Tag: pubmed

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09656-7. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare the ability of two major language models, ChatGPT-4.0 and Gemini 1.5 Flash, to establish a research methodology based on scientific publications in laryngology.

METHODS: We screened 80 articles selected from five prestigious otolaryngology journals and included 60 articles with a methods section and statistical analysis. These were classified according to six research types: cell culture, animal experiments, prospective, retrospective, systematic review, and artificial intelligence. A total of 30 studies were analyzed, with five articles randomly selected from each group. For each article, both language models were asked to produce research methodologies, and the responses were evaluated by two independent raters.

RESULTS: There was no statistically significant difference between the mean scores of the models (p > 0.05). ChatGPT 4.0 had a higher mean score (5.17 ± 1.12), especially in the data collection and measurement-assessment category. The Gemini model showed relatively more balanced performance in the statistical analysis category. The weighted kappa values were between 0.54 and 0.71, indicating a moderate to high agreement between the raters. In the analysis by article type, Gemini’s performance in Q1 showed significant variation (p = 0.038).

CONCLUSION: Large language models such as ChatGPT and Gemini provide similarly consistent results in establishing the methodology of scientific studies in laryngology. Both models can be considered supportive tools; however, expert supervision is needed, especially for complex constructs such as statistical analysis. This study makes original contributions to the usability of LLMs for study design in laryngology.

PMID:40968205 | DOI:10.1007/s00405-025-09656-7

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09647-8. Online ahead of print.

ABSTRACT

PURPOSE: Laryngeal cancer is a major malignancy in head and neck oncology, with total laryngectomy (TL) as a key intervention for advanced and recurrent disease. This systematic review and meta-analysis compare primary total laryngectomy (PTL) and salvage total laryngectomy (STL) in survival, functional outcomes, and complications.

METHODS: A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted up to January 18, 2025. Studies comparing PTL and STL were included based on predefined eligibility criteria. Data extraction and quality assessment were performed independently by two reviewers. Random-effects models were used to calculate pooled odds ratios (ORs) and mean differences (MDs), with heterogeneity assessed via I² statistics. Sensitivity analyses ensured result robustness.

RESULTS: Thirteen studies (2,704 patients: 913 STL, 1,791 PTL) met inclusion criteria. PTL showed significantly higher overall survival at 1 year (OR = 2.21; 95% CI: 1.38-3.55), 2 years (OR = 1.95; 95% CI: 1.40-2.71), and 3 years (OR = 1.64; 95% CI: 1.10-2.47). STL had higher risks of pharyngocutaneous fistula (OR = 2.78; 95% CI: 1.96-3.95) and reconstructive surgery (OR = 0.11; 95% CI: 0.02-0.75). PTL significantly reduced swallowing difficulty (OR = 0.12; 95% CI: 0.05-0.28) and hypopharyngeal stricture (OR = 0.14; 95% CI: 0.04-0.49). Speech functional outcomes showed no significant differences.

CONCLUSION: PTL improves survival and swallowing function with fewer complications, making it a preferred upfront treatment. STL remains essential for managing failures. Early identification of high-risk patients may improve clinical decision-making, optimizing survival and functional outcomes.

PMID:40968204 | DOI:10.1007/s00405-025-09647-8

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09663-8. Online ahead of print.

ABSTRACT

BACKGROUND: Work-related musculoskeletal disorders (WRMD) are an increasing concern among surgeons, especially otorhinolaryngologists (ENT physicians), due to prolonged static postures and repetitive movements during clinical practice. However, data on the prevalence of WRMD among ENT physicians in Germany are lacking.

METHODS: A nationwide online survey was conducted among members of the German Society for ENT to assess demographic data, work-related factors, and musculoskeletal complaints. Data were analyzed using descriptive statistics.

RESULTS: A total of 751 ENT physicians participated (53% female; mean age 51 years). Lifetime prevalence of neck complaints was 93%, with 82% reporting symptoms in the past 12 months. Shoulders, upper and lower back were also frequently affected. More than a half (53%) reported limitations in professional activities, and 22% had taken sick leave due to these complaints. The prevalence of symptoms increased with years of professional experience. Female physicians reported higher rates of neck and upper back complaints compared to males.

CONCLUSION: This study reveals a high prevalence and significant burden of WRMD among German ENT physicians, particularly in the neck and upper back regions. The findings emphasize the urgent need for preventive measures to improve occupational health and maintain professional longevity in this population.

PMID:40968203 | DOI:10.1007/s00405-025-09663-8

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09677-2. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic rhinosinusitis with nasal polyposis (CRSwNP), often Linked to asthma, significantly affects quality of life. While dupilumab 300 mg every two weeks (Q2W) is effective, it is costly. This real-world Saudi study evaluated whether extending dosing to every four weeks (Q4W) maintains effectiveness in patients with or without asthma.

METHODS: In this retrospective single-cohort study, 42 adults with CRSwNP who completed at least one year of stable Q2W dupilumab therapy were transitioned to Q4W and followed for one additional year. Clinical, biomarker, and imaging outcomes were analyzed.

RESULTS: Clinical outcomes between Q2W and Q4W were largely comparable. Eight CRSwNP patients had comorbid asthma (19%). Median nasal polyp scores remained stable, and symptom scores for nasal congestion, discharge, smell loss, and fatigue showed no significant changes. Sino-Nasal Outcome Test (SNOT)-22 and Lund-Mackay scores trended lower in the Q4W group compared to Q2W group but were not statistically significant. Blood eosinophils were modestly reduced, while asthma control remained stable, with high asthma control test scores. Total IgE levels (IU/mL) were significantly lower in the Q4W group (32.5 [10.1-76.4] vs. 52.7 [19.8-215], p<0.001), suggesting immunologic benefit. Fractional exhaled nitric oxide (FeNO) levels were unchanged. Overall, 92.9% maintained symptom control on Q4W for one year; three reverted to Q2W due to worsening of asthma control symptoms.

CONCLUSION: Transitioning from Q2W to Q4W dupilumab dosing is effective for most CRSwNP patients, including those with asthma, after one year of stable therapy. This approach may reduce treatment burden without compromising clinical outcomes.

PMID:40968202 | DOI:10.1007/s00405-025-09677-2

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09649-6. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare short-term language outcomes following hearing aid rehabilitation in pediatric patients with severe bilateral hearing loss (70-90 dB), with a particular focus on differences according to etiology. We hypothesized that children with enlarged vestibular aqueduct (EVA) exhibit more favorable speech development compared to those with other genetic or structural causes of hearing loss, and explored the potential presence of a “hidden” air-bone gap associated with EVA.

METHODS: We retrospectively reviewed 36 children under five years of age diagnosed with bilateral severe sensorineural hearing loss and ascertained before age two at Seoul National University Bundang Hospital. Patients were classified into EVA (n = 16) and non-EVA (n = 20) groups based on radiologic and genetic data. All participants underwent one year of bilateral hearing aid rehabilitation. Speech and language outcomes were assessed using the Categories of Auditory Perception (CAP), Sequenced Language Scale for Infants (SELSI), and Receptive and Expressive Vocabulary Test (REVT), and were compared pre- and post-treatment.

RESULTS: Both groups showed improved CAP scores after one year. However, the EVA group exhibited significantly better expressive language percentile scores (mean 41.8 ± 30.9) compared to the non-EVA group, despite progressive threshold deterioration. Receptive language also improved more in the EVA group, although not statistically significant.

CONCLUSION: Children with EVA may achieve superior short-term language outcomes with hearing aids, potentially due to a third window-related hidden air-bone gap. However, given the progressive nature of EVA, long-term follow-up is required to assess articulation development and determine optimal timing for cochlear implantation.

PMID:40968201 | DOI:10.1007/s00405-025-09649-6

Eur Arch Otorhinolaryngol. 2025 Sep 18. doi: 10.1007/s00405-025-09626-z. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates differences in meta-emotional beliefs and meta-emotional intelligence between preadolescents and adolescents with cochlear implants (CIs) and their typically hearing (TH) peers.

METHODS: The sample included 86 participants aged 10-18 years, evenly divided between those with CIs and TH individuals. The IE-ACCME test, a multi-method tool, was used to assess meta-emotional intelligence. Statistical analyses were carried out to compare meta-emotional intelligence dimensions between CIs and TH groups.

RESULTS: The findings reveal that the CIs group had significantly higher overall meta-emotional belief scores, suggesting that individuals with CIs perceive emotions as playing a more significant role in their lives. Despite this, no significant differences were found in subscales related to emotion perception, comprehension, and management, indicating similar beliefs across both groups. However, the CIs group scored higher on the facilitation subscale, reflecting stronger beliefs about using emotions to enhance thinking. Additionally, the CIs group tended to overestimate their emotional abilities, both in everyday life and in emotional ability tests.

CONCLUSION: CIs group exhibited heightened meta-emotional beliefs and a tendency to overestimate their emotional abilities, reflecting a distinct meta-emotional intelligence profile linked to hearing loss and cochlear implantation. These findings suggest a distinct emotional profile for individuals with CIs, highlighting the need for targeted emotional and meta-emotional skills training.

PMID:40968200 | DOI:10.1007/s00405-025-09626-z

Hepatol Int. 2025 Sep 19. doi: 10.1007/s12072-025-10903-6. Online ahead of print.

ABSTRACT

BACKGROUND: Several studies have shown similar efficacy between nonselective beta-blockers (NSBBs) and endoscopic variceal ligation (EVL) in preventing esophageal variceal bleeding in cirrhosis. However, the comparative effectiveness between propranolol (PPL) and EVL remains uncertain. This meta-analysis evaluated both strategies.

METHODS: PubMed, Embase, and Cochrane Central were searched for randomized-controlled trials (RCTs) comparing PPL and EVL for primary prophylaxis of esophageal variceal bleeding in cirrhotic patients. Outcomes were evaluated using risk ratios (RR) with 95% confidence intervals (CI), and heterogeneity was assessed by the I² statistic. Meta-regressions were conducted based on Child-Pugh classification and presence of ascites. All statistical analyses were performed using RStudio version 4.4.2.

RESULTS: Fourteen RCTs were included, comprising 1345 patients: 664 (49.4%) received EVL and 681 (50.6%) PPL. EVL was more effective in preventing esophageal variceal hemorrhage (RR: 1.40; 95% CI: 1.02-1.91; p = 0.035; I² = 8.5%). No differences were found in variceal bleeding-related deaths (RR: 1.28; 95% CI: 0.76-2.15; p = 0.351; I² = 0%), all-cause mortality (RR: 0.93; 95% CI: 0.76-1.14; p = 0.503; I² = 0%), or in the incidence of adverse events (RR: 1.20; 95% CI: 0.59-2.46; p = 0.612; I² = 84.7%).

CONCLUSION: EVL was superior in preventing esophageal variceal bleeding. Such results suggest that not all NSBBs provide equivalent efficacy in primary prophylaxis, reinforcing the need for further studies to confirm these findings.

PMID:40968192 | DOI:10.1007/s12072-025-10903-6

Diabetologia. 2025 Sep 18. doi: 10.1007/s00125-025-06534-z. Online ahead of print.

ABSTRACT

AIMS/HYPOTHESIS: Previous studies have indicated that 29-amino-acid glucagon (i.e. ‘pancreatic’ glucagon) circulates in totally pancreatectomised individuals and that a postprandial glucagon response can be detected. Using a glucagon receptor antagonist (GRA), we investigated the possible role of extrapancreatic glucagon on glucose, lipid and amino acid metabolism in totally pancreatectomised individuals.

METHOD: In a randomised, crossover study, nine totally pancreatectomised individuals and nine matched healthy control individuals were given, in randomised order (planned on the website www.random.org ), 300 mg GRA (LY2409021; Eli Lilly) or placebo 10 h before two 3 h OGTTs. The experiment was double-masked (i.e. both participants and investigator were masked for the type of the experimental day [day A vs day B]). The key inclusion criteria for the healthy control participants were age >18 years, normal fasting plasma glucose and HbA_1c 31-44 mmol/mol (6.0-7.2%), haemoglobin >7.0 mmol/l (men) / >6.5 mmol/l (women) and informed consent. Key inclusion criteria for the pancreatectomised individuals were age >18 years, haemoglobin in the normal range and informed consent. The primary endpoint was the difference in plasma glucose excursions between study days.

RESULTS: Glucagon concentrations remained unchanged from fasting concentrations during the OGTT in the totally pancreatectomised individuals on both study days and circulating glucose, lipids and amino acid levels were unaffected by treatment with LY2409021 compared with placebo. In the control group, LY2409021 resulted in relevant pharmacodynamic effects, including lower fasting plasma glucose (4.7 [0.1] vs 5.2 [0.1] mmol/l, p=0.001) and augmented concentrations of amino acids in plasma, compared with placebo.

CONCLUSIONS/INTERPRETATION: We conclude that inhibition of the glucagon receptor using LY2409021 during OGTT in totally pancreatectomised individuals does not produce detectable effects on glucose, lipid or amino acid metabolism, ruling out metabolic effects of extrapancreatic glucagon.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT02944110).

FUNDING: This study was supported by grants from the Aase and Ejnar Danielsen’s Foundation and the Novo Nordisk Foundation.

PMID:40968190 | DOI:10.1007/s00125-025-06534-z

Nat Commun. 2025 Sep 18;16(1):8313. doi: 10.1038/s41467-025-64122-6.

NO ABSTRACT

PMID:40968170 | DOI:10.1038/s41467-025-64122-6

J Perinatol. 2025 Sep 18. doi: 10.1038/s41372-025-02431-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyse trends of outcomes of very low birth weight (VLBW) infants born after 27 weeks of gestation over 15 years in South Wales, UK.

STUDY DESIGN: Trends of clinical outcomes were analysed by deriving multivariable logistic regression models and presented as odds ratios (aOR) with 95% confidence intervals (95% CI). A p-value of <0.05 was considered to be statistically significant.

RESULTS: Between 2007 and 2021, 2321 infants were included in the cohort. There was a decline in the incidence of mortality (aOR 0.941; 95% CI 0.895, 0.988), severe brain injury (0.937; 0.893, 0.982), necrotising enterocolitis (0.911; 0.862, 0.964) and sepsis (0.949; 0.920, 0.978). At birth, odds of mechanical ventilation (0.909; 0.888, 0.930) & receipt of surfactant (0.920; 0.899, 0.942), and mechanical ventilation after admission (0.940; 0.919, 0.961) were significantly reduced. Analysis of a subgroup of 1797 preterm infants born before 32 weeks suggested significant improvement in all major outcomes studied.

DISCUSSION: Trends of care patterns and outcomes improved over time in this cohort of VLBW infants in South Wales, especially preterm infants below 32 weeks of gestation.

PMID:40968140 | DOI:10.1038/s41372-025-02431-w