The clinical trajectory of normoalbuminuric chronic kidney disease (CKD), particularly in the absence of diabetes, has not yet been well-studied. This study evaluated the association of kidney and cardiovascular outcomes with levels of albuminuria in a cohort of patients with non-diabetic CKD. 

Cardiovascular and Kidney Outcomes of Non-Diabetic CKD by Albuminuria Severity: Findings From the CRIC Study

Artificial Intelligence Supported Analysis of Anal Sphincter and Levator Ani Muscle Using Medical Imaging Techniques: A Systematic Review

Steps in the Right Direction: The Importance of High-Quality Sex- and Gender-Based Analyses in CKD and Cardiovascular Disease Research

This article examines the role of aspirin in the primary prevention of cardiovascular disease. It highlights findings from major studies such as ASPREE (ASPirin in Reducing Events in the Elderly), ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events), and ASPREE-XT (ASPirin in Reducing Events in the Elderly - eXTension) , among others. The review focuses on aspirin's role in primary prevention for specific populations including older adults, diabetics, hypertension patients, rheumatoid arthritis patients, kidney transplant recipients, and those with specific lipoprotein(a) genotypes, among other groups. We review these studies, noting aspirin's role in reducing events such as myocardial infarctions and its potential for increasing bleeding risks. The review also considers the implications for patients with kidney disease, referencing the Chronic Renal Insufficiency Cohort (CRIC) study and the International Polycap Study-3 (TIPS-3) trial. Additionally, it addresses the shifting paradigms in guidelines from the US Preventive Services Task Force and other entities, underscoring the importance of individualized aspirin use by balancing benefits against bleeding risks. The article further explores the concept of platelet reactivity, discusses strategies for improving adherence to aspirin therapy, and identifies existing research gaps, such as the phenomenon of aspirin resistance. It concludes by suggesting potential areas for future investigation to enhance understanding and application of aspirin in cardiovascular disease prevention.

A Thorough Literature Review of the Potential Benefits and Drawbacks of Long-Term Aspirin Use for the Primary Prevention of Cardiovascular Disease.

This systematic review evaluated the application of artificial intelligence (AI) in the imaging-based diagnosis of cholesteatoma. A comprehensive search of PubMed, Scopus, and Web of Science up to September 2025 identified 8,160 records, of which 7 studies met the inclusion criteria. Five studies used temporal bone CT, one investigated otoscopic images, and one assessed CT-based staging of mastoid extension. Reported internal validation accuracies were generally high (>90%), particularly with convolutional neural network (CNN) architectures, while external validations showed moderate performance (78-88%). A multicenter 3D convolutional neural network (CNN) with automated region-of-interest detection demonstrated consistent generalizability and aided surgical planning in prospective testing. The otoscopy-based model achieved high accuracy for differentiating cholesteatoma from normal membranes (>98%), though performance decreased when distinguishing it from other middle ear pathologies. Across studies, AI models often performed comparably to human readers, and explainability tools highlighted relevant diagnostic features. Most studies were retrospective and single-center, with limited external validation. Overall, AI shows strong potential for cholesteatoma diagnosis using CT and otoscopic imaging, but multicenter prospective studies with standardized evaluation and clinical impact assessment are needed before routine implementation.

pdf/artificial-intelligence-in-the-diagnosis-of-cholesteatoma-a-5skygahlv2q8.pdf

Artificial Intelligence in the Diagnosis of Cholesteatoma: A Systematic Review of Current Evidence

PROBAST+AI: an updated quality, risk of bias, and applicability assessment tool for prediction models using regression or artificial intelligence methods

This systematic review describes representation of adults with chronic kidney disease (CKD) in randomized clinical trials for antithrombotic, antihypertension, glucose-lowering, and cholesterol-lowering drugs from 2000 to 2021.

Representation of Patients With Chronic Kidney Disease in Clinical Trials of Cardiovascular Disease Medications

Adherence to TRIPOD+AI guideline: An updated reporting assessment tool.

Background: Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease, but their systematic underrepresentation in cardiovascular randomised controlled trials (RCTs) limits appropriate evidence to guide cardiovascular risk management (CVRM). This systematic review aims to evaluate trends in the underrepresentation of patients with CKD in cardiovascular RCTs in the past 20 years and highlight evidence gaps for CVRM medications in this population. Methods: A systematic search was conducted in ClinicalTrials.gov from its inception in 2000 until October 2021, targeting RCTs evaluating the efficacy of CVRM medications on mortality, cardiovascular disease, and kidney failure in adults with cardiovascular disease or one or more cardiovascular risk factors. Two reviewers independently screened references and extracted data. Outcomes were the exclusion rate of patients with CKD over time and an evidence map of studies reporting results for this population. Results: In total, 1194 RCTs involving 2,207,677 participants were included. Since 2000, the percentage of cardiovascular RCTs that exclude patients with CKD has increased from 66% to 79% (74% overall, 884 RCTs). In 73% of RCTs, more patients were excluded than anticipated on safety grounds (63% without dose adjustment necessary and 79% of RCTs with dose adjustment necessary). In total, 158 RCTs (13%) reported results patients with CKD separately (e.g. in subgroup analyses). Significant evidence gaps exist for most CVRM interventions for patients with CKD, particularly for those with CKD stage 4-5. For patients with an eGFR <30 ml/min/1.73m2, 23 RCTs reported results, for dialysis patients 15 RCTs, and for kidney transplant patients only 1 RCT. Conclusion: The underrepresentation of patients with CKD in cardiovascular RCTs has not improved in the past two decades and three-quarters of RCTs excluded more patients than expected on safety grounds. A lack of RCTs that report results for patients with CKD has resulted in significant evidence gaps for most CVRM medications in all subgroups of patients with CKD, in particular for those with CKD stage 4-5. Primary funding source: Dutch Heart Foundation, 2020B008 RECONNEXT Registration: PROSPERO (CRD42022296746)

The persistent underrepresentation of patients with chronic kidney disease in cardiovascular trials: a systematic review and evidence map of exclusion and outcomes

Improving the Reporting and Use of Trial Results in Clinical Trials Registries: Global Practices, Barriers, and Recommendations.

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