Terms Of Entry Research Articles

Impact of Digital Innovations on Health Literacy Applied to Patients with Special Needs: A Systematic Review

MHealth strategies have been used in various health areas, and mobile apps have been used in the context of health self-management. They can be considered an adjuvant intervention in oral health literacy, mainly for people with special health needs. Thus, the aim of this study was to identify the improvement of oral health literacy in patients with special needs when using digital platforms. A systematic literature review, based on the Joanna Briggs Institute (JBI) guidelines, was the main research method employed in this study. A search was undertaken in PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases, according to the relevant Mesh descriptors, their synonyms, and free terms (Entry Terms). Studies published between the years 2012 and 2023 were included. Two researchers independently assessed the quality of the included studies by completing the Newcastle–Ottawa Quality Assessment Scale questionnaire. The analysis corpus comprised 5 articles among the 402 articles selected after applying the inclusion/exclusion criteria (k = 0.97). The evidence from the considered articles is consensual regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs. The interventions were based on using the Illustration Reinforcement Communication System, inspired by the Picture Exchange Communication System, Nintendo® Wii™ TV, virtual reality, smartphones, with software applications to read messages sent, Audio Tactile Performance technique, and Art package. One study had a low-quality assessment, and four had a high quality. The evidence from the articles included in this systematic review is consistent regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs.

An Umbrella Review for Assessment of Treatment Effectiveness of Clear Aligners Compared to Conventional Fixed Appliances in Orthodontic Patients

Introduction Orthodontic improvements, mainly through the previous decade, have led to a substantial rise in patients’ esthetic needs. Traditional orthodontic procedures have been linked with a compromise in facial appearance, which increases concern among patients pursuing orthodontic treatment. Methods PubMed, MEDLINE, Google Scholar, and Cochrane Library of Systematic Reviews databases were searched using appropriate entry terms and Boolean operators. Search strategy was conducted till June 2022 for systematic reviews and meta-analyses. Publications were systematically assessed for eligibility, and two observers independently graded the methodologic quality using AMSTAR-2 tool. For each meta-analysis, we estimated the summary effect size by the use of random-effects and fixed-effects models and the 95% confidence interval. We estimated the between-study heterogeneity expressed by I 2 (defined as large for I 2 ≥50%), evidence of small-study effects (i.e., large studies had significantly more conservative results than smaller studies), and evidence of excess significance bias (i.e., more studies than expected with significant results). Results Overall, 16 unique systematic reviews and meta-analyses following the eligibility criteria were selected for umbrella review. The results of qualitative analysis of studies revealed that 4 studies had a critically low risk of bias, 11 showed low risk, and 1 study had moderate risk. The results of the meta-analysis favored clear aligners with respect to oral hygiene and root resorption parameters. When tooth movements were considered, the results favored conventional orthodontic treatment. Conclusion Clear aligner therapy (CAT) has significant advantages with regard to efficiency (treatment time, chair time) in mild-moderate malocclusion cases. The overall accuracy of CAT when compared to fixed orthodontic treatment was found to be 55-82%.

Reconciling Britain’s agricultural trade policy initiatives with world trade rules: 1960–1975

ABSTRACT Between 1960 and 1972 successive British governments explored, and sometimes pursued, a series of agricultural trade policy initiatives designed to shift the burden of supporting UK farmers from taxpayers to consumers, and to reduce the UK’s agri-food imports by expanding home production. These included a minimum import price scheme for cereals; a Selective Expansion Programme; debate about Agriculture’s Import Saving Role; and 1970 proposals for a fundamental change to farm policy that would apply whether or not the UK joined the European Communities (EC). Prior to EC membership the rules of the General Agreement on Tariffs and Trade (GATT), bilateral agreements with a number of countries, and pressure from the UK’s trading partners (particularly the United States) constrained its room for manoeuvre. Consequently, this dimension of farm policy could not safely be left to agriculture ministers and the Treasury, but was one that involved other departments, and prime ministers, as it necessitated detailed international negotiations. Following EC entry, GATT Article XXIV deliberations and the UK’s renegotiation of its terms of entry failed to secure meaningful reform of the common agricultural policy (CAP). The 1975 referendum confirming EC membership meant the UK no longer had an independent agri-food trade policy.

Breast Implant Silicones and B Cell-Mediated Immune Responses: A Systematic Review of Literature

Breast implants are under recent scrutiny owing to concerns about their potential for inducing immunological diseases, namely breast implant-associated anaplastic large cell lymphoma and breast implant illness. However, the impact of silicone on biologic systems remains unclear. Therefore, we performed a systematic literature review to evaluate the information available on silicone breast implants and their effect on one arm of the adaptive immune response-B lymphocytes and antibody formation. We conducted a systematic review in EMBASE/PUBMED in accordance with the PRISMA guidelines, with search entry terms requiring discussion of silicone and immunity. The initial review returned 1079 citations. Manual screening was performed to include studies that were specific to the humoral response after exposure to silicone. Secondary full text review was performed. The extracted data included animal models and findings pertinent to B cells/antibodies in response to breast implant silicones. In total, 39 studies on B cells/antibodies and breast-implant-associated silicones were identified. Among them, 23 studies were in humans, 14 in animal models, and 2 were in vitro. Common themes included identification of antisilicone antibodies in women with breast implants, anticollagen antibodies, presence of activated B cells or immunoglobulin G in implant capsules, and sensitization of lymphocytes to silicone in vitro. Despite controversial findings in the literature, there is evidence that silicone breast implants activate B cells in the breast implant capsule and may have systemic effects on the production of autoantibodies and/or sensitization of B lymphocytes to silicone. Further research is needed on how breast implants impact other arms of the immune system to understand their long-term biological impact.

Cost-of-Illness of Skin Cancer: A Systematic Review.

Skin cancer's rising incidence demands understanding of its economic impact. The current understanding is fragmented because of the various methodological approaches applied in skin cancer cost-of-illness studies. This study systematically reviews melanoma and keratinocyte carcinoma cost-of-illness studies to provide an overview of the applied methodological approaches and to identify the main cost drivers. This systematic review was conducted adhering to the 2020 PRISMA guidelines. PubMed, Embase, and Web of Science were searched from December 2022 until December 2023 using a search strategy with entry terms related to the concepts of skin cancer and cost of illness. The records were screened on the basis of the title and abstract and subsequently on full text against predetermined eligibility criteria. Articles published before 2012 were excluded. A nine-item checklist adapted for cost-of-illness studies was used to assess the methodological quality of the articles. This review included a total of 45 studies, together evaluating more than half a million patients. The majority of the studies (n = 36) focused on melanoma skin cancer, a few (n = 3) focused on keratinocyte carcinomas, and 6 studies examined both. Direct costs were estimated in all studies, while indirect costs were only estimated in nine studies. Considerable heterogeneity was observed across studies, mainly owing to disparities in study population, methodological approaches, included cost categories, and differences in healthcare systems. In melanoma skin cancer, both direct and indirect costs increased with progressing tumor stage. In advanced stage melanoma, systemic therapy emerged as the main cost driver. In contrast, for keratinocyte carcinoma no obvious cost drivers were identified. A homogeneous skin cancer cost-of-illness study design would be beneficial to enhance between-studies comparability, identification of cost drivers, and support evidence-based decision-making for skin cancer.

The Effect of Menopausal Status, Insulin Resistance and Body Mass Index on the Prevalence of Non-Alcoholic Fatty Liver Disease.

Non-alcoholic fatty liver disease (NAFLD) is common and presents in a large proportion-up to 30%-of the global adult female population. Several factors have been linked with NAFLD in women, such as age, obesity, and metabolic syndrome. To extract appropriate details about the topic, we conducted an extensive search using various medical subject headings and entry terms including 'Menopause', 'Non-alcoholic fatty liver disease', 'Insulin resistance', and 'BMI'. This exhaustive search resulted in a total of 180 studies, among which only 19 were able to meet the inclusion criteria. While most of these studies indicated a significant rise in NAFLD prevalence among postmenopausal women, two did not find strong evidence linking menopause with NAFLD. Moreover, it was observed that women with NAFLD had higher insulin resistance levels and BMIs compared to those without the condition. In summary, it is important to consider specific factors like risk profile, hormonal status, and age along with metabolic components when treating women presenting with NAFLD. There is need for data-driven research on how gender affects the sensitivity of biomarkers towards NAFLD as well as the development of sex-specific prediction models-this would help personalize management approaches for women, who stand to benefit greatly from such tailored interventions.

Etiology of bacterial pneumonia and multi-drug resistance pattern among pneumonia suspected patients in Ethiopia: a systematic review and meta-analysis

BackgroundBacterial pneumonia can affect all age groups, but people with weakened immune systems, young children, and the elderly are at a higher risk. Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa are the most common causative agents of pneumonia, and they have developed high MDR in recent decades in Ethiopia. This systematic review and meta-analysis aimed to determine the pooled prevalence of bacterial pneumonia and multidrug resistance in Ethiopia.MethodsThe articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I2 value. Publication bias was assessed using a funnel plot and Egger’s test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size.ResultOf the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72–46.62), with substantial heterogeneity (I2 = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05–78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11–27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19–24.86), respectively.ConclusionThe pooled prevalence of bacterial isolates from bacterial pneumonia and their multidrug resistance were high among Ethiopian population. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.

WOMEN IN ACCOUNTING AND AUDITING: A REVIEW OF PROGRESS, CHALLENGES, AND THE PATH FORWARD

This comprehensive review explores the evolving landscape of women in accounting and auditing, shedding light on the progress made, persistent challenges faced, and the promising path forward. Over the past few decades, the accounting profession has witnessed a notable increase in the representation of women, reflecting a broader societal shift towards gender inclusivity. While significant strides have been made in terms of entry into the profession and academic achievements, gender disparities persist, particularly in reaching leadership positions within accounting firms and corporate boardrooms. The review delves into the factors contributing to the progress of women in accounting and auditing, examining initiatives such as mentorship programs, diversity and inclusion policies, and educational outreach. It also highlights the pivotal role of professional organizations in fostering an environment that encourages and supports the career advancement of women in the field. Despite these positive developments, the review identifies persistent challenges, including gender stereotypes, work-life balance issues, and unconscious bias, which continue to impede the full realization of gender equality in accounting. Moreover, the paper explores the implications of the gender gap on the profession's overall effectiveness, emphasizing the importance of diverse perspectives in ensuring robust financial reporting and auditing processes. The review concludes with a forward-looking perspective, proposing strategies and recommendations for overcoming existing challenges and advancing the role of women in accounting and auditing. This includes targeted mentorship and sponsorship programs, continued advocacy for workplace flexibility, and a commitment to challenging and dismantling systemic barriers. This review provides a comprehensive analysis of the status of women in accounting and auditing, offering insights into both the achievements and hurdles they face. By understanding the current state of affairs, stakeholders can collaboratively work towards creating a more equitable and inclusive future for women in the accounting profession.&#x0D; Keywords: Accounting, Women, Auditing, finance, Review.

The Potential Harmful Effects of Genetically Engineered Microorganisms (GEMs) on the Intestinal Microbiome and Public Health.

Gut luminal dysbiosis and pathobiosis result in compositional and biodiversified alterations in the microbial and host co-metabolites. The primary mechanism of bacterial evolution is horizontal gene transfer (HGT), and the acquisition of new traits can be achieved through the exchange of mobile genetic elements (MGEs). Introducing genetically engineered microbes (GEMs) might break the harmonized balance in the intestinal compartment. The present objectives are: 1. To reveal the role played by the GEMs' horizontal gene transfers in changing the landscape of the enteric microbiome eubiosis 2. To expand on the potential detrimental effects of those changes on the human genome and health. A search of articles published in PubMed/MEDLINE, EMBASE, and Scielo from 2000 to August 2023 using appropriate MeSH entry terms was performed. The GEMs' horizontal gene exchanges might induce multiple human diseases. The new GEMs can change the long-term natural evolution of the enteric pro- or eukaryotic cell inhabitants. The worldwide regulatory authority's safety control of GEMs is not enough to protect public health. Viability, biocontainment, and many other aspects are only partially controlled and harmful consequences for public health should be avoided. It is important to remember that prevention is the most cost-effective strategy and primum non nocere should be the focus.

Modernisation of legislation in the field of economic and commercial activity in the context of European integration

The article deals with the issues of peculiarities of modernisation of legislation in the field of trade and economic activity in the context of European integration.It is noted that economic and trade activity is the industry which is subject to active modernisation, taking into account the requirements of the Association Agreement. The author concludes that the obligations to adapt Ukrainian legislation to EU legislation in trade have changed due to the fact that a number of EU acts have been amended or repealed, and therefore it is now important to implement the novelties of EU legislation in the period after ratification of the Association Agreement.&#x0D; The term «economic and commercial activity» used in the Commercial Code of Ukraine essentially means trading activities carried out by business entities. Expanding the scope of digitalisation of economic and commercial activities is another vector of European integration.&#x0D; The food supply chain is vulnerable to unfair trade practices due to a sharp imbalance between small and large agricultural market operators. In Ukraine, we see unfair practices when large retailers dictate the terms of market entry and payment for products. Therefore, the implementation of the provisions of Directive 2019/633 of the European Parliament and of the Council of 17 April 2019 on unfair trade practices between undertakings in the agriculture and food sectors is important for Ukraine.&#x0D; In general, EU legislation is quite dynamic, especially given the direction of EU policy towards the development of a green economy and digitalisation, and a number of provisions are being adopted to improve trade in these areas. For Ukraine, an important task is not only to adapt national legislation to the existing EU acts, but also to take into account the legal policy ideas that are actively discussed and developed in the EU, in particular, the provisions on harmonisation of business law.

Seroprevalence of hepatitis B and C viruses among waste handlers in Ethiopia: A systematic review and meta-analysis.

Hepatitis B virus and hepatitis C virus are the leading causes of global liver-related morbidity and mortality. Waste handlers are one of the high-risk groups for hepatitis B virus and hepatitis C virus acquisition. Thus, the aim of this study was to assess the pooled prevalence of hepatitis B virus and hepatitis C virus among waste handlers in Ethiopia. Articles were extensively searched in bibliographic databases and gray literature using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 14 software for statistical analysis. A random-effects model was used to compute the pooled magnitude of hepatitis B virus and hepatitis C virus. Heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was performed to assess the impact of a single study on pooled effect size. Of the 116 studies identified, 8 studies were selected for meta-analysis. All studies reported hepatitis B virus, while 5 studies reported hepatitis C virus infection among waste handlers. The overall pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was 5.07% (2.0-8.15) and 1.46% (0.52-2.4), respectively. Moreover, the pooled prevalence of lifetime hepatitis B virus exposure among Ethiopian waste handlers was 33.98% (95% CI: 21.24-46.72). Hepatitis B virus and hepatitis C virus infection were not statistically associated with the type of waste handlers, that is, there was no difference between medical and nonmedical waste handlers. CRD42023398686. The pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was intermediate and moderate, respectively. This showed that there is a strong need to scale up preventive efforts and strategic policy directions to limit the spread of these viruses. Moreover, we also conclude that handling healthcare and domestic waste is associated with a similar risk of hepatitis B virus and hepatitis C virus infection.

A literature review of biomarkers used for diagnosis of relative energy deficiency in sport.

The review aims to summarize the markers used in diagnosing relative energy deficiency in sport (REDs) and compare them with the REDs CAT2 score. A systematic search was performed in the PubMed, Web of Science, and SPORTDiscus databases during April 2023. The descriptors used were "athlete" AND "REDs," along with respective entry terms. The selection process followed the PRISMA 2020 recommendations, identifying 593 records, from which 13 studies were ultimately selected. Seventy-nine markers were identified and categorized into six groups: bone mineral density (BMD), metabolic resting rate, blood biomarkers, anthropometrics, nutritional intake, and performance parameters. The most frequently utilized biomarkers included BMD, anthropometric parameters (e.g., body mass index, body mass, and fat mass), and the triiodothyronine (T3) concentration. According to the REDs CAT2 pointed indicators, the biomarkers varied among the studies, while 7 out of the 13 included studies achieved a ≥60% agreement rate with this tool. The prevalence of low energy availability, an etiological factor in the development of REDs, was detected in 4 out of 13 studies, with an average of 39.5%. In conclusion, this review highlights the most commonly used markers in diagnosing REDs, such as BMD, anthropometric parameters, and T3 hormone concentration. Due to the current inconsistencies, standardizing diagnostic methodologies is crucial for future research. By focusing on widely used markers, this review aids future research planning and result interpretation and points out the ongoing need for methodological consistency in evolving diagnostic tools. https://www.crd.york.ac.uk/, PROSPERO (CRD42022320007).

The effects of low-carbon awareness on remanufacturing strategy in the presence of competition

PurposeThis paper examines how the level of low-carbon awareness (LCA) affects the remanufacturing strategy in a supply chain with an original equipment manufacturer (OEM) and an independent remanufacturer (IR) competing with each other.Design/methodology/approachGame theory and operations optimization.FindingsThe studies analytically characterize the threshold levels of the LCA in response to which the OEM and the IR will change their remanufacturing strategies from no remanufacturing to partial remanufacturing and then to full remanufacturing. In addition, the studies reveal that as compared with the OEM, the IR has more flexibility in terms of the market entry to remanufacturing with the level of LCA increasing. With the extended studies, it is exhibited that the above findings are robust to a good extent.Originality/valueIt can provide decision support for remanufacturing enterprises.

Prevalence of biofilm producing Acinetobacter baumannii clinical isolates: A systematic review and meta-analysis.

Acinetobacter baumannii, the first human pathogen to be designated as a "red-alert" pathogen, is on the critical priority list of pathogens requiring new antibiotics. Biofilm-associated diseases are the most common infections caused by the antibiotic-resistant bacteria A. baumannii. Multidrug-resistant strains are more easily transmitted around the world due to A. baumannii's ability to produce biofilms, which allows it to develop antibiotic resistance mechanisms and thrive in healthcare environments. As a result, A. baumannii infections are becoming increasingly common in hospital settings allover the world. As a result, a comprehensive systematic review and meta-analysis were carried out to determine the global prevalence of biofilm-producing A. baumannii clinical isolates. Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 12 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of biofilm-producing A. baumannii clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size. Of the 862 studies identified, 26 studies consisted of 2123 A.baumannii clinical isolates of which 1456 were biofilm-producing. The pooled prevalence of biofilm-producing A.baumannii clinical isolates was 65.63% (95% CI = 56.70%-74.56%). There was substantial heterogeneity with an I2 value of 98.1%. Moreover, 41.34%, 33.57%, and 27.63% of isolates of strong, mild, and weak producers of biofilm. Higher prevalence was found in studies published after 2014 (66.31%); Western Pacific region (76.17%); and Asia (66.22%) followed by the African continent (57.29%). The pooled prevalence of biofilm-producing A. baumannii clinical isolates has risen alarmingly, posing a public health risk. This indicates the burden of biofilm-producing A. baumannii infections urges routine screening and appropriate treatment for better management of hospitalized patients, as well as effective controlling of the emergence of drug resistance. Furthermore, this finding is an alert call for the stakeholders to develop strong infection prevention and antibiotics stewardship programs for the prevention and control of biofilm-producing bacterial infections.

The risk factors for and the frequency and outcomes of subsyndromal delirium among patients who have undergone cardiac surgery: a protocol for systematic review and meta-analysis

IntroductionSeveral key symptoms must be present for the accurate diagnosis of patients with postoperative cardiac delirium. Some patients present with symptoms of delirium but do not meet the diagnostic criteria...

Migratory class-making in global Asian cities: the European mobile middle negotiating ambivalent privilege in Tokyo, Singapore, and Dubai

ABSTRACT This paper discusses the fraught status paradoxes and settlement impediments of European migrants in Asian cities like Tokyo, Singapore, and Dubai. Global European emigration is predominantly imagined as professional ‘expatriation’, framed as temporary if not steeped in linear career pathways of manifest privilege. The implied bifurcation between voluntary European mobilities and economic migrations from the Global South is complicated here by foregrounding the existential aspirations of middling European emigrants who are anxious about their future class position in Europe and therefore resettle along a wider trans-Asian economic corridor. While this European mobile middle retains global advantages in terms of transnational circulation and entry by virtue of their European citizenship capital, they face under-documented legal hurdles and social precarities in their quest for overseas permanence. We conceptualise this transcontinental process, marked by a complex set of mobility ambivalences over time, as ‘migratory class-making’, the distinctive aspirations of which elucidate that structural socioeconomic incentives are equally bound up with contemporary forms of European migration. Enmeshed in this global process of migratory class-making lays a European predicament that speaks of blighted existential hopes about middle-class stability imagined to be the ideal result of multi-year investments in class-making across Europe and Asia.

A retrospective cohort study evaluating the improvement of medical records management based on whole-process control.

Whole-process management is a novel approach widely applied in industry and commerce; however, it is not widely used in the management of medical records in hospitals. The purpose of this study is to investigate the application of whole-process control in the administration of a hospital's medical records department to achieve refined management of medical records. Whole-process control is a management measure that begins with process conception and implementation and includes control over all processes. The control group included medical records that were created prior to the implementation of whole-process control, i.e., those created between June 1 and December 31, 2020. The observation group included medical records that were created after the implementation of whole-process control. The behavior of the medical records staff (in terms of medical record collection, sorting, entry, inquiry, and supply) and the final quality of the medical records (the number of grade-A medical records and their front-page quality) were compared between the two groups, and subjective judgments related to staff satisfaction were reviewed. The implementation of whole-process control improved the behavior of the medical records staff. The final quality of the medical records was also improved, as was the job satisfaction of the medical records staff. Implementing whole-process control improved the management of medical records and quality of medical records.

‘They gave me an opportunity, and I took it’: motivations and concerns of adult apprentices

ABSTRACT In the UK context of an ageing population, degree apprenticeships represent a new opportunity to study for a degree while working. Apprentices are full-time employees granted time to study for a degree with a significant workplace learning component. The aim of this study was to focus on whether degree apprenticeships are working for adult apprentices (aged 26 and up in this context). New apprentices (n = 162) in six universities in Scotland, UK were surveyed to gain a better understanding of background, prior work and study experience, motivations and expectations. Results show that adult apprentices join apprenticeship programmes with significant work experience and workplace metaskills, together with a consolidated sense of self as a professional. Adult apprentices aimed to gain a degree while remaining in work, thus increasing skills in situ. The main barrier identified was the challenge of achieving work-study-life balance. The findings can be used to more closely align apprenticeship provision with adult apprentices’ skills needs while reducing barriers to accessing and succeeding in apprenticeships. We make recommendations for more flexibility in terms of advanced entry and Masters-level apprenticeships, with better recognition of prior experience, motivations and anticipated challenges.

Diagnostic value of conventional endoscopic ultrasound for lymph node metastasis in upper gastrointestinal neoplasia: A meta-analysis.

Upper gastrointestinal neoplasia mainly includes esophageal cancer and gastric cancer, both of which have high morbidity and mortality. Lymph node metastasis (LNM), as the most common metastasis mode of both diseases, is an important factor affecting tumor stage, treatment strategy and clinical prognosis. As a new fusion technology, endoscopic ultrasound (EUS) is becoming increasingly used in the diagnosis and treatment of digestive system diseases, but its use in detecting LNM in clinical practice remains limited. To evaluate the diagnostic value of conventional EUS for LNM in upper gastrointestinal neoplasia. Using the search mode of "MeSH + Entry Terms" and according to the predetermined inclusion and exclusion criteria, we conducted a comprehensive search and screening of the PubMed, EMBASE and Cochrane Library databases from January 1, 2000 to October 1, 2022. Study data were extracted according to the predetermined data extraction form. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool, and the results of the quality assessment were presented using Review Manager 5.3.5 software. Finally, Stata14.0 software was used for a series of statistical analyses. A total of 22 studies were included in our study, including 2986 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic score and diagnostic odds ratio of conventional EUS in the diagnosis of upper gastrointestinal neoplasia LNM were 0.62 [95% confidence interval (CI): 0.50-0.73], 0.80 (95%CI: 0.73-0.86), 3.15 (95%CI: 2.46-4.03), 0.47 (95%CI: 0.36-0.61), 1.90 (95%CI: 1.51-2.29) and 6.67 (95%CI: 4.52-9.84), respectively. The area under the summary receiver operating characteristic curve was 0.80 (95%CI: 0.76-0.83). Sensitivity analysis indicated that the results of the meta-analysis were stable. There was considerable heterogeneity among the included studies, and the threshold effect was an important source of heterogeneity. Univariable meta-regression and subgroup analysis showed that tumor type, sample size and EUS diagnostic criteria were significant sources of heterogeneity in specificity (P < 0.05). No significant publication bias was found. Conventional EUS has certain clinical value and can assist in the detection of LNM in upper gastrointestinal neoplasia, but it cannot be used as a confirmatory or exclusionary test.

Effect of backstroke ledge on backstroke start technique for water entry

ABSTRACT This study aimed to investigate how the use of a backstroke ledge (BSL) affects backstroke start performance in terms of flight distance and water entry posture in competitive backstroke swimmers. Ten male swimmers performed a maximum of 15 m in backstroke, starting with or without a BSL. Two 120 Hz and one 60 Hz video cameras were used to analyse the kinematic variables and angular momentum of the whole body. Using a BSL reduced the time to reach 5 and 15 m compared with not using a BSL (p < 0.04). Using a BSL heightened vertical position of the centre of mass (CM) at take-off, lengthened flight distance, and increased angular momentum (p < 0.02). Additionally, the lower limb entry angle was larger, and the hole entry posture angle was smaller with a BSL than without a BSL (p < 0.04). These results suggest that a high CM position at the start of the backstroke with a BSL increased the flight distance, and a large angular momentum enabled hole entry as well as improved the horizontal velocity after water entry. Hence, increases in flight distance and velocity after water entry were contributing factors in improving the start performance of the backstroke when using a BSL.