Systematic Reviews最新文献

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

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

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

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

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

{"title":"Methods and validity indicators for measuring adherence to statins in secondary cardiovascular prevention: a systematic review.","authors":"Adriana López-Pineda, María Martinez-Muñoz, Rauf Nouni-García, Amanda Esquerdo-Arroyo, Álvaro Carbonell-Soliva, Elizabeth Ramirez-Familia, Mª Isabel Tomás-Rodríguez, Jose A Quesada, Concepción Carratalá-Munuera C, Vicente F Gil-Guillén","doi":"10.1186/s13643-025-02853-9","DOIUrl":"10.1186/s13643-025-02853-9","url":null,"abstract":"<p><strong>Background: </strong>Adherence to statin therapy is crucial for reducing the recurrence of cardiovascular events. Numerous methods exist to measure medication adherence, including those based on prescription data, patient self-report, medication counting, and direct methods. It is important to determine which of these methods are appropriate for use in clinical practice. This systematic review aimed to identify the methods used to measure adherence and persistence to statins in patients undergoing cardiovascular secondary prevention and to evaluate the validity indicators of these methods.</p><p><strong>Methods: </strong>This systematic review included studies reporting methods to measure adherence and/or persistence to statins in cardiovascular secondary prevention. Medline, Embase, and Scopus databases were searched from inception to February 2025. Rayyan was used for the study selection and extraction data processes. Validity indicators of the adherence/persistence methods were collected; it was reported. Risk of bias of studies reporting the method validity was evaluated using the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool.</p><p><strong>Results: </strong>A total of 77 studies were included. Regarding adherence measurement, the most frequently used method was prescription refill records (n = 55) and self-report methods (n = 20). Electronic monitoring methods (n = 2), self-perceived adherence by physician (n = 1), and pill counting (n = 1) were less frequently used methods. Direct methods, using HPLC-MS/MS, were used in combination with other indirect methods (n = 5). For measuring persistence, prescription refill records were the predominant method (n = 9), while self-report methods were used in three studies, and one study used a standardized questionnaire. Several of the indirect methods have validity indicators for measuring adherence in different study populations and to different medications. Only one study provides validity indicators for the MAT questionnaire specifically adapted for statins.</p><p><strong>Conclusions: </strong>The methods for measuring adherence to statins in secondary cardiovascular prevention were predominantly indirect, relying on prescription and supply records and self-report methods. Pill counting, electronic monitoring, and direct measurement via LC-MS/MS were less commonly used. Persistence was primarily measured through prescription refill records. None of the indirect methods was validated; thus, their use for measuring adherence to statins is not recommended. There is a need for new validated tools, incorporating a gender perspective, to measure adherence to statins in this population.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023463981.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"110"},"PeriodicalIF":6.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080427","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":"Revolutionizing cancer diagnosis and dose biodistribution: a meta-analysis of [68ga] FAPI- 46 vs. [18f] FDG imaging.","authors":"Samaneh Abbasi, Mohsen Dehghani, Sara Khademi, Rasoul Irajirad, Zahra Pakdin Parizi, Mahdieh Sahebi, Masoumeh Sadeghi, Alireza Montazerabadi, Meysam Tavakoli","doi":"10.1186/s13643-025-02835-x","DOIUrl":"https://doi.org/10.1186/s13643-025-02835-x","url":null,"abstract":"<p><strong>Background: </strong>Advancements in novel peptides significantly affect cancer diagnosis by targeting cancer-specific markers, thereby improving imaging modalities, such as positron emission tomography combined with computed tomography (PET/CT) for more accurate tumor detection. This systematic review and meta-analysis aimed to assess the diagnostic accuracy of [18F] Fluorodeoxyglucose (FDG) and ⁶⁸Ga-fibroblast activation protein inhibitor (FAPI- 46) PET/CT for early cancer detection.</p><p><strong>Methods: </strong>A comprehensive search was conducted in Scopus, MEDLINE, Web of Science, and Embase databases up to March 28, 2024, using MeSH keywords. Titles and abstracts were screened to identify studies on hybrid [68Ga] FAPI- 46 and [18F] FDG, followed by a detailed full-text evaluation. Only cohort or cross-sectional studies published in English, focusing on the clinical diagnosis of cancer patients, were included, while reviews, case reports, conference proceedings, and abstracts were excluded. Random-effects meta-analysis was used for the estimation of pooled specificity and sensitivity with 95% confidence intervals (CIs). In addition, the heterogeneity was assessed across studies and subgroup meta-analyses for the detection rate via Stata.</p><p><strong>Results: </strong>Among the 615 retrieved studies, nine articles were incorporated in the present systematic review, with five (n = 144 patients) eligible for meta-analysis. For [68Ga] FAPI- 46, the pooled sensitivity and specificity compared with immunohistopathology were 0.96 (95% CI 0.84, 0.99) and 0.92 (95% CI 0.53, 0.99), respectively, with a positive likelihood ratio (LR +) of 4.41 (95% CI 1.64, 11.79) and a negative likelihood ratio (LR -) of 3.07 (95% CI 1.01, 9.37). For [18F] FDG, pooled sensitivity and specificity compared with immunohistopathology were 0.73 (95% CI 0.34, 0.93) and 0.83 (95% CI 0.57, 0.95), with an LR + of 12.73 (95% CI 1.43, 113.45) and an LR - of 0.32 (95% CI 0.11, 0.17). The pooled odds ratio for the detection rate on a per-lesion basis was 1.73 (95% CI 0.99, 3.02) for [68Ga] FAPI- 46 compared with [18F] FDG. The pooled weighted mean differences in the standardized uptake value (SUV_max) for primary tumor uptake and the tumor-to-background ratio (TBR) in [68Ga] FAPI- 46 vs. 18F-FDG were 4.40 (95% CI - 0.7, 9.5) and 6.18 (95% CI 1.74, 10.61), respectively. Moderate to high heterogeneity was noted because of the variations in patient selection, interpretation criteria, and scanning procedures.</p><p><strong>Conclusions: </strong>This study revealed that [68Ga] FAPI- 46 outperforms [18F] FDG in cancer diagnosis, with higher sensitivity (0.96 vs. 0.73) and specificity (0.92 vs. 0.83). [Ga] FAPI- 46 improved tumor detection with higher SUVmax and TBR. While FDG had a higher LR +, its lower LR - highlighted more false negatives. Accordingly, [68Ga] FAPI- 46 exhibited superior accuracy and reliability than FDG in cancer diagnosis.</p><p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"109"},"PeriodicalIF":6.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019737","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 scalp acupuncture and comparison with traditional acupuncture for stroke: an overview of systematic reviews and updated evidence.","authors":"Sun-Young Park, In Heo, Man-Suk Hwang, Eui-Hyoung Hwang, Byung-Cheul Shin","doi":"10.1186/s13643-025-02819-x","DOIUrl":"10.1186/s13643-025-02819-x","url":null,"abstract":"<p><strong>Background: </strong>Stroke recovery is a critical global-health priority; there is growing interest alternative therapies in scalp acupuncture (SA) to overcome the limitations of conventional treatments and improve outcomes. This study provides an overview of systematic reviews to evaluate the evidence on the effectiveness and safety of SA and to compare its therapeutic potential with traditional acupuncture (TA).</p><p><strong>Methods: </strong>A systematic search of 12 databases was conducted to identify systematic reviews and meta-analyses, completed on September 30, 2023, was performed without language restrictions. Selection criteria included adult stroke patients treated with SA, focusing on comparisons of effectiveness and safety in neurological deficits, motor function, disability, and total efficacy rate. Two reviewers independently screened studies and assessed methodological quality using AMSTAR-2, ROBIS, PRISMA-A, and GRADE frameworks. Data were synthesized to compare SA and TA for stroke outcomes, using total searched SA studies and TA data from the Cochrane review, followed by an analysis of high-quality studies to enhance evidence reliability.</p><p><strong>Results: </strong>After overviewing seven systematic reviews, the certainty of evidence supporting the standalone effectiveness and safety of SA remains low owing to methodological shortcomings. However, SA showed a greater effect size in the neurological deficits (-0.96 vs -0.53) in total studies and high-quality studies (-0.92 vs -0.48). Regarding motor function, SA had a higher effect size in total studies (0.94 vs 0.70), but TA outperformed it in high-quality studies (0.39 vs 0.82). Regarding disability outcomes, TA had a slightly larger effect size in total studies (1.27 vs 1.06), whereas SA surpassed it in high-quality studies (1.65 vs. 1.16).</p><p><strong>Conclusions: </strong>This overview highlights the potential of SA as an effective alternative therapy for stroke recovery, with high-quality studies demonstrating its effectiveness in improving neurological deficits and disability outcomes. This work guides clinicians on integrating SA for stroke recovery and offers insights for improving public health rehabilitation strategies. Despite limitations in the overall evidence owing to methodological shortcomings, the positive results from high-quality studies support SA as a possible approach for stroke recovery, underscoring the need for further rigorous research to strengthen its clinical application.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"108"},"PeriodicalIF":6.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015676","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 scoping review of worldwide guidelines for diagnosis and treatment of Helicobacter pylori infection.","authors":"Mingyao Sun, Enyu Liu, Liwen Yang, Huijuan Cao, Mei Han","doi":"10.1186/s13643-025-02816-0","DOIUrl":"10.1186/s13643-025-02816-0","url":null,"abstract":"<p><strong>Background: </strong>This study comprehensively analyzes the diagnostic criteria, eradication indications, treatment, and other information in the latest guidelines published by various countries around the world, so that researchers can have a systematic understanding of Helicobacter pylori and further provide a basis for clinical H. pylori diagnosis and treatment.</p><p><strong>Methods: </strong>Nine online databases were searched to find the latest version of guidelines for H. pylori worldwide. Two researchers read the included guidelines independently and extracted the eradication indications, diagnostic criteria, and treatment in the guidelines, conducting a summary of them.</p><p><strong>Results: </strong>A total of 25 guidelines or consensus were included. Among all diagnostic methods for H. pylori infection, the urea breath test is widely recommended as the first choice. A total of 20 guidelines mentioned indications for H. pylori eradication. Among them, the indications with a higher proportion of recommendations were long-term use of non-steroidal anti-inflammatory drugs (including low-dose aspirin) in 90% of patients with peptic ulcer history or active peptic ulcer disease 80%; gastric mucosa-associated lymphoid tissue (MALT) lymphoma 75%. It is worth mentioning that 40% of the guidelines pointed out that, as long as H. pylori infection is confirmed, it should be eradicated. A total of 24 guidelines mentioned treatment for H. pylori. Among them, bismuth quadruple therapy (a combination of a bismuth, two antibiotics, and a proton pump inhibitor (PPI)) was the most recommended first-line therapy. Levofloxacin triple therapy (a combining of a bismuth, an antibiotic, and a PPI) was the most recommended second-line therapy.</p><p><strong>Conclusion: </strong>Current global Helicobacter pylori management guidelines share foundational consensus, yet exhibit regional variations in diagnostic criteria, eradication indications, and therapeutic regimens due to context-specific epidemiological, socioeconomic, and antimicrobial resistance profiles. Clinical practice should prioritize regionally tailored approaches, integrating local guidelines while maintaining awareness of international recommendations to optimize decision-making. Moreover, health authorities responsible for guideline development must ensure timely updates based on dynamic surveillance of local resistance patterns and socioeconomic realities.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"107"},"PeriodicalIF":6.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018626","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":"Prognostic and clinicopathological impact of systemic inflammation response index (SIRI) on patients with esophageal cancer: a meta-analysis.","authors":"Zhong Wu, Zongxin Zhang, Chao Gu","doi":"10.1186/s13643-025-02847-7","DOIUrl":"https://doi.org/10.1186/s13643-025-02847-7","url":null,"abstract":"<p><strong>Background: </strong>Although the systemic inflammation response index (SIRI) is often associated with prognostic significance in esophageal cancer (EC) patients, the results continue to be conflicting. We focused on identifying SIRI's precise role in forecasting EC prognosis through performing this meta-analysis.</p><p><strong>Methods: </strong>This work searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI till November 16, 2024, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for evaluating EC prognosis forecasting efficiency of SIRI. The inclusion criteria: (1) pathologic confirmation of EC; (2) those reporting associations of SIRI with EC survival outcomes; (3) those reporting HRs and 95% CIs; (4) those with an available cut-off value of SIRI; and (5) no restriction in language. The exclusion criteria: (1) case reports, reviews, meeting abstracts, comments and letters; (2) those enrolling duplicate cases; and (3) animal studies.</p><p><strong>Results: </strong>We enrolled six studies comprising 2176 cases into the present work. Based on our combined findings, elevated SIRI showed significant relation to dismal overall survival (OS) (HR = 1.43, 95%CI = 1.20-1.71, p < 0.001; I² = 48.8%, p = 0.098) and shortened progression-free survival (PFS) (HR = 2.00, 95%CI = 1.35-2.98, p = 0.001; I² = 0, p = 0.409) in EC. Moreover, high SIRI exhibited obvious relation to male gender (OR = 1.86, 95%CI = 1.07-3.22, p = 0.027; I² = 69.4%, p = 0.020), TNM stage of III-IV (OR = 1.52, 95%CI = 1.18-1.94, p = 0.001; I² = 24.3%, p = 0.265), T3-T4 stage (OR = 1.73, 95%CI = 1.12-2.69, p = 0.014; I² = 61.0%, p = 0.053), and lymph node metastasis (OR = 1.29, 95%CI = 1.02-1.64, p = 0.036; I² = 42.7%, p = 0.155). However, SIRI was not markedly related to age, tumor location, tumor differentiation, or smoking history.</p><p><strong>Conclusion: </strong>In summary, high SIRI is significantly related to dismal OS and shortened PFS of EC cases, together with advanced tumor stage, T3-T4 stage, and lymph node metastasis of EC. Due to some limitations, large prospective studies that utilize standardized threshold SIRI should be conducted to validate our results in the future.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"104"},"PeriodicalIF":6.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034853","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}