Medical Subject Headings Terms Research Articles

Comparison of Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban in Patients With Valvular Atrial Fibrillation: A Network Meta-Analysis of Randomized-Control Trials and Observational Studies.

The objective of this network meta-analysis was to assess the efficacy and safety of apixaban, dabigatran, rivaroxaban, and edoxaban in patients diagnosed with atrial fibrillation and valvular heart disease. A comprehensive search was conducted across various electronic databases, including PubMed, Embase, and Web of Science, from inception to February 15, 2024. The search strategy utilized a combination of medical subject headings (MeSH) terms and relevant keywords related to valvular heart disease, atrial fibrillation, anticoagulant therapy, and study design, such as randomized controlled trials and observational studies. The outcomes evaluated in this analysis comprised the incidence of stroke or systemic embolism (SE), as well as the occurrences of major bleeding events. A total of 10 studies were incorporated into this meta-analysis, encompassing 40,662 participants. Of these, 12,385 received apixaban, 2,829 received dabigatran, 13,662 received rivaroxaban, 2,582 received edoxaban, and 9,202 received warfarin. The duration of follow-up in the included studies ranged from 3 to 54 months. Among the four direct oral anticoagulants (DOACs) studied, apixaban demonstrated a significant reduction in the risk of stroke or SE when compared to other DOACs and warfarin, highlighting its efficacy in patients with atrial fibrillation and valvular heart disease. Additionally, apixaban exhibited a lower risk of major bleeding events, further emphasizing its favorable safety profile compared to the other agents assessed. In conclusion, our findings suggest that apixaban may be more effective and safer than other DOACs and warfarin in this patient population. However, additional studies are warranted to compare the various DOACs in this cohort to identify the optimal treatment strategy for preventing adverse outcomes.

323 Applying MeSH Tree Structures and Condition-to-MeSH Mapping to Catalog and Characterize Clinical Trials Research Focus Areas

OBJECTIVES/GOALS: Characterizing and analyzing research studies presents several challenges given the various ways studies may be labeled or organized. The Medical Subject Headings (MeSH) thesaurus is a hierarchical vocabulary that can index and organize research foci using common business intelligence tools to enable rapid exploration of research portfolios. METHODS/STUDY POPULATION: Metadata from ClinicalTrials.gov on 455,437 trials were downloaded and all MeSH terms associated with trials in the condition_browse section were loaded into a database. The corresponding MeSH trees for each term were then identified and mapped to their ancestor terms within the tree. Trials were then indexed based on top four hierarchical levels for each associated MeSH term. Trials performed at the University of Miami (UM) were identified based on locations associated with the trial as well as matching National Clinical Trial (NCT) numbers identified from internal research administration systems. Business intelligence software (Microsoft PowerBI) was applied to the corresponding dataset to enable end user exploration and analysis of the trials within ClinicalTrials.gov. RESULTS/ANTICIPATED RESULTS: A total of 3,271 studies associated with UM were identified, of which, 3,054 (93.3%) had at least one condition MeSH term linked. A total of 7,711 MeSH terms were associated with the trials overall, representing 1,112 unique MeSH terms; the most common terms were carcinoma (164), lymphoma (155), HIV Infections (139), neoplasms (136), and leukemia (122). Utilizing MeSH hierarchy, trials were characterized were categorized into 36 different trees. The most common top tree nodes were neoplasms (1,181), followed by pathological conditions/signs and symptoms (913), immune system diseases (574), nervous system diseases (513), and digestive system diseases (483). Within trees, a total of 184, 681, and 1057 different MeSH terms were specified at the second, third, and fourth nodes in the hierarchy respectively. DISCUSSION/SIGNIFICANCE: Utilizing existing metadata from trials posted on ClinicalTrials.gov and MeSH tree structures can enable organizations to readily explore the foci of clinical trials research. High rates of MeSH term association to research study conditions are necessary to ensure adequate representation of research foci.

A Narrative Review-Participation of Fathers in Child Health Care in India

Abstract Review studies of the father’s role in child care and father involvement, attitudes, and values associated with it, and strategies for promoting their participation. This review aims to analyze fathers’ involvement in child care and father behavior, as well as associated values and strategies for development. To study the father-child connection and factors such as the child’s social behavior, academic performance, and health-related psychological factors. They are more sensitive, loving, and encouraging toward their young children. When it comes to their young children, they are more receptive, affectionate, and assured. They are also better at maintaining their composure when dealing with rebellious toddlers. A child’s emotional and social development is significantly influenced by how fathers cooperate with their children through play. Compared to mothers, fathers spend a far larger volume of their one-on-one time with infants and preschoolers engaging in stimulating play activities. PubMed and Google Scholar Searches were conducted using Medical Subject Headings terms and related keywords. This study examined the various reviews on the relationship between the roles of fathers in childcare and the factors that may influence the same. Traditional gender norms in child care influence the group of people’s images of fathers’ obligation and serve as a barrier to their involvement in the community. In most populations, fathers can support their families financially. They act as positive role models for their children, defend their families from harm, and exercise control over their wives, children, and other family members. Fathers may provide for and nurture their children. Fathers play and teach their children alone or hold them when their mothers are busy. Interventions focused on improving fathers’ and mothers ideas and attitudes about child care, and the relevance of shared childcare duties may improve fathers’ engagement. Fathers’ participation has various impacts on the child’s healthy development of character, social skills, understanding, intellect, academic achievement, gender roles, morality, and emotion. Fathers’ participation in childcare is affected by family and society, and fathers’ personalities affect children’s personalities to some extent. Father involvement, results also revealed that father involvement was low in childcare responsibilities only; however, other subareas of involvement were high. It was found that especially mothers were responsible as primary caregivers for child care.

Disparities in Study Inclusion and Breast Cancer Screening Rates Among Transgender People: A Systematic Review

BackgroundBreast cancer screening trends of transgender and gender diverse (TGD) people remain largely unknown. This is concerning, as data are necessary to inform recommendations made by clinicians to their patients and by national guidelines to clinicians. The aim of this review is to explore the state of existing research literature and provide a summary report of current breast cancer screening rates in TGD adults. MethodsAll articles were identified using Medical Subject Headings terms. Inclusion criteria were all the following: (1) documents inclusion of at least one participant who identifies as a TGD person; (2) at least one TGD participant with top surgery or currently receiving estrogen-based gender-affirming hormone therapy; (3) results that report rates of breast cancer screening or mammogram referral. ResultsTwelve articles met inclusion criteria, six cross-sectional studies and six retrospective chart reviews. Three studies conducted secondary analysis of the Behavioral Risk Factor Surveillance System national dataset, and nine articles recruited their own sample with number of TGD participants ranging from 30 to 1,822 and number of cisgender women ranging from 242 to 18,275. Three studies found lower rates of screening in transfeminine persons receiving gender-affirming care compared with cisgender women; two studies found lower rates among TGD people compared with cisgender women; and three studies found no differences between the breast cancer screening rates of TGD and cisgender participants. ConclusionLimited studies recruit and report trends in breast cancer screening of TGD people. Those that do include TGD participants have mixed results, but overall TGD people had lower rates of breast cancer screening. More research is needed regarding breast cancer screening of TGD people to inform the development of protocols that ensure equitable access to preventative care.

The Impact of Nutritional Condition and Compression Treatment on Venous Ulcer Recovery: A Systematic Review.

Venous ulcers are open wounds commonly associated with chronic venous insufficiency. Each patient's healing process is unique, and factors like nutrition and compression therapy can affect it. Compression therapy and optimal nutritional status can assist in improving venous blood circulation, decreasing swelling, and promoting wound healing. This in-depth review looks at all the recent research on how nutrition and compression therapy can help heal venous ulcers, aiming to develop evidence-based guidelines for improving treatment outcomes. The systematic review, registered in the International Prospective Register of Systematic Reviews (PROSPERO) and following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles, conducted an extensive electronic search in databases such as PubMed, MEDLINE, Cochrane, Web of Science, and Scopus. Using Medical Subject Headings (MeSH) terms and different types of studies, the search method focused on studies that directly looked at how nutrition and compression therapy affected the healing of venous ulcers. After deduplicating and screening publications, a collaborative full-text review was conducted to determine their inclusion. As a result, several research studies were chosen for the qualitative synthesis. The authors created a data extraction form to document important variables such as demographics, therapy specifics, and wound features. Several studies on patients with venous ulcers have shown that consuming basic nutrients can improve wound healing. Treatment results differed depending on the types of compression and pressure intensity. Although minimal data indicates the possible benefits of two-layer therapy, a definitive comparison is still uncertain. Further clinical studies are necessary to investigate a wider range of dietary factors and to evaluate different treatments in similar situations.

Association Between Maternal Diabetes and ChildhoodNeurodevelopmental Disorders

IntroductionThe prevalence of metabolic disorders is rising, diabetes prevalence doubled during 1990-2017. In 2020, 7.8% of US pregnancies were complicated by Gestational Diabetes Mellitus (GDM). Our aim is to assess the impact this increase has on childhood developmental disorders and understand the link between maternal metabolic disorders and neurodevelopmental disorders in children with focus on Autism Spectrum Disorder (ASD) and ADHD.ObjectivesOur aim is to assess the impact this increase has on childhood developmental disorders and understand the link between maternal metabolic disorders and neurodevelopmental disorders in children with focus on Autism Spectrum Disorder (ASD) and ADHD.MethodsA literature search was conducted using medical subject heading (MeSH) terms in PubMed, database from Jan 1 2014 to Feb 15, 2023. Only large-scale (n>20,000) were reviewed. A total of 3 articles were included in our final qualitative synthesis review.ResultsAn increased rate of ASD and ADHD are observed in children of mothers with insulin resistance, demonstrated by Type 2 Diabetes (T2DM) and GDM (Kuan-Ru Chen, et al.). T2DM had the strongest association with ASA and ADHD when looking at other neurodevelopmental disorders (Chen, et al.). GDM severity correlates to increased risk of ADHD (Xiang, et al.). Maternal obesity as a risk factor for ASA and ADHD has confidence intervals in the same ranges as immune dysregulatory disorders including Asthma and Autoimmune disorders (Woolfenden, et al.).ConclusionsPathomechanism of neurodevelopmental disorders involves maternal oxidative stress and inflammation. Maternal T2DM and obesity are pro-inflammatory states that can be targeted as modifiable risk factors of ASD and ADHD in children. Preconception metabolic optimization and tight glycemic control in pregnancy are two ways clinicians can start to address the rates of rising ASD and ADHD.Disclosure of InterestNone Declared

IJCM_129A: Is intelligent Breast Exam (iBE) a sensitive and specific test compared with mammography in the early detection of breast cancer and patient triage in adults? A Diagnostic review and Meta-analysis

Background: Breast cancer represents the most common cause of cancer death among women globally. Early cancer detection in low-income countries is difficult because of the relatively expensive mammographic screening. Intelligent Breast Exam [iBE] is a portable device that is available at low cost and provides electronic documentation for additional diagnostic workup. Objectives: This study aims to investigate the diagnostic accuracy of i breast device in the early detection of breast cancer and patient triage in adults. Secondary objectives: 1) To review the usability of i Breast device as a triage test for breast pathologies in primary care setting. 2) To review the feasibility, ease and cost-effectiveness of i Breast device Methodology: A systematic literature search of the MEDLINE, Embase and Cochrane Library databases will be performed to identify the studies reporting the accuracy of i breast device for the detection of breast cancer from January 2010 to December 2023. The search strategy will be carried out by using key words and MeSH (Medical Subject Headings) terms. The reference test will be mammogram. The search will be in accordance with the PRISMA-DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy studies) guidelines. Two reviewer authors will independently screen the results. The full-text articles will be reviewed when studies meet the inclusion criteria or in any uncertainty. Non-consensus will be resolved by a third reviewer. The quality of the studies will be examined using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. The review will be registered with PROSPERO (Prospective Register of Systematic Reviews). The estimates of sensitivity, specificity and area under the curve will be attempted using the bivariate model for the diagnostic meta-analysis.

Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis.

Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982-November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48h and (3) median cohort age over 65years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346). Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39-3.30), movement (OR 1.30; 95% CI 0.66-2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09-5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08-0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2 = 0%-77%) and continuous analyses (I2 = 85%). An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium.

The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol

IntroductionAdolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity...

A New Scoring System of Oral Lichen Planus.

The aim of the present study is to critically review all the disease scoring systems on oral lichen planus (OLP) that have been reported in the literature during the past decades. A systematic literature search was performed using PUBMED, MEDLINE, EMBASE, and COCHRANE Library with language restriction to English. The search was carried out incorporating the published literature from 1980 to 2020 using the MeSH (medical subject heading) terms. A literature search was done using keywords: Staging, Grading, Oral lichen planus, Diagnostic, and Therapeutic. Out of 25 publications, related to search strategy, 22 full articles, which were related to the disease scoring system for oral lichen planus, were acquired for further inspection. Out of the 22 articles, 15 articles met the inclusion criteria. The data was collected and a brief summary of the studies regarding the different disease scoring systems for oral lichen planus was explained. Taking into consideration, the parameters were not included in the previous disease scoring system. A new proposal encompassing a scoring system for oral lichen planus considering the missing parameters along with an amalgamation of histopathological criteria of dysplasia is presented. It also proposes to grade and stage the lesions and recommend appropriate therapy for each of such lesions.

Machine Learning-based Analysis of Publications Funded by the National Institutes of Health's Initial COVID-19 Pandemic Response.

The National Institutes of Health (NIH) mobilized more than $4 billion in extramural funding for the COVID-19 pandemic. Assessing the research output from this effort is crucial to understanding how the scientific community leveraged federal funding and responded to this public health crisis. NIH-funded COVID-19 grants awarded between January 2020 and December 2021 were identified from NIH Research Portfolio Online Reporting Tools Expenditures and Results using the "COVID-19 Response" filter. PubMed identifications of publications under these grants were collected and the NIH iCite tool was used to determine citation counts and focus (eg, clinical, animal). iCite and the NIH's LitCOVID database were used to identify publications directly related to COVID-19. Publication titles and Medical Subject Heading terms were used as inputs to a machine learning-based model built to identify common topics/themes within the publications. We evaluated 2401 grants that resulted in 14 654 publications. The majority of these papers were published in peer-reviewed journals, though 483 were published to preprint servers. In total, 2764 (19%) papers were directly related to COVID-19 and generated 252 029 citations. These papers were mostly clinically focused (62%), followed by cell/molecular (32%), and animal focused (6%). Roughly 60% of preprint publications were cell/molecular-focused, compared with 26% of nonpreprint publications. The machine learning-based model identified the top 3 research topics to be clinical trials and outcomes research (8.5% of papers), coronavirus-related heart and lung damage (7.3%), and COVID-19 transmission/epidemiology (7.2%). This study provides key insights regarding how researchers leveraged federal funding to study the COVID-19 pandemic during its initial phase.

The Application of Foot Reflexology for Anxiety and Pain Management in Women's Childbirth: A Literature Review

Context: Uncontrolled childbirth anxiety (CA) and labor pain (LP) may cause negative consequences for the mother during subsequent deliveries. This study aimed to evaluate the effect of foot reflexology (F-REFL) on reducing LP and CA during childbirth in the form of a review study. Evidence Acquisition: In this literature review, the findings were collected by evaluating the results of previous similar studies in the last three decades. The most important and common medical subject headings (MeSH) terms related to the topic under discussion were identified to conduct this study. Then, the most relevant studies were searched, and 226 studies were identified at this stage by searching them in the most reliable and essential international databases, including Google Scholar, Scopus, PubMed, and Web of Science. Considering the inclusion and exclusion criteria, 26 studies were identified to extract the results. Results: Most of the previous research studies were clinical trials, and their findings showed that F-REFL significantly reduces LP and CA. Conclusions: Foot reflexology has been shown to reduce LP and CA, making it an easy, cheap, and noninvasive method to reduce cesareans. Implementing this method is simple and does not require specialized personnel, and midwives can efficiently perform for mothers during childbirth. Additionally, reducing LP and CA experienced during birth through F-REFL improves women's positive birth experiences and protects postpartum mental health.

P238: The use of artificial intelligence in 3D imaging modalities and diabetic foot disease – a systematic review

Abstract Introduction Diabetic foot disease (DFD) is serious complication of diabetes with a multifactorial aetiology and carries a significant risk. The prevalence of DFD continues to grow globally. Artificial intelligence has been proposed in aiding early detection and risk stratification for ulceration and other major complications including sepsis, minor or major lower limb amputation and death. Aims To systematically review the literature available on the use of artificial intelligence in three-dimensional imaging modalities in diabetic foot disease. Method A literature review was conducted in accordance with PRISMA guidelines. Embase and Medline (via the Ovid interface), CINAHL (via Ebsco Host), Web of Science and Scopus databases were searched. The grey literature was also reviewed on ClinicalTrials.gov and the NIHR journals library. The medical subject headings terms “Diabetes” AND “Diabetic foot disease” AND “Artificial intelligence” and various permutations of three-dimensional imaging modalities including “Computed Tomography”, “Magnetic Resonance Imaging” and “Positron Emission Tomography” were employed in the primary search string. Articles were independently screened by two reviewers. Results 4,865 studies were identified. 102 duplicates were removed. 4,721 were excluded in the abstract screening. 42 articles underwent full text review. Existing use centers around binary use of CT based imaging in predicting risk. Conclusion The use of deep learning models is still being explored and evaluated. Current methodologies focus on wound imaging classification, plantar thermography and plantar pressures. Specialised models which evaluate 3D imaging have potential for generation of supra-human insights into extraction of novel metadata features and prediction utilising integration of multidimensional patient characteristics.

Current status and future perspectives on stem cell transplantation for spinal cord injury.

Previous assessments of stem cell therapy for spinal cord injuries (SCI) have encountered challenges and constraints. Current research primarily emphasizes safety in early-phase clinical trials, while systematic reviews prioritize effectiveness, often overlooking safety and translational feasibility. This situation prompts inquiries regarding the readiness for clinical adoption. To offer an up-to-date systematic literature review of clinical trial results con cerning stem cell therapy for SCI. A systematic search was conducted across major medical databases [PubMed, Embase, Reference Citation Analysis (RCA), and Cochrane Library] up to October 14, 2023. The search strategy utilized relevant Medical Subject Heading (MeSH) terms and keywords related to "spinal cord", "injury", "clinical trials", "stem cells", "functional outcomes", and "adverse events". Studies included in this review consisted of randomized controlled trials and non-randomized controlled trials reporting on the use of stem cell therapies for the treatment of SCI. In a comprehensive review of 66 studies on stem cell therapies for SCI, 496 papers were initially identified, with 237 chosen for full-text analysis. Among them, 236 were deemed eligible after excluding 170 for various reasons. These studies encompassed 1086 patients with varying SCI levels, with cervical injuries being the most common (42.2%). Bone marrow stem cells were the predominant stem cell type used (71.1%), with various administration methods. Follow-up durations averaged around 84.4 months. The 32.7% of patients showed functional impro vement from American spinal injury association Impairment Scale (AIS) A to B, 40.8% from AIS A to C, 5.3% from AIS A to D, and 2.1% from AIS B to C. Sensory improvements were observed in 30.9% of patients. A relatively small number of adverse events were recorded, including fever (15.1%), headaches (4.3%), muscle tension (3.1%), and dizziness (2.6%), highlighting the potential for SCI recovery with stem cell therapy. In the realm of SCI treatment, stem cell-based therapies show promise, but clinical trials reveal potential adverse events and limitations, underscoring the need for meticulous optimization of transplantation conditions and parameters, caution against swift clinical implementation, a deeper understanding of SCI pathophysiology, and addressing ethical, tumorigenicity, immunogenicity, and immunotoxicity concerns before gradual and careful adoption in clinical practice.

Circulating biomarkers of oxidative stress in people with acne vulgaris: a systematic review and meta-analysis.

The relationship between acne vulgaris and oxidative stress biomarkers lacks a clear consensus. This study aimed to explore the potential correlation between acne vulgaris and circulating oxidative stress biomarkers (superoxide dismutase [SOD], malondialdehyde [MDA], and total antioxidant capacity [TAC]).We searched the PubMed, Embase, and Cochrane Library databases for articles published before June 26, 2023. The literature search combined free words and the medical subject headings terms related to acne vulgaris, SOD, MDA, and TAC. Data were analyzed using Stata 15 software. Additionally, we conducted a subgroup analysis stratified by the severity of acne vulgaris.A total of 14 trials involving 1191 participants were included. Overall results revealed that acne vulgaris was associated with MDA concentrations (SMD = 1.73; 95% CI 1.05, 2.4; P < 0.001). Subgroup analyses indicated that the severity of acne vulgaris was correlated with levels of circulating biomarkers of oxidative stress. TAC concentrations were significantly lower in patients with moderate acne vulgaris compared to controls (SMD = - 1.37; 95% CI = - 2.15, - 0.58, P = 0.001). SOD concentrations were significantly lower (SMD = - 2.92; 95% CI = - 5.39, - 0.46, P = 0.02) and MDA concentrations were significantly higher (SMD = 2.26; 95% CI = 0.95, 3.57, P = 0.001) in patients with severe acne vulgaris compared to controls.Our results implied that oxidative stress may exist in acne vulgaris. Furthermore, the severity of acne vulgaris was also correlated with oxidative stress.

Exploring refugees' experience of accessing dental health services in host countries: a scoping review.

Refugees often face worse oral health outcomes, such as periodontal diseases and dental caries in host countries due to barriers including language and cultural differences, institutional discrimination, and restricted use of dental health services. This scoping review aims to map and summarise the available studies on refugees' experience of accessing dental health services in the host countries, to identify the main characteristics of the dental health services that refugees access and to explore the barriers and enablers to navigate the dental health service system in their host countries. The Joanna Briggs Institute (JBI) framework was adopted. PubMed, Scopus, Assia, CINAHL and Social Services Abstract were searched. A search strategy was developed using Medical Subject Headings (MeSH) terms and a combination of search operators and syntax used in MEDLINE were adopted for the remaining databases. Data were synthesised using thematic analysis. Fourteen articles were included. Most studies used qualitative methods and Australia seemed to be the country with the highest number of publications surrounding this topic. The included studies showed that refugees frequently encountered substantial obstacles when attempting to access dental services in host countries. Numerous barriers such as language barriers, cultural differences, and lack of health insurance or financial support hindered refugees' ability to access these services. Additionally, many refugees possessed limited knowledge of the dental care system in their new country. As a result of untreated dental problems, refugees suffered from pain and other health complications. This scoping review explored the challenges refugees have experienced in accessing dental health services in host countries, which included the key barriers such as affordability, accessibility, accommodation, availability, awareness, and acceptability. The scarcity of relevant research highlighted the need for a more comprehensive understanding of refugees' experiences accessing dental health services in host countries. Limited data were identified regarding evidence focusing on the characteristics of dental services accessed by refugees in host countries.

Bridging, Mapping, and Addressing Research Gaps in Health Sciences: The Naqvi-Gabr Research Gap Framework.

Innovations pertaining to the ever-evolving needs of the medical and healthcare sciences remain constant. This creates a gap between the rationalized needs of the study and the proposed research question. However, classifying, identifying, and addressing these research gaps require a systematic and precise structured map. Using the Medical Subject Heading (MeSH) terms "Research Gaps" AND "Healthcare" AND "Framework" in MEDLINE, Scopus, and CINAHL databases with the filters yielded no relevant literature. Therefore, this review aims to fill this practical and clinical knowledge gap by developing the Naqvi-Gabr Research Gap Framework through critical synthesis based on extensive research on medical and healthcare research gaps. Fourteen research gaps are distributed for allocation as per the healthcare delivery system approach: developing new treatments or prevention strategies, improving diagnostic tools and techniques, addressing health disparities, and improving access to healthcare services. This structured framework determines the strategic mapping of research gaps corresponding to the nature of the research. The identification and classification of the appropriate research gap led to precise and concise conclusions corresponding to the research process proposed in this study. Hence, the Naqvi-Gabr Research Gap Framework is a valuable tool for determining the potential application of gaps by researchers, policymakers, and other stakeholders with a productive address.

The Effectiveness of Neurofeedback on Improving Social Interactions and Activity of Daily Living in Children with Autism Spectrum Disorder: A Narrative Review

Context: Impairment in social interactions and daily activities of autism spectrum disorder (ASD) patients is one of the negative and important consequences of ASD. Recently, the use of non-pharmacological methods to improve behavior and rehabilitation in patients with ASD has attracted the attention of researchers and specialist physicians. According to the mentioned topic, This study aimed to evaluate the effectiveness of neurofeedback (NF) in improving social interactions and activity of daily living (ADL) in children with ASD. Evidence Acquisition: This narrative review obtained the desired results by collecting previous similar studies related to the study's primary purpose. First, 182 articles were extracted through the search of MeSH (medical subject headings) terms associated with the particular objectives of the study in international reliable databases. Then, twenty-five studies were selected as final studies considering the inclusion and exclusion criteria. Results: The results of the present study showed that NF can help to improve the performance of children with ASD through brain waves as a new treatment method based on conditioning and reinforcement. NF helps identify cognitive problems and improve cognitive processes in autistic children by improving self-regulation of the brain. In addition, NF leads to better cognitive performance by increasing beta waves and decreasing theta waves. On the other hand, increasing beta waves increases alertness, concentration, and metabolism, which can improve cognitive and social functioning. Conclusions: Based on the results, NF has a positive and significant effect in improving social interactions and ADL in children with autism spectrum disorder. Therefore, this method should be used to improve behavioral disorders and strengthen the ADL of patients with ASD, considering the side effects of pharmacological intervention methods.

Addressing burnout in surgery and vascular surgery

ObjectiveBy exploring the scientific literature, this article seeks to equip health care professionals with the knowledge to identify solutions to burnout within surgery and vascular surgery. MethodsA narrative literature review included French and English articles and was conducted in April 2023 with the help of PubMed and Google Scholar databases. Our search included specific Medical Subject Heading terms such as “burnout,” “solution,” and “healthcare.” The review focused on surgical specialties, with a particular lens toward vascular surgery when evidence was available. However, it was broadened to include non-surgical specialties to address knowledge gaps. Through the literature review, we canvased information about operational interventions against burnout, which was then described descriptively. ResultsWe presented a summary of interventions to mitigate burnout as a tiered approach, categorized into three groups that encompass the individual, the team, and the system. Research supports individual-focused interventions that enhance work-life balance and the use of other tools such as peer support groups, coaching, and counseling. Team-based strategies encompass relationships and mentorship as vital positive factors that curb burnout rates. Finally, the literature advocates for organizational support through good leadership and institutional investment into the workforce’s culture and well-being for solutions to burnout at the system level. ConclusionsThe prevalence of burnout in health care professionals is a public health crisis. Contemporary evaluations in the vascular surgery specialty demonstrate that nearly one-half of the workforce has experienced burnout. This paper explores the current literature to identify solutions that could help address burnout for vascular surgeons. Current literature supports a tiered approach to mitigate burnout that encompasses elements at the individual, team, and organizational levels.

Etiological Factors Affecting Female Sexuality: A Systematic Review

Introduction: Evidence suggests that masturbation, genital stimulation, body awareness and movement, pelvic floor exercises, depression, anxiety, positive and negative feelings, personality type, emotional and overall well-being and emotional intelligence have been studied in association with female orgasm through the years. Additionally, healthcare providers of sexual health and most women lack information regarding sexual satisfaction and reaching orgasm. Few studies have addressed this issue. Aim: To systematically study the effect of social, behavioral, and psychological factors on female orgasm. Methods: An extensive search was conducted in PubMed, CINAHL, Google Scholar and Scopus, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA) guidelines, for relevant articles published between June 2002 and June 2022. Studies in languages other than English were excluded. The following Medical Subject Headings (MeSH) terms were used: female, orgasm, psychological, behavioral, social, sexual. Inclusion criteria concerned studies that sampled adult healthy women, used quantitative methodology and explored factors influencing sexual satisfaction. Results: Out of 531 studies, forty-five were further screened. A total of twenty-one studies were reviewed, most of which were conducted in the USA, Portugal and the United Kingdom. They were followed by Switzerland, Iran, Brazil, Sweden, Canada, Hungary and the Netherlands. Four major themes influencing female sexual satisfaction emerged from the synthesis: psychological disorders, psychological background, genital stimulation, body awareness and movement. Conclusions: The female orgasm was influenced by a number of factors, some of which adversely affected it.