Four-point Scale Research Articles

Translation and Adaptation to Hebrew of the Singers' Voice Handicap Index Questionnaire.

Translation and Adaptation to Hebrew of the Singers' Voice Handicap Index Questionnaire.

Deep learning reconstruction for accelerated 3-D magnetic resonance cholangiopancreatography.

This study aimed to compare a conventional three-dimensional (3-D) magnetic resonance cholangiopancreatography (MRCP) sequence with a deep learning (DL)-accelerated MRCP sequence (hereafter, MRCPDL) regarding acquisition time and image quality. We conducted a prospective study of consecutive patients referred for MRCP between November 2023 and April 2024 at a single tertiary center. Each participant underwent 1.5T 3-D T2-weighted turbo spin echo MRCP using both a conventional sequence (threefold acceleration) and MRCPDL (eightfold acceleration). Three blinded readers independently evaluated image quality, including background signal suppression, bile and pancreatic duct visibility, artifact level, and diagnostic confidence on an ordinal four-point scale. Acquisition times were compared using a paired t-test. Image quality parameters were assessed with repeated measures ANOVA. Interreader agreement was analyzed using Fleiss' κ. Out of 419 consecutive patients, 30 participants were evaluated (mean age, 63 ± 15years; 16 men, 14 women). The mean acquisition time was 10:30 ± 03:04min for conventional MRCP and 3:57 ± 01:13min for MRCPDL, P < 0.001. MRCPDL reduced acquisition time by 62.4%. Artifact levels were rated at 3.17 ± 0.77 for conventional MRCP and 3.56 ± 0.66 for MRCPDL (P = 0.041). Background signal suppression, bile duct visibility, pancreatic duct visibility, and diagnostic confidence did not differ significantly (P > 0.05). Interreader agreement was substantial to almost perfect (κ: 0.64-87). Deep learning-accelerated 3-D MRCP reduced acquisition time by 62%, minimized artifacts, and preserved bile and pancreatic duct visibility, supporting its adoption in routine clinical practice.

Using Large Language Models in the Diagnosis of Acute Cholecystitis: Assessing Accuracy and Guidelines Compliance.

BackgroundLarge language models (LLMs) are advanced tools capable of understanding and generating human-like text. This study evaluated the accuracy of several commercial LLMs in addressing clinical questions related to diagnosis and management of acute cholecystitis, as outlined in the Tokyo Guidelines 2018 (TG18). We assessed their congruence with the expert panel discussions presented in the guidelines.MethodsWe evaluated ChatGPT4.0, Gemini Advanced, and GPTo1-preview on ten clinical questions. Eight derived from TG18, and two were formulated by the authors. Two authors independently rated the accuracy of each LLM's responses on a four-point scale: (1) accurate and comprehensive, (2) accurate but not comprehensive, (3) partially accurate, partially inaccurate, and (4) entirely inaccurate. A third author resolved any scoring discrepancies. Then, we comparatively analyzed the performance of ChatGPT4.0 against newer large language models (LLMs), specifically Gemini Advanced and GPTo1-preview, on the same set of questions to delineate their respective strengths and limitations.ResultsChatGPT4.0 provided consistent responses for 90% of the questions. It delivered "accurate and comprehensive" answers for 4/10 (40%) questions and "accurate but not comprehensive" answers for 5/10 (50%). One response (10%) was rated as "partially accurate, partially inaccurate." Gemini Advanced demonstrated higher accuracy on some questions but yielded a similar percentage of "partially accurate, partially inaccurate" responses. Notably, neither model produced "entirely inaccurate" answers.DiscussionLLMs, such as ChatGPT and Gemini Advanced, demonstrate potential in accurately addressing clinical questions regarding acute cholecystitis. With awareness of their limitations, their careful implementation, and ongoing refinement, LLMs could serve as valuable resources for physician education and patient information, potentially improving clinical decision-making in the future.

Developing An Interactive English Teaching Module for Visual Communication Design Students using Google Sites at Grade X SMK Negeri 1 Mataram

This research addresses a critical gap in independent curricula (IKM) that fails to meet Visual Communication Design (VCD) students' specific needs for professional English communication. This study addresses the lack of industry-specific English learning materials for Visual Communication Design (VCD) students by developing an interactive teaching module using Google Sites. Guided by the ADDIE model within an R&amp;D framework, the research employed a mixed-methods approach to collect both qualitative and quantitative data. Qualitative data from teacher interviews and document analysis were processed through Miles and Huberman's model. Quantitative data included expert validation using a four-point Likert scale and responses from 32 student participants. The developed module featured a whole-part-whole framework with visual branding content reflecting industry practices. Implementation through Google Sites with interactive features achieved a 90% expert validation score, indicating high feasibility. Student feedback data revealed strong positive responses across multiple dimensions: 89% satisfaction with practical examples, 85.9% for content comprehensibility, and particularly enthusiastic reception of the industry-relevant materials. During evaluation, student input led to specific improvements in text display. The research successfully bridges the gap between general English teaching and vocational preparation by creating an empirically validated, interactive learning tool that equips VCD students with the specialized English communication skills essential for success in the visual design industry.

Classification of upper lip larger defect and the corresponding surgical plan

Objective: To classify the extensive defects after upper lip cancer surgery and explore the efficacy of nasolabial flap with Abbe flap combined or vermilion elastic flap in extensive defects after upper lip cancer ablation. Methods: Twenty-seven patients with upper lip cancer who underwent surgical resection in the Department of Oral and Maxillofacial, The Second Xiangya Hospital, Central South University from January 2010 to December 2021 were recruited, including 13 males and 14 females aged from 19 to 78 years old. The defects of upper lip were more than 50%, and local flaps (Abbe flap, nasolabial flap or vermilion elastic flap) were used to reconstruct the defects of upper lip cancer. According to the extent of defects and the application type of flaps, the defects were classified into 3 sub-types: ①Type Ⅰ defect: median upper lip defect, with more than 50% defect of vermilion and nearly complete defect of upper lip skin, which can be repaired by Abbe flap combined with double nasolabial flap.②Type Ⅱ defect: median upper lip defect, with more than 50% defect of vermilion and upper lip skin defect, repaired by Abbe flap alone. ③Type Ⅲ defect: lateral upper lip defect, with more than 50% defect of vermilion and upper lip skin defect. The nasolabial flap was used to reconstruct the skin defect, and the vermilion elastic flap was used to repair the labial redness defect. A four-point scale was used to evaluate the function and aesthetic outcome of the lips 3 months after surgery, and postoperative complications were recorded. Results: Among the included patients with lip cancer, there were 2 cases of type Ⅰ, 9 cases of type Ⅱ, and 16 cases of type Ⅲ. All Abbe flap and nasolabial flap survived, with tip necrosis occurring in 2 Abbe flaps and have been resected. The average functional score was 2.89±0.80, and the average cosmetic score was 3.04±0.76. Conclusions: The reconstructive method based on Abbe flap and nasolabial flap provides a novel surgical technique for the reconstruction of extensive defects after upper lip cancer surgery.

First Ordinal Birth Position in the Family and Resilient Identity of Adolescents in Bamenda II Subdivision

Aim: This study investigated the influence of "First Ordinal Birth Position in the Family on the Resilient Identity of Adolescents" in the Bamenda II Sub-division of the Northwest Region of Cameroon. Specifically, it sets out to find out how the first ordinal birth position of adolescents in their families influences their resilient identity.Methods: A concurrent nested mixed-method research design was adopted in this study. In this light, both the quantitative and qualitative research paradigms were adopted. A total of 200 adolescents within the age range of 12 to 19 years were selected as sample using purposive and snowball sampling techniques. Krejie and Morgan's table of calculation was used to calculate the sample size. A questionnaire with a four-point Likert scale, and structured and closed-ended questions was used to collect quantitative data from adolescents and a Focused Group Discussion guide was used to collect qualitative data from parents. Inferential statistics were calculated using the Omnibus test of Model coefficient and all statistics were presented at the 95% confidence level (CL). The regression test was used to test hypotheses at a 0.05 significance level. Reliability was calculated using Cronbach's alpha reliability coefficient which ranged from 0.684 to 0.774. Results: The findings indicated that there is a significant influence on the first-birth position and the psychological resilience of adolescents as they enjoy first-born privileges and equally perform different responsibilities assigned to first-birth position children only. These findings highlight the significant role of birth order in shaping adolescent resilience and the need for targeted interventions by parents, educators, and policymakers. Conclusion: The study conclude that the first ordinal birth position influences the resilient identity of adolescents. Recommendations: Policy policymakers should come up with guidelines for parents and adolescents on how to manage their families for sustainable development and the psychological well-being of adolescents. Teachers, and counsellors should identify values which will build adolescents self-esteem, resilience and teach them in the classroom. Adolescents should also be sensitized on how to develop coping and resilient identity skills.

COVID-19 Related Challenges in Virtual Dental Education: Dental Students Experience

Background: Dental students have experienced changes in their learning format due to the SARS-CoV-2 pandemic. This study aimed to evaluate their perspectives on E-learning during this time. Methods: A cross-sectional study utilizing a validated and reliable questionnaire and an online self-report was conducted with dental students in 2022 in Yazd. The study included 120 dental students from the last three years of their program. Socio-demographic and academic data were collected, and certain questions explored students' perspectives on E-learning and its impact on dental education during the COVID-19 pandemic. Responses were rated using a four-point Likert-like scale. Data analysis was performed using SPSS (v. 24) with paired T-tests, one-way ANOVA, Tukey tests, and Pearson correlation (P &lt; 0.05). Results: There was an insignificant difference between the two genders across all dimensions. Overall, 39 students (32.5%) believed that online courses are more appealing than in-person classes, whereas 72 students (60%) found dental professional courses with a laboratory format more engaging than online courses. A significant difference in the fear of COVID-19 was noted among 5thyear students compared to 4thyear and 6thyear students (P-value = 0.0001). Endodontics (39.2%) and prosthodontics (30.8%) were the two fields that were most negatively affected. Conclusions: The results of this study indicated that online activity could serve as a beneficial substitute for dental students during the quarantine. Overall, students expressed positive views about the impact of E-learning during the COVID-19 pandemic. Additionally, a significant correlation was found between the fear of COVID-19 infection and the positive experiences associated with online activity.

An Assessment of ChatGPT's Responses to Common Patient Questions About Lung Cancer Surgery: A Preliminary Clinical Evaluation of Accuracy and Relevance.

Background: Chatbots based on artificial intelligence (AI) and machine learning are rapidly growing in popularity. Patients may use these technologies to ask questions regarding surgical interventions, preoperative assessments, and postoperative outcomes. The aim of this study was to determine whether ChatGPT could appropriately answer some of the most frequently asked questions posed by patients about lung cancer surgery. Methods: Sixteen frequently asked questions about lung cancer surgery were asked to the chatbot in one conversation, without follow-up questions or repetition of the same questions. Each answer was evaluated for appropriateness and accuracy using an evidence-based approach by a panel of specialists with relevant clinical experience. The responses were assessed using a four-point Likert scale (i.e., "strongly agree, satisfactory", "agree, requires minimal clarification", "disagree, requires moderate clarification", and "strongly disagree, requires substantial clarification"). Results: All answers provided by the chatbot were judged to be satisfactory, evidence-based, and generally unbiased overall, seldomly requiring minimal clarification. Moreover, information was delivered in a language deemed easy-to-read and comprehensible to most patients. Conclusions: ChatGPT could effectively provide evidence-based answers to the most commonly asked questions about lung cancer surgery. The chatbot presented information in a language considered understandable by most patients. Therefore, this resource may be a valuable adjunctive tool for preoperative patient education.

Logistics management and operational efficiency in ABC company

The study aimed to describe and assess the logistics management and operational efficiency of the ABC Company. Quantitative Correlational research design was utilized to determine the relationship between the level of implementation in Logistics Management and Operational efficiency in ABC Company. Through stratified random sampling, the study gathered 150 respondents composed of department managers, supervisors, team leaders, and rank-and-file employees of ABC Company. Four-point Likert Scale, mean, ANOVA, and Pearson’s r were utilized for quantitative data treatment. The study found that there was a significant difference among the assessments of department managers, team leaders, and rank-and-file employees on the level of manifestation of logistic management in terms of transaction system, management control, tactical planning, control, and decision analysis, and job performance task level. Likewise, there was a significant difference among the assessment of the respondents on level of operational efficiency in terms of logistics effectiveness, and logistics efficiency. However, in terms of logistic differentiation, there was no significant relationship. On the other hand, there was a significant relationship between the level of manifestation of logistic management and the level of operational efficiency in ABC Company.

Developing a comprehensive model of home-based long-term care for older people in Iran: a multi-method study

IntroductionWith the increasing aging population, the demand for care that fosters independence in older adults is rising. Complications from hospitalization and the preference for aging in place highlight the need for geriatric home care systems. This study aims to develop a comprehensive home-based care model specifically for Iranian seniors and evaluate its feasibility.MethodsThis study employed a multi-phase approach in Iran. It began with a mixed-methods analysis, including a survey on caregiver reliance, followed by qualitative interviews to identify challenges in home care services. Phase 2 involved a scoping review of home care frameworks from various countries. In Phase 3, an initial model was created based on previous findings and relevant documents in Iran. In the fourth phase, feedback was gathered from an expert panel selected through purposive sampling, with discussions recorded and concluding at saturation. The feedback was then integrated into the final model. Additionally, in a Delphi study, experts evaluated the model components using a four-point Likert scale, calculating the content validity index (CVI) for each item. A CVI of 79% or higher indicated validity, and continuous feedback led to iterative refinements.ResultsFollowing the design of the initial model, an expert panel convened with 15 participants to review the framework. The final model comprises seven key components: leadership and governance, legislative framework, financial framework, human resource management system, information management system, and control and monitoring system. Results from the Delphi study indicated that with a CVI exceeding 80%, this model is deemed a valid framework for delivering home-based care.ConclusionThis study presents a comprehensive model that serves as a valuable guide for policymakers seeking to implement integrated home care with professional oversight. By doing so, it aims to enhance the quality of care and improve stakeholder satisfaction.

Arabic Translation, Cultural Adaptation, and Validation of the Hyperhidrosis Disease Severity Scale (Ar-HDSS).

Background: Hyperhidrosis (HH) is characterized by excessive sweating, which affects quality of life. The Hyperhidrosis Disease Severity Scale (HDSS) is a four-point scale used to evaluate HH severity by measuring how much excessive sweating disrupts daily activities. This study aimed to translate, validate, and adapt the HDSS tool into Arabic. Methods: A quantitative, analytical, cross-sectional study was carried out from May to June 2024 on patients clinically diagnosed with HH. The process of translating the HDSS into Arabic involved three independent forward translations, followed by a preliminary version created by a reviewer. Three additional independent translators conducted backward translations. All of the versions were then revised and merged to produce the final version. Reliability was evaluated through a test-retest reliability approach to ensure the reproducibility of the results. For validity, we used construct validity to compare the HDSS with the HidroQoL index. Results: A total of 167 patients were included, with a mean age of 29 ± 9.02 years, and over half of the patients were male (61%). The interrater agreement between the HDSS test and the retest results was substantial, with a kappa coefficient of 0.732. Significant positive correlations were observed between the HDSS score and daily life (r = 0.413, p < 0.001), the psychological domain (r = 0.374, p < 0.001), and HidroQOL (r = 0.425, p < 0.001). Conclusions: Our findings demonstrate that the Arabic HDSS has excellent psychometric properties, including construct validity and reproducibility. Proper use of the Arabic HDSS will allow the effective assessment of HH severity.

Relationship between self-rated health, physical frailty, and incidence of disability among Japanese community-dwelling older adults: A longitudinal prospective cohort study.

Relationship between self-rated health, physical frailty, and incidence of disability among Japanese community-dwelling older adults: A longitudinal prospective cohort study.

Exploring residents' and fellows' confidence in sexually transmitted infection management and confidential care for adolescents.

Background In the United States, many residents and fellows lack confidence in their ability to confidentially counsel adolescents regarding sexual health topics. Little is known about how personal and professional experiences may affect medical residents' and fellows' confidence in counselling adolescents about sexual health services. Methods We invited 361 residents and fellows (trainees) from paediatric, obstetrics and gynaecology, as well as family medicine programs at an academic medical centre in Texas to complete a survey about confidence in counselling about sexual health services. We describe respondents' demographics, medical training, personal sexual healthcare experiences, and confidence in confidential care and STI management measured on a four-point Likert scale. We calculated average confidence scores, dichotomised responses into confident (≥3 points) and not-so-confident ( Results Among 228 trainees (63% response rate), 54% were confident in confidential care and 81% were confident in STI management. Those who received training in aspects of confidential care and STI management reported significantly greater confidence in many of these areas. Respondents who recalled private discussions with their personal healthcare provider as an adolescent reported confidence in STI management (P =0.02) compared to those who did not have that experience. Conclusions Medical training should focus on communication training to address gaps in confidence, particularly regarding adolescent confidentiality. Clinicians' personal experiences may impact aspects of confidence, highlighting the importance of encouraging trainees to reflect on how their background might influence their clinical practice.

Predictors of Nurses' Job Satisfaction in Home Care Settings: Findings From the AIDOMUS-IT Study.

Nurses' job satisfaction in hospitals is fundamental for the quality of care and the safety of patients. However, sociodemographic trends require moving care to patients' homes, and the predictors of job satisfaction for nurses working in the home care settings remain largely unknown. Therefore, the aim of this study was to investigate job satisfaction of nurses working in Italian home care settings and its determinants. Multicenter observational cross-sectional study. This study was conducted in the districts of 70 local health authorities in Italy. Data on the characteristics of the organization and nurses were collected. Nursing job satisfaction was evaluated on a four-point scale ranging from "very satisfied" to "very dissatisfied." Additionally, the following variables were assessed: workload, quality of leadership, work-private life conflict, burnout symptoms, possibility for development, staffing and resource adequacy, nurse manager ability, safety climate, and teamwork climate. A logistic regression analysis was conducted to identify factors influencing job satisfaction. Only organizational variables had a predictive value for nurses' job satisfaction. Workload (OR = 1.01; p = 0.033), work-private life conflict (OR = 1.02; p < 0.001), burnout (OR = 1.02; p < 0.001), and staffing inadequacy (OR = 1.44; p = 0.003) predicted higher levels of nurse dissatisfaction. Instead, high-quality leadership (OR = 0.981; p < 0.001), possibility for development (OR = 0.973; p < 0.001), and good teamwork climate (OR = 0.994; p = 0.003) were predictors of better levels of satisfaction. This study suggested that home care nurses are generally satisfied with their jobs. To enhance job satisfaction, it is essential to improve nurses' work environment, the leadership quality and ensure professional development. Our results are globally relevant as they contribute to the limited evidence available on this topic in home care settings. This study emphasizes the need of measuring nurses' job satisfaction and implementing interventions to promote healthy work environments.

Development and Validation of Polygon Puzzlers: An Adaptive Learning Webpage Intervention to Solve Problems Involving Sides and Angles of a Polygon

Geometry is a fundamental branch of mathematics essential for developing students' spatial reasoning, problem-solving abilities, and critical thinking skills. This study aimed to develop an adaptive learning webpage entitled “Polygon Puzzlers” to assist Grade 7 students with the least learned competencies in Mathematics, specifically in “solving problems involving sides and angles of a polygon” (M7GE-IIIg-1). The study employed a developmental descriptive research design. A panel of three (3) expert validators was selected using a sampling technique. To gather the necessary data, the evaluators used a four-point rating scale and a standardized Experts Evaluation Checklist provided by the Department of Education (DepEd). Descriptive statistics, including frequency count, percentage, and mean, were computed using Microsoft Excel to analyze the data. The validators rated the learning material as “passed” for meeting the standards set by the DepEd in terms of content quality, instructional quality, technical quality, and other criteria. They also recommended the material for possible use in public schools, provided that the corrections and revisions suggested in their report were addressed. Based on these findings, the developed and validated adaptive learning webpage offers personalized learning experiences tailored to students' individual needs and learning pace. It promotes active engagement with the content, reinforcing key concepts while fostering critical thinking and problem-solving skills.

Laryngopharyngeal Reflux and Upper Airway Obstruction Patterns in Nonobese Sleep Apnea Patients.

The study aims to investigate the relationship between the presence of laryngopharyngeal reflux (LPR) and obstruction levels identified during drug-induced sleep endoscopy (DISE) in obstructive sleep apnea (OSA) among nonobese patients. We conducted a prospective study of 105 adult patients diagnosed with OSA who underwent DISE using propofol sedation from 2019 to 2024 at a tertiary hospital. To control for the confounding impact of obesity on LPR, the study selectively enrolled individuals presenting a body mass index within the normal range. LPR was assessed using Reflux Symptom Index and Reflux Finding Score. DISE was performed to evaluate upper airway obstruction at various levels, documented using the VOTE classification system by three blinded reviewers. Hypertrophy of the lingual and palatine tonsils was graded using a four-point scale. Approximately 48.57% of 105 patients showed the presence of LPR. The chi-square test demonstrated a statistically significant association between LPR and the level of airway obstruction, particularly at the tongue base (p = 0.039). Lingual tonsil hypertrophy Grade 3 at the tongue base and palatine tonsil hypertrophy Grade 3 at the oropharynx both showed significant overrepresentation, with adjusted residual values of 4.0 and 4.8, respectively. Complete tongue base obstruction showed a statistically significant association with LPR, with a strong predictive value in both univariate (β = 2.325, OR = 10.227, p = 0.007) and multivariate analyses (β = 2.295, OR = 9.921, p = 0.008). The presence of LPR in nonobese OSA patients appears to be significantly associated with an increased likelihood of tongue base obstruction. 3 Laryngoscope, 2025.

Teachers’ knowledge and differentiated instruction in basic schools in Ghana / Conocimiento docente e instrucción diferenciada en los centros de Educación Básica de Ghana

The study analysed teacher knowledge and implementation of Differentiated Instruction in basic schools in the Effutu Municipality. The study adopted the cultural-historical theory by Lev Vygotsky as the theoretical framework. A quantitative research method and a cross-sectional survey were employed as the research design. Sixty teachers were selected via multi-stage sampling which involved purposive and simple random sampling. A close-ended questionnaire was used to collect information about knowledge, awareness and extent of usage or implementation of Differentiated Instruction among the teachers on a four-point Likert scale. The results showed that the teachers had very good knowledge of Differentiated Instruction in the study area but that the proportion of teachers who implemented it in core subjects was not statistically significantly different from the proportion who did not. It was recommended that policymakers and heads of basic schools should enforce the use of Differentiated Instruction due to its significant benefits to learners.

Analysis Of Factors Influencing Students' Interest In Management At Bandar Lampung University In Entrepreneurship

In the era of globalization, entrepreneurship become solution strategic For reduce unemployment and increase growth economy. Research This aiming For analyze influence motivation and creativity to interest entrepreneurship among? students of the Management Study Program at Bandar Lampung University. The research method used is quantitative descriptive with approach statistical data analysis. Population study totaling 724 students, and the sample as many as 88 respondents chosen use Slovin technique. Primary data was collected through questionnaire with four-point Likert scale level and analyzed use multiple linear regression. Research results show that motivation and creativity in a way significant influence interest entrepreneurship, with contribution by 53%. Motivation own more influence? dominant compared to creativity, but both of them each other complete in increase interest student to entrepreneurship. Implications study This confirm importance institution education For strengthening training and learning programs entrepreneurship based on motivation and creativity For push birth generation innovative entrepreneur.

Adding salt to foods and risk of incident depression and anxiety

BackgroundDiet is a well-known determinant of mental health outcomes. However, epidemiologic evidence on salt consumption with the risk of developing depression and anxiety is still very limited. This study aimed to examine the association between adding salt to foods and incident depression and anxiety longitudinally.MethodsThis study used data from 444,787 adults who had never been diagnosed with depression or anxiety at baseline from the UK Biobank, a national community-based cohort from 2006 to 2010. Adding salt to foods was measured using a four-point Likert scale at baseline from a touch-screen questionnaire. The outcomes were incidents of diagnosed depression (F32-F33) and anxiety (F40-F48), defined by the International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. Cox proportional hazards models were used to investigate the association between the frequency of adding salt to foods and incident depression and anxiety.ResultsDuring a mean follow-up period of 14.5 years, 16,319 incidents of depression and 18,959 incidents of anxiety were documented. A higher frequency of adding salt to foods was associated with elevated risk for depression and anxiety. Compared with the group of never/rarely adding salt to foods, the adjusted HRs of incident depression were 1.07 (95% CI: 1.02–1.12), 1.18 (95% CI: 1.10–1.26), and 1.29 (95% CI: 1.18–1.41) across the groups of sometimes, usually, and always, respectively (P trend < 0.001). Participants who reported always adding salt to foods had a 1.17-fold higher risk for developing anxiety (95% CI: 1.07–1.28) compared with those who never/rarely added salt to foods.ConclusionsA higher frequency of adding salt to foods was independently associated with a higher hazard of depression and anxiety. Interventions such as public awareness campaigns promoting reduced salt consumption may be promising preventative measures to reduce the incidence of depression and anxiety.

Exploring the performance of large language models on hepatitis B infection-related questions: A comparative study.

Patients with hepatitis B virus (HBV) infection require chronic and personalized care to improve outcomes. Large language models (LLMs) can potentially provide medical information for patients. To examine the performance of three LLMs, ChatGPT-3.5, ChatGPT-4.0, and Google Gemini, in answering HBV-related questions. LLMs' responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale, and disagreements were resolved by a third reviewer. Each question was run three times using three LLMs. Readability was assessed via the Gunning Fog index and Flesch-Kincaid grade level. Overall, all three LLM chatbots achieved high average accuracy scores for subjective questions (ChatGPT-3.5: 3.50; ChatGPT-4.0: 3.69; Google Gemini: 3.53, out of a maximum score of 4). With respect to objective questions, ChatGPT-4.0 achieved an 80.8% accuracy rate, compared with 62.9% for ChatGPT-3.5 and 73.1% for Google Gemini. Across the six domains, ChatGPT-4.0 performed better in terms of diagnosis, whereas Google Gemini demonstrated excellent clinical manifestations. Notably, in the readability analysis, the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight, far exceeding the reading level of the normal population. Our results highlight the potential of LLMs, especially ChatGPT-4.0, for delivering responses to HBV-related questions. LLMs may be an adjunctive informational tool for patients and physicians to improve outcomes. Nevertheless, current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.