UNASSIGNED: Gastric cancer is a significant contributor to the global cancer burden. Risk prediction models aim to estimate future risk based on current and past information, and can be utilized for risk stratification in population screening programs for gastric cancer. This review aims to explore the research design of existing models, as well as the methods, variables, and performance of model construction.
UNASSIGNED: Six databases were searched through to November 4, 2023 to identify appropriate studies. PRISMA extension for scoping reviews and the Arksey and O\'Malley framework were followed. Data sources included PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP, focusing on gastric cancer risk prediction model studies.
UNASSIGNED: A total of 29 articles met the inclusion criteria, from which 28 original risk prediction models were identified that met the analysis criteria. The risk prediction model is screened, and the data extracted includes research characteristics, prediction variables selection, model construction methods and evaluation indicators. The area under the curve (AUC) of the models ranged from 0.560 to 0.989, while the C-statistics varied between 0.684 and 0.940. The number of predictor variables is mainly concentrated between 5 to 11. The top 5 most frequently included variables were age, helicobacter pylori (Hp), precancerous lesion, pepsinogen (PG), sex, and smoking. Age and Hp were the most consistently included variables.
UNASSIGNED: This review enhances understanding of current gastric cancer risk prediction research and its future directions. The findings provide a strong scientific basis and technical support for developing more accurate gastric cancer risk models. We expect that these conclusions will point the way for future research and clinical practice in this area to assist in the early prevention and treatment of gastric cancer.

Cardiovascular disease (CVD) is a leading global health concern, and effective primary prevention strategies are essential to mitigate its impact. This comprehensive review examines current risk assessment strategies for primary prevention of CVD, emphasizing the importance of early identification and intervention to reduce disease incidence. Traditional risk factors such as hypertension, hyperlipidemia, smoking, and lifestyle choices are discussed alongside emerging factors, including genetic predispositions and biomarkers. The review evaluates various risk assessment tools and models, such as the Framingham risk score, atherosclerotic CVD risk calculator, QRISK, and Reynolds risk score, highlighting their methodologies, strengths, and limitations. Additionally, the review explores lifestyle modifications, including dietary changes, physical activity, weight management, smoking cessation, and pharmacological interventions like statins and antihypertensives. Special considerations for different populations, including the elderly, women, and those with a family history of CVD, are addressed. Future directions in cardiovascular risk assessment are also discussed, focusing on technological advancements and personalized medicine. This review aims to enhance the implementation of effective primary prevention measures and improve cardiovascular health outcomes by providing a thorough analysis of risk assessment strategies.

OBJECTIVE: Primary prevention strategies are critical to reduce the global burden of congenital heart defects (CHDs); this requires robust knowledge of causal agents. We aimed to review associations between CHDs and maternal advanced age, obesity, diabetes, hypertension, smoking and alcohol consumption and assess the causal nature of the associations.
METHODS: Systematic review of reviews with application of a Bradford Hill criteria score-based causal assessment system.
METHODS: We searched PubMed, Embase and Episteminokos (January 1990-April 2023).
METHODS: Systematic reviews of original epidemiological studies reporting association (relative risk) between one or more of the above maternal factors and CHDs overall (any type) in subsequent offspring.
METHODS: Two independent reviewers selected eligible reviews, assessed the risk of bias and assigned the strength of evidence for causality.
RESULTS: There was strong evidence of a causal relationship between CHDs and maternal obesity (prepregnancy and early pregnancy) and pre-existing diabetes (six of seven Bradford Hill criteria met). For pre-existing hypertension (strength and biological gradient not met), and advanced age (strength, consistency and biological gradient not met), causal evidence was moderate. Evidence for the causal contribution of gestational diabetes, gestational hypertension, smoking and alcohol consumption was weak (strength, consistency, temporality and biological gradient not met).
CONCLUSIONS: CHDs can be reduced with stronger action to reduce maternal obesity and pre-existing diabetes prevalence. Investigating environmental exposures that have received limited attention, such as air pollutants and chemical exposures, is important to further inform prevention.

OBJECTIVE: This scoping review aims to survey healthcare providers (HCPs) in the Middle East and North Africa (MENA) about their knowledge, attitudes and barriers to working with women who have experienced intimate partner violence (IPV). This review aims to map the breadth of available peer-reviewed literature that may inform future educational training programmes.
METHODS: Scoping review.
METHODS: The scoping review included studies up to December 2023 from PUBMED, Medline, COCHRANE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO and Arabic medical journals.
METHODS: Selected articles were restricted to those carried out in the MENA region, available in full text and with no date restrictions.
METHODS: Data were extracted from all studies to include research location, year of publication, type of journal, methodology, design, participants, knowledge, attitudes and barriers. By charting the information into a table, the data were analysed using frequency, counts and descriptive content analysis.
RESULTS: Of the 1060 articles reviewed, 29 eligible studies were included in this scoping review. 27% of the articles reported HCPs\' lack of knowledge about IPV protocols. The dominant attitude reported was a preference to treat the presenting health complaint and avoid discussing IPV. Finally, 30% of articles reported HCPs\' lack of training as the main barrier.
CONCLUSIONS: Our paper concluded that there is a lack of research in understanding the knowledge, attitudes and barriers surrounding HCPs in the MENA region and IPV. This scoping review highlights the need for further research, informed interventions and training for HCPs in the region.

UNASSIGNED: Results from studies were inconsistent with regard to the effect of folic acid on the primary prevention of stroke. The aim of this study was to analyze the association between folic acid and the primary prevention of stroke using the data from observational studies and randomized controlled trials (RCTs).
UNASSIGNED: Eligible publications published until June 2024 were searched in the database of PubMed, Web of Science and Embase. This study included all observational studies and RCTs of folic acid with first stroke as the reporting endpoints. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled in the random-effects model to assess the effect of folic acid on the primary prevention of stroke.
UNASSIGNED: Results from 12 observational publications with 16 research, including 312,320 participants, were combined to explore the association between dietary folic acid intake and the primary prevention of stroke. The results showed that high dietary folic acid intake was associated with a 17% reduction in stroke incidence (RR:0.83; 95% CI: 0.73-0.94), and the effect of dietary folic acid was greater in areas without grain fortification (RR:0.80; 95% CI: 0.67-0.95). The pooled results from 12 RCTs, totaling 75,042 participants, indicated that folic acid supplementation was not associated with the stroke primary prevention (RR:0.92; 95% CI: 0.80-1.05), but folic acid supplementation was effective in areas without grain fortification (RR:0.78; 95% CI: 0.68-0.89).
UNASSIGNED: Our meta-analysis demonstrated that dietary folic acid is effective in stroke primary prevention, and folic acid supplementation is effective in stroke primary prevention only in areas without grain fortification.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42024516991.

OBJECTIVE: Statins are widely prescribed for cardiovascular diseases (CVD) prevention; however, a significant proportion of users discontinue the medication for various reasons. This review aimed to determine the prevalence of statin therapy discontinuation, its associated factors, and adverse cardiovascular outcomes within the first year of discontinuation.
METHODS: The PubMed, EMBASE, ScienceDirect, SCOPUS, and Google Scholar databases were systematically searched from their inception to December 2022. Manual searches were also conducted on the bibliographies of relevant articles. Studies were included for qualitative data synthesis and assessed for methodological quality.
RESULTS: Fifty-two studies, predominantly cohort studies (n = 38), involving 4 277 061 participants were included. The prevalence of statin discontinuation within the first year of statin initiation ranged from 0.8% to 70.5%, which was higher for primary prevention indications. Factors frequently associated with an increased likelihood of statin discontinuation included male sex, nonWhite ethnicity, smoking status, and being uninsured. Conversely, discontinuation was less likely in patients with CVD who received secondary prevention statin therapy and in patients with polypharmacy. Furthermore, age showed diverse and inconsistent relationships with statin discontinuation among various age categories. Five studies that reported the cardiovascular risk of statin discontinuation within the first year of initiation showed significantly increased risk of discontinuation, including all-cause mortality (hazard ratio: 1.36-3.65).
CONCLUSIONS: Our findings indicate a high prevalence of statin discontinuation and an increased likelihood of adverse cardiovascular outcomes within the first year of discontinuation, despite wide variability across published studies. This review highlights the importance of addressing the modifiable risk factors associated with statin discontinuation, such as smoking and lack of insurance coverage.

UNASSIGNED: Evidence on statin use for primary prevention of cardiovascular disease (CVD) in older people needs to be extended and updated, aiming to provide further guidance for clinical practice.
UNASSIGNED: PubMed, EMBASE, Cochrane Library and Web of Science were searched for eligible observational studies comparing statin use vs. no-statin use for primary prevention of CVD in older people (age ≥ 65 years). The primary outcomes were all-cause mortality, CVD mortality, coronary heart disease (CHD)/myocardial infraction (MI), stroke and total CV events. Risk estimates of each relevant outcome were synthesized as a hazard ratio (HR) with 95% confidence interval (95% CI) using in the random-effects model.
UNASSIGNED: Twelve eligible observational studies (n = 1,627,434) were enrolled. The pooled results suggested that statin use was associated with a significantly decreased risk of all-cause mortality (HR: 0.54, 95% CI: 0.46-0.63), CVD mortality (HR: 0.51, 95% CI: 0.39-0.65), CHD/MI (HR: 0.83, 95% CI: 0.69-1.00), stroke (HR: 0.79, 95% CI: 0.68-0.92) and total CV events (HR: 0.75, 95% CI: 0.66-0.85). The association in all-cause mortality still remained obvious at higher ages ( ≥ 70 years old, HR: 0.56, 95% CI: 0.44-0.71; ≥ 75 years old, HR: 0.70, 95% CI: 0.60-0.80; ≥ 85 years old, HR: 0.85, 95% CI: 0.74-0.97), ≥ 20% (HR: 0.47, 95% CI: 0.35-0.62) and < 20% diabetic populations (HR: 0.50, 95% CI: 0.40-0.64), and ≥ 50% (HR: 0.68, 95% CI: 0.59-0.79) and < 50% hypertensive populations (HR: 0.38, 95% CI: 0.16-0.88).
UNASSIGNED: Statin use was related to a 46%, 49%, 17%, 21% and 25% risk reduction on all-cause mortality, CVD mortality, CHD/MI, stroke and total CV events in older patients, respectively. The significant association was also addressed in older patients and ≥ 75 years old individuals for CVD primary prevention.

BACKGROUND: The role of anticoagulants in the primary prevention of venous Thromboembolism(VTE) in high-risk cancer patients has been proven in previous studies; however, the routine use of thromboprophylaxis in cancer patients with Khorana score≤ 2 is still debated. This systematic review and meta-analysis aimed to investigate the role of prophylaxis with anticoagulants in cancer patients with low to moderate risk for first time.
METHODS: PubMed, Scopus, Google Scholar, and Web of Science databases were searched with Mesh terms to find Randomized controlled trial studies (RCTs) that evaluated the effect of thromboprophylaxis against placebo on VTE up to January 2024 in low-risk cancer patients. This systematic review was conducted based on the PRISMA guidelines. Heterogeneity between studies was evaluated using the I2 test. Egger\'s test was used to check publication bias. In general, 21 studies with 9985 participants were included.
RESULTS: The majority of studies had high quality and low risk of bias. The pooled estimate showed that using anticoagulants compared to placebo significantly reduces the risk of VTE (HR: 0.53, 95% CI: 0.43, 0.60, I2: 8.1%). Analysis of subgroups based on the class of anticoagulants showed that both direct oral anticoagulants (DOACs) (HR: 0.46, 95% CI: 0.36, 0.56, I2:8.5%) and Low molecular weight heparin (LMWH) (HR: 0.60, 95% CI: 0.51, 70, I2:0%) were significantly related to VTE risk compared to placebo. A pooled estimate of 18 studies did not show a significant association between increased major bleeding and anticoagulant prophylaxis. (HR: 1.25, 95% CI: 0.96, 1.54, I2: 4%).
CONCLUSIONS: Anticoagulant prophylaxis with both classes of LMWHs and DOACs compared to placebo can be associated with a reduction in VTE risk in low-to-intermediate risk cancer patients. DOACs were associated with a greater reduction in VTE risk. Anticoagulant prophylaxis had no significant relationship with increased major bleeding.

BACKGROUND: Clinicians and patients often face a decision to continue or discontinue statins. We examined the impact of discontinuation of statins compared with continuation on clinical outcomes (all-cause mortality, cardiovascular [CV] mortality, CV events, and quality of life).
METHODS: We conducted a systematic review. Randomized controlled trials (RCTs), cohort studies, case-control studies, and quasi-randomized studies among people ≥18 years were eligible. We searched MEDLINE, Embase, and Cochrane Central Registry (inception to August 2023). Two independent reviewers performed screening and extracted data. Quality assessment was performed by one author and verified by another. We summarized results narratively, performed meta-analysis for a subset of studies, and used GRADE to assess certainty of evidence. We summarized findings in the subgroup of persons ≥75 years.
RESULTS: We retrieved 8369 titles/abstracts; 37 reports from 36 studies were eligible. This comprised 35 non-randomized studies (n = 1,708,684) and 1 RCT (n = 381). The 1 RCT was conducted among persons with life expectancy <1 year and showed there is probably no difference in 60-day mortality (risk difference = 3.5%, 90% CI -3.5 to 10.5) for statin discontinuation compared with continuation. Non-randomized studies varied in terms of population and setting, but consistently suggested that statin discontinuation might be associated with a relative increased risk of mortality (hazard ratio (HR) 1.92, 95% CI 1.52 to 2.44, nine studies), CV mortality (HR 1.63, 95% CI 1.27 to 2.10, five reports), and CV events (HR 1.31, 95% CI 1.23 to 1.39, eight reports). Findings in people ≥75 years were consistent with main results. There was a high degree of uncertainty in findings from non-randomized studies due to methodological limitations.
CONCLUSIONS: Statin discontinuation does not appear to affect short-term mortality near end-of-life based on one RCT. Outside of this population, findings from non-randomized studies consistently suggested statin discontinuation may be associated with worse outcomes, though this is uncertain.

OBJECTIVE: To assess the inclusion of individuals\' perspectives in the development of osteoporosis Clinical Practice Guidelines (CPGs) for primary fracture prevention in postmenopausal women.
METHODS: We performed a comprehensive systematic search across guideline databases and (CPGs) developing organizations websites. Using the AGREE II tool, we assessed the quality of the guidelines, with particular emphasis on the inclusion of patients, or representatives in the development process. We also examined if women\'s perspectives were considered at the recommendations level and explored the potential association between the inclusion of patients\' values and preferences with the quality of the CPGs.
RESULTS: We retrieved a total of 491 eligible CPGs, of which 33 were finally included. The majority of the CPGs were developed by scientific societies (63.6%), primarily from Europe (39.4%) and North America (30.3%). One in every four (24.2%) guidelines explicitly included individuals\' perspectives in their development, and one in ten (12.1%) included research evidence about this aspect to support their recommendations. The domains with the lowest mean scores in the quality assessment were applicability (42.4%), rigor of development (44.7%), and stakeholder involvement (45.7%), and 61% were recommended for use according to our assessment. Guidelines of higher quality were more likely to include women\'s perspective in their development (mean difference 39.31, P = .003).
CONCLUSIONS: The incorporation of women\'s perspectives into the process of developing guidelines for primary fracture prevention in osteoporosis remains inadequate. Our findings serve as a call for guideline developers to improve this situation, and for users, and policymakers to be aware of these limitations, when using or implementing guidelines in this field.