Assessing The Methodological Quality Of Systematic Reviews Research Articles

Effect of acupuncture in eczema: An overview of systematic reviews.

Eczema is a common chronic relapsing inflammatory skin disease, which is characterized by intense itching. Acupuncture can be effective for eczema, and it is thus regarded as a common complementary treatment. The intention of this overview is to methodically appraise and synthesize evidence about systematic reviews/meta-analyses (SRs/MAs) on acupuncture in eczema. We searched for SRs/MAs of acupuncture with eczema in eight databases. We evaluated the methodological quality by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the reporting quality with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 Checkist), and the evidence quality according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. A total of 7 SRs/MAs were included. According to AMSTAR-2, all the SRs/MAs included were categorized as critically low-quality. According to the PRISMA 2020 checklist, none of the reviews completed all the 27 items, thus their compliance was relatively weak. On the base of GRADE system, 2 of the 12 outcomes were rated as moderate, and 5 outcomes were rated as low-quality, while the others were regarded as very low-quality. Compared with the control group, the included reviews of the acupuncture group were more effective and safer; however, the conclusion should be treated cautiously because the quality of evidence was not high enough to support it. In order to improve the quality, more rigorous, standardized, and comprehensive SRs/MAs need designing in the future.

A Systematic Review and Meta-Analysis of Prevalence and Outcomes of Cardiac Metastasis of Neuroendocrine Malignancies

Neuroendocrine tumors (NETs) are a rare group of malignancies which are aggressive and widely metastatic. Cardiac metastases (CMs) are rarely reported because of NET. We aim to analyze the available literature to study the proportional prevalence of CM because of NET and its location and effect on the ejection fraction (EF) and survival rate. Our search strategy and meta-analysis are in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) AMSTAR-2 (Assessing the methodological quality of systematic Reviews-2) Guidelines. A literature search was conducted on MEDLINE (EMBASE and PubMed) for randomized clinical trials, pilot trials, and retrospective and prospective studies. Statistical analysis was performed using the CRAN-R software (https://CRAN.R-project.org/doc/FAQ/R-FAQ.html). The quality assessment of the included articles was performed using the Cochrane Risk of Bias and Newcastle-Ottawa Scale. A total of 16,685 patients were included in the study. The mean age of patients included in the study was 61.28 ± SD 9.89years. Of these, 257 patients had a total of 283 CM. Metastasis was mainly located in the left ventricle with a pooled proportion of 0.48, 95% confidence interval (CI) 0.4 to 0.56, pericardium: 0.34, 95% CI 0.19 to 0.53, right ventricle 0.28, 95% CI 0.16 to 0.44, interventricular septum 0.25, 95% CI 0.16 to 0.37, left atrium 0.1, 95% CI 0.03 to 0.26 and right atrium 0.05, 95% CI 0.01 to 0.20. Decrease in EF at the time of CM diagnosis was the effect most consistently reported in patients with CM. Pooled mean survival was 35.89, 95% CI 8.27 to 155.68 months after the diagnosis of CM. CM due to NET was <2% and the left ventricle is the most common metastatic location, followed by the pericardium. Decreased EF was the most common clinical picture observed. Further studies are needed to analyze the clinical impact of NET CM.

Comparison of Perioperative Outcomes and Complications of Laparoscopic and Robotic Nephroureterectomy Approaches in Patients with Upper-Tract Urothelial Carcinoma.

For medical institutions without robotic equipment, it remains uncertain whether laparoscopic radical nephroureterectomy (LNU) can achieve results similar to those of robotic surgery for the treatment of upper tract urothelial carcinoma (UTUC). This meta-analysis aimed to compare the efficacy and safety of robot-assisted radical nephroureterectomy (RANU) with that of LNU using a large sample size of patients. A systematic meta-analysis was performed using data (available to May 2022) acquired from multiple scientific databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guidelines, according to the protocols registered with PROSPERO (CRD42021264046), were followed to perform this cumulative analysis. Nine high-quality studies were included in this analysis, considering factors such as operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), positive surgical margins (PSM), and complications. Statistical indicators revealed no significant differences between the RANU and LNU groups in terms of OT (weighted mean difference [WMD] 29.41, 95% confidence interval [CI] -1.10 to 59.92; p=0.22), EBL (WMD -55.30, 95% CI -171.14 to 60.54; p=0.13), LOS (WMD -0.39, 95% CI -1.03 to 0.25; p=0.12), PSM (odds ratio [OR] 1.22, 95% CI 0.44-3.36; p=0.17], or complications (OR 0.91, 95% CI 0.49-1.69; p=0.13). The meta-analysis showed that the perioperative and safety indicators of both RANU and LNU were similar and both showed favorable outcomes in UTUC treatment. However, some uncertainties remain in the implementation and selection of lymph nodes for dissection.

Big Data Management Algorithms, Deep Learning-Based Object Detection Technologies, and Geospatial Simulation and Sensor Fusion Tools in the Internet of Robotic Things

The objective of this systematic review was to analyze the recently published literature on the Internet of Robotic Things (IoRT) and integrate the insights it articulates on big data management algorithms, deep learning-based object detection technologies, and geospatial simulation and sensor fusion tools. The research problems were whether computer vision techniques, geospatial data mining, simulation-based digital twins, and real-time monitoring technology optimize remote sensing robots. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were leveraged by a Shiny app to obtain the flow diagram comprising evidence-based collected and managed data (the search results and screening procedures). Throughout January and July 2022, a quantitative literature review of ProQuest, Scopus, and the Web of Science databases was performed, with search terms comprising “Internet of Robotic Things” + “big data management algorithms”, “deep learning-based object detection technologies”, and “geospatial simulation and sensor fusion tools”. As the analyzed research was published between 2017 and 2022, only 379 sources fulfilled the eligibility standards. A total of 105, chiefly empirical, sources have been selected after removing full-text papers that were out of scope, did not have sufficient details, or had limited rigor For screening and quality evaluation so as to attain sound outcomes and correlations, we deployed AMSTAR (Assessing the Methodological Quality of Systematic Reviews), AXIS (Appraisal tool for Cross-Sectional Studies), MMAT (Mixed Methods Appraisal Tool), and ROBIS (to assess bias risk in systematic reviews). Dimensions was leveraged as regards initial bibliometric mapping (data visualization) and VOSviewer was harnessed in terms of layout algorithms.

Effectiveness of manual lymphatic drainage for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses

There are several studies on the treatment of breast cancer-related lymphedema (BCRL) based on the manual lymphatic drainage (MLD) technique, making it a widely accepted conservative treatment for BCRL. In this study, PubMed, Embase and Cochrane Library databases were searched for systematic reviews (SRs) or meta-analyses (MAs) from inception till 28 March 2022. The methodological quality of the included SRs/MAs was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the evidence quality of outcome measures using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Grading of Recommendations, Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) was used to describe the certainty of evidence from qualitative data. The study results identified 7 eligible SRs/MAs. Evaluation using AMSTAR-2 revealed only one moderate quality study, while the others were rated as low or critically low. The GRADE criteria identified 3 very-low-quality evidence studies, 1 low-quality evidence study, and 9 moderate-quality evidence studies. The GRADE-CERQual assessment showed the confidence for decision-making was either low or moderate. Overall, the results indicated that MLD could significantly reduce lymphedema in patients aged &lt;60 years (standard mean difference (SMD): −1.77, 95% confidence interval (CI): (−2.23 to −1.31)), and the optimal intervention duration was 1 month. Although MLD for BCRL might reduce lymphoedema volume, their effects were not well established, and therefore, we could not recommend the addition of MLD to complete decongestive therapy (CDT) or compression therapy for patients with BCRL. Thus, MLD treatment appeared to be an ambiguous but potentially effective BCRL treatment. Rigorously designed high-quality randomized controlled trials with larger sample sizes are needed to further verify the effectiveness of MLD therapy in BCRL treatment.

Quality of the Evidence Supporting the Role of Acupuncture Interventions for Vascular Dementia.

Inflammation is an important pathogenesis of vascular dementia (VaD), and the regulatory effect of acupuncture on neuroinflammation has received extensive attention. There is conflicting evidence regarding the efficacy and safety of acupuncture for postpartum VaD. This overview aims to systematically evaluate systematic reviews/meta-analyses (SRs/MAs) of acupuncture on VaD. From the establishment of the electronic database to August 2022, search and identify SRs/MAs on acupuncture treatment for VaD. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were used to evaluate the methodological, reporting, and evidence quality of the included SRs/MAs. Twelve SRs/MAs were included in this research, and the quality of methodological, reporting, and evidence for these SRs/MAs were not satisfactory. The shortcomings of these SRs/MAs mainly include lack of protocol registration, incomplete literature search, missing list of excluded literature, and high risk of bias of included original clinical trials. VaD patients may benefit from acupuncture therapy. However, the high risk of bias in original clinical trials and the low quality of SRs/MAs make evidence-based decisions less reliable.

Artificial intelligence-based decision-making algorithms, Internet of Things sensing networks, and sustainable cyber-physical management systems in big data-driven cognitive manufacturing

Research background: With increasing evidence of cognitive technologies progressively integrating themselves at all levels of the manufacturing enterprises, there is an instrumental need for comprehending how cognitive manufacturing systems can provide increased value and precision in complex operational processes. Purpose of the article: In this research, prior findings were cumulated proving that cognitive manufacturing integrates artificial intelligence-based decision-making algorithms, real-time big data analytics, sustainable industrial value creation, and digitized mass production. Methods: Throughout April and June 2022, by employing Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a quantitative literature review of ProQuest, Scopus, and the Web of Science databases was performed, with search terms including ?cognitive Industrial Internet of Things?, ?cognitive automation?, ?cognitive manufacturing systems?, ?cognitively-enhanced machine?, ?cognitive technology-driven automation?, ?cognitive computing technologies,? and ?cognitive technologies.? The Systematic Review Data Repository (SRDR) was leveraged, a software program for the collecting, processing, and analysis of data for our research. The quality of the selected scholarly sources was evaluated by harnessing the Mixed Method Appraisal Tool (MMAT). AMSTAR (Assessing the Methodological Quality of Systematic Reviews) deployed artificial intelligence and intelligent workflows, and Dedoose was used for mixed methods research. VOSviewer layout algorithms and Dimensions bibliometric mapping served as data visualization tools. Findings &amp; value added: Cognitive manufacturing systems is developed on sustainable product lifecycle management, Internet of Things-based real-time production logistics, and deep learning-assisted smart process planning, optimizing value creation capabilities and artificial intelligence-based decision-making algorithms. Subsequent interest should be oriented to how predictive maintenance can assist in cognitive manufacturing by use of artificial intelligence-based decision-making algorithms, real-time big data analytics, sustainable industrial value creation, and digitized mass production.

Remote Big Data Management Tools, Sensing and Computing Technologies, and Visual Perception and Environment Mapping Algorithms in the Internet of Robotic Things

The purpose of our systematic review was to inspect the recently published research on Internet of Robotic Things (IoRT) and harmonize the assimilations it articulates on remote big data management tools, sensing and computing technologies, and visual perception and environment mapping algorithms. The research problems were whether robotic manufacturing processes and industrial wireless sensor networks shape IoRT and lead to improved product quality by use of remote big data management tools, whether IoRT devices communicate autonomously regarding event modeling and forecasting by leveraging machine learning and clustering algorithms, sensing and computing technologies, and image processing tools, and whether smart connected objects, situational awareness algorithms, and edge computing technologies configure IoRT systems and cloud robotics in relation to distributed task coordination through visual perception and environment mapping algorithms. A Shiny app was harnessed for Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to configure the flow diagram integrating evidence-based gathered and processed data (the search outcomes and screening procedures). A quantitative literature review of ProQuest, Scopus, and the Web of Science databases was carried out throughout June and October 2022, with search terms including “Internet of Robotic Things” + “remote big data management tools”, “sensing and computing technologies”, and “visual perception and environment mapping algorithms”. Artificial intelligence and intelligent workflows by use of AMSTAR (Assessing the Methodological Quality of Systematic Reviews), Dedoose, DistillerSR, and SRDR (Systematic Review Data Repository) have been deployed as data extraction tools for literature collection, screening, and evaluation, for document flow monitoring, for inspecting qualitative and mixed methods research, and for establishing robust outcomes and correlations. For bibliometric mapping by use of data visualization, Dimensions AI was leveraged and with regards to layout algorithms, VOSviewer was harnessed.

Effectiveness and safety of acupuncture for children with cerebral palsy: An overview of systematic reviews

: Evidence on the effectiveness and safety of acupuncture for cerebral palsy (CP) is inconsistent, and methodological quality has not been comprehensively assessed in systematic reviews (SRs) or meta-analyses (MAs). This overview aims to integrate the evidence from SRs, summarize the safety issues, and comprehensively assess the methodological quality. : 11 databases were searched for SRs/MAs. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used to evaluate the methodological quality of the included SRs. The quality of the reporting was determined according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses of acupuncture (PRISMA-A). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to assess the quality of evidence for the primary outcomes. Risk of Bias in Systematic Reviews (ROBIS) evaluated the risk of bias of included SRs. Network meta-analysis(NMA) for comparing the relative effectiveness of different acupuncture treatments for CP. : 9 SRs/MAs included 107 randomized controlled trials (RCTs) with 9744 patients. Evidence suggests that acupuncture can increase the total effective rate and improve motor function, independence, and activities of daily living without serious adverse events. NMA indicated that needle acupuncture showed a slight statistical difference in improving the overall effectiveness of CP. : Evidence from SRs and NMA suggests that acupuncture for CP is promising and safe. Needle acupuncture is expected to be the best treatment for CP; however, the clinical differences may not be significant. The low methodological quality and the slight overlap of SRs limit the conclusions of this overview. 1 1 1. AMSTAR-2: Assessing the Methodological Quality of Systematic Reviews 2 2. PRISMA-A: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses of acupuncture 3. GRADE: Grading of Recommendations Assessment, Development, and Evaluation 4. ROBIS: Risk of Bias in Systematic Reviews 5. CP: Cerebral palsy 6. SRs: Systematic reviews 7. MAs: Meta-analysis 8. SCPE: The Surveillance of Cerebral Palsy in Europe 9. RCTs: Randomized controlled trials 10. EBM: Evidence-based medicine 11. GMFM: Gross Motor Function Scale 12. MAS: Modified Ashworth Scale 13. ADL: Activities of Daily Living Scale 14. CFADC: Comprehensive Function Assessment for Disabled Children 15. NMA: Network meta-analysis 16. CCA: Corrected covered area 17. IF: Inconsistency factors 18. SMD: Standardized Mean Difference 19. WMD: Weighted Mean Difference 20: OR: Odds ratio 21. RR: Relative risk 22. CI: 95% credible intervals

Treatment of Acute Achilles Tendon Ruptures: A Systematic Review of Overlapping Meta-Analyses

Category: Ankle Introduction/Purpose: Acute Achilles tendon rupture (AATR) is a common injury of an incidence rate of up to 31 per 100,000 per year. The current meta-analyses on the treatment of AATR have conflicted data that may, in part, be due to the differences in their methodologies. The aim of this study is to systematically review and present the current meta-analyses for the treatment of AATR. The outcomes of this study can provide clinicians with a clear overview of the current literature to help decide on the optimal treatment for patients. Methods: Two independent reviewers searched PubMed and Embase on March 17, 2020 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Assessment of evidence was two-fold: level of evidence (LoE) and quality of evidence (QoE). LoE was evaluated using published criteria by The Journal of Bone and Joint Surgery and the QoE by the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scale. Pooled complication rates were highlighted for significance in favor of 1 group or no significance. Statistical analysis was performed using a statistical software package (R version 3.5.1; R Foundation for Statistical Computing, Vienna, Austria). Descriptive statistics were calculated for each study and statistical parameters analyzed. Continuous variables were reported as mean +- standard deviation and categorical variables were reported as frequencies with percentages. P-values &lt; 0.05 was considered statistically significant. Results: 21 meta-analyses were included in the study. Re-rupture rates ranged between 2.3% to 5.0% for open repair/MIS and 3.9% to 13% for conservative treatment (p &lt; 0.05). Re-rupture rates were reported in 3 of 4 meta-analyses that ranged between 2.3% to 7.8% for conservative treatment earlier rehabilitation and 5.0% to 12.2% for conservative treatment later rehabilitation. Re-rupture rates were 2.5% for open repair earlier rehabilitation and 3.8% for open repair later rehabilitation. When comparing surgical techniques, re-rupture rates ranged between 1.4% to 3.1% for percutaneous repair/MIS and 2.2% to 2.7% for open repair. Infection rates ranged between 2.8% to 5.0% for open repair/MIS and 0% to 0.02% for conservative treatment. The majority of meta-analyses (3 of 5) significantly favored by effect size, open repair/MIS for total infection rates (p &lt; 0.05). Conclusion: The results of this study demonstrate that operative repair reduced the rate of re-rupture when compared to conservative treatment. There is currently conflicting information on whether early functional rehabilitation reduces the difference between the two treatments. Operative treatment has been shown to have a higher rate of wound complications, although the rates of deep wound infections remains to be determined. Percutaneous repair resulted in similar re-rupture rates when compared to open surgery but for the rates of other complications including wound infections, this was diminished. Further meta- analyses which compare all cohorts are needed to ascertain best evidence.

Smartphone addiction risk, technology-related behaviors and attitudes, and psychological well-being during the COVID-19 pandemic.

COVID-19 pandemic-related perceived risk of infection, illness fears, acute stress, emotional anxiety, exhaustion, and fatigue, psychological trauma and depressive symptoms, and sustained psychological distress can cause smartphone addiction risk and lead to technology-related cognitive, emotional, and behavioral disorders, thus impacting psychological well-being. Behavioral addiction of smartphone users can result in anxiety symptom severity, psychiatric symptoms, and depressive stress. We carried out a quantitative literature review of the Web of Science, Scopus, and ProQuest throughout June 2022, with search terms including “smartphone addiction + COVID-19” + “stress,” “anxiety,” “depression,” “psychological distress,” “screen time,” and “fear.” As we analyzed only articles published between 2020 and 2022, 288 papers met the eligibility criteria. By excluding sources with similar titles, having unclear findings or unsupported by replication, or displaying inconsistent content, we selected 64, mainly empirical, sources. We used layout algorithms (VOSviewer) and bibliometric mapping (Dimensions) as data visualization tools. Assessing the Methodological Quality of Systematic Reviews (AMSTAR), a systematic review and literature review software (Distiller SR), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed as methodological quality assessment tools. As limitations, we analyzed only articles published between 2020 and 2022 in scholarly outlets indexed in the Web of Science, Scopus, and ProQuest databases. The scope of our study also does not advance the inspection of sources covering vulnerable individuals suffering from certain diseases or specific generations. Subsequent analyses should develop on smartphone use and addiction among children and adolescents. Future research should thus investigate problematic smartphone use and addiction across generations Z and Alpha. Attention should be directed to their personality traits and psychopathological symptoms.

Systematic evaluation and re-evaluation of buyang huanwu decoction in treating ischemic stroke

BackgroundThe Buyang Huanwu Decoction (BYHWD) originated from Wang Qingren’s “Yi Lin Gai Cuo”. It has the effect of tonifying qi and activating blood circulation and dredging collaterals which is recommended for the treatment of Ischemic stroke in China. In recent years, there have been many systematic reviews of Ischemic stroke treated by BYHWD assessing the efficacy of BYHWD in the treatment of Ischemic stroke in the acute, convalescent and sequelae stages. Because of the different methods of analysis, the quality and quality of the evidence obtained in these systematic reviews is different, so a systematic re-evaluation was needed to comprehensively evaluate the strength of these studies. MethodsSystematic reviews and meta-analyses of Ischemic stroke treated by BYHWD were identified through the Web of Science, PubMed, CNKI, Weipu, and Wanfang databases. The included studies were selected for literature screening, methodological quality evaluation, and evidence level evaluation by two investigators. The methodological quality was evaluated by the 2020 PRISMA guidelines, Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scale, and the evidence quality was evaluated by the GRADE criteria. ResultsOverall, 12 studies involving 28,594 patients between 2006–2021 were included in this analysis. The methodological quality evaluation based on 2020 PRISMA guidelines results showed that there were many weaknesses in registration and protocol, support, competing interests, competing interests and availability of data, code and other materials. The AMSTAR scale evaluation results showed that the 12 studies were very low quality. The results of the GRADE criteria evaluation showed that the quality of the evidence was scattered, with mainly low-quality evidence. ConclusionThe methodological quality of systematic reviews and meta-analyses of BYHWD in treating Ischemic stroke was generally poor, and the quality of evidence was generally low.

Common traditional Chinese medicine therapies for diarrhea-predominant irritable bowel syndrome: An overview of systematic reviews

To critically evaluate and summarize the methodological quality of systematic reviews (SRs) and present objective and important outcomes on the effectiveness of traditional Chinese medicine (TCM) therapies, including Chinese herbal medicine (CHM), acupuncture, and moxibustion, for diarrhea-predominant irritable bowel syndrome (IBS-D). We conducted a comprehensive literature search for SRs in 7 databases until April 16, 2022. Two reviewers independently extracted data and assessed the methodological quality of the reviews according to the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to rate the quality of evidence. IBS-D patients included in 12 reviews were diagnosed in accordance with the Rome criteria, 9 reviews focused on CHM, 2 articles observed moxibustion and heat-sensitive moxibustion, 1 article studied acupuncture and CHM. The outcomes of the SRs were the effectiveness rate, the total effectiveness rate, global symptom improvement, and adverse effects. Based on AMSTAR-2, which measures the quality of methodology, all of the included studies were of low or critically low quality. According to the ROBIS tool, 10 SRs (83.33%) had a high risk of bias. With the PRISMA checklist, only 3 SRs reached over 90% compliance. Based on GRADE, most evidence was of low quality, and there was a moderate quality of evidence that the effectiveness rate of modified-Tongxie Yaofang was superior to Western medicine in the treatment of IBS-D. Given the suboptimal reporting and methodological quality of existing SRs, more studies are needed to clarify whether TCM therapies are more effective or safe than pharmacological medicine. Future studies should combine evidence-based medicine with TCM research according to the characteristics of TCM.

Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta-analysis.

Interventions for heavy menstrual bleeding; overview of Cochrane reviews and network meta-analysis.

An Overview of Systematic Reviews on the Effectiveness of Wenxin Keli in the Treatment of Atrial Fibrillation.

Background Atrial fibrillation is one of the most common cardiac arrhythmias. Wenxin Keli (WXKL) is a Chinese herbal extract widely used in China to treat patients with atrial fibrillation. This study aimed to outline and summarize the current evidence of systematic reviews (SRs)/meta-analyses (MAs) investigating the clinical efficacy of WXKL in atrial fibrillation. Methods From inception to December 2021, 6 electronic databases in English and Chinese were searched for potential SRs/MAs. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist, and AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews-2) were used to evaluate the quality of the evidence, reporting, and methodology of SRs/MAs regarding WXKL for the treatment of atrial fibrillation. Results A total of 8 SRs/MAs were included in the present study. The results of AMSTAR-2 and PRISMA were unsatisfactory for the main insufficiency founded in registration and protocol, search strategy, excluded study statement, evidence certainty assessment, and funding and conflict of interest information. All the included SRs/MAs were assessed as very low in methodological quality. Moreover, 23 outcomes were evaluated by GRADE for the certainty of evidence, and 2 outcomes were assessed as moderate, while 15 were low and 6 were very low. Risk of bias and publication bias contributed to the downgrading. Conclusion WXKL may be clinically efficacious and safe for the treatment of atrial fibrillation. This finding, however, should be regarded with caution because of the low level of evidence and methodological qualities of the involved SRs/MAs. More standardized, rigorous, and comprehensive SRs/MAs and randomized control trials are needed to provide strong evidence to reach more convincing conclusions.

Effectiveness of moist dressings in wound healing after surgical suturing: A Bayesian network meta-analysis of randomised controlled trials.

The moist healing theory proves that a moderately moist and airtight environment is conducive to wound healing. However, different moist dressings have different functions. We aim to evaluate the effects of moist dressings on wound healing after surgical suturing and identify superior moist dressings. Randomised controlled trials investigating the application of moist dressings were retrieved from electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library. Wound healing, surgical site infection (SSI), and times of dressing change were assessed. The values of the surface under the cumulative ranking (SUCRA) curve were calculated based on the Bayesian network meta-analysis. Inconsistency tests and funnel plots were applied to analyse the consistency and publication bias. All the analysis complies with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 Checklist and AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines. Sixteen randomised controlled trials involving 4444 patients were pooled in the network meta-analysis. The ionic silver dressing (SUCRA, 93%) ranked first in wound healing, the metallic silver dressing (SUCRA, 75.9%) ranked first in SSI, and the hydrocolloid dressing (SUCRA, 73.9%) ranked first in times of dressing change. Inconsistency was only observed in wound healing, and no publication bias was observed in this study. The effects of moist dressings are better than gauze dressings in the process of wound healing. The ionic silver dressing is effective in wound healing, whereas the metallic silver dressing is effective in SSI prevention. The hydrocolloid dressing requires the fewest times of dressing change. More high-quality RCTs are required to support the network meta-analysis.

The effectiveness of virtual reality for rehabilitation of Parkinson disease: an overview of systematic reviews with meta-analyses

BackgroundAn increasing number of systematic reviews (SRs) and meta-analyses (MAs) of clinical trials have begun to investigate the effects of virtual reality (VR) in patients with Parkinson disease (PD). The aim of this overview was to systematically summarize the current best evidence for the effectiveness of VR therapy for the rehabilitation of people with PD.MethodsWe searched SR-MAs based on randomized controlled trials (RCTs) for relevant literature in PubMed, Embase, and Cochrane library databases for systematic reviews from inception to December 5, 2020, and updated to January 26, 2022. The methodological quality of included SR-MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the certainty of evidence for outcomes with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We created an evidence map using a bubble plot format to represent the evidence base in 5 dimensions: effect size of VR therapy versus active intervention (AT), clinical outcome area, number of trials, statistical significance, and certainty of evidence.ResultsFrom a total of 585 reports, 12 reviews were identified, of which only one was rated moderate quality, three were rated low quality, and eight were rated critically low quality by AMSTAR 2. Compared with AT, VR therapy induced increased benefits on stride/step length, balance, and neuropsychiatric symptoms. Compared with passive intervention (PT), VR therapy had greater effects on gait speed, stride/step length, balance, activities of daily living, and postural control in people with PD. Certainty of evidence varied from very low to moderate.ConclusionsWe found the methodological quality of the reviews was poor, and certainty of the most evidence within them was low to very low. We were therefore unable to conclude with any confidence that, in people with PD, VR therapy is harmful or beneficial for gait, balance, motor function, quality of life, activities of daily living, cognitive function, neuropsychiatric symptoms, and postural control. In the future, rigorous-designed, high-quality RCTs with larger sample sizes are needed to further verify the effectiveness of VR therapy in the treatment of PD.

Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review.

Background Tai chi (TC) has received increased attention in stroke rehabilitation, yet services are greatly underutilized. An increasing number of systematic reviews and meta-analyses (SRs/MAs) have begun to investigate the effects of TC on balance function in stroke patients. The aim of this current study was to systematically collate, appraise, and synthesize the results of these SRs/MAs using a systematic overview. Methods Eight databases were searched: PubMed, Cochrane Library, Embase, Web of Science, CNKI, SinoMed, Chongqing VIP, and Wanfang Data. SRs/MAs of TC on balance function in stroke patients were included. Literature selection, data extraction, and assessment of the review quality were performed by two independent reviewers. Methodological quality was assessed by the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), reporting quality by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and evidence quality by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Nine SRs/MAs were included in this study. For methodological quality, what resulted in unsatisfactory methodological quality was noncompliance with critical item 4 (using a comprehensive literature search strategy) and critical item 7 (providing the list of excluded research literature). For reporting quality, what resulted in unsatisfactory reporting quality was inadequate reporting of Q1 (protocol and registration), Q8 (search), Q15 (risk of bias across studies), Q16 (additional analyses), Q22 (risk of bias across studies), Q23 (additional analysis), and Q27 (funding). For GRADE, the evidence quality was high in 0, moderate in 3, low in 11, and very low in 6. Risk of bias was the most common factor leading to downgrading of evidence, followed by inconsistency, imprecision, publication bias, and indirectness. Conclusions TC may have beneficial effects on balance function in stroke survivors; however, this finding is limited by the generally low methodology, reporting quality, and evidence quality for published SRs/MAs.

The Synthetic Scaffolds for Ventral Hernia Repair: Perspectives for Regenerative Surgery—Systematic Review

AbstractVentral hernia (VH) frequently affects patients after abdominal surgery. The use of a mesh is often recommended. Different materials are described, from synthetic non-resorbable meshes to biological meshes. New generation meshes, also named scaffolds, aim to combine the advantages of both materials. The aim of this review is to provide an overview of the cytological, histological, biomechanical, and clinical outcomes of the use of the newest resorbable synthetic scaffolds in VH repair, based on experimental studies in a pre-clinical setting. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guidelines. Only experimental studies were included. Outcome parameters were building technique, in vitro cytocompatibility, in vivo histocompatibility, biomechanical analysis, and clinical outcomes. The articles included were nine. The total number of cases treated was 257. Materials analyzed included electrospun silk fibroin (SF)/poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) hybrid scaffolds, biodegradable polyester poly-ε-caprolactone (PCL) in the form of nanofibers, biodegradable mesh in poly-4-hydroxybutyrate (P4HB), nanofibrous polylactic acid (PLA) scaffold with a polypropylene (PP) material to generate a sandwich-like mesh, the collagen sponge (CS) group, the hybrid scaffold (HS) containing CS and poly-L-lactide (PLLA), and the hybrid scaffold (HS) + bone marrow (HSBM). Resorbable synthetic scaffolds are new, safe, surgical materials for the treatment or prevention of ventral hernia in animal models. Scaffolds should be tested in a contaminated surgical field for emergency use. Rigorous schematic indications for data collection are needed to improve the quality of the data in order to definitively clarify the pathway involved in inflammatory induced response.

Effectiveness of feeding supplementation in preterm infants: an overview of systematic reviews

BackgroundPreterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review was to comprehensively describe the effectiveness of feeding supplementation in promoting health outcomes of preterm infants.MethodsA literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SRs selection followed clear inclusion and exclusion criteria. Pairs of reviewers independently applied the criteria to both titles/abstracts and full texts. Screening and data extraction were performed by using the advanced tables. The methodological quality of SRs and the quality of the evidence were carried out according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool and the Grades of Recommendation, Assessment, Development, and Evaluation guidelines (GRADE) respectively. A qualitative synthesis of evidence is presented.ResultsSeventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. In preterm infants, the effectiveness of feeding supplementation in addition to regular breast-feeding was mainly shown in six aspects: physical health, neurodevelopment, biochemical outcomes, other health outcomes, morbidity and all-cause mortality. And the effectiveness of the interventions on health outcomes in preterm infants was found by most systematic reviews. The methodological quality of all the included SRs was high, and most of the evidences was of low or very low quality.ConclusionsOur results will allow a better understanding of the feeding supplementation in preterm infants. Although the feeling supplements may improve the health outcomes of in preterm infants, the existing evidence is uncertain. Therefore, the clinical use of these supplements should be considered cautiously and more well-designed RCTs are still needed to further address the unsolved problems of the included SRs.