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JAMA Network Open Jul 2024Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use.... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use. Rules with high sensitivity risk increasing inappropriate transport of nonsurvivors, while rules without excellent specificity risk missed survivors. Further examination of the performance of TOR rules in estimating survival of out-of-hospital cardiac arrest (OHCA) is needed.
OBJECTIVE
To determine whether TOR rules can accurately identify patients who will not survive an OHCA.
DATA SOURCES
For this systematic review and meta-analysis, the MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science databases were searched from database inception up to January 11, 2024. There were no restrictions on language, publication date, or time frame of the study.
STUDY SELECTION
Two reviewers independently screened records, first by title and abstract and then by full text. Randomized clinical trials, case-control studies, cohort studies, cross-sectional studies, retrospective analyses, and modeling studies were included. Systematic reviews and meta-analyses were reviewed to identify primary studies. Studies predicting outcomes other than death, in-hospital studies, animal studies, and non-peer-reviewed studies were excluded.
DATA EXTRACTION AND SYNTHESIS
Data were extracted by one reviewer and checked by a second. Two reviewers assessed risk of bias using the Revised Quality Assessment Tool for Diagnostic Accuracy Studies. Cochrane Screening and Diagnostic Tests Methods Group recommendations were followed when conducting a bivariate random-effects meta-analysis. This review followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) statement and is registered with the International Prospective Register of Systematic Reviews (CRD42019131010).
MAIN OUTCOMES AND MEASURES
Sensitivity and specificity tables with 95% CIs and bivariate summary receiver operating characteristic (SROC) curves were produced. Estimates of effects at different prevalence levels were calculated. These estimates were used to evaluate the practical implications of TOR rule use at different prevalence levels.
RESULTS
This review included 43 nonrandomized studies published between 1993 and 2023, addressing 29 TOR rules and involving 1 125 587 cases. Fifteen studies reported the derivation of 20 TOR rules. Thirty-three studies reported external data validations of 17 TOR rules. Seven TOR rules had data to facilitate meta-analysis. One clinical study was identified. The universal termination of resuscitation rule had the best performance, with pooled sensitivity of 0.62 (95% CI, 0.54-0.71), pooled specificity of 0.88 (95% CI, 0.82-0.94), and a diagnostic odds ratio of 20.45 (95% CI, 13.15-31.83).
CONCLUSIONS AND RELEVANCE
In this review, there was insufficient robust evidence to support widespread implementation of TOR rules in clinical practice. These findings suggest that adoption of TOR rules may lead to missed survivors and increased resource utilization.
Topics: Out-of-Hospital Cardiac Arrest; Humans; Cardiopulmonary Resuscitation; Emergency Medical Services; Clinical Decision Rules; Resuscitation Orders
PubMed: 38958975
DOI: 10.1001/jamanetworkopen.2024.20040 -
Journal of Fluorescence Jul 2024Three d metal complexes, ZnL(OAc) (1), CdL(OAc) (2) and [CdL(NO)]·CHCN (3) were synthesized using the ligand...
Three d metal complexes, ZnL(OAc) (1), CdL(OAc) (2) and [CdL(NO)]·CHCN (3) were synthesized using the ligand (E)-N-(3-methoxy-4-methylphenyl)-1-(quinolin-2-yl)methanimine (L) and characterized by FT-IR spectra, NMR spectra, and CHN elemental analysis. Single-crystal X-ray diffraction analysis revealed that complexes 1 and 2 are isostructural, with the central metal adopting a hexacoordinate octahedral geometry, while complex 3 adopts a triangular dodecahedron geometry. Thermal gravimetric analysis showed that these complexes exhibit good thermal stability. Solid-state fluorescence spectroscopy measurements demonstrated that complexes 1-3 exhibit bright yellow-green fluorescence (λ = 564 nm for 1; 524 nm for 2; 542 nm for 3), suggesting their potential as photoluminescent materials. Furthermore, DFT calculations, including frontier molecular orbitals, energy levels, and surface electrostatic potential, provided insights into the structural and electronic spectral properties of complexes 1-3.
PubMed: 38958906
DOI: 10.1007/s10895-024-03786-7 -
Tropical Animal Health and Production Jul 2024Seasonal scarcity of quality feed continues to be a bottleneck for agro-pastoralists and is the most important limitation to livestock production in agro-pastoral...
Seasonal scarcity of quality feed continues to be a bottleneck for agro-pastoralists and is the most important limitation to livestock production in agro-pastoral systems in the West African Sahel. In this regard, diverse promising technologies to increase the production and availability of quality feed have been introduced. Despite the introduction of various feed technologies in the region, the adoption rate by smallholder farmers is very low. The objective of this study was to identify factors affecting the likelihood of using improved livestock feed technologies among agro-pastoral households in two regions of Niger. A logit model was employed using data collected from randomly selected 218 agro-pastoral households between February and April 2023. The study revealed low awareness and use of improved livestock feed technologies among agro-pastoral households. The findings suggested the positive impact of education level, membership of farmer groups and ownership of small ruminant on enhancing the probability of using improved livestock feed technologies. Households' geographical area was one of the determinant factors in using improved livestock feed technologies. The use of improved livestock feed technologies was also influenced by family size. The study provides guidance to inform strategies by the decision-makers to enhance the utilization of improved livestock feed technologies among agro-pastoral households in the West African Sahel. Suggested strategies may in turn alleviate the current problem of low productivity of livestock, contribute to improving household food security and nutrition among agro-pastoral communities.
Topics: Animal Husbandry; Animals; Animal Feed; Niger; Livestock; Family Characteristics; Farmers; Humans; Awareness
PubMed: 38958837
DOI: 10.1007/s11250-024-04052-5 -
Health Economics Review Jul 2024Significant gaps in scholarship on the cost-benefit analysis of haemodialysis exist in low-middle-income countries, including Nigeria. The study, therefore, assessed the...
BACKGROUND
Significant gaps in scholarship on the cost-benefit analysis of haemodialysis exist in low-middle-income countries, including Nigeria. The study, therefore, assessed the cost-benefit of haemodialysis compared with comprehensive conservative care (CCC) to determine if haemodialysis is socially worthwhile and justifies public funding in Nigeria.
METHODS
The study setting is Abuja, Nigeria. The study used a mixed-method design involving primary data collection and analysis of secondary data from previous studies. We adopted an ingredient-based costing approach. The mean costs and benefits of haemodialysis were derived from previous studies. The mean costs and benefits of CCC were obtained from a primary cross-sectional survey. We estimated the benefit-cost ratios (BCR) and net benefits to determine the social value of the two interventions.
RESULTS
The net benefit of haemodialysis (2,251.30) was positive, while that of CCC was negative (-1,197.19). The benefit-cost ratio of haemodialysis was 1.09, while that of CCC was 0.66. The probabilistic and one-way sensitivity analyses results demonstrate that haemodialysis was more cost-beneficial than CCC, and the BCRs of haemodialysis remained above one in most scenarios, unlike CCC's BCR.
CONCLUSION
The benefit of haemodialysis outweighs its cost, making it cost-beneficial to society and justifying public funding. However, the National Health Insurance Authority requires additional studies, such as budget impact analysis, to establish the affordability of full coverage of haemodialysis.
PubMed: 38958775
DOI: 10.1186/s13561-024-00529-z -
Oncotarget Aug 2023With the rapid adoption of immunotherapy into clinical practice for HPV-associated malignancies, assessing tumor burden using "liquid biopsies" would further our... (Review)
Review
With the rapid adoption of immunotherapy into clinical practice for HPV-associated malignancies, assessing tumor burden using "liquid biopsies" would further our understanding of clinical outcomes mediated by immunotherapy and allow for tailoring of treatment based on real-time tumor dynamics. In this review, we examine translational studies on peripheral surrogates of tumor burden derived from peripheral blood in HPV-associated malignancies, including levels and methylation of circulating tumor DNA (ctDNA), miRNA derived from extracellular vesicles, circulating tumor cells (CTCs), and HPV-specific antibodies and T cell responses. We review their utility as prognostic and predictive biomarkers of response to chemotherapy and radiation, with a focus on how they may inform and guide immunotherapies to treat locally advanced and metastatic HPV-associated malignancies. We also highlight unanswered questions that must be addressed to translate and integrate these peripheral tumor biomarkers into the clinic.
Topics: Humans; Papillomavirus Infections; Immunotherapy; Biomarkers, Tumor; Tumor Burden; Circulating Tumor DNA; Neoplasms; Neoplastic Cells, Circulating; Prognosis; Liquid Biopsy
PubMed: 38958745
DOI: 10.18632/oncotarget.28487 -
Analytical and Bioanalytical Chemistry Jul 2024The study of glycoproteomics presents a set of unique challenges, primarily due to the low abundance of glycopeptides and their intricate heterogeneity, which is...
The study of glycoproteomics presents a set of unique challenges, primarily due to the low abundance of glycopeptides and their intricate heterogeneity, which is specific to each site. Glycoproteins play a crucial role in numerous biological functions, including cell signaling, adhesion, and intercellular communication, and are increasingly recognized as vital markers in the diagnosis and study of various diseases. Consequently, a quantitative approach to glycopeptide research is essential. One effective strategy to address this need is the use of multiplex glycopeptide labeling. By harnessing the synergies of N metabolic labeling via the isotopic detection of amino sugars with glutamine (IDAWG) technique for glycan parts and tandem mass tag (TMT)pro labeling for peptide backbones, we have developed a method that allows for the accurate quantification and comparison of multiple samples simultaneously. The adoption of the liquid chromatography-synchronous precursor selection (LC-SPS-MS3) technique minimizes fragmentation interference, enhancing data reliability, as shown by a 97% TMT labeling efficiency. This method allows for detailed, high-throughput analysis of 32 diverse samples from 231BR cell lines, using both N and N glycopeptides at a 1:1 ratio. A key component of our methodology was the precise correction for isotope and TMTpro distortions, significantly improving quantification accuracy to less than 5% distortion. This breakthrough enhances the efficiency and accuracy of glycoproteomic studies, increasing our understanding of glycoproteins in health and disease. Its applicability to various cancer cell types sets a new standard in quantitative glycoproteomics, enabling deeper investigation into glycopeptide profiles.
PubMed: 38958703
DOI: 10.1007/s00216-024-05352-3 -
European Journal of Nuclear Medicine... Jul 2024While sedation is routinely used in pediatric PET examinations to preserve diagnostic quality, it may result in side effects and may affect the radiotracer's...
PURPOSE
While sedation is routinely used in pediatric PET examinations to preserve diagnostic quality, it may result in side effects and may affect the radiotracer's biodistribution. This study aims to investigate the feasibility of sedation-free pediatric PET imaging using ultra-fast total-body (TB) PET scanners and deep learning (DL)-based attenuation and scatter correction (ASC).
METHODS
This retrospective study included TB PET (uExplorer) imaging of 35 sedated pediatric patients under four years old to determine the minimum effective scanning time. A DL-based ASC method was applied to enhance PET quantification. Both quantitative and qualitative assessments were conducted to evaluate the image quality of ultra-fast DL-ASC PET. Five non-sedated pediatric patients were subsequently used to validate the proposed approach.
RESULTS
Comparisons between standard 300-second and ultra-fast 15-second imaging, CT-ASC and DL-ASC ultra-fast 15-second images, as well as DL-ASC ultra-fast 15-second images in non-sedated and sedated patients, showed no significant differences in qualitative scoring, lesion detectability, and quantitative Standard Uptake Value (SUV) (P = ns).
CONCLUSIONS
This study demonstrates that pediatric PET imaging can be effectively performed without sedation by combining ultra-fast imaging techniques with a DL-based ASC. This advancement in sedation-free ultra-fast PET imaging holds potential for broader clinical adoption.
PubMed: 38958680
DOI: 10.1007/s00259-024-06818-3 -
Langmuir : the ACS Journal of Surfaces... Jul 2024MXene has attracted considerable attention for supercapacitor applications in the past decade owing to its exceptional electrochemical properties. Although major... (Review)
Review
MXene has attracted considerable attention for supercapacitor applications in the past decade owing to its exceptional electrochemical properties. Although major research interests are focused on composite-based MXene, doping engineering of MXene has recently emerged as a promising alternative. This work unveils the potential of doped MXene for supercapacitor applications with a critical perspective. Various doping engineering strategies and synthesis methods adopted are explicitly delineated. Detailed discussions on the optimization of lattice, functionalization, substitution, and interface modification are provided. Further, it sheds light on recent developments with the asssociated mechanism of doped MXene supercapacitors, followed by the associated challenges. Finally, a roadmap for further progress of doped MXene for the realization of advanced and high-performing energy storage systems has been described. We envision that this Perspective will open up new avenues for the further exploration of this domain.
PubMed: 38958650
DOI: 10.1021/acs.langmuir.4c01242 -
Anti-cancer Drugs Jun 2024The aim of this study was to observe the therapeutic effect of sintilimab combined with a modified docetaxel + cisplatin + fluorouracil (DCF) regimen on advanced...
The aim of this study was to observe the therapeutic effect of sintilimab combined with a modified docetaxel + cisplatin + fluorouracil (DCF) regimen on advanced gastric cancer and its effect on Th1/Th2 immune balance. Ninety-eight cases of advanced gastric cancer patients who visited our hospital from April 2020 to May 2022 were selected and divided into 48 cases each in the conventional group and the research group by random number table method; the DCF regimen was adopted in the conventional group, and sintilimab combined with modified DCF regimen was adopted in the research group, and the therapeutic effects of the patients in the two groups and the changes of Th1/Th2 immune indexes were compared. CEA, CA199, CA242, CD168 AQ3, and IL-4 in the study group were lower than those in the conventional group at the end of three cycles of treatment, and the difference was statistically significant (P < 0.001). The levels of IFN-γ and IL-4 in the study group at the end of three cycles of treatment were higher than those in the conventional group (P < 0.001). The incidence of adverse reactions during treatment in the study group was lower than that in the conventional group (P < 0.001), and the grading of adverse reactions in the study group was milder than that in the conventional group. Sintilimab combined with a modified DCF regimen in the treatment of advanced gastric cancer not only improves the therapeutic effect but also positively affects the Th1/Th2 immune balance, which provides better immune regulation for patients with advanced gastric cancer.
PubMed: 38958648
DOI: 10.1097/CAD.0000000000001629 -
Cytotherapy Jun 2024Since their first production in 2007, human induced pluripotent stem cells (iPSCs) have provided a novel platform for the development of various cell therapies targeting...
Since their first production in 2007, human induced pluripotent stem cells (iPSCs) have provided a novel platform for the development of various cell therapies targeting a spectrum of diseases, ranging from rare genetic eye disorders to cancer treatment. However, several challenges must be tackled for iPSC-based cell therapy to enter the market and achieve broader global adoption. This white paper, authored by the Japanese Society for Regenerative Medicine (JSRM) - International Society for Cell Therapy (ISCT) iPSC Committee delves into the hurdles encountered in the pursuit of safe and economically viable iPSC-based therapies, particularly from the standpoint of the cell therapy industry. It discusses differences in global guidelines and regulatory frameworks, outlines a series of quality control tests required to ensure the safety of the cell therapy, and provides details and important considerations around cost of goods (COGs), including the impact of automated advanced manufacturing.
PubMed: 38958627
DOI: 10.1016/j.jcyt.2024.05.022