High-quality Studies Research Articles

Strengthening executive functioning to disrupt binge eating in youth - a commentary on Goldschmidt etal. (2024).

A recent publication in the Journal of Child Psychology and Psychiatry examined the role of executive functioning in treatment outcomes and engagement for adolescents receiving cognitive behavioral therapy (CBT) for binge eating. While some executive functioning facets, such as impulsive decision making and cognitive flexibility, predicted eating and weight outcomes in this sample, others including inhibition, sustained attention, and parent-reported global executive functioning scores did not. Interestingly, none of the executive functioning measures related to attrition in this study. This commentary highlights the importance of conducting research in youth with binge eating and why investigating potential moderators to enhance treatment outcomes matters. The role of parents as well as mHealth adaptations are noted. Practical clinical considerations and avenues for further research are discussed. Additional randomized clinical trials and high-quality replicable studies are needed to determine if enhancing executive functioning prior to initiating psychotherapy can improve outcomes for this population.

A Systematic Review of Circulating miRNAs Validated by Multiple Independent Studies in Laryngeal Cancer

Background and Objectives: Laryngeal squamous cell carcinoma (LSCC) is a common head and neck cancer with significant morbidity and mortality. Circulating microRNAs (miRNAs) have emerged as promising non-invasive biomarkers for cancer diagnosis and prognosis. This systematic review aims to identify circulating miRNAs associated with LSCC, emphasizing those validated by at least two independent studies to improve reliability and clinical applicability. Methods: An extensive literature search was performed in the PubMed, Scopus, and Web of Science databases up to October 2024, using keywords related to LSCC and circulating miRNAs. Studies involving human participants that provided quantitative data on circulating miRNA expression levels and their clinical correlations were included. Data extraction and quality assessment were conducted following standardized protocols, highlighting miRNAs reported in multiple studies. Results: Nine high-quality studies encompassing 660 patients with LSCC and 212 controls were included. Several miRNAs were consistently identified across these studies. miR-21-5p was upregulated in four studies and associated with advanced disease stages, lymph node metastasis, and decreased survival rates. miR-125b-5p and miR-126-3p were consistently downregulated, linked to advanced clinical stages and poor tumor differentiation. miR-27a-3p was upregulated in two studies and correlated with poor prognosis, promoting LSCC progression by targeting Smad4. Additionally, miR-33a-5p was identified as a potential diagnostic biomarker with high sensitivity and specificity. These miRNAs show potential as non-invasive biomarkers for the diagnosis and prognosis of LSCC. Conclusions: This systematic review highlights specific circulating miRNAs—particularly miR-21-5p, miR-125b-5p, miR-126-3p, miR-27a-3p, and miR-33a-5p—as promising biomarkers for LSCC. The consistent findings across independent studies emphasize their potential clinical utility in early detection, prognostic assessment, and therapeutic targeting. However, further validation in larger and more diverse populations, along with the standardization of detection methods, is necessary before these biomarkers can be implemented in clinical practice.

Heart disease in pregnancy and adverse outcomes: an umbrella review

BackgroundHeart disease in pregnancy encompasses both congenital heart disease and maternal-acquired heart disease, both of which are associated with an increased risk of various adverse outcomes for mothers and their offspring.ObjectiveThe objective of the study was to review and summarize the evidence regarding the association between heart disease in pregnancy and adverse outcomes in mothers and their offspring.Data sourcesA comprehensive search was conducted in Embase, PubMed, Web of Science, and the Cochrane Database of Systematic Reviews from inception to March 2024. The protocol for this review was registered in PROSPERO (CRD42024519144).Study eligibility criteriaThis review included systematic reviews and meta-analyses that examined the association between heart disease in pregnancy and adverse outcomes for mothers and their offspring.Study appraisal and synthesis methodsData were independently extracted by two reviewers. The quality of the systematic reviews and meta-analyses was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2), while Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the strength of the evidence for each outcome.ResultsA total of 12 meta-analyses and systematic reviews were included, which documented 156 adverse outcomes for mothers and 65 adverse outcomes for offspring. Evidence was found for both primary and secondary adverse outcomes. Adverse outcomes for mothers were death, cardiac events (cardiac arrest, heart failure, surgery, arrhythmia, anesthesia or sedation, endocarditis, mitral regurgitation, myocardial infarction, NYHA III–IV, restenosis, syncope, and others), pulmonary events (respiratory failure, pulmonary edema, and respiratory support), embolism, cerebrovascular events, postpartum hemorrhage, arterial events, delivery mode, and hospital stay. Adverse outcomes for offspring were death, pregnancy loss, growth restriction, low birth weight, preterm birth, recurrence, and uncertainty. No publication bias was detected using Egger’s test. The overall AMSTAR 2 confidence rating for the included meta-analyses and systematic reviews was moderate. The majority (55.3%) of the evidence evaluated by GRADE was of low quality, while the remaining outcomes were categorized as having “very low”-quality evidence.ConclusionCurrent evidence links heart disease during pregnancy to adverse maternal outcomes, including death and cardiac, pulmonary, and cerebrovascular events, as well as increased mortality risk for offspring. Many meta-analyses in this field have limitations that raise concerns about their validity, highlighting the need for high-quality prospective studies.

Comparison of the efficacy and safety of GLP-1 receptor agonists on cardiovascular events and risk factors: A review and network meta-analysis.

This study aims to systematically evaluate and perform a systematic review and network meta-analysis comparing the comprehensive cardiovascular protective effects of various glucagon-like peptide-1 receptor agonists (GLP-1RAs), focusing on cardiovascular events and risk factors. We searched PubMed, Embase, Cochrane Library and Web of Science from inception to December 15, 2024. Included studies were published randomized controlled trials (RCTs) comparing GLP-1RAs to placebo or other GLP-1RAs. Missing data were standardized, and network meta-analysis was performed using Stata 17.0. Study heterogeneity, publication bias and evidence quality were assessed using the Cochrane Risk of Bias tool and Confidence in Network Meta-Analysis (CINeMA). As of December 15, 2024, a total of 18 313 articles were retrieved. Based on the inclusion and exclusion criteria, 156 high-quality studies were included, incorporating 144 782 patients and 14 different GLP-1RAs. The network meta-analysis demonstrated low heterogeneity, ensuring the reliability of the results. Comprehensive analysis revealed the following: Efpeglenatide was the most effective in reducing major adverse cardiovascular events. Oral semaglutide shows more significant advantages in reducing all-cause mortality and cardiovascular mortality. Orforglipron excelled in glycaemic control and weight reduction. SC-Semaglutide showed the greatest efficacy in lowering both systolic blood pressure and diastolic blood pressure, Liraglutide showed the greatest efficacy in lowering total cholesterol, Noiiglutide in triglycerides and Taspoglutide in low-density lipoprotein cholesterol, but no GLP-1RAs in high-density lipoprotein cholesterol. GLP-1RAs did not significantly increase the incidence of adverse events, but Orforglipron and Taspoglutide significantly increased the incidence of gastrointestinal adverse events compared with placebo. This study compared the cardiovascular benefits of different GLP-1RAs, including reductions in cardiovascular events and improvements in multiple cardiovascular risk factors. However, due to limitations in the quantity and quality of the included studies, the conclusions should be interpreted with caution. Future large-scale, high-quality clinical trials are needed to validate these findings and further optimize comprehensive cardiovascular management strategies for patients.

Chronic Pain and Obsessive-Compulsive Disorder: A Scoping Review.

The aim of this study was to map the association between Chronic Pain (CP) and Obsessive-Compulsive Disorder (OCD) in the present literature. A scoping review was conducted with a comprehensive search of literature in peer-reviewed journals. Search parameters included articles written in English, published at any time, and including terms associated with both CP and OCD. Databases searched for purposes of this study included Psychinfo, Medline, Embase, Emcare, CINAHL, Scopus, Web of Science, Cochrane, and Google Scholar. The review included 87 records, comprising 49 primary research and 38 secondary research records. Extracted information from these were grouped into four broad classifications. The Prevalence and Severity classification included information from 39 records which comprised: (1) primary research detailing current OCD prevalence rates in CP conditions (differentiated between general population and Pain/Medical/Hospital clinics); (2) primary research detailing lifetime OCD prevalence rates in CP conditions; (3) primary research detailing CP prevalence rates in OCD; (4) primary research detailing relationships between OCD and CP through psychometric measures; and (5) secondary research relating to prevalence rates. The Neurobiology classification included information from 28 records (primary and secondary research) detailing convergent and divergent neurobiological/neurophysiological aspects as reported for both OCD and CP. The Psychological Models/Factors classification included information from 7 records (primary and secondary research) detailing pain-related anxiety, neuropsychological measures, catastrophic thinking, preservative thinking, early maladaptive schemas, schema modes, childhood trauma experiences, and conditional associative learning, as reported for OCD and CP. The Intervention classification included information from 32 records which comprised: (1) primary research on neurosurgical, medication, and psychotherapeutic interventions; (2) secondary research on Deep Brain Stimulation; (3) secondary research on Medication; (4) secondary research on lesion, cingulotomy, and other surgical procedures; and (5) secondary research on other interventional procedures. While there has been considerable and growing research in the fields of both OCD and CP over the years, focused research into their potential association has been limited and potentially overlooked. The results of this review, however, suggest a complex relationship between CP and OCD. Prevalence rates between the two conditions vary widely across different populations, although the underlying reason for this remains unclear at this stage. There are commonalities in terms of alterations in pain processing, the dysregulation of certain brain regions, and the abnormalities in neurotransmitter systems in both conditions. In their treatment, use can be made of overlapping pathophysiological processes, the convergent and divergent psychological aspects, and the range of interventional approaches that share targets to promote efficacy. However, the complex presentations of both OCD and CP make it a challenging relationship to accurately clarify. Further directed and robust, high-quality studies will be needed to expand our understanding of this area.

Systematic review and meta-analysis of the impact of abnormal expression of long non coding RNA on the prognosis of acute myeloid leukemia

ObjectiveLong non-coding RNA (lncRNA) is aberrantly expressed in a variety of tumor diseases. To date, its specific role in acute myeloid leukemia (AML) has not been fully elucidated. This study aims to evaluate the association between aberrant lncRNA expression and poor prognosis in AML patients, and to systematically assess the relationship between aberrant lncRNA expression and AML prognosis.MethodsWe conducted a comprehensive literature search in PubMed, Embase, Cochrane Library, CNKI (China National Knowledge Infrastructure), WanFang (China Wanfang Database), VIP (China VIP Database), and Sinomed (China Biomedical Literature Database) to identify relevant Chinese and English articles. The search period covered from the inception of these databases to 4 August 2024. Articles were screened according to predefined inclusion and exclusion criteria, and meta-analysis was performed using Stata.ResultsA total of 25 articles were included in the analysis. Aberrant lncRNA expression was significantly associated with reduced overall survival (univariate HR = 2.46, 95%CI 2.11–2.88, P < 0.001; multivariate HR = 2.46, 95%CI 2.11–2.88, P < 0.001), event-free survival (HR = 1.51, 95%CI 1.19–1.90, P = 0.001), recurrence-free survival (HR = 2.82, 95%CI 2.03–3.91, P < 0.001), and disease-free survival (HR = 2.390, 95%CI 1.037–5.507, P = 0.041). These findings were statistically significant. The 25 articles collectively identified 22 lncRNAs whose aberrant expression was associated with AML prognosis. Notably, multiple studies highlighted the aberrant expression of lncRNA CRNDE, ZEB2-AS1, and TUG1 as being particularly relevant to AML prognosis. Our meta-analysis revealed that high expression of lncRNA CRNDE and TUG1 was associated with reduced overall survival, while high expression of lncRNA ZEB2-AS1 was linked to decreased disease-free survival, both with statistically significant differences.ConclusionThe expression levels of lncRNAs are closely associated with the prognosis of AML patients and may serve as important indicators for monitoring prognosis in the future. However, further high-quality studies are needed to validate these findings.

Comparative efficacy of topical commercial Chinese polyherbal preparation for vulvovaginal candidiasis: a network meta-analysis

ObjectiveTo systematically evaluate the differences in the efficacy of commonly used topical commercial Chinese polyherbal preparations (CCPPs) for vulvovaginal candidiasis (VVC), and to provide evidence-based reference for clinical drug regimens.MethodsComputer searched major Chinese and English literature databases, and collected randomized controlled trials (RCTs) of external use of CCPPs combined with conventional treatment (CT, test group) versus CT alone (control group) in patients with VVC. After screening the literature, the quality of the included studies was assessed using the risk of bias assessment tool recommended in 5.3 of the Cochrane Handbook. Outcome data for each outcome measure were extracted and a network meta-analysis was performed using Stata 15.0.ResultsA total of 74 RCTs with a total of 8,151 patients were included, nine interventions were involved. The results of network meta-analysis showed that, Fufang Shajiziyou suppository combined with CT was more effective in improving the negative conversion rate and controlling the recurrence rate of Candida albicans. Kangfu gel combined with CT had the better effect in relieving pruritus. Baofukang suppository combined with CT was the most effective in reducing leukorrhea. Fufukang spray combined with CT had fewer adverse reactions.ConclusionThe addition of CCPPs to CT may acquire a better curative effect in patients with VVC and external does not significantly increase the occurrence of adverse reactions. However, due to the low quality of the included literature, larger-scale, higher-quality clinical studies are still needed.Systematic Review RegistrationPROSPERO, NO: CRD42023410244.

The prognostic utility of the ratio of lymphocyte to monocyte in patients with metastatic colorectal cancer: a systematic review and meta-analysis

BackgroundAlthough advancements in treatment have resulted in improved overall outcomes for patients diagnosed with colorectal cancer, the prognosis remains unfavorable for individuals with metastatic colorectal cancer (mCRC). The association between lymphocyte/monocyte ratio (LMR) and clinical outcomes in mCRC patients is a subject of controversy. To systematically evaluate the correlation between LMR and prognostic factors in individuals with mCRC, we conducted this meta-analysis.MethodsThe databases PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for all relevant studies from their inception until October 26, 2024. Study selection was conducted based on predetermined inclusion and exclusion criteria. The primary outcomes of interest included prognosis measures such as overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS) in patients with metastatic colorectal cancer. Random-effects models or fixed-effects models were used to determine the pooled risk ratio (HR) and corresponding 95% confidence interval (CI) for each outcome indicator. Additionally, the pooled odds ratio (OR) and its corresponding 95% CI were calculated for LMR and clinicopathological characteristics.ResultsFourteen studies involving 3,089 patients were included in the analysis. The pooled analysis found that high LMR was correlated with better OS (HR: 0.55, 95% CI: 0.49-0.62, p<0.00001), PFS (HR: 0.68, 95% CI: 0.57-0.81, p<0.0001) and CSS(HR: 0.55, 95% CI: 0.32-0.95, p=0.03),The prognostic value of high LMR values for DFS(HR: 0.93, 95% CI: 0.78-1.12, p=0.46) in patients with metastatic rectal cancer was not found to be significant. We performed subgroup analyses based on study characteristics to confirm the robustness of our findings. Further clinicopathological analysis showed no significant difference between patients with elevated LMR and those without elevated LMR.ConclusionsIn conclusion, the results demonstrate a robust correlation between elevated LMR levels and a favorable prognosis in terms of overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) among patients diagnosed with metastatic colorectal cancer. However, further high-quality prospective studies are warranted to validate our findings since the majority of current investigations have relied on retrospective study designs.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024496467, identifier CRD42024496467.

Surgical management of metastatic lesions in the proximal femur: a systematic review

Purpose The proximal femur is a frequent site of cancer dissemination in the extremities. Patients treated surgically for skeletal metastases have poorer overall health compared to other orthopedic patients, with only one-third expected to survive two years post-surgery. Choosing a treatment that minimizes revision risk and ensures the implant outlives the patient is therefore crucial. We conducted a systematic review to assess the revision rate following internal fixation (IF) or endoprosthetic reconstruction (EPR) of the proximal femur for metastatic bone disease (MBD). Methods This study adhered to the PRISMA guidelines. MEDLINE and Embase were searched, identifying 10,299 records. After removing duplicates, 7731 unique records were screened, 334 of which were retrieved for full-text screening. We included 34 studies in the qualitative synthesis. The MINORS instrument was used for quality assessment. Results The quality of the included studies was low to moderate, with median scores of 6/16 for non-comparative studies and 10/24 for comparative studies. We therefore refrained from a comparative analysis. Revision rates varied between 0 and 12.4% following EPR (25 studies) and between 0 and 26.7% following IF, while implant removal rates ranged between 0 and 8.3% and 0 and 26.7%, respectively. Conclusions Revision and implant removal rates for various methods of EPR and IF are satisfactory. However, a meta-analysis or comparison between IF and EPR is not feasible due to a lack of prospective studies, randomized trials and high-quality studies.

The efficacy of medial patellofemoral ligament reconstruction combined with distal femoral varus osteotomy inrecurrent patellar dislocation and genu valgum.

Medial patellofemoral ligament (MPFL) reconstruction is a widely recognized treatment for recurrent patellar dislocation. However, limited research addresses the outcomes of combining MPFL reconstruction with distal femoral varus osteotomy, particularly in patients with genu valgum. This study aims to evaluate the clinical outcomes of this combined surgical approach in individuals experiencing recurrent patellar dislocation associated with genu valgum. A systematic review followed PRISMA guidelines by searching the PubMed, Scopus, and Cochrane Library databases through July 1, 2024. Studies included patients whose MPFL reconstruction was combined with distal femoral varus osteotomy to treat recurrent patellar dislocation and genu valgum. A meta-analysis was performed to evaluate pain, clinical and functional outcomes, with data reported as mean difference (MD) and 95% confidence interval (CI). A total of three studies with 58 knees were included. Most of the patients were female 62.5%, with a mean patient age of 20.5years and a mean follow-up of 26.4months. The mean preoperative mechanical leg axis was 6.8° of valgus. After MPFL reconstruction with distal femoral varus osteotomy significant improvements were found in the Kujala score (MD, 33.64 [95% CI 31.3-35.99]), Lysholm score (MD, 34.89 [95% CI 23.27-46.51]), visual analog scale score for pain (MD, -3.99 [95% CI -5.66 to -2.31]), and Tegner Activity Score (MD, 1.96 [95% CI 1.63-2.29]). No subluxation or redislocation occurred in any study during the follow-up period, and all reported radiological correction of genu valgum. Combined medial patellofemoral ligament reconstruction and distal femoral varus osteotomy in patients with recurrent patellar dislocation and genu valgum lead to significant improvements in clinical outcomes, such as pain relief and functional scores, as well as effective radiological correction of valgus deformity. However, further high-quality studies are needed to confirm these findings and establish stronger evidence for this combined approach. Systematic review and meta-analysis, level IV.

Closing the gap in dementia research by community-based cohort studies in the Chinese population.

China accounts for 1/5 of the global population and China faces a particularly heavy dementia burden due to its rapidly ageing population. Unique historical events, genetic background, sociocultural factors, lifestyle, and the COVID-19 pandemic further influence cognitive outcomes in the Chinese population. We searched PubMed, Web of Science, and Embase for community-based cohort studies related to dementia in the Chinese population, and summarized the characteristics, methodologies, and major findings published over the last 25 years from 39 cohorts. We identified critical research gaps and propose future directions, including enhancing sample representativeness, investigating China-specific risk factors, expanding exposure measurements to the whole life-span, collecting objective data, conducting administer-friendly domain-specific cognitive assessments, adopting pathological diagnostic criteria, standardizing biobank construction, verifying multi-modal biomarkers, examining social and genetic-environmental aspects, and monitoring post-COVID cognitive health, to approach high quality of dementia studies that can provide solid evidence to policy making and promote global brain health research.

Oncological outcomes following extreme oncoplastic breast conserving surgery (eOPBCS) for locally advanced breast cancer (LABC): A systematic review and meta-analysis.

Locally advanced breast cancer (LABC) accounts for 5% of new breast cancer diagnoses in developed countries and 30-60% in developing regions. Historically, treatment relied on mastectomy guided by the Halstedian theory. Advances in neoadjuvant chemotherapy (NACT), breast-conserving surgery (BCS), and radiation have transformed treatment into a multimodal approach. Extreme oncoplastic BCS (eOPBCS) has expanded the boundaries of BCS, enabling large-volume resections with breast reshaping. However, its oncologic outcomes compared to mastectomy remain unclear, particularly in LABC. A systematic review and meta-analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024535182). Studies involving eOPBCS for LABC were reviewed, and those comparing outcomes with mastectomy were included in the meta-analysis. The primary outcomes were overall survival (OS), disease-free survival (DFS), and local recurrence rates (LRR). Data were synthesized using a random-effects model. Of 866 identified studies, 33 were included in the systematic review and 4 in the meta-analysis, involving 2902 patients with LABC. Among them, 16.1% underwent eOPBCS. Patients receiving eOPBCS were younger, had larger tumours, and more frequently underwent axillary clearance. The pooled hazard ratio (HR) for OS comparing mastectomy to eOPBCS was 1.72 (95% CI 1.04-2.83). Meanwhile, HRs for DFS (1.11, 95% CI 0.60-2.08) and LRR (0.67, 95% CI 0.38-1.18) showed that there were no statistically significant differences but a trend toward lower recurrence rates with mastectomy. eOPBCS demonstrates comparable to superior oncological outcomes to mastectomy in LABC, offering a promising option for selected patients. However, slightly elevated local recurrence rates, though not statistically significant, highlight the importance of careful patient selection and further research. High-quality prospective studies are essential to validate these findings and refine criteria for incorporating eOPBCS into routine clinical practice.

The effect of tart cherry juice (TCJ) supplementation on exercise-induced muscle damage (EIMD) in an athletic population

Introduction: This systematic review and meta-analysis quantified the effect of tart cherry juice (TCJ) supplementation on exercise-induced muscle damage (EIMD). Evidence supported TCJ’s beneficial effects on muscular function and inflammatory biomarkers interleukin (IL)-6 and IL-8. Method: PubMed, Scopus, and Web of Science were searched up to January 2024. Risk of bias was assessed using RevMan® software. Mean differences and 95% confidence intervals (CIs) of maximal voluntary isometric contraction (MVIC), inflammatory markers, creatine kinase (CK), and visual analog scale (VAS) score were pooled using fixed- or random-effect models. Heterogeneity was assessed using Chi-square or I 2 statistics. Results: Ten trials were included in the analysis. TCJ supplementation significantly improved MVIC [weighted mean difference (WMD) = 9.13%, 95% CI (6.42–11.84), I 2 = 62.3%] and decreased IL-6 [WMD = −0.4 pg/ml, 95% CI (−0.68 to −0.11), I 2 = 62.2%] and IL-8 [WMD = −0.3 pg/ml, 95% CI (−0.6 to −0.0), I 2 = 46.3%]. No significant changes were found in CK, C-reactive protein, IL-1β, tumor necrosis factor-alpha, or VAS score. Dose–response analysis revealed a significant non-linear association between daily TCJ dose and MVIC effect size. Conclusion: TCJ supplementation may improve muscle function and some inflammatory biomarkers in EIMD. Further high-quality studies with larger sample sizes are needed to determine TCJ’s long-term effects.

Veterinary medical care in rodent models of stroke: Pitfalls and refinements to balance quality of science and animal welfare.

Rodent models of cerebral ischemia provide a valuable contribution to a better understanding of stroke pathophysiology, to validate diagnostic methods, and to enable testing of new treatments for ischemia-reperfusion damage and comorbidities. However, ethical concerns have led to increased attention to the welfare aspects of such models. Supportive therapies are an essential part of the overall animal care and use program and should be tailored to the experimental model being studied, the regulatory requirements, and research objectives to achieve high-quality preclinical studies and ethical research practices. On the other hand, the use of veterinary medical treatments in preclinical models of stroke must balance the needs of animal care and potential sources of bias in experimental results. This report provides a systematic review of the scientific literature covering the relevant period from years 1988 to September 2024, with the aim to investigating veterinary medical interventions useful to minimize suffering in rodent models of stroke without producing experimental bias. The research findings, consolidated from 181 selected studies, published from 1991 to 2023, indicate the feasibility of implementing personalized protocols of anesthesia, analgesics, antibiotics, and other supportive therapies in rodent models of stroke, while avoiding scientific interferences. These data fill a gap in current knowledge and could be of interest for an interdisciplinary audience working with rodent models of stroke, stimulating further refinements to safeguard both animal welfare and the validity of experimental findings, and may promote the culture of ethical conduct in various research fields and disciplines.

Trends of hospital-acquired lower limb deep venous thrombosis in an academic medical center in China from 2007 to 2021.

This study aimed to evaluate the demographic characteristics and changing trends in the incidence of hospital-acquired lower limb deep vein thrombosis (HA-LEDVT) in Chinese inpatients over the course of 15 years. We performed a retrospective analysis of the HA-LEDVT events in a medical center between January 1, 2007 and December 31, 2021. A total of 846347 eligible patients were analyzed. The overall incidence of HA-LEDVT was 2.53 per 1,000 admissions. The incidence was 0.22 and 4.20 per 1,000 admissions respectively in 2007 and 2017(P < 0.01). Medical patients had a higher incidence of HA-LEDVT than surgical patients (3.19 vs. 2.14 per 1,000 admissions; P < 0.01). The incidence of HA-LEDVT increased from 0.28 to 11.90 per 1,000 admissions for those aged 17-29 years and 80-89 years respectively (P < 0.01). The increase in HA-LEDVT incidence mainly occurred in patients aged ≥ 60 years. The median length of stay of HA-LEDVT patients was longer than that of other eligible patients (17 vs. 7 days; P < 0.01). Most of the HA-LEDVT events (77.8%) were diagnosed between hospital day 3 and 15, and the time from admission to HA-LEDVT diagnosis decreased by year. The rate of vascular surgery consultation for diagnosed or suspected HA-LEDVT and HA-LEDVT-related discharge instructions both decreased by half gradually over the 15 years of this study. Isolated distal DVT accounted for 83.3% of all HA-LEDVT events and the proportion increased significantly from 62.5% in 2007 to 88.7% in 2021 (P < 0.01). The incidence of HA-LEDVT has been high in the Chinese population. More high-quality prospective studies are needed to guide prevention of HA-LEDVTs.

Intra-articular injection of orthobiologics for temporomandibular joint osteoarthritis: a systematic review of randomized controlled trials.

Temporomandibular joint (TMJ) osteoarthritis (OA) leads to pain, limited jaw function, and bite changes. When non-invasive treatments fail, minimally invasive procedures like TMJ arthrocentesis with saline and hyaluronic acid (HA) injections are commonly used. Orthobiologics, including platelet-rich plasma (PRP) and cell-derived products, have gained attention for their potential to enhance tissue healing. This review aimed to compare the outcomes of orthobiologic injections with HA injections following arthrocentesis in TMJ-OA treatment. A systematic search, following PRISMA guidelines, identified nine studies (403 patients). Risk of bias was assessed using the Cochrane Risk of Bias Tool. PRP and cell-derived products showed potential benefits in reducing TMJ pain and improving maximum mouth opening (MMO). However, three of four studies comparing PRP with HA found no significant difference between the two. In contrast, cell-derived orthobiologics demonstrated significantly greater improvements in TMJ pain and MMO compared to HA. Risk of bias varied, with some studies showing moderate to high levels. This review highlights the potential but inconsistent benefits of orthobiologics in treating TMJ-OA. While cell-derived orthobiologics appear promising, PRP did not demonstrate superiority over HA. Further high-quality studies are needed to validate these findings.

A bibliometric analysis of the 50 most cited articles on acromioclavicular joint reconstruction.

The aim is to identify the 50 most cited papers and thus the most influential papers pertaining to ACJ reconstruction, and specifically, analysing the level of evidence (LOE), article content, journals occurring, and countries represented within the 50 most cited. A search of the Web of Science database was carried out using the following terms: "Acromioclavicular joint" OR "AC joint" (Topic) AND Reconstruction OR Repair (Topic). The top 50 relevant articles were analysed in relation to citations, citation density, geographic origin of the article, year published, and article type. The articles were cited a total of 6053 times. The most cited article was cited 347 times. The highest citation density was 20.02, with a mean citation density of 7.71 ± 4.13. Seventy per cent of the articles involved clinical research, 74% of which involved level IV evidence. Fifty-two per cent of the articles were published in the American Journal of Sports Medicine (AJSM). Most authors originated from USA (n = 26 or 52%), followed by Germany (n = 14 or 28%). This study revealed a paucity of articles with higher LOE among the most cited. Eight of the top 10 are either theoretical or biomechanical studies, and one reports an examination technique. Only two of the top 10 reported outcomes following surgical intervention and can thus directly guide treatment. Future research in the area of ACJ reconstruction should focus on generating high-quality interventional studies capable of informing/impacting patient care. Publishing in journals such as AJSM or Arthroscopy may lead to more citations.

Predictive role of the prognostic nutritional index for long-term prognosis among patients undergoing pancreatoduodenectomy: a meta-analysis

PurposeTo identify the predictive role of the preoperative prognostic nutritional index (PNI) for long-term survival in patients undergoing pancreatoduodenectomy.MethodsThe PubMed, EMBASE, Web of Science, Cochrane Library and CNKI databases were searched up to October 28, 2024. The primary outcomes included overall survival (OS) and disease-free survival (DFS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, and subgroup analyses by country, type of cancer and source of HR were performed.ResultsFifteen studies with 2106 patients were included. The pooled results demonstrated that a lower preoperative PNI was related to poorer OS (HR = 1.60, 95% CI: 1.38–1.86, P < 0.001) and DFS (HR = 1.44, 95% CI: 1.00–2.07, P = 0.051). Subgroup analysis stratified by country (China vs. non-China), type of cancer (pancreatic cancer vs. nonpancreatic cancer vs. mixed) and source of HR (univariate vs. multivariate analysis) revealed similar results.ConclusionOn the basis of the available evidence, the preoperative PNI might serve as a novel prognostic indicator in patients undergoing pancreatoduodenectomy, with a lower PNI predicting worse survival. However, more high-quality studies are needed to further verify the above findings.

Autologous Peripheral Blood-Derived Orthobiologics for the Management of Elbow Disorders: A Review of Current Clinical Evidence.

Elbow ailments are common, but conventional treatment modalities have shortcomings, offering only interim pain relief rather than targeting the underlying pathophysiology. The last two decades have seen a marked increase in the use of autologous peripheral blood-derived orthobiologics (APBOs), such as platelet-rich plasma (PRP), to manage elbow disorders. Platelet-rich plasma (PRP) is the most widely used APBO, but its efficacy remains debatable. Consequently, other APBOs, such as platelet lysate (PL), autologous conditioned serum (ACS), gold-induced cytokine (GOLDIC), plasma rich in growth factors (PRGF), autologous protein solution (APS), and hyperacute serum (HS), have been considered. Only a few reviews summarize the results of clinical studies investigating the efficacy of these APBOs in elbow disorders. This review documents the results of clinical studies involving APBOs in managing elbow disorders and summarizes the ongoing clinical studies on different clinical trial protocol repositories comprising these APBOs to manage elbow disorders. This systematic review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. In December 2024, PubMed, Embase, and Web of Science were accessed with no additional filters or time constraints. All available clinical studies published in English, French, Spanish, German, or Italian concerning the management of elbow disorders by means of APBOs were considered. Only three clinical studies met our predefined search and inclusion criteria. In particular, two and one studies involving the use of PL and ACS, respectively, were included in this review. Data from 99 patients were obtained. Of them, 57.6% (57 of 99 patients) were women. The mean length of follow-up was 11.9 ± 0.6months, and the mean age was 42.0 ± 3.5years. No complications were reported in any of the studies included. The included studies have low to medium risk of bias, and a very low score on methodological quality. Finally, no clinical studies involving the use of GOLDIC, PRGF, APS or HS were identified, and only one ongoing clinical study involving the use of PL was registered. The current peer-reviewed published studies demonstrated that administering APBOs, including PL and ACS, might be safe and effective in reducing pain and improving function in patients with elbow disorders. Further, high-quality studies are required.

Transperitoneal vs retroperitoneal robotic partial nephrectomy: a meta-analysis and systematic review of propensity-matched studies.

The main aim of this meta-analysis is to assess and compare the impact of two different surgical approaches, transperitoneal and retroperitoneal, on perioperative outcomes in robotic partial nephrectomy. A systematic search of MEDLINE, PubMed, Google Scholar, and the Cochrane Database was conducted to identify relevant studies published between January 2000 and January 2025. Included were nine non-randomized controlled trials with a total of 2420 patients with matching propensity scores. Among these patients, 1321 had robotic TPPN and 1099 had robotic RPPN, the abbreviation for robotic partial nephrectomy. Shorter operating times, shorter hospital stays, less estimated intraoperative blood loss, and fewer total postoperative problems were related to RPPN compared to TPPN. There were no notable disparities between the two groups when comparing the duration of renal ischemia, the fall in postoperative glomerular filtration rate (GFR), the occurrence of serious postoperative sequelae, or the necessity for blood transfusions. Compared to TPPN, RPPN demonstrates certain advantages in perioperative metrics such as surgical time, hospital stay, and overall complication rates. However, further high-quality studies are needed to confirm these findings.