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Background: Interventions that alter aspects of the physical environments in which unhealthy behaviours occur have the potential to change behaviour at scale, i.e., across populations, and thereby decrease the risk of several diseases. One set of such interventions involves reducing serving sizes, which could reduce alcohol consumption. The effect of modifying the available range of serving sizes of wine in a real-world setting is unknown. W e aimed to assess the impact on the volume of wine sold of removing the largest serving size by the glass from the options available in licensed premises. Methods and findings: The study was conducted between September 2021 and May 2022 in 21 licensed premises in England that sold wine by the glass in serving sizes greater than 125 ml (i.e., 175 ml or 250 ml) and used an electronic point of sale till system. It used an A-B-A reversal design, set over 3 four-weekly periods. "A" represented the nonintervention periods during which standard serving sizes were served and "B" the intervention period when the largest serving size for a glass of wine was removed from the existing range in each establishment: 250 ml (18 premises) or 175 ml (3 premises). The primary outcome was the daily volume of wine sold, extracted from sales data. Twenty-one premises completed the study, 20 of which did so per protocol and were included in the primary analysis. After adjusting for prespecified covariates, the intervention resulted in −420·8 millilitres (ml) (95% confidence intervals (CIs) −681·4 to −160·2 p = 0·002) or −7·6% (95% CI −12·3%, −2·9%) less wine being sold per day. There was no evidence that sales of beer and cider or total daily revenues changed but the study was not powered to detect differences in these outcomes. The main study limitation is that we were unable to assess the sales of other alcoholic drinks apart from wine, beer, and cider, estimated to comprise approximately 30% of alcoholic drinks sold in participating premises. Conclusions: Removing the largest serving size of wine by the glass from those available reduced the volume of wine sold. This promising intervention for decreasing alcohol consumption across populations merits consideration as part of alcohol licensing regulations. Trial registration: ISRCTN https://doi.org/10.1186/ISRCTN33169631; OSF https://osf.io/xkgdb. Author summary: Why was this study done?: Reducing the portion size of food reduces the amount of food people eat. Reducing the size of servings of alcoholic drinks sold by the glass in licensed premises could reduce alcohol consumption but there is no real-world evidence for this. What did the researchers do and find?: We asked 21 licensed premises in England to remove the offer of their larger serving size of wine by the glass (usually 250 ml) from available options for 4 weeks. We compared the total daily volume of wine sold during the intervention period to that sold during nonintervention periods. Removing the largest serving size of wine by the glass (usually 250 ml) in licensed premises reduced the volume of wine sold by 7.6%. There was no evidence that it impacted sales of beer or cider, or total daily revenues. What do these findings mean?: This intervention merits consideration for inclusion in alcohol licensing regulations. These findings are limited by our inability to assess the sales of cocktails and spirits and the potential for people to have compensated for reducing wine consumption by drinking more cocktails and spirits. [ABSTRACT FROM AUTHOR]

The open solar flux (OSF) is the integrated unsigned magnetic flux leaving the top of the solar atmosphere to form the heliospheric magnetic field. As the OSF modulates the intensity of galactic cosmic rays at Earth, the production rate of cosmogenic isotopes – such as 14C and 10Be stored in tree rings and ice sheets – is closely related to the OSF. Thus on the basis of cosmogenic isotope data, OSF can be reconstructed over millennia. As sunspots are related to the production of OSF, this provides the possibility of reconstructing sunspot number (SSN) and hence properties of the solar cycles prior to the first sunspot telescopic observations in 1610. However, while models exist for estimating OSF on the basis of SSN, the hysteresis present in OSF and the lack of a priori knowledge of the start/end dates of individual solar cycles means that directly inverting these models is not possible. We here describe a new method that uses a forward model of OSF to estimate SSN and solar cycle start/end dates through a Monte Carlo approach. The method is tested by application to geomagnetic reconstructions of OSF over the period 1845-present, and compared to the known SSN record for this period. There is a substantial improvement in reconstruction of both the SSN time series and the solar cycle start/end dates compared with existing OSF-SSN regression methods. This suggests that more accurate solar-cycle information can be extracted from cosmogenic isotope records by forward modelling, and also provides a means to assess the level of agreement between independent SSN and OSF reconstructions. We find the geomagnetic OSF and observed SSN agree very well after 1875, but do differ during the early part of the geomagnetic record, though still agree within the larger observational uncertainties. [ABSTRACT FROM AUTHOR]

Background: Chronic migraine in children has been a challenging condition to treat, prompting the investigation of alternative therapies. This retrospective single-center chart review aimed to evaluate the efficacy and safety of Botox injections for managing chronic migraine in children. Methods: The study included children with chronic daily headaches and chronic migraine who were medically refractory to previous treatments at OSF Healthcare/Illinois Neurological Institute, Peoria, between 2015 and 2021. Botox injections were administered quarterly following a specific protocol. Data were obtained from electronic medical records by manual review. Results: Twenty-four patients met the inclusion criteria (median age 15.4 years, 87% female). Comorbidities included depression (41.6%) and sleep disturbances (33.2%). Prior to Botox treatment, patients had been tried on a median number of 5 (interquartile range [IQR] 4, 7) medications. Botox injections resulted in a significant reduction in headache frequency, with a mean difference (6 months vs pretreatment) in the Headache Impact Test (HIT 3) scores of −19.6 (95% CI −24.8, −14.3), P <.001, and mean difference in the Migraine Disability Assessment (MIDAS) scores of −50.8 (95% CI −62.6, −39.0, P <.001). Subjective improvements included mood enhancement (13/24, 54.2%) and improved concentration (12/24, 50%). Treatment-related side effects were reported by 5/24 (20%) of patients and were mostly mild to moderate. Conclusions: Botox injections offer a promising therapeutic option for managing chronic migraine in children who have not responded to traditional medications. Future controlled trials and long-term follow-up studies are needed to further evaluate Botox treatment's benefits and adverse effects in children with chronic migraine. [ABSTRACT FROM AUTHOR]

The Cambridge UK BabyRhythm project is a study of 122 infants as they age from 2 - 30 months, investigating cortical tracking and sensorimotor synchronisation to acoustic and visual rhythm in relation to language acquisition. As there are few standardised language tasks appropriate for this age range, the BabyRhythm project adapted a range of parent-report and infant-led experimental measures that could be used within a home testing environment. Here we present a rich description of infant performance on tasks intended to sample 5 linguistic domains: semantics, phonology, grammar, rhythmic timing and gesture. For each task we describe infant performance (mean, median, range), and we also report performance by sex (N female = 57) and by monolingual (N = 91) versus multilingual (N = 31) home environments. We report relations between measures. We share our unique longitudinal database (all data available on OSF), and 'lessons learned' on adapting language assessments for very young children. Critically, we identify the language tasks that will be utilised in our longitudinal brain-behaviour analyses, providing the benchmark upon which future neural and behavioural markers will be measured. [ABSTRACT FROM AUTHOR]

This systematic review and meta-regression analysis compares the prognostic risk factors in patient samples reported in 105 randomized clinical trials of face-to-face and internet-based psychotherapy for treating depression. Key Points: Question: Do samples of randomized clinical trials (RCTs) of face-to-face therapy (FTF) and internet-based therapy (IBT) for depression differ with regard to the prognostic risk factors (ie, prognosis) of the included patients? Findings: In this systematic review and meta-regression analysis of 105 RCTs comprising 18 363 participants, the prevalence of patients with poor prognosis was higher in RCTs of FTF than in the RCTs of IBT. The quality of reporting of prognostic risk factors was not optimal. Meaning: These results suggest that indirect comparisons of FTF and IBT may be problematic because, in terms of reporting prognostic risk factors, samples of RCTs may not be drawn from the same clinical population. Importance: Variables such as severe symptoms, comorbidity, and sociodemographic characteristics (eg, low educational attainment or unemployment) are associated with a poorer prognosis in adults treated for depressive symptoms. The exclusion of patients with a poor prognosis from RCTs is negatively associated with the generalizability of research findings. Objective: To compare the prognostic risk factors (PRFs) in patient samples of RCTs of face-to-face therapy (FTF) and internet-based therapy (IBT) for depression. Data Sources: PsycINFO, Cochrane CENTRAL, and reference lists of published meta-analyses were searched from January 1, 2000, to December 31, 2021. Study Selection: RCTs that compared FTF (individual or group therapy) and IBT (guided or self-guided interventions) against a control (waitlist or treatment as usual) in adults with symptoms of depression were included. Data Extraction and Synthesis: Data were extracted by 2 independent observers. The Cochrane revised risk-of-bias tool was used to assess the risk of bias. The study was preregistered with OSF Registries and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures: The primary outcome was the standardized mean difference (Hedges g effect size) in depressive symptoms at treatment termination (assessed with standard patient self-report questionnaires), with a positive standardized mean difference indicating larger improvements in the intervention compared with those in the control group. Meta-regression analyses were adjusted for the type of control group. Three preregistered and 2 exploratory sensitivity analyses were conducted. A prognostic risk index (PROG) was created that calculated the sum of 12 predefined individual indicators, with scores ranging from 0 to 12 and higher scores indicating that a sample comprised patients with poorer prognoses. Results: This systematic review and meta-regression analysis identified 105 eligible RCTs that comprised 18 363 patients. In total, 48 studies (46%) examined FTF, and 57 studies (54%) examined IBT. The PROG was significantly higher in the RCTs of FTF than in the RCTs of IBT (FTF: mean [SD], 3.55 [1.75]; median [IQR], 3.5 [2.0-4.5]; IBT: mean [SD], 2.27 [1.66]; median [IQR], 2.0 [1.0-3.5]; z = −3.68, P <.001; Hedges g = 0.75; 95% CI, 0.36-1.15). A random-effects meta-regression analysis found no association of the PROG with the effect size. Sensitivity analyses with outliers excluded and accounting for risk of bias or small-study effects yielded mixed results on the association between the PROG and effect size. Conclusions and Relevance: The findings of this systematic review and meta-regression analysis suggest that samples of RCTs of FTF vs IBT differ with regard to PRFs. These findings have implications for the generalizability of the current evidence on IBT for depression. More RCTs of internet-based interventions with clinically representative samples are needed, and the reporting of PRFs must be improved. [ABSTRACT FROM AUTHOR]

Oral submucosal fibrosis (OSF) is a premalignant disorder positively associated with betel nut chewing. Recent studies supported the promising benefits of histone deacetylase (HDAC) inhibitors for fibrosis treatment. Here we aim to clarify the pro-fibrogenic role of HDAC9 in regulating OSF. Healthy and OSF specimens were collected to investigate the clinical significance of HDAC9. Chronic arecoline treatment process was used to induce arecoline-mediated myofibroblasts-related activation of primary buccal mucosa fibroblasts (BMFs). Functional analysis of collagen gel contraction, transwell migration, and wound-healing assays were performed to assess the change in pro-fibrogenic properties of BMFs and fibrotic BMFs (fBMFs). Lentiviral-mediated HDAC9 knockdown was used to verify the role of HDAC9 in the pro-fibrogenic process. We found that arecoline significantly increased the mRNA and protein expression of HDAC9 of BMFs in a dose-dependent manner. Knockdown of HDAC9 in BMFs reversed the strengthened effects of arecoline on collagen gel contraction, cell migration, and wound-healing ability. We further demonstrated that knockdown of HDAC9 in fBMFs significantly attenuated its inherent pro-fibrogenic properties. Furthermore, we confirmed a significantly increased expression of HDAC9 mRNA in OSF compared to normal tissues, which suggested a positive correlation between the up-regulation of HDAC9 and OSF. We demonstrated that silencing of HDAC9 inhibited arecoline-induced activation and inherent pro-fibrogenic properties, suggesting potential therapeutics by targeting HDAC9 in the OSF treatment. [ABSTRACT FROM AUTHOR]

According to the Theory of Natural Pedagogy, object-directed emotion may provide different information depending on the context: in a communicative context, the information conveys culturally shared knowledge regarding the emotional valence of an object and is generalizable to other individuals, whereas, in a non-communicative context, information is interpreted as a subjective disposition of the person expressing the emotion, i.e., personal preference. We hypothesized that this genericity bias, already present in infants, may be a feature of human communication and, thus, present at all ages. We further questioned the effects of robotic ostensive cues. To explore these possibilities, we presented object-directed emotions in communicative and non-communicative contexts under two conditions: adult participants (N = 193) were split into those who underwent the human-demonstrator condition and those who underwent the robot-demonstrator condition, i.e., a human actor or a robot displayed object-directed emotions, respectively. Questionnaires further assessed the participants' attachment style and mentalization ability. The results showed that (1) Natural Pedagogy Theory applies to humans across the lifespan; (2) Shared knowledge depends on the contexts (communicative vs. non-communicative) and who is sharing the information (human or robot); and (3) robotic ostensive cues trigger participants' attention, conversely, in their absence, participants do not turn the robot into a communicative partner by not assigning it a communicative intention due to a difficulty in reading the robot's mind. Taken together, our findings indicate that robotic ostensive cues may ease the human-robot interaction (HRI), which is also biased by the human attachment style. The study has been preregistered in Open Science Framework, OSF on September 9, 2021 (Registration DOI https://doi.org/10.17605/OSF.IO/9TWY8). [ABSTRACT FROM AUTHOR]

Background: Pregnancy, birth, and early parenthood are significant life experiences impacting women and their families. Growing evidence suggests models of maternity care impact clinical outcomes and birth experiences. The aim of this study was to explore the strengths and limitations of different maternity models of care accessed by women in Australia who had given birth in the past 5 years. Methods: The data analysed and presented in this paper is from the Australian Birth Experience Study (BESt), an online national survey of 133 questions that received 8,804 completed responses. There were 2,909 open-ended comments in response to the question on health care provider/s. The data was analysed using content analysis and descriptive statistics. Results: In models of fragmented care, including standard public hospital care (SC), high-risk care (HRC), and GP Shared care (GPS), women reported feelings of frustration in being unknown and unheard by their health care providers (HCP) that included themes of exhaustion in having to repeat personal history and the difficulty in navigating conflicting medical advice. Women in continuity of care (CoC) models, including Midwifery Group Practice (MGP), Private Obstetric (POB), and Privately Practising Midwifery (PPM), reported positive experiences of healing past birth trauma and care extending for multiple births. Compared across models of care in private and public settings, comments in HRC contained the lowest percentage of strengths (11.94%) and the highest percentage of limitations (88.06%) while comments in PPM revealed the highest percentage of strengths (95.93%) and the lowest percentage of limitations (4.07%). Conclusions: Women across models of care in public and private settings desire relational maternity care founded on their unique needs, wishes, and values. The strengths of continuity of care, specifically private midwifery, should be recognised and the limitations for women in high risk maternity care investigated and prioritised by policy makers and managers in health services. Trial registration: The study is part of a larger project that has been retrospectively registered with OSF Registries Registration DOI https://doi.org/10.17605/OSF.IO/4KQXP. [ABSTRACT FROM AUTHOR]

Background: Practice-based research networks (PBRNs) have been recognized as essential laboratories and mechanisms for developing primary care research. This scoping review aims to examine and map the features and development trends of productivity, research categories, and methods in original primary care research conducted by global PBRNs between 1991 and 2023. Methods: We have assembled an interdisciplinary team that will undertake this scoping review, following the framework developed by Arksey and O'Malley. Targeted literature includes original primary care research conducted by PBRNs, published from January 1, 1991, to December 31, 2023. An integrated search strategy will gather publications from 3 electronic databases (PubMed, Web of Science, and Embase), 16 major primary health care journals, and 364 relevant organizations. Two experienced researchers will independently screen the titles, keywords, and abstracts of all references and extract data regarding eight key elements. Disagreements between the reviewers will be resolved through group discussions, moderated by a third reviewer. Articles to be included will (1) be conducted in the primary care context, (2) be led by PBRNs, (3) provide a full report of original research, and (4) be published in a peer-reviewed journal between the aforementioned dates in any language. Exclusions encompass reviews, letters, commentaries, case reports, and conference papers. Final data will be displayed using tables and charts according to different conceptual categories. Discussion: This scoping review is one of the initial attempts to delineate the development trends and features of primary care research conducted by PBRNs. This study will provide reference information for researchers in countries/regions that are building their research infrastructure and capacity in general practice, family medicine, and primary care. Systematic review registration: Registered in OSF on July 25, 2022 (https://osf.io/zgv9c). [ABSTRACT FROM AUTHOR]

Background/Introduction: Depressive and anxiety disorders constitute major mental health challenges affecting adults of all ages globally. It has been reported that individuals with depressive or anxiety disorders face an elevated risk of developing neurological conditions, including seizures and epilepsy. Additionally, people with these disorders tend to exhibit distinct clinical outcomes compared to the general population. However, the associations between depressive or anxiety disorders and epilepsy remain contentious. Thus, this study aims to elucidate the associations between these neuropsychiatric disorders, including depressive and anxiety disorders, and epilepsy or seizures. Methods: We will systematically search three electronic databases—PubMed, EMBASE, and the Cochrane Library—from inception through March 2023 to identify relevant cohort studies investigating the associations between depressive or anxiety disorders and epilepsy or seizures. Two independent reviewers will extract data from eligible studies using pre-designed standardized data extraction forms, and cross-check results. A third author will resolve any discrepancies. Quality assessment will be performed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Pooled risk estimates (Relative risks or hazard ratios with their 95% CI) will be calculated using the DerSimonian-Laird random-effects model. If between-study heterogeneity is identified, we will conduct subgroup analyses or meta-regressions to explore the possible sources of heterogeneity (participants, exposure, outcome, and study design) stratified by various study characteristics. Potential publication bias will be detected through the inspection of funnel plot asymmetry, complemented by the Egger linear regression approach (Egger's test) and the Begg rank correlation test (Begg's test). Discussion: This pooled analysis will evaluate the association between depressive or anxiety disorders and epilepsy or seizures, providing high-level evidence to inform early identification and prevention strategies for epilepsy or seizures. Ethics and dissemination: Given that the data utilized for analysis in this pooled analysis does not involve human subjects or medical records, no ethical approval is required for this study. We intend to present the results of this study at national or international conferences or submit the findings to a peer-reviewed journal. OSF registration number: DOI 10.17605/OSF.IO/WM2X8 [ABSTRACT FROM AUTHOR]

Arecoline is the primary active carcinogen found in areca nut and has been implicated in the pathogenesis of oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSF). For this study, we conducted a stepwise review process by combining iterative scoping reviews with a post hoc search, with the aim of identifying the specific mechanisms by which arecoline initiates and promotes oral carcinogenesis. Our initial search allowed us to define the current trends and patterns in the pathophysiology of arecoline-induced OSF and OSCC, which include the induction of cell proliferation, facilitation of invasion, adhesion, and migration, increased collagen deposition and fibrosis, imbalance in immune and inflammatory mechanisms, and genotoxicity. Key molecular pathways comprise the activation of NOTCH1, MYC, PRDX2, WNT, CYR61, EGFR/Pl3K, DDR1 signaling, and cytokine upregulation. Despite providing a comprehensive overview of potential pathogenic mechanisms of OSF, the involvement of molecules functioning as areca alkaloid receptors, namely, the muscarinic and nicotinic acetylcholine receptors (AChRs), was not elucidated with this approach. Accordingly, our search strategy was refined to reflect these evidence gaps. The results of the second round of reviews with the post hoc search highlighted that arecoline binds preferentially to muscarinic AChRs, which have been implicated in cancer. Consistently, AChRs activate the signaling pathways that partially overlap with those described in the context of arecoline-induced carcinogenesis. In summary, we used a theory-driven interpretive review methodology to inform, extend, and supplement the conventional systematic literature assessment workflow. On the one hand, the results of this critical interpretive synthesis highlighted the prevailing trends and enabled the consolidation of data pertaining to the molecular mechanisms involved in arecoline-induced carcinogenesis, and, on the other, brought up knowledge gaps related to the role of the local cholinergic axis in oral carcinogenesis, thus suggesting areas for further investigation. [ABSTRACT FROM AUTHOR]

The empirical wavelet transform (EWT), along with its adaptable spectrum segmentation technique, finds extensive application in the incipient detection of rolling bearing faults. However, determining mode boundaries adaptively under strong noise interference remains a substantial challenge. Herein, an improved parameterless EWT based on the order statistics filter (OSF) is proposed to overcome this shortcoming. This approach replaces the Fourier spectrum with its envelope spectrum through OSF, and the local minima of the envelope spectrum are selected as the initial boundary to obtain the initial empirical modes. Furthermore, the adjacent initial empirical modes are combined using Pearson's correlation coefficient, and the final number and boundaries of empirical modes are automatically determined using the mean envelope entropy. The advantages of the proposed method are demonstrated through an accelerated degradation bearing test bench and a wheelset-bearing test bench, as well as by comparing it with empirical mode decomposition (EMD), ensemble empirical mode decomposition (EEMD), and Autogram. [ABSTRACT FROM AUTHOR]

The organisation of concepts in the mental lexicon is a widely studied research topic in experimental psychology. For instance, several studies have shown that whereas concrete concepts are organised according to semantic similarity, abstract concepts are organised according to verbal association. However, these results are not systematically replicated, mainly due to a lack of normative database especially in French. To that end, we introduce a French word-association database for 1,100 cues with varying levels of concreteness from abstract to concrete concepts. Analyses from the word-association task revealed stronger association strength for concrete concepts compared with abstract concepts. Additional results showed that cues tend to elicit responses of a similar level of concreteness. The database will be useful for investigators interested in French verbal associations for abstract and concrete concepts. The data (available on OSF https://osf.io/dhuqs/) introduce responses organised according to association strength and provides cue concreteness. [ABSTRACT FROM AUTHOR]

Thermography provides non-invasive, radiation-free diagnostic imaging. Despite the extensive literature on medical thermography, a comprehensive overview of current applications is lacking. Hence, the aim of this scoping review is to identify the medical applications of passive infrared thermography and to catalogue the technical and environmental modalities. The diagnostic performance of thermography and the existence of specific reference data are evaluated, and research gaps and future tasks identified. The entire review process followed the Joanna Briggs Institute (JBI) approach and the results are reported according to PRISMA-ScR guidelines. The scoping review protocol is registered at the Open Science Framework (OSF). PubMed, CENTRAL, Embase, Web of Science, OpenGrey, OSF, and PROSPERO were searched using pretested search strategies based on the Population, Concept, Context (PCC) approach. According to the eligibility criteria, references were screened by two researchers independently. Seventy-two research articles were identified describing screening, diagnostic, or monitoring studies investigating the potential of thermography in a total of 17,314 participants within 38 different health conditions across 13 therapeutic areas. The use of several camera models from various manufacturers is described. These and other facts and figures are compiled and presented in a detailed, descriptive tabular and visual format. Thermography offers promising diagnostic capabilities, alone or in addition to conventional methods. [ABSTRACT FROM AUTHOR]

Background: People with hearing impairment have many problems with healthcare use, which is associated with health literacy. Research on health literacy is less focused on people with hearing impairments. This research aimed to explore the levels of health literacy in people with hearing impairment, find the barriers to health literacy, and summarize methods for improving health literacy. Methods: A systematic review was conducted using three databases (PubMed, Cochrane, and Embase) to search the relevant articles and analyze them. The studies were selected using pre-defined inclusion/exclusion criteria in two steps: first, selection by examining the title and abstract; and second, after reading the study in full. The Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) was used to assess the quality of the articles. Results: Twenty-nine studies were synthesized qualitatively. Individuals with hearing impairment were found to have lower health literacy, when compared to those without impairment, which can lead to a higher medical cost. Most of the people with hearing impairment faced barriers to obtaining health-related information and found it difficult to communicate with healthcare providers. To improve their health literacy, it is essential to explore new ways of accessing health information and improving the relationship between patients and healthcare providers. Conclusions: Our findings show that people with hearing impairment have lower health literacy than those without. This suggests that developing new technology and policies for people with hearing impairment is necessary not to mention promoting provision of information via sign language. Trial registration: OSF: https://doi.org/10.17605/OSF.IO/V6UGW. PROSPERO ID: CRD42023395556. [ABSTRACT FROM AUTHOR]

Upper limb lymphedema (ULLy) is an external (and/or internal) manifestation of lymphatic system insufficiency and deranged lymph transport for more than 3 months and frequently affects people as a consequence of breast cancer (BC). ULLy is often underestimated despite diminished motor skills, mood, and cognitive-behavioral complaints negatively condition the health-related quality of life (HRQoL) of persons. BC can also metastasize to the jawbone, further impacting on the HRQoL. In time, the implementation of robot-assisted rehabilitation (RR) for neurological diseases has grown to improve HRQoL and pain. This study aims to evaluate the effectiveness of a RR program in the treatment of individuals who develop an ULLy; as a further analysis, the study will assess the effectiveness of the same program in people with jawbone metastases from BC who will also develop ULLy. A randomized, parallel-group superiority-controlled trial will be conducted. 44 participants will be randomly allocated to either the experimental (receiving a RR program) or the control group (regular rehabilitation). Both groups will follow individual-based programs three times a week for 10 weeks. The main outcome measure will be the Lymphedema Quality of Life Questionnaire. Secondary outcomes will be a pain intensity numerical rating scale and the Cranio-Facial Pain Disability Inventory. Evaluations are before and after training and 6 months later. Findings may provide evidence on the effectiveness of a RR program on inducing improvements in the HRQoL and pain of individuals with ULLy due to BC. People with ULLy and jawbone metastases from BC are expected for similar or higher improvements as per the same comparisons above. This trial might contribute towards defining guidelines for good clinical rehabilitation routines and might be used as a basis for health authorities' endorsements. Trial registration OSF REGISTRIES, osf-registrations-jz7ax-v1. Registered on 26 June 2023. [ABSTRACT FROM AUTHOR]

• The Systematic Review analyses 17 articles concerning Range Anxiety (RA). • RA is faced from a psychological, Human-Factors and Socio-Technical prospective. • RA was measured with PASA questionnaire, scenarios and behavioural analysis. • RA interact with HMI features, coping skills and information, attitude, experience. • Adaptive HMI and consideration of users driving-style are strategies to overcome RA. The use of Battery Electric Vehicles is one of the biggest transformations in the field of sustainable development, holding the potential to address many sustainability challenges. Despite their high energy efficiency, the utilisation of these vehicles remains largely underexplored due to several factors. One of the prominent factors is the phenomenon of range anxiety (RA). This review aims to provide an overview of the range anxiety phenomenon, identifying its primary influencing variables and strategies for mitigating it. The review places particular emphasis on the methodologies and tools employed for assessing range anxiety and related factors. Following PRISMA guidelines, a systematic search was performed in PubMed, Scopus, and APA PsycInfo, using the following keywords: "range" AND ("stress" OR "anxiety") AND ALL ("electric" AND "vehicle"). The protocol was registered with OSF, registration number is https://doi.org/10.17605/OSF.IO/FN4VW. The articles were selected by two independent authors. The methodological quality and risk of bias were assessed. A total of 17 studies were included in the systematic review. Studies were analysed by sample size, conceptual framework, assessment method and results. The findings highlight that an approach grounded in Human-Factors principles and psychological metrics can significantly contribute to addressing range anxiety. More, individual (level of experience, self-efficacy, threatening perceptions, attitude, technology commitment and personality) and interface features (range estimation, State of Charge, adaptability, GPS, charging points map, road information) have a role in influencing the EV usage and the onset of RA. Among the commonly employed methods for assessing range anxiety were questionnaires (PASA), scenario-based analyses, and behavioral observations (including facial expression and gaze analysis). This review shows that the best solution to reduce the range anxiety may be to design improvements that minimize alterations to lifestyle and behaviour in comparison to the traditional vehicle. The most effective approach for mitigating range anxiety might involve designing improvements that minimise disruptions to lifestyle and behaviours when compared to traditional vehicles. As a novel contribution, this research presents a diagram illustrating the significant relationships between range anxiety and individual, socio-technical, and Human-Factors variables. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) has a high incidence in Asia countries, but its underlying molecular mechanism was not exploited completely. In this research, we investigated the expression of the phosphatidyl inositol 3‐kinase (Pi3k)/protein kinase B (Akt) pathway and vascular endothelial growth factor (VEGF) in oral submucosal fibrosis, explore the correlation between the Pi3k/Akt pathway and VEGF, and identify the mechanisms involved in OSF. The pathological changes and fibrosis stages of OSF tissues (n = 30, 10 each of early, moderate and advanced OSF) were determined using Haematoxylin–eosin staining (HE) and Masson staining, respectively. Collagen type I (Col‐I), Pi3k, Akt, VEGF, TGF‐β and p‐Akt expression was detected using immunohistochemistry, qPCR and WB. The correlation between Pi3k, Akt and VEGF was analysed. Col‐I expression increased as OSF progressed. However, their expression was downregulated in normal and moderate to advanced OSF tissues. VEGF expression positively correlated with Pi3k and Akt expression. VEGF expression correlated positively and negatively with the Pi3k inhibitor, LY294002 below and above a concentration of 10 μM, respectively. VEGF expression correlated positively with the Pi3k/Ak activator, IGF‐1. Due to the synergistic effect between Pi3k/Akt pathway and VEGF on OSF lesions and fibrosis process, targeted Pi3k/Akt pathway regulation can induce VEGF expression and improve ischemia, ultimately treating OSF. [ABSTRACT FROM AUTHOR]

Prior research suggests that brief interventions (BIs) for alcohol and other drug use may vary in effectiveness across patient sociodemographic factors. The objective of this individual participant data (IPD) meta-analysis was to explore for whom BIs delivered in general healthcare settings are more or less effective. We examined variability in BI effects by patient age, sex, employment, education, relationship status, and baseline severity of substance use using a two-stage IPD meta-analysis approach. All trials included in a parent aggregate data meta-analysis (k = 116) were invited to contribute IPD, and 29 trials provided patient-level data (12,074 participants). Among females, BIs led to significant reductions in binge alcohol consumption ( g ¯ = 0.09, 95% CI [0.03, 0.14]), frequency of alcohol consumption ( g ¯ = 0.10, 95% CI [0.03, 0.17]), and alcohol-related consequences ( g ¯ = 0.16, 95% CI [0.08, 0.25]), as well as greater substance use treatment utilization ( g ¯ = 0.25, 95% CI [0.21, 0.30]). BIs yielded larger reductions in frequency of alcohol consumption at 3-month follow-up for individuals with less than a high school level education ( g ¯ = 0.16, 95% CI [0.09, 0.22]). Given evidence demonstrating modest BI effects on alcohol use and mixed or null findings for BI effects on other drug use, BI research should continue to investigate potential drivers of effect magnitude and variation. Protocol registration details: The protocol for this review was pre-registered in PROSPERO #CRD42018086832 and the analysis plan was pre-registered in OSF: osf.io/m48g6. [ABSTRACT FROM AUTHOR]

Purpose: This study analyzed the relationship between patient age and the prevalence and fluoroquinolone susceptibility of gram-positive cocci from the ocular surface flora before ophthalmic surgery. Methods: This surveillance study included scraped samples from the conjunctival sac of 8923 eyes of 5490 patients (70.0 ± 13.7 years) without ocular infection before ophthalmologic surgery between August 2018 and December 2020. A review of microbiological records regarding patient age was used to determine the number of isolates and gram-positive species obtained, as well as their fluoroquinolone susceptibility. Fluoroquinolone susceptibility was determined using the Clinical and Laboratory Standards Institute protocols of broth microdilution. Statistical analysis was performed using a generalized additive model and a log-linear model. Results: In total, 9,894 bacterial isolates obtained from scraped samples from the patients were analyzed. The detected species were Staphylococcus epidermidis (31.0%), Staphylococcus aureus (6.1%), Staphylococcus lugdunensis (3.9%), Enterococcus faecalis (5.8%), Corynebacterium species (31.7%), and Cutibacterium acnes (7.5%) and others. The number of species isolated from the ocular surface was increased at the rate of 1.018 per 10 years of age (p < 0.0001). S. epidermidis, S. lugdunensis, E. faecalis, and Corynebacterium species were isolated more often with an increase in patient age. The levofloxacin resistance ratio of methicillin-sensitive S. epidermidis and Corynebacterium species increased at the rate of 1.204 and 1.087 respectively with a 10-year increase in age (both p < 0.0001). Conclusion: Gram-positive bacteria in the ocular surface flora (OSF) exhibited gradual changes in diversity and fluoroquinolone resistance with an increase in patient age. It is important to monitor the OSF of the patients before ophthalmologic surgery to prevent refractory ocular postoperative infection. [ABSTRACT FROM AUTHOR]

Objective: The sequencing panel composed of 61 target genes was used to explore the related mutation genes of oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSF) cancerization, so as to provide a theoretical basis for the early diagnosis of oral submucous fibrosis cancerization, find the most important mutations in OSF cancerization, and more targeted prevention of OSF cancerization. Methods: A total of 74 clinically diagnosed samples were included, including 36 cases of OSCC and 38 cases of OSF cancer patients. DNA was extracted, and targeted gene panel sequencing technology was used to analyze the gene frequency of pathogenic mutation sites in clinical samples. Results: Gene panel sequencing analysis showed that there were 69 mutations in 18 genes in OSCC and OSF cancerous specimens. The results of gene panel sequencing were screened, and 18 mutant genes were finally screened out and their mutation frequencies in the samples were analyzed. According to the frequency of gene mutations from high to low, they were TP53, FLT4, PIK3CA, CDKN2A, FGFR4, HRAS, BRCA1, PTPN11, NF1, KMT2A, RB1, PTEN, MSH2, MLH1, KMT2D, FLCN, BRCA2, APC. The mutation frequency of FLT4 gene was significantly higher than that of OSCC group (P < 0.05). Conclusion: FLT4 gene may be related to OSF cancerization and is expected to be an early diagnostic biomarker for OSF cancerization. [ABSTRACT FROM AUTHOR]

Tele-neuropsychology, i.e., the application of remote audio-visual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cut-offs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cut-offs, are accessible on OSF at https://osf.io/t3bma/ under a Creative Commons license. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) is a chronic, progressive, and precancerous condition mainly caused by chewing areca nut. Currently, OSF therapy includes intralesional injection of corticosteroids with limited therapeutic success in disease management. Therefore, a combined approach of in silico, in vitro and in vivo drug development can be helpful. Polyphenols are relatively safer than other synthetic counterparts. We used selected polyphenols to shortlist the most suitable compound by in silico tools. Based on the in silico results, epigallocatechin-3-gallate (EGCG), quercetin (QUR), resveratrol, and curcumin had higher affinity and stability with the selected protein targets, transforming growth factor beta-1 (TGF-β1), and lysyl oxidase (LOX). The efficacy of selected polyphenols was studied in primary buccal mucosal fibroblasts followed by in vivo areca nut extract induced rat OSF model. In in vitro studies, the induced fibroblast cells were treated with EGCG and QUR. EGCG was safer at higher concentrations and more efficient in reducing TGF-β1, collagen type-1A2 and type-3A1 mRNA expression than QUR. In vivo studies confirmed that the EGCG hydrogel was efficient in improving the disease conditions compared to the standard treatment betamethasone injection with significant reduction in TGF-β1 and collagen concentrations with increase in mouth opening. EGCG can be considered as a potential, safer and efficient phytomolecule for OSF therapy and its mucoadhesive topical formulation help in the improvement of patient compliance without any side effects. Highlights Potential polyphenols were shortlisted to treat oral submucous fibrosis (OSF) using in silico tools Epigallocatechin 3-gallate (EGCG) significantly reduced TGF-β1 and collagen both in vitro and in vivo EGCG hydrogel enhanced antioxidant defense, modulated inflammation by reducing TGF-β1 and improved mouth opening in OSF rat model. [ABSTRACT FROM AUTHOR]

Background: Inflammatory cells and cytokines in the chronically injured mucosa promote fibrosis in the oral submucous fibrosis (OSF) fibrotic milieu. Osteopontin (OPN) is a wound-healing mediator that upregulates the inflammatory response and is involved in the malignancy and fibrosis of multiple organ systems. Objectives: We investigated the expression of OPN in oral potentially malignant disorders (OPMDs) and oral squamous cell carcinomas (OSCCs) to determine its role in the malignant transformation and fibrosis of oral tissues. The expression of OPN in OPMDs and OSCCs was compared and correlated, and the role of OPN as a fibrotic mediator in OSF was explained. Study Design: A total of 30 cases of normal mucosa and OPMDs (mild dysplasia, severe dysplasia, OSF and OSCCs) were studied by purposive sampling. In these groups, OPN immunoreactivity was examined and correlated with clinical findings. Results: In mild dysplasia, OPN expression was restricted to the basal cell layer with moderate staining intensity. In severe dysplasia, it was extremely intense and extended throughout the epithelium. In the OSF, OPN expression was moderate in the perinuclear areas of the basal cell layer. The expression of OPN was very strong in OSCC. A flow diagram explaining the profibrotic role of OPN in OSF has been provided. Conclusion: A positive role of OPN in both pathogenesis and malignant transformation of OPMDs and OSCC has been demonstrated. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) is a chronic, progressive and potentially malignant oral mucosal disease. Patients often have a habit of chewing betel nuts. Areca catechu has been listed as a Class 1 carcinogen by the International Agency for Research on Cancer (IARC), and its main active component, arecoline, is classified as a Group 2B carcinogen by the IARC. The World Health Organization (WHO) categorises OSF as an oral potentially malignant disorder (OPMD). The present guideline describes the risk factors, clinical symptoms and clinical signs of OSF. Clinical staging, auxiliary examination methods, basis for diagnosis and differential diagnosis and the need to improve bad lifestyle habits are proposed and addressed, and local treatment drugs, therapies, dosage and course of treatment, possible adverse reactions, and oral treatment drugs, dosage and course of treatment are proposed. The guideline also addresses the indications for surgical treatment, alternative non–drug treatment methods, selection of treatment plans for different clinical stages, criteria for efficacy evaluation, and preventive measures. [ABSTRACT FROM AUTHOR]

Background. During hospitalization older adults have a high risk of developing functional impairments unrelated to the reasons for their admission. This is termed hospital-associated disability (HAD). This systematic review aimed to assess the incidence of HAD in older adults admitted to acute care with two outcomes: firstly in at least one activity of daily living from a set of functional tasks (e.g., Katz Index) and secondly the incidence of functional decline in an individual functional task (e.g., bathing), and to identify any tools or functional tasks used to assess activities of daily living (ADL) in hospitalized older patients. Methods. A rapid systematic review was performed according to the recommendations of the Cochrane Rapid Reviews Methods Group and reported the data according the PRISMA statement. A literature search was performed in Medline (via Ovid), EMBASE, and Cochrane Central Register of Controlled Trials databases on 26 August 2021. Inclusion criteria: older adults (≥65 years), assessment of individual items of activities of daily living at baseline and discharge. Exclusion criterion: studies investigating a specific condition that could affect functional decline and studies that primarily examined a population with cognitive impairment. The protocol was registered on OSF registries (https://osf.io/9jez4/) identifier: DOI 10.17605/OSF.IO/9JEZ4. Results. Ten studies were included in the final review. Incidence of HAD (overall score) was 37%(95% CI 0.30-0.43). Insufficient data prevented meta-analysis of the individual items. One study provided sufficient data to calculate incidence, with the following values for patients' self-reported dependencies: 32% for bathing, 27% for dressing, 27% for toileting, 30% for eating and 27% for transferring. The proxy reported the following values for patients' dependencies: 70% for bathing, 66% for dressing, 70% for toileting, 61% for eating and 59% for transferring. The review identified four assessment tools, two sets of tasks, and individual items assessing activities of daily living in such patients. Conclusions. Incidence of hospital-associated disability in older patients might be overestimated, due to the combination of disease-related disability and hospital-associated disability. The tools used to assess these patients presented some limitations. These results should be interpreted with caution as only one study reported adequate information to assess the HAD incidence. At the item level, the latter was higher when disability was reported by the proxies than when it was reported by patients. This review highlights the lack of systematic reporting of data used to calculate HAD incidence. The methodological quality and the risk of bias in the included studies raised some concerns. [ABSTRACT FROM AUTHOR]

Introduction: Academic fraud is any behavior that gives a student an undeserved advantage over another student. Few studies have explored the causes of and possible solutions to academic fraud in Latin America. We aim to map the knowledge of stakeholders in a Colombian faculty of medicine about the factors that facilitate and prevent academic fraud. Methods: Fuzzy cognitive mapping. We will use the approach proposed by Andersson and Silver to generate fuzzy cognitive maps representing stakeholder knowledge. This process consists of ten steps: (1) definition of the research question; (2) identification of participants; (3) generation of ideas; (4) rationalization of ideas; (5) organization and connection of ideas; (6) weighing; (7) pattern grouping; (8) list of links and digitization; (9) combination of maps and network analysis; and (10) deliberative dialogue. To draw the maps, we will invite medical students, interns, resident physicians, master's students, and professors in the faculty of medicine. Four medical students will receive training to facilitate the sessions. Participants will identify the factors contributing to academic fraud and their causal relationships. We will use a combination of network analysis and graph theory to identify the chains of factors with greatest influence on academic fraud. Conclusion: The maps will serve to discuss strategies to reduce academic fraud in the Faculty of Medicine and to identify factors that could be addressed in other contexts with similar problems. This research will allow the students who facilitate mapping sessions to learn about research techniques, fuzzy cognitive mapping and academic fraud. Study registration: Registered in OSF Registries on August 2nd, 2022. Registration number: osf.io/v4amz [ABSTRACT FROM AUTHOR]

Background: Inspiratory muscle training (IMT) has been recognized as an effective form of training in patients with cardiovascular disease and heart failure. However, little is known about the efficacy of IMT in the treatment of patients with coronary artery disease (CAD). The aim of this systematic review will be to evaluate randomized controlled studies to understand the effect of IMT on CAD patients. Method: We will include randomized controlled trials evaluating the efficacy of IMT in patients 18 years and older diagnosed with CAD. Crossover trials, cluster-randomized, quasi-randomized, and non-randomized trials will be excluded. Study search will be conducted in major databases (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and PEDro). The study intervention will be IMT independent of the duration, frequency, or intensity of training. The primary outcome will be quality of life, patient-reported health status, and all adverse events related to IMT. Secondary outcomes will include exercise capacity and respiratory muscle strength. The risk of bias will be evaluated based on the Cochrane Risk of Bias tool. Screening, data extraction, and quality assessment will be performed by two independent reviewers. If two or more studies are considered to be clinically homogeneous, a meta-analysis based on the random-effects model will be performed. The quality of evidence will be evaluated based on the GRADE approach. Conclusion: This systematic review will improve our understanding of the effects of IMT on CAD patients and potentially establish IMT as an alternative form of exercise training for the treatment of CAD. Trial registration: Study registration. OSF registries (https://osf.io/3ch7m). Date registered: May 10, 2022. Registration DOI: https://doi.org/10.17605/OSF.IO/GVMY7. [ABSTRACT FROM AUTHOR]

Adolescence is a crucial period of development which coincides with changes in circadian rhythmicity. This may augment the impact of circadian preference on performance in this group. We aimed to scope the literature available on chronotypes and their effect on physical and mental aspects of performance in adolescents. Studies were identified by systematically searching bibliographical databases and grey literature. The Morningness-Eveningness Questionnaire was the most frequently reported tool for circadian preference assessment. Academic achievement was the most prevailing outcome, with evidence suggesting that morning type adolescents tend to outperform evening types, yet the results vary depending on multiple factors. Performance in tests of intelligence and executive functions was generally better at optimal times of the day (synchrony effect). Physical performance was examined in 8 studies, with very heterogeneous outcomes. Although the associations between circadian preference and performance in adolescents are evident in some areas, there are many factors that may be involved in the relationship and require further investigation. This review highlights the assessment of physical performance in relation to chronotypes, the multidimensional assessment of circadian preference, and the need for longitudinal studies as priorities for further research. Protocol: OSF Registration – Public registration, DOI: [ABSTRACT FROM AUTHOR]

AIM: To investigate whether Panax notoginseng saponins (PNS) attenuate arecoline (ANE)-induced human oral submucous fibrosis (OSF) by regulating ferroptosis, and to study its mechanism. METHODS: The OSF model was established by treating human immortalized keratinocyte cell line HaCaT with ANE. There were 6 groups created: blank group, model group(50 mg/L ANE), low-, medium- and high-dose (12. 5, 25 and 50 mg/L)PNS groups, and liproxstatin-1 (ferroptosis inhibitor) group. The morphological changes of the cells were observed under a light microscope. Cell viabilty was detected by CCK-8 assay. Collagen type I (Col-l), solute carrier family 7 member 11(SLC7A11) and glutathione peroxidase 4(GPX4)protein expression levels were detected by Western blot. The morphological changes of mitochondria were observed by transmission electron microscopy. The Fe2+ level was detected by FerroOrange fluorescent probe. The intracellular reactive oxygen species (ROS) content was detected by DCFH-DA fluorescent probe. The content of glutathione (GSH)was determined by colorimetry. RESULTS: Compared with blank group, the majority of the cells in model group displayed long spindle shape, fibrotic appearance, unstable adhesion, and obvious morphological changes. Under electron microscope, mitochondrial double membrane density increased, and cristae decreased significantly, presenting typical ferroptosis. The expression of Col-I increased, GPX4 and SLC7A11 protein expression decreased, Fe2+ and ROS levels increased, and GSH content decreased (all/><0. 05). Compared with model group, most of the cells in low-, medium- and high-dose PNS groups were round and epit he lo id, with decreased mitochondrial membrane density, increased ridge number and normal morphology, decreased Col-I expression and ROS level, and increased GSH content (all P<0. 05). Compared with model group, the protein expression levels of GPX4 and SLC7A11 in medium- and high-dose PNS groups were significantly increased, while the content of Fe2+ was significantly decreased (all P<0. 05). There were no significant differences in cell and mitochondrial morphology and indicator levels between liproxstatin-1 group and high-dose PNS group (all 05). CONCLUSION: Panax notoginseng saponins can alleviate OSF by preventing the ferroptosis of HaCaT cells induced by ANE. [ABSTRACT FROM AUTHOR]

Innovative models of health care that involve advanced technology in the form of a digital hospital are emerging globally. Models include technology such as machine learning and smart wearables, that can be used to integrate patient data and improve continuity of care. This model may have benefits in situations where patient deterioration must be detected quickly so that a rapid response can occur such as cardiopulmonary settings. The purpose of this scoping review was to examine the evidence for a digital hospital model of care, in the context of cardiac and pulmonary settings. Scoping review. Databases searched were using PsycInfo, Ovid MEDLINE, and CINAHL. Studies written in English and containing key terms related to digital hospital and cardiopulmonary care were included. The Joanna Briggs Institute methodology for systematic reviews was used to assess the risk of bias. Thirteen (13) studies fulfilled the inclusion criteria. For cardiac conditions, a deep-learning-based rapid response system warning system for predicting patient deterioration leading to cardiac arrest had up to 257% higher sensitivity than conventional methods. There was also a reduction in the number of patients who needed to be examined by a physician. Using continuous telemonitoring with a wireless real-time electrocardiogram compared with non-monitoring, there was improved initial resuscitation and 24-hour post-event survival for high-risk patients. However, there were no benefits for survival to discharge. For pulmonary conditions, a natural language processing algorithm reduced the time to asthma diagnosis, demonstrating high predictive values. Virtual inhaler education was found to be as effective as in-person education, and prescription error was reduced following the implementation of computer-based physician order entry electronic medical records and a clinical decision support tool. While we currently have only a brief glimpse at the impact of technology care delivery for cardiac and respiratory conditions, technology presents an opportunity to improve quality and safety in care, but only with the support of adequate infrastructure and processes. Open Science Framework (OSF: DOI 10.17605/OSF.IO/PS6ZU). [ABSTRACT FROM AUTHOR]

Introduction: Social functioning (SF) is the ability to fulfil one's social obligations and a key outcome in treatment. Objective: The aim of the study was to estimate the effects of antidepressants on SF in patients with major depressive disorder (MDD). Methods: This meta-analysis and its reporting are based on Cochrane Collaboration's Handbook of Systematic Reviews and Meta-Analyses and PRISMA guidelines (protocol registration at OSF). We systematically searched CENTRAL, Medline, PubMed Central, and PsycINFO for double-blind RCTs comparing antidepressants with placebo and reporting on SF. We computed standardized mean differences (SMDs) with 95% CIs and prediction intervals. Results: We selected 40 RCTs out of 1,188 records screened, including 16,586 patients (mean age 46.8 years, 64.2% women). In 27 studies investigating patients with MDD (primary depression), antidepressants resulted in a SMD of 0.25 compared to placebo ([95% CI: 0.21; 0.30] I2: 39%). In 13 trials with patients suffering from MDD comorbid with physical conditions or disorders, the summary estimate was 0.24 ([0.10; 0.37] I2: 75%). In comorbid depression, studies with high/uncertain risk of bias had higher SMDs than low-risk studies: 0.29 [0.13; 0.44] versus 0.04 [−0.16; 0.24]; no such effect was evident in primary depression. There was no indication of sizeable reporting bias. SF efficacy correlated with efficacy on depression scores, Spearman's rho 0.67 (p < 0.001), and QoL, 0.63 (p < 0.001). Conclusions: The effect of antidepressants on SF is small, similar to its effect on depressive symptoms in primary MDD, and doubtful in comorbid depression. Strong correlations with both antidepressive and QoL effects suggest overlap among domains. [ABSTRACT FROM AUTHOR]

Purpose: Prevention and management of postoperative pancreatic fistula (POPF) after pancreatic resections is still an unresolved issue. Continuous irrigation of the peripancreatic area is frequently used to treat necrotizing pancreatitis, but its use after elective pancreatic surgery is not well-known. With this systematic review, we sought to evaluate the current knowledge and expertise regarding the use of continuous irrigation in the surgical area to prevent or treat POPF after elective pancreatic resections. Methods: A systematic search of the literature was conducted according to the PRISMA 2020 guidelines, screening the databases of Pubmed, Scopus, Web of Science, and Ovid MEDLINE. Because of the heterogeneity of the included articles, a statistical inference could not be performed and the literature was reviewed only descriptively. The study was pre-registered online (OSF Registry). Results: Nine studies were included. Three studies provided data regarding the prophylactic use of continuous irrigation after distal and limited pancreatectomies. Here, patients after irrigation showed a lower rate of clinically relevant POPF, related complications, lengths of stay, and mortality. Six other papers reported the use of local lavage to treat clinically relevant POPF and subsequent fluid collections, with successful outcomes. Conclusion: In the current literature, only a few publications are focused on the use of continuous irrigation after pancreatic resection to prevent or manage POPF. The included studies showed promising results, and this technique may be useful in patients at high risk of POPF. Further investigations and randomized trials are needed. [ABSTRACT FROM AUTHOR]

The airworthiness standards of the transport category airplanes stipulate that the high energy rotor equipment must be of the sufficient containment capacity. It is of great importance to study the containment and weight reduction for the air turbine starter. In this paper, based on an OSF design, Kriging response surface model and MOGA algorithm, a neck structure optimal design method was proposed for the air turbine wheel. Using the optimal design method, the optimal structural parameters were suggested as the design parameters, and verified by the over-speed burst test. The maximum errors of the burst speeds between the experimental and design values are less than 2%, and the neck structure turbine wheel breaks in the neck as expected, validating the accuracy of the optimal design method. Then, the effects of turbine wheel burst modes on the containment were investigated quantitatively, and verified by the containment tests. Based on the experimental and simulation results, the containment design method was proposed for the neck structure turbine wheel. The results show that compared with the trisection wheel burst, the rim burst dramatically decrease the mass and initial kinetic energy of burst released fragments by 63.3% and 24.8%, thereby greatly reducing the thickness and the mass of the containment ring by 29.5% and 29.1%. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this scoping review was to determine the underlying design of simulations that help undergraduate nursing students acquire evidence-based practice (EBP) experiences. Method: The JBI methodology was used for this review. The inclusion criteria were studies conducted in academic, clinical, or virtual settings that examined simulation programs designed to facilitate the acquisition of EBP by undergraduate nursing students. A comprehensive search was performed on Jan 3, 2022, using the Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), and the Excerpta Medica database (EMBASE). Grey literature was not included. Publication year was limited to 2020 and later. There was no language restriction. Data were extracted using a tool developed by the reviewers and based on the National League for Nursing Jeffries Simulation Theory. Result: A total of 12,931 articles were found, and after duplicate articles and articles deemed ineligible based on the title and abstract (12,914 articles), 17 published papers were examined. The full texts of these studies were reviewed for eligibility, and one study was selected for the present scoping review. The selected study examined a mock trial designed to allow undergraduate nursing students to experience the ethical decision-making based on a diversity of evidence. The program reported in the study consisted of a prebriefing—simulation (mock)—debriefing structure with verified positive effects on EBP education. Conclusion: A mock trial is a useful educational strategy for allowing undergraduate nursing students to experience EBP, but a creative method should be found that can modify the mock trial for practical operation as the designing the program demands high levels of human and material resources. Registration: OSF Registries, https://osf.io/gdtyu, We updated OSF registry data for documenting important protocol amendments. [ABSTRACT FROM AUTHOR]

Background: Melasma is one of the most encountered dermatoses in dermatology and skin care clinics. It is a challenging chronic, recurrent condition associated with hyperpigmentation. Its aetiology is poorly understood. Melasma affects all races and gender but is more prevalent in women with darker skin types. Being a facial lesion, melasma has a severe impact on quality of life due to its disfigurement. While many modalities of treatment for melasma exists, unfortunately, effectiveness and safety remain a huge concern. Treatment modalities are variable and often unsatisfactory. The objective of this scoping review is to systemically map available evidence from literature regarding melasma on people with darker skin types, garner insight as to how melasma affects the quality of life and begin to investigate and gain understanding on effectiveness of different treatments used for melasma. Methods: A scoping review guided by Arksey and O'Malley's framework, the enhancements and recommendations of Levac, Colquhoun and O'Brien, Daudt and associates and the 2015 Johanna Briggs Institute's guidelines will be conducted. Systematic electronic searches of databases and search engines will include Scopus, PubMed, CINAHL Complete, Cochrane, Science Direct, and Web of Science which will be conducted to attain published peer-reviewed articles of all study designs excluding reviews and grey literature. All literature that meets the inclusion criteria, research question and sub-question will be included in this review. All the retrieved literature will be exported to an Endnote X20 library. Quality appraisal of the included articles will be conducted using the mixed methods appraisal tool (MMAT) 2018 version. Discussion: We anticipate mapping relevant literature on the melasma, investigating the effectiveness of treatment options of melasma as well as evaluating its association with quality of life in people with darker skin types. This study is likely to reveal research gaps, which could guide future implementation research on melasma treatment interventions. Systematic review registration: This protocol has been registered a priori with OSF and is accessible on this link: https://osf.io/ru3jc/. [ABSTRACT FROM AUTHOR]

Animacy plays an important role in cognition (e.g., memory and language). Across languages, a processing advantage for animate words (representing living beings), comparatively to inanimate words (i.e., non-living things), has been found mostly in young adults. Evidence in older adults, though, is still unclear, possibly due to the use of stimuli not properly characterised for this age group. Indeed, whereas several animacy word-rating studies already exist for young adults, these are non-existent for older adults. This work provides animacy ratings for 500 British English and 224 European Portuguese words, rated by young and older adults from the corresponding countries. The comparisons across languages and ages revealed a high interrater agreement. Nonetheless, the Portuguese samples provided higher mean ratings of animacy than the British samples. Also, the older adults assigned, on average, higher animacy ratings than the young adults. The Age X Language interaction was non-significant. These results suggest an inter-age and inter-language consistency in whether a word represents an animate or an inanimate thing, although with some differences, emphasising the need for age- and language-specific word rating data. The animacy ratings are available via OSF: https://osf.io/6xjyv/. [ABSTRACT FROM AUTHOR]

The current food chain both contributes to, and is affected by, climate change. While GHG emissions and emissions to water and soil are a problem for the whole food chain, the majority of such emissions and the major solutions to them can be found in the farming and land use sector. The farming system needs to reduce its greenhouse-gas emissions and adapt its supply chain to cope with climate change. A broad variety of payment tools have been proposed to motivate farmers and landowners to take certain actions to reduce greenhouse gas emissions and encourage the protection or restoration of natural resources. The protocol described here (OSF preregistration https://doi.org/10.17605/OSF.IO/STGQ6) outlines the methodology for a systematic review to explore how financial mechanisms such as green bonds can provide incentives to agri-food sector to support environmental sustainability and ecosystem service delivery through land-use change. Our primary research question is: how do financial mechanisms incentivize land restoration? Studies will be categorized according to the types of financial mechanisms, their characteristics, methods of land restoration and their impact on mitigating agri-food footprint. The results are expected to increase our understanding about the design of financing tools currently used to accelerate nature restoration. Moreover, they will inform us about the effectiveness of deploying such tools on rural communities, food companies and landowners. [ABSTRACT FROM AUTHOR]

Background: The daily life of informal caregivers assisting individuals with dementia widely varies throughout the day and week. As an answer, an increasing number of researchers have used intensive longitudinal methods (ILMs) such as diary studies, experience sampling methods, or ecological momentary assessment. Objectives and Methods: The present scoping review aims at synthesizing the use of ILMs in informal dementia caregivers to clarify what is currently done and how, as well as what remains unaddressed. Results: The screening process identified 48 studies from 22 different datasets. Synthesis of these studies showed the diversity of devices and uses of ILMs in informal care, including the exploration of associations between variables or accompanying an intervention. ILMs showed the important variability of caregiving phenomena, as well as the important association of momentary stress and well-being. Gaps were nevertheless identified, such as transparency in the construction of the tool or the absence of focus on emotions and dyads. Conclusions: For now, this field of research remains in its infancy and does not seem to have reached its full potential as it has in other fields. Nevertheless, it appears that ILMs are promising tools for informal dementia caregivers as they contribute to understanding the complexity of their daily life, with changing resources and challenges. Future directions include focusing more on (emotion) regulation, temporal lags, and the use of ILMs in interventional designs. Trial registration: The present review was registered on OSF (osf.io/b2qr4). [ABSTRACT FROM AUTHOR]

Many cognitive processes, ranging from perception to action, depend on the ability to predict the timing of forthcoming events. Yet, how the brain uses predictive models in the temporal domain is still an unsolved question. In previous work, we began to explore the neural correlates of temporal predictions by using a computational approach in which an ideal Bayesian observer learned the temporal probabilities of target onsets in a simple reaction time task. Because the task was specifically designed to disambiguate updating of predictive models and surprise, changes in temporal probabilities were explicitly cued. However, in the real world, we are usually incidentally exposed to changes in the statistics of the environment. Here, we thus aimed to further investigate the electroencephalographic (EEG) correlates of Bayesian belief updating and surprise associated with incidental learning of temporal probabilities. In line with our previous EEG study, results showed distinct P3-like modulations for updating and surprise. While surprise was indexed by an early fronto-central P3-like modulation, updating was associated with a later and more posterior P3 modulation. Moreover, updating was associated with a P2-like potential at centro-parietal electrodes, likely capturing integration processes between prior beliefs and likelihood of the observed event. These findings support previous evidence of trial-by-trial variability of P3 amplitudes as an index of dissociable inferential processes. Coupled with our previous findings, the present study strongly bolsters the view of the P3 as a key brain signature of temporal Bayesian inference. Data and scripts are shared on OSF: osf.io/sdy8j/ [ABSTRACT FROM AUTHOR]

Staphylococci sp. are the most commonly associated pathogens in infective endocarditis, especially within high-income nations. This along with the increasing burden of healthcare, aging populations, and the protracted infection courses, contribute to a significant challenge for healthcare systems. A systematic review was conducted using relevant search criteria from PubMed, Ovid's version of MEDLINE, and EMBASE, and data were tabulated from randomized controlled trials (RCT), observational cohort studies, meta-analysis, and basic research articles. The review was registered with the OSF register of systematic reviews and followed the PRISMA reporting guidelines. Thirty-five studies met the inclusion criteria and were included in the final systematic review. The role of Staphylococcus aureus and its interaction with the protective shield and host protection functions was identified and highlighted in several studies. The interaction between infective endocarditis pathogens, vascular endothelium, and blood constituents was also explored, giving rise to the potential use of antiplatelets as preventative and/or curative agents. Several factors allow Staphylococcus aureus infections to proliferate within the host with numerous promoting and perpetuating agents. The complex interaction with the hosts' innate immunity also potentiates its virulence. The goal of this study is to attain a better understanding on the molecular pathways involved in infective endocarditis supported by S. aureus and whether therapeutic avenues for the prevention and treatment of IE can be obtained. The use of antibiotic-treated allogeneic tissues have marked antibacterial action, thereby becoming the ideal substitute in native and prosthetic valvular infections. However, the development of effective vaccines against S. aureus still requires in-depth studies. [ABSTRACT FROM AUTHOR]

Oral mucosal patches striae diseases (OMPSD) represent an important category of oral mucosal disease, most of which may have malignant potential (OMPSD-MP). The differential diagnosis is challenging due to overlap of their clinical and pathological features. 116 OMPSD-MP patients were included in this cross-sectional study from November 2019 to February 2021, including oral lichen planus (OLP), oral lichenoid lesions (OLL), discoid lupus erythematosus (DLE), oral submucous fibrosis (OSF) and oral leukoplakia (OLK). The general information, clinical manifestation, histopathological and direct immunofluorescence (DIF) features were statistically analyzed and compared. OLP was the major type of OMPSD-MP (64.7%), followed by OLL (25.0%), OLK (6.0%), DLE (2.6%) and OSF (1.7%), which were pooled as non-OLP group for further assessment. They shared many clinical and histological features in common. The rate of clinical-pathological diagnosis concordance was 73.5% for OLP, and 76.7% for total OMPSD-MP. DIF positive rate was significantly higher in OLP group than non-OLP group (76.0% vs. 41.5%, P < 0.001), in which the deposition of fibrinogen (Fib) and IgM were most frequently found. A significant overlap in clinical and histopathological features of OMPSD-MP was found, while DIF could be useful in differential diagnosis. Fib and IgM might be important immunopathological factors in OLP, which need further exploration. [ABSTRACT FROM AUTHOR]

Background: Oral submucous fibrosis (OSF), a premalignant condition, demands early diagnosis and treatment for an improved prognosis of the patients. Being a chronic inflammatory disease, various markers of inflammation can be used to predict the prognosis of the disease. The present study was undertaken to assess the plasma levels of fibrinogen degradation products (FDPs), D-dimer, and mast cell density (MCD) in patients with OSF. Materials and Methods: Forty histopathologically confirmed cases of OSF and 10 age- and sex-matched individuals were included in the study. Two ml of venous blood was obtained from all the study participants and was evaluated for the levels of FDPs, d-dimer, and mast cell densities. Results: Comparison of mean plasma levels of FDPs and D-dimer showed a statistically significant increase with the increase in the grades of OSF. Also, a significant association was evident between the plasma FDPs and D-dimer levels. The values of mean mast cell densities from grade I to grade IV OSF were 191.1/mm2, 258.5/mm2, 182.4/mm2, and 165.7/mm2, respectively, and were significantly higher than the value in NOM i.e., 86.5/mm2. There was a statistically significant increase in the values of mast cell densities from grade I to grade II OSF, with grade II OSF showing the highest mast cell densities among all the grades, and the values decreased toward grades III and IV OSF, with grade IV showing the least mast cell densities. Conclusion: Excessive areca nut chewing may stimulate collagen synthesis by fibroblasts, enhancing fibrosis, and in turn, raising the plasma fibrinogen levels and thereby the FDPs and d-dimers associated with the advancement of the grade of OSF. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta‐analysis aimed to summarize available evidence regarding the effect of horizontal glass fiber posts (HGFPs) on fracture strength and fracture pattern of endodontically treated teeth (ETT) compared to controls without HGFP. The review protocol was registered on the OSF registries. Methods: Literature searches were conducted in MEDLINE/PubMed, Scopus, Web of Science, Embase, Google Scholar, and ProQuest for all relevant studies published up to February 2022. All in vitro studies that assessed the influence of HGFPs on fracture strength and fracture pattern of ETT whether mesio‐occluso‐distal or mesio‐occlusal or DO cavities were considered eligible. Review Manager (RevMan) was used for the meta‐analysis. Subgroup and funnel plot analyses were also performed. Quality assessment was conducted by two independent reviewers. Results: A total of 12 articles met the inclusion criteria, and 10 studies underwent quantitative evaluation. The pooled effect showed that fracture resistance of molar teeth restored with HGFP was significantly higher than teeth without HGFP (standardized mean difference [SMD]: 1.61, 95% confidence interval [CI]: 0.14, 3.09, p = 0.03), whereas marginally significant for premolars (SMD: 1.36, 95% CI: −0.00, 2.73, p = 0.05). Regarding fracture patterns, the presence of an HGFP significantly increased the occurrence of restorable fracture patterns for premolars (odds ratios [OR]: 4.15, 95% CI: 1.60, 10.82, p = 0.004) compared to controls, whereas the difference was not significant for molars (OR: 1.09, 95% CI: 0.43, 2.77, p = 0.85). Moderate risk of bias was identified in 9/12 studies; one study showed a high risk of bias and two studies showed a low risk of bias. Conclusions: Within the limitations of this study, there is evidence from in vitro studies that the use of HGFP increases the fracture resistance of the ETT when compared to teeth without HGFP and also reduces the occurrence of non‐restorable fractures for premolars. However, well‐conducted in vitro and prospective clinical studies are warranted to validate this finding. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) is a chronic progressive fibrosis disease that affects in oral mucosal tissues. Interleukin (IL)‐13 has been implicated in the development of fibrosis in multiple organs. Indeed, it contributes to diseases such as pulmonary fibrosis, liver cirrhosis among others. Currently, its expression in OSF and the specific mechanisms are not well understood. The aim of this study was to investigate the role of IL‐13 in OSF and further explore whether IL‐13 regulates—polarization of M2‐macrophages in OSF. Initially, in the tissues of patients with OSF, we observed a high expression of M2‐macrophages and IL‐13 protein. Additionally, we found a correlation between the expression of IL‐13 and the stage of OSF. Arecoline inhibited the proliferation of fibroblasts (FBs) and promoted IL‐13 production in vitro. Furthermore, our observations revealed that M2‐macrophages increased upon co‐culturing M0‐macrophages with supernatants containing the IL‐13 cytokine. In conclusion, our study demonstrated that arecoline stimulates FBs leading to increased secretion of IL‐13, which in turn IL‐13 leads to polarization of M2‐macrophages and promotes the occurrence of OSF. This suggests that IL‐13 may be a potential therapeutic target of OSF. [ABSTRACT FROM AUTHOR]

Background: Smaller serving sizes of alcoholic drinks could reduce alcohol consumption across populations thereby lowering the risk of many diseases. The effect of modifying the available range of serving sizes of beer and cider in a real-world setting has yet to be studied. The current study assessed the impact on beer and cider sales of adding a serving size of draught beer and cider (2/3 pint) that was between the current smallest (1/2 pint) and largest (1 pint) standard serving sizes. Methods: Twenty-two licensed premises in England consented to taking part in the study. The study used an ABA reversal design, set over three 4-weekly periods, with A representing the non-intervention periods, during which standard serving sizes were served and B the intervention period when a 2/3 pint serving size of draught beer and cider was added to the existing range, along with smaller 1/2 pint and larger 1 pint serving sizes. The primary outcome was the daily volume of beer and cider sold, extracted from sales data. Results: Fourteen premises started the study, of which thirteen completed it. Twelve of those did so per protocol and were included in the primary analysis. After adjusting for pre-specified covariates, the intervention did not have a significant effect on the volume of beer and cider sold per day (3.14 ml; 95%CIs -2.29 to 8.58; p = 0.257). Conclusions: In licensed premises, there was no evidence that adding a smaller serving size for draught beer and cider (2/3 pint) when the smallest (1/2 pint) and largest (1 pint) sizes were still available, affected the volume of beer and cider sold. Studies are warranted to assess the impact of removing the largest serving size. Trial registration: ISRCTN: https://doi.org/10.1186/ISRCTN33169631 (08/09/2021), OSF: https://osf.io/xkgdb/ (08/09/2021). [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) has been linked to several negative health outcomes. Therefore, reducing SB or breaking up prolonged periods of SB improves functional fitness, food consumption, job satisfaction, and productivity. Reducing SB can be achieved by introducing a health-enhancing contextual modification promoted by a sit-stand desk in the workplace. The primary goal will be to test the effectiveness of this intervention in reducing and breaking up SB, while improving health outcomes in office-based workers during a 6-month intervention. Methods: A two-arm (1:1), superiority parallel-group cluster RCT will be conducted to evaluate the effectiveness of this intervention in a sample of office-based workers from a university in Portugal. The intervention will consist of a psychoeducation session, motivational prompts, and contextual modification promoted by a sit-stand desk in the workplace for 6 months. The control group will work as usual in their workplace, with no contextual change or prompts during the 6-month intervention. Three assessment points will be conducted in both groups, pre-intervention (baseline), post-intervention, and a 3-month follow-up. The primary outcomes include sedentary and physical activity-related variables, which will be objectively assessed with 24 h monitoring using the ActivPAL for 7 days. The secondary outcomes include (a) biometric indices as body composition, body mass index, waist circumference, and postural inequalities; and (b) psychosocial variables such as overall and work-related fatigue, overall discomfort, life/work satisfaction, quality of life, and eating behavior. Both the primary and secondary outcomes will be assessed at each assessment point. Discussion: This study will lean on the use of a sit-stand workstation for 6 months, prompted by an initial psychoeducational session and ongoing motivational prompts. We will aim to contribute to this topic by providing robust data on alternating sitting and standing postures in the workplace. Trial registration: The trial was prospectively registered, and the details are at: https://doi.org/10.17605/OSF.IO/JHGPW; Registered 15 November 2022. OSF Preregistration. [ABSTRACT FROM AUTHOR]

Machine learning tools for analysing lubricating oil data have enabled better information in the condition based maintenance (CBM) approach to the process of diagnosing and predicting failures in diesel‐powered vehicle fleets. With the increase in the number of sensors inserted in vehicles, it is possible for companies to stockpile large quantities of information in real time. As such, the development of data‐driven tools will enable accurate identification of the level of wear of a system, evolving CBM into a more reliable and dynamic approach. Following this type of data‐based analysis focusing on determining the wear of systems and equipment, this paper presents an intelligent system for assessing the condition of lubricating oil in automotive diesel engines. To this end, we analyse the use of raw data obtained from the sensors installed in the car and evaluate in conjunction with the insertion of engineered features designed the best way to determine the operating state of the oils. The results presented in this analysis show that to explain 90% of the variation in the original data only the variables kinematic viscosity, dynamic viscosity, engine oil temperature and OSF_v3 are needed. After evaluating the quality of the variables, we conducted an experimental study to analyse the performance of various machine learning algorithms, taking into account the number of features as input data. The results show that the proposed system has the ability to identify the operating conditions of lubricating oil using seven variables as input to a model based on gradient boosting, obtaining a recall result of 93%, precision of 96% and F1‐score of 94%. We conducted a set of additional studies to understand how different subsets of variables affected the performance of the models, and the results show that the best combination includes information regarding the engine speed, coolant and oil temperature, oil pressure, the oil stress factor (OSF_v3), kinematic viscosity, and the dynamic viscosity. [ABSTRACT FROM AUTHOR]

Background: Quality of Life (QoL) is an important outcome in mental disorders. We investigated whether antidepressant pharmacotherapy improved QoL vs. placebo among patients with MDD. Methods: Systematic literature search in CENTRAL, Medline, PubMed Central, and PsycINFO of double‐blind, placebo‐controlled RCTs. Screening, inclusion, extraction, and risk of bias assessment were conducted independently by two reviewers. We calculated summary standardized mean differences (SMD) with 95%‐CIs. We followed Cochrane Collaboration's Handbook of Systematic Reviews and Meta‐Analyses and PRISMA guidelines (protocol registration at OSF). Results: We selected 46 RCTs out of 1807 titles and abstracts screened, including 16.171 patients, 9131 on antidepressants and 7040 on placebo, a mean age of 50.9 years, with 64.8% women. Antidepressant drug treatment resulted in a SMD in QoL of 0.22 ([95%‐CI: 0.18; 0.26] I2 39%) vs. placebo. SMDs differed by indication: 0.38 ([0.29; 0.46] I2 0%) in maintenance studies, 0.21 ([0.17; 0.25] I2 11%) in acute treatment studies, and 0.11 ([−0.05; 0.26], I2 51%) in studies focussing on patients with a physical condition and major depression. There was no indication of subtstantial small study effects, but 36 RCTs had a high or uncertain risk of bias, particularly maintenance trials. QoL and antidepressive effect sizes were associated (Spearman's rho 0.73, p < 0.001). Conclusions: Antidepressants' effects on QoL are small in primary MDD, and doubtful in secondary major depression and maintenance trials. The strong correlation of QoL and antidepressive effects indicates that the current practice of measuring QoL may not provide sufficient additional insights into the well‐being of patients. [ABSTRACT FROM AUTHOR]