A REVIEW OF GENERAL MEDICAL LITERATURE

Written By The Staff of the Reproductive Times

We in this section offer commentaries on a broad survey of recent articles. Articles are mostly chosen for two reasons: their potential translational value for immediate clinical practice or to help in determining where clinical practice might evolve to. Today’s subjects offer information on a format of clinical trials that is quickly gaining in popularity, address statistical data analyses, and bring to our readers attention attempts to improve trustworthiness of published papers in the fertility field.

And more on artificial intelligence (A.I.), though it may be more bad than good news

One almost wonders which among the two papers we are mentioning here is worse: One, an Opinion article in Science magazine by Frederik Joelving from Retraction Watch, reported that AI-generated commentaries flood medical journals, distorting journal metrics (1). A joint investigation by Science and Retraction Watch confirmed this fact at several journals in different specialty areas. Letter, comments, and editorials in several among them made up over half of all submissions. Interestingly over 80% of these commentaries are coming from South Asian countries, compared to less than 20% of research and review articles. 

Their investigation furthermore revealed that everybody appears to benefit from the scheme, even though it floods the literature with poor quality publications and threatened metrics for scholarly output and impact: authors get quick and easy publications and citations and don’t even need original data. For journals, moreover, it can be good business, especially if the journal has publication charges. And institutions, as the article pointed out, especially in India, use such papers for advertisement purposes. 

And we thought we by now know all the dirty laundry in medical publishing! 

But now to the second paper, which may be bad news for very different reasons: Up to this point the widely held assumption in the medical community has been that A.I will, except in rare circumstances, not replace physicians as diagnosticians but “augment” their decision making. But as a recent paper in JAMA Network Open suggested, this may have been a much too optimistic view of the need for human intelligence (2). The paper involved use of a large language A.I. model which somewhat surprisingly did not significantly affect physicians’ diagnostic reasoning. But even more surprisingly the large language model—alone—performed better than physicians, whether alone or with help of the large language model. 

If confirmed in other studies, this observation would significantly affect how physicians have to view the threat of being replaced, especially in certain functions and – maybe – in some medical specialties more than others. So far we, however, would consider the suggestions made in this paper as extremely preliminary. Moreover, the methodology behind this study seems somewhat questionable. So don’t start looking for another career yet; you still may make it to retirement! 

References

1.      Joelving F. Science 2024;386(6728):1331-1332

2.      Goh et al., JAMA Network Open 2024;7(1):e2440969

Medicine is continuing in becoming an increasingly female profession 

For the sixth year in a row more women than men have been entering medical school studies (1). This stands in contrast to, for example, the 1980s, when only approximately 30% of medical students were female. And if we go back to the 1970s, even Ob/Gyn residencies – in those days almost considered a surgical specialty – hardly ever had a female resident. And how that has changed: nowadays, Ob/Gyn residencies hardly ever have a male resident in their midst. 

In 2024/2025, women were 57% of applicants, 55% of matriculants, pretty steady with the preceding year, where the respective percentages were 55% and 54% based on reports from the Association of American Medical Colleges (AAMC). 

One big reason for this trend is that more women are getting undergraduate degrees and that the par to males is, indeed, increasing. As the article noted, in 1995 women and men had bachelor’s degrees at very similar percentages. Today women have a significant lead: 47% of women at ages 25-34 have one, but only 37% of men. 

And the anti-aging train is rolling on

It appears that a microRNA molecule, at least in mice, can rejuvenate aged animals by simply restoring old cells, thereby expanding their lifetime and demonstrating diminished aging markers (1). The Chinese investigators of this paper propose an antiaging strategy which aims to reverse the proliferative arrest of senescent cells. Exosomal miR-302b is identified as a candidate that targets the cell cycle inhibitors Cdkn1a and Ccng2, rejuvenating aging mice by improving physical and cognitive functions, extending lifespan, and apparently demonstrating no safety concerns throughout a 24-months observation period. 

The experiments were simple and straightforward: Using 20- to 25-month-old mice (60-70 years in human years), they were injected with human exosomes either loaded with extra mir-302b (affecting 2 genes in cell division) or not. Saline was used in controls. Treated mice lived for approximately 4.5 months longer (roughly 9 years in humans) and re-grew hair and had better balance as well as grip strength. They also had lower inflammation markers. In short miR-302b treatment not only expanded life span, but also improved the animals physically as well as mentally, while reducing aging markers. The paper was also subject to a News article in Nature magazine (2). 

And then there is a Commentary article by CHR friend and colleague Eli Adashi, MD, in The American Journal of Medicine (2). in which he muses about human immortality by pointing out the progress made in anti-aging research, offering a very optimistic outlook by concluding that, “all indications are that the ability to arrest aging with immortality in mind may just be a matter of time.”

Of course, hoping that he is correct, it still appears important to differentiate between a concept of long(er)jevity and immortality. Mankind for the moment would be more than satisfied with only the former. 

References

1.      Bi et al., Cell Metab 2025;37:527-541

2.      Simms C. Nature 2025;637:1030-1031

3.      Adashi EY. Am J Med 2025;138(1)::13-14

The Staff of the Reproductive Times
Previous

 AN IMPORTANT PRESS RELEASE - Has the hypothesis of EMBRYO SELECTION been finally laid to rest? Announcing an important paper 
Next

Older and older women are at quickly increasing numbers requesting fertility care, - and infertility practice is largely failing them