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Mapping scoping reviews in neurosurgery: a scoping review protocol

IntroductionThe realm of neurosurgery is currently witnessing a surge in primary research, underscoring the importance of adopting evidence-based approaches. Scoping reviews, as a type of evidence synthesis, offer a broad...

OUTCOMES OF PRIMARY JOINT REPLACEMENT IN PATIENTS WHO ARE INTRAVENOUS DRUG USERS: A SYSTEMATIC REVIEW

Arthroplasty in patients who are intravenous drug abusers presents a complex challenge, frequently requiring intervention at a younger age. The cohort suffer increased complication rates due to significant co-morbidities and poor engagement in medical services, in comparison to other patients undergoing lower limb arthroplasty. Multiple small studies show arthroplasty in this patient cohort is associated with high complication and mortality rates.A search of electronic databases were undertaken with the assistance of the library services from the Rotherham NHS Foundation Trust, including Chocraine, SCOPUS and PubMed.Abstracts were reviewed and relevant studies extracted for full review. Full text articles were reviewed based on strict inclusion and exclusion criteria.Searches identified Two thousand and forty-four papers; twenty-seven studies were identified for full review of the paper based on the inclusion criteria above. From this, nine studies were deemed appropriate to for data extraction.These nine papers present one hundred and thirty-two cases of lower limb arthroplasty, fifty nine Total Knee Arthroplasty and seventy three Total Hip Arthroplasty. From this the authors examined incidences of implant failure due to infection, revision, mortality, dislocation, aseptic loosening, peri-prosthetic fracture, or other causes. Of these, 58% of patients (n = 77) with a history of intravenous drug abuse suffered some form of significant complication; 4% of this cohort (n = 5) were lost to follow up. Infection was reported in 32% of cases and a mortality rate of 4.7%.The rising demand of lower limb arthroplasty for intra-venous drug abusers presents a very real problem for the modern Orthopaedic surgeon. Within the studies examined, more than half report implant failure. This study synthesises the available literature regarding treatment of these patients to help facilitate decision making and informed consent.

ПРОЦЕССЫ РЕГЕНЕРАЦИИ КОСТНОЙ ТКАНИ ПРИ ПЕРЕЛОМАХ НИЖНЕЙ ЧЕЛЮСТИ

Item. The review of literature devoted to the actual problem of maxillofacial surgery — processes of bone tissue regeneration in mandibular fractures is presented. The purpose of the study — to study and analyze the materials of publications on the processes of bone tissue regeneration in mandibular fractures. Methodology. The publications of domestic and foreign authors devoted to the processes of bone tissue regeneration in mandibular fractures were studied. The publications were analyzed using scientific search library databases: PubMed Central, Google, Cyberleninka, eLibrary. Materials were selected by keywords. Full-text articles were included in the search. Results. In domestic and foreign literature, the processes of restoration of bone structures of the maxillofacial region as an organism's response to damage have been studied and described in detail. It has been established that two processes are simultaneously launched: resorption of damaged osteocytes and formation of osteoid tissue, one of which may be predominant at the moment. Conclusions. The article presents modern data on the key moments of bone tissue regeneration in the region of the mandible. All stages of the reparative process in bone tissue are described at the cellular level, and information about the main mechanisms, pathways and cell types involved in bone tissue regeneration is presented in detail, taking into account the stage of osteogenesis. Knowledge of the regularities of biological processes in the bone tissue regeneration zone allows scientific search and development of effective methods of treatment of mandibular fractures.

Abstract PO3-12-03: SAFETY AND TOLERABILITY OF SHOCKWAVE THERAPY FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA: A SYSTEMATIC REVIEW

Abstract Introduction: Breast cancer is currently the most common malignancy among women, after non-melanoma skin cancer. Upper limb lymphedema is the most feared complication of breast cancer treatment. Currently, the approach described in the literature as the most effective for the treatment of lymphedema is Complex Physical Therapy. In the search for more efficient therapeutic actions, Shockwave Therapy emerges as an alternative in the treatment of upper limb lymphedema secondary to breast cancer. Objective: to systematically review the available literature and verify the safety, tolerance and efficacy of using Shockwave Therapy (ESWT) in the treatment of upper limb lymphedema secondary to breast cancer. Methods: The following databases were used: PubMed; PEDro, The Cochrane Library, EMBASE, Web of science and Scopus and through manual search of articles. The PICO research method was adopted, and the descriptors adjusted according to the respective database. This study was registered in PROSPERO: CRD42020209588. Results: Combined searches, including reference lists, manual searches, and database searches, yielded 64 articles, of which 35 articles were duplicates, 23 studies were excluded by title, abstract, or full reading. Six full-text articles were selected. Of these, only 3 randomized clinical trials and 3 non-randomized clinical trials met all established inclusion criteria and were analyzed in this systematic review. Two more RCTs were added by manual search of references from other articles. None of the studies found had safety and tolerability as their primary objective, and one reported transient redness with the use of the device. Shockwave Therapy, combined with other resources, can significantly improve lymphedema volume and shoulder range of motion, but there is not enough evidence to support the use of ESWT as a substitute for complex physical therapy (CPT). Final considerations: There is evidence that it can improve ROM and upper limb volume when used in association with CPT, which is the gold standard for the treatment of lymphedema. Keywords: Lymphedema, Breast Cancer, Extracorporeal Shockwave Therapy. Citation Format: Patricia Lima Ventura, Cinira Haddad, Afonso Nazário, Gil Facina, Vanessa Sanvido, Amanda Estevao, Samantha Lopes de Almeida Rizzi. SAFETY AND TOLERABILITY OF SHOCKWAVE THERAPY FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA: A SYSTEMATIC REVIEW [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-12-03.

Wolbachia and Lymphatic Filarial Nematodes and Their Implications in the Pathogenesis of the Disease

Lymphatic filariasis (LF) is an infection of three closely related filarial worms such as Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms can cause a devastating disease that involves acute and chronic lymphoedema of the extremities, which can cause elephantiasis in both sexes and hydroceles in males. These important public health nematodes were found to have a mutualistic relationship with intracellular bacteria of the genus Wolbachia, which is essential for the development and survival of the nematode. The host’s inflammatory response to parasites and possibly also to the Wolbachia endosymbiont is the cause of lymphatic damage and disease pathogenesis. This review tried to describe and highlight the mutualistic associations between Wolbachia and lymphatic filarial nematodes and the role of bacteria in the pathogenesis of lymphatic filariasis. Articles for this review were searched from PubMed, Google Scholar, and other databases. Article searching was not restricted by publication year; however, only English version full-text articles were included.

Impacts on paediatricians testifying in cases of child maltreatment: protocol for a systematic review

IntroductionPaediatricians perform medical assessments for children in cases of suspected child maltreatment. Due to their role with statutory child protection agencies and police, paediatricians may be asked to testify in...

Optimal fluoride levels in pediatric toothpastes: A review of the literature

Aim:Through this literature review, we seek to determine the optimal level of fluoride present in pediatric toothpastes, identifying the recommended amount according to scientific literature, in addition to evaluate the effects of fluoride on children's dental health and its effectiveness in prevention of caries and also identify the risks of excessive fluoride exposure. Materials and methods: Searches were carried out for articles published in the last 5 years in electronic databases such as PubMed, Scopus, Scielo, ScienceDirect, UpToDate, Google Academic. The search used a combination of the following keywords: "toothpaste" AND "pediatrics" AND "dosage" AND "fluoride". Results: 14,118 abstracts were registered: 1,407 from PubMed, 1,043 from Scopus, 355 from ScienceDirect, 10,200 from Google Academic, 913 from Scielo, 200 from UpToDate. After reviewing the abstracts, 14,095 records were removed according to the inclusion and exclusion criteria, leaving 31 full-text articles for examination. Finally, 19 full-text articles were included and evaluated in this review. Conclusion: The presence of adequate concentrations of fluoride in toothpastes has a positive influence in oral health, especially on the prevention of dental caries. Several reviewed studies reveal that the optimal amount of fluoride in pediatric toothpastes should be greater than 1000 ppm but not exceed 1500 ppm to obtain the maximum anti-caries effect and prevent adverse effects such as dental fluorosis.

Efficacy of nivolumab in comparison to chemotherapy and gefitinib for advanced NSCLC

Background: Lung cancer is one of the major causes of cancer related death worldwide, while non-small cell lung cancer (NSCLC) consists of 85% of all lung cancer cases. Despite adequate treatment, most of the NSCLC patients progress to advance stages. Single or doublet-chemotherapy are considered as standard care for advance NSCLC patients. Gefitinib is considered as standard therapy for EGFR mutant advanced NSCLC. Recently, a human monoclonal antibody called Nivolumab has shown encouraging efficacy for advanced NSCLC patients. The aim of this systematic review is to show the efficacy of nivolumab in comparison to single or doublet chemotherapy and gefitinib.         Method: A systematic search was performed in PubMed, Google Scholar and Cochrane Library to identify primary research, published in English language between 2000 and 2018, involving Nivolumab, chemotherapy and gefitinib for advanced NSCLC patients. The primary outcome of interest was median overall survival (mOS). The secondary outcome of interest were progression free survival, objective response rate and grade-3 and treatment related adverse effects.   Results: After screening 600 full-text articles, 17 clinical studies involving 9284 patients of advanced NSCLC were included. All treatment regimen seemed to be feasible. The mOS for nivolumab was ranging between 9.2 months and 16.2 months; for chemotherapy between 6 months and 18.8 months; and for gefitinib between 7.6 months and 30.5 months. Conclusion: Nivolumab is more effective and safe for EGFR non-mutant advanced NSCLC patients than either chemotherapy or gefitinib. However, gefitinib is more effective than nivolumab for EGFR-mutant NSCLC patients. J Bangladesh Coll Phys Surg 2024; 42: 176-188

Application of immersive virtual reality mirror therapy for upper limb rehabilitation after stroke: a scoping review.

Mirror therapy is a commonly used rehabilitation intervention in post stroke upper limb rehabilitation. Despite many potential technological developments, mirror therapy is routinely delivered through the use of a static mirror or mirror box. This review aims to synthesise evidence on the application of immersive virtual reality mirror therapy (IVRMT) in poststroke upper limb rehabilitation.A scoping review was performed on relevant English studies published between 2013 to 2023. Literature search was undertaken on APA PsycInfo, CINAHL, Cochrane Library, MEDLINE, PubMed and Web of Science between August 5 and 17, 2023. Additional studies were included from Google Scholar and reference lists of identified articles.A total of 224 records were identified, of which 8 full-text articles were selected for review. All included studies were published between 2019 and 2023, and from high- and upper-middle-income nations. All the studies were experimental (n = 8). The total sample size in the studies was 259, most of whom were stroke patients with upper limb weakness (n = 184). This review identified three major themes and two sub-themes based on the contents of the studies conducted on the application of IVRMT: IVRMT's technical application, feasibility and impact on clinical outcomes (motor recovery and adverse events).IVRMT was concluded to be a safe and feasible approach to post-stroke upper limb rehabilitation, offering enhanced engagement and motor recovery. However, more methodologically robust studies should be conducted to advance this area of practice, and to include a uniform IVRMT intervention protocol, dose, and use of outcome measure.

Effectiveness of Methotrexate Versus Cyclosporine in the Management of Moderate to Severe Atopic Dermatitis- Meta-Analysis of Randomised Controlled Trials

Objective: To compare the effectiveness of Methotrexate (MTX) versus Cyclosporine (CyA) in the patients of moderate to severe atopic dermatitis (AD) Study Design: Systematic review and Meta-analysis. Methodology: After formulating our research team and PICO question rationally, a search strategy and literature search were carried out as per Cochrane guidelines. Full-text articles were retrieved after title and abstract screening per our inclusion criteria. The whole search process was documented in the form of a PRISMA flow chart. Team members made and filed data extraction sheets, and qualitative data synthesis was performed. Afterwards, a meta-analysis was carried out, involving a total of 03 randomized controlled trials. Revman was used to process the continuous and dichotomous data collected for our outcomes. RoB 2 was used to assess the risk of bias in the included studies. Grade pro-GDT was used to summarize the findings in the table. Results: Pooled results from 3 RCTs showed that CyA in a 2.5mg/kg dose is better than MTX @0.4 mg/kg/week at 12 weeks in AD. At follow-up, MTX maintains better disease control, i.e., until 24 weeks post-treatment. MTX has a better safety profile than CyA. Conclusion: MTX and CyA are both effective drugs for moderate to severe AD, but they have their pros and cons.

Monitoring Global Progress in Core Diabetes Control Metrics: Protocol for a Systematic Review of Prevalence (2015–2023)

Background The Global Diabetes Compact is a WHO-sponsored initiative that aims to improve diabetes care and prevention, and to reduce the global burden of diabetes. This includes the goal of monitoring the progress and achievement of country-level diabetes metrics and targets. The objective of this systematic review is to examine population-based studies from 2015–2023 to determine the status of core diabetes control metrics: glycaemic (HbA1c), blood pressure and lipid control (low-density lipoprotein and non-high-density lipoprotein cholesterol), and statin use. This review will describe regional and country-level variation in attainment gaps concerning these indicators. Methods This review will follow the JBI methodological approach to systematic reviews of prevalence, and will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We will include population-based observational studies, conducted in all geographic settings that report data on adult populations (≥18 years) with diagnosed Type 1 or Type 2 diabetes, with no language restrictions. We will search the following databases: Ovid MEDLINE, Embase, Scopus, Cochrane Library, and WHO Global Index Medicus. Using Covidence, two reviewers will independently screen titles and abstracts against eligibility criteria, review potentially relevant full-text articles, and extract data from eligible studies. A third reviewer will resolve any conflicts. Reviewers will use a standardised data extraction form to extract study population, methodological, and outcome data. Primary outcomes are levels of glycaemic, blood pressure, and lipid control, and statin use. Methodological quality of included studies will be assessed using the JBI Critical Appraisal tool for studies reporting prevalence data. Extracted data will be synthesised using descriptive statistics and summarised narratively. Dissemination Findings will be used to inform global diabetes surveillance, prevention, and treatment initiatives. The completed review will be submitted for publication in a peer-reviewed journal, and presented at national and international conferences. PROSPERO registration CRD42024505286 OSF https://doi.org/10.17605/OSF.IO/DZYJK

A scoping review to investigate recruitment and retention of people with dementia in clinical trials

Abstract Introduction The literature acknowledges difficulties in recruiting people with dementia (PwD) to research studies. Despite efforts of researchers and policymakers to improve participant recruitment and retention in clinical studies,[1] challenges remain.[2] Further work is needed to describe recruitment and retention of PwD in clinical studies and strategies used to promote these activities. Aim This scoping review aimed to investigate recruitment and retention of PwD in clinical trials focused on evaluating the pharmacological management of cognitive symptoms of dementia. Methods Five electronic databases (Medline, Embase, PsychINFO, Scopus, Web of Science) and the International Clinical Trials Registry Platform were searched using a variety of search terms to identify articles published in English from date of inception until July 2023. All registered, unregistered, published, and unpublished randomised controlled trials that evaluated pharmacological treatments for cognitive symptom management among PwD, with a mean age ≥65 years and dementia of any sub-type or stage were included; studies were not excluded based on setting. Two reviewers independently reviewed full texts of potentially eligible records. Data were extracted by one reviewer using a table constructed in Microsoft Excel; a 10% subset was checked by a second reviewer. Findings were summarised using frequencies and percentages and/or narratively presented in tables. Results In total, 3,253 records were found, with 2,953 records remaining after removal of duplicates. Following title/abstract screening, 229 full-text articles were assessed for eligibility. A total of 129 records met the inclusion criteria for this review. Fifty-eight studies (45.0%) recruited community dwelling PwD. Common reasons for participants to be excluded from trials were having no carer present (n=128 studies, 99.2%), using specific medications such as anticholinergic medications (n=28 studies, 21.7%), and being unable to swallow tablets without crushing (n=10 studies, 7.7%). A limited number of studies (n=45, 34.9%) provided details about how they recruited participants. A variety of different recruitment sites were used including clinical research facilities (n=16, 12.4%), memory clinics (n=17, 13.2%), general practices (n=2, 1.6%), nursing homes (n=2, 1.6%), hospitals (n=2, 1.6%). Few studies recruited through advertisements in local newspapers/radio stations (n=2, 1.6%). Only one study reported that PwD and their carers were supported by research/clinical staff throughout the trial to improve participant retention. The mean sample size was 439 participants, and the mean retention rate was 73.5%. On average, 99 participants per study withdrew from the clinical trials, with common reasons for withdrawal being adverse events (n=45 participants per study), carer no longer available (n=37 participants per study), and death (n=12 participants per study). Conclusion This study has provided important evidence on recruitment and retention of PwD in clinical studies. The findings highlight how poorly recruitment is described in the literature and it is unclear what strategies were used to promote recruitment and retention. Researchers working in this field should consider this when disseminating their work. Whilst a quality assessment of included studies was not undertaken, this is acceptable in scoping reviews. Future research should focus on enhancing transparency of reporting recruitment and retention of PwD in clinical research.

Tools used to measure the impact of comorbidities on surgical outcomes in children with complex chronic conditions: A scoping review.

To identify and describe assessment tools used to measure the impact of comorbidities on postoperative outcomes in children with complex chronic conditions (CCC). This was a scoping review using five electronic databases. The search was conducted in March 2022 by a medical librarian. There were no date or language restrictions. Included studies were full-text articles published in peer-reviewed journals that described a tool used to measure the impact of comorbidities in children with CCC to assess postoperative outcomes. A standardized data charting tool was used. A total of 2157 articles were retrieved. Five studies reporting on six comorbidity measures met inclusion criteria. All were cohort studies and were secondary analyses of data from an administrative database (n = 4) or a patient registry (n = 1). Sample sizes ranged from 645 to 25 747 participants. One paper described the assessment of reliability. Only one form of validity - predictive validity - was assessed in three papers for five measures. Findings from this scoping review revealed a paucity of comorbidity assessment tools validated for use with children with CCC; significant conceptual and measurement challenges exist in the current scientific literature.

Relative carcinogenicity of tacrolimus vs mycophenolate after solid organ transplantation and its implications for liver transplant care.

De novo malignancy is a leading cause of late morbidity and mortality in liver transplant recipients. Cumulative immunosuppression has been shown to contribute to post-transplant malignancy (PTM) risk. There is emerging evidence on the differential carcinogenic risk profile of individual immunosuppressive drugs, independent of the net effect of immunosuppression. Calcineurin inhibitors such as tacrolimus may promote tumourigenesis, whereas mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil, may limit tumour progression. Liver transplantation (LT) is relatively unique among solid organ transplantation in that immunosuppression monotherapy with either tacrolimus or MPA is often achievable, which makes careful consideration of the risk-benefit profile of these immunosuppression agents particularly relevant for this cohort. However, there is limited clinical data on this subject in both LT and other solid organ transplant recipients. To investigate the relative carcinogenicity of tacrolimus and MPA in solid organ transplantation. A literature search was conducted using MEDLINE and Embase databases using the key terms "solid organ transplantation", "tacrolimus", "mycophenolic acid", and "carcinogenicity", in order to identify relevant articles published in English between 1st January 2002 to 11th August 2022. Related terms, synonyms and explosion of MeSH terms, Boolean operators and truncations were also utilised in the search. Reference lists of retrieved articles were also reviewed to identify any additional articles. Excluding duplicates, abstracts from 1230 records were screened by a single reviewer, whereby 31 records were reviewed in detail. Full-text articles were assessed for eligibility based on pre-specified inclusion and exclusion criteria. A total of 6 studies were included in this review. All studies were large population registries or cohort studies, which varied in transplant era, type of organ transplanted and immunosuppression protocol used. Overall, there was no clear difference demonstrated between tacrolimus and MPA in de novo PTM risk following solid organ transplantation. Furthermore, no study provided a direct comparison of carcinogenic risk between tacrolimus and MPA monotherapy in solid organ transplantation recipients. The contrasting carcinogenic risk profiles of tacrolimus and MPA demonstrated in previous experimental studies, and its application in solid organ transplantation, is yet to be confirmed in clinical studies. Thus, the optimal choice of immunosuppression drug to use as maintenance monotherapy in LT recipients is not supported by a strong evidence base and remains unclear.

Tracing Class and Capital in Critical AI Research

This article explores the rapidly developing field of Critical AI Studies and its relation to issues of class and capitalism through a hybrid approach based on distant reading of a newly collected corpus of 300 full-text scientific articles, the creation of which is itself a first attempt at properly delineating the field. We find that words related to issues of class are predominantly but not exclusively confined to a set of studies that make up their own distinct subfield of Critical AI Studies, in contrast to, e.g., issues of race and gender, which are more broadly present in the corpus.

Systematic Review of Chemical Compounds with Immunomodulatory Action Isolated from African Medicinal Plants

A robust, well-functioning immune system is the cornerstone of good health. Various factors may influence the immune system’s effectiveness, potentially leading to immune system failure. This review aims to provide an overview of the structure and action of immunomodulators isolated from African medicinal plants. The research was conducted according to PRISMA guidelines. Full-text access research articles published in English up to December 2023, including plant characteristics, isolated phytochemicals, and immuno-modulatory activities, were screened. The chemical structures of the isolated compounds were generated using ChemDraw® (version 12.0.1076), and convergent and distinctive signaling pathways were highlighted. These phytochemicals with demonstrated immunostimulatory activity include alkaloids (berberine, piperine, magnoflorine), polysaccharides (pectin, glucan, acemannan, CALB-4, GMP90-1), glycosides (syringin, cordifolioside, tinocordiside, aucubin), phenolic compounds (ferulic acid, vanillic acid, eupalitin), flavonoids (curcumin, centaurein, kaempferin, luteolin, guajaverin, etc.), terpenoids (oleanolic acid, ursolic acid, betulinic acid, boswellic acids, corosolic acid, nimbidin, andrographolides). These discussed compounds exert their effects through various mechanisms, targeting the modulation of MAPKs, PI3K-Akt, and NF-kB. These mechanisms can support the traditional use of medicinal plants to treat immune-related diseases. The outcomes of this overview are to provoke structural action optimization, to orient research on particular natural chemicals for managing inflammatory, infectious diseases and cancers, or to boost vaccine immunogenicity.

Digital Health Interventions and Patient Safety in Abdominal Surgery

Over the past 2 decades, several digital technology applications have been used to improve clinical outcomes after abdominal surgery. The extent to which these telemedicine interventions are associated with improved patient safety outcomes has not been assessed in systematic and meta-analytic reviews. To estimate the implications of telemedicine interventions for complication and readmission rates in a population of patients with abdominal surgery. PubMed, Cochrane Library, and Web of Science databases were queried to identify relevant randomized clinical trials (RCTs) and nonrandomized studies published from inception through February 2023 that compared perioperative telemedicine interventions with conventional care and reported at least 1 patient safety outcome. Two reviewers independently screened the titles and abstracts to exclude irrelevant studies as well as assessed the full-text articles for eligibility. After exclusions, 11 RCTs and 8 cohort studies were included in the systematic review and meta-analysis and 7 were included in the narrative review. Data were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline and assessed for risk of bias by 2 reviewers. Meta-analytic estimates were obtained in random-effects models. Number of complications, emergency department (ED) visits, and readmissions. A total of 19 studies (11 RCTs and 8 cohort studies) with 10 536 patients were included. The pooled risk ratio (RR) estimates associated with ED visits (RR, 0.78; 95% CI, 0.65-0.94) and readmissions (RR, 0.67; 95% CI, 0.58-0.78) favored the telemedicine group. There was no significant difference in the risk of complications between patients in the telemedicine and conventional care groups (RR, 1.05; 95% CI, 0.77-1.43). Findings of this systematic review and meta-analysis suggest that perioperative telehealth interventions are associated with reduced risk of readmissions and ED visits after abdominal surgery. However, the mechanisms of action for specific types of abdominal surgery are still largely unknown and warrant further research.

A Scoping Review of GIS Mapping of Type 1 Diabetes in Children: Identifying Current Gaps and Future Research Directions Using PRISMA-ScR.

Type 1 Diabetes poses a significant public health threat, especially in low-and-middle countries, where resources are limited. The use of geographical information systems in diabetes research has shown the potential to reveal several epidemiological risk factors. This scoping review aimed to identify the scope and extent of the current literature and explore its limitations on the geographical mapping of children with type 1 diabetes. A scoping review was conducted using five electronic databases and included studies published between the years 2000 and 2023. The search terms included: "Type 1 Diabetes Mellitus", "GIS mapping", "Juvenile Onset Diabetes Mellitus", "Spatial Epidemiology", "Spatial Clustering", "Spatial analysis", and "Geographic information system". Relevant full-text articles that met the inclusion criteria were selected for review. The search identified 17 studies that met the criteria for inclusion in the review. More than half the studies were conducted before 2015 (n=11; 61%). All studies were conducted in High-Income Countries. More than 10 articles studied environmental factors, 3 of them focused on the environment, 6 of them included sociodemographic factors, and 1 study incorporated nutrition (as a variable) in environmental factors. 2 studies focused on the accessibility of health services by pediatric patients. Studies on type 1 diabetes highlight the complex relationship between incidence and risk, suggesting comprehensive prevention and treatment. Geographical mapping has potential in low- and middle-income nations, but further research is needed to develop innovative strategies. The importance of geomappping in understanding the risk factors for Type 1 Diabetes is highlighted in this scoping review, which also suggests a possible direction for focused interventions, particularly in settings with low resources.

Left bundle branch area pacing using a lumenless lead: A systematic literature review and meta-analysis.

Although left bundle branch area pacing (LBBAP) has been shown to be a feasible option for delivering physiological pacing, data are largely limited to single-center reports. The aim of this analysis was to systematically assess the safety and efficacy of LBBAP with the Model 3830 lead among primarily bradycardia patients. PubMed, Embase, Cochrane Library, and Google Scholar were searched for full-text articles on LBBAP using the SelectSecure Model 3830 lumenless lead. Rates and means were estimated using random- and mixed-effects models. Of 3395 articles, 53 met inclusion criteria, representing 6061 patients undergoing an implant attempt. Average patient age was 68.1 years (95% CI: 66.6, 69.6) and 53.1% were male (95% CI: 50.5%, 55.7%). The average implant success rate among bradycardia-indicated patients was 92.7% (95% CI: 89.5%, 94.9%). The overall estimated procedural adverse event rate was 2.5% (95% CI: 1.1%, 5.4%). The estimated septal perforation rate at implant was 1.6% (95% CI: 1.0%, 2.6%) with no adverse clinical sequelae reported. Pacing thresholds were low at implant (0.67 V [95% CI: 0.64, 0.70]) and remained stable through 12 months (0.76 V [95% CI: 0.72, 0.80]). Among bradycardia-indicated patients, LVEF remained stable from baseline to post-implant (59.5% [95% CI: 57.9%, 61.1%] vs. 60.1% [95% CI: 58.5%, 61.7%]). This meta-analysis including 6061 patients implanted with a Model 3830 lead for LBBAP found an average implant success rate of 92.7% and a procedural adverse event rate of 2.5% with stable electrical parameters and LVEF post-implant.

Patients with Celiac Disease Have High Prevalence of Fatty Liver and Metabolic Syndrome.

In recent years, patients with celiac disease (CeD) have been reported to have a high prevalence of fatty liver and metabolic syndrome. We conducted a systematic review and meta-analysis to assess the prevalence of fatty liver and metabolic syndrome in patients with CeD and effect of gluten-free diet in them. The PubMed, Embase and the Cochrane Library databases were searched for original studies upto November 18, 2022. We included full-text articles published in the English language after 1990 that used well-defined criteria for CeD, fatty liver and metabolic syndrome. A random effects model was used to calculate pooled prevalence. Of 350 studies identified, 11 studies (n = 2578) were included in the analysis. On analysis of both cross-sectional and longitudinal studies, pooled prevalence of fatty liver and metabolic syndrome in treatment-naïve patients with CeD were 18.2% (95% CI 8.3-30.8%, n = 1237) and 4.3% (95% CI 2.4-6.7, n = 1239) and in those on GFD of varying duration was 28.2% (95% CI 20.7-36.4%, n = 1368) and 21.3% (95% CI 11.7-32.9%, n = 2193), respectively. There was no difference in the prevalence of fatty liver and metabolic syndrome between low- or high-income group countries. Patients with CeD have a high prevalence of fatty liver and metabolic syndrome which increases further with the initiation of GFD. Patients with CeD should thus be screened and monitored for development of fatty liver and metabolic syndrome. They should be counselled appropriately regarding their diet and inclusion of physical activity in their lifestyle.