Systematic Reviews最新文献

{"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}

{"title":"Association of inflammatory fluid biomarkers with the progression of Alzheimer's disease: a protocol for a systematic review and meta-analysis.","authors":"Ji-Woo Seok, Kahye Kim, Jaeuk U Kim, Jin Mi Chun","doi":"10.1186/s13643-026-03252-4","DOIUrl":"https://doi.org/10.1186/s13643-026-03252-4","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is a neurodegenerative disease that typically begins with mild cognitive impairment (MCI) and gradually worsens to mild, moderate, and severe dementia. There is increasing evidence that inflammatory responses in both peripheral and central compartments contribute to the pathophysiology of AD. However, meta-analyses that compare the changes in inflammatory biomarkers according to AD stages remain limited. This study aims to systematically evaluate the differences in inflammatory marker levels according to AD progression stages and to assess their potential utility as stage-specific biological indicators.</p><p><strong>Methods: </strong>This meta-analysis will be conducted according to the PRISMA-P guidelines. PubMed, Embase, Cochrane Library, and MEDLINE will be searched for studies involving elderly people aged 60 years or older with MCI or AD diagnosed through June 30, 2025. According to the PECO framework, the primary comparison will be each AD-related clinical stage, including MCI, mild AD, moderate AD, and severe AD, versus cognitively normal older adults. Secondary analyses will examine between-stage comparisons when sufficient data are available. The primary outcomes will be inflammatory biomarker levels measured in blood-derived samples, including serum and plasma. Cerebrospinal fluid inflammatory biomarkers will be included as predefined secondary outcomes and analyzed separately. Biomarkers of interest include IL-6, CRP, TNF-α, IL-1β, YKL-40, complement C3, C5a, IL-2, IFN-γ, GFAP, sTREM2, ferritin, and related inflammatory markers. Literature selection and data extraction will be performed independently by two reviewers. Statistical analysis will be performed using JASP to calculate the standardized mean differences (SMD) and 95% CI. A heterogeneity test, meta-regression, subgroup analysis, sensitivity analysis, and publication bias test will also be performed.</p><p><strong>Discussion: </strong>This study will systematically evaluate stage-specific changes in inflammatory biomarkers and identify potential response patterns and biological relevance of each marker in relation to AD progression. This review will examine whether some biomarkers follow nonlinear trajectories rather than linear changes, which may help explore their association with pathological mechanisms such as microglial activation and peripheral-central immune axis changes. This meta-analysis may provide foundational data for the development of inflammatory fluid biomarkers for early diagnosis and stage-specific prognosis in AD.</p><p><strong>Systematic review registration: </strong>As this protocol is not eligible for registration in PROSPERO, a preliminary search has been performed to confirm that there are no duplicate systematic reviews.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental moderators of neighbourhood socioeconomic inequalities in mental health: a systematic review protocol.","authors":"Rebecca A Reid, Suzanne Mavoa, Julia Gilmartin-Thomas, Sarah Foster, Jerome N Rachele","doi":"10.1186/s13643-026-03237-3","DOIUrl":"10.1186/s13643-026-03237-3","url":null,"abstract":"<p><strong>Background: </strong>Mental health inequalities exist across levels of neighbourhood socioeconomic disadvantage. Numerous reviews have examined the relationship between neighbourhood social, economic, and physical environmental attributes and mental health. However, reviews investigating whether environmental attributes present an opportunity to reduce neighbourhood socioeconomic inequalities in mental health are scarce. Therefore, the aim of the systematic review proposed in this protocol is to identify potential environmental moderators to neighbourhood socioeconomic inequalities in mental health.</p><p><strong>Methods: </strong>The following electronic databases will be searched: PubMed, Scopus, Web of Science, PsycINFO, CINAHL Complete, GreenFILE and ProQuest. In addition, grey literature will be searched. Quantitative studies will be included if they include community-dwelling adults, with neighbourhood socioeconomic disadvantage as an exposure, mental health as an outcome and an objective measure of an environmental attribute as a potential moderator. Two reviewers will independently determine the eligibility of studies based on the inclusion/exclusion criteria. Data extraction and quality appraisal will be conducted. Data synthesis will be carried out and a meta-analysis will be considered if sufficient studies are available. If a meta-analysis is not feasible a descriptive summary of the study characteristics will be presented.</p><p><strong>Discussion: </strong>Existing research illustrates the diversity of environmental attributes and the potential for them to moderate the association between neighbourhood socioeconomic disadvantage and mental health. Therefore, a synthesis of these studies is needed to inform urban planning policies aimed at reducing mental health inequalities.</p><p><strong>Systematic review registration: </strong>PROSPERO registration number: CRD42024519354.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of health education interventions on breast cancer literacy and breast screening uptake in sub-Saharan Africa: a systematic review protocol.","authors":"Joshua Okyere, Bibha Simkhada, Padam Simkhada","doi":"10.1186/s13643-026-03243-5","DOIUrl":"10.1186/s13643-026-03243-5","url":null,"abstract":"<p><strong>Background: </strong>The extant literature identifies low breast cancer literacy as a major reason for the low uptake of breast cancer screening among women in sub-Saharan Africa (SSA). Recognizing the potential of health education interventions to improve breast cancer literacy, researchers in SSA have implemented varied interventions. However, evidence on the effectiveness of these interventions in SSA is limited and fragmented, with variations in educational strategies, delivery methods, and cultural contexts. A systematic review is needed to synthesize existing evidence, assess the effectiveness of health education interventions in improving breast cancer literacy and screening uptake, and guide the development of culturally appropriate interventions aimed at improving breast cancer outcomes in SSA.</p><p><strong>Objectives: </strong>The aim of the study is to review empirical evidence on the effectiveness of health education interventions on breast cancer literacy and breast screening uptake in SSA. Specifically, the review seeks to identify the methods of delivering breast cancer education in SSA, determine the effectiveness of educational interventions on breast cancer literacy, and assess the effectiveness of educational interventions on breast cancer screening uptake.</p><p><strong>Methods: </strong>This systematic review will include randomized controlled trials and quasi-experimental studies conducted among women aged 15 years and older in sub-Saharan Africa. Studies evaluating health education interventions designed to improve breast cancer literacy, awareness, or screening uptake will be eligible. Searches will be conducted in PubMed, Web of Science, Scopus, CINAHL, PsychInfo, and selected grey literature sources. Two reviewers will independently screen studies, assess eligibility, extract data, and evaluate methodological quality using the Cochrane Risk of Bias Tool (RoB 2) and the Joanna Briggs Institute Critical Appraisal Checklist, as appropriate. Findings will be synthesized narratively and, where sufficient methodological homogeneity exists, pooled using random-effects meta-analysis.</p><p><strong>Discussion: </strong>It is envisioned that this study will provide evidence of the various health education interventions implemented across SSA to improve breast cancer literacy and screening uptake. It is also anticipated that the study will provide a means of comparing the effectiveness of the different interventions to inform policy and intervention scaling funds decisions in SSA.</p><p><strong>Systematic review registration: </strong>The protocol is prospectively registered in Open Science Framework ( https://doi.org/10.17605/OSF.IO/XWKU9 ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332964","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":"Defining interstitial lung disease related to idiopathic inflammatory myopathies: a systematic review protocol of the Myositis Clinical Trial Consortium (MCTC).","authors":"Konstantinos Triantafyllias, Ramiro Gomez, Jisna Paul, Simone Appenzeller, Elena Bartoloni, Alejandro Benitez, Daniel Brito de Araujo, Solciris A Dominguez, Komal Ejaz, Antonis Fanouriakis, Kristin Houghton, Marc Janssen, Chandana Keshavamurthy, Marina Khoury, Shaye Kivity, Océane Landon-Cardinal, Ignacio Lopez, Nikolaos Marketos, Edoardo Marrani, Jan Willem Marsden, Clio Mavragani, Pintip Ngamjanyaporn, Apostolos Perelas, Victor Pimentel-Quiroz, Vasilios Tzilas, Juan David Urriago Gil, Susan Vehar, Gwen Wilson, Erin Wilfong, Charalampia Papadopoulou, Rohit Aggarwal, Robert Hallowell, Vivek Nagaraja, Faye Pais, Elena K Joerns","doi":"10.1186/s13643-026-03230-w","DOIUrl":"10.1186/s13643-026-03230-w","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic inflammatory myopathies (IIM) are systemic autoimmune diseases that include dermatomyositis, polymyositis, antisynthetase syndrome, and immune-mediated necrotizing myopathy in both adult and juvenile populations. Interstitial lung disease (ILD) is a common and serious complication of IIM, with a highly variable clinical course ranging from indolent disease to rapidly progressive respiratory failure, often influenced by underlying myositis-specific autoantibody profiles. Despite the substantial morbidity and mortality associated with IIM-ILD in both adults and children, high-quality evidence to guide clinical management remains limited. A major barrier to progress in this field is the lack of standardized disease nomenclature and uniform diagnostic or classification criteria, which hampers cohort development, limits comparability across studies, and restricts generalizability of findings. To address this gap, we will conduct a systematic review to inform a consensus-based disease definition for adult and juvenile IIM-ILD, with detailed methodology outlined in this protocol. This review will not evaluate prognosis, treatment, or clinical outcomes, but instead focus exclusively on how IIM-ILD is defined and operationalized across studies.</p><p><strong>Methods: </strong>Following PRISMA 2020 statement and Cochrane methodology, we will search PubMed, EMBASE, Scopus, Cochrane Systematic Reviews, and Cochrane Central from inception to June 30, 2025, using a ''Peer Review of Electronic Search Strategies (PRESS)''-validated strategy. Eligible studies will include randomized controlled trials (RCTs), cohort and case-control studies, systematic reviews, meta-analyses, guidelines, and consensus statements explicitly reporting IIM-ILD definitions in human participants of all ages. Study selection will be performed in Covidence using predefined criteria. Data extraction will capture case definitions, classification criteria, diagnostic methods, ILD patterns, autoantibody profiles, and study characteristics. Quantitative synthesis will summarize the frequency and components of definitions where possible; otherwise, a structured narrative synthesis will be performed.</p><p><strong>Discussion: </strong>Our systematic review protocol is the first comprehensive attempt at synthesizing the highly heterogenous disease nomenclature currently employed in adult and juvenile IIM-ILD literature. Findings will map areas of agreement and inconsistency in existing definitions, forming an evidence base for subsequent consensus processes, such as Delphi, to establish standardized nomenclature. Harmonized definitions are expected to improve research reproducibility, facilitate multicentric collaboration, and improve patient stratification in clinical practice and trials.</p><p><strong>Systematic review registration: </strong>PROSPERO ID: 1129967.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340085","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":"Circulating microRNA dysregulation in hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and dilated cardiomyopathy: a systematic review.","authors":"Laurens Léger, Sabina Ferron, Nele S Pauwels, Franne Lingier, Alba Rodriguez-Muñoz, Mora Murri-Pierri, Jolanda van Hengel, Martina Calore","doi":"10.1186/s13643-026-03246-2","DOIUrl":"10.1186/s13643-026-03246-2","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopathy (ACM) and dilated cardiomyopathy (DCM) represent the most frequent structural heart disorders. Due to the complexity of their diagnosis and the frequent occurrence of sudden cardiac death as the first manifestation, these diseases impose a relevant socio-economic burden, highlighting the urgent need for novel disease-specific biomarkers. Here, we assess the potential of microRNAs (miRNAs) as non-invasive predictors for HCM, ACM, and DCM. Electronic databases were systematically searched using relevant keywords pertaining to the disorders and miRNAs. To minimize spurious associations, only studies reporting the area under the curve (AUC) and including healthy controls were taken into account, resulting in the selection of 19 papers for further analyses. miR-29a-3p, miR-185-5p, and miR-454-3p were found overexpressed in HCM, ACM, and DCM, respectively, across different studies. Assessment of the correlation between circulating miRNA levels and cardiac features or genetic background failed to detect consistent profiles among different studies. Thus, further investigations employing consistent approaches and larger cohorts are required to validate the clinical utility of circulating miRNAs as non-invasive biomarkers for these structural cardiomyopathies.Systematic review registration PROSPERO CRD42023330236.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332970","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":"Sexual and reproductive health information needs of young adults with chronic conditions: a scoping review protocol.","authors":"Salima Meherali, Yared Asmare Aynalem, Saba Nisa, Claire Tellier, Megan Kennedy, Lisa Hartling, Shannon Scott, Anam Shahil-Feroz, Ashley Vandermorris, Amanda Steiman, Janani Kassiri, Deborah Levy, Kambiz Norozi, Laura Kirkpatrick, Wendy V Norman, Michael Khoury, Simone Lebeuf","doi":"10.1186/s13643-026-03253-3","DOIUrl":"10.1186/s13643-026-03253-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review aims to identify, map, and synthesize evidence on the sexual and reproductive health (SRH) information needs of youth 15-24 years living with epilepsy, congenital heart disease (CHD), or systemic lupus erythematosus (SLE) in the USA and Canada, and identify barriers and facilitators to access to SRH information and services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Youth and young adults with chronic health conditions face elevated and condition-specific reproductive risks. Among youth with epilepsy, interactions between seizures, antiseizure medications, hormones, and hormonal contraceptives increase the risk of unintended pregnancy. For youth with congenital heart disease, a substantial proportion of pregnancies are associated with cardiac complications, and contraceptive counseling is often delayed or inconsistently delivered. In systemic lupus erythematosus, limited contraceptive options and teratogenic therapies further heighten reproductive risk, with active disease associated with significantly increased risks of preterm birth and pre-eclampsia. Despite these well-documented risks, youth with chronic conditions frequently report unmet SRH information needs related to contraception, medication safety, fertility, and pregnancy planning. Evidence remains fragmented across specialties and largely focused on pregnancy outcomes rather than youth-centered informational needs and access to services. Our preliminary search did not identify a comprehensive scoping review that maps sexual and reproductive health (SRH) information needs, barriers, and facilitators across these three chronic conditions among young people in North America. Given the anticipated heterogeneity in study designs, populations, and outcomes, a scoping review is appropriate for characterizing the breadth and nature of the evidence base.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Inclusion criteria: &lt;/strong&gt;Eligible sources will include empirical studies from the USA and Canada involving youth aged 15-24 years diagnosed with epilepsy, CHD, or SLE. Studies must address SRH information needs and/or barriers and facilitators to accessing SRH information or services. Youth-reported needs will be distinguished from caregiver or provider perspectives, which will be included only when directly relevant to youth experiences. All primary qualitative, quantitative, and mixed-methods designs, as well as empirical grey literature, will be considered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review will follow Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR guidelines. A three-step search strategy will be implemented across MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science, CENTRAL, and targeted grey literature sources from the inception of each database to the final search date. Two reviewers will independently screen records and extract data using a piloted standardized tool. Results will be synthe","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340045","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 critical systematic review of the impact of sedentarism and physical inactivity on the cognitive performance of children.","authors":"Nathália Petraconi, Jéssica Salles Henrique, Fabrízio Dos Santos Cardoso, Flávia Maria Ribeiro Vital, Ricardo Mario Arida, Camila Bertini Martins, Sérgio Gomes da Silva","doi":"10.1186/s13643-026-03172-3","DOIUrl":"10.1186/s13643-026-03172-3","url":null,"abstract":"<p><strong>Objective: </strong>Sedentarism and physical inactivity are growing concerns for global health institutions, especially with the rising number of adolescents failing to meet daily physical activity guidelines. These inactive lifestyles can adversely affect cognitive functions during development. Thus, a systematic review of observational studies was conducted to evaluate the impact of sedentary behavior and physical inactivity on cognitive performance in children aged 6 to 12.</p><p><strong>Methods: </strong>Eligible studies included English-language observational designs (such as cohort and case-control studies), enrolling neurotypical children classified as sedentary, insufficiently active, or physically inactive (experimental group), compared to active children (control group), according to ACSM recommendations. Studies were also required to report outcomes related to executive functions, academic performance metrics, memory, and attention. Systematic searches were conducted in MEDLINE (PubMed), Embase, Cochrane Library, Web of Science, and Scopus, from inception to February 2026. Risk of bias was assessed using the Risk Of Bias In Non-randomised Studies-of Exposure (ROBINS-E) tool. Data were synthesized through a narrative method.</p><p><strong>Results: </strong>Of the 5438 articles initially identified, two studies directly compared inactive and active groups with contrasting results. One showed negative associations between light, moderate physical activity, and total activity time with verbal and perceptual skills in the active group, alongside positive effects of vigorous PA and sedentary behavior on verbal skills. The other pointed positive dose-response effects of sustained moderate-to-vigorous PA trajectories on academic achievement (reading, mathematics, language). However, caution is advised when interpreting these results due to the high risk of bias in both studies, lack of control for confounding variables, and insufficient information on missing data and blinding procedures. While other studies show significant associations between physical activity and cognitive measures, it is crucial to question whether group compositions accurately reflect the cognitive effects of exercise. Given the limited number of articles meeting international physical activity organization criteria, caution is recommended when interpreting the cognitive effects of physical activity-related exposures in children.</p><p><strong>Conclusions: </strong>This review introduces a novel data analysis approach that classified groups based on established physical activity recommendations, aiming to standardize group criteria. This method potentially sparks essential debates on group definitions and contributes to enhancing the methodological quality of future observational or experimental studies, enabling more robust and reliable data interpretation.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333018","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 of probiotics in the management of oral candidiasis: an umbrella review of systematic reviews and meta-analyses.","authors":"Vini Mehta, Cosimo Galletti, Ankita Mathur, Namrata Suresh, Dhruva Nandi, Javier Flores-Fraile","doi":"10.1186/s13643-026-03249-z","DOIUrl":"10.1186/s13643-026-03249-z","url":null,"abstract":"<p><strong>Background: </strong>Oral candidiasis (OC) is among the most prevalent oral infections, frequently associated with immunosuppression, denture wearing, advanced age, and excessive antibiotic use. Given the growing concerns about antifungal resistance, probiotics are being explored as potential adjuncts in the management of oral Candida overgrowth. Existing literature provides fragmented evidence; thus, an umbrella review was planned to synthesize the available evidence on the effectiveness of probiotic interventions in reducing oral Candida spp.</p><p><strong>Count: </strong></p><p><strong>Methods: </strong>A comprehensive, independent search was conducted in four databases (PubMed, Embase, Scopus, and Web of Science) covering literature from inception to 31st January 2026. Systematic reviews (SRs) with or without meta-analyses (MAs) assessing the effectiveness of probiotics in reducing oral Candida spp. count in terms of colony-forming units/mL (CFU/mL) were included. The quality assessment of the evidence was evaluated using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Out of the 157 retrieved records, 7 studies were included in this umbrella review, out of which 5 were SRMAs, and 2 were SRs. The interventions involved multi-strain probiotics delivered through various formulations, routes, and treatment durations. Across the 5 SRMAs, probiotic interventions demonstrated beneficial effects by reducing Candida spp. with effect estimates ranging from odds ratio (OR) 0.06 to 0.71; however, wide interstudy heterogeneity (I² = 0-78%) restricts the reliability and comparability of these findings. These effect estimates were derived from individual meta-analyses with heterogeneous study populations. Methodological assessment of the 7 included studies using the AMSTAR 2 tool identified 3 studies (42.8%) as having low confidence, while 4 studies (57.1%) were rated critically low. Similarly, the overall quality of evidence, as assessed by GRADE, ranged from low for the adult population to very low for the pediatric population, across three key clinical outcomes: reduction in oral Candida spp., clinical cure rate of OC, and recurrence rate.</p><p><strong>Conclusions: </strong>Probiotics may have a potential role in the prevention and treatment of OC; however, the current evidence base cannot be generalized due to significant heterogeneity and methodological constraints. Probiotics can supplement conventional antifungal treatment, but their standalone use is not recommended yet. High-quality, standardized randomized controlled trials and comprehensive SRMAs are necessary to better understand the effectiveness of probiotics in OC management.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420251117392.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318995","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":"Early risk prediction in endometrial cancer using biomarker and machine learning models: a systematic review and meta-analysis protocol.","authors":"Priya Giri, Rakesh Kumar Saroj","doi":"10.1186/s13643-026-03248-0","DOIUrl":"10.1186/s13643-026-03248-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Globally, endometrial cancer (EC) is among the most prevalent gynaecological cancers, with rising incidence driven by demographic and metabolic changes. Accurate early prognostic assessment is essential to guide personalized treatment and improve long-term outcomes. Traditional clinicopathological prognostic methods-including FIGO (International Federation of Gynaecology and Obstetrics) staging, tumor grade, and histological subtype remain the current standard but have limitations in detecting early recurrence risk. In recent years, biomarker-based prognostic signatures and machine-learning (ML) guided risk models, including radiomics and multi-omics approaches, have emerged as promising tools for improving prognostic accuracy. However, no systematic review and meta-analysis have comprehensively evaluated whether these biomarker or ML-based prognostic models offer improved early risk prediction compared with conventional methods in EC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We will undertake a comprehensive search of MEDLINE, Scopus, IEEE Xplore, and Web of Science from 2010 to 2025. Two reviewers will independently perform title/abstract screening, full-text assessment, data extraction, and quality appraisal, with arbitration by a third reviewer where necessary. Studies developing, validating, or evaluating biomarker-based, radiomics-based and ML-guided prognostic models in human EC patients will be eligible for inclusion. Purely laboratory-based biomarker discovery studies that do not develop or evaluate a prognostic model in human participants will be excluded. Outcomes of interest include measures of prognostic performance such as AUC (area under the curve), C-index (concordance index), time-dependent AUC, calibration metrics, hazard ratios for survival outcomes, and decision analytic measures. Risk of bias will be assessed using PROBAST (Prediction model Risk of Bias Assessment Tool) and QUIPS (Quality in Prognosis Studies), and certainty of evidence will be summarized using GRADE (Grading of Recommendations Assessment, Development and Evaluation). When feasible, meta-analysis of performance metrics will be performed using random-effects models with restricted maximum likelihood (REML) estimation, with subgroup analysis restricted to histological subtype when sufficient data permits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This systematic review will synthesize current evidence on the prognostic performance of biomarker and ML-guided prognostic models in EC, comparing them with conventional clinicopathological risk assessment methods. Findings will help clarify whether emerging model types offer meaningful improvements in the early prognostic accuracy, provide insight into methodological limitations of existing models, and identify gaps in evidence requiring future research. This review will support clinicians, researchers, and policymakers seeking to integrate precision-based prognostic tools into EC care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309242","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}