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Mathieson K, Weemer M, Lipke L. Approaches to teaching evidence-based medicine in residency: a systematic review. MEDICAL EDUCATION ONLINE 2025; 30:2504467. [PMID: 40401510 PMCID: PMC12100962 DOI: 10.1080/10872981.2025.2504467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 10/02/2024] [Accepted: 05/06/2025] [Indexed: 05/23/2025]
Abstract
BACKGROUND Studies of evidence-based medicine (EBM) curricula in graduate medical education are common, but little consensus exists on the best methods to teach EBM. OBJECTIVE The purpose of the current study was to evaluate EBM teaching approaches for graduate medical trainees and to update a 2014 systematic review. METHODS We conducted a systematic literature search of major health and education databases for articles published from January 2014 through October 2022. Articles were independently screened to ensure they described an experimental or quasi-experimental evaluation of EBM teaching for graduate medical trainees. Quality of included studies was appraised using the Medical Education Research Study Quality Instrument. Data were extracted and synthesized using Coomarasamy and Khan's hierarchy of EBM teaching and learning. RESULTS Over 1400 articles were screened; 35 met eligibility criteria and were included in our review. Interactive, classroom-based teaching approaches were most common (23/35, 66%). Only 2 (6%) studies used a clinically integrated teaching approach. Most studies reported positive short-term outcomes in EBM knowledge, skills, attitudes, or learner satisfaction. Few studies evaluated EBM behaviors, and none measured long-term application of EBM principles. CONCLUSIONS Reviewed studies had low to moderate study quality, often limited by small sample size and lack of validated measures. Although commonly encouraged as a teaching approach, few studies used clinically integrated EBM teaching. Instead of reporting individual, site-specific efforts, future studies should examine the broader culture of EBM in graduate medical education and prioritize sustained application of EBM into practice as a key outcome.
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Affiliation(s)
- Kathleen Mathieson
- College of Graduate Health Studies, A.T. Still University, Mesa, AZ, USA
| | - Megan Weemer
- College of Graduate Health Studies, A.T. Still University, Mesa, AZ, USA
| | - Laura Lipke
- Health Sciences Librarian, Binghamton University, Binghamton, NY, USA
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2
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Qanitha A, Alkatiri AH, Qalby N, Soraya GV, Alatsari MA, Larassaphira NP, Hanifah R, Kabo P, Amir M. Determinants of stroke following percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis. Ann Med 2025; 57:2506481. [PMID: 40411506 DOI: 10.1080/07853890.2025.2506481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 02/18/2025] [Accepted: 04/26/2025] [Indexed: 05/26/2025] Open
Abstract
BACKGROUND Despite advances in the field, no systematic review has thoroughly documented the occurrence of stroke following Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndrome (ACS). This study aimed to investigate the factors contributing to stroke occurrence post-PCI in ACS patients. METHODS A systematic search of PubMed and EMBASE identified 2,369 articles. After full-text screening, 109 articles were included in the systematic review, with 55 articles selected for meta-analysis. RESULTS Data from 18,466,823 patients across 109 studies were analyzed. Among these, 202,999 patients (1.1%) experienced post-PCI stroke. The participants' ages ranged from 49.0 to 87.6 years (mean 64.3 ± 6.2 years). The incidence of early post-PCI stroke within 30 days was 1.1%, while the incidence of stroke occurring >30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of stroke following PCI in ACS patients included traditional risk factors (i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke or transient ischemic attack); comorbidities (i.e. chronic kidney disease, atrial fibrillation, anemia, high bleeding risk); and procedural factors (i.e. thrombus aspiration and Clopidogrel use). CONCLUSIONS This study highlights the relatively low prevalence of stroke following PCI, estimated at approximately 1% of the studied population. These findings emphasize the critical need for continued vigilance in identifying and managing risk factors associated with post-PCI stroke in ACS patients. Future research should prioritize refining risk prediction models, developing innovative preventive strategies, and optimizing post-PCI care pathways to effectively reduce the incidence of stroke in this population.
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Affiliation(s)
- Andriany Qanitha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
- Makassar Cardiac Center (Pusat Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital, Makassar, Indonesia
- Department of Physiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Abdul Hakim Alkatiri
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
- Makassar Cardiac Center (Pusat Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital, Makassar, Indonesia
| | - Nurul Qalby
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
- Departement of Cardiology, Heart and Lung Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gita Vita Soraya
- Makassar Cardiac Center (Pusat Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital, Makassar, Indonesia
- Department of Neurology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | - Rif'at Hanifah
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Peter Kabo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
- Makassar Cardiac Center (Pusat Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital, Makassar, Indonesia
| | - Muzakkir Amir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
- Makassar Cardiac Center (Pusat Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital, Makassar, Indonesia
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3
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Teigen LM, Hoeg A, Zehra H, Shah P, Johnson R, Hutchison K, Kocher M, Lin AW, Johnson AJ, Vaughn BP. Nutritional optimization of fecal microbiota transplantation in humans: a scoping review. Gut Microbes 2025; 17:2446378. [PMID: 39772953 PMCID: PMC11730610 DOI: 10.1080/19490976.2024.2446378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 11/27/2024] [Accepted: 12/18/2024] [Indexed: 01/11/2025] Open
Abstract
Diet constitutes a major source of nutrient flow to the gut microbes. As such, it can be used to help shape the gut microbiome. Fecal microbiota transplantation (FMT) is an increasingly promising therapy in disease states beyond recurrent Clostridioides difficile infection, but diet is largely overlooked for its potential to help optimize this therapy. Therefore, the aim of this scoping review is to present the literature landscape that captures pre- and post-FMT dietary intake in humans, identify research gaps, and provide recommendations for future research. A comprehensive search strategy was developed and searches were run in five databases. Studies were included if they discussed adults who underwent FMT for any recognized treatment indication and had dietary intake as a study objective, this search encompassed studies with interventions that included foods and dietary supplements. The initial screening identified a total of 7721 articles, of which 18 met the inclusion criteria for this review. Studies were heterogeneous, but taken together, they introduce a framework that defines important nutritional considerations for both donors and FMT recipients in the period around FMT dosing. This framework is summarized with this review and highlights the opportunities available to develop FMT-based precision nutrition strategies to optimize its clinical efficacy.
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Affiliation(s)
- Levi M Teigen
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Austin Hoeg
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Hijab Zehra
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Priyali Shah
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Remy Johnson
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | | | - Megan Kocher
- University of Minnesota Libraries, St. Paul, MN, USA
| | - Annie W Lin
- The Hormel Institute, University of Minnesota, Austin, MN, USA
| | - Abigail J Johnson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Byron P Vaughn
- Medical School, University of Minnesota, Minneapolis, MN, USA
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4
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Paul RW, Osman A, Windsor JT, Slavick C, Romeo AA, Erickson BJ. Psychological readiness of return to sport after arthroscopic Bankart repair: A systematic review. J Orthop 2025; 66:43-48. [PMID: 39896854 PMCID: PMC11779653 DOI: 10.1016/j.jor.2024.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Accepted: 12/24/2024] [Indexed: 02/04/2025] Open
Abstract
Introduction Surveys such as the Shoulder Instability-Return to Sport after Injury (SIRSI) scores can help identify athletes who are better prepared to return to sport (RTS) after arthroscopic Bankart repair (ABR). Therefore, the purpose of this systematic review was to clarify how psychologically ready athletes are to RTS after ABR, with the secondary purpose of evaluating the impact of psychological readiness on athletes' ability to RTSS after ABR. Methods The Ovid Medline, PubMed, and SportDiscus databases were searched from inception until January 2023 using keywords such as Bankart, anterior labral repair, shoulder stabilization, return to play, and return to sport. Original studies were included if both RTS outcomes after ABR and a psychological factor were reported, with potential psychological factors being psychological readiness to RTS and reasons of failing to RTS. Results Overall, 707 studies were screened and 16 met criteria for inclusion. The mean MINORS score of included studies was 13.3 ± 4.1. In patients who failed to RTS, most (74 %) patients failed due to recurrent shoulder instability, pain, or injury, while 26 % reported failing to RTS due to non-shoulder related causes such as apprehension and fear of reinjury. Eight studies evaluated post-operative SIRSI scores with a mean of 65.4 (95 % CI: 62.9-72.8) at an average of 5.4 years post-operatively. Conclusion Most athletes fail to RTS due to shoulder-related causes, with apprehension and fear of reinjury as common causes as shoulder-independent causes for failed RTS. The mean SIRSI score after ABR was 65.4, and athletes with higher post-operative SIRSI scores were more likely to RTS. Level of evidence IV.
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Affiliation(s)
- Ryan W. Paul
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Alim Osman
- Eastern Virginia Medical School, Norfolk, VA, USA
| | | | | | | | - Brandon J. Erickson
- Rothman Orthopaedic Institute, Department of Orthopaedic Surgery, New York, NY, USA
- New York University Langone Health, Department of Orthopaedic Surgery, New York, NY, USA
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Yema DPR, Wong VWH, Ho FYY. The prevalence of common mental disorders, stress, and sleep disturbance among international migrant workers: A meta-analysis with subgroup analysis. J Affect Disord 2025; 381:436-450. [PMID: 40180048 DOI: 10.1016/j.jad.2025.03.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 03/19/2025] [Accepted: 03/30/2025] [Indexed: 04/05/2025]
Abstract
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.
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Affiliation(s)
| | | | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Sadeghi H, Bakht M, Khanjani S, Aslanimehr M, Nikkhahi F, Fardsanei F, Maleki MR, Rahimi S, Gholamzadeh Khoei S. Systematic review and meta-analysis on the prevalence of extended-spectrum β-lactamases-producing Acinetobacter baumannii in Iran: Evaluation of TEM, PER, SHV, CTX-M, VEB and GES. Microb Pathog 2025; 204:107554. [PMID: 40194610 DOI: 10.1016/j.micpath.2025.107554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 02/10/2025] [Accepted: 04/05/2025] [Indexed: 04/09/2025]
Abstract
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.
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Affiliation(s)
- Hamid Sadeghi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mehdi Bakht
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Susan Khanjani
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Masoumeh Aslanimehr
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farhad Nikkhahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Fardsanei
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Reza Maleki
- Clinical Research Development Unit, Kowsar Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sara Rahimi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeideh Gholamzadeh Khoei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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7
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Cao A, Lewis M, Tsuji S, Bergmann C, Cristia A, Frank MC. Estimating Age-Related Change in Infants' Linguistic and Cognitive Development Using (Meta-)Meta-Analysis. Dev Sci 2025; 28:e70028. [PMID: 40353560 DOI: 10.1111/desc.70028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 04/21/2025] [Accepted: 04/22/2025] [Indexed: 05/14/2025]
Abstract
Developmental psychology focuses on how psychological constructs change with age. In cognitive development research, however, the specifics of this emergence is often underspecified. Researchers often provisionally assume linear growth by including chronological age as a predictor in regression models. In this work, we aim to evaluate this assumption by examining the functional form of age trajectories across 25 phenomena in early linguistic and cognitive development by combining the results of multiple meta-analyses in Metalab, an open database. Surprisingly, for most meta-analyses, the effect size for the phenomenon did not change meaningfully across age. We investigated four possible hypotheses explaining this pattern: (1) age-related selection bias against younger infants; (2) methodological adaptation for older infants; (3) change in only a subset of conditions; and (4) positive growth only after infancy. None of these explained the lack of age-related growth in most datasets. Our work challenges the assumption of linear growth in early cognitive development and suggests the importance of uniform measurement across children of different ages.
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Affiliation(s)
| | | | - Sho Tsuji
- École Normale Supérieure - PSL, Paris, France
| | - Christina Bergmann
- Hochschule Osnabrück, Osnabrück, Germany
- Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
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8
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Kumar P, Hama S, Cheung HYW, Hadjichristodoulou C, Mouchtouri VA, Anagnostopoulos L, Kourentis L, Wang Z, Galea ER, Ewer J, Grandison A, Jia F, Siilin N. Airborne pathogen monitoring and dispersion modelling on passenger ships: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2025; 980:179571. [PMID: 40318375 DOI: 10.1016/j.scitotenv.2025.179571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Revised: 04/08/2025] [Accepted: 04/28/2025] [Indexed: 05/07/2025]
Abstract
The COVID-19 pandemic demonstrated a profound inability of pre-pandemic passenger ship policies implemented by both ship operators and governmental authorities to detect and address newly emerging diseases. The essentiality of maritime transport puts into focus the risk of approach to address known and new emerging airborne infectious diseases that, due to increasing capacity, are likely to occur on passenger ships. In order to enhance the passenger experience, prepare shipping for pandemics like COVID-19, and improve the resilience and safety of the industry, this review critically synthesises existing literature on (1) monitoring ventilation conditions and aerosol dispersion, linking them to airborne transmission risk using airborne aerosols and ventilation performance as input parameters for computational fluid dynamics (CFD) simulations, and (2) modelling airborne disease transmission risk in controlled passenger ship environments. This review analysed 39 studies on aerosol monitoring, thermal comfort, and infection risk modelling on passenger ships (2000-2023). Additionally, 55 papers on CFD modelling of airborne pathogen dispersion were reviewed: 22 included validation, with most focused on built environments and only four specifically addressing ship environments. Two major challenges relate to the complexity and poorly characterised ventilation boundary conditions on passenger ships, and the other is the lack of suitable validation data. For this reason, ship experimental studies are required for CFD model validation. Only a handful of studies were found that have measured aerosol concentrations on board passenger ships. To the best of our knowledge, there have been no studies conducted on aerosol mass or airborne transmission sampling on board passenger ships or other types of vessels. The results of this review have the potential to create synergistic connections between experimental and modelling studies to inform, characterise and improve the development of numerical models that can accurately estimate infection risk on ships for prevention, mitigation and management of outbreaks.
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Affiliation(s)
- Prashant Kumar
- Global Centre for Clean Air Research (GCARE), School of Engineering, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Institute for Sustainability, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom.
| | - Sarkawt Hama
- Global Centre for Clean Air Research (GCARE), School of Engineering, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Ho Yin Wickson Cheung
- Global Centre for Clean Air Research (GCARE), School of Engineering, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
| | | | - Varvara A Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece
| | - Leonidas Kourentis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece
| | - Zhaozhi Wang
- Fire Safety Engineering Group, School of Computing and Mathematical Sciences, Faculty of Engineering and Science, University of Greenwich, Greenwich SE10 9LS, United Kingdom
| | - Edwin R Galea
- Fire Safety Engineering Group, School of Computing and Mathematical Sciences, Faculty of Engineering and Science, University of Greenwich, Greenwich SE10 9LS, United Kingdom
| | - John Ewer
- Fire Safety Engineering Group, School of Computing and Mathematical Sciences, Faculty of Engineering and Science, University of Greenwich, Greenwich SE10 9LS, United Kingdom
| | - Angus Grandison
- Fire Safety Engineering Group, School of Computing and Mathematical Sciences, Faculty of Engineering and Science, University of Greenwich, Greenwich SE10 9LS, United Kingdom
| | - Fuchen Jia
- Fire Safety Engineering Group, School of Computing and Mathematical Sciences, Faculty of Engineering and Science, University of Greenwich, Greenwich SE10 9LS, United Kingdom
| | - Niko Siilin
- VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland; Aalto University, Department of Civil Engineering, 00076 Espoo, Finland
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Lee LZY, Nicholson P, Gerber K, Naicker R, Hutchinson AM. PROTOCOL: Understanding Intergenerational Programmes to Improve the Psychosocial Health and Well-Being of Older Adults in Residential Aged Care: A Rapid Realist Review Protocol. CAMPBELL SYSTEMATIC REVIEWS 2025; 21:e70023. [PMID: 40201335 PMCID: PMC11976665 DOI: 10.1002/cl2.70023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 12/16/2024] [Accepted: 01/29/2025] [Indexed: 04/10/2025]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows. The aim of this study is to briefly outline the objectives of the proposed review. While Campbell systematic reviews might be motivated by many reasons, their overarching aim should be to gather, summarise and integrate empirical research so as to help people understand the evidence.
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Affiliation(s)
- Lysha Z. Y. Lee
- School of Nursing & Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin UniversityMelbourneVictoriaAustralia
- National Ageing Research InstituteMelbourneVictoriaAustralia
| | - Patricia Nicholson
- School of Nursing & Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin UniversityMelbourneVictoriaAustralia
| | - Katrin Gerber
- National Ageing Research InstituteMelbourneVictoriaAustralia
- Faculty of Medicine, Dentistry and Health Sciences, The University of MelbourneMelbourneVictoriaAustralia
| | - Ramona Naicker
- Library, Outreach and Scholarly ServicesDeakin UniversityMelbourneVictoriaAustralia
| | - Alison M. Hutchinson
- School of Nursing & Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin UniversityMelbourneVictoriaAustralia
- Barwon HealthGeelongVictoriaAustralia
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Shankar R, Bundele A, Mukhopadhyay A. Effectiveness of Chatbot interventions for reducing caregiver burden: Protocol for a systematic review and meta-analysis. MethodsX 2025; 14:103272. [PMID: 40201159 PMCID: PMC11978356 DOI: 10.1016/j.mex.2025.103272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 03/14/2025] [Indexed: 04/10/2025] Open
Abstract
This protocol outlines a systematic review and meta-analysis examining the effectiveness of fully automated, AI-driven chatbot interventions in reducing subjective burden among informal caregivers. We will search 8 electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, PsycINFO, Scopus) and grey literature sources from January 2010 to December 2024 for randomized controlled trials (RCTs) meeting predefined eligibility criteria. The primary outcome is caregiver burden, assessed using validated scales such as the Zarit Burden Interview. Secondary outcomes encompass caregiver mental health, quality of life, self-efficacy and care recipient status. Two reviewers will independently perform study selection, data extraction, risk of bias evaluation using Cochrane RoB 2 tool, and appraise certainty of evidence utilizing the GRADE approach. We will conduct random-effects meta-analyses, subgroup analyses, and meta-regression to compute pooled effect estimates and explore heterogeneity. If quantitative synthesis is precluded, narrative synthesis will be undertaken following SWiM guideline. Caregiver partners will provide input on interpretation and dissemination of findings.•Protocol adheres to PRISMA-P reporting standards and will be prospectively registered in PROSPERO•Graphviz code for replicating the systematic review methodology diagram is provided•Review will yield critical evidence to guide development and implementation of chatbots into caregiver support services.
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Affiliation(s)
- Ravi Shankar
- Research and Innovation, Medical Affairs, Alexandra Hospital, Singapore, Singapore
| | - Anjali Bundele
- Research and Innovation, Medical Affairs, Alexandra Hospital, Singapore, Singapore
| | - Amartya Mukhopadhyay
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
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11
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Steijger D, Christie H, Aarts S, IJselsteijn W, Verbeek H, de Vugt M. Use of artificial intelligence to support quality of life of people with dementia: A scoping review. Ageing Res Rev 2025; 108:102741. [PMID: 40188991 DOI: 10.1016/j.arr.2025.102741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 03/28/2025] [Accepted: 03/30/2025] [Indexed: 04/09/2025]
Abstract
BACKGROUND Dementia has an impact on the quality of life (QoL) of people with dementia. Tailored services are crucial for improving their QoL. Advances in artificial intelligence (AI) offer opportunities for personalised care, potentially delaying institutionalisation and enhancing QoL. However, AI's specific role in approaches to support QoL for people with dementia remains unclear. This scoping review aims to synthesise the scientific evidence and grey literature on how AI can support the QoL of people with dementia. METHOD Following Joanna Briggs Institute guidelines, we searched PubMed, Scopus, ACM Digital Library, and Google Scholar in January 2024. Studies on AI, QoL (using Lawton's four-domain QoL definition), and people with dementia across various care settings were included. Two reviewers conducted a two-stage screening, and a narrative synthesis identified common themes arising from the individual studies to address the research question. RESULTS The search yielded 5.467 studies, after screening, thirty studies were included. Three AI categories were identified: monitoring systems, social robots, and AI approaches for performing activities of daily living. Most studies were feasibility studies, with little active involvement of people with dementia during the research process. Most AI-based approaches were monitoring systems targeting Lawton's behavioural competence (capacity for independent functioning) domain. CONCLUSION This review highlights that AI applications for enhancing QoL in people with dementia are still in early development, with research largely limited to small-scale feasibility studies rather than demonstrating clinical effectiveness. While AI holds promise, further exploration and rigorous real-world validation are needed before AI can meaningfully impact the daily lives of people with dementia.
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Affiliation(s)
- Dirk Steijger
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Health Service Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; The Living Lab in Ageing & Long-Term Care, Maastricht, the Netherlands.
| | - Hannah Christie
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sil Aarts
- Department of Health Service Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; The Living Lab in Ageing & Long-Term Care, Maastricht, the Netherlands
| | - Wijnand IJselsteijn
- Human-Technology Interaction, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Hilde Verbeek
- Department of Health Service Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; The Living Lab in Ageing & Long-Term Care, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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12
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Chang T, Chan Y, Chao T, Lin C, Lin Y, Chang S, Lo L, Hu Y, Chung F, Chen S. Efficacy and safety of non-vitamin K antagonist oral anticoagulants versus warfarin in atrial fibrillation and kidney failure under hemodialysis: A meta-analysis of controlled randomized trials. J Arrhythm 2025; 41:e70094. [PMID: 40390785 PMCID: PMC12087299 DOI: 10.1002/joa3.70094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Revised: 04/23/2025] [Accepted: 05/07/2025] [Indexed: 05/21/2025] Open
Abstract
Background Atrial fibrillation (AF)-related strokes are associated with disability and mortality. Stroke prevention with non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) is the cornerstone of holistic management of AF. However, the safety and efficacy of NOACs in patients with AF on hemodialysis remain uncertain. This meta-analysis aimed to evaluate currently available data to determine the potential utility of NOACs in AF patients with kidney failure receiving hemodialysis. Methods We searched the literature for randomized clinical trials comparing NOACs to VKA therapy in this population. Results About the Principal Efficacy Outcome, NOACs Did Not Decrease the Risk Compared to Warfarin (Relative Risk [RR] 0.79, 95% CI 0.45-1.37) while a Significant Heterogeneity Was Noted (p = 0.03). In the Valkyrie Study, Rivaroxaban Had better Cardiovascular Outcome than Warfarin (RR 0.57, 95% CI 0.43-0.75). For the Principal Safety Outcome, the Risk Was Similar between NOACs and Warfarin (RR 0.81, 95% CI 0.52-1.27) without Significant Heterogeneity (p = 0.11). The Pooled Event Rate of 3 Trials Disclosed a High Risk of all-Cause Mortality (39.9% for NOACs, 34.6% for Warfarin) and Cardiovascular Mortality (10.1% for NOACs, 8.5% for Warfarin) for AF Patients with Kidney Failure Receiving Hemodialysis Even on Oral Anticoagulants. Conclusion Our results suggest that NOACs (rivaroxaban or apixaban) are as safe and effective as VKAs in patients with AF and kidney failure with hemodialysis. Even on oral anticoagulants, these patients remain at high risk of cardiovascular events and all-cause mortality. Integrated care and holistic management are important for this high-risk population.
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Affiliation(s)
- Ting‐Yung Chang
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
- National Taipei University of Nursing and Health SciencesTaipeiTaiwan
| | - Yi‐Hsin Chan
- The Cardiovascular DepartmentChang Gung Memorial HospitalTaoyuanTaiwan
- College of Medicine, Chang Gung UniversityTaoyuanTaiwan
- Microscopy Core LaboratoryChang Gung Memorial HospitalTaoyuanTaiwan
| | - Tze‐Fan Chao
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Chin‐Yu Lin
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Yenn‐Jiang Lin
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Shih‐Lin Chang
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Li‐Wei Lo
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Yu‐Feng Hu
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Fa‐Po Chung
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Shih‐Ann Chen
- Heart Rhythm Center, Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Division of CardiologyTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Cardiovascular CenterTaichung Veterans General HospitalTaichungTaiwan
- National Chung Hsing UniversityTaichungTaiwan
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13
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Alshehri D, Noman N, Chiong R, Miah SJ, Sverdlov AL, Ngo DT. Factors influencing the adoption of Internet of Medical Things for remote patient monitoring: A systematic literature review. Comput Biol Med 2025; 192:110142. [PMID: 40375424 DOI: 10.1016/j.compbiomed.2025.110142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 04/02/2025] [Accepted: 04/03/2025] [Indexed: 05/18/2025]
Abstract
The Internet of Medical Things (IoMT) is a network of interconnected medical devices and applications aiming to facilitate real-time data sharing and personalised patient care. IoMT devices collect vast amounts of data, which are then analysed using advanced computational methods. Real-time patient monitoring is crucial, particularly for people with chronic diseases and older adults. Moreover, traditional in-person monitoring by healthcare providers can be resource-intensive and time-consuming. By leveraging IoMT technology for remote patient monitoring (RPM), healthcare providers can improve service quality, reduce costs and enhance patient care. To evaluate the current state of knowledge and address research gaps in IoMT adoption for RPM, we conducted a thorough systematic literature review (SLR). This SLR aims to provide a comprehensive overview of existing research, identify knowledge gaps, and analyse the factors that influence IoMT adoption. It follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. PRISMA guidelines allow us to systematically evaluate and synthesise the current state of relevant literature. After analysing the theoretical models used in previous studies on IoMT adoption for RPM, UTAUT2 was identified as the most effective framework for technology adoption in this area. Additionally, this SLR has identified the key factors influencing the adoption of IoMT technology, including privacy, trust, security, and perceived risk, and suggested their inclusion in future studies by analysing and integrating the findings of other studies. As much of the current research focuses solely on patient viewpoints, our SLR points to the necessity of giving equal weight to the opinions of both patients and healthcare professionals. To create IoMT systems that are more effective and inclusive, these deficiencies must be filled. This study will benefit researchers, healthcare professionals, policymakers and technology developers by offering insights to inform decision-making, guide future research and aid the development of effective IoMT solutions for RPM.
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Affiliation(s)
- Dalal Alshehri
- School of Information and Physical Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia; Department of Information Technology, King Abdulaziz University, Rabigh, 21911, Saudi Arabia
| | - Nasimul Noman
- School of Information and Physical Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Raymond Chiong
- School of Information and Physical Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia; School of Science and Technology, The University of New England, Parramatta, NSW, 2150, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Shah J Miah
- Newcastle Business School, The University of Newcastle, Newcastle, NSW, 2300, Australia
| | - Aaron L Sverdlov
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia; Cardiovascular Department, John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia; Heart & Stroke Program, Hunter Medical Research Institute, New Lambton, NSW, 2305, Australia
| | - Doan Tm Ngo
- Heart & Stroke Program, Hunter Medical Research Institute, New Lambton, NSW, 2305, Australia; School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, 2308, Australia
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14
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Vahey N, Nicholson E, Barnes-Holmes D. A decade on: Reflecting on the limitations of the first meta-analysis of the Implicit Relational Assessment Procedure's (IRAP) criterion validity in the clinical domain. J Behav Ther Exp Psychiatry 2025; 87:102016. [PMID: 39904709 DOI: 10.1016/j.jbtep.2024.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 12/12/2024] [Indexed: 02/06/2025]
Abstract
Hussey (in press) recently conducted a detailed critical reanalysis of Vahey, Nicholson and Barnes-Holmes' (2015) meta-analysis. Its stated purpose was to (a) examine the extent to which Vahey et al.'s (2015) meta-analysis contains errors; and (b) to test how computationally reproducible it is by current standards of best practice. Hussey identified a small number of minor numerical errors, but crucially was unable to exactly replicate the original meta-effect of r‾ = .45. Six different variations of the meta-analysis reported by Vahey et al. were used and obtained meta-effects that deviated from the original by Δr‾ = .01-.02. Hussey also reported corresponding 95% credibility intervals that were all of zero width. These discrepancies prompted the present authors to conduct a detailed audit of the original meta-analysis. This revealed one minor transposing error in addition to three identified by Hussey. Once corrected this resulted in a marginally increased Hunter and Schmidt meta-analytic effect of r‾ = .46 without a credibility interval, and a Hedges-Vevea meta-effect of r‾ = .47 with 95% confidence interval (.40, .54). This correction was too small to have any bearing on Vahey et al.'s supplementary analyses regarding publication bias or statistical power. Vahey et al. contained a much lower proportion of transposing errors than is typical of meta-analyses even still (cf. Kadlec, Sainani, & Nimphius, 2023; Lakens et al., 2016; Lakens et al., 2017). Nonetheless, Hussey highlighted important ambiguities about the theoretical and practical meaning of the meta-effect reported by Vahey et al. We clarify our position on these matters in summary, and in so doing explain why we believe that the wider IRAP literature would undoubtedly benefit from increased adoption of contemporary open science standards.
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15
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R P R, Rao BK, Rao SBG, Gudi N, Parsekar S, Mani R. Prevalence of oculomotor, binocular vision anomalies and refractive error among children with cerebral palsy in WHO South-East Asia: A protocol of systematic review and meta-analysis. MethodsX 2025; 14:103241. [PMID: 40103775 PMCID: PMC11919324 DOI: 10.1016/j.mex.2025.103241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Accepted: 02/19/2025] [Indexed: 03/20/2025] Open
Abstract
Introduction Children with cerebral palsy (CP) may experience a variety of visual abnormalities, which might hamper their daily activities. Most physical therapy for the CP population focuses on visual aspects, which postpone rehabilitation outcomes. Considering the significance of vision to the CP community, we aimed to conduct a systematic review of the prevalence of ocular abnormalities such as oculomotor abnormalities, refractive errors, and binocular vision anomalies in children with Cerebral palsy in the absence of eye injury in WHO South-East Asia region. Methods & analysis This systematic review and meta-analysis protocol are reported as per the PRISMA- P and MOOSE guidelines. A complete search strategy will be framed using MeSH terms and the opinion of the subject expert. A detailed search on PubMed, the Cochrane Library, Scopus, Web of Science and CINHAL will be carried out to retract the data on the prevalence of visual problems in the CP population (age< 18 years), published in English between January 2010 and 2024. Covidence software will be used to manage data, screen records and extract the information. The Newcastle-Ottawa Scale will be used to evaluate the listed studies quality and risk of bias. RevMan V.5 will be used to analyse the data.
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Affiliation(s)
- Radhika R P
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | | | - Nachiket Gudi
- MPH, Program Officer, Digital Health Division, PATH, Delhi, India
| | | | - Revathy Mani
- School of Optometry &Science, UNSW, Sydney, Australia
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16
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Birkenhead P, Birkenhead PJ, Vella C, Laubscher M, Maqungo S, Graham SM. Outcomes of femoral shaft fractures in Sub-Saharan Africa: A systematic review. INTERNATIONAL ORTHOPAEDICS 2025; 49:1499-1508. [PMID: 40053064 DOI: 10.1007/s00264-025-06407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Accepted: 01/02/2025] [Indexed: 05/14/2025]
Abstract
PURPOSE Femoral shaft fractures are significant injuries and if not managed appropriately can result in high complication rates and long-term disability. These complex injuries occur at a higher rate across low and middle income countries and sub-Saharan Africa is thought to have a higher incidence than other regions across the world. This study aims to summarise the most up to date evidence surrounding the treatment and associated outcomes of adult femoral shaft fractures in sub-Saharan Africa - giving a clear understanding of current practices and highlighting potential areas for further research. METHODS PubMed, Google Scholar, Africa Journals Online, Cochrane, Clinicaltrial.gov were searched using Boolean search strategies. Data collected included demographics, fracture classification, interventions, union rates, time to union, patient-reported outcomes / functional outcome scores, and secondary outcomes (orthopaedic and medical complications, malunion / non-union, length of admission). RESULTS Twenty-three studies reporting 2,180 patients were included-73% (1592/2180) of patients were male, with a mean age of 35 years. Overall, 59% of patients were treated with intramedullary nailing (IMN), 23% with skeletal traction, and 14% with open reduction internal fixation (ORIF). There was a heterogeneity in practice in different regions, with the highest reported rates of IMN in Tanzania (99%), and lowest in Malawi (29.4%). Union rates were highest in IMN (82.4-100%) versus traction (48 - 100%) and ORIF (83.3-87%). Intramedullary nailing demonstrated a super complication profile, with better functional outcomes, shorter hospital stays and time to mobilisation. CONCLUSION Intramedullary nailing demonstrated superior clinical and functional outcomes compared to other modalities for the treatment of femur shaft fractures across sub-Saharan Africa. However, there is significant sparsity of research and variable management approaches across the region. Focused research to determine the burden of injury, current healthcare resources and cost-effective and appropriate interventions to improve outcomes are now a public health priority.
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Affiliation(s)
- Patrick Birkenhead
- Liverpool Orthopaedic and Trauma Service, Liverpool University Teaching Hospital Trust, Liverpool, UK
| | - Paul Joseph Birkenhead
- Liverpool Orthopaedic and Trauma Service, Liverpool University Teaching Hospital Trust, Liverpool, UK
| | - Clara Vella
- Liverpool Orthopaedic and Trauma Service, Liverpool University Teaching Hospital Trust, Liverpool, UK
| | - Maritz Laubscher
- Division of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
- University of Cape Town, Rondebosch, South Africa
| | - Sithombo Maqungo
- Division of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
- University of Cape Town, Rondebosch, South Africa
| | - Simon Matthew Graham
- Liverpool Orthopaedic and Trauma Service, Liverpool University Teaching Hospital Trust, Liverpool, UK.
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- NIHR Global Health Research Group on Global Injury, Oxford, UK.
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Gutierrez-Arias R, Fernández-Fuentes J, Ríos-Ossandón J, Vásquez-Gatica F, Yáñez-Cartes M, Guajardo-Latorre N, Moreno-Huircaleo A, Salinas-Barahona F, Seron P. Postoperative physiotherapy interventions in hospitalized adults undergoing pulmonary resection surgery. A protocol for a scoping review. MethodsX 2025; 14:103349. [DOI: 10.1016/j.mex.2025.103349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2025] Open
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18
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Yang L, Hu FX, Wang K, Wang ZZ, Yang J. Association of sleep duration with hypertension in young and middle-aged adults: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2025; 25:200387. [PMID: 40129525 PMCID: PMC11929947 DOI: 10.1016/j.ijcrp.2025.200387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 01/09/2025] [Accepted: 03/05/2025] [Indexed: 03/26/2025]
Abstract
Background Hypertension is a primary risk factor for cardiovascular and cerebrovascular diseases. A number of studies have suggested that sleep duration play an important role in the development of hypertension. Hypertension in young and middle-aged individuals is characterized by low awareness and treatment rates, increasing the risk of adverse events. To further elucidate the relationship between sleep duration and hypertension risk in young and middle-aged individuals, we conducted a meta-analysis. Methods This study searched PubMed, Embase, and the Cochrane Library from January 2003 to November 5, 2023. Data analysis was performed using STATA 17. Using Q test and I2-statistic, heterogeneity test for the included studies was conducted. Potential small-sample effects were evaluated based on the symmetry of funnel plots, and publication bias in included studies was evaluated using Egger's test. Results Data analysis of sleep duration was conducted for 16 studies, which revealed that both long sleep duration (OR, 1.10; 95 % CI, 1.05-1.15) and short sleep duration (RR: 1.10, 95 % CI: 1.05 to 1.15) were associated with hypertension in young and middle-aged individuals, particularly in Asian populations. Conclusions This meta-analysis revealed an association between sleep duration (short [<7 h] and long [≥9 h]) and the development of hypertension in young and middle-aged adults, particularly in Asian populations. Sleep is a behavior that can be modified. Clinicians and health professionals should be encouraged to intensify efforts to promote healthy sleep for all and reduce the occurrence of high blood pressure in young and middle-aged individuals.
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Affiliation(s)
- Lei Yang
- Shandong University of Traditional Chinese Medicine, 250014, Jinan, China
| | - Fang-Xiao Hu
- Shandong University of Traditional Chinese Medicine, 250014, Jinan, China
| | - Kun Wang
- Shandong University of Traditional Chinese Medicine, 250014, Jinan, China
| | - Zhi-Zheng Wang
- Shandong University of Traditional Chinese Medicine, 250014, Jinan, China
| | - Jie Yang
- Department of Cardiovascular, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
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Wiley L, Cheek M, LaFar E, Ma X, Sekowski J, Tanguturi N, Iltis A. The Ethics of Human Embryo Editing via CRISPR-Cas9 Technology: A Systematic Review of Ethical Arguments, Reasons, and Concerns. HEC Forum 2025; 37:267-303. [PMID: 39302534 PMCID: PMC12014773 DOI: 10.1007/s10730-024-09538-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2024] [Indexed: 09/22/2024]
Abstract
The possibility of editing the genomes of human embryos has generated significant discussion and interest as a matter of science and ethics. While it holds significant promise to prevent or treat disease, research on and potential clinical applications of human embryo editing also raise ethical, regulatory, and safety concerns. This systematic review included 223 publications to identify the ethical arguments, reasons, and concerns that have been offered for and against the editing of human embryos using CRISPR-Cas9 technology. We identified six major themes: risk/harm; potential benefit; oversight; informed consent; justice, equity, and other social considerations; and eugenics. We explore these themes and provide an overview and analysis of the critical points in the current literature.
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Affiliation(s)
- Lindsay Wiley
- Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA
| | - Mattison Cheek
- Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA
| | - Emily LaFar
- Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA
| | - Xiaolu Ma
- Department of Communication Studies, University of Minnesota, Minneapolis, USA
| | - Justin Sekowski
- Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA
| | - Nikki Tanguturi
- Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA
| | - Ana Iltis
- Department of Philosophy, Wake Forest University Center for Bioethics, Health and Society, Winston-Salem, USA.
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20
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Oaks BM, Gyimah EA, Kleban E, Ragsdale K, Iannotti LL. Mollusc and crustacean consumption in the first 1000 days: a scoping review. Nutr Res Rev 2025; 38:181-191. [PMID: 38343136 DOI: 10.1017/s0954422424000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Mollusc and crustacean consumption in the first 1000 d may improve maternal and child health by providing essential nutrients. However, in some contexts, molluscs and crustaceans have been associated with allergies and environmental contamination, potentially leading to adverse health and development outcomes. It is unclear whether the health benefits of consuming molluscs and crustaceans, collectively classified as shellfish in nutrition, are outweighed by the potential risks to pregnant women and children. We conducted a scoping review (PROSPERO: CRD42022320454) in PubMed, Scopus and EBSCO Global Health of articles published between January 2000 and March 2022 that assessed shellfish consumption during pregnancy, lactation or childhood (0-2 years) in relation to maternal health, child health or child development. A total of forty-six articles were included in this review. Overall, shellfish consumption was associated with higher biomarkers of environmental contaminants, with mercury being the most studied and having the strongest evidence base. The limited research on nutritional biomarker status shows an association between shellfish consumption and iodine status. Preterm birth was not associated with shellfish consumption, but newborn anthropometry showed mixed results, with several studies reporting lower birth weight with higher shellfish consumption. The few studies that examined child development and maternal health outcomes reported no significant associations. This review revealed trade-off health risks and benefits with inclusion of molluscs and crustaceans in the dietary patterns of mothers and young children. More research is needed to understand how these aquatic animal-source foods may be safely consumed and leveraged for improving human nutrition.
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Affiliation(s)
- Brietta M Oaks
- Department of Nutrition, University of Rhode Island, Kingston, RI, USA
| | - Emmanuel A Gyimah
- Institute for Global Nutrition, University of California, Davis, CA, USA
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Eliza Kleban
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Kathleen Ragsdale
- Social Science Research Center, Mississippi State University, Mississippi State, MS, USA
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
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21
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Vieira F, Caliman-Fontes AT, Souza-Marques B, Faria-Guimarães D, Lins-Silva DH, Santos-Lima C, Jesus-Nunes AP, Quarantini LC. Measuring suicidal behavior in the era of rapid-acting antidepressants: A systematic review of ketamine studies. Psychiatry Res 2025; 348:116443. [PMID: 40121819 DOI: 10.1016/j.psychres.2025.116443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 03/08/2025] [Accepted: 03/12/2025] [Indexed: 03/25/2025]
Abstract
Assessment measures for suicidal behavior range from depression scales to longer suicide-specific instruments. In this review, we systematically summarize and discuss the currently used instruments for assessing suicidal behavior in the context of ketamine and its enantiomers. We searched Medline/PubMed, Embase, and PsycINFO databases for ketamine (and its enantiomers) human studies exploring this drug's antisuicidal effects on major depressive disorder patients, published from February 2000 to June 2023. Forty-six studies were included, identifying 16 assessment tools, mostly explicit and clinician-rated measures. Prominent tools included the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), and both the clinician and patient-rated Beck Scales for Suicide Ideation (SSI and BSS). With the exception of the Suicide Ideation and Behavior Assessment Tool (SIBAT), to the best of our knowledge, no other instrument that assesses suicidality seems to be specifically developed for measuring treatment response in rapid-acting antidepressants trials. Most scales have been validated in conventional antidepressant or psychotherapy contexts, though, for MADRS, as well as for SSI, BDI, and HAM-D, efforts have been made towards investigating their psychometric properties in the field of rapid-acting antidepressants. The heterogeneity of suicidal behavior assessment in ketamine studies may hinder adequate comparisons between them. Although there does not seem to be a universally preferable instrument for measuring suicidal behavior to date, the MADRS potentially emerges as an adequately recommended choice.
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Affiliation(s)
- Flávia Vieira
- Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil; Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | - Ana Teresa Caliman-Fontes
- Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil; Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | - Breno Souza-Marques
- Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil; Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | | | - Daniel H Lins-Silva
- Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | - Cassio Santos-Lima
- Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil; Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | - Ana Paula Jesus-Nunes
- Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil
| | - Lucas C Quarantini
- Postgraduate Program in Medicine and Health, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil; Laboratory of Neuropsychopharmacology, Federal University of Bahia, Salvador, Brazil.
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Papazisi O, van der Schoot MM, Berendsen RR, Arbous SM, le Cessie S, Dekkers OM, Klautz RJM, Marczin N, Palmen M, de Waal EEC. Vasoplegia in Cardiac Surgery: A Systematic Review and Meta-analysis of Current Definitions and Their Influence on Clinical Outcomes. J Cardiothorac Vasc Anesth 2025; 39:1451-1463. [PMID: 40074583 DOI: 10.1053/j.jvca.2025.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Revised: 02/07/2025] [Accepted: 02/16/2025] [Indexed: 03/14/2025]
Abstract
OBJECTIVES To identify differences in the reported vasoplegia incidence, intensive care unit (ICU) length of stay (LOS), and 30-day mortality rates as influenced by different vasoplegia definitions used in cardiac surgery studies. DESIGN A systematic review was performed covering the period 1977 to 2023 using PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and Emcare and a meta-analysis (PROSPERO: CRD42021258328) was performed. SETTING AND PARTICIPANTS One hundred studies defining vasoplegia in cardiac surgery patients were systematically reviewed. Sixty studies with 20 or more patients, irrespective of design, reporting vasoplegia incidence, ICU LOS, or 30-day mortality were included for meta-analysis. INTERVENTIONS Cardiac surgery on cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS Studies were categorized depending on the used mean arterial pressure (MAP) thresholds. Random intercept logistic regression models were used for meta-analysis of incidence and mortality. Random effect meta-analysis was used for ICU LOS. One hundred studies were reviewed systematically. MAP and cardiac index thresholds varied considerably (<50-80 mmHg and 2.0-3.5 L·min-1m-2, respectively). Vasopressor dosages also differed between definitions. The reported incidence (60 studies; mean incidence, 19.9%; 95% confidence interval [CI], 16.1-24.4) varied largely between studies (2.5%-66.3%; I2 = 97%; p < 0.0001). Meta-regression models, including the MAP-threshold, did not explain this heterogeneity. Similarly, the effect of vasoplegia on ICU LOS, and 30-day mortality was very heterogeneous among studies (I2 = 99% and I2 = 73%, respectively). CONCLUSIONS The large variability in vasoplegia definitions is associated with significant heterogeneity regarding incidence and clinical outcomes, which cannot be explained by factors included in our models. Such variations in definitions leads to inconsistent patient diagnosis and renders published vasoplegia research incomparable.
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Affiliation(s)
- Olga Papazisi
- Department of Cardiothoracic surgery, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Remco R Berendsen
- Department of Anesthesiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sesmu M Arbous
- Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Olaf M Dekkers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert J M Klautz
- Department of Cardiothoracic surgery, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiothoracic surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Nandor Marczin
- Division of Anaesthesia, Pain Medicine and Intensive Care, Imperial College London, Royal Brompton & Harefield Hospitals, Guy's & St. Thomas' NHS, London, United Kingdom; Department of Anesthesia and Intensive Care, Semmelweis University, Budapest, Hungary
| | - Meindert Palmen
- Department of Cardiothoracic surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Eric E C de Waal
- Department of Anesthesiology, University Medical Center Utrecht, the Netherlands; Department of Cardiothoracic surgery, Leiden University Medical Center, Leiden, the Netherlands.
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Tipping NG, Campbell RJ, Khuong JN, Mostofi Zadeh Haghighi DL, Carty CP, Walsh HP. Anterior distal femoral hemiepiphysiodesis for knee flexion contracture in paediatric patients with neuromuscular disorders: A systematic review and meta- analysis. Gait Posture 2025; 119:222-228. [PMID: 40153888 DOI: 10.1016/j.gaitpost.2025.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 02/09/2025] [Accepted: 03/19/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND This meta-analysis assesses the effectiveness of ADFH in the operative management of knee flexion contracture in children with neuromuscular disorders. METHODS The study included 218 patients and assessed 340 knees. Patients had a median age of 11 years (age range 4-17 years) at initial evaluation. The mean follow up time was 25 months. RESULTS Gait deviation index improved by 8.49 points following ADFH (95 % CI 4.82-12.15, p < 0.01). Minimum flexion angle saw an overall improvement of 20.61 degrees (95 % CI 15.8 - 26.04, p < 0.001). Knee flexion contracture had an overall improvement of 11.74 degrees across (95 % CI 10.14-13.33, p < 0.001). Popliteal angle improved by 15.59 degrees overall following ADFH (95 % CI 7.57-23.60), p < 0.01). CONCLUSION Orthopaedic operations are known to improve knee kinematics and clinical examination findings in neuromuscular disorder patients. ADFH is effective in improving passive and dynamic sagittal knee function.
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Affiliation(s)
- Nicholas G Tipping
- Department of Orthopaedics, Monash Health, Dandenong, Victoria, Australia.
| | - Ryan J Campbell
- Department of Orthopaedics, Monash Health, Dandenong, Victoria, Australia; Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Medicine and Dentistry, Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia
| | - Jacqueline N Khuong
- Department of Orthopaedics, Monash Health, Dandenong, Victoria, Australia; Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Medicine and Dentistry, Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia
| | - David L Mostofi Zadeh Haghighi
- Department of Orthopaedics, Monash Health, Dandenong, Victoria, Australia; Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Medicine and Dentistry, Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia
| | - Christopher P Carty
- Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Medicine and Dentistry, Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia
| | - Henry Pj Walsh
- Griffith Center of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Australia
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24
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Disfani RA, Asghari A, Pouryousef A, Shamsi L, Farzam A, Ghafari-Cherati M, Bijani B, Maleki F. Comparative global epidemiology and species distribution of Sarcocystis spp. in new and old world camelids: A systematic review and meta-analysis. Comp Immunol Microbiol Infect Dis 2025; 120:102340. [PMID: 40300268 DOI: 10.1016/j.cimid.2025.102340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2025] [Revised: 04/08/2025] [Accepted: 04/22/2025] [Indexed: 05/01/2025]
Abstract
This study aimed to investigate the global prevalence, species diversity, and geographical distribution of Sarcocystis spp. in Old World Camelids (OWCs) and New World Camelids (NWCs). A comprehensive literature search was conducted across multiple databases, covering studies up to December 22, 2024. The analysis included 36 studies (28 on OWCs and 8 on NWCs), comprising data from 5942 camelids (4850 OWCs and 1092 NWCs) across 13 countries in three continents. A random-effects model was used to estimate pooled prevalence rates, and heterogeneity was assessed using the I² statistic. The overall prevalence of Sarcocystis spp. in camelids was 57.7 % (95 % CI: 49.4-65.6 %). NWCs exhibited a significantly higher pooled prevalence (77.6 %, 95 % CI: 55-90.8 %) compared to OWCs (55.1 %, 95 % CI: 46.4-63.6 %). The highest regional pooled prevalence was observed in South America (82.3 %), particularly in the WHO AMR region (82.3 %), with Peru reporting the highest pooled prevalence at 99.3 %. The oesophagus was the most frequently infected tissue. Four valid Sarcocystis species were identified in camelids: S. cameli and S. ippeni in OWCs, and S. aucheniae and S. masoni in NWCs. Many positive samples were classified only as Sarcocystis spp. Although none of these species poses a zoonotic risk, some like S. cameli and S. aucheniae are particularly significant due to their economic and veterinary impact on camelids. Their ability to form macroscopic cysts can negatively affect meat quality, leading to considerable economic losses in the camel industry. Targeted surveillance and control measures are recommended, particularly in high-prevalence regions.
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Affiliation(s)
- Reza Ataee Disfani
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Asghari
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Ali Pouryousef
- Leishmaniasis Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Laya Shamsi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Amir Farzam
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Behzad Bijani
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farajolah Maleki
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran; Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran.
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25
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Pang Y, Fu J, Tan Y, Zhang L, Bai L, Yan M, Li H, Wang X. Incidence and related factors of catheter-associated bloodstream infection in neonates: A systematic review and meta-analysis. Intensive Crit Care Nurs 2025; 88:103927. [PMID: 39733759 DOI: 10.1016/j.iccn.2024.103927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 12/01/2024] [Accepted: 12/02/2024] [Indexed: 12/31/2024]
Abstract
OBJECTIVE To identify the related factors of neonatal catheter-associated bloodstream infection (CABSI), and provide a basis for constructing a scientific and rational strategy for neonatal CABSI prevention. METHODS CNKI, Wanfang, PubMed, MEDLINE-Ovid, Web of Science, Embase, CINAHL, and Cochrane Library were searched for publications on neonatal CABSI from the time the database was established until September 30, 2023. The language of publications was not specified. Unpublished reports and gray studies were excluded. All cohort, case-control, and cross-sectional studies were included. A meta-analysis of the incidence and related factors of neonatal CABSI were made using Revman software. Heterogeneity was evaluated using the I2 statistic method, and the publication bias was analyzed with funnel plot tests. RESULTS A total of 35 studies involving 34,743 patients from 13 different countries were included. There were 15 case-control, 15 cohort, and 5 cross-sectional studies, with 14 related factors discussed. All the studies scored high (score ≥ 6) in their overall quality. According to the meta-analysis, the incidence of neonatal CABSI was 5.93/1000 catheter days (OR = 5.29). The risk factors were identified and ranked as follows according to the degree of influence: 5-minute Apgar score (OR = 4.69), the number of punctures during the stay of the line (OR = 3.49), male (OR = 3.17), mechanical ventilation (OR = 2.73), catheter repair (OR = 2.66), lower gestational age at birth (OR = 2.47), femoral vein catheter (OR = 1.92), dwell time of the catheter (OR = 1.34), and lower birth weight (OR = 1.05). Establishing sterile barrier throughout was a protective factor (OR = 0.41). Subgroup analysis suggested that the study design, catheter type and year of publication might be the primary sources of heterogeneity. The sensitivity analysis demonstrated the robustness of the results. However, the funnel plot indicated a potential publication bias. CONCLUSION Neonatal CABSI carries a significant morbidity rate and is influenced by numerous factors. IMPLICATIONS FOR CLINICAL PRACTICE It is crucial to underscore the necessity for additional longitudinal studies to explore evidence-based approaches to lowering the risk and ultimately reducing the incidence of CABSI. Registration The study protocol has been registered with the PROSPERO: CRD42023443697.
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Affiliation(s)
- Yan Pang
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China.
| | - Jinzhu Fu
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Ying Tan
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Lina Zhang
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Li Bai
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Miaomiao Yan
- Obstetrics Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Huimin Li
- Nursing Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
| | - Xin Wang
- Nursing Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731,China
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26
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Turker S, Fumagalli B, Kuhnke P, Hartwigsen G. The 'reading' brain: Meta-analytic insight into functional activation during reading in adults. Neurosci Biobehav Rev 2025; 173:106166. [PMID: 40254114 DOI: 10.1016/j.neubiorev.2025.106166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 04/07/2025] [Accepted: 04/15/2025] [Indexed: 04/22/2025]
Abstract
Literacy provides the key to social contacts, education, and employment, and significantly influences well-being and mental health. Summarizing 163 studies, the present coordinate-based meta-analysis confirms the importance of classical left-hemispheric language regions and the cerebellum across reading tasks. We found high processing specificity for letter, word, sentence, and text reading exclusively in left-hemispheric areas. Subregions within the left inferior frontal gyrus showed differential engagement for word and pseudoword reading, while subregions within the left temporo-occipital cortex showed differential engagement for words and sentences. The direct comparison of overt and covert reading revealed higher activation likelihood in auditory and motor regions during the first, and more consistent reliance on multiple demand regions during the latter. Last, silent word and pseudoword reading (explicit reading) yielded more consistent activation in left orbito-frontal, cerebellar and temporal cortices when compared to lexical decisions (implicit reading). Lexical decisions, in contrast, showed more consistent bilateral recruitment of inferior frontal and insular regions. The present meta-analysis significantly extends our understanding of the neural architecture underlying reading, corroborates findings from neurostimulation studies and can provide valuable neural insight into reading models.
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Affiliation(s)
- Sabrina Turker
- Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, Leipzig 04103, Germany; Brain and Language Lab, Department for Behavioral and Cognitive Biology, Department of Life Sciences, Vienna University, Austria.
| | - Beatrice Fumagalli
- Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, Leipzig 04103, Germany
| | - Philipp Kuhnke
- Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, Leipzig 04103, Germany; Cognitive and Biological Psychology, Wilhelm Wundt Institute for Psychology, Leipzig University, Neumarkt 9-19, 04109, Germany
| | - Gesa Hartwigsen
- Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, Leipzig 04103, Germany; Cognitive and Biological Psychology, Wilhelm Wundt Institute for Psychology, Leipzig University, Neumarkt 9-19, 04109, Germany
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27
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Fürtig MA, Kovalenko Y, Kreutz R, Riemer TG. Calcium channel blockers and mental health: a comprehensive meta-analysis of psychiatric adverse events in double-blind randomized controlled trials. J Hypertens 2025; 43:1049-1056. [PMID: 40156332 DOI: 10.1097/hjh.0000000000004011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 02/27/2025] [Indexed: 04/01/2025]
Abstract
OBJECTIVE L-type calcium channel blockers (CCBs) are pivotal in managing cardiovascular disorders, such as hypertension and angina pectoris. Their action on L-type calcium channels, which are not only integral to cardiovascular function but also present in the brain, prompts questions about potential effects on mental health. While previous cohort studies explored this association with mixed results, our study aims to build upon these findings by systematically investigating psychiatric adverse events (PAEs) reported in double-blind randomized controlled trials (RCTs). METHODS A systematic search identified double-blind RCTs reporting frequencies of PAEs during CCB therapy across different indications. Separate meta-analyses were conducted for dihydropyridine (DHP) and nondihydropyridine (non-DHP) CCBs against placebo and active controls. This study was registered on INPLASY (INPLASY202480075). RESULTS In 187 studies, encompassing 28,201 patients exposed to CCBs, several PAEs were reported, with the most common being depression, insomnia, somnolence, and agitation. Meta-analyses revealed no significant difference in PAE occurrence for CCBs vs. placebo, β-blockers, renin-angiotensin system blockers, and thiazide/thiazide-like diuretics (all P > 0.05). Restricting the analyses to cardiovascular studies, DHP CCBs were linked to lower risks of depression and insomnia compared to placebo [odds ratio (OR) 0.84, confidence interval (CI) 0.70-1.00 and OR 0.38, CI 0.15-0.99, both P = 0.05); however, these results may be artifacts and should be interpreted with caution. CONCLUSION Concerns about negative mental health effects of CCBs appear to be unwarranted and should not deter clinicians from prescribing them when indicated. A detected signal towards positive mental health benefits in cardiovascular patients warrants further investigation.
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Affiliation(s)
- Marc-Alexander Fürtig
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Yana Kovalenko
- Department of Psychology, Humboldt-Universität zu Berlin
| | - Reinhold Kreutz
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
| | - Thomas G Riemer
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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28
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Liu J, Li Y, Liu J, Zhang X. Efficacy of Acupuncture in Postoperative Pain-Relieving: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2025; 26:319-329. [PMID: 39814622 DOI: 10.1016/j.pmn.2024.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 12/11/2024] [Accepted: 12/23/2024] [Indexed: 01/18/2025]
Abstract
OBJECTIVES This study aimed to assess the efficacy of acupuncture in relieving postoperative pain. DESIGN Systematic review and meta-analysis. DATA SOURCES The search strategy was designed according to the PICOS principle (population, intervention, comparison, outcome, and study). PubMed, Web of Science, Cochrane Library, and Embase were searched from the inception of databases to August 25th, 2022 to collect studies on acupuncture in the management of postoperative pain. REVIEW METHODS Two researchers independently screened the searched studies using the EndNote X9 software. Relevant data were extracted, and the risk of bias in included studies was assessed. RevMan 5.4 software was used for data analysis, and the Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence. RESULTS A total of 25 studies were included. This meta-analysis showed statistically significant differences in the pain scores (SMD=-0.38, 95 %CI [-0.69, -0.07], p = .02) and the dosage of analgesics (SMD = -0.53, 95% CI [-0.99, -0.06], I2 = 90 %, p < .00001] between the acupuncture group and the control group. CONCLUSION Acupuncture is effective for alleviating postoperative pain and reducing the dosage of analgesics. More well-designed, and large-scale prospective studies are needed to further validate the efficacy of acupuncture in relieving postoperative pain. NURSING PRACTICE IMPLICATIONS Acupuncture is an acceptable choice for relieving postoperative pain since it is convenient, effective, and acceptable. Nurses can provide tailored guidance for patients to enhance their recovery and satisfaction.
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Affiliation(s)
- Jin Liu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
| | - Yinyin Li
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Junya Liu
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou China
| | - Xingshuo Zhang
- The First Rongjun Special Care Hospital of Hebei Province, Xingtai, China
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29
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Rahman A, Leifels K, Adakporia KO. Risk and Causative Factors of Psychological Harm Among Construction Workers: A Systematic Review. Workplace Health Saf 2025; 73:266-285. [PMID: 39846355 PMCID: PMC12022379 DOI: 10.1177/21650799241303529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2025]
Abstract
BACKGROUND The construction industry, known for its high-risk environment, increasingly acknowledges the psychological risks to workers. Despite well-documented physical hazards, mental health challenges within this workforce have garnered attention. This systematic review provides a scholarly synthesis of literature on psychological risks and their causative factors affecting construction workers, adhering to PRISMA protocols. METHODS An exhaustive literature search was conducted across PubMed, Scopus, PsycINFO, and Google Scholar using relevant keywords. Rigorous screening of selected studies focused on the psychological aspects of construction work, with systematic data extraction and analysis. FINDINGS From 1992 to 2022, 68 studies met inclusion criteria, identifying key psychological harm factors: job insecurity, long working hours, high demands, poor work-life balance, and workplace bullying. A lack of mental health support and awareness in the sector was noted, with a significant correlation between these factors and increased stress, anxiety, and depression levels among workers. CONCLUSIONS The review highlights the urgent need for industry recognition of psychological hazards and the relationship between work conditions and mental health issues. It calls for supportive policies, awareness programs, and counseling services, with a suggestion for future longitudinal research on the long-term impacts and intervention efficacy. APPLICATION TO PRACTICE This study provides an overview of psychological risks in the construction sector from 1994 to 2022, aiming to identify causative factors for mental health issues. It seeks to pave the way for targeted interventions and policy changes to improve mental health outcomes in the industry.
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30
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Tipton JF, Schulze C, Schnadthorst PG. Orthosis in the Treatment of Osteoporosis-associated Fractures and Chronic Symptoms in the Spine - a Systematic Review. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2025. [PMID: 40418979 DOI: 10.1055/a-2566-1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2025]
Abstract
Osteoporosis is a systemic skeletal disease of multi-aetiological origin and is a major factor in health economics. The reduction in bone mass and disruption of the microarchitecture lead to an increased risk of fracture. The therapy is versatile, with orthoses being used in the treatment of acute vertebral fractures as well as chronic pain.The aim of this work is to formulate evidence-based recommendations for the use of orthoses in osteoporotic vertebral fractures and chronic symptoms.The literature search was conducted according to the PRISMA protocol at PubMed, ScienceDirect, Cochrane and Google Scholar. The risk of bias of the studies was assessed using RoB2 for randomised studies and ROBINS-I for non-randomised studies. The level of evidence was determined according to AHCPR.A total of 18 studies were identified, with 11 studies focussing on the treatment of chronic back pain in osteoporosis and 7 studies on pain therapy for acute osteoporotic vertebral fractures. The non-RCTs matched 5× to evidence levels IIa. The risk of bias was 10× moderate, 4× severe and 3× critical. The RCTs could be divided by the following evidence levels: 10× Ib, 1× IIb, 1× III and 1× IV. The risk of bias was 10× moderate and 3× critical.In the case of chronic back pain, the use of orthoses leads to a reduction in pain and has a positive effect on back extensor strength, but a significant reduction in pain cannot be achieved in osteoporosis-associated vertebral body fractures. The currently available literature do not support the superiority of a specific type of orthosis.
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Affiliation(s)
- John Fitzgerald Tipton
- Klinik für Orthopädie und Unfallchirurgie, Plastische, Rekonstruktive und Handchirurgie, Bundeswehrkrankenhaus Westerstede, Westerstede, Deutschland
| | - Christoph Schulze
- Rehabilitation, Zentrum für Sportmedizin der Bundeswehr, Warendorf, Deutschland
- Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
- Universitätsinstitut für Physikalische Medizin und Allgemeine Rehabilitation, Universitätsklinik Salzburg LKH, Salzburg, Österreich
| | - Philipp Georg Schnadthorst
- Zentrale Notaufnahme, Klinik für Anästhesie, Intensiv- und Notfallmedizin, Schmerztherapie, Bundeswehrkrankenhaus Hamburg, Hamburg, Deutschland
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31
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Zhang X, Zhang X. Comparison of perioperative outcomes between robotic surgery and traditional laparoscopy for colorectal endometriosis: a systematic review and meta-analysis. J Robot Surg 2025; 19:239. [PMID: 40418406 DOI: 10.1007/s11701-025-02374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2025] [Accepted: 04/25/2025] [Indexed: 05/27/2025]
Abstract
Robotic-assisted surgery (RAS) offers a broader surgical field, enhanced visualization, and greater instrument maneuverability, suggesting potential advantages over traditional laparoscopic surgery (LPS), which is currently the gold standard for treating colorectal endometriosis. To address this gap, we conducted a comprehensive review of existing studies to compare the perioperative outcomes of RAS and LPS in the management of colorectal endometriosis. A comprehensive search was conducted in the databases of PubMed, Web of Science, the Cochrane Library, and SpringerLink to identify any studies that prior to February 2nd, 2025. To compare RAS to LPS for colorectal endometriosis, we looked at things like operation duration, expected blood loss, length of stay, conversion to laparotomy, all complications, and bowel endometriosis resection. The operative time for RAS in colorectal endometriosis resection was significantly longer than that for LPS (data aggregated from six studies; WMD 21.51 min, 95% CI 4.58-38.43, p < 0.05). However, there were no significant differences between the two groups in intraoperative blood loss (four studies; WMD 1.2 ml, 95% CI - 34.01-36.41, p = 0.95), length of hospital stay (four studies; WMD 0.2 days, 95% CI - 1.09-1.49, p = 0.76), or the number of cases requiring conversion to laparotomy (four studies; OR 2.27, 95% CI 0.52-9.95, p = 0.28) (Fig. 2). LPS demonstrated a significantly higher utilization of segmental resection (six studies; OR 0.71, 95% CI 0.54-0.93, p < 0.05), while no significant differences were observed in the rates of shaving (six studies; OR 1.06, 95% CI 0.77-1.47, p = 0.71) or double discoid excision (six studies; OR 1.3, 95% CI 0.95-1.78, p = 0.1) (Fig. 3). Additionally, the included studies reported no significant differences in overall complication rates (five studies; OR 0.9, 95% CI 0.64-1.28, p = 0.57) (Fig. 3) or the incidence of Clavien-Dindo classification complications classified as Grade I(five studies; OR 0.85, 95% CI 0.44-1.65, p = 0.64), II(five studies; OR 0.59, 95% CI 0.35-1.0, p = 0.5), III(five studies; OR 1.12, 95% CI 0.63-2.0, p = 0.7), or IV(five studies; OR 0.8, 95% CI 0.14-4.59, p = 0.81). Our study found that, apart from a significantly longer operative time for RAS compared to LPS, RAS demonstrated comparable outcomes in intraoperative blood loss, length of hospital stay, conversion to open surgery, bowel endometriosis resection, and postoperative complication rates. These findings suggest that RAS has the potential to become a viable alternative to LPS in the future. However, this conclusion still requires validation through large-scale, prospective, randomized controlled trials.
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Affiliation(s)
- Xiao Zhang
- Department of Gynaecology and Obstetrics, Zibo Central Hospital, Zibo, China
| | - Xin Zhang
- Department of Gynaecology and Obstetrics, Zibo Central Hospital, Zibo, China.
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Abasi A, Fatemi Aghda SA, Zahedian M, Jamshiddoust Miyanroudi Z, Bahariniya S, Yazdani B, Fallah-Aliabadi S, Hazhir S. An investigation into telemedicine utilization for refugee mental health: a systematic review. Global Health 2025; 21:31. [PMID: 40420111 DOI: 10.1186/s12992-025-01119-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2025] [Accepted: 04/14/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Telemedicine is mentioned as a technological solution in various fields of medicine and nowadays using telemedicine in the field of mental health in the refugee population, has attracted special attention in the world. This research was conducted with the aim of investigating the usage of telemedicine in the refugee populations mental health. METHODS This study, conducted in 2024, involved a comprehensive search of databases including Web of Science, Cochrane, ProQuest, Ovid, EBSCO, PubMed, and Scopus, up until April 2023. Based on predefined inclusion and exclusion criteria, 12 relevant articles were identified. The quality and methodology of the selected articles were evaluated using the Mixed Methods Appraisal Tool (MMAT) checklist. RESULTS A total of 12 articles were included in the review. Feasibility and investigation of telemedicine challenges (5 articles) and its evaluation and effectiveness investigation (7 articles) were used. Most of the studies were quantitative (8 cases) and mostly dealt with socio-economic-cultural application issues (5 cases) and screening (2 cases). Most of the studies were purely focused on refugees (5 cases). CONCLUSIONS Results have shown that paying attention to the challenges, disadvantages, and telemedicine required Infrastructure in the field of mental health, will lead to effectiveness, screening, and treatment. This causes positive social, economic, and cultural effects on refugees. However, the need for future studies with more attention to technical and governmental challenges and their issues (security and reimbursement), the refugee population with various ethnicities, and different health fields (prevention, treatment, follow-up, rehabilitation, etc.) seems to be necessary.
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Affiliation(s)
- Arezoo Abasi
- Student Research and Technology Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fatemi Aghda
- Student Research and Technology Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran.
- Fakher Mechatronic Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mehdi Zahedian
- Student Research and Technology Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Jamshiddoust Miyanroudi
- Department of Health Information Management, School of Health Management and Information Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajjad Bahariniya
- Department of Healthcare Services Management, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Department of Health management and economics, Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Benyamin Yazdani
- Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Saeed Fallah-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shadi Hazhir
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hohmann E, Keough N, Stokes D, Frank R, Rodeo S. Adipose- and bone marrow-derived stromal cells reduce pain in patients with knee osteoarthritis but do not substantially improve knee functionality: an updated systematic review and meta-analysis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2025; 35:214. [PMID: 40407910 PMCID: PMC12102120 DOI: 10.1007/s00590-025-04322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Accepted: 04/25/2025] [Indexed: 05/26/2025]
Abstract
PURPOSE To perform a systematic review and meta-analysis of randomized and comparative studies comparing mesenchymal stromal cells other orthobiological injections for patients with knee osteoarthritis. METHODS Systematic review of Medline, Embase, Scopus, and Google Scholar, including all level 1-3 from 2014 to 2024. Validated scores (VAS, KOOS, Lysholm, IKDC) were included as outcome measures. Risk of bias was assessed using the Cochrane Collaboration's tools. The GRADE system was used to assess the quality of the body of evidence and the modified Coleman Methodology score was used to assess study quality. Heterogeneity was assessed using χ2 and I2 statistics. RESULTS Ten studies were included; all published in English between 2019 and 2023, encompassing a total of 563 cases (281 treated with MSCs and 282 with other biologics). Two studies had a high risk of bias, one had some bias, and seven had a low risk of bias. Publication bias was detected (Egger's test 3.26447; p = 0.007). The pooled estimates revealed significant differences favoring MSCs for VAS scores at 3, 6, and 12 months. For KOOS pain and symptoms, significant differences were observed at 3 and 6 months. CONCLUSION The results of this meta-analysis demonstrated a significant effect of adipose and bone marrow-derived stromal cell injections on pain reduction at all assessed time points, and showed superiority over other non-surgical treatment options. These differences were not reflected in clinical and functional outcomes, indicating that the observed reduction in pain did not correspond to substantial improvements in knee functionality.
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Affiliation(s)
- Erik Hohmann
- Medical School, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Gabriel KMA, Schröder C, Wolf R, Bolm-Audorff U, Kienast C, Smolinska J, Petereit-Haack G, Seidler A. SARS-CoV-2 infection risk by non-healthcare occupations: a systematic review and meta-analysis. J Occup Med Toxicol 2025; 20:17. [PMID: 40405221 PMCID: PMC12096541 DOI: 10.1186/s12995-025-00462-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Accepted: 05/08/2025] [Indexed: 05/24/2025] Open
Abstract
BACKGROUND During the COVID-19 pandemic, several industries were deemed essential. However, information on infection risk in occupational settings outside of healthcare workers and medical staff (HCWs) remain scarce. Thus, a systematic review with meta-analysis was conducted to compile the risk of infection to SARS-CoV-2 in non-healthcare workers (non-HCWs). METHODS We screened three databases (EMBASE, PubMed, medRχiv) for studies on SARS-CoV-2 infection risk in working population. Several stages of severity (infection, hospitalisation, admission to intensive care unit (ICU), mortality) were eligible. Occupational specifications were harmonised according to the German classification of professions (KldB). All reported risk estimators were considered. Studies were analysed for their risk of bias. Results of random-effects meta-analyses were assessed for their evidence according to GRADE. Subgroup analyses were run for 'outcome', 'comparison group', and 'risk of bias'. RESULTS Of 9,081 publications identified, 25 were recognised as eligible, mainly describing the first year of the pandemic. For 20 occupations, we were able to carry out meta-analyses on KldB-4-level by integrating all stages of severity. Nine occupations were identified with a statistically significantly increased risk of infection for SARS-CoV-2, four of which had a relative risk (RR) of > 2: Occupations in meat processing (RR = 3.58 [95%-CI 1.46; 8.77]), occupations in building cleaning services (RR = 2.55 [95%-CI 1.51; 4.31]), occupations in cargo handling (RR = 2.52 [95%-CI 2.27; 2.79]) and cooks (RR = 2.53 [95%-CI 1.75; 3.67]). The certainty of evidence of eight results was found moderate or high. CONCLUSIONS The first systematic review and meta-analysis of occupational SARS-CoV-2 infection risk in occupations other than HCWs revealed a considerably elevated risk in individual related services as well as in commercial services. TRIAL REGISTRATION PROSPERO CRD42021297572.
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Affiliation(s)
- Katharina M A Gabriel
- Division 'Work and Health', Unit 'Medical Occupational Safety and Health, Occupational Diseases', Federal Institute for Occupational Safety and Health, Nöldnerstr. 42, Berlin, 10317, Germany.
| | - Christin Schröder
- Division 'Work and Health', Unit 'Medical Occupational Safety and Health, Occupational Diseases', Federal Institute for Occupational Safety and Health, Nöldnerstr. 42, Berlin, 10317, Germany
| | - Rebecca Wolf
- Division 'Work and Health', Unit 'Medical Occupational Safety and Health, Occupational Diseases', Federal Institute for Occupational Safety and Health, Nöldnerstr. 42, Berlin, 10317, Germany
| | - Ulrich Bolm-Audorff
- Faculty of Medicine, Technische Universität Dresden, Institute and Policlinic of Occupational and Social Medicine (IPAS), Fetscherstraße 74, Dresden, 01307, Germany
| | - Camilla Kienast
- Division 'Work and Health', Unit 'Medical Occupational Safety and Health, Occupational Diseases', Federal Institute for Occupational Safety and Health, Nöldnerstr. 42, Berlin, 10317, Germany
- Center for Occupational Medical Care, Charité - Universitaetsmedizin Berlin, Turmstraße 21, Berlin, 10559, Germany
| | - Joanna Smolinska
- Division 'Work and Health', Unit 'Medical Occupational Safety and Health, Occupational Diseases', Federal Institute for Occupational Safety and Health, Nöldnerstr. 42, Berlin, 10317, Germany
| | - Gabriela Petereit-Haack
- Division of Occupational Health, Department of Occupational Safety, Regional Government of South Hesse, Kreuzberger Ring 17, Wiesbaden, 65205, Germany
| | - Andreas Seidler
- Faculty of Medicine, Technische Universität Dresden, Institute and Policlinic of Occupational and Social Medicine (IPAS), Fetscherstraße 74, Dresden, 01307, Germany
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Abidi S, Kumar A, Dwivedi S, Sharma V, Talegaonkar S, John D. Cost-effectiveness of clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a systematic review protocol. JBI Evid Synth 2025:02174543-990000000-00450. [PMID: 40400280 DOI: 10.11124/jbies-24-00390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2025]
Abstract
OBJECTIVE This systematic review will assess the cost-effectiveness of clopidogrel in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). INTRODUCTION Antiplatelet drugs, including clopidogrel, ticagrelor, prasugrel, and aspirin, are crucial in managing ACS, preventing ischemia, and ultimately, death in PCI patients. Clopidogrel is the main treatment for those who have undergone PCI, used either alone or with aspirin. The incidence of ACS is rising globally, and is a major cause of premature death for millions. ACS management involves continuous medical therapy and costly procedures such as PCI, significantly straining health care resources. INCLUSION CRITERIA Studies will be eligible for inclusion if they report on the cost-effectiveness of clopidogrel in patients with ACS compared with other antiplatelet drugs. METHODS This systematic review will adhere to the JBI methodology guidelines for systematic reviews of economic evaluation evidence. A preliminary search was conducted of MEDLINE (PubMed) using MeSH terms. Two independent reviewers will screen records at the title/abstract level, followed by full-text screening. Two reviewers will then assess methodological quality and extract data as per JBI guidelines. The JBI Dominance Ranking Matrix for economic evaluations will be used to summarize and compare the included studies. The cost-effectiveness measures will be incremental cost, incremental cost per quality-adjusted life year gained, or incremental cost per disability-adjusted life year averted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to appraise the certainty of economic evidence, such as using resources and expenditure, for incorporating the results into the decision-making process. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42024504614.
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Affiliation(s)
- Saba Abidi
- School of Allied Health Sciences and Management, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Anoop Kumar
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | | | | | - Sushama Talegaonkar
- School of Allied Health Sciences and Management, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Denny John
- Faculty of Life and Allied Health Sciences, MS Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
- Evidence Synthesis and Implementation for Indigenous Health: A JBI Affiliated Group, MANT (Manbhum Ananda Ashram Nityananda Trust), Kolkata, India
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Wang L, Huang Q, Cai T, Ding Y, Yuan C. Effects of different types of exercise intervention for alleviating breast cancer-related lymphedema: a systematic review protocol and network meta-analysis. BMJ Open 2025; 15:e098064. [PMID: 40398933 PMCID: PMC12097084 DOI: 10.1136/bmjopen-2024-098064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 05/06/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Exercise is the main treatment for patients with breast cancer-related lymphedema (BCRL) and different types of exercises were performed in these patients. However, it is unclear which type of exercise or combination of these is the most effective in reducing arm swelling and lymphedema-related symptoms, and quality of life in patients with BCRL. AIMS This study aimed to compare the relative efficacy of different types of exercise in treating BCRL and determine the most effective exercise therapy for patients with BCRL. METHODS AND ANALYSIS This review will search English-language databases (Cochran Library, Cumulative Index to Nursing and Allied Health Literature, EBSCO, EMBASE, PubMed/Medline and Web of Science). The following Chinese-language databases will also be searched: Chinese Biomedical Literature Database (SinoMed), China National Knowledge Infrastructure, Wanfang Data and China Science and Technology Journal Database. The search was conducted up to 31 December 2024. Randomised controlled trials comparing different types of exercise on BCRL will be eligible. Data will be extracted from eligible trials by two independent researchers based on the selection criteria. Two reviewers will ascertain the risk of bias of the selected studies using a modified version of the Cochrane Risk of Bias Tool. The study's characteristics (study type, characteristics of the patients, intervention prescriptions) and primary outcomes (limb volume, physical function, physical and psychological symptoms) will be summarised in a narrative format. Meta-analyses (ie, network and pairwise) will be used to assess the indirect and direct effects of the exercise interventions. The relative effects of different types of exercise in treating BCRL will be examined by the surface under the cumulative ranking curve to calculate the ranking of treatments and determine the most effective intervention. ETHICS AND DISSEMINATION This review does not require ethical approval. The findings will be submitted for peer-reviewed publication. PROSPERO REGISTRATION NUMBER The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (CRD42022370817).
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Affiliation(s)
- Ling Wang
- School of Nurisng, Fudan University, Shanghai, China
| | - Qingmei Huang
- School of Nurisng, Fudan University, Shanghai, China
| | - Tingting Cai
- School of Nurisng, Fudan University, Shanghai, China
| | - Yuanqi Ding
- School of Nurisng, Fudan University, Shanghai, China
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Mewes L, Langhammer T, Torbecke J, Fendel JC, Lueken U. Augmentation of trauma-focused psychotherapy for post-traumatic stress disorder: a protocol for a systematic review and meta-analysis. BMJ Open 2025; 15:e090571. [PMID: 40398931 PMCID: PMC12096967 DOI: 10.1136/bmjopen-2024-090571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 04/01/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Despite the established status of trauma-focused psychotherapy (TFP) as a first-line treatment for post-traumatic stress disorder (PTSD), a substantial proportion of individuals do not achieve clinically significant improvement or discontinue treatment. Exploring augmentation strategies to enhance treatment outcomes is essential to reduce the overall burden PTSD puts on individuals and society. This protocol outlines a systematic review and meta-analysis of randomised controlled trials (RCTs) evaluating the efficacy of non-pharmacological augmentation strategies in addition to TFP for PTSD treatment. METHODS AND ANALYSIS We comprehensively searched PubMed, Embase, CENTRAL, PTSDpubs, PsycArticles, PsycINFO, PSYNDEX and CINAHL for RCTs without restrictions on publication dates or languages in October 2024. Study screening is currently ongoing. Additionally, we will perform forward and backward searches of the included studies and relevant reviews. Two reviewers will independently screen and select studies, extract data and assess the risk of bias. We will conduct a narrative review to qualitatively synthesise data and a meta-analysis to quantitatively compare the treatment efficacy of augmented TFP with TFP alone or TFP plus placebo. Primary outcomes will be both symptom severity and response rates. The secondary outcome will be dropout rates. We will explore sources of between-study heterogeneity and potential moderators through subgroup and meta-regression analyses. We will assess the overall quality of the included studies with the Grading of Recommendations Assessment, Development, and Evaluation system. ETHICS AND DISSEMINATION Ethical approval is not required. We intend to publish results in a peer-reviewed journal and provide materials and data through the Open Science Framework. PROSPERO REGISTRATION NUMBER CRD42024549435.
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Affiliation(s)
- Lisa Mewes
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- PartnerSite Berlin/Potsdam, Deutsches Zentrum für Psychische Gesundheit, Berlin, Germany
| | - Till Langhammer
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Jonathan Torbecke
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Johannes Caspar Fendel
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- PartnerSite Berlin/Potsdam, Deutsches Zentrum für Psychische Gesundheit, Berlin, Germany
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Lingani M, Ouoba S, Rouamba T, Valea I, Sanou M, Samadoulougou S, Tinto H, Sorgho H. Sulfadoxine-pyrimethamine alone or with azithromycin for the intermittent preventive treatment of malaria in pregnancy: protocol for a systematic review and meta-analysis. BMJ Open 2025; 15:e093931. [PMID: 40398947 PMCID: PMC12096964 DOI: 10.1136/bmjopen-2024-093931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 05/07/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Increasing Plasmodium resistance levels to sulfadoxine-pyrimethamine (SP) threaten the effectiveness of intermittent preventive treatment in pregnancy (IPTp) and have prompted the evaluation of alternative strategies. Azithromycin (AZ) could have add-on effects on malaria and treat sexually transmitted infections (STIs), both conditions described as major causes of adverse pregnancy outcomes (APO). Inconsistent findings on the utility of AZ for the prevention of APO were reported; however, thus far, no comprehensive meta-analytic synthesis of data has been published. This review aims to investigate the effects of SP+AZ administered in women as IPTp on the risk of low birth weight in malaria-endemic areas. METHODS AND ANALYSIS Eligible studies will be identified through a pre-established search strategy in several electronic databases (Medline, Cochrane Library, Web of Science, EMBASE, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and AJOL) and will comprise peer-reviewed papers reporting original data on the effects of SP+AZ on the risk of APO. Only randomised controlled trials published until 30 September 2024 in English or French will be included. IPTp with SP+AZ regimens (intervention) will be compared with IPTp with SP alone or with a placebo (control). As primary outcomes, data on the frequency of low birth weight will be collected. Secondary outcomes include the rates of stillbirth, preterm birth, miscarriage and neonatal death. Data will be extracted independently by two reviewers using a predefined extraction form. If the data quality allows for quantitative synthesis, a fixed-effects meta-analysis will be conducted if there is low inter-study heterogeneity. Otherwise, the random-effects meta-analysis will be conducted to take into account uncertainty in pooled estimates that could be due to inter-study heterogeneity. The review protocol was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) guidelines. ETHICS AND DISSEMINATION Ethical clearance is not needed as the data will be from already published studies in which informed consent and ethical approval were obtained by primary investigators. Our dissemination plan includes the publication in a peer-reviewed journal as well as conference presentations. PROSPERO REGISTRATION NUMBER CRD42020149592.
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Affiliation(s)
- Moussa Lingani
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
| | - Serge Ouoba
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
| | | | - Sékou Samadoulougou
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Laval University, Quebec city, Québec, Canada
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Unité de Recherche Clinique de Nanoro (URCN), Ouagadougou, Burkina Faso
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Webster S, Ritson JE, Barnard EBG. Abdominal aortic junctional tourniquet (AAJT-S): a systematic review of utility in military practice. BMJ Mil Health 2025; 171:262-268. [PMID: 37400126 DOI: 10.1136/military-2023-002451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Haemorrhage is the leading cause of potentially survivable death on the battlefield. Despite overall improvement in battlefield mortality, there has been no improvement in survival following non-compressible torso haemorrhage (NCTH). The abdominal aortic junctional tourniquet-stabilised (AAJT-S) is a potential solution that may address this gap in improving combat mortality. This systematic review examines the evidence base for the safety and utility of the AAJT-S for prehospital haemorrhage control in the combat setting. METHODS A systematic search of MEDLINE, Cumulated Index to Nursing and Allied Health Literature and Embase (inception to February 2022) was performed using exhaustive terms, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The search was limited to English-language publications in peer-reviewed journals; grey literature was not included. Human, animal and experimental studies were included. Papers were reviewed by all authors to determine inclusion. Each study was assessed for level of evidence and bias. RESULTS 14 studies met the inclusion criteria: 7 controlled swine studies (total n=166), 5 healthy human volunteer cases series (total n=251), 1 human case report and 1 mannikin study. The AAJT-S was demonstrated to be effective at cessation of blood flow when tolerated in healthy human and animal studies. It was easy to apply by minimally trained individuals. Complications were observed in animal studies, most frequently ischaemia-reperfusion injury, which was dependent on application duration. There were no randomised controlled trials, and the overall evidence base supporting the AAJT-S was low. CONCLUSIONS There are limited data of safety and effectiveness of the AAJT-S. However, there is a requirement for a far-forward solution to improve NCTH outcomes, the AAJT-S is an attractive option and high-quality evidence is unlikely to be reported in the near future. Therefore, if this is implemented into clinical practice without a solid evidence base it will need a robust governance and surveillance process, similar to resuscitative endovascular balloon occlusion of the aorta, with regular audit of use.
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Affiliation(s)
- Stacey Webster
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - J E Ritson
- Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - E B G Barnard
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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McCrabb S, Hunter KE, Turon H, Barnes C, Williams JG, Aberoumand M, Banks E, Yoong S, Milat A, Hodder RK, Gardner LA, Newton N, Little MA, Halpern-Felsher B, Steeger C, Fox KR, Wyman P, Shrier L, Harris SK, Seidler L, Wolfenden L. Synthesis using prospective meta-analysis to reduce youths' e-cigarette use (SPARKE): a protocol for an individual participant data prospective meta-analysis (IPD PMA) examining interventions for the prevention of youth e-cigarette use. BMJ Open 2025; 15:e093028. [PMID: 40398953 PMCID: PMC12096961 DOI: 10.1136/bmjopen-2024-093028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 05/01/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Youth electronic cigarette (e-cigarette) use is a global health challenge, with multiple jurisdictions wrestling with appropriate responses, in the face of limited evidence available on effective interventions. Identifying and synthesising evidence on the effects of interventions to prevent youth e-cigarette use is required to inform prevention-focussed health policy and practice. METHODS AND ANALYSIS We plan to undertake an individual participant data (IPD) prospective meta-analysis (PMA). We will conduct systematic searches to identify eligible planned or ongoing randomised controlled trials (RCTs) using trial registries via WHO ICTRP and ClinicalTrials.gov and databases Medline, Embase, CENTRAL, PsycINFO, Web of Science, CINAHL and Europe PMC. We will also search grant websites for additional studies. We will include any RCT of e-cigarette and cigarette prevention interventions for youth including non-smoking and non-vaping youth aged 10 to 19 years, with no intervention, waitlist, usual care or active control. Primary outcomes will be measures of current or ever e-cigarette use. Secondary outcomes include measures of current and ever cigarette (conventional cigarette) use.Investigators from relevant trials will be invited to join the Synthesis using Prospective meta-Analysis to Reduce youths' E-cigarette use (SPARKE) consortium prior to trial outcomes being known using harmonised methods. They are then asked to share their data within 12 months of trial completion.The primary outcomes will be analysed in a two-stage IPD meta-analysis model under an intention-to-treat framework. First, effect estimates and variances will be calculated for each trial with log-binomial regression models adjusting for key prognostic factors. For cluster RCTs, a nested random effect will be specified within trials to account for correlations within clusters. Second, effect estimates will be combined across trials in a random treatment effect, inverse variance meta-analysis model. Effect estimates will be reported as relative risk ratios with 95% CIs. DISCUSSION This study aims to generate and expedite the synthesis of data regarding prevention interventions for adolescent e-cigarette use to inform real-world decision making. Findings will be of interest to key stakeholders, including policy makers and research funders. ETHICS AND DISSEMINATION Each trial will be responsible for obtaining their own ethics approval. While secondary analysis of data does not usually require ethics approval, we have received cross-institutional ethics approval from the University of Sydney (2023/714) and the University of Newcastle (H-2023-0389).
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Kylie E Hunter
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Heidi Turon
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Jonathan G Williams
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Mason Aberoumand
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Emily Banks
- The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Serene Yoong
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Andrew Milat
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Melissa A Little
- Department of Public Health Sciences, University of Viriginia Cancer Center, University of Virginia, Charlottesville, Virginia, USA
| | - Bonnie Halpern-Felsher
- REACH Lab, Department of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Christine Steeger
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - Kristen R Fox
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Peter Wyman
- Department of Chhild and Adolescent Psychiatry, School of Medicine, University of Rochester, Rochester, New York, USA
| | - Lydia Shrier
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sion Kim Harris
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lene Seidler
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
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Gbogbo S, Axame WK, Wuresah I, Gbogbo E, Klutse P, Hayibor F, Kugbey N, Imakando MM, Doku VCK, Hennegan J, Baiden FE, Binka F, Danso-Appiah A. Menstrual health needs and educational outcomes among adolescent girls living in countries in sub-Saharan Africa: systematic review protocol. BMJ Open 2025; 15:e094613. [PMID: 40398941 PMCID: PMC12097000 DOI: 10.1136/bmjopen-2024-094613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 04/30/2025] [Indexed: 05/23/2025] Open
Abstract
INTRODUCTION Poor menstrual health and unmet menstrual needs influence several aspects of adolescent girls' lives, including their educational outcomes. However, evidence on menstrual health needs and educational outcomes among these vulnerable girls living in countries across sub-Saharan Africa (SSA) is fragmented and inconclusive. The systematic review aims to explore the association between menstrual health needs and educational outcomes among adolescent girls (10-19 years) living in SSA. METHODS AND ANALYSIS Studies (published and unpublished) will be identified from relevant electronic databases including PubMed, CINAHL, ScienceDirect, Google Scholar and LILACS without language restriction from January 2012 to December 2024. A comprehensive set of search terms and their alternate terms, together with the names of countries in sub-Saharan Africa, will be used for running the searches. We will also search Scopus, Web of Science, African Index Medicus, HINARI, African Journals Online, Academic Search Premier, MedRXIV, ProQuest, EBSCO Open Dissertations and reference lists of relevant studies. We will contact experts, identified through authorship of key publications in menstrual health research and recommendations from established research networks, for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. The pre-defined eligibility criteria will be followed to screen papers for inclusion in the review. The flow of studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Given the anticipated volume of literature to be reviewed, at least two reviewers will independently select studies, extract data and assess the quality of the included studies for risk of bias using the Robbins-E risk of bias assessment tool. Any disagreements will be resolved through discussion between the reviewers. The Joanna Briggs Institute's Sumari Software will be used for citation management. Binary outcomes will be estimated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), reported with their 95% CIs. The mean difference (MD) will be used for reporting continuous outcomes with their 95% CIs. In the case where different instruments have been used to report means, we will employ standardised mean difference (SMD). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I2 statistic, and if heterogeneity is detected to be high (>50%), subgroup analysis will be performed to assess the impact of such variation. ETHICS AND DISSEMINATION While ethical approval is not required for the systematic review methodology itself, appropriate data sharing agreements and confidentiality protocols will be followed when collecting unpublished data from experts. The findings from this review will be published in a peer-reviewed journal and presented at relevant conferences. Also, the findings will be communicated to local stakeholders (eg, adolescent girls, parents/guardians, school authorities) in appropriate formats and languages to support translation into policy and practice to improve menstrual health and hygiene and education for adolescent girls in sub-Saharan Africa. PROSPERO REGISTRATION NUMBER CRD42024565296.
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Affiliation(s)
| | | | | | | | | | - Fred Hayibor
- University of Health and Allied Sciences, Ho, Ghana
| | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | - Mercy Monde Imakando
- Department of Population, Family and Reproductive Health, University of Ghana, Accra, Ghana
- Department of Obstetrics and Gynaecology, University Teaching Hospitals, Lusaka, Zambia
| | | | | | | | - Fred Binka
- University of Health and Allied Sciences, Ho, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, University of Ghana, Accra, Ghana
- Centre for Evidence Synthesis and Policy, University of Ghana, Accra, Ghana
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Alighieri C, Vandewiele F, Pereira V. What works for whom? A systematic review on personalized speech intervention in children and adolescents with a cleft palate. Int J Pediatr Otorhinolaryngol 2025; 194:112401. [PMID: 40412144 DOI: 10.1016/j.ijporl.2025.112401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2025] [Revised: 05/15/2025] [Accepted: 05/19/2025] [Indexed: 05/27/2025]
Abstract
OBJECTIVE Personalized health care involves intervention that is tailored to the unique characteristics of the individual. Even though personalized interventions have gained more attention in the past decades, this topic has not yet been systematically studied in the area of speech and language intervention in children with a cleft (lip and) palate (CP ± L). The aim of this systematic review is to summarize the evidence of the effects of personalized speech intervention in children with a CP ± L, aged 3-18 years, with a narrow focus on anterior oral, posterior oral, and non-oral cleft speech characteristics. METHODS This systematic literature review was developed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), and Embase were searched and the grey literature was checked. The search strategy was based on three concepts: cleft palate, speech intervention, and children. Two raters independently determined the eligibility and extracted all relevant data from the included studies. The methodological quality of the included study was also assessed using the QualSyst tool. RESULTS Four studies were included in this review. The overall quality of the included studies was good. Children with severe, non-oral cleft speech characteristics were found to benefit from motor-phonetic based intervention strategies. Linguistic-phonological strategies, in contrast, were more effective in improving speech and health-related quality of life in children with less severe, anterior oral or posterior oral cleft speech characteristics. CONCLUSION There is some evidence that personalized speech intervention yields better outcomes than a "one-size-fits-all" approach. Further research, especially randomized (sham-)controlled trials, is necessary to confirm these results.
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Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences, Ghent University, Belgium.
| | - Febe Vandewiele
- Department of Rehabilitation Sciences, Centre for Speech and Language Sciences, Ghent University, Belgium
| | - Valerie Pereira
- Department of Otorhinolaryngology, Head and Neck Surgery, Division of Speech Intervention, The Chinese University of Hong Kong, China
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Hollowood L, Taylor J, Allen K. The Experiences of People From Ethnic Minority Backgrounds Living in Care Homes-A Qualitative Systematic Review. J Adv Nurs 2025. [PMID: 40387323 DOI: 10.1111/jan.17060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/30/2025] [Accepted: 05/06/2025] [Indexed: 05/20/2025]
Abstract
The experiences of people from ethnic minority backgrounds living in care homes-A qualitative systematic review. AIM Despite the increasing need for older people from ethnic minority backgrounds to be able to access good quality, culturally competent care home provision, globally, there is an absence of literature exploring care home residents' perspectives. This study conducted a systematic review, identifying and synthesising qualitative evidence, which explored the experiences of residents', and their families, from ethnic minority backgrounds, who live in care home settings. DESIGN A qualitative systematic review. Nine electronic databases, MEDLINE, Nursing and Allied Health, CINAHL, ASSIA, AMED, Sociological Abstracts, PsycINFO, Web of Science, SCOPUS, were systematically searched for research published after 2005 until 2025. REVIEW METHODS This systematic review of qualitative studies was conducted in accordance with The PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement. Studies were appraised for quality based upon validated critical appraisal tools from the Joanna Briggs Institute. Qualitative data were extracted and synthesised using reflexive thematic analysis. RESULTS Sixteen studies were identified from the international literature that explored care home experiences from the resident's and families' perspectives. Three key themes were extrapolated: Patter, which includes how cross-cultural communication skills and language affect care experiences; Place, which includes the care home environment, the multi-ethnic environment, and quality of care; and Person, which encompasses the individual's culture, values, beliefs, food, and family. CONCLUSION There is limited literature from the UK and low-to-middle income countries exploring care home residents' perspectives on care provision. Key components of culturally competent care include culturally sensitive communication, adaptable environments that support residents' chosen lifestyles, and inclusive, family-centred approaches to living well. IMPACT For nurses within the adult social care sector, to recognise the need for further research, education, and policy initiatives aimed at enhancing the care home provision for people from ethnic minority groups. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
- Lorna Hollowood
- Department of Nursing and Midwifery, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK
| | - Julie Taylor
- Department of Nursing and Midwifery, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Kerry Allen
- School of Social Policy and Society, Health Services Management Centre, University of Birmingham, Birmingham, UK
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Mazzone E, Thomson A, Chen DC, Cannoletta D, Quarta L, Pellegrino A, Gandaglia G, Moon D, Eapen R, Lawrentschuk N, Montorsi F, Siva S, Hofman MS, Chiti A, Briganti A, Perera ML, Murphy DG. The Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Assessment of Local Recurrence and Distant Metastases in Patients with Biochemical Recurrence of Prostate Cancer After Definitive Treatment: A Systematic Review and Meta-analysis. Eur Urol 2025:S0302-2838(25)00285-4. [PMID: 40393864 DOI: 10.1016/j.eururo.2025.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 04/21/2025] [Accepted: 05/06/2025] [Indexed: 05/22/2025]
Abstract
BACKGROUND AND OBJECTIVE Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) radioligands has an established role in the assessment of recurrence of prostate cancer (PC) after primary treatment. However, an updated understanding of its diagnostic utility is warranted, particularly in the context of emerging targeted and systemic treatment options for recurrent PC. Our aim was to evaluate the diagnostic performance of PSMA PET for staging and detection of local or metastatic disease in patients with biochemical recurrence (BCR) following definitive treatment for PC. METHODS We conducted a systematic review (Web of Science/MEDLINE, Cochrane Library, and EMBASE from inception to April 25, 2024) and meta-analysis. Eligible retrospective and prospective studies had extractable data on PSMA PET for patients with BCR after radical prostatectomy (RP) or radiation therapy (RT). Risk of bias was assessed using the QUADAS-2 tool. Random-effects models were used to evaluate PSMA PET positivity rates across clinical subgroups stratified by PSA, primary treatment, PSMA PET radioligand, and anatomic lesion sites. KEY FINDINGS AND LIMITATIONS A total of 43 studies (8119 patients) were included. PSMA PET positivity rates varied substantially among patients with BCR after primary definitive treatment, with significant study heterogeneity (τ2 = 0.6; p < 0.001), which was mitigated in part after stratification by PSA category. Positivity rates were significantly higher after RT (92%) than after RP (60%; p < 0.001). PSMA PET positivity by anatomic location was 23% for local recurrence, 32% for pelvic nodes, 14% for extrapelvic nodes, 16% for bone metastases, and just 1% for visceral metastases. The positivity rate increased with PSA, from 48% at PSA 0.2-0.5 ng/ml to >90% at PSA >2 ng/ml. Gleason score (GS) at RP did not significantly influence the positivity rate (50% for GS ≤7 vs 62% for GS 8-10; p = 0.08). Heterogeneity limits the generalisability of our findings. CONCLUSIONS AND CLINICAL IMPLICATIONS We observed substantial variability in PSMA PET positivity rates in BCR because of significant study heterogeneity, mostly related to differences in treatment type, PSA, and anatomic sites. In post-RP BCR, approximately half of patients undergoing PSMA PET had positive findings, even at low PSA (0.2-0.5 ng/ml). In the post-RT setting, PSMA PET use was generally aligned with the Phoenix criterion for BCR, with most studies performing PSMA PET at PSA ≥2 ng/ml. Further research is needed to refine PSA thresholds for PSMA PET, particularly in the post-RT setting, and to assess its role in guiding salvage treatment decisions.
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Affiliation(s)
- Elio Mazzone
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Alice Thomson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - David C Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Donato Cannoletta
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Quarta
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antony Pellegrino
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgio Gandaglia
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Daniel Moon
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Royal Melbourne Clinical School, University of Melbourne, Melbourne, Australia
| | - Renu Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, Australia
| | - Francesco Montorsi
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Shankar Siva
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Michael S Hofman
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Arturo Chiti
- Vita-Salute San Raffaele University, Milan, Italy; Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Briganti
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Marlon L Perera
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Urology, Austin Hospital, Heidelberg, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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Govindsamy K, Noll S, Blose N, Amponsah-Dacosta E. Effectiveness of integrating cervical cancer prevention strategies into HIV care programmes: A mixed-methods systematic review protocol. PLoS One 2025; 20:e0306496. [PMID: 40388461 PMCID: PMC12088019 DOI: 10.1371/journal.pone.0306496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 04/17/2025] [Indexed: 05/21/2025] Open
Abstract
INTRODUCTION Cervical cancer, which is the fourth most frequently diagnosed cancer among women globally, remains a significant health burden despite being preventable and treatable, exposing gaps in accessing prevention and control services. Adolescent girls and young women (AGYW) living with HIV face heightened risk of persistent HPV infection, a primary cause of cervical cancer, making this population the ideal target for preventing cervical cancer before HPV exposure or disease progression. The overlap of cervical cancer and HIV exacerbates public health challenges, urging intensified efforts in bolstering prevention and control measures. Integration of cervical cancer prevention strategies into HIV care programs shows promise in effectively addressing this dual burden. METHODS To evaluate the effectiveness of integrating cervical cancer prevention strategies within HIV care programs, a mixed-methods systematic review will be conducted. A comprehensive Boolean search for literature published and indexed in PubMed, Cochrane Library, EBSCO Host, Web of Science, Scopus, and Google Scholar will be conducted, without imposing any language restrictions. This review will be conducted in alignment with the Joanna Briggs guidelines on systematic reviews together with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data from eligible studies will be extracted and synthesized, and their quality assessed. DISCUSSION There is limited understanding of the effectiveness of integrating cervical cancer prevention and HIV care in the real-world setting. While some studies touch on integration, focus tends to be on cervical cancer screening alone, neglecting vaccination, treatment of precancerous lesions, and education programs. Previous reviews on this focus are outdated, surpassing six years. This systematic review aims to fill these evidence gaps by thoroughly evaluating the challenges and opportunities associated with integrating the full complement of HPV prevention strategies and HIV care programs. The anticipated findings could enhance service delivery models aimed at reducing cervical cancer incidence and mortality among AGYW living with HIV. TRIAL REGISTRATION Systematic review registration: PROSPERO registration number: CRD42024535821.
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Affiliation(s)
- Kimeshnee Govindsamy
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Western Cape, South Africa
- Vaccines for Africa Initiative (VACFA), Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Susanne Noll
- Vaccines for Africa Initiative (VACFA), Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative (VACFA), Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Malekzadeh M, Dehghanzadeh R, Ebrahimi SM, Sarbakhsh P, Fathifar Z, Aslani H. Occurrence, sampling, identification and characterization of microplastics in tap water: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2025; 299:118347. [PMID: 40393317 DOI: 10.1016/j.ecoenv.2025.118347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 05/16/2025] [Accepted: 05/16/2025] [Indexed: 05/22/2025]
Abstract
Identifying microplastics (MPs) in tap water has recently attracted considerable attention. The present study aimed to systematically review MPs contamination and characteristics in tap water. All techniques used for sampling, processing, and analyzing MPs in tap water were also assessed. Furthermore, the characteristics of MPs, including abundance, type, color, and shape, were summarized. Various databases, including Web of Science, PubMed, ScienceDirect, Scopus, Springer, and MDPI, were searched to find published articles up to January 2025. The occurrence of MPs in tap water was meta-analyzed using a random-effects model. A total of 6100 articles were found, of which 43 were included in the systematic review. The results indicated that the pooled mean concentration of MPs in tap water was 56.98 particles per liter (P/L). Manual sampling with a sample volume of less than 1 liter was most commonly used, and microscopic, Raman, and Fourier-transform infrared spectroscopy (FTIR) methods were frequently applied for extracting and identifying MPs. The most abundant polymer identified was polyethylene (PE), followed by polyethylene terephthalate (PET) and polypropylene (PP). Fibers and fragments were the dominant forms of MPs found in water. The lack of a harmonized protocol and the difficulty in validating MP analysis methods in tap water have led to inconsistent and sometimes contradictory results, making comparisons unreliable. The findings of this systematic review can support the development of a comprehensive protocol and promote standardized, harmonized methods for MP analysis in tap water.
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Affiliation(s)
- Masoumeh Malekzadeh
- Department of Environmental Health Engineering, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Reza Dehghanzadeh
- Reza Dehghanzadeh, Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Seyedeh Masoumeh Ebrahimi
- Department of Environmental Health Engineering, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Parvin Sarbakhsh
- Parvin Sarbakhsh, Epidemiology and Biostatistics Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Zahra Fathifar
- Zahra Fathifar, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hassan Aslani
- Reza Dehghanzadeh, Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Amobonye A, Bendoraitiene J, Peciulyte L, Rutkaite R. Review of recent advancements in starch modification: Improving the functionality of starch-based films. Int J Biol Macromol 2025; 315:144354. [PMID: 40393596 DOI: 10.1016/j.ijbiomac.2025.144354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Revised: 05/08/2025] [Accepted: 05/16/2025] [Indexed: 05/22/2025]
Abstract
Starch-based materials have been gained popularity as top among the most sustainable alternatives to conventional plastics due to their structural and functional diversity. However, the full potential and applicability of films derived from native starch in food packaging, as well as in other non-food applications, is limited by their inferior mechanical strength, thermal stability and barrier properties. Consequently, various scientific and industrial efforts have since been focused on modifying starch at the molecular level to circumvent these shortcomings and improve their functionality in material science. Thus, in this systematic review, the recent advancements in the chemical, physical and biological approaches of modifying starch structure, for enhanced film formation and bioplastic production were critical analysed. In recognition of the fact that the industrial utilization of starch is also impeded by their food use which creates a composite demand, various alternative sources of starch vis a vis, the underutilized sources, agricultural residues and algae, were also part of the discourse. This paper also explored the current industrial applications of starch-based films, including as packaging, adhesives, agricultural practice and drug delivery. Finally, the challenges to the real-time utilization of these innovative materials and possible solutions to be considered in the future were highlighted.
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Affiliation(s)
- Ayodeji Amobonye
- Department of Polymer Chemistry and Technology, Kaunas University of Technology, Radvilenu Rd. 19, 50254 Kaunas, Lithuania
| | - Joana Bendoraitiene
- Department of Polymer Chemistry and Technology, Kaunas University of Technology, Radvilenu Rd. 19, 50254 Kaunas, Lithuania
| | - Laura Peciulyte
- Department of Polymer Chemistry and Technology, Kaunas University of Technology, Radvilenu Rd. 19, 50254 Kaunas, Lithuania
| | - Ramune Rutkaite
- Department of Polymer Chemistry and Technology, Kaunas University of Technology, Radvilenu Rd. 19, 50254 Kaunas, Lithuania.
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48
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Vaccarezza S, Labbé N, López A, Mundt AP, Errázuriz P. Psychotherapeutic Process in Adults with Depressive and Anxiety Symptoms Who Report Childhood Maltreatment: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2025:15248380251335040. [PMID: 40383972 DOI: 10.1177/15248380251335040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2025]
Abstract
Extensive research exists regarding the impact of childhood maltreatment (CM) on depression and anxiety in adulthood. Still, its effect on the psychotherapeutic process, particularly symptomatic change and working alliance, remains unclear. Evaluating studies on the impact of CM on the psychotherapeutic process can help identify research gaps. This study aimed to conduct a scoping review of studies on the psychotherapeutic process in individual psychotherapy of adults with symptoms of depression and anxiety who report CM. The study followed the JBI Scoping Review Methodology. Searches were conducted in October 2022 across eight databases for peer-reviewed articles, books, and gray literature. Eligible studies examined the psychotherapeutic process in individual psychotherapy of adults with depression and/or anxiety who reported CM. A narrative method was employed to analyze and synthesize the studies. A total of 39 studies were included, consisting of 35 scientific articles and four doctoral dissertations. Most were randomized controlled trials evaluating different psychotherapeutic approaches, primarily cognitive-behavioral, interpersonal, and psychodynamic therapies. Patients with CM responded to psychotherapies for anxiety and depression, but showed higher symptom levels at both the beginning and end of treatment, along with delayed responses. A strong working alliance was essential for outcomes across different psychotherapeutic approaches. Psychotherapies for anxiety and depression in patients with CM should focus on building a strong working alliance and consider additional time for treatment responses. Future psychotherapy research on people with CM should report on the processes, including the working alliance. More studies assessing personality, anxiety, therapists' perspectives, and employing qualitative methodologies are needed.
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Affiliation(s)
- Stephanie Vaccarezza
- Doctoral Program in Psychotherapy, Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- PsiConecta Mental Health NGO, Santiago, Chile
| | - Nicolás Labbé
- Doctoral Program in Psychotherapy, Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Alberto López
- Doctoral Program in Psychotherapy, Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Adrian P Mundt
- Department of Psychiatry and Mental Health, Medical Faculty, Universidad de Chile, Santiago, Chile
- Medical Faculty, Universidad Diego Portales, Santiago, Chile
| | - Paula Errázuriz
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- PsiConecta Mental Health NGO, Santiago, Chile
- Department of Clinical Psychology, School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
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49
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Menichelli D, Gazzaniga G, Pannunzio A, Palumbo IM, Pani A, Pignatelli P, Valeriani E, Pastori D. Risk of New-Onset Atrial Fibrillation in Opioid Users: A Systematic Review and Meta-Analysis on 24,006,367 Participants. Drug Saf 2025:10.1007/s40264-025-01555-4. [PMID: 40383741 DOI: 10.1007/s40264-025-01555-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2025] [Indexed: 05/20/2025]
Abstract
BACKGROUND Despite ongoing efforts, the prescription of opioids is still common. Long-term opioid use has been associated with an increased risk of adverse cardiovascular outcomes. OBJECTIVE We aimed to evaluate the association between opioid use and the risk of new-onset atrial fibrillation. METHODS We performed a systematic review and meta-analysis of studies retrieved from MEDLINE and EMBASE databases according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines from inception to 29 January, 2024. The protocol was registered at PROSPERO (CRD42024512500). Two authors independently screened and extracted data from included studies. The quantitative analysis included only observational studies and results were synthesised by a pooled hazard ratio. Risk of bias was performed according to the ROBINS-I Cochrane tool, and the summary of evidence according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS Four out of 782 studies met the inclusion criteria for a quantitative analysis with 24,006,367 participants. Overall, 153,734 were opioid users. The proportion of women ranged from 13.2 to 100% and the median age ranged from 34 to 65 years. Studies reported 991,263 cases of new-onset atrial fibrillation. The pooled analysis showed a significant association between use of opioids and new-onset atrial fibrillation (hazard ratio 1.96, 95% confidence interval 1.43-2.69 with high heterogeneity). A sensitivity analysis by removing the study with the largest cohort showed similar results to the main analysis. In the summary of findings, the certainty of the evidence according to GRADE was moderate. CONCLUSIONS We found a significant association between opioid use and the risk of new-onset atrial fibrillation. When prescribing opioids, the risk of new-onset atrial fibrillation should be considered, especially in the presence of other risk factors for atrial fibrillation.
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Affiliation(s)
- Danilo Menichelli
- Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, Rome, Italy
| | - Gianluca Gazzaniga
- Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, Rome, Italy
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, Università degli Studi di Milano, Milan, Italy
| | - Arianna Pannunzio
- Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, Rome, Italy
| | - Ilaria Maria Palumbo
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00185, Rome, Italy
| | - Arianna Pani
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00185, Rome, Italy
| | - Emanuele Valeriani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00185, Rome, Italy
| | - Daniele Pastori
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00185, Rome, Italy.
- IRCCS Neuromed, Pozzilli, IS, Italy.
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50
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Quattlaender RA, Rothmore P, Hutchinson MR, Lathlean TJ. Effects of different movement velocities during resistance training on bone mineral density in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2025; 136:105906. [PMID: 40409129 DOI: 10.1016/j.archger.2025.105906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Revised: 04/24/2025] [Accepted: 05/17/2025] [Indexed: 05/25/2025]
Abstract
OBJECTIVE To investigate the effects of different movement velocities during progressive resistance training (PRT) on bone mineral density (BMD) in older adults, with an emphasis on program design and training principles. METHODS Seven databases were comprehensively searched to identify studies investigating the effect of PRT at different movement velocities on BMD. The primary outcome was BMD at fracture-relevant sites measured by dual-energy X-ray absorptiometry (DXA). Meta-analysis of within-group changes was conducted using a random-effects model. RESULTS Of 1830 screened records, 9 studies met the inclusion criteria. No statistical comparison was possible regarding movement velocity. However, the findings suggest benefits of incorporating high-velocity movements. The analysis revealed that moderate-velocity programs frequently failed to prevent bone loss. In terms of program design, significant benefits of variation in PRT programs were observed. Moreover, the interventions demonstrated substantial interindividual variability in efficacy. CONCLUSION High-velocity PRT effectively enhanced BMD when overarching training principles were met. Nevertheless, further research is required to confirm the superior efficacy of high-velocity training. Moreover, individualization is essential since responses to programs vary, prompting questions about underlying differences. Considering that osteoporosis involves defective mechanotransduction, factors beyond established confounders may influence the intervention's efficacy.
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Affiliation(s)
- Riccarda A Quattlaender
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, 5000, SA, Australia.
| | - Paul Rothmore
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, 5000, SA, Australia.
| | - Mark R Hutchinson
- School of Biomedicine, University of Adelaide, Adelaide, 5000, SA, Australia; Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, 5000, SA, Australia.
| | - Timothy Jh Lathlean
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, 5000, SA, Australia.
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