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.

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.

Pregnancy requires a careful immune balance between tolerance for the semi-allogenic fetus and protection against pathogens. Women with immune-mediated inflammatory diseases (IMIDs), where the interleukin (IL)-23/IL-17 axis plays an important role, often experience changes in disease severity during pregnancy. These changes and the association between disease flares and pregnancy complications, suggests a role for IL-17 and IL-23 in pregnancy.

We systemically searched PubMed, EMBASE, and Web of Science (March 2024), to assess the role of IL-17 and IL-23 in pregnancy-related in vitro assays, animal or human studies.

Eighty articles (8 in vitro, 11 animal and 61 human studies) were included. Seventy-one studies reported on IL-17 and 16 studies on IL-23. In vitro trophoblast proliferation, migration and invasion was increased in the presence of IL-17, but impaired with IL-23. IL-17 levels were increased in animal models for pregnancy complications. In humans, IL-17 levels seemed to be increased in pregnant women versus non-pregnant women. Additionally, elevated IL-17 levels were associated with pregnancy complications. Although similar trends were found for IL-23, data were limited.

We identified a large, but heterogenic, body of evidence for a significant role of IL-17 in all stages of pregnancy: while an excessive increase seemed to be associated with complications. The limited number of studies prevents firm conclusions on the role of IL-23. Future research is needed to find biomarkers for patients with IMIDs to predict the effect of possible disease flares on pregnancy, and the effect of therapeutic inhibition of IL-17 or IL-23.

West Nile Virus (WNV) exemplifies the complexities of managing vector-borne diseases, expanding globally due to human activities and ecological changes. Originating from Africa and transmitted by Culex mosquitoes, WNV is now reported across multiple continents. The aim of this study was to identify the environmental, ecological, and individual factors influencing WNV transmission.

An umbrella review was conducted. Comprehensive searches were performed in PubMed, Scopus, Web of Science, Embase, and LILACS. Inclusion criteria were reviews involving WNV transmission agents (reservoirs, vectors, hosts) and associative analyses between environmental, ecological, or individual factors and WNV transmission. Data extraction and quality appraisal were performed using templates and the AMSTAR 2 tool.

From 404 retrieved studies, 23 systematic reviews and meta-analyses were included. Almost 70 % were low or critically low quality. The co-occurrence network highlighted emerging research on climate change and environmental factors. Temperature, precipitation, and land use significantly influence WNV transmission. Warmer temperatures enhance mosquito populations and viral replication, while extreme weather events like droughts increase mosquito-human contact. Climate change significantly contributes to WNV dynamics by altering temperature and precipitation patterns, enhancing vector proliferation, and extending transmission seasons. Ecological factors such as higher avian diversity, vegetation indexes, and distribution of mosquito species can impact WNV transmission significantly. Education and income levels influence preventive behaviors and infection risk, with lower socioeconomic status linked to higher WNV risk. Certain occupational groups are also at elevated risk of WNV infection.

Environmental factors like temperature and precipitation critically affect WNV transmission by influencing mosquito behavior and avian reservoir dynamics. Socio-economic status and education levels significantly impact individual preventive behaviors and infection risk. Multifactorial influences on infection risk make necessary integrated surveillance systems and public health strategies. Longitudinal studies with One Health approaches are necessary to better understand WNV dynamics and reduce WNV transmission.

Animal models investigating sevoflurane or compound A and renal function serve as the initial basis for concerns regarding renal injury following sevoflurane anesthesia and subsequent recommendations of minimum fresh gas flow, but this evidence basis has not been critically appraised. Primary literature searches were performed in MEDLINE OVID, PubMed, EMBASE, the Cochrane Library), the Cochrane Central Register of Controlled Trials, the International HTA Database, CINAHL, and Web of Science to identify randomized controlled trials and quasi-experimental studies in animals utilizing sevoflurane or compound A. The primary outcomes included renal function as determined by blood urea nitrogen, serum creatinine, creatinine clearance, and urine volume. The secondary outcomes included the serum fluoride concentration and histopathological findings. A total of 2537 records were screened, and 21 randomized controlled trials and 9 quasi-experimental animal studies were identified. No associations between sevoflurane exposure and subsequent changes in renal function (blood urea nitrogen, serum creatinine or changes in urine volume) were noted. A similar effect on renal function was observed following compound A exposure, but urine volume was elevated following compound A exposure. In addition, the histopathological damage following compound A exposure was observed only at concentrations that are unachievable in clinical practice. Our review of evidence from animal models revealed that sevoflurane usage was not associated with changes in renal function tests or urine volume. Histopathologic changes after sevoflurane exposure were either nonexistent or minor. Studies on compound A did not reveal an alteration in renal function, although histopathological evidence of injury was present when compound A was administered at very high, unphysiologic concentrations. In light of the existing evidence, the initial concerns of sevoflurane-related nephrotoxicity based on animal studies that leads to minimum fresh gas flow recommendations are called into question.

Elbow stiffness poses a significant challenge for surgeons as well as physiotherapists during and after surgery. To date, there is no consensus regarding the subsequent rehabilitation after surgical release of the stiff elbow.

The aim is to evaluate the most important therapeutic strategies following open or arthroscopic release of the stiff elbow based on a comprehensive literature review, and to develop a consensus for or against specific therapeutic methods with the help of a survey among elbow experts of the D-A-CH Association for Shoulder and Elbow Surgery (DVSE).

Literature search was performed based on guidelines, the "health technology assessments", systematic reviews and clinical studies that examined rehabilitation after osteocapsular release of the stiff elbow. The databases of the "Guidelines International Network", various national guidelines, PubMed, the "Cochrane Central Register of Controlled Trials", the "Cochrane Database of Systematic Reviews", and the "Physiotherapy Evidence Database" were scanned, each for the period from January 1989 to December 2019. As part of an online survey, all active members of the DVSE were asked about their strategies in immediate aftercare and rehabilitation after elbow arthrolysis.

A total of 5 reviews and 55 articles could be identified from 107 articles since 1989, which served as the basis for the preparation of an evidence-based aftercare recommendation. By reviewing all the mentioned paper and evaluation of the survery of DVSE members, a basic concept could be finalized.

Physical activity interventions positively influence executive functions in both the general population and individuals with ADHD. However, there is limited research focusing on school-aged children, who have the highest ADHD diagnosis rates. This study aims to provide targeted intervention strategies for improving executive function in this population, offering a practical reference for selecting specific exercise types when designing interventions for children with ADHD.

A systematic search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant RCTs up to September 2023. Two independent reviewers handled literature screening, data extraction, and quality assessment. Stata 15.1 software was used for the meta-analysis.

The meta-analysis included 19 studies, revealing that physical activity interventions significantly improved executive functions in school-aged children with ADHD. Cognitive flexibility (SMD = 0.70, 95 % CI: 0.09, 1.31) and working memory (SMD = 0.74, 95 % CI: 0.20, 1.28) showed moderate to large effects, while inhibition switching had a small to medium effect (SMD = -0.35, 95 % CI: -0.74, 0.03). Subgroup analysis indicated that cognitively engaging exercises were more effective, with intervention outcomes moderated by duration, frequency, and length.

Inconsistent measurement tools among the included studies may introduce biases.

Physical activity interventions are effective in enhancing executive functions in school-aged children with ADHD. Cognitively engaging exercises show the most promise, especially when tailored by intervention duration, frequency, and length.

Transcatheter aortic valve implantation (TAVI) has been growing rapidly. We aim to evaluate the performance and outcomes of the Myval transcatheter heart valve (THV) in patients with severe aortic stenosis and its use in quantitative videodensimetry, transcatheter valve-in-valve (ViV), and non-calcified aortic regurgitation (NCAR).

A systematic search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to October 2024. We used the relevant keywords to include studies that reported the outcomes of patients with severe aortic stenosis who underwent TAVI using the Myval THV and off-label usage in transcatheter ViV and NCAR. Data analysis was done using R software.

A total of 29 studies were included in this study. The results of the mean aortic gradient at discharge, 30-day, one-year, and 2-year were 9.25 mmHg (95 % CI [8.20, 10.29]), 8.46 (95 % CI [7.57, 9.34]). 10.63 (95 % CI [9.12, 12.14]), and 7.2 (95 % CI [6.78, 7.63]), respectively. Additionally, the pooled percentages of patients with ≥ moderate aortic regurgitation were found in 1 % (95 % CI [1,2]) at discharge, 3 % (95 % CI [2,4]) at 30-day, 4 % (95 % CI [2,7]) at one-year follow-up and 5 % (95 % CI [3,8]) at 2-year. Furthermore, usage of the Myval THV in transcatheter ViV and NCAR led to a reduction in mean aortic gradient and incidence of aortic regurgitation, respectively.

The Myval THV showed good safety and efficacy outcomes in short- and long-term follow-ups following the TAVI. Also, it showed promising results during transcatheter ViV and NCAR.

Hypertriglyceridemia is related to atherosclerotic cardiovascular risk and pancreatitis risk. The efficacy and safety of apolipoprotein C-III (APOC-III) inhibitors remains unclear.

To investigate the effects of APOC-III inhibitors on hypertriglyceridemia and its complications.

We systematically searched PubMed, Embase, and Cochrane Central databases from inception to May 2024 for randomized controlled trials (RCTs) comparing APOC-III inhibitors to placebo in patients with hypertriglyceridemia. We pooled percentage standardized mean difference (SMD) changes and risk ratio (RR) for continuous and binary outcomes, respectively, with 95 % confidence interval (CI). Subgroup analyses were performed with APOC-III inhibitors drugs doses (Olezarsen, Volanesorsen and Plozasiran), and primary and secondary hypertriglyceridemia.

10 RCTs with 1204 participants were included, of which 46 % were men. APOC-III inhibitors significantly reduced triglycerides (TG) (SMD: -60.56 %; 95 % CI -68.94 to -52.18; p < 0.00001), APOC-III (SMD: -75.44 %; 95 % CI -80.81 to -70.07; p < 0.00001) and non-HDL-c (SMD: -27.49 %; 95 % CI -34.16 to -20.82; p < 0.00001) levels. Consistent results were found for all subgroup analyses. APOC-III inhibitors were capable to normalize TG levels in patients with severe hypertriglyceridemia (RR: 7.92; 95 % CI 4.12 to 15.23; p < 0.00001). There was a significant increase in HDL-c (SMD: 43.92 %; 95 % CI 37.27 to 50.57; p < 0.00001) and LDL-c (SMD: 33.05 %; 95 % CI 9.08 to 57.01; p = 0.007) levels. There was a significant relative risk reduction in acute pancreatitis in the APOC-III inhibitors group (RR 0.17; 95 % CI 0.05 to 0.53; p = 0.007). Adverse events were similar in both groups.

APOC-III inhibitors improve TG levels and other lipid panel parameters, as well as reduce episodes of acute pancreatitis in patients with primary and secondary hypertriglyceridemia.

Tick-borne encephalitis virus (TBEV) is one of the most significant zoonotic diseases in Europe. It primarily spreads through the bites of infected ticks and, less frequently, through consumption of raw milk and dairy products from viremic domestic ruminants.

Assess the prevalence of TBEV or anti-TBEV antibodies in milk and milk products from domestic ruminants in Europe.

Systematic literature review adhering to the JBI methodology, and reported following the PRISMA framework.

From the 16 included scientific articles, we extracted 35 data collections (31 on raw milk and 4 on raw milk cheese); studies focused on cow (n = 15), goat (n = 11) and sheep milk (n = 5), goat (n = 3) and cow/goat cheese (n = 1). Fifteen data collections involved individual milk and 16 bulk milk samples. The estimated prevalence of TBEV in individual raw milk and cheese was 6% and 3%, respectively. TBEV prevalence in bulk milk was very heterogeneous, with most values either 0% or 100%.

Although published research on TBEV transmission to humans through milk and dairy products in the EU countries is limited, our results highlight the potential infection risk for consumers. The variable prevalence reported in the studies may reflect the focal nature of TBEV.

Studies on unpasteurised dairy products from domestic ruminants can be valuable for the detection of TBEV presence in a geographic area, even when human cases are not reported. Thanks to the ease of sample collection, their testing could be adopted in monitoring plans on TBEV.

The concept of Industry 5.0 underscores the societal importance of aligning digital technologies, human centrality (including work), and sustainability within production systems. However, its practical implementation faces significant challenges. Considering the central role of work in production systems as envisioned by ergonomics, this study addresses the following research question: What is the role of work, and how can it contribute to ensuring that technology-intensive production systems align with the principles of Industry 5.0, making them human-centered, sustainability-driven, and resilient? In this context, the objective of this research is (i) to map scientific contributions that connect digital technologies, sustainability, and work in production systems, (ii) to investigate gaps and opportunities in scientific literature and possible contributions related to the discipline of ergonomics and (iii) propose theoretical and practical implications. To this end, a systematic literature review was conducted in the Scopus database, aiming to identify studies that connected the three themes. A final sample of 115 articles was obtained, which served as the basis for a content analysis. The results revealed scientific contributions linking digital technologies and work within the context of sustainable development and corporate sustainability. The study also identified seven groups of papers (technology improvement, competent workers, interaction, expanded capabilities, work management, training and embodying) focusing on the intersection of work and digital technology, specifically, ways in which technology influences work/worker and vice versa. Future studies are called to deepen the theoretical concept of Industry 5.0; develop tools, frameworks and indicators; develop more empirical studies; focus more on the role of the worker; and develop solutions to monitor the impacts of technology on work overtime. This study also reinforces the potential of using the discipline of ergonomics as theoretical background to leapfrog knowledge for this research agenda. This is because this discipline has been already developing knowledge on the connection between work and sustainability towards different lines of research that can also be applied in the context of production systems with intensive use of digital technologies. Based on this, theoretical implications for researchers and practical implications for organizations and policymakers were defined, aiming to build human-centered and sustainable production systems.

Low breastfeeding rates continue to be a global concern among nurses and midwives, raising critical questions about knowledge and effectiveness in promoting breastfeeding. Summarising evidence on nursing and midwifery interventions to protect, promote, and support breastfeeding enables a deeper understanding of how these professionals can enhance breastfeeding practices, inform decision-makers, and improve care quality.

To synthesise nursing and midwifery interventions that protect, promote, and support breastfeeding.

The JBI methodology for umbrella reviews guided this study. Searches were conducted in databases aggregated by EBSCOhost, SCOPUS, and Web of Science, as well as relevant grey literature. Systematic reviews published in English, Portuguese, and Spanish from January 2018 to December 2023 were included. Two independent reviewers used a JBI critical appraisal tool and a specific data extraction instrument to synthesise findings.

A total of 29 studies met the inclusion criteria. Synthesised findings include: (1) the absence of nursing/midwifery interventions focused on breastfeeding protection; (2) five nursing/midwifery interventions aimed at breastfeeding promotion, with the primary intervention being prenatal education; and (3) twenty-four interventions of nurses/midwives on breastfeeding support, the most frequent being home visits, telephone technology and follow-up.

This umbrella review reveals limited involvement of nurses/midwives in breastfeeding protection, despite their expertise and potential influence on policy development to support breastfeeding. They are involved in breastfeeding promotion, but most of their intervention is focused on breastfeeding support. The diverse roles and settings of nursing and midwifery practice present challenges in evaluating intervention effectiveness. Further research specific to nursing and midwifery is needed to inform evidence-based practice and policymaking in breastfeeding care.

Metastatic castration resistance prostate cancer (mCRPC) is a challenging disease with a significant burden of mortality and morbidity. Most of the patients attain resistance to the available treatments, necessitating further novel therapies in this clinical setting. Actinium 225 (225Ac) prostate-specific membrane antigen (PSMA) radioligand therapy has emerged as a promising option and has been utilized for the last decade. Although a few meta-analyses were performed on the efficacy and safety of 225Ac-PSMA RLT in mCRPC patients, several current studies have been added to the literature since the latest meta-analysis. We aimed to gather all individual studies to perform up-to-date meta-analyses.

We searched the literature using Pubmed-Medline, Web of Science, Elsevier-Sceince Direct, and Cochrane-Central databases. The data for any PSA decline, over 50% PSA decline, overall survival (OS), progression-free survival (PFS), and toxicity profile were captured from the studies eligible for meta-analysis. We utilized the random effect model to generate pooled estimates.

The sixteen eligible studies contained 1102 patients. Sixty-three percent of patients achieved more than 50% PSA decline, while 82% had any PSA decline after the completion of therapy. The pooled mean OS and PFS were 12.72 months (9.52-15.91) and 11.02 months (6.88-15.15), respectively. The most common adverse event was xerostomia, with a pooled proportion of 84%. Grade ≥ 3 anemia, thrombocytopenia, leucopenia, and nephrotoxicity were encountered in 9%, 5%, 4%, and 4% of the patients.

225Ac-PSMA RLT is an efficacious and safe treatment for mCRPC. Future well-designed randomized controlled studies comparing 225Ac-PSMA RLT with other approved therapeutic options would better comprehend the exact role of this therapy in the treatment sequence of mCRPC.

Nonsurgical therapeutic approaches for thumb carpometacarpal (CMC) osteoarthritis (OA) often offer only inconsistent symptom relief and fail to restore hand function. Intra-articular platelet-rich plasma (PRP) injections have recently emerged as a promising alternative, with encouraging outcomes in knees and hips. This systematic review and meta-analysis aims to highlight the safety and efficacy of PRP injections in thumb CMC OA. A systematic review was completed using Medline, Embase, and Cochrane. Primary outcomes focused on patients with basal thumb osteoarthritis treated with intra-articular PRP injections. Patient characteristics, product administration, functional outcomes and complications were analyzed as means of central tendency. A meta-analysis was performed focusing on pain relief and improvement in hand function. Seven articles were included, comprising 115 patients with an average age of 62.6 years, predominantly female (67.0 %). Patients received an average of 1.4 PRP injections per joint, with an average follow-up of 14.1 months. Control groups were administered corticosteroids, normal saline, and hyaluronic acid. All PRP-treated patients resumed their prior activities of daily living with a satisfaction rate at 73.7 % (n = 76). Statistically significant pain reduction (n = 98) and improvement in pinch strength were reported, while no statistically significant improvement in grip strength was observed (n = 39). No adverse events occurred, with only one complication (a palmar wrist ganglion) reported. Intra-articular PRP injections in thumb CMC OA yields favorable outcomes for pain relief and hand function without major complications. However, procedural and data heterogeneity affect reliability. Further randomized controlled trials comparing PRP and cortisone injections are needed.

MICRO: and nanoplastics (MNPs) are fragments derived from physical, chemical, or biological degradation of plastic items. MNPs are one of the main sources of both marine and terrestrial plastic pollution. This study systematically and meta-analytically assesses the reproductive toxicity in mammals of key plastic components found in MNPs, focusing on polystyrene (PS), polyethylene (PE), polypropylene (PP), polyethylene terephthalate (PET), and polyvinyl chloride (PVC). PubMed, Medline, and CAB Abstracts databases were used to identify the relevant scientific papers, and 79 articles were selected for the systematic review. Six articles included two different species, and 19 papers contained both in vivo and in vitro studies, resulting in a total of 102 experiments being considered and analysed in the meta-analysis. Interest in the reproductive toxicity of MNPs in mammals has increased, peaking in the last two years. Five species (rat, mouse, bovine, pig, and human) have been studied, with most experiments carried out in vivo in mice, focusing on male fertility. The most studied plastic polymer is PS, and both micro- and nanoparticles were tested at single or multiple concentrations. Toxic effects are documented across various species, particle size, and polymer type. A pronounced concentration-dependent toxicity has been observed, particularly at high concentrations/doses of MNPs. There is a gap in research on food-producing animals, which are both relevant models for human health and potential vectors for MNPs into the human food supply chain. Overall, these findings emphasizpe the importance of continued research to elucidate the pathways and mechanisms through which MNPs impact mammalian reproductive health, ultimately advancing our understanding of how these pervasive pollutants interact with biological systems across diverse species.

Obesity during childhood is a critical public health issue. The summer break from school is a time when children are prone to accelerated weight gain. We aimed to investigate how obesity prevention or treatment programs implemented over the summer affect anthropometric measures or weight-related behaviors.

Published studies examining the impact of obesity prevention/treatment interventions targeting the summer with anthropometric or weight-related behaviors in children (5-18 years old) were identified using systematic searches of Medline, Cochrane, Scopus, CINAHL, PsycINFO, and EMBASE until April 2024. The summarized effect estimate was computed by applying the random-effects approach. The evidence certainty was assessed using GRADE.

Forty-seven studies were identified for inclusion. The majority of studies identified focused on physical activity and dietary habits. Only six studies that examined the effects of prevention interventions on weight, body mass index (BMI), and waist circumference (WC) were meta-analyzed. There was no evidence that prevention interventions impacted children's weight, BMI, and WC. However, most of the studies included in the systematic review indicated beneficial effects of interventions for anthropometric measures.

There was no evidence that summertime obesity interventions targeting physical activity and dietary intake were effective in the prevention of obesity in children.

Eating disorders (EDs) and non-suicidal self-injury (NSSI) are both phenomena with onset in adolescence. Their co-occurrence is associated with higher symptom severity and an elevated risk of suicide. In this meta-analysis, we examine the lifetime prevalence of NSSI in youth with EDs.

We searched PsycInfo, PubMed and previously published systematic reviews for studies reporting on lifetime NSSI prevalence among children and adolescents (19 years or younger) with an ED (anorexia nervosa, bulimia nervosa, binge eating or other specified feeding and EDs) published until June 2024. A generalized linear mixed model meta-analysis was performed to estimate the pooled prevalence. Meta-regressions and multivariate meta-analyses were conducted to estimate separate prevalence rates based on ED diagnosis and care frame (e.g., inpatient vs. outpatient), respectively.

Fifteen studies comprising 3311 children and adolescents were included. Pooled lifetime NSSI prevalence across all ED diagnoses was 34.2% [CI: 27.5%-41.7%]. Heterogeneity was large (I2 = 93.8%). Lifetime NSSI prevalence rates were significantly higher for participants with bulimia nervosa (53.6%) and those with anorexia nervosa binge-eating/purging type (51.9%) than for participants with anorexia nervosa restrictive type (15.8%).

The small number of studies and the large heterogeneity limit the conclusiveness of this meta-analysis. Results suggest an even higher prevalence of lifetime NSSI in adolescents with an ED than in adults with an ED. The results support previous findings indicating higher prevalence rates of NSSI for EDs associated with binge eating and purging behaviours than for restrictive EDs.

Sleep deprivation is a common health condition among people with intellectual disabilities. Studies have linked sleep problems with challenging behaviors. However, it is unclear if there is a consistent effect on challenging behavior and what reinforcement mechanism(s) might be involved. A systematic review of PsychINFO, PubMed, and Scopus identified seven studies meeting the inclusion criteria that had been published over the past 50 years. Data were extracted regarding participant characteristics, specific aim, sleep deprivation, functional behavioral assessments, results, and key findings. Studies consistently reported increased rates of challenging behavior following bouts of sleep deprivation. Five of the seven studies demonstrated negative reinforcement as the mechanism associated with increased challenging behavior. Results were unclear or lacking for other reinforcer mechanisms. Current evidence shows that sleep deprivation can increase negatively reinforced challenging behavior, but automatic and positive reinforcement mechanisms may be unaffected. Theoretical and practice implications are discussed.

To synthesize the experiences of 15- to 34-year-olds with cerebral palsy (CP) as they participate in key life situations of young adulthood.

A mixed-methods scoping review was undertaken and six electronic databases searched (January 2001 to August 2023). Participation foci and thematic outcomes were mapped to the International Classification of Functioning, Disability and Health. Results were integrated using a convergent integrated analysis framework, and data analysis completed through thematic synthesis. Themes were mapped to the family of Participation-Related Constructs.

Thirty-eight publications (32 studies; 2759 participants) were included. More participants were male (n = 1435), walked independently (n = 1319), and lived with their families (n = 1171). 'Claiming my adulthood and "doing" life' was the unifying descriptor of participation, conveying the effortful work young people felt necessary to take their places in the adult world. The physical accessibility of the environment was a significant barrier to participation, as were people's negative attitudes or misconceptions about disability. A close-knit 'circle of support', typically family members, formed a supportive foundation during this period.

Young people with CP aim to participate fully in adult life, alongside their peers. Improved community accessibility, inclusion, and more supportive health environments would ensure they could live the lives they choose.

To conduct a network meta-analysis (NMA) comparing the efficacy of anti-vascular endothelial growth factor (VEGF) monotherapy versus anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy for diabetic macular edema (DME).

PubMed, Embase, and the Cochrane Library were systematically searched for randomized controlled trials comparing anti-VEGF monotherapy with anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy for DME. The primary outcomes included the mean best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes from the baseline. A NMA for continuous outcomes was conducted using a fixed-effects model, with mean difference (MD) and corresponding 95% credible interval (CI) reported.

The NMA included 21 randomized controlled trials involving 1798 eyes. Anti-VEGF monotherapy and anti-VEGF combined with laser or intravitreal glucocorticoid therapy did not significantly change the mean CMT and BCVA at 6 and 12 months from the baseline. Simulation-based ranking results for mean BCVA changes suggested that anti-VEGF therapy combined with laser therapy was likely the most effective at 6 (70.7515%) and 12 (70.9315%) months. Similar results were observed in the simulation-based ranking of mean CMT changes, suggesting that anti-VEGF therapy combined with laser therapy was likely the most effective at 6 (83.6350%) and 12 (74.7730%) months.

Anti-VEGF monotherapy and anti-VEGF therapy combined with laser or intravitreal glucocorticoid therapy exerted comparable effects. However, the ranking chart recommends anti-VEGF therapy combined with laser therapy. Meanwhile, anti-VEGF therapy combined with intravitreal glucocorticoid therapy did not demonstrate significant benefits.

Mini-tablets have recently raised huge interest in pharmaceutical industry. The present review aims to identify the rational, the opportunities and challenges of this emerging small solid drug dosage form by a structured literature review following the PRISMA algorithm. In total, more than 5,000 literature and patent sources have been found starting with the very first in the 60s of the past century, followed by the first multiparticular products using mini-tablets with pancreatin (Panzytrat® by the former BASF subsidiary Knoll/Nordmark) authorized in 1985. There seems to be a second boost of common interest in the 2000s when clinical studies demonstrated that one or more mini-tablets could enable superior drug administration even in very young patients including neonates over the former gold standard, a liquid drug preparation. Several pharmaceutical companies immediately started clinical development programs using the mini-tablet concept and the first products have been recently authorized by the competent authorities. Superiority was given as the mini-tablets ease the swallowing procedure compared to conventional tablets, enable various modified drug release opportunities including taste-masking by film-coating technology and provide excellent drug stability compared to liquid oral dosage forms. Due to these product attributes they are particularly beneficial to children and their caregivers. Furthermore, there is potential for precise individual drug dosing by counting adequate amounts of the multiple drug carriers. Most recently, two novel products with different concepts were authorized by the EMA and entered the market which are highlighted in this review: the first orodispersible mini-tablet with enalapril maleate for congenital heart failure (Aqumeldi® from Proveca Pharma) and the first single unit mini-tablet with matrix-type controlled melatonin release for insomnia (Slenyto® from Neurim Pharmaceuticals). Our review reveals, that the majority of the published scientific papers use co-processed, ready-to-use excipients for the orodispersible mini-tablet formulations. However, traditional fillers such as microcrystalline cellulose or lactose have also been used for immediate release mini-tablets after adding a (super)disintegrant and a lubricant. The manufacturing of mini-tablets is conducted on conventional rotary tablet presses, predominantly equipped with multi-tip toolings to improve the yield or production speed. Scaling-up has been successfully realized from compaction simulators to pilot and production scale. Film-coatings enabling gastric resistance, taste masking or sustained-release properties have been realized in both fluid-bed and drum coaters using the same polymers as for conventional tablets. There is still a significant lack in regulatory guidance despite the recent success of the mini-tablet concept, starting from suitable characterization methods in the pharmacopoeias up to the design and conduct of clinical studies on mini-tablets.

A 2005 review identified smoking, hypertension, and excessive alcohol intake as the most important risk factors of aneurysmal subarachnoid hemorrhage (aSAH), but data on other factors remained inconclusive. While aSAH is more prevalent in female participants, evidence on sex differences and female-specific factors remains limited. Comprehensive identification of all risk factors, including potential sex differences and female-specific factors, is essential for improving prevention and accurately assessing aSAH risk. We aimed to determine whether there is now greater certainty around previously inconclusive risk factors, identify any new emerging factors, and explore sex differences in both established and emerging risk factors.

We conducted a systematic review and meta-analysis of cohort and case-control studies on prevalent lifestyle exposures, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. These exposures included smoking, hypertension, alcohol abuse, oral contraception, hormone replacement therapy, hypercholesterolemia, rigorous physical activity, lean body mass index, and diabetes. We calculated pooled sex-specific relative risks (RRs) and odds ratios (ORs) with 95% CIs for overall risk and female-to-male ratios of RRs (RRRs) and ORs (RORs) for sex comparisons.

We included 67 studies (34 cohort [8 with sex-specific data], 33 case-control [6 with sex-specific data]; n = 5,743,262; 57% female). A sex-specific association was found for current smoking (RRR 1.53, 95% CI 1.05-2.23), but not for hypertension (RRR 1.50, 95% CI 0.78-2.89) or excessive alcohol intake (RRR 0.46, 95% CI 0.13-1.63). Regular rigorous exercise (RR 0.74, 95% CI 0.53-1.04; OR 0.69, 95% CI 0.57-0.83) and diabetes (RR 0.75, 95% CI 0.55-1.02; OR 0.52, 95% CI 0.41-0.65) were associated with reduced risk, without sex-specific associations. Data on hypercholesterolemia (RR 1.24, 95% CI 0.97-1.58; OR 0.52, 95% CI 0.37-0.74) and lean BMI (RR 1.31, 95% CI 1.15-1.50; OR 1.39, 95% CI 0.74-2.60) were inconsistent and showed no sex-specific associations. Hormone replacement therapy (RR 1.03, 95% CI 0.72-1.48) and oral contraceptive use (RR 5.40, 95% CI 0.68-42.57) were limited to female patients, with current users compared with never users. Most studies contained potential sources of bias.

Current smoking, but not hypertension or excessive alcohol, has a stronger association with aSAH in female patients than in male patients. Regular exercise and diabetes are associated with a reduced risk, with no sex-specific associations. Data on female-specific factors remain inconsistent. Targeted smoking prevention may particularly benefit female patients. Large-scale studies are needed to clarify the role of female-specific factors in explaining the higher incidence of aSAH in female patients.

Polyethylene (PE) mulch film has been widely used in agricultural production. However, the residual PE mulch film fragments in the soil can cause severe pollution, affecting the quality of agricultural products and even the stability of the ecological environment. Moreover, PE mulch film has high calorific value and thermoplasticity, so recycling is necessary. This review provides an overview of the current pretreatment and recycling methods for waste PE mulch film, cites application examples from plastic recycling enterprises, and offers suggestions for future research directions. In the pretreatment technology, the research status of mechanical collection with high efficiency and mechanical collection with pretreatment function was summarized, and the advantages and disadvantages of different collection machines were pointed out. In the treatment technology, several technologies' advantages, disadvantages and research progress, including incineration, thermal pyrolysis, direct regranulation and modified regranulation, were summarized. It points out that improving the degree of resource recycling and optimizing the quality of recycled products is the key to reuse. In summary, this review points out that the research on collecting and recycling waste PE mulch film requires joint efforts in raising collecting awareness, promoting resource recycling technology, preventing secondary pollution, and making positive contributions to agricultural production and ecological environment protection.

Systematic Reviews (SRs) rigorously synthesize findings on a theme, but some articles with this design are redundant due to errors and conflicts. Meta-research aims to rigorously analyze research, assessing SRs' methodological quality and result reliability. This study evaluates SRs' overall quality in low- and middle-income countries (LMICs) on chronic non-communicable Diseases (NCDs) and key modifiable risk factors, using assessment tools.

A search strategy was conducted in the following databases: MEDLINE (via PubMed), Embase, (via Elsevier), Cochrane Library, and Grey Literature for published studies from January 1, 2014 - April 5, 2024. SRs addressing the association between at least one of the four most important modifiable behavioral risk factors (tobacco use, inadequate diet, alcohol consumption, and physical inactivity) and chronic NCDs in populations classified as LMICs according to the 'World Bank list of countries' were included. The selected studies were imported into the EndNote 20 software and analyzed using a form for the extraction of their main data and four tools were chosen to assess each of the most important domains of scientific evidence: Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) for article writing; Template for Intervention Description and Replication (TIDieR) for intervention description; A Measurement Tool for Evaluating Systematic Reviews (AMSTAR-2) for methodological assessment; and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) for certainty of evidence.

Nine studies were included in this analysis. The average Overall Score on the PRISMA 2020 checklist was 13.5 for articles published before 2020 and 25.67 for those published after 2020. TIDieR analysis revealed complete correspondence (100%) for item 'Brief Name', while other items, like 'Why' (89%), and 'What', 'Who Provided', and 'How' (78%), were partially met but significantly so. Regarding AMSTAR-2 criteria, only one study fulfilled all critical items, meeting item 7 by providing a detailed list of excluded studies and justifying each exclusion motive. Additionally, among critical items applicable to multiple articles, only item 11 was consistently fulfilled by all studies. In the final classification, one article achieved a moderate quality rating, three were critically low quality, and five had low quality among the nine evaluated articles. In the GRADE tool evaluation, limitations resulted in estimations for only 19 outcomes and 8 intervention-exposure sets.

The results demonstrated that the writing of recent scientific articles meets most of the PRISMA 2020 criteria, with a checklist being the most used tool. Interventions and exposure were also very well reported, with the TIDieR checklist not being cited in any study as a guiding tool. AMSTAR-2 revealed a methodological approach of varied quality, mainly low and critically low. The GRADE approach classified the certainty of the evidence as generally very low. Therefore, it is necessary to encourage adherence to these approaches to improve the methodological quality in SR studies on chronic NCDs and behavioral factors in LMICs.

Raising awareness about dementia risk reduction is particularly important for ethno-culturally diverse or immigrant women, who have greater risk of dementia compared with men due to multiple interacting factors. We aimed to synthesize prior research on culturally-safe strategies to raise diverse women's awareness of dementia risk reduction.

We conducted a theoretical review. We searched for studies published up to April 2023 included in a prior review and multiple databases. We screened studies and extracted data in triplicate, informed by existing and compiled theoretical frameworks (WIDER, RE-AIM, cultural safety approaches) and used summary statistics, tables and text to report study characteristics, and strategy design, cultural tailoring, implementation and impact.

We included 17 studies published from 2006 to 2021. Most were conducted in the United States (15, 88%), before-after cohorts (7, 41%), and included African, Caribbean or Latin Americans (82%). No studies focused solely on women (median women 72%, range 50% to 95%). All strategies consisted of in-person didactic lectures, supplemented with interactive discussion, role-playing, videos and/or reinforcing material. Strategies varied widely in terms of format, delivery, personnel, and length, frequency and duration. Details about tailoring for cultural safety were brief and varied across studies. Ten approaches were used to tailor strategies, most often, use of target participants' first language. Assessment of implementation was limited to reach and effectiveness, offering little insight on how to promote adoption, fidelity of implementation and longer-term maintenance of strategies. Strategies increased knowledge of dementia and decreased misconceptions, but did not prompt participants to seek dementia screening in the single study that assessed behaviour.

While this review revealed a paucity of research, it offers insight on how to design culturally-safe dementia risk reduction strategies that may be suitable for ethno-culturally diverse or immigrant women. Healthcare professionals can use these findings to inform policy, clinical guidelines and public health programs. Future research is needed to establish the ideal number, length and duration of sessions, and confirm strategy effectiveness for diverse women.

To compare the augmentative efficacy of second-generation anti-psychotics (SGA) to anti-depressants in adult patients with treatment-resistant depression (TRD) adjusting follow-up period and explore the underlying"time window"effects of the regimens.

Databases included Embase, PubMed, Scopus, Cochrane Library and Google Scholars as well as Clinicaltrials.gov from inception to May 15, 2024, for relevant randomized controlled studies (RCTs) were retrieved. The primary endpoint was Montgomery Asberg Depression Rating Scale (MADRS). The secondary endpoint was MADRS response rate. The tertiary endpoints were Clinical Global Impression-severity (CGI-S) and MADRS remission rate. Standard mean difference (SMD) and hazard ratio (HR) were generated by Bayesian network meta-regression (NMR) for pairwise comparisons on dichotomous and consecutive variants, respectively.

A total of 23 studies (N = 10679) with 24 augmentation agents were included in the NMR. For the primary endpoint, compared with ADT, aripiprazole 3 - 12 mg/d, brexpiprazole 1 - 3 mg/d, cariprazine 1.5 - 3 mg/d, olanzapine 6 - 12 mg/d and fluoxetine 25 - 50 mg/d combination, and quetiapine XR were significantly effective (SMD ranged from - 0.28 to - 0.114) and their effect sizes were comparable, after adjusting follow-up period, the results resembled the former except for quetiapine XR (SMD = - 0.10, 95%CI: - 0.212 to 0.014). Brexpiprazole 3 mg/d (7.22 weeks), cariprazine 1 - 2 mg/d (2.97 weeks), cariprazine 2-4.5 mg/d (2.81 weeks), cariprazine 3 mg/d (7.16 weeks), olanzapine 6 - 12 mg/d (4.11 weeks) and quetiapine 150 - 300 mg/d (3.89 weeks) showed"time window". For the secondary endpoint, brexpiprazole 3 mg/d and rispridone 0.5 - 3 mg/d was evidently superior to all others (HR ranged from 1.748 to 2.301). For the tertiary endpoints, as for CGI-S, aripiprazole 2 - 20 mg/d, brexpiprazole 2 - 3 mg/d, cariprazine 3 mg/d, olanzapine 6 - 12 mg/d and fluoxetine 25 - 50 mg/d combination, and rispridone 0.5 - 3 mg/d were conspicuously effective compared with ADT (SMD ranged from - 0.438 to - 0.126) and for MADRS remission rate, aripiprazole 2 - 20 mg/d, brexpiprazole 3 mg/d, cariprazine 3 mg/d, rispridone 0.5 - 3 mg/d were conspicuously effective compared with ADT (HR ranged from 0.477 to 3.326).

Holistically considering each endpoint and corresponding "time window", certain SGAs appeared to be efficient augmentation to anti-depressants for TRD, but aripiprazole was relatively more effective and better tolerated.

Schizophrenia (SCZ) and depression are two prevalent mental disorders characterized by comorbidity and overlapping symptoms, yet the underlying genetic and neural mechanisms remain largely elusive. Here, we investigated the genetic variants and neuroimaging changes shared by SCZ and depression in Europeans and then extended our investigation to cross-ancestry (Europeans and East Asians) populations. Using conditional and conjunctional analyses, we found 213 genetic variants shared by SCZ and depression in Europeans, of which 82.6% were replicated in the cross-ancestry population. The shared risk variants exhibited a higher degree of deleteriousness than random and were enriched for synapse-related functions, among which fewer than 3% of shared variants showed horizontal pleiotropy between the two disorders. Mendelian randomization analyses indicated reciprocal causal effects between SCZ and depression. Using multiple trait genetic colocalization analyses, we pinpointed 13 volume phenotypes shared by SCZ and depression. Particularly noteworthy were the shared volume reductions in the left insula and planum polare, which were validated through large-scale meta-analyses of previous studies and independent neuroimaging datasets of first-episode drug-naïve patients. These findings suggest that the shared genetic risk variants, synapse dysfunction, and brain structural changes may underlie the comorbidity and symptom overlap between SCZ and depression.

Engineered nanoparticles (ENPs) have widely revolutionized many fields, including medicine, technology, environmental science, and industry. However, with the wide use of ENPs in everyday life, concerns are increasingly being raised about their potential neurotoxic effects on the central nervous system (CNS), particularly in relation to neurodegeneration and neuroinflammation. The present systematic review focuses on reporting the current knowledge about the neurotoxic potential of ENPs, with particular attention to their mechanism of action in neuroinflammation and neurodegeneration. This PRISMA based systematic review encompassed studies from Pubmed, Embase, and Web of Science. Eligibility criteria included focusing on engineered NPs and their impacts on neuroinflammation, neurodegeneration, and neurotoxicity. Evidence shows that ENPs easily can cross the blood-brain barrier (BBB) inducing neuronal damage and neurotoxicity due to oxidative stress, inflammation, mitochondrial dysfunction, and cell death. Inflammation plays a crucial role in activating glial cells, such as microglia and astrocytes, leading to the release of pro-inflammatory cytokines, chemokines, and reactive oxygen species (ROS). This increases the vulnerability of the brain to systemic inflammation. In conclusion, as ENP exposure continues to increase, understanding their long-term effects on the brain is fundamental to developing effective strategies to mitigate their impact on neuronal human health.

Inborn errors of immunity (IEI) are congenital disorders of the immune system. Due to impaired immune system, they are at a higher risk to develop a more severe COVID-19 course compared to general population.

Herein, we aimed to systematically review various aspects of IEI patients infected with SARS-CoV-2. Moreover, we performed a meta-analysis to determine the frequency of COVID-19 in patients with different IEI.

Embase, Web of Science, PubMed, and Scopus were searched introducing terms related to IEI and COVID-19.

3646 IEI cases with a history of COVID-19 infection were enrolled. The majority of patients had critical infections (1013 cases, 27.8%). The highest frequency of critical and severe cases was observed in phenocopies of IEI (95.2%), defects in intrinsic and innate immunity (69.4%) and immune dysregulation (23.9%). 446 cases (12.2%) succumbed to the disease and the highest mortality was observed in IEI phenocopies (34.6%). COVID-19 frequency in immunodeficient patients was 11.9% (95% CI: 8.3 to 15.5%) with innate immunodeficiency having the highest COVID-19 frequency [34.1% (12.1 to 56.0%)]. COVID-19 case fatality rate among IEI patients was estimated as 5.4% (95% CI: 3.5-8.3%, n = 8 studies, I2 = 17.5%).

IEI with underlying defects in specific branches of the immune system responding to RNA virus infection experience a higher frequency and mortality of COVID-19 infection. Increasing awareness about these entities and underlying genetic defects, adherence to prophylactic strategies and allocating more clinical attention to these patients could lead to a decrease in COVID-19 frequency and mortality in these patients.

Pain control following laparoscopic gynaecologic surgery is key to successful recovery. The efficacy of the transversus abdominis plane (TAP) block compared to no block or a local anaesthetic injection has not been well established in this population.

To evaluate the benefits and harms of single-shot transversus abdominis plane blocks for the prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery compared to no block, sham block, or injection of local anaesthetic.

We searched CENTRAL, MEDLINE, Embase, two trials registers, and handsearched abstracts to 6 December 2024.

We included prospective randomised controlled trials (RCTs) of adult women undergoing minimally invasive gynaecologic surgery that compared single-shot TAP block to no block, sham block, or injection of local anaesthetic. We excluded studies that were non-randomised or of non-gynaecologic surgery.

Critical and important outcomes: participant-reported pain intensity 24 hours following surgery (combined, at rest, and with movement), adverse events (serious adverse events, nausea and vomiting, postoperative sedation), opioid consumption 24 and 48 hours after surgery. Other outcomes: pain intensity 2, 6, 12, and 48 hours after surgery, opioid consumption intraoperatively, time from surgery to first participant requirement for postoperative opioid, time from surgery until discharge.

We assessed the risk of bias with RoB 1.

We conducted meta-analyses using random-effects models. We calculated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes. We reported serious adverse events as described by the study authors. We summarised the certainty of evidence using GRADE methods.

We included 21 RCTs with a total of 1645 participants. Studies were conducted in 10 countries, and published between 2011 and 2023. Six studies compared TAP block to no block, eight compared TAP block to an injection of local anaesthetic, and seven studies compared TAP block to sham block. Studies reported pain outcomes in various ways, so we made assumptions to allow us to combine data.

1. TAP block compared to no block TAP blocks may result in little or no difference in pain 24 hours after surgery for women undergoing laparoscopic or robotic gynaecologic procedures (MD -4.66, 95% confidence interval (CI) -11.06 to 1.74; 4 RCTs, 242 women; I2 = 88%; very low-certainty evidence). TAP blocks may result in little or no difference in pain at rest (MD -0.16, 95% CI -1.60 to 1.28; 2 RCTs, 146 women; I2 = 0%, low-certainty evidence), or pain with movement (MD -1.59, 95% CI -4.44 to 1.25; 2 RCTs, 146 women; I2 = 0%, low-certainty evidence) 24 hours after surgery. Two studies reported serious adverse events. None reported an event related to the TAP block (out of 50 women). TAP blocks may result in little or no difference in postoperative nausea and vomiting (RR 0.60, 95% CI 0.24 to 1.54; 2 RCTs, 111 women; I2 = 0%, low-certainty evidence). TAP blocks may have little or no effect on 0- to 24-hour postoperative morphine consumption (MD 3.08, 95% CI -3.71 to 9.88; 3 RCTs, 140 women; I2 = 70%; very low-certainty evidence). None of the studies reported 48-hour morphine consumption. 2. TAP block compared to local anaesthetic Women who received TAP blocks may experience a small reduction in 24-hour postoperative pain compared to local anaesthetic (MD -11.58, 95% CI -20.52 to -2.64; 6 RCTs, 393 women; I2 = 89%; low-certainty evidence). None of the studies reported pain at rest or with movement. Four studies reported serious adverse events. None reported an event related to the TAP block (out of 168 women). TAP block may result in little or no difference in postoperative nausea and vomiting compared to local anaesthetic (RR 0.63, 95% CI 0.34 to 1.15; 1 RCT, 62 women; low-certainty evidence). There may be little or no difference in opioid consumption 0 to 24 hours after surgery for women who received a TAP block compared to local anaesthetic (MD -8.21, 95% CI -19.69 to 3.27; 2 RCTs, 177 women; I2 = 81%; very low-certainty evidence). TAP block compared to local anaesthetic may result in little or no difference in opioid consumption 0 to 48 hours after surgery (MD -15.80, 95% CI -32.11 to 0.51; 1 RCT, 40 women; low-certainty evidence). 3. TAP block compared to sham block TAP block probably results in a small decrease in 24-hour postoperative pain compared to sham block (MD -14.26, 95% CI -27.03 to -1.48; 4 RCTs, 371 women; I2 = 98%; moderate-certainty evidence). None of the studies reported pain at rest. TAP block probably results in a small reduction in pain with movement 24 hours following surgery (MD -3.60, 95% CI -6.72 to -0.48; 1 RCT, 60 women; moderate-certainty evidence). Six studies reported serious adverse events. None reported an event related to the TAP block (out of 307 women). There may be little or no difference in postoperative nausea and vomiting between TAP and sham blocks (RR 0.68, 95% CI 0.45 to 1.03; 3 RCTs, 244 women; I2 = 0; low-certainty evidence). There may be little or no difference in 24-hour postoperative morphine consumption between TAP and sham blocks (MD -13.08, 95% CI -30.78 to 4.63; 5 RCTs, 310 women; I2 = 99%; low-certainty evidence). None of the studies reported 48-hour postoperative opioid consumption.

Amongst women undergoing minimally invasive gynaecologic surgery, we did not find a clinically meaningful effect of TAP block on postoperative pain or opioid consumption. However, there may be a small reduction of pain using TAP blocks compared to local anaesthetic or sham blocks. The TAP block is probably safe, since no adverse events were noted amongst the 525 women who received a block, and for whom safety data were available. The evidence is limited by heterogeneity in the results, risk of bias in the studies, and assumptions made for synthesis when combining data.

The review had no dedicated funding.

Protocol (2022): DOI: 10.1002/14651858.CD015145.

It is often difficult to identify treatment-related changes (TRC) from tumor progression (TP) in patients with glioma, and the current application of PET scanning is expected to improve the diagnosis.

We used a systematic review and meta-analysis to reveal diagnostically more promising tracers by comparing the diagnostic accuracy of different PET tracers in identifying TRC and TP in patients with glioma.

We searched PubMed, Web of Science, and EMBASE databases, and we selected studies that used PET scans to identify TP and TRC in patients with glioma.

Twenty-eight studies were identified based on the set criteria. The studies involved a total of 10 different tracers and 1405 patients. TP occurred in 67.4% (947) of patients, while TRC occurred in 32.6% (458) of patients.

The sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of various PET tracers were calculated and summarized. Moreover, the diagnostic value of various tracers was compared.

This systematic review included 28 studies comparing 10 different PET tracers, including 18F-fluoro-deoxy-glucose FDG (18F-FDG), 11C methionine (11C -MET), 18F-fuoroethyl-L-tyrosine (18F-FET), 3,4-dihydroxy-6-18F-fluoro-L-phenylalanine (18F-FDOPA), 18F-fluorothymidine (18F-FLT), 18F-PSMA-1007, 68Ga-PSMA-11, 18F-choline (18F-CHO), 18F-fluciclovine, and [11]C-Alpha-Methyl-Tryptophan(11C-AMT). The results revealed that 11C-MET exhibited the highest diagnostic value, with an overall sensitivity and specificity of 0.89 [0.85, 0.93] and 0.91 [0.84, 0.99], respectively. Although the number of 18F-FDOPA studies is limited, it exhibited high diagnostic value, with an overall sensitivity and specificity of 1.00 [0.91, 1.00] and 0.92 [0.75, 0.99], respectively.

Most studies consisted of small sample sizes; however, the included studies differed to some extent regarding the reference standard for the final diagnosis and the standard of care. Additionally, most selected studies were retrospective.

Amino acid-based tracers exhibited the highest diagnostic value in identifying TRC and TP in gliomas, with 11C-MET and 18F-FDOPA having the most notable advantages. Research on other new tracers is limited, therefore, further studies are needed to prove their diagnostic value.

Voxel-based morphometry (VBM) reveals diverse alterations in gray matter volume in acute lymphoblastic leukemia (ALL) patients after chemotherapy. However, the reported results are inconsistent. Therefore, our objective was to conduct a meta-analysis to synthesize findings from existing VBM studies and identify consistent patterns of altered gray matter volume in ALL patients post-chemotherapy.

A systematic search was conducted across PubMed, Web of Knowledge, Embase, Google Scholar, and CNKI for VBM studies that compared ALL patients post-chemotherapy with healthy controls (HCs) up to April 1, 2024. Significant cluster coordinates were extracted for comprehensive analysis.

We included 7 studies involving 143 ALL patients post-chemotherapy and 140 HCs. ALL patients who underwent chemotherapy presented decreased gray matter volume in the left caudate nucleus, left calcarine fissure/surrounding cortex, left precentral gyrus and right anterior thalamic projections. Jackknife sensitivity analysis validated the robustness of these findings.

This meta-analysis revealed consistent gray matter volume alterations in ALL patients post-chemotherapy, emphasizing the need to explore their underlying mechanisms and long-term effects on cognitive and neurological health.

The optimal antithrombotic therapy strategies for patients with atrial fibrillation (AF) and acute myocardial infarction (AMI) remain uncertain. We aimed to evaluate the efficacy and safety of oral anticoagulants (OAC) among patients with AF and AMI.

PubMed, Embase, and Web of Science were searched from inception till 5 February 2025. The primary outcome was any stroke.

Eleven studies with 83 549 patients were included. OAC therapy was associated with lower risks of any stroke (odds ratio [OR]: 0.68; 95% confidence interval [CI]: 0.60-0.77; P < .001), ischemic stroke (OR: 0.64; 95% CI: 0.57-0.73; P < .001), and all-cause mortality (OR: 0.81; 95% CI: 0.74-0.89; P < .001). Additionally, OAC therapy was associated with a higher risk of any bleeding (OR: 1.24; 95% CI: 1.06-1.46; P = .009), but not for major bleeding (OR: 1.28; 95% CI: 0.87-1.90; P = .21).

OAC therapy is effective for patients with AF and AMI, but should be administered cautiously in those at high bleeding risk.

Transcranial Direct Current Stimulation (tDCS) has shown potential in modulating cortical activity and treating depression. Despite its promise, variability in electrode montage configurations and electric field strength across studies has resulted in inconsistent outcomes. Traditional meta-analytic methods assessing the effect of tDCS in depression typically do not compare tDCS montage and the anatomical distribution of electric field, which is a major source of inter-experimental variability. We hypothesize that considering these parameters and anatomical variability in a meta-analysis might unravel brain regions associated with tDCS response in patients with depression. We correlate the clinical outcome (Effect size) with electric field intensities across 8 diverse head models, analyzing data from 29 studies involving 1766 patients between 2000 and 2023. Our analysis found a significant effect of tDCS on depression, with a Hedge's g = 0.66 (95 % CI: 0.565 to 0.767). Although studies aimed to target the L-DLPFC, particularly Brodmann area (BA) 46, based on the Frontal Brain Asymmetry theory, our findings show that all the montages do not selectively target the L-DLPFC as intended. Instead, our findings indicated that the electric field impact was dispersing broadly across the frontal lobes and exhibiting significant heterogeneity. We found a correlation between electric field strength and clinical outcomes in BA 10, BA 11, and the anterior part of BA 46 despite tDCS montages heterogeneity and individual variability, suggesting that targeting frontopolar prefrontal and orbitofrontal cortices could be ideal for tDCS in treating depression. Our work underscores brain regions associated with tDCS response and highlights the need for simulation-guided, personalized trials that consider individual anatomical differences.

Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations.

We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus.

The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels.

Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject's ethnicity.

The objective of this research is to evaluate the effectiveness and safety of photobiomodulation or low-level laser therapy on burning mouth syndrome compared to placebo, no-laser, clonazepam and alpha-lipoic acid.

A systematic review of randomised clinical trials was performed. The databases consulted were MEDLINE, CENTRAL, LILACS, EMBASE and clinical trial registries ClincalTrial.org and WHO-ICTRP, to retrieve citations published until April 4, 2023. In addition, we consulted the grey literature for unpublished studies. There were no restrictions on language, publication status and publication date. Outcomes included pain relief, change in oral health quality of life, adverse effects and change in the quality of life concerning anxiety and depression. Two independent authors performed the study selection, and the risk of bias was assessed using the Cochrane collaboration tool. The random effect was calculated with a 95% confidence interval to calculate the relative risk. We performed heterogeneity by I2 and subgroup analysis. For all calculations, we used Review Manager 5.4.1 software.

In total, 528 references were located, and 13 studies were included, with 503 participants. Seven studies were evaluated qualitatively, and six were grouped for data meta-analysis according to the type of laser used, red or infrared. The following comparisons were evaluated: laser versus placebo, laser versus clonazepam and laser versus alpha-lipoic acid. Less pain was reported with the use of a laser, with low quality of evidence, in the comparisons: red laser versus placebo with a weighted mean difference (WMD) of -1.18; 95% CI [-2.16 to -0.19]; I2 = 61%; N = 58; 2 RCTs; infrared laser versus placebo with WMD = -1.34; 95% CI [-1.86 to -0.82]; I2 = 14%; N = 87; 3 RCTs; laser versus clonazepam with mean difference (MD) of -1.66; 95% CI [-3.17 to -0.15]; I2 = 0%; N = 33; 1 RCT. Oral health quality of life was better with the use of the laser, with very low quality of evidence, in the comparisons: red laser versus placebo with WMD = -1.08; 95% CI [-1.49 to -0.66]; I2 = 0%; N = 105; 2 RCTs; infrared laser versus placebo with WMD = -0.46; 95% CI [-1.70 to 0.78]; I2 = 86%; N = 85; 3 RCTs; laser versus clonazepam with MD = -19.65; 95% CI [-45.97 to 6.67]; N = 33; 1 RCT. For anxiety and depression, there was no significant difference between the groups, with very low quality of evidence, in the comparisons: infrared laser versus placebo, for anxiety with MD = 0.11; 95% CI [-2.64 to 2.86]; N = 28; 1 RCT; and for depression with MD = -0.66; 95% CI [-3.56 to 3.44]; N = 28; 1 RCT. Likewise, the comparison of laser versus clonazepam for anxiety and depression with MD = 1.05; 95% CI [-2.83 to 4.93]; N = 33; 1 RCT.

Pain was less common, and quality of life was better when using a low-level laser than placebo and clonazepam. The certainty of the evidence obtained was low and very low, respectively, meaning that the true effect may differ substantially from the effect estimate. Further well-conducted RCTs are needed to increase the degree of certainty of the evidence obtained.

Olfactory dysfunction is commonly treated with olfactory training, but there is a lack of standardization in its methods, leading to inconclusive results about its effectiveness. This systematic review aims to investigate the effectiveness of classical olfactory training in the treatment of olfactory dysfunction compared to modified training or no-intervention control groups.

This systematic literature review follows the PRISMA protocol and is registered with PROSPERO (CRD42022357528). The databases used for the search were PubMed MEDLINE, LILACS, Scopus, Web of Science, and Embase. Randomized clinical trials carried out in adults with olfactory disorders and published in all languages until December 2023 were included. The quality assessment of these studies was conducted using the Cochrane Risk of Bias tool.

A total of eight studies, involving 896 participants with olfactory dysfunction, were included in the analysis. Overall, these studies showed that classical olfactory training produces improvements in at least 20%-30% in olfactory function in patients affected by different etiologies of smell loss, with all of them reporting clinically significant post-treatment results.

Classical olfactory training can be a promising intervention for the recovery of olfactory function in individuals with olfactory dysfunction. However, olfactory training should not be seen as a universal solution for anosmia, given the variability of results.

The purpose of this study was to analyze epidemiological characteristics, clinical spectrum, and treatment outcome of mycotic keratitis (MK) caused by uncommon species.

The systematic review in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines has been registered on "PROSPERO" (CRD42023410825), whereas the systematic literature search was conducted on PubMed, Cochrane, Google Scholar, and Semantic Scholar on uncommon MK from January 1963 to March 2023. The main keywords for the literature search comprised: "mycotic keratitis," "fungal keratitis," "keratomycosis," "oculomycosis," "uncommon," "rare," "emerging," "atypical," "unusual," and various combinations of it.

The study identified a pool of 13,662 articles. Five hundred sixty-six studies were deemed suitable, and 186 studies met the inclusion criteria to ascertain the pooled prevalence. A total of 154 uncommon fungal species/genera were identified among 61 countries. Australia exhibited the highest pooled prevalence, whereas India reported the maximum number of cases, genera, and species. Clinical presentation varied from mild to severe disease with unequivocal response to standard therapeutic regimes. Microbiologically proven species with reported sensitivity had better visual and structural outcomes.

The study provides the first-ever global prevalence estimate of MK caused by uncommon species, estimating 154 fungal genera/species with varying severity, assuming that several culture-negative cases with specific predispositions would also qualify as cases of MK. Microbiologically proven species with reported sensitivity have better visual and structural outcomes. Cases that fail to respond to standard therapy should be re-evaluated for uncommon species with a high index of suspicion. Prompt diagnosis with culture and sensitivity analysis, PCR or in vivo confocal microscopy (IVCM)-based test and timely treatment remain the most important factors in salvaging visual and structural function.

This review catalogues the epidemiological, clinical, and morphological traits of rare fungi implicated in atypical MK and also provides a global prevalence estimate. Further, it emphasizes the role of implementation of specialized diagnostic techniques and collaborative efforts to combat the visual disability stemming from afflictions due to rare or atypical fungal species. Information on continent and country wise prevalence of atypical species would be helpful in appropriate management of such cases, in event of inconclusive diagnosis and consequent suboptimal response to treatment.

Lung cancer screening (LCS) is crucial for Indigenous populations due to their higher lung cancer incidence rates and poorer outcomes. Despite efforts to establish LCS programmes, evidence on LCS cost-effectiveness, participation rates, facilitators and barriers for Indigenous peoples remains limited. This systematic review aims to address this gap by reviewing available evidence.

This systematic review conducted searches for relevant articles in PubMed, Scopus, CINAHL, Google Scholar and references/citations of included articles.

Fifteen out of 19 eligible studies were conducted in the USA, three in New Zealand and one in Canada, with 23 715 Indigenous participants in the 15 quantitative studies. New Zealand studies found that LCS is cost-effective for Māori, while the participation rate for American Indian/Alaska Natives (4.7%) was lower than for White Americans (21.7%). Facilitators included positive views of LCS, trust in Indigenous-centred care/providers, trusted invitations, family and community support, transportation or flexible scheduling, culturally competent navigators and detailed health education. Barriers included limited knowledge about LCS/eligibility criteria, fear of the screening process or cancer diagnosis, mistrust or negative experiences in healthcare, cost and time constraints, limited transportation/resources and non-inclusive eligibility criteria.

Further research is needed to understand the LCS among Indigenous peoples. Enhancing LCS participation requires leveraging positive experiences and addressing barriers with culturally tailored education and strategic resource allocation. SO WHAT?: For Australia and similar countries preparing for LCSPs, global evidence highlights the need for adequate resources, integration of Indigenous cultural practices and active involvement of Indigenous communities in programme planning.

Despite advances in technology, stereotactic brain tumour biopsy remains challenging due to the risk of injury to critical structures. Indeed, choosing the correct trajectory remains essential to patient safety. Artificial intelligence can be used to perform automated trajectory planning. We present a systematic review of automated trajectory planning algorithms for stereotactic brain tumour biopsies.

A PRISMA adherent systematic review was conducted. Databases were searched using keyword combinations of 'artificial intelligence', 'trajectory planning' and 'brain tumours'. Studies reporting applications of artificial intelligence (AI) to trajectory planning for brain tumour biopsy were included.

All eight studies were in the earliest stage of the IDEAL-D development framework. Trajectory plans were compared through a variety of surrogate markers of safety, of which the minimum distance to blood vessels was the most common. Five studies compared manual to automated planning strategies and favoured automation in all cases. However, this comes with a significant risk of bias.

This systematic review reveals the need for IDEAL-D Stage 1 research into automated trajectory planning for brain tumour biopsy. Future studies should establish the congruence between expected risk of algorithms and the ground truth through comparisons to real world outcomes.

This study aimed to explore the relationship between circulating vascular endothelial growth factor (VEGF) levels and Behçet's disease (BD), as well as to examine the association between VEGF gene polymorphisms and BD.

We conducted a comprehensive search of the MEDLINE, Embase, and Web of Science databases to identify relevant research articles. A meta-analysis was performed to compare serum or plasma VEGF levels in BD patients with those in control groups. Additionally, we evaluated the potential associations between BD susceptibility and specific VEGF polymorphisms, namely -634 C/G, +936 C/T, and the 18 bp insertion/deletion (I/D) at -2549.

The analysis included 15 studies with a total of 1,020 BD patients and 1,031 controls. BD patients exhibited significantly higher circulating VEGF levels compared to controls (standardized mean difference [SMD]=1.726, 95% confidence interval [CI]=1.030~2.421, p<0.001). Elevated VEGF levels were noted among BD patients from European and Arab populations. Subgroup analysis further confirmed the increase in VEGF levels across different data types and sample sizes. Patients with active BD had higher VEGF levels than those with inactive BD (SMD=0.635, 95% CI=0.092~1.177, p=0.022). However, no significant association was found between BD and the VEGF -634 C allele (odds ratio=1.023, 95% CI=0.707~1.481, p=0.904). Similarly, no association was detected between BD and the VEGF +936 C/T or 18 bp I/D at -2549 polymorphisms.

Our meta-analysis showed a strong association between elevated circulating VEGF levels and BD. However, the VEGF polymorphisms examined in this study do not appear to be associated with susceptibility to BD.