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Clinical and radiological outcomes following biportal endoscopic lumbar interbody fusion: A comparative study of three interbody cage strategies

Wed, 01 Jul 2026 00:00:00 GMT

Title: Clinical and radiological outcomes following biportal endoscopic lumbar interbody fusion: A comparative study of three interbody cage strategies Authors: Kim, Ju-Eun; Kim, Hee Soo; Park, Daniel K. Abstract: Background: While traditional open fusions yield high fusion rates, they can result in significant muscle damage. Biportal Endoscopic Lumbar Interbody Fusion (BELIF) has emerged. This study compares clinical and radiological outcomes of BELIF using three different interbody cage strategies. Methods: This retrospective cohort study included 106 consecutive patients undergoing single-segment BELIF for lumbar degenerative disease. Patients were divided into three groups based on cage strategy: Group A (n = 34, two 28 & times; 10 mm Titanium cages), Group B (n = 32, single 40 & times; 15 mm PEEK cage), and Group C (n = 40, single 32 & times; 10 mm PEEK cage). Clinical outcomes and radiological outcomes were assessed preoperatively and at final follow-up. Results: All groups showed significant improvements in VAS and ODI scores, with no significant intergroup differences in final scores. Group B had the longest operative time (p < 0.001). No major neurological complications occurred. While sagittal parameters improved within groups, there were no significant intergroup differences in the degree of correction. Fusion rates differed significantly at 6 and 12 months (Groups A & B > Group C) but were not significantly different at final follow-up (p = 0.845). The incidence of subsidence was significantly higher in Group C (15.0%) compared to Group A (5.9%) and Group B (6.3%) (p = 0.035) Conclusion: BELIF provide satisfactory clinical outcomes regardless of the cage strategy. However, cage size and potentially material significantly influenced early fusion rates and subsidence. Cages with larger footprints demonstrated superior early fusion, whereas the smallest footprint cage was associated with a significantly higher subsidence rate.

Natural language processing-based chatbots for chronic disease self-management: A systematic review of implementation and health outcomes

Fri, 01 May 2026 00:00:00 GMT

Title: Natural language processing-based chatbots for chronic disease self-management: A systematic review of implementation and health outcomes Authors: Han, Ga In; Lee, Hi Jae; Son, Youn-Jung Abstract: BackgroundConversational agents (chatbots) are increasingly used as digital health interventions to support chronic disease self-management. Advances in natural language processing (NLP) have improved their capacity for interactive dialogue and personalization, yet evidence regarding their implementation and clinical impact remains limited.ObjectivesThis systematic review identifies and synthesizes studies implementing NLP-based chatbots for chronic disease self-management.MethodsWe searched seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Scopus, Cochrane Library, and IEEE Xplore) and Google Scholar for studies published between January 2010 and November 2025. Studies evaluating NLP-based chatbots designed to support chronic disease self-management were deemed eligible. Study quality and risk of bias were assessed using the Mixed Methods Appraisal Tool and the Quality Assessment with Diverse Studies instrument.ResultsSix studies met the inclusion criteria; most were published in 2023 and targeted conditions such as cancer, diabetes, and hypertension. Chatbot functions primarily focused on symptom monitoring and disease-related education. Reported outcomes included improvements in disease-related knowledge, symptom burden, mental well-being, and self-care adherence. Usability and acceptability were generally favorable, with high satisfaction, perceived usefulness, and engagement. However, evidence of objective clinical benefits, including laboratory outcomes, was limited. Technical architectures varied widely, and advanced NLP capabilities-such as free-text natural language understanding-were rarely implemented.ConclusionsNLP-based chatbots show promise for supporting chronic disease self-management, particularly for psychosocial and behavioral outcomes. However, evidence of clinical efficacy remains limited. Future research should prioritize adaptive, context-aware designs and standardized outcome frameworks aligned with real-world self-management needs.

Trends and Sociodemographic Characteristics of Nontuberculous Mycobacterial Infections in South Korea: A Nationwide NHIS-Based Study (2010-2022)

Wed, 01 Apr 2026 00:00:00 GMT

Title: Trends and Sociodemographic Characteristics of Nontuberculous Mycobacterial Infections in South Korea: A Nationwide NHIS-Based Study (2010-2022) Authors: Seo, Jeong Mi; Kang, Sungchan; Lim, Taeyoon; Shin, So-mi; Whang, Jake; Ko, Jinsoo; Lee, Gyeong In Abstract: Background: In South Korea, nontuberculous mycobacteria (NTM) is not a notifiable disease, while the absence of a national surveillance system hampers accurate assessment of its incidence. Therefore, this study utilized National Health Insurance Service (NHIS) claims data to investigate nationwide trends in NTM occurrence over the past decade. Methods: We used NHIS claims (2010-2022) to assemble a cohort with International Classification of Diseases, 10th Revision A31 (A31.0, A31.1, A31.8, A31.9). For incidence, cases diagnosed in 2010-2011 were excluded. Incidence was estimated under three definitions: >= 2 outpatient visits or >= 1 inpatient admission with A31 during the study period; same as A, but with <= 180 days between visits; meeting B plus >= 1 antibiotic prescription within 180 days (treatment initiation). Age-standardized prevalence and incidence were calculated using the 2010 Korean population. Results: A total of 178,287 newly diagnosed NTM cases were identified from 2012 to 2022 (mean age 51.4 years; 66.8 % female). The age-standardized prevalence increased from 15.5 to 69.8 per 100,000 in 2010 to 2022. Incidence peaked in 2017 (38.9/100,000), then declined to 26.9 in 2022. Age-specific incidence of NTM infection showed distinct sex-related patterns. Among men, incidence was consistently concentrated in older adults, particularly those >= 80 years, throughout 2012-2022. In contrast, women experienced a marked epidemiologic shift beginning in 2017, with incidence in their 20s and 30s surpassing older age groups. Medical Aid beneficiaries consistently showed higher incidence rates. By region, Daejeon and Chungnam showed the greatest increase in incidence rates in 2022, compared to 2012. Conclusion: NTM infection is increasing in Korea, with distinct epidemiologic patterns by sex, age, and socioeconomic status. The rising burden, especially among young women and the socioeconomically disadvantaged, warrants targeted public health strategies.

Radiologic and Clinical Predictors of Reoperation Following Unilateral Biportal Endoscopic Spine Surgery: A Retrospective Cohort Study

Sun, 01 Mar 2026 00:00:00 GMT

Title: Radiologic and Clinical Predictors of Reoperation Following Unilateral Biportal Endoscopic Spine Surgery: A Retrospective Cohort Study Authors: Shin, Jun Jae; Kim, Keonhee; Park, Se Jun; Jeong, Won Joo; Yoo, Sun Joon; Shin, Dong Ah; Shin, Joongkyum; Jang, Hyun Jun; Chin, Dong Kyu Abstract: Purpose Unilateral biportal endoscopic discectomy (UBE) is an effective and minimally invasive technique for the treatment of degenerative lumbar diseases. However, reoperation may be required, and evidence on how risk factors vary according to the timing of reoperation remains limited. This study aimed to identify the clinical and radiologic factors associated with short-term (<6 months) and long-term (>= 6 months) reoperations following UBE. Materials and Methods This retrospective study included 80 patients who underwent reoperation after UBE between January 2016 and December 2023 with a minimum 24-month follow-up. The patients were classified into short-term and long-term reoperation groups. Clinical and radiologic parameters, including disc degeneration grade, facet joint osteoarthritis grade, and comorbidities, were compared between groups. Multivariable logistic regression was used to evaluate preoperative factors predicting postoperative functional improvement. Results Reoperations were performed for incomplete decompression (27.5%), facet cysts (10.0%), recurrent herniation (8.8%), restenosis (8.0%), and postoperative instability (43.7%). Long-term reoperation was associated with greater disc degeneration, a higher grade of facet joint osteoarthritis, and a higher prevalence of diabetes mellitus (DM). Short-term reoperation was mainly due to inadequate decompression, whereas long-term reoperation was largely attributable to postoperative instability. Multivariable analysis identified a higher preoperative grade of facet joint osteoarthritis as a predictor of postoperative functional improvement. Conclusion Short-term reoperation after UBE is primarily related to inadequate decompression, whereas long-term reoperation is linked to advanced disc degeneration, severe facet joint osteoarthritis, postoperative instability, and DM. These findings highlight the importance of thorough preoperative assessment of facet arthropathy and disc degeneration, ensuring adequate initial decompression, and careful postoperative management, particularly in patients with DM.