microRNA. Diagnostic Perspective

Biomarkers are biological measures of a biological state. An ideal marker should be safe and easy to measure, cost efficient, modifiable with treatment, and consistent across gender and ethnic groups. To date, none of the available biomarkers satisfy all of these criteria. In addition, the major limitations of these markers are low specificity, sensitivity, and false positive results. Recently identified, microRNAs (miRNAs) are endogenous, evolutionarily conserved small non-coding RNA (about 22-25 nt long), also known as micro-coordinators of gene expression, which have been shown to be an effective tools to study the biology of diseases and to have great potential as novel diagnostic and prognostic biomarkers with high specificity and sensitivity. In fact, it has been demonstrated that miRNAs play a pivotal role in the regulation of a wide range of developmental and physiological processes and their deficiencies have been related to a number of disease. In addition, miRNAs are stable and can be easily isolated and measured from tissues and body fluids. In this review, we provide a perspective on emerging concepts and potential usefulness of miRNAs as diagnostic markers, emphasizing the involvement of specific miRNAs in particular tumor types, subtypes, cardiovascular diseases, diabetes, infectious diseases, and forensic test

Evolution of behavioral research on E‐waste management: Conceptual frameworks and future research directions

The rapid growth of e-waste or waste electrical and electronic equipment (WEEE) has garnered significant attention from scholars, particularly in the behavioral domain. This study aims to conduct a comprehensive bibliometric analysis and content analysis to provide a systematic review of WEEE-behavioral research. Firstly, a bibliometric analysis was performed using Biblioshiny (R packages) on a sample of 293 articles from Scopus and WOS databases. This part addresses the research question: A) How has the WEEE-behavioral domain evolved over time in terms of key journals, institutions, countries, trending topics, and research streams? Secondly, a content analysis was conducted on 41 relevant articles that were able to address the following research questions: B) What are the main theories utilized and their implications in WEEE-behavioral research? and C) what are the potential directions for future research? The findings reveal two distinct research categories, namely circular economic behavior and behavioral spillovers, with seven underlying and emerging clusters followed by corresponding research streams. Additionally, the theory of planned behavior (TPB) emerged as the core theory that was extensively utilized and expanded upon. Consequently, this study contributes to 1) understanding the evolution of the WEEE-behavioral domain, 2) proposing an integrated theoretical framework, 3) identifying the primary research streams and their interconnections, and 4) suggesting avenues for future research, supported by a robust conceptual model for hypothesis generation

Outcomes and Indications for Thoracofemoral Bypass in the Endovascular Age: A case series and Literature Review

Introduction: Endovascular revascularization is commonplace in vascular surgery; however, thoracofemoral bypass (TFB) is optimal in particular patients. Little research focuses on TFB outcomes. This case series and literature review investigated indications, efficacy, and safety of TFB. Methods: Cases at Thomas Jefferson University Hospital (TJUH) included one male and four females (average age 57.2) from 2015-2019. Literature review yielded 124 cases from other institutions. PubMed and Scopus search using the term “thoraco femoral bypass” yielded 39 articles. Articles published before 2000 and case studies published in any year were excluded. Seven articles were selected. Primary outcomes included 30-day mortality and graft patency; secondary outcomes included complications and indications. Data was tabulated in tables and percentages were calculated. Results: One hundred and twenty-nine cases of TFB were identified. Some indications included revascularization of failed aortobifemoral bypass (31.8% of patients) and circumferential aortic calcification with or without concomitant infrarenal or mesenteric calcification (20.1%). Thirty-day mortality for all cases was 4.7%. Thirty-day mortality for TJUH patients was 0%. Graft patency for TJUH patients was 100% at six months. At publication, three of five patients had been revascularized for over one year and had patent grafts at one year. Some complications included pulmonary (12.5% of patients), major vascular reintervention (7.8% of patients) and incision site infection (4.1% of patients). Discussion: In recent years, few institutions have reported TFB outcomes. High graft patency and low 30-day mortality at TJUH and other institutions emphasize the safety and efficacy of TFB

Improving Utilization of SGLT2 Inhibitors in the Inpatient Setting

SGLT2 inhibitors have been shown to have a significant benefit for patients with DM2 or CAD (DAPA-HF, Emperor-reduced) The usage of these medications are low compared to other Goal Directed Medical Therapy. There are multiple contributing factors as to why these medications are underutilized Our aim is to assess barriers against prescription of SGLT2-i at the time of discharge from TJUH and to increase utilization after placement on formulary

Short-term Pain Outcomes in Robotic versus Manual Total Hip Arthroplasty

Background: Four-hundred-fifty-thousand patients annually undergo total hip arthroplasty (THA) in the United States. THA has been shown to alleviate pain, restore function, and improve quality of life. Manual implant postoperative complications have led to a need for more advanced technology. Robotic assisted THA has the potential for greater accuracy in component positioning compared to manual. Comparing robotic and manual THA, significant differences have been shown in hip-specific functional outcomes, component positioning, complications, and patient-centered outcomes. The effects of these techniques on differences from baseline pain have yet to be investigated. Methods: A retrospective review of the Berkshire Medical Center electronic medical record system identified 70 patients undergoing THA between March 1, 2020 to October 31, 2021 with preoperative diagnosis of osteoarthritis or degenerative joint disease of the hip. Patients were admitted for at least one day postoperatively with documented preoperative and POD1 vital signs, POD1 pain scores, and LOS were included. The primary objective was to identify differences in postoperative day 1 (POD1) pain scores between robotic and manual THA. The secondary objective was to identify differences in length of stay (LOS) and preoperative versus postoperative vital signs (blood pressure, heart rate) between groups. Results: A statistically significant difference was identified for postoperative pain scores indicating significantly lower pain scores in patients undergoing manual THA in comparison to robotic (3.0 versus 5.0; P = 0.01). No significant differences were identified for systolic blood pressure (P = 0.46), diastolic blood pressure (P = 0.43), heart rate (p = 0.93), or LOS (P = 0.35). Discussion: Previous studies have demonstrated decreases in postoperative pain, LOS, and costs in patients undergoing robotic versus manual THA. The results of our study were not consistent with these studies which may be due to small sample size, quantity of anesthetic used, and surgeon differences. THA performed via robotic technique demonstrated a statistically significant increase in postoperative pain outcomes when compared to manual. There may be a lack of clinical difference in postoperative pain scores between groups and no differences were identified for vital signs or LOS

Cryoballoon versus Radiofrequency Ablation for Atrial Fibrillation: A Meta-analysis of 16 Clinical Trials.

Introduction: We aimed to study the procedural characteristics, efficacy and safety of cryoballoon ablation (CBA) versus radiofrequency ablation (RFA) for catheter ablation of paroxysmal atrial fibrillation (AF). Methods: A systematic literature search was performed using PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to clinical trials comparing CBA and RFA for AF. Outcomes were evaluated for efficacy, procedure characteristics and safety. For each study, odd ratio (OR) and 95% confidence intervals (CIs) were calculated for endpoints for both approaches. Results: We analyzed a total of 9,957 participants (3,369 in the CBA and 6,588 in RFA group) enrolled in 16 clinical trials. No significant difference was observed between CBA and RFA with regards to freedom from atrial arrhythmia at 12-months, recurrent atrial arrhythmias or repeat catheter ablation. CBA group had a significantly higher transient phrenic nerve injury (OR 14.19, 95% CI: 6.92-29.10;

Evaluation of the SPOT™ Photoscreener’s Efficacy for Detecting Amblyopia Risk Factors Compared to Optometrists’ Examinations in 305 South Dakota Children

Purpose: This study sought to further validate the efficacy of the SPOTTM photoscreener version (v) 3.0.0500 as a screening device for amblyopia risk factors (ARF). Methods: This was a cross-sectional study from five different western South Dakota outpatient clinics. Data from 610 eyes of 305 children aged 6 months to 13.5 years collected between July 2018 to September 2018 were analyzed, using both the out-of-box referral criteria and the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria. Optometrist (eye care provider or ECP) cycloplegia practice patterns were deferred to each clinics’ specific protocols. Power vector and Bland-Altman plot analyses were performed. Results: The average age of the 305 children in the study population is 99.6 months (~8.3 years), with a total of 42% of these subjects receiving no dilating drops prior to testing. From these cases, the SPOTTM v3.0.0500 photoscreener evaluation parameters for detecting ARFs using the out-of-box referral criteria yielded an overall sensitivity (SN) of 95.2%, specificity (SP) of 91.9%, positive predictive value (PPV) of 81.6%, and negative predictive value (NPV) of 98.1%; the SPOTTM v3.0.0500 photoscreener evaluation parameters for detecting ARFs using the 2013 AAPOS referral criteria yielded an overall SN of 96.3%, SP of 92.4%, PPV of 82.1%, and NPV of 98.6%. Conclusions: With SN and NPV values exceeding 95%, this study supports the efficacy of the SPOTTM v3.0.0500 photoscreener as a pediatric screening device to detect ARFs. Power vector analyses help to provide further objective comparisons of refractive measurements between photoscreening devices and refractive examinations