Open Research Oklahoma (Oklahoma State Univ.)
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Evaluation on artificial intelligence guidelines in the leading clinical pulmonology and respiratory medicine journals: A cross-sectional analysis
No full textBackground: Artificial intelligence (AI) is advancing research in pulmonology and respiratory medicine, offering improvements in data analysis, systematic reviews, and clinical applications. Despite these benefits, its adoption also raises critical concerns around ethical use, transparency, and reproducibility. This study investigates how leading journals in the field of pulmonology and respiratory medicine respond to these challenges and opportunities through their author instructions and policies.Methods: A cross-sectional analysis was carried out on the top 100 pulmonology and respiratory medicine journals, identified based on the 2023 SCImago SJR indicator. Each journal’s “Instructions for Authors” was reviewed to identify AI-related policies, including AI-specific reporting guidelines, authorship criteria, and the use of AI tools for manuscript writing and image creation. Correlation analyses were used to explore associations between these AI policies and journal characteristics.Results: Among the 100 journals reviewed, 66% addressed AI usage in their author guidelines, commonly prohibiting AI authorship while mandating disclosure of AI involvement in submissions. Only 26% permitted AI-generated content, and 17% allowed the use of AI-generated images. Two editorial organizations, dedicated to improving editorial standards, were mentioned within the journals’ “Instructions for Authors” in regard to the use of AI in manuscript development: the Committee on Publication Ethics (COPE) and the World Association of Medical Editors (WAME). While 14% of journals recommended adherence to COPE guidelines, only 1% directed authors to WAME for regulations pertaining to AI use. Furthermore, only 5% addressed AI-specific reporting guidelines such as CONSORTAI and SPIRIT-AI, with 60% of those journals only “recommending” adherence to said guidelines. Additionally, journals with higher impact factors were more likely to feature comprehensive AI policies. However, significant inconsistencies and a lack of standardized guidance were observed across journals.Conclusion: Although many pulmonology and respiratory medicine journals acknowledge the growing role of artificial intelligence in research, few have endorsed AI-specific guidelines, leading to limited standardization and transparency in its use. To address this gap, we recommend the development and adoption of comprehensive policies to promote ethical, reproducible, and high-quality research in the age of AI-driven advancements
Atypical fibroxanthoma-like melanoma: A rare subtype of high-cumulative sun damage melanoma with partial dedifferentiation and an aggressive molecular profile
No full textBackground: We report a rare case of atypical fibroxanthoma (AFX)-like melanoma on the scalp of a 75- year-old man. This case illustrates the phenomenon of melanoma dedifferentiation, resulting in an AFXlike appearance.Case Presentation: A biopsy of an erythematous, tender nodule on the left posterior parietal scalp revealed an ulcerated nodular lesion composed of epithelioid and spindle cells with pleomorphic nuclei arranged in a fascicular pattern. The tumor's architectural and cytologic features, including the presence of an epidermal collarette, marked anisonucleosis, and numerous atypical mitoses, closely resembled those of AFX. Immunohistochemical analysis demonstrated SOX10 positivity and negativity for other melanocytic markers. Molecular profiling confirmed the diagnosis of melanoma and identified mutations in the TERT promoter, NRAS, NF1, PBRM1, FAT1, and ATM genes. The tumor was categorized as Class 2B by the DecisionDx-Melanoma test, indicating a high risk of recurrence and metastasis. Sentinel lymph node excision revealed metastatic melanoma in 2 of the 5 examined nodes, further supporting the aggressive biological nature of this neoplasm.Discussion: Various molecular mechanisms potentially underly this transformation, with mutations in NF1, PBRM1, and FAT1 likely contributing to the tumor's atypical morphology and loss of melanocytic markers. The high tumor mutational burden and aggressive molecular profile align with the reported poor prognosis of dedifferentiated melanomas. Recognizing this rare variant is critical for accurate diagnosis, effective patient management, and prognosis assessment
Xylazine adulteration modulates heroin-induced behavioral responses
No full textIntroduction: The United States is currently facing a severe crisis involving opioids and opioid use disorder (OUD), which is characterized by compulsive use despite its harmful effects. The American Society of Addiction Medicine defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.” In 2022, opioids were involved in 81.8% of 51,435 fatal overdose deaths in the U.S., and there were 96,332 reported non-fatal opioid overdose emergency visits based on CDC data. However, these figures, collected from only 30 states for fatal cases and 21 states for non-fatal cases, likely underestimate the true scale of the crisis. Compounding the epidemic is the growing concern over drug adulteration, particularly with xylazine, a veterinary anesthetic with no approved use in humans. Xylazine has been linked to severe side effects, including injection site lesions, respiratory depression, and other harmful physical effects. However, the impact of Xylazine adulteration on behavioral modalities is not clearly understood. Currently, there are no studies performed to examine how xylazine adulteration influences heroin-induced behavioral outcomes.Methods: Adult Sprague-Dawley rats were tested in a self-administration paradigm to investigate the impact of xylazine adulteration preclinically. Subjects were divided into four groups: saline, heroin, xylazine, and a heroin-xylazine cocktail. Following jugular vein catheter implantation, rats selfadministered their assigned drugs for two hours daily over ten days. On the 11th day, a progressive ratio test measured motivation, followed by an extinction protocol (abstinence days 5-14) and a cue-induced reinstatement experiment on abstinence day 15.Results: Rats in the heroin group exhibited significantly higher self-administration levels compared to the heroin-xylazine group despite showing similar motivation in the progressive ratio test. Cue-induced reinstatement revealed no differences in the extinction of drug-paired cues between the heroin and heroin-xylazine groups.Conclusions: This suggests that xylazine adulteration may decrease active heroin-taking behavior while preserving opioid motivation comparable to heroin alone. It appears following cue-induced reinstatement that xylazine adulteration neither slows nor accelerates cue extinction. These compelling findings warrant further investigation into the neurobiological changes induced by xylazine in heroinexposed animals that drive these behavioral outcomes
North American Beaver (Castor canadensis) gut mycobiome
No full textThe North American Beaver (Castor canadensis) is a semi-aquatic, hindgut-fermenting rodent that follows a tree bark-based diet and shows long feed retention time (14-40 hours). Their enlarged cecum harbors a complex microbial community that plays a key role in lignocellulose degradation. While some studies have investigated its gut microbiome, most focused on bacteria and archaea with little attention to the fungal community. Since anaerobic gut fungi (AGF) are known lignocellulose degraders in other herbivores, we hypothesize that beavers host AGF and furthermore possess a unique fungal community due to their lignocellulose-rich diet.
To test this hypothesis, cecal samples from 32 wild beavers were collected by trappers throughout the state of Utah. Amplicon sequencing targeting the D2 region of the LSU rRNA gene of the general fungal community has been performed. Preliminary results showed that Neocallimastigomycota constituted an integral component of the beaver’s gut (~23% of the total fungal community). Within this AGF community, genera encountered included Orpinomyces, Liebetanzomyces, and a novel genus in the Joblinomyces clade. Other than Neocallimastigomycota, the beaver gut harbored novel fungal lineages closely related to the Neocallimastigomycota and Chytridiomycota (~63% of the total fungal community). Comparative analysis of all 32 samples will elucidate community differences based on sex, age, and weight. In addition, enrichment and isolation efforts are underway.
This study provides the first report of AGF in beavers and aims to comprehensively characterize the fungal community associated with North American beavers.Microbiology and Molecular Genetic
Neck strengthening reduces the risk of concussion: A critical appraisal topic
No full textClinical Scenario: A concussion is a traumatic brain injury (TBI) that is caused by a direct or indirect blow. Symptom duration and severity vary depending on the individual and trauma. There are multiple predisposing factors that can increase the risk of concussion such as collision sports, sport position, history of concussions, age, being female, and neck strength. Neck strength is a risk factor that can be assessed and modified to reduce the risk of concussions.Clinical Question: Does neck strengthening reduce the risk of concussions in collision sports?Summary of Key Findings: Based on the studies’ findings, neck strengthening may mitigate the risks of concussions in collision sports. Among the individuals that sustained a concussion, weak extension strength was the weakest. A handheld dynamometer is a reliable tool to measure neck strength.Clinical Bottom Line: Implementing neck strengthening may reduce the risk of concussions in collision sports. The outcome measures showed that after increasing neck strength the incidence of concussions decreased. In the subjects that sustained a concussion, overall neck strength was weaker, especially in extension.Strength of Recommendation: Based on CEBM and PEDro scores of evidence assessments, the strength of recommendation is a B
Effectiveness of biceps tenodesis surgical intervention in treating SLAP labral tears in active-duty military members: A critically appraised topic
No full textClinical Scenario: Shoulder injuries are prevalent in military service members. Biceps tenodesis may provide an effective alternative to SLAP repairs regarding pain and function outcomes.Clinical Question: In active-duty military members ages 18-45 with SLAP labral tears, does the biceps tenodesis surgical procedure reduce pain, improve patient-reported outcomes, and increase level of function?Summary of Key Findings: A literature search was conducted on the effectiveness of biceps tenodesis surgical intervention on function and pain in the active-duty military population. Four studies discussing the use of biceps tenodesis as a treatment in military patients were included. All four of the studies demonstrated improved pain scores and increased function outcomes.Bottom Line: The evidence suggest biceps tenodesis surgical intervention is an effective treatment method for SLAP tears in military personnel. Biceps tenodesis allows military patients an alternative surgical intervention compared to the traditional SLAP repair.Strength of Recommendation: Based on the CEBM level of evidence and JBI Checklist for Qualitative Research all four studies should be included in this critically appraised topic
Systematic review of health policy interventions for overweight-obesity in adolescents and their impact
No full textIntroduction: Childhood obesity is a public health concern in the United States, affecting nearly one-third of adolescents. While many school-based programs have implemented nutritional and physical activity (PA) programs to address this, there have been varying degrees of success. Given the rates of childhood obesity and its impact on long-term health, examining programmatic outcomes from these health policy initiatives targeting childhood obesity is warranted.Methods: We conducted a systematic review of Pubmed (MEDLINE), Embase, and the Cochrane database to examine nutrition and PA programs targeting childhood obesity and prevention. We included studies that stemmed from policy initiatives that were implemented in elementary and secondary (middle/high schools) in the United States. Article screening and data extraction were conducted in a masked, duplicative fashion to identify the article’s intervention type, duration, and outcome measures.Results: The searches produced 205 articles, from which 189 were excluded due to duplicates, not including PA or nutrition intervention, not having obesity outcome measures, or being older than the date range. Of the included articles, 11 (68.75%) were PA-related, 11 (68.75%) involved nutrition, and 6 (37.5%) contained both. Eight (50%) articles also included wellness education in their primary interventions. Outcome measures of all studies used BMI criteria for obesity. Notable secondary outcomes included nutrient intake (4/16, 25%). A study by Matsuzaki et al. in 2021 showed the most benefit—with a nutrition access intervention between the years 2002 and 2016 revealing evidence of favorable associations of the state and federal school nutrition policies with overweight/obesity prevalence trends.Conclusion: Our systematic review showed that the majority of interventions published in the literature were either PA or nutrition based and related to State/Local policy guidelines. Between intervention types, more publications of nutrition interventions showed positive effects than PA studies. As the concerns for addressing pediatric obesity are critical, school-based programs targeting both PA and nutrition are necessary, but may not be sufficient alone. We encourage not only physician organizations to help lead policy changes at the national and state levels, but also with every pediatric patient and parent they treat
Endorsement of artificial intelligence guidelines across leading ophthalmology journals: A cross-sectional analysis
No full textBackground: Artificial intelligence (AI) is transforming ophthalmology by enhancing data analysis, facilitating systematic reviews, and improving clinical applications. However, its incorporation into research and publishing introduces challenges related to transparency, ethical considerations, and reproducibility. This study explores how top ophthalmology journals address these issues and leverage AI's potential through their author guidelines and editorial policies.Methods: A cross-sectional review of the top 100 peer-reviewed ophthalmology journals, ranked by the 2023 SCImago SJR indicator, was conducted. Data were extracted from the “Instructions for Authors” of each journal to assess AI-related policies, with a focus on authorship criteria, AI-specific reporting guidelines, and the use of AI in manuscript preparation and image generation. Correlational analyses were conducted to investigate potential links between AI policies and the distinctive characteristics of each journal.Results: Among the 100 journals reviewed, 79% addressed AI use in their author guidelines, with most prohibiting AI authorship but requiring disclosure of AI involvement in submissions. AI-generated content was permitted by 62% of journals, while 24% accepted AI-generated images. Journals with higher impact factors were more likely to implement detailed AI policies; however, significant gaps in standardization and guidance persist.Conclusion: Although many ophthalmology journals acknowledge AI’s growing role in research, few have adopted AI-specific reporting guidelines, limiting the consistency and transparency of AI integration. We advocate for the development and adoption of comprehensive guidelines to promote ethical, reproducible, and high-quality research in this evolving landscape of AI-driven innovation
Endorsement of artificial intelligence guidelines across leading obstetrics and gynecology journals: A preliminary cross-sectional analysis
No full textBackground: Artificial intelligence (AI) is transforming research in Obstetrics and Gynecology by advancing data analysis, facilitating systematic reviews, and enhancing clinical applications. However, its adoption raises concerns related to transparency, ethical considerations, and reproducibility. This study investigates how leading Obstetrics and Gynecology journals address these concerns and opportunities through their author instructions and editorial policies.Methods: A cross-sectional analysis was conducted on the top 100 peer-reviewed Obstetrics and Gynecology journals, ranked by the 2023 SCImago SJR indicator. Information was collected from each journal's "Instructions for Authors" to assess AI-related policies, including specific guidelines for reporting AI use, authorship criteria, and the role of AI in manuscript development and image creation. Correlation analyses were used to explore the relationship between AI-related policies and the journals’ characteristics.Results: Among the 100 journals reviewed, 92% included guidance on AI usage in their author instructions. Most journals prohibited AI authorship while mandating disclosure of AI involvement in manuscript submissions. While 14% of the journals allowed AI-generated content, only 7% permitted AIgenerated images. Journals with higher impact factors were more likely to have detailed AI policies, although there were notable gaps in standardization and clarity.Conclusion: Although many Obstetrics and Gynecology journals recognize the growing influence of AI in research, few have implemented specific AI reporting guidelines (RGs), limiting the consistency and transparency of AI usage. We advocate for the development of robust and standardized guidelines to ensure that research remains ethical, reproducible, and of high quality in this new era of AI innovation
Novel emergency medicine simulation addressing high risk scenarios with fire first responders
No full textIntroduction: Simulation has been shown to improve resident understanding of high-risk scenarios, especially with topics that are not covered in graduate medical education. Simulation training in healthprofessionals education is associated with positive effects on knowledge, skills, behaviors, and patient outcomes. This novel interprofessional simulation with paramedic trained firefighters and emergency medicine (EM) residents was created on the belief that physician residents would benefit from a better understanding of the pre-hospital identification, assessment, and treatment of trauma and fire-related patients.Methods (Innovation/Implementation): We outline a novel framework for designing, implementing, and evaluating the impact of a fire simulation event for an EM residency program that is concordant with ACGME standards. After touring the fire simulation site, the EM and fire department leadership collaborated on the development of fire scenarios. The three learning groups, consisting of 8-9 resident physicians (PGY1-4), rotated through the stations: a smoke house structure fire simulation case, a collapsed building trauma simulation case, and a fire hose dynamics activity. Following the identification and rescue potion, the case was transitioned to EM and simulation faculty who led the resuscitation portion. When the scenario concluded in field stabilization of the patient, the case was coded to the local emergency department and the simulation mannequin was loaded into an ambulance.Results (Evaluation): Evaluation of the simulation was determined by participant’s feedback and informal commentary on areas of improvement. An initial debriefing was conducted with the learners to evaluate the immediate impact on their knowledge and understanding of the simulation. A subsequent debriefing was held with the planning team to discuss successes and areas for future enhancements.Conclusions: We have described the design and implementation of a novel EM resident fire simulation to address the needs of our 4-year EM residency program located within an urban hospital. Not only does this project highlight the importance of collaboration in patient care, but it also emphasizes the critical role of interdisciplinary understanding of roles and challenges. This project has the potential for expansion in similar urban settings and could also serve as a valuable tool for training rural physicians in first responder and fire rescue education. This study provides valuable insight into the development and implementation of a novel simulation event and can serve as an adjunct to the EM residency curriculum