Vitamin B12 and folic acid could reduce blood homocysteine levels, which was thought to slow down the progression of Alzheimer’s disease (AD), but previous studies regarding the effect of vitamin B12 and folic acid in treatment of AD have not reached conclusive results. We searched PubMed and Embase until January 12, 2023. Only randomized control trials involving participants clearly diagnosed with AD and who received vitamin B12 and folic acid were enrolled. Five studies that met the criteria were selected for inclusion in the meta-analysis. Changes in cognitive function were measured based on either the Mini-Mental State Examination (MMSE) or the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). Changes in daily life function and the level of blood homocysteine were also investigated. After a 6-month treatment, administration of vitamin B12 and folic acid improved the MMSE scores more than placebo did (SMD = 0.21, 95% CI = 0.01 to 0.32, p = 0.04) but did not significantly affect ADAS-Cog scores (SMD = 0.06, 95% CI = −0.22 to 0.33, p = 0.68) or measures of daily life function. Blood homocysteine levels were significantly decreased after vitamin B12 and folic acid treatment. Participants with AD who received 6 months of vitamin B12 and folic acid supplementation had better MMSE scores but had no difference in ADAS-Cog scores. Daily life function did not improve after treatment.

Systemic lupus erythematosus (SLE) potentially involves multiple parts of the ocular system, including the lacrimal glands and the cornea. The present study sought to assess the risk of aqueous-deficient dry eye disease (DED) and corneal surface damage in patients with SLE. We conducted a population-based cohort study using Taiwan’s National Health Insurance research database to compare the risks of DED and corneal surface damage between subjects with and without SLE. Proportional hazard regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the study outcomes. The propensity score matching procedure generated 5083 matched pairs with 78,817 person-years of follow-up for analyses. The incidence of DED was 31.90 and 7.66 per 1000 person-years in patients with and without SLE, respectively. After adjusting for covariates, SLE was significantly associated with DED (aHR: 3.30, 95% CI: 2.88–3.78, p < 0.0001) and secondary Sjögren’s syndrome (aHR: 9.03, 95% CI: 6.86–11.88, p < 0.0001). Subgroup analyses demonstrated that the increased risk of DED was augmented among patients with age < 65 years and female sex. In addition, patients with SLE had a higher risk of corneal surface damage (aHR: 1.81, 95% CI: 1.35–2.41, p < 0.0001) compared to control subjects, including recurrent corneal erosion (aHR: 2.98, 95% CI: 1.63–5.46, p = 0.0004) and corneal scar (aHR: 2.23, 95% CI: 1.08–4.61, p = 0.0302). In this 12-year nationwide cohort study, we found that SLE was associated with increased risks of DED and corneal surface damage. Regular ophthalmology surveillance should be considered to prevent sight-threatening sequelae among patients with SLE.

Background: Myasthenia gravis (MG), a chronic autoimmune disorder with variable disease trajectories, presents considerable challenges for clinical stratification and acute care management. This systematic review evaluated machine learning models developed for prognostic assessment in patients with MG. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, and Scopus for relevant articles published from January 2010 to May 2025. Studies using machine learning techniques to predict MG-related outcomes based on structured or semi-structured clinical variables were included. We extracted data on model targets, algorithmic strategies, input features, validation design, performance metrics, and interpretability methods. The risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool. Results: Eleven studies were included, targeting ICU admission (n = 2), myasthenic crisis (n = 1), treatment response (n = 2), prolonged mechanical ventilation (n = 1), hospitalization duration (n = 1), symptom subtype clustering (n = 1), and artificial intelligence (AI)-assisted examination scoring (n = 3). Commonly used algorithms included extreme gradient boosting, random forests, decision trees, multivariate adaptive regression splines, and logistic regression. Reported AUC values ranged from 0.765 to 0.944. Only two studies employed external validation using independent cohorts; others relied on internal cross-validation or repeated holdout. Of the seven prognostic modeling studies, four were rated as having high risk of bias, primarily due to participant selection, predictor handling, and analytical design issues. The remaining four studies focused on unsupervised symptom clustering or AI-assisted examination scoring without predictive modeling components. Conclusions: Despite promising performance metrics, constraints in generalizability, validation rigor, and measurement consistency limited their clinical application. Future research should prioritize prospective multicenter studies, dynamic data sharing strategies, standardized outcome definitions, and real-time clinical workflow integration to advance machine learning-based prognostic tools for MG and support improved patient care in acute settings.

Background: Although endovascular treatment (EVT) is beneficial for large vessel occlusion in anterior circulation stroke, whether these benefits exist for basilar artery occlusion (BAO) remains unclear. This systematic review and meta-analysis compared the outcomes of patients with BAO undergoing EVT and standard medical treatment (SMT). Methods: The PubMed, Embase, and Cochrane Library databases were searched for eligible randomized control trials (RCTs) and non-RCTs involving patients with acute ischemic stroke and BAO undergoing EVT or SMT. The following outcomes were assessed: 90-day functional outcomes (favorable outcome and functional independence: modified Rankin scale [mRS] score of 0–3 or 0–2, respectively), mortality, and symptomatic intracranial hemorrhage (sICH) incidence. The summary effect sizes were determined as risk ratios (RRs) through the Mantel–Haenszel method with a random-effects model. Results: Four RCTs and four non-RCTs were included. Compared with SMT, EVT resulted in a higher proportion of patients with 90-day mRS scores of 0–3 (RR: 1.54 [1.16–2.06] in RCTs and 1.88 [1.11–3.19] in non-RCTs), a higher proportion of patients achieving functional independence (90-day mRS score of 0–2; RR: 1.83 [1.07–3.12] and 1.84 [0.97–3.48], respectively), a lower risk of mortality (RR: 0.76 [0.65–0.89] and 0.72 [0.62–0.83], respectively), and a higher sICH risk (RR: 5.98 [2.11–16.97] and 4.95 [2.40–10.23], respectively). Severe neurological deficits, intravenous thrombolysis, and higher posterior circulation Acute Stroke Prognosis Early Computed Tomography Score (pc-ASPECTS) were associated with EVT benefits. Conclusion: In patients with BAO, EVT results in superior functional outcomes, lower mortality risk, and higher sICH risk than does SMT, independent of age and sex. Higher National Institutes of Health Stroke Scale scores, intravenous thrombolysis, and higher pc-ASPECTSs before treatment are associated with greater benefits from EVT.