Search

Objectives: This study aimed to explain and categorize key ethical concerns about integrating large language models (LLMs) in healthcare, drawing particularly from the perspectives of clinicians in online discussions. Materials and methods: We analyzed 3049 posts and comments extracted from a self-identified clinician subreddit using unsupervised machine learning via Latent Dirichlet Allocation and a structured qualitative analysis methodology. Results: Analysis uncovered 14 salient themes of ethical implications, which we further consolidated into 4 overarching domains reflecting ethical issues around various clinical applications of LLM in healthcare, LLM coding, algorithm, and data governance, LLM's role in health equity and the distribution of public health services, and the relationship between users (human) and LLM systems (machine). Discussion: Mapping themes to ethical frameworks in literature illustrated multifaceted issues covering transparent LLM decisions, fairness, privacy, access disparities, user experiences, and reliability. Conclusion: This study emphasizes the need for ongoing ethical review from stakeholders to ensure responsible innovation and advocates for tailored governance to enhance LLM use in healthcare, aiming to improve clinical outcomes ethically and effectively. [ABSTRACT FROM AUTHOR]

Regulatory T cells (Treg cells) hold promise for sustainable therapy of immune disorders. Recent advancements in chimeric antigen receptor development and genome editing aim to enhance the specificity and function of Treg cells. However, impurities and functional instability pose challenges for the development of safe gene-edited Treg cell products. Here, we examined different Treg cell subsets regarding their fate, epigenomic stability, transcriptomes, T cell receptor repertoires, and function ex vivo and after manufacturing. Each Treg cell subset displayed distinct features, including lineage stability, epigenomics, surface markers, T cell receptor diversity, and transcriptomics. Earlier-differentiated memory Treg cell populations, including a hitherto unidentified naïve-like memory Treg cell subset, outperformed late-differentiated effector memory-like Treg cells in regulatory function, proliferative capacity, and epigenomic stability. High yields of stable, functional Treg cell products could be achieved by depleting the small effector memory-like Treg cell subset before manufacturing. Considering Treg cell subset composition appears critical to maintain lineage stability in the final cell product. [ABSTRACT FROM AUTHOR]

Background: childbearing is a key component of population movements and sustainable development in low-fertility nations. This study was conducted with the aim of determining the impact of multimedia education on the childbearing intention in One-child women of Maragheh city. Method: In this intervention study in Maragheh in 2023, 94 women with one child were randomly selected and placed in two intervention and control groups. Before the intervention, people were examined using demographic information and Miller's questionnaire of desire to have children. Then, For the intervention group, three 60-minute multimedia training videos were shown in person for three weeks, and the control group did not receive any training. The data were collected using the researcher's demographic questionnaire and Miller's childbearing questionnaire in three stages before the intervention, immediately after and six weeks after the intervention. Data analysis was done with SPSS version 16 software. Results: There was no significant difference between the two groups in terms of the average score of desire to have children and demographic variables (p > 0.05). Before the intervention, there was no significant difference between the intervention and control groups in terms of the demographic characteristics of the subjects and the average score of women's willingness to have children in the positive and negative dimensions. While after the multimedia educational intervention, the average score of desire to have children in positive and negative dimensions, immediately after the intervention and six weeks after the intervention, had a significant difference compared to before the intervention (p < 0.001). Conclusion: The findings of the study showed that carrying out multimedia educational interventions to single-child women can have a positive effect on their desire to have children. It seems that the implementation of such programs is effective in the conscious decision of families to have children and ultimately increases the intention of the individual to carry out the behavior. Trial registration: Iranian Registry of Clinical Trials: IRCT20230227057549N1. Date of registration: 16/04/2023. URL: https://irct.behdasht.gov.ir/. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the effects of thiamine (vitamin B1) on general health and infertility treatment outcomes in women with polycystic ovary syndrome (PCOS). Materials and Methods: The study is a triple-blinded, randomized, placebo-controlled clinical trial performed on 64 infertile women with PCOS referred to Sarem Hospital in Tehran, Iran. The primary outcomes of the study were general health and infertility treatment outcomes. Eligible women were randomly assigned to the vitamin B1 group (n=32, vitamin B1 tablet at a dose of 300 mg/day for 4 weeks) or the placebo group (n=32, placebo tablet daily for 4 weeks). A general health questionnaire was completed before and after the intervention by both groups, and treatment success was evaluated at the end of the study. Data were analyzed using SPSS software ver.16 P<0.05 was considered statistically significant. Results: The mean age of participants in the vitamin B1 (VB1) group was 30.4 ± 3.27 years and in the placebo (Pl) group was 29.1 ± 2.66 years with the mean duration of marriage 12.7 ± 3.01 and 13.2 ± 2.97 years respectively. Our results showed that there were significant differences between the two groups in overall score (P<0.001) and scores for all domains of the general health questionnaire including somatic symptoms (P<0.001), anxiety and insomnia (P<0.001), social dysfunction (P=0.028), and severe depression (P<0.001) after the intervention. Four weeks consumption of vitamin B1 also resulted in higher numbers of positive pregnancy tests (P=0.006), although the number of fetuses was not significantly different between the two groups after the intervention. Conclusion: The results of the current study support a possible favourable effect of vitamin B1 on improving general health, infertility treatment outcome, and retrieved follicle count without changing the number of fetuses in women with polycystic ovary syndrome (registration number: IRCT201510266917N3). [ABSTRACT FROM AUTHOR]