Eligible Papers Research Articles

Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials

Abstract Introduction Incontinence is a common, distressing condition, most prevalent in older people. There is an unmet need for effective interventions to support continence. This review focuses on non-pharmacological interventions to reduce incontinence among homebound older people. Aim: to identify interventions with potential to be delivered by care workers, nurses or family members in a person’s home. Methods Multiple databases were searched until 15 September 2023 for randomised controlled trials reporting home-based interventions for incontinence for older people (≥65 years) living at home. Two reviewers independently screened titles, abstracts and papers against inclusion criteria, then assessed for the Risk of Bias (RoB2). A third reviewer resolved the discrepancies. Primary data were extracted and synthesised. Results A full-text review of 81 papers identified seven eligible papers (1996–2022, all USA), including n = 636 participants (561 women and 75 men). Two studies focusing on multicomponent behavioural interventions showed benefit, as did one study of transcutaneous tibial nerve stimulation self-administered through electrode-embedded socks. Three, which included cognitively impaired people, reported improvement with toileting assistance programmes, but the effects were not all significant. Results were inconclusive from a study examining the effects of fluid intake adjustments. Interventions were delivered by nurses, three in collaboration with family caregivers. No faecal incontinence interventions met the criteria. Conclusion There is scant evidence for continence supporting interventions delivered in older people’s own homes. With an ageing population often reliant on family or social care workers well-placed to support continence promotion and policy drives for services to support older people remaining at home, this evidence gap needs addressing.

Evaluating the Performance of Topic Modeling Techniques for Bibliometric Analysis Research: An LDA-based Approach

Digital technologies have been used for a vast amount of bibliometric analysis research. Although these technologies have made scientific investigation more accessible and efficient, scholars now face the daunting task of sifting through an overwhelming number of documents. This study aims to identify bibliometric research analysis's primary topics, categories, and latent topics from a global perspective. This study utilized topic modeling techniques to analyze the abstracts of 16,039 eligible papers published between 1977 and 2023 in the Scopus database. Through the use of Latent Dirichlet Allocation (LDA) topic modeling, the study was able to identify four distinct research topics and observe how they have evolved over time. The research topic has shifted its focus from individual concepts and words to relationships between nodes and conceptual, intellectual, and social structures. The study’s findings have significant implications for bibliometric analysis-related research, providing valuable insights into trends and patterns in bibliometric analysis content within large digital article archives. The LDA has proven to be an efficient tool for analyzing these trends and patterns quickly. This study's novel approach considers factors for word embedding usage and optimal topic numbers. It focuses on a full understanding of the LDA results and combines statistical analysis, domain knowledge, and temporal exploration to better understand how data structures work. Doi: 10.28991/HIJ-2024-05-02-07 Full Text: PDF

Does cervical root canal preparation influence the quality of endodontic treatment? A systematic review

Cervical preparation aims to remove dentin prominences located in the cervical region of the root canal. However, there is no consensus in the literature regarding the importance of this operative maneuver in endodontic treatment. The objective of this systematic review was to answer the question: Does cervical root canal preparation influence the quality of endodontic treatment? Material and methods: Electronic databases (Medline/PubMed, Lilacs, Scopus, Embase, Scientific Electronic Library Online – SciELO, and Central Register of Controlled Trials – Central) were searched until July 2023, without language or year restriction. Grey literature was also searched through Google scholar and OpenGrey repository. Only in vitro studies were included that evaluated the influence of cervical preparation on endodontic treatment. Relevant results were summarized and evaluated. The risk of bias was also assessed in the studies. Results: Initial screening of databases resulted in 235 studies, of which 80 were excluded for being duplicates. Of 155 eligible papers, twenty-nine studies met the inclusion criteria and were selected for full-text reading. Most of studies included in this review were qualified with low risk of bias. Five studies showed moderate risk. Conclusion: Based on the analyzed studies, it is possible to conclude that performing the cervical preparation facilitates the execution of the steps of odontometry and mechanical chemical preparation in clinical practice.

The Use of Metabolomes in Risk Stratification of Heart Failure Patients: Protocol for a Scoping Review.

Heart failure (HF) is a significant health problem that is often associated with major morbidity and mortality. Metabolic abnormalities occur in HF and may be used to identify individuals at risk of developing the condition. Furthermore, these metabolic changes may play a role in the pathogenesis and progression of HF. Despite this knowledge, the utility of metabolic changes in diagnosis, management, prognosis, and therapy for patients with chronic HF has not been systematically reviewed. This scoping review aims to systematically appraise the literature on metabolic changes in patients with HF, describe the role of these changes in pathogenesis, progression, and care, and identify knowledge gaps to inform future research. This review will be conducted using a strategy based on previous reports, the JBI Manual for Evidence Synthesis, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search of electronic databases (Medline, EBSCOhost, Scopus, and Web of Science) will be conducted using keywords related to HF, myocardial failure, metabolomes, metabonomics, and analytical chemistry techniques. The search will include original peer-reviewed research papers (clinical studies conducted on humans and systematic reviews with or without a meta-analysis) published between January 2010 and September 2023. Studies that include patients with HF younger than 18 years or those not published in English will be excluded. Two authors (UGA and MB) will screen the titles and abstracts independently and perform a full-text screen of the relevant and eligible papers. Relevant data will be extracted and synthesized, and a third author or group will be consulted to resolve discrepancies. This scoping review will span from January 2010 to September 2023, and the results will be published in a peer-reviewed, open-access journal as a scoping review in 2024. The presentation of the findings will use the PRISMA-ScR flow diagram and descriptive and narrative formats, including tables and graphical displays, to provide a comprehensive overview of the extracted data. This review aims to collect and analyze the available evidence on metabolic changes in patients with HF, aiming to enhance our current understanding of this topic. Additionally, this review will identify the most commonly used and suitable sample, analytical method, and specific metabolomes to facilitate standardization, reproducibility of results, and application in the diagnosis, treatment, and risk stratification of patients with HF. Finally, it is hoped that this review's outcomes will inspire further research into the metabolomes of patients with HF in low- and middle-income countries. Open Science Framework; https://osf.io/sp6xj. DERR1-10.2196/53905.

The value of fetal magnetic resonance imaging in diagnosis of congenital anomalies of the fetal body: a systematic review and meta-analysis.

To undertake a systematic review to assess the accuracy of fetal MRI in diagnosis of non-CNS congenital anomalies of the fetal body in comparison with antenatal ultrasound when correlated to postnatal diagnosis. Searches were conducted from electronic databases, key journals and reference lists for eligible papers. Inclusion criteria was original research studies comparing the diagnostic results of antenatal ultrasound, fetal MRI and final postnatal diagnosis via imaging, surgery or post-mortem testing. Studies of CNS anomalies were excluded. Studies were assessed for risk of bias by two reviewers working independently and data was then extracted by a single reviewer. 12 studies were included with a total of 361 eligible patients who underwent USS and MRI and had a postnatal diagnosis. USS alone had a diagnostic accuracy of 60.6% whereas MRI had an improved diagnostic accuracy of 86.4%. The overall odds ratio was 0.86 (CI 0.202-1.519 and p-value < 0.01). Fetal MRI makes a significant contribution to accurate diagnosis of congenital abnormalities of the fetal body; especially in genito-urinary anomalies. More research is needed to improve the evidence base for the role of fetal MRI in diagnosis of congenital anomalies in other body systems.

Recommendations for light-dosimetry field studies based on a meta-analysis of personal light levels of office workers

Daytime light levels are important for human physiology. Office workers spend most of their daytime inside buildings where it is unclear whether they receive healthy light levels. A recent publication presented recommendations for the minimum daytime light level for optimal human health, expressed in melanopic equivalent daylight illuminance (EDI). The current paper assesses whether this recommended daytime light level is achieved by office workers through a meta-analysis of personal light levels of office workers, obtained from light-dosimetry field studies. From our literature search, we identified nine eligible papers. These papers comprised data from studies in one or multiple office buildings, over one or more seasons, from 1 to 62 participants, and for 19 to 564 workdays. After analysing the data, we found that in none of the offices the recommended minimum light level of 250 melanopic EDI was met for the entire day. Only 1 out of 6 median and 6 out of 13 mean reported personal light levels were above this recommended value. Unfortunately, these conclusions are less groundbreaking than we hoped for, due to large differences between study protocols. This resulted in a large variety of (unreported) study characteristics (i.e. light data, light-dosimeter, participant, building and environment) which complicated a fair comparison between the different studies. To facilitate meta-analyses of light-dosimetry field studies, we introduce recommendations for data collection and reporting in light-dosimetry field studies. We based these recommendations on the gaps identified from our meta-analysis, supplemented by recommendations from other papers.

Reflexivity in pharmacy practice qualitative research: systematic review of twelve peer-reviewed journals

Abstract Introduction Reflexivity is named as an important component for establishing trustworthiness and authenticity within qualitative research. Depending on the philosophical stance of the researcher, subjectivity is often intertwined with qualitative research, thus engagement in reflexivity accounts for how this subjectivity shapes the study and aids to increase its rigor. Walsh’s typology[1] proposed personal, interpersonal, methodological, and contextual dimensions of reflexivity, which are overlapping and interacting, and was endorsed by the International Association for Medical Education (AMEE).[2] As pharmacy professionals conducting research, we bring many aspects (personal and professional experiences, beliefs, values) that can help us develop deeper and richer insights into our work; if not considered through reflexivity, this may have unrealised impacts which can bring the findings under scrutiny. Aim This systematic review aimed to explore reflexivity reporting, type, and strategies in qualitative studies published in peer-reviewed pharmacy journals. Methods Two reviewers screened twelve pharmacy related peer-reviewed journals from inception to 1st August 2023 for qualitative studies; these were identified as the ‘top’ pharmacy practice journals in JANE (Journal/Author Name Estimator). Then, studies were independently reviewed against inclusion criteria. Any disagreements were discussed to reach a consensus. Qualitative studies discussing reflexivity, having dedicated reflexivity sections in the manuscript, or providing quality checklists with reflexivity were included. Quantitative, mixed methods, and educational research studies were excluded. Two reviewers completed data extraction: reflexivity methods, where discussed in the paper and to what extent, and type of reflexivity as per Walsh’s typology to determine the dimension of reflexivity.[1] Data were synthesised narratively. Quality appraisal of study conduct was not completed and all eligible papers were included. Results 452 qualitative studies were reviewed and 102 were included from seven journals. Thirty-four studies provided quality checklists and 18 had personal (n=10), interpersonal (n=2), methodological (n=1), or multi-type (n=5) reflexivity. In the remaining 68 articles, reflexivity was personal (n=20), interpersonal (n=3), methodological (n=16), multi-type (n=28), or unclear (n=1). Where reflexivity was presented, it was mostly reported in the manuscript’s methods section or within limitations sections of discussions; some had reflexivity named sections. However, reviewed studies lacked true reflexive comments, and often descriptions of research team backgrounds were provided without consideration of the impact on the study, or the focus was on minimising study bias. Twelve studies alluded to the use of reflexive diaries, journals, or note sheets but lacked detail in how they were implemented. Conclusion This is the first systematic review, to our best knowledge, focused on reflexivity reporting in pharmacy practice qualitative studies. It highlighted that reflexivity reporting was poor, often misunderstood, and use of the quality checklist did not increase appropriate reporting. Reflexivity was often described as something researchers ‘did’ to minimise bias, rather than something to embrace and explore as part of qualitative research process. We posit that this could be due to a lack of understanding of what true reflexivity is, unclear quality checklist instructions and limited potential to include it meaningfully in the final manuscript. The review was limited to twelve pharmacy practice journals and articles published in English.

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes.

Background/Objectives: to assess surgical, oncological, and functional outcomes of robot-assisted radical prostatectomy (RARP) performed using the novel Hugo™ RAS system. Methods: A systematic review was conducted following the PRISMA guidelines, using PubMed, Web of Science, Scopus, and Embase databases. Eligible papers included studies involving adult males undergoing RARP with the Hugo™ RAS platform, with at least ten patients analyzed. The pooled analysis was performed using a random-effect model. Results: Quantitative analysis was conducted on 12 studies including 579 patients. The pooled median docking time, console time, and operative time were 11 min (95% CI 7.95-14.50; I2 = 98.4%, ten studies), 142 min (95% CI 119.74-164.68; I2 = 96.5%, seven studies), and 176 min (95% CI 148.33-203.76; I2 = 96.3%, seven studies), respectively. The pooled median estimated blood loss was 223 mL (95% CI 166.75-280.17; I2 = 96.5%, eleven studies). The pooled median length of hospital stay and time to catheter removal were 2.8 days (95% CI 1.67-3.89; I2 = 100%, ten studies) and 8.3 days (95% CI 5.53-11.09; I2 = 100%, eight studies), respectively. The pooled rate of postoperative CD ≥ 2 complications was 4.1% (95% CI 1-8.5; I2 = 63.6%, eleven studies). The pooled rate of positive surgical margins and undetectable postoperative PSA were 20% (95% CI 12.6-28.5; I2 = 71.5%, nine studies) and 94.2% (95% CI 87.7-98.6; I2 = 48.9%, three studies), respectively. At three months, a pooled rate of social continence of 81.9% (95% CI 73.8-88.9; I2 = 66.7%, seven studies) was found. Erectile function at six months was 31% in one study. Conclusions: despite the preliminary nature of the evidence, this systematic review and pooled analysis underscores the feasibility, safety, and reproducibility of the Hugo™ RAS system in the context of RARP.

P038 Measuring social engagement in rheumatic and musculoskeletal diseases

Abstract Background/Aims Rheumatic and musculoskeletal diseases (RMDs) result in reduced social well-being and social engagement (SE). Despite being an important outcome for patients, SE is rarely measured in studies or clinical practice. Furthermore, social media and COVID-19 has changed how we interact with society. We aimed to evaluate existing SE measures used in RMD populations. Methods A systematic review of the qualitative literature and thematic analysis identified key impacts of RMDs and associated treatments on SE [unrestricted date -February 2023]. A systematic review of the quantitative literature [unrestricted date-February 2022] identified existing SE measures validated for use within RMDs, their constructs and compared these to themes identified from the qualitative literature. Results From 2601 records screened, we identified 30 eligible qualitative papers. Thematic analysis highlighted barriers and facilitators of SE in RMDs:. Barriers to SE included: 1) Direct effects of RMDs 2) Practicalities of undertaking SE 3) Social networks and roles. Facilitators of SE included: 1) Benefits of SE 2) Resilience &amp; Acceptance 3) Activity Adjustment. From 7772 records screened we identified 15 specific SE measures validated in RMD populations. These measures focused on measuring frequency, satisfaction, difficulty, and modification of SE. Table 1 shows how many of the existing SE measures validated for use in RMDs identified in the quantitative systematic review measure the key impacts of RMDs on SE as identified in the qualitative thematic analysis. Conclusion Existing measures of SE do not assess the wide range of impacts identified as important to patients. There is a need for a new SE measure to inform interventions to improve health and social outcomes for people with RMDs. Focus groups involving individuals with RMDs, and key stakeholders are planned to present the findings from the systematic reviews and facilitate discussion to help inform development of a new measure of SE. Disclosure A. Maciver: None. G. Macfarlane: None. R.J. Hollick: None.

Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review.

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O'Malley's framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity.

Mental Health of Homicidally Bereaved Individuals: A Systematic Review of Post-Homicide Factors.

Experiencing the homicide of a loved one has a substantial impact on the mental health of family members and friends who must survive their loved one's tragic death. This systematic review aims to synthesize the current findings on post-homicide factors and identify the factors most frequently related to the mental health of homicidally bereaved individuals (HBI). Four databases were searched (PsycINFO, SCOPUS, Sociological Abstract, PubMed). The selection of studies was based on a peer review process conducted by two independent researchers to ensure interrater reliability. The articles were screened to ensure the presence of homicidally bereaved adults, resulting in a total of 35 eligible papers to be considered in the current review. Factors were organized into categories, with the criminal justice system-related factors (n = 18), social factors (n = 17), and coping factors (n = 13) being the most prevalent. This review identifies clinical avenues for preventing distress and fostering the well-being of HBI.

689 Technical Success and Occlusion Rates of eCLIPs Bifurcation Remodeling System for Treatment of Wide-neck Bifurcation Aneurysms: Summary of the Early Experience

INTRODUCTION: Wide-necked bifurcation aneurysms (WNBA) are among the most difficult aneurysms to treat. Very low dome-to-neck and aspect ratios provide an even greater challenge in the management of WNBAs. METHODS: A systematic review and meta-analysis was conducted following the PRISMA recommendations. On April 4, 2022, we searched for eligible papers in Pubmed, Web of Science (ISI), Scopus, and Embase databases. The meta-analysis was done using R software version 4.3.0. and the "meta" package. Pooled prevalence (%) and their corresponding 95% confidence intervals (CI), random-effects model based and the generalized linear mixed models (GLMMs) method. On the presence of multiple follow-up points, we included the last available in the analysis. Complete occlusion was defined as Raymond–Roy occlusion classification (RROC) class I, and adequate occlusion was defined as RROC class I or II. RESULTS: Four studies were finally included following the double-reviewer screening of the retrieved literature. The patients' mean age ranged from 56 ± 5.4 to 60±9.2 years, and 82.5% were females. The mean follow-up duration ranged from 8 ± 6.6 months to 28.8 ± 17.6, with all studies giving dual antiplatelet regimens and one added heparinization to their anticoagulation protocol. Technical success was achieved in 88.61% (95% CI = 75.54-95.15) of the cases, while successful adjunctive coiling was obtained in 91.38% (95% CI = 70.71-97.90) of them. The complete occlusion rate was 50.65 (95% CI = 39.63-61.60), while the adequate occlusion rate was 84.42 (95% CI = 74.53-90.93). There was no significant heterogeneity in all pooled outcomes. CONCLUSIONS: The early experience of the device shows an efficacy profile comparable with the currently available devices in treating WNBAs.

Understanding barriers and facilitators to diet and physical activity modification in people with polycystic ovary syndrome: a mixed method systematic review

Polycystic Ovary Syndrome PCOS is an endocrine disorder affecting 8 to 13% of reproductive aged women(1). Dietary and physical activity changes are the first-line therapy to assist with symptom and weight management and to reduce the risk of reproductive, metabolic and psychological comorbidities(2). However, women with PCOS have a higher weight, experience weight gain, and a higher prevalence of living in a larger body. Health care professionals (HCPs) play a crucial role in delivering diet and physical activity advice for people with PCOS. Thus, the aim of this systematic review is to understand the barriers, facilitators, experiences, and perceptions of engagement and compliance with diet and physical activity modifications in people with PCOS and in HCPs providing or referring people with PCOS to diet and physical activity modifications. A mixed-method systematic review was conducted with quantitative studies narratively synthesised and all studies thematically analysed. There were 68 eligible papers, including n = 59 (n = 5198) people with PCOS and n = 17 (n = 2,622) HCPs. Several themes were identified as impacting people with PCOS’ ability to make diet and physical activity changes. HCP education on PCOS management through diet and physical activity was viewed by HCPs and people with PCOS to be inadequate, further impacting the quality of care and health outcomes. Dietary and physical activity advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. Both people with PCOS and HCPs agreed that there was a need for individualised and PCOS-specific diet and physical activity advice. However, HCPs viewed that there was limited evidence supporting these recommendations and a lack of time to deliver this care. Weight stigma was identified as impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that diet and physical activity are overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including receiving diet and physical activity advice that meet the individual’s needs, are necessary for leading to long-term sustainable changes and improvements in health outcomes. A multidisciplinary team approach and an overhaul of HCPs’ perceptions and mentality of weight and weight-centric care for those with PCOS are essential in delivering effective diet and physical activity advice.

Toxicological Effects of Naturally Occurring Endocrine Disruptors on Various Human Health Targets: A Rapid Review.

Endocrine-disrupting compounds are chemicals that alter the normal functioning of the endocrine system of living organisms. They can be natural (N-EDCs) or synthetic compounds (S-EDCs). N-EDCs can belong to different groups, such as phytoestrogens (PEs), including flavonoids, or mycotoxins originating from plants or fungi, and cyanotoxins, derived from bacteria. Humans encounter these substances in their daily lives. The aim of this rapid review (RR) is to provide a fine mapping of N-EDCs and their toxicological effects on human health in terms of various medical conditions or adverse consequences. This work is based on an extensive literature search and follows a rigorous step-by-step approach (search strategy, analysis strategy and data extraction), to select eligible papers published between 2019 and 2023 in the PubMed database, and to define a set of aspects characterizing N-EDCs and the different human target systems. Of the N-EDCs identified in this RR, flavonoids are the most representative class. Male and female reproductive systems were the targets most affected by N-EDCs, followed by the endocrine, nervous, bone and cardiovascular systems. In addition, the perinatal, pubertal and pregnancy periods were found to be particularly susceptible to natural endocrine disruptors. Considering their current daily use, more toxicological research on N-EDCs is required.

Daily Duration of Eating for Children and Adolescents: A Systematic Review and Meta-Analysis.

Time-limited eating is a dietary intervention whereby eating is limited to a specific window of time during the day. The usual eating windows of adults, and how these can be manipulated for dietary interventions, is well documented. However, there is a paucity of data on eating windows of young people, the manipulation of which may be a useful intervention for reducing obesity. This paper reviewed the existing literature on the eating windows of children and adolescents, aged 5-18 years, plus clock times of first and last intakes and variations by subgroup. Two databases (Medline and Embase) were searched for eligible papers published between February 2013 and February 2023, with forward searching of the citation network of included studies on Web of Science. Articles were screened, and data extracted, in duplicate by two independent reviewers. Ten studies were included, with both observational and experimental designs. Narrative synthesis showed large variations in eating windows with average values ranging from 9.7 h to 16.4 h. Meta-analysis, of five studies, showed a pooled mean daily eating window of 11.3 h (95% CI 11.0, 11.7). Large variations in eating windows exist across different study populations; however, the pooled data suggest that it may be possible to design time-limited eating interventions in paediatric populations aimed at reducing eating windows. Further high-quality research, investigating eating windows and subsequent associations with health outcomes, is needed.

Intradermal testing of iodinated contrast media: Should we test up to pure or with diluted compounds only?

Intradermal testing (IDT) with iodinated contrast media (ICMs) is an established diagnostic tool in patients with ICM hypersensitivity. Currently, it is unclear which test concentration is the more useful one, up to pure or up to 1:10 diluted ICMs. We searched the literature database PubMed for eligible papers dealing with ICM allergy and their IDT results. We analyzed the data presented by the papers and compared the pooled groups tested with diluted and undiluted ICMs. We identified 29 eligible original papers, and extracted data of 1137 patients that formed the study population. Although in the cohort tested with diluted ICMs the number of tested ICMs was greater, the percentage of positive tests was significantly less (9.0% vs. 24.7%; P < 0.0001; OR 0.30 [0.26-0.34]). The frequency of positive tested culprit ICMs was also lesser in the group tested with diluted ICMs (31.0% vs. 72.5%; P < 0.0001; OR 0.17 [0.12-0.23]). The number of drug provocation tests (DPTs) was greater in patients with diluted IDTs (374 vs. 89; P < 0.0001; OR 2.54 [1.93-3.36]). We detected an increased sensitivity in patients with undiluted tests (0.774 vs. 0.282) and a nearly identical specificity in both groups (1 vs. 0.983). For the first time, we show that IDT up to pure ICM concentrations is superior to using diluted ICMs only. Possibly, we can reduce the number of DPTs when performing IDTs with pure ICMs. In the undiluted group, there were no hints for skin irritations or unspecific test reactions.

Food marketing communication targeting children: A content analysis of research literature (2000–2023)

ABSTRACT This study provides a big picture of research in the field of food marketing communication targeting children. It aims to identify conceptual and methodological gaps, and set future research agenda for investigating less-explored aspects of food marketing communication effects on children’s food choices. A content analysis of the most influential scientific literature related to food marketing communication targeting children was conducted. Each eligible paper was analyzed based on lines of research and methodology. Analysis of 495 eligible papers revealed that “advertising” was the dominant line of research, followed by “sales promotion”. The most common research method was content analysis, and the most common analysis technique was comparison tests. Among data gathering methods, two categories of “structured questionnaires and surveys” and “nonreactive measures” had the most frequencies. One of the main findings of this study is the scarcity of research within the domains of “personal selling”, “direct marketing” and “public relations”, all of which have significant potential in influencing children’s food behaviors, both unhealthy and healthy. Additionally, there is the lack of studies using methods to consider children’s voices that will be discussed based on the United Nations Convention on the Rights of the Child.

A Review of Patient's Knowledge and Practice of Diabetic Foot Self-Care.

Since diabetic foot ulcers (DFUs) are common among diabetes patients, it is essential to increase patients' knowledge and self-care practices to ensure early recognition and management and reduce amputation risk. Therefore, the goal of this review was to identify the range and level of knowledge of people with DFUs and the type of self-care they undertake. A literature review was conducted using the electronic databases PubMed and Google scholar with 'diabetic foot', 'self-care', 'practice' and 'behaviour' as searching keywords. The identification and selection process were conducted to sort the eligible papers through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The criteria are the original papers describing knowledge and practice in DFU; reporting knowledge and practice in their non-intervention studies; writing in English language; and publishing between years 2016 and 2022. The eligible papers were assessed using the strength of reporting observational studies in epidemiology (STROBE) checklist for appraising their quality. Twenty-two papers of 2,073 titles met the inclusion criteria and included in the review. The lowest and the highest quality score of included papers based on STROBE checklist are 11 and 26, respectively. The included papers showed various levels of knowledge from good to poor, which prominent the highest percentage are 88% (good knowledge) and 84.8% (poor knowledge). The majority of the foot-care activities found in the reviewed papers involved the following steps: washing, drying, applying moisturiser and trimming nails routinely. Those activity should be followed by checking the feet with a mirror for ulcers, looking for ingrown nails, choosing appropriate footwear, not walking barefoot and routinely consulting a healthcare provider. The knowledge levels were found variable and acceptable. Daily foot care, choosing the right footwear, foot activity and regular health checks should all be used to manage diabetes.

Autoimmune Movement Disorders Complicating Treatment with Immune Checkpoint Inhibitors.

Immune checkpoint inhibitors (ICI) may trigger autoimmune neurological conditions, including movement disorders (MD). The aim of this study was to characterize MDs occurring as immune-related adverse events (irAEs) of ICIs. A systematic literature review of case reports/series of MDs as irAEs of ICIs was performed. Of 5682 eligible papers, 26 articles with 28 patients were included. MDs occur as a rare complication of cancer immunotherapy with heterogeneous clinical presentations and in most cases in association with other irAEs. Inflammatory basal ganglia T2/fluid attenuated inversion recovery abnormalities are rarely observed, but brain imaging is frequently unrevealing. Cerebrospinal fluid findings are frequently suggestive of inflammation. Half of cases are associated with a wide range of autoantibodies. Steroids and ICI withdrawal usually lead to improvement, even though some patients experienced relapses or a severe clinical course. MDs are a rare complication of ICIs that should be promptly recognized to offer patients a correct diagnosis and treatment.

Can "Stop The Bleed" training courses for laypersons improve hemorrhage control knowledge, skills, and attitudes? A systematic review.

In many regions of the world, most trauma deaths occur within 1-2 h of injury due to uncontrolled bleeding. For this reason, training lay first-person responders in trauma care, focusing on hemorrhage control, has been recommended. We hypothesized that STOP THE BLEED(STB) training courses that teach laypersons how to stop traumatic compressible bleeding immediately are needed to potentially prevent deaths due to hemorrhage. This systematic review will analyze the effect of the STB training course on the knowledge, skill, and attitudes of lay first-person responders for hemorrhage control. PubMed and Google Scholar databases were used to identify relevant peer-reviewed research articles describing evaluations of STB courses for laypersons from December 1 2013 to October 31 2022. In addition, a hand search of article references was undertaken. Studies were included if they implemented the STBcourse; trainees were laypersons, and the study had some outcome measures such as knowledge, skill, confidence gained, and willingness to provide or utilization of care provided to and outcomes of trauma patients. The database searches yielded 2,893 unique papers. We retained 33 articles for full-text review, resulting in 24 eligible papers. Gray literature and manual searches yielded 11 additional publications for a total of 35 studies. The most reported finding was a statistically significant increase in hemorrhage control knowledge or tourniquet application skills in 26 studies. Twenty-two studies reported statistically significant improvements in willingness, confidence, comfort, and likelihood to respond to a bleeding patient, and 6 studies reported substantial reductions in the retention of bleeding control knowledge or skills. Only one study reported on the effect on patient outcomes. STB courses for laypersons have demonstrated significant improvements in knowledge, skill, confidence, and willingness to intervene to stop traumatic exsanguination. The evaluation of clinically relevant patient outcomes, specifically their effect on preventable deaths from traumatic exsanguination, is needed to strengthen further the evidence behind the recommendations for more widespread teaching of "STB" courses.