Systematic Reviews最新文献

{"title":"Dual orexin receptor antagonists for preventing delirium in hospitalized older adults: protocol for a randomized-trial systematic review and meta-analysis.","authors":"Shilang He, Jiamin Zeng, Yuehong Zhang, Xiangcai Ruan","doi":"10.1186/s13643-026-03262-2","DOIUrl":"10.1186/s13643-026-03262-2","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common, serious, and potentially preventable neuropsychiatric syndrome among hospitalized older adults. It is characterized by acute disturbance in attention and awareness with additional cognitive disturbance and a fluctuating course. Dual orexin receptor antagonists (DORAs), including suvorexant, lemborexant, and daridorexant, promote sleep by antagonizing orexin-mediated wakefulness rather than by direct gamma-aminobutyric acid-ergic sedation. Whether DORAs prevent delirium in hospitalized older adults remains uncertain, and prior syntheses have not fully resolved the applicability of this evidence to older inpatients.</p><p><strong>Methods: </strong>We will conduct a randomized trial systematic review and meta-analysis, if feasible, evaluating DORAs for delirium prevention in hospitalized adults aged 65 years or older. We will search MEDLINE via PubMed, Embase via Ovid, the Cochrane Central Register of Controlled Trials via the Cochrane Library, Web of Science Core Collection, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from inception to the planned final search date, without language or date restrictions. Eligible interventions will include suvorexant, lemborexant, or daridorexant administered before delirium onset. Eligible comparators will include placebo, usual care, no prophylaxis, or clinically interpretable active comparators. The primary outcome will be incident delirium during hospitalization. Secondary outcomes will include delirium severity, duration, subtype, time to onset, sleep-related outcomes, length of stay, mortality, discharge destination, treatment discontinuation, and adverse events. Two reviewers will independently screen records, extract data, assess risk of bias using RoB 2, and judge applicability for the primary quantitative synthesis. Meta-analysis will be performed only when at least two studies are clinically and methodologically sufficiently similar. We will use random-effects models, prespecified sparse-data methods, exploratory trial sequential analysis only if feasible, and GRADE to assess certainty of evidence.</p><p><strong>Discussion: </strong>This protocol addresses a focused clinical question while explicitly separating formal review inclusion from eligibility for the primary quantitative synthesis. This distinction is intended to prevent clinically indirect evidence, including mixed-age data, post-delirium treatment, unbalanced combination regimens, or unvalidated delirium ascertainment, from being interpreted as practice-changing evidence for prevention in hospitalized older adults.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420251087526.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430727","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":"Do robot-assisted percutaneous vascular interventions improve effectiveness and safety compared with manual procedures: protocol for a systematic review and meta-analysis.","authors":"Xiaotian Wu, Shuaiwei Guo, Xiao Zhang, Zixuan Xing, Linsen Zhang, Shengyan Cui, Xiangyu Li, Yixin Sun, Jichang Luo, Xinjie Lin, Liqun Jiao, Shiqi Liu, Tao Wang","doi":"10.1186/s13643-026-03261-3","DOIUrl":"10.1186/s13643-026-03261-3","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted percutaneous vascular interventions have emerged as a promising technology across cardiovascular, neurovascular, and peripheral vascular procedures. Although robotic systems may offer advantages such as enhanced precision and reduced radiation exposure, their clinical effectiveness and safety compared with conventional manual techniques remain uncertain, and the current level of procedural autonomy has not been systematically evaluated. This study seeks to provide direct and practical clinical evidence for clinicians.</p><p><strong>Methods and analysis: </strong>In this protocol, Preferred Reporting Items for systematic review and meta-analysis Protocols were followed. A comprehensive search will be conducted in PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials from inception to January 31, 2026. Inclusion criteria encompass randomized controlled trials and observational studies (both comparative and single-arm) evaluating robot-assisted interventions across cardiovascular, neurovascular, and peripheral vascular territories in adult populations. The primary outcomes are clinical success rates and major adverse cardiovascular/cerebrovascular events (MACE) rates. Secondary outcomes include technical success rates, procedural efficiency metrics, and radiation exposures. Comparative studies will be used for the primary effectiveness analyses, whereas single-arm studies will be analyzed separately as descriptive and supportive evidence. We will assess the quality of evidence, heterogeneity, and reporting bias following the recommendations of the Cochrane Handbook for systematic reviews of interventions.</p><p><strong>Discussion: </strong>This systematic review will synthesize high-quality evidence on the comparative efficacy and safety of robot-assisted versus manual vascular interventions, with territory-specific analyses as the primary analytical framework. Any pan-vascular pooled estimate will be considered secondary or exploratory and interpreted in the context of cardiovascular, neurovascular, and peripheral vascular-specific findings. By clarifying the true clinical value of endovascular robotics across multiple territories, our findings will directly inform clinical decision-making, optimize procedural strategies, and guide future technological innovation.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420251231572.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424233","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":"Correction: Practical methods for incorporating summary time-to-event data into meta-analysis: updated guidance.","authors":"Jayne F Tierney, Sarah Burdett, David J Fisher","doi":"10.1186/s13643-026-03241-7","DOIUrl":"10.1186/s13643-026-03241-7","url":null,"abstract":"","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"15 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424257","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":"Grading the evidence for CPET variables in predicting perioperative morbidity and long-term mortality in lung cancer surgery: a systematic review and meta-analysis.","authors":"Yaoshan Dun, Jialin Yu, Yang Gao, Randal J Thomas, Ray W Squires, Thomas P Olson, Wenliang Zhang, Shaoping Wu, Yang Du, Suixin Liu","doi":"10.1186/s13643-026-03258-y","DOIUrl":"10.1186/s13643-026-03258-y","url":null,"abstract":"<p><strong>Objective: </strong>Current cardiopulmonary exercise testing (CPET) guidelines for lung cancer surgery rely on expert consensus and scientific statements, lacking robust, graded evidence. This study aimed to provide an evidence-based evaluation of CPET variables for assessing perioperative morbidity and long-term mortality risks.</p><p><strong>Methods: </strong>Electronic databases were searched through December 20, 2025, for cohort studies on CPET variables and lung cancer surgery. Quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the Q-test and I² statistic, with fixed or random effects models. Publication bias was assessed via funnel plots and Egger's test, with adjustment using the trim-and-fill method when necessary. Effect sizes were pooled, and evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Of 3080 studies, 47 studies involving 11,356 surgeries and 13 CPET variables were included. Meta-analysis and GRADE assessment showed lower peak oxygen uptake (peak <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂) increased the risk of perioperative complications by 2.04-3.02 times (P < 0.001), using a cutoff point of 15 mL/kg/min or peak <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂ expressed as %pred. A higher minute ventilation to carbon dioxide production ( <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> E/ <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> CO₂) slope was associated with a 2.44-fold increased risk (95% CI [1.82-3.27], P < 0.001), with a cutoff point of 35 (high-level). Limited studies suggest peak <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂ (L/min) and <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> E/ <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> CO₂ slope relate to cancer-specific and all-cause mortality. Evidence for variables such as <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂ at anaerobic threshold and peak ventilation remains low.</p><p><strong>Conclusion: </strong>Among 13 CPET variables, only peak <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> O₂ (15 mL/kg/min or %pred values) and <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> E/ <math><mover><mi>V</mi> <mo>˙</mo></mover> </math> CO₂ slope (35) are supported by high-certainty evidence for perioperative risk. Further studies are needed to establish CPET's role in predicting cancer-specific mortality in lung cancer surgery.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023405083.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424298","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":"Compliance with existing standards: overview comparing Cochrane with non-Cochrane living systematic reviews.","authors":"Melanie M Golob, Andrea Leinberger-Jabari, Brenna Tilka Loufek, Jonathan Livingstone-Banks, Nia W Roberts, David Nunan","doi":"10.1186/s13643-026-03209-7","DOIUrl":"10.1186/s13643-026-03209-7","url":null,"abstract":"<p><strong>Background: </strong>Living systematic reviews (LSRs) have been published with increasing frequency since the start of the COVID-19 pandemic, but there has been little formal evaluation of their methodological consistency and compliance with best-practice standards. The objective of this overview was to evaluate the extent and nature of current LSRs in health research, as well as the degree to which they acknowledge and adhere to existing methodological standards.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, PROSPERO, Scopus, Epistemonikos, and TRIPdatabase from inception to 24 June 2022. We ran a restricted update search for LSRs published 1 January 2025 to 9 January 2026 to see if conclusions would be similar. We extracted data in duplicate. The primary outcome was the number and proportion of LSRs that conform to existing living standards: criteria and guidance for their need and conduct as published by Cochrane. Secondary outcomes assessed reliability and other reporting aspects. Outcomes were assessed according to explicit author reporting for each review.</p><p><strong>Results: </strong>Final analysis included all 23 Cochrane LSRs at the time and a randomly selected 23 non-Cochrane LSRs (among a total of 113). Ten (43%) Cochrane LSRs clearly met the three need criteria for living mode. None of the non-Cochrane LSRs met all three criteria. Cochrane LSRs were also more likely than non-Cochrane LSRs to adhere to Cochrane methodological guidance for the conduct of LSRs, with six (26%) of 23 Cochrane reviews meeting all guidance items. None of the non-Cochrane reviews met all guidance items. In the restricted update (10 LSRs included: five Cochrane and five non-Cochrane), Cochrane LSRs were still more likely to adhere to the three need criteria (four of five, 80%) and five methodological guidance items (three of five, 60%) compared to non-Cochrane LSRs (one of five, or 20% for criteria and guidance adherence). Ten (22%) of all 46 included LSRs were cited by clinical practice guidelines, according to PubMed.</p><p><strong>Conclusions: </strong>This overview highlights a lack of methodological consistency among LSRs, potentially stemming from a lack of awareness of Cochrane's LSR standards. One criterion to become living is that the topic is a priority for decision-making; however, there is little evidence that LSRs are cited frequently in clinical practice guidelines. Establishing clear, objective LSR standards would help to support both Cochrane and non-Cochrane authors and improve evidence-based health care.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022332327.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424270","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":"Scoping review of physical activity and sedentary behavior in Brazilian national surveys: a protocol study.","authors":"Rafael Martins da Costa, Camilo Luis Monteiro Lourenço, Shara da Silva Costa, Enry Eduardo de Souza Figueiredo, Sabrina Souza Barros, Daniel Umpierre","doi":"10.1186/s13643-026-03245-3","DOIUrl":"10.1186/s13643-026-03245-3","url":null,"abstract":"<p><strong>Background: </strong>This study presents a scoping review protocol aimed at analyzing the methodological and structural characteristics of studies on physical activity (PA) and sedentary behavior (SB) that use the databases of the Brazilian National Health Survey (PNS), the Brazilian National School Health Survey (PeNSE), and the Brazilian Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). PA, associated with multisectoral health benefits, and SB, linked to deleterious effects, have been widely investigated as part of public policies in Brazil. However, the absence of a centralized repository limits the efficiency of using these data, resulting in redundant publications with limited impact.</p><p><strong>Methods: </strong>The review will be conducted according to the guidelines and checklists of the Joanna Briggs Institute and PRISMA-ScR, covering studies of any population, operating with broad definitions of PA and SB. In addition, it will seek to identify methodological discrepancies and promote the integration of evidence in an open-access online platform. The sources include four scientific databases (LILACS, PubMed, Scopus, and Web of Science).</p><p><strong>Discussion: </strong>This protocol emphasizes the relevance of open science, aligning with UNESCO recommendations to increase transparency and scientific collaboration. The results are expected to guide evidence-based policies and strengthen public health practices. The study is a strategic response to the fragmentation of the literature, proposing to consolidate existing data, optimize its reuse, and foster interdisciplinarity in the field of public health.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412932","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":"Promoting equity for children and adolescents through implementation processes in health and social care: a scoping review.","authors":"Michelle Gooey, Heather Morris, Rebecca Madill, Callie Walsh-Bailey, Ahlia Griffiths, Melissa Savaglio, Claire Blewitt, Amanda O'Connor, Sara Holton, Helia Khalesi, Sofia Grage-Moore, Maria Fernandez, Echezona E Ezeanolue, Allison Metz, Ana Baumann, Helen Skouteris","doi":"10.1186/s13643-026-03176-z","DOIUrl":"10.1186/s13643-026-03176-z","url":null,"abstract":"<p><strong>Background: </strong>Despite the many existing implementation methods, theories, and frameworks, implementation science is insufficiently closing the research-to-practice gap. Bridging this gap is critical to achieving healthy and thriving communities globally, and requires implementation processes that promote equity and reach diverse populations, especially those most in need. The aim of this scoping review was to identify, thematically analyse, categorise, and provide examples of implementation processes described in equity-focused literature, with a focus on health and social care interventions for children and adolescents from birth to 18 years of age.</p><p><strong>Methods: </strong>A comprehensive search of literature was undertaken across six electronic databases (Medline, Embase, Cinahl, Scopus, PsycInfo, and Proquest) and Google Scholar, seeking peer-reviewed articles published in English between January 2018 and April 2024. All articles were double-screened at abstract and full text stage. Implementation processes were identified then thematically analysed.</p><p><strong>Results: </strong>A total of 14,374 articles were screened; 80 articles (59 health, 21 social care) were included in the analysis. Seven main themes were identified: (1) foster trusting relationships; (2) dismantle top-down approaches and redistribute power; (3) invest with intention; (4) respect and value community-defined evidence; (5) tailor according to context; (6) broaden perspectives beyond practice norms; and (7) use strengths- and value-based approaches. Twenty-six sub-themes and 140 implementation processes were identified, including examples of how these can be operationalised in practice.</p><p><strong>Conclusion: </strong>This is the first review of equity-focused implementation processes in health and social care. By offering practical examples of the identified implementation processes, the review synthesises findings from published literature into tangible actions directly relevant to implementation practice. However, while these processes show promise, further research is required as their effectiveness remains largely untested and most evidence is from high-income countries. To promote health and social care equity for all children and adolescents, the evidence-base for effective equitable implementation work must be strengthened by, and reflective of, globally diverse voices and experiences.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412912","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":"Epigenetic biomarkers and the progression of Barrett's oesophagus to oesophageal adenocarcinoma: a systematic review protocol.","authors":"David N Johnston, Helen G Coleman, Amy Jayne McKnight, Richard C Turkington","doi":"10.1186/s13643-026-03256-0","DOIUrl":"10.1186/s13643-026-03256-0","url":null,"abstract":"<p><strong>Background: </strong>Oesophageal adenocarcinoma (OAC) is often diagnosed at a late stage and has a poor survival rate. Barrett's oesophagus (BO) is a precursor to OAC, and progression occurs in a stepwise fashion, although the annual risk of progression is relatively low. The incidence of both BO and OAC have been increasing in the Western world. At present, guidelines advise that patients with BO should undergo regular endoscopic surveillance with biopsies, with the degree of dysplasia on biopsy being used to guide further management. However, there are potential disadvantages of this surveillance approach. For example, it is invasive and expensive, and there is interobserver variability between pathologists in the assessment of dysplasia. There is an urgent clinical need for new approaches to identify which patients with BO are at high risk of progression. Biomarkers could potentially be used to risk-stratify patients with BO. Epigenetic changes can occur early in the neoplastic progression of BO, making them attractive for use as potential biomarkers.</p><p><strong>Methods: </strong>A systematic review will be performed to investigate whether epigenetic biomarkers, including DNA methylation, histone modification, and non-coding RNAs, can predict the risk of progression of patients with BO to high-grade dysplasia or OAC. The electronic databases Ovid MEDLINE, Embase, and Web of Science Core Collection will be searched for terms relating to biomarkers, methylation, epigenetics, BO, and OAC. Observational (case-control, retrospective cohort, and prospective cohort) studies and interventional studies will be eligible for inclusion. Studies will be screened independently by two reviewers, and relevant data will be extracted from eligible studies. The risk of bias will be assessed for each study. Random effects meta-analyses will be carried out if possible, otherwise a synthesis without meta-analysis will be performed.</p><p><strong>Discussion: </strong>This systematic review aims to assess whether epigenetic biomarkers can predict progression of BO to OAC. This is an important clinical question, with national gastroenterology societies advising that risk stratification biomarkers could significantly improve the care of patients with BO.</p><p><strong>Systematic review registration: </strong>This systematic review protocol has been registered in PROSPERO (international prospective register of systematic reviews), with registration number CRD42024509643.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405951","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":"Prevalence of Epstein-Barr virus infection in North African cancer patients: a systematic review and meta-analysis protocol.","authors":"Yosra Souiden, Imen Ayouni, Sarra Mestiri, Sihem Hmissa, Nabiha Missaoui","doi":"10.1186/s13643-026-03257-z","DOIUrl":"10.1186/s13643-026-03257-z","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus (EBV) is a well-recognized oncogenic virus associated with the development of various malignancies. In North Africa, EBV-related cancers, such as nasopharyngeal carcinoma, gastric cancer, and lymphomas, present a significant health challenge due to their high mortality rates. Despite the common occurrence of these malignancies, the prevalence and impact of EBV infection in this context remain largely unexamined. Addressing this knowledge gap is crucial for understanding the virus's role in cancer pathogenesis and for informing effective prevention and treatment strategies.</p><p><strong>Methods: </strong>Electronic databases will be searched for literature published up to 2025 using a Boolean search approach combining common terms and Medical Subject Headings (MeSH) for EBV infection, cancer, and North Africa. The review will only include studies carried out in North Africa that assess the prevalence of EBV infection in patients with cancer. Using the Joanna Briggs Institute (JBI) critical appraisal tools, the quality and potential risk of bias of all selected full-text articles will be evaluated.</p><p><strong>Discussion: </strong>This protocol outlines a systematic review and meta-analysis aiming to evaluate the prevalence of EBV infection in cancer patients in North Africa to better understand its role in the region's cancer burden. Insights from this study will support improved prevention, early detection, and more personalized treatment strategies, ultimately aiding the reduction of cancer mortality in the region.</p><p><strong>Systematic review registration: </strong>This protocol has been published in the PROSPERO International Prospective Register of Systematic Reviews ( http://www.crd.york.ac.uk/PROSPERO ), under the registration number CRD42024594373.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412885","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":"Outcomes in offspring of interventions to treat substance use in pregnancy: protocol for an umbrella review.","authors":"Joshuan J Barboza, Oriana Rivera-Lozada, Cesar Bonilla-Asalde, Danis Castillo-Esquivel, Nancy Calzada-Gonzales, Felipe Montecino-Rojas, Oscar Jorge-Zapata, Mahycol Bravo-Ramirez","doi":"10.1186/s13643-026-03239-1","DOIUrl":"10.1186/s13643-026-03239-1","url":null,"abstract":"<p><strong>Background: </strong>Substance use during pregnancy is linked to adverse neonatal and longer-term outcomes in offspring, yet evidence syntheses have primarily focused on maternal outcomes. An umbrella review is needed to consolidate and critically appraise findings from systematic reviews on how interventions to treat substance use in pregnancy affect outcomes in offspring of pregnant women and pregnant individuals.</p><p><strong>Methods: </strong>We will conduct an umbrella review of systematic reviews (with or without meta-analysis) that include quantitative primary studies of pregnant women and pregnant individuals with substance use who receive pharmacological, psychosocial/behavioural, integrated care, or community-based interventions. Searches will cover MEDLINE (PubMed), Embase, Web of Science, Scopus, the Cochrane Database of Systematic Reviews and Epistemonikos from inception. Two independent reviewers will perform title/abstract screening, full-text screening, and data extraction at every stage; a third reviewer will arbitrate disagreements. Methodological quality of included systematic reviews will be assessed using AMSTAR 2; risk of bias of primary studies will be reported as appraised in the original systematic reviews. Overlap of primary studies will be quantified using the Corrected Covered Area (CCA), with attention to multi-arm studies and to whether overlapping primary studies actually answer the same PICO question. We will narratively synthesise findings (avoiding vote counting) and, where systematic reviews report pooled estimates, we will summarise these without conducting de novo meta-analyses of primary studies. Certainty of evidence will be reported using existing GRADE assessments, complemented by a structured umbrella-level appraisal that incorporates large effects and dose-response gradients when relevant.</p><p><strong>Discussion: </strong>This umbrella review will clarify which interventions have the strongest evidence of benefit (or harm) for neonatal, congenital, neurodevelopmental, and behavioural/mental health outcomes in offspring, identify evidence gaps and methodological limitations, and inform clinical guidance and maternal-child health policy.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420261321678.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368998","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}