Pediatric massage therapy in infants and children under 5 years: An umbrella review of systematic reviews.

Objective: To systematically evaluate and synthesize quantitative evidence regarding the effects of pediatric massage in infants and children under five years. Review methods: We conducted searches in databases including MEDLINE, Embase, Health Technology Assessment Database, the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, Embase, the China National Knowledge Infrastructure, Wanfang Data, SinoMed, and CQVIP up to February 2024. Two reviewers independently screened articles, extracted data, and conducted quality appraisals on the included studies. We focused on systematic reviews with meta-analyses comparing pediatric tuina with a waitlist control, placebo, medication, massage combined with other interventions, and usual care. Outcomes analyzed included physical, psychological, developmental, and safety-related measures for children and their caregivers. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated using the GRADE approach. Pooled effect estimates and heterogeneity were extracted for each meta-analyzed outcome. Evidence evaluated as 'high' and 'moderate' quality by GRADEpro with low heterogeneity are presented in the result section. Results: Twenty-two systematic reviews with meta-analysis of 81 outcomes were included. Seven studies (31.8 %) were high quality, and the evidence of 6 (7.4 %) outcomes were evaluated as high quality. The meta-analysis results demonstrate significant benefits of pediatric massage for infants compared to routine care, with increased weight gain (MD 455.07 g; 95 % CI 86.33 to 823.8; I2 = 0 %) based on 2 studies with 157 cases, length growth (MD 1.58 cm; 95 % CI 1.42 to 1.74; I2 = 25 %) from 9 studies with 1294 cases, reduced fussing (MD -0.37 time; 95 % CI -0.53 to -0.21; I2 = 30 %) according to 3 studies with 271 cases, and lower post-intervention bilirubin levels (3 studies/345 cases; MD -31.75 mmol/L; 95 % CI -40.05 to -23.46; I2 = 0 %). Pediatric massage was associated with reduced diarrhea incidence compared to waitlist controls (2 RCTs/310 cases; RR 0.39; 95 % CI 0.2 to 0.76; I2 = 0 %) and improved psychomotor development indices (4 RCTs/466 cases; SMD -0.35; 95 % CI -0.54 to -0.15; I2 = 1.06 %). Additionally, pediatric massage significantly enhanced blood oxygen saturation variation post-procedure for pain management (5 RCTs/355 cases; MD 1.05; 95 % CI 0.51 to 1.58; I2 = 0 %). Conclusions: Pediatric massage significantly enhances mother-child attachment, promotes physical growth, reduces fussing, lowers bilirubin levels, improves motor and psychomotor development, as well as manages digestive conditions and pain in children under 5 years. Future research should improve study quality and comprehensively report adverse events.

Nafamostat mesilate for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis based on prospective, randomized, and controlled trials.

OBJECTIVES: To evaluate the efficacy of nafamostat mesilate in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) by conduct a systematic review and meta-analysis. METHOD: We retrieved for all randomized controlled trials (RCTs) about compare nafamostat mesilate with placebo in preventing PEP published before August 23, 2022, in 5 major electronic databases. The primary outcome was PEP rate, and the secondary outcome was post-ERCP hyperamylasemia (PEHA) rate. Subgroup analyses were performed to reveal the factors that may affect the preventive effect of nafamostat. Assessment of the quality of evidence was conducted based on Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. RESULTS: According to the search strategy and criteria of inclusion and exclusion, 8 articles with a number of 3210 patients were included. The PEP incidence of the nafamostat group was inferior compared with the placebo group (4.6% vs 8.5%, RR = 0.50, 95% CI: 0.38-0.66). Subgroup analyses revealed that nafamostat had a preventive effect on patients with different risk stratification (High-risk: RR = 0.61, 95% CI: 0.43-0.86, Low-risk: RR = 0.28; 95% CI: 0.17-0.47). Different doses (20 mg: RR = 0.50, 95% CI: 0.36-0.69, 50 mg: RR = 0.45, 95% CI: 0.27-0.74) and duration (<12 hour: RR = 0.55, 95% CI: 0.37-0.81, ≥12 h: RR = 0.44, 95% CI: 0.29-0.66) of administration of nafamostat are adequate for the prevention of PEP, but postoperative administration may not help (preoperative: RR = 0.52, 95% CI: 0.39-0.69, postoperative: RR = 0.54, 95% CI: 0.23-1.23). Nafamostat may not efficacious in preventing severe PEP (Mild: RR = 0.49, 95% CI, 0.35-0.68, Moderate: RR = 0.47, 95% CI: 0.25-0.86, Severe: RR = 0.91, 95% CI, 0.25-3.29) or in low-quality studies (Low-quality: RR = 0.69, 95% CI: 0.13-3.60, High-quality: RR = 0.49, 95% CI: 0.37-0.65). CONCLUSION: Preoperative use of nafamostat can effectively prevent PEP in patients with various risk stratification. Nafamostat can prevent mild and moderate PEP, but may not prevent severe PEP and PEHA. There should be more high-quality RCTs in future to strengthen the evidence of nafamostat in preventing PEP.

Pulsation of visible vessel or adherent clot in duodenal ulcer may indicate pseudoaneurysm: Case series.

RATIONALE: Owing to the anatomical characteristics of the duodenum, gastroduodenal artery (GDA) pseudoaneurysms can be caused by duodenal ulcers, which may rupture and lead to massive or repeated bleeding. Pseudoaneurysms are usually diagnosed using enhanced computerized tomography or angiography, whereas endoscopic signs have rarely been reported. PATIENT CONCERNS: Three patients aged 18 to 83 years with bleeding duodenal ulcers and GDA pseudoaneurysms were treated. DIAGNOSIS: All patients had symptoms of gastrointestinal bleeding, and endoscopy revealed duodenal ulcers with visible vessels or adherent clot pulsations. Angiography confirmed the presence of a GDA pseudoaneurysm, which had an adjacent relationship with the duodenum. INTERVENTIONS: The GDA pseudoaneurysm was embolized in each patient. OUTCOMES: Through transcatheter arterial embolization, endoscopic treatment, and traditional treatment, hematemesis or melena was gradually stopped and all patients were discharged. LESSONS: The pulsation of visible vessels or adherent clots observed during endoscopy in patients with duodenal ulcer may indicate the formation of a gastroduodenal artery pseudoaneurysm. Therefore, we suggest that such patients receive enhanced computerized tomography or angiography to assess whether they need timely endovascular intervention treatment to avoid bleeding caused by a pseudoaneurysm.

Intrahepatic hematoma secondary to transjugular intrahepatic portosystemic stent-shunt procedure: Case report and literature review.

RATIONALE: Transjugular intrahepatic portosystemic stent-shunt (TIPSS) is a minimally invasive procedure used for the treatment of portal hypertension. Intrahepatic hematoma is the rare complication caused by hepatic arterial injuries from TIPSS procedure. PATIENT CONCERNS: This case report illustrated a 77-year-old man with hepatitis B virus-induced cirrhosis who underwent TIPSS. DIAGNOSES: The patient suffered from intrahepatic hematoma and hepatic pseudoaneurysm because of the hepatic artery injury after TIPSS. INTERVENTIONS: The hepatic artery laceration began at the level of the branch of the left hepatic artery was embolized. OUTCOMES: The acute intrahepatic hematoma and hepatic pseudoaneurysm of the patient were cured. CONCLUSION: In this report, we describe a cirrhosis patient with a large intrahepatic hematoma secondary to TIPSS, and a literature review is also presented. The intrahepatic hematoma and hepatic pseudoaneurysm should be paid more attention after TIPSS while early-stage prevention should be carried out.

Luminescence-guided and visibly transparent solar concentrators based on silicon quantum dots.

In this work, we demonstrate a new tapered prism-shaped luminescent solar concentrator (LSC), which guides most of the luminescence toward one edge instead of four, for the solar window application. Only one Si photovoltaic (PV) strip attached to the light-emitting sidewall is needed to collect the luminescence, which further reduces PV material cost and avoids electrical mismatch. To achieve high visible transmission and mitigate reabsorption, colloidal silicon quantum dots (SiQDs) with ultraviolet-selective absorption and large Stokes shift are used as the fluorophores. With the SiQD concentration equal to 8 mg mL-1, the SiQD-LSC as a solar window can attain a power conversion efficiency (PCE) equal to 0.27%, while ensuring high average visible transmission (AVT = 86%) and high color rendering index (CRI = 94 with AM1.5G as the incident spectrum). When adjusted to front-facing, the Si PV strip can harvest not only the direct sunlight but also the concentrated SiQD fluorescence guided from the LSC. As a result, the overall solar window PCE can be increased to 1.18%, and the PCE of the front-facing Si PV strip alone can be increased by 7% due to the luminescence guided from the SiQD-LSC.

Janus second-order nonlinear optical dendrimers: their controllable molecular topology and corresponding largely enhanced performance.

A new type of Janus dendrimers, consisting of two different side dendrons with the dipole orientation of the second-order nonlinear optical (NLO) chromophore moieties partially in a non-centrosymmetric direction, was intelligently designed and synthesized in order to enhance the macroscopic NLO performance and break through the limitation of NLO efficiency in the current molecular topological structure of azo chromophore-based polymers. This kind of Janus dendritic structure was constructed by the combination of convergent and divergent methods, with the utilization of a powerful "click chemistry reaction". The obtained three dendrimers, D-13N, D-17N and D-21N, show very high NLO performance, especially the dramatically enhanced NLO coefficient of 299 pm V-1 for D-13N, which is the highest value ever reported for polymers containing a simple azo chromophore. The new dendrimers provide a clear structure-properties relationship between high NLO efficiency and the controllable molecular topology with the non-centrosymmetrical alignment of dipole orientation, thus opening up a new avenue for the further development of NLO dendrimers with high performance and more importantly providing some clues for the rational design of functional dendrimers with controllable molecular topology.