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Background: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. Objectives: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. Methods: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. Results: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). Conclusions: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839. Key Points: We found a reduced risk of all-cause mortality associated with cycling (–21%), running (–23%) and swimming (–24%). Running also improves body composition, cardiovascular function at rest and cardiorespiratory fitness, while swimming also improves body composition and blood lipids. Football improves body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength, while handball improves body composition and cardiorespiratory fitness. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to critically re-appraise the published trials assessing amitriptyline for migraine prophylaxis. Methods: We report our methods and results following the Preferred Reporting Items for Systematic Reviews (PRISMA), by searching MEDLINE, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov for randomized trials of pharmacologic treatments for migraine prophylaxis. We included randomized trials that compared amitriptyline with placebo for migraine prophylaxis in adults. Our outcomes of interest were informed by the Outcome Set for preventive intervention trials in chronic and episodic migraine (COSMIG) and include the proportion of patients who experience a 50% or more reduction in migraine days per month, migraine days per month, and adverse events leading to discontinuation. We assessed risk of bias by using a modified Cochrane RoB 2.0 tool and the certainty of evidence by using the GRADE approach. Results: Our search yielded 10.826 unique records, of which three trials (n = 622) were eligible for data synthesis and analysis. We found moderate certainty evidence that amitriptyline increases the proportion of patients who experience a 50% or more reduction in monthly migraine days, compared to placebo (relative risk: 1.60 (95% CI 1.17 to 2.19); absolute risk difference: 165 more per 1,000 (95% CI 47 more to 327 more). We found moderate certainty evidence that amitriptyline increases the proportion of patients who discontinue due to adverse events compared to placebo (risk difference: 0.05 (95% CI 0.01 to 0.10); absolute risk difference: 50 more per 1,000 (95% CI 10 more to 100 more). Conclusions: Our meta-analysis showed that amitriptyline may have a prophylactic role in migraine patients, however these results are far from robust. This warrants further large-scale research to evaluate the role of amitriptyline in migraine prevention. [ABSTRACT FROM AUTHOR]

Scientific research of artificial intelligence (AI) in dermatology has increased exponentially. The objective of this study was to perform a systematic review and meta-analysis to evaluate the performance of AI algorithms for skin cancer classification in comparison to clinicians with different levels of expertise. Based on PRISMA guidelines, 3 electronic databases (PubMed, Embase, and Cochrane Library) were screened for relevant articles up to August 2022. The quality of the studies was assessed using QUADAS-2. A meta-analysis of sensitivity and specificity was performed for the accuracy of AI and clinicians. Fifty-three studies were included in the systematic review, and 19 met the inclusion criteria for the meta-analysis. Considering all studies and all subgroups of clinicians, we found a sensitivity (Sn) and specificity (Sp) of 87.0% and 77.1% for AI algorithms, respectively, and a Sn of 79.78% and Sp of 73.6% for all clinicians (overall); differences were statistically significant for both Sn and Sp. The difference between AI performance (Sn 92.5%, Sp 66.5%) vs. generalists (Sn 64.6%, Sp 72.8%), was greater, when compared with expert clinicians. Performance between AI algorithms (Sn 86.3%, Sp 78.4%) vs expert dermatologists (Sn 84.2%, Sp 74.4%) was clinically comparable. Limitations of AI algorithms in clinical practice should be considered, and future studies should focus on real-world settings, and towards AI-assistance. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the rate at which screening colonoscopy is performed on patients younger or older than the age range specified in national guidelines, or at shorter intervals than recommended. Such non-indicated use of the procedure is considered low-value care, or overuse. This study is the first systematic review of the rate of non-indicated completed screening colonoscopy in the USA.Methods: PubMed and Embase were queried for relevant studies on overuse of screening colonoscopy published from January 1, 2002, until January 23, 2019. English-language studies that were conducted for screening colonoscopy after 2001 for average-risk patients were included. Studies must have followed national guidelines for detecting rates of overuse. We followed methods outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the reporting recommendations of the Meta-analysis of Observational Studies in Epidemiology group (MOOSE).Results: A total of 772 papers were reviewed for inclusion; 42 were reviewed in full text. Of those reviewed, six studies met eligibility criteria, including a total of 459,503 colonoscopies of which 242,756 were screening colonoscopies. The rate of overuse ranged credibly from 17 to 25.7%.Discussion: This study demonstrates that screening colonoscopy is regularly performed in the USA more often, and in populations older or younger, than recommended by national guidelines. Such overuse wastes resources and places patients at unnecessary risk of harm. Efforts to reduce non-indicated screening colonoscopy are needed. [ABSTRACT FROM AUTHOR]

Background: Chronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI. Methods: Without language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2–0.5), moderate (0.5–0.8), or large (> 0.8). Results: A total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls. Conclusions: Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size. Registration: The protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855). Key Points This study conducted a meta-analysis to investigate bilateral functions in patients with unilateral chronic ankle instability (CAI). The analysis compared the injured limb of unilateral CAI with healthy control and the uninjured limb with healthy control. Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinesthesia. However, further large-scale studies are required to validate these findings. In future research, it is crucial to apply bilateral assessment in individuals with unilateral CAI and explore interventions targeting both limbs. Additionally, considering the differences between mechanical and functional ankle instability, future studies could explore the bilateral characteristics based on this classification to gain a better understanding of the variations between the two. This will provide more specific guidance for developing effective training methods. [ABSTRACT FROM AUTHOR]

Background: Globally, just one in five adolescents meet physical activity guidelines and three-quarters of the school day is spent sitting. It is unclear which types of school-based interventions strategies increase physical activity and reduce sedentary time among adolescents, or how these interventions are implemented influences their effectiveness. Objective: The three aims of our systematic review were to (a) identify intervention strategies used within secondary school settings to improve students' movement behaviours throughout school-based initiatives, delivered at or by the school; (b) determine the overall effect of the interventions (meta-analysis) on physical activity (all intensities), sedentary time, cognitive/academic, physical health and/or psychological outcomes; and (c) describe factors related to intervention implementation. Methods: Searches were conducted in MEDLINE complete, EMBASE, CINAHL, SPORTDiscus, APA PsycINFO, and ERIC in January 2023 for studies that (a) included high school-aged adolescents; (b) involved a school-based intervention to increase physical activity and/or decrease sedentary time; and (c) were published in English. Reported effects were pooled in meta-analyses where sufficient data were obtained. Results: Eighty-five articles, representing 61 interventions, met the inclusion criteria, with 23 unique intervention strategies used. Interventions that involved whole-school approaches (i.e., physical activity sessions, environmental modifications, teacher training, peer support and/or educational resources) were favourably associated with most of the outcomes. The meta-analyses showed: (a) non-significant effects for sedentary time (Standardized mean difference [SMD] = -0.02; 95%CI, -0.14, 0.11), physical activity at all intensities (light: SMD= -0.01; 95%CI, -0.08, 0.05; moderate: SMD = 0.06; 95%CI, -0.09, 0.22; vigorous: SMD = 0.08; 95%CI, -0.02, 0.18; moderate-to-vigorous: SMD = 0.05; 95%CI, -0.01, 0.12) and waist circumference (SMD = 0.09; 95%CI, -0.03, 0.21), and (b) a small statistically significant decrease in body mass index (SMD= -0.09, 95%CI -0.16, -0.0). Factors related to intervention implementation were reported in 51% of the articles. Conclusion: While some intervention approaches demonstrated promise, small or null effects were found in meta-analyses. Future school-based interventions should utilize a whole-school approach designed to increase adolescents' activity across the day. Consistent reporting of implementation will increase understanding of how interventions are adopted, implemented and sustained. Registration: PROSPERO (CRD42020169988). Key Points: School-based interventions with adolescents have had null effects on increasing physical activity and reducing sedentary time. The impact on physical and psychological outcomes has been poorly reported among secondary school students. This review included articles with all experimental study designs, any intervention length, and that reported a variety of outcomes among adolescents in secondary schools (11–18 years old). Although meta-analyses showed that these interventions did not increase physical activity or reduce sedentary time, studies that quantify adiposity markers showed a small decrease in body mass index. The review identified that additional physical activity sessions, environmental modifications, teacher training, peer support, educational resources and/or active lesson strategies were associated with greater benefits. Fidelity and participant responses were the most commonly reported implementation factors, adaptation was the least commonly reported; however, factors associated with effective implementation were not a focus of the included studies. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcomes associated with the use of lasmiditan, rimegepant, ubrogepant, and zavegepant for the acute management of migraine headaches. Methods: We searched four electronic databases from database inception to August 31, 2023, to identify randomized controlled trials (RCTs) that report efficacy and safety for the acute treatment of migraine. The risk of bias in the included RCTs was evaluated according to the Cochrane tool, and the certainty of evidence using the CINeMA approach. We conducted frequentist network meta-analyses (NMA) to summarise the evidence. Data were analyzed using R-4.3.1. Results: A total of 18 eligible studies including 10 different types of interventions with 22,429 migraine patients were included. NMA results showed that compared to ubrogepant (25 mg and 50 mg) and zavegepant, lasmiditan (100 mg and 200 mg) exhibits an elevated probability of achieving pain relief within a 2-hour interval. Similarly, relative to zavegepant, rimegepant (75 mg) and ubrogepant (50 mg and 100 mg) demonstrate an enhanced likelihood of sustaining pain relief over a 24-hour period. Furthermore, in contrast to ubrogepant (25 mg) and lasmiditan (50 mg), rimegepant (75 mg) presents a heightened probability of achieving freedom from photophobia within 2 h. Regarding safety, lasmiditan carries the highest risk of adverse events, which are associated with an increased incidence of adverse effects, including dizziness, somnolence, asthenia, paresthesia, and fatigue. Conclusions: In this NMA, a spectrum of evidence ranging from very low to high levels underscores the favorable efficacy and tolerability of rimegepant 75 mg and ubrogepant 100 mg, positioning them as potential candidates for the acute management of migraine. Concurrently, lasmiditan (100 mg and 200 mg) exhibits notable efficacy, albeit accompanied by an increased susceptibility to adverse events. These findings should still be approached with caution, primarily due to the intrinsic limitations associated with indirect comparisons. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI)-assisted PET imaging is emerging as a promising tool for the diagnosis of Parkinson's disease (PD). We aim to systematically review the diagnostic accuracy of AI-assisted PET in detecting PD. The Ovid MEDLINE, Ovid Embase, Web of Science, and IEEE Xplore databases were systematically searched for related studies that developed an AI algorithm in PET imaging for diagnostic performance from PD and were published by August 17, 2023. Binary diagnostic accuracy data were extracted for meta-analysis to derive outcomes of interest: area under the curve (AUC). 23 eligible studies provided sufficient data to construct contingency tables that allowed the calculation of diagnostic accuracy. Specifically, 11 studies were identified that distinguished PD from normal control, with a pooled AUC of 0.96 (95% CI: 0.94–0.97) for presynaptic dopamine (DA) and 0.90 (95% CI: 0.87–0.93) for glucose metabolism (18F-FDG). 13 studies were identified that distinguished PD from the atypical parkinsonism (AP), with a pooled AUC of 0.93 (95% CI: 0.91 − 0.95) for presynaptic DA, 0.79 (95% CI: 0.75–0.82) for postsynaptic DA, and 0.97 (95% CI: 0.96–0.99) for 18F-FDG. Acceptable diagnostic performance of PD with AI algorithms-assisted PET imaging was highlighted across the subgroups. More rigorous reporting standards that take into account the unique challenges of AI research could improve future studies. [ABSTRACT FROM AUTHOR]

Background: Despite the increasing number of research studies examining the effects of age on the control of posture, the number of annual fall-related injuries and deaths continues to increase. A better understanding of how old age affects the neural mechanisms of postural control and how countermeasures such as balance training could improve the neural control of posture to reduce falls in older individuals is therefore necessary. The aim of this review is to determine the effects of age on the neural correlates of balance skill learning measured during static (standing) and dynamic (walking) balance tasks in healthy individuals. Methods: We determined the effects of acute (1–3 sessions) and chronic (> 3 sessions) balance skill training on balance in the trained and in untrained, transfer balance tasks through a systematic review and quantified these effects by robust variance estimation meta-analysis in combination with meta-regression. We systematically searched PubMed, Web of Science, and Cochrane databases. Balance performance and neural plasticity outcomes were extracted and included in the systematic synthesis and meta-analysis. Results: Forty-two studies (n = 622 young, n = 699 older individuals) were included in the systematic synthesis. Seventeen studies with 508 in-analysis participants were eligible for a meta-analysis. The overall analysis revealed that acute and chronic balance training had a large effect on the neural correlates of balance skill learning in the two age groups combined (g = 0.79, p < 0.01). Both age groups similarly improved balance skill performance in 1–3 training sessions and showed little further improvements with additional sessions. Improvements in balance performance mainly occurred in the trained and less so in the non-trained (i.e., transfer) balance tasks. The systematic synthesis and meta-analysis suggested little correspondence between improved balance skills and changes in spinal, cortical, and corticospinal excitability measures in the two age groups and between the time courses of changes in balance skills and neural correlates. Conclusions: Balance skill learning and the accompanying neural adaptations occur rapidly and independently of age with little to no training dose-dependence or correspondence between behavioral and neural adaptations. Of the five types of neural correlates examined, changes in only spinal excitability seemed to differ between age groups. However, age or training dose in terms of duration did not moderate the effects of balance training on the changes in any of the neural correlates. The behavioral and neural mechanisms of strong task-specificity and the time course of skill retention remain unclear and require further studies in young and older individuals. Registration: PROSPERO registration number: CRD42022349573. Key Points: We examined the effects of balance training on balance performance, and its neural correlates in healthy younger (n = 21 studies) and older individuals (n = 18 studies) Balance training improves the trained balance skill rapidly, i.e., 30–40 min Balance training improves the non-trained balance skills (i.e., transfer tasks) much less or not at all Balance training improves neural measures independently of age and training dose Age and training duration do not moderate the training-induced changes in the neural correlates of balance learning There is little-to-no temporal correspondence between improvements in balance skills and the neural correlates examined [ABSTRACT FROM AUTHOR]

Background: Chronic migraine can be a profoundly disabling disorder that may be treated with preventive medications. However, uncertainty remains as to which preventive medication is the most effective. We present a network meta-analysis to determine the effectiveness and rank of preventive drugs for chronic migraine in adults. Methods: We identified, reviewed, and extracted data from randomised controlled trials (RCTs) of preventive drugs for chronic migraine with at least 200 participants. Data were analysed using network meta-analysis. Findings: We included 12 RCTs of six medications (Eptinezumab, Erenumab, Fremanezumab, Galcanezumab, Onabotulinumtoxin A, and Topiramate) compared to placebo or each other. All drugs effectively reduced monthly headache and migraine days compared with placebo. The most effective drug for monthly headache days was Eptinezumab 300mg, with a mean difference of -2.46 days, 95% Credible Interval (CrI): -3.23 to -1.69. On the Surface Under the Cumulative Ranking Area (SUCRA) analysis, the probability that Eptinezumab 300mg was ranked highest was 0.82. For monthly migraine days, the most effective medication was Fremanezumab-monthly, with a mean difference: -2.77 days, 95% CrI: -3.36 to -2.17, and 0.98 probability of being ranked the highest. All included drugs, except Topiramate, improved headache-related quality of life. No eligible studies were identified for the other common preventive oral medications such as Amitriptyline, Candesartan, and Propranolol. The main reasons were that the studies did not define chronic migraine, were undertaken before the definition of chronic migraine, or were too small. Interpretation: All six medications were more effective than the placebo on monthly headache and migraine days. The absolute differences in the number of headache/migraine days are, at best, modest. No evidence was found to determine the relative effectiveness of the six included drugs with other oral preventive medications. Registration: PROSPERO (number CRD42021265990). [ABSTRACT FROM AUTHOR]

Background: Single nucleotide variants (SNVs) of functional diabetogenic genes are also involved in the pathogenetic mechanism of gestational diabetes mellitus (GDM). This study aimed at assessing associations of GDM with MTNR1B and PPARG gene variants in different racial populations. Methods: Literatures from PubMed and Embase databases were searched. Data were abstracted by two reviewers, and a consensus method was used to resolve disagreements. All reviewers worked independently. Twenty-one eligible literatures were enrolled by our data selection strategies, and heterogeneity, subgroup, sensitivity, and publication bias analysis. Results: G allele variant of rs10830963 was significantly associated with an increasing risk of GDM (GG + CG vs. CC: pooled OR = 1.52, 95% CI = 1.37–1.69, p < 0.001; GG vs. CG + CC: pooled OR = 1.49, 95% CI = 1.37–1.62, p < 0.001; G vs. C: pooled OR = 1.40, 95% CI = 1.30–1.52, p < 0.001). Further subgroup analysis showed the risk G allele were significantly associated with the GDM risk in women from Europe, Asia, and America, while European women carrying the G allele had a higher risk of GDM (G vs. C: pooled OR = 1.617, 95% CI = 1.46–1.79, p < 0.001) than the other regional ones. No significant correlation between the G allele of PPARG rs1801282 (C > G) SNV risk of GDM, which is consistent with some former studies. Conclusions: MTNR1B rs10830963(C > G) significantly increases the risk of GDM in Europeans, Asians, and Americans. G allele carriers in European population were confirmed a higher risk of GDM than Asian and American populations. No association between GDM and PPARG rs1801282 SNV indicates further validation may be needed. [ABSTRACT FROM AUTHOR]

Background: Although stretching can acutely increase joint range of motion (ROM), there are a variety of factors which could influence the extent of stretch-induced flexibility such as participant characteristics, stretching intensities, durations, type (technique), and muscle or joint tested. Objective: The objective of this systematic review and meta-analysis was to investigate the acute effects of stretching on ROM including moderating variables such as muscles tested, stretch techniques, intensity, sex, and trained state. Methods: A random-effect meta-analysis was performed from 47 eligible studies (110 effect sizes). A mixed-effect meta-analysis subgroup analysis was also performed on the moderating variables. A meta-regression was also performed between age and stretch duration. GRADE analysis was used to assess the quality of evidence obtained from this meta-analysis. Results: The meta-analysis revealed a small ROM standard mean difference in favor of an acute bout of stretching compared to non-active control condition (ES = −0.555; Z = −8.939; CI (95%) −0.677 to −0.434; p < 0.001; I2 = 33.32). While there were ROM increases with sit and reach (P = 0.038), hamstrings (P < 0.001), and triceps surae (P = 0.002) tests, there was no change with the hip adductor test (P = 0.403). Further subgroup analyses revealed no significant difference in stretch intensity (P = 0.76), trained state (P = 0.99), stretching techniques (P = 0.72), and sex (P = 0.89). Finally, meta-regression showed no relationship between the ROM standard mean differences to age (R2 = −0.03; P = 0.56) and stretch duration (R2 = 0.00; P = 0.39), respectively. GRADE analysis indicated that we can be moderately confident in the effect estimates. Conclusion: A single bout of stretching can be considered effective for providing acute small magnitude ROM improvements for most ROM tests, which are not significantly affected by stretch intensity, participants' trained state, stretching techniques, and sex. Key Points: The meta-analysis on joint range of motion (ROM) increases revealed a small effect size in favor of an acute bout of stretching compared to the control condition. Subgroup analysis revealed a significant increase in ROM with sit and reach, hamstrings, and triceps surae tests, but no improvement with the hip adductor tests. Whereas all moderating variables presented significant increases in ROM, further subgroup analyses revealed no significant difference in ROM gains with the stretch intensity, trained state of the participants, stretching techniques, and sex. A meta-regression showed no relationship between the effect sizes to age and stretch duration, respectively. [ABSTRACT FROM AUTHOR]

Background: Intranasal agents may be ideal for the treatment of migraine patients. Many new acute intranasal-specific therapies have been developed, but few of them have been directly compared. The aim of this network meta-analysis (NMA) was to compare the efficacy and safety of various intranasal agents for the treatment of acute migraine in adult patients. Methods: The Cochrane Register of Controlled Trials, Embase, and PubMed were searched from inception to 15 August 2023. Randomized controlled trials (RCTs) using intranasal agents (no restrictions on dose, formulation, dosing regimen or timing of the first dose) to treat adult patients with acute migraine were included. The primary efficacy endpoint was pain freedom at 2 h, and the primary safety endpoint was adverse events (AEs). The analysis process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Nineteen studies (21 RCTs, 9738 participants) were included. Compared to the placebo, 5 mg of zolmitriptan using a conventional liquid nasal spray device was the most effective for pain freedom at 2 h [odds ratio (OR): 4.67, 95% confidence interval (CI): 3.43 to 6.43] and 24 h (OR: 5.49, 95% CI: 3.58 to 8.42) among all the interventions. Butorphanol nasal spray 1 mg was the most effective (OR: 8.62, 95% CI: 1.11 to 66.92) for pain freedom at 1 h, but with low-quality evidence. DFN-02 presented the highest freedom from nausea (OR: 4.95, 95% CI: 1.29 to 19.01) and phonophobia (OR: 5.36, 95% CI: 1.67 to 17.22) at 2 h, albeit with lower odds of achieving complete pain freedom. ROX-828 showed the highest improvement in freedom from photophobia at 2 h (OR: 4.03, 95% CI: 1.66 to 9.81). Dihydroergotamine nasal spray was significantly associated with the highest risk of AEs (OR: 9.65, 95% CI: 4.39 to 21.22) and was not recommended for routine use. Zavegepant nasal spray demonstrated the lowest risk of AEs (OR: 2.04, 95% CI: 1.37 to 3.03). The results of sensitivity analyses for the primary endpoints (pain freedom at 2 h and AEs) were generally consistent with those of the base case model. Conclusions: Compared with other new intranasal-specific therapies in treating migraine attacks, zolmitriptan nasal spray 5 mg was the most effective agent for pain freedom at 2 h. Zavegepant nasal spray 10 mg had the fewest adverse side effects. [ABSTRACT FROM AUTHOR]

Introduction: Exercise therapy is usually prescribed as first-line treatment for lower limb tendinopathies. The multitude of exercise- and non-exercise-based management options can be overwhelming for the treating sports professional and patient alike. We chose to investigate the comparative effectiveness of exercise therapy with or without adjuncts for managing the commonest lower limb tendinopathies. Methods: Through an extensive systematic literature search using multiple databases, we aimed to identify eligible randomised controlled trials (RCTs) on Achilles tendinopathy, patellar tendinopathy or greater trochanteric pain syndrome (GTPS) that included at least one exercise intervention in their treatment arms. Our primary outcomes were patient-reported pain and function (Victorian Institute of Sport Assessment; VISA). Follow-up was defined as short-term (≤ 12 weeks), mid-term (> 12 weeks to < 12 months) and long-term (≥ 12 months). The risk of bias and strength of evidence were assessed with the Cochrane Collaboration and GRADE-NMA tools, respectively. Analyses were performed separately for each one of the three tendinopathies. Results: A total of 68 RCTs were included in the systematic review. All pairwise comparisons that demonstrated statistically and clinically significant differences between interventions were based on low or very low strength of evidence. Based on evidence of moderate strength, the addition of extracorporeal shockwave therapy to eccentric exercise in patellar tendinopathy was associated with no short-term benefit in pain or VISA-P. From the network meta-analyses, promising interventions such as slow resistance exercise and therapies administered alongside eccentric exercise, such as topical glyceryl trinitrate for patellar tendinopathy and high-volume injection with corticosteroid for Achilles tendinopathy were based on low/very low strength of evidence. Conclusion: In this network meta-analysis, we found no convincing evidence that any adjuncts administered on their own or alongside exercise are more effective than exercise alone. Therefore, we recommend that exercise monotherapy continues to be offered as first-line treatment for patients with Achilles and patellar tendinopathies and GTPS for at least 3 months before an adjunct is considered. We provide treatment recommendations for each tendinopathy. PROSPERO registration number CRD42021289534. [ABSTRACT FROM AUTHOR]

Previous studies have shown that lower social support is associated with higher all-cause mortality (Holt-Lunstad et al. in PLoS ONE Medicine 7:e1000316, 2010). While social support has been associated with system-specific biological measures (e.g., cardiovascular), there is the need to elucidate more general biological mechanisms linking social support to health risk across a number of diseases. In this meta-analytic review, the link between social support and telomere length (Cawthon et al. in Lancet 361:393–395, 2003) was conducted based on the updated PRISMA guidelines (Page et al., 2021). Across 17 studies, higher social support was not significantly related to longer telomere length (Zr = 0.010, 95% CI [− 0.028, 0.047], p > 0.05). The confidence interval indicated that the bulk of plausible values were small to null associations. Little evidence for bias was found as shown by funnel plots and Kendall's Tau. Moderator analyses focusing on the measure of support, health of sample, age, type of assay specimen, and gender were not significant. In conclusion, this review showed no significant relationship between social support and telomere length and highlights important future directions. [ABSTRACT FROM AUTHOR]

Background: Weak lower body strength and balance impairments are fundamental risk factors for mobility impairments and falls that can be improved by physical activity (PA). Previous meta-analyses have focused on these risk factors in adults aged ≥ 65 years. Yet, the potential of PA for improving these risk factors in middle-aged populations has not been systematically investigated. This systematic review and meta-analysis aim to examine the effect of general and structured PA on lower limb strength, postural balance and falls in middle-aged adults. Methods: A computerized systematic literature search was conducted in the electronic databases MEDLINE, CINAHL, Web of Science and Cochrane Library. PA intervention types were classified according to the ProFaNE taxonomy. Randomized controlled trials exploring the effects of PA on strength (e.g., leg press one-repetition-maximum), balance (e.g., single limb stance) and falls (e.g., fall rates) in adults aged 40–60 years were systematically searched and included in a network analysis. Moderator analyses were performed for specific subgroups (age, sex, low PA). The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Results: Out of 7170 articles screened, 66 studies (median PEDro score 5) with 3387 participants were included. Strong, significant effects on muscle strength were found for strength (SMD = 1.02), strength–aerobic (SMD = 1.41), strength–endurance (SMD = 0.92) and water-based (SMD = 1.08) training (52 studies, I2 = 79.3%). Strength training (SMD = 1.16), strength–aerobic (SMD = 0.98) and 3D training (SMD = 1.31) improved postural balance (30 studies, I2 = 88.1%). Moderator analyses revealed significant effects of specific intervention types on certain subgroups and subdomains of strength and balance. No studies were found measuring falls. Conclusions: Structured PA interventions in middle-aged adults improve strength and balance outcomes related to functional impairments and falls. Strength training increases both strength and balance and can be recommended to prevent age-related functional decline. However, the interpretability of the results is limited due to considerable heterogeneity and the overall low methodological quality of the included studies. Long-term trials are needed to determine the preventive potential of PA on strength, balance and falls. This meta-analysis may inform guidelines for tailored training during middle age to promote healthy aging. Prospero registration: CRD42020218643. [ABSTRACT FROM AUTHOR]

Background: Long-term stretching of human skeletal muscles increases joint range of motion through altered stretch perception and decreased resistance to stretch. There is also some evidence that stretching induces changes in muscle morphology. However, research is limited and inconclusive. Objective: To examine the effect of static stretching training on muscle architecture (i.e., fascicle length and fascicle angle, muscle thickness and cross-sectional area) in healthy participants. Design: Systematic review and meta-analysis. Methods: PubMed Central, Web of Science, Scopus, and SPORTDiscus were searched. Randomized controlled trials and controlled trials without randomization were included. No restrictions on language or date of publication were applied. Risk of bias was assessed using Cochrane RoB2 and ROBINS-I tools. Subgroup analyses and random-effects meta-regressions were also performed using total stretching volume and intensity as covariates. Quality of evidence was determined by GRADE analysis. Results: From the 2946 records retrieved, 19 studies were included in the systematic review and meta-analysis (n = 467 participants). Risk of bias was low in 83.9% of all criteria. Confidence in cumulative evidence was high. Stretching training induces trivial increases in fascicle length at rest (SMD = 0.17; 95% CI 0.01–0.33; p = 0.042) and small increases in fascicle length during stretching (SMD = 0.39; 95% CI 0.05 to 0.74; p = 0.026). No increases were observed in fascicle angle or muscle thickness (p = 0.30 and p = 0.18, respectively). Subgroup analyses showed that fascicle length increased when high stretching volumes were used (p < 0.004), while no changes were found for low stretching volumes (p = 0.60; subgroup difference: p = 0.025). High stretching intensities induced fascicle length increases (p < 0.006), while low stretching intensities did not have an effect (p = 0.72; subgroup difference: p = 0.042). Also, high intensity stretching resulted in increased muscle thickness (p = 0.021). Meta-regression analyses showed that longitudinal fascicle growth was positively associated with stretching volume (p < 0.02) and intensity (p < 0.04). Conclusions: Static stretching training increases fascicle length at rest and during stretching in healthy participants. High, but not low, stretching volumes and intensities induce longitudinal fascicle growth, while high stretching intensities result in increased muscle thickness. Registration: PROSPERO, registration number: CRD42021289884. Key Points: Static stretching training induces trivial increases in fascicle length at rest and small increases in fascicle length during stretching. High, but not low, stretching volumes and intensities induce longitudinal fascicle growth. High stretching intensities result in increased muscle thickness. Fascicle angle remains unaffected by static stretching training. [ABSTRACT FROM AUTHOR]

Objectives: There is little evidence in the literature about the relationship between frailty and falls in older adults. Our objective was to explore the relationship between frailty and falls, and to analyze the effect factors (e.g., gender, different frailty assessment tools, areas, level of national economic development, and year of publication) of the association between frailty and falls among older adults. Design: Systematic review and meta-analysis. Setting and Participants: Cohort studies that evaluated the association between frailty and falls in the older adults were included. We excluded any literature outside of cohort studies. Methods: We did a systematic literature search of English databases PubMed, Scopus, Web of Science, EBSCOhost, and SciElO, as well as the Chinese databases CNKI, WANFANG, and VIP from 2001 until October 2022. The eligible studies were evaluated for potential bias using the Newcastle-Ottawa Scale (NOS). Study selection, data extraction and assessment of study quality were each conducted by two investigators. In Stata/MP 17.0 software, we calculated pooled estimates of the prevalence of falls by using a random-effects model, Subgroup analysis was conducted based on gender, different frailty assessment tools, areas, level of economic development, and year of publication. The results are presented using a forest plot. Results: Twenty-nine studies were included in this meta-analysis and a total of 1,093,270 participants aged 65 years and above were enrolled. Among the older adults, frailty was significantly associated with a higher risk for falls, compared with those without frailty (combined RR-relative risk = 1.48, 95% CI-confidence interval: 1.27–1.73, I2=98.9%). In addition, the results of subgroup analysis indicated that men had a higher risk for falls than women among the older adults with frailty (RR 1.94, 95% CI: 1.18–3.2 versus RR 1.44, 95% CI: 1.24–1.67). Subgroup analysis by different frailty assessment tools revealed an increased risk of falls in older adults with frailty when assessed using the Frailty Phenotype (combined RR 1.32, 95%CI: 1.17–1.48), FRAIL score (combined RR 1.82, 95%CI: 1.36–2.43), and Study of Osteoporotic Fractures index (combined RR 1.54, 95%CI: 1.10–2.16). Furthermore, subgroup analysis by areas and level of national economic development found the highest fall risk in Oceania (combined RR 2.35, 95%CI: 2.28–2.43) and the lowest in Europe (combined RR 1.20, 95%CI: 1.05–1.38). Developed countries exhibited a lower fall risk compared to developing countries (combined RR 1.44, 95%CI: 1.21–1.71). Analysis by year of publication showed the highest fall risk between 2013–2019 (combined RR 1.79, 95%CI: 1.45–2.20) and the lowest between 2001–2013 (combined RR 1.21, 95%CI: 1.13–1.29). Conclusion: Frailty represents a significant risk factor for falls in older adults, with the degree of risk varying according to the different frailty assessment tools employed, and notably highest when using the FRAIL scale. Additionally, factors such as gender, areas, level of national economic development, and healthcare managers' understanding of frailty may all impact the correlation between frailty and falls. Thus, it's imperative to select suitable frailty diagnostic tools tailored to the specific characteristics of the population in question. This, in turn, facilitates the accurate identification of frailty in older adults and informs the development of appropriate preventive and therapeutic strategies to mitigate fall risk. [ABSTRACT FROM AUTHOR]

Given the limitations of traditional approaches, wearable artificial intelligence (AI) is one of the technologies that have been exploited to detect or predict depression. The current review aimed at examining the performance of wearable AI in detecting and predicting depression. The search sources in this systematic review were 8 electronic databases. Study selection, data extraction, and risk of bias assessment were carried out by two reviewers independently. The extracted results were synthesized narratively and statistically. Of the 1314 citations retrieved from the databases, 54 studies were included in this review. The pooled mean of the highest accuracy, sensitivity, specificity, and root mean square error (RMSE) was 0.89, 0.87, 0.93, and 4.55, respectively. The pooled mean of lowest accuracy, sensitivity, specificity, and RMSE was 0.70, 0.61, 0.73, and 3.76, respectively. Subgroup analyses revealed that there is a statistically significant difference in the highest accuracy, lowest accuracy, highest sensitivity, highest specificity, and lowest specificity between algorithms, and there is a statistically significant difference in the lowest sensitivity and lowest specificity between wearable devices. Wearable AI is a promising tool for depression detection and prediction although it is in its infancy and not ready for use in clinical practice. Until further research improve its performance, wearable AI should be used in conjunction with other methods for diagnosing and predicting depression. Further studies are needed to examine the performance of wearable AI based on a combination of wearable device data and neuroimaging data and to distinguish patients with depression from those with other diseases. [ABSTRACT FROM AUTHOR]

Background: Among youth, plyometric-jump training (PJT) may provide a safe, accessible, and time-efficient training method. Less is known on PJT effectiveness according to the maturity status. Objective: This systematic review with meta-analysis set out to analyse the body of peer-reviewed articles assessing the effects of PJT on measures of physical fitness [i.e., maximal dynamic strength; change of direction (COD) speed; linear sprint speed; horizontal and vertical jump performance; reactive strength index] and sport-specific performance (i.e., soccer ball kicking and dribbling velocity) according to the participants' maturity status. Methods: Systematic searches were conducted in three electronic databases using the following inclusion criteria: (i) Population: healthy participants aged < 18 years; (ii) Intervention: PJT program including unilateral and/or bilateral jumps; (iii) Comparator: groups of different maturity status with control groups; (iv) Outcomes: at least one measure of physical fitness and/or sport-specific performance before and after PJT; (v) experimental design with an active or passive control group, and two or more maturity groups exposed to the same PJT. The DerSimonian and Laird random-effects models were used to compute the meta-analysis. The methodological quality of the studies was assessed using the PEDro checklist. GRADE was applied to assess certainty of evidence. Results: From 11,028 initially identified studies across three electronic databases, 11 studies were finally eligible to be meta-analysed (n total = 744; seven studies recruited males; four studies recruited females). Three studies were rated as high quality (6 points), and eight studies were of moderate quality (5 points). Seven studies reported the maturity status using age at peak height velocity (PHV; pre-PHV values up to − 2.3; post-PHV up to 2.5). Another four studies used Tanner staging (from Tanner I to V). The training programmes ranged from 4 to 36 weeks, using 1–3 weekly training sessions. When compared to controls, pre-PHV and post-PHV participants obtained small-to-moderate improvements (ES = 0.35 − 0.80, all p < 0.05) in most outcomes (i.e., sport-specific performance; maximal dynamic strength; linear sprint; horizontal jump; reactive strength index) after PJT. The contrast of pre-PHV with post-PHV youth revealed that PJT was similarly effective in both maturity groups, in most outcome measures except for COD speed (in favour of pre-PHV). PJT induces similar physical fitness and sport-specific performance benefits in males and females, with a minimal exercise dosage of 4 weeks (8 intervention sessions), and 92 weekly jumps. Results of this meta-analysis are based on low study heterogeneity, and low to very low certainty of evidence (GRADE analysis) for all outcomes. Conclusion: Compared to control participants, PJT resulted in improved maximal dynamic strength, linear sprint speed, horizontal jump performance, reactive strength index, and sport-specific performance (i.e., soccer ball kicking and dribbling velocity). These effects seem to occur independently of the maturity status, as both pre-PHV and post-PHV participants achieved similar improvements after PJT interventions for most outcomes. However, several methodological issues (e.g., low sample sizes and the pooling of maturity categories) preclude the attainment of more robust recommendations at the current time. To address this issue, consistency in maturity status reporting strategies must be improved in future studies with the general youth population and youth athletes. [ABSTRACT FROM AUTHOR]

Despite research into the development of digital cognitive behavioral therapy for insomnia (dCBT-I), research into the outcomes of dCBT-I on insomnia and the associated clinical conditions of depression and anxiety have been limited. The PubMed, PsycINFO (Ovid), Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) on adult patients with insomnia also having reported measures of depressive or anxiety symptoms. In total, 2504 articles were identified after duplicate removal, and 22 RCTs were included in the final meta-analysis. At the post-treatment assessment, the dCBT-I group had a small to moderate effect in alleviating depressive (standardized mean difference (SMD) = −0.42; 95% CI: −0.56, −0.28; p < 0.001; k = 21) and anxiety symptoms (SMD = −0.29; 95% CI: −0.40, −0.19; p < 0.001; k = 18), but had a large effect on sleep outcome measures (SMD = −0.76; 95% CI: −0.95, −0.57; p < 0.001; k = 22). When considering treatment adherence, the treatment effects of those in the high adherent groups identified a more robust outcome, showing greater effect sizes than those in the low adherent groups for depression, anxiety, and sleep outcomes. Furthermore, additional subgroup analysis on studies that have used the fully automated dCBT-I treatment without the support of human therapists reported significant treatment effects for depression, anxiety, and sleep outcomes. The results demonstrated that digital intervention for insomnia yielded significant effects on alleviating depressive and anxiety symptoms as well as insomnia symptoms. Specifically, the study demonstrated significant effects on the above symptoms when considering treatment adherence and implementing fully automated dCBT-I. [ABSTRACT FROM AUTHOR]

Background: The negative effect of mental fatigue (MF) on physical performance has recently been questioned. One reason behind this could lie in the interindividual differences in MF-susceptibility and the individual features influencing them. However, the range of individual differences in mental fatigue-susceptibility is not known, and there is no clear consensus on which individual features could be responsible for these differences. Objective: To give an overview of interindividual differences in the effects of MF on whole-body endurance performance, and individual features influencing this effect. Methods: The review was registered on the PROSPERO database (CRD42022293242). PubMed, Web of Science, SPORTDiscus and PsycINFO were searched until the 16th of June 2022 for studies detailing the effect of MF on dynamic maximal whole-body endurance performance. Studies needed to include healthy participants, describe at least one individual feature in participant characteristics, and apply at least one manipulation check. The Cochrane crossover risk of bias tool was used to assess risk of bias. The meta-analysis and regression were conducted in R. Results: Twenty-eight studies were included, with 23 added to the meta-analysis. Overall risk of bias of the included studies was high, with only three presenting an unclear or low rating. The meta-analysis shows the effect of MF on endurance performance was on average slightly negative (g = − 0.32, [95% CI − 0.46; − 0.18], p < 0.001). The multiple meta-regression showed no significant influences of the included features (i.e. age, sex, body mass index and physical fitness level) on MF-susceptibility. Conclusions: The present review confirmed the negative impact of MF on endurance performance. However, no individual features influencing MF-susceptibility were identified. This can partially be explained by the multiple methodological limitations such as underreporting of participant characteristics, lack of standardization across studies, and the restricted inclusion of potentially relevant variables. Future research should include a rigorous description of multiple different individual features (e.g., performance level, diet, etc.) to further elucidate MF mechanisms. [ABSTRACT FROM AUTHOR]

Objectives: Summarize the existing evidence regarding the prevalence and risk factors of frailty in stroke patients. Design: A meta-analysis and systematic review. Participants: Stroke patients in hospitals or communities. Methods: We undertook a systematic review and meta-analysis using articles available in 8 databases, including PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Weipu Database (VIP) from January 1990 to April 2022. Studies were quality rated using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality tool. Results: A total of 24 studies involving 30,423 participants were identified. The prevalence of frailty and pre-frailty in stroke patients was 27% (95%CI: 0.23–0.31) and 47.9% (95%CI: 0.43–0.53). Female gender (OR = 1.76, 95%CI: 1.63–1.91), advanced age (MD = 6.73, 95%CI: 3.55–9.91), diabetes (OR = 1.34, 95%CI: 1.06–1.69), hyperlipidemia (OR = 1.46, 95%CI: 1.04–2.04), atrial fibrillation (OR = 1.36, 95%CI: 1.01–1.82), National Institutes of Stroke Scale (NIHSS) admission scores (MD = 2.27, 95%CI: 1.72–2.81) were risk factors of frailty in stroke patients. Conclusions: Frailty was more prevalent in stroke patients. Female gender, advanced age, diabetes, hyperlipidemia, atrial fibrillation, and National Institutes of Stroke Scale (NIHSS) admission scores were identified as risk factors for frailty in stroke patients. In the future, medical staff should pay attention to the early screening of frailty in high-risk groups and provide information on its prevention. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore the correlation between vitamin D and diabetic nephropathy. Methods: Relevant evidences were searched from PubMed, Embase, Web of Science, Ovid and China Knowledge Resource Integrated (CNKI), Wanfang Data Knowledge Service Platform databases (WANFANG), and VIP dating from inception to December 2019 to obtain the randomized controlled trials (RCTs) of vitamin D in the treatment of diabetic nephropathy. According to inclusion and exclusion criteria, two researchers independently screened the literature, extracted data, and evaluated the quality of included studies. Rev Man 5.3 software was used to conduct statistical analysis. Results: A total of 10 studies involving 651 patients were identified. These studies were finally included into the meta-analysis. A meta-analysis results showed that vitamin D is the protection factor in diabetic nephropathy, the group treated with vitamin D did better than the traditional drug and the placebo group. After taking vitamin D, the level of vitamin D in the patient's body increased significantly. Pooled results showed that there was a significant difference for vitamin D (MD = 38.24, 95%CI = 32.69–43.79, p < 0.001.) The patient had a significant decrease in urinary protein; the difference was statistically significant (MD = − 180.92, 95%CI = − 212.67 to − 149.16, p < 0.001). The blood creatinine content decreased obviously (MD = − 17.13, 95%CI = − 27.88 to − 6.37, p < 0.01). However, most of the included studies did not report the quality of life and adverse reactions of patients, making it impossible to analyze these measures. Conclusion: This study showed that vitamin D played an active role in the treatment of diabetic nephropathy and can be used in future clinical applications. However, there are still some studies of low quality in the included studies, so it is suggested that clinical and scientific researchers carry out more high-quality, large sample, multi-center randomized controlled trials (RCTS) to provide more evidence-based medical evidence for future studies on vitamin D treatment of diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Background: Sedentary, digital screen time in children represents a major concern due to its detrimental effect on children's development. Nowadays, however, advances in technology allow children to actively interact with a digital screen using their whole body (e.g., exergaming), providing potential for movement learning. Exergaming technology may prove valuable in supporting children's development of foundational movement skills (FMS). Objective: To examine the impact of exergaming technology on the development of FMS in children 3–12 years through a skill acquisition lens. Methods: Systematic review and meta-analysis were conducted following the PRISMA guidelines. Web of Science, PubMed, PsycINFO and SPORTDiscus databases were searched between 2007 and 2022. Studies were eligible if they conducted an exergaming intervention to improve FMS in typically developing children aged three to twelve with a control group, using a baseline and post-intervention assessment design. FMS outcomes were pooled with a random effects model. Results: Nine trials (4 RCTs, 2 cluster RCTs and 3 non-randomized trials) of varying methodological quality (2 had low, 6 had some concerns, and 1 had a high risk of bias) were included, with a total of 783 participants. FMS outcome measures across studies comprised object control skills, locomotor skills, coordination, agility, balance and balance-related skills. The meta-analysis included showed a small positive effect in favor of the exergaming intervention (r = 0.24 [95% confidence interval: 0.11–0.36]). Conclusion: Our results indicate that screen-based technology that requires an active engagement of the child can promote the development of FMS. Considering that FMS are the foundation of a child's physical, mental, health and academic development, this finding could lead to a reshaping of the perception of digital screen-based technology and the role this should play in children's lives. We speculate that the observed benefits most likely depend upon the quality of information–movement coupling specificity and the motor learning strategies built into the exergame and/or the intervention design. We do not believe this is dependent on the type of FMS being performed or the amount of practice. We recommend therefore that future research should examine how practitioners (school teachers, coaches and parents) can facilitate the interaction between a child and exergaming technology. [ABSTRACT FROM AUTHOR]

Sexual dysfunctions are highly prevalent and undertreated. Internet- and mobile-based psychological interventions (IMIs) could be a promising addition to close this treatment gap, given their accessibility, anonymity, and scalability. This systematic review and meta-analysis investigated the efficacy of IMIs for sexual dysfunctions. A comprehensive literature search was conducted in August 2021 on randomized controlled trials investigating the effects of IMIs on sexual functioning and satisfaction compared to a control condition. Twelve RCTs with 14 comparisons were reviewed with six IMIs targeting female and six IMIs targeting male sexual dysfunctions and n = 952 participants were evaluated in the meta-analysis. IMIs were significantly more effective than control conditions (k = 11 waitlist control group, k = 3 online discussion board) at post-treatment for female sexual functioning (g = 0.59, CI: 0.28–0.90, I2 = 0%) and satisfaction (g = 0.90, CI: 0.02–1.79, I2 = 82%), and male sexual functioning (g = 0.18, CI: 0.02–0.34, I2 = 0%). No significant effect was found for male sexual satisfaction (g = 0.69, CI: −0.13–1.51, I2 = 88%) with substantial heterogeneity in studies. Most studies showed high dropout, with ten studies indicating some concern of risk of bias, and two studies showing high risk of bias. The results suggest that IMIs can be an effective treatment for sexual dysfunctions, although additional high-quality research is needed. Given the limited availability of specialized treatment for sexual dysfunctions and individual preferences for discrete treatment options, IMIs seem to be a valuable addition to routine care, empowering individuals to promote their sexual health on a guided self-help basis. [ABSTRACT FROM AUTHOR]

Background: Physical activity is essential in acquiring healthy lifestyle behaviors in the early years of maturational development and preventing various diseases. Resistance training (RT) is fundamental for improving body composition and is increasingly recommended for obese adolescents. A systematic review and meta-analysis were performed to synthesize and analyze data on the effects of RT programs in this population, seeking to develop useful recommendations for health and sports professionals. Methods: A search was performed using four databases (Web of Science, Scopus, PubMed, and ScienceDirect). According to specific inclusion criteria, twenty-one studies were selected to evaluate the impact of RT on body mass index (BMI), body fat, waist circumference, muscle strength, insulin sensitivity, lean mass and cardiorespiratory fitness. Results: After the RT programs, the adolescents improved their muscle strength (SMD, 1.44; 95% CI: 0.76–2.12), cardiorespiratory fitness (SMD, 1.09; 95% CI: 0.15–2.04), BMI (SMD, 0.21; 95% CI: 0.07–0.35), waist circumference (SMD, 0.27; 95% CI: 0.06–0.47) and body fat (SMD, 0.20; 95% CI: 0.05–0.34). However, insulin sensitivity (SMD, 0.32; 95% CI: − 0.47 to 1.10) and lean mass (SMD, 0.12; 95% CI: − 0.06 to 0.31) did not reveal any changes. Different RT programs were used but it seems that 2–3 times/week ∼60 min/session of RT for 12 weeks should be recommended for positive changes. Conclusions: RT seems to be effective when the objective is to improve muscle strength, cardiorespiratory fitness and can be an efficient strategy to reduce obesity in adolescents by reducing body fat, waist circumference and body mass index. PROSPERO Registration number: CRD42022333411. [ABSTRACT FROM AUTHOR]

Background: Collisions in rugby union and sevens have a high injury incidence and burden, and are also associated with player and team performance. Understanding the frequency and intensity of these collisions is therefore important for coaches and practitioners to adequately prepare players for competition. The aim of this review is to synthesise the current literature to provide a summary of the collision frequencies and intensities for rugby union and rugby sevens based on video-based analysis and microtechnology. Methods: A systematic search using key words was done on four different databases from 1 January 1990 to 1 September 2021 (PubMed, Scopus, SPORTDiscus and Web of Science). Results: Seventy-three studies were included in the final review, with fifty-eight studies focusing on rugby union, while fifteen studies explored rugby sevens. Of the included studies, four focused on training—three in rugby union and one in sevens, two focused on both training and match-play in rugby union and one in rugby sevens, while the remaining sixty-six studies explored collisions from match-play. The studies included, provincial, national, international, professional, experienced, novice and collegiate players. Most of the studies used video-based analysis (n = 37) to quantify collisions. In rugby union, on average a total of 22.0 (19.0–25.0) scrums, 116.2 (62.7–169.7) rucks, and 156.1 (121.2–191.0) tackles occur per match. In sevens, on average 1.8 (1.7–2.0) scrums, 4.8 (0–11.8) rucks and 14.1 (0–32.8) tackles occur per match. Conclusions: This review showed more studies quantified collisions in matches compared to training. To ensure athletes are adequately prepared for match collision loads, training should be prescribed to meet the match demands. Per minute, rugby sevens players perform more tackles and ball carries into contact than rugby union players and forwards experienced more impacts and tackles than backs. Forwards also perform more very heavy impacts and severe impacts than backs in rugby union. To improve the relationship between matches and training, integrating both video-based analysis and microtechnology is recommended. The frequency and intensity of collisions in training and matches may lead to adaptations for a "collision-fit" player and lend itself to general training principles such as periodisation for optimum collision adaptation. Trial Registration PROSPERO registration number: CRD42020191112. [ABSTRACT FROM AUTHOR]

Introduction: Based on the available data on ovarian cancer during pregnancy, we performed a review and meta-analysis to evaluate the efficacy and safety of platinum-based chemotherapy against ovarian cancer during pregnancy. Methods: We systematically searched three databases including the PubMed, Embase, and Cochrane Library databases for articles published from January 1986 to December 2020 using the following terms: "ovarian tumors OR ovarian carcinoma OR adnexal masses OR ovarian cancer" AND "pregnancy" AND "chemotherapy." Two authors (Yaping Pei and Yuanfeng Gou) independently searched the literature and extracted data from each eligible study. The outcome measures were overall survival (OS) and progression-free survival (PFS). The OS and PFS of all patients were estimated by Kaplan–Meier survival curves and log-rank tests. Results: A total of 43 studies including 55 cases of ovarian cancer during pregnancy were selected. Forty-eight patients were comprehensively staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system. Twenty-six of the 48 patients (54.17%) were diagnosed with early-stage disease, while the remaining had advanced stages (II, III, and IV). The mean age at diagnosis was 29.31 years. The majority of patients in this meta-analysis were diagnosed at a mean gestational age of 16.05 weeks. The mean GA at chemotherapy administration was 17.42 weeks. Overall, 55 women gave birth to 56 newborns, including a pair of twins. At the end of follow-up (median 10 months, range 0–73 months), all the children were healthy, except for one child who died 5 days after delivery due to a congenital abnormality. During 2–204 months of follow-up, there were five cases of recurrence, with no evidence of recurrence in the remaining cases. Unfortunately, one patient died 29 months after diagnosis. Neither median overall survival nor median progression-free survival was obtained. Conclusion: Platinum-based chemotherapy may be a good choice for pregnant women with ovarian cancer who want to continue their pregnancy. [ABSTRACT FROM AUTHOR]

Study Design: A meta-analysis.Background: Hip fracture (HF), as common geriatric fracture, is related to increased disability and mortality. Preoperative deep vein thrombosis (DVT) is one of the most common complications in patients with hip fractures, affecting 8-34.9% of hip fracture patients. The study aimed to assess the risk factors of preoperative DVT after hip fractures by meta-analysis.Methods: An extensive search of the literature was performed in the English databases of PubMed, Embase, and the Cochrane Library; and the Chinese databases of CNKI and WAN FANG. We collected possible predictors of preoperative DVT from included studies, and data analysis was conducted with RevMan 5.3 and STATA 12.0.Results: A total of 26 English articles were included, and the rate of DVT was 16.6% (1627 of 9823 patients) in our study. Our findings showed that advanced age [p = 0.0003, OR = 0.13 95% CI (0.06, 0.21)], female patients [p = 0.0009, OR = 0.82 95% CI (0.72, 0.92)], high-energy injury [p = 0.009, OR = 0.58 95% CI (0.38, 0.87)], prolonged time from injury to admission [p < 0.00001, OR = 0.54 95% CI (0.44, 0.65)], prolonged time from injury to surgery [p < 0.00001, OR = 2.06, 95% CI (1.40, 2.72)], hemoglobin [p < 0.00001, OR = - 0.32 95% CI (- 0.43, - 0.21)], coronary heart disease [p = 0.006, OR = 1.25 95% CI (1.07, 1.47)], dementia [p = 0.02, OR = 1.72 95% CI (1.1, 2.67)], liver and kidney diseases [p = 0.02, OR = 1.91 95% CI (1.12, 3.25)], pulmonary disease [p = 0.02, OR = 1.55 95% CI (1.07, 2.23)], smoking [p = 0.007, OR = 1.45 95% CI (1.11, 1.89)], fibrinogen [p = 0.0005, OR = 0.20 95% CI (0.09, 0.32)], anti-platelet drug [p = 0.01, OR = 0.51 95% CI (0.30, 0.85)], C-reactive protein [p = 0.02, OR = 5.95 95% CI (1.04, 10.85)], < 35 g/l albumin [p = 0.006, OR = 1.42 95% CI (1.1, 1.82)], and thrombosis history [p < 0.00001, OR = 5.28 95% CI (2.85, 9.78)] were risk factors for preoperative DVT.Conclusions: Many factors, including advanced age, female patients, high-energy injury, prolonged time from injury to admission, prolonged time from injury to surgery, patients with a history of coronary heart disease, dementia, liver and kidney diseases, pulmonary disease, smoking, and thrombosis, fibrinogen, C-reactive protein, and < 35 g/l albumin, were found to be associated with preoperative DVT. Our findings suggested that the patient with above characteristics might have preoperative DVT.Level Of Evidence: Level III. [ABSTRACT FROM AUTHOR]