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Abstract Background This overview of reviews aims to identify evidence on the benefits (i.e. tobacco use abstinence and reduction in smoking frequency) and harms (i.e. possible adverse events/outcomes) of smoking cessation interventions among adults aged 18 years and older. Methods We searched Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, the CADTH Health Technology Assessment Database and several other websites for grey literature. Searches were conducted on November 12, 2018, updated on September 24, 2020, with publication years 2008 to 2020. Two reviewers independently performed title-abstract and full-text screening considering pre-determined inclusion criteria. Data extraction and quality assessments were initially completed by two reviewers independently (i.e. 73% of included studies (n = 22)) using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR 2), and the remainder done by one reviewer and verified by another due to resources and feasibility. The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) was performed by one independent reviewer and verified by another. Results A total of 22 Cochrane systematic reviews evaluating the impact of smoking cessation interventions on outcomes such as tobacco use abstinence, reduction in smoking frequency, quality of life and possible adverse events were included. Pharmaceutical (i.e. varenicline, cytisine, nicotine replacement therapy (NRT), bupropion) and behavioural interventions (i.e. physician advice, non-tailored print-based self-help materials, stage-based individual counselling, etc.) showed to have increased smoking cessation; whereas, data for mobile phone-based interventions including text messaging, hypnotherapy, acupuncture, continuous auricular stimulation, laser therapy, electrostimulation, acupressure, St John’s wort, S-adenosyl-L-methionine (SAMe), interactive voice response systems and other combination treatments were unclear. Considering harms related to smoking cessation interventions, small/mild harms (i.e. increased palpitations, chest pain, nausea, insomnia, headache) were observed following NRT, varenicline and cytisine use. There were no data on harms related to behavioural therapies (i.e. individual or group counselling self-help materials, internet interventions), combination therapies or other therapies (i.e. laser therapy, electrostimulation, acupressure, St John’s wort, SAMe). Conclusion Results suggest that pharmacological and behavioural interventions may help the general smoking population quit smoking with observed small/mild harms following NRT or varenicline. Consequently, evidence regarding ideal intervention strategies and the long-term impact of these interventions for preventing smoking was unclear. Systematic review registration PROSPERO CRD42018099691

Implementing information technology in production has triggered an increase in Industry 4.0. Owing to this technological advancement, manufacturing tools that can communicate with each other through the Internet of Things are now able to collect real-time data. Under dynamic production conditions, real-time information can enhance production control and supply chain efficiency. To optimize the production process, the food industry must utilize new technologies and the Internet of Things (IoT) to reduce costs, increase productivity, and eliminate waste. This is particularly true with the growing trend in this area. The study created and implemented a manufacturing production planning system that utilized Internet of Things technology, with specialized equipment used in dairy factory operations as the case study. This system collects information on the dairy production process, including material and product inventory, in real-time on Internet of Things devices, then analyzes it with the help of a neural network, and predicts the demand for the next 3 days. The dynamic schedule optimization, optimal timing of milk production, product quantity, and raw materials are determined using two heuristic algorithm methods. Additionally, there are multiple algorithms available for further processing. The optimization results indicate that implementing dynamic scheduling via the Internet of Things can mitigate uncertainty and boost income by 10 to 15%, profit by 13 to 18%, and job shop-level productivity by 13%.

Abstract Background Chronic disease management (CDM) through sustained knowledge translation (KT) interventions ensures long-term, high-quality care. We assessed implementation of KT interventions for supporting CDM and their efficacy when sustained in older adults. Methods Design: Systematic review with meta-analysis engaging 17 knowledge users using integrated KT. Eligibility criteria: Randomized controlled trials (RCTs) including adults (> 65 years old) with chronic disease(s), their caregivers, health and/or policy-decision makers receiving a KT intervention to carry out a CDM intervention for at least 12 months (versus other KT interventions or usual care). Information sources: We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from each database’s inception to March 2020. Outcome measures: Sustainability, fidelity, adherence of KT interventions for CDM practice, quality of life (QOL) and quality of care (QOC). Data extraction, risk of bias (ROB) assessment: We screened, abstracted and appraised articles (Effective Practice and Organisation of Care ROB tool) independently and in duplicate. Data synthesis: We performed both random-effects and fixed-effect meta-analyses and estimated mean differences (MDs) for continuous and odds ratios (ORs) for dichotomous data. Results We included 158 RCTs (973,074 participants [961,745 patients, 5540 caregivers, 5789 providers]) and 39 companion reports comprising 329 KT interventions, involving patients (43.2%), healthcare providers (20.7%) or both (10.9%). We identified 16 studies described as assessing sustainability in 8.1% interventions, 67 studies as assessing adherence in 35.6% interventions and 20 studies as assessing fidelity in 8.7% of the interventions. Most meta-analyses suggested that KT interventions improved QOL, but imprecisely (36 item Short-Form mental [SF-36 mental]: MD 1.11, 95% confidence interval [CI] [− 1.25, 3.47], 14 RCTs, 5876 participants, I 2 = 96%; European QOL-5 dimensions: MD 0.01, 95% CI [− 0.01, 0.02], 15 RCTs, 6628 participants, I 2 = 25%; St George’s Respiratory Questionnaire: MD − 2.12, 95% CI [− 3.72, − 0.51] 44 12 RCTs, 2893 participants, I 2 = 44%). KT interventions improved QOC (OR 1.55, 95% CI [1.29, 1.85], 12 RCTS, 5271 participants, I 2 = 21%). Conclusions KT intervention sustainability was infrequently defined and assessed. Sustained KT interventions have the potential to improve QOL and QOC in older adults with CDM. However, their overall efficacy remains uncertain and it varies by effect modifiers, including intervention type, chronic disease number, comorbidities, and participant age. Systematic review registration PROSPERO CRD42018084810.

Abstract Epidermal growth factor (EGF) can be efficiently used in wound healing process; but the main obstacle of its clinical use is its susceptibility to proteolysis and maintaining its effective concentration in the site of action. In this study, chitosan nanoparticles containing EGF is formulated using a simple method to increase its stability in physiological pH as well as protect its biological activity and effectiveness in wound healing process. Nanoparticles with different ratios of chitosan/EGF were prepared and evaluated in vitro and in vivo. Obtained results showed nanoparticles with 2:1 ratio of chitosan/EGF were able to release 80% of encapsulated protein after 12 h. Cell proliferation study demonstrated that prepared nanoparticles could protect EGF functionality in physiological pH. In vivo results showed that nanoparticles with 2:1 ratio of chitosan/EGF could significantly accelerate the wound closure‐rate, re‐epithelialisation and collagen deposition. In conclusion, the designed nanoparticles in optimal ratio can be considered as a potential vehicle for EGF delivery to wounds with the aim of improving healing process.

Abstract Background Preliminary evidence suggests that people who inject drugs (PWID) may be at an increased risk of developing infective endocarditis (IE), hepatitis C virus (HCV) infection, and/or human immunodeficiency virus (HIV) infection from hydromorphone controlled-release formulation. The hypothesized mechanism is related to insolubility of the drug, which promotes reuse, leading to contamination of injecting equipment. However, this relationship has not been confirmed. We aimed to conduct a systematic review including adult PWID exposed to controlled-release hydromorphone and the risk of acquiring IE, HCV, and HIV. Methods We searched MEDLINE, EMBASE, and Evidence Based Medicine reviews from inception until September 2021. Following pilot testing, two reviewers conducted all screening of citations and full-text articles, as well as abstracted data, and appraised risk of bias using the Newcastle–Ottawa scale and Effective Practice and Organization of Care tool. Equity issues were examined using the PROGRESS-PLUS framework. Discrepancies were resolved consistently by a third reviewer. Meta-analysis was not feasible due to heterogeneity across the studies. Results After screening 3,231 citations from electronic databases, 722 citations from unpublished sources/reference scanning, and 626 full-text articles, five studies were included. Five were cohort studies, and one was a case–control study. The risk of bias varied across the studies. Two studies reported on gender, as well as other PROGRESS-PLUS criteria (race, housing, and employment). Three studies focused specifically on the controlled-release formulation of hydromorphone, whereas two studies focused on all formulations of hydromorphone. One retrospective cohort study found an association between controlled-release hydromorphone and IE, whereas a case–control study found no evidence of an association. One retrospective cohort study found an association between the number of hydromorphone controlled-release prescriptions and prevalence of HCV. None of the studies specifically reported on associations with HIV. Discussion Very few studies have examined the risk of IE, HCV, and HIV infection after exposure to controlled-release hydromorphone. Very low-quality and scant evidence suggests uncertainty around the risks of blood-borne infections, such as HCV and IE to PWID using this medication.

Abstract A mild and efficient method was developed for the synthesis of new derivatives of thiazolo[3,2-a] pyrimidin-3(2H)-ones from available starting materials based on the oxidation of catechols to ortho-quinone by Myceliophthora thermophila laccase (Novozym 51,003) and 1,4-addition of active methylene carbon to these in situ generated intermediates in moderate to good yields (35–93%). The structure of the products was confirmed through 1H NMR, 13C NMR, HMBC, HSQC, DEPT-135, and mass spectroscopy techniques. These novel compounds were evaluated as active antitumor agents against human colorectal adenocarcinoma and liver adenocarcinoma cell lines. All compounds displayed potent inhibition activities against the HT-29 cell line with IC50 values of 9.8–35.9 µM, superior to the positive control doxorubicin, and most showed potent anticancer activities against the HepG2 cell line.

Background and purpose: Infants with persistent pulmonary hypertension (PPHN) are readmitted to hospital three times more than other infants or die after discharge. The disease imposes a high cost on families and health systems. In this study, for the first time, the prevalence of PPHN and associated factors were investigated in mature neonates born in southeast of Iran. Materials and methods: In this cross-sectional study, the clinical records of 1859 infants born in Kerman Afzalipour Hospital, 2020 were reviewed. Infants hospitalized from delivery, congenital heart disease, other differential diagnoses of PPHN, and evidence of genetic diseases were excluded from the study. Then, mature infants with clinical evidence of PPHN underwent Doppler echocardiography to confirm the final diagnosis. Information about pregnancy, childbirth, infant gender, birth, 1-minute and 5-minute Apgar scores, and advanced respiratory support were also obtained. Data were analyzed by SPSS V25. Results: Out of 229 neonates meeting the inclusion criteria, 31 (11.9%) had PPHN. Signification relationship was observed between frequency of PPHN and cesarean delivery and 5-minute minute Apgar score (P0.05). The mean parameters of PPHN, including tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitation rate, mean pulmonary artery pressure, and pulmonary artery diameter were significantly higher in infants delivered by cesarean section than those born by normal vaginal delivery group (P

Objectives To chart the global literature on gender equity in academic health research.Design Scoping review.Participants Quantitative studies were eligible if they examined gender equity within academic institutions including health researchers.Primary and secondary outcome measures Outcomes related to equity across gender and other social identities in academia: (1) faculty workforce: representation of all genders in university/faculty departments, academic rank or position and salary; (2) service: teaching obligations and administrative/non-teaching activities; (3) recruitment and hiring data: number of applicants by gender, interviews and new hires for various rank; (4) promotion: opportunities for promotion and time to progress through academic ranks; (5) academic leadership: type of leadership positions, opportunities for leadership promotion or training, opportunities to supervise/mentor and support for leadership bids; (6) scholarly output or productivity: number/type of publications and presentations, position of authorship, number/value of grants or awards and intellectual property ownership; (7) contextual factors of universities; (8) infrastructure; (9) knowledge and technology translation activities; (10) availability of maternity/paternity/parental/family leave; (11) collaboration activities/opportunities for collaboration; (12) qualitative considerations: perceptions around promotion, finances and support.Results Literature search yielded 94 798 citations; 4753 full-text articles were screened, and 562 studies were included. Most studies originated from North America (462/562, 82.2%). Few studies (27/562, 4.8%) reported race and fewer reported sex/gender (which were used interchangeably in most studies) other than male/female (11/562, 2.0%). Only one study provided data on religion. No other PROGRESS-PLUS variables were reported. A total of 2996 outcomes were reported, with most studies examining academic output (371/562, 66.0%).Conclusions Reviewed literature suggest a lack in analytic approaches that consider genders beyond the binary categories of man and woman, additional social identities (race, religion, social capital and disability) and an intersectionality lens examining the interconnection of multiple social identities in understanding discrimination and disadvantage. All of these are necessary to tailor strategies that promote gender equity.Trial registration number Open Science Framework: https://osf.io/8wk7e/.

Abstract Introduction Cardiovascular diseases are very common in the general population, and several factors play a role in their development. The purpose of this study was to investigate the relationship between hyperuricaemia and other cardiovascular disease risk factors. Methods This cross‐sectional study was conducted on 1008 people over the 15‐year‐old general population in Kerman, Iran. The blood samples of all patients were analysed for the uric acid serum level, and they completed a checklist including physical activity, previous history of hypertension and diabetes, smoking and opium. Results A number of 1008 cases of people were entered into the study. According to the results of this study, 254 patients had uric acid levels above the 75th percentile (6 mg/dl in males, and 5 mg/dl in females). No significant difference was observed between gender (p = .249) and age groups (p = .125) of people with and without hyperuricaemia. The prevalence of overweight/obesity (p

Background: Irritable bowel syndrome (IBS) is a highly prevalent disorder of the gut interaction characterized by abdominal discomfort and pain associated with altered bowel habits in the absence of structural abnormalities. In spite of IBS' high prevalence and disease burden across the globe, no explanations have been given as to its underlying pathophysiology. As for the treatment of IBS, there is no specific medication, and the most beneficial treatment is usually supportive therapy. Recent animal and human studies have demonstrated the therapeutic potential of curcumin or turmeric in the treatment of IBS. Methods: We systematically reviewed all available evidence supporting curcumin and turmeric's therapeutic potential in relieving IBS symptoms in the present study. For this purpose, a database search was performed using curcumin, turmeric, and IBS and all their equivalents as of the search terms in Web of Science, PubMed, Scopus, Ovid, Embase, and Google Scholar from1990 up to Feb 2021. The investigation was then limited to clinical trials, and then nine articles were collected for data analysis. Results: The findings of the included literature showed that curcumin and turmeric alone or in combination with other medications could improve the severity of IBS as well as the quality of life among people who suffer from IBS symptoms. Conclusion: Overall, medications containing curcumin and turmeric extract due to these compounds' anti-inflammatory effects may improve IBS symptoms, particularly abdominal pain and life quality.

The aim of this work is a green synthesis of gold nanoparticles using the aqueous extract of Anthriscus sylvestris, Ferula gummosa, and Achillea eriohora leaf and stems as the reducing agents. The effects of reducing agent concentration in the reaction mixture and temperature on the size of the gold nanotriangles were studied. The nanoparticles were characterized using UV–Vis spectroscopy, XRD, and SEM. XRD studies show that the particles are crystalline in the cubic phase. However, the reduction of gold ions by plant extracts resulted in the formation of spherical gold nanoparticles with diameters from 18 to 56 nm.

OBJECTIVE:A current assessment of case reports of possible drug-induced pancreatitis is needed. We systematically reviewed the case report literature to identify drugs with potential associations with acute pancreatitis and the burden of evidence supporting these associations. METHODS:A protocol was developed a priori (PROSPERO CRD42017060473). We searched MEDLINE, Embase, the Cochrane Library, and additional sources to identify cases of drug-induced pancreatitis that met accepted diagnostic criteria of acute pancreatitis. Cases caused by multiple drugs or combination therapy were excluded. Established systematic review methods were used for screening and data extraction. A classification system for associated drugs was developed a priori based upon the number of cases, re-challenge, exclusion of non-drug causes of acute pancreatitis, and consistency of latency. RESULTS:Seven-hundred and thirteen cases of potential drug-induced pancreatitis were identified, implicating 213 unique drugs. The evidence base was poor: exclusion of non-drug causes of acute pancreatitis was incomplete or poorly reported in all cases, 47% had at least one underlying condition predisposing to acute pancreatitis, and causality assessment was not conducted in 81%. Forty-five drugs (21%) were classified as having the highest level of evidence regarding their association with acute pancreatitis; causality was deemed to be probable or definite for 19 of these drugs (42%). Fifty-seven drugs (27%) had the lowest level of evidence regarding an association with acute pancreatitis, being implicated in single case reports, without exclusion of other causes of acute pancreatitis. DISCUSSION:Much of the case report evidence upon which drug-induced pancreatitis associations are based is tenuous. A greater emphasis on exclusion of all non-drug causes of acute pancreatitis and on quality reporting would improve the evidence base. It should be recognized that reviews of case reports, are valuable scoping tools but have limited strength to establish drug-induced pancreatitis associations. REGISTRATION:CRD42017060473.

Plain English summary With the growing movement to engage patients in research, questions are being asked about who is engaging patients and how they are being engaged. Internationally, research groups are supporting and funding patient-oriented research studies that engage patients in the identification of research priorities and the design, conduct and uptake of research. As we move forward, we need to know what meaningful patient engagement looks like, how it benefits research and clinical practice, and what are the barriers to patient engagement? We conducted a review of the published literature looking for trials that report engaging patients in the research. We included both randomized controlled trials and non-randomized comparative trials. We looked at these trials for important study characteristics, including how patients were engaged, to better understand the practices used in trials. Importantly, we also discuss the number of trials reporting patient engagement practices relative to all published trials. We found that very few trials report any patient engagement activities even though it is widely supported by many major funding organizations. The findings of our work will advance patient-oriented research by showing how patients can be engaged and by stressing that patient engagement practices need to be better reported. Abstract Background Patient-Oriented Research (POR) is research informed by patients and is centred on what is of importance to them. A fundamental component of POR is that patients are included as an integral part of the research process from conception to dissemination and implementation, and by extension, across the research continuum from basic research to pragmatic trials [J Comp Eff Res 2012, 1:181–94, JAMA 2012, 307:1587–8]. Since POR’s inception, questions have been raised as to how best to achieve this goal. We conducted a systematic review of randomized controlled trials and non-randomized comparative trials that report engaging patients in their research. Our main goal was to describe the characteristics of published trials engaging patients in research, and to identify the extent of patient engagement activities reported in these trials. Methods The MEDLINE®, EMBASE®, Cinahl, PsycINFO, Cochrane Methodology Registry, and Pubmed were searched from May 2011 to June 16th, 2016. Title, abstract and full text screening of all reports were conducted independently by two reviewers. Data were extracted from included trials by one reviewer and verified by a second. All trials that report patient engagement for the purposes of research were included. Results Of the 9490 citations retrieved, 2777 were reviewed at full text, of which 23 trials were included. Out of the 23 trials, 17 were randomized control trials, and six were non-randomized comparative trials. The majority of these trials (83%, 19/23) originated in the United States and United Kingdom. The trials engaged a range of 2-24 patients/ community representatives per study. Engagement of children and minorities occurred in 13% (3/23) and 26% (6/23) of trials; respectively. Engagement was identified in the development of the research question, the selection of study outcomes, and the dissemination and implementation of results. Conclusions The prevalence of patient engagement in patient-oriented interventional research is very poor with 23 trials reporting activities engaging patients. Research dedicated to determining the best practice for meaningful engagement is still needed, but adequate reporting measures also need to be defined.

Abstract Background Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis. Methods MEDLINE, EMBASE, and Cochrane CENTRAL were searched from inception to December 15, 2015. Two reviewers independently screened titles/abstracts and full-text papers for experimental and observational studies comparing mono- or poly-therapy AEDs versus control (no AED exposure) or other AEDs, then abstracted data and appraised the risk of bias. The primary outcome was incidence of major CMs, overall and by specific type (cardiac malformations, hypospadias, cleft lip and/or palate, club foot, inguinal hernia, and undescended testes). Results After screening 5305 titles and abstracts, 642 potentially relevant full-text articles, and 17 studies from scanning reference lists, 96 studies were eligible (n = 58,461 patients). Across all major CMs, many AEDs were associated with higher risk compared to control. For major CMs, ethosuximide (OR, 3.04; 95% CrI, 1.23–7.07), valproate (OR, 2.93; 95% CrI, 2.36–3.69), topiramate (OR, 1.90; 95% CrI, 1.17–2.97), phenobarbital (OR, 1.83; 95% CrI, 1.35–2.47), phenytoin (OR, 1.67; 95% CrI, 1.30–2.17), carbamazepine (OR, 1.37; 95% CrI, 1.10–1.71), and 11 polytherapies were significantly more harmful than control, but lamotrigine (OR, 0.96; 95% CrI, 0.72–1.25) and levetiracetam (OR, 0.72; 95% CrI, 0.43–1.16) were not. Conclusion The newer generation AEDs, lamotrigine and levetiracetam, were not associated with significant increased risks of CMs compared to control, and were significantly less likely to be associated with children experiencing cardiac malformations than control. However, this does not mean that these agents are not harmful to infants/children exposed in utero. Counselling is advised concerning teratogenic risks when the prescription is written for a woman of childbearing age and before women continue with these agents when considering pregnancy, such as switching from polytherapy to monotherapy with evidence of lower risk and avoiding AEDs, such as valproate, that are consistently associated with CMs. These decisions must be balanced against the need for seizure control. Systematic Review Registration PROSPERO CRD42014008925

Abstract Background We conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion. Methods We searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3–4 months daily INH plus rifampicin (INH/RFMP 3–4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints. Results Sixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3–4 months were associated with a greater likelihood of adequate completion. Conclusions Most of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3–4 months duration are more likely to be completed than longer regimens.

BACKGROUND:Preventable adverse drug reactions (PADRs) in inpatients are associated with harm, including increased length of stay and potential loss of life, and result in elevated costs of care. We conducted an overview of reviews (i.e., a systematic review of systematic reviews) to determine the incidence of PADRs experienced by inpatients. Secondary review objectives were related to assessment of the effects of patient age, setting, and clinical specialty on PADR incidence. METHODS:The protocol was registered in PROSPERO (CRD42016043220). We performed a search of Medline, Embase, and the Cochrane Library, limiting languages of publication to English and French. We included published systematic reviews that reported quantitative data on the incidence of PADRs in patients receiving acute or ambulatory care in a hospital setting. The full texts of all primary studies for which PADR data were reported in the included reviews were obtained and data relevant to review objectives were extracted. Quality of the included reviews was assessed using the AMSTAR-2 tool. Both narrative summaries of findings and meta-analyses of primary study data were undertaken. RESULTS:Thirteen systematic reviews encompassing 37 unique primary studies were included. Across primary studies, the PADR incidence was highly varied, ranging from 0.006 to 13.3 PADRs per 100 patients, with a pooled incidence estimate of 0.59 PADRs per 100 patients. Substantial heterogeneity was present across both reviews and primary studies with respect to review/study objectives, patient age, hospital setting, medical discipline, definitions and assessment tools used, event detection methods, endpoints of interest, and units of measure. Thirteen primary studies used prospective event detection methods and had a pooled PADR incidence of 3.13 (2.87-3.38) PADRs per 100 patients; however, extreme statistical heterogeneity (I2 = 97%) indicated this finding should be considered with caution. Subgroup meta-analyses demonstrated that PADR incidence varied significantly with event detection method (prospective > retrospective > voluntary reporting methods), hospital setting (ICU > wards), and medical discipline (medical > surgical). High statistical heterogeneity (I2 > 80%) was present across all analyses, indicating results should be interpreted with caution. Effects of patient age could not be assessed due to poor reporting of age groups used in primary studies. DISCUSSION:The method of event detection appeared to significantly influence PADR incidence, with prospective methods having the highest reported PADR rate. This finding is in agreement with the background literature. High methodological and statistical heterogeneity across primary studies evaluating adverse drug events reduces the validity of the overall PADR incidence derived from the meta-analyses of the pooled data. Data pooled from studies using only prospective methods of event detection should provide an overall estimate closest to the true PADR incidence; however, our estimate should be considered with caution due to the statistical heterogeneity found in this group of studies. Future studies should employ prospective methods of detection. This review demonstrates that the true overall incidence of PADRs is likely much greater than the overall pooled incidence estimate of 0.59 PADRs per 100 patients obtained when event detection method was not taken into consideration.

In this study we surveyed the average survival time of the treated Hodgkin's lymphoma patients and also the side effects and malignancies occurring secondary to the treatment. This is a retrospective study of patients referring to Ahwaz's Shafa hospital in a period of 10 years diagnosed with Hodgkin's lymphoma without any age restriction. After gathering all their data, we calculated their survival rate and the chance for a relapse and the secondary malignancies. 389 patients were included in the study with an average age of 27.5 years old and they had received only chemotherapy regimens. 87.9% of them had been treated by ABVD and 12.1 % by Stanford V regimen. 23.1% of them experienced a relapse and 13.1% of all patients, passed away during the study. Secondary malignancies were observed in 11 cases. An overall mean survival time of 295.31 months was resulted. The secondary malignancies after treating Hodgkin's lymphoma patients are different between chemotherapy regimens and chemotherapy - radiotherapy.

Systematic reviews (SRs) are abundant. The optimal reporting of SRs is critical to enable clinicians to use their findings to make informed treatment decisions. Complementary and alternative medicine (CAM) therapies are widely used therefore it is critical that conduct and reporting of systematic research in this field be of high quality. Here, methodological and reporting characteristics of a sample of CAM-related SRs and a sample of control SRs are evaluated and compared.MEDLINE(®) was searched to identify non-Cochrane SRs indexed from January 2010 to May 2011. Control SRs were retrieved and a search filter was used to identify CAM SRs. Citations were screened and publications that met a pre-specified definition of a SR were included. Pre-designed, standardized data extraction forms were developed to capture reporting and methodological characteristics of the included reviews. Where appropriate, samples were compared descriptively.A total of 349 SRs were identified, of which 174 were CAM-related SRs and 175 were conventional SRs. We compared 131 CAM-related non-Cochrane SRs to the 175 conventional non-Cochrane reviews. Fifty-seven percent (75/131) of CAM SRs specified a primary outcome compared to 21% (37/175) of conventional sample reviews. Reporting of publication bias occurred in less than 5% (6/131) of the CAM sample versus 46% (80/175) of the conventional sample of SRs. Source of funding was frequently and consistently under-reported. Less than 5% (11/306) of all SRs reported public availability of a review protocol.The two samples of reviews exhibited different strengths and weaknesses. In some cases there were consistencies across items which indicate the need for continued improvements in reporting for all SR reports. We advise authors to utilise the PRISMA Statement or other SR guidance when reporting SRs.

The effectiveness of nitrate removal was assessed in a 9.5 L packed bed column bioreactor through the evaluation of various feeding strategies and initial concentrations. The bioreactor was filled with zeolite mineral particles and initially treated with Thiobacillus denitrificans. Multiple hydraulic retention times were investigated to determine the efficiency of nitrate removal. The results demonstrate that the designed bioreactor is capable of achieving an 87% reduction in nitrate levels within a three-hour timeframe. This indicates that the bioreactor system can effectively remove nitrate ions from water, even when the initial nitrate content is as high as 400 mg/L, which exceeds the standard limit of 45 mg/L. The computational fluid dynamics (CFD) model yielded satisfactory results, confirming the effectiveness of the bioreactor design. It revealed that the optimal length of the bioreactor is suitable for influents containing 400 mg/L of nitrate. However, for influents with lower nitrate concentrations or when employing lower hydraulic retention times (HRTs), the bioreactor can be constructed with shorter heights. This CFD model can serve as a valuable tool for future studies, particularly in scaling up the bioreactor system.

In recent years, antibacterial wound dressings have gained considerable attention. Bacterial cellulose (BC) has received significant interest due to its unique physiochemical characteristics such as biocompatibility, high porosity, superior mechanical properties, water holding capacity, and nontoxicity. In this work, silver nanoparticles/graphitic carbon nitride/eucalyptus extract (Ag/gCN/EE) nanocomposite was synthesized as an antibacterial agent and incorporated into nanofibrous structures composed of BC. The BC/Ag/gCN/EE and polyvinyl alcohol/BC/Ag/gCN/EE (PVA/BC/Ag/gCN/EE) nanocomposites were synthesized using immersion and electrospinning methods, respectively. Then, the swelling ratio was optimized and the wound dressings were prepared based on the optimal formulation. The release profile, biodegradability and mechanical properties of the wound dressings were assessed. The antibacterial property of Ag/gCN/EE was studied demonstrating strong antibacterial activity on E. coli and S. aureus. MTT assay was carried out on NIH 3T3 fibroblast cells, and BC/Ag/gCN/EE and PVA/BC/Ag/gCN/EE nanocomposites showed 89 ± 2.31 % and 96 ± 3.28 % viability, respectively and no toxicity. To assess the effect of the composites on in vitro wound healing and cell migration, scratch wound assay was performed. The results indicated that after 24 h, BC/Ag/gCN/EE and PVA/BC/Ag/gCN/EE reduced 18.69 and 23.97 % of the scratch area compared to the control group. The prepared composites are promising wound dressings that could accelerate wound healing and kill bacteria simultaneously.

5-Fluorouracil (5FU) is a common chemotherapy drug for various cancers. It has exhibited large potentials for the treatment of both malignant and premalignant tumors. In the meantime, topical application of 5FU has been limited to surface pre-carcinogenic tumors. So far, a number of nano systems have been developed for encapsulation and targeted delivery of 5FU to improve its solubility, bioavailability, and functional characteristics, leading to the development of, for example, 5FU carriers in topical treatments. Due to their considerable advantages over ordinary therapies, nanotechnology-based drug delivery systems (DDSs), particularly polymeric nanocarriers (PNCs), have led to some sorts of evolution in many fields, including disease diagnosis and DDS. As a naturally occurring polymer, chitosan (CS) has long been regarded because of its biodegradability, biocompatibility, polycationic nature, non-toxicity, and non-allergenic nature. In addition, the pH-responsive nature of CS provides an exact drug dispersion in the cancer environment, converting it a promising carrier system. Utilization of 5-FU into carbon nanocarriers has indicated positive results such as targeted delivery to tumors and prevention of cancer activity. Researchers have successfully synthesized a handful of CS nanocarriers with distinctive characteristics for targeted delivery of 5FU; these come in different forms, including nano-sized particles (NPs), composites (NCs), emulsions (NEs), and fibers (NFs). This study reviews the mechanism of CS in different formulations by analyzing the physicochemical characteristics of the corresponding DDS in terms of morphology, surface charge, release profile, and encapsulation driving force. A more detailed analysis was performed on the most popular pharmaceutical applications of 5FU-loaded CS NPs. Effective facilitation of targeted delivery of 5FU and improvement of its therapeutic effects for various cancers by the CS were also indicated. Herein, the readers are introduced to nanoscale systems based on natural polymers like chitosan as promising platforms for cancer diagnosis and therapy. More recent discoveries on mechanistic anticancer behavior of 5FU-loaded CS NPs was further discussed.

3D bioprinting techniques have emerged as a flexible tool in tissue engineering and regenerative medicine to fabricate or pattern functional 3D bio-structures with precise geometric designs, bridging the divergence between engineered and natural tissue constructs. A significantly increasing development has been achieved in understanding the relationship between the 3D-printing process and the structures, properties, and applications of the objects created. The ongoing advancement of novel biomaterial inks has enabled manufacturing of models and in vitro implants capable of achieving some level of success in preclinical trials. Remarkable progress in cell biology and biology-inspired computational design has assisted in achieving the latest milestone with planned tissue- or organ-like constructs having specific levels of functionality. However, biofabricated constructs still have a long way to go before reaching clinics. This review presents a picture of 3D bioprinting in the context of tissue engineering and regenerative medicine, with focus on biomaterials-related and design-centred aspects. Biomedical applications are described in detail in relation to major tissues or organs considered in the human body. Current technical limitations, challenges, future prospects and improvements are critically outlined and discussed.