Tag: nevin manimala

BMC Womens Health. 2025 Jun 4;25(1):277. doi: 10.1186/s12905-025-03808-x.

ABSTRACT

BACKGROUND: Endometriosis (EM) is a prevalent gynecological condition impacting roughly 10% of women of reproductive age worldwide, causing chronic pain, infertility, and menstrual irregularities. Traditional diagnosis typically relies on invasive surgical methods, and non-invasive diagnostic techniques remain underdeveloped. This study seeks to investigate the association between creatinine levels and endometriosis through cross-sectional analysis and mendelian randomization (MR) analysis, while also developing and assessing diagnostic models.

METHOD: This research integrates data from the NHANES database (1999-2006) and the affiliated hospital of Jining Medical College in China. The study cohort consists of women aged 20-60, with data collection covering age, race, education level, marital status, family income, weight, height, body mass index(BMI), and serum creatinine levels. Logistic regression models were used for univariate and multivariate analyses. Bidirectional MR analysis, utilizing genetic variation data from Large Genome Association Studies (GWAS), was performed to evaluate causal relationships using the inverse variance weighted (IVW) method, complemented by sensitivity analysis. A diagnostic model based on data from top-tier hospitals in China was constructed and its performance assessed through receiver operating characteristic(ROC) curves, area under the curve(AUC) values, and calibration curves.

RESULT: In the NHANES dataset, univariate analysis indicated a significant correlation between creatinine levels and endometriosis (OR = 1.01, 95% CI: 1.00-1.01, P = 0.0048), while multivariate analysis maintained significant results after adjustment (OR = 1.00, 95% CI: 1.00-1.01, P = 0.0431). Bidirectional MR analysis demonstrated a causal relationship between creatinine levels and endometriosis, with a positive IVW result of 1.001 (95% CI: 1.00-1.002, P = 0.0350). In the chinese tertiary hospital dataset, the AUC for the diagnostic model on both training and validation sets were 0.721 and 0.730, respectively. An increase of 10 μmol/L in creatinine levels raised the risk of endometriosis by approximately 8% (OR = 1.08, 95% CI: 1.07-1.09, P < 0.001).

CONCLUSION: This study establishes a significant link between creatinine levels and endometriosis, confirming creatinine as an independent risk factor. Elevated creatinine levels could be used as non-invasive biomarkers for the early detection and diagnosis of endometriosis. Future research should aim to validate these findings in larger, multicenter studies and delve into the specific biological mechanisms, paving the way for novel therapeutic strategies.

PMID:40468362 | DOI:10.1186/s12905-025-03808-x

BMC Health Serv Res. 2025 Jun 4;25(1):802. doi: 10.1186/s12913-025-12884-6.

ABSTRACT

BACKGROUND: In recent years, Ireland has seen a decline in the number of private general dental practitioner (GDP) contractors delivering state funded dental care. Meanwhile, the National Oral Health Policy – Smile agus Sláinte, proposes contracting more state funded care to private GDPs including care for all children and vulnerable adults. Understanding Irish GDP workforce characteristics will be key in evaluating services and informing workforce planning into the future. This study describes the primary oral healthcare system and GDP workforce indicators in Ireland and compares private GDPs by current state dental scheme participation.

METHODS: Documentary analysis was used to describe and trace the origins of Ireland’s current primary oral healthcare services. Secondary analysis of publicly available data was undertaken to map GDP workforce indicators to critical dimensions of the World Health Organization (WHO) ‘Dimensions of Universal Health Coverage (UHC) relating to Human Resources for Health’ framework. Private GDPs were compared by state dental scheme participation utilising available demographics. Descriptive statistics were computed using STATA/SE 17 software.

RESULTS: Private GDP contractors have participated in the delivery of state-funded dental care in Ireland since the early 1950s. The number of private GDPs holding Dental Treatment Services Scheme (DTSS) contracts fell from 1,664 in 2016 to 787 in August 2023, while the number holding Dental Treatment Benefit Scheme (DTBS) contracts increased from 1,959 in 2016 to 2,384 in 2023. The number of private GDPs submitting claims on the DTSS has also declined from 1,318 in 2016 to 831 in 2022. DTSS contractors are more likely to be male and qualified longer (> 20 years) than GDPs holding only DTBS contracts.

CONCLUSION: These findings are very relevant and timely to the planned policy implementation given that Smile agus Sláinte is reliant on the greater provision of publicly funded care by private GDPs. There is a potential lack of GDP supply into the public system as the Irish Government seeks to implement Smile agus Sláinte and meet its WHO obligations on developing UHC for oral health.

PMID:40468361 | DOI:10.1186/s12913-025-12884-6

J Ovarian Res. 2025 Jun 4;18(1):121. doi: 10.1186/s13048-025-01703-5.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovaries, significantly impacting reproductive health. Obesity, prevalent in 50-80% of PCOS patients, exacerbates metabolic disturbances and negatively influences assisted reproductive technology outcomes. This study investigates how obesity alters the proteomic profile of follicular fluid-derived small extracellular vesicles (FF-sEVs), aiming to elucidate mechanisms underlying reproductive impairments in this population.

METHODS: This study included women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), categorized into PCOS and non-PCOS control groups, further divided by BMI. Follicular fluid was collected, and sEVs isolated via ultracentrifugation. Proteomic analysis utilized data-independent acquisition (DIA) technology, with bioinformatics tools applied for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, along with protein-protein interaction (PPI) analysis. Statistical comparisons were performed using Analysis of variance (ANOVA) and t-tests to identify differentially expressed proteins. Correlation analysis assessed relationships between sEV protein profiles and reproductive outcomes, employing the Pearson correlation coefficient.

RESULTS: Proteomic profiling of sEVs revealed that the overweight/obese PCOS group had 180 upregulated and 256 downregulated proteins compared to lean counterparts. Additionally, differential functional analysis and PPI analysis indicated significant pathway and key proteins alterations in the PCOS group related to inflammation, while non-PCOS women demonstrated metabolic reprogramming and anti-inflammatory responses, suggesting a differential response to obesity that may preserve oocyte quality. Correlation analysis revealed significant associations between specific differentially expressed proteins and IVF/ICSI outcomes, while a protective role for Heat Shock Protein 90 Beta Family Member 1 (HSP90B1) protein was observed in the non-PCOS group. Lastly, validation through Western blot confirmed critical protein expression changes, particularly for S100 Calcium-binding Protein A8 (S100A8), emphasizing the impact of obesity on reproductive health outcomes in PCOS patients.

CONCLUSIONS: In conclusion, our findings indicate that obesity exacerbates inflammation and oxidative stress in PCOS women, adversely affecting oocyte development and IVF/ICSI outcomes. In contrast, non-PCOS women exhibit protective metabolic and inflammatory adaptations. These insights underscore the necessity for tailored fertility management approaches, including weight loss strategies and specific interventions for PCOS patients, to optimize reproductive outcomes and enhance pregnancy success rates.

PMID:40468347 | DOI:10.1186/s13048-025-01703-5

BMC Med Educ. 2025 Jun 4;25(1):831. doi: 10.1186/s12909-025-07438-7.

ABSTRACT

BACKGROUND: The integration of ChatGPT with educational settings is happening at an unprecedented rate, and there is a growing trend for students to use ChatGPT for various academic work. Although numerous studies have evaluated the knowledge, attitudes, and practices related to ChatGPT among students in diverse medical fields, there remains a notable absence of such research within the Chinese context.

METHODS: The questionnaire survey was conducted to a sample of 1,133 medical students from various medical colleges across Sichuan Province, China, between May 2024 and November 2024 to explore the awareness and attitudes of medical students towards ChatGPT. Descriptive statistics were used to tabulate the frequency of each variable. A chi-square test and multiple regression analysis were employed to investigate the factors influencing participants’ positive attitudes toward the prospective use of ChatGPT.

RESULTS: The findings revealed that 62.9% of participants had employed ChatGPT in their medical studies, with 16.5% having utilized the tool in a published article. Participants primarily used ChatGPT for searching information (84.4%) and completing academic assignments (60.4%). However, concerns were expressed regarding the potential for ChatGPT to disseminate misinformation (76.9%) and facilitate plagiarism or complicate its detection (65.4%). Despite these concerns, 64.4% of respondents indicated a willingness to use ChatGPT to seek assistance with learning problems. Overall, a majority of participants (60.7%) maintained a positive attitude on the future use of ChatGPT in the medical field.

CONCLUSION: Our research showed that while most medical students perceived ChatGPT as a valuable tool for academic study and research, they remained cautious about its potential risks, particularly regarding misinformation and plagiarism concerns. Despite these reservations, a majority participants indicated a willingness to incorporate ChatGPT into their academic workflow, specifically for problem-solving tasks, and maintained optimistic perspectives regarding its potential integration into medical education and clinical practice. It is therefore essential to improve student literacy about AI, develop clear guidelines for its acceptable use, and implement support systems to ensure that medical students are fully prepared for the upcoming integration of AI into medical education.

TRIAL REGISTRATION: Not applicable.

PMID:40468340 | DOI:10.1186/s12909-025-07438-7

Chiropr Man Therap. 2025 Jun 4;33(1):23. doi: 10.1186/s12998-025-00587-y.

ABSTRACT

BACKGROUND: In the realm of biomedical research articles, authors typically utilize descriptive statistics to outline the characteristics of their study samples. The standard deviation (SD) serves to illustrate variability among the individuals in a sample, whereas the standard error of the mean (SEM) conveys the level of uncertainty associated with the sample mean’s representation of the population mean. It is not unusual for authors of scientific articles to incorrectly utilize the SEM rather than the SD when explaining data variability. This is problematic because the SEM is consistently smaller than the SD, which could cause readers to underestimate variation in the data. In medical journals, inappropriate use has been found in 14-64% of articles. Moreover, in the field of musculoskeletal health and manual medicine, there is a noticeable absence of literature on the appropriate presentation of statistics.

AIM: The aim of this study was to map the frequency of inappropriate reporting of SEM in articles published over a three-year period in three prominent journals in manual medicine.

METHODS: In this critical analysis, all articles in three journals – BMC Chiropractic and Manual Therapies (CMT), Journal of Manipulative and Physiological Therapeutics (JMPT) and Musculoskeletal Science and Practice: An International Journal of Musculoskeletal Physiotherapy (MSP) – published between 2017 and 2019 were analysed based on descriptive statistics that inappropriately or vaguely reported SEMs.

RESULTS: In total, 790 articles were analysed from the three journals, 487 of which were found to report the SEM. Among these articles, we identified a frequency of 1.4% of inadequate SEM use. The investigation also showed that in 2.5% of the cases, authors did not clarify whether the ± sign presented in text, tables or figures expressed SDs or SEMs.

CONCLUSION: There was a low frequency (1.4%) of inaccurately reported SEMs in scientific journals focusing on manual medicine, which was notably lower than studies conducted in other fields. Additionally, it was noted that in 2.5% of the articles, the ± sign was not adequately defined, which could lead to confusion among readers and hinder the interpretation of the results.

PMID:40468335 | DOI:10.1186/s12998-025-00587-y

BMC Pulm Med. 2025 Jun 4;25(1):281. doi: 10.1186/s12890-025-03748-0.

ABSTRACT

BACKGROUND AND AIM: Lung cancer (LC) is one of the most prevalent and fatal malignancies worldwide. With the progress of society, the pathogenic factors, medical diagnosis, and environmental health policies of lung cancer have all changed. Therefore, predicting the incidence trend of LC is of significance for people to understand the future burden of LC.In this study, we aimed to analyze temporal trends in LC incidence across 45 areas from 1978 to 2017, investigate regional and demographic patterns of LC incidence, and predict trends from 2018 to 2035.

METHODS: Data on annual LC cases and population statistics, stratified by age and sex, were collected from 111 cancer registries in 45 areas across five continents using the Cancer Incidence in Five Continents Plus database. From 1978 to 2017, age-standardized rates (ASRs) per 100,000 individuals were calculated for both sexes and different age groups. A Bayesian age-period-conhort (BAPC) model was applied to forecast ASRs until 2035.

RESULTS: From 1978 to 2017, LC ASRs decreased in most areas for men (32/45 areas) but increased for women (37/45 areas), and mainly due to the rising incidence rate among elderly women (> 60 years old). Among men, the country with the largest increase was Cyprus (+ 71.95%), and the largest decrease was Costa Rica (-64%). Among women, France saw the greatest increase (+ 515.15%) while Kuwait had the least (-72.85%). In addition, the LC ASR in high-income areas is higher than that in middle – and low-income areas. However, projections from 2018 to 2035 suggested that only 8 of 45 areas will witness increasing LC ASRs for men, whereas 18 areas will experience ASR increases for women.

CONCLUSION: Overall, global LC incidence is gradually declining. However, considerable disparities exist across areas, sexes, and developmental stages. Therefore, understanding area-specific trends, customizing control measures to local contexts, and conducting screening and early interventions in high-incidence areas and populations are central to overcoming these differences.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40468326 | DOI:10.1186/s12890-025-03748-0

World J Surg Oncol. 2025 Jun 4;23(1):217. doi: 10.1186/s12957-025-03870-7.

ABSTRACT

BACKGROUND: Breast cancer is one of the most common malignant tumors found in women. Plastic endoscopic surgery is a new surgical procedure that incorporates treatment for the tumor followed by breast reconstruction. The goal of this study was to compare the effectiveness of plastic endoscopic surgery vs. traditional procedures (modified radical surgery) regarding the quality of life and clinical prognosis for patients with early-stage breast cancer.

METHODS: Patients were divided into two groups depending on their surgical type. One group was the endoscopic group, which consisted of patients who had plastic endoscopic surgery (the patients with breast conservation needs included only tumors that were adequate for endoscopic surgery); the other was the traditional group, which consisted of patients who underwent traditional modified radical surgery (patients with no breast conservation needs, or were unsuitable for breast-conserving surgery due to a tumor or breast shape).

RESULTS: Among the 66 patients in the endoscopic group, 3 were lost to follow-up, while 2 out of the 52 participants were lost to follow-up in the traditional group. The operative time was longer in the endoscopic group versus the traditional group; however, intra-operative blood loss, duration of drainage, drainage volume, and length of incision were all significantly lower in the endoscopic group (P < 0.05). Repeated measures ANOVA revealed statistically significant differences in FACT-B scores across time between groups (P < 0.05). Pairwise comparisons indicated that FACT-B scores improved over time from measures taken before surgery to measures taken after surgery (P < 0.05). There were no significant differences between groups regarding local recurrence, distant metastasis, or mortality at 1, 2, or 3 years on follow-up (P > 0.05). The endoscopic group had a significantly lower rate of short-term complications than the traditional group (P < 0.05).

CONCLUSION: Endoscopic plastic surgery is a safe and effective treatment alternative for eligible patients seeking breast-conserving surgery, especially concerning improving perioperative outcomes and reducing short-term complications. However, as with any surgical approach, an individualized surgical approach must be made considering patient characteristics.

PMID:40468315 | DOI:10.1186/s12957-025-03870-7

Otol Neurotol. 2025 Jun 2. doi: 10.1097/MAO.0000000000004524. Online ahead of print.

ABSTRACT

OBJECTIVE: To understand trends in Medicare reimbursement for neurotology procedures from 2000 through 2024.

METHODS: The Physician Fee Schedule (PFS) Look-Up Tool from the Center for Medicare and Medicaid Services was used to assess reimbursement data for relevant otologic/neurotologic Current Procedural Terminology (CPT) codes from 2000 to 2024. All monetary data were adjusted to 2024 U.S. dollars using the U.S. Bureau of Labor Statistics Consumer Price Index. Percent changes in reimbursement were calculated.

RESULTS: The average nominal value of reimbursement for all procedures increased by 11.20% from 2000 to 2024. However, after adjusting for inflation, the average change in Medicare reimbursement was -33.52%. The greatest decrease was in CPT code 69714, which saw a 2024 U.S. dollar -66.43% change. The greatest increase was in CPT code 61798, which saw a 43.43% change. An increase in reimbursement for all CPT codes occurred only in 2024. This increase was associated with the calendar year 2024 PFS final rule, which came into effect on March 9 and increased the PFS conversion factor from $32.7442 to $33.2875. From 2000 to 2024, the PFS conversion factor decreased from $36.6137 to $33.2875.

CONCLUSION: From 2000 to 2023, Medicare reimbursements for otologic and neurotologic procedures decreased after adjusting for inflation. The only year with an increase in reimbursement was 2024, which saw an increase to the PFS conversion factor. These trends highlight the need for greater awareness of, and agreement on, neurotology reimbursement models among surgeons, policy makers, and facility administrators.

PMID:40466113 | DOI:10.1097/MAO.0000000000004524

JMIR Med Inform. 2025 Jun 4;13:e78151. doi: 10.2196/78151.

ABSTRACT

[This corrects the article DOI: 10.2196/63906.].

PMID:40466103 | DOI:10.2196/78151

J Med Internet Res. 2025 Jun 4;27:e67489. doi: 10.2196/67489.

ABSTRACT

BACKGROUND: Wasp stings are a significant public health concern in many parts of the world, particularly in tropical and subtropical regions. The venom of wasps contains a variety of bioactive compounds that can lead to a wide range of clinical effects, from mild localized pain and swelling to severe, life-threatening allergic reactions, such as anaphylaxis. With the rapid development of artificial intelligence (AI) technologies, large language models (LLMs) are increasingly being used in health care, including emergency medicine and toxicology. These models have the potential to assist health care professionals in making fast and informed clinical decisions. This study aimed to assess the performance of 4 leading LLMs-ERNIE Bot 3.5 (Baidu), ERNIE Bot 4.0 (Baidu), Claude Pro (Anthropic), and ChatGPT 4.0-in managing wasp sting cases, with a focus on their accuracy, comprehensiveness, and decision-making abilities.

OBJECTIVE: The objective of this research was to systematically evaluate and compare the capabilities of the 4 LLMs in the context of wasp sting management. This involved analyzing their responses to a series of standardized questions and real-world clinical scenarios. The study aimed to determine which LLMs provided the most accurate, complete, and clinically relevant information for the management of wasp stings.

METHODS: This study used a cross-sectional design, creating 50 standardized questions that covered 10 key domains in the management of wasp stings, along with 20 real-world clinical case scenarios. Responses from the 4 LLMs were independently evaluated by 8 domain experts, who rated them on a 5-point Likert scale based on accuracy, completeness, and usefulness in clinical decision-making. Statistical comparisons between the models were made using the Wilcoxon signed-rank test, and the consistency of expert ratings was assessed using the Kendall coefficient of concordance.

RESULTS: Claude Pro achieved the highest average score of 4.7 (SD 0.603) out of 5, followed closely by ChatGPT 4.0 with a score of 4.5. ERNIE Bot 4.0 and ERNIE Bot 3.5 received average scores of 4 (SD 0.600) and 3.8, respectively. In analyzing the 20 complex clinical cases, Claude Pro significantly outperformed ERNIE Bot 3.5, particularly in areas such as managing complications and assessing the severity of reactions (P<.001). The expert ratings showed moderate agreement (Kendall W=0.67), indicating that the assessments were consistently reliable.

CONCLUSIONS: The results of this study suggest that Claude Pro and ChatGPT 4.0 are highly capable of providing accurate and comprehensive support for the clinical management of wasp stings, particularly in complex decision-making scenarios. These findings support the increasing role of AI in emergency and toxicological medicine and suggest that the choice of AI tool should be based on the specific needs of the clinical situation, ensuring that the most appropriate model is selected for different health care applications.

PMID:40466102 | DOI:10.2196/67489