Purpose To estimate referral compliance rates and evaluate intervention effectiveness after post-school vision screening in children and adolescents. Methods We systematically searched PubMed, Embase, CINAHL, Web of Science and the Cochrane Library for studies published from January 2015 to December 2025. Eligible studies reported referral compliance data for school-aged populations. Study quality was assessed using the Effective Public Health Practice Project tool. Due to significant heterogeneity, a narrative synthesis was conducted. The review protocol was registered with PROSPERO (CRD420251268955). Results A total of 30 articles were included. Real-world referral compliance rates were suboptimal, with a median of 43.1% (range: 12.0–79.7%). Analysis of 14 intervention studies revealed three main strategies for improving compliance: the on-site care model which provided prescriptions for eyeglasses at school, the referral pathway model which provided clear instructions regarding the pathway to follow-up care, and the education model which provided health education and referral encouragement primarily. On-site care achieved relatively higher compliance rates (51.8–96.0%), whereas providing a clear referral pathway also benefited referral compliance (25.0–65.7%). However, the education model alone is insufficient to significantly improve compliance (21.3–24.5%). Conclusions Referral compliance is suboptimal and variable. It is crucial for settings to provide on-site care whenever feasible. Alternatively, establishing clear referral pathways is essential to ensure that children receive the appropriate eye care they need.

배경: 급성 편두통 치료를 위한 다양한 약리학적 치료 옵션이 존재하지만, 일반적으로 사용되는 일반의약품(OTC) 요법의 효능과 안전성이 새로운 처방약에 비해 어떻게 되는지는 여전히 불분명하다. 직접적인 대조 임상시험이 부족한 점을 감안하여, 본 무작위 대조 임상시험(RCT)에 대한 네트워크 메타분석(NMA)은 선별된 일반의약품(OTC) 치료법을 CGRP 길항제 및 5-HT1F 수용체 작용제를 포함한 최신 경구용 약물과 비교 평가하였다. 방법: PubMed, Embase 및 CENTRAL에서...

We conducted a systematic review and meta-analysis of group B Streptococcus (GBS) rectovaginal colonization prevalence, serotype distribution, and antimicrobial drug resistance (AMR) rates among pregnant women in the Asia-Pacific region. We included articles published in the MEDLINE, Embase, and PubMed databases during January 2014–October 2025. Overall, 1,623 studies were identified; 98 of those were included in the meta-analysis. Of 978,150 pregnant women, 172,973 were colonized with GBS; pooled estimated prevalence was 18.0% (95% CI 12%–23%). Studies from Southeast Asia were limited. GBS serotype distributions were reported in 24 studies; serotype III was the most common (range 5.0%–100.0%). Thirty studies included AMR rates; low (0%–2.0%) AMR rates were found for β-lactams. GBS colonization is common among pregnant women in the Asia-Pacific region. Continued surveillance of GBS prevalence will be needed, particularly in Pacific and Southeast Asian countries, to guide effective GBS prevention and treatment programs.

A strong systematic review starts with knowing where and how to search. Join Julie Glanville and Carol Lefebvre, who each bring over 30 years of experience, for the online seminar “Searching for systematic reviews: selecting and searching databases and other resources.” Designed for PhD students, researchers, clinicians and information specialists, this practical workshop explores how to choose and search resources such as MEDLINE, Embase and the Cochrane Library, alongside clinical trials registers, grey literature and unpublished evidence. You’ll also learn how to adapt search strategies across resources, with time for questions and discussion. Attend live via Zoom or revisit the recording and materials for 30 days afterward. The seminar can be taken on its own or as part of the two-part Searching for Systematic Reviews: Where and How to Search course, with a 10% discount when both seminars are purchased together: https://instats.org/structuredcourse/searching-for-systematic-reviews-where-2 #Psychology #PublicPolicy #Epidemiology #PublicHealth #ClinicalorLaboratoryScience #PharmaceuticalScience #Psychiatry #Ophthalmology #Neuroscience #Immunology #Pharmacology #InformationScience #Research #ResearchTraining #Instats

Background: The traditional method for diagnosing obstructive sleep apnea (OSA) through polysomnography may be expensive and inaccessible. Recent developments in AI propose the use of photoplethysmography (PPG) to aid OSA diagnosis. Objective: This study seeks to evaluate the diagnostic accuracy of an AI-based approach in diagnosing OSA using PPG. Methods: PubMed, Embase, Scopus, Web of Science, and IEEE Xplore were searched from inception to November 3, 2025. The inclusion criteria comprised observational studies that evaluated the accuracy of AI-based methods of OSA diagnosis using PPG compared with conventional sleep testing used in adults. We excluded case reports, case series, reviews, meta-analyses, letters, conference abstracts, pediatric studies, animal studies, foreign language studies, studies with incomplete data, and studies focusing on individual apneic events without patient-level classification. The outcome of interest was the diagnostic accuracy of PPG-based AI models for OSA, as assessed in primary studies using random split tests, cross-validation, or external validation. Independent reviewers extracted data and assessed risk of bias using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. A Bayesian bivariate meta-analysis was used to pool estimates. Further subgroup, sensitivity, and meta-regression analyses were conducted. Overall quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. Results: From 12,579 records, we included 13 studies, comprising 9983 participants. All studies were rated as either low or unclear for risk of bias. The overall evidence quality was moderate. AI trained on PPG achieved a pooled sensitivity of 79.6% (95% credible interval [CrI] 55.5%‐93.8%) and specificity of 76.5% (95% CrI 48.2%‐94.0%), compared to conventional diagnosis. The overall specificity increased (apnea-hypopnea index [AHI] ≥5: 63.6%; AHI ≥15: 81.8%; AHI ≥30: 85.1%), but overall sensitivity decreased (AHI ≥5: 87.2%; AHI ≥15: 79.7%; AHI ≥30: 76.7%) with greater categorical AHI severity cutoffs. Additionally, deep learning models achieved a higher specificity (82.9%) than traditional machine learning (63.6%). OSA prevalence and device type were not clearly associated with sensitivity or specificity. Conclusions: AI models trained on PPG have reasonable accuracy and may potentially serve as a low-cost screening tool. However, limitations such as small sample sizes, potential sources of bias, underrepresentation of certain geographic regions, and the influence of potential confounding factors highlight the necessity for further research. Future work should focus on deep learning to improve the feasibility and accessibility of this approach in primary care. Trial Registration: PROSPERO CRD42024534235; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024534235

Objective To compare body composition and physical fitness between transgender and cisgender individuals. Design Systematic review with meta-analysis. Data sources PubMed, Web of Science, Embase and...

BACKGROUND: CSF-venous fistulas (CVFs) are an important and underrecognized cause of spontaneous intracranial hypotension. Accurate localization is essential for effective treatment. However, data regarding which areas of the spine are at higher risk are limited. PURPOSE: To evaluate the prevalence of affected laterality and spinal levels in patients with CVFs. DATA SOURCES: Scopus, Web of Science, Embase, and PubMed databases. STUDY SELECTION: Studies involving 3 or more patients with confirmed CVFs that specified the level and side of involvement were included. When multiple studies originated from the same institution or research group, they were further reviewed and narrowed to avoid data overlap, prioritizing inclusion of the largest studies. DATA ANALYSIS: Meta-analysis of demographic characteristics, side of involvement, and spinal levels of CVFs. Pooled prevalence rates were computed, and age and gender distribution across studies were analyzed. Pair-wise meta-regression was used, and laterality was further assessed at each spinal level to determine the distribution of right-versus left-sided leaks. Heterogeneity was assessed using Q statistics and the I2 test, with significance defined as an I2 value >50% or a P value <.05. DATA SYNTHESIS: Thirty-six observational studies consisting of 1145 patients (63% women) were analyzed. Most CVFs involved the lower portion of the thoracic spine, including T7 (28/180; 19%; 95% CI: 0.13–0.28), T9 (33/238; 19%; 95% CI: 0.13–0.30), and T10 (31/190; 17%; 95% CI: 0.13–0.24). More CVFs occurred on the right side of the spine (394/709; 67%; 95% CI: 0.62–0.73; P <.001) when compared to the left (214/786; 31%; 95% CI: 0.24–0.39) and bilaterally (18/313; 8%; 95% CI: 0.04–0.18). LIMITATIONS: Study limited by retrospective approach, reporting bias, and paucity of large published series of patients with CVFs. Furthermore, reporting was not standardized, making statistical comparison difficult. CONCLUSIONS: In patients with CVFs, the thoracic spine appears to be the most heavily involved region, especially on the right side. CVF : CSF-venous fistula DSM : digital subtraction myelography JBI : Joanna Briggs Institute SIH : spontaneous intracranial hypotension

Teprotumumab, the first approved therapy for thyroid eye disease, is highly effective, but has been increasingly associated with otologic adverse events, prompting a United States Food and Drug Administration warning regarding hearing impairment in 2023. Reported incidence varies widely across studies, and the true burden of toxicity remains uncertain. We conducted a systematic review and meta-analysis of PubMed/MEDLINE, Embase, and Cochrane CENTRAL from inception through May, 2026 (PROSPERO CRD420261337579), identifying 22 eligible studies (5 randomized controlled trials and 17 observational studies) comprising 856 teprotumumab-treated patients.

Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV (PLHIV). Although M72/AS01 demonstrated efficacy against active TB in HIV-negative adults, its safety in PLHIV is uncertain. As AS01 induces strong innate immune activation, evaluating tolerability in immunocompromised individuals is essential. We assessed the safety of M72/AS01 in PLHIV receiving antiretroviral therapy (ART).MethodsWe systematically searched MEDLINE, Embase, CENTRAL, and Web of Science for randomized controlled trials (RCTs) of PLHIV receiving M72/AS01 or placebo (last search 28 September 2025). Risk of bias was assessed using RoB 2 and certainty of evidence with GRADE. The protocol was registered in PROSPERO (CRD420251180412). Primary outcomes were risks of solicited local and systemic adverse events (AEs), any grade and grade 3, within seven days post-vaccination. Pooled risk ratios (RRs) were estimated using random-effects inverse-variance models.ResultsThree RCTs (510 participants; M72/AS01=263, placebo=247) were included. M72/AS01 increased risk of pain (RR 3.24, 95% CI 1.87–5.62), swelling (RR 4.64, 95% CI 2.93–7.34), headache (RR 1.83, 95% CI 1.52–2.20), myalgia (RR 2.36, 95% CI 1.80–3.10), and fever (RR 1.95, 95% CI 1.45–2.63). Events were predominantly mild-to-moderate and self-limited. No meaningful difference was observed in unsolicited AEs, and no vaccine-related serious adverse events were reported. Certainty ranged from high (common events) to low (rare grade 3 AEs) due to imprecision.ConclusionsM72/AS01 demonstrated a favorable safety profile in immunologically stable, virologically suppressed adults living with HIV on ART, with no increase in serious or unsolicited adverse events. These findings support its safe use and justify future studies evaluating its efficacy for TB prevention in this population.