Tag: pubmed

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

JMIR Res Protoc. 2025 Jun 4;14:e68677. doi: 10.2196/68677.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a complex, incurable condition requiring lifelong care, often placing significant psychological strain on parents and emerging as a public health concern. While various interventions exist to enhance the psychological health of parents, the role of digital health interventions (DHIs) in this context remains underexplored.

OBJECTIVE: This scoping review aims to systematically assess the availability of DHIs targeting the psychological health of parents of children with ASD and evaluate the effectiveness of these interventions in improving parental psychological health.

METHODS: The review will include English-language studies published from inception to June 25, 2024, focusing on DHIs aimed at improving the psychological health of parents of children with ASD. Eligible studies will involve parents of children with ASD less than the age of 18 years, across various settings, and assess psychological health outcomes. A comprehensive search will be conducted across six databases: (1) CINAHL, (2) Ovid EMBASE, (3) Ovid Global Health, (4) Ovid MEDLINE, (5) Ovid PsycINFO, and (6) Web of Science. Studies will be screened and selected based on predefined eligibility criteria. Data extraction will include publication details, study design, participants’ characteristics, intervention specifics, comparisons, psychological outcomes, and key findings. Results will be synthesized using descriptive statistics, charts, and narrative analysis.

RESULTS: The initial keyword-based search, completed in June 2024, identified 5825 records, which were subsequently screened and analyzed. Screening and evidence synthesis were finalized in winter 2024, and the completed scoping review was submitted in December 2024.

CONCLUSIONS: This study will provide a comprehensive overview of commonly used DHIs for supporting the psychological health of parents of children with ASD and their effectiveness. The findings will help identify research gaps, inform future studies and funding priorities, and contribute to the development of practice guidelines to enhance parental psychological health.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/68677.

PMID:40466097 | DOI:10.2196/68677

JMIR Mhealth Uhealth. 2025 Jun 4;13:e60855. doi: 10.2196/60855.

ABSTRACT

BACKGROUND: Gestational diabetes is a type of diabetes that develops during pregnancy and increases the risk of developing type 2 diabetes later in life. The rising prevalence of gestational diabetes mellitus (GDM) highlights the need for more comprehensive treatment strategies, with a particular emphasis on supporting maternal self-management. We showed recently that a mobile app, eMOM, where glucose, nutrition, and physical activity are combined within a single app, significantly improves multiple clinical outcomes among persons with gestational diabetes.

OBJECTIVE: This study aims to explore the effects of the eMOM on maternal self-discovery and learning, autonomous motivation to manage GDM, and psychological well-being. Additionally, we examine the correlation between improved maternal clinical outcomes and change in autonomous motivation. We also assess the acceptance and usability of the eMOM app.

METHODS: Building upon the original randomized controlled trial (RCT), in which the intervention arm used a mobile app (eMOM), we conducted a mixed methods study that included an investigation of eMOM log files, semistructured interviews on self-discovery, and an examination of questionnaires assessing motivation (Treatment Self-Regulation Questionnaire and Perceived Competence Scale), depression (Edinburgh Postnatal Depression Scale), technology use and acceptance (Unified Theory of Acceptance of Use of Technology questionnaire), and usability (modified Software Usability Measurement Inventory). Additionally, we monitored participants’ stress levels using wearable electrocardiographic devices (FirstBeat Bodyguard 2). A total of 148 individuals participated in the original RCTs, with 76 in the intervention arm and 72 in the control arm. From the intervention arm, 18 participants were randomly selected for interviews in this study.

RESULTS: Results show that the use rate of eMOM was high, and novel visualization supported self-discovery in persons with GDM. Most participants (17/18, 94%) indicated that the eMOM app helped to find the associations between their daily activities and glucose levels. Especially having nutrition visualized together with glucose was highly appreciated. Participants also reported learning about the associations between physical activity and glucose levels. No differences were observed between the intervention and control arms in autonomous motivation, depression, or stress. Furthermore, there were no correlations between improved clinical outcomes and changes in motivation. Accessibility and usability ratings were consistently high throughout the intervention.

CONCLUSIONS: The eMOM mobile app combining data from continuous glucose monitor, food diary, and physical activity tracker supports maternal self-discovery related to GDM without contributing to depression or adding extra stress. This encourages the use of such mobile apps in maternity care. Notably, motivational factors did not correlate with the positive outcomes observed in our prior RCT, suggesting that self-discovery has a greater impact on clinical results.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04714762; https://www.clinicaltrials.gov/study/NCT04714762.

PMID:40466096 | DOI:10.2196/60855