BackgroundPrevious studies have shown that an awake prone position may be beneficial for the treatment of acute respiratory distress syndrome (ARDS) or acute hypoxic respiratory failure (AHRF) in patients with COVID-19, but the results are not consistent, especially in terms of oxygenation outcomes and intubation rate. This systematic review and meta-analysis assessed the effects of the awake prone position on AHRF in patients with COVID-19 with all randomized controlled trials (RCTs).MethodsAn extensive search of online databases, including MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials from 1 December 2019 to 30 October 2022, with no language restrictions was performed. This systematic review and meta-analysis are based on the PRISMA statement. We only included RCTs and used the Cochrane risk assessment tool for quality assessment.ResultsFourteen RCTs fulfilled the selection criteria, and 3,290 patients were included. A meta-analysis found that patients in the awake prone position group had more significant improvement in the SpO2/FiO2 ratio [mean difference (MD): 29.76; 95% confidence interval (CI): 1.39–48.13; P = 0.001] compared with the usual care. The prone position also reduced the need for intubation [odd ratio (OR): 0.72; 95% CI: 0.61 to 0.84; P < 0.0001; I2 = 0%]. There was no significant difference in mortality, hospital length of stay, incidence of intensive care unit (ICU) admission, and adverse events between the two groups.ConclusionThe awake prone position was a promising intervention method, which is beneficial to improve the oxygenation of patients with ARDS or AHRF caused by COVID-19 and reduce the need for intubation. However, the awake prone position showed no obvious advantage in mortality, hospital length of stay, incidence of ICU admission, and adverse events.Systematic review registrationInternational Prospective Register of Systematic Reviews (PROSPERO), identifier: CRD42022367885.

COVID-19, which occurred at the end of December 2019, has evolved into a global public health threat and affects every aspect of human life. COVID-19's high infectivity and mortality prompted governments and the scientific community to respond quickly to the pandemic outbreak. The application of personal protective equipment (PPE) is of great significance in overcoming the epidemic situation. Since the discovery of severe acute respiratory coronavirus 2 (SARS-CoV-2), bibliometric analysis has been widely used in many aspects of the COVID-19 epidemic. Although there are many reported studies about PPE and COVID-19, there is no study on the bibliometric analysis of these studies. The citation can be used as an indicator of the scientific influence of an article in its field. The aim of this study was to track the research trends and latest hotspots of COVID-19 in PPE by means of bibliometrics and visualization maps.

Osteoporosis has become a major public health problem and bisphosphates treatment for osteoporosis is a rapidly developing research field. Every year, plenty of studies devoted to the treatment of osteoporosis are published, giving clinicians a new perspective on bisphosphates treatment for osteoporosis. However, the quality of the scientific papers in this area is unclear. The aim of the present study was to characterize the 100 top-cited articles regarding bisphosphates treatment for osteoporosis. This analysis provides an accessible list for practitioners of endocrinology, pharmacy, epidemiology, imaging, surgery, and scientific research to identify the most frequently cited literature and better understand the future direction.

Background With the rapid development of science and technology, artificial intelligence (AI) has been widely used in the diagnosis and prognosis analysis of various spine diseases. It has been proved that AI has a broad prospect in the accurate diagnosis and treatment of spine field. Methods On May 07, 2022, the Web of Science (WOS) Core Collection database was used to identify the documents on the application of AI in spine field. HistCite and VOSviewer softwares were used for citation analysis and visualization mapping. Results A total of 693 documents were included in the final analysis. The most prolific authors were Karhade AV and Schwab JH. The USA was the most productive country. The leading journal was Spine. The most frequently used keyword was spinal. The most prolific institution was Northwestern Univ. Network visualization map showed that USA was the largest network of international cooperation. The keyword “machine learning” had the strongest total link strengths (TLS) and largest number of occurrences. The latest trends suggest that AI for the diagnosis of spine diseases may receive widespread attention in the future. Conclusions AI has a wide range of application prospect in the subject of spine field, and an increasing number of scholars are committed to the research of AI in spine field. Bibliometric analysis in the field of AI and spine provides an overall perspective, and the appreciation and research of these influential publications are useful for future research.

Osteoporosis has become a major public health problem and bisphosphates treatment for osteoporosis is a rapidly developing research field. Every year, many studies are devoted to the treatment of osteoporosis, which makes clinicians have a new understanding of bisphosphates treatment for osteoporosis. However, the quality of the scientific papers in this area is unclear. The aim of the present study was to characterize the 100 top-cited articles regarding bisphosphates treatment for osteoporosis. This analysis provides an accessible list for practitioners of endocrinology, pharmacy, epidemiology, imaging, surgery and scientific research to identify the most frequently cited literature, and better understand the future direction.

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Background: Adequate visualization in percutaneous endoscopic interlaminar discectomy (PEID) surgery is essential for the successful completion of lumbar discectomy. However, there is currently no relevant research on the efficacy and safety of adding tranexamic acid (TXA) to the saline irrigation fluid in PEID surgery. To evaluate the efficacy and safety of topical saline-irrigation with TXA for PEID in the treatment of lumbar disc herniation.Methods: Patients who underwent PEID surgery for L5-S1 lumbar disc herniation were divided into two groups. PEID was performed with saline-irrigation fluid containing 0.33 g of TXA per 1 L of saline in the TXA group (n=38) and only saline in the control group (n=51). All PEID surgeries were performed by the same spine surgery team. The hidden blood loss (HBL), intraoperative blood loss (IBL), total blood loss (TBL), amount of fluid used, operation time, visual clarity, hospital stay, blood transfusion rate, coagulation index and complication rate were compared between the two groups.Results: The TBL, HBL, and IBL in the TXA group were significantly lower than those of the control group. The postoperative hemoglobin in the TXA group was significantly higher than that of the control group. Visual clarity was significantly better and operation time was significantly shorter in the TXA group. However, there was no significant difference in postoperative hematocrit, blood coagulation function, amount of fluid used, blood transfusion rate and perioperative complications between the two groups.Conclusion: In PEID surgery, addition TXA to topical saline-irrigating fluid can significantly reduce HBL, IBL and TBL. Addition TXA to topical saline-irrigating fluid can improve visual clarity in the surgery and reduce operation time, but do not change coagulation function or increase complication rate.

Background: Previous studies have shown that prone position may be beneficial for the treatment of acute respiratory distress syndrome (ARDS) or acute hypoxic respiratory failure (AHRF) in COVID-19 patients, but the results are not consistent, especially in terms of oxygenation outcomes and intubation rate. This systematic review and meta-analysis assessed the effects of prone position on AHRF in COVID-19 patients with all randomized controlled trials (RCTs). Methods: An extensive search of online databases, including MEDLINE, Embase, Web of Science and Cochrane Central Register of Controlled Trials from December 1, 2019 to October 30, 2022, with no language restrictions. This systematic review and meta-analysis are based on the PRISMA statement and has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the registered ID: CRD42022367885. We only included RCTs and used Cochrane risk assessment tool for quality assessment. Results: Twelve RCTs fulfilled the selection criteria and 3154 patients were included. Meta-analysis found that patients in prone position group had more significant improvement in the SpO2/FiO2 ratio (mean difference [MD]: 29.76; 95% confidence interval [CI]: 1.39 to 48.13; P=0.001) compared with usual care. Prone position also reduced the need for intubation (odd ratio [OR]: 0.72; 95% CI: 0.62 to 0.85; P＜0.0001; I2=0%). There was no significant difference in mortality, hospital length of stay, incidence of intensive care unit (ICU) admission and adverse events between the two groups. Conclusions: Prone position was a promising intervention method, which is beneficial to improve the oxygenation of patients with ARDS or AHRF caused by COVID-19 and can reduce the need for intubation. However, prone position had no significant difference in mortality, hospital length of stay, incidence of ICU admission and adverse events.