Journal Of Medicine Research Articles

Abstracts from international emergency medicine journals

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will...

Trends and predictors of reporting social determinants of health in shoulder surgery

IntroductionThe role of social determinants of health (SDH) in patient outcomes, quality of life, and overall well-being has been well documented. However, the inclusion of these variables in randomized control trials (RCTs) remains limited; thus, the extent of generalizability from such trials is brought into question. The purpose of this study is to explore the rates of reporting SDH variables in RCTs focused on shoulder surgery from the past decade. MethodsThe PubMed database was searched for RCTs with a focus on shoulder surgery from 2013-2023. Duplicates, responses to the editor, biomechanical studies, and non-shoulder studies were excluded. Each article was reviewed and data pertaining to patient demographics, socioeconomic covariates. Journal of publication was recorded, and studies from the five most common journals were analyzed. These journals were the Journal of Shoulder and Elbow Surgery (JSES), the Journal of Bone and Joint Surgery (JBJS), the American Journal of Sports Medicine (AJSM), the Bone and Joint Journal (BJJ), and The Journal of the American Medical Association (JAMA). Multivariate logistic regression was performed to determine the independent effect of study characteristics on the reporting rates of SDH. ResultsA total of 255 articles were reviewed. Of these, 93.3% and 90.2% of articles reviewed reported age and sex, respectively. Employment status was reported in 11.8% of articles. Fewer than 10% reported race, ethnicity, income, insurance, and housing, with even less performing formal analyses on these variables. Studies that were conducted in the United States (US), multicenter, had a sample size 251+, and had a combination of public and private funding were significantly more likely to report on race and ethnicity. Reporting employment status was significantly associated with being European-based, multicenter, sample size 251+, double-blinded, and published in AJSM, Newer studies were significantly less likely to report education. Only publication in AJSM was significant for reporting income. Study intervention and topic were not significant for any SDH reporting. DiscussionThis data reflects how small of a proportion of RCTs report and analyze on SDH variables. These findings reflect a need for future RCTs to accurately report SDH variables that influence outcomes, such as race, ethnicity, education, employment, income, housing status, and insurance.. ConclusionsSDH are infrequently reported and analyzed in RCTs pertaining to shoulder surgery. Academic medical journals should incorporate guidelines to encourage studies to include such variables and enable the assessment of outcomes to apply to a broader population.

Rates of positive vs negative studies in the spine literature

BackgroundAccuracy in the interpretation of data, and publication of studies regardless of outcomes are vital to the development of the scientific literature. ObjectiveTo determine the proportion of studies in the spine literature that report positive results. Study designReview article of studies published in nine major spine, pain, and physical medicine and rehabilitation (PM&R) journals from January 1, 2018–December 31, 2022. Patient sampleNot applicable. MethodsArticles that reported on pain and/or function from 2018 to 2022 in nine major journals were reviewed by two independent evaluators. The articles were graded as either positive or negative based on the authors’ own conclusions about their work. ResultsOverall, 91 % [95 % CI 88–94 %] of all articles were reported to have positive results. No significant differences were found between the broad categories of spine, pain, and PM&R journals. When comparing different categories of treatments, there were lower rates of positive results from medication/supplement studies (54 % [95 % CI 27–81 %]) compared to studies of spine injections/interventions (95 % [95 % CI 91–99 %]) and those of surgery (100 % [95 % CI 96–100 %]), and a lower rate of positive results from studies on physical treatments (85 % [95 % CI 75–95 %]) compared to those of surgery (100 % [95 % CI 96–100 %]). Studies with placebo controls were less likely to report positive results (60 % [95 % CI 44–76 %]) compared to those that did not use placebo controls (96 % [95 % CI 94–98 %]). ConclusionsDespite the vast majority of studies in the spine literature concluding positive results, the high disease prevalence of spine conditions and the enormous burden on the healthcare system remain.

Enhancing predictive accuracy in hypertriglyceridemia-induced acute pancreatitis: Role of red cell distribution width and prospective studies.

This letter addresses the study titled "Red cell distribution width: A predictor of the severity of hypertriglyceridemia-induced acute pancreatitis" by Lv et al published in the World Journal of Experimental Medicine. The study offers a valuable analysis of red cell distribution width (RDW) as a predictive marker for persistent organ failure in patients with hypertriglyceridemia-induced acute pancreatitis. The study results suggest that RDW, combined with the Bedside Index for Severity in Acute Pancreatitis score, could enhance the predictive accuracy for severe outcomes. Further investigation into the role of RDW in different severities of acute pancreatitis is recommended. Additionally, the need for large-scale and multicenter prospective studies to validate these findings is emphasized.

Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer: a plain language summary of the DESTINY-Lung01 study.

This is a summary of the publication about the DESTINY-Lung01 study, which was published in the New England Journal of Medicine in September 2021. The DESTINY-Lung01 study includes 181 adults with metastatic non-small-cell lung cancer (NSCLC) that could not be treated with surgery and who have had previous standard anticancer treatment. The publication includes information and results about 91 of the 181 study participants. These 91 participants had HER2-mutant NSCLC. Researchers wanted to learn if the drug trastuzumab deruxtecan (T-DXd) could help treat participants with HER2-mutant NSCLC. At the time of this publication, this study is ongoing. Results from the study showed that 55% of participants responded to treatment with T-DXd. The median length of time participants continued to respond to T-DXd was 9.3months.After receiving T-DXd, 92% of participants had disease control. After receiving T-DXd, half of the participants lived for at least 17.8months. After receiving T-DXd, half of the participants lived for 8.2months before their cancer got worse.During the study, 97% of participants had drug-related adverse events, with nausea being the most common. There were 20% of participants with serious drug-related adverse events. Based on these results, T-DXd could be a treatment option for people with HER2-mutant NSCLC that has been previously treated.Clinical Trial Registration: NCT03505710 (DESTINY-Lung01) (ClinicalTrials.gov).

Ethical requirements of instructions for authors of complementary and alternative medicine journals: a cross-sectional study

BackgroundMedical research in complementary and alternative medicine (CAM) has increased recently, raising ethical concerns about the moral status of CAM. Medical academic journals are responsible for conducting ethical review (ER) of manuscripts to protect the interests of human subjects and to make ethical results available before deciding to publish. However, there has been no systematic analysis of the ER in CAM journals. This study is aim to evaluate the current status of ethical requirements and compliance in CAM journals.MethodsThis is a cross-sectional study. We reviewed instructions for authors (IFAs) of CAM journals included in the Journal Citation Reports (2021) (https://jcr.clarivate.com) for general information and requirements for ER. We also browsed the manuscripts regarding randomized controlled trials published by CAM journals in Q1 and Q2 section from January to June, 2023, to check the actual situation of ethical requirement. Descriptive statistics and Fisher’s exact test were used for statistical analysis.Results27 journals and 68 manuscripts were ultimately included. 92.6% (25/27) IFAs included keywords of ER, indicating the presence of ethical considerations. However, no specific ER was required for CAM (n = 0). We categorized journals by Geographic origin, JCR section, Year of electronic JCR, Types of studies, % of OA Gold to explore the factors that could influence CAM journals to have certain ethical review policies. The results showed there was no statistical significance in certain ethical review policy in any classification of journals (p > 0.05). All RCT manuscripts included in the study generally met the requirements of the published journals for ethical review.ConclusionsAll IFAs discussed ER, but the content was scattered, unfocused, and there were no specific ER requirements regarding CAM. Although the manuscripts basically met the requirements of the journal, it was not possible to get closer to the process of ER in the manuscript. To ensure full implementation of these policies in the future, CAM journals should require authors to provide more details, or to form a list of items necessary for CAM ethical review.

Exploring The Impact of Acceptance and Commitment Based Cultural Humility Training on Standardized Patient Interactions: Revisiting the Measurement Process.

Recent findings in health sciences and medical education highlight the importance of training healthcare professionals to interact with their patients in a culturally humble manner (Nadal et al., in Journal of Counseling and Development 92: 57-66, 2014; Pascoe & Smart Richman, in Psychological Bulletin 135: 531, 2009; Sirois & Burg, in Behavior Modification 27: 83-102, 2003; Williams & Mohammed, in Journal of Behavioral Medicine 32: 20-47, 2009). An important piece in the progression of our ability to address training challenges is the assessment of cultural humility. As an extension of previous research (Lombardero et al., in Journal of Clinical Psychology in Medical Settings, 30: 261-273, 2023), this study implemented an evidence-based cultural humility intervention (based onAcceptance and Commitment Training) to improve medical students' interactions with standardized patients (SPs) which was assessed via direct behavioral observation. Specifically, the observational measurement system was focused on culturally humble responses to patients reporting microaggressions to the medical professional. A pre-post comparison of the results demonstrated statistically significant improvements pertaining to participants' culturally humble responses to SPs' reports of microaggressions for one of the measurement scales used (i.e., ARISE), but not the other (i.e., Responsiveness to Racial Challenges Scale). Further analyses, on the bottom quartile of performers, were conducted to assess a possible ceiling effect of the scale that did not demonstrate significant change. These results and implications for future research will be discussed.

A knowledge synthesis of health research reporting standards relevant to epilepsy surgery.

Numerous studies have examined epilepsy surgery outcomes, yet the variability in the level of detail reported hampers our ability to apply these findings broadly across patient groups. Established reporting standards in other clinical research fields enhance the quality and generalizability of results, ensuring that the insights gained from studying these surgeries can benefit future patients effectively. This study aims to assess current reporting standards for epilepsy surgery research and identify potential gaps and areas for enhancement. The Enhancing the Quality and Transparency of Health Research (EQUATOR) repository was accessed from inception to April 27, 2023, yielding 561 available reporting standards. Reporting standards were manually reviewed in duplicate independently for applicability to epilepsy and/or neurosurgery research. The reporting standards had to cover the following aspects in human studies: (1) reporting standards for epilepsy/epilepsy surgery and (2) reporting standards for neurosurgery. Disagreements were resolved by a third author. The top five neurosurgery, neurology, and medicine journals were also identified through Google Scholar's citation index and examined to determine the relevant reporting standards they recommended and whether those were registered with EQUATOR. Of the 561 EQUATOR reporting standards, 181 were pertinent to epilepsy surgery. One was related to epilepsy, six were specific to surgical research, and nine were related to neurological/neurosurgical research. The remaining 165 reporting standards were applicable to research across various disciplines and included but were not limited to CONSORT (Consolidated Standards of Reporting Trails), STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). None of these required reporting factors associated with epilepsy surgery outcomes, such as duration of epilepsy or magnetic resonance imaging findings. Reporting standards specific to epilepsy surgery are lacking, reflecting a gap in standards that may affect the quality of publications. Improving this gap with a set of specific reporting standards would ensure that epilepsy surgery studies are more transparent and rigorous in their design.

Bibliometric and visual analysis of immunisation associated with acute kidney injury from 2003 to 2023.

This study aims to conduct a detailed bibliometric and visual analysis of acute kidney injury (AKI) and immune-related research conducted over the past two decades, focusing on identifying emerging trends and key areas of interest. The Web of Science Core Collection (WoSCC) was utilised for the meticulous examination of various parameters including publication volume, authorship, geographic distribution, institutional contributions, journal sources, prevalent keywords and citation frequencies. Data were intricately visualised and interpreted using VOSviewer, CiteSpace and Excel 365 software. Analysis of the WoSCC database revealed 3,537 articles on AKI and immunisation, originating from 94 countries and regions, involving 3,552 institutions and authored by 18,243 individuals. Notably, the top five countries contributing to this field were the United States, China, Germany, Italy and the United Kingdom, with the United States leading with 35.76% of total publications. Among the 3,552 contributing institutions, those in the United States were predominant, with Harvard University leading with 134 papers and 3,906 citations. Key journals driving productivity included Frontiers in Immunology, Kidney International, Journal of the American Society of Nephrology and International Journal of Molecular Sciences, with Kidney International being the most cited, followed by Journal of the American Society of Nephrology and New England Journal of Medicine. Prominent authors in the field included Ronco Claudio, Okusa Mark D and Anders, Hans-Joachim. Co-citation clustering and timeline analysis highlighted recent research foci such as COVID-19, immune checkpoint inhibitors, regulated necrosis, cirrhosis and AKI. Keyword analysis identified "inflammation," "ischaemia-reperfusion injury," "sepsis," "covid-19," and "oxidative stress" as prevalent terms. This study provides the first bibliometric analysis of AKI and immune research, offering a comprehensive overview of research hotspots and evolving trends within the field.

STOP-MSU: Is It Time to STOP-Tranexamic Acid?: July 2024 Annals of Emergency Medicine Journal Club

STOP-MSU: Is It Time to STOP-Tranexamic Acid?: July 2024 Annals of Emergency Medicine Journal Club

Global research trends on the links between prostate cancer and erectile dysfunction between 2003 and 2023: A bibliometrics and visualized study

BackgroundThe incidence of prostate cancer (PC) has increased in recent years. Erectile dysfunction (ED) after prostate cancer treatment has aroused extensive attention. Bibliometric analysis was designed to investigate a systematic understanding of developments between PC and ED during the past 20 years. MethodsLiteratures on PC and ED were retrieved from the Web of Science Core Collection database (WoSCC). By using the VOS viewer and CiteSpace software to analysis the metrics of bibliometric literature, such as number of articles, journals, countries, institutions, authors, keywords and associated information. The number of publications per year was statistically analysed and plotted thorough Microsoft Office. In addition, Pajek software was used to adjust the visual map. ResultsA total of 2332 screened articles were included in the analysis. The Journal of Sexual Medicine, ranking first among the analysed journals, published 235 articles. The United States and Canada were leaders in PC and ED research. There is a need to strengthen inter-agency cooperation in this area of research on a global scale. Mulhall JP, as the most prolific author in this area of research, published 80 articles. And Rosen RC was the author with the most co-citated (693 co-citated). The main research focus on the prevention, treatment and management of ED after PC treatment in this field through the keyword analysis. ConclusionsResearch on PC and ED is expected to expand further worldwide. We found ED, as new sustainable treatment modalities, scientific postoperative management and psychological interventions for patients, may become the research hotspots and should be closely concerned in this study.

The endocrine basis of the cardio-renal axis: New perspectives regarding corin.

The central role of natriuretic peptides (NPs) in the complex cardio-renal integrated physiology and organ failure has been revealed over the last four decades. Atrial natriuretic peptide (ANP), the oldest representative of the NPs family, is produced through conversion of proANP to the mature peptide by corin, a trans-membrane protease localized to the cardiac myocyte membrane. Similarly, brain natriuretic peptide (BNP) is generated by furin, which cleaves proBNP to BNP in myocytes. Though the components of NPs system, their synthesis and target organs are well established, understanding their role in the interplay between the heart and the kidney is steadily evolving. In this context, Feldman etal. (New England Journal of Medicine, 389, 1685) recently described patients with hypertension, cardiomyopathy, atrial arrhythmia and left atrial fibrosis, associated with a homozygous loss-of-function variant of the gene encoding corin (Cor-/-). Notably, reduced baseline urinary electrolyte and creatinine excretion have been observed in one of the studied patients. This renal excretory functional impairment could be attributed to the lack of cardiac-derived ANP in these patients, as implied by Feldman etal. Yet, in this mini-review we suggest that this aberrant renal manifestation may principally stem from lack of local ANP production at renal tissue, as corin is normally expressed in proximal tubules, Henle's loop and collecting ducts, with locally produced ANP provoking Na+ and water exertion. Collectively, it seems that beside the classic well-established cardio-renal axis, the renal NPs system functions as local endocrine machinery in the regulation of sodium excretion.

Abstracts from international emergency medicine journals

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will...

Global and Latest Hotspots of Female Genital Plastic Surgery in the Past 20 Years: A Bibliometric and Visualized Review.

An increasing number of surgical and nonsurgical interventions are available in the field of female genital plastic surgery. The rate of female genital plastic surgery has increased by nearly 220 percent over the past 5 years. Despite several studies on the topic, no relevant bibliometric analysis has been conducted. We searched the Web of Science Core Collection for articles related to female genital plastic surgery. CiteSpace 6.1.R2 (Drexel University, USA) and VOSviewer 1.6.10.0 (Leiden University, the Netherlands) were used, and national distribution, institutions, journals, authors, and key words were analyzed and calculated. From 2003 to 2022, 1299 papers in the field of female genital plastic surgery were retrieved. There were more articles produced in the United States, and there were also two institutions in the Netherlands that were highly productive. A wide and close relationship has been established between researchers and institutions conducting female genital plastic surgery. Professor Bouman MB published the most articles on female genital plastic surgery in the Journal of Sexual Medicine. Female genital plastic surgery dominated the top 10 references with the highest local citation score. There were four clusters of key words with the most citations, and the most recently trending key words were "vaginal agenesis," "transgender," and "congenital adrenal hyperplasia." The purpose of this article is to provide a summary of the current research status focusing on female genital plastic surgery. It is hoped that more efforts will be made to promote the development of female genital plastic surgery in the future.

Publication of observational studies making claims of causation over time

To examine methodology characteristics over time and investigate research impact before and after the start of the COVID-19 era, we analyzed original articles published in The New England Journal of Medicine between October 26, 2017 and August 27, 2022. April 1, 2020 was used as the defining date dividing before and after the COVID-19 era. Out of 1051 original articles, 515 (49 %) were before and 536 (51 %) were after the COVID-19 era. Two independent reviewers categorized and reconciled methodology into groups: “randomized trial” (715 articles), “uncontrolled experimental study” (128), “descriptive observational study” (168), and “observational study making a causal claim” (40). We extracted subsequent citations and Altmetric data for each article to assess impact.The median number of social media shares was 2272 (IQR: 743–7821) for observational studies making a causal conclusion, compared to 306 (IQR: 70–606) for randomized trials (p-value=<0.001). The median Altmetric score for randomized COVID-19 trials (2421, IQR: 1063–3920) was not significantly different than that of COVID-19 observational studies making a causal claim (2583, IQR: 1513–6197, p-value = 0.42), but it was significantly lower than descriptive observational COVID-19 studies (4093, IQR: 2545–6823, p-value = 0.04).We conclude that there has been a steady increase in the number and percentage of observational studies that make causal conclusions about the efficacy of an intervention. Research concerning COVID-19, regardless of methodology, has seen a sharp rise in dissemination as measured through Altmetric's social media score and subsequent citations.

Advances in Human Leukocyte Antigen Testing Technologies and Management Strategies for Platelet Transfusion Refractoriness.

The blood bank is often consulted for transfusion support of patients with suspected platelet transfusion refractoriness (PTR). The workup is complex because testing includes specialized assays that are uncommonly ordered with limited availability. Add to this the variety of possible products-crossmatched platelets, human leukocyte antigen (HLA)-matched platelets, HLA antigen-negative platelets-and the approach to PTR can be overwhelming. Moreover, most literature on the subject is published in transfusion medicine journals aimed at transfusion medicine physicians and blood bank specialists in academic settings. Resources tailored to community hospital blood banks are lacking. To provide pathologists who may not have subspecialized training in transfusion medicine and who direct blood banks algorithmic workflows based on clinical scenario and test availability to provide appropriate transfusion support for patients with PTR. This review is a comprehensive overview of terminology, HLA testing procedures, interpretations, and practical recommendations for managing PTR in various scenarios based on expert opinion as well as relevant medical literature published from 2007 to 2022. Consultation on PTR is complicated and encompasses many clinical and laboratory aspects. The lack of guidelines derived from high-quality prospective studies poses challenges in the workup and management of PTR. Hindering the process further are limited test availability, unfamiliarity with the technical assays, and the various specialized platelet products. The clinical evaluation algorithm presented herein along with the workflow pathways offer pathologists user-friendly and best-practice guidelines with different options based on the clinical scenario and the tests available.

Global overview of anterior cruciate ligament reconstruction in children and adolescents over the past 20 years: a bibliometric analysis

ObjectivesThe objectives of this paper is to conduct a bibliometric analysis to examine the research status and development trend of anterior cruciate ligament injury and reconstruction in children and adolescents over the past 20 years.DesignDescriptive Research.MethodsThis study obtained information regarding studies on Anterior Cruciate Ligament Reconstruction in Children and Adolescents from the Web of Science Core Collection database. Visual and bibliometric analysis were conducted using VOSviewer, Origin 2022, Pajek64 5.18and Excel 2019. These analytic tools facilitated the analysis of various aspects, including countries/regions, institutions, authors, journals and keywords related to the research.ResultsFrom 2003 to 2023, a total of 1328 articles were retrieved in WOS, and 637 articles were selected by two authors. The most productive institutions are Childrens Hosp Philadelphia, Kocher, ms. Their articles have the highest number of publications and citations. The American journal of sports medicine is the most frequently cited journal for articles on anterior cruciate ligament reconstruction in children and adolescents. The most common keywords used in these articles were “anterior cruciate ligament reconstruction”, “injury, children, adolescent”, and “skeletally immature patients”.ConclusionsThis study provides valuable insights into the research focus of anterior cruciate ligament reconstruction in children and adolescents. In recent years, there has been significant attention paid to areas of “the return to sport, re-repture rate and functional recovery after anterior cruciate ligament reconstruction” in this specific population. These aspects have emerged as key directions for future research in this field.

Bibliometric Analysis on Equine-Assisted Interventions.

Equine Assisted Interventions (EAIs) integrate the active participation of horses in therapeutic or educational interventions. A bibliometric analysis was carried out on this topic, using traditional bibliometric laws and recommendations. For this purpose, a search on the Web of Science (WoS) Core Collection database was carried out, obtaining 333 documents. Annual publications followed an exponentially increasing trend (R2 = 86%), pointing out that this topic is a growing interest among researchers, publishers, and journals. The USA was the most productive country worldwide and Jeong-yi Kwon and Ji Lee were the prolific co-authors. The WoS category with the highest number of papers was Rehabilitation (84 papers). The Journal of Alternative and Complementary Medicine, and Pediatric Physical Therapy were the journals with the highest number of publications. The most cited paper was "State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy". The most used author keywords were rehabilitation, balance, and those related to specific populations such as Cerebral Palsy and Autism Spectrum Disorder. These results suggest that EAIs is a topic of increasing interest for researchers, editors, and professionals.

Dapagliflozin - new solution in chronic kidney disease treatment

Despite being developed relatively recently, SGLT2 inhibitors have proven to be versatile pharmaceuticals useful in treatment of diabetes mellitus, heart failure and chronic kidney disease. Extensive and ongoing studies confirm more and more of their beneficial effects on metabolic, cardiovascular and renal health. Most of the conducted studies focused on patients suffering from diabetes mellitus type 2. Recent study, DAPA - CKD, published in the New England Journal of Medicine confirmed dapagliflozin’s beneficial effect on chronic kidney disease of any etiology. This discovery has cemented flozins’ status as nephroprotective drugs and led to a new indication of use for dapagliflozin - chronic kidney disease. In Poland treatment of chronic kidney disease with dapagliflozin is reimbursed in patients with chronic kidney disease with eGFR &lt;60 ml/min/1.73m2, albuminuria or proteinuria who were treated with ACEi/ARB for ≥4 weeks or with contraindications for ACEi/ARB therapy. Due to reimbursement, dapagliflozin therapy is financially available for a wide population of patients and, in light of recent discoveries, should be considered by clinicians.

Higher autism risk with valproate than topiramate, lamotrigine

A cohort study examining both publicly and commercially insured individuals has found that prenatal exposure to topiramate or lamotrigine is associated with lower risk of childhood autism compared with exposure to valproate. Study results were largely unchanged in analyses limited to women who received the medications late in pregnancy. Results were published March 21/28, 2024, in The New England Journal of Medicine.