Landmark Study Research Articles

Sarcoma: Last Year's Practice Changing Papers.

In 2023 and 2024, a wide variety of new studies have been published in the field of soft tissue sarcomas, representing the enormous heterogeneity of sarcoma histotypes, anatomical location, treatment variability, and biological behavior. This article summarizes the, in our view, seven most important publications in the field that will have an impact on the surgical practice and future treatment strategies of our patients. In the last year, we gained more insight in the genetic background of patients with sarcoma from a large Australian study, which will have an impact on future counseling and screening of our patients. Also, the role of radiotherapy in retroperitoneal liposarcoma became clearer in the combined STRASS-STREXIT study. Radiotherapy for extremity sarcomas can now also be done in a 3-week, hypofractioned manner, which is a major improvement for our patients. Furthermore, more evidence has been presented regarding the improved outcome of patients with retroperitoneal sarcoma when treated in high volume centers. Landmark studies with systemic treatment include the positive trial with nirogacestat in desmoid tumors, which have finally shifted the paradigm of desmoid treatment from surgery to systemic treatment. Also, the results of 2 phase 3 randomized controlled trials recently showed 1) that the combination of doxorubicin with trabectedin significantly improved progression free survival for patients with leiomyosarcoma when compared with doxorubicin alone and 2) that the combination of neoadjuvant pembrolizumab and radiotherapy followed by 1-yr adjuvant pembrolizumab significantly improved disease free survival for patients with primary localized undifferentiated pleomorphic sarcoma/myxofibrosarcoma or dedifferentiated/pleomorphic liposarcoma of the extremities or girdles. Key papers from the last year informs us that management of soft tissues sarcoma is constantly improving, since more data became available to guide us in defining the best treatment strategies.

ANCA-associated glomerulonephritis – diagnosis and therapy Proceedings of the Henry Shavelle Lectureship

Background. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) frequently affects the kidney. Glomerulonephritis (GN) in AAV, ANCA-GN, not only dictates therapeutic decisions, but is also of relevance for overall survival influencing the risk of cardiovascular disease and serious infections. Summary. A diagnosis of ANCA-GN includes laboratory investigations including urinalysis and a thorough assessment of potential organ involvement. A kidney biopsy can be performed to ascertain the diagnosis, but has an additional prognostic relevance and tools have been established to predict long-term kidney survival. Experimental biomarkers indicating kidney inflammation include urinary soluble CD163 and the presence of urinary T cells. Therapeutic options are refined and some of these therapies, such as the added value of performing plasma exchange, are the matter of controversial discussions. Safe reduction of cumulative exposure to glucocorticoids and eventually the use of avacopan to substantially reduce glucocorticoid exposure has been implemented in most centers. In the remission of maintenance, the optimal duration of therapy is still unclear, but extended use of rituximab as maintenance agent has shown long-term remission rates, thus limiting the damage accrued by relapsing disease and thus also reducing the risk of end-stage kidney disease (ESKD). Avacopan has been the first agent with a glomerular filtration rate-sparing effect, likely due to more rapid control of kidney inflammation. Those reaching ESKD should be evaluated for kidney transplantation and the risk of remaining on dialysis must be balanced against the risk of recurrence of disease following transplantation. Key Messages. The advent of a magnitude of landmark studies in ANCA-GN has refined diagnostic approaches, implemented tools to predict kidney outcome and eventually led to the approval of newer therapies, with avacopan the latest addition to the armamentarium. Once ESKD is present, patients should be considered for kidney transplantation, as remaining on dialysis portends poor overall prognosis.

Post-Transplantation Late Complications Increase Over Time for Patients With SCID: A Primary Immune Deficiency Treatment Consortium (PIDTC) Landmark Study

Post-Transplantation Late Complications Increase Over Time for Patients With SCID: A Primary Immune Deficiency Treatment Consortium (PIDTC) Landmark Study

Feasibility and oncological outcomes of sentinel lymph biopsy in early stage breast cancer using blue dye alone in limited-resource country – compared to dual tracers and the landmark studies

Feasibility and oncological outcomes of sentinel lymph biopsy in early stage breast cancer using blue dye alone in limited-resource country – compared to dual tracers and the landmark studies

Revisiting ICD Therapy for Primary Prevention in Patients With HeartFailure and Reduced Ejection Fraction.

Implantable cardioverter-defibrillators (ICDs) are recommended to reduce the risk of sudden cardiac death (SCD) in patients with heart failure with reduced ejection fraction (HFrEF). The landmark studies leading to the current guideline recommendations preceded the 4 pillars of guideline-directed medical therapies (GDMTs). Therefore, some have questioned the role of ICDs for primary prevention in current clinical practice. In this paper, the authors provide an overview of the current ICD recommendations, including the instrumental clinical trials, the risk of SCD as observed in clinical trials vs real-world scenarios, disparities in ICD use among different patient populations, the impact of contemporary GDMT on outcomes, and ongoing and future trials and methodologies to help identify patients who are at an increased risk of SCD and who may benefit from an ICD. The authors also propose a pragmatic guidance for clinicians when they engage in the shared decision-making discussions for primary ICD implantation.

Application of Brain-Computer Interface Technology in Neurorehabilitation

Abstract. Neurorehabilitation is a very important area that aims at bettering lives of patients who have neurological disorders and have severely damaged motor functions and impaired communications abilities. Brain-Computer Interface (BCI) technology has emerged as one of the highly promising tools in the application of neurorehabilitation, having innovations in motor recovery, speech restoration, and independence for patients. This review presents the applications and efficiency of brain-computer interface technology in neurorehabilitation procedures related to high-incidence neurological disorders like stroke, traumatic brain injury, and spinal cord injury, and complex neurological disorders like amyotrophic lateral sclerosis, multiple sclerosis, and cerebral palsy. Among these, some BCI approaches, mostly based on electroencephalographic recordings, have shown promising potential for motor recovery, communication, and improvement of independence in patients. It discusses key modalities like motor imagery-based training, neurofeedback, and robotic assistance, together with the landmark studies proving their efficacy. Moreover, it pays attention to basic and clinical research and points out the challenges and future directions for the alleviation of limitations in BCI technology. Despite the fact that BCI technology still has some basic problems at this point in terms of signal acquisition, processing, and individual training, there is huge potential for application in developing neurorehabilitation and improving the quality of life of those patients who have undergone serious neurological injury.

A spectrum of nonsense-mediated mRNA decay efficiency along the degree of mutational constraint

Despite its importance for regulating gene expression, nonsense-mediated mRNA decay (NMD) remains poorly understood. Here, we extend the findings of a previous landmark study that proposed several factors associated with NMD efficiency using matched genome and transcriptome data from The Cancer Genome Atlas Program (TCGA) by incorporating additional data including Genotype-Tissue Expression (GTEx), gnomAD, and metrics for mutational constraints. Factors affecting NMD efficiency are analyzed using an allele-specific expression (ASE)-based measure to reduce noise caused by random variations. Additionally, by combining our data with the updated allele frequency database of gnomAD, we demonstrate the spectrum of NMD efficiency according to the degree of gene-level mutational constraints (degree of a gene-tolerating loss-of-function variants). The NMD prediction model, trained on TCGA data, shows that gene-level mutational constraint is an important predictor of NMD efficiency. Findings of this study suggest the potential role of NMD on shaping the landscape of mutational constraints.

NIpple Position to Pinpoint Localization of Chest Drain Insertion in FEmale Trauma Patients: The NIPPLE-Trial-A Landmark Study.

Background: The insertion of chest drains (CD) in trauma patients is a lifesaving, albeit high-risk intervention. Safe insertion of CD in settings where aids like ultrasound are not available relies on a landmark technique defining the so-called triangle of safety. The inferior margin of this triangle is identified by nipple height, which is thought to correspond to the fifth intercostal space (ICS). Training manikins are modeled after a lean male body and oftentimes insinuating jokes fuel uncertainty about the height of the nipple as a reliable landmark in female trauma patients. This study aims to prove that the nipple can be considered a safe landmark for CD insertion in women: even if larger breasts follow the force of gravity, it should not act towards the direction of the feet, but to the sides of the thorax in a flat-lying trauma patient. Methods: An online questionnaire was designed and distributed amongst female surgeons. Epidemiological data (age, nr of pregnancies, history of breastfeeding) was collected. Height, weight, and body mass index (BMI) were reported. Chest circumference and underbust girth were self-measured. The nipple position in relation to the ICS was measured by the women while lying in a supine position. Results: 237 female surgeons completed the questionnaire. Nine questionnaires were excluded due to incomplete data sets. 20 women were excluded due to previous breast surgery. Thus, 208 participants (or 416 nipples) were included in analysis. In supine position, both nipples were located in the 5th (±0.8) intercostal space. Age, BMI, height, weight, and status post-pregnancy had no significant impact on nipple position. Interestingly, a history of breastfeeding correlated with lower nipple position. Conclusions: The nipple is a safe landmark for identifying the correct insertion position of chest drains in supine-lying female trauma patients.

Sodium glucose cotransporter 2 inhibitors in the management of heart failure: Veni, Vidi, and Vici.

Heart failure (HF) is a chronic disease associated with high morbidity and mortality rates. Renin-angiotensin-aldosterone system blockers (including angiotensin receptor/neprilysin inhibitors), beta-blockers, and mineralocorticoid receptor blockers remain the mainstay of pharmacotherapy for HF with reduced ejection fraction (HFrEF). However, despite the use of guideline-directed medical therapy, the mortality from HFrEF remains high. HF with preserved ejection fraction (HFpEF) comprises approximately half of the total incident HF cases; however, unlike HFrEF, there are no proven therapies for this condition. Sodium glucose cotransporter-2 inhibitors (SGLT-2is) represent a new class of pharmacological agents approved for diabetes mellitus (DM) that inhibit SGLT-2 receptors in the kidney. A serendipitous finding from seminal trials of SGLT-2is in DM was the significant improvement in renal and cardiovascular (CV) outcomes. More importantly, the improvement in HF hospitalization (HHF) in the CV outcomes trials of SGLT-2is was striking. Multiple mechanisms have been proposed for the pleiotropic effects of SGLT-2is beyond their glycemic control. However, as patients with HF were not included in any of these trials, it can be considered as a primary intervention. Subsequently, two landmark studies of SGLT-2is in patients with HFrEF, namely, an empagliflozin outcome trial in patients with chronic HF and a reduced ejection fraction (EMPEROR-Reduced) and dapagliflozin and prevention of adverse outcomes in HF (DAPA-HF), demonstrated significant improvement in HHF and CV mortality regardless of the presence of DM. These impressive results pitchforked these drugs as class I indications in patients with HFrEF across major guidelines. Thereafter, empagliflozin outcome trial in patients with chronic HF with preserved ejection fraction (EMPEROR-Preserved) and dapagliflozin evaluation to improve the lives of patients with preserved ejection fraction HF (DELIVER) trials successively confirmed that SGLT-2is also benefit patients with HFpEF with or without DM. These results represent a watershed as they constitute the first clinically meaningful therapy for HFpEF in the past three decades of evolution of HF management. Emerging positive data for the use of SGLT-2is in acute HF and post-myocardial infarction scenarios have strengthened the pivotal role of these agents in the realm of HF. In a short span of time, these classes of drugs have captivated the entire scenario of HF.

Simulating the methodological bias in the ATLS classification of hypovolemic shock: a critical reappraisal of the base deficit renaissance

BackgroundThe Advanced Trauma Life Support classification (ATLS) of hypovolemic shock is a widely used teaching and treatment reference in emergency medicine, but oversimplifies clinical reality. A decade ago, a landmark study compared vital parameters to base deficit (BD) in trauma patients. The investigators concluded that BD had higher accuracy to detect the need for early blood product administration. BD was subsequently introduced in the ATLS shock classification and has since been widely accepted as a laboratory standard for hypovolemia. The aim of this study is to investigate whether a methodological bias may have inadvertently contributed to the study’s results and interpretation.MethodsIn the current study, we replicate the original study by simulating a cohort of trauma patients with randomly generated data and applying the same methodological strategies. First, a predefined correlation between all predictor variables (vital parameters and BD) and outcome variable (transfusion) was set at 0.55. Then, in accordance with the methods of the original study we created a composite of ATLS parameters (highest class amongst heart rate, systolic blood pressure, and Glasgow Coma Scale) and compared it with BD for resulting transfusion quantity. Given the preset correlations between predictors and outcome, no predictor should exhibit a stronger association unless influenced by methodological bias.ResultsApplying the original imbalanced grouping and composite allocation strategies caused a systematic overestimation of shock class for traditional ATLS parameters, favoring the association between BD and transfusion. This effect persisted when the correlation between BD and transfusion was set substantially worse (rho = 0.3) than the correlation between ATLS parameters and transfusion (rho = 0.8).ConclusionsIn this fully reproducible simulation, we confirm the inadvertent presence of methodological bias. It is physiologically reasonable to include a metabolic parameter to classify hypovolemic shock, but more evidence is needed to support widespread and preferred use of BD.

Investigating measurement invariance of the IDS-2 intelligence scales between migrant and non-migrant groups

Intelligence plays a crucial role in various aspects of human life, impacting health, academic achievement, and socio-economic success. However, cultural and linguistic disparities in intelligence testing pose challenges, particularly for individuals from migrant backgrounds. This study replicates and extends the landmark study by Wicherts and Dolan (2010) exploring measurement invariance of the German language intelligence test, the Intelligence and Development Scales – 2 (IDS-2), between children and adolescents from migrant (N = 132) and non-migrant (N = 1898) groups. The results revealed partial strict measurement invariance in the IDS-2 intelligence scale subtests across the examined groups. The breach of full strict measurement invariance is primarily due to intercept differences on the verbally loaded subtests—Naming Categories, Naming Opposites, and Story Recall—highlighting the confounding impact of language complexity on test outcomes. These discrepancies resulted in a cumulative intercept difference disadvantaging migrant participants of approximately 4 IQ points on the Full-Scale IQ Score. The findings indicate that while the IDS-2 scales generally assess intelligence consistently across diverse groups, the influence of language complexity on the verbal subtests may result in a disadvantage for children and adolescents with migration backgrounds. To address these biases, we propose the development of non-verbal and culturally fair intelligence tests.

Gut-first Parkinson's disease is encoded by gut dysbiome.

In Parkinson's patients, intestinal dysbiosis can occur years before clinical diagnosis, implicating the gut and its microbiota in the disease. Recent evidence suggests the gut microbiota may trigger body-first Parkinson Disease (PD), yet the underlying mechanisms remain unclear. This study aims to elucidate how a dysbiotic microbiome through intestinal immune alterations triggers PD-related neurodegeneration. To determine the impact of gut dysbiosis on the development and progression of PD pathology, wild-type male C57BL/6 mice were transplanted with fecal material from PD patients and age-matched healthy donors to challenge the gut-immune-brain axis. This study demonstrates that patient-derived intestinal microbiota caused midbrain tyrosine hydroxylase positive (TH +) cell loss and motor dysfunction. Ileum-associated microbiota remodeling correlates with a decrease in Th17 homeostatic cells. This event led to an increase in gut inflammation and intestinal barrier disruption. In this regard, we found a decrease in CD4 + cells and an increase in pro-inflammatory cytokines in the blood of PD transplanted mice that could contribute to an increase in the permeabilization of the blood-brain-barrier, observed by an increase in mesencephalic Ig-G-positive microvascular leaks and by an increase of mesencephalic IL-17 levels, compatible with systemic inflammation. Furthermore, alpha-synuclein aggregates can spread caudo-rostrally, causing fragmentation of neuronal mitochondria. This mitochondrial damage subsequently activates innate immune responses in neurons and triggers microglial activation. We propose that the dysbiotic gut microbiome (dysbiome) in PD can disrupt a healthy microbiome and Th17 homeostatic immunity in the ileum mucosa, leading to a cascade effect that propagates to the brain, ultimately contributing to PD pathophysiology. Our landmark study has successfully identified new peripheral biomarkers that could be used to develop highly effective strategies to prevent the progression of PD into the brain.

Exploring the Cardiorenal Benefits of SGLT2i: A Comprehensive Review

The history of sodium-glucose cotransporter 2 inhibitors (SGLT2i) is so long and started in 1835 when Petersen extracted a compound called phlorizin from apple tree bark. About fifty years later, von Mering discovered its glucosuric properties. In the 1980s, it was discovered that the glucosuria resulted from inhibition by phlorizin of glucose reabsorption by the renal tubules, which lowered blood glucose levels in diabetic rats. Nowadays, beyond their glucose-lowering effects, growing evidence suggests significant cardiorenal benefits associated with SGLT2i therapy. Indeed, several clinical trials, including landmark studies such as EMPA-REG OUTCOME, CANVAS Program, and DECLARE-TIMI 58, have demonstrated robust reductions in cardiovascular events, particularly heart failure hospitalizations and cardiovascular mortality, among patients treated with SGLT2i. However, subsequent trials showed that SGLT2i benefits extend beyond the diabetic population, encompassing individuals with and without diabetes. Additionally, SGLT2i exhibit nephroprotective effects, manifesting as a slowing of the progression of chronic kidney disease and a reduction in the risk of end-stage kidney disease. The mechanisms underlying the cardiorenal benefits of SGLT2i are multifactorial and include improvements in glycemic control, reduction in arterial stiffness, modulation of inflammation and oxidative stress, reduction of intraglomerular pression and promotion of natriuresis and diuresis through inhibition of SGLT2 in the luminal brush border of the first segments of the proximal kidney tubule. This narrative review aims to explore the cardiorenal outcomes of SGLT2i, encompassing their mechanisms of action, clinical evidence, safety profile, and implications for clinical practice.

Is Weight Loss the Most Effective Method for the Prevention of Type 2 Diabetes? A Discussion in View of Evidence from Landmark Studies

Type 2 Diabetes mellitus (T2DM) and obesity are a continuum and intertwined in a complex way. Both these chronic conditions pose a significant challenge to the global health system, if the current trend continues, it is estimated that by 2045 the number of people affected globally will increase by almost 700 million. Considering the above, effective strategies have to be implemented to tackle this global pandemic. The main strategies discussed in the literature are lifestyle intervention (ESI) with or without weight loss and medication. This article looked at the evidence from the various landmark studies which include the Diabetes Prevention Program (DPP) and Diabetes Prevention Study (DPS) Outcomes of these studies suggest that ELSI with loss is superior to ELSI without weight loss and metformin in risk reduction of T2DM. The evidence from the Swedish obese subject study also concludes that weight loss achieved through bariatric surgery reduces the risk. Lifestyle modification programmes even without weight loss have greater health benefits but as far as risk reduction for T2DM the evidence is not conclusive. This review article concludes that reducing weight is paramount for preventing T2DM, especially in high-risk individuals, compliance plays a vital role in overcoming these challenges and stresses the importance of tailored strategies for person-to-person characteristics to overcome those challenges.

Intrasaccular Treatment of Intracranial Aneurysms: A Comprehensive Review

Background: The endovascular treatment of complex intracranial aneurysms, such as wide-neck aneurysms (WNAs), remains a challenge. More established endovascular techniques, which include balloon-assisted coiling, stent-assisted coiling, and flow diversion, all have their drawbacks. Intrasaccular flow disruptor devices have emerged as a useful tool for the neurointerventionalist. Methods: Here, we discuss landmark studies and provide a comprehensive, narrative review of the Woven EndoBridge (WEB; Microvention, Alisa Viejo, CA, USA), Artisse (Medtronic, Irvine, CA, USA), Contour (Stryker, Kalamazoo, MI, USA), Saccular Endovascular Aneurysm Lattice Embolization System (SEAL; Galaxy Therapeutics Inc, Milpitas, CA, USA), Medina (Medtronic, Irvine, CA, USA), and Trenza (Stryker, Kalamazoo, MI, USA) devices. Results: Intrasaccular devices have proven to be effective in treating complex aneurysms like WNAs. Conclusions: Intrasaccular flow disruptors have emerged as a new class of effective endovascular therapy, and results of ongoing clinical studies for the newer devices (e.g., SEAL and Trenza) are much anticipated.

Heuristic assumptions

AbstractInterpreting any decision requires making auxiliary assumptions regarding how the decision makers viewed their options and related them to their lives. Theories constrain those assumptions. The more general the theory, the fewer constraints it imposes and the more assumptions must be made in any application. Like the rational actor models that they challenged, Daniel Kahneman and Amos Tversky’s heuristics-and-biases and prospect theory research programs were general theories, with broad application. One of the many marvels of their landmark studies is that they rarely test their auxiliary assumptions. Rather, readers were trusted to agree about how people interpret the tasks (e.g., select anchors in studies of that heuristic). Subsequent studies have often accepted those interpretations in order to examine boundary conditions (e.g., extreme anchors). Applying the theories to naturally occurring tasks requires making additional auxiliary assumptions. This article illustrates three ways to evaluate those assumptions: direct assessment, systematic manipulation, and archival analysis. It concludes with proposals for loosely coordinated evaluation of shared and contested assumptions.

IN SITU STABLE ISOTOPE MEASUREMENTS IN FORAMINIFERAL TESTS BY SIMS

ABSTRACT Fossilized tests of foraminifera are arguably the most important archives of past climate, and many of the longest paleoclimate records have been compiled by the measurement of the oxygen and carbon isotope composition of foraminiferal tests collected from seafloor sediments. Since the analytical methodology was established in the late 1940s, multiple tests are pooled and analyzed, resulting in a single oxygen and carbon isotope value representing their mean composition. These records compiled by multi-test analysis provide, in most scenarios, a faithful picture of the Earth’s past climate. However, foraminiferal tests feature isotopic heterogeneity on micrometer scales and thus record a wealth of additional information that can be assessed by secondary ion mass spectrometry (SIMS) using spots of 10 µm or less. This paper provides a history of in situ stable isotope measurements in foraminifer tests by SIMS, discusses landmark studies, and offers an outlook on future research.

Rett Syndrome: The Emerging Landscape of Treatment Strategies.

Rett syndrome (RTT) has enjoyed remarkable progress in achieving specific therapies. RTT, a unique neurodevelopmental disorder first described in 1966, progressed slowly until the landmark paper of Hagberg and colleagues in 1983. Thereafter, rapid advances were achieved including the development of specific diagnostic criteria and the active search for a genetic etiology, resulting 16 years later in identification of variants in the methyl-CpG-binding protein (MECP2) gene located at Xq28. Shortly thereafter, the NIH Office of Rare Diseases funded the RTT Natural History Study (NHS) in 2003, initiating the acquisition of natural history data on clinical features from a large population of individuals with RTT. This information was essential for advancement of clinical trials to provide specific therapies for this disorder. In the process, the International Rett Syndrome Association (IRSA) was formed (now the International Rett Syndrome Foundation-IRSF), which participated directly in encouraging and expanding enrollment in the NHS and, subsequently, in developing the SCOUT program to facilitate testing of potential therapeutic agents in a mouse model of RTT. The overall objective was to review clinical characteristics developed from the NHS and to discuss the status of specific therapies for this progressive neurodevelopmental disorder. The NHS study provided critical information on RTT: growth, anthropometrics, longevity, key comorbidities including epilepsy, breath abnormalities, gastroesophageal dysfunction, scoliosis and other orthopedic issues, puberty, behavior and anxiety, and progressive motor deterioration including the appearance of parkinsonian features. Phenotype-genotype correlations were noted including the role of X chromosome inactivation. Development of clinical severity and quality of life measures also proved critical for subsequent clinical trials. Further, development of biochemical and neurophysiologic biomarkers offered further endpoints for clinical trials. Initial clinical trials prior to the NHS were ineffective, but advances resulting from the NHS and other studies worldwide promoted significant interest from pharmaceutical firms resulting in several clinical trials. While some of these have been unrewarding such as sarizotan, others have been quite promising including the approval of trofinetide by the FDA in 2023 as the first agent available for specific treatment of RTT. Blarcamesine has been trialed in phase 3 trials, 14 agents have been studied in phase 2 trials, and 7 agents are being evaluated in preclinical/translational studies. A landmark study in 2007 by Guy et al. demonstrated that activation of a normal MECP2 gene in a null mouse model resulted in significant improvement. Gene replacement therapy has advanced through translational studies to two current phase 1/2 clinical trials (Taysha102 and Neurogene-401). Additional genetic therapies are also under study including gene editing, RNA editing, and X-chromosome reactivation. Taken together, progress in understanding and treating RTT over the past 40 years has been remarkable. This suggests that further advances can be expected.

Diagnosis and management of eosinophilic esophagitis and esophageal food impaction in adults : Aposition paper issued by the Austrian Society of Gastroenterology and Hepatology (ÖGGH).

This position paper deals with an expert consensus on diagnosis and management of eosinophilic esophagitis and esophageal food impaction issued by the Austrian Eosinophilic Esophagitis Network, aworking group under the patronage of the Austrian Society of Gastroenterology and Hepatology (ÖGGH). In need of astandardized approach on the management of EoE, recommendations were made based on international guidelines and landmark studies.

Big data analysis of endovascular treatment for acute ischemic stroke: a study based on bibliometric analysis.

While bibliometric analyses are prevalent in the medical field, few have focused on ther endovascular treatment for acute ischemic stroke (AIS). To employ big data analysis to examine the research status, trends, and hotspots in endovascular treatment for AIS. We conducted a comprehensive search using the Web of Science (WOS) database to identify relevant articles on the endovascular treatment for AIS from 1980 to the present. We used various tools for data analysis, including an online platform (https://bibliometric.com/app), the Citespace software, the Vosviewer software, and the ArcMap software, version 10.8. A number of bibliometric indicators were collected and analyzed, such as publication date, country where the studies were conducted, institutions to which the authors were affiliated, authors, high-frequency keywords, cooperative relationship etc. RESULTS: A total of 5,576 articles were retrieved. A substantial increase in the number of articles occurred after 2010. High-frequency keywords included terms such as large vessel occlusion, reperfusion, outcome, and basilar artery occlusion. Among the top 10 most productive authors, Raul G. Nogueira ranked first, with 136 published articles. Among the journals, The New England Journal of Medicine ranked first, with 5,631 citations. The United States has the closest collaborative ties with other nations. In the present study, we found that the reports of endovascular treatment for AIS gradually increased after 2010. Among them, Raul G. Nogueira was the most productive author in this field. The New England Journal of Medicine was the most cited, and it had the greatest impact. The Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial study was the most cited, and it was a landmark study. There are many interesting studies on endovascular treatment for AIS, such as ischemic penumbra, collateral circulation, bridging therapy etc.