Measuring the radioactivity of organically bound tritium in environmental samples is difficult. For the past twenty years, many laboratories have been working on the development of reliable tritium measurement methods. In this context, several interlaboratory comparisons have been organised to develop these methods and enable laboratories to compare themselves. However, the trueness of the measurement methods has never been estimated due to the lack of certified reference materials available for use during the analyses. This document presents the production of the first certified reference material for the measurement of organically bound tritium radioactivity in environmental samples.

Suicidal behaviours, including ideation, attempts, and mortality, are significant yet often overlooked concerns among women with breast cancer. While the psychological burden of breast cancer has been studied, comprehensive data on the prevalence and risk factors of suicidal behaviours in this population remain limited.

This systematic review and meta-analysis aim to assess the prevalence, incidence, and risk factors associated with suicidal behaviours among women with breast cancer.

A literature search was conducted using Embase, MEDLINE, CINAHL, Web of Science, and Academic Search Complete for studies published up to June 2024. Search terms included 'breast cancer,' 'suicidal behaviour,' 'suicide ideation,' 'suicide attempts,' 'self-harm,' and 'self-injury.' Eligible studies included primary data on suicidal ideation, attempts, or completed suicides among women with breast cancer. Meta-analyses were performed using random-effects models, and heterogeneity was assessed with the I2 statistic.

Twenty studies comprising 3450,022 participants were included. The pooled prevalence of suicidal ideation was 10 % (95 % CI 0.01-0.63, p < 0.001), while suicide attempts were reported at 2 % (95 % CI 0.01-0.03, p < 0.001). Suicide mortality was observed in 0.001 % (95 % CI 0.001-0.002, p < 0.001). Younger age (18-45 years), advanced cancer stages (stage IV), and unmarried status were significant risk factors.

Suicidal behaviours are prevalent among women with breast cancer, particularly in younger, unmarried patients with advanced cancer stages. Comprehensive mental health support is crucial in reducing suicide risk.

To conduct an updated meta-analysis evaluating the efficacy and safety of tranexamic acid (TXA) versus control during endoscopic sinus surgery.

Six databases were screened until July 7, 2024, and the quality of included randomized controlled trials (RCTs) was assessed. Endpoints were summarized as mean difference (MD) with 95% confidence intervals (CIs) using a random-effects model.

A total of 23 RCTs, including 29 arms and 1597 patients, were analyzed. The overall quality was rated as low-risk in 15 RCTs, high-risk in five RCTs, and of some concern in three RCTs. TXA significantly reduced intraoperative blood loss (n = 22 arms, MD = - 68.87 ml, 95% CI - 79.66, - 58.07) and operative time (n = 21 arms, MD = - 13.93 min, 95% CI - 17.49, - 10.37) compared to control. TXA also improved surgical field quality (measured on a 5-point Boezaart scale, n = 22 arms, MD = - 0.61, 95% CI - 0.88, - 0.34) and surgeon satisfaction scores (n = 9 arms, MD = 0.85, 95% CI 0.53, 1.17). No thromboembolic events were reported in either group. Leave-one-out sensitivity analyses confirmed the robustness of all endpoints, and no publication bias was detected. Subgroup analyses by route of administration (intravenous, topical, and oral) showed equal effectiveness. Additionally, analyses by sinus pathology demonstrated effectiveness in patients with severe chronic rhinosinusitis with nasal polyposis (CRSwNP). Trial sequential analysis showed conclusiveness for all outcomes.

Perioperative TXA, whether administered systemically or topically, correlates with decreased intraoperative blood loss, shortened operating times, and enhanced surgical visualization compared to control interventions. However, these findings are constrained by significant heterogeneity and varying reporting quality among studies.

Sudden sensorineural hearing loss (SSHL) is an abrupt hearing loss, often of unknown cause. Apheresis is a treatment option aimed at improving blood hemorheology by removing pathogenic blood components. There are currently no previous meta-analyses on its efficacy. Therefore, the aim of this study was to evaluate the efficacy of apheresis in achieving total, complete, and partial remission of SSHL, as well as remission outcomes based on the type of apheresis used.

A systematic search was performed in PubMed, Scopus, Web of Science, and the Cochrane Library until March 2024. Random-effects models were used to calculate pooled estimates of treatment success rates (TSR) and their respective 95% CI to analyze the efficacy of apheresis in the remission of SSHL. Subgroup analyses were performed by type of apheresis (HELP-apheresis and rheopheresis).

The systematic review included 12 studies (10 in the meta-analysis) involving 786 adults with SSHL. The effect of apheresis showed significant total remission (TSR: 0.55; 95% CI: 0.47, 0.64), complete remission (TSR: 0.21; 95% CI: 0.11, 0.30), and partial remission (TSR: 0.43; 95% CI: 0.37, 0.48). Subgroup analysis revealed significant remission rates for HELP-apheresis (TSR: 0.58; 95% CI: 0.52, 0.64) and rheopheresis (TSR: 0.51; 95% CI: 0.30, 0.72).

These findings support apheresis as an equally or more effective treatment for SSHL, particularly in cases where corticosteroid therapy fails. However, due to the unknown etiology of SSHL, further clinical trials with larger, diverse populations are essential to confirm these results.

Recurrent abdominal hernias remain a significant clinical challenge, with relatively high recurrence rates despite prosthetic mesh repair. Accurate imaging modalities are essential to assess mesh positioning and detect complications. Our study aims to compare computed tomography (CT) and magnetic resonance imaging (MRI) for mesh visualization, recurrence detection, and related postoperative outcomes in recurrent hernia patients.

A systematic review and meta-analysis were conducted, including CT scan or MRI studies, to assess mesh visualization in recurrent hernia cases. A comprehensive search of PubMed, Scopus, Embase, and Web of Science was performed up to July 2024. Data were extracted for mesh visualization, recurrence rates, seroma detection, and reoperation rates. Statistical analysis employed a random-effects model with subgroup analysis for CT and MRI modalities.

A total of 26 studies were included (18 for CT, and 8 for MRI). Recurrence rates were 20% (95% CI: 0-42%) for CT-based studies and 15% (95% CI: 4-26%) for MRI-based studies (p = 0.72). MRI exhibited superior mesh visualization (73%; 95% CI: 42-100%) compared to CT-(48%; 95% CI: 0-100%) (p = 0.44) studies. Seroma detection rates were similar: 12% (95% CI: 4-19%) for CT- and 10% (95% CI: 4-15%) for MRI- (p = 0.65) studies. Reoperation rates were 6% (95% CI: 1-11%) for CT- and 34% (95% CI: 3-66%) for MRI-based studies, showing a non-significant trend (p = 0.08).

CT and MRI offer distinct advantages in detecting mesh-related complications after hernia surgery. CT remains preferred for identifying recurrence and acute complications, while MRI excels in mesh visualization and soft-tissue assessment. Tailored imaging strategies based on clinical scenarios can optimize outcomes and improve postoperative care.

The aim of this study was to analyze the effects of wine consumption on the lipid profile, distinguishing between triglycerides, total cholesterol, LDL, HDL and fibrinogen.

We examined the MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases to conduct this systematic review and meta-analysis. PROSPERO has already recorded this study under registration number CRD42023396666.

Thirty-three studies were included in this systematic review, and 29 were included in the meta-analysis. The pooled ES for the effect of red wine consumption on the different lipid profile parameters was significant only for the effect of red wine on the LDL parameter in the prepost studies (-0.29 (95% CI -0.54, -0.05)). The pooled ES for the effect of white wine in prepost studies and clinical trials for the effect of wine consumption on the different parameters did not show any significant results.

This systematic review and meta-analysis revealed that wine consumption has an effect on reducing LDL and has no effect on total cholesterol, HDL, triglycerides, or fibrinogen. This research revealed that the duration of the intervention affects triglyceride and total cholesterol levels, indicating that longer interventions are more effective for these two parameters.

CRD42023396666 (PROSPERO). URL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396666.

Despite rising rates of sexually transmitted infections (STIs) in Thailand, including syphilis, data on its prevalence and associated risk factors among blood donors remain scarce. This systematic review and meta-analysis aimed to estimate the prevalence of syphilis and identify the key risk factors among blood donors in Thailand to inform targeted interventions for enhanced blood safety.The study protocol was registered in PROSPERO (CRD42024560215) and conducted following PRISMA guidelines. Comprehensive searches were performed across major databases, including ProQuest, Journals@Ovid, Embase, Scopus, PubMed, and MEDLINE, to identify relevant studies. A random-effects model was used to calculate the pooled prevalence and odds ratios (ORs) for syphilis risk factors. Heterogeneity was quantified using the I² statistic, and meta-regression and subgroup analyses were employed to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test. A total of 23 studies involving 1,142,910 blood donors were included. The pooled prevalence of syphilis among blood donors in Thailand was 0.42% (95% CI 0.27-0.66%, I²: 99.3%, number of infections: 6,173), with a decreasing trend over time. Male donors were significantly more likely to have syphilis (P < 0.0001; pooled OR: 1.76; 95% CI 1.53-2.03; I²: 34.2%, 651,019 participants). First-time donors also had an elevated risk of syphilis (P = 0.02; pooled OR: 2.02; 95% CI 1.10-3.70; I²: 94.0%, 215,245 participants). Additionally, the analysis revealed a significant association between increasing age and higher syphilis risk among blood donors. The systematic review and meta-analysis indicated that syphilis prevalence among blood donors in Thailand is declining; however, male and first-time donors, as well as older age groups, remain at higher risk. To enhance blood safety, targeted interventions are needed, including refining donor screening questionnaires, expanding educational campaigns for high-risk groups, and incorporating advanced screening technologies. Strengthening and regularly updating national screening policies will ensure the effective mitigation of syphilis transmission among blood donors in Thailand.

Background/Objectives: To assess the effectiveness of the levonorgestrel-releasing intrauterine device (LNG-IUD) compared to hysteroscopic resection for managing women with symptomatic cesarean scar defects (CSDs). Methods: This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search of four electronic databases was conducted to identify studies comparing LNG-IUD with hysteroscopic management for symptomatic CSDs. Studies reporting outcomes of bleeding and spotting days and effectiveness rates were included. Quality assessment was performed using the ROBINS-I and RoB-2 tools. Results: Three studies involving 344 patients met the inclusion criteria. At 6 months, LNG-IUD use significantly reduced total bleeding days (MD -4.13; 95% CI: -5.17 to -3.09; p < 0.00001) and spotting days (MD 1.90; 95% CI: 0.43 to 3.37; p = 0.01) compared to hysteroscopic treatment. By 12 months, LNG-IUD demonstrated superior effectiveness (OR 3.46; 95% CI: 1.53 to 7.80; p = 0.003), with fewer total bleeding days (MD -5.69; 95% CI: -6.55 to -4.83; p < 0.00001) and spotting days (MD 3.09; 95% CI: 1.49 to 4.69; p = 0.0002). Approximately 50% of LNG-IUD users experienced amenorrhea within 1 year. Conclusions: LNG-IUD offers a minimally invasive and effective alternative to hysteroscopic resection for women with symptomatic CSD and no desire for future pregnancies. Its role should be considered in clinical practice, but further research is needed to validate these findings and define its long-term benefits and limitations.

Utilization of lung cancer screening (LCS) among eligible patients remains low at 16% in 2022. In this systematic review and meta-analysis we assessed the (a) LCS completion rate, and (b) intention to complete LCS, among patients who receive patient decision aids (PDAs).

PubMed, Cochrane, Scopus, CINAHL, and Web of Science were searched for articles published in English between 1 January 2011, and 28 February 2023. Two independent reviewers selected randomized controlled trials and prospective cohort studies that reported PDA interventions targeting either LCS completion rate or intention to complete LCS. Quality appraisal and data extraction were performed independently by 2 reviewers using the National Heart, Lung, and Blood Institute quality assessment tool. A random-effects model meta-analysis was performed. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines.

Thirteen studies with 2,277 total participants (51.5% male) were included. The pooled LCS completion rate across all follow-up periods (range, 1-6 months) was 40% (95% confidence interval [CI], 15-65%) with an I2 of 97% for heterogeneity. Pooled intention to complete LCS among patients who received PDA across all follow-up periods (same day to 3 months) was 57% (95% CI, 34% to 80%) with significant heterogeneity (I2) of 96% (p < 0.0001). No publication bias was identified.

LCS completion and intention to complete LCS among patients who use PDAs is high. Our findings support the need to implement PDAs in clinical practice which could further facilitate shared decision-making and improve LCS uptake among eligible patients.

Green tea, a plant rich in bioactive compounds, has been highlighted for its beneficial effects. In the present systematic review and meta-analysis of randomised controlled trials (RCTs), the impact of green tea on inflammatory and oxidative markers is investigated. Using pre-defined keywords, online databases (PubMed, Scopus, Web of Science Core Collection, and Google Scholar) were searched for relevant articles, published from inception up to February 2024. The outcomes included C-reactive protein (CRP), tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1 beta (IL-1β), total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPX). Analyses of subgroups, linear, and non-linear associations were also carried out. Out of 1264 records initially retrieved, 38 RCTs were included. Supplementation with green tea improved the following indicators: IL-1β (weighted mean difference (WMD): -0.10 pg/mL; 95% CI: -0.15, -0.06), MDA (WMD: -0.40 mcmol/L; 95 % CI: -0.63, -0.18), TAC (WMD: 0.09 mmol/L; 95% CI: 0.05, 0.13), SOD (WMD: 17.21 u/L; 95% CI: 3.24, 31.19), and GPX (WMD: 3.90 u/L; 95% CI: 1.85, 5.95); but failed to improve others, including CRP (WMD: 0.01 mg/L; 95% CI: -0.14, 0.15), IL-6 (WMD: -0.34 pg/mL; 95% CI:-0.94, 0.26), and TNF-α (WMD: -0.07 pg/mL; 95% CI: -0.42, 0.28). Supplementation with green tea can improve the body's oxidative status. However, the results showed no significant effect of green tea on inflammatory markers, except for IL-1β. Further studies are needed to determine the effectiveness of green tea, particularly on inflammatory status.

This systematic review and meta-analysis aim to examine the profile and extent of cognitive deficits in patients with cerebellar disorders, and to provide a complete overview of the cognitive domains that might be affected in the Cerebellar Cognitive Affective Syndrome (CCAS).

MEDLINE, Embase, PsycINFO, and Web of Science were systematically searched to 17-07-2024. Studies were considered if the participants were adult patients with a clinical diagnosis of cerebellar disorder and were neuropsychological assessed. Outcomes were grouped into the domains of processing speed, language, social cognition, executive function, visuospatial skills, episodic memory, verbal intelligence, attention, and working memory. All aetiologies were included for first evaluation and patients were assigned to one of two groups (focal vs. degenerative) for secondary evaluation. Random-effects models were employed for the meta-analyses.

129 studies with a total of 3140 patients with cerebellar disorders were included. Patients performed significantly worse compared to control/standardized data in all domains. Deficits were most pronounced in processing speed, ES [95% CI] = - 0.83 [- 1.04, - 0.63], language, ES [95% CI] = - 0.81 [- 0.94, - 0.67], and social cognition, ES [95% CI] = - 0.81 [- 1.19, - 0.42]. Cognitive impairment varied between patients with focal cerebellar lesions and degenerative cerebellar disorders, but was overall worse in the degenerative group.

Cerebellar disorders can impact many cognitive domains, extending beyond executive functioning, visuospatial skills, and language. These outcomes contribute to a broader understanding of the cerebellum's role in cognition and sheds light on the cognitive deficits associated with cerebellar disorders.

Restrictive physical activity after pelvic reconstructive surgery is recommended, although the optimal duration and intensity are not standardized.

This systematic review and meta-analysis aimed to evaluate the existing literature comparing clinical outcomes for liberal postoperative physical activity versus standard of care, defined as restricted postoperative physical activity, after pelvic reconstructive surgery.

PubMed, CENTRAL, Scopus, Web of Science, and CINAHL databases were searched for observational and randomized studies comparing liberal postoperative physical activity and standard of care in women undergoing pelvic reconstructive surgery, reporting anatomic and functional outcomes. Statistical analysis was performed using RevMan software, presenting results as mean difference (MD) or odds ratio in a random-effects model, with 95% confidence intervals (CIs).

Five randomized trials, representing total n = 434, were included, with 2 studies on sling surgical procedures and 3 on prolapse surgical procedures. Data from 3 studies suggest no significant difference between liberal and standard postoperative instructions in surgical outcomes, measured by Point Ba from POP-Q assessment tool, up to 3 months follow-up (MD, -0.04; 95% CI, -0.16 to 0.07; P = 0.49). Disease-specific symptom distress, measured by Pelvic Floor Distress Inventory-20, favored the liberal approach (MD, -10.09; 95% CI, -18.33 to -1.86; P = 0.02). Other domains, including Urinary Distress Inventory-6, also showed significant improvements with liberal postoperative activities (MD, -4.29; 95% CI, -7.84 to -0.74; P = 0.02).

Patients with liberal postoperative physical activity recommendations in prolapse repair surgical procedures had similar short-term anatomic outcomes compared with standard restrictions, with more favorable outcomes in disease-specific symptom relief and quality of life.

Persons with schizophrenia are excluded from psychedelic-assisted therapy due to concerns about the risk of triggering or worsening psychosis. However, there is limited meta-analytic data on the risk of psychedelic-induced psychosis in individuals with pre-existing psychotic disorders.

We conducted a systematic review, meta-analysis, and overview of reviews to assess the incidence of psychedelic-induced psychosis and symptom exacerbation in schizophrenia. Our pre-registered protocol (CRD42023399591) covered: LSD, psilocybin, mescaline, DMT, and MDMA, using data from Embase, PubMed, PsyARTICLES, PsyINFO, and trial registries up to November 2023. A random-effects model was used to calculate psychosis incidence, with standardized assessments of study quality.

From 131 publications, we analyzed 14 systematic reviews, 20 reviews, 35 randomized-controlled trials (RCTs), 10 case-control studies, 30 uncontrolled trials (UCTs), and 22 cohort studies, most of which were low quality. Meta-analysis of nine studies showed an incidence of psychedelic-induced psychosis at 0.002% in population studies, 0.2% in UCTs, and 0.6% in RCTs. In UCTs including individuals with schizophrenia, 3.8% developed long-lasting psychotic symptoms. Of those with psychedelic-induced psychosis, 13.1% later developed schizophrenia. Sensitivity analyses confirmed the results.

In summary, the reviewed evidence suggests that schizophrenia might not be a definite exclusion criterion for clinical trials exploring safety and efficacy of psychedelics for treatment-resistant depression and negative symptoms. However, given the low quality and limited number of studies, more high-quality research is needed, and a conservative approach is recommended until further data is available.

Background: Recent studies have indicated that cluster of differentiation 36 (CD36) is closely linked to dyslipidemia and early-onset coronary artery disease (EOCAD). This study is aimed at investigating the impacts of CD36 gene variants on lipid profiles and EOCAD risk. Methods: PubMed, Cochrane Library, Central, CINAHL, and ClinicalTrials.gov were searched until June 15, 2024. Results: In total, 25 studies (11,494 individuals) were included for the analysis. The A allele carriers of the rs1761667 variant had higher high-density lipoprotein cholesterol (HDL-C) levels and higher EOCAD risk than noncarriers. In contrast, the G allele carriers of the rs1049673 and rs3211956 variants had lower low-density lipoprotein cholesterol (LDL-C) levels and lower EOCAD risk than noncarriers. Subgroup analysis indicated that the antiatherosclerotic impact and reduced EOCAD risk were primarily observed in Chinese with rs1049673 and rs3211956. Conclusions: The rs1761667, rs1049673, and rs3211956 variants of the CD36 gene have significant impacts on lipid levels and may serve as genetic markers for the risk of EOCAD primarily in Chinese. The impacts of CD36 variants on EOCAD risk are mediated, at least partly, by dyslipidemia. Genetic screening of CD36 gene variants may be helpful for early intervention or prevention of EOCAD in individuals with high risk factors.

Road traffic accidents have become a global public health issue, especially in low- and middle-income countries (LMICs). According to the World Health Organization (WHO) Global Road Safety Report 2018, there are over 1.35 million deaths related to road traffic accidents (RTAs) annually. Although several primary studies have been conducted to determine the prevalence and associated factors of post-traumatic stress disorder (PTSD) among RTA survivors in sub-Saharan Africa (SSA), these studies have reported inconsistent findings. Therefore, this study aimed to determine the pooled prevalence and associated factors of PTSD among RTA survivors in SSA.

The studies were accessed through the Google Scholar, Scopus, PubMed, and Web of Science databases using search terms. Moreover, citation tracking was also performed. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of PTSD and determine associated factors among RTA survivors in SSA.

A total of 17 primary studies with a sample size of 9,056 RTA survivors were included in the final meta-analysis. The pooled prevalence of PTSD among RTA survivors in SSA was 23.36% (95% CI: 18.36, 28.36); I2 = 96.73%; P < 0.001). Female gender [AOR = 2.33, 95% CI: 1.80, 3.01], depression symptoms [AOR = 2.96, 95% CI: 2.17, 4.03], duration since the accident (1-3 months) [AOR = 2.08, 95% CI: 1.23, 3.52], poor social support [AOR = 2.97, 95% CI: 1.09, 8.11], and substance use [AOR = 3.31, 95% CI: 1.68, 6.52] were significantly associated with PTSD.

The pooled prevalence of PTSD was low in SSA compared to studies that have been conducted outside the region. Female gender, depression symptoms, duration since the accident (1-3 months), poor social support, and substance use were the pooled independent predictors of PTSD among RTA survivors in SSA. Those RTA survivors with these identified risk factors would be screened and managed early for PTSD using pharmacological treatment and brief psychological intervention. Future researchers shall conduct further studies using different methods, including qualitative studies to identify additional predictors of PTSD among RTA survivors in SSA.

Tumor necrosis factor-alpha (TNF-α), is partly attributed to pathogenesis of end-stage renal disease (ESRD). Inconsistency of reported associations between TNF-α G-308A polymorphism (rs1800629) and ESRD prompted a meta-analysis to obtain more precise estimates. Eleven case-control studies from 11 articles were included. Pooled odds ratios (OR) and 95% confidence intervals (95% CIs) were estimated to evaluate the association. Subgroup analysis was based on ethnicity (Caucasian and Asian). Multiple comparisons were Bonferroni-corrected. Trial sequential analysis (TSA) was implemented to ascertain the reliability of results. Sensitivity analyses and publication bias tests were performed on significant results. There were no significant association (pa >0.05) in the overall and ethnic subgroup. Indians, three significant pool ORs (pa < 0.01-0.03) showed increased susceptibility to ESRD in homozygous (OR, 6.57; 95% CI, 1.45 to 29.75; pa = 0.01), recessive (OR, 6.75; 95% CI, 1.44 to 31.56; pa = 0.02), and codominant (OR, 2.06; 95% CI, 1.08 to 3.94; pa = 0.03) models. TSA indicated the robustness of such association in the Indian population. The main outcomes were robust without evidence of publication bias. This study showed associations between TNF-α G-308A and ESRD are confined to Indians, which are susceptible to ESRD up to approximately 7 times.

We aimed to determine: (a) the chronic effects of interval training (IT) combined with blood flow restriction (BFR) on physiological adaptations (aerobic/anaerobic capacity and muscle responses) and performance enhancement (endurance and sprints), and (b) the influence of participant characteristics and intervention protocols on these effects.

Searches were conducted in PubMed, Web of Science (Core Collection), Cochrane Library (Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform), and Chinese National Knowledge Infrastructure on April 2, with updates on October 17, 2024. Pooled effects for each outcome were summarized using Hedge's g (g) through meta-analysis-based random effects models, and subgroup and regression analyses were used to explore moderators.

A total of 24 studies with 621 participants were included. IT combined with BFR (IT+BFR) significantly improved maximal oxygen uptake (VO2max) (g = 0.63, I2 = 63%), mean power during the Wingate 30-s test (g = 0.70, I2 = 47%), muscle strength (g = 0.88, I2 = 64%), muscle endurance (g = 0.43, I2 = 0%), time to fatigue (g = 1.26, I2 = 86%), and maximal aerobic speed (g = 0.74, I2 = 0%) compared to IT alone. Subgroup analysis indicated that participant characteristics including training status, IT intensity, and IT modes significantly moderated VO2max (subgroup differences: p < 0.05). Specifically, IT+BFR showed significantly superior improvements in VO2max compared to IT alone in trained individuals (g = 0.76) at supra-maximal intensity (g = 1.29) and moderate intensity (g = 1.08) as well as in walking (g = 1.64) and running (g = 0.63) modes. Meta-regression analysis showed cuff width (β = 0.14) was significantly associated with VO2max change, identifying 8.23 cm as the minimum threshold required for significant improvement. Subgroup analyses regarding muscle strength did not reveal any significant moderators.

IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance, with moderators including training status, IT protocol (intensity, mode, and type), and cuff width. This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.

Patients with adult congenital heart disease (CHD) have various indications for anticoagulation (e.g., presence of Fontan circuit, atrial fibrillation due to surgical scar). Guidelines recommend vitamin K antagonists (VKA) for thromboprophylaxis in adult CHD, as trial data comparing safety/efficacy of direct oral anticoagulants (DOAC) to VKA are not available in this population.

PubMed/MEDLINE, Embase, Web of Science, and Google Scholar were searched for trials comparing DOAC with VKA in patients with ACHD. Outcomes of interest were efficacy endpoints (thromboembolic complications) and safety endpoints (bleeding complications). Results were meta-analyzed and sensitivity analyses were performed.

A total of 4 retrospective studies comprising 6004 patients (2566 DOAC, 3438 VKA) were analyzed. Compared with VKA, DOAC did not cause a statistically significant difference in incidence of thromboembolism (risk ratio, RR, 0.76; 95% confidence intervals, CI, 0.28, 2.07); composite bleeding (RR 1.02, 95% CI 0.71, 1.47); major bleeding (RR 1.05, 95% CI 0.92, 1.21); minor bleeding (RR 1.12, 95% CI 0.51, 2.44); or intracranial bleeding (RR 0.86, 95% CI 0.50, 1.46). Numerically, the DOAC arm had fewer thromboembolisms/intracranial bleeds but more major/composite bleeds. However, upon removal of the largest study, the DOAC arm had fewer major/composite bleeds.

DOAC did not confer a significant increase in either thromboembolic or bleeding risk as compared with VKA. Sensitivity analysis showed notable heterogeneity among studies. Large-scale trials comparing DOAC with VKA in patients with adult CHD are needed.

Cardiovascular disease is the leading cause of death among women worldwide, and hypertension is one of the most prevalent and modifiable risk factors. Parity and gravidity, independent of pregnancy complications, have each been associated with hypertension, although results are conflicting. Therefore, we propose to estimate the association between parity and gravidity with hypertension and blood pressure in a systematic review of the literature.

A systematic review will be conducted to estimate the association between parity and gravidity and hypertension and blood pressure. Electronic databases (Excerpta Medica Database, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature Plus and Web of Science) will be searched from inception to January 2025. Two investigators will independently screen identified abstracts and select observational cohort studies, case-control studies and randomised controlled trials examining parity or gravidity and hypertension or blood pressure. Extracted data will include study and population characteristics, comorbidities, parity, gravidity, incidence of hypertension and changes in blood pressure, study quality and risk of bias. If there are sufficient data, they will be summarised using random effects meta-analysis to estimate the pooled risk ratio or odds ratio of hypertension. Stratified and subgroup analyses will be used to explore potential sources of heterogeneity.

CRD42024560535.

The rise of multidrug-resistant tuberculosis (MDR-TB) remains a critical public health challenge, particularly in developing countries like Ethiopia. This systematic review and meta-analysis aimed to estimate the pooled prevalence of MDR-TB with co-infections and assess its effects among different co-infections in Ethiopia. The systematic review and meta-analysis were conducted from August to October 2024. The study adhered to PRISMA guidelines and utilized various academic databases including PubMed, Web of Science and Science Direct to identify relevant articles. To check for publication bias and small study effects, a funnel plot and Egger's test were employed. The statistical analysis was performed with R software version 4.4.1. From an original pool of 6,461 papers, 15 studies published between 2014 and 2024 were considered after applying certain inclusion and exclusion criteria. The analysis revealed an overall pooled prevalence of MDR-TB in the context of co-infections at 20% (95% CI: 14.0-26.0). Notably, the prevalence was higher among individuals with HIV co-infection at 23.2% (95% CI: 18.3-28.0), while it was lower in those with diabetes co-infection at 10% (95% CI: 3.0-17.3). The study found significant heterogeneity among the reported prevalence rates (I² = 94.93%, p < 0.001). These findings highlight the complex interplay between MDR-TB and other co-infections, posing significant challenges for clinical management and public health in Ethiopia. To enhance health outcomes and curb the spread of MDR-TB, government and public health authorities must implement targeted interventions, including monitoring and treatment programs in high-prevalence areas.

The potential intricacy of skull fractures as well as the complexity of underlying anatomy poses diagnostic hurdles for radiologists evaluating computed tomography (CT) scans. The necessity for automated diagnostic tools has been brought to light by the shortage of radiologists and the growing demand for rapid and accurate fracture diagnosis. Convolutional Neural Networks (CNNs) are a potential new class of medical imaging technologies that use deep learning (DL) to improve diagnosis accuracy. The objective of this systematic review and meta-analysis is to assess how well CNN models diagnose skull fractures on CT images.

PubMed, Scopus, and Web of Science were searched for studies published before February 2024 that used CNN models to detect skull fractures on CT scans. Meta-analyses were conducted for area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. Egger's and Begg's tests were used to assess publication bias.

Meta-analysis was performed for 11 studies with 20,798 patients. Pooled average AUC for implementing pre-training for transfer learning in CNN models within their training model's architecture was 0.96 ± 0.02. The pooled averages of the studies' sensitivity and specificity were 1.0 and 0.93, respectively. The accuracy was obtained 0.92 ± 0.04. Studies showed heterogeneity, which was explained by differences in model topologies, training models, and validation techniques. There was no significant publication bias detected.

CNN models perform well in identifying skull fractures on CT scans. Although there is considerable heterogeneity and possibly publication bias, the results suggest that CNNs have the potential to improve diagnostic accuracy in the imaging of acute skull trauma. To further enhance these models' practical applicability, future studies could concentrate on the utility of DL models in prospective clinical trials.

Growing evidence has suggested that the consumption of chia seed can decrease blood pressure and obesity in adults. However, even studies have reported uncertain findings. The current meta-analysis aimed to assess the findings of randomized controlled trials (RCTs) on the efficacy of chia seed supplementation on blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP]) and body composition (waist circumference [WC], weight, body mass index [BMI]) in adults.

A systematic search of the literature was carried out in the PubMed, Web of Knowledge, Scopus, Cochrane Central Library, and EMBASE from inception up to October 2024. Data were extracted and analyzed using a random-effects model, and reported as weighted mean differences (WMD) with 95% confidence intervals (CI).

A total of eight RCTs involving 372 participants were included in the meta-analysis. The results showed that chia consumption significantly reduced DBP (WMD: -7.49 mmHg; 95% CI: -9.64, -5.34; P < 0.001) and SBP (WMD: -5.61 mmHg; 95% CI: -8.77, -2.44; P = 0.001). Moreover, consuming chia seeds was linked to a notable decrease in WC (WMD: -1.46 cm; 95% CI: -2.68, -0.25; P = 0.01), but it had no significant effect on, BMI (WMD: -0.31 kg/m2; 95% CI: - 0.96, 0.34; P = 0.34) and weight (WMD: 0.09 kg; 95% CI: -0.76, 0.93; P = 0.84).

Chia consumption can significantly reduce SBP, DBP, and WC in adults, but no significant impact was showed on BMI and weight. To verify these results, more studies involving a greater number of participants are required.

Currently, there is no consensus regarding whether super-elderly (aged > 80 years) patients are suitable candidates for laparoscopic surgery. This study aimed to analyse the short-term outcomes and oncological prognosis of laparoscopic gastrectomy in super-elderly patients with gastric cancer (GC).

Following PRISMA and AMSTAR-2 guidelines, we searched the Web of Science, Embase, Cochrane Library, and Pubmed databases from inception until May 2024 and performed a meta-analysis. All published studies exploring the surgical outcomes and oncological prognosis of laparoscopic versus open gastrectomy in super-elderly patients with GC were reviewed. Statistical analyses were performed using RevMan 5.3.

A total of 1,085 studies were retrieved, eight of which were included in the meta-analysis, comprising 807 patients > 80 years of age with GC. The meta-analysis showed that compared with open gastrectomy, patients with GC > 80 years old who underwent laparoscopic gastrectomy had a longer operative time (weighted mean difference [WMD] = 30.48, p < 0.001), less intraoperative blood loss (WMD = -166.96, P < 0.001), shorter postoperative exhaust time (WMD =-0.83, p < 0.001), shorter length of stay (WMD = -0.78, p < 0.001), fewer overall complications (Odds ratio [OR] = 0.54, p = 0.003), higher 5-year overall survival rate (OR = 1.66, p = 0.03) and disease-specific survival rate (OR = 3.23, p < 0.001). Furthermore, laparoscopic gastrectomy did not significantly affect the number of lymph node dissections, the rate of D2 radical gastrectomy, major postoperative complications, or postoperative pneumonia.

Compared to open gastrectomy, patients with GC aged > 80 years who underwent laparoscopic gastrectomy may have better short-term outcomes. Age should not be a contraindication for minimally invasive surgery.

Sarcopenia is associated with poor prognosis and mortality following injury. This systematic review and meta-analysis aimed to analyze diagnostic criteria for sarcopenia, as well as to assess its prevalence and impact on health outcomes among trauma patients. We conducted a literature search on MEDLINE, EMBASE, and the Cochrane Library from inception to June 2023. A total of 27 studies were included, involving 8692 individuals (55.5 % men) with a mean age ranging from 42.2 to 80.5 years. The pooled prevalence of sarcopenia in trauma patients was 36.0 % [95 % confidence interval (CI): 29.1-43.0 %, I2 = 97.8 %], with a 39.3 % prevalence (95 % CI: 31.0-48.5 %, I2 = 96.8 %) in men and a 39.0 % prevalence (95 % CI: 31.4-46.2 %, I2 = 94.4 %) in women. Trauma patients with sarcopenia were more prone to complications [risk ratio (RR): 1.16, 95 % CI: 1.03-1.31, I2 = 45.8 %] and less able to discharge independently (RR: 0.74, 95 % CI: 0.63-0.86, I2 = 33.3 %). The risk of death in trauma patients with sarcopenia was higher than in non-sarcopenic patients [hazard ratio (HR): 1.64, 95 % CI: 1.31-2.04]. Sarcopenia is commonly present in trauma patients and has a negative impact on prognosis. Early assessment and interventions for sarcopenia should be conducted in trauma patients.

This systematic review and meta-analysis aimed to evaluate the effectiveness of Electronic Screening and Brief Intervention (e-SBI) in changing or reducing alcohol consumption and/or related risk behaviours among trauma patients compared to standard of care. Following Cochrane Collaboration's guidelines and PRISMA recommendations, a search of electronic databases (MEDLINE via PubMed, CINAHL, Scopus and Web of Science) and grey literature (Google Scholar) was conducted. Randomised controlled trials (RCTs) from 1995 to 2023 were included, focusing on e-SBI for alcohol misuse in trauma patients. Quality assessment utilised the Cochrane risk of bias tool. Bayesian meta-analysis was employed for synthesising outcomes. Four RCTs, totalling 2641 participants, were included. While e-SBI demonstrated a significant reduction in problematic alcohol consumption up to 6 months post-implementation, uncertainties were noted in risk behaviours determined by: average alcohol consumption, binge drinking and alcohol-related consequences. Heterogeneity in measurements and population variations contributed to the nuanced findings. The review suggests that e-SBI may be effective in reducing problematic alcohol consumption in the short term among alcohol-related trauma patients. However, uncertainties and methodological variations highlight the need for standardised outcome measurements, consistent reporting and further exploration of e-SBI's long-term impact. Relevance to health promotion: Understanding the effectiveness of e-SBI in managing alcohol-related issues among trauma patients is crucial for health promotion. Despite uncertainties, the findings underscore the potential of e-SBI as a scalable and accessible intervention. e-SBI in the setting of the present study, emphasises the importance of tailored approaches in public health strategies.

Nivolumab and ipilimumab combination immunotherapy has become a standard treatment option for certain cancers. However, the benefits of combination therapy compared to nivolumab monotherapy in lung cancer patients are not entirely clear. We aimed to evaluate whether nivolumab plus ipilimumab improves clinical outcomes in lung cancer patients compared to nivolumab monotherapy.

A literature search was performed on PubMed, Web of Science, and Scopus from inception until November 2024 to identify relevant randomized controlled trials. The Cochrane risk of bias tool was used to assess the risk of bias, the hazard ratio (HR) was calculated for survival, risk ratios (RRs) were calculated for response rate and safety outcomes, and a random effects model meta-analysis was performed to estimate the safety and efficacy of the treatments.

Seven trials comprising 2134 patients were included. Compared with patients receiving nivolumab monotherapy, non-small cell lung cancer patients who received combination therapy had better progression-free survival (HR = 0.82, 95% CI 0.71; 0.93, P < 0.01, low certainty), and there were no significant differences in overall survival (HR = 0.95, 95% CI 0.86; 1.0, P = 0.31, moderate certainty), or objective response rate (RR = 1.36, 95% CI 0.91; 2.02, P = 0.14 very low certainty). The combination group had a significantly greater risk of grade 3-4 adverse events (RR = 2.77, 95% CI 1.38; 5.56, P < 0.01, low certainty).

Although combination treatment significantly improved progression-free survival in NSCLC patients, it was also associated with a greater risk of adverse events and treatment-related mortality than nivolumab monotherapy. The current evidence is insufficient for choosing combination treatment over nivolumab monotherapy.

Pulmonary embolism is associated with a significant burden of morbidity, mortality, and health care costs. Catheter-directed thrombolysis has emerged as a promising option for patients with intermediate-risk pulmonary embolism which aims to improve outcomes over standard anticoagulation.

We constructed a decision-analytic model comparing the cost-effectiveness of catheter-directed thrombolysis to anticoagulation alone for the management of intermediate-risk pulmonary embolism. Cost-effectiveness was determined by calculating deaths averted and incremental cost-effectiveness ratios (ICER). Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. The main outcome was ICER (US dollars/deaths averted).

In the base case analysis, derived using systemic lysis data, the cost associated with catheter-directed thrombolysis was estimated at $22,353 with a probability of survival at 1 month of 0.984. For the anticoagulation alone strategy, the cost was $25,060, and the probability of survival at 1 month was 0.958. Overall, catheter-directed thrombolysis resulted in savings of $104,089 per death averted (ICER,-$104,089 per death averted). Sensitivity analysis revealed that catheter-directed thrombolysis would no longer be cost-effective when its associated mortality is greater than 0.042. In the probabilistic analysis, at a willingness-to-pay of $100,000, catheter-directed thrombolysis had a 63% chance of being cost-effective, and in cost-effectiveness acceptability curves, it was cost-effective in 63%-78% of simulations for a willingness to pay ranging from $0 to $100,000.

If the assumptions made in our model are shown to be accurate then CDT would be cost-effective and may lead to considerable cost savings if used where clinically appropriate.

The objective of this study is to explore the impact of the use of granulocyte-macrophage colony-stimulating factor (GM-CSF) in female undergoing assisted reproductive technology (ART) on reproductive outcomes. A literature search was performed using electronic databases (PubMed, EMBASE, Web of Science, CNKI, Wanfang data, Geen Medical, and Cochrane Library). Risk ratio (RR), odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CI) for various outcomes were presented. The publication bias and heterogeneity were determined using funnel plot symmetry and I2 test separately. The combined results of the RCT studies did not reveal statistical differences between the GM-CSF group and the control group for any outcome indicators. However, our pooling of results showed that after meta-analysis of non-RCT studies, GM-CSF had a positive effect on implantation rate (OR 1.90; 95% CI 1.11-3.24), clinical pregnancy rate (OR 1.54; 95% CI 1.21-1.95), live birth rate (OR 1.43; 95% CI 1.04-1.98), and available embryo rate (OR 1.27; 95% CI 1.10-1.46). In conclusion, these results suggest that for a subset of women undergoing ART, GM-CSF may favorably affect CPR, LBR, IR, and available embryo rate (AER). TRIAL REGISTRATION: PROSPERO registration number CRD42022322778.

Extracorporeal Membrane Oxygenation (ECMO) use is associated with substantial psychiatric morbidity in patients and their families. This systematic review and meta-analysis quantifies the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression among ECMO survivors and their families. Included studies enrolled patients on ECMO or their families and reported at least one trauma-related psychopathology. Of 1767 screened studies, 55 were included (5146 participants): 50 in adult ECMO survivors, one in pediatric ECMO survivors, and four in families of ECMO patients (two adult, two pediatric.). The pooled prevalence of PTSD was 19% in adult ECMO survivors, 20% in pediatric ECMO survivors, 25% in families of adult ECMO patients, and 21% in families of pediatric ECMO patients. The pooled prevalence of anxiety was 30% in adult ECMO survivors, 8% in pediatric ECMO survivors, 67% in families of adult ECMO patients, and 46% in families of pediatric ECMO patients. The pooled prevalence of depression was 24% in adult ECMO survivors, 8% in pediatric ECMO survivors, 50% in families of adult ECMO patients, and 32% in families of pediatric ECMO patients. This meta-analysis demonstrates a high prevalence of trauma-related psychopathologies surrounding ECMO use, highlighting the need for interventions to improve post-ECMO outcomes.

Previous studies found that it is promising to achieve the protective effects of dietary patterns on cardiovascular health through the modulation of gut microbiota. However, conflicting findings have been reported on how dietary patterns impact gut microbiota in individuals either established or at risk of cardiovascular disease (CVD). Our systematic review aimed to explore the effect of dietary patterns on gut microbiota composition and on risk factors for CVD in these populations.

We systematically searched seven databases, including PubMed/MEDLINE, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), Web of Science, CNKI (Chinese), and Wanfang (Chinese), covering literature from inception to October 2024. Studies were included if they focused on adults aged 18 years and older with CVD or at least two CVD risk factors, implemented dietary pattern interventions, and incorporated outcomes related to microbiome analysis. The risk of bias for included studies was assessed using the revised Cochrane risk of bias tool (RoB2) for randomized trials and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) for non-randomized studies. Changes in the relative abundance of the gut microbiome were summarized at various taxonomic levels, including phylum, class, order, family, genus, and species. Random-effects meta-analysis was conducted to analyze the mean difference in cardiometabolic parameters pre- and post-intervention.

Nineteen studies were identified, including 17 RCT and two self-controlled trails. Risk of bias across the studies was mixed but mainly identified as low and unclear. The most frequently reported increased taxa were Faecalibacterium (N = 8) with plant-rich diets, Bacteroides (N = 3) with restrictive diets, and Ruminococcaceae UCG 005 and Alistipes (N = 9) with the polyphenol-rich diets. The most frequently reported decreased taxa were Parabacteroides (N = 7) with plant-rich diets, Roseburia (N = 3) with restrictive diets, and Ruminococcus gauvreauii group (N = 6) with the polyphenol-rich diets. Plant-rich diets showed a significant decrease in total cholesterol (TC) with a mean difference of -6.77 (95% CI, -12.36 to -2.58; I2 = 84.7%), while restrictive diets showed a significant decrease in triglycerides (TG) of -22.12 (95% CI, -36.05 to -8.19; I2 = 98.4%).

Different dietary patterns showed distinct impacts on gut microbiota composition. Plant-rich diets promoted the proliferation of butyrate-producing bacteria, suggesting promising prospects for modulating gut microbiota and butyrate production through dietary interventions to enhance cardiovascular health. Further research is warranted to investigate the long-term effects of dietary patterns on clinical endpoints, such as CVD events or mortality.

Registration number: CRD42024507660.

Inhaled corticosteroids (ICS) are recommended treatment for mild asthma. We aimed to update the evidence on the efficacy and safety of ICS-containing regimens, leukotriene receptor antagonists (LTRA), and tiotropium relative to as-needed (AN) short-acting β2-agonists (SABA) in children (aged 6-11 years) and adolescents/adults.

A systematic review of randomized controlled trials (RCTs) of regular and AN treatment for mild asthma was conducted (CRD42022352384). PubMed, Scopus, and ClinicalTrials.gov were searched up to 31st March 2024. RCTs in children or adolescents/adults with mild asthma were eligible if they compared any of the following treatments: ICS alone or in combination with fast-acting bronchodilators (FABA, i.e., formoterol or SABA) or long-acting β2-agonists (LABA), LTRA, tiotropium, and SABA alone, for the following outcomes: exacerbations, asthma symptoms, forced expiratory volume in 1 s (FEV1), asthma-specific quality-of-life (QoL), or severe adverse events (SAEs). The two-stage network meta-analysis (NMA) was used to pool risk ratios (RR) or mean differences for treatment outcomes. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). This review followed the PRISMA reporting guideline and the PRISMA checklist is presented in Additional file 2.

Thirteen RCTs in children and 29 in adolescents/adults were included. Regular ICS ranked best for preventing exacerbations and improving FEV1 in children. NMA of RCTs suggested regular ICS were better in preventing exacerbations than LTRA (RR [95% confidence intervals], (0.81 [0.69,0.96]) and AN-SABA (0.61 [0.48,0.78]), and not different from AN-ICS (0.83 [0.62,1.12]). In adolescents/adults, for preventing severe exacerbations, regular ICS outperformed AN-SABA (0.58 [0.46,0.73]), but AN-ICS/FABA (0.73 [0.54,0.97]), and regular ICS/LABA (0.68 [0.48,0.97]) surpassed regular ICS. Symptom relief and improved FEV1 were not different among the ICS-containing regimens. Regular ICS ranked best for improved QoL and least likely for SAEs.

Regular ICS use may be the most effective treatment for preventing exacerbation and increasing FEV1 in children with mild asthma. In adolescents/adults, ICS-containing regimens outperformed AN-SABA for exacerbation prevention. With varying degrees of heterogeneity, severe exacerbation risk in adolescents/adults might be lower with regular ICS/LABA or AN-ICS/FABA than regular ICS, where AN-ICS/FABA may not be suitable for patients with low FEV1. Additionally, regular ICS use may enhance FEV1 and QoL more than AN-SABA and LTRA.

It seems that diet is one of the main triggers of migraine; one of the most studied is alcohol, and also, over the years, red wine has been shown to trigger headaches. Therefore, this systematic review and meta-analysis aims to examine the strength of the association between wine consumption and migraine.

In this systematic review and meta-analysis, a search of MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases was conducted to assess the association between wine consumption and migraine, covering baseline to December 2023. Pooled Odds Ratio (p-OR) were calculated using the DerSimonian and Laird methods. This study was previously registered in PROSPERO (CRD42024511115). The risk of bias was evaluated using The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Five studies were included in this systematic review, and only four of them were in the meta-analysis. Using the DerSimonian and Laird method, the p-OR for the effect of wine consumption on migraine was 0.63 (95% CI 0.36-1.09). The included studies after the risk of bias assessment showed a moderate risk of bias.

The findings of this systematic review and meta-analysis indicate that there is no conclusive evidence to support an increased or decreased risk of migraine associated with wine consumption.

Background/Objectives: Age is a known predictor of skin autofluorescence (SAF) across populations, but age-based reference values are lacking for the Spanish population. This study aims to establish SAF reference values for healthy Spanish adults by age group, compare these with other populations, and estimate optimal SAF cut-off points by age range. Additionally, it aims to analyse the influence of sex, smoking, and skin phototype. Methods: This cross-sectional EVasCu study included 390 healthy subjects aged over 18 years. Participants' age, sex, smoking status, and skin were recorded and categorised into age groups. Advanced glycation end products were measured through the SAF. A systematic review and meta-analysis, including an EVasCu study, was performed to obtain pooled means and standard deviations by age group. Results: The mean SAF Spanish values by age were (95% CI): (i) 18-19 years: 1.34-1.56 arbitrary units (AU); (ii) 20-29 years: 1.56-1.70 AU; (iii) 30-39 years: 1.66-1.84 AU; (iv) 40-49 years: 1.79-1.91 AU; (v) 50-59 years: 2.07-2.21 AU; (vi) ≥60 years: 2.07-2.50 AU. SAF was significantly correlated with age (r = 0.531; p < 0.001), smoking status (r = -0.196; p < 0.001), and skin phototype (r = 0.138; p = 0.007), and SAF was greater in smokers and dark-skinned individuals (p < 0.05). No significant differences were found in the SAF values for sex. The results of the meta-analysis were in line with those of the present study, providing reference values of SAF for the general population. Conclusions: SAF increases linearly with age in healthy individuals, and higher levels of SAF are observed in smokers and dark-skinned individuals.

Marital status is among the factors influencing type 2 diabetes mellitus (T2DM). However, the precise relationship remains incompletely understood. This meta-analysis aims to evaluate the association between marital status and the incidence of T2DM.

A review and meta-analysis of observational studies were conducted to investigate the relationship between marital status and diabetes incidence. We searched three databases, including PubMed, Google Scholar, and Scopus, for relevant studies published up to August 16th, 2023. In our initial search, we identified a total of 358 articles. After a demanding screening process involving evaluating titles, abstracts, and full-text content, we ultimately included six studies for our meta-analysis.

Comprising a total of 1,440,904 participants, our study found that in comparison to married individuals, unmarried participants exhibited a higher likelihood of developing diabetes [odds ratio (OR): 1.47, 95% confidence interval (CI): 0.88-2.45, I 2: 91%, p-value = 0.14]. Divorced participants had a reduced likelihood of developing diabetes compared to married participants (OR: 0.84, 95% CI: 0.77-0.91, I 2: 17%, p < 0.001). Similarly, widowed participants showed a lower risk of developing diabetes compared to divorced participants (OR: 0.35, 95% CI: 0.26-0.46, I 2: 83%, p < 0.00001).

This study provides strong evidence of links between marital status and type 2 diabetes risk. Unmarried individuals are more susceptible to T2DM, divorced individuals have a lower risk, and widowed individuals exhibit reduced T2DM risk. Further research should investigate underlying mechanisms and confounding factors.

There is no consensus in the existing literature regarding the effect of soluble fiber on the lipid profile of patients with type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis of randomized controlled trials aimed to assess the effect of soluble fiber on triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in T2DM patients.

PubMed/MEDLINE, Scopus, and ISI Web of sciences were searched for RCTs up to 4 May 2024. Data from RCTs were pooled using the generic inverse variance method and expressed as weighted mean differences (WMD) with 95 % confidence interval (CIs).

Pooled data from 38 RCTs reporting patient outcomes were evaluated for mean effects. Results indicated that soluble fiber significantly altered TG (WMD: -16.97 mg/dL, 95 % CI: -29.16 to -4.78, P = 0.021), HDL-C (WMD: 1.74 mg/dL, 95 % CI: 1.02-2.46, P < 0.001), LDL-C (WMD: -11.14 mg/dL, 95 % CI: -15.41 to -6.87, P < 0.001), and TC (WMD: -13.87 mg/dL, 95 % CI: -17.99 to -9.75, P = 0.027).

Soluble fiber supplementation has the potential to improve lipid profile in patients with T2DM, and may provide a feasible approach for improving metabolic health in T2DM patients.

Although conservative treatment of calcific tendinopathy has a high success rate, arthroscopic excision of the calcific deposit is occasionally necessary. Controversy exists as to whether the remaining rotator cuff defect can be left in situ or should be repaired to achieve better functional outcomes. This study aimed to compare the results of debridement versus debridement combined with suturing in arthroscopic surgery for calcific tendinopathy.

MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched from inception to February 2023 for articles on arthroscopic treatment of calcific tendinopathy. Functional outcomes (VAS, ASES, UCLA, and Constant) and the number of complications were analyzed. The effect size was calculated using Cohen's d-index.

Twenty-one studies were included, including a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The combined ES estimates for the total score of the VAS, ASES, UCLA, and Constant scales were very strong (>1.0) for both debridement and combined debridement with suture. The ES estimates for the number of total complications were 1.75 (95% CI: 0.08-3.43, I2 = 0%) for debridement and 9.07 (95% CI: -0.03-18.17, I2 = 50.4%) for combined debridement with suture.

Both arthroscopic procedures improve the total score significantly on the EVA, ASES, UCLA, and Constant scales. However, a higher proportion of complications was observed in the group that performed suturing. In this regard, we must consider whether it is really necessary to repair all partial tears after the calcified deposits removal.

Previous studies have yielded controversial results regarding the effect of spirulina on blood pressure (BP), which need updating. So, this updated systematic review and meta-analysis of randomized controlled trials (RCTs) carry out a more accurate estimation of the effect of spirulina on BP in adults. This systematic searches (in PubMed/Medline, Scopus, and ISI Web of Science) until April 1, 2024, to identify related RCTs based on PICOS guidelines (population (individuals > 18 years old), the intervention (spirulina), the comparison (control or placebo group), the outcomes (systolic BP (SBP) and diastolic BP (DBP)), the study design (RCTs)), and PRISMA-checklist (Supporting Information, data S2). We evaluated the impact of spirulina on DBP and SBP. Conventional procedures were employed for analyzing publication bias, heterogeneity, and sensitivity. The GRADE criteria and the Cochrane assessment method were employed to evaluate the risk of bias (ROB) and certainty of evidence across the studies, respectively. The result shows spirulina consumption decreases SBP (WMD: -4.41 mmHg, 95% CI: -6.74 to -2.07, I 2 = 66.1%) and DBP (WMD: -2.84 mmHg, 95% CI: -4.65 to -1.03, I 2 = 62.3%). Subgroup analysis demonstrated SBP and DBP were still lower in individuals with ≥ 120 and ≥ 80 mmHg, hypertension (HTN) individuals, overweight individuals, age > 50 years, and > 8 weeks of intervention. Indeed, we do not observe publication bias, ROB, or interference studies in the overall results of BPs, and based on GRADE, our outcomes have moderate quality. Because of the low number of studies and participants, the dose-response and meta-regression are not significant. His study demonstrated spirulina intervention decreased SBP and DBP in HTN and overweight individuals, age > 50 years, and > 8 weeks of intervention. So, spirulina intake decreases BP and could be used in clinical practice. Furthermore, more and high-quality RCTs are needed to establish the clinical efficacy of the spirulina and determine cutoff spirulina interventions based on dose and duration. Trial Registration: PROSPERO: CRD42024534608.

Although conservative treatment of calcific tendinopathy has a high success rate, arthroscopic excision of the calcific deposit is occasionally necessary. Controversy exists as to whether the remaining rotator cuff defect can be left in situ or should be repaired to achieve better functional outcomes. This study aimed to compare the results of debridement versus debridement combined with suturing in arthroscopic surgery for calcific tendinopathy.

MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched from inception to February 2023 for articles on arthroscopic treatment of calcific tendinopathy. Functional outcomes (VAS, ASES, UCLA, and Constant) and the number of complications were analyzed. The effect size was calculated using Cohen's d-index.

Twenty-one studies were included, including a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The combined ES estimates for the total score of the VAS, ASES, UCLA, and Constant scales were very strong (>1.0) for both debridement and combined debridement with suture. The ES estimates for the number of total complications were 1.75 (95% CI: 0.08-3.43, I2=0%) for debridement and 9.07 (95% CI: -0.03 to 18.17, I2=50.4%) for combined debridement with suture.

Both arthroscopic procedures improve the total score significantly on the EVA, ASES, UCLA, and Constant scales. However, a higher proportion of complications was observed in the group that performed suturing. In this regard, we must consider whether it is really necessary to repair all partial tears after the calcified deposits removal.

Randomized clinical trials (RCTs) provide the most reliable estimates of treatment effectiveness for therapeutic interventions. However, flaws in their design and conduct may bias treatment effect estimates, leading to overestimation or underestimation of the true intervention effect. This is especially relevant for complex interventions, such as those in rehabilitation, which are multifaceted and tailored for individual patients or providers, leading to variations in delivery and treatment effects. To assess whether poor intervention fidelity, the faithfulness of the intervention delivered in an RCT to what was intended in the trial protocol, influences (biases) estimates of treatment effects derived from meta-analysis of rehabilitation RCTs.

In this metaepidemiological study of 19 meta-analyses and 204 RCTs published between 2010 and 2020, we evaluated the difference in intervention effects between RCTs in which intervention fidelity was monitored and those in which it was absent. We also conducted random-effects metaregression to measure associations between intervention fidelity, risk of bias, study sample size, and treatment effect estimates.

There was a linear relationship between fidelity and treatment effect sizes across RCTs, even after adjusting for risk of bias and study sample size. Higher degrees of fidelity were associated with smaller but more precise treatment effect estimates (d = -0.23 95% CI: -0.38, -0.74). Lower or absent fidelity was associated with larger, less precise estimates. Adjusting for fidelity reduced pooled treatment effect estimates in 4 meta-analyses from moderate to small or from small to no negligible or no effect, highlighting how poor fidelity can bias meta-analyses' results.

Poor or absent intervention fidelity in RCTs may lead to overestimation of observed treatment effects, skewing the conclusions from individuals studies and systematic reviews with meta-analyses when pooled. Caution is needed when interpreting the results of complex intervention RCTs when fidelity is not monitored or is monitored but not reported.

Patients, the public, and health-care providers rely on clinical trials for information about how effective treatments are when making decisions about health care. However, the way that clinical trials are conducted may alter the evidence that clinical trials provide about how effective interventions truly are. In this study, we investigated whether how closely health-care providers monitor how they deliver rehabilitation treatments to patients in clinical studies, and how closely those treatments match the treatment that the researchers had planned, influences the results of those studies. We found that when researchers or health-care providers don't closely monitor how they deliver treatments during a study, those studies may provide exaggerated estimates of the effectiveness of the treatments studies. This is important, because it may mean that some health-care providers and patients may opt for treatments that are less effective than they appeared in clinical studies, or may overlook treatments that are more effective than they appeared in other studies.

Autologous peripheral blood stem cell (PBSC) transplantation is a standard treatment of multiple myeloma (MM), Hodgkin lymphoma and various subtypes of non-Hodgkin lymphoma. Cryopreservation of hematopoietic stem cells is standard practice that allows time for delivery of conditioning regimen prior to cell infusion. The aim of this Worldwide Network for Blood & Marrow Transplantation (WBMT) work was to assess existing evidence on non-cryopreserved autologous transplants through a systematic review/meta-analysis, to study feasibility and safety of this approach. We searched PubMed, Web of Science and SCOPUS for studies that utilized non-cryopreserved autologous PBSC transplantation. Identified literature was reviewed for information on mobilization, apheresis, preservation and viability, conditioning regimen, engraftment, response, and survival. Results highlight collective experience from 19 transplant centers (1686 patients), that performed autologous transplants using non-cryopreserved PBSCs. The mean of infused CD34+ was 5.6 × 106/kg. Stem cell viability at transplantation was >90% in MM and >75% in lymphomas, after a storage time of 24-144 h at +4 °C. Mean time-to-neutrophil engraftment was 12 days and 15.3 days for platelets. Pooled proportion estimates of day 100 transplant-related mortality and graft failure were 1% and 0%, respectively. Non-cryopreservation of apheresed autologous PBSCs appears feasible and safe.