To evaluate and compare the accuracy of implant placement measured by using CBCT or intraoral scanning in computer-assisted implant surgery in terms of angular, coronal, apical and depth deviations between planned and actual implant position. A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in the International Prospective Register of Systematic Reviews database (CRD420250648755). The population, intervention, comparison, outcomes and study design and study type question addressed the accuracy of implant placement surface scanning versus CBCT in in vitro and in vivo studies on computer-assisted implant surgery. The literature was searched using the PubMed, Scopus and Web of Science databases up to 2025. Studies reporting quantitative data on angular, coronal, apical and signed depth deviations were included. Risk of bias was assessed using the Quality Assessment Tool for In Vitro Studies, Risk of Bias In Non-randomised Studies of Interventions tool and Cochrane Risk of Bias Tool. Meta-analyses were conducted using standardised mean differences, heterogeneity was assessed with I2 and forest plots were generated. Eight studies were included. The meta-analysis showed no statistically significant differences in angular deviation (standardised mean difference 0.76 degrees, P = 0.2315) or apical deviation (standardised mean difference 0 mm, P = 0.9820) between CBCT and intraoral scanning. Intraoral scanning demonstrated lower coronal deviation (standardised mean difference -0.21 mm, P = 0.0435) and a trend towards reduced depth deviation (standardised mean difference -0.40 mm, P = 0.0620). Intraoral scanning also exhibited lower variability across studies. Risk of bias was low in in vitro studies and moderate to high in most in vivo studies. Most existing studies rely on pre- and postoperative CBCT imaging, whereas intraoral scanning-based methods remain underexplored. Preliminary evidence suggests that intraoral scanning-based analyses may offer higher accuracy than CBCT, although the differences are not statistically significant. When deciding between intraoral scanning and CBCT, clinicians should consider clinical practicality, including equipment availability and radiation exposure.

To evaluate the accuracy of guided implant placement using surgical guides with or without metallic sleeves through a systematic review and meta-analysis. A comprehensive search was conducted on PubMed, Scopus and Web of Science up to 2025, identifying in vivo and in vitro studies comparing static surgical guides with and without metallic sleeves. Studies reporting angular, horizontal or vertical deviations between planned and actual implant positions were included. Data were extracted and analysed using standardised mean differences, with heterogeneity assessed via the I² index and Cochran Q test. Four studies met the inclusion criteria: three in vitro and one in vivo randomised clinical trial, totalling 90 implants. Meta-analysis showed no statistically significant differences between sleeveless and sleeved guides in terms of angular deviation (standardised mean difference 0.18; 95% confidence interval -0.24 to 0.59; P = 0.402) or horizontal deviation (standardised mean difference -0.23; 95% confidence interval -0.70 to 0.24; P = 0.340). All studies demonstrated low heterogeneity (I² = 0%). Clinical evidence comparing sleeveless and sleeved surgical guides remains very limited. Current data, mainly derived from in vitro studies and one small randomised clinical trial, suggest that both guide types may offer comparable accuracy; however, these findings should be interpreted with caution, and further high-quality clinical studies are required to validate these preliminary results and establish their applicability in different clinical scenarios.

ObjectiveThis systematic review and meta-analysis aim to evaluate the prevalence of dental anomalies in primary versus permanent dentition among individuals with non-syndromic cleft lip and palate (CLP) and to elucidate the differences in these anomalies between the two dentitions.MethodsA comprehensive literature search was conducted across PubMed, LILACS, Web of Science, EMBASE, and Scopus. Studies included were those assessing dental anomalies in patients with CLP, with data on both primary and permanent dentition. The review adhered to PRISMA guidelines and included data extraction, risk of bias assessment, and meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was utilized to evaluate the quality of evidence.ResultsSeven retrospective cohort studies met the inclusion criteria. The pooled prevalence of hyperdontia was higher in primary dentition (25%) compared to permanent dentition (12%), while hypodontia was more prevalent in permanent dentition (32%) than in primary dentition (12%). Patients with BCLP exhibited a greater prevalence of hypodontia in permanent dentition. Significant heterogeneity was observed across studies in terms of methodologies and sample sizes.ConclusionDental anomalies in patients with CLP differ between primary and permanent dentition, with hyperdontia being more prevalent in primary dentition and hypodontia in permanent dentition. Variations in prevalence and types of anomalies between patients with UCLP and BCLP highlight the need for standardized diagnostic protocols. Future research should address methodological inconsistencies to improve the robustness of findings.

Immune checkpoint inhibitors (ICIs) are a novel and promising anti-cancer therapy. We conducted this systematic review to precisely quantify the occurrence and development for actue kidney injury(AKI) following ICIs treatment for cancer. We conducted a search of the PubMed, Embase, Web of Science, and Cochrane Library databases. Twenty-nine studies, comprising 24,953 cancer patients who received ICIs were finally eligible. The incidence of AKI was 16.2% (95%CI:12.8%-19.8%); the incidence of immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) was 3.1%(95%CI:2.4%-4%); the incidence of non-ICPi-AKI was 11.2%(95%CI:8.4%-14.3%), and the incidence of sustained AKI was 14.9%(95%CI:7.5%-24.3%). Patients who developed AKI (HR = 1.521(95%CI:1.208-1.916)) and ICPi-AKI (HR = 1.407(95%CI:1.059-1.869)) exhibited an elevated risk of all-cause mortality. An increased risk for AKI was observed with preexisting chronic kidney disease (CKD) and combined with other extrarenal immune-related adverse events (irAEs). The use of nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitor (PPI), diuretic, renin-angiotensin-aldosterone system (RAASi), antibiotics and fluidone was also significantly associated with incident AKI. Combined therapy had a greater impact on renal injury compared to monotherapy. Patients using ipilimumab were more prone to developing AKI, compared to those using nivoluma. CTLA4 (ref'PD-1) was associated with a higher likelihood of sustained AKI. The use of PDL-1(ref='PD-1) was linked to an increased susceptibility to ICPi-AKI. The occurrence of AKI was intricately linked to specific complications, the concomitant use of certain medications, and the specific regimen of ICIs. This deserves our attention.

Transitions of care (ToC) services are essential for maintaining care continuity. The complex and fast-paced nature of care and high patient turnover in emergency departments (EDs) create unique challenges and opportunities for improving transitional care. Although the benefits of pharmacy-supported ToC interventions are established in non-ED settings, there is a lack of evidence exploring their characteristics and outcomes in EDs. We aimed to identify and present the available evidence regarding the characteristics and outcomes of pharmacy-supported ToC interventions beyond medication reconciliation, as the sole intervention, in EDs. This review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. A literature search was performed across PubMed, Embase, CINAHL, Web of Science, and grey literature from their inception until 22/12/24. The search included terms related to pharmacy, transitional care, and EDs. Data was extracted using a custom tool adapted from the Template for Intervention Description and Replication checklist, which was used to assess the articles' compliance with the items. A total of 64 publications were included. Most studies (n = 58) enrolled adult patients, with 13 focusing on older adults. Most interventions were delivered by pharmacists in collaboration with other healthcare providers in 64% of studies. Interventions were most implemented post-discharge (54.7%), followed by arrival to the ED (42.2%). Around 90.6% of interventions included two or more activities, combining medication reconciliation, discharge planning, and follow-up care. Most studies focused on health utilization metrics (e.g., readmission rates) as their outcomes (28.8%). Positive effects were observed on medication safety, antibiotic stewardship, patient satisfaction, and resource use. However, pediatric populations and intrahospital transitions were underrepresented. This scoping review highlights the potential of pharmacist-supported transitional care interventions within EDs. The role of pharmacists in ToC interventions in emergency settings is evidently growing. Despite this, critical gaps persist in reporting and implementing these interventions. Future research is needed to systematically explore such initiatives and evaluate their implementation and long-term impact.

This study aimed to evaluate the efficacy of low-level laser application in the treatment of periodontal intra-bony defects. Two independent reviewers conducted searches for articles published in English. The primary objective was to investigate whether clinical parameters improved in periodontal regeneration therapy with and without low-level laser therapy (LLLT). The primary outcome was probing depth (PD), while the secondary outcome measures were clinical attachment level (CAL), gingival recession (GR), and bone defect depth. After screening and eligibility assessment, eight studies were included in the analysis. For the primary outcome measure (PD), after sensitivity analysis, the reduction in PD from baseline to 3 months was greater in the laser group than in the non-laser group (P = 0.02). For the secondary outcome measure (CAL), after sensitivity analysis, the increase in CAL from baseline to 3 months was greater in the laser group (P < 0.001). Although laser therapy may be beneficial for early wound healing, the current evidence does not support its routine use in periodontal regenerative surgery. Further high-quality studies are warranted to evaluate its clinical efficacy.

Alcohol use disorder (AUD) is a prevalent, chronic condition generating considerable global morbidity, mortality and socioeconomic burden. Despite the availability of established pharmacotherapies, overall treatment uptake remains low and effect sizes are moderate at best. Emerging evidence highlights substantial differences in treatment response between sexes and genders, yet these factors are rarely systematically considered in clinical trials or routine care. Existing reviews have limited scope and often exclude gender-diverse populations. This project aims to (1) Synthesise evidence on gender- and sex-specific efficacy, safety and adherence in AUD pharmacotherapies, (2) Evaluate the consideration of sex and gender beyond binary classifications in existing research and (3) Develop recommendations for gender- and sex-sensitive treatment strategies. A systematic review and meta-analysis will be conducted using (PubMed, Web of Science, Scopus, Google Scholar, German Clinical Trials Register and ClinicalTrials.gov). We will include randomised controlled trials of pharmacotherapies for AUD with a minimum treatment duration of 4 weeks, reporting gender-specific and/or sex-specific results. The literature search will cover studies published up to October 2025, with inclusion restricted to articles published in English or German, regardless of setting. Two reviewers will independently screen records and assess risk of bias (Cochrane RoB), with evidence certainty evaluated using Grading of Recommendations Assessment, Development and Evaluation and aligned to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Sex and Gender Equity in Research guidelines. Ethics approval is not required as only data from already completed studies and supplementary information directly provided by study authors are used. Findings and recommendations will be disseminated in peer-reviewed journals and presented at conferences and workshops. CRD420251079160.

Mesalamine (5-aminosalicylic acid, [5-ASA]) is the first-line therapeutic agent in mild-to-moderate ulcerative colitis (UC). The continuous use of 5-ASA involves costs, adverse effects, and delayed treatment escalation. In certain circumstances, such as in patients with Crohn disease (CD) or patients escalated to advanced therapies, discontinuation of 5-ASA may be feasible. However, the implications of withdrawal on disease outcomes remain unclear. We sought to assess the relative risk (RR) of relapse in patients with quiescent UC or CD who discontinue 5-ASA compared with those who maintain treatment with 5-ASA. A search of 5 databases was conducted from inception until July 2024. Eligible studies were selected and subjected to quality assessment. The studies were categorized into 6 clinically relevant cohorts, and the RR of relapse was analysed. A total of 7203 studies were identified, with 29 meeting inclusion criteria. The discontinuation of oral 5-ASA monotherapy was associated with a 60% increase in the risk of relapse in patients with UC (relative risk, 1.60; 95% C, 1.25-2.05; Grading of Recommendations Assessment, Development, and Evaluation [GRADE] level of certainty, low). The withdrawal of rectal 5-ASA resulted in a RR of relapse of 2.03 (95% CI, 1.58-2.61; GRADE level of certainty, moderate). In contrast, in patients receiving immunomodulators and/or biologics, the cessation of 5-ASA was not associated with an increased risk of relapse (very low and low GRADE level of certainty, respectively). The discontinuation of oral or rectal 5-ASA monotherapy in patients with UC is associated with an increased risk of relapse. The data for discontinuation of 5-ASA in patients with UC or CD who are on immunomodulators and/or biologics is marginal for a meta-analysis; considering this limitation, these patients do not seem to have an increased risk of relapse upon discontinuation of 5-ASA, suggesting that monitored withdrawal may be a viable strategy.

We aimed to determine whether central line-associated bloodstream infection (CLABSI) rates differ between tunneled and conventionally inserted PICCs (tPICCs and cPICCs). This systematic review and meta-analysis was prospectively registered in PROSPERO (CRD42024616470) and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and the Cochrane Library were comprehensively searched from inception to November 27, 2024, to identify randomized controlled trials that compared CLABSI rates between tPICCs and cPICCs. Risk ratios along with the 95% confidence intervals (CI) were calculated for outcomes using a random-effects meta-analysis model following the Hartung-Knapp-Sidik-Jonkman method. Statistical heterogeneity was assessed using the I2 statistic. Methodological quality and risk of bias were assessed using the Cochrane risk of bias tool. A meta-analysis of four relevant studies, comprising 2,659 participants (pooled mean age ± standard deviation, 59.3 ± 15.5years; 1,481 women) and 177,879 catheter days, revealed overall CLABSI rates of 0.31 per 1,000 catheter-days in the tPICC group and 0.68 per 1,000 catheter-days in the cPICC group. The risk ratio (0.48; 95% CI, 0.28-0.81; p = 0.02) indicated a 52% reduction in the tPICC group compared with the cPICC group, with low heterogeneity (I2 = 0%). Subcutaneous tunneling for PICC placement is associated with a significant reduction in CLABSI rate among hospitalized adult patients.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic liver condition strongly associated with overweight or obesity, often accompanied by dyslipidemia, insulin resistance, and elevated liver enzymes. Exercise is recommended as a first-line lifestyle intervention, but evidence on the effects of different modalities, frequencies, and durations on metabolic and hepatic markers remains inconsistent. This study conducted a systematic review and meta-analysis to quantify overall effects and compare intervention strategies. To evaluate the effects of exercise interventions on metabolic and hepatic function markers in overweight or obese patients with MASLD. A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted from inception to March 15, 2025, to identify randomized controlled trials (RCTs) evaluating the effects of exercise on metabolic and hepatic function markers in overweight or obese patients with MASLD. Backward citation tracking and manual searches were additionally performed to capture eligible studies through April 2025. Meta-analysis was performed using Review Manager version 5.4 and Stata version 16. A total of 23 articles comprising 26 trials with 1,012 participants were included. The meta-analysis showed that exercise interventions significantly reduced total cholesterol (SMD = - 0.22, P = 0.004), triglycerides (SMD = - 0.27, P = 0.044) and low-density lipoprotein cholesterol (SMD = - 0.22, P = 0.005), while significantly increasing high-density lipoprotein cholesterol (SMD = 0.24, P = 0.001). For liver function markers, exercise markedly improved alanine aminotransferase (SMD = - 0.40, P = 0.024), whereas the reductions in aspartate aminotransferase (SMD = - 0.29, P = 0.087) and γ-glutamyl transferase (SMD = - 0.29, P = 0.217) did not reach statistical significance. Regarding glucose metabolism, exercise significantly improved homeostasis model assessment of insulin resistance (SMD = - 0.35, P = 0.001), fasting glucose (SMD = - 0.15, P = 0.039) and insulin (SMD = - 0.19, P = 0.038). Subgroup analyses indicated that interventions with a frequency of three sessions per week, moderate duration (8-12weeks), and combined training modalities yielded greater improvements in triglycerides and alanine aminotransferase. Exercise interventions exert beneficial effects on lipid profiles, liver function, and glucose metabolism in overweight or obese patients with MASLD, with combined training performed at a moderate frequency over an 8-12-week period may show a more consistent pattern of improvement. The study protocol has been prospectively registered in the International Prospective Register of Systematic Reviews, ID: CRD420251051095.

Adolescents with Type 1 Diabetes Mellitus (T1DM) face a significantly increased risk of developing disordered eating behaviors (DEBs), a phenomenon that includes the deliberate omission of insulin, commonly referred to as diabulimia. The aim of this systematic review and meta-analysis was to determine the prevalence of diabulimia in adolescents with T1DM and consolidate the scientific evidence on this issue. Following PRISMA guidelines, observational studies published in English and Spanish involving adolescents aged 10 to 19 were identified through comprehensive searches in SCOPUS, LILACS, PubMed, Web of Science, and PsycINFO. After rigorous screening and eligibility assessment, 13 studies were included. Data were extracted independently, and meta-analyses were performed using random-effects models. Reported prevalence rates of DEB in T1DM varied widely among studies, ranging from 20.8% to 48%. The pooled prevalence in the final meta-analytic model was 11% (95% CI: 9–13%), with prevalence substantially higher in females (45%) than males (26%). These findings highlight not only the elevated risk of DEB and diabulimia among adolescents with T1DM but also considerable gender differences likely shaped by psychological, sociocultural, and biological factors. The lack of standardized diagnostic criteria for diabulimia remains a barrier to clinical management. Early detection and gender-sensitive preventive strategies are crucial for reducing complications and improving the quality of life in this vulnerable population.

Safety and efficacy of salvage surgery for unresectable hepatocellular carcinoma after conversion with triple therapy: a systematic review and meta-analysis of data from Chinese patients.

Background Individuals with autism spectrum disorder (ASD) commonly experience comorbid depression, anxiety, and impaired quality of life (QoL), significantly affecting daily functioning and social adaptation. Non-pharmacological interventions (NPIs), offering an alternative without drug-related side effects, have gained increasing attention for emotional improvement and health promotion. However, the comparative effectiveness of different NPIs remains unclear, and clinical decisions lack robust evidence. Methods This study adhered to the PRISMA-NMA guidelines. Five databases (PubMed, Embase, Cochrane Library, Web of Science, and EBSCOhost) were systematically searched to identify randomized controlled trials (RCTs) published before March 2025. A total of 67 RCTs involving 3,604 ASD participants were included. A frequentist network meta-analysis using a multivariate random-effects model was conducted in Stata, along with pairwise meta-analyses, to compare the relative effects of mindfulness-based interventions (MBI), cognitive behavioral therapy (CBT), behavioral and functional training (BEHAVE), physical activity (PHYS), sensory therapies (SENS), technology- and family-based interventions (TAFI), and other interventions (OTH) on anxiety, depression, and QoL. Standardized mean differences (SMDs) with 95% credible intervals (CIs) were used to estimate effects, and SUCRA rankings were calculated to assess comparative efficacy. Results MBI showed the greatest improvement in anxiety symptoms (SMD = –0.84, 95% CI: –1.32 to –0.36; SUCRA = 91.4%), CBT ranked highest for depression reduction (SMD = –0.77, 95% CI: –1.25 to –0.28; SUCRA = 90.1%), and PHYS performed best for enhancing QoL (SMD = 0.59, 95% CI: 0.20 to 0.98; SUCRA = 87.5%). The analyzed population primarily consisted of high-functioning male individuals. Subgroup analyses showed stronger effects in adults and with moderate-duration interventions (9-16weeks). No significant inconsistency or publication bias was detected. Limitations Findings mainly apply to high-functioning ASD populations without intellectual disability. Heterogeneity in interventions and assessments should be considered. Conclusions Different NPIs exhibit distinct advantages in improving emotional symptoms and QoL among individuals with ASD. MBI, CBT, and PHYS demonstrate relative superiority for anxiety, depression, and QoL respectively, supporting their targeted application in clinical and rehabilitative settings. Future studies should prioritize long-term follow-up, refined intervention designs, and personalized strategies tailored to ASD subgroups to enhance clinical utility and scalability. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD420251021423.

Annals Video Summary - Systemic Corticosteroids, Mortality, and Infections in Pneumonia and Acute Respiratory Distress Syndrome: A Systematic Review and Meta-analysis.

Integrating systematic review, meta-analysis, and secondary data for spatial and temporal risk analysis of avian influenza in poultry: A comparative evaluation of OLS, GWR, and MGWR models.

Prevalence and determinants of unused medicines among households in Ethiopia: A systematic review and meta-analysis.

Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome. This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes. Systematic review and meta-analysis of randomized controlled trials. A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis. A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = -2.55, 95% CI [-4.16, -0.94]) (MD = -2.15, 95% CI [-3.18, -1.12]) and low-density lipoprotein (MD = -9.06, 95% CI [-14.33, -3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [-4.30, 7.61]) and reducing total cholesterol (MD = -2.72, 95% CI [-7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = -0.20, 95% CI [-0.44, 0.04]) and depression (SMD = -0.07, 95% CI [-0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]). The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future. PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894.

Varus and neutral coronal knee phenotypes dominate globally: insights from a systematic review and meta-analysis of the CPAK classification.

Efficacy and safety of pharmacological therapies for functional constipation in children: a systematic review and meta-analysis.

Association of chemsex and risk of chlamydia, gonorrhoea, and syphilis infections: a systematic review and meta-analysis.