Silicosis mostly happens in workers with high silica exposure and may accompany the development of various diseases like tuberculosis, cancer, or autoimmune diseases. The term silico-tuberculosis describes a condition in which an individual is affected by both silicosis and tuberculosis at the same time. This systematic review and meta-analysis study was conducted to evaluate the risk of tuberculosis in silicosis patients and individuals exposed to silica dust.

We performed a systematic search for relevant studies up to 6 September 2022 using PubMed/ Medline, and Embase with the following keywords in titles or abstracts: "silicosis" OR "silicoses" OR "pneumoconiosis" OR "pneumoconioses" AND "tuberculosis". Cohort and case-control studies containing relevant and original information about tuberculosis infection in silicosis patients were included for further analysis. Pooled estimates and 95% confidence intervals (CI) for the relative risk of tuberculosis in individuals with silicosis compared to those without; these were evaluated using the random effects model due to the estimated heterogeneity of the true effect sizes.

Out of 5352 potentially relevant articles, 7 studies were eligible for systematic review, of which 4 cohort studies were included for meta-analysis. The total population of all studies was 5884, and 90.63% were male. The mean age of participants was 47.7 years. Our meta-analysis revealed a pooled risk ratio of 1.35 (95%CI 1.18-1.53, I 2: 94.30%) which means an increased risk of silicosis patients and silica-exposed individuals to tuberculosis infection.

Silicosis and silica dust exposure increase the risk of tuberculosis. Therefore, we suggest that individuals with long-time silica exposure, like mine workers, be routinely considered for both silicosis and tuberculosis screening programs.

Chronic Wasting Disease (CWD) research has experienced significant growth, spanning diverse disciplines such as genetics, immunology, modelling, and behaviour. To gain a broad understanding of the changes in CWD research focusing cervids, we analysed temporal trends in study location, species, genus investigated, infection types, and population type since the discovery of CWD in 1980s. Our findings indicate that Colorado, USA, published the highest number of articles, followed by Wisconsin, and publication numbers correlated with reported CWD cases in states/provinces. Odocoileus emerged as the most studied genus. Wild populations are studied more commonly than captive populations. Keyword analysis of transmission types shows the discovery of novel transmission modes in the recent past. We also used a novel approach to categorize studies into five themes: field-based, lab-based, math/analytics/modelling-based, management-based, and human dimensions. Overall, most studies captured had a lab-based component. The interdisciplinary or transdisciplinary nature of major disciplines and evolving trends in keywords, particularly the increased reliance on genetics/genomics, accentuate the beginning of using genomics to under and tackle CWD at a fundamental scale. Encapsulated in our analysis, these dynamic changes offer valuable insights for navigating CWD through scientifically informed proactive management decisions in conjunction with existing surveillance efforts not only for the commonly studied species but also for potentially susceptible species.

Community health workers (CHWs) are key players in providing primary healthcare in low- and middle-income countries. However, their absence from the formal health system in many of these countries often presents a challenge to their remuneration. The objective of this scoping review is to document programs implemented at both small and large scales in low- and middle-income countries, the remuneration strategies they have established, and the effects of these strategies on the work of CHWs. In total, we included 50 articles in this review. We have identified four types of compensation: fixed compensation, performance-based compensation, compensation based on income-generating activities (IGAs), and combined compensation. We identified the strengths and weaknesses of each type of compensation. A common strength for most models was improvement in motivation and performance. A common weakness for most models was irregular payments. The results of this review highlight the need to consider the economic, social, and cultural settings of the countries or environments at hand, and to include CHWs in discussions regarding the selection of a compensation model.

Background: Evidence supporting the association between posttraumatic stress disorder (PTSD) and cognitive impairment is accumulating. However, less is known about which factors influence this association.Objective: The aims of this meta-analysis were to (1) elucidate the association between PTSD and a broad spectrum of cognitive impairment, including the risk of developing neurocognitive disorder (NCD) later in life, using a multilevel meta-analytic approach, and (2) identify potential moderating factors of this association by examining the effects of age (20-39, 40-59, 60+), study design (cross-sectional or longitudinal), study population (war-exposed populations/veterans or the general population), neurocognitive outcome assessed (i.e. a diagnosis of NCD or type of cognitive domain as classified according to A Compendium of Neuropsychological tests), gender (≥50% women or <50% women), study quality (high vs low), type of PTSD measure (self-report or clinical diagnosis), as well as the presence of comorbidities such as traumatic brain injury (TBI), depression, and substance use (all coded as either present or absent).Method: Peer-reviewed studies on this topic were extracted from PubMed and Web of Science with predetermined keywords and criteria. In total, 53 articles met the criteria. Hedge's g effect sizes were calculated for each study and a three-level random effect meta-analysis conducted.Results: After accounting for publication bias, the results suggested a significant association between PTSD and cognitive impairment, g = 0.13 (95% CI: 0.10-0.17), indicating a small effect. This association was consistent across all examined moderators, including various neurocognitive outcomes, age, gender, study design, study population, study quality, type of PTSD measure, and comorbidities such as depression, substance use, and TBI.Conclusions: These findings collectively suggest that PTSD is associated with both cognitive impairment and NCD. This emphasizes the need for early intervention (including prevention strategies) of PTSD, alongside monitoring cognitive function in affected individuals.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42021219189, date of registration: 02.01.2021.

In general (i.e. in heteronormative and cisgendered samples), authenticity appears protective against threats to well-being. Authenticity may also, in part, protect well-being against the minority stressors experienced by sexually minoritized (LGB; lesbian, gay, and bisexual) individuals. In this scoping review, we examined the relation between authenticity and well-being in LGB samples experiencing minority stress. We hypothesized that (i) LGB minority stress relates to decreased authenticity (i.e. inauthenticity), (ii) authenticity relates to increased well-being, and (iii) authenticity influences the relation between LGB minority stress and well-being. We identified 17 studies (N = 4,653) from systematic searches across Medline, ProQuest, PsycINFO, and Scopus using terms related to sexual identity, minority stress, authenticity, and well-being. In almost all studies, proximal (but not distal) stress was associated with inauthenticity, and inauthenticity with decreased well-being. In all but one study, the association between proximal stress and well-being was associated with inauthenticity. Although these results are consistent with our hypotheses, the included studies were limited in scope and heterogenous in their methods, instruments, and samples, restricting conclusions regarding mediation or moderation. The results require replication, well-powered direct comparisons between LGB and non-LGB samples, and consideration of the varied ways authenticity can be conceptualized and measured.

Atrial fibrillation (AF) and left ventricular dysfunction (LVD) are common conditions that often coexist, with about 25% of patients in NYHA classes I-II having AF. Efficacy and safety of surgical ablation (SA) in this population remains unclear.

We aimed to perform a single-arm meta-analysis to assess the outcomes of standalone and concomitant SA in adult patients with AF and LVD. We searched PubMed, Scopus and the Cochrane Library. Endpoints of interest were maintenance of sinus rhythm, freedom from anti-arrhythmic drug (AAD) use, change in LVEF, 30-day mortality, 1 year mortality and major procedural complications. We calculated pooled proportions or means for binary and continuous endpoints, respectively, with a 95 % confidence interval (CI).

Ten observational studies comprising 863 patients (mean follow-up of 19 months) were included. At 1 year, SA resulted in a sinus rhythm rate of 83.9 % (95 % CI: 69.5-92.3); freedom from AAD use of 81.6 % (95 % CI: 64.7-91.7); and mortality of 5.77 (95 % CI:3.7-8.9). 30-day mortality was 2.16 % (95 % CI: 0.9-4.9); major complications 16.73 % (95 % CI: 12-23); and an improvement in LVEF of 12 % (95 % CI: 9-17).

This meta-analysis found that SA appears to be an effective strategy to achieve sinus rhythm in patients with AF and LVD, with a pooled 30-day mortality of 2.2%. Comparative studies are warranted to evaluate the relative safety and efficacy of SA compared with other rhythm control strategies in this population.

Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients.

This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients.

This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024.

The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06-1.35; p = 0.01. Heterogeneity: Q = 8.69; p = 0.28; I2 = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05-0.29; p = 0.02. Heterogeneity: Q = 0.45; p = 0.93; I2 = 0%) significantly increased in the eHealth intervention group compared with the control group.

The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.

Gender differences in the associations of adverse childhood experiences (ACEs) with depression and anxiety, remain underexplored. We aimed to quantify and directly compare gender-specific associations between ACEs and depression and anxiety.

We systematically searched PubMed, Medline, and Embase for observational studies. Eligible articles should have reported effect sizes for depression or anxiety associated with varying number or specific types of ACEs. Using a random-effects model, we calculated the gender-specific pooled odds ratios (ORs) and derived the pooled women-to-men ratio of ORs (RORs) for the associations of ACEs with depression or anxiety, with corresponding 95 % confidence intervals (CIs).

In total, 42 articles met inclusion criteria. Regarding anxiety, gender differences were most pronounced for individuals exposed to 2 ACEs (compared to none), with women showing significantly higher odds of anxiety than men (ROR = 2.04, 95 % CI = 1.15-3.62), In addition, women exposed to emotional abuse (ROR = 0.66, 95 % CI = 0.52-0.83), sexual abuse (ROR = 0.58, 95 % CI = 0.37-0.91), and having a family member incarcerated (ROR = 0.83, 95 % CI = 0.71-0.98) showed lower odds of anxiety than men. For depression, women exposed to bullying showed lower odds of depression compared to men (ROR = 0.86, 95 % CI = 0.83-0.88).

Gender differences in the associations between ACEs and mental health outcomes vary by type and cumulative exposure to ACEs. This finding highlights the importance of incorporating gender-specific perspectives in research and interventions addressing the long-term mental health effects of ACEs.

Anemia is a common comorbidity in heart failure (HF) patients, often leading to worsened outcomes. Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors represent a novel approach for anemia management, yet their efficacy and safety in HF patients remain unclear. We aimed to conduct a systematic review and meta-analysis of studies on the effects of HIF-PH inhibitors on hemoglobin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), or estimated glomerular filtration rate (eGFR) in HF patients with chronic kidney disease (CKD).

The search of electronic databases identified four studies including 98 patients. Among the included studies, two were conducted prospectively, while two were retrospective in design. No studies were identified that compared HIF-PH inhibitors with erythropoiesis-stimulating agents or placebo. In cases of significant heterogeneity (I2 > 50 %), data were pooled using a random-effects model; otherwise, a fixed-effects model was used. In pooled analyses, hemoglobin levels increased at one (weighted mean difference [WMD]: 0.697 [0.473, 0.920] g/dL; Pfix < 0.001; I2 = 24 %) and three months (WMD: 0.760 [0.443, 1.076] g/dL; Pfix < 0.001; I2 = 31 %) after the use of HIF-PH inhibitors. NT-proBNP levels showed a modest decrease at one month but no significant changes at three months. eGFR remained unchanged, and no severe adverse events were reported.

This meta-analysis suggests that HIF-PH inhibitors effectively improve anemia in HF patients with CKD without notable changes in renal or HF-related biomarkers. However, the small number of included studies and the absence of a comparator group underscore the need for cautious interpretation of the findings.

Much research has been conducted on takeover behavior in automated driving, and integrating these studies into a knowledge system can help to gain a deeper understanding of the current research status and guide critical future research. The takeover focused in this study refers to the takeover related to human intervention (i.e. the transfer of control between the human driver and the auto drive system), rather than the context of overtaking another vehicle (e.g., lane changes and acceleration). The takeover behavior is a multi-stage process consisting of situation awareness, decision & reaction, and takeover performance stages. An in-depth review of takeover behavior characteristics from the three takeover stages is helpful to describe the takeover process and analyze takeover behavior characteristics systematically. Therefore, this paper aims to review driver's takeover performance from the three levels of driver, automated vehicle, and road environment based on the takeover behavior mode. First, we identified 1329 articles through a systematic literature search. 122 articles were included in this review. Second, we use the knowledge graph method for bibliometric analysis. Third, we systematically review the characteristics of takeover behavior in three stages (situation awareness, decision & reaction, takeover performance) from three dimensions: driver, vehicle, and road environment. At the same time, this study develops scoring rules that quantify each factor's contribution to takeover behavior. Fourth, based on the reviewed literature and scores, 18 suggestions were proposed to improve takeover behavior from three levels: drivers, vehicles, road environment. Finally, we have outlined the future fundamental research of takeover behavior. This review summarizes the research content of takeover behavior testing and forms a knowledge system, which provides researchers with a window to understand the research status and development context. This review can guide future research on takeover behavior.

The global population is experiencing a significant increase in the number of older people, highlighting the need to maintain both physical and mental health among this cohort and to promote healthy ageing. One critical area that has been insufficiently explored is the prevalence and scope of ageism and its assessment. Therefore, the present review evaluated the psychometric properties of instruments designed to assess ageism against older people.

To locate relevant instruments, a search was conducted using seven databases comprising MEDLINE, PubMed, Embase, PsycINFO, Web of Science, ScienceDirect and Scopus. The review utilised the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to assess the methodological quality of the studies identified, ensuring a thorough evaluation of relevant literature.

From an initial pool of 338,180 outputs, 20 studies were deemed suitable for inclusion. These studies addressed various aspects of ageism, with eight focusing on self-directed ageism and 12 on attitudes towards older individuals. The review found that while 18 studies tested internal consistency, only three assessed cross-cultural validity. None of the studies achieved a high methodological quality rating concerning content validity based on the COSMIN criteria.

These findings suggest a significant gap in the development of reliable and comprehensive psychometric instruments for assessing ageism, indicating a need for further refinement of these instruments.

This systematic review equips healthcare policymakers with evidence to advance the development of more robust ageism measurement tools. Additionally, the results underscore the need for researchers to conduct more thorough validation and evaluation of ageism instruments that address its multidimensional nature, thereby enhancing the quality of future gerontological research.

This systematic review equips healthcare policymakers with evidence to advance the development of more robust ageism measurement tools. Additionally, the results underscore the need for researchers to conduct more thorough validation and evaluation of ageism instruments that address its multidimensional nature, thereby enhancing the quality of future gerontological research.

In the modern era of constant digital technological advancements, problematic smartphone use has become a key issue in educational psychology. This phenomenon affects individual psychological well-being and academic or other performance and encompasses interpersonal relationships and societal aspects, divulging the intricate correlation between technology usage and human behavior. This study aims to explore mindfulness as an intervention measure to lessen problematic smartphone use.

Based on the PRISMA method, this study used a meta-analytic approach to explore the relationship between mindfulness and problematic smartphone use systematically. Systematic literature searches for papers published before February 2024 yielded 29 studies, including 17,534 individuals and 30 effect sizes. The sample comprised participants from Eastern cultures (n = 22 studies) and Western cultures (n = 8 studies).

The meta-analysis revealed a significant negative correlation between mindfulness and problematic smartphone use (r = -0.399, 95 % CI [-0.457, -0.338], p < 0.001). Moderator analyses revealed the strongest relationship when using the Child and Adolescent Mindfulness Measure (CAMM) (r = -0.498), while the Five Facet Mindfulness Questionnaire (FFMQ) showed the weakest (r = -0.245). Cultural background analyses indicated stronger effects in Eastern cultures (r = -0.428) compared to Western cultures (r = -0.316). Gender analyses revealed stronger effects among female participants (β = -0.510, p < 0.05).

These findings demonstrate that mindfulness serves as an effective approach to addressing problematic smartphone use. The significant moderating effects identified have important implications for the implementation of mindfulness-based interventions in educational settings.

The relationship between frailty/pre-frailty, and multimorbidity in the elderly is recognized, but specific prevalence among community-dwelling elderly with multimorbidity is unclear. This study aims to determine these rates, analyze subgroup, and identify sources of heterogeneity to bolster evidence-based interventions and health policies.

We searched nine databases from inception to November 16, 2023, for cross-sectional and cohort studies on community-dwelling elderly with multimorbidity. Data were extracted to calculate the prevalence of frailty and pre-frailty. Study quality was assessed using AHRQ and NOS tools.

Fifteen studies encompassing 9,683 participants with multimorbidity were analyzed. The pooled prevalence of frailty and pre-frailty was 18.1 % and 48.9 %, respectively. Age-stratified analyses found 17 % frailty and 58.4 % pre-frailty in the 70-74 age group, and 16.7 % and 54.2 % in those above 75 years. Cross-sectional studies showed 18.8 % frailty and 48.1 % pre-frailty, while cohort studies showed 18.1 % and 50.5 %, respectively. Asia had higher rates (22.7 % frailty, 43.5 % pre-frailty) than the Americas (9.9 % frailty, 56.3 % pre-frailty). By sample size, frailty prevalence was 21.3 % (<500), 9.1 % (500-999), and 17.9 % (≥1000), with pre-frailty at 51.1 %, 45.6 %, and 47.7 %. The FP method yielded higher prevalence estimates (17.7 % frailty, 51.6 % pre-frailty) than the FS method (9.5 % frailty, 39.2 % pre-frailty).

This study provides insights into the prevalence of frailty and pre-frailty among community-dwelling elderly with multimorbidity. Variations in prevalence rates may be attributed to differences in sample size and measurement tools, which also contribute to heterogeneity observed across subgroups.

Benzene is recognized as leukemogenic. However, the association between it and solid cancers has been the subject of less investigation. We aim to conduct a systematic review and meta-analysis to evaluate the association between occupational exposure to benzene and the risk of urinary tract cancer, including kidney and bladder.

We included 41 cohort and case-control studies listed in the most recent International Agency for Research on Cancer (IARC) Monograph on benzene exposure and the result of a literature review to identify more recent studies. Forest plots of relative risk (RR) were constructed for kidney, bladder, and urinary tract cancer overall. A random-effects model was used to address heterogeneity between studies. Stratified analyses were conducted to explore effect modification.

Our findings revealed an association between exposure to occupational benzene and kidney and unspecified urinary tract cancers (RR = 1.20, 95% confidence interval = 1.03-1.39), and an association of borderline statistical significance with bladder cancer (RR = 1.07, 95% confidence interval = 0.97-1.18). Publication bias was excluded for both kidney ( P  = 0.809) and bladder cancer ( P  = 0.748). Stratification analysis according to the selected study characteristics showed no difference except regarding the industry for kidney cancer ( P  < 0.000), with a stronger association in the chemical industry. An analysis by exposure level did not reveal any trend for kidney cancer, whereas there was a trend ( P  = 0.01) for bladder cancer.

Our study found an association between occupational benzene exposure and kidney cancer and a dose-effect association between benzene exposure and bladder cancer.

This systematic review and meta-analysis aimed to evaluate (1) if bilingual children differ from monolingual peers in stuttering severity, (2) if severity varies between their first (L1) and second (L2) languages, and (3) how bilingualism affects treatment outcomes.

Twenty-six empirical studies were analyzed after a comprehensive search and screening. Random-effects models compared stuttering severity between bilingual and monolingual children, assessed L1 versus L2 differences, and evaluated fluency post-treatment.

Bilingual children showed significantly greater stuttering severity than monolingual peers, likely due to heightened cognitive and speech motor demands of managing two languages. Severity was higher in L2 than L1, reflecting proficiency and dominance effects. Treatment outcomes revealed substantial fluency improvements in bilingual children, comparable to monolingual results. However, inconsistent bilingualism definitions and severity measures limited comparisons.

Bilingualism increases stuttering severity, particularly in L2, but does not impair treatment success. Comprehensive bilingual assessments and culturally responsive interventions are essential. Future research should use longitudinal designs, diverse language pairs, and standardized criteria to improve clinical practices for bilingual children who stutter.

Community-acquired pneumonia (CAP) is a frequent and potentially life-threatening condition. Even though the disease is common, evidence on CAP management is often of variable quality. This may be reinforced by the lack of a systematic and homogeneous way of defining the disease in randomized controlled trials (RCTs).

This study aims to assess the diagnostic criteria and definitions of the term 'community-acquired' used in RCTs on CAP management.

On the basis of the protocol (PROSPERO 2019 CRD42019147411), we conducted a systematic search of Medline/PubMed and the Cochrane Register of Controlled Trials for RCTs published or registered between 2010 and 2024.

Study eligibility criteria included completed and ongoing RCTs.

Participants included adults hospitalized with CAP.

Data were collected using a tested extraction sheet, as endorsed by the Cochrane Collaboration. After cross-checking, data were synthesized in a narrative and tabular form.

In total, 7173 records were identified through our searches. After removing records that did not fulfil the eligibility criteria, 170 studies were included. Diagnostic criteria were provided in 69.4% of studies, and the term 'community-acquired' was defined in 55.3% of studies. The most frequently included diagnostic criteria were pulmonary infiltrates (94.1%), cough (78.8%), fever (77.1%), dyspnoea (62.7%), sputum (57.6%), auscultation/percussion abnormalities (55.9%), and chest pain/discomfort (52.5%). The different criteria were used in 87 different sets across the studies. The term 'community-acquired' was defined in 57 different ways.

The diagnostic criteria and definitions of CAP in RCTs exhibit significant heterogeneity. Standardizing these criteria in clinical trials is crucial to ensure comparability across studies.

Today, there are many discussions about the best way to maintain weight and prevent weight regain after a period of weight loss.

The aim of this study was to summarize, based on data from randomized clinical trials (RCTs), the impact of nonsurgical interventions for adults' weight loss maintenance.

The Medline (PubMed), Scopus, and Web of Science databases were reviewed during June 2023.

Meta-analyses assessing the impacts of nonsurgical interventions for weight loss maintenance were conducted. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was implemented to determine evidence certainty.

Meta-analysis of data from a total of 56 RCTs (n = 13 270 participants) represented a significant weight reduction after behavior and lifestyle interventions (mean difference [MD], -0.64 kg [95% CI, -1.18 to -0.09]; I2 = 89.5%; P < .001 for heterogeneity). Pharmacological interventions had also a significant effect on weight change during the weight maintenance phase (MD, -2.57 kg [95% CI, -3.12 to -2.02]; I2 = 91.6%; P < .001 for heterogeneity). The weight loss reduction from pharmacological interventions was greater with sibutramine (MD, -2.57; 95% CI: -3.12 to -2.02). Additionally, diet intervention and dietary and physical activity strategies were associated with a negligible trending decrease in weigh regain (respectively: MD, -0.91 kg [95% CI, -2.18 to 0.36], I2 = 55.7%, P = .016 for heterogeneity; and MD, -0.3 kg [95% CI, -4.13 to 3.52], I2 =  94.1%, P < .001).

The findings of this review indicate there is a favorable impact of behavior-based interventions and antiobesity medications on weight maintenance.

PROSPERO registration no CRD42023468056.

Three bacteria extensively acknowledged as venereal pathogens with the potential to induce endometritis include Taylorella equigenitalis, the causative agent of contagious equine metritis (CEM), specific strains of Pseudomonas aeruginosa, and certain capsule types of Klebsiella pneumoniae. The United Kingdom's Horserace Betting Levy Board recommends pre-breeding screening for these bacteria in their International Codes of Practice and >20 000 samples are tested per annum in the United Kingdom alone. While the pathogenesis and regulatory importance of CEM are well established, an evaluation of the literature pertaining to venereal transmission of P. aeruginosa and K. pneumoniae was lacking. The aim of this review was to evaluate published literature and determine the significance of P. aeruginosa and K. pneumoniae as venereal pathogens in horses. Literature definitively demonstrating venereal transmission was not available. Instead, application of molecular typing methods suggested that common environmental sources of contamination, such as water, or fomites be considered as modes of transmission. The presence of organisms with pathogenic potential on a horse's external genitalia did not predict venereal transmission with resultant endometritis and reduced fertility. These findings may prompt further investigation using molecular technologies to confirm or exclude venereal spread and investigation of alternative mechanisms of transmission are indicated.

While total knee arthroplasty (TKA) is a generally successful procedure, 10 to 30% of patients still report suboptimal outcomes after surgery. Prehabilitation may offer potential benefits to improve poorer outcomes, although its effectiveness remains uncertain. Our study aimed to assess the efficacy of prehabilitation interventions on patients at risk of poor outcomes following TKA.

There were six electronic databases searched up until December 2023. All randomized controlled trials comparing prehabilitation versus usual care in adult patients with osteoarthritis undergoing primary TKA and at risk of poorer outcomes were included. There were four reviewers who independently extracted data and assessed the risk of bias for each study.

The 13 included studies assessed prehabilitation among patients at risk of poor outcomes, identified with various factors including range of motion deficit, functional limitations, high body mass index, psychological factors, frailty, older age, central sensitization, and high risk of discharge to inpatient rehabilitation. The interventions were initiated across a wide range, from 4 to 277 days before surgery. The efficacy of exercise therapy and multidisciplinary rehabilitation remains inconclusive due to limited, low-quality evidence. The results failed to indicate that various forms of nonexercise therapy, including education, psychological intervention, and weight loss therapy, were effective in improving outcomes after TKA. The included studies have major limitations such as small sample size, inappropriate comparators, substantial clinical heterogeneity in intervention characteristics, inadequate blinding for providers and participants, a lack of justification for identifying patients at risk of poor recovery, and a lack of appropriate interventions for managing modifiable factors.

While our finding fails to show that nonexercise therapy is effective, results of exercise therapy and multidisciplinary rehabilitation remain inconclusive. Further high-quality research is warranted to establish evidence on modifiable factors predictive of poorer postoperative outcomes and investigate how they can be effectively managed.

Etiological therapy has been documented to improve portal hypertension. We aimed to analyze the effectiveness of etiological therapy on hepatic venous pressure gradient (HVPG) reduction by conducting a systematic review and meta-analysis.

Literature search of the PubMed, EMBASE, and Cochrane Library was performed to identify studies involving patients with PHT published up to January 2024. The absolute HVPG reduction and the HVPG response rate were assessed. Pooled analyses were performed using random-effects models, and the heterogeneity was evaluated using sensitivity and subgroup analyses.

Altogether 21 studies were included for analysis. After etiological therapy, the absolute reduction in HVPG was 2.25 mmHg (95% confidence interval [CI] 1.80-2.71). Longer (> 1 year) duration of etiological therapy showed more significant HVPG reduction compared with those treated with 1 year or less (3.02 mmHg vs. 2.24 mmHg, p = 0.001). A more pronounced HVPG reduction was also observed in patients with viral hepatitis-induced cirrhosis than in those with non-viral hepatitis-induced cirrhosis (2.39 mmHg vs. 1.27 mmHg, p = 0.001). Furthermore, 64% and 41% of patients showed ≥ 10% HVPG reduction and a reduction of ≥ 20% or to ≤ 12 mmHg, respectively, after etiology control.

Effective etiology control can significantly decrease HVPG and increase the HVPG response rate, which may contribute to the improvement of the prognosis of cirrhotic patients.

Pregnancy-Associated Breast Cancer (PABC) is a special type of breast cancer that either occurs during pregnancy or one year postpartum. The aim of this systematic review and meta-analysis is to investigate the global incidence of PABC.

In this meta-analysis, to find related studies, three international databases including PubMed (Medline), Scopus and Web of Science (Clarivate analytics) were explored. An additional search was also carried out using Google Scholar in December 2023 looking for any new relevant article, and the list of references for all new supposedly relevant papers were manually searched for and investigated as well. The required data were extracted from retrieved studies and the quality of the studies was evaluated using the Newcastle-Ottawa scale checklist. Heterogeneity among studies was assessed by I-square statistic and chi-square test and due to presence of a significant heterogeneity among studies, a random-effects model was used to pool the data.

Twenty-two studies were included in this meta-analysis. Among 51,944,490 number of female individuals included in the study, a total number of 7,267 cases of PABC were identified. Based on these results, the global incidence of PABC was estimated 19.2 cases per 100,000 pregnancies (95%CI: 16.1-22.2, I-square = 98.9%). The results of cumulative analysis showed that the incidence rate of PABC has risen over decades, as it increased from 13.3 cases (in 1969) to 19.2 cases (in 2022) per 100,000 pregnancies. The lowest incidence rate belonged to the American continent with 14.4 (95%CI: 9.8-19) cases per 100,000 pregnancies.

The results obtained from this study demonstrates that the global incidence of PABC amounts to 19.2 cases per 100,000 pregnancies and it has been increasing slowly during the last few decades as time went by. The incidence rate in developing countries seem to be higher than in the developed countries. However, more studies are required in order to reach a better conclusion on this issue.

Sunlight is a known biocide, and photodriven inactivation is an important avenue for controlling viruses in both natural and engineered systems. However, there remain significant unknowns regarding damage to viruses by sunlight, including the impact of wavelength and viral characteristics. Herein, a systematic review of the literature and meta-analysis was conducted to identify inactivation rate constants (k-values) when exposed to solar wavelengths (280-700 nm) for common human viruses and surrogates in natural and synthetic matrices. We identified 457 k-values, with 356 for nonenveloped viruses. Extracted rate constants were transformed into UV fluence-normalized k-values to isolate the most photobiologically relevant wavelengths in the solar spectrum and reported for the first time in terms of energy, rather than time, based units. Each spectral region was assessed independently, with UVB illumination reporting the highest inactivation rates, UVA contributing to inactivation both in the presence and absence of photosensitizers, and visible light demonstrating no biocidal activity. Inactivation mechanisms are reviewed identifying knowledge gaps in translating UVC mechanisms to longer wavelengths. The data compiled in this meta-analysis can be applied to inform the environmental transport of viruses, estimate solar disinfection performance in variable light conditions, or design disinfection systems based on UVA and UVB light.

Drug delivery vehicles optimize therapeutic outcomes by enhancing drug efficacy, minimizing side effects, and providing controlled release. Injectable hydrogels supersede conventional ones in the field of drug delivery owing to their less invasive administration and improved targeting. However, they face challenges such as low biodegradability and biocompatibility, potentially compromising their effectiveness. To address these limitations, a modified amino acid-based pH-responsive injectable shear-thinning hydrogel cl-β-CD-g-p(Gly-MA) has been developed as an efficient drug carrier. In the two-step synthetic approaches, first, the well-known amino acid glycine (Gly) is modified to form glycine methacrylate (Gly-MA). Afterward, Gly-MA is chemically crosslinked with β-cyclodextrin (β-CD), an oligosaccharide, using an ethylene glycol dimethacrylate (EGDMA) crosslinker. The presence of these biomaterials as building blocks enhances the biocompatibility, hemocompatibility, and biodegradability of the hydrogel. They also reduce the risk of immunogenicity. The unique property of easy injectability enables minimally invasive administration. This feature also helps prolong drug retention at the target site, further optimizing drug delivery efficiency. Moreover, the pH-responsive feature of the developed cl-β-CD-g-p(Gly-MA) hydrogel ensures controlled drug release in response to the physiological conditions of the target site, enhancing therapeutic efficacy. The study focuses on investigating the in vitro loading and release of diclofenac sodium (DS), a non-steroidal anti-inflammatory drug (NSAID) commonly used to treat arthritic pain and inflammation.

Studies have shown inconsistent associations between quality of life (QoL) and survival in patients with lung cancer (LC).

To assess the association between baseline functioning scales from the EORTC QoL Questionnaire Core 30 (QLQ-C30) and overall survival in patients with LC by conducting a meta-analysis.

Two independent authors searched PubMed and Embase databases using the following PECOS criteria: population (patients with pathological diagnosis of LC), exposure (poor health-related QoL, as measured by the functioning scales of EORTC QLQ-C30), comparator (better QoL), outcomes (overall survival), and study design (cohort studies).

Sixteen studies with 9429 patients were identified. Compared to the highest scores, the lowest scores on the global QoL (hazard ratios [HR] 1.59; 95% confidence intervals [CI] 1.38-1.84), physical functioning (HR 1.58; 95% CI 1.24-2.03), role functioning (HR 1.43; 95% CI 1.19-1.73), and emotional functioning (HR 1.29; 95% CI 1.05-1.60) scales significantly predicted poorer overall survival. A 10-point increase in the global QoL, physical functioning, and role functioning scales was associated with a reduced risk of mortality (HR 0.87; 95% CI 0.84-0.91, HR 0.88; 95% CI 0.85-0.92, and HR 0.93; 95% CI 0.87-0.99, respectively). However, 10-point increases in the emotional functioning (HR 0.97; 95% CI 0.92-1.01), cognitive functioning (HR 0.97; 95% CI 0.95-1.00), and social functioning (HR 0.95; 95% CI 0.90-1.01) scales did not significantly predict overall survival.

Baseline QoL, specifically lower scores on the global QoL, physical functioning, and role functioning scales of the EORTC QLQ-C30, significantly predicts poorer overall survival in patients with LC.

The aim of this study was to systematically review evidence that supports best practice post-crash response emergency care.

The research questions to achieve the study objective were developed using the Patient, Intervention, Control, Outcome standard following which a systematic literature review (SLR) of research related to prehospital post-road-crash was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

A total of 89 papers were included in the analysis, presented according to the PRISMA guidelines.

This research explored and identified key insights related to emergency care post-road-crash response. The findings showed that interservice coordination and shared understanding of roles was recommended. Application of traditional practice of the "Golden Hour" has been explored and contested as a standard for all care. Notwithstanding this, timeliness of provision of care remains important to certain patient groups suffering certain injury types and is supported as part of a trauma system approach for patient care.

Randomized, controlled trials (RCTs) comparing the effectiveness of metabolic bariatric surgery (MBS) in addition to one or more treatment interventions for obesity (i.e., lifestyle structured interventions-LSI, medical therapy-MT, obesity management medication-OMM or endobariatric procedures-EP) are lacking. This study aims to assess the effectiveness of multiple simultaneous (before or immediately after MBS) interventions for treating obesity.

We performed a meta-analysis including all RCTs enrolling patients undergoing different MBS procedures add-on to other anti-obesity strategies (LSI, MT, OMM or ES) versus MBS alone, with a duration of at least 6 months. The primary outcome was BMI at the end-point; secondary end-points included percentage total and excess weight loss (%TWL%, and EBWL%), total weight loss (TWL), fasting plasma glucose (FPG), HbA1c, surgical and non-surgical severe adverse events (SAE), mortality, remission of type 2 diabetes, hypertension, dyslipidemia and health-related quality of life (HR-QoL).

A total of 25 RCTs were retrieved. The addition of either OMM (i.e., liraglutide) or EP (i.e., intragastric balloon-IB, endosleeve-ES) to MBS was associated with a significantly lower BMI at the end-point (p = 0.040). The addition of liraglutide only to MBS was associated with a greater %EWL%, but not %TWL and TBWL (p = 0.008). Three trials evaluated end-point HbA1c, showing a significant reduction in favour of liraglutide as an add-on therapy to MBS (p = 0.007). There was no mortality.

MBS combined with non-surgical approaches appears more effective than MBS alone in reducing BMI. Further RCTs on combined therapies to MBS for severe obesity are needed to enhance the tailoring of treatment for severe obesity.

Current interventions for major depressive disorder (MDD) demonstrate limited and heterogeneous efficacy, highlighting the need for improving the precision of treatment. Although findings have been mixed, resting-state functional connectivity (rsFC) at baseline shows promise as a predictive biomarker. This meta-analysis evaluates the evidence for baseline rsFC as a predictor of treatment outcomes of MDD interventions.

We included MDD literature published between 2012 and 2024 that used antidepressants, non-invasive brain stimulation, and cognitive behavioral therapy. Pearson correlations or their equivalents were analyzed between baseline rsFC and treatment outcome. Nodes were categorized according to the type of brain networks they belong to, and pooled coefficients were generated for rsFC connections reported by more than three studies.

Among the 16 included studies and 892 MDD patients, data from nine studies were used to generate pooled coefficients for the rsFC connection between the frontoparietal network (FPN) and default mode network (DMN), and within the DMN (six studies each, with three overlapping studies, involving 534 and 300 patients, respectively). The rsFC between the DMN and FPN had a pooled predictability of -0.060 (p = 0.171, fixed effect model), and the rsFC within the DMN had a pooled predictability of 0.207 (p < 0.001, fixed effect model). The rsFC between the DMN and FPN and the rsFC within the DMN had a larger effect in predicting the outcome of non-invasive brain stimulation (-0.215, p < 0.001, fixed effect model) and antidepressants (0.315, p < 0.001, fixed effect model), respectively. Heterogeneity was observed in both types of rsFC, study design, sample characteristics and data analysis pipeline.

Baseline rsFC within the DMN and between the DMN and FPN demonstrated a small but differential predictive effect on the outcome of antidepressants and non-invasive brain stimulation, respectively. The small predictability of rsFC suggested that rsFC between the FPN and DMN and the rsFC within the DMN might not be a good biomarker for predicting treatment outcome. Future research should focus on exploring treatment-specific predictions of baseline rsFC and its predictive utility for other types of MDD interventions.

The review was pre-registered at PROSPERO CRD42022370235 (33).

Although diabetes is a risk factor for dementia, the effect of glucose-lowering therapy for prevention of incident dementia is uncertain.

To determine whether cardioprotective glucose-lowering therapy (sodium-glucose cotransporter-2 inhibitors [SGLT2is], glucagon-like peptide-1 receptor agonists [GLP-1RAs], metformin, and pioglitazone), compared with controls, was associated with a reduction in risk of dementia or cognitive impairment, and among primary dementia subtypes.

The PubMed and Embase databases were searched for studies published from inception of the database to July 11, 2024.

Randomized clinical trials comparing cardioprotective glucose-lowering therapy with controls that reported dementia or change in cognitive scores. Cardioprotective glucose-lowering therapies were defined as drug classes recommended by guidelines for reduction of cardiovascular events, based on evidence from phase III randomized clinical trials. Inclusion criteria were assessed independently and inconsistencies were resolved by consensus.

Data were screened and extracted independently by 2 authors adhering to the PRISMA guidelines in August 2024. Random-effects meta-analysis models were used to estimate a pooled treatment effect.

The primary outcome measure was dementia or cognitive impairment. The secondary outcomes were primary dementia subtypes, including vascular and Alzheimer dementia, and change in cognitive scores.

Twenty-six randomized clinical trials were eligible for inclusion (N = 164 531 participants), of which 23 trials (n = 160 191 participants) reported the incidence of dementia or cognitive impairment, including 12 trials evaluating SGLT2is, 10 trials evaluating GLP-1RAs, and 1 trial evaluating pioglitazone (no trials of metformin were identified). The mean (SD) age of trial participants was 64.4 (3.5) years and 57 470 (34.9%) were women. Overall, cardioprotective glucose-lowering therapy was not significantly associated with a reduction in cognitive impairment or dementia (odds ratio [OR], 0.83 [95% CI, 0.60-1.14]). Among drug classes, GLP-1RAs were associated with a statistically significant reduction in dementia (OR, 0.55 [95% CI, 0.35-0.86]), but not SGLT2is (OR, 1.20 [95% CI, 0.67-2.17]; P value for heterogeneity = .04).

While cardioprotective glucose-lowering therapies were not associated with an overall reduction in all-cause dementia, this meta-analysis of randomized clinical trials found that glucose lowering with GLP-1RAs was associated with a statistically significant reduction in all-cause dementia.

Distinguishing between productive (wet) and non-productive (dry) cough types is important for evaluating respiratory health, assisting in differential diagnosis, and monitoring disease progression. However, assessing cough type through the perception of cough sounds in clinical settings poses challenges due to its subjectivity. Employing objective cough sound analysis holds promise for aiding diagnostic assessments and guiding the management of respiratory conditions. This systematic review aims to assess and summarize the predictive capabilities of machine learning algorithms in analyzing cough sounds to determine cough type.

A systematic search of the Scopus, Medline, and Embase databases conducted on March 8, 2025, yielded three studies that met the inclusion criteria. The quality assessment of these studies was conducted using the checklist for the assessment of medical artificial intelligence (ChAMAI).

The inter-rater agreement for annotating wet and dry coughs ranged from 0.22 to 0.81 across the three studies. Furthermore, these studies employed diverse inputs for their machine learning algorithms, including different cough sound features and time-frequency representations. The algorithms used ranged from conventional classifiers like logistic regression to neural networks. While the classification accuracy for identifying wet and dry coughs ranged from 78% to 87% across these studies, none of them assessed their algorithms through external validation.

The high variability in inter-rater agreement highlights the subjectivity in manually interpreting cough sounds and underscores the need for objective cough sound analysis methods. The predictive ability of cough-type classification algorithms shows promise in the small number of studies analyzed in this systematic review. However, more studies are needed, particularly those validating their models on independent and external datasets.

Paediatric emergency department (ED) presentations for self-harm and suicidality have significantly increased worldwide in the past decade, making paediatric EDs a key point of contact for young people experiencing suicidal ideation. Since 2022, four systematic reviews have been conducted on interventions for self-harm/suicidality in paediatric EDs, but findings were limited by small sample sizes and high heterogeneity. This meta-review provides recommendations to guide clinical practice and future research to enhance the quality of interventions in paediatric EDs for addressing self-harm and suicide related behaviours. Of 286 studies identified, five reviews synthesising 14 individual studies on ED-based interventions published up to May 2022 were included. Key themes and conclusions were synthesised. Three main themes emerged including: lack of informative trials, low levels of intervention effectiveness and common intervention elements. Informativeness of prior trials was limited by small sample sizes, lack of globally relevant research and limited stakeholder perspectives. Common intervention elements included: follow-up contact post-ED discharge, family involvement and psychoeducation with safety planning. Limited progress has been made in this field, likely due to challenges in conducting rigorous trials in paediatric EDs. Research has failed to incorporate voices of young people and their families, crucial for meeting their needs. Future research must prioritise co-design with youth, parents, and stakeholders as a critical next step in developing more effective paediatric ED interventions. Digital tools may offer promise for delivering interventions in the ED but should complement face-to-face professional contact.

To review the outcomes of robotic-assisted laparoscopic donor nephrectomy in the published literature.

Robotic-assisted laparoscopic donor nephrectomy has demonstrated to be a safe, efficient and effective technique of minimally invasive surgery, that offers multiple advantages to the surgeon, and good outcomes for the kidney donor and recipient. Although still a recent technique, it has been adopted by multiple centers worldwide. Robotic donor nephrectomy studies demonstrated consistent perioperative outcomes with low complication rates. Mean operative time was approximately 208 min, which is within acceptable limits. Mean warm ischemia time of 3.84 min remains well below the threshold for graft function preservation. Blood loss during is consistently low, below 150 mL, and conversion to open surgery remains rare, with a rate of 1.08%. These findings suggest that robotic-assisted procedures are feasible and safe for donor nephrectomy.

This meta-analysis aimed to determine the efficacy of melatonin on mortality in patients with severe-to-critical illness COVID-19.

A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized Controlled Trials (RCTs) on the treatment of severe-to-critical COVID-19 with melatonin, compared with placebo or blank, were reviewed. Studies were pooled to Odds Ratios (ORs), with 95 % Confidence Intervals (95 % CIs).

Three RCTs (enrolling 451 participants) met the inclusion criteria. Melatonin showed a significant effect on in-hospital mortality (OR = 0.19, 95 % CI 0.05 to 0.74; p = 0.02).

Melatonin significantly reduced in-hospital mortality in patients with severe-to-critical COVID-19. Melatonin should be considered for severe-to-critical COVID-19 patients.

Chronic inflammation is a critical public health concern that, in children and adolescents, increases the long-term risk of a variety of different health issues. While mind-body therapies like yoga, meditation, and acupuncture have shown promise in modulating immune responses in adults, their safety and effectiveness in pediatric populations remain underexplored. This protocol outlines the methodology for a systematic review and meta-analysis aimed at evaluating the effects of mind-body therapies on immune modulation in children and adolescents.

This systematic review and meta-analysis will follow PRISMA 2020 guidelines. We will include randomized controlled trials, non-randomized controlled trials, cohort studies, and case-control studies that examine the relationship between mind-body therapies and immune markers in pediatric populations. Electronic searches will be conducted in MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and the Cochrane Library, supplemented by trial registries. Risk of bias will be assessed using the Cochrane Risk of Bias Tool (RoB 1), the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I), and the Newcastle-Ottawa Scale (NOS). Two independent reviewers will screen studies, extract data, and assess study quality, with a third reviewer resolving any discrepancies. Results will be synthesized both narratively and through meta-analysis using R software.

The review will evaluate the effectiveness and safety of mind-body therapies on immune markers in children and adolescents. The synthesized evidence will guide clinical practice and public health policies in integrating mind-body therapies into pediatric care. The findings will also provide a foundation for future research and policymaking in this area.

PROSPERO CRD42024546585.

The global antibiotic resistance crisis necessitates optimized stewardship programs, with telemedicine emerging as a promising delivery strategy. This systematic review evaluated the effectiveness of telemedicine interventions in improving antibiotic stewardship across clinical settings. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched seven databases from January 2010 to July 2024. Two independent reviewers assessed studies using Risk of Bias in Non-randomized Studies (ROBINS-I) and Cochrane Risk of Bias 2.0 tools, with evidence certainty evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-one studies met inclusion criteria (10 observational, 8 quasi-experimental, 2 Randomized Controlled Trials [RCTs], 1 mixed-methods), predominantly from the United States (57.0%, n = 12). Among studies reporting antibiotic use outcomes (52.4%, n = 11), 90.9% demonstrated significant reductions ranging from 5.3% to 62.7%, with the highest-quality evidence showing a 28% reduction (95% Confidence Interval [CI]: 22-34%). Guideline adherence studies (57.1%, n = 12) showed acceptance rates of 67.7% to 98%, with comparable effectiveness between telemedicine and in-person consultation (79.1% vs 80.4%, p = 0.36). Prescribing rate outcomes (38.1%, n = 8) revealed setting-dependent variations: inpatient implementations demonstrated significant reductions (Relative Risk [RR] 0.68; 95% CI: 0.63-0.75), while outpatient findings showed mixed results. Quality assessment revealed predominantly low risk of bias [ROB] (66.7%, n = 14). These findings suggest that telemedicine effectively improves antibiotic stewardship compared to traditional care models, particularly in hospital settings, while outpatient applications demonstrated variable effectiveness. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023454663).

Managing electrolyte abnormalities, particularly sodium and potassium, in patients with heart failure (HF) remains a concern. A novel anti-diabetic drug, sodium-glucose co-transporter-2 (SGLT2) inhibitors, has become suitable for HF patients, improving cardiovascular outcomes. Therefore, we aimed to conduct a meta-analysis to evaluate the effect of SGLT2 inhibitors on serum sodium and potassium.

We systematically searched five databases, identifying randomized clinical trials (RCTs) reporting changes in serum sodium and potassium levels with SGLT2 inhibitors compared to comparator groups. Outcomes were presented as weighted mean differences (WMD) and standardized MD (SMD) with 95% confidence intervals (CI). Subgroup and sensitivity analyses were also conducted.

13 studies were included, with 13 studies with 10,617 participants reporting on serum sodium and nine studies with 9877 participants on serum potassium. In acute HF, SGLT2 inhibitors did not significantly affect serum sodium (WMD: 1.21 mmol/L; 95% CI: - 0.79, 3.21) or potassium levels (WMD: 0.11 mEq/L; 95% CI: - 0.20, 0.42). Subgroup analyses suggested possible variations by follow-up duration (< 7 days vs. ≥ 30 days) and drug type, but findings remained non-significant. Sensitivity analysis using the leave-one-out method and risk of bias assessment results showed no considerable changes in the statistical significance of the pooled results. Similarly, in chronic HF, no significant differences were observed for serum sodium (WMD: 0.23 mmol/L; 95% CI: - 0.45, 0.91) or potassium (WMD: 0.07 mEq/L; 95% CI: - 0.29, 0.44). Sensitivity and subgroup analyses based on duration, drug type, diabetes status, renal function, or systolic blood pressure did not reveal clinically meaningful differences across all analyses. For all analyses, Egger's test was non-significant, indicating no strong evidence of small-study effects. Moreover, the trim-and-fill method combined with the funnel plot did not identify any missing studies, and the recalculated effect size remained unchanged.

SGLT2 inhibitors did not significantly alter serum sodium or potassium levels in acute or chronic HF, suggesting that these drugs can be safe regarding electrolyte disturbances. Additional RCTs are warranted to enhance the robustness of evidence regarding the mechanisms and effects of SGLT2 inhibitors on serum electrolyte levels, considering variations across different types of SGLT2 inhibitors.

Copper is an essential trace element for fish, yet defining its optimal dietary levels remains a challenge in aquaculture nutrition. This meta-analysis quantitatively evaluated the effects of dietary copper supplementation on fish growth performance, superoxide dismutase activity, tissue copper levels, and body composition. Significant benefits in terms of fish survival, weight gain, hepatic Cu-Zn superoxide dismutase activity, and copper concentrations in the whole body, liver, and intestine were observed following supplementation with varying levels of copper, while excessive copper intake (> 25 mg/Kg) led to trade-offs in feed conversion, protein efficiency, and condition factor. Meta-regression identified that dietary copper levels, source of copper, feeding duration, and main protein content in the diet significantly moderated effect sizes of weight gain. Piecewise regression showed that the optimal dietary copper concentration determined to be 5.7 mg/kg. Structural equation models revealed that increased dietary protein and feeding duration enhance effect sizes of weight gain through elevated copper and crude protein levels in the body. This study provides a nuanced understanding of dietary copper supplementation effects on fish physiology, offering valuable insights for formulating diets that enhance aquaculture productivity while maintaining fish health.

The Balance Evaluation Systems Test (BESTest) and two abbreviated versions, Mini-BESTest and Brief-BESTest are used to assess functioning of balance control systems. Its reliability across different populations remains to be determined.

The present study followed reliability generalization procedures to estimate an average internal consistency and inter and intra-rater reliability for the BESTest, Mini-BESTest and Brief-BEStest. In this study, the heterogeneity of reliability coefficients in each instrument is evaluated. If heterogeneity is significant, a moderator analysis is performed to identify the characteristic which explains such variability.

A search of the PubMed, Embase, PsycINFO, Web of Science, Scopus and CINAHL databases was carried out to February 10th 2024. Two reviewers independently selected empirical studies published in English or Spanish that applied the BESTest, Mini-BESTest and/or Brief-BESTest and reported any reliability coefficient and/or internal consistency with data at hand.

Sixty-four studies reported any reliability estimate BESTest, Mini-BESTest and/or Brief-BESTest scores (N. = 5225 participants). Mean Cronbach alpha for the Mini-BESTest and Brief-BESTest (total score = 0.92) indicating no variability in estimated internal consistency. Likewise, no variability was obtained for inter-rater and intra-rater mean agreement of the BESTest (ICC = 0.97; 0.94), Mini-BESTest (ICC = 0.95; 0.94) and Brief-BESTest (ICC = 0.96; 0.95). Mean scores, standard deviation of scores, mean age, gender, population type, mean history of the disorder, disease, raters´ experience, number of raters, rater formation, continent of study and design type presented statistically significant relationships with ICC and/or Cronbach´s alpha for BESTest and the two abbreviated versions.

The mean intraclass correlations and Cronbach alpha obtained for BESTest, Mini-BESTest and Brief-BESTest exhibited an excellent inter and intra-rater reliability and internal consistency. The average reliability obtained three scales adequate to be applied for screening balance problems in different populations. Some continuous and categorical moderator variables increase reliability and internal consistency of these scales.

Proliferative diabetic retinopathy is a major cause of sight loss in people with diabetes, with a high risk of vitreous haemorrhage, tractional retinal detachment and other complications. Panretinal photocoagulation is the primary established treatment for proliferative diabetic retinopathy. Anti-vascular endothelial growth factor drugs are used to treat various eye conditions and may be beneficial for people with proliferative diabetic retinopathy.

To investigate the efficacy and safety of anti-vascular endothelial growth factor therapy for the treatment of proliferative diabetic retinopathy when compared to panretinal photocoagulation.

A systematic review and network meta-analysis of randomised controlled trials comparing anti-vascular endothelial growth factor (alone or in combination) to panretinal photocoagulation in people with proliferative diabetic retinopathy. The database searches were updated in May 2023. Trials where the primary focus was treatment of macular oedema or vitreous haemorrhage were excluded. Key outcomes were best corrected visual acuity, diabetic macular oedema and vitreous haemorrhage. Individual participant data were obtained and analysed for three large, high-quality trials in combination with published data from other trials. Network meta-analyses of best corrected visual acuity and meta-analyses of other outcomes combined individual participant data with published data from other trials; regression analyses against patient covariates used just the individual participant data.

Twelve trials were included: one of aflibercept, five of bevacizumab and six of ranibizumab. Individual participant data were available from 1 aflibercept and 2 ranibizumab trials, representing 624 patients (33% of the total). When considered together, anti-vascular endothelial growth factors produced a modest, but not clinically meaningful, benefit over panretinal photocoagulation in best corrected visual acuity, after 1 year of follow-up (mean difference in logarithm of the minimum angle of resolution -0.116, 95% credible interval -0.183 to -0.038). There was no clear evidence of a difference in effectiveness between the anti-vascular endothelial growth factors. The benefit of anti-vascular endothelial growth factor appears to decline over time. Analysis of the individual participant data trials suggested that anti-vascular endothelial growth factor therapy may be more effective in people with poorer visual acuity, in those who have vitreous haemorrhage and, possibly, in people with poorer vision generally. Anti-vascular endothelial growth factor was superior to panretinal photocoagulation at preventing macular oedema after 1 year (relative risk 0.48, 95% confidence interval 0.28 to 0.83) and possibly at preventing vitreous haemorrhage (relative risk 0.72, 95% confidence interval 0.47 to 1.10). Anti-vascular endothelial growth factor reduced the incidence of retinal detachment when compared to panretinal photocoagulation (relative risk 0.41, 95% confidence interval 0.22 to 0.77). Data on other adverse events were generally too limited to identify any differences between anti-vascular endothelial growth factor and panretinal photocoagulation.

Anti-vascular endothelial growth factor has no clinically meaningful benefit over panretinal photocoagulation for preserving visual acuity. However, anti-vascular endothelial growth factor therapy appears to delay or prevent progression to macular oedema and vitreous haemorrhage. The possibility that anti-vascular endothelial growth factor therapy may be more effective in patients with poorer health and poorer vision merits further clinical investigation. The long-term effectiveness and safety of anti-vascular endothelial growth factor treatment are unclear, particularly as additional panretinal photocoagulation and anti-vascular endothelial growth factor treatment will be required over time.

This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132948.

Cochlear nerve deficiency (CND) is commonly implicated in moderate-to-profound pediatric sensorineural hearing loss (SNHL). Although cochlear implantation (CI) was previously contraindicated in CND patients, recent studies have demonstrated the potential for auditory response to CI in a subset of CND patients, though clinical outcomes remain variable. This study aims to evaluate pre- and postoperative speech and auditory outcomes of CI in pediatric patients with bilateral SNHL and radiographically confirmed CND.

Embase and Ovid MEDLINE.

A systematic review was conducted to identify studies reporting pre- and postoperative outcomes of children with CND confirmed by magnetic resonance imaging who underwent CI. A random-effects model was used to account for within- and between-study variance in speech and auditory outcomes.

After abstract screening of 818 distinct articles, 16 studies were selected for final inclusion, consisting of 248 patients with cochlear nerve hypoplasia or aplasia who underwent CI. Various speech perception and language development tests were investigated across studies (Speech Intelligibility Rating, Speech Perception Category, Speech Awareness Thresholds, Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance, and Auditory Level). Pooled outcomes demonstrated improvement in speech perception after CI in pediatric patients with CND (SMD 2.18, 95% CI 1.68-2.69).

Indications for CI are expanding as research demonstrates benefit in populations previously thought inappropriate. Our study demonstrates global postoperative improvement in speech and auditory outcomes in children with bilateral SNHL and CND after CI.

NA Laryngoscope, 135:1259-1266, 2025.

The optimal red blood cell transfusion (RBCT) strategy for traumatic brain injury (TBI) patients remains a topic of debate. This systematic review and meta-analysis aimed to compare the outcomes of a liberal transfusion strategy versus a restrictive strategy in critically ill patients with TBI.

PubMed, Web of Science, Embase, and Cochrane Library were searched from inception to November 17, 2024. We included randomized controlled trials (RCTs) of critically ill adult patients with TBI, reporting data on RBCT strategies. The outcomes included intensive care unit (ICU) mortality, long-term mortality, unfavorable functional outcomes, and the incidence of adverse events, such as transfused acute respiratory distress syndrome (TARDS) and venous thromboembolism. We also performed subgroup analyses comparing the association between disease severity and long-term mortality. This review was submitted to PROSPERO (Registration number: CRD42024558797).

In the results, our analysis revealed that compared to a restrictive transfusion strategy, a liberal strategy did not significantly reduce the risk of ICU mortality (RR: 0.74; 95% CI 0.28-1.91; P = 0.53) and long-term mortality (RR: 1.02; 95% CI 0.83-1.25; P = 0.87), but it was able to reduce the risk of unfavorable functional outcomes (RR: 0.90; 95% CI 0.82-0.98; P = 0.01), although there may be a false positive error. In addition, the liberal transfusion strategy was associated with a higher incidence of Transfused Acute Respiratory Distress Syndrome (TARDS) (RR: 1.78; 95% CI 1.06-2.98; P = 0.03).

In critically ill patients with TBI, a liberal RBCT strategy appears to improve functional outcomes but carries the risk of false positive errors. In addition, this strategy does not seem to improve survival and may increase the risk of TARDS. Despite this, there remains insufficient evidence to recommend either strategy in this population.

Lower urinary tract symptoms (LUTS) significantly impact men's quality of life and can cause bothersome symptoms, which often interfere with daily functioning and contribute to psychological distress. While pharmacological and surgical treatments are effective, they can have side effects, and not all men require or desire these interventions. The aim of this study is to assess the impact of self-management interventions on symptom severity.

We conducted a systematic search across multiple databases, including PubMed, Embase, and Cochrane Library, from inception to August 2024. We identified randomized controlled trials (RCTs) assessing self-management interventions for LUTS in men. Studies were evaluated for quality and analyzed for outcomes on BPH Impact Index, International Prostate Symptom Score (IPSS), and QoL. Publication bias and heterogeneity were examined through LFK indices, sensitivity analyses, and Doi plots.

Self-management significantly reduced the BPH Impact Index at 3 months (SMD: -0.73; p = 0.0003) and 6 months (SMD: -0.95; p = 0.05), though publication bias was indicated. The IPSS decreased significantly at 3 months (MD: -5.52; p < 0.01), 6 months (MD: -5.50; p = 0.002), and 12 months (MD: -3.51; p = 0.01). Quality of life also improved at 6 and 12 months (SMD: -0.34, p = 0.002, and SMD: -0.30, p < 0.01, respectively). Sensitivity analysis confirmed the consistency of these findings after adjusting for study heterogeneity.

Our findings suggest that self-management interventions provide a significant benefit in reducing LUTS severity and enhancing quality of life in men.

We aimed to summarize the available evidence examining the association between prenatal ultrasound findings and adverse fetal, obstetric, and neonatal outcomes in pregnancies complicated by type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) and to evaluate whether the predictive value of ultrasound findings for adverse outcomes varies between T1DM and T2DM pregnancies.We conducted a systematic review of the existing literature through August 12, 2024. We included articles in English that reported associations between ultrasound findings and fetal, obstetric, and neonatal outcomes in pregnant people with T1DM and T2DM. The primary outcome of interest was stillbirth; secondary outcomes were neonatal demise, neonatal intensive care unit admission, neonatal hypoglycemia, respiratory distress syndrome, polycythemia, hyperbilirubinemia, organomegaly, electrolyte disturbances, shoulder dystocia, permanent brachial plexus injury, cord gas, Apgar scores, large for gestational age (LGA), small for gestational age (SGA), and preterm birth. Two independent reviewers examined articles at the abstract level and, if eligible, at the full-text level; disagreements were adjudicated by a third reviewer.Of the 2,088 unique citations reviewed, 12 studies met the inclusion criteria describing associations between ultrasound findings and fetal, obstetric, and neonatal outcomes among a total of 1,165 pregnant people with T1DM and 489 pregnant people with T2DM. Most studies (10/12) examined the association between ultrasound measures of growth, including estimated fetal weight and its individual components, abdominal wall thickness, head circumference to abdominal circumference ratio, and birth weight, LGA or SGA. Studies did not examine stillbirth, neonatal demise, or maternal outcomes other than cesarean section.This systematic review synthesizes the available literature on ultrasound risk markers of adverse fetal, obstetric, and neonatal outcomes separately in pregnant people with T1DM and T2DM. We identified very few studies that distinguished between pregnant people with T1DM and T2DM, and the majority focused on surrogate outcomes (e.g., LGA, SGA) of morbidity. Our findings highlight the need for further studies investigating these distinct diseases to provide evidence for antenatal management recommendations. · This systematic review compares ultrasound risk markers for adverse outcomes in pregnancies with T1DM and T2DM.. · Few studies compare ultrasound risk markers for adverse outcomes among pregnancies with T1DM and T2DM.. · Additional targeted studies to inform antenatal ultrasound care are necessary..