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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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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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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] [MESH Headings] [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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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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7
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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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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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9
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Hjelmager JS, Andersen K, Andersen TE, Stærk K. What is chronic urinary tract infection? A systematic review. BJU Int 2025; 136:12-18. [PMID: 40326061 PMCID: PMC12134415 DOI: 10.1111/bju.16764] [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] [Subscribe] [Scholar Register] [Indexed: 05/07/2025]
Abstract
OBJECTIVE To define 'chronic' urinary tract infection (UTI) by reviewing current published research that employs this term. METHODS We systematically searched Medline and Embase for studies covering all aspects of human UTI. For comparison, current urological and infectious disease guidelines were also reviewed. RESULTS The electronic search yielded a total of 2175 articles, of which 154 were eventually included for data extraction. Of these, six studies presented a definition of chronic UTI within the text. The definitions were highly incongruent among studies and often identical to the current definition of 'recurrent' UTI. CONCLUSION Chronic UTI is an undefined term, which has nevertheless been increasingly used in the past 15 years. Chronic UTI does not represent a distinct clinical or microbiological condition that justifies its use as medical diagnosis.
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Affiliation(s)
| | - Karin Andersen
- Department of UrologyOdense University HospitalOdenseDenmark
| | - Thomas Emil Andersen
- Research Unit of Clinical MicrobiologyUniversity of Southern DenmarkOdenseDenmark
- Department of Clinical MicrobiologyOdense University HospitalOdenseDenmark
| | - Kristian Stærk
- Research Unit of Clinical MicrobiologyUniversity of Southern DenmarkOdenseDenmark
- Department of Clinical MicrobiologyOdense University HospitalOdenseDenmark
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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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11
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Zhao X, Wang Y, Li L, Lan M, He X. Prediction Models for Postoperative Delirium of Cardiovascular Surgery (PODOCVS): Protocol for a Systematic Review. JMIR Res Protoc 2025; 14:e75368. [PMID: 40489772 DOI: 10.2196/75368] [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: 04/02/2025] [Revised: 04/16/2025] [Accepted: 04/17/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Postoperative delirium of cardiovascular surgery (PODOCVS) is an acute brain dysfunction characterized by inattention, impaired consciousness, and cognitive disorders, and the severity and presence of these symptoms fluctuate over time. PODOCVS occurs during the early postoperative period and is associated with adverse outcomes, including prolonged mechanical ventilation, premature mortality, and so on. Advances in its early diagnosis and treatment have mitigated some of the initial adverse effects of PODOCVS, but models for predicting risk in patients who have already developed PODOCVS remain inadequate for effective secondary prevention. Developing multivariable prediction models for stratifying PODOCVS risk would enable early, personalized interventions. OBJECTIVE This study aims to systematically review and critically evaluate the development, performance, and applicability of existing prediction models for PODOCVS. METHODS An extensive systematic search will be performed across multiple databases, including Embase, PubMed, the Web of Science, and so on, to identify studies related to multivariate predictive models for PODOCVS. A manual search of the included studies' reference lists will also be conducted to identify any additional relevant publications. This systematic review will include studies that meet the following criteria: (1) studies with subject populations comprising adult cardiovascular surgery patients aged ≥18 years, (2) studies involving the development and internal or external validation of predictive models for PODOCVS via multivariate analysis, and (3) studies with outcome measures focused on postoperative delirium. Two researchers (ZXL and WYK) will independently extract the data and assess the included studies' model quality using the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist and the Predictive Model Bias Risk Assessment Tool (PROBAST). Since this study will not involve patient data, ethics approval is not required. Our findings will be published in a peer-reviewed scientific journal and the dataset will be made freely available. RESULTS Literature searches were conducted from the inception of the database to May 20, 2024 (updated up to January 31, 2025), and data extraction and analysis are expected to be complete by the end of May 2025. We currently have a preliminary plan to publish the complete study results by August 2025, subject to any unforeseen delays or changes in the research timeline. CONCLUSIONS We present a protocol for the systematic review of prediction models for postoperative delirium in cardiac surgery patients. Aiming to identify, summarize, and critically appraise existing risk models globally, this review seeks to provide an up-to-date reference for stakeholders involved in patients with cardiac surgery care, policy making, and research. In addition, we aim to investigate whether machine learning models for PODOCVS offer more accurate predictions than traditional statistical models. TRIAL REGISTRATION PROSPERO CRD42024578957; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024578957. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/75368.
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Affiliation(s)
| | - Yike Wang
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Liju Li
- Zhejiang Taizhou Hospital, Linhai, China
| | - Meijuan Lan
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaodi He
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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12
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Kharko A, Hägglund M, Angelova D, Scott Duncan T, Hagström J, Hansford K, Hunt J, Trolle Lagerros Y, Locher C, McMillan B, Nivins AJ, Rosch SA, Schwarz J, Simola S, Blease C. Prevalence and types of errors in the electronic health record: protocol for a mixed systematic review. BMJ Open 2025; 15:e098241. [PMID: 40490366 DOI: 10.1136/bmjopen-2024-098241] [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] [Indexed: 06/11/2025] Open
Abstract
INTRODUCTION In countries with access to the electronic health record (EHR), both patients and healthcare professionals have reported finding errors in the EHR, so-called EHRrors. These can range from simple typos to more serious cases of missing or incorrect health information. Despite their potential detrimental effect, the evidence on EHRrors has not been systematically analysed. It is unknown how common EHRrors are or how they impact patients and healthcare professionals. METHODS AND ANALYSIS A mixed systematic review will be carried out to address the research gap. We will search PubMed, Web of Science and CINAHL for studies published since 2000, which report original research data on patient-identified and healthcare professional-identified EHRrors. We will analyse (1) the prevalence of EHRrors, (2) the types of EHRrors and (3) their impact on care. Quantitative and qualitative findings will be synthesised following the Joanna Briggs Institute Framework for Mixed Systematic Reviews. Identified studies will be critically appraised for meta-biases and risk of bias in individual studies. The confidence in the emerging evidence will be further assessed through the Grading of Recommendations Assessment, Development and Evaluation approach. Findings will be contextualised and interpreted involving an international team of patient representatives and practising healthcare professionals. ETHICS AND DISSEMINATION The study will not involve collection or analysis of individual patient data; thus, ethical approval is not required. Results will be published in a peer-reviewed publication and further disseminated through scientific events and educational materials. PROSPERO REGISTRATION NUMBER CRD42024622849.
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Affiliation(s)
- Anna Kharko
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Maria Hägglund
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
- MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Dafina Angelova
- Department of Obstetrics and Gynaecology, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
- Department of Physiology, Development, and Neuroscience, Cambridge University, Cambridge, UK
| | | | - Josefin Hagström
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Kirralise Hansford
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Joanne Hunt
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ylva Trolle Lagerros
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Cosima Locher
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
- Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, UK
| | - Asha-Judy Nivins
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sophie Anna Rosch
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | | | - Saija Simola
- Department of Computer Science, Aalto University, Aalto, Finland
| | - Charlotte Blease
- Department of Women and Children's Health, Uppsala University, Uppsala, Sweden
- Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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13
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Wang T, Deng J, Li W, Zhang Q, Yan H, Liu Y. The effects of aerobic exercise in patients with cancer-related fatigue: A systematic review and meta-analysis. PLoS One 2025; 20:e0325100. [PMID: 40489401 DOI: 10.1371/journal.pone.0325100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 05/07/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is characterized by an unusual and persistent sensation of tiredness that can occur during or after treatment, potentially impacting both physical and mental capability, and which does not ameliorate with rest. Aerobic exercise (AE) has been identified as a potent modality to mitigate the severity of CRF in such patients. OBJECTIVE This study aims to investigate the efficacy of AE in alleviating CRF among patients. METHODS A comprehensive literature search was implemented on PubMed, Web of Science, EBSCO, Cochrane, and Embase until June 2024. Studies were selected based on the following PICOS criteria: Participants (P): cancer patients undergoing treatment or in recovery; Intervention (I): aerobic exercise, including activities such as walking, running, yoga, or tai chi; AE interventions conducted during both treatment and recovery were included. Comparison (C): usual care, no-treatment/wait-list, or attention/activity placebo controls; Outcome (O): cancer-related fatigue (CRF) measured by validated scales; Study design (S): randomized controlled trials (RCTs). The meta-analysis was performed using Review Manager 5.3. RESULTS The results indicate that AE exerts a significant impact on CRF, but the heterogeneity is high (SMD = -0.76, 95% CI: -1.30 to -0.22, P < 0.05, I² = 94%). Subgroup analysis revealed that AE interventions lasting at least 12 weeks (SMD = -1.12, 95% CI = -2.02 ~ -0.22, P < 0.05, I² = 96%), 3 times or less per week (SMD = -1.00, 95% CI = -1.83 ~ -0.16, P < 0.05, I2 = 96%), with each session exceeding 60 minutes (SMD = -1.48, 95% CI = -2.32 ~ -0.64, P < 0.01, I2 = 96%), compared to the control group, significantly improve CRF in patients. CONCLUSION The research findings confirm the effectiveness of AE in alleviating CRF. Subgroup analysis further elucidated that AE interventions lasting at least 12 weeks, 3 times or less per week, with 60 minutes or more per session, significantly alleviated CRF among patients. However, given the limited number of included studies, caution is warranted in interpreting these subgroup analysis outcomes. The protocol for this review was duly registered on PROSPERO under the registration number CRD42024559098.
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Affiliation(s)
- Tong Wang
- School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Jiaxin Deng
- School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Weicheng Li
- School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Qiubo Zhang
- Primary School Attached to Chengdu Normal College, Chengdu, Sichuan, China
| | - Haoming Yan
- School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Yongfeng Liu
- School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
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14
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Fanciulli G, Favara G, Maugeri A, Barchitta M, Agodi A, Basile G. Comparing percutaneous treatment and cholecystectomy outcomes in acute cholecystitis patients: a systematic review and meta-analysis. World J Emerg Surg 2025; 20:50. [PMID: 40483437 PMCID: PMC12145639 DOI: 10.1186/s13017-025-00622-6] [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] [Received: 03/07/2025] [Accepted: 05/24/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Acute cholecystitis (AC) is a common and serious condition characterized by gallbladder inflammation, most often caused by cystic duct obstruction due to gallstones. Although laparoscopic cholecystectomy (CC) is the preferred surgical treatment, percutaneous cholecystostomy (PC) is frequently considered for high-risk surgical patients. The optimal management strategy for these patients remains a topic of debate. These systematic review and meta-analysis aim to provide an updated evaluation of studies comparing the clinical outcomes of AC patients treated with PC versus those undergoing CC, as well as the outcomes of CC alone versus PC followed by CC. METHODS A literature search was carried out across Web of Science, Medline, Embase, and PubMed up to April 2024. Observational studies comparing patients undergoing PC versus CC, as well as CC versus PC followed by CC, and reporting mortality, morbidity, and readmission were included. Data extraction and quality assessment were independently performed by two reviewers, with bias risk evaluated using the Newcastle-Ottawa Quality Scale. The pooled odds ratio (OR) was obtained through meta-analyses by using STATA software (Version 18). RESULTS A total of 27 studies were included, with 16 comparing PC versus CC and 11 assessing PC followed by CC versus CC alone. Meta-analyses revealed that CC was associated with significantly lower mortality (OR = 0.26; 95% CI = 0.14-0.48) and readmission rates (OR = 0.37; 95% CI = 0.18-0.75) compared to PC. The benefits of laparoscopic cholecystectomy over percutaneous cholecystostomy were particularly evident for mortality (OR = 0.17; 95% CI = 0.09-0.33), while a non-significant trend towards reduced readmission rates was also observed (OR = 0.28; 95% CI = 0.07-1.13). However, PC was identified as a viable alternative in high-risk surgical patients. Studies examining PC followed by CC versus CC alone showed diverse results, with some indicating reduced surgical complications and improved outcomes, while others reported no significant benefits. CONCLUSION This work highlights that CC is associated with better outcomes, including lower mortality and readmission rates, compared to both PC alone and PC followed by CC. The combined approach did not show a significant advantage over immediate CC. Further research with larger studies and standardized protocols is needed to refine treatment strategies for high-risk AC patients.
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Affiliation(s)
- Gabriele Fanciulli
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Giuliana Favara
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
| | - Guido Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Gaeini Z, Bahadoran Z, Malmir H, Mirmiran P. Dose-dependent effect of coconut oil supplementation on obesity indices: a systematic review and dose-response meta-analysis of clinical trials. BMC Nutr 2025; 11:113. [PMID: 40481535 PMCID: PMC12142848 DOI: 10.1186/s40795-025-01090-6] [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: 09/07/2024] [Accepted: 05/14/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Coconut oil has been suggested as a potential dietary intervention for weight management. However, the evidence regarding the effects of coconut oil supplementation on anthropometric measures (body weight, body mass index (BMI) and waist circumference (WC)) remains inconclusive. OBJECTIVE we aimed to assess the overall effect of coconut oil supplementation on these anthropometric parameters and explore potential sources of heterogeneity. METHODS We comprehensively searched electronic databases using appropriate keywords. We included 15 studies with the following criteria: (1) clinical trials in adults, with parallel or cross-over design, (2) evaluated the effect of coconut oil on body weight, BMI or WC, (3) compared the effect of a specific dose of coconut oil against a coconut oil-free diet or other types of oils, (4) considered the change in anthropometric parameters as the primary or one of the secondary outcomes, (5) provided mean and standard deviation (SD) of change in anthropometric parameters across study arms, (6) reported the number of participants in each study arm. RESULTS The trials included 620 participants and assessed the effects of coconut oil supplementation on body weight, BMI and WC. Our meta-analysis revealed statistically significant effects of coconut oil supplementation on weight and BMI, with mean differences of 0.04 kg (95% CI: 0.01 to 0.08 kg) and 0.01 kg/m2 (95% CI: 0.00 to 0.02). However, the effects were not clinically meaningful. There was no significant effect of coconut oil on WC. Subgroup analyses suggested that the duration of the intervention may influence the effect of coconut oil on body weight. In the sensitivity analysis, we found that the result of one study influenced the associations between coconut oil supplementation and weight or BMI. CONCLUSIONS Overall, our findings suggest no clinically significant effects of coconut oil supplementation on weight loss. Further research is needed to clarify the issue. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD420251031291.
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Affiliation(s)
- Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Zahra Bahadoran
- , Micronutrient Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Malmir
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran.
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16
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Harvey J, Western MJ, Townsend NP, Francombe-Webb J, Sebire S, Malkowski OS, Remskar M, Burfitt E, Solomon-Moore E. Adolescents, menstruation, and physical activity: insights from a global scoping review. BMC Womens Health 2025; 25:281. [PMID: 40481462 PMCID: PMC12142975 DOI: 10.1186/s12905-025-03825-w] [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] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Accepted: 05/22/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND Adolescent girls tend to be less physically active than boys, a trend that coincides with puberty. Menstruation may act as a barrier to physical activity, which in turn may influence menstrual symptoms. The purpose of this scoping review was to synthesise the global literature on the association between menstruation and physical activity among adolescents. METHODS A systematic search was conducted across five databases, identifying studies on menstruation and physical activity in adolescents (aged 10-18 years) without date restrictions. Studies not in English, including only athlete populations and focusing solely on premenstrual syndrome were excluded. Titles and abstracts, followed by full texts were screened by two independent reviewers. RESULTS Eighty-six studies were included, spanning 33 countries. Thematic synthesis of data from the selected studies suggests a bidirectional relationship in that menstruation may act as a barrier to physical activity due to symptoms, societal stigma and menstrual product access, while physical activity may alleviate symptoms for some. The review highlights variability in study methodologies, with most relying on self-report data. CONCLUSION This review provides insights into the varied experiences of adolescent girls' physical activity and menstruation, influenced by cultural, social, and resource-related factors. It makes important and timely recommendations for the direction of future research, which should employ longitudinal and mixed methods approaches to better understand the association between menstruation and physical activity in this population and address gaps regarding the mechanisms and magnitude of this relationship.
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Affiliation(s)
- Jessica Harvey
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK.
| | - Max J Western
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Nick P Townsend
- Centre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Jessica Francombe-Webb
- Department for Health, Centre for Sport, Physical Activity & Health Equality, University of Bath, Bath, UK
| | - Simon Sebire
- The Health Improvement Commission for Guernsey and Alderney LBG, Castel, Guernsey, Channel Islands, UK
| | - Olivia S Malkowski
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Masha Remskar
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Ella Burfitt
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Emma Solomon-Moore
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
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17
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Spanoudakis E, Vampertzis T, Wadia F, Rad DR, Barmpagianni C, Zervos IA, Tsiridis E, Galanis N. Botulinum toxin in fracture management: a scoping review. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2025; 35:233. [PMID: 40467894 PMCID: PMC12137460 DOI: 10.1007/s00590-025-04295-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 04/04/2025] [Indexed: 06/11/2025]
Abstract
PURPOSE Using botulinum toxin (BoNT) as an adjunct in fracture management is a novel approach with the potential to improve clinical outcomes, particularly in atypical fractures and patients with concurrent neuromuscular disorders. This scoping review explores the literature on BoNT's effectiveness in facilitating fracture healing and immobilisation across various fracture types. METHODS The PubMed, Embase, and Cochrane databases were searched with defined operators. Two investigators conducted independent searches, which were combined. Animal studies, case reports, case series, cohort reviews and randomised control trials were included. RESULTS Fifty studies were identified for screening, from which 15 studies were included in the review. The findings highlight mixed outcomes in BoNT's role in enhancing bone healing and reducing muscle-induced displacement. While BoNT injections demonstrated potential benefits in specific cases, such as atypical fractures, periprosthetic fractures and fractures in patients with motor dysfunctions, results from animal studies were inconsistent, showing varied effects on callous formation and bone mineral density. CONCLUSION Clinical applications of BoNT in fracture management indicate its utility as an immobilisation agent to promote fracture healing and reduce complications. However, this review highlights that further research is necessary to bridge the gap between experimental and clinical studies and to clarify BoNT's effectiveness in different use cases.
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Affiliation(s)
- Emmanuel Spanoudakis
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
| | | | - Farokh Wadia
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Darius Rares Rad
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | | | - Eleftherios Tsiridis
- Papageorgiou General Hospital, Thessaloniki, Greece
- Aristotle University of Thessaloniki, Thessaloniki, Greece
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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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Ingram LA, Tomkinson GR, d'Unienville NMA, Gower B, Gleadhill S, Boyle T, Bennett H. Mechanisms Underlying Range of Motion Improvements Following Acute and Chronic Static Stretching: A Systematic Review, Meta-analysis and Multivariate Meta-regression. Sports Med 2025; 55:1449-1466. [PMID: 40180774 DOI: 10.1007/s40279-025-02204-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2025] [Indexed: 04/05/2025]
Abstract
BACKGROUND Static stretching (SS) is routinely used in sports and clinical settings to increase joint range of motion (ROM). However, the mechanisms underlying improvements in ROM remain unclear. OBJECTIVE We aimed to determine the effects of a single session (acute) and multiple sessions (chronic) of SS on stretch tolerance, passive stiffness and fascicle length, and whether such effects are moderated by specific training parameters and participant characteristics. A secondary aim was to explore the mechanisms associated with improved ROM. METHODS Seven databases (CINAHL Complete, Cochrane CENTRAL, Embase, Emcare, MEDLINE, Scopus and SPORTDiscus) were systematically searched up to 6 June, 2024. Randomised and non-randomised controlled trials investigating the effects of acute (single session) or chronic (two or more sessions) SS on muscle-tendon unit structure (fascicle length), mechanical properties (stiffness) or stretch tolerance (maximum tolerable passive resistive torque) compared to non-stretching passive controls (adults aged ≥ 18 years) were included. The effects of SS were examined using a multi-level meta-analysis, with associations between changes in maximum tolerable passive resistive torque, stiffness and fascicle length with improvements in ROM examined using multivariate meta-regression. RESULTS Data from 65 studies representing 1542 adults (71% male; mean ± standard deviation age = 26.1 ± 11 years) were included. We found a small decrease in overall stiffness following both acute (Hedges' g = 0.42, 95% confidence interval [CI] 0.21, 0.63, p < 0.001) and chronic SS (Hedges' g = 0.37, 95% confidence interval 0.18, 0.56, p < 0.001), and a moderate increase in maximum tolerable passive resistive torque following chronic SS (Hedges' g = 0.74, 95% CI 0.38, 1.10, p < 0.001). Neither acute nor chronic SS had a significant effect on fascicle length. For acute SS, greater reductions in overall stiffness were found with moderate (p < 0.002) and high SS intensities (p = 0.02) compared with low-intensity SS, and in individuals with normal flexibility compared with those with poor flexibility at baseline (p < 0.001). Conversely, the effects of chronic SS on overall stiffness and maximum tolerable passive resistive torque were not moderated by stretching intensity, intervention length, baseline flexibility or sex (p > 0.05). Last, improved ROM following chronic SS was significantly associated with both decreased overall stiffness (g = 0.59, 95% CI 0.08, 1.10, p = 0.03) and increased maximum tolerable passive resistive torque (g = 0.74, 95% CI 0.41, 1.09, p < 0.001). CONCLUSIONS While both acute and chronic SS reduced overall stiffness, stretch tolerance only increased following chronic SS. Neither acute nor chronic SS altered fascicle length. The effect of acute SS on reduced overall stiffness was greater when stretching at a moderate or higher intensity and in those with normal flexibility. Increased ROM was significantly associated with decreased overall stiffness and increased stretch tolerance following chronic SS. Understanding the mechanisms underlying SS will assist coaches and clinicians in deciding whether and when to prescribe SS to their athletes and patients. CLINICAL TRIAL REGISTRATION PROSPERO CRD42023420168.
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Affiliation(s)
- Lewis A Ingram
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Noah M A d'Unienville
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Bethany Gower
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Sam Gleadhill
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Hunter Bennett
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
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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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21
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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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22
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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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23
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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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24
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Kartibou J, El Ouali EM, Del Coso J, Hackney AC, Rfaki A, Saeidi A, El Hage R, Granacher U, Mesfioui A, Zouhal H. Association Between the c.34C > T (rs17602729) Polymorphism of the AMPD1 Gene and the Status of Endurance and Power Athletes: A Systematic Review and Meta-Analysis. Sports Med 2025; 55:1429-1448. [PMID: 40332645 DOI: 10.1007/s40279-025-02202-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2025] [Indexed: 05/08/2025]
Abstract
BACKGROUND Previous research has shown that variants in the AMPD1 gene, which encodes the adenosine monophosphate deaminase 1 (AMPD1) protein, may affect energy supply of the muscle and fatigue resistance during high-intensity exercise. A single nucleotide substitution in this gene, specifically a cytosine-to-thymine substitution (c.34C > T; rs17602729), results in a nonsense mutation that causes a deficiency in the AMPD1 protein. Deficiency of the AMPD1 protein due to this polymorphism can influence exercise performance, ultimately affecting the likelihood of reaching the status of elite endurance or power athlete. OBJECTIVE This systematic review and meta-analysis aimed to investigate the distribution of CC, CT, and TT genotypes of the AMPD1 c.34C > T polymorphism (rs17602729) in endurance and power athletes to assess potential associations between this polymorphism and elite athlete status. METHODS Studies investigating genotype distribution in the AMPD1 c.34C > T (rs17602729) polymorphism in endurance and/or power athletes were searched for in four electronic databases (PubMed, Web of Science, Scopus, Science Direct). The studies were selected and the genotypic and allelic frequencies of the AMPD1 c.34C > T (rs17602729) polymorphism were extracted if data for endurance and/or power athletes were compared with controls (non-athletes). Meta-analyses were computed using fixed or random effects models to calculate odds ratios (OR) with confidence interval (95% CI). Heterogeneity of the meta-analyses was reported using I2 statistics. RESULTS After examining 1229 studies on the distribution of the AMPD1 c.34C > T (rs17602729) polymorphism in endurance and/or power athletes, 20 studies were considered eligible to be included in our meta-analysis. The studies were conducted in 11 different countries, including 5717 participants. There was a higher frequency of the CC genotype (OR 1.72; 95% CI 1.40-2.12; p < 0.00001) in endurance athletes compared with non-athletic controls with a lower frequency of CT (OR 0.61; 95% CI 0.49-0.75; p < 0.00001) and TT genotypes in endurance athletes versus non-athletic controls (OR 0.43; 95% CI 0.19-0.97; p = 0.04). A higher frequency of the CC genotype was also observed in power athletes compared with controls (OR 2.17; 95% CI 1.69-2.78; p < 0.00001) with a lower frequency of the CT (OR 0.51; 95% CI 0.39-0.65; p < 0.00001) and TT genotypes (OR 0.25; 95% CI 0.09-0.68; p = 0.007) in power athletes compared with controls. Overall, the genotype distribution of the AMPD1 c.34C > T polymorphism (rs17602729) was similar in endurance and power athletes (OR between 0.76 and 1.39; p = 0.47-0.72). CONCLUSION Our findings indicate that the CC genotype was overrepresented in endurance and power athletes compared with controls, suggesting that possessing two copies of the C allele of the AMPD1 c.34C > T (rs17602729) polymorphism may be associated with a 1.72-2.17 times greater likelihood of achieving elite or sub-elite athlete status in disciplines reliant on aerobic and anaerobic metabolic pathways. No statistically significant differences were found in the AMPD1 genotype distribution between endurance and power athletes.
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Affiliation(s)
- Jihan Kartibou
- Department of Biology, Laboratory of Biology and Health, Ibn Tofail University of Kenitra, Kenitra, Morocco
| | - El Mokhtar El Ouali
- Sports Science Research Team, Institute of Sports Sciences, Hassan I University, Settat, Morocco.
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Abderrazak Rfaki
- National Center for Scientific and Technical Research (CNRST), Rabat, Morocco
| | - Ayoub Saeidi
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Rawad El Hage
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany.
| | - Abdelhalem Mesfioui
- Department of Biology, Laboratory of Biology and Health, Ibn Tofail University of Kenitra, Kenitra, Morocco
| | - Hassane Zouhal
- Movement, Sport, Health and Sciences Laboratory (M2S). UFR-STAPS, University of Rennes 2-ENS Cachan, Av. Charles Tillon, 35044, Rennes Cedex, France.
- Institut International Des Sciences du Sport (2IS), 35850, Irodouer, France.
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25
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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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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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27
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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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Mazzone E, Cannoletta D, Quarta L, Chen DC, Thomson A, Barletta F, Stabile A, Moon D, Eapen R, Lawrentschuk N, Montorsi F, Siva S, Hofman MS, Chiti A, Murphy DG, Briganti A, Perera ML. A Comprehensive Systematic Review and Meta-analysis of the Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Prostate Cancer Diagnosis and Primary Staging before Definitive Treatment. Eur Urol 2025; 87:654-671. [PMID: 40155242 DOI: 10.1016/j.eururo.2025.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 03/01/2025] [Accepted: 03/13/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND AND OBJECTIVE Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) in the diagnosis and primary staging of patients with prostate cancer (PCa) has an established role, but recent summative evidence on its actual diagnostic and staging value is still missing. We aimed to collect and analyze published studies reporting the accuracy of PSMA PET for the diagnosis of clinically significant prostate cancer (csPCa) and detection of distant metastases at primary staging before definitive treatment. METHODS We performed a systematic review of the literature, by searching the PubMed/MEDLINE, Cochrane library's CENTRAL, EMBASE, and Scopus databases, from inception to April 2024. Two coprimary outcomes were assessed: first, to evaluate the sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of PSMA PET in detecting intraprostatic csPCa on a per-patient level, and second, to assess the positivity rates of metastatic disease in the primary staging, prior to definitive therapy. As a secondary outcome, the diagnostic accuracy of PET PSMA for the detection of lymph nodal invasion (LNI) was tested in a per-patient-level analysis of studies where pelvic lymph node dissection (PLND) was available as the reference standard. Positivity and detection rates were pooled using random-effect models. Preplanned subgroup analyses tested the diagnostic accuracy of PET PSMA across different study cohorts. Variation in PPV and NPV over csPCa and LNI prevalence was evaluated. KEY FINDINGS AND LIMITATIONS In total, 12 and 99 studies, with a total of 1533 and 18 649 participants, respectively, were included in the quantitative synthesis for intraprostatic diagnosis and staging. For intraprostatic disease, the sensitivity, specificity, PPV, and NPV of PSMA PET for csPCa were 82% (95% confidence interval [CI] 73-90%), 67% (95% CI 46-85%), 77% (95% CI 63-88%), and 73% (95% CI 56-87%), respectively. At a bivariate analysis, the diagnostic accuracy of PSMA PET estimated through a summary receiver operating characteristic curve-derived area under the curve was 84%, increasing up to 88% when combined with magnetic resonance imaging (MRI). On staging level, PSMA PET results were positive outside the prostate in 23% of the patients, with substantial variation in positivity rates between high-risk (31%) and intermediate-risk (12%) subcohorts. When using PLND as the reference standard (51 studies, 7713 patients), the sensitivity, specificity, PPV, and NPV of PSMA PET were, respectively, 54%, 94%, 77%, and 86%. With higher csPCa and LNI prevalence, a similar increase in PPV and a decrease in NPV were observed. CONCLUSIONS AND CLINICAL IMPLICATIONS The current updated systematic review and meta-analysis provides updated evidence on the diagnostic and staging accuracy of PSMA PET in PCa. We reported good accuracy of PSMA PET to discriminate csPCa, particularly when added to MRI, but NPV alone is insufficient to omit a biopsy. Regarding staging, PSMA PET cannot be used alone to determine the need for lymph node dissection (LND) and should be combined with additional clinical information within predictive tools. As such, further research should develop and validate models that incorporate PSMA PET to reliably inform biopsy or LND.
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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 Lab, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Donato Cannoletta
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Lab, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Quarta
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Lab, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - David C Chen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Alice Thomson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Francesco Barletta
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Lab, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Armando Stabile
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Lab, URI, IRCCS San Raffaele Scientific Institute, 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
| | - 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 Lab, URI, 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, Molecular Imaging and Therapeutic Nuclear Medicine, 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
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Alberto Briganti
- Division of Oncology/Unit of Urology, Gianfranco Soldera Prostate Cancer Lab, URI, 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
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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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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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Zuckerman BP, Gibson M, Roy R, Hughes M, Mehta D, Yang Z, Adas M, Ng K, Russell MD, Cope A, Norton S, Galloway J. Abatacept and the risk of malignancy: a meta-analysis across disease indications. Rheumatology (Oxford) 2025; 64:3280-3287. [PMID: 39992258 DOI: 10.1093/rheumatology/keaf114] [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] [Received: 11/07/2024] [Revised: 02/10/2025] [Accepted: 02/10/2025] [Indexed: 02/25/2025] Open
Abstract
OBJECTIVES To estimate the association between abatacept use and the incidence of malignancy excluding non-melanomatous skin cancers (NMSCs). METHODS Systematic database searches were performed, to April 2024, to identify phase II/III/IV randomized clinical trials (RCTs), long-term extension (LTE) and observational cohort studies of abatacept in people with rheumatoid arthritis and psoriatic arthritis. Network and pairwise meta-analyses were performed to estimate incidence rate ratios (IRRs) for malignancy excluding NMSC, comparing abatacept with placebo and tumour necrosis factor inhibitors (TNFi) in RCT/LTE studies. Pairwise meta-analyses evaluated the same outcome in observational studies, comparing abatacept with conventional synthetic DMARDs (csDMARDs) and biologic/targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs). RESULTS In 18 eligible RCTs and 10 LTE studies, there were 15 535 person-years of exposure to abatacept, 1495 to placebo and 733 to TNFi. In network meta-analyses of combined RCT/LTE data, the incidence of all malignancies excluding NMSCs was not significantly different between abatacept and placebo (IRR 0.58; 95% CI 0.32-1.09) or TNFi (IRR 0.72; 95% 0.27-1.87). In observational data, the incidence of malignancy was higher with abatacept, relative to other b/tsDMARDs (IRR 1.21; 95% CI 1.15-1.28), but not significantly different compared with csDMARDs (IRR 0.97; 95% CI 0.90-1.06). CONCLUSIONS Abatacept was associated with a higher incidence of malignancy compared with other b/tsDMARDs in observational studies, but not when compared with placebo or TNFi in RCT/LTE data. Further pharmacovigilance data is essential to help elucidate whether abatacept modifies cancer risk. PROSPERO REGISTRATION NUMBER CRD42023382314.
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Affiliation(s)
| | - Mark Gibson
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Ritika Roy
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
| | - Mark Hughes
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
| | - Daksh Mehta
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
| | - Zijing Yang
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Maryam Adas
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Kenrick Ng
- Department of Medical Oncology, University College London, London, UK
| | - Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Andrew Cope
- Centre for Rheumatic Diseases, King's College London, London, UK
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
| | - Sam Norton
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
| | - James Galloway
- Centre for Rheumatic Diseases, King's College London, London, UK
- Guy's King's and St Thomas' Medical School, King's College London, London, UK
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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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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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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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Viana P, Castillo-Flores S, Mora MMR, Cabral TDD, Martins PN, Kueht M, Faria I. Normothermic Machine Perfusion vs. Static Cold Storage in Liver Transplantation: A Systematic Review and Meta-Analysis. Artif Organs 2025; 49:945-954. [PMID: 39887468 DOI: 10.1111/aor.14960] [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: 11/11/2024] [Revised: 12/30/2024] [Accepted: 01/16/2025] [Indexed: 02/01/2025]
Abstract
BACKGROUND Normothermic machine perfusion (NMP) represents an alternative to prolong liver preservation and reduce organ discard rates. We performed an updated systematic review and meta-analysis to compare NMP with static cold storage (SCS) in liver transplantation. METHODS MEDLINE, Embase, and Cochrane were searched for randomized controlled trials (RCTs) or observational studies. Risk ratios (RR) and mean differences were calculated. p < 0.05 was considered significant. A random-effects model was applied for all outcomes. PROSPERO ID CRD42023486184. RESULTS We included 1295 patients from 5 RCTs and 6 observational studies from 2016 to 2023. 592 (45.7%) underwent NMP. A subgroup RCT analysis favored NMP for non-anastomotic strictures (RR 0.4; 95% CI 0.2, 0.9), postreperfusion syndrome (RR 0.4; 95% CI 0.27, 0.56), and early allograft dysfunction (RR 0.6; 95% CI 0.4, 0.9). NMP favored higher organ utilization rates (RR 1.1; 95% CI 1.02, 1.18). No significant differences between NMP and SCS were observed in graft survival or patient survival at 12 months, primary non-function, serious adverse events, overall biliary complications, AST, or bilirubin levels peak within the first 7 days, ICU or hospital length of stay. CONCLUSION Our findings suggest that NMP is associated with lower non-anastomotic biliary stricture rates, postreperfusion syndrome, early allograft dysfunction, and higher organ utilization in the RCT subgroup analysis, without increasing adverse events.
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Affiliation(s)
- Patricia Viana
- University of Extreme South of Santa Catarina, Criciuma, Brazil
| | | | - Maria M R Mora
- Univeristat Internacional de Catalunya, Barcelona, Spain
| | | | - Paulo N Martins
- Division of Organ Transplantation, Department of Surgery, University of Massachusetts, Worcester, Massachusetts, USA
| | - Michael Kueht
- Division of Transplant Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Isabella Faria
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
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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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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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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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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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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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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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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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Hulshoff M, Sun C, Book E, Tanner C, Dahodwala N, Reynolds B, Boon H, Marras C. Care partner needs in Parkinson's disease: A systematic review of qualitative and quantitative data. JOURNAL OF PARKINSON'S DISEASE 2025:1877718X251344066. [PMID: 40448327 DOI: 10.1177/1877718x251344066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2025]
Abstract
BACKGROUND Care for persons with Parkinson's disease (PD) is to a great extent carried out by care partners. It is important to understand their needs to ease their burden and help with their important role. OBJECTIVE To present (1) what is known about needs in caregiving for someone with PD from both qualitative and quantitative papers; and (2) to identify research gaps in the existing literature to guide future research. METHODS A systematic search was conducted, searching PubMed, CINAHL, PsychINFO, and MEDLINE for both qualitative and quantitative studies examining care partner needs in Parkinson's disease published from the start of the databases up to 13 November 2024. The best-fit framework synthesis method was employed for qualitative data extraction and analysis. The Critical Appraisal Skills Programme (CASP) and the Newcastle-Ottawa Scale (NOS) were used for quality assessment of studies. RESULTS Forty-eight qualitative studies, ten quantitative studies, and three mixed methods studies met the eligibility criteria. All studies were of observational, cross-sectional design. A total of nine themes (the need for information, the need to be heard, PD healthcare, emotional support, daily living, financial support, skills, care partner physical well-being, and respite care) were identified from qualitative data and all quantitative data could fit this framework. Quantitative data on the frequency of needs and when they arise over the course of PD were scarce. Only one quantitative study made use of a validated measurement instrument to measure care partner needs, the Family Needs Questionnaire. CONCLUSIONS Care partner needs in PD are wide-ranging. A significant gap identified is the absence of quantitative data to determine the prevalence, timing, and factor contributing to the needs revealed by the qualitative research.
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Affiliation(s)
- Max Hulshoff
- Department of Neurology, Haga ziekenhuis, Den Haag, The Netherlands
| | - Christine Sun
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Book
- Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Tanner
- Department of Neurology, Weill Institute for Neuroscience, University of California - San Francisco, San Francisco, CA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Heather Boon
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
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Ostap-Chec M, Antoł W, Bajorek D, Berbeć E, Moroń D, Rapacz M, Miler K. Meta-Analysis and Experimental Evidence Reveal No Impact of Nosema ceranae Infection on Honeybee Carbohydrate Consumption. MICROBIAL ECOLOGY 2025; 88:56. [PMID: 40442489 PMCID: PMC12122660 DOI: 10.1007/s00248-025-02550-z] [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: 12/23/2024] [Accepted: 05/09/2025] [Indexed: 06/02/2025]
Abstract
Honeybees (Apis mellifera) are indispensable pollinators for ecosystem stability and agricultural productivity. However, they face numerous challenges, including pathogens threatening their survival and ecosystem services. Among these pathogens, Nosema ceranae, a microsporidian parasite, causes significant damage to the intestinal tract and induces energetic imbalances in the organism, posing a major threat to both individual bees and entire colonies. In response to infections, bees often engage in behavioral defenses, such as self-medicating with antimicrobial substances available in their environment. We hypothesized that bees infected with N. ceranae might compensate behaviorally by increasing their carbohydrate consumption. To test this hypothesis, we conducted a meta-analysis of existing studies comparing sugar consumption in healthy and infected bees, complemented by an experimental study. In our experiment, we measured sugar intake and quantified trehalose levels in the hemolymph, a key indicator of energy reserves. Both the meta-analysis and experimental results consistently showed no significant differences in sugar consumption between healthy and infected bees. Similarly, trehalose levels in the hemolymph remained comparable between the two groups. Our findings suggest that the infection caused by N. ceranae does not elicit compensatory feeding behavior in honeybees. Moreover, the meta-analysis revealed significant gaps in current research, particularly a lack of studies focusing on forager bees, which face the highest energetic demands among colony members. Our findings call for future studies on the energetic effects of nosemosis and studies conducted under natural or semi-natural conditions.
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Affiliation(s)
- Monika Ostap-Chec
- Institute of Systematics and Evolution of Animals of the Polish Academy of Sciences, Kraków, Poland.
| | - Weronika Antoł
- Institute of Systematics and Evolution of Animals of the Polish Academy of Sciences, Kraków, Poland
| | - Daniel Bajorek
- Institute of Systematics and Evolution of Animals of the Polish Academy of Sciences, Kraków, Poland
| | - Ewelina Berbeć
- Department of Bees Breeding, Institute of Animal Husbandry and Breeding, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
| | - Dawid Moroń
- Institute of Systematics and Evolution of Animals of the Polish Academy of Sciences, Kraków, Poland
| | - Marcin Rapacz
- Department of Plant Breeding, Physiology, and Seed Science, University of Agriculture in Kraków, Kraków, Poland
| | - Krzysztof Miler
- Institute of Systematics and Evolution of Animals of the Polish Academy of Sciences, Kraków, Poland.
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Vijendran S, Alok Y, Kuzhuppilly NIR, Bhat JR, Kamath YS. Effectiveness of smartphone technology for detection of paediatric ocular diseases-a systematic review. BMC Ophthalmol 2025; 25:323. [PMID: 40448047 DOI: 10.1186/s12886-025-04160-2] [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: 12/25/2024] [Accepted: 05/22/2025] [Indexed: 06/02/2025] Open
Abstract
BACKGROUND Artificial intelligence has become part of healthcare with a multitude of applications being customized to roles required in clinical practice. There has been an expanding growth and development of computer technology with increasing appearance in the ophthalmological universe with roles in detection of most ophthalmic diseases. This article attempts to study the efficacy of smartphones and their applications in detection of paediatric eye diseases. METHODS On 24 January 2024, a comprehensive search was performed across five databases-PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and ProQuest-focusing on studies assessing smartphone-based disease detection and diagnostic accuracy compared to validated methods. Keywords and MeSH terms, including "smartphone," "eye diseases," and "children," were combined using Boolean operators and eligible studies were obtained. The inclusion criteria covered studies from 2000 to 2023, involving children under 18 years, and reporting diagnostic outcomes. Exclusions included studies not exclusive to eye disease, purely adult population studies, reviews, studies with non-availability of full text, and studies exploring other uses of smartphone and designs lacking diagnostic efficacy analysis. Article quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS A total of 2054 articles were retrieved. After removing 1112 duplicates, 507 records were excluded through title screening, followed by 333 through abstract screening. A full-text review of 83 articles led to the inclusion of 33 studies, involving 16,015 participants. Most of the studies (28, 84.84%) were of high quality, with five (15.15%) of moderate quality. Twelve smartphone applications assessed refractive errors using visual acuity tests or photorefraction, five detected amblyogenic risk factors, six identified strabismus, and three targeted leukocoria. Additional applications evaluated stereoacuity (two), eyelid position (one), chalazion (one), corneal diameter (one), and retinopathy of prematurity (two). Overall, these applications demonstrated the potential of smartphones in paediatric eye disease detection. CONCLUSION Smartphone applications are effective tools for detecting important causes of childhood eye disorders such as strabismus, retinopathy of prematurity, chalazion, and refractive errors. These technologies offer promising opportunities for teleophthalmology and integration into routine clinical practice.
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Affiliation(s)
- Sruthi Vijendran
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Yash Alok
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Jayasheela R Bhat
- Consultant Optometrist, Karthik Nethralaya Institute of Ophthalmology Pvt Ltd, Bangalore, 560050, India
| | - Yogish S Kamath
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Healy D, Gilmore J, King J, McSharry J, Meade O, Ní Shé É, Sweeney L, Foley C, Noone C. Exploring how health inequalities are conceptualised and measured in patient experience surveys in acute care: a protocol for a scoping review. HRB Open Res 2025; 7:74. [PMID: 40070555 PMCID: PMC11895858 DOI: 10.12688/hrbopenres.13998.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2025] [Indexed: 03/14/2025] Open
Abstract
Introduction Measuring patient experience has become standard practice in many countries. However, despite the widespread awareness of the impact of health inequalities on various aspects of health, including patient experience, a comprehensive examination of whether and how health inequalities are measured in patient experience surveys has yet to be completed. The ways in which these surveys conceptualise health inequalities may have important implications for how information about inequalities in patient experience is reported and used to allocate resources and plan quality improvement in health services. Objective The objective of this scoping review is to map measured and overlooked health inequalities in patient experience surveys in acute care and explore what factors potentially explain current conceptualisations and measurement practices of these health inequalities. Inclusion criteria: Papers and survey programmes that contain survey materials relating to adult patient experience measurement in any acute care context will be included. No limits will be placed the personal characteristics of people who completes the survey. Inclusion criteria Papers and survey programmes that contain survey materials relating to adult patient experience measurement in any acute care context will be included. No limits will be placed the personal characteristics of people who completes the survey. Methods A search strategy was developed with an information specialist. The database search will be limited to after September 2021. Reviews, opinion pieces, letters, editorials, conference proceedings and other such sources will be excluded as a publication source. Grey literature searches will be completed, and relevant experts will also be contacted to identify any patient experience surveys not captured through database or grey literature searches. Non-English papers will be included only if resources allow. Two independent reviewers will complete title and abstract, and full-text screening. Additional reviewers will resolve any conflicts. A data extraction form developed by the review team is being used. The extracted data will be analysed using Critical Discourse Analysis, a qualitative method used to examine how power, dominance and inequality are enacted in text.
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Affiliation(s)
- David Healy
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| | - John Gilmore
- School of Nursing Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Jenny King
- Picker Institute Europe, Oxford, England, OX4 2JY, UK
| | - Jenny McSharry
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| | - Oonagh Meade
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
| | - Éidín Ní Shé
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, D02 YN77, Ireland
| | - Lorna Sweeney
- Health Information and Quality Authority, Cork, T12 Y2XT, Ireland
| | - Conor Foley
- Health Information and Quality Authority, Cork, T12 Y2XT, Ireland
| | - Chris Noone
- School of Psychology, University of Galway, University Road, Galway, H91 TK33, Ireland
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Walsh S, Bartlett M, Salvo-Halloran EM, Sears J, Li Y, Kelly M, Gavata-Steiger S, Nenci C, Jacobs I, Pragst I, Ray N, Samjoo IA. Network Meta-Analysis of Pharmacological Therapies for Long-Term Prophylactic Treatment of Patients with Hereditary Angioedema. Drugs R D 2025:10.1007/s40268-025-00511-y. [PMID: 40434599 DOI: 10.1007/s40268-025-00511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2025] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND AND OBJECTIVES Several treatments for long-term prophylaxis (LTP) of hereditary angioedema (HAE) are in clinical use, such as garadacimab, lanadelumab, subcutaneous C1 esterase inhibitor (C1INH), and berotralstat. In the absence of head-to-head comparative evidence, indirect comparison methods are needed to compare LTP treatments in patients with HAE. The objective of this analysis was to estimate the comparative efficacy, safety, and impact on quality of life of LTP treatments for patients with HAE through NMAs. METHODS A systematic literature review was conducted to identify randomized controlled trials (RCTs) investigating LTP treatments in patients (at least 12 years old) with HAE (PROSPERO protocol #CRD42022359207). A network meta-analysis (NMA) feasibility assessment evaluated trial suitability and Bayesian NMAs were conducted for evaluable efficacy, safety, and quality of life (QoL) outcomes. RESULTS The results of these NMAs show improved efficacy, QoL, and reduced rate of adverse events with garadacimab (200 mg once monthly), lanadelumab (300 mg every two or four weeks), subcutaneous C1INH (60 IU/kg twice weekly), and berotralstat (150 mg once daily) compared to placebo in the treatment of patients with HAE. For the primary outcome of time-normalized number of HAE attacks, garadacimab statistically significantly reduced the rate of attacks compared to lanadelumab Q4W and berotralstat. A similar statistically significant reduction was shown for HAE attacks treated with on-demand treatment. Garadacimab showed statistically significant reduction in the rate of moderate and/or severe HAE attacks compared to lanadelumab Q2W. Garadacimab also showed statistical improvements in change from baseline in AE-QoL total score as compared to berotralstat. CONCLUSIONS Overall, garadacimab ranked as the most probable effective treatment among all comparators assessed, with lanadelumab Q2W or subcutaneous C1INH ranking second, across most outcomes.
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Affiliation(s)
- Sarah Walsh
- EVERSANA, 113-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | - Meaghan Bartlett
- EVERSANA, 113-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada
| | | | | | | | | | | | | | | | | | | | - Imtiaz A Samjoo
- EVERSANA, 113-3228 South Service Road, Burlington, Ontario L7N 3H8, Canada.
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Yayeh MB, Dinkayehu TE, Endrias EE, Assegie MT. Prevalence and associated factors of caring behavior among nurses in Ethiopia: a systematic review and meta-analysis. BMC Health Serv Res 2025; 25:756. [PMID: 40426167 PMCID: PMC12107867 DOI: 10.1186/s12913-025-12916-1] [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] [Received: 12/31/2024] [Accepted: 05/16/2025] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND Caring behaviors among nurses have positive and negative impacts on patient care quality and the essence of nursing leadership paradigms. Most studies on caring behavior among nurses in Ethiopia have reported inconsistent findings and are regionally dispersed. It is believed that combining regional evidence to obtain nationally representative information could help program implementers. Therefore, the objective of this review was to estimate the pooled prevalence of caring behaviors and associated factors among nurses working in Ethiopia. METHODS PubMed, Scopus, Web of Science, EMBASE, Science Direct and African Journals Online were used to search for relevant studies. Additionally, studies were identified through manual reference searches. Data extraction was performed using Microsoft Excel, and analysis was conducted using STATA software V. 18. Funnel plots, Egger's test, and meta-regression were employed to assess publication bias. Heterogeneity (I²) and the overall estimate were calculated. Subgroup analysis was conducted based on study region and publication year. The pooled odds ratio was calculated for the main factors associated with caregiving behavior. RESULTS A total of 7 studies were included that involved 2,206 nursing professionals. According to the random effects model, the pooled prevalence of good care behavior was 63% (95% CI: 55%, 72%) among nurses. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (80.3%), and studies with a sample size of 300 had a higher prevalence of 52% caring behavior. Higher professional satisfaction (AOR = 1.84; 95% CI 1.41, 2.27), higher job satisfaction (AOR = 3.04; 95% CI 1.13, 4.94), a low workload (OR = 3.14; 95% CI 2.04, 4.25) and good relationships with coworkers (AOR = 4.72; 95% CI 1.57, 7.87) were factors associated with caring behaviors among nurses working in Ethiopia. CONCLUSIONS Caring behavior among nurses is moderately good, with professional satisfaction, job satisfaction, low workload, and good relationships with workers that affect the caring behaviors among nurses working in Ethiopia. Strategies must be designed to improve satisfaction packages to improve caring behavior among nurses and ultimately improve the quality of nursing care. TRIAL REGISTRATION The PROSPERO registration number is CRD42024570781.
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Affiliation(s)
- Melesse Belayneh Yayeh
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Temesgien Ergetie Dinkayehu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eshetu Elfios Endrias
- Department of Nursing, School of Health Science, College of Medicine and Health Sciences, Wolaita Sodo University, Woliata Sodo, Ethiopia
| | - Mastewal Tamiru Assegie
- Department of Inpatient Nursing Services, Tibebe Ghion Specialized Hospital, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Mainville L, Xu L, Piguet V, Drucker AM, Croitoru DO. Time to Disease Control with Dupilumab for Bullous Pemphigoid: A Systematic Review and Meta-analysis. Acta Derm Venereol 2025; 105:adv43667. [PMID: 40423583 DOI: 10.2340/actadv.v105.43667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2025] [Accepted: 05/13/2025] [Indexed: 05/28/2025] Open
Abstract
Bullous pemphigoid (BP) is a chronic autoimmune blistering disease primarily affecting the elderly population. While awaiting the results from randomized clinical trials to assess the effect of dupilumab in patients with BP, clinicians have begun to introduce dupilumab into their therapeutic arsenal, with few data supporting their clinical decisions. The objectives were to assess time to disease control, predictors of response, achievement of disease control, disease recurrence, and occurrence of adverse events. Randomized and non-randomized studies of interventions (NRSIs) from Medline and Embase were reviewed. A total of 315 studies were identified and 5 NRSIs (167 participants with moderate-to-severe BP) meeting our inclusion criteria were found. Dupilumab was significantly associated with shorter time to disease control compared with the control group (HR 2.71 [95% CI, 1.85-3.96; I2 = 35%; 127 participants; 4 studies]). The overall strength of the evidence was graded as very low due to serious risk of bias and imprecision of effect measures. There were insufficient data to inform conclusions regarding BP recurrence and adverse events. Evidence was found that dupilumab reduces time to disease control in BP. It was not possible to assess predictors of response using pre-planned meta-regression. Randomized controlled trials are needed to determine dupilumab's place in therapeutic algorithms for BP. PROSPERO number: CRD42024599235.
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Affiliation(s)
- Laurence Mainville
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada; Division of Dermatology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada.
| | | | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - David O Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada;Division of Dermatology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
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