Comprehensive Systematic Review Research Articles

Does Aid Matter? A Systematic Review and Meta-Analysis of the Effects of Grant Aid on College Student Outcomes

The College Board reported that, in 2022–2023, about two thirds of $177 billion in U.S. financial assistance awarded to undergraduates through programs sponsored by the federal government, state governments, colleges and universities, philanthropic organizations, and other entities was in the form of grants. While researchers have examined the effects of individual grant aid programs on particular college student outcomes, results have indicated varied effects. Moreover, individual study findings have not been widely synthesized or examined to understand why some programs succeed where others do not. We conducted a comprehensive systematic review and meta-analysis to provide structure to this varied field and better understand programmatic effects. The results of the systematic searching and screening yielded 86 studies, across seven outcome domains, and the meta-analysis synthesized findings from 709 effect sizes from study samples representing 7,656,062 individuals. The meta-analytic results found small but meaningful positive average effects on college enrollment, credit accumulation, persistence, and completion. We cannot conclude from available studies that grant aid increased academic achievement or postcollege labor market outcomes. We also found that grants had larger positive effects on credit accumulation for studies with samples of students at 2-year institutions and studies that combined samples of 2- and 4-year students than for studies with samples of students at 4-year institutions only. Using a relatively new method called an evidence gap map, we illustrate where researchers should focus on producing new evidence.

Landscape of NRXN1 Gene Variants in Phenotypic Manifestations of Autism Spectrum Disorder: A Systematic Review.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication challenges and repetitive behaviors. Recent research has increasingly focused on the genetic underpinnings of ASD, with the Neurexin 1 (NRXN1) gene emerging as a key player. This comprehensive systematic review elucidates the contribution of NRXN1 gene variants in the pathophysiology of ASD. Methods: The protocol for this systematic review was designed a priori and was registered in the PROSPERO database (CRD42023450418). A risk of bias analysis was conducted using the Joanna Briggs Institute (JBI) critical appraisal tool. We examined various studies that link NRXN1 gene disruptions with ASD, discussing both the genotypic variability and the resulting phenotypic expressions. Results: Within this review, there was marked heterogeneity observed in ASD genotypic and phenotypic manifestations among individuals with NRXN1 mutations. The presence of NRXN1 mutations in this population emphasizes the gene's role in synaptic function and neural connectivity. Conclusion: This review not only highlights the role of NRXN1 in the pathophysiology of ASD but also highlights the need for further research to unravel the complex genetic underpinnings of the disorder. A better knowledge about the multifaceted role of NRXN1 in ASD can provide crucial insights into the neurobiological foundations of autism and pave the way for novel therapeutic strategies.

Advancements in Sensor Technologies and Control Strategies for Lower-Limb Rehabilitation Exoskeletons: A Comprehensive Review.

Lower-limb rehabilitation exoskeletons offer a transformative approach to enhancing recovery in patients with movement disorders affecting the lower extremities. This comprehensive systematic review delves into the literature on sensor technologies and the control strategies integrated into these exoskeletons, evaluating their capacity to address user needs and scrutinizing their structural designs regarding sensor distribution as well as control algorithms. The review examines various sensing modalities, including electromyography (EMG), force, displacement, and other innovative sensor types, employed in these devices to facilitate accurate and responsive motion control. Furthermore, the review explores the strengths and limitations of a diverse array of lower-limb rehabilitation-exoskeleton designs, highlighting areas of improvement and potential avenues for further development. In addition, the review investigates the latest control algorithms and analysis methods that have been utilized in conjunction with these sensor systems to optimize exoskeleton performance and ensure safe and effective user interactions. By building a deeper understanding of the diverse sensor technologies and monitoring systems, this review aims to contribute to the ongoing advancement of lower-limb rehabilitation exoskeletons, ultimately improving the quality of life for patients with mobility impairments.

Resveratrol and male infertility: a systematic review of the literature.

The aim of this study is to provide an updated and comprehensive systematic review on the effects of resveratrol (RSV) in male infertility and sperm preservation. This systematic review followed the MOOSE guidelines for Meta-analyses and Systematic Reviews of Observational Studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Only original articles evaluating the effect of RSV on human spermatozoa in vivo or in vitro were included. Of the 1806 abstracts evaluated for eligibility, only 12 studies were included in the qualitative synthesis, of which three were prospective in-vivo studies and nine were in-vitro studies. Out of three human studies on RSV, only two studies administered RSV alone, one of them reported a positive impact and the other reported no significant impact on semen parameters. Overall, the in-vitro studies have reported the ability of RSV to protect spermatozoa against damage due to freeze-thaw cycles during cryopreservation. Other in-vitro studies have reported positive effects of RSV in fresh samples and protective effects in cell lines. Available in-vivo studies are controversial with regard to the effect of RSV in improving semen parameters. In-vitro studies support the use of RSV before sperm cryopreservation. Further well-designed prospective studies on large sample sizes are needed to fully understand the role of RSV in the treatment of male infertility in vivo.

What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries? A systematic review

BackgroundAs many patients are spending their last days in critical care units, it is essential that they receive appropriate end-of -life care. However, cultural differences, ethical dilemmas and preference practices can arise in the intensive care settings during the end of life. Limiting therapy for dying patients in intensive care is a new concept with no legal definition and therefore there may be confusion in interpreting the terms ‘no resuscitation’ and ‘comfort care’ among physicians in Middle East. Therefore, the research question is ‘What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries?’MethodsThe authors conducted a comprehensive systematic literature review using five electronic databases. We identified primary studies from Medline, Embase, CINAHL, Psycinfo and Scopus. The team assessed the full-text papers included in the review for quality using the Joanna Briggs Institute checklist (JBI). We completed the literature search on the first of April 2022 and was not limited to a specific period.ResultsWe identified and included nine relevant studies in the review. We identified five main themes as end-of-life care challenges and/or facilitators: organisational structure and management, (mis)understanding of end-of-life care, spirituality and religious practices for the dying, communication about end-of-life care, and the impact of the ICU environment.ConclusionsThis review has reported challenges and facilitators to providing end-of-life care in ICU and made initial recommendations for improving practice. These are certainly not unique to the Middle East but can be found throughout the international literature. However, the cultural context of Middle East and North Africa countries gives these areas of practice special challenges and opportunities. Further observational research is recommended to confirm or modify the results of this review, and with a view to developing and evaluating comprehensive interventions to promote end-of-life care in ICUs in the Middle East.

Comparison of efficacy and safety between daptomycin plus β-lactam and daptomycin monotherapy for bloodstream infections due to gram-positive cocci: A systematic review and meta-analysis

ObjectivesWe performed a comprehensive systematic review and meta-analysis to evaluate the clinical or microbiological outcomes and safety of a combination of daptomycin (DAP) and β-lactams compared to DAP monotherapy in patients with blood stream infection (BSI) due to gram-positive cocci (GPC). MethodsWe searched Scopus, PubMed, EMBASE, CINAHL, and Ityuushi databases up to January 30, 2023. Outcomes included all-cause mortality, clinical failure, and creatine phosphokinase (CPK) elevation. ResultsSix cohorts or case-control studies fulfilled the inclusion criteria and were included in the final meta-analysis. Combination therapy of DAP and β-lactams significantly reduced the mortality and clinical failure rate for all BSI due to GPC compared with the DAP monotherapy (mortality, odds ratio [OR] = 0.63, 95 % confidence interval [CI] = 0.41–0.98; clinical failure, OR = 0.42, 95 % CI = 0.22–0.81). In contrast, no significant difference was noted in the incidence of CPK elevation between the two groups (OR = 0.85, 95 % CI = 0.39–1.84). ConclusionAltogether, combination therapy of DAP and β-lactams can improve the prognosis for patients with BSI due to GPC compared with DAP alone. Therefore, it should be considered as an option for the empirical treatment of BSI caused by GPC.

Muslim women’s tourist gaze: a comprehensive systematic review

Muslim women’s tourist gaze: a comprehensive systematic review

A SMARTPHONE APPLICATION FOR LEARNING ARABIC VOCABULARY: A COMPREHENSIVE SYSTEMATIC REVIEW

The drastic technological advancement has paved the way for innovative approaches to language learning, with smartphone applications emerging as powerful tools in education. This systematic review explores the design and evaluation of a smartphone application that enhances Arabic vocabulary acquisition. Numerous language learning applications exist. Nevertheless, a gap exists in the literature regarding the specific design elements and evaluation criteria tailored for Arabic vocabulary acquisition. This review addresses the lack of a consolidated understanding of the challenges and opportunities in developing a smartphone application dedicated to learning Arabic vocabulary. This comprehensive systematic review explores the design and evaluation of smartphone applications dedicated to enhancing Arabic vocabulary acquisition, employing advanced search techniques on Scopus and Eric databases with keywords “smart phone,” “Arab,” and “vocabulary.” The flow of the study is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. The final primary data (n = 28) articles were identified, clustering around three main themes: (1) Language Skills and Comprehension in Bilingual Contexts, (2) Technology and Language Learning, and (3) Corpus and Text Analysis. This systematic review contributes to the academic discourse by highlighting the current landscape and paving the way for future research in the dynamic intersection of technology and Arabic language education. This systematic review sheds light on the current landscape of smartphone applications designed for learning Arabic vocabulary. The findings from this review are expected to inform educators, developers, and policymakers, ultimately contributing to improving Arabic language education through innovative technological solutions.

Computer-based pre- and intra-operative planning modalities for Total Knee Arthroplasty: A comprehensive review

Introduction Since the introduction of total knee arthroplasty (TKA) into modern medicine, many types of digital pre- and intra-operative planning methods have been introduced. Due to the abundance of planning modalities for TKA, physicians are posed with the challenge of which type to implement into their daily practice. In the current fast-paced and research-driven medical environment it is important to understand the differences between the computer-based pre- and intra-operative planning modalities for TKA. Materials and methods The following databases were searched: MedLine, EMBASE, Web of Science, and the Cochrane Library. All articles were independently reviewed by the two reviewers (DS, ID). The following data were extracted, if available: study ID, country of conduction, type of planning modality or modalities, and the use and explanation of historical and currently employed pre- and intra-operative planning modalities for TKA. Results 39 studies were included into the systematic review. Computer assisted surgery (CAS) represents a surgical concept where computer technology is used for surgical planning. CAS for TKA was introduced in the late 1980s. Subsequently, three different types of CAS were developed to plan TKA. The first type of CAS, computer integrated instruments, also known as CAS navigation, provides a real-time view of anatomy and marked surgical instruments intra-operatively. For the second type of CAS, rapid prototyping, or 3D printing, was derived from CAS technology in which the development of patient specific instrumentation (PSI) for TKA followed. Furthermore, CAS aided the evolution of the third type of CAS for TKA: robotics. Conclusion With a high demand for TKA surgery, the challenge to achieve more accurate alignment, improved prosthesis survival, and improved patient satisfaction rates is a very topical one. Planning modalities for TKA were developed to address this demand. This comprehensive systematic review showed that the monumental development of digital planning modalities for TKA has led to a vast amount of well-researched options that surgeons can choose from and use in daily practice.

Network Meta-Analysis for Determining the Best Lean Tools Synergy to Improve Productivity by Reducing Rework in Garment Factories

The textile industry plays an important role in the global economy; however, it faces persistent challenges related to reducing rework for improving productivity. The purpose of this study is to summarize some scientific researches about production delay caused by rework in a clothing and accessory industry. It provides a general overview of the current state of knowledge concerning the interdependence between reduced productivity and rework rate. The research process is based on the Functional Analysis System Technique. It facilitates a systematic examination of sequential and logical steps necessary to achieve objective and attain outcomes. Functional Analysis System Techniques not only provides a structured methodology but also aids in identifying the successive functions crucial for attaining desired outcomes. The initial phase involves conducting a comprehensive systematic literature review focused on productivity issues stemming from rework within the textile industry. The first phase, related to the Seiri of the 5S methodology, involves conducting a comprehensive systematic literature review focused on productivity issues stemming from rework within the textile industry. Subsequently, the filling of a literature review synthesis matrix using Excel is conducted which represents Seiton. Next, focusing specifically on the Lean tools employed utilized and the corresponding productivity improvements, data are extracted. This corresponds to Seiso step. Following this, a Network Meta-Analysis is applied, representing the Seiketsu. Finally, the identification of the most effective Lean tools combination to reduce rework is undertaken, corresponding to Shitsuke. As results, the Ishikawa Diagram appears to have obtained the best ranking position according to the rankogram. Ishikawa Diagram is often associated with other tools to multiply its performance. The study's findings highlight that the Ishikawa, Pareto, Single-Minute Exchange of Die and Work Study combination emerges as the most effective approach for minimizing rework and enhancing productivity, as indicated by the League Table. This network meta-analysis provides a comprehensive overview of the Lean tools synergy effectiveness in rework reduction and productivity improvement strategies in textile industries. While powerful, Network Meta-Analysis has limitations including reliance on indirect comparisons from studies that may not directly compare all treatments, inheriting biases and complexities, which can pose challenges in assessing result certainty.

Effects of intra-articular injection of platelet-rich plasma on the inflammatory process and histopathological characteristics of cartilage and synovium in animals with osteoarthritis: a systematic review with meta-analysis

BackgroundOsteoarthritis (OA) affects the entire joint, causing structural changes in articular cartilage, subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles that afflicts millions of people globally, leading to persistent pain and diminished quality of life. The intra-articular use of platelet-rich plasma (PRP) is gaining recognition as a secure therapeutic approach due to its potential regenerative capabilities. However, there is controversial clinical data regarding efficacy of PRP for OA treatment. In this context, gathering scientific evidence on the effects of PRP in treating OA in animal models could provide valuable insights into understanding its impact on aspects like cartilage health, synovial tissue integrity, and the inflammatory process in affected joints. Thus, the objective of this study was to assess the effects of PRP injections on inflammation and histopathological aspects of cartilage and synovium in animal models of OA through a comprehensive systematic review with meta-analysis.MethodsA electronic search was conducted on Medline, Embase, Web of Science, The Cochrane Library, LILACS, and SciELO databases for relevant articles published until June 2022. A random-effects meta-analysis was employed to synthesize evidence on the histological characteristics of cartilage and synovium, as well as the inflammatory process. The GRADE approach was utilized to categorize the quality of evidence, and methodological quality was assessed using SYRCLE’s RoB tool.ResultsTwenty-one studies were included in the review, with twelve of them incorporated into the meta-analysis. PRP treatment demonstrated superior outcomes compared to the control group in terms of cartilage histology (very low quality; p = 0.0002), synovium histology (very low quality; p < 0.0001), and reductions in proinflammatory markers, including IL-1 (low quality; p = 0.002), IL-6 (very low quality; p < 0.00001), and TNF-α (very low; p < 0.00001). However, PRP treatment did not yield a significant impact on PDGF-A levels (very low quality; p = 0.81).ConclusionPRP appears capable of reducing proinflammatory markers (IL-1, IL-6, TNF-α) and mitigating cartilage and synovium damage in animals with OA. However, the levels of evidence of these findings are low to very low. Therefore, more rigorous studies with larger samples are needed to improve the quality of evidence.PROSPERO registrationCRD42022250314

The Impact of Gender Diversity in Top Management on Firm Performance

This paper provides a comprehensive systematic literature review of the existing research on the impact of gender diversity in top management team on firm financial and non-financial performance. This paper summarizes the studies on the impact of gender diversity in TMT on performance through a systematic literature review. Firstly, this paper present the theoretical basis used to describe the relationship between them, and highlight the significance of the complexity perspective to address the limitation of measuring firm financial performance intently as a function of gender diversity in top management team from a singular theoretical perspective. Further, this paper review empirical literature on the relationship between gender diversity in top management team and corporate financial and non-financial performance, and discussed both positive and negative impacts in financial performance. Finally, based on the results of literature review, this paper present the conclusion and future research recommendations.

DIABETES MANAGEMENT IN CHRONIC KIDNEY DISEASE: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: The increase in type 2 diabetes has positioned it as the leading cause of chronic kidney disease (CKD) and is responsible for approximately half of all cases of end-stage kidney disease (ESKD) worldwide. Managing CKD in diabetic patients entails addressing its complications and minimizing the risk of other associated conditions, such as cardiovascular disease. This study aims to serve a comprehensive systematic review on diabetes management in CKD patients in literatures of the last 10 years. Methods: The systematic review followed PRISMA 2020 standards and examined full-text English literature published between 2014 and 2024. This review excluded editorials, review papers from the same journal, and submissions without a DOI. Literature was sourced from online platforms such as PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 43,740 articles were retrieved from online databases (PubMed, SagePub, SpringerLink and Google Scholar). After three rounds of screening, four articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: Chronic kidney disease (CKD) is a common and serious complication in individuals with diabetes. Management involves controlling hypertension and hyperglycemia, along with using ACE inhibitors like finerenone and SGLT2 inhibitors such as dapagliflozin, sotagliflozin, and bexagliflozin.

THE EFFECT OF BARIATRIC SURGERY ON BREAST CANCER INCIDENCE AND CHARACTERISTICS: A COMPREHENSIVE SYSTEMATIC REVIEW

Background: Obesity elevates estrogen levels and pro-inflammatory cytokines, increasing breast cancer risk via macrophage migration to breast tissue and stimulating epithelial proliferation. Observational studies suggest that intentional weight loss, such as through bariatric surgery, can mitigate this risk. This study aims to conduct a comprehensive systematic review, focusing on the impact of bariatric surgery on breast cancer incidence and characteristics using recent literature. Methods: The systematic review followed PRISMA 2020 standards and examined full-text English literature published between 2014 and 2024. This review excluded editorials, review papers from the same journal, and submissions without a DOI. Literature was sourced from online platforms such as PubMed, SagePub, and SpringerLink. Result: A total of 1,011 articles s were retrieved from online databases (PubMed, SagePub, and SpringerLink). After three rounds of screening, five articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: Bariatric surgery decreases overall cancer risk in women, especially for breast cancer, by lowering estrogen levels and altering tumor biology. It also improves glucose homeostasis and reduces insulin resistance, both linked to higher cancer risk.

Manejo conservador e abordagens cirúrgicas no tratamento de Doença Arterial Obstrutiva Periférica (DAOP): Uma overview

Introduction: Peripheral Obstructive Arterial Disease (PAD) is a condition in which there is a narrowing or blockage of the arteries that supply the lower limbs. The main objective of this systematic review was to identify studies that addressed the pathophysiology, epidemiology and signs and symptoms of PAD, with special emphasis on surgical intervention strategies. Methods:The search was conducted in renowned databases such as PubMed, Scopus, SciELO, Cochrane Library, LILACS, UpToDate and Embase, using controlled descriptors from DeCS. In order to effectively search for studies, descriptors such as "Peripheral Arterial Disease", "Vascular Surgical Procedures", "Myocardial Revascularization", "Angioplasty", "Vascular Grafting", "Thromboendarterectomy" and "Vascular Surgery" were used. These descriptors were combined with Boolean operators "OR" and "AND" to improve the precision of the search. The methodological approach adopted allowed for a thorough and comprehensive search, ensuring the inclusion of relevant studies. Results: The final sample consisted of 28 articles published in indexed scientific journals, addressing different aspects of POAD, such as symptomatology, epidemiology and surgical approach. The articles were available in full for analysis and were written in Portuguese. Analysis of the studies provided a better understanding of the pathophysiology of POAD, identified the main symptoms and examined the different surgical approaches used in treatment.Conclusion: The comprehensive systematic review of the literature on POAD provided valuable information on the disease and its surgical treatment modalities. The results obtained are essential for guiding clinical practice and assisting in decision-making regarding the management of POAD. The methodological approach adopted ensured the inclusion of relevant studies and provided a solid basis for understanding PAOD and providing appropriate care to patients.

Analyzing the impact of sleep duration on atrial fibrillation risk: a comprehensive systematic review and meta-analysis.

Recent studies have suggested an association between sleep duration and cardiovascular diseases; however, the link to AF is inconclusive. This study aimed to explore the relationship between sleep duration and AF by conducting a systematic review and meta-analysis of primary studies to provide evidence of the link between insufficient sleep and AF. A review of the existing literature was conducted to identify the primary studies that examined the association between AF and sleep duration. The inquiry spanned databases, including PubMed, Embase, MEDLINE, and Google Scholar, from their inception through October 2023. Meta-analysis revealed a statistically significant association (p < 0.01) between shorter sleep duration and the incidence of AF (hazard ratio (HR), 1.18; 95% CI, 1.03-1.34; I2 = 89%). Conversely, longer sleep duration did not exhibit a statistically significant association with the incidence of AF (HR, 1.03; 95% CI, 0.92-1.14; I2 = 66%, p = 0.02). The sensitivity analysis demonstrated reduced heterogeneity after excluding specific studies. Insufficient sleep duration was associated with an increased risk of AF, whereas a longer sleep duration did not show a significant correlation. Standardized methods for sleep assessment and AF diagnosis as well as adjustments for confounding factors are suggested for future studies to improve the clarity and understanding of these associations.

Important soil microbiota's effects on plants and soils: a comprehensive 30-year systematic literature review.

Clarifying the relationship between soil microorganisms and the plant-soil system is crucial for encouraging the sustainable development of ecosystems, as soil microorganisms serve a variety of functional roles in the plant-soil system. In this work, the influence mechanisms of significant soil microbial groups on the plant-soil system and their applications in environmental remediation over the previous 30 years were reviewed using a systematic literature review (SLR) methodology. The findings demonstrated that: (1) There has been a general upward trend in the number of publications on significant microorganisms, including bacteria, fungi, and archaea. (2) Bacteria and fungi influence soil development and plant growth through organic matter decomposition, nitrogen, phosphorus, and potassium element dissolution, symbiotic relationships, plant growth hormone production, pathogen inhibition, and plant resistance induction. Archaea aid in the growth of plants by breaking down low-molecular-weight organic matter, participating in element cycles, producing plant growth hormones, and suppressing infections. (3) Microorganism principles are utilized in soil remediation, biofertilizer production, denitrification, and phosphorus removal, effectively reducing environmental pollution, preventing soil pathogen invasion, protecting vegetation health, and promoting plant growth. The three important microbial groups collectively regulate the plant-soil ecosystem and help maintain its relative stability. This work systematically summarizes the principles of important microbial groups influence plant-soil systems, providing a theoretical reference for how to control soil microbes in order to restore damaged ecosystems and enhance ecosystem resilience in the future.

Prognostic factors of chronic postsurgical pain following gastrointestinal surgery: A systematic review protocol.

Chronic postsurgical pain (CPSP) presents a considerable healthcare challenge, impacting patients, and healthcare providers, particularly in the context of gastrointestinal surgery. The notable incidence of CPSP in this specific surgical domain emphasizes the need to identify patients with a high risk of developing this condition. Despite various studies exploring this topic, a comprehensive systematic review focusing on prognostic factors of CPSP following gastrointestinal surgery is currently lacking. Therefore, the aim of this systematic review is, through systematically examination of existing literature, to assess both established and potentially novel prognostic factors, associated with CPSP following gastrointestinal surgery. Adhering to the Cochrane Handbook and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist, we will use pre-established criteria based on Population, Intervention, Comparator, Outcome, Timing, and Setting (PICOT-S), to determine eligibility for inclusion. Essentially, this entails studies reporting on prognostic factors of CPSP following gastrointestinal surgery. Relevant studies will be identified through systematic searches in medical databases, examination of reference lists from included studies, and screening of Clinicaltrials.gov. No restrictions will be imposed regarding language, publication time or source, and both randomized trials and observational studies will be included. Data extraction will follow the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of prognostic factor studies (CHARMS-PF) and for quality assessment, we will use the Quality in Prognosis Studies (QUIPS) tool. The aim for the systematic review is to identify and assess the prognostic value of potential factors for the development of CPSP following gastrointestinal surgery. By creating a comprehensive overview of important prognostic factors for the development of CPSP following gastrointestinal surgery, the findings of this systematic review have the potential to guide future research and to enhance patient information resources.

Pathological response in resectable non-small cell lung cancer: a systematic literature review and meta-analysis.

Surrogate endpoints for overall survival in patients with resectable non-small cell lung cancer receiving neoadjuvant therapy are needed to provide earlier treatment outcome indicators and accelerate drug approval. This study's main objectives were to investigate the association among pathological complete response, major pathological response, event-free survival and overall survival and to determine whether treatment effects on pathological complete response and event-free survival correlate with treatment effects on overall survival. A comprehensive systematic literature review was conducted to identify neoadjuvant studies in resectable non-small cell lung cancer. Analysis at the patient level using frequentist and Bayesian random effects (hazard ratio [HR] for overall survival or event-free survival by pathological complete response or major pathological response status, yes vs no) and at the trial level using weighted least squares regressions (hazard ratio for overall survival or event-free survival vs pathological complete response, by treatment arm) were performed. In both meta-analyses, pathological complete response yielded favorable overall survival compared with no pathological complete response (frequentist, 20 studies and 6530 patients: HR = 0.49, 95% confidence interval = 0.42 to 0.57; Bayesian, 19 studies and 5988 patients: HR = 0.48, 95% probability interval = 0.43 to 0.55) and similarly for major pathological response (frequentist, 12 studies and 1193 patients: HR = 0.36, 95% confidence interval = 0.29 to 0.44; Bayesian, 11 studies and 1018 patients: HR = 0.33, 95% probability interval = 0.26 to 0.42). Across subgroups, estimates consistently showed better overall survival or event-free survival in pathological complete response or major pathological response compared with no pathological complete response or no major pathological response. Trial-level analyses showed a moderate to strong correlation between event-free survival and overall survival hazard ratios (R2 = 0.7159) but did not show a correlation between treatment effects on pathological complete response and overall survival or event-free survival. There was a strong and consistent association between pathological response and survival and a moderate to strong correlation between event-free survival and overall survival following neoadjuvant therapy for patients with resectable non-small cell lung cancer.

Clear Aligners in the Growing Patient: A Systematic Review.

Mixed dentition represents a critical phase in the oral development of pediatric patients, characterized by the simultaneous presence of primary and permanent teeth. This article proposes a comprehensive systematic review of the application of aligners as an innovative methodology in managing mixed dentition. The primary objective is to explore the efficacy, safety, and acceptability of this emerging orthodontic technology in the evolving age group. This systematic review focuses on randomized controlled trials, cohorts, and observational studies investigating the use of aligners in patients with mixed dentition. Clinical, radiographic, and psychosocial parameters will be considered to assess the overall impact of aligner therapy in this critical phase of dental development. An in-depth analysis of such data aims to provide a comprehensive overview of the potential of this technology in pediatric orthodontics. Expected outcomes may contribute to outlining practical guidelines and targeted therapeutic strategies for orthodontists involved in managing mixed dentition. Furthermore, this article aims to identify gaps in the current research and suggest future directions for studies exploring the use of transparent aligners in patients with mixed dentition, thereby contributing to the ongoing evolution of evidence-based orthodontic practices.