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1878-55061442026Apr01Sleep MedPrevalence of restless legs syndrome during pregnancy: a systematic review and meta-analysis.10890410890410.1016/j.sleep.2026.108904S1389-9457(26)00143-7Restless legs syndrome (RLS) is known as one of the most common movement disorders during pregnancy, which is most aggravated in the third trimester of pregnancy and can affect up to one-third of pregnant women.This study intends to determine the total prevalence of RLS during pregnancy through a systematic review and meta-analysis.The present study was conducted using a systematic review approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search for relevant studies was performed in the Scopus, Web of Science (WOS), ScienceDirect, and Medline databases using keywords related to RLS and pregnancy. Following data extraction, the necessary statistical analyses were conducted using the random-effects model and performed with the second version of the Comprehensive Meta-Analysis software.In the final 35 studies, a total of 56,989 individuals were examined. Due to the heterogeneity observed based on the related tests (I²: 99.1%), a random-effects model was used to synthesize the results. Publication bias was assessed using the Egger's test, which indicated no significant bias in the final results the pooled results, the prevalence of RLS in pregnant women was calculated to be 21.9% (CI: 17.3% - 27.4% P ≤ 0.001). the prevalence of RLS in pregnant women in Asia was calculated to be 19.2% (effect size: 19.2%, CI 95% 12.9-27.6, P ≤ 0.001). Furthermore, the prevalence of RLS in Europe (effect size: 22.4%, CI 95% 17.2-28.6, P ≤ 0.001), America (effect size: 19.9%, CI 95% 12.6-29.9, P ≤ 0.001), and Africa (effect size: 58.1%, CI 95% 54.4-61.8, P ≤ 0.001).This study reveals a global prevalence of 21.9% for RLS among pregnant women. The subgroup analysis further highlights significant regional variation in RLS prevalence, with Africa exhibiting the highest rate at 58.1%, followed by Europe at 22.4%, the Americas at 19.9%, and Asia at 19.2%. These findings underscore the impact of geographical, cultural, and possibly environmental factors on the manifestation of RLS in pregnant women. Such variability calls for further research to explore the underlying causes of these differences, particularly in relation to genetic, nutritional, and healthcare access factors.Copyright © 2026 Elsevier B.V. All rights reserved.AltalbawyFarag M AFMADepartment of Chemistry, University College of Duba, University of Tabuk, Tabuk, Saudi Arabia.KareemMuthenaMDepartment of Medical Analysis, Medical Laboratory Technique College, The Islamic University, Najaf, Iraq; Department of Medical Analysis, Medical Laboratory Technique College, The Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq; Department of Medical Analysis, Medical Laboratory Technique College, The Islamic University of Babylon, Babylon, Iraq.SanghviGauravGMarwadi University Research Center, Department of Microbiology, Faculty of Science, Marwadi University, Rajkot, 360003, Gujarat, India.RRoopashreeRDepartment of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to Be University), Bangalore, Karnataka, India.KashyapAdityaACentre for Research Impact & Outcome, Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, 140401, Punjab, India.IndumathiS MSMDepartment of Biotechnology, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India.PanigrahiRajashreeRDepartment of Microbiology, IMS and SUM Hospital, Siksha 'O' Anusandhan (Deemed to Be University), Bhubaneswar, Odisha, 751003, India.KubaevAzizADepartment of Maxillofacial Surgery, Samarkand State Medical University, 18 Amir Temur Street, Samarkand, 140100, Uzbekistan.JoshiKamal KantKKDepartment of Allied Science, Graphic Era Hill University, Dehradun, India; Adjunct Professor, Graphic Era Deemed to Be University, Dehradun, Uttarakhand, India. Electronic address: kkjoshi@gehu.ac.in.engJournal ArticleReview20260401

NetherlandsSleep Med1008987591389-9457IMMovement disordersPregnancyPrevalenceRestless legs syndromeWomenDeclaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.20264150322026415032202511242026216202631820264141829aheadofprint4198053510.1016/j.sleep.2026.108904S1389-9457(26)00143-74198033720260414

1618-095X1552026Feb28PhytomedicinePhytotherapy for ageing-related multimorbidity: Systems-level insights into Centella asiatica in diabetes and Alzheimer's Disease.15802615802610.1016/j.phymed.2026.158026S0944-7113(26)00262-XThe increasing burden of age-related illnesses underscores the urgent necessity for integrative treatment approaches that simultaneously address the complex connections between metabolic and neurodegenerative disorders. Diabetes mellitus (DM) and Alzheimer's disease (AD) are strongly interconnected through shared pathological mechanisms. Plant-based therapeutics with their rich diversity of multitarget bioactive compounds are able to compromise such a complex network. Centella asiatica (l.) Urb. (C. asiatica), A medicinal herb, it has garnered significant attention for its metabolic and neuroprotective activities in ethnopharmacology, as well as preclinical and clinical studies.In this study, we employ a computational approach to elucidate the key bioactive constituents of C. asiatica and their ability to modulate shared pathological mechanisms linking DM and AD. Provide a scientific rationale for its use as a multitarget phyto-therapeutic candidate against ageing-associated comorbidities.Relevant keywords were used to search databases Scopus, Science Direct, PubMed, Google Scholar and WOS. To gather the scientific evidence of its phytoconstituents, anti-diabetic activity and anti-Alzheimer's activity. Further, a network pharmacology-based approach was adopted.From the identified phytoconstituents, fifty-four have favourable oral bioavailability, targeting 486 proteins. Venn interaction revealed 404 genes are cross-linked among C. asiatica, DM, and AD. Network pharmacology and enrichment analysis suggested that the PI3K-Akt signalling pathway is the key regulatory axis.C. asiatica demonstrates potential as a multi-target phyto-therapeutic agent for managing interconnected ageing disorders, i.e., DM and AD, through modulation of the PI3K-Akt signalling pathway.Copyright © 2026 Elsevier GmbH. All rights reserved.PattanaikSandesh KumarSKDepartment of Pharmacology, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.MohantyDebajaniDCentre of Biotechnology, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.RayAsitACentre of Biotechnology, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.JenaSudiptaSCentre of Biotechnology, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.PattanaikSovanSDepartment of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.RathDiptiraniDDepartment of Pharmacology, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India. Electronic address: diptiranirath@soa.ac.in.engJournal ArticleReview20260228

GermanyPhytomedicine94387940944-7113IMAgeing disordersAlzheimer’s diseaseCentella asiaticaDM-AD crosstalkMultimorbidityNetwork pharmacologyPi3k-aktType 2 diabetesDeclaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.20264150362026415036202511520262920262262026414183aheadofprint4198033710.1016/j.phymed.2026.158026S0944-7113(26)00262-X4197999320260414

1421-97512026Apr14CardiologyCardiovascular Outcomes in Diabetic Patients Treated with SGLT2i and GLP1-RA: A Systematic Review and Meta-Analysis.1311-3110.1159/000551686Introduction Type 2 diabetes mellitus (T2DM) represents a significant public health issue due to its high prevalence and associated complications, particularly the cardiovascular and renal impairments that characterize its natural history. Glucagon-like peptide receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) are two new classes of glucose-lowering agents. Large-scale international randomized controlled trials (RCTs) have demonstrated that both GLP1-RA and SGLT2i significantly reduce cardiovascular events in patients with T2DM. This study aims to conduct a systematic review and meta-analysis to evaluate cardiovascular outcomes in diabetic patients treated with GLP1-RA, SGLT2i or their combination. Subgroup analysis were performed for specific populations including older adults and patients with chronic kidney disease (CKD). Methods This meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search was performed across MEDLINE, WOS (Web of Science), SCOPUS, Embase, PubMed, CENTRAL and clinicaltrials.gov to identify multinational RCTs. The primary cardiovascular outcome was 3P-MACE (3 Point-Major Adverse Cardiovascular Events; nonfatal stroke, nonfatal myocardial infarction and cardiovascular death). Safety outcomes included hypoglycemia, pancreatitis, gastrointestinal disorders and cancer for GLP1-RA; hypoglycemia, ketoacidosis, fractures and genitourinary infections for SGLT2i. Risk of bias was assessed using the Cochrane Risk of Bias tool. Hazard ratio (HR), risk difference (RD) and relative risk (RR) were calculated with a 95% confidence interval using inverse variance-weighted method. A random-effects model was applied to synthesize the effect sizes of the studies assuming inter-study heterogeneity. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD420261306111) Results Seventeen clinical trials met the inclusion criteria; 11 compared GLP1-RA vs placebo and 6 compared SGLT2i vs placebo. Based on the random-effect model, GLP1-RA and SGLT2i significantly reduced 3P-MACE risk with HR of 0.85 (95% CI: [0.80 - 0.90]) and HR 0.87 (95% CI: [0.82 - 0.93]) respectively. No statistically significant differences were observed between combination therapy (GLP1-RA + SGLT2i) vs GLP1-RA monotherapy regarding 3P-MACE (HR 0.76 [0.54 - 1.08] vs HR 0.78 [0.70 - 0.87]; p interaction=0.89) or hospitalization for heart failure (HR 0.58 [0.36 - 0.92] vs HR 0.73 [0.63 - 0.85]; p interaction=0.89). Similarly, combination therapy showed no significant difference compared to SGLT2i monotherapy for 3P-MACE (HR 0.87 [0.66 - 1.15] vs HR 0.89 [0.84 - 0.94]; p interaction=0.87) and heart failure hospitalization (HR 0.82 [0.53 - 1.27] vs HR 0.77 (95% CI: [0.71 - 0.85]; p interaction=0.87). Subgroup analysis revealed that SGLT2i therapy was more effective in reducing 3P-MACE in patient with reduced eGFR (estimated Glomerular Filtration Rate) (p interaction=0.04). In older adults SGLT2i increased genital infections (p interaction < 0.01). Conclusions This meta-analysis highlights the cardiovascular benefits of these two new pharmacological classes in patients with T2DM. Both GLP1-RA and SGLT2i, whether as monotherapy or in combination, show a statistically significant difference in reducing 3P-MACE. These findings provide robust evidence to support the clinical use of these drugs.S. Karger AG, Basel.MarinoGaetanoGDi FuscoStefania AngelaSAAlonzoAlessandroAAltamuraVitoVColivicchiFurioFengJournal ArticleSystematic Review20260414

SwitzerlandCardiology12664060008-6312IM2025932026316202641418322026414183220264141313aheadofprint4197999310.1159/000551686000551686419795272026041420260414

1066-29365312026First QuarterUndersea Hyperb MedHyperbaric Oxygen Therapy in Traumatic Brain Injury: A Comprehensive Structure Review.658265-82Hyperbaric oxygen (HBO₂) treatment has sparked increasing attention as a potential therapeutic intervention for traumatic brain injury (TBI), but the variability in findings necessitates a comprehensive analysis of recent literature. This review aims to evaluate the latest empirical evidence on the effectiveness of HBO₂ treatment for TBI, focusing on its impact on neurological recovery, cognitive function, and physiological markers.To achieve this, we extensively searched scholarly articles in reputable databases such as Scopus and Web of Science (WoS), focusing on studies published between 2015 and 2024, and followed the PRISMA framework for study selection. The final dataset comprised 74 cases (n=74) and was analyzed using both quantitative methods (descriptive statistics) and qualitative techniques (thematic analysis). The findings were divided into three themes: (1) clinical efficacy of HBO₂ treatment for TBI, (2) mechanisms of action and biological pathways in HBO₂ treatment, and (3) evolving therapeutic applications of HBO₂ in TBI.Mixed outcomes; while some studies reported significant cognitive, physiological, and clinical improvements, others raised concerns about methodological variability and limited reproducibility. Mechanistic studies highlighted HBO₂'s role in modulating pathways such as TLR4/NF-κB and VEGF/ERK, facilitating neuroprotection, angiogenesis, and synaptogenesis. Emerging therapies combining HBO₂ with regenerative approaches, such as stem cell treatments, showed promise in enhancing recovery.In conclusion, HBO₂ treatment demonstrates clinical efficacy in improving memory, executive function, and neuroprotection, particularly in the treatment of post-concussive symptoms. Mechanistic studies highlight its role in reducing neuroinflammation and oxidative stress while promoting neurogenesis and angiogenesis. However, standardized protocols and long-term follow-up are needed to confirm its full therapeutic potential in TBI management.Copyright© Undersea and Hyperbaric Medical Society.JusohAzizul FadzliAFFaculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia.Emergency & Trauma Department, Hospital Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia.IsmailIsmawatiIFaculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia.Emergency & Trauma Department, Hospital Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia.YahayaRoslizaRFaculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia.Department of Psychiatry & Mental Health, Hospital Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia.HassanAzlieAEmergency & Trauma Department, Hospital Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia.YusoffHarmy MohamedHMFaculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia.engJournal ArticleReview

United StatesUndersea Hyperb Med93129541066-29360Vascular Endothelial Growth Factor AIMHyperbaric OxygenationmethodsHumansBrain Injuries, TraumatictherapyphysiopathologyCognitionphysiologyRecovery of FunctionTreatment OutcomeVascular Endothelial Growth Factor AHBO₂ treatmentHyperbaric oxygen treatmenthyperbaric researchtraumatraumatic brain injuryThe authors of this paper declare no conflicts of interest exist with this submission.202641412362026414123520264141022ppublish41979527419794492026041420260414

1118-48413072026Apr14Afr J Reprod HealthThe therapeutic potential of exosomes derived from mesenchymal stem cells for premature ovarian failure: A systematic.124138124-13810.29063/ajrh2026/v30i7.11(Afr J Reprod Health 2026; 30 [7]:124-138This review evaluates mesenchymal stem cell-derived exosomes (MSC-Exos) for treating premature ovarian failure (POF). A comprehensive search was conducted across five databases, including PubMed, Embase, and Web of Science (WoS), yielding 17 English-language studies published between 2016 and 2025. Studies primarily using animal and in vitro models assessed the therapeutic effects and mechanisms of MSC-Exos from diverse sources. MSC-Exos significantly elevated estrogen levels, reduced follicle-stimulating hormone (FSH), increased antral follicle counts, and restored estrous cyclicity. Specifically, BMSC-Exos activated the PI3K/AKT pathway via miRNAs to suppress granulosa cell apoptosis; hUCMSC-Exos mitigated cellular senescence and autophagy; ADSC-Exos promoted follicular development through SMAD and SIRT1/FOXO1; PMSC-Exos attenuated ROS damage by improving mitochondrial function; AFSC-Exos together with MenSC-Exos enhanced oocyte maturation via the P53 pathway. Notably, perinatal exosomes showed 18-32% greater efficacy in functional recovery than adult-tissue counterparts with fewer doses. MSC-Exos present a promising therapeutic strategy for POF by targeting apoptosis, autophagy, angiogenesis, and oxidative stress. Perinatal-derived exosomes offer superior potential due to their non-invasive collection and minimal ethical concerns. Nonetheless, challenges pertaining to heterogeneity, long-term safety, and standardized manufacturing necessitate resolution through multicenter clinical trials to advance clinical applicability..African Journal of Reproductive Health © 2026.ChenChu-QiaoCQDepartment of Gyn ecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.Department of Gynecology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou.WangXin-RunXRDepartment of Gyn ecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.ZhaoXiao-JingXJDepartment of Gyn ecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.WangLiangLDepartment of Gyn ecology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.engJournal ArticleSystematic Review

NigeriaAfr J Reprod Health97122631118-4841IMPrimary Ovarian InsufficiencytherapyFemaleHumansExosomestransplantationmetabolismMesenchymal Stem CellscytologymetabolismAnimalsApoptosisMesenchymal Stem Cell TransplantationmethodsCette revue évalue l’utilisation d’exosomes dérivés de cellules souches mésenchymateuses (MSC-Exos) pour le traitement de l’insuffisance ovarienne prématurée (IOP). Une recherche exhaustive a été menée dans cinq bases de données, notamment PubMed, Embase et Web of Science (WoS), et a permis d’identifier 17 études publiées en anglais entre 2016 et 2025. Les études, reposant principalement sur des modèles animaux et in vitro, ont examiné les effets thérapeutiques et les mécanismes d’action des MSC-Exos issus de différentes sources. Les MSC-Exos ont significativement augmenté les taux d’œstrogènes, réduit l’hormone folliculostimulante (FSH), accru le nombre de follicules antraux et rétabli la cyclicité œstrale. Plus précisément, les exosomes dérivés de cellules souches mésenchymateuses de la moelle osseuse (BMSC-Exos) ont activé la voie PI3K/AKT via des miARN afin de supprimer l’apoptose des cellules de la granulosa ; les exosomes dérivés de cellules souches mésenchymateuses du cordon ombilical humain (hUCMSC-Exos) ont atténué la sénescence cellulaire et modulé l’autophagie ; les exosomes dérivés de cellules souches mésenchymateuses du tissu adipeux (ADSC-Exos) ont favorisé le développement folliculaire via les voies SMAD et SIRT1/FOXO1 ; les exosomes dérivés de cellules souches mésenchymateuses placentaires (PMSC-Exos) ont réduit les dommages liés aux espèces réactives de l’oxygène (ROS) en améliorant la fonction mitochondriale ; les exosomes dérivés de cellules souches du liquide amniotique (AFSC-Exos), associés aux exosomes dérivés de cellules souches mésenchymateuses menstruelles (MenSC-Exos), ont amélioré la maturation ovocytaire via la voie P53. Il est à noter que les exosomes d’origine périnatale ont montré une efficacité de récupération fonctionnelle supérieure de 18 à 32 % à celle des exosomes issus de tissus adultes, et ce avec un nombre de doses plus faible. Les MSC-Exos constituent une stratégie thérapeutique prometteuse pour l’IOP en ciblant l’apoptose, l’autophagie, l’angiogenèse et le stress oxydatif. Les exosomes d’origine périnatale offrent un potentiel supérieur grâce à un prélèvement non invasif et à des préoccupations éthiques limitées. Néanmoins, des défis liés à l’hétérogénéité, à la sécurité à long terme et à la standardisation de la fabrication doivent être résolus au moyen d’essais cliniques multicentriques afin de favoriser une application clinique.African Journal of Reproductive Health © 2026.Cette revue évalue l’utilisation d’exosomes dérivés de cellules souches mésenchymateuses (MSC-Exos) pour le traitement de l’insuffisance ovarienne prématurée (IOP). Une recherche exhaustive a été menée dans cinq bases de données, notamment PubMed, Embase et Web of Science (WoS), et a permis d’identifier 17 études publiées en anglais entre 2016 et 2025. Les études, reposant principalement sur des modèles animaux et in vitro, ont examiné les effets thérapeutiques et les mécanismes d’action des MSC-Exos issus de différentes sources. Les MSC-Exos ont significativement augmenté les taux d’œstrogènes, réduit l’hormone folliculostimulante (FSH), accru le nombre de follicules antraux et rétabli la cyclicité œstrale. Plus précisément, les exosomes dérivés de cellules souches mésenchymateuses de la moelle osseuse (BMSC-Exos) ont activé la voie PI3K/AKT via des miARN afin de supprimer l’apoptose des cellules de la granulosa ; les exosomes dérivés de cellules souches mésenchymateuses du cordon ombilical humain (hUCMSC-Exos) ont atténué la sénescence cellulaire et modulé l’autophagie ; les exosomes dérivés de cellules souches mésenchymateuses du tissu adipeux (ADSC-Exos) ont favorisé le développement folliculaire via les voies SMAD et SIRT1/FOXO1 ; les exosomes dérivés de cellules souches mésenchymateuses placentaires (PMSC-Exos) ont réduit les dommages liés aux espèces réactives de l’oxygène (ROS) en améliorant la fonction mitochondriale ; les exosomes dérivés de cellules souches du liquide amniotique (AFSC-Exos), associés aux exosomes dérivés de cellules souches mésenchymateuses menstruelles (MenSC-Exos), ont amélioré la maturation ovocytaire via la voie P53. Il est à noter que les exosomes d’origine périnatale ont montré une efficacité de récupération fonctionnelle supérieure de 18 à 32 % à celle des exosomes issus de tissus adultes, et ce avec un nombre de doses plus faible. Les MSC-Exos constituent une stratégie thérapeutique prometteuse pour l’IOP en ciblant l’apoptose, l’autophagie, l’angiogenèse et le stress oxydatif. Les exosomes d’origine périnatale offrent un potentiel supérieur grâce à un prélèvement non invasif et à des préoccupations éthiques limitées. Néanmoins, des défis liés à l’hétérogénéité, à la sécurité à long terme et à la standardisation de la fabrication doivent être résolus au moyen d’essais cliniques multicentriques afin de favoriser une application clinique.African Journal of Reproductive Health © 2026.ExosomesMesenchymal stem cellsPremature ovarian failuretreatment characteristicstreatment effectThe Authors declared no conflict of interest20264141236202641412352026414953ppublish4197944910.29063/ajrh2026/v30i7.11(Afr J Reprod Health 2026; 30 [7]:124-138419792672026041420260414

1118-48413072026Apr14Afr J Reprod HealthMapping research fronts of reproductive medicine using the NHANES database: A bibliometric and thematic analysis.667966-7910.29063/ajrh2026/v30i6.7Reproductive health, infertility, and perinatal diseases significantly challenge human health development and continuity, requiring multidisciplinary approaches for enhanced academic understanding and practical solutions. This study used bibliometric analysis to examine related articles in the web of science (WoS) database, employing tools including bibliometrix and VOSviewer for systematic literature analysis. To capture the broader context of high-impact research, we first analyzed 1,026 highly-cited and hot papers in reproductive medicine, which revealed evolving thematic trends and global collaboration patterns. Then we examined 232 literatures using NHANES datasets for reproductive health research to identify research gaps and opportunities for further research in this field. The analysis revealed key trends, areas of concentration, and potential knowledge gaps in the literature, while the thematic analysis of reproductive health studies utilizing the NHANES database further underscored the wealth of data amenable to multidisciplinary investigation. Future research directions to explore new dimensions of reproductive health, improving health policies and clinical practices in this field using NHANES database are also suggested. The study concludes that multidisciplinary research using comprehensive datasets like NHANES is crucial for advancing understanding of reproductive health, infertility, and perinatal outcomes.African Journal of Reproductive Health © 2026.YangJieJGuilin Medical University, Guilin, 541000, P. R. China.LiaoJunJGuilin Medical University, Guilin, 541000, P. R. China.GaoYanYGuilin Medical University, Guilin, 541000, P. R. China.GuYueYGuilin Medical University, Guilin, 541000, P. R. China.ChenYun-XiangYXGuilin Medical University, Guilin, 541000, P. R. China.ZhaoLing-YunLYGuilin Medical University, Guilin, 541000, P. R. China.YanQiu-YiQYGuilin Medical University, Guilin, 541000, P. R. China.LiHui-MinHMGuilin Medical University, Guilin, 541000, P. R. China.engJournal Article

NigeriaAfr J Reprod Health97122631118-4841IMHumansBibliometricsReproductive MedicineDatabases, FactualReproductive HealthFemaleBiomedical ResearchNutrition SurveysPregnancyLa santé reproductive, l'infertilité et les maladies périnatales constituent un défi majeur pour le développement et la continuité de la santé humaine, nécessitant des approches multidisciplinaires afin d'améliorer la compréhension académique et de proposer des solutions pratiques. Cette étude a utilisé une analyse bibliométrique pour examiner les articles pertinents dans la base de données WoS, en employant des outils tels que Bibliometrix et VOSviewer pour une analyse systématique de la littérature. Afin de saisir le contexte plus large de la recherche à fort impact, nous avons d'abord analysé 1 026 articles hautement cités et à tendance chaude en médecine reproductive, ce qui a révélé les tendances thématiques évolutives et les modèles de collaboration internationale. Nous avons ensuite examiné 232 publications utilisant les jeux de données NHANES pour la recherche sur la santé reproductive, afin d'identifier les lacunes de recherche et les opportunités pour de futures études dans ce domaine. L'analyse a mis en évidence les tendances clés, les domaines de concentration et les lacunes de connaissances potentielles dans la littérature, tandis que l'analyse thématique des études sur la santé reproductive utilisant les jeux de données NHANES a en outre souligné la richesse des données susceptibles d'être étudiées de manière multidisciplinaire. Les orientations futures de la recherche visant à explorer de nouvelles dimensions de la santé reproductive, à améliorer les politiques sanitaires et les pratiques cliniques dans ce domaine à l'aide des jeux de données NHANES sont également proposées. L'étude conclut que la recherche multidisciplinaire utilisant des jeux de données complets tels que NHANES est cruciale pour faire progresser la compréhension de la santé reproductive, de l'infertilité et des issues périnatales.African Journal of Reproductive Health © 2026.The Authors declared no conflict of interest20264141236202641412352026414844ppublish4197926710.29063/ajrh2026/v30i6.7(Afr J Reprod Health 2026; 30 [7]: 66-79).419778532026041420260414

1424-82202672026Mar26Sensors (Basel)The Effectiveness of Virtual Reality-Based Interventions in Patients with Ataxic Conditions: A Systematic Review with Meta-Analysis.206910.3390/s26072069Ataxic symptoms are characterized by causing motor, balance and coordination disorders. Virtual reality-based interventions (VRBIs) including video games and exergames can improve ataxic symptoms. The aim of this systematic review with meta-analysis was to assess the effectiveness of VRBI on severity of ataxia, postural balance, mobility and manual dexterity in patients with ataxia.According to the PRISMA guidelines, we searched PubMed Medline, SCOPUS, WOS, CINAHL, PEDro and other sources for randomized controlled trials (RCTs) that assessed the effectiveness of VRBI, compared to others, on the severity of ataxia, balance, mobility and manual dexterity in patients with ataxia. The pooled effect was calculated using Cohen's standardized mean difference (SMD) and a 95% confidence interval (95% CI).With data from seven RCTs, providing data from 171 patients with ataxia, our meta-analysis elucidated that VRBI is effective in reducing the severity of ataxia (SMD = -0.43; 95% CI -0.84 to -0.03; p = 0.04) and increasing functional balance (SMD = 0.97; 95% CI 0.16 to 1.78; p = 0.02) and manual dexterity (SMD = -0.63; 95% CI -1.16 to -0.11; p = 0.018).Our findings suggest that VRBI could be a promising and effective therapeutic approach in reducing ataxia disability and increasing balance and manual dexterity in ataxic patients.Piñar-LaraMarinaM0009-0006-0242-7659Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain.CAIT APROMPSI, C/Clara Campoamor 7, 23470 Cazorla, Spain.González-CarmonaAnaADepartment of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain.Obrero-GaitánEstebanE0000-0002-8430-5500Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain.Cortés-PerezIreneI0000-0002-1876-1399Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain.engJournal ArticleSystematic ReviewMeta-AnalysisReview20260326

SwitzerlandSensors (Basel)1012043661424-8220IMHumansAtaxiatherapyphysiopathologyPostural BalancephysiologyVirtual RealityVideo Gamesataxiadisabilitymanual skillsmeta-analysispostural balancevirtual realityvirtual reality exposure therapy20262520263182026324202641463220264146312026414110epublish4197785310.3390/s26072069s26072069419773542026041420260414

1422-00672772026Mar31Int J Mol SciImpact of SGLT2 Inhibitors on Mortality Across Different Populations: A Systematic Review and Meta-Analysis.316810.3390/ijms27073168Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer glucose-lowering, cardio-protective and reno-protective properties. Mortality rates constitute a central endpoint for understanding the overall clinical value of SGLT2 inhibitors. This systematic review and meta-analysis aims to compare mortality outcomes associated with SGLT2 inhibitors across different populations. A systematic search was performed in four databases-PubMed, Scopus, Web of Science (WOS) and Cochrane CENTRAL-in March 2025. We strictly included randomized controlled trials (RCTs) that compared patients who received SGLT2is to control patients regarding mortality outcomes. All-cause mortality up to one year, all-cause mortality more than one year, cardiovascular mortality, renal mortality and in-hospital mortality were the extracted outcomes. Finally, RevMan (5.4) was adopted for meta-analysis, and OpenMeta analyst software was adopted for meta-regression. Fifty clinical trials met the eligibility criteria of the current systematic review and meta-analysis. SGLT2 inhibitors significantly reduced all-cause mortality in studies with follow-up of up to one year (RR = 0.89, 95% CI [0.80-0.99], p = 0.03). This early survival benefit was primarily driven by the subgroup of patients treated during acute cardiac decompensation (RR = 0.76, 95% CI [0.60-0.97], p = 0.03). Furthermore, long-term follow-up beyond one year showed a significant reduction in all-cause mortality (RR = 0.89, 95% CI [0.85-0.94], p < 0.0001), particularly among patients with chronic heart failure, chronic kidney disease (CKD), and diabetes mellitus (DM) with established cardiovascular disease (CVD) (following sensitivity analyses). Cardiovascular mortality was also significantly reduced overall (RR = 0.88, 95% CI [0.84-0.94], p < 0.0001), with the greatest benefit observed in chronic heart failure and CKD subgroups. SGLT2 inhibitors as a class provide a consistent and significant reduction in all-cause mortality across both short-term (up to one year) and long-term follow-up. The early survival benefit is particularly evident when initiated during acute cardiac decompensation, while the long-term benefit extends to chronic heart failure, CKD, and high-risk DM. Future well-designed trials are needed to address the impact of less-explored SGLT2 inhibitors and understudied populations.MovilaDana EmiliaDEUniversity Clinic of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department VI-Cardiology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.Research Centre of Timisoara Institute of Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.MotofeleaAlexandru CatalinAC0000-0003-4297-077XCentre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.DraganSimona RuxandaSR0000-0002-3892-0211University Clinic of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department VI-Cardiology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.Research Centre of Timisoara Institute of Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.SchillerAdalbertACentre for Molecular Research in Nephrology and Vascular Disease/MOL-NEPHRO-VASC, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.IonacAdinaADepartment of Cardiology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.MotofeleaNadicaN0009-0007-7597-823XDepartment of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.CaruntuFlorinaFFirst Department of Internal Medicine, Medical Semiology II, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.Multidisciplinary Heart Research Center, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.engJournal ArticleSystematic ReviewMeta-AnalysisReview20260331

SwitzerlandInt J Mol Sci1010927911422-00670Sodium-Glucose Transporter 2 InhibitorsIMHumansSodium-Glucose Transporter 2 Inhibitorstherapeutic useDiabetes Mellitus, Type 2drug therapymortalityCardiovascular Diseasesmortalitydrug therapyRandomized Controlled Trials as TopicSGLT2 inhibitorall-cause mortalitycardiovascular mortalitydeath2026252026315202632020264146322026414631202641418epublish4197735410.3390/ijms27073168ijms27073168419760022026041420260414

2076-26151672026Mar27Animals (Basel)Balancing Effectiveness and Ethics: Global Systematic Review of Sus scrofa Population Control Methods.102310.3390/ani16071023The rapid global wild boar (Sus scrofa) population growth, coupled with increasing agricultural crop damage and disease transmission, suggests that current management and control strategies remain inadequate. Therefore, an international systematic review using the Web of Science database (WoS; Clarivate Analytics, Philadepphia, PA, USA), including a quantitative synthesis (119 studies up to 11 November 2025, containing 181 experiments) of population reduction methods was conducted, with an emphasis on evaluating their effectiveness, selectivity, and animal welfare aspects relating to wild boar and feral pigs. The results demonstrate a significant increase in research interest for population control methods in recent years. The highest average effectiveness was observed for aerial shooting (56.2% of the population per month), followed by poison baiting (27.6%) and trapping (6.0%). Aerial shooting appeared highly selective in the reviewed contexts; however, together with poison baiting, it is generally not permitted under current European conditions. Trapping (6.0%) and individual hunting (3.9%) offer moderate effectiveness but are highly context-dependent. From a welfare perspective, the analysis indicated that no significant difference in effectiveness was detected between studies that included welfare or stress assessment and those that did not, indicating that consideration of animal welfare does not reduce control efficiency. The study concluded that the analysis did not identify a single universally applicable solution that combines animal welfare considerations with high effectiveness, highlighting a significant research gap. This underscores the urgent need for an effective and publicly acceptable method of reducing wild boar populations, or for the development of strategies that appropriately integrate multiple approaches. However, the interpretation of results is limited by heterogeneity in study design and variability in reported data.CukorJanJ0000-0002-0003-3174Forestry & Game Management Research Institute, Strnady 136, 252 02 Jíloviště, Czech Republic.Faculty of Forestry and Wood Sciences, Czech University of Life Sciences Prague, Kamýcká 129, 165 00 Prague, Czech Republic.PařízkováMonikaM0000-0003-1847-2877Forestry & Game Management Research Institute, Strnady 136, 252 02 Jíloviště, Czech Republic.Faculty of Forestry and Wood Sciences, Czech University of Life Sciences Prague, Kamýcká 129, 165 00 Prague, Czech Republic.LindaRostislavR0000-0002-9602-7915Forestry & Game Management Research Institute, Strnady 136, 252 02 Jíloviště, Czech Republic.VacekZdeněkZFaculty of Forestry and Wood Sciences, Czech University of Life Sciences Prague, Kamýcká 129, 165 00 Prague, Czech Republic.SkotákVlastimilV0000-0002-6342-4623Forestry & Game Management Research Institute, Strnady 136, 252 02 Jíloviště, Czech Republic.Faculty of Forestry and Wood Technology, Mendel University in Brno, Zemědělská 1, 613 00 Brno, Czech Republic.engTQ03000038Technology Agency of the Czech RepublicMZE-RO0118Ministry of AgricultureExcellent Team 2025Czech University of Life Sciences PragueJournal ArticleReview20260327

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Evaluation of Damage to Forest Tree Plantations by Wild Boar in the Czech Republic. Hum. Wildl. Interact. 2021;15:66–73.Cukor J., Faltusová M., Vacek Z., Linda R., Skoták V., Václavek P., Ježek M., Šálek M., Havránek F. Wild Boar Carcasses in the Center of Boar Activity: Crucial Risks of ASF Transmission. Front. Vet. Sci. 2024;11:1497361. doi: 10.3389/fvets.2024.1497361.10.3389/fvets.2024.1497361PMC1169369439748874Sauter-Louis C., Conraths F.J., Probst C., Blohm U., Schulz K., Sehl J., Fischer M., Forth J.H., Zani L., Depner K., et al. African Swine Fever in Wild Boar in Europe—A Review. Viruses. 2021;13:1717. doi: 10.3390/v13091717.10.3390/v13091717PMC847201334578300Blome S., Franzke K., Beer M. African Swine Fever—A Review of Current Knowledge. Virus Res. 2020;287:198099. doi: 10.1016/j.virusres.2020.198099.10.1016/j.virusres.2020.19809932755631Costard S., Mur L., Lubroth J., Sanchez-Vizcaino J.M., Pfeiffer D.U. Epidemiology of African Swine Fever Virus. 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1664-2392172026Front Endocrinol (Lausanne)Effects of non-pharmacological interventions on ulcer healing in patients with diabetic foot: a network meta-analysis of randomized controlled trials.18115951811595181159510.3389/fendo.2026.1811595Diabetic Foot Ulcers are a serious complication of diabetes, and the clinical treatment is challenging. In this study, network meta-analysis was used to evaluate the effect of different non-drug interventions on Diabetic Foot Ulcer healing and provide evidence to support clinical decision-making.Data sources: 8 databases, including PubMed, Embase, Cochrane, WOS, CNKI, Wanfang Data, CBM, and VIP, were systematically searched. Literature screening: According to the principle of PICOS, two researchers independently screened. Quality evaluation: Two researchers independently used the Cochrane bias risk assessment tool (RoB 2.0) to evaluate the risk of bias. Statistical analysis: by NMA of the random effects model under the framework of frequency.A total of 24 randomized controlled trials involving 15 types of interventions were included. The overall quality of the included literature was moderate. The results of NMA showed that Negative Pressure Wound Therapy + Standard Care had the best effect on 12-week healing rate. Compared with Standard Care, Gas Therapy+ Dressing Therapy + Standard Care had the best healing time.Negative Pressure Wound Therapy + Standard Care may be more beneficial for improving the 12-week healing rate of Diabetic Foot Ulcer, while Gas Therapy + Dressing Therapy + Standard Care may show potential advantages in shortening healing time. However, these results rely on a limited number of small-sample studies with wide confidence intervals, indicating limited certainty of evidence. Consequently, the SUCRA rankings should be interpreted with caution as they are primarily exploratory; further high-quality RCTs are required to confirm these findings.https://www.crd.york.ac.uk/prospero/, identifier CRD420251122143.Copyright © 2026 Zheng, Xie, Wu, Xu, Lin and Dong.ZhengJiaxingJThe Second Affiliated Hospital of Shantou University Medical College, Shantou, China.Shantou University Medical College, Shantou, China.XieDannaDThe Second Affiliated Hospital of Shantou University Medical College, Shantou, China.WuMinyuMThe Second Affiliated Hospital of Shantou University Medical College, Shantou, China.XuHongtaoHThe Second Affiliated Hospital of Shantou University Medical College, Shantou, China.Shantou University Medical College, Shantou, China.LinSiyinSShantou University Medical College, Shantou, China.Shantou University Medical College Cancer Hospital, Shantou, China.DongLiliLThe Second Affiliated Hospital of Shantou University Medical College, Shantou, China.engJournal ArticleMeta-AnalysisSystematic Review20260326

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1873-426X5652026Mar18Carbohydr ResA biometric analysis of research advances in polysaccharides from genus Schisandra: Extraction, structural characterization, quality evaluation, and pharmacological activities.10989610989610.1016/j.carres.2026.109896S0008-6215(26)00085-6Genus Schisandra polysaccharides (GSPs), with Schisandra chinensis polysaccharides (SCPs) as the representative, are recognized as principal bioactive constituents derived from Schisandra spp., exhibit diverse biological activities, encompassing antioxidant, immunomodulatory, anti-inflammatory, hepatoprotective, and anti-fatigue effects. These properties have garnered significant research interest globally in recent years. To systematically review the hot topics and development trends in GSPs research, this paper screened and analyzed a total of 147 relevant publications from the WOS database. Using CiteSpace software, keyword co-occurrence maps and burst detection maps were constructed to reveal the focal themes and dynamic evolution pathways within the research field. The results demonstrate that international researchers have reached a broad consensus on the pharmacological effects of GSPs, which are mainly attributed to antioxidant, antitumor, and immunomodulatory mechanisms. Research focus has shifted from the isolation and identification of crude components toward in-depth mechanistic investigations and application-oriented optimization. On the basis of current research progress, this review systematically summarizes the extraction and isolation, structural characteristics, pharmacological activities, structure-activity relationships, quality control, and application development of GSPs, aiming to provide theoretical support and practical references for the in-depth understanding and industrial utilization of GSPs.Copyright © 2026. Published by Elsevier Ltd.JiangShiNengSCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China; College of Chinese Medicine, Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, 650500, China.CaoMingYangMCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China; College of Medicine, Kunming University, Kunming, Yunnan, 650214, China.ZhuZeMeiZCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China.LiQingQCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China; College of Medicine, Kunming University, Kunming, Yunnan, 650214, China.XueWenJunWCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China; College of Medicine, Kunming University, Kunming, Yunnan, 650214, China.ZhaoFeiYaFCollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China. Electronic address: 1305531253@qq.com.TaoAiEnACollege of Medicine, Lijiang College of Culture and Tourism, Lijiang, 674199, China. Electronic address: 2515073996@qq.com.engJournal Article20260318

NetherlandsCarbohydr Res00435350008-6215IMApplication developmentBiometric analysisExtraction and purificationGenus schisandra polysaccharidesPharmacological activitiesStructure-activity relationshipDeclaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.20261192026362026317202641212322026412123220264121033aheadofprint4196657210.1016/j.carres.2026.109896S0008-6215(26)00085-64196596220260412

1878-74871202026Apr04J Forensic Leg MedMapping 25 years of forensic and legal medicine research: a multi-database bibliometric and science-mapping analysis (2000-2025).10312710312710.1016/j.jflm.2026.103127S1752-928X(26)00059-4Forensic and legal medicine spans forensic pathology, clinical forensic practice, toxicology, genetics, imaging, and emerging digital methods. Long-horizon mapping can support research prioritisation and editorial strategy.We conducted performance analysis and science-mapping of records published between 2000 and 2025. Primary analyses were performed on Web of Science Core Collection records (articles and reviews) using bibliometrix/biblioshiny. Outputs included annual production, leading sources and countries, citation indicators, collaboration metrics, keyword co-occurrence, Callon centrality-density thematic mapping, and trend-topic analysis. A conservative, prespecified keyword harmonisation was applied to a small set of orthographic variants (medico-legal, postmortem, machine learning, deep learning). Scopus-derived outputs were used as a robustness comparison for source and country landscapes.The WoS corpus comprised 16,190 documents from 3052 sources with 49,746 distinct authors and 372,874 cited references. Annual growth was 7.68%, with 5.07 co-authors per document and 13.38% international co-authorship. Output was concentrated in a compact Bradford nucleus of specialist forensic journals, while a long tail of occasional publications appeared in adjacent clinical and multidisciplinary venues. Thematic mapping identified four macro-domains-identification, risk/epidemiology, autopsy/postmortem pathology, and clinical forensic practice-with recent growth in COVID-19-related work, postmortem interval research, and AI/ML terminology.Forensic and legal medicine shows sustained growth with a stable conceptual backbone and accelerating innovation in digital and computational themes. These maps can inform research prioritisation, training needs, and editorial planning across specialist forensic outlets.Copyright © 2026 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.SiragoGianmarcoGUniversity of Bari Aldo Moro, Policlinico of Bari, Bari, Italy. Electronic address: gianmarco.sirago@uniba.it.SolarinoBiagioBUniversity of Bari Aldo Moro, Policlinico of Bari, Bari, Italy.Dell'ErbaAlessandroAUniversity of Bari Aldo Moro, Policlinico of Bari, Bari, Italy.FerorelliDavideDUniversity of Bari Aldo Moro, Policlinico of Bari, Bari, Italy.engJournal ArticleReview20260404

EnglandJ Forensic Leg Med1013000221752-928XIMBibliometricsForensic medicineLegal medicineScience-mappingScopusWeb of scienceDeclaration of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.2026224202643202643202641263820264126382026412026aheadofprint4196596210.1016/j.jflm.2026.103127S1752-928X(26)00059-44196118620260410

0975-07112026Apr10Indian J GastroenterolThe effectiveness of indomethacin and pancreatic duct stenting in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and network meta-analysis.10.1007/s12664-026-01974-wEndoscopic retrograde cholangiopancreatography (ERCP) has significant diagnostic and therapeutic roles in pancreaticobiliary disorders. Post-ERCP pancreatitis (PEP) is the most common adverse event that can be encountered and affects 1% to 9% of the average-risk group and 11% to 40% of the high-risk group. Several methods have been used to prevent PEP, including pancreatic duct (PD) stenting and pharmacological use, including indomethacin.We conducted a systematic review of PubMed (MEDLINE), Scopus and Web of Science (WOS) databases until November 1, 2024, using relevant keywords. Only randomized clinical trials (RCTs) were included. The network meta-analysis is reported using odds ratios (ORs) with 95% confidence intervals (CIs) with a significance level < 0.05. Rank probabilities were calculated using p-scores to rank treatments based on their effectiveness. All analyses were performed using R version 4.3.1 (2023-06-16 ucrt) with the netmeta package. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment of the certainty of the evidence was performed.Of 1828 references, total 31 RCTs with 9050 participants were included in this meta-analysis. Compared to placebo, indomethacin (OR = 0.50, 95% CI = 0.39-0.64, p < 0.001), PD stenting (OR = 0.33, 95% CI = 0.23-0.47, p < 0.001) and indomethacin combined with PD stenting (OR = 0.36, 95% CI = 0.18-0.73, p = 0.005) were effective in reducing PEP. Sub-group analysis of high-risk patients revealed similar results, indomethacin (OR = 0.43, 95% CI = 0.31-0.61, p < 0.001), PD stenting (OR = 0.32, 95% CI = 0.22-0.47, p < 0.001) and indomethacin combined with PD stenting (OR = 0.32, 95% CI = 0.14-0.72, p = 0.006). Notably, indomethacin did not show significant effects in mild, moderate or severe PEP. Notably, indomethacin showed significant benefit in the prevention of moderate-severe PEP only.The present network meta-analysis indicated that PD stenting seems to be the most effective in reducing PEP incidence among the examined treatments, particularly in high-risk patients, with inconsistent benefits of indomethacin in different PEP severities.© 2026. Indian Society of Gastroenterology.ElshaarAhmed GamalAGFaculty of Medicine, Menofia University, Shibin El Kom, Menofia, Egypt.SamirAhmed AmirAAFaculty of Medicine, Al-Azhar University, Cario, Egypt.ElgammalAhmed SamyASFaculty of Medicine, Tanta University, Tanta, Egypt.ElawRoaa AbdulrhmanRAFaculty of Nursing, Damanhour University, Al-Buhyrah, Egypt.ZainEffa AfifEAFaculty of Medicine and Human Sciences, University of Aden, Aden, Yemen.Bin-SahelOmerOFaculty of Medicine and Health Sciences, Seiyun University, Seiyun, Yemen.KamhNada RamadanNRFaculty of Medicine, Tanta University, Tanta, Egypt.SeragZahra Faried FarouqZFFFaculty of Medicine, Al-Azhar University, Cario, Egypt.RamadanMohamed DiabMDFaculty of Medicine, Suez Canal University, Suez, Egypt.AnberMagdy MostafaMMTanta University Hospital, Tanta, Egypt.OsamaZainabZFaculty of Medicine, Al Butana University, Gazira State, Ruffa City, Sudan.ElgoharyMohamedMFaculty of Medicine, Port Said University, Port Said, Egypt.AliHossam TharwatHT0000-0001-8077-5911Qena Faculty of Medicine, Qena University, Qena, Egypt. Hossam.Tharwat@med.svu.edu.eg.engJournal ArticleReview20260410

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1664-2295172026Front NeurolEffectiveness of combined versus single circadian interventions in neonatal and pediatric intensive care units: a systematic review with meta-analysis.18011941801194180119410.3389/fneur.2026.1801194Admission to neonatal or pediatric intensive care units exposes vulnerable patients to confounding environmental cues, disrupting circadian rhythms and potentially compromising physiological stability. While various circadian interventions exist, ranging from simple light cycling to complex multicomponent bundles, it remains unclear whether complex bundles offer superior clinical benefits over single-modality interventions. This systematic review evaluated the efficacy of circadian interventions on physiological parameters and sleep primarily in critically ill neonates and children, specifically comparing single versus combined strategies.A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. We searched five major electronic databases: PubMed, ScienceDirect, CINAHL, WoS, Scopus and LILACS. Additionally, the Epistemonikos and SciELO databases were screened to identify relevant studies published in languages other than English. The search covered from inception to 2025 and was conducted during October 2025. Risk of bias was assessed using the Cochrane RoB 2 tool and ROBINS-I, while the certainty of evidence was evaluated using the GRADE approach. Data were synthesized using random-effects meta-analysis for physiological outcomes and SWiM guidelines for studies with non-parametric or incompatible data.Forty-one studies (N = 2,548) met the inclusion criteria. Meta-analysis of 16 studies demonstrated that circadian interventions significantly reduced heart rate (SMD -0.70; 95% CI [-1.10, -0.30]; p < 0.001) and respiratory rate (SMD -0.75; p < 0.001), while improving oxygen saturation (SMD + 1.33; p < 0.001) and increasing sleep duration (SMD + 0.92; p < 0.001). Narrative synthesis of 16 additional studies confirmed these findings, with 81.2% reporting positive outcomes. Importantly, subgroup analysis revealed no statistically significant difference between single and multicomponent interventions across any outcome (p > 0.05). The certainty of evidence was graded as low due to the inherent inability to blind environmental interventions and statistical heterogeneity.Circadian interventions are effective strategies for modulating physiological parameters and improving sleep quality in the NICU. Single interventions, such as cycled lighting, yielded similar outcomes to complex multicomponent bundles, but due to the lack of pediatric research, our results should be interpreted with caution. Future research should prioritize primary research in pediatric settings to deepen our understanding about circadian interventions.https://doi.org/10.17605/OSF.IO/8SPZM, Identifier: CRD4201091137.Copyright © 2026 Corrotea-Maltez, Fernández-Flores, Gutiérrez-Neira, Nirrian-Pérez, Mansilla-Muñoz and Bustos-González.Corrotea-MaltezConstanza CCCSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.Fernández-FloresCatalina VCVSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.Gutiérrez-NeiraConstanza LCLSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.Nirrian-PérezAntonia JAJSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.Mansilla-MuñozJavieraJSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.Bustos-GonzálezLilianaLSchool of Nursing, Faculty of Medicine, Universidad de Valparaíso, Viña del Mar, Chile.engJournal ArticleSystematic Review20260325

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1918-30031832026MarJ Clin Med ResRestrictive Versus Liberal Fluid Strategy for Initial Resuscitation in Sepsis and Septic Shock: A Systematic Review and Meta Analysis.177195177-19510.14740/jocmr6464Intravenous fluid resuscitation is essential in early management of sepsis, but the optimal volume and resuscitation strategy are uncertain. This systematic review and meta-analysis aimed to synthesize the evidence comparing the efficacy and safety of restrictive versus liberal fluid resuscitation strategies in adults with sepsis or septic shock.A systematic search of PubMed, Web of Science (WoS), Scopus, and CENTRAL was conducted from inception to November 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Randomized controlled trials (RCTs) and observational cohort studies comparing protocolized restrictive fluid strategies with liberal or standard care were included. Primary outcomes were all-cause mortality and acute kidney injury (AKI). Random-effects models were used to calculate pooled risk ratios (RRs) and mean differences (MDs), while trial sequential analysis (TSA) assessed the conclusiveness of evidence.Sixteen reports from 15 unique studies (nine RCTs and six observational studies) involving 5,013 patients were included. In the analysis of RCTs, restrictive fluid therapy resulted in no significant difference in all-cause mortality (RR = 0.99; 95% CI, 0.90-1.08; I² = 0%); however, observational studies showed a significant mortality reduction (RR = 0.69), suggesting confounding by indication in observational datasets. TSA of the RCT data indicated insufficient evidence for mortality benefit. Restrictive strategies were associated with a lower risk of AKI (RR = 0.89; 95% CI, 0.81-0.99; P = 0.02; I² = 0%) and a reduced incidence of acute respiratory distress syndrome (ARDS) (RR = 0.69; 95% CI, 0.56-0.85; P < 0.001; I² = 0%). No significant differences were observed in other ischemic, metabolic, or organ support outcomes. However, restrictive fluid therapy reduced the need for mechanical ventilation, shortened the ventilation duration and vasopressin use, and increased ventilator-free days.Restrictive fluid resuscitation does not reduce overall mortality in adults with sepsis or septic shock, but it is associated with lower AKI and ARDS risk and decreased dependence on mechanical ventilation. Evidence regarding mortality is inconclusive, highlighting the need for large-scale trials to validate this finding.Copyright 2026 Authors.AliAhmed OsmanAODepartment of Critical Care, Dr. Soliman Fakeeh Hospital, Riyadh, Saudi Arabia.KordiHossam Ahmad AdibHAAEmergency Department, Abha International Private Hospital, Abha, Saudi Arabia.AlhagMarwa Hussein Said AhmadMHSADepartment of Pediatric Emergency, Maternity and Children Hospital, Hail, Saudi Arabia.SalamaAbdelghafar Mohamed AbdelghafarAMADepartment of Emergency Medicine, Alghad College for Applied Medical Sciences, Riyadh, Saudi Arabia.AlqarniZahra GumaidZGIntensive Care Unit, King Fahad Hospital, Madinah, Saudi Arabia.DwayatAbdallahAFaculty of Medicine, Al-Quds University, Jerusalem, Palestine.MustafaAlam Eldin MusaAEMDepartment of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia.Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Kordofan, El Obeid, Sudan.OkashaAbdelhadiAJordan University Hospital, Amman, Jordan.AbdullahShouqSPrince Sultan Military College of Health Sciences (PSMCHS), Al Amal, Dhahran, Saudi Arabia.AlaliNada Saleem MohammedNSMManchester Program for Medical Education, Mansoura, Egypt.AlaliZainab Saleem MohammedZSMManchester Program for Medical Education, Mansoura, Egypt.HakamiManal SaMSResearch Science in Nursing and Midwifery, Department of Material and Child Health Nursing, Faculty of Nursing, Al-Baha University, Al-Baha, Saudi Arabia.AlghammasYazan Yousef AYYACollege of Surgeons in Ireland, Dublin, Ireland.AliNiemat Mohammed TahirNMTDepartment of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia.AlghannamiAliAMinistry of Health, Riyadh, Riyadh Region, Saudi Arabia.engJournal Article20260326

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2296-2565142026Front Public HealthGlobal research trends and hotspots in the health effects of Tai Chi on older adults: a bibliometric analysis (2010-2025).17999371799937179993710.3389/fpubh.2026.1799937Tai Chi has potential benefits in promoting healthy aging, but a comprehensive understanding of its global research landscape, thematic evolution, and emerging trends remains limited. This study aims to use bibliometric methods to systematically analyze the knowledge structure, hotspot evolution, and collaborative networks of global research on Tai Chi and the health of the older adult(s) from 2010 to 2025, in order to explore future research hotspots and trends.A bibliometric approach was employed to conduct a visualized analysis of 2,532 eligible publications retrieved from the Web of Science (WOS) and Scopus databases. VOSviewer and CiteSpace software were used to examine publication trends, collaborative patterns, keyword co-occurrence, and thematic evolution.The number of publications increased from approximately 80 in 2010 to a peak of about 270 in 2025, indicating that the field has entered a phase of accelerated development. China (1,034 publications, 41%) and the United States (865 publications, 34%) constituted the dual core of global research output. Institutions such as Shanghai University of Sport (52 publications) and Harvard University (38 publications) formed key cross-regional collaborative networks. Keyword co-occurrence analysis identified four major research clusters: balance and fall prevention (175 occurrences), quality of life (127 occurrences), depression (103 occurrences), and cognitive function. Burst keyword analysis revealed that the research frontier has shifted from "alternative medicine" toward "Parkinson's disease" (burst strength = 3.66) and "network meta-analysis" (burst strength = 8.37).Research on Tai Chi has been deeply integrated into the modern rehabilitation medicine system, with the research paradigm shifting from single functional outcome validation toward multidimensional health promotion and precision evidence-based approaches encompassing physical, psychological, and cognitive domains. This study supports the inclusion of Tai Chi as a low-cost, high-efficiency mind-body intervention model within global strategies for promoting healthy aging.Copyright © 2026 Niu, Zhang, Liu and Wang.NiuYantaoYInstitute of Physical Education, Huaiyin Normal University, Huai'an, China.ZhangQiushiQInstitute of Physical Education, Huaiyin Normal University, Huai'an, China.LiuQiaofangQInstitute of Physical Education, Huaiyin Normal University, Huai'an, China.WangMinMInstitute of Physical Education, Huzhou University, Huzhou, China.School of Physical Education, Qufu Normal University, Qufu, China.engJournal Article20260324

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