Tag: nevin manimala

Int J Clin Pharm. 2025 Jun 10. doi: 10.1007/s11096-025-01947-7. Online ahead of print.

ABSTRACT

BACKGROUND: Pharmaceutical calculations are required elements of the Doctor of Pharmacy curriculum in the United States. With the growth of artificial intelligence chatbots, pharmacists and educators are exploring their application. The accuracy of artificial intelligence chatbots in performing pharmaceutical calculations remains unknown.

AIM: To evaluate the accuracy of artificial intelligence chatbots for pharmaceutical calculations.

METHOD: Eleven free-access chatbots were tested using 7 faculty-generated questions: 1 control, 2 creatinine clearance, 1 oral to intravenous dose conversion, 2 antibiotic pharmacokinetic dosing, and 1 number needed to harm. Descriptive statistics were used to evaluate the primary outcome, which was proportion of correct responses. Secondary outcomes included types of errors and teachability.

RESULTS: Ten (90.9%) chatbots answered the control question correctly, and all answered the dose conversion question correctly. Eight (72.7%) chatbots correctly calculated number needed to harm. Only 1 (9.1%) provided the correct antibiotic dosing, and none correctly calculated creatinine clearance. Common errors included incorrect weight selection for creatinine clearance and use of incorrect formulas. Nine (81.8%) chatbots were teachable on at least 1 question.

CONCLUSION: Artificial intelligence chatbots demonstrated limited accuracy for multi-step pharmaceutical calculations and may be more reliable for low complexity calculations.

PMID:40493330 | DOI:10.1007/s11096-025-01947-7

Am J Cardiovasc Drugs. 2025 Jun 10. doi: 10.1007/s40256-025-00738-9. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim was to systematically evaluate the effect of semaglutide on blood pressure in obese populations using meta-analysis methods.

METHODS: Randomized controlled trials on the effect of semaglutide on blood pressure regulation published from the inception of the databases to October 2024 were searched for in PubMed, Embase, the Cochrane Library, and Web of Science. Stata software was used for statistical analysis of the outcome measures in all included studies. Egger’s test was applied to assess the risk of publication bias.

RESULTS: A total of 22 studies involving 15,347 participants were included in this meta-analysis. The results showed that, compared to the control group, the semaglutide group significantly reduced systolic blood pressure (SBP) (mean difference [MD] – 2.90, 95% confidence interval [CI] – 3.70 to – 2.11; P < 0.01) and diastolic blood pressure (DBP) (MD – 0.86, 95% CI – 1.34 to – 0.38; P < 0.01). Further subgroup analysis revealed that, compared to diabetic populations, semaglutide had a more significant reduction in SBP (- 1.87, 95% CI – 2.67 to – 1.06, vs – 5.02, 95% CI – 6.10 to – 3.94) and DBP (- 0.43, 95% CI – 0.89 to 0.02, vs – 1.96, 95% CI – 3.12 to – 0.80) in non-diabetic populations. The higher dose of semaglutide (2.4 mg) was found to significantly lower SBP (MD – 4.31, 95% CI – 5.18 to – 3.44) and DBP (MD – 1.84, 95% CI – 2.70 to – 0.98), although mild heterogeneity was present. Sensitivity analysis showed that the exclusion of any single study did not significantly affect the final results.

CONCLUSION: Current evidence suggests that semaglutide can lower SBP and DBP, and increasing the dosage can enhance the blood pressure-lowering effect.

PMID:40493329 | DOI:10.1007/s40256-025-00738-9

J Epidemiol Glob Health. 2025 Jun 10;15(1):82. doi: 10.1007/s44197-025-00420-y.

ABSTRACT

BACKGROUND: Despite a high burden of injuries in low-income and middle-income countries (LMICs), a lack of empirical evidence on mechanism, location, and distribution of unintentional injuries requiring medical attention (hereafter injuries) hinders informed health system policy development.

METHODS: Using individual-level data from nationally representative surveys conducted in LMICs between 2014-2019, we describe the weighted annual prevalence of non-fatal injuries, their mechanisms, environments in which they occur, and characteristics of people injured, in individuals aged 15-64 years. Multivariable logistic regression models were estimated to evaluate associations of injuries with individual-level characteristics.

RESULTS: We included data on 47,747 participants from 12 LMICs in four WHO regions. The weighted prevalence of non-fatal injuries in the past year was 6.8% (95% CI: 6.3%-7.2%); men suffered a greater prevalence of injuries than women (8.3% [95% CI 7.6%-9.0%] vs. 5.4% [95% CI 5.0%-5.9%], respectively). In the multivariable logistic regression, the odds of having any injury were lower among females and married people and higher among individuals with some primary education. Prevalence of non-road traffic collision injuries was almost threefold that of road traffic collision (RTC) injuries: 5.6% (5.2%-6.0%) vs. 1.7% (1.5%-2.0%). When considering non-RTC injuries, falls were the most common mechanism (47.0%, 95% CI 44.0%-50.1%), and homes were the most common location (38.1%, 95% CI 34.9%-41.4%), followed by road (17.9%, 95% CI 15.7%-20.4%), and workplace (17.4%, 95% CI 15.2%-19.8%). The largest proportion (23.2%, [95% CI 20.6%-25.9%]) of non-RTC injuries happened to women at home.

CONCLUSION: Non-RTC injuries, in particular falls, predominate in this population. This highlights a neglected side of injuries, many of which happen at home to women, whereas global attention tends to focus on RTCs. Data on all mechanisms of injuries and care-seeking behaviour after injuries are required for health system planning.

PMID:40493309 | DOI:10.1007/s44197-025-00420-y

Egypt Heart J. 2025 Jun 10;77(1):57. doi: 10.1186/s43044-025-00651-1.

ABSTRACT

BACKGROUND: Acute type A aortic dissection is a rapidly progressive and life-threatening condition. Without timely surgical intervention, the mortality rate can reach up to 50% within the first 48 h. Although surgery remains the primary effective treatment, it is associated with significant complexity and potential risks, particularly in managing the aortic root, where both intraoperative and postoperative bleeding complications are common. This study aims to evaluate the efficacy of the modified “sandwich” technique using a synthetic vascular patch for aortic root reconstruction in acute type A aortic dissection surgery.

METHODS: A retrospective analysis was conducted on the clinical data of 28 patients with acute type A aortic dissection who underwent aortic root reconstruction using the modified “sandwich” technique with synthetic vascular patches at the Department of Cardiovascular Surgery, the Third Hospital of Hebei Medical University, from October 2020 to November 2022. All patients underwent surgical treatment, during which the modified “sandwich” technique was applied for aortic root reconstruction. Statistical analysis was performed on operative time, cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, postoperative drainage volume, perioperative mortality, and complications.

RESULTS: All 28 patients underwent successful surgery with a cardiopulmonary bypass (CPB) time of 265.0 (210.0-322.5) min, an aortic cross-clamping (ACC) time of 151.0 (112.0-209.0) min, and a drainage flow rate of 237.5 (126.0-297.0) mL at 12 h postoperatively. There were 2 (7.1%) perioperative deaths caused by renal failure, ischemia in 1 case, and coronary artery causes in 1 case. Postoperative complications included reopening of the chest for hemostasis in 1 case (3.6%) for reasons unrelated to the vascular anastomosis, hemodialysis in 3 cases (10.7%), paraplegia in 1 case (3.6%), and cerebral infarction resulting in impaired mobility of the left upper extremity in 1 case (3.6%). Tracheotomy was performed in 1 case (3.6%), and the duration of mechanical ventilation was 89 (48.0-165) h. Among the 26 recovered patients reviewed with aortic enhancement CT before discharge, the artificial vascular anastomosis had smooth blood flow, though 1 case still had residual entrapment in the sinus of the aorta.

CONCLUSION: In acute type A aortic dissection surgery, the “modified sandwich” technique using an artificial vascular sheet for aortic root shaping is simple, effective, and easy to master. This method can reduce anastomotic blood seepage and prevent anastomotic tear and bleeding, making it worth recommending for clinical application.

PMID:40493299 | DOI:10.1186/s43044-025-00651-1

Infection. 2025 Jun 10. doi: 10.1007/s15010-025-02580-2. Online ahead of print.

ABSTRACT

BACKGROUND: Clostridioides difficile infection (CDI) poses a significant healthcare challenge, with the most frequent cause being antibiotic-associated diarrhea, affecting hospitalized individuals with substantial cost and mortality concerns. However, there is no information regarding probiotic efficiency for initial CDI treatment, and the modulation of microbiota by probiotics has been suggested as a potential preventive measure against CDI.

OBJECTIVE: To evaluate the efficacy of probiotics in preventing CDI in hospitalized patients.

METHODS: An exhaustive literature search was performed using PubMed to identify controlled/clinical trials investigating the use of probiotics for CDI prevention among hospitalized individuals based on PRISMA guidelines and the PICO framework. Relevant data were extracted from selected studies. Statistical meta-analysis (subgroup or sensitivity analyses) was performed using R Studio to calculate the pooled effect size, odds ratio (OR) with a 95% CI, p-value, and heterogeneity. The risk of bias was assessed using the Cochrane risk-of-bias (RoB) tool to determine publication bias and sensitivity of the included studies.

RESULTS: Four studies with a significant number of participants were identified and included in the meta-analysis. The incidence of CDI was reduced in the probiotic group compared to the placebo group, with an overall OR of 0.99 (95% CI [0.56; 1.7]), increased heterogeneity, and a non-significant p-value, using a random effects model in R Studio. Subgroup analysis suggested possible beneficial outcomes regarding the selection of probiotic strain and dose regimen, supporting the effective use of probiotics in preventing CDI. Two of the included studies showed a high risk of bias in the randomization process, while others indicated a significantly low risk of bias.

CONCLUSION: Detailed or systematic information on CDI treatment provides evidence that the direction of the odds ratio suggests a possible protective role of probiotics, although the overall effect was not significant. The OR < 1.0 indicates a neutral efficiency of probiotics, on CDI incidence observed in the probiotics group compared to the placebo group.

PMID:40493294 | DOI:10.1007/s15010-025-02580-2

J Epidemiol Glob Health. 2025 Jun 10;15(1):81. doi: 10.1007/s44197-025-00417-7.

ABSTRACT

PURPOSE: This study aims to describe the social-relational context of adolescents and young adults living with (AYALHIV) and without HIV (AYAHIV-) in the city of Beira (Mozambique) and to assess how it can impact their mental health.

METHODS: A cross-sectional study with three-level assessment was conducted between July and August 2023. Socio-economic factors were assessed through an ad-hoc questionnaire, mental health through symptom Checklist-90 (SCL-90), and social-relational networks using social network analysis (SNA). SNA parameters included were: average degree centrality, closeness centrality, betweenness centrality, eigenvector centrality and transitivity. Robust linear regression model was used to assess association between SNA parameters and SCL-90 scores.

RESULTS: AYAs involved were 352 (F: 50.7%) and 341 (96.9%) completed both sociogram and SCL-90. Average degree centrality was 1.44 (SD 0.77) for supportive networks (supSN) and 0.49 (SD 0.39) for stressful ones (strSN). The average degree centrality was higher in AYAHIV- compared to AYALHIV (0.009). Supportive edges occurred more often between the individual and their mother (65.1%), while stressful edges between one (24.3%) or two (18.8%) neighbourhood people. The supSN betweenness was 0.27 (SD 0.24) in females and was significantly lower compared to males (0.33, SD 0.27, p = 0.017). The mean score at the SCL-90 was 1.1 (SD 0.5). An increase in 1 SD of the average degree centrality of the supSN was associated with a decrease of 0.14 SD at the SCL-90 (p = 0.014). The SCL-90 score was significantly lower in males (p = 0.045) and in AYAs from the high socio-economic group (p = 0.009).

CONCLUSION: Two groups proved to be more vulnerable with regard to socio-relational networks, women and AYALHIV. Better interconnected social support networks were associated with better mental health (i.e. lower scores on the SCL-90). Improving support within the community is therefore important for achieving better mental well-being for all.

PMID:40493276 | DOI:10.1007/s44197-025-00417-7

Res Health Serv Reg. 2025 Jun 10;4(1):7. doi: 10.1007/s43999-025-00066-0.

ABSTRACT

INTRODUCTION: The German hospital reform introduces population-based planning to allocate hospital budgets, considering each hospital’s role in meeting regional care needs. However, current hospital case numbers may reflect supply-side factors, such as physician density and socioeconomic disparities, rather than actual morbidity. Ambulatory care utilization inversely correlates with hospital usage, emphasizing the need to integrate ambulatory sector data into hospital planning. This study examines factors influencing hospital and office-based case numbers at the district level.

METHODS: Linking 2021 data from the Federal and State Statistical Offices, INKAR data and health insurance claims data in Germany at the district level, a multiple linear regression model assessed the association between case counts in hospitals or office-based practices per 10,000 residents and distance to the nearest general practitioner (GP), as well as hospital bed and GP density. The Global Moran’s I as well as a geographically weighted regression (GWR) analysis were conducted to assess regional differences.

RESULTS: Multiple linear regression revealed that greater GP distance, fewer GPs and more hospital beds were linked to more hospital cases, while office-based cases rose with shorter GP distance. Global Moran’s I confirmed spatial clustering, and GWR revealed heterogeneous effects of primary-care access on hospital admissions, whereas bed capacity uniformly increased hospital cases and shorter GP distances consistently predicted more office visits across Germany.

DISCUSSION: Our findings align with research showing supply-induced demand of hospital cases and emphasize the need for coordinated hospital and ambulatory care planning to improve access, reduce unnecessary hospital admissions, and optimize patient outcomes.

PMID:40493273 | DOI:10.1007/s43999-025-00066-0

J Mater Sci Mater Med. 2025 Jun 10;36(1):50. doi: 10.1007/s10856-025-06899-y.

ABSTRACT

The rapid advancement of three-dimensional (3D) printing in dentistry has prompted comparisons between the mechanical properties of polylactic acid (PLA) samples fabricated using material extrusion (MEx) and resin samples produced using digital light processing (DLP). This study aims to assess the potential of replacing resin-based models with PLA models in clinical settings by evaluating the mechanical properties and accuracy of MEx-printed PLA and DLP-printed resin samples. The investigated materials include pure PLA, a PLA composite containing gypsum, and a clinically approved resin material. Strength and hardness tests were conducted using custom-made samples measuring 16 × 4 × 2 mm³. Additionally, oral cavity scans were used to generate oral models for each material to assess their accuracy, trueness, and precision. The results indicated that pure PLA exhibited the highest flexural modulus (2055 ± 217.70 MPa) and compression modulus (2.40 ± 0.14 GPa). The PLA-Gypsum composite displayed the highest hardness (19.48 ± 2.12 HV1). As for the trueness of the oral models, there were no statistically significant differences between the models made from the three materials. However, the PLA-Gypsum composite demonstrated the best precision (23.84 ± 4.12 μm). These findings suggest that both PLA materials have significant potential to replace DLP-produced resin models in the clinical applications.

PMID:40493269 | DOI:10.1007/s10856-025-06899-y

Lasers Med Sci. 2025 Jun 10;40(1):267. doi: 10.1007/s10103-025-04523-7.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the effectiveness of photodynamic therapy (PDT) in reducing lipopolysaccharides (LPS) and lipoteichoic acid (LTA) levels in secondary endodontic infections and assess their correlation with clinical symptoms.

MATERIALS & METHODS: Seventy patients requiring nonsurgical endodontic retreatment were selected for this study and divided into two groups: one group received photodynamic therapy (PDT), while the other was treated with sodium hypochlorite (NaOCl). Using ELISA and chromogenic assays, endodontic samples were collected to measure lipoteichoic acid (LTA) levels and lipopolysaccharides (LPS). Strict aseptic techniques and contamination prevention measures were adhered to throughout the procedures. The data were analyzed using SPSS version 26, applying descriptive statistics and significance tests with a p-value threshold of 0.05, a 95% confidence level, and 80% power.

RESULTS: The study found that photodynamic therapy significantly reduced lipoteichoic acid and lipopolysaccharides levels compared to sodium hypochlorite irrigation, with mean changes of 253.78 and 154.35 (p = 0.02). Additionally, a significant mean reduction in lipopolysaccharide levels favored PDT (p = 0.013). Symptomatic patients exhibited a higher mean level of lipoteichoic acid (507.48) than asymptomatic patients (210.14, p = 0.001). However, no significant correlation was found between lipopolysaccharide levels and symptoms (p = 0.606). Endodontic infections and to assess their correlation with clinical symptoms.

CONCLUSION: This study shows that photodynamic therapy (PDT) significantly reduces lipoteichoic acid and lipopolysaccharides levels, outperforming sodium hypochlorite irrigation in secondary apical periodontitis management. It also reveals a strong correlation between higher lipoteichoic acid levels and clinical symptoms, with no significant link found for lipopolysaccharide levels.

PMID:40493268 | DOI:10.1007/s10103-025-04523-7

Oral Maxillofac Surg. 2025 Jun 10;29(1):120. doi: 10.1007/s10006-025-01414-7.

ABSTRACT

PURPOSE: This study aimed to evaluate intergenerational differences in miniscrew placement accuracy in the palatine vault using dynamic computer-assisted surgery (d-CAS), and to assess the correlation between the number of surgeries, and both accuracy variables and procedure duration.

MATERIALS AND METHODS: 72 subjects were enrolled and for each two miniscrews were inserted in the paramedian region via d-CAS (144 overall). Subjects were randomly allocated into three groups according to the operator’s generation: Group A (Generation X), Group B (Generation Y), and Group C (Generation Z). CBCT scans were superimposed to evaluate five variables: Entry-3D, Entry-2D, Apex-3D, Apex-Vertical, and angular deviation. Procedure duration was calculated. Statistical analyses included descriptive statistics, Shapiro-Wilk, ANOVA, Kruskal-Wallis, Tukey and Dunn’s tests and Pearson Correlation. P-value was set at ≤ 0.05.

RESULTS: ANOVA test demonstrated significant differences between the three groups in Entry-3D (P < 0.001), Entry-2D (P < 0.001), and Apex-3D (P = < 0.001) parameters, while Kruskal-Wallis test found a significant difference in angular deviation (P = 0.003). Post-hoc comparison revealed significant differences between groups A and C, and groups B and C. Pearson correlation indicated a negative correlation between intervention time and number of surgeries.

CONCLUSIONS: Miniscrew insertion using d-CAS is operator-dependent, and the generational cohort of the operator is a factor that influences certain accuracy parameters. There is a correlation between the progression of surgeries and a reduction in the time employed. Understanding the impact of generational differences can encourage the use of digital technologies for novices in clinical practice.

CLINICAL TRIAL NUMBER: NCT06661551 (clinicaltrials.gov; 10/25/2024).

PMID:40493264 | DOI:10.1007/s10006-025-01414-7