The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.

It is unclear whether patients with Global Initiative for Chronic Obstructive Lung Disease stage 1 (mild) chronic obstructive pulmonary disease (COPD) have worse respiratory outcomes than individuals with normal spirometry.

For this systematic review and meta-analysis, we conducted a search of PubMed, Embase, and Web of Science for all literature published up to 1 March 2023. Studies comparing mortality between mild COPD and normal spirometry were included. A random-effects model was used to estimate the combined effect size and its 95% confidence interval (CI). The primary outcome was all-cause mortality. Respiratory disease-related mortality were examined as secondary outcomes.

Of 5242 titles identified, 12 publications were included. Patients with mild COPD had a higher risk of all-cause mortality than individuals with normal spirometry (pre-bronchodilator: hazard ratio [HR] = 1.21, 95% CI: 1.11-1.32, I2 = 47.1%; post-bronchodilator: HR = 1.19, 95% CI: 1.02-1.39, I2 = 0.0%). Funnel plots showed a symmetrical distribution of studies and did not suggest publication bias. In jackknife sensitivity analyses, the increased risk of all-cause mortality remained consistent for mild COPD. When the meta-analysis was repeated and one study was omitted each time, the HR and corresponding 95% CI were >1. Patients with mild COPD also had a higher risk of respiratory disease-related mortality (HR = 1.71, 95% CI: 1.03-2.82, I2 = 0.0%).

Our results suggest that mild COPD is associated with increased all-cause mortality and respiratory disease-related mortality compared with normal spirometry. Further research is required to determine whether early intervention and treatment are beneficial in mild COPD.

Prior study in healthy subjects has shown a reduction of partial pressure of arterial oxygen (PaO2) by -1.60 kPa/kilometre of altitude gain. However, the association of altitude-related change in PaO2 and altitude-related adverse health effects (ARAHE) in patients with chronic obstructive pulmonary disease (COPD) remain unknown.

To provide an effect size estimate for the decline in PaO2 with each kilometre of altitude gain and to identify ARAHE in relation to altitude in patients with COPD. www.crd.york.ac.uk/prospero: CRD42020217938.

A systematic search of PubMed and Embase was performed from inception to May 30, 2023.

Peer-reviewed and prospective studies in patients with COPD staying at altitudes >1500 m providing arterial blood gases within the first 3 days at the target altitude.

Aggregate data (AD) on study characteristics were extracted, and individual patient data (IPD) were requested. Estimates were pooled using random-effects meta-analysis.

Relative risk estimates and 95 % confidence intervals for the association between PaO2 and altitude in patients with COPD.

Thirteen studies were included in the AD analysis, of which 6 studies (222 patients, 45.2 % female) provided IPD, thus were included in the quantitative analysis. The estimated effect size of PaO2 was -0.84 kPa [95 %CI, -0.92 to -0.76] per 1000 m of altitude gain (I2=65.0 %, P < 0.001). In multivariable regression analysis, COPD severity, baseline PaO2, age and time spent at altitude were predictors for PaO2 at altitude. Overall, 37.8 % of COPD patients experienced an ARAHE, whereas older age, female sex, COPD severity, baseline PaO2, and target altitude were predictors for the occurrence of ARAHE (area under ROC curve: 0.9275, P < 0.001).

This meta-analysis, providing altitude-related decrease in PaO2 and risk of ARAHE in patients with COPD ascending to altitudes >1500 m, revealed a lower altitude-related decrease in PaO2 in COPD patients compared with healthy. However, these findings might improve patient care and facilitate decisions about initiating preventive measures against hypoxaemia and ARAHE in patients with COPD planning an altitude sojourn or intercontinental flight, i.e. supplemental oxygen or acetazolamide.

This systematic review and meta-analysis aimed to examine the prevalence of Attention deficit hyperactivity disorder (ADHD) in homeless children and adolescents, and the factors that may influence its prevalence.

Relevant publications in Medline, Web of Science, Scopus and PsycINFO were systematically searched to identify studies on the prevalence of ADHD in homeless children and adolescents (≤19 years). The extracted data were pooled using a random-effects model.

Thirteen studies involving 2878 homeless children and adolescents were included (mean age: 12.0 years, sex F/M: 0.43). The prevalence rates of ADHD vary considerably across studies, ranging from 1.6% to 64.5%. The pooled prevalence of ADHD was 22.8% (95% CI 12.9-34.4%, I2 =98%). Meta-regression analyses indicated that age (slope = 0.046; p = .042) significantly increased ADHD prevalence. The prevalence of ADHD in studies with a mean age ≥ 12 years (43.1%, 95% CI 26.5-60.4%) was higher than those with a mean age < 12 years (13.1%, 95%CI 4.3-25.6).

Despite the high heterogeneity of the studies, we observed that ADHD could affect almost a quarter of homeless children and adolescents. Reintegrating them into care systems and ensuring access to public health interventions tailored for homeless families and youth is imperative for breaking the cycle of homelessness and improving long-term trajectories.

This review aims to examine the effectiveness of interventions in increasing faecal occult blood test (FOBT) uptake rates among older adults with an average-risk of colorectal cancer (CRC) and to identify essential components of such interventions based on current evidence.

Five databases were included in a systematic literature search for studies reporting randomized controlled trials (RCT) and interventions aimed at increasing FOBT uptake rates among average-risk individuals aged 50-75. Review Manager 5.4.1 was used for conducting meta-analyses and subgroup analyses.

A meta-analysis of the 20 included studies demonstrated that health promotion interventions led to significant increases in FOBT uptake rates (odds ratio [OR] ​= ​1.55, 95% confidence interval (CI) ​= ​1.30-1.85; I 2 ​= ​95%). Provision of information, mailing of FOBT outreach, and reminders were identified as core components of promotion interventions to increase FOBT uptake rates. Among the different significant reminder strategies, a digital message (via text) plus telephone calls (automated and navigator-initiated) had a larger effect size than a telephone call alone. In addition, there was no significant evidence that financial incentives were associated with FOBT uptake. Most studies included a diverse mixture of components, but only a few studies utilized theoretical framework-based interventions.

Future studies with rigorous methodologies are warranted to examine the effectiveness and understand the mechanisms of theoretical framework-based multi-component educational programmes aimed at increasing FOBT uptake rates.

PROSPERO CRD42024520859.

Frozen embryo transfer (FET) has been associated with higher risks of hypertensive disorders of pregnancy (HDP), large for gestational age and high birth weight. This systematic review and meta-analysis evaluates obstetric and perinatal outcomes in medicated, stimulated and natural FET cycles. A literature search was performed using MEDLINE, EMBASE, CINAHL and the Cochrane Library database; 152,590 FET cycles were analysed from 31 included studies. Risk ratios (RR) and 95% confidence intervals (CI) were calculated using fixed and random effects models determined by the heterogeneity (I2). There was significantly higher risk of obstetric and perinatal complications, including HDP (RR 1.84, CI:1.48-2.29, I2 87%) and low birth weight (LBW) (RR 1.25, CI:1.12-1.39, I2 57%) following medicated compared to natural FET cycles. A higher risk of HDP (RR 1.50, CI:1.33-1.64, I2 32%) and macrosomia (RR 1.28, CI:1.17-1.40, I2 37%) was noted following medicated compared to stimulated cycles. Natural demonstrated lower risk of HDP (RR 0.77, CI:0.60-0.99, I2 32%), gestational diabetes (RR 0.78, CI:0.68-0.89, I2 43%), LBW (RR 0.78, CI:0.64-0.95, I2 48%) and small for gestational age (RR 0.83, CI:0.70-0.98, I2 12%) than stimulated cycles. These findings indicate that medicated FET cycles convey greater risks of obstetric and perinatal complications than natural or stimulated cycles.

This systematic review and meta-analysis aimed to evaluate differences in cardiopulmonary fitness between healthy controls and children/adolescents with chronic kidney disease (CKD) and the effects of exercise training.

PubMed, Embase, Scopus and Web of Science were searched for published studies from reception to 14 June 2023, and updated search on 15 October 2023. The included observational studies reported on cardiorespiratory fitness, included maximal oxygen uptake (VO2max), peak oxygen consumption (VO2peak) and 6-minute walk distance (6MWD), in children/adolescents with CKD and age-matched healthy controls, as well as clinical intervention trials of exercise training on cardiorespiratory fitness in samples of children and/or adolescents up to 19.

Fifteen observational studies and five clinical trials were included, respectively. The studies found that the mean cardiopulmonary fitness was 1.82 standardized mean differences (SMDs) units (95% confidence interval (95% CI) 1.43-2.20) lower in children/adolescents with CKD than in healthy controls or reference values. Except for pre-dialysis CKD patients, peritoneal dialysis, haemodialysis and kidney transplant recipients had significantly lower cardiorespiratory fitness than healthy controls. The results of a meta-analysis based on a pre-post single-arm trial showed that compared to baseline, exercise training improved the 6MWD by approximately 58.17 m (95% CI 16.27-100.06), with very low evidence.

This systematic review and meta-analysis of observational studies and clinical trials that included children/adolescents with CKD found that cardiorespiratory fitness is severely reduced in this population and that exercise training may be an effective strategy for improvement. Given the low evidence certainty, additional high-quality trials are necessary.

To systematically evaluate and meta-analyze the performance, validity, and influencing factors of frailty risk prediction models specifically developed for patients undergoing maintenance hemodialysis in China.

China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, SinoMed, PubMed, Web of Science, Cochrane Library, CINAHL and Embase were searched from inception to October 10, 2024. Two independent reviewers conducted literature screening, data extraction, and risk of bias assessment using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed to pool the incidence rates and identify independent predictors.

Fourteen studies incorporating 16 distinct frailty risk prediction models were included. The predictive accuracy, measured by the area under the receiver operating characteristic curve (AUC), ranged from 0.819 to 0.998. Seven studies performed internal validation, one study executed external validation, and one study conducted both internal and external validation. All studies exhibited a high overall risk of bias. Pooled incidence of frailty among maintenance hemodialysis patients was 32.2% (95% CI: 26.9%-37.6%). Significant predictors of frailty included advanced age, hypoalbuminemia, poor nutritional status, female sex, comorbid conditions, and depression (p < 0.05).

The pooled incidence of frailty among maintenance hemodialysis patients was notably high at 32.2%, with advanced age, hypoalbuminemia, poor nutritional status, female sex, comorbid conditions, and depression emerging as significant predictors. Existing frailty prediction models for maintenance hemodialysis patients demonstrated robust predictive capacity but exhibited substantial methodological limitations, high bias and limited external validation. Future research should prioritize multicenter, large sample, validation studies to enhance applicability and reliability.

A systematic review and meta-analysis were performed to determine the association of metabolic syndrome (METS) in women with and without overactive bladder (OAB).

PRISMA guidelines were followed and the protocol was registered at PROSPERO (CRD42024606398). We searched PubMed, Embase, Cochrane Library, and LILACS databases to obtain relevant articles for studies reporting METS outcomes related to OAB published through October 2024. A meta-analysis was performed of available studies using random effect models. Results are reported as mean difference (MD), standardized MD (SMD), or odds ratio (OR) and their 95% confidence interval (CI). Heterogeneity was described with the I2 statistic. The quality of studies was assessed using the Newcastle-Ottawa Scale.

Of the 108 non-duplicated retrieved citations, after successive selection, four case-control studies with low or moderate risk of bias reported information about the association of METS in women assessed with the 8-item OAB Symptom Bother Scale. OAB patients displayed higher body mass index (BMI, MD: 3.27, 95% CI: 2.12, 4.43), waist circumference (MD: 7.96, 95% CI: 4.41, 11.52), fasting blood glucose (SMD: 1.26, 95% CI: 0.18, 2.34), triglycerides (SMD: 0.24, 95% CI: 0.01, 0.47), and LDL-cholesterol (SMD: 0.30, 95%CI: 0.06, 0.54) levels. In addition to low HDL-cholesterol levels (SMD: -0.40, 95% CI: -0.74, -0.06) compared to the control group. There were no significant differences in circulating total cholesterol levels and rates of hypertension, hysterectomy, postmenopausal status, and constipation in women with and without OAB.

Women with OAB display associations with age, BMI, waist circumference, and METS factors.

Several randomized controlled trials (RCTs) have investigated the benefits of atrial fibrillation (AF) screening. However, since none have shown a significant reduction in stroke rates, the impact of screening on clinical outcomes remains uncertain.

We conducted a systematic review and meta-analysis of RCTs reporting clinical outcomes of systematic AF screening in participants without known AF. Pooled risk ratios (RRs) were computed for all-cause stroke or systemic embolism, major bleeding, and all-cause mortality, comparing screening with no screening.

Seven RCTs encompassing 76 458 participants were identified. One trial utilized implantable loop recorders for rhythm monitoring, while the others employed non-invasive screening methods. Pooled results indicated that AF screening was associated with a significant reduction in all-cause stroke or systemic embolism (RR 0.932, 95% CI 0.873-0.996, I2 = 0%, p = 0.037), but had no effect on major bleeding (RR 0.996, 95% CI 0.935-1.060, I2 = 0%, p = 0.876) or all-cause mortality (RR 0.987, 95% CI 0.945-1.031, I2 = 0%, p = 0.550). We estimated a number needed to screen of 148 to prevent one stroke or systemic embolism over a 10-year period in a population of 75-year-olds. When only non-invasive screening methods were considered, the reduction in strokes was not statistically significant (RR 0.942, 95% CI 0.880-1.008, I2 = 0%, p = 0.083).

Systematic AF screening is associated with a modest yet statistically significant 7% relative reduction in stroke and systemic embolism, with no observed impact on major bleeding or all-cause mortality.

This study evaluates and compares the effectiveness and safety of febuxostat and allopurinol in chronic kidney disease (CKD) stages 3-5 patients with asymptomatic hyperuricemia using a network meta-analysis.

A systematic review and network meta-analysis were conducted, adhering to PRISMA-NMA guidelines. Searches included PubMed, Embase, Cochrane Library, and Chinese databases up to June 2024. Randomized controlled trials (RCTs) and cohort studies were assessed for methodological rigor using GRADE.

A total of 12 RCTs and 4 cohort studies (n = 2,423 participants) were included. Febuxostat was associated with greater improvements in estimated glomerular filtration rate compared to allopurinol (MD, 4.99 mL/min/1.73 m2; 95%CI -0.65 to 10.78; certainty: low) and placebo (MD, 4.72 mL/min/1.73 m2; 95%CI 0.67 to 8.82; low). Serum uric acid reduction was also more pronounced with febuxostat (MD, -0.61 mg/dL; 95%CI -1.15 to -0.05; moderate). Safety outcomes, including major cardiovascular events and adverse events, showed no significant differences between febuxostat and allopurinol. Subgroup analyses revealed enhanced effectiveness of febuxostat at six months of treatment.

This analysis provides robust evidence that febuxostat might offers greater improvements in kidney function and uric acid levels compared to allopurinol or placebo in asymptomatic hyperuricemia with CKD stage 3-5 patients, without compromising safety. These findings can guide clinical decision-making and treatment optimization.

There is a lack of a synthesis of longitudinal studies that clarify the relationship between gaming disorder (GD) symptoms and mental health. To address this gap, we undertook a systematic review with meta-analysis of longitudinal studies. The study protocol was preregistered online on PROSPERO (CRD42023407665). We included studies analyzing the association between GD or problematic/pathological videogame use, and internalizing psychopathology (depression and anxiety), psychological distress (loneliness and stress), and well-being (life satisfaction, quality of life, and well-being). Research articles were searched in PsycInfo, PsycArticles, PubMed, and Web of Science up until December 29, 2022.30 articles were considered for meta-analysis (N = 28,782). Effect sizes (partial correlation) were pooled using random-effects models. Sensitivity analyses excluded studies rated as "poor" - using the National Institutes of Health quality assessment tool for observational cohort studies - and Chinese studies. The associations between GD and subsequent depression, emotional mixed symptoms (i.e., a combination of internalizing symptoms) and life satisfaction were statistically significant. GD was not associated with subsequent anxiety. On the other hand, depression, anxiety, emotional mixed symptoms, life satisfaction and loneliness were significantly associated with subsequent GD. Overall, sensitivity analyses supported the robustness of the main results. In conclusion, this study found reciprocal longitudinal associations between GD and depression, life satisfaction, and emotional mixed symptoms, an effect of anxiety on GD (but not the inverse), and of loneliness on GD. However, the causal nature and practical relevance remain uncertain because effect sizes were small - or medium, depending on effect size guidelines - and based on observational studies.

Depression, a common psychological problem in multiple sclerosis (MS) patients, can exacerbate the deterioration of the disease and have an impact on the quality of life of MS. Non-pharmacological therapies are effective alternatives to pharmacological treatments. It is not clear which non-pharmacological therapies are most effective in improving depression in MS at present.

To compare the effectiveness of non-pharmacological interventions in enhancing depression in people with MS.

A total of seven databases were searched from the establishment of the database to June 2024. After literature screening and data extraction, the Cochrane Bias Assessment Tool 2.0 version of randomized controlled trials (RCTs) was used to evaluate the quality of the literature. A network meta-analysis was performed to evaluate the relative efficacy of the non-pharmacological interventions on depression. Statistical analysis was performed using R (version 4.3.2) and STATA 17.0 software.

A total of 33 RCTs involving seven non-pharmacological interventions (cognitive behavioral therapy, mindfulness therapy, acceptance of commitment therapy, exercise therapy, relaxation therapy, education, and computer-assisted cognitive rehabilitation) were included. The results of the network meta-analysis showed that cognitive-behavioral therapy (SMD = -4.04, 95%CrI = -6.80 to -1.45), exercise therapy (SMD= = -3.62, 95 % CrI= = -6.55 to -0.85), and education (SMD = -2.94, 95 % CrI = -5.69 to -0.25) were effective in improving depression in multiple sclerosis patients relative to the control group.

This study confirms that non-pharmacological interventions can improve depression in MS patients. Healthcare professionals can choose non-pharmacological therapies according to the specific conditions of MS patients to improve the depression of them and thus enhance their quality of life in future.

Children in clinical settings are prone to anxiety due to developmental limitations, which hinders treatment progress. This systematic review and meta-analysis aimed to evaluate the efficacy of social robot interventions compared to routine care or alternative non-pharmacological strategies in reducing anxiety among children aged 4-12 years undergoing medical procedures in clinical settings, based on evidence from randomized controlled trials.

The review protocol was prospectively registered in PROSPERO. Five electronic databases PubMed, Web of Science, Embase, Cochrane Library and PsycINFO were searched for randomized controlled trials (RCTs) examining the effects of SRs on children's anxiety. The search ends on 1 December 2024. A total of 10 RCTs meeting the inclusion criteria were identified, involving 877 children aged 4-12 years.

The meta-analysis reveals a significant reduction in anxiety levels among children who interacted with social robots in clinical settings. Subgroup analyses showed that 1) Both inpatient and outpatient children exhibited reduced anxiety levels. 2) School-age children experienced a decrease in anxiety following interventions with social robots. 3) The social robots were effective in alleviating children's anxiety using distraction techniques and psycho-educational interventions.

This meta-analysis is the first to summarize the effects of social robots on anxiety in children and finds an overall positive trend. It's more effective than traditional psychotherapy and has no adverse effects due to drug use. In the context of care shortages, social robots represent a significant tool for reducing anxiety among children in clinical settings and demonstrate promising potential.

Surgical treatment for patellofemoral osteoarthritis (PFOA) consists of soft tissue, bony, and arthroplasty interventions. Partial lateral facetectomy (PLF) is a bone-reducing procedure, commonly done in conjunction with soft tissue and realignment procedures, that has grown in popularity after failure of conservative treatment due to its efficacy and minimally invasive nature. This systematic review and meta-analysis thus seeks to evaluate the efficacy of PLF in the absence of reviews on this topic.

A systematic review of three databases (PubMed, EMBASE, Scopus) was conducted, identifying studies that evaluated postoperative outcomes of PLF on patients who had PFOA. Pairwise meta-analysis was conducted between preoperative versus postoperative values of a subjective outcome measure (Knee Society Score (KSS)) and radiographic outcome measure (Congruence Angle (CA)). Subgroup analysis was performed on different concomitant procedures aside from PLF to determine their effect on clinical outcomes.

Ten studies were included in this review, with 463 patients and 495 knees and a pooled mean follow-up of 63.2 months and age of 56.3 years. Six studies investigated PLF with lateral release, two with realignment procedures, one with lateral lengthening, and one with both lateral release and realignment. Five studies found significant improvement (p < 0.01) in KSS (34.45; 95%CI: 26.41 to 42.49, and four studies reported significant improvement (p < 0.01) in CA (-10.31; 95%CI: 13.80 to -6.81). Subgroup analysis showed a significant difference in KSS between PLF with lateral release, lateral lengthening, and realignment (p < 0.01) but not for CA (p = 0.65).

PLF is an effective treatment for PFOA using subjective and radiographic outcome measures. Current cohort studies have shown significant improvement in PFOA treatment, even in the context of long-term outcomes and severe PFOA, and provides valuable insight into the use of PLF as a viable minimally invasive surgical option to treat PFOA in addition to other procedures such as lateral retinacular release and realignment procedures.

Antidepressants use is linked to poor response, treatment discontinuation, and treatment-resistant depression. However, evidence regarding efficacy of cranial electrotherapy stimulation (CES) in treating depression is limited. Therefore, we conducted the first meta-analysis to explore efficacy of CES in treating primary and secondary depression in adults.

PubMed, Embase, CINAHL, Web of Science, EBSCOHost, and Cochrane Library were comprehensively searched. Dersimonian-Lard random-effects model in Comprehensive Meta-Analysis 4.0 was used, presenting Hedges' g with corresponding 95 % confidence interval (CI) for depressive symptoms and Quality of life (QoL) while odds ratio (OR) for safety and acceptability of CES. Heterogeneity was examined using Cochrane's Q and I2 statistics with moderator analysis determining sources of variation.

Sixteen randomized controlled trials involving 1148 adults were included. CES significantly reduced depressive symptoms with small effect (g = -0.33 [95%CI -0.46, -0.20]) compared to non-CES treatment; it was safe (OR = 0.84 [95%CI 0.32, 2.18]) and acceptable (OR = 0.72 [95%CI 0.41, 1.27]). CES revealed non-significant effect on improving QoL (g = 0.13 [95%CI -0.05, 0.31]). Substantial improvement of CES were observed for females (β = -0.010 [95%CI -0.019, -0.0003]), secondary depression (g = -0.42 [95%CI -0.58, -0.27]), current >100 μA (g = -0.38 [95%CI -0.58, -0.18]), frequency > 100 Hz (g = -0.50 [95%CI -0.81, -0.20]), length ≤ 30 min (g = -0.39 [95%CI -0.64, -0.14]), sessions/week ≤5times (g = -0.34 [95%CI -0.49, -0.19]), and duration ≤5 weeks (g = -0.45 [95%CI -0.63, -0.27]).

CES, a safe adjunctive therapy, demonstrates small effect in the treatment of depression. Future research should explore long-term effects of CES for treating adults with depression.

Diabetes and frailty are prevalent and burdensome in middle-aged and older adults. However, current evidence on their association is inconsistent, and no quantitative meta-analysis exists. We conducted a systematic review and meta-analysis to examine whether diabetes increased the risk of frailty and vice versa.

We systematically searched PubMed, Web of Science, Embase, and CINAHL databases from inception to 10 April 2025. Random-effects models were used to calculate pooled odds ratio (OR) and 95 % confidence interval (CI) for cross-sectional analysis and pooled relative risk (RR) for longitudinal analysis. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

From 8559 non-duplicated records, 31 articles were included. People with diabetes had increased risks of prevalent frailty (OR=2.21, 95 %CI: 1.60-3.06, I2=99.0 %, n = 15; GRADE=Low), prevalent pre-frailty (OR=2.23, 95 %CI: 2.19-2.28, I2=0.0 %, n = 2; GRADE=Very low), and incident frailty (RR=1.50, 95 %CI: 1.36-1.65, I2=0.0 %, n = 7; GRADE=Moderate). Those with pre-frailty (OR=1.95, 95 %CI: 1.61-2.36, I2=0.0 %; GRADE=Very low) but not with frailty (OR=2.28, 95 %CI:0.96-5.46, I2=92.3 %; GRADE=Very low) had increased odds of prevalent diabetes in two studies. In 15 studies, the pooled RRs for incident diabetes were 1.47 (95 %CI: 1.37-1.57, I2=91.0 %; GRADE=Moderate) in pre-frail participants and 1.96 (95 %CI: 1.73-2.23, I2=92.7 %; GRADE=Moderate) in frail participants.

Our findings support the bidirectional relationship between diabetes and frailty in middle-aged and older adults, with each condition contributing to the development of the other. This highlights the importance of early detection and integrated management strategies for diabetes and frailty.

International migrant workers face an elevated risk of common mental disorders (CMDs), stress, and sleep disturbances due to various individual, psychosocial, and occupational factors. This meta-analysis systematically evaluated the prevalence of CMDs, stress, and sleep disturbance among international migrant workers. Two independent reviewers systematically searched the literature on five electronic databases from inception to June 2022. Random effects meta-analyses were performed to estimate the pooled prevalence of depressive symptoms, anxiety symptoms, stress, and sleep disturbance among international migrant workers. Additionally, subgroup analyses were conducted to examine potential modifiers for the prevalence rates. Of 8461 records, 57 studies (n = 29,481) were included in this meta-analysis. The pooled prevalence rates of depressive symptoms, anxiety symptoms, stress, and sleep disturbance were 20.3 %, 17.8 %, 17.3 %, and 25.3 %, respectively. Subgroup analyses revealed that the prevalence of CMDs and stress was statistically significantly modified by country of destination and type of work, stress by gender and country of origin, and anxiety by migration type. Potential publication bias was observed only in the meta-analysis of stress. Most of the studies included were of moderate to high methodological quality. However, given that the included studies were predominantly cross-sectional and used non-probability sampling, the results should be interpreted with caution. This meta-analysis highlights that CMDs, stress, and sleep disturbances are prevalent among international migrant workers, posing a significant public health concern for host countries. These findings underscore the urgent need for tailored mental health interventions for specific subgroups within this population.

Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to systematically examine the effectiveness of Mindfulness-based interventions (MBIs) on health outcomes, including menopausal symptoms, quality of life (QOL), sleep quality, anxiety, depressive symptoms, stress, mindfulness levels, and female sexual function index.

Eight databases were searched from inception to November 4, 2024 for randomized controlled trials. Two researchers independently selected, extracted, and appraised trials using the Cochrane Collaboration's 'risk of bias' tool. Meta-analysis, subgroup analysis, leave-one-out sensitivity analysis, and meta-regression were performed using Stata 18.0. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence.

A total of 19 studies (1670 participants) published between 2011 and 2024 were identified. Of these, 18 studies were included in the meta-analysis. Compared with control group, The pooled analysis demonstrated that MBIs had statistically significant effects on menopausal symptoms (SMD, -2.10; 95 % CI, -3.49 to -0.70), QOL (SMD, -0.88; 95 % CI, -1.67 to -0.09), sleep quality (SMD, -0.92; 95 % CI, -1.65 to -0.20), anxiety (SMD, -1.03; 95 % CI, -1.42 to -0.66), depressive symptoms (SMD, -0.91; 95 % CI, -1.30 to -0.53), stress (SMD, -0.85; 95 % CI, -1.55 to -0.15), and mindfulness levels (SMD, 1.19; 95 % CI, 0.35 to 2.02). The overall quality of evidence for all pooled estimates were graded as low and moderate due to methodological limitations and small sample size. The low attrition rate (6 %) and relatively high adherence rate (79 %) highlight the acceptability of MBIs.

This systematic review and meta-analysis support using of MBIs to improve health outcomes in menopausal women. Rigorous randomized controlled trials with extended follow-up are needed to elucidate the mechanisms linking MBIs to menopausal health and strengthen evidence for clinical application.

Bone augmentation can be a risk factor for complications in dental implant therapy. Aim of this systematic review and meta-analysis was to assess the marginal bone loss (MBL) between dental implants placed in augmented or pristine bone sites.

Four electronic databases (PubMed, Embase, Scopus, and Web of Science) were searched for clinical studies with a follow-up period of at least five years. Additionally, a hand search was performed. Risk of bias was assessed using the Newcastle-Ottawa-Scale for non-randomized studies and Cochrane risk-of-bias-tool-2 for randomized controlled trials. Random-effect meta-analysis was performed for the mean MBL at implant level after 5 years of loading for dental implants placed in pristine and augmented bone sites. The study was registered in PROSPERO: CRD42024615716.

A total of 11 sources reporting on 10 studies were included. Four studies examined dental implants placed in pristine bone sites, four in augmented bone sites, and two in both conditions.

Random-effect meta-analysis for pristine bone sites estimated a mean MBL of 0.79 mm (95 % CI: 0.32-1.26) and for augmented bone sites a mean MBL of 1.90 mm (95 % CI: 1.73-2.07) after five years with a high heterogeneity of MBL reported in included studies.

Pre-implant augmentation appears to be one but not the only risk factor for MBL. Future studies on implant complications should describe in detail the patient (e.g., adherence, periodontitis history) and local factors (e.g., cleanability of superstructure, attached mucosa) in order to identify further risk factors in the long term.

Dental implants in augmented bone sites show greater MBL after five years compared to pristine bone sites. Augmentation may increase early bone remodeling. Clinicians should consider augmentation-related remodeling dynamics and patient-specific risk factors when planning implant therapy to optimize long-term outcomes and reduce complications associated with peri‑implant bone loss.

The relationship between dissociation features, maladaptive regulation strategies, and emotional dysregulation is a controversial issue. This meta-analytic review provides a comprehensive and multidimensional overview of the association between aspects of dissociation and emotional (dys)regulation.

We conducted systematic research on the main databases (Psycinfo, PsycARTICLES, Pubmed, MEDLINE, Scopus), collecting the literature of the last 20 years. A total of 120 studies were included in the meta-analytic review. The analyses were based on the Pearson coefficient as a measure of the size of the effect, using the random effect model and performing moderation analysis.

Results showed significant relationships between emotion (dys)regulation and the different facets of dissociation. Overall, we observed stronger associations between deficits in emotion regulation/maladaptive regulating strategies, rather than alexithymia, and dissociation, supporting the prior involvement of emotional dimensions in dissociative experiences.

This work confirms the connection between emotion (dys)regulation and dissociation, revealing differential patterns according to the specific assessed dimensions and, thus, providing a systematization of the associations between specific aspects of the examined constructs.

Obstructive sleep apnea (OSA), a sleep disorder, is associated with cognitive decline and is potentially linked to glymphatic system dysfunction. This meta-analysis investigates glymphatic function in severe OSA (apnea-hypopnea index ≥30) using the Diffusion Tensor Imaging Analysis along the Perivascular Space (DTI-ALPS) index.

This study followed PRISMA guidelines for systematic reviews and meta-analyses. A comprehensive search of PubMed, Web of Science, Scopus, and Embase was conducted from inception to January 20, 2024. Studies investigating the ALPS index in OSA using DTI were included. Analyses included a random-effects meta-analysis, sensitivity analysis, meta-regression, publication bias evaluation (funnel plot, Egger's test, and Begg's test), and risk of bias assessment.

Systematic review identified four studies (137 patients with severe OSA and 170 healthy controls (HCs)). Pooled analysis revealed a significant reduction in the DTI-ALPS index in severe OSA patients compared to HCs (standardized mean difference: -0.95, 95 % CI: -1.46 to -0.44, p < 0.001), indicating impaired glymphatic function. Heterogeneity was moderate to high (I2 = 76.07 %), but sensitivity analyses confirmed robustness. Meta-regression analyses identified the sources of heterogeneity as the apnea-hypopnea index (β = -0.039, p = 0.009) and the Epworth Sleepiness Scale (β = -0.150, p = 0.032), with no effects observed for age or male ratio. Qualitative (funnel plot) and quantitative publication bias assessments (Egger's and Begg's tests) showed no significant bias, and risk of bias evaluations using the Newcastle-Ottawa Scale indicated high methodological quality across studies.

These findings suggest that severe OSA disrupts glymphatic activity. The DTI-ALPS index emerges as a promising tool for assessing glymphatic dysfunction in OSA.

Nomophobia (no mobile phone phobia) is a term used to describe discomfort or anxiety experienced when individuals are unable to use or access their mobile phones. Although not formally recognized in the DSM-5 or ICD-11, nomophobia has gained increasing research attention. The present study systematically reviewed and meta-analyzed the global prevalence of nomophobia, based on 43 studies (n = 36,656 participants) from 18 countries. Only studies using validated self-report instruments, primarily the Nomophobia Questionnaire (NMP-Q), were included. Subgroup analysis and meta-regression were conducted to determine the sources of heterogeneity. Results indicated that nomophobia is widespread, with 26 % of participants reporting mild symptoms, 51 % moderate symptoms, and 21 % severe symptoms. Importantly, these figures reflect self-reported levels of distress rather than clinical diagnoses. Higher prevalence was observed among university students and young adults. The wide variation across regions and instruments suggests nomophobia is influenced by cultural, behavioral, and technological contexts. Despite ongoing debates regarding whether nomophobia is an anxiety disorder, these findings highlight the critical need for precise definitions and continued exploration of its psychological correlates.

Patient safety is a global concern, and nurses, as the largest group of healthcare professionals, play a critical role in ensuring patient safety. This study aimed to systematically review and analyze the effects of patient safety education programs on nursing students' knowledge, attitudes, and competencies by synthesizing existing research and identifying key factors contributing to program effectiveness.

Systematic review and meta-analysis.

Ovid-EMBASE, MEDLINE, CINAHL, and PubMed were selected for their comprehensive coverage of healthcare and nursing literature. Articles published between January 2000 and July 2024 were included, as the year 2000 marked the beginning of global efforts to prioritize patient safety in healthcare systems.

This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search of Ovid-EMBASE, MEDLINE, CINAHL, and PubMed (2000-2024) identified interventional studies on patient safety education for nursing students. Eligible studies underwent quality appraisal using the weight of evidence framework.

The meta-analysis showed significant improvements in nursing students' knowledge (Z = 5.315, p < .001), attitudes (Z = 2.727, p = .006), and competencies (Z = 4.870, p < .001). Effect sizes ranged from medium to very large (g = 0.684-2.461). Meta-regression analysis indicated that participants' grades (β = -3.29, p < .001) influenced attitudes, while both grades (β = -2.04, p = .007) and education methods (β = 0.85, p = .042) affected competency.

Patient safety education programs significantly enhance nursing students' knowledge, attitudes, and competencies. Structured, long-term education and interactive methods, such as simulation and virtual reality, enhance competency development. Integrating these approaches into nursing curricula can help bridge the gap between theory and practice, ultimately improving patient safety.

Acinetobacter baumannii's resistance to antibiotics restricts treatment ways, and has enhanced its mortality rates approaching 35 %. Resistance to β-lactams in Acinetobacter baumannii, related to extended-spectrum β-lactamases (ESBLs), has become a worldwide concern. This study aimed to assess the prevalence of Extended-Spectrum Beta-Lactamase-Producing Acinetobacter baumannii in Iran. Important databases (PubMed, Scopus, Wily Online Library, ScienceDirect and Google Scholar) were searched for related literature published from January 2010 to April 2024. The inclusion criteria were predefined based on PRISMA guidelines. A random-effects model was used according to the heterogeneity test. Publication bias was specified using Egger's weighted regression and Begg's rank correlation methods. The statistical analyses were carried out relying on the Comprehensive Meta-Analysis Software (CMA). Among 2409 articles identified, 15 papers met the eligibility criteria. Among encoding genes of ESBLs, TEM, PER, SHV, CTX-M, VEB and GES were found with the prevalence of 25.0 % (95 % CI: 15.9-37.1 %), 16.1 % (95 % CI: 7.4-31.5 %), 14.3 % (95 % CI: 6.3-29.4 %), 11.1 % (95 % CI: 4.3-25.8 %), 9.9 % (95 % CI: 5.2-18.1 %) and 8.5 % (95 % CI: 1.4-37.2 %), respectively. A subgroup analysis based on province showed some differences in TEM prevalence. The evaluated pooled prevalence of TEM was highest in Ilam (53.4 %; 95 % CI: 42.0-64.5 %), however, it was based only on one study. It was 51.1 % (95 % CI: 33.7-68.3 %) in Tehran. The present studies demonstrate a high prevalence of ESBL in Acinetobacter Baumannii in Iran which poses a serious concern in critically ill patients. As well as these findings can assist our conception of the real prevalence of ESBL to work on new strategies for the control and prevention of infection.

This study evaluates the impact of different feedback elements in serious games (SGs) on nursing education outcomes.

Systematic review and meta-analysis.

6546 English-language studies published between 2000 and 2023 were retrieved from seven electronic databases.

This systematic review and meta-analysis followed the PRISMA guidelines. The Cochrane Risk of Bias tool was used for quality assessment. Meta-analysis and subgroup analysis were conducted using RevMan 5.4, and the certainty of evidence for each outcome was assessed using the GRADE approach.

Eight studies were included in the meta-analysis. Findings showed that, compared to traditional learning methods, outcome feedback had a moderate effect size on knowledge (SMD = 0.51, 95 % CI [0.09, 0.92]), while comparative feedback had a small, non-significant effect size (SMD = 0.38, 95 % CI [-0.36, 1.12]). Immediate feedback had a large effect size on skills (SMD = 0.87, 95 % CI [0.61, 1.14]), and outcome feedback had a moderate effect size (SMD = 0.50, 95 % CI [0.21, 0.79]). Serious games with feedback had a large effect size on motivation (SMD = 1.31, 95 % CI [0.45, 2.17]). For confidence, outcome feedback had a moderately large effect size (SMD = 0.64, 95 % CI [-0.22, 1.51]), and comparative feedback had a small effect size (SMD = 0.24, 95 % CI [-0.44, 0.91]), but neither reached statistical significance. GRADE assessment showed high certainty for immediate feedback on skills, moderate certainty for outcome feedback on knowledge and skills, and very low certainty for comparative feedback on knowledge. Evidence certainty for motivation and confidence was low or very low.

Serious games incorporating feedback elements can enhance nursing students' motivation. Immediate feedback significantly improves nursing skills, while outcome feedback improves knowledge acquisition. However, further research is needed to validate these findings due to the limited number of studies and high heterogeneity.

X-linked hypophosphatemia (XLH) is a rare genetic disorder caused by PHEX gene variants, leading to elevated FGF23 levels and impaired phosphate reabsorption, resulting in abnormal bone growth. Skull abnormalities, including craniosynostosis, are often reported in children with XLH, but the true prevalence of craniosynostosis among children with XLH is unknown.

We performed a systematic review and meta-analysis to estimate craniosynostosis prevalence in children with XLH. We searched PubMed, Embase, and Web of Science for cohort studies or large case series published before June 2024. Eligible studies included at least ten children with XLH and reported craniosynostosis prevalence without selection based on skull abnormalities. Pooled prevalence was calculated using a random-effects model, with heterogeneity assessed.

Of 517 studies initially identified, ten studies with 461 patients met the criteria for inclusion. The pooled prevalence of craniosynostosis among children with XLH was 22 % (95 % confidence interval (CI) 9.0 % to 44 %) with significant heterogeneity across studies (I2 = 88.5 %, p < 0.01). This prevalence is far greater than the prevalence of craniosynostosis in the general pediatric population, which is estimated to be one in 2100-2500 births. We confirmed an expected female predominance among children with XLH (median 65.9 % female, interquartile range [IQR] 53.7 % to 68.4 %) but not among children with XLH and craniosynostosis (median 42 % female, range 21 % to 48 %).

Craniosynostosis is more common among children with XLH compared to the general pediatric population and may be disproportionately common among males. Increased vigilance for craniosynostosis is warranted for children with XLH.

Deficits in executive functioning are a common consequence of Traumatic Brain Injury (TBI) and the severity of TBI is known to predict functional outcomes. In this review, the authors examine the ability of three commonly used tests of executive functioning [The Trail Making Test (TMT-B), The Wisconsin Card Sorting Test (WCST), and Verbal Fluency (VF)] to predict domains of function.

Seven hundred and twenty articles were identified and twenty-four met inclusion criteria (original articles published in English examining an adult TBI population). Data were subject to a study quality analysis and then meta-analyzed to assess whether tests of executive functioning (TMT-B, WCST, and VF) can predict functional, employment, and driving outcomes following a TBI.

The TMT-B (r = 0.29; 95% CI 0.17-0.41) and the WCST (r = 0.20; 95% CI 0.02-0.37) were significantly associated with functional outcomes. The TMT-B was also associated with a person's ability to return to driving (r = 0.3890; 95% CI 0.2678-0.5103). No test of executive functioning was associated with employment outcomes following a TBI.

These findings are important to guide rehabilitation strategies and future planning. This review has also highlighted the scarcity of research on specific outcomes.

Drinking water disinfection byproducts (DBPs) have received widespread attention due to their high concentrations and toxicity. However, the correlation between exposure to disinfection byproducts and bladder cancer in published papers is inconsistent. In this study, a time-updated meta-analysis was conducted, which aimed to elucidate the relationship between the historical exposure time and exposure levels of trihalomethanes (THMs) in drinking water and the associated risk of bladder cancer. A total of 433 relative publications was obtained from databases, however only 16 publications satisfied the inclusive criteria, including 13 case-control studies and 3 cohort studies. The case-control studies encompassed 8126 bladder cancer cases and 13,843 controls, while the cohort studies included 112,654 cases and 955 bladder cancer patients. In comparison to individuals who have never been exposed to or have only experienced brief exposure to THMs, the odds ratio (OR) for medium-term and long-term exposure of THMs was 1.30 (95 % CI = (1.11, 1.53)), and 1.59 (95 % CI = (1.40, 1.81)), respectively. This suggests a statistically significant positive correlation between long-term exposure to chlorinated drinking water and an increased risk of bladder cancer. The pooled OR for low and high exposure group was 1.28 (95 % CI = (1.06, 1.55)) and 1.45 (95 % CI = (1.14, 1.85)), respectively, indicating an increased risk of bladder cancer occurrence compared to the unexposed group. Interestingly, subgroup analysis revealed that high levels of THM exposures of males caused an increased risk of bladder cancer (OR= 1.59, 95 % CI = (1.11, 1.53)), while this association was not significant for females (OR = 1.05, 95 % CI = (0.61, 1.80)). More importantly, although the case-control studies were consistent with the overall findings, the cohort studies suggest that there is insufficient evidence to establish a definitive causal link between THMs exposure levels and bladder cancer. In general, long-term consumption of chlorinated drinking water was associated with the occurrence of bladder cancer of male rather than female.

Forcibly displaced populations are growing exponentially and are at increased risk of experiencing mental health difficulties. However, it remains unclear if, and how, their resilience and mental health are associated. This systematic review and meta-analyses investigated the relationship between resilience and mental health outcomes among forcibly displaced groups.

MEDLINE Ultimate, APA PsycInfo and SCOPUS were searched up until January 2024. Peer-reviewed studies measuring a statistical association between resilience and mental health among forced migrants were eligible for inclusion. Random-effects meta-analyses for each identified mental health category were conducted. Study quality was evaluated using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Thirty-one studies were included in the review (n = 6656). Meta-analyses revealed a significant negative association between resilience and symptoms of post-traumatic stress (k = 13, n = 2446, r = -0.15, 95 % CI [-0.23; -0.06]), depression (k = 14; n = 2952, r = -0.34, 95 % CI [-0.41; -0.26]), anxiety (k = 7, n = 1516, r = -0.19, 95 % CI [-0.27; -0.11]), and psychological distress (k = 10; n = 2712, r = -0.29, 95 % CI [-0.36; -0.23]).

Effect sizes were highly heterogenous, most studies recruited small samples using non-random sampling strategies, and data was collected cross-sectionally.

Our findings point to an association between resilience and mental health difficulties in forcibly displaced groups. Directions for future research are discussed.

PROSPERO (CRD42023395925).

An increasing number of parents are forced to part with their children due to the pressures of life or unpredictable circumstances. This forced separation often has a devastating effect on children's minds, leading to a range of mental health problems.

We searched five databases (EBSCO, PubMed, Scopus, Web of Science, and China National Knowledge Infrastructure) from inception to November 17, 2023, and performed a systematic analysis using Comprehensive Meta-Analysis (CMA) 3.0.

We identified 28 eligible meta-analyses with 746,175 participants across 170 outcomes. Parent-child separated (PcS) children were at higher risk for emotional problems (d = 0.22 [95 % CI 0.17-0.28]), cognitive problems (d = 0.20 [95 % CI 0.10-0.29]), behavioral problems (d = 0.21 [95 % CI 0.15-0.27]) and psychosis (d = 0.22 [95 % CI 0.15-0.29]) than non-PcS children. Regarding influencing factors, both personal and social factors were moderately positively correlated with emotional and behavioral problems. Family factors had a moderate positive correlation between emotional problems (z = 0.20, [95CI% 0.12-0.28]), and a low positive correlation with behavioral problems (z = 0.13, [95CI% 0.04-0. 22]). After addressing the issue of overlapping data, there were no significant differences in emotional problems in children with PcS compared to non-PcS children.

The majority of studies included in our umbrella review were from China, which may limit the generalizability of our findings.

PcS children suffer more mental health problems than non-PcS children. The community needs to act and intervene proactively to promote the improvement of the mental health of these children.

The comorbidity of major depressive disorder (MDD) and Parkinson's disease (PD) were prevalent and has a profound impact on patients. However, whether this comorbidity results from specific pathological processes or a mutual cause-and-effect relationship was largely controversial. Additionally, although MDD can appear before or after PD, the health impact of the comorbidity sequence is poorly understood.

We used mendelian randomization (MR) and UK biobank (UKB) cohort to explore the associations between MDD and PD. MR was also utilized to investigate potential confounders. By classifying UKB patients into MDD first and PD first groups, we evaluated the health impact of the comorbidity sequence using Cox regression.

Bidirectional MR and cohort study showed conflicting results. MR did not find associations between MDD followed by PD (odds ratio [OR] = 1.28, 95 % confidence interval [CI] = 0.85-1.94) or PD followed by MDD (OR = 0.99, 95 % CI = 0.97-1.01). However, the cohort study found a significant effect of MDD on PD (hazard ratio [HR] = 1.75, 95 % CI = 1.55-1.97) and PD on MDD (HR = 4.35, 95 % CI = 3.65-5.19). By performing MR on 4709 proteins, we identified ESD, LEAP2, NDRG3, NRXN3, and PLXNB2 as potential common causes of MDD and PD. Additionally, PD first group had higher risks of all-cause mortality (HR = 1.65, 95 % CI = 1.03-1.90), dementia (HR = 1.88, 95 % CI = 1.16-3.04), and aspiration pneumonia (HR = 1.89, 95 % CI = 1.09-3.27).

Our study suggested the comorbidity of MDD and PD is likely the result of certain pathological processes. Additionally, patients with PD first had higher risks of several adverse outcomes.

Rhythm control strategies are a key component of atrial fibrillation (AF) therapy, with recent reports suggesting racial and ethnic disparities in their utilization. We aimed to determine differences in the utilization of catheter ablation (CA), direct current cardioversion (DCCV), and anti-arrhythmic drugs (AAD) among different racial and ethnic groups. We searched PubMed/MEDLINE, EMBASE, and Cochrane Library (from inception to January 31st, 2024) for studies including adults with AF and reporting CA, DCCV, or AAD utilization rates in at least 2 racial and ethnic groups. Our primary outcome was the likelihood of Black, Hispanic, and Asian individuals undergoing each rhythm control strategy compared to White patients. Pooled estimates were calculated with a random-effects model and were reported as odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs). Nineteen studies were included comprising 12,598,109 patients. The pooled ORs (95% CI) of undergoing CA for Black individuals was 0.68 (95% CI 0.56 to 0.83), for Hispanic individuals was 0.72 (95% CI 0.63 to 0.82), and for Asian individuals was 0.64 (95% CI 0.48 to 0.86), compared to White individuals. The likelihood of undergoing DCCV (OR [95% CI]) was lower in Black (0.69 [95% CI 0.57 to 0.82]), Hispanic (0.67 [95% CI 0.57 to 0.80]), Asian (0.68 [95% CI 0.64 to 0.72]) patients compared to White patients. Our results identified that racial and ethnic minoritized groups with AF are significantly less likely to undergo treatment with a rhythm control strategy. In conclusion, these findings highlight a significant gap in healthcare delivery that stakeholders, healthcare systems, and clinicians should address.

Cardiovascular diseases from abnormal lipid metabolism significantly increase mortality in systemic lupus erythematosus (SLE). The causal link between dyslipidemia and SLE is unclear.

Lipid metabolism in patients with SLE was evaluated based on clinical data from 511 patients with SLE and 706 healthy individuals. Bidirectional Mendelian randomization (MR) was employed to assess causal links between 179 plasma lipid metabolites, lipid-lowering drug targets, and SLE risk. Genetic instruments from GWAS and eQTL data were used to evaluate CETP and APOA4 effects. Peripheral blood CETP and apolipoprotein levels in SLE patients were validated via ELISA.

SLE patients exhibited reduced HDL-C (P < 0.0001), APOA1 (P < 0.0001), and APOA4 (P < 0.0001), alongside elevated triglycerides (TG, P < 0.0001), APOC3, APOD, and APOF. MR identified three lipid metabolites-PC(18:2_20:4), TG(56:6), and TG(58:7)-as causal factors for SLE (P < 2.79E-5). CETP inhibition significantly reduced SLE risk via HDL-C modulation (OR = 0.72, P = 3.38E-08) and influenced LDL-C, TG, and apolipoproteins. Clinical validation confirmed elevated CETP and reduced APOA4 in SLE, correlating with disease activity. APOA4 activation showed protective effects, while PCSK9 inhibition lacked relevance.

Bidirectional Mendelian randomization analyses confirmed dyslipidemia as a causal antecedent to SLE, with no evidence of reverse causation. A variety of MR analyses and clinical validation indicated that targeting HDL-C regulation offers significant advantages for managing dyslipidemia in patients with SLE, with CETP identified as the optimal pharmacological target.

Endometriosis is a common cause of chronic pelvic pain and lacks precise pathophysiological mechanisms. Advanced oxidation protein products (AOPPs), markers of oxidative stress and inflammation, are implicated in pain-related diseases and have been suggested to play a crucial role in endometriosis pathophysiology. We aim to assess the significance of AOPP in endometriosis by analyzing their levels across serum, follicular fluid, peritoneal fluid, and ovarian endometrioma tissue, and their association with different disease stages. A systematic review of articles published up to Nov 2024 examining AOPP levels in endometriosis patients compared to controls was conducted (PROSPERO: CRD42022343714). Using the Newcastle-Ottawa Scale (NOS), the quality and risk of bias of included studies were assessed, and publication bias was evaluated using Egger's and Begg's tests. The analysis 12 studies involving 561 control patients without endometriosis and 670 patients with endometriosis. Compared to controls, elevated AOPP levels were observed in endometriosis patients' serum and peritoneal fluid. Patients with type III/IV endometriosis exhibited higher AOPP levels in serum and plasma compared to control patients, suggesting a potential association with disease severity. The study underscores the potential of AOPP levels as biomarkers for endometriosis severity and proposes them as pharmacological targets for disease management, including pelvic pain treatment.

The correlation between air pollution and cancer incidence has been a longstanding concern, understanding the need to elucidate the specifics of this relationship. Thus, this study aimed to assess the association between exposure to air pollution and cancer incidence, and to identify the possible biological links between the two. We examined global cohort studies investigating the association between air pollution and cancer and performed a univariate Mendelian randomization (MR) analysis. Our analysis revealed that the presence of particulate matter (PM)2.5, PM10, NO2, and NOx substantially impacted the risk of developing cancer. MR analysis identified 130 CpGs sites associated with three ambient air pollutants that have significant casual effects on the risk of 14 cancer sites (false discovery rate<0.05). Gene annotation was conducted using g-Profiler by screening for single nucleotide polymorphisms significantly associated with outcome, followed by analysis of the gene interaction network using GeneMANIA, and visualization using igraph. In conclusion, this study demonstrates that air pollution has a significant impact on cancer incidence, provides strong evidence for an epigenetic causal link between the two, and provides new insights into the molecular mechanisms by which air pollution affects cancer development.

Compassion fatigue is the emotional response generated by continuous exposure to human suffering and is especially common among nursing professionals. This phenomenon can lead to decreased empathy and increased emotional exhaustion while affecting the quality of care.

To synthesize information from primary studies that have used and evaluated interventions aimed at managing compassion fatigue in nursing professionals.

A systematic review with meta-analysis of studies with randomized and nonrandomized control groups.

Medline, CINAHL, Scopus, and Web of Science databases were searched for studies published between 2013 and 2023. The search was conducted in January 2024 to identify control group studies that provided quantitative pre-post data on both groups of compassion fatigue assessed with the Professional Quality of Life Scale (ProQol). Quality was assessed using the RoB2 and ROBINS-I scales. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024537935).

The search strategy yielded a total of 1006 records, of which 11 studies were selected; these provided a total of 763 participants. Most of the interventions consisted of providing knowledge and skills to increase resilience, emotional well-being, and stress coping. The interventions had an average duration of 6 weeks distributed in 9 sessions with an average of 90 minutes. After the intervention, a statistically significant increase in satisfaction was obtained and a statistically significant reduction in fatigue and burnout.

Interventions aimed at reducing compassion fatigue are effective among nursing professionals. In the future, further high-quality research with prospective follow-up designs is required.

Photogrammetry has been widely used in postural assessment. However, many of the available protocols do not present information about measurement properties.

To identify which methods using photogrammetry to assess knee alignment on the sagittal plane are valid and/or reliable.

Systematic review with meta-analysis.

Searches were conducted on databases systematically and manually according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The selection, data extraction, and assessment of the methodological quality of the studies were conducted by two independent raters. The studies were assessed using a tool proposed by Brink and Louw. Meta-analyses of the intraclass correlation coefficient (ICC) were performed.

Twelve studies were included, ten assessing reliability, one assessing the validity, and one assessing both reliability and validity of the methods used to assess the knee using photogrammetry. We did not find any method that presented both the reliabilities and validities attested. It was possible to identify only values of ICC for intra-rater and inter-rater reliabilities.

The results show the need for more investigation, since we did not find any method that has both validity and reliability attested for assessing knee alignment on the sagittal plane using photogrammetry.

The purpose of this study was to evaluate the effect of del Nido cardioplegia versus conventional cardioplegic solutions on early outcomes of isolated coronary artery bypass grafting (CABG). PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched through July 2024 to conduct a meta-analysis for a comparison between del Nido and other cardioplegic solutions in isolated CABG. Major end points of the study included operative mortality and morbidities. A random effects model was used to estimate the pooled effect size. For subgroup analyses, meta-analyses were conducted for outcomes derived from either randomized controlled-trials, propensity score analysis, or multivariable analysis. Twenty-four studies met our eligibility criteria, including 4 randomized controlled trials and 5 propensity score-matched studies with a total of 34,737 patients. Operative mortality was not significantly associated with cardioplegic solutions (del Nido vs other solutions; p = 0.262). The incidence of postoperative stroke, reoperation, deep wound infection, and atrial fibrillation was also comparable between the 2 groups. The incidence of postoperative myocardial infarction and renal failure was significantly lower in the del Nido group with a pooled odds ratio of 0.43 (95% confidence interval, 0.24-0.77) and 0.61 (95% confidence interval, 0.45-0.81), respectively. Subgroup analyses also demonstrated these significant differences. In patients undergoing isolated CABG, del Nido cardioplegia provides comparable mortality compared with other cardioplegic solutions. Del Nido solution was significantly protective against myocardial infarction and renal failure.

Global obesity prevalence among pregnant women is associated with adverse health outcomes for both the mother and the infant.

This study aims to evaluate the efficacy of a behavioural intervention management model for controlling gestational weight gain (GWG) in pregnant women with overweight or obesity.

The quality of the evidence was assessed using the Confidence In Network Meta-Analysis technique. Moreover, a Bayesian network meta-analysis summarised the comparative efficacy of various intervention methods on GWG outcomes.

The analysis included 24 trials with 11,008 participants across three different management models: in-person, remote (electronic health (eHealth) or mobile health (mHealth)), and mixed. Evidence quality ranged from very low to high. The multi-behavioural intervention delivered via a blended in-person and mHealth model demonstrated the highest likelihood of being in the top ranks of intervention effectiveness compared to the other interventions included in the analysis, scoring 85.9%.

The multi-behavioural intervention delivered via a blended in-person and mHealth administration mode ranked highest in effectiveness for reducing GWG in pregnant women with overweight or obesity compared to the other interventions included in the analysis. Future studies may focus on addressing evidence gaps through more rigorous and direct comparative analyses.

Breast cancer (BC) is a prevalent global health concern, with various risk factors contributing to its heterogeneity. This comprehensive meta-analysis aims to explore the association between dairy consumption and BC risk, stratified by hormone receptor, menopausal status, and age. To assess the association between dairy consumption and BC risk, a systematic literature review based on studies published until December 2024 retrieved from PubMed, SCOPUS, Web of Science, and Cochrane Library. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated and then aggregated using random-effects models. Summary RR from 51 studies with 62,602 BC cases showed that overall dairy consumption is inversely associated with BC risk (RR = 0.91, 95% CI: 0.84-0.98, I2 = 75%), particularly among individuals aged over 45 (RR = 0.81, 95% CI: 0.68-0.98, I2 = 0%). Notably, higher intake of low-fat dairy products showed potential protective effects (RR = 0.91, 95% CI: 0.84-0.98, I2 = 56%), especially in premenopausal women (skimmed milk, RR = 0.86, 95% CI: 0.76-0.97, I2 = 0%). Fermented dairy products, including yogurt, exhibited a decreased BC risk, particularly in postmenopausal women (RR = 0.91, 95% CI: 0.87-0.96, I2 = 0%). However, a positive association was observed between total milk intake and the risk of estrogen receptor-negative BC (RR = 1.31, 95% CI: 1.08-1.59, I2 = 0%). This meta-analysis provides comprehensive insights into the association between specific dairy product consumption and BC risk. The findings highlight the protective impact of specific dairy products on different subtypes, offering valuable insights for BC prevention.

To summarize the occurrence rates and identified the risk factors for pain at rest and during procedures in critically ill patients.

This study conducted a systematic review and meta-analysis. The Embase, PubMed, CINAHL Plus, Web of Science Core Collection and ProQuest Dissertations & Theses A&I databases were searched from inception to January 10, 2025, for relevant studies. Two independent researchers screened the articles, reviewed them, and extracted data. The data were analyzed using a random-effects model.

This meta-analysis included 23 observational studies with prospective, retrospective, and cross-sectional study designs encompassing 8,073 adult participants. The pooled occurrence rate of pain at rest among critically ill patients was 41 % (95 % confidence interval [CI] = 0.27 to 0.57), whereas that of pain during procedures was 68.4 % (95 % CI = 0.58 to 0.77). Most studies on intensive care unit (ICU)-related pain were conducted in the Asia Pacific region, the Americas, and Western Europe. Age was determined to be negatively associated with pain at rest, whereas opioid use percentage and percentage of male were positively associated with the occurrence of pain during procedures.

Pain at rest and during procedures is highly prevalent and often undertreated in ICU patients. Health-care providers should develop and implement effective pain management strategies to mitigate both pain at rest and procedural pain in critically ill patients.

Pain is a frequent and troubling experience for patients in the ICU, so healthcare providers need to assess and address it regularly. This study also pinpointed specific factors linked to pain at rest and during procedures, some of which can be changed or managed. These results offer ICU medical team valuable insights for identifying high-risk patients and delivering personalized interventions to minimize pain.