Full-text Review Research Articles

Do educational interventions reduce the gender gap in communication skills?- a systematic review

BackgroundEfficient doctor-patient communication is essential for improving patient care. The impact of educational interventions on the communication skills of male and female students has not been systematically reviewed. The aim of this review is to identify interventions used to improve communication skills in medical curricula and investigate their effectiveness in improving the communication skills of male and female medical students.MethodsA systematic review of the literature was conducted using the PRISMA guidelines. Inclusion criteria were as follows: used intervention strategies aiming to improve communication skills, participants were medical students, and studies were primary research studies, systematic reviews, or meta-analyses.Results2913 articles were identified based on search terms. After title, abstract, and full-text review, 58 studies were included with interventions consisting of Training or Drama Courses, Curriculum-Integrated, Patient Learning Courses, and Community-Based Learning Courses. 69% of articles reported improved communication skills for both genders equally, 28% for women more than men, and 3% for men more than women. 16 of the 58 articles reported numerical data regarding communication skills pre-and post-intervention. Analysis revealed that post-intervention scores are significantly greater than pre-intervention scores for both male (p < 0.001) and female students (p < 0.001). While the post-test scores of male students were significantly lower than that of female students (p = 0.01), there is no significant difference between genders for the benefits, or difference between post-intervention and pre-intervention scores (p = 0.15), suggesting that both genders benefited equally.ConclusionImplementation of communication training into medical education leads to improvement in communication skills of medical students, irrespective of gender. No specific interventions benefitting male students have been identified from published literature, suggesting need of further studies to explore the phenomenon of gender gap in communication skills and how to minimize the differences between male and female students.

Postmortem characteristics of drowning death in freshwater: a systematic review

BACKGROUND: Drowning is the third leading cause of death by unintentional injury, accounting for 7% of all injury-related deaths worldwide. According to the latest World Health Organization Global Health Estimates, 236,000 people died from drowning in 2019. AIM: This systematic review aimed to examine the clinical, laboratory, and other postmortem characteristics associated with death from drowning in freshwater areas. MATERIALS AND METHODS: A systematic search of PubMed, Epistemonikos, and Cochrane Library databases was performed with no restrictions to find relevant articles. After the removal of duplicates, articles were reviewed, and information on the clinical, laboratory, and other postmortem characteristics of freshwater drowning deaths was extracted. RESULTS: Of the 493 articles, 73 papers were considered relevant for full-text review. Of these, 22 articles met the inclusion criteria for the review. Most drowning deaths occurred in freshwater. Victims were males, with a male-to-female ratio of 8:3. External and internal clinical characteristics that are widely reported included signs of asphyxia such as cyanosis of the lips and bilateral fingernails, immersion signs such as washerwoman’s hand, pink teeth, Neil’s sign, Svechnikov’s sign, Wydler’s sign, and debris in the airways, and typical drowning signs such as froth in the airway, emphysema aquosum, and Paltauf spot. CONCLUSION: The results of this study suggest that the presence of signs of asphyxia, immersion signs, and typical drowning signs such as froth in the airway, emphysema aquosum, and Paltauf spots were associated with drowning deaths in freshwater.

A Systematic Review of Economic Evidence of Cardiovascular Interventions in India.

Cardiovascular diseases (CVDs) continue to be the primary cause of mortality globally and invariably in India as well. The rapid upsurge in the prevalence of CVDs in India has created a pressing need to promote contemporary, sustainable, and cost-effective interventions to tackle the CVD burden. This systematic review integrates the research-based evidence of the cost-effectiveness of various interventions that can be adapted to control CVDs in India. Databases, namely, PubMed, Cochrane Library, Embase, and Google Scholar, were searched for data on the economic evaluation of interventions targeting CVD based on the Indian population for a period of 30 years (1991-2021). Two reviewers assessed the articles for eligibility, and data were extracted from the shortlisted articles as per a predefined template, including the quantification of methodological aspects. In total, 1249 studies were examined, out of which 23 completely met the inclusion criteria for full-text review. A total of 16 studies were based solely on the Indian population, while the rest (7) included South Asia/Asia for the intervention, of which India was a participant nation. Most of the economic evaluations targeted treatment-based or pharmacological interventions (14) for CVDs. The evaluations were based on Decision-based models (10), Randomized controlled Trials (RCTs) (9), and Observational studies (4). The cost-effectiveness ratio for the included studies exhibited a diverse range due to variations in methodological approaches, such as differences in study settings, populations, and inconsistencies in study design. The mean ICER (Incremental Cost-effectiveness ratio) for primordial and primary preventions was found to be 3073.8 (US $2022) and 17489.9 (US $2022), respectively. Moreover, the combined mean value for secondary and tertiary prevention was 2029.6 (US$2022). The economic evidence of public health interventions are expanding, but their focus is restricted towards pharmacological interventions. There is an urgency to emphasize primordial and primary prevention for better outcomes in health economics decision-making. Technology- based avenues for intervention need more exploration in order to cater to a large population like India.

Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review.

The objective of this review was to examine the role of adverse drug events (ADEs) caused by pharmacological interventions in cost-effectiveness models for diabetes mellitus, diabetic retinopathy, and diabetic macular edema. Guidelines for economic evaluation recognize the importance of including ADEs in the analysis, but in practice, consideration of ADEs in cost-effectiveness models seem to be vague. Inadequate inclusion of these harmful outcomes affects the reliability of the results, and the information provided by economic evaluation could be misleading. Reviewing whether and how ADEs are incorporated in cost-effectiveness models is necessary to understand the current practices of economic evaluation. Studies included were published between 2011-2022 in English, representing cost-effectiveness analyses using modeling framework for pharmacological interventions in the treatment of diabetes mellitus, diabetic retinopathy, or diabetic macular edema. Other types of analyses and other types of conditions were excluded. The databases searched included MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, Web of Science Core Collection, and NHS Economic Evaluation Database. Gray literature was searched via the National Institute for Health and Care Excellence, European Network for Health Technology Assessment, the National Institute for Health and Care Research, and the International Network of Agencies for Health Technology Assessment. The search was conducted on January 1, 2023. Titles and abstracts were screened for inclusion by 2 independent reviewers. Full-text review was conducted by 3 independent reviewers. A data extraction form was used to extract and analyze the data. Results were presented in tabular format with a narrative summary, and discussed in the context of existing literature and guidelines. A total of 242 reports were extracted and analyzed in this scoping review. For the included analyses, type 2 diabetes was the most common disease (86%) followed by type 1 diabetes (10%), diabetic macular edema (9%), and diabetic retinopathy (0.4%). The majority of the included analyses used a health care payer perspective (88%) and had a time horizon of 30 years or more (75%). The most common model type was a simulation model (57%), followed by a Markov simulation model (18%). Of the included cost-effectiveness analyses, 26% included ADEs in the modeling, and 13% of the analyses excluded them. Most of the analyses (61%) partly considered ADEs; that is, only 1 or 2 ADEs were included. No difference in overall inclusion of ADEs between the different conditions existed, but the models for diabetic retinopathy and diabetic macular edema more often omitted the ADE-related impact on quality of life compared with the models for diabetes mellitus. Most analyses included ADEs in the models as probabilities (55%) or as a submodel (40%), and the most common source for ADE incidences were clinical trials (65%). The inclusion of ADEs in cost-effectiveness models is suboptimal. The ADE-related costs were better captured than the ADE-related impact on quality of life, which was most pronounced in the models for diabetic retinopathy and diabetic macular edema. Future research should investigate the potential impact of ADEs on the results, and identify the criteria and policies for practical inclusion of ADEs in economic evaluation.

Meditation modalities for ADHD in minority pediatric populations in the USA: a scoping review.

Roughly 10% of children aged 3 -17 in the USA are diagnosed with attention-deficit hyperactivity disorder (ADHD), and minorities are less likely to initiate common pharmacologic treatment. We conducted a review of the literature to examine meditation as a safe, effective, and low-cost alternative. We searched PubMed and other journals using "meditation," "mindfulness," "minority," related keywords, and relevant MeSH terms. Eligible studies involved racial/ethnic minorities in the USA, reported quantitative psychosocial outcomes, and were published in a peer-reviewed, English-language journal. Out of 119 "hits," 111 were eliminated as duplicates or were not relevant. A full-text review of the remaining eight revealed that none fully met our eligibility criteria. Besides the obvious lack of studies, those reviewed reported incomplete demographic and clinical data. They also employed different and inconsistent research methodologies, interventions and modalities, and statistical analyses. This hindered understanding exactly which populations may benefit from meditation, and for which specific symptoms. We recommend a socio-ecological model in examining intervention modalities, especially in the context of intrapersonal, interpersonal, organizational, environmental, and policy domains. We also suggest the possible inclusion of research older than 10 years, conducted outside of the USA, on minority and non-minority populations, for supplementary and confirmatory data. We advocate for consistency in study design and data collection, which would help align research conducted in different countries. Searches should also include variations of meditation such as "mindfulness" and "guided imagery," and associated symptoms and comorbidities of ADHD, including "learning disorder" and "behavioral problems."

Psychosocial Interventions to Reduce Post operative Pain in Total Knee Arthroplasty: A Systematic Review

Background: Total knee arthroplasty (TKA) is a common surgical remedy for patients with end-stage osteoarthritis. Although TKA is generally effective, a significant number of patients experience chronic post-surgical pain. Psychosocial interventions have increasingly become an area of interest in pain management following surgical procedures. Purpose: We aimed to evaluate the impact of pre-operative, peri-operative, and post-operative psychosocial interventions on reducing the likelihood of developing chronic pain after TKA. Methods: We performed a systematic review following the Cochrane guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A comprehensive search strategy was employed using PubMed, Embase, and Cochrane Central Register of Controlled Trials. Inclusion criteria were (1) patients undergoing; (2) pain outcome assessed ≥1 month post-operatively; (3) prospective and longitudinal study design (eg, randomized controlled trial, experimental non-randomized trial, cohort, case-control studies with measurement of exposure prior to outcome); (4) English language; and (5) psychosocial intervention (cognitive-behavioral, biopsychosocial, dialectical behavioral, psychoeducation, mindfulness, meditation, psychotherapy, relaxation, mind-body therapies, hypnosis). Exclusion criteria were non-primary literature (eg, review articles), non–peer-reviewed studies, and conference proceedings. The methodological quality of included studies was assessed using Cochrane’s tool for Risk of Bias 2 (RoB 2), the methodological index for non-randomized studies (MINORS), and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I). Results: Of 4297 studies reviewed with title and abstract, 4160 were excluded. Of the remaining 137 studies that underwent full-text review, 122 were excluded using the same inclusion and exclusion criteria, and 15 studies were included. Our review indicates a variable but positive impact of psychosocial interventions, such as pre-operative education, relaxation techniques, and cognitive-behavioral therapy, on post-TKA pain. Of the 15 included studies, 9 studies found that psychosocial interventions reduced post-TKA pain. Our review also suggests that cognitive-behavioral therapy may aid in reducing kinesiophobia, pain catastrophizing, and knee pain intensity. For the 12 randomized studies, the risk of bias was deemed “high” concerns for 3 studies, “some” concerns for 5 studies, and “low” concerns for 4 studies. For the 3 non-randomized studies, the risk of bias was deemed “moderate” due to confounding bias. Conclusions: This systematic review of level-I and level-II studies found that the integration of psychosocial interventions into care protocols for TKA offers benefits including improved patient satisfaction and quality of life and reduced health care costs. Limitations include heterogeneity in intervention types and outcomes measured and the varying levels of risk of bias across studies, which may affect the generalizability of the findings. The findings support a broader adoption of holistic, patient-centered approaches in pain management after TKA, emphasizing the importance of psychological well-being for optimal patient outcomes. However, the evidence is limited and constitutes a strong impetus for the further study of these interventions.

Meteorological gaps in audits of pedestrian environments: a scoping review

BackgroundWeather and season are determinants of physical activity. Therefore, it is important to ensure built environments are designed to mitigate negative impacts of weather and season on pedestrians to prevent these losses. This scoping review aims to identify built environment audits of pedestrian environments developed for use during a specific weather condition or season. Secondly, this review aims to investigate gaps in the inclusion of relevant weather mitigating built environment features in pedestrian environment audit tools.MethodsFollowing a standard protocol, a systematic search was executed in CINAHL, Medline and Web of Science to identify built environment audit tools of pedestrian spaces. These databases were chosen since they are well-known to comprehensively cover health as well as multi-disciplinary research publications relevant to health. Studies were screened, and data were extracted from selected documents by two independent reviewers (e.g., psychometric properties and audit items included). Audit items were screened for the inclusion of weather mitigating built environment features, and the tool’s capacity to measure temperature, precipitation, seasonal and sustainability impacts on pedestrians was calculated.ResultsThe search returned 2823 documents. After screening and full text review, 27 articles were included. No tool was found that was developed specifically for use during a specific weather condition or season. Additionally, gaps in the inclusion of weather mitigating items were found for all review dimensions (thermal comfort, precipitation, seasonal, and sustainability items). Poorly covered items were: (1) thermal comfort related (arctic entry presence, materials, textures, and colours of buildings, roads, sidewalk and furniture, and green design features); (2) precipitation related (drain presence, ditch presence, hazards, and snow removal features); (3) seasonal features (amenities, pedestrian scale lighting, and winter destinations and aesthetics); and (4) sustainability features (electric vehicle charging stations, renewable energy, car share, and bike share facilities).ConclusionsCurrent built environment audit tools do not adequately include weather / season mitigating items. This is a limitation as it is important to investigate if the inclusion of these items in pedestrian spaces can promote physical activity during adverse weather conditions. Because climate change is causing increased extreme weather events, a need exists for the development of a new built environment audit tool that includes relevant weather mitigating features.

Interventions to improve equity in emergency departments for Indigenous people: A scoping review.

Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs. This scoping review was conducted using the procedures outlined by Arksey and O'Malley and guidance on conducting scoping reviews from the Joanna Briggs Institute. A systematic search of MEDLINE, CINAHL, SCOPUS, and EMBASE was conducted. A total of 3636 articles were screened by title and abstract, of which 32 were screened in full-text review and nine articles describing seven interventions were included in this review. Three intervention approaches were identified: the introduction of novel clinical roles, implementation of chronic disease screening programs in EDs, and systems/organizational-level interventions. Relatively few interventions for improving equity in care were identified. We found that a minority of interventions are aimed at creating organizational-level change and suggest that future interventions could benefit from targeting system-level changes as opposed to or in addition to incorporating new roles in EDs.

Influence of post-migration living difficulties on mental health among refugees and asylum seekers: A scoping-review on clinical tools.

The literature indicates an increasing interest in the mental health of refugees (R) and asylum seekers (AS) - particularly how it could be affected by previous exposure to trauma and violence - but less has been written about the issues they are forced to face during the post-migration period and how these also can affect mental health. Research shows that the mental health of R/AS is highly influenced by their post-migration conditions and may deteriorate due to post-migration social health-related determinants; in addition, a lack of language skills, discrimination, separation from family, poverty, and other stressors can contribute to social isolation. The difficulty in asking for help in case of psychological distress and, consequently, in accessing care, contributes to the worsening of their clinical condition. The primary purpose of this study is to identify and provide a review of the clinical tools used to screen migrants (R/AS) at risk of developing psychological distress, identifying post-migration difficulties. We searched studies in PubMed, Embase, Scopus, Cochrane (Central), and Cinahl (ultimate) with the last search on 14 April 2023, using a combination of keywords and Medical Subject Headings (MeSH). Our systematic search identified 1,878 records. After removing duplicates, we screened 1,238 records by title and abstract, retaining 97 for full text review. Of these, 68 met full eligibility criteria (1995-2023). A total of 30 social scales have been identified, as well as structured or semi-structured questionnaires and interviews. Translated into multiple languages, the tools can be self-administered or administered by trained professionals. PMLD is known for its effectiveness in evaluating the post-migration period and predicting mental health issues. Considering the limited number of studies and, consequently, the limited number of tools found, it can be inferred that not enough attention is given to post-migration in the broader sense.

Adolescent Substance Use, and Related Emergency Room Visits, and Continuum of Care

Abstract: Adolescence is a unique developmental period marked by biophysiological changes and psychosocial exploration. Risk-taking behaviors, including experimentation with psychoactive substances, are common during this period. Emergency room (ER) visits for adverse events related to adolescent substance use have increased over the last two decades. Without a continuum of care from the ER, significant opportunities to intervene are missed. The narrative review article aims to provide an overview of substance use during Adolescence in the United States, highlight related ER visits, and discuss extending care beyond the ER. A literature review was conducted to reveal historical and recent studies related to adolescent substance use trends, morbidity, and mortality patterns, as well as the much-needed continuum of care after the ER. Our approach prioritized capturing diverse perspectives and significant studies relevant to these themes, aiming for a thorough discussion without strict adherence to systematic review methodologies. The selection of studies involved a comprehensive search across multiple databases, including PubMed, Google Scholar, and relevant academic journals. Search terms were tailored to capture studies addressing adolescent substance abuse, ER visitation, and aftercare. Studies were screened based on title, abstract, and full-text review, with a focus on relevance and significance to the review's objectives. The strategy for this narrative review facilitated a detailed exploration of the selected themes while also allowing for flexibility in study selection and interpretation. National studies indicate an overall decline in the proportions of adolescents using substances compared to pre-COVID-19 levels. However, morbidity and mortality patterns have not mirrored this decline. Various factors, including gender, location, and specific mental health disorders, are associated with adolescent substance use presentations. Acute care providers in emergency settings, employing protocols like SBIRT, can significantly impact outcomes by facilitating appropriate screening and referral to aftercare treatment programs. Identification of barriers to care, such as stigma and social determinants of health, is important in formulating tailored interventions. While acute care provides an opportunity to intervene and initiate treatment, a continuum of care is essential to reduce morbidity and mortality patterns among adolescents with substance use.

Population-specific equations of age-related maximum handgrip force: a comprehensive review.

The measurement of handgrip force responses is important in many aspects, for example: to complement neurological assessments, to investigate the contribution of muscle mass in predicting functional outcomes, in setting realistic treatment goals, evaluating rehabilitation strategies. Normative data about handgrip force can assist the therapist in interpreting a patient's results compared with healthy individuals of the same age and gender and can serve as key decision criteria. In this context, establishing normative values of handgrip strength is crucial. Hence, the aim of the this study is to develop a tool that could be used both in rehabilitation and in the prevention of work-related musculoskeletal disorders. This tool takes the form of population-specific predictive equations, which express maximum handgrip force as a function of age. In order to collect data from studies measuring maximum handgrip force, three databases were searched. The search yielded 5,058 articles. Upon the removal of duplicates, the screening of abstracts and the full-text review of potentially relevant articles, 143 publications which focussed on experimental studies on various age groups were considered as fulfilling the eligibility criteria. A comprehensive literature review produced 1,276 mean values of maximum handgrip force. A meta-analysis resulted in gender- and world region-specific (general population, USA, Europe and Asia) equations expressing maximum force as a function of age. The equations showed quantitative differences and trends in maximum handgrip force among age, gender and national groups. They also showed that values of maximum handgrip force are about 40% higher for males than for females and that age-induced decrease in force differs between males and females, with a proved 35% difference between the ages of 35 and 75. The difference was lowest for the 60-64 year olds and highest for the 18-25 year-olds. The equations also showed that differences due to region are smaller than those due to age or gender. The equations that were developed for this study can be beneficial in setting population-specific thresholds for rehabilitation programmes and workstation exposure. They can also contribute to the modification of commonly used methods for assessing musculoskeletal load and work-related risk of developing musculoskeletal disorders by scaling their limit values.

A Family-Based Approach to Promoting Pediatric Mental Health Recovery in Response to the COVID-19 Pandemic.

The purpose of this scoping review is to identify strategies from existing literature, for school-based professionals to share with parents, that may be used on a family-level to help the recovery from the effects of the COVID-19 pandemic on pediatric mental health. This scoping review consists of a comprehensive PubMed, CINAHL, and Google Scholar database search. Studies published between 2020 and 2023 that were written in English, originated in the United States, and evaluated pediatric mental health in the context of the COVID-19 pandemic were considered for inclusion in the scoping review. One researcher independently conducted the PubMed, CINAHL, and Google Scholar literature search. Subsequently, results were reviewed independently by two additional researchers. Title and abstract review were conducted for 2563 articles. After excluding studies not written in English, studies with international origin, and studies which were not relevant to this scoping review, 101 studies remained for full-text review. After full-text review, 32 studies (31.68%) were deemed relevant and concordant with the inclusion criteria and were included in this scoping review. We identified five prominent themes: 1) maintaining daily life and routines, 2) the importance of physical activity and the pandemic's effect on student athletes' mental health, 3) the use of screen time, 4) the effect of parent and caregiver stress on their children's mental health, and 5) the effect of pandemic-related health disparities and racism on pediatric mental health. This scoping review focused on interventions and practices which can be implemented at the family level to help children and adolescents recover from the effects of the COVID-19 pandemic on their mental health.

Possible pathophysiologic roles of neurotransmitter systems in men with lifelong premature ejaculation: a scoping review.

Lifelong premature ejaculation (LPE) is a subtype of premature ejaculation. Genetic research on LPE has primarily focused on neurotransmitters such as serotonin, dopamine, and norepinephrine, whereas LPE treatment studies have focused on drugs such as selective serotonin reuptake inhibitors. However, findings from genetic association and pharmacotherapeutic studies have been inconsistent. To provide a quality overview of neurobiological targets that are potentially associated with LPE by investigating genetic association and pharmacotherapeutic studies. This scoping review was conducted per the PRISMA-ScR tool (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews). Five databases were searched in March 2023 without timeline- or language-related restrictions. After deduplication, 3949 records were obtained for review. Following screening and full-text review with citation tracking, 52 studies were included: 18 genetic and 34 pharmacotherapy studies. Serotonergic targets, such as the serotonin transporter and pre- and postsynaptic serotonergic receptors, were most often associated with LPE in genetic and pharmacotherapeutic studies. Mixed results were found among polymorphisms within genetic studies. This mechanism is in accordance with pharmacotherapeutic studies, as the highest efficacy was found for potent serotonergic antidepressants. Successful treatment was also observed with medication acting on phosphodiesterase-5 enzyme, such as tadalafil and vardenafil. Analyses of other genetic association studies did not yield any further evidence for associated targets. This review is the first comprehensive scoping review on LPE. We found that serotonergic targets are most often associated with LPE, suggesting that the serotonergic pathway is a predisposing factor in LPE. Furthermore, there is some evidence for phosphodiesterase 5 inhibitors, which should be investigated. Other previously investigated neurobiological targets appear less likely to contribute to LPE. Future studies should focus on multiple targets, ideally in a genome-wide association study design.This review has been registered with the Open Science Framework (doi:10.17605/OSF.IO/JUQSD).

The prevalence and effects of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis

Background and AimsSarcopenia is a common complication in patients with metabolic dysfunction- associated steatotic liver disease (MASLD). However, the prevalence and its impact on the survival of sarcopenia in patients with MASLD is unknown. In this study, we aimed to assess the prevalence and effects of sarcopenia in patients with MASLD. MethodsSystematic review and meta-analysis of full texts of relevant studies were searched from inception until June 12, 2024 in five databases (PubMed, Cochrane Library, Embase, Web of Science, and the China National Knowledge Infrastructure). Next, we assessed the prevalence of sarcopenia in MASLD, and calculated the ORs and HRs between sarcopenia and MASLD based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0. ResultsOf the 2,984 records considered, 29 studies recruiting 63,330 patients were included. The pooled prevalence of sarcopenia in patients with MASLD was 23.5% overall (95% CI; 19.1%-27.9%, I2 = 99.6%), and was higher in Asian patients, male, cross-sectional studies, when BIA were employed to measure muscle mass, one criterion of diagnosis sarcopenia, MASLD was diagnosed employing MRI, and moderate-quality studies. Sarcopenia was associated with MASLD patients (adjusted odds ratio [aOR] 2.08, 95% CI 1.58-2.74, I2 = 93.6%) with similar findings in subgroups stratified by age, study design, methods for measuring muscle mass, assessment method to detect sarcopenia, and study quality. The association between all-cause mortality further supports the association between sarcopenia and poor prognosis with MASLD (aHR 1.59, 95% CI 1.33-1.91, I2 =0%). ConclusionsSarcopenia was strongly associated with MASLD progression and was a risk factor not only for MASLD pathogenesis but was also markedly correlated with MASLD-associated mortality.

A systematic review and meta-analysis of complications associated with crushed cartilage in rhinoplasty

BackgroundCrushed cartilage grafts improve augmentation and contour irregularities in rhinoplasty; however, they are associated with complications including resorption, asymmetries, palpability, and need for revisionary surgery. MethodsA systematic review and meta-analysis using PRISMA guidelines was performed of all recorded history to November 2022 using the search query ("crush" or "crushed") AND cartilage AND rhinoplasty for the PubMed, World of Science, Embase, and Cochrane online registries. Data was collected on study information, patient demographics, surgical details and outcomes. Graft resorption and revision surgery were pooled in a random-effects model, and a subgroup analysis for different coverage of the cartilage and degree of crushing. ResultsThe initial search yielded 163 results with 11 studies included in final full text review. A total of 1,132 patients were analyzed with 456 (40.3%) females, mean age 48.0, and average follow-up of 24.9 months. Cartilage resorption rates were statistically higher in graft preparation with severe crushing (3.4%) compared to non-severe crushed (0.9%) (p=0.049). There was no significant difference in resorption rate for patients with covered cartilage graft (1.3%) compared to non-covered grafts (1.8%) (p=0.7). There were significantly more revision surgeries for severely crushed (17.9%) compared to non-severely crushed cartilage (3.5%) (p=0.003). ConclusionsSevere crushed cartilage grafting provides smooth contour and less palpability compared to other degrees of crushing but demonstrates significantly higher rate of resorption.

Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: a scoping review of systematic reviews

BackgroundMusculoskeletal injuries can cause distress, and distress is associated with delayed recovery. Numerous interventions have been developed to facilitate recovery from injury, and several systematic reviews evaluate the efficacy of...

Advanced optical imaging techniques for bladder cancer detection and diagnosis: a systematic review.

To systematically assess the current available literature concerning advanced optical imaging methods for the detection and diagnosis of bladder cancer (BCa), focusing particularly on the sensitivity and specificity of these techniques. First a scoping search was performed to identify all available optical techniques for BCa detection and diagnosis. The optical imaging techniques used for detecting BCa are: the Storz professional image enhancement system (IMAGE1 S), narrow-band imaging (NBI), photoacoustic imaging (PAI), autofluorescence imaging (AFI), photodynamic diagnosis (PDD), and scanning fibre endoscopy (SFE). The staging and grading techniques for BCa are: optical coherence tomography (OCT), confocal laser endomicroscopy (CLE), Raman spectroscopy, endocytoscopy, and non-linear optical microscopy (NLO). Then a systematic literature search was conducted using MEDLINE, EMBASE and Web of Science from inception to 21 November 2023. Articles were screened and selected by two independent reviewers. Inclusion criteria were: reporting on both the sensitivity and specificity of a particular technique and comparison to histopathology, and in the case of a detection technique comparison to white light cystoscopy (WLC). Out of 6707 articles, 189 underwent full-text review, resulting in 52 inclusions. No articles met criteria for IMAGE1 S, PAI, SFE, Raman spectroscopy, and endocytoscopy. All detection techniques showed higher sensitivity than WLC, with NBI leading (87.8-100%). Overall, detection technique specificity was comparable to WLC, with PDD being most specific (23.3-100%). CLE and OCT varied in sensitivity and specificity, with OCT showing higher specificity for BCa diagnosis, notably for carcinoma in situ (97-99%) compared to CLE (62.5-81.3%). NLO demonstrated high sensitivity and specificity (90-97% and 77-100%, respectively) based on limited data from two small ex vivo studies. Optical techniques with the most potential are PDD for detecting and OCT for staging and grading BCa. Further research is crucial to validate their integration into routine practice and explore the value of other imaging techniques.

Safety, Immunogenicity, and Effectiveness of Chinese-Made COVID-19 Vaccines in the Real World: An Interim Report of a Living Systematic Review.

Background: Several COVID-19 vaccines were developed and approved in China. Of these, the BIBB-CorV and CoronaVac inactivated whole-virion vaccines were widely distributed in China and developing countries. However, the performance of the two vaccines in the real world has not been summarized. Methods: A living systematic review based on findings from ongoing post-licensure studies was conducted, applying standardized algorithms. Articles published between 1 May 2020 and 31 May 2022 in English and Chinese were searched for in Medline, Embase, WanFang Data, medRxiv, bioRxiv, arXiv, SSRN, and Research Square, using SARS-CoV-2, COVID-19, and vaccine as the MeSH terms. Studies with estimates of safety, immunogenicity, and effectiveness from receiving the BIBB-CorV or CoronaVac vaccine that met the predefined screening criteria underwent a full-text review. The Joanna Briggs Institute's Critical Appraisal Checklist and the Cochrane risk of bias were used for assessment of the quality. A random-effects meta-regression model was applied to identify the potential impact factors on the vaccines' effectiveness. Results: In total, 32578 articles were identified, of these, 770 studies underwent a full-text review. Eventually, 213 studies were included. The pooled occurrence of solicited and unsolicited adverse events after any dose of either vaccine varied between 10% and 40%. The top five commonly reported rare adverse events were immunization stress-related responses (211 cases, 50.0%), cutaneous responses (43 cases, 10.2%), acute neurological syndrome (39 cases, 9.2%), anaphylaxis (17 cases, 4.0%), and acute stroke (16 cases, 3.8%). The majority (83.3%) recovered or were relieved within several days. The peak neutralization titers against the ancestral strain was found within 1 month after the completion of the primary series of either vaccine, with a GMT (geometric mean titer) of 43.7 (95% CI: 23.2-82.4), followed by a dramatic decrease within 3 months. At Month 12, the GMT was 4.1 (95% CI: 3.8-4.4). Homologous boosting could restore humoral immunity, while heterologous boosting elicited around sixfold higher neutralization titers in comparison with homologous boosting. The effectiveness of receiving either vaccine against death and severe disease was around 85% for both shortly after the primary series. At Month 12, the protection against death did not decline, while the protection against severe disease decreased to ~75%. Conclusions: Both the BIBP-CorV and CoronaVac inactivated vaccines are safe. Sustained vaccine effectiveness against death was determined 12 months after the primary series, although protection against severe disease decreased slightly over time. A booster dose could strengthen the waning effectiveness; however, the duration of the incremental effectiveness and the additional benefit provided by a heterologous booster need to be studied.

Effect of maternal obsessive-compulsive disorder (OCD) on feto-maternal outcomes: A systematic review and meta-analysis.

Mental health disorders in pregnant women have been related to unfavorable obstetric and neonatal outcomes. Obsessive-compulsive disorder (OCD) significantly distresses mothers and affects the maternal-infant bond. The present meta-analysis and systematic review aimed to assess the association of maternal OCD with adverse feto-maternal outcomes. A systematic search was undertaken in the five databases-Cochrane, Embase, ProQuest, Web of Science, and PubMed-on September 5, 2023. Studies that included pregnant women with OCD in whom the feto-maternal outcomes were reported were included in the systematic review. Two pass screening ("title-abstract screening" followed by "full-text review"), and data extraction by two authors independently using the Nested-Knowledge Auto living semi-automated systematic review platform was carried out. The decision for selected studies was reviewed by a third author. Of the 360 studies identified, eight were included for the meta-analysis. Meta-analysis was conducted using R software. Of the 24 maternal and neonatal adverse outcomes assessed, 11 were found to be associated with maternal OCD, notably pre-eclampsia (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.19-1.57), antepartum hemorrhage or placental abruption (OR 1.32, 95% CI 1.13-1.54), postpartum hemporrhage (OR 1.19, 95% CI 1.08-1.31), cesarean section delivery (OR 1.32, 95% CI 1.23-1.41), emergency cesarean section (OR 1.22, 95% CI 1.15-1.30), preterm birth (OR 1.41, 95% CI 1.21-1.64), low birth weight (OR 1.41, 95% CI 1.28-1.54), low Apgar score at 5 min (OR 2.37, 95% CI 1.32-4.27), neonatal hypoglycemia (OR 1.37, 95% CI 1.23-1.53), neonatal respiratory distress (OR 1.77, 95% CI 1.44-2.16), and major congenital malformations (OR 1.37, 95% CI 1.08-1.74). OCD in pregnant women might be associated with multiple adverse feto-maternal outcomes.

Women's Economic Transformation: A Literature Review on Empowerment through Entrepreneurship and Financial Inclusion in Pekalongan, Indonesia

This systematic literature review (SLR) explores factors influencing women's empowerment through entrepreneurship and financial inclusion in Pekalongan. Key elements supporting or hindering women entrepreneurs include access to capital, entrepreneurship education, training, and robust support networks. Financial inclusion, encompassing banking services, microcredit, and financial education, is crucial for enhancing women's economic capacity and independence. The research employs a structured SLR methodology, using databases like Scopus to identify relevant studies from the past decade. The data collection involves keyword identification, literature search, screening, full-text review, and data extraction, followed by thematic analysis and coding. The findings reveal that well-designed government and NGO programs significantly impact women's economic and social well-being, with success dependent on local context and sustained support. Policy recommendations for Pekalongan include increasing access to financial services through microcredit and entrepreneurship training, expanding financial education programs, strengthening support networks via women's business groups and mentoring, and addressing socio-cultural barriers. Tailored policies and programs that consider the local context are essential for effective implementation. This study's comprehensive approach, combining women's entrepreneurship and financial inclusion within Pekalongan's context, provides practical recommendations for policymakers and enriches existing literature, offering a framework for future research and policy development in similar socio-economic settings.