12703036 research outputs found
Sort by
En bloc versus conventional transurethral resection for non-muscle-invasive bladder cancer: an expanded and updated systematic review and meta-analysis reconciling contemporary evidence on oncological, pathological, and safety outcomes
No full textAbstract Background This systematic review and meta-analysis compares oncological outcomes, pathological quality, and safety profiles between en bloc (ERBT) and conventional transurethral resection (cTURBT) for non-muscle-invasive bladder cancer (NMIBC), incorporating the latest evidence from randomized trials and high-quality observational studies. Methods We systematically searched PubMed, Embase, Cochrane Library, and Web of Science (up to December, 2024) for studies comparing ERBT and cTURBT outcomes. Methodological quality was assessed using standardized tools, with statistical analysis performed using RevMan 5.3. Results Our meta-analysis incorporated 35 studies involving 6,013 patients with NMIBC. The overall methodological quality was high with a low risk of bias in most included trials; however, moderate to substantial heterogeneity was observed for several outcomes, and potential publication bias was detected for certain safety endpoints. The pooled results demonstrated statistically significant advantages for ERBT in reducing tumor recurrence at 12 months (OR = 0.56, 95% CI: 0.33–0.95; p = 0.03) and 24 months (OR = 0.70, 95% CI: 0.53–0.91; p = 0.009), though recurrence rates at 36 months showed no significant difference between techniques (p > 0.05). Similarly, progression risks did not differ significantly between groups at any time point (all p > 0.05). Pathological evaluation revealed superior outcomes with ERBT, including significantly higher detrusor muscle presence in specimens (OR = 2.60, 95% CI: 1.70–3.99; p < 0.0001) and lower residual tumor rates (OR = 0.60, 95% CI: 0.37–0.99; p = 0.05). However, mucosal muscle detection rates were comparable between techniques (p = 0.21). Regarding safety outcomes, ERBT demonstrated significantly lower risks of bladder perforation (OR = 0.36, 95% CI: 0.22–0.59; p < 0.0001), obturator nerve reflex (OR = 0.13, 95% CI: 0.06–0.29; p < 0.00001), and transfusion requirements (OR = 0.17, 95% CI: 0.04–0.80; p = 0.02). Perioperative metrics favored ERBT with shorter catheterization duration (p = 0.002), reduced hospital stay (p = 0.0002), faster resection time (p = 0.009), and better hemoglobin preservation (p = 0.006), while maintaining equivalent overall surgical times (p = 0.15). Conclusions ERBT offers superior short-term oncological control, improved pathological assessment, and enhanced perioperative safety versus cTURBT, supporting its role as a preferred resection technique for NMIBC, despite equivalent long-term outcomes. Clinical implementation should consider individual tumor characteristics and surgeon expertise. Trial registration CRD420251032096
Effect of combined continuity care guided by Orem’s self-care model and low FODMAP diet on gut microbiota composition and symptoms in patients with irritable bowel syndrome
No full textAbstract Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, affecting 10%-15% of the global population, characterized by symptoms such as abdominal pain, bloating, and altered bowel habits. A low fermentable oligo-, di-, and mono-saccharides and polyols (FODMAP) diet has shown promise in managing IBS symptoms. This study evaluates the combined impact of continuity care guided by Orem’s Self-Care Model with a low FODMAP diet on gut microbiota composition and IBS symptoms. Methods A retrospective cohort study included 196 patients with IBS, divided into conventional treatment (n = 84) and low FODMAP care (n = 112) groups. The intervention spanned six weeks, integrating Orem’s Model to enhance dietary adherence. Outcomes were assessed using IBS Symptom Severity Scale (IBS-SSS), gut microbiota analysis via qPCR, and quality of life measures (IBS-QOL, SF-36). Results Baseline characteristics between the groups showed no significant differences. Post-intervention, the low FODMAP group experienced significant improvements in IBS-SSS scores, reporting reduced abdominal pain severity (P = 0.01), frequency (P = 0.002), bloating (P = 0.006), and greater bowel movement satisfaction (P = 0.003). Gut microbiota analysis revealed increased Bifidobacterium and Lactobacillus, and decreased Enterococcus levels in the low FODMAP group (P < 0.001). SF-36 scores indicated elevated physical functioning (P < 0.001), role physical (P = 0.002), and mental health (P = 0.005) domains. Notably, IBS-QOL scores improved markedly, especially in dysphoria (P = 0.003), worry about symptoms (P = 0.001), and food avoidance (P = 0.004). Conclusion The integration of a low FODMAP diet with continuity care guided by Orem’s Self-Care Model significantly alleviates IBS symptoms and improves gut microbiota composition and quality of life
Outcomes of bile duct-guided right hepatic inflow occlusion and extended procedures in laparoscopic liver surgery
No full textAbstract Objective This study aimed to assess the safety and feasibility of bile duct-guided right hepatic inflow occlusion and associated extended procedures in laparoscopic liver surgery (LLS). Methods A cohort of 23 patients who underwent laparoscopic right hemihepatectomy, which involved laparoscopic dissection and occlusion of the right hepatic artery and right portal vein using the bile duct-guided approach (primary procedure) were included in this study. Ten additional patients with insufficient future liver remnant (FLR) volume in the left hemiliver, as determined by preoperative assessment, underwent a staged approach. In the first stage, laparoscopic right portal vein ligation (LRPVL) was performed via the bile duct-guided approach (extended procedure). Following an observation interval, and upon confirmation of sufficient hypertrophy of the left hemiliver, either laparoscopic or open right hemihepatectomy, with or without combined procedures, was performed as the second stage. Results All procedures were completed without major postoperative complications. In the primary procedure cohort, the mean operative duration was 4.2 ± 0.4 h, the mean right hepatic portal occlusion time was 18 ± 8 min, intraoperative blood loss ranged from 200 to 400 ml, and the length of hospital stay was 7–12 days. For the first-stage extended procedure, the mean operative duration was 1.2 ± 0.3 h, the mean right portal vein occlusion was 14 ± 5 min, intraoperative blood loss ranged from 20 to 80 ml, and the length of hospital stay was 3–5 days. The second-stage procedure was performed 3 to 5 days after the most recent three-dimensional imaging assessment. The mean left liver volume increased from 456.14 ± 84.42 cm3 before the first-stage procedure to 649.06 ± 102.26 cm3 before the second-stage procedure, corresponding to a 44 ± 18% increase. Conclusion Bile duct-guided right hepatic inflow occlusion and its extended procedures demonstrated safety and feasibility in the context of LLS
Conceptual and operational consistency in defining intestinal failure across randomized controlled trials: a systematic review and meta-research analysis
No full textAbstract Background Intestinal failure (IF) is a rare but serious condition associated with high morbidity, mortality, and healthcare resource use. Although consensus-based definitions for IF exist, their adoption in randomized controlled trials (RCTs) remains uncertain. This variability compromises the comparability of evidence and hinders the development of robust clinical guidelines. The aim of this study was to examine the conceptual and operational consistency of IF definitions in RCTs, assess methodological and reporting quality, and explore implications for research synthesis and clinical decision-making. Methods Systematic review of RCTs. We searched PubMed/MEDLINE, Embase, Web of Science, and Scopus up to May 2025 for RCTs involving participants with IF. Two reviewers independently extracted data, focusing on the presence and nature of IF conceptual and operational definitions, and assessed methodological and reporting quality. Studies were categorized by quality thresholds defined a priori. Results From 9354 records screened, 12 RCTs (2011–2025) involving 617 participants with IF were included. Most were conducted in high-income countries and focused on adults, although some involved pediatric short bowel syndrome (SBS) and intestinal failure-associated liver disease populations. Only 3 trials (25%) provided an explicit, ESPEN-aligned conceptual definition of IF, integrating both functional classification and parenteral support (PS) dependency. The majority (66.7%) relied solely on operational thresholds, most often PS frequency (≥ 3 days/week) and duration (≥ 12 months), without conceptual framing, while 4 trials (33.3%) incorporated surrogate markers such as fecal output ≥ 1500 g/day or bowel length without confirming PS dependence. Two trials (16.7%) lacked any explicit definition. Variability extended to terminology, inclusion thresholds, and conflation of SBS with IF. Conclusions Definitions of IF in RCTs remain heterogeneous, with frequent divergence from consensus standards and variable study quality. This heterogeneity in IF definitions fundamentally limits evidence synthesis and reduces the clinical applicability of trial findings. Establishing and enforcing harmonized, consensus-driven definitions is not merely a methodological refinement but an urgent necessity to build a reliable evidence base for this high-impact condition
Genetic associations of circulating plasma proteins with cardiometabolic diseases
No full textAbstract Background Cardiovascular disease is the leading cause of death worldwide, and its risk is closely linked to metabolic abnormalities. Through summary-data-based mendelian randomization and colocalization analysis, we investigate the causal relationships between plasma proteins, six cardiovascular diseases (atrial fibrillation, coronary artery disease, heart failure, venous thromboembolism, peripheral artery disease and stroke), and 19 metabolic traits (including anthropometric phenotypes, blood pressure, glycemic phenotypes, inflammatory phenotypes, kidney-related phenotypes, lipidemic phenotypes, and liver-related phenotypes). Results We identify 49 proteins genetically associated with cardiovascular diseases, validated across two proteomic platforms. Among them, 35 are also associated with one or more metabolic phenotypes, with six showing evidence of colocalization. These six candidate proteins are classified into three categories based on drug development status, with PCSK9 already successful in therapies for cardiovascular diseases and hypercholesterolemia. DUSP13B, LRIG1, APOH, INHBC, and GUSB also demonstrate high therapeutic potential. Further phenome-wide MR analysis indicates that INHBC, APOH and DUSP13B represent promising therapeutic targets for cardiovascular diseases characterized by metabolic disorders. Conclusions Overall, this study revealed causal plasma proteins underlying the onset of cardiovascular diseases and metabolic abnormalities, advancing the understanding of disease mechanisms and facilitating drug discovery
Research on the impact of nose shape parameters on the pressure wave characteristics of high-speed trains in open air
No full textAbstract The generation of a pressure wave will result in a forceful transient impact on the train body by two high-speed trains passing each other. In order to improve the pressure wave characteristics of trains crossing in open line, seven distinct head types were designed by modifying the longitudinal and lateral shape parameters of train's nose. In this research, a comparative Computational Fluid Dynamics (CFD) study of the three-dimensional slipstreams induced by two trains passing by each other at the same speed conducted using the unsteady Reynolds-Averaged Navier–Stokes (RANS) method. The results demonstrate that the peak-to-peak values of the pressure wave increases by 2.11% when the train nose is designed as flat. The amplitude of pressure wave decreases by 3.86% in the head wave and 9.53% in the tail wave as the lateral width of the nose increases. The peak-to-peak values of pressure wave decreases significantly, the maximum reduction of the head wave is 13.09%, and the maximum difference of the tail wave is 13.75% when the nose shape is designed as flat and wide. Accordingly, the flat and wide design of the train nose can effectively improve the pressure wave characteristics by two trains passing each other in open air
Sustainable citizenship and societies: a review and qualitative analysis
No full textAbstract Sustainable citizenship has emerged as a critical yet enigmatic concept in the pursuit of achieving sustainable societies. Despite considerable scholarly attention, the intricate connections between sustainable citizenship and societal sustainability remain underexplored. This study seeks to bridge this gap by conducting a comprehensive systematic literature review and bibliometric analysis of 379 research articles. Using VOSviewer and the Biblioshiny package within R Studio, we unveil publication trends and identify the most influential sources, offering valuable insights for both established and nascent researchers. Furthermore, themes are discussed using science mapping which uncovers underexplored and emergent themes, shedding light on promising directions for future inquiry. By synthesizing existing knowledge and proposing a forward-looking research agenda, this study contributes to a deeper understanding of how sustainable citizenship can serve as a cornerstone for fostering sustainable societies. The themes exploring the conjunction of sustainable citizenship and society and a framework developed express varied angles via which such societies may be developed
Unlocking innovation: the role of self-sacrificial leadership in bridging knowledge behaviors and AI-driven job satisfaction
No full textAbstract Purpose Current research study has examined the role of AI adoption for job satisfaction among teaching faculty of Pakistani universities. To bridge these relationships, two mediators have been used that are knowledge sharing and knowledge hoarding. Self-sacrificial leadership moderates the relationship between AI adoption and knowledge behaviors. The novel moderated mediation approach adds significant value to this study. Design Research study deployed quantitative technique. Data from teaching faculty were collected through structured questionnaires in different waves. Using 190 appropriate response data analysis has been conducted by using AMOS-SEM. Finding Results revealed that AI adoption has positive and significant effects on job satisfaction. Knowledge sharing and knowledge hoarding both are found mediating factor in between the relationship of AI adoption and job satisfaction. Self-sacrificial leadership has been explored as strong moderator in between the relationships of AI adoption, knowledge sharing, and knowledge hoarding. Furthermore, moderated mediation has been conducted to confirm the conditional indirect effect. Implications Findings suggest that higher education institutions must consider AI adoption investment as essential element and make the system digitally rich. Digitally rich universities can help faculty to improve the quality of knowledge. When teachers at university level will be rich in knowledge, they will have higher level of job satisfaction. Universities are suggested by current research that leaders (HODs, Deans, Principal Academic Officers) must have self-sacrificial leadership style to provide fruitful environment to faculty members
Oral rehabilitation using three-dimensional-guided autotransplantation following pediatric rhabdomyosarcoma and secondary non-Hodgkin lymphoma with severe dental late effects: a case report
No full textAbstract Background Pediatric cancer therapies often cause severe dental developmental disturbances. While extractions are common, biological rehabilitation using autotransplantation is rarely reported, particularly in patients with secondary malignancies and complex medical histories. This case describes multidisciplinary oral rehabilitation using tooth autotransplantation, guided implant placement, and three-dimensional digital planning in a young patient with dual pediatric malignancies and severe dental anomalies. Case presentation A 17-year-old White female patient from Latvia presented with multiple dental anomalies following intensive treatment for rhabdomyosarcoma at the age of 11 years and subsequent B-cell precursor non-Hodgkin lymphoma at the age of 14 years. Oncologic management included systemic chemotherapy, intrathecal therapy, and image-guided fractionated intensity-modulated radiation therapy to the entire brain and spinal cord (18 Gy total dose, 2 Gy per fraction, 9 fractions), resulting in severe root resorption of tooth 16, bilateral agenesis of mandibular second premolars (35, 45), and structural malformations of third molars. Treatment involved orthodontic space preparation, extraction of tooth 16, and autotransplantation of tooth 28 using a cone-beam computed tomography-guided three-dimensionally printed replica. Guided implant placement was performed in sites 35 and 45 after space opening. Extracted third molars were analyzed using micro-computed tomography, revealing therapy-induced disorganized dentin-pulp morphology and abnormal mineralization. At 3-year follow-up, the autotransplanted tooth exhibited complete root maturation and stable periodontal integration. Both implants showed stable osseointegration with no complications at 2-year follow-up. The patient reported high functional and aesthetic satisfaction. Conclusions Biological rehabilitation using tooth autotransplantation and guided implant placement is feasible and effective in select patients post-oncology who have severe therapy-related dental anomalies. Integration of three-dimensional digital planning improves surgical accuracy and treatment outcomes. Interdisciplinary care is essential for managing complex oral rehabilitation after pediatric cancer therapy
Talin1 is downregulated in testicular germ cell tumors according to combined bioinformatics and experimental approaches
No full textAbstract Talin1 is a focal adhesion protein involved in cell adhesion and migration, with abnormal expression linked to cancer progression. However, its role in testicular germ cell tumors (TGCTs) remains unclear. This study aimed to evaluate Talin1 expression in TGCTs using integrated bioinformatics and immunohistochemical approaches. Differentially expressed genes were identified through GEO and proteomics datasets. Venn diagram, Gene Ontology (GO), and protein-protein interaction (PPI) analyses revealed Talin1 as a key gene in cell adhesion and migration pathways. Prognostic relevance was assessed using TCGA and GTEx data. Talin1 expression was further examined via immunohistochemistry on 191 TGCT tissues. Results showed that reduced Talin1 expression was associated with higher pT-stage in seminomas (P = 0.036), embryonal carcinoma (P = 0.021), and teratomas (P = 0.044). It was also significantly linked to venous invasion (P = 0.021) and tunica vaginalis invasion (P = 0.049) in embryonal carcinoma, as well as hilum involvement and the presence of tumor-infiltrating lymphocytes in yolk sac tumors. These findings suggest that decreased cytoplasmic Talin1 expression correlates with aggressive tumor behavior and disease progression in TGCTs. Talin1 may have potential as a prognostic biomarker in TGCTs, though further functional studies are necessary to elucidate its mechanistic role and therapeutic significance
Data sources:
Access Repository Dashboard
Do you manage Directory of Open Access Journals? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!