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14, 95% 1.18-15.38]. Reported ORs ranged from 2.8 to 22.4. The overall MTR was 26.8%, with the high-risk and low-risk lesions having MTRs of 57.9% (95% CI 0.386-0.723) and 12.7% (95% CI - 0.210 to 0.438), respectively. Pooled unweighted interobserver kappa values for the binary grading system and three-tiered system were 0.693 (95% CI 0.640-0.740) and 0.388 (95% CI 0.195-0.552), respectively. Conclusion Binary grading of OED into low-risk and high-risk categories may effectively determine malignant potential, with improved interobserver agreement over three-tiered grading. Improved grading schemes of OED may help guide management (watchful waiting vs. excision) of these OPMDs.Researchers have examined if olfaction is a sensitive biomarker of anorexia nervosa, but considerable heterogeneity across studies makes it difficult to reach a consensus. This review and meta-analysis sought to clarify if olfaction is altered in individuals with anorexia nervosa and explore potential moderators of olfaction in this population. We performed quantitative and qualitative analyses of olfactory function in individuals with anorexia nervosa compared with healthy controls. A random effect model was used to estimate pooled effect sizes, and meta-regression was conducted to identify potential moderators. We found that individuals with anorexia nervosa had largely intact olfactory function compared with healthy controls in terms of threshold (g = -0.09, 95% confidence interval [CI] (-0.65,0.47), p = 0.757), identification (g = -0.06, 95% CI (-0.32,0.20), p = 0.642), and overall olfactory function (g = -0.47, 95% CI (-1.02,0.07), p = 0.090). Discrimination was different from control (g = -0.51, 95% CI (-0.97,-0.05), p = 0.029). However, after sensitivity analysis, the pooled effect size was nonsignificant in discrimination. Olfactory sensitivity covaried with anorexia nervosa severity, body mass index (BMI) positively moderated olfactory threshold score (β = 0.79, 95% CI (0.18,1.41), p = 0.020) in individuals with anorexia nervosa. Disease duration negatively moderated olfactory threshold score (β = -0.21, 95% CI (-0.40,-0.03), p = 0.034). The results suggest that olfaction is not a sensitive marker of anorexia nervosa diagnosis, but olfactory sensitivity may be a useful indicator of anorexia nervosa severity.In June 2018, WHO published the 11th edition of the International Classification of Diseases (ICD). The new edition introduced numerous changes. One of the most important was to rebuild the coding system and adapt ICD to digital use. A reconstruction of the coding system enabled more comprehensive alphanumeric coding of complex clinical situations by the introduction of cluster coding. The chapter on mental disorders has also changed. ICD-11 has been updated to take into account the results of international expert cooperation and new information on mental disorders. Many of the secondary clinical categories have been moved higher in the hierarchy that created new subchapters. Many categories have been moved to other subchapters. Taking into account the modern epidemiology and knowledge about the etiology of mental disorders, some categories have been removed from ICD. Moreover, several nonexistent categories have been added. The article summarizes and discusses the most important changes in ICD with the introduction of ICD-11, both in the coding system and in individual subchapters covering mental health issues.Objective To evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects. find more Methods We searched electronic databases for randomized clinical trials investigating the effect of commercial exergames versus alternative interventions on balance dysfunction as assessed by standard clinical scales in adults with acquired neurological disabilities. Standardized mean differences (Hedge's g) were calculated with random-effects models. Subgroup analyses and meta-regression were run to explore potential modifiers of effect size. Results Out of 106 screened articles, 41 fulfilled criteria for meta-analysis, with a total of 1223 patients included. Diseases under investigation were stroke, Parkinson's disease, multiple sclerosis, mild cognitive impairment or early Alzheimer's disease, traumatic brain injury, and myelopathy. The pooled effect size of exergames on balance was moderate (g = 0.43, p less then 0.001), with higher frequency (number of sessions per week) associated with larger effect (β = 0.24, p = 0.01). There was no effect mediated by the overall duration of the intervention and intensity of a single session. The beneficial effect of exergames could be maintained for at least 4 weeks after discontinuation, but their retention effect was specifically explored in only 11 studies, thus requiring future investigation. Mild to moderate adverse events were reported in a minority of studies. We estimated a low risk of bias, mainly attributable to the lack of double-blindness and not reporting intention-to-treat analysis. Conclusions The pooled evidence suggests that exergames improve balance dysfunction and are safe in several neurological conditions. The findings of high-frequency interventions associated with larger effect size, together with a possible sustained effect of exergaming, may guide treatment decisions and inform future research.Vaccines have contributed substantially to decreasing the morbidity and mortality rates of many infectious diseases worldwide. Despite this achievement, an increasing number of parents have adopted hesitant behaviours towards vaccines, delaying or even refusing their administration to children. This has implications not only on individuals but also society in the form of outbreaks for e.g. measles, chicken pox, hepatitis A, etc. A review of the literature was conducted to identify the determinants of vaccine hesitancy (VH) as well as vaccine confidence and link them to challenges and opportunities associated with vaccination in India, safety concerns, doubts about the need for vaccines against uncommon diseases and suspicions towards new vaccines were identified as major vaccine-specific factors of VH. Lack of awareness and limited access to vaccination sites were often reported by hesitant parents. Lastly, socio-economic level, educational level and cultural specificities were contextual factors of VH in India.