Category: Statistics

Pol Przegl Chir. 2026 Jun 8;98(3):1-9. doi: 10.5604/01.3001.0055.7863.

ABSTRACT

<p><strong>Introduction:</strong> Artificial intelligence, particularly large language models like ChatGPT-5.0, is increasingly applied in medical education and decision support. At the same time, there is a lack of research assessing the effectiveness of the latest language models in high-stakes specialized examinations in Poland, which justifies the need for such an analysis.</p><p><strong>Aim: </strong>This study evaluates ChatGPT-5.0’s performance on the Polish Specialization Examination (PES) in general surgery.</p><p><strong>Methods:</strong> A total of 701 single-choice questions from six PES sessions (2023-2025) were analyzed. The questions were divided into various categories. Each question was independently posed to ChatGPT-5.0 three times, and responses were compared with official answer keys. AI performance was compared with that of residents.</p><p><strong>Results:</strong> ChatGPT-5.0 achieved scores ranging from 75.6% to 82.8%, with an overall accuracy of 81-84%, consistently exceeding both the 60% pass threshold and the average score of residents. While ChatGPT-5.0 occasionally outperformed the top-performing residents, the highest human scores were superior in most sessions. Confidence scores were positively correlated with answer accuracy.</p><p><strong>Conclusions:</strong> ChatGPT-5.0 demonstrates strong written exam performance in general surgery. These findings highlight the potential of AI in medical education and exam preparation, while underscoring the limitations of single-choice assessments for clinical competence.</p><p><strong>The significance of the study:</strong> This study provides the first systematic evaluation of ChatGPT-5.0 on the National Specialty Examination in General Surgery in Poland, offering new insights into how advanced AI models perform across clinical domains and cognitive task types, and highlighting their potential role in future surgical training frameworks.</p&gt.

PMID:42439001 | DOI:10.5604/01.3001.0055.7863

Pol Przegl Chir. 2026 May 26;98(3):1-10. doi: 10.5604/01.3001.0055.7787.

ABSTRACT

<p><strong>Introduction:</strong> Diabetic foot infection (DFI) is a major complication of diabetes associated with high rates of amputation, recurrence, and healthcare utilization. The prognostic interaction between clinical and microbiological markers remains unclear.</p><p><strong>Aim:</strong> The present analysis aimed to characterize clinical, inflammatory, and microbiological predictors of course and resource use in surgically managed DFI.</p><p><strong>Material and methods:</strong> We retrospectively analyzed 121 hospitalizations of 86 patients treated surgically for DFI (2021-2025). Clinical, laboratory, and microbiological variables were assessed in relation to amputation, reamputation, rehospitalization, length of stay (LOS), and mortality.</p><p><strong>Results:</strong> Amputation was performed in 72/121 episodes (59.5%), including 57 minor and 15 major procedures. Reamputation occurred in 13/72 cases (18.1%). Rehospitalization was recorded in 42/86 patients (48.8%). Median LOS was 13 days (IQR 8-21). A total of 227 isolates were obtained, with <em>Enterococcus faecalis</em> (38 isolates, 16.7%) and <em>Staphylococcus aureus</em> (28 isolates, 12.3%) being the most frequent. Polymicrobial infections were present in 75/121 episodes (63%). Neuro-ischemic ulcer phenotype independently predicted reamputation (aOR 3.72; p = 0.036). <em>Staphylococcaceae</em> increased the likelihood of rehospitalization (aOR 3.32; p = 0.014). NLR >5 prolonged LOS by 42%, and <em>Enterococcus</em> spp. by 51%. Repeat hospitalizations showed enrichment of ESBL <em>Klebsiella pneumoniae</em> (5 cases) and HLAR E. faecalis (9 cases).</p><p><strong>Conclusions: </strong>Ulcer phenotype and systemic inflammatory response were the strongest predictors of adverse outcomes. Microbiology contributed selective yet clinically meaningful prognostic information, particularly regarding <em>Staphylococcaceae</em> and <em>Enterococcus</em> spp.</p&gt.

PMID:42439000 | DOI:10.5604/01.3001.0055.7787

Psychol Rep. 2026 Jul 13:332941251378975. doi: 10.1177/00332941251378975. Online ahead of print.

ABSTRACT

The widespread growth of smartphones in recent decades has significantly influenced the social and daily lives of individuals. The proliferation of technological devices along with their unique features has become one of the major challenges for individuals, especially young people. The present study examines the relationship between smartphone addiction, Narcissism, impulsivity with the moderating role of gender in young people in Tehran. A correlation approach using structural equation modeling is used to investigate these relationships. The statistical population was all young people aged 18 to 35 in Tehran, 347 people (M = 24.51, SD = 5.63) were selected using convenience sampling who were provided with the Smartphone Addiction Inventory by Lin et al. (2014), Ames’s Narcissistic Personality Inventory (1988), and the Barratt Impulsiveness Scale (2004). Data were analyzed using SPSS 26 software and AMOUS software was used to analyze the moderating role of gender. The results of this study showed that individuals with high levels of narcissism and impulsivity are more likely to develop addiction to smartphones. The results particularly emphasized that gender acts as an important moderating variable in these relationships. The relationship between narcissism, impulsivity, and smartphone addiction is stronger in women and weaker in men. The findings of this research can be useful for organizations, educational institutions, and addiction therapists, especially in the field of virtual addictions, as an effective tool for understanding and preventing smartphone addiction.

PMID:42438995 | DOI:10.1177/00332941251378975

Minerva Urol Nephrol. 2026 Jun;78(3):430-437. doi: 10.23736/S2724-6051.26.06906-5.

ABSTRACT

BACKGROUND: Robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (iUD) has facilitated the development of several orthotopic neobladder (ON) configurations. However, comparative evidence between iON types remains limited. This study aimed to provide a head-to-head comparison between modified Bordeaux Neobladder (mBN) and Padua Ileal Bladder (PIB) in terms of surgical technique, perioperative outcomes and functional results.

METHODS: We prospectively analyzed patients from an IRB-approved database undergoing RARC with totally iON reconstruction between January 2022 and July 2025. Eligible patients had muscle-invasive bladder cancer or BCG-refractory high-grade NMIBC and received either mBN or PIB reconstruction by a single experienced robotic surgical team. Outcomes included operative time, transfusion rates, perioperative and early postoperative complications, diversion-related morbidity and continence recovery assessed through 3-day voiding diaries. Continuous variables were compared with Student’s t-test, while categorical variables with χ² Fisher’s Exact Tests. Functional recovery was compared via Kaplan-Meier analyses and log-rank tests. A two-sided P value <0.05 was considered statistically significant.

RESULTS: Seventy-nine patients were included (38 mBN; 41 PIB). Baseline characteristics were comparable. Operative time (286±45 vs. 297±33 min; P=0.18), transfusion rates (11% vs. 17%; P=0.31) and hospital stay (7±7 vs. 6±3 days; P=0.41) showed no significant differences. Perioperative and 30-day complication rates were similar, as were 90-day outcomes. Uretero-ileal leakages (3% vs. 12%; P=0.12) and strictures (11% vs. 12%; P=1.00) occurred infrequently in both groups. Day- and night-time continence recovery and intermittent self-catheterization rates (8% vs. 15%; P=0.28) were comparable.

CONCLUSIONS: In this single-center observational cohort, the modified Bordeaux Neobladder demonstrated perioperative and early functional outcomes comparable to those of the Padua Ileal Bladder after RARC with intracorporeal orthotopic diversion. These findings require confirmation in larger multicenter studies with longer follow-up and objective functional assessment.

PMID:42438988 | DOI:10.23736/S2724-6051.26.06906-5

Eur J Paediatr Dent. 2026 Jul 1:1. doi: 10.23804/ejpd.2026.2560. Online ahead of print.

ABSTRACT

AIM: In paediatric dentistry, it is essential to investigate the individual risk factors for caries development and to assign each patient a risk category for the onset of new lesions. This approach is crucial to planning personalised preventive and therapeutic strategies. This study aims to develop a simple and reproducible caries risk assessment index, designed for daily use by dental hygienists and assistants to support consistent monitoring of patients’ caries risk in clinical practice.

MATERIALS: This cross-sectional observational study was conducted following a comprehensive literature review to identify evidence-based caries risk indicators. A simplified caries risk assessment tool was developed and structured into a colour-coded evaluation grid. The tool was tested in a paediatric clinical setting on 494 patients aged 0-16 years, of whom 417 met the inclusion criteria and were analysed. Each assessment was completed by a dentist, dental assistant or dental hygienist after standardised training. Descriptive statistics were applied to evaluate the distribution of risk scores and associated variables.

CONCLUSION: The simplified tool demonstrated good applicability in routine paediatric care and enabled consistent identification of individual caries risk profiles. Its ease of use and visual scoring system make it suitable for implementation in daily practice, including by trained non-dental personnel, supporting preventive strategies and early intervention.

PMID:42438975 | DOI:10.23804/ejpd.2026.2560

Glob Health Action. 2026 Dec;19(1):2698916. doi: 10.1080/16549716.2026.2698916. Epub 2026 Jul 13.

ABSTRACT

BACKGROUND: The psychological impact of disasters extends beyond directly exposed populations to those indirectly affected through close social networks. Sex is a critical factor of post-trauma outcomes, yet its role in shaping the mental health of indirectly exposed individuals remains underexplored.

OBJECTIVE: This study investigates sex-based disparities in psychosocial distress among a cohort remotely exposed to a major earthquake.

METHODS: Approximately 3 months after the 2023 Kahramanmaras earthquakes, 129 Turkish medical students with indirect exposure (e.g. via affected relatives or close social circles) took part in this cross-sectional study, completing a structured anxiety survey and a self-report form. The self-report form assessed academic stress, health behaviors (smoking, alcohol use, exercise, and nutrition status), and lifestyle factors.

RESULTS: After Bonferroni correction, no variable remained statistically significant. However, using the Benjamini-Hochberg false discovery rate procedure, peer bullying was associated with sex (χ²(3) = 13.581, p_FDR = .046, Cramer’s V = 0.324). All other chi-square tests were nonsignificant under both correction methods.

CONCLUSION: After rigorous correction, sex differences were largely attenuated. Peer bullying showed a possible association under FDR, but not under Bonferroni, suggesting the need for larger confirmatory studies.

PMID:42438926 | DOI:10.1080/16549716.2026.2698916

Pediatr Int. 2026 Jan-Dec;68(1):e70482. doi: 10.1111/ped.70482.

ABSTRACT

BACKGROUND: Weight changes following gluten-free diet (GFD) initiation in children with celiac disease remain debated. The diet corrects malabsorption in underweight children but may promote excessive weight gain in those diagnosed at normal weight. We examined whether weight gain on the GFD represents physiological recovery or emerging obesity risk in a Turkish pediatric cohort.

METHODS: We retrospectively analyzed 117 children diagnosed with celiac disease between 2015 and 2025. Patients were stratified by dietary adherence: strict (n = 56), partial (n = 44), and non-adherent (n = 17). Adherence was assessed via clinical symptoms, tissue transglutaminase serology, and patient interviews. Body mass index (BMI) and height-for-age z-scores were calculated at diagnosis and follow-up (minimum 12 months) per WHO 2007 Growth Reference standards.

RESULTS: BMI z-scores increased significantly only in the strict adherence group (median Δ +0.27, p = 0.036), while partial adherence (p = 0.451) and non-adherence (p = 0.579) groups showed no significant change. Between-group comparison was not significant (p = 0.326). Height-for-age z-scores showed no significant change in the strict adherence group (p = 0.247); BMI gains reflected disproportionate weight gain rather than proportional growth recovery. Six patients (5.1%) exceeded the obesity threshold (z-score > +2) during follow-up.

CONCLUSION: Weight gain occurred primarily with strict GFD adherence. Without corresponding linear growth improvement, BMI increases in strictly adherent children may not represent catch-up growth alone. Low obesity frequency may reflect traditional Turkish dietary patterns. Dietary counseling for celiac patients should extend beyond gluten avoidance to address overall nutritional balance.

PMID:42438923 | DOI:10.1111/ped.70482

Pediatr Int. 2026 Jan-Dec;68(1):e70477. doi: 10.1111/ped.70477.

ABSTRACT

BACKGROUND: This study aimed to validate our therapeutic strategy for the nonselective conservative treatment of pediatric acute appendicitis.

METHODS: This single-center retrospective comparative study was conducted using the data of 368 patients with acute appendicitis. Two therapeutic strategies were compared: emergent open appendectomy (early group, n = 138 patients; 2007-2011) and conservative antibiotic treatment (late group, n = 230; 2012-2023). Both strategies were nonselectively applied, regardless of the degree of disease progression.

RESULTS: None of the patients in the late group required admission to the intensive care unit or experienced mortality. Compared with the early group, the late group had a significantly longer duration of hospitalization (5 vs. 7 days; p = 0.0017) and a higher rate of non-planned readmission after initial admission (2% vs. 13%; p = 0.0004). Surgery was performed on a nonworking day for 26% of patients and at night for 59% of patients in the early group. However, subsequent interval appendectomy for patients in the late group was not performed on a nonworking day or at night.

CONCLUSIONS: Nonselective conservative treatment with antibiotics was safe for managing acute appendicitis in children and eliminated the need for surgery at night and during nonworking days, despite longer duration of the initial hospitalization and the higher rate of readmission.

PMID:42438921 | DOI:10.1111/ped.70477

Korean J Intern Med. 2026 Jul;41(4):734-747. doi: 10.3904/kjim.2025.375. Epub 2026 Jul 1.

ABSTRACT

BACKGROUND/AIMS: The optimal adjuvant chemotherapy and anti-human epidermal growth factor receptor 2 (HER2) therapy regimen following surgery for T1a/b HER2-positive breast cancer remains debatable.

METHODS: In this single-center retrospective analysis, we examined the postoperative treatment strategies for patients diagnosed with T1a/b node-negative HER2-positive breast cancer. Invasive breast cancer-free survival (IBCFS), invasive disease-free survival, and overall survival (OS) were compared between patients who received chemotherapy only, chemotherapy plus anti-HER2 therapy, and neither adjuvant treatment.

RESULTS: The analysis included 165 patients, with a median follow-up duration of 98.4 (25.8-238.5) months. Patients who did not receive any adjuvant therapy had a 15-year IBCFS rate of 86.9%, and those who received only chemotherapy exhibited a rate of 77.6%. Conversely, those who received both trastuzumab and chemotherapy had the highest 15-year IBCFS rate of 97.4%, although the difference between the treatment groups was not statistically significant (p = 0.492). Among patients with T1a tumors, chemotherapy plus anti-HER2 therapy showed the most favorable long-term IBCFS, with a 15-year rate of 100%, compared with 57.5% in the chemotherapy-only group and 79.8% in the no-treatment group (p = 0.363). The 15-year OS rate was 100% in both chemotherapy-containing treatment groups, compared with 90.4% in the no-treatment group (p = 0.068).

CONCLUSION: In this retrospective cohort of patients with HER2-positive T1a/bN0 breast cancer, anti-HER2-containing adjuvant treatment was associated with numerically favorable long-term outcomes, particularly among those with T1a tumors. Given the retrospective study design and limited number of events, these findings should be interpreted cautiously.

PMID:42438913 | DOI:10.3904/kjim.2025.375

Korean J Intern Med. 2026 Jul;41(4):597-619. doi: 10.3904/kjim.2025.301. Epub 2026 Jul 1.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has highlighted a complex, bidirectional relationship between SARSCoV-2 infection and autoimmune diseases. This review examines how SARS-CoV-2 infection influences the incidence, progression, and outcomes of five major autoimmune conditions: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and Guillain-Barré syndrome. Patients with autoimmune diseases are at increased risk of severe COVID-19 due to intrinsic immune dysregulation and the use of immunosuppressive therapies, both of which impair antiviral host defenses. Conversely, COVID-19 has been implicated in the initiation and exacerbation of autoimmune responses through mechanisms such as molecular mimicry and bystander activation. Concerns have also arisen regarding the safety and efficacy of COVID-19 vaccines in immunocompromised populations. Although vaccines are generally tolerated in these individuals, certain immunosuppressive therapies may attenuate humoral and cellular immune responses. Strategies such as adjusting immunosuppressive regimens and optimizing the timing of vaccination have been proposed to improve vaccine efficacy. Disease-specific considerations are essential to balance infection risk with adequate control of autoimmune activity. Overall, this review underscores the importance of individualized treatment strategies, close clinical monitoring, and interdisciplinary care in managing patients with autoimmune diseases during the COVID-19 pandemic. A deeper understanding of these interactions will be critical for improving patient outcomes and preparing for future pandemics involving immune-mediated diseases.

PMID:42438903 | DOI:10.3904/kjim.2025.301