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Wojciechowski P, Wdowiak M, Panek M, Lunk I, Carrasco J, Zhang X, Wu O, Korobelnik JF, Lanzetta P. Efficacy, Safety, and Injection Frequency with Novel Aflibercept 8 mg in Neovascular Age-Related Macular Degeneration: A Comparison with Existing Anti-VEGF Regimens Using a Bayesian Network Meta-Analysis. Ophthalmol Ther 2025; 14:733-753. [PMID: 39994103 PMCID: PMC11920537 DOI: 10.1007/s40123-025-01098-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 01/24/2025] [Indexed: 02/26/2025] Open
Abstract
INTRODUCTION Aflibercept 8 mg administered in extended dosing intervals has shown non-inferior visual gains and comparable safety profile to aflibercept 2 mg in the PULSAR pivotal randomized clinical trial and has the potential to reduce the treatment burden of treating neovascular age-related macular degeneration (nAMD). This study aimed at gathering robust evidence to assess the comparative efficacy, safety, and treatment burden of aflibercept 8 mg against other anti-vascular endothelial growth factor (VEGF) agents as ranibizumab, brolucizumab, faricimab, and bevacizumab in patients with nAMD. METHODS A systematic literature review (SLR) was conducted, targeting clinical trials of anti-VEGF agents in patients with nAMD. The results of the SLR were included in a network meta-analysis (NMA) comparing aflibercept 8 mg to other anti-VEGF treatments in nAMD, considering a 1-year time horizon. Treatment efficacy was assessed based on the change in best-corrected visual acuity (BCVA) from baseline, the proportion of patients gaining or losing 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters and changes in anatomical outcomes measured as change in central retinal thickness (CRT) or central subfield thickness (CST). Safety was assessed considering the incidence of ocular and non-ocular adverse events. Treatment burden was defined as the mean number of intravitreal injections over the study period. RESULTS The base-case NMA involving 21 studies did not show significant differences between aflibercept 8 mg and comparators regarding BCVA change from baseline and proportion of patients with a gain or loss of ≥ 15 letters. On the anatomical endpoints, aflibercept 8 mg was associated with statistically significant improvement in CRT/CST change from baseline compared with ranibizumab in fixed and pro re nata regimens. No significant differences were identified versus the other anti-VEGF. The analysis of the safety outcomes did not identify any significant differences between aflibercept 8 mg and any of the comparators. During the first year of treatment, patients treated with aflibercept 8 mg (following 12- or 16-week injection intervals) received on average 5.9 and 5.1 injections, respectively. For the same period, patients treated with faricimab received from 6.2 to 6.7 injections, patients treated with ranibizumab from 7.62 to 12.14 injections, and patients treated with aflibercept 2 mg up to 7.67 injections. CONCLUSION Aflibercept 8 mg demonstrates a comparable efficacy and safety to currently available anti-VEGF treatments for nAMD, with the potential added benefit of requiring fewer injections. These results suggest that aflibercept 8 mg could be a favourable treatment option for nAMD, achieving sustained disease control while alleviating the burden of injections on patients, caregivers, and healthcare providers.
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Affiliation(s)
| | | | | | - Izabella Lunk
- Pharmaceuticals, Bayer Consumer Care AG, Basel, Switzerland.
| | - Joao Carrasco
- Pharmaceuticals, Bayer Consumer Care AG, Basel, Switzerland
| | - Xin Zhang
- Pharmaceuticals, Bayer Consumer Care AG, Basel, Switzerland
| | - Olivia Wu
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jean-François Korobelnik
- Service d'Ophthalmologie, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
- Inserm, Bordeaux Population Health Research Center, Université de Bordeaux, Bordeaux, France
| | - Paolo Lanzetta
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
- Istituto Europeo di Microchirurgia Oculare-IEMO, Udine, Milan, Italy
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Nana P, Kölbel T. Endovascular Ascending Aortic Repair: Experience Talks and Knowledge Listens. Eur J Vasc Endovasc Surg 2025; 69:545-546. [PMID: 39864493 DOI: 10.1016/j.ejvs.2025.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 12/04/2024] [Accepted: 01/16/2025] [Indexed: 01/28/2025]
Affiliation(s)
- Petroula Nana
- German Aortic Centre, Department of Vascular Medicine, University Heart and Vascular Centre UKE Hamburg, Hamburg, Germany.
| | - Tilo Kölbel
- German Aortic Centre, Department of Vascular Medicine, University Heart and Vascular Centre UKE Hamburg, Hamburg, Germany
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Nisi F, Ratibondi L, Hagger M, Giustiniano E, Piccioni F, Badalamenti G, Lepidi S, D'Oria M. Prognostic Impact of Anemia and Blood Transfusions on Cardiovascular Outcomes in Patients Undergoing Vascular Surgery: A Scoping Review. J Cardiothorac Vasc Anesth 2025; 39:511-525. [PMID: 39547866 DOI: 10.1053/j.jvca.2024.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 10/13/2024] [Accepted: 10/16/2024] [Indexed: 11/17/2024]
Abstract
OBJECTIVE Prior studies suggest an association of anemia and blood transfusion with increased morbidity and mortality in patients undergoing cardiac surgery. However, the impact of perioperative anemia and blood transfusion on clinical outcomes in patients undergoing major vascular surgery has been poorly defined yet. The primary objectives of this scoping review were to determine the extent of the evidence base that links anemia and blood transfusions to mortality and cardiovascular outcomes in patients undergoing major vascular surgery, and identify recurring themes or gaps in the literature to guide future research. METHODS A scoping review of the literature from PubMed, Cochrane, and EMBASE databases was conducted up to December 2023 to identify articles related to the impact of anemia and blood transfusions on postoperative cardiovascular outcomes on patients undergoing vascular surgery. Methodology followed the PRISMA Protocols Extension for Scoping Reviews. RESULTS Twenty-two articles met the inclusion criteria, including 15 retrospective and 6 observational prospective studies. Anemia definition varied across studies, mainly based on hemoglobin cut-off levels. An association with older age, coronary artery disease, hypertension, diabetes, and other comorbidities was reported. Particularly in peripheral and endovascular aortic surgery, anemia was linked consistently with higher mortality, major adverse cardiac events, and other postoperative complications, such as respiratory and renal issues, surgical site infections, and longer hospital stays, depending on hemoglobin levels. Anemia itself is an important predictor of transfusions. Transfusions in anemic patients were associated with increased mortality, postoperative complications, and increased need for major amputation. CONCLUSIONS The weight of the evidence suggests that anemia carries a substantial burden of cardiovascular complications, mortality, and multiorgan complications, resulting in increased health care costs. Peripheral and endovascular aortic surgery are affected deeply by the impact of anemia. Anemia itself stands out as a crucial predictor for requiring transfusions. In turn, the effect of transfusion of blood products is associated with worse outcomes and complications.
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Affiliation(s)
- Fulvio Nisi
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Luca Ratibondi
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mattia Hagger
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Enrico Giustiniano
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Federico Piccioni
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giovanni Badalamenti
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Sandro Lepidi
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
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Hair K, Arroyo-Araujo M, Vojvodic S, Economou M, Wong C, Tinsdeall F, Smith S, Rackoll T, Sena ES, McCann SK. Connecting the dots in neuroscience research: The future of evidence synthesis. Exp Neurol 2025; 384:115047. [PMID: 39510296 DOI: 10.1016/j.expneurol.2024.115047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 10/31/2024] [Accepted: 11/03/2024] [Indexed: 11/15/2024]
Abstract
Making progress in neuroscience research involves learning from existing data. In this perspective piece, we explore the potential of a data-driven evidence ecosystem to connect all primary data streams, and synthesis efforts to inform evidence-based research and translational success from bench to bedside. To enable this transformation, we set out how we can produce evidence designed with evidence curation in mind. All data should be findable, understandable, and easily synthesisable, using a combination of human and machine effort. This will require shifts in research culture and tailored infrastructure to support rapid dissemination, data sharing, and transparency. We also discuss improvements in the way we can synthesise evidence to better inform primary research, including the potential of emerging technologies, big-data approaches, and breaking down research silos. Through a case study in stroke research, one of the most well-established areas for synthesis efforts, we demonstrate the progress in implementing elements of this ecosystem, with an emphasis on the need for coordinated efforts between laboratory researchers and synthesists.
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Affiliation(s)
- Kaitlyn Hair
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
| | - María Arroyo-Araujo
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, QUEST Center, Charitéplatz 1, 10117 Berlin, Germany.
| | - Sofija Vojvodic
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, QUEST Center, Charitéplatz 1, 10117 Berlin, Germany.
| | - Maria Economou
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, QUEST Center, Charitéplatz 1, 10117 Berlin, Germany.
| | - Charis Wong
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; Euan MacDonald Centre for Motor Neuron Disease Research, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; Anne Rowling Regenerative Neurology Clinic, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; MRC Clinical Trials Unit, 90 High Holborn, London WC1V 6LJ, United Kingdom.
| | - Francesca Tinsdeall
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
| | - Sean Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
| | - Torsten Rackoll
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, QUEST Center, Charitéplatz 1, 10117 Berlin, Germany.
| | - Emily S Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
| | - Sarah K McCann
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, QUEST Center, Charitéplatz 1, 10117 Berlin, Germany.
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Mesina-Estarrón I, Plascencia Jiménez JA. Letter to the Editor Regarding: An Online Model for Neurosurgical Research in Developing Countries: A One-Year Experience in Mexico and Latin America. World Neurosurg 2025; 193:280-281. [PMID: 39732013 DOI: 10.1016/j.wneu.2024.10.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 10/26/2024] [Indexed: 12/30/2024]
Affiliation(s)
- Ignacio Mesina-Estarrón
- Research Fellow at the Department of Neurosurgery, Brigham & Women's Hospital, Boston, Massachusetts, USA.
| | - José Alberto Plascencia Jiménez
- Hispanic Leadership and Development Fellow at the National Hispanic Medical Association, Washington, District of Columbia, USA
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Fabre I, Bosanquet DC. Surgeon-Physician Co-management for Vascular Surgery in Patients: In Need of Data Multiplication or Practice Implementation? Eur J Vasc Endovasc Surg 2024; 68:346-347. [PMID: 38802039 DOI: 10.1016/j.ejvs.2024.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Ismay Fabre
- South-East Wales Vascular Network, University Hospital Wales, Cardiff and Vale University Health Board, Cardiff, UK.
| | - David C Bosanquet
- South-East Wales Vascular Network, University Hospital Wales, Cardiff and Vale University Health Board, Cardiff, UK; Gwent Vascular Institute, Aneurin Bevan University Health Board, Newport, UK
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Pouncey AL, Meuli L, Lopez-Espada C, Budtz-Lilly J, Boyle JR, Behrendt CA, Mani K, Pherwani AD. Editor's Choice - Vascular Registries Contributing to VASCUNET Collaborative Abdominal Aortic Aneurysm Outcome Projects: A Scoping Review. Eur J Vasc Endovasc Surg 2024; 68:152-160. [PMID: 38697257 DOI: 10.1016/j.ejvs.2024.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/06/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Vascular surgery registries report on procedures and outcomes to promote patient safety and drive quality improvement. International registries have contributed significantly to the VASCUNET collaborative abdominal aortic aneurysm (AAA) outcome projects. This scoping review aimed to outline the national registries in vascular surgery that currently participate in the VASCUNET collaborative AAA projects. METHODS A scoping review of all published VASCUNET AAA studies and validation reports between 1997 and 2024 was undertaken. A survey was conducted among representatives of the international vascular registries contributing to VASCUNET collaborative AAA projects. RESULTS Currently, vascular registries from 10 countries (Australia, Denmark, Finland, Hungary, Iceland, New Zealand, Norway, Sweden, Switzerland, and the UK) contribute to the current VASCUNET collaborative AAA project, of which eight have national coverage. In the past, three countries (Germany, Malta, and Italy) have participated in previous VASCUNET AAA projects, and a further three countries (Serbia, Greece, and Portugal) have planned participation in future projects. External validity is high for all current registries, with most reporting rates of > 90%. The majority have internal validation processes to assess data accuracy. VASCUNET mediated validation has also been performed by the consortium for five countries to date (Hungary, Sweden, Denmark, Malta, and Switzerland), for which a high degree of external and internal validity was identified. Most registries have established mechanisms for data linkage with national administrative datasets or insurance claims datasets and contribute to quality improvement through regular reporting to participating centres. CONCLUSION National vascular registries from nations participating in the VASCUNET collaborative AAA projects are largely comprehensive, with high case ascertainment rates and good quality data with internal quality assurance. This provides a template for new registries wishing to join the VASCUNET collaboration and a benchmark for future research.
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Affiliation(s)
- Anna L Pouncey
- Vascular Department, Division of Surgery and Cancer, Imperial College London, London, UK
| | - Lorenz Meuli
- Department of Vascular Surgery, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland; Copenhagen Aortic Centre, Department of Vascular Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Cristina Lopez-Espada
- Department of Surgery, University Hospital Virgen de las Nieves, University of Granada, Granada, Spain
| | - Jacob Budtz-Lilly
- Division of Vascular Surgery, Department of Cardiovascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jonathan R Boyle
- Cambridge University Hospitals NHS Trust & Department of Surgery, University of Cambridge, Cambridge, UK
| | - Christian-Alexander Behrendt
- Department of Vascular and Endovascular Surgery, Asklepios Clinic Wandsbek, Asklepios Medical School, Hamburg, Germany
| | - Kevin Mani
- Department of Surgical Sciences, Section of Vascular surgery, Uppsala University, Uppsala, Sweden
| | - Arun D Pherwani
- Keele University School of Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK; The National Vascular Registry (NVR), UK.
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Robertson DA, Timmons S, Lunn PD. Behavioural evidence on COVID-19 vaccine uptake. Public Health 2024; 227:49-53. [PMID: 38104419 DOI: 10.1016/j.puhe.2023.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES The World Health Organization has declared that COVID-19 is no longer a public health emergency of international concern. Nevertheless, it remains a public health issue, and seasonal vaccinations, at the same time of year as influenza vaccinations, will be necessary. When the first vaccines were administered in 2020, decision-makers had to make assumptions about the best methods to communicate and administer vaccines to increase uptake. Now, a body of evidence can inform these decisions. STUDY DESIGN A narrative review written by three behavioural scientists who design research for policy. METHODS We searched the PubMed database for: (i) reviews of interventions to increase uptake of COVID-19 or influenza vaccines and (ii) empirical studies on uptake of COVID-19 and influenza vaccines. In addition, registered trials gathered by a Cochrane scoping review of interventions to increase uptake of COVID-19 vaccines were searched for updated results. RESULTS Results centre around two aspects of a vaccination campaign of interest to policymakers: communication and administration. Results suggest that communications highlighting the personal benefits of vaccination are likely to be more effective than those highlighting collective benefits. The efficacy of vaccination may be underestimated and stressing efficacy as a strong personal benefit may increase uptake. Keeping vaccines free, sending personalised messages, reminders and prebooked appointment times may also increase uptake. CONCLUSIONS There is now a body of evidence from behavioural science that suggests how vaccination campaigns for COVID-19 can be structured to increase uptake. These recommendations may be useful to policymakers considering seasonal vaccination campaigns and to researchers generating hypotheses for country-specific trials.
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Affiliation(s)
- D A Robertson
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - S Timmons
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - P D Lunn
- Behavioural Research Unit, Economic and Social Research Institute, Dublin, Ireland; Department of Economics, Trinity College Dublin, Dublin, Ireland
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D'Oria M, Zuccon G, Wanhainen A. Reply to "A holistic approach to identifying the origins of and investigating predictive factors for type Ib endoleak in endovascular aneurysm repair". Eur J Vasc Endovasc Surg 2024; 67:182-183. [PMID: 37572868 DOI: 10.1016/j.ejvs.2023.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Affiliation(s)
- Mario D'Oria
- Section of Vascular and Endovascular Surgery, Department of Medical Surgical and Health Sciences, University of Trieste, Italy.
| | - Gianmarco Zuccon
- Vascular Division, Cardiovascular Department, HPG23 Hospital, Bergamo, Italy
| | - Anders Wanhainen
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden; Department of Peri-operative and Surgical Sciences, Surgery, Umeå University, Umeå, Sweden
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Abstract
Evidence-based practice relies on using research evidence to guide clinical decision-making. However, staying current with all published research can be challenging. Many clinicians use review articles that apply predefined methods to locate, identify, and summarize all available evidence on a topic to guide clinical decision-making. This paper discusses the role of review articles, including narrative, scoping, and systematic reviews, to synthesize existing evidence and generate new knowledge. It provides a step-by-step guide to conducting a systematic review and meta-analysis, covering key steps such as formulating a research question, selecting studies, evaluating evidence quality, and reporting results. This paper is intended as a resource for clinicians looking to learn how to conduct systematic reviews and advance evidence-based practice in the field.
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Affiliation(s)
- Marco Zaccagnini
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada; and Department of Respiratory Therapy, McGill University Health Centre, Montréal, Québec, Canada
| | - Jie Li
- Department Cardiopulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, Illinois.
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11
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Pettersson ABV, Ballardini RM, Mimler M, Li P, Salmi M, Minssen T, Gibson I, Mäkitie A. Legal issues and underexplored data protection in medical 3D printing: A scoping review. Front Bioeng Biotechnol 2023; 11:1102780. [PMID: 36923458 PMCID: PMC10009255 DOI: 10.3389/fbioe.2023.1102780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Introduction: 3D printing has quickly found many applications in medicine. However, as with any new technology the regulatory landscape is struggling to stay abreast. Unclear legislation or lack of legislation has been suggested as being one hindrance for wide-scale adoption. Methods: A scoping review was performed in PubMed, Web of Science, SCOPUS and Westlaw International to identify articles dealing with legal issues in medical 3D printing. Results: Thirty-four articles fulfilling inclusion criteria were identified in medical/technical databases and fifteen in the legal database. The majority of articles dealt with the USA, while the EU was also prominently represented. Some common unresolved legal issues were identified, among them terminological confusion between custom-made and patient-matched devices, lack of specific legislation for patient-matched products, and the undefined legal role of CAD files both from a liability and from an intellectual property standpoint. Data protection was mentioned only in two papers and seems an underexplored topic. Conclusion: In this scoping review, several relevant articles and several common unresolved legal issues were identified including a need for terminological uniformity in medical 3D printing. The results of this work are planned to inform our own deeper legal analysis of these issues in the future.
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Affiliation(s)
- Ante B. V. Pettersson
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Surgery, South Karelia Central Hospital, Lappeenranta, Finland
| | | | - Marc Mimler
- The City Law School City, University of London, London, United Kingdom
| | - Phoebe Li
- Sussex Law School, University of Sussex, Brighton, United Kingdom
| | - Mika Salmi
- Department of Mechanical Engineering, Aalto University, Espoo, Finland
| | - Timo Minssen
- Center for Advanced Studies in Biomedical Innovation Law (CeBIL), Faculty of Law, University of Copenhagen, Copenhagen, Denmark
| | - Ian Gibson
- Department of Design, Production and Management, University of Twente, Enschede, Netherlands
| | - Antti Mäkitie
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Atenas J, Havemann L, Timmermann C. Reframing data ethics in research methods education: a pathway to critical data literacy. INTERNATIONAL JOURNAL OF EDUCATIONAL TECHNOLOGY IN HIGHER EDUCATION 2023; 20:11. [PMID: 36846483 PMCID: PMC9939253 DOI: 10.1186/s41239-023-00380-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
This paper presents an ethical framework designed to support the development of critical data literacy for research methods courses and data training programmes in higher education. The framework we present draws upon our reviews of literature, course syllabi and existing frameworks on data ethics. For this research we reviewed 250 research methods syllabi from across the disciplines, as well as 80 syllabi from data science programmes to understand how or if data ethics was taught. We also reviewed 12 data ethics frameworks drawn from different sectors. Finally, we reviewed an extensive and diverse body of literature about data practices, research ethics, data ethics and critical data literacy, in order to develop a transversal model that can be adopted across higher education. To promote and support ethical approaches to the collection and use of data, ethics training must go beyond securing informed consent to enable a critical understanding of the techno-centric environment and the intersecting hierarchies of power embedded in technology and data. By fostering ethics as a method, educators can enable research that protects vulnerable groups and empower communities.
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Affiliation(s)
- Javiera Atenas
- Centre for Excellence in Learning and Teaching, University of Suffolk, Ipswich, UK
| | - Leo Havemann
- Arena Centre for Research-Based Education, University College London, London, UK
- Institute of Educational Technology, The Open University, Milton Keynes, UK
| | - Cristian Timmermann
- Ethics of Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
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Antoniou GA, Kontopodis N, Rogers SK, Golledge J, Forbes TL, Torella F, Verhagen HJM, Schermerhorn ML. Editor's Choice - Meta-Analysis of Compliance with Endovascular Aneurysm Repair Surveillance: The EVAR Surveillance Paradox. Eur J Vasc Endovasc Surg 2023; 65:244-254. [PMID: 36273676 DOI: 10.1016/j.ejvs.2022.10.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/24/2022] [Accepted: 10/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the survival of patients who attended surveillance after endovascular aneurysm repair (EVAR) with those who were non-compliant. DATA SOURCES MEDLINE and Embase were searched using the Ovid interface. REVIEW METHODS A systematic review was conducted complying with the PRISMA guidelines. Eligible studies compared survival in EVAR surveillance compliant patients with non-compliant patients. Non-compliance was defined as failure to attend at least one post-EVAR follow up. The risk of bias was assessed with the Newcastle-Ottawa scale, and the certainty of evidence using the GRADE framework. Primary outcomes were survival and aneurysm related death. Effect measures were the hazard ratio (HR) or odds ratio (OR) and 95% confidence interval (CI) calculated using the inverse variance or Mantel-Haenszel statistical method and random effects models. RESULTS Thirteen cohort studies with a total of 22 762 patients were included. Eight studies were deemed high risk of bias. The pooled proportion of patients who were non-compliant with EVAR surveillance was 43% (95% CI 36 - 51). No statistically significant difference was found in the hazard of all cause mortality (HR 1.04, 95% CI 0.61 - 1.77), aneurysm related mortality (HR 1.80, 95% CI 0.85-3.80), or secondary intervention (HR 0.66, 95% CI 0.31 - 1.41) between patients who had incomplete and complete follow up after EVAR. The odds of aneurysm rupture were lower in non-compliant patients (OR 0.63, 95% CI 0.39 - 1.01). The certainty of evidence was very low for all outcomes. Subgroup analysis for patients who had no surveillance vs. those with complete surveillance showed no significant difference in all cause mortality (HR 1.10, 95% CI 0.43 - 2.80). CONCLUSION Patients who were non-compliant with EVAR surveillance had similar survival to those who were compliant. These findings question the value of intense surveillance in all patients post-EVAR and highlight the need for further research on individualised or risk adjusted surveillance.
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Affiliation(s)
- George A Antoniou
- Department of Vascular and Endovascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK; Division of Cardiovascular Sciences, School of Medical Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
| | - Nikolaos Kontopodis
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University General Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Greece
| | - Steven K Rogers
- Department of Vascular and Endovascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK; Division of Cardiovascular Sciences, School of Medical Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia; Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Thomas L Forbes
- Division of Vascular Surgery, Peter Munk Cardiac Centre and University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Francesco Torella
- Liverpool Vascular & Endovascular Service, Liverpool, UK; School of Physical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Hence J M Verhagen
- Division of Vascular and Endovascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Marc L Schermerhorn
- Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Centre, Boston, MA, USA
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14
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Snelleksz M, Rossell SL, Gibbons A, Nithianantharajah J, Dean B. Evidence that the frontal pole has a significant role in the pathophysiology of schizophrenia. Psychiatry Res 2022; 317:114850. [PMID: 36174274 DOI: 10.1016/j.psychres.2022.114850] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 01/04/2023]
Abstract
Different regions of the cortex have been implicated in the pathophysiology of schizophrenia. Recently published data suggested there are many more changes in gene expression in the frontal pole (Brodmann's Area (BA) 10) compared to the dorsolateral prefrontal cortex (BA 9) and the anterior cingulate cortex (BA 33) from patients with schizophrenia. These data argued that the frontal pole is significantly affected by the pathophysiology of schizophrenia. The frontal pole is a region necessary for higher cognitive functions and is highly interconnected with many other brain regions. In this review we summarise the growing body of evidence to support the hypothesis that a dysfunctional frontal pole, due at least in part to its widespread effects on brain function, is making an important contribution to the pathophysiology of schizophrenia. We detail the many structural, cellular and molecular abnormalities in the frontal pole from people with schizophrenia and present findings that argue the symptoms of schizophrenia are closely linked to dysfunction in this critical brain region.
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Affiliation(s)
- Megan Snelleksz
- Synaptic Biology and Cognition Laboratory, The Florey Institute for Neuroscience and Mental Health, Parkville, Victoria, Australia; The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Andrew Gibbons
- The Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Jess Nithianantharajah
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Brian Dean
- Synaptic Biology and Cognition Laboratory, The Florey Institute for Neuroscience and Mental Health, Parkville, Victoria, Australia; The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
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15
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Grandi A, D'Oria M, Melloni A, Calvagna C, Taglialavoro J, Chiesa R, Lepidi S, Bertoglio L. A scoping review on the approaches for cannulation of reno-visceral target vessels during complex endovascular aortic repair. Eur J Cardiothorac Surg 2022; 62:ezac478. [PMID: 36190336 DOI: 10.1093/ejcts/ezac478] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the approaches to reno-visceral target vessels (TVs) cannulation during branched-fenestrated endovascular aortic repair, determine the evidence base that links these approaches to clinical outcomes and identify literature gaps. METHODS A scoping review following the PRISMA Protocols Extension for Scoping Reviews was performed. Available full-text studies published in English (PubMed, Cochrane and EMBASE databases; last queried, 31 June 2022) were systematically reviewed and analysed. Data were reported as descriptive narrative or tables, without any statistical analysis nor quality assessment. RESULTS Fourteen retrospective articles were included. Seven articles studied the use of upper extremity access (UEA) during branched-fenestrated endovascular aortic repair, 3 studied the use of steerable sheaths and 4 included both approaches. A left UEA was used in 757 patients (technical success: 99%, stroke rate: 1-3%) and a right UEA in 215 patients (technical success: 92-98%, stroke rate: 0-13%). Seven studies (1066 patients) described a surgical access only (technical success: 80-99%, stroke rate: 0-13%), while 3 studies (146 patients) described a percutaneous access only (technical success: 83-90%, stroke rate: 3%) and lastly 4 studies compared UEA versus use of steerable sheaths from the transfemoral approach (TFA) (UEA: 563 patients, technical success: 95-98%, stroke rate: 1-8%; TFA: 209 patients, technical success: 98-100%, stroke rate: 0-1%). CONCLUSIONS Both UEA and TFA as cannulation approaches were associated with high technical success and low perioperative complications. Currently, there is a paucity of high-quality data to provide definitive indication. Optimal UEA in terms of side (left versus right) and approach (surgical versus percutaneous) needs further study.
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Affiliation(s)
- Alessandro Grandi
- Division of Vascular Surgery, IRCCS San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Andrea Melloni
- Division of Vascular Surgery, "Maggiore della Carità" University Hospital, Novara, Italy
| | - Cristiano Calvagna
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Jacopo Taglialavoro
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Roberto Chiesa
- Division of Vascular Surgery, IRCCS San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - Sandro Lepidi
- Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Luca Bertoglio
- Division of Vascular Surgery, IRCCS San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
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16
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Twine CP, Mani K. A Brief Guide to Performing Review and Meta-analysis of Rare Diseases, Procedures, and Other Low Frequency Pathology. Eur J Vasc Endovasc Surg 2022; 64:297-298. [PMID: 35934224 DOI: 10.1016/j.ejvs.2022.07.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023]
Affiliation(s)
| | - Kevin Mani
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala university, Uppsala, Sweden
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17
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Abu-Zidan FM, Östlundh L. The nature and consequences of camel-related injuries: Is this a scoping review? Injury 2022; 53:2693. [PMID: 35365352 DOI: 10.1016/j.injury.2022.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/23/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Linda Östlundh
- National Medical Library, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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