Evaluating the strengths and weaknesses of large language models in answering neurophysiology questions.

Large language models (LLMs), like ChatGPT, Google's Bard, and Anthropic's Claude, showcase remarkable natural language processing capabilities. Evaluating their proficiency in specialized domains such as neurophysiology is crucial in understanding their utility in research, education, and clinical applications. This study aims to assess and compare the effectiveness of Large Language Models (LLMs) in answering neurophysiology questions in both English and Persian (Farsi) covering a range of topics and cognitive levels. Twenty questions covering four topics (general, sensory system, motor system, and integrative) and two cognitive levels (lower-order and higher-order) were posed to the LLMs. Physiologists scored the essay-style answers on a scale of 0-5 points. Statistical analysis compared the scores across different levels such as model, language, topic, and cognitive levels. Performing qualitative analysis identified reasoning gaps. In general, the models demonstrated good performance (mean score = 3.87/5), with no significant difference between language or cognitive levels. The performance was the strongest in the motor system (mean = 4.41) while the weakest was observed in integrative topics (mean = 3.35). Detailed qualitative analysis uncovered deficiencies in reasoning, discerning priorities, and knowledge integrating. This study offers valuable insights into LLMs' capabilities and limitations in the field of neurophysiology. The models demonstrate proficiency in general questions but face challenges in advanced reasoning and knowledge integration. Targeted training could address gaps in knowledge and causal reasoning. As LLMs evolve, rigorous domain-specific assessments will be crucial for evaluating advancements in their performance.

Time indicators of pre-hospital emergency missions in Qazvin province in 2021-2022.

BACKGROUND: Pre-hospital emergency has a crucial role in providing timely care for patients. In this system, seconds and minutes mean the difference between life and death. Considering the importance of the role of pre-hospital emergency in providing services to different patients and the necessity of continuous evaluation of this system, the present study was conducted to investigate time indicators in pre-hospital emergency missions. METHODS: This cross-sectional study was conducted in 2022 in Qazvin province, Iran. The research population was all the calls made to pre-hospital emergency bases in Qazvin province The required information, including time indicators and demographic characteristics of the patient, was obtained using the electronic registration system (Asayar). Data were Analysis using descriptive statistics and SPSS 20 software. RESULTS: Out of the 35,943 patients admitted to the hospital, 20,915 were male while the remaining were female. The mean age of the patients was 44.09 ± 21.82 years. Accidents (29.41%) were the most common reason for contacting the pre-hospital emergency. In all transfer missions, the mean delay time (0:02:23 ± 0:03:33), response time (0:15:02 ± 0:09:42), the time on the scene (0:18:33 ± 0:11:10), total run time (0:54:02 ± 0:25:20), transport time (0:20:25 ± 0:16:49), round trip time (1:32:43 ± 1:08: 43). CONCLUSIONS: The findings of the present study provided valuable information about the variety and number of missions in a pre-hospital emergency. The results showed that some indicators are within the standard range and some indicators are far from other regions of the country and the world. Increasing the number of bases, increasing the number of ambulances, and Implementation of continuous training courses for personnel can improve time indicators and increase the quality of service to different types of patients.

International aspects in healthcare and medical education: Scientometric trends and knowledge maps before the COVID-19 pandemic.

BACKGROUND: Literature shows that healthcare and medical education are associated with the countries/institutes' developments, and reviewing the global patterns can shed light on various aspects of this competition. The study aims to investigate the current research aspects on the internationalization of healthcare and medical education and assess its trends worldwide. MATERIALS AND METHODS: In this descriptive study, based on documents in Web of Science (n = 609), PubMed (n = 395), and Scopus (n = 6598), scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and trends from 1900 to 2020. Results were preprocessed in BibExcel (version 2016-02-20) to create a mapping file, and word co-occurrence analysis was applied to evaluate the publications. Scientific maps, authors' networks, and countries'/institutes' contributions were depicted using VOS (Visualization of Similarity) viewer and NetDraw. For trend analysis, highly frequent words were examined at intervals before 2000, 2000-2004, 2005-2009, 2010-2014, and 2015-2019. RESULTS: Altogether, 129 countries and 14536 (co)authors with 7007 affiliations contributed to the production of 6895 documents. Of the 2378 journals, the top 20 journals published 1298 (18.83%) articles. The top 20 authors together contributed to 247 papers (3.58%). High-income countries made up the most prolific nations. Also, institutes from North America, Europe, and Oceania pioneered production and cooperation. Highly co-occurring words were international cooperation, medical education, medical school, curriculum, medical research, and medical students. CONCLUSION: The countries/institutions' efforts in internationalizing healthcare and medical education are reflected in the publications in the databases of Web of Science, PubMed, and Scopus. Thus, the findings offer evidence-based information about past and present trends and help researchers and policymakers understand their global impact.

Investigating the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic.

BACKGROUND: Pre-hospital emergency staffs as the frontline forces fighting against COVID -19 have been affected by this pandemic. Today, the occupational and mental health of these individuals is particularly important to the health care system. Death anxiety is one of the inevitable things in this job, and not paying attention to it can cause unwanted effects such as changing the level of job satisfaction of the personnel. The purpose of this study was to determine the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic. METHODS: This cross-sectional descriptive study was conducted among pre-hospital emergency staffs in Qazvin Province, Iran in 2021-2022. Among the bases chosen by the census method, 198 samples were included in the study by the available method. Data collection tools included the Demographic Checklist, Templer's Death Anxiety scale, and the Minnesota Job Satisfaction Questionnaire. The data were analyzed with descriptive and inferential statistics and SPSS 20 software. RESULTS: The mean age of the samples was (33.14 ± 6.77). 167 persons were male and the others were female. The average job satisfaction and death anxiety of the personnel were 55.07 ± 11.50 and 8.18 ± 1.96, respectively. Pearson's correlation coefficient between the two variables was r = -0.126 And a null correlation coefficient hypothesis has been confirmed with p-value = 0.077. CONCLUSIONS: The results showed a high level of death anxiety and average job satisfaction. Although these two variables do not have a significant relationship with each other, considering that they do not have the appropriate level, it needs more investigation and consideration.

Error analysis of nonnative authors' publications in health-care journals: A descriptive study.

BACKGROUND: As nonnative speakers of English, Iranian health researchers/authors often need to publish in English; however, published manuscripts may reflect a need for language editing. The study is aimed to investigate the language accuracy of Persian authors' articles published in Iranian health journals, and to explore whether these journals take steps towards an acceptable level of Standard written English. MATERIALS AND METHODS: In this descriptive study, fifty original articles were selected from five health journals (from April 2017 to April 2018) with nonnative editors/proofreaders based on convenience sampling in 2019. The articles were carefully read several times; errors were identified according to Gass and Selinker's model and classified into four categories and further expanded into 22 subcategories. RESULTS: The results showed 4322 errors in the 50 articles, where the "grammatical errors" obtained the highest frequency, with punctuation errors (n = 989) ranking first, and errors in using auxiliary verbs (n = 19) the last in frequency. The descending order of the errors emerged as follows: the grammatical, mechanical, lexical, and discoursal errors. CONCLUSION: All categories of errors contributed to textual unintelligibility, attributable to either the authors' inadequate English proficiency or their native language interference. Most errors could have been corrected by the journal editors. Professional development courses and hands-on workshops are advised for both nonnative authors and journal editors/proofreaders in Iran to help authors keep to the conventions of scientific writing.

Sexual self-esteem in mothers of normal and mentally-retarded children.

Sexual self-esteem is negatively influenced by the stressful experiences in lifetime. This study compared the sexual self-esteem and its components in mothers with normal and mentally-retarded children in Qaen city, in 2014. A total of 120 mothers were selected and assigned into two groups of 60 samples based on convenient sampling method and randomized multiple stage sampling. Both groups completed sexual self-esteem questionnaire. The data were analyzed employing t-test through SPSS software version15. The results showed that the rate of sexual self-esteem in mothers of mentally-retarded children decreased significantly compared with that of mothers with normal children (p<0.05). Moreover, the mean scores of all components of sexual self-esteem including skill and experience, attractiveness, control, moral judgment, and adaptiveness in mothers of mentally-retarded children were significantly less than those of mothers with normal children (p <0.05). Therefore, it is recommended that self-esteem, especially the sexual one, be taught to mothers of mentally-retarded children by specialists.

DNA damage assessment in the lymphocytes of construction painters by comet assay.

BACKGROUND: Exposure to chemicals is inevitable for certain occupational groups, particularly in industrial countries. Some cytogenetic tests such as comet assay are effectively utilized to screen genotoxic effects of these chemicals in humans. The purpose of this study has been to assess the DNA damage in construction painters' lymphocytes using the comet assay. METHODS: Fourteen male construction painters with 1 year of required work experience were randomly selected from the list of Painter Union in Gonabad city, Iran. In addition, 14 healthy male non-painters were randomly selected as controls. The DNA damage degree was determined using a fluorescence microscope and CometScore software. The obtained data were analyzed employing independent t-test using SPSS software v. 14 at the significant level of p < 0.05. RESULTS: All participants were non-smokers and non-alcoholics. No significant differences were found between the two groups in terms of age, weight, height, body mass index, and systolic and diastolic blood pressure. The DNA damage in the painter group was significantly greater than that of the control group. Tail length (µm) was 12.63 ± 6.54 versus 2.90 ± 0.84, tail DNA (%) was 4.33 ± 1.84 versus 1.29 ± 0.43, and tail moment (µm) was 1.85 ± 0.98 versus 0.14 ± 0.20 in painter and control groups ( p < 0.001), respectively. CONCLUSION: The chemicals used in oil paint may increase the DNA damage in painter blood lymphocytes.

Evaluation of Antibiotic Residues in Pasteurized and Raw Milk Distributed in the South of Khorasan-e Razavi Province, Iran.

INTRODUCTION: The presence of antibiotic residues in milk and other products livestock is a health problem which can endanger public health. Antibiotics are used widely in animal husbandry to treat diseases related to bacterial infections. Antimicrobial drugs have been in use for decades in industry. They are commonly used in livestock facilities to treat mastitis. AIM: This study aimed to investigate antibiotic residues in pasteurized milk distributed in schools, in milk collection centers, and in milk production factories in Gonabad city. MATERIALS AND METHODS: This cross-sectional study was conducted on 251 samples of commercial pasteurized milk packet distributed in schools (code A), raw milk collection centers in Gonabad city (code B), and pasteurized milk production factories (code C) in Gonabad city. The Copan test kit of Denmark Christian Hansen Company was used to monitor antibiotic residues in milk. The data were analysed employing Chi-square test and one-way analysis of variance (ANOVA) to determine significant differences using SPSS software version 20. The significant level was considered at p<0.05. RESULTS: In total, 251 milk samples were collected out of which 143 (57%) were code A, 84 (33.5%) code B and 24 (9.6%) code C. Total number of 189 samples (75.2%) were negative and 62 (24.8%) were positive. From the three types of milk samples, 41 samples (28.7%) of the code A, 18 samples (21.4%) of the code B and 3 samples (12.5%) of the code C were positive. In general, from the milk samples most contaminated with antibiotics, 17 samples were positive in January and regarding code A, 13 samples were positive in the same month. There was not a significant difference among the three types of milk (p>0.05). The highest number of milk samples (n=7) contaminated with antibiotics were related to code B (38.5%). Most positive cases were related to code A in winter. Also, there was no significant difference among the three types of contaminated milk regarding the year and month (p=0.164 and p=0.917, respectively). CONCLUSION: Pasteurized milk supplied in the studied city has high level of contamination due to high use of antibiotics. A standard limit needs to be set for the right level of residue of antibiotics in milk to avoid the harmful effects.

Psychometric Properties of the Iranian Version of Modified RHAQWRA Questionnaire.

OBJECTIVE: This study aimed to examin the psychometric characteristics of the Persian version of Reproductive Health Assessment Questionnaire for Women of Reproductive Age (RHAQWRA). MATERIALS AND METHODS: This study was a cross sectional study. We selected 150 women aged 18- 45 years based on convenience sampling method who lived in the Quake-hit areas in eastern part of Iran in 2013. Some previously recognized and established instructions were undertaken in translating and adapting the RHAQWRA questionnaire culturally. We sought help and feedback from teenagers and experts in the fields of midwifery, sociology, and epidemiology to establish the face and content validity of the questionnaire. To examine the test-retest reliability indices of all the items, we used Kappa and McNemar tests. RESULTS: The Content Validity Index (CVI) and Content Validity Ratio (CVR) scores for RHAQWRA were above 0.70. RESULTS from Kappa and McNemar tests indicated a high degree of test-retest reliability. In order to evaluate the construct validity, known- group comparison (women with and without unwanted pregnancy) was used. The internal consistency reliability indexes for the subscales obtained through Cronbach's alpha were between 0.68 and 0.87. CONCLUSION: The findings suggest that the Iranian version of RHAQWRA is a valid and reliable questionnaire which can be used for measuring reproductive health needs during disasters.

Effect of repetitive transcranial magnetic stimulation on reducing spasticity in patients suffering from HTLV-1-associated myelopathy.

PURPOSE: Human T-lymphotropic virus type 1 has been implicated in human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Regarding its endemicity in Iran and the role of repetitive transcranial magnetic stimulation in reducing spasticity, we decided to evaluate the efficacy of repetitive transcranial magnetic stimulation in reducing spasticity (as primary outcome) and pain, muscle power, and quality of life (as secondary outcomes) in patients suffering from HAM/TSP. METHODS: In this pretest-posttest study, nine definite patients with HAM/TSP (according to WHO guidelines) were recruited. All patients underwent five consecutive daily sessions of active repetitive transcranial magnetic stimulation (each session consisting of 20 trains of 10 pulses at 5 Hz and an intensity of 90% of resting motor threshold for the biceps brachii muscle). Main outcome measures including spasticity (by modified Ashworth scale), pain (by visual analog scale), muscle power, and quality of life (by SF 36) were measured before the study and days 5, 7, 30 after the termination of the sessions. RESULTS: Seven (77.8%) females and 2 (22.2%) males were recruited with the mean age of 52 ± 12.67 years, and the mean duration of the disease was 5 ± 3.94. Comparison of the repeated measures showed a statistically significant decrease in pain and spasticity in lower limbs. The decrement in spasticity was persistent even 30 days after the intervention; however, the pain reduction was seen only 5 days after the procedure. No change in quality of life, and muscle power was detected. CONCLUSIONS: It seems that repetitive transcranial magnetic stimulation could decrease spasticity and pain in patients with HAM/TSP, and this effect could persistently continue by 1 month, but it did not influence patients' muscle power and quality of life, and it could be used as an adjuvant therapy in patients suffering from human T-lymphotropic virus type 1-associated HAM/TSP.

Chronic inflammatory demyelinating polyneuropathy associated with diabetes mellitus.

Various forms of neuropathy are seen diabetic patients; chronic inflammatory demyelinating polyneuropathy (CIDP) seems not to be infrequent neuropathy in patients suffering from diabetes and it seems to be more common than in the general population; on the contrary, some authorities do not support pathogenetic association between diabetes mellitus (DM) and CIDP. Also, there are some controversies on the subject of CIDP treatment in diabetic patients. Some studies showed that patients with CIDP-DM considerably had recovered following treatment with immunotherapeutic modalities like (Intravenous immunoglobulin) IVIG and conversely, some else have argued against the prescription of IVIG in this group and recommend treatment with corticosteroids and provided that resistant, rituximab may be beneficial. The main limitation in most studies is the inadequate number of cases and as a result, problematic decision making in treatment. This article represents an inclusive review of diabetic CIDP presentation and treatment.

One-pot synthesis of tetrazolo[1,5-a]pyrimidines under solvent-free conditions.

A series of 5,7-diaryl-4,7-dihydrotetrazolo [1,5-a]pyrimidines and 5-methyl-7-aryl-4,7-dihydrotetrazolo [1,5-a]pyrimidine-6-carboxylates were obtained from aryl aldehydes, 2-aminotetrazole, substituted acetophenones, or ethyl acetoacetate in good to excellent yields by proceeding through a simple, mild, and efficient procedure utilizing N,N,N,N-tetrabromobenzene-1,3-disulfonamide as catalyst.

N, N, N', N'-Tetrabromobenzene-1,3-disulfonamide and poly (N-bromo-N-ethylbenzene-1,3-disulfonamide) as new and efficient catalysts for the synthesis of highly substituted 1,6-dihydropyrazine-2,3-dicarbonitrile derivatives.

Various mono and bis-1,6-dihydropyrazine-2,3-dicarbonitrile derivatives were efficiently synthesized by reacting 2,3-diaminomaleonitrile (DAMN), isocyanides and ketones in the presence of a catalytic amount of N, N, N ,N-tetrabromobenzene-1,3-disulfonamide [TBBDA] and poly(N-bromo-N-ethylbenzene-1,3-disulfonamide) [PBBS] in EtOH/H2O at ambient temperature.