Original Article Research Articles

Laparoscopic Orchidopexy after 4 Weeks of Testicular Traction with Preservation of Blood Supply: A New Concept for the Treatment of Intra-Abdominal Cryptorchidism: Original Article

Laparoscopic Orchidopexy after 4 Weeks of Testicular Traction with Preservation of Blood Supply: A New Concept for the Treatment of Intra-Abdominal Cryptorchidism: Original Article

Dietary Polycyclic Aromatic Hydrocarbon (PAH) Consumption and Risk of Adverse Birth Outcomes: A Systematic Review and Meta-Analysis.

There is suggestive epidemiological evidence that maternal dietary polycyclic aromatic hydrocarbons (PAH) may increase the risk of adverse birth outcomes. We sought to summarize the available evidence on the effect of dietary PAH exposure on birth outcomes. PubMed and Scopus databases were systematically searched from inception up to November 2022. Studies were included if they were original articles, were conducted in a human population, assessed dietary PAH consumption, and investigated the relationship between dietary PAH consumption and any adverse birth outcomes. Risk of bias in the included studies was assessed qualitatively and quantitatively. A random effects model was used to compute summary effect estimates in the meta-analysis. Six observational studies (five prospective cohort studies, and one prevalence case-control study) were included. The included studies assessed dietary PAH exposure using dietary questionnaires. Information on the outcomes of interest was obtained from medical records. Three of the included studies were rated as good quality with the remaining three studies rated as fair quality. One study was considered as having low risk of bias for selection, information and confounding bias. Dietary PAH consumption was associated with [95% confidence interval (CI): , 5.06] and (95% CI: , 0.01) reductions in birth weight and birth length, respectively, and an increase in head circumference [; 95% CI: , 0.005]. The CI of all the summary effect estimates, however, included the null value. In the sensitivity analysis that included only studies that assessed dietary PAH exposure as the primary exposure of interest, dietary PAH consumption was associated with much higher reductions in birth weight (; 95% CI: , ) and birth length (; 95% CI: , ). High statistical heterogeneity was observed in the birth weight and birth length analysis and in the head circumference sensitivity analysis. The body of epidemiological evidence suggests that maternal dietary PAH exposure is associated with reduced fetal growth, measured as birth weight and length. There was considerable heterogeneity in the measurement of PAH exposure among the included studies. Also, nonstandardized and validated dietary questionnaires were employed by a majority of the included studies with potential exposure misclassification. These issues are likely to impact the summary effect estimates computed and underscores the need for high-quality epidemiological studies with improved exposure assessment and adequate confounding control to strengthen the evidence base. https://doi.org/10.1289/EHP12922.

Cuidados de enfermería en la higiene bucal de pacientes intubados. Revisión de la Literatura

Objective: Determine nursing care in oral hygiene of intubated patients through a bibliographic review. Methods: A documentary, non-systematic and descriptive research was carried out on the nursing care received by intubated patients in intensive care units for oral hygiene, using databases such as: PubMed, BVS, Scielo, Google scholar, using descriptors from Health Sciences DESC and Medical Subject Headings MeSH, whose inclusion criteria were: original articles, bibliographic review and case reports directly related to the topic, published in the period 2019-2023, in language Spanish and English and of scientific quality (SJR). The bibliographic review was developed with nine bibliographic sources, predominantly qualitative and in English. Results: Oral hygiene care generally includes the use of oral antiseptics such as chlorhexidine, brushing with small soft bristles, suction and hydration of the oral cavity to reduce plaque formation and consequently infections and mortality in intubated patients. Conclusion: It is established that nursing care in oral hygiene of intubated patients is essential to keep the oral cavity clean, stimulate saliva flow, avoid inflammation, pain and discomfort in the patient, keep the mucosa and lips hydrated and above all reduce dental plaque, microbial and colonization of the oropharynx.

Direct-Acting Oral Anticoagulants in patients at extremes of body weight: a review of pharmacological considerations and clinical implications.

Patients at extremes of body weight are underrepresented in randomized controlled trials of direct-acting oral anticoagulants (DOACs). Therefore, their optimal anticoagulant treatment remains a topic of debate. The aim of this narrative review is to summarize the evidence on the pharmacokinetic and pharmacodynamic profile of DOACs for treating patients at extremes of body weight in venous thromboembolism (VTE) and in the prevention of cardioembolic stroke in nonvalvular atrial fibrillation (NVAF). A literature search was conducted in the main bibliographic databases, and the most relevant reviews and original articles on the topic were selected. Although data in these patient groups are limited, apixaban and rivaroxaban show a favorable pharmacokinetic and pharmacodynamic profile in obese VTE treatment and NVAF patients and, in the case of apixaban, also in underweight patients. In particular, these drugs demonstrated comparable efficacy and safety to standard therapy. Very few data were available for dabigatran and edoxaban; the latter drug was safer at a lower dose, mainly in underweight patients. Our findings are in line with the last International Society of Haemostasis and Thrombosis position paper and European Heart Rhythm Association 2021 practical guide, suggesting the use of apixaban and rivaroxaban in morbidly obese patients (>120 kg or body mass index ≥40 kg/m 2 ) and the reduced dosage of edoxaban in low-weight patients. Future studies should focus on large populations of patients at extremes of body weights to acquire more clinical and pharmacokinetic evidence on all available DOACs, especially those currently less investigated.

Knowledge structure and global trends of machine learning in stroke over the past decade: A scientometric analysis

ObjectiveMachine learning (ML) models have been widely applied in stroke prediction, diagnosis, treatment, and prognosis assessment. We aimed to conduct a comprehensive scientometrics analysis of studies related to ML in stroke and reveal its current status, knowledge structure, and global trends. MethodsAll documents related to ML in stroke were retrieved from the Web of Science database on March 15, 2023. We refined the documents by including only original articles and reviews in the English language. The literature published over the past decade was imported into scientometrics software for influence detection and collaborative network analysis. Results2389 related publications were included. The annual publication outputs demonstrated explosive growth, with an average growth rate of 63.99 %. Among the 90 countries/regions involved, the United States (729 articles) and China (636 articles) were the most productive countries. Frontiers in Neurology was the most prolific journal with 94 articles. 234 highly cited articles, each with more than 31 citations, were detected. Keyword analysis revealed a total of 5333 keywords, with a predominant focus on the application of ML models in the early diagnosis, classification, and prediction of “acute ischemic stroke” and “atrial fibrillation-related stroke”. The keyword “classification” had the first and longest burst, spanning from 2013 to 2018. ‘Upport vector machine’ got the strongest burst strength with 6.2. Keywords such as ‘mechanical thrombectomy’, ‘expression’, and 'prognosis' experienced bursts in 2022 and have continued to be prominent. ConclusionThe applications of ML in stroke are increasingly diverse and extensive, with researchers showing growing interest over the past decade. However, the clinical application of ML in stroke is still in its early stages, and several limitations and challenges need to be addressed for its widespread adoption in clinical practice.

Mitigating Cross-Species Viral Infections in Xenotransplantation: Progress, Strategies, and Clinical Outlook.

Xenotransplantation holds great promise as a solution to address the critical shortage of organs, but it raises concerns regarding the potential transmission of porcine viruses to recipients, leading to infections and even zoonotic diseases. Data used in this review were mainly from literature of Pubmed database. Keywords included xenotransplantation, infection, virus, and epidemiology. The original articles and critical reviews selected were relevant to this review's theme. We review the major viral infections of concern in xenotransplantation, their risk of transmission, diagnosis, treatment, and ways to prevent infection. Then, we pivot to a comprehensive overview of the current status of xenotransplantation. In addition, we offer our own insights and recommendations for propelling xenotransplantation forward, transitioning from preclinical experiments to the critical phase of clinical trials. Viral infections pose considerable safety concerns within xenotransplantation, particularly with the possibility of emerging or currently unidentified viruses. Clinical trials serve as a crucial platform to progress the safety standards of xenotransplantation. However, further studies and dedicated efforts are required to effectively translate findings into practical applications that can improve safety measures in this field.

Analysis of maternal-fetal complications associated with preeclampsia. Literature review

Objective: Identify maternal-fetal complications associated with preeclampsia. Method: the research was developed through a documentary review, a descriptive study, with a qualitative approach around maternal-fetal complications due to preeclampsia. It was investigated in high-impact databases such as: PubMed, Scielo, Scopus, Dimensions and the Google Scholar search engine. Inclusion criteria will be applied such as articles from the last 5 years, between 2018 and 2023, original articles in Spanish and English. The bibliographic review was developed with ten bibliographic sources. Results: It was identified that young women, especially between 20 and 34 years old, face a higher risk of preeclampsia, therefore, early detection is key and could be implemented in settings with limited resources. Furthermore, attention to risk factors, such as chronic hypertension, is vital, and the combination of acetylsalicylic acid and calcium is suggested in high-risk women as a pharmacological approach. Conclusion: It is revealed that there are significant maternal-fetal complications, such as high blood pressure and proteins in the urine, with serious consequences for the health of mother and child.

Development of Green Product Processes in Textile Industry Using Mathematical Modeling and NSGA-II Metaheuristic Algorithm: A Case Study in Oyaz Industrial Group Document Type : Original Article

Development of Green Product Processes in Textile Industry Using Mathematical Modeling and NSGA-II Metaheuristic Algorithm: A Case Study in Oyaz Industrial Group Document Type : Original Article

Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review.

A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.

Swedish nursing research: A bibliometric and content analysis revealing author and institute collaborations, impact, and topics

Nursing research plays a pivotal role in advancing healthcare practices and guiding the nursing profession. Given its global impact, understanding the unique characteristics of individual countries is important for identifying and comprehending the successful components of nursing research infrastructures. The aim of the present study was to analyze nursing research articles indexed as Swedish in the Web of Science Core Collection from the database's inception to the time of data collection. A search string was developed and employed to find relevant publications. Original research and review articles, indexed as Swedish and written in English, were included. Using a bibliometric and content analytical approach, evaluations of both research publications and their corresponding topics were conducted. A total of 7213 articles were included. The most prolific authors were part of extensive networks, as were the most productive higher educational institutes. International co-authorship made up 32% of all publications. The findings reveal comparably high productivity among Swedish nursing researchers, likely attributed to international collaborations as well as collaborations between universities and university hospitals. The research spanned diverse clinical and nursing-specific areas. The most cited articles focused on methodological or conceptual aspects. Current research topic trends encompass health literacy and telehealth/digital health.

Evidence Based Management of Labor.

Induction of labor (IOL) is a common obstetric intervention. Augmentation of labor and active management of the second stage is frequently required in obstetric practice. However, techniques around labor and induction management vary widely. Evidence-based practice regarding induction and labor management can reduce birth complications such as infection and hemorrhage and decrease rates of cesarean delivery. To review existing evidence on IOL and labor management strategies with respect to preparing for induction, cervical ripening, induction and augmentation, and second stage of labor techniques. Review of recent original research, review articles, and guidelines on IOL using PubMed (2000-2022). Preinduction, pelvic floor training and perineal massage reduce postpartum urinary incontinence and perineal trauma, respectively. Timely membrane sweeping (38 weeks) can promote spontaneous labor and prevent postterm inductions. Outpatient Foley bulb placement in low-risk nulliparous patients with planned IOL reduces time to delivery. Inpatient Foley bulb use beyond 6 to 12 hours shows no benefit. When synthetic prostaglandins are indicated, vaginal misoprostol should be preferred. For nulliparous patients and those with obesity, oxytocin should be titrated using a high-dose protocol. Once cervical dilation is complete, pushing should begin immediately. Warm compresses and perineal massage decrease risk of perineal trauma. Several strategies exist to assist in successful IOL and promote vaginal delivery. Evidence-based strategies should be used to improve outcomes and decrease risk of complications and cesarean delivery. Recommendations should be shared across interdisciplinary team members, creating a model that promotes safe patient care.

A Current State of the Art and Science of Exercise in Dialysis: A Narrative Review.

The purpose of the review is to discuss current proven benefits and problems of integrating exercise in the care of people receiving dialysis by reviewing literature from the last few years and identifying important questions that still need to be asked and answered. A focused review and appraisal of the literature were done. Original peer-reviewed articles, review articles, opinion pieces and guidelines were identified from PubMed and Google Scholar databases. Only sources in English were accessed. Search terms "exercise" and "dialysis" were used to find active recruiting randomized trials in various clinical trial registry platforms. Numerous studies have demonstrated the benefits of exercise training in individuals receiving dialysis, limited by factors such as short duration of follow-up and inconsistent adverse event reporting and outcomes selected. Notable gaps in exercise research in dialysis include ways to maintain programs and patient motivation, studies in peritoneal dialysis and home hemodialysis patients, and how best to define and measure outcomes of interest. This review summarizes the current state of exercise in people receiving dialysis and serves as a call to action to conduct large, randomized controlled trials to improve the quality of evidence needed to implement and sustain innovative, exercise interventions, and programs for this population.

The effects of pharmacists' counseling on patients with hypertension and diabetes mellitus; a systematic review

Proper management, medication adherence, and changes in lifestyle lead to control of diabetes and hypertension. Counseling patients is an approach to the management of hypertension and diabetes. Pharmacists\' counseling can assist patients in understanding their medications, coping with the barriers of the treatment plans, and receiving emotional support. This study aimed to assess the impact of counseling by pharmacists on hypertensive and diabetic patients by reviewing the previous studies who assessed this subject. Online databases, including PubMed, Science Direct, Google Scholar, Elsevier, Scopus, and Springer, were searched for eligible articles between the year 2018 and 2024. The terms including \"Pharmacists, Counselling, Outcomes, Diabetes mellitus, Diabetic, Hypertension, Hypertensive, Patients, HbA1C, SBP, and DBP\" were used for the search process. The included original English articles reporting counselling of diabetic/and/or hypertensive patients by pharmacists. A total of eight articles met the inclusion criteria and were involved in this review. The total number of patients was 1,390; there were three studies that assessed counseling impact on T2DM patients, three studies conducted on hypertensive patients, and two studies conducted on patients with both diseases. Counseling diabetic and/ or hypertensive patients by pharmacists resulted in potential improvement in the outcomes of diabetes and hypertension, improvement in BMI, lipid profile, adherence to medication, knowledge, attitude, and practice, as well as health related quality of life (HRQOL). Therefore, pharmacists have an important role in controlling diabetes and hypertension and improving patients' outcomes.

What We Know about HV.1 (EG.5.1.6.1) SARS-CoV-2 Variant

Background: HV.1 (EG.5.1.6.1) was the dominant strain in the U.S. as of the end of second week of December 2023, according to the U.S. Centers for Disease Control and Prevention (CDC). The strain is a descendant of EG.5 family that was identified in China in February 2023 and was first detected in the United States in April 2023. 44 mutations in S-protein, 2 in Membrane and Envelope viral structures, 5 mutations in the Nucleocapsid, 21 mutations in Orf1a, 1 mutation in Orf3a, Orf6, Orf10, and 2 mutations in Orf8 virus genome open reading frames are reported. The symptoms of HV.1 are similar that of other Omicron variants, these include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea, but congestion, sore throat and dry cough seem to be the three most prominent symptoms right now. Since HV.1 belongs to the same family as XBB, health experts assumethat updated vaccines are expected to be effective against this new dominant subvariant.The only way to distinguish (COVID-19) from RSV and flu, both of which are now gaining steam, is by testing. Aim: The purpose of the manuscript is to present a systematic review on the prevalence, structural, genomic, and pathogenic characteristics of HV.1 from October 1, 2023, as of December 31, 2023, emphasizing on the variant genetic characteristics, contagiousness, and potential pathogenicity. Material and Methods: Original scientific articles published in Medline, Pubmed, Science Direct, Web of Science, Scopus, EBSCO and BioMed Central databases, official health organizations electronic publications, and specialized media in the subject, were electronically searched to accomplish the aim of the study. Articles published in any language were included from October 2023 to present using a variety of keywords in combination. The studies relevant to our review were analysed and compared. Results and Discussion: HV.1 showed significantly lower plasma neutralisation titers compared with their parental strains after acquiring L452R and A475V mutations, explaining their growth advantages. A475V mutation also resulted in decreased binding affinity, enhancing immune evasion compared to HK.3 (XBB.1.5+FLip). However, the L452R mutation of HV.1 did not affect binding affinity. 44 mutations in S-protein, 2 in Membrane and Envelope viral structures, 5 in the Nucleocapsid, 21 in Orf1a, 1 mutation in Orf3a, Orf6, Orf10, and 2 in Orf8 virus genome open reading frames mutations are reported. These mutations give to HV.1 improved ability to enter the human cell, although no greater pathogenicity or severity of the symptoms. Conclusions: The latest data from US-CDC in 2023, shows HV.1 as the second prevalent SARS-CoV-2 variant in the United States. HV.1 (XBB.1.9.2.5.1.6.1 or EG.5.1.6.1) in October 2023, quickly increase its prevalence and surpassed other variants, includingEG.5 (Eris) to become the most prevalent strain in USA until week ending on December 9, 2023. HV.1 has a similar transmission rate, exhibits a greater evasive capacity of immune-generated antibodies than EG.5.1* family of SARS-CoV-2, produce similar symptoms that of other Omicron variants, are expected not to produce an increase in hospitalizations and mortality rate and the SARS-CoV-2 vaccines recently developed by Pfizer and Moderna, must be effective against this Omicron subvariant.For now HV.1 does not seem harmful in terms of creating a deadly disease but is still contagious enough to not be ignored.

Incorporating a Prognostic Gene Expression Profile Test into the Management of Cutaneous Squamous Cell Carcinoma: An Expert Consensus Panel Report.

 Cutaneous squamous cell carcinoma (cSCC) is a growing health concern with a rapidly increasing incidence. Disease-specific mortality is typically preceded by a metastasis, but current staging systems have significant limitations in predicting this event. The 40-gene expression profile (40-GEP) test is a validated method of further stratifying patients based on the risk of regional or distant metastasis, but limited guidelines exist for incorporating this test into clinical practice.  To review the available literature on the use of gene expression profile (GEP) testing to assess prognosis in cSCC and create consensus statements to guide dermatology clinicians on its use.  A comprehensive literature search of PubMed, EMBASE, and Scopus was completed for English-language original research articles on the use of GEP testing to assess cSCC prognosis. A panel of 8 dermatologists with significant expertise in diagnosing and managing cSCC gathered to review the articles and create consensus statements. A modified Delphi process was used to approve each statement and a strength of recommendation was assigned using the Strength of Recommendation Taxonomy (SORT) criteria.  The literature search produced 157 articles that met the search criteria. A thorough screening of the studies for relevance to the research question resulted in 21 articles that were distributed to the panelists for review prior to the roundtable discussion. The panel unanimously voted to adopt 7 consensus statements and recommendations, 6 of which were given a strength of "A" and 1 of which was given a strength of "C".  The 40-GEP test provides accurate and independent prognostic information beyond standard staging systems that only incorporate pathologic data. Incorporation of GEP testing into national guidelines can help further stratify patients based on risk of metastasis and thus may improve morbidity and mortality. J Drugs Dermatol. 2023;22(12):54-60.   doi:10.36849/JDD.7691.

Traditional uses, Phytochemistry and Pharmacology of Asparagus adscendens Roxb.: A Review

Background: Musali (Asparagus adscendens Roxb.) is a traditionally important medicinal plant of the family Asparagaceae. It is used worldwide to treat several ailments due to the presence of various bioactive constituents, mainly concentrated in the tubers of plants. It has been used since time immemorial as a popular drug for treating chronic leucorrhea, spermatorrhea, general weakness, diarrhea, dysentery, and pharmacological purposes like rejuvenation, aphrodisiac, etc. This review aimed to gather information on the traditional uses, phytochemistry, and pharmacology of Asparagus adscendens Roxb. Materials and methods: Primarily, classical literatures of Ayurveda, including Brihat-trayi (greater triad), Laghu-trayi (lesser triad), and Nighantus (lexicons), were reviewed for the terms “Musali” and “Shweta Musali.". Establishing an overview, library resources, and online collections of books and original research articles, other online databases such as Pubmed Central, Scopus, Embase, Web of Science, ERIC, IEEE Xplore, ScienceDirect, DOAJ, JSTOR, Henari, Google Scholar, and NepJoL were explored with search words like “Musali”, “Safed Musali”, “Shweta Musali” “Asparagus adscendens”, botanical characteristics, traditional and contemporary uses, pharmacognosy, phytochemical constituents, pharmacology, agriculture, and miscellaneous aspects. Ethnobotanical reports, wet laboratory experiments, pharmacognostic characteristics, phytoconstituents, and pharmacology (experimental works and clinical trials) are selected to include in this review. Evidence-based papers from indexed sources were also considered. Results and discussion: Asparagus adscendens has been used for the treatment of chronic leucorrhea, spermatorrhea, general weakness, diarrhea, dysentery, rejuvenation, and aphrodisiacs in Ayurveda by its various names and formulations since 1000 BC, the period of Agnivesa. This plant has great pharmacological actions such as antifertility, antioxidant, anthelminthic, antidiabetic, etc. Conclusion: Musali has been a unique gift of nature to mankind since time immemorial. It is a major ingredient in many Ayurvedic formulations. It has several uses, including as a strong "Rasayana" (rejuvenator), a tonic and vitalizer that promotes health, a therapeutic remedy for prenatal and postnatal problems, a restorative agent that boosts immunity, and a strong aphrodisiac. It will take a number of scientific endeavors to investigate the pharmacological actions that are hidden and described in the classics. To assess the pharmacotherapeutics of Asparagus adscendens and provide a solid, evidence-based treatment, more clinical studies may be carried out.

Effectiveness of Single-Tablet Combination Therapy in Improving Adherence and Persistence and the Relation to Clinical and Economic Outcomes

Background: Single-tablet combination therapies (STCTs) combine multiple drugs into one formulation, making drug administration more convenient for patients. STCTs were developed to address concerns with treatment adherence and persistence, but the impact of STCT use is not fully understood across indications. Objectives: We conducted a systematic literature review (SLR) to examine STCT-associated outcomes across 4 evidence domains: clinical trials, real-world evidence (RWE), health-related quality of life (HRQoL) studies, and economic evaluations. Methods: Four SLRs were conducted across the aforementioned domains. Included studies compared STCTs as well as fixed-dose combinations ([FDCs] of non-tablet formulations) with the equivalent active compounds and doses in loose-dose combinations (LDCs). Original research articles were included; case reports, case series, and non-English-language sources were excluded. Databases searched included EconLit, Embase, and Ovid MEDLINE® ALL. Two independent reviewers assessed relevant studies and extracted data. Conflicts were resolved with a third reviewer or consensus-based discussion. Results: In all, 109 studies were identified; 27 studies were identified in more than one SLR. Treatment adherence was significantly higher in patients receiving FDCs vs LDCs in 12 of 13 RWE studies and 3 of 13 clinical trials. All 18 RWE studies reported higher persistence with FDCs. In RWE studies examining clinical outcomes (n = 17), 14 reported positive findings with FDCs, including a reduced need for add-on medication, blood pressure control, and improved hemoglobin A1C. HRQoL studies generally reported numerical improvements with STCTs or similarities between STCTs and LDCs. Economic outcomes favored STCT use. All 6 cost-effectiveness or cost-utility analyses found FDCs were less expensive and more efficacious than LDCs. Four budget impact models found that STCTs were associated with cost savings. Medical costs and healthcare resource use were generally lower with FDCs than with LDCs. Discussion: Evidence from RWE and economic studies strongly favored STCT use, while clinical trials and HRQoL studies primarily reported similarity between STCTs and LDCs. This may be due to clinical trial procedures aimed at maximizing adherence and HRQoL measures that are not designed to evaluate drug administration. Conclusions: Our findings highlight the value of STCTs for improving patient adherence, persistence, and clinical outcomes while also offering economic advantages.

Global knowledge mapping and emerging research trends in the microbiome and asthma: A bibliometric and visualized analysis using VOSviewer and CiteSpace

BackgroundNumerous prior studies have extensively highlighted the significance of the microbiome in association with asthma. While several studies have concentrated on the asthma microbiome in previous research, there is currently a lack of publications that employ bibliometric methods to assess this area. MethodsIn this study, the Web of Science Core Collection database was utilized as the data source, and the SCI-EXPANDED index was employed to ensure that the retrieved data were comprehensive and accurate. All original research articles and review articles related to the correlation between asthma and the microbiome were systematically searched from the inception of the database until June 20, 2023. These articles were subsequently visualized and analyzed using VOSviewer and CiteSpace software. ResultsA total of 1366 relevant publications were acquired, indicating a consistent annual increase in global publications in the field. The United States and China emerged as the top two contributors to international publications. Among prolific authors, Susan V. Lynch achieved the highest publication record, with Hans Bisgaard and Jakob Stokholm sharing the second position. The majority of publications concentrated on allergy-related and microbiome areas, with a few comprehensive journals standing out. Journals with 40 or more publications included the Journal of Allergy and Clinical Immunology, Allergy, Frontiers in Immunology, and PLOS One. The top 5 cited journals were the Journal of Allergy and Clinical Immunology, PLOS One, American Journal of Respiratory and Critical Care Medicine, Clinical and Experimental Allergy, and Nature. Upon analyzing keywords, high-frequency terms, such as asthma, gut microbiota, microbiome, children, childhood asthma, allergy, risk, exposure, inflammation, diversity, and chain fatty acids emerged as representative terms in the field. ConclusionThis study systematically presented a comprehensive overview of the literature regarding the association between asthma and the microbiome over the last two decades. Through a bibliometric perspective, the findings may assist researchers with a better understanding of the essential information in the field.

Preliminary discussion on pyrrhotite, gold killer in Wells-Barkerville, British Columbia, Canada

The Wells-Barkerville area of the Cariboo gold mining district is situated within the Quesnel Highlands on the eastern edge of the Interior Plateau in central British Columbia, Canada of the eastern Circum-Pacific volcanicmetallogenic belt. Recorded gold production from the area totals more than 4.0 million ounces, including an estimated 2.7 million ounces from placer mining from 101 creeks and 1.3 million ounces from lode mining. There are five principal types of lode gold deposits in the district; namely, auriferous pyrite replacement, including replacement in limestone and that in calcareous clastic rock; pyrite-quartz vein/veinlet lode gold, including strike vein, diagonal vein, orthogonal vein, and quartz veinlets; basalt-hosted auriferous pyrrhotite-pyrite lode gold; and associated gold in porphyry copper styles. This area is historically a famous gold production area in western Canada, including the initial alluvial gold and later and current lode gold. This original short article uses drilling results to illustrate that pyrrhotite in this area is the killer of gold. Wherever there is pyrrhotite, the gold grade is very poor or even contains no gold. In other words, gold grade is inversely related to pyrrhotite content. Then, the spatial distribution characteristics of the pyrrhotite anomaly zone(s) existing in this area were summarized, including the approximate thickness of zone(s). On this basis, several deep drill holes are recommended to verify whether there is considerable gold mineralization beneath the pyrrhotite anomaly zone(s).

Assessment Tools for Detecting Malnutrition among Elderly in Shelter Homes: A Systematic Review

Assessing nutritional status in older people is essential to screen for malnutrition and identify the individuals requiring nutritional intervention for a better quality of life and longer life expectancy. This review aimed to investigate malnutrition and the role of nutritional assessment tools among older people in Malaysia. We systematically reviewed the publications from 2000 to 2019 using PubMed/MEDLINE and Scopus databases, recovering 15 original articles published until January 2022. This systematic review was conducted from May to September 2022. Two reviewers were involved in the process of the selection of articles and data extraction. Only research papers on malnutrition among older people in institutionalized settings in Malaysia were included. Four articles related to malnutrition in older people in old folk homes in Malaysia were included in this review. The tools with the most significant evidence were Mini Nutritional Assessment (MNA) and Nutritional Health Checklist (NHC) in residential care for the elderly. It was found that the incidence of malnutrition among the elderly in old folk homes in Malaysia ranged from 12.3% to 17.4%. Meanwhile, 40.4% to 57.7% of the population are documented to be at risk of malnutrition. NA and DETERMINE NHC were found to be most suitable for use in residential care due to their high sensitivity and specificity. A subsequent study is proposed to build and implement a scoring system to rate screening tools based on the validity, suitability, and practicability of the tools to help with malnutrition screening research and clinical practice in Malaysia and internationally.