Background: In malnourished patients with colorectal cancer, hypoalbuminemia is common and was proposed to determine the postoperative outcome of colorectal surgery. Mounting articles published but have not been evaluated. We aim to assess the predictive value of preoperative hypoalbuminemia in patients undergoing colorectal surgery.Methods: We performed a literature search from PubMed, Euro PMC, and Cochrane with the terms serum albumin, hypoalbuminemia, prognosis, outcome, colorectal cancer, and neoplasm. We also hand-searched and included any relevant papers. Hypoalbuminemia is defined as plasma albumin level < 3.5 mg/dL. We restricted the included studies to English language and adults undergoing colectomy, laparotomy, laparoscopy, or abdominoperineal resection. Any types of articles were included, except an abstract-only publication and those that did not report the key exposure or outcome of interest. The key exposures were mortality, hospitalization time, and morbid conditions (thrombosis, surgical site infection, sepsis, and wound events). We pooled the odds ratio from each included literature as effect size. The Newcastle Ottawa scale and GRADE were used to determine the quality of each included study.Results: Hereof 7 observational studies (236,480 individuals) were included. Our meta-analysis found that preoperative hypoalbuminemia can predict the postoperative outcome in colorectal cancer patients. Individuals with hypoalbuminemia were not associated with 30-day mortality (risk ratio [RR] 2.05 [0.72, 5.86], P = .18, I 2 = 99%) but were associated with morbidity (RR 2.28 [1.78,2.93], P < .00001, I 2 = 87.5%), surgical complication (RR 1.69 [1.34,2.13], P < .00001, I 2 = 98%), and hospitalization (RR 2.21 [1.93,2.52], P < .00001, I 2 = 0%). According to newcastle ottawa scale, the included studies are of moderate to sound quality. Conclusions:The current systematic review and meta-analysis showed that preoperative hypoalbuminemia was significantly associated with morbidity, length of stay, and surgical complication but not mortality.Abbreviations: BSA = basal serum albumin, CRC = colorectal cancer, NOS = newcastle ottawa scale, RR = risk ratio.

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This research study explores the effect of promotion practices, training initiatives, and leadership style on employee career development in a start-up company. The study employs a mixed-methods research design, including quantitative surveys and qualitative interviews, to gather comprehensive data. The findings from the quantitative analysis indicate a positive correlation between promotion opportunities and employee career advancement, as well as a positive relationship between the effectiveness of training programs and perceived skill development. The qualitative analysis reveals the importance of supportive and empowering leadership behaviors and the impact of specific training initiatives on employee career growth. The integration of quantitative and qualitative findings provides a holistic understanding of the factors influencing employee career development in start-up companies. The implications of the study contribute to theoretical knowledge and offer practical recommendations for start-up companies to optimize promotion practices, training initiatives, and leadership styles to support employee career development.

Diabetes mellitus is a chronic metabolic disease characterized by elevated blood glucose levels, insufficient insulin secretion by pancreatic cells, insulin resistance, and inadequate insulin secretory compensatory response. Various reports have shown that low-grade chronic inflammation is associated with the risk of developing T2DM. In recent years, studies have suggested that increased concentrations of circulating inflammatory markers, such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) have been reported may increase the incidence of T2DM. Recently it has been found that vitamin D plays a role not only in bone remodeling, but as an immunomodulator. Administration of vitamin D therapy suppresses the proliferation of T cells and monocytes and downregulates proinflammatory cytokines including CRP, TNF-α, Interleukin-1, 6, 8, and increases the production of the anti-inflammatory cytokine IL-10. A literature review was carried out to collect the latest results from several studies regarding the role of vitamin D on IL-6 in type 2 diabetes mellitus. The literature sources were taken from journal articles published online in the period 2017-2021. The databases used are MDPI, PubMed, ScienceDirect, Wiley, and Hindawi. The results of the literature review show various findings. Several studies showed a significant difference and no significant difference in IL-6 after vitamin D administration clinically or statistically. Additional studies are needed to specifically examine the optimal dose of vitamin D to reduce IL-6-mediated inflammation in T2DM, determine the best dose between calcemic and immunomodulating effects, and the role of vitamin D in inflammation so that it can be an effective adjunct therapy in the treatment of T2DM.

Introduction: HIV is an infection that attacks the immune system which is characterized by a decrease in CD4+ cells with MSM as the 2nd largest contributor globally. PPrP serves as an additional option in the prevention of HIV-negative MSM from becoming infected with HIV. Objective: This study was conducted to review more deeply the role of pre-exposure prophylaxis in reducing the risk of contracting HIV in male sex groups with HIV negative men and to review the effectiveness and implementation of HIV/AIDS pre-exposure prophylaxis in male sex men so that it is expected to be a consideration in efforts to combat HIV/AIDS. Methods: Literature search was conducted from journal articles published online in the period 2012-2021. The databases used are ScienceDirect, Pubmed, Google Scholar, and Cochrane. Results: The study showed that the factors that significantly affected the high prevalence of HIV cases among MSM were anal sex and based on the findings the use of PrEP showed a significant effectiveness for the MSM group with pre-exposure prophylaxis as a preventive measure in dealing with HIV positive cases. Conclusion: PrEP has been shown to significantly reduce the risk of contracting HIV in HIV-negative MSM groups and has the potential to be an additional prevention option so that it can be applied in efforts to prevent HIV infection and reduce the spread of HIV in MSM.