Systematic Reviews最新文献

{"title":"How to quantify between-study heterogeneity in single-arm evidence synthesis?-It depends!","authors":"Stefania Iaquinto, Lea Bührer, Maria Feldmann, Beatrice Latal, Ulrike Held","doi":"10.1186/s13643-025-02831-1","DOIUrl":"10.1186/s13643-025-02831-1","url":null,"abstract":"<p><strong>Background: </strong>Random-effects meta-analysis models account for between-study heterogeneity by estimating and incorporating the heterogeneity variance parameter <math> <msup><mrow><mi>τ</mi></mrow> <mn>2</mn></msup> </math> . Numerous estimators for <math> <msup><mrow><mi>τ</mi></mrow> <mn>2</mn></msup> </math> have been proposed, but no widely accepted guidance exists on when to best use which heterogeneity variance estimator. Especially in the context of single-arm observational studies, studies with unique challenges, such as outcome measure variability, sparse data, and high methodological heterogeneity, systematic evaluations and comparisons of the various heterogeneity variance estimators are lacking. This study investigates the advantages of different heterogeneity variance estimators for typical single-arm meta-analysis scenarios through comprehensive simulations in a neutral comparison study setting and with an empirical application in pediatrics.</p><p><strong>Methods: </strong>We compared seven heterogeneity variance estimators for random-effects meta-analysis. The estimators were selected on the basis of methodological diversity and availability and were evaluated both empirically and in a simulation study. We simulated typical meta-analysis scenarios for continuous and binary outcomes in a single-arm meta-analysis setting. Through a non-systematic literature review, we assessed which heterogeneity variance estimators are currently used in high-ranked journals, and evaluated their reporting quality.</p><p><strong>Results: </strong>Our simulation study showed that all evaluated heterogeneity estimators were imprecise and often failed to estimate the true amount of heterogeneity. The estimation is particularly imprecise in situations where the meta-analysis contained few studies or when the binary outcomes included rare events. Moreover, we discovered that most heterogeneity variance estimators produce zero heterogeneity estimates under all simulated conditions, even though heterogeneity was present. The estimated overall effect was found to be relatively robust to different estimators in the empirical application and in our simulation study. However, the prediction intervals for the overall effect vary depending on the estimator chosen.</p><p><strong>Conclusions: </strong>Although different heterogeneity variance estimators produce substantially different heterogeneity variance estimates, too little attention is paid to selecting a suitable heterogeneity variance estimator in single-arm evidence synthesis. Based on our literature review, we conclude that the awareness of different heterogeneity variance estimators and their properties needs to be strengthened in practice. Given that it is rarely appropriate to rely on a single heterogeneity variance estimator, we suggest careful consideration and evaluation of a wider range of plausible estimators in a sensitivity analysis before drawing a final conclusion about the met","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"138"},"PeriodicalIF":6.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567839","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":"Impact of alcohol consumption, substance use, and smoking on treatment outcomes in tuberculosis: a systematic review and meta-analysis.","authors":"Bahram Heshmati, Sanaz Omidi, Younes Mohammadi","doi":"10.1186/s13643-025-02888-y","DOIUrl":"10.1186/s13643-025-02888-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to elucidate the influence of alcohol, smoking, and substance use on tuberculosis (TB) treatment failure using a meta-analysis approach.</p><p><strong>Method: </strong>A comprehensive search strategy was developed and applied to three major databases: MEDLINE, Web of Science, and Scopus. Additionally, Google Scholar, and Google were used to locate grey literature. Studies were identified through title and abstract screening, followed by a full-text review for eligibility. The Newcastle-Ottawa Scale checklist was employed to assess the quality of included studies. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated for each factor.</p><p><strong>Results: </strong>The initial database search and other sources yielded 10,518 articles. After applying inclusion criteria, 19 studies with a total of 180,119 participants were selected for the meta-analysis. The results revealed significant associations between all three factors and treatment failure. Pooled ORs indicated that alcohol consumption (OR 2.05; 95% CI 1.65 to 2.55), smoking (OR = 1.85; 95% CI 1.44 to 2.37), and substance use (OR 2.04; 95% CI 1.63 to 2.55) were each associated with an increased risk of TB treatment failure. Additionally, the majority of included studies demonstrated high methodological quality.</p><p><strong>Conclusion: </strong>Our findings suggest that alcohol, smoking, and substance use are significant risk factors for unsuccessful TB treatment. To enhance TB treatment efficacy, preventive interventions aimed at reducing these behaviors before treatment initiation are recommended.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"139"},"PeriodicalIF":6.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567841","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":"Bacterial pathogens causing skin and soft tissue infections and antibiotic susceptibility in South Asia: a scoping review protocol.","authors":"Rajalakshmi Rajendran, Shravya Chitrapady, Haritha K, Tejashree M U, Jayaraj Mymbilly Balakrishnan, Girish Thunga","doi":"10.1186/s13643-025-02885-1","DOIUrl":"10.1186/s13643-025-02885-1","url":null,"abstract":"<p><strong>Background: </strong>Skin and soft tissue infections (SSTIs) have become a global public health threat especially in the Indian context. Secondary complications from untreated skin lesions make the patient life miserable and result in serious adverse effects. The main purpose of this scoping review is to identify the common bacterial pathogens causing SSTIs in South Asia.</p><p><strong>Methods: </strong>This scoping review adheres to the Joanna Briggs Institute (JBI) guidelines. The search strategy and screening follow the Peer Review of Electronic Search Strategies (PRESS) checklist, and the review will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The initial search set will follow the keyword such as \"bacteria\", \"microbial susceptibility\", and \"South Asia\". Based on the predetermined inclusion and exclusion criteria, literature search will be carried out at the Cochrane Library, PubMed/MEDLINE, SCOPUS, Embase, CINAHL and Web of Science databases, relevant regional databases, and other grey literature will also be searched to cover maximum information. The data extraction and synthesis will be carried out by the researchers independently and the results will be summarised narratively.</p><p><strong>Discussion: </strong>The present scoping review seeks to address this gap by synthesizing evidence on the common bacterial pathogens causing SSTIs in children and adults across South Asia and their antibiotic susceptibility profiles. By contextualizing these findings, the review aims to inform region-specific empirical guidelines, ultimately enhancing clinical decision-making and improving patient outcomes in managing SSTIs in South Asia. In summary, the insights of this review are not only critical for improving clinical outcomes but also hold considerable public health significance by informing antimicrobial stewardship strategies and guiding policy efforts to address the growing challenge of antimicrobial resistance in the region.</p><p><strong>Scoping review registration: </strong>This research has been registered in the Open Science Framework (OSF) ( https://osf.io/xve49 ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"136"},"PeriodicalIF":6.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565319","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":"Collaborations between local health authorities and community leaders in responding to health emergencies in low- and-middle-income countries: a scoping review protocol.","authors":"Emmanuel Kwang, Monica Ansu-Mensah, Julian David Pillay, Desmond Kuupiel","doi":"10.1186/s13643-025-02883-3","DOIUrl":"10.1186/s13643-025-02883-3","url":null,"abstract":"<p><strong>Background: </strong>Effective collaboration between local health authorities and community leaders is critical for timely and inclusive responses to health emergencies in low- and middle-income countries (LMICs). However, evidence on how these partnerships function, their effectiveness, and associated challenges remains scattered. This scoping review aims to map existing research on such collaborations to identify strategies, best practices, and gaps.</p><p><strong>Methods: </strong>This scoping review will be conducted using the Arksey and O'Malley methodological framework. A systematic search of electronic databases, including PubMed, Scopus, Web of Science, CINAHL, and relevant grey literature sources, will be performed, covering publications from inception to 2025 without restrictions on language or publication date. The inclusion criteria will focus on studies that explore collaboration strategies, their effectiveness, challenges, and outcomes in the context of health emergencies in LMICs. Two independent reviewers will screen studies, and extract data, with any discrepancies resolved by a third reviewer. The findings will be synthesised narratively, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guideline.</p><p><strong>Discussion: </strong>This scoping review will offer a comprehensive overview of the current literature on collaborations between local health authorities and community leaders during health emergencies in LMICs. The review will identify effective strategies, common challenges, and successful practices, as well as highlight areas where further research is needed. The insights gained from this review will inform policymakers, practitioners, and researchers aiming to strengthen community-based responses to health emergencies. The findings will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences, and discussions with key stakeholders to support improved collaborations and response strategies in LMICs.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"134"},"PeriodicalIF":6.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561226","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":"Health professional's data management practice in Ethiopia: a systematic review and meta-analysis.","authors":"Mequannent Sharew Melaku, Bedilu Geremew, Tesema Zewdu, Zemenu Molla, Rukya Yassin, Agmasie Damtew Walle, Lamrot Yohannes","doi":"10.1186/s13643-025-02851-x","DOIUrl":"10.1186/s13643-025-02851-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A global focus is producing high-quality data for use in decision-making at all levels of the health system. Healthcare professionals' data handling techniques have been the subject of numerous research, yet the findings have been wildly inconsistent in Ethiopia. This inconsistency has not been thoroughly examined, leaving a gap in reliable evidence regarding the overall magnitude of effective data management practices within the healthcare system of Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aimed to determine the pooled magnitude of data management practices amid healthcare professionals in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed a search strategy and conducted a comprehensive search across PubMed, Web of Science, African journals of online, Ethiopian journal of health science, Scopus, Medline, Embase, WHO Global Health Library, Google Scholar, Scopus, HINARI, CINAHL, and the Cochrane Library to identify relevant studies between October 10 and November 10, 2024. The Joanna Briggs Institute quality assessment methodology, which has nine categories, was used to evaluate each study's quality. Microsoft Excel version 2019 and Stata software was used to extract and analyzes the data. We calculated total heterogeneity across studies using the I&lt;sup&gt;2&lt;/sup&gt; statistic and estimated the pooled rate of good data management practices with a fixed-effects model at a 95% confidence interval.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the first phase, 943 publications on data management practices of healthcare professionals were identified from multiple databases between October 10 and November 10, 2024. A total of 221 studies were excluded due to duplication, and an additional 705 studies were removed for being irrelevant to the outcome of interest. An additional 10 articles were excluded due to missing outcome data or unavailable full texts. Ultimately, 7 studies involving a total of 2654 health professionals were included in the meta-analysis. The overall pooled estimate of good data management practice in Ethiopia was 64.4% (95% CI, 52.27-76.47%). The subgroup analysis revealed the highest proportion in Gondar at 73.02% (95% CI, 52.33-93.70%), and the lowest proportion was observed in the Oromia Special Zone, at 53.62% (95% CI, 29.21-78.02%). Similarly, studies conducted before 2019 reported a slightly lower prevalence (63.60%; 95% CI, 44.76-82.45%) compared to those conducted after 2019 (64.91%; 95% CI, 49.13-80.69%). However, the subgroup analysis indicated that these differences were not statistically significant across study years or regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The pooled meta-analysis result revealed that approximately six out of ten healthcare professionals in Ethiopia engage in good data management practices, highlighting a significant improvement in this critical area. Although there were a geographical variations and study year, it was not statistically significant. These result","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"135"},"PeriodicalIF":6.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561227","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 and acceptability of exergaming in people with mild cognitive impairment: protocol for an overview of systematic reviews and network meta-analysis.","authors":"Xi Chen, Dian Jiang, Yifei Chen, Yishu Zhu, Hongting Ning, Hui Feng","doi":"10.1186/s13643-025-02875-3","DOIUrl":"10.1186/s13643-025-02875-3","url":null,"abstract":"<p><strong>Introduction: </strong>Exergaming shows great potential in the intervention of individuals with mild cognitive impairment (MCI). However, further research is needed on the use of exergaming in people with MCI. The current evidence of the use of exergaming in MCI has conflicting results. Which kind of exergaming is the most effective is uncertain. There is no overview of systematic reviews of exergaming in MCI, which makes the quality of the methods used for these systematic reviews unclear. The acceptability of the application of exergaming in people with MCI is uncertain. Therefore, this study will explore the effectiveness and acceptability of exergaming in MCI.</p><p><strong>Methods and analysis: </strong>An overview of systematic reviews will be conducted according to the general principles of systematic reviewing methodology. A network meta-analysis will be conducted to compare the effectiveness of different exergames. A Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist has been completed. We will retrieve systematic reviews or meta-analysis from six databases from inception to January 2025. A list of included randomized controlled trials (RCTs) will be retrieved from eligible systematic reviews. AMSTAR 2 will be used for methodological quality assessment. Methodological quality assessment of the included RCTs will be performed using \"the Version 2 of the Cochrane tool for assessing risk of bias in RCTs\" (RoB 2). We will use the PRISMA statement to report quality evaluation. The certainty of evidence that contributes to network estimation will be assessed through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Effectiveness and acceptability will be measured by standardized mean differences (SMDs) and odds ratios (ORs) with a 95% confidence interval (CI). In this study, we will adhere to established methods for conducting pairwise meta-analyses, followed by a network meta-analysis. Data analysis will be performed using Stata version 14.1.</p><p><strong>Results: </strong>The results of this study will provide a comprehensive synthesis of evidence regarding the effectiveness and acceptability of exergaming in people with mild cognitive impairment.</p><p><strong>Conclusion: </strong>The conclusions of this study will provide evidence-based recommendations to guide the implementation of exergaming interventions for individuals with mild cognitive impairment and provide valuable insights for guidelines and future research in this field.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023421052.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"132"},"PeriodicalIF":6.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554993","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":"Caregiver-involved reminiscence for persons with dementia: a scoping review protocol.","authors":"Xin Min Lim, Esther Yin Hui Chew, George Glass Frederick, Ee-Yuee Chan","doi":"10.1186/s13643-025-02865-5","DOIUrl":"10.1186/s13643-025-02865-5","url":null,"abstract":"<p><strong>Background: </strong>Reminiscence has been shown to improve cognitive functions in persons with dementia and maintain meaningful relationships with their familial caregivers. However, there is a dearth of reviews on caregiver-involved or caregiver-led reminiscence activities.</p><p><strong>Objectives: </strong>This protocol aims to outline the process for a scoping review of the existing literature on caregiver-involved reminiscence for persons with dementia.</p><p><strong>Inclusion criteria: </strong>This review will examine studies involving persons with dementia diagnosed with any form of dementia (i.e. Alzheimer's, vascular dementia, Lewy body, or frontotemporal dementia) and their familial caregivers. It will focus on reminiscence activities involving any recalling and storytelling of past events, sometimes known as \"life story work\", where caregivers may actively or passively participate or facilitate. The context is community care, specifically in a home setting. The review will cover literature including primary research, reviews, meta-analyses, and case reports.</p><p><strong>Methods: </strong>Literature written in English will be searched in major relevant databases which are MEDLINE, Embase, CINAHL and PsycINFO, Cochrane, and Web of Science. Based on the inclusion criteria, the scoping review will include reviews, quantitative primary studies, qualitative primary studies, and mixed-methods studies. Two reviewers will independently select the articles based on the agreed search strategy and inclusion criteria. Data will be extracted by the two reviewers independently using a standardised data extraction tool. Descriptive mapping and descriptive content analysis will be used to analyse and present the results.</p><p><strong>Discussion: </strong>This protocol will outline the scoping review of current literature on caregiver-involved reminiscence for persons with dementia. The scoping review's findings aim to identify the research gaps in this emerging field where reminiscence is not just pertaining to persons with dementia but involved or even led by caregivers. This will thereby provide guidance for future studies on caregiver engagement with persons with dementia in the community and outpatient settings and provide insights into effective caregiver-involved reminiscence activities. Practical challenges include study heterogeneity on specific caregiver involvement.</p><p><strong>Systematic review registration: </strong>https://doi.org/10.17605/OSF.IO/H2ZST .</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"133"},"PeriodicalIF":6.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554992","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":"Efficacy and safety of ketamine and esketamine for preventing opioid-induced cough: a systematic review and meta-analysis of randomized controlled trials.","authors":"Kuo-Chuan Hung, Ting-Sian Yu, Chih-Wei Hsu, Wei-Cheng Liu, Jheng-Yan Wu, Shu-Wei Liao, Chien-Ming Lin, I-Wen Chen","doi":"10.1186/s13643-025-02886-0","DOIUrl":"10.1186/s13643-025-02886-0","url":null,"abstract":"<p><strong>Background: </strong>Opioid-induced cough (OIC) is a common side effect during anesthetic induction. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of ketamine/esketamine in preventing OIC during anesthetic induction.</p><p><strong>Methods: </strong>We systematically searched Medline, Embase, Cochrane Library, and Google Scholar from inception through December 2024 for randomized controlled trials that examined the efficacy of ketamine/esketamine in preventing OIC (Registration: INPLASY2024120102). Studies were included if they: (1) evaluated surgical patients receiving short-acting opioids (e.g., fentanyl) during anesthetic induction; (2) compared ketamine or esketamine against placebo/no treatment; and (3) reported OIC incidence. Studies were assessed using the Cochrane Risk of Bias 2.0 tool. Random-effects meta-analysis was performed using risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). The primary outcome was the overall incidence of OIC within 3 min after opioids administration.</p><p><strong>Results: </strong>Twelve trials involving ketamine (nine trials) and esketamine (three trials) were analyzed. Notably, both agents significantly reduced the overall incidence of OIC compared to placebo (RR: 0.30; 95% CI: 0.22-0.41; p < 0.00001, I² = 61%, moderate certainty). All studies demonstrated low risk of bias across all domains for primary outcome. These agents also demonstrated efficacy against mild cough (RR: 0.41, 95% CI: 0.28-0.59, high certainty) and moderate-to-severe cough (RR: 0.26, 95% CI: 0.18-0.38, moderate certainty). The intervention delayed cough onset by 2.77 s (95% CI: 1.25-4.29, moderate certainty) and showed mild improvement in oxygen saturation (MD: 0.55%, 95% CI: 0.15-0.95, high certainty) without significant effects on heart rate or blood pressure. Subgroup analyses confirmed consistent benefits across adult and pediatric populations, as well as between ketamine and esketamine.</p><p><strong>Conclusions: </strong>Our findings suggest that ketamine and esketamine are effective in reducing OIC during anesthetic induction. However, given the short delay in cough onset and mild improvements in oxygen saturation, the clinical significance of these findings may be limited in routine practice. Their use may be most beneficial in selected patients at risk of OIC-related complications. Further research is warranted to assess their value in high-risk populations and their role in combination prevention strategies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"131"},"PeriodicalIF":6.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544878","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":"A protocol for a systematic review of health consequences of conflict-related sexual violence (2015-2024).","authors":"Anna Julia Kwiatkowska, Solveig Frøiland, Andrea Solnes Miltenburg, Cynthia Khamala Wangamati","doi":"10.1186/s13643-025-02874-4","DOIUrl":"10.1186/s13643-025-02874-4","url":null,"abstract":"<p><strong>Background: </strong>Conflict-related sexual violence (CRSV) is a public health issue affecting thousands of survivors and with long-term consequences; however, it is underreported and difficult to investigate. This systematic review, covering 2015 to 2024, will explore sexual violence in conflict zones, extract and summarize the various reported health outcomes, and address knowledge gaps.</p><p><strong>Methods: </strong>Quantitative, qualitative, and mixed method studies will be included to explore the physical, mental, and social consequences of sexual violence. The WHO definition of sexual violence will guide the review to ensure consistency and alignment with global standards. Search terms will be selected with the assistance of a health information specialist and based on previous research. Only peer-reviewed articles will be included. Two reviewers will independently screen titles and abstracts.. Selected articles will be assessed for quality using the MMAT tool. Covidence will be used to assist in the study selection and data extraction.</p><p><strong>Objective: </strong>The objective of this study is to assess the reported health consequences of CRSV. Key research questions include the following: how sexual violence is defined in the literature; its physical, mental, and social health consequences; how perpetrators and the type of sexual violence are portrayed; and the contextual factors that facilitate or hinder such violence in conflict settings.</p><p><strong>Discussion: </strong>In light of ongoing global conflicts, this review will address the urgent need to understand the health consequences of CRSV. Building on previous work, including Ba and Bhopal (Public Health 1(142):121-35, 2017) and to supplement Rubini et al. (Int J Equity Health 27(22):1-227, 2023), this study integrates quantitative, qualitative, and mixed-method research within a Biopsychosocial Model (Engel, Fam Syst Med 1977:317-31, 1992) framework to provide a holistic perspective on CRSV. Recognizing challenges such as underreporting by the survivors-shaped by stigma, safety concerns, and survivor agency (Mannergren-Selimovic, Peacebuilding 30:1-15, 2018)-this review also considers how perpetrators and experiences are portrayed.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD42024503037).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"130"},"PeriodicalIF":6.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340385","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":"Efficacy and incidence of complications of hemodialysis in the treatment of diabetic nephropathy: a systematic review and meta-analysis.","authors":"Xiaojing Liu, Jingjing Zhou, Conghui Liu, Zhongxin Li","doi":"10.1186/s13643-025-02872-6","DOIUrl":"10.1186/s13643-025-02872-6","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) progresses inexorably to kidney failure; whether initiating hemodialysis earlier than usual confers additional clinical benefit remains uncertain.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the effects of hemodialysis, compared with conventional medical care, on glycemic control, renal function, inflammatory markers, and treatment-related complications in adults with DKD.</p><p><strong>Methods: </strong>We searched eight databases (Chinese Biomedical Database, Wanfang, CNKI, PubMed, EMBASE, ScienceDirect, Cochrane Library and VIP) and conference proceedings from January 2010 to 30 March 2025. Randomized controlled trials comparing hemodialysis plus standard therapy with standard therapy were eligible for inclusion in adult DKD patients. Two reviewers independently screened records extracted data and assessed risk of bias with the Cochrane Handbook 5.3 tool. Mean differences (MD) and 95% confidence intervals (CI) were pooled with random-effects models.</p><p><strong>Results: </strong>Eight studies (645 participants) met the criteria. Compared with controls, hemodialysis significantly reduced parathyroid hormone (MD =  - 37.30, 95% CI - 43.16 to - 31.43; I² = 0%), tumour necrosis factor-α (MD =  - 15.29, 95% CI - 25.05 to - 5.53; I² = 89%), interleukin-4 (MD =  - 20.42, 95% CI - 25.89 to - 14.94; I² = 42%), and interleukin-8 (MD =  - 13.56, 95% CI - 20.85 to - 6.27; I² = 76%). Glycemic indices improved (fasting glucose MD =  - 0.80, 95% CI - 1.59 to - 0.02; HbA₁c MD =  - 0.63, 95% CI - 1.34 to 0.08). Serum creatinine (MD =  - 1.03, 95% CI - 1.69 to - 0.36) and blood urea nitrogen (MD =  - 0.94, 95% CI - 1.49 to - 0.39) also fell, despite high heterogeneity (I² ≥ 99%). Four studies reported complications; pooled analysis showed no significant difference in overall adverse events (risk ratio = 0.91, 95% CI 0.62 to 1.34).</p><p><strong>Limitations: </strong>Evidence is based on small, single-center studies with unclear allocation concealment, substantial heterogeneity for several outcomes, and no assessment of long-term clinical endpoints.</p><p><strong>Conclusion: </strong>In adults with DKD, adjunctive hemodialysis improves biochemical surrogates of renal function, inflammation, and glycemic control without increasing short-term complications. Robust multicentre randomised trials powered for patient-important outcomes are warranted.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"129"},"PeriodicalIF":6.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337019","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}