Error rates of data processing methods in clinical research: A systematic review and meta-analysis of manuscripts identified through PubMed.

Background: In clinical research, prevention of data errors is paramount to ensuring reproducibility of trial results and the safety and efficacy of the resulting interventions. Over the last 40 years, empirical assessments of data accuracy in clinical research have been reported, however, there has been little systematic synthesis of these results. Although notable exceptions exist, little evidence exists regarding the relative accuracy of different data processing methods.

The spatial and temporal effect of electrochromic windows on indoor and human microbiome in an inpatient hospital.

Objective: Improving the hospital environment and developing novel disinfection strategies are critical for infection control in healthcare settings. In this study, we explored the effects of electrochromic (EC) windows on indoor and patient microbiome in an inpatient hospital.

Patient And Setting: Hematology-Oncology patients at the University of Vermont Medical Center.

Upper Extremity Blocks for Hand Surgeons: A Literature Review of Regional Anaesthesia Techniques, Efficacy, and Safety.

Regional anaesthesia (RA) techniques have increased in popularity due to evidence of reductions in acute pain, chronic pain, postoperative nausea and vomiting (PONV), and pulmonary complications. While upper extremity blocks (UEBs) have been the subject of several comprehensive reviews, no review to date has synthesised the information on their use in hand surgery. A search of PUBMED and Cochrane databases was performed to identify the evidence associated with upper extremity blocks.

How Should Harm Reduction Strategies Differ for Adolescents and Adults?

Overall rates of opioid use are low in adolescents; however, recent increases in mortality from overdose in adolescents have outpaced increases in the general population. This article highlights the importance of expanding evidence-based treatment for adolescent opioid use, especially medication, while also addressing key ethical considerations of harm reduction practices and how application of such practices with adolescents may differ from adults. Concepts related to adolescent populations are discussed, including autonomy, confidentiality, and brain development.

Utility of spinal anesthesia in plastic surgery and other surgical subspecialties: A literature review.

Introduction: Spinal anesthesia (SA) is commonly used within the specialties of orthopedic surgery, obstetrics and gynecology, spine surgery, and general surgery, and offers several benefits over general anesthesia (GA). However, SA is used much less frequently in plastic surgery. This review analyzed currently existing data on SA use across various surgical specialties and compared the benefits and complications of SA to those of GA, to assess its utility and potential for more widespread use in plastic surgery.

Causes and outcomes of non-chemotherapy induced neutropenic fever in hospitalized adults: An observational study.

Neutropenic fever in adults undergoing chemotherapy for cancer treatment is a medical emergency and has been the focus of numerous studies. However, there is a paucity of data about non-chemotherapy induced neutropenic fever (non-CINF). We retrospectively reviewed 383 adults with neutropenic fever hospitalized at one academic medical center between October 2015 and September 2020 to characterize the frequency, causes, and outcomes of non-CINF.

Error Rates of Data Processing Methods in Clinical Research: A Systematic Review and Meta-Analysis of Manuscripts Identified Through PubMed.

Background: In clinical research, prevention of systematic and random errors of data collected is paramount to ensuring reproducibility of trial results and the safety and efficacy of the resulting interventions. Over the last 40 years, empirical assessments of data accuracy in clinical research have been reported in the literature. Although there have been reports of data error and discrepancy rates in clinical studies, there has been little systematic synthesis of these results.

Cost Effectiveness of Genomic Population Health Screening in Adults: A Review of Modeling Studies and Future Directions.

Background: Detecting actionable health risks for genetic diseases prior to symptomatic presentation at population scale using genomic test technologies is a preventive health innovation being piloted in multiple locations. Standard practice is to screen for risks only in those with personal or family history of specific disease. Genomic population heath screening has proven feasible and potentially scalable.

Stress-induced symptom exacerbation: Stress increases voiding frequency, somatic sensitivity, and urinary bladder NGF and BDNF expression in mice with subthreshold cyclophosphamide (CYP).

Symptom exacerbation due to stress is prevalent in many disease states, including functional disorders of the urinary bladder (e.g., overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS)); however, the mechanisms underlying the effects of stress on micturition reflex function are unclear.

Changes in nerve growth factor signaling in female mice with cyclophosphamide-induced cystitis.

IC/BPS is a chronic inflammatory pelvic pain syndrome characterized by lower urinary tract symptoms including unpleasant sensation (pain, pressure, or discomfort) in the suprapubic or bladder area, as well as increased urinary frequency and urgency, and decreased bladder capacity. While its etiology remains unknown, increasing evidence suggests a role for changes in nerve growth factor (NGF) signaling. However, NGF signaling is complex and highly context dependent.

Repeated variate stress increased voiding frequency and altered TrpV1 and TrpV4 transcript expression in lower urinary tract (LUT) pathways in female mice.

Psychological stress is associated with urinary bladder dysfunction (e.g., increased voiding frequency, urgency and pelvic pain); however, the mechanisms underlying the effects of stress on urinary bladder function are unknown.

Contemporary Management of Blunt Liver Trauma: An Analysis of the Trauma Quality Improvement Program Registry (2007-2019).

Purpose: To evaluate the effectiveness of management strategies for blunt liver injuries in adult patients.

Materials And Methods: Patients aged ≥18 years with blunt liver injuries registered via the Trauma Quality Improvement Program (2007-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as nonoperative management (NOM), embolization, surgery, or combination therapy.

Rapid infusion of infliximab biosimilars and the incidence and severity of infusion-related reactions in patients with inflammatory bowel disease.

What Is Known And Objective: Infliximab is an anti-tumour necrosis factor agent used in the treatment of inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. While the use of infliximab is well established in the treatment of IBD, there are now four recently FDA-approved infliximab biosimilars that are increasingly used due to their cost-benefit for patients, institutions and payors. In addition, shortening the length of infliximab infusions from 120 min (standard infusion) to 60 min or less (rapid infusion) has been shown to safely provide further cost-benefit while also improving patient convenience.

Measuring and controlling medical record abstraction (MRA) error rates in an observational study.

Background: Studies have shown that data collection by medical record abstraction (MRA) is a significant source of error in clinical research studies relying on secondary use data. Yet, the quality of data collected using MRA is seldom assessed. We employed a novel, theory-based framework for data quality assurance and quality control of MRA.

Rat bite fever in a patient with human immunodeficiency virus.

The authors report the case of a 45-year-old male with history of human immunodeficiency virus who presented unresponsive and with injuries to his hands after spending a night on a lakeside beach. During his hospitalization, he developed a fever with arthralgias and was initially thought to have calcium pyrophosphate dihydrate crystal deposition disease before a diagnosis of Rat Bite Fever was ultimately discovered. He was successfully treated with six-weeks of ceftriaxone.

Navigating the Debate on Managing Large (≥4 cm) Thyroid Nodules.

Purpose: Discordant practice guidelines for managing large thyroid nodules may result in unnecessary surgeries and costs. Recent data suggest similar false-negative rates in fine needle aspiration (FNA) biopsies between small (<4 cm) and large (≥4 cm) nodules, indicating that monitoring rather than surgery may be appropriate for large biopsy-negative nodules. We investigated the management of thyroid nodules ≥4 cm to determine the proportion of surgeries not necessary for diagnostic purposes and examined for potential predictors.

Efficacy of Combination Therapy with the JAK Inhibitor Baricitinib in the Treatment of COVID-19.

Unlabelled: Coronavirus disease-19 (COVID-19), resulting from infection with SARS-CoV-2, spans a wide spectrum of illness. In severely ill patients, highly elevated serum levels of certain cytokines and considerable cytolytic T cell infiltrates in the lungs have been observed. These same patients may bear low to negligible viral burdens suggesting that an overactive immune response, often termed cytokine storm, contributes to the severity of COVID-19.

Retention With Medication for Opioid Use Disorder: The Role of the Primary Care Relationship.

Objectives: Primary care providers (PCPs) prescribe medication for opioid use disorder (MOUD), but patients may receive MOUD from a provider who only prescribes MOUD, and who does not provide routine medical care that would be expected from a PCP. The importance of receiving MOUD from one's own PCP versus another provider on patient MOUD retention is not known.

Methods: All patients receiving MOUD from December 2016 through November 2019 within a rural, Federally Qualified Health Center were included.

Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis.

Background: Although the use of prenatal ultrasound services has increased in low- income and lower middle-income countries, there has not been a concurrent improvement in perinatal mortality. It remains unknown whether individual ultrasound findings in this setting are associated with neonatal death or the need for resuscitation at delivery. If associations are identified by ultrasound, they could be used to inform the birth attendant and counsel the family regarding risk, potentially altering delivery preparedness in order to reduce neonatal mortality.

Influence of Opioid Prescription Policy on Overdoses and Related Adverse Effects in a Primary Care Population.

Background: In response to the opioid epidemic, many states have enacted policies limiting opioid prescriptions. There is a paucity of evidence of the impact of opioid prescribing interventions in primary care populations, including whether unintended consequences arise from limiting the availability of prescribed opioids.

Objective: Our aim was to compare changes in opioid overdose and related adverse effects rate among primary care patients following the implementation of state-level prescribing policies.

An Active-Learning Quality Improvement Curriculum for Faculty in Hospital Medicine.

Introduction: Despite the growing importance of quality improvement (QI) training in medical education, there is a lack of faculty with expertise in QI at many academic medical centers. In this report, we describe the design, implementation, and evaluation of a QI training program for faculty in hospital medicine at an academic medical center aimed at increasing faculty capacity in QI.

Methods: With input from an initial focus group of hospital medicine faculty, we developed a 12-session, active-learning curriculum incorporating core concepts in QI applied to a real-life QI problem.

Eribulin Plus Pembrolizumab in Patients with Metastatic Triple-Negative Breast Cancer (ENHANCE 1): A Phase Ib/II Study.

Purpose: As monotherapies, eribulin (chemotherapy) and pembrolizumab (immunotherapy) have shown promise for patients with metastatic triple-negative breast cancer (mTNBC). This phase Ib/II study examined eribulin plus pembrolizumab as a potential mTNBC treatment in first-line and later-line settings.

Patients And Methods: In this open-label, single-arm, phase Ib/II study, eligible patients had mTNBC, measurable disease, and ≤2 prior systemic anticancer therapies in the metastatic setting.

Effect of Low-Frequency Therapeutic Ultrasound on Induction of Nitric Oxide in CKD: Potential to Prevent Acute Kidney Injury.

Introduction: Post-contrast acute kidney injury (PC-AKI) develops in a significant proportion of patients with CKD after invasive cardiology procedures and is strongly associated with adverse outcomes.

Objective: We sought to determine whether increased intrarenal nitric oxide (NO) would prevent PC-AKI.

Methods: To create a large animal model of CKD, we infused 250 micron particles into the renal arteries in 56 ± 8 kg pigs.