematological and coagulation) were recorded. RESULTS: The study included a total of 302 subjects, including 122 healthy controls and 180 measles patients. Significantly lower values observed for aPTT, absolute number of eosinophils and basophils, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC in measles patients. Significantly higher values were observed for fibrinogen, D-dimer, WBC, neutrophils, lymphocytes, monocytes, RDW and MPV in measles patients in contrast to controls. Significantly higher values were also observed for serum chloride, glucose, CRP, AST, ALT and LDH values. AST/ALT, NLR, PLR, NPR, LMR, LCR, SII and AISI also showed significant differences in measles patients compared to controls. CONCLUSION: The results of our study showed that laboratory tests have great significance and potential in measles in pediatric patients admitted to the hospital. Lymphocyte/C-reactive protein ratio also showed good diagnostic potential.
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