Databases Web Of Science Research Articles

To systematically reveal the spatiotemporal distribution, collaboration networks, and thematic evolution of global transrectal ultrasound (TRUS) research in prostate cancer from 2015 to 2024 using bibliometric analysis and visualization. A total of 12,894 relevant articles from the Web of Science database were analyzed using VOSviewer and CiteSpace for co-occurrence networks, burst detection, and density visualization, combined with social network analysis (SNA) and kernel density estimation (KDE) to decode country/institution collaboration patterns and geographical agglomeration. Annual publications peaked at 1800 in 2019, with a secondary surge in 2023 (1563 articles) driven by AI applications (e.g., AI-assisted biopsy). Mean citations per article reached 7.8 in 2020, coinciding with the release ofGLOBOCAN 2020and the rise of teleultrasound research. The United States (5333 articles) and Canada formed the North American core cluster (edge weight 5333 × 1099), while the UK (1287 articles) and Germany served as secondary hubs in Europe. Asian countries showed scattered distributions, though South Korea (2015-2017 burst strength 7.64, elastography) and Australia (2019-2022 burst strength 8.33, focal ablation) emerged as regional technical frontiers. The University of Toronto (242 articles) led TRUS-targeted biopsy research, while the University of Michigan became a rising affiliation due to TRUS-AI integration (post-2020 annual publications > 50). The high-impact journalJ Clin Oncol(5783 citations) focused on fusion biopsy, with annual articles increasing from 42 to 117.Keywords shifted from "systematic biopsy" (2015-2017) and "radiotherapy planning" (2018-2020) to "AI-assisted diagnosis" (2021-2024 burst strength 20.6) and "teleultrasound" (COVID-19-related studies, annual growth 19%), reflecting technology-driven clinical transformation. TRUS research exhibits significant regional inequality and technological iteration, with AI integration and multimodal fusion (e.g., MRI-TRUS fusion) as future priorities. Strengthening cross-regional collaboration is recommended to promote technological equity, particularly for low-cost TRUS innovations in resource-constrained regions.

The scientific literature unanimously assumes that intimate partner violence (IPV) increases the vulnerability of victims to such an extent that the link between this type of violence and suicide appears to be particularly critical. The aim of this scoping review was to summarize the scientific evidence on the prevalence of suicide-suicidal ideation, attempts, and completions-in women who were victims of IPV admitted to emergency departments (EDs) due to suicide attempts. The review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Review. The PubMed, Ebsco, and Web of Science databases were systematically searched using a string of Boolean operators that combined multiple synonyms of IPV, suicide, and EDs. The inclusion criteria were: adult women who were victims of IPV; being admitted to the ED for suicide attempts, and/or died by suicide; with or without a comparison group; and quantitative studies with all types of study design. The review included 22 studies from 1995 to 2023. All studies emphasized the extent to which a history of IPV particularly affects the psychological well-being of victims, limiting their sense of agency and impoverishing their identity and self-esteem, so that suicide was often seen as a way out of what had already occurred for many victims: a sense of psychological disintegration. A further urgency is to prevent the persistence of IPV, as this means preventing women from suicidal thoughts and attempts.

Mechanical ventilation provides life-saving support to patients with respiratory failure, but inadequately tailored settings can lead to respiratory muscle dysfunction and poor patient outcomes. Surface electromyography (sEMG) offers a non-invasive modality to monitor respiratory muscle function. However, variability in acquisition setups limits the comparability of study findings and hinders broad clinical implementation.Therefore, we systematically appraised setup rationales and reporting quality in respiratory sEMG literature. The MEDLINE ALL, Embase, and Web of Science databases were systematically searched on 19 September 2024 for studies reporting original respiratory sEMG data in adults during spontaneous breathing. sEMG methodology was extracted in accordance with the reporting guidelines of the International Society of Electrophysiology and Kinesiology and analyzed by target muscle and medical domain. 240 out of 402 unique articles were included. The diaphragm was the most studied respiratory muscle (61%) with 48 unique setups out of 160 descriptions. Diaphragm setups with small inter-electrode distances (IEDs) were most common (n = 138, 86%). Large IED setups were predominantly applied in ICU (n = 8, 36%) and COPD (n = 5, 23%) populations. Setups for non-diaphragmatic respiratory muscles typically featured one or two dominant positions grounded in methodological studies. Reporting quality was low with a median of 5 out of 10 recommended items documented. This review reveals substantial diversity of diaphragm sEMG setups, reflecting differences in clinical contexts and study populations. The setups for extra-diaphragmatic muscles were more consistent and methodologically grounded. Muscle- and context-specific guidelines are essential to improve consistency and support clinical implementation of respiratory sEMG.

ObjectiveCleft lip scars can significantly impact patients' facial esthetics and psychological well-being. This meta-analysis aimed to evaluate the effectiveness of various non-surgical interventions in reducing cleft lip scars.MethodsA systematic search was performed across PubMed, Embase, Scopus, Cochrane, and Web of Science databases up to May 21, 2024. Inclusion criteria encompassed human studies with cohort or randomized controlled trial (RCT) designs that assessed non-surgical interventions for reducing cleft lip scarring following surgery. Articles in any language, regardless of publication date, were considered. Eligible studies underwent quality assessment, and data were extracted for an inverse variance random-effects meta-analysis.ResultsOf 1664 initially identified articles, 14 met the inclusion criteria for review, with 8 included in the meta-analysis. The reviewed studies primarily focused on botulinum toxin type A (BTA) and laser treatments as non-surgical approaches. Meta-analysis revealed significant improvement in scar appearance with laser therapy (P < .001) but not with BTA (P = .15) when the assessment was conducted by the Vancouver scar scale (VSS). BTA also had no significant effect on scar width reduction (P > .05), but improved scar appearance based on the subjective visual analogue scale (VAS) assessment (P < .001).ConclusionsBased on the VSS index, laser therapy improved scar appearance more effectively than BTA. However, BTA enhanced esthetics as measured subjectively by VAS. These findings support non-surgical interventions as a viable approach for managing cleft lip scars.

A comparison between mandibular overdentures retained by a single midline implant and by two implants: A systematic review.

To compare clinical outcomes and complications between sensor-assisted and manual balancing techniques in total knee arthroplasty, focusing on randomized controlled trials (RCTs). A systematic search of the Cochrane Library, Medline, Embase, Scopus, and Web of Science databases was conducted through February 22, 2024. RCTs comparing sensor-guided and manual balancing methods in primary TKA were included. Outcomes assessed include patient reported outcome measures, range of motion, and total complications. Data from four RCTs (667 knees: 334 sensor-guided, 333 manual) were extracted and analyzed using RevMan V.5.4 with random- and fixed-effects models. The meta-analysis revealed no significant improvement in functional scores for sensor-guided balancing compared to manual techniques (SMD 0.10; 95% CI - 0.15-0.34; I2 = 57%). No significant differences were observed in complication rates (OR 0.84; 95% CI 0.46-1.54; I2 = 0%) or postoperative range of motion (MD 1.20; 95% CI - 0.26-2.65; I2 = 0%). Sensor-guided balancing did not significantly enhance functional outcomes, reduce complication rates, or improve range of motion compared to manual techniques. While the clinical impact of intraoperative sensors remains limited, they hold promise as training tools to standardize soft tissue balancing. Further high-quality, long-term studies are required to explore their potential benefits and establish definitive guidelines for TKA procedures.

Purpose ChatGPT gained significant attention around the world, reinforcing the interaction between humans and sophisticated computer programs. The effects of this technology on people’s quality of life are multifaceted, and a key area of debate is how it affects the natural human need for creativity. Recent advancements in large language models (LLMs) have motivated numerous studies to evaluate the use of ChatGPT in the context of investment strategies and portfolio management, particularly taking into account the complex and dynamic nature of financial market data. Considering this overview, the purpose of this research is to conduct a literature review to explore the recent history of artificial intelligence (AI) in investment, asset pricing and portfolio management. Design/methodology/approach To develop this literature review, the papers were selected from Scopus and Web of Science databases. Findings LLMs, in general, and ChatGPT, in particular, are transforming the way researchers can conduct studies in the field of finance, as well as the way individuals, firms and investment teams can analyze large amounts and diverse types of financial data to support investment strategies and portfolio management. The results suggest that while LLMs mark a relevant milestone in the history of finance, it still has some limitations. Practical implications Investors and financial institutions can use the results of this paper to understand how AI can support financial data analysis. Originality/value This research summarizes key contributions of studies addressing LLMs to the literature, with a particular focus on its applications in investments and portfolio management.

Background/Objectives: The aim of this literature review is to evaluate the clinical and radiographic success of various types of lasers used in pulpotomy procedures for primary teeth. Methods: A comprehensive literature search was conducted using PubMed and Web of Science databases, with no time limits applied. Keywords included various types of lasers (e.g., diode, Nd:YAG, Er:YAG, LLLT, CO2) and terms related to pulpotomy in primary teeth. The search was performed in August 2025. Studies were screened for eligibility based on inclusion and exclusion criteria, focusing on clinical trials and studies assessing long-term outcomes of laser pulpotomies. Results: The review included 36 studies, categorized by laser type. Diode lasers were the most commonly used laser and showed high clinical success rates (&gt;85%) with various dressing materials. Nd:YAG lasers demonstrated positive long-term outcomes, while Er:YAG lasers had inconsistent results. Low-Level Laser Therapy (LLLT) and CO2 lasers also showed high clinical and radiographic success. The studies highlighted the variability in laser specifications and clinical protocols, making direct comparisons challenging. Conclusions: Laser pulpotomy offers a viable alternative to traditional methods, with diode and Nd:YAG lasers showing particularly high success rates. However, the lack of standardized protocols and the variability in study methodologies call for further research to establish clear guidelines for clinical practice.

PurposeEndovascular removal of the Woven EndoBridge device (WEBectomy) is rarely reported but crucial for managing complications such as migration, compaction, and malposition, which may lead to recurrence and retreatment. This review aimed to assess treatment strategies, outcomes, and complications associated with WEBectomy.MethodsWe searched PubMed, Embase, and Web of Science databases from inception to January 14,2025,following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies reporting on cases of WEBectomy.ResultsEight studies with 16 patients (range age 30-89; 50% male) with 16 aneurysms were included. The basilar artery was the most common site in 25% (4/16) of the cases, and 50% (7/14) of the aneurysms were ruptured. Migration was the most frequent complication (11/16, 69%), followed by protrusion (4/16, 25%) and malposition (1/16, 6%) that required the removal of WEB. The Amplatz Goose Neck Microsnare was the most commonly used retrieval device (12/16, 75%), with no reported failures or major complications. Retreatment involved a new WEB in 50% (8/16) and coiling techniques in 31% (5/16). Among nine patients with follow-up imaging, most showed complete occlusion (67%, 6/9). Functional outcomes were favorable in 83% (4/6) (mRS 0-1).ConclusionReported cases show that WEBectomy can be successfully performed in selected situations, allowing tailored retreatment planning. However, due to the small number of cases and limited follow-up, no definitive conclusions about safety or efficacy can be drawn. This review provides a concise synthesis of current management strategies for this rare complication.

Medical and dental education share the common goal of preparing clinically competent and socially responsible health professionals. Despite this shared goal, the two disciplines have evolved as distinct academic fields, with limited empirical comparisons between them. Understanding their commonalities and differences can foster mutual development and cross-disciplinary collaboration. This study aims to compare research priorities in medical and dental education by analyzing author keywords from representative journals in each field. A bibliometric analysis was conducted using author keywords from two medical education journals (Advances in Health Sciences Education and BMC Medical Education) and two dental education journals (European Journal of Dental Education and Journal of Dental Education) over a 10-year period (2015-2024). Data were retrieved from the Web of Science database, including only original research articles and review articles. Frequency analysis of the top 10 author keywords was performed in 2-year intervals, and bump charts were created to visualize temporal ranking changes. In addition, co-occurrence network maps were constructed using all keywords appearing 10 or more times over the study period. Data processing and visualization were conducted using VOSviewer and Tableau software. A total of 9391 articles were analyzed, comprising 6806 articles from medical education journals and 2585 articles from dental education journals. Both fields consistently emphasized "students," "assessment," and "curriculum" as core research topics. However, medical education placed greater emphasis on "postgraduate medical education" and student mental health (e.g., empathy, resilience, and depression), whereas dental education focused more on "educational technology" and clinical skills development (e.g., simulation, virtual reality, and psychomotor skills). The keyword "covid-19" emerged prominently in both fields from 2019 to 2020 onward, reflecting the pandemic's transformative impact on education. "Interprofessional education" appeared as a shared emerging theme, suggesting growing recognition of collaborative practice needs. This study identifies both foundational commonalities and discipline-specific innovations in medical and dental education research over the past decade. These findings suggest that shared interests and distinctive priorities can lead to meaningful opportunities for collaborative educational development and joint research efforts across health professions education.

Surgical management of cervical spinal fractures accompanying ankylosing spondylitis (ASCSF) is intractable in clinical practice. There is still debate about whether surgery by a single-anterior approach is enough for treating ASCSF. The purpose of this study is to summarize and share relevant experience and lessons from both our team and the literature. Patients referred to our center for ASCSF following single-anterior surgery (from January 2008 to December 2020) were distinguished and enrolled. In addition, literature published from 2000 to 2021 on PubMed and Web of Science databases was systematically reviewed. A total of 63 patients (7 from our center and 56 from the literature) who underwent single-anterior surgery for treating ASCSF were brought into this study. The average follow-up time of patients in our center is 44 months. The average age of all patients was 58.6. C6/7 was the most commonly injured level (22 patients, 34.9%), and 44 patients (69.8%) experienced neurological impairment at admission. Most ASCSF patients have lordotic cervical alignment and minimal displacement of the fracture. A total of 8 patients died at an early stage after surgery. Apart from these 8 cases, the incidence rates of general complications and surgical complications were relatively 10.9% and 20.0% respectively. The incidence analysis revealed pneumonia (5.45%) as the predominant general complication, contrasting with implant failure (14.55%), which emerged as the most common surgical complication. Among the 8 cases (14.55%) demonstrating implant failure, radiographic analysis revealed preserved cervical lordosis in 4 patients (50%), kyphotic deformity in 1 patient (12.5%), while cervical alignment data were unavailable for the remaining 3 cases (37.5%). Moreover, 29 patients (52.7%) achieved improvement, and 18 patients (37.5%) maintained stable neurological function. For most ASCSF patients with preserved lordotic alignment and minimal displacement, a single anterior surgery can achieve significant neurological improvement and result in a relatively lower incidence of complications. This provides a good basis for orthopedic physicians to handle cervical spine trauma patients with ankylosing spondylitis.

The widespread use of artificial intelligence (AI) technologies has not only streamlined internal processes of the public sector but also advanced public services to citizens globally. Although these trailblazing technologies have been valued for their enhanced efficiency and streamlined processes, they have been susceptible to challenges that hinder their full potential, particularly in developing countries like South Africa. The purpose of this study is to explore the key challenges faced by the South African public sector in adopting AI. Grounded in the interpretivist paradigm, this study employs a qualitative methodology, utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) technique to collect and synthesise data from the literature. The systematic analysis included 20 studies extracted from the Web of Science database. The findings of this study reveal that digital infrastructural deficit, digital illiteracy, policy and regulatory gaps, and ethical dilemmas are all key challenges encountered in the adoption of AI in the South African public sector. The implications of this study are relevant to deepening understanding and advising policymakers, decision-makers, and practitioners on AI challenges.

Metabolic biomarkers are important for the early detection and prognostic assessment of cancer. Nevertheless, a bibliometric analysis examining their research landscape within this domain has not been performed. This study seeks to investigate the current research landscape of metabolic biomarkers related to cancer from 2015 to 2025 and to highlight emerging trends, offering valuable insights for future research directions. Articles published from 2015 to 2025 were extracted from the Web of Science database, and an analysis was performed utilizing R software, along with CiteSpace and VOSviewer.We retrieved clinical trials published between 2015 and 2025 from the PubMed database to analyze the clinical progress in this field. This research encompassed 943 articles in total. Investigations into metabolic biomarkers related to cancer have demonstrated a consistent growth in publications between 2015 and 2023, which was succeeded by a significant surge from 2023 to 2024. The country with the highest number of publications is China, with the United States, the United Kingdom, Japan, and Italy following in that order. Furthermore, China has demonstrated exceptional performance in international collaboration, with the Chinese Academy of Sciences, Shanghai Jiao Tong University, and Zhejiang University emerging as the most prominent collaborative centers. Cancers is recognized as the journal that publishes the greatest quantity of articles within this domain, whereas PLOS One stands out as the journal with the highest citation frequency. Common keywords in the literature include terms such as 'risk,' 'metabolism,' and 'breast cancer.' Research hotspots primarily focus on their application across different cancer types, multi-omics and big data-driven discovery, and the development potential of microbiota-derived markers, and the lag of clinical transformation of metabolic biomarkers, etc. CONCLUSION: The vast promise that metabolic biomarkers hold for the diagnosis and treatment of cancer has attracted considerable interest from researchers across the globe. They are anticipated to emerge as a central theme in the future of cancer prevention and therapeutic strategies. This article offers an in-depth analysis of existing research, addresses key challenges in the field, and provides critical insights for future studies.

Introduction: Acromegaly is a chronic endocrine disorder caused by excessive secretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Acromegaly leads to a wide range of systemic alterations, including metabolic disturbances, abnormalities in bone microarchitecture, soft tissue overgrowth, and morphological changes in the maxilla and mandible. All these factors may significantly complicate the planning and success of implant therapy. Study Aim: This narrative review aimed to critically analyze the impact of acromegaly on bone healing and osseointegration, with particular emphasis on the stability of implant biomaterials, and to assess whether the disease constitutes a contraindication to implant prosthetic treatment. Methods: A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, covering publications from 2000 to August 2025. Manual screening of reference lists from key articles was also performed. Peer-reviewed publications in English, including experimental and preclinical studies, case reports, biomaterials research, and conceptual reviews, were included based on their relevance to acromegaly, bone metabolism, stomatognathic alterations, and implant therapy outcomes. No formal inclusion or exclusion criteria were applied, and methodological quality was not formally assessed, reflecting the exploratory and conceptual nature of this review. Results: Patients with acromegaly exhibit persistent structural bone deficits, such as reduced trabecular number, irregular trabecular distribution, and increased cortical porosity, despite normal or even elevated bone mineral density. In parallel, profound changes in soft tissues and dentition are observed, including macroglossia, diastemas, gingival overgrowth, and mandibular prognathism, which further complicate prosthetic rehabilitation. Animal studies suggest that GH and IGF-1 may support early osseointegration, although the long-term effects of their excess remain inconclusive. Clinical data, although limited, indicate that implant placement in patients with acromegaly is feasible when treatment is meticulously planned and carried out within an interdisciplinary setting. Standard biomaterials, such as titanium and its alloys, may undergo degradation under conditions of chronic inflammation and oxidative stress, underscoring the need for innovative solutions integrating bioactive and immunomodulatory materials, as well as patient-specific implants manufactured using 3D printing technologies. Conclusions: Acromegaly should not be regarded as an absolute contraindication to implant therapy; however, the current evidence is limited. Implant placement requires individualized planning, endocrine control, and interdisciplinary coordination. Further clinical and preclinical studies are needed to establish reliable treatment protocols for this population.

The acquisition of Arabic as a second language (L2) presents a unique set of challenges for learners, particularly in mastering foundational elements such as the numeral system, which differs significantly from its Western counterparts. This paper introduces ARQAMified, a comprehensive conceptual framework for an innovative mobile application designed to mitigate these difficulties through the synergistic integration of gamification, transliteration, and established principles of mobile-assisted language learning (MALL). The proposed framework aims to scaffold the learning process for non-native speakers by employing transliteration as a cognitive bridge to facilitate the transition from a familiar script (e.g., Roman) to the Arabic script. Simultaneously, it leverages evidence-based game mechanics to enhance intrinsic motivation, sustained engagement, and learning outcomes, grounded in psychological theories such as Self-Determination Theory. This conceptual paper provides a detailed exposition of the pedagogical rationale, theoretical underpinnings, and a proposed architectural blueprint for the ARQAMified application. The framework is developed through a meticulous synthesis of recent, high-impact scholarly literature from the Scopus and Web of Science databases, ensuring an evidence-based approach to its design. It discusses the potential of the framework to support holistic language skill development, encompassing reading, writing, listening, and speaking, and explores its implications for both self-directed learning and formal classroom integration. By addressing a distinct gap in the current landscape of Arabic language learning technology, ARQAMified presents a scalable, theoretically robust solution. This paper concludes by outlining a structured path for future empirical research, commencing with a formal needs analysis to validate the framework's assumptions and guide an iterative, user-centered development process.

Background: Cardiac surgery remains associated with a high incidence of cardiac and renal complications, mainly due to oxidative stress. This provides a rationale for evaluating antioxidant therapy as a preventive strategy. Despite advances in perioperative care improving outcomes and lowering mortality, the role of nutritional interventions—particularly antioxidants—remains under investigation. Methods: We conducted a systematic search across PubMed, Embase, Scopus, and Web of Science databases (1990-2025) We included randomized controlled trials (RCTs) that evaluated antioxidant supplementation, ascorbic acid (Vitamin C), polyunsaturated fatty acids (PUFAs), or N-acetylcysteine (NAC) in comparison to placebo among patients undergoing any form of cardiac surgery. Primary outcomes assessed were postoperative atrial fibrillation (POAF), acute kidney injury (AKI), all-cause mortality, and the need for renal replacement therapy (RRT) .A meta-analysis was conducted using a random-effects model to estimate pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Results: A total of 65 studies encompassing 12,259 patients were included. N-acetylcysteine administration was associated with a statistically significant reduction in the incidence of postoperative atrial fibrillation (OR 0.47; 95% CI: 0.32–0.71; p = 0.0002); it did not result in a substantial reduction in the incidence of postoperative acute kidney injury (OR 0.81; 95% CI: 0.63–1.06; p = 0.12), postoperative mortality (OR 0.69; 95% CI: 0.38–1.25; p = 0.22), or need for renal replacement therapy (OR 1.11; 95% CI: 0.58–2.13; p = 0.76). Vitamin C supplementation significantly reduced the incidence of postoperative atrial fibrillation (OR 0.46; 95% CI: 0.28–0.78; p = 0.004) and postoperative mortality (OR 0.20; 95% CI: 0.05–0.75; p = 0.02);, it showed no change in the incidence of acute kidney injury (OR 0.63; 95% CI: 0.27–1.49; p = 0.30). Supplementation with polyunsaturated fatty acids was associated with a reduction in the incidence of postoperative atrial fibrillation (OR 0.70; 95% CI: 0.54–0.92; p = 0.009); however, it did not reduce the incidence of postoperative acute kidney injury (OR 1.11; 95% CI: 0.51–2.41; p = 0.80) or postoperative mortality (OR 0.61; 95% CI: 0.32–1.16; p = 0.13). Conclusion: Antioxidant therapies, particularly N-acetylcysteine and vitamin C, significantly reduce POAF after cardiac surgery, underscoring oxidative stress as a key therapeutic target.

This bibliometric study analyses scientific output over the last 10 years on music using the following keywords “youth”, “culture” and “education”. Based on a sample of 904 documents extracted from the Web of Science database, the research analyses emerging trends in the United States, the United Kingdom and Australia, in patterns of collaboration between authors and countries, and the main topics related to music, culture, identity and young people. To this end, we have applied a quantitative bibliometric methodology, using the Biblioshiny tool from RStudio, generating frequency network maps, multiple correspondence analysis and thematic graphs showing the relationships between keywords and those used by authors. The results show that the United States is the leading scientific producer in this field. The two main terms obtained in the analysis are popular culture and popular music, in addition to related concepts such as identity, gender and education, among others. In conclusion, this study shows how globalisation alters popular culture by influencing the behaviour of adolescents. The research is limited in terms of contributions from the Global South, given the database used, but it is presented as an inclusion in future lines of research.

Introduction: Saphenous vein graft (SVG) failure remains a key limitation in coronary artery bypass grafting (CABG). The no-touch harvesting technique aims to improve graft durability by preserving perivascular tissue and preventing endothelial injury caused by mechanical trauma during conventional harvesting. Purpose: To assess whether the no-touch SVG harvesting technique offers superior graft patency and acceptable safety outcomes compared to conventional SVG harvesting in patients undergoing CABG. Methods: A systematic search was conducted in PubMed, Cochrane CENTRAL, Ovid Medline, and Web of Science databases through May 5, 2025. Randomized controlled trials (RCTs) comparing no-touch versus conventional SVG harvesting in CABG were included. The primary outcome was SVG occlusion per graft at the end of follow-up. Secondary outcomes included SVG occlusion per patient, all-cause mortality, total surgery time, and wound complications. Data were pooled using an inverse variance–weighted random-effects model. Analyses were conducted using the “meta” package in R (version 4.4.3). Results: Eight RCTs comprising 4,234 patients (mean age: 62.6 ± 8.5 years) were included. No-touch SVGs were associated with significantly decreased risk of SVG occlusion by 31% compared to conventional SVGs (RR: 0.69; 95% CI: 0.60–0.80; I2 = 0%, p &lt; 0.0001). A similar benefit was observed at the patient level (RR: 0.68; 95% CI: 0.56–0.83; I2 = 0%, p = 0.0002). All-cause mortality was comparable among the techniques (RR: 1.04; 95% CI: 0.63–1.71; I2 = 0%, p = 0.88). The no-touch technique was associated with a statistically significant but clinically negligible increase in operative time (MD: 9.69 minutes; 95% CI: 2.48–16.90; I2 = 62%, p = 0.0084). However, wound complications occurred more frequently in the no-touch group (RR: 2.03; 95% CI: 1.67–2.47; I2 = 0%, p &lt; 0.0001). Conclusion: The no-touch SVG harvesting technique provides superior graft patency at both the graft and patient levels compared to conventional methods. Although associated with a modest prolongation in operative time and a higher risk of wound complications, these drawbacks may acceptable in patients with low risk for wound morbidity and can potentially be improved upon by increased operator experience with this technique.

The timing of anti-hypertensive medication may influence cardiovascular outcomes and blood pressure control, yet the evidence remains inconclusive. We conducted a meta-analysis to compare the effects of bedtime versus morning dosing of anti-hypertensives on mortality, cardiovascular events, and ambulatory blood pressure. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing bedtime versus morning administration of antihypertensive therapy. A comprehensive literature search was performed in PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases up to June 2025. Pooled risk ratios (RRs) were calculated for categorical outcomes, and mean differences (MDs) for continuous variables. All statistical analyses were performed using R version 4.3.3. PROSPERO registration ID: CRD420251113957. Pooled analysis of six RCTs with 49,983 patients was included. Bedtime dosing of anti-hypertensive medications resulted in a lower incidence of heart failure (1.3% vs. 2.0%; RR 0.63, 95% CI 0.47-0.85) but not myocardial infarction (1.4% vs. 1.6%; RR 0.87, 95% CI 0.64-1.17), stroke or transient ischemic attack (0.9% vs. 1.3%; RR 0.71, 95% CI 0.49-1.05), all-cause mortality (2.6% vs. 3.1%; RR 0.75, 95% CI 0.53-1.06), or cardiovascular mortality (1.0% vs. 1.5%; RR 0.52, 95% CI 0.22-1.21). For blood pressure, bedtime dosing significantly reduced evening systolic blood pressure (MD - 4.71mmHg, 95% CI - 6.64 to - 2.78) and evening diastolic blood pressure (MD - 1.66mmHg, 95% CI - 1.92 to - 1.40), with no significant differences observed in morning readings. Bedtime administration of anti-hypertensive medications may be associated with reduction in MACE and heart failure incidence. No significant effect was observed in mortality, myocardial infarction, or stroke.

BackgroundLarge language models (LLMs) are increasingly being applied in healthcare; however, their performance in specialized fields, such as oncology, is subject to temporal factors, including knowledge decay and concept drift. The impact of these temporal dynamics on LLM question-answering accuracy in oncology remains inadequately evaluated. This study aims to systematically assess the temporal evolution of LLM accuracy in responding to oncology-related questions using real-world data.MethodWe systematically collected relevant literature through 2025 by searching LLM-related keywords in PubMed, Google Scholar, and Web of Science databases. The inclusion criteria were as follows: (1) cancer-related research; (2) clear and complete question descriptions; and (3) complete answers. The final sample (n = 23) contained 614 research questions, comprising subjective questions (n = 223) and multiple-choice questions (n = 391). Following randomization of responses generated by three LLMs (ChatGPT-3.5, ChatGPT-4, and Gemini), we evaluated their accuracy across different cancer categories using both original scoring criteria and Likert scale scoring methods. Data analysis was performed using R statistical software, employing random or fixed effects models to calculate pooled mean differences (MD) and relative risks (RR) with their 95% confidence intervals (CI).ResultsThe findings demonstrated that in both subjective and objective oncology assessments, ChatGPT-3.5 (subjective questions MD = −3.30; objective questions RR = 0.92) and ChatGPT-4 (subjective questions MD = −7.17; objective questions RR = 0.93) showed declining performance trends over time, while Gemini exhibited significant improvements over time (subjective questions MD = 11.48; objective questions RR = 1.15). Notably, ChatGPT-3.5‘s performance on subjective questions revealed a significant turning point between March 14, 2023, and April 26, 2023, shifting from initially superior performance on newer questions to inferior performance compared with original questions, with the performance gap progressively widening.ConclusionsOur meta-analysis reveals temporal performance degradation in ChatGPT-3.5 and ChatGPT-4, which contrasts with the consistent improvement observed in Gemini. These findings provide essential guidance for the evidence-based deployment of LLMs in oncology.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12967-025-07227-2.