Category: Statistics

Cureus. 2023 Apr 11;15(4):e37448. doi: 10.7759/cureus.37448. eCollection 2023 Apr.

ABSTRACT

BACKGROUND: Refractive error is the most common cause of decreased visual acuity. Refractive measurement in adults consists of cycloplegic (objective) and manifest (subjective) refraction. Although the effectiveness of autorefraction is a crucial factor, there needs to be more information on its accuracy and precision on each autorefractor compared with subjective measurement in Thai patients.

OBJECTIVE: To compare the accuracy and precision of the two autorefractors’ findings in Rajavithi Hospital, OptoChek Plus, and TOMEY Auto Refractometer RC-5000, with each other and with those of the subjective method.

MATERIALS & METHODS: An observational study was conducted at the Ophthalmology clinic in Rajavithi Hospital from March 1, 2021, to March 31, 2022. All subjects were tested using the two autorefractors (OptoChek Plus and TOMEY Auto Refractometer RC-5000) and subjective refraction. One eye per subject was included in the study.

RESULTS: Forty-eight patients (48 eyes) were enrolled in the study. The difference between spherical powers obtained by OptoChek and subjective refraction was not significantly different; however, there was a significant difference between those calculated by Tomey and the subjective method (p=0.77, p=0.04 respectively). The variations between cylindrical powers arrived at by the two autorefraction techniques and those calculated by the subjective method were significantly different (OptoChek and Tomey p-=0.01, p-value<0.001, respectively). In addition, 95% of the limit of agreement (95% of LOA) was low in the cylindrical measurement of each autorefractor compared with subjective refraction. (84.61%, 86.36%, respectively). No statistically significant difference between the spherical equivalent calculated by the two autorefractors and that of subjective refraction was observed in the present study (OptoChek: p-value=0.26 and Tomey: p-value=0.77).

CONCLUSIONS: There was a clinically significant difference between the cylindrical power calculated by the two autorefractors and those obtained from subjective refraction. Patients with high astigmatism should be monitored closely when measured by autorefractors, as there can be a slightly lower agreement between objective and subjective refraction.

PMID:37182059 | PMC:PMC10174683 | DOI:10.7759/cureus.37448

Cureus. 2023 Apr 11;15(4):e37432. doi: 10.7759/cureus.37432. eCollection 2023 Apr.

ABSTRACT

Background Chatbots are computer programs that use artificial intelligence (AI) and natural language processing (NLP) to simulate conversations with humans. One such chatbot is ChatGPT, which uses the third-generation generative pre-trained transformer (GPT-3) developed by OpenAI. ChatGPT has been praised for its ability to generate text, but concerns have been raised about its accuracy and precision in generating data, as well as legal issues related to references. This study aims to investigate the frequency of AI hallucination in research proposals entirely drafted by ChatGPT. Methodology An analytical design was employed to investigate AI hallucination by ChatGPT. A total of 178 references listed by ChatGPT were verified for inclusion in the study. Statistical analysis was performed by five researchers who entered their data into a Google Form, and the final results were represented using pie charts and tables. Results Out of the 178 references analyzed, 69 references did not have a Digital Object Identifier (DOI), and 28 references neither turned up on Google search nor had an existing DOI. Three references were listed from books and not research articles. These observations suggest that ChatGPT’s ability to generate reliable references for research topics may be limited by the availability of DOI and the accessibility of online articles. Conclusions The study highlights the potential limitations of ChatGPT’s ability to generate reliable references for research proposals. AI hallucination is a problem that may negatively impact decision-making and may give rise to ethical and legal problems. Improving the training inputs by including diverse, accurate, and contextually relevant data sets along with frequent updates to the training models could potentially help address these issues. However, until these issues are addressed, researchers using ChatGPT should exercise caution in relying solely on the references generated by the AI chatbot.

PMID:37182055 | PMC:PMC10173677 | DOI:10.7759/cureus.37432

Cureus. 2023 Apr 11;15(4):e37442. doi: 10.7759/cureus.37442. eCollection 2023 Apr.

ABSTRACT

Osteosarcomas are a type of bone cancer that typically affect young adults, often in the bones of the arms and legs. To treat osteosarcoma, doctors typically use a combination of chemotherapy, radiotherapy, and surgery, with External Beam Radiation Therapy (EBRT) being the most commonly used form of radiotherapy. EBRT involves directing high-energy photons, X-rays, gamma rays, protons, and electrons at the tumor to induce cancer cell death. Additionally, healthcare providers use imaging techniques to monitor treatment success. This literature review aims to explore the relationship between osteosarcomas and EBRT, investigate the impact of the delayed diagnosis on survival rates, and examine the effectiveness of innovative uses of EBRT for treating osteosarcomas in unusual locations using comprehensive diagnostic techniques. To achieve these objectives, the review examines case studies and literary analyses and categorizes them based on the delay between symptom onset and diagnosis. The null hypothesis is that the presence or absence of a delay in diagnosis does not significantly impact outcomes for the “Delay” category. A lack of delay results in a more favorable outcome in the “Lack of Delay” category. However, the data and statistical results suggest that additional follow-up care in patients with rare or commonly recurring cancers could benefit outcomes. It is important to note that due to the rarity of osteosarcoma with EBRT, the small sample size in the studies warrants further investigation. Interestingly, many patients presented with head and neck tumors despite the most common location of osteosarcoma being in the long bones.

PMID:37182042 | PMC:PMC10174335 | DOI:10.7759/cureus.37442

Cureus. 2023 Apr 11;15(4):e37426. doi: 10.7759/cureus.37426. eCollection 2023 Apr.

ABSTRACT

Background The orthopedic surgery workforce constitutes a vital role in the healthcare system, with data being scarce. Therefore, through this study, we share an overview of the orthopedic workforce distribution, demographic trends, and changes over the past decade in Saudi Arabia. Methods All practicing orthopedic surgeons in Saudi Arabia from January 1, 2010, to December 31, 2021, were included in the study. Data regarding orthopedic surgeons’ demographics and numbers were obtained from the Saudi Commission for Health Specialties (SCFHS), whereas the data related to the geographical distribution of orthopedic surgeons was obtained from the Ministry of Health Statistical Yearbook of 2020. Results The ratio of orthopedic surgeons per 100,000 people was 5.42 in 2010, which grew subsequently to 12.29 in 2021. The number of Saudi orthopedic surgeons has been noticeably rising through the years, while a slowly growing pattern can be seen among non-Saudi orthopedic surgeons. In addition, the highest ratios of orthopedic surgeons per 100,000 were in Makkah (1.72), Riyadh (1.26), and the Eastern Region (1.06). Conclusion In this study, we demonstrate the progress of the orthopedic workforce in Saudi Arabia over a period of 12 years. The number of orthopedic surgeons per 100,000 people showed a significant rise due to several factors, one of which is road traffic accidents. Also, although the number of female orthopedic surgeons has been rising lately, they are still much fewer than males in this field. In addition, Saudi Arabia has been developing a new healthcare system via the privatization of some of the governmental hospitals, which will lead to changes in the future workforce and its accommodations.

PMID:37182036 | PMC:PMC10173370 | DOI:10.7759/cureus.37426

Cureus. 2023 Apr 11;15(4):e37447. doi: 10.7759/cureus.37447. eCollection 2023 Apr.

ABSTRACT

Background The outcomes after fixation of the supracondylar humerus fracture (SCHF) are not documented in the current literature. In our study, we endeavour to determine the factors that influence the functional outcome and gauge their respective impact. Methodology We retrospectively reviewed the outcomes of patients who presented to our tertiary care centre (Royal London Hospital) with SCHFs between September 2017 and February 2018. We analysed patient records to assess several clinical parameters, including age, Gartland’s classification, comorbidities, time to treatment, and fixation configuration. We conducted a multiple linear regression analysis to determine each of the clinical parameter’s impact on the functional and cosmetic outcome, as reflected in Flynn’s criteria. Results We included 112 patients in our study. Pediatric SCHFs had good functional outcomes based on Flynn’s criteria. There was no significant statistical difference in functional outcomes with respect to sex (p= 0.713), age (p= 0.96), fracture type (p= 0.14), K-wire configuration (p=0.83), and time elapsed since surgery (p= 0.240). Conclusions Our results demonstrate that good functional outcomes can be expected with paediatric SCHFs based on Flynn’s criteria, regardless of age at injury, sex, or pin configuration, provided satisfactory reduction is achieved and maintained. The only variable with statistical significance was Gartland’s grade; Grades III and IV were correlated with poorer outcomes.

PMID:37182015 | PMC:PMC10174634 | DOI:10.7759/cureus.37447

Cureus. 2023 Apr 10;15(4):e37394. doi: 10.7759/cureus.37394. eCollection 2023 Apr.

ABSTRACT

BACKGROUND: As the general population is expanding their choices regarding healthcare, many are opting for complementary and alternative medicine (CAM) in addition to or instead of conventional modes of treatment, for the management of various health conditions.

AIMS: This study investigated the utilization of CAM for the management of various cardiovascular diseases as well as its risk factors among the adult population in Ajman, UAE.

MATERIALS AND METHODS: The study was conducted upon receiving approval from the Institutional Review Board (IRB). This cross-sectional study was conducted by administering an interviewer-administered questionnaire, consisting of three domains aimed at assessing the sociodemographic features and use of CAM and factors associated with the use among the respondents. A total of 414 responses were collected from adults residing in Ajman, UAE, who consented to participate in the study. A chi-square test was performed on Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 27.0, Armonk, NY) to assess the association between the use of CAM and factors. Statistical significance was set to p ≤ 0.05.

RESULTS: Out of 414 participants in the study, 57% of the participants used CAM before, while 43% of the participants never used CAM. Among the CAM users, 23% used it for anxiety and stress, 7.6% utilized it for the management of hypertension, 3.3% used it for high cholesterol, 3.1% for obesity, 1.9% for chronic kidney disease, 0.9% used it for diabetes mellitus, 0.5% used it for stroke, and 0.5% used it for heart failure.

CONCLUSIONS: From the results of the study, it can be concluded that the majority (57%) of the participants have used CAM before. Most of the participants utilized CAM to manage chronic conditions (81.9%).

PMID:37182011 | PMC:PMC10171885 | DOI:10.7759/cureus.37394

Front Immunol. 2023 Apr 27;14:1133656. doi: 10.3389/fimmu.2023.1133656. eCollection 2023.

ABSTRACT

BACKGROUND: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) has significant morbidity and mortality and is associated with the induction of cytokines/chemokines, which might contribute to the pathogenesis of liver injury. This study aimed to explore the cytokine/chemokine profiles of patients with HBV-ACLF and develop a composite clinical prognostic model.

METHODS: We prospectively collected blood samples and the clinical data of 107 patients with HBV-ACLF admitted to the Beijing Ditan Hospital. The concentrations of 40-plex cytokines/chemokines were measured in 86 survivors and 21 non-survivors using the Luminex assay. Discrimination between the cytokine/chemokine profiles in different prognosis groups was analyzed using the multivariate statistical techniques of principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). An immune-clinical prognostic model was obtained using multivariate logistic regression analysis.

RESULTS: The PCA and PLS-DA indicated that cytokine/chemokine profiling could clearly distinguish patients with different prognoses. A total of 14 cytokines, namely, IL-1β, IL-6, IL-8, IL-10, TNF-α, IFN-γ, CXCL1, CXCL2, CXCL9, CXCL13, CX3CL1, GM-SCF, CCL21, and CCL23, were significantly correlated with disease prognosis. Multivariate analysis identified CXCL2, IL-8, total bilirubin, and age as independent risk factors that constituted the immune-clinical prognostic model, which showed the strongest predictive value of 0.938 compared with those of the Chronic Liver Failure Consortium (CLIF-C) ACLF (0.785), Model for End-Stage Liver Disease (MELD) (0.669), and MELD-Na (0.723) scores (p < 0.05 for all).

CONCLUSION: The serum cytokine/chemokine profiles correlated with the 90-day prognosis of patients with HBV-ACLF. The proposed composite immune-clinical prognostic model resulted in more accurate prognostic estimates than those of the CLIF-C ACLF, MELD, and MELD-Na scores.

PMID:37180134 | PMC:PMC10172591 | DOI:10.3389/fimmu.2023.1133656

Front Immunol. 2023 Apr 27;14:1176403. doi: 10.3389/fimmu.2023.1176403. eCollection 2023.

ABSTRACT

INTRODUCTION: The prevalence of obesity in general pediatric population increases without sparing children with T1D. We intended to find factors associated with the possibility of preserving endogenous insulin secretion in individuals with long-standing T1D. At onset, higher BMI is associated with higher C-peptide level, which may indicate to be one of the favorable factors involved in preserving residual β-cell function. The study determines the influence of BMI on C-peptide secretion in children newly diagnosed with T1D in two years observation.

METHODS: We assessed the possible relationship between selected pro- and anti-inflammatory cytokines, body mass at recognition and β-cell function status. 153 pediatric patients with newly diagnosed T1D were divided into quartiles according to BMI-SDS index. We separated a group consisted of patients with BMI-SDS >1. Participants were followed up for two years and examined for changes in body weight, HbA1c, and insulin requirement. C-peptide was assessed at baseline and after two years. We evaluated the patients’ levels of selected inflammatory cytokines at baseline.

RESULTS: Subjects with higher BMI-SDS presented higher serum C-peptide levels and lower insulin requirements at diagnosis than children with lower body weight. The two-year follow-up showed that C-peptide levels of obese patients dropped more rapidly than in children with BMI-SDS within normal limits. The group with BMI-SDS >1 showed the greatest decrease in C-peptide level. Despite statistically insignificant differences in HbA1c at diagnosis between the study groups, in the fourth quartile and BMI-SDS >1 groups, HbA1c as well as insulin requirements increased after two years. The levels of cytokines varied the most between BMI-SDS <1 and BMI-SDS >1 groups and were significantly higher within BMI-SDS >1 group.

DISCUSSION: Higher BMI, associated with enhanced levels of inflammatory cytokines, relates to preservation of C-peptide at T1D recognition in children but is not beneficial in the long term. A decrease in C-peptide levels combined with an increase in insulin requirements and in HbA1c among patients with high BMI occur, which may indicate a negative effect of excessive body weight on the long term preservation of residual β-cell function. The process seems to be mediated by inflammatory cytokines.

PMID:37180128 | PMC:PMC10174309 | DOI:10.3389/fimmu.2023.1176403

Front Vet Sci. 2023 Apr 27;10:1167387. doi: 10.3389/fvets.2023.1167387. eCollection 2023.

ABSTRACT

Artificial insemination (AI) is the first and the most used biotechnologies in reproduction all over the world. Many studies reported the beneficial role of gonadotropin-releasing hormone (GnRH) administrated some hours before the AI or at the artificial insemination time. This study aimed to assess the effect of GnRH analogs given at the time of insemination on the first, second, and third AIs and to assess the economical implications of GnRH administration. We hypothesized that administration of GnRH at the time of insemination would increase ovulation and pregnancy rate. The study was conducted on small farms in northwestern Romania and included animals of the Romanian Brown and Romanian Spotted breeds. Animals in estrous at the first, second, and third inseminations were randomly divided into groups that received GnRH at insemination and groups that did not. A comparison between the groups was performed and the cost of GnRH administration to obtain one gestation was calculated. The GnRh administration increased the pregnancy rate at the first and the second inseminations by 12 and 18%, respectively. For one pregnancy, the cost of GnRH administration was approximately 49 euros for the first insemination group and around 33 euros for the second insemination group. No improvement of the pregnancy rate was observed after the GnRH administration for the cows at the third insemination, so, for this group, no economic statistics were performed.

PMID:37180075 | PMC:PMC10172496 | DOI:10.3389/fvets.2023.1167387

Front Vet Sci. 2023 Apr 25;10:1106619. doi: 10.3389/fvets.2023.1106619. eCollection 2023.

ABSTRACT

The use of co-products as a feed supplement for ruminants makes livestock sustainable and optimizes the use of available areas and animal performance. Furthermore, when cakes are used, the residual fat composition can influence ruminal metabolism and methane (CH₄) production. This study aimed to assess the effects of a diet containing cupuassu (CUP; Theobroma grandiflorum) and tucuma (TUC; Astrocaryum vulgare Mart.) cakes on intake, digestibility, serum metabolites, performance, and CH₄ emissions in confined sheep in the Amazon. Approximately 28 animals, Dorper-Santa Inês, castrated, with an average initial live weight (ILW) of 35 ± 2.3 kg, were distributed in metabolic cages, in a completely randomized design, with four treatments and seven replications: (1) Control (C40), without the addition of Amazonian cake and with 40 g of ether extract (EE)/kg of dietary dry matter (DM); (2) CUP, the inclusion of the CUP cake and 70 g of EE/kg; (3) TUC, the inclusion of the TUC cake and 70 g of EE/kg; and (4) Control (C80), without the addition of Amazonian cake and with 80 g of EE/kg of dietary DM, with roughage to concentrate ratio of 40:60. The use of the TUC cake as a feed supplement reduced the intake of DM, crude protein (CP), and EE compared to the inclusion of the CUP cake (p < 0.05); however, it increased the intake of neutral detergent fiber (NDF) by 32% (p < 0.01). The highest averages of DM (732 g/kg) and CP (743 g/kg) digestibility were presented in C40, while the highest digestibility of NDF was presented in TUC (590 g/kg). Albumin levels stayed above and protein levels were below the reference values, and the C40 diet also obtained below results for cholesterol, triglycerides and High Density Lipoprotein (HDL) (P < 0.05). Sheep fed CUP (91 g) and TUC (45 g) had lower daily weight gains (DWGs) than those fed with diets without the inclusion of cakes (C40 = 119 g; C80 = 148 g), and feed efficiency (FE) was also lower in CUP (84) and TUC (60) diets than in C40 (119) and C80 (137) diets. CH₄ emissions were lower in animals fed TUC (26 L/day) and higher in C40 (35 L/day); however, TUC resulted in higher CH₄ emissions in grams/body live weight (BW) gain/day (353 g/BW/day) vs. 183 g/BW/day (C40), 157 g/BW/day (C80), and 221 g/BW/day (CUP). The supplementation with cakes did not improve intake, digestibility and performance, did not compromise blood metabolites and did not reduce the enteric CH4 emission in confined sheep in the Amazon; however, the use of CUP cake showed similar results to the control treatments and did not increase CH₄ emissions, as occurred with the inclusion of TUC cake.

PMID:37180068 | PMC:PMC10167019 | DOI:10.3389/fvets.2023.1106619