The reduction in the blood supply following the 2019 coronavirus pandemic has been exacerbated by the increased use of balanced resuscitation with blood components including whole blood in urban trauma centers. This reduction of the blood supply has...
Background/Objectives: The United States is facing a national blood shortage, which is a function of the reduced number of donors since the COVID-19 pandemic and the increasing use of balanced hemostatic resuscitation for severely bleeding trauma pat...
In the trauma resuscitation literature, there are inconsistent definitions of what constitutes massive transfusion and a unit of blood, complicating the use of transfusion cut-points to declare futility. This is problematic as it can lead to the inef...
The treatment for patients with alcoholic hepatitis (AH) who have a discriminant function (DF) score greater than 32 has been steroids. A prior study reported that mortality approaches 100% when the DF score is greater than 54, despite the use of pre...
This review explores the concept of futility timeouts and the use of traumatic brain injury (TBI) as an independent predictor of the futility of resuscitation efforts in severely bleeding trauma patients. The national blood supply shortage has been e...
20 August 2021
In clinical trials, futility rules are widely used to monitor the study while it is in progress, with the aim of ensuring early termination if the experimental treatment is unlikely to provide the desired level of efficacy. In this paper, we focus on...
17 December 2022
The debate on limiting futile therapy in the aspect of End of Life (EoL) care has been going on in Poland over the last decade. The growing demand for EoL care resulting from the aging of societies corresponds to the expectation of a satisfactory qua...
Background: Endovascular therapy (EVT) is a standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO), but inter-hospital transfers from primary stroke centers (PSCs) to comprehensive stroke centers (CSCs) can result in del...
This paper explores the intersection of personal responsibility, futility, and faith in visual representations of nuclear apocalypse. In two films produced during the late Cold War, Testament (1983) and When the Wind Blows (1986), the protagonists at...
The approach to reperfusion therapies in stroke patients is rapidly evolving, but there is still no explanation why a substantial proportion of patients have a poor clinical prognosis despite successful flow restoration. This issue of futile recanali...
Previously, we demonstrated that disruption of ribose-5-phosphate biosynthesis in the pentose phosphate pathway increases the sensitivity of E. coli bacteria to a broad spectrum of antibiotics, and this sensitivity can be suppressed by deletion of th...
In 1991, development economist and American public intellectual Albert O. Hirschman wrote the Rhetoric of Reaction [1]. In this book, which was prescient of more contemporary popular books such as Naomi Klein’s The Shock Doctrine [2] and James C. Sco...
Background: Futile reperfusion (FR), which is defined as successful revascularization without a favorable functional outcome, is a major limitation of endovascular treatment (EVT) for acute ischemic stroke. Although clinical and imaging predictors of...
Objective: This study aims to develop and validate the Futile Recanalization Prediction Score (FRPS), a novel tool designed to predict the severity risk of FR and aid in pre- and post-EVT risk assessments. Methods: The FRPS was developed using a rigo...
Background and Objectives: Functional independence is not always achieved after successful recanalization with endovascular therapy (EVT) for acute ischemic stroke, a phenomenon termed futile recanalization (FR). We investigated factors independently...
Background: Futile recanalization (FR) continues to raise concern despite the success of endovascular thrombectomy (EVT) in acute ischemic stroke (AIS). Understanding the prevalence of FR and identifying associated factors are crucial for refining pa...
Surgical resection combined with chemotherapy offers the best chance of survival in pancreatic ductal adenocarcinoma (PDAC), but many will experience recurrence and early mortality. We examined soluble AXL (sAXL), a blood protein, for its ability to...
Transcatheter aortic valve replacement (TAVR) offers a novel treatment option for patients with severe symptomatic aortic valve stenosis, particularly for patients who are unsuitable candidates for surgical intervention. However, high therapeutical c...
Background: End-of-life care raises ethical, moral, legal and economic dilemmas, especially when physicians have to decide whether to initiate or to stop treatments that may be considered disproportionate and futile. Aim: To explore the opinion of he...
Background and Objectives: Acute respiratory failure (ARF) represents an increasingly relevant clinical challenge in older subjects due to population aging and the high prevalence of cardiopulmonary comorbidities. Non-invasive ventilation (NIV), deve...
Photorespiration, or C2 photosynthesis, is generally considered a futile cycle that potentially decreases photosynthetic carbon fixation by more than 25%. Nonetheless, many essential processes, such as nitrogen assimilation, C1 metabolism, and sulfur...
Randomization is a well-established statistical tool for obtaining fair treatment comparisons in clinical trials. Despite this, most investigators conducting small early-phase oncology trials of different experimental treatments or doses of a single...
This study examines the potential market for residential hydrogen systems in light of the trends towards digitalisation and environmental awareness. Based on a survey of 350 participants, the results indicate that although energy experts are sceptica...
Human NAD(P)H-quinone oxidoreductase1 (HNQO1) is a two-electron reductase antioxidant enzyme whose expression is driven by the NRF2 transcription factor highly active in the prooxidant milieu found in human malignancies. The resulting abundance of NQ...
Adipose tissue exhibits dynamic metabolic and structural changes in response to environmental stimuli, including temperature fluctuations. While continuous cold exposure has been extensively studied, the molecular effects of prolonged intermittent co...
Background/Objectives: The change in critically ill patients makes limitation of therapeutic effort (LTE) a widespread practice when therapeutic goals cannot be achieved. We aimed to describe the application of LTE in a post-surgical Intensive Care U...
Futile recanalization remains a significant challenge for endovascular treatment (EVT) of acute ischemic stroke (AIS). The inflammatory response that occurs after cerebral infarct plays a central role in stroke pathobiology that can influence the out...
Metaphysics is championed among contemporary philosophers as the way to combat the nihilism of our age and is simultaneously rejected as nihilism’s source. Thinkers who are serious about the Catholic tradition stand on either side of this argum...
Background: Cancer-directed treatment near the end of life may represent low-value, high-intensity care and potential medical futility, but data from middle-income countries are limited. This study used digitally documented advanced care planning (AC...
Obesity has reached epidemic proportions, driven by energy imbalance and limited capacity for adaptive thermogenesis. Brown (BAT) and beige adipose tissues dissipate energy through non-shivering thermogenesis (NST), primarily via uncoupling protein-1...
In addition to competition from independent refurbishers, consumer distrust of refurbished product quality is a major bottleneck for brand manufacturers when selling refurbished products. This paper focuses on a duopoly competition consisting of a br...
Previous studies identifying the potential anti-apoptotic role of neuroglobin raise the question as to how cells might employ neuroglobin to avoid the apoptotic impact of acute hypoxia whilst also avoiding chronic enhancement of tumour formation. We...
10 November 2026
Background: Total calcanectomy has been proposed as a definitive limb-salvage strategy in non-ambulatory patients with heel ulceration and calcaneal osteomyelitis, potentially facilitating primary wound closure and reducing complications associated w...
The N88S mutation in human seipin causes a dominant motor neuron disease marked by ER stress and inclusion body formation, lipid imbalance, and oxidative damage. However, the metabolic mechanisms connecting these defects remain poorly understood. Pre...
Background: Combined positron-emission tomography and computed tomography (PET-CT) reduces futile thoracotomy (FT) rates in patients with non-small-cell lung cancer (NSCLC). We sought to identify preoperative risk factors for FT in patients staged wi...
Clinically, infertility is defined as the inability to conceive after a certain period. In contrast, sterility is defined as the inability to produce a biological child; however, this is not a practical definition that can be applied in a clinical se...
Background and Objectives: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data reg...
Based on the origin, we can classify different types of stress. Environmental factors, such as high light intensity, adverse temperature, drought, or soil salinity, are summarized as abiotic stresses and discriminated from biotic stresses that are ex...
Background: It is unclear whether doctors base their resuscitation decisions solely on their perceived outcome. Through the use of theoretical scenarios, we aimed to examine the ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) deci...
Subinsular stroke (subIS) can occur between the penetrating middle cerebral artery (MCA) branches, which clinical and radiological findings sometimes encounter in patients after the recanalization of left proximal MCA occlusion. However, no supportiv...
Background: Gastrointestinal perforation is a life-threatening surgical emergency associated with high morbidity and mortality despite advances in imaging, perioperative care, and emergency surgical management. Early identification of patients at inc...
This article shows how “reasons of state” can sometimes influence end-of-life care decisions made by top politicians. Drawing on Ivan Illich’s concept of “medical nemesis” and the myth of Tithonus and Eos, it argues that...
Inhibition of respiratory chain complex I (NADH dehydrogenase) is a widely encountered biochemical consequence of drug intoxication and a primary consequence of mtDNA mutations and other mitochondrial defects. In an organ-selective form, it is also d...
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Background: Studies assessing poor postoperative recovery using patient-centered metrics among older adults are scarce. We aimed to explore poor postoperative recovery in octogenarians and nonagenarians, characterized using the validated patient-cent...
Introduction: Endovascular thrombectomy (EVT) is highly effective for ischemic stroke patients with a large vessel occlusion. EVT is typically only offered at urban hospitals; therefore, patients are transferred for EVT from hospitals that solely off...
Conventional chemical control compounds used for the management of insect pests have been much maligned, but still serve a critical role in protecting people and agricultural products from insect pests, as well as conserving biodiversity by eradicati...
6 April 2020
Background: Current detection methodologies are often unable to identify the location and extent of recurrent prostate cancer (PCa) leading potentially to ‘futile’ local therapies in the presence of metastatic disease. The use of 18 F-fluciclovine PE...
Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal cancers with a dismal prognosis for the patient. This is due to limited diagnostic options for the early detection of the disease as well as its rather aggressive nature. Despite major...
Epilepsy is a common neurological disorder in veterinary practice, complicated by frequent occurrence of medication-resistant epilepsy. In human medicine, it has been noted that some patients with medication-resistant epilepsy have in fact other reas...
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