US National Library Research Articles

A Brief Review of the Impact of Ergogenic Supplements for Athletes

Background: The study aims to investigate and evaluate the impacts of energy drink and ergogenic aid use among athletes and examine the possible results of these consumptions. Materials and methods: In the search for scientific literature related to this review the US National Library of Medicine (PubMed) used MEDLINE and Sport Discus data and the terms “energy drink”, “ergogenic aid”, “physical activity” and ‘’sports drink ‘’were used. The relevant literature has also taken its source from the research of relevant articles from reference lists derived from data studies. Results: Energy drinks are known to enhance performance. However, they also pose a possible threat to the athletes’ health. The consequences of energy drink use may result in a variety of disorders such as nervousness, headaches, nausea, organ damage, cardiac disorders, and even sudden death. Conclusion: Achieving top athletic performance is the primary goal for every athlete. For this reason, the use of ergogenic aids is a very common choice among athletes. Water and minerals lost by athletes during exercise and competitions should be replaced with water consumption and sports drinks.

A prospective observational cohort study and systematic review of 40 patients with mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome

ObjectiveMouth and genital ulcers with inflamed cartilage (MAGIC) syndrome is characterized by overlapping features of relapsing polychondritis (RP) and Behcet's disease (BD). To date, no studies have defined the clinical spectrum of disease in a cohort of patients with MAGIC syndrome. MethodsAdult patients within an ongoing prospective, observational cohort study in RP were clinically assessed for MAGIC syndrome. A systematic review was conducted to identify additional cases of MAGIC syndrome by searching four databases: PubMed (US National Library of Medicine), Embase (Elsevier), Scopus (Elsevier) and Web of Science: Core Collection (Clarivate Analytics). The inclusion criteria used were: [1] patients of any age or gender who were diagnosed with MAGIC syndrome, or both RP and BD; [2] case report or case series study; [3] published from 1985 – July 2020; and [4] in English language. Risk of bias was assessed using a checklist developed by the authors and based on the Consensus-based Clinical Case Reporting (CARE) Guidelines. Search results screening, article inclusion, data extraction and risk of bais assessment was performed independently by two investigators. Clinical characteristics, particularly BD-related features, were compared between patients with MAGIC syndrome and cases of non-MAGIC RP. The performance characteristics of different criteria to classify MAGIC syndrome were also evaluated. ResultsOut of 96 patients with RP, 13 (14%) patients were diagnosed with MAGIC syndrome. For the systematic review, 380 articles were retrieved of which 90 were screened at title and abstract levels. Of these screened, 60 were excluded and 30 proceeded to full text review where an additional 8 were excluded. Twenty-two articles were included in our review and from which 27 additional cases of MAGIC syndrome were identified. Pooling all 40 cases together and comparing them with non-MAGIC RP, there was a significantly higher prevalence of ocular involvement (28% vs 4%, p<0.01), cutaneous involvement (35% vs 1%, p<0.01), GI involvement (23% vs 4%, p<0.01), and CNS involvement (8% vs 0, p = 0.04) in MAGIC syndrome. A higher prevalence of aortitis (23% vs 1%, p<0.01), Raynaud's phenomenon (54% vs 11%, p<0.01), and elevated anti-collagen II antibodies (50% vs 9%, p = 0.04) were observed in MAGIC syndrome. Fulfillment of either McAdam's or Damiani's Criteria for RP plus the International Criteria for Behçet's Disease had excellent sensitivity (98%) to classify cases of MAGIC syndrome. ConclusionA substantial proportion of patients with RP can be clinically diagnosed with MAGIC syndrome. These patients have features of RP, BD, and other unique features including aortitis, Raynaud's phenomenon and elevated anti-collagen II antibodies.

Pharmacotherapy for nontuberculous mycobacterial pulmonary disease.

To provide an updated review of the diagnosis and pharmacotherapy of nontuberculous mycobacteria pulmonary disease (NTM-PD) and summarize guideline recommendations for an interdisciplinary treatment approach. A systemic approach was taken in which all articles in English in MEDLINE and PubMed were reviewed. The US National Library of Medicine's DailyMed database was used to assess drug package inserts. Analysis of NTM treatment guidelines is summarized in the article with a focus on medications, dosing, interactions, and medication monitoring. It is critical to manage patients with NTM with a multidisciplinary team approach. Treatment is prolonged and expensive, and the potential for drug toxicity, adverse effects, and drug interactions requires monitoring. Clinical pharmacists play a role in the management of NTM.

Obstructive sleep apnea: a modern view of the problem

Introduction. In recent years, there has been evidence not only of the widespread prevalence of the obstructive sleep apnea (OSA) in the population, but also of the progression of the disease in the dynamic follow-up of patients. The purpose of this review article is to analyze the current state of etiopathogenesis, clinics of obstructive sleep apnea and to identify more promising treatment approaches and risk factors for its development. Materials and methods. The analysis of publications was performed for the period 2016-2021 on the basis of data from Elibrary, the Federal Electronic Medical Library of the Ministry of Health of the Russian Federation, the bibliographic database of medical publications MEDLINE, created by the US National Library of Medicine. Sixty-one sources were selected for the review. Results and discussion. Obstructive sleep apnea is widely represented in the group of sleep disorders and is correlated with a number of clinical conditions: cardiovascular diseases (acute cerebrovascular disease, resistant arterial hypertension, coronary heart disease, heart rhythm disorder), endocrine system (diabetes mellitus, hypothyroidism, metabolic syndrome, obesity), ophthalmological pathology (neurooptikopathies), sudden death, etc. Severe daytime sleepiness due to OSA is not only a medical but also a social problem due to increased injury rates, accidents at work and on the road, and decreased labor productivity. Conclusion. The introduction of a comprehensive interdisciplinary approach to diagnostic standards will improve the detection and treatment of obstructive sleep apnea and improve the quality of life of patients. Change of lifestyle and use of PAP-therapy in patients with OSA is currently the most adequate direction in the treatment of this pathology. High prevalence, serious consequences for the nation's health and economy dictate the need for further study of markers of this disease for early prediction and primary prevention of cardiovascular diseases and diseases associated with obstructive sleep apnea.

The roles of the US National Library of Medicine and Donald A.B. Lindberg in revolutionizing biomedical and health informatics.

Over a 31-year span as Director of the US National Library of Medicine (NLM), Donald A.B. Lindberg, MD, and his extraordinary NLM colleagues fundamentally changed the field of biomedical and health informatics-with a resulting impact on biomedicine that is much broader than its influence on any single subfield. This article provides substance to bolster that claim. The review is based in part on the informatics section of a new book, "Transforming biomedical informatics and health information access: Don Lindberg and the US National Library of Medicine" (IOS Press, forthcoming 2021). After providing insights into selected aspects of the book's informatics-related contents, the authors discuss the broader context in which Dr. Lindberg and the NLM accomplished their transformative work.

Current approaches to HIV vaccine development: a narrative review.

IntroductionThe development of an effective vaccine to protect against HIV is a longstanding global health need complicated by challenges inherent to HIV biology and to the execution of vaccine efficacy testing in the context of evolving biomedical prevention interventions. This review describes lessons learnt from previous efficacy trials, highlights unanswered questions, and surveys new approaches in vaccine development addressing these gaps.MethodsWe conducted a targeted peer‐reviewed literature search of articles and conference abstracts from 1989 through 2021 for HIV vaccine studies and clinical trials. The US National Library of Medicine's Clinical Trials database was accessed to further identify clinical trials involving HIV vaccines. The content of the review was also informed by the authors’ own experience and engagement with collaborators in HIV vaccine research.DiscussionThe HIV vaccine field has successfully developed multiple vaccine platforms through advanced clinical studies; however, the modest efficacy signal of the RV144 Thai trial remains the only demonstration of HIV vaccine protection in humans. Current vaccine strategies include prime‐boost strategies to improve elicitation of immune correlates derived from RV144, combination mosaic antigens, novel viral vectors, antigens designed to elicit broadly neutralizing antibody, new nucleic acid platforms and potent adjuvants to enhance immunogenicity across multiple classes of emerging vaccine candidates.ConclusionsHIV vaccine developers have applied lessons learnt from previous successes and failures to innovative vaccine design approaches. These strategies have yielded novel mosaic antigen constructs now in efficacy testing, produced a diverse pipeline of early‐stage immunogens and novel adjuvants, and advanced the field towards a globally effective HIV vaccine.

A Clinical Review of the Psychiatric Sequelae of Primary Hyperparathyroidism.

Despite one-quarter of patients with primary hyperparathyroidism (PHPT) experiencing psychiatric symptoms, there remains a dearth of literature regarding the diagnosis and further management of psychiatric sequelae in PHPT. We aim to review the literature pertaining to the epidemiology, disease presentation, pathophysiology, diagnostics, and therapeutics regarding psychiatric sequelae of PHPT with an emphasis on clinical pearls for practicing psychiatrists. A literature search was conducted using the US National Library of Medicine’s PubMed resource using the following keywords in various combinations: primary hyperparathyroidism, neuropsychiatric, calcium, psychosis, mania, depression, catatonia, delirium, parathyroidectomy, and psychotropic medication. We discuss in depth all aspects of the diagnosis and management of psychiatric sequela in PHPT. We have also identified epidemiological trends, discussed the most common clinical presentations, and postulated possible mechanisms for psychiatric symptoms in PHPT. Psychiatrists should maintain diagnostic suspicion for PHPT in older adult female patients presenting with new-onset psychiatric illness. Several mechanisms involving the following may explain the variety of psychiatric symptoms in PHPT: tyrosine hydroxylase, parathyroid hormone, interleukin-6, monoamine oxidase, calcium, and the sodium-potassium adenosine triphosphatase transporter. We recommend psychiatrists take a symptom-oriented approach to management. Treating a patient’s psychosis, mania, depression, catatonia, delirium, or eating disorder pathology via conventional therapeutics seems like a rational approach despite the underlying medical etiology. Only parathyroidectomy has been proven to be definitive in the complete amelioration of psychiatric symptoms.

The incidence of depressive disorders in patients with schizophrenia

Summary. Introduction. Historically, depressive disorders have been described in various forms of schizophrenia by Kraepelin (1923) or as a reaction to illness by Bleuler (1922). One of the alternative points of view that has been considered in recent years is that depressive disorders are a comorbid condition of schizophrenia or one of the manifestations of schizophrenia. However, to date, depression, as a symptom, is not included in the diagnostic criteria of the ICD-10. Methodological approaches to diagnosing depressive disorders in patients with schizophrenia differ in different countries and research groups. This influences the prevalence rates of depressive disorders in schizophrenic patients. Purpose. The study and systematization of studies of the incidence of depressive disorders in patients with schizophrenia.Methods. Russian-language and foreign literature was analyzed with a search depth of 10 years (2010–2020) in the following databases: PubMed, Springer, Wiley Online Library, Taylor &amp; Francis Online, US National Library of Medicine National Institutes of Health, Science Direct and eLIBRARY .RU.Results. A total of 51 studies of depressive disorders in children and adults with schizophrenia were found.Conclusion. The frequency of occurrence of depressive disorders in patients with schizophrenia varies from 9.1 and to 100%, the average frequency is 41.6%. Their frequency is variable and depends on the region of residence and ethnicity. It is noted that depressive disorders in patients with schizophrenia are more often recorded among residents of the Middle East (72.7%), Russia (61.8%) and Europe (39.6%), less often among residents of Southeast Asia (32%) and the Pacific region ( 37.3%). The countries with the highest incidence of depressive disorders in schizophrenia include: USA, Germany, China; and to the countries with the lowest frequency — Denmark, Israel, South Africa. Also, I would like to note that the largest number of studies conducted was in Europe (16 studies with 36 928 patients with schizophrenia), the USA (6 studies with 2314 patients) and the Russian Federation (6 studies with 582 patients). In general, in the world, according to 51 studies analyzed, the incidence of depressive disorders in schizophrenia in men is higher than in women, although gender differences did not reach statistical significance in all regions of the world.

FINITE ELEMENT ANALYSIS OF ROOT RESORPTION ASSOCIATED WITH TOOTH MOVEMENT: A SYSTEMATIC REVIEW”

Background: The purpose of this systematic review was to examine the available evidence of root resorption during orthodontic treatment with different force systems using nite element analysis. Methods: The following electronic databases were searched for literature till June 2021 : Pro-Quest Dissertation Abstracts and Thesis database, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Google Scholar, Embase, US National Library of Medicine, and National Research Register. Root resorption studied under orthodontic forces, which simulated under various technique of nite element method (3D FEM) models were included in the study. The selected studies were assessed for the risk of bias using the Cochrane Collaboration risk of bias tool. The “trafc plot” and “weighted plot” risk of bias distribution were designed using the ROBVIS tool. The authors extracted and analyzed the data. Results: Fourteen studies fullled the inclusion criteria. The risks of biases were high for all studies.Data on quantity and direction of force applied, different type of root morphology and its various surface inuence on root resorption were extracted. The outcomes of the included studies were heterogeneous. Conclusion: Based on the current available literature, for reducing root resorption the excessive force may accelerate root resorption when it exceeds the typical human capillary blood pressure. Root resorption occurs more when extrusion/intrusion and tipping occur than when teeth actually move. A tooth with little or no orthodontic force load hardly shows any root resorption compared to one that has orthodontic force.

Integrative Review Verification of the Influence of Atrazine Exposure on Behavioral, Neurochemical and Parkinsons Disease Disorders

Herbicides represent the largest portion of pesticides used both worldwide and in Brazil. Many of these compounds are applied on a large scale in native forests and in urban and industrial water environments, including atrazine. Due to its low cost, ability to remain active in the soil for long periods and potential effect on weed removal, atrazine ranks 5th in the ranking of most used pesticide in Brazil. Although the use of pesticides increases agricultural production, their intensive use can often cause negative effects on fauna and flora. Studies have shown that exposure to atrazine can cause various harmful effects in mammals, of both sexes, such as structural, neuroendocrine and/or behavioral changes. Considering the seriousness of the situation and the possible toxicological and pathological implications that atrazine can generate in the animal organism, the objective of this work was to carry out an integrative literature review in order to verify the scientific panorama on issues related to atrazine exposure and its impacts, mainly with regard to its toxicity on the central nervous system. To carry out this article, a bibliographic survey of scientific material obtained in the following databases was carried out: US National Library of Medicine - National Institutes of Health (PubMed), Virtual Health Library (Latin American and Caribbean Literature in Health Sciences - LILACS), Science Direct and Google® Academic, in the last 25 years. The MeSH Terms used in the search were: “Parkinson's disease”, “atrazine”, “herbicide” and “endocrine disruptor”. The following were found in the Science Direct indexers: 115 records, PubMed 52 records, in LILACS no articles were found, and 1330 records were found in Google® Academic.

Regional Innovation Systems of Medical Technology

We investigated the role of external funding in cardiovascular device innovation across 31 countries in Europe. We rely on the knowledge production function (KPF) framework that establishes the knowledge output of a region as a function of innovatory effort and other characteristics of that region. In a cross-sectional analysis, we investigated regional variation in knowledge production by the number of publications in cardiovascular device research obtained from the bibliometric data of the world’s largest biomedical library, the US National Library of Medicine, 2014‒2017. We mapped these publications to product categories of medical devices approved for cardiovascular diseases by the US Food and Drug Administration. Considering spatial correlation across regions of Europe in our estimates of the KPF, we investigated the impact of two types of funding mechanisms: grants reported in the publications and the volume of European Union Horizon 2020 funding received by the innovating regions. We obtained 123,487 cardiovascular device-related publications distributed across 1,051 (75% of total) regions (NUTS-3 level). Receiving external funding strongly contributes to a region’s knowledge output. The estimated elasticities of innovatory effort range between 0.51 and 0.64. These estimates were consistently larger than the elasticities of other characteristics in the region measured by gross domestic product (0.14‒0.56). We also documented spillover effects from neighboring regions when the funding was measured by the grants reported in the publications, concluding that innovatory efforts in the form of external research investments are effective for promoting innovation in the medical device industry at the regional level.

Posterior reversible leukoencephalopathy syndrome associated with acute postinfectious glomerulonephritis: systematic review

BackgroundKidney diseases are a recognized cause of posterior reversible leukoencephalopathy syndrome, usually abbreviated as PRES. The purpose of this review was to systematically address the association between acute postinfectious glomerulonephritis and PRES.MethodsWe performed a systematic review of the literature on acute postinfectious glomerulonephritis associated with PRES. The principles recommended by the Economic and Social Research Council guidance on the conduct of narrative synthesis and on the Preferred Reporting Items for Systematic Reviews and Meta-analyses were used. Databases searched included Excerpta Medica, US National Library of Medicine, and Web of Science.ResultsFor the final analysis, we evaluated 47 reports describing 52 cases (32 males and 20 females). Fifty patients were ≤ 18 years of age. Blood pressure was classified as follows: normal-elevated (n = 3), stage 1 hypertension (n = 3), stage 2 hypertension (n = 5), and severe hypertension (n = 41). Acute kidney injury was classified as stage 1 in 32, stage 2 in 16, and stage 3 in four cases. Neuroimaging studies disclosed a classic posterior PRES pattern in 28 cases, a diffuse PRES pattern in 23 cases, and a brainstem-cerebellum PRES pattern in the remaining case. Antihypertensive drugs were prescribed in all cases and antiepileptic drugs in cases presenting with seizures. A resolution of clinical findings and neuroimaging lesions was documented in all cases with information about follow-up.ConclusionsThe main factor associated with PRES in acute postinfectious glomerulonephritis is severe hypertension. Prompt clinical suspicion, rapid evaluation, and management of hypertension are crucial.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

HLA-DRB1 risk alleles for RA are associated with differential clinical responsiveness to abatacept and adalimumab: data from a head-to-head, randomized, single-blind study in autoantibody-positive early RA

BackgroundCertain risk alleles associated with autoantibody-positive rheumatoid arthritis (RA) have been linked to poorer prognoses. In patients with autoantibody-positive RA, abatacept shows differential efficacy to tumor necrosis factor inhibitors. Our aim was to investigate the relationship between clinical response to abatacept and to adalimumab and presence of risk alleles encoding human leukocyte antigen (HLA)-DRB1 shared epitope (SE) in RA.MethodsIn this head-to-head study, biologic-naïve adults with early (≤ 12 months), moderate-to-severe RA and inadequate response to methotrexate (MTX-IR), autoantibody-positive for both anti-cyclic citrullinated peptide 2 and rheumatoid factor, were randomized 1:1 to receive subcutaneous abatacept 125 mg weekly or subcutaneous adalimumab 40 mg every 2 weeks for 24 weeks with stable, weekly oral MTX. An open-label period to 48 weeks followed, during which adalimumab-treated patients were switched to abatacept. Patients were genotyped for HLA-DRB1 alleles and classified as SE-positive (≥ 1 SE allele) or SE-negative (no SE alleles). Efficacy was assessed at weeks 24 and 48.ResultsForty patients each received abatacept (9 SE-negative, 30 SE-positive, one unknown) or adalimumab (9 SE-negative, 31 SE-positive). Mean age and disease duration were 46.0 years and 5.5 months, respectively. At week 24, a greater percentage of abatacept patients achieved 50% improvement in ACR criteria (ACR50) compared with adalimumab patients (73% vs 45%, respectively) and estimate of difference (95% confidence interval [CI]), 28 (5, 48). In SE-positive patients, ACR50 estimate of difference (95% CI) was 32 (7, 55). During the open-label period, responses were sustained in the abatacept non-switch group and showed trends toward further improvement in the adalimumab-to-abatacept switch group at week 48, in both the overall and the SE-positive subpopulation. No new safety signals were identified.ConclusionsIn MTX-IR patients with early, autoantibody-positive RA, abatacept resulted in numerically higher efficacy responses versus adalimumab after 24 weeks, with more pronounced treatment differences in SE-positive patients. After 48 weeks, responses were sustained in patients who continued abatacept while those who switched to abatacept showed further clinical improvement, overall, and in SE-positive patients. This supports co-stimulation blockade as an effective treatment strategy for patients with early, autoantibody-positive RA, particularly among SE-positive patients.Trial registrationNIH US National Library of Medicine, NCT02557100. Registered on September 23, 2015.

Mind-Body Health Benefits of Traditional Chinese Qigong on Women: A Systematic Review of Randomized Controlled Trials.

Most women live with an inactive lifestyle, which suggests a need for preference-based choices to promote their participation in physical activity. This systematic review synthesized key findings on the health benefits of Qigong among women. We conducted a systematic search of randomized controlled trials (RCTs) of Qigong among women according to the PRISMA guidelines using the following databases from their inception through March 2021: PubMed/MEDLINE, Web of Science, Cochrane Library, and US National Library of Medicine. The risk of bias was examined using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. Altogether, 18 RCTs were included for final review. Results showed that Qigong was a feasible exercise in improving health outcomes, particularly depressive symptoms (63% of trials), quality of life (43%), and fatigue (29%), among general women, intimate partner violence survivors, and women with chronic conditions (e.g., breast cancer patients or survivors). Almost 90% (7/8) of trials reported high adherence rates ranging from 73 to 95% for supervised group training and 63 to 80% for home self-practice. Thus far, there was no evidence of serious adverse effects from performing Qigong. For the risk of bias across trials, a lack of allocation concealment (72% of trials), no blinding of participants and personnel (67%), and incomplete outcome data (67%) were the major sources. In summary, Qigong is a safe, feasible, and beneficial exercise for general women, abused sufferers, and health-compromised women. However, given the potential risk of bias found in many studies, improved rigor of study design in future trials will be imperatively required.

A Structured Review of the Literature on Abusive Head Trauma Prevention

We searched the US National Library of Medicine's PubMed, Google Scholar and the American Psychological Association's Psychinfo databases during September 2019 for citations and abstracts on abusive head trauma (AHT) and shaken baby syndrome prevention dated 1 January 2000 to 31 August 2019. We identified 53 empirical studies and performed a structured review to identify the effects of prevention, if any, on AHT. We identified three lines of investigation that have focused on: (i) strategies which teach parents how to respond to newborn crying and the dangers of shaking babies; (ii) community and public health factors; and (iii) professional education and practice. Most studies were observational, although a small number used sophisticated designs such as prospective or randomised controlled trials. We note other strengths and weaknesses of these articles and suggest future directions for research in each of these areas based on the current level of scientific inquiry.‘Identified 53 empirical studies and performed a structured review to identify the effects of prevention… on AHT’Key Practitioner Messages Research on AHT prevention is limited, although a growing research base supports teaching parents how to respond to newborn crying and about the dangers of shaking babies. Social care systems addressing provision of material and other support have positive effects on AHT rates. Professional education should improve practitioners' identification of families with increased risk and enhance AHT identification and treatment. Those wishing to prevent AHT should consider multilevel approaches and their own community needs, practice setting, and patient/client risk profiles when designing strategies.

Ertugliflozin and Slope of Chronic eGFR: Prespecified Analyses from the Randomized VERTIS CV Trial.

A reduction in the rate of eGFR decline, with preservation of ≥0.75 ml/min per 1.73 m2 per year, has been proposed as a surrogate for kidney disease progression. We report results from prespecified analyses assessing effects of ertugliflozin versus placebo on eGFR slope from the eValuation of ERTugliflozin effIcacy and Safety CardioVascular outcomes (VERTIS CV) trial (NCT01986881). Patients with type 2 diabetes mellitus and established atherosclerotic cardiovascular disease were randomized to placebo, ertugliflozin 5 mg, and ertugliflozin 15 mg (1:1:1). The analyses compared the effect of ertugliflozin (pooled doses, n=5499) versus placebo (n=2747) on eGFR slope per week and per year by random coefficient models. Study periods (weeks 0-6 and weeks 6-52) and total and chronic slopes (week 0 or week 6 to weeks 104, 156, 208, and 260) were modeled separately and by baseline kidney status. In the overall population, for weeks 0-6, the least squares mean eGFR slopes (ml/min per 1.73 m2 per week [95% confidence interval (95% CI)]) were -0.07 (-0.16 to 0.03) and -0.54 (-0.61 to -0.48) for the placebo and ertugliflozin groups, respectively; the difference was -0.47 (-0.59 to -0.36). During weeks 6-52, least squares mean eGFR slopes (ml/min per 1.73 m2 per year [95% CI]) were -0.12 (-0.70 to 0.46) and 1.62 (1.21 to 2.02) for the placebo and ertugliflozin groups, respectively; the difference was 1.74 (1.03 to 2.45). For weeks 6-156, least squares mean eGFR slopes (ml/min per 1.73 m2 per year [95% CI]) were -1.51 (-1.70 to -1.32) and -0.32 (-0.45 to -0.19) for the placebo and ertugliflozin groups, respectively; the difference was 1.19 (0.95 to 1.42). During weeks 0-156, the placebo-adjusted difference in least squares mean slope was 1.06 (0.85 to 1.27). These findings were consistent by baseline kidney status. Ertugliflozin has a favorable placebo-adjusted eGFR slope >0.75 ml/min per 1.73 m2 per year, documenting the kidney function preservation underlying the clinical benefits of ertugliflozin on kidney disease progression in patients with type 2 diabetes mellitus and atherosclerotic cardiovascular disease. US National Library of Medicine, ClinicalTrials.gov NCT01986881. Date of trial registration: November 13, 2013.

The efficient and disciplined path to the indexing of Latin American journals in PubMed

In 1997, the US National Library of Medicine (NLM) developed an Internet search system for publications in the medical field based on the MEDLINE database, PubMed.PubMed was established in 1966 and has more than 32 million citations in 5400 American journals from 80 countries around the world, offering users multiple ways to search for these publications. They can be searched by title, by field, by author, by diagnosis, or a multitude of other ways.&#x0D; This search tool is offered as a free service by NLM and has completely changed information systems in the medical field worldwide, making the electronic publication of scientific papers possible and desirable.&#x0D; The vast majority of these publications are originally from the MEDLINE database of NLM, but there are other publication sources.&#x0D; Belonging to PubMed makes the publication, the authors, the institution, and the research itself accessible without restrictions.&#x0D; There is currently a large number of requirements to include a journal in PubMed. Some are of a legal nature, such as the International Standard Serial Number (ISSN), others refer to journal publication frequency (at least 25 peer-reviewed articles published), and some refer to the quality and type of articles (minimum number of original studies, case reports, etc.).&#x0D; With the online publication of a large number of journals, PubMed is able to classify journals into more restricted categories – for example, accepting journals devoted exclusively to surgical techniques.&#x0D; The requirements are published and easily accessible, but Latin American journals have great difficulty in getting indexed. In the field of orthopedics in Latin America, the Brazilian Orthopaedic Journal (RBO), Acta Ortopédica Brasileira, and Revista Mexicana de Ortopedia y Traumatología are the only ones indexed.Assessments are conducted by third-party assessors who place great value on some points, about which we were able to learn through RBO’s indexing process.&#x0D; 1. PublisherPublishers with an international reach are more valued, as they already have established contracts and methods.&#x0D; 2. Publication frequencyFrom 20 to 25 issues of the journal are usually analyzed, as well as publication time (how long the journal has been published) and the regularity of publications.&#x0D; 3. Citations by peersFrequency with which authors cite studies published in the applicant journal in the manuscript they are submitting for publication in the journal in question.&#x0D; 4. Streamlined and qualified editorial staff“Latin” editorial boards with a large number of members are viewed with reservation. Having members from other countries in the editorial board is a valued resource, but they should confirm their participation when questioned.&#x0D; 5. Diversity of authors regarding the origin of publications Assessors check whether there are authors from various origins, and not always the same authors being frequently cited.&#x0D; 6. Indexing in other databases (eg, LILACS)Even though the database is a regional one, the assessors will consider that the journal has already been through other assessments.&#x0D; 7. A recommendation made from an international author to the board of directors of PubMed’s orthopedics field has considerable weight.&#x0D; Getting indexed is a long way to go. However, as in any path to improvement, the process will provide parallel gains for the journal and its authors.

The Impact of Rheumatoid Arthritis on Bone Loss: Links to Osteoporosis and Osteopenia.

Rheumatoid arthritis (RA) is an autoimmune chronic connective tissue disease that produces persistent systemic inflammation, with joint inflammation leading to function loss and joint destruction. Low bone mass causes skeletal bone loss, commonly referred to as osteopenia or osteoporosis. We conducted this literature review to examine the relationship between RA and osteoporosis and the variables contributing to this connection. We used articles from the US National Library of Medicine (PubMed), Google Scholar, Science Direct to access the required information. Eventually, our results concluded that RA could result in local periarticular and generalized bone loss. Many risk factors contribute to this association, such as chronic joints inflammation, glucocorticoid use, genetics, and estrogen hormone effects. Still, it is not clear yet whether this is due to a consequence of treatment, immobility, or the activity of the disease. There are many recommendations by the American College of Rheumatology for RA patients during the disease course to reduce the risk of osteoporosis development, which include early starts of disease-modifying anti-inflammatory drugs (DMARDs), doing a dual-energy x-ray (DXA) or quantitative ultrasound (QUS) for identifying a patient at risk of osteoporosis, taking vitamin D, calcium, and bisphosphonates. Further prospective studies and clinical trials are essential to provide a solid evidence-based recommendation that will help to prevent bone loss in RA patients.

Diversity and Inclusion in Pancreatic Cancer Clinical Trials

Diversity and Inclusion in Pancreatic Cancer Clinical Trials

Variable trajectory: a systematic review, analytic synthesis and construct domain consolidation of international measures of competence in doctors and medical students

BackgroundCompetence is assessed throughout a doctor’s career. Failure to identify and manage impaired competence can have critical consequences. Consistent conceptualisation and accurate measurement of this construct is imperative. Therefore, the...