Search Results (484)

Background: Breast reconstruction post-mastectomy has increasingly emphasized the importance of sensory restoration. This study aimed to evaluate the comparative efficacy of anterior versus lateral cutaneous intercostal nerve branches in neurotization during abdominal-based autologous breast reconstruction. Methods: Through a systematic literature search and meta-analysis, we reviewed studies published between January 2003 and August 2023. Our methods involved categorizing studies based on the nerve branch used, extracting relevant data, and conducting a quality assessment. To determine the difference in the magnitude of sensory recovery, a meta-analysis was conducted to pool the effect sizes (mean differences) from individual studies. Given the potential for heterogeneity across studies, a random-effects model was employed using the DerSimonian and Laird method. Subgroup analysis was then performed to separately evaluate the effect sizes for the anterior and lateral groups. Results: We identified five studies for the anterior group and five studies for the lateral group. The anterior group included a total of 225 non-neurotized and 240 neurotized breasts, while the lateral group consisted of 62 non-neurotized and 51 neurotized breasts. The anterior group exhibited superior sensory recovery compared to the lateral group (p = 0.08 for the common effect model). The result was borderline significant, suggesting a trend towards a difference between the two groups. In terms of patient-reported outcomes, the anterior group provided data, while the lateral group lacked such data, underscoring a potential research gap. Conclusions: Results indicated a trend favoring the anterior cutaneous branch, with studies showing improved sensory outcomes and patient satisfaction. However, the choice between the two should be individualized, considering the patient’s unique needs and the surgeon’s expertise. Full article

Background/Objectives: Constitutive activation of the PI3K/AKT/mTOR signaling cascade underlies the aggressive phenotype of fibroblast-like synoviocytes (FLSs) in rheumatoid arthritis (RA); however, a quantitative synthesis of in vitro data on pathway inhibition remains lacking. This systematic review and meta-analysis aimed to (i) aggregate standardized effects of pathway inhibitors on proliferation, apoptosis, migration/invasion, IL-6/IL-8 secretion, p-AKT, and LC3; (ii) assess heterogeneity and identify key moderators of variability, including stimulus type, cell source, and inhibitor class. Methods: PubMed, Europe PMC, and the Cochrane Library were searched up to 18 May 2025 (PROSPERO CRD420251058185). Twenty of 2684 screened records met eligibility. Two reviewers independently extracted data and assessed study quality with SciRAP. Standardized mean differences (Hedges g) were pooled using a Sidik–Jonkman random-effects model with Hartung–Knapp confidence intervals. Heterogeneity (τ², I²), 95% prediction intervals, and meta-regression by cell type were calculated; robustness was tested with REML-HK, leave-one-out, and Baujat diagnostics. Results: PI3K/AKT/mTOR inhibition markedly reduced proliferation (to –5.1 SD), IL-6 (–11.1 SD), and IL-8 (–6.5 SD) while increasing apoptosis (+2.7 SD). Fourteen of seventeen outcome clusters showed large effects (|g| ≥ 0.8), with low–moderate heterogeneity (I² ≤ 35% in 11 clusters). Prediction intervals crossed zero only in small k-groups; sensitivity analyses shifted pooled estimates by ≤0.05 SD. p-AKT and p-mTOR consistently reflected functional changes and emerged as reliable pharmacodynamic markers. Conclusions: Targeted blockade of PI3K/AKT/mTOR robustly suppresses the proliferative and inflammatory phenotype of RA-FLSs, reaffirming this axis as a therapeutic target. The stability of estimates across multiple analytic scenarios enhances confidence in these findings and highlights p-AKT and p-mTOR as translational response markers. The present synthesis provides a quantitative basis for personalized dual-PI3K/mTOR strategies and supports the adoption of standardized long-term preclinical protocols. Full article

Introduction: Asthma is a chronic respiratory disease affecting approximately 5 million children in the US, but little is known about whether asthma alters children’s attention and memory functions. Most studies on this topic focus on psychiatric and QoL outcomes rather than cognitive functions, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate the attention deficit and memory function outcomes in children with bronchial asthma. Methods: A systematic search was conducted in PubMed, Web of Science, and Cochrane Library from inception to 28 February 2025 for studies evaluating attention deficit and memory function in children with bronchial asthma. Outcomes of interest included attention deficit and memory function. Statistical analysis was performed with R 4.3.1. Heterogeneity was accessed using the I² statistics and Cochrane Q test. The standardized mean difference (SMD) with restricted maximum-likelihood estimator random-effects method was computed for all outcomes. Results: A total of seven studies were included in the final meta-analysis, comprising 104,975 patients, of whom 10,200 (9.7%) had bronchial asthma (mean age ± 8.98 years, mean 45% females). In the pooled analysis, children with asthma had a worsened attention deficit compared to the healthy group (SMD 0.29; 95% CI [0.07; 0.51]; p = 0.01; I² = 92%). However, no statistically significant difference was found in memory function between groups (SMD −0.24; 95% CI [−1.81; 1.33]; p = 0.77; I² = 96%). Conclusions: Children with asthma showed significantly higher attention deficit scores compared to healthy children. No statistically significant differences were observed in memory function between the groups. These findings may have implications for early cognitive screening in pediatric asthma management. Full article

Introduction: Unruptured intracranial aneurysms (UIAs) can induce psychological stress, leading to anxiety, depression, and impaired quality of life (QoL). Most studies on this topic are limited by small sample sizes, cross-sectional designs, and a focus on treated rather than untreated cases, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate mental health and QoL outcomes in patients with untreated UIAs. Methods: A systematic search was conducted up to 30 November 2024 using PubMed, Scopus, and Cochrane Central for studies comparing patients with untreated UIAs to a control group. The outcomes of interest included anxiety, depression, and QoL. Statistical analysis was performed using RevMan 5.1.7 and R 4.3.1. Heterogeneity was assessed using I² statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. Results: We included five studies with 417,152 patients, of whom 85,668 (20.53%) had untreated UIAs. In the pooled analysis, patients with untreated UIAs had significantly higher anxiety levels (SMD 0.66; 95% CI [0.16; 1.17]; p = 0.01; I² = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; p = 0.01; I² = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; p = 0.84; I² = 88%) between groups. Conclusions: This meta-analysis indicates a potential association between untreated UIAs and increased anxiety levels and reduced QoL. Regarding depression, no significant differences were observed between groups. Full article

Background: Sarcopenia significantly affects the health and quality of life in older adults. Exercise combined with nutritional interventions is widely recognized as an effective strategy for improving sarcopenia outcomes. However, current studies rarely focus on differential effects across subpopulations with distinct demographic and health characteristics. This study aimed to explore the effects of combined exercise and nutrition interventions on sarcopenia-related outcomes, considering the variations in population characteristics. Methods: A systematic search was conducted across PubMed, Embase, the Web of Science, and Cochrane Library, covering the literature published between January 2010 and March 2025. Only randomized controlled trials (RCTs) evaluating combined exercise and nutritional interventions for sarcopenia were included. The primary outcomes were handgrip strength (HS), the skeletal muscle mass index (SMI), gait speed (GS), and the five-times sit-to-stand test (5STS). The mean differences (MD) with 95% confidence intervals (CIs) were calculated. Random-effects models were used for the meta-analysis and subgroup comparisons. Results: Fifteen RCTs involving 1258 participants in the intervention group and 1233 in the control group were included. Exercise combined with nutritional interventions significantly improved sarcopenia-related outcomes. HS improved with a pooled MD of 1.77 kg (95% CI: 0.51 to 3.03, p = 0.006); SMI increased by 0.22 kg/m² (95% CI: 0.09 to 0.35, p = 0.0007); GS improved by 0.09 m/s (95% CI: 0.04 to 0.14, p = 0.0002); and 5STS performance improved with a time reduction of −1.38 s (95% CI: −2.47 to −0.28, p = 0.01). Subgroup analyses indicated that the intervention effects varied according to age, BMI, and living environment. Conclusions: Exercise combined with nutrition is effective in improving key outcomes associated with sarcopenia in older adults. The magnitude of these effects differed across population subgroups, underscoring the importance of tailoring interventions to specific demographic and health profiles. Full article

Youth unemployment remains a pressing issue in many emerging economies, where educational disparities and demographic pressures interact in complex ways. This study investigates the links between higher-education enrolment, demographic structure and youth unemployment in eight developing countries from 2009 to 2023. Panel cointegration techniques—Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS)—are applied to estimate the long-run effects of gross tertiary-school enrolment on youth unemployment while controlling for GDP growth and youth-cohort size. Robustness is confirmed through complementary estimations with pooled-mean-group ARDL and system-GMM panels, which deliver consistent coefficient signs and significance levels. Results show a significant negative elasticity between enrolment and youth unemployment, indicating that wider access to higher education helps lower joblessness among young people. Youth-population growth exerts an opposite, positive effect, while GDP growth reduces unemployment but less uniformly across regions. The evidence points to an integrated policy mix—expanding tertiary (especially vocational and technical) education, managing demographic pressure and maintaining macro-economic stability—to improve youth-employment outcomes in emerging economies. Full article

This study investigates the relationship between ESG performance and economic growth in BRICS nations from 2000 to 2020, aiming to understand how ESG practices influence development trajectories. By integrating economic theories with relevant conceptual frameworks, this study provides a comprehensive analysis of ESG dynamics in emerging economies. The purpose of this study is to determine how the economic growth of the BRICS countries between 2000 and 2020 was impacted by ESG performance at the national level. This work contributes to the body of knowledge by offering a fresh macroeconomic examination of the connection between economic growth and ESG performance in the BRICS nations, a topic that is still relatively unexplored in comparison to firm-level research. A significant knowledge gap on how developing economies strike a balance between rapid economic expansion and environmental and social sustainability is filled by the research’s use of a thorough national-level ESG framework. The study employed a dynamic panel auto regressive distributed lag (ARDL) model, utilising a dynamic pooled mean group (PMG) ARDL econometric technique for both short- and long-term estimates. The findings reveal a short-term negative relationship between ESG performance and economic growth in the BRICS countries, which implies that there are high transitional effects involved in sustainable growth solutions. It also highlights the structural and developmental heterogeneity among BRICS countries. Moreover, the study highlights that carbon emissions positively influence short-term economic growth, underscoring the challenge of balancing sustainability with the continued reliance on fossil fuels in these economies. However, the long-term results show that strong ESG practices ultimately positively affect economic growth, reinforcing the importance of investing in sustainable development for achieving high-quality, long-term prosperity. This conclusion emphasises that, while short-term trade-offs may exist, robust ESG frameworks are crucial for fostering enduring economic and environmental well-being. Full article

Soil degradation exerts profound impacts on soil ecological functions, global food security, and human development, making the development of effective technologies to mitigate degradation a critical research focus. Microorganisms play a leading role in rehabilitating degraded land, improving soil hydraulic properties, and enhancing soil structural stability. Mosses contribute to soil particle fixation through their unique rhizoid structures; however, the mechanisms underlying their interactions in mixed inoculation remain unclear. Therefore, this study addresses soil and water loss caused by rainfall erosion in the cold black soil region. We conducted controlled laboratory experiments cultivating Bacillus subtilis and cold-adapted moss species, evaluating the erosion mitigation effects of different biological treatments under gradient slopes (3°, 6°, 9°) and rainfall intensities (70 mm h⁻¹, 120 mm h⁻¹), and elucidating their carbon-based structural reinforcement mechanism. The results indicated that compared to the control group, Treatment C significantly increased the mean weight diameter (MWD) and geometric mean diameter (GMD) of soil aggregates by 121.6% and 76.75%, respectively. In separate simulated rainfall events at 70 mm h⁻¹ and 120 mm h⁻¹, Treatment C reduced soil loss by 95.70% and 96.75% and decreased runoff by 38.31% and 67.21%, respectively. Crucially, the dissolved organic carbon (DOC) loss rate in Treatment C was only 21.98%, significantly lower than that in Treatment A (32.32%), Treatment B (22.22%), and the control group (51.07%)—representing a 59.41% reduction compared to the control. This demonstrates the following: (1) Bacillus subtilis enhances microbial metabolism, driving carbon conversion into stable pools, while mosses reduce carbon leaching via physical barriers, synergistically forming a dual “carbon protection–structural reinforcement” barrier. (2) The combined inoculation optimizes soil structure by increasing the proportion of large soil particles and enhancing aggregate stability, effectively suppressing soil loss even under extreme rainfall erosion. This study elucidates, for the first time, the biological pathway through which microbe–moss interactions achieve synergistic carbon sequestration and erosion resistance by regulating aggregate formation and pore water dynamics. It provides a scalable “carbon–structure”-optimized biotechnology system (co-inoculation of Bacillus subtilis and moss) for the ecological restoration of the cold black soil region. Full article

Background: Epicardial adipose tissue (EAT) may contribute to the pathogenesis of atrial fibrillation (AF). The attenuation of EAT assessed by means of computed tomography (CT) may reflect the severity of local tissue inflammation. This study aimed to systematically analyze the relationship between the attenuation of EAT surrounding the left atrium (LA-EAT) and AF recurrence after catheter ablation (CA). Methods: Five databases were searched up to April 10, 2025. Original studies involving adult patients with paroxysmal or persistent AF undergoing CA were included if they provided quantitative measurements of LA-EAT attenuation on cardiac CT before ablation. Results: A total of seven retrospective observational studies with 2440 patients were included in the analysis. The percentage of male participants ranged from 60.9% to 73.0%, and the mean or median age of patients varied from 57.5 to 68.2 years. The mean body mass index across studies ranged from 24.0 to 32.4 kg/m². A pooled analysis of all included trials demonstrated that the mean LA-EAT attenuation in the AF recurrence group was −78.97 ± 15.34 HU, which was less negative compared to the non-recurrence group (−81.37 ± 15.46 HU; mean difference [MD] = 2.22; 95% confidence interval [CI]: 0.84 to 3.61; p = 0.002). Conclusions: LA-EAT attenuation is significantly more positive in patients experiencing AF recurrence compared to those without recurrence following CA procedures. Full article

Sleep disturbances frequently affect postmenopausal women, yet the evidence supporting the use of aromatherapy as a therapeutic intervention remains inconclusive. This systematic review and meta-analysis evaluated the efficacy of aromatherapy in improving sleep quality in postmenopausal women by analyzing data from randomized controlled trials (RCTs). Three RCTs comprising a total of 301 participants were included. Eligible studies compared aromatherapy with control conditions and reported sleep-related outcomes. The pooled analysis revealed no statistically significant difference in global Pittsburgh Sleep Quality Index (PSQI) scores between the aromatherapy and control groups (mean difference, −2.66; 95% CI −6.49 to 1.17; p = 0.17), with high heterogeneity (I² = 98%). However, subgroup analyses demonstrated significant improvements in sleep latency (mean difference, −0.98; 95% CI −1.75 to −0.21; p = 0.01) and daytime drowsiness (mean difference, −0.79; 95% CI −1.30 to −0.28; p = 0.002). These findings suggest that aromatherapy may provide targeted benefits for certain aspects of sleep, particularly sleep latency and daytime dysfunction. Further high-quality RCTs with larger sample sizes, standardized aromatherapy protocols, and long-term follow-up are necessary to validate these outcomes and establish evidence-based clinical guidelines for the use of aromatherapy in managing sleep disturbances among postmenopausal women. Full article

Objective: This study aims to investigate the effect of shot selection on the muscle coordination characteristics during basketball shooting. Methods: A three-dimensional motion capture system, force platform, and wireless surface electromyography (sEMG) were used to simultaneously collect shooting data from 14 elite basketball players. An inverse mapping model of sEMG signals and spinal α-motor neuron pool activity was developed based on the Debra muscle segment distribution theory. Non-negative matrix factorization (NMF) and K-means clustering were used to extract muscle coordination features. Results: (1) Significant differences in spinal segment activation timing and amplitude were observed between stationary and jump shots at different distances. In close-range stationary shots, the C5-S3 segments showed higher activation during the TP phase and lower activation during the RP phase. For mid-range shots, the C6-S3 segments exhibited greater activation during the TP phase. In long-range shots, the C7-S3 segments showed higher activation during the TP phase, whereas the L3-S3 segments showed lower activation during the RP phase (p < 0.01). (2) The spatiotemporal structure of muscle coordination modules differed significantly between stationary and jump shots. In terms of spatiotemporal structure, the second and third coordination groups showed stronger activation during the RP phase (p < 0.01). Significant differences in muscle activation levels were also observed between the coordination modules within each group in the spatial structure. Conclusion: Shot selection plays a significant role in shaping neuromuscular control strategies during basketball shooting. Targeted training should focus on addressing the athlete’s specific shooting weaknesses. For stationary shots, the emphasis should be on enhancing lower limb stability, while for jump shots, attention should be directed toward improving core stability and upper limb coordination. Full article

Background: Long-lasting insecticidal nets (LLINs) have significantly reduced the malaria burden in recent decades, and this malaria prevalence reduction has been achieved through the upgrading of pyrethroid long-lasting insecticidal nets. However, this reduction has stalled due to many factors, including rapidly developing pyrethroid resistance. Method: The protocol was registered in PROSPERO, and we used Cochrane methodology to assess bias and evidence quality. Three reviewers extracted data from individual studies, and a meta-analysis was performed using Excel and STATA version 17, expressing the data as a risk ratio. Result: A study involving 21,916 households from 11 randomized controlled trials showed that the chlorfenapyr treatment group had a 10% reduction in malaria infection risk, with a pooled overall prevalence of 25.96 per 100 children in the chlorfenapyr group and 32.38 per 100 children in the piperonyl butoxide group, compared to 41.60 per 100 children in the control (pyrethroid-only) group. This meta-analysis determined that the entomological outcomes of effectiveness and efficacy showed that these treatments effectively reduced vector density per household per night and mean inoculation rates, with a 23% reduction in chlorfenapyr, a 7% reduction in pyrethroid-only treatments, and a 12% reduction in piperonyl-butoxide-treated groups. This study shows that chlorfenapyr (CFP) and pyriproxyfen (PPF) LLINs are highly effective and more efficacious in reducing malaria infection, case incidence, and anemia among children, as well as in reducing mean indoor vector density, mean entomological inoculation rate, and sporozoite rate, compared to pyriproxyfen (PPF) LLINs in Africa. Conclusions: This study found that chlorfenapyr (CFP) LLINs are highly effective and more efficacious in reducing malaria infection, case incidence, and anemia among children in Africa. Therefore, policymakers and health planners should place strong emphasis on addressing the effectiveness, efficacy, and resistance management of LLINs as part of their current public health agenda to eliminate malaria. Full article

Background/Objectives: Polymer-free drug-eluting stents (PF-DESs) aim to mitigate long-term adverse effects associated with polymer-based platforms. However, clinical comparisons with biodegradable polymer DESs (BP-DESs) remain limited. The objective of this review is to assess the efficacy and safety of PF-DESs versus thin-struts (<100 μm) BP-DESs in patients undergoing percutaneous coronary intervention (PCI). Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PF-DESs and BP-DESs in adults undergoing PCI. PubMed, Embase, and CENTRAL were searched up to 1 February 2025. A random-effects model was used to calculate pooled risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Outcomes included myocardial infarction (MI), all-cause and cardiac death, target lesion revascularization (TLR), stent thrombosis, and angiographic/OCT parameters. Subgroup and sensitivity analyses were conducted for outcomes with high heterogeneity (I² > 50%). Results: Nine RCTs (n = 9597) were included. At 12 months, no significant differences were found between PF-DESs and BP-DESs for TLR (RR 1.51; 95% CI: 0.83–2.75), MI, or stent thrombosis. At 24 months, MI and all-cause death were similar between groups. A subgroup analysis showed lower cardiac death with the BioFreedom stent (RR 0.57; 95% CI: 0.35–0.90), not observed in non-BioFreedom devices. No significant differences were detected in angiographic or OCT outcomes, though heterogeneity was high. Conclusions: PF-DESs and BP-DESs demonstrated comparable clinical performance. The observed benefit in cardiac death with BioFreedom may reflect device-specific effects and merits further investigation. Full article

Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment. Full article

Background: Lycopene, a dietary carotenoid with antioxidant properties, protects against sun-induced skin damage, prostatic conditions such as chronic prostatitis, and cancer; however, its role in metabolic disorders, including metabolic syndrome and nonalcoholic fatty liver disease (MAFLD), remains unclear. This study aimed to systematically assess the association between lycopene levels (serum and dietary) and the risk of metabolic diseases. Methods: This study adhered to the PRISMA guidelines and was prospectively registered on the Open Science Framework (OSF). We searched PubMed, Scopus, Web of Science, and Medline via WoS. Pooled odds ratios (OR), hazard ratios (HR), and mean differences (MD) with 95% confidence intervals (CIs) were calculated using fixed or random-effects models based on heterogeneity. Results: Twenty-nine studies were included, of which twenty-five were eligible for the meta-analysis. Pooled analysis showed that the individuals with the lowest serum lycopene levels had a significantly higher risk of MAFLD (OR = 1.39, 95%CI: 1.02–1.89, p = 0.0388). No significant associations were found between HbA1c levels, diabetes history, and weight status. Although not statistically significant, a clear trend of patients with DM having lower lycopene levels than the control group was observed (MD = −0.09, 95% CI: −0.19 to 0.00, p = 0.054). Comparisons based on weight status showed no significant differences. Conclusions: While lower serum lycopene levels are significantly associated with increased MAFLD risk, their impact on glycemic control remains inconclusive, underscoring the need for targeted clinical research. Full article