Free Full-text Articles Research Articles

Potential Use of Organoids in Regenerative Medicine.

In vitro cell culture is crucial for studying human diseases and development. Compared to traditional monolayer cultures, 3D culturing with organoids offers significant advantages by more accurately replicating natural tissues' structural and functional features. This advancement enhances disease modeling, drug testing, and regenerative medicine applications. Organoids, derived from stem cells, mimic tissue physiology in a more relevant manner. Despite their promise, the clinical use of regenerative medicine currently needs to be improved by reproducibility, scalability, and maturation issues. This article overviews recent organoid research, focusing on their types, sources, 3D culturing methods, and applications in regenerative medicine. A literature review of "organoid" and "regenerative medicine" in PubMed/MEDLINE highlighted relevant studies published over the past decade, emphasizing human-sourced organoids and their regenerative benefits, as well as the availability of free full-text articles. The review uses descriptive data, including tables and text, to illustrate the challenges and potential of organoids in regenerative medicine. The transition from 2D to 3D models, particularly organoids, has significantly advanced in vitro research. This review covers a decade of progress in various organoid types-such as liver, cholangiocyte, intestinal, pancreatic, cardiac, brain, thymus, and mammary organoids-and their 3D culture methods and applications. It addresses critical issues of maturity, scalability, and reproducibility and underscores the need for standardization and improved production techniques to facilitate broader clinical applications in regenerative medicine. Successful therapy requires increased scalability and standardization. Organoids have enormous potential in biological research, notwithstanding obstacles.

The Long-Term Impact of Cardiac Rehabilitation on Cognitive Function in Older Patients With Myocardial Infarction: A Systematic Review.

Myocardial Infarction (MI) isan obstruction in the coronary arteries, resulting in restricted blood flow and oxygen supply to the heart, leading to damage to the heart's tissues. Beyond the cardiovascular system, the impact of MI extends to potentially affecting cognitive abilities, especially in elderly populations. To optimize patient recovery and long-term outcomes, timely cardiac interventions and subsequent rehabilitation programs are essential. This systematic review aims to assess the potential benefits of cardiac rehabilitation (CR) in enhancing cognitive function among elderly individuals who have experienced an MI. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and utilizes PubMed, PubMed Central, Cochrane, Google Scholar, and ScienceDirect databases. Studies included in the review encompass meta-analyses, controlled trials, systematic/narrative reviews, randomized/nonrandomized trials, observational studies, and research articles published within the past five years. Only accessible, full-text English-language studies meeting the inclusion criteria are selected, while books, documents over five years old, animal studies, and individuals under 65 are excluded. Following a predefined template, the initial search identifies 4,915 studies. From this pool, 27 free full-text articles are then selected for quality appraisal based on relevance. After performing a quality assessment on each survey, 12 high-quality studies are included in this systematic review. The research studies demonstrate notable cognitive improvements among elderly patients who have experienced an MI and participated in CR programs. Additional clinical trial studies are recommended to substantiate these findings further and advance our understanding.

Nutritional Ketosis as a Therapeutic Approach in Critical Illness: A Systematic Review.

Critical illness encompasses the dysfunction of vital organs, the risk of death, and potential reversibility; it is a major cause of morbidity and mortality globally. The pathophysiology underlying many critical illnesses includes bioenergetic failure, inflammation, and oxidative stress. This systematic review aims to explore the use of nutritional ketosis (ketogenic feeds and exogenous ketone body administration) as a potential therapy, affecting the aforementioned pathways in patients with critical illnesses. This study was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The search was conducted, systematically using PubMed, PubMed Central (PMC), Google Scholar, and the ScienceDirect databases in February 2024. The inclusion criteria were set to free full-text articles published within the past five years: human and animal studies, literature reviews, systematic reviews, meta-analyses, observational studies, randomized controlled trials, case reports, book chapters, gray literature, studies investigating adult samples, and articles in the English language. Exclusion criteria included pediatric studies as the topic has been studied more extensively in children, and this review aims to explore potential benefits in adult patients. The search was conducted through four databases; after the screening process, the remaining studies were assessed through quality appraisal tools appropriate to each study type. In the end, 11 studies were selected, including eight narrative reviews, one cohort study, one animal study, and one randomized controlled trial. The results of this review demonstrated that nutritional ketosis has potential safe and effective benefits for humans and animals. Nutritional ketosis shows therapeutic benefits for a vast variety of complications commonly associated with critical illness, status epilepticus, sepsis, viral infections, and glycemic control. In the end, both randomized and nonrandomized clinical trials are necessary for more conclusive findings.

ROLE OF STATINS ON CARDIAC REMODELING IN HEART FAILURE: A SYSTEMATIC REVIEW

Heart Failure is a chronic condition in which the heart doesnt pump blood as well as it should it is a major cause of morbidity and mortalityglobally.Heart failure is the pathophysiologic state in which the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues or is able to do so only with an elevated diastolic filling pressure. As recent studies describe Statins to have a beneficial role in preventing Cardiac remodeling in Heart Failure, this systematic review aims to explore the use of Statins as a potential therapy in patients with Heart Failure. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)2020 guidelines. The search was conducted using PubMed, PubMed Central, Google Scholar in July 2023. The inclusion criteria were set to free full-text articles published within 5 years, human studies, literature reviews, systematic reviews, meta -analyses, observational studies, RCTs, studies investigating adult samples, and the English language. Exclusion criteria included animal studies, posters, editorials. The primary search yielded18,166 studies, which were screened and subsequently assessed through quality appraisal tools respective to each study. The result of this review demonstrated that statins prevent cardiac remodeling in heart failure. In the end, both randomized and nonrandomized clinical trails are necessary for more conclusive findings.

The Role of Etanercept in Controlling Clinical and Radiological Progression in Rheumatoid Arthritis: A Systematic Review.

Etanercept (ETN) is a disease-modifyinganti-rheumatic drug (DMARD) used in the treatment of rheumatoid arthritis (RA) that works as a tumor necrosis factor inhibitor (TNF inhibitor) by blocking the effects of naturally occurring TNF. This review will evaluate the effect of ETN as a monotherapy or combination therapy with methotrexate (MTX) in the treatment of RA. This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. A systematic search was done on PubMed and Google Scholar from 1999 to 2023. Predefined eligibility criteria were set for selected studies, which include: free full-text articles published; randomized control trials (RCTs); systematic reviews and meta-analyses; and observational studies in a patient with RA treated with ETN as initial therapy or as an add-on to conventional disease-modified therapy. Hence, the data had been extracted, and a quality assessment of each study was done by two individual authors. When comparing patients who received 15-25 mg of MTX with those who also received 25 mg of ETN in combination, 71% achieved American College of Rheumatology 20 (ACR20) by 24 weeks, compared to 27% in the MTX and placebo groups (p<0.001), and 39% achieved American College of Rheumatology 50 (ACR50), compared to 3% in the placebo + MTX group (p<0.001). Low disease activity (DAS 28)was more common in patients who had both MTX and ETN (64.5% with DAS <2.4 and 56.3% with DAS 28 <3.2) compared to patients who received only one medication (44.4% with DAS <2.4 and 33.2% with DAS 28 <3.2 for ETN and 38.6% with DAS <2.4 and 28.5% with DAS 28 <3.2 for MTX, with P<0.01). ETN demonstrated smaller changes from baseline in the modified Sharp score (TSS) and erosion scores (ES) at 12 months and two years, as well as a decreased change in the ES score at one year (with a trend of P value = 0.06 for the TSS score), in comparison to those receiving DMARD. Reactions at the injection site (42% vs. 7%, P<0.001) were the only events that occurred significantly more frequently in the ETN plus-MTX group. Combining ETN and MTX appears to help control RA symptoms by decreasing the American College of Rheumatology (ACR) response and DAS score, as well as halting the disease's progression on X-rays. The most common adverse effects were reactions to ETN administered alone at the injection site, likely because of patient awareness of the treatment received. There was also concern about tuberculosis and malignancy, but no recent data is available. Therefore, a larger clinical trial with longer follow-up is required to ascertain long-term safety and benefits.

A scoping review of shoulder kinesthetic function in individuals with diabetes mellitus, with and without frozen shoulder

Abstract Background: Kinesthesia, the ability to perceive movements, is diminished in individuals with type II diabetes mellitus. People with frozen shoulders also experience kinesthetic deficits. Thus, obtaining accurate information on shoulder kinesthetic function in individuals with diabetes mellitus, both with and without a frozen shoulder, will aid in developing preventive and therapeutic strategies to optimize shoulder function. Aim: The study aims to investigate kinesthetic deficits in the shoulder among individuals with diabetes mellitus, both with and without frozen shoulder. Materials and Methods: A thorough literature search was performed using PubMed, Cochrane, CINAHL, and Science Direct. Free full-text articles in English, published from 2010 to October 2020, were identified using keywords and MeSH terms. Inclusion and exclusion criteria were developed based on the PICO format. The search results were then screened to identify relevant articles for this scoping review. Results: This review included fourteen articles, encompassing systematic reviews, cross-sectional studies, and prospective studies. Six studies examined the impact of diabetes mellitus on shoulder kinesthesia. These kinesthetic deficits adversely affected basic daily activities, recreational pursuits, and occupational tasks. Conclusion: Reduced kinesthetic function in the shoulder is attributed to structural changes such as capsular tightness, alterations in the fascicle length of rotator cuff muscles, the long head of the biceps, and glenohumeral joint laxity. Factors contributing to the loss of kinesthetic function include muscular fatigue from repetitive shoulder motion, limited joint mobility, blood glucose levels, and decreased muscle strength. This study provides valuable insights for clinicians to design rehabilitation programs, enhance shoulder function, and prevent re-injury risk.

A Systematic Review on the Pharmacological Prospectives of &lt;i&gt;Vitex negundo&lt;/i&gt; in &lt;i&gt;Ayurveda&lt;/i&gt; Drug Research

In Ayurveda, there are many formulations containing Vitex negundo which is indicated in specific pathogenic and non-pathogenic condition. Hence this review attempted to explore the data of research at a glimpse. Peer reviewed and published data from PubMed had been selected for the same. The PubMed database (2009 to 2019) were searched using the keyword ‘Vitex negundo’, ‘Ayurveda’ with Boolean operator ‘AND’. A total of 45 free full text articles were retrieved from 57 articles with specific inclusion criteria. All the 45 studies were categorized into in silico studies, analytical studies, in vitro studies, in vivo studies and clinical studies. Then the data such as the type and design of research, the techniques used, and sample size were categorized into tables and the results were attained through thorough reading and analysis. A descriptive method is adopted for the review and quality aspects of the data were not taken into consideration. Compounds namely, acerosin and thymol were studied in in silico as an inhibitor for mTOR and on skin diseases respectively. Analytical studies explored the presence of compounds such as estriol, angnuside, phydroxybenzoicacid etc. Pharmacological activities such as anti-bacterial, anti-cancerous, anti-tubercular were studied in vitro and in vivo. A clinical study on Nirgundi khanavati in gridrasi (sciatica) is found to be effective in reducing the pain threshold. The phytochemical research of the drug were also proven against carcinoma. There is a high scope for research for more clinical studies and standardization with advanced analytical procedures and marker compounds.

Gestational Diabetes Mellitus: An overview and its potential treatment with herbs

Gestational Diabetes Mellitus (GDM) is a hyperglycemia condition with onset in the second or third trimester of pregnancy. Currently, the first-line prevention and management of GDM are lifestyle modifications that must be implemented throughout pregnancy, even before pregnancy. When lifestyle management is unable to maintain normoglycemia in pregnancy, treatment therapy such as insulin and/or oral antidiabetic drugs is needed. Insulin as a first-choice therapy still has drawbacks, including its high price, potential weight gain, hypoglycemia, and uncomfortable route of administration. Herbal therapy using plant extracts and bioactive compounds with antidiabetic effects has become a concern as preventive, alternative, and complementary therapy. This article will provide information about GDM and the potential of herbal plants that can be used in the treatment of GDM. This review will focus on recent herbal remedies derived from various types of medicinal plants that have been validated through scientific evaluation as promising treatments for GDM. Data was collected through Google Scholar using the keywords "herbs and gestational diabetes mellitus". The references were articles with publication years from 2019 to 2023, written in English, original research, and free full-text articles that were relevant. 6,970 works of literature met the keywords "herbs and gestational diabetes mellitus". Then we selected 15 articles that were most relevant. The bioactive compounds found in plants may be used in the future to complement current treatment strategies for GDM. This review has demonstrated that herbal plants can reduce blood glucose levels in GDM. Additionally, unsaturated fatty acids have also shown the potential for lowering blood glucose levels in GDM. These findings have beneficial effects in regulating glucose metabolism, reducing inflammation, and protecting against oxidative damage associated with GDM.

Effectiveness of Non-Pharmacological Intervention to Reduce Perineal Pain In Postpartum Women

The morbidity and mortality rates for pregnant, postpartum and postpartum women are still a big problem. One of the factors of this morbidity rate is postpartum pain caused by perineal tears. Pain management has two methods, namely pharmacological and non-pharmacological. The purpose of this study was to determine the effectiveness of non-pharmacological interventions in reducing perineal wound pain in postpartum mothers. The method used in this paper is a literature review. The preparation of the literature review was carried out by searching articles from the Google Scholar and Pubmed databases. The keywords used included non-pharmacological, perineal pain OR reducing perineal pain, and postpartum. The inclusion criteria in this literature search were articles from 2018-2023, articles in Indonesian, articles in English, free full-text articles, original articles and articles on non-pharmacological therapy to reduce perineal wound pain in postpartum mothers. The results of the study, it was obtained the results of several non-pharmacological interventions that were effective in reducing perineal wound pain, namely Papaya Leaf Decoction, Red Ginger, Cinnamon Extract, Aromatherapy (Chamomile Aromatherapy, Lavender Aromatherapy, Lemon Aromatherapy), Sitz Bath Therapy, Compress Ice Gel and Acuyoga Postpartum. Based on the findings of the literature, this non-pharmacological intervention in postpartum mothers has proven effective to be applied in practice and is recommended for health workers.

Effects of Exercises and Physiotherapeutic Modalities on Diabetes Mellitus and Its Complications - A Narrative Review

&lt;b&gt;Background: &lt;/b&gt;Diabetes mellitus is slowly and steadily increasing with an estimate that 783 million people will be living with this condition by the end of 2045. Diabetic neuropathy, a complication of diabetes mellitus, is experienced by more than 50&amp;#37; to 70&amp;#37; of all patients with diabetes and results in decreased sensations, proprioception, reflexes, and strength in the lower limbs. This article includes effects of different types of exercises and physiotherapeutic modalities on diabetes mellitus and its complications. &lt;b&gt;Methods:&lt;/b&gt; A literature search was carried out in PubMed and Google Scholar by using key words including &lt;i&gt;diabetes mellitus, diabetic neuropathy, diabetic foot, exercises, modalities,&lt;/i&gt; and &lt;i&gt;quality of life&lt;/i&gt;. Thirty free full-text articles published between 2016 and 2022 were selected and reviewed to know about the recent trends, under 4 different sub-topics: (1) effects of exercises on diabetic neuropathy and diabetic foot, (2) effects of physiotherapeutic modalities on diabetes mellitus/diabetic neuropathy, (3) effects of exercises on diabetes mellitus, (4) effects of exercises on quality of life in diabetic patients. Case reports, randomized controlled trials, a cross-sectional study, and a pilot study, published in only the English language were included, regardless of country of origin. &lt;b&gt;Discussion:&lt;/b&gt; The studies deduced that the patients who followed any type of exercise protocol and used physiotherapeutic modalities in addition to following only pharmacological management showed significant decrease in the symptoms of diabetes mellitus and diabetic neuropathy. Various exercise protocols have produced improvements in diabetic neuropathy symptoms, with significant improvement in self-esteem, mental health, anxiety, depression, and insomnia in diabetic patients. &lt;b&gt;Conclusion:&lt;/b&gt; This review suggests that implementation of exercises significantly benefited the overall functional gait and balance along with an improvement in the signs and symptoms of diabetic and diabetic neuropathic patients thereby increasing the individual's quality of life. Similarly, the use of recent modalities has proven to be remarkably efficient in reducing the size of wound ulcers.

The Relationship Between Sleep Duration and Obesity in Children and Adolescents in Asia: A Meta-Analysis

In recent years, short sleep duration has been proposed and received attention as a modifiable factor of obesity. Observational studies on the relationship between sleep duration and obesity in children and adolescents in the Asian region have been carried out. This study aims to determine the relationship between short sleep duration and obesity in children and adolescents in Asia. This study used a meta-analysis method. Search for articles using the Pubmed, Proquest, Science direct and Google Scholar databases. Article search is limited to research in English, publications from 2000 to 2020 and free full text articles. Data is processed using the Revman 5.3 application. There were 12 research articles that were systematically reviewed from 1,281 identified articles. Ten of these articles were included in the meta-analysis. The results of the study proved that there was a significant relationship between short sleep duration and obesity in children and adolescents with a pooled OR of 1.15 (95% CI: 1.04-1.28), and an analysis of the age subgroup also showed the same results as the pooled OR. 1.17 (95% CI: 1.02-1.35) in the age group before 3-4 years and combined OR 1.29 (95% CI: 1.14-1.48) in children aged 6-12 years. Avoiding short sleep duration can be considered as one way to reduce the risk of obesity in children and adolescents.

Strategies for handling dysmenorrhea in adolescents

Background of the problem: Dysmenorrhea has been identified as a public health problem because of its high prevalence. Dysmenorrhea is a condition that affects various aspects of a woman's life. Although this condition occurs in many women, it is often underestimated and underdiagnosed, and therefore untreated. Early diagnosis of dysmenorrhea is very important. Therefore, women who experience menstrual pain and other accompanying symptoms during menstruation should be referred to an experienced gynecologist for differential diagnosis. Destination: The scoping review was conducted to map the available evidence on the dysmenorrhea treatment strategies used by adolescents to cope with their dysmenorrhea. Method: The database used by Pubmed, Ebscho, Sience Direct and gray literature, namely Google Scholar with inclusion criteria, original articles, published above in 2017 published in English, articles discussing strategies for dealing with dysmenorrhea in adolescents, free full text and open access articles. Exclusion criteria for review articles, opinion articles, organizational documents/guidelines. The eligibility of articles was assessed using the Joanna Briggs Institute tools (JBI), and the Critical Appraisal Program (CSAP). Results: The worldwide prevalence of dysmenorrhea ranges between 50% and 90%. A total of eleven studies said most of the women used pharmacological methods to relieve menstrual pain.

Effectiveness of Constraint Induced Movement Therapy (CIMT) in Comparison with Other Therapeutic Interventions in Treatment of Adult Stroke Patients: A Systematic Review

Background: Stroke is a leading cause of adult disability. Among the various therapeutic modalities used for improving upper extremity function post stroke, Constraint Induced Movement Therapy (CIMT) is one of the most investigated interventions. Objectives: To review the available literature to find evidence for CIMT intervention in overcoming upper extremity impairment in adult stroke patients. Methods: A literature search was conducted on PubMed, Cochrane, EMBASE, CINAHL, and Google Scholar databases. Free full text articles from 2015 - April 2021 with interventional studies, comparing CIMT with other therapeutic interventions for stroke patients with unilateral upper limb involvement were reviewed Results: Twenty-five articles were reviewed after applying the inclusion exclusion criteria. Sample size in case of interventional studies ranged from 19-159 participants. Fifteen studies (60%) concluded that CIMT is superior to conventional therapy in overcoming non-use of affected upper limb, two articles (8%) concluded CIMT brings about limited improvements functionally. 50% studies denied long term gains or improvements, one article (4%) specifically denying any effects lasting post 6 months, three studies (12%) reported better results when CIMT was used in combination with other therapies, one study (4%) has shown Botox and CIMT combination to be a promising treatment method for improving motor function. Conclusion: We found CIMT a useful therapy in adult stroke patients with more studies showing a significant improvement in early phases of rehabilitation. Even if the articles have denied long-term gains or improvements beyond six months, none have shown deterioration in CIMT group Keywords: Adult stroke, Constraint induced movement therapy (CIMT), systematic review

How Residing in a Long-Term Care Facility Affects Suicidal Risk in Patients With Dementia: A Systematic Review.

This study aims to review the current literature regarding the association between suicide risk in patients aged 65 years or over with dementia residing in long-term care facilities (LTCs). We also evaluate the most common methods of suicide and protective versus risk factors of nursing home (NH) life on suicide behavior in patients with dementia.Following preferred reporting items for systematic reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of the relevant free full-text articles found in PubMed, Pub Psych, Cochrane library, and Science Direct up until April 4, 2022. Medical Subject Heading (MeSH) terms and keywords (nursing home, long-term care facility, suicide, self-injurious behavior, dementia), were used to search for full-text randomized clinical trials (RCTs), cross-sectional, case-control, cohort studies, systematic reviews, and studies published in the English language in the last 12 years, focused on human subjects 65 years and older were selected based on predefined eligibility criteria. The search yielded 57,909 articles, of which 12 studies met our inclusion criteria. The articles were subjected to quality appraisal by two reviewers. We used the Newcastle Ottawa scale (NOS) for quality assessment with a mean score of six for 12 observational studies used in this paper.Of the included reports, six were cross-sectional, five were cohort, and one was case-control. Four articles carefully examine the relationship between dementia and suicide, and all confirm the hypothesis that staying in LTCs reduces the risk of suicide in patients with dementia. However, the rest of the articles generally determine a higher risk of suicide in demented patients and describe male gender, non-Hispanic white race, younger age, newly diagnosed with dementia within one-year, mild dementia, comorbidities, depression, previous history of suicidal behavior, low social support and unstable family relationship as the risk factors of suicide in this population. In comparison, extended stay in NHs and other kinds of LTCs, severe dementia with impaired insight, older age, comorbid schizophrenia, physical disability with limitation and more difficulty preparing and executing a suicide plan, positive and robust social relationships, access to professional caregivers and high frequency of visits from relatives marked as the protective factors.Existing research on suicide risk in long-term care facility residents with dementia is limited. However, due to the increase in dementia rates that require people to reside in NHs and on the other hand, considering the multiple risk factors of suicide in the elderly living in such places, the need for a screening system for identifying people at suicide risk and performing preventive therapeutic and behavioral interventions is well felt.

Preferences for Online Learning among Nursing Students: A Systematic Review

Background and objectives: The traditional teaching methods have transitioned to distance learning in all fields of education, including medical and nursing education during the Covid 19 pandemic. We aimed to perform a systematic review on preferences for online modes of learning among nursing students.. Materials and Methods: The investigator conducted a thorough literature search on PubMed and Google scholar using comprehensive search strategies to find published English free full-text scientific articles related to preferences of nursing students to online and face-to-face learning modes. Based on the inclusion criteria, articles were searched. Results: The studies that were selected based on databases give the evidence to convince the different perceptions of nursing students to online learning modes. Out of six, 4 studies show less than 50% of preferences for online learning. Interpretation and conclusions: Current evidence suggests that the online mode of learning has increasing preference along with face-to-face learning in nursing. However, further studies with a larger sample size and longer duration are required. Keywords : Online learning, preferences, nursing students

Biological Effects of High Radiofrequency Radiation on Wistar Rats: A Literature Review

Aim and Objective Despite the growing concerns about the relationship between exposure to radiofrequency radiation (RFR) and detrimental health effects due to the changes in biological processes of experimental animals, there is still ongoing debate on the significance of these findings in causing significant public health problems with the growing advancement in internet technology. The aim of this study is to review existing literature on the effects of high RFR on wistar rats. Method A search was conducted on Google scholar and PubMed to identify relevant peer-reviewed articles to be included into the review. Studies eligible for inclusion included free full text articles on wistar rats exposed to ≥ 2.45GHz RFR conducted in the past 5 years. Studies included in this review were written or transcribed in English language. From 286 titles, 36 eligible studies were included in the review and assessed for quality using the Strengthening the Report of Observational Studies in Epidemiology – Veterinary Extension (STROBE-Vet) quality assessment tool. Results Studies included in this review generally had good quality (&gt;60%) based on the STROBE-Vet assessment. This review identified numerous biological changes in wistar rats exposed to high RFR including variations in biochemical, cholinergic, genetic, histopathologic, psychological, optical, and dermatological parameters. In this review, studies identified variations in protein and liver enzymes while high RFR was found to induce oxidative stress and cellular damage of exposed wistar rats compared to the unexposed groups. This was seen in the changes in protein, lipids, enzymatic and non-enzymatic antioxidants. Studies also identified changes in expression of genes and neurotransmitters with imbalance in hormones. In addition, this review identified structural changes of cells, tissues and organs indicative of apoptosis, damage and death. Exposed rats were identified to have behavioral changes indicative of anxiety and memory decline while studies identified optical and dermatologic changes in exposed rats compared to the unexposed. Conclusion With numerous biological changes identified in wistar rats exposed to high RFR, there is an increasing risk of detrimental health events giving the advancement in internet technology and limited regulations to control exposures to RFR. Therefore, studies should be conducted to identify strategies to mitigate human exposure to RFR while policies are developed and enforced to protect human health.

Evaluating the quality of clinical evidence in gastrointestinal cancers PubMed searches: How relevant are the results?

11037 Background: Bibliographic repositories have become increasingly important as clinical evidence is more accessible on the internet. Often, oncologists rely on published literature to guide patient care. However, with the proliferation of journals and increasing number of peer reviewed papers, current search strategies have the potential to retrieve large numbers of irrelevant or misleading articles. Moreover, access to current best evidence may require paid subscriptions. Here, we assessed the quality of retrieved medical literature pertaining to treatment of gastrointestinal cancers using the PubMed database. Methods: We interrogated 6 focused-therapy questions in 3 categories: medical oncology (MedOnc), surgical oncology (SurgOnc), and alternative medicine (AltMed). We extracted journal metrics of the first two pages (40 results) from each search. We defined the composite outcome “relevant result” as the product of removing results from 1) predatory journals (Beall’s list), 2) non-English language, and 3) no free access publications. As a sensitivity analysis, we defined 2007 as a cutoff for “relevant” publications and Impact Factor (IF) &gt; 3 or H-index &gt; 50. Results: Two hundred and forty results were retrieved (80 per search type). Forty-eight percent of the journals were European (n = 115), 40% US-based (n = 96), and 94% were in English (n = 225). Most journals (n = 170; 70.8%) had an IF between 1-10, followed by ̃21% with an IF &gt; 10 (n = 51); yet ̃45% (n = 107) were in the Clarivate Analytics top quartile. Sixty percent (n = 139) of articles were free to access. The articles had a median H-index of 117 [IR 59, 168]. When modelling the multivariate association with “relevant result”, year of publication after 2007 had an OR = 1.07 (95% CI = 1.01-1.14; p&lt; 0.02) and availability through GOLD Open Access by Clarivate Analytics had an OR = 1.09 (95% CI = 1.03-1.15; p&lt; 0.0008). MedOnc retrieved more papers published in journals with IF &gt; 10 (n = 31; 38.8%) than SurgOnc searches (n = 12; 15%; p&lt; 0.001). Only the AltMed searches included non-peer reviewed publications (n = 4; 5%) and 4 results were from “predatory journals”, all in MedOnc. Conclusions: Articles had a 7% higher chance of being considered a “relevant result” if they were published after 2007 and a 9% higher chance if available under GOLD Open Access. Publications identified as “relevant results” with an IF or H-index above the established cutoffs, had a 6% higher chance to be in the top 40 PubMed search results. In the sensitivity analysis the results remain virtually unchanged. Importantly, nearly 40% of papers indexed in PubMed do not have free full-text articles, making them unavailable to oncologists without access to a medical library or paid subscription. These results highlight the imperative to deliver relevant, freely accessible information that can impact the care of the cancer patients.

Uterine septum and reproductive outcome. From diagnosis to treatment. How, why, when?

Septate uterus is a benign congenital malformation and represents the most common uterine anomaly in women with poor reproductive outcome. To review the available scientific data concerning the biological context of the intrauterine septum and the association with poor reproductive outcome, the best methods for diagnosis and treatment. From July 2020 to October 2020, we searched for relevant free full text articles in PubMed, written in English, and published from the 1st of January 2000 to 31st of July 2020. Association of the pathophysiology of septate uterus with poor reproductive outcome, evaluation of the different classification systems, the accuracy of diagnostic methods and the efficacy of the available treatment options. 259 articles were screened, and 22 articles were finally included in our study. Many theories regarding the pathophysiology of this congenital anomaly and its' association with reproductive problems have been proposed along the recent decades. Combination of diagnostic methods should be used to avoid misclassification of this congenital anomaly. Lack of uniformity in the different classification systems makes the diagnosis of septate uterus challenging as there is no universally accepted definition. Data regarding the reproductive outcome of women with septate uterus are still limited, thus recommendations regarding optimal treatment of these women are biased. According to new insights regarding the pathophysiology of the uterine septum, differences in the underlying embryological defects are associated with changes in the histological composition and vascularisation of septa, as well as in clinical significance.

The Role of Childhood Trauma in Psychosis and Schizophrenia: A Systematic Review.

Schizophrenia (SCZ) is a prevalent cause of disability worldwide. Distinguished mainly by psychosis, behavioral alterations could range from hallucinations to delusions. This systematic review examines evidence of a relationship between childhood trauma/adverse life events and psychosis, especially in SCZ. A methodical search provided reproducible results using these five databases: PubMed, ScienceDirect, Semantic Scholar, JSTOR, and Cochrane Library. The systematic search focused on articles published between July 2016 and July 2021. The search strategy utilized specific keywords relevant to SCZ, psychosis, and childhood trauma. The formulation of specified inclusion and exclusion criteria was necessary to ensure a comprehensive narrowed-down search, such as the inclusion of free full-text articles published or translated in English and exclusion of irrelevant subject areas. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a strategic search initially identified 741 articles; three additional articles were identified from citation searching. After relevance screening, duplicate removal, and quality appraisal, 12 studies from databases/registers and three from citation searching met the criteria proving relevance to our review with minimal evidence of bias. The final selected 15 studies included observational studies and reviews. A review of relevant data unveiled findings on childhood adversity, individual lived experiences, and their involvement in SCZ. Evidence suggests that certain neurobiological processes occur in brain after trauma. The inflammation and dysregulation from oxidative stress predispose patients to an at-risk-mental state, facilitating the progression to SCZ. This review encourages further evaluation of early trauma detection and the potential benefits of early intervention.

The Physiotherapy Evidence Database (PEDro) has better free full-text access than PubMed: An observational study

BackgroundAccess to full-text articles is an essential element of evidence-based practice. ObjectiveEstimate the percentage of articles in the Physiotherapy Evidence Database (PEDro) that have free full-text access and compare free access between PEDro and PubMed. Secondary objectives for access via PEDro: determine if publication year and geographic location impact on free access; determine if adding a link to a portable document format (PDF) locator website would improve free access; and evaluate the association between article characteristics and free access. MethodsThis observational study used a random sample of 200 articles published in 2000–2019 and indexed in PEDro. Data collectors in Australia, Brazil, Nepal, and Spain attempted to access free full text for each article via PEDro. One data collector attempted to access free full text via PubMed. One data collector attempted to access full text via a PDF locator (http://www.pdfsearchengine.net/). The percentage (95% confidence interval [CI]) of articles with free full-text access from PEDro, PubMed, and the PDF locator website were calculated. Logistic regression was used to evaluate the association between free full-text access and article characteristics. ResultsFree full text could be accessed via PEDro for 51% of the articles (95% CI: 44, 58). PEDro had 4% higher free access than PubMed (95% CI: 1, 7). Access via PEDro did not vary systematically with time, geographic location, or article characteristics. Access improved by 9% (95% CI: 6, 14) by adding a PDF locator website. ConclusionsPEDro is a good source of free full-text articles for physical therapists and other rehabilitation professionals. Evidence resources, professional organisations, employers, researchers, and research agencies could all help to increase access to free full text.