Systematic Reviews最新文献

{"title":"Circulating cell-free DNA methylation as biomarker for lung cancer detection: a systematic review and meta-analysis of diagnostic studies.","authors":"Diana Inês Machado, Tiago Brito-Rocha, Sofia Salta, Teresa Monjardino, Rui Henrique, Carmen Jerónimo","doi":"10.1186/s13643-025-02860-w","DOIUrl":"10.1186/s13643-025-02860-w","url":null,"abstract":"<p><p>Lung cancer (LC) is the most incident malignancy and a leading cause of cancer-related fatalities. The lack of dissemination of effective screening tools hinders early detection, resulting in late-stage diagnosis, mostly associated with high mortality. Gene-specific methylation alterations detected in plasma or serum circulation cell-free DNA (ccfDNA) have been investigated as a possible screening tool. Thus, the main aim of this systematic review and meta-analysis was to critically assess published data on the use of ccfDNA methylation-based biomarkers for detection of LC. PubMed, including MEDLINE and Scopus databases, were systematically searched for eligible articles evaluating the diagnostic performance of ccfDNA methylation alterations in that setting. A bivariate random-effect model was employed to calculate pool estimated sensitivity and specificity. Accuracy subgroup analyses, according to histological subtype, stage, and smoker status were carried out. A total of 1961 articles were retrieved, of which 44 met inclusion criteria. The meta-analysis generated a pooled sensitivity of 54% (CI 95% 48-60%) and a pooled specificity of 86% (CI 95% 83-87%) for LC detection. The most frequently tested host-genome methylation markers were RASSF1 A, APC, SHOX2, SOX17, and HOXA9. Overall, methylation analysis of ccfDNA detects LC with high specificity but modest sensitivity. Further research is required to improve diagnostic performance, establish methodological standards and determine whether this might complement existing screening strategies to increase effectiveness. Systematic review registration PROSPERO CRD42023408964.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"120"},"PeriodicalIF":6.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of interventions designed to increase safe medicine disposal: a systematic review and meta-analysis of randomised trials.","authors":"Amy Soo-Bin Ma, Andrew J McLachlan, Christina Abdel Shaheed, Danijela Gnjidic, Jonathan Penm, Toni Riley, Stephanie Mathieson","doi":"10.1186/s13643-025-02820-4","DOIUrl":"10.1186/s13643-025-02820-4","url":null,"abstract":"<p><strong>Background: </strong>Drug-related harm is a major cause of mortality, poisonings, hospitalisations and misuse. Reducing the availability of unused medicines is a component of ensuring medication safety. However, the current literature on how to increase the implementation of medicine disposal strategies needs to be clarified. This systematic review evaluated the effectiveness of strategies designed to promote medicine disposal.</p><p><strong>Methods: </strong>Electronic databases and clinical trial registries were searched from inception to 16th February 2024 without restriction for randomised trials of any interventions aiming to increase medicine disposal compared to any control. Medicine disposal could be done using any method as reported by eligible studies. The primary outcome was the change in the proportion of participants who disposed of unused medicines. Secondary outcomes were changes in patient (e.g. knowledge of disposal strategies), population (e.g. poisonings), environmental (e.g. preventing going to landfill) and economic (e.g. cost-effectiveness) outcomes. The original Cochrane tool was used to assess the risk of bias. Random-effects meta-analysis was conducted on the primary outcome, and a narrative synthesis was performed on secondary outcomes due to heterogeneity. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. PROSPERO registration: CRD42023491797.</p><p><strong>Results: </strong>Eighteen randomised trials were included (plus five ongoing, registered trials). All studies were conducted in North America, published from 2016 to 2023, targeted opioid analgesic disposal and included 5347 participants. Interventional strategies of providing disposal kits (risk ratio [RR] 1.42, 95% confidence Interval [CI] 1.13 to 1.79, moderate evidence), education alone (RR 1.47, 95% CI 1.03 to 2.09, low evidence), education plus reminder prompts (RR 2.51, 95% CI 1.30 to 4.83, moderate evidence) and education plus disposal kits (RR 2.00, 95% CI 1.03 to 3.87, moderate evidence) increased disposal compared to routine practice. Secondary outcomes were infrequently reported, including no studies reporting population-level (poisonings, hospitalisations) and environmental outcomes.</p><p><strong>Conclusions: </strong>There is moderate quality of evidence supporting interventions of disposal kits, disposal kit and education and education with text reminders to increase the disposal of unused medicines compared to routine practice. The conclusions of this review should be interpreted following consideration on the quality of evidence and the number of trials conducted.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"119"},"PeriodicalIF":6.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can interprofessional collaboration be fostered and sustained in team-based care integration for older people in community settings? A realist evidence synthesis.","authors":"Deirdre O'Donnell, Carmel Davies, Catherine Devaney, Apolonia Radomska, Marie O'Shea, Gráinne O'Donoghue, Aoife De Brún, Sarah Donnelly, Helen Whitty, P J Harnett, Deirdre Lang, Emer Ahern, Sahar Hammoud, Éidín Ní Shé","doi":"10.1186/s13643-025-02862-8","DOIUrl":"10.1186/s13643-025-02862-8","url":null,"abstract":"<p><strong>Background: </strong>Community-centred care integration for older adults is a cornerstone of the WHO's Integrated Care for Older People (ICOPE) implementation framework. Realising the potential of care integration for older people requires cohesive coordination of services and interprofessional collaboration (IPC) within and across teams. There is a gap in research evidence to understand how IPC can be fostered and sustained within team-based community care integration for older people. We report on a realist evidence synthesis to identify the contextual influences and mechanisms that support IPC in interprofessional community care teams for older people.</p><p><strong>Methods: </strong>The three phases of the realist synthesis included an exploratory scoping of research evidence and consultation with four local stakeholder groups to produce initial programme theories. The second phase involved systematic retrieval and synthesis of evidence, including peer-reviewed published empirical studies and grey literature recommended by an expert panel. The third phase involved the development of refined programme theory with stakeholder validation. The stakeholder cohorts included representatives of older people and caregivers, healthcare professionals and operational managers of community specialist older person teams, national policymakers, and programme managers.</p><p><strong>Results: </strong>The resource and reasoning mechanisms that enable contexts for IPC and their associated outcomes are identified within seven programme theory areas: (1) professional identity and growth, (2) information sharing and care coordination across boundaries, (3) effective operational and clinical governance, (4) developing a team learning culture, (5) meaningful inclusion of older people and caregivers, (6) quality improvement and programme development, (7) workforce planning and retention.</p><p><strong>Conclusions: </strong>The results provide policymakers and clinicians with evidence-based programme theory that will catalyse critical dialogue on IPC implementation. This programme theory informs the prioritisation of resources to enable favourable contexts for successful IPC intervention development and implementation. This research complements and expands the work presented in the WHO ICOPE implementation framework. We encourage local realist application and evaluation of the programme theory within varying health system contexts.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"117"},"PeriodicalIF":6.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-thickness skin graft versus split-thickness skin graft for fasciocutaneous radial forearm free flap donor site closure: a systematic review and meta-analysis.","authors":"Jasper J E Moors, Zhibin Xu, Kunpeng Xie, Ashkan Rashad, Oliver Vladu, Jan Egger, Rainer Röhrig, Frank Hölzle, Behrus Puladi","doi":"10.1186/s13643-025-02863-7","DOIUrl":"10.1186/s13643-025-02863-7","url":null,"abstract":"<p><strong>Background: </strong>The radial forearm free flap (RFFF) is widely used in microvascular reconstructions. However, donor site morbidity remains a concern, with complications such as wound healing issues, functional impairments, and aesthetic concerns. While both full-thickness skin grafts (FTSG) and split-thickness skin grafts (STSG) are commonly used for donor site closure, there is insufficient evidence to determine which technique leads to fewer complications. This study aims to systematically compare FTSG and STSG in RFFF donor site closure.</p><p><strong>Methods: </strong>We searched six databases and four clinical trial registries up to 1 March 2025. We focused on studies comparing FTSG and STSG. Primary outcome was the incidence of wound complications. Secondary outcomes included functional and aesthetic impairment. Risk of bias was assessed using the Risk Of Bias In Non-Randomized Studies-of Interventions (ROBINS-I) and quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Fifteen studies were analyzed, involving 933 donor site closures. No RCTs met our inclusion criteria. Meta-analysis comparing FTSG versus STSG revealed no significant differences in major wound complications (RR 0.43; 95% CI 0.11 to 1.70; p = 0.23) and minor wound healing complications (RR 0.83; 95% CI 0.60 to 1.13; p = 0.23), with the evidence graded as low to very low certainty.</p><p><strong>Conclusion: </strong>Current evidence does not conclusively favor either FTSG or STSG for radial forearm free flap donor site closure regarding wound, functional, or aesthetic outcomes. Future well-designed RCTs are needed to provide higher-quality evidence to guide clinical decision-making. Until more robust evidence becomes available, the optimal skin graft choice should be guided by patient-specific factors, surgical considerations, and donor site characteristics.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023351903.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"118"},"PeriodicalIF":6.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity interval training and strength conditioning in patients with chronic lymphocytic leukemia: a systematic review.","authors":"Pedro M P Cunha, Ricardo J Ribeiro, Andreia Pizarro, Jorge Mota, Jose C D Ribeiro","doi":"10.1186/s13643-025-02764-9","DOIUrl":"10.1186/s13643-025-02764-9","url":null,"abstract":"<p><strong>Background: </strong>This systematic review explores the impact of physical exercise on chronic lymphocytic leukemia (CLL) patients' physical fitness, immunologic, and quality of life outcomes.</p><p><strong>Methods: </strong>Eligible studies were searched in PubMed and Web of Science up to February 2024 and were included if they involved participants in adult age, with confirmed CLL diagnose, using physical activity protocols with study design helding intervention protocols, clinical trials, or quantitative data reporting. Bias was assessed with ROBINS-I and RoB2 tools from Cochrane. The results are presented in tables and figures. A qualitative synthesis describes the main outcomes of the included studies. Meta-analysis was not performed due to significant heterogeneity.</p><p><strong>Results: </strong>This review identifies 92 studies, with 6 meeting the inclusion criteria, with a sample size of 323 patients. These studies focus on cardiovascular training combined with resistance training (four studies with total sample of 177 patients), continuous cardiovascular training (one study with 122 patients), and endurance resistance training (one study with 24 patients), highlighting the importance of physical exercise in CLL patients before treatment, with significant improvements in physical fitness and immunologic parameters on intervention groups.</p><p><strong>Discussion: </strong>The paucity regarding exercise influence on CLL, with small samples of patients in pilot study experiments, noted that exercise plays a vital role in improving physical fitness and immunologic parameters. However, none addressed strength training, which is known as one of the best options to increase muscular mass in physical activity interventions. The inconsistency of intervention and/or evaluation protocols ravels the advice of exercise and medical professionals on prescribing different modes of exercise, improving compliance with the prescribed exercise program, and determining which intervention in the context of exercise prescription should be used. More studies are needed to evaluate the impact of physical activity on the health-related quality of life and life span of the CLL patient.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023464877.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"116"},"PeriodicalIF":6.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place-based approaches to improve the mental health and wellbeing of children and young people: a rapid realist review.","authors":"Anna March, Kate Allen, Karuna Davies, Julie Harris, Alison Bethel, Laura Kennedy, Tamanna Malhotra, Rachael Stemp, Bianca Alexandrescu, Tim Hobbs, Peter Fonagy, Steve Pilling, Vashti Berry","doi":"10.1186/s13643-025-02838-8","DOIUrl":"10.1186/s13643-025-02838-8","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental health continues to be a pressing public health concern across the globe, in spite of renewed efforts in recent years to improve mental health and wellbeing outcomes. With many mental health services and systems ill-equipped to meet young people's needs, there is growing evidence that prevention interventions addressing the social and structural determinants of mental health should be prioritised. Consequently, there is a move away from isolated interventions towards 'place-based approaches' that aim to unlock systemic or structural change. However, there is limited evidence on how these approaches create change and the different contextual factors or underlying mechanisms that influence outcomes. This is the first realist review on place-based approaches to improve young people's mental health.</p><p><strong>Methods: </strong>This rapid realist review synthesises relevant literature on place-based approaches to improve the mental health and wellbeing of children and young people. The review involved consultation with programme developers, an expert panel of content specialists and a Young Person's Advisory Group. Online databases were searched for peer-reviewed and grey literature published between January 2000 and August 2023, resulting in 5685 articles.</p><p><strong>Results: </strong>Fifteen articles from eight countries were included in the review, from which 11 realist context-mechanism-outcome configurations (CMOCs) were developed to explain the underlying mechanisms present in the place-based approaches. These CMOCs were categorised into three themes: (1) Building relationships and trust, (2) bringing a social determinants lens, and (3) educating and empowering community stakeholders.</p><p><strong>Conclusions: </strong>This review provides valuable insights into the mechanisms underpinning place-based approaches. However, the mechanisms identified primarily address the intermediate outcomes of place-based approaches, such as engaging the right stakeholders and creating opportunities for youth voices to be heard. Articles did not address the challenges around long-term sustainability and there remain crucial questions around the pathway to wider systemic change. Recommendations are included for future development and evaluation of place-based approaches to improve young people's mental health.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023450778.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"115"},"PeriodicalIF":6.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis.","authors":"Xiaohua Huang, Jia Zhou, Yuxiao Qian, Jing He, Lu Yang, Zhigang Wang, Diu Wei, Mengjie Li, Wei Ma, Haiyan Lang","doi":"10.1186/s13643-025-02804-4","DOIUrl":"10.1186/s13643-025-02804-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Daratumumab (Dara)-based regimens have been investigated in randomized controlled trials (RCTs) involving patients with newly diagnosed and previously untreated multiple myeloma (NDMM), but the optimal daratumumab-based regimen remains unclear. This study compares the efficacy of daratumumab-containing regimens for NDMM patients and explores optimal combinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Databases were searched from inception until February 29, 2024. Trials comparing regimens with and without daratumumab, as well as their mutual comparisons, were included. Random effects models for serious adverse events (SAEs) and fixed effects models for other outcomes were utilized in both network meta-analysis (NMA) and component NMA (CNMA), with pooled effects estimated. The efficacy of all possible combinations of daratumumab with other drugs was assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 17 trials were included, enrolling 7261 patients, of whom 2083 were treated with daratumumab. The optimal regimens for different outcomes were identified as follows: Dara-bortezomib (V)-melphalan (M)-corticosteroids (D) (Dara-VMD) showed the best results for both overall response rate (ORR) [RR = 1.97; 95% CI: 1.42 to 2.75; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 16 trials; 7136 participants; P = 0.00] and ≥ very good partial response (≥ VGPR) [RR = 7.46; 95% CI: 4.10 to 13.46; I&lt;sup&gt;2&lt;/sup&gt; = 23.96%; 16 trials; 7118 participants; P = 0.00]; Dara-V-thalidomide (T)-D (Dara-VTD) was optimal for achieving ≥ complete response (≥ CR) [RR = 14.15; 95% CI: 3.74 to 53.52; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 17 trials; 7261 participants; P = 0.00]. The individual effects of daratumumab were calculated as follows: [ORR: RR = 1.14; 95% CI: 1.08 to 1.21; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 16 trials; 7136 participants; P = 0.00; ≥ VGPR: RR = 1.46; 95% CI: 1.36 to 1.58; I&lt;sup&gt;2&lt;/sup&gt; = 23.96%; 16 trials; 7118 participants; P = 0.00; ≥ CR: RR = 1.77; 95% CI: 1.55 to 1.99; I&lt;sup&gt;2&lt;/sup&gt; = 0.00; 17 trials; 7261 participants; P = 0.00; progression-free survival (PFS): hazard ratio (HR) = 0.53; 95% CI: 0.43 to 0.65; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 13 trials; 5977 participants; P = 0.00; overall survival (OS): HR = 0.68; 95% CI: 0.58 to 0.79; I&lt;sup&gt;2&lt;/sup&gt; = 28.97%; 12 trials; 5977 participants; P = 0.00]. Additionally, the optimal regimens for PFS and OS were Dara-lenalidomide (R)-D [HR = 0.37; 95% CI: 0.23 to 0.61; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 13 trials; 5977 participants; P = 0.00] and Dara-VRD [HR = 0.40; 95% CI: 0.19 to 0.85; I&lt;sup&gt;2&lt;/sup&gt; = 28.97%; 12 trials; 5977 participants; P = 0.02], respectively. Finally, CNMA indicated that Dara-VRD, Dara-carfilzomib (K)-RD, Dara-RD, and Dara-cyclophosphamide (C)-RD were four regimens, which could improve remission rate, and reduce death or progression during induction and prolong lifetime.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dara-VRD, Dara-KRD, Dara-RD, and Dara-CRD are optimal daratumumab-based regimens for patients with newly diagnosed and previously ","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"113"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deficiency of B vitamins in women of childbearing age, pregnant, and lactating women in Brazil: a systematic review.","authors":"Tatiane Salgado Galvão de Macedo, Michel Carlos Mocellin, Simone Augusta Ribas, Michelle Teixeira Teixeira, Alessandra da Silva Pereira, Gabriel Montalvão Palermo, Cintia Chaves Curioni","doi":"10.1186/s13643-025-02861-9","DOIUrl":"10.1186/s13643-025-02861-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prevalence of B-complex vitamin deficiencies in Brazilian women of childbearing age, pregnant women, and lactating women.</p><p><strong>Methods: </strong>This systematic review analyzed cross-sectional and cohort studies published up to August 2023 and indexed in MEDLINE, SciELO, LILACS, Scopus, Embase, Web of Science, and the Brazilian Digital Library of Theses and Dissertations. Additional data were obtained by contacting researchers from Brazilian public universities. Studies assessing deficiency rates using biochemical markers were included. Two reviewers independently selected studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute tool.</p><p><strong>Results: </strong>Of the 3772 records identified, 13 studies were included. Only folate (n = 13), B12 (n = 11), and B6 (n = 1) deficiencies were investigated, and all studies were cross-sectional. B12 deficiency prevalence varied widely, reaching up to 29.4%. Folate deficiencies were generally low, with only one study reporting a rate as high as 37%. Other B-complex vitamins were insufficiently studied. Most studies had methodological limitations, particularly small sample sizes. The significant heterogeneity across studies limited the feasibility of a pooled quantitative meta-analysis.</p><p><strong>Conclusion: </strong>There is a clear need for more robust studies across all Brazilian regions to improve understanding of vitamin deficiency rates and to support effective nutritional interventions.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42020188474.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"111"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best evidence toolkits: a case study on interventions for preventing violence against women and girls (VAWG).","authors":"Michelle Richardson, Theo Lorenc, Katy Sutcliffe, Amanda Sowden, James Thomas","doi":"10.1186/s13643-025-02798-z","DOIUrl":"10.1186/s13643-025-02798-z","url":null,"abstract":"<p><p>Research teams report challenges in conducting overviews and many of these relate to the synthesis of outcome data from multiple reviews that lead to unclear evidence. This limits research from being used by policymakers and other review users who need accessible robust evidence. In this commentary, we present a case study on creating a toolkit of interventions for preventing violence against women and girls (VAWG). This toolkit is underpinned by systematic methods and a priori criteria that identify a single best up-to-date systematic review of each subtopic. The best evidence toolkit approach does not require the synthesis of multiple reviews and produces clear, standardised evidence across subtopics efficiently. This approach offers a pragmatic alternative to overviews when presenting a broad spectrum of intervention approaches, populations or outcomes. This approach may be particularly beneficial when the primary aim is to communicate with policymakers.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"112"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social prescribing for people living with long-term health conditions: a scoping review.","authors":"Anna Wilson, Helen Noble, Karen Galway, Julie Doherty","doi":"10.1186/s13643-025-02848-6","DOIUrl":"10.1186/s13643-025-02848-6","url":null,"abstract":"<p><strong>Introduction: </strong>Social prescribing links people to activities and services typically provided by local voluntary and community sectors to address social determinants of health and wellbeing. People living with long-term health conditions are a target population. This relatively new approach is rapidly expanding, and there is varied evidence regarding how social prescribing is being delivered for people living with long-term conditions. This scoping review aims to report on what is known about the approach for these patient populations.</p><p><strong>Methods: </strong>Electronic databases MEDLINE, CINAHL, Scopus, Web of Science, and PsycINFO were searched in December 2023, and relevant sources of gray literature in January 2024, with both updated in February 2025. Studies eligible for inclusion included adults (18 +) with long-term conditions engaging with social prescribing in health and community contexts. Studies published in English in any year were included. A data charting template captured key characteristics including reasons for referral, referral pathways, activities and services being utilized, and outcome measures. A descriptive narrative synthesis was conducted, guided by the review questions to explore the current evidence.</p><p><strong>Results: </strong>Thirty-seven sources of evidence were included. Diabetes was the most common of 65 conditions identified (n = 23). The presence of a long-term condition was the most frequent reason for referral (n = 30), followed by mental health concerns (n = 15), and social isolation or loneliness (n = 11). Most referrals were made within primary care (n = 33), to a link worker or social prescriber (n = 29), who supported participants to access activities and services including exercise (n = 22), information, support, and advice (n = 19), mental health support (n = 15), social and leisure activities (n = 15) and condition-specific support (n = 14). Wellbeing was the most commonly identified measured outcome (n = 23), with studies utilizing the Warwick Edinburgh Mental Wellbeing Scales (n = 7) and Wellbeing Star (n = 7) most frequently.</p><p><strong>Conclusions: </strong>While common factors were identified, there is considerable variation in social prescribing approaches for people living with long-term conditions, reflecting the diversity of needs, availability of community services, and necessity for personalized care. Further research is needed to inform the development of evidence-based practice which addresses the complex needs of diverse patient populations and supports access to a broad range of referral pathways.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"114"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}