Search Results (2,378)

Background/Objectives: Cycle threshold (Ct) values from SARS-CoV-2 RT-PCR are widely reported in clinical practice, yet their interpretation in outpatient settings remains challenging due to substantial temporal and clinical variability. This study aimed to characterize day-by-day Ct distributions after symptom onset and to evaluate how symptom timing and fever severity inform diagnostic interpretation in primary care. Methods: We conducted a single-center retrospective study of 906 outpatients with COVID-19 who underwent saliva RT-PCR testing (January 2022–April 2023). Ct values were summarized according to days since symptom onset (Day 0–14). Peak self-reported temperature was categorized into 1 °C strata (36–40 °C), with temperature analyses restricted to patients tested on Day 0. Spearman’s correlation and multivariable linear regression with 95% confidence intervals were used to assess associations. Results: Ct values increased with longer intervals from symptom onset but demonstrated substantial variability within each day (Spearman’s ρ = 0.166, p < 0.001). On Day 0, higher temperature strata were associated with lower Ct values (p = 0.018). In multivariable analysis, days since onset, temperature category, sex, and age group were independently associated with Ct values, whereas vaccination doses and comorbidities were not. Conclusions: Incorporating symptom onset timing and fever severity may support more nuanced, context-based interpretation of Ct values in primary care, rather than reliance on isolated thresholds. Full article

Cancer caregiving is increasingly recognized as a major psychosocial challenge, yet the mental health needs of caregivers remain insufficiently addressed in oncology research and practice. This narrative review examines the experiences of cancer caregivers within the context of rising cancer incidence and prolonged survival, conditions frequently accompanied by sustained psychological burden and anticipatory grief, with particular attention to depressive symptoms. Relevant qualitative and quantitative studies were identified through targeted searches of major databases (PubMed, Scopus, PsycINFO, and Google Scholar), including studies published up to January 2026. Study selection was guided by conceptual relevance and applied significance to the intersection between religiosity, spirituality, caregiving, and mental health outcomes. The reviewed literature highlights substantial psychological burden among caregivers, with depression affecting approximately 20–40% of cancer caregivers and identifies religiosity and spirituality as potentially supportive resources. Across studies, recurrent themes include meaning-making, hope maintenance, emotional regulation, moral orientation, and perceived social support as mechanisms through which these dimensions are associated with lower levels of depression and improved psychological adjustment. Evidence suggests that both religiosity, understood as the lived engagement with religious values, and spirituality, defined as a broader existential orientation toward meaning and purpose, contribute to coping in caregiving contexts; however, findings remain heterogeneous and largely based on cross-sectional analyses. Notable gaps persist, including limited caregiver-specific research, conceptual imprecision, and a lack of longitudinal designs. By integrating conceptual clarification with empirical synthesis, this review outlines potential psychological pathways linking religiosity and spirituality to caregiver mental health outcomes. In summary, religiosity and spirituality are considered adjunctive, non-exclusive resources that complement conventional psychological and psychiatric care within comprehensive models of caregiver support. Full article

Background: Women with endometriosis frequently experience mobility limitations that affect daily functioning. A specific tool to assess these restrictions would help clinicians to better understand patients’ functional challenges, facilitating more effective communication and shared decision making. Addressing this gap is essential for strengthening patient–professional dialogue and improving individualized care. Objective: To develop the new instrument MobEndo and to perform initial psychometric testing of the tool. Methods: The initial domains and items were generated through semi-structured interviews with patients and based on experts’ advice. Guided by the International Classification of Functioning, Disability, and Health (ICF) framework, exploratory factor analysis was conducted on data from patients diagnosed with endometriosis. Internal consistency was assessed using Cronbach’s alpha, considering values ≥ 0.70 as acceptable. Test–retest reliability was examined using intraclass correlation coefficients (ICCs), and ICC values were judged as excellent if >0.75. Construct validity was evaluated through concurrent, discriminant, and known-groups validity. For the known-groups validity hypothesis, participants were categorized by baseline pain levels. Results: The final questionnaire included 18 items, developed from responses from 301 women (mean age 38.96 ± 6.85). Factor analysis revealed two components—transitioning between body positions and performing movements requiring stabilization and executing load-bearing tasks involving the upper limbs—with the model explaining 71.78% of the total variance. Reliability was excellent, with a Cronbach’s alpha of 0.977. The ICC for the total score was 0.976 (95% CI 0.949–0.988), with similarly high values for each component. Concurrent validity correlations were significant, while discriminant validity showed no relevant associations. Known-groups analyses showed clear differences across pain-level groups. Conclusions: The questionnaire is a valid and reliable tool for capturing women’s perceived mobility limitations in endometriosis. Full article

This article investigates whether increasing economic status through adopting digital payment capabilities in Delhi fosters economic and financial inclusion among urban women street vendors in Mahila Haat. Digital freedom is a new step forward in technology for everyone. Still, a woman not only balances the social responsibilities of childbearing, caring for her children and family, and struggling with economic issues, health issues, and undernourishment, but can also balance the household job of street vending to increase self-esteem and financial independence. This research work conducted a sampling survey and applied the Kruskal–Wallis H-test with a p-value (0.05) significance level by evaluating 11 variables to investigate the relationship between the digital capabilities and economic independence of street vendors in Mahila Haat (a women’s market where the vendors are all women) in the Red Fort area of New Delhi. UPI systems were created using measurements based on a five-point Likert scale to analyze different levels of satisfaction in clusters of digital capabilities on digital platforms. Further, the ordinary least squares (OLS) method was used to estimate quality of life and social happiness in the context of digital empowerment. Digital payment systems positively influence women’s empowerment. Women vendors can adopt digital payment methods, making them economically independent. The positive relationship between women vendors and customer satisfaction before UPI use and after UPI use is also analyzed. This research will be helpful for both government and non-government organizations to provide financial assistance, informational awareness, skill development training, and advocacy for gender equality to increase women’s empowerment. Full article

Background: Non-invasive scoring systems for predicting the hepatic venous pressure gradient (HVPG) and, thus, clinically significant portal hypertension (CSPH) have been proposed; the aim of this study was to evaluate the accuracy of these scores in a cohort of patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) placement and to further analyze patients without a markedly elevated portosystemic gradient (PSG) at the time of the procedure. Methods: We retrospectively analyzed 314 patients who underwent TIPS implantation at our tertiary care center between 2010 and 2022. The diagnostic performance of CT-based scoring systems by Iranmanesh (Score 1) and Kihira (Score 2), as well as laboratory-based scores including MELD (Score 3), FIB-4 (Score 4), and APRI (Score 5), was assessed for detecting a markedly elevated PSG (PSG > 10 mmHg). Additionally, we evaluated whether incorporating the inferior vena cava (IVC) diameter as a surrogate marker of central venous pressure (CVP) improves the accuracy of CT-based scores. Results: Both Scores 1 and 2 showed high sensitivity (89–87%) but low specificity (33–27%). ROC analysis revealed AUC values between 0.65 and 0.62. Laboratory-based scores (Score 3–5) performed poorly with AUCs of 0.57–0.54. Adding IVC diameter as an estimator for CVP to Scores 1 and 2 significantly increased the AUC to 0.74 and 0.76. In Lasso regression, IVC diameter was selected as a significant variable for PSG estimation. Conclusions: CT-based scoring systems showed promise in assessing markedly elevated PSG, but their specificity was low. Including the IVC diameter improved accuracy in detecting elevated PSG in TIPS patients. Future scoring systems should incorporate CVP estimators like the IVC diameter. Full article

Auditory pseudowords are widely used in psycholinguistics and cognitive neuroscience, but their construction requires control of sublexical familiarity and careful characterization of how acoustic cue manipulations may shift perceived lexical plausibility. Here we introduce the Minho Pseudoword Wordlikeness Ratings (MPWR), the first normative dataset of wordlikeness judgments for European Portuguese (EP) auditory trisyllabic CV pseudowords, and evaluate whether adding a localized F0-based prominence cue modulates wordlikeness beyond distributional familiarity. One hundred and twenty pseudowords were assembled from naturally produced syllables drawn from the Minho Spoken Syllable Pool (MSSP) and recorded under uniform conditions. Each item was implemented in three token types with constant segmental content: a flat baseline and two F0-enhanced versions (+15%) targeting either the penultimate or final syllable. Native EP listeners (N = 101) provided wordlikeness ratings on a 7-point scale. MSSP-derived indices quantified pseudoword syllable familiarity (SWI_All, SWI_N3) and stress-position propensity for the targeted syllable (SPP_marked). Ratings were intentionally low overall yet showed substantial item-to-item variability. F0 enhancement produced a small but reliable decrease in wordlikeness relative to flat tokens, with no reliable difference between penultimate and final targeting positions. SWI_All robustly predicted ratings, whereas SPP_marked added little explanatory value. MPWR provides a practical EP resource for selecting and matching auditory pseudowords using normative wordlikeness ratings and transparent corpus-based descriptors. Full article

Background/Objectives: The clinical utility of summarizing long-term C-reactive protein (CRP) trends with a single mean remains unclear. We systematically characterized annual changes in CRP test volume and CRP level distributions using large-scale laboratory data collected at Dankook University Hospital (2008–2023) across the coronavirus 2019 pandemic period. Methods: Overall, 1,845,258 CRP values were analyzed; annual arithmetic, harmonic, and geometric means were calculated; long-term trends were assessed using weighted least squares (WLS) regression weighted by annual test volume; and temporal changes around the pandemic period were examined using a WLS-based interrupted time-series (ITS) segmented model with a prespecified 2020 break. Results: The annual test volume rose from 2008 to 2013 and 2019, dropped in 2020, increased in 2022, and declined in 2023. The arithmetic mean showed no long-term trend, whereas the harmonic and geometric means declined. ITS models exhibited no statistically significant immediate level-change term in 2020; however, post-2020 slope changes indicated a decline in the arithmetic mean and attenuation of the prior decline in the harmonic mean. As only four annual observations were available after 2020, these post-2020 trend estimates should be interpreted cautiously. Conclusions: Within this single-center tertiary-care dataset, different CRP summary measures showed different long-term patterns and post-2020 trend changes, without evidence of an abrupt shift in 2020, suggesting stratum-specific shifts that may be invisible to arithmetic mean-based surveillance. These findings are best interpreted as institution-specific and hypothesis-generating, and broader interpretive or operational implications require validation in multicenter settings with differing case-mix and care structures. Full article

Background: Gaucher disease (GD) is a rare lysosomal storage disorder caused by mutations in the GBA1 gene. Traditionally, GD is classified into three subtypes based on the severity of neurological involvement; however, overlapping clinical features increasingly suggest a continuum of phenotypes rather than distinct categories. In this prospective observational cohort study, we conducted a multidisciplinary assessment of patients with GD to identify and monitor neurological, cognitive, auditory, and visual impairments. Materials and Methods: A comprehensive clinical and instrumental evaluation was performed at baseline and repeated at follow-up, with a median interval of 37 months (IQR 36–38). Neurological assessments included physical examination, clinical rating scales, video-EEG, and brain MRI. Cognitive status was assessed using a standardized battery of neuropsychological tests. Detailed audiological and ophthalmological evaluations were also conducted. Paired parametric or non-parametric tests were applied as appropriate, with Bonferroni correction for cognitive outcomes (p < 0.05). Results: Of the 22 patients assessed at baseline, 18 completed the follow-up evaluation. Neurological assessments showed a worsening of subtle parkinsonian signs, with significant increases in Movement Disorder Society–Unified Parkinson’s Disease Rating Scale Part III scores (p = 0.04) and non-motor symptom scores (p = 0.01). Two of the eighteen patients developed epilepsy during follow-up. A high prevalence of sleep disturbances was confirmed, with 27.8% exhibiting excessive daytime sleepiness and 16.7% reporting REM sleep behaviour disorder on standardized questionnaires. Compared with baseline, cognitive assessments revealed a higher proportion of patients with performance below normative population scores in at least one cognitive domain, particularly memory. Sensorineural hearing loss was confirmed in 11 of 15 patients (73.3%) who underwent audiological evaluation, with progressive worsening of audiometric thresholds observed in 7 of 11 (64%). Ophthalmological evaluations showed no changes in visual acuity or OCT findings; however, multifocal electroretinography abnormalities were detected in 12 of 13 patients. Conclusions: Through in-depth phenotyping, this study identifies measurable neurological, cognitive, and sensory progressive changes in patients with GD over time, supporting the value of tailored, multidisciplinary long-term care strategies to monitor and address emerging clinical needs in this rare disease. Full article

Background: Post-Traumatic Stress Disorder (PTSD) is among the most prevalent and disabling mental health conditions affecting military veterans in Western countries. In recent decades, PTSD has increasingly been conceptualized as a systemic neuropsychological injury shaped not only by individual psychopathology, but also by institutional, cultural, and political contexts, particularly in settings of prolonged conflict and political violence. This shift has given rise to diverse national rehabilitation models that extend beyond symptom-focused care. This narrative comparative review aims to examine national models of PTSD rehabilitation among military veterans and to derive policy-relevant insights for Israel. Methods: We conducted a narrative comparative review of peer-reviewed literature and national policy documents published between 2014 and 2023, examining military and veteran PTSD rehabilitation frameworks in six Western countries: the United States, Canada, the United Kingdom, Germany, Australia, and the Netherlands. Sources were identified through PubMed, PsycINFO, Google Scholar, and governmental repositories. The review focused on system-level rehabilitation structures, including clinical services, peer-based programs, occupational integration, community and cultural components, and national monitoring practices. Results: Across countries, recurring challenges included persistent stigma limiting help-seeking, fragmented service delivery, inconsistent access to evidence-based care and a lack of standardized outcome indicators capturing functional and social recovery. Innovative approaches included biopsychosocial-spiritual rehabilitation models, peer-led interventions, intra-systemic employment pathways, and symbolic forms of social recognition. In this context, the biopsychosocial-spiritual approach refers to integrative rehabilitation models that extend beyond traditional frameworks by incorporating meaning-making, identity reconstruction, and value-based recovery processes. Conclusions: The findings highlight the need to reconceptualize PTSD rehabilitation as a multidimensional, system-level process. In light of the 2023 “Iron Swords” war and the scale of trauma exposure in Israel, the review informs actionable recommendations for developing a coordinated national rehabilitation strategy that integrates clinical care with occupational, community and cultural recovery. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) coexists with lung cancer in 40–70% of cases and increases perioperative risk, particularly in patients with severely impaired pulmonary function. Preoperative pulmonary rehabilitation (PR) has been proposed as a perioperative optimization strategy; however, its effect on hospital length of stay (LOS) in patients with advanced COPD remains unclear. This study aimed to compare postoperative complications, intensive care unit (ICU) utilization, and hospital LOS between patients with lower and higher baseline forced expiratory volume in one second (FEV1), and to evaluate the role of preoperative PR as a risk-adaptive perioperative strategy in high-risk COPD patients undergoing lung cancer surgery. Methods: This retrospective cohort study comprises patients with spirometry-confirmed COPD and non-small cell lung cancer (NSCLC) who underwent elective lung resection at a tertiary care center between March 2019 and June 2020. Disease severity was classified using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) framework: GOLD 1–2 (FEV1 ≥ 50% predicted) and GOLD 3–4 (FEV1 < 50% predicted). Patients in the GOLD 3–4 group received a uniform 15-day hospital-based preoperative PR program prior to surgery. Primary outcomes were ICU stay, postoperative complications, and hospital LOS. Factors independently associated with prolonged hospital stay were examined using an exploratory multivariable linear regression model. Results: Among 63 patients (95.2% male; median age 64 years), those with GOLD 3–4 COPD had significantly lower baseline FEV1 values and longer COPD duration compared with the GOLD 1–2 group. Despite a higher perioperative risk profile, postoperative complication rates (28.6% overall; p = 0.237) and ICU utilization were comparable between groups. Median postoperative hospital LOS was significantly longer in patients with GOLD 3–4 COPD (15 [IQR 6] vs. 11 [IQR 4] days; p < 0.001). In the exploratory regression analysis, lower predicted FEV1 percent (p = 0.003) and older age were independently associated with prolonged hospital stay, whereas PR was not an independent determinant of LOS. Conclusions: In patients with lung cancer and severe COPD (GOLD 3–4) who received preoperative PR, postoperative complication rates and ICU utilization were comparable to those observed in patients with less severe disease. Prolonged hospital stay in the high-risk group was independently associated with lower FEV1 and older age, reflecting underlying disease severity. Prospective controlled studies stratified by COPD severity are needed to establish the independent contribution of preoperative PR in this population. Full article

Background: This study aimed to compare the prognostic value of three surrogate insulin resistance (IR) markers for predicting 360-day mortality in critically ill patients with ischemic stroke (IS): the triglyceride–glucose (TyG) index, TyG–shock index (TyG-SI), and TyG–lactate (TyG-Lac). Methods: The study population comprised critically ill IS patients identified from the Medical Information Mart for Intensive Care (MIMIC) IV database. The main outcome was 360-day mortality. We employed multiple analytical approaches to examine relationships between the three biomarkers and mortality outcomes, including multivariable Cox proportional hazards models (Cox models), Kaplan–Meier survival analysis, and restricted cubic spline (RCS). Furthermore, receiver operating characteristic (ROC) curve analyses were conducted to assess the predictive capacity of these three indices. We performed ROC analyses to evaluate whether the IR index improved the discriminatory ability of a base model that included baseline variables significantly different between survivors and non-survivors. Results: Altogether, 812 patients with IS were included in the analysis. In Cox proportional hazards models, the TyG index was independently associated with higher 360-day mortality (HR, 1.68; 95% CI, 1.52–1.76). Similarly, both TyG-SI and TyG-Lac indices showed significant associations with 360-day mortality, with the HR (95% CI) of 1.24 (1.05–1.38) and 1.11 (1.08–1.23), respectively. Kaplan–Meier survival curves showed a progressive elevation in cumulative 360-day mortality across ascending quartiles of each index (TyG, TyG-SI, and TyG-Lac). ROC curve analysis revealed relatively better discriminatory ability of the TyG-SI compared to TyG and TyG-Lac for all-cause 360-day mortality prediction (area under the curve: 0.605 [0.578–0.623] vs. 0.566 [0.532–0.592] vs. 0.587 [0.532–0.614]). Furthermore, incorporation of either the TyG-SI or TyG index modestly improved the 360-day mortality prognostic accuracy of the base model (area under the curve [AUC], 0.701 for the base model vs. 0.723 for the base model + TyG-SI vs. 0.716 for base model + TyG index). Conclusions: When analyzed as continuous variables, each of the three indices demonstrated significant associations with 360-day mortality risk of critically ill IS populations. Moreover, both TyG-SI and TyG can improve the 360-day mortality predictive accuracy of the base model. Among the three indices, TyG-SI showed comparatively better discriminatory performance; however, the magnitude of AUC improvement was modest, and its clinical utility should be interpreted cautiously pending external validation. Full article

Background: Effective management of key physiological parameters, such as blood pressure, temperature, blood glucose, and gas exchange, is central to neurocritical care. However, the clinical impact of variability within guideline target ranges after an acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage remains unclear. Methods: In this multicenter observational study of nine German neurocritical care units, we analyzed in-range measurements over 96 h. Of 524 screened patients, 281 met the predefined criteria for sufficient in-range data. Variability in systolic blood pressure, mean arterial pressure, body temperature, blood glucose, partial arterial pressure of oxygen and carbon dioxide was quantified using the coefficient of variation. Associations between in-range variability of each physiological parameter and clinical outcomes including duration of mechanical ventilation, NIHSS score at discharge, and in-hospital mortality were evaluated using multivariable regression models. Results: Variability for all parameters peaked in the first 24 h and then remained largely stable; blood glucose showed a secondary rise after ~60 h. Greater in-range blood glucose variability was associated with in-hospital mortality in hemorrhagic stroke (adjusted OR 1.08; 95% CI 1.00–1.17; p = 0.04), while no other parameter’s variability was associated with the evaluated outcomes. Conclusions: Overall, in-range variability had limited short-term prognostic value, supporting current guideline-based management. Full article

Background and Objectives: Postpartum depression (PPD) is a prevalent mental health condition with substantial consequences for mothers, infants, and families. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD; however, optimal cut-off scores vary across populations, necessitating local validation. No prior study has evaluated the diagnostic performance of the EPDS against a structured clinical interview in Latvia. To assess the reliability and diagnostic accuracy of the Latvian version of the EPDS and to determine the optimal cut-off score for detecting PPD in a Latvian outpatient population 4–6 weeks after childbirth. Materials and Methods: A cross-sectional study was conducted at the outpatient department of Riga Maternity Hospital between June 2024 and May 2025. Women aged ≥18 years attending routine postnatal check-ups were screened using the Patient Health Questionnaire-9 (PHQ-9). Those scoring ≥5 were invited to complete the EPDS and participate in a structured diagnostic interview using the Mini International Neuropsychiatric Interview (MINI) 7.0.2. Internal consistency was assessed using Cronbach’s alpha. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic accuracy and identify the optimal cut-off score based on sensitivity, specificity, likelihood ratios, and the Youden Index. Results: A total of 272 women were screened, and 101 completed the EPDS; 78.63% of screen-positive participants underwent the MINI. The EPDS demonstrated excellent internal consistency (Cronbach’s α = 0.871). ROC analysis indicated strong discriminative ability (AUC = 0.852, 95% CI 0.759–0.945, p < 0.001). A cut-off score of ≥11 provided the optimal balance between sensitivity (0.74) and specificity (0.82), with the highest Youden Index (0.56) and a positive likelihood ratio of 4.14. Conclusions: The Latvian version of the EPDS is a reliable and diagnostically accurate screening instrument for PPD 4–6 weeks after delivery. A cut-off score of ≥11 appears optimal for routine screening in Latvian outpatient settings. These findings support the integration of EPDS-based screening into structured postpartum care and underscore the value of validating screening instruments within specific cultural and clinical contexts. Full article

Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality. Nonetheless, blood pressure control rates remain suboptimal despite established treatment guidelines and effective pharmacologic therapies. In parallel, artificial intelligence (AI) has rapidly expanded within cardiovascular medicine, demonstrating promising capabilities in disease detection, risk prediction, and clinical decision support. However, most AI applications in hypertension have focused primarily on algorithmic performance rather than real-world implementation or measurable improvements in patient outcomes. This review examines artificial intelligence-driven hypertension management through the lens of quality improvement and prevention of end-organ damage. We summarize current applications of machine learning, deep learning, natural language processing, and imaging analytics in hypertension detection and risk stratification, and critically evaluate their integration into clinical workflows. Particular emphasis is placed on therapeutic inertia, primary care-centered implementation, and the use of AI to support continuous quality improvement frameworks. Beyond blood pressure reduction alone, we explore the potential of AI to identify patients at risk for hypertensive heart disease, heart failure, aortic pathology, renal dysfunction, and cerebrovascular events. We discuss implementation challenges, including external validation, algorithmic bias, workflow integration, and regulatory considerations, which must be addressed to ensure safe and equitable deployment. Artificial intelligence offers the opportunity to transform hypertension management from reactive blood pressure control to proactive organ protection. Critically, AI-driven quality improvement interventions must be evaluated against established non-AI strategies, including pharmacist-led management and team-based care, which provide the benchmarks for demonstrating added clinical value. Achieving this shift will require embedding predictive analytics within structured, outcome-oriented systems of care and rigorously evaluating their impact on cardiovascular morbidity and mortality. Full article

Background: Gastrointestinal surgery in children and neonates carries high risks of postoperative infections, inflammation, and delayed recovery. Probiotics may help restore gut microbial balance and improve clinical outcomes. This study systematically evaluates the effects of probiotic supplementation on postoperative outcomes in pediatric and neonatal gastrointestinal surgery. Methods: A systematic review and meta-analysis was conducted following Cochrane and PRISMA guidelines. PubMed, Scopus, Cochrane, and Web of Science were searched for randomized controlled trials (RCTs) and observational studies comparing probiotics with placebo, standard care, or surgery alone in children and neonates. Meta-analyses were performed using R programming, with pooled effect estimates reported alongside 95% confidence intervals (CI) and corresponding p-values. Results: Eight studies (6 RCTs and two cohorts) with 437 patients were included. Probiotics significantly reduced postoperative infections (risk ratio = 0.49, 95% CI: 0.26–0.92, p = 0.027) and C-reactive protein elevation (risk ratio = 0.42, 95% CI: 0.26–0.68, p < 0.001) and increased Bifidobacterium abundance (standardized mean difference = 0.84, 95% CI: 0.51–1.17, p < 0.001). No significant effect was seen on hospital length of stay or Lactobacillus concentrations. Qualitative synthesis indicated improvements in bowel function, immune markers, and growth in selected neonatal populations. Conclusions: Probiotics, particularly Bifidobacterium species, may reduce postoperative infections and inflammation in pediatric gastrointestinal surgery; however, the evidence is based on a limited number of studies and small pooled analyses, and larger well-designed trials are needed to confirm these findings. Full article