Comparative evaluation of artificial intelligence systems'accuracy in providing medical drug dosages:A methodological study

BACKGROUND Medication errors,especially in dosage calculation,pose risks in healthcare.Artificial intelligence(AI)systems like ChatGPT and Google Bard may help reduce errors,but their accuracy in providing medication information remains to be evaluated.AIM To evaluate the accuracy of AI systems(ChatGPT 3.5,ChatGPT 4,Google Bard)in providing drug dosage information per Harrison's Principles of Internal Medicine.METHODS A set of natural language queries mimicking real-world medical dosage inquiries was presented to the AI systems.Responses were analyzed using a 3-point Likert scale.The analysis,conducted with Python and its libraries,focused on basic statistics,overall system accuracy,and disease-specific and organ system accuracies.RESULTS ChatGPT 4 outperformed the other systems,showing the highest rate of correct responses(83.77%)and the best overall weighted accuracy(0.6775).Disease-specific accuracy varied notably across systems,with some diseases being accurately recognized,while others demonstrated significant discrepancies.Organ system accuracy also showed variable results,underscoring system-specific strengths and weaknesses.CONCLUSION ChatGPT 4 demonstrates superior reliability in medical dosage information,yet variations across diseases emphasize the need for ongoing improvements.These results highlight AI's potential in aiding healthcare professionals,urging continuous development for dependable accuracy in critical medical situations.

Nitrogen Metabolism,Carbohydrates and Sucrose in Young Plants of Paricá(Schizolobium amazonicum)Submitted to Different Dosages of Aluminum

The paricá [Schizolobium amazonicum Huber ex Ducke] is a native species of the Amazon region, belonging to the Fabaceae family and is a legume that has great social and economic importance, raw material for the manufacture of wood panels. Heliophilous, with wood of light density and good workability. Amazonian soils are highly weathered and characterized by high acidity, so Al harms the growth and development of sensitive plants, as well as the presence of resistant and/or tolerant plants. Thus, in this work, we sought to study the biochemical metabolism alterations generated in young plants of Schizolobium amazonicum Huber ex Ducke affected at different dosages of AlCl3. The research was conducted in a greenhouse of the Federal Rural University of Amazonia, using pre-scarified paricá seeds, which were seeded in plastic containers of 3.5 L capacity, with black soil fertilized with NPK 15-15-20. On the 8th day after sowing (DAS), thinning of 5 seedlings was performed for 2, and on day 12 of 2 for 1 seedling. The treatments started after 1 month and 22 days of sowing and the plants were collected 24 days later. A completely randomized experimental design (RED) was used, with 6 treatments (Control, Al 15 mg/L-1, Al 30 mg/L-1, Al 45 mg/L-1, Al 60 mg/L-1 and Al 75 mg/L-1) with 5 replicates each (one plant/pot) totaling 30 experimental units. The AlCl3 dosages resulted in considerable changes in the biochemical variables evaluated, especially when the 75 mg·L-1 dosage was applied. The considerable reduction in some variables such as nitrate reductase, glycine betaine and total soluble carbohydrates of these compounds to the applied AlCl3·6H2O dosages, is a way to create resistance mechanisms to try to overcome stress or as a way of showing limitations in the applied dosages. The species was sensitive to the AlCl3 dosages, and resisted only 23 days to the imposed stress. However, it presented defense mechanisms that were able to prolong the physiological activities;since without them, the time of exposure to the stress would possibly be less.

Effects of SSA Dosages on Seedling Quality and Yield by Mechanical Transplanting

[Objective] The aim was to research the influence of gradient dosages of seedling-strengthening agent （SSA） on rice seedling quality and yield. [Method] The influence of four dosages of SSA on late rice seedling quality and yield was investi- gated, using Oryza sativa cv. Yongyou 9 and Huanghuazhan as test materials. [Re- sult] The results showed that applying SSA significantly increased several indexes of seedling quality including the leaf age, basal stem width and dry matter weight. In addition, SSA greatly increased the rice yield, mainly through influencing two yield component factors, effective panicle number and grain number per panicle. [Conclu- sion] SSA was beneficial to nurse strong seedling which satisfied mechanical trans- plant and improve yield. Considered both seedling quality and yield trait, the optimal SSA dosage is 50 g/m2 under this cultivating condition.

A Survey among Texas Pain Society Physicians Regarding the Types and Dosages of Steroids Utilized Clinically in Epidural Steroid Injectates

Objective: Epidural steroid injections (ESI) are used extensively to treat radicular back pain. This study is designed to evaluate the types and dosages of steroids commonly used and understand prescribing habits of the Texas Pain Society pain management physicians. Method: From April to May 2014, we sent all 270 Texas Pain Society members a questionnaire to complete online. We collected 45 responses. Result: Type of steroid commonly used in injectate: Eighteen (41.9%) phy-sicians reported using methylprednisolone most. Fifteen (34.9%) physicians use triamcinolone, 9 (20.9%) physicians use dexamethasone, 1 (2.3%) uses betamethasone, and 2 skipped this question. Important factors influencing the type of steroid use in injectate: Half of the physicians reported that the location of the ESI was most important (19 responses, 48.7%). Ten (25.6%) reported that the approach of the ESI was most important. Another ten (25.6%) agreed that the potency of the steroid was most important. Dosage of steroid used in injectate: About half of the physicians use a fixed dose of steroid (22, 51.2%) while 21 (48.8%) use a variable dose of steroid. Of those who use a fixed dose of steroid, many use methylprednisolone 80 mg (9, 39.1%). Of those who use a variable dosage of steroid, the most important factor in their determination of the dosage is the patient’s comorbidities (20 responses, 58.8%). The use of depo-steroid in injectate: Thirty-two out of 43 (74.4%) use depo-steroid while 11 out of 43 (25.6%) wouldn’t use depo-steroid. Of those who use depo-steroid, the duration and availability in the epidural space is the most common reason for its use (23, 76.7%). Conclusion: By using a simple questionnaire detailing what types and dosages of steroids are used, compiling a list of best practices can help Texas Pain Society physicians tremendously in the treatment of radicular back pain.

Efficacy and Phytotoxicity Trial of Different Dosages of 4% Nicosulfuron SC on Weeds in Corn Fields

[Objective]The paper was to study efficacy and phytotoxicity of different dosages of 4% nicosulfuron on weeds in corn fields.[Method]With summer corn variety Zhengdan 958commonly used in field production in Hengshui area of Hebei Province of China as the test material,different dosages（1 050,1 500 and 1 950mL/hm2）of corn postemergence herbicide 4% nicosulfuron SC were sprayed during five-leaf stage of corn,and the treatments with water spraying and manual weeding were set as controls.The effects of different dosages of 4% nicosulfuron SC on weed control efficacy and safety and yield of corn were analyzed in order to determine the optimal dosage.[Result]Spraying 4% nicosulfuron SC with dosage of 1 500mL/hm2 during five-leaf stage of corn not only had better control effect against various weeds,but also did not produce phytotoxicity on corn,and the yield of corn was higher.[Conclusion]The study provided scientific information for using 4% nicosulfuron to eradicate weeds in corn fields.

Different dosages of methylprednisolone therapy for acute necrotizing encephalopathy of childhood:a 6-year multicenter retrospective study

To the Editor:Acute necrotizing encephalopathy(ANE)is a rare but often devastating neurologic disorder in children.[1]Hereditary susceptibility and cytokine storm play important roles in ANE pathogenesis,[2,3]but the specific molecular biological mechanism is unclear.

The biological functions and metabolic pathways of valine in swine

Valine is an essential amino acid and a type of branched-chain amino acid. Due to the involvement of branchedchain amino acids in various metabolic pathways, there has been a surge of interests in valine nutrition and its role in animal physiology. In pigs, the interactions between valine and other branched-chain amino acids or aromatic amino acids are complex. In this review, we delve into the interaction mechanism, metabolic pathways, and biological functions of valine. Appropriate valine supplementation not only enhances growth and reproductive performances, but also modulates gut microbiota and immune functions. Based on past observations and interpretations, we provide recommended feed levels of valine for weaned piglets, growing pigs, gilts, lactating sows, barrows and entire males. The summarized valine nutrient requirements for pigs at different stages offer valuable insights for future research and practical applications in animal husbandry.

Diagnosis and therapy of tacrolimus toxicity in a liver transplant recipient during COVID-19 treatment

To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].

A spotlight on dosage and subject selection for effective neuroprotection: exploring the central role of mitochondria

Neurons are notoriously vulnerable cell types.Even the slightest change in their internal and/or external environments will cause much distress and dysfunction,leading often to their death.A range of pathological conditions,including stroke,head trauma,and neurodegenerative disease,can generate stress in neurons,affecting their survival and proper function.In most neural pathologies,mitochondria become dysfunctional and this plays a pivotal role in the process of cell death.The challenge over the last few decades has been to develop effective interventions that improve neuronal homeostasis under pathological conditions.Such interventions,often referred to as disease-modifying or neuroprotective,have,however,proved frustratingly elusive,at both preclinical and,in particular,clinical levels.In this perspective,we highlight two factors that we feel are key to the development of effective neuroprotective treatments.These are:firstly,the choice of dose of intervention and method of application,and secondly,the selection of subjects,whether they be patients or the animal model.

The impact of female sex hormones on cardiovascular disease:from mechanisms to hormone therapy

Cardiovascular disease remains the leading cause of mortality in women,yet it has not raised the awareness from the public.The pathogenesis of cardiovascular disease differs significantly between females and males concerning the effect of sex hormones.Estrogen and progestogen impact cardiovascular system through genomic and non-genomic effects.Before menopause,cardiovascular protective effects of estrogens have been well described.Progestogens were often used in combination with estrogens in hormone therapy.Fluctuations in sex hormone levels,particularly estrogen deficiency,were considered the specific risk factor in women’s cardiovascular disease.However,considerable heterogeneity in the impact of hormone therapy was observed in clinical trials.The heterogeneity is likely closely associated with factors such as the initial time,administration route,dosage,and formulation of hormone therapy.This review will delve into the pathogenesis and hormone therapy,summarizing the effect of female sex hormones on hypertension,pre-eclampsia,coronary heart disease,heart failure with preserved ejection fraction,and cardiovascular risk factors specific to women.

Biopolymer stabilization of clayey soil

This study investigates the efficacy of sodium alginate(SA),xanthan gum(XG),guar gum(GG)and chitosan(CS)d each applied at five different solid biopolymer-to-water mass ratios(or dosages)and cured for 7 d and 28 d d on the unconfined compressive strength(UCS)performance of a high plasticity clayey soil.Moreover,on identifying the optimum biopolymer-treatment scenarios,their performance was compared against conventional stabilization using hydrated lime.For a given curing time,the UCS for all biopolymers followed a riseefall trend with increasing biopolymer dosage,peaking at an optimum dosage and then subsequently decreasing,such that all biopolymer-stabilized samples mobilized higher UCS values compared to the unamended soil.The optimum dosage was found to be 1.5%for SA,XG and CS,while a notably lower dosage of 0.5%was deemed optimum for GG.Similarly,for a given biopolymer type and dosage,increasing the curing time from 7 d to 28 d further enhanced the UCS,with the achieved improvements being generally more pronounced for XG-and CS-treated cases.None of the investigated biopolymers was able to produce UCS improvements equivalent to those obtained by the 28-d soilelime samples;however,the optimum XG,GG and CS dosages,particularly after 28 d of curing,were easily able to replicate 7-d lime stabilization outcomes achieved with as high as twice the soil’s lime demand.Finally,the fundamental principles of clay chemistry,in conjunction with the soil mechanics framework,were employed to identify and discuss the clayebiopolymer stabilization mechanisms.

Strengthening pharmacotherapy research for COVID-19-induced pulmonary fibrosis

The global spread of severe acute respiratory syndrome coronavirus 2 has resulted in a significant number of individuals developing pulmonary fibrosis(PF),an irreversible lung injury.This condition can manifest within a short inter-val following the onset of pneumonia symptoms,sometimes even within a few days.While lung transplantation is a potentially lifesaving procedure,its limited availability,high costs,intricate surgeries,and risk of immunological rejection present significant drawbacks.The optimal timing of medication administration for coronavirus disease 2019(COVID-19)-induced PF remains controversial.Despite this,it is crucial to explore pharmacotherapy interventions,involving early and preventative treatment as well as pharmacotherapy options for advanced-stage PF.Additionally,studies have demonstrated disparities in anti-fibrotic treatment based on race and gender factors.Genetic mutations may also impact therapeutic efficacy.Enhancing research efforts on pharmacotherapy interventions,while considering relevant pharmacological factors and optimizing the timing and dosage of medication administration,will lead to enhanced,personalized,and fair treatment for individuals impacted by COVID-19-related PF.These measures are crucial in lessening the burden of the disease on healthcare systems and improving patients'quality of life.

A Multilayer Network Constructed for Herb and Prescription Efficacy Analysis

Chinese Medicine(CM)has been widely used as an important avenue for disease prevention and treatment in China especially in the form of CM prescriptions combining sets of herbs to address patients’symptoms and syndromes.However,the selection and compatibility of herbs are complex and abstract due to intrinsic relationships between herbal properties and their overall functions.Network analysis is applied to demonstrate the complex relationships between individual herbal efficacy and the overall function of CM prescriptions.To illustrate their connections and correlations,prescription function(PF),prescription herb(PH),and herbal efficacy(HE)intranetworks are proposed based on CM theory to identify relationships between herbs and prescriptions.These three networks are then connected by PF-PH and PH-HE interlayer networks adopting herb dosage to form a multidimensional heterogeneous network,a Prescription-Herb-Function Network(PHFN).The network is applied to 112 classic prescriptions from Treatise on Exogenous Febrile and Miscellaneous Diseases to illustrate the application of PHFN.The PHFN is constructed including 146 functions in PF intra network,89 herbs in the PH intra network,and 163 herbal efficacies in the HE intra network.The results show that herb pairs with synergistic actions have stronger relevance,such as licorice-cassia twig,licorice-Chinese date,fresh ginger-Chinese date,etc.The integration of dosage to the network helps to indicate the main herbs for cluster analysis and automatic formulation.PHFN also reveals the internal relationships between the functions of prescriptions and composed herbal efficacies.

Vitamin D and selenium for type 2 diabetes mellitus with Hashimoto’s thyroiditis:Dosage and duration insights

This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.

Exploration of standard dosage for GnRH antagonist protocol and dosage adjustments after premature luteinizing hormone surge

The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.

Dosage Formula in Anesthesia for Manual Intrauterine Aspiration Post-Abortion in Resource-Limited Settings

Setting: Provincial General Reference Hospital of Bukavu, General Reference Hospital of Panzi, General Reference Hospital of Ciriri, General Reference Hospital of Nyatende and Biopharm Hospital Center. Objective: Contribute to the improvement of the anesthetic ECP of patients benefiting from MVA for incomplete abortion, Describe the methodology used for adoption of the dosage formula in Anesthesia for MVA, present the mathematical demonstration leading to the dosage formula in anesthesia for MVA. Materials and Methods: Our study was descriptive by mathematical demonstration of obtaining the equilibrium constant of the dosage formula of bipuvacaine 0.1% and Fentanyl 50 µg% adapted to the weight and specific size of patients treated anesthetically in MVA cases for incomplete abortion. We also carried out an operational research by first determining the interval where our equilibrium constant is included and secondly by means of the ends of the intervals found correlated to the ends of intervals of possible weights and sizes in the being normal human female of childbearing age to arrive at the real numerical value of the equilibrium constant of the BUKAVU Dosage Formula in the case of anesthesia for MVA during the management of incomplete abortions. Results: TWO-STAGE OPERATIONAL RESEARCH: • Determination of the interval where the equilibrium constant x = −0.95 x x by crossing the means between the extremes of volumes of anesthetic drugs giving a satisfactory sensory block without hemodynamic disturbance and the extremes of normal weight and height for women of childbearing age. We ended up with X = 0.37. Conclusion: At the end of our study which had the general objectives of contributing to the improvement of the anesthetic PEC of patients receiving MVA for incomplete abortion and specific objectives of describing the methodology used for adoption of the dosage formula in Anesthesia for MVA and present the mathematical demonstration which resulted in the dosage formula in nesthesia for MVA, it appears that the dosage formula of Bukavu, in case of intrathecal spinal analgesia of MVA for incomplete abortion provides precision on the specificity of the doses of bipuvacaine hypobarre 0.1% and Fentanyl 50 µg% reported to each patient according to her weight and height. Its application could therefore reduce morbidity and mortality and improve patient-practitioner comfort in the event of MVA for incomplete abortion following the dosage precision it provides.

Dosage and utilization of dexamethasone in the management of COVID-19: A critical review

BACKGROUND The severe respiratory manifestations observed in severe coronavirus disease 2019(COVID-19)cases are often associated with an excessive inflammatory response.Dexamethasone,a synthetic glucocorticoid,exerts its anti-inflammatory effects by inhibiting the transcription of pro-inflammatory genes and suppressing the activity of various immune cells.This mechanism has implications for mitigating the cytokine storm observed in severe COVID-19 cases.Early on in the pandemic,the Recovery Collaborative working group showed a mortality benefit of using dexamethasone in decreasing mortality in patients with COVID-19 requiring respiratory support.However,the optimal dosage of corticosteroids remains debatable.Several studies that compare different doses of dexamethasone in COVID-19 exist,but the results are conflicting.AIM To review the latest evidence regarding dosage,safety,and efficacy of dexamethasone in severe COVID-19.METHODS We followed preferred reporting items for systematic reviews and meta-analysis guidelines.A detailed literature search was conducted across PubMed,Google Scholar,and Medline to include publications up to March 2024.Our keywords included“COVID-19”“SARS-CoV-2”“dexamethasone”“corticosteroid”“steroid”and“glucocorticoid”-along with their combinations.We employed the Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale to evaluate the integrity and potential of bias in the included studies.A meta-analysis was conducted using a random-effects model,assessing pooled odds ratios and mean differences,with heterogeneity gauged by the I2 statistic and theχ^(2) tests.RESULTS No statistical differences were found in 28-day all-cause mortality[pooled odds ratio(OR)=1.109,95%CI:0.918-1.340],60-day all-cause mortality(OR=0.873,95%CI:0.744-1.024;I2=47.29%),mean length of hospital stay(mean difference=-0.08 days,95%CI:-0.001 to 0.161)and adverse events(OR=0.877,95%CI:0.707-1.087).CONCLUSION Differing doses of corticosteroids have no clinical implications on mortality,mean length of hospital stay,and adverse events in COVID-19 patients.Additional research is required in patients requiring invasive or noninvasive ventilation.

Prevalence and Individual-Level Determinants of Uptake of Three or More Doses of Sulphadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Busia County, Kenya

Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.

Who may benefit from lower dosages of intravenous tissue plasminogen activator? Results from a cluster data analysis

background The risk of symptomatic intracranial haemorrhage(sICH)after thrombolysis is low but severe.Lower dose of alteplase may reduce the risk of sICH.We aim to identify subsets of patients who could benefit from lower dose of alteplase compared with standard dose.Methods Data from two observational registries were pooled together.A total of 3479 patients who had acute ischaemic stroke were entered into the interaction tree model.The response variable was the rate of sICH per the definition of the National Institute of Neurological Disorders and Stroke Study.Clinical improvement was measured by the National Institutes of Health Stroke Scale(NIHSS)and defined as NIHSS 0 or 1 or an improvement of more than 4 points(within 7 days or at discharge).Rare event logistic regression was performed to analyse the OR of safety outcome.results To optimise the interaction effect between tissue plasminogen activator(tPA)dosage(standard/lower)and patient subgroups,three subgroups based on the severity of stroke were identified:(1)NIHSS≤4,(2)NIHSS between 5 and 14,and(3)NIHSS≥15.The estimated difference of OR of having sICH was 2.71(95%CI 0.80 to 7.69,p=0.10)for mild,0.13(95%CI 0.02 to 0.68,p=0.01)for moderate,and 0.65(95%CI 0.19 to 2.55,p=0.52)for severe,respectively.In addition,patients who had moderate stroke treated with lower dose had comparable efficacy outcome(OR 1.23,95%CI 0.71 to 2.13,p=0.45).Conclusion Our analysis demonstrated that in patients who had moderate stroke,lower doses of alteplase are associated with significant sICH reduction and non-inferior performance in efficacy,compared with those in the standard dose group.

Low dosages:new chemotherapeutic weapons on the battlefield of immune-related disease

Chemotherapeutic drugs eliminate tumor cells at relatively high doses and are considered weapons against tumors in clinics and hospitals.However,despite their ability to induce cellular apoptosis,chemotherapeutic drugs should probably be regarded more as a class of cell regulators than cell killers,if the dosage used and the fact that their targets are involved in basic molecular events are considered.Unfortunately,the regulatory properties of chemotherapeutic drugs are usually hidden or masked by the massive cell death induced by high doses.Recent evidence has begun to suggest that low dosages of chemotherapeutic drugs might profoundly regulate various intracellular aspects of normal cells,especially immune cells.Here,we discuss the immune regulatory roles of three kinds of chemotherapeutic drugs under low-dose conditions and propose low dosages as potential new chemotherapeutic weapons on the battlefield of immune-related disease.