Medical Literature Research Articles

The effect of the COVID-19 health disruptions on breast cancer mortality for older women: a semi-Markov modelling approach

ABSTRACT Public health measures necessitated by the COVID-19 pandemic have affected cancer pathways by halting screening, delaying diagnostic tests and reducing the numbers starting treatment. Specifically, this moves individuals from observed and treated pathways to unobserved and untreated pathways. We introduce a semi-Markov model that includes both, extending an industry-based multiple state model used for life and critical illness insurance. Our model includes events related to cancer diagnosis and progression based on publicly available population data for women aged 65–89 in England and on relevant medical literature. We quantify age-specific excess deaths, for a period up to 5 years, along with years of life expectancy lost and changes in cancer mortality by cancer stage. Our analysis suggests a 3–6% increase in breast cancer deaths, and a 4–6% increase in registrations of advanced breast cancer, robust under sensitivity analysis. This should be applicable to actuarial work in areas where longevity and advanced age morbidity affect healthcare, retirement and insurance.

Multidisciplinary comprehensive treatment of massive hepatocellular carcinoma with hemorrhage: A case report and review of literature

BACKGROUND Hepatocellular carcinoma (HCC), a major contributor to cancer-related deaths, is particularly prevalent in Asia, largely due to hepatitis B virus infection. Its prognosis is generally poor. This case report contributes to the medical literature by detailing a unique approach in treating a large HCC through multidisciplinary collaboration, particularly in patients with massive HCC complicated by ruptured bleeding, a scenario not extensively documented previously. CASE SUMMARY The patient presented with large HCC complicated by intratumoral bleeding. Treatment involved a multidisciplinary approach, providing individualized care. The strategy included drug-eluting bead transarterial chemoembolization, sorafenib-targeted therapy, laparoscopic partial hepatectomy, and standardized sintilimab monoclonal antibody therapy. Six months after treatment, the patient achieved complete radiological remission, with significant symptom relief. Imaging studies showed no lesions or recurrence, and clinical assessments confirmed complete remission. This report is notable as possibly the first documented case of successfully treating such complex HCC conditions through integrated multidisciplinary efforts, offering new insights and a reference for future similar cases. CONCLUSION This study demonstrated effective multidisciplinary treatment for massive HCC with intratumoral bleeding, providing insights for future similar cases.

Caudal Regression Syndrome First Diagnosed in Adulthood: A Case Report and a Review of the Literature

Caudal regression syndrome (CRS) is a rare congenital malformation characterized by incomplete development of the lower spine and spinal cord. Its estimated incidence ranges from 1 to 2 per 100,000 live births, leading to a spectrum of clinical presentations. Although most cases are diagnosed during childhood, only a small number of cases have been documented in adults in the medical literature. Case Report: A 27-year-old woman underwent an outpatient magnetic resonance imaging (MRI) of the thoracolumbar spine due to severe lower back pain experienced for the first time. Despite congenital leg abnormalities and multiple childhood surgeries, no further investigations were conducted at that time. MRI revealed congenital anomalies consistent with CRS, including coccygeal agenesis, L5 sacralization, and spinal cord defects. The patient also had a long-standing pilonidal cyst treated conservatively, now requiring operative treatment due to an abscess. Conclusions: This report underscores a rare case of CRS initially misdiagnosed and mistreated over many years. It emphasizes the importance of considering less common diagnoses, especially when initial investigations yield inconclusive results. This clinical case demonstrates a highly valuable and educative radiological finding. In the literature, such cases with radiological findings in adults are still lacking.

Vocabulary Matters: An Annotation Pipeline and Four Deep Learning Algorithms for Enzyme Named Entity Recognition.

Enzymes are indispensable in many biological processes, and with biomedical literature growing exponentially, effective literature review becomes increasingly challenging. Natural language processing methods offer solutions to streamline this process. This study aims to develop an annotated enzyme corpus for training and evaluating enzyme named entity recognition (NER) models. A novel pipeline, combining dictionary matching and rule-based keyword searching, automatically annotated enzyme entities in >4800 full-text publications. Four deep learning NER models were created with different vocabularies (BioBERT/SciBERT) and architectures (BiLSTM/transformer) and evaluated on 526 manually annotated full-text publications. The annotation pipeline achieved an F1-score of 0.86 (precision = 1.00, recall = 0.76), surpassed by fine-tuned transformers for F1-score (BioBERT: 0.89, SciBERT: 0.88) and recall (0.86) with BiLSTM models having higher precision (0.94) than transformers (0.92). The annotation pipeline runs in seconds on standard laptops with almost perfect precision, but was outperformed by fine-tuned transformers in terms of F1-score and recall, demonstrating generalizability beyond the training data. In comparison, SciBERT-based models exhibited higher precision, and BioBERT-based models exhibited higher recall, highlighting the importance of vocabulary and architecture. These models, representing the first enzyme NER algorithms, enable more effective enzyme text mining and information extraction. Codes for automated annotation and model generation are available from https://github.com/omicsNLP/enzymeNER and https://zenodo.org/doi/10.5281/zenodo.10581586.

On Seeing Long Shadows: Is Academic Medicine at its Core a Practice of Racial Oppression?

Suggestions that academic medicine is systemically racist are increasingly common in the medical literature. Such suggestions often rely upon expansive notions of systemic racism that are deeply controversial. The author argues for an empirical concept of systemic racism and offers a counter argument to a recent suggestion that academic medicine is systemically racist in its treatment of medical trainees: Anderson et al.'s(Academic Medicine, 98(8S), S28-S36, 2023) "The Long Shadow: a Historical Perspective on Racism in Medical Education." Contra the authors of "The Long Shadow," the author argues that racial performance disparities in medical education cannot be validly attributed to racism without careful empirical confirmation; he further argues that standards of assessment in medical education cannot be properly deemed racist merely because minority trainees are disproportionately disadvantaged by them. Furthermore, the history of medicine and society in the Anglo-European West is not, as argued by the authors of "The Long Shadow," best viewed as one long tale of racial oppression culminating in the present day pervasive racism of academic medicine in the United States. Racism is a deplorable stain on our history and our present but it is not the historical essence of Christianity, European civilization, Western medicine, or contemporary academic medical institutions.

Diagnostic performance of acoustic radiation force impulse for acute pancreatitis: A meta-analysis.

The objective of this meta-analysis is to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) in acute pancreatitis (AP) patients. PubMed, Web of Science, Embase, Wanfang, Chinese Biological Medicine databases, and Chinese Biomedical Literature Service System were searched for relevant studies to explore the potential diagnostic performance of ARFI in AP from inception to November 2023. STATA 14.0 was used to analyze the standardized mean difference (SMD) with 95% confidence interval (CI), pooled sensitivity, specificity, area under the curve, meta-regression analysis, sensitivity analysis, and publication bias. Nine studies, involving 533 AP patients and 585 healthy controls, were included. AP patients had significantly higher ARFI levels than healthy controls (SMD: 3.13, 95% CI: 1.88-4.39, P = .001). The area under the curve of ARFI for diagnosing AP was 0.99 (95% CI: 0.98-1.00), with 98% sensitivity and 94% specificity. Meta-regression identified the study region and study period as the sources of heterogeneity. Sensitivity analysis showed that the exclusion of any single study did not materially alter the overall combined effect. No evidence of publication bias was observed in the included studies. This meta-analysis demonstrated that ARFI exerted satisfactory diagnostic performance in AP.

Data augmentation and transfer learning for cross-lingual Named Entity Recognition in the biomedical domain

AbstractGiven the increase in production of data for the biomedical field and the unstoppable growth of the internet, the need for Information Extraction (IE) techniques has skyrocketed. Named Entity Recognition (NER) is one of such IE tasks useful for professionals in different areas. There are several settings where biomedical NER is needed, for instance, extraction and analysis of biomedical literature, relation extraction, organisation of biomedical documents, and knowledge-base completion. However, the computational treatment of entities in the biomedical domain has faced a number of challenges including its high cost of annotation, ambiguity, and lack of biomedical NER datasets in languages other than English. These difficulties have hampered data development, affecting both the domain itself and its multilingual coverage. The purpose of this study is to overcome the scarcity of biomedical data for NER in Spanish, for which only two datasets exist, by developing a robust bilingual NER model. Inspired by back-translation, this paper leverages the progress in Neural Machine Translation (NMT) to create a synthetic version of the Colorado Richly Annotated Full-Text (CRAFT) dataset in Spanish. Additionally, a new CRAFT dataset is constructed by replacing 20% of the entities in the original dataset generating a new augmented dataset. We evaluate two training methods: concatenation of datasets and continuous training to assess the transfer learning capabilities of transformers using the newly obtained datasets. The best performing NER system in the development set achieved an F-1 score of 86.39%. The novel methodology proposed in this paper presents the first bilingual NER system and it has the potential to improve applications across under-resourced languages.

Physiotherapeutic Scoliosis-Specific Exercise for the treatment of adolescent idiopathic scoliosis: A systematic review and network meta-analysis.

To compare the rehabilitative efficacy of different physiotherapy scoliosis-specific exercises (PSSE) for adolescent idiopathic scoliosis (AIS) using a network meta-analysis. PubMed, Cochrane Library, Web of Science, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan Fang Data were searched until October 2023. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and R4.3.1. This study follows the PRISMA statement and was registered on the PROSPERO platform (No. CRD42022379206). Seventeen RCTs involving 857 patients were included. The meta-analysis showed that PSSE therapy improved Cobb's angle than conventional rehabilitation therapy (standardized mean difference [SMD] = -0.7; 95% confidence interval [CI] = -0.95, -0.44; p = 0.001), angle of trunk rotation (ATR; SMD = -1.05; 95% CI = -1.52, -0.58; p < 0.001), and quality of life (QoL; SMD = 0.61; 95% CI = 0.16, 1.07; p < 0.001). Network meta-analysis showed that Schroth + Scientific Exercise Approach to Scoliosis (SEAS) was the most effective in improving Cobb angle and ATR, while Schroth alone was most effective in improving the QoL. The combination of Schroth and SEAS improved the body posture and trunk deformity in patients with AIS, while Schroth alone improved the QoL. The effectiveness of combining different PSSE techniques supports future evidence-based research on AIS treatment.

Distinct clinical features of transplanted children with Parvovirus B19 infection

BackgroundThe immature and suppressed immune response makes transplanted children a special susceptible group to Parvovirus B19 (PVB19). However, the clinical features of transplanted children with PVB19 infection haven’t been comprehensively described.MethodsWe searched the medical records of all the transplant recipients who attended the Children’s Hospital of Fudan University from 1 Oct 2020 to 31 May 2023, and reviewed the medical literature for PVB19 infection cases among transplanted children.ResultsA total of 10 cases of PVB19 infection were identified in 201 transplanted children at our hospital, and the medical records of each of these cases were shown. Also, we retrieved 40 cases of PVB19 infection among transplanted children from the literature, thus summarizing a total of 50 unique cases of PVB19 infection. The median time to the first positive PVB19 DNA detection was 14 weeks post-transplantation. PVB19 IgM and IgG were detected in merely 26% and 24% of the children, respectively. The incidence of graft loss/dysfunction was as high as 36%. Hematopoietic stem cell transplant (HSCT) recipients showed higher PVB19 load, lower HGB level, greater platelet damage, lower PVB19 IgM/IgG positive rates, and more graft dysfunction than solid-organ transplant (SOT) recipients, indicating a more incompetent immune system.ConclusionsCompared with the published data of transplanted adults, transplanted children displayed distinct clinical features upon PVB19 infection, including lower PVB19 IgM/IgG positive rates, more graft dysfunction, and broader damage on hematopoietic cell lines, which was even more prominent in HSCT recipients, thus should be of greater concern.

Women's perspectives on mHealth behavior change interventions for the management of overweight, obesity, or gestational diabetes: A qualitative meta-synthesis.

mHealth interventions play an increasingly important role in health behavior change for gestational diabetes or peripartum obesity management. This qualitative systematic review and meta-synthesis aims to explore women's perceptions of mHealth behavior change interventions for gestational diabetes and/or overweight/obesity management during pregnancy and the postpartum period. Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, Excerpta Medica Database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Psychological Information Database (PsycINFO) databases were searched using a Sample, Phenomenon of Interest, Design, Evaluation and Research type (SPIDER) concept framework through to February 2024. Included studies were quality assessed using the Critical Appraisal Skills Programme checklist. Study findings were evaluated using reflexive thematic analysis and GRADE-Confidence in the Evidence from Reviews of Qualitative Research (CERQual) checklist. We identified 29 studies, representing 604 women's views from one upper middle-income and nine high-income countries. Two themes were generated: mHealth as a supportive tool; and mHealth as a personalizable tool. Women highlighted the importance of self-monitoring, information trustworthiness, peer support, motivational tools (goal setting, risk awareness, and problem solving) and convenience in achieving behavior change using mHealth technology. They suggest mHealth programs incorporate these elements to support user engagement and improved health outcomes. Understanding what women want as mHealth users is particularly important for effective interventions in gestational diabetes, weight management, and chronic disease prevention. Creating a better, more woman-centered experience by addressing central engagement issues should result in improved maternal health outcomes.

"Incorporating large language models into academic neurosurgery: embracing the new era".

This correspondence examines how LLMs, such as ChatGPT, have an effect on academic neurosurgery. It emphasises the potential of LLMs in enhancing clinical decision-making, medical education, and surgical practice by providing real-time access to extensive medical literature and data analysis. Although this correspondence acknowledges the opportunities that come with the incorporation of LLMs, it also discusses challenges, such as data privacy, ethical considerations, and regulatory compliance. Additionally, recent studies have assessed the effectiveness of LLMs in perioperative patient communication and medical education, and stressed the need for cooperation between neurosurgeons, data scientists, and AI experts to address these challenges and fully exploit the potential of LLMs in improving patient care and outcomes in neurosurgery.

Giant fibroepithelial breast polyp

Introduction: Fibroepithelial polyps are common benign skin lesionsrarely noted in the female nipple. In this location, they have the potentialto ulcerate and cause bloody discharge.Case history: A 55-year-old female patient presented to a breast clinicwith a left nipple lesion present since childhood. The patient self-reportedthat the lesion had increased in size. Clinical examination revealed a 9 ×7 cm lesion with a soft and pliable stem extending from the left nipple.Mammography from 2017 revealed this previously measured 6 × 6 cm.An excision biopsy under general anaesthetic preserving the nippleanatomy was undertaken on 18/8/23. There were no immediate or subsequentcomplications. The final histology demonstrated the excised specimenweighed 131 g and measured 90 × 70 × 60 mm with an 8 mm base.The specimen was processed and microscopically found to be a giantfibroepithelial polyp (FEP). The central core of the lesion was formed byexcessive collagen deposition. Normal dermal structures including bloodvessels were still present with no glandular component and there was noevidence of atypia or malignancy.Discussion: FEPs are benign dermal mesenchymal tumours also knownas acrochordons. They are noted most commonly on the neck, axilla,perineum, and thighs but have also been found in the vagina, vulva, orcervix and present in &lt; 2% of cases in the nipple area.FEPs rarely grow larger than 5 cm, with larger lesions rarely reportedin medical literature worldwide. It is possible to excise these lesions andpreserve the nipple anatomy with careful surgical planning.

Convivial Populations: Ivan Illich and Public Health in the 21st Century.

Ivan Illich (1926-2002) was a historian, social critic, and professor at multiple universities. He came to intellectual fame through his criticisms of modern institutions, including health care, and his concern with social structures that he believed to impede human flourishing. However, Illich has not been thoroughly explored as a source of insight for public health professionals. Although he populates the medical and public health literature, discourse remains sparse about how Illich might contribute to key conversations in public health today. In this article, I explore Illich's potential contributions to modern public health through one of his seminal works, Tools for Conviviality. I frame Illich as a valuable conversational partner for public health professionals at a crucial moment in the field's history. (Am J Public Health. Published online ahead of print May 9, 2024:e1-e6. https://doi.org/10.2105/AJPH.2024.307675).

Association between low birth weight and impaired glucose tolerance in children: a systematic review and meta-analysis

BackgroundA potential association between the onset of diabetes and normal birth weight (NBW) has been discovered. Diverse conclusions and study methodologies exist regarding the connection between low birth weight (LBW) and impaired glucose tolerance in children, underscoring the need for further robust research. Our institution is embarking on this study to thoroughly examine the association between LBW and impaired glucose tolerance in children.MethodsWe conducted searches on Cochrane Library, ScienceDirect, EMBASE, PubMed, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature data (CBM) online database, VIP full-text Database, and Wanfang Database to identify correlation analyses or case-control studies investigating the relationship between LBW and abnormal glucose tolerance in children. The search spanned from January 2010 to September 2023. The quality of observational studies was evaluated using the Newcastle–Ottawa Scale (NOS) tool. Data synthesis was performed using the statistical software RevMan 5.3 for meta-analysis.ResultsBased on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, we finally included 10 clinical control studies consisting of a total of 2971 cases. There wasn’t considerably change in blood sugar levels among LBW, NBW and high birth weight (HBW) infants (P &amp;gt; 0.05). There was no significant difference in insulin levels between LBW infants and NBW infants (P &amp;gt; 0.05). The HOMA-IR of LBW infants was considerably higher than that of NBW infants (P &amp;lt; 0.05). The risk of abnormal glucose tolerance in LBW infants was 0.42 times higher than that in NBW and HBW infants [Fisher's Z = 0.42, 95% CI = (0.09, 0.75), P = 0.01].ConclusionLBW is associated with an increased risk of abnormal glucose tolerance, as indicated by elevated HOMA-IR level in LBW infants compared to NBW and HBW pediatric population. Further research is needed to confirm and expand upon these findings to better understand the complex relationship between LBW and impaired glucose tolerance in children.

Meta-analysis of the efficacy of Jingjin acupuncture therapy in the treatment of spastic cerebral palsy

BackgroundThis study aimed to systematically evaluate the clinical efficacy of Jingjin (muscle region of the meridian, sinew/tendon/fascia) acupuncture therapy for the treatment of spastic cerebral palsy.MethodsComputer searches of the Cochrane Library, Web of Science, PubMed, Embase, Chinese Biomedical Literature (CBM) Database, Wanfang database, Wipu (VIP) database, and China National Knowledge Infrastructure (CNKI) database for published randomized controlled trial (RCT) studies on Jingjin acupuncture treatment of cerebral palsy from the beginning of the database construction until 30 November 2023 were performed, and the quality of the papers was assessed through independent data extraction by two individuals and then meta-analyzed using RevMan5.4 software. A total of 20 RCTs involving 1,453 patients were included.ResultsThe overall effective rate of Jingjin acupuncture therapy was better than that of conventional therapy, with a combined odds ratio (OR) of 4.70 and a 95% confidence interval (CI) of [3.05, 7.24]. The Modified Ashworth Spasticity (MAS) Scale, Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM), and Comprehensive Spasticity Scale (CSS) scores are superior to conventional therapy.ConclusionJingjin acupuncture therapy is effective in treating spastic cerebral palsy and has better overall efficacy than conventional therapy. Due to the low quality of some of the literature in this study type, more high-quality, well-designed clinical studies are needed to validate it.

Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis.

Over the past decade, numerous studies have described the types of pathogens and their antibiotic resistance patterns in patients with burn injuries in China; however, the findings have generally been inconsistent. We conducted a literature search and meta-analysis to summarize the infection spectra and antimicrobial resistance patterns in patients with burn injuries. We searched the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature, Wanfang, and Weipu databases for relevant articles published between January 2010 and December 2023. The DerSimonian-Laird random-effects model was used to estimate the proportions and 95% confidence intervals (CIs) of pathogens among Chinese patients with burn injuries. Meta-regression analyses were performed to explore differences in the proportions of pathogens among different subgroups and their resistance patterns. This study was registered with PROSPERO (CRD42024514386). The database searches yielded 2017 records; after removing duplicates and conducting initial screening, 219 articles underwent full-text screening. Ultimately, 60 studies comprising a total of 62,819 isolated strains reported the proportions of pathogens in patients with burn injuries and were included in this meta-analysis. Meta-analyses were conducted on 18 types of pathogens. The most common pathogens causing infections in Chinese patients with burn injuries were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis. Similar results were observed in the subgroup analysis focusing on wound infections. Since 2015, there has been a significant decrease in the proportion of Pseudomonas aeruginosa (R2 = 4.89%) and a significant increase in the proportion of Klebsiella pneumoniae (R2 = 9.60%). In terms of antibiotic resistance, there has been a significant decrease in the resistance of Staphylococcus aureus to multiple antibiotics and an increasing trend in the resistance of Klebsiella pneumoniae. We systematically summarized the epidemiological characteristics and antibiotic resistance patterns of pathogens among individuals suffering from burns in China, thus providing guidance for controlling wound infections and promoting optimal empirical antimicrobial therapy. The observed high levels of antibiotic resistance underscore the need for ongoing monitoring of antibiotic usage trends.

Brain fog in chronic pain: Protocol for a discourse analysis of social media postings.

Brain fog is a phenomenon that is frequently reported by persons with chronic pain. Difficulties with cognition including memory impairments, attentional issues, and cloudiness are commonly described. The current medical literature demonstrates a similar cloudiness: there is no clear taxonomy or nomenclature, no well-validated evaluations and a dearth of effective interventions. To focus our understanding of this complex phenomenon, we will perform a discourse analysis to explore how brain fog is described in public posts on social media. Discursive methodology will generate insights regarding the societal understanding and meanings attributed to brain fog, by sampling perspectives of persons with lived experience, currently underrepresented in the medical literature. It is anticipated that the results of the proposed study will 1) help healthcare professionals better understand the experience of chronic pain-related brain fog and 2) generate hypotheses for future research. To conclude, by incorporating innovative and contemporary methods, this proposed discourse analysis of social media sources will generate nuanced insights, bridging the gap between researchers, health care providers, and persons with lived experience.

Efficacy and safety of mirror therapy for post-stroke aphasia: A systematic review and meta-analysis protocol.

Aphasia is one of the most common complications of stroke. Mirror therapy (MT) is promising rehabilitation measure for the treatment of post-stroke aphasia. Although some studies suggested that MT is effective and safe for aphasia, the effects and safety remain uncertain due to lacking strong evidence, such as the relevant systematic review and meta- analysis. This study will search PubMed, Web of Science, Cochrane Library, EMBASE, Medline, China Knowledge Network (CNKI), WANFANG, China Biomedical Literature Database (CBM), from inception to 1th May 2023 to identify any eligible study. No language or date of publication shall be limited. We will only include randomised controlled trials of MT in the Treatment of poststroke aphasia. Two investigators will work separately on the study selection, data extraction, and study quality assessment. The western aphasia battery (WAB) and aphasia quotient (AQ) will be included as the main outcomes. Boston diagnostic aphasia examination method (BDAE), Chinese standard aphasia examination (CRRCAE) will be included as the secondary outcomes. The statistical analysis will be conducted by RevMan V.5.4 software. The risk of bias of included studies will be assessed by the Cochrane 'Risk of bias' tool. The quality of proof of the results will be evaluated by using the Grading of Recommendations Assessment, Development and Evaluation guidelines. The finding will be presented in a journal or related conferences. This study will provide a basis for whether mirror therapy (MT) is effective and safe in the treatment of post-stroke aphasia. Systematic review registration INPLASY registration number: INPLASY 202340054.

The usefulness of patient-reported outcome measures in decision making in Chagas cardiomyopathy: a scoping review.

Chagas cardiomyopathy (ChC) presents many biopsychosocial complexities, highlighting the need to have patient self-report questions. This study demonstrates the scope of the use of patient-reported outcome measures (PROMs) in patients with ChC and highlights the main research gaps. This is a scoping review and the search strategy was performed in the Online Medical Literature Analysis and Retrieval System (MEDLINE), Excerpta Medica database (EMBASE), Accumulated Index of Nursing and Allied Health Literature (CINAHL), Cochrane Central, Latin American Literature and Caribbean in Health Sciences (LILACS) and Diagnostic Test Accuracy (DITA). The search identified 4484 studies and 20 studies met the inclusion criteria. The Short-Form of 36 items (SF-36) had potential prognostic value and the ability to identify systolic dysfunction. The Human Activity Profile was able to screen for functional impairment, and the New York Heart Association showed potential prognostic value. The SF-36 and Minnesota Living with Heart Failure Questionnaire were responsive to interventions. The pharmaceutical care affected adherence to treatment as assessed by the Morisky score and also for SF-36. Despite the increased use of PROMs, there are still a large number of gaps in the literature, and further studies using PROMs are needed.

The effect of music therapy on language communication and social skills in children with autism spectrum disorder: a systematic review and meta-analysis

BackgroundStudies have shown that music therapy can be used as a therapeutic aid for clinical disorders. To evaluate the effects of music therapy (MT) on language communication and social skills in children with autism spectrum disorder (ASD), a meta-analysis was performed on eligible studies in this field.MethodsA systematic search was conducted in eight databases: PubMed, Embase, Web of Science, Cochrane Library databases, the China National Knowledge Infrastructure (CNKI), Wanfang Data, the Chinese Biomedical Literature (CBM) Database, and the VIP Chinese Science and Technology Periodicals Database. The standard mean difference (SMD) values were used to evaluate outcomes, and the pooled proportions and SMD with their 95% confidence intervals (CIs) were also calculated.ResultsEighteen randomized controlled trial (RCT) studies were included, with a total of 1,457 children with ASD. This meta-analysis revealed that music therapy improved their language communication [SMD = −1.20; 95%CI –1.45, −0.94; χ2 (17) = 84.17, I2 = 80%, p &amp;lt; 0.001] and social skills [SMD = −1. 13; 95%CI –1.49, −0.78; χ2 (17) = 162.53, I2 = 90%, p &amp;lt; 0.001]. In addition, behavior [SMD = −1.92; 94%CI –2.56, −1.28; χ2 (13) = 235.08, I2 = 95%, p &amp;lt; 0.001], sensory perception [SMD = −1.62; 95%CI –2.17, −1.08; χ2 (16) = 303.80, I2 = 95%, p &amp;lt; 0.001], self-help [SMD = −2. 14; 95%CI –3.17, −1.10; χ2 (6) = 173.07, I2 = 97%, p &amp;lt; 0.001] were all improved.ConclusionMusic therapy has a positive effect on the improvement of symptoms in children with ASD.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/.