Evaluation of spin in systematic reviews and meta-analyses of Matrix-induced Autologous Cartilage Implantation (MACI).

Suicide mortality among adolescents and young adults aged 10-24 years in the Americas, 2000-2021: an analysis using the WHO Global Health Estimates.

Effects of mindfulness-based interventions (MBIs) on psychological outcomes and HbA1C in patients with diabetes: A systematic review and meta-analysis of randomized controlled trials.

The high placebo response in acne clinical trials has slowed down the progress of new drug development. Therefore, this study used a model-based meta-analysis method to quantitatively analyse the placebo response and explore its influencing factors. This study included 21 627 subjects from acne-related randomized double-blind placebo-controlled trials. Pharmacodynamic models were developed for four endpoints: total lesion counts absolute change, noninflammatory lesion counts absolute change, inflammatory lesion counts absolute change and treatment success rate defined by the investigator global assessment scale. Covariate modelling and subgroup analyses were performed to explore influencing factors. Placebo response under different conditions was simulated based on the final model. Model simulation results showed that for the typical population, after 12 weeks of placebo intervention, their total lesion counts, noninflammatory lesion counts and inflammatory lesion counts were reduced by 19.05 (95% confidence interval: 16.54-21.52), 10.71 (9.18-12.17) and 8.58 (7.55-9.58) from baseline, respectively; the treatment success rate was 11.83% (9.41%-14.35%). Baseline lesion counts, female proportion, Caucasians proportion, sample size, dosage form, type of control drug, skincare programme, number of centres, funding source, study locations and publication year could all influence placebo response. We also used our model to synthesize placebo arms for two single-arm studies, demonstrating the efficacy superiority of the drugs. This study quantitatively described the time-response relationship of placebo in acne clinical trials, revealing the influence of baseline characteristics and trial design characteristics, which could provide evidence for optimizing clinical trial design. PROSPERO (CRD420250649902).

Ayushman card (PM-JAY) as a tool for financial risk protection in orthopaedic trauma care: Evidence from a Level-1 trauma centre.

North Carolina's (NC) healthcare workforce shortages have been a major concern, as geographic health disparities become more pronounced and health outcomes decline in rural communities compared to those in urban areas. Rural residents face severe challenges accessing primary and specialized care and behavioral health services, especially in counties designated as Health Professionals Shortage Areas (HPSAs). NC will continue to experience these challenges as its overall population grows.Historically, NC had to pivot and reimagine policies and programs to improve its workforce crisis with federal assistance. Medicaid expansion and transformation, provider incentives, international labor recruitment, and innovative federal funding sources helped mitigate critical provider gaps and enhance access to care. However, in the wake of state budget challenges and fiscal restraints, persistent provider differentials remain.This article discusses how federal assistance has impacted the rural healthcare workforce crisis in North Carolina prior to the passage of the H.R.1 One Big Beautiful Bill Act (OBBBA) of 2025 (Congress.gov 2025). It also examines OBBBA's policy provisions and NC's plan for workforce improvements with the $213 million funding awarded through the Rural Health Transformation Program.

ABSTRACT Clinical trials drive evidence generation in men's health, yet temporal patterns in trial duration and completion remain poorly characterized. We examined relationships between trial duration, completion rates, and trial characteristics in men's health research registered over two decades. We conducted a cross‐sectional analysis of 5401 men's health clinical trials registered on ClinicalTrials.gov ClinicalTrials.gov between January 2005 and December 2024. Trials were identified using systematic Medical Subject Heading (MeSH) terms, including but not limited to hypogonadism, erectile dysfunction, infertility, benign prostatic hyperplasia, and prostate cancer. Primary outcomes were trial duration and completion status. Multivariable linear regression quantified associations between duration and calendar year, trial phase, funding source, and enrollment. Multivariable logistic regression evaluated predictors of trial completion. Median trial duration was 730 days (IQR: 365–1370). Trial duration decreased by 46 days annually ( β = −46.16 days/year; p < 0.01; R 2 = 0.06), representing approximately 920 fewer days over the study period. Completion rates declined concurrently, with 14% lower annual odds of completion (OR = 0.86/year; p < 0.01). Longer duration independently predicted non‐completion (OR = 0.89/day; p < 0.01). Phase 2 trials were 353 days longer than not applicable phase trials ( p < 0.01). NIHNIH‐funded‐funded trials exceeded industry‐funded trials by 1401 days ( p < 0.01), while network‐funded trials were 1333 days longer ( p < 0.01). Only 774 trials (14%) reported results despite regulatory requirements. Men's health trials demonstrate declining duration yet paradoxically decreasing completion rates over two decades. Funding source substantially influences trial timelines. Low results reporting limits evidence accessibility. These patterns may constrain the scope of feasible research innovation in men's health. Level of Evidence Level III.

This paper examines the impact of diverse financial sources on the export performance of small and medium-sized enterprises (SMEs) in Togo, with a specific focus on gender-based disparities. Utilizing firm-level data from the 2018 General Business Census (RGE), the study employs probit and ordered probit models, validated by the Lewbel instrumental variable (IV) procedure to address endogeneity. The results reveal that while nearly 94% of SMEs rely on microfinance, this access remains insufficient for internationalization. Conversely, formal banking significantly drives export intensity. Interaction analysis reveals a gendered duality: while male-led firms leverage networks more effectively for market entry, female entrepreneurs demonstrate superior marginal efficiency in scaling export intensity once the initial barriers have been overcome. These findings suggest that gender-sensitive financial reforms and institutional guarantee mechanisms are essential for transforming SME potential into sustainable export growth under the AfCFTA framework.

China’s football development is at a critical stage. Although many youth training bases have emerged under national policies, high costs, staff shortages, and single training models hinder sustainability and youth talent development. Existing research primarily looks at sports-education integration or industry-education integration separately, with little focus on their combined role in maintaining youth football training bases. Therefore, this work investigates an operational model for such bases under the combination of education and industry. By analyzing the current status and bottlenecks of training base operations in China and drawing on successful foreign experience, the study found that the sustainable operation mode should take the integration of industry and education as the core, integrate the resources of educational institutions and the football industry, and form a collaborative mechanism of "joint talent cultivation, joint process management, and shared outcomes". Market-oriented operation elements should be introduced to broaden the source of funds and enhance the influence of the base. This model offers useful advice for strengthening sports-education integration, enhancing the youth training system, and advancing the strategy of turning China into a sporting power. It also helps address resource shortages and operational challenges and encourages alignment between football talent cultivation and industry needs.

There is significant interest in jugular venous compression (JVC) devices from multiple parties, including sports physicians, athletic trainers, athletes, and parents. To examine the effects of JVC on repetitive head impacts and evaluate their effectiveness in reducing brain injury and concussion risk in sport. Embase, Cochrane Central Register of Controlled Trials, CINAHL Plus, SPORTDiscus, Web of Science Core Collection - SCI-EXPANDED, SSCI, AHCI, ESCI, American Psychological Association, PsycInfo, WHO International Clinical Trials Registry Platform (ICTRP), ProQuest Dissertations and Theses Citation Index (Web of Science), Europe PMC, and PubMed. Full-text, peer-reviewed manuscripts of primary research, published between 2010 and 2024. Scoping review. Level 5. A total of 22 articles met the inclusion criteria. These articles were categorized into 4 groups: animal models (n = 4), biomechanics in humans (n = 4), evidence in athletes (n = 11), and evidence in Special Weapons and Tactics Breacher Training (SWAT) (n = 3). Several of the athlete articles used the same cohort of athletes. There was no difference in concussion rates in athletes between collared and noncollared groups during a season, while evidence from animal and tactical populations was limited to mechanistic and imaging outcomes. In both athletes and SWAT personnel, there were no clinically significant differences in neurocognitive performance between groups. There are statistically significant imaging changes between collared and noncollared groups; however, the imaging changes were not consistent and are of uncertain clinical significance. Furthermore, 6 out of 11 studies in athletes are currently under investigation. The available evidence supports that JVC can increase intracranial pressure, but it remains unknown if this results in any clinically meaningful benefit. Although no adverse outcomes are reported with collar use, current research does not support the effectiveness of JVC collars for concussion reduction and use for mitigation of repetitive head impact. Additional studies from diverse research teams with independent funding sources are required.

Mental health is increasingly recognised as a major public health concern among university students, particularly in low- and middle-income settings where financial insecurity, food access constraints, and environmental disruptions may exacerbate vulnerability. However, limited empirical evidence from South Africa has examined how these structural stressors jointly influence depression severity. A cross-sectional online survey was administered to registered students at a university in KwaZulu-Natal (n = 445). Findings reflect associations within a single institution and should not be interpreted as representative of all university students in KwaZulu-Natal or South Africa. Depression severity was measured using the Patient Health Questionnaire-9 (PHQ-9) and categorised into five ordered levels (none to severe). Socio-demographic, economic, food security, and disaster exposure variables were assessed. An ordered probit model with marginal effects was employed to identify determinants of depression severity. Approximately 59.8% of students reported moderate-to-severe depressive symptoms. Female students exhibited a 7.4% higher probability of severe depression relative to males. Greater dietary diversity was associated with a 2.4% lower probability of severe symptoms, while reliance on less stable funding sources increased risk by 1.1%. Exposure to the July 2021 unrest and April 2022 floods raised the likelihood of severe depression by 3.5% and 3.4%, respectively. Students with advanced age showed a modest protective effect. Other covariates were not statistically significant. Depression severity among students is associated with gender, food security, financial stability, and exposure to socio-environmental shocks. These findings suggest that university mental health strategies should extend beyond clinical services to include food, financial, and disaster-resilience support. Addressing these determinants aligns with Sustainable Development Goals (SDGs) related to health, food security, education, and climate resilience.

Willingness to pay for influenza vaccination among the elderly in Vietnam: A triple-bounded dichotomous choice analysis of economic and behavioral determinants.

Kenya Electronic Medical Records (KenyaEMR) has improved data availability for patient services and programmatic purposes in Kenya. Maturity models provide a framework to assess health information systems (HIS) capabilities across maturity levels to ensure they are effective. This study aimed to determine KenyaEMR's current and goal maturity status, highlight gaps, and establish priorities for continuous improvement. The HIS Stages of Continuous Improvement (SOCI) Toolkit guided KenyaEMR's maturity assessment across five HIS domains and five maturity stages: 1-emerging/ad hoc; 2-repeatable, 3-defined, 4-managed, and 5-optimized. Participants included KenyaEMR experts representing the Ministry of Health, implementing partners, donor agencies, and faith-based organizations. The consensus-building process to determine final maturity scores utilized a two-round modified Delphi process. Improvement roadmaps were developed as action plans to bridge identified gaps. The assessment occurred in August 2024. Thirty-two stakeholders participated in the assessment. The overall KenyaEMR average maturity score was 3.2/5. Across the five HIS domains, the highest maturity scoring domain was standards and interoperability (4.4/5) and the lowest was management and workforce (2.3/5). The other domains maturity scores include leadership and governance (2.8/5), Information and Communication Technology (ICT) infrastructure (2.9/5), data quality and use (3.7/5). Among the 39 subcomponents, 7/39 (17.9%) scored at the 5-optimized maturity stage, of which six included data exchange standards, terminology management, master facility list, unique person identity management, person data exchange, and aggregated data exchange under the standards and interoperability domain. In comparison, 6/39 (15.4%) subcomponents scored lowest at the 2-repeatable level, with three (HR policy, HIS financing plan, and resource mobilization) under the management and workforce domain. The overall goal status maturity score was 4.6/5, with all subcomponents expected to reach 4-managed or 5-optimized levels by 2027. KenyaEMR's overall maturity level was 3.2/5. The workforce and management domain will require attention so that national-level investments in the HIS workforce and an increase in local funding sources can decrease the high donor funding dependency by the Kenya Ministry of Health. Conducting routine assessments coupled with the upcoming promising commitments from the local government to increase digital health investments will benefit continued support for KenyaEMR as it evolves.

Pharmacoeconomic evaluations are critical for healthcare decision-making, especially as South Korea has emphasized cost-effectiveness since the 2006 positive list system. However, no official cost-effectiveness threshold (CET) has been established. This study aimed to systematically review cost-utility analyses (CUAs) conducted in South Korea since 2007 and to describe how CET values have been reported and applied in published pharmacoeconomic studies. We conducted this systematic review following the PRISMA guidelines. We searched five databases, including PubMed and KoreaMed, for CUAs published after 2007. We included CUAs of medications conducted in South Korea that reported CET. Data on baseline year, outcome measures, CET values, drug type (anticancer drugs, vaccines, and other treatments), and funding sources were extracted. We assessed the association between CETs and categorical variables using the chi-square tests or Fisher's exact tests, as appropriate. A total of 8,510 studies were initially identified, of which 53 met the inclusion criteria after screening. Median CETs showed an increasing trend over time. GDP per capita-based references were more frequently used than WTP-based approaches (60.4% vs. 37.7%). Anticancer drugs consistently demonstrated higher CET values than other treatment categories, and drug type was significantly associated with CET levels (p < 0.05). In contrast, other study characteristics, including funding source, were not significantly associated in categorical analyses. This study provides an overview of CET trends in South Korea, highlighting differences by drug type. As the number of high-cost drugs and healthcare demands increase, CETs are expected to play a key role in balancing financial sustainability and patient access. These findings offer insights into how CET values have been applied in the literature and may inform ongoing discussions on the use of CETs in health economic evaluations.

Outcome measurement in aesthetic medicine is complicated by subjective definitions of beauty, psychosocial factors, and a lack of standardized assessment metrics. Outcome reporting heterogeneity limits physicians' ability to synthesize results from multiple studies. The purpose of this study was to identify the outcomes and outcome scales used in minimally-invasive facial rejuvenation clinical trials to determine the degree of outcome heterogeneity. A systematic review was conducted to identify all randomized control trials published in 2020-2025 focusing on non-operative or minimally-invasive facial and neck rejuvenation treatments. We identified outcome measurements reported in each study, including investigator assessment scales, patient-reported outcome scales, and objective outcomes and metrics. Our search identified 242 articles for inclusion. From these, we identified 79 investigator assessment scales, 69 patient-reported outcome scales, and 53 objective outcomes reported. No investigator-reported or patient-reported outcome was used in greater than 40% of trials, and within studies comparing the same treatment type applied to the same facial region, there existed substantial heterogeneity in definitions of treatment efficacy. Furthermore, differences in reported measures existed between regions and funding sources. There is substantial heterogeneity in outcomes reporting among facial rejuvenation studies. Clinicians, researchers, and industry stakeholders should strive to develop a core outcome set to ensure that meaningful and consistent outcomes are reported in all clinical trials.

Modern business operations take place under conditions of intense globalisation, increased competition, and constant changes in international financial markets. In such an environment, business financing is one of the key factors for sustainable growth and long-term stability. Aligning financial decisions with internationally accepted accounting principles, particularly with the International Financial Reporting Standards (IFRS), is of special importance, as they ensure the transparency, comparability, and reliability of financial information. The subject of this paper is the analysis of business financing in the international economic environment, with a special focus on the application of accounting principles in the financial decision-making process. The aim of the paper is to determine the role of accounting standards in securing quality sources of financing, reducing financial risks, and strengthening the trust of investors and creditors. The paper is based on an analysis of relevant domestic and foreign literature, as well as the application of scientific methods of analysis, synthesis, and comparison. The research findings indicate that the consistent application of international accounting principles positively impacts the efficiency of business financing and a company's competitive position in the global market.

ABSTRACT Immigration policy and international higher education policy were traditionally distinct domains in Australia, yet they have become intertwined over the last quarter century. Australia has expanded international student migration as both a key part of higher education and a funding source, while shifting from facilitating two-step pathways to skilled immigration to imposing strict barriers. Taking a medium-term analysis from 2001 to now, we assess these policy trends through boundary spanning theory, noting that once discernible policy areas have undergone periods of convergence. We outline the policy benefits and disadvantages of such trends, reflecting on the implications for other major Commonwealth Nations.

A Survey of Pharmacy Technician Training Programs Within Schools of Pharmacy.

The traditional practice of rice paddy pawning remains a financing mechanism used by rural communities to meet economic needs and capital for agricultural businesses. While it provides quick and easy access to financing, this practice often places farmers at a disadvantage, as the pawn recipient receives economic benefits from land management and harvests during the pawn period. This situation indicates problems in rural financing governance, particularly regarding the protection of farmers' productive assets and weak regulations governing the practice of rice paddy pawning. This study aims to evaluate the practice of traditional rice paddy pawning from a public policy perspective, analyze its alignment with Yusuf Qardhawi's concept of rahn, and formulate a policy model that can strengthen farmer protection. This study used a qualitative approach with a case study design in Balang Pasui Village, Jeneponto Regency. Data were obtained through interviews, observation, documentation, and literature review, then analyzed descriptively and comparatively. The results indicate that the traditional rice paddy pawning practice is effective as an alternative financing source, but does not fully meet the principles of justice, property rights protection, and welfare as proposed by Yusuf Qardhawi. Based on the analysis, this study formulates a Community-Based Sharia Rahn Policy model that integrates regulations for farmer asset protection, strengthening Islamic microfinance institutions, community-based supervision, and Islamic financial literacy. This model is expected to support the realization of fairer, more inclusive, and sustainable rural financial governance

As the global demand for hip and knee arthroplasty procedures grow, advancements in orthopedic research are vital for progress. Pilot and feasibility trials play a critical role in optimising research efficiency, highlighting methodological gaps, and maximising study insights. However, the completeness of reporting in hip and knee arthroplasty pilot and feasibility trials remains unclear. The primary objective was to evaluate reporting completeness, assessed using the CONSORT checklist extension to pilot and feasibility trials. Secondary objectives included evaluating the reporting of key feasibility items and exploring factors associated with reporting completeness. This methodological survey analysed pilot and feasibility trials in hip and knee arthroplasty. A PubMed search identified relevant manuscripts published between January 1, 2017, and December 31, 2023. A minimum acceptable sample size of 147 (of 278 eligible) was identified, based on a calculation involving an estimated reporting completeness of 25% of the CONSORT checklist, a 95% confidence interval, and a 5% margin of error. Descriptive statistics were reported, and a multivariable linear regression with robust (HC1) standard errors was completed. Of 278 eligible publications identified from PubMed, a random sample of 147 studies was included. Reporting completeness was low, with studies accounting for a mean of 54.98% (16.95) of applicable CONSORT extension items. Notably, pilot-specific objectives and future study implications were often underreported. Similarly, manuscripts missed approximately 71.35% (10/14) of key feasibility elements. Studies that referenced reporting guidelines in the manuscript text were associated with better reporting, while those that failed to disclose their funding sources and lacked more key feasibility items demonstrated weaker reporting completeness. Hip and knee arthroplasty pilot and feasibility trials exhibit suboptimal reporting completeness with several missing feasibility elements. Improved adherence to CONSORT guidelines and enhanced transparency are needed.