Medicine and Health Sciences Commons^™

Rosai-Dorfman Disease In A Rare Cardiac Presentation: Left Ventricular Mass Causing Ventricular Tachycardia, Motaz Al Yafi, Swetha Pasala, Valentina Robila, Cory Trankle, Bharadhwaj Kolipakkam, Patricia Nicolato

Faculty, Staff and Student Publications

Background: Rosai-Dorfman disease (RDD) is a rare, benign histiocytic disorder that most often presents with nodal involvement. Cardiac involvement is exceedingly uncommon and poses significant diagnostic and therapeutic challenges.

Case summary: A 51-year-old woman presented with shortness of breath and palpitations and was found to have monomorphic ventricular tachycardia. Imaging revealed a left ventricular mass, and biopsy confirmed RDD. The lesion was surgically excised with cryoablation and CorMatrix reinforcement. The patient recovered uneventfully and remains disease free 25 months postoperatively.

Discussion: RDD with cardiac involvement has been reported in only approximately 25 cases, with very few affecting the left ventricle. …

Expanding The Mutation Spectrum Of Non-Syndromic Retinitis Pigmentosa In Consanguineous Pakistani Families: Unraveling Novel Pathogenic Variants In Rp1, Pde6b, And Prcd Genes For Precision Diagnosis, Tayyaba Shan, Nimra Mukhtar, Sayyed Hammad Ullah, Asad Ullah, Asfandyar Ahmad Khan, Yumei Li, Meng Wang, Raeesa Tehreem, Amtul Aziz, Kiran Afshan, Rui Chen, Sabika Firasat

Faculty, Staff and Students Publications

No abstract provided.

Culturally Tailored Materials For Smoking Cessation And Hiv Care Adherence Among Hispanic Adults: Protocol For Content Development And Formative Evaluation, Lorra Garey, Jacqueline J Charles, Ashley L Ruiz, Rodrigo Castillo-Avilés, Virmarie Correa-Fernández, Marshall K Cheney, Thomas P Giordano, Michael J Zvolensky

Faculty, Staff and Students Publications

Background: Hispanic people with HIV who smoke cigarettes experience unique stressors (eg, stigma), which contribute to health disparities. Anxiety sensitivity (AS) may worsen mood management problems, which are a leading barrier to smoking cessation. Interventions targeting AS can improve HIV-specific outcomes and smoking cessation. However, no prior research has culturally tailored an AS reduction program to improve quality of life among Hispanic people with HIV who smoke. The research team previously developed a mobile health (mHealth) intervention addressing AS reduction, smoking cessation, and HIV care management for Black people with HIV who smoke. Building on this work, this study represents …

All-Inside Endoscopic Zone 1 Flexor Hallucis Longus Transfer: A Cadaveric Feasibility Study., Kevin D Martin, Yi Wei, Adam G F Smith, Franco Piscitani, Luke M Martin, Brian Steginsky, Brian Tscholl, Nathaniel A Bates

Surgery Articles

BACKGROUND: Endoscopic flexor hallucis longus (FHL) tendon transfer addresses chronic Achilles tendon ruptures. Traditional percutaneous plantar incisions gain FHL length but risk neurovascular injury. This study evaluated the feasibility of an all-inside endoscopic FHL zone 1 tenotomy and transfer technique, which avoids plantar incisions by using zone 1 of the FHL tendon. We hypothesized that this technique would (1) provide sufficient tendon length, (2) avoid neurovascular damage, and (3) securely anchor the FHL tendon without tunnel blowout.

METHODS: Ten cadaveric all-inside endoscopic zone 1 FHL tendon transfers were performed without fluoroscopic guidance. Specimens were independently assessed post hoc by 2 …

Heart Rate Variability In The Context Of Mental Health And Substance Use, Sage M. Lopez

Bridges: An Undergraduate Journal of Contemporary Connections

Heart Rate Variability (HRV) has been linked to various areas of cardiovascular disease and mortality in previous research. Within this area, certain mental illnesses and use of psychoactive substances have been associated with low HRV and its health implications. Little research exists that examines the combined effects of mental illness and psychoactive substance use. The current research aims to understand if there is a compounding negative effect of these two factors when studied in tandem. Using a three-phase study design, HRV was analysed at baseline and at physiological relaxation, with participants being included under certain mental health, substance use, or …

Drug Risk Knowledge Discovery For Western Medicines Based On Knowledge Graph Link Prediction, Jianxiang Wei, Ma Hengyuan Ma, Yuehong Sun, Wenwen Du, Letian Hu

Journal of Scientific Information Research

[Purpose/significance] The risk information contained in drug instructions is usually incomplete, and some new adverse reactions can only be discovered in actual clinical use. This paper proposes an information organization and knowledge discovery method for pharmacovigilance, in order to timely and accurately identify missing risk knowledge in drug instructions. [Method/process] Drug instructions of 8 152 Western medicines are collected as the research data; On the basis of ontology construction, data annotation, and model training, the UIE model is used to jointly extract entity and relationship triplets from the research data; A new knowledge graph link prediction method CompGCN-RotatE, is proposed, …

Research On Temporal Knowledge Graph Completion Method For Emergent Events Based On Bigru And Graph Contrastive Learning, Peng Wu, Zhenyu Lu, Xuechen Zhang

Journal of Scientific Information Research

[Purpose/significance] During emergencies, social media short texts contain critical information but are heavily interfered with by noise. Traditional static knowledge graph completion techniques struggle to effectively address their dynamic evolution and data sparsity issues, making it imperative to introduce temporal modeling methods. [Method/process] This study proposes a dynamic completion framework that combines the temporal feature capture capability of Bidirectional Gated Recurrent Units (BiGRU) with the noise-resistant representation learning advantages of Graph Contrastive Learning (GCL). At the completion level, the ConBiTE method is introduced, which captures temporal dependencies through self-attention mechanisms and BiGRU, while leveraging GCL to enhance the completion of …

How Digital News Impacts Health Knowledge And Decisions, Ellya Asatryan

Pepperdine Journal of Communication Research

This literature review examines how digital news and online health information (OHI) influence health knowledge and decision-making. This review focuses specifically on young adults, who increasingly rely on digital platforms for health information. Evidence indicates that OHI can support informed health decisions, such as lifestyle changes and self-care, particularly when individuals possess higher digital health literacy. However, the rise of social media, influencer marketing, and misinformation complicates these effects, making critical evaluation skills essential. Trust in digital health news is mediated by source credibility, exposure to misinformation, and individuals’ media and health literacy levels. Lower health literacy is associated with …

Program (Pdf), School Of Allied Health Professions

School of Health Professions Research Day

No abstract provided.

Erratum To ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, And Emerging Interventions For Prevention And Management'' [Saudi Medical Journal 2026; 47(2):183–194], Fahad H. Baali

Saudi Medical Journal

In the manuscript entitled: ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, and Emerging Interventions for Prevention and Management'' Published in Saudi Med J 2026; Vol. 47(2): 183–194. doi: 10.15537/1658-3175.1001
The tables included in the published version were incorrect due to a production error.

Erratum To ``The Association Between Inflammatory Bowel Disease And Ischemic Heart Disease: A Retrospective Cohort Study'' [Saudi Medical Journal 2025 Oct; 46(10):1174–1181], Mahmoud H. Mosli, Dima M. Alsulami, Yara K. Alghamdi, Abdullah S. Badahdah, Asmaa H. Alhibshi, Thamer M. Alamri, Maan S. Alkhattabi, Khames T. Alzahrani, Hadeel A. Alsufyani, Omar I. Saadah

Saudi Medical Journal

In the manuscript entitled ``The Association between Inflammatory Bowel Disease and Ischemic Heart Disease: A Retrospective Cohort Study,'' published in Saudi Med J 2025 Oct;46(10):1174–1181. doi: 10.15537/smj.2025.46.10.20250181, the affiliation of Dr. Maan Alkhattabi was omitted from the final published version.
The correct affiliation for Dr. Maan Alkhattabi is as follows:
Department of Medicine, Faculty of Medicine, King Abdulaziz University–Rabigh, Jeddah, Kingdom of Saudi Arabia.

Erratum To ``Unmasking Iron Deficiency And Iron Deficiency Anemia In Saudi Arabia'' [Saudi Medical Journal 2025; 46(9):1000–1007], Osman O. Radhwi, Omar M. Raslan, Eman M. Mansory

Saudi Medical Journal

In the manuscript entitled ``Unmasking Iron Deficiency and Iron Deficiency Anemia in Saudi Arabia,'' published in Saudi Med J 2025; Vol. 46(9):1000–1007. doi: 10.15537/smj.2025.46.9.20240970.
The correct affiliation should read as follows: Department of Basic Science, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.

Advancing Rheumatology In The Middle East: Mrc 2025 Abstracts, Martin Lee, Ahmed Zayat, Beena Hameed, Elsadeg Sharif, Fahda Al Okaily, Fehaid Alanazi, Francis Kynaston-Pearson, Khalid A. Alnaqbi, Mahmood Hachim, Mayam Al Nesf, Mira Mirashli, Mohammed Tariq, Ravi Gutta, Reem Abdwani, Saadeya Naji, Shamma Lootah, Tareq Al Araimi, Waleed Hafiz, Suad Hannawi

Saudi Medical Journal

No abstract provided.

Middle East Bifurcation Club Consensus Document On Percutaneous Revascularization Of Bifurcation Lesions In Association With The National Heart Center – Saudi Health Council, Khaled Al-Shaibi, Mirvat Alasnag, Haitham Amin, Ali Nazmi Calik, Ali Almasood, Abdullah Alenezi, Nouf Alanazi, Abdulrahman Almoghairi, Hadi Abu-Hantash, Khaled Almerri

Saudi Medical Journal

Bifurcation lesions are among the most challenging in percutaneous coronary intervention (PCI), with outcomes affected by anatomy, side-branch disease, and procedural variability. Existing European definitions and strategies require adaptation for Middle Eastern populations, where diabetes, obesity, and hypertension are highly prevalent and present earlier. The Middle East Bifurcation Club (MEBC), with the National Heart Center, used the Nominal Group Technique to standardize bifurcation PCI terminology, techniques, and treatment pathways tailored to regional demographics. The consensus provides evidence-based recommendations on imaging, provisional and 2-stent strategies, POT, and left main versus non-left main bifurcations, alongside practical algorithms and heart team guidance, highlighting …

Rethinking Health-Care Efficiency: A Call For A Multi-Dimensional Framework For Assessing Healthcare System Efficiency, Yasser K. Alotaibi, Ali N. Alharbi

Saudi Medical Journal

No abstract provided.

Prevalence Of Brca1 And Brca2 Germline Mutations In Western Saudi Patients With Epithelial Tubo-Ovarian Carcinoma, Wala Mehros, Faisal Aldaheri, Anas Alqarni, Saif Aljehani, Abdulrahman Alnamlah, Alaa Althubaiti, Safaa Huneef, Hatim Jifree

Saudi Medical Journal

Objective: Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. BRCA gene mutations are associated with ovarian cancer, younger age at presentation, strong family history of EOC, and multiple malignancies in a single patient. This study calculated the rate of BRCA-positive EOC and compared BRCA-mutated vs non-mutated EOC cases. Methods: This retrospective cohort study, conducted at Princess Noura Oncology Center between May 2016 and December 2023, explored outcomes in BRCA-positive EOC patients. The inclusion criteria covered all EOC cases. A total of 70 patients were selected. Results: Of the 70 …

The Nephroprotective Effects Of Dulaglutide In Patients With Type 2 Diabetes And Chronic Kidney Disease: A Multicenter Saudi Arabian Study, Maha H. Jamal, Hassan A. Alzahrani, Duaa M. Bakhshwin, Ranya A. Ghamri, Fatmah S. Binzomah, Wisam H. Jamal, Moaz W. Abulfaraj

Saudi Medical Journal

Objective: This study aimed to evaluate the effectiveness and safety of dulaglutide in individuals with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). Methods: This retrospective cohort study included 212 patients with CKD (stages 1–4) and T2DM treated with once-weekly dulaglutide (1.5 mg) for either 12 or 24 months at three tertiary care centers in Saudi Arabia from January 2021 to December 2023. Safety was assessed based on the presence of adverse events. Efficacy was measured using the changes in estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), and body mass index (BMI). Changes in efficacy outcomes were …

Combined Predictive Value Of Serum Ngal, Cysc, Urinary Nag, And Egfr For Sepsis-Associated Acute Kidney Injury In Patients In Icu, Yu Han, Wenna Ning, Jian Lu, Jinwei Zhu, Zhiliang Qin, Xiao Wang

Saudi Medical Journal

Objective: To evaluate critically ill patients who had sepsis and how various kidney-related measurements, including eGFR, NGAL, CysC, and the urinary enzyme NAG, predict the onset of sepsis-induced renal damage. Methods: The 135 individuals who were admitted to our sepsis intensive care within 2 years to the end of early 2024 were recruited on a prospective basis and were enrolled based on the predefined criteria. Upon admission, they were dichotomized into 2 groups of participants who developed septic-associated kidney injury (82) and without (53). A comparison of baseline laboratory analyses and blood and urine baseline examinations in the groups was …

Comparison Of Clinical Outcome Of Mushroom Poisonings With And Without Specific Treatment: A 5-Year Retrospective Analysis, Kamil Deveci, Necmi Baykan, Baycan Kus, Fatma Ünlü, Ömer Salt, Serhat Koyuncu

Saudi Medical Journal

Objectives: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. Methods: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. Results: The median age of the 425 patients admitted was 51 years (34–63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% …

Ethnic Background As A Determinant Of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics In Saudi Arabia, Nizar A. Khamjan

Saudi Medical Journal

Objectives: To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers. Methods: We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013–2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis. Results: Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio …

Comparison Of The Predictive Value Of Crp/Albumin, Crp/Prealbumin, And The Clinical Frailty Scale For Mortality In Geriatric Intensive Care Patients, Natali T. Aksoy, Bülent B. Güven, Sümeyya M. Soyalan, Dilek Metin Yamaç, Tuna Ertürk, Süheyla Abitağaoğlu

Saudi Medical Journal

Objectives: To evaluate the relationship between C-reactive protein (CRP)/prealbumin and CRP/albumin ratios, Clinical Frailty Scale (CFS) scores, and short-term (first 3 days) and long-term (28 days) mortality in geriatric patients hospitalized in the intensive care unit. Methods: After obtaining ethical approval and informed consent, 213 patients aged 65 years and older were included. Patients discharged within 24 hours, those discharged and readmitted during the study period, those receiving routine albumin replacement, and patients with cirrhosis or undergoing chronic dialysis were excluded. Demographic characteristics, admission diagnoses, chronic comorbidities, frailty scores at admission, and laboratory values, including albumin, prealbumin, and CRP …

Tumor-Associated Neutrophils In Advanced Non-Small Cell Lung Cancer Patients Predicted By Clinicopathologic Characteristics And Peripheral Blood Markers, Weiwei Hong, Xie Xiong, Chen Fang, Chuanhong Luo, Xiaoying Qian, Xinyuan Yao, Xin Ye, Biao Yu, Bingbiao Zhou, Dengying Chen, Chengsi Shu, Yong Wang, Yong Li

Saudi Medical Journal

Objectives: The process of analyzing tumor-associated neutrophils (TANs) types is complex. This study explored the relationships among clinicopathological characteristics, peripheral blood markers, and TANs. Methods: Clinical information was retrospective gathered for 115 patients in our hospital from May 2019 to May 2021, and multiplex immunofluorescence staining was utilized to access the expression of TANs and analyze the potential relationship between TANs and clinicopathological features or peripheral blood markers. Results: Among the 115 patients, the proportion of female patients within the neutrophils (N1)-low group was notably greater compared to the N1-high group (87.5% vs. 12.5%, p = 0.022). In nonsmoking patients, …

Clinical Role Of Hematologic Inflammatory Markers In The Diagnosis Of Missed Abortion, Mustafa Bakırcı, Çağlayan Ateş, Ethem S. Yalvaç

Saudi Medical Journal

Objectives: To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester. Methods: This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed. Results: The …

Concurrent Appendectomy In Patients Undergoing Surgery For Gynecological Malignancies: A Retrospective Analysis From A Tertiary Referral Center, Gazi Güner, Can Tercan, Emrah Dağdeviren, Ali Selçuk Yeniocak, Ceylin Elbistanli, Sure Nur Erdoğmuş, Ayşe Hazirbulan, Yiğit Mert Bayrak, Neçirvan Çağdaş Çaltek, Gözde Şahin, Ergun Tercan, Figen Efe Çamili, Nazlıaylin Vural, Hüseyin Karatay, Saniye Merve Gül Kara, İlkbal Temel Yüksel

Saudi Medical Journal

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated. Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, …

Reliability And Validity Of The Arabic Version Of The Nose-Perf Scale, Rayan M. Alfallaj, Abdullah I. Binghaith, Mohammed Y. Alyoussef, Ahmed S. Alsaleh, Saad A. Alsaleh, Abdulaziz A. Alqahtani, Ahmad S. Alroqi

Saudi Medical Journal

Objectives: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation–perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. Methods: Conducted between May 2024 and June 2025, the study included 100 participants—20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, …

A Multi-Centre Study: Quantitative Evaluation Of Radiation Dose For Adults Head Computed Tomography, Abdulaziz A. Qurashi, Shrooq T. Aldahery

Saudi Medical Journal

Objectives: To determine regional radiation dose in adults head computed tomography (CT) examinations in Jeddah by assessing the volume computed tomography dose index (CTDI_vol) and dose length product (DLP) values. Methods: A retrospective study was conducted from February to April 2025 across 10 CT scanners from 5 governmental hospitals in Jeddah. Data for 20 head CT examinations per scanner were collected. Dose metrics including CTDI_vol and DLP (mGy·cm), were extracted from digital imaging and communications in medicine (DICOM) images. Mean values per scanner and the 75^th percentile were calculated across centres to identify the regional DRL. …

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Integrative Approaches To Gut Microbiota: Biomarkers, Dysbiosis, And Therapeutic Potential, Zeyad M. Alharbi

Saudi Medical Journal

The human gut contains bacteria, viruses, and archaea that influence health depending on age, diet, and location. An individual harbours about 150 bacterial species. An imbalance of these microorganisms, known as dysbiosis, can negatively impact health. Commensal bacteria maintain microbial homeostasis by building short chain fatty acids. The 2-way communication channel that connects the gut and the brain is referred to as the gut-brain axis. Dysbiosis of the gut leads to some autoimmune diseases. A decline of beneficial bacteria causes the progression of rheumatoid arthritis. Gut dysbiosis increases intestinal permeability, allowing toxins and cytokines to enter the bloodstream and damage …

Emerging Nanotherapy Applications In Cancer Treatment: A Comprehensive Review, Waleed H. Mahallawi

Saudi Medical Journal

This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically ``cold'' tumors to ``hot'' responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence …

Treatment Of Odontogenic Sinusitis With Oroantral Communication And Fistula: A Systematic Review And Meta-Analysis, Rana R. Alharbi, Omar F. Alnajar, Reham E. Almahdi, Salman A. Alrougi, Remas A. Alshehri, Ruyuf A. Alotaibi, Shahad S. Alharbi, Manal A Eltahir, Yahya A. Fageeh

Saudi Medical Journal

Objective: To assess the available data regarding medicinal, surgical, and combination therapy approaches for odontogenic sinusitis linked to OAC and OAF. Oroantral communication (OAC), an atypical connection between the oral cavity and maxillary sinus, commonly arises following upper jaw procedures, trauma, or infection. Chronic odontogenic maxillary sinusitis may result from OAC developing into an oroantral fistula (OAF) if treatment is not received. Recurrent infections and functional difficulties can be avoided by managing these illnesses effectively. Methods: A systematic search was conducted in National Library of Medicine's (PubMed [MEDLINE]) and Google Scholar for studies published between 2000 and 2024. A total …