Reference Lists Research Articles

Analysis of the idioms of (head) in Kurdish language, from the perspective of cognitive linguistics

This study is entitled (Analysis of the idioms of (head) in Kurdish language, from the perspective of cognitive linguistics). Language is one of the most important human achievements and occupies a large space in human life. Therefore, since the ancient times, humans have paid attention to it and tried to understand its secrets. Idioms are an important part of any language, and studying them helps us to understand the relationship between idioms and metaphors. The school of cognitive linguistics looks at idioms differently from all other linguistic schools. Other linguistic schools have studied the syntactic, semantic and pragmatic aspects of idioms and viewed them as fixed and inseparable structures and expressions. However, the cognitive linguists have a completely different view; they see idioms as conceptual metaphors and interpret every conceptual metaphor in terms of the conceptual matching and interaction between the source and target fields. Our study is an interpretation of the idioms of (head) from the school of cognitive linguistics’ perspective, in light of the theory of conceptual metaphor, the interpretation of idioms has been conducted. In general, the study consists of the introduction, two chapters, the results and the list of references. The first chapter discusses the perception of both schools of ancient and cognitive linguistics for idioms as well as the theory of conceptual metaphor, types of conceptual metaphors and metaphorical interaction between the source and target fields. In the second chapter, the idioms of (head) have been analyzed according to the theory of conceptual metaphor, followed by the results and a list of references.

Nursing care to patients who have the home as the preferred place of death: a scoping review

BackgroundThe existing literature on nursing care for patients who choose home as their preferred place of death is scattered and lacks a coherent overview. This scoping review aimed to explore and categorize the available evidence on how nurses provide care for patients preferring to die at home.MethodsStudies that included nurses and were focused on nursing care for patients who choose the home as their preferred place of death were included in the review. The scoping review considered studies with quantitative, qualitative, or mixed method designs; systematic reviews; and meta-analyses. No time restrictions were added. Key information sources were Medline, CINAHL (EBSCO), Scopus (Elsevier) and Google Scholar. Systematic reviews were searched for in the Cochrane Database of Systematic Reviews. Unpublished studies and grey literature were searched for in ProQuest Dissertations and Theses. The reference list of the studies included was searched.ResultsA total of 13 studies were deemed eligible for inclusion in the review, of which (n = 11) were qualitative and (n = 2) were both qualitative and quantitative. The studies were published between 2008 and 2023 and were conducted in the United Kingdom (n = 5), Norway (n = 4), Australia, Sweden, Canada and Japan. The studies included in this review highlighted issues of competence, resource limitations, flexibility as a coping mechanism, as well as collaboration and family caregivers.ConclusionsThis review identified significant challenges in delivering nursing care for patients who prefer to die at home, including staff shortages, resource limitations, and educational deficiencies. Despite these barriers, nurses showed a strong commitment to patient care, highlighting the need for increased support and collaboration with family caregivers to improve home-based end-of-life care.Implications for researchTo improve care for patients who wish to die at home, it is crucial to address staff shortages and enhance nurse training to close knowledge gaps and ensure consistent, high-quality care. Healthcare systems must also allocate adequate resources to ensure that nurses have the necessary tools to deliver safe and effective care in home settings. Strengthening interdisciplinary collaboration will further enhance patient outcomes by supporting both nurses and family caregivers in end-of-life care.

Resilience rewritten: Ann’s journey from adversity to entrepreneurship

Research methodology None. Case overview/synopsis The case study follows Ann’s journey towards entrepreneurship, focusing on the challenges she faced and how early educational interventions influenced her life decisions. Despite numerous obstacles, Ann’s perseverance, bolstered by her family’s support and her passion, led to her successful reintegration into academia and the launch of an entrepreneurial venture in the UK. Her story highlights the dilemma of balancing educational attainment with entrepreneurial aspirations, especially for at-risk students. Ann’s experience prompts critical discussions about the intersection of education and entrepreneurship, the importance of experiential learning and the role of mentorship in realizing business ideas. The nurturing environment of her business school, through guest lectures and real-world success stories, played a significant role in shaping her academic and professional outlook. This case raises essential questions about the role of higher education in fostering entrepreneurial skills and integrating experiential learning within academic curricula. Ann’s journey exemplifies the power of resilience and determination in overcoming systemic and entrepreneurial challenges, particularly for women facing similar struggles. Her story illuminates the multifaceted process of turning a personal experience into an entrepreneurial opportunity, emphasizing the critical role of mentorship and support networks in developing a viable business idea. Complexity academic level This case study is best suited to undergraduate and graduate students enrolled in management and business-related courses that focus on entrepreneurship and entrepreneurial education. The case study is relevant in various business disciplines as it informs students of the process and challenges related to business start-ups and acquiring related capabilities. Instructors are encouraged to have students read the extensive reference list provided at the end to broaden their understanding and knowledge of entrepreneurship, including its processes, context and practices.

Cyclosporin for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN): a systematic review of observational studies and clinical trials focusing on single therapy, combination therapy, and comparative assessments.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, severe, and potentially life-threatening skin and mucous membrane disorders. They are characterized by widespread skin and mucosal detachment and necrosis, and are classified based on the percentage of total body surface area (TBSA) affected. Given the severe and often life-threatening nature of these conditions, the identification and implementation of effective treatments is crucial. Notably, cyclosporin has demonstrated efficacy in managing these challenging conditions. A systematic search was carried out through the PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases until May 2024. Additionally, a manual search was conducted through the reference lists of the included studies to minimize the risk of missing reports. Overall, 17 studies involving 4761 patients were included in our analysis. The majority of the included studies suggested favorable outcomes for the use of cyclosporin in SJS/TEN patients. The use of cyclosporin was associated with improved survival rates, early arrest of disease progression, faster re-epithelialization, reduced length of hospital stays, and lower rates of multi-organ failure. However, a few studies did not find a survival advantage with cyclosporin and even reported an increased risk of mortality, as well as an increased TBSA detachment and risk of infection. Most studies indicate positive outcomes with cyclosporin treatment in SJS/TEN patients. This is likely due to cyclosporin's immunomodulatory properties, which may help attenuate the severe inflammatory response associated with these conditions.

Remote monitoring of implantable cardioverter defibrillators: a systematic review and meta-analysis of randomised controlled trials

Abstract Background Remote monitoring (RM) of implantable cardioverter defibrillators (ICD) has been widely adopted as the standard follow-up strategy [1]. Observational data [2,3] has suggested morbidity and mortality reduction associated with RM compared to traditional in-person ICD follow-up, however, randomised controlled trials (RCTs) demonstrate heterogeneous results. Purpose To assess the impact of RM of ICDs on morbidity and mortality through a systematic review and meta-analysis of RCTs comparing RM versus in-person follow-up. Methods PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and reference lists were searched for RCTs evaluating RM compared to in-person follow-up of patients with ICDs or cardiac resynchronisation therapy with defibrillator (CRT-D) devices. Meta-analyses of all-cause mortality, cardiovascular (CVD) hospitalisation and inappropriate ICD shock rates were performed. Results Literature search identified 1011 relevant publications, out of which 15 RCTs [4-18] involving a total of 7579 patients (13 RCTs reporting mortality rate, 7 RCTs reporting CVD hospitalisation rate, 6 RCTs reporting inappropriate ICD shock rate) met the inclusion criteria. Pooled analyses demonstrated that RM is not associated with a significant reduction in all-cause mortality (OR 0.95; 95% CI 0.78-1.16; p=0.60)(Figure 1, panel a) or odds of CVD hospitalisation (OR 0.95; 95% CI 0.72-1.25; p=0.70) (Figure 1, panel b). RM was, however, shown to be associated with significantly lower odds of receiving an inappropriate ICD shock compared to the control group (OR 0.63; 95% CI 0.46-0.88; p=0.006) (Figure 1, panel c). The IN-TIME study (the only RCT that independently reached statistical significance in terms of RM effect on mortality) enrolled patients exclusively with a Biotronik ICD or CRT-D; this raised the question as to whether the choice of vendor had an impact on mortality. Our subgroup analysis of the Biotronik device studies demonstrated that there was no significant all-cause mortality benefit (OR 0.87, 95% CI 0.59-1.27; p=0.46). Conclusions This meta-analysis of 15 RCTs including 7579 patients suggests that RM of ICDs is associated with a reduction in inappropriate ICD shocks, without a significant reduction in mortality or CVD hospitalisation when compared to in-person follow-up. Further studies comparing different RM processing and alert response models are warranted.

The predisposing factors to heart failure diagnosis and early mortality among young adults in Africa: a narrative review

Abstract Introduction Heart failure (HF) is a major health concern mainly diagnosed among elderly individuals. Primarily, researchers have focused on this age group, nevertheless, compared to individuals from other regions of the world, Africans presents with HF two decades sooner (52 versus 79 years). Even though it manifests early, young persons (18–35 years old) are also diagnosed with HF with prognoses comparable to the older group. Less is known about how much study is concentrated on this age range, although globally, young adults of African origin make up the majority of those with an early onset of heart failure. Additionally, obtaining information about how HF impacts African youth remains challenging. Purpose To determine the cause of Africans' early HF diagnosis as well as the risk factors for HF diagnosis and early mortality among young adults. Methodology Three electronic databases— MEDLINE Ovid, Scopus, and CINAHL Plus—were searched using the Boolean operators. The first retrieved hits were checked for relevancy by titles and abstracts. Then, publications were fully screened for inclusion in the review based on the pre-established criteria. Also, reference lists of the articles were snowballed for pertinent studies. The scientific integrity of the studies was evaluated using a guided, in-depth peer-reviewed article on how to critically analyse clinical research and the Critical Appraisal Skill Programme (CASP) tool cohort checklist. Pertinent information regarding the study was analysed using a narrative review methodology. Eleven (11) articles out of the 135 pulled from the databases met the requirements for inclusion in the review after a thorough screening. One article was eliminated upon critical evaluation of the research's methodology, and an eligible article was discovered from snowballing reference lists. Therefore, only 11 articles qualified for this review study. Results Findings from the review show that HF is diagnosed earlier among Africans due to the early presentation of the major causes of HF before the age of 30 years. Rheumatic heart disease, cardiomyopathy, ischemic heart disease, HTN, and pulmonary illnesses (COPD, TB, and pulmonary arterial hypertension) are known aetiologies. More so, young adults who are diabetic, obese, have hyperlipidaemia or smoke cigarettes are more likely to develop HF. Furthermore, socioeconomic status, alcohol use, smoking, renal dysfunction, higher serum levels of brain natriuretic peptide (BNP) and creatine kinase (Isomer MB), cardiogenic shock, and decreased ejection fraction were the predictors of death with significant p-values (0.05). Conclusion Although HF affects young African adults disproportionately causing them to live lower quality of life and shorter lives, no research before this has been conducted. Therefore, further study is required to understand how HF affects this target age range (18 to 35 years) and to develop a long-term plan to fight this illness before it worsens.

Placebo-controlled efficacy of 17 anti-anginal drugs and percutaneous coronary intervention for first-line treatment of stable angina: systematic review & meta-analysis of 5153 patients from 53 trials

Abstract Background Percutaneous coronary intervention (PCI) for stable angina is currently recommended for patients with residual symptoms despite maximal anti-anginal medication. Placebo-controlled data demonstrating efficacy of PCI has recently become available. Purpose We evaluated the placebo-controlled efficacy of anti-anginal agents and PCI, as monotherapies for stable angina. Methods We performed a systematic review and meta-analysis of placebo-controlled randomised controlled trials (RCTs) of anti-anginal agents (17 medications across 7 drug classes [beta-blocker, dihydropyridine (DHP) calcium channel blocker (CCB), non-DHP CCB, ivabradine, nicorandil, nitrates and ranolazine]), and PCI, which reported the placebo-controlled treatment effect on standardised exercise duration in patients with stable angina, who were receiving no background anti-anginal medications. We searched MEDLINE, EMBASE, and Cochrane CENTRAL from database inception to 01 December 2023. Relevant systematic reviews and reference lists were inspected to identify publications which had not been identified in the primary searches. Two independent reviewers extracted the data and assessed the risk of bias of included studies. Intention-to-treat data were used. Meta-analyses were carried out using random-effects methods and reported using the PRISMA guidelines. The primary outcome was mean difference in total exercise time with treatment compared with placebo. A pairwise comparison of all anti-anginal medications and PCI was performed to evaluate their relative placebo-controlled efficacy on total exercise time. Results A total of 52 trials were eligible, evaluating 83 treatment arm comparisons of anti-anginal monotherapy (2408 patients) and placebo (2444 patients). The number of trials per medication class ranged from one (ivabradine) to 19 (non-DHP CCBs). All classes improved exercise time compared to placebo, with mean increment ranging from 22.4 seconds (95% confidence interval, 0.8 to 44.0, p=0.04) for ranolazine, to 76.5 seconds (63.2 to 89.8, p<0.0001) for DHP CCBs (Figure 1). There was substantial heterogeneity in exercise time increment between drug classes (I2 98%, p<0.0001). However, across all classes, there was a clear dose-response relationship (b-coefficient 24.8, 15.8 to 33.9, <0.0001). The only trial which compared PCI (151 patients) to placebo (150 patients) showed a placebo-controlled exercise duration increment of 59.5 seconds (16 to 103, P=0.001). This was comparable to the global mean effect across all anti-anginal medications (59, 39 to 79, P<0.0001). Conclusions Each anti-anginal drug class showed a clear increase in placebo-controlled exercise time, with varying effect sizes between classes. The DHP CCB class showed the largest effect size, and ivabradine and ranolazine showed the smallest. The effect of PCI monotherapy was similar to the mean anti-anginal medication monotherapy effect.Figure 1

Stimulation of the withdrawal reflex in gait training after stroke: A systematic review and meta-analysis.

After a stroke many people experience hemiparesis, resulting in walking difficulties which affects independence, mobility, and participation in activities of daily living. Activating the nociceptive withdrawal reflex (NWR) during gait training aims to support the initiation and facilitation of the swing phase of the paretic leg. The aim of this review is to investigate the orthotic and therapeutic effects of a NWR stimulation intervention to improve gait in patients after a stroke. We searched the databases CENTRAL, DORIS, MEDLINE, and PEDro, trial registers and reference lists. We selected randomized controlled trials using any type of stimulation of the NWR in people after stroke, comparing it to any control intervention, and reporting a change in gait performance assessed by means of any appropriate measurement method. We included three studies in this review, all of which used electrical stimulation to elicit the NWR during walking. The orthotic effect was investigated in one study, and the therapeutic effect in two studies, comparing walking with and without electrical stimulation-triggered NWR. The meta-analysis revealed a borderline statistical significance result for the therapeutic effect. The pooled mean difference between the treatment and control group (random-effects model) for walking speed was 0.13 m/s (95% CI -0.04 to 0.29; I2 = 72%) after treatment and 0.17 m/s (95% CI -0.03 to 0.37; I2 = 62%) at follow-up. Activating the NWR during gait training has not been investigated frequently so far. By using electrical stimulation-elicited NWR, severely affected hemiparetic patients may improve their walking speed.

Scanning the horizon- environmental health indicator surveillance

Abstract Aim This work aimed to conduct a comprehensive literature review with narrative synthesis of evidence in relation to the surveillance of environmental health indicators by Public Health agencies internationally. This will strengthen the All-Hazards approach to Health Protection in Ireland. Methods The project proposal was registered on PROSPERO. Preferred Reporting Systems for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. A systematic search was conducted across five databases. In addition, relevant websites, reference lists and the grey literature were searched. Data were extracted following TIDieR-PHP guidelines. Risk of bias was considered and quality appraisal was performed using SANRA and AGREE-HS tools. A narrative synthesis of the evidence was completed. Results 12 papers were included in the final review. Four were narrative review articles describing European and worldwide initiatives and the remaining eight described a single health system. Only three papers were deemed high quality. The number of indicators monitored varied widely from one in Italy to over 400 in the USA. The most established programmes described the use of a framework such as Drivers-Pressures-States-Exposures-Effects-Actions (DPSEEA) and indicator selection criteria were applied. The papers described a variety of public health actions arising from the surveillance of environmental health indicators. The knowledge provided by this review can inform the implementation process. Establishment of a project team, and beginning with monitoring one domain is suggested. Air quality is the most frequently monitored domain internationally. The DPSEEA framework is recommended, and Briggs’ indicator selection criteria should be applied to any indicator under consideration. The system should measure both hazard and outcome measures. Finally, meaningful public health action should result from the monitoring. Key messages • Environmental health indicator surveillance is essential to all-hazards health protection. • Few public health agencies internationally are systematically monitoring environmental health outcomes.

Sex differences in mortality associated with heatwaves: a systematic review and meta-analysis

Abstract Introduction The existence of sex and gender differences in the mortality associated with heatwaves remains unclear. Methods A systematic review and random-effects meta-analysis of population-based studies that investigated the mortality associated with heatwaves and reported results stratified by sex/gender was conducted (PROSPERO registration CRD42023430208). Bibliographic databases Medline and Embase were searched from inception to May 2024 with MESH terms for heatwaves/extreme heat and mortality. This was complemented with hand-searching of reference lists of relevant studies. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute critical appraisal tool. Results In total, 931 studies were identified, of which 32 studies were included in the qualitative review and 11 in the meta-analysis. Most studies (20/32) reported a higher risk of heat-related death for women than men even after adjusting for or stratifying by age. Twelve studies showed statistically significant higher risks of death for women than men and 7 studies identified an increased risk of death for women, but the wide confidence intervals precluded making definite conclusions. Two studies reported a higher risk of death for men in comparison to women but only one was statistically significant. The remaining 10 studies found comparable risks for women and men. For the 11 studies included in the meta-analysis, women had an 8% increased risk of death in comparison to men (RR 1.08, 95% CI [1.02 to 1.14]). There was significant heterogeneity (I2=69%, p = 0.001) due to the variability in the definition of exposure, population, and setting. Most studies had a low to moderate risk of bias. Conclusions Women appeared to have an increased risk of death associated with heatwaves in comparison to men. Further research is warranted to understand the underlying factors and ensure the health protection response considers the gendered impact of heatwaves.

Predictors and outcomes of adolescent alcohol and drug use: a scoping review

Abstract Background Adolescence is a pivotal life stage marked by educational advancement, entry into the workforce and formation of lasting relationships. Globally, adolescence is also the peak period during which individuals first engage in alcohol and/or drug consumption. This scoping review aimed to summarize existing longitudinal research on factors and outcomes related to adolescent substance use to identify gaps in existing evidence. Methods A scoping review was conducted in accordance with the PRISMA extension for scoping reviews. A systematic literature search was conducted on PubMed. Additional studies were identified through hand-searching key reference lists and Google Scholar searches. A narrative synthesis was completed. Results 123 studies were included; 12 reviews and 111 cohort studies. 60% of cohort studies originated from North America, 29% Europe, 7% Australia/New Zealand, 2% South America and 2% Asia. Factors consistently associated with increased risk of ASU include male sex, increasing age, externalizing disorders, adverse childhood experiences and peer or parental substance use. Few studies considered wider community or neighbourhood factors. Early initiation and higher frequency of adolescent drug use were predictive of later-life substance use patterns, education derailment, contact with the justice system and mental health disorders. Conclusions The body of longitudinal evidence on adolescent substance use is rapidly expanding yet significant research gaps exist. Rising levels of cocaine use and its substantial health impacts motivate further research on all potentially important factors associated with cocaine use to guide interventions for prevention and treatment. Key messages • There are important gaps in existing research on adolescent substance use. • These include neighbourhood influences and factors associated with initiation of illicit drugs other than cannabis.

Barriers to young people’s use of sexual and reproductive health services in Asia-Pacific

Abstract Background Qualitative literature extensively documents young people’s barriers to accessing sexual and reproductive health (SRH) services in Asia-Pacific countries. However, efforts to synthesise this research for practical use in healthcare policy and practice are lacking. This systematic review aims to systematically review and synthesise published qualitative literature focusing on young people’s utilisation of SRH services and understanding common access barriers. Methods We systematically searched five electronic databases from inception until 24 June 2022: MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science. Google Scholar and reference lists of all included studies were also searched. We used the Critical Appraisal Skills Programme (CASP) checklist for appraising the quality of included studies and analysed the data using a thematic synthesis approach. Results We included 31 papers reporting the experiences of over 1800 young people from 16 Asia-Pacific countries. Thematic synthesis identified several factors affecting adolescents’ utilisation of SRH services, which were grouped into six descriptive themes: navigating puberty; lack of SRH knowledge; embarrassment and confidentiality concerns; low decision-making autonomy; traditional practices and religious beliefs; and socio-cultural norms. Our overreaching analytical theme highlighted the role of shame as a key emotion hindering young people’s utilisation of SRH services. Conclusions Direct communication about SRH issues is crucial for teenagers. Embarrassment, privacy concerns, and stigma significantly affect their service utilisation decisions. Inclusive interventions for both youth and their communities by addressing socio-cultural factors are essential for optimising service accessibility and guiding evidence-based interventions and policies across diverse cultural contexts. Key messages • Understanding young people’s SRH service barriers in Asia-Pacific countries: Socio-cultural norms are highlighted as crucial for optimising service utilisation among young individuals in this area. • Inclusive interventions and policies are needed for enhanced accessibility.

The Types and Effectiveness of Mobile Health Applications Used in Improving Oral Cancer Knowledge: A Mixed Methods Systematic Review

ABSTRACTBackground and AimsThe global burden of oral cancer (OC) is enormous. Mobile health applications have been found to play a promising role in cancer prevention; however, no known systematic review evidence exists on whether the use of mobile health applications is effective in increasing public knowledge of OC or not. Therefore, this systematic review aimed to synthesize evidence on the types and effectiveness of mobile health applications used for improving OC knowledge.MethodsThis study adopted a mixed methods systematic review design. The review methodology was informed by Joanna Brigg's Institute's PRISMA checklist and the AMSTAR‐2 guidelines. The literature used for this review were obtained through the search of multiple sources, including 12 electronic databases, web sources, and manual searching of the reference lists and citations of the included articles. Quality appraisal of the included articles was done using the Mixed Methods Appraisal Tool, after which relevant data were collected, synthesized, and configured.ResultsA total of three high‐quality articles, from two studies conducted in India, were included in this review. The studies investigated 574 participants, who are predominantly doctors and community members, on two Android‐based mobile health applications (M‐OncoED and Prayaas). Only Prayaas was found to significantly increase OC knowledge among its users (p < 0.05). Only M‐OncoED was found to significantly increase the practice of OC screening advice provision among a selected group of users. No other significant finding was reported on the effect of OC knowledge obtained from the use of these applications on clinical, behavioral, and epidemiological outcomes.ConclusionMobile health application‐based education is a highly underutilised but very promising strategy that can be used to improve public knowledge of OC. This strategy needs to be adopted in public education programmes on OC.

Spinal cord injury and risk of overall and type specific cardiovascular diseases: A meta-analysis.

Cardiovascular disease (CVD) is a growing concern among people with spinal cord injury (SCI). This meta-analysis aims to explore the risk of overall CVD and specific types of cardiovascular events among SCI patients. This meta-analysis is registered on PROSPERO (CRD CRD42024537888). The data sources comprised PubMed, Embase, the Cochrane Library, and reference lists of the included studies. The literature collection span is from database establishment until April 17, 2024. This meta-analysis encompassed observational studies investigating the association between SCI and the risk of overall types of CVD or specific CVD types. Risk of bias was evaluated utilizing the Newcastle-Ottawa Quality Assessment Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) Scale. Odds ratios (ORs) with 95% confidence intervals (CIs) were aggregated using a random-effects model. Our initial search generated 5357 relevant records form these international databases. This meta-analysis encompassed 9 observational studies involving 2,282,691 individuals, comprising 193,045 patients with SCI and 2,209,646 controls. We observed a 1.56-fold [OR = 1.56, 95% CI (1.43, 1.70), I2 = 91.3%, P < 0.001] rise in the risk of overall types of CVD among SCI patients, with a 1.82-fold increase in males and a 1.76-fold increase in females. SCI patients without comorbidities exhibited a 2.10-fold elevated risk of overall CVD types, while those with comorbidities had a 1.48-fold increased risk. Concerning specific CVD types, SCI patients showed a 1.58-fold [OR = 1.57, 95% CI (1.22, 2.03), I2 = 92.4%] higher risk of myocardial infarction, a 1.52-fold [OR = 1.52, 95% CI (1.07, 2.16), I2 = 88.7%] increase in atrial fibrillation, a 1.64-fold [OR = 1.64, 95% CI (1.22, 2.20), I2 = 95.5%] elevation in heart failure risk, and 2.38-fold [OR = 2.38, 95% CI (1.29, 4.40), I2 = 92.5%] increments in stroke risk. But there was no statistically significant difference in the risk of hypertension [OR = 1.54, 95% CI (0.98, 2.42), I2 = 96.6%]. The risk of overall CVD in SCI patients surpassed that of the non-SCI control group, with elevated risks of specific cardiovascular events like myocardial infarction, atrial fibrillation, heart failure, and stroke. Clinicians should prioritize awareness of CVD risks in SCI patients.

Levels of Hell in the Sunnah

This research is allocated to studying what is stated in Sunnah about the levels of Hell, to derive benefits from it and prove the facts. Its importance comes from the absence of an independent study on this topic. After the introduction, I divided the research, into an introduction and two sections: The first section: The partitions of the levels of Hell, and the second section: The lowest level of Hell. Then I concluded the research with a conclusion in which I showed the most important results, then a list of sources and references. It has been proven that Hell has seven gates and that each gate represents a level of the levels of Hell. As for the names of these levels and who will be punished in them, this has not been proven by any authentic Hadith. It has also been proven that the people of Hell vary in the degrees of their punishment, and that the lowest level of Hell is its bottom, and its depth is enormous, estimated at seventy years for the sake of increasing, where the hypocrites, the oppressors, and the arrogant reside.

Comparing the efficacy of different embolisation materials in improving pain and fertility outcomes in patients with varicoceles: A systematic review.

Radiological embolisation has emerged as a safe and effective alternative to surgery for varicocele treatment. While systematic reviews have compared embolisation to surgery, attempts to compare different embolisation materials have been limited. The objective was to conduct a systematic review assessing the potential benefits of combining coils with sclerosants for varicocele embolisation on fertility, pain, recurrence and complication rates in male patients, as compared to using coils alone. The search was conducted through MEDLINE, Embase and CENTRAL databases from inception to May 2023. Comparative studies that reported male varicocele patients treated with embolisation using either coils or coils with sclerosants were included, with primary outcomes of either fertility, pain or recurrence. Pearling of reference lists was also performed to identify additional articles. Risk of bias for each study was assessed using the Downs and Black Checklist. Overall, 21 studies (2236 patients) were included. Patients were treated with coils in 14 studies, and nine studies used coils with sclerosants. An improvement in sperm concentration and motility was identified post-embolisation in most studies that reported these outcomes. Pregnancy and recurrence rates were comparable between the two materials. All four studies that reported pain outcomes following embolisation noted improvement in pain scores. Only one comparative study was included, for recurrence. This review has identified improvements in pain and fertility following varicocele embolisation. However, it could not be determined which material was superior due to the lack of high-quality comparative studies in the literature.

Impact of Antidepressant Use on Survival Outcomes in Glioma Patients: A Systematic Review and Meta-Analysis

Abstract Background Depression is common among glioma patients, and antidepressants are frequently prescribed to manage symptoms. Understanding the impact of antidepressants on glioma patient survival is crucial for informing treatment strategies. Methods A systematic search was conducted in PubMed and EMBASE databases for studies published from January 1994 to March 2024. The search strategy included terms related to overall survival, prognosis, antidepressants, and gliomas. A manual search was performed in the reference lists. According to PRISMA guideline, two authors independently extracted data. Statistical analysis was performed using Review Manager (version 5.4.1) software, employing random effects model based on study heterogeneity. The primary outcome was overall survival (OS). Hazard ratios (HRs) were used to present survival differences between the two arms. HRs after correcting for confounders were prioritized for extraction. Results Seven retrospective cohort studies involving 5579 patients were analyzed. Selective serotonin reuptake inhibitors (SSRIs) showed no significant survival difference in all glioma patients (HR=1.34, 95% CI: 0.66-2.70) and in GBM patients (HR=1.05, 95% CI: 0.45-2.46), while non-SSRIs had an unfavorable impact on OS in GBMs (HR=3.54, 95% CI: 2.51-4.99). When considering LGG, both SSRIs and non-SSRIs usage demonstrated associations with poorer survival outcomes (SSRIs: HR=3.26, 95%CI: 2.19-4.85; Non-SSRIs: HR=7.71, 95% CI: 4.25-14.00). Conclusions Antidepressant use was not significantly associated with better survival outcomes, emphasizing the need for reconsidering the real effects of antidepressants medication. Future clinical research should address patient heterogeneity to better clarify the effects of antidepressants on glioma survival.

Functional Assessment of Anterior Cruciate Ligament Reconstruction Using Peroneus Longus vs. Hamstring Tendon at 6, 12, And 24 Months Follow Up: A Meta-Analysis

Background: Anterior cruciate ligament (ACL) tear occurs between 29 to 38 cases per 100.000 people annually with more than half of cases requiring an ACL reconstruction. Peroneus longus tendon (PLT) has growing popularity as an autograft for ACL reconstruction providing comparable outcomes with proper graft diameter size, lack of donor site morbidity and uncomplicated harvesting technique. Unfortunately, certain studies did not agree with the superiority of PLT to the standard hamstring tendon (HT). Objective: The aim of study is to compare the knee functional outcome of an ACL reconstruction using peroneus longus and hamstring tendon according to recent publications. Methods: This study conducted a thorough systematic search for relevant scientific reports on multiple medical databases, including PubMed, Embase, and Google Scholar, using a combination of keywords such as "peroneus longus," “hamstring tendon,” "ACL reconstruction," “IKDC,” and “Lysholm”. The search was performed in April 2013-2023, resulting in 1567 studies. Two reviewers (RR, WA) independently screened the abstracts and reference lists, with any discrepancies resolved through consensus, concluding 5 included studies. Results: Five studies are included with a total of 538 patients consisting of 267 patients who underwent ACL reconstruction with PLT and 271 patients who underwent ACL reconstruction with HT. Up to 24 months follow-up, there are equally balanced satisfactory functional outcomes between ACL reconstruction using peroneus longus and hamstring tendon, in terms of IKDC (I2 = 74%; SMD = 0.08 95%CI, -0.21 to 0.38; p = 0.57) and Lysholm score (I2 = 75%; SMD = 0.06 95%CI, -0.27 to 0.39; p = 0.73). Conclusion: ACL reconstruction using the peroneus longus tendon is a safe and effective procedure with excellent short to long term functional outcome of the knee. Keywords: Anterior Cruciate Ligament Reconstruction, Functional Outcome, Hamstring tendon, Human, Peroneus Longus Tendon Keywords: Anterior Cruciate Ligament Reconstruction, Functional Outcome, Hamstring tendon, Human, Peroneus Longus Tendon.

Interventions to reduce low-value care in intensive care settings: a scoping review of impacts on health, resource use, costs, and the environment.

Low-value care is common in intensive care units (ICUs), unnecessarilyexposing patients to risks and harms, incuring costs to the patient and healthcare system, and contributing to healthcare's carbon footprint. We aimed to identify, collate, and summarise published evidence on the impact of interventions to reduce low-value care in ICUs. We searched MEDLINE, Embase, and Cochrane CENTRAL from inception to 22 September 2023 for evaluations of interventions aiming to reduce low-value care, supplemented by reference lists and recently published articles. We recorded impacts on the low-value target,health outcomes, resource use, cost, and the environment. From 1155 studies screened, 32 eligible studies were identified evaluating interventions toreduce: routine blood testing (n = 13), routine chest X-rays (n = 10), and other types (or multiple types) of low-value care (n = 9). All but 3 of the interventions found reductions in the immediate low-value care target (usually the primary outcome). Although the small sample size ofmost included studies, limited their ability to detect impactson other outcomes, manyinterventions were alsoassociated with improved health outcomes and financial savings. The only study that reported environmental impacts found the intervention was associated with reduced carbon dioxide equivalent (CO2-e) emissions. Interventions to reduce low-value care in ICUs may have important health, financial, and environmental co-benefits. Further research may inform wider scale-up and sustainability of successful strategies to decrease low-value healthcare. More empirical evidence on potential environmental benefits may inform policies to lower healthcare's carbon footprint.

A systematic review protocol of injuries and illness across all the competitive cycling disciplines, including track cycling, mountain biking, road cycling, time trial, cyclocross, gravel cycling, BMX freestyle, BMX racing, e-sport, para-cycling and artistic cycling.

The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to "promote and support research in cycling epidemiology and medicine, especially for the benefit of lesser-known disciplines" within its 2030 Agenda. This paper outlines a proposed protocol to conduct a systematic review that comprehensively analyses and synthesises the existing literature about cycling-related injuries and illness across all competitive disciplines. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed through each stage of this systematic review. Cycling is an umbrella term used for many individual disciplines. Investigation of all types of injuries and/or illnesses sustained during training and/or competition among competitive athletes across all disciplines will be included in this review. A computerised, systematic literature search will be conducted in electronic databases MEDLINE, Scopus, Embase, and Cochrane Library. Independent screening by two reviewers in a two-step process: title/abstract screening followed by full-text review. The reference lists of included articles will be searched to identify any other potentially relevant articles. Narrative synthesis and tabular/charted presentation of the extracted data will be included. This protocol paper outlines the methodology to conduct a systematic review of injuries and illness across all competitive cycling disciplines. The aims of outlining this systematic review protocol are to aid research transparency, help reduce publication bias, prevent selective publication, and prevent the selective reporting of results. Future systematic reviews based on the proposed protocol will summarise the known prevalence, incidences, locations and burden of injury and illness across the sport of cycling. This study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42024502703).