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Trauma-related esophageal injuries (TEIs) are a rare but highly lethal condition. The presentation of TEIs is very diverse depending on the location and mechanism of injury (blunt vs. penetrating), as well as the presence or absence of concurrent injuries. The aim of the present systematic review and meta-analysis is to delineate the clinical features impacting TEI management. A systematic review of the Medline, Embase, and web of science databases was undertaken for studies reporting on patients with TEIs. A random effects model was employed in the meta-analysis of aggregated data. Eleven studies, incorporating 4605 patients, were included, with a pooled mortality rate of 19% (95% confidence interval (CI) 13–25%). Penetrating injuries were 34% more likely to occur (RR 0.66, 95% CI 0.49–0.89, P  = 0.01), predominantly in the neck compartment. Surgery was employed in 53% of cases (95% CI 32–73%), with 68% of patients having associated injuries (95% CI 43–94%). In terms of choice of surgical repair technique, primary suture repair was most frequently reported, irrespective of injury location. Postoperative drainage was employed in 27% of the cases and was more common following repair of thoracic esophageal injuries. The estimated dependence on mechanical ventilation was 5.91 days (95% CI 5.1–6.72 days), while the length of stay in the intensive care unit averaged 7.89 days (95% CI 7.14–8.65 days). TEIs are uncommon injuries in trauma patients, associated with considerable mortality and morbidity. Open suture repair of ensuing esophageal defects is by large the most employed approach, while stenting may be indicated in carefully selected cases. [ABSTRACT FROM AUTHOR]

Trichomonas vaginalis is a protozoan parasite and probably one of the main causes of adverse birth outcomes. Still, there is a paucity of information regarding the burden of T. vaginalis infection in Iranian women. To address this gap, we conducted a systematic review and meta-analysis of studies on trichomoniasis among females in Iran from January 2000 to January 2023. We searched multiple electronic databases (PubMed, Science Direct, Scopus, ProQuest, Web of Science, Google Scholar, Scientific Information Database, Iran Medex, Magiran and Iran Doc) and identified 108 articles with a total of 200 728 women. Using a random effects model, we found a pooled prevalence of 4.30% (95% CI 3.23 to 5.52%). Subgroup analysis, also, demonstrated a statistically significant association between the T. vaginalis prevalence in Iranian women, and the age range, city, sample type, being in prison, sex working and symptomatic infections. Our findings provide important information for healthcare authorities and can inform prevention strategies against trichomoniasis in Iran. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Randomized controlled trials are the gold standard for evidence generation in medicine but are limited by their real-world generalizability, resource needs, shorter follow-up durations and inability to be conducted for all clinical questions. Decision analysis (DA) models may simulate trials and observational studies by using existing data and evidence- and expert-informed assumptions and extend analyses over longer time horizons, different study populations and specific scenarios, helping to translate population outcomes to patient-specific clinical and economic outcomes. Here, we present a scoping review and methodological primer on DA for cardiac surgery research. METHODS A scoping review was performed using the PubMed/MEDLINE, EMBASE and Web of Science databases for cardiac surgery DA studies published until December 2021. Articles were summarized descriptively to quantify trends and ascertain methodological consistency. RESULTS A total of 184 articles were identified, among which Markov models (N  = 92, 50.0%) were the most commonly used models. The most common outcomes were costs (N  = 107, 58.2%), quality-adjusted life-years (N  = 96, 52.2%) and incremental cost-effectiveness ratios (N  = 89, 48.4%). Most (N  = 165, 89.7%) articles applied sensitivity analyses, most frequently in the form of deterministic sensitivity analyses (N  = 128, 69.6%). Reporting of guidelines to inform the model development and/or reporting was present in 22.3% of articles. CONCLUSION DA methods are increasing but remain limited and highly variable in cardiac surgery. A methodological primer is presented and may provide researchers with the foundation to start with or improve DA, as well as provide readers and reviewers with the fundamental concepts to review DA studies. [ABSTRACT FROM AUTHOR]

Objectives: Oligo-/polysaccharides from Cyathula officinalis Kuan (COPs) and Achyranthes bidentata Blume (ABPs) have attracted researchers' attention in the fields of healthy food supplements and traditional Chinese medicine (Niúxī) due to their multiple bioactivities combined with their nontoxic and highly biocompatible nature. The purpose of this paper was to provide a systematic and comprehensive overview of the extraction, purification, and structural analysis methods, chemical characteristics, biological activities, and structure bioactivity relationship. Furthermore, the possible development trends and perspectives for future research, and traditional uses of Niúxī are also summarized. Methods: All the information was gathered from a library search and scientific databases. Key findings: Although COPs and ABPs are derived from different plants, they have similar structural features in type, structure, and glycosidic linkage patterns and biological activities in vivo and in vitro. However, there are differences in monosaccharide compositions, which can be used as an identification mark. Conclusions: As traditional Chinese herbal medicine, C. officinalis and A. bidentata have similar pharmacological activities. The COPs and ABP possess wide pharmacological effects such as antitumor, antioxidant, anti-osteoporosis, and anti-inflammatory. Meanwhile, the biological activity and structure–activity relationship of purified COPs and ABPs are less studied, future research should focus on them. Graphical Abstract [ABSTRACT FROM AUTHOR]

This study aimed to estimate the prevalence of hypertension in Chinese patients with type 2 diabetes mellitus (T2DM) using the results of a regional study. The studies were reviewed using PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, Wan Fang Data and Chinese Science Citation Database. After screening articles and data extraction, Stata V.16 was used for statistical analysis. This study was registered in the Prospective Register Systematic Reviews (CRD42020170649). A total of 2126 articles were identified, and nine papers were finally included. Random-effects modelling showed that the pooled prevalence of hypertension among Chinese patients with T2DM was 54% (95% CI 47 to 61%). Subgroup analysis showed that the prevalence in men (59.8%; 95% CI 49.0 to 70.7%) was higher than that in women (40.2%; 95% CI 29.3 to 59.2%). The prevalence in North China was higher than that in East China. The prevalence in institution-based settings (56%; 95% CI 48 to 64%) was higher than that in community-based settings (51%; 95% CI 34 to 69%). Appropriate preventive measures should be undertaken, such as health education, to control and reduce the risk of hypertension in diabetic patients and reduce the burden of cardiovascular disease. [ABSTRACT FROM AUTHOR]

In recent years, knowing the risks of stochastic effects of radiation, patient dose in diagnostic radiology is taken in to consideration extensively. Many countries and international organization, including International Commission on Radiological Protection, use quantities such as dose area product, entrance surface dose, etc. in radiological investigations, which serve as a guide for patient dose reduction. The concept of diagnostic reference level (DRL) is used to optimizing the dose of patients undergoing diagnostic radiology examinations. The present study aimed to review the studies on the DRLs in Iran. This study was conducted to review the status of patient dose in diagnostic radiology in Iran. A comprehensive literature search was performed without time constraints in the popular databases such as Google Scholar, Medline, Embase, PubMed, Irandoc, Iran Medex, Magiran and Scientific Information Database under the key words 'Entrance Surface Dose', 'dose area product, 'diagnostic reference level' and 'DRL' in Iran. Data on the radiation dose to patients has demonstrated further reductions in patient doses in the Iran. Considering advanced techniques and dose reduction methodologies complicates comparability between studies. Joint efforts of experts in the field of radiological protection and medical imaging and training program are necessary for achieving an acceptable condition. [ABSTRACT FROM AUTHOR]

Notably, the growing use of radionuclear technology, especially in diagnostic and therapeutic procedures involving radiation exposure, raises concerns about the health effects of radiation. Although epidemiological studies have provided strong evidence for elevated thyroid cancer risk after radiation exposure in childhood, the risk of thyroid cancer associated with adult exposure remains to be investigated. We conducted a systematic review and meta-analysis of relevant studies on the risk of developing thyroid cancer after radiation exposure in adulthood. The PubMed and Web of Science databases were used to select eligible articles. After screening, a total of 15 studies were identified in which estimates of the standardized incidence ratio (SIR) and the relative risk (RR) of thyroid cancer were available in 8 and 11 studies, respectively. The overall SIR estimated by the random effects model was 2.19 [95% confidence interval (CI), 1.54, 3.10]. Cochran's Q test showed significant heterogeneity in the SIRs (Q  = 178, P  < 0.0001). The overall RR at 10 mGy was 1.0038 (95% CI, 0.9991, 1.0085), with no significant heterogeneity (Q  = 9.30, P  = 0.5041). The total SIR, as well as that from each study, indicated a statistically significant excess, which could be related to screening bias. Radiation-related thyroid cancer risk was elevated in a few studies; however, the overall estimate of the RR at 10 mGy was not significant. This study demonstrates no strong epidemiological evidence for the risk of thyroid cancer in radiation exposure during adulthood; however, further research is needed. [ABSTRACT FROM AUTHOR]

BACKGROUND The endometrium is a highly dynamic tissue that undergoes dramatic proliferation and differentiation monthly in order to prepare the uterus for implantation and pregnancy. Intrauterine infection and inflammation are being increasingly recognized as potential causes of implantation failure and miscarriage, as well as obstetric complications later in gestation. However, the mechanisms by which the cells of the endometrium respond to infection remain understudied and recent progress is slowed in part owing to similar overlapping studies being performed in different species. OBJECTIVE AND RATIONALE The aim of this scoping review is to systematically summarize all published studies in humans and laboratory animals that have investigated the innate immune sensing and response of the endometrium to bacteria and viruses, and the signaling mechanisms involved. This will enable gaps in our knowledge to be identified to inform future studies. SEARCH METHODS The Cochrane Library, Ovid Embase/Medline, PubMed, Scopus, Google Scholar, and Web of Science databases were searched using a combination of controlled and free text terms for uterus/endometrium, infections, and fertility to March 2022. All primary research papers that have reported on endometrial responses to bacterial and viral infections in the context of reproduction were included. To focus the scope of the current review, studies in domesticated animals, included bovine, porcine, caprine, feline, and canine species were excluded. OUTCOMES This search identified 42 728 studies for screening and 766 full-text studies were assessed for eligibility. Data was extracted from 76 studies. The majority of studies focused on endometrial responses to Escherichia coli and Chlamydia trachomatis , with some studies of Neisseria gonorrhea , Staphylococcus aureus , and the Streptococcus family. Endometrial responses have only been studied in response to three groups of viruses thus far: HIV, Zika virus, and the herpesvirus family. For most infections, both cellular and animal models have been utilized in vitro and in vivo , focusing on endometrial production of cytokines, chemokines, and antiviral/antimicrobial factors, and the expression of innate immune signaling pathway mediators after infection. This review has identified gaps for future research in the field as well as highlighted some recent developments in organoid systems and immune cell co-cultures that offer new avenues for studying endometrial responses to infection in more physiologically relevant models that could accelerate future findings in this area. WIDER IMPLICATIONS This scoping review provides an overarching summary and benchmark of the current state of research on endometrial innate immune responses to bacterial and viral infection. This review also highlights some exciting recent developments that enable future studies to be designed to deepen our understanding of the mechanisms utilized by the endometrium to respond to infection and their downstream effects on uterine function. [ABSTRACT FROM AUTHOR]

Introduction It is unclear whether hydrodilatation is beneficial in the management of frozen shoulder compared with other common conservative management modalities. This systematic review evaluates the efficacy of hydrodilatation for the management of frozen shoulder. Sources of data A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An extensive search of PubMed, Embase, Scopus, Cochrane Central, Web of Science and CINAHL databases using multiple keyword combinations of 'shoulder', 'rotator', 'adhesive capsulitis', 'hydrodilatat*', 'distension' since inception of the databases to June 2023 was implemented. Areas of agreement Hydrodilatation leads to at least transient more marked improvements in shoulder disability and passive external rotation compared with intra-articular corticosteroid injections. Areas of controversy Hydrodilatation improves passive external rotation in the longer term. Moreover, hydrodilatation may be a preferable option over manipulation under anaesthesia, given its lower cost and better patient convenience. Growing points Intensive mobilization after hydrodilatation is a promising adjuvant treatment option for patients suffering from a frozen shoulder. Areas timely for developing research Although current evidence suggests that hydrodilatation provides a transient improvement in disability in patients with frozen shoulder, its clinical relevance remains unclear. Further research is necessary to establish its role in the management of the condition. [ABSTRACT FROM AUTHOR]

Objectives: Saikosaponins (SSs) constitute a class of medicinal monomers characterised by a triterpene tricyclic structure. Despite their potential therapeutic effects for various pathological conditions, the underlying mechanisms of their actions have not been systematically analysed. Here, we mainly review the important anti-inflammatory, anticancer, and antiviral mechanisms underlying SS actions. Methods: Information from multiple scientific databases, such as PubMed, the Web of Science, and Google Scholar, was collected between 2018 and 2023. The search term used was saikosaponin. Key findings: Numerous studies have shown that Saikosaponin A exerts anti-inflammatory effects by modulating cytokine and reactive oxygen species (ROS) production and lipid metabolism. Moreover, saikosaponin D exerts antitumor effects by inhibiting cell proliferation and inducing apoptosis and autophagy, and the antiviral mechanisms of SSs, especially against SARS-CoV-2, have been partially revealed. Interestingly, an increasing body of experimental evidence suggests that SSs show the potential for use as anti-addiction, anxiolytic, and antidepressant treatments, and therefore, the related molecular mechanisms warrant further study. Conclusions: An increasing amount of data have indicated diverse SS pharmacological properties, indicating crucial clues for future studies and the production of novel saikosaponin-based anti-inflammatory, efficacious anticancer, and anti-novel-coronavirus agents with improved efficacy and reduced toxicity. [ABSTRACT FROM AUTHOR]

Background: Careful review of the scientific databases revealed that no stability-indicating analytical method is available for the binary mixture of allopurinol (ALO) and thioctic acid (THA). Objective: A comprehensive stability-indicating HPLC-DAD procedure has been executed for concurrent analysis of ALO and THA. Method: Successful chromatographic separation of the cited drugs was reached using a Durashell C18 column (4.6 250 mm, 5 mm particle size). The mobile phase consisted of a mixture of acidified water (pH 4.0) using phosphoric acid and acetonitrile pumped in gradient elution mode. For quantification of ALO and THA, their respective peak areas were recorded at 249 and 210 nm. A systematic validation of analytical performance was investigated in terms of system suitability, linearity, ranges, precision, accuracy, specificity, robustness, detection, and quantification limits. Results: ALO and THA peaks emerged at retention times 4.26 and 8.15 min, respectively. Linear ranges for ALO and THA were 5–100 and 10–400 μg/mL, respectively, with correlation coefficient values exceeding 0.9999. Both drugs were exposed to conditions of neutral, acidic, and alkaline hydrolysis, oxidation, and thermal decomposition. Stability-indicating features have been demonstrated by resolution of the drugs from their forced degradation peaks. For verification of peak identity and purity, the diode-array detector (DAD) was used. In addition, degradation pathways for the cited drugs were postulated. Furthermore, separation of both analytes from about 13 medicinal compounds of different therapeutic classes disclosed optimum specificity of the proposed method. Conclusions: Advantageous application of the validated HPLC method for the concurrent analysis of ALO/THA in their tablet dosage form was accomplished. Highlights: So far, the described HPLC-DAD method is considered the first detailed stability-indicating analytical study for this pharmaceutical mixture. [ABSTRACT FROM AUTHOR]

Background Prior work suggests that people experiencing homelessness (PEH) are at heightened risk for developing pain and have a uniquely burdensome pain experience. Purpose The aim of this scoping review was to map the current peer-reviewed, published literature on the pain experience of PEH. Methods In accordance with the US Annual Homeless Assessment Report, we defined homelessness as lacking shelter or a fixed address within the last year. We conceptualized the pain experience via a modified version of the Social Communication Model of Pain, which considers patient, provider, and contextual factors. Published articles were identified with CINHAL, Embase, PubMed, PsycINFO, and Web of Science databases. Results Sixty-nine studies met inclusion criteria. Studies revealed that PEH have high rates of pain and experience high levels of pain intensity and interference. Substantially fewer studies examined other factors relevant to the pain experience, such as self-management, treatment-seeking behaviors, and pain management within healthcare settings. Nonetheless, initial evidence suggests that pain is undermanaged in PEH. Conclusions Future research directions to understand pain and homelessness are discussed, including factors contributing to the under-management of pain. This scoping review may inform future work to develop interventions to address the specific pain care needs of PEH. [ABSTRACT FROM AUTHOR]

Background Antimicrobial resistance (AMR) is propagated by widespread inappropriate use of antibiotics. In response, point-of-care interventions (POCIs) have been developed in primary care to preserve antibiotic effectiveness. Many of these POCIs are adopted based on their clinical value. However, assessment of their cost-effectiveness is crucial as well. Objectives To summarize the evidence on cost-effectiveness of POCIs aimed at tackling inappropriate antibiotic prescriptions in primary care in middle- and high-income countries. We also evaluate the quality of the evidence with particular attention to how these economic evaluations faced the challenge of capturing the impact of these POCIs on AMR. Methods Six scientific databases (MEDLINE, Embase, Web of Science, NHS EED, NHS HTA, the Cochrane Library) were searched for eligible articles published from 1999 to 2022. Their quality was appraised by means of the Drummond and CHEERS checklist. Results Twenty-nine articles met the selection criteria. Using their own (implicit) definitions of cost-effectiveness, evidence reported that point-of-care testing, scoring tools, electronic interventions, communication training, and multidimensional and educational interventions are more cost-effective than standard care. In contrast, studies found dipstick testing and audit-and-feedback interventions to be not cost-effective. Data synthesis took a narrative approach as eligible studies were not similar and/or reliable enough to pool their results through meta-analysis. Conclusions More high-quality evidence is needed to attain a thorough understanding of the cost-effectiveness of POCIs. Heterogeneity in terms of interventions and efficiency measures complicates comparing and generalizing results. Methodological recommendations are urgently needed to economically evaluate POCIs, focusing on how AMR should be accounted for. [ABSTRACT FROM AUTHOR]

Objectives: Spondias mombin is traditionally used as an herbal medicine for several human diseases and ailments in the tropical regions across the globe including the African countries. This study aimed to provide comprehensive information on nutritional benefits, ethnomedicinal uses, phytochemical constituents, pharmacological properties and toxicology study of S. mombin. Information was gathered from documented literatures in scientific database. Key findings: The study revealed that S. mombin has nutritional values; with the leaf, fruit, flower, seed, and stem bark possessing a wide range of ethnomedicinal uses across several regions, with documented pharmacological properties. S. mombin has a frequent rate of ethnomedicinal utility in cases of abortion, constipation, fever, gonorrhea, postpartum hemorrhage, digestive pain, diarrhoea, dysentery and wounds. Ethnopharmacological studies showed that crude extracts and chemical compounds from S. mombin manifested in vivo and in vitro biological and pharmacological activities. About 102 isolated compounds from the leaf, fruit, or stem bark of S. mombin have been reported. Summary: Overall, S. mombin has several nutritive and ethnomedicinal benefits owing to its chemical constituents, which are linkable to the several pharmacological activities. There remains however, the need for dosage intake caution, upon the advice of medical professionals. [ABSTRACT FROM AUTHOR]

Objective To assess the effect of clear aligners on the speech of patients undergoing orthodontic therapy through a systematic review of the literature. Search methods and selection criteria: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694. An electronic search of the Scopus, Embase, Pubmed, and Web of Science databases was done for papers published between January 2000 till September 2021. Studies that evaluated speech difficulties in patients undergoing orthodontic treatment with clear aligners using objective and subjective analyses were included. The evaluated primary outcome was speech difficulties. Secondary outcomes were time to adaptation and recovery from speech difficulties. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions Handbook guidelines and ROBINS-I tool. Results Two hundred and eighty-three articles were screened to identify seven studies (n = 332 patients) that assessed speech difficulty with aligners, of which two were randomized trials. Meta-analysis was not performed due to the heterogeneity in the study designs. Five studies compared speech difficulty with aligners to fixed appliances. Two studies showed a moderate risk of bias and five studies had a serious risk of bias. Level of evidence was downgraded to low due to the methodological insufficiencies and risk of bias in the studies. All seven studies reported that aligners could influence the clarity and delivery of speech, similar to fixed appliances. Various phonemes were affected including /s/,/z/,/zh/,/sh/,/th/,/ch/ on wearing aligners. Errors in articulation of consonants and sibilants were noted with lisping and speech impairment. These speech difficulties were temporary and most patients recovered in 7–14 days while few patients took 30-60 days to recover. Conclusion The likelihood of speech difficulties appears high with clear aligners. However, patients adapt quickly and speech returns to normal. The results of this review must be interpreted with caution and more well-designed randomized trials examining long-term effects of aligners on speech are indicated. Clinical Significance Orthodontists should counsel patients opting for clear aligner treatment of the potential transient speech difficulties. Registration The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694. [ABSTRACT FROM AUTHOR]

In human health research, metabolic signatures extracted from metabolomics data have a strong added value for stratifying patients and identifying biomarkers. Nevertheless, one of the main challenges is to interpret and relate these lists of discriminant metabolites to pathological mechanisms. This task requires experts to combine their knowledge with information extracted from databases and the scientific literature. However, we show that most compounds (>99%) in the PubChem database lack annotated literature. This dearth of available information can have a direct impact on the interpretation of metabolic signatures, which is often restricted to a subset of significant metabolites. To suggest potential pathological phenotypes related to overlooked metabolites that lack annotated literature, we extend the "guilt-by-association" principle to literature information by using a Bayesian framework. The underlying assumption is that the literature associated with the metabolic neighbors of a compound can provide valuable insights, or an a priori , into its biomedical context. The metabolic neighborhood of a compound can be defined from a metabolic network and correspond to metabolites to which it is connected through biochemical reactions. With the proposed approach, we suggest more than 35,000 associations between 1,047 overlooked metabolites and 3,288 diseases (or disease families). All these newly inferred associations are freely available on the FORUM ftp server (see information at https://github.com/eMetaboHUB/Forum-LiteraturePropagation). [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES A conclusive interpretation of the role of ventricular dominance in outcomes after Fontan palliation has not been formulated yet. We conducted a systematic review and meta-analysis of scientific literature to give an insight into the impact of ventricular morphology in single-ventricle palliation, focusing on its influence on survival, morbidities, ventricular performance and functional capacity. METHODS A systematic review of PubMed, Web of Science and Scopus databases was performed. A random-effect meta-analysis was conducted, and survival data were reconstructed using the published Kaplan–Meier survival curves. RESULTS Twenty-seven studies were selected, for a total of 4529 left-dominant versus 4844 right-dominant patients. Estimated survival at 1, 5, 10, 20 and 30 years of follow-up was 0.99 [95% confidence interval (CI) = 0.98–0.99], 0.95 [95% CI = 0.94–0.96], 0.92 [95% CI = 0.91–0.93], 0.86 [95% CI = 0.84–0.88] and 0.68 [95% CI = 0.65–0.83] for left-dominant patients and 0.94 [95% CI = 0.93–0.95], 0.89 [95% CI = 0.88–0.9], 0.85 [95% CI = 0.83–0.87], 0.69 [95% CI = 0.63–0.75] and 0.59 [95% CI = 0.5–0.69] for right-dominant patients, respectively. Survival was statistically lower for right-dominant patients (P  < 0.001), with an hazard ratio for the mortality of 2.38 (2.03–2.80); also, they displayed significantly longer hospital stay, worse ventricular function, larger ventricular volumes and a higher incidence of moderate or severe atrioventricular valve regurgitation when compared to left-dominant patients. CONCLUSIONS According to our meta-analysis, the morphology of the dominant ventricle has a significant impact on outcomes after Fontan palliation. Right-dominant patients experience an inferior long-term survival when the anatomical right ventricle is included in the systemic circulation. [ABSTRACT FROM AUTHOR]

The aim of this study was threefold. First, it analyzed the characteristics of the publication outputs for the Legal Medicine (LM) category using the Web of Science (WoS) database during 2011–2020. Second, it discussed the distribution of the papers for the 25 most productive countries/regions in terms of quality and quantity, such as the h-index and GDP per capita. Finally, it investigated the trend and temporal stability of the journal impact factor (JIF) and determined the percentage of the journal self-citations. The findings suggested that the number of papers, the average number of pages of the papers, the average number of cited references in the papers, the average number of authors per paper, the percentage of open access papers, as well as international and domestic collaboration tended to increase regularly. However, the productivity was limited when compared to the whole WoS database, since there was no significant change in the number of the journals. The countries/regions with the highest number of publications were not those that made the most impact in terms of the widespread impact of the publications. The level of international cooperation and the funding for the research had dramatic impact on the visibility of papers. The average JIF has increased significantly while the journal self-citation rates have decreased in a similar way. The journals have had very stable (have not fluctuated) impact factors over time. During the period studied, the journals with the higher impact factors (Q1, Q2) published many more papers than journals with the lower impact factors (Q3, Q4). [ABSTRACT FROM AUTHOR]

Previous epidemiologic evidence suggests a protective effect of Toxoplasma gondii infection against multiple sclerosis (MS) development; however, inconsistent findings have been reported in this regard. Therefore, we performed an updated meta-analysis of observational studies to investigate the association of To. gondii infection with MS development. We searched all articles published in PubMed, Scopus, Embase and Web of Science databases as of 20 December 2021. A random effects meta-analysis model was used to generate the pooled OR at 95% CIs. The heterogeneity between studies was assessed using I 2 and Cochran's Q statistics. Moreover, the likelihood of publication bias was determined by Egger's regression test. A total of 11 studies were eligible for meta-analysis, including 1172 MS cases and 1802 controls. Our findings indicated that 29.8% (95% CI 22.8 to 37.2%) of MS patients were seropositive for To. gondii infection, compared with 34.2% (95% CI 21.9 to 47.6%) of control subjects. The estimated pooled OR was 0.79 (95% CI 0.49 to 1.26), suggesting a non-significant negative association between To. gondii infection and MS development (p>0.05). The current study does not support the significant protective role of To. gondii infection on MS development. Our findings imply that further well-designed epidemiological and mechanistic studies are warranted to ascertain the possible association between To. gondii infection and MS and to exclude the potential confounders. [ABSTRACT FROM AUTHOR]

Background Hepatitis C virus (HCV) coinfection is associated with higher mortality and morbidity in people with human immunodeficiency virus (PWH). Methods We aimed to characterize the epidemiology and factors associated with HCV coinfection among PWH in Iran. In this systematic review, we searched 3 English databases (MEDLINE, SCOPUS, Embase) and 2 Farsi databases (Scientific Information Database and Magiran) for studies that measured the prevalence of HCV coinfection among PWH, published between 2000 and January 1, 2021. We included studies with a minimum sample size of 5 PWH. Reviews, editorials, conference abstracts, theses, studies with no relevant data, and unclear serological assays were excluded. Results We summarized the HCV coinfection prevalence by random-effect meta-analysis and assessed the sources of heterogeneity by a meta-regression model. Of the 858 records identified, 69 eligible studies with 12 996 PWH were included. Overall, HCV coinfection prevalence was 64% (95% confidence interval [CI], 58–69). The prevalence was higher among older (mean age ≥35 years) PWH (69%; 95% CI, 64–74) and PWH who inject drugs (77%; 95% CI, 71–82). Furthermore, we found that coinfection was higher among studies conducted between 2000 and 2014 (67%; 95% CI, 59–75) versus 2015–2020 (57%; 95% CI, 50–64). Conclusions The prevalence of HCV coinfection is high in Iranian PWH, with significant geographical variations. Hepatitis C virus screening and treatment among PWH are warranted to avoid the future burden of HCV-related liver damage, cancer, and mortality. [ABSTRACT FROM AUTHOR]

Background: Burnout among general practitioners (GPs) has attracted the attention of more and more researchers. An adequate understanding the prevalence and related factors of burnout to prevent and reduce burnout is necessary. This study systematically measured the global prevalence of burnout among GPs.Methods: Eligible original studies were identified from the PubMed, Ovid Embase, Ovid Medline (R), and Web of science databases. We searched the full-time period available for each database, up to 30 September 2021. The adjusted prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study-level characteristics were estimated via subgroup analyses and meta-regression.Results: A total of 16 cross-sectional studies with 7,595 participants were included. The pooled burnout rate showed 37%, 28%, and 26% of general GPs suffer from high emotional exhaustion (EE), high depersonalization (DP), and low personal exhaustion (PA), respectively. Groups comparisons found that high EE, high DP, and low PA rate data obtained from 2001 to 2009, high DP rate data obtained from Europe, low PA rate data obtained from high-quality studies had much higher rates.Conclusions: This study demonstrated the prevalence of burnout in the GPs and alert health managers to tailor their strategies to retain this community. Targeted initiatives are needed to provide adequate GPs' well-being and maintain primary health care. [ABSTRACT FROM AUTHOR]

Background Circular staplers are commonly used for reconstruction after radical resection for colorectal cancer. Pathological analysis of the anastomotic rings is common practice, although the benefits are unclear. The purpose of this study was to evaluate the usefulness of routine histopathological analysis of anastomotic rings in an original series and in a systematic review of the literature. Method The retrospective study was performed at two university-associated academic hospitals in Winnipeg, Canada, including patients investigated for colorectal cancers (within 30 cm of the anal verge) who underwent resection between 2007 and 2020. The systematic review involved Ovid MEDLINE, Embase, Scopus, and Web of Science databases, selecting for adult human studies involving analysis of anastomotic rings in elective colorectal cancer resections. The main outcome measure was the proportion of patients with cancer in the anastomotic ring specimens. The frequency of benign pathology findings and changes to patient management were also examined. Results Out of 673 eligible patients, 487 were included in the retrospective analysis. No patients had cancer within the anastomotic ring specimens. Twenty-five patients (5.1 per cent) had benign pathological findings within the anastomotic ring specimens, and patient management was never affected. In the systematic review, 27 articles were included in the final analysis out of 5848 records reviewed. The rate of cancer within anastomotic ring specimens was 0.34 per cent, and the rate of change in patient management was 0.19 per cent. Conclusion The likelihood of finding cancer within anastomotic rings is rare and their histopathological examination seldom changes patient management. [ABSTRACT FROM AUTHOR]

Background Diagnostic outcomes for fever of unknown origin (FUO) remain with notable numbers of undiagnosed cases. A recent systemic review and meta-analysis of studies reported geographic variation in FUO-related infectious diseases. Whether geography influences types of FUO noninfectious diagnoses deserves examination. Methods We systematically searched Medline (PubMed), Embase, Scopus, and Web of Science databases using medical subject headings published from January 1, 1997 to March 31, 2021. Prospective clinical studies investigating participants meeting adult FUO defining criteria were selected if they assessed final diagnoses. Meta-analyses were based on the random-effects model according to World Health Organization (WHO) geographical regions. Results Nineteen studies with significant heterogeneity were analyzed, totaling 2667 participants. Noninfectious inflammatory disorders had a pooled estimate at 20.0% (95% confidence interval [CI], 17.0%–23.0%). Undiagnosed illness had a pooled estimate of 20.0% (95% CI, 14.0%–26.0%). The pooled estimate for cancer was 15.0% (95% CI, 12.0%–18.0%). Miscellaneous conditions had a pooled estimate of 6.0% (95% CI, 4.0%–8.0%). Noninfectious inflammatory disorders and miscellaneous conditions were most prevalent in the Western Pacific region with a 27.0% pooled estimate (95% CI, 20.0%–34.0%) and 9.0% (95% CI, 7.0%–11.0%), respectively. The highest pooled estimated for cancer was in the Eastern Mediterranean region at 25.0% (95% CI, 18.0%–32.0%). Adult-onset Still's disease (114 [58.5%]), systemic lupus (52 [26.7%]), and giant-cell arteritis (40 [68.9%]) predominated among the noninfectious inflammatory group. Lymphoma (164 [70.1%]) was the most common diagnosis in the cancer group. Conclusions In this systematic review and meta-analysis, noninfectious disease diagnostic outcomes varied among WHO-defined geographies. Evaluations for FUO should include local variations in disease prevalence. [ABSTRACT FROM AUTHOR]

Background: Intrahepatic cholangiocarcinoma (ICC) is a relatively rare malignancy. The aim of this meta-analysis was to evaluate outcomes of repeat liver resection and non-surgical approaches for treatment of recurrent ICC. Methods: PubMed, Embase, and Web of Science databases were searched from their inception until March 2021 for studies of patients with recurrent ICC. Studies not published in English were excluded. Two meta-analyses were performed: a single-arm meta-analysis of studies reporting pooled short- and long-term outcomes after repeat liver resection for recurrent ICC (meta-analysis A), and a metaanalysis of studies comparing 1-, 3-, and 5-year overall survival (OS) rates after repeat liver resection and non-surgical approaches for recurrent ICC (meta-analysis B). Results: Of 543 articles retrieved in the search, 28 were eligible for inclusion. Twenty-four studies (390 patients) were included in metaanalysis A and nine studies (591 patients) in meta-analysis B. After repeat liver resection, 1-, 3-, and 5-year OS rates were 87 (95 per cent c.i. 81 to 91), 58 (48 to 68), and 39 (29 to 50) per cent respectively. The 1-, 3-, and 5-year OS rates were higher after repeat liver resection than without surgery: odds ratio 2.70 (95 per cent c.i. 1.28 to 5.68), 2.89 (1.15 to 7.27), and 5.91 (1.59, 21.90) respectively. Conclusion: Repeat liver resection is a suitable strategy for recurrent ICC in selected patients. It improves short- and long-term outcomes compared with non-surgical treatments. [ABSTRACT FROM AUTHOR]

This study aims to shed light on how research and development (R&D) funding plays a role in producing academic articles in Shenzhen from 2008 to 2020. The metadata from the Web of Science database, various governmental documents, and relevant literature can help understand the structure of R&D spending, the publication of scholarly articles, the funding programs, recipient institutions, research categories, and how geographical factors play a role. The prosperous economy has enabled the increased input of municipal and national governmental funding. The majority of scholarly articles are now funded publicly rather than privately and are published by public universities and research institutes rather than private firms. Geography plays an important role in the cooperation of Shenzhen's scientists and other domestic and worldwide scholars. To better understand the academic performance of Shenzhen, this article used a bibliometric method to compare its academic performance with that of Silicon Valley. [ABSTRACT FROM AUTHOR]

Background Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy. Methods A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included. Results A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery. Conclusions This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era. [ABSTRACT FROM AUTHOR]

Motivation Cancer genetic heterogeneity analysis has critical implications for tumour classification, response to therapy and choice of biomarkers to guide personalized cancer medicine. However, existing heterogeneity analysis based solely on molecular profiling data usually suffers from a lack of information and has limited effectiveness. Many biomedical and life sciences databases have accumulated a substantial volume of meaningful biological information. They can provide additional information beyond molecular profiling data, yet pose challenges arising from potential noise and uncertainty. Results In this study, we aim to develop a more effective heterogeneity analysis method with the help of prior information. A network-based penalization technique is proposed to innovatively incorporate a multi-view of prior information from multiple databases, which accommodates heterogeneity attributed to both differential genes and gene relationships. To account for the fact that the prior information might not be fully credible, we propose a weighted strategy, where the weight is determined dependent on the data and can ensure that the present model is not excessively disturbed by incorrect information. Simulation and analysis of The Cancer Genome Atlas glioblastoma multiforme data demonstrate the practical applicability of the proposed method. Availability and implementation R code implementing the proposed method is available at https://github.com/mengyunwu2020/PECM. The data that support the findings in this paper are openly available in TCGA (The Cancer Genome Atlas) at https://portal.gdc.cancer.gov/. Supplementary information Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

Contributory citizen science projects (hereafter "contributory projects") are a powerful tool for avian conservation science. Large-scale projects such as eBird have produced data that have advanced science and contributed to many conservation applications. These projects also provide a means to engage the public in scientific data collection. A common challenge across contributory projects like eBird is to maintain participation, as some volunteers contribute just a few times before disengaging. To maximize contributions and manage an effective program that has broad appeal, it is useful to better understand factors that influence contribution rates. For projects capitalizing on recreation activities (e.g., birding), differences in contribution levels might be explained by the recreation specialization framework, which describes how recreationists vary in skill, behavior, and motives. We paired data from a survey of birders across the United States and Canada with data on their eBird contributions (n = 28,926) to test whether those who contributed most are more specialized birders. We assigned participants to 4 contribution groups based on eBird checklist submissions and compared groups' specialization levels and motivations. More active contribution groups had higher specialization, yet some specialized birders were not active participants. The most distinguishing feature among groups was the behavioral dimension of specialization, with active eBird participants owning specialized equipment and taking frequent trips away from home to bird. Active participants had the strongest achievement motivations for birding (e.g., keeping a life list), whereas all groups had strong appreciation motivations (e.g., enjoying the sights and sounds of birding). Using recreation specialization to characterize eBird participants can help explain why some do not regularly contribute data. Project managers may be able to promote participation, particularly by those who are specialized but not contributing, by appealing to a broader suite of motivations that includes both appreciation and achievement motivations, and thereby increase data for conservation. [ABSTRACT FROM AUTHOR]

Background: Evidence-based smoking cessation interventions provided by healthcare professionals can be successful in helping citizens to quit smoking. Yet, evidence is needed about the active ingredients of these interventions, how these ingredients work and how they are implemented in practice. Such knowledge is required to effectively support healthcare professionals to optimally put evidence-based smoking cessation interventions to (inter)national practice.Objective: To identify active ingredients (including behavior change techniques), mechanisms of action and implementation fidelity reported in smoking cessation interventions in Dutch primary care settings and to relate these to intervention effectiveness.Methods: A systematic review was conducted by searching nine national intervention or funding databases, five international scientific databases and consulting 17 national smoking cessation experts. Out of 1066 identified manuscripts, 40 interventions were eligible for this review. Based on published protocols, information regarding behavior change techniques and mechanisms of action was systematically abstracted. Additionally, information regarding study characteristics and other active ingredients, effects on smoking behavior and implementation fidelity was abstracted. Comparative effectiveness concerning abstracted intervention characteristics was qualitatively explored.Results: Active ingredients, mechanisms of action and implementation fidelity were moderately to poorly reported. Interventions applying behavior change techniques and interventions with a single behavioral target (i.e. smoking-only versus multiple behaviors) seemed to provide stronger evidence for successfully changing smoking behavior.Conclusion: Attention to and reporting on interventions' active ingredients (e.g. behavior change techniques), mechanisms of action and implementation fidelity are prerequisites for developing more effective evidence-based smoking cessation interventions to be successfully implemented in primary healthcare.Implications: This systematic review provides an overview of smoking cessation interventions in Dutch primary care settings, identified since the year 2000. Smoking cessation support is offered in various forms, but our qualitative findings show that interventions including more behavior change techniques and interventions targeting only smoking cessation (compared to multiple behaviors) might be more effective. Results also show that-based on available intervention reports-it is difficult to distinguish patterns of active ingredients (such as behavior change techniques), mechanisms of action and fidelity of implementation in relation to interventions' effectiveness. This means (quality of) reporting on these intervention characteristics should improve. [ABSTRACT FROM AUTHOR]

Objectives Polygonum hydropiper is a herb with worldwide distribution, having tremendous value as traditional medicine among different communities. It is used to cure many kinds of ailments such as gynaecological disorders, ulcer, anxiety, pain, cancer, etc. The present review gives emphasis on a thorough and updated study of the botanical description and taxonomy, distribution, habitat, ethnopharmacology, phytochemical constituents, pharmacological activities and toxicological aspects of P. hydropiper. Methods The information included in this review was collected from different scientific databases like PubMed, ScienceDirect, Google Scholar, etc. In addition to the botanical description and taxonomy, lots of ethnomedicinal use of the water-pepper plant could be found. Result A good number of compounds belonging to the categories like alkaloids, carbohydrates, flavonoids, etc. were confirmed to be present in the plant. Moreover, in different studies, this plant was found to possess activities like anti-Alzheimer, antibacterial, antidementia, antifertility, neuropharmacological, sedative, anxiolytic, thrombolytic and membrane-stabilizing activity, etc. with minimal toxicity. Conclusion These properties may be directly related to its possession of a large number of bioactive molecules of different categories. Based on these properties, isolation of responsible compound(s), evaluation of molecular mechanisms of their action and clinical trials are recommended. [ABSTRACT FROM AUTHOR]

Purpose: Observations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.Methods: PubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.Results: We included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).Conclusions: Statin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic. [ABSTRACT FROM AUTHOR]

Genomic evidence of introgression in natural populations has reinvigorated the study of hybridization in recent years. Still, it is largely unknown how frequently individual organisms mate across species lines. Recently, Justyn et al. suggested that eBird, one of the world's largest citizen science databases, may supply adequate data for estimating hybridization rates. Here, we compare Justyn et al.'s estimates—and their conclusions that hybridization is rare—with estimates from museum and molecular data. We also estimate hybridization using eBird observations from areas and times when hybridization is possible, namely, in contact zones during the breeding season. These estimates are all considerably higher than those reported in Justyn et al., emphasizing that inferences from multiple datasets can differ radically. Finally, we demonstrate an approach for predicting the location of hybrid zones using eBird data, which can be done with high confidence and with unprecedented resolution. We show that citizen science data, far from settling the question of how frequently bird species hybridize, instead offer a promising step toward more focused study of hybrid zones. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis infection is the most common sexually transmitted infectious disease and carries a risk of complications. However, the optimal treatment for rectal chlamydial infection remains unclear.Objectives: To compare the efficacy of doxycycline and azithromycin for the treatment of rectal chlamydia by undertaking a systematic review and meta-analysis of published data.Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science and clinicaltrials.gov databases from inception to 7 July 2021 for randomized controlled trials (RCTs) and observational studies that compared the efficacy of doxycycline and single-dose azithromycin on rectal chlamydia cure rates. Data were synthesized using a random-effects model, and subgroup analysis was conducted.Results: All included studies were conducted in developed countries. Two RCTs and nine observational studies, with a total of 2457 patients, were analysed. Doxycycline had a higher microbiological cure rate than azithromycin (risk ratio = 1.21; 95% CI = 1.15-1.28; P < 0.05). Pooled results from two RCTs also revealed a higher microbiological cure rate for doxycycline than azithromycin (risk ratio = 1.27; 95% CI = 1.20-1.35; P < 0.05). The results remained consistent in subgroups of different study designs, countries and sexes.Conclusions: On the basis of our findings, we recommend doxycycline rather than azithromycin as a first-line treatment for rectal chlamydia in developed countries. More RCTs from developing countries are warranted. [ABSTRACT FROM AUTHOR]

Objectives In Africa, antipsychotic polypharmacy (APP) is increasing due to a high antipsychotic dose prescribing, repeated psychiatric hospitalization, uncontrolled psychotic symptoms, and greater side effect burden. Therefore, the aim of this review and meta-analysis is to assess the prevalence and correlates of APP among patients with schizophrenia in Africa. Methods A systematic search was performed from August 1 to 31, 2020, on PubMed, MEDLINE, Google Scholar, and Science Direct databases to select articles based on the inclusion criteria. Meta-Analysis of Observational studies in Epidemiology guidelines were employed. Cross-sectional observational studies that reported APP and/or its correlates in schizophrenia patients in English language published in peer-reviewed journals without time limits were included in the review. The quality of included articles was assessed using Newcastle-Ottawa quality assessment tool. Prevalence and correlates of APP were the outcome measures of this review and meta-analysis. Open Meta Analyst and RevMan version 5.3 software were used for meta-analysis. A random effect model was used to synthesize data based on the heterogeneity test. Results Six studies that involved 2154 schizophrenia patients met the inclusion criteria in this review and meta-analysis. The quality of included studies ranges from 6.5 to 10 based on the Newcastle-Ottawa quality assessment tool. The pooled prevalence of APP among patients with schizophrenia was 40.6% with 95% confidence interval: 27.6% to 53.7%. Depot first-generation antipsychotics and oral first-generation antipsychotics were the most commonly prescribed APP combinations. Socio-demographic, clinical, and antipsychotic treatment characteristics were significantly associated with APP. There was a wide variation in the correlates of APP assessed by studies and the way that association/correlations was determined and reported. Conclusions APP is common and highly prevalent. Advanced age, male gender, longer duration of schizophrenia, hospital admission, and longer antipsychotic treatment were correlates of APP in Africa. [ABSTRACT FROM AUTHOR]

Motivation Metabolomics studies aim at reporting a metabolic signature (list of metabolites) related to a particular experimental condition. These signatures are instrumental in the identification of biomarkers or classification of individuals, however their biological and physiological interpretation remains a challenge. To support this task, we introduce FORUM: a Knowledge Graph (KG) providing a semantic representation of relations between chemicals and biomedical concepts, built from a federation of life science databases and scientific literature repositories. Results The use of a Semantic Web framework on biological data allows us to apply ontological-based reasoning to infer new relations between entities. We show that these new relations provide different levels of abstraction and could open the path to new hypotheses. We estimate the statistical relevance of each extracted relation, explicit or inferred, using an enrichment analysis, and instantiate them as new knowledge in the KG to support results interpretation/further inquiries. Availability and implementation A web interface to browse and download the extracted relations, as well as a SPARQL endpoint to directly probe the whole FORUM KG, are available at https://forum-webapp.semantic-metabolomics.fr. The code needed to reproduce the triplestore is available at https://github.com/eMetaboHUB/Forum-DiseasesChem. Supplementary information Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

Hybridization has important effects on the evolutionary trajectories of natural populations but estimates of this process in the wild and at the individual‐level are lacking. Justyn et al. attempted to fill this gap using the citizen science database eBird but there are limitations to this approach. Here, we outline and directly test these limitations using literature searches, case studies, and a comparison between eBird and Birds of North America (BNA), a database that documents hybridization using the scientific literature. We use a hybrid zone between Lazuli and Indigo buntings to highlight the importance of considering geographic range when estimating rates of hybridization and two literature searches to show the importance of considering cryptic hybrids (those that cannot be identified using phenotypic traits) when quantifying these rates. We also use BNA and a case study of hybrid White‐faced and Glossy Ibises to show that citizen scientists are underreporting hybrids compared with experts. Justyn et al. highlighted an important gap in the literature, but their results likely represent the lower limit of hybridization between birds and a more nuanced interpretation of their results (e.g., considering extrinsic postzygotic selection) is needed. [ABSTRACT FROM AUTHOR]

Background Central nervous system (CNS) tumors pose a substantial health problem. Although data on specific time periods and regions of Africa have been previously reported, no study has yet to provide a systematic review of CNS tumors for the entire continent of Africa. This study aims to analyze the frequency of CNS tumors in Africa from 1960 to 2017. Methods A comprehensive literature search on CNS tumors in Africa was performed using multiple online scientific databases. The following keywords were queried in combination with the phrase "CNS tumors in Africa": incidence, frequency, epidemiology, prevalence, brain, and cancer. A total of 26 articles met the inclusion criteria. Each selected article reported incidence and mortality rates from different regions of Africa in a time period between 1960 and 2017. SPSS21 statistical software was used to analyze the data. Results Nigeria, Egypt, and Uganda were found to have the most of the cases of CNS tumors in Africa. Males made up 54% of the 5902 cases per 100 000 population. The most common CNS tumors found were astrocytoma (24.70%), meningioma (22.22%), pituitary adenoma (8.4%), medulloblastoma (4.26%), craniopharyngioma (4.07%), and other not specified (25.17%). Conclusions Given the large population of Africa, the total reported cases may be underestimated when compared with other continents due to the lack of a central brain tumor registry in Africa. A comprehensive knowledge of CNS tumors in Africa is critical to population-based research and improving the current healthcare system. [ABSTRACT FROM AUTHOR]

Background: Measuring the quality and effectiveness of antimicrobial stewardship (AMS) programmes with quality indicators (QIs) is an area of increasing interest. We conducted a systematic review to identify QIs of AMS programmes in the hospital setting and critically appraise their methodological quality.Methods: We searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL, Scopus/web of science databases and the grey literature for studies that defined and/or described the development process and characteristics of the QIs developed. The Appraisal of Indicators through Research and Evaluation (AIRE) instrument was used to critically appraise the methodological quality of the QI sets.Results: We identified 16 studies of QI sets consisting of 229 QIs. The QI sets addressed a broad range of areas of AMS in the hospital setting and consisted of 75% process indicators, 24% structural indicators and 1% outcome indicators. There was a wide variation in the information and level of detail presented describing the methodological characteristics of the QI sets identified.Conclusions: The QIs identified in this study focused on process and structural indicators with few outcome indicators developed-a major deficiency in this area. Future research should focus on the development of outcome indicators or the use of process or structural indicators linked to outcomes to assess AMS. Testing of the QIs in practice is an essential methodological element of the QI development process and should be included in the QI development study or as planned validation work. [ABSTRACT FROM AUTHOR]

Background: Although female sex workers (FSWs) have long been identified as a key human papillomavirus (HPV)-affected population, the burden and scope of their disproportionate risk for HPV infection have not been systematically estimated. We therefore aimed to estimate the prevalence of HPV and the distribution of HPV types in FSWs at the country, regional and global levels.Methods: We searched the PubMed, Embase, SCOPUS, EBSCO, ProQuest, Cochrane Library and Web of Science databases for articles published between 1 January 1990 and 31 June 2019. Studies of genital HPV prevalence in FSWs, or with sufficient data (e.g. adequate number of HPV-positive cases and sample size) to compute prevalence rates in FSWs, were included in this systematic review. The meta-analysis was completed using the random effects model.Results: We ultimately identified 107 studies in 45 countries or regions with sufficient data to calculate HPV prevalence in FSWs. The pooled global HPV prevalence among FSWs was 39.5% (95% CI 35.3, 43.9%), with notable variations by WHO region and country. Globally, the five most common HPV types in FSWs were HPV16 (9.0%), HPV 52 (8.3%), HPV89 (7.0%), HPV58 (6.2%), and HPV53 (5.3%).Conclusions: Our findings suggest that FSWs are disproportionately affected by HPV, which is more pronounced in the Western Pacific and African regions, and are therefore in need of prevention, treatment and care services. [ABSTRACT FROM AUTHOR]

Post-translational modifications (PTMs) are ubiquitous and essential for protein function and signaling, motivating the need for sustainable benefit and open models of web databases. Highly conserved O -GlcNAcylation is a case example of one of the most recently discovered PTMs, investigated by a growing community. Historically, details about O -GlcNAcylated proteins and sites were dispersed across literature and in non- O -GlcNAc-focused, rapidly outdated or now defunct web databases. In a first effort to fill the gap, we recently published a human O -GlcNAcome catalog with a basic web interface. Based on the enthusiasm generated by this first resource, we extended our O -GlcNAcome catalog to include data from 42 distinct organisms and released the O -GlcNAc Database v1.2. In this version, more than 14 500 O -GlcNAcylated proteins and 11 000 O -GlcNAcylation sites are referenced from the curation of 2200 publications. In this article, we also present the extensive features of the O -GlcNAc Database, including the user-friendly interface, back-end and client–server interactions. We particularly emphasized our workflow, involving a mostly automatized and self-maintained database, including machine learning approaches for text mining. We hope that this software model will be useful beyond the O -GlcNAc community, to set up new smart, scientific online databases, in a short period of time. Indeed, this database system can be administrated with little to no programming skills and is meant to be an example of a useful, sustainable and cost-efficient resource, which exclusively relies on free open-source software elements (www.oglcnac.mcw.edu). [ABSTRACT FROM AUTHOR]

When working with a citizen science database like eBird, there are many possible ways to filter or subsample observations. Here, we discuss the potential biases and assumptions that surround different subsampling approaches or filtering that can be done to the eBird database. Restricting observations to species that are known to frequently hybridize, a specific time of the year, or a specific location, has the potential to greatly inflate the calculated per‐individual rate of hybridization. Such filtering also assumes that researchers know a birds' capacity to hybridize with all other species in its range, which we argue is an unfounded assumption. We ultimately conclude that a limited filtering approach is ideal when using a citizen science database to attempt to address a broad question such as: what is the per individual rate of hybridization across all of the bird species in the United States? [ABSTRACT FROM AUTHOR]

Motivation Molecular pathway databases represent cellular processes in a structured and standardized way. These databases support the community-wide utilization of pathway information in biological research and the computational analysis of high-throughput biochemical data. Although pathway databases are critical in genomics research, the fast progress of biomedical sciences prevents databases from staying up-to-date. Moreover, the compartmentalization of cellular reactions into defined pathways reflects arbitrary choices that might not always be aligned with the needs of the researcher. Today, no tool exists that allow the easy creation of user-defined pathway representations. Results Here we present Padhoc, a pipeline for pathway ad hoc reconstruction. Based on a set of user-provided keywords, Padhoc combines natural language processing, database knowledge extraction, orthology search and powerful graph algorithms to create navigable pathways tailored to the user's needs. We validate Padhoc with a set of well-established Escherichia coli pathways and demonstrate usability to create not-yet-available pathways in model (human) and non-model (sweet orange) organisms. Availability and implementation Padhoc is freely available at https://github.com/ConesaLab/padhoc. Supplementary information Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

Citizen science data have already been used to effectively address questions regarding migration, a fundamental stage in the life history of birds. In this study, we use data from eBird and from 3 additional regional citizen science databases to describe the migration routes and timing of the red-footed falcon Falco vespertinus in the Mediterranean region across 8 years (2010–2017). We further examine the seasonal and yearly variation in migration patterns and explore sites used during the species migration. Our results suggest that the autumn passage is spatially less variable and temporally more consistent among years than in spring and that birds migrate faster in spring than in autumn. The species seems to be more prevalent along the Central Mediterranean during spring migration, probably as a result of the clockwise loop migration that red-footed falcons perform. There was a high variation in annual median migration dates for both seasons as well as in migration routes across years and seasons. Higher variation was exhibited in the longitudinal component thus indicating flexibility in migration routes. In addition, our results showed the species' preference for lowlands covered with cropland and mosaics of cropland and natural vegetation as stopover sites during migration. Stopover areas predicted from our distribution modeling highlight the importance of the Mediterranean islands as stopover sites for sea-crossing raptors, such as the red-footed falcon. This study is the first to provide a broad-scale spatiotemporal perspective on the species migration across seasons, years and flyways and demonstrates how citizen science data can inform future monitoring and conservation strategies. [ABSTRACT FROM AUTHOR]

Summary: Background: The infection caused by the recently identified SARS‐CoV‐2, called coronavirus disease‐19 (COVID‐19), has rapidly spread throughout the world. With the exponential increase of patients worldwide, the clinical spectrum of COVID‐19 is being better defined and new symptoms are emerging. Numerous reports are documenting the occurrence of different cutaneous manifestations in patients with COVID‐19. Objectives: To provide a brief overview of cutaneous lesions associated with COVID‐19. Methods: A literature search was performed in the PubMed, Scopus and Web of Science databases up to 30 April 2020. This narrative review summarizes the available data regarding the clinical and histological features of COVID‐19‐associated skin manifestations. Results: The literature reports showed a great heterogeneity in COVID‐19‐associated cutaneous manifestations, as well as in their latency periods and associated extracutaneous symptoms. Pathogenic mechanisms are unknown, although the roles of a hyperactive immune response, complement activation and microvascular injury have been hypothesized. Based on our experience and the literature data, we subdivided the reported cutaneous lesions into six main clinical patterns: (i) urticarial rash; (ii) confluent erythematous–maculopapular–morbilliform rash; (iii) papulovesicular exanthem; (iv) chilblain‐like acral pattern; (v) livedo reticularis–livedo racemosa‐like pattern; and (vi) purpuric 'vasculitic' pattern. These six patterns can be merged into two main groups: the first – inflammatory and exanthematous – includes the first three groups listed above, and the second includes the vasculopathic and vasculitic lesions of the last three groups. Conclusions: The possible presence of cutaneous findings leading to suspect COVID‐19 puts dermatologists in a relevant position. Further studies are needed to delineate the diagnostic and prognostic values of such cutaneous manifestations. What is already known about this topic? The infection caused by the SARS‐CoV‐2, called coronavirus disease‐19 (COVID‐19), has rapidly spread throughout the world, becoming pandemic.The heterogeneous spectrum of COVID‐19‐associated cutaneous manifestations is based on preliminary reports of different types of skin lesions, leading to a need for clarity. What does this study add? A summary of the clinical and histological features of COVID‐19‐associated skin manifestations is provided.Six main clinical patterns can be identified: (i) urticarial rash; (ii) confluent erythematous–maculopapular–morbilliform rash; (iii) papulovesicular exanthem; (iv) chilblain‐like acral pattern; (v) livedo reticularis–livedo racemosa‐like pattern; and (vi) purpuric 'vasculitic' pattern. Plain language summary available online [ABSTRACT FROM AUTHOR]

A literature review spanning January 1, 2010, to December 31, 2019, was conducted using the PubMed and ISI Web of Science databases to determine the breadth of publication activity in the area of gram-negative bacteria antimicrobial therapy. The number of articles was used as a reflection of scholarly activity. First, PubMed was searched using the following Medical Subject Headings (MeSH): antibacterial agents, Enterobacteriaceae , Acinetobacter , and Pseudomonas. A total of 12 643 articles were identified within PubMed, and 77 862 articles were identified within ISI Web of Science that included these terms. Second, these articles were categorized by antibiotic class to identify relative contributions to the literature by drug category. Third, these studies were used to identify key trends in the treatment of gram-negative bacterial infections from the past decade. This review highlights advances made in the past 10 years in antibacterial pharmacotherapy and some of the challenges that await the next decade of practice. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide Open in new tab Download slide OBJECTIVES We sought to determine the optimal antithrombotic therapy after transcatheter aortic valve replacement. METHODS Related scientific databases were searched until December 2018. We conducted a pairwise and a network meta-analysis within a frequentist framework, measuring 30-day bleeding, stroke and all-cause mortality. The surface under the cumulative ranking (SUCRA) curve was estimated to rank the therapies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was performed. The protocol was registered with PROSPERO (CRD42018111163). RESULTS Eight studies comprising 2173 patients were analysed. The risk of 30-day bleeding was higher for dual antiplatelet therapy (DAPT) than single antiplatelet therapy (SAPT) [odds ratio (OR) 1.90 (1.10–3.28); P  =   0.02], whereas there was no difference in the risk of 30-day stroke [OR 1.27 (0.38–4.20); P  =   0.69] and mortality [OR 1.46 (0.67–3.22); P  =   0.34] between DAPT and SAPT. In the network meta-analysis, DAPT + oral anticoagulant (OAC) increased the risk of 30-day bleeding compared with SAPT [OR 6.21 (1.74–22.17); P  =   0.005], DAPT [OR 3.27 (1.04–10.32); P  =   0.043], SAPT + OAC [OR 4.87 (2.51–9.45); P  <   0.001] and OAC [OR 14.4 (1.3–154.7); P  =   0.028]. Additionally, patients receiving DAPT + OAC had the highest risks for 30-day bleeding (SUCRA 1.0%). OAC seemed to be superior to SAPT and DAPT in terms of 30-day bleeding (SUCRA OAC: 86.3%, SAPT: 72.3%, DAPT: 32.3%) and stroke (SUCRA 54.2%, 47.4%, 40.5%), but not mortality (SUCRA 69.6%, 74.1%, 43.4%). CONCLUSIONS There is a trend towards less bleeding with the application of SAPT, but no mortality benefit with the application of DAPT is shown. The comparison of SAPT, DAPT and OAC shows that OAC may improve the balance between stroke and bleeding, which can reduce the risk of mortality. In addition, the application of DAPT + OAC was ranked the worst amongst all treatment modalities and should be avoided due to an increased risk of bleeding. Clinical trial registration number PROSPERO (International Prospective Register of Systematic Reviews, CRD42018111163). [ABSTRACT FROM AUTHOR]

Background: Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults.Methods: MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses.Results: Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07-1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08-1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92-1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63-0.68).Conclusions: Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age. [ABSTRACT FROM AUTHOR]

Summary: Background: Exposure to artificial tanning devices is carcinogenic to humans, and government regulations to restrict or ban indoor tanning appear to be increasing. Objectives: We evaluated changes in the international prevalence of indoor tanning among adolescents and adults after artificial tanning devices were classified as carcinogenic by the International Agency for Research on Cancer (IARC) in 2009. Methods: Systematic searches in PubMed and Web of Science databases were undertaken. Overall, 43 studies reporting 'ever' or 'past‐year' indoor tanning exposure after 2009 were identified. We used metaregression analysis to evaluate the prevalence of indoor tanning over time. Random effects meta‐analysis was used to summarize the prevalence of indoor tanning in adolescents and adults according to sex, region and presence of age prohibitions. Results: Global prevalence of indoor tanning in adolescents for 2013–2018 was 6·5% [95% confidence interval (CI) 3·3–10·6], 70% lower than the 22·0% (95% CI 17·2–26·8) prevalence for 2007–2012. Among adults, the prevalence was 10·4% (95% CI 5·7–16·3) for 2013–2018, a decrease of 35% from 18·2% for 2007–2012. Since 2009, the overall past‐year prevalence among adolescents was 6·7% (95% CI 4·4–9·6) and 12·5% (95% CI 9·5–15·6) among adults. The prevalence of tanning indoors in the past year was similar in North America (adults, 12·5%; adolescents, 7·6%) and Europe (adults, 11·1%; adolescents, 5·1%). In 2009, three countries had regulations restricting indoor tanning, compared with 26 countries today. Conclusions: Prevalence of indoor tanning has declined substantially and significantly in adolescents and adults since the 2009 IARC statement, reflecting the rise in regulations that limit this source of unnecessary exposure to carcinogenic ultraviolet radiation. What is already known about this topic? Indoor tanning is associated with an increased risk of melanoma.A meta‐analysis of worldwide indoor tanning prevalence for 1986–2012 found a past‐year prevalence of 18% in adolescents and 14% in adults, with higher prevalences during the period 2007–2012.Policies to regulate indoor tanning began to be implemented across the globe in 2009.Only one study carried out in the U.S.A. has evaluated the efficacy of such policies in reducing indoor tanning prevalence. What does this study add? For the period 2013–2018, we found indoor tanning prevalences of 6·7% in adolescents and 11·9% in adults.This implies a reduction in indoor tanning use of 70% in adolescents and 35% in adults during the last 10 years.Our study encourages policy makers to strengthen indoor tanning regulations that reduce sunbed use among the general population in order to produce maximum public health benefit. Linked Comment:Wehner. Br J Dermatol 2020; 182:824. [ABSTRACT FROM AUTHOR]

Background: Adverse drug event (ADE) reporting enhances early detection of risks associated with drug use. Pharmacists are uniquely suited to detect and report ADEs, but their contribution is diminished by under‐reporting. Objectives: To assess pharmacists' knowledge and perceptions towards ADE reporting and to determine factors that improve or impede reporting using data from published survey articles using PRISMA. Methods: A systematic review was conducted to identify published survey articles that assess pharmacists' knowledge of and attitudes towards ADE reporting. PubMed, CINAHL and Web of Science databases were searched. The following information was extracted from eligible articles: demographic factors, sample size, response rate, survey delivery, pharmacists' working setting, barriers and facilitators of ADE reporting. Results: Only 68 survey articles were eligible to be included in the review (out of 820). The number of respondents ranges from 10 to 1870, and response rate varied between 10.5% and 100%. Pharmacists working in hospital settings and clinical pharmacists were more likely to report, to have better knowledge, favourable attitudes and familiarity with ADE reporting systems compared to pharmacists working in community settings. The main barrier towards reporting (recorded in >70% of the studies) was lack of confidence/basic knowledge of pharmacovigilance systems/concepts and ADE reporting process. Providing special training and education programmes related to pharmacovigilance concept was the most commonly mentioned factor to enhance reporting. Conclusion: To improve ADE reporting by pharmacists, it is recommended to design and integrate educational interventions related to pharmacovigilance within the pharmacy curriculum or continuous education courses. [ABSTRACT FROM AUTHOR]

Background Epidemiological studies have reported associations between pesticide exposure and respiratory health effects, but the quantitative impact on lung function is unclear. To fill this gap, we undertook a systematic review of the available literature on the association between pesticide exposure and pulmonary function. Aims To examine all available literature regarding the relationship between occupational and environmental exposure to pesticides and lung function. Methods We searched MEDLINE, EMBASE and Web of Science databases to 1 October 2017 without any date or language restrictions using a combination of MeSH terms and free text for 'pesticide exposure' and 'lung function'. We included studies that met the criteria of our research protocol registered in PROSPERO, and we assessed their quality using a modified Newcastle-Ottawa scale. Results Of 2356 articles retrieved, 56 articles were included in the systematic review and pooled in meta-analyses for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FVC and FEV1. There was tentative evidence that exposure to cholinesterase (ChE) inhibiting pesticides reduced FEV1/FVC and no evidence that paraquat exposure affected lung function in farmers. Conclusions Respiratory surveillance should be enhanced in those exposed to ChE-inhibiting pesticides which reduced FEV1/FVC according to the meta-analysis. Our study is limited by heterogeneity between studies due to different types of exposure assessment to pesticides and potential confounders. Further studies with a more accurate exposure assessment are suggested. [ABSTRACT FROM AUTHOR]