Science Electronic Databases Research Articles

Prognostic impact of serum testosterone in metastatic hormone-naive prostate cancer: a systematic review and meta-analysis.

In daily practice, there is an unmet medical need for biomarkers that facilitate therapeutic decision-making in the metastatic hormone sensitive prostate cancer (mHSPC) scenario. Although recent studies have highlighted the potential of testosterone as a prognostic and predictive marker in prostate cancer, the evidence is controversial. The objective of this review was to summarize and analyze the scientific evidence regarding the prognostic role of basal testosterone levels in patients with mHSPC. A systematic review was performed. Three authors selected the articles from Web of Science, PubMed, Scopus, and Cochrane Library electronic databases. Risk of bias was assessed by the Newcastle Ottawa Scale. Most of the selected articles suggest that low testosterone levels before starting hormonal blockade imply a worse prognosis for patients with mHSPC. However, the quality of the evidence is poor, the studies are heterogeneous, and it is not possible to meta-analyze most of the published results. Testosterone is an accessible and affordable biomarker. If it were correctly demonstrated that it harbors a prognostic and/or predictive role in the mHSPC setting, it could represent an advance in decision-making in these patients. Well designed prospective studies are needed to correctly answer this question.

Auditory function in humans at high altitude. A scoping review.

High-altitude (HA) affects sensory organ response, but its effects on the inner ear are not fully understood. The present scoping review aimed to collect the available evidence about HA effects on the inner ear with focus on auditory function. The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews. PubMed, Scopus, and Web of Science electronic databases were systematically searched to identify studies conducted in the last 20 years, which quantified in healthy subjects the effects of HA on auditory function. The systematic search identified 17 studies on a total population of 888 subjects (88.7% male, age: 27.8 ± 4.1 years; median sample size of 15 subjects). Nine studies were conducted in a simulated environment and eight during real expeditions at HA. To quantify auditory function, six studies performed pure tone audiometry, four studies measured otoacoustic emissions (OAE) and eight studies measured auditory evoked responses (AER). Study protocols presented heterogeneity in the spatio-temporal patterns of HA exposure, with highly varying maximal altitudes and exposure durations. Most studies reported a reduction of auditory function with HA in terms of either elevation of auditory thresholds, lengthening of AER latencies, reduction of distortion-product and transient-evoked OAEs. Future studies in larger populations, using standardized protocols and multi-technique auditory function evaluation, are needed to further characterize the spatio-temporal pattern of HA effects along the auditory pathways and clarify the pathophysiological implications and reversibility of the observed changes.

Pairing spontaneous awakening and breathing trials to improve weaning of intensive care unit patients: A Systematic Review Protocol

Abstract:
 Background: The ICU nursing role is to minimize the agitation and suffering experienced by mechanically ventilated sedated patients while facilitating effective and safe clinical care, seeking to optimize outcomes for service users and health systems. This can be achieved with bundled EBP interventions. One care bundle for those patients is the “Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility” (ABCDEF) bundle. It deploys tailored, patient-centered pharmacological and non-pharmacological therapies for implementation in ward management and clinical practice. It seeks to shatter the paradigm of extended mechanical ventilation and associated sedation for ICU patients by guiding clinical decision-making and interventions algorithmically. 
 Method: Randomized controlled studies will be included for the present systematic review with adult and pediatric patients who have been managed using the Awakening and Breathing Coordination protocol compared to the routine care in the ICUs. The Cochrane Library (Wiley), MEDLINE (PubMed), Scopus, and Web of Science electronic databases will be searched for articles published in English. The clinical outcomes of interest include successful weaning, incidence/prevalence of VAP, sedation level, and reduced stay in the ICU/hospital stay time. The reviewers will independently extract data with a standard form, recording observations concerning the reviewed studies’ research design, population, clinical interventions and outcomes, and techniques of data collection and analysis. Their independent findings will then be compared to check for consistency, and in the event of contrasting findings or interpretations, a third-party research expert will arbitrate.
 Results: The evidence from this review would particularly assist nursing decision-making on using spontaneous awakening trials and spontaneous breathing trials in combination for ventilated patients.
 Conclusion: The results could drive evidence-based practice to improve the quality of care for mechanically ventilated sedated patients in ICUs by building on the safety and clinical effectiveness of Randomized controlled trials.
 Protocol registration: PROSPERO CRD42022344884

Association between statins exposure and risk of skin cancer: an updated meta-analysis.

This study aimed to investigate the relationship between statin (lipophilic statin and hydrophilic statin) exposure and the risk of skin cancer. The incidence of skin cancer under statin exposure was used as the primary outcome, and the relevant studies were screened from Web of Science, PubMed, Cochrane Library, and EBSCO electronic database until September 2022. Ten observational studies and two randomized controlled trials (RCTs) were included. The statistical results indicated that in lipophilic statins, the exposed group had a higher risk of skin cancer than the non-exposed group (OR: 1.09, P = 0.003). However, compared with the non-exposed group, there was no significant difference between hydrophilic statins exposure and the incidence of skin cancer (OR: 1.02, P = 0.341). Further subgroup analysis of the subtypes of statins revealed that compared with the non-exposed group, exposure to lovastatin (OR: 1.18, P = 0.048) or simvastatin (OR: 1.11, P < 0.001) was a risk factor for skin cancer. Besides, subgroup analysis based on the subtypes of skin cancer demonstrated that the risks of melanoma (OR: 1.13, P = 0.009), basal cell carcinoma (BCC) (OR: 1.05, P = 0.036), and squamous cell carcinoma (SCC) (OR: 1.13, P = 0.026) under lipophilic statin exposure were significantly higher than those in the non-exposed group. On the contrary, compared with the non-exposed group, the risk of BCC was significantly reduced under the exposure of hydrophilic statins (OR: 0.93, P = 0.031). This study showed that the relationship between statin exposure and skin cancer risk was affected by the subtypes of statins and skin cancer subtypes.

Reflux Disease Questionnaire Scoring and Utilization: A Scoping Review

Background: The RDQ was developed to assist in diagnosing GERD, but is now widely used in multiple contexts and validated in several languages. However, there is no standard RDQ scoring rubric, making comparisons between its uses challenging. Therefore, we performed a scoping review to explore the current applications and scoring cutoffs of the RDQ. Methods: The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science electronic databases were systematically searched from January 2001 to January 2021 by a medical librarian using controlled vocabulary terms and keywords to identify experimental and observational study designs. Results: The search strategy yielded 5707 studies and 116 met inclusion criteria yielding a total patient population of 115 064. Studies utilized the RDQ to establish a GERD diagnosis (n = 52, 45%), report the prevalence of GERD symptoms within a specific population (n = 21, 18%), and assess the effect of an intervention on symptoms (n = 43, 37%). There was variability between the scoring threshold used for diagnosing GERD, with total GERD domain score ≥12 being the most commonly used (n = 16, 14%). Conclusions: The RDQ was designed as an aid for diagnosing GERD, but scoring methods and thresholds vary and the RDQ now is used to describe the prevalence of GERD symptoms and to assess symptom response to intervention. Based on the current review, the use of RDQ appears best suited for comparing diagnostic or treatment cohorts in which symptoms are evaluated. Interpretation of RDQ findings outside of a study-specific context is limited without accepted scoring standards.

Relationship between body mass index and mortality of burns patients: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the relationship between body mass index (BMI) and mortality of burn patients. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Body mass index", "Burns" and "Mortality" from the earliest to the April 1, 2023. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Finally, six articles were included in this systematic review and meta-analysis. A total of 16 154 burn patients participated in six studies. Their mean age was 46.32 (SD = 1.99). Of the participants, 71.7% were males. The mean length of hospitalization was 18.80 (SD = 8.08) days, and the average TBSA in burn patients was 38.32 (SD = 2.79) %. Also, the average BMI in burn patients was 27.10 (SD = 1.75). Results found mortality in patients with abnormal BMI (overweight to morbidity BMI) was 0.19 more than normal BMI (ES: 1.19, 95%CI: 0.76-1.87, Z = 0.75, I2 : 71.8%, p = 0.45). Results of linear dose-response showed each 5 kg/m2 increase in BMI was associated with a 5% increase in mortality that was marginally significant (ES: 1.05, 95%CI: 1.00-1.11, Z = 1.99, I2 : 22.2%, p = 0.047). There was a non-linear relationship between levels of BMI and mortality (Prob > χ2 = 0.02). There was an increase in mortality from percentile 10 to 50, although it was not significant (Correlational coefficient: 0.01, p = 0.85). Also, there was an increase in mortality rate from percentile 50 to 90 that was statistically significant (correlational coefficient: 0.06, p = 0.047). Finally, the results of the study indicated BMI can increase the chance of mortality by 0.19, although it was not significant. As a result, more studies are needed to better judge the relationship between BMI and mortality in burn victims.

The effect of perceived teachers' interpersonal behavior on students' learning in physical education: a systematic review.

The primary purpose of this study was to conduct the first systematic review on teachers' interpersonal behaviors and students' learning within the physical education context. We searched the English literature in the EBSCOhost, Web of Science, SCOPUS and PubMed electronic databases and following screening, data extraction, quality assessment, 35 published articles were included in this review. The results showed that: perceived teachers' supportive behaviors have effect on autonomous motivation of students, and perceived teachers' controlling behaviors have effect on students' controlling motivation and amotivation, the influencing mechanism may be that teachers' interpersonal teaching behaviors make students' basic psychological needs satisfaction or frustration; perceived teachers' international behaviors have effect on PE learning emotion of students, and perceiving teachers' supportive behaviors can trigger students' positive learning emotion, on the contrary, perceiving teachers' controlling behaviors can stimulate students' negative learning emotion; teachers' interpersonal behaviors have effect on students' psychological well-being and physical activity levels in class with the evidence insufficient, and more evidence are needed. It is extremely necessary to expand such study direction and strengthen better quality study to explore the effect of teachers' interpersonal behaviors on learning process and learning outcome in physical education class, and examine the indirect influence mechanism through that the relationship is connected. The present review provides preliminary evidence to enhance the quality of physical education teaching in class, promote students' academic performance by intervening teachers' interpersonal behaviors.

Association between choline supplementation and Alzheimer's disease risk: a systematic review protocol.

There is growing evidence suggesting choline intake might have beneficial effects on cognitive function in the elderly. However, some studies report no relationship between choline intake and cognitive function or improvement in Alzheimer's disease patients. This protocol is for a systematic review of choline intake and Alzheimer's disease that aims to assess the comparative clinical effectiveness of choline supplementation on Alzheimer's disease risk. literature search will be performed in PubMed, MEDLINE, EMBASE, CINAHL, Scopus, Cochrane, and the Web of Science electronic databases from inception until October 2023. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies will be included if they compared two different time points of choline biomarkers measures in men or women (65+) with Alzheimer's Disease. The risk of bias in the included studies will be assessed within the Covidence data-management software. This review will summarize the clinical trial and quasi-experimental evidence of choline intake on Alzheimer's disease risk for adults aged 65+. The results from all eligible studies included in the analysis will be presented in tables, text, and figures. A descriptive synthesis will present the characteristics of included studies (e.g., age, sex of participants, type, length of intervention and comparator, and outcome measures), critical appraisal results, and descriptions of the main findings. This systematic review will summarize the existing evidence on the association between Choline intake and AD and to make recommendations if appropriate. The results of this review will be considered with respect to whether there is enough evidence of benefit to merit a more definitive randomized controlled trial. The results will be disseminated through peer-reviewed journals population. This protocol outlines the methodology for a systematic review of choline intake and AD. The resulting systematic review from this protocol will form an evidence-based foundation to advance nutrition care for individuals with AD or poor cognitive function. http://www.crd.york.ac.uk/PROSPERO, identifier CRD42023395004.

The use of hydrotherapy in the first stage of labour: A systematic review and meta-analysis.

To explore the effect of hydrotherapy applied in the first stage of labour on the health of mother and newborn. This systematic review and meta-analysis was carried out by following PRISMA. The studies were obtained by scanning EBSCO, PubMed, Science Direct, Ovid, Web of Science and Scopus electronic databases. Twenty studies published between 2013 and 2023 were included. The total sample size of the studies was 8254 (hydrotherapy: 2953, control: 5301). Meta-analyses showed that the perception of pain decreased, comfort level and vaginal birth rate were higher and assisted vaginal birth rate and APGAR scores in the first minute were lower in women who underwent hydrotherapy. There was no difference between groups in terms of the duration of the first and second stage of labour, episiotomy, perineal trauma, intrapartum and postpartum bleeding amounts, use of pain medication and labour augmentations, APGAR scores in the fifth minute, positive neonatal bacterial culture and neonatal intensive care unit need. This study revealed that the results that hydrotherapy decreased the perception of pain and assisted birth, increased the rate of vaginal birth and comfort level and did not adversely affect the health of the mother and baby during the birth process.

The reliability of pressure pain threshold in individuals with low back or neck pain: a systematic review.

Low-back and neck pain affect a great number of individuals worldwide. The pressure pain threshold has the potential to be a useful quantitative measure of mechanical pain in a clinical setting, if it proves to be reliable in this population. The objectives of this systematic review are to: (1) analyze the literature evaluating the reliability of pressure pain threshold (PPT) measurements in the assessment of neck and low-back pain, (2) summarize the evidence from these studies, and (3) characterize the limitations of PPT measurement. Relevant literature from PubMed and the Web of Science electronic databases were screened in a 3-step process according to inclusion/exclusion criteria. Relevant studies were assessed for risk of bias using the Quality Appraisal of Reliability Studies (QAREL) tool, and results of all studies were summarized and tabulated. Of 922 citations identified, 11 studies were deemed relevant for critical appraisal, and 8 studies were deemed to have low risk-of bias. Intra-rater reliability, reported in all studies (n = 637) and inter-rater reliability, reported in 2 studies (n = 200) were consistently reported to be good to excellent (ICC 0.75-0.99 and ICC 0.81-0.90, respectively). Studies were also found to have significant variation in PPT measurement procedures. Though intra- and inter-rater reliability was found to be high in all studies, the variation in PPT measurement protocols could affect validity and absolute reliability. As such, it is recommended that standard guidelines be developed for clinical use.

Artificial intelligence in orthodontics and orthognathic surgery: a bibliometric analysis of the 100 most-cited articles

BackgroundThe application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of bibliometric reports that analyze the academic literature in this field to identify publishing and citation trends. By conducting an analysis of the top 100 most-cited articles on AI in orthodontics and orthognathic surgery, we aim to unveil popular research topics, key authors, institutions, countries, and journals in this area.MethodsA comprehensive search was conducted in the Web of Science (WOS) electronic database to identify the top 100 most-cited articles on AI in orthodontics and orthognathic surgery. Publication and citation data were obtained and further analyzed and visualized using R Biblioshiny. The key domains of the 100 articles were also identified.ResultsThe top 100 most-cited articles were published between 2005 and 2022, contributed by 458 authors, with an average citation count of 22.09. South Korea emerged as the leading contributor with the highest number of publications (28) and citations (595), followed by China (16, 373), and the United States (7, 248). Notably, six South Korean authors ranked among the top 10 contributors, and three South Korean institutions were listed as the most productive. International collaborations were predominantly observed between the United States, China, and South Korea. The main domains of the articles focused on automated imaging assessment (42%), aiding diagnosis and treatment planning (34%), and the assessment of growth and development (10%). Besides, a positive correlation was observed between the testing sample size and citation counts (P = 0.010), as well as between the time of publication and citation counts (P < 0.001).ConclusionsThe utilization of AI in orthodontics and orthognathic surgery has shown remarkable progress, particularly in the domains of imaging analysis, diagnosis and treatment planning, and growth and development assessment. This bibliometric analysis provides valuable insights into the top-cited articles and the trends of AI research in this field.

Prevalence of surgical site infection and risk factors in patients after foot and ankle surgery: A systematic review and meta-analysis.

The present systematic review and meta-analysis aimed to determine the prevalence of surgical site infection (SSI) and related factors in patients after foot and ankle surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as 'Prevalence', 'Surgical wound infection', 'Surgical site infection' and 'Orthopaedics' from the earliest to 1 June 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 10 447 patients undergoing foot and ankle surgery participated in nine studies. The pooled prevalence of SSI in patients who underwent foot and ankle surgery was reported in nine studies was 4.2% (95% CI: 2.4%-7.2%; I2 = 96.793%; p < 0.001). The odds ratio of SSI prevalence in men was higher than that of women and was significant (OR: 1.335; 95% CI: 1.106-1.612; Z = 3.009; p = 0.003). The pooled prevalence of SSI in patients with hindfoot fracture sites reported in five studies was 4.9% (95% CI: 2.6%-8.9%; I2 = 90.768%; p < 0.001). The pooled prevalence of SSI in patients with diabetes mellitus (DM) reported in six studies was 9.1% (95% CI: 5.6%-14.6%; I2 = 73.957%; p = 0.002). The pooled prevalence of SSI in patients with hypertension (HTN) reported in five studies was 5.5% (95% CI: 2.5%-11.6%; I2 = 91.346%; p < 0.001). The pooled prevalence of SSI in patients with tobacco use reported in eight studies was 6.6% (95% CI: 4.1%-10.4%; I2 = 85.379%; p < 0.001). In general, the existing differences in the prevalence of SSI after foot and ankle surgery in different studies can be based on different risk factors such as comorbidities and gender. Therefore, it is suggested to design appropriate interventions to reduce SSI in these patients.

Prevalence of fatigue in adolescents and adults with cerebral palsy: a systematic review and meta-analysis

ABSTRACT Background Fatigue is a common problem for adults with cerebral palsy (CP) and may be related to the decline in physical function, including the loss of the ability to walk. Objective To estimate the overall prevalence of fatigue in adolescents and adults with cerebral palsy. Methods MEDLINE (OVID), EMBASE (OVID), CINAHL, PsycINFO, and Web of Science electronic databases were searched in September 2021. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration CRD42021275596. Two authors independently screened studies according to Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist. Results Of the 1022 studies identified, fifteen met the inclusion criteria. Study quality assessment was performed using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Checklist, with scores ranging from 4 out of 10 to 10 out of 10. Pooled prevalence estimates for twelve studies were 52.9% (95% confidence interval [CI]40.9–64.6). Fatigue was higher in people with bilateral CP than unilateral CP, and higher in people classified as Gross Motor Function Classification System (GMFCS) levels III-V. Conclusion More than half of the adults with CP (52.9%) reported living with fatigue. Adults with CP frequently reported fatigue that may lead to activity limitations and/or restrictions. Fatigue was strongly correlated with pain, depression, and reduced quality of life. Assessment and appropriate fatigue management techniques are necessary to enhance capacity for everyday functioning and quality of life.

Effectiveness of biochar as an adsorbent for pesticides: Systematic review and meta-analysis

The use of pesticides is intense in agriculture and has caused contamination in water, air and soil. This fact led to the need to study strategies that can minimize the effects that these pesticides have caused to the environment. In this context, biochar appears, as a type of material that has the ability to remove chemical substances, and because they can be activated with different chemical agents, they are extremely effective in the adsorption of toxic substances. Therefore, the aim of the study was to evaluate the use of biochar as a bioadsorbent for pesticides. This is a systematic review with meta-analysis and meta-regression, as the PRISMA protocol recommendations. Studies from the last 20 years were included, with at least the abstract available and considering preferentially experimental studies. Qualitative studies or studies with high risk of bias, other reviews and duplicates were excluded. The variables analyzed were the presence of factors that prove the effectiveness or not of pesticide adsorption. Studies with a superficial approach or those that do not show positivity or negativity in relation to the outcome were excluded. The search was conducted on the sources: Scopus, Web of Science electronic databases, PubMed (of the US National Library of Medicine, National Institutes of Health) and ScienceDirect (Elsevier). For better investigative determination, the data were searched separately. The descriptors used for the search were the following: Agrochemicals AND Activated Carbon AND Adsorption. Initially, 2431 references were found, from which 14 were selected to compose the meta-analysis review. With the joint analysis of the data, it was possible to verify using the random model (since the studies assess different contexts) that there is a proportion of effectiveness of the intervention of 81% (with a 95% confidence interval), ranging from 75 to 88%, which is represented by the meta-analysis diamond that is the final result of the statistical analysis. Biochar is effective in removing impurities, even including features such as low cost. There is a considerable lack of studies on the topic of pesticide adsorption with the use of biochar. The studies approach a very heterogeneous perspective on the subject, exposing different contexts.

The Association between Gestational Diabetes Mellitus and Infections in Pregnancy-Systematic Review and Meta-Analysis.

We conducted a systematic review and meta-analysis to evaluate the association between gestational diabetes mellitus and infections during pregnancy. We included cross-sectional, case-control, cohort studies and clinical trials, evaluating the frequency of infections in women with and without gestational diabetes mellitus. A search was conducted in Embase, PubMed, and Web of Science electronic databases and by manually searching references, until 23 March 2022, resulting in 16 studies being selected for review, with 111,649 women in the gestational diabetes mellitus group, and 1,429,659 in the controls. Cochrane's Q test of heterogeneity and I² were used to assess heterogeneity. Pooled odds ratio (OR) was calculated. Funnel plots and Egger test were used for assessment of publication bias. The results showed a significant association between gestational diabetes mellitus and infections (pooled-OR 1.3 95% CI [1.2-1.5]). Sub-analyses showed a significant association for urinary tract infections (pooled-OR of 1.2 95% CI [1.1-1.3]), bacterial infections (pooled-OR were 1.2 95% CI [1.1-1.4]), and SARS-CoV-2 (pooled-OR 1.5 95% CI [1.2-2.0]) but not to gingivitis or vaginal candidiasis. The results underscore the significance of acknowledging gestational diabetes mellitus as a risk factor for infections.

Robot-assisted DIEAP flap harvesting: a review of techniques

Robotic surgery has expanded the capabilities of human surgical techniques by offering tremor elimination, ergonomic positioning, 3D viewing, and improved resolution.The purpose of the study: to examine DIEAP flap harvesting techniques using minimally invasive robot-assisted techniques.Material and Methods. The PubMed, SCOPUS, ScienceDirect, and Russian scientific electronic library databases were used for the review; the search was performed using the key phrases robotic deep inferior epigastric artery perforator flap, robotic DEIAP, robotic breast surgery, robot-assisted breast reconstruction. Inclusion criteria: case reports or cadaveric studies.Results. Nine studies were found that met the inclusion parameters. Nine studies looking at DIEAP flap extraction using robot-assisted techniques included a total of 59 patients. Five studies defined the flap harvesting technique as transperitoneal or intraperitoneal. Only 1 study described extroperitoneal flap harvesting. Three studies used the same terminology: transabdominal preperitoneal and total extroperitoneal. A lack of consensus in terminology was found.Conclusion. Robot-assisted DIEAP flap harvesting can be performed using transabdominally preperitoneal and total extraperitoneal techniques, as well as using monoport and multiport accesses with different port locations. However, for a more detailed study, randomized controlled trials with control of anterior abdominal wall weakness and with comparison of complications of different techniques are needed.

Prognostic value of geriatric nutritional risk index in patients with diffuse large B-cell lymphoma: a meta-analysis.

Geriatric nutritional risk index (GNRI) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. The purpose of this meta-analysis was to discuss the value of the GNRI in evaluating long-term outcomes in DLBCL. We systematically and roundly retrieved PubMed, Cochrane Library, Embase, Scopus and Web of Science electronic databases from inception of the databases to March 20, 2023. At the same time, we calculated the pool hazard ratios (HRs) with their 95% confidence interval (CI) for overall survival and progression-free survival to assess the effect of GNRI on the prognosis of DLBCL patients. In our primary meta-analysis, 7 trials with a total of 2448 patients were enrolled. Results showed that lower level of GNRI was related to poorer overall survival (HR = 1.78, 95% CI 1.27, 2.50, p < 0.01) and worse progression-free survival (HR = 2.31, 95% CI 1.71, 3.13, p < 0.01) in DLBCL patients. The results of our meta-analysis indicate that a lower GNRI significantly associated with poorer prognosis for DLBCL. It is believed that GNRI was a promisingly predictive indicator of survival outcomes in DLBCL patients. However, large multicenter prospective studies are necessary to verify the results.

Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta-analysis.

The goal of this systematic review and meta-analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Prevalence", "Surgical wound infection", "Surgical site infection" and "Orthopedics" from the earliest to the May 1, 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%-7.2%; I2 = 99.39%; p < 0.001). The pooled prevalence of surgical wound infection in male and female patients who underwent long bone surgery was 4.6% (95% CI: 1.7%-11.7%; p < 0.001; I2 = 99.34%) and 2.6% (95% CI: 1.0%-6.3%; I2 = 98.84%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with femur surgery sites reported in nine studies was 3.7% (95% CI: 2.1-6.4%; I2 = 93.43%; p < 0.001). The pooled prevalence of surgical wound infection in open and close fractures was 16.4% (95% CI: 8.2%-30.2%; I2 = 95.83%; p < 0.001) and 2.9% (95% CI: 1.5%-5.5%; I2 = 96.40%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) was 4.6% (95% CI: 2.3%-8.9%; I2 = 81.50%; p < 0.001), 2.7% (95% CI: 1.2%-6.0%; I2 = 83.82%; p < 0.001) and 3.0% (95% CI: 1.4%-6.4%; I2 = 69.12%; p = 0.006), respectively. In general, the different prevalence of surgical wound infection in patients undergoing surgical treatment after long bone fracture may be caused by underlying factors (gender and co-morbidity) and fracture-related factors (surgery site and type of fracture).

High-dose oral vitamin D supplementation for prevention ofinfections in children aged 0 to 59 months: a systematic review and meta-analysis.

Vitamin D plays an important role in immune function, and the deficiency thereof has been associated with several infections, most notably respiratory tract infections. However, data from intervention studies investigating the effect of high-dose vitamin D supplementation on infections have been inconclusive. The aim of this study was to evaluate the level of evidence regarding the efficacy of vitamin D supplementation above the standard dose (400 IU) in preventing infections in apparently healthy children < 5 years of age. PubMed, Scopus, Science Direct, Web of Science, Google Scholar, CINAHL, and MEDLINE electronic databases were searched between August 2022 and November 2022. Seven studies met the inclusion criteria. Meta-analyses of outcomes in more than one study were performed using Review Manager software. Heterogeneity was evaluated using the I2 statistic. Randomized controlled trials in which vitamin D was supplemented at > 400 IU compared with placebo, no treatment, or standard dose were included. Seven trials that enrolled a total of 5748 children were included. Odds ratios (ORs) with 95%CIs were calculated using random- and fixed-effects models. There was no significant effect of high-dose vitamin D supplementation on the incidence of upper respiratory tract infection (OR, 0.83; 95%CI, 0.62-1.10). There was a 57% (95%CI, 0.30-0.61), 56% (95%CI, 0.27-0.07), and 59% (95%CI, 0.26-0.65) reduction in the odds of influenza/cold, cough, and fever incidence, respectively, with daily supplementation of vitamin D > 1000 IU. No effect was found on bronchitis, otitis media, diarrhea/gastroenteritis, primary care visits for infections, hospitalizations, or mortality. High-dose vitamin D supplementation provided no benefit in preventing upper respiratory tract infections (moderate certainty of evidence) but reduced the incidence influenza/cold (moderate certainty of evidence), cough, and fever (low certainty of evidence). These findings are based on a limited number of trials and should be interpreted with caution. Further research is needed. PROSPERO registration number CRD42022355206.

Kluver-Bucy Syndrome in Children with Traumatic Brain Injury: A Case Report and Review of Literature

Abstract Background: Kluver-Bucy syndrome (KBS), a symptom complex of hyperorality, dietary pattern changes, hypersexuality, memory disturbances, and visual agnosia, has been infrequently reported following traumatic brain injury (TBI) in children. Materials and Methods: We report a 5-year-old girl presenting with KBS following moderate traumatic brain injury. A literature search was conducted in July 2022 and extended till February 2023 on PubMed, Embase, and Web of Science electronic databases using search terms “children” OR “child” OR “infant” OR “pediatric” OR “adolescent”) AND “Kluver-Bucy syndrome” AND “trauma.” Original research studies, case reports, and case series of children (&lt;18 years of age) with KBS following TBI were identified and evaluated by two authors. Results: Of the 30 articles identified on screening, 12 studies were included and reviewed for phenotypic characterization. Including the index child, 33 children (21 boys) were identified with a median age at presentation of 14 years. Clinically, the commonly described findings were hyperorality (90.9%), placidity (87.9%), hypersexuality (69.7%), hypermetamorphosis (57.6%), dietary pattern changes (54.5%), visual agnosia (51.5%), and memory disturbances (45.5%). Neuroimaging abnormalities were reported in 24 children. Carbamazepine was somewhat useful in 4/5 children where it had been tried. Conclusions: KBS is rare in young children with TBI. A high degree of suspicion is required for the identification of this phenotype in young children. Symptoms are often transitory and carbamazepine may be useful.