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Background: Recent studies suggest that low-molecular-weight heparin (LMWH) may play a role in mitigating the severity of acute pancreatitis (AP). This systematic review and meta-analysis aims to synthesise existing evidence on the effectiveness and safety of LMWH in the treatment of moderately-severe and severe AP. Methods: This systematic review and meta-analysis was conducted in accordance with the 2020 update of the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The systematic search was conducted in MEDLINE, the Cochrane Central Register of Controlled Trials, Scopus, and EMBASE, covering studies published up to February 2024. Randomised controlled trials (RCTs) and observational studies (n-RCTs) that reported the differences in the outcomes of AP for patients receiving LMWH in addition to the standard treatment (Intervention), compared to patients managed by standard treatment without LMWH (Control) were eligible. A random-effects model was used to calculate the pooled relative risk (RR) and mean differences (MD) with the corresponding 95% CI. Results: Thirteen studies were included in the meta-analysis, all published between 2004 and 2022. Eight studies were RCTs, and five were n-RCTs. Data from 13,709 patients (6.971 Interventions and 6.738 Controls) were analysed. The comparison of Intervention and Control groups showed the superiority of LMWH to standard treatments in terms of overall mortality (RR = 0.44, 95% CI = 0.31; 0.64, P < 0.0001, I2 = 51%), acute necrotic collections (RR = 0.24, 95% CI = 0.09; 0.62, P = 0.003, I2 = 0%), and organ failure (RR = 0.67, 95% CI = 0.48; 0.93, P = 0.02, I2 = 78%). The Intervention group showed superior outcomes compared with the Control group for gastrointestinal bleeding (RR = 0.64, 95% CI = 0.44; 0.94, P = 0.02, I2 = 0%), length of hospital stay (MD= − 6.08, 95% CI = − 10.08; − 2.07, P = 0.003, I2 = 98%), need for operative interventions (RR = 0.50, 95% CI = 0.29; 0.87, P = 0.01, I2 = 61%), and vascular thrombosis (RR = 0.43, 95% CI = 0.31; 0.61, P < 0.00001, I2 = 0%). Conclusions: Moderate to high-quality evidence suggests that early intervention with LMWH could improve the prognosis of non-mild AP in terms of mortality, organ failure, and decreased incidence of vascular thrombosis. In light of our findings, integrating LMWH into the treatment regimen for moderate-severe to severe AP is advocated. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Previous studies have reported an association between metabolic dysfunction‐associated steatotic liver disease (MASLD) and the risk of serious bacterial infections. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta‐analysis of observational studies to quantify the association between MASLD and serious bacterial infections requiring hospital admission.We systematically searched PubMed, Scopus, Web of Science and Embase from database inception to 1 April 2024, using predefined keywords to identify studies examining the risk of serious bacterial infections among individuals with and without MASLD. MASLD was diagnosed using liver biopsy, imaging or International Classification of Diseases codes. Meta‐analysis was performed using random‐effects modelling.We identified six cross‐sectional and two prospective cohort studies with aggregate data on ~26.6 million individuals. MASLD was significantly associated with higher odds of serious bacterial infections (pooled random‐effects odds ratio 1.93, 95% confidence interval [CI] 1.44–2.58; I2 = 93%). Meta‐analysis of prospective cohort studies showed that MAFLD was associated with an increased risk of developing serious bacterial infections (pooled random‐effects hazard ratio 1.80, 95% CI 1.62–2.0; I2 = 89%). This risk further increased across the severity of MASLD, especially the severity of fibrosis (pooled random‐effects hazard ratio 2.42, 95% CI 1.89–2.29; I2 = 92%). These results remained significant after adjusting for age, sex, obesity, diabetes and other potential confounders. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias.This meta‐analysis shows a significant association between MASLD and an increased risk of serious bacterial infections requiring hospital admission. [ABSTRACT FROM AUTHOR]

ABSTRACT The professional quality of life (ProQOL) is increasingly applied to nurses and is a measure of the positive and negative aspects of their work. This systematic review and meta‐analysis evaluated the level of compassion satisfaction, burnout and secondary traumatic stress (STS) in empirical studies. Electronic databases Scopus, PubMed and Web of Science were searched on 7th February 2024, and the review followed PRISMA guidelines. The pooled estimate of compassion satisfaction, burnout and secondary traumatic stress mean scores using a random‐effects model for meta‐analyses was undertaken. R statistical software and the dmetar program were used to execute the analysis. Heterogeneity was evaluated with the I2 statistics, while publication bias was evaluated using Egger's regression test. Twenty‐four studies (sample size = 4274) were systematically reviewed and 18 studies (n = 3163) were incorporated into the meta‐analysis. Burnout, secondary traumatic stress and compassion satisfaction are found to be at moderate levels in this research. The qualitative analysis informs that variables such as healthy lifestyle, work environment and psychological resilience contribute towards optimum ProQOL scores. The pooled mean estimate was 32.79 (95% CI = 29.57–36) for compassion satisfaction, 24.99 (95% CI = 23.75–26.23) for burnout and 21.99 (95% CI = 18.93–25.06) for secondary traumatic stress, respectively. Mental health nurse managers need to address the factors in the work environment and promote interventions to enhance coping with burnout and STS. Subgroup analyses of country‐based economies & regions and years revealed significant results. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Results Conclusion Artificial intelligence (AI)‐based tools have shown promise in histopathology image analysis in improving the accuracy of oral squamous cell carcinoma (OSCC) detection with intent to reduce human error.This systematic review and meta‐analysis evaluated deep learning (DL) models for OSCC detection on histopathology images by assessing common diagnostic performance evaluation metrics for AI‐based medical image analysis studies.Diagnostic accuracy studies that used DL models for the analysis of histopathological images of OSCC compared to the reference standard were analyzed. Six databases (PubMed, Google Scholar, Scopus, Embase, ArXiv, and IEEE) were screened for publications without any time limitation. The QUADAS‐2 tool was utilized to assess quality. The meta‐analyses included only studies that reported true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN) in their test sets.Of 1267 screened studies, 17 studies met the final inclusion criteria. DL methods such as image classification (n = 11) and segmentation (n = 3) were used, and some studies used combined methods (n = 3). On QUADAS‐2 assessment, only three studies had a low risk of bias across all applicability domains. For segmentation studies, 0.97 was reported for accuracy, 0.97 for sensitivity, 0.98 for specificity, and 0.92 for Dice. For classification studies, accuracy was reported as 0.99, sensitivity 0.99, specificity 1.0, Dice 0.95, F1 score 0.98, and AUC 0.99. Meta‐analysis showed pooled estimates of 0.98 sensitivity and 0.93 specificity.Application of AI‐based classification and segmentation methods on image analysis represents a fundamental shift in digital pathology. DL approaches demonstrated significantly high accuracy for OSCC detection on histopathology, comparable to that of human experts in some studies. Although AI‐based models cannot replace a well‐trained pathologist, they can assist through improving the objectivity and repeatability of the diagnosis while reducing variability and human error as a consequence of pathologist burnout. [ABSTRACT FROM AUTHOR]

In the current study, Ochratoxin A (OTA) levels and prevalence in beer were meta‐analyzed, and non‐carcinogenic risk was calculated using the target hazard quotient. Thirty papers with 70 data reports were included in our study. The pooled prevalence of OTA was 50.60%, 95% CI (confidence interval) (36.97–64.19). Five countries with the highest levels of OTA in beer were South Africa (1170.750 μg/L), Slovakia (31.300 μg/L), Portugal (3.140 μg/L), Tunisia (1.052 μg/L), and Greece (0.707 μg/L). The pooled levels of OTA were 0.089 μg/L, 95% CI (0.077–0.101 μg/L). Meta‐regression shows that OTA prevalence in beer decreased over time insignificantly (p value: .084). Except in South Africa and Slovakia, consumers in other countries are at an acceptable non‐carcinogenic risk due to OTA in beer. Hence, it is recommended that the quality of raw materials, especially barley, be controlled in the storage and processing conditions in South Africa and Slovakia. [ABSTRACT FROM AUTHOR]

Background and Aims: The purpose of this meta‐analysis was to investigate the effect of vitamin D supplementation on hemoglobin A1C (HbA1C), fasting blood sugar (FBS), low‐density lipoprotein (LDL), high‐density lipoprotein (HDL), systolic blood pressure (SBP), and the total vitamin D level in patients with Type 2 diabetes (T2DM). Methods: A systematic search was conducted in databases such as PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov using relevant keywords from January 1990 to January 2024. After screening and extracting data, a qualitative evaluation of articles was performed using the Cochrane risk‐of‐bias tool for randomized trials (RoB 2). Results: The findings revealed that vitamin D supplementation significantly decreased the mean HbA1C (SMD: −0.15; 95% CI: −0.29, −0.20; Isquare: 79.76%; p value < 0.001) and mean FBS (SMD: −0.28; 95% CI: −0.40, −0.15; Isquare: 70.13%; p value < 0.001), lowered SBP (SMD: −0.06; 95% CI: −0.16, −0.05; Isquare: 39.63%; p value = 0.23), and reduced LDL (SMD: −0.11; 95% CI: −0.28, −0.05; Isquare: 73.66%; p value < 0.001). Furthermore, vitamin D supplementation increased the average HDL (SMD: 0.13; 95% CI: 0.04, 0.29; Isquare: 79.33%; p value < 0.001) and vitamin D levels (SMD: 1.78; 95% CI: 1.53, 2.04; Isquare: 91.92%; p value < 0.001) in patients with T2DM. Subgroup analyses showed that weight gain, BMI, and duration of the disease could reduce the effect of vitamin D supplementation on diabetes control in affected patients. Conclusion: The results also indicated that taking vitamin D supplements in the amount of 50,000 IU had a significant effect on reducing the indicators related to diabetes control. Based on the combined evidence, the findings of this meta‐analysis suggest that vitamin D supplementation can significantly improve glycemic control and reduce the risk of complications associated with T2DM, especially cardiovascular diseases (CVDs). [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions People with HIV might be at an increased risk of long COVID (LC) because of their immune dysfunction and chronic inflammation and alterations in immunological responses against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2; coronavirus disease 2019 [COVID‐19]). This systematic review aimed to evaluate the association between HIV infection and LC and the prevalence and characteristics of and risk factors for LC among people with HIV.Multiple databases, including Embase, PubMed, PsycINFO, Web of Science, and Sociological Abstracts, were searched to identify articles published before June 2023. Published articles were included if they presented at least one LC outcome measure among people with HIV and used quantitative or mixed‐methods study designs. For effects reported in three or more studies, meta‐analyses using random‐effects models were performed using R software.We pooled 39 405 people with HIV and COVID‐19 in 17 eligible studies out of 6158 publications in all the databases. It was estimated that 52% of people with HIV with SARS‐CoV‐2 infection developed at least one LC symptom. Results from the random‐effects model showed that HIV infection was associated with an increased risk of LC (odds ratio 2.20; 95% confidence interval 1.25–3.86). The most common LC symptoms among people with HIV were cough, fatigue, and asthenia. Risk factors associated with LC among people with HIV included a history of moderate–severe COVID‐19 illness, increased interferon‐gamma‐induced protein 10 or tumour necrosis factor‐α, and decreased interferon‐β, among others.The COVID‐19 pandemic continues to exacerbate health inequities among people with HIV because of their higher risk of developing LC. Our review is informative for public health and clinical communities to develop tailored strategies to prevent aggravated LC among people with HIV. [ABSTRACT FROM AUTHOR]

Meta‐analysis is an essential tool to comprehensively synthesize and quantitatively evaluate results of multiple clinical studies in evidence‐based medicine. In many meta‐analyses, the characteristics of some studies might markedly differ from those of the others, and these outlying studies can generate biases and potentially yield misleading results. In this article, we provide effective robust statistical inference methods using generalized likelihoods based on the density power divergence. The robust inference methods are designed to adjust the influences of outliers through the use of modified estimating equations based on a robust criterion, even when multiple and serious influential outliers are present. We provide the robust estimators, statistical tests, and confidence intervals via the generalized likelihoods for the fixed‐effect and random‐effects models of meta‐analysis. We also assess the contribution rates of individual studies to the robust overall estimators that indicate how the influences of outlying studies are adjusted. Through simulations and applications to two recently published systematic reviews, we demonstrate that the overall conclusions and interpretations of meta‐analyses can be markedly changed if the robust inference methods are applied and that only the conventional inference methods might produce misleading evidence. These methods would be recommended to be used at least as a sensitivity analysis method in the practice of meta‐analysis. We have also developed an R package, robustmeta, that implements the robust inference methods. [ABSTRACT FROM AUTHOR]

The prevalence of frailty is increasing, and it is associated with increased risk of diseases and adverse outcomes. Although substantial research has focused on post-stroke frailty, understanding of pre-stroke frailty remains limited. Our aim was to synthesize literature on pre-stroke frailty and stroke risk to explore their relationship and impact on prognosis. A systematic search of multiple databases was conducted to identify cohort studies published until October 28, 2023. Meta-analysis was conducted using a random effects model. Heterogeneity was assessed with the I² statistic, and publication bias was evaluated using Begg's test. Finally, we included 11 studies (n = 1,660,328 participants). The pooled hazard ratios (HRs) for stroke risk associated with pre-stroke frailty compared to non-frail individuals was 1.72 (95% confidence interval, CI: 1.46–2.02, p = 0.002, I2 = 69.2%, Begg's test: p = 0.536). The pooled HRs for mortality and the pooled relative risk (RRs) modified Rankin Scale (mRs) associated with pre-stroke frailty were 1.68 (95% CI: 1.10–2.56, p = 0.136, I2 = 49.9%, Begg's test: p = 0.296) and 3.11 (95% CI: 1.77–5.46, p = 0.192, I2 = 39.4%, Begg's test: p = 1.000), respectively. In conclusion, pre-stroke frailty is strongly associated with stroke risk and impacts its prognosis, irrespective of the measurement method. Future research should focus on prospective studies to assess the effects of early intervention for frailty. This has significant implications for primary healthcare services and frailty management. [ABSTRACT FROM AUTHOR]

Objective: To comprehensively and quantitatively evaluate the impact of body weight support training (BWST) on balance and gait function in stroke patients based on an evidence-based basis and to identify the most effective intervention strategies. Methods: PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and Chinese SinoMed Database were searched until November 25, 2023. Quality assessment and meta-analysis were performed using RevMan 5.2 and Stata 14.0 software. Results: A total of 31 randomized controlled trials involving 1,918 patients were included in the study. The meta-analysis demonstrated that body weight support training (BWST) significantly improved Berg Balance Scale (BBS) scores (MD = 3.60; 95% CI: 1.23 to 5.98; p = 0.003), gait speed (SMD = 0.77; 95% CI: 0.38 to 1.15; p < 0.0001), and step length (SMD = 0.46; 95% CI: 0.19 to 0.72; p = 0.0008) in stroke patients compared to conventional rehabilitation. For enhancing balance function, the most effective interventions were identified as a disease duration of 3-6 months (MD = 5.16; 95% CI: 0.76 to 9.57; p = 0.02), intervention time of 4-8 weeks (MD = 5.70; 95% CI: 2.90 to 8.50; p < 0.0001), a maximum body weight support level above 30% (MD = 3.80; 95% CI: 1.48 to 6.13; p = 0.001), and a maximum training walking speed of 0.2 m/s or more (MD = 4.66; 95% CI: 0.37 to 9.70; p = 0.03). For improving walking function, the optimal interventions were also a disease duration of 3-6 months (gait speed: SMD = 0.59; 95% CI: 0.15 to 1.03; p = 0.008; step length: SMD = 0.27; 95% CI: 0.06 to 0.56; p = 0.04), intervention time of 4-8 weeks (gait speed: SMD = 1.01; 95% CI: 0.44 to 1.59; p = 0.0006; step length: SMD = 0.83; 95% CI: 0.54 to 1.12; p < 0.00001), a maximum body weight support level above 30% (gait speed: SMD = 0.79; 95% CI: 0.36 to 1.22; p = 0.0003; step length: SMD = 0.79; 95% CI: 0.47 to 1.11; p < 0.00001), and a maximum training walking speed of 0.2 m/s or more (gait speed: SMD = 1.26; 95% CI: 0.62 to 1.90; p = 0.0001; step length: SMD = 0.85; 95% CI: 0.38 to 1.31; p = 0.0003). Conclusion: Compared with conventional rehabilitation training, BWST demonstrates superior efficacy in enhancing balance and walking function in stroke patients, with a consistent optimal intervention strategy. The most effective program includes a disease duration of 3-6 months, an intervention period of 4-8 weeks, a maximum body weight support of 30% or more, and a maximum training walking speed of 0.2 m/s or greater. [ABSTRACT FROM AUTHOR]

The novel object recognition (NOR) paradigm is a cognitive test that has been used with many species to detect differences in ability. Various iterations of the paradigm have been implemented, making it difficult to compare results both within and across species. Interpretations of the results are equally diverse, threatening the integrity of the paradigm. These inconsistencies have prompted a deeper dive into the variability of the resultant data. For the purposes of this meta-analysis, data originated from 12 studies involving 367 pigs that were subjected to the same NOR paradigm beginning between postnatal days 21 and 24. The main cognitive measure from the NOR paradigm is recognition index (RI), which was the focus of most of the analyses in this meta-analysis. RI was chosen as the main outcome as it determines a pig's preference for novelty, an innate behavior of cognitively intact pigs. A histogram of RI values (range 0 to 1) showed a bimodal distribution skewed to the right, suggesting that the interpretation of positive performance on the task may need to be stricter. Correlational analyses proved that the number of investigations and investigation time with both the novel and familiar objects were the strongest predictors of resultant RI values. Objective data inclusion criteria were then considered to eliminate non-compliant pigs. Results indicated that requiring at least 5 s of investigation over a minimum of 3 investigations with the novel object reduced overall variability for RI with a concomitant increase in the mean. Further analyses showed that pigs preferred to spend more time with and interact more with the novel object across the entire testing trial, especially in the first minute. Together, these findings suggest that future interpretations of NOR should consider applying stricter statistical analyses as well as additional data processing, such as binning, with emphasis on novel object and familiar object investigation. Overall, modifications to the existing iterations of the NOR paradigm are necessary to improve paradigm reliability. [ABSTRACT FROM AUTHOR]

Four hundred and sixty-six references with 625 data reports were included in our study. The high frequency of ratio OC/EC for PM0.1 was observed in 3.92–5.93; PM1 in 1.08–3.08; PM2.5, 2.08–4.08; PM10 in 2.70–4.70 and TSP in 2.66–4.66. The rank order of areas based on the pooled concentration of OC bound to PM2.5 was traffic (17.893 µg/m3) > industrial (10.58 µg/m3) > urban (7.696 µg/m3) > rural (4.08 µg/m3). The rank order of areas based on the pooled (mean) concentration of EC in PM2.5 was traffic (17.893 µg/m3) > industrial (2.65 µg/m3) > Urban (1.48 µg/m3) > rural (1.06 µg/m3). The pooled concentrations of OC and EC bound to PM2.5 in traffic areas were higher than in other areas. Therefore, it is recommended that monitoring and effectively reducing concentration plans are carried out, especially in traffic areas. [ABSTRACT FROM AUTHOR]

Background: There has been a significant surge in animal studies of stem cell-derived extracellular vesicles (EVs) therapy for the treatment of premature ovarian failure (POF) but its efficacy remains unknown and a comprehensive and up-to-date meta-analysis is lacking. Before clinical translation, it is crucial to thoroughly understand the overall impact of stem cell-derived EVs on POF. Methods: PubMed, EMBASE, Cochrane Library, Web of Science were searched up to February 18, 2024. The risk of bias was evaluated according to Cochrane Handbook criteria, while quality of evidence was assessed using the SYRCLE system. The PRISMA guidance was followed. Trial sequential analysis was conducted to assess outcomes, and sensitivity analysis and publication bias analysis were performed using Stata 14. Results: Data from 25 studies involving 339 animals were extracted and analyzed. The analysis revealed significant findings: stem cell-derived EVs increase ovary weight (SMD = 3.88; 95% CI: 2.50 ~ 5.25; P < 0.00001; I2 = 70%), pregnancy rate (RR = 3.88; 95% CI: 1.94 ~ 7.79; P = 0.0001; I2 = 0%), count of births (SMD = 2.17; 95% CI: 1.31 ~ 3.04; P < 0.00001; I2 = 69%) and counts of different types of follicles. In addition, it elevates the level of AMH (SMD = 4.15; 95% CI: 2.75 ~ 5.54; P < 0.00001; I2 = 88%) and E2 (SMD = 2.88; 95% CI: 2.02 ~ 3.73; P < 0.00001; I2 = 80%) expression, while reducing FSH expression (SMD = -5.05; 95% CI: -6.60 ~ -3.50; P < 0.00001; I2 = 90%). Subgroup analysis indicates that the source of EVs, animal species, modeling method, administration route, and test timepoint affected efficacy. Trial sequential analysis showed that there was sufficient evidence to confirm the effects of stem cell-derived EVs on birth counts, ovarian weights, and follicle counts. However, the impact of stem cell-derived EVs on pregnancy rates needs to be further demonstrated through more animal experimental evidence. Conclusions: Stem cell-derived EVs demonstrate safety and efficacy in treating POF animal models, with potential improvements in fertility outcomes. Trial registration: PROSPERO registration number: CRD42024509699. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews and data synthesis of randomised clinical trials play a crucial role in clinical practice, research, and health policy. Trial sequential analysis can be used in systematic reviews to control type I and type II errors, but methodological errors including lack of protocols and transparency are cause for concern. We assessed the reporting of trial sequential analysis. Methods: We searched Medline and the Cochrane Database of Systematic Reviews from 1 January 2018 to 31 December 2021 for systematic reviews and meta-analysis reports that include a trial sequential analysis. Only studies with at least two randomised clinical trials analysed in a forest plot and a trial sequential analysis were included. Two independent investigators assessed the studies. We evaluated protocolisation, reporting, and interpretation of the analyses, including their effect on any GRADE evaluation of imprecision. Results: We included 270 systematic reviews and 274 meta-analysis reports and extracted data from 624 trial sequential analyses. Only 134/270 (50%) systematic reviews planned the trial sequential analysis in the protocol. For analyses on dichotomous outcomes, the proportion of events in the control group was missing in 181/439 (41%), relative risk reduction in 105/439 (24%), alpha in 30/439 (7%), beta in 128/439 (29%), and heterogeneity in 232/439 (53%). For analyses on continuous outcomes, the minimally relevant difference was missing in 125/185 (68%), variance (or standard deviation) in 144/185 (78%), alpha in 23/185 (12%), beta in 63/185 (34%), and heterogeneity in 105/185 (57%). Graphical illustration of the trial sequential analysis was present in 93% of the analyses, however, the Z-curve was wrongly displayed in 135/624 (22%) and 227/624 (36%) did not include futility boundaries. The overall transparency of all 624 analyses was very poor in 236 (38%) and poor in 173 (28%). Conclusions: The majority of trial sequential analyses are not transparent when preparing or presenting the required parameters, partly due to missing or poorly conducted protocols. This hampers interpretation, reproducibility, and validity. Study registration: PROSPERO CRD42021273811 [ABSTRACT FROM AUTHOR]

Background: The way the healthcare delivery system is reflected by patient satisfaction. Establishing a health system with better results depends on it. It has been assumed that higher patient satisfaction levels correlate with quality healthcare outcomes. There is little national data to support patient satisfaction with inpatient health services in Ethiopia. In order to estimate the pooled proportion of patient satisfaction and determine the associated factors with inpatient health services at public hospitals, a systematic review and meta-analysis were conducted. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed in the extraction of the data. To get the included studies, the following electronic databases were searched: Pub-Med, Google Scholar, Med-Line, Web of Science, Scopus and Repositories. Software called STATA version 17 was used to analyze statistical data using the random effects model. Forest plots were used to display the pooled results. Results: Of the 1583 records resulted in electronic databases searching, 11 studies with 3,958 participants were included in this systematic review and meta-analysis. The estimated pooled proportion of patient satisfaction with inpatient health services was found to be 57.4% (95% CI: 50.88–64.59, I2 = 95.25%). Assuring privacy for patients (OR = 7.44, 95% CI: 3.63–15.25, I2 = 0.0%), availability of direction signs (2.96, 95% CI: 1.91–4.57, I2 = 0.0%), providing adequate information (OR = 3.27, 95% CI: 1.63–6,58, I2 = 65.60%), history of previous admission (OR = 0.29, 0.18–0.46, I2 = 86.36%) and providing on time treatment (OR = 1.63, 95% CI: 1.21–2.20, I2 = 86.36%) were statistically significant factors associated with patient satisfaction with inpatient health services. Conclusion: The estimated pooled level of patient satisfaction with inpatient health services is low in Ethiopia. A higher level of patient satisfaction with inpatient health treatments was predicted by factors such as privacy assurance, fast services, availability of direction signs, provision of services with adequate information transfer, and no history of previous admission. To improve patient satisfaction, the Ministry of Health and hospital administration must place a strong emphasis on ensuring the provision of high-quality, standard-based inpatient healthcare. [ABSTRACT FROM AUTHOR]

Background: Nasopharyngeal carcinoma (NPC) is diagnosed relatively late and has a poor prognosis, requiring early detection to reduce the disease burden. This diagnostic test accuracy meta-analysis evaluated the serological diagnostic value of nine EBV-related IgA antibody panels (EBNA1-IgA, VCA-IgA, EA-IgA, Zta-IgA, EBNA1-IgA + VCA-IgA, VCA-IgA + EA-IgA, VCA-IgA + Rta-IgG, EBNA1-IgA + VCA-IgA + Zta-IgA and VCA-IgA + EA-IgA + Rta-IgG), aiming to identify suitable serological detection biomarkers for NPC screening. Methods: PubMed, Embase, China National Knowledge Infrastructure and Chinese BioMedical Literature Database were searched from January 1st, 2000 to September 30th, 2023, with keywords nasopharyngeal carcinoma, IgA, screening, early detection, early diagnosis, sensitivity and specificity. Articles on the diagnostic value of serum EBV-related IgA antibody panels for NPC were included. Study selection, data extraction, and quality assessment were performed independently by two researchers, and a third researcher was consulted in the case of disagreement. Bivariate models were used for statistical analysis. The quality of included studies was evaluated through Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). Results: A total of 70 articles were included, involving 11 863 NPC cases and 34 995 controls. Among the nine EBV-related IgA antibody panels, EBNA1-IgA + VCA-IgA [0.928 (0.898, 0.950)], VCA-IgA + Rta-IgG [0.925 (0.890, 0.949)], EBNA1-IgA + VCA-IgA + Zta-IgA [0.962 (0.909, 0.985)] and VCA-IgA + EA-IgA + Rta-IgG [0.945 (0.918, 0.964)] demonstrated higher pooled sensitivity (95%CI). In terms of diagnostic odds ratio (DOR) (95%CI), EBNA1-IgA + VCA-IgA [107.647 (61.173, 189.430)], VCA-IgA + Rta-IgG [105.988 (60.118, 186.857)] and EBNA1-IgA + VCA-IgA + Zta-IgA [344.450 (136.351, 870.153)] showed superior performance. Additionally, the SROC curves for EBNA1-IgA + VCA-IgA and VCA-IgA + Rta-IgG were more favorable. However, publication bias was detected for VCA-IgA (P = 0.005) and EBNA1-IgA + VCA-IgA (P = 0.042). Conclusions: In general, parallel detection of serum EBNA1-IgA, VCA-IgA and Zta-IgA antibodies using ELISA demonstrates better pooled sensitivity and DOR among the studied panels. In the cases where fewer indicators are used, serum VCA-IgA and EBNA1-IgA/Rta-IgG antibody panel exhibits a comparable performance. Trial registration: The International Prospective Register of Systematic Reviews registration number: CRD42023426984, registered on May 28, 2023. [ABSTRACT FROM AUTHOR]

A meta-analysis including all relevant randomized controlled trials was conducted to compare soft bandage, splint and cast as the treatment of torus fracture. PubMed, Scopus, and Web of Science databases were searched in January 2023. Two comparisons were made: (1) splint versus cast, and (2) bandage versus rigid immobilization (i.e. splint or cast). Main outcomes were pain, clinical healing of the fracture and return to activities. Secondary outcomes were adverse events (skin issues, problems with cast/splint/bandage) and patient/parental satisfaction. Seven studies with 1550 patients were included. Splint was associated with higher pain scores at 3 days compared to cast (Mean difference [MD] 1.00, CI 0.06–1.94) and at 1 week (MD 1.46, CI 0.84–2.08, moderate-certainty evidence), but faster return to activities (at 3 weeks RR 1.77, CI 1.09–2.88, at 4 weeks RR 1.44, CI 1.11–1.82, moderate-certainty evidence). All torus fractures heal clinically within 3–4 weeks (low-certainty evidence). Bandage may lead to slightly higher pain score (MD 0.35, CI 0.04–0.66, moderate-certainty evidence) at first day after treatment compared to rigid immobilization, but no evidence of a difference was found in later time points. In conclusion, soft bandage or removable wrist splint seem to be optimal first-line treatment of distal forearm torus fracture. [ABSTRACT FROM AUTHOR]

Introduction: Depression and anxiety are pervasive mental health disorders with substantial global burdens. Probiotics, live microorganisms known for their health benefits, have emerged as a potential therapeutic intervention for these conditions. This systematic review and meta-analysis aim to evaluate the strain-specific effects of probiotics on relieving depressive and anxiety symptoms while elucidating underlying mechanisms. Methods: EMBASE, Cochrane CENTRAL and PubMed/Medline were systematically queried to identify studies released until May 15, 2024. Randomized Controlled Trials (RCTs) that employed standardized assessment tools for depression and anxiety namely Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), Depression Anxiety Stress Scales (DASS), or Montgomery-Asberg Depression Rating Scale (MADRS) were included. Results: 12 RCTs involving 707 participants were included. Seven RCTs utilizing the BDI questionnaire demonstrated a significant decrease in depressive symptoms favoring probiotics containing strains such as Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus casei, Lactobacillus plantarum, Lactobacillus salivarius, Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium breve, and Bifidobacterium longum (MD: -2.69, CI95%: -4.22/-1.16, p value: 0.00). Conversely, RCTs using HAMD showed a non-significant reduction in depressive symptoms (MD: -1.40, CI95%: -3.29/0.48, p value: 0.14). RCTs employing DASS and MADRS scales also showed no significant differences. Conclusion: This meta-analysis offers valuable insights into the strain-specific effects of probiotics containing Lactobacillus and Bifidobacterium species on depressive and anxiety symptoms. While our findings suggest a significant reduction in depressive symptoms based on the BDI scale favoring probiotics, the lack of significant effects observed on the HAMD, DASS, and MADRS scales underscores the complexity inherent in these conditions. It is imperative to acknowledge the mixed results across different measurement scales, indicating the need for cautious interpretation. Therefore, we advocate for a nuanced understanding of probiotics' impacts on various dimensions of mood, emphasizing the necessity for further research. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis aimed to explore the impact of prophylactic negative pressure wound therapy (NPWT) on the occurrence of deep surgical site infections (SSIs) following orthopedic surgery. Methods: A systematic search was conducted across Medline, Embase, Cochrane Library, and Web of Science databases for articles concerning NPWT in patients who underwent orthopedic surgery up to May 20, 2024. Using Stata 15.0, the combined odds ratios (ORs) were calculated with either a random-effects model or a fixed-effects model, depending on the heterogeneity values. Results: From a total of 440 publications, studies that utilized NPWT as the experimental group and conventional dressings as the control group were selected to analyze their impact on SSIs. Ultimately, 32 studies met the inclusion criteria. These included 12 randomized controlled trials and 20 cohort studies, involving 7454 patients, with 3533 of whom received NPWT and 3921 of whom were treated with conventional dressings. The results of the meta-analysis demonstrated that the NPWT group had a lower incidence of deep SSIs in orthopedic surgeries than did the control group [OR 0.64, 95% CI (0.52, 0.80), P = 0.0001]. Subgroup analysis indicated a notable difference for trauma surgeries [OR 0.65, 95% CI (0.50, 0.83), P = 0.001], whereas joint surgeries [OR 0.65, 95% CI (0.38, 1.12), P = 0.122] and spine surgeries [OR 0.61, 95% CI (0.27, 1.35), P = 0.221] did not show significant differences. Additionally, when examined separately according to heterogeneity, trauma surgeries exhibited a significant difference [OR 0.50, 95% CI (0.31, 0.80), P = 0.004]. Conclusion: The results of our study indicate that the prophylactic use of NPWT reduces the incidence of deep SSIs following orthopedic trauma surgery when compared to the use of conventional dressings. We postulate that the prophylactic application of NPWT in patients at high risk of developing complications from bone trauma may result in improved clinical outcomes and an enhanced patient prognosis. [ABSTRACT FROM AUTHOR]

Purpose: A growing body of research indicates a correlation between occupational exposure, particularly among individuals in driving-related occupations, and the incidence of low back pain (LBP). Methods: Databases were systematically searched, including PubMed, Embase, Web of Science, Cochrane Library, and SinoMed, from their inception through December 2023 for relevant studies of the prevalence and risk factors of LBP among professional drivers. Subsequent meta-analyses were performed utilizing Stata 17.0 and RevMan 5.4 software, while risk factor indicators were assessed using the Grading of Recommendations, Assessment, Development and Evaluation evidence quality grading system. Results: A systematic review and meta-analysis comprising 19 studies involving 7,723 patients indicated that the incidence of LBP among drivers was 39% (95% confidence interval [CI] 0.20–0.57) in the past 7 days and 53% (95% CI 0.43–0.63) in the past 12 months. A subgroup analysis revealed a prevalence of 48% (95% CI 0.33–0.64) in 2005–2015 and 56% (95% CI 0.42–0.70) in 2016–2023. Among the identified factors, robust evidence highlighted age ≥ 41 years (odds ratio [OR] = 2.10; 95% CI 1.36–3.24; P = 0.0008), alcohol consumption (OR = 1.75; 95% CI 1.31–2.34; P = 0.0001), sleeping < 6 h/night (OR = 1.60; 95% CI 1.13–2.24; P = 0.007), uncomfortable seating (OR = 1.71; 95% CI 1.23–2.36; P = 0.001), improper driving posture (OR = 2.37; 95% CI 1.91–2.94; P < 0.00001), and manual handling (OR = 2.23; 95% CI 1.72–2.88; P < 0.00001) as significant risk factors for LBP. There was moderate evidence of a lack of exercise (OR = 1.78; 95% CI 1.37–2.31; P < 0.0001), working > 10 h/day (OR = 2.49; 95% CI 1.89–3.28; P < 0.00001), > 5 years' driving experience (OR = 2.12; 95% CI 1.66–2.69; P < 0.00001), a lack of back support (OR = 1.81; 95% CI 1.25–2.62; P = 0.002), high work-related pressure (OR = 2.04; 95% CI 1.59–2.61; P < 0.00001), and job dissatisfaction (OR = 1.57; 95% CI 1.23–2.01; P = 0.0003) as moderate risk factors. There was no evidence of body mass index or smoking as risk factors for LBP among professional drivers. Conclusion: The current evidence indicates an increasing annual trend in the prevalence of LBP among professional drivers. Factors including age ≥ 41 years, alcohol consumption, and sleeping < 6 h/night were among the 12 influential factors contributing to LBP in professional drivers. Enhancing awareness of these factors and formulating targeted preventive strategies may be beneficial. [ABSTRACT FROM AUTHOR]

Background: Post-transplant lymphoproliferative disorders (PTLD) are rare but severe complications that occur after solid organ or allogeneic hematopoietic stem cell transplantations (allo-HSCT), with rapid progression and high mortality. Primary central nervous system (CNS)-PTLD are rarely recognized histo-pathologically. In addition, the diagnostic value of the Epstein–Barr virus (EBV) DNA copies in CNS-PTLD remains poorly understood. Objectives: We herein report a case of monomorphic EBV-associated CNS-PTLD (diffuse large B-cell lymphoma, DLBCL) after allo-HSCT and perform a meta-analysis to assess the efficacy of PTLD treatment strategies in recent years. Methods: We present the case report covering clinical manifestations, diagnosis, treatment, and outcomes of a patient with primary CNS-PTLD. Additionally, we include a systematic review and meta-analysis of the clinical characteristics of 431 patients with PTLD after allo-HSCT. We evaluate the main treatment options and outcomes of PTLD management, including rituximab, chemotherapies, and autologous or human leukocyte antigen (HLA)-matched EBV-specific cytotoxic T lymphocyte infusion (EBV-CTLs)/donor lymphocyte infusion (DLI). Results: The meta-analysis revealed an overall response rate of 69.0% for rituximab alone (95% CI: 0.47–0.84), 45.0% for rituximab plus chemotherapies (95% CI: 0.15–0.80), and 91.0% for rituximab plus EBV-CTLs/DLI (95% CI: 0.83–0.96). The complete response (CR) rate after treatments for PTLD was 67.0% (95% CI: 0.56–0.77). Moreover, the 6-month and 1-year overall survival (OS) rate was 64.0% (95% CI: 0.31–0.87) and 49.0% (95% CI: 0.31–0.68), respectively. Conclusions: This case highlighted the urgent need for effective, low-toxic treatment regimens for CNS-PTLD. Our meta-analysis suggested that rituximab combined with EBV-CTLs/DLI could be a favorable strategy for the management of PTLD after allo-HSCT. [ABSTRACT FROM AUTHOR]

The benefit of high-dose melphalan followed by autologous hematopoietic stem cell transplantation (HDM-ASCT) for multiple myeloma (MM) patients with renal insufficiency (RI) is debated. A systematic review and meta-analysis were conducted to assess the safety and efficacy of HDM-ASCT in MM patients with RIs, and the findings were compared with real-world data. The study included 26 articles, 13 of which were pooled for meta-analysis. We compared three different types of MM patients with RI against MM patients with normal renal function (NRF). These patients were: MM patients with RI at the time of transplantation; MM patients with RI at the time of diagnosis; MM patients with RI at diagnosis but with NRF at transplantation. The meta-analysis indicated that MM patients with RIs conditioned with melphalan ≤ 140 mg/m2 followed by ASCT had transplant-related mortality rates comparable to those without RIs. The complete response rates post-ASCT were similar between MM patients with RIs and those with NRF. Although progression-free survival (PFS) was statistically similar between the groups, MM patients with RIs had significantly poorer overall survival (OS) than those with NRF. The real-world data supported these findings. With a reduced dose of melphalan, ASCT is safe and effective for MM patients with RI. MM patients with RI have similar complete response rates and PFS after ASCT compared to MM patients with NRF. The lower OS in MM patients with RI indicates the need for further research to improve OS in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Neurosurgery is an intensely competitive field. With the USMLE Step 1 transitioning to a pass/fail system, research has become a crucial component of the neurosurgery residency application process. This emphasis on research is particularly critical for international medical graduates (IMGs), who often face greater challenges compared to their U.S. counterparts. IMGs typically need more publications and higher H-indices to stand out. However, accessing quality research opportunities is significantly more difficult for those from low- and middle-income countries. This mini-review aims to provide a new perspective for IMGs, demonstrating that publishing in prestigious neurosurgical journals is possible even with limited resources. Methods: We searched Scopus and reviewed Brazilian publications from 2014 to 2023 in Neurosurgery and the Journal of Neurosurgery. We extracted the methodological designs of the studies and the graduation status of the first authors. Results: In 2023–2024, four Brazilian medical students published systematic reviews in major neurosurgical journals as first authors, marking a revolutionary change in the Brazilian neurosurgical landscape not seen in the past decade. These achievements illustrate that high-impact publications are attainable without geographical proximity, substantial financial support, or access to extensive institutional databases. Letters to the editor also represented a considerable Brazilian contribution. Conclusion: Literature reviews and letters to the editor are accessible methods for IMGs to engage in impactful research. IMGs can maximize their abilities and significantly contribute to neurosurgery by embracing literature reviews and meta-analyses. These approaches can open doors for those without other avenues to begin their research careers. [ABSTRACT FROM AUTHOR]

Aims Methods and results Conclusion Angiotensin receptor–neprilysin inhibitor (ARNI) has played an increasingly important role in the management of heart failure (HF). However, the evidence on the benefits of ARNI in HF patients with end‐stage kidney disease (ESKD) undergoing dialysis is limited. This study aimed to investigate the efficacy and safety of ARNI in patients with concomitant HF and ESKD on maintenance dialysis.We systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and ClinicalTrials.gov databases for studies reporting outcomes after ARNI treatment in HF patients with ESKD on dialysis. All meta‐analyses were performed using the random effects model. Twenty‐six studies comprising 2494 patients with concomitant HF and ESKD undergoing dialysis were included. Our synthesis showed a significant improvement in left ventricular ejection fraction (LVEF) between before and after ARNI treatment (mean change: 8.05%; 95% confidence interval [CI] 5.57–10.54). Compared to the conventional group, the ARNI group showed a greater improvement in LVEF (mean difference: 4.03%; 95% CI 2.90–5.16). This effect was more pronounced in patients with HF with reduced ejection fraction (pinteraction < 0.0001). Patients treated with ARNI had a lower risk of all‐cause mortality (risk ratio [RR] 0.64; 95% CI 0.45–0.92; p = 0.01) but had a similar rate of HF hospitalization (RR 0.71; 95% CI 0.43–1.18; p = 0.19). ARNI treatment showed benefits in the improvement of left ventricular end‐systolic diameter, left ventricular mass index, left atrial diameter, and E/e′ ratio (p < 0.05), while it did not significantly increase the risk of severe hyperkalaemia (p = 0.33) or symptomatic hypotension (p = 0.53).This meta‐analysis provided insights into the benefits of ARNI in HF patients with ESKD undergoing dialysis by improving left ventricular function, reversing left ventricular remodelling, and reducing the risk of all‐cause mortality, without increasing the risk of HF hospitalizations, severe hyperkalaemia, and symptomatic hypotension. [ABSTRACT FROM AUTHOR]

ABSTRACT The existing paradigm on recovery in mental health prioritises self‐empowerment and person‐centred, community‐based care, which necessitates family caregivers' collaboration to support individuals with schizophrenia in the community. However, the role of family caregivers is often under‐recognised and hence insufficiently supported. This consequently compromises caregivers' well‐being and, ultimately, the recovery of individuals with schizophrenia. Although caregiver‐targeted psychoeducation may offer practical support, its effectiveness lacks conclusive evidence. This review aimed to evaluate the impacts of psychoeducation on caregiver‐related outcomes (caregiver burden, quality of life and expressed emotion). Eight electronic databases were searched from inception to September 2023, supplemented by hand searching of end‐reference lists. Two reviewers independently conducted title and abstract screening with predetermined eligibility criteria. A third reviewer was consulted to resolve any discrepancies. A random‐effects meta‐analysis was performed to estimate pooled effect sizes alongside subgroup and sensitivity analyses where appropriate. Twenty‐one studies (totalling 1639 caregivers) were included, based on which psychoeducation contributed to a statistically significant improvement in caregiver‐related outcomes. Given substantial heterogeneity, subgroup and sensitivity analyses were done for the durations and the evaluative scales for psychoeducation. Quality appraisal revealed unclear or high bias in most studies. Notwithstanding the heterogeneity, the directions of the effect sizes consistently indicated the effectiveness of psychoeducation across all outcomes. This finding aligned with Lazarus' stress appraisal and coping theory, which states that psychoeducation improves caregivers' knowledge, coping mechanisms and situation appraisal. Our findings offer encouraging evidence to advocate the integration of psychoeducation into healthcare services, but policy‐based support is warranted for sustained implementation. Further research is merited to optimise its duration and content and appraise its long‐term impacts through disease‐specific scales for objective and subjective outcomes. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Recent studies have demonstrated an obesity paradox, where obese patients with cardiovascular disease have a better outcome compared to those with normal weight. However, the effect of obesity and body mass index (BMI) on the outcome of patients with cardiac resynchronization therapy (CRT) devices remains unclear. The current study aims to investigate this relationship using all available published data.We systematically reviewed studies from Medline and EMBASE databases from inception to January 2024. Eligible studies must investigate the association between BMI status and all‐cause mortality in individuals with CRT devices. Relative risk (RR) or hazard ratio (HR) and 95% CIs were retrieved from each study and combined using the generic inverse variance method.A total of 12 cohort studies were included in the meta‐analysis. Pooled analysis showed that overweight and obesity patients had lower all‐cause mortality compared to those with normal body weight with the pooled risk ratios (RR) for overweight of 0.77 (95% CI 0.69–0.87, I2 47%) and for obesity of 0.81 (95% CI 0.67–0.97, I2 59%). Conversely, the underweight exhibited higher all‐cause mortality than the group with normal weight, with a pooled RR of 1.37 (95% CI 1.14–1.64, I2 0%). Additionally, higher BMI as continuous data was associated with decreased all‐cause mortality, with a pooled HR of 0.94 (95% CI 0.89–0.98, I2 72%).The pooled analyses observed an obesity paradox in patients with CRT, where overweight and obesity were associated with reduced all‐cause mortality, while underweight individuals exhibited higher all‐cause mortality. Further research is necessary to investigate the underlying mechanisms and their implications for clinical practice. [ABSTRACT FROM AUTHOR]

The meta-analysis investigated first-generation adult immigrants’ commitment toward their culture of origin and their new cultural environment and identified core factors related to cultural identity formation. Effects of the survey methodology used in studies on cultural identity were also considered. Forty-four samples in English-language peer-reviewed journal articles published between 1971 and 2021 were analyzed. The results of random-effects analysis revealed that first-generation adult immigrants identified strongly with their culture of origin and moderately with the residence country. The level of identification was moderated by cultural distance, region of origin, type of immigration, gender, and the questionnaire language used. The implications of moderators and methodological issues for the study of identity formation in acculturation settings are discussed. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionSystemic Therapy conceives mental health symptoms in the context of social systems. Previous meta-analyses on Systemic Therapy focused on symptoms. This meta-analysis aims to focus on family system functioning while including all types of outcomes.We conducted a systematic literature research in multiple databases (PsycInfo, PubMed, Embase, Cochrane Central). We included RCT-studies on adults with psychiatric diagnoses, which compared Systemic Therapy with active psychosocial control. The literature research resulted in 171 coded effect sizes of 32 RCTs. We conducted a random-effects three-level meta-analysis. We categorized outcomes into symptoms of patients, family system functioning, further secondary outcomes of patients, and psychopathology of family members.The results show a small significant overall effect size of g = .30 (CI: .15–.45, p < .001, k = 171, s = 32) for all outcomes. Systemic Therapy revealed small effect sizes with regard to family system functioning (g = .34, z = 3.51, p = .0004, k = 26, s = 12), symptoms (g = .30, z = 3.74, p = .0002, k = 73, s = 29), and further secondary outcomes (g = .32, z = 3.83, p = .0001, k = 63, s = 19). The effect sizes for psychopathology of family system members were reported rarely (k = 9, s = 6).This meta-analysis shows the potential relevance of investigating family system functioning as a primary outcome for Systemic Therapy. [ABSTRACT FROM AUTHOR]

Background: The effect of omentum preservation (OP) on locally advanced gastric cancer (LAGC) remains controversial. This study aimed to investigate the long-term prognosis of LAGC patients with OP versus omentum resection (OR). Methods: A comprehensive search of databases including PubMed, Web of Science, Embase, and Cochrane Library was conducted up until February 2024. Statistical analysis was performed using Stata 12.0 software. The primary outcome was to assess the impact of OP on the long-term prognosis of patients with LAGC, including overall survival (OS) and recurrence-free survival (RFS). Results: A total of six case-control studies were included, encompassing a cohort of 1897 patients. The OP group consisted of 844 patients, while the OR group comprised 1053 patients. The study results showed that the OS (HR = 0.72, 95% CI: 0.58–0.90, P = 0.003) and 5-year RFS (HR = 0.79, 95% CI: 0.63–0.99, P = 0.038) in the OP group were superior to those observed in the OR group. Subgroup analysis indicated that 5-year OS (HR = 0.64, P = 0.003) and 5-year RFS (HR = 0.69, P = 0.005) in the OP group were also better than those in the OR group in Korea. However, the subgroup analysis conducted on stage T3-T4 tumors revealed no statistically significant differences in OS (P = 0.083) and 5-year RFS (P = 0.173) between the two groups. Conclusion: Compared with OR, OP shows non-inferiority in patients with LAGC and can be considered a potential treatment option for radical gastrectomy. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults. Methods: A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions. Results: A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P < 0.001). We examined the effects of patient recruitment from various regions, medication usage, therapist involvement, weekly intervention time, and intervention duration. Patients selected from school, primary healthcare centers, clinics and local communities had better results. Intervention lasting 30 to 60 min and 60 to180 minutes per week were effective in the short term. Conclusion: The internet-based self-help intervention can be effective in treating depression in adolescents and young adults. However, factors such as patient recruitment locations, medication usage, Therapists' involvement, weekly intervention time, and intervention duration interacted with the outcome. Subgroup analysis on potential adverse effects and gender was impossible due to insufficient data from the included studies. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the clinical efficacy (pain, function, quality of life) and safety of platelet-rich plasma (PRP) in the treatment of frozen shoulder through meta-analysis, and provide evidence-based medical evidence for the effectiveness of PRP in the treatment of frozen shoulder. Methods: A search was conducted on international databases (Pubmed, Web of science, Embase) and Chinese databases (CNKI, Wanfang, VIP) to search the clinical studies on the efficacy of platelet-rich plasma in treating frozen shoulder (adhesive capsulitis/periarthritis/50 shoulder) and their corresponding references published from inception until January 2024. Thoroughly excluded literature not meeting the predetermined inclusion criteria, extracted relevant data from the literature, and input it into RevMan5.4 for meta-analysis. Results: This study ultimately included 14 RCTs, with a total of 1024 patients. The results showed that PRP has significant advantages compared with control groups in VAS (mean difference (MD) =-0.38, 95% confidence interval(CI)(-0.73, -0.03), P = 0.03), UCLA (MD = 3.31, 95% CI (1.02,5.60),P = 0.005), DASH (MD = -4.94,95% CI (-9.34, -0.53),P = 0.03), SPADI (SPADI Total: MD =-16.87, 95% CI (-22.84, -10.91), P < 0.00001; SPADI Pain: MD =-5.38, 95% CI (-7.80, -2.97), P < 0.0001; SPADI Disability: MD =-11.00, 95% CI (-13.61,-8.39), P < 0.00001), and the active and passive Range of Motion (active flexion: MD = 12.70, 95% CI (7.44, 17.95), P < 0.00001; passive flexion: MD = 9.47, 95% CI(3.80, 15.14), P = 0.001; active extension: MD = 3.45, 95% CI(2.39, 4.50), P < 0.00001; active abduction: MD = 13.54, 95% CI(8.42, 18.67), P < 0.00001; passive abduction: MD = 14.26, 95% CI (5.97, 22.56), P = 0.0008; active internal rotation: MD = 5.16, 95% CI (1.84, 8.48), P = 0.002; passive internal rotation: MD = 3.65, 95% CI(1.15, 6.15), P = 0.004; active external rotation: MD = 10.50, 95% CI(5.47, 15.53), P < 0.0001; passive external rotation: MD = 6.00, 95% CI (1.82, 10.19), P = 0.005) except passive extension (MD = 2.25, 95% CI (-0.77, 5.28), P = 0.14). In terms of safety, most studies reported no adverse effects, and only one study reported common complications of joint puncture such as swelling and pain after treatment in both PRP and control groups. Previous studies have shown a risk of osteonecrosis caused by corticosteroids. Therefore, the safety of PRP treatment is more reliable. Conclusion: The results showed that PRP was more durable and safer than corticosteroids and other control groups in the treatment of frozen shoulder. Study Design: Systematic review. Trial registration: PROSPERO CRD42022359444, date of registration: 22-09-2022. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis aims to clarify the association between the TNF-α -308G > A and − 238G > A polymorphisms and lung cancer risk. Method: A comprehensive search was conducted for relevant articles across databases such as PubMed, Google Scholar, Web of Science, EMBASE, and CNKI, up to September 25, 2023. Lung cancer risk was assessed by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). The Z-test was used to determine the significance of combined ORs, with P < 0.05 considered statistically significant. All analyses were performed using Comprehensive Meta-Analysis (CMA) 2.0 software. Results: The analysis included 19 case-control studies with 3,838 cases and 5,306 controls for the TNF-α -308G > A polymorphism, along with 10 studies comprising 2,427 cases and 2,357 controls for the − 238G > A polymorphism. The − 308G > A polymorphism showed no significant overall relationships, though in the Asian subgroup, the A allele was significantly reduced compared to G (OR: 0.831, p = 0.028) and the AA genotype showed significant reductions versus GG (OR: 0.571, p = 0.021), with no significant correlation in Caucasians. In non-small cell lung cancer (NSCLC), the A allele was associated with increased risk compared to G (OR: 1.131, p = 0.049). For the − 238G > A polymorphism, the AA genotype significantly increased risk compared to GG (OR: 3.171, p = 0.014), while showing a protective effect in Caucasians (OR: 0.120, p = 0.024) and a heightened risk in Asians (OR: 7.990, p = 0.007). In small cell lung cancer (SCLC), the A allele conferred protective effects, whereas NSCLC showed increased risk for the AA genotype (OR: 11.375, p = 0.002). Conclusion: The − 308G > A polymorphism has no significant overall relationships but suggests a protective role of the A allele in the Asian subgroup. Conversely, the − 238G > A polymorphism presents a complex risk profile, increasing lung cancer likelihood in Asians while protecting Caucasians. Notably, the AA genotype significantly raises risk for NSCLC, indicating its potential as a risk factor. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the efficacy of five analgesic strategies combined with conventional physiotherapy program (CPT) in managing chronic shoulder pain. Methods: Two authors independently screened studies, extracted data using a pre-formatted chart, and assessed bias using the Cochrane Risk of Bias tool. A network meta-analysis was performed by the Stata 17.0 and R 4.3.2 software. Results: A total of 14 studies with 862 subjects were identified. These analgesic strategies included extracorporeal shock wave therapy (ESWT), suprascapular nerve block (SSNB), corticosteroid injection (CSI), hyaluronic acid injection (HAI), and kinesio taping (KT). ESWT plus CPT was the most efficient intervention in alleviating pain intensity and improving physical function. SSNB plus CPT was the optimal intervention in improving shoulder mobility. Compared to CPT alone, CSI + CPT only significantly improved the SPADI total score, but showed no difference in pain intensity or shoulder mobility. HAI + CPT showed no significant difference in improving pain intensity, physical function, or shoulder mobility compared to CPT alone. Adding KT to CPT did not yield additional benefits in improving shoulder mobility. Conclusion: Overall, in managing chronic shoulder pain, ESWT + CPT was the most effective intervention for reducing pain intensity and improving physical function. SSNB + CPT was optimal for enhancing shoulder mobility. Future rigorous clinical trials with larger sample sizes and higher methodological rigor are strongly required to confirm the current results. [ABSTRACT FROM AUTHOR]

Background: Studies comparing the effectiveness of arthroscopic knee surgery and conservative treatment on knee osteoarthritis (OA) came up with inconsistent results. Systematic review on this topic still is still lacking. This systematic review and meta-analysis aimed to evaluate the effectiveness of arthroscopic knee surgery on knee OA, compared to conservative treatments. Materials and methods: Literature searches were performed in PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) published before on 1st July 2024. Studies comparing the effectiveness of arthroscopy and conservative treatments only on knee OA were included. Quality of included studies was evaluated by risk of bias 2 (ROB2). Long-term results in terms of pain relief, functional recovery and patients reported satisfaction were meta-analyzed to evaluate the therapeutic effectiveness. Results: Ten studies were included in this review, among which only 1 was considered as low risk of bias. Five studies were involved in meta-analyses and no difference was found in therapeutic effectiveness of arthroscopic surgery and conservative treatment on knee OA, in the evaluation of VAS (p = 0.63), WOMAC (p = 0.38), SF-36 (p = 0.74) and patient satisfaction (p = 0.07). Conclusion: The evidence does not support the effectiveness of arthroscopic knee surgery compared to conservative treatments in knee OA. [ABSTRACT FROM AUTHOR]

Background: The prognosis of patients with hepatocellular cancer is substantially correlated with the abnormal expression of growing long non-coding RNA small nucleolar host gene RNA (SNHG) families in liver cancer tissues. This study aimed to examine the relationship between SNHG expression and liver cancer prognosis. Methods: After searching six internet databases, pertinent manuscripts were found based on inclusion and exclusion criteria. To determine whether SNHG expression levels affect liver cancer prognosis, raw data were collected and hazard ratios (HRs) and odds ratios (ORs) were calculated. The results were examined for potential publication bias using the sensitivity analysis and Beeg's test. Results: Most SNHG family members were up-regulated in liver cancer tissues. High SNHG expression predicts poor liver cancer outcomes of, including overall survival (OS) (HR: 1.697, 95% confidence interval [CI]: 1.373–2.021), especially SNHG5 (the HR of OS is 4.74, 95%CI range from 1.35 to 6.64), progression-free survival (HR: 1.85, 95% CI: 1.25–2.73), tumor, node, metastasis (TNM) stage (OR: 1.696, 95% CI: 1.436–2.005), lymph node metastasis (OR: 2.383, 95% CI: 1.098–5.173), and tumor size (OR: 1363, 95% CI: 1.165–1.595). The OS results were found to be reliable and robust, as indicated by the sensitivity analysis. Additionally, Beeg's test demonstrated the absence of any potential publication bias for each result. Conclusion: In liver cancer tissues, most SNHGs are highly expressed, which may signal poor prognosis. SNHG has the potential to be an intriguing predictive marker and a prospective therapeutic target for liver cancer. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion The primary aim of this systematic review and meta‐analysis was to synthesize and compare the clinical efficacy of intense pulsed light (IPL) and pulsed‐dye laser (PDL) therapies for the management of rosacea.The literatures were searched in the Web of Science, PubMed, Embase, and Cochrane Library databases to identify relevant studies investigating the use of IPL and PDL for the treatment of rosacea. Screening of the retrieved articles and data extraction were performed as per the pre‐established inclusion and exclusion criteria. The primary outcome measures evaluated in this meta‐analysis included clearance rates, erythema scores, and pain scores.The meta‐analysis incorporated data from four studies involving a total of 141 participants. The meta‐analysis did not reveal a statistically significant difference between IPL and PDL in the rate of achieving greater than 50% clearance (RR = −0.07, 95% CI: −0.19, 0.05). However, the IPL group demonstrated a significantly higher rate of clearance exceeding 75% compared to the PDL group (RR = −0.13, 95% CI: −0.23, −0.04). The change in erythema index, a key measure of rosacea severity, was similar between the two treatment modalities (SMD = −0.15, 95% CI: −0.55, 0.26). Interestingly, the PDL group reported a notably lower VAS pain score than the IPL group (SMD = 1.54, 95% CI: 0.08, 3.00).Either PDL or IPL appears to be effective modalities for the management of rosacea. IPL exhibits a slight advantage in achieving a higher rate of substantial (>75%) clearance, while PDL may be preferable for patients with lower tolerance for post‐treatment discomfort. However, the existing literature directly comparing these two laser/light‐based therapies is limited, warranting further well‐designed, large‐scale studies to establish the optimal treatment algorithm for this chronic inflammatory skin condition. [ABSTRACT FROM AUTHOR]

Summary Objective Methods Results Conclusion To summarize the literature on pharmacotherapy for managing paediatric obesity.A systematic review and meta‐analysis were conducted of randomized controlled trials (RCTs) with <18‐year‐olds of pharmacotherapeutic agents published up to November 2022. Estimates of effect for outcomes were presented relative to minimal important differences and GRADE certainty of evidence. We examined data on patient/proxy‐reported outcome measures (PROMs), cardiometabolic risk factors, anthropometry and adverse events (AEs).Overall, 35 RCTs were included. Trials examined metformin (n = 26), glucagon‐like peptide‐1 receptor agonists (GLP1RAs) (n = 7) and a lipase inhibitor (orlistat; n = 2). Intervention duration varied (3−24 months). Metformin had little to no benefit on PROMs (e.g., health‐related quality of life [HRQoL]; 6 RCTs), moderate reductions in triglycerides, a moderate decline in insulin resistance, a small to moderate decline in BMI z‐score (BMIz) and a moderate increase in mild to moderate gastrointestinal AEs. Response to GLP1RAs was heterogeneous and results of subgroup analysis demonstrated variability of impact. Liraglutide (2 RCTs) resulted in a small reduction in HOMA‐IR and BMIz, but little to no benefit on other outcomes. Exenatide (4 RCTs) had a moderate reduction on blood pressure and a small decrease in BMIz with little to no benefit on other outcomes. Semaglutide (1 RCT) had a small benefit on HRQoL, a small reduction on SBP, a moderate reduction on total cholesterol and LDL‐cholesterol, a large reduction on triglyceride, and a very large decline in BMIz accompanied by a small increase in mild to moderate gastrointestinal AEs. Orlistat had a moderate reduction in DBP and little to no benefit in other outcomes measured, but had a very large increased risk of mild to moderate gastrointestinal AEs. Serious AEs were rare and for interventions with sufficent AE reporting, were considered not likely attributable to the interventions.Few studies examined the impact of pharmacotherapy on PROMs. There is evidence that metformin and GLP1RAs lead to important improvements in cardiometabolic and anthropometric outcomes while accompanied by mild to moderate AEs. Long‐term effectiveness and safety of GLP1RAs remain to be evaluated. [ABSTRACT FROM AUTHOR]

The development of new statistical models for the meta‐analysis of diagnostic test accuracy studies is still an ongoing field of research, especially with respect to summary receiver operating characteristic (ROC) curves. In the recently published updated version of the “Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy”, the authors point to the challenges of this kind of meta‐analysis and propose two approaches. However, both of them come with some disadvantages, such as the nonstraightforward choice of priors in Bayesian models or the requirement of a two‐step approach where parameters are estimated for the individual studies, followed by summarizing the results. As an alternative, we propose a novel model by applying methods from time‐to‐event analysis. To this task we use the discrete proportional hazard approach to treat the different diagnostic thresholds, that provide means to estimate sensitivity and specificity and are reported by the single studies, as categorical variables in a generalized linear mixed model, using both the logit‐ and the asymmetric cloglog‐link. This leads to a model specification with threshold‐specific discrete hazards, avoiding a linear dependency between thresholds, discrete hazard, and sensitivity/specificity and thus increasing model flexibility. We compare the resulting models to approaches from the literature in a simulation study. While the estimated area under the summary ROC curve is estimated comparably well in most approaches, the results depict substantial differences in the estimated sensitivities and specificities. We also show the practical applicability of the models to data from a meta‐analysis for the screening of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and Purpose Methods Results Conclusions This study was undertaken to conduct a meta‐analysis on the prevalence of aspiration pneumonia (AP) and hospital mortality in Parkinson disease (PD) as well as the risk of AP in PD patients compared to controls.We searched MEDLINE and Embase from inception to 19 March 2024 to identify cross‐sectional, cohort, and case–control studies comparing the frequency of AP and hospital mortality in PD patients. We computed risk ratios (RRs) with accompanying 95% confidence intervals (CIs) for each study and pooled the results using a random‐effects meta‐analysis.A total of 781 studies were initially screened, and 13 studies involving 541,785,587 patients were included. Patients with PD had >3 times higher risk of AP compared to controls (RR = 3.30, 95% CI = 1.82–6.00, p < 0.0001). This increased risk was similar in both cohort studies (RR = 3.01, 95% CI = 1.10–8.24, p = 0.03) and case–control studies (RR = 3.86, 95% CI = 3.84–3.87, p < 0.00001). The prevalence of AP in 12 studies was 2.74% (95% CI = 1.69–4.41), and hospital mortality was 10% in six studies (10.0%, 95% CI = 5.32–18.0). Prevalence of AP was higher in studies with smaller sample size (5.26%, 95% CI = 3.08–8.83 vs. 2.06%, 95% CI = 1.19–3.55, p = 0.02).Our meta‐analysis showed that patients with PD had >3 times higher risk of AP, with an average 2.74% prevalence and 10.0% hospital mortality. Early recognition and treatment of AP in PD patients will help reduce morbidity and mortality. A multidisciplinary holistic approach is needed to address the multifactorial causes of AP. [ABSTRACT FROM AUTHOR]

Background: COVID-19, as a significant public health issue, has had a major impact on the mental health of people worldwide. Research shows a significant positive correlation between individuals' risk perception levels and negative emotions during the outbreak of COVID-19. However, some studies also suggest that the relationship between the two is not significant. Therefore, we will conduct a meta-analysis to explore the relationship between risk perception and negative emotions from cultural, temporal, and individual psychological perspectives. Methods: Searches were conducted in the Web of Science, Pub Med, Google Scholar, PsycINFO, Scopus, and China National Knowledge Infrastructure databases, focusing on publications from January 2020 onwards, specifically targeting studies examining the relationship between risk perception and negative emotion during COVID-19. Results: A total of 58 papers with 85 effect sizes were meta-analyzed using Comprehensive Meta-Analysis 3.0 software, with a combined sample of 83,948 individuals. Risk perception of COVID-19 showed a moderate positive correlation with negative emotions (r = 0.211, 95%CI [0.18, 0.24]). There was no moderating effect of tight-loose cultures on the relationship between risk perception of COVID-19 and negative emotions. However, the epidemic period, gender ratio, and measurement methods did have moderating effects on the relationship between risk perception of COVID-19 and negative emotions. Conclusion: In future research, we can further develop theories related to the risk perception of COVID-19 and negative emotions, and based on these, formulate interventions to promote people's mental health. [ABSTRACT FROM AUTHOR]

Background: Labor pain is the nastiest conceivable pain women are involved in during labor and delivery. In this way, the end of labor pain is frequently outlined by myths and equivocalness. Hence, giving a compelling absence of pain in labor remained a challenge specifically in developing countries including Ethiopia. Objectives: This systematic review and meta-analysis aimed to explore the pooled prevalence of labor analgesia and associated factors to pregnant women in Ethiopia. Design: A systematic review and meta-analysis were utilized in agreement with the Preferred Reporting Items for Systematic Reviews. Data Sources: PubMed/Medline, SCOPUS, EMBASE, Web of Science, Google Scholars, and the Cochrane Library and supplemented it with manual were deliberately looked at until January 1–30, 2024. Methods: Two authors independently extricated all principal information utilizing standardized data extraction designs, and the analysis was done utilizing STATA version 17. Heterogeneity over the studies was evaluated utilizing I 2 measurement. The funnel plot and Egger's weighted regression tests were utilized to assess subjective and objective publication biases respectively. Also, the pooled effect of labor pain management and the associations were evaluated utilizing a random-effects model. Results: The general pooled prevalence of labor analgesia in the present study was 23.3% with a (95% confidence interval (CI): 13.5, 33.1). Maternal age (odds ratio (OR): 1.91; 95% CI: 1.11, 2.77), parity of the mother (OR: 0.28; 95% CI: 0.06, 0.63), history of pregnancy misfortune (OR: 0.12; 95% CI: 0.11, 0.36), length of labor (OR: 2.09; 95% CI: 1.06, 3.13), and awareness about labor analgesia (OR: 1.91; 95% CI: 0.34, 3.49) were significantly related with labor analgesia among pregnant women in Ethiopia. Conclusions: The generally pooled prevalence of labor analgesia among pregnant women in Ethiopia was low. Maternal age, parity of the mother, history of pregnancy loss, length of labor, and awareness of labor analgesia were factors influencing labor analgesia among pregnant women in Ethiopia. This finding proposes exceptional consideration to make laboring mothers free of pain by scaling up the strategies and utilizing labor pain administration in a way that universally recognized standards are met. Registration number: PROSPERO CRD: 42024525636 [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, a condition marked by progressive muscle mass and function decline, presents significant challenges in aging populations and those with chronic illnesses. Current standard treatments such as dietary interventions and exercise programs are often unsustainable. There is increasing interest in pharmacological interventions like bimagrumab, a monoclonal antibody that promotes muscle hypertrophy by inhibiting muscle atrophy ligands. Bimagrumab has shown effectiveness in various conditions, including sarcopenia. Aim: The primary objective of this meta-analysis is to evaluate the impact of bimagrumab treatment on both physical performance and body composition among patients diagnosed with sarcopenia. Materials and methods: This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed, Ovid/Medline, Web of Science, and the Cochrane Library databases up to June 2024 using appropriate Medical Subject Headings (MeSH) terms and keywords related to bimagrumab and sarcopenia. Eligible studies were randomized controlled trials (RCTs) that assessed the effects of bimagrumab on physical performance (e.g., muscle strength, gait speed, six-minute walk distance) and body composition (e.g., muscle volume, fat-free body mass, fat body mass) in patients with sarcopenia. Data extraction was independently performed by two reviewers using a standardized form, with discrepancies resolved through discussion or consultation with a third reviewer. Results: From an initial search yielding 46 records, we screened titles, abstracts, and full texts to include seven RCTs in our meta-analysis. Bimagrumab treatment significantly increased thigh muscle volume (mean difference [MD] 5.29%, 95% confidence interval [CI] 4.08% to 6.50%, P < 0.001; moderate heterogeneity χ2 = 6.41, I2 = 38%, P = 0.17) and fat-free body mass (MD 1.90 kg, 95% CI 1.57 kg to 2.23 kg, P < 0.001; moderate heterogeneity χ2 = 8.60, I2 = 30%, P = 0.20), while decreasing fat body mass compared to placebo (MD − 4.55 kg, 95% CI − 5.08 kg to − 4.01 kg, P < 0.001; substantial heterogeneity χ2 = 27.44, I2 = 89%, P < 0.001). However, no significant improvement was observed in muscle strength or physical performance measures such as gait speed and six-minute walk distance with bimagrumab treatment, except among participants with slower baseline walking speeds or distances. Discussion and conclusion: This meta-analysis provides valuable insights into the effects of bimagrumab on sarcopenic patients, highlighting its significant improvements in body composition parameters but limited impact on functional outcomes. The observed heterogeneity in outcomes across studies underscores the need for cautious interpretation, considering variations in study populations, treatment durations, and outcome assessments. While bimagrumab shows promise as a safe pharmacological intervention for enhancing muscle mass and reducing fat mass in sarcopenia, its minimal effects on muscle strength and broader physical performance suggest potential limitations in translating body composition improvements into functional gains. Further research is needed to clarify its long-term efficacy, optimal dosing regimens, and potential benefits for specific subgroups of sarcopenic patients. [ABSTRACT FROM AUTHOR]

Introduction: This meta-analysis aims to evaluate the complications associated with prepectoral breast reconstruction (PBR) compared to subpectoral breast reconstruction (SBR) in patients diagnosed with breast cancer. Materials and methods: A comprehensive search was performed in four databases, including Medline, Embase, Web of Science and CENTRAL, to collect literature published up until December 31, 2024. In addition, we conducted a thorough manual examination of the bibliographies of the identified papers, as well as pertinent reviews and meta-analyses. We conducted a search on three clinical trial registries, namely ClinicalTrials.gov, Controlled-trials.com, and Umin.ac.jp/ctr/index.htm. Meta-analyses were conducted on total complications, hematoma, infection, wound healing issues, necrosis, capsular contracture, rippling, animation deformity, and reoperation. Results: A total of 40 studies were included in the meta-analysis. Compared with SBR, PBR significantly reduced the incidence of animated malformations (OR=0.37, 95% CI: 0.19 to 0.70, P=0.003, I ²=12%), but increased the incidence of ripples (OR=2.39, 95% CI: 1.53 to 3.72, P=0.0001, I ²=10%) and seroma (OR=1.55, 95% CI: 1.02 to 2.35, P=0.04, increasing I ²=70%). Conclusions: Our findings indicate that PBR and SBR have comparable safety profiles, with similar total complication rates. Specifically, PBR is more likely to cause rippling and seroma, whereas SBR is more prone to causing animation deformity. [ABSTRACT FROM AUTHOR]

Background: Integrating computational thinking (CT) into STEM education has recently drawn significant attention, strengthened by the premise that CT and STEM are mutually reinforcing. Previous CT-STEM studies have examined theoretical interpretations, instructional strategies, and assessment targets. However, few have endeavored to delineate the transfer effects of CT-STEM on the development of cognitive and noncognitive benefits. Given this research gap, we conducted a systematic literature review and meta-analysis to provide deeper insights. Results: We analyzed results from 37 studies involving 7,832 students with 96 effect sizes. Our key findings include: (i) identification of 36 benefits; (ii) a moderate overall transfer effect, with moderate effects also observed for both near and far transfers; (iii) a stronger effect on cognitive benefits compared to noncognitive benefits, regardless of the transfer type; (iv) significant moderation by educational level, sample size, instructional strategies, and intervention duration on overall and near-transfer effects, with only educational level and sample size being significant moderators for far-transfer effects. Conclusions: This study analyzes the cognitive and noncognitive benefits arising from CT-STEM's transfer effects, providing new insights to foster more effective STEM classroom teaching. [ABSTRACT FROM AUTHOR]

Background: Global population aging poses a significant global challenge, necessitating an increased demand for proficient caregivers specialized in elderly care. In our study, a systematic review and meta-analysis were conducted to synthesize the evidence concerning nursing students' willingness to participate in caring for older people. Methods: Eligibility criteria focused on cross-sectional studies involving nursing students' willingness to participate in caring for older people and were reported in English or Chinese. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WANFANG databases were searched from inception until July 24, 2022. The methodological quality assessment in the included studies was evaluated using the AHRQ instrument. The pooled effects of the nursing students' willingness to participate in caring for older people were computed using a random-effects model. Funnel plots and Egger's test were employed to evaluate publication bias. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was conducted to verify the robustness of the meta-analysis findings. All statistical tests were conducted with Stata 16.0 software. Results: A total of 68 studies of medium or high quality met the eligibility criteria, involving 30,328 nursing students. The rate of nursing students' willingness to participate in caring for older people was 49.0% (95% CI = 46–53%, I2 = 98.1%, P = 0.000). The results of meta-regression analysis showed that the following four predictor variables were significantly associated with nursing students' willingness to participate in caring for older people: experience of living with and caring for older people, nursing as their first choice and their year-level in education, respectively. Subgroup analyses for these four predictor variables revealed the following pooled estimates of nursing students' willingness: having experience of living with older people (0.54, 95% CI = 0.46–0.62) vs. no such experience (0.38, 95% CI = 0.30–0.46), having experience of caring for older people (0.55, 95% CI = 0.48–0.63) vs. no such experience (0.38, 95% CI = 0.30–0.46), nursing as their first choice (0.54, 95% CI = 0.51–0.58) vs. not their first choice (0.44, 95% CI = 0.35–0.53), being in the first year of nursing education (0.44, 95% CI = 0.34–0.55), second year (0.45, 95% CI = 0.34–0.56), and third and fourth year (0.62, 95% CI = 0.53–0.71). Conclusion: The study found that approximately half of the nursing students confirmed their willingness to participate in caring for older people.The present study can serve as a resource for policymakers to increase the willingness of nursing students to participate in caring for older people. [ABSTRACT FROM AUTHOR]

This study has undertaken a scrutiny of research pertaining to enrichment programs based on future problem-solving skills, aimed at enhancing the cognitive dimensions of gifted students between the years 2010 and 2023. The study used a sample of 10 studies; 3 correlational studies and 7 quasi-experimental studies. The study employed the descriptive-analytical approach by following a meta-analysis method. The study aimed to discern the effectiveness of enrichment programs based on future problem-solving skills in developing the cognitive dimensions of the gifted. The study's findings have indicated a significant impact of enrichment programs based on future problem-solving skills in the development of the cognitive dimensions of the gifted, as per both correlational and quasi-experimental designs. Moreover, statistically significant differences were found related to the variables of educational level and gender in accordance with both correlational and quasi-experimental designs. The study also advocates the need for further research in this domain to facilitate the generalization of the novel findings of this study within the gifted field. [ABSTRACT FROM AUTHOR]

Background: The anatomic characteristics of the masticatory muscles differ across craniofacial skeletal patterns. Objective: To identify differences in the anatomic characteristics of masticatory muscles across different sagittal and vertical craniofacial skeletal patterns. Eligibility criteria: Studies measuring the thickness, width, cross-sectional area (CSA), volume and orientation of masticatory muscles in healthy patients of different sagittal (Class I, Class II, and Class III) and/or vertical (normodivergent, hypodivergent, and hyperdivergent) patterns. Information sources: Unrestricted literature searches in 8 electronic databases/registers until December 2023. Risk of bias and synthesis of results: Study selection, data extraction, and risk of bias assessment with a customised tool were performed independently in duplicate. Random-effects meta-analysis and assessment of the certainty of clinical recommendations with the GRADE approach were conducted. Results: 34 studies (37 publications) were selected with a total of 2047 participants and data from 16 studies were pulled in the meta-analysis. Masseter muscle thickness in relaxation was significantly greater by 1.14 mm (95% CI 0.74–1.53 mm) in hypodivergent compared to normodivergent patients while it was significantly decreased in hyperdivergent patients by − 1.14 mm (95% CI − 1.56 to − 0.73 mm) and − 2.28 mm (95% CI − 2.71 to − 1.85 mm) compared to normodivergent and hypodivergent patients respectively. Similar significant differences were seen between these groups in masseter muscle thickness during contraction as well as masseter muscle CSA and volume. Meta-analyses could not be performed for sagittal categorizations due to insufficient number of studies. Conclusions: Considerable differences in masseter muscle thickness, CSA and volume were found across vertical skeletal configurations being significantly reduced in hyperdivergent patients; however, results should be interpreted with caution due to the high risk of bias of the included studies. These variations in the anatomic characteristics of masticatory muscles among different craniofacial patterns could be part of the orthodontic diagnosis and treatment planning process. Registration: PROSPERO CRD42022371187. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is correlated with metabolic deterioration in patients experiencing polycystic ovary syndrome (PCOS). Women diagnosed with PCOS exhibit a heightened prevalence of OSAHS. This meta-analysis aims to assess the morbidity of OSAHS in women affected by PCOS and to examine the differences in metabolismrelated indicators between OSAHS-positive and OSAHS-negative in women with PCOS. Methods: A comprehensive literature analysis of OSAHS morbidity in women with PCOS was conducted, utilizing databases such as CNKI, EMBASE, PubMed, Web of Science, and Wanfang. A comparison was carried out between patients with OSAHS-positive and those with OSAHS-negative in terms of their clinical characteristics and metabolic differences. The search language included English and Chinese. The acquired data were analyzed by employing RevMan 5.2 and Stata 11.0. Continuous variables with the same units were combined and analyzed through weighted mean differences (WMDs) as effect sizes, while continuous variables with different units were combined and analyzed through standardized mean differences (SMDs) as effect sizes. A conjoint analysis was performed on the basis of I² value, using either a fixed effect model (I² = 50%) or a random effect model (I² > 50%). Results: A total of 21 articles met the inclusion criteria for this study. The findings indicated that 20.8% of women with PCOS were found to have comorbid OSAHS. The subjects were categorized into various subgroups for meta-analysis on the basis of race, age, disease severity, body mass index (BMI), and diagnostic criteria of PCOS. The results revealed high morbidity of OSAHS in all subgroups. In addition, most metabolic indicators and parameters of metabolic syndrome were notably worse in women suffering from both PCOS and OSAHS in comparison to their counterparts solely diagnosed with PCOS. Conclusion: The current literature indicates higher morbidity of OSAHS among women with PCOS, linking OSAHS with worse metabolic status and obesity in this population. Consequently, clinicians are advised to prioritize the detection and management of OSAHS in women with PCOS. [ABSTRACT FROM AUTHOR]

Background: Previous studies based on resting-state functional magnetic resonance imaging(rs-fMRI) and voxel-based morphometry (VBM) have demonstrated significant abnormalities in brain structure and resting-state functional brain activity in patients with early-onset schizophrenia (EOS), compared with healthy controls (HCs), and these alterations were closely related to the pathogenesis of EOS. However, previous studies suffer from the limitations of small sample sizes and high heterogeneity of results. Therefore, the present study aimed to effectively integrate previous studies to identify common and specific brain functional and structural abnormalities in patients with EOS. Methods: The PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), and WanFang databases were systematically searched to identify publications on abnormalities in resting-state regional functional brain activity and gray matter volume (GMV) in patients with EOS. Then, we utilized the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software to conduct a whole-brain voxel meta-analysis of VBM and rs-fMRI studies, respectively, and followed by multimodal overlapping on this basis to comprehensively identify brain structural and functional abnormalities in patients with EOS. Results: A total of 27 original studies (28 datasets) were included in the present meta-analysis, including 12 studies (13 datasets) related to resting-state functional brain activity (496 EOS patients, 395 HCs) and 15 studies (15 datasets) related to GMV (458 EOS patients, 531 HCs). Overall, in the functional meta-analysis, patients with EOS showed significantly increased resting-state functional brain activity in the left middle frontal gyrus (extending to the triangular part of the left inferior frontal gyrus) and the right caudate nucleus. On the other hand, in the structural meta-analysis, patients with EOS showed significantly decreased GMV in the right superior temporal gyrus (extending to the right rolandic operculum), the right middle temporal gyrus, and the temporal pole (superior temporal gyrus). Conclusion: This meta-analysis revealed that some regions in the EOS exhibited significant structural or functional abnormalities, such as the temporal gyri, prefrontal cortex, and striatum. These findings may help deepen our understanding of the underlying pathophysiological mechanisms of EOS and provide potential biomarkers for the diagnosis or treatment of EOS. [ABSTRACT FROM AUTHOR]

Background: Voriconazole plasma concentration exhibits significant variability and maintaining it within the therapeutic range is the key to enhancing its efficacy. We conducted a systematic review and meta-analysis to estimate the prevalence of patients achieving the therapeutic range of plasma voriconazole concentration and identify associated factors. Methods: Eligible studies were identified through the PubMed, Embase, Cochrane Library, and Web of Science databases from their inception until 18 November 2023. We conducted a meta-analysis using a random-effects model to determine the prevalence of patients who reached the therapeutic plasma voriconazole concentration range. Factors associated with plasma voriconazole concentration were summarized from the included studies. Results: Of the 60 eligible studies, 52 reported the prevalence of patients reaching the therapeutic range, while 20 performedmultiple linear regression analyses. The pooled prevalence who achieved the therapeutic range was 56% (95% CI: 50%-63%) in studies without dose adjustment patients. The pooled prevalence of adult patients was 61% (95% CI: 56%-65%), and the pooled prevalence of children patients was 55% (95% CI: 50%-60%) The study identified, in the children population, several factors associated with plasma voriconazole concentration, including age (coefficient 0.08, 95% CI: 0.01 to 0.14), albumin (-0.05 95% CI: -0.09 to -0.01), in the adult population, some factors related to voriconazole plasma concentration, including omeprazole (1.37, 95% CI 0.82 to 1.92), pantoprazole (1.11, 95% CI: 0.17-2.04), methylprednisolone (-1.75, 95% CI: -2.21 to -1.30), and dexamethasone (-1.45, 95% CI: -2.07 to -0.83). Conclusion: The analysis revealed that only approximately half of the patients reached the plasma voriconazole concentration therapeutic range without dose adjustments and the pooled prevalence of adult patients reaching the therapeutic range is higher than that of children. Therapeutic drug monitoring is crucial in the administration of voriconazole, especially in the children population. Particular attention may be paid to age, albumin levels in children, and the use of omeprazole, pantoprazole, dexamethasone and methylprednisolone in adults. [ABSTRACT FROM AUTHOR]