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The aim of this study is to describe the association between electrolyte abnormalities and adverse clinical outcomes, as well as to estimate the prevalence of these abnormalities in individuals with eating disorders. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020-compliant systematic review searching Ovid MEDLINE, EMBASE, and PsycINFO databases from January 2000 to February 2025 was conducted. We included studies with any electrolyte abnormality or clinical adverse outcome among individuals with eating disorders. We conducted two meta-analyses to assess (1) the odds of having an electrolyte abnormality among those with an eating disorder diagnosis compared to healthy controls, and (2) the prevalence of electrolyte abnormalities across eating disorder diagnoses. 20 studies incorporating 25,401 individuals were analysed, with most assessing a young female population. Study designs were predominantly retrospective cohort (n = 11) and cross-sectional (n = 5), with few including general population controls (n = 4). Anorexia nervosa was the most common eating disorder studied, with hypokalemia (n = 13 studies), hyponatremia (n = 11 studies), and hypophosphatemia (n = 7 studies) being the most frequently reported electrolyte abnormalities. The most prevalent adverse outcomes included anemia (n = 5 studies) and skeletal conditions (osteoporosis, osteopenia; n = 5 studies). The results from the meta-analyses showed (1) that individuals with eating disorders had significantly higher odds of experiencing electrolyte abnormalities compared to controls (OR = 3.20, 95% CI:1.48-6.94), and (2) varying pooled prevalences of abnormalities, including hypokalemia (15%), hyponatremia (13%), and hypophosphatemia (17%), across studies. Electrolyte abnormalities are common among individuals with eating disorders and are associated with adverse health outcomes. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) - (ID CRD42023477497).

Background Physician wellness programs are being implemented to offset rises in physician burnout. Insight into the effectiveness of these programs and to whom they are being offered, remains unclear. Objectives To identify and characterize wellness program interventions to improve physician wellness. Methods A PRISMA-P 2020-compliant systematic review as conducted, searching PubMed, Scopus, and Medline from May 2006 to July 2024. Search terms included Medical Subject Headings terms and keywords related to physicians and wellness program interventions. Peer reviewed published studies that qualitatively and/or quantitively measured outcomes of wellness interventions for practicing physicians were included. Results Thirty-six studies involving 6,708 total participants were included. Interventions were heterogenous and included group therapy, stress reduction strategies, time off/workload reductions, education, and peer support. The efficacy of interventions varied, with sixteen studies (44.4%) demonstrating some measurable degree of effectiveness, with statistically significant changes ( p  < 0.05) post-intervention. Few studies reported improvements by physician sex, age groups, or comparisons across specialities. Conclusion Studies examining physician wellness program interventions are highly heterogenous in terms of intervention, study design and methods of outcome assessment, limiting definitive conclusions about their general effectiveness. Trial registration The review protocol has been registered on Open Science Framework ( https://doi.org/10.17605/OSF.IO/8SDM9 ).

IntroductionPredictive scoring systems support clinicians in decision-making by estimating the prognosis of patients in intensive care units (ICUs). However, there is limited evidence on the accuracy of these systems in predicting mortality and organ dysfunction in special populations. The aim of this review is to assess the performance of predictive scoring systems in forecasting mortality in adult ICU patients in relation to baseline kidney function. It is anticipated that the assessment of predictive scoring systems’ performance and patient outcomes in this review may reveal information that will contribute to improve the quality of care and outcomes for special or under-represented ICU patient populations. It might also inform future research and contribute to the development of novel risk prediction models to address identified gaps or unanswered questions.Methods and analysisThis review will include only observational studies, as these allow us to assess the real-world performance of predictive scoring systems in ICU settings by examining the original validation studies. By excluding randomised trials, paediatric studies, case reports and machine learning-derived models, this review focuses on the direct practical use of the scoring systems in adult ICU patients. A comprehensive search of MEDLINE, Embase and Scopus was conducted from database inception to 10 October 2024. The data will be extracted on study characteristics, patient outcomes and performance metrics.Ethics and disseminationThis review will analyse data from previously published studies; no ethical approval is required. All data that will be included in the analysis will be publicly available and will be included in the final manuscript. Results will be disseminated through publication in a peer-reviewed journal and will also be presented at seminars and conferences.PROSPERO registration numberCRD42024611547.

Background: Tacrolimus dose optimization remains challenging due to its narrow therapeutic range and multiple influencing variables. This systematic review aimed to identify effective analytical modeling techniques for optimal tacrolimus dose prediction in solid organ transplant recipients. Methods: Two independent researchers conducted a comprehensive review of studies examining analytical models that optimize tacrolimus dosing, searching Medline, Scopus, Embase, Web of Science, and PubMed. Results: In total, 115 studies met the inclusion criteria. Pharmacokinetic models (74 studies), particularly two-compartment with Bayesian forecasting, were most frequently used. Machine learning (ML) approaches, with increasing adoption, have demonstrated promising improved predictive accuracy. Key predictive variables included CYP3A5 genotype, hematocrit levels, post-operative days, and weight; however, the significance of genomic features seemed to diminish progressively as therapeutic drug monitoring calibrates dosing in the months following post-transplant. Only ten studies performed external validation, and none incorporated adherence data or predicted long-term graft outcomes. Conclusions: Clinical deployment of predictive models for tacrolimus dosing remains uncommon. In research, pharmacokinetic models remain prevalent, with ML approaches showing early incremental promise. Limited external validation raises generalizability concerns. Future research should prioritize outcome-based evaluation metrics rather than error metrics.

This case study examines the total physiotherapy care of a 50-year-old male patient, who had a right-sided displaced distal tibia and fibula fracture, a talus fracture due to a road traffic accident, and an above-knee amputation due to a serious infection. Enhancing muscle strength, reducing pain from phantom limbs, avoiding problems, maintaining range of motion, increasing endurance, and promoting functional independence in the postoperative period were the main goals of the patient's rehabilitation. The recovery plan included an intensive four-week program of physiotherapy care. The regimen included a variety of interventions, such as pain management, edema control, wound healing techniques, range of motion (ROM) exercises, muscle strengthening activities, mobility and transfer exercises, cardiovascular endurance training, psychosocial support, education on prosthetic use, and independence in daily living activities. ROM measures, manual muscle testing, and functional independence measure scores were used to evaluate the patient's improvement. The patient's physical health and level of functional independence both exhibited significant improvements, according to the statistics. Following treatment, the patient's ROM, muscle strength, and overall functional independence all improved. The study highlights the positive impacts of physical therapy interventions on the patient's quality of life, mobility, and self-sufficiency following the amputation and subsequent recovery. These findings support the patient's transition to a more self-sufficient and active lifestyle by providing valuable insights into the efficient use of physiotherapy and the comprehensive post-amputation treatment plan.