Sarcopenia and intrinsic capacity are closely linked factors that impact the health and functional aging of older adults.

This systematic review aims to investigate the associations between the domains of IC and sarcopenia in older adults.

The study follows PRISMA guidelines and is registered on PROSPERO. The review included original studies (cohort, cross-sectional, or randomized controlled trials) with participants aged 60+ diagnosed with sarcopenia (based on EWGSOP or other recognized definitions). Intrinsic capacity (IC) was assessed based on the five domains defined within the IC framework-cognition, locomotion, sensory, psychological, and vitality. The Integrated Care for Older People (ICOPE) approach developed by the World Health Organization supports the optimization of IC and functional ability through person-centred and coordinated care. Exclusion criteria included studies with insufficient data on sarcopenia prevalence and IC scores, as well as reviews or studies unrelated to sarcopenia or IC.

A total of 397 articles were identified, with 5 meeting the inclusion criteria. These studies, involving 6651 participants aged 60 to 82 years (54.8 % male, 45.2 % female), examined the association between sarcopenia and intrinsic capacity in older adults, using the diagnostic criteria for sarcopenia proposed by the EWGSOP and assessing IC based on its key components. Despite the limited number of studies, the findings suggest a significant link between declining intrinsic capacity and sarcopenia.

These results underscore the importance of a multifactorial approach in assessing and managing sarcopenia, which may improve early detection and support healthy aging.

Several prospective cohort studies have investigated the association between glycemic index (GI), glycemic load (GL), dietary sugar, and total dietary fiber intake, with female breast cancer (BC) risk and reported inconsistent results. In the last decade, several large epidemiological studies have investigated these associations, suggesting the need to revisit the current body of evidence.

The aim of this study was to update a systematic review and meta-analysis conducted by Schlesinger et al in 2017 using recent scientific evidence published since 2015.

Publications indexed in PubMed, Embase, and The Cochrane Library were retrieved from the inception of the database up to January 2024.

Two reviewers independently extracted data and assessed each study's quality.

A random-effects model was used to estimate summary risk ratios (RRs) and 95% CIs for a meta-analysis that included 33 publications, with 26 prospective cohort studies cumulatively enrolling 2 212 645 women, among whom 79 777 were diagnosed with incident BC.

Dietary GI and GL (highest vs lowest exposure intake) were both associated with 5% higher BC risk-RR (95% CI): 1.05 (1.01-1.09; P = .007) and 1.05 (0.97-1.13; P = .24), respectively. No clear associations were observed for sugar and total dietary fiber intake (highest vs lowest exposure intake)-RR (95% CI): 1.12 (0.95-1.11; P = .16) and 0.93 (0.86-1.00; P = .05), respectively. For the latter, the association was more pronounced among premenopausal women (RR: 0.78; 95% CI: 0.68-0.90; P = .0008).

This meta-analysis supports a significant positive association between high dietary GI intake and higher risk of BC and a significant inverse association between high dietary fiber intake and lower risk of BC. Interventions promoting a high-fiber and low-sugar diet may be useful components of BC-prevention strategies.

PROSPERO registration no. CRD42023463143.

Microneedling (MN) has risen in popularity as a non-surgical treatment option for facial skin aging. We aimed to evaluate patient-reported outcomes (PROMs) and safety profiles associated with MN.

A systematic review was conducted adhering to PRISMA guidelines. Articles were screened for relevance in a two-stage process. Descriptive statistics and a proportion meta-analysis was utilized for patient satisfaction using Stata statistical software.

Of 346 studies identified, a total of 21 articles reporting outcomes of 723 patients undergoing MN for facial rejuvenation were included for review and meta-analysis. The patient cohort was majority female (72%), and the average age was 48 years. The most common esthetic study endpoints were wrinkling (71%, 15/21), skin texture (33%, 7/21), photoaging (29%, 6/21), and skin laxity (14%, 3/21). The majority of trials (90%, 19/21) treated patients with multiple MN sessions, and these studies' treatment schedules also varied by number and timing of sessions. Pooled meta-analysis revealed that 83% of patients reported satisfaction with their treatment (95% CI [0.76; 0.88]). The most common reported adverse effects were transient erythema (6.8%), scaling (1.7%), burning sensation (1.5%), and pruritus (0.4%).

Our meta-analysis revealed that MN is associated with high patient satisfaction and low rates of adverse events. High patient satisfaction coupled with a low incidence of adverse events supports MN as a viable non-surgical treatment option for facial rejuvenation. However, the lack of standardized measures for esthetic outcomes warrants continued research to better determine its efficacy in treating signs of facial aging.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This paper considers weaknesses in a study by Cohen et al. (2006) on the impacts of community singing on health. These include high demand characteristics, lack of attention to attrition, flawed statistical analysis, and measurement. Nevertheless, the study is uncritically cited, in evidence reviews, with findings taken at face value.

Google Scholar, SCOPUS and BASE citation functions for Cohen et al. identified 32 evidence reviews in peer-reviewed journals. Eleven of these reviews, published between 2010 and 2023, focused on creative arts interventions.

We demonstrate limitations in the Cohen et al. research which undermine the conclusions they reach regarding the health benefits of group singing. Subsequent evidence reviews take the findings at face value and offer little critical commentary.

We consider what is needed to improve evidence reviews in the field of creative arts and health research.

A more robust approach is needed in reviewing research evidence in the field of arts and health. The Cohen et al. paper is not suitable for inclusion in future evidence reviews.

Diabetes management often requires insulin therapy, yet adherence to daily injections can be challenging due to complexity, injection pain, and fear of hypoglycemia. Basal Insulin Fc (BIF) is a novel once-weekly insulin analog designed to simplify regimens, improve adherence, and enhance glycemic control. This meta-analysis evaluates the efficacy and safety of BIF compared to once-daily insulin degludec.

A systematic search of PubMed, Google Scholar, EBSCO, ScienceDirect, and the Cochrane Library, along with ClinicalTrials.gov, was conducted up to November 2024 to identify RCTs comparing BIF with insulin degludec. The search employed MeSH terms like "type 1 diabetes mellitus," "type 2 diabetes mellitus," "once weekly basal insulin Fc," and "insulin degludec." Studies were screened in accordance with PRISMA guidelines, and data on glycemic outcomes, safety, and patient demographics were extracted. Statistical analysis included pooled mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CIs) using random-effects models. Heterogeneity was assessed using the I2 statistic, and sensitivity analyses were conducted for cases of high heterogeneity. Subgroup and meta-regression analyses assessed moderators such as diabetes type, insulin status, follow-up duration, and heterogeneity.

Five RCTs with 2,562 participants (Type 1 and Type 2 diabetes) were included. BIF showed non-inferiority to degludec in HbA1c reduction (MD 0.03, p = 0.37) and percentage time in range (MD 0.56, p = 0.27). No significant differences were observed in self-monitored fasting blood glucose (MD 2.73, p = 0.40) or clinically significant hypoglycemia (RR 1.00, p = 0.95). However, BIF increased time spent below range (MD 0.30, p = 0.0004) and was associated with higher treatment-emergent adverse events (RR 1.12, p = 0.006). The subgroup analysis highlighted differences in hypoglycemia risks between Type 1 and Type 2 diabetes.

BIF offers comparable glycemic control to insulin degludec while reducing injection frequency, potentially enhancing adherence. However, increased hypoglycemia risks in certain subgroups and higher adverse event rates warrant further evaluation.

The online version contains supplementary material available at 10.1007/s40200-025-01602-y.

Background: Osteosarcopenic obesity (OSO) syndrome, also defined as osteosarcopenic adiposity (OSA), is characterized by the concurrent loss of bone and muscle mass, accompanied by excess fat, leading to reduced functionality and metabolic imbalances. Recent studies have highlighted the role of microRNAs (miRNAs) in the pathophysiology of OSO/OSA, showing differential expression in individuals with osteosarcopenia and obesity. However, a thorough investigation in this area has been limited. Methods: A comprehensive search of international bibliographic databases, including Embase, PubMed and Scopus, was conducted. Results: From an initial search yielding 1311 records, 19 studies met the eligibility criteria for final evaluation. These findings highlight how physical exercise and nutritional factors can influence miRNA expression, emphasizing their role in promoting better health outcomes in aging populations. Furthermore, the critical role of miRNAs as indicators of muscle atrophy and the biological processes associated with aging and sarcopenia have been documented in various animal studies. Conclusions: Despite the limitations of this review, the findings indicate that miRNAs could serve as promising biomarkers and therapeutic targets for managing OSO/OSA. These results suggest that targeted interventions, such as resistance training and lifelong exercise, may effectively influence miRNA expression, potentially alleviating the impacts of OSO/OSA.

To assess the efficacy of remote blood pressure monitoring to prevent readmission due to complications of hypertensive disorders of pregnancy.

The search was conducted using MEDLINE, EMBASE, Web-of-Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane-Library as electronic databases from the inception of each database to November 2023. Selection criteria included randomized controlled trials of postpartum individuals randomized to remote blood pressure monitoring or telehealth strategies vs. routine-care. The primary outcome was postpartum readmission, defined as postpartum hospital admission after discharge. Secondary maternal outcomes included stroke, eclampsia, ICU-admission, maternal death, emergency department visit, ascertainment of a blood pressure measurement within 7-10 days after delivery, attendance of the 4-6-week postpartum visit. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95 % confidence intervals (CI).

Four RCTs including 714 individuals randomized to either telematic reporting of blood pressure measurements (n=356, 49.8 %) or standard postpartum care (n=358, 50.1 %). There were no significant differences in the rate of hospital readmission due to hypertensive related causes (5.3 % vs. 11.8 %). However, emergency department visit rate differed significantly among the two groups (9.0 % vs. 4.4 %). With regards to postpartum follow up, blood pressure assessment at 10 days postpartum and 4-6-week postpartum visit attendance rate were similar. No included RCT provided data on maternal secondary outcome like pulmonary edema, stroke, maternal death, and ICU admission.

Remote blood pressure monitoring is not superior to standard care to prevent hypertensive related readmission and increases emergency department visits.

Haematological cancers are common in the UK, with a variety of morphologies. Stem cell transplants and chimeric antigen receptor (CAR) T-cell therapies provide significant options for hard to treat haematological cancers, although with difficult to predict outcomes. Research into the determinates of treatment efficacy, and access to treatments, is key to ensuring equal benefit across patients and patient safety. With this, there are concerns about the small representation of minority groups in related research. We aim to report on the current knowledge to guide future research.

A variety of databases will be searched for literature on UK minority ethnic populations receiving haematopoietic stem cell transplant or CAR T-cell therapy. Searches will be restricted to the year 2011 or later. Many outcomes will be analysed, covering the patient care pathway for those of the target population, although with a focus on follow-up after therapy. Plans have been made to conduct narrative synthesis, with meta-analysis where applicable.

Ethical approval is not required for this study. Outputs will be published in an appropriate journal and discussed with the wider National Institute for Health and Care Research Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics (BTRU) group. Discussions will also be undertaken with the BTRU patient partners group.

Research reporting checklists are itemised writing standards to improve transparency and facilitate reproducibility. Previous assessments of their recommendation or requirement have demonstrated improved checklist adherence across medical specialties and study designs. Here, we investigated the endorsement of reporting checklists within pathology, laboratory medicine and forensic science journals.

We queried Google Scholar Metrics and the Scopus CiteScore tool to identify top pathology and forensic medicine journals. Two authors independently assessed for the mention, recommendation or requirement or checklists-derived from the Enhancing the Quality and Transparency Of Health Research (EQUATOR) network-as well as study preregistration within each journal's aims and instructions for authors. Journal editors were contacted by one author every 3 weeks to confirm whether or not certain study designs would be considered for publication.

Of the 88 journals evaluated, most did not mention or endorse the EQUATOR Network (73.9%) or International Committee of Medical Journal Editors reporting standards (51.1%). The most commonly reported checklists included Animal Research: Reporting of In Vivo Experiments (38.6%), Consolidated Standards of Reporting Trials (28.4%) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (25.0%). The CARE reporting checklist for case reports was required most often by five journals (5.7%). The final email response from journal editors and contacts was 9.1%.

Reporting checklists were suboptimally mentioned and rarely required. Even with many basic and diagnostic science reporting checklists and initiatives, endorsement remains low. We recommend that authors, reviewers and editors become familiar with relevant reporting checklists for their fields and publishing spaces to improve checklist visibility and adherence for scientific transparency, reproducibility and rigour.

To identify and assess the state of knowledge regarding compassion-based interventions and outcomes, targeted to the organisational level, that aim to improve health professionals' well-being.

Systematic review.

Using the PICO model, the clinical question and search strategy were structured. The searches were performed on 20 September 2022 and 26 December 2023 in the Scopus, CINAHL, EMBASE, PsycINFO and ProQuest Dissertations & Theses Global databases. Content analysis was applied to analyse data, and the PRISMA and SWiM guidelines were followed for reporting.

Thirty-eight studies, mostly from the United Kingdom and the United States, met the inclusion criteria and were quality assessed and analysed. Compassion-based interventions that target the organisational level are quite new, thus representing a burgeoning initiative. In this review, many included quantitative studies revealed significant methodological challenges in effectively measuring organisational compassion (interpersonal relationships, organisational culture and retention/turnover). However, the review findings overall indicate that interpersonal connections between colleagues that foster a sense of community, through shared experiences, mindfulness and (self-)compassion practices and social activities, may be a protective factor for well-being. Further, the review emphasises the crucial role of management support in catalysing organisational changes to improve health professionals' well-being.

Evidence strongly suggests that fostering human interconnectedness among health professionals is associated with enhanced well-being. Further rigorous studies are needed to validate these findings, clarify the organisational cultural aspects of compassion and develop an effective outcome measurement tool for organisational compassion.

Organisational compassion-based interventions may help foster a culture of compassion within organisations, enhance health professionals' capacity for compassion and benefit both their well-being and the quality of care provided to patients and relatives.

This review is part of a larger project about compassion and includes two patient representatives (mothers of children with cancer) in the research team.

Climate change is a global phenomenon affecting every segment of the population. Yet, older adults are more vulnerable to climate change events (e.g., floods, heatwaves, landslides) owing to their functional limitations. Understandably, stakeholders have called for healthy ageing policies that enable older adults and individuals in the general population to maintain wellbeing despite climate change. This review aims to describe healthy ageing policies adopted or recommended in response to climate change. Eight databases (i.e., CINAHL, Cochrane library, ProQuest, PsycINFO, Google Scholar, Web of Science, Scopus, and MEDLINE) will be searched to identify relevant studies. Materials published anywhere in English to date will be included in the review. The Critical Appraisal Skills Programme (CASP) or Joanna Briggs Institute (JBI) checklist will be employed to assess the quality of studies. A narrative synthesis will be adopted to present the results. This review will highlight groups targeted with healthy ageing policies and describe policies in use or recommended. It will proffer implications for practice, research, and sustainability.

Network meta-analysis (NMA) is a method for comparing multiple interventions simultaneously, combining evidence to estimate and rank their relative effectiveness and safety across a network of studies. This study evaluates (i) epidemiological and descriptive characteristics, (ii) reporting completeness, and (iii) methodological quality of NMAs.

In this metaresearch study (protocol at https://osf.io/pa6dz/), we searched PubMed for systematic reviews with NMAs indexed in January 2023. We extracted epidemiological and descriptive data, assessed reporting completeness using the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for NMA, and evaluated the methodological quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2).

Among the 139 NMAs, 77% were published in specialty journals (median journal impact factor [JIF] 4), and 52% originated from China. Reporting completeness and methodological quality were generally of a medium quality, with the median NMAs fulfilling 71% of the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analyses (PRISMA-NMA) and 63% of the AMSTAR-2 criteria. Items such as "network geometry" for modified PRISMA-NMA (15%) and "list of excluded studies" for AMSTAR-2 (12%) were frequently unfulfilled. Better reporting and methodological quality were associated with registered protocol, non-Chinese country, higher JIF, and larger author teams.

We highlight gaps in both reporting and methodological quality in NMAs. We recommend future authors to plan and conduct NMAs within a large author team that includes statistical experts and to strictly adhere to reporting and methodological quality standards. More attention should be given to the reporting of network geometry and documenting the list of excluded studies.

We aimed to examine a) the policies of national and international clinical trial registries regarding observational studies; b) the time trends of observational study registration; and c) the published arguments for and against observational study registration.

Scoping review of registry practices and published arguments. We searched the websites and databases of all 19 members of the World Health Organization's Registry Network to identify policies relating to observational studies and the number of observational studies registered annually from the beginning of the registries to 2022. Regarding documents with arguments, we searched Medline, Embase, Google Scholar, and top medical and epidemiological journals from 2009 to 2023. We classified arguments as "main" based on the number (n ≥ 3) of documents they occurred in.

Of 19 registries, 15 allowed observational study registration, of which seven (35%) had an explicit policy regarding what to register and two (11%) about when to register. The annual number of observational study registrations increased over time in all registries; for example, ClinicalTrials.gov increased from 313 in 1999 to 9775 in 2022. Fifty documents provided arguments concerning observational study registration: 31 argued for, 18 against, and one was neutral. Since 2012, 19 out of 25 documents argued for. We classified nine arguments as main: five for and four against. The two most prevalent arguments for were the prevention of selective reporting of outcomes (n = 16) and publication bias (n = 12), and against were that it will hinder exploration of new ideas (n = 17) and it will waste resources (n = 6).

Few registries have policies regarding observational studies; an increasing number of observational studies were registered; there was a lively debate on the merits of registration of observational studies, which, since 2012, seems to converge toward proregistration.

Technology-based interventions are increasingly integrated to improve symptom management of pediatric oncology patients. However, evidence for their effectiveness remains low across various studies characterized by different methodologies and patient populations. This study aimed to synthesize and analyze the effectiveness of technology-based intervention in symptom management in pediatric oncology patients.

Six databases (PubMed, Web of Science, Cochrane Library, Ovid MEDLINE, CINAHL, and Scopus) were searched from January 1, 2014, to January 1, 2024. The methodological quality of the included studies was assessed using the Cochrane and JBI checklists. The PRISMA guidelines for systematic reporting were followed in this study. The search protocol has been registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42024516320).

Thirteen studies with 624 pediatric oncology patients were analyzed. Significant differences were found between intervention and control groups in pain (Hedge's g = -0.695, 95% CI: -0.994 to -0.396, p < 0.001), fear (Hedge's g = -0.737, 95% CI: -1.01 to -0.464, p < 0.001), anxiety, and nausea and vomiting (Hedge's g = -0.573, 95% CI: -0.912 to -0.235, p < 0.001).

The findings indicate that VR, iPad, humanoid robots, and Pain Squad reduce pain in pediatric oncology. VR, biofeedback-based VR, and iPads also alleviate fear, while all three plus humanoid robots mitigate anxiety. VR, interactive mobile apps, tablet games, text reminders, and iPads effectively decrease nausea and vomiting. More research is needed to evaluate the long-term effects of these interventions.

Cardiovascular disease (CVD) remains the foremost cause of morbidity and mortality worldwide. Recent advancements in machine learning (ML) have demonstrated substantial potential in augmenting risk stratification for primary prevention, surpassing conventional statistical models in predictive performance. Thus, integrating ML with Electronic Health Records (EHRs) enables refined risk estimation by leveraging the granularity and breadth of longitudinal individual patient data. However, fundamental barriers persist, including limited generalizability, challenges in interpretability, and the absence of rigorous external validation, all of which impede widespread clinical deployment.

This review adheres to the methodological rigor of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. A systematic literature search was performed in March 2024, encompassing the Medline and Embase databases, to identify studies published since 2010. Supplementary references were retrieved from the Institute for Scientific Information (ISI) Web of Science, and manual searches were curated. The selection process, conducted via Rayyan, focused on systematic and narrative reviews evaluating ML-driven models for long-term CVD risk prediction within primary prevention contexts utilizing EHR data. Studies investigating short-term prognostication, highly specific comorbid cohorts, or conventional models devoid of ML components were excluded.

Following an exhaustive screening of 1757 records, 22 studies met the inclusion criteria. Of these, 10 were systematic reviews (four incorporating meta-analyses), while 12 constituted narrative reviews, with the majority published post-2020. The synthesis underscores the superiority of ML in modeling intricate EHR-derived risk factors, facilitating precision-driven cardiovascular risk assessment. Nonetheless, salient challenges endure heterogeneity in CVD outcome definitions, undermine comparability, data incompleteness and inconsistency compromise model robustness, and a dearth of external validation constrains clinical translatability. Moreover, ethical and regulatory considerations, including algorithmic opacity, equity in predictive performance, and the absence of standardized evaluation frameworks, pose formidable obstacles to seamless integration into clinical workflows.

Despite the transformative potential of ML-based CVD risk prediction, it remains encumbered by methodological, technical, and regulatory impediments that hinder its full-scale adoption into real-world healthcare settings. This review underscores the imperative circumstances for standardized validation protocols, stringent regulatory oversight, and interdisciplinary collaboration to bridge the translational divide. Our findings established an integrative framework for developing, validating, and applying ML-based CVD risk prediction algorithms, addressing both clinical and technical dimensions. To further advance this field, we propose a standardized, transparent, and regulated EHR platform that facilitates fair model evaluation, reproducibility, and clinical translation by providing a high-quality, representative dataset with structured governance and benchmarking mechanisms. Meanwhile, future endeavors must prioritize enhancing model transparency, mitigating biases, and ensuring adaptability to heterogeneous clinical populations, fostering equitable and evidence-based implementation of ML-driven predictive analytics in cardiovascular medicine.

The pathophysiology and treatment of post-stroke cognitive impairment (PSCI) are not clear. Stroke triggers an inflammatory response, which might affect synapse function and cognitive status. We performed a systematic review and meta-analysis to assess whether patients with PSCI have increased levels of inflammatory markers and whether anti-inflammatory interventions in animals decrease PSCI. We systematically searched PubMed, EMBASE, and PsychInfo for studies on stroke. For human studies, we determined the standardized mean difference (SMD) on the association between PSCI and markers of inflammation. For animal studies, we determined the SMD of post-stroke cognitive outcome after an anti-inflammatory intervention. Interventions were grouped based on proposed mechanism of action. In patients, the SMD of inflammatory markers for those with versus those without PSCI was 0.46 (95% CI 0.18; 0.76; I2 = 92%), and the correlation coefficient between level of inflammation and cognitive scores was - 0.25 (95% CI - 0.34; - 0.16; I2 = 75%). In animals, the SMD of cognition for those treated with versus those without anti-inflammatory interventions was 1.43 (95% CI 1.12; 1.74; I2 = 83%). The largest effect sizes in treated animals were for complement inhibition (SMD = 1.94 (95% CI 1.50; 2.37), I2 = 51%) and fingolimod (SMD = 2.1 (95% CI 0.75; 3.47), I2 = 81%). Inflammation is increased in stroke survivors with cognitive impairment and is negatively correlated with cognitive functioning. Anti-inflammatory interventions seem to improve cognitive functioning in animals. Complement inhibition and fingolimod are promising therapies on reducing PSCI.

Whether the use of osseodensification burs for indirect sinus lift improves primary implant stability and bone height as compared with the osteotome technique to overcome the challenges of the pneumatization of the maxillary sinus and vertical bone loss after extraction in the edentulous posterior maxilla is unclear.

The purpose of this systematic review and meta-analysis was to evaluate the difference in primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique.

Two independent reviewers searched the MEDLINE/PubMed, EBSCO, and Cochrane Library databases and the Google Scholar Search engine for randomized clinical trials, nonrandomized clinical trials, and cross-sectional studies published from 2000 to 2022 to identify relevant studies evaluating the primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique. A meta-analysis was performed to evaluate the cumulative data on primary implant stability and increase in bone height.

A total of 8521 titles were obtained by electronic database search, of which 75 were duplicates. A total of 8446 abstracts were screened, and 8411 that were not relevant to the topic were excluded. Thirty-five articles were eligible for full-text assessment. After the screening of full-text articles as per the selection criteria, 26 studies were excluded. For qualitative synthesis, 9 studies were included. For quantitative synthesis, 5 studies were included. For an increase in bone height, no statistically significant difference was observed (I2 = 89%, P=.15, pooled mean difference=0.30 [-0.11, 0.70], CI=95%). For primary implant stability, the osseodensification group showed higher values than the osteotome group (I2 = 20%, P<.001, pooled mean difference=10.61 [7.14, 14.08], CI=95%).

The evidence obtained from quantitative analysis of the studies determined that the osseodensification group showed higher primary implant stability than the osteotome group (P<.05). However, for mean increase in bone height, there was no statistically significant difference between the groups.

Recent guidelines indicated that, in addition to antibiotics, nonantibiotic interventions serve as available preventive options for urinary tract infections (UTIs). This study aimed to compare the efficacy and safety of various nonantibiotic interventions in preventing UTIs.

The authors systematically searched databases for eligible studies. The inclusion criteria encompassed randomized controlled trials (RCTs) focusing on one or more nonantibiotic interventions for UTI prevention, with the incidence of UTIs being a key outcome measure. Subgroup analyses were performed according to age, sex, and follow-up.

50 RCTs comprising 10,495 subjects and investigating 14 interventions, were included. Nearly 80% of the RCTs utilized double-blind or triple-blind designs. In the whole group, D-mannose (risk ratio [RR] 0.34, 0.21 to 0.56), vaccine (RR 0.65, 0.52 to 0.82), probiotics (RR 0.69, 0.50 to 0.94), cranberry (RR 0.72, 0.60 to 0.87), and triple therapy (cranberry plus probiotics plus vitamin A) (RR 0.27, 0.09 to 0.87), exhibited a significant reduction in UTI incidence compared to the placebo. Probiotics (RR 0.50, 0.28 to 0.89) were the most effective in the nonadult group, while vitamin D (RR 0.46, 0.27 to 0.81) showed the highest efficacy in the long follow-up group (≥ 1 year). There was no significant difference in the incidence of adverse events between the interventions and the placebo group.

D-mannose, triple therapy, vaccine, probiotics, and cranberry serve as potential nonantibiotic intervention options for clinical UTI prevention.

This systematic review aimed to investigate the association between serum vitamin D levels and key outcomes following anterior cruciate ligament reconstruction (ACLR), including ACL injury risk, postoperative muscle recovery and post-reconstruction functional outcomes.

We conducted a comprehensive search across five databases (Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science) until July 2024. Studies were selected based on specific inclusion criteria, such as studies evaluating the relationship between vitamin D and injury risk, ACLR outcomes and muscle strength. Risk of bias was assessed using the MINORS tool, and results were synthesized narratively due to study heterogeneity.

Five studies with 656,243 participants met the inclusion criteria. Most studies reported that low vitamin D levels were associated with a significantly increased risk of ACL injuries and poorer postoperative muscle strength recovery. However, evidence regarding bone health and functional outcomes was inconsistent. No meta-analysis was conducted due to the variability of study designs and outcomes, but qualitative synthesis indicated a potential protective role of vitamin D in ACL recovery.

Vitamin D deficiency appears to increase the risk of ACL injury and impede muscle recovery post-surgery. However, limitations include a high risk of bias and inconsistent evidence on functional outcomes, underscoring the need for further research. The review was registered in PROSPERO (ID: CRD42024584483).

Level III, systematic review.

Evidence was reviewed to assess the decrease in compressive strength postoperatively. The PRISMA guidelines were followed. PubMed, Embase, Web of Science, Google Scholar, and ProQuest were searched. Five cadaver studies met the inclusion criteria (49 cadavers). Three reported force leading to fracture (FLF), which ranged between 1034 N and 9962 N consistently higher than three times cadaver body weight. Only one reported statistically significant lower FLF in decancellated tibias compared to the contralateral tibias (mean 3766.9 N vs 5126.4; stability reduction 26.5%). The overall estimate of FLF in decancellated tibias was 4321.6 N (95% confidence interval 3434.4-5208.8 N. Meta-analysis estimated a significant difference in force leading to fracture (ΔFLF) 1098.1 N, 95% confidence interval 547.8-1648.5 N. While mean FLF in all studies and the pooled data was above a force three times the body weight of an average adult (70 kg x 3 = 2100 N), three cadavers showed FLF values below this threshold. Increasing the threshold to 2400 N (roughly relating to a body weight of 80 kg, increased this number to six. Normal weight-bearing after decancellation seems to be statistically safe. Clinically, however, the authors are not able to generalize this assumption.

Chronic pelvic pain syndrome (CPPS) is pain in the region of the lower pelvis for three months or longer. Which is often accompanied by complaints of organ systems in the lower abdomen. CPPS is often a subjective diagnosis where electrodiagnostic tests are recommended as a supplement in defining a diagnosis.

Synthesize the clinical studies that describe electrodiagnostic testing in humans with a clinical diagnosis of CPPS.

Registered in PROSPERO (CRD42024510404). A systematic search in Medline/PubMed, Embase, CINAHL, and Web of science, from inception till February 2024, complemented with reference examining. Two reviewers independently reviewed titles, abstracts, and full-text papers, and performed data extraction. Reviews were excluded, and papers were included if patients were clinically diagnosed with CPPS and underwent EMG and/or SSEP. The QUADAS-2 tool was used to assess the quality of studies.

Fourteen papers were included concerning EMG and/or SSEP, nine papers reported on EMG and five on SSEP. In total, 432 patients clinically diagnosed with CPPS underwent electrodiagnostic testing. 152/277 patients showed abnormalities on EMG and 102/155 patients had abnormal findings on SSEP. Due to the lack of quantitative data, no meta-analysis could be performed.

Abnormalities on electrodiagnostic testing are seen in half of the patients with CPPS, and therefore not recommended as a substitute in the diagnostic process. The low number of patients enrolled in this review needs to be taken into consideration when interpreting the results. Further research on the sensitivity of EMG and/or SSEP in PN is recommended.

Occupational incidents comprising injuries and accidents remain a serious concern globally. With sleep deprivation and fatigue representing key drivers of many workplace incidents, one strategy to reduce occupational incidents is implementing effective sleep management systems. Yet, to date, there are complaints about the methodological approach in sleep-safety studies. The extent of work carried out with respect to the impact of sleep on safety outcomes needs to be reviewed to highlight the state of the art in the face of increasing technological advancement and changing lifestyle attitudes. A systematic search of the Scopus and PubMed databases retrieved 63 journal articles published up to 2023. The units of analysis included article performance and thematic analysis. It was deduced that workers in healthcare and construction have been the focus of most studies, pointing to the prevalence of safety issues in both these sectors. Most of the studies adopted a quantitative methodology employing validated sleep questionnaires, especially the Pittsburgh Sleep Quality Index. Using thematic analysis, the research focus was mapped into six areas, including sleep disorders, cognition and performance, and injury and accident prevention in the construction sector. In objective studies, alertness and cognitive performance were considered a proxy for sleep deprivation and safety performance. Harmonising sleep questionnaires is necessary to prevent excessive paperwork and ineffective safety systems. This study has the potential to provide occupational health and safety researchers outside of the medicine and psychology disciplines with knowledge on baseline information that could advance efforts to address sleep deprivation and the resulting safety concerns in the workplace.

BackgroundOffice workers spend approximately two-thirds of their daily work time in a sitting position.ObjectiveThis scoping review aimed to identify and categorize key themes and knowledge gaps in research on how sitting time, posture, and behavior affect the risk of low back pain among office workers.MethodsThe authors conducted a comprehensive literature search in electronic databases [MEDLINE [via PubMed], SCOPUS, CINAHL, PEDro, and CENTRAL] from inception to March 2024, resulting in 22 studies involving 7814 participants. The methodological quality of these studies was assessed using the Mixed Methods Appraisal Tool (MMAT).ResultsSeventeen studies [77%] were rated as high quality, four studies [18%] as moderate quality, and one study [5%] as low quality. Thirteen studies assessed sitting time, ten assessed sitting posture, and thirteen assessed sitting behavior. Among the studies investigating sitting time, five showed no relationship with low back pain (LBP) prevalence, while eight demonstrated a relationship with LBP prevalence. For studies exploring sitting posture, seven found a relationship with LBP. Regarding studies on sitting behavior, only one showed no relationship between LBP prevalence, while twelve indicated a relationship.ConclusionsLonger sitting time, poor sitting posture, fewer breaks and more static sitting in sitting behavior, were found to be associated with LBP. The strongest evidence for an association with LBP was found for sitting behavior. When considering workplace ergonomics and interventions for LBP, it is advisable to consider all factors, including sitting, posture and behavior.

Patients with cancer often experience persistent or intractable hiccups, which negatively impact their quality of life. Yet, interventions aimed at managing hiccups among patients with cancer receiving active treatment are lacking.

To describe existing evidence on interventions that address hiccup management in patients with cancer receiving active treatment with curative intent.

Our narrative synthesis review was conducted through a systematic search of 3 electronic databases (CINAHL Complete, PubMed, and HOLLIS) augmented by hand search from January 2003 to July 2023 to retrieve peer-reviewed articles published in English. Our review was guided by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and registered through the National Institute for Health Research, International Prospective Register of Systematic Reviews (CRD42023444545).

The database searches yielded 2686 records. After removing duplicates and ineligible articles, 13 articles met the inclusion criteria. Most were noninterventional observational studies. The most common pharmacologic interventions were as follows: steroid rotation (replacing dexamethasone with methylprednisolone or omitting dexamethasone), baclofen, and olanzapine. Of these pharmacologic interventions, replacing dexamethasone with another antiemetic was most beneficial in reducing hiccups. Baclofen was also found to be beneficial in reducing chronic or intractable hiccups. Acupuncture was found to be an effective nonpharmacologic intervention.

This review identified several promising interventions such as steroid rotation (replacing dexamethasone with methylprednisolone or omitting dexamethasone), baclofen, and acupuncture for hiccup management among patients with cancer undergoing active treatment.

Future studies to identify efficacious interventions for hiccups among patients with cancer receiving active treatment are warranted.

Elective lumbar spine surgery is increasingly being implemented to treat patients with specific low back pain. However, approximately 30% of patients continue to have long-term pain and disability after surgery.

The aim of this study was to systematically review the literature on the effectiveness of pre-surgical rehabilitation (prehab) alone or in combination with usual care versus usual care on patient-oriented outcomes and health-related costs following elective lumbar spine surgery.

Electronic databases from MEDLINE, CINAHL, EMBASE, and AMED were systematically searched from their inception to November 2022.

Randomized controlled trials that examined adult (age >18 years) prehab programs and evaluated one or more outcomes of interest were included in this review.

In pairs, six reviewers independently conducted a risk-of-bias assessment and extracted outcome data from included studies, in accordance with the Template for Intervention Description and Replication (TIDieR). A meta-analysis was conducted when trials were homogeneous.

A total of eight trials (n = 739 participants), reported in 13 different manuscripts, were eligible for inclusion. Exercise prehab interventions are superior to usual care for disability at 3-month (MD: -2.56, 95% CI -4.98 to -0.15), back pain at 6-month (MD: -6.65, 95% CI -13.25 to -0.05), and health-related costs (MD: €2572.8, 95% CI: €1963.0 to €3182.5). CBT prehab interventions seem to be superior to usual care for back pain at 3-month (MD: -7.3, 95% CI: -14.5 to -0.05). Individual trials showed that education prehab interventions may be superior to usual for back pain at 1-month post-operative (MD: 12.3, 95% CI: 0.9 to 23.7).

Overall, the inclusion of heterogeneous trials (e.g., diagnosis, types of surgery, dosage, content, and duration of interventions) with small sample sizes leads to inconclusive and very low certainty of effect estimates.

The present systematic review has brought to light the dearth of high-quality evidence in support of prehab interventions for patients undergoing lumbar spine surgery. Given the uncertainty surrounding the results obtained from low-quality randomized controlled trials, it is currently not feasible to provide recommendations for clinical practice.

Sickle cell disease (SCD) and Diamond-Blackfan anemia syndrome (DBAS) are two hereditary blood diseases that present significant challenges to patients, their caregivers, and the healthcare system. Both conditions cause severe health complications and have limited treatment options, leaving many individuals without access to curative therapies like hematopoietic stem cell transplantation. Recent advancements in gene and cell therapies offer the potential for a new curative option, marking a pivotal shift in the management of these debilitating diseases. However, the implementation of these therapies necessitates a nuanced understanding of the ethical and social implications.

In this mixed methods systematic review, we explore the responsible development and implementation of gene and cell therapies for SCD and DBAS and aim to sketch a path toward ethically and socially sound implementation. Drawing upon principles of Responsible Research & Innovation and the 4A framework of availability, accessibility, acceptability, and affordability, we thematically analyze existing research to illuminate the ethical and social dimensions of these therapies. Following established PRISMA and JBI Manual guidelines, a search across multiple databases yielded 51 peer-reviewed studies with publication dates ranging from 1991 to 2023.

Our thematic analysis shows that the theme of acceptability is heavily shaped by interactions between patients, caregivers, healthcare professionals and researchers, influencing treatment decisions and shaping the development of curative gene and cell therapies. Despite the generally positive perspective on these therapies, factors like the limited treatment options, financial constraints, healthcare professional attitudes, and (historical) mistrust can impede stakeholder decision-making. While acceptability focuses on individual decisions, the themes of availability, accessibility, and affordability are interconnected and primarily driven by healthcare systems, where high research and development costs, commercialization and a lack of transparency challenge equitable access to these therapies. This diminishes the acceptability for patients, revealing a complex interdependence of the themes.

The findings suggest the need for improved communication strategies in clinical practice to facilitate informed decision-making for patients and caregivers. Policy development should focus on addressing pricing disparities and promoting international collaboration to ensure equitable access to therapies. This review has been pre-registered in PROSPERO under registration number CRD42023474305.

Schwannomas are benign, slow-growing peripheral nerve sheath tumors. Approximately 8% of intracranial schwannomas originate from the trigeminal nerve. No consensus exists regarding superiority of outcomes after resection vs stereotactic radiosurgery (SRS) in the treatment of trigeminal schwannomas (TS). The aim of this study was to compare the efficacy and outcomes of resection vs SRS for TS management.

Embase, PubMed, and SCOPUS databases were queried from the date of inception to July 2023 for primary data reporting TS treatment outcomes after SRS or resection. Risk of bias was reported under Newcastle-Ottawa Scale.

Overall, 29 retrospective observational studies comprising 949 patients were included in the analysis. A total of 13 studies (n = 589) reported outcomes after SRS, and 16 studies (n = 360) reported outcomes after surgical resection, and 182 patients in the SRS group had previous resection. To ensure statistical validity of comparing the cohorts, 3 checkpoints were assessed: the median age (SRS: 48 vs surgery: 40 years old, P < .01), tumor volume (5.2 vs 8.9 cm3, P = .06), and median follow-up (53.9 vs 48.5 months, P = .59), which reflected the choice of treatment. Compared with surgical resection, the SRS group demonstrated significantly higher rates of facial hypesthesia improvement (44% vs 12%, P < .01) and lower rates of new onset (4% vs 15%, P = .051) at last follow-up. Facial pain was less likely to improve (58% vs 81%, P = .024) after SRS compared with surgery. However, worsened (5% vs 1%, P = .71) and new facial pain (2% vs 1%, P = .55) were comparable between cohorts.

SRS seems to offer improvement in rates of hypesthesia and trigeminal motor deficits compared with surgical resection for TS. However, facial pain improvement was more favorable after surgery. These findings highlight the importance of individualized treatment decisions based on patient characteristics, tumor profile, and pretreatment symptoms.

Tuberculosis (TB) remains a significant health concern, contributing to the highest mortality among infectious diseases worldwide. However, none of the various TB diagnostic tools introduced is deemed sufficient on its own for the diagnostic pathway, so various artificial intelligence (AI)-based methods have been developed to address this issue.

We aimed to provide a comprehensive evaluation of AI-based algorithms for TB detection across various data modalities.

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 guidelines, we conducted a systematic review to synthesize current knowledge on this topic. Our search across 3 major databases (Scopus, PubMed, Association for Computing Machinery [ACM] Digital Library) yielded 1146 records, of which we included 152 (13.3%) studies in our analysis. QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies version 2) was performed for the risk-of-bias assessment of all included studies.

Radiographic biomarkers (n=129, 84.9%) and deep learning (DL; n=122, 80.3%) approaches were predominantly used, with convolutional neural networks (CNNs) using Visual Geometry Group (VGG)-16 (n=37, 24.3%), ResNet-50 (n=33, 21.7%), and DenseNet-121 (n=19, 12.5%) architectures being the most common DL approach. The majority of studies focused on model development (n=143, 94.1%) and used a single modality approach (n=141, 92.8%). AI methods demonstrated good performance in all studies: mean accuracy=91.93% (SD 8.10%, 95% CI 90.52%-93.33%; median 93.59%, IQR 88.33%-98.32%), mean area under the curve (AUC)=93.48% (SD 7.51%, 95% CI 91.90%-95.06%; median 95.28%, IQR 91%-99%), mean sensitivity=92.77% (SD 7.48%, 95% CI 91.38%-94.15%; median 94.05% IQR 89%-98.87%), and mean specificity=92.39% (SD 9.4%, 95% CI 90.30%-94.49%; median 95.38%, IQR 89.42%-99.19%). AI performance across different biomarker types showed mean accuracies of 92.45% (SD 7.83%), 89.03% (SD 8.49%), and 84.21% (SD 0%); mean AUCs of 94.47% (SD 7.32%), 88.45% (SD 8.33%), and 88.61% (SD 5.9%); mean sensitivities of 93.8% (SD 6.27%), 88.41% (SD 10.24%), and 93% (SD 0%); and mean specificities of 94.2% (SD 6.63%), 85.89% (SD 14.66%), and 95% (SD 0%) for radiographic, molecular/biochemical, and physiological types, respectively. AI performance across various reference standards showed mean accuracies of 91.44% (SD 7.3%), 93.16% (SD 6.44%), and 88.98% (SD 9.77%); mean AUCs of 90.95% (SD 7.58%), 94.89% (SD 5.18%), and 92.61% (SD 6.01%); mean sensitivities of 91.76% (SD 7.02%), 93.73% (SD 6.67%), and 91.34% (SD 7.71%); and mean specificities of 86.56% (SD 12.8%), 93.69% (SD 8.45%), and 92.7% (SD 6.54%) for bacteriological, human reader, and combined reference standards, respectively. The transfer learning (TL) approach showed increasing popularity (n=89, 58.6%). Notably, only 1 (0.7%) study conducted domain-shift analysis for TB detection.

Findings from this review underscore the considerable promise of AI-based methods in the realm of TB detection. Future research endeavors should prioritize conducting domain-shift analyses to better simulate real-world scenarios in TB detection.

PROSPERO CRD42023453611; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023453611.

A novel noninvasive score, Agile-4 score, combining liver stiffness measurements, aspartate aminotransferase/alanine aminotransferase, platelet count, diabetes status and sex has been developed for the identification of cirrhosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). We assessed the performance of Agile-4 for ruling-in/out liver cirrhosis in MASLD patients.

We searched Medline, Cochrane library, Web of science, Scopus and Echosens website up to May 2024. Eligible studies assessed the accuracy of Agile-4 for ruling-in (≥0.565) and ruling-out (<0.251) liver cirrhosis, using biopsy as the reference standard, at predefined thresholds. We calculated pooled sensitivity and specificity estimates for both Agile-4 thresholds alongside 95% confidence intervals following bivariate random-effect models. We assessed the risk of bias using Quality Assessment of Diagnostic Accuracy Studies-2 tool.

We included seven studies with 6037 participants. An Agile-4 score ≥0.565 yielded a pooled specificity of 0.93 (95% CI, 0.86-0.97). Similarly, an Agile-4 score <0.251 excluded cirrhosis with a summary sensitivity of 0.90 (0.80-0.95). Assuming a cirrhosis prevalence of 30%, the positive predictive value (PPV) for ruling-in cirrhosis was 80%, while the negative predictive value for ruling-out cirrhosis was 95%. Most studies were at high or unclear risk for bias due to concerns regarding patient selection and the blinding status of Agile-4 score interpretation in relation to biopsy results.

Agile-4 score performs well for ruling-in/out liver cirrhosis in MASLD patients. Owing to the relatively low PPV, sequential application of the Agile-4 after fibrosis-4 index (FIB-4) testing might further enhance its performance.

To summarize and analyze the usage and reporting of dental patient-reported outcomes (dPROs) within systematic reviews (SRs) published in 5 leading orthodontic journals between 2015 and 2023.

A manual search was conducted to identify intervention (therapeutic or preventive) involved SRs published in selected journals between 2015 and 2023 from the official online archives. Two authors independently and in duplicate extracted the characteristics of each included SR, recording both the usage of dPROs in the Methods sections and the reporting of dPROs in the Results sections.

A total of 244 SRs were found eligible and included, of which 81 (33.2%) included dPROs. Out of the 81 SRs, 19 (23.5%) described dPROs in the Methods sections, 6 (7.4%) reported dPROs exclusively in the Results sections, and 56 (69.1%) included dPROs in both sections. In the 75 SRs that stated dPROs in their Methods sections, 38 (50.7%) identified them as primary outcomes, while 37 (49.3%) considered them secondary outcomes. Among the 62 SRs that reported dPROs in the Results section, 17 (27.4%) performed quantitative synthesis, and the remaining 45 (72.6%) conducted only qualitative synthesis. A total of 26 dPROMs were identified, of which only 11 were included in meta-analyses.

Only about one-third of SRs published in leading orthodontic journals included dPROs. It is recommended that researchers consider the usage of dPROs and dPROMs during the design and registration stages of orthodontic SRs and ensure transparent reporting of the results, thus facilitating evidence-based practice and shared decision-making in clinical care.

Background: The quest for minimally invasive disinfection in endodontics has led to using Erbium:Yttrium-Aluminum-Garnet (Er:YAG) lasers. Conventional approaches may leave bacterial reservoirs in complex canal anatomies. Er:YAG's strong water absorption generates photoacoustic streaming, improving smear layer removal with lower thermal risk than other laser systems. Methods: This systematic review followed PRISMA 2020 guidelines. Database searches (PubMed/MEDLINE, Embase, Scopus, Cochrane Library) identified studies (2015-2025) on Er:YAG laser-assisted root canal disinfection. Fifteen articles met the inclusion criteria: antibacterial efficacy, biofilm disruption, or smear layer removal. Data on laser settings, irrigants, and outcomes were extracted. The risk of bias was assessed using a ten-item checklist, based on guidelines from the Cochrane Handbook for Systematic Reviews of Interventions. Results: All studies found Er:YAG laser activation significantly improved root canal disinfection over conventional or ultrasonic methods. Photon-induced photoacoustic streaming (PIPS) and shock wave-enhanced emission photoacoustic streaming (SWEEPS) yielded superior bacterial reduction, especially apically, and enabled lower sodium hypochlorite concentrations without sacrificing efficacy. Some research indicated reduced post-operative discomfort. However, protocols, laser parameters, and outcome measures varied, limiting direct comparisons and emphasizing the need for more standardized, long-term clinical trials. Conclusions: Er:YAG laser-assisted irrigation appears highly effective in biofilm disruption and smear layer removal, supporting deeper irrigant penetration. While findings are promising, further standardized research is needed to solidify guidelines and confirm Er:YAG lasers' long-term clinical benefits.

This study aimed to assess whether high- vs low-dose oxytocin regimens for labor augmentation are associated with differential risk of low Apgar score, neonatal acidosis, and other adverse labor outcomes.

We searched electronic databases (MEDLINE, Embase, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov) from inception up to March 2024 using combinations of the following key words: "oxytocin," "oxytocin regimen," "oxytocin protocol," "oxytocin dosage," "active management," "high dose protocol," "low dose protocol," and "augmentation of labor."

We included quasi-randomized and randomized controlled trials comparing continuous oxytocin infusion with high-dose regimens (intervention group) vs low-dose regimens (control group) in nulliparous or multiparous patients undergoing labor augmentation. High-dose regimens were defined as a starting oxytocin dose of ≥4 mU/min, increasing in increments of 3 to 7 mU/min every 15 to 40 minutes. Low-dose regimens were defined as a starting oxytocin dose of <4 mU/min, increasing in increments of 1 to 2 mU/min every 15 to 40 minutes (PROSPERO CRD42024500197).

The coprimary outcomes were incidence of Apgar score <7 at 5 minutes and umbilical arterial pH <7.00. The secondary outcomes included cesarean delivery and chorioamnionitis. We performed random-effects head-to-head meta-analyses to compare high-dose with low-dose strategies, and reported summary risk ratios with 95% confidence intervals.

Ten randomized and quasi-randomized controlled trials of 5508 pregnancies met the inclusion criteria and were included in this meta-analysis. There was no difference in risk for the coprimary outcomes of Apgar score <7 at 5 minutes (relative risk, 0.94; 95% confidence interval, 0.60-1.46) and umbilical arterial pH <7.00 (relative risk, 0.77; 95% confidence interval, 0.50-1.20). There was also no difference in risk for cesarean delivery (relative risk, 0.83; 95% confidence interval, 0.67-1.02). High-dose oxytocin regimens were associated with significantly lower risk of chorioamnionitis (relative risk, 0.70; 95% confidence interval, 0.57-0.84; number needed to treat=25) and higher risk of tachysystole (relative risk, 1.32; 95% confidence interval, 1.21-1.43; P<.001).

When used for labor augmentation, high-dose oxytocin regimens decreased the risk of chorioamnionitis compared with low-dose regimens without affecting the risk of low Apgar scores, neonatal acidosis, or cesarean delivery. El resumen está disponible en Español al final del artículo.

Systematic reviews are critical for evidence-based healthcare decisions, but their validity depends on the quality of conduct and reporting. AMSTAR-2, a widely used tool for assessing the quality of systematic reviews, identifies seven critical domains influencing review validity, although its developers recommend flexibility in prioritizing these domains. To date, no studies have analyzed the impact of this change on systematic reviews with meta-analysis (SRMAs) evaluating clinical pharmacy services.

To evaluate the quality of SRMAs on clinical pharmacy services and the effect of modifying AMSTAR-2 domains criticality on quality assessment.

Systematic searches (updated January 1, 2023) were conducted in PubMed, Scopus, and Web of Science to identify SRMAs reporting the effects of clinical pharmacy services. Manual reference list searches of included studies were also performed. The methodological quality of SRMAs was assessed using the AMSTAR-2 tool. Changes in the overall classification of each SRMA were analyzed by hypothetically removing the critical designation for domains in the original tool.

Out of 153 eligible SRMAs, 138 (90.2 %) were classified as critically low quality, 13 (8.5 %) as low quality, and 2 (1.3 %) as moderate quality. Despite slight improvement in methodological quality over time, this change was not directly linked to the creation of various reporting and conducting guidelines and registries. Our analysis showed that the hypothetical removal of the criticality of each AMSTAR-2 domain did not significantly impact the overall quality assessment. Furthermore, all critical domains in AMSTAR-2 are considered essential in the field of pharmacy practice.

Most SRMAs on clinical pharmacy services were classified as low or critically low quality and modifying the AMSTAR-2 domain criticality did not improve these assessments. Researchers, journal editors, and peer reviewers must work to enhance SRMAs quality, which are crucial for providing robust evidence for pharmaceutical services.

Meta-analysis (MA) is a fundamental statistical tool for combining the results of different studies to obtain potentially high-level evidence that can be implemented in clinical practice. Although its use in clinical research is increasing, MAs are still relatively rare in hand surgery. Therefore, it should be important for every hand surgeon to not only know how to interpret a MA, but also how to perform one. The purpose of this first of a two-part article is to introduce the principles of MA and describe the main models and methods used to pool effect estimates.

Historically, cementless patellar implants were fraught with issues of fixation and polyethylene wear. However, contemporary cementless patellar implants incorporate modern technologies for implant design and offer the potential for improved biological fixation and longevity. As such, an evaluation of the performance of modern cementless patellae is needed. The purpose of this study was to perform a systematic review and meta-analysis of contemporary cementless patellar implants used during primary total knee arthroplasty (TKA), with a particular focus on aseptic loosening of the patellar component.A systematic review of the literature was performed from January 2000 to February 22, 2024. We included all peer-reviewed studies that reported the number of revisions in patients who had cementless patellae placed in 2000 or later during primary TKA. Reviews and case reports were excluded. Out of 639 studies, 13 were included with a total of 3,005 cementless patellae analyzed. The mean patient age was 64 years and the mean body mass index (BMI) was 31 kg/m2. Meta-analyses were performed to calculate the pooled revision rate per person-year of revision for aseptic loosening of the patellar component and revision for any patellar failure.Upon analysis of 13 studies involving a total of 3,005 cementless patellae, the revision rate for aseptic loosening of the patella was 0.2 per 1,000 person-years and the revision rate for any patellar failure was 1 per 1,000 person-years.Contemporary cementless patellar implants showed an overall revision rate of 1 per 1,000 person-years, demonstrating excellent longevity. The high survivorship, together with a low rate of loosening, show the utility and effectiveness of these implants. Given the nature of biologic fixation, these results are promising for long-term implant stability but additional follow-up is warranted.

Although multiple strategies have been suggested for evidence-based practice educational interventions, few studies have focused on the development of abilities for evidence-based practice implementation.

To explore the effectiveness of evidence-based practice in higher education and understand its teaching methods.

Narrative review was conducted at the Universidade Municipal de São Caetano do Sul, Brazil.

Narrative review included research studies that measured any type of evidence-based practice teaching method and its effectiveness. Searches included publications from inception to June 2022, conducted on MEDLINE, EMBASE, CINAHL, CENTRAL, ERIC, and the Cochrane Library. Two independent authors descriptively extracted and analyzed the data. The methodological quality of the studies was also analyzed.

The results determined that 79.2% of the studies proved their effectiveness. Teaching methods varied according to the time period, format, and types of questionnaire.

Most studies demonstrated the effectiveness of the chosen teaching methods. This study shows the importance of health professionals using evidence-based practice to ensure effective patient treatment.

Background:Bartonella quintana is a body-louse-borne bacterium. Canadian B. quintana disease has been reported primarily in populations experiencing homelessness and in Indigenous communities with limited access to water. We sought to understand the epidemiology of B. quintana in Canada. Methods: This study combined an analysis of laboratory data from Canada's National Microbiology Laboratory (NML) with a systematic review of the literature. Laboratory data included quantitative polymerase chain reaction (qPCR) cycle threshold values and indirect immunofluorescent antibody titers with the year and province of the sample acquisition. For the systematic review, we searched PubMed, Scopus, Embase, and Web of Science for articles published before 15 July 2024, with terms related to B. quintana in Canada. Results: Thirty-three individuals with qPCR-positive B. quintana were documented in seven provinces and one territory. The number of cases increased over time (p-value = 0.005), with the greatest number of cases being reported in 2022 and 2023. The percent positivity for the B. quintana qPCR performed at the NML increased over time (p-value = 0.036). The median immunoglobulin G titer demonstrated a sustained increase starting in 2017. The systematic review identified fourteen individuals with qPCR-positive B. quintana (none had a qPCR performed at the NML) and seven probable cases of B. quintana disease. Four of these twenty-one individuals from the systematic review died (19%). All fatalities were attributed to endocarditis. Conclusions: The detection of B. quintana disease in seven provinces and one territory suggests that B. quintana has a national distribution. B. quintana disease is increasingly diagnosed in Canada, indicating ongoing transmission across geographic settings.

This systematic review aimed to provide a comprehensive overview of the application of machine learning (ML) in predicting multiple adverse drug events (ADEs) using electronic health record (EHR) data.

Systematic searches were conducted using PubMed, Web of Science, Embase, and IEEE Xplore from database inception until 21 November 2023. Studies that developed ML models for predicting multiple ADEs based on EHR data were included.

Ten studies met the inclusion criteria. Twenty ML methods were reported, most commonly random forest (RF, n = 9), followed by AdaBoost (n = 4), eXtreme Gradient Boosting (n = 3), and support vector machine (n = 3). The mean area under the summary receiver operator characteristics curve (AUC) was 0.76 (95% confidence interval [CI] = 0.26-0.95). RF combined with resampling-based approaches achieved high AUCs (0.9448-0.9457). The common risk factors of ADEs included the length of hospital stay, number of prescribed drugs, and admission type. The pooled estimated AUC was 0.72 (95% CI = 0.68-0.75).

Future studies should adhere to more rigorous reporting standards and consider new ML methods to facilitate the application of ML models in clinical practice.

Antibody-drug conjugates (ADCs) are revolutionizing metastatic breast cancer treatment, resulting in a better prognosis and a higher safety profile than chemotherapy. Nevertheless, treatment-related adverse events (TRAE) have been extensively documented. We searched five databases for articles published up to December 2023 and conducted a meta-analysis on 23 clinical trials to estimate TRAE prevalence related to currently approved ADCs. The prevalence of the most common TRAEs ranged from 12 % to 33 %, depending on the ADC type and study design. Gastrointestinal disorders were highly prevalent during Trastuzumab Deruxtecan, general disorders were extremely common during Trastuzumab Emtansine, and blood system disorders and gastrointestinal disorders were the most prevalent during Sacituzumab Govitecan. This study provides an estimate of ADC-related TRAEs for each treatment based on study design. Despite each ADC having specific toxicities, gastrointestinal symptoms were highly prevalent in all treatments. This study lays the groundwork for developing personalized risk-stratified care pathways.

Reproducibility is key for diagnostic tests involving subjective evaluation by experts. Our aim was to systematically review the reproducibility of visual analysis in clinical electroencephalogram (EEG). In this paper, we give data on the scope of EEG features found, and detailed reproducibility data for the most studied feature.

We searched four databases for articles reporting reproducibility in clinical EEG, until June 2023. Two raters screened 24 553 citations, and then 2736 full texts. Quality was assessed according to the GRRAS guidelines.

We found 275 studies (268 interrater and 20 intrarater), addressing 606 different EEG features. Only 38 EEG features had been studied in >2 studies. Most studies had <50 patients and EEGs. The most often addressed feature was seizure detection (62 papers). Interrater reproducibility of seizure detection was substantial-to-almost-perfect with experienced raters and raw EEG (kappa .62-.88). With experienced raters and transformed EEG, reproducibility was substantial (kappa .63-.70). Inexperienced raters had lower reproducibility. Seizure lateralization reproducibility was moderate to substantial (kappa .58-.77) but lower than for seizure detection.

Most EEG reproducibility studies are done only once. Intrarater studies are rare. The reproducibility of visual EEG analysis is variable. Interrater reproducibility for seizure detection is substantial-to-perfect with experienced raters and raw EEG, less with inexperienced raters or transformed EEG. The results of visual EEG analysis vary within the same rater, and between raters. There is a need for larger collaborative studies, using improved methodology, as well as more intrarater studies of EEG interpretation.

Lumbar medial branch nerve radiofrequency ablation (LRFA) is an interventional procedure used to treat chronic lumbar facet joint pain. Because the medial branch nerves also innervate the multifidus muscle, it has been proposed that LRFA may pose a risk of multifidus atrophy and/or dysfunction. However, the quality and level of evidence to answer this clinical question have not been established. Therefore, this review aimed to systematically appraise the literature to discern whether the prevailing evidence substantiates the hypothesis in question.

A systematic review compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to evaluate the quality and level of evidence of studies reporting functional and/or structural changes in the multifidus muscle following LRFA.

Only five cohort studies met inclusion criteria. Two studies assessed changes in multifidus function following LRFA with confirmed denervation at electromyography and significant reduction in multifidus shear modulus with ultrasound shear wave elastography. Of the four studies that evaluated changes in multifidus structure with magnetic resonance imaging following LRFA, two demonstrated a decrease in cross-sectional area or an increase in fat infiltration, one demonstrated no change, and one revealed an apparent increase. Given the destructive nature attributed to LRFA, some degree of multifidus atrophy and/or dysfunction may be plausible, albeit with a very low certainty that relies on a restricted body of literature of modest quality and with a presence of high bias.

There is a paucity of studies discussing the potential association between LRFA and multifidus atrophy and/or dysfunction. In light of the shortage of high-quality studies and the absence of standardized protocols to assess both changes in the structure and function of the multifidus subsequent to LRFA, there is a pressing need for more prospective studies with a high methodological rigor to comprehensively address and answer this enduring debate in clinical practice.

To determine the effects of extracorporeal shock wave therapy (ESWT) on lower limb function, walking, and quality of life in patients with lower limb poststroke spasticity.

A comprehensive and systematic electronic database search of PubMed, Web of Science, ProQuest thesis Dissertation checks, Google Scholar was conducted from January 2010 to March 2022.

Initially, the bibliography was screened to identify randomized and nonrandomized controlled trials evaluating the effects of ESWT on lower limb spasticity and functional outcomes in stroke patients. Two reviewers independently screened the title and abstract, full-text articles, extracted data, and assessed the quality of the selected studies. The primary evaluation outcome was spasticity assessed by Modified Ashworth Scale (MAS), and the secondary outcomes were walking performance and quality of life measured on different scales.

Out of the total of 483 records, 15 studies (389 participants) were finally found eligible for inclusion. A meta-analysis was performed and beneficial effects of ESWT were observed in the experimental group compared with the control group on spasticity. MAS: Standard mean difference (SMD = 0.626), (95%CI = -0.133, 1.119), (p < 0.01), ROM: (SMD = 0.573), (95%CI = 0.074, 1.072), (p < 0.02). The result for before and after ESWT application on TUG: (SMD = 0.174), (95%CI=-0.151, 0.499), (p = 0.29). The results for walking performance were not significant and inconclusive which may be due to the heterogeneity of the studies included.

Evidence suggests that ESWT has promising effects in reducing spasticity and improving lower limb motor function. However, uncertainty exists regarding its effectiveness in walking performance.