Sean Loke

Objectives: This study aims to investigate the association between self-reported pornographic consumption habits and anxiety and depression. Methods: We systematically searched PubMed, Embase, Cochrane, and PsycINFO for all studies that examined anxiety and depression across consumption habits in pornographic content consumers (PCCs). PRISMA reporting guidelines were followed. Random effects meta-analyses were conducted for the primary analysis using correlation coefficients (CORs) and standardised mean differences (SMDs). A synthesis without a meta-analysis approach was further performed to examine factors affecting pornography consumption. Results: A total of 19 studies were included. The overall meta-analysis indicated significant positive correlations between pornographic consumption and both anxiety (COR = 0.16; 95% CI: 0.08; 0.25) and depression (COR = 0.24; 95% CI: 0.15; 0.32). Exploratory study-level subgroup analyses suggested that problematic consumption or addiction, but not general consumption, was associated with anxiety and depression. A stronger anxiety correlation was also observed in samples with a mean age ≤25 years compared with older users (COR = 0.22 vs. COR = 0.09; p = 0.0321). Systematically reviewing the studies showed that male gender and younger age significantly increased pornographic content consumption. Conclusions: The study found significant positive correlations between pornographic consumption and both anxiety and depression, with an increased effect on younger users. These findings suggest that pornography consumption habits may be important to psychosocial assessment, although substantial heterogeneity, residual confounding, and the observational nature of the evidence preclude causal inference.

Background/Objectives: Bereavement in childhood, adolescence, and young adulthood is associated with a range of grief responses, and a subset of bereaved individuals develop persistent or severe grief symptoms. Understanding the prevalence and risk factors of prolonged grief symptoms is important for guiding supportive care. Methods: We systematically searched PubMed, MedLine, Embase and PsycINFO for all studies comparing the prevalence and prognostic factors of prolonged grief-related symptoms among young individuals following parental or sibling death from cancer. Young individuals were defined as those not more than 25 years old before losing a parent or sibling to any cancer. Prolonged grief-related symptoms were defined as the presence of grief symptoms at least six months following the death of a parent or sibling of the bereaved person. Retrospective cross-sectional studies were included for evaluating prognostic factors affecting prolonged grief-related symptoms, but were not used for meta-analyses. Random-effects meta-analyses were conducted for the primary analysis. Results: From 1561 records identified, thirteen studies were included with five for quantitative pooling in meta-analysis. The pooled prevalence of self-reported prolonged grief-related symptoms was 48% (95% CI: 29–67%). Stratified analyses suggested a prevalence of 28% (95% CI: 7–65%) after parental death and 59% (95% CI: 45–72%) after sibling death. Factors associated with elevated prolonged grief-related symptoms included pre-existing depression, emotional difficulties, and insomnia. As no included studies conducted diagnostic clinical interviews, prolonged grief disorder according to the ICD-11 or DSM-5-TR criteria could not be assessed. Conclusions: Prolonged grief-related symptoms appear common among young individuals bereaved by loss of a parent or sibling to cancer, especially after sibling loss. However, interpretation remains limited by substantial heterogeneity, such as outcome measures, symptom thresholds, assessment time window, non-validated symptom measures, and predominance of cross-sectional studies. Future larger and methodologically rigorous studies using validated grief instruments across diverse settings are needed to clarify grief trajectories and guide developmentally appropriate intervention strategies.

Background: PPPD is purported to be better than the Whipple procedure as it preserves full gastric capacity. Approaching this surgery using the MIS technique [minimally invasive pylorus-preserving pancreaticoduodenectomy (MI-PPPD)] may confer additional advantages compared to the open method. However, literature comparing MI-PPPD to open pylorus-preserving pancreaticoduodenectomy (O-PPPD) is scarce. This study seeks to review the efficacy and long-term outcomes of MI-PPPD against O-PPPD. Materials and Methods: This PRISMA-adherent review involved a systematic search of PubMed, Scopus, Cochrane, and Embase for studies evaluating the outcomes of MI-PPPD compared to O-PPPD. Two independent reviewers extracted the summary data from included studies. Random effects meta-analyses were used for analysis. All analyses were performed in RStudio (Posit Software, PBC, Boston, Massachusetts) Version 4.3.2. Artificial intelligence was not used for research and manuscript development. Results: Nine articles with 682 patients (391 in the MI-PPPD group and 291 in the O-PPPD group) were included. Postoperatively, there was no statistically significant differences in postoperative complications [risk ratio (RR) = 1.00, 95% CI: 0.69; 1.46], length of hospital stay [mean difference (MD) = −0.21, 95% CI: −0.53; 0.11], postoperative pancreatic fistula formation (RR = 0.78, 95% CI: 0.59; 1.05), delayed gastric emptying (RR = 0.63, 95% CI: 0.35; 1.14), postpancreatectomy hemorrhage (RR = 1.38, 95% CI: 0.77; 2.46), and 90-day mortality (RR = 2.42, 95% CI: 0.92; 6.34). Perioperatively, MI-PPPD had nonsignificant reduction in estimated blood loss (MD = −129.07, 95% CI: −579.35; −312.20) and nonsignificant difference in operative time (MD = 0.38 min, 95% CI: −0.18; 0.95). Oncological outcomes revealed equivalent outcomes in R ₀ resection (MD = 0.50%, 95% CI: 0.07; 3.82) and lymph node yield (MD = −1.31, 95% CI: −2.83; 0.22). Conclusion: MI-PPPD is noninferior to O-PPPD. Whilst MI-PPPD outcomes have been influenced by its high complexity and steep learning curve, this approach is believed to be on an upwards trajectory with the potential to surpass O-PPPD. Investment toward MI-PPPD training is recommended given the potential benefits it brings to patients.

Introduction: Caffeine, in the form of coffee, tea and energy drinks, is recognised as the world’s most utilised psychoactive substance and consumed by approximately 80% of the global population daily. Emerging studies have suggested a more complex relationship in terms of the mental health outcomes that can arise after consumption. This is the first systematic review and meta-analysis that aims to explore the effects of caffeine consumption on the risk of suicide attempts, ideation and self-harm. Methods: This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the effects of caffeine consumption on the risk of suicide attempts, ideation and self-harm. Random effects meta-analyses and meta-regression were used for primary analysis. Results: Seventeen studies were included. The results demonstrated that coffee consumption of more than 60 cups per month significantly decreases the risk of suicide attempts. In contrast, energy drink consumption from as low as one cup per month was significantly associated with an increased risk of both suicide attempts and ideation. Meta-regression demonstrated a strong association between the dosage consumed and suicidality outcomes. Systematic review highlighted that male gender and substance usage significantly increased caffeine consumption. Conclusion: The results studied the associations between coffee and energy drink intake with suicide risk and suicidal ideation. Coffee intake was associated with reduced odds of suicide ideation and attempts, while consuming energy drinks was associated with an increased risk of both adverse outcomes. Further studies would be essential to elucidate the psychosocial factors and causative links underlying this association. Understanding the relationship between caffeine consumption and mental health outcomes is crucial to develop public health strategies to boost the mental health of consumers.