Controlled Study Research Articles

Safety comparison of single-donor and pooled fecal microbiota transfer product preparation in ulcerative colitis: systematic review and meta-analysis.

Multiple studies have evaluated fecal microbiota transfer (FMT) in patients with ulcerative colitis (UC) using single-donor (SDN) and multidonor (MDN) products. Systematic review and meta-analysis were performed to compare the safety of SDN and MDN products. Systematic searches were performed in Web of Science, Scopus, PubMed, and Orbit Intelligence to identify studies that compared FMT products manufactured using SDN or MDN strategies against control treatment in patients with UC. Fifteen controlled studies were selected for meta-analysis (11 randomized controlled trials and 4 controlled cohort trials). Safety of each treatment type was assessed using the counts of adverse events and serious adverse events using fixed- and random-effects models. Significance of the indirect difference between FMT preparations was assessed using a network approach. Benefit-risk ratios were calculated by multiplicative utility model, incorporating geometric mean of risk ratios (RRs) of efficacy and safety. Safety data was collected for a total of 587 patients (193 exposed to SDN products, 114exposed to MDN products and 280 exposed to control treatment). The 12 studies showed similar overall safety event counts for MDN and SDN versus placebo (RRs: 0.90 and 1.09, respectively [P = 0.206 and P = 0.420, respectively]). Results indicated similar risk of safety events for MDN compared to SDN (RR: 0.83, P = 0.159). Positive benefit-risk ratios were demonstrated for MDN and SDN versus placebo (RRs: 1.70 and 1.16, respectively [P = 0.003 and P = 0.173, respectively]). MDN had a greater benefit-risk ratio compared to SDN (RR: 1.46, P = 0.072). Similar safety profiles were observed for MDN and SDN strategies. Alongside previously described superior efficacy, treatment with MDN has greater benefit-risk ratio than SDN in patients with UC. Further development of MDN FMT treatment for UC should be considered.

GSDMB Gene Polymorphisms and Their Association with Asthma Susceptibility: A Systematic Review and Meta-Analysis of Case–Control Studies

Background: Asthma is a respiratory disorder influenced by genetic and environmental factors. The rs7216389 polymorphism in the gasdermin B (GSDMB) gene on chromosome 17q21 has been implicated in asthma susceptibility with conflicting results. This meta-analysis aims to bring forward new findings on the association between this polymorphism and asthma across diverse populations and its potential as a genetic marker for asthma risk. Methods: A systematic review and meta-analysis were conducted through March 2024, and odd ratios were calculated. Results: The meta-analysis included 22 studies with a total of 9012 asthma patients and 11,657 controls. The results show an OR = 1.24, 95% CI [1.13, 1.37], p < 0.00001. Subgroup analyses stratified by age and ethnicity between asthma patients with T alleles vs. C alleles demonstrated an association between having the T allele and asthma susceptibility across Asian, Caucasian, and American minorities, but not among Arabs. Young asthma patients with the dominant allele (T) showed higher asthma risk than those with C allele or heterozygote TC, and to a higher extent than for adults. Conclusions: This meta-analysis indicates the importance of genetic factors in asthma in certain ethnicities and underscores the potential utility of the rs7216389 polymorphism as a genetic marker for asthma risk assessment.

Impact of upper extremity robotic rehabilitation on respiratory parameters, functional capacity and dyspnea in patients with stroke: a randomized controlled study.

Stroke leads to reduced mobility and functional capacity, also negatively affects respiratory functions and muscle strength. To examine the effects of adding upper extremity robotic rehabilitation to conventional treatment on respiratory parameters, functional capacity, mobility, and dyspnea. Thirty-four stroke patients aged 18-65/years were randomized into Conventional Rehabilitation (CR) or Upper Extremity Robotic Rehabilitation (RR) groups. Both groups received conventional treatment for 5 days/week, for 6 weeks. Additionally, the RR group participated in upper extremity robotic rehabilitation (ExoRehab X, Houston Bionics) twice/week. Respiratory muscle strength (Maximum Inspiratory Pressure-MIP and Maximum Expiratory Pressure-MEP) and respiratory functions (forced expiratory flow first second (FEV1)), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow-25-75% (FEF 25-75%) were assessed. Functional capacity was evaluated with 6-minute walk test (6-MWT), mobility was assessed with Timed Up and Go (TUG) test, and dyspnea was measured using Dyspnea-12 test. Both groups showed improvements in MIP, MEP, 6MWT and TUG scores. Additionally, significant increases were observed in PEF in the CR group and in FVC, FEV1, %FEF 25-75, and reduced dyspnea in the RR group (all p < 0.05). The groups were similar in terms of mean changes, except for FVC (p = 0.004) and FEV1 (p = 0.002), which were significantly higher in RR group. Combining upper extremity robotic rehabilitation with conventional rehabilitation in stroke patients led to similar improvements in respiratory muscle strength, functional capacity, and mobility while also improving some respiratory parameters and reducing the perception of dyspnea. NCT05550311.

Enhancing Automated Peer Code Reviews in Software Engineering Education with Context-Aware Generative AI

This study investigates the enhancement of peer code reviews in software engineering education through the integration of Generative Artificial Intelligence (GenAI) with contextual awareness. Previous implementations of GenAI, such as ChatGPT, lacked detailed context about the educational content and assessment goals, limiting their effectiveness. Our work-in-progress research addresses this gap by providing GenAI with additional static and dynamic contextual information, including project overviews, pull-request descriptions, and comments. In a controlled study involving 26 students from a 12-week software engineering course, we compared the efficacy of the original GenAI system with a context-enhanced version. Results demonstrated that the context-aware GenAI provided more accurate and useful feedback, as perceived by the students. These findings suggest that incorporating contextual information improves the quality of automated peer reviews, offering a promising tool for educators to enhance student learning and engagement in code review activities.

Cu−Bi Bimetallic Catalysts Derived from Metal–Organic Framework Arrays on Copper Foam for Efficient Glycine Electrosynthesis

AbstractGlycine as one of the most abundant amino acids in human proteins, with extensive applications in both life and industry, is conventionally synthesized through complex procedures or toxic feedstocks. In this study, we present a facile and benign electrochemical pathway for synthesis of glycine through reductive coupling of glyoxylic acid and nitrate over a copper‐bismuth bimetal catalyst derived from a metal–organic framework (MOF) array on copper foam (Cu/Bi−C@CF). Remarkably, Cu/Bi−C@CF achieves a fantastic selectivity of 89 %, corresponding a high Faraday efficiency of 65.9 %. From control experiments, the introduction of Bi caused the binding energy of Cu shift to a lower state, which leads to a high selectivity towards the formation of key intermediate hydroxylamine rather than ammonia product, facilitating the formation of oxime and providing additional sites for subsequent hydrogenation reaction on the way to glycine. Moreover, the derivation of MOF arrays ensures the effective dispersion of Bi and enhances the stability of Cu/Bi−C@CF. This innovative approach not only presents sustainable pathways for the production of value‐added organonitrogen compounds utilizing readily available carbon and nitrogen sources, but also provides novel insights into the design of multistage structural catalysts for sequential reactions.

Association of Oral Tobacco-Free Nicotine Delivery Product with Acute Renal Tubular Necrosis

Usage of novel non-tobacco oral nicotine delivery products (ONDPs) has been increasing among adolescents in the United States. It is presumed that they are less toxic than their tobacco-containing counterparts, but that has not been examined in controlled studies. Most of the studies have focused on non-renal manifestations of tobacco consumption via different means. The renal manifestations of non-tobacco ONDPs are not very well known, especially in immunocompromised patients. A 19-year-old male transplant recipient presented with flank pain and a few days’ history of intake of ZYNR pouches. Immunosuppression was with tacrolimus, mycophenolate, and steroids. Baseline serum creatinine was 1.1–1.3 mg/dL. Laboratory evaluation showed elevated C-reactive protein, increased serum creatinine and blood urea nitrogen, leukocytosis, neutrophilia, and increased lactate dehydrogenase (LDH). Infectious disease work-up was negative. A kidney transplant biopsy showed severe acute tubular injury/necrosis (ATN) without evidence of rejection. Donor-specific antibodies were negative. Other etiologies of hemolysis were negative. He did not require renal replacement therapy. Kidney function and LDH improved gradually. The most recent follow-up eight months after presentation showed a serum creatinine level of 2.6 mg/dL with stable electrolytes, with eGFR of 35 mL/min/1.73 m2. Here, we describe a 19-year-old adolescent with a kidney transplant who sustained ATN leading to advanced chronic disease apparently following the usage of non-tobacco ONDP. Further larger studies are needed to study ATN as a possible renal manifestation of these next-generation products to raise awareness among the public.

The impact of prolonged walking on fasting plasma glucose in type 2 diabetes: A randomised controlled crossover study.

In many low-income countries, fasting glucose is the primary measure for monitoring glycaemic control. Many patients in these countries walk long distances to the clinic, but the impact of walking on fasting glucose in type 2 diabetes is unknown. We aimed to determine the impact of walking on fasting glucose in people with type 2 diabetes. In a randomised crossover trial, the change in glucose from baseline in the fasting state was compared between walking on a treadmill at a predetermined speed of 4.5 km/h for 1 h and not walking (resting) in people with type 2 diabetes. In all, 45 participants were enrolled and all completed both visits; 21/45 (46.7%) were women, and the median age was 51. Glucose during and after walking was similar to glucose while at rest; the glucose difference (walking minus rest) was -0.15 (95% CI: -0.55, 0.26) and -0.10 (95% CI: -0.50, 0.31) mmol/L at 1 and 2 h, respectively, p > 0.4 for both. Fasting plasma glucose is not meaningfully affected by prolonged walking in participants with type 2 diabetes; therefore, the reliability of fasting glucose for monitoring glycaemic burden is unlikely to be altered in patients who walk to the clinic.

Rapid and General Access to α‐Halogenated Carbonyl Compounds Using Amidine Halide Salts as Halogen Sources under Mild Conditions

AbstractRapid and efficient construction of α‐haloketones with diazo compounds and amidine ⋅ HX (X=Cl, Br, I) salts as halogen sources has been recognized as a simple and practical strategy. The reaction exhibits a broad scope and scalability, thereby enabling synthesis of a broad spectrum of functionally orchestrated α‐haloketones under mild and metal‐free conditions in a short time. Control experiments established the involvement of triffate 10 in the mechanism.

Where Should We Intervene, 20 Years Later? Case–Control and Prospective Cohort Designs Provide Similar Answers

In 2000, this journal published an influential case–control study identifying dynamic risk factors for sexual recidivism (Hanson &amp; Harris, 2000). In 2017, updated recidivism information for the same sample was obtained with an average follow-up of 20 years. The current study compared the risk factors that differentiated between sexual recidivists and nonrecidivists between the two research designs: original case–control and updated prospective cohort. Of the 82 comparisons, 50 favored the prospective design while 32 favored the case–control; however, most of the differences were small and nonsignificant. Static and dynamic risk factors were approximately equivalent between study designs. Factors identified as sex-specific (e.g., sexual deviancy) were also equivalent between designs while general risk factors (e.g., substance use) were more likely identified in the prospective design. Overall, case–control studies can be used for the identification of risk factors, especially for low base rate behaviors such as sexual recidivism.

Placental Extracts, Proteins, and Hydrolyzed Proteins as Active Ingredients in Cosmetic Preparations for Hair Loss: A Systematic Review of Available Clinical Evidence

Placentae and their derivatives have been used in both traditional and modern medicine, as well as in cosmetic sciences. Although hair loss is frequently mentioned among problems for which the placenta is supposed to be a remedy, the evidence seems rather scarce. The aim of this study was to highlight the clinical evidence for the efficacy of placenta products against baldness and hair loss. Methods: This systematic review was performed according to PRISMA and PICO guidelines. Database searches were conducted in PubMed, Google Scholar and Scopus. Results: Among the 2922 articles retrieved by the query, only 3 previously published clinical trials on placental products were identified. One study was a randomized controlled trial, in which the efficacy of a bovine placenta hair tonic was found to be comparable to that of minoxidil 2% in women with androgenic alopecia. Another controlled study showed that a porcine placenta extract significantly accelerated the regrowth of shaved hair in healthy people. The third study was an uncontrolled trial of a hair shampoo and tonic containing equine placental growth factor in women with postpartum telogen effluvium with unclear and difficult-to-interpret results. Due to the design and methodology of these studies, the level of evidence as assessed with the GRADE method was low for the first study and very low for the other two. Conclusions: The very limited scientific evidence available to date appears, overall, to indicate the efficacy of placental products in both inhibiting hair loss and stimulating hair growth. Unfortunately, the number of clinical studies published to date is very limited. Further, carefully designed, randomized controlled trials of well-defined placental products are needed to definitively address the question of the value of the placenta and its derivatives in hair loss.

Exercise in Postural Orthostatic Tachycardia Syndrome: Focus on Individualized Exercise Approach

Exercise is a vital component of health and is commonly utilized as a non-pharmacologic therapy for many disorders, including postural orthostatic tachycardia syndrome (POTS). However, exercise intolerance is a key feature of POTS and other autonomic disorders and, therefore, presents a major barrier for many patients. Despite exercise being uniformly recommended as a therapeutic intervention, a majority of patients with POTS, especially those with severe orthostatic intolerance and fatigue, are unable to complete or sustain rigorous exercise programs or successfully integrate them into their daily routine. In this narrative review, we discuss the current literature on exercise and POTS and our clinical experience with a home-based exercise approach developed at the Dysautonomia Clinic. We conclude that individualized exercise programs that are delivered remotely by a certified physical therapist may be convenient, easily accessible, and safe for patients with POTS, especially those with severe symptoms who may be home- or bedbound. Future randomized controlled studies are needed to quantify and characterize the benefits of home-based exercise programs delivered remotely compared to standard therapy.

The effect of face-to-face and online education provided to individuals with atrial fibrillation on medication adherence and satisfaction.

This randomized controlled study was conducted to investigate effects of face-to-face education and tele-education given to individuals with atrial fibrillation (AF) taking oral anticoagulants on their medication compliance and satisfaction levels. The study sample comprised 150 individuals. Of them, 50 were assigned to the control group, 50 to experimental Group 1, and 50 to experimental Group 2. Data were collected with the Descriptive Information Form, Medication Compliance Notification Scale, and Duke Anticoagulation Satisfaction Scale (DASS). Intervention Group 1 was given face-to-face education. Intervention Group 2 was given tele-education. The control group underwent no intervention. The scales were administered to all the groups twice. Intragroup analysis demonstrated that the Medication Compliance Notification Scale score of the face-to-face education group increased significantly in the final measurement compared to those of the control group and tele-education group. Intergroup analysis demonstrated that the DASS scores of the three groups significantly differed. The difference stemmed from intervention Group 1. Face-to-face education given to individuals with AF on oral anticoagulants improved their medication compliance and medication satisfaction levels. Nurses should primarily use face-to-face education in the care and education programs of individuals with AF.

Trastuzumab plus chemotherapy versus chemotherapy alone in HER2-positive gastric cancer treatment in Iran: a cost-effectiveness analysis

BackgroundCombining Trastuzumab with chemotherapy for HER2-positive gastric cancer shows treatment promise but may raise costs. We aimed to evaluate the cost-effectiveness of combining Trastuzumab with chemotherapy for HER2-positive gastric cancer treatment in Iran.MethodsWe employed a partitioned survival model (PSM) to evaluate the cost-effectiveness of trastuzumab plus chemotherapy versus chemotherapy alone. The PSM framework included three distinct health states: progression-free, post-progression, and death. Clinical data, including overall survival and progression-free survival rates, were derived from the ToGA trial, a randomized controlled study. A bottom-up approach was used to calculate costs by considering drug costs, adverse event management costs and other disease management costs separately for the progression-free and post-progression states. The analysis was conducted from the Iranian healthcare system’s perspective, considering direct medical costs. We performed a cost-effectiveness analysis to determine the optimal strategy by comparing the incremental cost-effectiveness ratio (ICER) to Iran’s cost-effectiveness threshold, set at one to three times the GDP per capita. Additionally, we conducted sensitivity analyses to assess the robustness of our findings.ResultsBoth FOLFOX-based regimens were strongly dominated. In comparison, the CAPOX regimen cost $2,811.11 for 0.75 QALYs. Adding Trastuzumab to CAPOX increased the cost to $6,128 and improved effectiveness to 0.92 QALYs, resulting in an ICER of $19,089.94 per QALY, which is between 2 and 3 times the GDP per capita in 2022.ConclusionThe addition of trastuzumab to chemotherapy regimens improved clinical outcomes in HER2-positive gastric cancer patients. From an economic perspective, the CAPOX regimen is the most cost-effective option when considering a cost-effectiveness threshold of up to two times Iran’s GDP per capita. However, when the threshold increases to three times the GDP per capita, the CAPOX + Trastuzumab regimen becomes the preferred choice. These findings provide valuable insights for healthcare policymakers in Iran.

Iron-Mediated Segment Coupling of Alkenols with Acceptors via C-C Radical Translocation and Remote Oxidative 1,5/6-Hydrogen Atom Transfer.

Iron-mediated segment coupling followed by oxidative 1,5/6-hydrogen atom transfer (HAT) for synthesis of ε-oxo alkene derivatives is developed. This transformation involved translocation of the radical from H-to-C-to-C-to-C followed by the oxidation under MHAT conditions providing rapid access to 1,6/1,7-keto functionalized esters/ketone/sulfones/phosphonates/arenes. The different outcomes of coupling with acceptors could be explained by bond dissociation energies (BDEs), and mechanistic insights were gained through control experiments, including deuterium labeling studies.

Pd Nanoparticles Decorated CeZrOx for Enhanced Photocatalytic Hydrogenation of Biomass‐Derived Compounds

The photocatalytic conversion of biomass‐derived compounds into value‐added chemicals presents a promising protocol for the sustainable production of renewable chemicals. Our study explores the hydrogenation of biomass model compounds under visible light illumination. Zr was incorporated into the CeO2 framework, forming a CeZrOx(1:0.5) solid solution, confirmed by powder X‐ray diffraction (PXRD) and X‐ray photoelectron spectroscopy (XPS) analyses. The light uptake capacity of the CeZrOx solid solution was characterized using UV‐visible spectroscopy. Additionally, the band structure of the CeZrOx solid solution was assessed using valance band X‐ray photoelectron spectroscopy (VB‐XPS) and Ultraviolet photoelectron spectroscopy (UPS) analysis, revealing a Z‐Scheme, which was further confirmed by various control experiments. Upon decorating the CeZrOx(1:0.5) solid solution with 1 wt% palladium (Pd), the resulting 1Pd/CeZrOx(1:0.5) composite exhibited improved charge separation and enhanced visible light absorption capacity. This composite achieved ~99% conversion of furfural to tetrahydrofurfuryl alcohol under a 15 W blue LED illumination and 0.2 MPa hydrogen. Similarly, it demonstrated ~99% conversion of benzyl phenyl ether (BPE) to toluene and phenol under a 10 W blue LED illumination. Our findings elucidate the active sites and demonstrate the recyclability of mixed metal oxides for selective furfural hydrogenation and BPE hydrogenolysis under visible light.

Design of a Novel Macro-Micro Integrated Brain Surgery Robot Based on Modular Parallel Mechanisms

The advancement and development of medical surgical robots have provided new technological support for brain surgery and neurosurgical procedures, improving the reliability of highly complex and precise surgeries. In turn, this urges the design and development of novel surgical robots to possess higher precision, stability, and enhanced motion capabilities. In response to this practical demand, this paper introduces a macro-micro integrated medical brain surgery robot system based on the concept of modular PMs (parallel mechanisms), which have a total of 13 active DOFs (degrees of freedom). This system divides the motion process of brain surgery into a large-scale macro-motion space and a small-scale high-precision motion space for design and planning control. The introduction of the design concept that combines multiple modular parallel sub-mechanisms has brought a significant level of decoupling characteristics to the mechanism itself. A comprehensive introduction and analysis of the surgical robot are provided, covering aspects such as design, kinematics, motion planning, and performance indicators. To address the pose allocation and coordination of motion between the macro platform and the micro platform, a pose allocation algorithm based on the decoupling and non-decoupling characteristics in various dimensions of the macro-micro platform is proposed. The designed measurement experiments have demonstrated that the repeatability in positioning accuracy of the macro and micro platform reaches the level of micron and submicron respectively. Practical experiments of motion control and simulated brain electrode implantation validate the excellent performance and stability of the entire surgical robot system. This research contributes innovative insights to the development of medical surgical robot systems, particularly in the domain of mechanism design.

A scoping review of the integration of non-medical prescribing for acute common clinical conditions by community pharmacists

Abstract Introduction Non-medical prescribing enhances patient care, safety, and medication accessibility, while also maximising expertise1. Some evidence exists for a variety of factors at individual, organisational, regulatory, and policy levels impacting the implementation of PP in community pharmacy2. Common clinical conditions (CCC) can be defined as ‘a broad range of self-limiting conditions that are more complex in their diagnosis and treatment than minor ailments and management that often involves the need for prescription medicines’. Aim To collate and characterise literature on the integration of non-medical prescribing for acute common clinical conditions by community pharmacists. Method This scoping review followed the Arksey and O’Malley framework. The review team comprised a doctoral student (LK), a research fellow (TJ) and a professor of pharmacy (SC), all with experience of review methodology, community pharmacy research and /or practice. Eligibility criteria, search databases and terms were defined. Medline, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched for full text, English language, peer reviewed original papers, randomised controlled trials, cross-sectional and cohort studies, papers reporting empirical data from primary research and review articles including systematic reviews /scoping reviews /narrative reviews from January 2006 to October 2023. The (global) focus was on services delivered by pharmacists and pharmacy team members in community pharmacy for the management of CCC, using non-medical prescribing rights. Search terms included “independent prescrib*”, “pharm* independent prescri*”, “pharm* prescrib*”, “non-medical prescri*, “non-medical prescri*”, “pharm* supplementary prescri*” and “collaborative prescrib*”. Following screening and full text review a narrative synthesis approach3 was used to address the aim which involved: preliminary synthesis through data extraction and tabulation of key study characteristics, exploration of relationships and differences across the studies and finally evaluation of the robustness of the synthesis. The Consolidated Framework for Implementation Research provided a theoretical lens to support synthesis, identifying barriers and facilitators for integration. All steps were independently checked by two review team members. Ethics approval was not required because this was a scoping review. Results From a total 1018 records identified, 10 papers remained after removal of duplicates, title /abstract screening and full text review. The majority of studies were from Canada and the aims and linked outcomes of studies focused on pharmacists’ views and experiences, evaluation of safety, effectiveness, and patient satisfaction. A range of CCCs were included with a focus on antibiotic prescribing. A wide range of barriers and facilitators to implementation were identified including “regulatory constraints” and “fiscal challenges” at a macro socio-organisational level and a plethora of dichotomous challenges within organisations including a lack of clarity on the pharmacist’s scope of practice and linked consumer confusion, staffing levels and workload, with specific mention of paperwork and access to patient records. Conclusion The small number of studies included indicates that there is a paucity of research in this area. There is a need for increased efforts to consider this topic further and identify ways to address the challenges for further widespread implementation and uptake of such services.

Efficacy of four internal fixation devices on femoral neck fractures in young adults: A systematic review and network meta-analysis.

The primary treatment of femoral neck fracture in young adults is internal fixation. The high complication rate after femoral neck fracture greatly affects the life of patients. There are many internal fixation devices for femoral neck fracture, but each has its advantages and disadvantages. Our aim was to determine the best internal fixation for young people with femoral neck fractures. We searched 5 databases from January, 2016 to December, 2023. Randomized controlled trials and cohort studies that met the inclusion criteria were assessed for quality using the RoB.2 and ROBINS-I scales, respectively. The network meta-analysis was conducted within a Bayesian framework utilizing a random effect model. Data analysis was performed using the "multinma" package within the R 4.2.0 software. A network meta-analysis of 34 studies involving 2291 patients was conducted. Results indicated that the inverted triangular cannulated screws demonstrated the lowest intraoperative bleeding volume (surface under the cumulative ranking curve [SUCRA] = 0.8732) based on the SUCRA. The medial buttress plate (MBP) exhibited superior efficacy in improving the Harris hip score (SUCRA = 0.8465), reducing complications (SUCRA = 0.9251), and accelerating fracture healing time (SUCRA = 0.8111). Additionally, the femoral neck system was ranked highest in terms of operation time (SUCRA = 0.7749) and femoral neck shortening (SUCRA = 0.7933). This network meta-analysis findings indicated that MBP resulted in superior postoperative hip function, reduced complication rate, faster fracture healing time. Considering the good physical condition of young adults, surgeon may consider utilizing MBP to achieve improved postoperative outcomes.

Continuous peri-operative glucose monitoring in noncardiac surgery: A systematic review.

Glucose management is an important component of peri-operative care. The usefulness of continuous glucose monitoring (CGM) in noncardiac surgery is uncertain. To systematically assess the glycaemic profile and clinical outcome of patients equipped with a CGM device during the peri-operative period in noncardiac surgery. Systematic review. Electronic databases were systematically searched up to July 2024. Any studies performed in the peri-operative setting using a CGM device were included. Closed-loop systems also administering insulin were excluded. Analyses were stratified according to diabetes mellitus status and covered intra-operative and postoperative data. Outcomes included glycaemic profile (normal range 3.9 to 10.0 mmol l-1), complications, adverse events, and device dysfunction. Twenty-six studies (1016 patients) were included. Twenty-four studies were not randomised, and six used a control arm for comparison. In bariatric surgery, diabetes mellitus patients had a mean ± SD glucose of 5.6 ± 0.5 mmol l-1, with 15.4 ± 8.6% time below range, 75.3 ± 5.5% in range and 9.6 ± 6.7% above range. During major surgery, diabetes mellitus patients showed a mean glucose of 9.6 ± 1.1 mmol l-1, with 9.5 ± 9.1% of time below range, 56.3 ± 13.5% in range and 30.6 ± 13.9% above range. In comparison, nondiabetes mellitus patients had a mean glucose of 6.4 ± 0.6 mmol l-1, with 6.7 ± 8.4% time below range, 84.6 ± 15.5% in range and 11.2 ± 4.9% above range. Peri-operative complications were reported in only one comparative study and were similar in CGM and control groups. Device-related adverse events were rare and underreported. In 9.21% of cases, the devices experienced dysfunctions such as accidental removal and issues with sensors or readers. Due to the limited number of controlled studies, the impact of CGM on postoperative glycaemic control and complications compared with point-of-care testing remains unknown. Variability in postoperative glycaemic profiles and a device dysfunction rate of 1 in 10 suggest CGM should be investigated in a targeted surgical group.

Effects of Kinesio tape on individuals with carpal tunnel syndrome: a randomized controlled study

ObjectiveCarpal tunnel syndrome (CTS) is a common neuromuscular disorder with an incidence rate of 4.9%. Research on the impact of Kinesio taping (KT) on electroneurography in individuals with CTS is limited, highlighting a significant gap in the literature. This study aimed to evaluate the effects of KT on palm numbness, pain intensity, hand grip strength, and median nerve electroneuromyography in individuals with mild to moderate CTS.MethodThis was a randomized, controlled, parallel design study. Twenty-seven participants diagnosed with CTS through hospital outpatient clinics were randomly assigned to either the control or KT group. The outcome measurements included hand grip strength, the Boston Carpal Tunnel Questionnaire (BCTQ), and electroneurography, assessed at baseline and after 6 weeks of intervention. The statistical method used was non-parametric analysis, comparing differences with the median and interquartile range (IQR).ResultsBoth the KT and control groups significantly improved the numbness grades, hand grip strength, and the BCTQ. The kinesio-taping group demonstrated an improvement in grip strength with a median increase of 2.21 kg (IQR: 0.65–3.79 kg), compared to the control group, which showed a median increase of only 0.70 kg (IQR: 0.22–1.45 kg). Statistical analysis revealed a significant difference between the two groups (p = 0.039), with an effect size of r = 0.33.ConclusionThis study suggested that KT can be a supplementary treatment to relieve pain intensity, enhance hand grip strength, and improve sensory conduction velocity, motor latency, and motor amplitude.Clinical Trial Registrationhttps://doi.org/10.1186/ISRCTN82192319, ISRCTNregistry (No. ISRCTN82192319).