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.

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.

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.

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.

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.

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.

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. OBJECTIVES: The aim of this survey was to find out the opinions of members of the World Association of Medical Editors (WAME) on the statistical reviews conducted in their journals and the related recommendations that should be implemented. METHODS: A questionnaire containing 25 questions on a range of statistical aspects was distributed to WAME members and their journals. RESULTS: The survey was completed by 141 respondents, the largest proportion of whom were editors-in-chief (36.9%). According to 40 per cent of them, only 31-50 per cent of accepted manuscripts are statistically correct. The higher their assessment of their own statistical knowledge, the lower they believe this percentage to be (P = 0.02). The frequency of statistical peer review was estimated by most respondents to be only 1-10%. These mainly include the difficulty in finding people with the right skills and the lack of funding in this area. Among respondents without a statistical editor on the editorial board, 49% believe that statistical reviews enhance the quality of published manuscripts, whereas those confirming such a presence evaluated the percentage as high as 84% (P <0.001). Only 5% of respondents said that their journal uses SAMPL (Statistical Analyses and Methods in the Published Literature) recommendations. CONCLUSIONS: Nowadays, members of editorial boards face significant problems in conducting reviews in their journals. For this reason, it is imperative to start implementing statistical peer review for biomedical journals.

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.

Precision medicine in oncology - machine learning recommendations.

The article describes recommendations related to machine learning methods in oncology.

ChatGPT's Skills in Statistical Analysis Using the Example of Allergology: Do We Have Reason for Concern?

BACKGROUND: Content generated by artificial intelligence is sometimes not truthful. To date, there have been a number of medical studies related to the validity of ChatGPT's responses; however, there is a lack of studies addressing various aspects of statistical analysis. The aim of this study was to assess the validity of the answers provided by ChatGPT in relation to statistical analysis, as well as to identify recommendations to be implemented in the future in connection with the results obtained. METHODS: The study was divided into four parts and was based on the exemplary medical field of allergology. The first part consisted of asking ChatGPT 30 different questions related to statistical analysis. The next five questions included a request for ChatGPT to perform the relevant statistical analyses, and another five requested ChatGPT to indicate which statistical test should be applied to articles accepted for publication in Allergy. The final part of the survey involved asking ChatGPT the same statistical question three times. RESULTS: Out of the 40 general questions asked that related to broad statistical analysis, ChatGPT did not fully answer half of them. Assumptions necessary for the application of specific statistical tests were not included. ChatGPT also gave completely divergent answers to one question about which test should be used. CONCLUSION: The answers provided by ChatGPT to various statistical questions may give rise to the use of inappropriate statistical tests and, consequently, the subsequent misinterpretation of the research results obtained. Questions asked in this regard need to be framed more precisely.

ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia.

BACKGROUND: COVID-19 can lead to functional disorders and complications, e.g., pulmonary, thromboembolic, and neurological. The neuro-invasive potential of SARS-CoV-2 may result in acute brain malfunction, which manifests as delirium as a symptom. Delirium is a risk factor for death among patients hospitalized due to critical illness. Taking the above into consideration, the authors investigated risk factors for delirium in COVID-19 patients and its influence on outcomes. METHODS: A total of 335 patients hospitalized due to severe forms of COVID-19 were enrolled in the study. Data were collected from medical charts. RESULTS: Delirium occurred among 21.5% of patients. In the delirium group, mortality was significantly higher compared to non-delirium patients (59.7% vs. 28.5%; p < 0.001). Delirium increased the risk of death, with an OR of 3.71 (95% CI 2.16-6.89; p < 0.001). Age, chronic atrial fibrillation, elevated INR, urea, and procalcitonin, as well as decreased phosphates, appeared to be the independent risk factors for delirium occurrence. CONCLUSIONS: Delirium occurrence in patients with severe COVID-19 significantly increases the risk of death and is associated with a cardiovascular burden. Hypophosphatemia is a promising reversible factor to reduce mortality in this group of patients. However, larger studies are essential in this area.