Acta Informatica Medica最新文献

Background: The integration of artificial intelligence (AI) into medical education has sparked a paradigm shift in pedagogical approaches, reshaping the way medical knowledge is accessed, processed, and applied. Medical education is a dynamic field that demands continuous adaptation to the evolving healthcare landscape. ChatGPT, an advanced AI language model, with its natural language understanding and generation capabilities, offers a multifaceted toolset that enhances various aspects of medical education.

Objective: The objective of this paper is to explore how ChatGPT, an advanced AI language model, is transforming medical education by serving as a dynamic information resource and driving curriculum reform. It aims to highlight the multifaceted uses of ChatGPT and its potential to reshape the pedagogical landscape in medical education.

Methods: PubMed, Scopus, Web of Science, ERIC, and Google Scholar databases were searched to assess the literature that met the study objectives from 2019 to August 2023 with explicit inclusion and exclusion criteria.

Results: The results demonstrate that ChatGPT's applications in medical education are diverse and encompass real-time curriculum adaptation, personalized learning, and collaborative learning. Its capacity to provide immediate and contextually relevant information has the potential to enhance the quality of medical education significantly.

Conclusion: ChatGPT's integration into medical education represents a transformative shift in educational approaches. It offers a wide range of capabilities, from serving as a repository of medical knowledge to facilitating collaborative learning. As medical education continues to evolve, ChatGPT emerges as a powerful tool that can reshape pedagogy and drive meaningful curriculum reform to meet the needs of modern healthcare practice.ChatGPT emerges as a transformative tool that holds the potential to reshape the landscape of medical pedagogy and drive meaningful curriculum reform.

Background: Health information systems (HIS) are considered a vital tool to strengthen Low- and Middle-Income Countries' (LMIC) health systems. Unfortunately, little is known about the technical factors of HIS in LMIC.

Objective: This study aimed to make an empirical contribution, using the case of Kosova to find out about HIS development, trying to identify dysfunctional areas and opportunities for improvement.

Methods: Technical factors of the PRISM framework were analyzed via document analysis, and semi-structured interviews were held with 15 respondents from the Ministry of Health, the National Institute of Public Health of Kosova, and the Hospital Clinical University Services of Kosova. Interviews were transcribed and coded deductively, using the defined theoretical framework to guide the content analysis.

Results: The results indicate that MoH considered technical factors while developing HIS in Kosova. Nevertheless, HIS fulfills only some of the essential functions. Barriers to efficient HIS among technical factors are lengthy, time-consuming manual HIS forms, inadequate data from HIS forms for NIPHK analysis, difficulties when changing software and HIS economic operators, and the complexity of HIS functioning.

Conclusion: Kosova still faces technical difficulties with an efficient and sustainable HIS system. Complex processes of extensive efforts have yet to produce the desired results, which prevent evidence-based health analysis and informed decision-making in Kosovar healthcare. More research is needed into organizational and behavioral factors influencing HIS efficiency in LMIC.

Background: Inflammatory cytokines like Matrix Metalloproteinases (MMPs) are associated with the destruction observed in periodontal disease (3). There has been evidence of significant increases in MMP levels in patients with systemic disorders, such as Diabetes Mellitus (DM), which is associated with microvascular complications, causing increased MMP activity, directly or indirectly, due to oxidative stress. Objective: The aim of this study was conducted in order to assess wound healing using MMP-8 levels in GCF of diabetics with chronic periodontitis after diode laser assisted flap surgery.

Methods: This interventional, comparative clinical trial, was conducted after obtaining approval from the Institutional Ethics Committee (IEC), (Study protocol number: 48/2020), and registered with Clinical Trials Registry of India (CTRI/2022/07/043898). Purposive sampling technique was used to select 30 patients with chronic periodontitis (15 systemically healthy patients, and 15 diabetic patients), who visited the Department of Periodontology.

Results: Out of the 30 patients initially selected, 3 patients were lost to follow up and 1 patient was excluded from the study due to lack of compliance towards oral hygiene maintenance. Intragroup comparison of the clinical parameters at baseline and 3 months in both groups was statistically significant (p=0.000). This concludes that there was statistically significant improvement in the periodontal parameters of non-diabetic patients after diode laser assisted flap surgery. Inter-group comparison of the clinical parameters did not show statistical significance at baseline and at 3 months (p > 0.05). It can be concluded that there was comparable changes in the periodontal parameters in both groups after surgery.

Conclusion: MMP-8 could be used as a futuristic tool for assessing wound healing especially in diabetics, so that necessary treatment interventions can be undertaken prior to development of any post-op complications. Laser assisted Modified Widman flap showed noteworthy improvement in the clinical parameters in both groups. Thus, proving that laser assisted MWF surgery is a favorable treatment modality, especially in diabetics who are immunocompromised and prone to infections.

Background: SARS-CoV-2 is an infectious disease caused by the coronavirus that was first reported in December 2019 in China and immediately spread around the world causing a pandemic, which has caused countless deaths and cases in global health. Mental health has not gone untouched by this pandemic; due to the lockdown and the vast amounts of information disseminated, the Panamanian population has begun to feel the collateral effects.

Objective: We propose classifying tweets using a machine learning (ML) and deep learning (DL) approach and pattern search to make recommendations to the emotional and psychological reactions of the Panamanian population.

Methods: Our study has been carried out with a corpus in spanish extracted from X for the automatic classification of texts, from which we have categorized, through the ML&DL approach, the tweets about Covid-19 in Panama, in order to know if the population has suffered any mental health effects.

Results: We can say that the ML models provide competitive results in terms of automatic identification of texts with an accuracy of 90%.

Conclusion: X is a social network and an important information channel where you can explore, analyze and organize opinions to make better decisions. Text mining and patron search are a natural language processing (NLP) task that, using ML&DL algorithms, can integrate innovative strategies into information and communication technologies.

Background: Simulations have revolutionized surgical training and are an invaluable adjunct tool for augmenting the proficiency of surgeon and patient safety. Before being included in a practical assessment process, simulators need to be using various validity inference frameworks.

Objective: We examine the construct validity and reliability of the Rezum simulator.

Methods: Seventeen candidates of different professions voluntarily participated in the Rezum simulation workshop. The simulator provides a variety of variable metrics and challenges. Each candidate performed three cases of different difficulty levels with three trials of each case. Validity was measured statistically through a one-way analysis of variance (ANOVA) test, and a p-value of < 0.05 was considered significant. Additional reliability tests were provided, including intraclass correlation coefficients, a Cronbach test (0.7 is considered acceptable), and standard error of measurement.

Results: The ANOVA of total scores among candidates was significant (p = 0.029). Senior registrars and consultants had the highest total scores. Procedure times did not differ significantly among candidates (p = 0.169). The reliability test for the total score was 0.899 (0.831-0.942), with a standard error value of 2.75, a standard deviation of 8.67, and a Cronbach alpha value of 0.915.

Conclusion: We confer the primer evidence of Rezum simulation as a valid, reliable simulator of most of its metrics.

Background: The rapid development of medical technology in managing breast cancer patients still cannot solve the problem of recurrence and resistance. One of the causes of recurrence and molecular resistance is the presence of breast cancer stem cells (BCSCs). Clinacanthus nutans (C.nutans) is a plant found in Medan, North Sumatra, Indonesia. This plant is believed to have anticancer activity in community.

Objective: Our study aimed to assess phytochemical of C.nutans leaves, isolate breast cancer stem cells and determine the cytotoxic effects of the ethanolic extract and water extract of C.nutans leaves on breast cancer stem cells at 24, 48, and 72 h of observation.

Methods: We underwent the cytotoxic test by using MTT assay and isolated breast cancer stem cells by using MACS and validated them by mammosphere test.

Results: We found alkaloids, flavonoids, glycosides and tannins in simplicia and all extracts. BCSCs was valid with the diameter of the mammosphere BCSCs was > 60 μm. The IC50 values of 100%, 60%, 40%, 20% EE, and WE of C.nutans leaves were 227.30; 46.05; 31.12; 98.54, and 16.16 μg/ml respectively in the first 24 hours. In administering WE of C.nutans leaves, BCSCs viability was decreased at 24,48 and 72 hours of observation, namely 69.29±26%; 75.82 ± 21.02% and 38.94±9.34 % (p < 0.0001).

Conclusion: The WE of C.nutans leaves had more substantial cytotoxic potential against BCSCs than the EE. The capability of WE C.nutans leaves to suppress BCSC's viability was time-dependent. The anticancer activity were believed originate from alkaloid and flavonoid group.

Background: The lumbar spinal canal consists of 5 interconnected lumbar vertebrae through which the final part of the spinal cord passes and the lumbar and sacral spinal nerves that form the cauda equina. The lumbar canal stenosis can directly affect neurological symptoms and pain in the lumbar region and lower extremities. Due to the frequency of such symptoms, lumbar stenosis has been the subject of research around the world.

Objective: The objective of this study was to measure, analyze and compare the mediosagital and interpeduncular diameters of the lumbar spinal canal in the population of Bosnia and Herzegovina to other populations around the world.

Methods: We conducted a retrospective descriptive study on patients (n=200) who underwent Multi-slice computer tomography (MSCT) performed on a 40-slice CT scanner (Siemens Somatom Definition AS) for lumbar pain between January 1, 2013 and December 31, 2014. Age, gender, midsagittal (MSG) and interpeduncular (IP) diameters of the lumbar spine were recorded for each patient.

Results: Results of our study show that the largest MSG diameter is at L1 level for both sexes, with an average length of 19,06mm, and the smallest at L3 level, with an average length of 16,66mm. Our study shows that the MSG diameter is significantly larger in females than males on all levels from L1 to L5. In both sexes, MSG diameter shows the form of an hourglass with narrowing at L3 level. IPD is largest at L5 level for both sexes, with an average length of 31,94mm, and the smallest average length at L1 level, at 24,78mm. IPD diameter is significantly larger in males than females on all levels from L1 to L5. IPD shows a tendency of growth from L1 to L5 in both sexes.

Conclusion: There were significant differences in the dimensions of the lumbar spine canal between female and male patients. We found significant difference in MSG and IP diameters measurements between Bosnian and Herzegovinian population compared to other populations. The dimensions of the lumbar canal provide a baseline of normative data for the evaluation of patients presenting with lower back pain and lumbar canal stenosis in study population.

Background: Psoriasis as an immune-mediated inflammatory skin disease. The basis of the pathogenesis of psoriasis is the dysregulation of immune cell function in genetically predisposed individuals. The characteristic dysfunction of the immune system in patients with psoriasis is manifested as a variation in the cellular phenotypic profile in accordance with the disease status.

Objective: The aim of this study was to evaluate the immunophenotypic profile of lymphocytes obtained by flow cytometry as an auxiliary diagnostic tool in the objectivization of the PASI score.

Methods: The study group included 40 patients with psoriasis, hospitalized and treated at Dermatology Clinic of Clinical center University of Sarajevo and 30 healthy individuals as controls. After venepunction, the blood samples for determining the immune profile were prepared following standard laboratory procedures using conjugated monoclonal antibodies and BD FACSCanto II flow cytometer. T-lymphocytes (CD3, CD4, CD8), B lymphocytes (CD19), Natural killer cells (NK), and activatet T-cells (CD3HLA) were determined for all patients. Based on the PASI score, the severity and area of the disease was assessed for all psoriasis patients by dermatology specialist.

Results: Our data shows no significant difference in any of the lymphocyte subpopulations between psoriasis patients and healthy controls, except CD3HLA. CD3HLA has higher values in patients with psoriasis, p=0.015. Of all the parameters, only NK cells were significantly correlated to the PASI score (rho -0.279; p=0.048). ROC curve analysis revealed a statistically significant difference for the proportion of CD3 lymphocytes (AUC 0.799; p=0.004), CD8 lymphocytes (AUC 0.733; p= 0.023), NK cells (AUC 0.722; p=0.008) and CD3HLA activated T lymphocytes (AUC 0.347; p=0.034).

Conclusion: Profile of major lymphocyte subsets in patients with psoriasis is similar to that of healthy controls. The values of CD3, CD8, NK, CD3HLA were defined as biomarkers capable of distinguishing psoriasis according to the severity of the disease. Immunophenotyping of peripheral blood lymphocytes can play an important role as an auxiliary diagnostic method in differentiating the clinical stages of psoriasis and objectifying the PASI score.

Background: Immediate implant placement (IIP) has become an attractive treatment for many patients. It reduces time and the number of appointments and protects soft and hard tissue, which, in many circumstances, leads to a better esthetic outcome. IIP with provisionalization (IIPP) may contribute to a more promising result due to the guidance of soft tissue and the preservation of the hard tissue. Indications for IIPP are quite strict, and cone beam computed tomography (CBCT) is a must for case selection.

Objective: This case report will demonstrate how IIP with immediate provisionalization can result in a high esthetic outcome and no discomfort for the patient.

Case presentation: A 50-year-old female presented for implant placement following the extraction of a superior central incisor due to a vertical fracture. IIPP has been used.

Conclusion: IIPP can accomplish a stable esthetic result in the case of ideal three-dimensional implant positioning, a well-polished provisional restoration with an S-shaped buccal emergence profile, and by respecting the mesial and distal embrasure spaces for papilla maturity.

Background: Evidence Based Practice is considered a complex process with many factors hindering its implementation. The use of focus groups to detect barriers to its application can provide an in-depth investigation of the phenomenon.

Objective: The investigation of nurses' views regarding the obstacles connected to the implementation of Evidence Based Practice.

Methods: This is a qualitative study carried out using focus groups and constitutes the continuation of a quantitative study. Deliberate sampling was used to recruit a total of 31 nurses.

Results: The main categories that emerged regarding the obstacles in the implementation of Evidence Based Practice in nursing, concerned the lack of logistical support, the difficulty of accessing data, the insufficient knowledge of nurses as well as their attitude, the nature of the work, the decision-making process and the impossibility of safeguarding decisions made.

Conclusion: In this study, various factors were identified that affect the application of Evidence Based Practice, in the nursing environment of Cyprus. Identifying these factors can be the basis for discussions and finding ways to resolve the problems that exist by health care managers.