Evaluated Study Quality Research Articles

Membranous urethral length and urinary incontinence following robot-assisted radical prostatectomy: asystematic review and meta-analysis.

To provide an update on the association between preoperative membranous urethral length (MUL) and postoperative urinary incontinence (UI) in men who undergo robot-assisted radical prostatectomy (RARP)/robot-assisted laparoscopic prostatectomy (RALP). Urinary incontinence is common after RARP/RALP, and early recovery of continence is one of the most important functional outcomes following surgery. MUL has been identified as a factor associated with continence recovery after RARP/RALP. A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Embase, and Scopus databases. Inclusion criteria were English language full journal articles authored within the last 5 years that assessed continence using the Expanded Prostate Cancer Index Composite. The Critical Appraisal Skills Programme tool for retrospective cohort studies was used to evaluate study quality. A random-effects meta-analysis was performed to pool odds ratios (ORs) from available studies relating to continence as a function of MUL. The Grading of Recommendations, Assessment, Development and Evaluations framework was used to synthesise evidence. Six studies including 970 patients reported an association between MUL and continence at 12 months. Longer MUL was associated with reduced UI odds at 12 months after surgery (pooled OR 0.74, 95% confidence interval 0.68-0.87, P < 0.001). Significant methodological and statistical heterogeneity was encountered. Preoperative MUL measured on magnetic resonance imaging (MRI) is significantly associated with postoperative continence in men undergoing RARP/RALP. We recommend consideration of MRI measurement of MUL prior to RARP/RALP to guide treatment decisions in this population.

Integration of non-targeted multicomponent profiling, targeted characteristic chromatograms and quantitative to accomplish systematic quality evaluation strategy of Huo-Xiang-Zheng-Qi oral liquid

Huo-Xiang-Zheng-Qi oral liquid (HXZQOL) is a well-known traditional Chinese medicine formula for the treatment of gastrointestinal diseases, with the pharmacologic effects of antiinflammatory, immune protection and gastrointestinal motility regulation. More significantly, HXZQOL is recommended for the treatment of COVID-19 patients with gastrointestinal symptoms, and it has been clinically proven to reduce the inflammatory response in patients with COVID-19. However, the effective and overall quality control of HXZQOL is currently limited due to its complex composition, especially the large amount of volatile and non-volatile active components involved. In this study, aimed to fully develop a comprehensive strategy based on non-targeted multicomponent identification, targeted authentication and quantitative analysis for quality evaluation of HXZQOL from different batches. Firstly, the non-targeted high-definition MSE (HDMSE) approach is established based on UHPLC/IM-QTOF-MS, utilized for multicomponent comprehensive characterization of HXZQOL. Combined with in house library-driven automated peak annotation and comparison of 47 reference compounds, 195 components were initially identified. In addition, HS-SPME-GC-MS was employed to analyze the volatile organic compounds (VOCs) in HXZQOL, and a total of 61 components were identified by comparison to the NIST database, reference compounds as well as retention indices. Secondly, based on the selective ion monitoring (SIM) of 24 “identity markers” (involving each herbal medicine), characteristic chromatograms (CCs) were established on LC-MS and GC-MS respectively, to authenticate 15 batches of HXZQOL samples. The targeted-SIM CCs showed that all marker compounds in 15 batches of samples could be accurately monitored, which could indicate preparations authenticity. Finally, a parallel reaction monitoring (PRM) method was established and validated to quantify the nine compounds in 15 batches of HXZQOL. Conclusively, this study first reports chemical-material basis, SIM CCs and quality evaluation of HXZQOL, which is of great implication to quality control and ensuring the authenticity of the preparation.

Violence against nurses by patients and visitors in the emergency department: An integrative review.

This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. Integrative review. Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses. This project was an integrative review of the literature therefore no patient or public contribution was necessary. Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.

Clinical efficacy and safety of folic acid and vitamin B12 for the adjuvant treatment of schizophrenia: a systematic review and meta-analysis.

Given the different effects of folate and vitamin B12 on the ad-juvant treatment of schizophrenia (SCH), their efficacy and safety as adjuvant therapies for SCH were systematically evaluated by evidence-based medicine. Publication retrieval was performed using authoritative databases such as the Cochrane Library, PubMed, and Web of Science to screen randomized con-trolled trials (RCTs). After the quality evaluation and data extraction of includ-ed studies, eligible RCTs were systematically reviewed using Review Manager 5.2 software. In total, 14 RCTs were included. The results of the meta-analysis revealed that as the adjuvant therapy for SCH, vitamin B12 differed significantly from folate in terms of anxiety relief rate [odds ratio (OR)=1.28, 95% con-fidence interval (CI) (1.02, 1.61), p=0.03, I2 =0%, Z=2.13]. However, there were no significant differences in the incidence rate of mania [OR=1.13, 95% CI (0.78,1.65), p=0.65, I2=36%, Z=0.65], total efficacy [OR=1.06, 95% CI (0.72, 1.56), p=0.77, I2=0%, Z=0.30] and incidence rate of adverse reactions [OR=1.15, 95% CI (0.88, 1.49), p=0.31, I2=0%, Z=1.03]. Although folate and vitamin B12 exhibit no significant differences in the adjuvant treatment of SCH, vitamin B12 exerts markedly fewer side effects than folate drugs, and it is of de-terminant significance for the clinical adjuvant medication of SCH.

Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta-analysis.

Diabetes mellitus (DM) has been proposed to be positively associated with breast cancer (BCa) risk due to shared risk factors, metabolic dysfunction, and the use of antidiabetic medications. We conducted a systematic review and meta-analysis to evaluate the association between DM and BCa risk. We searched PubMed, Embase, and Web of Science for cohort and case-control studies assessing the association between DM and BCa published before 10 December 2021. Two reviewers independently screened the studies for inclusion, abstracted article data, and rated study quality. Random effects models were used to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). From 8396 articles identified in the initial search, 70 independent studies were included in the meta-analysis. DM was associated with an overall increased risk of BCa (RR=1.20, 95% CI: 1.11-1.29). The 24 case-control studies demonstrated a stronger association (RR=1.26, 95% CI: 1.13-1.40) than the 46 cohort studies (RR=1.15, 95% CI: 1.05-1.27). Studies reporting risk by menopausal status found that postmenopausal women had an elevated risk of developing BCa (RR=1.12, 95% CI: 1.07-1.17). No association between DM and BCa risk was observed among premenopausal women (RR=0.95, 95% CI: 0.85-1.05). In addition, DM was associated with significantly increased risks of oestrogen receptor (ER)+ (RR=1.09, 95% CI: 1.00-1.20), ER- (RR=1.16, 95% CI: 1.04-1.30), and triple negative BCa (RR=1.41, 95% CI: 1.01-1.96). The association estimate for human epidermal growth factor 2-positive BCa was also positive (RR=1.21, 95% CI: 0.52-2.82), but the CI was wide and crossed the null. Our meta-analysis confirms a modest positive association between DM and BCa risk. In addition, our results suggest that the association between DM and BCa may be modified by menopausal status, and that DM may be differentially associated with BCa subtypes defined by receptor status. Additional studies are warranted to investigate the mechanisms underlying these associations and any influence of DM on BCa receptor expression.

Systematic review of the association between talc and female reproductive tract cancers.

Talc is a hydrous magnesium sheet silicate used in cosmetic powders, ceramics, paints, rubber, and many other products. We conducted a systematic review of the potential carcinogenicity of genitally applied talc in humans. Our systematic review methods adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and incorporated aspects from the US Institute of Medicine (IOM, now the National Academy of Medicine) and several US EPA frameworks for systematic reviews, evaluating and integrating the epidemiological, animal, and mechanistic literature on talc and cancer. We conducted a comprehensive literature search. Detailed data abstraction and study quality evaluation, adapting the Toxic Substances Control Act (TSCA) framework, were central to our analysis. The literature search and selection process identified 40 primary studies that assessed exposure to talc and female reproductive cancer risks in humans (n = 36) and animals (n = 4). The results of our evaluation emphasize the importance of considering biological plausibility and study quality in systematic review. Integrating all streams of evidence according to the IOM framework yielded classifications of suggestive evidence of no association between perineal application of talcum powders and risk of ovarian cancer at human-relevant exposure levels. We also concluded that there is suggestive evidence of no association between genital talc application and endometrial cancer, and insufficient evidence to determine whether a causal association exists between genital talc application and cervical cancer based on a smaller but largely null body of literature.

Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis.

Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention. We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea. We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model. This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26). Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL. The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.

Impact of Standardised Patient Simulation Training on Clinical Competence, Knowledge, and Attitudes in Mental Health Nursing Education

BACKGROUND: The limited practical placement opportunities in mental health care often induce uncertainty among nursing students. To ameliorate this, simulation training, especially with standardized patients (SPs), is employed to promote clinical competence, allowing students to navigate the complexities associated with mental health nursing, including stigma and stereotypes.&#x0D; &#x0D; OBJECTIVE: This systematic literature review primarily aims to explore and synthesise the studies in simulation education research conducted related to the effects of SPs on clinical competence, knowledge and attitudes of undergraduate pre-registration mental health nursing students.&#x0D; &#x0D; METHODS: following the systematic literature review approach, a comprehensive search was conducted across five electronic databases: MEDLINE, CINAHL, Embase, PsycINFO, and Scopus. The PICO model guided the identification of search terms. The Mixed Methods Appraisal Tool (MMAT) evaluated study quality.&#x0D; &#x0D; RESULTS: Ten studies were included, all examining the impact of SP simulations on undergraduate nursing students. Of these, five evaluated confidence and anxiety levels, while two assessed competence and satisfaction. Other aspects such as motivation, preparation, knowledge, communication skills, and critical thinking were examined individually. The collective results indicate SP simulation as a potentially efficacious strategy for enhancing competencies in graduate nursing education.&#x0D; &#x0D; CONCLUSION: Across all studies, SPs in simulation methods exerted a positive influence on mental health nursing education, bolstering students&amp;#39; preparation for clinical practice by reducing anxiety and fostering confidence, competence, knowledge, and communication skills. However, limitations including insufficient supervision, small sample sizes, homogenous samples, and absence of control groups were present in all studies. Future research should address these issues to fortify evidence supporting the use of SPs in mental health nursing education.&#x0D; &#x0D; RECOMMENDATIONS: Further robust, experimental research with larger sample sizes and validated assessment tools is needed to corroborate these findings and explore the effects of SP simulations on a wider array of learning outcomes.

Coronavirus Disease 2019 (COVID-19) Vaccination and Assisted Reproduction Outcomes: A Systematic Review and Meta-analysis.

To assess the association between coronavirus disease 2019 (COVID-19) vaccination and female assisted reproduction outcomes through a systematic review and meta-analysis. We searched Medline (OVID), EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov on January 11, 2023, for original articles on assisted reproduction outcomes after COVID-19 vaccination. The primary outcome was rates of clinical pregnancy; secondary outcomes included number of oocytes retrieved, number of mature oocytes retrieved, fertilization rate, implantation rate, ongoing pregnancy rate, and live-birth rate. Two reviewers independently screened citations for relevance, extracted pertinent data, and rated study quality. Only peer-reviewed published studies were included. Our query retrieved 216 citations, of which 25 were studies with original, relevant data. Nineteen studies reported embryo transfer outcomes, with a total of 4,899 vaccinated and 13,491 unvaccinated patients. Eighteen studies reported data on ovarian stimulation outcomes, with a total of 1,878 vaccinated and 3,174 unvaccinated patients. There were no statistically significant results among our pooled data for any of the primary or secondary outcomes: clinical pregnancy rate (odds ratio [OR] 0.94, 95% CI 0.88-1.01, P =.10), number of oocytes retrieved (mean difference -0.26, 95% CI -0.68 to 0.15, P =.21), number of mature oocytes retrieved (mean difference 0.31, 95% CI -0.14 to 0.75, P =.18), fertilization rate (OR 0.99, 95% CI 0.87-1.11, P =.83), implantation rate (OR 0.92, 95% CI 0.84-1.00, P =.06), ongoing pregnancy rate (OR 0.95, 95% CI 0.86-1.06, P =.40), or live-birth rate (OR 0.95, 95% CI 0.78-1.17, P =.63). A subanalysis based on country of origin and vaccine type was also performed for the primary and secondary outcomes and did not change the study results. Vaccination against COVID-19 is not associated with different fertility outcomes in patients undergoing assisted reproductive technologies. PROSPERO, CRD42023400023.

Applying Shear Wave and Magnetic Resonance Elastography to Grade Brain Tumors: Systematic Review and Meta-Analysis

Reports find that magnetic resonance elastography (MRE) and shear wave elastography (SWE) can classify intracranial tumors according to stiffness. However, systematic syntheses of these articles are lacking. To perform a systematic review and meta-analysis evaluating whether SWE and MRE can predict meningioma and glioma grades. PubMed and Scopus were searched between February 10, 2022 and March 2, 2022 using manual search criteria. 8 out of 106 non-duplicate records were included, encompassing 84 patients with low-grade tumors (age: 42±13, 71% female) and 92 patients with high-grade tumors (age: 50±13, 42% female). Standardized mean difference in stiffness between high-grade and low-grade tumors were measured using a forest plot. The I2, X2, and T-tests were performed, and bubble plots were constructed to measure heterogeneity. An adapted QUADAS-2 scale evaluated study quality. Additionally, a funnel plot was constructed, and an Egger's intercept test determined study bias. Low-grade tumors were stiffer than high-grade tumors (Cohen's D = -1.25; 95% CI [-1.88, -0.62]). Moderate heterogeneity was observed (I2 = 67%; p=0.006) but controlling for publication year (I2 = 0.2%) and age (I2 = 0.0-17%) reduced heterogeneity. Included studies revealed unclear or high bias for the reference standard and flow and timing (>50%). Elastography techniques have potential to grade tumors intraoperatively and postoperatively. More studies are needed to evaluate the clinical utility of these technologies.

Quality of reporting of prospective in vivo and ex vivo studies published in the Journal of Veterinary Emergency and Critical Care over a 10-year period (2009-2019).

To evaluate the reporting of key items associated with risk of bias and weak study design over a 10-year period. Literature survey. Not applicable. Not applicable. Papers published in the Journal of Veterinary Emergency and Critical Care between 2009 and 2019 were screened for inclusion. Inclusion criteria consisted of prospective experimental studies describing in vivo or ex vivo research (or both), containing at least 2 comparison groups. Identified papers had identifying information (publication date, volume and issue, authors, affiliations) redacted by an individual not involved with paper selection or review. Two reviewers independently reviewed all papers and applied an operationalized checklist to categorize item reporting as fully reported, partially reported, not reported, or not applicable. Items assessed included randomization, blinding, data handling (inclusions and exclusions), and sample size estimation. Differences in assessment between reviewers were resolved by consensus with a third reviewer. A secondary aim was to document availability of data used to generate study results. Papers were screened for links to access data in the text and supporting information. After screening, 109 papers were included. Eleven papers were excluded during full-text review, with 98 papers included in the final analysis. Randomization was fully reported in 31.6% of papers (31/98). Blinding was fully reported in 31.6% of papers (31/98). Inclusion criteria were fully reported in all papers. Exclusion criteria were fully reported in 60.2% of papers (59/98). Sample size estimation was fully reported in 8.0% of papers (6/75). No papers (0/99) made data freely available without a requirement to contact study authors. There is substantial room for improvement in reporting of randomization, blinding, data exclusions, and sample size estimations. Evaluation of study quality by readers is limited by the low reporting levels identified, and the risk of bias present indicates a potential for inflated effect sizes.

Yoga for proprioception: A systematic review

ABSTRACT Proprioception is an important and effective measure for neuromuscular function training. Researchers primarily use the joint position sense (JPS) to assess proprioception. The study’s aim was to conduct a systematic review of the research on yoga for improving proprioception, with the objective of providing a systematic review for the various bodies’ JPSs. Relevant articles were found using the keywords “Yoga AND Proprioception” and “Yoga AND Joint Position Sense (JPS)” in major databases such as Google Scholar, PubMed, Science Direct, EMBASE, and the Cochran Library. The peer-reviewed English language articles published between January 2011 and December 2021 were included in the study. Individually, the rated study quality was assessed using the Downs and Black checklist. The possible scores ranged from 0 to 27. Where possible, the effect size was calculated in the article. Three of the 60 identified studies met the inclusion criteria: one randomized controlled trial and two quasi-experimental studies. All three studies discovered a positive improvement in JPS. The current research has shown that yogic intervention may have a positive effect on proprioception, but research is limited. The number of studies was small, and more research on specific poses for improving proprioception is needed.

Health Disparities among Rural Individuals with Mental Health Conditions: A Systematic Literature Review.

There is growing concern about the availability of healthcare services for rural patients. This systematic literature review evaluates original research on health disparities among rural and urban populations with mental health conditions in North America. Using PRISMA guidelines, we used four electronic databases (Pubmed, Cochrane, PsychInfo, Web of Science) and hand searches and included original research conducted in the United States or Canada before July 2021 that compared health outcomes of patients with any mental health disorder in rural versus non-rural areas. Both qualitative and quantitative data were extracted including demographics, mental health condition, health disparity measure, rural definition, health outcome measures/main findings, and delivery method. To evaluate study quality, the modified Newcastle Ottawa Scale was used. Our initial search returned 491 studies and 17 studies met final inclusion criteria. Mental health disorders included schizophrenia (4 studies), PTSD (10), mood disorders (9), and anxiety disorders (6). Total sample size was 5,314,818 with the majority being military veterans. Six studies (35.2%) showed no significant rural-urban disparities while eleven (64.7%) identified at least one. Of those, nine reported worse outcomes for rural patients. The most common disparities were diagnostic differences, increased suicide rates and access problems. This review found mixed results regarding outcomes in rural patients with mental health disorders. Disparities were found regarding risk of suicide and access to services. Telehealth in addition to in person outreach to these rural communities may be alternatives to impact these outcomes.

Impact of community-based interventions on out-of-hospital cardiac arrest outcomes: a systematic review and meta-analysis

Survival following out-of-hospital cardiac arrest (OHCA) remains low, typically less than 10%. Bystander cardiopulmonary resuscitation (CPR) and bystander-AED use have been shown to improve survival by up to fourfold in individual studies. Numerous community-based interventions have been implemented worldwide in an effort to enhance rates of bystander-CPR, bystander-AED use, and improve OHCA survival. This systematic review and meta-analysis aims to evaluate the effect of such interventions on OHCA outcomes. Medline and Embase were systematically searched from inception through July 2021 for studies describing the implementation and effect of one or more community-based interventions targeting OHCA outcomes. Two reviewers screened articles, extracted data, and evaluated study quality using the Newcastle–Ottawa Scale. For each outcome, data were pooled using random-effects meta-analysis. Of the 2481 studies identified, 16 met inclusion criteria. All included studies were observational. They reported a total of 1,081,040 OHCAs across 11 countries. The most common interventions included community-based CPR training (n = 12), community-based AED training (n = 9), and dispatcher-assisted CPR (n = 8). Health system interventions (hospital or paramedical services) were also described in 11 of the included studies. Evidence certainty among all outcomes was low or very low according to GRADE criteria. On meta-analysis, community-based interventions with and without health system interventions were consistently associated with improved OCHA outcomes: rates of bystander-CPR, bystander-AED use, survival, and survival with a favorable neurological outcome. Bystander CPR—14 studies showed a significant increase in post-intervention bystander-CPR rates (n = 285 752; OR 2.26 [1.74, 2.94]; I2 = 99%, and bystander AED use (n = 37 882; OR 2.08 [1.44, 3.01]; I2 = 54%) and durvival—10 studies, pooling survival to hospital discharge and survival to 30 days (n = 79 206; OR 1.59 [1.20, 2.10]; I2 = 95%. The results provide foundational support for the efficacy of community-based interventions in enhancing OHCA outcomes. These findings inform our recommendation that communities, regions, and countries should implement community-based interventions in their pre-hospital strategy for OHCA. Further research is needed to identify which specific intervention types are most effective.

Prevalence of type 2 diabetes mellitus and related factors among the general adult population in Saudi Arabia between 2016-2022: A systematic review and meta-analysis of the cross-sectional studies.

Health officials need current knowledge of type 2 diabetes mellitus (T2DM) and related risk factors to prioritize prevention and control measures due to lifestyle changes, population structure, and the high incidence of diabetes in Saudi Arabia. The present systematic review aims to estimate the current pooled prevalence of T2DM and related risk factors among the general adult population in Saudi Arabia between 2016 and 2022. PubMed, Web of Science, and Google Scholar databases were searched for cross-sectional studies that reported T2DM among adults in Saudi Arabia and were published between December 31, 2016, and December 31, 2022. The PRISMA guidelines and the AXIS tool were employed to report and evaluate study quality and bias risk. The meta-analysis with a fixed effect model included 10 studies comprising 8457 general men and women adults aged 18 or older. The prevalence of T2DM was 28% (95% CI = 27-28, P < .001), and risks of T2DM in persons over 40 were nearly twice as high (OR = 1.74, 95% CI = 1.34-2.27) than in age under 40 among general adult population in Saudi Arabia between 2016-2022. This difference was statistically significant (P < .0001). The evidence from this review provided alarming and highlighted points about the prevalence of T2DM between 2016 and 2022, but there was high heterogeneity between the studies. Individuals aged 40 or older had a high risk of T2DM among the general adult population in Saudi Arabia.

Association between baseline C‑reactive protein level and survival outcomes for cancer patients treated with immunotherapy: A meta‑analysis.

The prognostic impact of baseline C-reactive protein (CRP) in patients with cancer receiving immune checkpoint inhibitors (ICIs) is unclear. The present meta-analysis aimed to review the prognostic value of baseline C-reactive protein (CRP) levels for patients with cancer receiving immunotherapy. Electronic databases, including PubMed, EMbase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, WanFang, Chinese Literature Biomedical Database and Weipu Database, were used to identify cohort studies on the relationship between the baseline CRP levels and ICI survival outcomes from inception to November 2020. Literature screening, data extraction and quality evaluation of studies were independently performed by two reviewers. Subsequently, a meta-analysis was performed using STATA 14.0. A total of 13 cohort studies comprising 2,387 patients with cancer were included in the present meta-analysis. The results indicated that high baseline CRP levels (serum CRP measured within 2 weeks before ICI treatment) were associated with low overall survival (OS) and progression-free survival (PFS) rate among patients treated with ICIs. The subgroup analysis based on cancer type showed that high baseline CRP levels were associated with poor survival outcomes of multiple types of cancer, such as non-small cell lung cancer (6/13; 46.2%), melanoma (2/13; 15.4%), renal cell (3/13; 23.0%) and urothelial carcinoma (2/13; 15.4%). Similar results were observed in subgroup analysis based on the CRP cut-off value of 10 mg/l. In addition, a higher mortality risk was reported in patients with cancer and CRP ≥10 mg/l (hazard ratio, 2.76; 95% CI, 1.70-4.48; P<0.001). Compared with patients with low baseline CRP levels, increased baseline CRP levels were associated with low OS and PFS rate in patients with cancer receiving ICIs. Furthermore, CRP ≥10 mg/l indicated a worse prognosis. Therefore, baseline CRP levels may serve as a marker for the prognosis of patients with certain types of solid tumor treated with ICIs. Due to the limited quality and quantity of included studies, more prospective well-designed studies are required to verify the present findings.

Brilliant Cresyl Blue Staining Enhances the Morphological Quality Evaluation of Porcine Oocytes-a Preliminary Study

Abstract Brilliant cresyl blue (BCB) staining is a method used for selection of developmentally competent porcine oocytes, in addition to the standard morphological classification. The aim of the current study was to assess the relationship between BCB staining in porcine oocytes with high and low morphological characteristics and its maturation rate. In the first part of the study, cumulus-oocytes complexes (COCs) (n=434) were aspirated from 60 ovaries. According to the morphological classification and BCB staining, they were divided in 4 groups: COC+/BCB+, COC−/BCB+, COC+/BCB−, and COC−/BCB−. In the second experiment, COCs (n=445) were categorized into 3 groups: control, BCB+, and BCB−. Significant differences in the maturation rate were observed between COC+/BCB+ and COC−/BCB− (66% vs. 23%), and between COC+/BCB+ and COC−/BCB+ (66% vs. 38%) (p&lt;0.0001). Significant differences were also registered between COC−/BCB+ and COC−/BCB-(38% vs. 23%) and between COC+/BCB− and COC−/BCB− (53% vs. 23%) (p&lt;0.01). Results from the second experiment showed that only BCB− oocytes had a significantly lower maturation rate (28%) compared to the control (63%) and BCB+ oocytes (59%) (p&lt;0.001). These findings showed that COCs with high morphological characteristics had higher developmental ability compared to COCs with low morphology. The BCB-staining in high-quality oocytes did not have a significant impact on their maturation ability compared to a control group, but it might be useful for selecting developmentally competent oocytes with low morphology characteristics.

Perioperative, functional, and oncological outcomes of robotic vs. laparoscopic partial nephrectomy for complex renal tumors (RENAL score ≥7): an evidence-based analysis.

To evaluate the current literature comparing outcomes of robotic partial nephrectomy (RPN) versus laparoscopic partial nephrectomy (LPN) treating complex renal tumors (RENAL nephrometry score ≥7). We systematically searched the Cochrane Library, PubMed, Google Scholar, EMBASE, and Scopus databases up to March 2023. Review Manager 5.4 performed a pooled analysis of the data for random effects. Besides, sensitivity and subgroup analyses to explore heterogeneity, Newcastle-Ottawa scale, and GRADE to evaluate study quality and level of evidence. Eight observational studies comprising 1346 patients (RPN: 695; LPN: 651) were included in this study. Compared to LPN, RPN had a shorter operative time (OT) (weight mean difference [WMD]: -14.73min; p = 0.0003), shorter warm ischemia time (WIT) (WMD: -3.47min; p = 0.002), lower transfusion rate (odds ratio [OR]: 0.66; p = 0.04), shorter length of stay (LOS) (WMD: -0.65 days; p < 0.00001), lower postoperative estimated glomerular filtration rate (eGFR) change (WMD = -2.33 mL/min/1.73 m2; p = 0.002) and lower intraoperative complications (OR: 0.52; p = 0.04). No significant differences were observed between the two groups in terms of estimated blood loss (EBL) (p = 0.84), conversion to radical nephrectomy (p = 0.12), postoperative complications (p = 0.11), major complications (defined Clavien-Dindo grade 3 (p = 0.43), overall complications (p = 0.15), postoperative eGFR (p = 0.28), local recurrence (p = 0.35), positive surgical margin (PSM) (p = 0.63), overall survival (OS) (p = 0.47), cancer-specific survival (CSS) (p = 0.22) and 3-year recurrence-free survival (RFS) (p = 0.53). Patients with complex renal tumors (RENAL score ≥7), RPN is superior to LPN in decreasing the OT, WIT, LOS, transfusion rate, change in eGFR and the incidence of intraoperative complications while maintaining oncological control and avoiding a decline in renal function. However, our findings need further validation in a large-sample prospective randomized study.

Association between IL-25, IL-33 and atopic dermatitis: A systematic review and meta-analysis

Objective: To evaluate the association between IL-25, IL-33 and AD more generally. Methods: Databases, including PubMed, Web of Science, EMBASE, Scopus, CNKI and Sinomed were searched. Based on the criteria, publications were collected. The evaluation of study quality was through Newcastle-Ottawa Scale (NOS). Fixed or random effect model was selected according to the between-study heterogeneity to evaluate the association. The analysis procedure and the construction plots were using Review Manager 5.3 software. Results: Six studies were included. A total of 282 subjects were included from four studies to analyze the association between IL-25 and AD. The level of IL-25 was significantly elevated in AD patients, comparing with the control subjects (SMD = 0.89, 95% CI: 0.64, 1.14, p &lt; 0.05). For IL-33, a total of 247 subjects were included from two studies, and the level of IL-33 was also significantly elevated in AD patients comparing to the control subjects (SMD = 0.49, 95% CI: 0.19, 0.80, p &lt; 0.05). Conclusions: The serum levels of IL-25, IL-33 are elevated in AD patients of this study. The IL-25 and IL-33 are significantly associated with the risk of AD. Further studies with larger samples, in multiple countries and focused on different age groups are need.

Transvaginal needle versus laparoscopic ovarian drilling in hormonal profile and pregnancy outcomes of polycystic ovary syndrome: A systematic review and meta-analysis.

Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder distinguished by a persistent absence of ovulation. Ovarian drilling is a recognized therapeutic approach for PCOS patients who are unresponsive to medication and can be performed through invasive laparoscopic access or less-invasive transvaginal access. The aim of this systematic review and meta-analysis was to assess the efficacy of transvaginal ultrasound -guided ovarian needle drilling with conventional laparoscopic ovarian drilling (LOD) in patients with PCOS. PUBMED, Scopus, and Cochrane databases were systematically searched for eligible randomized controlled trials (RCTs) from articles published from inception to January 2023. We include RCTs of PCOS that compared transvaginal ovarian drilling and LOD and reported on ovulation and pregnancy rates as the main outcome variable. We evaluated study quality using the Cochrane Risk of bias 2 tool. A random-effects meta-analysis was performed and the certainty of the evidence was assessed according to the GRADE approach. We registered the protocol prospectively in PROSPERO (CRD42023397481). Six RCTs including 899 women with PCOS met the inclusion criteria. LOD was found to significantly reduce anti-Mullerian hormone (AMH) (SMD: -0.22; 95% CI: -0.38, -0.05; I2=39.85%) and antral follicle count (AFC) (SMD: -1.22; 95% CI: -2.26, -0.19; I2=97.55%) compared to transvaginal ovarian drilling. Our findings also indicated that LOD significantly increased the ovulation rate by 25% compared to transvaginal ovarian drilling (RR: 1.25; 95% CI: 1.02, 1.54; I2=64.58%). However, we found no significant difference between the two groups in terms of follicle stimulating hormone (SMD: 0.04; 95% CI: -0.26, 0.33; I2=61.53%), luteinizing hormone (SMD: -0.07; 95% CI: -0.90, 0.77; I2=94.92%), and pregnancy rate (RR: 1.37; 95% CI: 0.94, 1.98; I2=50.49%). LOD significantly lowers circulating AMH and AFC and significantly increases ovulation rate in PCOS patients compared to transvaginal ovarian drilling. As transvaginal ovarian drillingremains a less-invasive, more cost-effective, and simpler alternative, further studies are warranted to compare these two techniques in large cohorts, with a particular focus on ovarian reserve and pregnancy outcomes.