Original Research Articles Research Articles

Flow diversion for the treatment of intracranial bifurcation aneurysms: a systematic review and meta-analysis

BackgroundFlow diversion (FD: flow diversion, flow diverter) is an endovascular treatment for many intracranial aneurysm types; however, limited reports have explored the use of FDs in bifurcation aneurysm management. We...

Cost identification in health professions education: A scoping review.

Resource scarcity in health professions education (HPE) demands rigorous consideration of costs. Yet, thus far, we have been unable to completely and consistently identify the costs of HPE. To address this knowledge gap and enable use of economic evidence in decision making, a detailed overview of all existing costs and approaches to cost identification in HPE is needed. This review summarises the diversity of costs, cost perspectives and cost identification methods used in economic research of HPE to answer the following questions: which educational topics, costs, cost perspectives and cost identification methods are being investigated in HPE literature? This investigation followed the Joanna Briggs Institute guidelines for scoping reviews. PubMed, ERIC, CINAHL and PsycINFO were iteratively searched for English language publications between 2012 and 2022 that reported costs of HPE. Data was extracted for study characteristics, educational context and economic methodology. A total of 136 articles of original research on the costs of educating all major licence healthcare professionals were included. A diffuse interest in costs is reflected in publications from 93 distinct journals and by the diversity of educational topics and cost types explored. However, the majority of investigations failed to define the cost perspective (86, 63%) and cost identification methods (117, 86%) and did not demonstrate common reporting structure or cost terminology, all of which contribute to persistent inconsistencies in cost identification. The source of disharmonious cost identification in HPE is fuelled by diverse interests and divergent concepts of costs and costing methodology. Left in its current state, disharmonious cost identification will continue to limit transparency, comparison and synthesis of evidence, hamper objectivity in implementation and policy decisions and impede the efficient and sustainable allocation of resources. A research agenda must be developed, prioritised, and validated by the broader community to develop a theoretical framework for HPE cost research, define stakeholders, elicit values and preferences and chart a path toward harmonised costing.

758 An Appraisal of the Quality of Development and Reporting of Predictive Models in Neurosurgery

INTRODUCTION: Overwhelming evidence indicates that the quality of reporting of predictive models is poor, often being confounded by small datasets, inappropriate statistical methods, a lack of validation, and reproducibility. METHODS: Articles reporting prediction models published in the top five neurosurgery journals by SJR2-rank (Neurosurgery, Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of NeuroInterventional Surgery, and Journal of Neurology, Neurosurgery, and Psychiatry) between January 1st, 2018, and January 1st, 2023, were identified via a PubMed search strategy that combined terms related to machine learning and prediction models. The identified original research articles were analyzed against the TRIPOD criteria. RESULTS: 110 articles were included and analyzed against the TRIPOD checklist. Among the articles screened, the median compliance was 57.4% (50.0-66.7%). Models utilizing machine learning-based models exhibited lower compliance on average compared to conventional learning-based models (57.1%, 50.0-66.7% vs. 68.1%, 50.2-68.1%, p = 0.472). Among the TRIPOD criteria, the lowest compliance was observed in blinding the assessment of predictors and outcomes (n = 7, 12.7% and n = 10, 16.9%, respectively), including an informative title (n = 17, 15.6%) and reporting model performance measures including confidence intervals (n = 27, 24.8%). Few studies provided sufficient information to allow for the external validation of results (n = 26, 25.7%). CONCLUSIONS: Published machine learning models predicting outcomes in neurosurgery often fall short of meeting the established guidelines laid out by TRIPOD for their development, validation, and reporting. This lack of compliance may indicate the extent to which these models have been subjected to external validation or adopted into routine clinical practice in neurosurgery.

El papel de los revisores de artículos de investigación científica en medicina

The aim of this article is to describe the task and responsibility of the peer reviewers of medical scientific articles. It succinctly defines what constitutes an original scientific research article and discusses the responsibility and ethics involved in performing this task. Reviewing scientific articles is a commendable yet challenging job that requires knowledge and time to delve into the depth required. This has generated a shortage of reviewers of scientific articles willing to carry out this important task.

Research gap in esophageal achalasia: a narrative review.

In recent years, new translational evidence, diagnostic techniques, and innovative therapies have shed new light on esophageal achalasia and revamped the attention on this relatively rare motility disorder. This narrative review aims to highlight the most recent progress and the areas where further research is needed. The four senior authors identified five topics commonly discussed in achalasia management: i.e. pathogenesis, role of functional lumen imaging probe in the diagnostic flow chart of achalasia, how to define the outcome of achalasia treatments, how to manage persistent chest pain after the treatment, and if achalasia patients' may benefit from a regular follow-up. We searched the bibliographic databases to identify systematic reviews, meta-analyses, randomized control trials, and original research articles in English up to December 2023. We provide a summary with the most recent findings in each of the five topics and the critical points where to address future research, such as the immune-genetic patterns of achalasia that might explain the transition among the different phenotypes, the need for a validated clinical definition of treatment success, the use of neuromodulators to manage chest pain, and the need for identifying achalasia patients at risk for cancer and who may benefit of long-term follow-up. Although undoubtedly, progress has been made on the definition and management of achalasia, unmet needs remain. Debated aspects range from mechanistic insights, symptoms, objective measure relationships, and accurate clinical responses to therapeutic interventions. Translational research is eagerly awaited to answer these unresolved questions.

The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review.

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5-18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations.

Evaluating the Efficacy and Safety of Bimekizumab for Plaque Psoriasis and Psoriatic Arthritis: An Expert Consensus Panel Report

Background: While there are numerous effective therapies for psoriasis, there remains an unmet need as some patients still suffer from inadequate response with available medications. Bimekizumab is a first-in-class monoclonal antibody that inhibits both interleukin (IL)-17A and IL-17F and was recently approved by the Food and Drug Administration. The aim of this study was for a panel of experts in psoriasis management to review the available data on bimekizumab and create consensus statements on its use in clinical practice.
 Methods: A comprehensive literature search of PubMed, Scopus, and Google Scholar was conducted for English-language original research articles, systematic reviews, and meta-analyses discussing the safety and efficacy of bimekizumab for moderate to severe plaque psoriasis and psoriatic arthritis. A panel of nine dermatology physician assistants and one dermatology nurse practitioner with significant expertise in the management of psoriasis convened virtually on December 16, 2023, to review the studies and create recommendations for their peers on the use of bimekizumab. A modified Delphi process was implemented to reach a consensus on these statements and the Strength of Recommendation Taxonomy was used to assign each one a strength of recommendation.
 Results: The literature search resulted in 92 articles that met search criteria. After a thorough screening of these studies for relevance to the discussion questions, 20 articles remained and were distributed to each panelist prior to the meeting. The panel unanimously voted to adopt 10 consensus recommendations and assigned all 10 statements a strength of recommendation of “A.”
 Conclusion: Bimekizumab has a very high efficacy in the treatment of moderate to severe psoriasis and psoriatic arthritis. It also has a favorable safety profile that is consistent with that of other biologics, except for an increased risk of oral candidiasis.

Methods of measurement for pneumothorax in pediatric patients: a systematic review.

Accurate measurement of pneumothorax (PTX) size is necessary to guide clinical decision making; however, there is no consensus as to which method should be used in pediatric patients. This systematic review seeks to identify and evaluate the methods used to measure PTX size with CXR in pediatric patients. A systematic review of the literature through 2021 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was conducted using the following databases: Ovid/MEDLINE, Scopus, Cochrane Database of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Original research articles that included pediatric patients (< 18years old) and outlined the PTX measurement method were included. 45 studies were identified and grouped by method (Kircher and Swartzel, Rhea, Light, Collins, Other) and societal guideline used. The most used method was Collins (n = 16; 35.6%). Only four (8.9%) studies compared validated methods. All found the Collins method to be accurate. Seven (15.6%) studies used a standard classification guideline and 3 (6.7%) compared guidelines and found significant disagreement between them. Pediatric-specific measurement guidelines for PTX are needed to establish consistency and uniformity in both research and clinical practice. Until there is a better method, the Collins method is preferred.

Impact of carotid stenosis on the outcome of stroke patients submitted to reperfusion treatments: a narrative review.

Intravenous thrombolysis (IT) and mechanical thrombectomy (MD) are the two interventional approaches that have changed the outcome of patients with acute ischemic stroke (AIS). Ipsilateral and contralateral carotid stenosis (ICS, CCS) play an important role in regulating cerebral hemodynamics, both in chronic and acute situations such as AIS. Several studies have explored their role in the incidence and severity of stroke, but very few have investigated the possible impact of ICS and CCS on the efficacy of interventional procedures. The purpose of this review was to I) highlight the incidence and prevalence of carotid stenosis (CS); II) assess the impact of ICS and CCS on cerebral hemodynamics; III) evaluate the effect of carotid stenosis on the efficacy of interventional therapies (IT and MT) for AIS; and IV) report therapeutic complications related to CS. We searched PubMed/Medline for case reports, reviews, and original research articles on English-language review topics during the period from January 1, 2000 to October 1, 2023. CS is associated with 15-20 % of the total number of AIS. ICS and CCS had a negative influence on both cerebral hemodynamics before AIS and outcome after interventional procedures (IT, MT alone or in bridging). Available data on cerebral hemodynamics and efficacy of interventional therapies for AIS suggest a negative role of CS. Therefore, early diagnosis of CS may be considered relevant to preventive and post-stroke treatment strategies.

Geochemistry of Terrestrial Plants in the Central African Copperbelt: Implications for Sediment Hosted Copper-Cobalt Exploration

Mineral exploration has increasingly targeted areas covered by in situ or transported overburden for shallow to deep-seated orebodies. It remains critical to develop better means to detect the surficial chemical footprint of mineralized areas covered by thick regolith. In such settings, plant geochemistry could potentially be a useful exploration tool, as different plant species have varying degrees of tolerance to metal enrichment in the soil. This review provides insights into the geological and geochemical controls on metal accumulation patterns in soil–plant systems of the Central African Copperbelt. In addition, it highlights the opportunities for integrating the geochemistry of terrestrial plants in emerging exploration technologies, identifies research gaps, and suggests future directions for developing phytogeochemical sampling techniques. This review was conducted using reputable online scholarly databases targeting original research articles published between January 2005 and March 2023, from which selected articles were identified, screened, and used to explore current advances, opportunities, and future directions for the use of plant geochemistry in sediment hosted Cu–Co exploration in the Central African Copperbelt. Various plant species are recognized as ore deposit indicators through either independent phytogeochemistry or complementary approaches. In the Central African Copperbelt, the successful application of hyperaccumulator species for phytoremediation provides the basis for adopting phytogeochemistry in mineral exploration. Furthermore, current advances in remote sensing, machine learning, and deep learning techniques could enable multi-source data integration and allow for the integration of phytogeochemistry.

Adherence to Reporting Guidelines in Major Otolaryngology Publications.

The aim of this study is to determine the adherence rate to reporting guidelines in published otolaryngology research. We performed an evidence-based review of all original clinical research published in 2021 in five otolaryngology journals for adherence to the appropriate guideline for the study type by evaluating whether the corresponding reporting guideline was mentioned in the body of the published manuscript. There were 1140 original research articles included in this study. Most studies were observational, for which the STROBE reporting guidelines are recommended (n = 791, 70.3%). All studies had an average adherence rate of 16.8% (n = 192/1140). The STROBE adherence rate was 4.9%, with JAMA Otolaryngology having the highest proportion of observation studies using the STROBE guidelines (23/49, 46.9%). Reporting guidelines are important tools to use in presenting original research. The use of these guidelines varies in the otolaryngology literature and highlights the ongoing need to support research reproducibility and usefulness.

(249) Association of Single Nucleotide Polymorphisms (rs2301365 &amp; Rs737008) in PRM1 Gene and Male Infertility: A Meta-Analysis

Abstract Introduction In the sperm nucleus, protamine is a major DNA-binding protein that replaces histone. It is a basic arginine-rich protein responsible for DNA compaction. Protamin I (PRM1) is one of the important genes that produces protamine. Mutations and polymorphisms in PRM1 may increase the odds of male infertility. Objective The present meta-analysis investigated the association of single nucleotide polymorphisms (SNPs) (rs2301365 &amp; rs737008) in the PRM1 gene and male infertility. Methods The original research articles, published till July 2023 in the English language, on the association of rs2301365 and rs737008 in the PRM1 gene and male infertility, were retrieved from Science Direct, PubMed, NCBI and Google Scholar. Results A total of 129 studies were retrieved by searching in the different databases, after the removal of duplicates, meta-analysis, and abstracts, 14 were finally selected. In 11 case-control studies, the association of the rs2301365 (-190C &amp;gt;A) polymorphism was presented as the meta-analysis of different models, Allelic model (C vs. A), Dominant model (CC + CA vs. AA), Recessive model (CC vs. CA + AA), Additive model (CC vs. AA), Heterozygous model (AC vs. AA). Allelic, additive, dominant and heterozygous models reported that the -190C&amp;gt;A (rs2301365) increased the odds of male infertility. The ethnic subgroup analysis showed the same pattern of association for the Caucasian infertile men. However, none of these overall and subgroup analyses based on ethnicity showed an association between rs2301365 (-190C &amp;gt;A) and infertility in Asian men. For rs737008 (139C &amp;gt; A) in the meta-analysis of 14 studies, none of these overall and subgroup analyses based on ethnicity showed an association with male infertility. Trial sequential analysis (TSA) for the allelic model of rs2301365 (-190C &amp;gt;A) showed the required sample size was 2252 at 90% power and 5% type-I error, whereas the cumulative z-curve crossed the trial sequential monitoring boundaries of harm. However, the sample size was greater than required therefore further studies will not likely change results. For rs737008 (139C &amp;gt; A), TSA recommended more studies to be conducted. Conclusions The PRM1 rs2301365 (-190C &amp;gt;A) was associated with male infertility in overall analysis and Caucasian men. Further studies on this SNP may not change results. However, rs737008 (139C &amp;gt; A) was not associated with male infertility. However, further studies are recommended. Disclosure No.

Bibliometric mapping analysis of Pickering emulsion applied in 3D food printing

SummaryThree‐dimensional food printing (3DFP) can produce foods with tailored nutritional content, complex shapes and textures. This technology requires food formulations (food inks) with specific rheological properties. Pickering emulsions (PE) have gained attention due to their long‐term stability and desirable printable properties, making them an excellent candidate for 3DFP. The purpose of this study is to use bibliometric analysis to identify the most important scientific research on PE used in 3DFP. This includes identifying key authors, countries and universities or institutions where the research was conducted, as well as the primary journals that provide information on this topic. Our study provides insight into the relevance of food ink properties for next‐generation 3DFP and the main raw materials used for the development of PE. Out of the 28 original research articles analysed, only 10 countries have studied the application of PE for 3DFP. China and the United Kingdom have been the primary leaders in researching this topic. The Food Hydrocolloids Journal has been the main source of scientific information. The studies cited Pickering stabiliser particles, including soy protein isolate, microcrystalline cellulose and acetylated microcrystalline cellulose, as well as oil phases based on sunflower, canola, olive and soybean oils. High internal phase Pickering emulsions (HIPPEs) have shown great thermal and conductive stability, making them a promising choice for 3DFP post‐processing. Further studies should assess the bioavailability and bioaccessibility of the bioactive compounds that are encapsulated. It is also important to explore their potential use in real food systems and to integrate innovative packaging solutions.

Reply to “Comment on Comparison of direct and indirect measures of transport efficiency in single particle inductively coupled plasma mass spectrometry” by H. Goenaga-Infante

This paper provides a rebuttal to the comments on our original research article entitled “Comparison of Direct and Indirect Measures of Transport Efficiency in Single Particle ICP-MS” recently published by Goenaga-Infante in Spectrochimica Acta Part B: Atomic Spectroscopy.The intent of our study is not to condemn the dynamic mass flow (DMF) method but rather to explore the use parameters under which it can and cannot be applied. As explained in the original paper, the goal of this study is to evaluate the ranges of use conditions under which measures of transport efficiency (TE) yield accurate and reproducible results for spICP-MS measurements of particle number concentration (PNC) and particle size (diameter, PS) of various gold nanoparticle (AuNP) suspensions. The evaluation was performed through a systematic comparison of three methods for the measurement of TE: the particle frequency (TEF), particle size (TES), and DMF methods using three types of spray chambers operated at cooled and ambient temperature conditions and employing different ICP-MS platforms. While we appreciate thorough critical and constructive comments on our paper, we strongly disagree that the conclusions and highlights are not supported by the content and findings about the features and benefits of the DMF method.The discussion of three additional independent studies in this field by other spICP-MS expert groups that have been published after the submission of our manuscript is included in this paper. While the DMF approach has been used in two interlaboratory comparisons for TE determination in spICP-MS measurements of PNC, only one laboratory, namely the laboratory led by Goenaga-Infante, provided results using the DMF method in both projects. A method cannot be considered validated if successful results have only been demonstrated within one laboratory.The paper by Goenaga-Infante claims that the main use of DMF, the assignment of a SI traceable PNC value to new commercial nanomaterials (NMs), has not been highlighted explicitly in our original paper. The advantages and disadvantages of the DMF, TES, and TEF methods to measure TE were presented throughout the manuscript and are clearly summarized in the conclusion. The assignment of PNC that is metrologically traceable to the SI implies that all known or suspected uncertainty components including bias are taken into account. Our research shows that under some use conditions, the biases inherent to the DMF method are not yet fully understood and cannot be accounted for. While Cuello-Nuñez et al. Journal of Analytical Atomic Spectrometry, 2020, DOI: https://doi.org/10.1039/c9ja00415g state that cooled conditions (2 °C) were used in their work, they do not define the level of bias that can be expected if different spray chamber temperatures are used, and they do not provide recommendations on the optimal use conditions that define the field of applicability of the DMF method. Furthermore, besides the use of a Scott-type spray chamber cooled to 2 °C, neither the composition material of the spray chamber nor the volume of the Scott-type spray chamber were specified. It is important to note that in our original research, fifteen of the nineteen experiments were conducted using a cooled spray chamber. Also, the four different ICP-MS platforms were used in the standard configuration and with additional spray chamber options encountered in common ICP-MS usage. The value of our work is that it extends the study of Cuello-Nuñez et al. to a wide variety of use conditions routinely encountered in spICP-MS analysis.

Machine learning review of hand surgery literature

Background: Latent Dirichlet Allocation is an artificial intelligence model which processes text into topics, and has had broad application in medicine, political science, and engineering. As the orthopedic hand literature continues to grow, such technology may have value in efficiently conducting identifying trends and conducting systematic reviews. The purpose of this study is to demonstrate the use of Latent Dirichlet Allocation and machine learning to review literature and summarize the past 21 yr of hand surgery research. Methods: All original research articles published in the Journal of Hand Surgery (American), Journal of Hand Surgery (European), Hand, Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and Plastic and Reconstructive Surgery (PRS) from 2000-2021 were analyzed using Latent Dirichlet Allocation, generating 50 topics which were then ranked by popularity and trended over the previous 21 yr. Results: Research article abstracts totaling 11,501 from 2000-2020 were extracted and analyzed to create 50 topics. Conclusion: This is the first study of its kind to utilize machine learning models for reviewing the hand surgery literature. Machine learning possesses the ability to rapidly process a large body of test and assess the current state of research and trends or research topics, which can aid clinicians and researchers in time-intensive tasks to provide clues that will promote areas of further study.

Role of polymorphism in vitamin D receptor gene on diabetic foot ulcer: A systematic review and meta-analysis

Context: Once vitamin D is converted to its active form, the molecule binds to its receptor (VDR) and performs its function as a transcription factor in modulating immune response, inflammation cascade, and insulin signaling. Among diabetic individuals, these activities are thought to be correlated with foot ulceration. Gene polymorphisms could change the function of VDR, thereby affecting the development of foot ulceration among individuals with diabetes. Aims: To construct evidence on the role of VDR gene variants or single nucleotide polymorphisms (SNPs) on diabetic foot ulcers. Methods: Records reporting the distribution of genotypes and/or alleles among diabetic foot ulcer (DFU) patients and published until 10 March 2023 were retrieved from 12 major databases using predetermined keywords. The original research articles included in the study were assessed for reporting quality using the Newcastle Ottawa Scale. The quality of genotypic and allelic data was appraised by Hardy-Weinberg equilibrium (HWE). A quantitative analysis-based fixed-effects model was performed to estimate the proportion of genotype and allele frequencies among DFU patients. Results: Three studies were included in the systematic review reporting the FokI (rs2228570), TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232) SNPs. Based on pooled estimates, among DFU patients CC, CT, and TT genotypes of VDR FokI SNPs had a prevalence of 45%, 43%, and 12%, respectively, without significant heterogeneity found in the reported data (p-Het&lt;0.001; I2&gt;0%). ApaI and FokI were associated with DFU, while no association in all genotypic and allelic models was found between TaqI or BsmI and DFU. CC genotype of BsmI and T allele of FokI was associated with oxidative stress (one of the underlying factors in DFU). Conclusions: Certain genotypes and alleles of FokI and ApaI SNPs could act as the risk factor for foot ulceration among diabetic individuals. More high-quality studies are still needed to draw solid conclusions on the role of VDR SNPs among DFU patients.

Radiomics Studies on Ischemic Stroke and Carotid Atherosclerotic Disease: A Reporting Quality Assessment.

Objective: To assess the reporting quality of radiomics studies on ischemic stroke, intracranial and carotid atherosclerotic disease using the Image Biomarker Standardization Initiative (IBSI) reporting guidelines with the aim of finding avenues of improvement for future publications. Method: PubMed database was searched to identify relevant radiomics studies. Of 560 articles, 41 original research articles were included in this analysis. Based on IBSI radiomics reporting guidelines, checklists for CT-based and MRI-based studies were created to allow a structured and comprehensive evaluation of each study's adherence to these guidelines. Results: The main topics covered included radiomics studies were ischemic stroke, intracranial artery disease, and carotid atherosclerotic disease. The reporting checklist median score was 17/40 for the 20 CT-based radiomics studies and 22.5/50 for the 20 MRI-based studies. Basic items like imaging modality, region of interest, and image biomarker set utilized were included in all studies. However, details regarding image acquisition and reconstruction, post-acquisition image processing, and image biomarkers computation were inconsistently detailed across studies. Conclusion: The overall reporting quality of the included radiomics studies was suboptimal. These findings underscore a pressing need for improved reporting practices in radiomics research, to ensure validation and reproducibility of results. Our study provides insights into current reporting standards and highlights specific areas where adherence to IBSI guidelines could be significantly improved.

Fabry disease: integrative aspects from diagnosis to treatment

Aim: identify the main aspects of Fabry disease (FD) from clinical suspicion to diagnosis, its vascular and cellular effects, in addition to treatment. Methods: This study is an integrative review of the literature supported by the search for articles in databases, Pub Med, Lilacs, Scielo, journals, and websites, with the following descriptors “Fabry disease”, “Fabry Disease treatment”, “Agalsidase-β”, “Agalsidase-α”, “Migalatast”, “inflammatory biomarkers” and “oxidative stress”, using original research articles and reviews between the years 1991 and 2023. This bibliographic survey was carried out in the period 01/10/2022 to 20/04/2023. Results: From a total of 340 articles found, 85 articles were selected. Discussion: The natural history of FD appears to be very complex, with multisystemic involvement and phenotypic variability. The analysis of FD symptoms is essential to the early diagnosis, aiming for greater success in therapy and prognosis, ensuring better patients’ quality of life and survival. Conclusion: This review addresses the diagnosis and main therapeutic approaches to guide health professionals and researchers, and to stimulate the development of research on FD.

Mental Health in Elite Athletes: A Systematic Review of Suicidal Behaviour as Compared to the General Population.

Previous systematic reviews on mental health in athletes have found athletes to be at a potentially increased risk for mental health diagnoses compared to the public. Multiple cross-sectional studies have examined suicide behaviour within different athlete populations, but there is a need for a comprehensive review to synthesize and identify risk factors and epidemiology regarding suicide behaviour in the elite athlete population, especially as it compares to the general population. A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science from 1990 to January 2023. Inclusion criteria included original peer-reviewed research articles examining suicidal ideation, suicide attempt, or suicide completion within elite athlete populations. Exclusion criteria included athletes participating in high-school or Paralympic level sports, studies that did not report results regarding elite athletes and non-athletes separately, and non-peer reviewed work. All studies were screened for inclusion by two independent reviewers. The primary outcome variables extracted from included studies included rates, risk factors, and protective factors for suicide behaviour. The study quality and risk of bias was evaluated for each study using the Joanna-Briggs Institute (JBI) critical appraisal tools. Of the 875 unique studies identified, 22 studies, all of which were cross-sectional in nature, met the inclusion criteria. Seven studies evaluated previous athletes, 13 studies evaluated current athletes, and two studies included a combination of previous and current athletes. Seven studies involved varsity college athletes, nine involved professional athletes of various sports, and six focused on international or Olympic level athletes. The rate of suicidal ideation in professional athletes ranged from 6.9 to 18% across four studies, while the rate in collegiate athletes ranged from 3.7 to 6.5% across three studies. Ten studies compared athletes to the general population, the majority of which found athletes to be at reduced risk of suicidal ideation, suicide attempt, and suicide completion. Only one study found athletes to have increased rates of suicide compared to matched non-athletes. Risk factors for suicide behaviour identified across multiple studies included male sex, non-white race, older age, and depression. Player position, athletic level, sport played, and injuries showed trends of having limited effect on suicide behaviour risk. This review suggests that elite athletes generally demonstrate reduced risk of suicidal ideation, suicide attempt, and suicide completion compared to the general population. Coaches should remain aware of specific factors, such as male sex, non-white race, and higher athletic level, in order to better identify at-risk athletes. Limitations of this review include the heterogeneity in the methodology and athlete populations across the included studies. Therefore, future targeted research is essential to compare suicide behaviour between sports and identify sport-specific suicide risk factors. PROSPERO Registration: CRD42023395990.

Reporting and presentation of statistical analyses: instructions for authors of health sciences journals based in South Africa

Background: Statistical analyses are a key component of quantitative research in health sciences. Objectives: To review the instructions for authors on reporting and presentation of statistical methods by all health sciences journals based in South Africa. Methods: Health sciences journals based in South Africa that publish original quanti-tative research articles were identified using three sources, namely the list of accred-ited South African journals compiled by the South African Department of Higher Education and Training in 2022, relevant journals covered in Scopus, and web pages of major health sciences publishers in South Africa. The list was cross-checked against the listing of journals in Sabinet, an online database covering South Africa, under the category &amp;lsquo;Collection: Medicine and Health&amp;rsquo;. The instructions for authors given by the journals were accessed through their websites. The form for recording data was based on items listed in the &amp;lsquo;Statistical Analyses and Methods in the Published Literature&amp;rsquo; (SAMPL) guidelines. Results: All except one of the 52 journals could be located online. Of the 51, 13 (25%) made no mention of statistics in their instructions, and 11 (22%) made only a gen-eral statement regarding statistical content with no further guidance. The statistical item most frequently mentioned was the P value (45% of journals), whereas the rest of the items appeared in the instructions of 20% or fewer journals. Nine journals (18%) referred to the EQUATOR guidelines, mainly CONSORT (10%). Conclusion: Nearly half of the health sciences journals based in South Africa either did not mention statistics at all in their instructions for authors or made only a cur-sory reference to statistics. The study thus emphasizes that these journals, in their instructions for authors, need to cover in greater detail the reporting and presenta-tion of statistical methods in articles reporting quantitative research.