Content Of Guidelines Research Articles

Molecular Tools to Study and Control Dopaminergic Neurotransmission With Light.

Dopaminergic neurotransmission is involved in several important brain functions, such as motor control, learning, reward-motivated behavior, and emotions. Dysfunctions of dopaminergic system may lead to the development of various neurological and psychiatric disorders, like Parkinson's disease, schizophrenia, depression, and addictions. Despite years of sustained research, it is not fully established how dopaminergic neurotransmission governs these important functions through a relatively small number of neurons that release dopamine. Light-driven neurotechnologies, based on the use of small light-regulated molecules or overexpression of light-regulated proteins in neurons, have greatly contributed to the advancement of our understanding of dopaminergic circuits and our ability to control them selectively. Here, we overview the current state-of-the-art of light-driven control of dopaminergic neurotransmission. While we provide a concise guideline for the readers interested in pharmacological, pharmacogenetic, and optogenetic approaches to modulate dopaminergic neurotransmission, our primary focus is on the usage of photocaged and photo-switchable small dopaminergic molecules. We argue that photopharmacology, photoswitchable molecules of varied modalities, can be employed in a wide range of experimental paradigms, providing unprecedent insights into the principles of dopaminergic control, and represent the most promising light-based therapeutic approach for spatiotemporally precise correction of dopamine-related neural functions and pathologies.

Improving Antiemetic and Analgesic Prescribing Practices for Patients With Advanced Liver Disease: A Clinical Audit.

Background and objective Previous studies have demonstrated that local analgesic and antiemetic prescribing practices were inconsistent with best practices. In light of this, we aimed to assess the current prescribing practices against best practices, as defined by national guidelines. Methods This study involved a point-prevalence audit in the inpatient gastroenterology wards at a University Teaching Hospital in Glasgow. Patients were identified by case notes; a clinical diagnosis of cirrhosis documented by a consultant hepatologist was required for inclusion. Data including Child-Pugh score and prescribed medications were collected. Prescribing practice was reaudited after each intervention. Interventions included educational seminars, posters, and the formulation of new local guidelines. Results A total of 249 inpatients were included; 70 were identified as having a clinical diagnosis of cirrhosis. The number of patients who were prescribed weak opioids decreased from 23% in cycle 1 to 11% in cycle 3. Prescription of 3 g/day paracetamol decreased from 36% to 24%. The number of patients who were prescribed an inappropriate antiemetic decreased from 45% to 17%. Laxatives, topical analgesics, and adjuvant analgesics were variably prescribed in all three cycles. Conclusions The development of concise local guidelines and targeted educational interventions for junior medical staff can improve prescribing practices for inpatients with decompensated cirrhosis. Currently, significant variability exists in the routine prescription of laxatives, adjuvants, and topical analgesics.

JADES Data Release 3: NIRSpec/Microshutter Assembly Spectroscopy for 4000 Galaxies in the GOODS Fields

Abstract We present the third data release of the JWST Advanced Deep Extragalactic Survey (JADES), providing both imaging and spectroscopy in the two GOODS fields. Spectroscopy consists of medium-depth and deep NIRSpec/microshutter assembly spectra of 4000 targets, covering the spectral range 0.6–5.3 μm and observed with both the low-dispersion prism (R = 30–300) and all three medium-resolution gratings (R = 500–1500). We describe the observations, data reduction, sample selection, and target allocation. We measured 2375 redshifts (2053 from multiple emission lines); our targets span the range from z = 0.5 up to z = 13, including 404 at z > 5. The data release includes 2D and 1D fully reduced spectra, with slit-loss corrections and background subtraction optimized for point sources. We also provide redshifts and signal-to-noise ratio > 5 emission-line flux catalogs for the prism and grating spectra, and concise guidelines on how to use these data products. Alongside spectroscopy, we are also publishing fully calibrated NIRCam imaging, which enables studying the JADES sample with the combined power of imaging and spectroscopy. Together, these data provide the largest statistical sample to date to characterize the properties of galaxy populations in the first billion years after the Big Bang.

Temporary recommendations of the russian association of functional diagnostics specialists on the registration of a conclusion based on the results of spirometry

The article presents concise guidelines for quality control and protocol development for spirometry, a routine test of lung function. Based on Russian methodological recommendations for spirometry, standards of the American Thoracic Society, and the European Respiratory Society, these guidelines cover all stages of spirometry, from patient preparation to result interpretation, aiming to ensure high quality and reliability of the tests performed. The importance of adhering to standards and quality control is emphasized to guarantee the accuracy and reliability of spirometry results. The guidelines provide criteria for the quality of individual attempts and the entire test, criteria for selecting the best attempt, and recommendations for assessing the severity of abnormalities. Examples of formulating spirometry protocols are also given. These recommendations are intended for physicians in functional diagnostics, pulmonologists, therapists, anesthesiologists, medical staff, and aim to standardize the formation of spirometry protocols.

Pharmacological Treatment of Obesity in Older Adults.

Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population.

Concise guidelines for the clinical management of thrombocytopenia in cirrhosis

Thrombocytopenia in cirrhosis is causing puzzlement in clinical practice. Therefore, in order to help clinical practitioners grasp quickly and standardize the diagnosis and treatment of thrombocytopenia in cirrhosis, liver fibrosis, and portal hypertension, the Group of the Chinese Society of Hepatology of the Chinese Medical Association has organized relevant field experts to formulate the "Concise Guidelines for Clinical Management of Thrombocytopenia in Cirrhosis" with aim of providing guidance for the clinical diagnosis and treatment.

The role of ChatGPT on academic research: perspectives from filipino students across diverse educational levels

With the emergence of technology, artificial intelligence (AI) is introducing a new wave of remarkable tools and transformations in education. One such technological development is ChatGPT, a dialogue system designed to collect and organize information, which is then converted into text-based inputs to address user inquiries. There is also a clear trend in which many Filipino students increasingly use ChatGPT for academic research. Filipino students' growing usage of ChatGPT demands immediate attention to examine its role in academic research within the Philippine educational setting. Thus, this study examines how ChatGPT is used in academic research by exploring students' perspectives and analyzing its perceived benefits and challenges. A descriptive cross-sectional design was conducted in the Eastern Visayas region of the Philippines, explicitly targeting selected secondary and tertiary schools. A total of 316 students were involved in the study, selected through convenience sampling. Results revealed ChatGPT to be moderately useful for various aspects of academic research and moderately influential in the student's academic performance. Receiving additional information or resources, getting help with mechanics, writing, paraphrasing, and generating ideas were found to be the benefits of using ChatGPT. Nonetheless, students commonly encountered issues such as redundant, inadequate, and inaccurate information provided by ChatGPT and concerns regarding its accessibility and the potential for plagiarism. To optimize advantages and address possible concerns, academic institutions should establish concise guidelines and regulations for responsible student utilization of ChatGPT

Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline

BackgroundThe Scandinavian Neurotrauma Committee guideline (SNC-16) was developed and published in 2016, to aid clinicians in management of pediatric head injuries in Scandinavian emergency departments (ED). The objective of this study was to explore determinants for use of the SNC-16 guideline by Swedish ED physicians.MethodsThis is a nationwide, cross-sectional, web-based survey in Sweden. Using modified snowball sampling, physicians managing children in the ED were invited via e-mail to complete the validated Clinician Guideline Determinants Questionnaire between February and May, 2023. Baseline data, data on enablers and barriers for use of the SNC-16 guideline, and preferred routes for implementation and access of guidelines in general were collected and analyzed descriptively and exploratory with Chi-square and Fisher's tests.ResultsOf 595 invitations, 198 emergency physicians completed the survey (effective response rate 33.3%). There was a high reported use of the SNC-16 guideline (149/195; 76.4%) and a strong belief in its benefits for the patients (188/197; 95.4% agreement). Respondents generally agreed with the guideline's content (187/197; 94.9%) and found it easy to use and navigate (188/197; 95.4%). Some respondents (53/197; 26.9%) perceived a lack of organizational support needed to use the guideline. Implementation tools may be improved as only 58.9% (116/197) agreed that the guideline includes such. Only 37.6% (74/197) of the respondents agreed that the guideline clearly describes the underlying evidence supporting the recommendation. Most respondents prefer to consult colleagues (178/198; 89.9%) and guidelines (149/198; 75.3%) to gain knowledge to guide clinical decision making. Four types of enablers for guideline use emerged from free-text answers: ease of use and implementation, alignment with local guidelines and practice, advantages for stakeholders, and practicality and accessibility. Barriers for guideline use were manifested as: organizational challenges, medical concerns, and practical concerns.ConclusionsThe findings suggest high self-reported use of the SNC-16 guideline among Swedish ED physicians. In updated versions of the guideline, focus on improving implementation tools and descriptions of the underlying evidence may further facilitate adoption and adherence. Measures to improve organizational support for guideline use and involvement of patient representatives should also be considered.

Cardiac implantable electronic device infection awareness – A European survey amongst implanting physicians

Cardiac implantable electronic device infection awareness – A European survey amongst implanting physicians

Barriers to early diagnosis of chronic kidney disease and use of sodium-glucose cotransporter-2 inhibitors for renal protection: A comprehensive review and call to action.

Chronic kidney disease (CKD) affects approximately 13% of people globally, including 20%-48% with type 2 diabetes (T2D), resulting in significant morbidity, mortality, and healthcare costs. There is an urgent need to increase early screening and intervention for CKD. We are experts in diabetology and nephrology in Central Europe and Israel. Herein, we review evidence supporting the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors for kidney protection and discuss barriers to early CKD diagnosis and treatment, including in our respective countries. SGLT2 inhibitors exert cardiorenal protective effects, demonstrated in the renal outcomes trials (EMPA-KIDNEY, DAPA-CKD, CREDENCE) of empagliflozin, dapagliflozin, and canagliflozin in patients with CKD. EMPA-KIDNEY demonstrated cardiorenal efficacy across the broadest renal range, regardless of T2D status. Renoprotective evidence also comes from large real-world studies. International guidelines recommend first-line SGLT2 inhibitors for patients with T2D and estimated glomerular filtration rate (eGFR) ≥20 mL/min/1.73 m2, and that glucagon-like peptide-1 receptor agonists may also be administered if required for additional glucose control. Although these guidelines recommend at least annual eGFR and urine albumin-to-creatinine ratio screening for patients with T2D, observational studies suggest that only half are screened. Diagnosis is hampered by asymptomatic early CKD and under-recognition among patients with T2D and clinicians, including limited knowledge/use of guidelines and resources. Based on our experience and on the literature, we recommend robust screening programmes, potentially with albuminuria self-testing, and SGLT2 inhibitor reimbursement at general practitioner (GP) and specialist levels. High-tech tools (artificial intelligence, smartphone apps, etc.) are providing exciting opportunities to identify high-risk individuals, self-screen, detect abnormalities in images, and assist with prescribing and treatment adherence. Better education is also needed, alongside provision of concise guidelines, enabling GPs to identify who would benefit from early initiation of renoprotective therapy; although, regardless of current renal function, cardiorenal protection is provided by SGLT2 inhibitor therapy.

Observation and treatment of patients with progressive metastatic differentiated thyroid cancer after establishment of radioiodine refractoriness

Differentiated thyroid cancer is one of the most common malignant diseases of the endocrine system. Usually, it responds well to the standard treatment (surgery + radioiodine therapy), especially at early stages. During both treatment and dynamic observation, distant metastases are detected in 10–15 % of patients. In these cases, the patients continue treatment with radioactive iodine. If tumor cells have insufficient ability to capture and retain 131I or completely lose this ability, the effect of radioiodine therapy becomes limited and the disease progresses during therapy which leads to 5–10 % decrease in 10-year survival. The main problem in treatment of differentiated thyroid cancer is communication between radiologists in centers performing radioiodine therapy and clinical oncologists performing surgeries and observation at patient’s place of residence. For both specialists, the main goal is to identify clinical situations where early and effective treatment intervention can be beneficial without the risk of overdiagnosis and excessive treatment.The article considers common questions arising during multidisciplinary interactions with radiologists of radioiodine centers and presents concise guidelines on the observation and treatment procedures for patients with differentiated thyroid cancer.

Guidelines for mechanistic modeling and analysis in cardiovascular research.

Computational, or in silico, models are an effective, noninvasive tool for investigating cardiovascular function. These models can be used in the analysis of experimental and clinical data to identify possible mechanisms of (ab)normal cardiovascular physiology. Recent advances in computing power and data management have led to innovative and complex modeling frameworks that simulate cardiovascular function across multiple scales. While commonly used in multiple disciplines, there is a lack of concise guidelines for the implementation of computer models in cardiovascular research. In line with recent calls for more reproducible research, it is imperative that scientists adhere to credible practices when developing and applying computational models to their research. The goal of this manuscript is to provide a consensus document that identifies best practices for in silico computational modeling in cardiovascular research. These guidelines provide the necessary methods for mechanistic model development, model analysis, and formal model calibration using fundamentals from statistics. We outline rigorous practices for computational, mechanistic modeling in cardiovascular research and discuss its synergistic value to experimental and clinical data.

Persistent varices in cured patients: Understanding the role of hepatic venous pressure gradient

Persistent varices in cured patients: Understanding the role of hepatic venous pressure gradient

Requirements quality research artifacts: Recovery, analysis, and management guideline

Requirements quality research, which is dedicated to assessing and improving the quality of requirements specifications, is dependent on research artifacts like data sets (containing information about quality defects) and implementations (automatically detecting and removing these defects). However, recent research exposed that the majority of these research artifacts have become unavailable or have never been disclosed, which inhibits progress in the research domain. In this work, we aim to improve the availability of research artifacts in requirements quality research. To this end, we (1) extend an artifact recovery initiative, (2) empirically evaluate the reasons for artifact unavailability using Bayesian data analysis, and (3) compile a concise guideline for open science artifact disclosure. Our results include 10 recovered data sets and 7 recovered implementations, empirical support for artifact availability improving over time and the positive effect of public hosting services, and a pragmatic artifact management guideline open for community comments. With this work, we hope to encourage and support adherence to open science principles and improve the availability of research artifacts for the requirements research quality community.

What do meta-analysts need in primary studies? Guidelines and the SEMI checklist for facilitating cumulative knowledge

Meta-analysis is often recognized as the highest level of evidence due to its notable advantages. Therefore, ensuring the precision of its findings is of utmost importance. Insufficient reporting in primary studies poses challenges for meta-analysts, hindering study identification, effect size estimation, and meta-regression analyses. This manuscript provides concise guidelines for the comprehensive reporting of qualitative and quantitative aspects in primary studies. Adhering to these guidelines may help researchers enhance the quality of their studies and increase their eligibility for inclusion in future research syntheses, thereby enhancing research synthesis quality. Recommendations include incorporating relevant terms in titles and abstracts to facilitate study retrieval and reporting sufficient data for effect size calculation. Additionally, a new checklist is introduced to help applied researchers thoroughly report various aspects of their studies.

Heart failure related to contemporary breast cancer treatment.

This article addresses cardiotoxicity in patients with breast cancer who are treated with anthracyclines and/or anti-human epidermal growth factor 2 (HER2) therapy, namely doxorubicin and trastuzumab. Development of concise clinical guidelines for chemotherapy-induced heart failure is ongoing. Through identification of specific risk factors and clinical predictors of cardiotoxicity, clinicians are able to better understand and define effective monitoring strategies and optimize patient care. Close cardiac monitoring is recommended for patients throughout treatment with anthracyclines and anti-HER2 therapy. Pretreatment risk assessment with echocardiography and evaluation of cardiovascular risk factors aid in predicting the development of left ventricular (LV) dysfunction. Further clinical trials are needed to increase understanding and optimize treatment guidelines for LV dysfunction in patients taking anthracyclines or anti-HER2 therapy.

WHS guidelines for the treatment of pressure ulcers-2023 update.

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated that hospital-acquired pressure ulcers cost the health system $26.8 billion annually with over 50% of the cost attributed to treating Stage 3 and 4 pressure injuries. Thus, it is critical to examine the literature and develop guidelines that will improve the outcomes of this complex and costly condition. This guideline update is a compendium of the best available evidence for the treatment of Pressure Ulcers published since the last update in 2015 and includes a new section based on changing demographics entitled 'Palliative wound care for seriously ill patients with pressure ulcers'. The overall goal of the Wound Healing Society Guideline project is to present clear, concise and commercial free guidelines that clinicians can use to guide care, that researchers can use to develop studies that will improve treatment and that both clinicians and researchers can use to understand the gaps in our knowledge base.

Saudi consensus guidance for the management of inflammatory bowel disease during pregnancy.

The management of inflammatory bowel disease (IBD) in pregnant women is challenging and must be addressed on a patient-by-patient basis. Optimal patient management requires a multidisciplinary team and clear evidence-based recommendations that cater to this subset of patients. In this article, we provide concise guidelines and clinical care pathway for the management of IBD in pregnant women. Our recommendations were developed by a multidisciplinary working group that includes experts from the Saudi Ministry of Health in collaboration with the Saudi Gastroenterology Association and the Saudi Society of Clinical Pharmacology. All recommendations are based on up-to-date information following an extensive literature review. A total of 23 evidence-based expert opinion recommendations for the management of IBD in pregnant women are herein provided.

Guidelines for an optimized differential centrifugation of cells

Literature reviews reveal a significant deficiency in conceptual comprehension concerning centrifugation, a crucial step in both medical and research protocols. The arbitrary fluctuations in centrifugal forces present a potential threat to the reproducibility of results. To address this, we propose concise guidelines that integrate key factors such as temperature, osmolarity, fluid volume, and viscosity. These guidelines aim to enhance comprehension of optimal sedimentation conditions for cell suspensions. Additionally, we introduce a standardized protocol for determining the optimal RCF and centrifugation time. The goal is to maximize sedimentation efficiency while minimizing cell damage, contributing to a universally applicable and reproducible method in centrifugation practices.

Knowledge and beliefs of intensive care nurses about urinary catheter securement: Results of a national survey

Knowledge and beliefs of intensive care nurses about urinary catheter securement: Results of a national survey