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| '''Title'''  
| '''Title'''  
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| style="width:200px;" | Artificial Intelligence Tools for Scientific Writing: The Good, The Bad and The Ugly
| style="width:200px;" | Impact of the COVID-19 Pandemic on Emergency Department Visits for Idiopathic Facial Nerve Palsy: An Interrupted Time-Series Analysis
|-  
|-  
| '''Authors'''
| '''Authors'''
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|  Giuseppe Biondi-Zoccai, Anna Cazzaro, Elisa Cobalchin, Diletta D’Auria, Giovanni Ardizzone, Salvatore Giordano, Ulvi Mirzoyev, Petar M Seferovic, Gani Bajraktari, Denisa Muraru.
|  Francesco Brigo, Gianni Turcato, Serena Sibilio, Arian Zaboli.
|-
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| '''DOI'''
| '''DOI'''
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| [https://doi.org/10.62684/BXVS8359 10.62684/BXVS8359]
| [https://doi.org/10.62684/XYYW4586 10.62684/XYYW4586]
|-
|-
| '''Keywords'''
| '''Keywords'''
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| Artificial Intelligence; ChatGPT; Medical writing; Peer review; Research; Science; Scientific writing.
| Bell’s palsy; COVID-19 pandemic; Emergency Department; Epidemiology; Idiopathic facial nerve palsy; SARS-Cov-2.
|-
|-
| '''Downloads'''
| '''Downloads'''
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|  style="text-align: center;" | [[File:PDF_file_icon.png|center|50px|'''Download PDF'''|link=https://journal.topitalianscientists.org/images/a/a8/Artificial_Intelligence_Tools_for_Scientific_Writing_The_Good_The_Bad_and_The_Ugly.pdf]]
|  style="text-align: center;" | [[File:PDF_file_icon.png|center|50px|'''Download PDF'''|link=https://journal.topitalianscientists.org/images/f/fe/Impact_of_the_COVID-19_Pandemic_on_Emergency_Department_Visits_for_Idiopathic_Facial_Nerve_Palsy_An_Interrupted_Time-Series_Analysis.pdf]]
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'''[https://www.topitalianscientists.org/tis/2587/Giuseppe_Biondi_Zoccai_-_Top_Italian_Scientist_in_Biomedical_Sciences Giuseppe Biondi-Zoccai]'''<sup>(a,b)</sup>, Anna Cazzaro<sup>(a)</sup>, Elisa Cobalchin<sup>(a)</sup>, Diletta D’Auria<sup>(a)</sup>, Giovanni Ardizzone<sup>(a)</sup>,  Salvatore Giordano<sup>(c)</sup>, Ulvi Mirzoyev<sup>(d)</sup>, Petar M Seferovic<sup>(e)</sup>, Gani Bajraktari<sup>(f,g,h)</sup>, Denisa Muraru<sup>(i,j)</sup>
'''[https://www.topitalianscientists.org/tis/51477/Francesco_Brigo_-_Top_Italian_Scientist_in_Neurosciences_&_Psychology Francesco Brigo]'''<sup>(a)</sup>, '''Gianni Turcato'''<sup>(b)</sup>, '''Serena Sibilio'''<sup>(c)</sup>, '''Arian Zaboli'''<sup>(a)</sup>  


<sup>(a)</sup> Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. giuseppe.biondizoccai@uniroma1.it
<sup>(a)</sup> Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.


<sup>(b)</sup> Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.  
<sup>(b)</sup> Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy.


<sup>(c)</sup> Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy. sasigiordano@gmail.com
<sup>(c)</sup> Institute of Nursing Science, University of Basel-Department of Public Health, Basel, Switzerland


<sup>(d)</sup> Medical Center of the Ministry of Emergency Situations, Baku, Azerbaijan. ulvi.mirzoyev@adam.az
''Correspondence to'': Francesco Brigo, francesco.brigo@sabes.it
 
<sup>(e)</sup> Faculty of Medicine, University of Belgrade, Serbian Academy of Sciences and Arts, Belgrade, Serbia. seferovic.petar@gmail.com
 
<sup>(f)</sup> Clinic of Rheumatology, University Clinical Centre of Kosova, Prishtina, Kosova. ganibajraktari@gmail.com
 
<sup>(g)</sup> Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
 
<sup>(h)</sup> Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
<sup>(i)</sup> Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. denisa.muraru@gmail.com
 
<sup>(j)</sup> Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
 
 
''Correspondence to'': Prof. Giuseppe Biondi-Zoccai, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100 Latina, Italy. Email: giuseppe.biondizoccai@uniroma1.it


==Abstract==
==Abstract==
The integration of artificial intelligence (AI) tools in the workflow of scholarly writing, including scientific and medical writing, offers transformative advantages while raising critical ethical and practical concerns. Among the pros, AI substantially enhances efficiency by automating several time-consuming tasks such as literature review, data synthesis and text editing. In particular, tools such as ChatGPT, Grammarly, and SciSpace Copilot remarkably empower researchers when they draft, refine, and format manuscripts, increasing precision and speed. In addition, AI tools may foster inclusivity by assisting non-native English speakers with seamless translations and also enabling interdisciplinary collaboration, thereby hopefully democratizing access and boosting scientific communication and cooperation. However, the rapid adoption of novel AI tools brings significant challenges. First, there is a distinct risk of perpetuating biases in training datasets, and other key issues include ambiguity in authorship accountability and the potential erosion of critical thinking skills. In addition, AI tools could be purposefully misused to generate mock datasets and fraudulent papers (e.g. by paper mills), and this clearly poses a threat to academic integrity. This challenge is all too pressing given that traditional plagiarism detection tools often fall short against sophisticated AI-generated content. We hereby explore the pros and cons of AI on medical writing, poignantly leveraging Sergio Leone’s The Good, The Bad, and The Ugly movie as a metaphor. By providing general concepts as well as focusing on several key AI tools, we are hopeful this overview may prove useful to anyone wishing to conscientiously adopt AI tools for scientific writing. In addition, we make a compelling case for transparent guidelines, robust and freely available detection mechanisms, and ongoing critical oversight to ensure AI will be able to serve as a catalyst for innovation and dissemination without compromising the credibility of scholarly endeavors.
This study evaluated the impact of the COVID-19 pandemic and related social restrictions on emergency department (ED) visits for idiopathic facial nerve palsy (IFNP). A retrospective observational analysis was conducted on a consecutive cohort of patients presenting to a hospital ED from January 1, 2015, to December 31, 2021. Monthly ED visit rates for IFNP were compared before and after the onset of the pandemic and the national lockdown in March 2020 using interrupted time-series analysis. Data were standardized to 1,000 ED visits per month. Among 248,606 total ED visits during the study period, 266 (0.11%) were due to IFNP. No significant change in standardized ED visits for IFNP was observed immediately following the pandemic’s onset (1.08/1,000 visits; 95% CI: -0.06 to 2.23; p=0.063). However, a significant reduction in visit rates was noted in the months following March 2020 (-0.08/1,000 visits; 95% CI: -0.15 to -0.002;
p=0.043). The decline in IFNP ED visits likely reflects the protective effects of social distancing measures, face mask usage, and reduced viral transmission during the pandemic. These findings challenge claims of increased IFNP risk associated with SARS-CoV-2 infection or vaccination. Furthermore, the results support the hypothesis that neurotropic viruses contribute to the pathogenesis of IFNP and highlight the role of public health measures in reducing disease incidence. This study provides novel insights into the indirect benefits of pandemic-related interventions on viral-associated conditions such as IFNP.


==Declarations==
==Declarations==
===Conflict of interest===
===Conflict of interest===
Giuseppe Biondi-Zoccai has consulted for Abiomed, Advanced Nanotherapies, Aleph, Amarin, Balmed, Cardionovum, Crannmedical, Endocore Lab, Eukon, Guidotti, Innovheart, Meditrial, Menarini, Microport, Opsens Medical, Terumo, and Translumina, outside the present work. Denisa Muraru reports research support and speakers' fees from GE Healthcare and Philips Medical Systems, outside the present work. All other authors report no conflict of interest.
The Authors declare that there is no conflict of interest.


===Acknowledgement===
===Funding===
Research leading to this report has received funding from the European Union - NextGenerationEU, through the Italian Ministry of University and Research, under PNRR - M4C2-I1.3 Project PE_00000019 "HEAL ITALIA" to Giuseppe Biondi-Zoccai CUP B53C22004000006 Sapienza University of Rome. The views and opinions expressed are those of the authors only and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union nor the European Commission can be held responsible for them.
The authors have no funding sources to report.
This manuscript was based on analysis conducted and was drafted with the assistance of artificial intelligence tools, including ChatGPT 4 (OpenAI, San Francisco, CA, USA), in keeping with established best practices (Biondi-Zoccai G, editor. ChatGPT for Medical Research. Torino: Edizioni Minerva Medica; 2024). The final content, including all conclusions and opinions, has been thoroughly revised, edited, and approved by the authors. The authors take full responsibility for the integrity and accuracy of the work and retain full credit for all intellectual contributions. Compliance with ethical standards and guidelines for the use of artificial intelligence in research has been ensured.
 
===Author Contributions===
Francesco Brigo: Conceptualization, Methodology, Investigation, Supervision, Data curation, Writing-Original draft preparation; Serena Sibilio: Investigation; Gianni Turcato: Investigation; Arian Zaboli: Conceptualization, Methodology, Investigation, Formal analysis, Data curation, Writing-Original draft preparation


==References==
==References==
<ol class="references">  
<ol class="references">  
<li></li>
<li>Hauser WA, Karnes WE, Annis J, Kurland LT (1971) Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc 46:258-264</li>
<li>Morris AM, Deeks SL, Hill MD, Midroni G, Goldstein WC, Mazzulli T, Davidson R, Squires SG, Marrie T, McGeer A, Low DE (2002) Annualized incidence and spectrum of illness from an outbreak investigation of Bell's palsy. Neuroepidemiology 21(5):255-61. DOI: 10.1159/000065645</li>
<li>Adour KK, Bell DN, Hilsinger RL Jr (1975) Herpes simplex virus in idiopathic facial paralysis (Bell palsy). JAMA. 233(6):527-30.</li>
<li>Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N (1996) Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med. 124(1 Pt 1):27-30. DOI: 10.7326/0003-4819-124-1_part_1-199601010-00005</li>
<li>Schirm J, Mulkens PS (1997) Bell's palsy and herpes simplex virus. APMIS. 105(11):815-23. DOI: 10.1111/j.1699-0463.1997.tb05089.x</li>
<li>Kennedy PG (2010) Herpes simplex virus type 1 and Bell's palsy-a current assessment of the controversy. J Neurovirol. 16(1):1-5. DOI: 10.3109/13550280903552446</li>
<li>Morgan M, Nathwani D (1992) Facial palsy and infection: the unfolding story. Clin Infect Dis. 14(1):263-71. DOI: 10.1093/clinids/14.1.263</li>
<li>Peitersen E (2002) Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 549:4-30.</li>
<li>Monini S, Lazzarino AI, Iacolucci C, Buffoni A, Barbara M (2010) Epidemiology of Bell's palsy in an Italian Health District: incidence and case-control study. Acta Otorhinolaryngol Ital. 30(4):198.</li>
<li>Corey L, Spear PG (1986) Infections with herpes simplex viruses (1). N Engl J Med. 314(11):686-91.</li>
<li>Zaboli A, Brigo F, Sibilio S, Fanni Canelles M, Rella E, Magnarelli G, Pfeifer N, Turcato G (2022) The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department. Int Emerg Nurs. 65:101229. DOI: 10.1016/j.ienj.2022.101229</li>
<li>Gupta S, Jawanda MK, Taneja N, Taneja T (2021) A systematic review of Bell's Palsy as the only major neurological manifestation in COVID-19 patients. J Clin Neurosci. 90:284-292. DOI: 10.1016/j.jocn.2021.06.016</li>
<li>Lai YH, Chen HY, Chiu HH, Kang YN, Wong SB (2022) Peripheral Nervous System Adverse Events after the Administration of mRNA Vaccines: A Systematic Review and Meta-Analysis of Large-Scale Studies. Vaccines (Basel). 10(12):2174. DOI: 10.3390/vaccines10122174</li>
<li>Gordon AJ, Varelas A, Eytan DF (2023) Bell's Palsy After Vaccination Against Covid-19: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. doi: 10.1002/ohn.385.</li>
<li>Soltanzadi A, Mirmosayyeb O, Momeni Moghaddam A, Ghoshouni H, Ghajarzadeh M (2023) Incidence of Bell's palsy after coronavirus disease (COVID-19) vaccination: a systematic review and meta-analysis. Neurologia (Engl Ed). 9:S2173-5808(23)00038-X. DOI: 10.1016/j.nrleng.2023.06.002</li>
<li>Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, Amanollahi M, Sakhaei D, Rahimlou M, Kheradmand A (2023) Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 149(6):493-504. DOI: 10.1001/jamaoto.2023.0160</li>
<li>Bernal JL, Cummins S, Gasparrini  (2017). Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 46:348-355. DOI: 10.1093/ije/dyw098</li>
<li>Turcato G, Zaboli A, Luchetti A, Sighele F, Sibilio S, Donato C, et al (2022) "Effect of the SARS-COV-2 pandemic outbreak on the emergency department admission for an acute psychiatric condition". J Psychiatr Res. 151:626-632. DOI: 10.1016/j.jpsychires.2022.05.035</li>
<li>Brigo F, Zaboli A, Rella E, Sibilio S, Canelles MF, Magnarelli G, et al (2022) The impact of COVID-19 pandemic on temporal trends of workplace violence against healthcare workers in the emergency department. Health Policy. 126:1110-1116. DOI: 10.1016/j.healthpol.2022.09.010</li>
</ol>
</ol>
[[Category:Open Access]]
[[Category:Article]]
[[Category:Neurosciences & Psychology]]

Latest revision as of 11:44, 11 March 2025

Published
January 10, 2025
Title
Impact of the COVID-19 Pandemic on Emergency Department Visits for Idiopathic Facial Nerve Palsy: An Interrupted Time-Series Analysis
Authors
Francesco Brigo, Gianni Turcato, Serena Sibilio, Arian Zaboli.
DOI
10.62684/XYYW4586
Keywords
Bell’s palsy; COVID-19 pandemic; Emergency Department; Epidemiology; Idiopathic facial nerve palsy; SARS-Cov-2.
Downloads
Download PDF
Download PDF

Francesco Brigo(a), Gianni Turcato(b), Serena Sibilio(c), Arian Zaboli(a)

(a) Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.

(b) Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy.

(c) Institute of Nursing Science, University of Basel-Department of Public Health, Basel, Switzerland

Correspondence to: Francesco Brigo, francesco.brigo@sabes.it

Abstract

This study evaluated the impact of the COVID-19 pandemic and related social restrictions on emergency department (ED) visits for idiopathic facial nerve palsy (IFNP). A retrospective observational analysis was conducted on a consecutive cohort of patients presenting to a hospital ED from January 1, 2015, to December 31, 2021. Monthly ED visit rates for IFNP were compared before and after the onset of the pandemic and the national lockdown in March 2020 using interrupted time-series analysis. Data were standardized to 1,000 ED visits per month. Among 248,606 total ED visits during the study period, 266 (0.11%) were due to IFNP. No significant change in standardized ED visits for IFNP was observed immediately following the pandemic’s onset (1.08/1,000 visits; 95% CI: -0.06 to 2.23; p=0.063). However, a significant reduction in visit rates was noted in the months following March 2020 (-0.08/1,000 visits; 95% CI: -0.15 to -0.002; p=0.043). The decline in IFNP ED visits likely reflects the protective effects of social distancing measures, face mask usage, and reduced viral transmission during the pandemic. These findings challenge claims of increased IFNP risk associated with SARS-CoV-2 infection or vaccination. Furthermore, the results support the hypothesis that neurotropic viruses contribute to the pathogenesis of IFNP and highlight the role of public health measures in reducing disease incidence. This study provides novel insights into the indirect benefits of pandemic-related interventions on viral-associated conditions such as IFNP.

Declarations

Conflict of interest

The Authors declare that there is no conflict of interest.

Funding

The authors have no funding sources to report.

Author Contributions

Francesco Brigo: Conceptualization, Methodology, Investigation, Supervision, Data curation, Writing-Original draft preparation; Serena Sibilio: Investigation; Gianni Turcato: Investigation; Arian Zaboli: Conceptualization, Methodology, Investigation, Formal analysis, Data curation, Writing-Original draft preparation

References

  1. Hauser WA, Karnes WE, Annis J, Kurland LT (1971) Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc 46:258-264
  2. Morris AM, Deeks SL, Hill MD, Midroni G, Goldstein WC, Mazzulli T, Davidson R, Squires SG, Marrie T, McGeer A, Low DE (2002) Annualized incidence and spectrum of illness from an outbreak investigation of Bell's palsy. Neuroepidemiology 21(5):255-61. DOI: 10.1159/000065645
  3. Adour KK, Bell DN, Hilsinger RL Jr (1975) Herpes simplex virus in idiopathic facial paralysis (Bell palsy). JAMA. 233(6):527-30.
  4. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N (1996) Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med. 124(1 Pt 1):27-30. DOI: 10.7326/0003-4819-124-1_part_1-199601010-00005
  5. Schirm J, Mulkens PS (1997) Bell's palsy and herpes simplex virus. APMIS. 105(11):815-23. DOI: 10.1111/j.1699-0463.1997.tb05089.x
  6. Kennedy PG (2010) Herpes simplex virus type 1 and Bell's palsy-a current assessment of the controversy. J Neurovirol. 16(1):1-5. DOI: 10.3109/13550280903552446
  7. Morgan M, Nathwani D (1992) Facial palsy and infection: the unfolding story. Clin Infect Dis. 14(1):263-71. DOI: 10.1093/clinids/14.1.263
  8. Peitersen E (2002) Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 549:4-30.
  9. Monini S, Lazzarino AI, Iacolucci C, Buffoni A, Barbara M (2010) Epidemiology of Bell's palsy in an Italian Health District: incidence and case-control study. Acta Otorhinolaryngol Ital. 30(4):198.
  10. Corey L, Spear PG (1986) Infections with herpes simplex viruses (1). N Engl J Med. 314(11):686-91.
  11. Zaboli A, Brigo F, Sibilio S, Fanni Canelles M, Rella E, Magnarelli G, Pfeifer N, Turcato G (2022) The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department. Int Emerg Nurs. 65:101229. DOI: 10.1016/j.ienj.2022.101229
  12. Gupta S, Jawanda MK, Taneja N, Taneja T (2021) A systematic review of Bell's Palsy as the only major neurological manifestation in COVID-19 patients. J Clin Neurosci. 90:284-292. DOI: 10.1016/j.jocn.2021.06.016
  13. Lai YH, Chen HY, Chiu HH, Kang YN, Wong SB (2022) Peripheral Nervous System Adverse Events after the Administration of mRNA Vaccines: A Systematic Review and Meta-Analysis of Large-Scale Studies. Vaccines (Basel). 10(12):2174. DOI: 10.3390/vaccines10122174
  14. Gordon AJ, Varelas A, Eytan DF (2023) Bell's Palsy After Vaccination Against Covid-19: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. doi: 10.1002/ohn.385.
  15. Soltanzadi A, Mirmosayyeb O, Momeni Moghaddam A, Ghoshouni H, Ghajarzadeh M (2023) Incidence of Bell's palsy after coronavirus disease (COVID-19) vaccination: a systematic review and meta-analysis. Neurologia (Engl Ed). 9:S2173-5808(23)00038-X. DOI: 10.1016/j.nrleng.2023.06.002
  16. Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, Amanollahi M, Sakhaei D, Rahimlou M, Kheradmand A (2023) Association of SARS-CoV-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 149(6):493-504. DOI: 10.1001/jamaoto.2023.0160
  17. Bernal JL, Cummins S, Gasparrini (2017). Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 46:348-355. DOI: 10.1093/ije/dyw098
  18. Turcato G, Zaboli A, Luchetti A, Sighele F, Sibilio S, Donato C, et al (2022) "Effect of the SARS-COV-2 pandemic outbreak on the emergency department admission for an acute psychiatric condition". J Psychiatr Res. 151:626-632. DOI: 10.1016/j.jpsychires.2022.05.035
  19. Brigo F, Zaboli A, Rella E, Sibilio S, Canelles MF, Magnarelli G, et al (2022) The impact of COVID-19 pandemic on temporal trends of workplace violence against healthcare workers in the emergency department. Health Policy. 126:1110-1116. DOI: 10.1016/j.healthpol.2022.09.010
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