Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pa...Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.展开更多
Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical perf...BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into...The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.展开更多
Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention...Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.展开更多
Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and d...Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and develop individualized rehabilitation plans to improve patient prognosis.Methods Databases including the China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBMdisc),China Science and Technology Journal(VIP),WanFang,PubMed,Embase,CINAHL,Web of Science,the Cochrane Library,and Scopus were retrieved to search for literature on the predictors of recovery from dysphagia after stroke.The retrieval period was from January 2013 to December 2023.The quality of studies was assessed using the Newcastle-Ottawa Scale(NOS)and the Prediction model Risk of Bias Assessment Tool(PROBAST).Meta-analysis was performed using Revman5.3 and Stata15.1 software.The review protocol has been registered with PROSPERO(CRD42024605570).Results A total of 1,216 results were obtained,including 599 in English and 617 in Chinese.A total of 34 studies were included,involving 156,309 patients with post-stroke dysphagia,and the rate of dysphagia recovery increased from 13.53%at 1 week to 95%at 6 months after stroke.Meta-analysis results showed that older age[OR=1.06,95%CI(1.04,1.08),P<0.001],lower BMI[OR=1.28,95%CI(1.17,1.40),P<0.001],bilateral stroke[OR=3.10,95%CI(2.04,4.72),P<0.001],higher National Institutes of Health Stroke Scale(NIHSS)score[OR=1.19,95%CI(1.01,1.39),P=0.030],tracheal intubation[OR=5.08,95%CI(1.57,16.39),P=0.007]and aspiration[OR=4.70,95%CI(3.06,7.20),P<0.001]were unfavorable factors for the recovery of swallowing function in patients with post-stroke dysphagia.Conclusions The lack of standardized criteria for rehabilitation assessment of post-stroke dysphagia has resulted in reported recovery rates of swallowing function exhibiting wide variability.Nurses should take targeted preventive measures for patients aged≥70 years,low BMI,bilateral stroke,high NIHSS score,tracheal intubation,and aspiration to promote the recovery of swallowing function in patients with post-stroke dysphagia.展开更多
Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A sea...Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.展开更多
Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air poll...Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air pollution is crucial for mitigating climate change,improving air quality,and promoting the sustainable development of food systems.However,the literature lacks a comprehensive review of these interactions,particularly in the current phase of rapid development in the field.To address this gap,this study systematically reviews recent research on the impacts of climate change and air pollution on food systems,as well as the greenhouse gas and air pollutant emissions from agri-food systems and their contribution to global climate change and air pollution.In addition,this study summarizes various strategies for mitigation and adaptation,including adjustments in agricultural practices and food supply chains.Profound changes in food systems are urgently needed to enhance adaptability and reduce emissions.This review offers a critical overview of current research on the interactions among food systems,climate change,and air pollution and highlights future research directions to support the transition to sustainable food systems.展开更多
Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The ...Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。展开更多
Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the t...Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.展开更多
Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniq...Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniques coming up rapidly.The purpose of this study is to review the recent developments in the field of security integration in the software development lifecycle(SDLC)by analyzing the articles published in the last two decades and to propose a way forward.This review follows Kitchenham’s review protocol.The review has been divided into three main stages including planning,execution,and analysis.From the selected 100 articles,it becomes evident that need of a collaborative approach is necessary for addressing critical software security risks(CSSRs)through effective risk management/estimation techniques.Quantifying risks using a numeric scale enables a comprehensive understanding of their severity,facilitating focused resource allocation and mitigation efforts.Through a comprehensive understanding of potential vulnerabilities and proactive mitigation efforts facilitated by protection poker,organizations can prioritize resources effectively to ensure the successful outcome of projects and initiatives in today’s dynamic threat landscape.The review reveals that threat analysis and security testing are needed to develop automated tools for the future.Accurate estimation of effort required to prioritize potential security risks is a big challenge in software security.The accuracy of effort estimation can be further improved by exploring new techniques,particularly those involving deep learning.It is also imperative to validate these effort estimation methods to ensure all potential security threats are addressed.Another challenge is selecting the right model for each specific security threat.To achieve a comprehensive evaluation,researchers should use well-known benchmark checklists.展开更多
BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only l...BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only limited cases were reported in the literature,certain intra-operative and post-operative ocular risk factors might contribute to the different extend of SiO migration in the CNS.AIM To study the risk factors for cerebral ventricular migration(CVM)on top of visual pathway migration(VPM).METHODS Conforming to the preferred reporting items for systematic reviews and metaanalyses guidelines,literature searches on PubMed,MEDLINE,EMBASE were performed on June 1,2024.Publications on SiO migration to CNS were included in this review.Non-English articles,and studies without neuro-imaging of the CNS were excluded.Patient demographics,SiO filled eyes'ocular characteristics and vitrectomy surgical details were extracted from included studies in this review.VPM and CVM were assigned as group 1 and group 2 respectively.Fisher's exact tests,Mann-Whitney U tests and binary logistic regression were performed.RESULTS Total 68 articles were obtained after searches,48 publications were included for analysis.Total 54 SiO filled eyes were analyzed.Post-vitrectomy intraocular pressure(IOP)was found to be significant in both Mann-Whitney U test(P=0.047)and binary logistic regression(P=0.012).Diabetic was found to be significant in binary logistic regression(P=0.037),but at borderline risk for CVM in Fisher's exact test(P=0.05).Other significant factors include longer SiO tamponade time(P=0.002 in Fisher's exact test)and visual acuity(P=0.011 in binary logistic regression).Optic nerve atrophy or disc cupping(P=1.00,P=0.790)and congenital optic disc anomalies(P=0.424)were all with P>0.05.CONCLUSION SiO migration to CNS is rare with limited case reports only.Our analysis of the existing literature demonstrated higher post-vitrectomy IOP was associated with CVM,followed by patients’diabetic status,longer SiO tamponade time and visual acuity.Optic nerve atrophy,disc cupping and congenital optic disc anomalies were not associated.Modifiable risk factors of post-vitrectomy IOP and SiO tamponade time should be closely monitored by vitreoretinal surgeons.Lower IOP target post-vitrectomy and earlier SiO removal surgeries should be arranged.展开更多
BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a n...BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a non-treatable condition.Constant attempts are made to identify newer therapies that could support better management of the diabetes condition and improve overall quality of life.Numerous studies have supported the potential role of probiotics therapy in the diabetes condition.AIM To evaluate the efficacy of triple probiotic combination on glycaemic,metabolic,oxidative stress,and inflammatory parameters in the diabetic population.METHODS Randomized controlled trials evaluating the efficacy of the triple probiotic combination in diabetic patients were identified.The quality of the studies was evaluated using the PEDro scale while biasness between and within the studies was assessed using the Risk of Bias tool.Meta-analysis was conducted using RevMan software,and sensitivity analysis was performed using OpenMeta Analyst software.The study protocol was registered in PROSPERO(CRD42-024530999).RESULTS Five good-quality clinical trials were included.Low-to-moderate risk of bias was observed.Data from 300 participants were included(150 participants in both groups).Probiotics supplementation significantly improved glycaemic and insulin parameters(glucose level:-23.86 mg/dL;insulin level:-5.02μIU/mL;HOMA-IR:-1.82 score;QUICKI:+0.02 score;HOMA-B:-16.30 score;P<0.05 for all parameters),reduced oxidative stress and improved antioxidant parameters[TAC:+92.55 mmol/L;glutathione(GSH):+40.55μmol/L;nitric oxide(NO):+6.45μmol/L;malondialdehyde(MDA):-0.48μmol/L;hs-CRP:-2.24 mg/L;P<0.05 for all parameters except GSH],and improved lipid parameters(total cholesterol(TC):-3.43 mg/dL;triglycerides(TG):-4.26 mg/dL;low-density lipoprotein:-4.62 mg/dL;very low-density lipoprotein:-0.83 mg/dL;high-density lipoprotein(HDL):+1.83 mg/dL;TC/HDL ratio:-0.25;P<0.05 for HDL and TC/HDL ratio parameters)compared to the control group.CONCLUSION The combination of L.acidophilus,L.casei,and B.bifidum is effective in diabetic patients with cardio/renal complications.Further well-designed studies are warranted to support the results of current research.展开更多
Background:Glioblastoma(GBM)remains themost aggressive primary brain tumour in adults,marked by pronounced cellular heterogeneity,diffuse infiltration,and resistance to conventional treatment.In recent years,transcrip...Background:Glioblastoma(GBM)remains themost aggressive primary brain tumour in adults,marked by pronounced cellular heterogeneity,diffuse infiltration,and resistance to conventional treatment.In recent years,transcriptomic profiling has provided valuable insights into the molecular mechanisms that govern the progression of glioblastoma.This systematic review aims to synthesise the current literature on dysregulated gene expression in GBM,focusing on gene signatures associatedwith stemness,immunemodulation,extracellularmatrix remodelling,metabolic adaptation,and therapeutic resistance.Methods:We conducted a systematic search of PubMed,The Cancer Genome Atlas(TCGA),Chinese Glioma Genome Atlas(CGGA),and the GlioVis portal for studies published between January 2005 and April 2025,limited to English-language reports.Studies were eligible if they included adult glioblastoma tissue or patient-derived datasets and reported gene-level expression or clinical associations.Reviews,commentaries,and studies on non-GBM gliomas were excluded.Screening followed the PRISMA 2020 checklist,with 410 records initially identified,90 duplicates removed,and 125 studies retained after full-text review.Data were synthesised descriptively,and findings were validated against TCGA/CGGA expression datasets to ensure consistency across cohorts.Results:We categorised recurrently dysregulated genes by their biological function,including transcription factors(SOX2,ZEB2),growth factor receptors(EGFR,PDGFRA),immune-related markers(PD-L1,TAP1,B2M),extracellular matrix regulators(MMP2,LAMC1,HAS2),and metabolic genes(SLC7A11,PRMT5,NRF2).For each group,we examine the functional consequences of transcriptional alterations and their role in driving key glioblastoma phenotypes,including angiogenesis,immunosuppression,invasiveness,and recurrence.Conclusion:We further discuss the prognostic implications of these gene signatures and evaluate their potential utility in precisionmedicine,including current clinical trials that target molecular pathways identified through transcriptomic data.This review highlights the power of gene expression profiling to stratify glioblastoma subtypes and improve personalised therapeutic strategies.展开更多
Enterprise Resource Planning(ERP)systems play a pivotal role in modern organizations by integrating business processes,enhancing operational efficiency,and supporting decision-making.Evaluating the success of ERP impl...Enterprise Resource Planning(ERP)systems play a pivotal role in modern organizations by integrating business processes,enhancing operational efficiency,and supporting decision-making.Evaluating the success of ERP implementations remains a critical challenge for both researchers and practitioners.The DeLone&McLean(D&M)Information Systems(IS)Success Model has been widely adopted as a theoretical framework to assess ERP success,yet its application in dynamic and evolving technological landscapes requires further examination.This systematic review synthesizes empirical studies from 2017 to 2024 that apply the D&M Model to evaluate ERP system success.The study aims to:(1)identify key trends in the application of the D&M Model across different organizational and technological contexts,(2)analyze the most influential success factors-system quality,information quality,service quality,user satisfaction,use,and net benefits-and their interrelationships,and(3)highlight emerging challenges and opportunities for refining the model in ERP research.Findings reveal that while the D&M Model provides a robust foundation for assessing ERP success,contextual factors such as organizational climate,leadership support,and mandatory vs.voluntary usage significantly influence outcomes.Additionally,advancements in digital transformation,AI,and cloud-based ERP systems introduce new dimensions that the traditional model may not fully capture.The review also identifies gaps in longitudinal studies and cross-cultural validations of the D&M Model in ERP settings.Based on the analysis,this paper proposes an enhanced framework that integrates dynamic moderators and post-implementation metrics to better align the D&M Model with contemporary ERP environments.The study contributes to IS literature by offering a comprehensive evaluation of the D&M Model’s applicability and limitations in ERP research,while providing actionable insights for organizations seeking to optimize ERP success.展开更多
BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM ...BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.展开更多
BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide...BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide on infection and gastrointestinal adverse events in pediatric SBS patients via systematic review and meta-analysis.METHODS Following PRISMA 2009 guidelines and PROSPERO registration,we searched PubMed,Web of Science,and EMBASE for randomized controlled trials(RCTs)(pediatric SBS patients≤18 years;teduglutide vs placebo/standard care).Two reviewers screened studies,extracted data,and assessed bias(ROB2).Metaanalyses used RevMan 5.4(Mantel-Haenszel method,random-effects if I^(2)≠0).Trial sequential analysis and GRADE were applied.RESULTS Three RCTs involving 115 pediatric patients were included.Pooled analysis revealed no statistically significant differences between the teduglutide and control groups for the primary outcome of infection events[RR=0.83;(95%CI:0.44-1.56);P=0.57;I^(2)=0%;2 studies,n=55].Similarly,no significant differences were found for secondary outcomes:Upper respiratory tract infection[RR=0.68;(95%CI:0.32-1.47);P=0.33;I^(2)=0%],catheter site infection[RR=1.86;(95%CI:0.23-14.78);P=0.56;I^(2)=0%],vomiting[RR=1.35;(95%CI:0.10-18.23);P=0.82;I^(2)=72%],abdominal pain[RR=2.47;(95%CI:0.50-12.16);P=0.27;I^(2)=0%],nausea[RR=1.31;(95%CI:0.24-7.22);P=0.75;I^(2)=0%],diarrhea[RR=1.02;(95%CI:0.23-4.43);P=0.98;I^(2)=0%],and abdominal distension[RR=1.49;(95%CI:0.18-12.35);P=0.71;I^(2)=0%].The overall certainty of evidence assessed by GRADE was moderate.CONCLUSION Teduglutide does not increase infection or gastrointestinal adverse event risk in pediatric SBS,but small sample sizes limit conclusions.Larger studies are needed.展开更多
Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous revie...Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.展开更多
基金supported by grants from Collaborative Research Fund(Ref:C4032-21GF)General Research Grant(Ref:14114822)+1 种基金Group Research Scheme(Ref:3110146)Area of Excellence(Ref:Ao E/M-402/20)。
文摘Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.
基金supported by the National Natural Science Foundation of China,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
文摘BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金funded by Macao Polytechnic University grant number RP/FCA-08-2023.
文摘The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.
文摘Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.
文摘Objective This systematic review aimed to identify the predictors of recovery from dysphagia after stroke in the last ten years,thereby providing an evidence-based basis for nurses to identify high-risk patients and develop individualized rehabilitation plans to improve patient prognosis.Methods Databases including the China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBMdisc),China Science and Technology Journal(VIP),WanFang,PubMed,Embase,CINAHL,Web of Science,the Cochrane Library,and Scopus were retrieved to search for literature on the predictors of recovery from dysphagia after stroke.The retrieval period was from January 2013 to December 2023.The quality of studies was assessed using the Newcastle-Ottawa Scale(NOS)and the Prediction model Risk of Bias Assessment Tool(PROBAST).Meta-analysis was performed using Revman5.3 and Stata15.1 software.The review protocol has been registered with PROSPERO(CRD42024605570).Results A total of 1,216 results were obtained,including 599 in English and 617 in Chinese.A total of 34 studies were included,involving 156,309 patients with post-stroke dysphagia,and the rate of dysphagia recovery increased from 13.53%at 1 week to 95%at 6 months after stroke.Meta-analysis results showed that older age[OR=1.06,95%CI(1.04,1.08),P<0.001],lower BMI[OR=1.28,95%CI(1.17,1.40),P<0.001],bilateral stroke[OR=3.10,95%CI(2.04,4.72),P<0.001],higher National Institutes of Health Stroke Scale(NIHSS)score[OR=1.19,95%CI(1.01,1.39),P=0.030],tracheal intubation[OR=5.08,95%CI(1.57,16.39),P=0.007]and aspiration[OR=4.70,95%CI(3.06,7.20),P<0.001]were unfavorable factors for the recovery of swallowing function in patients with post-stroke dysphagia.Conclusions The lack of standardized criteria for rehabilitation assessment of post-stroke dysphagia has resulted in reported recovery rates of swallowing function exhibiting wide variability.Nurses should take targeted preventive measures for patients aged≥70 years,low BMI,bilateral stroke,high NIHSS score,tracheal intubation,and aspiration to promote the recovery of swallowing function in patients with post-stroke dysphagia.
基金the support provided by the 2D43 TW009883 D43 Post-Doctoral Program at the School of Nursing,University of Michigan,USA。
文摘Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.
基金supported by the National Natural Science Foundation of China(42277087,42130708,42471021,42277482,and 42361144876)the Natural Science Foundation of Guangdong Province(2024A1515012550)+3 种基金the Hainan Institute of National Park grant(KY-23ZK01)the Tsinghua Shenzhen International Graduate School Cross-disciplinary Research and Innovation Fund Research Plan(JC2022011)the Shenzhen Science and Technology Program(JCYJ20240813112106009 and ZDSYS20220606100806014)the Scientific Research Start-up Funds(QD2021030C)from Tsinghua Shenzhen International Graduate School。
文摘Food systems are deeply affected by climate change and air pollution,while being key contributors to these environmental challenges.Understanding the complex interactions among food systems,climate change,and air pollution is crucial for mitigating climate change,improving air quality,and promoting the sustainable development of food systems.However,the literature lacks a comprehensive review of these interactions,particularly in the current phase of rapid development in the field.To address this gap,this study systematically reviews recent research on the impacts of climate change and air pollution on food systems,as well as the greenhouse gas and air pollutant emissions from agri-food systems and their contribution to global climate change and air pollution.In addition,this study summarizes various strategies for mitigation and adaptation,including adjustments in agricultural practices and food supply chains.Profound changes in food systems are urgently needed to enhance adaptability and reduce emissions.This review offers a critical overview of current research on the interactions among food systems,climate change,and air pollution and highlights future research directions to support the transition to sustainable food systems.
文摘Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。
文摘Background:Isotonic crystalloids are recommended as the first choice for fluid therapy in acute pan-creatitis(AP),with normal saline(NS)and lactate Ringer’s(LR)used most often.Evidence based recom-mendations on the type of fluid are conflicting and generally come from small single-center randomized controlled trials(RCTs).We therefore conducted a systematic review and meta-analysis to compare the effect of balanced solutions(BS)versus NS on patient-centered clinical outcomes in AP.Methods:From four databases searched up to October 2024,we included only RCTs of adult patients with AP that compared the use of BS(including LR,acetate Ringer’s,etc.)with NS.The primary out-come was the disease advances from AP to moderately severe and severe AP(MSAP/SAP).Trial sequential analyses(TSA)were conducted to control for type-I and type-II errors and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)was used to assess the quality of evidence.Results:Six RCTs were identified and included,involving 260 patients treated with BS and 298 patients with NS.Patients who received the BS had less MSAP/SAP[odds ratio(OR)=0.50,95%confidence in-terval(CI):0.29 to 0.85,P=0.01,I^(2)=0%;5 studies,299 patients],reduced the need of ICU admission(OR=0.60,95%CI:0.39 to 0.93,P=0.02,I^(2)=0%;5 studies,507 patients)and shorter length of hospital stay[mean difference(MD)=-0.88,95%CI:-1.48 to-0.28,P=0.004,I^(2)=0%;6 studies,558 patients;confirmed by TSA with high certainty]compared with those who received NS.The evidence for most of the clinical outcomes was rated as moderate to low due to the risk of bias,imprecision and inconsistency.Conclusions:BS,compared with NS,was associated with improved clinical outcomes in patients with AP.However,given the moderate to low quality of evidence for most of the outcomes assessed,further trials are warranted.
文摘Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniques coming up rapidly.The purpose of this study is to review the recent developments in the field of security integration in the software development lifecycle(SDLC)by analyzing the articles published in the last two decades and to propose a way forward.This review follows Kitchenham’s review protocol.The review has been divided into three main stages including planning,execution,and analysis.From the selected 100 articles,it becomes evident that need of a collaborative approach is necessary for addressing critical software security risks(CSSRs)through effective risk management/estimation techniques.Quantifying risks using a numeric scale enables a comprehensive understanding of their severity,facilitating focused resource allocation and mitigation efforts.Through a comprehensive understanding of potential vulnerabilities and proactive mitigation efforts facilitated by protection poker,organizations can prioritize resources effectively to ensure the successful outcome of projects and initiatives in today’s dynamic threat landscape.The review reveals that threat analysis and security testing are needed to develop automated tools for the future.Accurate estimation of effort required to prioritize potential security risks is a big challenge in software security.The accuracy of effort estimation can be further improved by exploring new techniques,particularly those involving deep learning.It is also imperative to validate these effort estimation methods to ensure all potential security threats are addressed.Another challenge is selecting the right model for each specific security threat.To achieve a comprehensive evaluation,researchers should use well-known benchmark checklists.
文摘BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only limited cases were reported in the literature,certain intra-operative and post-operative ocular risk factors might contribute to the different extend of SiO migration in the CNS.AIM To study the risk factors for cerebral ventricular migration(CVM)on top of visual pathway migration(VPM).METHODS Conforming to the preferred reporting items for systematic reviews and metaanalyses guidelines,literature searches on PubMed,MEDLINE,EMBASE were performed on June 1,2024.Publications on SiO migration to CNS were included in this review.Non-English articles,and studies without neuro-imaging of the CNS were excluded.Patient demographics,SiO filled eyes'ocular characteristics and vitrectomy surgical details were extracted from included studies in this review.VPM and CVM were assigned as group 1 and group 2 respectively.Fisher's exact tests,Mann-Whitney U tests and binary logistic regression were performed.RESULTS Total 68 articles were obtained after searches,48 publications were included for analysis.Total 54 SiO filled eyes were analyzed.Post-vitrectomy intraocular pressure(IOP)was found to be significant in both Mann-Whitney U test(P=0.047)and binary logistic regression(P=0.012).Diabetic was found to be significant in binary logistic regression(P=0.037),but at borderline risk for CVM in Fisher's exact test(P=0.05).Other significant factors include longer SiO tamponade time(P=0.002 in Fisher's exact test)and visual acuity(P=0.011 in binary logistic regression).Optic nerve atrophy or disc cupping(P=1.00,P=0.790)and congenital optic disc anomalies(P=0.424)were all with P>0.05.CONCLUSION SiO migration to CNS is rare with limited case reports only.Our analysis of the existing literature demonstrated higher post-vitrectomy IOP was associated with CVM,followed by patients’diabetic status,longer SiO tamponade time and visual acuity.Optic nerve atrophy,disc cupping and congenital optic disc anomalies were not associated.Modifiable risk factors of post-vitrectomy IOP and SiO tamponade time should be closely monitored by vitreoretinal surgeons.Lower IOP target post-vitrectomy and earlier SiO removal surgeries should be arranged.
文摘BACKGROUND Diabetes is an epidemic condition affecting people globally with a high rate of morbidity and mortality.While various pharmacological and non-pharmacological treatment options are used,diabetes is still a non-treatable condition.Constant attempts are made to identify newer therapies that could support better management of the diabetes condition and improve overall quality of life.Numerous studies have supported the potential role of probiotics therapy in the diabetes condition.AIM To evaluate the efficacy of triple probiotic combination on glycaemic,metabolic,oxidative stress,and inflammatory parameters in the diabetic population.METHODS Randomized controlled trials evaluating the efficacy of the triple probiotic combination in diabetic patients were identified.The quality of the studies was evaluated using the PEDro scale while biasness between and within the studies was assessed using the Risk of Bias tool.Meta-analysis was conducted using RevMan software,and sensitivity analysis was performed using OpenMeta Analyst software.The study protocol was registered in PROSPERO(CRD42-024530999).RESULTS Five good-quality clinical trials were included.Low-to-moderate risk of bias was observed.Data from 300 participants were included(150 participants in both groups).Probiotics supplementation significantly improved glycaemic and insulin parameters(glucose level:-23.86 mg/dL;insulin level:-5.02μIU/mL;HOMA-IR:-1.82 score;QUICKI:+0.02 score;HOMA-B:-16.30 score;P<0.05 for all parameters),reduced oxidative stress and improved antioxidant parameters[TAC:+92.55 mmol/L;glutathione(GSH):+40.55μmol/L;nitric oxide(NO):+6.45μmol/L;malondialdehyde(MDA):-0.48μmol/L;hs-CRP:-2.24 mg/L;P<0.05 for all parameters except GSH],and improved lipid parameters(total cholesterol(TC):-3.43 mg/dL;triglycerides(TG):-4.26 mg/dL;low-density lipoprotein:-4.62 mg/dL;very low-density lipoprotein:-0.83 mg/dL;high-density lipoprotein(HDL):+1.83 mg/dL;TC/HDL ratio:-0.25;P<0.05 for HDL and TC/HDL ratio parameters)compared to the control group.CONCLUSION The combination of L.acidophilus,L.casei,and B.bifidum is effective in diabetic patients with cardio/renal complications.Further well-designed studies are warranted to support the results of current research.
文摘Background:Glioblastoma(GBM)remains themost aggressive primary brain tumour in adults,marked by pronounced cellular heterogeneity,diffuse infiltration,and resistance to conventional treatment.In recent years,transcriptomic profiling has provided valuable insights into the molecular mechanisms that govern the progression of glioblastoma.This systematic review aims to synthesise the current literature on dysregulated gene expression in GBM,focusing on gene signatures associatedwith stemness,immunemodulation,extracellularmatrix remodelling,metabolic adaptation,and therapeutic resistance.Methods:We conducted a systematic search of PubMed,The Cancer Genome Atlas(TCGA),Chinese Glioma Genome Atlas(CGGA),and the GlioVis portal for studies published between January 2005 and April 2025,limited to English-language reports.Studies were eligible if they included adult glioblastoma tissue or patient-derived datasets and reported gene-level expression or clinical associations.Reviews,commentaries,and studies on non-GBM gliomas were excluded.Screening followed the PRISMA 2020 checklist,with 410 records initially identified,90 duplicates removed,and 125 studies retained after full-text review.Data were synthesised descriptively,and findings were validated against TCGA/CGGA expression datasets to ensure consistency across cohorts.Results:We categorised recurrently dysregulated genes by their biological function,including transcription factors(SOX2,ZEB2),growth factor receptors(EGFR,PDGFRA),immune-related markers(PD-L1,TAP1,B2M),extracellular matrix regulators(MMP2,LAMC1,HAS2),and metabolic genes(SLC7A11,PRMT5,NRF2).For each group,we examine the functional consequences of transcriptional alterations and their role in driving key glioblastoma phenotypes,including angiogenesis,immunosuppression,invasiveness,and recurrence.Conclusion:We further discuss the prognostic implications of these gene signatures and evaluate their potential utility in precisionmedicine,including current clinical trials that target molecular pathways identified through transcriptomic data.This review highlights the power of gene expression profiling to stratify glioblastoma subtypes and improve personalised therapeutic strategies.
文摘Enterprise Resource Planning(ERP)systems play a pivotal role in modern organizations by integrating business processes,enhancing operational efficiency,and supporting decision-making.Evaluating the success of ERP implementations remains a critical challenge for both researchers and practitioners.The DeLone&McLean(D&M)Information Systems(IS)Success Model has been widely adopted as a theoretical framework to assess ERP success,yet its application in dynamic and evolving technological landscapes requires further examination.This systematic review synthesizes empirical studies from 2017 to 2024 that apply the D&M Model to evaluate ERP system success.The study aims to:(1)identify key trends in the application of the D&M Model across different organizational and technological contexts,(2)analyze the most influential success factors-system quality,information quality,service quality,user satisfaction,use,and net benefits-and their interrelationships,and(3)highlight emerging challenges and opportunities for refining the model in ERP research.Findings reveal that while the D&M Model provides a robust foundation for assessing ERP success,contextual factors such as organizational climate,leadership support,and mandatory vs.voluntary usage significantly influence outcomes.Additionally,advancements in digital transformation,AI,and cloud-based ERP systems introduce new dimensions that the traditional model may not fully capture.The review also identifies gaps in longitudinal studies and cross-cultural validations of the D&M Model in ERP settings.Based on the analysis,this paper proposes an enhanced framework that integrates dynamic moderators and post-implementation metrics to better align the D&M Model with contemporary ERP environments.The study contributes to IS literature by offering a comprehensive evaluation of the D&M Model’s applicability and limitations in ERP research,while providing actionable insights for organizations seeking to optimize ERP success.
文摘BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.
文摘BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide on infection and gastrointestinal adverse events in pediatric SBS patients via systematic review and meta-analysis.METHODS Following PRISMA 2009 guidelines and PROSPERO registration,we searched PubMed,Web of Science,and EMBASE for randomized controlled trials(RCTs)(pediatric SBS patients≤18 years;teduglutide vs placebo/standard care).Two reviewers screened studies,extracted data,and assessed bias(ROB2).Metaanalyses used RevMan 5.4(Mantel-Haenszel method,random-effects if I^(2)≠0).Trial sequential analysis and GRADE were applied.RESULTS Three RCTs involving 115 pediatric patients were included.Pooled analysis revealed no statistically significant differences between the teduglutide and control groups for the primary outcome of infection events[RR=0.83;(95%CI:0.44-1.56);P=0.57;I^(2)=0%;2 studies,n=55].Similarly,no significant differences were found for secondary outcomes:Upper respiratory tract infection[RR=0.68;(95%CI:0.32-1.47);P=0.33;I^(2)=0%],catheter site infection[RR=1.86;(95%CI:0.23-14.78);P=0.56;I^(2)=0%],vomiting[RR=1.35;(95%CI:0.10-18.23);P=0.82;I^(2)=72%],abdominal pain[RR=2.47;(95%CI:0.50-12.16);P=0.27;I^(2)=0%],nausea[RR=1.31;(95%CI:0.24-7.22);P=0.75;I^(2)=0%],diarrhea[RR=1.02;(95%CI:0.23-4.43);P=0.98;I^(2)=0%],and abdominal distension[RR=1.49;(95%CI:0.18-12.35);P=0.71;I^(2)=0%].The overall certainty of evidence assessed by GRADE was moderate.CONCLUSION Teduglutide does not increase infection or gastrointestinal adverse event risk in pediatric SBS,but small sample sizes limit conclusions.Larger studies are needed.
基金Supported by grants from Shanghai Municipal Health Commission for the Inheritance and Innovation of Traditional Chinese Medicine:ZY (2021-2023)-0204。
文摘Background Acupuncture and its related therapies,as an important part of traditional Chinese medicine,have been widely accepted by the public and healthcare professionals all over the world.According to previous reviews,the department of acupuncture is a potential place where nosocomial infection might occur.Objectives To investigate the common pathogens and possible risk factors for nosocomial infection,figure out the measures and strategies for control and prevention,and provide general reporting guideline for future cases.Methods A systematic literature search of 6 libraries(EMBASE,CINAHL,PubMed,VIP,CNKI,SinoMed)was carried out on nosocomial infection(NIs)after acupuncture and its related therapies(e.g.,moxibustion,cupping,massage,dry needling)published from January 1,2012 to August 31,2023.Studies providing primary data were included;reviews,comments,and non-primary data studies were excluded to prevent duplicate case analysis.Data on bibliographic details,study characteristics,and clinical information were extracted.Results were synthesized through tabulation and categorized by therapy type,country income level,symptoms/diagnoses,pathogens,risk factors,treatments,and outcomes.Conclusion Nosocomial infections after acupuncture and its related therapies are possible but preventable.Prevention measures can be carried out in terms of the risk factors listed above.Future case reports are suggested to provide specific details of infection,including the setting,qualification,treatment,disinfection,and causal evidence.
