Controlled Vocabulary Terms Research Articles

Effects Of Resistance Training On Body Composition In Obese Youth: Systematic Review And Meta-analysis

BACKGROUND: Resistance training may serve as an alternative intervention modality to address body composition in children and adolescents with overweight/obesity (OWOB). Several studies have been conducted to date, yet it is unclear what the overall impact of resistance training (RT) interventions is on measures of body composition (BC) in this population. PURPOSE: The purpose of this meta-analysis was to examine the effects of RT-exclusive interventions, compared to alternative exercise modalities (e.g., aerobic exercise, combined exercise) on BC in youth with OWOB. METHODS: In September 2021, Web of Science, EMBASE, Ebscohost, PubMed/Medline, OVID, and Science Direct were systematically searched using keyword and controlled vocabulary terms to identify studies examining RT in OWOB pediatric populations (≤18 yrs). Markers of BC (e.g., % body fat, lean body mass, waist circumference) were extracted from full-text articles meeting a priori inclusion/exclusion criteria. Fixed effects difference in means and 95% confidence intervals (95CI) were calculated. RESULTS: 2229 titles/abstracts were screened by two independent reviewers from 3307 records, resulting in 17 RT studies in the final sample. Percent body fat (%BF) decreased by 2.02% (95%CI = 1.70, 2.34) for RT, 2.455% (95CI = 2.100, 2.810) with aerobic training (AT), and 1.893% (95CI = 1.529, 2.258) with combined training (CT). Skeletal muscle mass increased by 0.822 kg (95%CI = 0.702, 0.943) with RT and 1.122 kg (95CI = 0.938, 1.306) with CT, but did not significantly increase with AT (0.289 kg, 95CI = 0.255, 0.833). Waist circumference decreased by 1.578 cm (95CI = 1.191, 1.965) with RT, 3.186 cm (95CI = 2.798, 3.574) with AT, and 1.630 cm (95CI = 1.240, 2.019) with CT. CONCLUSIONS: This meta-analysis provides insight into the effectiveness of RT-exclusive interventions on BC of children and adolescents with OWOB. RT, when performed exclusively and when combined with AT, has a positive effect on BC in children and adolescents with OWOB and should be furthered examined to evaluate its feasibility characteristics and metabolic risk factors.

Direct Oral Anticoagulants Versus Vitamin K Antagonists in Cerebral Venous Thrombosis: A Systematic Review and Meta-Analysis.

High level evidence for direct oral anticoagulants (DOACs) in patients with cerebral venous thrombosis is lacking. We performed a systematic review and meta-analysis to assess the efficacy and safety of DOACs versus vitamin K antagonists in patients with cerebral venous thrombosis. This systematic review was registered in PROSPERO (CRD42021228800). We searched MEDLINE (via Ovid), EMBASE, CINAHL, and the Web of Science Core Collection between January 1, 2007 and Feb 22, 2022. Search terms included a combination of keywords and controlled vocabulary terms for cerebral venous thrombosis, vitamin K antagonists/warfarin, and DOACs. We included both randomized and nonrandomized studies that compared vitamin K antagonists and DOACs in 5 or more patients with cerebral venous thrombosis. Where studies were sufficiently similar, we performed meta-analyses for efficacy (recurrent venous thromboembolism and complete recanalization) and safety (major hemorrhage) outcomes, using relative risks (RRs). Out of 10 665 records identified, we screened 254 as potentially eligible. Nineteen studies (16 observational studies [n=1735] and 3 randomized controlled trials [n=215]) met the inclusion criteria. All 3 randomized controlled trials had some concerns, and all 16 observational studies had at least moderate risk of bias. When compared with vitamin K antagonist treatment, DOAC had comparable risks of recurrent venous thromboembolism (relative risk [RR], 0.85 [95% CI, 0.52-1.37], I2=0%), major hemorrhage (RR, 0.70 [95% CI, 0.40-1.21], I2=0%), intracranial hemorrhage (RR, 0.58 [95% CI, 0.30-1.12]; I2=0%), death (RR, 1.14 [95% CI, 0.54-2.43], I2=1%), and complete venous recanalization (RR, 0.98 [95% CI, 0.87-1.11]; I2=0%). This systematic review and meta-analysis suggest that in patients with cerebral venous thrombosis, DOACs, and warfarin may have comparable efficacy and safety. Given the limitations of the studies included (low number of randomized controlled trials, modest total sample size, rare outcome events), our findings should be interpreted with caution pending confirmation by ongoing randomized controlled trials and large, prospective, observational studies.

Drug repurposing: a systematic review on root causes, barriers and facilitators

BackgroundRepurposing is a drug development strategy receiving heightened attention after the Food and Drug Administration granted emergency use authorization of several repurposed drugs to treat Covid-19. There remain knowledge gaps on the root causes, facilitators and barriers for repurposing.MethodThis systematic review used controlled vocabulary and free text terms to search ABI/Informa, Academic Search Premier, Business Source Complete, Cochrane Library, EconLit, Google Scholar, Ovid Embase, Ovid Medline, Pubmed, Scopus, and Web of Science Core Collection databases for the characteristics, reasons and example of companies deprioritizing development of promising drugs and barriers, facilitators and examples of successful re-purposing.ResultsWe identified 11,814 articles, screened 5,976 for relevance, found 437 eligible for full text review, 115 of which were included in full analysis. Most articles (66%, 76/115) discussed why promising drugs are abandoned, with lack of efficacy or superiority to other therapies (n = 59), strategic business reasons (n = 35), safety problems (n = 28), research design decisions (n = 12), the complex nature of a studied disease or drug (n = 7) and regulatory bodies requiring more information (n = 2) among top reasons. Key barriers to repurposing include inadequate resources (n = 42), trial data access and transparency around abandoned compounds (n = 20) and expertise (n = 11). Additional barriers include uncertainty about the value of repurposing (n = 13), liability risks (n = 5) and intellectual property (IP) challenges (n = 26). Facilitators include the ability to form multi-partner collaborations (n = 38), access to compound databases and database screening tools (n = 32), regulatory modifications (n = 5) and tax incentives (n = 2).ConclusionPromising drugs are commonly shelved due to insufficient efficacy or superiority to alternate therapies, poor market prospects, and industry consolidation. Inadequate resources and data access and challenges negotiating IP are key barriers to repurposing reaching its full potential as a core approach in drug development. Multi-partner collaborations and the availability and use of compound databases and tax incentives are key facilitators for repurposing. More research is needed on the current value of repurposing in drug development and how to better facilitate resources to support it, where valuable, especially financial, staffing for out-licensing shelved products, and legal expertise to negotiate IP agreements in multi-partner collaborations.Trial registrationThe protocol was registered on Open Science Framework (https://osf.io/f634k/) as it was not eligible for registration on PROSPERO as the review did not focus on a health-related outcome.

One Concept, One Term, Good Practice but How to Achieve? —Improving Facet Values Quality for Samuel Proctor Oral History Collection, Hosted by the University of Florida Digital Collections

Faceted search, also known as dynamic taxonomies, is a popular feature applied to digital collection sites. Appearing as clickable labels, facets facilitate search result refinement and content browsing. To achieve the utmost efficiency, faceted search requires each facet value to represent a single concept–that is, one controlled vocabulary term represents one concept. However, in reality, this status is hard to achieve. An example of this can be seen in the digital collection of Samuel Proctor Oral History Program, a high-profile international resource hosted by the University of Florida Digital Collections. The Topical Subject and Genre terms appear with many vocabulary control issues: the same concept is often expressed with different terms; the same term appears with different spelling variations; and/or outdated terms mingle with more up-to-date ones. Additionally, compound terms that represent multiple concepts prohibit the grouping of content that share individual concepts. In short, a great deal of improvement will be needed to optimize the faceted search. To address these issues, the Digital Support Services department of the George A. Smathers Libraries at the University of Florida launched a pilot metadata remediation project using an out-of-box product – Oxygen XML Editor. This article, in addition to providing one more metadata remediation case study, traces the discussions around metadata quality and analyses the general metadata remediation process. Moreover, this article enriches the discussion of vocabulary control in relation to a core function of digital collection sites–faceted search.

Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries: A scoping review.

Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; yet, research contributions from these regions remain negligible or absent. We undertook a scoping review to describe barriers and facilitators for the conduct of critical care research. We searched MEDLINE and EMBASE up to December 2021 using a strategy that combined keyword and controlled vocabulary terms. We included original studies that reported on barriers or facilitators to the conduct of critical care research in these settings. Two reviewers independently reviewed titles and abstracts, and where necessary, the full-text to select eligible studies. For each study, reviewers independently extracted data using a standardized data extraction form. Barriers and facilitators were classified along the lines of a previous review and based on additional themes that emerged. Study quality was assessed using appropriate tools. We identified 2693 citations, evaluated 49 studies and identified 6 for inclusion. Of the included studies, four were qualitative, one was a cross-sectional survey and one was reported as an 'analysis'. The total number of participants ranged from 20-100 and included physicians, nurses, allied healthcare workers and researchers. Barriers identified included limited funding, poor institutional & national investment, inadequate access to mentors, absence of training in research methods, limited research support staff, and absence of statistical support. Our review identified potential solutions such as developing a mentorship network, streamlining of regulatory processes, implementing a centralized institutional research agenda, developing a core-outcome dataset and enhancing access to low-cost technology. Our scoping review highlights important barriers to the conduct of critical care research in low and lower-middle income countries, identifies potential solutions, and informs researchers, policymakers and governments on the steps necessary for strengthening research systems.

A Reader's Guide to Medical Education Systematic Reviews.

Systematic reviews are rigorous and complex. It is paramount that readers—consumers of systematic reviews as well as researchers—understand the steps necessary for high-quality systematic reviews. Here are brief summaries of key quality considerations for readers of medical education systematic reviews. For detailed research steps aimed at those performing systematic reviews, see our companion paper.1Did the researchers use resources such as the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement2 or the STructured apprOach to the Reporting In healthcare education of Evidence Synthesis (STORIES) Statement?3 Both the PRISMA and STORIES statements act as guidelines for what is necessary to report in the manuscript.Systematic reviews are not solo endeavors.4,5 Team composition can vary but should include content experts, a librarian or information specialist, and, depending on the research question and nature of included studies, a statistician.5 Having multiple team members also helps to manage bias.6,7The research team should have a focused research question that is neither too broad nor too narrow. A question that is too broad can lead to retrieving far too many studies to review and failing to provide a focused overview for readers. A too narrow question may result in being unable to find any existing studies that meet the inclusion criteria.Register the protocol with a systematic review protocol registry such as PROSPERO. Researchers should register the protocol to promote transparency of the process and reduce duplication of efforts.8,9A systematic review search strategy is based on the review's focused research question and includes a variety of search terms synonyms (eg, faculty, educator, teacher) and, depending on the database, controlled vocabulary terms (eg, medical subject headings [MeSH]). The intention is to comprehensively identify all studies that possibly meet the inclusion criteria. Once the main search elements are defined, the search is conducted in a minimum of 3 databases.4 If conducting a review for medical education, databases such as ERIC (Education Resources Information Center) or PsycINFO may be searched.10 The authors may have also searched grey literature sources such as theses, dissertations, and conference abstracts to reduce publication bias: some studies are conducted but never published. The search strategy for each resource and the date it was searched should be documented.11 (Note that these details are expected by most journals, and the PRISMA reporting guidelines require authors to include the full search for at least one database.2)There should be 2 levels of screening: title/abstract and full text, both guided by the review's inclusion and exclusion criteria. In both screening levels, 2 reviewers should independently screen each result; this minimizes bias in the application of inclusion and exclusion criteria. If the reviewers disagree, the conflict may be resolved by a third individual or by the 2 reviewers reaching consensus through discussion. While it is unnecessary for authors to report exclusion reasons when screening at the title/abstract level, it is necessary to report this information at the full-text level. This information is often presented as a PRISMA flow diagram2 using tracking software programs (eg, Covidence, Rayyan, DistillerSR).After completing the screening processes, the researchers will extract data from individual studies. To facilitate this process, authors should collaboratively draft and pilot a data extraction tool designed to capture all relevant data and extract it in a format that is conducive to analysis and synthesis. Data extraction should be conducted by 2 team members independently to assure reliability and reduce errors.Authors should critically appraise each study through a quality and risk of bias assessment, such as with the Newcastle-Ottawa Scale-Education (NOS-E) or the Medical Education Research Study Quality Instrument (MERSQI).12 Depending on the review's research question, the extracted data may be analyzed qualitatively or through a meta-analysis. Meta-analysis of quantitative studies is possible only if the data from the individual studies is homogenous; if the data are too heterogeneous, as is often found in medical education, it is not possible to accurately perform a meta-analysis. In qualitative analyses, the data are analyzed, and themes are drawn out, synthesized, categorized, and presented.13Authors may reference the PRISMA2 or STORIES statements3 as their writing and reporting structure. Whether or not these guidelines are cited, the article should present the rationale, methods, and findings in a clear, ordered, succinct fashion and discuss the relevance to existing literature and to readers.

Proteomics Standards Initiative's ProForma 2.0: Unifying the Encoding of Proteoforms and Peptidoforms.

It is important for the proteomics community to have a standardized manner to represent all possible variations of a protein or peptide primary sequence, including natural, chemically-induced and artifactual modifications. The Human Proteome Organization (HUPO) Proteomics Standards Initiative (PSI) in collaboration with several members of the Consortium for Top-Down Proteomics (CTDP) has developed a standard notation called ProForma 2.0, which is a substantial extension of the original ProForma notation developed by the CTDP. ProForma 2.0 aims to unify the representation of proteoforms and peptidoforms.ProForma 2.0 supports use cases needed for bottom-up and middle-/top-down proteomics approaches and allows the encoding of highly modified proteins and peptides using a human-and machine-readable string. ProForma 2.0 can be used to represent protein modifications in a specified or ambiguous location, designated by mass shifts, chemical formulas, or controlled vocabulary terms, including cross-links (natural and chemical), and atomic isotopes. Notational conventions are based on public controlled vocabularies and ontologies. The most up-to-date full specification document and information about software implementations are available at http://psidev.info/proforma.

Suggestions for Improving Morale, Part 2: Review of Existing Literature on Librarian and Library Staff Morale

Purpose Significant research has been done on morale within libraries focusing on librarians as teachers, administrators, staff, and faculty members. This review is the second in a series of two with the purpose of providing suggestions on ways to improve morale in librarians and library staff. The first part of this review discusses contributors to low morale in these populations. Methods Searches were conducted between Spring 2020 and 2021 across six databases and by hand (Medline via PubMed, Library and Information Science Collection via ProQuest, Sociological s via ProQuest, PsycInfo via EBSCO, Library Literature and Information Science Full Text via EBSCO, and ERIC via EBSCO). Broad and narrow searches were performed utilizing keywords and controlled vocabulary terms related to morale and librarians or library staff. Results were reviewed by authors in three stages according to inclusion and exclusion criteria outlined in the article. Results The initial search resulted in 735 articles for review. After completion of a three-stage review process and hand search, 52 articles remained. The search and hand search update resulted in 13 additional articles for a total of 65 articles for inclusion in the initial review. These articles were then split into two main groups: articles that address contributors to low morale and those that provide suggestions for improving morale. This article will address 28/65 articles retrieved that provided suggestions for improving morale within libraries. Conclusion There is currently a large body of research on morale related to librarians and library staff; however, it is worth reexamining morale as librarianship and the world around it continues to change. Researchers confirmed that libraries have unique cultures based upon their region, overarching institution, type of library, customer or patron base, and other factors. As such, supervisors must be creative in terms of encouraging their staff and must adapt morale improvement efforts to their individual institution as material resources are not always available as rewards.

Teaching Medical Students How to Teach: A Scoping Review

Phenomenon Teaching medical students how to teach is a growing and essential focus of medical education, which has given rise to student teaching programs. Educating medical students on how to teach can improve their own learning and lay the foundation for a professional identity rooted in teaching. Still, medical student-as-teacher (MSAT) programs face numerous obstacles including time constraints, prioritizing curriculum, and determining effective evaluation techniques. The purpose of this scoping review is to map the current landscape of the literature on medical school initiatives designed to train students to teach to describe why medical student teaching programs are started; the benefits and barriers; who teaches them; what content is taught; and how content is delivered. With this new map, the authors aimed to facilitate the growth of new programs and provide a shared knowledge of practices derived from existing programs. Approach The authors conducted a scoping review, guided by Arksey and O’Malley’s framework, to map the literature of MSAT training programs. Six databases were searched using combinations of keywords and controlled vocabulary terms. Data were charted in duplicate using a collaboratively designed data charting tool. This review builds on the Marton et al. review and includes articles published from 2014 to 2020. Findings Of the 1,644 manuscripts identified, the full-text of 57 were reviewed, and ultimately 27 were included. Articles included empirical research, synthetic reviews, opinion pieces, and a descriptive study. Analysis focused on modalities for teaching medical students how to teach; content to teach medical students about teaching; benefits and barriers to starting teaching programs; and the value of teaching programs for medical students. Insights The rapid growth of MSAT programs suggests that this curricular offering is of great interest to the field. Literature shows an increase in evaluative efforts among programs, benefits for students beyond learning to teach, and evidence of effective engagement in medical students’ designing and implementing programs.

Contributions to Low Morale, Part 1: Review of Existing Literature on Librarian and Library Staff Morale

Purpose Significant research has been done on morale within libraries, focusing on librarians as teachers, administrators, staff, and faculty members. This review is the first in a series of two with the intention to provide perspective on contributors to low morale in librarians and library staff. The second part of this review will be forthcoming and will discuss ways to improve morale in these populations. Methods Searches were conducted between Spring 2020 and 2021 across six databases (Medline via PubMed, Library and Information Science Collection via ProQuest, Sociological s via ProQuest, PsycInfo via EBSCO, Library Literature and Information Science Full Text via EBSCO, and ERIC via EBSCO). A hand search was added in Spring 2021 in the interest of completeness. Broad and narrow searches were performed utilizing keywords and controlled vocabulary terms related to morale and librarians or library staff. Results were reviewed by authors in three stages according to inclusion and exclusion criteria outlined in the article. Results The initial search resulted in 735 articles for review. After completion of a three-stage review process and initial hand search, 52 articles remained. The search update and hand search update resulted in 13 additional articles for a total of 65 articles for inclusion in the initial review. These articles were then split into two main groups: articles that address contributors to low morale and those that provide suggestions for improving morale. This article will address 40/65 articles retrieved that discuss contributors to low moral within libraries. Remaining articles and articles that discuss both contributors to low morale and ways in which to improve morale will be discussed in the second half of this review series. Conclusion There is currently a large body of research on morale related to librarians and library staff; however, it is worth reexamining morale as this profession and the world around it continues to change. Researchers confirmed that libraries have unique cultures based upon their region, overarching institution, type of library, customer or patron base, and other factors. As such, supervisors and managerial staff indicate the importance of examining the culture of one’s own library including the motivations of staff/faculty and barriers that they encounter.

Assessment of the climacteric syndrome: a narrative review.

Many menopausal women suffer from a variety of estrogen deficiency-related symptoms and chronic medical conditions. Health care professionals should be able to identify and quantify symptoms to facilitate diagnosis, indicate and monitor treatment. Therefore, various questionnaires have been developed and are used as a simple, time-saving and cost-effective mean to assess and monitor menopausal complaints. The aim of this review is to provide an overview and comparison of the available tools for climacteric syndrome assessment. Three electronic databases (Pubmed, EMBASE and Cochrane Database of Systematic Reviews/CDRS) were searched covering a time period of 10years using a combination of relevant controlled vocabulary terms and free-text terms. Relevant references were evaluated for inclusion in a stepwise approach. The literature research revealed four questionnaires (Kupperman Index, Menopause Rating Scale, Menopause Specific Quality of Life Questionnaire and Greene Climacteric Scale) that are used to holistically assess the climacteric syndrome, varying in type of assessment, included symptoms, rating system of severity, weighing of symptoms, resulting total rating score and validation status. Further questionnaires are available to assess single symptoms or group of symptoms relating to specific aspects of menopause (e.g., vasomotor symptoms, insomnia, etc.). Four holistic questionnaires addressing menopausal symptoms have been developed [KI, MRS, MENQOL (-Intervention), Greene Climacteric Scale]. All but one (KI) have been validated and are available in different languages. However, there are still several shortcomings such as the lack of recognition of ethnic and cultural background and missing thresholds for treatment initiation and monitoring.

Systematic Review of Smartphone Apps as a mHealth Intervention to Address Substance Abuse in Adolescents and Adults.

Substance abuse represents a foremost national concern for adolescents and adults; investigators have implemented a variety of interventions, delivered with both in-person and mobile-based apps' modalities. The electronic techniques could be more effective because they avoid the cost, privacy, and accessibility issues associated with in-person intervention. To address this issue, a systematic review of the scientific evidence relative to the efficacy of app-based interventions delivered by mobile devices (smartphones) to reduce substance abuse in adolescents and adults was carried out. To identify relevant studies published from 2005 to 2019, a comprehensive search was conducted. Databases that were searched include CINAHL, Cochrane CENTRAL, Embase, PsycINFO, PubMed, and Web of Science. Keywords and relevant controlled vocabulary terms related to substance abuse and technology were included. Studies were included if they had examined reductions in substance abuse and problem behaviors as a primary outcome with app-based interventions delivered to adolescents and adults. The initial search yielded 21,641 articles, duplicates were removed, and 14,797 citations remained; title/abstract screening yielded 190 full-text articles. One hundred seventy-three were excluded because they did not meet the inclusion criteria, leaving 17 final articles to be analyzed in this review. Use of app-based interventions showed some evidence of effectiveness in reducing substance abuse in the adolescent adult population. Most intervention studies analyzed focused on alcohol reduction. Further research is needed on diverse substance abuse utilizing larger sample sizes, longitudinal studies, and theoretical foundations on the practice of delivering interventions using mobile-based apps.

EHealth solutions to fight against COVID-19: A scoping review of applications.

Background: eHealth has a notable potential to help in prevention, diagnosis, treatment, screening, management, and control of the COVID-19 pandemic. Since ehealth is considered here broadly, as an umbrella term, it also covers subsets like telehealth and mhealth. This study aimed to review the literature to identify and classify subdomains of eHealth solutions that have been utilized, developed, or suggested for the COVID-19 pandemic. Methods: A comprehensive literature search was performed using the PubMed, Scopus, Embase, and Cochrane library databases in April 2020, with no time limitation. The search strategy was built based on 2 concept domains of eHealth solutions and covid-19. For each concept domain, the search query comprised a combination of free text keywords identified from reference papers and controlled vocabulary terms. Obtained results were classified, graphically presented, and discussed. Results: Of the 423 studies identified initially, 35 were included in this study. From related papers, general characteristics, study objective, eHealth-related outcomes, target populations, eHealth interventions, health service category, eHealth solution, and eHealth domain were extracted, classified, and tabulated. Most publication types were ideas, editorials, or opinions (46%). The most targeted populations were people of the community and medical staff (80%). The most implemented or suggested eHealth solution was telehealth (63%), followed by mhealth, health information technology, and health data analytics. Most of the COVID-19 ehealth interventions designed or suggested for improving prevention (48%) and diagnosis (48%). Most of the studies applied or proposed eHealth solutions for general practice or epidemiological purposes (48%). Conclusion: eHealth solutions have the potential to provide useful services to help in COVID-19 pandemics in terms of prevention, diagnosis, treatment, screening, surveillance, resource allocation, education, management, and control. The obtained results from this review might be used for a better understanding of current ehealth solutions provided or recommended in response to the COVID-19 pandemic.

A System for Phenotype Harmonization in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) Program.

Genotype-phenotype association studies often combine phenotype data from multiple studies to increase statistical power. Harmonization of the data usually requires substantial effort due to heterogeneity in phenotype definitions, study design, data collection procedures, and data-set organization. Here we describe a centralized system for phenotype harmonization that includes input from phenotype domain and study experts, quality control, documentation, reproducible results, and data-sharing mechanisms. This system was developed for the National Heart, Lung, and Blood Institute’s Trans-Omics for Precision Medicine (TOPMed) program, which is generating genomic and other -omics data for more than 80 studies with extensive phenotype data. To date, 63 phenotypes have been harmonized across thousands of participants (recruited in 1948–2012) from up to 17 studies per phenotype. Here we discuss challenges in this undertaking and how they were addressed. The harmonized phenotype data and associated documentation have been submitted to National Institutes of Health data repositories for controlled access by the scientific community. We also provide materials to facilitate future harmonization efforts by the community, which include 1) the software code used to generate the 63 harmonized phenotypes, enabling others to reproduce, modify, or extend these harmonizations to additional studies, and 2) the results of labeling thousands of phenotype variables with controlled vocabulary terms.

The immunogenicity and safety of respiratory syncytial virus vaccines in development: A systematic review.

BackgroundRespiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection globally. There are vaccine candidates in development, but a systematic review on immunogenicity and safety of vaccine is lacking.MethodsThis systematic review of RSV vaccine clinical trials was undertaken using four databases. Searches were conducted using both controlled vocabulary terms such as “Respiratory Syncytial Virus, Human,” “Respiratory Syncytial Virus Infections,” “Respiratory Syncytial Virus Vaccines,” “Immunization,” “Immunization Programs” and “Vaccines” and corresponding text word terms. The included studies were limited to clinical trials published from January 2000 to 31 December 2020. RSV infection case was defined as RSV‐associated medically attended acute respiratory illness (MAARI) or RSV infection by serologically confirmed test (Western blot) during the RSV surveillance period. We calculated the relative risk of each vaccine trial with RSV infection case.ResultsOf 6306 publications, 38 were included and data were extracted covering four major types of RSV vaccine candidates, these being live‐attenuated/chimeric (n = 14), recombinant‐vector (n = 6), subunit (n = 12) and nanoparticle vaccines (n = 6). For RSV infection cases, nine trials were involved and none of them showed a vaccine‐related increased MAARI during RSV surveillance season.ConclusionLID ∆M2‐2, MEDI M2‐2, RSVcps2 and LID/∆M2‐2 /1030s (live‐attenuated) were considered the most promising vaccine candidates in infant and children. In the elderly, a nanoparticle F vaccine candidate and Ad26.RSV.preF were considered as two potential effective vaccines. A promising maternal vaccine candidate is still lacking.

A systematic review of ketamine for the treatment of depression among older adults

<h3>Introduction</h3> Depression is the second most prevalent mental health disorder among older adults after anxiety disorders. It effects 7% of the general older population globally 5.6% of US older adults. Suicide rates also increase between ages of 60-90 in both men and women around the world. A large body of literature shows increased association of late life depression with increased morbidity and mortality in this age group. Evidence for depression as a risk factor for physical and cognitive decline that results in lower quality of life and function among older adults underlines the importance of early recognition and prompt treatment of this serious condition. The most common modalities currently used for treatment of late life depression include pharmacotherapy, psychotherapy and electroconvulsive therapy (ECT). Pharmacotherapy mostly consists of antidepressants targeting the monoaminergic system. Ketamine has recently emerged as a novel, rapid acting option for treatment resistant depression in adults. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, which has been used primarily as an anesthetic since the 1960s. In 1990s preclinical studies demonstrated the role of NMDA receptor antagonists in treatment of depression, which was later confirmed in a pilot clinical study. Berman et al administered subanaesthetic doses of Ketamine (0.5mg/kg) vs. placebo to 7 study participants which resulted in robust decreases in Hamilton Depression Rating Scale scores within 4 hours of the infusion in all participants. The effect was sustained for 3 days followed by diminution of the scores and relapse of symptoms. This rapid onset anti-depressant effect of ketamine compared to conventional antidepressants attracted considerable interest and these findings have since been reliably replicated in multiple different studies, using different protocols and routes of administration of ketamine. This systematic review evaluates randomized controlled trials completed in the older adult population with depression to appraise the efficacy and tolerability of ketamine specifically in this population. <h3>Methods</h3> The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) On November 09, 2019 the authors conducted a comprehensive search of multiple databases: PubMed (through November 09, 2019), MEDLINE (Ovid ALL 1946 to November 08, 2019), Embase (Ovid 1974 to 2019 November 08), PsycINFO (Ovid 1806 to October Week 4 2019), Web of Science Core Collection (through November 09, 2019), and Cochrane Central Register of Controlled Trials (Issue 11 of 12, November 2019). The search strategy was filtered for human studies in PubMed, MEDLINE, and Embase using controlled vocabulary terms in the search strategy. On December 13, 2019 an updated search was completed. The search repeated the controlled vocabulary terms and free text terms. <h3>Results</h3> A total of 1699 citations were deduplicated to 1005 and uploaded to Covidence for screening by two separate screeners. Two studies were found to meet the inclusion criteria for this review. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine. This study also showed a higher response and remission rates in esketamine group when compared to the placebo group. Both the studies showed relapse in symptoms after a week of last treatment, but the benefits were better sustained with repeated treatments. The adverse effects from ketamine generally lasted only lasted a few hours and abated spontaneously without any additional intervention. No cognitive adverse effects were noted in either trial from the use of ketamine. <h3>Conclusions</h3> The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trails did not achieve significance on primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Both studies show longer sustenance of antidepressant effects at higher doses and with repeated treatments. One of the studies showed better ketamine efficacy in younger old subjects (65 to 74 years) when compared to older old (³75 years) subjects. Ketamine was well tolerated in both studies with adverse-effects being mild and transient. Additionally, there were no negative cognitive effects of ketamine noted among any of the study participants. Based on the limited current evidence, it is our opinion that ketamine shows some benefit in relieving depressive symptoms in older adults. However, there is dearth of randomized controlled trials and we need more well designed studies to arrive at a reliable conclusion regarding ketamine's benefit in treating depression among older adults. <h3>Funding</h3> None

Prevalence and risk factors for falls in patients with spondyloarthritis: A systematic review.

Patients with spondyloarthritis (SpA) may have a greater risk of falling due to poor postural balance and decreased mobility. To our best knowledge, there are no published reviews that study falls in patients with SpA. Therefore, we aim to systematically review the literature and identify the prevalence and risk factors of falls in patients with SpA. We conducted a systematic review using 5 electronic databases: PubMed, EMBASE, Scopus, Web of Science and Google Scholar using controlled vocabulary terms (eg MeSH terms) in the search strategy for the concepts: falls, fall risk, SpA and its subtypes. We identified 7279 articles, of which 3 studies with a total of 441 patients were included. Prevalence of falls ranged from 13% to 25%. We identified 16 main factors across 5 categories. Under socio-demographic factors, functional limitation, decreased quality of life, advanced age and job loss were associated with an increased risk of falls. Poor balance and mobility and fear of falling were associated with increased risk of falls. Active disease and symptoms of SpA were medical factors that were associated with increased risk of falls. Medication factors including polypharmacy, myorelaxants and antidepressants were not associated with increased fall risk. We identified potentially modifiable risk factors associated with increased risk of falls in patients with SpA, including functional limitation, poor balance and mobility, fear of falling and active disease. Clinicians should recognize these factors and address them in the holistic management of patients with SpA, thereby reducing falls and their complications.

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

Comparison of Surgical Treatments for Zenker Diverticulum

Zenker diverticulum (ZD) can cause significant dysphagia, and symptoms can return or persist after surgery. This systematic review and network meta-analysis is the first to our knowledge to compare 3 common surgical techniques for ZD. To compare the 3 most common surgical techniques-endoscopic laser-assisted diverticulotomy, endoscopic stapler-assisted diverticulotomy, and transcervical diverticulectomy with cricopharyngeal myotomy-in adult patients with ZD. The published literature was searched using strategies designed by a medical librarian (search performed September 21, 2018). Strategies were established using a combination of controlled vocabulary terms and keywords and were executed in Ovid MEDLINE (1946 to September 21, 2018), Embase (1947 to September 21, 2018), Scopus (1823 to September 21, 2018), Cochrane Library, and ClinicalTrials.gov. Results were limited to English using database-supplied filters, which generated studies from 1997 to 2017. Inclusion criteria were cohort studies or randomized clinical trials. Studies that included patients needing revision surgery or undergoing an alternative technique were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-analyses-Network Meta-analyses (PRISMA-NMA) checklist was used to report the study findings. Two authors independently reviewed the studies. The primary outcome measure was the incidence of persistent or recurrent symptoms following surgery. The primary study outcome was planned before data collection began. The search generated 529 studies. After applying inclusion and exclusion criteria, 9 cohort studies remained, consisting of 903 patients treated with either laser-assisted diverticulotomy (n = 283), transcervical diverticulectomy (n = 150), or stapler-assisted diverticulotomy (n = 470). A network meta-analysis was performed. Between endoscopic laser-assisted diverticulotomy and open diverticulectomy, the open approach showed a statistically lower likelihood of persistent/recurrent symptoms following treatment (odds ratio [OR], 0.20; 95% CI, 0.04-0.91). Comparing laser-assisted diverticulotomy with the stapler-assisted technique, there was not a significant difference between the 2 techniques (OR, 0.83; 95% CI, 0.43-1.60). The consistency model for the network meta-analysis was supported (χ21 = 0.12; P = .73). This systematic review and meta-analysis compared 3 common techniques for treating ZD. The open approach showed a decreased likelihood of persistent or recurrent symptoms following surgery compared with the 2 other techniques.

Systematic review of postoperative therapy for resected squamous cell carcinoma of the head and neck: Executive summary of the American Radium Society appropriate use criteria.

BackgroundThe aims of this systematic review are to (a) evaluate the current literature on the impact of postoperative therapy for resected squamous cell carcinoma of the head and neck (SCCHN) on oncologic and non‐oncologic outcomes and (b) identify the optimal evidence‐based postoperative therapy recommendations for commonly encountered clinical scenarios.MethodsAn analysis of the medical literature from peer‐reviewed journals was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guideline. Prospective studies and methodology‐based systematic reviews and meta‐analyses of postoperative therapy for SCCHN were identified by searching Medline (OVID) and EMBASE (Elsevier) using controlled vocabulary terms (ie, National Library of Medicine Medical Subject Headings [MeSH], EMTREE). Study screening and selection was performed with Covidence software and full‐text review. The RAND/UCLA appropriateness method was used by the expert panel to rate the appropriate use of postoperative therapy, and the modified Delphi method was used to come to consensus.ResultsA total of 5660 studies were identified and screened using the title and abstract, leading to 201 studies assessed for relevance using full‐text review. After limitation to the eligibility criteria, 101 studies from 1977 to 2020 were identified, including 77 with oncologic endpoints and 24 with function and quality of life endpoints. All studies reported staging prior to the implementation of American Joint Committee on Cancer (AJCC‐8).ConclusionsProspective clinical studies and systematic reviews identified through the PRISMA systematic review provided good evidence for consensus statements regarding the appropriate use of postoperative therapy for resected SCCHN. Further research is needed in domains where consensus by the expert panel could not be achieved for the appropriateness of specific postoperative therapeutic interventions.