Can a DNA vaccine protect against Chagas disease? A systematic review of preclinical studies.

Effects of anodal transcranial direct current stimulation on athletic performance among elite athletes: A systematic review and meta-analysis.

Hydrotherapy is the external use of water for therapeutic purposes, using the physical, physiological, and kinesiological effects of immersing the body in a pool to aid rehabilitation or prevent functional alterations. This systematic review aims to assess hydrotherapy's effects on gait control in older adults with neurological conditions. Computerised search in Scopus, PubMed, Web of Science, B-on, PEDro, and Cochrane databases, using the combination of keywords: Thermal water, Gait control, hydrotherapy, and Aquatic therapy for older adults. Methodological quality was analysed using the Physiotherapy Evidence Database (PEDro) scale. The selection criteria included randomised clinical trials in neurological cases in older adults with altered gait and balance. A comprehensive search was conducted in Scopus, PubMed, Web of Science, B-on, PEDro, and Cochrane databases. Randomised controlled trials involving older adults (≥65 years) with neurological disorders affecting gait and balance were included. Methodological quality was assessed using the PEDro scale. Hydrotherapy appears safe and more effective than conventional physiotherapy for improving gait control, balance, and mobility in older adults with neurological impairments. Its buoyancy and resistance effects facilitate motor re-education and confidence in movement. Integrating aquatic therapy into neurorehabilitation programs may enhance outcomes and quality of life, although long-term follow-up studies are still needed.

Charcot Arthropathy (CA) is a destructive joint condition tied to neurotrophic and neuropathic processes. The clinical course is often complicated-high amputation rates and a generally poor prognosis have long made management difficult. Decades of research have brought progress in basic science and clinical care, yet a clear, data-driven picture of the global research landscape and how it has shifted over time remains, in many ways, incomplete. This study set out to map the core components, current hotspots, and emerging frontiers in the CA literature. We focused on English-language publications in the Web of Science (WoS) database from 1995 to 2025. Using tools such as CiteSpace, the R package bibliometrix, and GraphPad, we conducted a quantitative analysis of the countries or regions, institutions, authors, collaboration patterns, journals, cited references, and keywords associated with CA-related publications. We screened 349 papers. Annual output has generally trended upward-perhaps a sign of growing interest in the field. The United States ranked first in both total publications (n=180) and citations (n=3949), and sat at the center of international collaboration networks. Key authors (e.g.,Dane K. Wukich) and institutions (e.g.,the University of Texas System) emerged as major contributors; their dense collaborations appear to drive much of the field's progress. The Journal of Foot and Ankle Surgery published the most CA-related papers (n=47). Current research hotspots appear to center on the foot and ankle, pathogenesis, and surgical treatment. Looking at keyword trends, the field seems to be moving toward biomechanics, advanced reconstruction, and three-dimensional imaging. This study is the first comprehensive mapping of CA literature over three decades. It highlights the United States' leading role and a shift toward technology in diagnosis and surgery. These findings may guide future research, collaboration, and clinical practice.

Multifaceted interventions to enhance patient's adherence to self-monitoring blood glucose: A systematic review.

As large language models (LLMs) grow in sophistication, their potential role in scientific writing is being explored with growing interest and caution. However, LLMs vary in their performance, contextual accuracy, and reliability. This study compares the outputs of 3 leading LLMs (ChatGPT-4o, Deepseek, and Claude 3.7) against a manually curated bibliometric analysis of the most highly cited panniculectomy articles. The 50 most highly cited panniculectomy publications were manually extracted from Web of Science (WoS) to serve as a reference data set. ChatGPT-4o, Deepseek, and Claude 3.7 Sonnet were each prompted to generate their own list of the 50 most cited panniculectomy articles. Outputs were compared across citation totals and averages, publication year trends, journal distribution, author co-occurrence, and article authenticity. The manual data set totaled 2494 citations (density: 49.8). ChatGPT-4o, Deepseek, and Claude 3.7 produced 2111 (42.2), 4736 (94.7), and 8592 (171.8) citations, respectively. Overlap with the manual list was limited: ChatGPT-4o (14.00%), Claude 3.7 (4.00%), Deepseek (0.00%) ( P <0.001). "Plastic and Reconstructive Surgery" was the most cited journal across all outputs. Unique authors: manual (241), ChatGPT-4o (114), Deepseek (72), and Claude 3.7 (129). Article accuracy: ChatGPT-4o had 34.00% accurate, 26.00% confabulated, and 40.00% hallucinated articles. Claude 3.7: 4.00% accurate, 26.00% confabulated, and 70.00% hallucinated. Deepseek: 100.00% hallucinated ( P <0.001). Year trends and journal representation varied notably from the manual set. Current LLMs struggle to replicate accurate bibliometric data. ChatGPT-4o performed best but still showed major limitations. WoS remains the gold standard, and LLM-generated outputs should be treated cautiously in bibliometric analyses.

A scientometric overview of 75 years of epigenetics research in poultry

Metformin Use and Risk of Glaucoma: A Systematic Review and Meta-Analysis.

Effects of exercise interventions on clinical outcomes in pre-clinical and early rheumatoid arthritis: a systematic review and meta-analysis.

Drug repurposing has gained prominence in oncology by enabling the investigation of approved drugs for new therapeutic purposes. In lung cancer, this strategy may reduce the time and costs associated with drug development. This study aimed to map the landscape of in silico, in vitro, in vivo, and clinical research on drug repurposing for lung cancer, while identifying key molecular targets and research gaps. A systematic search was conducted in PubMed, Embase, and Web of Science, following Joanna Briggs Institute and PRISMA-ScR guidelines. Two reviewers independently selected and extracted the data. A total of 58 studies, published between 2010 and 2024-mainly from the United Kingdom (19%) and United States (17%), were included. Most studies used in vitro models (53%), followed by in vivo (31%) and in silico (16%), with frequent combinations of methods. The most investigated drug classes were antibiotics (10%), antipsychotics (9%), antidiabetics (8%), anthelmintics (6%), and antihistamines (6%). Frequently studied drugs included niclosamide, metformin, atorvastatin, and doxazosin, targeting pathways such as PI3K/AKT/mTOR, apoptosis, and autophagy. Bibliometric analysis revealed increasing scientific output, with emphasis on combination therapies, cellular mechanisms, and technologies like molecular docking and nanosystems. These findings highlight the growing relevance of drug repurposing in lung cancer, especially in accelerating effective therapy discovery using approved compounds. Progress in this field depends on integrating diverse methodologies and fostering interdisciplinary collaboration. As a next step, rigorous clinical trials are essential to confirm the efficacy and safety of promising repurposed agents in oncology.

Malpractice and compensation claims after hip fracture care: A systematic review of cross-jurisdiction trends and predictors of plaintiff success.

Clinical outcome reporting in randomised controlled trials of remote obstetric antenatal monitoring: a systematic review.

The integration of artificial intelligence in healthcare has transformed clinical practice and research methodologies. However, concerns regarding algorithmic accountability, interpretability, and safety have necessitated human oversight in AI systems. Human in the loop artificial intelligence represents a collaborative paradigm where human expertise and machine intelligence converge to enhance decision making while maintaining ethical standards and clinical safety. This review synthesizes current evidence on human in the loop AI in healthcare delivery and research, examining implementation frameworks, clinical outcomes, comparative advantages over fully automated and clinician-only approaches, and challenges. A comprehensive narrative review was conducted using PubMed, Scopus, Web of Science, and IEEE Xplore databases covering studies from 2018 to 2025. Data were thematically synthesized to identify patterns, frameworks, and outcomes. This narrative approach enables comprehensive conceptual synthesis across diverse HITL-AI applications and contexts. Human in the loop AI demonstrates significant applications across diagnostic imaging, clinical decision support, patient monitoring, drug discovery, and research data analysis. Evidence indicates improved diagnostic accuracy, reduced medical errors, enhanced patient safety, and increased clinician trust compared to both automated AI and traditional approaches. Implementation requires EHR interoperability, clear liability frameworks, adaptive training protocols, and quantum-safe cryptographic security. Challenges include workflow integration, regulatory gaps for adaptive systems, and sustainability concerns. This review advances the field by synthesizing cross-domain implementation patterns, mapping collaboration models to risk-stratified contexts, identifying regulatory gaps for adaptive systems, and proposing future directions including post-quantum cryptographic integration, AI-driven adaptive architectures, and multi-center scalability frameworks for optimizing human-machine collaboration in healthcare.

The development of effective therapeutics for dry eye disease (DED) is challenging due to its complex pathophysiology, heterogeneous patient presentation and the significant failure rate of previous clinical development programs. This underlines the importance of the selection of appropriate endpoints for clinical trials. The presented systematic review retrospectively analyzes the endpoints used in controlled clinical trials in studies of DED. Published clinical trials in the field of DED were reviewed from 2000 to 2023 and the used clinical endpoints were recorded by type and frequency of use. All studies that met the primary keyword search across various databases (PubMed, Embase, The Cochrane Library, Web of Science and Medline) were imported into Rayyan which was used to facilitate the screening process and support the collaboration between the reviewers. 93 876 studies were found of which 33 908 remained after duplicates were removed. All abstracts were screened for eligibility independently by two reviewers. 355 articles remained for full-text review, of which 194 were included in the present systematic review. The most frequently investigated product was topical medicinal products (88 studies), followed by topical lubricants (57 studies) and nutritional supplements (22 studies). Corneal fluorescein staining (45 studies) and the ocular surface disease index (OSDI; 96 studies) were the most frequently used primary objective and subjective outcome parameters. However, a sustainable number of studies failed to show statistically significant differences between treatment and control groups, despite improvements from baseline. Our findings show that corneal fluorescein staining and OSDI are the most frequently used endpoints in clinical studies, although they frequently are not able to detect differences between the treatment and control groups. Therefore, to enhance the efficiency and reliability of DED clinical trials, a consensus on optimal outcome measures is crucial, and the exploration of novel endpoints should be prioritized. PROSPERO Registration Number: CRD42022350817.

Episiotomy is a common obstetric procedure often associated with significant postpartum pain and delayed wound healing. Conventional treatments provide limited relief and might not be suitable for all women. Energy-based therapies, including infrared irradiation and low-level laser therapy (LLLT), a non-thermal photo biomodulation technique, have shown potential for enhancing pain relief and tissue recovery, but their effectiveness in post-episiotomy care remains unclear. This study evaluates the efficacy of energy-based treatments on pain reduction and wound healing following episiotomy in postpartum women. A database search was performed using MEDLINE with Ovid and PubMed interfaces, The Cochrane Central Register of Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov and Web of Science up to December 2024. Prospective randomized and non-randomized controlled trials were considered for inclusion. No restriction was imposed regarding the year or language of publication. Included studies compared one method of energy-based treatment to placebo, standard of care, no treatment or another intervention. Data were synthesized using RevMan Web (Version 8.14.0) with a random-effects model to account for interstudy heterogeneity. Pooled results were expressed as standardized mean differences (SMDs) with 95% confidence intervals. Evidence certainty was assessed using the GRADE approach. A total of 173 studies were identified through database searches, of which 13 studies were included in the final analysis, encompassing a total of 1377 patients. Analyses were stratified by intervention type: infrared irradiation versus standard care or no treatment (n = 1088), LLLT versus placebo (n = 209) and LLLT versus therapeutic ultrasound (n = 80). Infrared irradiation reduced postpartum pain compared to standard care or no treatment (SMD = -0.50, 95% confidence interval [CI]: -0.98 to -0.02, I2 = 88%, P < 0.01); however, it did not improve healing measures. LLLT showed no improvement in pain reduction (SMD: -0.31, 95% CI: -0.72 to 0.11, I2 = 53%, P = 0.1) or healing (SMD: 0.23, 95% CI: -0.18 to 0.63, I2 = 0%, P = 0.85) compared to placebo. LLLT compared to therapeutic ultrasound did not show advantage in pain or healing and was hindered by very high heterogeneity. Infrared therapy might reduce pain after episiotomy, although its effect on wound healing remains inconclusive. LLLT did not demonstrate significant benefits for pain relief or healing. CRD42024608543; registered December 2024.

Prognostic significance of carotid intima-media thickness in patients with coronary slow flow: A systematic review and meta-analysis.

Community-based interventions to improve tuberculosis treatment outcomes: A meta-analysis.

The efficacy of behavioral interventions on cardiovascular risk factors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized trials.

Hormonal fluctuations throughout the menstrual cycle are associated with a higher prevalence of musculoskeletal injuries in women; however, their impact at the foot and ankle level remains underexplored. The aim of this systematic review and meta-analysis was to examine the potential biomechanical effect of the ovulatory phase on foot and ankle structure compared to other phases of the menstrual cycle, given its possible association with injury occurrence. A systematic search was conducted in PubMed, Scopus, Web Of Science, and Embase (last 10 years), following PRISMA guidelines. Cohort studies, non-randomized trials, and case-control studies were included. Quality assessment was performed using the JBI critical appraisal tool. A quantitative synthesis (meta-analysis) was performed for homogeneous variables (muscle stiffness). Fifteen studies were selected. The systematic review demonstrated increase in foot length, reduction in fascial thickness, and greater longitudinal arch collapse during the ovulatory phase. Tone and stiffness of the tibialis anterior and peroneus longus muscles were greater during the menstrual phase. During ovulation, lower stiffness was observed during active contraction and increased tibialis anterior activation. Greater postural sway and oscillation were recorded during ovulation in complex static tasks, and, along with the menstrual phase, in dynamic balance tests. The meta-analysis indicated a tendency towards lower tibialis anterior stiffness during the follicular phase compared to the ovulatory phase. The ovulatory phase appears to be associated with an interaction of structural alterations (ligament laxity and arch collapse) and neuromuscular changes (reduced muscle stiffness and inefficient motor control) that, together, could constitute a risk factor for local pathologies such as plantar fasciitis and chronic ankle instability.

Evaluating the safety and efficacy of dengue vaccines: A comprehensive systematic review and meta-analysis.