Journal of Advanced Scientific Research

National-Scale Predictive Analytics for Medicare and Medicaid: An AI-Driven Approach to Identifying High-Risk Populations and Reducing Healthcare Costs

2026-06-22T13:23:31+00:00

Rising expenditures in Medicare and Medicaid continue to challenge the long-term sustainability of public healthcare financing in the United
States. A relatively small proportion of beneficiaries accounts for a disproportionate share of annual spending due to chronic disease burden,
repeated hospitalizations, fragmented care pathways, and unmet social needs. Early identification of these high-risk and high-cost populations is
therefore essential for improving outcomes while controlling avoidable expenditure. This study examines the application of artificial intelligencedriven
predictive analytics at national scale to strengthen population health management across Medicare and Medicaid programs. Using
integrated claims records, electronic health records, demographic indicators, utilization histories, and selected social determinants of health
variables, multiple machine learning models were developed to estimate future hospitalization risk, readmission probability, and annual cost
escalation. Comparative evaluation indicates that ensemble and deep learning approaches outperform conventional regression-based methods
in risk stratification accuracy, sensitivity, and cost forecasting performance. Prior utilization, multimorbidity burden, medication complexity,
emergency department use, and socioeconomic vulnerability emerged as the most influential predictors. Simulated deployment results suggest
that earlier targeting of case management, preventive outreach, and transitional care programs could reduce unnecessary admissions and moderate
total program spending. The findings demonstrate that scalable predictive systems can support more proactive and efficient allocation of limited
healthcare resources. From a policy perspective, national implementation of AI-enabled analytics may improve care coordination, strengthen
value-based purchasing strategies, and enhance equity by identifying underserved beneficiaries with elevated risk profiles.

Nationwide Multimodal Artificial Intelligence Framework for Early Prediction of Chronic Disease Progression Using Electronic Health Records and Social Determinants of Health

2026-06-23T05:50:32+00:00

Chronic disease progression remains a major challenge for national healthcare systems because risk often develops gradually across clinical,
behavioral, environmental, and socioeconomic dimensions. Existing prediction models frequently rely on limited electronic health record
variables and may overlook unstructured clinical notes, longitudinal patient trajectories, physiologic signals, and social determinants of health
that influence disease worsening. This paper proposes a nationwide multimodal artificial intelligence framework for early prediction of chronic
disease progression by integrating structured EHR data, clinical narratives, laboratory histories, medication records, physiologic indicators,
and SDOH variables. The framework combines deep learning, transformer-based EHR modeling, natural language processing, multimodal
fusion, explainable AI, and fairness auditing to support early risk identification and patient stratification across diverse healthcare settings. It
also emphasizes model validation across demographic, geographic, and socioeconomic groups to reduce algorithmic bias and improve clinical
reliability. The proposed framework offers a scalable pathway for preventive intervention, chronic care planning, population health surveillance,
and equitable clinical decision support. By combining medical and social risk signals, the study contributes to a more comprehensive and nationally
deployable approach for predicting chronic disease progression before severe complications occur.

A Study of Clinico-radiological, CSF Profile and Outcome of Scrub Typhus Meningoencephalitis with Special Reference to Atypical Presentation

2026-06-23T11:41:07+00:00

Background: Scrub typhus is an endemic disease, which is caused by Orientia tsutsugamushi. Scrub typhus affects a region known as “the
tsutsugamushi triangle”, which starts from the northern part of Japan and extends to the southern part of Northern Australia, northern part of
Russia, and Pakistan. The present study focued to generate evidence regarding clinical manifestation and treatment outcome of the scrub typhus
meningoencephalitis cases admitted in a tertiary care centre of Burdwan, West Bengal.
Materials & Methods: The cross-sectional observational study was done at inpatient department of General Medicine, Burdwan Medical College
& Hospital, Burdwan, West Bengal. The duration of study was 18 months. Diagnosed patients of scrub typhus meningoencephalitis, attending
inpatient (IPD) department of General Medicine were included in study population. Calculated final sample size was 68. Liver function test,
renal function test, coagulation profile, CSF analysis, NCCT brain, MRI brain was done.
Results: Prevalence of serious scrub typhus infection was 68.6%. Nearly 44.3% study subjects were within 18-36 years age group; majority were
male (64.3%). 70% had shown Eschar formation. 44.3% had comorbidities. Nearly 43% study subjects presented with pallor, 38% presented
with icterus, 27.6% with hypotension, 21% with hepatomegaly, 18.4% with splenomegaly and 22% with neck rigidity. Nearly 57.1% study
subjects had bleeding disorder, 37.1% with hepatitis, 25.7% with acute kidney injury and 22.9% with meningitis. Age and Eschar formation had
significant associations with disease severity of study subjects. Coagulation profile (platelet, INR, D-dimer, APTT), serum urea, creatinine, liver
function (bilirubin, SGOT, SGPT, albumin) and total count of WBC, Hemoglobin, CRP and serum ferritin were also significantly associated
with treatment outcome.
Conclusion: Atypical presentations in scrub typhus were common and they were needed to be treated early to reduce morbidity & mortality
burden of the disease.

Clinical Profile of AnoRectal Bleeding in Patients Attending a Tertiary Care Surgical Unit – A cross-sectional study from Northeast India

2026-06-23T11:39:29+00:00

Background: Anorectal bleeding is a common surgical presentation, often linked to benign conditions such as haemorrhoids and fissures, but
occasionally indicative of malignancy. Regional data from Northeast India remains limited.
Objective: To evaluate the sociodemographic profile, clinical presentation, and etiological spectrum of patients presenting with anorectal
bleeding at a tertiary care surgical unit.
Methods: A crosssectional study was conducted at AGMC & GBP Hospital, Agartala, enrolling 629 consecutive patients with rectal bleeding
between June 2024 and December 2025. Data on demographics, clinical features, comorbidities, digital rectal examination findings, haemoglobin
levels, and complications were collected using a structured proforma and analysed descriptively.
Results: The majority of patients were aged 40–60 years (37.2%) and male (69.8%). Urban residents comprised 59.9% of the cohort. Pain
(42.9%), constipation (32.8%), and rectal mass (24.3%) were the leading symptoms. Digital rectal examination revealed anal fissure (47.7%)
and haemorrhoids (46.3%) as the predominant causes, while malignancy was detected in 1.9%. Anaemia was the most frequent complication
(13.5%). Most patients had haemoglobin >10 g/dl (71.4%).
Conclusion: Anorectal bleeding in this region is primarily attributable to benign anorectal disorders, though malignancy, though infrequent,
remains a critical differential diagnosis. Early evaluation and lifestyle modification are essential to reduce morbidity and improve outcomes.

Pharmacist Interventions to Reduce Inappropriate Medication Use in Older Adults

2026-06-27T06:31:42+00:00

Potentially inappropriate medications (PIMs) represent a significant problem in geriatric care due to age-related physiological changes, multiple
chronic conditions, and the increasing prevalence of polypharmacy among older adults. Inappropriate prescribing has been linked to adverse
drug effects, hospitalizations owing to side effects of medications, disability, diminished quality of life, and higher health care costs. Medication
review, deprescribing programs, patient education, clinical decision support, and collaboration with other health care professionals have all
become important ways for pharmacists to help identify, prevent, and decrease inappropriate medication use. This systematic review examines the
impact of pharmacist-led interventions to promote more effective prescribing and medication safety in older people in hospitals, the community,
and long-term care environments. Randomized controlled trials, observational studies, and systematic reviews have all shown that pharmacist
interventions are effective in reducing PIMs, optimizing therapeutic outcomes, and improving health outcomes of patients. It also explores
the barriers to the implementation of pharmacist-led interventions, such as limited integration with the healthcare system, communication
issues, and limited availability of resources. Enhancing collaborative care models and expanding pharmacist involvement in geriatric medication
management may further improve medication appropriateness and patient safety among older adults.

HPV/Cervical Cancer Screening: Comparative Effectiveness of Primary HPV-Based Testing versus Cytology

2026-07-03T07:57:19+00:00

Background: Cervical cancer is a major preventable malignancy and in 2022, there were about 662,301 new cases and 348,874 deaths due to
cervical cancer worldwide. In more than 99% of cases, the necessary cause is high-risk human papillomavirus (hrHPV). Cytology (Pap smear)
screening has long been used and has proven effective, but its sensitivity has been identified as a limitation. HPV DNA-based primary screening
has become a molecularly superior tool; however, synthesized evidence from randomized trials based on detection of CIN2+ data is limited
over the last 6 years (2022-2026).
Objectives: To systematically review and metaanalyse comparative performance of HPV-based primary screening compared to cervical cytology
for detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+); to appraise HPV vaccination efficacy data; to evaluate self-sampling
strategies for under-screened populations; to evaluate emerging technologies such as AI-assisted colposcopy.
Methods: A systematic review and meta-analysis of peer-reviewed randomized controlled trials, systematic reviews and meta-analyses were carried
out between January 2022 and June 2026, in accordance with the guidelines of the PRISMA 2020 and the Cochrane guidelines. Databases
explored were PubMed/MEDLINE, Embase, CENTRAL, Scopus and Web of Science. Primary outcome: detection rate for CIN2+ (RR, 95%
CI). Secondary outcomes were HPV vaccination effectiveness, self-sampling uptake, test sensitivity/specificity, and cancer burden measures at
the population level.
Results: Across 8 RCTs encompassing 414,846 participants, HPV DNA-based screening detected CIN2+ lesions at a rate 61% higher than
cytology (RR 1.61; 95% CI: 1.30–1.98; p < 0.00001). HPV mRNA testing was found to be equally sensitive (93.2% for CIN2+) but was more
specific (84.0%) than HPV DNA testing (80.8%). Of the 145 RCTs included in the meta-analysis, HPV vaccination was found to be effective
in decreasing the risk of developing CIN I by 85%, CIN II by 80%, and persistent HPV16/18 infection by 84%. The self-sampling strategies
resulted in 2.1–3.1-fold higher screening participation rates than standard care. The risk of cervical cancer was 2.78-fold higher for vulnerable
populations (RR 2.78; 95% CI: 2.32–3.32). The deep learning colposcopy models had an AUC-ROC of 95.3%.
Conclusion: HPV-based primary screening is shown to be very clearly superior in terms of sensitivity for CIN2+ detection to cytology. The
WHO 90-70-90 elimination framework requires integrated vaccination, risk-stratified genotyping triage and self-sampling. AI-powered tools are
a game-changer in resource-constrained environments. There is an urgent need to address the disparities between high and low-HDI countries.

Determination of Microplastics as a Pollutant of Agricultural Land

2026-07-03T08:03:10+00:00

Bosnia and Herzegovina has not yet established adequate plastic waste management systems, which contributes to the increasing presence of microplastics in soil. Microplastics in soil may affect its physical properties, reduce water retention capacity, and negatively influence plant growth by inducing oxidative stress and reducing seed germination. This study investigates the presence of microplastics in different types of agricultural land (pasture, garden, arable land, mountain soil, and greenhouse soil) within the Tuzla Canton. The results confirmed the presence of microplastics in all analyzed samples. The occurrence and distribution of microplastics were influenced by land use, environmental conditions, and past anthropogenic activities at the sampling sites. Microplastics were identified through microscopic analysis based on particle number, morphology, and color. The detected concentrations ranged from 40 to 80 particles/kg. Although microplastics were present in all samples, no significant adverse effects on agricultural production or the health of humans and animals were observed within the scope of this study. The findings highlight the need for further research and improved waste management practices to better understand long-term environmental impacts.

Antagonistic Potential of Trichoderma against Fusarium pallidoroseum

2026-07-03T07:55:24+00:00

Trichoderma species, a biocontrol agent used as an alternative to harmful and pollution-causing chemical pesticides has been found to be effective against a wide range of bacterial and fungal plant pathogens. The present work studies the efficiency of different Trichoderma isolates against a fungal phytopathogen Fusarium pallidoroseum through dual culture method and poisoned agar method by calculating the percentage inhibition of radial growth (PIRG) of the fungal pathogen. In dual culture assay, all the isolates showed significant inhibition of the pathogen with isolate T4 identified as Trichoderma erinaceum showing maximum mycelial growth inhibition of 66.63% and isolate T3 identified as Trichoderma afroharzianum showing minimum inhibition of 63.28%. In poisoned agar method, the highest inhibition of the pathogen (75.98%) was shown by isolate T1 identified as Trichoderma yunnanense when concentration of 30% (v/v) of culture filtrate was used. The study concludes that Trichoderma isolates as well as the compounds secreted by them show an effective antagonism against Fusarium pallidoroseum, which not only infects important agricultural crops and plants in the field but also causes post-harvest fruit rot.

Study of Electrocardiography and Echocardiography changes in patients of acute cerebrovascular accidents presenting to the Emergency Department

2026-07-03T07:53:23+00:00

Cardiac abnormalities commonly accompany Acute Cerebrovascular accidents (CVA). This heart-brain interaction is reflected in the echocardiography and electrocardiographic changes. There is limited data on the assessments in the emergency ward of Indian hospitals. This study aims to evaluate the patterns of cardiac presentations among cases of CVA. The study was prospective observational in nature. The sample size was 67. All cases were above 18 years of age. All cases with any form of stroke underwent 12 lead ECG and an echo. Chi-square/Fisher’s exact test analysed the associations between stroke type and the cardiac findings. All p-values <0.05 were considered to be statistically significant. The mean age of cases was 57.9 years. More males were affected, and cases of ischemic stroke were higher (53.7%). Abnormality with cardiac findings was seen with 94% cases. Left ventricular dysfunction was predominant. Across the stroke subtypes, cardiac findings did not differ statistically. There is a higher prevalence of cardiac abnormalities among acute CVA cases. Routine cardiac evaluation should be carried out among patients before transferring them further to departments. Early treatment will help to prevent complications and reduce mortality rates.