A study of search strategy availability statements and sharing practices for systematic reviews: Ask and you might receive

The literature search underpins data collection for all systematic reviews (SRs). The SR reporting guideline PRISMA, and its extensions, aim to facilitate research transparency and reproducibility, and ultimately improve the quality of research, by instructing authors to provide specific research materials and data upon publication of the manuscript. Search strategies are one item of data that are explicitly included in PRISMA and the critical appraisal tool AMSTAR2. Yet some authors use search availability statements implying that the search strategies are available upon request instead of providing strategies up front. We sought out reviews with search availability statements, characterized them, and requested the search strategies from authors via email. Over half of the included reviews cited PRISMA but less than a third included any search strategies. After requesting the strategies via email as instructed, we received replies from 46% of authors, and eventually received at least one search strategy from 36% of authors. Requesting search strategies via email has a low chance of success. Ask and you might receive-but you probably will not. SRs that do not make search strategies available are low quality at best according to AMSTAR2; Journal editors can and should enforce the requirement for authors to include their search strategies alongside their SR manuscripts.

Advancing traffic safety through the safe system approach: A systematic review

The Safe System Approach (SSA) has emerged as a comprehensive framework for enhancing traffic safety through system-wide interventions. This systematic review, conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzes 82 relevant studies categorized based on the SSA pillars: safe road users, safe vehicles, safe speeds, safe roads, and post-crash care. The review provides insights into SSA's effectiveness in reducing road traffic fatalities and injuries, exploring implementation challenges and opportunities, including policy initiatives, institutional frameworks, and stakeholder collaborations. The findings highlight the potential for SSA to create a more forgiving and resilient transportation system, offering valuable guidance for policy decisions, future research, and interventions aimed at promoting safer road environments. SSA's comprehensive strategy for Safe Road Users encompasses considerations of road system design, behavior modification, and tailored measures for vulnerable users, showcasing its versatility in addressing diverse challenges. In the realm of Safe Vehicles, SSA actively involves manufacturers in a cycle of continuous improvement, rigorous testing, and collaborative efforts to establish new safety regulations. The emphasis on managing Safe Speeds, aligning with human parameters, and involving communities reflects SSA's adaptable nature and provides insights for establishing context-specific speed limits. SSA contributes significantly to Safe Roads through its implementation of innovative countermeasures, forgiving road designs, and the integration of emerging disciplines, resulting in a notable reduction in fatalities and injuries. In the domain of Post-Crash Care, SSA's integrated perspective fosters collaboration among emergency services, medical professionals, and the justice system. It addresses challenges through standardized approaches and information sharing, ensuring a comprehensive and unified approach to road safety. This review contributes to the ongoing efforts to prioritize safety and transform the transportation landscape on a global scale.

mHealth-Based Gamification Interventions Among Men Who Have Sex With Men in the HIV Prevention and Care Continuum: Systematic Review and Meta-Analysis

Background

In the past few years, a burgeoning interest has emerged in applying gamification to promote desired health behaviors. However, little is known about the effectiveness of such applications in the HIV prevention and care continuum among men who have sex with men (MSM).

Objective

This study aims to summarize and evaluate research on the effectiveness of gamification on the HIV prevention and care continuum, including HIV-testing promotion; condomless anal sex (CAS) reduction; and uptake of and adherence to pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and antiretroviral therapy (ART).

Methods

We comprehensively searched PubMed, Embase, the Cochrane Library, Web of Science, Scopus, and the Journal of Medical Internet Research and its sister journals for studies published in English and Chinese from inception to January 2024. Eligible studies were included when they used gamified interventions with an active or inactive control group and assessed at least one of the following outcomes: HIV testing; CAS; and uptake of and adherence to PrEP, PEP, and ART. During the meta-analysis, a random-effects model was applied. Two reviewers independently assessed the quality and risk of bias of each included study.

Results

The systematic review identified 26 studies, including 10 randomized controlled trials (RCTs). The results indicated that gamified digital interventions had been applied to various HIV outcomes, such as HIV testing, CAS, PrEP uptake and adherence, PEP uptake, and ART adherence. Most of the studies were conducted in the United States (n=19, 73%). The most frequently used game component was gaining points, followed by challenges. The meta-analysis showed gamification interventions could reduce the number of CAS acts at the 3-month follow-up (n=2 RCTs; incidence rate ratio 0.62, 95% CI 0.44-0.88). The meta-analysis also suggested an effective but nonstatistically significant effect of PrEP adherence at the 3-month follow-up (n=3 RCTs; risk ratio 1.16, 95% CI 0.96-1.38) and 6-month follow-up (n=4 RCTs; risk ratio 1.28, 95% CI 0.89-1.84). Only 1 pilot RCT was designed to evaluate the effectiveness of a gamified app in promoting HIV testing and PrEP uptake. No RCT was conducted to evaluate the effect of the gamified digital intervention on PEP uptake and adherence, and ART initiation among MSM.

Conclusions

Our findings suggest the short-term effect of gamified digital interventions on lowering the number of CAS acts in MSM. Further well-powered studies are still needed to evaluate the effect of the gamified digital intervention on HIV testing, PrEP uptake, PEP initiation and adherence, and ART initiation in MSM.

The Relevance of Marketing in Sports Betting Perceptions and Behaviors Across Different age Groups

Sports betting and its associated problems are increasing rapidly. Moreover, it has been widely advertised and marketed, successfully reaching young adult males. This work aims to review recent publications regarding the relationship between marketing and sports betting perceptions and behaviors across different ages. For this purpose, a search in the PubMed database was set for 5 years (November 2014 - November 2019). The search terms included: "Sports betting AND children", "Sports betting AND young adult", "Sports betting AND adult". The search generated 131 articles, including some duplications. Once duplicates were eliminated, the titles and abstract analysis led to 21 references. To this, four more recent references were added to complement the introduction and discussion sections. The total number of references is 25. The inclusion criteria were as follows: (a) human study, (b) quantitative, experimental, clinical study, or review, (c) emphasis on the relationship between marketing and sports betting perceptions and behaviors, (d) specified number of subjects, (e) male or female gender, and (f) written in English (title and abstract). The findings indicated that: (1) marketing plays a significant role in normalizing gambling in sports, (2) policymakers should consider comprehensive approaches to reduce the exposure of sports betting advertising to young individuals, and (3) future studies should explore potential differences in results based on gender and developmental stage. For instance, sports betting is more prevalent among males than females, and younger children tend to be more impulsive than older children.

Targeting strategies with lipid vectors for nucleic acid supplementation therapy in Fabry disease: a systematic review

Fabry disease (FD) results from a lack of activity of the lysosomal enzyme α-Galactosidase A (α-Gal A), leading to the accumulation of glycosphingolipids in several different cell types. Protein supplementation by pDNA or mRNA delivery presents a promising strategy to tackle the underlying genetic defect in FD. Protein-coding nucleic acids in FD can be either delivered to the most affected sites by the disease, including heart, kidney and brain, or to specialized organs that can act as a production factory of the enzyme, such as the liver. Lipid-based systems are currently at the top of the ranking of non-viral nucleic acid delivery systems, and their versatility allows the linking to the surface of a wide range of molecules to control their biodistribution after intravenous administration. This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines and provides an overview and discussion of the targeting ligands that have been employed so far to actively vectorize intravenously administered non-viral vectors based on lipid carriers to clinically relevant organs in the treatment of FD, for protein-coding nucleic acid (pDNA and mRNA) supplementation. Among the thirty-two studies included, the majority focus on targeting the liver and brain. The targeting of the heart has been reported to a lesser degree, whereas no articles addressing kidney-targeting have been recorded. Although a great effort has been made to develop organ-specific nucleic acid delivery systems, the design of active-targeted carriers with high quality, good clinical translation, and large-scale manufacturing capacity is still challenging.

Ecological validity of neuropsychological interventions: A systematic review

BACKGROUND

The concept of ecological validity (EV) in neuropsychological interventions (NI) has been consistently advocated, but there is a lack of reviews focused on how EV is operationalized in NI programmes. This review aims to address this gap by exploring the outcome measures more commonly used for assessing EV and to understand the main characteristics of programmes with good EV.

METHOD

A literature search was conducted to identify studies that examined the EV of NI programmes, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Collaboration Guidelines.

RESULTS

A total of twenty-seven studies were included in this review. Among these, only three studies explicitly described the procedures used to assess EV. Additionally, almost half of the studies assumed that interventions had good EV based on the characteristics of the programmes. The inconsistent assessment of EV of NI programmes prevented the identification of specific characteristics of programmes demonstrating good EV.

CONCLUSION

This systematic review reveals a significant gap in the literature concerning the operationalization of EV within the field of NI. Further research is required to establish a consistent definition of EV in the context of NI and to develop criteria for its effective operationalization.

Effects of Telemedicine on Informal Caregivers of Patients in Palliative Care: Systematic Review and Meta-Analysis

Background

Telemedicine technology is a rapidly developing field that shows immense potential for improving medical services. In palliative care, informal caregivers assume the primary responsibility in patient care and often face challenges such as increased physical and mental stress and declining health. In such cases, telemedicine interventions can provide support and improve their health outcomes. However, research findings regarding the use of telemedicine among informal caregivers are controversial, and the efficacy of telemedicine remains unclear.

Objective

This study aimed to evaluate the impacts of telemedicine on the burden, anxiety, depression, and quality of life of informal caregivers of patients in palliative care.

Methods

A systematic literature search was conducted using the PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL Plus with Full Text, CBM, CNKI, WanFang, and VIP databases to identify relevant randomized controlled trials published from inception to March 2023. Two authors independently screened the studies and extracted the relevant information. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Intervention effects were estimated and sensitivity analysis was conducted using Review Manager 5.4, whereas 95% prediction intervals (PIs) were calculated using R (version 4.3.2) and RStudio.

Results

A total of 9 randomized controlled trials were included in this study. The meta-analysis indicated that telemedicine has reduced the caregiving burden (standardized mean differences [SMD] -0.49, 95% CI -0.72 to -0.27; P<.001; 95% PI -0.86 to -0.13) and anxiety (SMD -0.23, 95% CI -0.40 to -0.06; P=.009; 95% PI -0.98 to 0.39) of informal caregivers; however, it did not affect depression (SMD -0.21, 95% CI -0.47 to 0.05; P=.11; 95% PI -0.94 to 0.51) or quality of life (SMD 0.35, 95% CI -0.20 to 0.89; P=.21; 95% PI -2.15 to 2.85).

Conclusions

Although telemedicine can alleviate the caregiving burden and anxiety of informal caregivers, it does not significantly reduce depression or improve their quality of life. Further high-quality, large-sample studies are needed to validate the effects of telemedicine. Furthermore, personalized intervention programs based on theoretical foundations are required to support caregivers.

Development and research directions in ship recycling: A systematic literature review with bibliometric analysis

Ship recycling has gained significant importance in recent years due to the growing awareness of environmental concerns and the need for sustainable practices within the maritime industry. As vessels reach the end of their operational life, proper recycling methods are crucial to mitigate environmental impacts and promote resource conservation. With an increasing number of ships being decommissioned annually, there has been a growing interest and emphasis on developing efficient and eco-friendly ship recycling practices worldwide. This article presents a systematic literature review and bibliometric analysis of 228 studies on ship recycling indexed in Scopus. Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology for its robustness in comprehensive literature analysis, this review uncovers key insights into prominent countries, authors, journals, collaborations, topics, and historical trends in ship recycling research, thereby extending the scope of previous reviews. Notably, major contributions from Turkey, India, Bangladesh, the USA, and China focus on environmental impact studies, reflecting urgent global sustainability concerns. The review discusses commonly adopted methodologies such as Life Cycle Assessment and Elemental Analysis, shedding light on their application in this field. Through thematic analysis across 8 categories, future research pathways are identified, highlighting crucial areas such as continuous environmental monitoring, innovative renewable energy extraction from end-of-life vessels, and the need for human factors in ship recycling. This comprehensive synthesis of existing knowledge and identification of emergent research needs and opportunities serve as a foundational resource for impactful future research and informed policymaking, particularly in aligning with global environmental and sustainability goals. Researchers, policymakers and other stakeholders in maritime safety and environmental sustainability may find the knowledge gained from this systematic literature review insightful.

Determining the Completeness of Registration and Reporting in Systematic Reviews of Yoga for Health

Introduction: Yoga is a mind-body practice often used to improve health. Systematic reviews (SRs) of randomized controlled trials on yoga for health are foundational to evidence-based yoga interventions and require rigorous and transparent methods, including preparation of a protocol (e.g., PROSPERO) and following SR reporting guidelines (e.g., Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA]). Objective: To evaluate the availability of protocols and the completeness of reporting for SRs on yoga for health. Methods: We used a previously assembled database of SRs focused on the use of yoga for health. The authors independently extracted data on protocol availability, PROSPERO registration, and reporting for each PRISMA 2009 checklist item. Discrepancies were discussed or referred to a third author. We used Stata 10 software to produce descriptive statistics and tests for relationships between registration, reporting, and publication year, country, and journal type. Results: We included 147 reviews published between 2005 and 2019. The most common first author country was the United States or Germany (total 67/147; 46%), and the most common journal type was specialty journals (71/147; 48%). Most reviews (116/147; 79%) made no mention of a protocol or registration, and only 15/147 (10%) reviews were linked to an accessible protocol or registration. Most SRs published in 2010 or later mentioned or cited PRISMA (97/139; 70%), and individual PRISMA items were addressed between 10% and 100% of the time. PRISMA reporting improved; over time, but there was no relationship with country or journal type. Discussion: This study identifies a need for increased SR registration for yoga research. The assessment of PRISMA reporting did not evaluate the comprehensiveness with which each item was reported, and while trends are encouraging, there is likely room for improvement. We recommend registering all yoga SRs and following updated PRISMA and recent yoga-specific guidelines for reporting. This may increase transparency, minimize bias, and produce high-quality data to inform evidence-based yoga practices.

Machine Learning Applications in Optical Fiber Sensing: A Research Agenda

The constant monitoring and control of various health, infrastructure, and natural factors have led to the design and development of technological devices in a wide range of fields. This has resulted in the creation of different types of sensors that can be used to monitor and control different environments, such as fire, water, temperature, and movement, among others. These sensors detect anomalies in the input data to the system, allowing alerts to be generated for early risk detection. The advancement of artificial intelligence has led to improved sensor systems and networks, resulting in devices with better performance and more precise results by incorporating various features. The aim of this work is to conduct a bibliometric analysis using the PRISMA 2020 set to identify research trends in the development of machine learning applications in fiber optic sensors. This methodology facilitates the analysis of a dataset comprised of documents obtained from Scopus and Web of Science databases. It enables the evaluation of both the quantity and quality of publications in the study area based on specific criteria, such as trends, key concepts, and advances in concepts over time. The study found that deep learning techniques and fiber Bragg gratings have been extensively researched in infrastructure, with a focus on using fiber optic sensors for structural health monitoring in future research. One of the main limitations is the lack of research on the use of novel materials, such as graphite, for designing fiber optic sensors. One of the main limitations is the lack of research on the use of novel materials, such as graphite, for designing fiber optic sensors. This presents an opportunity for future studies.

Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review

BACKGROUND

Suicide safety planning is an evidence-based approach used to help individuals identify strategies to keep themselves safe during a mental health crisis. This study systematically reviewed the literature focused on mobile health (mHealth) suicide safety planning apps.

OBJECTIVE

This study aims to evaluate the extent to which apps integrated components of the safety planning intervention (SPI), and if so, how these safety planning components were integrated into the design-based features of the apps.

METHODS

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we systematically analyzed 14 peer-reviewed studies specific to mHealth apps for suicide safety planning. We conducted an analysis of the literature to evaluate how the apps incorporated SPI components and examined similarities and differences among the apps by conducting a comparative analysis of app features. An independent review of SPI components and app features was conducted by downloading the available apps.

RESULTS

Most of the mHealth apps (5/7, 71%) integrated SPI components and provided customizable features that expanded upon traditional paper-based safety planning processes. App design features were categorized into 5 themes, including interactive features, individualized user experiences, interface design, guidance and training, and privacy and sharing. All apps included access to community supports and revisable safety plans. Fewer mHealth apps (3/7, 43%) included interactive features, such as associating coping strategies with specific stressors. Most studies (10/14, 71%) examined the usability, feasibility, and acceptability of the safety planning mHealth apps. Usability findings were generally positive, as users often found these apps easy to use and visually appealing. In terms of feasibility, users preferred using mHealth apps during times of crisis, but the continuous use of the apps outside of crisis situations received less support. Few studies (4/14, 29%) examined the effectiveness of mHealth apps for suicide-related outcomes. Positive shifts in attitudes and desire to live, improved coping strategies, enhanced emotional stability, and a decrease in suicidal thoughts or self-harm behaviors were examined in these studies.

CONCLUSIONS

Our study highlights the need for researchers, clinicians, and app designers to continue to work together to align evidence-based research on mHealth suicide safety planning apps with lessons learned for how to best deliver these technologies to end users. Our review brings to light mHealth suicide safety planning strategies needing further development and testing, such as lethal means guidance, collaborative safety planning, and the opportunity to embed more interactive features that leverage the advanced capabilities of technology to improve client outcomes as well as foster sustained user engagement beyond a crisis. Although preliminary evidence shows that these apps may help to mitigate suicide risk, clinical trials with larger sample sizes and more robust research designs are needed to validate their efficacy before the widespread adoption and use.

Accuracy of Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP Versus Polysomnography: Systematic Review

Background

Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern.

Objective

A systematic review of the literature was conducted to appraise the performance of 3 recent-generation wearable devices (Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP) in determining sleep parameters and sleep stages.

Methods

Per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a comprehensive search was conducted using the PubMed, Web of Science, Google Scholar, Scopus, and Embase databases. Eligible publications were those that (1) involved the validity of sleep data of any marketed model of the candidate wearables and (2) used PSG or an ambulatory electroencephalogram monitor as a reference sleep monitoring device. Exclusion criteria were as follows: (1) incorporated a sleep diary or survey method as a reference, (2) review paper, (3) children as participants, and (4) duplicate publication of the same data and findings.

Results

The search yielded 504 candidate articles. After eliminating duplicates and applying the eligibility criteria, 8 articles were included. WHOOP showed the least disagreement relative to PSG and Sleep Profiler for total sleep time (-1.4 min), light sleep (-9.6 min), and deep sleep (-9.3 min) but showed the largest disagreement for rapid eye movement (REM) sleep (21.0 min). Fitbit Charge 4 and Garmin Vivosmart 4 both showed moderate accuracy in assessing sleep stages and total sleep time compared to PSG. Fitbit Charge 4 showed the least disagreement for REM sleep (4.0 min) relative to PSG. Additionally, Fitbit Charge 4 showed higher sensitivities to deep sleep (75%) and REM sleep (86.5%) compared to Garmin Vivosmart 4 and WHOOP.

Conclusions

The findings of this systematic literature review indicate that the devices with higher relative agreement and sensitivities to multistate sleep (ie, Fitbit Charge 4 and WHOOP) seem appropriate for deriving suitable estimates of sleep parameters. However, analyses regarding the multistate categorization of sleep indicate that all devices can benefit from further improvement in the assessment of specific sleep stages. Although providers are continuously developing new versions and variants of wearables, the scientific research on these wearables remains considerably limited. This scarcity in literature not only reduces our ability to draw definitive conclusions but also highlights the need for more targeted research in this domain. Additionally, future research endeavors should strive for standardized protocols including larger sample sizes to enhance the comparability and power of the results across studies.

Patients and Health Professionals' Perceptions of Primary Health Care Services in Saudi Arabia: A Scoping Review

Objective

This scoping review aims to identify and summarize existing evidence concerning the quality and capacity of PHC services in the Kingdom of Saudi Arabia (KSA) with a focus on the patients and healthcare professionals' perceptions of PHC.

Methods

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The digital library, PubMed, and the search engine Google Scholar were searched to broaden our results for primary research involving patient and/or health professionals' perspectives on Primary Healthcare in KSA.

Results

A total of 38 publications were selected for the scoping review. Several studies examined patients' overall satisfaction with PHC services (n=14) while others focused their investigation on specific services provided by PHC (n=3). Several studies assessed the perceptions of certain groups of patients (n=5). Several studies examined health professionals' perceptions of the use of electronic health records (n=3), the safety culture (n=2), communicable disease management (n=1), emergency services (n=1), laboratory services (n=1), cost-effectiveness (n=1), and leadership (n=1). This review also included studies that assessed the health professionals' job satisfaction and burnout (n=6).

Conclusion

Patients were satisfied with some aspects of PHC services while recognizing that improvements in some areas were needed. These included waiting time, physician-patient communication, access to the services in rural areas, patient involvement in disease management, and oral health. Health workers were positive about certain quality aspects and services provided by PHC such as EHRs, safety culture, communicable disease management, emergency services, and laboratory services. Health workers demonstrated a low level of job satisfaction due to several reasons, including, working conditions, financial incentives, and burnout.

A blueprint for patient and public involvement in the development of a reporting guideline for systematic reviews of outcome measurement instruments: PRISMA-COSMIN for OMIs 2024

BACKGROUND

In recent years, projects to develop reporting guidelines have attempted to integrate the perspectives of patients and public members. Best practices for patient and public involvement (PPI) in such projects have not yet been established. We recently developed an extension of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to be used for systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) for OMIs 2024. Patients and public members formed a small but impactful stakeholder group. We critically evaluated the PPI component in this project and developed recommendations for conducting PPI when developing reporting guidelines.

MAIN TEXT

A patient partner was an integral research team member at the project development and grant application stage. Once the project started, five patient and public contributors (PPCs) were recruited to participate in the Delphi study; three PPCs contributed to subsequent steps. We collected quantitative feedback through surveys; qualitative feedback was garnered through a focus group discussion after the Delphi study and through debrief meetings after subsequent project activities. Feedback was thematically combined with reflections from the research team, and was predominantly positive. The following themes emerged: importance of PPI partnership, number of PPCs involved, onboarding, design of Delphi surveys, flexibility in the process, complexity of PPI in methodological research, and power imbalances. Impacts of PPI on the content and presentation of the reporting guideline were evident, and reciprocal learning between PPCs and the research team occurred throughout the project. Lessons learned were translated into 17 recommendations for future projects.

CONCLUSION

Integrating PPI in the development of PRISMA-COSMIN for OMIs 2024 was feasible and considered valuable by PPCs and the research team. Our approach can be applied by others wishing to integrate PPI in developing reporting guidelines.

Innovation in the realm of the unforeseen: a review of competence needed

Introduction

Our main research question in this article was: What are the competence structures for innovative processes? Both the nature of the unforeseen and innovation are related to something unknown, i.e., that competence needs to be developed to be able to handle situations and solutions that are not yet completely known. In our article, we address the question of how studies of innovation describe and use concepts of competence in various forms.

Method

We performed a systematic review of the relation between the unforeseen and innovation. In this systematic review we followed the Non-Interventional, Reproducible, and Open (NIRO) Systematic Reviews protocol. The identification of studies via databases and registers was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) statement. The various types of competence found in the literature review were grouped in such a way that we could develop a structure to use as the basis for a new concept of competence needed in order to initiate and implement innovative processes. We refer to this overview of different competence types as designated competence structures for innovative processes. The searches resulted in the following number of abstracts, respectively Web of Science (2997), ERIC (454), and PsycInfo (550), meaning that a total of 3,768 abstracts were found to be relevant. The 3,768 abstracts were imported into the program Covidence for screening in the first search.

Results

After completing the evaluation process in accordance with the PRISMA checklist and flow diagram, 32 abstracts were found to be relevant for our research question as they were related to competence for the unforeseen and innovation.

Conclusion

Few of the studies we investigated specifically mention competence. Another finding is that the innovation literature describes the activities that should take place linked to what it refers to as competence. Thus, the innovation research field does not define what the competence is or what it consists of, at either individual or group level, but rather describes the activities that contribute to successful innovation in an organization with little emphasis on how this competence should be developed. Training perspectives are lacking when it comes to innovation literature perspectives on competence.

Quality and Accessibility of Home Assessment mHealth Apps for Community Living: Systematic Review

BACKGROUND

Home assessment is a critical component of successful home modifications, enabling individuals with functional limitations to age in place comfortably. A high-quality home assessment tool should facilitate a valid and reliable assessment involving health care and housing professionals, while also engaging and empowering consumers and their caregivers who may be dealing with multiple functional limitations. Unlike traditional paper-and-pencil assessments, which require extensive training and expert knowledge and can be alienating to consumers, mobile health (mHealth) apps have the potential to engage all parties involved, empowering and activating consumers to take action. However, little is known about which apps contain all the necessary functionality, quality appraisal, and accessibility.

OBJECTIVE

This study aimed to assess the functionality, overall quality, and accessibility of mHealth home assessment apps.

METHODS

mHealth apps enabling home assessment for aging in place were identified through a comprehensive search of scholarly articles, the Apple (iOS) and Google Play (Android) stores in the United States, and fnd.io. The search was conducted between November 2022 and January 2023 following a method adapted from PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Reviewers performed a content analysis of the mobile app features to evaluate their functionality, overall quality, and accessibility. The functionality assessment used a home assessment component matrix specifically developed for this study. For overall quality, the Mobile Application Rating Scale (MARS) was used to determine the apps' effectiveness in engaging and activating consumers and their caregivers. Accessibility was assessed using the Web Content Accessibility Guidelines (WCAG) 2.1 (A and AA levels). These 3 assessments were synthesized and visualized to provide a comprehensive evaluation.

RESULTS

A total of 698 apps were initially identified. After further screening, only 6 apps remained. Our review revealed that none of the apps used thoroughly tested assessment tools, offered all the functionality required for reliable home assessment, achieved the "good" quality threshold as measured by the MARS, or met the accessibility criteria when evaluated against WCAG 2.1. However, DIYModify received the highest scores in both the overall quality and accessibility assessments. The MapIt apps also showed significant potential due to their ability to measure the 3D environment and the inclusion of a desktop version that extends the app's functionality.

CONCLUSIONS

Our review revealed that there are very few apps available within the United States that possess the necessary functionality, engaging qualities, and accessibility to effectively activate consumers and their caregivers for successful home modification. Future app development should prioritize the integration of reliable and thoroughly tested assessment tools as the foundation of the development process. Furthermore, efforts should be made to enhance the overall quality and accessibility of these apps to better engage and empower consumers to take necessary actions to age in place.

Police and hospital data linkage for traffic injury surveillance: A systematic review

This systematic review examines studies of traffic injury that involved linkage of police crash data and hospital data and were published from 1994 to 2023 worldwide in English. Inclusion and exclusion criteria were the basis for selecting papers from PubMed, Web of Science, and Scopus, and for identifying additional relevant papers using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and supplementary snowballing (n = 60). The selected papers were reviewed in terms of research objectives, data items and sample size included, temporal and spatial coverage, linkage methods and software tools, as well as linkage rates and most significant findings. Many studies found that the number of clinically significant road injury cases was much higher according to hospital data than crash data. Under-estimation of cases in crash data differs by road user type, pedestrian cases commonly being highly under-counted. A limited number of the papers were from low- and middle-income countries. The papers reviewed lack consistency in what was reported and how, which limited comparability.

Highly Superior Autobiographical Memory (HSAM): A Systematic Review

Individuals possessing a Highly Superior Autobiographical Memory (HSAM) demonstrate an exceptional ability to recall their own past, excelling most when dates from their lifetime are used as retrieval cues. Fully understanding how neurocognitive mechanisms support exceptional memory could lead to benefits in areas of healthcare in which memory plays a central role and in legal fields reliant on witnesses' memories. Predominantly due to the rareness of the phenomenon, existing HSAM literature is highly heterogenous in its methodologies used. Therefore, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed the first systematic review on this topic, to collate the existing behavioural, neuroanatomical, and functional HSAM data. Results from the 20 experimental selected studies revealed that HSAM is categorised by rapidly retrieved, detailed and accurate autobiographical memories, and appears to avoid the normal aging process. Functional neuroimaging studies showed HSAM retrieval seems characterised by an intense overactivation of the usual autobiographical memory network, including posterior visual areas (e.g., the precuneus). Structural neuroanatomical differences do not appear to characterise HSAM, but altered hippocampal resting-state connectivity was commonly observed. We discuss theories of HSAM in relation to autobiographical encoding, consolidation, and retrieval, and suggest future directions for this research.

Impacts of hydropeaking: A systematic review

Hydropower is commonly considered a renewable energy source. Nevertheless, this does not imply an absence of impacts on the riverine ecosystem, the extent of which is expected to increase in the coming years due to the energy transition from fossil fuels to renewable sources and for the climate change. A common consequence of hydroelectric power generation is hydropeaking, which causes rapid and frequent fluctuations in the water flow downstream of hydropower plants. The review incorporates 155 relevant studies published up until November 2023 and follows a systematic review method, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), which is a multi-stage systematic procedure for the identification and selection of research documents. The selected studies highlighted several prominent impacts of hydropeaking on aquatic environments. The primary effects include alterations in flow patterns, modification of water temperature, changes in sediment dynamics and fluctuations in dissolved gas levels. These alterations have been found to affect various aspects of aquatic ecosystems, including fish growth, behavior, reproductive success, habitat, and migration patterns, and benthic macroinvertebrate communities. Furthermore, hydropeaking can also lead to habitat fragmentation, erosion, and loss of riparian vegetation, thereby impacting terrestrial ecosystems that depend on the aquatic environment. Despite the body of literature reviewed, several knowledge gaps were identified, underscoring the need for further research. There is limited understanding of the long-term ecological consequences of hydropeaking and its cumulative effects on aquatic ecosystems. Additionally, there is lack of consensus regarding the quantification of ecosystem services, economic impact, soil moisture content, and weighted usable area due to flow fluctuation and global evolution of energy production from renewable energy sources. Addressing the identified research gaps is crucial for achieving a balance between energy production and the conservation of freshwater ecosystems in the context of a rapidly changing global climate.

Risks of Drone Use in Light of Literature Studies

This article aims to present the results of a bibliometric analysis of relevant literature and discuss the main research streams related to the topic of risks in drone applications. The methodology of the conducted research consisted of five procedural steps, including the planning of the research, conducting a systematic review of the literature, proposing a classification framework corresponding to contemporary research trends related to the risk of drone applications, and compiling the characteristics of the publications assigned to each of the highlighted thematic groups. This systematic literature review used the PRISMA method. A total of 257 documents comprising articles and conference proceedings were analysed. On this basis, eight thematic categories related to the use of drones and the risks associated with their operation were distinguished. Due to the high content within two of these categories, a further division into subcategories was proposed to illustrate the research topics better. The conducted investigation made it possible to identify the current research trends related to the risk of drone use and pointed out the existing research gaps, both in the area of risk assessment methodology and in its application areas. The results obtained from the analysis can provide interesting material for both industry and academia.

Dengue Fever Epidemics and the Prospect of Vaccines: A Systematic Review and Meta-Analysis Using Clinical Trials in Children

About half of the world's population is at risk of dengue infection. Epidemics of dengue fever have caused an increased risk of morbidity and mortality in recent years, which led to the exploration of vaccines as a preventive measure. This systematic review and meta-analysis aimed to evaluate the efficacy, immune response, and safety of dengue vaccines in children by analyzing clinical trials. The review followed standard procedures for data extraction using PRISMA guidelines and searching multiple databases, including PubMed, CINAHL, Medline, Health Source, Science Direct, and Academic Search Premiere. Eligible studies involved children (0-17 years old). Quality assessment was analyzed using the Cochrane Collaboration criteria, while data synthesis was conducted using thematic analysis and meta-analysis. Among the 38 selected studies, dengue vaccines showed varying efficacy against all four serotypes. The CYD-TDV (Dengvaxia®) and Tekade (TAK-003) vaccines showed strong protection against severe dengue, but their long-term efficacy varied. Vaccines triggered satisfactory immune responses, notably in those previously exposed to dengue. Safety profiles were mostly favorable, noting mild adverse events post-vaccination. Meta-analysis supported vaccine efficacy and immune response, but safety concerns warrant further exploration. In conclusion, dengue vaccines showed promising efficacy and immune response, particularly against severe manifestations.

Bibliometric analysis of safety management system research (2001-2021)

INTRODUCTION

Occupational health and safety (OHS) has become an integral part of human society, particularly considering the growing rates of injuries and deaths worldwide. Hence, numerous employers, governments, and stakeholders worldwide have established critical OHS measures to safeguard human health and occupational safety. Numerous studies have been conducted to identify and highlight risks and hazards, as well as to detect, monitor, minimize, and prevent workplace injuries and deaths.

METHOD

This study presents the publication trends, research landscape, and scientific developments related to safety management systems (SMS) based on published documents from the Elsevier Scopus database. Published documents on SMS and indexed in Scopus are identified, screened, and analyzed to examine the publication trends, research developments, and scientific landscape. For this purpose, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), bibliometric analysis (B.A.), and systematic literature review (SLR) procedures are used. The results reveal that 799 related documents were published between 2001 and 2021.

RESULTS

The most productive stakeholders, that is, top researchers, affiliations, and countries, include Liesbeth Jacxsens, Universiteit Gent (Belgium), and the United States. This study shows that the availability of research grants, incentives, or awards is critical to the productivity of top researchers, institutions, and nations actively researching SMS topics. The bibliometric analysis reveals that the topic is characterized by high productivity, co-authorships, keyword occurrence, and citations.

CONCLUSION

The analysis shows that SMS research is a broad, multidimensional, and impactful area that has become essential for identifying, reducing, monitoring, and eliminating risks in many industries. It is concluded that the topic of the SMS remains relevant because of its impact on human health, occupational safety, and environmental well-being.

PRACTICAL APPLICATIONS

This study provides in-depth insight into expanding the scope of SMS research. Moreover, research and policymakers can facilitate decision-making and collaboration based on this study's outtakes.

Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review

The rapid growth in digital technology usage among children and adolescents has highlighted the need for novel approaches to promote their physical and mental health. This paper investigates the viability of gamification-the application of game mechanics to non-gaming contexts-as a potent instrument for health promotion and mental health support. This conceptual systematic review seeks to examine the various published articles promoting children and adolescents' physical and mental health through gamified techniques. These interventions can provide an interactive and engaging platform for encouraging physical activity, promoting healthy nutrition, enhancing emotional regulation, and promoting mental health. The significance of this topic stems from the pervasive use of electronic games, beginning at a young age, which makes them popular educational tools. For the review to be systematic and reproducible, the PsycINFO, Scopus, PubMed, and Elsevier databases were searched and the PRISMA method was utilized for the analysis. After analyzing the research data, empirical studies assessing the use of gamification in promoting adolescents' physical and mental health are discussed. In conclusion, gamification has demonstrated promise for promoting children's and adolescents' physical and mental health. It improves motivation, commitment, and adherence to healthy behaviors. However, additional research is required to evaluate gamification interventions' long-term effectiveness and sustainability in promoting health behaviors among this population.

Understanding the Integrated Health Management System Policy in China From Multiple Perspectives: Systematic Review and Content Analysis

BACKGROUND

The integrated health management system (IHMS), which unites all health care-related institutions under a health-centered organizational framework, is of great significance to China in promoting the hierarchical treatment system and improving the new health care reform. China's IHMS policy consists of multiple policies at different levels and at different times; however, there is a lack of comprehensive interpretation and analysis of these policies, which is not conducive to the further development of the IHMS in China.

OBJECTIVE

This study aims to comprehensively analyze and understand the characteristics, development, and evolution of China's IHMS policy to inform the design and improvement of the system.

METHODS

We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to collect 152 policy documents. With the perspective of policy tools and policy orientation as the core, a comprehensive 6D framework including policy level, policy nature, release time, policy tools, stakeholders, and policy orientation was established by combining the content of policy texts. These dimensions were then analyzed using content analysis.

RESULTS

First, we found that, regarding the coordination of policy tools and stakeholders, China's IHMS policy was more inclined to use environment-based policy tools (1089/1929, 56.45%), which suggests a need for further balance in the internal structure of policy tools. Attention to different actors varied, and the participation of physicians and residents needs further improvement (65/2019, 3.22% and 11/2019, 0.54%, respectively). Second, in terms of level differences, Shanghai's IHMS policy used fewer demand-based policy tools (43/483, 8.9%), whereas the national IHMS policy and those of other provinces and cities used fewer supply-based tools (61/357, 17.1% and 248/357, 69.5%, respectively). The national IHMS strategy placed more emphasis on the construction of smart health care (including digital health; 10/275, 3.6%), whereas Shanghai was a leader in the development of healthy community and healthy China (9/158, 5.7% and 4/158, 2.5%, respectively). Third, in terms of time evolution, the various policy tools showed an increasing and then decreasing trend from 2014 to 2021, with relatively more use of environment-based policy tools and less use of demand-based policy tools in the last 3 years. The growth of China's IHMS policy can be divided into 3 stages: the disease-centered period (2014-2017), the e-health technology development period (2017-2019), and the health-centered period (2018-2021).

CONCLUSIONS

Policy makers should make several adjustments, such as coordinating policy tools and the uneven relationships among stakeholders; grasping key policy priorities in the context of local characteristics; and focusing on horizontal, multidimensional integration of health resources starting from the community. This study expands the objects of policy research and improves the framework for policy analysis. The findings provide some possible lessons for future policy formulation and optimization.

Modeling of Machine Learning-Based Extreme Value Theory in Stock Investment Risk Prediction: A Systematic Literature Review

The stock market is heavily influenced by global sentiment, which is full of uncertainty and is characterized by extreme values and linear and nonlinear variables. High-frequency data generally refer to data that are collected at a very fast rate based on days, hours, minutes, and even seconds. Stock prices fluctuate rapidly and even at extremes along with changes in the variables that affect stock fluctuations. Research on investment risk estimation in the stock market that can identify extreme values is nonlinear, reliable in multivariate cases, and uses high-frequency data that are very important. The extreme value theory (EVT) approach can detect extreme values. This method is reliable in univariate cases and very complicated in multivariate cases. The purpose of this research was to collect, characterize, and analyze the investment risk estimation literature to identify research gaps. The literature used was selected by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and sourced from Sciencedirect.com and Scopus databases. A total of 1107 articles were produced from the search at the identification stage, reduced to 236 in the eligibility stage, and 90 articles in the included studies set. The bibliometric networks were visualized using the VOSviewer software, and the main keyword used as the search criteria is "VaR." The visualization showed that EVT, the Generalized Autoregressive Conditional Heteroskedasticity (GARCH) models, and historical simulation are models often used to estimate the investment risk; the application of the machine learning (ML)-based investment risk estimation model is low. There has been no research using a combination of EVT and ML to estimate the investment risk. The results showed that the hybrid model produced better Value-at-Risk (VaR) accuracy under uncertainty and nonlinear conditions. Generally, models only use daily return data as model input. Based on research gaps, a hybrid model framework for estimating risk measures is proposed using a combination of EVT and ML, using multivariable and high-frequency data to identify extreme values in the distribution of data. The goal is to produce an accurate and flexible estimated risk value against extreme changes and shocks in the stock market. Mathematics Subject Classification: 60G25; 62M20; 6245; 62P05; 91G70.

I-REFF diagrams: enhancing transparency in systematic review through interactive reference flow diagrams

Systematic review methods are recognized for their rigor and transparency and are widely adapted to frameworks that cover review types such as systematic reviews, scoping reviews, and systematic evidence maps. Reporting guidelines help promote better systematic review practices and detailed documentation of the review process for different types of health research (e.g., PRISMA-Preferred Reporting Items for Systematic Reviews and Meta-Analyses; CONSORT-Consolidated Standards of Reporting Trials; and STROBE-Strengthening the Reporting of Observational Studies in Epidemiology). Transparency in the systematic review process and reporting of results is one of the key advantages of the methods and particularly important for hazard and risk assessments due to the high level of scrutiny these reviews face from scientific, political, and public communities. Data visualizations are important to clearly convey information from a review by helping readers perceive, understand, and assess the displayed information easily and quickly. The study flow diagram is a required element of a systematic review and maps out the number of included and excluded records identified, and the reasons for exclusion. Static literature flow diagrams help viewers readily understand the general review methodology and summarize the number of records included or excluded at each stage of the review. However, such diagrams can be time-consuming to develop and maintain during a systematic review or scoping review, and they provide limited summary-level information. We explored how the use of online systematic review tools such as DistillerSR coupled with visualization software such as Tableau can efficiently generate an Interactive REFerence Flow (I-REFF) diagram that is linked to the literature screening data, thus requiring minimal preparation, and resulting in a simplified process for updating the diagram. Furthermore, I-REFF diagrams enhance transparency and traceability by not only summarizing the records in the review but also allowing viewers to follow specific records throughout the review process. We present an example I-REFF diagram and discuss recommendations for key interactive elements to include in these diagrams and how this workflow can improve efficiency and result in an accessible and transparent interactive literature flow diagram without advanced programming.

A systematic review of the design considerations for the operation and maintenance of small-scale biogas digesters

This review investigates small-scale biogas digesters' design and construction considerations to address biogas digesters' failures shortly after installation. The frequent failures of small-scale or household biogas digesters negatively affect its adoption as a clean domestic cooking fuel in developing countries, affecting the achievement of Sustainable Development Goal (SDG) 7. The study considered Scopus database-indexed peer-reviewed journals published between 2000 and 2022. Selected papers focussed on real-time monitoring, stirring mechanisms, and temperature control systems based on predefined inclusion and exclusion criteria with initial search results of 4751 documents, narrowing to 55 papers. The PRISMA 2020 statement was adopted to conduct the study. The study highlights the importance of incorporating a real-time monitoring system as a design factor in small-scale biogas digesters for successful operation and maintenance. The study's findings may be helpful to practitioners, policymakers, and researchers promoting sustainable energy and waste management solutions in low-resource settings.

Flavonoids as dual-target inhibitors against α-glucosidase and α-amylase: a systematic review of in vitro studies

Diabetes mellitus remains a major global health issue, and great attention is directed at natural therapeutics. This systematic review aimed to assess the potential of flavonoids as antidiabetic agents by investigating their inhibitory effects on α-glucosidase and α-amylase, two key enzymes involved in starch digestion. Six scientific databases (PubMed, Virtual Health Library, EMBASE, SCOPUS, Web of Science, and WHO Global Index Medicus) were searched until August 21, 2022, for in vitro studies reporting IC50 values of purified flavonoids on α-amylase and α-glucosidase, along with corresponding data for acarbose as a positive control. A total of 339 eligible articles were analyzed, resulting in the retrieval of 1643 flavonoid structures. These structures were rigorously standardized and curated, yielding 974 unique compounds, among which 177 flavonoids exhibited inhibition of both α-glucosidase and α-amylase are presented. Quality assessment utilizing a modified CONSORT checklist and structure-activity relationship (SAR) analysis were performed, revealing crucial features for the simultaneous inhibition of flavonoids against both enzymes. Moreover, the review also addressed several limitations in the current research landscape and proposed potential solutions. The curated datasets are available online at https://github.com/MedChemUMP/FDIGA .

Clinical Efficacy of Mobile App-Based, Self-Directed Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis

Background

Pulmonary rehabilitation is well known to improve clinical symptoms (including dyspnea), quality of life, and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, researchers have reported difficulties in practicing center-based pulmonary rehabilitation. Recently, mobile app-based pulmonary rehabilitation has become available in clinical practice. We investigated the clinical outcomes of mobile app-based pulmonary rehabilitation in patients with COPD.

Objective

The objective of our study was to evaluate the clinical efficacy of mobile app-based pulmonary rehabilitation versus conventional center-based pulmonary rehabilitation for patients with COPD, using a systematic review and meta-analysis.

Methods

A systematic search of the literature published between January 2007 and June 2023 was performed, using the PubMed, Embase, Cochrane, and CINAHL databases to identify relevant randomized controlled trials involving patients with COPD. Pulmonary rehabilitation programs needed to provide an exercise program on a smartphone app. Study outcomes, including exercise capacity, symptom scores, quality of life, and hospitalization, were evaluated. The meta-analysis evaluated mean differences in 6-minute walk test distances (6MWDs), COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, St. George Respiratory Questionnaire (SGRQ) scores, and risk ratios for hospitalization resulting from disease exacerbation.

Results

Of the 1173 screened studies, 10 were included in the systematic review and 9 were included in the meta-analysis. Further, 6 studies were multicenter studies. There were a total of 1050 participants, and most were aged ≥65 years. There were discrepancies in the baseline participant characteristics, smartphone apps, interventions, and study outcomes among the included studies. In the meta-analysis, 5 studies assessed 6MWDs (mean difference 9.52, 95% CI -3.05 to 22.08 m), 6 studies assessed CAT scores (mean difference -1.29, 95% CI -2.39 to -0.20), 3 studies assessed mMRC dyspnea scale scores (mean difference -0.08, 95% CI -0.29 to 0.13), 2 studies assessed SGRQ scores (mean difference -3.62, 95% CI -9.62 to 2.38), and 3 studies assessed hospitalization resulting from disease exacerbation (risk ratio 0.65, 95% CI 0.27-1.53). These clinical parameters generally favored mobile app-based pulmonary rehabilitation; however, a statistically significant difference was noted only for the CAT scores (P=.02).

Conclusions

Despite some discrepancies in the baseline participant characteristics and interventions among studies, mobile app-based pulmonary rehabilitation resulted in favorable exercise capacity, symptom score, quality of life, and hospitalization outcomes when compared with conventional pulmonary rehabilitation. In the meta-analysis, the CAT scores of the mobile app-based pulmonary rehabilitation group were significantly lower than those of the control group (P=.02). In real-world practice, mobile app-based pulmonary rehabilitation can be a useful treatment option when conventional center-based pulmonary rehabilitation is not feasible.

Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

We described the diagnostic performance of [18F]F-FDG-PET in malignant melanoma by conducting a comprehensive systematic review and meta-analysis of the existing literature. The study was designed following PRISMA-DTA. Original articles with adequate crude data for meta-analytic calculations that evaluated [18F]F-FDG-PET and compared it with a valid reference standard were considered eligible. The pooled measurements were calculated based on the data level (patient/lesion-based). Regarding sub-groups, diagnostic performances were calculated for local, regional and distant involvement. The bivariate model was employed to calculate sensitivity and specificity. The initial search resulted in 6678 studies. Finally, 100 entered the meta-analysis, containing 82 patient-based (10,403 patients) and 32 lesion-based (6188 lesions) datasets. At patient level, overall, [18F]F-FDG-PET had pooled sensitivity and specificity of 81% (95%CI: 73-87%) and 92% (95%CI: 90-94%), respectively. To detect regional lymph node metastasis, the pooled sensitivity and specificity were 56% (95%CI: 40-72%) and 97% (95%CI: 94-99%), respectively. To detect distant metastasis, they were 88% (95%CI: 81-93%) and 94% (95%CI: 91-96%), respectively. At lesion level, [18F]F-FDG-PET had a pooled sensitivity and specificity of 70% (95%CI: 57-80%) and 94% (95%CI: 88-97%), respectively. Thus, [18F]F-FDG-PET is a valuable diagnostic modality for melanoma assessment. It was accurate in various clinical scenarios. However, despite its high specificity, it showed low sensitivity in detecting regional lymph node metastasis and could not replace lymph node biopsy.

Agent Transparency, Situation Awareness, Mental Workload, and Operator Performance: A Systematic Literature Review

OBJECTIVE

In this review, we investigate the relationship between agent transparency, Situation Awareness, mental workload, and operator performance for safety critical domains.

BACKGROUND

The advancement of highly sophisticated automation across safety critical domains poses a challenge for effective human oversight. Automation transparency is a design principle that could support humans by making the automation's inner workings observable (i.e., "seeing-into"). However, experimental support for this has not been systematically documented to date.

METHOD

Based on the PRISMA method, a broad and systematic search of the literature was performed focusing on identifying empirical research investigating the effect of transparency on central Human Factors variables.

RESULTS

Our final sample consisted of 17 experimental studies that investigated transparency in a controlled setting. The studies typically employed three human-automation interaction types: responding to agent-generated proposals, supervisory control of agents, and monitoring only. There is an overall trend in the data pointing towards a beneficial effect of transparency. However, the data reveals variations in Situation Awareness, mental workload, and operator performance for specific tasks, agent-types, and level of integration of transparency information in primary task displays.

CONCLUSION

Our data suggests a promising effect of automation transparency on Situation Awareness and operator performance, without the cost of added mental workload, for instances where humans respond to agent-generated proposals and where humans have a supervisory role.

APPLICATION

Strategies to improve human performance when interacting with intelligent agents should focus on allowing humans to see into its information processing stages, considering the integration of information in existing Human Machine Interface solutions.

Systematic evidence review and meta-analysis of outcomes associated with cancer genetic counseling

PURPOSE

Genetic counseling (GC) is standard of care in genetic cancer risk assessment (GCRA). A rigorous assessment of the data reported from published studies is crucial to ensure the evidence-based implementation of GC.

METHODS

We conducted a systematic review and meta-analysis of 17 patient-reported and health-services-related outcomes associated with pre- and post-test GC in GCRA in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.

RESULTS

Twenty-five of 5393 screened articles met inclusion criteria. No articles reporting post-test GC outcomes met inclusion criteria. For patient-reported outcomes, pre-test GC significantly decreased worry, increased knowledge, and decreased perceived risk but did not significantly affect patient anxiety, depression, decisional conflict, satisfaction, or intent to pursue genetic testing. For health-services outcomes, pre-test GC increased correct genetic test ordering, reduced inappropriate services, increased spousal support for genetic testing, and expedited care delivery but did not consistently improve cancer prevention behaviors nor lead to accurate risk assessment. The GRADE certainty in the evidence was very low or low. No included studies elucidated GC effect on mortality, cascade testing, cost-effectiveness, care coordination, shared decision making, or patient time burden.

CONCLUSION

The true impact of GC on relevant outcomes is not known low quality or absent evidence. Although a meta-analysis found that pre-test GC had beneficial effects on knowledge, worry, and risk perception, the certainty of this evidence was low according to GRADE methodology. Further studies are needed to support the evidence-based application of GC in GCRA.

Quality of systematic reviews with meta-analyses of resveratrol: A methodological systematic review

Recently, several meta-analyses (MAs) have focused on the health effects of resveratrol. However, the methodological and reporting quality of these MAs has not yet been fully evaluated so far. Therefore, the present study evaluated the quality of these MAs through a methodological systematic review. Systematic searches were conducted in PubMed, Embase, Web of Science, and Cochrane Library from inception until May 20, 2022, and PubMed was used to update the search until September 6, 2023. The methodological and reporting quality of the selected MAs was evaluated using AMSTAR-2 and PRISMA 2009. Fifty-one MAs published during 2013-2023 were included. In each review, the number of primary studies ranged from 3 to 37, and the number of participants ranged from 50 to 2114. Among the first-listed primary outcomes, only 23 (45.10%) were "positive." As for the methodological quality, most MAs (44, 86.27%) on resveratrol were rated critically low. Inadequate reporting of the included MAs mainly involved items 2 ("Structured summary"), 5 ("Protocol and registration"), 8 ("Search"), 9 ("Study selection"), 10 ("Data collection process"), 12 ("Risk of bias in individual studies"), and 24 ("Summary of evidence") based on the PRISMA 2009. Additionally, journal's impact factor, number of authors, and funding support were positively associated with the overall methodological quality but were not statistically significant (p > 0.05). Future MAs on resveratrol require better design, implementation, and reporting by following the Cochrane Handbook, AMSTAR-2, and PRISMA.

Racial and Ethnic Disparities in the Physical Health Outcomes of Children in Foster Care: A Systematic Review

Children of color-especially Black and Indigenous children-are disproportionately overrepresented in foster care and experience barriers in accessing services and receiving physical and behavioral healthcare compared to their White counterparts. Although racial disparities in mental health outcomes of children in foster care have been examined systematically, less is known about racial disparities in their physical health outcomes. This systematic review aimed to examine disparities in physical health outcomes (i.e., general health, developmental delays and disability, chronic illness, health-compromising behaviors, all-cause mortality) of children in foster care by their race and ethnicity (PROSPERO ID: CRD42021272072). Systematic literature searches were conducted in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, and Psychology and Behavioral Sciences Collection. Of the 6,102 unique studies identified, 24 met inclusion criteria: peer-reviewed journal article; published from 1991 to 2021; written in English; involved children in the U.S. foster care system; children were primarily in family-based placements; included health outcomes; included children's race and ethnicity; conducted quantitative analyses; and had an observational study design. There was limited evidence to suggest racial disparities among physical health domains examined, in part, due to the small number of studies, variability across study measures and designs, how race and ethnicity were categorized, and how related results were reported. Research that disaggregates results by more nuanced race and ethnicity categories, goes beyond including race and ethnicity as control variables, and uses more robust study designs to understand where racial disparities lie is necessary to inform practice and policy efforts to attain race and health equity in child welfare.

Measures of cognitive reserve: An umbrella review

Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.

The concentrations of polycyclic aromatic hydrocarbons in fish: A systematic review

This study was conducted on the concentrations of PAHs, including benzo[a]pyrene and the sum of four PAHs (benz[a]anthracene, chryseno, benzo[b]fluoranthene, and benzo[a]pyrene), in unsmoked fish tissues. The values were related to the time period, locality (country and region), living habits, eating habits, and types of environments of the fish species. The data obtained has been also compared with the limits established by the United States Environmental Protection Agency (U.S. EPA) and European Union (E.U.) legislation. The data were collected through a PRISMA systematic review (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) from 1982 to 2020. Only documents that presented the PAHs concentration values were selected. China, Nigeria, and Iran had the highest number of studies. The species Coptodon zillii, Siganus punctatus, and Liza abu were the most commonly used bioindicators. Fish inhabiting demersal and pelagic environments showed the highest concentrations of PAHs. The majority of PAH concentrations of the analyzed documents fell within permissible limits for human consumption, representing a total percentage of 79.49 % for benzo[a]pyrene and 82.86 % for the sum of the 4 PAHs. Although some studies identified concentrations of benzo[a]pyrene alone and benzo[a]pyrene, benz[a]anthracene, chryseno, benzo[b]fluoranthene above the legislation limits, in most of them, the concentrations reported in fish tissue were below the limits defined by European Legislation for human consumption.

Is green FinTech reshaping the finance sphere? Unravelling through a systematic literature review

The revolutionary and transformative potential of FinTech has led to the Green Digital Finance Alliance, noting the dawn of a new era of FinTech-"the green FinTech", yet, surprisingly, the scholarly exploration surrounding climate finance in general and green FinTech and climate FinTech remains restrained. In our attempt to decode the intricate interlinkage between green finance and FinTech, the study wrestles with the theoretical complexity of the "green FinTech" concept through a systematic review of relevant studies and conceptual mapping. We develop a comprehensive grasp of the concept, how to leverage it to combat the pressing climate crisis, and its implications for the FinTech segment-the first of its kind in the scanty green FinTech literature. Based on the PRISMA analysis, we find that green FinTech promotes a green economy through its manifold impact on all aspects of the finance sphere, thereby channelling climate finance and promoting sustainability. It has the power to heighten inclusivity, disclosure, trust, and democratisation, thus reducing information asymmetry and greenwashing. Hence, FinTech integration can be game-changing in eliminating the hurdles before conventional green finance. However, the literature remains fragmented, along with a young, growing green FinTech market. Therefore, this study proposes a framework for future researchers by providing a holistic research agenda to fully integrate "green FinTech" into practical real-world applications.

Effect of Hydroxychloroquine and Azithromycin Combination Use in COVID-19 Patients - An Umbrella Review

Background

Hydroxychloroquine and Azithromycin combination was used rampantly in management of COVID-19 patients in different countries. Present review was conducted to evaluate the efficacy of Hydroxychloroquine and Azithromycin combination compared to the control (standard care) and any adverse effect following this combination use in COVID-19 patients if any.

Material and Methods

We included all the systematic review with or without meta-analysis reporting the effect of Hydroxychloroquine (HCQ) and Azithromycin (AZM) combination use in COVID-19 patient using three databases namely PubMed, medline, CINHAL, Web of Science from July 2020 till Jan 2022.

Results

The systematic search strategy has identified 104 studies in total, after removal of duplicates only 4 systematic reviews were included in the qualitative synthesis. The various tools for assessing and reporting the data in the reviews were PRISMA, ROBINS-I, Robs2, AMSTAR, MASTER checklists. Mortality among the hydroxychloroquine with azithromycin combination group was significantly higher than among the Standard Care group. The duration of hospital stay in days was shorter in the Standard Care group in comparison with the hydroxychloroquine group or the hydroxychloroquine and azithromycin combination group. Of the 4 systematic reviews included, 3 had low risk of bias and one had unclear risk of bias using the ROBIS tool. Chloroquine or Hydroxychloroquine combination did not shorten the duration of hospital stay.

Conclusion

Rampant use of Chloroquine or Hydroxychloroquine alone or with Azithromycin combination caused adverse effects like QT prolongation. Finally, there is no evidence to support use of either Hydroxychloroquine with or without Azithromycin, for the treatment of COVID-19.

Systematic review of hematophagous arthropods present in cattle in France

The arrival of pathogens, whether zoonotic or not, can have a lasting effect on commercial livestock farms, with dramatic health, social and economic consequences. However, available data concerning the arthropod vectors present and circulating on livestock farms in France are still very imprecise, fragmentary, and scattered. In this context, we conducted a systematic review of the hematophagous arthropod species recorded on different types of cattle farms in mainland France (including Corsica). The used vector "groups" studied were biting flies, biting midges, black flies, fleas, horse flies, lice, louse flies, mosquitoes, sand flies, and ticks. A large number of documents were selected (N = 9,225), read (N = 1,047) and analyzed (N = 290), allowing us to provide distribution and abundance maps of different species of medical and veterinary interest according to literature data. Despite the large number of documents collected and analyzed, there are few data provided on cattle farm characteristics. Moreover, data on all arthropod groups lack numerical detail and are based on limited data in time and/or space. Therefore, they are not generalizable nor comparable. There is still little information on many vectors (and their pathogens) and still many unknowns for most studied groups. It appears necessary to provide new, updated and standardized data, collected in different geographical and climatological areas. Finally, this work highlights the lack of entomologists, funding, training and government support, leading to an increased risk of uncontrolled disease emergence in cattle herds.

Digital Health Interventions to Enhance Tuberculosis Treatment Adherence: Scoping Review

Background

Digital health technologies are widely used for disease management, with their computing platforms, software, and sensors being used for health care. These technologies are developed to manage chronic diseases and infectious bacterial diseases, including tuberculosis (TB).

Objective

This study aims to comprehensively review the literature on the use of digital health interventions (DHIs) for enhancing TB treatment adherence and identify major strategies for their adoption.

Methods

We conducted a literature search in the PubMed, Cochrane Library, Ovid Embase, and Scopus databases for relevant studies published between January 2012 and March 2022. Studies that focused on web-based or mobile phone-based interventions, medication adherence, digital health, randomized controlled trials, digital interventions, or mobile health and ubiquitous health technology for TB treatment and related health outcomes were included.

Results

We identified 27 relevant studies and classified them according to the intervention method, a significant difference in treatment success, and health outcomes. The following interventions were emphasized: SMS text messaging interventions (8/27, 30%), medicine reminders (6/27, 22%), and web-based direct observation therapy (9/27, 33%). Digital health technology significantly promoted disease management among individuals and health care professionals. However, only a few studies addressed 2-way communication therapies, such as interactive SMS text messaging and feedback systems.

Conclusions

This scoping review classified studies on DHIs for patients with TB and demonstrated their potential for the self-management of TB. DHIs are still being developed, and evidence on the impact of digital technologies on enhancing TB treatment adherence remains limited. However, it is necessary to encourage patients' participation in TB treatment and self-management through bidirectional communication. We emphasize the importance of developing a communication system.

Research on Predatory Publishing in Health Care: A Scoping Review

BACKGROUND

Predatory publishers and their associated journals have been identified as a threat to the integrity of the scientific literature. Research on the phenomenon of predatory publishing in health care remains unquantified.

PURPOSE

To identify the characteristics of empirical studies on predatory publishing in the health care literature.

METHODS

A scoping review was done using PubMed/MEDLINE, CINAHL, and Scopus databases. A total of 4967 articles were initially screened; 77 articles reporting empirical findings were ultimately reviewed.

RESULTS

The 77 articles were predominantly bibliometric analyses/document analyses (n = 56). The majority were in medicine (n = 31, 40%) or were multidisciplinary (n = 26, 34%); 11 studies were in nursing. Most studies reported that articles published in predatory journals were of lower quality than those published in more reputable journals. In nursing, the research confirmed that articles in predatory journals were being cited in legitimate nursing journals, thereby spreading information that may not be credible through the literature.

CONCLUSION

The purposes of the evaluated studies were similar: to understand the characteristics and extent of the problem of predatory publishing. Although literature about predatory publishing is abundant, empirical studies in health care are limited. The findings suggest that individual vigilance alone will not be enough to address this problem in the scholarly literature. Institutional policy and technical protections are also necessary to mitigate erosion of the scientific literature in health care.

[18F]-FDG PET in anal canal cancer: a systematic review and meta-analysis

PURPOSE

To provide comprehensive data on the diagnostic and prognostic value of [18F]-FDG PET (PET) in anal canal cancer patients.

METHODS

This study was designed following the PRISMA-DTA guidelines. For the meta-analysis, published original articles (until December 2022) that met the following criteria were included: Evaluated PET for locoregional and/or distant disease detection in patients with histopathology-proven anal canal cancer; Compared PET with a valid reference standard; Provided crude data to calculate meta-analytic estimates. Diagnostic measurements from subgroups were calculated in evaluating primary tumour detection, T stage, lymph node and distant metastases. Articles providing prognostic information on PET were also reported as a systematic review. For pooled meta-analytic calculations, the hierarchical method was used. The bivariate model was conducted to find the summary estimates. Analyses were performed using STATA 16.

RESULTS

After the screening, 28 studies were eligible to enter the meta-analytic calculations, and data from 15 were reported descriptively. For distinguishing T3/T4 from other T-stages, PET had pooled sensitivity and specificity of 91%(95%CI:72%-97%) and 96%(95%CI:88%-98%), respectively. The sensitivity and specificity for detecting metastatic (regional and/or distant) disease were 100% (95%CI:82%-100%) and 95% (95%CI:90%-98%), respectively. For therapy response assessment, the sensitivity and specificity of PET were 96%(95%CI:78%-99%) and 86%(95%CI:75%-93%), respectively. Higher pre-treatment total metabolic tumour volume was predictive of poorer survival. Conversely, for those achieving complete metabolic response, the 2-year PFS was 94%(95%CI:91%-97%) versus 51%(95%CI:42%-59%) for others (p-value < 0.001).

CONCLUSION

PET may be a useful tool for anal canal cancer therapy planning and provides valuable prognostic information.

Comparing the Efficacy and Safety of Adalimumab and Vedolizumab in Treating Moderate to Severe Crohn's Disease and Ulcerative Colitis

Background

Numerous patients with inflammatory bowel disease (IBD) do not respond to conventional or biological therapy. Adalimumab (ADA) and vedolizumab (VDZ), according to certain research, may be a useful alternative treatment for these people. The purpose of this study was to assess the effectiveness and safety of using ADA and VDZ to treat moderate to severe IBD: Crohn's disease (CD) and ulcerative colitis (UC).

Methods

We searched PubMed, Medline, Web of Science, Scopus, the Cochrane Library, Embase, Google Scholar, CINAHL, Clinicaltrials.gov, and WHO trials registry (ICTRP). Randomized controlled trials (RCTs) comparing ADA or VDZ with placebo in participants with active CD or UC were included. The primary outcomes were the clinical response and remission at induction and maintenance phases and mucosal healing. The secondary outcome was the incidence of profound negative events. The research used Comprehensive Meta-Analysis version 3 (Biostat Inc., USA).

Results

Eighteen RCTs were incorporated, in which 11 studies described the usefulness and safeness of ADA or VDZ in CD patients, and seven studies investigated the efficacy and safety of ADA or VDZ in UC patients. The meta-analysis revealed that both ADA and VDZ treatments were superior to placebo for producing clinical remission and eliciting clinical response at induction and maintenance phases in individuals with moderately to severely active CD or UC. Interestingly, we found that ADA was superior to VDZ as first-line treatment for patients with CD, but not UC.

Conclusion

ADA and VDZ are effective and safe in CD and UC patients. However, RCTs of a larger number of patients are still required for better assessing the safety profile of ADA and VDZ.

Completeness of reporting in systematic reviews and meta-analyses in vascular surgery

OBJECTIVE

Systematic reviews (SRs) and meta-analyses are essential in informing clinical guidelines and decision-making. Complete reporting of SRs through compliance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines promotes transparency, reproducibility, and consistency across the literature. The purpose of this meta-epidemiological study is to assess the completeness of reporting of SRs in the vascular surgery literature.

METHODS

MEDLINE and Embase were used to search through four major vascular surgery journals and four high impact general medical journals for SRs published between 2018 and October 2022 evaluating clinical treatments for any pathology treated by a vascular surgeon. Data screening and extraction were conducted in duplicate. The reporting completeness of each included SR was measured with reference to the 27-item PRISMA checklist, and methodological quality was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) tool. Parametric tests were used to evaluate for associations between PRISMA score and study funding, protocol registration, publication in a higher impact factor journal, and AMSTAR 2 score. The protocol is available online: 10.17605/OSF.IO/VBC5N.

RESULTS

Of 1653 articles captured in the initial search, 162 SRs were included in the final analysis. All SRs had more than one incomplete PRISMA item. The mean PRISMA score was 21.2/27 (standard deviation: 2.9, 78.5% compliance), and the mean AMSTAR 2 score was 11.7/16 (standard deviation: 1.9, 73%). SRs that had a prospectively registered protocol had a higher PRISMA score (22.9 vs 20.6, P < .001) as did those that were published in higher impact factor journals (23.3 vs 21.0, P = .017). There was a large positive correlation between an SR's PRISMA and AMSTAR 2 scores (Pearson r = 0.655, 95% confidence interval: 0.55-0.74). There were no associations between the PRISMA score and publication year (P = .067) or funding status (P = .076).

CONCLUSIONS

Overall, the reporting of SRs and meta-analyses in vascular surgery is less than ideal, with several key items being consistently under-reported. Prospective registration and methodological quality as measured by AMSTAR 2 scores are positively associated with improved reporting. Authors, reviewers, and journal editors should consider these findings moving forward to encourage completeness of SR reporting. Raising awareness surrounding the value of complete reporting of SRs can aid in enhancing the quality of evidence, and journals should consider these findings in methods used to promote SR reporting.

Intraindividual variability in sleep among athletes: A systematic review of definitions, operationalizations, and key correlates

Via systematic review with narrative synthesis of findings, we aimed to document the ways by which researchers have defined, operationalized, and examined sleep variability among athletes. We identified studies in which scholars examined intraperson variability in sleep among athletes via a search of six databases (Web of Science, Embase, Medline, PsycINFO, CINHAL Plus, and ProQuest Dissertations and Theses Global) using a protocol that included keywords for the target outcome (sleep*), population (athlet* OR sport*), and outcome operationalization (variability OR variation OR "standard deviation" OR fluctuate OR fluctuation OR stability OR instability OR reactivity OR IIV OR intraindividual). We complemented this primary search with citation searching of eligible articles. Assessments of study quality captured eight core elements, namely aims/hypotheses, sample size justification, sample representativeness, number of days sleep assessed, measures of sleep and its correlates, missing data, and inferences and conclusions. From a total of 1209 potentially relevant papers, we identified 16 studies as meeting our eligibility criteria. Concept definitions of variability were notably absent from this work and where available were vague. Quantitative deviations from one's typical level of target sleep metrics reflected the essence by which all but one of the research teams operationalized sleep variability. We assessed the overall quality of empirical work as moderate in nature. We propose a working definition of sleep variability that can inform knowledge generation on the temporal, day-to-day dynamics of sleep functioning that is required for personalized interventions for optimizing sleep health.

The Prevalence of Prison-based Physical and Sexual Victimization in Males and Females: A Systematic Review and Meta-Analysis

This systematic review investigated the prevalence of prison-based interpersonal harm by type of victimization (physical and sexual) and sex, along with the heterogeneity among studies using meta-regression. Using Preferred Reporting Items for Systematic Reviews and the Meta-Analysis guidelines, 24 articles met the selection criteria. Study quality was assessed using the Joana Briggs Institute (20.8% deemed low quality, 33.3% moderate, and 45.9% high). Searches were conducted in Criminal Justice Abstracts, PsycINFO, PubMed, and Web of Science. The 24 articles comprised 36 separate samples inclusive of 23,967 incarcerated individuals. The random-effects pooled prevalence estimate of prison-based physical victimization was 18.8%, with slightly higher rates for females (20.3%) than males (18.1%). For sexual victimization, the pooled prevalence estimate was 12.4%, with higher rates among females (15.3%) than males (9.7%). For females, younger individuals reported higher rates of physical and sexual victimization and studies using smaller samples had higher rates of physical victimization. Rates of physical and sexual victimization for men were higher if perpetrators included residents and staff, the recall period was since admission, data was collected using self-administered surveys, and in low-quality studies (sexual victimization only). Rates of prison-based interpersonal harm, while high, varied significantly by type of victimization, sex, and study methodology. High heterogeneity will be reduced only if future studies adhere to best methodological practices in defining and collecting data on interpersonal harm and consistently test risk and prevention factors instrumental to prevention efforts. Study limitations include the exclusion of unpublished and non-English-language studies, small sample sizes for female studies, and methodological "noise" within the literature that reduce predictive precision.

The relevance of oral exposure in the workplace: a systematic review and meta-analysis

Introduction

The inclusion of all relevant exposure routes in the exposure assessment is essential for the protection of workers. However, under European chemical regulations but also for workplace risk assessments according to occupational safety and health (OSH) requirements, the quantitative assessment of oral exposure is usually neglected assuming good occupational hygiene. In contrast, several studies point to the importance of unintentional ingestion in the workplace. To our knowledge, there is no systematic analysis of the extent of this exposure route.

Methods

Therefore, the aim of this study was to assess systematically the current knowledge on the relevance of occupational oral exposure using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. Five electronic databases and nine institutional websites were searched for all publications on the relevance. The data were extracted into a concept matrix. In the subsequent meta-analysis, the identified conclusions on the relevance were analyzed. In addition, the measurement methods or modeling approaches that were described for occupational oral exposure were determined as well as the potentially relevant workplaces and substances.

Results

In total, 147 studies were included in this analysis that contain a general or several, differentiated assessments of the relevance of occupational oral exposure. Nine of these studies assessed this exposure route as irrelevant. However, 123 studies considered oral exposure as potentially contributing and 80 studies explicitly identified it as relevant. 78 and 94 of the publications described modeling and measurement approaches, respectively. The workplaces frequently identified as potentially or explicitly relevant were other indoor, other industrial or recycling workplaces. Analogously, metals, dust and powders or pesticides were the most frequently investigated substance groups.

Discussion

As several studies assessed occupational oral exposure as relevant in the context of different workplaces and substances, further investigation of this exposure route is needed. This systematic review and meta-analysis serve as a basis for further development of feasible assessment methods for this route of exposure.

Identifying Predictors of Nursing Home Admission by Using Electronic Health Records and Administrative Data: Scoping Review

Background

Among older adults, nursing home admissions (NHAs) are considered a significant adverse outcome and have been extensively studied. Although the volume and significance of electronic data sources are expanding, it is unclear what predictors of NHA have been systematically identified in the literature via electronic health records (EHRs) and administrative data.

Objective

This study synthesizes findings of recent literature on identifying predictors of NHA that are collected from administrative data or EHRs.

Methods

The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines were used for study selection. The PubMed and CINAHL databases were used to retrieve the studies. Articles published between January 1, 2012, and March 31, 2023, were included.

Results

A total of 34 papers were selected for final inclusion in this review. In addition to NHA, all-cause mortality, hospitalization, and rehospitalization were frequently used as outcome measures. The most frequently used models for predicting NHAs were Cox proportional hazards models (studies: n=12, 35%), logistic regression models (studies: n=9, 26%), and a combination of both (studies: n=6, 18%). Several predictors were used in the NHA prediction models, which were further categorized into sociodemographic, caregiver support, health status, health use, and social service use factors. Only 5 (15%) studies used a validated frailty measure in their NHA prediction models.

Conclusions

NHA prediction tools based on EHRs or administrative data may assist clinicians, patients, and policy makers in making informed decisions and allocating public health resources. More research is needed to assess the value of various predictors and data sources in predicting NHAs and validating NHA prediction models externally.

Acupuncture for in vitro fertilization-embryo transfer: an overview of systematic reviews

OBJECTIVES

To evaluate the report quality, methodological quality and evidence quality of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture for in vitro fertilization-embryo transfer (IVF-ET).

METHODS

The SRs/MAs of acupuncture for IVF-ET were searched electronically from databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, from inception of each database to September 27th, 2022. Two reviewers independently screened the literature and extracted the data. Using PRISMA statement, the AMSTAR 2 scale and the GRADE system, the report quality, methodological quality and evidence quality of the included SRs/MAs were assessed.

RESULTS

A total of 28 SRs/MAs were included, with PRISMA scores ranging from 8.5 points to 27 points. The problems of report quality focused on protocol and registration, retrieval, risk of bias in studies, additional analysis, limitations and funding. The methodological quality of included studies was generally low, reflecting on items 2, 3, 7, 10, 12 and 16. A total of 85 outcome indexes were included in the GRADE system for evidence grade evaluation. Most of the evidences were low or very low in quality. The reasons for the downgrade were related to study limitations, inconsistency, imprecision and publication bias.

CONCLUSIONS

Acupuncture therapy improves the outcomes of IVF-ET, but the methodological quality and evidence quality of related SRs/MAs are low. It is recommended to conduct more high-quality studies in the future to provide more reliable evidences.

Epidemiology and Reporting Characteristics of Systematic Reviews in Orthopedic Journals: A Meta-Epidemiological Study

Systematic reviews (SRs) with complete reporting or rigorous methods can lead to less biased recommendations and decisions. A comprehensive analysis of the epidemiological and reporting characteristics of SRs in orthopedics is lacking. We evaluated 360 SRs, including 165 and 195 published in orthopedic journals in 2012 and 2022. According to the established reporting guidelines, we examined these SRs for key epidemiological characteristics, including focus areas, type of meta-analysis (MA), and reporting characteristics. Most SRs (71%) were therapy-related, with a significant proportion originating from authors in the USA, UK, and China. Pairwise MA was performed on half of the SRs. The proportion of protocol registrations improved by 2022 but remained low (33%). Despite a formal declaration of adherence to the reporting guidelines (68%), they were often not used and reported enough. Only 10% of the studies used full search strategies, including trial registries. Publication bias assessments, subgroup analyses, and sensitivity analyses were not even planned. The risk of bias assessment improved in 2022; however, the certainty of the evidence remained largely unassessed (8%). The use and reporting of standard methods in orthopedic SRs have remained suboptimal. Thus, authors, peer reviewers, journal editors, and readers should criticize the results more.