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

In Silico Evaluation of Algorithm-Based Clinical Decision Support Systems: Protocol for a Scoping Review.

Integrating algorithm-based clinical decision support (CDS) systems poses significant challenges in evaluating their actual clinical value. Such CDS systems are traditionally assessed via controlled but resource-intensive clinical trials. This paper presents a review protocol for preimplementation in silico evaluation methods to enable broadened impact analysis under simulated environments before clinical trials. We propose a scoping review protocol that follows an enhanced Arksey and O'Malley framework and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to investigate the scope and research gaps in the in silico evaluation of algorithm-based CDS models-specifically CDS decision-making end points and objectives, evaluation metrics used, and simulation paradigms used to assess potential impacts. The databases searched are PubMed, Embase, CINAHL, PsycINFO, Cochrane, IEEEXplore, Web of Science, and arXiv. A 2-stage screening process identified pertinent articles. The information extracted from articles was iteratively refined. The review will use thematic, trend, and descriptive analyses to meet scoping aims. We conducted an automated search of the databases above in May 2023, with most title and abstract screenings completed by November 2023 and full-text screening extended from December 2023 to May 2024. Concurrent charting and full-text analysis were carried out, with the final analysis and manuscript preparation set for completion in July 2024. Publication of the review results is targeted from July 2024 to February 2025. As of April 2024, a total of 21 articles have been selected following a 2-stage screening process; these will proceed to data extraction and analysis. We refined our data extraction strategy through a collaborative, multidisciplinary approach, planning to analyze results using thematic analyses to identify approaches to in silico evaluation. Anticipated findings aim to contribute to developing a unified in silico evaluation framework adaptable to various clinical workflows, detailing clinical decision-making characteristics, impact measures, and reusability of methods. The study's findings will be published and presented in forums combining artificial intelligence and machine learning, clinical decision-making, and health technology impact analysis. Ultimately, we aim to bridge the development-deployment gap through in silico evaluation-based potential impact assessments. DERR1-10.2196/63875.

Pervasive Games for Sexual Health Promotion: Scoping Literature Review.

Serious games play a fundamental role in promoting safe sexual behaviors. This medium has great potential for promoting healthy behaviors that prevent potential risk factors, such as sexually transmitted infections, and promote adherence to sexual health treatments, such as antiretroviral therapy. The ubiquity of mobile devices enhances access to such tools, increasing the effectiveness of video games as agents of change. In this scoping review, we aimed to (1) identify the extent to which pervasive games have been used in the field of sexual health, (2) determine the theories used in the design and evaluation of pervasive games for sexual health, (3) identify the methods used to evaluate pervasive games for sexual health, and (4) explore the reported benefits of using pervasive games for sexual health. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology, we conducted a comprehensive literature search in the Web of Science, Scopus, IEEE Xplore, and ACM databases for articles published between January 1, 2000, and August 4, 2024. Included articles were published in English between 2000 and 2024 and involved the design, implementation, or evaluation of a ubiquitous video game focused on promoting safe sexual behaviors, with qualitative and/or quantitative results based on theory-based techniques and ubiquitous technologies. Review articles, conference papers, or books without available data or quantitative or qualitative results were excluded. We screened 521 of 612 articles (85.1%) after removing duplicates. After the title and abstract review, 51 (9.8%) articles were assessed for eligibility, and 30 (5.8%) articles meeting the criteria were studied and evaluated in depth. The results suggested that the use of pervasive video games has a positive impact on promoting safe sexual behaviors. This is enhanced by the effectiveness of theory-based techniques and the use of mobile technologies as developmental factors that drive the gaming experience. The results indicated that this domain is a growing field that should not be ignored. The literature showed that pervasive video games have been effective in promoting safe sexual behaviors. Substantial growth has been seen in scientific community interest in researching this domain; nevertheless, there is still much to work on. In this context, we advocate for the standardization of design, implementation, and experimentation as essential phases in creating video game experiences. These 3 fundamental aspects are critical in the development of video game-based studies to ensure the reproducibility of experiments.

Barriers and enablers to delivering chronic disease preventive care in mental health settings: A scoping review protocol

Background Individuals with mental health difficulties have a higher risk of chronic disease and a lower life expectancy than the general population due, at least in part, to higher rates of modifiable health behaviours including smoking, alcohol and drug consumption, inadequate physical activity, and poor diet. The delivery of preventive care by healthcare professionals in mental health settings is recommended to improve health and wellbeing and reduce the risk of chronic disease in this population. However, there are barriers to the implementation of preventive care within these settings. Aim This scoping review aims to identify and narratively synthesise the available evidence of the barriers and enablers of healthcare professionals delivering preventive care for all of these modifiable health behaviours (smoking, alcohol and drug use, physical activity, and diet) in mental health settings. Methods This review will be guided by the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The following databases will be searched: Medline All, PsycINFO, Embase and CINAHL. Two independent reviewers will conduct initial title and abstract screening, followed by full-text screening for eligibility. Two independent reviewers will conduct data extraction. Data will be deductively analysed using the Theoretical Domains Framework (TDF) with results presented narratively. Conclusion This scoping review will provide a comprehensive overview of the factors influencing the delivery of chronic disease preventive care in mental health settings. The findings will inform future research, practice, and policy in these settings.

Toward a Sense of Place Unified Conceptual Framework Based on a Narrative Review: A Way of Feeding Place-Based GIS

Space and place are two of the main concepts in several fields of knowledge, such as human geography, environmental psychology, urban sociology, architecture, urban planning, and others. Space is an objective and structured concept. It is mainly a physical location characterized by measured dimensions and geographical coordinates, while place is a location that holds meaning and value for an individual or a group, created through the human experience and social interactions. Sense of place is thus a set of precepted meanings and attitudinal ties toward a place (conative, affective, and cognitive bonds). From a geospatial perspective, the subjective aspect of sense of place is difficult to depict in a cartographic projection. From this angle, Place-Based Geographic Information Systems represent a set of initiatives that attempt to combine the objectivity of spaces and the subjectivity of places in digital systems, and that integrate spatial semantic characteristics as described by places’ users. In this paper, the methodological approach is mainly based on a systematic analysis and search of the scientific literature. It is a narrative review inspired and based on a scoping review strategy following the JBI methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews) checklist. This bibliographic analysis is about understanding the characterization and the components of sense of place. Results take the form of a synthesis of the conceptual approaches most prominent in the literature, in addition to a conceptual model encompassing the full conceptual specificities of the sense of place concept.

Bridging the Gap in the Adoption of Trustworthy AI in Indian Healthcare: Challenges and Opportunities

The healthcare sector in India has experienced significant transformations owing to the advancement in technology and infrastructure. Despite these transformations, there are major challenges to address critical issues like insufficient healthcare infrastructure for the country’s huge population, limited accessibility, shortage of skilled professionals, and high-quality care. Artificial intelligence (AI)-driven solutions have the potential to lessen the stress on India’s healthcare system; however, integrating trustworthy AI in the sector remains challenging due to ethical and regulatory constraints. This study aims to critically review the current status of the development of AI systems in Indian healthcare and how well it satisfies the ethical and legal aspects of AI, as well as to identify the challenges and opportunities in adoption of trustworthy AI in the Indian healthcare sector. This study reviewed 15 articles selected from a total of 1136 articles gathered from two electronic databases, PubMed and Google Scholar, as well as project websites. This study makes use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). It finds that the existing studies mostly used conventional machine learning (ML) algorithms and artificial neural networks (ANNs) for a variety of tasks, such as drug discovery, disease surveillance systems, early disease detection and diagnostic accuracy, and management of healthcare resources in India. This study identifies a gap in the adoption of trustworthy AI in Indian healthcare and various challenges associated with it. It explores opportunities for developing trustworthy AI in Indian healthcare settings, prioritizing patient safety, data privacy, and compliance with ethical and legal standards.

Global perspectives in acute and emergency general surgery in low and middle-income countries: a WSES project protocol for scoping review on global surgery

BackgroundAround five billion people globally lack access to safe, timely, and affordable surgical facilities and care in low-income and middle-income countries (LMICs). Global initiatives have been launched, including efforts led by organizations. Also, regional efforts have shed light on the unique challenges faced by different areas within LMICs. Despite these efforts, many countries still face significant challenges, including inadequate infrastructure, limited availability of trained surgical personnel, lack of essential medical equipment, and insufficient financial resources allocated to healthcare and their related possible factors. Here is that we aim to identify the progress made in areas such as capacity building, training programs, infrastructure development, and policy reforms, as well as highlight the gaps that persist, providing a foundation for future research. Such a comprehensive scoping review will be crucial to enhance surgical care services and ultimately improve health outcomes in LMICs.MethodsA comprehensive literature search up to November 2024 will be conducted across six major databases. PubMed, Scopus, Ovoid, Web of Science, Cochrane Central, CNKI (China National Knowledge Infrastructure) database. The methodology will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. The first version of this project will not include a quality appraisal.

Content and outcome of non-pharmacological rehabilitation in hospital, or community-based care, for women with traumatic brain injury: a scoping review protocol

IntroductionTraumatic brain injury (TBI) is a global health issue and a leading cause of long-term disabilities and mortality worldwide. There is growing evidence that TBI rehabilitation should be differentiated and...

Exploring tele-speech therapy: A scoping review of interventions, applications, benefits, and challenges.

Speech disorders can significantly impact communication, social interaction, and overall quality of life, affecting individuals of all ages. Telespeech therapy has emerged as an innovative solution, leveraging technology to provide accessible and effective speech interventions remotely. This approach offers flexibility and convenience, addressing barriers such as geographical limitations and scheduling conflicts. This review aims to explore key interventions, applications, benefits, and challenges of telespeech therapy to enhance understanding of its potential in improving speech and language outcomes. The scoping review was carried out in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Three electronic databases PubMed, Scopus, and Web of Science were searched. Two authors independently screened and selected the studies. Of the 2,587 papers, 52 articles were included in our review. Telespeech was most commonly used for treating aphasia (n=17), stuttering (n=8), and Parkinson's disease (n=6). The primary interventions included videoconferencing (63%), web-based platforms (24%), and mobile applications (13%), with most services delivered synchronously (63%) and some asynchronously (37%). The most common applications were "rehabilitation and treatment" (59%) and "performance assessment of patients"(35%). A total of 264 tele-speech benefits and challenges were identified and later consolidated into 40 items (26 benefits, 14 challenges). Key benefits included "reliable access to healthcare services and addressing disparities" (n=26), "cost savings" (n=23), and "improving patient outcomes and quality of care" (n=21). Major challenges were "low-speed internet" (n=13), "lack of technology skills" (n=11), and "limited access to technology" (n=8). Telespeech therapy can be effectively integrated into routine practice, especially in underserved or remote areas. It offers a flexible, cost-effective solution for rehabilitation and performance assessment, improving patient outcomes and addressing healthcare gaps. Continued technological advancements and targeted training can further enhance its benefits and effectiveness.

Enhancing Disaster Preparedness Through Tabletop Disaster Exercises: A Scoping Review of Benefits for Health Workers and Students.

Tabletop Disaster Exercise (TDE) is a unique learning method through simulation designed to improve disaster preparedness. It is used every year to train health workers and students in disaster preparedness. However, no review has summarized the potential of TDE. This review aimed to identify the potential of using TDE to improve disaster preparedness among health workers and students. A scoping review was used by following the guidelines of The PRISMA Extension for Scoping Reviews (PRISMA-ScR). A literature search was conducted using five primary databases: CINAHL, PubMed, ScienceDirect, Scopus, Taylor and Francis, and one search engine, Google Scholar. The keywords were "health workers OR health professionals AND nursing student OR Student AND tabletop exercise OR tabletop disaster exercise AND Disaster preparedness". The inclusion criteria were full-text articles that can be accessed and published in English and primary studies. This scoping review includes 12 articles. Most of the studies included in this review employed quasi-experimental or pre-experimental designs. The studies were conducted across a variety of countries, including Indonesia, United States, Australia, Iran, Greece, Korea, Qatar, and India. The potential of TDE in improving disaster preparedness is divided into two groups: health workers and students. TDE can improve students' knowledge, attitudes, self confidence and disaster preparedness. In addition, for health workers, TDE improves knowledge, attitudes, awareness, competence, understanding of roles in disaster management, preparedness, performance, triage skills, and self confidence in managing disaster incidents. TDE, as a disaster management learning method, has great potential to improve disaster preparedness, emergency response, and the ability of health workers to deal with disasters. Nurse managers can design TDE based training and work with educational institutions to integrate it into the curriculum.

Identification of Increased Buccal Facial Fat as a Premature Predictor of Metabolic Syndrome: A Scoping Review

In recent decades, there has been a notable increase in the prevalence of obesity, particularly visceral obesity, which is associated with heightened morbidity and mortality worldwide. Recently, a series of studies have suggested that facial features, including buccal fat tissue, may serve as alternative indicators of insulin resistance, metabolic syndrome, and cardiovascular diseases, given that buccal and visceral adipose tissues share histological and metabolic similarities. This review followed the structure of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) protocol yo platforms to answer the research question: How does buccal facial fat act as an early predictor of metabolic syndrome? Buccal fat pad (BFP) was discovered by Xavier Bichat in 1801. Facial fat loss is related to a reduction in visceral fat. Facial parameters, such as the distance between earlobes and jaw width, were used to identify visceral obesity. The reviewed studies emphasize the relationship between facial adipose tissue, especially BFP, and visceral obesity, with valuable implications for clinical practice. Individuals with higher BFP tend to have more visceral fat, highlighting its potential in the early identification of metabolic risks.

Dialectical Behavior Therapy Skills Training as a Brief Intervention for Cigarette Smoking by Patients With Cancer: A Scoping Review and Narrative Synthesis of Related Literature.

Novel behavioral interventions are needed for patients with cancer who smoke cigarettes. Standard tobacco treatment may not effectively address the psychological distress and/or emotion dysregulation that makes quitting smoking difficult for many patients. Dialectical Behavior Therapy-Skills Training (DBT-ST) has demonstrated efficacy as a brief intervention for managing emotions and stress across varied populations but has not been adapted for patients with cancer who smoke. To determine its suitability for this population, we conducted a scoping review of brief DBT-ST with similar populations: people with substance use, breast cancer, or emotion dysregulation. We followed PRISMA-ScR (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews) guidelines. Studies were restricted to English-language publications of DBT-ST as a brief intervention of 20 or fewer sessions. We found 26 publications representing 23 research studies, extracted study details, and narratively synthesized the results. The 23 studies included 12 quasi-experimental designs, seven pilot randomized controlled trials (RCTs), and four RCTs. All studies found at least one improvement in a main outcome following DBT-ST intervention, with results maintained at follow-up. Qualitative outcomes indicated high satisfaction with DBT-ST and good retention. Studies recruited diverse participants, with some far exceeding population averages. Over half of the studies included only females or males. We found considerable heterogeneity across studies in intervention design, testing, and measurement. DBT-ST as a brief intervention for people with substance use, cancer, or emotion dysregulationdemonstrates sufficient positive outcomes to adapt this approach for patients with cancer who smoke cigarettes.

Factors Associated with Psychological Well-Being Among Children Under 18 Years Old with Cancer: A Scoping Review.

Cancer diagnosis and treatment can have severe psychological impacts on children that can affect various aspects of their emotional, social and cognitive functioning. Many children with cancer experience long-term psychological distresses. The psychological well-being (PWB) is a critical aspect of their overall health. Understanding the factors that influence their psychological state can help in developing effective interventions to support them. This scoping review aimed to identify and summarize the factors associated with PWB among children with cancer. This study applied a scoping review using the guidelines outlined in the PRISMA Extension for Scoping Reviews (PRISMA-ScR). A comprehensive literature search was conducted across multiple databases, including PubMed, CINAHL, Taylor and Francis, and Scopus. Inclusion criteria were included by keywords Psychological well-being OR Psychological AND Children OR Child OR Pediatric OR Childhood AND Adolescent OR Teenagers OR Youth AND Cancer OR Neoplasms OR Tumors OR Malignancy OR Cancer Survivors AND predictor OR factors OR determinant. Studies were included if they investigated psychological well-being in children (aged 0-18 years) with cancer. The Arksey and O'Malley framework for scoping reviews guided the methodology, including study selection, data extraction, and thematic analysis. The quality of the evidence was evaluated using the Joanna Briggs Institute (JBI) and the Mixed Methods Appraisal Tool (MMAT) critical appraisal checklist. 12 articles met the inclusion criteria and were included in the review. The factors most frequently reported in several categories are age (sociodemographic), psychological function (individual factors), age at diagnosis (health and history), parent attachment and school status (environmental factors). This review found several aspects that describe the PWB of the articles reviewed. These aspects consist of anxiety, depression, distress, well-being, and self-esteem. From these aspects, many predictors were obtained, which were classified into four categories of factors related to the PWB of children with cancer.

Viscoelastic testing of fibrinolytic capacity in acutely infected critically ill patients: Protocol for a scoping review.

Viscoelastic testing (VET) has been implemented in clinical care to diagnose and manage coagulation in patients with manifest or high risk of major bleeding. However, the breakdown of formed blood clots, that is, fibrinolysis, has been comparatively less studied. There is an increasing recognition that acute infections trigger a dysregulated immunothrombotic response, which has focused attention on viscoelastic testing to identify in particular fibrinolysis resistant states. This scoping review on fibrinolysis assessment using viscoelastic testing will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Publications will be included in the review if they evaluate the fibrinolytic capacity of adult patients admitted to an intensive care unit (ICU) for acute infection (including SARS-CoV2) using VET assays that included a fibrinolytic agent. No date or language restrictions will be applied, and all study designs will be considered. A peer-reviewed search strategy will be employed in multiple electronic bibliographic databases and will also include the grey literature. The included studies will be reported by descriptive analyses and tabulated results. This scoping review aims to map the research describing viscoelastic testing (VET) to assess fibrinolysis in acutely infected critically ill patients, with the goal of identifying diagnostic capabilities, any associations with patient outcomes, and the potential to guide clinical management.

Exploring Molecular Genetics Research on Obesity in Malaysia: Protocol for a Scoping Review.

Obesity presents a growing challenge to public health, and its intricate association with genetics continues to be a compelling field of study. In countries such as Malaysia, where diverse genetic backgrounds converge, exploring the molecular genetics of obesity is even more imperative. This scoping review aimed to explore the literature on molecular genetics of obesity in Malaysia. Specifically, we sought to characterize existing studies, identify the genetic determinants of obesity, and assess their association with obesity predisposition in the population. This scoping review followed the methodology of the Joanna Briggs Institute and used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist as its guiding framework. Searches were conducted using electronic databases such as PubMed, ScienceDirect, and Scopus, filtering for human studies published until March 2024. Eligible studies included peer-reviewed articles on the Malaysian population irrespective of age or sex. This review excluded review articles, book chapters, non-peer-reviewed conference proceedings, gray literature, and preclinical studies, and the reference lists of the retrieved studies were manually examined to ensure thorough inclusion. The articles were subjected to a 2-stage screening process (title/abstract and full text) conducted by 2 reviewers to assess eligibility. Eligible articles were then extracted following a data extraction framework and organized into a charting table. Only studies investigating the genetics of obesity in Malaysian populations were included. As of March 2024, our extensive search strategy has yielded 572 records. After removing 153 duplicates, 419 records were screened by title and abstract, resulting in 47 selected for full-text review. Of these, 34 were chosen for data extraction and detailed analysis. These studies predominantly involved participants from major ethnic groups (Malay, Chinese, and Indian) recruited from local health centers and university communities. The articles primarily explored the relationship between specific gene variants and obesity or obesity-related health parameters. This ongoing research is expected to be completed with a comprehensive scoping review by April 2025. This review provides valuable insights into the genetic determinants of obesity in Malaysia, despite limitations such as no quality appraisal being conducted for the included studies and the search strategy being restricted to selected databases, potentially omitting relevant studies. However, this review ensured reliability and reproducibility by adhering to the Joanna Briggs Institute and PRISMA-ScR guidelines. Ultimately, this study advances the understanding of local research and sets the foundation for future molecular genetic studies to improve obesity risk prediction and management in Malaysia's multiethnic population. DERR1-10.2196/60838.

Protocols for Postanesthesia Care Unit Handoff and Patient Safety: A Scoping Review.

To map studies that tested an intervention orienting patient transfer to Postanesthesia Care Unit (PACU) and identify outcomes related to care safety. Scoping review guided by recommendations of the JBI Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guide. The Population, Concept, and Context (PCC) framework was used to develop the research question and consolidate inclusion and exclusion criteria in databases consulted without date parameters. The review protocol was registered in the Open Science Framework. The systematic search identified 182 records. After reading their titles and abstracts, 49 studies were read in full. The final sample consisted of 17 texts published between 2013 and 2024. The main elements evaluated in the implementation of interventions to guide patient transfer to the PACU related to patient safety were as follows: increase in the number of transferred information; higher rates of professional satisfaction with teamwork; presence of surgical professionals; questions from the receiver and adequacy to the instrument. Also was identified a pause to monitor the patient before the transfer and reduction of omitting information, interruptions, distractions, task errors, hypoxemia, nausea, vomiting and excessive pain. The variables evaluated after the interventions to promote a structured patient transfer to the PACU have the potential to guide the development of quality assessment indicators and contribute to the promotion of a safety culture in institutions. Considering the constant increase in complexity and demand for perioperative care, the investigation of patient transfer processes to the PACU can provide support for the management of surgical practices and contribute to improving patient safety and the experience of the health professionals involved. No patient or public contribution. OSF registration: https://doi.org/10.17605/OSF.IO/M2FYN.

Exploring the effects of climate change on child malnutrition: protocol for a scoping review

IntroductionRapid climate changes in the early 21st century have triggered a global syndemic intertwining obesity, undernutrition and climate change, profoundly affecting health, especially children. Despite increasing research, a significant gap...

Consideration of Cybersecurity Risks in the Benefit-Risk Analysis of Medical Devices: Scoping Review.

The integration of connected medical devices (MDs) into health care brings benefits but also introduces new, often challenging-to-assess risks related to cybersecurity, which have the potential to harm patients. Current regulations in the European Union and the United States mandate the consideration of these risks in the benefit-risk analysis (BRA) required for MD approval. This important step in the approval process weighs all the defined benefits of a device with its anticipated risks to ensure that the product provides a positive argument for use. However, there is limited guidance on how cybersecurity risks should be systematically evaluated and incorporated into the BRA. This scoping review aimed to identify current legal frameworks, guidelines, and standards in the United States, Canada, South Korea, Singapore, Australia, the United Kingdom, and the European Union on how cybersecurity risks should be considered in the BRA of MDs. This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. A systematic literature search of 10 databases was conducted in two phases on July 3, 2024 and September 30, 2024, including the guidance databases of the Food and Drug Administration, the Medical Device Coordination Group, and other International Medical Device Regulators Forum members; the International Medical Device Regulators Forum database; PubMed; and Scopus. Search terms included "cybersecurity," "security," "benefit/risk," "benefit-risk," and "risk-benefit." Additional references were identified via citation searching and expert interviews. Inclusion criteria were met if a document was a guideline or standard in force that provided guidance on the BRA or cybersecurity risks of MDs. Documents were excluded when they were not relevant to MDs, they were limited to a subclass of devices, they were about in vitro diagnostic MDs or investigational devices, and the content of the source was insufficient to undertake a scientific analysis. Data were extracted and analyzed using MAXQDA 2022, and the findings were narratively summarized and visualized in figures and tables. The search identified 150 documents, with 34 (22.7%) meeting the inclusion criteria. These 34 documents included 4 (12%) regulations, 5 (15%) standards, 6 (18%) technical reports, and 19 (56%) guidance documents. While cybersecurity risks were acknowledged in most documents, detailed methods for their integration into the BRA were lacking. Some standards and guidelines provided examples of how to consider cybersecurity risks in the BRA, but a comprehensive and standardized approach was lacking. This review highlights a substantial gap between the recognition of cybersecurity risks in MDs and the guidance on their incorporation into the BRA. Standardized frameworks are needed to provide clear methods for evaluating cybersecurity risks and their impact on the safety and security of MDs.

Use of Antimicrobial Photodynamic Therapy to Inactivate Multidrug-Resistant Klebsiella pneumoniae: Scoping Review.

Klebsiella pneumoniae is a Gram-negative bacillus responsible for a wide variety of potentially fatal infections and, in turn, constitutes a critical agent of healthcare-associated infections. Moreover, K. pneumoniae is characterized by multi-drug-resistant (MDR) bacteria, such as extended-spectrum beta-lactamases (ESBL) and carbapenemase (KPC) producer strains, representing a significant health problem. Because resistances make it difficult to eradicate using antibiotics, antimicrobial photodynamic therapy (aPDT) promises to be a favorable approach to complementing conventional therapy against MDR bacteria. This study aims to provide relevant bibliographic information on the state of the art of application of aPDT against K. pneumoniae and MDR K. pneumoniae. Our methodology follows a protocol using the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines, and the search consults the PubMed (MESH), Google Scholar, and Scopus databases from January 2012 to September 2024. The eligibility criteria were (1) original articles after 2012 referring to antimicrobial photodynamic activity in K. pneumoniae in vitro and in vivo: clinical applications and synergism with antibiotics, other antimicrobial drugs, or PS coupled to other particles, (2) articles in English, and (3) articles peer-reviewed. Results. Following two independent searches in databases, 298 records were found. After applying eligibility criteria and various filters, such as removing duplicates, 25 studies were included in this review. The evidence demonstrates the effectiveness of aPDT in vitro in eradicating sensitive or MDR-K. pneumoniae strains, including strains producing biofilms, ESBL, and KPC. Finally, it is concluded that aPDT is a recommended antimicrobial therapy, but more research in vivo is needed to support studies in humans.

Barriers and Facilitators of Research Finding Utilization in Healthcare: A Scoping Review

Background: We aimed to identify and classify barriers and facilitators of implementation of research finding in healthcare. Methods: A scoping review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR). Articles were extracted from online databases. The initial search was implemented on Jun, 2022, and updated until end of 2023. Two independent reviewers screened, selected, and extracted the data. Data were synthesized using thematic analysis. Results: Overall, 32 studies from 3,435 documents met the inclusion criteria. From which 60 barriers and 45 facilitators were identified. The main barriers and facilitators extracted were grouped into eight components: Organization, Collaboration to knowledge utilization, Researcher role, Methodology and technical aspect of research, Management, Cultural and social determinants, Training, and Government and community. Organizational barriers and facilitators were the most concerning with insufficient attention, methodology and technical aspects of research were salient barriers, and the other components had similar roles. Conclusion: This study directly addresses a gap in implementing the research findings in organizations. The government would benefit from knowledge implementation with respect to evidence utilization. Additionally, implementation knowledge was not transferred to healthcare practice to a sufficient extent, thus restricting the systematic use of implementation knowledge in practice.

Digital symptom management interventions for people with chronic kidney disease: a scoping review based on the UK Medical Research Council Framework

BackgroundChronic Kidney Disease (CKD) is a growing global health issue with a complex symptom phenotype. It negatively impacts patients’ health-related quality of life and increases healthcare utilization. While digital health interventions offer promising avenues for improving symptom management in CKD, understanding their development, validation, and effectiveness is crucial for clinical application.ObjectiveTo comprehensively map the existing literature on digital health interventions designed to manage symptoms in patients with Chronic Kidney Disease (CKD), using the UK Medical Research Council’s complex intervention framework as a guiding lens. This scoping review aims to: (1) catalogue digital health interventions utilized in CKD symptom management; (2) detail the range of outcome measures assessing intervention effectiveness, including clinical efficacy, patient adherence, and quality of life; (3) examine the methodologies and frameworks employed in the creation of these interventions; (4) assess the pilot testing and effectiveness evaluations; and (5) categorize and analyze the barriers to implementation.MethodsA scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Databases searched included PubMed, Scopus, Embase, and others, covering literature up to December 2023. Studies were selected based on predefined eligibility criteria for digital health interventions for CKD symptom management.ResultsThe search yielded 31 studies, with a mix of development and validation studies, predominantly from developed countries. The review highlights the potential of digital interventions in enhancing symptom management, quality of life, and patient engagement in CKD care. However, gaps were identified as follows: (1) Iterative refinement cycles involving multidisciplinary stakeholders enhanced intervention acceptability and usability should be guaranteed, (2) Theory-driven and evidence-based approaches were underutilized in current intervention development, (3) Long-term implementation outcomes and process evaluations were rarely assessed. This review maps an evolving landscape where digital health interventions offer patient-centric solutions for CKD symptom management while highlighting opportunities for methodological advancements.ConclusionDigital health interventions hold promise for improving symptom management in CKD, yet more research is needed to overcome current limitations and fully realize their potential. Future studies should focus on patient-centred designs, comprehensive validation processes, exploring the underlying mechanism using process evaluation and the integration of these technologies into routine clinical practice.