Reference Lists Research Articles

Examining the relationship between women’s empowerment and food security in low- and middle-income countries: A narrative review

Prior research has proposed women’s empowerment in agriculture as one of the strategies to mitigate household and individual food insecurity within nutrition-sensitive agriculture interventions. Yet the current evidence on this relationship is inconclusive requiring further exploration to elucidate the pathways through which women’s empowerment is associated with food security. This literature review aimed to draw insights from studies on women’s empowerment and food security and identify the related challenges and best practices in this pathway within the context of low- and middle-income countries. Scopus, PubMed, and Global Health databases were searched, as well as reference lists for articles. In total 21 articles met the inclusion criteria. Findings suggest a mixed relationship between women’s empowerment and food security and highlighted a gap in conceptualizing and operationalizing food security. To achieve sustainable food security, particularly in the aftermath of COVID-19, researchers and stakeholders must respond to the broader context of gender systems that restricts women’s rights and access to productive resources to achieve food security.

Hypomagnesaemia, an independent risk factor for the development of post-transplant diabetes mellitus in liver and renal transplant recipients? A systematic review.

Post-transplantation diabetes mellitus (PTDM) is common after solid organ transplantation. In the past decade, there has been increasing interest in the association between hypomagnesaemia and the development of PTDM. This systematic review aimed to investigate the current knowledge regarding the association between hypomagnesaemia and PTDM in adult liver and renal transplant recipients. A literature search of five databases, Medline, Embase, ProQuest, Scopus and Google Scholar, as well as article reference lists, was performed. Eligible studies that focused on adult liver and renal transplant recipients without pretransplantation hyperglycaemia or diabetes were included. Other eligibility criteria included quantitative studies which reported magnesium concentrations, studies with at least 6 months of follow-up, and studies published in English. The Newcastle-Ottawa Assessment Tool was used for the quality assessment. In total, 12 studies were included in the final analysis. Eleven focused on renal transplantation and one on liver transplantation. All studies were medium to high quality with eight out of 12 achieving the highest rating of nine. Eight studies found a negative association between either pretransplant or early post-transplant serum magnesium concentration and the risk of PTDM, three studies found no association between these two variables, and one study found a positive association between the magnesium concentration at 8 weeks after transplantation and glycosylated haemoglobin A1C. Further large-scale prospective studies with at least 6 months of follow-up are needed to confirm these findings, particularly in liver transplantation, to further clarify and explore the relationship between hypomagnesaemia and PTDM.

The impact of limited English proficiency on oncological outcomes in the United States: A systematic review.

The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes. To assess the effects of LEP compared to English proficiency (EP) for oncological outcomes in adult cancer patients in the United States. We searched MEDLINE (Ovid), the Cochrane Library (Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials), PsycINFO, CINAHLand Scopus from data inception to 26 January2023. We also searched the reference lists and cited lists of included studies. Studies were limited to the UnitedStatesand the English language. We included retrospective and cross-sectional studies that analyzed one or more clinical outcomes (survival, readmission, length of stay, complicationsand discharge disposition) in LEP and EP cancer patients. Studies were eligible if they assessed cancer patients in the United Stateswho were 18 years and older. Using a piloted, standardized data collection form, two non-blinded, independent reviewers extracted data in duplicate from studies meeting our inclusion criteria. Reviewers resolved discrepancies through discussion. We then performed a qualitative assessment of the findings. We retrieved 2425 records from the database searches. We screened 1496 records by title and abstract and reviewed the full text of eight records. We retrieved 347 records from additional search methods and reviewed the full text of six records. We included 14 papers in total for analysis. The studies included 55,141 total patients and assessed outcomes in brain, oesophageal, head and neck, pancreaticand skin cancer. Our qualitative assessment demonstrated limited information on whether LEP impacted survival, complicationsand discharge disposition. We found no significant association between LEP and readmission or length of stay. Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.

Recognising dying in motor neurone disease: A scoping review.

Timely identification of dying in motor neurone disease enables optimal care, yet we know that healthcare professionals can fail to recognise when death is approaching. Clinical factors help predict the end of life in other terminal conditions. Examining these principles in motor neurone disease would help guide more accurate recognition of this critical phase. To examine and map out what is known about dying in patients with motor neurone disease, and the recognition of dying by healthcare professionals. A scoping review was conducted following the Arksey and O'Malley methodological framework. Four electronic databases (MEDLINE, Scopus, PsycINFO and CINAHL) and grey literature were searched on the 10th May 2023. Reference lists and citations were also reviewed. From 1512 articles, 13 studies were included. Dyspnoea, anxiety and pain were the most common symptoms associated with the dying phase. Worsening respiratory function, the development of specific new symptoms and deteriorating symptom control suggested approaching death. No studies reported changes in vital signs or biomarkers associated with dying. Barriers to the recognition of dying by healthcare professionals included a rapid and unpredictable terminal decline. Dying in motor neurone disease is associated with patterns of symptoms and signs, however evidence is limited compared with other terminal conditions and requires further exploration. The characteristic sudden and unpredictable terminal decline is a key barrier to recognition of dying by healthcare professionals. Optimising advance care planning is one approach to navigate these complex, unpredictable clinical situations.

Social participation classification and activities in association with health outcomes among older adults: Results from a scoping review.

The aim of this study is to summarize the characteristics of social participation classification and examine the association between activities and health outcomes among older adults. Scoping review. Eight databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase, ProQuest, Psychological Information Database, PubMed, Scopus and Web of Science) were searched. Reference lists of relevant social participation reviews were also considered. This study applied a five-stage methodological framework. A narrative synthesis summarized social participation classification and activities and their associations with health outcomes among older adults (≥65 years) living at home, in the community or in nursing residences. Forty-two articles published between 1975 and 2022 were selected. Four classification criteria of social participation were extracted and summarized from these studies. Based on the depth and breadth of social interactions, this review proposed a four-level classification schema. A lower risk of mortality and less visual impairment were associated with participation in level-one, level-three or level-four activities, whereas less depression, less pain and better cognitive function were linked to participation in level-three or level-four activities. Future studies should provide a clear definition, establish classification criteria for participation and properly select activity forms while considering both subjective and objective dimensions. The results could provide data for designing targeted social participation interventions to improve specific health outcomes among older adults. This review could help researchers examine the role of social participation activities in specific health outcomes. Moreover, a proposed classification of social participation activities would benefit researchers and community nurses in discerning the similarities and differences among activities. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guideline. No patient or public contribution.

Occurrence of Dumping Syndrome After Esophageal Cancer Surgery: Systematic Review and Meta-analysis.

Dumping syndrome occurs frequently after esophageal cancer surgery, but the reported prevalence varied across previous studies. This systematic review and meta-analysis aimed to clarify the prevalence of dumping syndrome after esophageal cancer surgery, particularly exploring the sources of heterogeneity in previous studies. A comprehensive literature search was conducted in PubMed, MEDLINE, Web of Science, Embase, and the Cochrane Library databases, supplemented by hand-search of reference lists, through March 2023. Random-effects meta-analysis estimated the average prevalence of dumping syndrome after esophageal cancer surgery. Heterogeneity across studies was examined by the I2 statistic and Cochran's Q test. Among the 2949 articles retrieved from the databases, 16 articles (15 cohort studies and 1 randomized controlled trial) met the inclusion criteria. The prevalence of dumping syndrome ranged 0-74% in these studies, showing high heterogeneity (I2 = 99%, P < 0.01), with the pooled prevalence of 27% (95% confidence interval [CI] 14-39%). The pooled prevalence in the three studies using specialized questionnaires was 67% (95% CI 60-73%), with reduced heterogeneity (I2 = 43%, P = 0.17). The prevalence also varied by year of publication, study population, and length and completeness of follow-up. Our findings revealed that dumping syndrome is common after esophageal cancer surgery. The varying prevalence across previous studies was probably owing to differences in measurement of dumping syndrome. Using specific patient reported outcome questionnaires is recommended for future investigations on dumping syndrome after esophageal cancer surgery.

Coercive Control in 2SLGBTQQIA+ Relationships: A Scoping Review.

Existing measures and theories of intimate partner coercive control largely evaluate men's coercion of women. The extent of knowledge pertaining to intimate relationships among other genders and sexual identities is unclear. Guided by a theoretical framework of intersectionality, we examined and synthesized original studies on coercive control by (perpetration) or against (victimization) Two Spirit, lesbian, gay, bisexual, trans, queer, questioning, intersex, and asexual individuals within intimate partner relationships. We searched eight academic databases for records from 2014 through 2022 and hand-searched review articles' reference lists, supplemented with gray literature and website searches. Using duplicate screening, we identified 1,774 unique documents; 526 met preliminary eligibility criteria and 277 were retained for data extraction in duplicate. Coercive control was more common among minority individuals and was related to mental health challenges. Few studies reported on gender- or sexual-identity specific forms of coercive control, and an intersectional focus was uncommon. This review revealed a lack of agreed definition of coercive control or accepted standard of measurement, and a gap in research with individuals who identify as gender diverse, gender fluid or intersex, or those identifying their sexuality as asexual, pansexual, or sexually diverse.

Women`s sexual function during the postpartum period: A systematic review on measurement tools.

Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women's sexual function/health during the postpartum period. We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability. From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire's medical impact scale and Carol scale. Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire's medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.

The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

BackgroundDeaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families.MethodsA systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method.ResultsTwenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death.ConclusionThe focus of end-of-life care in PICUs varies depending on HCPs’ and families’ preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families’ beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care.

What factors at discharge predict physical activity and walking outcomes 6 months after stroke? A systematic review.

This study aimed to identify factors at hospital discharge that predict physical activity and walking outcomes in the first 6 months after stroke. Searches were conducted in CINAHL (EBSCO), Web of Science, PubMed and Scopus from inception to 30 April 2024. Reference lists of included articles were manually screened to identify additional studies. Studies of adults with stroke reporting predictors at hospital discharge and outcomes of physical activity or walking across the first 6 months after hospital discharge were included. Two reviewers independently screened titles, abstracts and reviewed full texts. Quality of included studies was assessed with Quality in Prognostic Studies screening tool. A narrative synthesis was undertaken. The search strategy retrieved 7834 studies, from which 6 eligible studies were identified, including a total of 1433 participants. Overall, studies had a low risk of bias. Age, balance, walking speed and walking distance at hospital discharge predicted physical activity outcomes after stroke (n = 2 studies). Cognition, lower limb cycling rhythm and self-efficacy for walking at hospital discharge predicted walking outcomes after stroke (n = 4 studies). A range of factors predicted physical activity and walking outcomes 6 months after stroke. Physical capabilities at discharge appear to be a predictor of these outcomes; however, this needs to be interpreted with caution. Diverse measures and time points were used across studies to characterise physical activity and walking outcomes, highlighting the need for consistency in measurement and longitudinal studies in stroke research.

Investigating the therapeutic efficacy of psilocybin in advanced cancer patients: A comprehensive review and meta-analysis.

Psilocybin, a naturally occurring psychedelic compound found in certain species of mushrooms, is known for its effects on anxiety and depression. It has recently gained increasing interest for its potential therapeutic effects, particularly in patients with advanced cancer. This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer. To investigate the therapeutic effect of psilocybin in patients with advanced cancer. A comprehensive search of electronic databases was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar for articles published up to February 2023. The reference lists of the included studies were also searched to retrieve possible additional studies. A total of 7 studies met the inclusion criteria for the systematic review, comprising 132 participants. The results revealed significant improvements in quality of life, pain control, and anxiety relief following psilocybin-assisted therapy, specifically results on anxiety relief. Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months [35.15 (95%CI: 32.28-38.01)] and 6 to 6.5 months [33.06 (95%CI: 28.73-37.40)]. Post-administration compared to baseline assessments (P < 0.05). Additionally, patients reported sustained improvements in psychological well-being and existential distress following psilocybin therapy. The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life, pain control, and anxiety relief in patients with advanced cancer.

Lover’s Joy for Being Named with a Self–Associated Authored by the chief justice Jamal al-Din Abi Al-Mahasin Muhammad Bin Ali Bin Abi Bakr al-Qurashi Al-abdiri Al-Shibi Al-Makki Al-Shafi'i, who died in (837 AH/1433 AD) (Investigation and Study)

The present study deals with the investigation and study of the book “Lover’s Joy for Being Named with a Self–Associate”, by the chief justice Jamal al-Din Abu Al-Mahasin Muhammad Bin Ali Bin Abi Bakr al-Qurashi Al-abdiri Al-Shibi Al-Makki Al-Shafi'i, who died in (837 AH/1433 AD). The book is delicate in its size, rare in its field, The author distinguished it by getting it translated by more than twenty famous figures who had nicknames related to their bodies either for a congenital defect in one of them, or for a congenital advantage that distinguished them from others, it is as well a second-to-none analog in our Arab heritage. The nature of the research required it to come in two sections, first: the study; it came in two chapters, where in the first one the author was highlighted, and in the second we studied the book. The second section is the verified text, followed by a list of sources and references to which we have returned.

Summary of Evidence on the Impact of Mindfulness Training on Anxiety Levels of Pregnant Women

Background: Mental health during pregnancy is a global health problem, the percentage of pregnant women with antenatal anxiety or mood disorders ranges from 15% and 25%, with generalized anxiety disorder as the most common factor in the illness. Most of the research findings show a relationship between mothers’ psychological distress and poor prognosis for either the mother or the infant. Low well-being during pregnancy has significant adverse impacts on both mother and infant. Therefore, it is important to focus on antenatal anxiety and psychological stress in pregnant women. Mindfulness training, defined as an intentional and non-judgmental awareness of experience in the present moment, it is the most common intervention for antenatal education. Although the impact of positive thinking interventions on antenatal maternal well-being has been increasingly examined, the results still have not been systematically evaluated. Aim: This paper aims to systematically evaluate the effects of positive thinking interventions on evidence of antenatal anxiety in pregnant women and current research methods with a population of pregnant women by evaluating five studies of Randomized Controlled Trials (RCTs) using the CASP checklist tool. Summarize the implications of the evaluation results for future studies, and finally provide practical insights and research recommendations. Methods: Firstly, the research topic is identified: patient/problem: pregnancy anxiety; intervention: intervention in positive thinking; comparison: usual care. A complete internet-based search of five databases was conducted through Academic Search Complete, Medical Line, CINAHL, Health Source: Nursing/Academic Edition and Google Scholar to identify randomized controlled trials assessing positive thinking training versus postnatal depression controls. To select higher quality and relevant articles, the author rechecked titles and abstracts exclusion criteria and manually searched five peer-reviewed RCT articles from the last five years by further evaluating reference lists, while focusing on assessing interventions, measurement scale outcomes, study sample results, strengths and limitations. Secondly, randomized controlled trials were assessed using the CASP Randomized Controlled Trial Criteria Checklist. This version has now been updated to the 2020 Access Guide. Results: This paper provides a specific review of five RCT studies by using the CASP assessment tool, and concludes that positive thinking training shows potential benefits in terms of prenatal depression, anxiety and negative affect levels. From a comparison of the five intervention modalities of the positive thinking intervention, Mindfulness-integrated Cognitive Behavior Therapy (MICBT) had the broadest range of interventions and the most comprehensive curriculum. Most of the studies had small sample sizes of participants and an increase in sample size and longer follow-up time through comparative analysis would be beneficial to generalizability, therefore a sample size of 50 people on average between the intervention and control groups was chosen as appropriate, with a follow-up time of at least one month and three months. Also, the presence of potential bias was mentioned in these studies, by comparing randomized classification methods it was found that the smaller the base difference present through computer allocation and single-blind allocation, the less systematic bias there was. The choice of measurement instruments did not conflict with the sample size, the cultural background of the population and the findings. However, positive effects on anxiety and stress during pregnancy were less consistent with the assessment tool for the intervention group. Self-report instruments are highly sensitive and idiosyncratic, coupled with the tendency of participants to interact with researchers to produce bias. Therefore, when selecting a measurement tool, the best approach is to combine a self-report instrument with a researcher’s assessment. The literature highlights the increased interest in this area in recent years. Coupled with the prevalence of methodological issues and variation between studies, the current review is timely and necessary to determine intervention effects and best practice for future research. Findings: Mindfulness training is a useful intervention for improving anxiety and stress during pregnancy, but future research recommendations must follow robust methodological criteria with expanded sample sizes and longer follow-ups to examine the effects of positive thinking interventions during pregnancy.

Melatonin in Human Milk: A Scoping Review.

Melatonin is vital in human circadian rhythm and infant development. This scoping review summarized the current knowledge about melatonin's presence and effects in human milk to promote better understanding of its secretion pattern and clinical advancement of maternal-infant health. The review followed the Joanna Briggs Institute guideline and answered the question: What is the current knowledge about melatonin hormone in human milk? The databases searched were PubMed, CINAHL, SCOPUS, Web of Science, LILACS, Scielo, EMBASE, Science Direct, Eric, Cochrane, in addition to grey literature and reference lists of included sources. Research papers included English, Spanish, or Portuguese languages, regardless of study type or publication date. The study selection and data extraction involved two independent reviewers. Twenty-nine studies met inclusion criteria. The studies, conducted between 1993 and 2023, employed diverse designs, with cross-sectional studies being the most prevalent. Melatonin concentration exhibited a consistent pattern, being higher at night, and elevated in colostrum. The analysis methods for melatonin concentration evolved, with recent advancements contributing to more accurate measurements. Factors influencing melatonin levels, such as delivery type, maternal age, and health conditions, demonstrated a complex relationship, potentially impacting the health and development of infants. The dynamic nature of melatonin in human milk calls for continued interdisciplinary research, bridging gaps between clinical, biochemical, and epidemiological perspectives. Standardizing melatonin analysis methods are needed. Nurses should assess factors influencing melatonin levels in milk to promote interventions and guidance aimed at enhancing the regulation of the circadian cycle during the perinatal period and its benefits.

Transcutaneous electrical nerve stimulation (TENS) for pain control in women with primary dysmenorrhoea.

Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological treatment that works by delivering electrical currents via electrodes attached to the skin at the site of pain. It can be an alternative to pharmacological treatments. The mechanism of action of TENS for pain relief is related to the inhibition of the transmission of painful stimuli, release of endogenous opioids, and reduced muscle ischaemia of the uterus. Although it has been used for primary dysmenorrhoea ((PD); period pain or menstrual cramps), evidence of the efficacy and safety of high-frequency TENS, low-frequency TENS, or other treatments for PD is limited. To evaluate the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) in comparison with placebo, no treatment, and other treatments for primary dysmenorrhoea (PD). We searched the Gynaecology and Fertility Group's Specialized Register of controlled trials, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, and the Korean and Chinese language databases up to 9 April 2024. We also searched for ongoing trials in trials registries and the reference lists of relevant studies for additional trials. Language restrictions were not applied. We included randomized controlled trials (RCTs) that included women (aged 12 to 49 years) with PD. Included trials compared low-frequency TENS or high-frequency TENS with other TENS, placebo, or other treatment. Four review authors screened the trials, extracted the data according to the protocol, assessed the risk of bias using RoB 2, and assessed the certainty of evidence for all review comparisons and primary outcomes (i.e. pain relief and adverse effects) using the GRADE approach. This review replaces the current review, published in 2009. We included 20 RCTs involving 585 randomized women with high-frequency TENS, low-frequency TENS, placebo or no treatment, or other treatment. We included five comparisons: high-frequency TENS versus placebo or no treatment, low-frequency TENS versus placebo or no treatment, high-frequency TENS versus low-frequency TENS, high-frequency TENS versus other treatments, and low-frequency TENS versus other treatments. High-frequency TENS versus placebo or no treatment High-frequency TENS may reduce pain compared with placebo or no treatment (mean difference (MD) -1.39, 95% confidence interval (CI) -2.51 to -0.28; 10 RCTs, 345 women; low-certainty evidence; I2 = 88%). Two out of three RCTs reported no adverse effects and hence we were unable to estimate the effect of high-frequency TENS on adverse effects. Low-frequency TENS versus placebo or no treatment Low-frequency TENS may reduce pain compared with placebo or no treatment (MD -2.04, 95% CI -2.95 to -1.14; 3 RCTs, 645 women; low-certainty evidence; I2 = 0%). No trials reported adverse effects for this comparison. High-frequency TENS versus low-frequency TENS It is uncertain whether high-frequency TENS had an effect on pain relief compared with low-frequency TENS (MD 0.89, 95% CI -0.19 to 1.96; 3 RCTs, 54 women; low-certainty evidence; I2 = 0%). One trial contributed data on adverse effects but no adverse events occurred. High-frequency TENS versus other treatments It is uncertain whether high-frequency TENS had an effect on pain relief compared to acupressure (MD -0.66, 95% CI -1.72 to 0.40; 1 RCT, 18 women; very low-certainty evidence), acetaminophen (paracetamol) (MD -0.98, 95% CI -3.30 to 1.34; 1 RCT, 20 women; very low-certainty evidence), and interferential current therapy (MD -0.03, 95% CI -1.04 to 0.98; 2 RCTs, 62 women; low-certainty evidence; I2 = 0%). The occurrence of adverse effects did not differ significantly between high-frequency TENS and NSAIDs (OR 12.06, 95% CI 0.26 to 570.62; 2 RCTs, 88 women; low-certainty evidence; I2 = 78%). Low-frequency TENS versus other treatments It is uncertain whether low-frequency TENS had an effect on pain relief compared with acetaminophen (MD -1.48, 95% CI -3.61 to 0.65; 1 RCT, 20 women; very low-certainty evidence). No trials reported adverse effects for this comparison. High-frequency TENS and low-frequency TENS may reduce pain compared with placebo or no treatment. We downgraded the certainty of the evidence because of the risk of bias. Future RCTs should focus more on secondary outcomes of this review (e.g. requirement for additional analgesics, limitation of daily activities, or health-related quality of life) and should be designed to ensure a low risk of bias.

Physical therapy for muscle strengthening in individuals with amyotrophic lateral sclerosis: A protocol for a systematic review and meta-analysis.

People with Amyotrophic Lateral Sclerosis (ALS) can present initially muscle weakness, which is a debilitating symptom that may be improved by engaging in muscle strengthening activities. Currently, the effects of motor interventions for muscle strengthening in people with ALS are unclear. This review intends to analyze the effects of motor interventions for muscle strengthening in individuals with ALS. Randomized, non-randomized, and quasi-experimental clinical trials assessing individuals with ALS of both sexes, aged 18 years or older, who have received motor interventions for muscle strengthening considering all practices that can lead to increased strength, endurance, power and muscular hypertrophy will be included. No restriction on language, location, or publication date will be applied. MEDLINE, EMBASE, Cochrane Library (CENTRAL), SPORTDiscus, and Physiotherapy Evidence Database (PEDro) databases will be searched. The US National Institutes of Health Ongoing, ClinicalTrials.gov, and the reference lists of included studies will also be searched. Two reviewers will independently screen titles and abstracts and extract data from included studies. The methodological quality of the included studies will be assessed by the PEDro scale and the certainty of the evidence by the GRADE approach. Disagreements will be resolved by a third researcher. Findings will be presented in text and table formats. A meta-analysis will compare the effects of motor interventions for muscle strengthening versus placebo or other interventions.

Management of Metastatic Renal Cell Carcinoma Following First-Line Immune Checkpoint Therapy Failure: A Systematic Review.

There is a significant gap in the literature concerning the effective management of second-line therapy for patients with metastatic renal cell carcinoma (RCC) who have received immune checkpoint inhibitors (ICIs). Most of the published articles were small multicenter series or phase 2 studies. To our knowledge, a systematic review that comprehensively outlines the range of treatment options available for patients with metastatic RCC who do not respond to first-line ICIs has not yet been conducted. Our aim was to synthesize evidence on second-line therapies for patients with metastatic RCC after initial treatment with ICIs and to offer recommendations on the best treatment regimens based on the current literature. We conducted a search in PubMed, Embase, and the Cochrane Library on 29 February 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We selected articles that met the predetermined inclusion criteria (written in English, retrospective observational studies, prospective series, and randomized trials reporting second-line therapy for metastatic RCC after failure of ICI-based therapy). Relevant articles were identified in the reference lists. The main endpoint was the overall response rate (ORR), with the median progression-free survival (PFS) and overall survival (OS) as secondary endpoints. We included 27 studies reporting the outcomes of 1970 patients. Salvage therapies were classified as targeted therapy (VEGFR TKIs) in 18 studies and ICIs in 8 studies. In studies where TKIs were the second line of choice, the pooled ORR was 34% (95% CI: 30.2-38%). In studies where ICIs, alone or in combination with TKIs, were used as second-line therapies, the ORR was 25.7% (95% CI: 15.7-39.2%). In studies where TKIs and ICIs were the second-line choices, the pooled median PFS values were 11.4 months (95% CI: 9.5-13.6 months) and 9.8 months (95% CI: 7.5-12.7 months), respectively. This systematic review shows that VEGFR TKIs and ICIs are effective second-line therapies following an initial treatment with anti-PD(L)1 alone or in combination. The treatment choice should be personalized, taking into account the patient's response to first-line ICIs, the site of the disease, the type of first-line combination (with or without VEGFR TKIs), and the patient's overall condition.

Vitamin D and Muscle Status in Inflammatory and Autoimmune Rheumatic Diseases: An Update.

Background and Objectives: Vitamin D is a secosteroid hormone essential for calcium homeostasis and skeletal health, but established evidence highlights its significant roles also in muscle health and in the modulation of immune response. This review aims to explore the impact of impaired vitamin D status on outcomes of muscle function and involvement in inflammatory and autoimmune rheumatic diseases damaging the skeletal muscle efficiency both with direct immune-mediated mechanisms and indirect processes such as sarcopenia. Methods: A comprehensive literature search was conducted on PubMed and Medline using Medical Subject Headings (MeSH) terms: "vitamin D, muscle, rheumatic diseases." Additionally, conference abstracts from The European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR) (2020-2023) were reviewed, and reference lists of included papers were scanned. The review emphasizes the evidence published in the last five years, while also incorporating significant studies from earlier years, structured by the extent of evidence linking vitamin D to muscle health in the most commonly inflammatory and autoimmune rheumatic diseases encountered in clinical practice. Results: Observational studies indicate a high prevalence of vitamin D serum deficiency (mean serum concentrations < 10 ng/mL) or insufficiency (<30 ng/mL) in patients with idiopathic inflammatory myopathies (IIMs) and polymyalgia rheumatica, as well as other autoimmune connective tissue diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Of note, vitamin D insufficiency may be associated with reduced muscle strength (2 studies on RA, 2 in SLE and 1 in SSc), increased pain (1 study on SLE), fatigue (2 studies on SLE), and higher disease activity (3 studies on IIMs and 1 on SLE) although there is much heterogeneity in the quality of evidence and different associations for the different investigated diseases. Therefore, linked to the multilevel biological intervention exerted by vitamin D, several translational and clinical studies suggest that active metabolites of this secosteroid hormone, play a role both in reducing inflammation, but also in enhancing muscle regeneration, intra-cellular metabolism and mitochondrial function, although interventional studies are limited. Conclusions: Altered serum vitamin D status is commonly observed in inflammatory and autoimmune rheumatic diseases and seems to be associated with adverse muscle health outcomes. While maintaining adequate serum vitamin D concentrations may confer muscle-protective effects, further research is needed to confirm these findings and establish optimal supplementation strategies to obtain a safe and efficient serum threshold.

تداعيات الاختلاف بين المدارس الحديثية

When the disagreement occurred among the Fiqh schools in methodology and deduction, particularly between the school of Ahl Al-Hadith and the school of Ahl Al-Ra’y, it was important to examine and extrapolate the approach of each school in order to identify the points of agreement and disagreement between them. This research aims to identify Ahl Al-Hadith and the concept of Ahl Al-Hadith’s school, clarify the meaning of Ahl Al-Ra’y and the concept of Ahl Al-Ra’y’s school, deduce the methodology that each school adhered to and elucidate their contributions to the Sunnah and its sciences, and conduct a comparison between the two schools to highlight the points of agreement and disagreement between them. To this regard, I combine the inductive, analytical, and comparative approaches. The research is arranged into an introduction, three treatises, a conclusion, a list of bibliography and references. Then the research ends with several findings, including: Ahl Al-Hadith refers to those who have a close connection with the traditions (Athar) through seeking, collecting, understanding, memorizing, narrating, following, and acting accordingly, both outwardly and inwardly, and they possess the critical faculty and the fine discernment to distinguish between authentic and unauthentic narrations of the Prophet (PBUH). Meanwhile, Ahl Al-Ra’y refers to those who consider issues and engage in Ijtihad (Shariah-based-reasoning), and use analogical deduction (Qiyas) in matters of creed and Fiqh, whether their Ijtihad is reprehensible or praiseworthy. As for the recommendations, the most significant among them is the need to understand that disagreement among the four schools of Fiqh pertains to subsidiary matters, while they agree on the fundamental principles of issues.

Transfer Learning in Weather Prediction: Why, How, and What Should

Transfer learning (TL) is a popular phrase in deep learning (DL) domain. It is one of the latest artificial intelligence (AI) technologies that has a significant impact on big data analysis. Methods of traditional machine learning (ML) require the availability of an adequate quantity of training data as well as similarity of characteristics among the feature spaces corresponding to training and test data while performing supervised learning tasks. However, in real-life analytical problems, data scarcity often arises. In such scenarios, the TL approach has shown effectiveness in transferring knowledge from the source tasks that had large training data to a target task that has less training data. Basically, in TL, a model that has been trained on one task is essentially applied to a second related (but not exact) task. In this way, the issue of distribution mismatch can also be addressed. TL is not like conventional machine learning algorithms that try to learn each task starting from the beginning. Meteorological research is such an example of big data analysis which often faces the data scarcity issue. The current study addresses the contemporary challenges in weather forecasting that can be solved (or better dealt with) using TL methods. It presents a brief review of earlier research, followed by potential applications of TL algorithms to several key challenges in weather prediction, which includes the prediction of air quality, thunderstorms, precipitation, visibility, and cyclones, among others. Special emphasis is given to high-impact weather (HIW) prediction. These high-impact events are extremely difficult to predict, and they can cause enormous property damage and fatalities around the world. TL techniques have shown advantages in predicting HIW. Various challenging issues in implementing TL technology are then discussed. Finally, we address various prospects associated with TL, propose new research directions, and more importantly mention some concerns for beginners in DL-TL research. An extensive list of references is also provided.