Current Biomedical Literature Research Articles

Age- and sex-related changes in vertebral trabecular bone architecture in Neolithic and Mediaeval populations from Poland.

This paper investigates trabecular bone ontogenetic changes in two different Polish populations, one prehistoric and the other historical. The studied populations are from the Brześć Kujawski region in Kujawy (north-central Poland), one from the Neolithic Period (4500-4000 BC) and one from the Middle Ages (twelfth-sixteenth centuries AD), in total 62 vertebral specimens (32 males, 30 females). Eight morphometric parameters acquired from microCT scan images were analysed. Two-way ANOVA after Box-Cox transformation and multifactorial regression model were calculated. A significant decrease in percentage bone volume fraction (BV/TV; [%]) with age at death was observed in the studied sample; Tb.N (trabecular number) was also significantly decreased with age; trabecular separation (Tb.Sp) increased with advancing age; connectivity density (Conn.D) was negatively correlated with biological age and higher in the Neolithic population. These data are found to be compatible with data from the current biomedical literature, while no loss of horizontal trabeculae was recorded as would be expected based on modern osteoporosis.

SOARinG to New Heights Through a Structured Medical Student Research Program.

Since the US Medical Licensing Examination (USMLE) Step 1 became Pass/Fall in 2022, medical students competing for residency spots must distinguish themselves with alternative criteria. Research experiences and output offer valuable skill development and objective metrics to support competitive residency applications. We describe the methodological development of a structured program to support, enhance, and track medical student research efforts at the University of South Carolina School of Medicine Greenville, explain the implementation of the program, and summarize initial program outcomes. The Student Opportunities for Academic Achievement Through Research in Greenville (SOARinG) Program was established to serve as a centralized hub for rising second year medical student research. The program matched medical students with mentored research projects scheduled during the summer following first-year coursework. The program included a required weekly seminar series on research basics and current biomedical literature. SOARinG culminated with a student research symposium for which students submitted abstracts and presented a poster or a talk. Quantitative and qualitative program outcomes of student and mentor satisfaction with the program were measured through surveys. The program was successfully implemented in summers 2021 and 2022. Most students (80-95%) in each class engaged in mentored summer research projects. Students reported overall satisfaction with research projects and mentor support. Overall, 69% of students rated their overall research experience in the program as extremely good or very good. Each student submitted an abstract and presented at the program's symposium or alternate research venue. Overall, 97% of research mentors reported that students were adequately prepared for summer research and suggested that students would benefit from additional skills-specific research training. The SOARinG Program provided a formalized process for tracking and showcasing medical student research and allowed for increased student participation in research. Additionally, each participating student produced objective research output, thus enhancing future residency applications.

O5 - A review of post-dates induction of labour research: a critical discourse analysis

Despite equivocal evidence, induction of labour (IOL) for post-dates pregnancy is an increasingly common birth intervention that impacts well women and their babies. Birth interventions can cause iatrogenic harm to mothers and babies. Recent evidence shows that routine post-dates IOL does not reduce the chance of stillbirth. Previous studies have shown how assumptions and beliefs within biomedical discourse filter into medical research. Discourse influences clinical practice guidelines, policies and how information is communicated to women. We used Foucauldian discourse analysis to critically analyse the biomedical literature on IOL, adding to current knowledge about both the intervention itself and how it is shaped by medical discourse. We purposively sampled biomedical, quantitative research on IOL, published in the last five years, using key search terms. Twelve studies met the criteria. In this presentation, we show how current biomedical literature concerns itself with “the dangerousness of [prolonged] pregnancy”, which prioritises the safety of the fetus, while maintaining a narrative that post-dates IOL is “safe and necessary”, despite this not necessarily being the case, at least not for every woman. This exposes the “invisibility of women” in the research and practice of IOL for post-dates. We juxtapose these discourses and extend our findings, drawing on current qualitative literature to demonstrate how women’s experiences reflect these medical assumptions, feeling that IOL is inevitable, or that they do not have a choice. This is concerning, because although constructed as a “safe” intervention, it is not without risk, and raises questions about informed consent. There is increasing concern about overmedicalisation of birth. Critiquing the dominance of obstetric knowledge claims is important to give space for women’s voices, to recognise other forms of knowledge and to humanise birth.

Statistical significance or clinical significance? A researcher's dilemma for appropriate interpretation of research results.

It is incredibly essential that the current clinicians and researchers remain updated with findings of current biomedical literature for evidence-based medicine. However, they come across many types of research that are nonreproducible and are even difficult to interpret clinically. Statistical and clinical significance is one such difficulty that clinicians and researchers face across many instances. In simpler terms, the P value tests all hypothesis about how the data were produced (model as whole), and not just the targeted hypothesis that it is intended to test (such as a null hypothesis) keeping in mind how reliable are the of the research results. Most of the times it is misinterpreted and misunderstood as a measure to judge the results as clinically significant. Hence this review aims to impart knowledge about “P” value and its importance in biostatistics, also highlights the importance of difference between statistical and clinical significance for appropriate interpretation of research results.

Informatics Methodology Used in the Web-Based Portal of the NASCITA Cohort Study: Development and Implementation Study.

BackgroundMany diseases occurring in adults can be pinned down to early childhood and birth cohorts are the optimal means to study this connection. Birth cohorts have contributed to the understanding of many diseases and their risk factors.ObjectiveTo improve the knowledge of the health status of Italian children early on and how it is affected by social and health determinants, we set up a longitudinal, prospective, national-level, population-based birth cohort, the NASCITA study (NAscere e creSCere in ITAlia). The main aim of this cohort is to evaluate physical, cognitive, and psychological development; health status; and health resource use in the first 6 years of life in newborns, and potential associated factors. A web-based system was set up with the aim to host the cohort; provide ongoing information to pediatricians and to families; and facilitate accurate data input, monitoring, and analysis. This article describes the informatics methodology used to set up and maintain the NASCITA cohort with its web-based platform, and provides a general description of the data on children aged over 7 months.MethodsFamily pediatricians were contacted for participation in the cohort and enrolled newborns from April 2019 to July 2020 at their first well-child visit. Information collected included basic data that are part of those routinely collected by the family pediatricians, but also parental data, such as medical history, characteristics and lifestyle, and indoor and outdoor environment. A specific web portal for the NASCITA cohort study was developed and an electronic case report form for data input was created and tested. Interactive data charts, including growth curves, are being made available to pediatricians with their patients’ data. Newsletters covering the current biomedical literature on child cohorts are periodically being put up for pediatricians, and, for parents, evidence-based information on common illnesses and problems in children.ResultsThe entire cohort population consists of 5166 children, with 139 participating pediatricians, distributed throughout Italy. The number of children enrolled per pediatrician ranged from 1 to 100. The 5166 enrolled children represent 66.55% (5166/7763) of the children born in all of 2018 covered by the same pediatricians participating in the cohort. The number of children aged over 7 months at the time of these analyses, and for whom the most complete data were available upon initial analyses, was 4386 (2226/4381 males [50.81%] and 142/4370 twins [3.25%]). The age of the mothers at birth of the 4386 children ranged from 16 to 54 years. Most newborns’ mothers (3758/4367, 86.05%) were born in Italy, followed by mothers born in Romania (101/4367, 2.31%), Albania (75/4367, 1.72%), and Morocco (60/4367, 1.37%). Concerning the newborns, 138/4386 (3.15%) were born with malformations and 352/4386 (8.03%) had a disease, most commonly neonatal respiratory distress syndrome (n=52), neonatal jaundice (n=46), and neonatal hypoglycemia (n=45).ConclusionsThe NASCITA cohort is well underway and the population size will permit significant conclusions to be drawn. The key role of pediatricians in obtaining clinical data directly, along with the national-level representativity, will make the findings even more solid. In addition to promoting accurate data input, the multiple functions of the web portal, with its interactive platform, help maintain a solid relationship with the pediatricians and keep parents informed and interested in participating.Trial RegistrationClinicalTrials.gov NCT03894566; https://clinicaltrials.gov/ct2/show/NCT03894566

A Picture of Modern Medicine: Race and Visual Representation in Medical Literature

BackgroundThere has been a recent focus on the impact of race on health equity, which has revealed unsettling results. Multiple studies have shown that the underrepresentation of minorities in medical education such as course slides, pre-clinical lecture material, case studies, and textbooks impedes racial equity in the practice of medicine. Aim of studyIn this study, we aimed to survey the landscape of published imaging in modern medicine to understand the degree of racial diversity represented in current biomedical literature. MethodsWe performed a photogrammetric analysis of medical images from the New England Journal of Medicine representing various medical fields and geographic regions to examine implicit biases with regards to human skin color. ResultsOverall, 18% of images depicted non-white skin tone but there was considerable heterogeneity in the percentage of non-white medical images published from different geographic regions and specialties (ranging from 0% to 67%). ConclusionsUnfortunately, these results suggest that there is an underlying implicit racial bias in published images from medical literature with an underrepresentation of minorities compared to the general population, which could also contribute to inequities in health care. It is critical that health care providers, educators, and trainees promote cultural competency and work to understand the multifaceted influence of race and culture on the daily experience of patients in the modern healthcare system. We hope this study will encourage authors to critically evaluate their medical images for implicit bias so that documented photography in scientific literature may better reflect the populations we serve.

The Confounding of Race in High School Biology Textbooks, 2014–2019

Following on earlier examinations of biology high school textbooks’ handling of race, this study examines eleven biology textbooks, intended for US high school use and published between 2014 and 2019. It offers a close reading of these textbooks’ treatment of four topics that have been associated with race: genetic disorders, human origins, skin color, and eugenics, as well as the topic of race itself. While only one textbook has a section on “human races,” another nine refer directly or indirectly to race across these five topics. The textbooks’ treatment of genetic disorders gives a marked, if uneven, prominence to race and ethnicity. Their coverage of human origins and skin color largely undermines concepts of race essentialism and racial classification. At other points, the same textbooks introduce studies, questions, and concepts that reinforce the biological reality of race, much as was done by the textbooks of two and three generations ago. The study draws parallels between these textbooks’ decidedly mixed message on race and a similar stance present in the current biomedical research literature. In the face of this mixed message, three sets of pedagogical strategies—fact-checking, historical, and meta-scientific—are proposed that teachers might use with current biology textbooks to raise awareness of the varied positions that scientists have taken in the past and continue to take on questions of race and biology.

Agitation and impulsivity in mid and late life as possible risk markers for incident dementia.

To identify knowledge gaps regarding new‐onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre‐dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late‐onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. This scoping review of agitation and impulsivity pre‐dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis and measurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials. Validations for pre‐dementia scales such as the MBI Checklist, and incorporation into longitudinal and intervention trials, are needed to better understand impulse dyscontrol as a risk factor for mild cognitive impairment and dementia.

Advices On Search And Critical Appraisal Of Biomedical Literature Part I, General Workflow

Both physician-scientists and practicing physicians regularly experience the need to browse, select, and critically appraise the current biomedical literature. There have been many useful reviews on each of the aforementioned topics. Still, having a unified and coherent workflow, feasible to fit into a busy clinical routine, would surely be appreciated by physicians. In addition, many of the aforementioned reviews have been written to target the audience in developed countries. In contrast, particularities of the access to the literature in developing countries (or economies in transition) have been addressed less frequently. Finally, new computational approaches, including machine translation and automated text mining, are rapidly emerging. These are indeed worthy addressing as the initiatives that could provide a great help to practicing physicians for rapid, yet comprehensive literature appraisals. The present review aims to provide physicians with the workflow and methodological recommen- dation on browsing, selecting, and critical appraisal of the biomedical literature, with the specific focus on patient- and disease-oriented publications.The review further aims to overcome the aforementioned limitations of the previously published literature on this subject.

Personalized Medicine Implementation with Non-traditional Data Sources: A Conceptual Framework and Survey of the Literature.

Summary Objectives : With the explosive growth in availability of health data captured using non-traditional sources, the goal for this work was to evaluate the current biomedical literature on theory- driven studies investigating approaches that leverage non- traditional data in personalized medicine applications. Methods : We conducted a literature assessment guided by the personalized medicine unsolicited health information (pUHl) conceptual framework incorporating diffusion of innovations and task-technology fit theories. Results : The assessment provided an oveiview of the current literature and highlighted areas for future research. In particular, there is a need for: more research on the relationship between attributes of innovation and of societal structure on adoption; new study designs to enable flexible communication channels; more work to create and study approaches in healthcare settings; and more theory-driven studies with data-driven interventions. Conclusion : This work introduces to an informatics audience an elaboration on personalized medicine implementation with non-traditional data sources by blending it with the pUHl conceptual framework to help explain adoption. We highlight areas to pursue future theory-driven research on personalized medicine applications that leverage non-traditional data sources.

Resolving the Tension Between Exploration and Confirmation in Preclinical Biomedical Research.

Confirmation through competent replication is a founding principle of modern science. However, biomedical researchers are rewarded for innovation, and not for confirmation, and confirmatory research is often stigmatized as unoriginal and as a consequence faces barriers to publication. As a result, the current biomedical literature is dominated by exploration, which to complicate matters further is often disguised as confirmation. Only recently scientists and the public have begun to realize that high-profile research results in biomedicine can often not be replicated. Consequently, confirmation has become central stage in the quest to safeguard the robustness of research findings. Research which is pushing the boundaries of or challenges what is currently known must necessarily result in a plethora of false positive results. Thus, since discovery, the driving force of scientific progress, is unavoidably linked to high false positive rates and cannot support confirmatory inference, dedicated confirmatory investigation is needed for pivotal results. In this chapter I will argue that the tension between the two modes of research, exploration and confirmation, can be resolved if we conceptually and practically separate them. I will discuss the idiosyncrasies of exploratory and confirmatory studies, with a focus on the specific features of their design, analysis, and interpretation.

Rethinking research reproducibility.

“To boldly go where no man has gone before”! Exploring and innovating—isn9t this why we are in science after all? But as exciting this may be, others must be able to confirm our results through competent replication. As Karl Popper famously put it: “Single occurrences that cannot be reproduced are of no significance to science” (Popper, 1935). However, despite its status as a founding principle of modern science, replication is often viewed as pedestrian and unoriginal. Academia rewards the explorer, not the replicator. Not surprisingly, the current biomedical literature is dominated by exploration, but results are rarely confirmed. But how many of our discoveries are robust and will hold up if others try to reproduce them?

The P Value Problem in Otolaryngology: Shifting to Effect Sizes and Confidence Intervals.

There is a lack of reporting effect sizes and confidence intervals in the current biomedical literature. The objective of this article is to present a discussion of the recent paradigm shift encouraging the use of reporting effect sizes and confidence intervals. Although P values help to inform us about whether an effect exists due to chance, effect sizes inform us about the magnitude of the effect (clinical significance), and confidence intervals inform us about the range of plausible estimates for the general population mean (precision). Reporting effect sizes and confidence intervals is a necessary addition to the biomedical literature, and these concepts are reviewed in this article.

Glucocorticosteroid therapy in inflammatory bowel diseases: From clinical practice to molecular biology.

Inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease, are chronic pathologies associated with a deregulated immune response in the intestinal mucosa, and they are triggered by environmental factors in genetically susceptible individuals. Exogenous glucocorticoids (GCs) are widely used as anti-inflammatory therapy in IBDs. In the past, patients with moderate or severe states of inflammation received GCs as a first line therapy with an important effectiveness in terms of reduction of the disease activity and the induction of remission. However, this treatment often results in detrimental side effects. This downside drove the development of second generation GCs and more precise (non-systemic) drug-delivery methods. Recent clinical trials show that most of these new treatments have similar effectiveness to first generation GCs with fewer adverse effects. The remaining challenge in successful treatment of IBDs concerns the refractoriness and dependency that some patients encounter during GCs treatment. A deeper understanding of the molecular mechanisms underlying GC response is key to personalizing drug choice for IBDs patients to optimize their response to treatment. In this review, we examine the clinical characteristics of treatment with GCs, followed by an in depth analysis of the proposed molecular mechanisms involved in its resistance and dependence associated with IBDs. This thorough analysis of current clinical and biomedical literature may help guide physicians in determining a course of treatment for IBDs patients and identifies important areas needing further study.

The P Value Problem in Otolaryngology: Shifting to Effect Sizes and Confidence Intervals.

There is a lack of reporting effect sizes and confidence intervals in the current biomedical literature. The objective of this article is to present a discussion of the recent paradigm shift encouraging the use of reporting effect sizes and confidence intervals. Although P values help to inform us about whether an effect exists due to chance, effect sizes inform us about the magnitude of the effect (clinical significance), and confidence intervals inform us about the range of plausible estimates for the general population mean (precision). Reporting effect sizes and confidence intervals is a necessary addition to the biomedical literature, and these concepts are reviewed in this article.

Discovering biomedical semantic relations in PubMed queries for information retrieval and database curation.

Identifying relevant papers from the literature is a common task in biocuration. Most current biomedical literature search systems primarily rely on matching user keywords. Semantic search, on the other hand, seeks to improve search accuracy by understanding the entities and contextual relations in user keywords. However, past research has mostly focused on semantically identifying biological entities (e.g. chemicals, diseases and genes) with little effort on discovering semantic relations. In this work, we aim to discover biomedical semantic relations in PubMed queries in an automated and unsupervised fashion. Specifically, we focus on extracting and understanding the contextual information (or context patterns) that is used by PubMed users to represent semantic relations between entities such as ‘CHEMICAL-1 compared to CHEMICAL-2.’ With the advances in automatic named entity recognition, we first tag entities in PubMed queries and then use tagged entities as knowledge to recognize pattern semantics. More specifically, we transform PubMed queries into context patterns involving participating entities, which are subsequently projected to latent topics via latent semantic analysis (LSA) to avoid the data sparseness and specificity issues. Finally, we mine semantically similar contextual patterns or semantic relations based on LSA topic distributions. Our two separate evaluation experiments of chemical-chemical (CC) and chemical–disease (CD) relations show that the proposed approach significantly outperforms a baseline method, which simply measures pattern semantics by similarity in participating entities. The highest performance achieved by our approach is nearly 0.9 and 0.85 respectively for the CC and CD task when compared against the ground truth in terms of normalized discounted cumulative gain (nDCG), a standard measure of ranking quality. These results suggest that our approach can effectively identify and return related semantic patterns in a ranked order covering diverse bio-entity relations. To assess the potential utility of our automated top-ranked patterns of a given relation in semantic search, we performed a pilot study on frequently sought semantic relations in PubMed and observed improved literature retrieval effectiveness based on post-hoc human relevance evaluation. Further investigation in larger tests and in real-world scenarios is warranted.

Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct

Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to characterize the emerging construct of resilience as it pertains to physical health in older adults, and to identify gaps and opportunities to advance research in this area. We conducted a systematic review to identify English language papers published through January 2015 that apply the term "resilience" in relation to physical health in older adults. We applied a modified framework analysis to characterize themes in implicit or explicit definitions of physical resilience. Of 1,078 abstracts identified, 49 articles met criteria for inclusion. Sixteen were letters or concept papers, and only one was an intervention study. Definitions of physical resilience spanned cellular to whole-person levels, incorporated many outcome measures, and represented three conceptual themes: resilience as a trait, trajectory, or characteristic/capacity. Current biomedical literature lacks consensus on how to define and measure physical resilience. We propose a working definition of physical resilience at the whole person level: a characteristic which determines one's ability to resist or recover from functional decline following health stressor(s). We present a conceptual framework that encompasses the related construct of physiologic reserve. We discuss gaps and opportunities in measurement, interactions across contributors to physical resilience, and points of intervention.

Skull Base Inverted Papilloma: A Comprehensive Review

Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts.

Implementation of a journal surveillance program

The scope of pharmacy practice continues to evolve toward high-level medication therapy management and disease prevention services.1 The expansion of pharmacists’ clinical responsibilities has created new opportunities for pharmacists to play integral roles in patient care. In order to succeed in these evolving roles, pharmacists need to continuously improve as clinicians and as leaders and educators in the field of drug therapy management. In 2008 the American College of Clinical Pharmacy published a white paper on clinical pharmacy competencies that addressed the importance of keeping abreast of the current biomedical literature and incorporating this information into clinical decision-making.2 Staying current with new research and reviewing existing drug therapies allow pharmacists to improve their knowledge of drug therapy and patient care. The recent Pharmacy Practice Model Initiative Summit outlined the importance of competencies and education programs to optimal pharmacy practice models.3 With over 30,000 new articles added to the MEDLINE database each month, clinicians need help to remain up-to-date in their knowledge of new and innovative interventions described in the literature.4,5 Scanning the contents of the numerous publications related to clinical pharmacy practice is a daunting task for the individual clinician. There are commercially available journal surveillance publications; however, they may not cover the journals and information desired by representatives of the many subspecialties of clinical pharmacy practice. A journal surveillance program whereby pharmacists share the work of keeping abreast of new additions to the primary literature can make that task more manageable, increase staff exposure to the contents of a variety of journals, and promote continuous professional development.

A Critical Appraisal of the Biological Assessment of Materials in Orthodontics with Emphasis on the Differences Between Conventional and 3-D Cell Cultures

In this report, we look in a different way at a patient in need for an orthodontic treatment. Current biomedical literature seeks to link clinical orthodontics with mainstream molecular-genetic research. The demands of professionalism require the orthodontist to be conversant with all biological principles underlying treatment. Such knowledge leads to better patient care.