This systematic review and meta-analysis evaluated the efficacy and safety of intratympanic (IT) corticosteroid therapy compared with that of standard management of patients with treatment-resistant otitis media with effusion (OME). PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception to March 2026. Randomized controlled trials and observational studies comparing IT corticosteroid therapy with standard treatment were included. The primary outcomes were changes in pure-tone average (PTA) hearing thresholds and Type A tympanogram normalization. Secondary outcomes included air-bone gap improvement, OME recurrence, tympanosclerosis, otorrhea, and tympanic membrane perforation. Pooled effect estimates were calculated using random-effects models. Six studies involving 312 patients and 417 evaluated ears were included. Overall, IT corticosteroid therapy significantly improved the PTA hearing thresholds compared with the standard treatment (mean differences [MD]=-5.57 dB; 95% confidence interval [CI], -8.15 to -2.99; p<0.001; I²=71.88%). Stratified analyses showed significant improvements in both pediatric patients receiving IT methylprednisolone plus ventilation tube insertion (VTI) (MD=-4.03 dB; 95% CI, -4.98 to -3.07) and in adult patients receiving IT dexamethasone without VTI (MD=-13.68 dB; 95% CI, -19.52 to -7.84). IT corticosteroid therapy also significantly improved the air-bone gap (MD=-7.06 dB; 95% CI, -10.94 to -3.17), reduced the OME recurrence (risk ratios [RR]=0.27), and reduced tympanosclerosis (RR=0.21). No significant differences were observed in Type A tympanogram normalization, otorrhea, or tympanic membrane perforation. IT corticosteroid therapy may improve hearing outcomes and reduce recurrence in patients with persistent or treatment-resistant OME with no statistically significant increase in treatment-related adverse events detected. However, larger size trials with patient-level analyses, standardized protocols, and clinically meaningful hearing outcomes are required.

Pregnancy can pose significant cardiovascular risks for women with pre-existing cardiac conditions, including congenital heart disease. This presentation will provide an overview of the complex interplay between pregnancy and cardiac disease, highlighting the risks and challenges associated with pre-existing conditions such as hypertension and diabetes mellitus. We will discuss evidence-based treatments and nursing interventions for pregnant women with cardiac health problems, focusing on strategies to optimize maternal and fetal outcomes. By integrating current research and best practices, healthcare providers can deliver high-quality care to this vulnerable population.

Background: Evidence-based practice (EBP) is essential in nursing education, particularly in clinical placements, as it bridges the gap between theoretical knowledge and practical application. Objective: The study aimed to investigate the self-perceived competence of HCT nursing students regarding EBP and to explore the barriers they face in implementing EBP during clinical placements. Methods: A cross-sectional correlation design was employed, gathering data from 292 nursing students across three campuses in the UAE using a standardized questionnaire, including the Evidence-Based Practice Competence Questionnaire (EBP-COQ) and the Barriers to Research Utilization Questionnaire. Results: The study found that only 36.3% of students strongly agreed they could apply research findings in practice, while 70.2% viewed EBP as essential for quality patient care. However, 39% found EBP implementation time-consuming, and 39.3% struggled to understand research articles. Major obstacles to EBP implementation included inadequate facilities (73.5%), lack of access to relevant literature (73.2%), and feelings of isolation from knowledgeable colleagues (72.2%). A strong positive correlation was observed between the "knowledge" domain and both the "skills" and "attitude" domains. Conclusion: The study reveals that while nursing students possess positive attitudes and basic skills regarding EBP, substantial barriers impede their effective application of research findings in clinical settings. Addressing these barriers is essential for fostering an environment conducive to EBP, which ultimately enhances patient outcomes and promotes high-quality care in nursing practice.

Background: Organ donation is a critical global health concern, with disparities in knowledge, attitudes, and willingness (KAW) observed across different populations. Understanding these factors in specific contexts is essential for improving donation rates. Objective: Study aimed to explore the correlations between levels of KAW toward organ donation and demographic variables among adults in the Yemen. Method: A quantitative, cross-sectional, correlational design was employed. A convenience sample of 507 participants from seven Governorates completed a self-administered questionnaire measuring KAW using a validated bilingual scale. Data was analyzed using descriptive and inferential statistics, including regression analysis, via SPSS version 28. Results: Participants demonstrated moderate knowledge levels (mean = 4.21), with 52.5% expressing willingness to donate. Knowledge scores were higher among females, participants with higher education, and those from Sana'a. Logistic regression showed no significant predictive relationship between knowledge (OR = 0.992, p = 0.35) or attitude (OR = 1.07, p = 0.11) and willingness to donate. Socio-demographic factors, including education, gender, income, and religion, significantly influenced KAW scores. Misconceptions about brain death and religious permissibility persisted among many respondents. Conclusions: This study highlights the complex interplay between KAW and socio-demographic factors in the Yemen. Moderate willingness to donate, with no significant predictive power of knowledge or attitudes, underscores the dominant role of cultural and religious factors. Targeted education, culturally tailored outreach, and policy reforms are crucial to dispel misconceptions and enhance organ donation acceptance in the Yemen.

Background: Metabolic dysfunction–associated steatohepatitis (MASH) is a prevalent and progressive liver disease with limited pharmacologic treatment options. Pemvidutide, a GLP-1–glucagon dual receptor agonist, has shown promise in targeting both hepatic steatosis and fibrosis. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of pemvidutide in adults with MASH. Methods: We systematically searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL through December 15, 2025, for randomized controlled trials (RCTs) comparing once-weekly subcutaneous pemvidutide (1.2 mg, 1.8 mg, or 2.4 mg) with placebo in adult MASH patients. Primary outcomes were changes in liver fat content (LFC, % via MRI-PDFF) and Enhanced Liver Fibrosis (ELF) score. Secondary outcomes included body weight, glycemic and lipid parameters, blood pressure, heart rate, and adverse gastrointestinal events. Dose-specific pairwise meta-analyses were performed using a random-effects model. Results: Three RCTs encompassing 370 participants (195 pemvidutide, 175 placebo) were included. Pemvidutide significantly reduced LFC at all doses, with the greatest effect at 1.8 mg (MD = −21.63%, 95% CI: −27.23 to −16.02; p<0.0001). ELF score improvement was significant at 1.2 mg and 1.8 mg doses but not at 2.4 mg. Across all doses, body weight decreased significantly, while HbA1c remained unchanged. Pemvidutide also reduced systolic blood pressure and total cholesterol (1.8 mg and 2.4 mg), with modest HDL reduction at 2.4 mg. Mild-to-moderate gastrointestinal adverse events were observed, with nausea more frequent at 1.8 mg. Conclusions: Pemvidutide is effective in reducing liver fat and improving cardiometabolic parameters in MASH, with a favorable safety profile. Dose-specific effects on fibrosis suggest potential early antifibrotic activity, highlighting its promise as a dual-targeted therapy for MASH. Further long-term studies are warranted to confirm sustained hepatic and metabolic benefits.

Background: Meningiomas are the most common primary intracranial tumors, but the role of traumatic brain injury (TBI) as a risk factor remains unclear. This study aimed to systematically evaluate and quantify the association between TBI and meningioma risk. Methods: We conducted a systematic review and meta-analysis of observational studies and Mendelian randomization analyses following PRISMA guidelines. PubMed, Scopus, Web of Science, Embase, and Cochrane databases were searched through December 5, 2025. Studies comparing meningioma incidence in individuals with and without a history of TBI were included. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-MR tool. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity and sensitivity analyses were performed. Results: Eleven studies (seven case-control, three cohort, one Mendelian randomization) were included, with eight contributing to the quantitative synthesis. The pooled analysis demonstrated a statistically significant association between TBI and meningioma (OR = 1.96; 95% CI [1.31 to 2.95]; p = 0.0012) with moderate heterogeneity (I² = 65.6%). Sensitivity analyses confirmed the robustness of the findings, although funnel plot asymmetry suggested potential publication bias. Conclusion: While a statistical association exists between TBI and meningioma, current evidence suggests it is unlikely to be causal. The association is primarily driven by retrospective case-control studies prone to bias, whereas prospective and genetic studies do not support a direct etiological link. Further long-term prospective studies are warranted to fully elucidate this relationship.