System For Information On Grey Literature In Europe Research Articles

Pharmacological Activities and Safety of Ganoderma lucidum Spores: A Systematic Review.

Ganoderma lucidum is traditionally used to prevent and treat some diseases such as liver disorders, hypertension, insomnia, diabetes, and cancer. G. lucidum spore extracts are also reported to share similar bioactivities as extracts from its other parts. However, there is no systematic review that elucidates its pharmacological effect. Our aim is to comprehensively summarise current evidence of G. lucidum spore extracts to clarify its benefits to be applied in further studies. We searched five primary databases: PubMed, Virtual Health Library (VHL), Global Health Library (GHL), System for Information on Grey Literature in Europe (SIGLE), and Google Scholar on September 13, 2021. Articles were selected according to inclusion and exclusion criteria. A manual search was applied to find more relevant articles. Ninety studies that reported the pharmacological effects and/or safety of G. lucidum spores were included in this review. The review found that G. lucidum spore extracts showed quite similar effects as other parts of this medicinal plant including anti-tumor, anti-inflammatory, antioxidant effects, and immunomodulation. G. lucidum sporoderm-broken extract demonstrated higher efficiency than unbroken spore extract. G. lucidum extracts also showed their effects on some genes responsible for the body's metabolism, which implied the benefits in metabolic diseases. The safety of G. lucidum should be investigated in depth as high doses of the extract could increase levels of cancer antigen (CA)72-4, despite no harmful effect shown on body organs. Generally, there is a lot of potential in the studies of compounds with pharmacological effects and new treatments. Sporoderm breaking technique could contribute to the production of extracts with more effective prevention and treatment of diseases. High doses of G. lucidum spore extract should be used with caution as there was a concern about the increase in CA.

Evidence about biological and technical complications regarding tilted versus straight implants supporting fixed dental prostheses.

Systematic review and meta-analysis. MEDLINE, Embase, and Web of Science for English studies published until December 2017 using a controlled vocabulary (MeSH, Emtree) with no time restrictions were searched. The system for information on Grey literature in Europe (SIGLE), a manual search of all issues since 2000 of several implant-related journals, and reference list of all included studies were additionally surveyed by two reviewers in duplicate. Two reviewers assessed papers for eligibility by title and abstract and then by full text in duplicate. Disagreements were solved by a discussion with a third reviewer where agreement was almost perfect (κ = 0.91). Randomized (RCTs) and non-randomized clinical studies with a minimum follow-up of 3 years and minimum sample size of 20 patients reporting on biological, prosthetic complications, and patient-related outcome measures (PROMs) were eligible. The primary outcome was the biological complication of implant failure and the main secondary outcome was peri-implant marginal bone loss (MBL). No RCTs were found and eligible Non RCTs were assessed for risk of bias using ROBINS-I Tool. Implant failure and peri-implant MBL measured radiographically in mm were assessed between the two groups using relative risk and mean difference respectively with 95% confidence interval. Meta-analysis was conducted using a random effects model with Paule-Mandle estimator as wide variation of true effects was expected. Additional subgroup and sensitivity analyses were performed as well as rating the quality of meta-evidence using GRADE approach. 17 non-randomized studies (8 prospective and 9 retrospective) including a total of 7568 implants were included. Meta-analysis showed no difference in implant failure in 8 studies (RR = 0.95; 95% CI = 0.7 to 1.28; p = 0.74). Also, no significant difference was found in MBL in 16 studies (MD = 0.03 mm; 95% CI = -0.03 to 0.10 mm; p = 0.32). Considering the serious risk of bias of included studies, heterogeneity, and lack of randomized controlled clinical studies, the placement of tilted implants showed no added risk of failure or increased MBL compared to straight implants.

The Role of Ethnic Disparities in the Outcomes of Bariatric Surgery: A Systematic Review and Meta-Analysis.

Bariatric surgery is increasingly performed over the past decade for the treatment of morbid obesity. It has beneficial effects on weight reduction, along with diabetes remission. Conflicting results have been reported to evaluate the effect of ethics differences on the outcomes of bariatric surgery. We conducted this meta-analysis to outline the effects of ethnic differences on the outcomes of bariatric surgery, including weight reduction, biochemical variables, diabetes, and hypertension remission. A comprehensive literature search was conducted, using PubMed, Web of Science (ISI), Google Scholar, Popline, Global Health Library (GHL), Virtual Health Library (VHL) including Cochrane database, New York Academy of Medicine (NYAM), and System for Information on Grey Literature in Europe (SIGLE) for studies reporting body mass index (BMI), percentage of excess weight loss (%EWL), waist circumference, hypertension, lipid profile, and diabetes variables. We used the National Heart, Lung, and Blood Institute (NHLBI) tool (Bethesda, MD: NHLBI, National Institutes of Health {NIH}) for quality assessment. Comprehensive Meta-Analysis version 2 software (Englewood, NJ: Biostat, Inc.) was applied to perform the meta-analysis of the variables of interest. We included 23 studies of 71,679 subjects, who underwent bariatric surgery. The majority of the included cases were Whites 55,030 (77%), while 705 (1%) were Asians. The percentages of Blacks, African Americans, Hispanics, and Non-Hispanics were 9.3%, 1.3%, 10.4%, and 1%, respectively. BMI showed no significant difference between Whites vs African American and Hispanic vs Non-Hispanic groups (MD: 0.858; 95% CI: 3.408-1.691; p = 0.509 and MD: 0.455; 95% CI: 2.444-1.554; p = 0.663, respectively). The same result was reported for %EWL, comparing Whites vs African Americans. Lipid biochemical variables, diabetes remission, and hypertension control were significantly more seen among the Asian population. In conclusion, we reported a significant ethnic diversity and reduction in waist circumference, hyperlipidemia, and the associated morbidity one year after bariatric surgery in the Asian population. Further, high-quality prospective studies should focus on the social and psychological ethnic differences associated with obesity.

Periodontitis and Systemic Lupus Erythematosus: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluated the association between periodontitis (PD) and systemic lupus erythematosus (SLE). A systematic search was conducted through the following electronic databases: Cochrane Library, MEDLINE, EMBASE, Scopus, LILACS, CINAHL and SIGLE (System for Information on Grey Literature in Europe) for relevant publications up to September 2020 with no language restriction. The association between PD and SLE was assessed by the prevalence of PD in SLE patients (both sex and females only) as the primary outcome. Secondary outcomes included differences in common gingival parameters including probing pocket depth (PPD), clinical attachment level (CAL), disease activity index (SLEDAI) scores of SLE patients with or without PD. A total of 1183 citations and 22 full text articles were screened. Eighteen articles were included in the qualitative synthesis, and 13 in the quantitative analysis. SLE diagnosis was associated with greater odds of PD (OR=1.33, 95% Confidence Interval [CI]: 1.20-1.48), but these were non-significant when examined in females (OR=3.20, 95%CI: 0.85-12.02). Patients with SLE exhibited no differences in PPD (SMD: -0.09mm, 95%CI: -0.45-0.27) and CAL (SMD: 0.05mm, 95%CI: -0.30-0.40) when compared with systemically healthy controls. PD diagnosis was, however, associated with higher SLEDAI scores in patients suffering from SLE (SMD: 0.68, 95% CI: 0.03-1.32). PD and SLE are both inflammatory diseases and their association could be bi-directional. This review suggested that the patients with SLE have greater odds of suffering with PD. Further investigations are required to assess the association between PD and SLE.

The Prognosis and Predictors of Recovered Ejection Fraction Heart Failure: A Systematic Review and Meta-analysis

Introduction HFrecEF is a new entity included among the other types of heart failure. It represents the improvement of LVEF above the upper limit of HFrEF which usually ranges from 40 to 55%. Hypothesis We aimed to assess the predictors, measures of mortality and hospitalization of HFrecEF to compare it with HFrEF and HFpEF. Methods We conducted a systematic search in eight databases; PubMed, Scopus, Web of Science, Google Scholar, New York Academy of Medicine (NYAM), System for Information on Grey Literature in Europe (SIGLE), Global Health Library (GHL) and Virtual Health Library (VHL). Our primary endpoint was assessing the prognosis of HFrecEF in comparison with HFrEF and HFpEF. The secondary endpoint was assessing the predictors of LVEF recovery. Results Three-hundred eighty-two records were retrieved from the searched databases. After screening for eligibility criteria, 18 articles were chosen for qualitative synthesis and 15 articles were chosen for quantitative synthesis. All the prognostic measures including all-cause mortality, cardiovascular mortality, all-cause hospitalization, cardiovascular hospitalization and HF hospitalization were significantly lower in HFrecEF than HFrEF (RR= 0.58; 95% CI= 0.45-0.7, RR= 0.41; 95% CI= 0.29-0.58, RR= 0.75; 95% CI= 0.61-0.94, RR= 0.75; 95% CI= 0.73-0.78, RR, 0.56; 95% CI= 0.4-0.78 respectively) (Figures 1, 2, 3). The difference between HFrecEF and HFpEF patients regarding all-cause mortality was insignificant (Figure 1). Female gender, younger age, less severity of HF condition and lower rates of previous indications of CABG surgeries and defibrillator placements were associated with higher rates of LVEF recovery. Conclusion HFrecEF has a significantly different prognosis from HFrEF, which supports the hypothesis considering it a separate entity of heart failure types.

Do Tooth- and Cavity-related Aspects of Noncarious Cervical Lesions Affect the Retention of Resin Composite Restorations in Adults? A Systematic Review and Meta-analysis.

The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations? Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location). We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency. The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.

Is grey literature really grey or a hidden glory to showcase the sleeping beauty

PurposeThe study aims to showcase the developmental perspective of “grey literature” and its importance to different sectors of the society. Furthermore, issues, challenges and possibilities concerned with the existence of “grey literature” have also been discoursed.Design/methodology/approachThe study is based on the existing literature published in the field of “grey literature” which was identified with the aid of three leading indexing and abstracting services, Web of Science, SciVerse Scopus, and Google Scholar. Keywords like grey literature, black literature, The Grey Journal, The International Journal on Grey Literature, International Conference on Grey Literature, non-conventional literature, semi-published literature, System for Information on Grey Literature in Europe (SIGLE), European Association for the Exploitation of Grey Literature (EAGLE), white literature, white papers, theses and dissertations, GreyNet, grey literature-electronic media, Grey market, open access, OpenNet, open access repositories, institutional repositories, open archives, electronic theses and dissertations, institutional libraries, scholarly communication, access to knowledge, metadata standards for grey literature, metadata heterogeneity, disciplinary grey literature, etc. were searched in the select databases. Simple as well as advanced search feature of the databases were made use of. Moreover, for more recent and updated information on the topic, the “citing articles” feature of the databases was also used. The “citing articles” were consulted on the basis of their relevance with the subject content.FindingsThe study helps to understand the definitive framework and developmental perspective of “grey literature”. “Grey Literature” has emerged as a promising content for enhancing the visibility of the ideas that were earlier unexplored and least made use of “Grey literature” has also overcome the problems and issues with its existence and adoption. Technology has played a catalytic role in eradicating the issues and problems pertinent to the “grey literature” to a greater extent.Research limitations/implicationsThe study is based on the published literature that is indexed by only three databases, i.e. Web of Science, SciVerse Scopus and Google Scholar. Furthermore, some limited aspects of “grey literature” have been covered.Practical implicationsThe study will be of great help to various stakeholders and policymakers to showcase the value and importance of “grey literature” for better access and exploitation. It will also be of importance to those interested to know how the literature tagged as grey changed with the passing time and how it through its unseen characteristics has evolved as an important source of information at par with the “white literature”.Originality/valueThe study tries to provide a demarcated and segregated outlook of the “grey literature”. It also focuses on various issues, problems and possibilities pertinent to the adoption and existence of “grey literature”.

Efficacy of chalcone and xanthine derivatives on lipase inhibition: A systematic review.

Losing weight has significant impact on chronic disease management. Orlistat, a lipase inhibitor, has alternative effect for weight controlling. To find more candidates, we conducted a review of chalcone and xanthine derivatives regarding their anti-lipase activity. Eight databases were searched including PubMed, Scopus, Web of Science (ISI), Virtual Health Library (VHL), System for Information on Grey Literature in Europe (SIGLE), Global Health Library (GHL), EMBASE, and Google Scholar in August 2018. We found chalcone scaffold was more effective on lipase inhibition than xanthine scaffold. Among 19 investigated chalcones, only isoliquiritigenin and licuroside demonstrated an effect on preventing weight gain and increase in the total cholesterol and total triglycerides aside apart from their high activity on inhibiting lipase. Effect and type of inhibition of individual chalcones differed depending on their structure. In addition, very few studies investigated xanthine compounds and their activities were inconsistent. We suggest more studies investigate the ability of chalcones and modifying their structure to find out other compounds with higher efficacy.

Tooth Sensitivity After Dental Bleaching With a Desensitizer-containing and a Desensitizer-free Bleaching Gel: A Systematic Review and Meta-analysis.

A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity (TS) after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel in adult patients. Color change and risk of gingival sensitivity was also evaluated. A comprehensive search was performed MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), EMBASE and Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions to identify randomized clinical trials. Abstracts from the annual conference of the International Association for Dental Research (1990-2016), unpublished and ongoing trials registries, dissertations, and theses were also searched. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development and Evaluation (GRADE) approach. After duplicates were removed, 1352 articles were identified. After title and abstract screening, only 47 studies remained for qualitative evaluation. Most of the studies had unclear risk of bias. No difference between groups were observed for the risk ratio of TS (risk ratio = 0.99; 95% confidence interval [CI] = 0.74-1.33); intensity of TS (standardized difference in means [SMD] = 0.04; 95% CI = 0.79-0.70); color change in shade guide units (SMD - 0.04; 95% CI = 0.50-0.42); color change in ΔE* (SMD = 0.41 (95% CI = 0.07-0.89); and risk ratio of gingival irritation (SMD = 1.05; 95% CI = 0.81-1.36). Except for the risk of TS, graded as moderate quality of evidence, all other outcomes were rated as low and very low quality. Incorporating desensitizers in the bleaching gel did not reduce the risk of TS, and the quality of this evidence was considered moderate. On the other hand, the intensity of TS, color change, and risk of gingival irritation was similar between groups, but the quality of the evidence for these outcomes was graded as low or very low, thus reducing the level of confidence in these outcomes.

Efficacy of Exercise on Breast Cancer Outcomes: A Systematic Review and Meta-analysis of Preclinical Data

The use of preclinical models to investigate antitumor effects of exercise on breast tumor (BT) development and progression are critical. However, published results have not been quantitatively summarized or examined for potential exercise-moderating variables. We conducted this review to summarize and quantify the effect-size of exercise on BT outcomes in preclinical studies. A literature search was performed in MEDLINE, PubMed, Web of Science and System for Information on Grey Literature in Europe (SIGLE) databases. Risk of bias was assessed using SYRCLE's RoB tool. A total of 116 correlations were performed to analyze 28 preclinical studies published through December 2016, which included 2,085 animals and 51 exercise programs. Positive effects of small, medium and large magnitude were observed in tumor incidence, growth and multiplicity, respectively. In the tumor microenvironment, positive effects of large magnitude were also observed in proliferation and apoptosis but not in angiogenesis. Moderator variables correlated with higher intervention effects were identified along with a considerable heterogeneity in exercise protocols that precluded us from clearly perceiving the benefits of exercise exposure. In conclusion, exercise performed under specific conditions benefits BT outcomes. Preclinical studies with exercise designs mimicking exercise exposure that can be used in clinical contexts are needed.

PROTOCOL: Mass deworming for improving health and cognition of children in endemic helminth areas: a systematic review and individual participant data network meta-analysis.

PROTOCOL: Mass deworming for improving health and cognition of children in endemic helminth areas: a systematic review and individual participant data network meta-analysis.

Which adhesive strategy for non-carious cervical lesions?

Data sourcesMedline, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, System for Information on Grey literature in Europe (SIGLE), ProQuest Dissertations and Theses, Periódicos Capes Theses database, Current Controlled Trials (www.controlled-trials.com), International Clinical trials registry platform (http://apps.who.int/trialsearch/), the ClinicalTrials.gov (www.clinicaltrials.gov), Rebec (www.rebec.gov.br) and EU Clinical Trials Register (https://www.clinicaltrialsregister.eu), abstracts of the annual conference of the International Association for Dental Research (IADR) and their regional divisions.Study selectionTwo reviewers selected studies; parallel or split-mouth randomised controlled trials (RCTs) comparing adhesive strategies were considered.Data extraction and synthesisData were abstracted by two reviewers and into four follow up periods, 1 year; 18 months to 2 years; 3 years and 4 to 5 years. The Cochrane risk of bias tool was used to assess study quality. Data outcomes were dichotomous and summarised using relative risks and random effects meta-analysis.ResultsTwenty-nine studies were included in the meta-analysis. Bonding strategy did not influence postoperative sensitivity (risk ratio [RR] 1.04; 95% CI 0.81 to 1.34) or retention rates (RR = 1.04; 95% CI 0.81 to 1.34). The etch-and-rinse approach produced less marginal discoloration at 18 months to 2 years (RR 1.51; 95% CI 1.21 to 1.90) and at 4 to 5 years (RR 1.81; 95% CI 1.28 to 2.55) (p<0.0007).ConclusionsComposite resin restorations placed with self-etch and etch-and-rinse adhesives produce restoration with similar clinical service and POS, however using etch-and-rinse adhesives one can reduce marginal discoloration.

Association between overweight/obesity and periodontal disease in children and adolescents: a systematic review and meta-analysis.

To provide a systematic review and meta-analyses investigating the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in terms of clinical periodontal outcomes. A systematic search of the literature was conducted by two authors (SR and SD) independently in the Cochrane Library, PubMed, Web of Science (ISI), Scopus, Scielo, Lilacs and System for Information on Grey Literature in Europe (SIGLE) for full articles published until September 2015. Studies analysing the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in children and/or adolescents (age ≤18years) were included. The Gwets AC1 inter-rater reliability coefficient for screening data was calculated using Agreestat 2011.1. Meta-analyses were carried out by using RStudio version 0.97.551-©2009-2012 RStudio, Inc. software. A total of 769 titles and abstracts were screened and 12 articles met the inclusion criteria for the systematic review while only 7 were selected for meta-analyses. The Gwets AC1 inter-rater reliability coefficient for screening data was excellent (0.98; CI 0.98-0.99). A positive association between overweight/obesity and a number of periodontal diseases was seen. For the association between prevalent periodontal disease and obesity in children, the overall fixed-effects OR and 95% CI was 1.46 (1.20-1.77) with a χ2 statistic for heterogeneity (Q) of 33.4 with 6 degrees of freedom (P<0.005). The available evidence suggests a significantly positive association between periodontal disease and obesity in children. Paediatric dentists should be aware of periodontal alterations as a potential hazard associated with obesity.

Cone-beam computed tomography versus periapical radiograph for diagnosing external root resorption: A systematic review and meta-analysis.

To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and periapical radiographs (PR) for the detection of external root resorption (ERR). An electronic search in databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the China National Knowledge Infrastructure, and System for Information on Grey Literature in Europe (SIGLE), was performed until August 2016. A manual search of relevant journals and reference lists of enrolled studies was conducted. The studies investigating the diagnostic accuracy of CBCT or PR for ERR, with simulated ERR as the reference test, were considered eligible. The diagnostic accuracy of CBCT and PR was statistically pooled using a bivariate model. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was used to test the stability of the overall results in the meta-analysis. A total of 15 studies were included in this systematic review. The pooled results showed that CBCT had significantly higher sensitivity (0.89; 95% confidence interval [CI]: 0.77-0.96) and area under curve (0.96; 95% CI: 0.77-0.96) than PR (sensitivity: 0.68; 95% CI: 0.56-0.78; area under curve: 0.88; 95% CI: 0.85-0.90). No difference in sensitivity, specificity, and area under the curve between conventional and digital PR was observed. Currently available evidence suggests that CBCT could be reliable to detect the presence of ERR in clinical practice and has a higher diagnostic efficacy than PR.

Enamel bevelling and retention of composite restorations in non-carious cervical lesions.

Data sourcesMedline, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), the Cochrane Library, abstracts of the annual conference of the International Association for Dental Research (IADR), System for Information on Grey literature in Europe (SIGLE), ProQuest Dissertations and Theses Fulltext database as well as the Periódicos Capes Theses, Current Controlled Trials, International Clinical trials registry platform, the ClinicalTrials.gov, Rebec and the EU Clinical Trials Register.Study selectionRandomised clinical trials (RCTs) that compared the retention rates of restorations in NCCLs placed with or without bevel with at least one year follow-up were considered.Data extraction and synthesisData were abstracted using standardised forms and study quality was assessed using the Cochrane risk of bias tool. Marginal discolouration scores were dichotomised into yes and no, and risk differences for retention rate and marginal discolouration were calculated for each study for analysis.ResultsFour studies were included. Two studies were considered to be at high risk of bias and not included in the meta-analysis. The overall risk difference was 0.0 (95%CI; 0.04 to 0.04) for the retention rate and 0.05 ((95%CI; 0.02 to 0.13) for the marginal discolouration, suggesting that enamel beveling does not influence retention rate or marginal discolouration.ConclusionsOne may conclude that there is no difference between bevelled and non-bevelled technique over the short-term follow-up of 12-18 months of clinical service, although this conclusion was based on only two low risk of bias RCTs. Additionally, there is not enough evidence to support this conclusion over longer-term follow-ups. There is a need for better standardisation and the reporting of RCTs investigating this technique variation after longer-term follow-up periods.

Efficacy of Topical Tacrolimus for Erosive Oral Lichen Planus: A Meta-analysis.

To assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus (EOLP). Literatures published up to December 2013 were searched from PubMed, Embase, CENTRAL, Chinese BioMedical Literature Database (CBM), and System for Information on Grey Literature in Europe (SIGLE). All randomized controlled trials (RCTs) of topical tacrolimus for EOLP which compared with other interventions or a placebo were considered in this Meta-analysis. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane Handbook and the materials were analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms (e.g. pain, discomfort) complained by patients. The secondary outcome measures included the improvement rate of clinical signs assessed by the investigators and the incidence of adverse effects (e.g. clinical candidiasis). A total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio (OR) of clinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval (CI): 0.64-2.22, I2: 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87 (95% CI: 0.60-5.82) and 1.47 (95% CI: 0.14-16.04) respectively in subgroup analysis. No serious adverse events were reported in topical tacrolimus group. There was no evidence to support that topical tacrolimus for EOLP was more effective and safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be established and accepted by clinicians and researchers before further RCTs are undertaken.

Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis

To assess the evidence regarding the effect of time of gluten introduction and breastfeeding on the risk of developing celiac disease (CD). We included randomized controlled trials and observational studies evaluating the proper timing for introducing gluten to the infant diet, the appropriate quantity of gluten consumption at weaning, and the effect of breastfeeding on CD risk. Studies were located through the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), EMBASE (Ovid), and System for Information on Grey Literature in Europe (SIGLE). Two independent authors collected the data. A total of 1982 studies were identified, 15 of which were eligible for data extraction. A meta-analysis was performed on 2 randomized controlled trials, 10 cohort studies, and 1 case-control study. There was a 25% increase in CD risk with late (>6months) vs recommended (4-6months) gluten introduction (risk ratio [RR], 1.25; 95% CI, 1.08-1.45). There was no significant effect of breastfeeding vs no breastfeeding on CD risk (OR, 0.55; 95% CI, 0.28-1.10), with substantial heterogeneity (I(2)=92%) among studies. There is currently no evidence to support that early introduction of gluten to the infant diet increases the risk of CD; however, late introduction of gluten may be associated with increased risk of CD. More studies are needed that control for potential confounders and that evaluate environmental factors in low-risk families.

Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years.

A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed by the use of a general anaesthetic in children; however, use of sedation may lead to reduced morbidity and cost. The aim of this review was to compare the efficiency of sedation versus general anaesthesia (GA) for provision of dental treatment to children and adolescents younger than 18 years. This review was originally published in 2009 and was updated in 2012 and again in 2015. We will evaluate morbidity and effectiveness of sedation versus GA for provision of dental treatment to patients younger than 18 years. If data become available, we will analyse the cost-effectiveness of different interventions. If data are not available, we will obtain crude estimates of cost.Morbidity can be defined as 'an undesired result or complication'. For the purposes of this review, 'postoperative morbidity' refers to undesired results or complications such as nausea following a procedure, once the patient had been restored to consciousness and could breathe unaided. 'Intraoperative morbidity' refers to any complications that occur during the procedure that may necessitate action by the anaesthetist or the sedationist, such as respiratory arrest. In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE Ovid SP (1950 to July 2015); EMBASE Ovid SP (1974 to July 2015); System for Information on Grey Literature in Europe (SIGLE) (1980 to October July 2012); Latin American & Caribbean Health Sciences Literature (LILACS) (1982 to July 2015); and Institute for Scientific Information (ISI) Web of Science (1945 to July 2015).We also carried out handsearching of relevant journals to July 2015. We imposed no language restriction. We planned to include randomized controlled clinical trials that compared sedative agents versus general anaesthesia in children and adolescents up to 18 years of age undergoing dental treatment. We excluded complex surgical procedures and pseudo-randomized trials. Two review authors assessed titles and abstracts for inclusion in the review. We recorded information relevant to objectives and outcome measures by using a specially designed 'data extraction form'. We will employ the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach to interpret findings. In our original review, we identified 16 studies for potential inclusion after searching available databases and screening titles and abstracts. After retrieving full-text studies, we found none to be eligible. We identified no additional studies in the updated search of July 2012. We identified two studies for possible inclusion in the updated search of July 2015; again we found these to be ineligible. Randomized controlled studies comparing use of dental general anaesthesia versus sedation are needed to quantify differences such as morbidity and cost.

Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations.

Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. Two review authors independently extracted data and assessed risk of bias for each study. Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.

The Anxiolytic Effect of Midazolam in Third Molar Extraction: A Systematic Review

PurposeTo assess the efficacy of midazolam for anxiety control in third molar extraction surgery.MethodsElectronic retrievals were conducted in Medline (via PubMed, 1950-2013.12), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 3), Embase (via OVID 1974-2013.12), and the System for Information on Grey Literature in Europe (SIGLE). The bibliographies of relevant clinical trials were also checked. Randomized controlled trials satisfying the inclusion criteria were evaluated, with data extraction done independently by two well-trained investigators. Disagreements were resolved by discussion or by consultation with a third member of the review team.ResultsTen studies were included, but meta-analysis could not be conducted because of the significant differences among articles. All but one article demonstrated that midazolam could relieve anxiety. One article demonstrated that propofol offered superior anxiolysis, with more rapid recovery than with midazolam. Compared with lorazepam and diazepam, midazolam did not distinctly dominate in its sedative effect, but was safer. Two articles used midazolam in multidrug intravenous sedation and proved it to be more effective than midazolam alone.ConclusionIt was found, by comparison and analysis, that midazolam might be effective for use for anxiety control during third molar extraction and can be safely administered by a dedicated staff member. It can also be used with other drugs to obtain better sedative effects, but the patient’s respiratory function must be monitored closely, because multidrug sedation is also more risky.