Comprehensive Systematic Review Research Articles

Cardiovascular Outcomes Unveiled: Bempedoic Acid in Hyperlipidemia—A Comprehensive Updated Systematic Review and Meta-analysis of RCTs

Cardiovascular Outcomes Unveiled: Bempedoic Acid in Hyperlipidemia—A Comprehensive Updated Systematic Review and Meta-analysis of RCTs

Developments and research directions for collision avoidance in mixed navigation environment for MASS: A systematic literature review with bibliometric analysis.

ABSTRACT: The integration of advanced technologies, data-driven processes, and automation under the Industry 4.0 revolution is fostering increased connectivity among ships and maritime infrastructures, particularly with the emergence of Maritime Autonomous Surface Ships (MASS) and the imperative for safe navigation. Despite existing studies delving into collision regulations (COLREG), autonomous navigation, and risk assessment for MASS navigation, a comprehensive systematic literature review and bibliometric analysis of academic research studies addressing collision avoidance in the context of MASS within mixed navigational environments has, to our knowledge, not been undertaken. This review aims to provide a concise overview of academic research advancements concerning the challenges associated with MASS and the safety of navigation in mixed navigational environments. To achieve this objective, we conducted a bibliometric analysis of pertinent studies, utilizing metrics and analysis tools to discern academic research topics, primary challenges, and directions in this domain. Our approach adhered to the principles outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) for systematic literature reviews, incorporating tailored keywords in a Scopus search. The results revealed that China, Norway, Poland, and South Korea are the leading countries in MASS collision avoidance, based on the weighted number of authors. Additionally, Ocean Engineering and the Journal of IFAC-Papers Online emerged as the principal journals for publications on this topic. Through the analyzed literature, specific challenges were identified, paving the way for suggested avenues for future research.

Use of regenerative medicine in the treatment of endometritis in mares: A systematic review and meta-analysis

Defining the optimal therapy for endometritis remains a significant challenge for clinicians. Given the public health threat posed by antibiotic resistance and the inconclusiveness of traditional therapies, regenerative medicine has been proposed as an alternative. The objective of this study was to conduct a comprehensive systematic review and meta-analysis, to investigate the efficacy of regenerative medicine products in the treatment of both post-breeding persistent and chronic degenerative endometritis (PBIE/CDE) in mares, following the PRISMA guidelines. This research could be a comprehensive scientific reference for determining appropriate treatments and clinical strategies.All studies exploring the use of regenerative medicine therapies (i.e., plasma products, autologous conditioned serum, mesenchymal stem cells MSCs, and MSC derivatives) in the treatment of PBIE/CDE were included, regardless of the specific protocol used, the evaluated outcomes, or the diagnostic method employed. Two authors independently gathered data and evaluated the risk of bias for each study. Treatment effects were assessed using risk ratios for dichotomous data, accompanied by 95 % confidence intervals. Data were aggregated utilizing the fixed-effects model. The quality of evidence for each outcome was evaluated using GRADE criteria.Eighteen studies were included in the systematic review, while fifteen trials were included in the meta-analysis. A sub-meta-analysis was conducted separately on platelet-derived products, as well as on MSCs and their derivatives. The results demonstrated an overall positive effect of regenerative therapies in treating PBIE/CDE, particularly those involving MSCs and their derivatives. The positive outcomes include an anti-inflammatory effect, characterized by reduced intrauterine fluid accumulation, neutrophils, and cytokine concentrations. Additionally, improvements in pregnancy, foaling, and embryo recovery rates have been observed in some cases. Despite the limited number of randomized controlled studies and the high variability among protocols, including the timing of treatment, type, and volume of products used, the use of regenerative products, especially MSCs and their derivatives, has promising results in terms of both efficacy and safety for treating PBIE/CDE in mares.

Modifiable risk factors for hepatocellular carcinoma in patients with metabolic dysfunction-associated steatotic liver disease: a meta-analysis

Background and AimsThe increasing incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has led to a gradual increase in MASLD-related hepatocellular carcinomas (HCC). In this context, we aimed to investigate the association between modifiable factors and the risk of incident HCC in patients with MASLD. MethodsTwo authors independently searched electronic databases (PubMed, Embase, and the Cochrane Library) from their inception to April 1 2023. Observational studies reporting an association between modifiable risk factors and MASLD-related HCC were eligible for inclusion. The effect size on the study outcomes was calculated using a random-effects model and was presented as a risk ratio with 95% confidence interval. ResultsA total of 31 studies covering 1.02 million individuals were included. Regarding lifestyle factors, smoking and alcohol consumption were associated with 30% [1.30 (1.08-1.57)] and 140% [2.41 (1.03-5.65)] risk increase of MASLD-related HCC . Regarding metabolic risk factors, patients with MASLD who were overweight or obese [1.31 (1.13-1.52)], had diabetes [2.08 (1.71-2.53)] and hypertension[1.42 (1.12-1.80)] had a higher risk of developing HCC, while dyslipidemia was negatively associated with MASLD-HCC [0.78 (0.65-0.93)]. The use of metformin, statin and aspirin was associated with 18% [0.82 (0.68-0.98)], 55% [0.45 (0.36-0.56)] and 36% [0.64 (0.44-0.92)] risk reduction in incident HCC, respectively. ConclusionsThis comprehensive systematic review and meta-analysis showed statistically significant increases in the risk of incident HCC inpatients with MASLD due to smoking, alcohol use, obesity, diabetes and hypertension, whereas metformin, statin and aspirin therapy might modify disease progression.

Exposure to second-hand smoke and breast cancer risk in non-smoking women: a comprehensive systematic review and meta-analysis

Exposure to second-hand smoke and breast cancer risk in non-smoking women: a comprehensive systematic review and meta-analysis

Mindfulness programs for problematic usage ofthe internet: A systematic review and meta-analysis.

Problematic usage of the internet (PUI) is an umbrella term for a range of uncontrolled, excessive, and potentially harmful online behaviors. Recently, numerous studies have examined the potential of mindfulness programs (MPs) for reducing PUI. We conducted a comprehensive systematic review and meta-analysis in this emerging field. We searched eight databases from inception to October 18, 2022, with no language restrictions. We included randomized controlled trials (RCTs) and nonrandomized trials (NRTs). The primary outcome was change in self-reported PUI, the secondary outcome was change in screen time. Of 3,473 identified records, 19 RCTs and 20 NRTs with a total of 1,549 participants were included. Participation in an MP was associated with large reductions in PUI in between-group analysis in RCTs (k = 19; g = -1.67; 95% CI -2.15, -1.19) and in within-group pre-post analysis in all studies (k = 35; g = -1.67; 95% CI -1.99, -1.36). Screen time showed a medium reduction in within-group pre-post analysis (k = 10; g = -0.65; 95% CI -0.90, -0.41). The effects for PUI remained significant in a series of sensitivity analyses, such as excluding low quality studies, excluding outliers, adjusting for publication bias, or using follow-up data. Heterogeneity between studies was high and the overall quality of evidence was rated low. MPs are probably effective in reducing PUI and might be effective in reducing screen time. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials with long-term follow-ups to confirm results.

Exploring the impact of rotavirus vaccination on antibiotic prescription and resistance: A comprehensive systematic review.

Rotavirus is a highly contagious virus responsible for a significant burden of acute gastroenteritis, particularly among infants and young children worldwide, however, vaccination against this viral agent is available. Several studies have hypothesized that rotavirus vaccination has been linked to lower rates of antibiotic resistance. To assess the relationship between rotavirus vaccination and antibiotic resistance. The present systematic review was tailored based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Several electronic databases (PubMed/MEDLINE, Scopus and Web of Science) were searched independently by two investigators in order to retrieve relevant publications published until April 2023 that investigated the aforementioned research question. The comprehensive database search identified a total of 91 records. After the duplicates were removed (n = 75), we screened the titles and abstracts of 16 potentially eligible publications. After the irrelevant records were excluded (n = 5), we screened the full texts of 11 manuscripts. Finally, 5 studies were entered into the qualitative and quantitative analysis. In conclusion, all the studies support the idea that vaccinations can reduce the need for antibiotic prescriptions which could potentially contribute to mitigating antibiotic resistance. However, to fully comprehend the mechanisms of antibiotic resistance, enhance treatment guidelines, and consider diverse demographic situations, further research is necessary to use evidence-based strategies to fight antibiotic misuse and resistance.

Efficacy of Sacituzumab Govitecan in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: A Comprehensive Systematic Review and Meta-analysis.

Breast cancer is the most diagnosed cancer in women, with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) being the predominant subtype. Sacituzumab govitecan (SG), a novel antibody-drug conjugate, has emerged as a promising treatment for metastatic HR+/HER2- breast cancer. This systematic review and meta-analysis aimed to evaluate its efficacy and safety. Adhering to "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines, a comprehensive search was conducted in PubMed, Scopus, and Cochrane databases up to December 2023. We included clinical trials and observational studies evaluating SG in patients with HR+/HER2- advanced breast cancer. The primary outcome was progression-free survival (PFS). In contrast, the secondary outcomes included overall survival, objective response rate, clinical benefit rate, duration of response (DOR), and adverse event profiles. Review Manager (Version 5.4) was used for the statistical analysis. Nine studies met the inclusion criteria for systematic review; 2 were suitable for meta-analysis. The pooled analysis showed a hazard ratio of 0.53 (95% CI: 0.34-0.83; P= 0.005; I2 = 86%) for PFSl and a hazard ratio of 0.63 (95% CI: 0.36-1.11; P= 0.11; I2 = 92%) for overall survival. The pooled analysis of the duration of response showed significant results with a standard mean difference = 0.22 (95% CI: 0.03-0.42; P = 0.02; I2 = 61%). SG demonstrates significant benefit in PFS and duration of response in patients of HR+/HER2- advanced breast cancer.

Understanding urban perception with visual data: A systematic review

Visual characteristics of the built environment affect how people perceive and experience cities. For a long time, many studies have examined visual perception in cities. Such efforts have accelerated in recent years due to advancements in technologies and the proliferation of relevant data (e.g., street view imagery, geo-tagged photos, videos, virtual reality, and aerial imagery). There has not been a comprehensive systematic review paper on this topic to reveal an overarching set of research trends, limitations, and future research opportunities. Such omission is plausibly due to the difficulty in reviewing a large number of relevant papers on this popular topic. In this study, we utilized machine learning techniques (i.e., natural language processing and large language models) to semi-automate the review process and reviewed 393 relevant papers. Through the review, we found that these papers can be categorized into the physical aspects of cities: greenery and water, street design, building design, landscape, public space, and the city as a whole. We also revealed that many studies conducted quantitative analyses with a recent trend of increasingly utilizing big data and advanced technologies, such as combinations of street view imagery and deep learning models. Limitations and research gaps were also identified as follows: (1) a limited scope in terms of study areas, sample size, and attributes; (2) low quality of subjective and visual data; and (3) the need for more controlled and sophisticated methods to infer more closely examined impacts of visual features on human perceptions. We suggest that future studies utilize and contribute to open data and take advantage of existing data and technologies to examine the causality of visual features on human perception. The approach developed to accelerate this review proved to be accurate, efficient, and insightful. Considering its novelty, we also describe it to enable replications in the future.

Risk of Asthma and Allergies in Children Delivered by Cesarean Section: A Comprehensive Systematic Review

It is currently unclear whether cesarean section increases the risk of allergic diseases in offspring. To investigate the association between cesarean section and the risk of allergic diseases in offspring. We searched PubMed, Embase, and the Cochrane Library for relevant studies up to October 12, 2023. Observational studies comparing the risk of allergic diseases in offspring delivered by cesarean section versus those delivered vaginally were included. Most-adjusted estimates from individual studies were synthesized by meta-analysis. A total of 113 studies were included, 70 of which had a low risk of bias. Compared with offspring delivered vaginally, offspring delivered by cesarean section had significantly greater risks of asthma (odds ratio [OR] 1.20, 95% CI 1.16 to 1.25), allergic rhinitis/conjunctivitis (OR 1.15, CI 1.09 to 1.22), atopic dermatitis/eczema (OR 1.08, CI 1.04 to 1.13), food allergies (OR 1.35, CI 1.18 to 1.54), and allergic sensitization (OR 1.19, CI 1.10 to 1.28). Cesarean section did not significantly increase urticaria risk. Sensitivity analyses including only studies with a low risk of bias, adjusted estimates, prospective data collection, large sample sizes, or outcomes from medical records generally supported these findings. Offspring age, study region latitude, economy type, and cesarean section rate accounted for some of the clinical heterogeneity. No data on allergic purpura were found. Most-adjusted estimates suggest that cesarean section is associated with increased risks of asthma, allergic rhinitis/conjunctivitis, atopic dermatitis/eczema, food allergies, and allergic sensitization in offspring. The impact of cesarean section on urticaria and purpura remains uncertain.

Association between priori and posteriori dietary patterns and gastric cancer risk: an updated systematic review and meta-analysis of observational studies.

An increasing number of epidemiological studies have explored the relationship between the risk of gastric cancer and specific dietary patterns, but the findings remain inconclusive. We, therefore, performed this comprehensive systematic review and meta-analysis to analyze the available evidence regarding the associations between a priori and a posteriori dietary patterns and the risk of gastric cancer. A systematic search of six electronic databases, including PubMed, Web of Science, EBSCO, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Data, was carried out to retrieve the relevant articles published up to March 2024. Thirty-six studies (10 cohort and 26 case-control studies) with a total of 2 181 762 participants were included in the final analyses. Combining 15 effect sizes extracted from 12 articles, we observed a reduced risk of gastric cancer in the highest versus the lowest categories of the Mediterranean diet [relative risk (RR), 0.72; 95% confidence interval (CI), 0.61-0.85; P < 0.001]. Combining 11 effect sizes from 10 articles (involving 694 240 participants), we found that the highest Dietary Inflammatory Index scores were significantly associated with an increased risk of gastric cancer (RR, 1.32; 95% CI, 1.11-1.57; P < 0.001). A reduced risk of gastric cancer was shown for the highest compared with the lowest categories of healthy dietary pattern (RR, 0.78; 95% CI, 0.67-0.91; P = 0.002). Conversely, the highest adherence to the Western dietary pattern was associated with an increased risk of gastric cancer (RR, 1.33; 95% CI, 1.19-1.49; P < 0.001). Our study demonstrated that the Mediterranean diet and a healthy dietary pattern were associated with a decreased risk of gastric cancer. Conversely, the Dietary Inflammatory Index and Western dietary pattern were associated with an increased risk of gastric cancer.

The impact of triglyceride-glucose index on the prognosis of post-PCI patients–a meta-analysis

BackgroundPrevious research has demonstrated the validity of the triglyceride-glucose (TyG) index as a robust measure of insulin resistance (IR) and its association with coronary artery disease (CAD). The objective of this study is to elucidate the relationship between the TyG index and the prognosis of patients underwent percutaneous coronary intervention (PCI) through a comprehensive systematic review and meta-analysis. Our goal is to provide a thorough analysis of the available evidence to offer more clarity on this association.MethodsA systematic and thorough search was carried out in the PubMed, Embase, Cochrane Library, and Web of Science databases, covering studies published in English from the beginning until October 1, 2023. The focus of the search was to gather relevant studies pertaining to the occurrence of major adverse cardiovascular events (MACE). To address the variability among the included studies, random or fixed effect models were utilized to summarize the hazard ratios (HR). In cases where heterogeneity was detected, subgroup or sensitivity analyses were performed to explore potential sources. To evaluate publication bias, the Egger or Begg test was employed.ResultsThis study incorporated a total of 17 studies. Individuals with the highest TyG index exhibited an elevated risk of major adverse cardiovascular events (MACEs) compared to those with the lowest TyG index (HR = 1.69; 95% CI: 1.47–1.95; P &amp;lt; 0.001). When analyzing the TyG index as a continuous variable, each standard deviation increase was associated with an HR of 1.60 (95% CI: 1.48–1.73; P &amp;lt; 0.001). Moreover, in patients diagnosed with acute coronary syndrome (ACS), higher TyG index levels showed a trend of increased risk of MACE (HR = 1.54; 95% CI: 1.27–1.86; P &amp;lt; 0.001). Furthermore, an elevated TyG index was found to be associated with a higher risk of in-stent restenosis (HR = 1.62; 95% CI: 1.29–2.03; P &amp;lt; 0.001), new-onset atrial fibrillation (HR = 2.97; 95% CI: 2.10–4.06; P = 0.014), and a reduction in quantitative flow ratio (HR = 1.35; 95% CI: 1.101–1.592; P = 0.005). Subgroup analysis indicated the risk of MACE was comparable between varied durations of follow-up (P = 0.11). Furthermore, regression analysis revealed that the positive association between TyG index and the risk of MACE did not differ between individuals with or without diabetes (P = 0.23).ConclusionAn increase in the TyG index may lead to a higher vulnerability to major adverse cardiovascular events (MACE) in patients underwent PCI and there was no significant difference in the risk of major adverse cardiovascular events (MACE) between diabetic and non-diabetic individuals.

Machine Learning-Based Prediction of Thalassemia: A Review

This article presents a comprehensive systematic review of recent advancements in machine learning (ML) applications for diagnosing Thalassemia, a genetic hematologic disorder. Focusing on studies from the last five years, this review highlighted significant technological advancements in ML, including the use of predictive modeling, image analysis, and deep learning algorithms, which have considerably improved the accuracy and efficiency of Thalassemia diagnosis. The review evaluates the application of various ML models in analyzing extensive biomedical data, which significantly enhances patient management and treatment outcomes. Key challenges such as data diversity, model transparency, and the need for robust training datasets are discussed, along with the integration of ML into existing clinical workflows. The potential transformative impact of ML in hematology is underscored, critically evaluating its effectiveness and ongoing developments in the field. This review aims to provide insights into the current research trends and future directions in the use of ML for the diagnosis and management of Thalassemia and other similar hematological disorders.

Endoscopic management of greater trochanteric pain syndrome (GTPS): a comprehensive systematic review.

Greater trochanteric pain syndrome (GTPS) presents challenges in clinical management due to its chronic nature and uncertain etiology. Historically attributed to greater trochanteric bursitis, current understanding implicates abductor tendinopathy as the primary cause. Diagnosis usually involves a clinical examination and additional tests such as imaging and provocative testing. Surgical intervention may be considered for cases refractory to conservative therapy, with endoscopic techniques gaining ground over open procedures. A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence (LoE). The Coleman methodology score (mCMS) was used to analyze the retrospective studies. This systematic review was registered in the International Prospective Registry of Systematic Reviews. Surgical success rates ranged from 70.6-100%, significantly improving pain and function. Complications were generally mild, mainly hematomas and seromas, while recurrence rates were low. However, limitations such as the retrospective design and the absence of control groups warrant cautious interpretation of the results. Endoscopic surgery emerges as a promising option for refractory GTPS, offering effective symptom relief and functional improvement. Despite limitations, these results suggest a favorable risk-benefit profile for endoscopic procedures. Further research is needed, particularly prospective randomized trials, to confirm these findings and optimize surgical techniques to improve patient outcomes.

Efficiency, Research, and Healthcare Economics: (Vital Threat Detection System) A Systematic Review

Monitoring vital signs and detecting diseases like diabetes and cancer at an early stage are incredibly important for safeguarding patients' lives and ensuring a healthy environment. In this study, we present a comprehensive systematic review focusing on vital monitoring systems in diverse fields. We reviewed 85 articles spanning from 2019 to 2024. From the selected articles, our aim is to explore the frameworks and algorithms of vital signs monitoring, the latest techniques used in remote vital signs monitoring such as radar and smart watch, as well as the measurement of vital signs for heart rate and respiratory diseases. Also, we discuss the threats that may affect healthcare systems and how to secure against these threats. The findings emphasize the critical importance of acquiring continuous vital monitoring systems, which have immense potential for improving healthcare. These systems are crucial for early diagnosis and prediction of conditions that may negatively impact the patient's health. Additionally, it could be beneficial for doctors and healthcare staff by saving time and costs.

Cavernous Malformation From Cranial Nerves: A Systematic Review With a Novel Classification and Patient-Level Analysis.

Cavernous malformations (CMs) occurring in the cranial nerve (CN) are extremely rare, and there is currently no comprehensive review on CN CMs, leading to a lack of sufficient understanding of CN CMs. We aimed to systematically review all published CN CM cases; summarize the epidemiology, clinical manifestations, treatment, and prognosis of CN CMs; and identify factors influencing the prognosis of CN CMs. This systematic review identified all cases potentially diagnosed with CN CM through a systematic search of PubMed, SCOPUS, Web of Science, and Cochrane databases. This represents the most comprehensive systematic review to date. We classified CN CMs based on their anatomic origins. Patient characteristics, disease manifestations, treatment approaches, and prognosis were summarized descriptively. Further analysis was conducted to identify factors influencing the prognosis of CN CMs. The final analysis included 108 articles (127 individual patient cases). The optic nerve (49/128, 38.3%) is the most commonly affected nerve. Notably, CN CMs can be categorized into 3 types: Intraneural, Perineural, and Extraneural. Preoperative nerve function status and novel classification were associated with the prognosis of CN CMs (P = .001; P < .001). The postoperative neurological deterioration rate for the Intraneural type was 19/37 (51.4%); for the Extraneural type, it was 13/69 (18.8%); and for the Perineural type, it was 1/22 (4.5%) (P < .001). We reviewed all the published CN CMs to date, offering a comprehensive description of CN CMs for the first time and identifying prognostic factors. The classification of CN CMs proposed in this study could serve as guidance for the selection of intraoperative treatment regimens. The findings of this systematic review are expected to provide a foundation for clinical decision-making in this crucial rare disease and lay the groundwork for developing relevant clinical guidelines.

The role of myeloid differentiation of hematopoietic stem cells in pregnancy immunological tolerance: a systematic review.

The present research aimed to conduct a comprehensive critical analysis of existing literature, focusing on the differentiation of myeloid cells from hematopoietic stem cells within the context of immunological tolerance during pregnancy. A comprehensive systematic review was conducted by searching databases including PubMed, Scopus Biomedicine, EBSCOhost, ScienceDirect, Embase, Cochrane Library, and Web of Science. The focus was on the role of myeloid differentiation from hematopoietic stem cells in modulating immune tolerance, particularly during pregnancy and in certain disease states where they act to suppress the immune response. The quality of the evidence gathered was assessed using the GRADE rating system. Our analysis maintains objectivity and independence from the outcomes presented. The current systematic review offers a synthesis of existing research on the transformation of hematopoietic stem cells into fibroblasts across different tissue types. A thorough search of databases such as PubMed, EBSCOhost, Embase, ScienceDirect, Cochrane Library, and Web of Science was performed in conjunction with a specialist in medical information to identify original research on the derivation of fibroblasts following hematopoietic stem cell transplantation. This search yielded a total of 159 studies, of which 10 met the criteria for inclusion in this review. Reflecting on the constraints of this preliminary review, further in-depth and scientific investigations are warranted to comprehensively assess the impact of varied treatments, with a recommendation for clinicians to proceed with increased circumspection. The myeloid differentiation pathway of hematopoietic stem cells is pivotal in modulating the immune environment during pregnancy, supporting the sustenance of a healthy gestational period. Future research in this domain is expected to advance our understanding of the immunological processes occurring at the maternal-fetal boundary.

Comprehensive systematic review and meta-analysis of microplastic prevalence and abundance in freshwater fish species: the effect of fish species habitat, feeding behavior, and Fulton’s condition factor

Comprehensive systematic review and meta-analysis of microplastic prevalence and abundance in freshwater fish species: the effect of fish species habitat, feeding behavior, and Fulton’s condition factor

Automatic user story generation: a comprehensive systematic literature review

Automatic user story generation: a comprehensive systematic literature review

The Role of Environmental Factors in the Development of Chronic Diseases: A Comprehensive Systematic Review

The Role of Environmental Factors in the Development of Chronic Diseases: A Comprehensive Systematic Review