A rapid review on current and potential uses of large language models in nursing.

BACKGROUND: The application of large language models across commercial and consumer contexts has grown exponentially in recent years. However, a gap exists in the literature on how large language models can support nursing practice, education, and research. This study aimed to synthesize the existing literature on current and potential uses of large language models across the nursing profession. METHODS: A rapid review of the literature, guided by Cochrane rapid review methodology and PRISMA reporting standards, was conducted. An expert health librarian assisted in developing broad inclusion criteria to account for the emerging nature of literature related to large language models. Three electronic databases (i.e., PubMed, CINAHL, and Embase) were searched to identify relevant literature in August 2023. Articles that discussed the development, use, and application of large language models within nursing were included for analysis. RESULTS: The literature search identified a total of 2028 articles that met the inclusion criteria. After systematically reviewing abstracts, titles, and full texts, 30 articles were included in the final analysis. Nearly all (93 %; n = 28) of the included articles used ChatGPT as an example, and subsequently discussed the use and value of large language models in nursing education (47 %; n = 14), clinical practice (40 %; n = 12), and research (10 %; n = 3). While the most common assessment of large language models was conducted by human evaluation (26.7 %; n = 8), this analysis also identified common limitations of large language models in nursing, including lack of systematic evaluation, as well as other ethical and legal considerations. DISCUSSION: This is the first review to summarize contemporary literature on current and potential uses of large language models in nursing practice, education, and research. Although there are significant opportunities to apply large language models, the use and adoption of these models within nursing have elicited a series of challenges, such as ethical issues related to bias, misuse, and plagiarism. CONCLUSION: Given the relative novelty of large language models, ongoing efforts to develop and implement meaningful assessments, evaluations, standards, and guidelines for applying large language models in nursing are recommended to ensure appropriate, accurate, and safe use. Future research along with clinical and educational partnerships is needed to enhance understanding and application of large language models in nursing and healthcare.

Quantitative method to evaluate the functionality of the trigeminal nerve.

PURPOSE: The primary objective of this study was to yield normal range values, with a current perception threshold technique, that could be used to assess the functionality of the third division of the trigeminal nerve on a healthy population. Moreover, we wanted to evaluate the impact of gender and training on these values. PATIENTS AND METHODS: Standardized current perception threshold (CPT) measures using constant alternating current sinusoid waveform stimulus at 5, 250, and 2,000 HZ were obtained from 50 healthy patients at the mental foramen area bilaterally using a Neurometer current perception threshold device (Neurotron Inc, Baltimore, MD) (2,000 Hz specifically stimulates Abeta fibers, 250 Hz Adelta fibers, and 5 Hz stimulates C fibers). RESULTS: The mean CPT values for the 2,000, 250, and 5 Hz groups were respectively, 157.6 +/- 54.67, 53.10 +/- 27.64, and 33.44 +/- 23.17 mAmp. These values were used to construct a CPT scale to classify patients in the hyperesthetic, normative, or hypoesthetic range. There were no significant differences when comparing CPT values in men and women except in the 2,000 Hz group (P < .02; n = 23). In addition, the test was carried out a first time on the right side and a second time on the left. This training procedure showed a significant decrease in the CPT values in men at 2,000 Hz (P < .01; n = 23) for the second measure. CONCLUSION: The Neurometer can be beneficial for the evaluation and intraneural localization of sensory dysfunctions associated with the third division of the trigeminal nerve. It also could be used for initial diagnosis and subsequent evaluation of the patient's neurologic status through the course of their condition.

The expression pattern of the ITIM-bearing lectin CLECSF6 in neutrophils suggests a key role in the control of inflammation.

In our study of the modulation of the expression of inflammation-related genes in neutrophils, we have found a gene called CLECSF6 (C-type lectin superfamily 6). CLECSF6 expresses two mRNA species at low levels in resting neutrophils. Here, we describe for the first time the sequence of the short mRNA version. It lacks amino acids that are likely to affect the functionality of its protein product. GM-CSF, IL-3, IL-4, and IL-13 caused an accumulation of the short CLECSF6 mRNA in neutrophils. The surface expression of the CLECSF6 protein was reduced by TNF-alpha, IL-1alpha, LPS, and Matrigel. CLECSF6 bears the immunoreceptor tyrosine-based inhibition motif (ITIM) involved in signal transduction resulting in the inhibition of leukocyte activation. We propose that some neutrophil activators modulate the expression of CLECSF6 at the mRNA (GM-CSF, IL-3, IL-4, and IL-13) or protein (TNF-alpha, IL-1alpha, LPS, and Matrigel) levels in ways that block ITIM-based transduction of anti-inflammatory signals and therefore promote inflammation.

Antiplatelet drugs : is there a surgical risk?

Acetylsalicylic acid has long been the only nonsteroidal anti-inflammatory drug recommended for the treatment and prevention of thromboembolic diseases. More recently, new compounds have been used in patients with vascular diseases. However, these drugs are often associated with longer bleeding times and greater operative risk. In most surgical specialties, the question always arises as to whether antiplatelet therapy should be stopped before elective surgery. If so, for how long? If not, what are the risks? This article reviews the various antiplatelet drugs in use today, focusing on their mode of action, their effects on platelet function and the associated operative risks. It also proposes an algorithm for decision making in this setting, based on the literature and an understanding of the mechanisms of action of this class of drugs.