Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Purpose: Central venous catheter (CVC) insertion is a fundamental skill required for trainees to become proficient. Simulation-based training (SBT) has been shown to improve trainees’ CVC insertion performance effectively. However, implementing a CVC curriculum requires substantial costs and resources. Currently, there is a lack of validated CVC curricula that institutions can adopt as frameworks. This study aimed to evaluate the effectiveness of our institution’s CVC simulation curriculum in improving residents’ confidence and comfort with CVC insertion and management. Materials and Methods: First-year residents (n=118) participated in SBT between 2017 and 2023. Among them, 57 (48%) participants completed surveys before training and 6 months post-training to assess changes in comfort levels across various aspects of CVC insertion. Survey responses were analyzed to evaluate the overall changes in comfort by year and items. Results: Overall comfort increased from 42.1% before training to 81.3% after training (P<0.01), with notable improvements in nonprocedural aspects. Comfort with performing the unsupervised procedure increased by 16.7% (P<0.05) but remained low post-training (29.6%). Conclusion These findings suggest that the curriculum effectively enhances residents’ comfort, particularly in nonprocedural aspects, but only partially prepares them for unsupervised CVC insertions. This indicates a gap in procedural skill acquisition despite the overall positive trends. Implementing a similar CVC curriculum may help institutions reduce CVC insertion-associated complications.

Purpose: Chronic obstructive pulmonary disease (COPD) is characterized by alveolar destruction and increased inflammation, leading to respiratory symptoms. This study aimed to identify the traits for COPD progression from mild to severe stages. Additionally, we explored the correlation between coronavirus disease-2019 (COVID-19) and COPD to uncover overlapping respiratory patterns. Materials and Methods: Bulk RNA sequencing was conducted on data from 43 healthy individuals and 39 COPD patients across one dataset (GSE239897) to distinguish COPD characteristics. Single-cell RNA analysis was then performed on samples from seven mild patients, seven moderate patients, and three severe patients from three datasets (GSE167295, GSE173896, and GSE227691) to analyze disease progression. Finally, single-nuclei RNA analysis was applied to data from seven healthy individuals and 20 COVID-19 patients from one dataset (GSE171524) to compare the two conditions. Results: Bulk RNA sequencing revealed enhanced inflammatory pathways in COPD patients, indicating increased inflammation.Single-cell RNA sequencing showed a stronger inflammatory response from mild to moderate COPD with a decrease from moderate to severe stages. COVID-19 displayed similar biological patterns to moderate COPD, suggesting that stage-specific COPD analysis could enhance COVID-19 management. Conclusion The analysis found that immune responses increased from mild to moderate stages but declined in severe cases, marked by reduced pulmonary T cell activation. The overlap between moderate COPD and COVID-19 suggests shared therapeutic strategies, warranting further investigation.

Purpose: Large language models (LLMs) like ChatGPT (OpenAI) are increasingly used in healthcare, raising questions about their accuracy and reliability for medical information. This study compared 2 versions of ChatGPT in answering post-discharge follow-up questions in the area of pediatric emergency medicine (PEM). Methods: Twenty-three common post-discharge questions were posed to ChatGPT-4 and -3.5, with responses generated before and after a simplification request. Two blinded PEM physicians evaluated appropriateness and accuracy as the primary endpoint. Secondary endpoints included word count and readability. Six established reading scales were averaged, including the Automated Readability Index, Gunning Fog Index, Flesch-Kincaid Grade Level, Coleman-Liau Index, Simple Measure of Gobbledygook Grade Level, and Flesch Reading Ease. T-tests and Cohen’s kappa were used to determine differences and inter-rater agreement, respectively. Results: The physician evaluations showed high appropriateness for both defaults (ChatGPT-4, 91.3%-100% vs. ChatGPT-3.5, 91.3%) and simplified responses (both 87.0%-91.3%). The accuracy was also high for default (87.0%-95.7% vs. 87.0%-91.3%) and simplified responses (both 82.6%-91.3%). The inter-rater agreement was fair overall (κ = 0.37; P < 0.001). For default responses, ChatGPT-4 produced longer outputs than ChatGPT-3.5 (233.0 ± 97.1 vs. 199.6 ± 94.7 words; P = 0.043), with a similar readability (13.3 ± 1.9 vs. 13.5 ± 1.8; P = 0.404). After simplification, both LLMs improved word count and readability (P < 0.001), with ChatGPT-4 achieving a readability suitable for the eighth grade students in the United States (7.7 ± 1.3 vs. 8.2 ± 1.5; P = 0.027). Conclusion The responses of ChatGPT-4 and -3.5 to post-discharge questions were deemed appropriate and accurate by the PEM physicians. While ChatGPT-4 showed an edge in simplifying language, neither LLM consistently met the recommended reading level of sixth grade students. These findings suggest a potential for LLMs to communicate with guardians.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Purpose: Central venous catheter (CVC) insertion is a fundamental skill required for trainees to become proficient. Simulation-based training (SBT) has been shown to improve trainees’ CVC insertion performance effectively. However, implementing a CVC curriculum requires substantial costs and resources. Currently, there is a lack of validated CVC curricula that institutions can adopt as frameworks. This study aimed to evaluate the effectiveness of our institution’s CVC simulation curriculum in improving residents’ confidence and comfort with CVC insertion and management. Materials and Methods: First-year residents (n=118) participated in SBT between 2017 and 2023. Among them, 57 (48%) participants completed surveys before training and 6 months post-training to assess changes in comfort levels across various aspects of CVC insertion. Survey responses were analyzed to evaluate the overall changes in comfort by year and items. Results: Overall comfort increased from 42.1% before training to 81.3% after training (P<0.01), with notable improvements in nonprocedural aspects. Comfort with performing the unsupervised procedure increased by 16.7% (P<0.05) but remained low post-training (29.6%). Conclusion These findings suggest that the curriculum effectively enhances residents’ comfort, particularly in nonprocedural aspects, but only partially prepares them for unsupervised CVC insertions. This indicates a gap in procedural skill acquisition despite the overall positive trends. Implementing a similar CVC curriculum may help institutions reduce CVC insertion-associated complications.

Purpose: Chronic obstructive pulmonary disease (COPD) is characterized by alveolar destruction and increased inflammation, leading to respiratory symptoms. This study aimed to identify the traits for COPD progression from mild to severe stages. Additionally, we explored the correlation between coronavirus disease-2019 (COVID-19) and COPD to uncover overlapping respiratory patterns. Materials and Methods: Bulk RNA sequencing was conducted on data from 43 healthy individuals and 39 COPD patients across one dataset (GSE239897) to distinguish COPD characteristics. Single-cell RNA analysis was then performed on samples from seven mild patients, seven moderate patients, and three severe patients from three datasets (GSE167295, GSE173896, and GSE227691) to analyze disease progression. Finally, single-nuclei RNA analysis was applied to data from seven healthy individuals and 20 COVID-19 patients from one dataset (GSE171524) to compare the two conditions. Results: Bulk RNA sequencing revealed enhanced inflammatory pathways in COPD patients, indicating increased inflammation.Single-cell RNA sequencing showed a stronger inflammatory response from mild to moderate COPD with a decrease from moderate to severe stages. COVID-19 displayed similar biological patterns to moderate COPD, suggesting that stage-specific COPD analysis could enhance COVID-19 management. Conclusion The analysis found that immune responses increased from mild to moderate stages but declined in severe cases, marked by reduced pulmonary T cell activation. The overlap between moderate COPD and COVID-19 suggests shared therapeutic strategies, warranting further investigation.

Objectives: Limited access to high-quality green spaces could contribute to growing rates of chronic diseases and unhealthy behaviors. Public parks provide numerous benefits for population well-being. However, past research has shown mixed results regarding the association between proximal parks and residents’ physical and mental health. This study examined the relationship between diverse elements of park access and quality and multiple health outcomes. Methods: Seventy-three unique parks within 70 census tracts in 4 cities in South Carolina were analyzed. Data about 7 aspects of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, neighborhood quality concerns) were collected via on-site observations using the Community Park Audit Tool. Health data for each tract (obesity, no leisure time physical activity, high blood pressure, coronary heart disease, high cholesterol, diabetes, depression, poor mental health) were collected from the CDC PLACES dataset. Linear regression analyses examined the association between 10 park access and quality metrics and 8 health metrics, controlling for socio-demographic characteristics. Results: All associations were in the unexpected direction except 1 relationship involving mental health. Specifically, positive associations were found between the number of parks and obesity, the number of parks and no leisure time physical activity, transportation access and obesity, and transportation access and high blood pressure. As concerns about neighborhood quality increased, poor mental health status worsened. Conclusions This study provides valuable information for public health professionals and researchers. Further research is needed to expand on and elucidate these findings.