Proportional Assist Ventilation for Minimizing the Duration of Mechanical Ventilation (the PROMIZING study): update to the statistical analysis plan for a randomized controlled trial.

Background: We previously published the protocol and statistical analysis plan for a randomized controlled trial of Proportional Assist Ventilation for Minimizing the Duration of Mechanical Ventilation: the PROMIZING study in Trials ( https://doi.org/10.1186/s13063-023-07163-w ).

An AI dose-influence matrix engine for robust pencil beam scanning protons therapy.

Background: Rapid planning is of tremendous value in proton pencil beam scanning (PBS) therapy in overcoming range uncertainty. However, the dose calculation of the dose influence matrix (D) in robust PBS plan optimization is time-consuming and requires substantial acceleration to enhance efficiency.

Purpose: To accelerate the D calculations in PBS therapy, we developed an AI-D engine integrated into our in-house treatment planning system (TPS).

Factors Influencing Patient-Centered Care and Shared Decision-Making in Primary Care Settings in Saudi Arabia: A Scoping Review.

The Kingdom of Saudi Arabia has undergone many reforms in light of Vision 2030, and the health sector is no exception. Vision 2030 highlights the importance of utilization and increased quality in primary care. Patient-centered care (PCC) and shared decision-making (SDM) are two methods used to increase healthcare quality globally.

Developing a Strategy to Increase Lung Cancer Screening in Areas of Need.

Lung cancer screening (LCS) rates are low, and lung cancer mortality is high in the United States. This report describes a strategy that health systems can use to identify LCS areas of need and engage associated primary care providers and patients in screening. A research team from Jefferson Health (JH), a large, urban health system, used geocoded standardized lung cancer mortality rates (SMRs) to identify zip codes in Philadelphia where lung cancer mortality is high.

Clinicopathological Spectrum of Diabetic and Non-diabetic Renal Lesions in Patients with Diabetes Mellitus: An Experience from A Tertiary Care Center.

Background & Objective: Diabetic patients often develop lesions called non-diabetic renal diseases (NDRD), whose prognostic and therapeutic implications vary from diabetic nephropathy (DN). Since early identification of NDRD is associated with a better prognosis, we aimed to understand its spectrum.

Methods: One hundred and thirty-four patients were included in a cross-sectional study.

Implementing and evaluating shared decision-making before transcatheter aortic valve implantation with a dedicated pathway and questionnaire.

Aims: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for patients with aortic valve stenosis. The choice between TAVI, surgery, or a conservative approach should be based upon multiple factors including clinical considerations, technical feasibility, and informed patient preference. In this context, engaging patients in a shared decision-making (SDM) process becomes essential, but this practice is generally underused.

RH2Fusion: A universal tool for precise DNA fragment assembly.

Despite its limitations, restriction enzyme (RE)-mediated cleavage remains the prevalent method for generating sticky ends in DNA assembly. Here, we present RNase HII Fusion (RH2Fusion), a robust system for user-defined sticky ends, enabling scarless assembly of multiple DNA fragments alongside simultaneous site-directed mutagenesis (SDM) at multiple sites. In bacterial cells, DNA fragments with ribonucleotide modifications are expected to form complementary 3' overhangs after RNase HII treatment, followed by annealing and recombination via the bacterial self-repair system.

Comparing the Effectiveness of Online and Face-to-Face Teaching for Medical Students in Shared Decision-Making Communication Skills Training.

Background: Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking.

Long non-coding RNA H19 as a prognostic biomarker for oral squamous cell carcinoma.

Background: H19, a 2.3 kb lncRNA, has been linked to tumor metastasis and progression, but its significance in oral squamous cell carcinoma (OSCC) remains unclear. H19 was initially thought to have a tumor-suppressive function, but recent studies have shown that it possesses both tumor-promoting and suppressive functions.

Factors Associated With Receipt of Tobacco Treatment Integrated With Nurse Navigation in a Centralized Lung Cancer Screening Program at an Urban Academic Medical Center.

Purpose: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.

Methods: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022.

Evaluation of patient and encounter decision aid interventions for atrial fibrillation: Baseline characteristics of the RED-AF study - A Randomized Controlled Trial.

Background: The Randomized Evaluation of Decision Support Interventions for Atrial Fibrillation (RED-AF) trial is a multi-site, randomized controlled clinical trial examining the effectiveness of a patient decision aid and an encounter decision aid in promoting shared decision-making (SDM) during a clinical encounter for patients with atrial fibrillation (AF). We sought to describe baseline characteristics of patients and clinicians in the trial and compare them to the demographics of the larger AF population. We also conducted an analysis of possible predictors of attrition rates at baseline, 6 and 12 months.

Evaluating the antibacterial activity of engineered phage ФEcSw endolysin against multidrug-resistant Escherichia coli strain Sw1.

Objective: The emergence of bacteriophage-encoded endolysins hold significant promise as novel antibacterial agents, particularly against the growing threat of antibiotic-resistant bacteria. Therefore, we investigated the phage ФEcSw endolysin to enhance the lytic activity against multi-drug-resistant Escherichia coli Sw1 through site-directed mutagenesis (SDM) guided by in silico identification of critical residues.

Methods: A computational analysis was conducted to elucidate the protein folding pattern, identify the active domains, and recognize critical residues of ФEcSw endolysin.

Health Care Provider Perspectives on Shared Decision Making With Parents and Adolescents.

Little is known about health care provider perspectives on sharing decisions in a parent-adolescent-provider triad. This perspective is needed to develop tools for supporting shared decision-making (SDM) in a triad that involves an adolescent. To assess this perspective, we conducted individual interviews with pediatric health care providers.

Navigating shared decision-making after the Life-Sustaining Treatment Decision Act: a qualitative study of in-depth interviews with terminal cancer patients, families, and healthcare professionals.

Purpose: End-of-life decision-making, particularly relating to withholding life-sustaining treatment (LST), is a complex and emotionally charged process involving healthcare professionals, patients, and caregivers.

Methods: This qualitative study explored the decision-making process in South Korea, where cultural norms and ethical considerations influence the dynamics of shared decision-making (SDM). In-depth interviews were conducted with healthcare professionals, patients, and caregivers using a grounded theory approach to elucidate the themes and processes underlying SDM for LST.

The Ghost in the Machine: Artificial Intelligence in Neurocardiology Will Advance Stroke Care.

Innovations in artificial intelligence (AI) and machine learning (ML) are poised to transform stroke care, particularly for Neuro-Cardiac Programs (NCP) within both academic and community hospital systems. Given AI's success in large-vessel occlusion (LVO) detection and perfusion mapping delivered to our smartphones, the next leap for this "Ghost in the Machine" technology seems to be into the world of NCP: AI-enhanced logistics have started to help with cardiac monitoring after cryptogenic, large-artery and small-vessel stroke, looking for atrial fibrillation (AF) with an insertable loop recorder (ILR) and/or external patch. The 'CONNECT' study from UCSD demonstrated that AI can increase protocol efficiency and reduce patient wait-times for ILR; with more AF detected, fewer strokes may result as more patients receive anticoagulation or Left Atrial Appendage Closure (LAAC).

The utility of shared decision making in the management of hereditary angioedema.

Hereditary angioedema (HAE) is a complex disorder with a wide array of treatment options. Shared decision-making (SDM) should be used to ensure that patients are choosing their best treatment option. The goal was to develop and psychometrically test a brief instrument for assessing the patient's perspective of the SDM process during his or her clinical encounters with an HAE specialist/allergist.

Operationalizing shared decision making in clinical practice.

Shared decision-making (SDM) requires a clear-eyed view of evidence certainty, context, and equipoise in clinical care. This paradigm of care builds on the foundational ethical principle of patient autonomy, further leveraging beneficence, nonmaleficence, and justice to provide bespoke care in the appropriate clinical setting. When evidence is carefully evaluated together with acceptability and feasibility, equity, cost-effectiveness, resources, and patient preferences, an individualized assessment of the trade-off between possible benefits and harms can optimize patient management.

Durable complete response after discontinuation of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma with portal vein tumor thrombosis: the first report.

Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with a dismal prognosis. Atezolizumab plus bevacizumab (atezo-bev) is the recommended palliative treatment, and approximately 10% of the patients may experience a complete response (CR), according to the mRECIST criteria. The treatment duration is until disease progression or unacceptable side effects occur.

Fostering Shared Decision-Making Between Patients and Health Care Professionals in Clinical Practice Guidelines: Protocol for a Project to Develop and Test a Tool for Guideline Developers.

Background: Clinical practice guidelines (CPGs) are designed to assist health care professionals in medical decision-making, but they often lack effective integration of shared decision-making (SDM) principles to reflect patient values and preferences, particularly in the context of preference-sensitive CPG recommendations. To address this shortcoming and foster SDM through CPGs, the integration of patient decision aids (PDAs) into CPGs has been proposed as an important strategy. However, methods for systematically identifying and prioritizing CPG recommendations relevant to SDM and related decision support tools are currently lacking.