Observational Studies Research Articles

Exploring the Role of Internalized Weight Bias as a Metric of Cumulative Social Disadvantage Among People With Obesity or Overweight: Insights From the OBSERVE Study

ABSTRACTBackgroundExperiencing bias and stigma are social determinants of health (SDoH). Recently, internalized weight bias (IWB) has been included as an SDoH in obesity medicine. This study examined the association of IWB with other pillars of SDoH and how IWB contributes to cumulative social disadvantage for people living with obesity.MethodsA cross‐sectional, web‐based survey was conducted in the United States (May–December 2022) with a sample of adults with obesity or overweight. Multiple linear regression was performed to evaluate the relationship between WSSQ (higher score indicating experiencing more IWB) and other pillars of SDoH.ResultsParticipants who reported race as Black (adjusted mean difference [95% CI] −3.86 [−5.21, −2.52]; p < 0.001) or multiracial (−3.26 [−5.37, −1.16]; p = 0.002) had significantly lower total WSSQ scores than those who self‐identified as White race. Participants who experienced negative social interactions due to weight had significantly higher total WSSQ scores (7.04 [5.81, 8.27]; p < 0.001) than those who did not.ConclusionThe study showed that IWB is associated with certain other pillars of SDoH. Findings highlight the need for a comprehensive and patient‐centric approach to managing individuals with greater IWB, which may contribute to a higher cumulative social disadvantage and, consequently, worse health outcomes.

Lipid variations in different polycystic ovary syndrome phenotypes: A systematic review &amp; meta-analysis

Background &amp; objectives Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting reproductive-age women worldwide. Lipid abnormalities, such as elevated low-density lipoprotein (LDL) and triglyceride (TG) levels and reduced high-density lipoprotein (HDL) levels, are commonly observed in women with PCOS, increasing their risk of cardiovascular disease (CVD). Therefore, this study aims to quantify the magnitude and pattern of lipid levels (total cholesterol, HDL, LDL, and TG) in women with different phenotypes of PCOS versus control women. Methods Worldwide published observational (cross-sectional, case-control, and cohort) studies between January 2010 and December 2024 were systematically searched and assessed using electronic databases, such as PubMed, Google Scholar, Science Direct, and Web of Science-Science Citation Index, where women suffering from different PCOS phenotypes were compared with non-PCOS controls. The association between lipid levels and PCOS was estimated by the mean difference (MD) with a 95% confidence interval (CI). Results The studies included 3655 PCOS patients (phenotype A 1907, phenotype B 474, phenotype C 764, phenotype D 510) and 1824 control participants. Women with the complete phenotype polycystic ovarian morphology plus hyperandrogenism plus ovulatory dysfunction (PCO+HA+O) had increased levels of total cholesterol, LDL cholesterol, and TGs compared to women with other PCOS phenotypes. Total cholesterol was 12.69 mg/dl [95% confidence interval (CI): 8.25, 17.13] in phenotype A. TG levels exhibited the greatest MD in phenotype A and the smallest in phenotype C when compared to control subjects. Interpretation &amp; conclusions The study found significant differences in lipid levels among different PCOS phenotypes compared to control women, highlighting the significance of recognising these differences for cardiovascular risk management.

Equity in neuromuscular research: a 20-year analysis of race, ethnicity, sex, and age representation.

We conducted a systematic analysis of studies on neuromuscular diseases registered on ClinicalTrials.gov over the last 20years to assess disparities in study populations. Data from interventional and observational neuromuscular disease studies initiated between January 1, 2004, and December 31, 2024, were retrieved from ClinicalTrials.gov and PubMed/MEDLINE. Collected variables included participant race, ethnicity, sex, eligible age range, mean and median ages, as well as study funding source, start year, and phase. These variables were analyzed to evaluate disparities in race, ethnicity, and age across studies and over time. A total of 2166 studies were screened, with 462 meeting inclusion criteria, encompassing data from 37,131 participants. Most participants were male (61.4%), White (83.5%), and non-Hispanic/Latino (87.6%). While the proportion of studies reporting race and ethnicity increased over time (p < 0.001 and p = 0.001, respectively), the racial and ethnic composition of participants remained unchanged (p = 1). Studies on X-linked recessive disorders (i.e., Duchenne muscular dystrophy (DMD), Becker muscular dystrophy, and spinal and bulbar muscular atrophy (SMA)) predominantly excluded female participants. Regarding age accessibility, 37.9% of studies allowed children. Similarly, trial accessibility for older adults was limited. Even in studies with broader age eligibility, mean and median participant ages clustered around midlife, with underrepresentation at both age extremes. Notably, about half of DMD and SMA studies excluded participants over 16 and 18years, respectively. Significant disparities persist in race, ethnicity, and age representation in neuromuscular disease clinical research, highlighting the need for more inclusive study designs.

Prostate Cancer and Dietary Sugar Intake: A Systematic Review

Background: Prostate cancer is a leading malignancy among men globally, with its incidence expected to rise due to aging populations and shifting lifestyles. While established risk factors include age, ethnicity, and genetics, the role of modifiable dietary factors, particularly sugar intake, remains less clear. Emerging evidence suggests that high sugar consumption may promote carcinogenesis through insulin resistance, chronic inflammation, and hormonal dysregulation. This systematic review aimed to evaluate the current evidence on the association between dietary sugar intake and prostate cancer risk. Methods: A systematic search was conducted across six databases for observational studies published between January 2005 and April 2025. Eligible studies assessed the associations between quantitative sugar intake and prostate cancer outcomes. Screening, data extraction, and a risk of bias assessment (using ROBINS-E) were performed independently by multiple reviewers. Results: Six studies met the inclusion criteria, comprising four prospective cohorts, one case–control study, and one cross-sectional study, with a combined sample of 11,583 men from the USA, Canada, Sweden, and France. Three studies reported a significant positive association between a high intake of dietary sugars and prostate cancer risk, two found no association, and one showed mixed findings depending on the type of sugar. Heterogeneity in the exposure assessments and confounder control limited the comparability. Conclusions: This review suggests a possible association between high dietary sugar intake and increased prostate cancer risk, especially from added sugars and sugar-sweetened beverages. However, inconsistent findings and methodological limitations highlight the need for robust, prospective studies with standardized assessments to understand this relationship better.

Tendencies toward triadic closure: Field experimental evidence

Empirical social networks are characterized by a high degree of triadic closure (i.e., transitivity, clustering): network neighbors of the same individual are also likely to be directly connected. It is unknown to what degree this results from dispositions to form such ties (i.e., to close open triangles) per se versus other processes such as homophily and more opportunities for exposure. These mechanisms are difficult to disentangle in many settings. On social media, however, they can be decomposed - and platforms frequently make decisions that depend on these distinct processes. Here, using a field experiment on social media, we randomize the existing network structure that a user faces when they are followed by a target account that we control. We then examine whether the user reciprocates this tie formation. Being randomly assigned to have an existing tie to an account that follows the target user increases tie formation by 35%. Through multiple control conditions, we attribute this effect specifically to a minimal cue that indicates the presence of a potential mutual follower. Theory suggests that triadic closure should be especially likely in open triads of strong ties, and accordingly we find larger effects when the subject has interacted more with the existing follower. These results indicate a substantial role for tendencies toward triadic closure, but one that is substantially smaller than what might be inferred from prior observational studies. Platforms and others may rely on these tendencies in encouraging tie formation, with broader implications for network structure and information diffusion in online networks.

From Banff 1991 to Today: The Changing Landscape of the v-Lesion in Kidney Transplant Rejection

Intimal arteritis (v-lesion) has long been considered a hallmark of higher-grade T cell-mediated rejection (TCMR) in kidney transplantation, historically associated with poor graft survival and resistance to therapy. These associations have informed treatment strategies, often prompting intensified immunosuppression, including anti-thymocyte globulins (ATG). However, emerging evidence challenges the assumption that all v-lesions signify TCMR—particularly when they occur in isolation, without significant tubulo-interstitial inflammation. Recent observational studies and molecular analyses suggest that isolated v-lesions may instead reflect non-immune injury mechanisms, such as ischemia-reperfusion injury, particularly in the early post-transplant period. In addition, the shared nature of the v-lesion between TCMR and antibody-mediated rejection (AMR) raises concerns about overdiagnosis and potential overtreatment of “mixed rejection” phenotypes. Following advances in modern immunosuppression and improved donor-recipient matching, the clinical course of v-lesions may have evolved, with severe v3 presentations now rare—rendering historical comparisons less applicable to current practice. These insights highlight the need to revisit traditional paradigms and adopt a more nuanced, context-aware interpretation of v-lesions. This review integrates historical and contemporary perspectives, advocating for a reappraisal of the role of the v-lesion in kidney transplant biopsy evaluation.

A review on mTOR inhibitor use and outcomes of COVID-19 among patients with kidney transplantation

Kidney transplant recipients are at increased risk of severe COVID-19 due to immunosuppression and the impact of mTOR inhibitors on outcomes remains unclear. Hence, we evaluated 24 observational studies with 5,882 kidney transplant patients to assess the association of mTOR inhibitors with COVID-19 severity and mortality. Random-effects models showed that mTOR inhibitors were significantly associated with reduced mortality (OR=0.63, 95% CI 0.48–0.83, P=0.001) but not with COVID-19 severity (OR=0.70, 95% CI 0.41–1.20, P=0.865). Thus, mTOR inhibitors may provide a survival benefit in kidney transplant patients with COVID-19, highlighting the need for further research.

Ethnopharmacological Study of Medicinal Plants in Kedungpoh Village, Nglipar Sub-district, Gunungkidul District, Special Region of Yogyakarta

The scientific study of ethnopharmacology investigates the medicinal uses of plants by different ethnic groups and plays a crucial role in the early-stage drug discovery process by identifying potential drug candidates from traditional remedies. The transmission of knowledge concerning the diversity of plant species and their utilization is typically an intergenerational process, facilitating the preservation of cultural heritage and the transfer of experiential knowledge. The present study was conducted in the village of Kedungpoh, Nglipar, Gunungkidul. The objective of this study is to investigate the utilisation, management and comprehension of medicinal plants within the Kedungpoh village in Gunungkidul.The research methodology comprised of observational studies and interviews with local residents. The results revealed the utilization of 24 plant species, which classified into 17 distinct families by the local community. The utilization of these plants encompassed various plant organs, including leaves, stems, roots, fruits, and rhizomes, which were employed in different processing methods, such as crushing, boiling, or rubed. The most prevalent and utilized plant families were Asteraceae, which are notable for their abundance of bioactive compounds, including flavonoids, alkaloids, and essential oils, which have been demonstrated to be efficacious in addressing a wide range of health concerns. This study provides substantial support for scientific laboratory research into the safety, quality and efficacy of traditional medicine practices, with a view to further utilization of traditional medicine, whilst also protecting the intellectual property rights of traditional knowledge holders.

Heart rate variability in people with multiple sclerosis: A systematic review and meta-analysis.

Multiple sclerosis (MS) is a neurodegenerative disease with diverse symptoms, including autonomic nervous system impairment. While autonomic dysfunction is well-documented in MS, debate continues over its extent and whether it primarily affects the sympathetic or parasympathetic divisions. This review aimed to investigate heart rate variability (HRV) as an indicator of cardiac autonomic function in people with MS (PwMS)." PubMed/MEDLINE, Web of Science, Embase, and Scopus were systematically searched up to August 2024 to identify observational studies that assessed HRV in PwMS and healthy controls (HCs). The standard mean difference (SMD) of HRV parameters, along with its 95% confidence interval (CI), between PwMS and HCs was estimated utilizing R version 4.4.0 within the random-effects model. This study combined data from 43 studies on 1518 PwMS and 1062 HCs. The meta-analysis revealed significant autonomic dysfunction in PwMS compared to HCs. Specifically, the time-domain measures such as root mean square of successive differences (RMSSD) (SMD = -0.81, p < 0.01) and pNN50 (SMD = -0.63, p < 0.001) showed significant reductions in PwMS, compared to HCs. Furthermore, among frequency domains, high frequency (HF) power (SMD = -0.51, p < 0.01) and low frequency (LF) power were significantly lower in PwMS (SMD = -0.44, p < 0.05) than HCs. This review revealed that PwMS exhibited different HRV than healthy individuals. Additionally, HRV findings demonstrated greater sympathetic dominance in PwMS compared to healthy individuals. Future studies are needed to explore HRV in PwMS across varying severity levels, subtypes, and treatments to understand autonomic dysfunction in this population better.

Glucagon-like Peptide-1 Receptor Agonists: A New Frontier in Treating Alcohol Use Disorder

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), which were originally developed for managing type 2 diabetes by enhancing insulin secretion and reducing appetite, have emerged as promising candidates in alcohol use disorder (AUD). These medications offer a dual mechanism of action that aligns with the multifaceted nature of addiction by targeting both peripheral metabolic and central reward pathways. This review focused on the current clinical trials and real-world evidence regarding the effects of GLP-1RAs as novel therapeutics for AUD. We also discussed early but encouraging results from clinical trials in AUD, observational and real-world evidence, safety profiles, psychiatric considerations, and future directions leading beyond GLP-1RAs. Methods: A comprehensive English-language literature search was conducted per PRISMA guidelines across PubMed, Medline, Google Scholar, Web of Science, and trial registries. Using targeted keywords, we identified relevant clinical and observational studies on GLP-1RAs for alcohol use disorder, excluding off-topic or non-English works and assessing all studies for eligibility. Results: Out of 1080 records identified, seven studies met the inclusion criteria. The findings from recent clinical trials, large-scale observational studies, and real-world evidence suggest that GLP-1RAs may significantly reduce alcohol consumption, cravings, and alcohol-related hospitalizations. Their central effect on reward processing, coupled with a generally favorable safety profile, supports their potential therapeutic role beyond metabolic disorders. Conclusions: Emerging evidence positions GLP-1RAs as a promising new pharmacologic approach for managing AUD. Ongoing and future research should prioritize larger, longer-duration randomized controlled trials that include diverse populations, with specific attention to treatment motivation, co-occurring psychiatric conditions, and long-term outcomes.

Janus Kinase Inhibitors, Monoclonal Antibodies, and Fecal Microbiota Transplantation: Promising Therapies for Ulcerative Colitis

Ulcerative colitis (UC) is a chronic inflammatory bowel disease involving genetic, environmental, immunological, and microbial factors. Traditional treatments often fail in certain patient populations, necessitating exploration of more personalized therapies. This review aims to evaluate the efficacy, safety, and clinical potential of three emerging therapies for UC: Janus kinase (JAK) inhibitors, anti-TL1A monoclonal antibodies, and fecal microbiota transplantation (FMT). This narrative review was conducted by searching PubMed and Google Scholar for relevant peer-reviewed literature. Inclusion criteria focused on studies published in the last 10 years that investigated the mechanisms, clinical efficacy, or safety of JAK inhibitors, anti-TL1A antibodies, or FMT in UC. Both randomized controlled trials and observational studies were included. This narrative review explores emerging therapeutic strategies for ulcerative colitis, including Janus kinase inhibitors, monoclonal antibodies, and fecal microbiota transplantation. These approaches may support personalized treatment planning, particularly in patients who are refractory to conventional therapies.JAK inhibitors including tofacitinib, upadacitinib, and filgotinib demonstrated effectiveness in inducing and maintaining remission, although safety profiles varied based on selectivity. Anti-TL1A monoclonal antibodies, particularly PF-06480605 and tulisokibart, showed dual anti-inflammatory and anti-fibrotic activity, especially in patients with specific genetic biomarkers. FMT emerged as a non-pharmacological intervention capable of modulating gut microbiota and mucosal immunity, contributing to clinical and endoscopic remission in patients refractory to standard treatments. These three therapeutic modalities represent a significant shift toward individualized, pathophysiology-based treatment of UC. Future research should focus on biomarker-guided therapy selection, optimization of FMT protocols, and long-term safety data to support integration into clinical practice. Keywords: Fecal microbiota transplantation, janus kinase inhibitors, monoclonal antibodies, ulcerative colitis

Ore Genesis of the Jurassic Granite-Hosted Naizhigou Gold Deposit in the Jiapigou District of Northeast China: Constraints from Fluid Inclusions and H–O–S Isotopes

The Jiapigou mining district (&gt;180 t Au) is an important gold district in China. For a long time, the ore genesis of the gold deposits in the Jiapigou district has been a subject of controversy and differing opinions, which has severely hindered metallogenic theories and mineral exploration. Here we present a comprehensive investigation including geology, fluid inclusions (FIs), and H–O–S isotopic data for the Naizhigou deposit in the Jiapigou district to elucidate the sources of orefluids and metals, as well as the metallogenic mechanism. The results show the following: (1) The Naizhigou deposit is characterized by quartz vein-type ores and is hosted in the Middle Jurassic granitic pluton. Native gold and sulfides were mainly deposited in the second stage (quartz–polymetallic sulfides) compared with the first (quartz–pyrite–molybdenite) and third (quartz–calcite) stages. (2) The FI studies indicated that the orefluids evolved from the early–main-stage CO2–H2O–NaCl system to the late-stage H2O–NaCl system and have homogenization temperatures of 289–363, 210–282, and 124–276 °C and salinities of 4.1–20.9, 5.8–16.4, and 6.1–12.7 wt% NaCl equivalent, respectively. Fluid boiling and fluid mixing collectively controlled the precipitation of gold and ore-forming elements. (3) The δD values of the FIs hosted in quartz from the three stags range from −81 to −75 ‰, from −99 to −86 ‰, and from −110 to −101 ‰, while δ18Owater values of these FIs range from 5.3 to 5.9 ‰, from 1.1 to 5.2 ‰, and from −2.1 to −0.7 ‰, respectively. Pyrite samples from the three stages in the Naizhigou deposit have δ34S values of 2.1 to 2.5 ‰, 3.1 to 4.3 ‰, and 3.8 to 3.9 ‰, respectively. The stable isotopes indicate that the orefluids and metals mainly originated from magma. A comparative study of regional observations reveals that the Naizhigou deposit is a magmatic-related mesothermal gold deposit, rather than a metamorphism-related orogenic gold deposit. The estimated ore-forming depths are 4.0–20.7 km, with exhumation depths of 4.1–5.5 km, which indicated that the deposit has been well preserved. Regionally, the new exploration strategies should place greater emphasis on work concerning ore-related plutons, ore-controlling faults, and hydrothermal alteration.

How do Different Surgical Techniques for Cataract Removal Impact Quality of Life And Functional Vision in Elderly Patients? : A Systematic Review

Introduction: Age-related cataracts significantly impair vision and diminish the quality of life in elderly individuals worldwide. Cataract surgery is the primary intervention to restore vision and improve daily functioning, but the variety of surgical techniques and intraocular lens (IOL) options necessitates understanding their impact on patient outcomes. This systematic review evaluates the impact of different cataract surgery techniques on the quality of life and functional vision of elderly patients, synthesizing evidence from recent clinical trials and observational studies to identify optimal surgical approaches. Methods: This systematic review adhered to the PRISMA 2020 guidelines. We included studies focusing on patients aged 60 and older with age-related cataracts, evaluating surgical techniques like phacoemulsification, MSICS, or ECCE. Eligible studies were primary research (RCT, cohort, case-control) or systematic reviews/meta-analyses, measuring both quality of life and functional vision outcomes with at least a 3-month follow-up. Data extraction by a large language model focused on study design, setting, participant demographics, surgical technique, and visual performance/quality of life outcomes. The search strategy utilized Boolean MeSH keywords across databases like PubMed, Semantic Scholar, Springer, and Google Scholar. Results: Out of 1538 initial records, 14 studies were included. Visual acuity improved in 13 out of 14 studies, with 10 showing statistically significant improvement. All 14 studies reported improved functional vision or patient-reported outcomes, with 10 achieving statistical significance. Six studies found significant quality of life improvement after intervention. Comparisons revealed no significant difference between femtosecond laser-assisted and standard phacoemulsification, while multifocal/trifocal IOLs improved intermediate/near vision but increased dysphotopsia. Second eye surgery showed additional gains. MSICS was found to be cost-effective with comparable outcomes to phacoemulsification in resource-limited settings. Active-fluidics systems may offer faster early recovery. Discussion: The studies consistently show significant improvements in visual function and quality of life across various cataract surgery techniques, including phacoemulsification and MSICS. Second eye surgery further amplifies these benefits, encompassing socioemotional well-being. While advanced technologies like femtosecond laser-assisted phacoemulsification offer precision, they may not yield significantly better clinical or quality of life results compared to standard methods. The choice of IOL significantly impacts vision, with multifocal and trifocal lenses improving intermediate and near vision but potentially increasing dysphotopsia. MSICS provides a cost-effective alternative in certain settings , and active-fluidics systems may enhance early recovery. Patient-reported outcomes are crucial for capturing the real-world impact of surgery. Conclusion: Cataract surgery is highly effective in restoring vision and enhancing quality of life for elderly patients, with consistent improvements across various techniques. Phacoemulsification remains widely adopted, and advanced IOLs expand visual optimization. Bilateral surgery maximizes functional and emotional gains. Cost-effectiveness of MSICS and the promise of emerging technologies like active-fluidics systems underscore the need for individualized care based on patient needs, cost, and potential side effects.

Sustainable Plant-Based Diets and Food Allergies: A Scoping Review Inspired by EAT-Lancet

Background: The escalating prevalence of food allergies, alongside the global call for environmentally sustainable dietary transitions, has drawn attention to plant-based dietary models—particularly those inspired by the EAT-Lancet Commission. These frameworks not only reduce reliance on animal-sourced foods, benefiting planetary health, but may also play a role in modulating immune tolerance and allergic responses. Methods: This scoping review followed PRISMA guidelines and included 53 peer-reviewed studies published between 2000 and 2024, retrieved from PubMed, Scopus, and Google Scholar. Eligible articles were classified into two thematic domains: prevention of food allergy onset (n = 31) and modulation of allergic symptoms in sensitized individuals (n = 22). Included studies comprised randomized controlled trials (n = 6), observational studies (n = 17), systematic reviews and meta-analyses (n = 11), and narrative/scoping reviews (n = 19). Results: Sustainable plant-based diets were consistently associated with a lower incidence of allergic sensitization and reduced symptom severity. These effects were partly due to the exclusion of common allergens (e.g., dairy, eggs, and shellfish) but more importantly due to immunomodulatory mechanisms. Fermentable fibers can enhance short-chain fatty acid (SCFA)-producing bacteria (e.g., Faecalibacterium prausnitzii), elevating butyrate and acetate levels, which interact with G-protein-coupled receptors 43 and 109A (GPR43 and GPR109A) to induce regulatory T cells (Tregs) and reinforce epithelial integrity via tight junction proteins such as occludin and claudin-1. Polyphenols (e.g., quercetin and luteolin) can inhibit Th2-driven inflammation by stabilizing mast cells and downregulating IL-4 and IL-1. Conclusions: Following sustainable dietary guidelines such as those proposed by the EAT-Lancet Commission may confer dual benefits: promoting environmental health and reducing the burden of allergic diseases. By emphasizing plant-based patterns rich in fiber and polyphenols, these diets support microbiota-mediated immune education, mucosal barrier function, and immunological tolerance. When properly supervised, they represent a promising tool for allergy prevention and symptom management. Larger randomized trials and long-term population studies are needed to confirm and operationalize these findings in clinical and public health contexts.

Tolerance to surgically induced anisometropia-A systematic review.

Surgically induced anisometropia is well tolerated by some individuals, while others experience binocular visual complaints. Surgically induced anisometropia is a common treatment for presbyopia and may also intentionally or non-intentionally be the results after surgery for unilateral cataract with ametropia in the fellow eye. Research has shown significant variations in the tolerance of anisometropia. The aim of this systematic review was to examine the correlation between the degree of anisometropia, patient satisfaction and binocular visual complaints. We searched the databases: PubMed, EMBASE, Google Scholar, Cochrane and Web of Science for relevant reported studies. The search was supplemented with ongoing trials from www.clinicaltrials.gov. We searched for the following words: Anisometropia or monovision and satisfaction, aniseikonia, asthenopia, diplopia, headache, dizziness or fatigue. Our inclusion criteria encompassed all original studies, observational studies and randomized clinical trials that reported on clinical symptoms in patients with induced anisometropia. We included studies with induced anisometropia through cataract surgery or refractive surgery. Out of 1701 studies identified, 35 were included (N: 3186 patients): six randomized and 29 non-randomized studies. Six studies compared patients with surgically induced anisometropia to distance corrected emmetropic patients. Follow-up periods ranged from one to 32 months, with patient age from 22 to 96 years. Twenty-two studies reported on surgically induced anisometropia after cataract surgery, 13 after corneal refractive surgery and reported a combined mean anisometropia of 1.57 diopters (D). Overall, patient satisfaction with surgically induced anisometropia was generally high and comparable with emmetropia in four of six comparative studies. Independence from reading glasses was higher in anisometropic patients, while independence from glasses for distance vision was higher in emmetropic patients. Asthenopia was generally reported by few patients, and when it was reported, it was generally mild. In conclusion, this systematic review and meta-analysis of 35 studies involving 3186 patients suggests that surgically induced anisometropia just below 1 D is a viable approach to achieving high patient satisfaction with high degree of independence from reading glasses and minimal asthenopia. The majority of studies report high patient satisfaction and minimal incidence of asthenopia with no significant difference between anisometropic patients and distance-corrected emmetropic patients.

Impact of anti-VEGF therapy versus laser therapy on mortality and treatment outcomes in retinopathy of prematurity: A systematic review and meta-analysis.

Retinopathy of prematurity (ROP) is a major cause of childhood blindness, and selecting the optimal treatment between anti-vascular endothelial growth factor (anti-VEGF) and laser therapy is crucial. Understanding their impact on key outcomes, particularly mortality, is essential for informed clinical decision-making. A systematic literature search identified published studies comparing anti-VEGF and laser therapy for ROP up to December 31, 2024. Primary outcomes included mortality, retinal detachment, surgical interventions, myopia and neurodevelopmental outcomes. The risk of bias was assessed using the Cochrane Risk of Bias Tool and ROBINS-I. Data were synthesized using a random-effects model, with risk ratios (RR) and 95% confidence interval (CI). This review is registered in PROSPERO (CRD42024585336). A total of 12 randomized controlled trials (RCTs) and 58 observational studies, covering 10 516 infants, were included. Anti-VEGF therapy was associated with a higher mortality risk than laser therapy (RR: 1.68; 95% CI: 1.23-2.30), primarily in observational studies (1.85; 1.32-2.60), while RCTs showed no significant difference (1.02; 0.46-2.26). Anti-VEGF therapy was linked to lower risks of retinal detachment (0.36; 0.27-0.50), fewer surgical interventions (0.38; 0.22-0.65), and a lower risk of myopia (0.67; 0.54-0.82). No significant differences were found in neurodevelopmental outcomes (1.05; 0.96-1.15). Anti-VEGF therapy offers benefits over laser treatment, including reduced retinal detachment, fewer surgeries and lower myopia risk, with no observed increase in mortality or neurodevelopmental impairment. Future large-scale RCTs are needed to clarify mortality risks while minimising the impact of confounding factors.

Expert consensus on the burden of respiratory syncytial virus disease and the utility of nirsevimab for disease prevention and protection of infants.

Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide. In Singapore, RSV substantially contributes to the morbidity and mortality of children aged < 5years, particularly during their first year of life, with hospitalization rates peaking during epidemic outbreaks. This expert consensus paper aims to provide an overview of the RSV disease burden, unmet needs, and the urgency for RSV prevention in all infants. A comprehensive literature review was conducted using Medline via PubMed, to identify relevant studies, including randomized controlled trials, observational studies, systematic reviews, and meta-analyses, related to RSV burden and prevention and nirsevimab. A multidisciplinary group of physicians with RSV expertise from leading institutions in Singapore reviewed the literature on RSV-related topics, convened to deliberate and formulate evidence-based recommendations, summarizing the overall disease burden, unmet needs, and the optimal implementation of an immunization strategy for all infant protection against RSV infections in Singapore. Premeeting and in-meeting surveys were conducted to guide the development of final consensus recommendations. Epidemiology and burden of RSV in Singapore, current protection against RSV infections in infants, implementations of nirsevimab, and optimization of nirsevimab implementation in Singapore were discussed in this study. Although RSV brings substantial burden with underestimated costs, palivizumab is the only approved product for RSV prevention in Singapore. Existing evidences reveal that nirsevimab has a good safety profile and is effective in preventing RSV lower respiratory tract infections. Seven statements were formulated on the epidemiology and burden of RSV in Singapore, with emphasis on its high incidence and associated healthcare cost, and the clinical efficacy and safety of nirsevimab as a basis of its implementation for all infant protection in Singapore. The burden of RSV disease in young children is substantial, especially in those < 2years old, accounting for up to 47% of bronchiolitis and pneumonia admissions in children < 6months. The administration of a single dose of nirsevimab may be offered to infants at birth for the prevention of RSV in Singapore.

Guidelines on Lifestyle Changes and Breast Cancer-where are we up to and how does this Apply to Black Women with Breast Cancer.

Breast cancer remains a significant health concern globally, with lifestyle factors playing a crucial role in its prevention and management. This paper aims to summarize the current lifestyle guidelines for breast cancer for consistency and consensus of best practice and to explore their specific implications for Black women with breast cancer. There has been a growing body of data from both observational studies and some randomised controlled trials showing the relationship between diet, physical activity, body weight and cancer risk and outcomes. These has led to established national and international guidelines emphasizing the importance of lifestyle advice for survivors in reducing breast cancer risk and a drive for healthcare professionals to guide practice. However, the application and impact of these guidelines can vary across different populations, including Black women, who face unique challenges and disparities in breast cancer outcomes. Breast cancer survivors can benefit from counselling about lifestyle changes across the continuum from diagnosis, treatment through to survivorship. Guidelines recommending these changes for breast cancer survivors have been developed to guide healthcare professionals for consistency and best practice. Culturally sensitive approaches and targeted strategies are crucial to effectively reduce breast cancer disparities and improve survival rates in this population.

Influence of Electro-Acupuncture on Diplopia in Patients With Oculomotor and Abducens Nerves Palsy.

Diplopia (DP) can have a significant negative impact on one's quality of life, many clinical investigations lend credence to the notion that acupuncture could be used to treat DP symptoms, randomized controlled trials are lacking, and only clinical observational studies have assessed the effectiveness of acupuncture in managing DP. To examine the influence of electro-acupuncture on diplopia in patients with oculomotor and abducens nerve palsy. Forty eyes diagnosed with diplopia were randomly classified into study group (A) that received electro acupuncture therapy and standard prophylactic medications for 4weeks at points selected for treating double vision, and control group (B) who received standard prophylactic medications only. The Hess screen test was used to measure degrees of deviation. There were statistically significant differences in the post-test (p=0.38 and 0.003 respectively) in favor of the study group. In conclusion, integration between acupuncture therapies and standard prophylactic medications yields better results in treating DP.

Air Pollution and Pediatric Central Nervous Tumors: A Systematic Review of Evidence and Public Health Implications

Background: Exposure to environmental pollution, particularly air pollutants, and its relationship with childhood central nervous system (CNS) tumors is a growing public health concern. Understanding these associations is crucial for the implementation of protective measures for children and the development of strategic public policies. Objective: This systematic review examines the association between air pollution exposure and the risk of CNS tumors in the pediatric population aged 0-19 years. Methods: Following PRISMA guidelines, we used PubMed, SCOPUS, EMBASE, Google Scholar, and CENTRAL baselines up to May 2024. We included only observational studies focusing on children exposed to air pollutants, excluding tobacco-related exposures. Data on study design, population characteristics, exposure assessment, and types of CNS tumors were extracted and analyzed. Results: We included 25 studies (case-control and cohort) conducted across North America, Europe, Australia, and Asia. The studies assessed pollutants such as benzene, nitrogen dioxide (NO2), particulate matter (PM2.5), and polycyclic aromatic hydrocarbons (PAHs). Some studies reported positive associations between specific pollutants and increased CNS tumor risk, while others found no significant links. Variability in exposure assessment methods contributed to inconsistent findings. Conclusion: The evidence linking air pollution to childhood CNS tumors remains inconclusive. Further research, with standardized exposure assessments and consideration of critical exposure windows, is needed to clarify these associations and inform public health policies to reduce environmental risks to children.