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

There are suboptimal levels of HPV vaccine uptake among gay, bisexual and men who have sex with men (GBMSM), despite the prevalence and incidence rates of HPV infection among GBMSM being higher than heterosexual males. This systematic review provides a thematic synthesis of qualitative research which examined the perceptions and experiences of GBMSM to HPV vaccine acceptability and explored the barriers and facilitators to participating in HPV vaccination. This review offers new insights about GBMSM understandings of HPV and how they are shaped by a complex relationship between limited knowledge and information of HPV, feminization of HPV with the focus on cervical cancer and women, and the socio-political governmentality of health services in meeting their health needs. Public health communication is required that focuses on the risks of HPV for anal, penile and oropharyngeal cancers and is culturally congruent to tailor and work with GBMSM more effectively for HPV vaccination. Healthcare providers need training around sexual health stigma and should proactively offer the HPV vaccination outside sexual health clinics for this vulnerable group.

The effective implementation of vaccination heavily depends on the society's willingness to pay (WTP). There is currently a dearth of comprehensive evidence about WTP for vaccines in China. This systematic review aims to review studies on the WTP for vaccines, to summarize factors affect WTP in China. Base-case analysis and Sensitivity analysis of WTP for every vaccine were estimated via single-arm Bayesian meta-analysis. A total of 28 studies were included for systematic review. The point estimates and 95% Credible Interval of pooled WTP for influenza and HPV (9-valent) vaccine were $27.409 (23.230, 31.486), $464.707 (441.355, 489.456). Influencing factors to WTP were age, income, peer influence, health condition and etc. Future research should give focus to improving sample representativeness and survey tool, conducting intervention trials, identifying effective methods to promote WTP.

Previous studies have explored whether soluble programmed cell death ligand-1 (sPD-L1) can be used to predict the prognosis of patients with peripheral T-cell lymphoma (PTCL); however, no consistent results have been obtained. Consequently, we conducted the present meta-analysis to identify the precise significance of sPD-L1 in predicting the prognosis of PTCL.

We searched PubMed, Embase, Web of Science, and the Cochrane Library until July 31, 2024. The value of sPD-L1 in predicting PTCL prognosis was examined by combining the hazard ratios (HRs) with 95% confidence intervals (CIs).

Seven articles involving 445 patients were included in this study. Based on our pooled findings, increased sPD-L1 was associated with dismal overall survival (OS) (HR = 4.22, 95%CI = 1.89-9.43, p < 0.001) and worse progression-free survival (PFS) (HR = 2.57, 95%CI = 1.35-4.90, p = 0.004) in PTCL. Furthermore, higher sPD-L1 levels were correlated with male sex (OR = 1.80, 95%CI = 1.06-3.03, p = 0.029), International Prognostic Index (IPI) score ≥2 (OR = 4.32, 95%CI = 2.10-8.89, p < 0.001), elevated lactate dehydrogenase (LDH) level (OR = 5.15, 95%CI = 1.94-13.71, p = 0.001), presence of B symptoms (OR = 2.56, 95%CI = 1.45-4.52, p = 0.001), and ECOG PS ≥2 (OR = 7.41, 95%CI = 1.49-36.92, p = 0.015) in PTCL.

According to the present meta-analysis, higher sPD-L1 levels were significantly correlated with poor OS and inferior PFS in patients with PTCL. Additionally, high sPD-L1 levels were also associated with clinical features representing the development of PTCL.

Pediatric cancer patients often struggle to adhere to vaccination schedules, requiring personalized catch-up immunization after treatment. Currently, healthcare professionals create these schedules manually, which is time-consuming, error-prone, and limited in accessibility. We developed and validated an automated clinical decision support system to optimize this process through algorithmic schedule generation.

Following PRISMA guidelines, we systematically reviewed vaccination recommendations for pediatric cancer patients to develop comprehensive scheduling algorithms. The system implements multi-step optimization modeling incorporating age-dependent dosing, minimum intervals, and treatment-related timing rules for 27 vaccines. We validated the tool through a technical evaluation comparing algorithm-generated schedules against those created by experts for representative pediatric cancer cases and through clinical assessments by healthcare professionals in real-world settings.

Technical validation revealed high agreement between algorithm-generated and expert-created schedules, with only minor acceptable variations. Clinical evaluation demonstrated strong user acceptance, with 70% (95% CI: 58.1%-81.9%) of professionals using the system for schedule validation, 61% (95% CI: 48.3%-73.7%) for schedule creation, and 47% (95% CI: 34.0%-60.0%) for vaccination history verification. Users reported median time savings of 20 min per schedule and rated the tool's quality highly (median 4.5/5).

Our clinical decision support system demonstrates technical accuracy and clinical usefulness. It offers an effective solution for managing post-cancer treatment immunizations while alleviating healthcare professionals' workloads, particularly in resource-limited settings.

The landscape of digital health technologies is evolving rapidly, with clinical artificial intelligence increasingly integrated into primary care. Successfully adopting these technologies depends on the users' knowledge, attitude, and practice.

This systematic review and meta-analysis aims to assess primary care physicians' knowledge, attitude, and practice toward clinical artificial intelligence and to uncover the key determinants influencing its implementation in primary care.

PubMed, Web of Science, Scopus, and Institute of Electrical and Electronics Engineers (IEEE) were searched on 18.10.2023 and 03.05.2024 to systematically review quantitative and qualitative relevant primary studies. Three authors independently reviewed and appraised the studies using the Mixed Methods Appraisal Tool. Thematic analysis and proportion meta-analysis of the addressed domains were performed, with results aligned with a recent integration framework.

24 publications, including 4074 primary care physicians, suggested that knowledge levels were generally low, with passive opportunistic learning (pooled proportion 0·33, 95 % Confidence Interval (CI) 0·16-0·50, n = 6 studies, 2358 physicians). Attitudes varied, with concerns about losing jobs and rejecting new technologies (0·53, 95 %CI 0·42-0·64, n = 11, 2988). Practice experience was positive with AI simulation/prior training or negative with infrastructure and electronic medical records limitations (0·52, 95 %CI 0·36-0·68, n = 12, 3459). The risk of bias was low in 14 studies and moderate-high in ten, with significant heterogeneity between studies.

This review underscores the importance of effectively integrating clinical artificial intelligence-assisted digital health technologies within primary care. Acknowledging the current knowledge, attitude, and practice state and identifying gaps and opportunities, a physician-driven artificial intelligence implementation process with sustainable adoption might be possible. More attention is needed to counterbalance the concerns hindering the effectiveness of advanced tools in primary care practice.

The association between diet and the onset and treatment of depression is unclear. This study aims to estimate the evidence for the prospective association between diet quality and depression.

Systematic searches in PubMed, Web of Science and Embase up to 2024/01/04 of propective studies on the potential relationship between diet quality and depression identified 21 randomized clinical trials (RCT) and 92 prospective cohorts (PC) (>700,000 participants), that were pooled in random-effects frequentist and Bayesian meta-analyses.

Treatment-RCT yielded anecdotal-to-moderately strong support for the hypothesis that dietary interventions improve depression (d = -0.80, 95 % CI = -1.46 to -0.14), though their internal validity was low. Interventional effects were observed in nonpatient samples (d = -0.17, -0.29 to -0.08). Prevention-RCT yielded strong evidence indicating no association. Data from PC showed that adherence to some dietary patterns/food groups was associated with depression, e.g., adherence to the Mediterranean-diet was associated to fewer self-reported symptoms (OR = 0.91, 95%CI = 0.88-0.96), with anecdotal-to-moderate strength of evidence but no dose-response relationship. For most dietary patterns and food-groups (e.g., fish), data supported the null-hypothesis of no effect. Effect moderation was present: associations were evident when depression was self-reported but not when diagnosed. Postpartum-depression studies yielded evidence showing dose-response associations between fish (OR = 0.84, 95%CI = 0.78-0.91) and dietary DHA/EPA/Omega3 consumption (OR = 0.84, 95%CI = 0.77-0.92) with self-reported depression-scores.

The strength of the current evidence on the hypothesis that dietary quality influences depression outcome is very low, due to reverse causation and low internal and construct validity. The clinical significance of fish/dietary DHA/EPA/Omega3 intake to reduce the risk of postpartum-depression should be further investigated.

Meta-analysis assesses the safety and efficacy of Tranexamic Acid (TXA) in patients with hip fracture surgery compared to placebo.

On September 28, 2023, qualified RCT studies, including randomized control trials and cohort study, of intravenous Tranexamic Acid (TXA) in patients undergoing hip fracture surgery was searched. Review Manager was used for the meta-analysis.

The TXA group had significantly lower intraoperative total blood loss and overall blood loss across eighteen investigations. The blood transfusion rate in the TXA group was lower than that in placebo group. TXA maintained higher hemoglobin levels on the postoperative first and third day. TXA did not raise any possible complication or problems such as deep vein thrombosis, pulmonary embolism, and mortality.

The TXA treatment in patients undergoing hip fracture surgery reduced intraoperative blood loss, overall blood loss, transfusion rate, and length of hospital stay effectively and appeared to be safe to use without significant complication or problems.

Impairment in self-awareness (ISA) is an important obstacle in neurorehabilitation of severe acquired brain injury (ABI) patients since it can cause failure in adopting adequate compensatory strategies, or the implementation of ineffective or dangerous behaviors. Accordingly, it should be assessed as early and accurately as possible, even if, to date, no consensus exists on how best to measure SA, and on its explanatory models. The present systematic review aimed to address: (a) to which extent ISA has been assessed in studies enrolling severe ABI patients; (b) whether studies on assessment of SA after severe ABI considered any explanatory models of SA and which measures have been utilized accordingly; (c) possible gaps or criticism in the extant research on severe ABI patients; and (d) to provide a novel proposal for SA assessment/classification based on the results and discussion from the systematic review conducted in this well selected population of patients. A systematic review was carried out in the databases PubMed, Web of Science and PsycINFO; 701 studies were retrieved and finally 54 met the inclusion criteria. Our review evidenced the paucity of studies on assessment of SA in patients with severe ABI that specified the model and the level of SA. Only a few measures of SA went beyond its intellectual and declarative aspects, thus hindering an exhaustive assessment and a full comprehension of SA. Accordingly, we propose a more comprehensive classification of offline anticipatory SA, with some important implications in the neurorehabilitation field. The review demonstrated the need of measuring SA beyond its declarative level, differentiating between declarative and real anticipatory SA, as well as of assessing SA at both offline and online levels.

Vertebroplasty or kyphoplasty is a safe and effective procedure to treat persistent pain and correct deformity for early mobilisation in an osteoporotic vertebral compression fracture. However, there is conflicting evidence supporting the unipedicular or bipedicular approach in terms of the outcomes and complications with a recent increase in literature and no meta-analysis in this decade. This review is aimed at providing insight into the comparison between unipedicular and bipedicular approaches for making clinical decisions.

Multiple databases were screened using the keywords: "kyphoplasty", "vertebroplasty", "unipedicular", "bipedicular", "osteoporotic fracture", and "compression fracture", and all the results were reviewed for inclusion of 20 articles and data analysis done to look for significant differences between the two approaches. The quality of the studies included is evaluated using MINORS criteria. This review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CRD4202511004028.

We found no significant difference between the two groups in terms of patient-related outcomes (Visual Analogue scale and Oswestry Disability Index), radiological outcomes (kyphotic angle correction or vertebral height restoration), complications (cement leakage or adjacent vertebral fractures), fluoroscopy frequency with significantly less operative time in the unipedicular group.

Vertebroplasty and kyphoplasty, irrespective of unipedicular or bipedicular approach, are effective procedures providing pain relief and adequate functional outcomes with comparable complications, with the unilateral approach taking less operative time. However, in a clinical setting, the approach of kyphoplasty or vertebroplasty should depend on a patient's condition, fracture type and symmetry, along with the levels affected.

The optimal treatment of Osteochondral lesion of the talus (OLT) for subchondral bone cysts (SBCs) has not been finalized. The purpose of this systematic review and meta-analysis was to define whether OLT with small SBCs will affect the clinical outcomes of OLTs after arthroscopic microfracture.

We searched the Embase, Cochrane Library and PubMed databases up to May 13, 2024 for eligible comparative studies. The methodological index for non-randomized studies (MINORS) were used for assessing the methodological quality. The Review Manager 5.4 software was applied to perform the statistical analysis.

A total of 4 studies involving 257 patients were included in this meta-analysis. No significant difference was noted in American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the improvement of Foot and Ankle Ability Measure- Activities of Daily Life (FAAM-ADL) and Foot and Ankle Ability Measure (FAAM-SP), Tegner Score and Visual Analogue Scale (VAS) between the cyst and noncyst group. The noncyst group was statistically significant in term of FAAM-ADL and FAAM-SP. Radiological outcomes in the cyst group had improved after arthroscopic microfracture.

Based on the results of the present study, there are no clinical differences with the technique of bone marrow stimulation between simple and cystic ostechondral lesions of talus with depth smaller than 5-6 mm, with respect to the medial part of talus and referring to age younger than 40 years old.

Level 3.

We performed a comprehensive systematic review and network meta-analysis (NMA) to assess the efficacy of pharmacological agents for the treatment of proliferative vitreoretinopathy (PVR) following retinal detachment (RD) surgery. A systematic search was performed across PubMed, Scopus, Web of Science, and Embase. Randomized and non-randomized controlled trials and comparative observational studies evaluating the effect of pharmacological agents in a clinical setting were included. The primary outcome was retinal reattachment rate, and secondary outcomes were PVR recurrence, reoperation, intraocular pressure (IOP), epiretinal membrane (ERM), and macular edema. A total of 23 studies with 1749 eyes were included. Twelve different drugs or drug combinations were assessed. The NMA was performed for retinal reattachment, PVR recurrence, and reoperation rate outcomes. Among the pharmacological agents analyzed, adjunctive therapy with 13-cis-retinoic acid (13-cis-RA) demonstrated a statistically significant improvement in retinal reattachment rates (RR=1.36, 95 % CI: 1-1.84) and a reduction in reoperation rates (RR=0.23, 95 % CI: 0.07-0.69) compared to the control group, while none of the other drugs had statistically significant results. Additionally, adjunctive therapy did not yield significant improvements in IOP, ERM, or macular edema, except for a reduction in macular edema associated with dexamethasone in one study. This systematic review and NMA indicate that most pharmacological agents could not significantly improve retinal reattachment, reduce PVR recurrence, or lower reoperation rates following RD surgery. 13-cis-RA was the only drug that showed a significant impact on lowering retinal detachment and reoperation rates. Further high-quality clinical trials are warranted to confirm these findings.

Middle childhood, adolescence, and young adulthood are characterized by high nutritional demands and vulnerability to anemia. Limited efforts have been made to synthesize the evidence comparing the effects of iron and multiple micronutrient (MMN) supplementation in these populations.

In this study we sought to examine the effects of iron and MMN on anemia and anthropometric variables among people aged 5 to 24 years in low- and middle-income countries.

The PubMed, Embase, Cochrane Library, and CINAHL databases were searched from inception to July 2024 to identify 50 randomized controlled trials (RCTs) of iron or MMN supplementation with outcomes.

Only RCTs that used iron or MMN were included in this analysis.

Compared to placebo, supplementation with iron and MMN was associated with 5.81 g/L (95% CI: 4.19-7.44 g/L) and 4.82 g/L (95% CI: 2.32-7.32 g/L) incremental increases in hemoglobin levels, respectively. The therapeutic effects of MMN (hemoglobin: 9.3 g/L, 95% CI: 1.52-17.09 g/L) and iron (10.24 g/L, 95% CI: 5.10-15.39 g/L) were both observed in populations of older children, adolescents, and young adults with anemia. Stratified analysis showed that with either MMN or iron supplementation, higher iron content (> 30 mg/d) could lead to a higher increment of hemoglobin, while a shorter intervention duration (< 3 months) showed more benefits in improving hemoglobin. For ferritin, the significant benefit of supplementation was observed only with iron and not with MMN. Iron was also found to decrease serum transferrin receptor and zinc protoporphyrin, but there was no effect on C-reactive protein. For growth indicators, iron was found to increase weight (0.52 kg, 95% CI: 0.12-0.93 kg), while MMN was found to increase height (0.87 cm, 95% CI: 0.16-1.59 cm).

Overall, supplementation with iron compared with MMN had similarly beneficial effects on improving the hemoglobin level in older children, adolescents, and young adults, but there was some indication that there may be differential effects on growth indicators.

Road safety measures, e.g., speed limits, are widely used globally to prevent and reduce the number of road crashes, injuries, and fatalities. However, implementing such preventive measures has long-term and complex social, environmental, and economic interdependencies and impacts. Therefore, socio-economic appraisals of road safety measures are crucial for identifying such complex interdependencies and impacts on the well-being of individuals, society, the economy, and the environment. The study carries out a comprehensive review of the scientific literature dealing with socio-economic appraisal methodologies of road safety measures. The study comprehensively reviewed the scientific literature on socio-economic appraisal methodologies for road safety interventions. The review follows PRISMA guidelines for selecting scientific articles across Google Scholar, Scopus, and Web of Science. From 535 records identified on 18 January 2025, 80 studies (including grey and peer-reviewed articles in English) were selected. These studies are reviewed based on six themes, namely: (a) methodological frameworks of the methodologies, (b) classification, (c) key indicators, (d) datasets, (e) strengths, limitations, and biases, (f) stakeholders' involvement and impacts on policymaking. The review indicates that the existing socio-economic appraisal methodologies for road safety measures effectively capture specific dimensions, e.g., crash rate reduction, willingness-to-pay for road safety and improved social well-being. However, these methodologies also exhibit inconsistencies while accounting for factors like price inflation and replicability. The review identifies six methodological limitations that accentuate significant future research and innovation opportunities. The review also presents recommendations for future research to address the identified limitations.

This systematic review (SR) highlights principles for nutrient clinical trials and explore the diverse physiological functions of vitamin D beyond its traditional role in the musculoskeletal system related to clinical study designs.

Thousands of published research articles have investigated the benefits of vitamin D (a nutrient example taken in this SR) beyond the musculoskeletal system, including the immune, pulmonary, and cardiovascular systems; pregnancy; autoimmune disorders; and cancer. They illustrated vitamin D's molecular mechanisms, interactions, and genomic and nongenomic actions.

This SR was designed to identify shortcomings in clinical study designs, statistical methods, and data interpretation that led to inconsistent findings in vitamin D-related publications. SR also highlights examples and insights into avoiding study design errors in future clinical studies, including randomized controlled clinical trials (RCTs). The SR adheres to the latest PRISMA statement, guidelines, and the PICOS process.

Inappropriate or flawed study designs were frequent in clinical trials. Major failures discussed here include too short clinical study duration, inadequate or infrequent doses, insufficient statistical power, failure to measure baseline and achieved levels, and recruiting vitamin D-sufficient participants. These design errors have led to misleading interpretations. Thus, conclusions from such studies should not be generalized or used in guidelines, recommendations, or policymaking.

Adequately powered epidemiological studies and RCTs with sufficient vitamin D and duration in individuals with vitamin D deficiency reported favorable clinical outcomes, enriching the literature, enabling to understand its physiology and mechanisms. Proper study designs with rigorous methodologies and cautious interpretation of outcomes are crucial in advancing the nutrient field. The principles discussed apply not only to vitamin D, but also other micro-nutrients and nutraceutical research. Adhering to them enhances the credibility and reliability of clinical trials, SRs, and meta-analysis outcomes. The study emphasizes the importance of focused, hypothesis-driven, well-designed, statistically powered RCTs to explore the diverse benefits of nutrients, conducted in index nutrient deficient participants, and avoidance of study design errors. Findings from such studies should be incorporated into clinical practice, policymaking, and public health guidelines, improving the health of the nation and reducing healthcare costs.

The utilization of telehealth to deliver occupational therapy services and research focusing on the effectiveness of these interventions has increased since 2020.

To update systematic review findings since 2019 on the effectiveness of occupational therapy telehealth interventions for clients of all ages.

Data were gathered from PubMed, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews and hand searching relevant literature.

This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Articles selected included telehealth-delivered occupational therapy, peer-reviewed publications in English between 2019 and 2022, and Levels 1b, 2b, or 3b evidence.

Forty-three studies were included. Strong strength of evidence supports telehealth interventions for lifestyle interventions to address chronic conditions. Moderate strength of evidence supports telehealth interventions for various outcomes to address chronic conditions, developmental disorders, neurological conditions, and people affected by COVID-19 isolation. Low strength of evidence supports telehealth interventions for various outcomes across identified subthemes.

Telehealth use is rapidly increasing. Evidence supports occupational therapy-delivered telehealth for clients experiencing a chronic or musculoskeletal condition and may support interventions for other populations. Plain-Language Summary: This study provides a summary of 43 articles on the effectiveness of occupational therapy telehealth interventions for all ages and populations from 2019 to 2022. Telehealth occupational therapy interventions can effectively support clients with chronic conditions and shows promise for promoting outcomes to address developmental disorders, neurological conditions, musculoskeletal conditions, and those who were affected by isolation during the coronavirus disease 2019 (COVID-19) pandemic.

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

Systematic review and meta-analysis.

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

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

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

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

Research suggests that alcohol consumption is associated with neuroinflammation, impacting brain regions associated with addiction and cognitive function. Long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs), in particular docosahexaenoic acid (DHA), have been proposed to have neuroprotective effects against alcohol, reversing synaptic deficits caused by alcohol and alleviating anxiety in animal models.

The aim of this study was to evaluate the impact of an n-3 intervention in ameliorating behavioral changes, biochemical alterations, and the inflammatory responses induced by alcohol consumption.

A systematic review was performed using PubMed (Medline), Scopus, Web of Science, and OpenGrey databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

A total of 3829 records were identified. The records were subject to screening against the eligibility criteria, and the data extraction and risk-of-bias assessment were carried out by 2 investigators independently.

Twelve articles addressed n-3 PUFA interventions, and its effects on alcohol-related outcomes were finally included. Preclinical studies demonstrated that n-3 PUFAs improved behavioral, inflammation, lipid metabolism, and hepatic parameters altered by alcohol. However, clinical trials yielded inconclusive evidence.

Despite the paucity of clinical and preclinical studies, available evidence suggests that n-3 PUFAs may exert a protective influence on alcohol-related outcomes at both the behavioral and molecular levels.

PROSPERO registration no. CRD42023443095.

Improving the safety of cyclists, who are considered vulnerable road users, is essential. Implementing a warning system that alerts cyclists to nearby hazards is an effective method to improve their safety. Nevertheless, the literature needs a comprehensive and detailed review of cyclist warning systems. This paper presents a systematic review of existing studies about warning technologies and systems developed to improve cyclist safety, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (n = 78). Based on the review, it was found that the most used cyclist warning technologies were cameras with artificial intelligence (AI), ultrasonic sensors, lidar, and radar. Furthermore, there were some insights from the studies that conducted cycling experiments with the use of a warning system: (1) most participating cyclists responded positively to the warning technologies/systems, (2) most cyclists preferred auditory signals over visual or haptic signals as warning modalities, (3) warning technologies/systems influenced some cyclists' behaviour during critical situations, such as early braking, faster reactions, increased focus, maintaining a safer distance, and temporarily reducing speed, and (4) only two studies tried to explore how warning systems affect crash risk. Future research should focus on developing warning systems that are compact, lightweight, and affordable. More studies are also needed to demonstrate the impact of the cyclist warning system on cyclists' crash risk. This review identifies gaps in the current literature and offers a solid foundation for future studies to enhance cyclist safety.

This study provides a focused review on the use of saliva biomarkers, particularly salivary cortisol, for measuring cognitive fatigue. Through a systematic review and analysis of 25 articles sourced from five academic databases, we examine the relationship between cognitive fatigue and saliva biomarkers. The findings highlight the potential of salivary cortisol as an effective marker of cognitive fatigue, while also identifying limitations in current methodologies, including inconsistent saliva collection and analysis procedures. Although prior reviews have explored saliva biomarkers, our analysis focuses on gaps related to the empirical connection between cognitive fatigue and biomarkers. This review further meta-analysis reveals that cortisol and alpha-amylase levels significantly increased after completing cognitive fatigue-inducing tasks. Moreover, this review emphasizes the need for updated, standardized protocols and real-time detection methods. Future research should aim to conduct more focused empirical investigations to advance the field.

This systematic review investigates the integration of automatic segmentation techniques of magnetic resonance imaging (MRI) with neuropsychological assessments for early diagnosis and prognosis of Alzheimer's Disease (AD).

Focus on studies that utilise automated MRI segmentation and neuropsychological evaluations across the AD spectrum.

A literature search was conducted on the PubMed database on 7 November 2024, using key terms related to MRI, segmentation, brain structures, AD, and cognitive decline.

Studies including individuals with AD, mild cognitive impairment (MCI), or subjective cognitive decline (SCD), utilising structural MRI, focusing on grey matter and automatic segmentation, and reporting cognitive assessments were included.

Data were extracted and synthesised focusing on associations between MRI measures and cognitive tests, and discriminative values for diagnosis or prognosis.

Seven studies were included, showing a significant association between structural changes in the medial temporal lobe and cognitive decline. The combination of MRI volumetric measures and neuropsychological scores enhanced diagnostic accuracy. Neuropsychological measures demonstrated superiority in the identification of patients with MCI and mild AD in comparison to MRI measures alone.

Heterogeneity across studies, selection and measurement bias, and lack of non-response data were noted.

This review emphasises the necessity of integrating automated MRI segmentation with neuropsychological assessments for the diagnosis and prognosis of AD. While MRI is valuable, neuropsychological testing remains essential for early detection. Future studies should focus on developing integrated predictive models and refining neuroimaging techniques.

Childhood brain tumor and leukemia (CBTL) and their treatments can have negative effects on development, including communication and swallowing. Clinical practice guideline recommendations for managing communication and swallowing difficulties in children diagnosed with CBTL were informed by (i) a systematic review using the GRADE approach to rate certainty of evidence; (ii) GRADE Evidence to Decision Framework involving an international panel of experts; and (iii) a Health Professional and Consumer survey. To improve outcomes and quality of life, children with CBLT should have access to communication and swallowing assessment and intervention from cancer diagnosis, throughout and after treatment, and across survivorship.

Atrial fibrillation (AF) and cognitive decline represent significant health challenges with increasing prevalence and significant socioeconomic implications. Emerging evidence suggests a potential link between AF and cognitive decline, including dementia and Alzheimer's disease, although the underlying mechanisms remain incompletely understood. Inflammation has emerged as a key mediator in cardiovascular and neurological diseases, encouraging an investigation into its role in the atrial fibrillation-cognition association. A systematic search of PubMed, Web of Science, and PsycInfo was conducted to identify relevant studies investigating possible inflammatory mechanisms bridging AF and cognitive decline. Studies were assessed for quality and relevance, and data were synthesized using a narrative approach. Five papers were included, with only two longitudinal studies. Inflammatory biomarkers emerged as significant factors associated with both AF and cognitive decline. Three studies revealed a correlation between high-sensitivity CRP (HS-CRP) levels and cognitive decline in patients with AF, AF patients with cerebral infarction, and elderly individuals with AF. However, conflicting results were observed, as one study did not identify any associations between cognitive decline and HS-CRP levels. The scientific literature on this topic is scarce, and the results of existing studies often lack consistency in their findings, highlighting the need for further research to better understand and prevent this significant health burden in patients with AF. So, the results of this study are expected to inform future research directions and cognitive decline risk stratification, guiding the development of targeted interventions aimed at preserving cognitive function and improving outcomes in patients with AF.

Research on metal nanoparticles is crucial for their application in diverse fields, requiring detailed assessments of their effects and potential. Galleria mellonella larvae have emerged as a valuable model for studying the impacts of metal nanoparticles, offering ethical and logistical advantages over traditional models. This systematic review synthesizes evidence on the application of Galleria mellonella in evaluating the toxicity, distribution, and therapeutic potential of metal nanoparticles. Adhering to PRISMA guidelines, a comprehensive database search (MEDLINE, Embase, Cochrane, Scopus, Google Scholar, Science Citation Index Expanded) was conducted using keywords related to Galleria mellonella and metal nanoparticles. The SYRCLE's risk of bias tool (adapted for G. mellonella) was used for risk of bias assessment. Out of 1696 initially identified studies, 31 met the inclusion criteria, encompassing research from 2011 to 2024. The included studies effectively demonstrate G. mellonella's capacity to model the toxicity of metal nanoparticles, their therapeutic potential in treating infections, and the impact on the innate immune response, bridging the gap between simpler in vitro assays and more complex mammalian models. Galleria mellonella stands out as a critical model for the early-stage development and evaluation of metal nanoparticles, particularly in assessing toxicity, therapeutic efficacy in infection treatment, and interaction with immune systems. This review underscores the larvae's role in metal nanoparticle research, advocating for its broader use to streamline development processes while minimizing ethical concerns.

Temporomandibular joint (TMJ) osteoarthritis (OA) leads to pain, limited jaw function, and bite changes. When non-invasive treatments fail, minimally invasive procedures like TMJ arthrocentesis with saline and hyaluronic acid (HA) injections are commonly used. Orthobiologics, including platelet-rich plasma (PRP) and cell-derived products, have gained attention for their potential to enhance tissue healing. This review aimed to compare the outcomes of orthobiologic injections with HA injections following arthrocentesis in TMJ-OA treatment. A systematic search, following PRISMA guidelines, identified nine studies (403 patients). Risk of bias was assessed using the Cochrane Risk of Bias Tool. PRP and cell-derived products showed potential benefits in reducing TMJ pain and improving maximum mouth opening (MMO). However, three of four studies comparing PRP with HA found no significant difference between the two. In contrast, cell-derived orthobiologics demonstrated significantly greater improvements in TMJ pain and MMO compared to HA. Risk of bias varied, with some studies showing moderate to high levels. This review highlights the potential but inconsistent benefits of orthobiologics in treating TMJ-OA. While cell-derived orthobiologics appear promising, PRP did not demonstrate superiority over HA. Further high-quality studies are needed to validate these findings.

To examine association between high BMI, obesity, and kidney stone disease (KSD). For this, systematic review of empirical studies was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) guidelines. Cochrane Library, EMBASE, MEDLINE, CINAHL, AMED, Emcare, Clinicaltrials.gov, and WHO ICTRP were searched for English language population-based studies published from inception to October 2024, including adults aged at least 18 years reporting on high BMI, obesity and overweight, with incidence of KSD.

The search identified 943 records, of which 15 relevant articles with 97 645 participants and 17 158 cases in total were enrolled in the narrative synthesis. A high heterogeneity and imbalance were observed among baseline distribution of cohorts in most studies. Thirteen studies provided comparative data on stone occurrence in obese and nonobese participants, and on per-patient analysis, three studies demonstrated a lower risk (RR < 1; 95% CI: 0.78-1.03), four studies a higher risk (RR>1; 95% CI: 0.77-2.32), and six studies depicted similar risk (RR = 1; 95% CI: 0.94-1.06) of stone occurrence between the two cohorts.

Evidence in this study suggests an association between high BMI, being overweight, obesity, and increased risk of developing kidney stone disease. In the context of optimizing treatment, KSD should be considered a metabolic disease, with treatment to include dietary regimes, exercise intervention alongside pharmacotherapy to help reduce renal stone disease recurrence risk, alongside managing associated chronic diseases such as hypertension, type 2 diabetes mellitus, and coronary artery disease.

Alzheimer's disease (AD) is an age-associated disorder characterized by cognitive decline, with dementia representing the final stage of a complex clinical-biological process rather than simply a more severe form of cognitive decline. Circular RNAs (circRNAs), novel non-coding RNAs, have emerged as key regulators of brain function and associated disorders. This study explores the role of circRNAs in AD by reviewing experimentally validated circRNAs in human and animal models. We identified 10 human (seven pathogenic, three protective) and six animal (three pathogenic, three protective) AD-related circRNAs. Experimental studies have confirmed that human protective circRNAs are predominantly downregulated in AD, where they function by sequestering specific miRNAs within cells, particularly miR-7, miR-142-5p, and miR-217, which have well-recognized neuroinflammatory functions. In-silico analysis revealed that circLPAR1 (pathogenic), circHUWE1 (pathogenic), and circHOMER1 (protective) interact with miRNAs that mainly control AD-related genes. Notably, circHOMER1 plays a key role in regulating multiple AD-related pathways, including autophagy, apoptosis, and PI3K-AKT and amyloid fiber formation. Furthermore, circRNA/protein interaction analysis revealed that circHUWE1 predominantly associates with RNA transport proteins, whereas circHOMER1 interacts with proteins involved in mRNA surveillance pathways. Remarkably, docking analysis demonstrated that circAβ-a (pathogenic) exhibits a strong affinity for eukaryotic translation initiation factor 4A3 protein, while circHOMER1 shows a higher binding affinity for DGCR8 microprocessor complex subunit protein. Our study presents a concise list of circRNAs as potential key targets for further investigation in AD research. Future experimental research is essential to uncover their precise mechanisms and assess their potential as biomarkers, offering promising avenues for developing interventions to alleviate cognitive decline in AD.

Previous studies have consistently demonstrated that exercise mitigates cognitive decline in older adults. However, the most effective types of exercise, along with optimal frequency and duration of interventions, remain inadequately defined. To address these gaps, we conducted a network meta-analysis synthesizing direct and indirect evidence from existing literature to identify the most effective exercise interventions for enhancing cognitive function in older adults.

We conducted a systematic search across databases including PubMed and Web of Science to identify randomized controlled trials (RCTs) evaluating the impact of various exercise interventions on cognitive function in older adults. We assessed the quality of included studies and performed a traditional meta-analysis with Review Manager 5.3. Subsequently, a network meta-analysis was conducted using Stata 17.0 to evaluate the effects of different exercise modalities on cognitive outcomes, specifically memory, inhibitory control, and task-switching abilities.

A total of 37 studies encompassing 2585 older adults met the inclusion criteria. The network meta-analysis revealed that resistance training exerted the strongest effect on overall cognitive improvement. Aerobic exercise, multimodal exercise, and physical-mental training followed in effectiveness. Specifically, resistance training significantly enhanced inhibitory control compared to high-intensity interval training (HIIT), aerobic exercise, and other modalities. Physical-mental training emerged as the most effective intervention for improving task-switching ability and demonstrated superior efficacy in enhancing working memory compared to aerobic exercise. Conversely, aerobic exercise showed the strongest effect on memory function, outperforming resistance training, multimodal exercise, and physical-mental training.

Resistance training is the most effective exercise modality for enhancing overall cognitive function and inhibitory control in older adults. Physical-mental training offers the greatest benefits for improving working memory and task-switching ability, while aerobic exercise is most beneficial for enhancing memory function. Based on these findings, the recommended exercise protocols are: Resistance Training: 12 weeks, 2-3 times per week, 45 min per session. Aerobic Exercise: 21 weeks, twice per week, 60 min per session. These tailored exercise interventions can inform public health strategies and clinical practices aimed at optimizing cognitive health in the aging population.

The protocol for this review was registered in PROSPERO (CRD42024597545).

Clinical data comparing intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) with angiography-guided PCI for chronic total occlusions (CTOs) are limited. This study aimed to compare clinical outcomes of IVI-guided versus angiography-guided PCI in patients with CTOs. A systematic review and meta-analysis were conducted to identify randomized controlled trials (RCTs) comparing IVI-guided with angiography-guided PCI in CTO populations. The primary endpoint was the incidence of major adverse cardiac events (MACE), a composite of death/cardiac death, myocardial infarction (MI), and target-vessel revascularization (TVR). Secondary outcomes included the individual components of MACE. A prespecified subgroup analysis was performed for intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Five RCTs, including 1,296 patients, were analyzed, with 713 (55%) undergoing IVI-guided PCI. Over 1 to 3 years, MACE was significantly lower in the IVI-guided PCI group (7.2% vs 13%; relative risk [RR] 0.55; 95% confidence interval [CI] 0.35 to 0.88; p = 0.012; I² = 31%). In the secondary analysis, TVR incidence was lower in the IVI group (3.1% vs 6.7%; RR 0.52; 95% CI 0.29 to 0.97; p = 0.038). No statistical differences were observed for MI or death/cardiac death. In the IVUS subgroup, MACE was also lower in the IVI-guided PCI group (8.4% vs 14.3%; RR 0.59; 95% CI 0.37 to 0.91; p = 0.019). A trial sequential analysis suggested a low likelihood of type I error. In conclusion, IVI-guided PCI is associated with improved clinical outcomes compared with angiography-guided PCI for the treatment of CTOs.

Neuropsychiatric symptoms emerged early in the COVID-19 pandemic as a key feature of the virus, with research confirming a range of neuropsychiatric manifestations linked to acute SARS-CoV-2 infection. However, the persistence of neurological symptoms in the post-acute and chronic phases remains unclear. This meta-analysis assesses the long-term neurological effects of COVID-19 in recovered patients, providing insights for mental health service planning.

A comprehensive literature search was conducted across five electronic databases: PubMed, Scopus, Web of Science, EBSCO, and CENTRAL, up to March 22, 2024. Studies evaluating the prevalence of long-term neurological symptoms in COVID-19 survivors with at least six months of follow-up were included. Pooled prevalence estimates, subgroup analyses, and meta-regression were performed, and publication bias was assessed.

The prevalence rates for the different symptoms were as follows: fatigue 43.3% (95% CI [36.1-50.9%]), memory disorders 27.8% (95% CI [20.1-37.1%]), cognitive impairment 27.1% (95% CI [20.4-34.9%]), sleep disorders 24.4% (95% CI [18.1-32.1%]), concentration impairment 23.8% (95% CI [17.2-31.9%]), headache 20.3% (95% CI [15-26.9%]), dizziness 16% (95% CI [9.5-25.7%]), stress 15.9% (95% CI [10.2-24%]), depression 14.0% (95% CI [10.1-19.2%]), anxiety 13.2% (95% CI [9.6-17.9%]), and migraine 13% (95% CI [2.2-49.8%]). Significant heterogeneity was observed across all symptoms. Meta-regression analysis showed higher stress, fatigue, and headache in females, and increased stress and concentration impairment with higher BMI.

Neurological symptoms are common and persistent in COVID-19 survivors. This meta-analysis highlights the significant burden these symptoms place on individuals, emphasizing the need for well-resourced multidisciplinary healthcare services to support post-COVID recovery.

This meta-analysis was registered in PROSPERO with registration number CRD42024576237.

Postoperative complications following neck dissection in head and neck squamous cell carcinoma (HNSCC) patients can significantly impact recovery and quality of life. This study aims to identify the types and incidence of these complications, thereby providing higher-level evidence to support clinical practice.

A systematic literature search was conducted across four databases: PubMed, Scopus, Web of Science, and Academic Search Complete (EBSCO), covering studies published from January 2010 to October 2024. A random-effects model was applied to pool the data. The incidence of surgical site infection (SSI), wound dehiscence, chyle leakage, hemorrhage or hematoma, and seroma were synthesized.

A total of 3,483 records were retrieved, from which 15 studies met the inclusion criteria and were ultimately analyzed. Meta-analysis showed that the pooled incidence of SSI was 7.1 % (95 % CIs: 0.036-0.115, p < 0.1, I2 = 55.843 %), hemorrhage/hematoma was 5.2 % (95 % CIs: 0.025-0.087, p < 0.1, I2 = 66.754 %), seroma was 2.4 % (95 % CIs: 0.004-0.054, p > 0.1, I2 = 0.000 %), wound dehiscence was 2.2 % (95 % CIs: 0.004-0.050, p > 0.1, I2 = 41.372 %), and chyle leakage was 1.1 % (95 % CIs: 0.001-0.028, p > 0.1, I2 = 29.600 %). Nerve injury was frequently reported, although data were insufficient for meta-analysis. Other less frequently reported postoperative complications included lymphedema, fistula, and dysphagia.

The incidence of postoperative complications after neck dissection in HNSCC patients varies across studies, but SSI remains the most frequent. Future research should focus on standardizing complication reporting and exploring treatment de-escalation to improve quality of life.

A profound understanding of the epidemiology of peri-implant diseases (PIDs) is essential for the development of preventive approaches to mitigate the occurrence and progression of peri-implant biological complications. The present systematic review and meta-analysis aimed to assess the incidence, prevalence, systemic, behavioral, and patient-related risk indicators and factors for PIDs in adult patients with dental implants.

Clinical studies assessing the prevalence, incidence, systemic risk indicators, and risk factors for PIDs were considered eligible for inclusion. MEDLINE-PubMed, EMBASE, Cochrane Central Library, and ClinicalTrials.gov electronic databases were searched for published articles. Pooled data analyses were performed using random-effects models to identify risk indicators and factors for PIDs.

Of 1120 potentially eligible records, 102 studies met the eligibility criteria and were included in this systematic review. Prevalence rates at the patient level for peri-implant mucositis and peri-implantitis were 46% (95% confidence interval [CI], 41-51) and 21% (95% CI, 17-24), respectively. Weighted mean incidence rates at the patient level for peri-implant mucositis and peri-implantitis were 53% and 22%, respectively, within 20 years of function. Pooled estimates identified periodontitis, obesity, and smoking habits as significant systemic risk indicators for mucositis. For peri-implantitis, the significant risk indicators were periodontitis, diabetes mellitus, smoking habits, and alcohol consumption. Only risk indicators could be identified in the selected evidence.

More than half of the patients treated with dental implants were affected by PID over a 10-year follow-up period, with peri-implant mucositis being the most prevalent condition. Periodontitis and smoking were identified as risk indicators for the development of both PID. Obesity was identified as a potential risk indicator for mucositis, while diabetes mellitus and alcohol consumption were recognized as potential risk indicators for peri-implantitis.

This systematic review looked at the causes and frequency of problems around dental implants, known as PID, which include conditions like peri-implant mucositis (inflammation around the implant) and peri-implantitis (more serious infection around the implant). Understanding these conditions and their etiology is important for finding ways to prevent them. This research reviewed 102 studies (including 13,030 patients) to gather data on how often these problems occur and what factors might increase the risk of developing them. The meta-analyses revealed that nearly half of people with dental implants had peri-implant mucositis, and about one in five had peri-implantitis. Over a period of 20 years, the incidence rates for developing these conditions were about 53% for mucositis and 22% for peri-implantitis. The study identified certain health and lifestyle factors that could increase the risk of these conditions. For mucositis, risk factors included having gum disease (periodontitis), obesity, and smoking. For peri-implantitis, the risks were similar, with periodontitis, smoking, and diabetes and alcohol use being important factors.

Depression is a common mental disorder significantly impacting daily functioning. Standard treatments include drugs, psychotherapies, or a combination of both. Treatment selection relies on scientific evidence, though the trustworthiness and applicability of this evidence can vary.

This protocol presents a method to evaluate evidence from systematic reviews for pharmacological and psychological treatments for depression, focusing on trustworthiness and applicability structured into five components: quality of conduct and reporting, risk of bias, spin in abstract conclusions, robustness of meta-analytical results, heterogeneity and clinical diversity.

We will conduct a systematic search of systematic reviews in MEDLINE, Embase, PsycInfo, and Cochrane Database of Systematic Reviews. Our focus will be on systematic reviews of first-line treatments for depression in adults, including antidepressants, psychotherapy, or combined treatments, compared to either active or inactive comparators. We will extract information needed for a comprehensive methodological evaluation using qualitative tools, including AMSTAR 2, ROBIS, Conflict-of-Interest assessment, Referencing Framework for SRs, Spin Measure, and heterogeneity exploration assessment. For quantitative analyses, such as Fragility Index, Ellipse of Insignificance, Region of Attainable Redaction, GRIM test, Leave-N-Out analysis, and prediction intervals, we will select and recalculate two meta-analyses per review. We define a set of outcomes to enable practical and intuitive interpretation of these analyses' results. Descriptive statistics, non-parametric statistical tests, and narrative summaries will be used to synthesize and compare outcomes across several pre-specified subgroups.

We expect these analyses to provide an enhanced perspective on the practice of evidence synthesis in the field of mental health, offer methodological guidance for future systematic reviews and meta-analyses, and contribute to improved informed decision-making by clinicians and patients.

osf.io/7f9cj and osf.io/ynejs.

AA amyloidosis (AAA) is a complication of chronic inflammation; the burden is expected to decrease with recent therapies. We conducted a systematic review of the incidence, prevalence, mortality and response to treatment of inflammatory joint disease (IJD)-related AAA.

MEDLINE, EMBASE and Cochrane library databases were searched until October 2024. Selected studies were prospective and retrospective cohorts as well as case series (≥ 10 patients) of histologically proven AAA occurring in IJD.

From 1094 articles identified, we included 33. Substantial heterogeneity among studies was observed. Most studies (75.8 %) were published before 2010. No clear trend was identifiable in AAA incidence and mortality during the last decades. AAA prevalence rates in rheumatoid arthritis ranged from 16.7 % to 25.2 % before 2010 and decreased to 0.7 % after 2010, which suggests a potential positive role of biologic therapies. Similarly, AAA prevalence rates in ankylosing spondylitis ranged from 6.1 % to 8.5 % before 2010 and 1.1 % to 1.3 % after 2010. Immunomodulating therapies (especially biologics) seemed to improve values of AAA biomarkers, such as glomerular filtration rate and serum amyloid A level.

Our work highlights the need for more recent and comprehensive population-based epidemiological data to decipher the actual IJD-related AAA burden.

This study aims to investigate the effectiveness and safety of the combination of liraglutide and metformin for clinical treatment of patients with polycystic ovary syndrome.

Computerized searches were performed on PubMed, Embase, Web of Science, The Cochrane Library, CNKI, CBM, Wanfang, and VIP databases to collect randomized controlled trials(RCT) on the efficacy of metformin and liraglutide in the treatment of polycystic ovary syndrome. The search period spanned from the inception of the databases to August 2024. Following literature screening, data extraction, and risk of bias assessment in the included studies, two reviewers independently conducted meta-analysis using RevMan 5.4 software.

A total of 12 RCT involving 1096 patients were analyzed. The meta-analysis revealed that the group receiving metformin combined with liraglutide demonstrated superiority over the group receiving metformin alone in terms of body mass index (BMI), glucose levels, lipid levels, hormone levels, establishment of menstrual cycles, normal ovulation rate, and rate of spontaneous conception. However, the former group also exhibited a higher incidence of gastrointestinal reactions compared to the latter group.

Current data indicates that the combination of liraglutide and metformin can effectively enhance glucose and lipid metabolism in Polycystic Ovary Syndrome infertility patients. Additionally, it can reduce serum sex hormone levels, leading to significant clinical therapeutic effects. This treatment also improves pancreatic islet and ovarian function, ultimately increasing the rate of ovulation and pregnancy. It is important to note that correct administration methods must be followed to minimize adverse reactions.

Critically ill patients with acute respiratory distress syndrome (ARDS) are one of the leading causes of death worldwide. Although a number of relevant predictors of ARDS have been identified, the current predictors are not satisfactory. Recent studies have revealed the predictive value of red blood cell distribution width (RDW) for ARDS. Therefore, we conducted the first meta-analysis to explore the predictive value of RDW in critically ill patients with ARDS.

A literature search was conducted to identify relevant observational studies from January 1, 2000, to August 1, 2024. Eligible studies were screened and data were extracted. The standardized mean difference (SMD) with 95% confidence interval (CI) of the RDW levels for each study were combined under the random-effect model.

Ten articles with a total of 2252 participants were included in the study. Elevated RDW levels on admission was significantly associated with significantly associated with an increased risk of ARDS morbidity (SMD = 1.09; 95% CI = 0.35-1.82; P = .004), and also significantly associated with an increased risk of ARDS mortality (SMD = 0.73; 95% CI = 0.53-0.93; P < .00001). Subgroup analysis further showed RDW ≥ 14.0 on admission could be regarded as a predictive morbidity factor for ARDS (SMD = 1.36; 95% CI = 0.66-2.07; P = .0002), and RDW ≥ 15.5 on admission could be also regarded as a predictive mortality factor for ARDS (SMD = 0.73; 95% CI = 0.49-0.97; P < .00001).

RDW levels seems to be a useful tool for predicting the morbidity and mortality of critically ill patients with ARDS.

This systematic review aimed to describe the work process of pharmaceutical care provided to patients with rheumatoid arthritis (RA).

A systematic review was undertaken based on a search of six databases. The protocol was registered in PROSPERO (CRD42020133705). The inclusion criteria were randomized clinical trials (RCTs) with pharmaceutical care as an intervention in patients previously diagnosed with RA. Two investigators independently selected the studies, extracted data, and assessed their methodological quality. The RoB 2 tool was used to evaluate the quality of the studies. A narrative synthesis of results was provided.

A total of 3078 titles were found in the initial search, but only six RCTs, with a total of 337 patients, met the established inclusion criteria. These RCTs had some limitations, and only one had a low risk of bias. In most studies (66.6%), the service performed as an intervention had low complexity, was focused only on health education and did not have an individualized care plan for each patient. Telephone interviews or counseling sessions prevailed. The most evaluated outcome was medication adherence. When the intervention was remote and of shorter duration, the improvement in medication adherence was up to 8% (P < .05), whereas when a pharmacotherapeutic follow-up service was provided, this improvement reached 59% (P = .002). Pharmaceutical intervention was also associated with a significant improvement in beliefs about medications, patient satisfaction, reduced drug-related problems, and the cost of treatment.

The pharmaceutical care processes should be adjusted to consider the complexity of treatment and patient profiles to produce tailored care plans.

Metabolic syndrome (MetS) is a multifactorial condition linked to increased risk of cardiovascular disease and type 2 diabetes. The Single-Point Insulin Sensitivity Estimator (SPISE), a non-invasive index calculated via 600 × HDL-C^0.185 / (TG^0.2 × BMI^1.338), offers a practical alternative. This systematic review and meta-analysis aim to evaluate the accuracy of SPISE as an indicator for MetS.

We conducted a systematic review and meta-analysis following PRISMA guidelines. We searched databases such as MEDLINE, Scopus, Web of Science, and Embase, focusing on studies evaluating SPISE's screening accuracy for MetS. Eligible studies were observational, reporting mean SPISE values and its predictive performance. Meta-analyses were performed using Hedges' g standardized mean differences (SMD) and pooled area under the curve (AUC) estimates.

Seven studies comprising 12,919 participants were included, with an age range of 9.2 ± 2.1 to 52.4 ± 11.0. Individuals with MetS had significantly lower SPISE scores than controls (SMD = -0.94, 95% CI: -1.25 to -0.63). The pooled AUC for SPISE as a predictor of MetS was 0.86 (95% CI: 0.83 to 0.90), surpassing other insulin resistance indices like HOMA-IR and the triglyceride/HDL-C ratio. Meta-regression showed that systolic and diastolic blood pressure were potential sources of heterogeneity and age, gender, BMI, waist circumference, fasting blood glucose, triglyceride, and HDL did not contribute to heterogeneity.

SPISE is a highly accurate and non-invasive tool for predicting MetS, potentially outperforming traditional indices like HOMA-IR. Its ease of use and precision make it a valuable clinical screening tool, especially in diverse populations.

Individuals from Black racially minoritised backgrounds are disproportionately diagnosed with psychotic disorders at higher rates. This presents unique caregiving challenges to informal (unpaid) carers. Black informal carers are more likely to face socio-economic challenges, including exposure to racism and discrimination, that impact their caregiving experiences and access to support. This systematic review aims to explore two primary questions: METHODS: A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases CINAHL, PsycINFO, EMABSE and MEDLINE via OVID were searched for articles reporting qualitative accounts of Black racially minoritised informal carers supporting a relative with psychosis from inception to 4th December 2024. The Critical Appraisal Skills Programme tool was used to assess the quality of included studies.

669 records were identified from the database searches and 11 studies were included in this systematic review. Seven key themes were identified from qualitative carer accounts that reflected issues related to stigma, shame and secrecy; mistrust and fear; faith communities; police relations; knowledge gaps; system navigation, and the cultural misfit of services.

Black racially minoritised informal carers in psychosis report several challenges in their roles, operating at individual, community, and societal levels. Improving our awareness of these issues and intervening to address their impacts are important as part of necessary steps required to provide effective support for Black informal carers and families affected by psychosis.

PROSPERO registration number: CRD42023438867.

Background/Objectives: The co-occurrence of Attention-deficit/hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) is very common and worsens adaptive functioning. This systematic review evaluates both pharmacological and non-pharmacological interventions in this underserved population. Methods: Registered on PROSPERO (CRD42024526157), a systematic search was conducted on PubMed, Embase, and Web of Science until 5 April 2025. The review includes (a) pilot studies and RCTs, (b) participants aged <18 years, (c) diagnoses of ASD and ADHD based on DSM-IV/V or ICD-9/10, (d) at least one group receiving any intervention, and (e) publications in English, Italian, Spanish, or German. Newcastle Ottawa Scale tools for non-randomized studies and the Cochrane Risk of Bias Tools for randomized controlled trials were used to assess studies' quality. Results: A total of 32 studies were included: 87.5% concerning pharmacological treatments. Specifically, methylphenidate (MPH, n = 11), atomoxetine (ATX, n = 11), guanfacina (n = 4), clonidine (n = 1), or atypical antipsychotics (n = 1) were examined. MPH and ATX were most frequently studied, with both showing positive effects in reducing ADHD core symptoms compared to placebo. ATX also reduces stereotyped behaviors and social withdrawal, although more withdrawals due to adverse events (AEs) were reported for ATX than MPH. Four studies (12.5%) examined non-pharmacological interventions, including treatment with virtual reality tools, digital platforms, educational animations, and biomedical protocols; improvements in emotion recognition, behavioral regulation, attention, and social functioning were found. Conclusions: While limited data prevent definitive conclusions, MPH and ATX appear to be relatively safe and effective on hyperactivity-impulsivity symptoms, even in individuals with ASD. Evidence on non-pharmacological treatments is limited, and further studies are needed to better establish their therapeutic potential.

Background: Oral ulceration with bone sequestration (OUBS) is an uncommon clinical lesion characterized by painful mucosal ulceration associated with exposed and necrotic bone in the oral cavity, often without known factors inducing osteonecrosis. Despite its potential for diagnostic confusion with more serious lesions, such as medication-related osteonecrosis, OUBS remains poorly understood and underreported. Objectives: To systematically review the literature on OUBS and identify its main clinical and radiographic characteristics to assist in early diagnosis and appropriate management. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in the PubMed, Scopus, and Web of Science databases on 27 January 2024, to identify case reports, case series, and observational studies that described OUBS. Data extraction focused on demographic information, lesion location, clinical features, radiographic findings, possible etiological factors, management, and outcomes. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized to assess the quality of the case reports and series. Data were synthesized narratively due to heterogeneity among studies. Results: Fifty-seven patients from 22 studies were included. The male-to-female ratio was 2.5:1, with most cases (71.9%) occurring in males. The mean age was 50.22 ± 11.49 years, with the highest incidence in patients aged 50-59 years (64.9%). Most cases were localized to the mandible (94.7%). Clinically, lesions were shallow ulcers (mean size: 0.75 ± 0.85 cm). Pain was the most common symptom (88.9%). Radiographs revealed no significant maxillary abnormalities, but some cases showed radiopaque areas in the mandible. Surgical interventions were most common (40.4%), with complete healing in 67.7% of cases within 4 weeks. Limitations include the predominance of case reports and series, which limits the strength of evidence. Conclusions: Recognizing OUBS can prevent misdiagnosis and unnecessary interventions. Further studies are needed to clarify its etiology and natural history. Registration: This review was registered on the PROSPERO database (registration number CRD42024541416).

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

Low brain-derived neurotrophic factor (BDNF) concentrations have been found in individuals with multiple sclerosis (MS). Physical exercise is an effective strategy for acutely increasing the levels of this neurotrophin in various populations; nevertheless, definitive results are still required for individuals with MS. Thus, this systematic review with meta-analysis aimed to analyze the acute and short-term effects of physical exercise on BDNF concentrations in MS patients. In this pre-registered systematic review (PROSPERO; ID: CRD42024505920), six electronic databases (PubMed-Medline, Scopus, Web of Science, SportDiscus, EbscoHost, and Cochrane) were searched by two independent researchers to identify eligible studies investigating the acute or short-term effects (≤ 3 weeks) of physical exercise sessions on blood concentration of BDNF in MS. Studies that used a sample population with other pathologies or did not provide or specify numerical data on the specified variables were excluded. After applying the inclusion and exclusion criteria, nine studies were included. A total sample of 259 people with MS were analyzed. Effect sizes of outcomes were presented as standardized mean difference (SMD) and 95% confidence intervals (95%CI). The effect estimation was computed using the inverse variance random effects method. Immediately after a session, a significant increase in BDNF was observed (large standardized mean difference (SMD) = 1.52, p = 0.001, I2 = 95). A significant effect (SMD = 0.27, p = 0.05; I2=0%) was found after three weeks of physical training on the BDNF. Our study indicates that physical exercise is an appropriate stimulus to increase BDNF release in MS patients. The acute and short-term increases in this neurotrophin reflect physical exercise's potential and interesting neuroprotective character in populations with neurodegenerative diseases.Trial registration: This study was preregistered in the International Prospective Register of Systematic Review (PROSPERO) with the following registration number: CRD42024505920.