Association between physical activity and risk of gastroesophageal reflux disease:A systematic review and meta-analysis

Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this association.Methods:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and GERD.Results:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against GERD.Subgroup analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing GERD.Conclusion:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and smokers.Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.

Systematic review and network meta-analysis of different nonsteroidal anti-inflammatory drugs for juvenile idiopathic arthritis

BACKGROUND Various non-steroidal anti-inflammatory drugs(NSAIDs)have been used for juvenile idiopathic arthritis(JIA).However,the optimal method for JIA has not yet been developed.AIM To perform a systematic review and network meta-analysis to determine the optimal instructions.METHODS We searched for randomized controlled trials(RCTs)from PubMed,EMBASE,Google Scholar,CNKI,and Wanfang without restriction for publication date or language at August,2023.Any RCTs that comparing the effectiveness of NSAIDs with each other or placebo for JIA were included in this network meta-analysis.The surface under the cumulative ranking curve(SUCRA)analysis was used to rank the treatments.P value less than 0.05 was identified as statistically significant.RESULTS We included 8 RCTs(1127 patients)comparing 8 different instructions including meloxicam(0.125 qd and 0.250 qd),Celecoxib(3 mg/kg bid and 6 mg/kg bid),piroxicam,Naproxen(5.0 mg/kg/d,7.5 mg/kg/d and 12.5 mg/kg/d),inuprofen(30-40 mg/kg/d),Aspirin(60-80 mg/kg/d,75 mg/kg/d,and 55 mg/kg/d),Tolmetin(15 mg/kg/d),Rofecoxib,and placebo.There were no significant differences between any two NSAIDs regarding ACR Pedi 30 response.The SUCRA shows that celecoxib(6 mg/kg bid)ranked first(SUCRA,88.9%),rofecoxib ranked second(SUCRA,68.1%),Celecoxib(3 mg/kg bid)ranked third(SUCRA,51.0%).There were no significant differences between any two NSAIDs regarding adverse events.The SUCRA shows that placebo ranked first(SUCRA,88.2%),piroxicam ranked second(SUCRA,60.5%),rofecoxib(0.6 mg/kg qd)ranked third(SUCRA,56.1%),meloxicam(0.125 mg/kg qd)ranked fourth(SUCRA,56.1%),and rofecoxib(0.3 mg/kg qd)ranked fifth(SUCRA,56.1%).CONCLUSION In summary,celecoxib(6 mg/kg bid)was found to be the most effective NSAID for treating JIA.Rofecoxib,piroxicam,and meloxicam may be safer options,but further research is needed to confirm these findings in larger trials with higher quality studies.

Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and metaanalysis

BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.

Neurophysiological, histological, and behavioral characterization of animal models of distraction spinal cord injury: a systematic review

Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.

Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma

BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.

Systematic treatment in gastric cancer patients with overt bleeding:A propensity score matching analysis

BACKGROUND Hemorrhage,which is not a rare complication in patients with gastric cancer(GC)/gastroesophageal junction cancer(GEJC),can lead to a poor prognosis.However,no study has examined the effectiveness and safety of chemotherapy as an initial therapy for GC/GEJC patients with overt bleeding(OB).AIM To investigate the impact of OB on the survival and treatment-related adverse events(TRAEs)of GC/GEJC patients.METHODS Patients with advanced or metastatic GC/GEJC who received systematic treatment at Peking University Third Hospital were enrolled in this study.Propensity score matching(PSM)analysis was performed.RESULTS After 1:2 PSM analysis,93 patients were assessed,including 32 patients with OB before treatment(OBBT)and 61 patients without OBBT.The disease control rate was 90.6%in the group with OBBT and 88.5%in the group without OBBT,and this difference was not statistically significant.There was no difference in the incidence of TRAEs between the group with OBBT and the group without OBBT.The median overall survival(mOS)was 15.2 months for patients with OBBT and 23.7 months for those without OBBT[hazard ratio(HR)=1.101,95%confidence interval(CI):0.672-1.804,log rank P=0.701].The mOS was worse for patients with OB after treatment(OBAT)than for those without OBAT(11.4 months vs 23.7 months,HR=1.787,95%CI:1.006-3.175,log rank P=0.044).CONCLUSION The mOS for GC/GEJC patients with OBBT was similar to that for those without OBBT,but the mOS for patients with OBAT was worse than that for those without OBAT.

How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May 2022.Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)checklists.Additional information was sought my study authors where reporting was incomplete.Risk of bias(ROB)was assessed with the Cochrane ROB-2 Tool.RCTs examining non-pharmacological interventions following concussion.Results:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck cooling.Median scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified supervisor.Reporting completeness improved after TIDieR and CERT publication,but publication in highly cited journals and low ROB do not guarantee reporting completeness.

Fast prototype and rapid construction of three-dimensional and multi-scaled pitcher for controlled drainage by systematic biomimicry

Biomimetic materials that use natural wisdom to solve practical problems are developing rapidly.The trend for systematic biomimicry is towards in-situ characterization of naturalcreatures with high spatial resolutions.Furthermore,rapid reconstruction of digital twin models with the same complex features as the prototype is indispensable.However,it faces bottlenecks and limits in fast characterization and fabrication,precise parameter optimization,geometricdeviations control,and quality prediction.To solve these challenges,here,we demonstrate astate-of-the-art method taking advantage of micro-computed tomography and three-dimensional printing for the fast characterization of the pitcher plant Nepenthes x ventrata and fabrication of its biomimetic model to obtain a superior drainage controller with multiscale structures withprecise surface morphology optimization and geometric deviation control.Thefilm-rupture-based drainage dynamic and mechanisms are characterized by x-ray and high-speed videography,which determines the crucial structures for unique directionaldrainage.Then the optimized artificial pitchers are further developed into sustained drainage devices with novel applications,such as detection,reaction,and smoke control.

Fear of Cancer Recurrence in Women with Gynecological Cancer:A Systematic Review

Although some types of gynecological cancer have a poor prognosis and high recurrence rate,less is known about the fear of cancer recurrence(FCR)in gynecological cancer patients than in other cancer populations.Psychosocial problems may be experienced more in gender-specific cancers.In order to prevent future health problems related to FCR,it is critical to identify the factors affecting FCR in different subgroups and to develop various interventions.The aim of this study was to review the literature on the factors affecting the FCR in women diagnosed with gynecological cancer and interventions to reduce the FCR.The protocol of this review was registered with PROSPERO(Registration number:CRD42023452570).A total of 18 studies from 10 different countries were included in the systematic review by searching on the PubMed,ScienceDirect,Ovid,Sage,Scopus,Taylor&Francis,Web of Science,CINAHL Complete,and Cochrane databases were searched in English between July-August 2023 without year limitation to identify studies on FCR in women with gynecological cancer.Data from eligible articles were extracted and appraised for quality by two independent reviewers.In addition,bibliometric analysis method was used to visually map the studies on FCR in women with gynecological cancer according to the most frequently repeated keyword,number of citations,most cited author and publication year.Thefindings of the study are categorized and interpreted under two headings,“Interventions affecting FCR”and“Factors influencing FCR”.Sociodemographic characteristics such as age,economic status,social support,family history of cancer,psychological characteristics,quality of life and symptoms affect FCR.Deterioration in mental health and emotional weakness predict higher FCR,increase in positive emotional expression reduces FCR.The negative effects of cancer on sexuality and relationships,concerns about future treatments and emotional problems,and anxiety about not being able to fulfill their roles at home/work are the underlying reasons for the FCR.Therefore,professional psychosocial support should be provided to cancer survivors.Further studies are needed to identify the factors that trigger FCR and to plan interventions accordingly.This study is expected to encourage health professionals to plan interventions and research for gynecological cancer survivors.

Efficacy evaluation of standardized Rheum rhaponticum root extract(ERr 731®)on symptoms of menopause:A systematic review and meta-analysis study

Menopause is characterized by various physical,mental and emotional symptoms.ERr 731®is a standardized extract from Rheum rhaponticum root and has been clinically studied for its role in reducing menopausal symptoms.The current systematic review and meta-analysis aimed to evaluate the efficacy of ERr 731®supplementation in alleviating the severity of menopausal symptoms.In this review,we searched across three online databases up to March 2023,evaluated the quality of the included studies by the Physiotherapy Evidence Database scale,and assessed the risk of bias by the Cochrane Risk of Bias tool.We then performed a metaanalysis using RevMan software to estimate the pooled mean difference(MD).The study protocol was registered in the Prospective Register of Systematic Reviews(CRD42023416808).After screening and evaluation,we included four high-quality studies(a total of 390 participants;the ERr 731®group:193 participants;the control group:197 participants)in the meta-analysis.The results showed that ERr 731®supplementation significantly reduced the Menopause Rating Scale score(MD:–15.12;P<0.001),compared with control therapy.Sensitivity analysis revealed no effect of individual studies on the overall pooled estimate or overall observed heterogeneity.The current review provides evidence that ERr 731®supplementation is effective in reducing menopause symptoms.Potential bias and high heterogeneity in the results warrant further clinical studies.

Pearls of meta-analyses and systematic review in scientific evidence

Scientific evidence develops bit by bit from case reports,case series;to larger casecontrol,case-cohort;and further escalate to randomized controlled trials.This echoed the importance of continue publishing World journal of Clinical Cases,where novel and advancing discoveries start from a single case.In contrast,at the other end of the realm of evidence synthesis,systematic review and meta-analysis represent distinct yet interconnected processes.Butorphanol in epidural labor analgesia has long been studied since 1989,and with 70 publications from MEDLINE searches.However,there was no meta-analysis,nor any systematic review published so far.The latest in-press article published by Tang et al.on the protocol for the systematic review and meta-analysis on the safety and effectiveness of butorphanol in epidural labor analgesia is encouraging.We believe the findings of this study will be valuable for clinical practice as well as for future research.

Feasibility of acupuncture as an adjunct intervention for ovulatory disorder infertility:A systematic review and meta-analysis

BACKGROUND Acupuncture(AT)is widely used in treatment of ovulatory disorder infertility(ODI),but the safety and efficacy of AT for ODI still lack an evidence-based basis.AIM To evaluate the feasibility and effectiveness of AT as an adjunct intervention for ODI.METHODS The Cochrane Library,Embase,PubMed,VIP,China National Knowledge Infrastructure,WanFang Data,and Chinese biomedical literature databases were searched from inception to January 20,2024.Two reviewers independently selected studies,collected data,and evaluated methodological quality through the Cochrane Risk of Bias tool.Revman 5.4 was used for meta-analysis,and the Grade system was performed to evaluate the level of evidence for the outcomes of the meta-analysis.RESULTS A total of 20 randomized controlled trials with 1677 ODI patients were included.Compared with the clomiphene citrate(CC)group,the AT plus CC group exhibited significant improvement of the pregnancy rate[relative risk(RR)=1.68,95%confidence interval(CI):1.45-1.95,P<0.00001,I^(2)=23%],ovulation rate(RR=1.34,95%CI:1.22-1.47,P<0.00001,I^(2)=32%),serum E2 level[mean difference(MD)=31.36,95%CI:21.83-40.88,P<0.00001,I^(2)=97%],thickness of endometrium(MD=1.76,95%CI:0.71-2.81,P=0.001,I^(2)=98%)and decreasing miscarriage rate(RR=0.25,95%CI:0.09-0.65,P=0.005,I^(2)=0%),serum follicle-stimulating hormone level(MD=-2.10,95%CI:-3.27 to-0.94,P=0.0004,I^(2)=99%),serum luteinizing hormone level(MD=-6.94,95%CI:-9.89 to-4.00,P<0.00001,I^(2)=100%),and serum progesterone level(MD=-1.66,95%CI:-2.98 to-0.34,P=0.01,I^(2)=96%).The AT group had a more favorable effect than CC group for improving pregnancy rate(RR=1.52,95%CI:1.33-1.73,P<0.00001,I^(2)=0%),thickness of endometrium(MD=2.48,95%CI:2.15-2.81,P<0.00001,I^(2)=0%)and reducing miscarriage rate(RR=0.23,95%CI:0.13-0.44,P<0.00001,I^(2)=0%),serum follicle-stimulating hormone level(MD=-0.55,95%CI:-0.86 to-0.24,P=0.0005,I^(2)=0%),and serum progesterone level(MD=-0.24,95%CI:-0.28 to-0.20,P<0.00001).However,the level of evidence was predominantly assessed as very low to moderate.CONCLUSION AT can improve the pregnancy outcomes and sex hormone levels for patients with ODI.However,further studies are needed to confirm these findings.

Impact of D-dimer on in-hospital mortality following aortic dissection:A systematic review and meta-analysis

BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is recognized.Yet,its predictive value for in-hospital mortality remains uncertain and subject to conflicting evidence.AIM To conduct a meta-analysis of AD-related in-hospital mortality(ADIM)with elevated DD levels.METHODS We searched PubMed,Scopus,Embase,and Google Scholar for AD and ADIM literature through May 2022.Heterogeneity was assessed using I2 statistics and effect size(hazard or odds ratio)analysis with random-effects models.Sample size,study type,and patients’mean age were used for subgroup analysis.The significance threshold was P<0.05.RESULTS Thirteen studies(3628 patients)were included in our study.The pooled prevalence of ADIM was 20%(95%CI:15%-25%).Despite comparable demographic characteristics and comorbidities,elevated DD values were associated with higher ADIM risk(unadjusted effect size:1.94,95%CI:1.34-2.8;adjusted effect size:1.12,95%CI:1.05-1.19,P<0.01).Studies involving patients with a mean age of<60 years exhibited an increased mortality risk(effect size:1.43,95%CI:1.23-1.67,P<0.01),whereas no significant difference was observed in studies with a mean age>60 years.Prospective and larger sample size studies(n>250)demonstrated a heightened likelihood of ADIM associated with elevated DD levels(effect size:2.57,95%CI:1.30-5.08,P<0.01 vs effect size:1.05,95%CI:1.00-1.11,P=0.05,respectively).CONCLUSION Our meta-analysis shows elevated DD increases in-hospital mortality risk in AD patients,highlighting the need for larger,prospective studies to improve risk prediction models.

Comparing the efficacy and safety of low,medium,and high dosages of selexipag for treating pulmonary hypertension:A systematic review and meta-analysis

Background:The maintenance dosage of selexipag is categorized as low,medium or high.In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension(PAH),we performed a sys-tematic review and meta-analysis.Methods:Studies assessing PAH risk stratification indices,such as the World Health Organization functional class(WHO-FC),six-minute walk distance(6MWD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,right atrial pressure(RAP),cardiac index(CI)and mixed venous oxygen saturation(SvO2),were included.Results:Thirteen studies were included.Selexipag led to improvements in the 6MWD(MD:24.20 m,95%CI:10.74-37.67),NT-proBNP(SMD:-0.41,95%CI:-0.79-0.04),CI(MD:0.47 L/min/m^(2),95%CI:0.17-0.77)and WHO-FC(OR:0.564,95%CI:0.457-0.697).Subgroup analysis demonstrated that all three dosages improved the 6MWD.A moderate dosage led to improvements in the CI(MD:0.30 L/min/m^(2),95%CI:0.15-0.46)and WHO-FC(OR:0.589,95%CI:0.376-0.922).Within 6 months of treatment,only the WHO-FC and CI were significantly improved(OR:0.614,95%CI:0.380-0.993;MD:0.30 L/min/m^(2),95%CI:0.16-0.45,respectively).More than 6 months of treatment significantly improved the 6MWD,WHO-FC and NT-proBNP(MD:40.87 m,95%CI:10.97-70.77;OR:0.557,95%CI:0.440-0.705;SMD:-0.61,95%CI:-1.17-0.05,respectively).Conclusions:Low,medium,and high dosages of selexipag all exhibited good effects.When treatment lasted for more than 6 months,selexipag exerted obvious effects,even in the low-dosage group.This finding is important for guiding individualized treatments.

Mapping ecosystem services in urban and peri-urban areas.A systematic review

Urban and peri-urban ecosystems are subjected to an intense impact.The demand for ecosystem services(ES)is higher in these areas.Nevertheless,despite the anthropogenic pressures,urban and peri-urban ecosystems supply important ES.Mapping is a crucial exercise to understand ES dynamics in these environments better.This work aims to systematically review mapping ES in urban and peri-urban areas studies,following the Preferred Reporting Items for Systematic Reviews and Meta-alpha Methods.A total of 207 studies were selected.The results show increased work between 2011 and 2023,mainly conducted in Europe and China.Most work were developed in urban areas and did not follow an established ES classification.Most studies focused on the ES supply dimension,the regulation and maintenance section.Regarding provisioning ES,most studies focused on Cultivating terrestrial plants for nutrition,regulating and maintainin g Atmospheric composition and conditions,and for cultural ES on Physical and experiential interactions with the natural environment.Quantitative methods were mostly applied following Indicator-based(secondary data:biophysical,socio-economic)models.Very few work validated the outputs.Several studies forecasted ES,primarily based on land use changes using CA-Markov approaches.This study provides an overview of the most mapped urban and peri-urban ES globally,the areas where more studies need to be conducted,and the methods developed.

Modified Xiaoyao powder for postpartum depression:A systematic review and meta-analysis

Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,Google Scholar,the SinoMed,Embase,Cochrane Library,and PubMed databases were searched from their inception to April 25,2023.The Cochrane Risk of Bias tool was used to assess the quality of the trials.We applied the risk ratio to present dichotomous data and the mean difference to present continuous data.Data with similar characteristics were pooled for meta-analysis and heterogeneity was assessed using I2.Results:This review included 35 trials involving 2848 participants.The quality of the included studies was low(unclear randomization processes and insufficient reporting of blinding).Participants treated with modified Xiaoyao powder plus Western medicine showed lower Hamilton Depression Scale(HAMD)depression score than those who used Western medicine alone(mean difference=-2.15;95%confidence interval:-2.52 to 1.78;P<.00001),and higher effective rate(relative risk=1.19;95%confidence interval:1.15 to 1.24;P<.00001),When comparing modified Xiaoyao alone with Western medicine,the HAMD depression score remained low,however,the efficacy rate was higher in the modified Xiaoyao group.Regarding adverse events,the modified Xiaoyao group reported weight gain,nausea,and diarrhea,but no severe adverse events were reported.Conclusion:Modified Xiaoyao may help relieve depression in PPD when used alone or in combination with Western medicine,with minor side effects.Therefore,future high-quality,large-sample size RCTs are warranted.

The Applicability and Productiveness of a Systematic Literature Review Methodology in Volcanology Research: Case of the Magma Pathway at the Mount Cameroon Volcano

The presented research illustrates the applicability and productiveness of the systematic literature review methodology, a non-empirical methodology in the geological sciences, particularly volcanology. The systematic literature review methodology is a replicable, rigorous, and transparent methodology for synthesizing existing literature to answer questions on a specific topic. The synthesis allows for knowledge consolidation, such as identifying knowledge gaps. In our illustration of this methodology, we focused on the expanding knowledge about the magma pathway at Mount Cameroon, one of Africa’s active volcanoes. Our synthesis of the relevant international geoscience research literature is based on the framework of knowledge about the magma pathway beneath a typical basaltic volcano. The framework has three primary components: magma supply, storage, and transport to erupting vents. Across these components is a total of twelve secondary components. The result is a previously non-existent and fragmented overall understanding of the magma pathway at Mount Cameroon. The gaps in the understanding (such as in the magma supply rates, timescales of chamber processes, and magma ascent rates) may be addressed in future research. Another key implication of the presented research lies in the proof of concept of the systematic literature review methodology as an applicable qualitative research methodology in the study of volcanoes.

Systematic Method for Constructing Lewis Representations

The systematic method for constructing Lewis representations is a method for representing chemical bonds between atoms in a molecule. It uses symbols to represent the valence electrons of the atoms involved in the bond. Using a number of rules in a defined order, it is often better suited to complicated cases than the Lewis representation of atoms. This method allows us to determine the formal charge and oxidation number of each atom in the edifice more efficiently than other methods.

Time trends and disparities of obesity and related national policies and programs in Nepal:a systematic review

Objective Overweight and obesity prevalence has increased in low-income countries.This study systematically reviewed the obesity trend,disparities,and prevention and control efforts in Nepal.Methods We searched PubMed and Google Scholar for articles and reports published between January 1,2004 and December 31,2022.Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts.Overweight and obesity were defined using the World Health Organization body mass index cut points.Thirty-two studies and reports were included.Results Overall,overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited.The combined overweight and obesity(OW/OB)and obesity rates in women aged 15-49 years increased from 8.5%to 22.2%and from 0.9%to 5.1%between 2006 and 2016,respectively.OW/OB and obesity rates in men were 17.1%and 2.5%based on data from the 2016 Demographic and Health Survey.OW/OB rate in under-five children increased from 0.6%to 2.8%between 2006 and 2016.Obesity rates for school-age(5-9 years)boys and girls in 2016 were 2.4%and 2.8%,respectively,and were 1.1%and 1.4%for male and female adolescents aged 10-19 years,respectively.OW/OB prevalence was much higher among women,residents in urban areas and central provinces,and in higher socioeconomic status groups.Projected prevalence of OW/OB and obesity for 2030 in adults aged 15-49 was 44.7%and 8.3%,respectively,while it was 2.2%for OW/OB in preschool children.Policies and direct interventions that specifically focused on obesity prevention and control are limited.Conclusions OW/OB prevalence in Nepal has increased during the past 1.8 decades,disproportionately affecting population groups.Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention.In the future,Nepal needs to develop population-based programs for obesity prevention.