Diet constitutes a major source of nutrient flow to the gut microbes. As such, it can be used to help shape the gut microbiome. Fecal microbiota transplantation (FMT) is an increasingly promising therapy in disease states beyond recurrent Clostridioides difficile infection, but diet is largely overlooked for its potential to help optimize this therapy. Therefore, the aim of this scoping review is to present the literature landscape that captures pre- and post-FMT dietary intake in humans, identify research gaps, and provide recommendations for future research. A comprehensive search strategy was developed and searches were run in five databases. Studies were included if they discussed adults who underwent FMT for any recognized treatment indication and had dietary intake as a study objective, this search encompassed studies with interventions that included foods and dietary supplements. The initial screening identified a total of 7721 articles, of which 18 met the inclusion criteria for this review. Studies were heterogeneous, but taken together, they introduce a framework that defines important nutritional considerations for both donors and FMT recipients in the period around FMT dosing. This framework is summarized with this review and highlights the opportunities available to develop FMT-based precision nutrition strategies to optimize its clinical efficacy.

Surveys such as the Shoulder Instability-Return to Sport after Injury (SIRSI) scores can help identify athletes who are better prepared to return to sport (RTS) after arthroscopic Bankart repair (ABR). Therefore, the purpose of this systematic review was to clarify how psychologically ready athletes are to RTS after ABR, with the secondary purpose of evaluating the impact of psychological readiness on athletes' ability to RTSS after ABR.

The Ovid Medline, PubMed, and SportDiscus databases were searched from inception until January 2023 using keywords such as Bankart, anterior labral repair, shoulder stabilization, return to play, and return to sport. Original studies were included if both RTS outcomes after ABR and a psychological factor were reported, with potential psychological factors being psychological readiness to RTS and reasons of failing to RTS.

Overall, 707 studies were screened and 16 met criteria for inclusion. The mean MINORS score of included studies was 13.3 ± 4.1. In patients who failed to RTS, most (74 %) patients failed due to recurrent shoulder instability, pain, or injury, while 26 % reported failing to RTS due to non-shoulder related causes such as apprehension and fear of reinjury. Eight studies evaluated post-operative SIRSI scores with a mean of 65.4 (95 % CI: 62.9-72.8) at an average of 5.4 years post-operatively.

Most athletes fail to RTS due to shoulder-related causes, with apprehension and fear of reinjury as common causes as shoulder-independent causes for failed RTS. The mean SIRSI score after ABR was 65.4, and athletes with higher post-operative SIRSI scores were more likely to RTS.

IV.

This is the protocol for a Campbell systematic review. The objectives are as follows. The aim of this study is to briefly outline the objectives of the proposed review. While Campbell systematic reviews might be motivated by many reasons, their overarching aim should be to gather, summarise and integrate empirical research so as to help people understand the evidence.

This protocol outlines a systematic review and meta-analysis examining the effectiveness of fully automated, AI-driven chatbot interventions in reducing subjective burden among informal caregivers. We will search 8 electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, PsycINFO, Scopus) and grey literature sources from January 2010 to December 2024 for randomized controlled trials (RCTs) meeting predefined eligibility criteria. The primary outcome is caregiver burden, assessed using validated scales such as the Zarit Burden Interview. Secondary outcomes encompass caregiver mental health, quality of life, self-efficacy and care recipient status. Two reviewers will independently perform study selection, data extraction, risk of bias evaluation using Cochrane RoB 2 tool, and appraise certainty of evidence utilizing the GRADE approach. We will conduct random-effects meta-analyses, subgroup analyses, and meta-regression to compute pooled effect estimates and explore heterogeneity. If quantitative synthesis is precluded, narrative synthesis will be undertaken following SWiM guideline. Caregiver partners will provide input on interpretation and dissemination of findings.•Protocol adheres to PRISMA-P reporting standards and will be prospectively registered in PROSPERO•Graphviz code for replicating the systematic review methodology diagram is provided•Review will yield critical evidence to guide development and implementation of chatbots into caregiver support services.

Children with cerebral palsy (CP) may experience a variety of visual abnormalities, which might hamper their daily activities. Most physical therapy for the CP population focuses on visual aspects, which postpone rehabilitation outcomes. Considering the significance of vision to the CP community, we aimed to conduct a systematic review of the prevalence of ocular abnormalities such as oculomotor abnormalities, refractive errors, and binocular vision anomalies in children with Cerebral palsy in the absence of eye injury in WHO South-East Asia region.

This systematic review and meta-analysis protocol are reported as per the PRISMA- P and MOOSE guidelines. A complete search strategy will be framed using MeSH terms and the opinion of the subject expert. A detailed search on PubMed, the Cochrane Library, Scopus, Web of Science and CINHAL will be carried out to retract the data on the prevalence of visual problems in the CP population (age< 18 years), published in English between January 2010 and 2024. Covidence software will be used to manage data, screen records and extract the information. The Newcastle-Ottawa Scale will be used to evaluate the listed studies quality and risk of bias. RevMan V.5 will be used to analyse the data.

Hussey (in press) recently conducted a detailed critical reanalysis of Vahey, Nicholson and Barnes-Holmes' (2015) meta-analysis. Its stated purpose was to (a) examine the extent to which Vahey et al.'s (2015) meta-analysis contains errors; and (b) to test how computationally reproducible it is by current standards of best practice. Hussey identified a small number of minor numerical errors, but crucially was unable to exactly replicate the original meta-effect of r‾ = .45. Six different variations of the meta-analysis reported by Vahey et al. were used and obtained meta-effects that deviated from the original by Δr‾ = .01-.02. Hussey also reported corresponding 95% credibility intervals that were all of zero width. These discrepancies prompted the present authors to conduct a detailed audit of the original meta-analysis. This revealed one minor transposing error in addition to three identified by Hussey. Once corrected this resulted in a marginally increased Hunter and Schmidt meta-analytic effect of r‾ = .46 without a credibility interval, and a Hedges-Vevea meta-effect of r‾ = .47 with 95% confidence interval (.40, .54). This correction was too small to have any bearing on Vahey et al.'s supplementary analyses regarding publication bias or statistical power. Vahey et al. contained a much lower proportion of transposing errors than is typical of meta-analyses even still (cf. Kadlec, Sainani, & Nimphius, 2023; Lakens et al., 2016; Lakens et al., 2017). Nonetheless, Hussey highlighted important ambiguities about the theoretical and practical meaning of the meta-effect reported by Vahey et al. We clarify our position on these matters in summary, and in so doing explain why we believe that the wider IRAP literature would undoubtedly benefit from increased adoption of contemporary open science standards.

Hypertension is a primary risk factor for cardiovascular and cerebrovascular diseases. A number of studies have suggested that sleep duration play an important role in the development of hypertension. Hypertension in young and middle-aged individuals is characterized by low awareness and treatment rates, increasing the risk of adverse events. To further elucidate the relationship between sleep duration and hypertension risk in young and middle-aged individuals, we conducted a meta-analysis.

This study searched PubMed, Embase, and the Cochrane Library from January 2003 to November 5, 2023. Data analysis was performed using STATA 17. Using Q test and I2-statistic, heterogeneity test for the included studies was conducted. Potential small-sample effects were evaluated based on the symmetry of funnel plots, and publication bias in included studies was evaluated using Egger's test.

Data analysis of sleep duration was conducted for 16 studies, which revealed that both long sleep duration (OR, 1.10; 95 % CI, 1.05-1.15) and short sleep duration (RR: 1.10, 95 % CI: 1.05 to 1.15) were associated with hypertension in young and middle-aged individuals, particularly in Asian populations.

This meta-analysis revealed an association between sleep duration (short [<7 h] and long [≥9 h]) and the development of hypertension in young and middle-aged adults, particularly in Asian populations. Sleep is a behavior that can be modified. Clinicians and health professionals should be encouraged to intensify efforts to promote healthy sleep for all and reduce the occurrence of high blood pressure in young and middle-aged individuals.

The possibility of editing the genomes of human embryos has generated significant discussion and interest as a matter of science and ethics. While it holds significant promise to prevent or treat disease, research on and potential clinical applications of human embryo editing also raise ethical, regulatory, and safety concerns. This systematic review included 223 publications to identify the ethical arguments, reasons, and concerns that have been offered for and against the editing of human embryos using CRISPR-Cas9 technology. We identified six major themes: risk/harm; potential benefit; oversight; informed consent; justice, equity, and other social considerations; and eugenics. We explore these themes and provide an overview and analysis of the critical points in the current literature.

To identify the related factors of neonatal catheter-associated bloodstream infection (CABSI), and provide a basis for constructing a scientific and rational strategy for neonatal CABSI prevention.

CNKI, Wanfang, PubMed, MEDLINE-Ovid, Web of Science, Embase, CINAHL, and Cochrane Library were searched for publications on neonatal CABSI from the time the database was established until September 30, 2023. The language of publications was not specified. Unpublished reports and gray studies were excluded. All cohort, case-control, and cross-sectional studies were included. A meta-analysis of the incidence and related factors of neonatal CABSI were made using Revman software. Heterogeneity was evaluated using the I2 statistic method, and the publication bias was analyzed with funnel plot tests.

A total of 35 studies involving 34,743 patients from 13 different countries were included. There were 15 case-control, 15 cohort, and 5 cross-sectional studies, with 14 related factors discussed. All the studies scored high (score ≥ 6) in their overall quality. According to the meta-analysis, the incidence of neonatal CABSI was 5.93/1000 catheter days (OR = 5.29). The risk factors were identified and ranked as follows according to the degree of influence: 5-minute Apgar score (OR = 4.69), the number of punctures during the stay of the line (OR = 3.49), male (OR = 3.17), mechanical ventilation (OR = 2.73), catheter repair (OR = 2.66), lower gestational age at birth (OR = 2.47), femoral vein catheter (OR = 1.92), dwell time of the catheter (OR = 1.34), and lower birth weight (OR = 1.05). Establishing sterile barrier throughout was a protective factor (OR = 0.41). Subgroup analysis suggested that the study design, catheter type and year of publication might be the primary sources of heterogeneity. The sensitivity analysis demonstrated the robustness of the results. However, the funnel plot indicated a potential publication bias.

Neonatal CABSI carries a significant morbidity rate and is influenced by numerous factors.

It is crucial to underscore the necessity for additional longitudinal studies to explore evidence-based approaches to lowering the risk and ultimately reducing the incidence of CABSI. Registration The study protocol has been registered with the PROSPERO: CRD42023443697.

While existing meta-analysis suggest that probiotic therapies may enhance cognitive functions and influence metabolic characteristics, the findings have been inconclusive. In light of these discrepancies, our study undertakes an umbrella review to more precisely determine the aggregate effects and rigorously evaluate the credibility and quality of evidence.

We conducted a systematic search across seven databases, including PubMed, Embase, the Cochrane Library, ProQuest, Web of Science, CINAHL, and Scopus, from their inception to June 20, 2024. We utilized the AMSTAR-2 tool to evaluate the quality of the meta-analyses and applied the GRADE system to rate the quality of the evidence. We estimated the final effect sizes (ESs) along with their 95% confidence intervals (CI) and performed both sensitivity and subgroup analyses to explore the sources of heterogeneity.

Among the 314 articles identified in our search, 13 meta-analysis that met the criteria were included in the study. The quality of the evidence in these studies was graded from high to very low. Our results demonstrate that probiotic treatment significantly enhances cognitive function in patients (ESSMD = 0.39, 95%CI: 0.19 to 0.59, p < 0.001). Moreover, probiotic treatment notably decreased level of serum malondialdehyde (MDA), insulin resistance as detected by homeostasis model assessment method (HOMA-IR) and high-sensitivity C-reactive protein (hs-CRP) (p < 0.001). Conversely, probiotic treatment did not significantly impact triglycerides and very-low-density lipoprotein (VLDL) in patients (p > 0.05).

Although preliminary evidence indicated that probiotic therapy may positively impact cognitive function, MDA, HOMA-IR, and hs-CRP, the overall quality of the existing evidence is insufficient to provide strong support. Therefore, future research must employ more rigorous designs or initiate larger clinical trials to produce more compelling evidence to further validate the efficacy of probiotic therapy on cognitive function of patients with cognitive dysfunction.

To evaluate the impact of delayed postoperative radiotherapy (PORT) on overall survival (OS) in patients with head and neck cancers (HNC).

A systematic review and meta-analysis were conducted by searching MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases.

Studies assessing the impact of delayed PORT in adult HNC patients were included. A total of 11,171 titles and abstracts were screened, with 52 studies meeting the inclusion criteria. Data were extracted, and a pooled random-effects analysis was performed. The primary outcome was overall survival (OS), comparing patients receiving timely PORT (within 42 days) to those with delays.

Of the included studies, 31 were conducted in the United States, with 16 using the National Cancer Database (NCDB). Patients who did not receive PORT within 42 days had a 4% increase in mortality (adjusted Hazard Ratio [aHR]: 1.04 [1.03-1.06]; I2 = 78%; N = 254,189; 16 studies). Excluding time-overlapping NCDB-based studies, the OS benefit for timely treatment persisted (aHR: 1.10 [1.01-1.20]; I2 = 39%; N = 52,003; 5 studies).

Initiating PORT within 42 days is significantly associated with decreased mortality in HNC patients, reinforcing CoC recommendations. However, more research is needed to understand the relationship between different time cutoffs and outcomes, and to identify factors contributing to PORT delays. Future studies should explore the impact of treatment delays on patient-centered outcomes, such as Quality of Life (QoL).

NA Laryngoscope, 135:1563-1570, 2025.

This study aimed to assess the global seroprevalence of IgG and IgM antibodies against Toxoplasma gondii (T. gondii) in solid organ transplant (SOT) recipients (kidney, liver, heart) through a literature review of studies published until October 24, 2024. Selected studies reported data on anti-T. gondii IgG and IgM seroprevalence in the post-transplant stage of SOT recipients. A random-effects model estimated pooled seroprevalence rates, and heterogeneity was evaluated using the I2 statistic. Sensitivity analysis examined prevalence changes after excluding studies, while subgroup analysis of IgG seroprevalence accounted for publication years, countries, continents, WHO regions, sample sizes, and types of transplanted organs. Out of 26 articles and 29 datasets analyzed, 21 articles and 24 datasets involving 19,391 transplant recipients and 880 controls were used to assess anti-T. gondii IgG and IgM seroprevalence and odds ratios (ORs). Additionally, 8 articles reported the anti-T. gondii IgG serostatus of donors and recipients. The pooled IgG seropositivity for T. gondii in SOT recipients was 9.8 % (95 % CI, 4.7-19.4 %), showing significant variation by region and organ type. The anti-T. gondii IgM seroprevalence in SOT recipients was 6.4 % (95 % CI, 3.3-12 %). Renal transplant recipients exhibited higher IgG seroprevalence compared to liver and heart transplant recipients. The pooled OR for T. gondii infections in SOT recipients vs. controls was 1.39 (95 % CI, 0.95-2.04, P = 0.08). The highest pooled anti-T. gondii IgG serostatus was 50.7 % in the undetermined group, followed by 38 % in the D-/R- group, 15.4 % in the D-/R+ group, 10.6 % in the D+/R- group, and 9.9 % in the D+/R+ group. Overall, T. gondii active infections and its increased risk trend in SOT recipients should not be overlooked.

To perform a systematic review and meta-analysis to assess the relationship between intraprostatic maximum standardised uptake value (SUVmax) of the dominant prostatic lesion as measured on preoperative prostate-specific membrane antigen (PSMA) positron emission tomography (PET) with radical prostatectomy International Society of Urological Pathology (ISUP) Grade Group, pathological tumour (pT) staging, and biochemical recurrence (BCR).

Prostate-specific membrane antigen PET may offer non-invasive assessment of histopathological and oncological outcomes before definitive treatment. SUVmax of the dominant lesion has been explored as a prognostic biomarker. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed reviews of digital libraries and databases and retrieved studies reporting SUVmax quantified on PSMA PET computed tomography or magnetic resonance imaging and subsequent radical prostatectomy ISUP Grade Group, pT stage, and BCR. Quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies-2 and Prediction model Risk of Bias Assessment tools. Random effects meta-analysis and meta-regression by ISUP Grade Group and pT2 vs pT3/4 stage was performed. This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023408170).

After removing duplicates, 23 studies were included for review. Pooled SUVmax (95% confidence interval [CI]) increased monotonically with advancing ISUP Grade Group, with ISUP 1: 5.8 (95% CI 3.9-7.7), through to ISUP 5: 17.3 (95% CI 13.1-21.5). For pT2 disease, pooled SUVmax: 9.7 (95% CI 7.8-11.5) increasing to 13.8 (95% CI 10.9-16.7) for pT3/4 disease. Substantial inconsistency was noted (I2 >50%) for all subgroups. This was not attenuated by restricting analysis only to studies using [68Ga]Ga-PSMA-11. Narrative synthesis of six papers reporting BCR showed increasing SUVmax was associated with reduced time to BCR.

Preoperative intraprostatic PSMA SUVmax increases monotonically with higher ISUP Grade Group and pathological tumour stage. Higher SUVmax is associated with reduced BCR-free survival. However, the use of single SUVmax thresholds for clinical decision making is not recommended as variability between studies is high.

Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.

The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.

This systematic review was directed by a protocol based on the Methodological Expectations of Cochrane Intervention Reviews. Quality of studies was assessed with the Cochrane risk of bias assessment tool. Searches were performed in the following databases: MEDLINE, Embase, APA PsycInfo, CINAHL Plus with Full Text, Academic Search Complete, RILM Abstracts of Music Literature, Web of Science, and Scopus.

We identified 59 articles meeting the inclusion criteria, 37 involving music and 22 involving nonmusic sound interventions, with one study comparing music and sound. The identified studies were representative of a general ICU population, regardless of patients' ability to communicate. Our review demonstrated that both slow-tempo music and sound interventions can significantly (i) decrease pain; (ii) improve sleep; (iii) regulate cortisol levels; (iv) reduce sedative and analgesic need; and (v) reduce stress/anxiety and improve relaxation when compared with standard care and noise reduction. Moreover, compared to nonmusic sound interventions, there is more evidence that music interventions have an effect on stress biomarkers, vital signs, and haemodynamic measures.

These results raise the possibility that different auditory interventions may have varying degrees of effectiveness for specific patient outcomes in the ICU. More investigation is needed to clarify if nonmusic sound interventions may be equivalent or not to music interventions for the management of discrete symptoms in ICU patients.

The protocol was registered on Open Science Framework in November 6 2023 (https://doi.org/10.17605/OSF.IO/45F6E).

Inflammation in patients with coronary artery disease (CAD) has been linked to adverse clinical outcomes. A useful biomarker for measuring inflammation levels, high-sensitivity C-reactive protein (hs-CRP) in the blood can be used to detect the presence of low-grade inflammation. This study sought to assess the predictive value of baseline hs-CRP levels for adverse clinical events in CAD patients undergoing percutaneous coronary intervention (PCI). To investigate this topic, a meta-analysis was performed. We conducted a systematic search of PubMed, Embase, and the Cochrane Library for original articles reporting the correlation between hs-CRP levels and adverse clinical events in CAD patients undergoing PCI. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and conducted a meta-analysis by extracting relevant data. Our pooled calculations yielded hazard ratios or odds ratios with 95% confidence intervals. A total of 28 studies comprising 60544 patients were included in this analysis. High baseline hs-CRP levels predicted increased risk for major adverse cardiac events ( P = 0.037), major adverse cardiac and cerebrovascular events ( P = 0.020), all-cause mortality ( P = 0.001), cardiovascular mortality ( P < 0.001), death and/or myocardial infarction ( P = 0.017) in patients, as well as restenosis ( P < 0.001). However, there was no association between elevated baseline hs-CRP levels and thrombosis. In conclusion, in CAD patients undergoing PCI, baseline hs-CRP levels are reliable predictors of major adverse cardiac events, major adverse cardiac and cerebrovascular events, all-cause mortality, cardiovascular mortality, death and/or myocardial infarction, and restenosis. Therefore, hs-CRP can effectively assist in prognosis determination for CAD patients undergoing PCI.

Our systematic review and meta-analysis elucidates the postoperative complication rates associated with 3 major surgical approaches, including the scleral tunnel, glued, and flanged techniques, for sutureless intrascleral intraocular lens (IOL) fixation. An online search was performed for articles published in PubMed and EMBASE between January 1, 1975, and January 7, 2023. Original studies reporting postoperative complications of sutureless intrascleral IOL fixation were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The initial search yielded 1854 articles, from which 1797 were excluded; 57 and 51 were included in the qualitative synthesis and meta-analysis, respectively. Based on the meta-analysis, the postoperative complication rates of cystoid macular edema (5.7 %), retinal detachment (3.5 %), vitreous hemorrhage (8.8 %), and hypotony (5.5 %) were highest with the scleral tunnel technique. The glued technique had the highest complication rate for corneal edema (14.2 %). The rates of temporarily elevated intraocular pressure (9.9 %), iris capture (5.4 %), haptic exposure (6.5 %), and IOL decentration (7.3 %) were the highest with the flanged technique. The flanged technique had a significantly shorter operative time (median, 17.1 min) compared with the scleral tunnel (42.7 min) and glued (56.5 min) techniques. Postoperative best-corrected visual acuity with the flanged technique was significantly better than that with the other techniques (P = 0.017). This meta-analysis identified high postoperative complication rates related to the impact of surgical manipulations with the scleral tunnel technique and IOL placement stability with the flanged technique. These findings enable surgeons to minimize postoperative complications in high-risk patients.

This umbrella review aimed to evaluate the evidence behind the Willems method for dental age estimation and detect methodological limitations in the existing systematic reviews. The study followed the Preferred Reporting Items for Overviews of Reviews (PRIOR), with the protocol registered in PROSPERO (CRD42023487745). Seven databases, including grey literature sources, were searched (Medline/PubMed, Scopus, LILACS, SciELO, Web of Science, Open Grey and Open Access Theses and Dissertations). Systematic reviews of cross-sectional studies on the Willems method were included. Two calibrated reviewers independently conducted study selection, data extraction, quality assessment (AMSTAR-2) and risk of bias (ROBIS). Five systematic reviews published between 2017 and 2022 were included. Combined sample sizes ranged from 9347 to 17,741 individuals aged 2.2 to 18 years. Meta-analyses reported minor overestimations in dental age, with differences varying by sex and ethnicity. However, significant methodological shortcomings were identified, such as lack of protocol registration, limited search strategies, and inadequate assessment of the risk of bias. All systematic reviews were rated as critically low quality and with a high risk of bias. The Willems method was deemed appropriate for dental age estimation by most studies, but methodological limitations of existing systematic reviews underscore the need for more rigorous research and improved standards.

Micro-osteoperforations and corticotomies are two surgical techniques commonly used to increase the rate of tooth movement. The aim of this systematic review was to respond to the question: Which method used for accelerating orthodontic tooth movement, micro-osteoperforations or alveolar corticotomy, produces a higher rate of tooth movement and present less adverse effects? Searches were performed in the electronic databases of PubMed, Scopus, Cochrane CENTRAL, Web of Science, Lilacs and Science Direct, as well as grey literature (Opengrey), up to March 2024. All the included studies were controlled, randomized clinical trials, cohort, case-control, cross-sectional, and multicentre studies of patients treated with orthodontics and corticotomies or micro-osteoperforations. Cochrane Collaboration risk of bias tool was used for quality assessment. For the quantitative analysis, studies were analyzed with a mixed-effect (random effect) meta-regresion model, with beta coefficients and R2 values, with I2 index and with Q and Egger tests. 31 articles were included for the qualitative analysis and 17 for the quantitative analysis. The rate of tooth movement of the corticotomy was 0.539 mm per month (CI95%: 0.117,0.961) higher than with micro-osteoperforations, being the values statistically significant (p = 0.012) but in a context of strong heterogeneity (89.6%). Adverse effects such as pain, quality of life impact and swelling were reported to be longer and harder after corticotomies. After corticotomy a greater rate of tooth movement has been observed during canine retraction compared to micro-osteoperforations. However, more well-designed randomized clinical trials directly comparing both techniques are needed. REGISTRATION NUMBER: CRD42020156448.

Elevated sperm DNA fragmentation has potential implications for semen quality and fertility. The commonly used sperm chromatin dispersion test offers an indirect estimation but has limitations in terms of bias and variability. This study aimed to assess the reliability of the sperm chromatin dispersion assay for predicting assisted reproductive technology outcomes.

This systematic review included studies published until December 2023 that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/MEDLINE, Scopus, and Google Scholar databases were searched. Various assisted reproductive technology outcomes in patients with high (≥ 30%) versus low (< 30%) sperm DNA fragmentation were compared using a sperm chromatin dispersion assay and including a sub-analysis of intracytoplasmic sperm injection versus in vitro fertilization. A comprehensive meta-analysis software facilitated quantitative analysis with statistical comparisons between cases and controls. Interstudy heterogeneity was assessed, and sensitivity and publication bias tests were performed.

Of the 199 abstracts assessed, 64 full-text articles were screened, and 44 articles were qualitatively synthesized. Fourteen articles representing 5346 participants were quantitatively analyzed. Using the sperm chromatin dispersion assay, elevated sperm DNA fragmentation was associated with lower fertilization and embryo cleavage rates. Notably, high sperm DNA fragmentation levels did not affect the clinical pregnancy, implantation, miscarriage, or live birth outcomes. Sub-analysis revealed lower fertilization, embryo cleavage, clinical pregnancy, live birth rates, and higher miscarriage rates in the intracytoplasmic sperm injection subgroup only.

The sperm chromatin dispersion assay did not show significant differences in pregnancy or live birth rates between the high- and low-sperm DNA fragmentation groups. Noteworthy, high sperm DNA fragmentation was associated with worse assisted reproductive technology outcomes in the intracytoplasmic sperm injection group. Given the current quality of the evidence, affected by the experimental design and the absence of correction for female factors of infertility, clinicians should be wary of the assay's limited predictive power for pregnancy and live birth outcomes.

Although previous studies suggest a link between workplace bullying and presenteeism, uncertainties persist regarding the direction, strength, and influencing factors. Understanding the potential mediators and moderators is crucial to addressing these issues in workplace settings.

This study aims to clarify the bidirectional relationship between workplace bullying and presenteeism, assess the strength and direction of this association, and identify individual and work-related factors that mediate or moderate these interactions.

A systematic search of nine databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PsycINFO, CNKI, WANFANG, and Chinese Biomedical) was conducted from inception through March 30, 2023, with an update on September 8, 2024. Independent reviewers screened the literature, extracted data, and evaluated methodological quality using the Risk Of Bias In Non-randomized Studies of Exposure tool. Odds ratios, relative risks, and 95% confidence intervals were calculated to assess effect sizes.

After adjusting for confounders, workers exposed to workplace bullying had 1.74 times higher odds of reporting presenteeism compared to non-exposed individuals (95% CI [1.02, 2.46]). Workers reporting presenteeism also had increased odds of later workplace bullying exposure (OR = 2.29, 95% CI [1.23, 3.36]). Various individual and work-related factors were identified as potential mediators and moderators influencing these associations.

This study establishes a bidirectional relationship between workplace bullying and presenteeism. Both individual and work-related factors play a critical role as mediators and moderators, potentially mitigating or amplifying the workplace bullying-presenteeism cycle. Future interventions should target these factors to disrupt this harmful dynamic and improve employee well-being.

To systematically evaluate the effect of cue-based feeding (CBF) on feeding outcomes in preterm infants.

Databases including CNKI, Wanfang, PubMed, Embase, CINAHL and Cochrane Library were searched from the database's inception to November 2023. The literature screening and quality assessment were conducted by two researchers independently, and a meta-analysis was performed using Review Manager (RevMan) 5.4 software.

A total of six randomised controlled trials and eight quasi-experimental studies involving 2239 preterm infants were included. The results indicated that CBF was effective in shortening the time to achieve full oral feeding (Z = 22.32, p < 0.01) and reducing the incidence of feeding intolerance (Z = 2.18, p < 0.05). Compared with scheduled feeding (SF), CBF was found to enhance parental participation and satisfaction. Health professionals such as paediatricians, nurses and feeding specialists, highly agreed on the positive effects of CBF.

Cue-based feeding has the potential to shorten the time to achieve full oral feeding, reduce the incidence of feeding intolerance and promote parental involvement in feeding behaviour for preterm infants.

Cue-based feeding is recommended for preterm infants, as it could enhance oral feeding competence, facilitate feeding progression and reduce the incidence of feeding complications.

Our paper is a systematic review and meta-analysis, and such details do not apply to our work.

The detailed study protocol can be found on the PROSPERO website.

The current study aimed at investigating the efficacies of probiotics in alleviating the symptoms of irritability/emotional lability in individuals with a neurodevelopmental condition.

Randomized placebo-controlled trials were identified through searching major electronic databases from inception to December, 2023. The outcome of interests included improvements in the symptoms of irritability/emotional lability. Outcomes were quantitatively expressed as effect size (ES) based on standardized mean difference (SMD) with 95 % confidence interval (CI).

Seven studies with 1479 participants were included in this meta-analysis. The primary results revealed a significant improvement in the symptoms of irritability/emotional lability in individuals with neurodevelopmental conditions receiving probiotics compared with the placebos (SMD= -0.17, p = 0.03). Subgroup analyses demonstrated an association between a significant improvement in the symptoms of irritability/emotional lability and the use probiotics relative to placebos only in studies using multiple-strain probiotics (SMD=-0.19, p = 0.04, three studies with 452 participant) but not in those adopting single-strain regimens.

Our study supported the use of probiotics for alleviating the symptoms of irritability/emotional lability in individuals with neurodevelopmental conditions, mainly in those receiving multiple-strain probiotics as supplements. Nevertheless, the limited number of studies targeting irritability as their primary outcomes, and most did not investigate other confounding factors such as dietary habits or consumption of other nutritional supplements may impair the robustness of evidence. Our results, which were derived from a limited number of available trials, warrant further large-scale clinical investigations for verification.

The utilization of extracorporeal liver support systems is increasingly prevalent for the management of acute-on-chronic liver failure in clinical settings. Yet, the efficacy of these interventions in terms of tangible clinical benefits for patients remains a matter of debate, underscoring the need for meta-analysis.

An updated meta-analysis was performed to elucidate the relationship between the application of extracorporeal liver support versus standard pharmacological treatment and the prognostic endpoints of patient survival, specifically assessing 1-month and 3-month mortality rates, as well as the incidence of complications such as hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome. Literature were searched via PubMed, EMBASE, and Web of Science.

The meta-analysis revealed the following: the odds ratio for 1-month mortality was 0.63 (95% confidence interval [CIs]: 0.51-0.76), for 3-month mortality was 0.70 (95% CI: 0.61-0.81), for hepatic encephalopathy was 0.81 (95% CI: 0.67-0.97), for spontaneous bacterial peritonitis was 0.66 (95% CI: 0.44-0.99), and for hepatorenal syndrome was 0.68 (95% CI: 0.51-0.92). These results suggest that patients with acute-on-chronic liver failure undergoing extracorporeal liver support system therapy have significantly better survival rates and lower complication incidences compared to those receiving conventional drug therapy. Further subgroup analysis indicated that patients with lower model for end-stage liver disease (MELD) scores and reduced total bilirubin (Tbil) levels demonstrated greater benefits from extracorporeal hepatic support.

This study establishes that in the management of acute-on-chronic liver failure, extracorporeal liver support systems confer a survival advantage and reduce complications relative to standard pharmacotherapy.

The meta-analysis systematically explored clinical studies investigating caries excavation with a laser.

Prospective controlled (non-)randomized clinical trials comparing caries excavation using a laser to using conventional burs.

Four electronic databases (Central Cochrane, PubMed-Medline, Ovid-EMBASE, Web of science) were screened. Outcomes were e.g. restoration survival, excavation speed, pulp sensitivity/vitality, need of anesthesia, pain sensation. No time restrictions were applied. Risk of Bias and level of evidence was graded using Risk of Bias 2.0 tool and Grade Profiler.

Twenty in vivo studies with at least 2263 teeth being assessed in more than 1090 patients were included. Meta-analysis for comparing laser vs. bur revealed that restoration survival (risk ratio (RR)[95%CI]=1.51 [0.87;2.64, low level of evidence) and pulp vitality (RR[95%CI]=1.46 [0.33;6.46], low level of evidence) was not significantly influenced by the use of a laser. Furthermore, significantly fewer patients required anesthesia (RR[95%CI]=0.29 [0.11;0.75, very low level of evidence) and patients' pain sensation was significantly decreased (RR[95%CI]=0.35 [0.22;0.54], very low level of evidence) when a laser was used for excavation and preparation. In contrast, when using a laser for excavation/preparation significantly more time has to be planed compared to the use of a conventional bur (mean difference [95%CI]=2.23 [1.89;2.57], low level of evidence).

Using a laser for excavation/preparation treatment does not affect restoration survival and pulp vitality compared to the use of conventional burs, while the need of anesthesia and patients' pain sensation can be reduced. However, significantly more time must be spent to achieve these benefits.

Laser-assisted caries removal reduces the need for anesthesia and minimizes patient discomfort compared to conventional rotary instruments, while restoration survival and pulp vitality are not affected. However, excavation speed remains significantly slower. Furthermore, results should be interpreted with caution considering the low level of the evidence.

To perform a systematic review and meta-analysis to estimate diagnostic performance, category-wise malignancy rates, and inter-observer reliability of Node Reporting and Data System 1.0 (Node-RADS).

Five electronic databases were systematically searched for primary studies on the use of Node-RADS to report the possibility of cancer involvement of lymph nodes on CT and MRI from January 1, 2021, until April 15, 2024. The study quality was assessed by modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Quality Appraisal of Diagnostic Reliability (QAREL) tools. The diagnostic accuracy was estimated with bivariate random-effects model, while the pooled category-wise malignancy rates were obtained with random-effects model.

Six Node-RADS-CT studies and three Node-RADS-MRI studies covering nine types of cancer were included. The study quality was mainly damaged by inappropriate index test and unknown timing according to QUADAS-2, and unclear blindness during the rating process according to QAREL. The area under hierarchical summary receiver operating characteristic curve (95% conventional interval) was 0.92 (0.89-0.94) for Node-RADS ≥ 3 as positive and 0.91 (0.88-0.93) for Node-RADS ≥ 4 as positive, respectively. The pooled malignancy rates (95% CIs) of Node-RADS 1 to 5 were 4% (0-10%), 31% (9-58%), 55% (34-75%), 89% (73-99%), and 100% (97-100%), respectively. The inter-observer reliability of five studies was interpreted as fair to substantial.

Node-RADS presented a promising diagnostic performance with an increasing probability of malignancy along higher category. However, the evidence for inter-observer reliability of Node-RADS is insufficient, and may hinder its implementation in clinical practice for lymph node assessment.

Question Node-RADS is designed for structured reporting of the possibility of cancer involvement of lymph nodes, but the evidence supporting its application has not been summarized. Findings Node-RADS presented diagnostic performance with AUC of 0.92, and malignancy rates for categories 1-5 ranged from 4% to 100%, while the inter-observer reliability was unclear. Clinical relevance Node-RADS is a useful tool for structured reporting of the possibility of cancer involvement of lymph nodes with high diagnostic performance and appropriate malignancy rate for each category, but unclear inter-observer reliability may hinder its implementation in clinical practice.

Meta-analyses of clinical trials have shown that vitamin D lowers the risk of progression from prediabetes to diabetes. Less is known about whether vitamin D promotes regression to normal glucose regulation (NGR). We conducted a systematic review and meta-analysis of clinical trials with vitamin D in adults with prediabetes that have reported on the outcome of regression to NGR. We searched Medline (through PubMed), Embase, and the trial registry ClinicalTrials.gov from inception to July 3, 2024, for randomized, controlled trials of at least 6 months' duration that reported on the effects of oral vitamin D supplementation on NGR in adults with prediabetes. The search identified 10 eligible trials, involving 4478 participants. The baseline characteristics of the study cohorts were: mean age range 20 to 74 years, mean body mass index range 24 to 38, mean blood 25-hydroxyvitamin D range 12 to 28 ng/mL. The median study duration range was 0.5 to 5 years. Across trials, 416 of 2253 (18.5%) participants randomly assigned to vitamin D reached NGR vs 312 of 2225 (14.0%) participants randomly assigned to placebo. In all trials, the relative risk of regression to NGR favored the vitamin D group, ranging from 1.09 to 12.6. After combining data, the summary relative risk of regression to NGR for vitamin D vs placebo was 1.27 (95% CI, 1.12-1.45), with no heterogeneity (I2 = 1%). Sensitivity analyses did not change the result. Participant-level variables were not available, limiting meaningful subgroup analyses. In conclusion, vitamin D increases the likelihood of regression to normoglycemia in adults with prediabetes.

Τhe aim of the present systematic review and meta-analysis was to critically appraise all evidence available on the effectiveness of biomimetic hydroxyapatite (HAP) toothpastes in promoting remineralization and inhibiting demineralization.

A literature search was conducted in electronic databases to identify in situ randomized controlled trials in children, adolescents, and young adults aged <25 years evaluating the effectiveness of fluoride-free HAP compared to conventional fluoride toothpastes.

Medline (via Pubmed), Embase, Scopus, Cochrane Central Register of Controlled Trials, Dentistry & Oral Sciences Source, LILACS database were searched. Additional search of the grey literature, abstracts of conferences and meetings as well as manual search of the reference lists of retrieved studies, was also performed.

The search retrieved 68 studies of which 4 were considered eligible.

Development of new and progression of existing lesions, recorded using DMFS/ICDAS indices, showed no significant differences between HAP and fluoride toothpastes. Significant differences were recorded in lesion size (p < 0.0001) and fluorescence value (p = 0.01) after 6 months. Meta-analysis showed non-significant Risk Ratio (0.98, p = 0.61; 95 % CIs 0.85, 1.12) and Odds Ratio (0.90, p = 0.68; 95 % CIs 0.57, 1.42) for HAP and fluoride toothpastes.

HAP toothpaste could be an effective alternative to fluoride-containing toothpaste in preventing caries progression and promoting enamel remineralization. The comparable performance of HAP to fluoride, coupled with its superior biocompatibility and lack of toxicity, positions it as a promising option for individuals seeking fluoride-free oral care solutions.

Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease due to its unique apo(a) component and its association with atherosclerosis and thrombogenesis. This meta-analysis was conducted to evaluate the effects of PCSK9 inhibitors on major adverse cardiac events (MACE) and Lp(a) levels in patients with coronary heart disease.

Randomized controlled trials (RCTs) were systematically searched in PubMed, the Cochrane Library, and other databases. Stata 15.1 software was used for data analysis, and a random- or fixed-effects model was selected based on inter-study heterogeneity. Egger's test was applied to detect publication bias.

A total of 12 RCTs were included, involving 48 116 patients with a mean age of 62 years, comprising 65% males and diverse ethnic backgrounds. The results showed that compared with the control group, PCSK9 inhibitors significantly reduced low-density lipoprotein cholesterol (WMD = -1.24 mmol/L, 95% confidence interval (CI): -1.28 to -1.20), total cholesterol, triglycerides, and Lp(a) levels while increasing high-density lipoprotein cholesterol levels. In terms of safety, there was no increased risk of adverse reactions other than injection site reactions. For MACE, PCSK9 inhibitors significantly reduced the risk of nonfatal myocardial infarction, stroke, and coronary revascularization events (RR = 0.87, 95% CI: 0.84-0.89).

PCSK9 inhibitors not only significantly improve blood lipid profiles and reduce Lp(a) levels but also reduce the risk of MACE in patients with coronary heart disease. Therefore, PCSK9 inhibitors offer an effective and safe treatment option for these patients.

Physical frailty and hypertension are both highly prevalent among older adults. Furthermore, physical frailty may impact the risk-benefit ratio of pharmacological hypertension treatment. Thus, it may be prudent to focus on physical activity and exercise interventions to achieve better patient outcomes that addresses both conditions. This systematic review aimed to investigate the effects of exercise interventions on physical frailty components and hypertension-related outcomes in older adults with hypertension. PubMed/Medline, Embase, Cochrane Library, Cinahl and PEDro were searched for exercise trials in older adults with hypertension, measuring physical frailty or physical frailty components. Preferred Reporting Items for Systematic Review and Meta-Analysis protocol (PRISMA-P) and Physiotherapy Evidence Database (PEDro) scale were used for internal validity. The searches retrieved 4965 titles without duplicates. Ninety-four potential full texts were evaluated, and 30 original studies were included in the review. Mean methodological quality of the included studies was 5.7 out of 10. Only one study measured frailty (using a cumulative deficit model) in older adults with hypertension. Different types of exercise training demonstrated improvements in components of physical frailty. This systematic review shows that there is no evidence whether exercise ameliorates the effects of physical frailty and hypertension and there is a need for more data to be generated.

A quarter of women experience heavy periods in their lifetime, often significantly impairing their well-being, productivity and quality of life.Several treatment options are offered for heavy menstrual bleeding; however, there is limited evidence on the effectiveness, safety and cost of available treatments. We aim to conduct a comprehensive systematic review, network meta-analyses and health economic evaluation to compare all available treatment options while considering the views and treatment preferences of women with heavy menstrual bleeding.

We will systematically search electronic databases (MEDLINE, EMBASE, CENTRAL) as well as the grey literature, conference proceedings and trial registries to identify all relevant randomised trials that evaluated any medical or surgical treatment for women with heavy menstrual bleeding regardless of their cause compared with placebo or other active treatments.We will perform pairwise and network meta-analyses using standard methods. We will report primarily on changes in menstrual blood loss (using Pictorial blood loss assessment chart scores or the Alkaline-Haematin method), quality-of-life measures, safety in addition to other important clinical outcomes.We will develop a health economic model to evaluate the cost-effectiveness of available treatments within a healthcare perspective using data inputs from the planned meta-analyses. We will calculate the incremental cost per change in alternative outcomes and present the net monetary benefit for a range of cost-effectiveness thresholds for quality-adjusted life-year gained. We will conduct consultations and a discrete choice experiment involving patient representatives to capture the factors influencing women's decision-making and treatment preferences in real life.

The project was approved by the UCL Institute for Women's Health Low-Risk Research Ethics Committee (reference: 004_2023_24) and UCL Research Ethics Committee (ID 16351/003) for the planned patient involvement and qualitative research. We will produce an evidence-based decision aid toolkit and will publish the findings in peer-reviewed journals, as well as lay media outputs to inform health professionals, policymakers and the patient community. PROSPERO REGISTRATION NUMBERS: https://doi.org/10.17605/OSF.IO/4MUSF, CRD42023468055, CRD42024519622, CRD42024520558 and CRD42024520634.

Autism Spectrum Disorder (ASD) affects social interaction, communication, and behavior, with significant challenges in sexual experiences, relationships, and victimization. This review consolidates findings to improve understanding of sexual health in ASD.

Following PRISMA guidelines, studies from PubMed, Scopus, Web of Science, and PsycInfo (1991-2024) were reviewed. Data were extracted using EndNote 21, focusing on demographics, autism support needs, and sexual behaviors. Methodological quality was assessed using modified Cochrane and Effective Public Health Practice Project tools.

Autistic individuals face unique challenges in romantic and sexual relationships, such as sensory sensitivities and communication difficulties. While they share typical sexual desires, these challenges can complicate their relationships and increase the risk of victimization. The review highlights the need for tailored sexual health education and supportive interventions, particularly for those at higher risk.

This review emphasizes the need for inclusive sexual health interventions for autistic individuals, considering the heterogeneity of ASD and its impact on sexual well-being. Further research should address current gaps, especially regarding non-Western contexts and individuals with co-occurring intellectual disabilities or gender diversity, to improve support and understanding.

Refractive lens exchange (RLE) is becoming a popular refractive solution for patients ineligible for corneal surgeries or phakic intraocular lenses. However, concerns regarding retinal detachment (RD) risk persist.

A systematic literature review and meta-analysis was performed in Medline and Scopus.The final search was updated on 30 March 2024.

Of 2415 full-text screening reports, 40 studies met inclusion criteria, encompassing 8 592 380 eyes. This included 20 264 eyes that underwent RLE and 8 572 116 eyes that underwent cataract surgery. In the RLE surgery subgroup, the RD incidence for follow-up <12 months was 0.00016% (0.00000%; 0.00034%), for follow-up between 12 and 24 months was 0.0000% (0.0000%; 0.03102%), and for follow-up >24 months was 0.02312% (0.00984%; 0.03640%) (p<0.01). In the cataract surgery subgroup, the incidence for follow-up >24 months was 0.01244% (0.00655%; 0.01832%), and for missing follow-up was 0.00429% (0.00221%; 0.00637%).

We found that the incidence of RD after RLE was approximately double that observed after cataract surgery with at least 24 months (median 4 years) follow-up. Thus, RD may be classified as rare complication after cataract surgery (1/1000) and an uncommon complication after RLE (1/500). It must be noted that the heterogeneity of the subgroups after RLE was low. While some limitations, such as the lack of long-term follow-up in certain studies and incomplete reporting of factors like axial length or PVD status, may slightly influence the interpretation, these findings provide valuable insights. Acknowledging the inherent uncertainty in interpreting these results, additional studies are recommended.

CRD42023431420.

RS-RARP appears to offer better functional outcomes compared to traditional RARP, particularly in terms of urinary continence. However, its oncological outcomes remain a topic of debate. Additionally, there is a lack of comparative analyses focusing on results from randomized-controlled trials (RCTs) in the current review. A comprehensive examination and synthesis of existing RCTs research were conducted to compare follow-up outcomes of RS-RARP versus RARP in PCa patients. A comprehensive search was conducted in PubMed, Web of Science, and the Cochrane Library, and SpringerLink databases for that compare RS-RARP to RARP before December 1st, 2024. Oncological and functional outcomes were used as outcomes to compare. This meta-analysis included 549 people from five research papers. RS-RARP outperformed RARP in immediate continence recovery, with an odds ratio of 0.39, a 95% confidence range of 0.18-0.81, and a p value of less than 0.05. Later follow-ups showed that RARP hampered the patient's functional recovery. At every time point, the RS-RARP group had less incontinence than the RARP group. For these reasons: 1 month (OR: 0.38, 95% CI 0.21-0.69), 3 months (OR: 0.34, 95% CI 0.13-0.90), 6 months (OR: 0.25, 95% CI 0.15-0.40), and 12 months (OR: 0.36, 95% CI 0.16-0.80). p < 0.05. There were no significant differences in BCR rates between RS-RARP and RARP (OR: 1.16, 95% confidence interval: 0.42 to 3.19, p = 0.78). This was the researchers' conclusion. The odds ratio of 0.45, with a 95% confidence range of 0.29 to 0.70 and a p value of less than 0.05, showed that RS-RARP was linked with more PSMs. In terms of functional recovery after surgery, our results show that RS-RARP is much better than RARP. Having said that, it does come with a greater incidence of PSMs. When comparing the two methods for BCR, we found no statistically significant differences. Based on these findings, RS-RARP may be considered as a surgical option for patients with prostate cancer; nevertheless, the choice should be made taking into account the surgeon's skill level and the patient's unique situation. To thoroughly assess the effects of these two techniques, further randomized-controlled studies are required, ideally with large sample numbers, multicenter participation, and long-term follow-up.

This meta-analysis evaluates the diagnostic value of SOX1 methylation across different cervical cancer types, including squamous cell carcinoma and adenocarcinoma, to assess its efficacy as a biomarker.

We reviewed studies published up to March 2024, employing a PICOS-based search strategy in databases like PubMed and Web of Science. We included clinical studies providing diagnostic performance indicators while excluding non-clinical and small-sample studies. Meta-Disc1.4 and Stata15.1 were used for statistical analyses focusing on SOX1 methylation's sensitivity, specificity, and diagnostic odds ratio.

Twelve articles encompassing 18 studies with 3,213 subjects were analyzed. The overall DOR for SOX1 methylation in cervical cancer diagnosis was 68.95 (95%CI: 27.63-172.07), with a Summary Receiver Operating Characteristic AUC of 0.92, indicating high diagnostic accuracy. Specifically, the DOR for adenocarcinoma was 87.57 (95%CI: 7.05-1087.44) with an AUC of 0.89, and for squamous cell carcinoma, it was 245.87 (95% CI: 26.49-2282.40) with an AUC of 0.93, reflecting significant diagnostic potential for both cancer types. No substantial publication bias was detected (P > 0.10).

SOX1 gene methylation demonstrates significant diagnostic value for both adenocarcinoma and squamous cell carcinoma of the cervix, particularly effective in large sample sizes and cervical exfoliated cell samples for early detection and screening, supporting its utility as a reliable biomarker.

Many systematic reviews and meta-analyses (SRs/MAs) have evaluated the efficacy of biologic therapies for severe asthma. However, the overall quality of these SRs/MAs is unclear, which may influence the selection of biologics and lead to misleading clinical decisions. This umbrella review aims to objectively evaluate the overall quality of these SRs/MAs and reassess the efficacy of biologic therapies for severe asthma. Thus, this study will provide reliable evidence for clinical practice.

A systematic search will be performed in PubMed, Embase, Cochrane Library, Web of Science, Scopus and conference abstracts up to 1 March 2025. Literature screening and data extraction will be conducted according to predefined inclusion and exclusion criteria. We will evaluate the reporting quality, methodological quality and evidence quality of these SRs/MAs using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, PRISMA for Network Meta-Analysis 2015 checklist, A MeaSurement Tool to Assess Systematic Reviews 2, Cochrane Risk of Bias 1.0 and Grading of Recommendations Assessment, Development and Evaluation system. Additionally, the re-analysis of outcomes will be performed using R software (V.4.3.3).

Since this umbrella review will use publicly available data, ethics approval is not required. The results of this study will be disseminated through publication in a peer-reviewed journal.

CRD42024607393.

This systematic review and proportional meta-analysis aims to evaluate the postoperative complication rate (CR%) of ceramic-based 3D-printed bone grafts based on the reported scientific articles conducted with human individuals.

MEDLINE and SCOPUS were used as information sources. The synthesis of the study was carried out from studies with human individuals and the use of 3D-printed bone graft-ceramic as inclusion criteria. Cohen's kappa (κ) was calculated for interrater reliability. Qualitative analysis was performed based on the characteristics and outcomes of the individual study, and quantitative analysis was performed using proportional meta-analysis for CR%.

A total of 1352 records were identified through databases and resulted in 11 included studies (κ = 0.81-1.00) consisting of prospective clinical trials (64.63%), case series (16.67%), and case reports (18.18%). The overall postoperative complication rate was 14.3% (95% Cl: 0.19-53.6). The postoperative complication rate for studies conducted on the cranial defect, the maxillofacial-zygomatic defect, and the tibial-femoral defect was 2.7%, 11.1%, and 15.6%, respectively. This review also highlights common 3D printing techniques, materials, and grafs' characteristics, as well as their clinical applications.

Ceramic-based 3D-printed bone grafts show potential as alternatives for bone tissue reconstruction.

Literacy provides the key to social contacts, education, and employment, and significantly influences well-being and mental health. Summarizing 163 studies, the present coordinate-based meta-analysis confirms the importance of classical left-hemispheric language regions and the cerebellum across reading tasks. We found high processing specificity for letter, word, sentence, and text reading exclusively in left-hemispheric areas. Subregions within the left inferior frontal gyrus showed differential engagement for word and pseudoword reading, while subregions within the left temporo-occipital cortex showed differential engagement for words and sentences. The direct comparison of overt and covert reading revealed higher activation likelihood in auditory and motor regions during the first, and more consistent reliance on multiple demand regions during the latter. Last, silent word and pseudoword reading (explicit reading) yielded more consistent activation in left orbito-frontal, cerebellar and temporal cortices when compared to lexical decisions (implicit reading). Lexical decisions, in contrast, showed more consistent bilateral recruitment of inferior frontal and insular regions. The present meta-analysis significantly extends our understanding of the neural architecture underlying reading processes, corroborates findings from neurostimulation studies and can provide valuable neural insight into reading models.

To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses (PDMSLs) and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.

A systematic search was carried out in the PubMed, Cochrane Library, Embase, CNKI, and Web of Science databases. The search targeted randomized controlled trials (RCTs) and cohort studies (CTs) that explored the effects of PDMSLs on myopia control among children and adolescents. The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies. The published biases of the included studies were evaluated using Egger's test.

Nine studies (7 RCTs, 2 CTs) were included, involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses (SVLs) group. Meta-analysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction (SER) than SVLs at 6, 12, 18, and 24mo after wearing glasses, with reductions of 0.19 D (95%CI: 0.14 to 0.24, P<0.00001), 0.36 D (95%CI: 0.25 to 0.46, P<0.00001), 0.43 D (95%CI: 0.32 to 0.55, P<0.00001), and 0.51 D (95%CI: 0.33 to 0.69, P<0.00001), respectively. The changes in axial length (AL) were also lower in PDMSLs compared to SVLs, with reductions of -0.09 mm (95%CI: -0.13 to -0.04, P=0.0002), -0.15 mm (95%CI: -0.21 to -0.08, P<0.00001), -0.27 mm (95%CI: -0.34 to -0.20, P<0.00001), and -0.29 mm (95%CI: -0.38 to -0.20, P<0.00001), respectively. There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia (both P>0.05).

The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and non-microlens design of PDMSLs in children and adolescents.

This study aimed to quantitatively assess the effectiveness of tamoxifen, anastrozole, and radiotherapy in preventing bicalutamide-induced breast events-specifically gynecomastia and breast pain-in patients with prostate cancer.

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted according to PRISMA-P guidelines. A comprehensive search was performed in PubMed, Scopus, and Web of Science for English-language studies without temporal restrictions. Studies were included if they involved prostate cancer patients treated with bicalutamide receiving preventive interventions (tamoxifen, anastrozole, or radiotherapy) compared to bicalutamide alone (or bicalutamide plus placebo/sham). Data extraction focused on the incidence of gynecomastia and breast pain, and study quality was assessed using the Jadad scale. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using fixed- or random-effects models, and heterogeneity was evaluated with the I² statistic. Publication bias was explored via funnel plots and the trim-and-fill method.

Nine RCTs met the inclusion criteria. Tamoxifen significantly reduced the risk of breast events by 82% (RR: 0.18, 95% CI: 0.08-0.38 for gynecomastia and RR: 0.18, 95% CI: 0.07-0.43 for breast pain). Radiotherapy reduced gynecomastia risk by 52% (RR: 0.48, 95% CI: 0.38-0.59) and breast pain by 34% (RR: 0.66, 95% CI: 0.48-0.90). Anastrozole did not show significant benefit.

Tamoxifen appears to be the most effective strategy for preventing bicalutamide-induced breast events, with radiotherapy serving as a viable alternative, and anastrozole offering no benefit. Further large-scale, high-quality studies are needed to confirm these findings and refine preventive treatment recommendations.

Tobacco use is a global issue, and non-combustible nicotine products (NCNPs) like electronic nicotine delivery systems, nicotine pouches, snus, and nicotine replacement therapies offer potential risk/harm reduction for smokers unable or unwilling to quit. Although NCNPs are less harmful than tobacco smoking, their impact on oral health remains unclear. A systematic review and network meta-analysis will be conducted to answer the research question: What are the oral signs and symptoms associated with NCNPs as both monotherapies and combination therapies compared to each other, placebo, standard care, no drug treatment, and combustible cigarette smoking?

We will search PubMed and Scopus databases, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to August 2024. This review will focus on randomized controlled trials (RCTs) with a minimum follow-up period of 1 month, comparing any NCNPs versus placebo, standard care, no drug treatment, combustible cigarette smoking or to each other in adult smokers. Our primary outcomes will be the number of participants reporting any oral side effect, aphthous ulcers, dry mouth and mouth irritation. Studies will be excluded if they involve: non-smokers, pregnant women, individuals with mental health or neurological disorders, participants consuming alcohol or other substances. Data will be analyzed using a network meta-analysis framework, estimating odds ratios with 95% confidence intervals. Risk of bias will be determined using the Cochrane risk of bias tool-version 2.0 for included RCTs and the Confidence In Network Meta-Analysis tool will be employed to assess the confidence of evidence contributing to each network estimate.

Our findings will provide critical insights into the oral health implications of NCNPs, informing clinical and public health decisions. Results are expected by May 2025 and will be disseminated through publications and presentations to guide tobacco harm reduction strategies.

PROSPERO CRD42024565118.

Persons with acquired brain injury (ABI) often experience mood problems like depression. While psychotherapy is widely accepted for managing depression in populations without ABI, its effectiveness for post-ABI depression is uncertain. The working mechanisms of psychotherapy in persons with ABI may differ from idiopathic depression. This scoping review aimed to identify studies on psychotherapeutic interventions for post-ABI depression, assess the use of process measures (instruments measuring the mechanisms of psychotherapy), and report effects on both process and primary outcome measures. In the 47 included studies, Cognitive Behavioural Therapy, Problem Solving Therapy, and Third-Wave Therapies were most frequently investigated. Results indicated that less than half of the studies implemented a process measure. Studies into Third-Wave Therapies most frequently implemented process measures. Around half of the studies found significant time or interaction effects on the process measure, while not necessarily finding effects on outcome measures for depression. Moreover, the review could not identify a specific type of intervention effective in improving depressive symptoms and the underlying process. Our findings emphasize that it is still unclear which psychotherapy works for whom, and how. To enhance understanding of effective interventions for post-ABI depression, it is crucial to incorporate process measures in future intervention studies.

This study aims to compare the efficacy of different mind-body exercises (MBEs) on cardiometabolic risk factors in patients with type 2 diabetes mellitus (T2DM) using a network meta-analysis of randomized controlled trials (RCTs).

This study followed PRISMA guidelines and was registered in PROSPERO (CRD42025630741). A systematic search of PubMed, Cochrane Library, Web of Science, and Embase was conducted up to December 15, 2024, using MeSH terms related to mind-body therapies and cardiometabolic risk in type 2 diabetes. Randomized controlled trials (RCTs) evaluating mind-body exercises (MBEs) on glucose metabolism, body composition, cardiovascular physiology, and lipid metabolism were included. Data extraction and risk of bias assessment (RoB 2 tool) were performed independently by two reviewers. Network meta-analysis was conducted using R (gemtc package) and Stata 17.0, with effect sizes reported as mean difference (MD) or standardized mean difference (SMD). Evidence quality was assessed using CINeMA.

This network meta-analysis compared the effects of various mind-body exercise interventions on ten cardiometabolic risk factors. Meditative Exercise (ME) was most effective in reducing fasting plasma glucose (SUCRA = 97.9%, SMD = -7.23, 95% CI: -8.27 to -6.20), while Mindfulness Intervention Training (MIT) showed the greatest benefit for glycated hemoglobin (SUCRA = 92.2%, MD = -0.78, 95% CI: -1.12 to -0.44) and blood pressure reduction (SBP: SUCRA = 86.1%, MD = -13.00, 95% CI: -17.22 to -8.78; DBP: SUCRA = 99.8%, MD = -6.00, 95% CI: -7.64 to -4.36), significantly outperforming conventional exercise. Yoga with Meditation (YWM) was most effective in lowering body mass index (SUCRA = 99.4%, MD = -2.90, 95% CI: -4.05 to -1.75). CINeMA assessments rated most comparisons as very low certainty due to within-study bias and between-study heterogeneity. Nevertheless, consistency was supported by node-splitting analysis, and no significant publication bias was detected, indicating robust and reliable findings.

Compared with conventional exercise intervention, MBE exerts unique and superior effects on various cardiometabolic risk factors in T2DM, underscoring their potential as effective and integrative interventions for personalized diabetes management. Clinicians should consider incorporating MBEs, such as MIT, ME, and YWM, into treatment plans based on individual patient needs, particularly for glycemic control, weight management, and cardiovascular health. Further research is warranted to explore the long-term benefits and optimal implementation strategies, especially given the heterogeneity in intervention protocols and the relatively short duration of the included trials.

The sensation of dyspnea is related to various cardiopulmonary and neuromuscular diseases and is characterized by its sensory and affective qualities. Although there is a vast number of studies investigating its pathophysiology, less is known about the neuroanatomy of dyspnea perception. An activation likelihood estimation (ALE) meta-analysis of 13 studies investigating different breathing challenges using either PET or fMRI was performed to demonstrate the neuroanatomical correlates of dyspnea perception. The ALE meta-analysis was performed using the GingerAle software 3.0.2 and was displayed with the Mango software 4.1. Synthesizing the results of all included studies, clusters involving the insula and cingulated cortex in both hemispheres were observed. Subgroup analysis for the restrained breathing condition revealed activation involving the right and left cingulate cortex and left anterior cingulate cortex. For the loaded breathing condition, statistically significant activation was found for the postcentral gyrus, the superior temporal gyrus, and the right thalamus. The combined ALE map for both conditions showed activity patterns in the right cingulate cortex, the right insula, and the right thalamus. This ALE meta-analysis demonstrates that two separate neuronal pathways related to either the affective or intensity domain are involved in the central processing of dyspnea perception.