Systematic Review Search Research Articles

Clinical performance of Bladder EpiCheck™ versus voided urine cytology for detecting recurrence of nonmuscle invasive bladder cancer: Systematic review and meta-analysis

BackgroundNonmuscle invasive bladder cancer (NMIBC) has a favorable prognosis but has high propensity for recurrence. Recent development in one of the urinary biomarker tests, Bladder EpiCheck™, offers a noninvasive and accurate method to detect NMIBC recurrence. In this study, we aimed to compare the diagnostic performance of Bladder EpiCheck™ with urine cytology to detect NMIBC recurrence. MethodsWe performed a systematic review search through PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to July 2023. Diagnostic accuracy was defined by sensitivity, negative predictive value (NPV), specificity, and positive predictive value (PPV). ResultsA total of 6 studies involving 1588 patients were included. Bladder EpiCheck™ has a sensitivity and specificity of 0.81 (95% CI: 0.63–0.91; I2: 43%) and 0.87 (95% CI: 0.83–0.91; I2: 20%), respectively. On the other hand, urine cytology has a sensitivity and specificity of 0.63 (95% CI: 0.29–0.87; I2: 61%) and 0.97 (95% CI: 0.78–1.00; I2: 79%), respectively. EpiCheck™ has a higher NPV (0.94 (95% CI: 0.87–0.97) vs. 0.84 (95% CI: 0.80–0.87) though a lower PPV (0.62 (95% CI: 0.45–0.76) vs. 0.87 (95% CI: 0.56–0.97) than urine cytology. In our subgroup analysis, the sensitivity of Bladder EpiCheck™ for detecting high-grade tumors improved to 0.90 (95% CI: 0.83–0.94) while that for urine cytology improved to 0.72 (95% CI: 0.50–0.87). ConclusionBladder EpiCheck™ has a high sensitivity and NPV for detecting recurrence among patients with NMIBC.

BN SO05 - Risk Factors associated with Complications Post-Laparoscopic Common Bile Duct Exploration: A Comprehensive Literature Review

Abstract Background Gallstone-related diseases, particularly common bile duct (CBD) stones, present a significant global health issue. The adoption of laparoscopic common bile duct exploration (LCBDE) has revolutionized the management of these conditions by providing a minimally invasive alternative to open surgery. This literature review aims to identify and analyze the risk factors associated with complications in LCBDE, thereby offering insights to improve patient care and outcomes. Method comprehensive search for primary research studies, systematic reviews, and meta-analyses pertaining to risk factors for complications following LCBDE. The search was conducted on PubMed, focusing on English-language articles published within the last 20 years and encompassing all age groups. Peer-reviewed journal articles were prioritized. All relevant studies reporting complications after LCBDE were eligible for inclusion if available as full texts, structured abstracts, or conference reports. The initial search yielded 826 articles. Exclusion criteria : open surgery, non-English articles, lacking full-text. A total of 29 records were identified by the literature search. Results Laparoscopic common bile duct exploration (LCBDE) is generally safe and effective, with complication rates influenced by patient and procedural factors. Older age, comorbidities, previous abdominal surgeries, high BMI, narrow common bile ducts, and difficult stones increase risks. Experienced surgeons and shorter operative times reduce complications. The transcystic approach and primary suture closure have fewer complications compared to the transductal route and T-tube drainage, respectively. Intraoperative imaging significantly reduces risks by ensuring complete stone clearance and identifying anatomical variations. Tailoring surgical approaches to patient-specific factors and leveraging surgical expertise are crucial for minimizing complications in LCBDE. Conclusion LCBDE emerges as a safe and effective therapeutic modality for addressing conditions impacting the bile ducts (31). The success and utility of LCBDE can be significantly enhanced through the meticulous optimization of patient-related, surgeon-related, and procedure-related factors. By addressing and fine-tuning these key elements, the occurrence of complications associated with LCBDE can be mitigated, thereby reinforcing its potential as a primary choice for managing various bile duct conditions. This strategic approach not only underscores the clinical efficacy of LCBDE but also advocates for its expanded utilization as a frontline intervention in the comprehensive management of bile duct disorders.

Effectiveness of hand and rotary instrumentations during biomechanical preparation in primary teeth: an umbrella review with evidence stratification.

Biomechanical preparation (BMP) of primary teeth often involves using hand and rotary instruments. This study aimed to assess the effectiveness of hand and rotary instruments during BMP in primary teeth. A thorough search for relevant systematic reviews and meta-analyses (SRMAs) was conducted in four databases, including MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. The primary outcome assessed was the instrumentation time (IT) for BMP, and the identified SRMAs were qualitatively analysed using the ROBIS tool. Furthermore, quantitative analysis, evidence stratification, and GRADE analysis of eligible SRMAs were performed using the browser-based R package metaumbrella software. Six SRMAs addressing the research question were included, with five being evaluated as having a high risk of bias (ROB). The findings indicated that the IT required for BMP in primary teeth was 3.2 min less (95% CI = 1.52 to 4.93; I2 = 96%; P = < 0.001) using rotary instruments compared to hand instruments, with a 'class IV' evidence stratification and 'very low' class of evidence. Based on the existing evidence, it can be inferred that there is insufficient quality data to recommend the use of rotary instruments over hand instruments in primary teeth.

The Role of 5-Phosphodiesterase Inhibitors (PDE-5I) in Current Benign Prostatic Hyperplasia Treatment: A Narrative Review.

Introduction: 5-phosphodiesterase inhibitors (PDE-5I) have been investigated as a treatment for urinary dysfunction for almost a decade. The general perception is that they play a significant role in managing lower urinary tract symptoms (LUTS), particularly those associated with benign prostatic hyperplasia (BPH). However, the specific biochemical processes by which PDE-5I repairs urinary function are still poorly understood and there is little instrumental evidence of significant improvement in urinary symptoms. Therefore, we explore the role of 5-phosphodiesterase inhibitors (PDE-5I) as complementary to the conventional treatment of symptomatic BPH; we provide the suggested biological procedures involved in the association between PDE-5 inhibitor use and improvement in LUTS; and we propose new approaches to this topic. Material and Methods: A systematic search for clinical trials, experimental studies, and systematic reviews was performed in electronic libraries (PubMed, EMBASE, Scopus) using the terms "benign prostate hypertrophy", "benign prostate hyperplasia", "lower urinary tract symptoms", "storage symptoms", "voiding symptoms", "bladder outlet obstruction" and the keywords "mechanism of action", "synergy", "PDE-5 inhibitor", "alpha1-adrenergic antagonist", "5-alpha-reductase inhibitors" in various combinations. There was no restriction on publication date. Results: To date, only a few randomized studies have been published in which the effect of the combination of a conventional drug for the treatment of symptomatic BPH and a PDE-5I was investigated. Almost all showed significant improvement in IPSS and QoL. Some studies showed significant improvements in maximum urine flow (Qmax) and postvoiding residual volume (PVR) with combination therapy compared with a single agent alone. Conclusions: PDE-5I seems effective in relieving symptoms of some BPH patients when administered as complementary to agents currently used to treat BPH. However, the mechanism of action of PDE-5 inhibitors in LUTS remains poorly understood and it is difficult to determine the specific subset of BPH patients who will benefit from the combination of PDE-5 inhibitors with the current treatment. Well-designed, sufficiently informative comparative studies focusing on specific target group profiles (age, urogenital parameters) are needed to define new therapeutic options.

Association between forensic DNA and odontology in human identification during mass disaster: a systematic review

BACKGROUND: According to the literature, forensic odontology is one of the most effective and affordable scientific techniques for identifying victims of mass disasters. This research methodically reviews the role and function of forensic odontologists in several global mass disasters. Forensic DNA in odontology is associated with the importance of its application in the identification of humans of mass disasters. As the crime rate continues to rise, the field of forensic medicine has evolved significantly. Forensic dentists play a pivotal role in various areas of crime scene investigations, thereby helping solve innumerable mysteries. AIM: The study aimed to increase the body of knowledge for future research on forensic odontology by conducting a systematic review search to investigate possible forensic DNA in odontology associated with the importance of its application in the identification of humans of mass disasters. MATERIALS AND METHODS: Six databases, including Google Scholar, PubMed, Scopus, Embase, Web of Science, and ScienceDirect, were analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality scale. The literature search, conducted until February 2024, informed important research choices. RESULTS: A total of 16 (100%) studies related to forensic DNA of mass disasters were identified. Of these, only seven (43.75%) articles related to dental DNA were included in this review. Of the 4,808 articles obtained, 138 duplicates or irrelevant articles were eliminated. Following a full-text review, seven studies were selected based on eligibility criteria. The highest percentage of victims was identified using dental DNA. In a few studies, some samples were insufficient for complete DNA profiling due to factors such as the method of DNA extraction. CONCLUSION: Forensic odontology has played a significant role in the identification of victims of several mass disasters around the world. Although teeth are an excellent source of DNA for humans, future studies with larger sample sizes, appropriate control groups, and standardized techniques of DNA extraction need to be conducted.

Exploring programmatic elements that foster neurodiverse children and adolescents’ participation in informal STEM learning programs: a systematic review

AbstractInformal STEM settings offer valuable opportunities for students, including neurodiverse students, to engage and participate in STEM activities. However, there is a limited information on how to best engage and include neurodiverse students in informal STEM programming. This systematic review aimed to identify the programmatic elements that facilitated the inclusion of K-12 neurodiverse STEM learners in informal STEM programs. In this systematic review, an academic and grey literature search was conducted, where the search resulted in 2632 records and 18 records were included in the systematic review. Records that met inclusion criteria were independently reviewed and assessed for quality by two reviewers using the Mixed Methods Appraisal Tool (MMAT) or a project-based MMAT. This paper describes how informal STEM programs were designed and implemented to foster the participation of neurodiverse K-12 STEM learners. A qualitative synthesis approach was used to identify the programmatic elements that fostered neurodiverse learner participation. Most of the informal STEM programming for neurodiverse youth occurred in after-school settings and with students with autism. Programmatic elements that facilitated the participation of this population in informal STEM were grouped into three categories: (1) environment/learning structure, (2) learning supports, and (3) instructional strategies and tools. Future informal STEM programming and research should expand to include the neurodiverse population in already established informal STEM programs.

The Use of Cone-Beam Computed Tomography (CBCT) Arthrography for Wrist Ligamentous Injuries - A Diagnostic Test Accuracy Meta-analysis.

Background: Diagnosis of ligamentous wrist injuries can be challenging with the absence of dynamic instability on radiographs. Our aim was to evaluate the accuracy of cone-beam computed tomography (CBCT) arthrography in diagnosing scapholunate ligament (SLL), lunotriquetral ligament (LTL) and triangular fibrocartilage complex (TFCC) injuries. Methods: A systematic review and literature search were conducted in compliance with Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) and registered at the International Prospective Register of Systematic Reviews, PROSPERO (CRD42024517655). A mixed-effects logistic regression bivariate model was used to estimate summary sensitivity and specificity, and hierarchical summary receiver operating characteristic (HSROC) curves were constructed to determine diagnostic accuracy of CBCT arthrography. Results: We identified five studies assessing the accuracy of CBCT arthrography against wrist arthrography or intraoperative findings as reference standard. The pooled estimates for sensitivity and specificity of CBCT arthrography was 93% (95% CI 40-100) and 91% (95% CI 81-96) for SLL injuries, 83% (95% CI 37-98) and 64% (95% CI 42-81) for LTL injuries and 78% (95% CI 57-91) and 80% (95% CI 54-93) for TFCC injuries. The area under the curve was 0.91 (95% CI 0.89-0.94), showing an excellent diagnostic accuracy of CBCT arthrography in SLL injuries. CBCT arthrography had an estimated mean effective dose of 3.2 mSv (2.0-4.8). Conclusions: Our study confirms that CBCT arthrography has an excellent diagnostic accuracy for wrist ligamentous injuries with comparably high sensitivity to conventional arthrography and a better specificity. While further studies with more robust methodology are required to support its implementation in clinical practice, our analysis shows that it is a reliable option and has a promising future. Level of Evidence: Level III (Diagnostic).

A guide to global access to HPV vaccination to all women in low- and middle-income countries; a minireview of innovation and equity.

Cervical cancer is caused by the human papillomavirus (HV), and accounts for more than 311,000 preventable deaths annually, with 85% occurring in low-and middle-income countries. Despite being preventable through screening and screening, significant barriers to implementing HPV vaccination persist in developing nations. This review study aims to identify these barriers and propose innovative, evidence-based solutions to improve vaccination rates and reduce cervical cancer mortality. A systematic review search was conducted using PubMed, Embase, and Cochrane Database of Systemic Reviews. Keywords related to HPV vaccination barriers and implementation strategies in developing countries were used. Relevant demonstration projects, pilot studies, and evidence-based research articles were reviewed. Identifiable barriers to a successful vaccine implementation program in a developing country include vaccine costs, societal, cultural resistance, misinformation, logistical challenges in vaccine delivery, and inadequate human resources. Solutions to these barriers include a subsidized vaccine pricing, community sensitization, education and well-trained media professionals to dispel misinformation, and partnerships with both public and private sector for efficient vaccine distribution. These findings highlight critical barriers that impede HPV vaccination efforts in developing countries and offers practical solutions to overcome these challenges. This aggregate of data can help inform future developing countries' implementation programs to further the World Health Assembly mission to vaccinate 90% of eligible girls globally by 2030.

Non-alcoholic fatty liver and periodontal disease in the adult population: Overview of systematic reviews

Introduction: Periodontal disease is a chronic inflammatory condition affecting the periodontal supporting tissues. In addition to dental loss, it has been associated with various metabolic disorders, including obesity, diabetes, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD). This study aimed to analyze the effects of periodontal disease on the prevention and treatment of NAFLD in the adult population. Method: An electronic search of systematic reviews published between 2019 and 2024 was conducted in the Medline, Scopus, and Web of Science databases, as well as in the Epistemonikos meta-search engine. The search strategy was "Non-alcoholic Fatty Liver Disease AND Periodontitis". A total of 47 articles were identified, of which three systematic reviews with meta-analyses were analyzed. Results: The results indicated a potential association between periodontal disease and NAFLD, with an odds ratio (OR) of 1.48 (95% CI: 1.15 to 1.89; I² = 92%) and 1.91 (95% CI: 1.21 to 3.02; I² = 95%). However, this link has not been definitively proven, as heterogeneity decreases and the number of patients increases, resulting in an OR of 1.04 (95% CI: 0.97 to 1.12; I² = 58%). Conclusion: It is suggested that systemic inflammation and pro-inflammatory markers may play a significant role in the pathophysiology of both conditions. Nonetheless, further studies are needed to clarify this relationship and explore the common metabolic parameters.

Guía de práctica clínica para el tamizaje de cáncer de mama en el Seguro Social del Perú (EsSalud)

Introduction. This article provides an overview of the clinical practice guideline (CPG) for breast cancer screening in the Social Security of Peru (EsSalud). Objective. To offer evidence-based clinical recommendations for breast cancer screening within EsSalud. Methods. The CPG for breast cancer screening was developed by establishing a guideline development group (local GDG) consisting of medical specialists and methodologists. The local GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and, when it was considered pertinent, primary studies were conducted in Pubmed and Cochrane CENTRAL during 2022. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of screening Finally, the CPG was approved with Resolution No. 68-IETSI-ESSALUD-2022. Results. The CPG examined 5 clinical questions related to physical examination and diagnostic imaging for breast cancer screening. This led to the development of 8 recommendations (2 strong and 6 conditional), 7 best practice points, and 1 flowchart. Conclusion. This article outlines the methodology and evidence-based findings of the CPG for breast cancer screening at EsSalud.

Guía de práctica clínica para el diagnóstico y tratamiento de la endometriosis sintomática en mujeres en edad reproductiva en el Seguro Social de Salud (EsSalud)

Introduction. This article summarizes the clinical practice guideline (CPG) for the diagnosis and treatment of women with symptomatic endometriosis in the Social Security of Peru (EsSalud). Objective. The aim is to offer evidence-based clinical recommendations for diagnosing and managing women with symptomatic endometriosis in EsSalud. Methods. A guideline development group (GEG), consisting of medical specialists and methodologists, was established to create this CPG. The GEG formulated six clinical questions that guided the development of the CPG. Systematic searches of systematic reviews and –where applicable– primary studies were carried out in PubMed and CENTRAL between December 2021 and February 2022. Relevant evidence was selected to address each clinical question. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Throughout the CPG development process, the GEG held regular meetings to assess the evidence and formulate recommendations, establish points of good clinical practice, and develop flowcharts. The CPG was formally approved through Resolution No. 62-IETSI-ESSALUD-2022. Results. The CPG addressed six clinical questions, categorized into two primary areas: the diagnosis and management of endometriosis. Based on these questions, eight recommendations were developed, comprising one strong recommendation and seven conditional ones. Additionally, 21 good clinical practice points and two flowcharts were created. Conclusion. This article outlines the methodology and evidence-based conclusions of the CPG for the diagnosis and treatment of women with symptomatic endometriosis in EsSalud.

Prognostic and post-surgical updates in the treatment of non-syndromic craniosynostosis: a systematic review

Introduction: Craniosynostosis represents a rare congenital condition characterized by the premature fusion of one or more cranial sutures. The majority of cases of this disorder are non-syndromic in nature. Objective: This study aims to conduct an analysis and comparison of available surgical techniques, evaluating their respective postoperative outcomes in the treatment of non-syndromic craniosynostosis. The focus lies on assessing functional, aesthetic, and neurological outcomes. Methods: A systematic review was undertaken, encompassing the search for clinical trials (including randomized trials), systematic reviews, and meta-analyses available online in both Portuguese and English languages. The search terms "prognosis" and "non-syndromic craniosynostosis" were utilized along with the boolean operator "AND". Articles published between 2018 and 2023 were filtered through the Virtual Health Library (VHL) and PubMed platforms, specifically targeting studies presenting prognostic data related to craniosynostosis in pediatric patients up to 12 months of age. Results: The most favorable prognostic outcomes identified in this investigation were associated with conventional cranioplasty and minimally invasive endoscopic craniectomy techniques. Notably, conventional cranioplasty demonstrated superior intellectual outcomes among patients undergoing this procedure, with an average intelligence quotient of 111.7 ± 13 and academic performance aligning closely with national averages across various domains. Conversely, minimally invasive endoscopic craniectomy exhibited low rates of blood transfusion, complications, and reoperations. Conclusion: The findings underscore the superior cognitive prognosis associated with conventional cranioplasty, positioning it as a highly applicable surgical option for addressing craniosynostosis, supported by robust evidence.

PRIMARY PREVENTION OF CARDIOVASCULAR DISEASES AND WAYS OF IMPROVING RISK ASSESSMENT OF THEIR DEVELOPMENT IN CLINICAL PRACTICE

Introduction. Cardiovascular diseases are a global problem and one of the main causes of death worldwide. Aim. To highlight and analyze modern approaches to the use in routine practice of risk factors for the development of cardiovascular pathology, which is appropriate for further clinical decision-making based on a meta-analysis of literary sources, clinical guidelines and the results of multicenter studies. Materials and methods. The search and selection of publications, systematic reviews and current recommendations is carried out using PubMed and Google Scholar databases, their detailed analysis and description. Results and discussion. The article provides data on primary prevention, which includes assessment and implementation of measures to reduce the overall risk of developing cardiovascular diseases in patients. Methods for assessing individual total or relative risk (use of SCORE and SCORE 2 scales, various risk calculators, etc.) taking into account the level of cholesterol and its various fractions are given. The importance of taking into account additional independent risk factors for the development of cardiovascular diseases is also considered. The possibility of taking into account the level of lipoprotein (a), high-density lipoprotein, and high-sensitivity C-reactive protein to improve the accuracy of predicting cardiovascular risk is discussed. Attention is paid to the possibility of using such "non-metabolic" factors as environmental pollution, psychosocial stress and stressful conditions, sleep disorders and obstructive sleep apnea syndrome, family history and genetic factors to change the risk category. Conclusions. The results of the conducted analysis prove that the given methods and importance of detection of subclinical atherosclerosis especially in patients with low or medium (marginal) cardiovascular risk. The use of both primary and secondary risk factors may be appropriate to inform decisions about changes in the calculated risk of such patients, the use and effectiveness of specific cardiac treatments, and the implementation of preventive measures such as statin therapy.

Empirical Testing of Alternative Search Methods to Retrieve Utility Values for Health Economic Modelling.

The objective of this study is to compare different information retrieval methods that can be used to identify utility inputs for health economic models. Theusual practice of using systematic review methods was compared with two alternatives (iterative searching and rapid review), using a health technology assessment (HTA) case study in ulcerative colitis (UC). We analysed whether there were differences in the utility values identified when using the alternative search methods. Success was evaluated in terms of time, burden and relevance of identified information. The identified utility values were tested in an executable health economic model developed for UC, and the model results were compared. The usual practice of using systematic review search approaches identified the most publications but was also the least precise method and took longest to complete.The inclusion of data from the different search methods in the model did not lead to different conclusions across search methods. In this case study, usual practice was less efficient and resulted in the same health economic model conclusions as the alternative search methods. Further case studies are required to examine whether this conclusion might be generalisable.

Developing reporting checklist items from systematic review findings: a roadmap and lessons to be learned from ACCORD

ObjectivesTo demonstrate how researchers can identify and translate reporting gaps from a systematic review into checklist items for reporting guidelines. Study Design and SettingGood quality research reporting ensures transparency, reproducibility, and utility, facilitated by reporting guidelines. Conducting a systematic review is an essential step in the development of these guidelines. The Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network's toolkit (2010) assists researchers in this process and is due for an update to address current gaps and evolving research methods. One significant gap is the translation of systematic review findings into checklist items. Reflecting on our experience developing the ACcurate Consensus Reporting Document, we illustrate this translation process aiming to empower researchers developing reporting guidelines to address potential biases and promote transparency. We highlight the challenges faced and how they were addressed. ResultsThe systematic review search process was iterative, involving multiple adjustments to balance precision and sensitivity. Excessively stringent exclusion criteria may lead to missed valuable insights, especially when studies offer relevant content. An information specialist was invaluable in developing the search strategy. Key lessons learned include the necessity of maintaining flexibility and openness during data extraction, continuous adaptation based on panelist feedback, and promoting clear communication through understandable language. These principles can guide the development of future reporting guidelines and the updating of the EQUATOR toolkit, promoting transparency and robustness in research reporting. ConclusionMaintaining flexibility, capturing evolving insights, clear communication, and accommodating changes in research and technologies are key to translating systematic review findings into effective reporting checklists.

Automation of duplicate record detection for systematic reviews: Deduplicator

BackgroundTo describe the algorithm and investigate the efficacy of a novel systematic review automation tool “the Deduplicator” to remove duplicate records from a multi-database systematic review search.MethodsWe constructed and tested the efficacy of the Deduplicator tool by using 10 previous Cochrane systematic review search results to compare the Deduplicator’s ‘balanced’ algorithm to a semi-manual EndNote method. Two researchers each performed deduplication on the 10 libraries of search results. For five of those libraries, one researcher used the Deduplicator, while the other performed semi-manual deduplication with EndNote. They then switched methods for the remaining five libraries. In addition to this analysis, comparison between the three different Deduplicator algorithms (‘balanced’, ‘focused’ and ‘relaxed’) was performed on two datasets of previously deduplicated search results.ResultsBefore deduplication, the mean library size for the 10 systematic reviews was 1962 records. When using the Deduplicator, the mean time to deduplicate was 5 min per 1000 records compared to 15 min with EndNote. The mean error rate with Deduplicator was 1.8 errors per 1000 records in comparison to 3.1 with EndNote. Evaluation of the different Deduplicator algorithms found that the ‘balanced’ algorithm had the highest mean F1 score of 0.9647. The ‘focused’ algorithm had the highest mean accuracy of 0.9798 and the highest recall of 0.9757. The ‘relaxed’ algorithm had the highest mean precision of 0.9896.ConclusionsThis demonstrates that using the Deduplicator for duplicate record detection reduces the time taken to deduplicate, while maintaining or improving accuracy compared to using a semi-manual EndNote method. However, further research should be performed comparing more deduplication methods to establish relative performance of the Deduplicator against other deduplication methods.

Improved Physical Performance Parameters in Patients Taking Nicotinamide Mononucleotide (NMN): A Systematic Review of Randomized Control Trials.

Nicotinamide adenine dinucleotide (NAD+) is essential in the proper function of many essential cellular processes in the human body.The purpose of this review is to investigate the effect of nicotinamide mononucleotide (NMN), a NAD+ precursor, on physical performance and evaluate the safety profile of supplementation.A systematic review search criteria following the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed in four databases for randomized controlled trials on NMN supplementation. Study variables included title, author, publication date, study year, number of patients, dosage, mean age, mean follow-up time, pre- and post-intervention reported outcomes, and rates of complications. Ten studies, including 437 patients, with a mean age of 58.0years (35.1 to 81.1 years) and a mean follow-up time of 9.6 weeks (4 to 12 weeks) were included in this study. NMN dosages ranged from 150 to 1200 mg/day. Mean pre-intervention grip strength (two studies) and skeletal mass index (two studies) were 29.9 kilograms (kg) (range: 21.4-40.1 kg) and 7.4 kg/m2 (range: 6.9-7.65 kg/m2), respectively. Mean post-intervention grip strength and skeletal mass index were 30.5 kg (range: 21.7-41.9 kg) and 7.4 kg/m2 (6.8-7.64 kg/m2), respectively. There were no serious adverse effects observed. Moreover, of the reported side effects, they were determined to be independent of NMN supplementation. Therefore, patients taking NMN supplementation demonstrated non-significantly improved physical performance parameters.NMN is well tolerated with no serious adverse effects observed.

Sperm DNA fragmentation and infertility: a narrative review.

The purpose of this narrative review is to provide a practical understanding of sperm DNA fragmentation (SDF) in the management of male infertility. A search for systematic reviews and meta-analyses (SRMA) on SDF between April 1st, 2018 and April 1st, 2023 was performed using PubMed and articles were selected as per their relevance to the topic. Guidelines from major societies were also reviewed. Three clinical cases are reported and discussed. The search initially identified 80 articles. We selected 13 SRMAs based on their relevance to the topic. Of the 13 SRMAs, 7 evaluated the effect of SDF on assisted reproductive technology (ART) outcomes and recurrent pregnancy loss, 3 studied the effect of varicocele repair on SDF, and 3 evaluated the role of SDF involving lifestyle and environmental health factors including body mass index and male factor treatment strategies. Evidence suggests that increased SDF has a negative impact on natural pregnancy and ART outcomes. SDF testing may be particularly important in the infertility evaluation of men with varicoceles, idiopathic or unexplained infertility, recurrent pregnancy loss, or previous ART failure. Further studies are needed on SDF testing and the implications it can have on male factor infertility and pregnancy outcomes as well as its implementation in the setting of ART.

Selection Bias Risk in Randomized Controlled Trials Rated as Low Bias Using Risk of Bias, Version 2 (RoB2) Tool.

Our study aimed to establish the risk of selection bias in randomized controlled trials (RCT) that were overall rated as having "low bias" riskaccording to Cochrane's Risk of Bias, version 2 (RoB 2) tool. A systematic literature search of current systematic reviews of RCTs was conducted. From the identified reviews, RCTs with overall "high bias" and "low bias" RoB 2 risk ratings were extracted. All RCTs were statistically tested for selection bias risk. From the test results, true positive, true negative, false positive, or false negative ratings were established, and the false omission rate (FOR) with a 95% confidence interval (CI) was computed. Subgroup analysis was conducted by computing the negative likelihood ratio (-LR) concerning RoB 2 domain 1 ratings: bias arising from the randomization process. A total of 1070 published RCTs (median publication year: 2018; interquartile range: 2013-2020) were identified and tested.We found that 7.61% of all "low bias" (RoB 2)-rated RCTs were of high selection bias risk (FOR 7.61%; 95% CI: 6.31%-9.14%) and that the likelihood for high selection bias risk in "low bias" (RoB 2 domain 1)-rated RCTs was 6% higher than that for low selection bias risk (-LR: 1.06; 95% CI: 0.98-1.15). These findings raise issues about the validity of "low bias" risk ratings using Cochrane's RoB 2 toolas well as about the validity of some of the results from recently published RCTs.Our results also suggest that the likelihood of a "low bias" risk-rated body of clinical evidence being actually bias-free is low, and that generalization based on a limited, pre-specified set of appraisal criteria may not justify a high level of confidence that such evidence reflects the true treatment effect.

Characteristics of quality improvement interventions to improve physical healthcare in mental health settings: a scoping review protocol

IntroductionMental health concerns globally impact millions of people, resulting in significant financial impact and adverse health outcomes. People living with mental health concerns are at higher risk of developing physical...