RESUMEN
Background: Rapid and accurate acute ischemic stroke (AIS) diagnosis is needed to expedite emergent thrombolytic and mechanical thrombectomy treatment. Changes in blood-based protein biomarkers during the first 24 h of AIS, the time window for treatment, could complement imaging techniques and facilitate rapid diagnosis and treatment. Methods: We performed a systematic review according to PRISMA guidelines. MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched for eligible studies comparing levels of blood-based protein biomarkers in AIS patients with levels in healthy controls and stroke mimics. Protein biomarkers from the following pathophysiological categories were included: neurovascular inflammation (MMP-9, TNF-alpha), endothelial integrity (VCAM-1, ICAM-1), cell migration (E-Selectin, P-Selectin, L-Selectin), markers of glial and neuronal origin (GFAP, S100, S100B, NSE), and cardiac dysfunction (BNP, NT-proBNP). The literature search was limited to English-language publications before November 7th, 2023. Results: A total of 61 studies from 20 different countries were identified, which included in total, 4,644 AIS patients, 2,242 stroke mimics, and 2,777 controls. Studies investigating TNF-alpha, MMP-9, VCAM-1, ICAM-1, E-Selectin, L-Selectin, GFAP, NSE, and S100B showed pronounced methodological heterogeneity, making between-study comparisons difficult. However, in 80% of NT-proBNP and BNP studies, and all P-selectin studies, higher biomarker levels were observed in AIS patients compared to healthy controls and/or patients with stroke mimics. Conclusion: None of the biomarkers included showed sufficient evidence for additional diagnostic benefit for AIS. Comprehensive standardized global multicenter studies are needed to (1) permit comparability, (2) enable valid statements about protein-based biomarkers, and (3) reflect real-world scenarios.
RESUMEN
BACKGROUND: Mentorship is critical to success in postgraduate science, technology, engineering, math, and medicine (STEMM) settings. As such, the purpose of this study is to comprehensively explore the state of mentorship interventions in postgraduate STEMM settings to identify novel practices and future research directions. The selection criteria for reviewed articles included: 1) published between 2002 and 2022, 2) peer-reviewed, 3) in English, 4) postgraduate mentees, 5) a program where mentorship is a significant, explicit focus, and 6) a description of mentee outcomes related to the mentorship intervention. Overall, 2583 articles were screened, and 109 articles were reviewed. RESULTS: Most postgraduate STEMM mentorship intervention studies lack strong evidence to evaluate the effectiveness of the intervention, with only 5.5% of articles designed as randomized controlled trials. Most mentorship interventions (45.6%) were created for faculty, and few (4%) were for postdoctoral researchers. Also, only 18.8% of interventions focused on underrepresented groups in STEMM. Most interventions (53.7%) prescribed a dyadic structure, and there was more mentorship training for mentors than mentees. CONCLUSION: Overall, these findings identify gaps in mentorship interventions and provide step-by-step guidance for future interventions, including a consideration for underrepresented groups and postdoctoral scholars, robust mentorship training, and more randomized controlled trials.