Measuring digital health competence among healthcare professionals: A rapid review of assessment tools.

Women are more likely than men to experience injuries to the anterior cruciate ligament (ACL). Biomechanical differences, assessed using tools such as the Landing Error Scoring System (LESS), may contribute to this risk. The LESS does not directly influence ACL injury risk but helps identify individuals who might be at higher risk. However, conflicting findings in the literature prevent clear conclusions about sex-based differences in LESS scores. This study systematically reviews and meta-analyzes research examining the influence of sex on LESS scores. Four databases (ScienceDirect, PubMed, Web of Science, and Scopus) were searched from 2009 (when LESS was introduced) to May 21, 2024. Only studies evaluating the impact of sex on LESS scores were included. Studies were screened for bias risk and critically appraised. A meta-analysis was performed utilizing a random-effects model, where sex served as the independent variable and LESS scores represented the dependent variable. The quality of evidence was assessed with the GRADE criteria. This study was registered with PROSPERO. Sixteen studies met the inclusion criteria. Females showed significantly higher LESS scores than males (p<0.0001), with a mean difference of 0.62 errors. However, substantial heterogeneity was observed across studies, and the overall quality of evidence was rated as very low according to GRADE. Although a statistically significant difference between sexes was identified, the mean difference of 0.62 errors is not clinically meaningful. The findings should be interpreted with caution due to their high heterogeneity and very low-quality evidence. Furthermore, sex differences in LESS scores may be context-dependent and influenced by population characteristics and study conditions. PROSPERO (CRD 42023470540, October 19, 2023).

Distal biceps brachii tendon avulsions are a significant clinical issue, particularly in physically active, middle-aged men. The choice of postoperative rehabilitation strategy, specifically early mobilization versus immobilization, and the effectiveness of different immobilization tools, remains unclear. This study aims to clarify these aspects by analysing the impact of rehabilitation protocols on clinical outcomes following tendon reinsertion. A detailed systematic literature search was conducted in January 2025 using multiple databases, including PubMed, Web of Science, and grey literature sources. The selection process followed PRISMA guidelines and included 50 studies encompassing 1,577 patients. The primary outcomes assessed were re-rupture rates, DASH scores, and functional outcomes, such as range of motion and strength ratios. The Downs and Black quality assessment checklist was used to evaluate the risk of bias, and the GRADE guidelines were applied to assess the quality of evidence. The meta-analysis showed no significant differences in re-rupture rates, DASH scores, or strength ratios between early mobilization and immobilization groups. Similarly, the type of immobilization tool (splint, sling, or hinged brace) did not significantly affect these outcomes. The overall risk of bias was predominantly rated as poor to fair, and the quality of evidence was low to very low. This study suggests that both early mobilization and immobilization are viable postoperative rehabilitation strategies following distal biceps tendon reinsertion, with no significant difference in patient outcomes. The choice of immobilization tool also does not appear to significantly affect recovery. However, due to the low quality of evidence and risk of bias in the included studies, further high-quality research is needed to establish definitive postoperative care guidelines.

The objectives of this study were to estimate and compare the 1-year clinical success rates of triple antibiotic paste (TAP), double antibiotic paste (DAP), calcium hydroxide (CH) within regenerative endodontic procedures (REPs) on permanent necrotic immature teeth. Trials investigating REP success were searched through MEDLINE, Scopus, Embase, Web of Science, GOOGLE Scholar (last update December 2025). Primary study quality was evaluated through the revised Cochrane Risk of Bias tool for Randomised Trials (RoB2). Pooled success rates with 95% confidence intervals (95% CIs) were assessed. Heterogeneity was investigated with the Cochran's Q and quantified with I2: The random-effects model was preferred to the fixed-effect model for I2 > 50%. Sensitivity (study quality, publication bias, study inclusion) and subgroup (scaffold type, world Region) analyses were made. The differences in pooled success rates between protocols were assessed and were evaluated using an equivalence range of -2.5%/+2.5%. The GRADE system was employed to evaluate the Quality of Evidence of the pooled success rates. Twenty-four studies of average quality were included involving 544, 64, 183 patients, for TAP, DAP, CH, respectively. The pooled success rates (tooth survival after 1 year with periapical healing, absence of signs and symptoms of pathology) were TAP 96.7% (95% CI, 94.8%-98.0%), DAP 84.2% (95% CI, 73.2%-92.0%), CH 97.4% (95% CI, 93.9%-99.1%). The pooled differences in success rates were TAP-DAP 12.5% (95% CI, 2.8%-22.1%, TAP superiority demonstrated), TAP-CH -0.7% (95% CI, -0.9%-2.5%, TAP/CH equivalence demonstrated), CH-DAP 13.2% (95% CI, 3.3%-23.0%, CH superiority demonstrated). Secondary analyses corroborated these results, although the overall statistical test power was low due to small sample sizes. The GRADE quality of evidence was high for TAP and CH, and low for DAP, due to substantial imprecision attributed to the small number of studies with small sample sizes. The lack of direct comparisons between protocols and of a common comparator did not allow for more robust analyses. Nevertheless, the use of TAP and CH as intracanal medicament within REPs resulted equivalent in eradicating the infection and promoting periapical healing in permanent necrotic immature teeth at 1-year follow up, and these protocols resulted superior over DAP. PROSPERO registration number: CRD42023484189.

Interest is growing in durable, cementless fixation in total knee arthroplasty (TKA). This study aimed to systematically review registry and large database studies, evaluating their quality of evidence and assessing implant survivorship. Additionally, we compared these findings to a systematic review of randomized controlled trials. A search of PubMed and Embase was conducted to identify eligible registry and large database studies on contemporary cementless TKA survivorship published between January 1, 2010, and December 31, 2024. Overlapping studies from the same registry were excluded. Modified Coleman methodology (MCM) scores were used to assess methodological quality, with a score of 85 to 100 considered excellent, 70 to 84 considered good, 55 to 69 considered fair, and below 55 considered poor. In addition, level of evidence assessments were made. Among eight included registry studies, the mean MCM score was 35.5 (range, 29 to 39), reflecting poor quality, and all were level III evidence. Differences in revision rates between cementless and cemented TKA were typically less than 1%. Cementless prostheses comprised less than 5% of total implants evaluated for most studies, with one study evaluating 1,056,492 cemented versus 26,768 cementless TKAs. For the two large database studies, the mean MCM score was low at 36.0 (range, 35 to 37), and both were level II evidence. Of these, one included only a 1-year follow-up, and neither reported specific implant survivorship. However, a recent systematic review of contemporary cementless TKA included 27 randomized controlled trials with a mean MCM score of 76.9 (range, 61 to 91), indicating good quality. Registry and large database studies on contemporary cementless TKA have limited comparative data, often of lower methodological quality, with cementless implants representing a small proportion of cases. Despite these shortcomings, results for survivorship are generally similar for cementless and cemented TKAs.

AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review.

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2025.

Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) guidelines on the use of autoantibody tests in the diagnosis of autoimmune liver diseases.

Women Emergency Physicians and Gender Disparities from Entry to Advancement.

Optimal perampanel dose as the treatment for refractory partial-onset seizures: Network meta-analysis based on pivotal randomized double-blind clinical trials.

Efficacy and safety of Breviscapine injection combined with conventional therapy for unstable angina pectoris: A meta-analysis of randomized control trials.

Systematic review of usability evaluations in medical devices: Methodological choices, heuristic application, and confounding factors.

The digital transformation of reproductive health has been accelerated by rapid advances in Femtech, which offers new approaches to addressing infertility-related challenges. This review synthesizes the current evidence across three domains: consumer-facing technologies for fertility awareness and at-home diagnostics; the integration of digital health tools, including telehealth and mobile health (mHealth), into clinical management pathways; and the application of artificial intelligence (AI) in assisted reproductive technology (ART). Fertility tracking applications and home-based diagnostic tools may improve accessibility and support patient engagement in reproductive health management; however, evidence regarding their effects on clinically meaningful outcomes, including pregnancy and live birth rates, remains limited or inconsistent. Telehealth and mHealth platforms have been widely adopted and have demonstrated high patient satisfaction and feasibility, with clinical outcomes comparable to those of traditional in-person care in selected settings. In ART, AI-based approaches show promise for gamete and embryo assessment, selection, and outcome prediction, although the current evidence is derived largely from observational and validation studies and does not yet demonstrate consistent improvements in clinical outcomes. Despite these advances, important challenges remain, including variability in evidence quality, data privacy concerns, regulatory uncertainty, and disparities in digital access. Overall, although Femtech technologies have substantial potential to enhance reproductive care, their clinical integration should be guided by rigorous validation and cautious interpretation of the existing evidence.

AGA Clinical Practice Update on Management of Clostridioides difficile Infection in Inflammatory Bowel Disease: Expert Review.

Devices in Onychomycosis: A Status Update.

SC-TSCPC significantly lowers intraocular pressure more effectively than MP-TSCPC and performs similarly to CW-TSCPC. Safety and visual outcomes are comparable, supporting its use as a nonincisional treatment option for various glaucoma patients. Slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) is an emerging laser modality for glaucoma management designed to lower intraocular pressure (IOP) with possible fewer complications than conventional continuous-wave (CW-TSCPC) and micropulse (MP-TSCPC) approaches. We conducted a systematic review and meta-analysis to compare the efficacy and safety of SC-TSCPC with those of MP-TSCPC and CW-TSCPC. PubMed, Embase, and Cochrane Library were searched from inception through December 2025 for studies comparing SC-TSCPC with MP-TSCPC or "conventional" CW-TSCPC. Primary outcomes were IOP reduction from baseline and IOP at last follow-up. Secondary outcomes included medication burden, best-corrected visual acuity (BCVA), treatment success, and complications. We computed mean differences (MDs) for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% CIs. Thirteen studies comprising 992 patients were included. SC-TSCPC achieved greater IOP reduction from baseline compared with MP-TSCPC ( MD 1.29mmHg, 95% CI 0.26-2.32, P =0.01, I2 =0%) but was comparable to conventional CW-TSCPC ( MD -1.00mmHg, 95% CI -3.14 to 1.13, P =0.36). IOP at last follow-up, number of medications, BCVA, treatment success, and total complication rates for SC-TSCPC were similar to those for MP-TSCPC or CW-TSCPC. SC-TSCPC may provide comparable IOP control to CW-TSCPC and appears more effective than MP-TSCPC in lowering IOP, with a similar safety profile. It may represent a viable nonincisional treatment option for glaucoma, including patients who retain visual potential. These results require cautious interpretation due to the overall low-to-very low quality of evidence and significant heterogeneity among studies. Larger randomized studies are needed to validate these findings.

Globally, laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric surgery. Multiple fascial plane blocks are used for postoperative analgesia, but their comparative efficacy remains unclear. A systematic search through January 2026 identified controlled trials comparing fascial plane blocks-including transversus abdominis plane block (TAP), erector spinae plane block (ESPB), quadratus lumborum (QL), external oblique intercostal (EOI), modified thoracoabdominal nerve block via perichondrial approach (M-TAPA), paravertebral block (PVB), and rectus sheath (RS) blocks-against each other, placebo, systemic analgesia (SA), or port-site infiltration (PSI) in LSG. The primary outcome was 24-hour opioid consumption (morphine milligram equivalents, MME). Secondary outcomes included pain scores at 2 to 24 hours, postoperative nausea and vomiting (PONV), and complications. A frequentist network meta-analysis was conducted. Treatment rankings were determined using surface under the cumulative ranking curve (SUCRA) values, and the certainty of evidence was appraised by the Grading of Recommendation Assessment, Development, and Evaluation (GRADE). Twenty-three randomized controlled trials (RCTs) comprising 2,005 patients were included. The EOI block achieved the greatest opioid-sparing effect versus SA (mean difference [MD] -19.66 MME; [SUCRA] 83%). At 24 hours, only ESPB significantly reduced pain intensity (MD -0.44). The QL block significantly decreased PONV incidence compared to placebo (odds ratio [OR] 0.31). No major block-related adverse events were reported. Overall, the quality of evidence ranged from moderate to low. In adults undergoing LSG, ultrasound-guided fascial plane blocks are effective and safe for postoperative analgesia. The EOI block was probabilistically ranked highest for reducing 24-hour opioid consumption (SUCRA 83%), though CIs overlapped with other blocks. The ESPB provided a small but statistically significant reduction in pain at 24 hours (MD -0.44), and the QL was associated with the lowest incidence of PONV (OR 0.31). However, the overall certainty of evidence ranged from moderate to low, with interventions supported by limited data from only one or two trials. SUCRA rankings represent probabilistic hierarchies and should not be interpreted as definitive evidence of superiority. Consequently, technique selection should be guided by specific analgesic goals, local expertise, and individual patient factors.

Efficacy of corticosteroid pretreatment in the management of deceased organ donors: A systematic review and meta-analysis.

Postoperative follow-up is critical in patient recovery, complication detection, and optimizing patient outcomes. Although traditionally, in-office postoperative visits have been the standard of care, remote postoperative follow-up via telehealth has emerged as a comparable alternative. The objective was to systematically review the literature comparing in-office and remote (telehealth visits, phone calls, or apps) postoperative follow-up after urogynecologic surgery to assess the effect on patient satisfaction, health care utilization, and adverse events. MEDLINE, CINAHL, Scopus, and ClinicalTrials.gov were searched through January 14, 2025. The population comprised women undergoing urogynecologic surgery, comparing remote follow-up methods with standard in-office visits. Outcomes assessed were patient satisfaction, health care utilization (unscheduled visits, patient-initiated calls, emergency department visits), and adverse events (eg, mesh complications, urinary retention, urinary tract infections). Abstracts and full-text articles were doubly screened and doubly extracted, with study quality graded using GRADE criteria and Cochrane risk of bias assessments. Meta-analyses were conducted for pooled proportions and mean ratios. Of 1,082 abstracts screened, 9 studies (5 randomized controlled trials, 4 retrospective studies) involving 1,270 patients were included, with 490 patients receiving remote visits and 333 receiving in-office visits. Evidence quality ranged from moderate to high. In the meta-analysis, in-office and remote follow-up had comparable patient satisfaction (89% vs 78%, P =0.30), with no significant mean difference in patient satisfaction scores (mean difference: 0, P =0.70). No difference in health care utilization metrics or adverse events (15% vs 12%, P =0.664) was found. Remote postoperative follow-up after urogynecologic surgery demonstrated no significant differences from in-office visits regarding patient satisfaction, health care utilization, or adverse events, supporting telehealth as an effective alternative to in-office visits.

Contemporary biomimetic and bioactive materials in paediatric dentistry: a narrative review.