PCOM Library / Archive for "Hot Topics in Research"

Category: Hot Topics in Research

Hot Topics: Color-Changing Bandages Treat Infection

Jackie Werner Hot Topics in Research, Infectious Disease

Colorimetric Band-aids for Point-of-Care Sensing and Treating Bacterial Infection

Sun Y, Zhao C, Niu J, Ren J, Qu X. Colorimetric band-aids for point-of-care sensing and treating bacterial infection. ACS Cent Sci. 2020. https://doi.org/10.1021/acscentsci.9b01104.

Sensing bacterial infections and monitoring drug resistance are very important for the selection of treatment options. However, the common methods of sensing resistance are limited by time-consuming, the requirement for professional personnel, and expensive instruments. Moreover, the abuse of antibiotics causes the accelerated process of bacterial resistance. Herein, we construct a portable paper-based band-aid (PBA) which implements a selective antibacterial strategy after sensing of drug resistance. The colors of PBA indicate bacterial infection (yellow) and drug resistance (red), just like a bacterial resistance colorimetric card. On the basis of color, antibiotic-based chemotherapy and Zr-MOF PCN-224-based photodynamic therapy (PDT) are used on site to treat sensitive and resistant strains, respectively. Eventually, it takes 4 h to sense, and the limit of detection is 104 CFU/mL for drug-resistant E. coli. Compared with traditional PDT-based antibacterial strategies, our design can alleviate off-target side effects, maximize therapeutic efficacy, and track the drug resistance in real time with the naked eye. This work develops a new way for the rational use of antibiotics. Given the low cost and easy operation of this point-of-care device, it can be developed for practical applications.

Hot Topics: YouTube Plastic Surgery Videos Inaccurate

Jackie Werner Hot Topics in Research, Surgery

Can You Trust What You Watch? An Assessment of the Quality of Information in Aesthetic Surgery Videos on YouTube

Gray MC, Gemmiti A, Ata A, et al. Can you trust what you watch? an assessment of the quality of information in aesthetic surgery videos on YouTube. Plast Reconstr Surg. 2020;145(2). https://dx.doi.org/10.1097/PRS.0000000000006463.

Background: 

Videos on YouTube can be posted without regulation or content oversight. Unfortunately, many patients use YouTube as a resource on aesthetic surgery, leading to misinformation. Currently, there are no objective assessments of the quality of information on YouTube about aesthetic surgery.

Methods: 

YouTube was queried for videos about the 12 most common aesthetic surgical procedures, identified from the 2015 American Society of Plastic Surgeons procedural statistics between May and June of 2016. The top 25 results for each search term were scored using the modified Ensuring Quality Information for Patients criteria based on video structure, content, and author identification. Average Ensuring Quality Information for Patients score, view count, and video duration were compared between authorship groups.

Results: 

A total of 523 videos were graded after excluding duplicates. The mean modified Ensuring Quality Information for Patients score for all videos was 13.1 (SE, 0.18) of a possible 27. The videos under the search “nose reshaping” had the lowest mean score of 10.24 (SE, 0.74), whereas “breast augmentation” had the highest score of 15.96 (SE, 0.65). Physician authorship accounted for 59 percent of included videos and had a higher mean Ensuring Quality Information for Patients score than those by patients. Only three of the 21 search terms had a mean modified Ensuring Quality Information for Patients score meeting criteria for high-quality videos.

Conclusions: 

The information contained in aesthetic surgery videos on YouTube is low quality. Patients should be aware that the information has the potential to be inaccurate. Plastic surgeons should be encouraged to develop high-quality videos to educate patients.

Hot Topics: Online Resource May Address Suicide Risk

Jackie Werner Hot Topics in Research, Psychology and Psychiatry

Lock to Live—An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults: Pilot Randomized Controlled Trial

Betz ME, Knoepke CE, Simpson S, et al. Lock to Live—An interactive web-based lethal means safety decision aid for suicidal adults: Pilot randomized controlled trial. J Med Internet Res. 2020;22(1). https://doi.org/10.2196/16253.

Background: Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based Lock to Live (L2L) decision aid to help suicidal adults and their families choose options for safer home storage.

Objective: This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs).

Methods: At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call.

Results: Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant.

Conclusions: The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means.

Hot Topics: Stroke Care Affected by Traffic

Jackie Werner Hot Topics in Research, Neurology, Public Health

Rubber Meeting the Road: Access to Comprehensive Stroke Care in the Face of Traffic

Dworkis DA, Axeen S, Arora S. Rubber meeting the road: Access to comprehensive stroke care in the face of traffic. Acad Emerg Med. 2020. https://doi.org/10.1111/acem.13909.

Acute stroke is one of the leading causes of death in the United States, with an estimated annual cost of $34 billion and a death from stroke occurring approximately every 4 minutes. Early access to specialized stroke care is critically important in the treatment of suspected acute stroke, but access to dedicated stroke centers is unequal and varies geographically. Among the different levels of hospitals providing stroke care, the comprehensive stroke center (CSC) is the highest designation: CSCs utilize multidisciplinary stroke teams to provide the most advanced stroke care, including therapies like endovascular clot retrieval that are not available at most non‐CSC hospitals.

Hot Topics: Novel Target for Addiction Treatment

Jackie Werner Hot Topics in Research, Neurology, Pharmaceutical Sciences, Substance Use Disorders

Dopamine-Evoked Synaptic Regulation in the Nucleus Accumbens Requires Astrocyte Activity

Corkrum M, Covelo A, Lines J, et al. Dopamine-evoked synaptic regulation in the nucleus accumbens requires astrocyte activity. Neuron. 2020. https://doi.org/10.1016/j.neuron.2019.12.026.

Dopamine is involved in physiological processes like learning and memory, motor control and reward, and pathological conditions such as Parkinson’s disease and addiction. In contrast to the extensive studies on neurons, astrocyte involvement in dopaminergic signaling remains largely unknown. Using transgenic mice, optogenetics, and pharmacogenetics, we studied the role of astrocytes on the dopaminergic system. We show that in freely behaving mice, astrocytes in the nucleus accumbens (NAc), a key reward center in the brain, respond with Ca2+ elevations to synaptically released dopamine, a phenomenon enhanced by amphetamine. In brain slices, synaptically released dopamine increases astrocyte Ca2+, stimulates ATP/adenosine release, and depresses excitatory synaptic transmission through activation of presynaptic A1 receptors. Amphetamine depresses neurotransmission through stimulation of astrocytes and the consequent A1 receptor activation. Furthermore, astrocytes modulate the acute behavioral psychomotor effects of amphetamine. Therefore, astrocytes mediate the dopamine- and amphetamine-induced synaptic regulation, revealing a novel cellular pathway in the brain reward system.

Hot Topics: Stroke Increases Risk of Heart Complications

Jackie Werner Cardiology, Hot Topics in Research, Neurology

First-Ever Ischemic Stroke and Incident Major Adverse Cardiovascular Events in 93,627 Older Women and Men

Sposato Luciano A, Melody L, Britney A, Shariff Salimah Z, Gustavo S. First-ever ischemic stroke and incident major adverse cardiovascular events in 93 627 older women and men. Stroke. https://doi.org/10.1161/STROKEAHA.119.028066.

Background and Purpose

Stroke risk is sex-specific, but little is known about sex differences of poststroke major adverse cardiovascular events (MACEs). Stroke-related brain damage causes autonomic dysfunction and inflammation, sometimes resulting in cardiac complications. Sex-specific cardiovascular susceptibility to stroke without the confounding effect of preexisting heart disease constitutes an unexplored field because previous studies focusing on sex differences in poststroke MACE have not excluded patients with known cardiovascular comorbidities. We therefore investigated sex-specific risks of incident MACE in a heart disease-free population-based cohort of patients with first-ever ischemic stroke and propensity-matched individuals without stroke.

Methods

We included Ontario residents ≥66 years, without known cardiovascular comorbidities, with first-ever ischemic stroke between 2002 and 2012 and propensity-matched individuals without stroke. We investigated the 1-year risk of incident MACE (acute coronary syndrome, myocardial infarction, incident coronary artery disease, coronary revascularization procedures, incident heart failure, or cardiovascular death) separately for females and males. For estimating cause-specific adjusted hazard ratios, we adjusted Cox models for variables with weighted standardized differences >0.10 or those known to influence MACE risk.

Results

We included 93 627 subjects without known cardiovascular comorbidities; 21 931 with first-ever ischemic stroke and 71 696 propensity-matched subjects without stroke. Groups were well-balanced on propensity-matching variables. There were 53 476 women (12 421 with and 41 055 without ischemic stroke) and 40 151 men (9510 with and 30 641 without ischemic stroke). First-ever ischemic stroke was associated with increased risk of incident MACE in both sexes. The risk was time-dependent, highest within 30 days (women: adjusted hazard ratio, 25.1 [95% CI, 19.3–32.6]; men: aHR, 23.4 [95% CI, 17.2–31.9]) and decreasing but remaining significant between 31 and 90 days (women: aHR, 4.8 [95% CI, 3.8–6.0]; men: aHR, 4.2 [95% CI, 3.3–5.4]), and 91 to 365 days (aHR, 2.1 [95% CI, 1.8–2.3]; men: aHR, 2.0 [95% CI, 1.7–2.3]).

Conclusions

In this large population-based study, ischemic stroke was independently associated with increased risk of incident MACE in both sexes.

Hot Topics: US Cancer Survivors Suffer Financial Hardship

Jackie Werner Hot Topics in Research, Oncology, Public Health

Medical Financial Hardship Intensity and Financial Sacrifice Associated with Cancer in the United States

Han X, Zhao J, Zheng Z, de Moor JS, Virgo KS, Yabroff KR. Medical financial hardship intensity and financial sacrifice associated with cancer in the united states. Cancer Epidemiol Biomarkers Prev. 2020. https://dx.doi.org/10.1158/1055-9965.EPI-19-0460.

Background: With rising costs of cancer care, this study aims to estimate the prevalence of, and factors associated with, medical financial hardship intensity and financial sacrifices due to cancer in the United States.

Methods: We identified 963 cancer survivors from the 2016 Medical Expenditures Panel Survey – Experiences with Cancer. Medical financial hardship due to cancer was measured in material (e.g., filed for bankruptcy), psychological (e.g., worry about paying bills and finances), and behavioral (e.g., delaying or forgoing care due to cost) domains. Nonmedical financial sacrifices included changes in spending and use of savings. Multivariable logistic models were used to identify characteristics associated with hardship intensity and sacrifices stratified by age group (18–64 or 65+ years).

Results: Among cancer survivors ages 18 to 64 years, 53.6%, 28.4%, and 11.4% reported at least one, two, or all three domains of hardship, respectively. Among survivors ages 65+ years, corresponding percentages were 42.0%, 12.7%, and 4.0%, respectively. Moreover, financial sacrifices due to cancer were more common in survivors ages 18 to 64 years (54.2%) than in survivors 65+ years (38.4%; P < 0.001). Factors significantly associated with hardship intensity in multivariable analyses included low income and educational attainment, racial/ethnic minority, comorbidity, lack of private insurance coverage, extended employment change, and recent cancer treatment. Most were also significantly associated with financial sacrifices.

Conclusions: Medical financial hardship and financial sacrifices are substantial among cancer survivors in the United States, particularly for younger survivors.

Impact: Efforts to mitigate financial hardship for cancer survivors are warranted, especially for those at high risk.

Hot Topics: Keywords Reveal Upcoming Research Trends

Jackie Werner Hot Topics in Research, Research and Scholarly Communication

Generating process of emerging topics in the life sciences

Ohniwa, R. L., & Hibino, A. (2019). Generating process of emerging topics in the life sciences. Scientometrics, https://dx.doi.org/10.1007/s11192-019-03248-z

Clarifying the mechanism of how emerging topics in science and technology research fields are generated is useful for both researchers and agencies to identify potential emerging topics of the future. In the present study, we use bibliometric analyses targeting data of about 30 million published articles from 1970 to 2017 on PubMed, the largest article database in the life science field, to test our hypothesis that existing emerging topics contribute to the generation of new emerging topics in that field. We first collected emerging keywords from medical subject headings attached to each article using our previously reported methodology (Ohniwa et al. in Scientometrics 85(1):111–127, 2010), and performed co-word analyses of each emerging keyword 1-year prior to it becoming an emerging keyword. About 75% of total emerging keywords, at 1-year prior to becoming identified as emerging, co-appeared with other emerging keywords in the same article. Furthermore, most of the keywords co-appeared again at the point when the target keyword was identified as emerging, which is consistent with our hypothesis regarding the mechanism that emerging topics generate emerging topics.

Hot Topics: Long-Held Perception Theory Disproven

Jackie Werner Hot Topics in Research, Otolaryngology

Rapid visual categorization is not guided by early salience-based selection

Tsotsos, J. K., Kotseruba, I., & Wloka, C. (2019). Rapid visual categorization is not guided by early salience-based selection. Plos One, 14(10), e0224306. https://doi.org/10.1371/journal.pone.0224306

The current dominant visual processing paradigm in both human and machine research is the feedforward, layered hierarchy of neural-like processing elements. Within this paradigm, visual saliency is seen by many to have a specific role, namely that of early selection. Early selection is thought to enable very fast visual performance by limiting processing to only the most salient candidate portions of an image. This strategy has led to a plethora of saliency algorithms that have indeed improved processing time efficiency in machine algorithms, which in turn have strengthened the suggestion that human vision also employs a similar early selection strategy. However, at least one set of critical tests of this idea has never been performed with respect to the role of early selection in human vision. How would the best of the current saliency models perform on the stimuli used by experimentalists who first provided evidence for this visual processing paradigm? Would the algorithms really provide correct candidate sub-images to enable fast categorization on those same images? Do humans really need this early selection for their impressive performance? Here, we report on a new series of tests of these questions whose results suggest that it is quite unlikely that such an early selection process has any role in human rapid visual categorization.

Hot Topics: ACE Inhibitors Less Effective for Hypertension

Jackie Werner Family Medicine, Hot Topics in Research, Pharmaceutical Sciences

Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis

Suchard, M. A., Schuemie, M. J., Krumholz, H. M., You, S. C., Chen, R., Pratt, N., . . . Ryan, P. B. (2019). Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: A systematic, multinational, large-scale analysis https://doi.org/10.1016/S0140-6736(19)32317-7

Background

Uncertainty remains about the optimal monotherapy for hypertension, with current guidelines recommending any primary agent among the first-line drug classes thiazide or thiazide-like diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, dihydropyridine calcium channel blockers, and non-dihydropyridine calcium channel blockers, in the absence of comorbid indications. Randomised trials have not further refined this choice.

Methods

We developed a comprehensive framework for real-world evidence that enables comparative effectiveness and safety evaluation across many drugs and outcomes from observational data encompassing millions of patients, while minimising inherent bias. Using this framework, we did a systematic, large-scale study under a new-user cohort design to estimate the relative risks of three primary (acute myocardial infarction, hospitalisation for heart failure, and stroke) and six secondary effectiveness and 46 safety outcomes comparing all first-line classes across a global network of six administrative claims and three electronic health record databases. The framework addressed residual confounding, publication bias, and p-hacking using large-scale propensity adjustment, a large set of control outcomes, and full disclosure of hypotheses tested.

Findings

Using 4·9 million patients, we generated 22 000 calibrated, propensity-score-adjusted hazard ratios (HRs) comparing all classes and outcomes across databases. Most estimates revealed no effectiveness differences between classes; however, thiazide or thiazide-like diuretics showed better primary effectiveness than angiotensin-converting enzyme inhibitors: acute myocardial infarction (HR 0·84, 95% CI 0·75–0·95), hospitalisation for heart failure (0·83, 0·74–0·95), and stroke (0·83, 0·74–0·95) risk while on initial treatment. Safety profiles also favoured thiazide or thiazide-like diuretics over angiotensin-converting enzyme inhibitors. The non-dihydropyridine calcium channel blockers were significantly inferior to the other four classes.

Interpretation

This comprehensive framework introduces a new way of doing observational health-care science at scale. The approach supports equivalence between drug classes for initiating monotherapy for hypertension—in keeping with current guidelines, with the exception of thiazide or thiazide-like diuretics superiority to angiotensin-converting enzyme inhibitors and the inferiority of non-dihydropyridine calcium channel blockers.