Digitally-enabled, person-centred care (PCC) in allergen immunotherapy: An ARIA-EAACI Position Paper.

In rhinitis and asthma, several mHealth apps have been developed but only a few have been validated. However, these apps have a high potential for improving person-centred care (PCC), especially in allergen immunotherapy (AIT). They can provide support in AIT initiation by selecting the appropriate patient and allergen shared decision-making. They can also help in (i) the evaluation of (early) efficacy, (ii) early and late stopping rules and (iii) the evaluation of (carried-over) efficacy after cessation of the treatment course. Future perspectives have been formulated in the first report of a joint task force (TF)-Allergic Rhinitis and Its Impact on Asthma (ARIA) and the European Academy of Allergy and Clinical Immunology (EAACI)-on digital biomarkers. The TF on AIT now aims to (i) outline the potential of the clinical applications of mHealth solutions, (ii) express their current limitations, (iii) make proposals regarding further developments for both clinical practice and scientific purpose and (iv) suggest which of the tools might best comply with the purpose of digitally-enabled PCC in AIT.

Enhancing biostatistics education for medical students in Poland: factors influencing perception and educational recommendations.

BACKGROUND: A number of recommendations for the teaching of biostatistics have been published to date, however, student opinion on them has not yet been studied. For this reason, the aim of the manuscript was to find out the opinions of medical students at universities in Poland on two forms of teaching biostatistics, namely traditional and practical, as well as to indicate, on the basis of the results obtained, the related educational recommendations. METHODS: The study involved a group of 527 students studying at seven medical faculties in Poland, who were asked to imagine two different courses. The traditional form of teaching biostatistics was based on the standard teaching scheme of running a test from memory in a statistical package, while the practical one involved reading an article in which a particular test was applied and then applying it based on the instruction provided. Other aspects related to the teaching of the subject were assessed. RESULTS: According to the students of each course, the practical form of teaching biostatistics reduces the stress level associated with teaching and the student exam (p < 0.001), as well as contributing to an increased level of elevated knowledge (p < 0.001), while the degree of satisfaction after passing the exam is higher (p < 0.001). A greater proportion of students (p < 0.001) believe that credit for the course could be given by doing a statistical review of an article or conducting a survey, followed by the tests learned in class. More than 95% also said that the delivery of the courses should be based on the field of study they were taking, during which time they would also like to have the opportunity to take part in optional activities and hear lectures from experts. CONCLUSION: It is recommended that more emphasis be placed on practical teaching the subject of biostatistics.

Clinical and Genetic Insights into Desbuquois Dysplasia: Review of 111 Case Reports.

Skeletal disorders encompass a wide array of conditions, many of which are associated with short stature. Among these, Desbuquois dysplasia is a rare but severe condition characterized by profound dwarfism, distinct facial features, joint hypermobility with multiple dislocations, and unique vertebral and metaphyseal anomalies. Desbuquois dysplasia is inherited in an autosomal recessive manner, with both the DBQD1 (MIM 251450) and DBQD2 (MIM 615777) forms resulting from biallelic mutations. Specifically, DBQD1 is associated with homozygous or compound heterozygous mutations in the CANT1 gene, while DBQD2 can result from mutations in either the CANT1 or XYLT1 genes. This review synthesizes the findings of 111 published case reports, including 54 cases of DBQD1, 39 cases of DBQD2, and 14 cases of the Kim variant (DDKV). Patients in this cohort had a median birth weight of 2505 g, a median length of 40 cm, and a median occipitofrontal circumference of 33 cm. The review highlights the phenotypic variations across Desbuquois dysplasia subtypes, particularly in facial characteristics, joint dislocations, and bone deformities. Genetic analyses revealed a considerable diversity in mutations, with over 35% of cases involving missense mutations, primarily affecting the CANT1 gene. Additionally, approximately 60% of patients had a history of parental consanguinity, indicating a potential genetic predisposition in certain populations. The identified mutations included deletions, insertions, and nucleotide substitutions, many of which resulted in premature stop codons and the production of truncated, likely nonfunctional proteins. These findings underscore the genetic and clinical complexity of Desbuquois dysplasia, highlighting the importance of early diagnosis and the potential for personalized therapeutic approaches. Continued research is essential to uncover the underlying mechanisms of this disorder and improve outcomes for affected individuals through targeted treatments.

Advanced Biomarkers of Hepatotoxicity in Psychiatry: A Narrative Review and Recommendations for New Psychoactive Substances.

One of the factors that increase the effectiveness of the pharmacotherapy used in patients abusing various types of new psychoactive substances (NPSs) is the proper functioning of the liver. However, the articles published to date on NPS hepatotoxicity only address non-specific hepatic parameters. The aim of this manuscript was to review three advanced markers of hepatotoxicity in psychiatry, namely, osteopontin (OPN), high-mobility group box 1 protein (HMGB1) and glutathione dehydrogenase (GDH, GLDH), and, on this basis, to identify recommendations that should be included in future studies in patients abusing NPSs. This will make it possible to determine whether NPSs do indeed have a hepatotoxic effect or whether other factors, such as additional substances taken or hepatitis C virus (HCV) infection, are responsible. NPS abusers are at particular risk of HCV infection, and for this reason, it is all the more important to determine what factors actually show a hepatotoxic effect in them.

Matrix metalloproteinase-3 serum levels in schizophrenic patients.

OBJECTIVES: It has been reported that matrix metalloproteinase, MMP-3 may play a significant role in the pathophysiology of mental disorders. However, there are no data on the level of MMP-3 in people suffering from schizophrenia, or its influence on the mental state of these people. The aim of this study was to investigate the effect of an antipsychotic treatment on the blood levels of MMP-3, as well as investigating its relationship with insight into schizophrenia. METHODS: Thirty people with schizophrenia were included in the study. The concentration of MMP-3 in the blood serum was assessed using enzyme-linked immunosorbent assay. Insight into the disease was assessed using the Beck Cognitive Insight Scale. RESULTS: The antipsychotic treatment applied decreased the levels of MMP-3 in patients with schizophrenia (p = 0.005), however, the statistically significant interaction (p = 0.02) indicates that the decrease only concerned men. There was also a statistically significant correlation between the level of MMP-3 and insight into the disease (p = 0.02). CONCLUSION: MMP-3 may be associated with gender, treatment and symptoms in schizophrenic patients.KEY POINTSMMP3 could be used as a potential biomarker for schizophrenia.The level of MMP-3 decreased due to the applied antipsychotic treatment.The higher the level of MMP-3 in a group of people with schizophrenia, the better insight into their disease.

The Psychiatric Characteristics of People on a Mephedrone ("bath salts") Binge.

Background: Despite solutions presented by the European Union and national regulations introduced by many countries, the problem of mephedrone (4-MMC) is growing. Objectives: The aim of this study was to investigate the effect of regular mephedrone intake with other psychoactive substances on the clinical picture of patients, including self-harms and suicide attempts. Methods: The study involved a group of 601 patients addicted to mephedrone who were admitted to a psychiatric hospital between 2010 and 2018 due to regular mephedrone intake. Results: There was a statistically significant relationship between sleep disorders and mephedrone combined with alcohol (p < .05) or cannabinols (p < .05). However, the highest number of statistically significant correlations was reported when mephedrone was combined with opioids. There was a growing year-on-year percentage of people who attempted suicide because of regular mephedrone intake (p < .001). The more psychoactive substances were combined with mephedrone, the greater the risk of attempted suicide (p < .01). 20% of the examined group were hospitalized several times. Among those hospitalized several times, significantly more people took more than one additional psychoactive substance (p < .01). Conclusions: The more psychoactive substances combined with mephedrone, the more clinical symptoms are associated with it.

Optimisation of methadone treatment in a group of patients on a mephedrone binge and dependent on many psychoactive substances.

Objectives: In recent years, an increase in the frequency of hospitalisations of patients on a mephedrone binge has been observed. The literature lacks data on the optimisation of methadone treatment in this group of people.Methods: The study included 601 patients who took mephedrone on a regular basis between 2010 and 2018. Based on the pharmacological database created, it was verified which methadone interaction contributed to subsequent hospitalisations in the group of people studied and which of them had the best therapeutic effect.Results: During the study, 62.4% of patients received methadone (p < .001). The higher the number of drugs taken together with methadone, the higher the frequency of hospitalisations (p < .001). The highest frequency of re-hospitalisations was recorded in patients who combined mephedrone with at least two other psychoactive substances, as well as those who used methadone with chlorprothixene (p < .001). The most optimal therapeutic effect is characteristic for the intake of methadone with thiazolidine carboxylic acid, namely 95% of people using this type of treatment were hospitalised once (p < .001).Conclusions: Therapy with methadone and thiazolidine carboxylic acid seems to be the most optimal therapy for patients taking mephedrone.Key pointsThe number of hospitalisations of patients receiving mephedrone on a regular basis grows from year to year.The multiple use of poly-pharmacotherapy increased in a group of patients on a mephedrone binge.There is a statistically significant correlation between the number of hospitalisations of patients on a mephedrone binge and the total number of drugs taken together with methadone.Administration of methadone with thiazolidine carboxylic acid was the most effective therapy for patients regularly combining mephedrone with at least two other psychoactive substances.

Effectiveness of the methadone programme in the treatment of patients on a mephedrone binge and dependent on heroin: a retrospective study, 2010-19.

Objectives: The purpose of this research was to investigate the effectiveness of the methadone programme in a group of patients taking mephedrone with heroin.Methods: The research involved 230 people who took part in the methadone programme between 2010 and 2019: 101 people on a mephedrone binge and taking heroin and 129 people addicted to heroin.Results: Number of re-hospitalisations was higher in a group of patients on a mephedrone binge taking heroin in comparison to heroin dependent patients (91.9 vs 79.8%, p < 0.01). The interaction of the hepatitis C virus (HCV) infection with the dose of methadone taken explains 67.6% of the variance in the frequency of hospitalisation of the patients on a mephedrone binge (p < 0.001), and in the case of the dose of methadone alone - only 12% (p < 0.001). Regression analysis indicated that statistically significant majority of the subjects (p < 0.001) who received the optimal dose of methadone, namely 100-110 ml, were hospitalised once.Conclusions: The interaction of the methadone dose with HCV infection plays a very important role in the frequency of hospitalisation of patients taking mephedrone with heroin on a regular basis.KEY POINTSThe number of hospitalisations was higher in a group of patients on a mephedrone binge taking heroin in comparison to heroin dependent patientsThe interaction of the sex of the subjects and HCV infection with the dose of methadone taken explains 80.3 and 67.6% of variance in the frequency of hospitalisations, respectivelyThe most optimal dose of methadone in the group of people taking mephedrone with heroin ranges between 100 and 110 ml.

Statistical recommendations for the Global Burden of Disease studies.

Studies Global Burden of Disease (GBD) presents an all-encompassing portrayal of mortality and disability, considering various countries, time periods, age groups, and sex. This article presents statistical recommendations for GBD studies.

Statistical reviews in journals of the World Association of Medical Editors.

INTRODUCTION: In recent years, there has been a decline in the quality of statistical reporting in biomedical scientific journals. OBJECTIVES: The aim of this survey study was to find out the opinions of the World Association of Medical Editors (WAME) members on statistical reviews conducted in their journals, and to summarize the related recommendations that should be implemented in this area. METHODS: A survey containing 25 questions on a range of aspects related to statistical peer review was distributed to WAME members and editorial staff of the journals they are affiliated with. RESULTS: The survey was completed by 141 individuals, the largest proportion of whom were editors­in­chief (36.9%). According to 40% of the respondents, only 31%-50% of the manuscripts accepted for publication are statistically correct. The higher the respondents' assessment of their own statistical knowledge, the lower they believed this percentage to be (P = 0.02). The frequency of statistical peer review was estimated by most respondents at only 1%-10% of the submitted manuscripts. The main reasons for this included difficulty in finding reviewers with the right skills and a lack of funding in this area. Among the respondents working for journals without a statistical editor on the editorial board, 49% believed that statistical reviews enhance the quality of published manuscripts, whereas among those confirming a presence of a statistical editor, this percentage was as high as 84% (P <0.001). Only 5% of the respondents stated that their journal uses the Statistical Analyses and Methods in the Published Literature recommendations. CONCLUSIONS: Nowadays, members of editorial boards face significant problems related conducting statistical reviews for their journals. For this reason, it is imperative to start implementing statistical guidelines for biomedical journals.

Poor statistical reporting: do we have a reason for concern? A narrative review and recommendations.

PURPOSE OF REVIEW: The aim of the review conducted was to present recent articles indicating the need to implement statistical recommendations in the daily work of biomedical journals. RECENT FINDINGS: The most recent literature shows an unchanged percentage of journals using specialized statistical review over 20 years. The problems of finding statistical reviewers, the impractical way in which biostatistics is taught and the nonimplementation of published statistical recommendations contribute to the fact that a small percentage of accepted manuscripts contain correctly performed analysis. The statistical recommendations published for authors and editorial board members in recent years contain important advice, but more emphasis should be placed on their practical and rigorous implementation. If this is not the case, we will additionally continue to experience low reproducibility of the research. SUMMARY: There is a low level of statistical reporting these days. Recommendations related to the statistical review of submitted manuscripts should be followed more rigorously.

Assessment Study of ChatGPT-3.5's Performance on the Final Polish Medical Examination: Accuracy in Answering 980 Questions.

BACKGROUND/OBJECTIVES: The use of artificial intelligence (AI) in education is dynamically growing, and models such as ChatGPT show potential in enhancing medical education. In Poland, to obtain a medical diploma, candidates must pass the Medical Final Examination, which consists of 200 questions with one correct answer per question, is administered in Polish, and assesses students' comprehensive medical knowledge and readiness for clinical practice. The aim of this study was to determine how ChatGPT-3.5 handles questions included in this exam. METHODS: This study considered 980 questions from five examination sessions of the Medical Final Examination conducted by the Medical Examination Center in the years 2022-2024. The analysis included the field of medicine, the difficulty index of the questions, and their type, namely theoretical versus case-study questions. RESULTS: The average correct answer rate achieved by ChatGPT for the five examination sessions hovered around 60% and was lower (p < 0.001) than the average score achieved by the examinees. The lowest percentage of correct answers was in hematology (42.1%), while the highest was in endocrinology (78.6%). The difficulty index of the questions showed a statistically significant correlation with the correctness of the answers (p = 0.04). Questions for which ChatGPT-3.5 provided incorrect answers had a lower (p < 0.001) percentage of correct responses. The type of questions analyzed did not significantly affect the correctness of the answers (p = 0.46). CONCLUSIONS: This study indicates that ChatGPT-3.5 can be an effective tool for assisting in passing the final medical exam, but the results should be interpreted cautiously. It is recommended to further verify the correctness of the answers using various AI tools.

Placebo-controlled randomized clinical trials of antidepressants for major depressive disorder: Analysis of ClinicalTrials.gov, 2008-2022.

The purpose of this study was to analyze the key aspects of the design of contemporary placebo-controlled randomized clinical trials (RCTs) of antidepressants enrolling patients with major depressive disorder (MDD) aged 18 years or older, especially the outcome measures and the eligibility criteria. The study included 122 RCTs registered with ClinicalTrials.gov and started from 2008 through 2022. Most RCTs assessed only clinical remission, with proportion of trials with outcome measures related to functional remission being rather low (n = 34; 28 %). Clinical remission was mostly evaluated in acute phase of depression, and only 7 (6 %) trials assessed the prevention of relapse. Proportion of trials utilizing self-report questionnaires that provide important information complementary to clinician-rated scales was moderate (n = 66; 54 %). Another problem in included RCTs was common use of stringent eligibility criteria. For instance, minimal symtpom severity required for the patient's inclusion was listed in 104 RCTs (85 %), and 41 RCTs (34 %) excluded patients based on comorbid anxiety disorders. Most RCTs (n = 103; 84 %) excluded older patients, and only 6 (5 %) trials were dedicated exclusively to them. To ensure optimal development of clinical pharmacotherapy of MDD, the investigators should consider modification of some of the key aspects of the design of RCTs of antidepressants.

Magnetic Resonance Imaging and Manganism: A Narrative Review and Laboratory Recommendations.

In recent years, a series of articles has been published concerning magnetic resonance imaging (MRI) studies in a group of patients exposed to manganism, specifically factory workers, welders, and individuals with liver diseases, as well as those abusing home-produced ephedrone. Some potential symptoms of manganese toxicity include motor disturbances, neurocognitive problems, sleep disorders, and psychosocial changes. Despite various publications on MRI research in individuals with an elevated risk of manganism, there is a noticeable absence of a comprehensive review in this field. The detection of the accumulation of manganese in the brain through MRI can confirm the diagnosis and guide appropriate treatment. Due to the high cost of determining manganese ion levels in biological material, an additional aim of the manuscript was to identify simple medical laboratory parameters that, when performed concurrently with MRI, could assist in the diagnosis of manganism. Among these types of parameters are the levels of bilirubin, magnesium, liver enzymes, creatinine, hemoglobin, and hematocrit.