English Publications Research Articles

How Delphi studies in the health sciences find consensus: a scoping review

BackgroundDelphi studies are primarily used in the health sciences to find consensus. They inform clinical practice and influence structures, processes, and framework conditions of healthcare. The practical research—how Delphi studies are conducted—has seldom been discussed methodologically or documented systematically. The aim of this scoping review is to fill this research gap and to identify shortcomings in the methodological presentation in the literature. On the basis of the analysis, we derive recommendations for the quality-assured implementation of Delphi studies.MethodsForming the basis of this scoping review are publications on consensus Delphi studies in the health sciences between January 1, 2018, and April 21, 2021, in the databases Scopus, MEDLINE via PubMed, CINAHL, and Epistemonikos. Included were publications in German and English containing the words “Delphi” in the title and “health” and “consensus” in the title or abstract. The practical research was analyzed for the qualitative content of the publications according to three deductive main categories, to which an influence on the result of Delphi studies can be imputed (expert panel, questionnaire design, process and feedback design).ResultsA total of 287 consensus Delphi studies were included in the review, whereby 43% reported having carried out a modified Delphi. In most cases, heterogeneous expert groups from research, clinical practice, health economics, and health policy were surveyed. In about a quarter of the Delphi studies, affected parties, such as patients, were part of the expert panel. In the Delphi questionnaires it was most common for standardized Likert scales to be combined with open-ended questions. Which method was used to analyze the open-ended responses was not reported in 62% of the Delphi studies. Consensus is largely (81%) defined as percentage agreement.ConclusionsThe results show considerable differences in how Delphi studies are carried out, making assessments and comparisons between them difficult. Sometimes an approach points to unintended effects, or biases in the individual judgments of the respondents and, thus, in the overall results of Delphi studies. For this reason, we extrapolate suggestions for how certain comparability and quality assurance can be achieved for Delphi studies.

Sociodemographic Profiles of Pregnant Woman with Urinary Tract Infection: A Systematic Review of Current Research

Introduction: Untreated UTIs during pregnancy can lead to complications for both the mother and the fetus, highlighting the importance of appropriate management. Understanding the sociodemographic profiles of pregnant women with UTIs can aid in tailored interventions and care. Methods: This systematic review followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024507145). Cohort cross-sectional studies focusing on the sociodemographic profiles of pregnant women with UTI were systematically searched and selected from databases such as ScienceDirect, Cochrane, Scopus, and PubMed. Eligibility criteria included relevance to sociodemographic profiles, clear extraction and statistical analysis methods, and publication in English. Data extraction and study selection were conducted independently by six researchers, with any discrepancies resolved through discussion. Results: Three studies met the inclusion criteria and were included in the systematic review. The studies conducted in the United States, Cameroon, and Bangladesh, which included 46,398 pregnant women, revealed diverse sociodemographic factors associated with UTI risk among pregnant women. Factors such as low educational attainment, low household income, and racial/ethnic disparities were identified as significant contributors to UTI prevalence in the United States. In Cameroon, although a high UTI prevalence was observed, no significant risk factors were identified. In Bangladesh, maternal undernutrition, primiparity, and low paternal education were significant risk factors for UTIs among pregnant women. Antibiotic sensitivity was varied, indicating the complexity of UTI management. Conclusion: The systematic review emphasizes the importance of considering sociodemographic factors in understanding and addressing UTI risk among pregnant women. Socioeconomic status, cultural disparities, and health-related factors play significant roles in UTI prevalence and management. An intervention to target specific sociodemographic characteristics may be necessary to effectively prevent and manage UTIs in pregnant women across different geographical and socioeconomic contexts.

Masking Ability of Subtractively and Additively Manufactured Dental Ceramic Restorations: A Systematic Review.

To conduct a systematic review on the masking ability of subtractively and additively manufactured dental ceramics. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The electronic search was carried out through MEDLINE, Scopus, and Website of Science databases with a date restriction being from 2001 onwards. Publications in English, invitro studies, and studies regarding the evaluation of the masking ability of crown materials that were subtractively and additively manufactured were included. Out of 619 eligible articles, 13 were included. A thickness of 1.5 mm for lithium disilicate (LD) resulted in a dramatic decrease in ∆Eab/∆E00 across all substrates compared to a 1 mm thickness. Low-translucent LD appeared to have the best masking ability regardless of the shade of the try-in paste. Layering flowable composite over the substrates improved masking ability. Darker substrates were the hardest to mask no matter the type of restorative material, try-in paste used, and layering technique. Bilayered restorative materials proved to be superior to monolithic materials regarding masking ability. Increasing the thickness of subtractively manufactured ceramics materials improves the masking ability. 1.5 mm thickness is found to provide the best masking ability for most ceramic materials. Darker substrates prove to be difficult to mask in comparison to lighter substrates and require either thicker materials and/or more opaque cements. Bilayered crowns are recommended for achieving optimal masking while preserving tooth structure. Despite the increasing demand, there is no study available on 3D-printed (additively manufactured) restoration's masking ability. This review provides a comparison of masking abilities of multiple subtractively manufactured ceramic materials and highlight the lack of current knowledge on additively manufactured crown materials. It also emphasizes the importance of having a universal approach to interpreting and communicating color changes between collaborative dental professionals to ensure the same shade predictions. In addition, when masking darker shades, clinicians should be aware that alternative material choice or clinical and technical procedures are essential.

Inclusive assessment in health professions education: Balancing global goals and local contexts.

In this article, we draw upon diverse and contextually different experiences of working on inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for health professions education (HPE) within universities. Instead of juxtaposing our views from three countries, we combine our perspectives to advocate for inclusive assessment. Creating an inclusive assessment culture is important for equitable education, even if priorities for inclusion might differ between contexts. We recognise challenges in the enactment of inclusive assessment, namely, the notion of lowering standards, harming reliability and robustness of assessment design and inclusion as a poorly defined and catchall term. Importantly, the lack of awareness that inclusion means recognising intersectionality is a barrier for well-designed inclusive assessments. This is why we offer considerations for HPE practitioners that can guide towards a unified direction of travel for inclusive assessments. This article highlights the importance of contextual prioritisation and initiatives to be considered at the global level to national, institutional, programme and the individual level. Utilising experience and literature from undergraduate, higher education contexts, we offer considerations with applicability across the assessment continuum. In this state of science paper, we were set the challenge of providing cross-cultural viewpoints on inclusive assessment. In this discursive article, we focus on inclusive assessment within undergraduate health professions education whilst looking to the wider higher education literature, since institutional policies and procedures frequently drive assessment decisions and influence the environment in which they occur. We explore our experiences of working in inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for HPE. Unlike other articles that juxtapose views, we all come from the perspective of supporting inclusive assessment. We begin with a discussion on what inclusive assessment is and then describe our contexts as a basis for understanding differences and broadening conversations. We work in the United Kingdom, Australia and Malaysia, having undertaken research, facilitated workshops and seminars on inclusive assessment nationally and internationally. We recognise our perspectives will differ as a consequence of our global context, institutional culture, individual characteristics and educational experiences. (Note that individual characteristics are also known as protected characteristics in some countries). Then, we outline challenges and opportunities associated with inclusive assessment, drawing on evidence within our contexts, acknowledging that our understanding of inclusive assessment research is limited to publications in English and currently tilted to publications from the Global North. In the final section, we then offer recommendations for championing inclusion, focussing firstly on assessment designs, and then broader considerations to organise collective action. Our article is unapologetically practical; the deliberate divergence from a theoretical piece is with the intent that anyone who reads this paper might enact even one small change progressing towards more inclusive assessment practices within their context.

Unravelling the Impact: Pulmonary Side Effects of Anti-Seizure Medications

Background: Epilepsy is a chronic brain condition affecting over 50 million people worldwide. Several new anti-seizure medications (ASMs) have been introduced to treat epilepsy in recent decades. Objective: Nearby the specific therapeutic action, ASMs, like other types of pharmacotherapy, can produce various side effects. In this review, we shall analyze the different pharmaceutical classes of ASMs, their mechanism of action, and their interaction with the respiratory system. Methods: This manuscript is based on a retrospective review of English publications indexed by Pubmed, UpToDate and datasheets published by the European Medicines Agency and the Food and Drug Administration (FDA), using various terms reminiscent of ASMs and pulmonary function. Results: ASMs act on organism homeostasis in different ways, acting on lung function directly and indirectly and playing a protective or damaging role. A damaging direct lung involvement ranged from infections, hypersensitivity reactions, and respiratory depression to other structured pulmonary diseases. Meanwhile, a damaging indirect effect, might be constituted by pulmonary artery hypertension. On the other hand, a protective effect might be the expression of developmental processing, decreasing airway remodelling in asthma patients, vascular remodelling in pulmonary hypertension and, nonetheless, anti-inflammatory and immunomodulatory actions. Conclusion: An adequate awareness of ASMs effects on the respiratory system seems essential for better managing frail individuals or/and those predisposed to respiratory disorders to improve our patients' clinical outcomes.

Promoting Transversal Skills for Enhanced Quality of Life and Inclusion in people with Cognitive Deficits: A Bibliometric Analysis

This study aims to explore and analyze the existing literature on interventions promoting transversal skills (TS) to improve quality of life, well-being, and inclusion in individuals with cognitive needs. By employing advanced bibliometric techniques such as citation analysis and keyword mapping, academic publications were systematically examined across databases including the Online Knowledge Library (b-on), Web of Science (WoS), and PubMed. The selection criteria included publications in English or Portuguese that focused on programs developing transversal skills, such as memory, problem-solving, self-regulation, and cognitive flexibility, with an emphasis on health, well-being, and inclusion. The analysis demonstrated the effectiveness of a variety of interventions—cognitive training, physical activities, and creative interventions—that consistently showed improvements in executive functioning, memory, physical performance, and psychosocial well-being. Despite these findings, there remains a scarcity of comprehensive studies, with research on problem-solving and cognitive flexibility being more prevalent than on skills like self-directedness and creativity. Most studies focused on single interventions rather than multi-skill strategies or broader integration into cognitive support programs. The findings provide quantitative and qualitative insights into research trends and gaps, offering guidance for policymakers, practitioners, and educators. The study emphasizes the need for evidence-based guidelines and a more cohesive, interdisciplinary approach to research, advocating for increased collaboration and funding to explore under-researched areas. Ultimately, this research contributes to advancing interventions that enhance the quality of life and autonomy of individuals with cognitive deficits, particularly within the aging population.

Наслідки воєнних дій для водних екосистем і рибного господарства України. Тематична вебліо-бібліографія

Purpose. Numerous facts of the harmful impact of military actions caused by the military aggression of the Russian Federation on the environment of Ukraine were recorded and documented by many Ukrainian and foreign scientists and other specialists. The purpose of this work was to form a reference list of publications on the impact of war on water resources and hydrobionts, as well as the aquaculture industry of Ukraine in general and fisheries in particular. Methods. The complete and selective methods were applied in the process of the systematic search. The bibliographic and webliographic core have been consisted of publications in Ukrainian and English, including monographs, materials of round tables, conferences and meetings, public reports, articles in collections of scientific collections and journals, as well as reviews, chronicles, news on the subject of the work, posted on publicly available websites. Results. A thematic list of publications with a total quantity of 97 sources covering the time interval from 2015 to 2024, and showing the issues of the impact of military operations on natural hydroecosystems, as well as the aquaculture industry of Ukraine has been composed. In addition, the range of issues covered includes methods for calculating the damage caused by war and possible ways to overcome its harmful consequences. The literary sources were arranged in alphabetical order by author or title, and described according to DSTU 8302:2015 “Information and documentation. Bibliographic reference. General principles and rules of composition”, with the amendments (code UKND 01.140.40), as well as in accordance with the requirements of APA style — international standard of references. Practical value. The list may be useful for ecologists, ichthyologists, hydrobiologists, fish farmers — both scientists, specialists, and teachers, students, and everyone interested in the topic of the publication. Key words: military aggression of the Russian Federation, hydroecosystems, fisheries of Ukraine, aquaculture, damage, fish kills, ecocide, Kakhovka Reservoir, recovery.

Entrepreneurial intention and innovation among students: A bibliometric analysis 2014–2024

The objective of this study is to analyze the existing literature and highlight significant trends in the area of entrepreneurial intention and innovation among students. The data employed in this analysis were sourced from the Scopus database, covering 361 publications in English over the last ten years (from 2014 to 2024, as of the survey conducted on September 10, 2024). The method employed is bibliometric analysis with the support of the VOSViewer software. The findings show that the topic of entrepreneurial intention and innovation among students is a rather interesting subject, which has been widely published in reputable journals, particularly in the fields of education, training, and entrepreneurship. This topic has been extensively researched in Asian countries, with China standing out as the top contributor in terms of the number of publications. Through bibliometric analysis, this study has also identified four main research themes related to the topic of entrepreneurial intention and innovation among students. They are: (1) the effect of individual student characteristics on entrepreneurial intention; (2) the role of education and innovation in shaping students’ entrepreneurial intentions; (3) utilizing the theory of planned behavior to explore factors influencing social entrepreneurial intentions among students in higher education; (4) the influence of entrepreneurship education on the development of students’ entrepreneurial mindset and actions. Furthermore, this study has outlined nine promising future research directions that aim to enhance both the quantity and quality of studies on students’ entrepreneurial intentions and innovation. AcknowledgmentThis study is a product of the doctoral dissertation project carried out under decision No. 5125/QD-ĐHDT dated November 30, 2021, from Duy Tan University, Vietnam.

Voice of the nurse in paediatric intensive care: a scoping review

ObjectivesThe objective was to explore how the voice of the nurse in paediatric intensive care units (PICU) is portrayed in the literature.DesignScoping review using the six-step scoping review framework outlined...

Hemolytic disease of the fetus and newborn and Rhesus alloimmunization in Latin American countries: a scoping review

BackgroundHemolytic disease of the fetus and newborn (HDFN) is a condition due to maternal blood group antibodies targeting antigens in fetal red blood cells, with significant prenatal/perinatal morbidity and mortality. Severe HDFN cases are often associated with alloimmunization against Rhesus D (RhD) or Kell antigens. Information about HDFN epidemiology and treatment in Latin American countries is limited. This review aims to identify and synthesize the available evidence on the epidemiology and management of HDFN in this region.MethodsIn July 2023, EMBASE, PubMed, LILACS, and other databases were searched for articles reporting epidemiology, treatment, prenatal and perinatal outcomes, and patient journey of HDFN cases in Latin American countries. A snowball search of cross-references and gray literature complemented the initial search. Publications in English, Spanish, and Portuguese were reviewed. Data were extracted using a defined template and charted in tables.ResultsWe reviewed five guidelines and 19 observational studies from Brazil, Chile, Mexico, Argentina, Colombia, Panamá, Paraguay, and Peru. HDFN due to Rh alloimmunization ranged from 0.5 to 5 per 1000 live births, and anti-D remains the most frequent alloantibody type for severe HDFN. The perinatal mortality rate of HDFN is approximately 1.3–1.6 per 100,000 live births, and fetal deaths can reach 30% among patients treated with intrauterine transfusions. Up to 47% of alloimmunized pregnancies were referred to reference centers only during the third trimester. About 60% of eligible pregnancies received anti-D IgG prophylaxis.ConclusionsAlthough estimates in LATAM countries are scarce and lack standardized measures, we observed that the incidence, morbidity, and mortality of HDFN in this region are problematic. RhD alloimmunization was reported in approximately up to 70% of severe HDFN cases, despite anti D HDFN being largely preventable.

Assessment of clinical competencies of medical students in a simulated environment: a scoping review protocol

Simulation in scenarios representative of clinical practice is an innovative teaching-learning strategy. Performance evaluation in this scenario must be carried out using methods that are valid, reliable, equivalent, feasible, acceptable, have an educational impact and a catalytic effect. It is therefore necessary to understand the methods available for this purpose. The aim was therefore to outline a scoping protocol on the assessment methods used to analyze the clinical competencies of medical students in a simulated environment. This protocol was conducted according to the methods proposed by the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The review question was defined based on the PCC (Population, Concept, Context) mnemonic: “What methods are used to assess the clinical skills of medical students in a simulated environment?”. The eligibility criteria are associated with publications in English, Portuguese and Spanish, available in full text, covering methodological approaches including qualitative, quantitative, mixed methods, primary research, systematic reviews, meta-analyses, letters, guidelines, published theses and dissertations, with no time frame. The searches will be carried out in the Scopus, CINAHL, Web of Science, Lilacs, PubMed and Scielo databases. The results will be presented in tables or diagrams, accompanied by explanatory text, according to the best use for the purpose of the review.

Beyond traditional teaching: a systematic review of innovative pedagogical practices in higher education

Background Pedagogical best practices play a pivotal role in ensuring the academic success of students within the higher education landscape. This study aims to systematically synthesize innovative pedagogical best practices within the university context. Methods We conducted a thorough systematic review using the rigorous PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Our review involved comprehensive searches of scientific databases, including Eric, Scopus, and Proquest, covering both Spanish and English publications. We strategically employed Boolean operators like AND and OR to create a robust search equation. Our primary research question guiding this investigation was: “What innovative pedagogical practices have been developed in university settings to improve teaching and learning effectiveness?” This central question led us to delve deeply into the strategies utilized, pedagogical approaches adopted, and the noticeable impact achieved after their implementation. Additionally, we carefully established stringent inclusion and exclusion criteria in accordance with PRISMA guidelines to ensure methodological rigor. Results A total of 25 scholarly articles that met the pre-established criteria were meticulously identified and included in this systematic review. The results were thoughtfully categorized into three distinct teaching strategies: the first emphasizing student-centered approaches, the second showcasing the integration of educational technology, and the third highlighting evaluation and feedback methodologies. Conclusions This systematic exploration of pedagogical best practices underscores their paramount importance in driving continuous improvement in teacher training and fostering innovation within the educational arena. Such practices not only create an engaging and effective learning environment but also set the stage for ongoing advancements in the teaching and learning processes.

Moving from Principles to Practice: A Scoping Review of Value-Based Healthcare (VBHC) Implementation Strategies.

The principles of value-based healthcare (VBHC) have received widespread endorsement, leading healthcare organizations worldwide to shift their strategies towards them. However, despite growing recognition and acceptance, the actual implementation of value-based approaches varies widely. This research aims to identify studies that address the implementation of VBHC at different levels (healthcare policymakers, hospital administrators, and healthcare providers), focusing on each level's relative strategies. To this end, a scoping review was conducted in accordance with the PRISMA extension for the scoping reviews checklist. The electronic databases of Web of Science, PubMed, MEDLINE, and Scopus were searched to identify relevant publications in English from January 2006 to 31 July 2023. We identified 30 eligible studies. Findings are organized into four main macro strategic levels, each comprising specific dimensions and operational approaches. Fourteen articles analyzed the role of government commitment in VBHC implementation, while six articles focused on regional integrated care systems. The role of hospitals was described in sixteen records. Our study suggests that a comprehensive approach is necessary for the successful implementation of VBHC. Hospitals emerge as pivotal in this shift, requiring organizational and attitudinal changes among healthcare professionals. However, a complete transition towards VBHC that ensures seamless patient management throughout the entire care delivery value chain necessitates government involvement in terms of state legislation, reimbursement methods, and hospital networking.

Assessing Professional Behaviors of Physician Assistant Students in Objective Structured Clinical Examinations: A Scoping Review.

Professionalism in physician assistant (PA) students is an essential behavior to assess during formative medical education. Objective structured clinical examinations (OSCEs) provide an opportunity to evaluate PA students performing professional behaviors within simulated clinical settings. This scoping review aims to explore insights the existing literature offers regarding evaluating the professional behaviors of PA students using an OSCE. A secondary objective is to identify gaps in the literature to clarify future research. This scoping review was conducted in March 2024. From January 2018 until March 2024, CINAHL, MEDLINE Ultimate, Health Source-Nursing/Education, and PubMed online databases were searched for publications in English. Records included research studying PA or medical students evaluated on professional behaviors using an OSCE or performance-based assessment instrument. Allied health profession students were excluded from the primary search because of their heterogeneous curriculum models outside the population of interest. This review includes 5 papers. All papers reported communication as a professional behavior measured in an OSCE or performance-based assessment. A consensus or formal definition of professional behavior is a notable absence in this scoping review. More definitive homogenous evidence is needed to assess the professional behaviors of PA students using an OSCE. This limits the guidance and educational standards for future health profession educators. Comprehensive research into professional behaviors among PA students is essential. Scholars must publish their findings on professionalism curriculum design and outcomes to facilitate a broader understanding and improvement in educating future PA professionals.

The role of cardiac adipose tissue in coronary artery disease: a narrative review of cardiac imaging studies.

Cardiac adipose tissue's (CAT) role in the pathogenesis of coronary artery disease (CAD) has become a hot topic in the literature in recent years. Cardiac computed tomography (CCT), a cutting-edge imaging modality, has become vital in quantifying and characterizing CAT. CAT is divided into paracardial adipose tissue (PAT), epicardial adipose tissue (EAT), and pericoronary adipose tissue (PCAT). Despite numerous studies investigating the association of EAT and PCAT with CAD, their connection remains equivocal. In this review, we clarify the relationship between EAT and PCAT with atherosclerotic burden, high-risk plaque, major adverse cardiovascular events, and the prediction of CAD through the use of CCT. A thorough literature research spanning from January 2004 to May 2024 of the PubMed database was conducted. Only publications in English which included reviews, clinical trials, meta-analyses, and systematic reviews on CAT's association with CAD were considered. The 63 articles in the review honed in on the influence of CAT metrics obtained mainly by CCT with multiple stages of CAD. Current evidence supports the interaction between dysfunctioning EAT and PCAT and the release of several molecules within the neighboring coronary arteries which is linked with the development and progression of CAD. EAT is related to coronary plaque synthesis. PCAT underlines ongoing inflammation within the plaques. CAT evaluation provides significant incremental value compared to existing assessment methods. It enables enhanced prognostic judgment and further stratified management of CAD patients. CAT metrics have the potential to become future biomarkers of CAD. Additional investigations are required to explore the potential of these metrics as composite scores CAD risk prediction.

Assessing fertility preservation strategies: A scoping review

Objective: To describe the various options available for preserving female and/or male fertility, taking into account both social and medical aspects, and to identify the effects of different natural products on male infertility extracted from plants. Methods: We reviewed the literature and included full-text publications in English provided by international biomedical databases, including Sciences Direct, Google Scholar, OVID, PubMed, and MEDLINE between 2016 and 2023. Search terms, such as fertility preservation, in vitro maturation, cryopreservation, plants for the treatment of male infertility, were taken from Medical Subject Headings (MeSH) and Boolean operators were used to improve sensitivity. Results: 112 papers were identified in the initial search, of which 18 were excluded due to duplication. After reviewing titles and abstracts, 70 papers were finally included. The main findings of this study are presented under three key themes: gametogenesis, fertility preservation techniques, and plant-based alternatives. Regarding gametogenesis, significant progress has been made in understanding oocyte and sperm maturation, with optimized conditions improving maturation rates and motility. For fertility preservation, techniques such as rescue in vitro maturation and cryopreservation have shown the enhanced outcomes, particularly in maintaining gamete quality. Lastly, plant-based alternatives, including extracts and essential oils, have demonstrated potential in reducing oxidative stress, improving sperm motility, and supporting oocyte development, thus providing a promising complementary approach to conventional methods. Conclusions: Fertility preservation is achieved in a variety of ways, including oocyte and embryo vitrification and sperm cryopreservation, and the use of plant-based treatment of male infertility.

Trauma-informed family carer education and practical skills training in dementia: a systematic scoping review protocol

IntroductionThe incurable and progressive nature of dementia requires complex care, the majority of which is provided via informal caring by family members within the family home. Carers experience significant stress...

Differential effects of exercise training protocols on blood pressures and lipid profiles in older adults patients with hypertension: A systematic review and meta-analysis.

Decreased physical activity and high blood pressure are both risk factors for cardiovascular diseases. Controlling blood pressure within the normal range can prevent or delay these complications. This systematic review and meta-analysis analyzed the effects of different types of exercise training on the blood pressure and lipid profiles of older adults patients with hypertension. Five electronic databases (Web of Science, Cochrane, PubMed, Google Scholar, and Scopus) were searched from their inception until March 03, 2024. English publications and randomized controlled trials involving different types of exercise training treatments for hypertensive populations were included. Data were analyzed using a random-effects model to estimate weighted mean differences (WMD) and 95 % confidence intervals. The systematic search identified 1998 articles, of which 92 studies met the inclusion criteria and were deemed eligible for inclusion. The results of the meta-analysis indicated that reduced systolic (SBP) and diastolic blood pressures (DBP) after aerobic training (p < 0.01), resistance training (p < 0.01), combined (aerobic + resistance) exercise training (p < 0.01) and isometric handgrip training (p < 0.01). Significant reductions were also observed in low-density lipoprotein (LDL) and triglyceride (TG) levels following combined (aerobic + resistance) exercise training (p < 0.05 and p < 0.001), and resistance training (p < 0.01), respectively. High-density lipoprotein (HDL) levels were increased following aerobic training (p < 0.01), and combined (aerobic + resistance) exercise training (p < 0.01), but not after resistance and Tai chi training. Isometric handgrip training leads to greater reductions in blood pressure in hypertensive patients compared to the effects of aerobic, resistance, combined aerobic and resistance exercise, and tai chi training. Additional studies are needed to determine the exercise prescription protocols to maximize the health of older adults patients with hypertension.

OP11 Assessing Patient And Societal Unmet Needs: The Needs Examination, Evaluation And Dissemination (NEED) Assessment Framework

IntroductionThe healthcare ecosystem is predominantly supply-driven, leading to a lack of innovation in financially less-attractive health areas, inefficient use of public resources for healthcare, and unmet patient and societal needs. This study proposes a framework to identify unmet health-related patient and societal needs for different health conditions, to inform and support the development of needs-driven healthcare policy and innovations.MethodsTwo systematic literature reviews were conducted: one to update an already published literature review that identified tools for measuring patient needs; another to identify criteria for measuring health-related societal needs. Ovid MEDLINE and Embase were searched for English, French, and Dutch publications. In April 2023, 22 Belgian stakeholders and experts reviewed selected societal needs criteria. The NEED (Needs Examination, Evaluation and Dissemination) assessment framework, incorporating literature-derived patient and societal needs criteria, underwent discussions with the Health Minister’s Cabinet and federal health agencies from May to July 2023. The framework was challenged in November 2023 during international and national advisory committee meetings.ResultsThe literature reviews covered 52 studies. The NEED framework addresses patient, societal, and future needs across health, healthcare, and social domains. Patient-level criteria (13) include health (e.g., impact on quality of life), healthcare (e.g., burden of treatment), and social (e.g., social support). Societal needs criteria (6) encompass health (e.g., transmissibility), healthcare (e.g., value for money), and social (e.g., productivity losses). Future needs criteria (2) consider future burden of disease and economic burden. Each criterion (total: 40) has measurable indicators with calculation methods and data sources. Equity is recognized as a transversal dimension, requiring unmet needs data disaggregated by population group.ConclusionsFor the first time, a transparent scientific framework containing criteria and indicators for assessing the unmet needs of patients and society has been developed. This lays the foundations for a major shift towards a more needs-driven healthcare policy and innovation.

Research hotspots and trends in immunotherapy for cholangiocarcinoma: a bibliometric analysis (2014-2023).

Cholangiocarcinoma (CCA) is a malignant tumor of the gastrointestinal tract with a poor prognosis. Immunotherapy plays an important role in the treatment of CCA. This study aimed to investigate the research hotspots and trends in immunotherapy for CCA. The Web of Science Core Collection was searched for literature related to CCA immunotherapy research from January 1, 2014, to December 31, 2023, and features such as country, institution, authors, references, and keywords in the included literature were quantitatively and visually analyzed using the VOS viewer and CiteSpace software. A total of 252 English publications published between 2014 and 2023 were included. The publications were mainly from China and the United States, with Fudan University being the institution that published the most papers. The highest number of publications came from Frontiers in Oncology. The most prolific authors were Jia Fan, Jian Zhou from China and Pa-Thai Yenchitsomanus from Thailand, while the Journal of Clinical Oncology ranked first in the number of citations among the co-cited journals. In recent years, the focus of research has shifted from "immune checkpoint" and "chemotherapy" to "immunotherapy combined therapy." Currently, the research frontiers are "microenvironment," "immune cells," and "macrophages." Our study analyzes the research hotspots and trends in CCA to provide a knowledge map of immunotherapy research, which will serve as a reference and direction for future research.