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Donor spins in ZnO NWs have promise for quantum information (QI) applications due to high crystalline quality, narrow excitonic luminescence linewidths, and a direct bandgap of this material. It is important to understand the processes that can lead to inhomogeneous broadening of the excitonic transitions for realization of QI devices. We investigate the effect of Ga dopant concentration on the low temperature photoluminescence (PL) of Ga-doped ZnO nanowires. Spectrometer-resolution-limited donor-bound exciton (D 0 X) PL lines are observed at low concentrations with linewidths of around 0.1 meV. A clear increase in the Ga D 0 X line is observed as trace amounts of Ga are added. Above a certain concentration threshold, we observe a strong increase in the lateral growth coupled with a significant tail on the low energy side of the D 0 X emission, which scales linearly with dopant precursor concentration. We have analyzed this behavior using different models, including a model based on a bound exciton wavefunction overlap with neigbhouring donors and a Stark effect model due to random charged impurities. We rule out both of these models based on PL excitation spectroscopy measurements and show that a simple exponential model of the Urbach form gives the best fit and points to disorder in the more heavily doped shells. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the effects of classroom-based physical activity (CBPA) interventions on academic performance and assessed the impact of different CBPA elements on academic performance. Methods: Relevant experimental studies in four databases were searched from their inception to September 2022. Random effects models were used to compute standardized mean differences (SMDs) and 95% confidence intervals. Results: A total of 13 studies were included. CBPA interventions could improve academic performance in children and adolescents (SMD = 0.17, p =.02). For the CBPA elements, low frequency (no more than three times per week; SMD = 0.19, p =.01), moderate intensity (SMD = 0.19, p =.01), long time (more than 20 min in each intervention; SMD = 0.14, p =.05), integrated physical activity (SMD = 0.18, p =.04), no more than 400 metabolic equivalents of energy-min/week (SMD = 0.33, p =.001), and more than 8-week interventions (SMD = 0.19, p =.04) tended to improve academic performance. Conclusions: CBPA may improve academic performance in children and adolescents. CBPA elements also have an impact on academic performance. [ABSTRACT FROM AUTHOR]

Carrots are main dietary sources of several potential anti-cancer compounds, including polyacetylenes, while β-carotene has shown no benefits in controlled cancer trials. Accordingly, associations between carrot intake and cancer incidence were quantified, where necessary using α-carotene as a non-causal biomarker of carrot consumption, by searching for studies published before June 2022 reporting risk estimates for relationships of cancer incidence with carrot intake or α-carotene intake or α-carotene plasma concentration, supplemented with hand searches of included studies and reviews. Meta-analyses comparing highest and lowest reported intakes in prospective studies using a random-effects model estimated summary relative risks (RRs) with 95% confidence intervals (CIs), separately for carrot intake or α-carotene plasma concentration, and the corresponding dose-responses. Of 198 observational studies, in 50 prospective studies with 52000 cases recording carrot intake, the cancer-risk was substantially reduced (RR 0.90, 95% CI 0.87–0.94, p ˂ 0·00004). In 30 prospective studies with 9331 cases reporting plasma α-carotene levels, summary RR was 0.80 (0.72–0.89, p ˂ 0·00006). For both exposure types, inter-study heterogeneity was moderate, interaction with cancer types insignificant, and the dose-response significant (p ˂ 0·01). In conclusion, carrot consumption is robustly associated with decreased cancer-risk; carrot consumption should be encouraged, and the causal mechanisms further investigated. [ABSTRACT FROM AUTHOR]

Intravenous (IV) ketamine has been evaluated alongside electroconvulsive therapy (ECT) in addressing major depressive disorder (MDD) or bipolar depression (BD), though the comparative outcomes remain inconclusive. This meta-analysis aimed to provide a systematic assessment of the efficacy, safety, and tolerability of IV ketamine relative to ECT for treating MDD or BD. Randomized controlled trials (RCTs) comparing IV ketamine and ECT in terms of efficacy, safety, and tolerability for MDD or BD were identified and reviewed. Three independent investigators extracted relevant data, which was synthesized using RevMan 5.3 software under a random effects model. Five RCTs encompassing 664 patients diagnosed with MDD or BD were analyzed. At 24 h post-initial treatment, IV ketamine demonstrated a statistically greater reduction in depressive symptoms compared to ECT (standardized mean difference (SMD) = −0.49, 95 % CI = −0.96 to -0.03, I2 = 77 %; P = 0.04). However, no significant differences were observed between groups in terms of the study-defined response (risk ratio (RR) = 1.49, 95 % CI = 0.08 to 28.42, I2 = 0 %; P = 0.79) at 24 h. Similarly, no notable differences were found for depressive symptom improvement (SMD = −0.48, 95 % CI = −2.41 to 1.45, I2 = 99 %; P = 0.63), the study-defined response (RR = 0.96, 95 % CI: 0.70 to 1.31, I2 = 75 %; P = 0.79) or remission (RR = 0.91, 95 % CI: 0.45 to 1.82, I2 = 90 %; P = 0.78) at the end-of-treatment visit. Among the three RCTs (60 %) comparing the neurocognitive outcomes of IV ketamine and ECT through varying test batteries, results were inconsistent. IV ketamine was associated with marked increases in dissociation, blurred vision, dizziness, and diplopia, while ECT led to a significant rise in muscle pain (all Ps < 0.05). Discontinuation rates due to any cause were comparable between both groups (P > 0.05). IV ketamine demonstrates a faster onset of antidepressant effects compared to ECT, despite both treatments yielding comparable outcomes at the end-of-treatment visit for patients with MDD or BD. However, large-scale RCTs are required to thoroughly evaluate the long-term efficacy and safety of IV ketamine relative to ECT in these populations. • IV ketamine has been evaluated alongside ECT in addressing MDD or BD, though the comparative outcomes remain inconclusive. • IV ketamine demonstrates a faster onset of antidepressant effects compared to ECT. • No notable differences were found for depressive symptom improvement, response or remission at the end-of-treatment visit. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence increases the risk of detrimental health, behaviors and psychological issues in mothers, affecting infant nutrition and development. However, the potential effects of maternal exposure to intimate partner violence on breastfeeding practices are understudied, and the results of individual studies are inconsistent and conflicting. The aims of this systematic review and meta-analysis are therefore to 1) estimate the prevalence of perinatal intimate partner violence and, 2) examine the relationship between perinatal intimate partner violence and breastfeeding outcomes. Methods and analysis: This systematic review and meta-analysis will investigate the association between perinatal intimate partner violence and breastfeeding outcomes, including early initiation within 1 hour after giving birth, exclusive breastfeeding under six months, and continued breastfeeding at two years or beyond. Comprehensive searches will be conducted in PsycInfo, Scopus, Web of Science, Medline, Cochrane, JBI EBP, CINAHL, Informit, and PubMed electronic databases. Data extraction will be performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analysis will be conducted using STATA/SE version 17, employing random-effects models to calculate pooled effect sizes and assess heterogeneity with I2 and Chi-square tests. Subgroup analyses and meta-regression will explore potential sources of heterogeneity. Discussion and conclusion: Evidence suggests that intimate partner violence is linked to poor breastfeeding outcomes. This systematic review and meta-analysis will update, compile, and critically review the evidence of the role of intimate partner violence on breastfeeding outcomes. This systematic review and meta-analysis will also inform effective strategies and interventions to support breastfeeding among IPV-affected women, thereby enhancing maternal and child health. Ethics and dissemination: As this review and meta-analysis involves secondary analysis of existing data, ethical approval is not required. Findings will be disseminated through peer-reviewed publications and scientific conferences, aiming to inform strategies to support breastfeeding among women affected by intimate partner violence. Study registration: This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42024555048. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease is a major public health concern among people living with human immunodeficiency virus (PLWHIV) who are taking tenofovir disoproxil fumarate-based regimen. Despite the available evidence showing a high prevalence of CKD in this population, comprehensive pooled estimate of CKD among PLWHIV receiving TDF based regimen across the globe is lacking. Hence, the present systematic review aimed to provide a global pooled prevalence estimate of CKD. Method: We conducted a systematic review of literatures published between January 2000 and May 2024. Articles and grey literature were searched from the following databases and search engine: PubMed, EMBASE, Scopus, Web of science, The Cumulative Index to Nursing and Allied Health Literature (CINHAL), and Google Scholar. We included eligible studies that report magnitude of CKD in TDF based regimen. We executed the pooled CKD, subgroup analysis, and funnel plot using random effect model. All statistical analysis including sensitivity analysis were made using Stata 17 software. Results: Sixty-nine studies with 88299 participants included in this meta-analysis. The pooled prevalence of CKD was 7% (95% CI:6–8). CD4 count less than 200 copies per milliliter, and being female were associated with CKD. Conclusion: We concluded that the magnitude of CKD across the globe is high in people living with HIV who have received TDF based regimen. Early identification of CKD by considering regular renal function monitoring, and risk factors especially low CD4 count, and female gender at birth are essential. Trial registration: The protocol has been prospectively registered with PROSPERO ((CRD42020136813). [ABSTRACT FROM AUTHOR]

Background: Cardiac autonomic neuropathy (CAN) is an underdiagnosed complication of type 2 diabetes mellitus (T2DM) and is associated with cardiovascular morbidity and mortality. Cardiac autonomic reflex tests (CARTs) are the gold standard; they are non-invasive and clinically feasible for screening CAN. The objective of the present meta-analysis was to examine exercise's effect on cardiac autonomic function using CARTs in T2DM. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis Checklist (PRISMA) was used. Electronic databases were systematically used to retrieve relevant studies after title and abstract screening. Studies utilizing exercise training with cardiac autonomic function (CARTs) outcomes in individuals with type 2 diabetes mellitus were included. The meta-analysis was conducted using RevMan 5.4.1, using the random effects model, and appropriate tests for heterogeneity. The Cohrane ROB-2 tool was used for randomized controlled trials (RCTs) and the ROBINS-I tool for non-RCT for risk of bias assessment were used. Results: Three studies were included (two for meta-analysis), considering the outcome of the E:I ratio, 30:15 ratio, and Valsalva ratio. The studies did not show any influence on the E:I and 30:15 ratio in the pooled analysis with a low risk of ineffectiveness for the exercise intervention. Exercise training significantly affected the Valsalva ratio. A different type of exercise intervention was utilized in all three studies. There was a low to moderate certainty for the evidence. Conclusion: The results indicate that further robust and high-quality randomized controlled trials utilizing cardiac autonomic reflex tests (which have clinical and physiological relevance) in type 2 diabetes mellitus are required for drawing conclusions. Systematic review registration: PROSPERO CRD42023445561. [ABSTRACT FROM AUTHOR]

Background: HIV is remaining the public health issues with an estimated of 39 million peoples are living with the virus till 2022. HIV positive pregnant women are at a greater risk of adverse birth outcomes including low birth weight (LBW), preterm delivery and perinatal mortality. Thus, this systematic review aimed to examine the pooled effect of maternal HIV infection on birth outcomes in Sub Saharan Africa. Method: A systematic literature searches were done from PubMed, Hinari, Google scholar and online research repositories. All observational studies (January/2012 to January 01/2024) reporting the effects of maternal HIV on birth outcomes among HIV positive women in Sub Saharan Africa were included. Heterogeneity between studies was assessed using I2 stastics. Publication bias was also assessed using Egger's test with 5% significance level. Finally, the random effects analysis model was used to estimate the pooled effect size. Result: A total of 19 articles met inclusion criteria and included in this systematic review. About 104,840 mothers were involved in this analysis. Maternal HIV infection had significant effects for giving low birth weight babies 9.68, 95%CI (6.72, 12.64), and preterm delivery 1.72; 95% CI: (1.49, 1.95) among HIV positive women in Sub Saharan Africa. Furthermore, the pooled estimate exhibited that maternal HIV had no risk for perinatal mortality among women living with HIV as compared to HIV negative women. Conclusion: Women living with HIV are at greater risk for giving low birth weight babies, preterm delivery than HIV negative women. We recommend that Health care providers and other stakeholders should focus on maternal HIV screening and providing special care to protect them from adverse birth outcomes during antenatal period. [ABSTRACT FROM AUTHOR]

Background: Glioma is a brain tumor and glioblastoma represents its most common type, accounting for almost 40% of primary tumors of the central nervous system, and is associated with the worst prognosis. Glioblastoma remains one of the major challenges in neurooncology. Recently, the Food and Drug Administration (FDA) has approved tumor treating fields (TTF) for the treatment of glioblastoma. In this analysis, we aimed to systematically assess the adverse outcomes associated with TTF when combined to temozolamide versus temozolamide alone for the treatment of glioblastoma. Methods: MEDLINE (subset PubMed), EMBASE, Web of Science, Cochrane databases, Google scholar, and http://www.ClinicalTrials.gov were searched for publications comparing TTF in combination with temozolomide versus temozolomide alone for the treatment of glioblastoma. The adverse outcomes were considered as the endpoints in this analysis. The statistical analysis was carried out by the latest version of the RevMan software (version 5.4). Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data following assessment. A random effect model was used during the statistical analysis. Results: A total number of 994 participants were included in this analysis whereby 572 participants were assigned to TTF + temozolomide, whereas 422 participants were assigned to temozolomide alone. All the studies were randomized trials. The majority of the participants were males (68.0–75.0%) with a mean age of the varying from 54.0 to 69.0 years. Results of this analysis showed that TTF in combination with temozolomide was not associated with significantly higher adverse outcomes related to blood and lymphatic system disorders (RR:0.87, 95% CI 0.30–2.48; P = 0.79), gastrointestinal disorders (RR: 0.83, 95% CI 0.14–4.72; P = 0.83), general deterioration and malaise (RR: 1.43, 95% CI 0.90–2.25; P = 0.13), infections and infestations (RR: 1.21, 95% CI 0.33–4.45; P = 0.78), injury/poison and procedural complications (RR: 1.78, 95% CI 0.88–3.61; P = 0.11), metabolic and nutritional disorders (RR: 0.61, 95% CI 0.34–1.08; P = 0.09), central nervous system disorders (RR: 1.14, 95% CI 0.89–1.46; P = 0.31), musculoskeletal and connective tissue disorders (RR: 0.99, 95% CI 0.48–2.07; P = 0.99), respiratory/thoracic/mediastinal disorders (RR: 0.85, 95% CI 0.44–1.62; P = 0.62), and psychiatric disorders (RR: 1.27, 95% CI 0.42–3.79; P = 0.67). Similar adverse effects were observed. Conclusion: TTF in combination with temozolomide was not associated with significantly worse adverse outcomes for the treatment of patients with glioblastoma. Hence, future trials should focus on the cost-effectiveness of TTF for the treatment of glioblastoma. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies have led to conflicting results regarding the effect of walnut consumption on glycemic control, and anthropometric indices. This study aimed to evaluate the efficacy of walnut consumption on serum levels of fasting blood sugar (FBS), fasting insulin, hemoglobin A1C (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), weight and body mass index (BMI) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: PubMed, Scopus, Web of Science, and the Cochrane databases were searched up to February 2023. Weighted mean difference (WMD) was analyzed using random effects models to assess the overall effect. Results: A total of thirty-two RCTs were included in the systematic review and meta-analysis. Walnut supplementation was found to significantly reduce HOMA-IR (WMD = -0.29; 95% CI: -0.57, -0.01, P = 0.04), and body weight (WMD = -0.14 kg; 95% CI: -0.24, -0.04; P = 0.008). However, the meta-analysis showed that walnut supplementation did not have a significant effect on FBS (WMD = 0.62 mg/dL; 95% CI: -0.66, 1.91; P = 0.34), insulin levels (WMD = 1.27 mIU/ml; 95% CI: -0.59, 3.14; P = 0.18), HbA1C (WMD = 0.00%; 95% CI: -0.09, 0.10; P = 0.95), and BMI (WMD = -0.10 kg/m2; 95% CI: -0.40, 0.20; P = 0.50). Conclusion: In conclusion, this study found a significant reduction in HOMA-IR levels and body weight with walnut supplementation, while other glycemic markers, and obesity-related indices did not change significantly. Future well-designed trials are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Improving dietary intake during pregnancy can mitigate adverse consequences for women and their children. The effective techniques and features for supporting and sustaining dietary change during pregnancy and postpartum are minimally reported. The primary aims of this systematic review and meta-analysis were to summarise the effectiveness of dietary interventions for pregnant woman, identify which behaviour change techniques (BCTs) and intervention features were most frequently used and determine which were most effective at improving dietary intake. Six databases were searched to identify randomised control trials (RCTs) reporting on dietary intake in pregnant women over the age of sixteen, with an active intervention group compared to a control group receiving usual care or less intensive interventions. The Cochrane Risk of Bias Tool 1 was used to assess study validity. BCTs were coded by two authors using Michie et al.'s BCT taxonomy V1. A random effect model assessed intervention effects on indices of dietary quality and food groups (fruit, vegetables, grains and cereals, meat, and dairy) in relation to the use of BCTs and intervention features. Thirty- seven RCTs met the inclusion criteria. High heterogeneity was observed across intervention characteristics and measures of fidelity. Only half of the available BCTs were used, with eleven used once. The BCT category Reward and threat was successful in improving dietary quality and vegetable intake, whilst 'Action planning' (1.4) from the category Goals and planning significantly improved dietary quality. Interventions delivered by a nutrition professional and those that included group sessions improved dietary quality more than those delivered by other health professionals, research staff, or application-delivered interventions and delivered via other modalities. Future dietary interventions during pregnancy should incorporate and report on BCTs used in the intervention. Successful design elements for improving antenatal dietary intake may include multimodal interventions delivered by nutrition professionals and the use of Rewards and Goal setting. Key messages: Defining the behaviour change techniques (BCTs) used within interventions allows them to be replicated, for the links between BCTs and mechanisms of action to be identified and for efficient intervention design. Interventions delivered by a nutrition professional and those that include group sessions were significantly more effective at improving dietary quality compared with other health professionals (i.e., midwives, nurses, gynaecologists), research staff, and application-delivered interventions and via other modalities. Reward was the most comparatively promising BCT category for improving dietary quality and vegetable intake, whilst the individual BCT 'Action planning' (1.4) from the category Goals and planning was the most comparatively promising for improving dietary quality. [ABSTRACT FROM AUTHOR]

Introduction: Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare providers in making informed decisions. This systematic review and meta-analysis aimed to determine the overall viral load suppression rate of third line antiretroviral therapy in Africa and to clarify the contradictory relationship between gender and viral load suppression, based on existing primary studies. Methods: A systematic review and meta-analysis were conducted using PubMed, Medline, Cochrane Library, Henari, African Journals Online (AJOL), Web of science, and Google Scholar to access studies up to December 6, 2024. The PRISMA guideline, JBI, and Newcastle Ottawa quality assessment scale checklists were used. Heterogeneity was evaluated with Cochrane's Q and I2 statistics. Publication bias was checked using a funnel plot, Begg's and Egger's test, followed by the DerSimonian and Laird random effects model. Meta-regression, subgroup and sensitivity analyses were also performed. The odds ratio with a 95% confidence interval was used to assess the association of gender with the viral load suppression rate in patients on third-line antiretroviral therapy. All analyses were conducted using Stata 18. Results: A total of 14 primary studies with a total sample size of 1791 were included. The pooled magnitude of the viral load suppression rate was 79.82% (95%CI: 75.75%, 83.90%). Around 75% of the included studies' heterogeneity were explained by country, study year, study settings and quality level of the study level variables. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Conclusion and recommendation: The pooled magnitude of the viral load suppression rate was 79.82%. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Therefore, to maintain and further improve the strong viral load suppression rates of TLARVT in Africa, it is essential to focus on appropriate regimen selection, patient counseling and switching, adherence support, and regular viral load testing. Future studies with larger sample sizes should explore the association between gender and viral load suppression to provide conclusive findings. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a major public health problem that continues to cause death in under-five children nearly every minute. The purpose of this systematic review and meta-analysis was to determine the pooled prevalence and predictors of asymptomatic malaria in children in Sub-Saharan Africa. Methods: Relevant studies were retrieved from Web of Science, Cochrane Library, PubMed, Google Scholar, Gray Literature, Embase, and African Online Journal databases published between 2014 and 2024. Data quality was assessed by a tool developed by Hoy and colleagues and classified as low, moderate, or high risk of bias. We performed a random effects model and sub-group analysis by age group, region, and diagnostic methods. The protocol was registered in the PROSPERO (CRD42024584354). Results: A total of 24 cross-sectional studies with 19,169 participants from 10 Sub-Saharan Africa countries were included in the analyses under the age of 15 years. The overall prevalence of asymptomatic malaria was 25% (95% CI: 20–30%) and showed no evidence of publication bias. Utilization of insecticide-treated nets was significantly associated with asymptomatic malaria. In addition, the overall prevalence of anemia in asymptomatic Plasmodium-infected children under the age of 15 was found to be 35% (95% CI: 24–46%). Subgroup analysis showed significant regional and diagnostic tool differences in asymptomatic Plasmodium infection. Conclusion: The findings of this study revealed a high prevalence of asymptomatic plasmodium infection in children with significant regional variations. There was a significant association with anemia and the utilization of insecticide-treated nets. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dengue fever (DF), a mosquito-borne viral disease, is rising worldwide. Its severe manifestations like thrombocytopenia and plasma leakage are associated with increased mortality. Ultrasound-detected gallbladder wall thickening (GBWT) has been suggested as a potential indicator of the severity of the disease. Aims: This systematic review and meta-analysis evaluated the predictive value of GBWT in identifying patients at risk for severe dengue. Methods: Following the PRISMA 2020 guidelines, we conducted a systematic search of Web of Science, PubMed, Embase, and Scopus. Among the inclusion criteria were original studies that assessed GBWT across various dengue severity categories. Then, we performed a meta-analysis using a random effects model and subgroup analyses based on severity criteria to determine the relationship between GBWT and severe dengue. Results: For the meta-analysis, 19 studies qualified for the inclusion criteria. There was a significant association between GBWT and severe dengue, according to the odds ratio (OR) of 2.35 (95% CI 1.88–2.82, p < 0.001). The subgroup analysis revealed consistent results for thrombocytopenia (OR: 2.65) and plasma leakage (OR: 2.26), among other severity criteria. Conclusions: A reliable ultrasound indicator, GBWT can help identify patients at risk for severe dengue early on, improving clinical decision-making and patient outcomes. However, the possibility of differential diagnosis requires cautious interpretation. [ABSTRACT FROM AUTHOR]

Introduction: Adnexal masses are a common health issue in gynecology; the challenge lies in the differential diagnosis of these masses. The International Ovarian Tumor Analysis Simple Rules (IOTA-SR) offers the first scoring system to aid in diagnosis. It is based on a set of five ultrasound imaging features indicative of a malignant ovarian tumor and five features indicative of a benign tumor. This review aims to assess the diagnostic performance of IOTA-SR for classifying ovarian tumors as benign or malignant. Methods: A systematic review was conducted on MEDLINE, Embase, Google Scholar, Scopus, and Web of Science. The terminologies "IOTA-SR", "adnexal, mass", and "ovarian tumors scoring" were employed. Twenty-seven research articles conducted from 2008 to 2022 were included in the meta-analysis; the publication outcome indicates that performance quality tests were extracted directly or indirectly, including true positive (TP), false positive (FP), true negative (TN), and false negative (FN). The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to evaluate the study quality and estimate the risk of bias. After estimating the pooled effect of the sensitivity, specificity, and diagnostic odds ratio (DOR), the summary receiver operating characteristic (SROC) curve was estimated using the bivariate random effects model. Utilizing Cochran's Q statistics and Higgins's inconsistency test through the I2 index for pooled analysis, the heterogeneity of studies was quantitatively evaluated. The funnel plot and Egger's test were utilized to visually and quantitatively evaluate potential publication bias. Results: Among 27 studies, including 7,841 adnexal masses, the results of this meta-analysis showed excellent diagnostic performance with a pooled sensitivity of 92% [95% confidence interval (CI), 0.89–0.94] and a pooled specificity of 92% (95% CI, 0.89–0.94). The IOTA-SR was applicable in 85.7% of adnexal masses. Conclusion: The IOTA-SR is highly effective in the presurgical differentiation of malignant versus benign adnexal masses when applied by an expert ultrasonography operator. [ABSTRACT FROM AUTHOR]

Background: Even though maternal nutrition has improved, food taboos and poor dietary practices during pregnancy can still lead to nutrient deficiencies, increasing the risk of complications for both mothers and children. Therefore, this study aimed to generate pooled evidence from across different countries in Sub-Saharan Africa to inform effective prevention actions. This meta-analysis aims to determine the pooled prevalence of food taboo practices and identify associated factors among pregnant women in Sub-Saharan Africa. Methods: This study systematically reviewed relevant articles and reports from databases including Embase, MEDLINE, Science Direct, PubMed, Google, and Google Scholar. The Newcastle–Ottawa Scale assessed article quality. Data extraction and analysis were done using Excel and STATA 17, respectively. Heterogeneity was assessed using Cochran's Q test and the I2 statistic, with a random effects model employed for meta-analysis. Publication bias was evaluated and addressed using Duval and Tweedie's Trim and Fill analysis. Results: A total of fifty-eight studies with 20,262 pregnant women were included in this meta-analysis. The pooled proportion of food taboo practices reported by the 58 studies was 41% (95% CI: 34, 48%). In the subgroup analysis, the pooled proportion of food taboo practices for studies conducted in urban areas was 40% (95% CI: 32, 48%), while it was 43% (95% CI: 32, 56%) among rural residents. Factors associated with food taboo practices among pregnant women included being unable to read and write (AOR = 2.64%; 95% CI: 1.79–3.90; I2 = 56.9%), not receiving antenatal care follow-up (AOR = 3.73%; 95% CI: 2.83–3.90; I2 = 55.1%), and poor maternal nutrition knowledge (AOR = 3.33%; 95% CI: 1.56–7.09; I2 = 84.3%). Conclusion: According to this review, over two out of every five pregnant mothers practiced food taboos in the region. The educational status of the mother, antenatal care follow-up, and maternal nutrition knowledge were factors affecting food taboo practices among pregnant women. Therefore, emphasis should be given to the uptake of antenatal care follow-up to improve maternal nutrition knowledge and nutritional status. [ABSTRACT FROM AUTHOR]

Introduction: Malaria is a climate-dependent disease influenced by gender, social determination, seasonal patterns, and relapse incidence This study reviews these characteristics of malaria in the Sistan and Baluchistan (S&B) province and another province of Iran. Methods: This systematic review and meta-analysis was conducted through systematic and manual searches in electronic databases such as PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and the Scientific Information Database. Studies from the S&B province, published from 1990 to 2024, written in Farsi and English, and reporting incidence, relapse, or death were included in this study. The quality of the studies was evaluated using the Newcastle–Ottawa Scale. Results: Out of 1941 studies initially identified, 43 were included in the systematic review, with 12 studies on relapse and 43 on incidence included in the meta-analysis. The combined results of the 43 primary studies using the random effect model showed that the frequency of malaria among infected women is 32% in S&B, 22% in other parts of Iran and 24% in the whole of Iran. This is 68%, 77% and 75% in men respectively. Among the primary studies, 8 deaths were reported in two studies, all of which were men. The incidence rate of malaria relapse varied from 0.30% to 46%. Based on the random effect model, the malaria relapse rate in Iran was estimated at 9%. The highest incidence of malaria in Iran was between spring and summer, and the lowest incidence was winter and spring. Most studies showed a downward trend in malaria incidence of malaria between 1986 to 2019. In term of socio-demographic status, malaria was more common in rural areas (82%). Although 28% were employed, and in term of age, young and old individuals (15 to 50 years) had the highest rate of infection. Conclusion: This systematic review and meta-analysis revealed a lower incidence of malaria in women compared to men. The findings highlight the need for health care and the importance of targeted malaria control interventions, especially for men, rural areas, hot weather conditions, and young to middle-aged age groups, particularly in the S&B province. [ABSTRACT FROM AUTHOR]

In Bayesian analysis, the selection of a prior distribution is typically done by considering each parameter in the model. While this can be convenient, in many scenarios it may be desirable to place a prior on a summary measure of the model instead. In this work, we propose a prior on the model fit, as measured by a Bayesian coefficient of determination ( R 2) , which then induces a prior on the individual parameters. We achieve this by placing a beta prior on R2 and then deriving the induced prior on the global variance parameter for generalized linear mixed models. We derive closed-form expressions in many scenarios and present several approximation strategies when an analytic form is not possible and/or to allow for easier computation. In these situations, we suggest approximating the prior by using a generalized beta prime distribution and provide a simple default prior construction scheme. This approach is quite flexible and can be easily implemented in standard Bayesian software. Lastly, we demonstrate the performance of the method on simulated and real-world data, where the method particularly shines in high-dimensional settings, as well as modeling random effects. [ABSTRACT FROM AUTHOR]

The classical meta-analytical random effects model (REM) has some weaknesses when applied to the standardized mean difference, g. Essentially, the variance of the studies involved is taken as the conditional variance, given a δ value, instead of the unconditional variance. As a consequence, the estimators of the variances involve a dependency between the g values and their variances that distorts the estimates. The classical REM is expressed as a linear model and the variance of g is obtained through a framework of components of variance. Although the weaknesses of the REM are negligible in practical terms in a wide range of realistic scenarios, all together, they make up an approximate, simplified version of the meta-analytical random effects model. We present an alternative formulation, as a mixture model, and provide formulas for the expected value, variance and skewness of the marginal distribution of g. A Monte Carlo simulation supports the accuracy of the formulas. Then, unbiased estimators of both the mean and the variance of the true effects are proposed, and assessed through Monte Carlo simulations. The advantages of the mixture model formulation over the “classical” formulation are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Recent trials have found that propolis supplementation can beneficially reduce blood pressure (BP) in adults, but there is no definitive consensus on this topic. The purpose of this study is to provide an overview and update the current documents regarding the effects of propolis supplementation on BP by presenting a systematic review and meta-analysis. Design/methodology/approach: The systematic search was conducted, considering all studies published up to July 2024, in the following databases: PubMed, Scopus, Cochrane Library and ISI Web of Science. Data were pooled by using the random-effects model, and weighted mean difference (WMD) was considered as the summary effect size. Findings: In this systematic review and meta-analysis, eight clinical trials were included. The obtained results show that propolis supplementation caused a significant decrease in systolic BP (WMD = −3.93 mmHg, 95% CI = −7.05 to −0.82, p = 0.01 and I2 = 45.2%). However, the meta-analysis results showed that propolis supplementation did not significantly change the levels of diastolic BP (WMD = −1.64 mmHg, 95% CI = −4.60 to 1.32, p = 0.27 and I2 = 74.0%). Originality/value: The findings of this study suggest that propolis supplementation may be used as a dietary supplement to improve systolic BP, but further studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

In many biomedical studies multiple responses are collected over time, which results in highdimensional longitudinal data. It is often of interest to model the continuous and binary responses jointly, which can be done with joint generalized mixed models in which the association is modelled through random effects. Investigating the association between the responses is often limited to scrutinizing the correlations between the latent random effects. In this article, this approach is extended by deriving closed-form formulas for the manifest correlations (and corresponding standard errors), which reflects the correlation between the observed responses as observed. In addition, the marginal joint model is constructed, from which predictions of subvectors of one response conditional on subvectors of other response(s) and potentially a subvector of the history of the response can be derived. Corresponding prediction and confidence intervals are constructed. Two case studies are discussed, in which further pseudo-likelihood methodology is applied to reduce the computational complexity. [ABSTRACT FROM AUTHOR]

The occurrence of PTSD, depression, and anxiety is notably high among older adults following an earthquake. This research aimed to assess the prevalence and determinants of mental health conditions among older survivors after an earthquake. The review was conducted in accordance with the PRISMA process. A comprehensive search was conducted across various databases including PubMed, EMBASE, Web of Science, Scopus, CINAHL, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals, and the Wan Fang Database for Chinese Periodicals for studies reporting on the prevalence of PTSD, depression, and anxiety among older survivors post-earthquake. Each database was searched from inception to August 1, 2023 each database, and updated the search on October 1, 2024. The random effects model was employed to conduct meta-analysis, and the I 2 index was taken into account to evaluate heterogeneity among studies. A narrative synthesis was performed to identify the risk factors associated with these mental health conditions. A total of 33 studies were analyzed in this meta-analysis, mainly from China, Japan, Nepal, and Mexico. The prevalence rates of PTSD, depression, and anxiety among older earthquake survivors were found to be 19.3 % (95 % CI [16.0–22.6 %]; I 2 = 99.486 %, P = 0.000), 23.5 % (95 % CI [13.9–33.1 %]; I 2 = 99.901 %, P = 0.000) and 10.9 % (95 % CI [6.7–15.1 %]; I 2 = 99.287 %, P = 0.000), respectively. The identified major risk factors were categorized into four dimensions, including demographic variables (e.g., older age, chronic illness), pre-disaster mitigation variables (e.g., lack of insurance), responding in disaster variables (e.g., being injured, property damage) and post-disaster relief variables (e.g., inadequate psychological care, low levels of social/family support). The optimal cut-off for different screening tools may be sensitive to changes in the prevalence of older survivors post-earthquake. Furthermore, due to the heterogeneity of the studies, a narrative synthesis of risk factors was conducted. The findings of this review may increase the awareness of the burden and risk factors associated with PTSD, depression, and anxiety in older survivors post-earthquake. It serves as a reference for the government in formulating recovery policies focusing on interventions, such as financial allocation, psychological treatment, and insurance claims. These policies aim to mitigate the long-term psychological effects on older survivors and ultimately lower the prevalence of mental health conditions. • This review illustrated multiple risk factors for PTSD, depression and anxiety among older survivors post-earthquake. • The prevalence of PTSD, depression and anxiety among older adults post-earthquake was 19.3%, 23.5% and 10.9%, respectively. • The existence of chronic illnesses is a unique risk factor for PTSD, depression, and anxiety in older adults post-earthquake. [ABSTRACT FROM AUTHOR]

Preterm birth (PB) is prevalent and associated with structural and functional brain alterations which may affect cognitive and behavioural outcomes, including social development. Facial emotion recognition (FER) is one of the main components of social interaction. PB individuals face distinct FER challenges that may impact social skills. Furthermore, both FER and social skills have shown distinctive developmental trajectories in PB individuals compared to term born controls. This study investigates the association between FER and social skills in PB individuals compared to term-born controls. To systematically review and meta-analyse relevant literature on the association between FER and social skills and to summarize the reported differences in FER and social skills between PB individuals and term-born controls of similar age. a systematic search of peer-reviewed and English written studies was performed in MEDLINE, Web of Science and CINAHL, with an additional forward and backward citation search. Eligible studies included any observational study that had a term-born control sample of similar age with reported FER and social skills measures and/or correlations between them. Quality assessment and data extraction was carried out. Correlation coefficients and Hedges' g for FER and social skills were calculated as effect size indexes. Random effects model and subgroup analysis considering gestational age and age at assessment was performed. Results were summarized using forest plots. I2 statistics and Cochran's Q were used to test for heterogeneity. 8 studies were included (PB = 410, controls =337). Only 3 studies explored the correlation between FER and social skills. The review found a higher correlation between FER and social skills in the PB group (Z = 0.18, CI = −0.03, 0.39) compared to controls (Z = 0.11, CI = −0.03, 0.25). FER was significantly lower in PB individuals (overall g = −1.48; 95%IC = −2.46, −0-5), particularly in very preterm and adolescent subgroups. FER might play a crucial role in the social development of PB individuals compared to those born at term, but existing research in this domain remains limited. • Preterm birth (PB) affects approximately 10.4% of live births and is linked to neurodevelopmental vulnerabilities. • PB individuals exhibit distinct facial emotion recognition (FER) patterns impacting social development. • This meta-analysis finds lower FER and social skills in PB individuals compared to term-born controls. • A stronger correlation between FER and social skills is noted in PB individuals compared to controls. • Early FER screening and interventions are crucial for improving PB individuals social development. [ABSTRACT FROM AUTHOR]

The meta-analysis examined the association between GLP-1 receptor agonists and the risk of ischemic optic neuropathy in patients with obesity and/or type 2 diabetes. While some observational studies suggested a potential link, the meta-analysis of randomized controlled trials did not find a significant detrimental effect of GLP-1 RA therapy on optic neuropathy. The estimated incidence of optic ischemic neuropathy was higher in the GLP-1 RA arm compared to the placebo arm, but the difference was not statistically significant. Further research is needed to fully understand the safety profile of GLP-1 RA, especially in patients at higher risk for optic neuropathy. [Extracted from the article]

Background: Intestinal parasitic infections are a significant public health concern, especially among food handlers, who can transmit these infections to the public through food preparation and handling. This systematic review and meta-analysis aimed to determine the pooled prevalence and associated factors of intestinal parasitic infections among food handlers in the East African region. Methods: A systematic review and meta-analysis on intestinal parasitic infections among food handlers involved a comprehensive search across various databases, including Scopus, PubMed, ScienceDirect, Google Scholar, and the institution's library registers. Forty relevant articles were identified and analyzed using STATA Software version 17.0. Sensitivity analysis, publication bias assessment with Egger's test, and the Trim-and-fill meta-analysis for bias adjustment were conducted. Heterogeneity across the studies was assessed using Cochran's Q statistic and I2 statistics, and subgroup analysis computed for significant heterogeneity (I2 value ≥ 50%). A random effect model was used to determine the pooled prevalence of intestinal parasitic infections. Results: The pooled prevalence of intestinal parasitic infections among food handlers was 32.27% (95% CI 27.90–36.65). The most prevalent parasites were Entamoeba histolytica/dispar 20.83% (95% CI 13.66–28%), Ascaris lumbricoides 13.84% (95% CI 10–17.68%), Giardia lamblia 8.55% (95% CI 6.03–11.06%), and hookworm 6.43% (95% CI 3.93–8.93%). Using a common knife for cutting raw meat (AOR = 2.27, 95% CI 1.21–4.31), food handler's untrimmed fingernails (AOR = 2.14, 95% CI 1.50–2.78), and no hand washing practices with soap after using the toilet (AOR = 2.25, 95% CI 1.33–3.18) were associated with higher rates of intestinal parasitic infections among food handlers. Conclusions: Parasitic infections among food handlers were found to be significantly prevalent. Factors contributing to this high prevalence included food handlers' untrimmed fingernails, poor hand hygiene practices, and using a shared knife for chopping various food items, including raw meat. These findings emphasize the need for proper personal hygiene and sanitation practices among food handlers to prevent transmitting parasitic infections to consumers. [ABSTRACT FROM AUTHOR]

This research aims to conclude the influence of eBooks in the learning process throughout the world. The meta-analysis design taken was a group contrast between control and experimental groups with a random effect size model. The criteria used are time "data published 2018-2023," published in English, type of publication is a quantitative research article, the research design is a difference between control and experimental groups, containing complete data "mean, sample size, and standard deviation," and recorded in the Scopus database. Data collection was guided by the PRISMA method. The results of the analysis showed that the data were heterogeneous and free from publication bias. The results of the analysis showed that there was a large "positive" effect as indicated by a p-value <0.001<5% "95% confidence interval" and a total effect size=0.86 [0.61; 1.11]. It can be concluded based on the latest findings that eBooks have an equally good effect on all conditions which are influenced by the type of competency developed, the eBook information base, the type of eBook, and class size. [ABSTRACT FROM AUTHOR]

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) is a public health problem and may result in co-infection with other pathogens such as influenza virus. This review investigates the co-infection of SARS-CoV-2 and influenza A/B among patients with COVID-19. Methods: This meta- analysis included 38 primary studies investigating co-infection of SARS-CoV-2 with influenza in confirmed cases of COVID-19. The global online databases were used to identify relevant studies published between December 2019 and July 2024. Data analysis was performed using STATA Ver. 17 software, and standard errors of prevalence were calculated using the binomial distribution formula. Heterogeneity of study results was evaluated using the I-square and Q index, and publication bias was examined using the Begg's and Egger's tests, as well as funnel plot. A random effects model was used to determine prevalence rates, and a forest plot diagram was used to present results with 95% confidence intervals. In addition, sensitivity analyses were performed to check the impact of each primary study on the overall estimate. Result: The analysis found that the prevalence of influenza in co-infected patients at 95% confidence interval using a random effect model was 14% (95% CI: 8–20%). Significant heterogeneity was observed in the random-effects model for influenza A, 11% (95% CI: 5-18%) and B, 4% (95% CI: 2-7%) in co-infected patients. The highest prevalence of influenza A/B (21%), influenza A (17%) and influenza B (20%) was shown in Asia and Europe respectively. Subgroup analysis by study year showed that the co-prevalence of COVID-19 and influenza A/B was similar in the pre-2021 and post-2021 time periods, at 14% (95% CI: 5-23%) for pre-2021 and 6-22% for 2021 and post-2021. Also, the overall prevalence of influenza A and B in COVID-19 patients is 11% and 4%, and there was no significant difference between the time periods before and after 2021. Meta-regression with a random-effects model showed that the variables location, year group, and total patients showed only 2.71% of very high heterogeneity (I² = 99.92%), and none of these variables had a significant effect on the co-prevalence of COVID-19 and influenza A/B (p > 0.05). Also, meta-regression results showed that these variables had no significant effect on influenza A and B prevalence (p > 0.05) and showed only a small proportion of the very high heterogeneity (I² = 99.72%), (I² = 68.78%). In our study, Egger's test indicated that there was publication bias or small study effects in this meta-analysis (p = 0.0000). Conclusion: The combination of SARS-CoV-2 with influenza and other respiratory viruses requires the best treatment protocols to reduce the severity of the disease. In this approach, high vaccination coverage against seasonal influenza and SARS-CoV-2 could reduce the risk of co-infection in the recent pandemic. [ABSTRACT FROM AUTHOR]

Background: Vision impairment is a common disability that poses significant challenges to individuals' ability to perform activities essential for independent living, including activities of daily living (ADL) and instrumental activities of daily living (IADL). Despite extensive research, the extent and nature of these associations remain unclear, particularly across varying levels and types of vision impairment. Objectives: This meta‐analysis aims to estimate associations between vision impairment and difficulties with ADL and IADL. Methods: We conducted a systematic review of relevant literature from the inception of the databases to February 2024, using electronic database searches, including PubMed, MEDLINE (Ovid), EMBASE, Cochrane CENTRAL, and CDSR. The articles were screened for title and abstract and then for the full-text reports by two independent reviewers and study quality was appraised. Meta‐analyses were performed using random effects models to calculate the pooled effect size, expressed as odds ratio (OR) with corresponding 95% confidence interval (CI) of each outcome. Results: Forty-six studies involving 210,960 participants were included. A positive large correlation between vision impairment and difficulties with ADL (Correlation coefficient [r] = 0.55, 95% CI 0.37–0.68, p = 0.001) and IADL (r = 0.60, 95% CI 0.49–0.69, p = 0.001) was shown. We also found that vision impairment was associated with difficulties in ADL (OR = 1.77, 95% CI 1.56–2.01, p < 0.0001) and IADL (OR = 1.96, 95% CI 1.68–2.30, p < 0.0001). Subgroup analysis revealed that moderate to severe impairment resulted in difficulties in ADL (OR = 1.78, 95% CI 1.43–2.21, p = 0.02) and IADL (OR = 1.86, 95% CI 1.57–2.20, p = 0.0003). Further, there was a significant association between mild to moderate vision impairment and difficulties in IADL (OR = 1.38, 95% CI 1.23–1.55, p < 0.0001). Greater impact was observed in individuals with near vision impairment compared to those with distance vision impairment. Near vision impairment was significantly associated with higher difficulties in ADL (OR = 1.77, 95% CI 1.57–2.01, p < 0.0001) and IADL (OR = 1.79, 95% CI 1.32–2.42, p < 0.0001). In contrast, distance vision impairment showed lower but still significant associations with IADL (OR = 1.19, 95% CI 1.05–1.34, p = 0.005) and a nonsignificant association with ADL (OR = 1.12, 95% CI 0.90–1.40, p = 0.30). Meta-regression analysis indicated that for every one-year increase in age, ADL performance decreased by an average of 0.0147 units (p < 0.001), while IADL performance declined at a slower rate of 0.0047 units/year (p = 0.031). Conclusion: The present systematic review and meta-analysis using several statistical methods indicates that vision impairment including near vision impairment, is associated with difficulties in ADL and IADL. Thus, vision impairment remains an urgent and increasingly important public health priority. These findings highlight the need for targeted measures to raise public health awareness to provide rehabilitation and eye care examination strategies to reduce the risk of developing disabilities in adults and the elderly who have vision impairment. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM) is one of the most significant public health problems. Globally, one in ten adults has diabetes, and it results in macro- or microvascular complications, such as diabetic retinopathy (DR). It is one of the most prevalent eye complications associated with DM, and it is the main cause of vision loss. Even though East African countries face a growing burden of diabetes and DR, no study depicts the regional prevalence and its associated factors. Therefore, this study aimed to estimate the pooled prevalence of DR and its associated factors among adults in East African countries. Methods: We extensively searched PubMed, Embase, Scopus, Google Scholar, and Google for relevant studies. A forest plot was used to estimate the pooled prevalence of diabetic retinopathy using DerSimonian and Laird's random-effects model. We checked publication bias using funnel plots and Egger's regression test. Potential heterogeneity was tested using the I-squared statistic. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also performed. Furthermore, the pooled odds ratios for the associated factors were estimated. The research protocol was registered in PROSPER. Results: Among the 29 included studies, the estimated pooled prevalence of DR in East African countries was 28% (95% CI 23.0, 33.0). Besides, age ≥60 (OR = 2.88, 95% CI: 1.55, 5.32), body mass index ≥ 25 (AOR = 2.85; 95% CI: 1.69, 4.81; I2 = 85.4%, p < 0.001), and hemoglobin A1c levels ≥7 (OR = 2.48, 95% CI: 1.46, 4.23) were significantly associated with the prevalence of DR. Conclusions: The prevalence of DR in East Africa was high, with more than one in four individuals with diabetes developing DR. Besides, advanced age, higher body mass index, and elevated hemoglobin A1c levels were significant factors associated with increased DR prevalence. Therefore, comprehensive diabetes management focusing on optimal glycemic control and healthy weight maintenance is essential to mitigate the problems. Also, the Ministries of Health and policymakers should prioritize and implement targeted strategies to address the identified modifiable risk factors, aiming to reduce the prevalence of DR in the region. Trial registration: Systematic review registration: PROSPERO (2024: ID = CRD42024511437). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness (SMI) are more likely to develop long-term physical health conditions, including type 2 diabetes and cardiovascular disease, compared to people without SMI. This contributes to an inequality in life expectancy known as the 'mortality gap'. Chronic kidney disease (CKD) is a growing global health concern set to be the 5th leading cause of life-years lost by 2040. However, there is limited research exploring the relationship between CKD and SMI. This systematic review will aim to examine the prevalence and incidence of CKD among people with SMI. Methods: We will search Medline, Embase, PsycINFO, CINAHL, Scopus and Web of Science for primary epidemiological research reporting the prevalence or incidence of CKD among people with SMI in any setting. Retrieved records will be managed in Covidence and screened by two independent reviewers. Data will be extracted from included studies using a piloted data extraction form, and the quality of studies will be evaluated using the appropriate JBI Critical Appraisal Checklist. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Data from the included studies will be narratively synthesised. Meta-analyses will be conducted using random effects models to examine the prevalence and incidence of CKD among people with SMI. Discussion: There is limited research exploring the relationship between CKD and SMI, and this proposed systematic review will be the first to examine the prevalence of CKD among people with SMI. This review will highlight the extent of the problem and provide a foundation for future research to improve health outcomes for people with SMI. [ABSTRACT FROM AUTHOR]

Introduction: The contribution of obesity phenotypes to dyslipidaemia in middle-aged adults from four sub-Saharan African (SSA) countries at different stages of the epidemiological transition has not been reported. We characterized lipid levels and investigated their relation with the growing burden of obesity in SSA countries. Methods: A cross-sectional study was conducted in Burkina Faso, Ghana, Kenya and South Africa. Participants were middle aged adults, 40–60 years old residing in the study sites for the past 10 years. Age-standardized prevalence and adjusted mean cholesterol, LDL-C, HDL-C, triglycerides and non-HDL-C were estimated using Poisson regression analyses and association of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WTHR) with abnormal lipid fractions modeled using a random effects meta-analysis. Obesity phenotypes are defined as BMI ≥ 30 kg/m2, increased WC and increased waist-to-hip ratio. Results: A sample of 10,700 participants, with 54.7% being women was studied. Southern and Eastern African sites recorded higher age-standardized prevalence of five lipid fractions then West African sites. Men had higher LDL-C (19% vs 8%) and lower HDL-C (35% vs 24%) while women had higher total cholesterol (15% vs 19%), triglycerides (9% vs 10%) and non-HDL-cholesterol (20% vs 26%). All lipid fractions were significantly associated with three obesity phenotypes. Approximately 72% of participants in the sample needed screening for dyslipidaemia with more men than women requiring screening. Conclusion: Obesity in all forms may drive a dyslipidaemia epidemic in SSA with men and transitioned societies at a higher risk. Targeted interventions to control the epidemic should focus on health promoting and improved access to screening services. [ABSTRACT FROM AUTHOR]

Background: Cold-water immersion (CWI) has gained popularity as a health and wellbeing intervention among the general population. Objective: This systematic review and meta-analysis aimed to evaluate the psychological, cognitive, and physiological effects of CWI in healthy adults. Methods: Electronic databases were searched for randomized trials involving healthy adults aged ≥ 18 years undergoing acute or long-term CWI exposure via cold shower, ice bath, or plunge with water temperature ≤15°C for at least 30 seconds. Outcomes of interest were sleep, stress, fatigue, energy, skin health, immunity, inflammation, mental wellbeing, depression, anxiety, mood, concentration, and alertness or focus. Meta-analyses were conducted using RevMan software (version 5.4), applying random effects models to calculate standardized mean differences (SMD) between pre- and post-CWI exposure outcomes. Risk of bias was assessed using the PEDro scale. Results: Eleven studies were included, comprising 3177 total participants and a mean PEDro score of 6.4 (n = 7 moderate quality, n = 4 high quality). CWI interventions were performed in baths (n = 10) or showers (n = 1) at temperatures ranging from 7°C to 15°C and durations ranging from 30 seconds to 2 hours. The meta-analysis revealed significant increases in inflammation immediately (SMD: 1.03, [95% CI: 0.37, 1.68], p < 0.01) and 1 hour post CWI (SMD: 1.26, [95% CI: 0.59, 1.94], p < 0.01), indicating an acute inflammatory response. A significant reduction in stress was observed 12 hours post-CWI (SMD: –1.00, [95% CI: –1.40, –0.61], p < 0.01), however, no significant effects on stress were detected immediately (SMD: –0.09 [95% CI: –0.45, 0.63], p > 0.05), 1 hour (SMD: –0.29 [95% CI: –0.66, 0.08], p > 0.05), 24 hours (SMD: –0.06 [95% CI: –0.50, 0.38], p > 0.05), or 48 hours (SMD: 0.09 [95% CI: –0.28, 0.46], p > 0.05) post-exposure. While meta-analysis showed no significant effects on immune function immediately (SMD: –0.16 [95% CI: –0.82, 0.51], p > 0.05) or 1 hour (SMD: –0.18 [95% CI: –1.09, 0.74], p > 0.05) post-CWI, narrative synthesis suggested longer-term benefits, including a 29% reduction in sickness absence among participants who took cold showers. Improvements were also observed in sleep quality and quality of life, but not mood. Conclusions: This systematic review suggests that CWI delivers time-dependent effects on inflammation, stress, immunity, sleep quality, and quality of life, offering potential practical applications for health practitioners considering CWI for stress management and wellbeing support. However, the current evidence base is constrained by few RCTs, small sample sizes, and a lack of diversity in study populations. Future high-quality RCTs are needed to examine the long-term effects of CWI, its impact on diverse health outcomes, and optimal CWI protocols. PROSPERO (ID: CRD42024500591) [ABSTRACT FROM AUTHOR]

Background: Anthracycline usage has been linked to cardiovascular adverse events (CAEs), which is unpredictable. It is critical to identify the characteristics of vulnerable populations and risk factors in order to reduce the occurrence of CAEs. Objectives: This meta-analysis aimed to assess the correlation between various risk factors and CAEs induced by anthracyclines. Methods: We systematically searched for studies from PubMed, Cochrane, Embase, and assessed the publication bias. Anthracyclines, hypertension, radiation therapy, diabetes, smoking, age, gender, hyperlipidemia, and obesity were meta-analyzed using a fixed or random effects model. Result: Sixteen studies were included in this meta-analysis. The results showed that pooled relative ratio for CAEs was 1.69 (95% CI: 1.39–2.06, p<0.001) for anthracyclines, and that risk factors for CAEs caused by anthracyclines included hypertension (RR = 2.15, 95% CI: 1.53–3.01, p < 0.001), radiation therapy (RR = 1.71, 95% CI: 1.19–2.47, p < 0.001), diabetes (RR = 1.57, 95% CI: 1.20–2.06, p<0.001), smoking (RR = 1.35, 95% CI: 0.96–1.88, p < 0.05), and age (RR = 1.16, 95% CI: 1.07–1.26, p < 0.001). In addition, BMI > 25 kg/m2 (RR = 1.34, 95% CI: 1.08–1.67, p = 0.470), gender (RR = 1.17, 95% CI: 1.06–1.2, p = 0.350), and hyperlipidemia (RR = 1.10, 95% CI: 0.91–1.34, p = 0.327) was not significantly associated with CAEs caused by anthracyclines. Conclusions: Our research findings indicate that patients with a history of hypertension, radiation therapy, diabetes, smoking, and elderly individuals are at an elevated risk of cardiovascular disease in the process of administration of anthracycline drugs. Consequently, careful case selection and condition monitoring are important in the treatment process. Patients with comorbidities are more prone to suffering from CAEs with anthracycline based chemotherapy, and the risk factors are arranged clockwise in a descending order: hypertension, radiation therapy, diabetes, smoking, age. BMI>25 kg/m2, gender, and hyperlipidemia are not significant associated with CAEs with anthracycline based chemotherapy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp[a]) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD). However, the relationship between Lp(a) level, LDL-C level, and ASCVD risk at different thresholds is not well defined. METHODS: A participant-level meta-analysis of 27 658 participants enrolled in 6 placebo-controlled statin trials was performed to assess the association of LDL-C and Lp(a) levels with risk of fatal or nonfatal coronary heart disease events, stroke, or any coronary or carotid revascularization (ASCVD). The multivariable-adjusted association between baseline Lp(a) level and ASCVD risk was modeled continuously using generalized additive models, and the association between baseline LDL-C level and ASCVD risk by baseline Lp(a) level by Cox proportional hazards models with random effects. The joint association between Lp(a) level and statin-achieved LDL-C level with ASCVD risk was evaluated using Cox proportional hazards models. RESULTS: Compared with an Lp(a) level of 5 mg/dL, increasing levels of Lp(a) were log-linearly associated with ASCVD risk in statin- and placebo-treated patients. Among statin-treated individuals, those with Lp(a) level >50 mg/dL (≈125 nmol/L) had increased risk across all quartiles of achieved LDL-C level and absolute change in LDL-C level. Even among those with the lowest quartile of achieved LDL-C level (3.1–77.0 mg/dL), those with Lp(a) level >50 mg/dL had greater ASCVD risk (hazard ratio, 1.38 [95% CI, 1.06–1.79]) than those with Lp(a) level ≤50 mg/dL. The greatest risk was observed with both Lp(a) level >50 mg/dL and LDL-C level in the fourth quartile (hazard ratio, 1.90 [95% CI, 1.46–2.48]). CONCLUSIONS: These findings demonstrate the independent and additive nature of Lp(a) and LDL-C levels for ASCVD risk, and that LDL-C lowering does not fully offset Lp(a)-mediated risk. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies highlighted the association between the triglyceride–glucose (TyG) index and cardiovascular events in patients with diabetes. However, whether diabetes affects TyG-cardiovascular diseases (CVD) is still unclear. This study aimed to evaluate the association between the TyG index and CVD risk, stratified by diabetes status, as well as the potential modifying effect of diabetic status. Methods/design: The PubMed, Cochrane Library, and Embase databases were searched for studies on the associations between the TyG index and cardiovascular events and mortality in patients with and without diabetes from inception to December 2, 2024. The random effects model was employed to pool the effect sizes. Results: A total of 50 cohort studies (7,239,790 participants) were included. The mean age of participants was 31.46 years (diabetes mellitus [DM]: 65.18; non-DM: 31.23), and 40.66% of participants were female (DM: 36.07%; non-DM: 40.70%). The associations between the TyG index and cardiovascular events (HR: 1.72 vs. 1.55, P = 0.55), major adverse cardiovascular and cerebrovascular events (HR: 2.02 vs. 1.91, P = 0.84), stroke (HR: 1.46 vs. 1.39, P = 0.77) and cardiovascular death (HR: 1.85 vs. 1.60, P = 0.56) were similar among DM and non-DM individuals. However, the associations between the TyG index and ischemic heart disease (IHD) (HR: 2.20 vs. 1.57, P = 0.03) as well as all-cause mortality (HR: 1.94 vs. 1.24, P = 0.01) were stronger in DM patients than in non-DM patients. Conclusion: TyG index showed association with cardiovascular events, mortality, and all-cause mortality independent of diabetic status, with low to moderate certainty. The associations for IHD and all-cause death were stronger in diabetic patients than in individuals without diabetes. Future studies should explore the role of diabetes in the TyG index-associated CVD outcomes and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Although COVID-19 vaccines have been recommended for children and adolescents since 2021, suboptimal vaccination uptake has been documented. No previous systematic review/meta-analysis (SRMA) investigated parents' willingness to administer COVID-19 vaccines for their children in Saudi Arabia. Accordingly, this SRMA aimed to estimate parents' willingness to immunize their children with COVID-19 vaccines in Saudi Arabia and to identify reasons and determinants influencing parents' decisions. Methods: This SRMA adhered to the PRISMA guidelines and the protocol was registered on PROSPERO (ID: CRD42023492760). An extensive systematic search was performed across electronic databases including Pub Med, Pub Med Central, ISI Web of science, Web of Science Core Collection, Medline, KCI-Korean Journal Database, ProQuest, and SciELO, to identify relevant studies published from January 1, 2020 to October 30, 2023. A random-effects model was utilized to estimate the pooled effects considering the expected variability across studies. Heterogeneity, risk of bias, publication bias and quality of studies were considered and evaluated by relevant appropriate tests to ensure robust results. Results: Twenty-five studies with 30,844 parents were included. The overall pooled rate of parents who intended to immunize their children with COVID-19 vaccines was 48.0% (95% CI: 41.0–54.0%) with high heterogeneity (I2 = 99.42%). The main reason for parents to vaccinate children was to protect child, family and community from COVID-19. Perceived efficacy/safety of vaccines were the most significant determinants associated with parents' willingness to vaccinate children. Conclusion: This was the first SRMA from Saudi Arabia which emphasized the priority to focus on vaccine-related factors as main/key strategy of COVID-19 vaccines' drivers to convince parents in a logical way based on accurate cumulative and emerging scientific data about efficacy and safety of COVID-19 vaccines to optimize their uptake by children/adolescents. This SRMA can provide valuable insights for development of evidence-based policies to improve parental willingness to vaccinate children, which is crucial for controlling SARS-CoV-2 spread and promoting herd immunity in the community particularly if the virus continues to pose a major threat. [ABSTRACT FROM AUTHOR]

[Display omitted] • A meta -analysis was conducted to investigate risk factors for delirium in COVID-19 patients. • There is no increased risk of delirium in COVID-19 patients with hypertension, COPD, ARDS. • Hydrocortisone and azithromycin use may increase the risk of delirium. • Medications for COVID-19 should be administered with caution to reduce the risk of developing delirium. • Risk factors should be addressed early to minimize delirium severity. Delirium is one of the serious neurological complications of Coronavirus Disease 2019 (COVID-19) and is associated with significant morbidity and mortality in patients with COVID-19, especially in older patients. There is currently no meta -analysis of risk factors for delirium in patients with COVID-19. This study aimed to identify potential risk factors for delirium in patients with COVID-19 through a meta -analysis of observational clinical studies. In conducting this analysis, literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science, and study quality was assessed using the Newcastle-Ottawa Quality Scale (NOS). Data were extracted independently by two reviewers and pooled using either fixed effects or random effects models based on the results of heterogeneity testing. As a result of this meta -analysis, a total of 21 studies were included, including 10,147 patients. The analysis revealed the identification of 26 predisposing factors and 54 precipitating factors associated with COVID-19-related delirium. Notably, the administration of hydrocortisone and azithromycin, among other specific medications designated for COVID-19, exhibited a potential to be positively associated with the incidence of delirium in patients afflicted with COVID-19. In conclusion, the present study identified potential predisposing and precipitating factors linked with delirium in COVID-19 patients. It is anticipated that these results will have a considerable impact on the management and treatment of delirium in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: Several antifungals are available for the treatment of patients with invasive aspergillosis (IA). This study aims to evaluate the relative efficacy and safety of the first-line monotherapies in primary therapy of IA through network meta-analysis (NMA). Methods: We systematically searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP database, Wanfang database, and China Biology Medicine for randomized controlled trials (RCTs) up to July 2023 that evaluated the efficacy and safety of monotherapies. We performed NMA with a frequentist random effects model and assessed the certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Primary outcomes were the all-cause mortality at week 12, and secondary outcomes included overall response rate, and incidence of adverse events (AEs) and severe adverse events (SAEs). Results: A total of three RCTs involving 1,368 participants (four antifungals) were included. The NMA showed that compared to amphotericin B deoxycholate (D-AmB), the triazoles (posaconazole (POS), isavuconazole (ISA) and voriconazole (VCZ)) can improve the overall response rate in primary therapy of IA, but only VCZ and ISA can reduce the all-cause mortality at week 12 for patients with proven and probable IA (VCZ vs D-AmB: RR = 0.66, 95%CI = 0.47–0.93, moderate certainty; ISA vs D-AmB: RR = 0.52, 95%CI = 0.31–0.86, low certainty). ISA (SUCRA = 93.50%; mean rank, 1.20) seemed to be the most effective therapy in the above population. As to proven, probable, and possible IA patients, the triazoles were superior to D-AmB in terms of reducing all-cause mortality. Furthermore, the risk of AEs and SAEs was comparable for the three triazoles, but the risk of SAEs was significantly higher for D-AmB than others. Conclusion: The efficacy and safety of triazoles are more favorable than D-AmB in the primary therapy of IA, with ISA being the optimal choice. Systematic Review Registration: PROSPERO CRD42023407632. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to compare the effect of photobiomodulation (PBM) therapy on implant stability and crestal bone loss placed in healed sites. The present systematic review and meta-analysis were conducted according to PRISMA (The Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two investigators carried out the electronic search of Pubmed, Google Scholar, and Ebscohost for published literature from 2012 till March 2024. Handsearch for articles relevant to the topic was also carried out along with references. Only randomized controlled trials were included for systematic review. The assessment quality was done using the revised JBI checklist (Joanna Biggs Institute). After screening and eligibility assessment, Qualitative analysis was envisaged for 15 studies on implant stability and crestal bone loss, followed by quantitative analysis of 8 studies on implant stability and only 2 studies for crestal bone loss. Meta-analysis showed that overall implant stability was significantly higher in the control group (P < 0.00001). Crestal bone loss showed a significant difference after the therapy when observed after six months of implant placement (P = 0.03). Heterogeneity was high with the random effects model for implant stability, while it was acceptable for crestal bone loss. However, more studies with similar parameters concerning implant stability and PBM characteristics are required for further subgroup analysis and to reach conclusive results. [ABSTRACT FROM AUTHOR]

Scholars and university administrators have a vested interest in building equitable valuation systems of academic work for both practical (e.g., resource distribution) and more lofty purposes (e.g., what constitutes "good" research). Well-established inequalities in science pose a difficult challenge to those interested in constructing a parsimonious and fair method for valuation as stratification occurs within academic disciplines, but also between them. The h-index, a popular research metric, has been formally used as one such method of valuation. In this article, we use the case of the h-index to examine how the distribution of research metrics reveal within and between discipline inequalities. Using bibliometric data from 1960-2019 on over 50,000 high performing scientists—the top 2% most frequently cited authors—across 174 disciplines, we construct random effects within-between models predicting the h-index. Results suggest significant within-discipline variation in several forms, specifically sole-authorship and female penalties. Results also show that a sole authorship penalty plays a significant role in well-known between-discipline variation. Field-specific models emphasize the "apples-to-oranges," or incommensurable, property of cross-discipline comparison with significant heterogeneity in sole-authorship and female penalties within fields. In conclusion, we recommend continued caution when using the h-index or similar metrics for valuation purposes and the prioritization of substantive valuations from disciplinary experts. [ABSTRACT FROM AUTHOR]

Background: In the last three decades, the increasing trend in female employment in Bangladesh has been critically analyzed from a socioeconomic point of view; however, its impact on infant and young child feeding (IYCF) practices has yet to be systematically reviewed. The aim of this systematic review and meta-analysis is to investigate the association between these variables. Methods: A systematic literature search was conducted in PubMed, Medline, Web of Science, Embase, CINAHL, and Google Scholar to retrieve relevant records with no restriction of publication period. The Covidence tool was used for screening and data extraction. Meta-analysis was carried out using random effect models. The Newcastle-Ottawa scale was used for the quality assessment of the included articles. Results: A total of 24 articles were included. Of these, 16 focused on breastfeeding-related indicators, 6 focused on complementary feeding-related indicators, and 2 focused on both. Maternal employment was found to have both positive (protective) and negative (detrimental) associations with exclusive breastfeeding, whereas it was mainly positively associated with complementary feeding practices. Meta-analysis showed the pooled odds ratio of recommended early initiation of breastfeeding, exclusive breastfeeding, and complementary feeding among employed mothers were 0.79 (95% CI: 0.49, 1.27; p = 0.33), 0.32 (95% CI:0.16, 0.67; p = 0.002), and 1.07 (95% CI: 0.81, 1.42; p = 0.63) compared to their counterparts, respectively. Conclusions: Maternal employment appears not to be a protective factor for some important breastfeeding indicators in Bangladesh. For example, there was a statistically significant lower likelihood of exclusive breastfeeding practice among employed mothers as compared to those who were not employed. Therefore, these issues should be taken into consideration when formulating relevant policies and interventions, e.g., breastfeeding-friendly workplace. [ABSTRACT FROM AUTHOR]

Purpose: The Youth Activity Profile (YAP) is a 7-day self-report designed to quantify physical activity and sedentary behaviors among youth. This study evaluated the reliability of the online version of the YAP and equivalence with the paper-based version. Method: A total of 2,490 participants from 17 schools in Iowa and Texas completed the YAP. Each classroom was randomly assigned to complete either the print or online version twice. A variance components model was used to assess the test-retest reliability and equivalence testing was also applied. Results: Both paper and online versions had similar reliability for the PA estimates in school (ICCprint = 0.69–0.91; ICConline = 0.54–0.84), at home (ICCprint = 0.72–0.83; ICConline = 0.64–0.94), PA at weekend (ICCprint = 0.33–0.72; ICConline = 0.39–0.70), and SB (ICCprint = 0.69–0.90; ICConline = 0.66–0.80). The two versions were statistically equivalent for most YAP items except for recess. Conclusion: The online YAP appears to be a reliable assessment of physical activity and sedentary behavior in youth populations. [ABSTRACT FROM AUTHOR]

Background: Multiple studies across Ethiopia have investigated the occurrence of DKA, showing significant variations and conflicting findings. This systematic review and meta-analysis seek to consolidate the overall prevalence of diabetic ketoacidosis and its associated factors in the Ethiopian context. Methods: The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. Data was collected from PubMed/MEDLINE, Science direct, Google Scholar, and gray literature sources. Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software version 4.3.2. The overall pooled prevalence of diabetic ketoacidosis and its components was estimated using a random effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger's regression test. Subgroup analysis were carried out to minimize random variations in the estimates from the primary studies. Result: The pooled estimated prevalence of diabetic ketoacidosis among diabetic patients in Ethiopia was 46% (95% CI; 36, 57; I2 = 100%, P≤0.001). Medication discontinuations (AOR = 1.30, 95 CI 1.20, 1.64), presence of comorbidity (AOR = 1.53, 95 CI 1.10, 2.20) and presence of infection (AOR = 1.62, 95 CI 1.31, 1.98) had an association with diabetic ketoacidosis among diabetic patients. Conclusions: Medication discontinuations, comorbidity, and infection are individual contributors to diabetic ketoacidosis in diabetic patients. Implementing initiatives to enhance medication adherence and establish comprehensive diabetes management programs covering glycemic control, comorbidities, and infection management can effectively address these factors. [ABSTRACT FROM AUTHOR]

Background: The definition of minor ischemic stroke (MIS) is a topic of debate, however, the most accepted definition is a stroke with National Institutes of Health Stroke Scale (NIHSS) ≤ 5. Intravenous thrombolysis (IVT) is a crucial treatment option for acute ischemic stroke (AIS) including: alteplase, recombinant human tissue-type plasminogen activator (r-tPA), and the recently approved tenecteplase. However, there is a debate regarding its safety and efficacy. Therefore, our objective was to determine the safety and efficacy of IVT in treating minor stroke patients (NIHSS ≤ 5). Methods: Using the search strategy assigned which was based on three keywords: "mild" or "minor", "stroke", and "intravenous thrombolysis", we searched for eligible articles on PubMed, Web of Science, Embase, and Scopus from inception till 10th January 2024. We conducted this meta-analysis using the random effect model to account for the heterogeneity among the studies. For the dichotomous variables, we calculated the odds ratio (OR) from the event and total of these variables. While for the continuous variables, we calculated the mean difference (MD) of these variables. Pooling of OR for the occurrence of events was also conducted. Results: A total of 21 articles with 93,057 patients with MIS were included. The mean age of the participants ranged from 62.3 to 79.6. Most of the included patients had comorbidities such as hypertension, diabetes, previous stroke, smoking, atrial fibrillation, and hyperlipidemia. Of these, 10,850 received IVT while 82,207 did not. The use of IVT was statistically significant associated with 90-day modified Rankin score (mRs) 0–1 when compared with control with OR of 1.67 (95%CI: 1.46, 1.91, p < 0.00001) and was statistically significantly associated with improvement of NIHSS on discharge with OR of 2.19 (95%CI: 1.56, 3.08, p < 0.00001). In terms of safety outcomes, IVT has proven a safe profile, as there was no significant difference in intracranial hemorrhage (ICH) and mortality rates between the IVT and control groups with OR of 1.75 (95CI: 0.95, 3.23, p = 0.07) and 0.93 (95%CI: 0.77, 1.11, p = 0.41), respectively. Conclusion: Although some studies have not found any benefits of IVT in MIS patients, a substantial body of literature strongly endorses IVT as an effective and safe treatment for MIS. IVT has been shown to improve the mRs and NIHSS scores at the 90-day mark without an increased risk of ICH or mortality. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate the association between hypertension and hearing loss. Methods: A standardized search for studies on hypertension and hearing loss in PubMed, Embase, Scopus, and Web of Science was performed using subject terms, free terms, and keyword combinations for the period of library construction to March 2024. Meta-analysis was performed using RevMan 5.4 and STATA 18.0. Results: A total of 12 studies were included, assessing 594,676 participants. The combined OR using the random effects model was 1.849 (95% CI: 1.549, 2.208). Heterogeneity in this analysis was high (I 2 = 98%, p < 0.1), and by sensitivity analysis we found that the heterogeneity may have originated from 3 studies, the removal of which significantly reduced the heterogeneity and had a small effect on the effect size [OR (95%CI): 1.893 (1.834, 1.953), I 2 = 0.0%, p = 0.465]. Conclusion: Hypertension may be one of the risk factors for hearing loss. Identification of hypertension can help in early assessment and management of hearing loss risk. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023460001. [ABSTRACT FROM AUTHOR]

Introduction: Gastrointestinal (GI) cancers represent a significant global health burden, and the need for more effective treatment options is exceptionally pressing. The present meta-analysis aimed to explore the efficacy and safety of the combination of nivolumab and ipilimumab in treating GI cancers. Methods: A systematic search of four databases (PubMed, Embase, Web of Science, and Cochrane Library) was conducted for articles on the treatment of GI cancers with nivolumab combined with ipilimumab, published from 2014 up to 30 August 2024. The inclusion criteria were designed according to the principles of Participants, Intervention, Control, Outcomes, and Study (PICOS). The control group was chemotherapy or nivolumab monotherapy or nivolumab in combination with other drugs. We extracted data from 10 randomized controlled trials and utilized a random effects model to assess the objective response rate (ORR), median progression-free survival (mPFS), median overall survival (mOS), median duration of response (mDOR), and treatment-related adverse events (TRAEs). The data analysis was conducted using Review Manager version 5.4 and Stata version 12.0. Results: Overall, the combination of nivolumab and ipilimumab demonstrated superior outcomes, including a higher ORR (OR = 1.69, P = 0.01), prolonged mOS (MD = 1.74, P = 0.04) and extended mDOR (MD = 5.64, P < 0.00001) compared to the control group. Subgroup analysis demonstrated that the ORR (OR = 1.75, P = 0.02) and mOS (MD = 5.02, P = 0.003) were significantly improved in patients with esophageal cancer. Notably, the ORR in patients with biliary cancer was significantly lower (OR = 0.11, P = 0.04). Additionally, the ORR was significantly higher in the NIVO1 + IPI3group (OR = 2.82, P = 0.01) and NIVO3 + IPI1 group (OR = 1.62, P = 0.01). Regarding safety, there was no statistically significant difference between the combination regimen and the control group in terms of any grade (OR = 0.72, P = 0.26) or grade 3-4 TRAEs (OR = 1.36, P = 0.14). Conclusions: Nivolumab in combination with ipilimumab demonstrated significant efficacy in GI cancers (especially esophageal cancer) without causing more adverse reactions. However, its efficacy in biliary cancer still needs to be further proven. Systematic review registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD42024590994. [ABSTRACT FROM AUTHOR]

Biomarkers are measured repeatedly in clinical studies until a pre-defined endpoint, such as death from certain causes, is reached. Such repeated measurements may present a dynamic process for understanding when to expect the study’s endpoint. Joint modelling is often employed to handle such a model. Typically, shared random effects are assumed to be common to both the longitudinal component and the study’s endpoint. These shared random effects usually assume homogeneous and follow a normal distribution. However, identifying homogeneous subgroups is important when the underlying population is heterogeneous. This issue has received little attention in the literature, particularly for multi-phase longitudinal responses. In this paper, we propose a joint modelling approach for longitudinal and survival models using a bent-cable mixed model for longitudinal measurements and a Weibull distribution for the survival component. We also incorporate a finite mixture of normal distribution assumptions to account for the unobserved heterogeneity in the shared random effects model. A Bayesian MCMC is developed for parameter estimation and inferences. The proposed method is evaluated using simulation studies and the Tehran Lipid and Glucose Study dataset. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii is a ubiquitous parasite that can cause significant complications when it infects pregnant women and immunocompromised patients. These complications include miscarriage, fetal abnormalities, and fatal cerebral toxoplasmosis. Despite its significance, the true burden of toxoplasmosis in Indonesia remains underexplored. Toxoplasmosis is usually diagnosed by detecting anti-Toxoplasma antibodies, especially IgG. Therefore, we aim to assess the seroprevalence of anti-Toxoplasma IgG among the human population in Indonesia. In addition, we assessed whether the seroprevalence differed across geographical regions, populations, or population risk levels. Its correlation with annual precipitation was also assessed. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review and meta-analysis of data retrieved from PubMed, Portal Garuda, Neliti, and Onesearch.id. Additionally, Google Scholar, government repositories, and the reference list of studies were searched for additional data. We pooled seroprevalence data using the inverse-variance method and a random effects model. Heterogeneity was assessed using I2 statistics and Cochran's Q test. Risk-of-Bias (RoB) was evaluated using the Joanna Briggs Institute Checklist for Prevalence Studies. Publication bias was assessed using Doi plots and the Luis Furuya-Kanamori (LFK) index. We performed subgroup analysis, meta-regression, and sensitivity analysis to explore source heterogeneity and the robustness of the pooled estimates. We used Spearman's rank correlation coefficient to assess the correlation between seroprevalence and annual precipitation. Result: In total, 56 studies were included in this study. The adjusted seroprevalence of anti-Toxoplasma IgG was 60.06% (95% CI: 52.22–67.65%). Study location and detection method were detected as significant sources of heterogeneity by subgroup analysis but not meta-regression. However, subgroup analysis and meta-regression identified the study population and population risk level as significant sources of heterogeneity. Publication year, sample size, and RoB were identified as non-significant moderators. Seroprevalence did not correlate with annual precipitation. Conclusion: Toxoplasmosis is highly prevalent among the human population in Indonesia; however, our study mainly relied on studies with small sample sizes. Furthermore, most of the studies were performed in Java; therefore, some high-quality population-based studies must be conducted in other regions of Indonesia to better estimate the prevalence of toxoplasmosis across the country. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis is endemic in Ethiopia and caused by Leishmania donovani. Although the disease manifests with significant clinical variability, a substantial number of individuals are asymptomatic. These individuals can serve as reservoirs, complicating control efforts. However, comprehensive data on asymptomatic L. donovani infections in Ethiopia are lacking, highlighting the need for a systematic review and meta-analysis to consolidate evidence and understand the distribution and determinants of this infection. Methods: PRISMA guidelines followed and registered with PROSPERO (CRD42024531454). Systematically searched electronic databases and grey literature sources up to April 13, 2024. Original research articles in English considered. Statistical analyses performed using STATA version 16. Publication bias evaluated using funnel plots and Egger's regression tests. Pooled estimate of asymptomatic L. donovani infection derived using a random effects model. Study heterogeneity assessed using Chi-square (χ²)-based Q test (p < 0.1) and I² subgroup analysis and meta-regression conducted with significance set at p < 0.05. Result: A total of 1,288 articles were identified, with 11 studies met inclusion criteria. These studies, published between 2012 and 2024, reported data from 17 districts across six regions. Sample sizes ranged from 185 to 1,682, with a total of 7,288. Six types of laboratory testing methods were employed. Prevalence of asymptomatic L. donovani infection per individual study ranged from 0.9 to 15.8%, while district-level prevalence varied from 0 to 31.1%. The overall pooled estimate of asymptomatic L. donovani infection in Ethiopia was 9.0% (95% CI: 6.0-11.0%). The pooled estimate in the Amhara region was 9.0% (95% CI: 8.0-11.0%), compared to 7.0% (95% CI: 3.0-12.0%) in other regions. Living in a household with domestic animals (OR: 2.54; 95% CI: 1.43–3.64) and being male (OR: 2.22; 95% CI: 1.21–3.23) were significantly associated with higher asymptomatic L. donovani infection. Conclusion: A considerable number of asymptomatic L. donovani infections were reported in Ethiopia. Close contact with domestic animals and being male were identified as significant risk factors. Regular screening of people living in close contact with animals. This will minimize role of man as reservoir host of asymptomatic L. donovani infection VL and hence aid in disease control and management. [ABSTRACT FROM AUTHOR]