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Clinical & Translational Oncology :... Sep 2023Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of...
Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of breast cancer cases are detected in early and potentially curable stages, despite the COVID-19 pandemic possibly having impacted these numbers (not yet quantified). In recent years, locoregional and systemic therapies are increasingly being directed by new diagnostic tools that have improved the balance between toxicity and clinical benefit. New therapeutic strategies, such as immunotherapy, targeted drugs, and antibody-drug conjugates have also improved outcomes in some patient subgroups. This clinical practice guideline is based on a systematic review of relevant studies and on the consensus of experts from GEICAM, SOLTI, and SEOM.
Topics: Female; Humans; Breast Neoplasms; Pandemics; COVID-19; Consensus; Drug Delivery Systems
PubMed: 37326826
DOI: 10.1007/s12094-023-03215-4 -
Journal of Fungi (Basel, Switzerland) Sep 2023Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused... (Review)
Review
Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused by fungi of the order Mucorales, which are usually avirulent but become pathogenic when the host's immune system is compromised. This systematic review was conducted according to PRISMA guidelines. The databases searched included PubMed, Scopus, and Web of Science. We chose articles that analyzed the oral manifestations of patients with mucormycosis, were published between 2018 and 2023, and met our search terms. The risk of bias in the articles was assessed using the CARE guideline for case reports and STROBE for a cross-sectional study. After the selection process, 20 articles were included in this review, all containing information about the different oral manifestations presented by people with mucormycosis. The most common oral manifestations are mainly bone exposures and oral ulcers, halitosis, pus discharge, gingival thickening, and periodontitis. However, despite the importance of recognizing these oral manifestations in the early stages of mucormycotic infection, providing early treatment, and reducing the high mortality rate of the infection, more studies are needed.
PubMed: 37755045
DOI: 10.3390/jof9090935 -
Journal of Clinical Medicine Oct 2023Crohn's disease (CD) is a chronic inflammatory intestinal condition that can affect the entire gastrointestinal tract. It is characterized by its clinical heterogeneity... (Review)
Review
Crohn's disease (CD) is a chronic inflammatory intestinal condition that can affect the entire gastrointestinal tract. It is characterized by its clinical heterogeneity and irregularities in its course. The etiology and pathogenesis are not well established, so it is difficult to establish an early diagnosis and an effective treatment plan. The objective of this systematic review was to present a qualitative synthesis of the studies referring to the oral manifestations of CD. This systematic review was carried out following the PRISMA guide. Research was conducted in the Pubmed, Web of Science, Scopus, Scielo, and Cocrahne Library databases on 23 February 2023, and updated on 1 September 2023. Articles published between 2012 and 2023 were selected. Articles that analyzed the oral manifestation of CD patients and met the established search terms. In addition, the quality of all the selected studies was analyzed following the CARE guidelines for case reports and the STROBE scale for observational studies. A total of 19 articles were included in this review that met the inclusion criteria. Regarding the oral manifestation of CD, oral ulcers, angular cheilitis, and gingivitis stand out. Periodontitis and vegetative pyostomatitis were the least representative manifestations. The most prevalent locations were lips, mucosa, and gingivae. Ulcers, gingivitis, and angular cheilitis are the most frequent oral manifestations in patients with CD. Their early identification and possible relationship with the disease are important for an early diagnosis and an adequate treatment plan.
PubMed: 37892587
DOI: 10.3390/jcm12206450 -
BMC Psychiatry Oct 2023Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to... (Meta-Analysis)
Meta-Analysis
Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to positive mental health outcomes in adults, their role during the developmental context of adolescence, and the mechanisms through which such beliefs might operate, is less well understood. Moreover, there is some evidence that negative aspects of religiosity are associated with poor mental health outcomes. Guided by lived experience consultants, we undertook a systematic review and quality appraisal of 45 longitudinal studies and 29 intervention studies identified from three electronic databases (Medline, PsycINFO and Scopus) exploring the role of religiosity and spiritual involvement (formal and informal) in prevention and management of depression and anxiety in young people aged 10 to 24 years. Most studies were from high-income countries and of low to moderate quality. Meta-analysis of high-quality longitudinal studies (assessed using Joanna Briggs Institute critical appraisal tools, n = 25) showed a trend towards association of negative religious coping (i.e., feeling abandoned by or blaming God) with greater depressive symptoms over time (Pearson's r = 0.09, 95% confidence interval (CI) -0.009, 0.188) whereas spiritual wellbeing was protective against depression (Pearson's r = -0.153, CI -0.187, -0.118). Personal importance of religion was not associated with depressive symptoms overall (Pearson's r = -0.024, CI-0.053, 0.004). Interventions that involved religious and spiritual practices for depression and anxiety in young people were mostly effective, although the study quality was typically low and the heterogeneity in study designs did not allow for a meta-analysis. The lived experience consultants described spirituality and religious involvement as central to their way of life and greatly valued feeling watched over during difficult times. While we require more evidence from low- and middle-income countries, in younger adolescents and for anxiety disorders, the review provides insight into how spirituality and religious involvement could be harnessed to design novel psychological interventions for depression and anxiety in young people.Review RegistrationThe systematic review was funded by Wellcome Trust Mental Health Priority Area 'Active Ingredients' 2021 commission and registered with PROSPERO 2021 (CRD42021281912).
Topics: Adult; Adolescent; Humans; Spirituality; Depression; Religion; Anxiety; Anxiety Disorders; Adaptation, Psychological
PubMed: 37817143
DOI: 10.1186/s12888-023-05091-2 -
Environmental Science and Pollution... Nov 2023Energy companies are in the spotlight regarding the environmental pressure to address the current environmental issues by initiating the sets of social responsibilities.... (Review)
Review
Energy companies are in the spotlight regarding the environmental pressure to address the current environmental issues by initiating the sets of social responsibilities. Energy sector companies are actively adopting Corporate Social Responsibility (CSR) practices to address the increased pressure and enablement to manage and prevent the risks of environmental impact at the same time concentrating on the economic growth. The current study provides a systematic literature review identifying CSR initiative measures towards sustainability and proposes a framework of CSR measurements in the energy sector. The framework combines the Search, Appraisal, Synthesis, and Analysis (SALSA) method together with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PSALSAR (Protocol, Search, Appraisal, Synthesis, Analysis and Report). Moreover, for setting the research scope, PICOC (Population, Intervention, Comparison, Outcome, and Context) is applied. As a result, eleven CSR measures for the energy sector were identified. The measurements were classified into 4 pillars: environmental pillar, stakeholder communication and external image, financial pillar, and organizational pillar. The environmental impact and GHG reduction align with the ecological modernization theories. Green energy innovations find theoretical resonance in the diffusion of innovation theories. Stakeholder engagement and branding link to the stakeholder theory, while financial performance, to the shareholder value theories. Occupational health and safety theory support the employee safety and corporate culture considerations. These measures, selected through theoretical lenses and systematic review, contribute to shaping a sustainable energy landscape. Furthermore, the research results were discussed, and the future research agenda together with policy recommendations were provided.
Topics: Occupational Health; Organizations; Social Responsibility; Organizational Culture
PubMed: 37798520
DOI: 10.1007/s11356-023-30131-5 -
The British Journal of Social Psychology Oct 2023The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we... (Meta-Analysis)
Meta-Analysis
The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.
Topics: Humans; Empathy; Decision Making; Judgment; Morals; Ethical Theory
PubMed: 37314211
DOI: 10.1111/bjso.12654 -
Autoimmunity Reviews Feb 2024Vitamin D plays a critical role in immunomodulation, and its deficiency is implicated in the pathogenesis of several autoimmune diseases. Nevertheless, its relationship... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitamin D plays a critical role in immunomodulation, and its deficiency is implicated in the pathogenesis of several autoimmune diseases. Nevertheless, its relationship with non-infectious uveitis (NIU), an inflammatory ocular disorder, remains inconclusive.
METHODS
A systematic search was conducted in three databases from database inception until May 8, 2023, to investigate the potential relationship between vitamin D deficiency and NIU. We included observational studies reporting the measurement of vitamin D levels in patients with NIU and healthy controls without restriction of language or date of publication. Three pairs of authors independently screened the title and abstracts for potential eligibility and then in full text. A third author resolved disagreements. Three pairs of independent reviewers abstracted the data from the fully reviewed records and evaluated the risk of bias. We followed The MOOSE and PRISMA guidelines. Random effects meta-analyses were used for primary analysis. Studies not included in the meta-analysis were summarized descriptively. This review was registered in PROSPERO: CRD42022308105.
FINDINGS
Of 933 records screened, 11 studies were included, and five were meta-analyzed, encompassing 354 cases and 5728 controls (mean participant age ranging from 7.1 to 58.9 years). Patients with vitamin D deficiency exhibited an Odds Ratio of 2.04 (95% CI = 1.55-2.68, P < 0.00001) for developing NIU compared to controls. Overall, potential sources of bias were low across most studies.
INTERPRETATION
Our findings suggest that vitamin D may play an essential role in the pathophysiology of NIU. While the included studies demonstrated generally low potential bias, additional rigorous prospective studies are necessary to confirm these findings and further elucidate the underlying mechanisms involved. Vitamin D supplementation could represent a possible therapeutic strategy for preventing or managing NIU if substantiated. Clinicians should consider screening for and addressing vitamin D deficiency in patients with or at risk for NIU.
Topics: Humans; Uveitis; Vitamin D; Vitamin D Deficiency
PubMed: 38052262
DOI: 10.1016/j.autrev.2023.103497 -
Journal of Assisted Reproduction and... Oct 2023Evaluate which factors are involved in the increased rate of mosaicism in embryos. (Meta-Analysis)
Meta-Analysis
PURPOSE
Evaluate which factors are involved in the increased rate of mosaicism in embryos.
METHODS
A systematic review and meta-analysis was performed. After an exhaustive search of the literature, a total of seven papers were included in the analysis. In addition, data collected from IVF cycles performed in our fertility clinic were also analysed. Day of biopsy, embryo quality, maternal and paternal age and seminal quality were the chosen factors to be studied.
RESULTS
The results of the meta-analysis show that neither embryo quality nor seminal quality were related to mosaic embryo rate (OR: 1.09; 95% CI: 0.94-1.28 and OR: 1.10; 95% CI: 0.87-1.37, respectively). A positive association was observed for the variable "biopsy day" with embryos biopsied at day 6 or 7 having the highest rate of mosaicism (OR: 1.06; 95% CI: 1.01-1.11). In opposite to what happens with aneuploidy rate, which increases with maternal age, embryo mosaicism is higher in younger women (<34 years) rather than in older ones (≥34 years) (OR: 0.95; 95% CI: 0.92-0.98). However, for the "paternal age" factor, no association with mosaicism was found (OR: 1.04; 95% CI: 0.90-1.21).
CONCLUSIONS
With the present study, we can conclude that the factors related to the presence of mosaicism in embryos are the embryo biopsy day and maternal age. The rest of the studied factors showed no significant relationship with mosaicism. These results are of great importance as knowing the possible causes leading to mosaicism helps to improve the clinical results of reproductive treatments.
Topics: Female; Humans; Aged; Adult; Mosaicism; Aneuploidy; Age Factors; Biopsy; Embryo, Mammalian
PubMed: 37592098
DOI: 10.1007/s10815-023-02914-9 -
JMIR Human Factors Dec 2023Humans currently dominate decision-making in both clinical health services and complex health services such as health policy and health regulation. Many assumptions... (Review)
Review
BACKGROUND
Humans currently dominate decision-making in both clinical health services and complex health services such as health policy and health regulation. Many assumptions inherent in health service models today are underpinned by Ramsey's Expected Utility Theory, a prominent theory in the field of economics that is rooted in rationality. Rational, evidence-based metrics currently dominate the culture of decision-making in health policy and regulation. However, as the COVID-19 pandemic has shown, rational metrics alone may not suffice in making better policy and regulatory decisions. There are ethical and moral considerations and other complex factors that cannot be reduced to evidence-based rationality alone. Therefore, this scoping review was undertaken to identify and map the attributes that influence human decision-making in complex health services.
OBJECTIVE
The objective is to identify and map the attributes that influence human decision-making in complex health services that have been reported in the peer-reviewed literature.
METHODS
This scoping review was designed to answer the following research question: what attributes have been reported in the literature that influence human decision-making in complex health services? A clear, reproducible methodology is provided. It is reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) standards and a recognized framework. As the topic of interest merited broad review to scope and understand literature from a holistic viewpoint, a scoping review of literature was appropriate here. Inclusion and exclusion criteria were developed, and a database search undertaken within 4 search systems-ProQuest, Scopus, PubMed, and Web of Science.
RESULTS
The results span 46 years, from 1976 to 2022. A total of 167 papers were identified. After removing duplicates, 81 papers remained. Of these, 77 papers were excluded based on the inclusion and exclusion criteria. The remaining 4 papers were found to be relevant. Citation tracking was undertaken, identifying 4 more relevant papers. Thus, a total of 8 papers were included. These papers were reviewed in detail to identify the human attributes mentioned and count the frequency of mentions. A thematic analysis was conducted to identify the themes.
CONCLUSIONS
The results highlight key themes that underline the complex and nuanced nature of human decision-making. The results suggest that rationality is entrenched and may influence the lexicon of our thinking about decision-making. The results also highlight the counter narrative of decision-making underpinned by uniquely human attributes. This may have ramifications for decision-making in complex health services today. The review itself takes a rational approach, and the methods used were suited to this.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/42353.
Topics: Humans; Pandemics; Benchmarking; COVID-19; Health Policy; Health Services
PubMed: 38117553
DOI: 10.2196/46490 -
Current Medical Research and Opinion Oct 2023To provide a systematic overview of bioethical debate on somatic gene therapy as documented in the scientific literature. (Review)
Review
OBJECTIVE
To provide a systematic overview of bioethical debate on somatic gene therapy as documented in the scientific literature.
METHODS
We performed a systematic review of reasons, following Strech and Sofaer approach, which is a method to systematically identify and classify arguments (reasons) used in the scientific literature. We identified 217 eligible publications retrieved from PubMed, Lilacs, PhilPapers, and Google Scholar. A meta-synthesis was performed to analyze the data.
RESULTS
We extracted 189 arguments. Arguments were grouped into 23 categories. Twelve categories were classified as research-related, including the risk/benefit ratio, priorities and limits, informed consent, review, and monitoring. Eleven were classified as society-related, including population impact, human identity, public perception, human health.
CONCLUSION
Our study provides a database of existing challenges and arguments of somatic gene therapy and may serve as the basis of normative analysis. By presenting collected arguments, we contribute to the discussion about the ethics and social dimensions of somatic gene therapy.
Topics: Humans; Bioethics; Genetic Therapy; Informed Consent
PubMed: 37772315
DOI: 10.1080/03007995.2023.2257600