Appraisal Checklist Research Articles

Exploring the Association between Periodontitis and Erectile Dysfunction: A Systematic Review

Background: Periodontitis (PD) remains a global public health problem. Evidence revealed that PD contributes to the development of systemic diseases, including effects on men's sexual health such as erectile dysfunction (ED). Objective: To review and explore the association between PD and ED. Methods: Following PRISMA guidelines, a systematic review of studies published in Scopus, PubMed, ScienceDirect, and Google Scholar was conducted. A comprehensive literature search until February 2024 by combining several keywords and applying eligibility criteria was performed. JBI critical appraisal checklist was employed for quality assessment. Results: A total of 15 studies involving 216,753 subjects were included. Of the 15 studies, 13 of them demonstrated a significant association between PD and ED, the other two did not. Only one study included examination of hormonal and biochemical levels. Also, one study revealed that periodontal treatment was significantly associated with improving ED. Summary: According to the findings, a significant association between PD and ED is evident. It is believed that the inflammatory processes associated with PD contributes to the emergence of ED, yet the exact underlying mechanism remains unclear. The scarcity of research and the complexity of the association between PD and ED suggest that future rigorous studies should be conducted. Additionally, dentists and general practitioners must be aware of the interconnection between these diseases, enabling them to provide comprehensive education to patients, particularly concerning the prevention and management of periodontal disease.

Rituximab as a Therapeutic Strategy in Hemophagocytic Lymphohistiocytosis: Efficacy, Outcomes, and Survival-Insights From a Systematic Review.

Hemophagocytic lymphohistiocytosis (HLH) is a severe immunologic disorder that can be fatal if left untreated. The condition is characterized by excessive immune system activation and is often triggered by infections such as Epstein-Barr virus (EBV). Rituximab, an anti-CD20 monoclonal antibody, has been suggested as a treatment, particularly for EBV-associated HLH. A systematic review was conducted using PRISMA guidelines, with a literature search spanning PubMed, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria focused on studies that assessed rituximab's efficacy in treating HLH. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports. Of 783 identified records, 24 studies were included in the final analysis. Rituximab was typically administered at 375mg/m2, with varying doses and treatment frequency. Clinical response, often seen within 1 month, was assessed by improvements in clinical symptoms and laboratory findings. Survival rates posttreatment displayed a wide range, with instances of complete remission and disease-free periods, as well as reports of relapse and mortality. Rituximab demonstrates the potential for significant clinical benefit in treating HLH, particularly when associated with EBV, showing promise in reducing disease activity and contributing to remission. These findings encourage further research and clinical trials to refine the therapeutic protocols and better understand the long-term effects of rituximab in HLH management.

The Experiences and Perceptions of Older Adults with Multimorbidity Toward E-Health Care: A Qualitative Evidence Synthesis.

Background: Given the growing population of older adults globally, e-Health plays an indispensable role in the chronic disease management of multimorbidity. However, qualitative evidence that synthesizes the experiences of older adults with multimorbidity using e-Health service is currently lacking. The objective was to explore the experiences and perceptions of e-Health care in community-based settings among the older adults with multimorbidity. Methods: Seven electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, China National Knowledge Infrastructure, and Chinese BioMedical Literature were searched, and the search was limited to studies from inception to September 1, 2023. Screening, data extraction, and quality appraisal were conducted independently by two reviewers. Thomas and Harden's thematic synthesis methodology was applied to synthesize the original themes. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the confidence of synthesized themes was evaluated by the Confidence in the Evidence from Reviews of Qualitative Research approaches. Results: Ten studies with moderate methodological quality met eligibility criteria and were included finally. Studies were conducted in four countries with 235 participants who were living with multiple chronic conditions. Among the 10 included studies, 37 credible findings were extracted and interpreted into 3 synthesized themes and 12 subthemes: (1) advantages and benefits perceived during e-Health service, (2) multidimensional challenges and negative experience posed by e-Health service, and (3) preferences, suggestions, and expectations for future e-Health improvement. The confidence in the majority of the three final synthesized themes was rated between "low" and "moderate" scales. Conclusions: The findings of this study provide new insights into implementing tailored e-Health care for older adults with multimorbidity. Further research should emphasize on realizing the potential value of e-Health service based on users' needs and perspectives to promote age-friendliness in geriatric practice.

The general impact of self-stigma of mental illness on adult patients with depressive disorders: a systematic review

BackgroundMental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called ‘self-stigma’. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression.MethodsAn etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants’ exposure to mental illness self-stigma, participants’ experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias.ResultsIn December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression.ConclusionSelf-stigma of depression has negatively impacted multiple aspects of the patient’s life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies.Trial registrationThe research proposal for this review has been registered to Prospero (ID number: CRD42022366555).

Prevention and management of rebound pain after resolution of regional block: a systematic review.

An extreme pain known as rebound pain develops after regional blockage wears off. Patient, surgical, and anesthesia-related factors influence the occurrence and intensity of rebound pain. Prior to the peripheral nerve block (PNB) being resolved, multimodal therapy should use. The objective of this review was to explore rebound pain prevention and management following PNB resolution. We conducted a thorough search across Pub Med, Hinari, Google Scholar, and Cochrane review databases, utilizing relevant keywords and search parameters to identify studies meeting our inclusion criteria. These studies aimed to provide sufficient evidence regarding the prevention and management of rebound pain following the resolution of regional blocks. Duplicate entries were removed using Endnote software. Screening of the literature was performed using a rigorous appraisal checklist. The findings of this review are reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Using an electronic search, 3526 items were found from databases and websites. After removing duplicates (n=500), 3026 articles remained. Of these, 2813 were excluded after going through their titles and abstracts. Of the 213 articles screened, 126 were removed for such reasons as ineligibility or similarity in objectives. Of the remaining 87 studies, 37 were excluded for such reasons as the inaccessibility of free full texts. Finally, 50 studies were included for review. Proper patient education about rebound pain, combined with the utilization of multimodal systemic analgesia before the resolution of PNBs, perineural dexamethasone, and employing a combination of nerve blocks, has been demonstrated to decrease the incidence of rebound pain. Therefore, clinicians should aim to prevent and manage rebound pain by implementing perioperative multimodal strategies before the resolution of regional blocks.

Germline rare variants in HER2-positive breast cancer predisposition: a systematic review and meta-analysis.

Approximately 10% of breast cancer (BC) cases result from hereditary causes. Genetic testing has been widely implemented in BC care to determine hereditary cancer syndromes and personalized medicine. Thus, identification of individuals carrying germline pathogenic variants could be useful to provide appropriate prophylactic or screening measures for each BC subtype, however, there are few formal recommendations for genetic testing in this sense so far. In this study, we assessed rare germline variants in a specific group of genes in order to determine the association with human epidermal growth factor 2 enriched (HER2+) BC phenotype through a systematic review and meta-analysis comparing subtypes overexpressing HER2 with other clinically recognized subtypes of BC. This review was registered with PROSPERO (ID: CRD42023447571). We conducted an online literature search in PubMed (MEDLINE), Scopus, and EMBASE databases. We included original studies that investigated germline variants in HER2+ BC patients and selected the studies that reported only rare and/or pathogenic germline variants. We assessed the risk of bias and quality of the studies using the Joanna Briggs Institute Critical Appraisal checklists and the Modified Newcastle-Ottawa Scale for Genetic Studies, respectively. Considering hormone receptor and HER2 expression status, we compared gene-based risks initially in HR-HER2-, HR+HER2-, HR+HER2+, and HR-HER2+ groups, conducting separate meta-analyses using the random effects model for each comparison, and within them for each gene. Of the total 36 studies describing germline variants, 11 studies provided information on the prevalence of variants in the different clinically relevant BC subtypes and allowed comparisons. Germline variants within eight genes showed significant differences when meta-analyzed between the BC groups: BRCA1, BRCA2, TP53, ATM, CHEK2, PALB2, RAD51C, and BARD1. Notably, TP53, ATM, and CHEK2 germline variants were identified as predisposing factors for HER2+ subtypes, whereas BRCA1, BRCA2, PALB2, RAD51C, and BARD1 germline variants were associated with a predisposition to low HER2 expression. Main concerns about bias and quality assessment were the lack of confounding factors control; and comparability or outcome assessment, respectively. Our findings underscore the connection between germline variants and differential expression of the HER2 protein and BC subtypes. https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023447571.

Alternative Health Care among Type 2 Diabetes in ASEAN Countries: A Scoping Review

Introduction: The prevalent rate of diabetes is increasing among the world and ASEAN countries itself. The treatment using alternative health care (AHC) is one of exist medication among diabetes patients. In addition, the evidence on the management of diabetes through the use of traditional medicine has not been addressed before. Objective: The purpose of this scoping review was to review and summarize the AHC therapies in literature that are the most well-known and successful for glycemic control complication and the burden among diabetes patients in ASEAN countries. Methods: To access all studies and articles related to the scoping review’s aim, seven databases were searched. The seven data based included PubMed, ProQuest, ScienceDirect, SCOPUS, Google Scholar, the Cochrane Library, and CINAHL unlimited until August 12, 2023. The search method used keywords “diabetes”, “alternative health care”, “ASEAN” and “Indonesia”, modifying the search statements of these phrases so that they were compatible with the various databases. Results: The result of study after critical appraisal using JBI critical appraisal checklist for RCT were found three kinds of alternative health care for diabetes patients, first herbs or traditional medication which are herbal extract of cinnamon bark powder 3%, pandan leaf 6%, and bay leaf 9% and herbs extract of breadfruit life, second community care, there is CIIC (Community Integrated Intermediary Care), and third, mind and body therapies such as acupuncture, acupressure and message. Conclusion: The utilization of AHC (Alternative Health Care) has demonstrated its efficacy in the management of diabetes, leading to enhanced clinical outcomes and a decrease in both blood glucose levels and associated burdens. Despite the scarcity of empirical data, it is widely acknowledged that the recommended therapeutic interventions yield advantages in inducing relaxation, which subsequently contributes to the alleviation of stress.

Barriers and facilitators to uptake and use of oral pre-exposure prophylaxis in pregnant and postpartum women: a qualitative meta-synthesis

BackgroundAcute HIV infection during pregnancy and in the postpartum period increases the risk of vertical transmission. The World Health Organization (WHO) has recommended preexposure prophylaxis for pregnant and postpartum women at risk of acquiring HIV. However, there are significant gaps between the actual practice and the ideal goal of preexposure prophylaxis implementation among pregnant and postpartum women. Therefore, it is important to determine what influences women’s implementation of preexposure prophylaxis during pregnancy and in the postpartum period. This review aims to aggregate barriers and facilitators to preexposure prophylaxis implementation among pregnant and postpartum women.MethodsA range of electronic databases, including PubMed, CINAHL Plus with Full Text, Embase, and Web of Science, were searched for potentially relevant qualitative studies. The search period extended from the establishment of the databases to March 16, 2023. This review used the ENTREQ (Enhancing transparency in reporting of qualitative research synthesis) statement to guide the design and reporting of qualitative synthesis. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The JBI meta-aggregation method was applied for guiding the data extraction, and the JBI ConQual method was applied for guiding the evaluation of the level of evidence for the synthesis.ResultsOf retrieved 2042 studies, 12 met the inclusion criteria. The total population sample included 447 participants, including 231 pregnant and postpartum women, 21 male partners, 75 healthcare providers (HCPs)/healthcare workers (HCWs), 18 policymakers, 37 mothers, and 65 women of childbearing age. A total of 149 findings with credibility ratings of “unequivocal” or “equivocal” were included in this meta-synthesis. Barriers and facilitators to preexposure prophylaxis implementation were coded into seven categories, including three facilitator categories: perceived benefits, maintaining relationships with partners, and external support, and four barriers: medication-related barriers, stigma, barriers at the level of providers and facilities, and biases in risk perception.ConclusionThis systematic review and meta-synthesis aggregated the barriers and facilitators of preexposure prophylaxis implementation among pregnant and postpartum women. We aggregated several barriers to maternal preexposure prophylaxis implementation, including medication-related factors, stigma, barriers at the level of providers and facilities, and risk perception biases. Therefore, intervention measures for improving preexposure prophylaxis services can be developed based on these points.PROSPERO NumberCRD42023412631.

Characteristics and Clinical Features of Anorectal Malformations Without Fistula: A Systematic Literature Review

Anorectal malformation (MA) without fistula is a form of congenital abnormality that is often found in newborn babies. This study aims to identify the characteristics and clinical features of MA without fistula based on the latest scientific evidence. A systematic search was conducted on the PubMed, Scopus, and Web of Science databases using relevant keywords. Inclusion criteria included observational studies reporting the characteristics and clinical features of MA without fistula in humans. Two independent researchers conducted study selection, data extraction, and study quality assessment using the JBI Critical Appraisal Checklist tool. A total of 25 studies (2018-2024) involving 1548 MA patients without fistula met the inclusion criteria. The majority of patients were male (62%). The average age at diagnosis is 2 days. The most frequently reported clinical symptoms were absence of anus (100%), abdominal distension (78%), and vomiting (65%). The most common classification of MA without fistula was perineal (45%), followed by vestibular (30%) and cloacal (25%). The most frequently performed definitive surgery was perineal anoplasty (55%), followed by posterior sagittal anorectoplasty (PSARP) (35%) and laparoscopic-assisted anorectoplasty (10%). The most frequently reported postoperative complications were anal stenosis (15%), surgical wound infection (10%), and rectal prolapse (5%). MA without fistula is more common in male babies. The main clinical symptoms are absence of anus, abdominal distension, and vomiting. The perineal classification is the most common. Perineal anoplasty is the most frequently performed definitive surgery. Post-operative complications that need to be watched out for are anal stenosis, surgical wound infection, and rectal prolapse.

The association between genetic factors and temporomandibular disorders: A systematic literature review

ObjectiveThis study aimed to investigate the correlation between genetic factors and the occurrence and progression of temporomandibular disorders (TMDs) using a comprehensive review and meta-analysis. DesignA comprehensive search was conducted using the ScienceDirect, PubMed, Cochrane Library, Dimensions, and Emerald databases. A reviewer selected the study using modified PICO criteria, considering human subjects with TMDs, comparing different genetic factors among TMD and non-TMD patients, and reporting TMD signs and symptoms as outcomes. The methodological standards of the eligible papers were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Non-randomized Experimental Investigations. Information was collected methodically and examined. ResultsThe electronic database search yielded 851 articles, 19 of which were included in this study. The data analysis showed a significant influence of genetic factors, such as polymorphisms and gene differences, on the development of TMD signs and symptoms, such as myofascial pain, chronic pain, and disc displacement. In addition, gene polymorphism significantly influenced TMD development, with an odds ratio of 2.46 (1.93–3.14) and p of 0.00001. ConclusionsGenetic factors significantly influenced TMD signs and symptoms, and genetic polymorphisms significantly influenced TMD onset and progression. Further research should be conducted in diverse settings with larger sample sizes to verify and validate these findings.

Prevalence of post-traumatic stress disorder and depressive symptoms among civilians residing in armed conflict-affected regions: a systematic review and meta-analysis

BackgroundGlobally, populations afflicted by armed conflict are known to have high rates of mental health disorders.AimsThis meta-analysis aims to estimate the prevalence of post-traumatic stress disorder (PTSD) and depressive symptoms...

Cyberincivility among Adolescents: A Systematic Review of Qualitative Evidence.

The ubiquitous use of social media places adolescents at high risk for cyberincivility (disrespectful, insensitive, or disruptive online behaviors). Adolescents who experience cyberincivility can have mental health issues including depression and suicidal ideation. However, no reviews synthesized findings from qualitative studies on cyberincivility among adolescents, which was the aim of this review. Eleven articles were extracted from MEDLINE, Embase, PsycINFO, ERIC, and Education Full Text. Study qualities were assessed using the JBI Critical Appraisal Checklist. A meta-ethnographic framework guided the thematic analysis. Five themes were identified: forms of cyberincivility, platforms used for cyberincivility, perceptions and understanding of cyberincivility, adverse impact on health, and perceptions of seeking support. Social media was often used for cyberincivility, and common forms of cyberincivility included impersonation, aggressive verbal behaviors, and social exclusion. Adolescents perceived cyberincivility as persistent and relentless, with severe health impacts including depression, but they hesitate to seek support. Considering the negative impact of cyberincivility on adolescents' physical and mental well-being, it is important to develop anti-cyberincivility programs in schools. Schools have opportunities to efficiently reach both perpetrators and victims of cyberincivility with anti-cyberincivility programs rooted in trust building and engagement from family, community, and peers.

Self-Directed Home- and Community-Based Services Improve Outcomes for Family Caregivers: A Systematic Review.

Self-direction is an approach that allows older adults and people with disabilities to determine the home- and community-based services they receive, including the ability to hire caregivers of their choice. Self-direction has been shown to improve outcomes for the service recipients. The promotion of choice and control in self-direction may also affect family caregivers. We conducted a systematic review examining the impact of self-direction on a broad range of caregiver outcomes. We conducted a systematic review guided by PRISMA guidelines. Literature search was conducted in 8 databases. We appraised risk of bias using the Joanna Briggs Institute critical appraisal checklists and assessed certainty of evidence using the GRADE framework. Sixteen studies meeting inclusion criteria were included. We found, with moderate certainty, that self-direction is associated with improved caregivers' personal and social well-being. Caregivers also reported reduced unmet needs and increased access to care for the care recipients under self-direction. Self-direction did not appear to reduce caregiving hours. With less certainty, self-direction was also positively associated with increased respite care use, perception of choice, and intention to continue caregiving by caregivers. Beyond delivering person-centered services that improve recipient outcomes, self-direction may also improve the outcomes of family caregivers.

Hemocoagulation Conditions Associated with Venom-Induced Consumption Coagulopathy due to Snakebite in Humans

Highlights:1. This review comprehensively highlighted aspects of hematologic abnormalities in snakebites, a topic that remains understudied globally.2. This review contributes insights into the field of snakebite research and improves the management of snakebites by examining the diverse effects of different types of snakebites on hemocoagulation status. Abstract Snakebite remains an underreported health hazard worldwide. The most common effects of snakebite envenomation globally are hematological disorders, with venom-induced consumption coagulopathy (VICC) being the most prevalent and significant condition. This review aimed to explore the hematological aspects of snakebite, with a focus on snakebite-induced consumption coagulopathy. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a search across several databases, namely PubMed, ScienceDirect, and Google Scholar. The inclusion criteria for this review were studies on snakebite envenomation in humans with a discussion of relevant cases. Additionally, the included studies were conducted between 2010 and 2023 and published in the English language. Studies on animal models were excluded. We used the keywords “venom-induced consumption coagulopathy AND snake" in the search. The critical appraisal was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and the Mixed Methods Appraisal Tool (MMAT). The findings were presented as a qualitative synthesis of 14 articles covering 316 patients and various snakebite types. The studies on snakebite came from various countries, but mostly from Sri Lanka. The snake types exhibited variation, with certain species existing only in specific areas. The subjects fell into different age groups, from children to the elderly. The majority of the subjects were male. The subjects' youngest age was 6 years old, while the oldest was 70 years old. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were the most discussed variables. Some of the studies demonstrated an increase in PT and APTT, although other studies reported contrasting findings. In conclusion, certain types of snakebite have a different impact on the hemocoagulation status.

Factors Influencing Dementia Care Competence among Care Staff: A Mixed-Methods Systematic Review Protocol.

Dementia care competence is defined as the ability, acquired through practical experience, to deliver high-quality care services to persons with dementia (PWD). However, many studies only focus on one aspect of competence using qualitative or quantitative research design and have small sample sizes of care staff with dementia. This study aims to conduct a mixed-methods systematic review of the factors influencing the competence of dementia care staff, and explore the relationship between these factors and competence. This review was designed following the PRISMA-P 2015 statement and methodological guidance for the conduct of mixed-methods systematic reviews from the Joanna Briggs Institute (JBI). Seven English and four Chinese databases will be searched to systematically review the existing eligible studies. JBI Critical Appraisal Checklist for Qualitative Research and Analytical Cross-Sectional Studies will be used to assess the methodological quality of each study. A JBI Mixed-Methods Data Extraction Form will be applied for data extraction. The JBI convergent integrated approach will be used for data synthesis and integration. The synthesized findings will be graded according to the JBI ConQual approach as high, moderate, low, or very low. The protocol was registered with PROSPERO in October 2023 (CRD42023474093).

Eye care service utilization and associated factors among diabetic patients in Africa: A Systematic Review and Meta-Analysis

Introduction'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international agency for the prevention of blindness, was launched in 1999, however, the initiative faces many challenges to hitting its target. One of the challenges for this is, the absence of comprehensive data regarding eye care service utilization among diabetes mellitus patients in Africa. Therefore, this study was aimed at assessing the prevalence of eye care service utilization and associated factors among adult diabetes mellitus patients in Africa. MethodsThis systematic review and meta-analysis was conducted as per the international preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Published articles were searched using reputable databases (PubMed, Cochrane Library) and Web searches (Science Direct, African Journals Online, and Google Scholar). Quality appraisal was assessed based on the Joanna Briggs Institute's (JBI) critical appraisal checklist. The extracted data was exported to STATA version 11 (STATA Corp., LLC) for further analysis. Heterogeneity between the results of primary studies was assessed using Cochran's Q chi-square test and quantified with the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression tests. ResultsThe database search found 26,966 articles. The pooled prevalence of eye care service utilization among diabetic patients in Africa is found to be 40.92 % (95 % CI: 27.14–54.70, P < 0.001). Good knowledge (POR = 3.57, 95 % CI: 2.67–4.76), good attitude (POR = 5.68, 95 % CI: 4.20–7.68), age greater than 65 years old (POR = 7.11, 95 % CI: 3.86–13.10), urban residence (POR = 5.03, 95 % CI: 2.12–11.96), and disease duration greater than 6 years (POR = 3.81, 95 % CI: 2.25–6.45) were factors associated with eye care service utilization. ConclusionThis meta-analysis revealed that a high proportion of people with diabetes failed to use eye care services. Older age, good knowledge, urban residence and longer duration of illness were found to be the contributing factors for the utilization of eye care services in diabetes mellitus patients. Therefore, by considering the negative impact of low eye care service utilization, it is important to improve the habit of regular screening of the eye into routine assessment of diabetes mellitus follow up targeting patients with older age and longer duration of illness to reduce the magnitude of the problem.

Variables associated with the secure attachment relationship with the teacher in adolescent students:

This document is a systematic review protocol that aims to investigate the variables associated with adolescent students' secure attachment relationship with teachers. The existing systematic review on this topic found that children with a secure attachment relationship with teachers have better academic and socio-emotional indices. However, there are currently no similar reviews for adolescents. Inclusion criteria for articles include: published in peer-reviewed journals in Portuguese, English, or Spanish; from 1969 to present; a sample of adolescents (10 to 19 years old); and results related to attachment with teachers. Furthermore, studies must be empirical, have Attachment Theory as a theoretical basis, and gathered from the following databases: ERIC (EBSCO), MEDLINE (EBSCO), PsycINFO (Ovid), Web of Science, Scopus, Scielo, Redalyc. The JBI Critical Appraisal checklists will be used to verify the risk of bias as well as the quality of the studies. It intends to present the outcomes through narrative descriptions and, if possible, meta-analytical statistics.

Global prevalence of antibiotic consumption during pregnancy: A systematic review and meta-analysis

Antibiotic use during pregnancy is widespread with notable variations across regions. This systematic review and meta-analysis (Prospero protocol CRD42023418979) examines the prevalence and variability of antibiotic use in pregnancy globally and regionally, considering different methodologies and maternal characteristics. We searched Embase, PubMed, and Web of Science for observational studies published in English from the year 2000 and onwards. Random-effect meta-analyses were used to pool the prevalence of antibiotic consumption during pregnancy, presented as percentages with 95% confidence intervals (CI). Joanna Briggs Institute Critical appraisal checklist for prevalence studies was used for bias assessment. Overall, 116 studies (14 from Africa, 24 from the Americas, six from Eastern Mediterranean, 57 from Europe, four from South-East Asia and 11 from Western Pacific) were included (33,821,194 pregnancies). The majority of studies (84.5%) were appraised with a low risk of bias. The prevalence of antibiotic consumption during pregnancy ranged between 0.04 to 90%, with a pooled estimate of 23.6% (95% CI: 20.1-27.5, I2 =100%). Low-income countries had the highest pooled prevalence (45.3%, 95% CI: 15.4-79.1, I2 =99.6%). Regionally, the Western Pacific had the highest pooled prevalence (34.4%, 95% CI: 13.4-64.1, I2 =100%). The prevalence of antibiotic consumption during pregnancy increased over time in the Americas and Western Pacific. The studies exhibited considerable heterogeneity (I2 >95%), and the trim-and-fill method estimated a potential 10% underestimation of the overall pooled prevalence, suggesting publication bias. This meta-analysis suggests that about 1/4 of women worldwide use antibiotics during pregnancy. This study suggests a high prevalence of antibiotic consumption during pregnancy with disparities according to region and level of country income, ethnicity and whether antibiotics were prescribed or self-medicated. There was a variability in reported findings across age categories, potential bias from small sample sizes, and language bias from including only studies published in English.

Current Evidence for a New Surgical Technique for Scleral Fixation: The Implantation of a Carlevale Lens, a Systematic Review.

Background: The Carlevale lens (FIL SSF, Soleko IOL Division, Italy) is a new lens for suture-less scleral fixation. This paper aimed to systematically review articles on this lens, the surgical techniques used for its implantation, complications and outcomes. Methods: This systematic review was performed following the PRISMA guidelines. The search string used was "Carlevale" AND "scleral fixation" from inception until March 2024. For completeness, either case-control studies, case reports or case series written in English were included. The authors used the Newcastle-Ottawa scale for the case-control studies and the JBI Critical Appraisal Checklist for case reports and case series. Results: Twenty-nine articles were included. Scleral fixation with Carlevale lens can be performed by creating scleral flaps or, alternatively, by using scleral pockets. The two sclerotomies must be diametrically opposed, and are preferably created by 25-gauge trocars. A pars plana vitrectomy should be performed every time, and the design of the lens should be suitable for self-anchoring to the sclera; the most accredited strategy to achieve this is to avoid scleral sutures. There were only a few intraoperative and postoperative complications reported; vitreous hemorrhages were the most frequent intraoperative events, while the most relevant postoperative complications were vitreous hemorrhages, cystoid macular oedema and transient variations in the intraocular pressure. Excellent results have been obtained in terms of BCVA, IOL centration and stability, mean intraocular pressure, postoperative spherical equivalent, separation between anterior and posterior chamber and the distance of the IOL from anterior chamber structures. Conclusions: The foldable hydrophilic design of the Carlevale lens has shown good effectiveness, IOL stability and few intra and post-operative complications.

Critical appraisal and assessment of bias among studies evaluating risk prediction models for in-hospital and 30-day mortality after percutaneous coronary intervention: a systematic review

ObjectiveWe systematically assessed prediction models for the risk of in-hospital and 30-day mortality in post-percutaneous coronary intervention (PCI) patients.DesignSystematic review and narrative synthesis.Data sourcesSearched PubMed, Web of Science, Embase, Cochrane...