Systematic Reviews最新文献

{"title":"Geospatial analysis of environmental atmospheric risk factors in neurodegenerative diseases: a systematic review update.","authors":"Mariana Oliveira, André Padrão, Ana Cláudia Teodoro, Alberto Freitas, Hernâni Gonçalves","doi":"10.1186/s13643-024-02637-7","DOIUrl":"10.1186/s13643-024-02637-7","url":null,"abstract":"<p><p>Following up the previously published systematic review on the same topic and realizing that new studies and evidence had emerged on the matter, we conducted an update on the same research terms. With the objective of updating the information relating environmental risk factors on neurodegenerative diseases and the geographic approaches used to address them, we searched PubMed, Web of Science and Scopus for all scientific studies considering the following three domains: neurodegenerative disease, environmental atmospheric factor and geographical analysis, using the same keywords as in the previously published systematic review. From February 2020 to February 2023, 35 papers were included versus 34 in the previous period, with dementia (including Alzheimer's disease) being the most focused disease (60.0%) in this update, opposed to multiple sclerosis on the last review (55.9%). Also, environmental pollutants such as PM_2.5 and NO₂ have gained prominence, being represented in 65.7% and 42.9% of the new studies, opposed to 9.8% and 12.2% in the previous review, compared to environmental factors such as sun exposure (5.7% in the update vs 15.9% in the original). The mostly used geographic approach remained the patient's residence (82.9% in the update vs 21.2% in the original and 62.3% in total), and remote sensing was used in 45.7% of the new studies versus 19.7% in the original review, with 42.0% of studies using it globally, being the second most common approach, usually to compute the environmental variable. This review has been registered in PROSPERO with the number CRD42020196188.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"267"},"PeriodicalIF":6.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508453","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":"Adult day programs and their effects on individuals with dementia and their caregivers (ADAPT-DemCare): a realist synthesis to develop program theories on the how and why.","authors":"Hung Nguyen, Atiqur Rahman, Andrea Ubell, Zahra Goodarzi, Colleen J Maxwell, Saleema Allana, Kaitlyn Tate, Holly Symonds-Brown, Lori Weeks, Sienna Caspar, Jim Mann, Matthias Hoben","doi":"10.1186/s13643-024-02683-1","DOIUrl":"10.1186/s13643-024-02683-1","url":null,"abstract":"<p><strong>Background: </strong>Adult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.</p><p><strong>Methods: </strong>We identified 14 literature reviews (including 329 references published between 1975 and 2021) on adult day programs. From this initial pool of studies, we will include those that focused on day program attendees with dementia or meaningful cognitive impairment, and/or their caregivers, and that report how day program contexts (C) and mechanisms (M) bring about outcomes (O) for attendees and caregivers. We will extract CMO statements (i.e., narratives that explain how and why day programs do or do not bring about certain outcomes for whom and under what circumstances). Using additional focused searches, citation mapping, citation tracking, and discussions with our researcher and expert team members, we will identify additional references. CMO statements will be synthesized, transformed into hypotheses, and linked and visualized to form program theories. Using focus groups and the James Lind Alliance Priority Setting Partnership method, we will discuss and prioritize our CMO statements and refine our program theories with 32 experts (older adults, caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and health system and policy decision makers).</p><p><strong>Discussion: </strong>By identifying essential elements and processes of day programs and related knowledge gaps, this study will generate much-needed knowledge to leverage the full potential of day programs so they can provide appropriate care, preventing premature institutionalization, and unnecessary acute and primary care use. This will ultimately improve the quality of life of persons with dementia and their caregivers, alleviate caregiver burden, and reduce social costs.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024504030.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"265"},"PeriodicalIF":6.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508450","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":"Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: a scoping review.","authors":"Brooke DiPetrillo, Paris B Adkins-Jackson, Ruqaiijah Yearby, Crystal Dixon, Terri D Pigott, Ryan J Petteway, Ana LaBoy, Aliza Petiwala, Margaret Leonard","doi":"10.1186/s13643-024-02679-x","DOIUrl":"10.1186/s13643-024-02679-x","url":null,"abstract":"<p><strong>Background: </strong>As a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles.</p><p><strong>Methods: </strong>This scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups.</p><p><strong>Results: </strong>A total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection.</p><p><strong>Conclusions: </strong>Most interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"266"},"PeriodicalIF":6.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508451","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":"The relationship between implicit motives and physical activity: a scoping review.","authors":"Julian Brummer, Nikkil Sudharsanan, Martin G Köllner","doi":"10.1186/s13643-024-02678-y","DOIUrl":"10.1186/s13643-024-02678-y","url":null,"abstract":"<p><strong>Background: </strong>Interventions that leverage implicit motives - affect-based, non-conscious motivational dispositions - may increase physical activity by making physical activity more pleasurable. However, there is no evidence synthesis of the empirical data linking the major implicit motives (achievement, affiliation, and power motives) and physical activity. We aimed to close this research gap.</p><p><strong>Methods: </strong>Following a systematic literature search in the PsycInfo, PubMed, and Web of Science databases until August 2024, we performed a scoping review. We included German- or English-language publications in peer-reviewed journals or books that followed an observational or intervention study design. Studies had to link ≥ 1 major implicit motive measured via a well-established method to physical activity behavior. We critically appraised the methodological quality of the included studies using an adaptation of the JBI critical appraisal checklist for analytical cross-sectional studies and synthesized the evidence qualitatively.</p><p><strong>Results: </strong>Out of 1047 potentially relevant records, five publications (seven studies, N = 550) were included. All eligible studies were observational (six cross-sectional, one prospective longitudinal). The achievement motive was researched the most. The data indicated a relatively consistent positive association between physical activity and the achievement motive, particularly in athletes and in sports-specific settings. The associations with the affiliation and power motives were more mixed. Most studies were conducted in sports-specific settings. All studies elicited methodological concerns, to varying degrees.</p><p><strong>Conclusions: </strong>The available data indicate a positive association between achievement motive strength and physical activity. However, important limitations, especially the lack of intervention studies and the use of non-gold standard assessment methods, limit the confidence in the findings. More, methodologically sound research is needed to better understand the link between implicit motives and physical activity, especially in the general population.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023392198.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"264"},"PeriodicalIF":6.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475218","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":"Academic partnerships in transforming nursing and midwifery education in Africa: a systematic scoping review protocol.","authors":"Claudine Muraraneza, Donatilla Mukamana, Godfrey Katende, Oliva Bazirete, Liz Wolvaardt","doi":"10.1186/s13643-024-02664-4","DOIUrl":"10.1186/s13643-024-02664-4","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence on academic partnerships in transforming nursing and midwifery education in Africa.</p><p><strong>Methods: </strong>The review will be guided by Arksey and O'Malley's methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collecting, summarizing, and reporting the results. A search will be conducted with the use of the following electronic databases: Cumulative Index to Nursing and Applied Health Literature (CINAHL), PubMed, ScienceDirect, and Google Scholar. Additional gray literature will be searched via the World Health Organization's website to locate relevant policies and guidelines. The search will be limited to work published in English from 2014 to 2023. All located resources will be exported to EndNote X8. All duplicates will be removed during when the abstracts are screened. Two independent reviewers will screen and extract the full text of the selected articles. Thematic analysis will be used to analyze data from this systematic scoping review.</p><p><strong>Discussion: </strong>Mapping the evidence on global partnerships in transforming nursing and midwifery education in Africa will outline the best practices and preferences for sustainable collaboration. The review will also highlight knowledge gaps and limitations that could inform future research projects.</p><p><strong>Systematic review registration: </strong>https://osf.io/h83cy.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"262"},"PeriodicalIF":6.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475300","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":"Risk of cancer development associated with disease-modifying therapies for multiple sclerosis: study protocol for a systematic review and meta-analysis of randomised and non-randomised studies.","authors":"Ferrán Catalá-López, Laura Tejedor-Romero, Jane A Driver, Brian Hutton, Joan Vicent Sánchez-Ortí, Manuel Ridao, Adolfo Alonso-Arroyo, Patricia Correa-Ghisays, Jaume Forés-Martos, Vicent Balanzá-Martínez, Alfonso Valencia, Inmaculada Cobos, Rafael Tabarés-Seisdedos","doi":"10.1186/s13643-024-02677-z","DOIUrl":"10.1186/s13643-024-02677-z","url":null,"abstract":"<p><strong>Background: </strong>The association between cancer and multiple sclerosis has long been investigated. Several studies and reviews have examined the risk of cancer among patients with multiple sclerosis treated with disease-modifying therapies (DMTs) but with conflicting results. This study will aim to investigate the association between DMTs for multiple sclerosis and subsequent cancer risk using research synthesis methods.</p><p><strong>Methods/design: </strong>We designed and registered a study protocol for a systematic review and meta-analysis. We will include randomised and non-randomised trials, prospective or retrospective cohort studies, and case-control studies of treatment with DMTs compared with placebo, no treatment, or another active agent. The primary outcome will be the risk of cancer (all-malignant neoplasms) in association with the exposure of DMTs. Secondary outcomes will include site-specific cancers (e.g. breast cancer). Literature searches will be conducted in multiple electronic databases (from their inception onwards), including the following: PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Two researchers will screen all citations, full-text articles, and abstract data independently. The risk of bias (quality) of individual studies will be appraised using an appropriate tool. If feasible, we will use a two-stage approach to evidence synthesis: (1) Peto's method for meta-analysis of data from randomised trials alone; and (2) Random-effects model for meta-analysis adding data from non-randomised studies. We will calculate odds ratios and their associated 95% confidence intervals. Potential sources of heterogeneity will be explored in additional analyses (e.g. subgroups considering different DMTs individually, mechanism of action, type of control, length of follow-up, mode of treatment).</p><p><strong>Discussion: </strong>This systematic review and meta-analysis of randomised and non-randomised studies will provide an updated synthesis of the risk of cancer associated with DMTs for adult patients with multiple sclerosis. This study will also examine some factors that may explain potential variations across studies. The findings will be published in a peer-reviewed journal.</p><p><strong>Systematic review registration: </strong>Open Science Framework ( https://osf.io/v4sez ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"263"},"PeriodicalIF":6.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475307","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":"Local inconsistency detection using the Kullback-Leibler divergence measure.","authors":"Loukia M Spineli","doi":"10.1186/s13643-024-02680-4","DOIUrl":"https://doi.org/10.1186/s13643-024-02680-4","url":null,"abstract":"<p><strong>Background: </strong>The standard approach to local inconsistency assessment typically relies on testing the conflict between the direct and indirect evidence in selected treatment comparisons. However, statistical tests for inconsistency have low power and are subject to misinterpreting a p-value above the significance threshold as evidence of consistency.</p><p><strong>Methods: </strong>We propose a simple framework to interpret local inconsistency based on the average Kullback-Leibler divergence (KLD) from approximating the direct with the corresponding indirect estimate and vice versa. Our framework uses directly the mean and standard error (or posterior mean and standard deviation) of the direct and indirect estimates obtained from a local inconsistency method to calculate the average KLD measure for selected comparisons. The average KLD values are compared with a semi-objective threshold to judge the inconsistency as acceptably low or material. We exemplify our novel interpretation approach using three networks with multiple treatments and multi-arm studies.</p><p><strong>Results: </strong>Almost all selected comparisons in the networks were not associated with statistically significant inconsistency at a significance level of 5%. The proposed interpretation framework indicated 14%, 66%, and 75% of the selected comparisons with an acceptably low inconsistency in the corresponding networks. Overall, information loss was more notable when approximating the posterior density of the indirect estimates with that of the direct estimates, attributed to indirect estimates being more imprecise.</p><p><strong>Conclusions: </strong>Using the concept of information loss between two distributions alongside a semi-objectively defined threshold helped distinguish target comparisons with acceptably low inconsistency from those with material inconsistency when statistical tests for inconsistency were inconclusive.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"261"},"PeriodicalIF":6.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475305","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":"Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies.","authors":"Silvia Awor, Felix Bongomin, Mark Mohan Kaggwa, Francis Pebalo Pebolo, Jackie Epila, Geoffrey Maxwell Malinga, Christine Oryema, Proscovia Nnamuyomba, Benard Abola, Acaye Ongwech, David Musoke","doi":"10.1186/s13643-024-02662-6","DOIUrl":"10.1186/s13643-024-02662-6","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.</p><p><strong>Methods: </strong>The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords \"liver function\", \"renal function\", \"sickle cell disease\", and \"Africa\" on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2.</p><p><strong>Results: </strong>Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI - 2.99-20.23, I² = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI - 0.16-15.80, I² = 99%, p < 0.01) and alkaline phosphatase (ALP) - 2.54 (95% CI - 64.72 - 59.64, I² = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine - 3.15 (95% CI - 15.02; 8.72, I²=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was - 0.57 (95% CI - 3.49; 2.36, I² = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89-28.68 mL/min/1.73 m², I² = 87%, p < 0.01) compared to controls.</p><p><strong>Conclusion: </strong>People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I²) > 50%, there was substantial variation in the reported articles' results.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022346771.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"260"},"PeriodicalIF":6.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475304","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":"Protocol for a systematic review and meta-analysis of interventions aimed at delabeling low-risk penicillin allergies with consideration for sex and gender.","authors":"Mira Maximos, Sameer Elsayed, Colleen Maxwell, Sherilyn K D Houle, Ryan Pelletier, Brie McConnell, Andrew Pylypiak, John-Michael Gamble","doi":"10.1186/s13643-024-02671-5","DOIUrl":"10.1186/s13643-024-02671-5","url":null,"abstract":"<p><strong>Background: </strong>Approximately, 10% of people report a penicillin allergy; however, more than 90% can safely undergo delabeling after a detailed history, oral challenge, or other investigations such as penicillin skin testing (PST). Although PST is the gold standard, the results can be heterogeneous, and awaiting specialist assessment may take an inordinate amount of time. Therefore, oral provocation challenge has become acceptable for individuals with low-risk penicillin allergy histories. There also appears to be an association with increased prevalence of adverse drug reaction reporting in female individuals, which may translate to penicillin allergy prevalence; however, the evidence has not been assessed through a sex and gender lens. This systematic review will identify and synthesize the findings from studies that report measures of effectiveness and safety of interventions aimed at delabeling penicillin allergies in low-risk individuals. Information related to sex and gender will be extracted, where available, to understand potential differences in allergy reporting and patient outcomes.</p><p><strong>Methods: </strong>The Cochrane Handbook for Systematic Reviews of Interventions and the Centre for Review and Dissemination's Guidance for Undertaking Reviews in Health Care will be used as frameworks for conducting this systematic review. The literature search will be conducted by a medical librarian (B. M. M.) and will consist of a search strategy to identify and retrieve published studies that meet our inclusion criteria. Studies that require penicillin skin testing (PST) as a step prior to other interventions will be excluded. Integrated knowledge translation involving co-design was carried out for this systematic review protocol creation. Data extraction will be conducted at four levels: (1) study level, (2) patient level, (3) intervention level, and (4) outcome level. A narrative descriptive synthesis of results and risk of bias of all included studies will be provided, and, if relevant, a meta-analysis will be performed.</p><p><strong>Discussion: </strong>The dissemination of findings from this knowledge synthesis to various stakeholders is intended to inform on options for evidence-based interventions to aid in delabeling penicillin allergies in individuals with a low risk of experiencing a hypersensitivity reaction. Detailed reporting on the characteristics of delabeling interventions as well as the effectiveness of similar interventions will benefit policy makers considering the implementation of a penicillin allergy delabeling protocol. Additionally, findings from this systematic review will report on the current evidence regarding the role of sex and gender in both the prevalence and outcomes associated with the presence of penicillin allergies.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022336457.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"259"},"PeriodicalIF":6.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475306","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":"Adipose derived or bone-marrow derived mesenchymal stem cell treatment for hyposalivation: protocol for a systematic review and network meta-analysis.","authors":"Joachim Hansen, Amanda-Louise Fenger Carlander, Kathrine Kronberg Jakobsen, Christian Grønhøj, Christian von Buchwald","doi":"10.1186/s13643-024-02674-2","DOIUrl":"10.1186/s13643-024-02674-2","url":null,"abstract":"<p><strong>Background: </strong>Salivary hypofunction leads to debilitating oral symptoms and has major complications for overall quality of life. Two of the most frequent causes of xerostomia are radiotherapy in the head and neck and Sjögren's syndrome. Only symptomatic treatment is available today. An increasing number of both preclinical and clinical studies have suggested that mesenchymal stem cell (MSC) transplantation treatment can increase the salivary flow rate and ameliorate symptoms of xerostomia. However, both adipose-derived and bone marrow-derived MSCs are used, although they differ in important ways. The primary objective of this study is an indirect comparison of the change in the unstimulated salivary flow rate after intervention between patients treated with adipose-derived or bone marrow-derived MSCs.</p><p><strong>Methods: </strong>This systematic review and network meta-analysis will search for eligible studies in the MEDLINE, EMBASE, and Cochrane CENTRAL register of Controlled Trials. Eligible studies are as follows: clinical studies including human patients with salivary hypofunction due to either radiotherapy or Sjogren's syndrome who were subsequently treated with either adipose-derived MSCs or bone marrow-derived MSCs. Studies with no control group will be excluded. The search phrase has been peer-reviewed following the PRESS guidelines. The primary outcome is the change in the unstimulated salivary flow rate after treatment with either adipose-derived or bone marrow-derived MSCs. Secondary outcomes are as follows: change in patient reported outcomes, methods of intervention administration, number of injected MSCs, and safety. Data from included studies will be pooled and compared with a fixed-effects or random effects model dependent on signs of heterogeneity, presented with a forest plot, and indirectly compared with a meta-regression in a network meta-analysis. Risk of bias will be assessed with the tools ROBINS-I or RoB-2 depending on type of study.</p><p><strong>Discussion: </strong>Both adipose-derived and bone marrow-derived MSCs are used today for experimental treatment of salivary hypofunction in humans as no direct or indirect comparisons have been made. Therefore, an evaluation of the effect of adipose-derived vs bone marrow-derived MSC treatment is needed to support future decision-making on the type of MSC used in a clinical trial.</p><p><strong>Systematic review registration: </strong>PROSPERO ID CRD42024527183.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"257"},"PeriodicalIF":6.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475301","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}