Systematic Review Of Evidence Research Articles

Alternative Scenarios for Projected Prevalence of Stroke and Post-Stroke Dementia to 2046 in Ireland: A Model-Based Analysis

Abstract Background Understanding future population need is key for informing stroke service planning. This study aims to evaluate alternative scenarios for future trends in stroke age-specific incidence and case-fatality and estimate impact on projected stroke and post-stroke dementia prevalence in Ireland. Methods We used a probabilistic Markov model to project and track incidence and prevalence of stroke and post-stroke dementia in the Irish population aged 40-89 years to 2046. Using systematic review and observational evidence, we extrapolated trends in stroke age-specific incidence and case-fatality from 1990-2019 to 2016-2046. We defined optimistic, realistic and pessimistic scenarios, including scenarios where trends decelerated over time. Results The stable (pessimistic) scenario indicates a projected 95,278 stroke survivors in 2046 (95% uncertainty interval, UI = 91,404-99,487) (30.1 per 1000 pop), an increase of 53% from 2022 to 2046. The most optimistic scenario would involve a 3.2% increase from 2022 to 2046, to a projected 61,000 survivors. More realistic scenarios based on lower rates of incidence/case-fatality decline, or rates of decline slowing over time, imply an increase ranging between 22.9% and 37.2%. There will be a projected 19,430 with post-stroke dementia in 2046 (95% UI 17,182-21,904), an increase of 69.2% from 2022. In the most optimistic scenario, the increase would be 22.6%, with realistic scenarios implying an increase ranging between 38.9% and 53.2%. Conclusion Future stroke healthcare needs will vary substantially depending on epidemiological trends. A large increase in post-stroke dementia is projected across scenarios. Further work is needed to identify optimal policies to promote continuing decline in stroke incidence.

Experiences and perceptions of patients with cancer receiving home-based chemotherapy: a qualitative systematic review protocol

BackgroundHome-based chemotherapy (HBC) has emerged as a standard option for treating various types of cancer, primarily to decrease the waiting time for treatment. As HBC gains more recognition, ongoing research is delving into the experiences of patients with cancer who receive chemotherapy in a home setting or chemotherapy closer to home. Understanding these experiences is vital for the use of chemotherapy delivery outside the traditional hospital environments. This review aims to synthesize and critically appraise qualitative studies that investigate the experience and perspectives of patients with cancer who received parenteral chemotherapy administration in home settings. Findings will be used to develop evidence-based policies to support home-based care models.MethodsThis review will follow JBI methods for systematic reviews of qualitative evidence. The databases for searching will include MEDLINE (PubMed), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), ProQuest Health and Medical Collection, two Chinese databases, CNKI and Wanfang, and one Thai database, ThaiJO. Studies published in English, Chinese, and Thai will be considered for inclusion. Two reviewers will independently undertake study selection, data extraction, and critical appraisal of the methodological quality of studies. The synthesized findings will be assessed using the ConQual approach.DiscussionThe synthesis of qualitative studies on this topic will provide insights into the nuanced and varied experiences of patients receiving chemotherapy within the comfort of their homes. The review will also provide evidence-based recommendations to policymakers and healthcare administrators, to support the implementation of HBC for patients.Systematic review registrationSystematic review registration: PROSPERO CRD42024500476.

Fertilizers and Human Health-A Systematic Review of the Epidemiological Evidence.

Fertilizers are widely used to supply nutrients to crops, thereby increasing yields and soil fertility. However, the effects of their production and application on human health through occupational, residential, and environmental exposure remain unclear. To conduct a systematic review of epidemiological studies on the association between exposure to fertilizers and health-related outcomes. We searched in PubMed, Scopus, and Web of Science for cohort, case-control, cross-sectional, and ecological studies (up to May 2024) related to exposure to fertilizers and any reported human health endpoints across all age groups, without language or geographical limitations. Data were extracted for population and study characteristics, type of fertilizer used, exposure assessment, sample size, outcome and its definition, effect estimate, and quality characteristics from the eligible studies, and they were descriptively synthesized. We found 65 eligible publications, with 407 postulated associations. Forty-six publications (321 associations) assessed exposure to inorganic fertilizers, and nineteen studies (93 associations) assessed organic fertilizers. Exposure assessed was related to occupation, residence, and/or proximity. The assessed outcomes were diverse, with considerable harmonization challenges. Inorganic fertilizers have been associated with an increased risk of cancerous outcomes in a small number of studies with methodological limitations and low replication validity, while organic fertilizers have been associated with infections and diarrhea. The epidemiological evidence suggests possible associations between inorganic fertilizers with solid organ tumors and hematological malignancies and organic fertilizers with infections and diarrhea. However, the available evidence is limited, and heterogeneity prevails. Further research is needed to enlarge the evidence base and increase the replication validity and robustness of the results.

The impact of mitomycin C in endoscopic sinus surgeries: a comprehensive review

Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinus linings, often resulting in various debilitating symptoms. Functional endoscopic sinus surgery (FESS) is a common treatment for CRS, aiming to alleviate symptoms by restoring sinus drainage and mucosal repair. However, postoperative complications, including adhesion formation, remain a concern. This systematic review aims to evaluate the effectiveness of mitomycin-C (MMC) in reducing postoperative complications, particularly adhesion formation, in patients undergoing ESS. A systematic review of available evidence on the role of MMC in FESS was conducted. Studies were selected based on predefined inclusion criteria, and relevant data were extracted and synthesized. Nineteen studies met the inclusion criteria, encompassing a total of 763 subjects. The majority of studies reported a reduction in postoperative adhesion formation with MMC use, although statistical significance varied. MMC dosages and application methods varied across studies, contributing to heterogeneity in outcomes. Overall, MMC showed promise in reducing adhesion formation and improving surgical outcomes in FESS. However, further high-quality, prospective, randomized controlled trials are warranted to establish optimal dosage, application methods, and long-term efficacy of MMC in FESS for CRS.

Return on investment of tobacco control measures: a systematic review protocol.

The objective of this systematic review will be to estimate the return on investment (ROI) and social return on investment (SROI) on tobacco control measures. Tobacco consumption has been proven to be associated with a huge epidemiological, humanistic, and economic burden. National and international organizations are making concerted efforts to control tobacco use. However, currently, there are no conclusive estimates of the ROI and SROI of such programs and policies. This review will include all studies that evaluate the ROI or SROI on tobacco control programs and policies on tobacco users and probable tobacco users globally. This review will follow the JBI methodology for systematic reviews of economic evidence. Databases to be searched will include Embase (Ovid), MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Health Economic Evaluation Database (HEED), National Health Service Economic Evaluation Database (NHS EED), CEA Registry, LILACS, Science Direct, Web of Science, EconLit, and Google Advanced Search. Gray literature will also be searched for in non-academic databases, including the websites of various civil societies and non-governmental organizations involved in tobacco control. Two independent reviewers will screen titles/abstracts, and later full-text studies. Critical appraisal will be conducted using the JBI checklist for economic evaluations and the SROI Quality Framework. Data will be extracted and synthesized using JBI data extraction forms and synthesis tools. The MPOWER framework will be considered for data synthesis across all selected studies using narrative synthesis, tables, and figures. PROSPERO CRD42023391591.

Targeting NETosis in Acute Brain Injury: A Systematic Review of Preclinical and Clinical Evidence.

Acute brain injury (ABI) remains one of the leading causes of death and disability world-wide. Its treatment is challenging due to the heterogeneity of the mechanisms involved and the variability among individuals. This systematic review aims at evaluating the impact of anti-histone treatments on outcomes in ABI patients and experimental animals and defining the trend of nucleosome levels in biological samples post injury. We performed a search in Pubmed/Medline and Embase databases for randomized controlled trials and cohort studies involving humans or experimental settings with various causes of ABI. We formulated the search using the PICO method, considering ABI patients or animal models as population (P), comparing pharmacological and non-pharmacological therapy targeting the nucleosome as Intervention (I) to standard of care or no treatment as Control (C). The outcome (O) was mortality or functional outcome in experimental animals and patients affected by ABI undergoing anti-NET treatments. We identified 28 studies from 1246 articles, of which 7 were experimental studies and 21 were human clinical studies. Among these studies, only four assessed the effect of anti-NET therapy on circulating markers. Three of them were preclinical and reported better outcome in the interventional arm compared to the control arm. All the studies observed a significant reduction in circulating NET-derived products. NETosis could be a target for new treatments. Monitoring NET markers in blood and cerebrospinal fluid might predict mortality and long-term outcomes. However, longitudinal studies and randomized controlled trials are warranted to fully evaluate their potential, as current evidence is limited.

Rethinking the Social Determination of Food in Chile Through Practices and Interactions of Actors in Food Environments: Nonexperimental, Cross-Sectional Study.

Food environments are crucial for promoting healthy and sustainable eating and preventing obesity. However, existing food environment frameworks assume an already installed causality and do not explain how associations in food environments are established or articulated, especially from an integrative and transdisciplinary approach. This research attempts to bridge these gaps through the use of Actor-Network Theory, which traces the relationship network between human (and nonhuman) actors in order to describe how these interact and what agencies (direct or remote) are involved. This study aims to explain the practices and interactions of actors in food environments in order to approach the problem of unhealthy eating with a transdisciplinary approach. This is a nonexperimental, cross-sectional study. Due to the complexity of the study phenomena, a mixed methods approach with 4 consecutive phases will be developed in Chile. Phase 1 involves a systematic literature review of food environment evidence since 2015, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol; phase 2 involves the application of a shortened version of the Nutrition Environment Measure Scale-Perceptions adapted to Chile (NEMS-P-Ch) in 2 neighborhoods with different socioeconomic levels; in phase 3, six focus groups in each neighborhood will be conducted to address social determinants such as gender, employment status, and migration; and in phase 4, participant observation and in-depth interviews will be used to analyze the direct and empirical exploration of the actors in their daily interaction with food environments. The triangulation and complementarity of the data will allow us to create a practical model about the practices and interactions of actors in their food environments, which reflects the complexity and transdisciplinary nature of the study. We have advanced in phases 1-3 of the study. In phase 1, a total of 109 manuscripts are being revised for data extraction. In phase 2, we applied the NEMS-P-Ch to 785 people, 49.4% (388/785) of whom belong to a low socioeconomic neighborhood. Participants from phase 2 are being contacted to participate in the focus groups (phase 3). By the end of July, we have conducted 6 focus groups with 5-11 participants. This study will provide a comprehensive understanding of how individuals interact with their food environments, offering deep insights into the factors influencing their food-related decisions. In addition, the study aims to develop a model that more accurately reflects reality by examining not only the food environments themselves but also the interactions among various stakeholders within these environments and their daily practices. The findings of this study will offer evidence-based insights to inform public policies tailored to the specific territories and communities under investigation or those with similar characteristics. DERR1-10.2196/62765.

Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy/Single Anastomosis Duodenal Switch (SADI-S/SADS) IFSO Position Statement-Update 2023.

The single anastomosis duodeno-ileostomy with sleeve gastrectomy/single anastomosis duodenal switch (SADI-S/SADS) has gained attention as an alternative to the traditional biliopancreatic diversion with duodenal switch (BPD-DS). In 2021, IFSO endorsed SADI-S/SADS as a safe and effective procedure, underscoring the necessity for long-term multidisciplinary care and randomized controlled trials (RCTs). A task force was established to conduct a systematic review of current evidence on SADI-S/SADS to guide clinical practice. A systematic review was conducted across three databases, focusing on studies examining SADI-S/SADS and its outcomes. A total of 93 studies were analyzed. SADI-S/SADS demonstrated efficacy in weight loss and medium-to-long-term control of type 2 diabetes mellitus (T2DM), along with positive outcomes regarding hypertension and hyperlipidemia. However, its impact on other comorbidities remains inconclusive. Frequent nutritional deficiencies were identified, particularly in fat-soluble vitamins, anemia, and hypoalbuminemia. Despite significant efforts, high-quality evidence on SADI-S/SADS remains scarce, prompting IFSO to advocate for increased registry participation, publication of long-term studies, and more RCTs. Lifelong supplementation and monitoring for nutritional deficiencies are recommended. The current position statement will be reviewed in 2 years.

Minimally Invasive Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease: A Systematic Review.

We conducted a systematic review of all available evidence on the feasibility and safety of minimally invasive coronary artery bypass grafting (MICS CABG) in patients with multivessel coronary artery disease (CAD). A systematic literature search in PubMed, MEDLINE via Ovid, Embase, Scopus, and Web of Science was performed to identify all relevant studies evaluating outcomes of MICS CABG among patients with multivessel CAD and including at least 15 patients with no restriction on the publication date. A total of 881 studies were identified, of which 26 studies met the eligibility criteria. The studies included a total of 7,556 patients. The average patient age was 63.3 years (range 49.5 to 69.0 years), male patients were an average of 77.8% (54.0% to 89.8%), and body mass index was 29.8 kg/m2 (24.5 to 30.1 kg/m2). Early mortality and stroke were on average 0.6% (range 0% to 2.0%) and 0.4% (range 0% to 1.3%), respectively. The average number of grafts was 2.8 (range 2.1 to 3.7). The average length of hospital stay was 5.6 days (range 3.1 to 9.3 days). MICS CABG appears to be a safe method in well-selected patients with multivessel CAD. This approach is concentrated at dedicated centers, and there is no widespread application, although it has potential to be widely applicable as an alternative for surgical revascularization. However, large randomized controlled studies with longer follow-up are still required to compare the outcomes with conventional CABG and other revascularization strategies.

Experiences of empathy of caregivers caring for persons with dementia: a qualitative systematic review protocol.

The aim of this systematic review will be to explore the experiences of empathy in informal caregivers caring for persons with dementia. Positive caregiving experiences of informal caregivers caring for persons with dementia have many beneficial outcomes, such as improved well-being of both caregivers and care receivers and a higher quality of care for the persons with dementia. Empathy is a factor associated with positive caregiving experiences and is strongly correlated with reduced depression and reduced anxiety in informal caregivers of persons with dementia. Therefore, it is essential to understand the experiences of empathy, especially the caregiver characteristics such as their caring behaviors, relationship with the patient, and cultural beliefs. This review will include studies on the empathy experiences of informal caregivers caring for persons with any type of dementia. It will consider qualitative studies, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, and feminist research. This study will follow the JBI guidance for systematic reviews of qualitative evidence and will use the meta-aggregation approach to synthesise qualitative studies. The search strategy will aim to locate both published and unpublished studies in English, Chinese, and Thai, with no date restrictions. Methodological quality will be evaluated using the standard JBI critical appraisal checklist for qualitative research. The findings will be pooled using the meta-aggregation approach or will be presented in narrative format. PROSPERO CRD42023490472.

Care partner engagement in patient safety at the direct care level in hospital: a qualitative systematic review protocol.

The objective of this systematic review is to understand the experiences of care partner engagement in patient safety at the direct care level from the perspective of care partners, patients, and health care professionals. Care partner engagement is a strategy for promoting patient safety in hospitals at the direct care level (ie, at the point where patient care is delivered). When present, care partners can increase safety by watching, listening, and taking action to protect admitted patients. To improve care partner presence policies and safety engagement strategies within hospitals, a comprehensive understanding of the current qualitative evidence about the breadth of experiences of care partner engagement in patient safety is required. This review will include qualitative studies that consider the experiences of care partners, adult patients, and health care professionals. The engagement of care partners in patient safety within pediatric hospital settings will not be considered. This review will follow the JBI methodology for systematic reviews of qualitative evidence. A preliminary literature search was conducted in MEDLINE and a full search strategy was developed for MEDLINE, Embase, CINAHL, and PsycINFO (all via Ovid), as well as the Cochrane Database of Systematic Reviews and JBI Evidence Synthesis. The JBI approach to study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence will be followed. Two reviewers will test the screening criteria and data extraction protocol. PROSPERO CRD42023476286.

Navigating the Criminal Justice System: A Systematic Review of Qualitative Evidence on the Experiences of Homicide Co-victims

Homicide is considered a crime against the state rather than the covictims, which impacts on criminal justice system (CJS) processes and can lead to secondary victimization. This review explores the experience of co-victims (i.e., family members) engaging with the CJS. Thirty studies met the inclusion criteria and were identified through searching six bibliographic databases (MEDLINE, HMIC, CINAHL, ASSIA, IBSS, and SSCI) and supplementary searches. Two reviewers conducted screening, data extraction, and quality appraisal. Thematic synthesis resulted in three themes: (a) information and meaningful inclusion, (b) who is the justice system for?, and (c) relating to victims as people. These themes highlight concerns regarding the marginalization of co-victims within the CJS and suggest ways to enhance processes to avoid further marginalizing and traumatizing co-victims.

Memory in Spina Bifida, from Childhood to Adulthood: A Systematic Review.

Background: Spina bifida (SB) is a rare congenital disease characterized by not only physical but also neuropsychological disturbances. Among these neuropsychological impairments, memory deficits are a significant concern, as they substantially hinder aspects of crucial importance in the lives of individuals with SB such as medical needs or daily life activities. The main objective is to conduct a systematic review of the current evidence on the memory deficits in the SB population, including children, adolescents, and adults. Methods: Four databases (PubMed, SCOPUS, Web of Science, and ProQuest) were systematically screened for eligible studies. Results: The present review reveals cognitive difficulties in different memory types among individuals with SB. These deficits, identified in childhood, seem to persist into adulthood. Specifically, impairments are evident in short-term memory, working memory, and long-term memory. The neuropsychological instruments applied in the studies that were included in this systematic review vary, however, most reach the same conclusions. Conclusions: The present findings underscore the importance of incorporating cognitive assessments, particularly those focused on the memory domain, into routine childhood evaluations for individuals with SB. Early identification of these cognitive difficulties allows for the timely implementation of cognitive interventions that could leverage the inherent plasticity of the developing brain, and prevent or delay the onset of these deficits in later adulthood for people with SB, ultimately improving their functionality and quality of life.

Zero-covid advocacy during the COVID-19 pandemic: a case study of views on Twitter/X.

During the COVID-19 pandemic, many advocacy groups and individuals criticized governments on social media for doing either too much or too little to mitigate the pandemic. In this article, we review advocacy for COVID-19 elimination or "zero-covid" on the social media platform X (Twitter). We present a thematic analysis of tweets by 20 influential co-signatories of the World Health Network letter on ten themes, covering six topics of science and mitigation (zero-covid, epidemiological data on variants, long-term post-acute sequelae (Long COVID), vaccines, schools and children, views on monkeypox/Mpox) and four advocacy methods (personal advice and promoting remedies, use of anecdotes, criticism of other scientists, and ofauthorities). The advocacy, although timely and informative, often appealed to emotions and values using anecdotes and strong criticism of authorities and other scientists. Many tweets received hundreds or thousands of likes. Risks were emphasized about children's vulnerability, Long COVID, variant severity, and Mpox, and via comparisons with human immunodeficiency viruses (HIV). Far-reaching policies and promotion of remedies were advocated without systematic evidence review, or sometimes, core field expertise. We identified potential conflicts of interest connected to private companies. Our study documents a need for public health debates to be less polarizing and judgmental, and more factual. In order to protect public trust in science during a crisis, we suggest the development of mechanisms to ensure ethical guidelines for engagement in "science-based" advocacy, and consideration of cost-benefit analysis of recommendations for public health decision-making.

Experiences of siblings of children with profound intellectual and multiple disabilities: a qualitative systematic review protocol.

The objective of this systematic review is to explore the experiences of siblings of children with profound intellectual and multiple disabilities. With improved life expectancy of children with profound intellectual and multiple disabilities, the research focus is on care at home and in the community. Although parents are the primary caregivers, siblings often assume the role of young caregivers, bearing the weight of caregiving responsibilities. Thus, a synthesis of qualitative findings is required regarding their experiences to facilitate the development of effective support strategies. Siblings of children with profound intellectual and multiple disabilities will be included, defined as children with an IQ of ≤40 or mental development below a 2-year-old's level, coupled with an inability to walk independently. Disabled children aged <20 years will be included. There will be no restrictions on the siblings' age or type of relationship. Qualitative studies on experiences, caregiving burdens, challenges, difficulties, and frustration in daily life will be considered, covering home, community, school, and hospital settings for children with disabilities. We will follow the JBI methodology for systematic reviews of qualitative evidence. The search strategy will be conducted in 3 phases: initial limited search, comprehensive database search, and reference list search of the included articles. The MEDLINE, CINAHL Plus, PsycINFO, Scopus, Ichushi-Web, and CiNii databases will be searched, with no restrictions on language or publication date. Study selection, critical appraisal, data extraction, and data synthesis will be conducted by 2 independent reviewers. We will evaluate the final synthesized findings using the ConQual approach. PROSPERO CRD42024499042.

Being a parent to a child with diabetes: systematic review of qualitative evidence from Asia

Being a parent to a child with diabetes: systematic review of qualitative evidence from Asia

Rapid Growth between 0 and 2 Years Old in Healthy Infants Born at Term and Its Relationship with Later Obesity: A Systematic Review and Meta-Analysis of Evidence.

Rapid growth in early childhood has been identified as a possible risk factor for long-term adiposity. However, there is a lack of studies quantifying this phenomenon only in healthy, full-term infants with appropriate birth weight for gestational age. This systematic review and meta-analysis aimed to investigate the association of rapid growth in full-term children up to 2 years of age with adiposity up to 18 years of age. A systematic review of the literature was conducted in PubMed, EMBASE, and Web of Science. 14 studies were included. We were unable to find strong evidence that rapid growth in early childhood is a risk factor for long-term adiposity. Rapid growth in early childhood was associated with taller heights (standardized mean difference: 0.51 (CI: 0.25-0.77)) and higher body mass index (standardized mean difference: 0.50 (CI: 0.25-0.76)) and a higher risk of overweight under 18 years. Rapid growth in early childhood in term infants with appropriate birth weight is associated with higher growth, body mass index, and risk of being overweight up to age 18, but further work is needed to identify the associations between early rapid growth and obesity later in adulthood.

A Systematic Review of Medicinal Plants and Their Compounds Validated as Agents for the Management of Sickle Cell Disease

Some plants used in traditional medicine to manage sickle cell disease have been validated pharmacologically to ascertain their anti-sickling properties. However, there is no global systematic review of the evidence in support of their use for sickle cell management. This research aimed to conduct a systematic review of the pharmacological evidence to highlight species, genera, and some phytochemicals which could be primed for novel anti-sickling medications. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were used. Articles in English, published from 2000 to 2022 were included in the analysis. The literature search covered 411 publications of which 82 were found to be eligible. More than half (53.65%) of the articles were published from 2016 to 2022. Anti-sickling research from Africa accounted for 86.58% of the publications, with more than half coming from Nigeria, 12.20% from Asia and only 1.22% from Europe. The Fabaceae, Euphorbiaceae, and Annonaceae were the top three plant families whereas Zanthoxylum and Terminalia were the most reported genera. Carica papaya and Terminalia catappa were the most reported species. Sickling reversal ( n = 33/82) and hemoglobin polymerization studies ( n = 29/82) were the most reported assays. Benzoic acid derivatives, butyl stearate, ellagic acid derivatives, and some pentacyclic triterpenoids were the only plant derived compounds validated for anti-sickling activities. A total of 117 plant species with anti-sickling activities were documented. Studies on secondary metabolites with anti-sickling properties to serve as scaffolds for novel drug development for sickle cell management were limited.

Cost and cost-effectiveness of treatments for rheumatic heart disease in low- and middle-income countries: a systematic review protocol.

This review will synthesize studies on costs, the impact of these costs, and the cost-effectiveness of treatments for rheumatic heart disease (RHD) in low- and middle-income countries. RHD incurs high costs owing to its clinical complexity, surgical treatments, and prolonged hospital stays. Thus, the disease has a substantial economic impact on the health system, patients, and their families. No systematic review on economic evidence of treatments for RHD has been published to date. This review will consider all cost and cost-effectiveness studies on RHD treatments for children and young adults (5─30 years) residing in low- and middle-income countries. The review will follow the JBI methodology for systematic reviews of economic evaluation evidence. The search strategy will locate published and unpublished studies in English. Systematic searches will be conducted in MEDLINE (PubMed), MEDLINE (Ovid), Embase (Ovid), Scopus, CINAHL (EBSCOhost), National Health Service Economic Evaluation Databases, Pediatric Economic Database Evaluation, and Cost-Effectiveness Analysis Registry. Two independent reviewers will screen titles and abstracts, followed by a full-text review based on the inclusion criteria. Data will be extracted using a modified JBI data extraction form for economic evaluations. JBI's Dominance Ranking Matrix for economic evaluations will be used to summarize and compare the results of cost and cost-effectiveness studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence for outcomes related to resource use. PROSPERO CRD42023425850.

Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report.

Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.