Peer Review Research Articles

Molecular dynamics simulation study of interface stability of spiral magnetic fluid seals of cone bit

Purpose The purpose of this paper is to investigate the interfacial stability between the magnetic fluid and the grease during the drilling process of a spiral magnetic fluid seal in a tooth wheel drill bit. Design/methodology/approach In this study, the actual working conditions of a tooth wheel drill bit in downhole operation are simulated by means of molecular dynamics, so as to observe the microscopic state of the interface between the magnetic fluid and the grease of the tooth wheel drill bit helical magnetic fluid seal during the actual operation. Findings Through the molecular dynamics simulation carried out under five working conditions, respectively, it can be obtained that with the increase of temperature and pressure, the magnetic particles diffuse more and more slowly in the system, and the interaction force between the magnetic particles and the grease molecules becomes weaker and weaker. And there is only a slight fusion of the interface between the magnetic fluid and the grease, and the overall performance of the magnetic fluid is not affected by the grease. Originality/value In this study, to the best of the authors’ knowledge, the spiral magnetic fluid sealing structure of a tooth wheel drill bit is proposed for the first time, which is highly innovative. And the study of using molecular dynamics to simulate the interfacial stability between the magnetic fluid and grease analyzes the feasibility of the spiral magnetic fluid sealing structure of the tooth wheel drill bit. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-03-2024-0065/

Independent serious case reviews relating to serious further offences since 2005: A thematic review

Serious further offences are rare but represent catastrophic harm to the public by people under probation supervision. Where cases had previously been identified at high risk of harm and there are significant failings in their management, independent reviews are commissioned. Surprisingly, learning from these reports has received scant attention, with the last review 20 years ago. To address this, a pre-registered systematic search was carried out, identifying 37 reports of reviews of offences committed in the UK, published between 2005 and 2024. These reports were reviewed, drawing on the rapid evidence assessment approach, and antecedent behaviours were qualitatively synthesised.

Assessment of the quality and diagnostic accuracy of patient self-generated photographs used in oculoplastic virtual clinics

Background A barrier to video consultation in oculoplastics is visualising pathology too small for video resolution. Patient self-generated photographs, which is well-documented in teledermatology but not in oculoplastics, may provide a solution. Purpose To assess the quality and diagnostic accuracy of patient self-generated photographs of presumed benign eyelid pathology. Methods 300 patients with suspected benign lid lesions emailed self-captured photographs that were reviewed by two independent reviewers for quality, focussing, and lighting. The photographs were used in a virtual clinic alongside video consultation. Accuracy of virtual clinic diagnosis was measured by comparison to biopsy or in-person diagnosis where available. Results 895 photographs were submitted. 84.5% of these were graded as excellent or adequate quality and there was no statistical difference in image quality based on patient age. Concordance between observers for quality of photographs, measured using Cohen's kappa, was k = 0.77 ( P = <0.01). Virtual clinic diagnosis was verified in 236 (78.7%) patients by biopsy or in-person review. Correct diagnosis was made in 80.5%. 99.1% of benign lesions were correctly identified as low-risk, 50% of pre-malignant lesions were identified as suspicious, and 100% of malignant lesions were correctly identified as cancerous. Conclusions Patients of all ages can provide adequate quality photographs that can aid video consultations for benign lid lesions. We still recommend in-person review where suspicious features are present, or photo quality is suboptimal.

THE ROLE OF POLYSACCHARIDE AEROGEL IN TISSUE REGENERATION AND REPAIR

Aerogel-based biomaterial is an important subject in materials sciences due to their vast attention in different sectors. These materials possess unique properties that distinguish them such as low density. In the area of tissue engineering, there application has been documented in areas such as blood vessel, soft tissue, nerves, bone and cartilage.There are several steps involved in aerogel preparation. The first step involves the appropriate selection of a precursor material such as polymers, silica or carbon. Aerogels have a unique property which includes the composition of mesoporous solid colloids that possess a light weight and a porous frame work structure. Aerogels also possess unique extraordinary physicochemical properties.Tissue engineering is a broad term that encompasses on using biocompatible materials to repair and replace damaged tissues. Notwithstanding, its diverse applications over the years, tissue engineering have had persistent hurdles which include the need to develop new novel biomaterials This article seeks to review the properties of aerogel and their preparation processes. The review also documented the challenges from current studies and future prospects were also discussed. Peer Review History: Received 2 December 2024; Reviewed 11 January 2025; Accepted 14 February; Available online 15 March 2025 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, gehankandeel9@yahoo.com

The adaptation of clinical practice guideline recommendations regarding family-centered collaborative care of people living with schizophrenia, major depressive disorder, and bipolar mood disorder in the Iranian context: using the resource toolkit for guideline adaptation

IntroductionChronic mental diseases are enduring and recurring, and need constant care and a collaborative approach for management. Based on clinical guidelines, family interventions can improve the quality of care for individuals with chronic mental diseases.ObjectiveSpecifically, the study examined family involvement in the care of people suffering from schizophrenia, major depressive disorder, and bipolar mood disorder by adapting international clinical guidelines.MethodsThe resource toolkit for guideline adaptation was selected as the adaptation process. Seven databases were searched for international clinical guidelines. Independent reviewers utilized the Appraisal of guidelines for research and evaluation II tools to assess guidelines that met the inclusion and quality criteria. The recommendations from the guidelines were combined with those from the systematic review and qualitative research, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and COnsolidated criteria for REporting Qualitative research checklists. Rephrased recommendations with redundant or overlapping content were excluded from the Iranian context due to the cultural, religious and belief changes of the people, as well as the lack of necessary facilities. Translations of the selected recommendations were made into Persian, along with modified recommendations.ResultsA total of 573 recommendations from 17 books, 10 national documents, 16 guidelines, 27 articles, and 31 English and Persian theses were identified. After the initial review (referred to as RAND/UCLA Appropriateness Method 1), 467 recommendations received an appropriate score, 106 had an uncertain score, and none of them received an inappropriate score. After merging the recommendations, they received 433 good grades and 98 uncertain grades. After the face-to-face meeting of the research team, 7 were merged due to similarity, and 91 recommendations were made in a hybrid panel of experts (RAND/UCLA Appropriateness Method 2). Finally, 524 recommendations were identified that applied to the psychiatric medical centers in Iran. The examined and revised recommendations suggest healthcare professional interventions for family involvement in the care of patients with schizophrenia, major depressive disorder, and bipolar mood disorder referred to medical centers in Iran. The adapted recommendations emphasize the need for family-centered collaborative care ( interventions which satisfy the needs of patients with chronic mental diseases and their caregivers, considering their preferences and capabilities.

Clinical, Radiographic, and Histological Features of Buccal Bifurcation Cysts: A Systematic Review to Aid Accurate Diagnosis and Treatment Decisions.

Clinical, Radiographic, and Histological Features of Buccal Bifurcation Cysts: A Systematic Review to Aid Accurate Diagnosis and Treatment Decisions.

A falls early response service in Aotearoa New Zealand: a scoping review.

To understand the extent and type of evidence available on a joint service between occupational therapy and paramedics in a community falls early response service (FERS). Three databases and Google Scholar were searched for published and grey material that combined occupational therapy and paramedicine community FERS. Two independent reviewers screened citations and then assessed articles for selection. Data extraction was performed by a third researcher and verified by the two reviewers. Fourteen sources were included from the initial 6,432 screened, and 128 were subsequently assessed. The 14 sources were published between 2010 and 2023, with over 50% published after 2019. The number of participants in the studies ranged from 23 to over 35,000, with a variety of combinations of healthcare professionals. This review suggests that a combined occupational therapy and paramedicine FERS would benefit people who fall, the ambulance service and hospital care providers from a cost and resource point of view. A pilot study to further evaluate the cost and benefits of this kind of service is being explored based on the results of this scoping review.

Supporting the well-being of nurses, paramedics, and firefighters during external crises by managing workload: an umbrella review.

Support is needed for the well-being of nurses and first responders in external crises. We aimed to synthesize the evidence between workload management strategies and well-being of nurses, paramedics, and firefighters during external crises in an umbrella review. The data sources OVID Medline, APA PsycInfo, CINAHL, Web of Science and the Cochrane Library were searched between 1.1.2013-20.6.2023. Two independent reviewers assessed the eligibility of the publications and conducted the data extraction and narrative synthesis. The search identified 1,073 references on nurses and 182 on paramedics and firefighters. Of the 62 full texts, 16 systematic reviews on nurses were included, and of the 13 full texts on paramedics and firefighters, two systematic reviews were included, making a total of 18 systematic reviews. The quality of the publications was predominantly good (83%). Both employee and work-directed strategies were beneficial in supporting employee well-being during external crises. Proactive practical skills training and psychological interventions were found as the most promising employee-directed strategies. The corresponding work-directed strategies were effective communication, providing useful information and adequate working conditions, supportive leadership, and peer support. To support well-being of nurses and first responders during external crises, workload management strategies need to be proactively planned in workplaces.

Quality assurance in cardiology with routine data : Requirement and reality

Routine data are very helpful as an instrument for health services research. In German hospitals the input data of the statutory quality assurance (in cardiology: left heart catheterization, cardiac implantable electronic devices and transcatheter aortic valve implantation, TAVI), the data according to §21 of the Hospital Remuneration Act and mandatory quality assurance reports of hospitals are available. In addition, the health insurance companies also have social data at their disposal. The very restrictive interpretation of data safety in Germany as well as apartition of the data according to the private or statutory health insurance status, outpatient and inpatient forms of treatment and two different remuneration sources exacerbate in the current reality an effective central use of routine data, as is possible in other countries, e.g., Sweden. Routine data are apowerful tool for quality assurance in terms of critical self-reflection and as abasis for peer review by colleagues; however, public reporting of routine data (publication of the results of individual hospitals) is questionable due to methodological limitations, such as data quality and risk adjustment, as it puts hospitals in the pillory without any chance to critically reflect on the validity of the data. Consequently, risk-avoiding behavior in medical services could compromise patient care. The current development of healthcare policies with a structural reform of the hospital landscape and the recommendations of the government committee will increase the demands on the quality assessment based on routine data. Simplified data acquisition, methodological improvements as well as new aspects, such as the quality of indications, assessment of nursing services and patient orientation will be added. In future, a quality-oriented remuneration based on routine data is intended to help control the healthcare system.

Autonomic Nervous System and Overactive Bladder: A Systematic Review.

This systematic review aims to evaluate the relationship between autonomic nervous system (ANS) dysregulation and lower urinary tract symptoms (LUTS), particularly in overactive bladder (OAB) and LUTS associated with benign prostatic hyperplasia (LUTS-BPH), while also assessing the impact of therapeutic interventions on ANS function. A comprehensive literature search was conducted in PubMed, Scopus, and Embase (September 2024, final update in March 2025) following PRISMA guidelines. Studies were included if they focused on non-neurogenic OAB and explicitly assessed ANS dysfunction using heart rate variability (HRV), skin sympathetic response (SSR), pupillometry, autonomic function tests, or noradrenergic hormonal system evaluations. Two independent reviewers screened, extracted, and categorized the data into ANS dysfunction and treatment effects on ANS function. Out of 1,285 screened abstracts, 29 studies were included. Thirteen studies investigated ANS dysregulation in OAB, with HRV being the most used method, revealing inconsistent patterns of sympathetic and parasympathetic imbalance. Four studies focused on LUTS-BPH, suggesting a possible role of ANS dysfunction in symptom severity. Fourteen studies examined the impact of treatments, including behavioral interventions, anticholinergics, alpha-blockers, tibial neurostimulation, and sacral neuromodulation, revealing variable effects on ANS function. ANS dysfunction is associated with OAB and LUTS-BPH, though findings are heterogeneous. Future research should focus on identifying distinct ANS response patterns to improve patient stratification and personalized treatments.

Mapping Perioperative Care Randomized Controlled Trials in Sub-Saharan Africa: A Scoping Review.

The World Health Organization has recognized surgical and anesthesia care as integral components of universal health coverage. In sub-Saharan Africa (SSA), 93% of the population lacks access to essential surgical services. Postsurgery mortality in Africa is double the global average. The involvement of anesthesia providers is crucial for improved outcomes. Perioperative research can produce context-specific solutions to challenges faced in the perioperative period. SSA conducts fewer randomized controlled trials (RCTs) than high-income countries, limiting its contribution to global evidence. Our primary objectives were to document the geographical distribution of included RCTs, describe their characteristics, and evaluate the reporting quality using the Consolidated Standards of Reporting Trials (CONSORT)-2010 checklist. We followed the PRISMA Scoping Reviews (PRISMAScR) Checklist. We searched MEDLINE, the Cochrane Library, and Scopus. We identified perioperative care RCTs within SSA published from 2000 to 2022. Two independent reviewers screened potential studies and extracted data in duplicate, with disagreements resolved through consensus or a third reviewer. Quantitative analysis was done with STATA 16, and data were summarized narratively. We compared RCT quality pre-CONSORT-2010 to post-CONSORT-2010, using Pearson's χ2 test or Fisher exact test (as applicable), considering P < .05 as statistically significant. Of 3319 records, 169 eligible RCTs were identified, randomizing 45,376 participants, with a mean sample size of 98. Between the years 2000 and 2022, there was an exponential trend towards an increasing number of RCTs in SSA (y = 1,5619e0,1051x). The RCTs were from 16 countries in SSA. Most studies were single-country, single-center, led by authors from Nigeria (63/169, 37.3 %) and South Africa (41/169, 24.3%). Most interventions were conducted intraoperatively (n = 125/169, 74%). Pharmacotherapy interventions were most investigated (n = 64/169, 37.9%), followed by analgesic interventions (n = 42/169, 24.9%). The surgical discipline most investigated was obstetrics (n = 51/169, 30.2%). The reporting quality was generally poor, with most RCTs not adhering to CONSORT guidelines and failing to register on a trial registry. This scoping review provides a comprehensive overview of perioperative care RCTs in SSA, highlighting limitations such as small sample sizes, under-representation of high surgical burden disciplines, and poor outcome reporting. Clinical trial capacity is limited to a few countries and institutions, and methodological quality remains poor despite reporting guidelines. There is an opportunity to enhance context-appropriate RCTs in SSA by prioritizing high-quality research through collaborative efforts. Our findings serve as a resource for researchers, funders, and policymakers in perioperative care research in Africa to improve future RCT designs and reporting.

Safety and activity of talquetamab in patients with relapsed or refractory multiple myeloma (MonumenTAL-1): a multicentre, open-label, phase 1-2 study.

Talquetamab is the first GPRC5D × CD3 bispecific antibody approved for relapsed or refractory multiple myeloma. In phase 1 of the MonumenTAL-1 study, initial results of subcutaneous talquetamab 0·4 mg/kg once a week and 0·8 mg/kg every 2 weeks showed preliminary clinical activity. We describe safety and activity results in patients treated with talquetamab, including patients who had received previous T-cell redirection therapy (TCR). This post-hoc analysis was done with more mature median follow-up to evaluate duration of response in patients treated with talquetamab 0·8 mg/kg every 2 weeks. MonumenTAL-1 is a multicentre, open-label, phase 1-2 study of talquetamab, phase 1 of which has previously been published. The 0·4 mg/kg once a week and 0·8 mg/kg every 2 weeks recommended subcutaneous doses identified in phase 1 were evaluated in phase 2 in patients who were 18 years of age or older, had at least three previous lines of therapy, had an Eastern Cooperative Oncology Group performance status of 0 to 2, and were naive or exposed to previous TCR. The primary endpoint was overall response rate assessed by independent review committee in all patients who received at least one dose of talquetamab. Safety was assessed in all patients who received at least one dose of talquetamab. This study was registered with ClinicalTrials.gov, NCT03399799 (phase 1) and NCT04634552 (phase 2). Between Jan 3, 2018, and Feb 20, 2023, 735 patients were screened across all phase 1-2 cohorts. Of these, 537 patients screened for inclusion were treated across phase 1 and 2 cohorts, of whom 1983 (27%) patients were excluded from the study, most commonly due to not meeting eligibility criteria or not having measurable disease. As of Oct 11, 2023, 375 patients had received recommended talquetamab doses across three groups: 143 (0·4 mg/kg once a week group) and 154 (0·8 mg/kg every 2 weeks group) TCR-naive patients and 78 with previous TCR who received either recommended dose (previous TCR group). 217 (58%) of 375 patients were male and 158 (42%) were female. 325 (87%) of 375 patients were White and 32 (9%) patients were Black. Median follow-up was 25·6 months (IQR 8·5-25·9) in the 0·4 mg/kg once a week group, 19·4 months (9·2-20·7) in the 0·8 mg/kg every 2 weeks group, and 16·8 months (7·6-18·7) in the previous TCR group. Overall response rate was 74% (106 of 143 patients, 95% CI 66-81) in the 0·4 mg/kg once a week group, 69% (107 of 154 patients, 62-77) in the 0·8 mg/kg every 2 weeks group, and 67% (52 of 78 patients, 55-77) in the previous TCR group. Most common adverse events in the 0·4 mg/kg once a week, 0·8 mg/kg every 2 weeks, and previous TCR groups were cytokine release syndrome (113 [79%] of 143 patients, 115 [75%] of 154 patients, and 57 [73%] of 78 patients), taste changes (103 [72%], 110 [71%], and 59 [76%]), and infections (85 [59%], 105 [68%], and 59 [76%]). Most common grade 3-4 adverse events were neutropenia (44 [31%], 33 [21%], and 37 [47%]), anaemia (45 [31%], 40 [26%], and 21 [27%]), and lymphopenia (37 [26%], 40 [26%], and 13 [17%]). Fatal adverse events occurred in five patients in the 0·4 mg/kg once a week group, seven patients in the 0·8 mg/kg every 2 weeks group, and no patients in the previous TCR group; none were related to treatment. Talquetamab continued to demonstrate high overall response rates in heavily pretreated patients with relapsed or refractory multiple myeloma with longer follow-up in this post-hoc analysis. Overall response rate was promising in patients with previous TCR, including therapies targeting BCMA. On-target, off-tumour adverse events were common but led to few treatment discontinuations. Janssen.

The craniofacial, dental and systemic manifestations of Enamel Renal Syndrome: A Scoping review.

The craniofacial, dental and systemic manifestations of Enamel Renal Syndrome: A Scoping review.

Challenges and support needs among family caregivers involved in solid organ transplant care process: a scoping review protocol

IntroductionFamily caregivers play an indispensable role in the care of solid organ transplant patients, undertaking a wide range of tasks from basic daily care to complex medical management. However, these...

RETRACTED ARTICLE: Construction of intelligent multi-construction management platform for bridges based on BIM technology

We, the Editor-in-Chief and Publisher of Intelligent Buildings International (the “Journal”), have retracted the following articles that were published in the Special Issue titled “Global Education for Sustainable Building Environment: Design, Construction and Maintenance” guest edited by Manju Khari: Wang, Y. (2023). Construction of intelligent multi-construction management platform for bridges based on BIM technology. Intelligent Buildings International, 1–14. https://doi.org/10.1080/17508975.2023.2221841 Zhao, M., Zhang, W., Xing, H., & Zhang, N. (2024). Application and development of BIM technology in prefabricated building design. Intelligent Buildings International, 1–13. https://doi.org/10.1080/17508975.2024.2308578 Following publication, the Publisher identified concerns regarding the editorial handling of the Special Issue and the peer review process. An investigation by the Taylor & Francis Publishing Ethics & Integrity team in full cooperation with the Editor-in-Chief concluded that the articles included in this Special Issue were not peer-reviewed appropriately, in line with the Journal's peer review standards and policy. As the stringency of the peer review process is core to the integrity of the publication process, the Editor-in-Chief and Publisher have decided to retract all of the articles within the above-named Special Issue. The Editor-in-Chief and the Publisher have not confirmed if the authors were aware of this compromised peer review process. The Journal is committed to correcting the scientific record and will fully cooperate with any institutional investigations into this matter. The authors have been informed of this decision. We have been informed in our decision-making by our editorial policies and the COPE guidelines. The retracted articles will remain online to maintain the scholarly record, but they will be digitally watermarked on each page as ‘Retracted’.

Role of circulating tumor DNA in early-stage triple-negative breast cancer: a systematic review and meta-analysis

BackgroundTriple-negative breast cancer (TNBC) accounts for 15% of all breast cancers and carries a worse prognosis relative to other breast cancer subtypes. This systematic review and meta-analysis evaluated the prognostic value of circulating tumor DNA (ctDNA) in early-stage TNBC.MethodsA literature search was conducted using Ovid Medline, Elsevier EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science Databases for publications up to 11/16/2023. Results were uploaded to Covidence and assessed by two independent reviewers. Studies assessing the use of ctDNA to predict recurrence free survival and related outcomes as well as overall survival were included. All recurrence outcomes were combined during analysis. Statistical analysis was performed using Revman Web. Log-hazard ratios (HR) were pooled for studies reporting recurrence and death as a time-to-event outcomes. Odds ratios (OR) were calculated and pooled for studies reporting patient-level data on recurrence, death, and pathological complete response (pCR). Prospero ID: CRD42023492529.ResultsA total of 3,526 publications were identified through our literature search, and 20 publications (n = 1202 patients) were included in the meta-analysis. In studies that reported recurrence as a time-to-event outcome, post-neoadjuvant (before or after surgery) ctDNA + status was associated with a higher likelihood of disease recurrence (HR 4.12, 95% confidence interval [CI] 2.81–6.04). For studies that reported patient-level data, post-neoadjuvant ctDNA + status was associated with higher odds of disease recurrence (OR 6.72, 95% CI 3.61–12.54). Pooled log-HR also revealed that ctDNA + status in the post-neoadjuvant setting (before or after surgery) was associated with worse overall survival (HR 3.26, 95% CI 1.88–5.63).ConclusionsOur findings suggest that ctDNA could be used as a prognostic biomarker to anticipate the risk of relapse. However, it remains unclear if therapeutic intervention for patients who are ctDNA + can improve outcomes. While more studies are needed before incorporating ctDNA into clinical practice, the findings of this meta-analysis are reassuring and show the promise of ctDNA as a biomarker.

Barriers to conversations about deceased organ donation among adults living in the UK: a systematic review with narrative synthesis

ObjectivesTo explore the barriers to conversations about deceased organ donation among adults living in the UK.DesignSystematic review with narrative synthesis.Data sourcesPubMed, MEDline via OVID, APA PsycInfo via EBSCO, Web of...

Effect of Home-based Virtual Reality Training on Upper Extremity Recovery in Patients with Stroke: Systematic Review.

Stroke is a leading cause of long-term disability, often resulting in upper extremity dysfunction. Traditional rehabilitation methods often face challenges such as limited patient access to resources and lack of sustained motivation. Home-based virtual reality (VR) training is gaining traction as an innovative, sustainable and interactive alternative. However, the effect of home-based VR, specifically for upper extremity recovery in patients with stroke, remains insufficiently explored. This systematic review aims to synthesize existing evidence to evaluate the impact of home-based VR interventions on upper extremity function recovery in patients with stroke. This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted across PubMed, Web of Science, Scopus, and CINAHL Ultimate databases, targeting English-language randomized controlled trials (RCTs) published up to June 30, 2024. Eligible studies involved stroke patients with upper extremity dysfunction who received home-based VR interventions. Data extraction was performed by two independent reviewers, and study quality was assessed using the PEDro scale. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was performed instead of a meta-analysis. Eight RCTs with 392 participants were included. This review shows that home-based VR training positively affects upper extremity function recovery in patients with stroke, especially in motor control improvement. Customized VR systems were more effective than commercial VR systems in patients with moderate to severe disorders. Although studies generally showed positive results, differences in intervention protocols and small sample sizes limited the validity of results. The effect of VR therapy also varied based on the VR system type, intervention intensity, and the functional level of patients. This systematic review shows that home-based VR training has a positive impact on upper extremity rehabilitation for stroke patients, particularly in those with varying degrees of dysfunction. However, heterogeneity in study design and differences in outcome measures affect the reliability of the current conclusions. Future studies should include larger, standardized RCTs with long-term follow-up to assess their continued effects. Future research should explore how VR technology can be integrated into comprehensive rehabilitation programs, focusing on patient-centered approaches that incorporate sustainable, personalized technology and support services to optimize recovery outcomes. PROSPERO CRD42024526650; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024526650.

120 Current Clinical Outcomes of Frozen Elephant Trunk Prostheses: where is the evidence?

Abstract Introduction The frozen elephant trunk (FET) procedure remains the mainstay treatment for managing complex aortic pathologies due to its ability to minimise the necessity for second-stage surgeries. The technique utilises hybrid prostheses, and although Thoraflex and E-vita have demonstrated favourable outcomes, much less is known about Cronus and Frozenix-J. This systematic review aims to evaluate the efficacy of the main FET prostheses. Methods A comprehensive search of major databases was performed, and relevant studies were identified by two independent reviewers. MetaXL 5.0 was used to calculate pooled rates for early mortality, stroke, Spinal cord injury (SCI), dSINE and reinterventions. Results In total 40 studies were included, encompassing a total of 6168 patients (2605 E-vita, 1566 Thoraflex, 1416 Frozenix-J and 578 Cronus). The 30-day mortality rates were similar for Thoraflex and E-vita 7% (95 CI 5.0-8.0), 5% for Cronus and 2% for Frozenix J. The dSINE rates were highest among the E-vita group (8%) and lowest using Frozenix-J (4%). Similarly, the stroke, SCI and reintervention rates were higher with Thoraflex (8%, 3% and 17% respectively) compared to other prostheses. While the stroke and SCI rates were lowest among Cronus studies (1%). Frozenix-J reported lower stroke and SCI rates (3%). A direct comparison between prostheses could not be performed due to the heterogeneity of studies. Conclusion Each prosthesis features a unique design and features resulting in varying clinical outcomes. Although there are limited studies, the available data suggests favourable outcomes using less widely available prostheses such as Cronus and Frozenix-J prostheses.

Classifying Continuous Glucose Monitoring Documents From Electronic Health Records.

Clinical use of continuous glucose monitoring (CGM) is increasing storage of CGM-related documents in electronic health records (EHR); however, the standardization of CGM storage is lacking. We aimed to evaluate the sensitivity and specificity of CGM Ambulatory Glucose Profile (AGP) classification criteria. We randomly chose 2244 (18.1%) documents from NYU Langone Health. Our document classification algorithm: (1) separated multiple-page documents into a single-page image; (2) rotated all pages into an upright orientation; (3) determined types of devices using optical character recognition; and (4) tested for the presence of particular keywords in the text. Two experts in using CGM for research and clinical practice conducted an independent manual review of 62 (2.8%) reports. We calculated sensitivity (correct classification of CGM AGP report) and specificity (correct classification of non-CGM report) by comparing the classification algorithm against manual review. Among 2244 documents, 1040 (46.5%) were classified as CGM AGP reports (43.3% FreeStyle Libre and 56.7% Dexcom), 1170 (52.1%) non-CGM reports (eg, progress notes, CGM request forms, or physician letters), and 34 (1.5%) uncertain documents. The agreement for the evaluation of the documents between the two experts was 100% for sensitivity and 98.4% for specificity. When comparing the classification result between the algorithm and manual review, the sensitivity and specificity were 95.0% and 91.7%. Nearly half of CGM-related documents were AGP reports, which are useful for clinical practice and diabetes research; however, the remaining half are other clinical documents. Future work needs to standardize the storage of CGM-related documents in the EHR.