Systematic Tool Research Articles

Magnitude and associated factors of postpartum family planning uptake among postpartum women in Ethiopia: an umbrella review

BackgroundThe World Health Organization indicates that despite advancements, the rates of maternal and neonatal mortality and morbidity during the postpartum period continue to be alarmingly high. Furthermore, untapped opportunities to enhance maternal health and promote effective newborn care, including family planning services, have not been fully leveraged. Earlier meta-analyses and systematic reviews have addressed this subject; however, a thorough evidence synthesis has not been provided. Therefore, the objective of this study was to compile the existing systematic reviews (SRs) concerning postpartum family planning uptake among postpartum women in Ethiopia.MethodThis review used an umbrella review method, incorporating numerous systematic reviews. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis of Observational Studies guideline (MOOSE). A comprehensive literature review was conducted across prominent four electronic databases (including MEDLINE/PubMed, Cochrane, Web of Science and Science Direct) from June 15, to July 15, 2024. This review encompassed investigations carried out within the uptake of family planning among post-partum women and its determinants in Ethiopia were the primary outcome. A set of inclusion criteria was established to identify all pertinent systematic reviews, including studies, with no restrictions on data collection and publication year. The quality of the methods was evaluated using the Assessment of Multiple Systematic Reviews tool, (AMSTAR) tool. Statistical analysis was conducted using STATA version 17 software, and the 95% confidence interval was utilized to establish statistical significance. I-squared statistics were employed to evaluate the heterogeneity of the studies by using a random-effects meta-analysis model.ResultsThe umbrella review includes five studies with a total of 44,276 postpartum women. The pooled prevalence of postpartum family planning utilization was 36.41% (95% CI: 24.78, 48.03). Family planning counseling (AOR: 4.12, 95% CI: 2.89, 4.71), couple discussion (AOR: 3.06, 95% CI: 1.42, 5.60), and postnatal follow-up (AOR: 3.48, 95% CI: 2.60, 4.83) were significantly associated with postpartum family planning uptake.ConclusionThe result (36.4%) which mentioned in the conclusion part will be removed and the whole text will be replaced by: The study results indicate that the adoption of postpartum family planning in Ethiopia requires focused intervention. This can be achieved by identifying and enhancing community frameworks to involve men in reproductive health initiatives and by providing comprehensive family planning information and services during postnatal care. Addressing the aforementioned factors is crucial to mitigate the risks associated with unintended pregnancies and to manage the swift increase in population.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024568435, PROSPERO (CRD42024568435).

Goethe´s nature observation and Materia medica methods crossing-over: a systematic tool to formulate homeopathic preparations for environmental purposes

Anamnesis, classification of symptoms and repertorization are the usual techniques for establishing a homeopathic treatment. However, the approach to be used for plants and the environment is still a challenge. In this paper, a new technique is proposed to select treatments for ultra-complex living systems that include several interconnected species (ecosystems), potentially significantly facilitating the practice of environmental homeopathy. Based on the crossing of two classic methods, Goethe's observation of nature [1] and homeopathic materia medica, this technique has shown promising results in promoting environmental recovery and regeneration. The foundations of the first method lay in a way of observing nature proposed by the German philosopher Goethe and systematized by Rudolf Steiner, in which an observer identifies discrepant elements that appear in a given living system after a stressful impact, representing a mimesis of suffering. The approach uses the same clinical tools for diagnosis, hierarchizing symptoms and identifying similarities between humans and animals. The first step is to take a long, detailed look at the affected area, without preconceptions or preconceived notions. The items to be observed are the climate, wind and lighting patterns, the characteristics and vitality of the soil, the remaining vegetation, the type of crop, the presence and appearance of water, changes in the local fauna and flora and the presence of indicator plants, which are elements of the biome itself capable of showing changes in the composition of the soil [2].Next, the type of aggression is described (logging, poor farming or grazing, frost, drought, flooding, soil pollution, leaching or compression).The third step is to observe the natural processes still present in the area (ecological succession, interaction between species, pollinating insect behavior and other characteristics that reveal the recovery of the local environmental archetype).This step allows the observer to gain an in-depth understanding of the process of environmental disturbance.The second method is based on identifying keywords in different homeopathic medical materials related to the response of various species of local fauna and flora to the same stressor, establishing the convergence of both methods. A table made up of the keywords, the corresponding remedies and the respective Materia Medica used as a reference is built to indicate the best treatment options to be used alone or in a complex. The last items to be defined are the potencies, forms of administration and dosage.For example, an area of degraded pasture was identified in the Pantanal biome (Mato Grosso do Sul, Brazil).The following parameters were listed: a high degree of desertification following drought, the presence of nitrogen-fixing plants (an indicator of a lack of nitrogen in the soil), such as Mimosa pudica (“Malicia”) and Mimosa farnesiana (“Aromita”) [3], and confirmation of the soil's condition by chemical analysis.The keywords identified were exhaustion and dryness, leading to homeopathic carbonic ammonium after cross-referencing the materia medica.The potency chosen is 6cH, once a month, taking into account the structure and time of the grass to germinate.The result was a rapid regrowth of the native grass, which had been absent for more than a decade, enough to recover an ideal grazing condition.The combination of the two methods was useful, as it allowed a deeper and more conscious approach to the whole environment and stimulated the potential vitality, adaptive abilities and self-regulation resources of its elements.

Unfolding humanistic wine tasting, based on wine professionals’ biographical expressions

In our time, wine-related industries express a growing demand for understanding new ideas about wine. This article explores how professional wine tasters develop their knowledge. Based on the idea of bildung as hermeneutic interpretation, we argue that there are three dominant ideas about how knowledge of wine can be approached: first, as an acquired canon; second, as a systematic tool; and third, as a search process. The intertwinement of these perspectives is exemplified by four autobiographical stories about experiences of learning, working with, and developing wine knowledge. One story is the first author's own autobiography; the others are published works by influential wine tasters. Autobiographical stories add a novel humanistic approach to explorations of wine knowledge, focusing on interpretation of experiences.In the discussion, the three different approaches to knowledge acquisition are related to how they support our understanding of different aspects of wine. We argue that canonic and systematic knowledge tends to be limited to conventional and technical aspects, while knowledge of the individuality of more unconventional wines and their aesthetic aspects is acquired through a search process. With increased influences of humanistic expressions in the world of wine, a greater focus on knowledge-seeking approaches to wine is required.

Consolidating the evidence on the effectiveness of strategies to promote vegetable intake in priority settings: An overview of systematic reviews.

Effective interventions to increase vegetable intake are urgently needed. This systematic rapid review aimed to summarise the effectiveness of interventions targeting increased vegetable intakes across diverse settings. The review was guided by the conduct of rapid reviews from the Cochrane Handbook. The literature was searched in February 2024 across PubMed, Web of Science and Cochrane Central for systematic review articles published since 2014. The Risk of Bias In Systematic Reviews tool was used and characteristics of reviews synthesised narratively with intervention effectiveness results were summarised. A total of 20 systematic reviews met the eligibility criteria. Most targeted school-based settings (n = 7) or community/home-based settings (n = 4). Early childhood education and workplaces had one review each, with none in retail, secondary or tertiary education, food service, food relief or aged care. The mean change in vegetable consumption was +0.12 serves per day, with increases of up to +0.42 serves reported (range -0.09 to +0.42). By setting, the largest increases were reported for interventions in school settings (+0.42 serves/day), followed by home (+0.38 serves/day). Almost half the studies reporting effect sizes suggested no effect on intake (46%), 41% suggested a small effect and 13% suggested a medium effect. Greater effect sizes were achieved in interventions implemented across multiple settings. Review findings indicate that the average increase in vegetable intake following interventions is about one-eighth of a serve but up to almost half a serve in some settings. An increase of this magnitude could have a substantial population impact, particularly in population groups with persistently low intakes.

Overall Prompting Effectiveness for Optimising Human-Machine Interaction in Cyber-Physical Systems

This paper presents the Overall Prompting Effectiveness (OPE) framework, designed to enhance interactions with systems employing generative AI(genAI) through prompt engineering. Leveraging principles from Total Productive Maintenance (TPM): Overall Equipment Effectiveness (OEE), the OPE framework provides a systematic tool for iterative refinement of prompts, crucial for optimising human-AI interactions in cyber-physical-social-human systems. Evaluating prompting results in three actionable categories: Availability, Performance, and Quality, OPE aims to generate more accurate, relevant, and effective AI responses. Preliminary applications and workshops with prompt engineers underscore the potential of OPE to significantly improve the efficiency and effectiveness of AI engagements. The integration of OPE within Large Language Models (LLMs) or other genAI systems promises to expand automation capabilities, enhancing the intellectualisation and personalisation of CPS. This framework fosters continuous improvement in prompt quality and contributes to the synthetic knowledge management and smart reasoning mechanisms essential for advanced CPS. Our findings suggest that OPE could play a significant role in cognitive engineering, offering a novel methodology for enhancing decision-making and problem-solving in intelligent systems. This aligns with the current research directions in CPS, emphasising the need for tools supporting technology's socialisation and personalisation in complex integrated environments.

Obstacles and Opportunities for Albuminuria Testing Based on the Perspective of Primary Care: A Qualitative Study.

Albuminuria testing is an easy way to identify, early on, a higher risk of cardiovascular and renal kidney morbidity and mortality in patients at-risk. In France, the urine albumin-to-creatinine ratio is an indicator for Remuneration for Public Health Objectives (pay-for-performance P4P) for patients with diabetes or hypertension. These tests must be performed annually by general practitioners (GPs), but are not sufficiently performed, although drug therapies depend on them. We wanted to understand the practice of urinary protein screening assays by means of a qualitative study on the experience of GPs in a French region, with a view to developing facilitating strategies. This qualitative, semiopragmatic, phenomenological study analyzed in-depth interviews held with a purposive sample (age, gender, training, type of practice, rural/urban context) of 27 general practitioners, with triangulation of researchers until data saturation. GPs recognized the assay as a systematic screening tool in accordance with the guidelines, but limited it to patients with diabetes or hypertension encouraged by P4P. Noting that their intervention was limited to kidney-protective measures already in place and, unaware of the new drugs, they saw no benefits and considered it a non-priority test. The existence of several urinary assays with varying intervention thresholds, changes in guidelines and the fact that specialists in laboratory medicine can decide which test to use depending on reimbursement by the health insurance scheme, all contributed to GPs' confusion in prescribing and interpreting tests. One consequence of this was inappropriate referral to the nephrologist. These tests required them to adopt a patient-centered educational approach, making it difficult for certain patients to perform them. GPs were aware of guideline recommendations to screen for albuminuria in patients with diabetes and hypertension but had difficulty interpreting the results. Their lack of perceived clinical consequences and new drugs should be targeted to improve the situation.

Framework and case study for the assembly accuracy prediction of prefabricated buildings using BIM and TLS

ABSTRACT Tolerance management in the Architecture, Engineering, and Construction (AEC) sector faces challenges due to a lack of systematic scientific methods and tools. Quality issues in construction, coupled with inefficiencies, rework, and waste arising from deviation problems, hinder the sustainable development of the AEC sector. Current deviation control methods in the AEC field rely on compliance inspections and on-site rework, which are reactive and costly. In contrast, the manufacturing industry, closely linked to AEC, has developed highly automated methods for tolerance management. Although prefabricated buildings are manufactured off-site with high precision, the on-site assembly precision remains low, failing to fully leverage manufacturing industry capabilities. This research proposes a framework for predicting assembly accuracy of prefabricated buildings during the design and early construction stages. The framework, based on tolerance analysis methods from the manufacturing industry, integrates Building Information Modeling (BIM) and Terrestrial 3D Laser Scanning (TLS) technologies. This innovative approach offers a computer-aided method for conducting tolerance analysis in prefabricated buildings. A completed prefabricated building project serves as a case study, utilizing the framework to predict variations in critical dimensions, and the predictions align with measured results, demonstrating the feasibility of the proposed framework.

Empathy enhancement through VR: A practice-led design study

Virtual reality (VR) has been widely acknowledged as a highly effective medium for augmenting empathy, enabling individuals to better comprehend and resonate with the emotions and lived experiences of others. Despite its acknowledged potential, the field lacks clear design guidelines and a systematic framework for creating VR environments for empathy training. In this article, we present a practice-led research project in which we triangulated design research using a paired sample t-test to evaluate and optimize the design guidelines of the empathy-training VR design (EVRD) framework. We evaluated the impact of a VR experience, designed based on the EVRD framework, on emotional, cognitive, and behavioral empathy among Chinese higher education students (n=84). A comprehensive assessment approach, including the Interpersonal Reactivity Index, interviews, system log analysis, and monitoring of donation activities was utilized, to measure changes in empathy before and after the VR intervention. The results validated the EVRD framework and demonstrated that it is a practical and systematic tool for designing a VR that training empathy. The findings of this study provide design insights with regard to (1) the process of VR empathy and (2) how to design “doomed-to-fail” interactions to promote cognitive empathy in VR.

ELEPHANT: ExtragaLactic alErt Pipeline for Hostless AstroNomical Transients

Context. Transient astronomical events that exhibit no discernible association with a host galaxy are commonly referred to as hostless. These rare phenomena can offer unique insights into the properties and evolution of stars and galaxies. However, the sheer number of transients captured by contemporary high-cadence astronomical surveys renders the manual identification of all potential hostless transients impractical. Therefore, creating a systematic identification tool is crucial for studying these elusive events. Aims. We present the ExtragaLactic alErt Pipeline for Hostless AstroNomical Transients (ELEPHANT), a framework for filtering hostless transients in astronomical data streams. It was designed to process alerts from the Zwicky Transient Facility (ZTF) presented in the Fink broker; however, its underlying concept can be applied to other data sources. Methods. We used Fink to access all the ZTF alerts produced between January 2022 and December 2023, selecting alerts associated with extragalactic transients reported in SIMBAD or TNS, as well as those classified as supernovae (SNe) or kilonovae (KNe) by the machine learning (ML) classifiers within the broker. We then processed the associated stamps using a sequence of image analysis techniques to retrieve hostless candidates. Results. We find that ≲2% of all analyzed transients are potentially hostless. Among them, only ~10% have a spectroscopic class reported on TNS, with type Ia SNe being the most common class, followed by superluminous SNe. In particular, among the host-less candidates retrieved by our pipeline, there is SN 2018ibb, which has been proposed to be a pair instability SN candidate, and SN 2022ann, one of only five known SNe Icn. When no class is reported on TNS, the dominant classes are quasi-stellar object (QSO) and SN candidates, with the former obtained from SIMBAD and the latter inferred using the Fink ML classifier. Conclusions. ELEPHANT represents an effective strategy to filter extragalactic events within large and complex astronomical alert streams. There are many applications for which this pipeline will be useful, ranging from transient selection for follow-up to studies of transient environments. The results presented here demonstrate the feasibility of developing specially crafted pipelines that enable a variety of scientific studies based on large-scale surveys.

Application of Multi-criteria Decision-making Methods for Forensic Analysis of Mechanical Parts in Vehicle Accidents using q-Rung Orthopair Fuzzy Numbers

This study explores the application of a Multi-Criteria Decision-Making (MCDM) approach based on q-rung orthopair fuzzy numbers to identify the origin of mechanical parts found at vehicle accident scenes. The primary objective is to determine the most likely vehicle to which these parts belong by evaluating key criteria such as compatibility, damage level, serial number matching, and color compatibility. Q-rung orthopair fuzzy numbers offer an advanced method to handle the inherent uncertainty and vagueness associated with forensic evaluations, particularly in scenarios where data is incomplete or imprecise. The proposed methodology involves defining the criteria, assigning membership and non-membership degrees using q-rung orthopair fuzzy sets, and applying an aggregation process to effectively rank alternatives. This approach facilitates flexible decision-making by accommodating different levels of confidence and uncertainty, making it particularly suitable for forensic applications where evidence is often ambiguous. The findings demonstrate that integrating q-rung orthopair fuzzy numbers into the MCDM framework significantly enhances the accuracy and reliability of identifying vehicle components involved in accidents. The proposed methodology provides a systematic tool to support forensic investigations, aiding in the determination of liability and contributing to more robust outcomes in mechanical evidence analysis.

Energy Transition Policy of the Mexican Electricity Sector: A Representation in Terms of the Theory of Change

Energy transition in the electricity sector is central to limiting global warming to 1.5 °C. Countries around the world rely on official planning documents, such as strategies, special programs, and action plans, to guide these efforts. However, there are few systematic approaches and tools that can help policy makers determine comprehensiveness, coherence, consistency, and coordination when designing these planning documents. This represents a risk to meet energy transition and climate change goals if the relationships of policies and actions included in these documents are not addressed properly. To this end, this paper proposes an approach to model hierarchical relationships using the theory of change, while causal relationships are allocated using policy makers’ experience (yet can also be exogenously allocated using other models). As a case study, this work investigates Mexico’s energy transition policy of the electricity sector over the 2013–2018 period. The results show that Mexico’s official planning documents lack a good design since most policies and actions are not articulated in the right sequence and privilege clean centralized and distributed generation and energy efficiency, while others related to the modernization of electrical grids and climate and environmental policies are barely included.

Highlighting the Urgent Need for Reforms in the Face of Financial Failures at State-Owned Enterprises in Iraq

General Background: The financial analysis of companies' reports is critical for assessing their past performance, forecasting future results, and identifying operational strengths and weaknesses. Specific Background: Financial failure, which occurs when a company cannot generate adequate returns to cover costs and capital expenses, poses significant risks to stakeholders. For state-owned companies, the implications of financial failure are especially profound, given their integral role in national economies, such as Iraq's. Knowledge Gap: There is limited understanding of the extent to which state-owned companies in Iraq utilize financial analysis to predict financial failure, particularly in the context of economic transitions and privatization pressures. Aims: This study aims to evaluate the dependence of Iraqi state-owned companies on financial analysis as a predictive tool for financial distress and to identify the key factors contributing to their financial failures. Results: The research reveals that 42% of the companies examined have experienced financial failure, as measured by the Argenti index. Contributing factors include employment challenges, insufficient financing, and the transition from a socialist to a capitalist economy, which has left companies vulnerable to privatization. Novelty: The study provides novel insights into how economic transition impacts the financial stability of state-owned companies, highlighting the practical application of the Argenti index in diagnosing financial weaknesses. Implications: The findings underscore the urgent need to support state-owned enterprises by revitalizing the industrial sector, improving administrative efficiency, and adopting more systematic financial analysis tools. Additionally, the research recommends creating an accessible information center for investors and creditors, which would enhance transparency and support decision-making. This approach could help mitigate financial distress and attract new investment, ultimately contributing to Iraq’s economic recovery. Highlights: Financial analysis helps predict failures in state-owned companies. 42% of companies fail, based on the Argenti index. Privatization and economic shifts increase financial risk. Keywords: Financial analysis, Argenti index, state-owned companies, financial failure, privatization

Capitalizing on Dementia Care Mapping in an Evaluation of a Montessori-Based Intervention for Individuals Living with Dementia.

Montessori-based interventions (MBIs) promote quality of life among older adults living with dementia. We used Dementia Care Mapping (DCM) to evaluate the impact of a small-scale MBI. DCM is a systematic observation tool that records the behavior and mood/engagement of individuals living with dementia and can be used to improve quality of care and well-being. Pre- and post-intervention data from 15 care community residents compared: 1) residents' range and types of behaviors, 2) their mood/engagement and 3) staff behaviors that facilitated and impeded residents' personhood. In this mixed-methods study, deductive qualitative content analysis of DCM field notes further explored staff behaviors. Post-intervention, a significantly higher proportion of residents' behaviors had the potential to promote their well-being, although there was little change in mood/engagement while engaging in those behaviors. Post-intervention, there was also a significant increase in staff behaviors that facilitated, and a decrease in staff behaviors that impeded, residents' personhood. Further, post-intervention, staff interactions with residents were more open-ended and inclusive. Although some staff behaviors still excluded residents, the exclusion was more benign than pre-intervention. DCM documented incremental changes toward person-centered care, and DCM field notes provided insight into missed opportunities for effective staff interactions with residents. Taken together, findings provide additional support for the use of MBIs and highlights the usefulness of DCM, especially its associated field notes, to help researchers and practitioners create environments that promote the personhood that individuals living with dementia deserve.

Characterising umbrella reviews in paediatrics: A systematic analysis.

To characterise typical practices in conducting and reporting umbrella reviews in paediatrics. PubMed database was searched for umbrella reviews focusing on children (0-18 years) published from 1 January 2020 to 15 June 2024, regardless of the speciality. The included studies were assessed for reporting practices, result summarisation and critical appraisal methods. Ninety-nine eligible umbrella reviews were included, of which 49 focused on interventions and 50 focused on epidemiology. The median number of included reviews in the umbrella reviews was 18 (range = 3-302), and statistical synthesis was performed in 32 studies. The most frequently used tool for critical appraisal of the included reviews was the updated Assessing the Methodological Quality of Systematic Reviews (AMSTAR-2) tool (n = 56); the original AMSTAR-1 tool was used in seven reviews, and the Risk of Bias in Systematic Reviews tool was used in 12 reviews. Evidence certainty was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework in 14 reviews and by the Ioannidis criteria in 18 reviews. Umbrella reviews have heterogeneous characteristics in terms of reporting practices. Greater adherence to guidelines on conducting and reporting umbrella reviews is needed, particularly for improving critical appraisal methods.

Relationship between temporomandibular and sleep disorders in adults: An overview of systematic reviews

ObjectiveThis study emphasizes the general relevance of sleep disorders (SD) and temporomandibular disorders (TMD), explores their bidirectional relationship, and describes the importance of systematic reviews in the critical analysis of the literature. This review aimed to comprehensively summarize the relationship between SD and TMD in adults while ensuring a reliable and objective analysis of data from the existing literature. MethodsSystematic reviews were evaluated to investigate this association between two conditions in adults. The study was registered with Prospero and followed the PECOT structure in identifying the research question. Searches in multiple databases were conducted until February 2024 using relevant keywords. The risk of bias was assessed using the Risk of Bias in Systematic Reviews tool, involving two independent reviewers. ResultsData were extracted using different evaluation instruments, and results were analyzed and presented through the synthesis of information collected in selected systematic reviews. The selection included seven systematic reviews of observational studies, with exclusion criteria defined to ensure methodological quality. The results showed that reviewed studies presented clarity and relevance in defining the eligibility criteria, but that the identification and selection of studies, data collection, and synthesis of results varied. Most studies considered the potential risks, but some require greater transparency and methodological rigor. ConclusionsThis review points out the association between SD and TMD in adults, with most studies presenting a low risk of bias, although some uncertainties were observed.

Diagnostic accuracy of point-of-care tests for acute respiratory infection: a systematic review of reviews.

Acute respiratory infections are a common reason for consultation with primary and emergency healthcare services. Identifying individuals with a bacterial infection is crucial to ensure appropriate treatment. However, it is also important to avoid overprescription of antibiotics, to prevent unnecessary side effects and antimicrobial resistance. We conducted a systematic review to summarise evidence on the diagnostic accuracy of symptoms, signs and point-of-care tests to diagnose bacterial respiratory tract infection in adults, and to diagnose two common respiratory viruses, influenza and respiratory syncytial virus. The primary approach was an overview of existing systematic reviews. We conducted literature searches (22 May 2023) to identify systematic reviews of the diagnostic accuracy of point-of-care tests. Where multiple reviews were identified, we selected the most recent and comprehensive review, with the greatest overlap in scope with our review question. Methodological quality was assessed using the Risk of Bias in Systematic Reviews tool. Summary estimates of diagnostic accuracy (sensitivity, specificity or area under the curve) were extracted. Where no systematic review was identified, we searched for primary studies. We extracted sufficient data to construct a 2 × 2 table of diagnostic accuracy, to calculate sensitivity and specificity. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. Where possible, meta-analyses were conducted. We used GRADE to assess the certainty of the evidence from existing reviews and new analyses. We identified 23 reviews which addressed our review question; 6 were selected as the most comprehensive and similar in scope to our review protocol. These systematic reviews considered the following tests for bacterial respiratory infection: individual symptoms and signs; combinations of symptoms and signs (in clinical prediction models); clinical prediction models incorporating C-reactive protein; and biological markers related to infection (including C-reactive protein, procalcitonin and others). We also identified systematic reviews that reported the accuracy of specific tests for influenza and respiratory syncytial virus. No reviews were found that assessed the diagnostic accuracy of white cell count for bacterial respiratory infection, or multiplex tests for influenza and respiratory syncytial virus. We therefore conducted searches for primary studies, and carried out meta-analyses for these index tests. Overall, we found that symptoms and signs have poor diagnostic accuracy for bacterial respiratory infection (sensitivity ranging from 9.6% to 89.1%; specificity ranging from 13.4% to 95%). Accuracy of biomarkers was slightly better, particularly when combinations of biomarkers were used (sensitivity 80-90%, specificity 82-93%). The sensitivity and specificity for influenza or respiratory syncytial virus varied considerably across the different types of tests. Tests involving nucleic acid amplification techniques (either single pathogen or multiplex tests) had the highest diagnostic accuracy for influenza (sensitivity 91-99.8%, specificity 96.8-99.4%). Most of the evidence was considered low or very low certainty when assessed with GRADE, due to imprecision in effect estimates, the potential for bias and the inclusion of participants outside the scope of this review (children, or people in hospital). Currently evidence is insufficient to support routine use of point-of-care tests in primary and emergency care. Further work must establish whether the introduction of point-of-care tests adds value, or simply increases healthcare costs. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159948.

Desafios e perspectivas na judicialização da saúde na América Latina: considerações sobre o fenômeno no Brasil e na Colômbia

Objective: The present study aims to understand how the judicialization of health develops as a global phenomenon, with particular emphasis on Latin American contexts, considering Brazil, and Colombia. Methodology: A literature review methodology supported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool was adopted. The research was conducted using specific descriptors, and search strategies were carried out in the PubMed, MEDLINE, Lilacs, SciELO, CRD, CDSR, BVS, and BIREME databases. Articles published between 2010 and 2024 that discuss the judicialization of health, considering Portuguese, Spanish, or English languages, were selected. Results: The search resulted in 455 articles, of which 18 met the inclusion criteria. The analysis of the selected articles reveals the need for balanced solutions that respect individual rights without compromising the accessibility and quality of collective healthcare. The challenges imposed by judicialization are highlighted, such as issues of equity, financial sustainability of health systems, and resource prioritization. Conclusion: It concludes by emphasizing the importance of a multidisciplinary approach involving legislative adjustments, improvements in health system management, health education, and the promotion of equitable public policies. Submission: 05/29/24| Review: 08/16/24| Approval: 08/16/24

Evidence-Based Critical Assessment of the Success Rate of Dental Implants in Smokers: An Umbrella Systematic Review.

The aim of this umbrella systematic review is to evaluate the success rate and osseointegration of dental implants in patients with a smoking habit. Electronic database searches of PubMed/Medline, Google Scholar, ScienceDirect, Cochrane Library, and EBSCOhost were done from 2006 until August 2024, using medical subject headings (MeSH) terms. Systematic reviews and meta-analyses (SRMAs) investigating the association between smoking and the rate of success of dental implants based on dental implant failure, marginal bone loss, survival, and peri-implant parameters were deemed eligible. The Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2) was used to assess the quality of the included SRMAs. Seventeen systematic reviews have been included. In the reviews, 10 studies included meta-analyses (MAs) that evaluated implant failure rate and marginal bone loss. According to the AMSTAR 2 checklist, one review was scored "high," seven reviews were scored "moderate," seven reviews were scored "low," and two reviews were scored "critically low" quality. The strength of evidence suggests a low level of success and high rate of failure of osseointegration of dental implants in smokers. However, the influence of smoking on the rate of dental implant failure seems to be associated with various factors such as peri-implant inflammatory markers, post-operative infections, etc. Inherently, the conclusion of this review is based on a limited number of systematic reviews.

Risk-based shelter network design in flood-prone areas: An application to Haiti

Evacuations occur when human safety is compromised by disasters, such as floods. Shelters play a crucial role in providing protection for individuals who have been displaced or have lost their housing, emphasizing the requirement for secure accessibility. This paper introduces an systematic optimization tool, utilizing mathematical programming, to assist decision-makers in designing an effective shelter network. It is effective preparedness decision as it minimizes the total risk of the network considering its flooding condition during the response phase while maximizing coverage for those most exposed and vulnerable to hazard. We propose a risk-based approach, wherein the inherent risks of the shelter network (i.e., population, shelter, and evacuation risks) have been thoroughly assessed and measured to consider the impacts of floods based on empirical research outputs. To formulate a well-parameterized and valid problem, extensive data collection and processing, incorporating the use of geographic information system (GIS) for data management, have been conducted. In collaboration with the World Bank and Government of Haiti, this project contributes to a development initiative focused on strengthening disaster response capacity and infrastructure for Haiti, experiencing recurrent devastating floods and in need of enhancing its existing shelter network. Detailed computational results highlight the value of our risk-based methodology compared to more common approaches, emphasizing contributions to addressing real humanitarian problems.

A comprehensive literature review and bibliometric analysis on shape grammar theory and applications in architecture

Shape Grammar is a systematic tool used in the logical argumentive method in research for interpreting spatial design and activities. Shape grammar applies a group of shape rules in stages to create a set or a language of design. Researchers worldwide have used this method in various fields including architecture, arts, graphical design, and pattern recognition. Even in the case of architecture, researchers worldwide have implemented the shape grammar method to analyze patterns in various architectural fields. This study analyzed publication trends in the shape grammar domain using “Bibliometrix”, an open-source tool that uses the R package. Research papers from the Web of Science and Scopus (WoS) database were identified and assessed in terms of annual publication trends, contributions of various authors, countries, citation counts of authors, universities, popular keywords, journal trends, etc. A comprehensive literature review of all relevant research papers available in the WoS and Scopus academic databases on shape grammar and its application in architecture was also conducted as part of this study. The research paper concludes with the possible research opportunities in the domain of shape grammar.