Preferred Reporting Items For Systematic Reviews And Meta-Analyses Statement Research Articles

Redefining the Concept of Local Wisdom-Based CSR and Its Practice

Local wisdom is very important for corporate social responsibility (CSR) activities which benefit local communities, especially in the case of companies in Indonesia; however, these companies have not yet understood the concept and examples of local wisdom-based CSR activities. This research aims to formulate the concept of such CSR and its practice in Indonesia. To fulfil its objective, the study makes a systematic review of 74 local wisdom-based, CSR articles with an Indonesian background based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Google Scholar, ScienceDirect, Scopus, and Emerald Insight were used as the main databases to find related articles. In accordance with the concept of local wisdom-based CSR, the research focuses on community empowerment activities and how local wisdom is a key part of these. Local wisdom-based CSR activities are categorised into three types: CSR based on local wisdom, CSR that considers local wisdom, and CSR that uses local wisdom. The findings will aid companies in planning and implementing such activities. Through the research gaps identified, the study will also facilitate future researchers in conducting local wisdom-based CSR research.

Protocol: The role of defunctioning stoma prior to neoadjuvant therapy for locally advanced colonic and rectal cancer-A systematic review.

Defunctioning stomas (ileostomy and colostomy) may be used prior to commencement of neoadjuvant therapy in patients with locally advanced colon or rectal cancer, in order to prevent clinical large bowel obstruction caused by radiotherapy associated oedema or progression of disease in patients who are not obstructed. However, the exact rate of clinical obstruction in patients undergoing neoadjuvant therapy who do not receive a defunctioning stoma is not known. Furthermore, it is not clear which factors predispose patients to developing clinical large bowel obstruction. Given that defunctioning stomas are associated with post operative and intra-operative risks, it is not currently possible to tailor defunctioning stomas to patients who have the greatest risk of developing obstruction. This systematic review which is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), aims to define the role of defunctioning stomas in prevention of obstruction patients with locally advanced colon or rectal cancer while undergoing neoadjuvant therapy. Two researchers will perform the literature search which will include all published and "in process" articles published in the English language between 2002-2022 in the following databases: EMBASE (OVID), MEDLINE (EBSCO), CINHAL complete, Web of Science, Cochrane Central Registry of Controlled Trials, Clinical Trials Registry. The full text of the selected articles will be independently screened by two researchers against the inclusion criteria. Data will be extracted from each article regarding: study design, participants, type of intervention and outcomes. The effect size will be expressed in incidence rates and when appropriate in relative risk with 95% confidence intervals. If possible, we will perform a meta-analysis. Heterogeneity will be assessed using I2 statistics. We will pool the data extracted from the randomised controlled trials to perform a meta-analysis using the Review Manager 5 software (RevMan 5). The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system will be used to assess the certainty of the evidence.

Evaluating the Effectiveness of Internet-Based Communication for Public Health: Systematic Review.

BackgroundCommunicating strategically is a key issue for health organizations. Over the past decade, health care communication via social media and websites has generated a great deal of studies examining different realities of communication strategies. However, when it comes to systematic reviews, there is fragmentary evidence on this type of communication.ObjectiveThe aim of this systematic review was to summarize the evidence on web institutional health communication for public health authorities to evaluate possible aim-specific key points based on these existing studies.MethodsGuided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, we conducted a comprehensive review across 2 electronic databases (PubMed and Web of Science) from January 1, 2011, to October 7, 2021, searching for studies investigating institutional health communication. In total, 2 independent researchers (AN and SS) reviewed the articles for inclusion, and the assessment of methodological quality was based on the Kmet appraisal checklist.ResultsA total of 78 articles were selected. Most studies (35/78, 45%) targeted health promotion and disease prevention, followed by crisis communication (24/78, 31%), general health (13/78, 17%), and misinformation correction and health promotion (6/78, 8%). Engagement and message framing were the most analyzed aspects. Few studies (14/78, 18%) focused on campaign effectiveness. Only 23% (18/78) of the studies had an experimental design. The Kmet evaluation was used to distinguish studies presenting a solid structure from lacking studies. In particular, considering the 0.75-point threshold, 36% (28/78) of the studies were excluded. Studies above this threshold were used to identify a series of aim-specific and medium-specific suggestions as the communication strategies used differed greatly.ConclusionsOverall, the findings suggest that no single strategy works best in the case of web-based health care communication. The extreme variability of outcomes and the lack of a unitary measure for assessing the end points of a specific campaign or study lead us to reconsider the tools we use to evaluate the efficacy of web-based health communication.

Determinants of Physical Activity in the Cardiac Population: Protocol for a Systematic Review

BackgroundLack of physical activity is a critical contributing risk factor to cardiovascular disease. Hence, regular physical activity is a mainstay in the primary and secondary prevention of cardiovascular disease. Despite the extensive promotion of physical activity in both primary and secondary prevention programs, including cardiac rehabilitation, physical activity levels in the cardiac population remain low. Therefore, it is crucial to understand critical determinants that influence physical activity behavior.ObjectiveThis study aims to deliver a systematic review of studies with collated observational data exploring the association between determinants and physical activity behavior in the target population. These new insights inform the design of future interventions targeted at lasting heart-healthy physical activity behavior in the cardiac population.MethodsPrimary studies with observational quantitative data on determinants and their association with physical activity behavior in the cardiac population will be included. Information on relevant primary studies will be retrieved from various databases, including Embase, CINAHL, MEDLINE, PsycInfo, and Web of Science Core Collection. Six reviewers will independently double-screen articles. Studies will be selected according to the prespecified inclusion and exclusion criteria. Data will be extracted and entered into suitable worksheets. The US-based National Heart, Lung, and Blood Institute’s Study Quality Assessment Tool for Observational Studies will be used to assess the quality of all eligible primary studies. The results will be presented in a descriptive and narrative synthesis. If the type and quality of data are suitable, meta-analyses will be conducted. Study reporting will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.ResultsData collection started in September 2020, and the literature search was updated in July 2021. Data synthesis is ongoing, and the literature search will be updated in October 2022.ConclusionsThis review will be valuable to relevant stakeholders, including clinicians and health care professionals, intervention developers, and decision makers in health care. It lays a comprehensive foundation for understanding the determinants of physical activity to inform the design of secondary prevention interventions relevant to the cardiac population.Trial RegistrationPROSPERO CRD42020206637; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206637International Registered Report Identifier (IRRID)RR1-10.2196/39188

Hyaluronic acid for periodontal tissue regeneration in intrabony defects. A systematic review.

To evaluate the clinical and radiographic outcomes of hyaluronic acid (HA) application alone and in combination with other therapies for the surgical treatment of periodontal intrabony defects. This review was designed in accordance with the PRISMA (preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement based on the proposed focused question. A literature review with no restrictions regarding the status or language of publication was performed until June 2022. Randomised clinical trials, controlled clinical trials, case series, and case reports were considered eligible for inclusion. The Cochrane risk of bias tool was used to assess the methodology of the included studies. The use of HA was divided into four categories depending on whether it was a) applied alone, b) in combination with barriers, c) in combination with growth factors, or d) in combination with bone grafts. Nine studies were included in the analysis. Some of the studies presented variable heterogeneity and a high risk of bias. Every group resulted in a statistically significant improvement in clinical attachment level (CAL) and probing pocket depth after 6–12 months of follow-up. Three studies showed significant results for bone defect filling on using HA. The application of HA can provide moderate and beneficial clinical and radiographic results for the surgical treatment of periodontal regeneration. The heterogeneity and high risk of bias of the included studies reveal the need to perform randomised clinical trials with an appropriate methodological design to evaluate the effect of HA in periodontal regeneration.

Dynamics of Patient-Based Benefit-Risk Assessment of Medicines in Chronic Diseases: A Systematic Review.

BackgroundA critical gap exits in understanding the dynamics of patient-based benefit-risk assessment (BRA) of medicines in chronic diseases during the disease journey.PurposeTo systematically review and synthesize current evidence on the changes of patients’ preferences about the benefits and risks of medicines during their disease journey including the influence of disease duration and severity, and previous treatment experience.MethodsA systematic review of studies identified in PubMed and Embase, from inception to November 2020, was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were eligible if they analyzed adult patient-based BRA of medicines with a chronic disease, based on at least one of the pre-specified dimensions: disease severity, disease duration, or previous treatment experience.ResultsA total of 26,228 articles were identified and 105 were eligible for inclusion. Of these, 85 detected a variation in patient-based BRA of medicines with at least one of the pre-specified criteria. Patients with higher disease severity and more treatment experience have increased risk tolerance. It remains inconclusive whether disease duration directly affects the relative importance of a patient’s preference.ConclusionFactors important for patients’ BRA of their medicines during a chronic disease journey vary more with their clinical situation and previous treatment experience than with time since diagnosis. Due to the importance of these factors on patients’ perspectives and potential impact on their decision-making and eventually their clinical outcomes, there is a need for more studies to assess the dynamics of patients’ BRA in every disease.

Clinical Success in Coronectomy: A 10 -Year Systematic Review

The purpose of the present study was to evaluate the incidence of damage to the inferior alveolar (IAN) after coronectomy, and compare the results within coronectomies that failed, as well as long-term success rates following this procedure. A literature review was made including studies from the years 2010 to 2021 in the PubMed, SCOPUS and Scielo databases, of which 14 met the selection criteria for this review. This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.

87 Surgical Versus Conservative Management of Acute Achilles Tendon Ruptures; A Systematic Review and Meta-Analysis

Abstract Aim To compare the functional outcomes including re-rupture rates, number of participants failing to return to work or sports and scoring scales between surgical and conservative treatment in a systematic review. Method A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) protocol. Studies were identified from these databases: PubMed, Cochrane and CINAHL. Risk-ratio analysis to compare rupture rates and failure to return to work/sports, whilst a standard mean difference analysis compared the functional outcome scores from both treatment groups. Results Seven randomised controlled trial studies included with a total of 486 participants involved in the trials, comprising of 245 participants for surgical intervention and 209 participants for conservative management. There is a higher re-rupture rate in the conservative group compared to the surgical group with a risk ratio (RR) of 0.38 (95% CI 0.16–0.92, P = 0.03). Statistically, there was no significant difference in number of individuals failing to return to work/sports in both treatment modalities, RR for all the three studies were 0.85 (95% CI 0.51,1.41, P = 0.52). A standardised mean analysis with an overall effect Z of 0.40 (std MD 0.09; P 0.69; 95%CI -0.35,0.53) indicate no statistically significant difference in the functional outcomes between the three different studies. Conclusions Surgical intervention only shows an advantage over conservative treatment in terms of re-rupture rates but similar results with conservative treatment when other outcomes including number of participants returning to previous activity levels, plantar flexion and functional scoring systems were assessed.

ANEURYSMAL BONE CYST OF THE JAWS: A SYSTEMATIC REVIEW

<h3>Objectives</h3> To integrate the literature data on aneurysmal bone cyst (ABC) of the jaws into a systematic review of the clinicopathologic features, treatment, and recurrence. <h3>Study design</h3> This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). PubMed, Web of Science, Scopus, and Embase electronic databases were searched. Case reports and case series reporting ABC of the jaws with predefined eligibility criteria were included. <h3>Results</h3> Out of 1,393 references, 151 articles (173 cases) met eligibility criteria. Female individuals (n = 88, 50.9%) with a mean age of 19.2 years (±12.35950 SD) were more affected. Regarding the anatomical location, the mandible (80.9%) was more affected. Clinically, most of the lesions presented as an extraoral swelling (n = 102, 50.2%), followed by intraoral swelling (n = 57, 28.1%). ABCs commonly presented as multilocular (n = 49, 20%) radiolucent (n = 93, 38%) lesions and 23.1% of the cases occurred in association with another lesion. Treatment of choice was mostly conservative (56.1%), presenting a low recurrence rate (n = 18, 10.4%). <h3>Conclusions</h3> Most of the ABCs included in this study occurred in young individuals presenting a low prevalence of recurrences. These results can help professionals to recognize the main clinicopathologic manifestations of ABCs.

Challenges of Telemedicine during the COVID-19 pandemic: a systematic review

BackgroundThe COVID-19 pandemic has prompted the decrease of in-person visits to reduce the risk of virus transmission. Telemedicine is an efficient communication tool employed between healthcare providers and patients that prevents the risk of exposure to infected persons. However, telemedicine use is not infallible; its users reported multiple issues that complicated the expansion of this technology. So, this systematic review aimed to explore the barriers and challenges of telemedicine use during the pandemic and to propose solutions for improving future use.MethodsA systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. PubMed, Scopus, Web of Science, Academic Search Complete, CINAHL, Embase, and Science Direct were used to look for articles addressing barriers and challenges, in addition to articles proposing solutions. Studies were screened by title and abstract, followed by a full-text review. Risk of bias assessment was done using Critical Appraisal Skills Program for qualitative studies, Newcastle–Ottawa Scale for cross-sectional studies, and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews. After the extraction of data, a narrative synthesis and analysis of the outcomes were performed.ResultsAmong 1194 papers identified, only 27 studies were included. Barriers and challenges were assembled under 7 categories: technical aspects, privacy, data confidentiality and reimbursement, physical examination and diagnostics, special populations, training of healthcare providers and patients, doctor-patient relationship, and acceptability. Poor internet connection and lack of universal access to technology were among the technical barriers. Concerns about patient privacy and reimbursement hindered the use of telemedicine too. Physical examination and certain procedures were impossible to perform via telemedicine. Training both healthcare providers and patients was deficient. The doctor-patient relationship was troubled by telemedicine, and both healthcare providers and patients were reluctant to use telemedicine.ConclusionWidespread use of telemedicine is still hampered by various barriers and challenges. Healthcare providers should work with various stakeholders to implement the proposed solutions. More research and policy changes are essential to optimize telemedicine utilization.

Clopidogrel Monotherapy versus Aspirin Monotherapy in Patients with Established Cardiovascular Disease: Systematic Review and Meta-Analysis.

There is no clear consensus on whether aspirin offers better outcomes in terms of secondary cardiovascular disease prevention compared with clopidogrel. The aim of the study was to compare the safety and efficacy of clopidogrel versus aspirin in patients with established cardiovascular disease. A systematic review of MEDLINE (via PubMed), Scopus, and Cochrane Library databases (last search date: August 28, 2021) was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement for randomized control trials (RCTs) of clopidogrel versus aspirin as monotherapy in patients with established cardiovascular disease. Random-effects meta-analyses were performed. Five RCTs incorporating 26,855 patients (clopidogrel: 13,426; aspirin: 13,429) were included. No statistically significant difference was observed between clopidogrel and aspirin in terms of all-cause mortality (odds ratio [OR]: 1.01 [95% confidence interval, CI: 0.91-1.13]; p = 0.83), ischemic stroke (OR: 0.87 [95% CI: 0.71-1.06]; p = 0.16), and major bleeding rates (OR: 0.77 [95% CI: 0.56-1.06]; p = 0.11). Patients receiving clopidogrel had borderline lower risk for major adverse cardiovascular events (MACE) (OR: 0.84 [95% CI: 0.71-1.00]; p = 0.05) and lower risk for nonfatal myocardial infarction (OR: 0.83 [95% CI: 0.71-0.97]; p = 0.02, relative risk reduction = 16.9%, absolute risk reduction = 0.5%, number needed to treat = 217 for a mean period of 20 months) compared with patients receiving aspirin. In patients with established cardiovascular disease, clopidogrel was associated with a 17% relative-risk reduction for nonfatal MI, borderline decreased risk for MACE, and similar risk for all-cause mortality, stroke, and major bleeding compared with aspirin. PROSPERO CRD42021283866.

Structural Heart Alterations in Brugada Syndrome: Is it Really a Channelopathy? A Systematic Review.

Brugada syndrome (BrS) is classified as an inherited cardiac channelopathy attributed to dysfunctional ion channels and/or associated proteins in cardiomyocytes rather than to structural heart alterations. However, hearts of some BrS patients exhibit slight histologic abnormalities, suggesting that BrS could be a phenotypic variant of arrhythmogenic cardiomyopathy. We performed a systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) criteria. Our comprehensive analysis of structural findings did not reveal enough definitive evidence for reclassification of BrS as a cardiomyopathy. The collection and comprehensive analysis of new cases with a definitive BrS diagnosis are needed to clarify whether some of these structural features may have key roles in the pathophysiological pathways associated with malignant arrhythmogenic episodes.

Summary of the evidence on responses and adaptations derived from crossfit training. A systematic review.

Objective: The present review aims to describe the state of the scientific evidence that exists about acute and chronic adaptations of CrossFit training. Method: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Original research articles published until 7 June 2020, were searched using five databases. A total of 994 original publications were found. A total of 62 papers matched the inclusion criteria. Results: Short-term effects: CrossFit training results in higher physiological demands than other training modalities. Different work of the day analysed by the studies have shown specific performance demand profiles. Besides psychological and mechanical acute effects have been found after CrossFit sessions. So, the negative moods perception appears to reduce after a CrossFit training session. Long-term effects: maximum oxygen consumption improves after CrossFit programmes, in which experienced athletes seem to achieve a higher gain than recreational athletes. Important changes in body composition have been reported by several studies included in this review. From a psychological perspective, CrossFit practitioners obtain a higher adherence to training than occurs in other training methodologies. Prospects and projects: Specific requirements of every work of the day should be studied for the correct administration to participants. Accumulative fatigue indexes should be explored as an overtraining syndrome in CrossFit athletes because several authors have reported psychological variables related to training addiction. Conclusion: CrossFit-based training drives several physiological changes that could be influenced by the athlete’s expertise. Moreover, this type of training requires a high physiological demand, which is perceived by athletes. Nevertheless, participants achieve adherence to CrossFit regardless of their objectives. In the case of high-performance athletes, addictive exercise behaviours have been identified.

Green Marketing Practices Related to Key Variables of Consumer Purchasing Behavior

This systematic review research has two objectives: (a) to identify Green Marketing (GM) practices related to the key variables of consumer purchasing behavior, and (b) to present a model for the generation of sustainable value by companies based on the results found. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement process was followed and Scopus and Web of Science (WoS) sources were used for the document search. A total of 248 documents were found (Scopus = 110; WoS = 138), and the final selection was 34 papers. The GM practices found were placed in five categories: (a) Green products and services; (b) Green business image; (c) Green advertising; (d) Green purchasing experience; (e) Green marketing mix. The key variables of purchasing behavior that were found are: Environmental awareness, Green satisfaction, Green attitude, Green purchasing intention, Green purchasing preference, Word of mouth, Perceived value, Green experiential value, Responsible consumption, Green engagement, Green trust, Green loyalty, and Green purchasing decision. Finally, a sustainable value generation model called “Green consumption cycle for sustainable value” was presented.

The Influence of Wearables on Health Care Outcomes in Chronic Disease: Systematic Review.

BackgroundChronic diseases contribute to high rates of disability and mortality. Patient engagement in chronic disease self-management is an essential component of chronic disease models of health care. Wearables provide patient-centered health data in real time, which can help inform self-management decision-making. Despite the perceived benefits of wearables in improving chronic disease self-management, their influence on health care outcomes remains poorly understood.ObjectiveThis review aimed to examine the influence of wearables on health care outcomes in individuals with chronic diseases through a systematic review of the literature.MethodsA narrative systematic review was conducted by searching 6 databases for randomized and observational studies published between January 1, 2016, and July 1, 2021, that included the use of a wearable intervention in a chronic disease group to assess its impact on a predefined outcome measure. These outcomes were defined as any influence on the patient or clinician experience, cost-effectiveness, or health care outcomes as a result of the wearable intervention. Data from the included studies were extracted based on 6 key themes, which formed the basis for a narrative qualitative synthesis. All outcomes were mapped against each component of the Quadruple Aim of health care. The guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement were followed in this study.ResultsA total of 30 articles were included; studies reported 2446 participants (mean age: range 10.1-74.4 years), and the influence of 14 types of wearables on 18 chronic diseases was presented. The most studied chronic diseases were type 2 diabetes (4/30, 13%), Parkinson disease (3/30, 10%), and chronic lower back pain (3/30, 10%). The results were mixed when assessing the impact on a predefined primary outcome, with 50% (15/30) of studies finding a positive influence on the studied outcome and 50% (15/30) demonstrating a nil effect. There was a positive effect of 3D virtual reality systems on chronic pain in 7% (2/30) of studies that evaluated 2 distinct chronic pain syndromes. Mixed results were observed in influencing exercise capacity; weight; and biomarkers of disease, such as hemoglobin A1c, in diabetes. In total, 155 outcomes were studied. Most (139/155, 89.7%) addressed the health care outcomes component. This included pain (11/155, 7.5%), quality of life (7/155, 4.8%), and physical function (5/155, 3.4%). Approximately 7.7% (12/155) of outcome measures represented the patient experience component, with 1.3% (2/155) addressing the clinician experience and cost.ConclusionsGiven their popularity and capability, wearables may play an integral role in chronic disease management. However, further research is required to generate a strong evidence base for safe and effective implementation.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42021244562; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=244562

Mucocutaneous Adverse Effects of Remdesivir and Favipiravir in Patients with Covid-19 Infection

Introduction: Remdesivir and favipiravir are two antiviral medicines used in the treatment of Covid-19 infection widely. The studies pertaining to the mucocutaneous adverse events of these two drugs are scarce. Hence, we performed a systematic review to bridge the above gap. Materials and Methods: The study is performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. All original articles, case series, and case reports pertaining to mucocutaneous adverse drug reactions caused by remdesivir and favipiravir, while any of these drugs were administered in Covid-19-infected patients, were included in the present study. Results: Six articles were identified pertaining to the mucocutaneous adverse reactions of remdesivir, of which two were original articles and four were case reports. Four case reports pertaining to the mucocutaneous adverse events of favipiravir are included in this study. The details regarding the same are elaborated in the main manuscript. Conclusion: In the present systematic analysis, the mucocutaneous adverse events of the two widely used antiviral medications in Covid-19 were described. This articles throws light on the aspects which are hardly reported or discussed in the literature.

Analyzing adverse drug reaction using statistical and machine learning methods: A systematic review.

Background:Adverse drug reactions (ADRs) are unintended negative drug-induced responses. Determining the association between drugs and ADRs is crucial, and several methods have been proposed to demonstrate this association. This systematic review aimed to examine the analytical tools by considering original articles that utilized statistical and machine learning methods for detecting ADRs.Methods:A systematic literature review was conducted based on articles published between 2015 and 2020. The keywords used were statistical, machine learning, and deep learning methods for detecting ADR signals. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines.Results:We reviewed 72 articles, of which 51 and 21 addressed statistical and machine learning methods, respectively. Electronic medical record (EMR) data were exclusively analyzed using the regression method. For FDA Adverse Event Reporting System (FAERS) data, components of the disproportionality method were preferable. DrugBank was the most used database for machine learning. Other methods accounted for the highest and supervised methods accounted for the second highest.Conclusions:Using the 72 main articles, this review provides guidelines on which databases are frequently utilized and which analysis methods can be connected. For statistical analysis, >90% of the cases were analyzed by disproportionate or regression analysis with each spontaneous reporting system (SRS) data or electronic medical record (EMR) data; for machine learning research, however, there was a strong tendency to analyze various data combinations. Only half of the DrugBank database was occupied, and the k-nearest neighbor method accounted for the greatest proportion.

Efficacy of Stem Cell Therapy for Tendon Graft Ligamentization After Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Background:Sufficient intra-articular graft ligamentization enhances the biomechanical and biological properties of the femur-graft-tibia complex to ensure knee stability after anterior cruciate ligament (ACL) reconstruction using a tendon graft. It remains unclear whether stem cell therapy promotes tendon graft ligamentization.Purpose/Hypothesis:The purpose of this study was to compare tendon graft ligamentization after primary ACL reconstruction with versus without stem cell therapy. It was hypothesized was that stem cell therapy would promote tendon graft ligamentization by enhancing the biomechanical and histological properties of the tendon graft after ACL reconstruction.Study Design:Systematic review.Methods:A systematic review was performed according to the guidelines outlined in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement to identify controlled animal studies that compared tendon graft ligamentization outcomes after primary ACL reconstruction in groups with and without stem cell therapy. Biomechanical and histological outcomes were assessed.Results:A total of 4 studies met the eligibility criteria and were included in this review. Bone marrow–derived mesenchymal stem cells were used in 3 studies, while tendon-derived stem cells were used in 1 study. An intra-articular injection was used to deliver conditioned medium and stem cells in 2 studies, while around-graft application was used to deliver bone marrow–derived mesenchymal stem cells in 2 studies. Stem cell therapy enhanced the biomechanical and histological properties of the tendon graft after ACL reconstruction.Conclusion:This review revealed that stem cell therapy is a promising technique that promotes graft ligamentization by enhancing the biomechanical and histological properties of the tendon graft after ACL reconstruction in animal models. There is a need for future preclinical studies aimed at evaluating the effect of stem cells on graft ligamentization and identifying the optimal method of intra-articular stem cell delivery.

Stereotactic Body Radiation Therapy (SBRT) for Oligorecurrent/Oligoprogressive Mediastinal and Hilar Lymph Node Metastasis: A Systematic Review.

Simple SummaryThis paper is a review of the literature on oligorecurrent/oligoprogressive mediastinal and hilar lymph node metastasis treated with SBRT. The use of mediastinal SBRT had historically been not feasible in view of the expected toxicity due to the proximity of critical structures such as the airways and esophagus. Despite the heterogeneity and lack of some data in the studies analyzed, this literature review is the first published and can be a valid guide for the radiotherapist in the management of oligometastatic/oligoprogressive patients, with particular regard to the radiotherapy doses, dose constraints for organs at risk, and clinical outcomes.Introduction: Mediastinal or hilar lymph node metastases are a challenging condition in patients affected by solid tumors. Stereotactic body radiation therapy (SBRT) could play a crucial role in the therapeutic management and in the so-called “no-fly zone”, delivering high doses of radiation in relatively few treatment fractions with excellent sparing of healthy surrounding tissues and low toxicity. The aim of this systematic review is to evaluate the feasibility and tolerability of SBRT in the treatment of mediastinal and hilar lesions with particular regard to the radiotherapy doses, dose constraints for organs at risk, and clinical outcomes. Materials and methods: Two blinded investigators performed a critical review of the Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA), starting from a specific question: What is the clinical impact of SBRT for the treatment of oligorecurrent/oligoprogressive mediastinal and hilar metastasis? All retrospective and prospective clinical trials published in English up to February 2022 were analyzed. Results: A total of 552 articles were identified and 12 of them were selected with a total number of 478 patients treated with SBRT for mediastinal or hilar node recurrence. All the studies are retrospective, published between 2015 and 2021 with a median follow-up ranging from 12 to 42.2 months. Studies following SBRT for lung lesions or retreatments after thorax radiotherapy for stage III lung cancer were also included. The studies showed extensive heterogeneity in terms of patient and treatment characteristics. Non-small cell lung cancer was the most frequently reported histology. Different dose schemes were used, with a higher prevalence of 4–8 Gy in 5 or 6 fractions, but dose escalation was also used up to 52 Gy in 4 fractions with dose constraints mainly derived from RTOG 0813 trial. The radiotherapy technique most frequently used was volumetric modulated arc therapy (VMAT) with a median PTV volume ranging from 7 to 25.7 cc. The clinical outcome seems to be very encouraging with 1-year local control (LC), overall survival (OS) and progression-free survival (PFS) rates ranging from 84 to 94%, 53 to 88% and 23 to 53.9%, respectively. Half of the studies did not report toxicity greater than G3 and only five cases of fatal toxicity were reported. CONCLUSIONS: From the present review, it is not possible to draw definitive conclusions because of the heterogeneity of the studies analyzed. However, SBRT appears to be a safe and effective option in the treatment of mediastinal and hilar lymph node recurrence, with a good toxicity profile. Its use in clinical practice is still limited, and there is extensive heterogeneity in patient selection and fractionation schedules. Good performance status, small PTV volume, absence of previous thoracic irradiation, and administration of a high biologically effective dose (BED) seem to be factors that correlate with greater local control and better survival rates. In the presence of symptoms related to the thoracic lymph nodes, SBRT determines a rapid control that lasts over time. We look forward to the prospective studies that are underway for definitive conclusions.

Use of Virtual Reality-Based Therapy in Patients with Urinary Incontinence: A Systematic Review with Meta-Analysis.

It is estimated that over 400 million people worldwide experience some form of urinary incontinence (UI). Pelvic floor muscle training (PFMT) is commonly used in cases of urine loss. Game therapy (GT) has been suggested as a new conservative modality for UI treatments. GT represents a form of virtual reality (VR) that allows users to interact with elements of a simulated scenario. The purpose of this review was to assess the potential of using VR-based PFMT in the treatment of UI with a particular focus on the impact of this form of therapy on the patients’ muscle function, symptoms of UI and quality of life (QoL). The following electronic databases were searched: PubMed, Embase, Cochrane Library, Scopus and Web of Science. Systematic review methods were based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Electronic medical databases were searched from inception to 28 January 2021. From a total of 38 articles, 26 were analyzed after removing duplicates, then 22 records were excluded according to inclusion criteria and 4 were assessed as full texts. Finally, 2 randomized controlled trials (RCT) with 79 patients were included. For the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the meta-analysis showed a significant difference in favor of the control condition (MD = 2.22; 95% CI 0.42, 4.01; I2 = 0%). Despite the popularity of the use of VR in rehabilitation, we found a scarcity of literature evaluating the application of VR in the field of UI therapy. Only one study matched all of the criteria established. The effects of VR training improved PFM function and QoL; however, these changes were comparable to those of traditional PFMT. It is not possible to reach final conclusions from one study; thus, further development of VR interventions in the field of UI treatments are needed.