Objective: Biportal endoscopic spine surgery (BESS) has emerged as a minimally invasive alternative for lumbar decompression, offering improved visualization with reduced tissue disruption. Therefore, this study aims to identify key anatomical considerations, particularly interlaminar-disc mismatch and the “banana-shaped” curvature of the lamina, and to examine their impact on portal trajectory, alignment of the surgical corridor, and preservation of spinal structures. Methods: A retrospective, video-based analysis was conducted on 23 BESS lumbar decompression cases performed between January and March 2024. Surgical levels included L3–4 (n=3), L4–5 (n=17), and L5–S1 (n=3). Intraoperative anatomical landmarks were assessed independently by 2 spine surgeons. Interobserver agreement was evaluated using Cohen kappa, based on the identification of 3 landmarks per case in 23 cases, calculated with unweighted kappa. Visualization quality was scored on a 3-point scale. Cranial and caudal interlaminar-disc mismatches were measured and averaged. Results: Interlaminar-disc mismatch was identified in 93% of cases, with cranial and caudal mismatches ranging from 5.5±1.02 mm to 8±1.2 mm. Laminar curvature was consistently observed at L4–5 and L5–S1, which required a medial-caudal portal. In addition, the superior articular process (SAP) served as a reliable fluoroscopic and endoscopic landmark, facilitating safe access to the intervertebral disc. A limited medial facetectomy provided adequate operating space. The findings also demonstrated high interobserver reliability for anatomical identification (κ=0.84), and the use of layer-specific flavectomy preserved the inner layer of the ligamentum flavum. Conclusion Successful BESS requires integrating detailed anatomical understanding with intraoperative adaptability. Recognizing interlaminar-disc mismatch, laminar curvature, and SAP orientation enables optimal portal placement and targeted decompression. These principles are essential for achieving reproducible and safe outcomes in BESS.

Vaginal dryness and dyspareunia are frequent complaints among postmenopausal women. Studies have shown that isoflavones reduce the severity of menopausal symptoms. This study aimed to evaluate the effects of isoflavones on vaginal dryness and dyspareunia in postmenopausal women. PubMed, ScienceDirect, and Cochrane Library electronic databases were searched until June 15, 2024. Revman 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to analyze the data. Ten randomized controlled trials (RCTs), totaling 675 participants, were included in the isoflavone treatment, and the duration was between 4 and 48 weeks. For the meta-analysis, four and two RCTs were conducted to analyze vaginal dryness and dyspareunia in postmenopausal women before and after isoflavone treatment, respectively. The analysis results for vaginal dryness showed a significant change after isoflavone therapy, whereas those for dyspareunia did not show a significant change. The random-effects estimation of the mean difference was -1.29, and 95% confidence interval (CI) was -2.53 to -0.04 (p=0.04) for vaginal dryness, and -0.82, with a 95% CI of -3.51 to 1.87 (p=0.55) for dyspareunia. This meta-analysis concluded that isoflavones have a significant effect on relieving vaginal dryness but have no impact on dyspareunia in postmenopausal women. Numerous larger, long-term trials are needed to fully assess their effects and efficacy.

Vaginal dryness and dyspareunia are frequent complaints among postmenopausal women. Studies have shown that isoflavones reduce the severity of menopausal symptoms. This study aimed to evaluate the effects of isoflavones on vaginal dryness and dyspareunia in postmenopausal women. PubMed, ScienceDirect, and Cochrane Library electronic databases were searched until June 15, 2024. Revman 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to analyze the data. Ten randomized controlled trials (RCTs), totaling 675 participants, were included in the isoflavone treatment, and the duration was between 4 and 48 weeks. For the meta-analysis, four and two RCTs were conducted to analyze vaginal dryness and dyspareunia in postmenopausal women before and after isoflavone treatment, respectively. The analysis results for vaginal dryness showed a significant change after isoflavone therapy, whereas those for dyspareunia did not show a significant change. The random-effects estimation of the mean difference was -1.29, and 95% confidence interval (CI) was -2.53 to -0.04 (p=0.04) for vaginal dryness, and -0.82, with a 95% CI of -3.51 to 1.87 (p=0.55) for dyspareunia. This meta-analysis concluded that isoflavones have a significant effect on relieving vaginal dryness but have no impact on dyspareunia in postmenopausal women. Numerous larger, long-term trials are needed to fully assess their effects and efficacy.

Vaginal dryness and dyspareunia are frequent complaints among postmenopausal women. Studies have shown that isoflavones reduce the severity of menopausal symptoms. This study aimed to evaluate the effects of isoflavones on vaginal dryness and dyspareunia in postmenopausal women. PubMed, ScienceDirect, and Cochrane Library electronic databases were searched until June 15, 2024. Revman 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to analyze the data. Ten randomized controlled trials (RCTs), totaling 675 participants, were included in the isoflavone treatment, and the duration was between 4 and 48 weeks. For the meta-analysis, four and two RCTs were conducted to analyze vaginal dryness and dyspareunia in postmenopausal women before and after isoflavone treatment, respectively. The analysis results for vaginal dryness showed a significant change after isoflavone therapy, whereas those for dyspareunia did not show a significant change. The random-effects estimation of the mean difference was -1.29, and 95% confidence interval (CI) was -2.53 to -0.04 (p=0.04) for vaginal dryness, and -0.82, with a 95% CI of -3.51 to 1.87 (p=0.55) for dyspareunia. This meta-analysis concluded that isoflavones have a significant effect on relieving vaginal dryness but have no impact on dyspareunia in postmenopausal women. Numerous larger, long-term trials are needed to fully assess their effects and efficacy.

Vaginal dryness and dyspareunia are frequent complaints among postmenopausal women. Studies have shown that isoflavones reduce the severity of menopausal symptoms. This study aimed to evaluate the effects of isoflavones on vaginal dryness and dyspareunia in postmenopausal women. PubMed, ScienceDirect, and Cochrane Library electronic databases were searched until June 15, 2024. Revman 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to analyze the data. Ten randomized controlled trials (RCTs), totaling 675 participants, were included in the isoflavone treatment, and the duration was between 4 and 48 weeks. For the meta-analysis, four and two RCTs were conducted to analyze vaginal dryness and dyspareunia in postmenopausal women before and after isoflavone treatment, respectively. The analysis results for vaginal dryness showed a significant change after isoflavone therapy, whereas those for dyspareunia did not show a significant change. The random-effects estimation of the mean difference was -1.29, and 95% confidence interval (CI) was -2.53 to -0.04 (p=0.04) for vaginal dryness, and -0.82, with a 95% CI of -3.51 to 1.87 (p=0.55) for dyspareunia. This meta-analysis concluded that isoflavones have a significant effect on relieving vaginal dryness but have no impact on dyspareunia in postmenopausal women. Numerous larger, long-term trials are needed to fully assess their effects and efficacy.

Vaginal dryness and dyspareunia are frequent complaints among postmenopausal women. Studies have shown that isoflavones reduce the severity of menopausal symptoms. This study aimed to evaluate the effects of isoflavones on vaginal dryness and dyspareunia in postmenopausal women. PubMed, ScienceDirect, and Cochrane Library electronic databases were searched until June 15, 2024. Revman 5.4 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to analyze the data. Ten randomized controlled trials (RCTs), totaling 675 participants, were included in the isoflavone treatment, and the duration was between 4 and 48 weeks. For the meta-analysis, four and two RCTs were conducted to analyze vaginal dryness and dyspareunia in postmenopausal women before and after isoflavone treatment, respectively. The analysis results for vaginal dryness showed a significant change after isoflavone therapy, whereas those for dyspareunia did not show a significant change. The random-effects estimation of the mean difference was -1.29, and 95% confidence interval (CI) was -2.53 to -0.04 (p=0.04) for vaginal dryness, and -0.82, with a 95% CI of -3.51 to 1.87 (p=0.55) for dyspareunia. This meta-analysis concluded that isoflavones have a significant effect on relieving vaginal dryness but have no impact on dyspareunia in postmenopausal women. Numerous larger, long-term trials are needed to fully assess their effects and efficacy.

Background: Dengue is a systemic, viral, mosquito-borne infection that continues to be a major public health issue in endemic regions in tropical and subtropical climates. Accurate tests for rapid diagnosis in point-of-care settings are important to reduce the fatality rates of severe dengue. We evaluated the diagnostic accuracy of the Standard M10 DENV 1-4 system (SD Biosensor, Gyeonggi, Korea), which is a cartridge-based, automated system that integrates nucleic acid extraction, reverse transcription-PCR (RT-PCR) amplification, and detection of dengue virus (DENV) serotypes. Methods: This was a retrospective diagnostic evaluation study. The index test, Standard M10 DENV 1-4, was evaluated using 320 dengue-positive and 279 dengue-negative archived samples. The reference tests were a combination of Centers for Disease Control and Prevention (CDC) DENV 1-4 real-time RT-PCR, dengue NS1 antigen and IgM antibody detection, and DENV whole-genome sequencing. Results: The overall sensitivity and specificity of Standard M10 DENV 1-4 were 94% and 100%, respectively. By serotype, the highest sensitivity was 100% for DENV-1, and the lowest was 82% for DENV-4. The overall between the CDC RT-PCR dengue serotyping method and the Standard M10 DENV 1-4 was 95%. Standard M10 DENV 1-4 RT-PCR had comparable sensitivity and specificity to CDC DENV RT-PCR. Conclusions Based on its commensurate performance to an established RT-PCR method combined with additional benefits of convenient storage and transport, easy use, and rapid processing, the Standard M10 DENV 1-4 system has potential for DENV detection and serotyping in point-of-care settings.

The effect of omega-3 supplementation on cardiovascular (CV) disease has been widely studied in several large clinical trials. However, the evidence of the effect of omega-3 supplementation in patients with heart failure (HF) remains controversial. This meta-analysis investigated the effects of omega-3 supplementation on patients with HF. We conducted a literature search on MEDLINE, Embase, and Cochrane databases for clinical trials and preprints of relevant articles. Following a literature search and critical appraisal, 5 studies were included in the meta-analysis. The pooling of the result of the studies shows that there were no significant association between omega-3 supplementation and CV mortality (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.84–1.05, p=0.16) nor hospitalization due to HF (OR, 0.94; 95% CI, 0.88–1.02; p=0.13). Our systematic review and meta-analysis showed that omega-3 supplementation has no beneficial effect in patients with HF.

Objectives: Recovery from drug addiction often poses challenges for the recovering person. The coping mechanisms employed by these individuals to resist temptations and manage stress play a key role in the healing process. This study was conducted to explore the coping strategies or techniques that individuals with addiction use to handle stress and temptation while undergoing treatment. Methods: A qualitative meta-synthesis approach was utilized to critically evaluate relevant qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used for article selection, with these standards applied to 4 academic databases: Scopus, PubMed, ProQuest, and CINAHL. The present review included studies published between 2014 and 2023, selected based on pre-established inclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024497789. Results: The analysis of 13 qualifying qualitative articles revealed 5 major themes illustrating the coping mechanisms employed in the pursuit of recovery by individuals who use drugs. These themes include seeking social support, as well as psychological coping strategies, spiritual experiences, professional interventions, and the enhancement of awareness. Conclusions Among individuals with drug addiction, coping mechanisms are crucial for resisting stress and temptations throughout the recovery process. Healthcare professionals, as medical specialists, can establish more thorough and effective plans to support these patients on their path to recovery.

Objective: Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. Methods: A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. Results: The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. Conclusion The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.